A survey on the prevalence and utilization characteristics of gua sha in the Hong Kong community.

OBJECTIVE: To conduct a community-based survey to describe the demographics, experience, and utilization variables among the users of gua sha living in Hong Kong. METHOD: A total of 3209 adult respondents were surveyed by using a short Chinese questionnaire. RESULTS: Gua sha was found to have a one-year prevalence of 22.7% and four-week prevalence of 6.6%. The users were seen to be old of age and less educated. The majority believed that gua sha is beneficial to health, practiced in non-regular basis, and mainly employed for treating illnesses. For both male and female, the top two common illnesses to be treated were the respiratory and pain problems, which accounting for 74% of all users. Other illnesses included nervousness, heat stroke, fever, infection, dizziness, diarrhoea and vomiting, oedema, and constipation. As practiced by most respondents, unidirectional pressured stroking was applied repeatedly on the lubricated skin surface at the back region using various smooth-edged tools typically spoons. Almost all users reported the occurrence of skin blemishing and subsequently faded within 7 days after the gua sha treatment. CONCLUSION: The general population of Hong Kong was found to have high prevalence of gua sha usage. The utilization characteristics as reported by the users were generally aligned with the current scientific knowledge, in particular the treatment procedures and response.

Molecular cloning and mRNA distribution of pituitary adenylate cyclase-activating polypeptide (PACAP)/PACAP-related peptide in the lungfish.

In this article, we report the isolation of a full-length cDNA clone encoding pituitary adenylate cyclase-activating polypeptide (PACAP)/PACAP-related peptide (PRP) from lungfish Protopterus dolloi. When comparing the deduced amino acid sequences, the lungfish PACAP was found to be highly conserved with other vertebrates; however, the PRP shares only lower levels of sequence identity with known PRP sequences. Consistently in phylogenetic analysis, the lungfish PRP, similar to sturgeon PRP, fails to cluster with other PRPs. In addition to the full-length clone, another cDNA encoding a short precursor that lacks the first 32 amino acids of the PRP was also isolated. Interestingly, similar isoforms were also identified in several nonmammalian vertebrates, and it was suggested that exon skipping of PRP/PACAP transcripts was a mechanism that regulated the expression ratio of PACAP to PRP in nonmammalian vertebrates. By real-time PCR, both long and short PRP/PACAP transcripts were found almost exclusively in the brain, and the short isoform is the more abundant transcript (3.7 times more), indicating that PACAP is the major product produced in lungfish brain. The expression patterns of lungfish and previously studied frog PRP/PACAP suggest that the PRP/PACAP gene in the tetrapod lineage may first express in the central nervous system; in the process of evolution, the functions of these peptides diversified and were later found in other tissues.

The structural basis of DNA target discrimination by papillomavirus E2 proteins.

The papillomavirus E2 proteins regulate the transcription of all papillomavirus genes and are necessary for viral DNA replication. Disruption of the E2 gene is commonly associated with malignancy in cervical carcinoma, indicating that E2 has a role in regulating tumor progression. Although the E2 proteins from all characterized papillomaviruses bind specifically to the same 12-base pair DNA sequence, the cancer-associated human papillomavirus E2 proteins display a unique ability to detect DNA flexibility and intrinsic curvature. To understand the structural basis for this phenomenon, we have determined the crystal structures of the human papillomavirus-18 E2 DNA-binding domain and its complexes with high and low affinity binding sites. The E2 protein is a dimeric beta-barrel and the E2-DNA interaction is accompanied by a large deformation of the DNA as it conforms to the E2 surface. DNA conformation and E2-DNA contacts are similar in both high and low affinity complexes. The differences in affinity correlate with the flexibility of the DNA sequence. Preferences of E2 proteins from different papillomavirus strains for flexible or prevent DNA targets correlate with the distribution of positive charge on their DNA interaction surfaces, suggesting a role for electrostatic forces in the recognition of DNA deformability.

Improving the diagnostic accuracy of MR in the detection of infraspinatus tendon injuries.

PURPOSE: Our goal was to determine the accuracy of MRI in the diagnosis of infraspinatus tendon injury and more specifically to determine if the antero-posterior extent of a rotator cuff tear is predictive of infraspinatus tearing. METHOD: The MR images of 41 shoulders with surgically proven supraspinatus tears at surgery were retrospectively reviewed. The following were assessed for each of the 41 studies: the number of oblique coronal images on which a tendon defect could be seen, the angle subtended by the tear on axial images (the rotator cuff "axial angle"), and the extent of signal abnormality on sagittal images. RESULTS: The rotator cuff axial angle was 75.6 degrees in patients with infraspinatus tendon tears (ITTs) versus 40 degrees in those without ITTs, and this difference was significant (p < 0.001, t = 3.06). The mean number of oblique coronal images (obtained with a 4 mm slice and 1 mm gap) showing signal abnormality was 5.4 in the ITT group versus 2.9 in those without ITTs, and this difference was also significant (p < 0.001, t = 4.45). The mean sagittal extent of the tendon abnormality was 24.6 mm in the ITT group and 11.6 mm in those without ITTs, but the difference was not significant (p > 0.05, t = 1.1364). CONCLUSION: The axial angle and the number of oblique coronal images in which signal abnormality was present were significantly related to a higher incidence of infraspinatus tears.

Patterns of contrast enhancement in the pediatric spine at MR imaging with single- and triple-dose gadolinium.

PURPOSE: To assess patterns of nerve root and spinal cord contrast enhancement in the pediatric spine at magnetic resonance (MR) imaging with single- and triple-dose gadolinium. MATERIALS AND METHODS: In three control patients with no suspected pathologic spinal condition and 19 patients with a suspected condition, spinal cords were evaluated prospectively for potential spread of tumor to cerebrospinal fluid ("drop metastases") (n = 18) or Guillain-Barré syndrome (n = 1). After enhancement with 0.1 mmol/kg gadolinium, patients without definite drop metastases (n = 8) received a booster of 0.2 mmol/kg gadolinium 30-40 minutes later; clinical follow-up was obtained 12 1/2 to 19 months later. RESULTS: Drop metastases appeared as nodular areas of enhancement in 11 patients. Vascular enhancement related to the spinal cord surface and emerging nerve roots was observed in images obtained in all control patients, as well as in patients with negative findings at lumbar puncture and at clinical or MR imaging follow-up examination (n = 6). Vascular and nerve root enhancement increased with triple-dose gadolinium and was greater in patients after radiation therapy (n = 17) than in control patients (n = 3). CONCLUSION: Use of triple-dose gadolinium did not result in detection of additional cases of drop metastases.

Conspicuity of tumors of the head and neck on fat-suppressed MR images: T2-weighted fast-spin-echo versus contrast-enhanced T1-weighted conventional spin-echo sequences.

OBJECTIVE: The purpose of this study was to compare the conspicuity of tumors of the head and neck on MR images acquired with T2-weighted fat-suppressed fast-spin-echo and contrast-enhanced T1-weighted fat-suppressed conventional spin-echo sequences. MATERIALS AND METHODS: The MR images of 29 patients with 36 pathologically proved tumors of the head and neck were retrospectively analyzed. The conspicuity of these tumors was assessed on the T2-weighted sequence (4700/108 [TR/TE]) and on the contrast-enhanced T1-weighted sequence (500/16) with a 1.5-T system. Qualitative tumor-to-background contrast was graded separately against background muscle, fat, and mucosa (0 = not visualized, 1 = poorly visualized, 2 = fairly well visualized, 3 = well visualized), and the best overall sequence was noted for each tumor. Quantitative tumor-to-background ratios were measured for 10 of the tumors by using the same background markers. RESULTS: The mean overall qualitative tumor-to-background contrast grades for the T2-weighted sequence were tumor/muscle = 2.84, tumor/fat = 2.20, and tumor/mucosa = 1.23, and for the contrast-enhanced T1-weighted sequence, they were tumor/muscle = 2.02, tumor/fat = 1.58, and tumor/mucosa = 0.73. Overall, 86% of the tumors were better or equally well visualized on the T2-weighted images. The mean overall quantitative tumor-to-background ratios for the T2-weighted sequence were tumor/muscle = 7.93, tumor/fat = 3.34, and tumor/mucosa = 0.68, and for the contrast-enhanced T1-weighted sequence, they were tumor/muscle = 2.43, tumor/fat = 2.28, and tumor/mucosa = 0.85. CONCLUSION: The T2-weighted fat-suppressed fast-spin-echo sequence offers better contrast between tumors and adjacent muscle, fat, and mucosa than does the contrast-enhanced T1-weighted fat-suppressed spin-echo sequence and thus improves overall tumor conspicuity. In addition, the T2-weighted sequence does not require IV contrast material and can be performed more rapidly than can the contrast-enhanced T1-weighted sequence. The contrast-enhanced T1-weighted sequence may offer complementary information on the precise characterization of complex tumors and on the potential determination of tumor extent.

Noradrenaline hyperalgesia is mediated through interaction with sympathetic postganglionic neurone terminals rather than activation of primary afferent nociceptors.

In hyperalgesic states, observed commonly as a major symptom of tissue inflammation or after central or peripheral nerve injury, non-noxious stimuli produce pain and noxious stimuli are perceived as more painful than usual. The mechanisms underlying the generation of hyperalgesia are not known. In patients with causalgia (burning pain and severe hyperalgesia after a nerve injury) activation of sympathetic post-ganglionic neurones or application of noradrenaline to painful skin exacerbates pain and hyperalgesia while sympathectomy may afford complete relief. One suggestion is that noradrenaline released from sympathetic post-ganglionic neurons increases the discharge of damaged small-diameter afferents by a direct action on the primary afferents. Here we present a new model for noradrenaline-sensitive hyperalgesia and demonstrate that the site of action of noradrenaline is not on the primary afferents but rather is presynaptic on the sympathetic post-ganglionic terminals.