Potential effects of age on screening for primary aldosteronism.

Aldosterone/renin ratio (ARR) is currently regarded as the most reliable and available screening test for primary aldosteronism (PA), however, the falling accuracy of ARR with increasing age has posed crucial challenge for PA screening among older-aged population. To clarify potential effects of age on screening for PA, 216 subjects with PA and 657 subjects with non-PA were recruited and subdivided into four age groups (⩽39, 40-49, 50-59 and ⩾60 years) and their biochemical parameters were compared. As expected, plasma renin activity (PRA) lowered more than plasma aldosterone concentration (PAC) and led to gradually elevated ARR with increasing age in the non-PA group (P<0.001), whereas this phenomenon was unconspicuous in the PA group. The best cut-off values of ARR for PA screening were elevated in subjects ⩾50 years, whereas the area under the receiver operating characteristic curves (AUCs), sensitivity, specificity and Youden's index (YI) of ARR were declined with increasing age, especially in patients ⩾60 years (AUC=0.863, sensitivity=95.2%, specificity=69.0%, YI=0.643). The AUCs of PAC increased with increasing age and even slightly surpassed that of ARR in patients ⩾60 years (AUCPAC=0.884). Our data suggest that the criteria of ARR for PA screening in patients ⩾50 years may need setting higher; the falling accuracy of ARR with increasing age, especially in patients ⩾60 years, could be improved by taking into account the absolute value of the PAC when applicable by the center.

Relationship between polymorphism of SOCS-3 and dyslipidemia in China Xinjiang Uygur.

We investigated the relationship between the polymorphism of SOCS-3 and dyslipidemia of people from Uygur in Xinjiang, China. This cross-sectional study included 1379 participants in a Hetian Xinjiang Uygur population who were 30-70 years of age and were not from interracial marriages of 3 generations; all subjects were genotyped (909 dyslipidemia subjects, 470 healthy subjects). Allele (P = 0.002) and genotype (P = 0.003) frequencies of the distribution of rs12953258 was significantly different between dyslipidemia and control groups. Between the total cholesterol abnormal and control groups, high-density lipoprotein cholesterol abnormal and control groups, triglycerides abnormal and control groups, the frequencies of genotype in rs12953258 were significantly different (P = 0.007, 0.012, 0.0004, respectively). Based on the logistic regression analysis, genotype CA and AA of rs12953258 were independent and risk factors for dyslipidemia in Uygur (CC vs CA; odds ratio = 1.48, 95% confidence interval = 1.11-1.98, P = 0.008), (CC vs AA; odds ratio = 2.48, 95% confidence interval1.07-5.79, P = 0.035). Genotype AA of rs12953258 merged with subjects whose waist-to-hip ratio was abnormal, indicating the presence of dyslipidemia. The frequency of haplotype 4(H4) A-G-C in the dyslipidemia group was higher than in the control group (8.44 vs 5.37%, P = 0.003). rs12953258 site of the SOCS-3 gene showed a close relationship with dyslipidemia in Uygur. Combining genotype AA with subjects whose waist-to-hip ratios were abnormal will increase prevalence of dyslipidemia obviously.

Epidermoid carcinoma of the anal margin: 17 cases treated with curative-intent radiation therapy.

Between 1973 and 1991, 17 patients with epidermoid carcinoma of the anal margin without evidence of distant metastasis were treated with curative-intent radiation therapy (RT). There were nine T1-tumors, six T2-, one T3- and one T4-tumor; two patients presented with inguinal node involvement: one N1 and one N3. Nine patients underwent prior incomplete local excision (six with microscopic involvement of surgical margins and two with macroscopic residual disease). The radiation dose to the tumor was 60-70 Gy; the radiation dose to the inguinal lymph nodes was 40-45 Gy in N0, and 50-60 Gy for involved inguinal nodes. The 5- and 10-year cancer-specific survival rates were 86.2% and 77.5%, respectively. The same probabilities were 100% and 100% for T1-tumors, 60% and 40% for T2-tumors. Severe complications occurred in two patients, one anal radionecrosis requiring a colostomy and one permanent anal incontinence after local excision, which was non-related to irradiation. For the cured patients, the sphincter preservation rate after 5 years was 82% (9/11). In univariate analysis and in Cox multivariate analysis, the cancer-specific survival rate was influenced by one factor: the tumor size.

Design of an efficient position sensitive gamma ray detector for nuclear medicine.

The shortcomings of conventional scintillation cameras are analysed theoretically with a view towards improving performance at gamma ray energies above 140 keV. A camera design is proposed which incorporates several new features to obtain good spatial resolution from thicker crystals of sodium iodide. Computer simulations show that in addition to having good efficiency and spatial resolution, the new design allows parallax error correction and (possibly) Compton scattering correction at gamma energies up to 511 keV.