Management of erectile dysfunction in hypertension:Tips and tricks

Arterial hypertension is a major risk factor for cardiovascular disease and affects approximately one third of the adult population worldwide. The vascular origin of erectile dysfunction is now widely accepted in the vast majority of cases. Erectile dysfunction is frequently encountered in patients with arterial hypertension and greatly affects their quality of life of hypertensive patients and their sexual partners. Therefore, the management of erectile dysfunction in hypertensive patients is of paramount importance. Unfortunately, erectile dysfunction remains under-reported, under-recognized, and under-treated in hypertensive patients, mainly due to the lack of familiarity with this clinical entity by treating physicians. This review aims to discuss the more frequent problems in the management of hypertensive patients with erectile dysfunction and propose ways to overcome these problems in everyday clinical practice.

Small hepatocellular carcinoma with ring calcification:A case report and literature review

Ring calcification in untreated hepatocellular carcinoma(HCC) is extremely rare,with only 3 previously reported cases in the English-language literature.A case of HCC with ring calcification was reported in this paper.Additionally,3 previously reported cases of HCC with ring calcification were reviewed.In 3 of these 4 cases(including our case),surgery was performed.Although the size of the ring-calcified lesion ranged from 3.0-3.7 cm in previously reported cases,the size was only 1 cm in ours.The differentiation of the tumor was moderate in the 2 previously reported cases in the histological findings and poor in ours.In spite of their poor differentiation for their sizes,these tumors showed no early enhancement in dynamic computed tomography.All calcified tumors showed a thick fibrous capsule and extensive necrosis histologically.Ring calcification was considered to result from a circulatory disturbance caused by the imbalance between the less abundant arterial blood flow and high inner pressure induced by either the thick fibrous capsule or vigorous proliferation due to the poor differentiation.Ring calcification in untreated HCC may suggest a lower differentiation of the tumor.Even if its size is small,hepatic resection should be performed for any tumor with ring calcification because poor differentiation is considered to be one of the risk factors for recurrence after local ablation therapy,including radio frequency ablation.

Drug-eluting beads transarterial chemoembolization sequentially combined with radiofrequency ablation in the treatment of untreated and recurrent hepatocellular carcinoma

BACKGROUND Drug-eluting beads transarterial chemoem-bolization(DEB-TACE)has the advantages of slow and steady release,high local concentration,and low incidence of adverse drug reactions compared to the traditional TACE.DEBTACE combined with sequentially ultrasound-guided radiofrequency ablation(RFA)therapy has strong anti-cancer effects and little side effects,but there are fewer related long-term studies until now.AIM To explore the outcome of DEB-TACE sequentially combined with RFA for patients with primary hepatocellular carcinoma(HCC).METHODS Seventy-six patients with primary HCC who underwent DEB-TACE sequentially combined with RFA were recruited.Forty patients with untreated HCC were included in Group A,and 36 patients with recurrent HCC were included in Group B.In addition,40 patients with untreated HCC who were treated with hepatectomy were included in Group C.The serological examination,preoperative magnetic resonance imaging examination,and post-treatment computed tomography enhanced examination were performed for all patients.The efficacy was graded as complete remission(CR),partial remission(PR),stable disease and progressive disease at the 3rd,6th,and 9th.All patients were followed up for 3 years and their overall survival(OS),disease-free survival(DFS)were assessed.RESULTS The efficacy of Group A and Group C was similar(P>0.05),but the alanine aminotransferase,aspartate aminotransferase and total bilirubin of Group A were lower than those of Group C(all P<0.05).The proportions of CR(32.5%),PR(37.5%)were slightly higher than Group A(CR:27.5%,PR:35%),but the difference was not statistically significant(χ2=0.701,P=0.873).No operationalrelated deaths occurred in Group A and Group C.The OS(97.5%,84.7%,and 66.1%)and the DFS(75.0%,51.7%,and 35.4%)of Group A at the 1st,2nd,and 3rd year after treatment were similar with those of Group C(OS:90.0%,79.7%,and 63.8%;DFS:80.0%,59.7%,and 48.6%;P>0.05).The OS rates in Group A and Group B(90%,82.3%,and 66.4%)were similar(P>0.05).The DFS rates in Group B(50%,31.6%,and 17.2%)were lower than that of Group A(P=0.013).CONCLUSION The efficacy of DEA-TACE combined with RFA for untreated HCC is similar with hepatectomy.Patients with recurrent HCC could get a longer survival time through the combined treatment.

Biological performance,water absorption,and swelling of wood treated with nano-particles combined with the application of Paraloid B72~

We evaluated fungal decay and mold resistance,leaching, and water absorption of nano-compounds and Paraloid B72-（PB72） in treated wood specimens to develop new methods of consolidation by combining nanoparticles and consolidants. Scots pine wood specimens were treated with dispersions of nano-Cu O, nano-Zn O,nano-B2O3, nano-Ti O2, and nano-Ce O2. PB72 treatments of nano-particle-treated wood specimens were then carried out by either vacuum or immersion for 24 h. Previously,decayed wood specimens were also consolidated with the nano-compounds and PB72. PB72 treatments reduced element release from treated wood specimens. Nearly all nano-compounds ？ PB72 treatments increased the biological performance of treated wood specimens against decay fungi tested. PB72-only treated wood specimens had the highest weight losses in decay tests. No improvements were obtained in mold resistance tests when the nanocompounds and PB72 were combined. In nano-compoundonly treatments, unleached specimens showed slightly lower water absorption values compared to untreated control specimens. Incorporation of PB72 into nano-compound-treated wood specimens resulted in considerably lower water absorption and volumetric swell. In previously decayed specimens treated with the nano-compounds and PB72 solution, water absorption after 2-h immersion declined compared to control specimens.

Impact of Untreated Sedimentation Tank Sludge Water Recycle on Water Quality During Treatment of Low Turbidity Water

The overall purpose of this research is to examine the impact of untreated sedimentation tank sludge water( USTSW) recycle on water quality during treatment of low turbidity water in coagulation—sedimentation processes. 950 m L of raw water and different concentrations of 50 m L USTSW are injected into six 1 000 m L beakers without coagulant.The results indicate that USTSW characterized as accumulated suspended solids and organic matter has active ingredients,which possess the equivalent function of coagulant. The optimal blended water turbidity is in the range of 10-20 NTU,within which USTSW recycle achieves the highest save coagulant rate. The mechanism of strengthening coagulation effect when USTSW recycle mainly depends on the chemical effect and physical effect. What is more,through scanning electron microscopy( SEM),it is found that the floc structures with USTSW recycle are more compact than those without USTSW recycle. Besides,the water quality parameters of color,NH3-N,CODMn,UV254,total aluminum,total manganese when USTSW recycle is better than the raw water without recycle,indicating that USTSW recycle can improve water quality with strengthening coagulation effect.

Effects of densification on untreated and nano-aluminum-oxide impregnated poplar wood

Effects of densification of poplar wood（Populus nigra） impregnated with nano-aluminum oxide（NA） and pre-treated with water vapor for 4 and 6 h were investigated in the present study. Physical and mechanical properties of treated poplar wood were measured according to the ASTM D-143 standard specifications, and then compared with the untreated specimens. Results showed significant improvement in all properties as a result of densification. A 4-h vapor pre-treatment improved effects on both physical and mechanical properties. When the duration of vapor-treatment increased to 6 h, wood polymers degraded to the extent that the improvements due to the vapor pre-treatment decreased substantially, though the final results were still significant improvements compared with the control specimens. High thermal conductivity coefficient of NA slightly but not significantly improved properties. Due to the high spring-back after 15 days,densified poplar is not recommended for applications in which densified wood will be exposed for long periods to high humidity or to direct water.

Partial Purification and Characterization of Cellulase Produced by <i>Bacillus sphaericus</i>CE-3

Cellulase is an enzyme produced by fungi, bacteria, protozoa and termite, that hydrolyze cellulose. They are known for their diverse applications in industry and medicine. The aim of this study is to purify and investigate cellulolytic properties of cellulase enzyme produced by Bacillus sphaericus CE-3 isolated from refuse dump in Nnamdi Azikiwe University, Awka, Nigeria. Enzyme was produced by submerged fermentation at 30°C for 30 h. The enzyme was purified to homogeneity by dialysis in 4M sucrose solution, ion-exchange chromatography on Q-Sepharose FF and by hydrophobic interaction chromatography on Phenyl Sepharose CL-4B. The relative molecular mass of the enzyme was estimated using SDS-Polyacrylamide gel electrophoresis. Effects of temperature, pH and metals on enzyme activity and stability and the relative rate of hydrolysis of various substrates were also studied. The Purification fold for the enzyme was 7.8, with 66.4 μ/mg specific activity protein and overall yield of 35.8. The relative molecular mass range of the enzyme was estimated between 22.3 kDa - 26.3 kDa. The enzyme was optimally active at pH 9.0 and 40°C, stable at pH 9.0 and unusually retained over 90% activity between 50°C - 100°C after 30 min incubation. It was strongly activated by Mn2+ but inhibited by Ba2+, Co2+, Hg2+, Pb2+, Cu2+, Sr2+, Fe2+, Ca2+ and Zn2+. The cellulase displayed high catalytic activity with untreated sawdust, followed by carboxymethyl cellulose, while sodium hydroxide treated sawdust was the least hydrolyzed. Since the enzyme is thermo-stable, alkalophilic and could utilize natural wastes like sawdust as substrate, it is obvious that it would be of great use in textile, starch processing and pulp and paper industries.

Comment on anisometropia magnitude and visual deficits in previously untreated anisometropic amblyopia

Dear Editor,We read with great interest article titled'Anisometropia magnitude and visual deficits in previously untreated anisometropic amblyopia'by Chen et al[1].The authors have analysed subjects with previously untreated anisometropic amblyopia and found a significant correlation between high degree of anisometropia and deep amblyopia,worse contrast sensitivity,fusion and stereopsis functions.We commend the authors in addressing a very important problem and agree with the authors in the notation that children with anisometropia are usually detected later owing to lack of noticeable physical abnormalities.

Exploitation of genetic variation caused by space treatment in rice

Seeds of early indica rice varieties 6188,D6049,of late indica rice varieties Minghui63,Xiangge,Waiqi,70321,and late japonicarice variety Beik 15’ were carried by the re-trieved satellite"921006"in order to investi-gate the comprehensive effects of the spacefactors.Treated seeds and untreated seeds(CK)were grown in the field.The results showed that although com-pared with the CK(which was very uniform)

Acute aortic dissection:utilizing imaging modalities to improve detection

Acute aortic dissection is a serious condition in elderly patients and may become fatal rapidly if left undiagnosed and untreated. As pointed out by Welch et al1chest radiography is a screening test for this condition by detecting these signs such as widening mediastinum,blurring of the aortic knob, left apical cap, etc.

TUMOR PROMOTOR PMA INDUCES CHROMOSOMAL DAMAGE AND LEVELS OF SOD ACTION OF PATIENTS WITH ESOPHAGEAL CARCINOMA

In this report,the PMA-induced chromosomeaberration rates (CAR) of cultured peripheralblood cells of 10 untreated esophageal cancer and14 normal subjects were studied.At the same time,the levels of SOD of midium ultrafiltrates fromPMA-treated cultures after 1 ed 48 h were deter-minated.

ANTITRANSFORMING ACTIVITY OF CHLOROPHYLLIN AGAINST SELECTED CARCINOGENS AND COMPLEX MIXTURES

Chlorophyllin,the sodium and copper salt of chlo-rophyll,has been shown by several investigators tobe an antimutagenic agent.In a previous study wefound that it is a potent inhibitor of the mutagenicactivity of dietary and environmental complex mixtu-res.No information is available,however。

Antiglutamatergic agents for obsessive-compulsive disorder:Where are we now and what are possible future prospects?

Recent data suggest that obsessive-compulsive disorder(OCD)is driven by an imbalance among the habit learning system and the goal-directed system.The frontostriatal loop termed cortico-striatal-thalamo-cortical(CSTC)circuitry loop is involved in habits and their dysfunction plays an important role in OCD.Glutamatergic neurotransmission is the principal neurotransmitter implicated in the CSTC model of OCD.Hyperactivity in the CSTC loop implies a high level of glutamate in the cortical-striatal pathways as well as a dysregulation of GABA ergic transmission,and could represent the pathophysiology of OCD.Moreover,the dysregulation of glutamate levels can lead to neurotoxicity,acting as a neuronal excitotoxin.The hypothesis of a role of neurotoxicity in the pathophysiology of OCD clinically correlates to the importance of an early intervention for patients.Indeed,some studies have shown that a reduction of duration of untreated illness is related to an earlier onset of remission.Although robust data supporting a progression of such brain changes are not available so far,an early intervention could help interrupt damage from neurotoxicity.Moreover,agents targeting glutamate neurotransmission may represent promising therapeutical option in OCD patients.

Disparities in Oral Health among School-Aged Children in Kansas

Background: The effects of age, rural-urban geographic location, and percentage of Free and Reduced Price Meal Program (FRPMP) participation on children’s oral health outcome measures (untreated decay, treated decay, and sealants) have not been fully explored in Kansas. Methods: The current study utilized a surveillance sample of 140,217 children (grades K through 12) attending 200 schools in Kansas, which requested screening assistance from the Kansas Department of Health and Environment (KDHE) from 2012 to 2013. Multilevel logistic regression analysis was conducted to identify significant factors associated with oral health outcome measures. Results: Older children were associated with decreased odds of having untreated decay, and increased odds of having treated decay and sealants. Children attending very rural schools had increased odds of untreated and treated decay and decreased odds of presence of sealants. For every 5% increase in the school-level %FRPMP, the odds of having untreated and treated decay increased by 5% and 3%, respectively. However, %FRPMP was not statistically associated with the presence of sealants. Conclusions: Children attending schools in very rural and rural areas appear to have worse oral health outcomes, as measured by higher proportions of untreated and treated decay, and a smaller proportion of presence of sealants.

Antibiotic Resistant Bacteria from Treated and Untreated Hospital Wastewater at Ayder Referral Hospital, Mekelle, North Ethiopia

The widespread emergence of antibiotic resistance among bacterial pathogens has become one of the most serious challenges in Ethiopia. This study determined the prevalence and drug resistance patterns of bacterial pathogens isolated from treated and untreated wastewater released from Ayder Referral Hospital in Northern Ethiopia. A cross sectional study design was conducted from September-December, 2015 in wastewater released from Ayder referral hospital. A total of 40 composite samples were aseptically collected, transported and processed for enumeration of indicator organisms, bacteriological identification and susceptibility testing following standard procedure. Data obtained were entered and analyzed using SPSS version 20. Mean heterotrophic plate count, total coliform count, fecal coliform count and E. coli count were found to be 1.6 × 106 CFU/mL, 2.2 × 106 CFU/100 mL, 2.0 × 105 CFU/100 mL and 1.1 × 104 CFU/100 mL from treated wastewater respectively. Among the total samples 134 bacterial isolates were detected and [84 (62.7%)] were from untreated wastewater and [50 (37.3%)] were from treated wastewater. The most frequently isolated bacteria from untreated wastewater samples was Klebsiella spp [14 (16.7%)] followed by S. aureus [13 (15.5%)] and P. aeruginosa [12 (14.3%)], similarly in treated wastewater samples Klebsiella spp [10 (20%)], P. aeruginosa [8 (16%)] and S. aureus [8 (16%)] were frequently detected. The overall multi-drug resistance (MDR) in this study was [79/134 (79.1%)]. MDR from untreated wastewater sample was [64/84 (76.2%)] while from treated wastewater sample was [42/50 (84%)] and shows significant difference with (COR: 1.64, 95% CI: 1.15 - 3.29, P: 0.001). It is concluded that treated hospital wastewater contains large numbers of antibiotic resistant bacteria. Therefore, there should be continuous monitoring and evaluation of the effluent quality of the ponds and chlorination of the final effluent should be developed.

Management of Hypertension (HTN) in a Cardiology Department in Bamako (Mali): Financial Aspects

Background: Studies on financial aspects of High blood pressure management are rare and old without differentiating categories of expenses. On the other hand there is an evolution in health system with the introduction of a medical insurance. Objective: We performed this study to estimate costs related to insurance status. Methodology: The prospective study on patients aged 15 years and older extended from 01 May to 31 August 2016 and was carried out in the cardiology department of the University Hospital Gabriel Touré. Only newly detected or untreated hypertensive patients were included. Sociodemographic data, those on physical examination and financial management (transport, consultation, labor tests and purchase of drugs) were collected. Regarding costs, patients were directly asked about: how much did you spend for transport, consultation, labor tests and drugs? Data analysis was carried out by comparing patients with health insurance (Ins+) and those without it (Ins?). The recorded data were inserted in a MS Access database, preliminarily processed by MS Excel and imported to SPSS version 20 for analysis. Results: Mean total cost of care was 57,018 FCFA [50,139 - 63,897] (around 92 USD). It was 50,072 [42,182 - 57,963] for the Ins? group against 79,670 [66,777 - 92,563] for the Ins+ group with a p value 0.0001. Highest amounts for spending were for cardiovascular medication and labor tests with means of 19,255 FCFA (32 USD) and 18,813 FCFA (30 USD). Mean consultation fee was significantly higher for Ins+ patients: 4064 FCFA with IC (95%) [3210 - 4917] versus 3124 with IC (95%) [2774 - 3474] for Ins? patients and p = 0.018. For ECG, however, mean costs were higher for Ins? patients with 6460 [5944 - 6976] against 5115 [4871 - 5360] for Ins+ patients, p = 0.001. Conclusion: Health insurance has few subscribers compared to patients requiring medical care. It increases the global costs of care while facilitating access to care for those who benefit from it.

Parenting style and oral health status

Objective: This study examined the correlation between parenting style and oral health status. Methods: Eighty-seven children aged 2 - 14 years old were examined and their oral health status was measured by the decayed, missing, filled teeth (DMFT/dmft) index, untreated caries and caries experience. Caries experience was defined as untreated and treated teeth, either restored or filled. The parenting style of parents was measured by the Parenting Style Dimension Questionnaire (PSDQ). Demographic information recorded included race/ethnicity, level of education and child’s type of dental insurance. Results: The majority of the parents identified with the authoritative parenting style. There was no correlation between parenting styles and oral health status. Hispanic children and those whose parents had less education and low socioeconomic status (Medicaid) tended to show poorer oral health status. Conclusion: The expected relationship between parenting style and oral health status was not confirmed. Race/ethnicity, level of parents’ education and socioeconomic status may have a greater impact on oral health than parenting approaches.

Contamination of copper in leafy vegetables grown near Kalyan Railway Track, Maharashtra, India

Background:Majority of human population is suffering from vitamins and mineral deficiencies.Leafy vegetables are used to overcome this problem.Heavy metal contaminations of vegetables cannot be underestimated as these are important components for diet.In Mumbai almost all the farms are closer to railway tracks along the harbour,central and western railways;local farmers in the absence of proper irrigation facilities use water from the drains to grow their crops.This Untreated sewage water increases heavy metals in soil and crops along with pathogens.Utilization of sewage water containing heavy metals due to small scale industries in urban areas deserves special attention as it makes environment quite unsuitable for human and animal health and growth of plants.Copper is essential element while in excess it can cause many diseases.Methods:The present study is undertaken with an aim to study presence of heavy metal i.e.copper in the vegetables,water and soil alongwith physico-chemical parameters.Atomic absorption spectrophotometer was used to determine copper content in vegetable samples like Spinacia oleracea and Amaranthus caudatus.Results:The level of copper present in the vegetable was found to be higher than the permissible limits with water being the major cause of excessive copper contamination.The physicochemical parameters were found to be exceeding the drinking water and irrigation standards.Conclusion:The irrigation water is the major source of copper which increases the copper content higher than the permissible limits.But more sampling and research is essential to understand the ingress of heavy metals in the leafy vegetables.

Lymphatic system and lymphoma

970385 The changes of cell immune function in ap-tients with non-Hodgkin’s lymphoma by flow cytome-try analysis. LU Ming(吕鸣), et al. Clin ImmunolCenter, Changzheng Hosp, 2nd Milit Med Univ, Shang-hai, 200003. Shanghai Med J 1997; 20(2): 73-75.

9.6.Hypophyseal disorder and others

920064 Evaluation of anterior pituitaryfunction by combined administration ofhypothalamic releasing hormone in patientswith idiopathic growth hormone deficiency.DENGJieying (邓洁英),et al.Dept Endocrinol,PUMC Hosp,Beijing(100730).Chin J Endocrinoland Metabol 1991; 7 (3): 134-136.