INTRODUCTIONGallstone disease (GSD) is one of the most common diseases in developed countries. Recent studies indicate varying prevalence of GSD with several predisposing factors in different study populations [1][2][3][4][5][6][7][8][9] . From a medical economic perspective, the direct and indirect costs of treating GSD patients were estimated at $16 billion and account for more than 800 000 hospitalizations yearly in the United States [9,10] . In Taiwan, the prevalence of GSD in the general population was 4.3% in 1989 [8] while another voluntary screening revealed that the prevalence of GSD was 10.7% among healthy subjects in 1995 [2] . For this reason, due to westernization of the diet and the environment, GSD is not rare in the Chinese population and has become one of the major health problems in Taiwan [7] . Without an appropriate and effective screening program for symptomatic GSD, the medical treatment of GSD and related complications contributes substantially to health care costs.From the viewpoint of preventive medicine, it is RAPID COMMUNICATION RESULTS:The overall prevalence of GSD among this study-population was 5.3%, including 1.7% (n = 40) having a single stone, 2.3% (n = 55) having multiple stones, and 1.3% (n = 31) having cholecystectomy. The prevalence revealed a statistically significant increase with increasing age (P < 0.0001). Females exhibited a greater prevalence of multiple stones than did males (3.0% vs 1.7%, P = 0.04). Using multiple logistic regression analysis, the following appeared to be significantly related to the prevalence of GSD: older

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Primary cardiac lymphoma (PCL) has rarely been reported in Chinese populations. PCL mostly occurs in the right atrium. The clinical manifestations may be variable and are attributed to its location, the presence of congestive heart failure, pericardial effusion, arrhythmia, and cardiomegaly. The prognosis is usually poor because it is usually found too late and therefore, clinicians should be aware of PCL. Imaging examinations are the best methods for initial diagnosis and include echocardiography, computed tomography (CT) scan, magnetic resonance imaging (MRI), and radioisotope scan. However, the final diagnosis is made by pathology, such as cytologic examination of the effusive fluid and tissue biopsy. Because the tumors are difficult to resect, the main treatment for the disease is chemotherapy, which can be successful. Here, we report a 58-year-old man who had a tumor measuring 8 x 5 cm in the right atrium. By clinical staging, including chest X-ray, echocardiography, CT scan of the abdomen, MRI of the heart, whole body tumor Gallium scan, and gastrointestinal series, no metastatic lesion or involvement was found in other parts of the body. Pathologic findings including cytology of pericardial effusion and heart tumor biopsy revealed the case as a diffuse large B-cell lymphoma. After chemotherapy with COP (cyclophosphamide + vincristine + prednisone) and CHOPBE (COP + doxorubicin + bleomycin + etoposide) regimens, the intracardiac tumor had disappeared, but the patient survived for 12 months in total, despite additional radiotherapy over the pericardial lesions. It was presumed that because the tumor was very large and involved all 3 layers of the heart, it did not respond as well to the therapy as expected.

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Ouabain, a cardiotonic steroid and specific Na+/K+‐ATPase inhibitor, has a potential to induce cancer cell apoptosis but the mechanisms of apoptosis induced by ouabain are not fully understand. The aim of this study was to investigate the cytotoxic effects of ouabain on human prostate cancer DU 145 cells in vitro. Cell morphological changes were examined by phase contrast microscopy. Cell viability, cell cycle distribution, cell apoptosis, DNA damage, the production of ROS and Ca2+, and mitochondrial membrane potential (ΔΨm) were measured by flow cytometry assay. Results indicated that ouabain induced cell morphological changes, decreased total cell viability, induced G0/G1 phase arrest, DNA damage, and cell apoptosis, increased ROS and Ca2+ production, but decreased the levels of ΔΨm in DU 145 cells. Ouabain also increased the activities of caspase‐3, ‐8, and ‐9. Western blotting was used for measuring the alterations of apoptosis‐associated protein expressions in DU 145 cells and results indicated that ouabain increased the expression of DNA damage associated proteins (pATMSer1981, p‐H2A.XSer139, and p‐p53Ser15) and ER‐stress‐associated proteins (Grp78, ATF6β, p‐PERKThr981, PERK, eIF2A, GADD153, CaMKIIβ, and caspase‐4) in time‐dependently. Furthermore, ouabain increased apoptosis‐associated proteins (DR4, DR5, Fas, Fas Ligand, and FADD), TRAIL pathway, which related to extrinsic pathway, promoted the pro‐apoptotic protein Bax, increased apoptotic‐associated proteins, such as cytochrome c, AIF, Endo G, caspase‐3, ‐8, and ‐9, but reduced anti‐apoptotic protein Bcl‐2 and Bcl‐x in DU 145 cells. In conclusion, we may suggest that ouabain decreased cell viability and induced apoptotic cell death may via caspase‐dependent and mitochondria‐dependent pathways in human prostate cancer DU 145 cells.

Although the exact pathophysiology of the association between sleep posture and recurrent unilateral stone disease remains to be elucidated, sleep posture may alter renal hemodynamics during sleep and promote stone formation. This observation needs further investigation and should be factored into the evaluation and prevention of unilateral urinary stone disease.