Revised cutoff values of serum aminotransferase in detecting viral hepatitis among CAPD patients: experience from Taiwan, an endemic area for hepatitis B

BACKGROUND: To determine the best cutoff values of aspartate aminotransferase (AST) and alanine amino-transferase (ALT) in detecting viral hepatitis C infection among patients of continuous ambulatory peritoneal dialysis (CAPD). METHODS: 90 (44 male and 46 female) CAPD patients and 526 adult controls (266 male, 260 female) were enrolled. Serum AST and ALT were measured by an auto-analyser monthly. Serum HBsAg was examined using a RIA method and anti-HCV by an second-generation EIA method. The best cutoff values of AST and ALT for detecting viral hepatitis were obtained from the ROC (receiver-operating characteristic) curve. RESULTS: The prevalence of anti-HCV(+) was significantly higher in CAPD patients (16.7%) than in normal controls (4.9%), while that of HBsAg(+) was similar in both groups. CAPD patients had significantly lower levels of serum aminotransferases compared to normal controls. Mean AST were 23.8 IU/l in normal control and 18.8 IU/l in the CAPD patients (P < 0.001). Mean ALT were 21.9 IU/l in normal controls and 15.3 IU/l in the CAPD patients (P < 0.001). CAPD patients with HCV infection had higher serum AST and ALT levels than those without. However, HBV infection did not cause significant serum aminotransferase elevation in patients. The conventional cutoff values of AST (40 IU/l) and ALT (40 IU/l) for detecting viral hepatitis yielded only a sensitivity of 27.3 and 18.2% respectively; on the contrary, our revised cutoff values of AST (24 IU/l) and ALT (17 IU/l) had better sensitivities (AST, 72.7%; ALT, 63.6%). For serial aminotransferase values, the sensitivity of AST and ALT for detecting HCV were 36.4 and 27.3% by conventional criteria, and were both 81.8%, by our newly revised criteria. CONCLUSIONS: Serum aminotransferase cutoff values should be modified for screening viral hepatitis in a CAPD population. Our new cutoff criteria had important clinical implications in providing benefits of earlier detection and possible prevention from chronic hepatic deteriorations.     

Frequency notched printed slot antenna with parasitic open-circuit stub

A new frequency notched ultra-wideband microstrip slot antenna with a parasitic tuning stub is proposed. The antenna is similar in configuration to a conventional microstrip slot antenna; by introducing a parasitic open-circuit tuning stub, flexible frequency notched function is achieved. Several properties of the antenna, such as frequency notched function, antenna transfer function and gain, have been investigated. As is reported, the operation bandwidth of the antenna is 2.91-11.16 GHz, in which a frequency notched band of 5.10-5.85 GHz has been achieved. Furthermore, good ultra-wideband linear transmission performance over the entire operation frequency range has also been achieved.     

Gastrointestinal autonomic nerve tumour presenting as small bowel volvulus: a rare disease with a rare presentation

A 78-year-old Chinese woman presented with recurrent postprandial abdominal pain. Computerised tomography revealed a small bowel tumour causing volvulus of a segment of the small bowel. Laparotomy confirmed an extraluminal ileal tumour with partial volvulus of the involved small bowel segment. Small bowel resection was done. Histological and ultrastructural studies confirmed a gastrointestinal autonomic nerve tumour. We review the medical literature on this rare tumour.     

High-breakdown-voltage AlInAs/GaInAs junction-modulated HEMT's(JHEMT's) with regrown ohmic contacts by MOCVD

A technology for increasing both the two-terminal gate-drain breakdown and subsequently the three-terminal-off-state breakdown of AlInAs/GaInAs high-electron-mobility transistors (HEMTs) to record values without substantial impact on other parameters is presented. The breakdown in these structures is dependent on the multiplication of electrons injected from the source (channel current) and the gate (gate leakage) into the channel. In addition, holes are generated by high fields at the drain and are injected back into the gate and source electrodes. These phenomena can be suppressed by increasing the gate barrier height and alleviating the fields at the drain. Both have been achieved by incorporating a p⁺-2DEG junction as the gate that modulates the 2DEG gas and by utilizing selective regrowth of the source and drain regions by MOCVD. The 1-μm-gate-length devices fabricated have two-terminal gate-drain and three-terminal-off-state breakdown voltages of 31 V and 28 V, respectively