Observation of early clinical efficacy of unilateral biportal endoscopy technique in the treatment of lumbar postoperative adjacent segmental diseases / 中国骨伤

OBJECTIVE@#To investigate early clinical efficacy of unilateral biportal endoscopy technique for the treatment of lumbar postoperative adjacent segmental diseases.@*METHODS@#Fourteen patients with lumbar postoperative adjacent segmental diseases were treated with unilateral biportal endoscopy technique from June 2019 to June 2020. Among them, there were 9 males and 5 females, aged from 52 to 73 years old, and the interval between primary and revision operations ranged from 19 to 64 months. Adjacent segmental degeneration occurred after lumbar fusion in 10 patients and after lumbar nonfusion fixation in 4 patients. All the patients received unilateral biportal endoscopy assisted posterior unilateral lamina decompression or unilateral approach to the contralateral decompression. The operation time, postoperative hospital stay and complications were observed. The visual analogue scale (VAS) of low back pain and leg pain, Oswestry Disability Index (ODI), modified Japanese Orthopaedic Association (mJOA) score were recorded before operation and at 3 days, 3 months, and 6 months after operation.@*RESULTS@#All procedures were successfully completed. Surgical duration ranged from 32 to 151 min. Postoperative CT showed adequate decompression and preservation of most joints. Out of bed walking 1 to 3 days after surgery, postoperative hospital stay was 1 to 8 days, and postoperative follow-up was 6 to 11 months. All 14 patients returned to normal life within 3 weeks after surgery, and VAS, ODI, and mJOA scores improved significantly at 3 days and 3, 6 months after surgery. One patient occurred cerebrospinal fluid leak after operation, received local compression suture, and the wound healed after conservative treatment. One patient occurred postoperative cauda equina neurologic deficit, which was gradually recovered about 1 month after rehabilitation therapy. One patients advented transient pain of lower limbs after surgery, and the symptoms were relieved after 7 days of treatment with hormones, dehydration drugs and symptomatic management.@*CONCLUSION@#Unilateral biportal endoscopy technique has a good early clinical efficacy in the treatment of lumbar postoperative adjacent segmental diseases, which may provide a new minimally invasive, non-fixation option for the treatment of adjacent segment disease.

Acupoints compatibility rules of acupuncture for depression disease based on data mining technology / 中国针灸

Based on data mining technology, the acupoints compatibility rules of acupuncture for depression diseases were explored. The randomized controlled trial (RCT) articles regarding acupuncture for depression diseases published from establishment of database to September 2nd, 2022 were searched in CNKI database, Wangfang database, VIP database, SinoMed database, PubMed, EMbase, Web of Science and Cochrane Library. The use frequency of acupoints, meridian tropism, selection of special acupoints and acupoint association rules for five common depression diseases, including primary depression, post-stroke depression, menopausal syndrome, psychoneurosis and anxiety disorder, were analyzed by Python programming language. Cytoscape software was used to analyze the acupoint association and the disease-acupoint co-occurrence network. As a result, totally 387 articles were included, and 319 acupoints prescriptions for the above five common depression diseases were extracted, involving 159 acupoints. The use frequency of acupoints was 2 574 times in total. The frequently-used acupoints were Baihui (GV 20), Sanyinjiao (SP 6), Taichong (LR 3), Neiguan (PC 6), Shenmen (HT 7), Yintang (GV 24+), Zusanli (ST 36), Hegu (LI 4), Sishencong (EX-HN 1) and Taixi (KI 3), etc. The frequently involved meridians were the governor vessel, foot-taiyang bladder meridian, foot-taiyin spleen meridian, and foot-jueyin liver meridian. The frequency of the special acupoints from high to low was crossing points, five-shu points, yuan-primary points, back-shu points, luo-connecting points, and eight confluent points, etc, which were often used in combination with "Baihui (GV 20)-Yintang (GV 24+)" (the highest degree of association). At the same time, the analysis of the co-occurrence network of depression diseases and acupoints showed that the core acupoints group of acupuncture for depression diseases were Baihui (GV 20), Taichong (LR 3), Shenmen (HT 7), Zusanli (ST 36), Neiguan (PC 6) and Sanyinjiao (SP 6). In conclusion, acupuncture treatment for depression diseases has gradually formed a rule of acupoint compatibility, with special acupoint as the main body and "unblocking the governor vessel, and regulating the spirit and qi " as the main therapeutic principle.

Effect of platelet-rich plasma treatment for partial rotator cuff injury and possible mechanism / 中华创伤杂志

Objective:To compare the clinical efficacy of platelet-rich plasma (PRP) injection and conventional treatment for partial rotator cuff tear and analyze the possible mechanism.Methods:A prospective randomize control study was performed for clinical data of 100 patients with partial rotator cuff tear admitted to Beijing Tongren Hospital affiliated to Capital Medical University between January 2019 and December 2020. The patients were assigned to observation group ( n=50) and control group ( n=50) according to the random number table. Both groups were given conventional non-operative treatment, together with PRP injection in observation group and steroid injection in control group. The visual analogue score (VAS), Constant-Murley Score (CMS) and serum levels of inflammatory cytokines [interleukin-6 (IL-6), IL-1β, tumor necrosis factor-α (TNF-α)] were measured before and at 3, 6 months after treatment. The MRI images were also evaluated in observation group before treatment and at 6 months after treatment. Results:There were 55 males and 45 females with the age range of 40-75 years [(55.9±9.1)years]. All patients were followed up for 6.0-8.2 months [(6.2±2.9)months]. There were no significant differences between the two groups in VAS, CMS, IL-6, IL-1β and TNF-α before treatment (all P>0.05). The VAS was (3.5±0.9)points and (1.4±0.4)points] in observation group at 3, 6 months after treatment, significant lower than (4.1±0.9)points and (1.8±0.5)points in control group (all P<0.01). The CMS was (59.5±9.4)points and (86.5±7.9)points in observation group at 3, 6 months after treatment, significant higher than (53.5±8.6)points and (78.5±8.4)points in control group (all P<0.01). The serum levels of IL-6, IL-1β and TNF-α were (0.69±0.21)μg/L, (2.06±0.55)μg/L and (2.12±0.49)μg/L in observation group at 3 months after treatment, significant lower than (0.92±0.26)μg/L, (2.67±0.48)μg/L and (2.87±0.51)μg/L in control group (all P<0.01). The serum levels of IL-6, IL-1β and TNF-α in observation group [(0.37±0.11)μg/L, (1.14±0.23)μg/L, (1.27±0.25)μg/L] were also significantly lower than those in control group [(0.45±0.09)μg/L, (1.36±0.27)μg/L, (1.88±0.26)μg/L] at 6 months after treatment (all P<0.01). In both groups, the VAS, CMS and inflammatory cytokines (IL-6, IL-1β, TNF-α) showed significant improvement at 3, 6 months after treatment when compared to the pre-treatment levels (all P<0.05). Simutaneously, each group showed significant differences in each indicator at 3, 6 months after treatment ( P<0.05). In observation group, MRI showed that the high signal on the superior surface of the supraspinatus disappeared whereas the high signal in the tendon decreased at 6 months after treatment. Conclusion:For patients with partial rotator cuff tear, PRP injection can relive shoulder pain and improve shoulder function, which may be associated with the down-regulation of inflammatory responses.

High-frequency skin ultrasonographic and dermoscopic features of seborrheic keratosis / 中华皮肤科杂志

Objective To describe high-frequency skin ultrasonographic and dermoscopic features of seborrheic keratosis (SK).Methods Between August and December in 2017,46 outpatients with SK were enrolled from the Department of Dermatology of Peking Union Medical College Hospital,and 50 SK lesions were observed by 50-and 20-MHz high-frequency skin ultrasonography and dermoscopy.The highfrequency ultrasonographic and dermoscopic features of SK lesions were summarized and analyzed.Statistical analysis was done by using chi-square test for comparisons of evaluation results of SK lesions between 50-and 20-MHz ultrasonography,and the correspondence between high-frequency skin ultrasonographic and dermoscopic features of SK was analyzed by calculating the simple matching coefficient.Results As 50-and 20-MHz ultrasonography showed,ultrasonographic features of SK lesions from top to bottom were enhanced hyperecho (48/50 vs.39/50,respectively,P =0.007),enhanced hyperechoic masses or spots in the stratum corneum (22/50 vs.11/50,respectively,P =0.019),sound shadows behind the epidermis (34/50 vs.13/50,respectively,P ＜ 0.001),skin lesions with regular shapes and clear borders (46/50 vs.41/50,respectively,P =0.137),heterogeneous hypoechoic areas in the lesions (50/50 vs.47/50,respectively,P =0.079) and internal hyperechoic spots (25/50 vs.2/50,respectively,P ＜0.001),the lesional bottom being at the same level (40/50 vs.36/50,respectively,P =0.349),and reduced dermal echogenicity below the lesion (50/50 vs.28/50,respectively,P ＜ 0.001).In regard to the overall evaluation of the above 8 ultrasonographic characteristics,50-MHz ultrasonography was superior to 20-MHz ultrasonography (P =0.002).The common dermoscopic features of the 50 SK lesions were clear borders (n =50),comedo-like openings (n =45),ridge or cerebriform pattern (n =31),hairpin-like vessels (n =30),multiple milia-like cysts (n =24),moth-eaten border (n =21) and shiny white streaks (n =3).Under 50-and 20-MHz ultrasonography,the simple matching coefficients between enhanced hyperechoic masses or spots in the stratum corneum and comedo-like openings under dermoscopy were 42％ (21) and 20％ (10) respectively,and the simple matching coefficients between internal hyperechoic spots and multiple milialike cysts (＞ 3) under dermoscopy were 58％ (29) and 48％ (24) respectively.Conclusion Highfrequency skin ultrasonography and dermoscopy both are of great value to the assessment of SK lesions,and 50-MHz ultrasonography is superior to 20-MHz ultrasonography for imaging skin lesions.

Dermoscopic features of vulvar lichen sclerosus / 中华皮肤科杂志

Objective To investigate the dermoscopic features of vulvar lichen sclerosus (VLS).Methods Seventeen patients with VLS,who visited the Department of Dermatology of Peking Union Medical College Hospital between August 2015 and June 2017 and underwent dermoscopy and skin histopathological examination,were enrolled into this study.The dermoscopic images of 75 skin lesions were collected and analyzed retrospectively.Results The common dermoscopic features in these VLS lesions included yellowish-white structureless areas (89.3％,67/75),reddish-violet globules or patches (77.3％,58/75),brownish or bluish-gray pigment structures (49％,37/75),shiny white streaks (40％,30/75),dotted vessels with irregular arrangement (28％,21/75),linear vessels (58.7％,44/75),hairpin-like vessels (6.7％,5/75),comma-like vessels (13％,10/75)and branching vessels (20％,15/75).Under dermoscopy,rosette sign could be observed in 3 (4％) lesions,comedo-like openings in 3 (4％) lesions,and keratotic plugs in 1 (1％) lesions.Conclusion Under dermoscopy,VLS is characterized by yellowishwhite structureless areas,reddish-violet globules or patches,pigment structures and vessels with various vessels.

Dermoscopic features of primary cutaneous amyloidosis / 中华皮肤科杂志

Objective To describe common dermoscopic features of primary cutaneous amyloidosis (PCA),and to explore the application value of dermoscopy in assisting the diagnosis of PCA.Methods Seventeen patients with PCA were collected from Department of Dermatology of Peking Union Medical College Hospital between April 2014 and December 2016.A total of 45 skin lesions were subjected to dermoscopy,and their dermoscopic features were analyzed.Results The common dermoscopic features of PCA included central hubs,which could be white,brown or scar-like areas,various pigment structures and shiny white streaks.Dermoscopy showed that central hubs could be observed in all the lesions (100％),while white center hubs alone were observed in 14 (31％) lichenoid lesions,both white center hubs and scar -like areas in 5 (11％) lichenoid lesions,brown center hubs alone in 8 (18％) macular lesions,both white and brown center hubs in 6 (13％) lichenoid lesions and 17 (38％) macular lesions.All the lesions showed various pigment structures.Shiny white streaks were observed in 4 (9％) lichenoid lesions.Conclusion Dermoscopy has good application value in assisting the diagnosis of PCA.

Isolation of a zoonotic pathogen Aeromonas hydrophila from freshwater stingray (Potamotrygon motoro) kept in a Korean aquarium with ricefish (Oryzias latipes)

In the present study, Aeromonas (A.) hydrophila was isolated from a captive-bred adult freshwater stingray (Potamotrygon motoro) reared at a commercial aquarium in Korea. The stingray had bites on its fins, hemorrhages on the ventral part, and congested internal organs. A bacterium was isolated from kidney and subsequently identified as A. hydrophila. Based on phylogenetic analysis results, the isolate in the present study (SNUAh-LA1) was most closely related to A. hydrophila AH10 (China) and A. hydrophila AKR1 (Korea). It is most likely that the pathogen infection resulted from Potamotrygon motoro cohabiting with ricefish (Oryzias latipes).

Impact of Renal Function Injury on the Diagnostic Value of NT-proBNP in Patients With Heart Failure / 中国循环杂志

Objective: To explore the impact of renal function injury on diagnostic value of NT-proBNP in patients with heart failure (HF). Methods: A total of 420 patients with cardiovascular disease at (50-75) years of age were divided into 2 groups based on left ventricular ejection fraction (LVEF): Control group, the patients with normal cardiac function, LVEF≥40%,n=232 and HF group, LVEFeGFR≥60 ml/min·1.73m2), Moderate renal injury (60>eGFR≥30 ml/min·1.73m2) and Severe renal injury (eGFR Results: Compared with Control group, HF group had increased blood level of NT-proBNP,P0.05, while it was much higher in Moderate and Severe renal injury subgroups than Normal renal function subgroup,P Conclusion: Moderate to severe renal function injury could increase circulating level of NT-proBNP and therefore, the cut-off value of NT-proBNP for HF diagnosis should be elevated accordingly in patients of HF combing renal injury.

Photochemistry and pharmacology of 9, 19-cyclolanostane glycosides isolated from genus Cimicifuga / 中国天然药物

The constituents of Cimicifuga plants have been extensively investigated, and the principal metabolites are 9, 19-cyclolanostane triterpenoid glycosides, which often exhibit extensive pharmacological activities. 9, 19-Cyclolanostane triterpenoid glycosides are distributed widely in genus Cimicifuga rather than in other members of the Ranunculaceae family. So far, more than 140 cycloartane triterpene glycosides have been isolated from Cimicifuga spp.. The aim of this review was to summarize all 9, 19-cyclolanostane triterpenoid glycosides based on the available relevant scientific literatures from 2000 to 2014. Biological studies of cycloartane triterpene glycosides from Cimicifuga spp. are also discussed.

Isolation and identification of Vibrio harveyi from chub mackerel (Scomber japonicus)

For several days, there was a series of mortalities of chub mackerel (Scomber japonicus) that were reared for public exhibition in a private aquarium in Seoul, Korea. As part of the diagnosis of the dead fish, a bacterial isolate from the kidney was cultured, identified, and confirmed to be Vibrio (V.) harveyi using Vitek System 2 and 16S rRNA gene sequencing. Phylogenetic analysis was also performed by the neighbor-joining method. As a result, the V. harveyi isolated from chub mackerels of a private aquarium in Korea, called as SNUVh-LW1, was clustered in the same group with V. harveyi ATCC33843.

Isolation and molecular identification of Vibrio harveyi from the look down fish (Selene vomer)

Gradual mortality of look down fish (Selene vomer) was observed in a private aquarium in Seoul, showing abnormal swimming behavior and lethargy. A bacterial pathogen from kidney was cultured, identified, and confirmed as Vibrio harveyi using Vitek System 2 and 16S rRNA gene sequencing. A predominant bacterial strain, SNUVh-LW2 was proved to be most closely related to isolates from China by phylogenetic analysis with minimum evolution method. Also, tetracycline was considered as the most sensitive antibiotic agent via antibiotic usceptibility test. The group of fish was treated according to the diagnostic result and no more mortality was observed.

Oral Lovastatin Attenuates Airway Inflammation and Mucus Secretion in Ovalbumin-Induced Murine Model of Asthma

PURPOSE: Lovastatin is an effective inhibitor of cholesterol synthesis. A previous study demonstrated that lovastatin can also suppress airway hyperresponsiveness (AHR) in murine model of asthma. We aimed to investigate the effect of lovastatin on mucus secretion and inflammation-associated gene expression in the lungs of murine model of asthma. METHODS: Female BALB/c mice were sensitized and challenged with ovalbumin (OVA) by intraperitoneal injection, and orally administered lovastatin from days 14 to 27 post-injection. Gene expression in lung tissues was analyzed using real-time polymerase chain reaction. AHR and goblet cell hyperplasia were also examined. BEAS-2B human bronchial epithelial cells were used to evaluate the effect of lovastatin on the expression of cell adhesion molecules, chemokines, and proinflammatory cytokines in vitro. RESULTS: We showed that lovastatin inhibits the expression of Th2-associated genes, including eotaxins and adhesion molecules, in the lungs of murine model of asthma. Mucin 5AC expression, eosinophil infiltration and goblet cell hyperplasia were significantly decreased in the lung tissue of murine model of asthma treated with lovastatin. Furthermore, lovastatin inhibited AHR and expression of Th2-associated cytokines in bronchoalveolar lavage fluid. However, a high dose (40 mg/kg) of lovastatin was required to decrease specific IgE to OVA levels in serum, and suppress the expression of Th2-associated cytokines in splenocytes. Activated BEAS-2B cells treated with lovastatin exhibited reduced IL-6, eotaxins (CCL11 and CCL24), and intercellular adhesion molecule-1 protein expression. Consistent with this, lovastatin also suppressed the ability of HL-60 cells to adhere to inflammatory BEAS-2B cells. CONCLUSIONS: These data suggest that lovastatin suppresses mucus secretion and airway inflammation by inhibiting the production of eotaxins and Th2 cytokines in murine model of asthma.

Experience of diagnosis and treatment for cervical tracheoesophageal fistula complicated with laryngotracheal stenosis / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To explore the treatment of cervical tracheoesophageal fistula (TEF) with complicated or remnant laryngotracheal stenosis (LTS) and anterior neck defect (AND).</p><p><b>METHODS</b>From 1980 to 2007, 14 patients were diagnosed as TEF. Among them, 9 patients had complicated or remnant LTS, 3 patients had complicated AND, and 2 patients had TEF which were induced by Nickel-Titanium alloy mesh stent for treating benign esophageal stricture. All these patients were retrospectively studied in Tangdu Hospital. Treatment consisted of conservative therapy of TEF, staged surgical repair of TEF and laryngotracheal reconstruction according to the dimension (small or large) of TEF and complications.</p><p><b>RESULTS</b>Four patients with small TEF (2 - 3 mm length) complicated LTS underwent laryngotracheal reconstruction stented with silicone T tube and TEF was adopted conservative treatment. The TEF and LTS were healed. Six patients with larger TEF (10 - 25 mm length) were repaired by staged surgical repair of TEF and laryngotracheal reconstruction. Among them, 3 cases had complicated LTS and AND, 2 cases had recent LTS and 1 case had TEF without complication. Two patients had TEF and LTS, whose TEF healed before laryngotracheal reconstruction, the remnant LTS were reconstructed and healed. During the follow-up ranged from one to ten years, 12 patients were successfully treated without complications. One patient with TEF and LTS was treated only LTS because of a segment of esophagus was closed and treated with esophagogastrostomy in the department of thoracic surgery after LTS was successfully reconstructed and cured. One patient died of bleeding and asphyxia induced by the Nickel-Titanium alloy stent because of the stent had not been taken out.</p><p><b>CONCLUSION</b>The small cervical TEF complicated or remnant LTS can be treated by laryngotracheal reconstruction and conservative treatment of TEF at the same time. A larger TEF complicated LTS should be treated by staged repair of TEF and LTS.</p>

Rhein improves insulin sensitivity of diabetic rats by increasing the protein expression levels of PPAR-? and GluT-4 in adipose tissue / 中国糖尿病杂志

Objective To investigate the mechanism for rhein to improve the insulin sensitivity in diabetes mellitus. Methods Male Wistar rats were randomly divided into normal control group (NC,n=15) and diabetic group (DM,n=40) induced by STZ and high-fat diet.Diabetic rats were randomly divided into diabetic control group (DM-C,n=15) and diabetic group treated with rhein (DM-T,n=15).Then DM-T group was given intragastric administration with rhein at the dose of 100 mg/ (kg-1?d-1) for 11 weeks.FBG,fasting serum insulin (FIns),triglyceride (TG),total cholesterol (TC),insulin sensitivity index (ISI) and other biochemical parameters in each group were measured.The protein expressions of PPAR-? and GluT-4 were determined by immunohistochemistry and Western blot. Results At the end of the 17th week,compared with NC group,DM-C group showed higher FBG and TG,lower ISI,lower protein expressions of PPAR-? and GluT-4 in the adipose tissue.Compared with DM-C group,DM-T group showed lower FBG [(15.73?3.08 vs 22.57?3.23) mmol/l,P

Rhein improves fasting blood glucose, insulin sensitivity of diabetic rats and increases expression levels of PPARγ, GLUT-2 in hepatic tissue / 中华内分泌代谢杂志

Objective To investigate the effects of rhein on insulin sensitivity of diabetic rats induced by high fat feeding and low dose streptozotocin (STZ), and the possible mechanisms. Methods (1) Fifty-five Wistar rats were randomly divided into normal control group (NC,n=15) and diabetes group (DM, n=40). The NC rats were fed with regular chow and DM rats were fed with high fat diet. Five weeks later, the DM rats were injected with STZ 30 mg/kg once. The 30 diabetic rats were randomly divided into two subgroups, diabetic control group (DM-C) and diabetic group treated with rhein (DM-T). DM-T rats received intragastric administration of rhein and DM-C rats were given equal doses of solvent. All rats were sacrificed eleven weeks later, the blood sample was collected. The body weight, fasting blood glucose (FBG), HbA1C, triglycerides (TG), tolal cholesterol (TC), glycosylated serum protein (GSP) and Fasting insulin (FINS) concentrations were examined.The insulin sensitive index (ISI) and homeostasis model assessment for insulin resistance (HOMA-IR) werecalculated. (2) The PPART and GLUT-2 expression in hepatic tissue were detected by immunohistoehemistry and Western-blot. Results At the end of experiment the FBG [(22.57±3.23 vs 7.11±1.44) mmol/L,P<0.01],HbA1C[(12.49±1.96 vs 8.36±0.84)%, P<0.01], TG [(0.89±0.29 vs 0.58±0.17)nunoL/L,P<0.01],GSP [(57.29±4.14 vs 13.43±2.70)μmoL/L, P<0.01] and tumor necrosis factor-α [TNF-α,(1.365±0.133 vs 1.233±0.159) μg/L, P<0.05] and the liver weight index (0.032±0.004 vs 0.024±0.002, P<0.01) in DM-C rats were higher than those in NC rats. Besides, the ISI of DM-C rats decreased [In(ISI),-5.46±0.61 vs -4.81±0.75, P<0.05] and HOMA-IR elevated [In(HOMA-IR),2.34±0.64 vs 1.70±0.78,P<0.05]. The expression of PPARγ [11 131.7(5 723.1-18 979.4) vs 48 782.1(21 576.7-108 829.5), P<0.01] and GLUT-2 (0.98±0.35 vs 1.29±0.27, P<0.05) of DM-C rats decreased markedly compared with NC rats. Compared with DM-C rats, FBG [(15.94±3.16) mmol/L], HbA1C[(10.51±1.74)%], GSP[(47-31±6.09) μmol/L] in DM-T and the In (HOMA-IR), (1.86±0.30) rats decreased (P<0.05 or P<0.01), and In (ISI), of DM-T rats increased (-4.97±0.29, P<0.05). The expressions of PPARγ [35 156.3(24 554.3-86 660.9)] and GLUT-2 (1.55±0.55) of DM-T rats were up-regulated markedly compared with DM-C rats (P<0.05 or P<0.01). Conclusion Rhein decreased FBG, HbA1C and GSP, and improved the insulin sensitivity in diabetic rats, which might be related to the up-regulated expressions of PPARγ and GLUT-2 in hepatic tissue.

A fourteen-year review of radical cystectomy for transitional cell carcinoma demonstrating the usefulness of the concept of lymph node density

OBJECTIVE: We studied the long-term outcome of radical cystectomy for transitional cell carcinoma and evaluated prognostic factors for disease specific survival. MATERIALS AND METHODS: A retrospective review was carried out for all cystectomies performed for transitional cell carcinoma between 1989 and 2002. Disease specific survival was correlated to patient, pathological and operative factors as well as to adjuvant therapy. RESULTS: Of the 133 cystectomies included, 100 were male and 33 were female patients. The median age was 69 years (range 43 to 86). The median follow up was 20 months (range 0 to 158). With univariate analysis, pT stage, N stage, lymph node density, carcinoma in-situ, surgical margin and post-operative radiotherapy to distant metastasis were predictive of disease specific survival. On the other hand, with multivariate analysis, only pT stage, lymph node density and post-operative radiotherapy to distant metastasis were predictive of disease specific survival. Within the group of node positive disease, lymph node density also predicted disease specific survival with both univariate and multivariate analyses. Patients with lymph node density 20 percent or below showed better disease specific survival. CONCLUSIONS: pT stage and lymph node density were found to be the most important predictive factors for disease specific survival after cystectomy in the Asian population.

Medical Consideration on Timing of Laparoscopic Sterilization in First Trimester Therapeutic Abortion Patients

At various intervals after first trimester therapeutic abortion, in a total of 1604 cases laparoscopic sterilization procedures were performed at Severance Hospital of Yonsei University Medical Center, Seoul, Korea, from May 1973 to October 1975. A total of 214 women were sterilized immediately after abortion, 359 were sterilized between one and 42 days after abortion and the remaining 1031 women were sterilized 43 or more days after abortion. Electrocoagulation and tubal ring were the two tubal-occlusion techniques used. The findings indicate that patients who underwent the combined abortion-sterilization procedures did not encounter higher rates of technical and/or complications than the other two groups. Only a few patients among the total study subjects had potentially serious complications which neceisstated subsequent laparotomy and hospitalization after sterilization.