以壳聚糖为佐剂的幽门螺杆菌蛋白抗原对幽门螺杆菌感染的免疫保护作用

目的探讨以壳聚糖为佐剂的幽门螺杆菌（脚）抗原对脚感染的免疫保护作用。方法BALB／c小鼠随机分为9组：（1）空白对照组：PBS溶液；（2）壳聚糖酸溶液组；（3）壳聚糖颗粒组；（4）印抗原组；（5）np抗原＋壳聚糖酸溶液组；（6）Hp抗原＋壳聚糖颗粒组；（7）Hp抗原＋CT组；（8）脚抗原＋壳聚糖酸溶液＋CT组；（9）Hp抗原＋壳聚糖颗粒＋CT组。各组于第0、7、14、21天灌胃各免疫1次，免疫后4周给予109CFUIml的SSlnp菌液0．5ml／只进行攻击，隔日1次，共2次。4周后，采用定量砌培养和病理改良Giemsa染色法检测胃黏膜内伽感染情况。结果（1）以壳聚糖为佐剂的印抗原的免疫保护率达60％，与以凹为佐剂的伽抗原的免疫保护率（58．33％）相似，显著高于单纯印抗原组及其他不含印抗原组（P〈0．05），同时以凹＋壳聚糖为佐剂的坳疫苗的保护率为84．62％、85．71％，高于CT或壳聚糖单独作佐剂组。（2）病理组织学检测含佐剂组的铷定植计分显著低于无佐剂组和无抗原组（P〈0．05），壳聚糖和CT联合应用组的跏定植计分最低，显著低于单以CT为佐剂组（P〈0．05）。（3）砌定量培养脚定植密度在佐剂中含壳聚糖组均显著低于对照组和单纯脚抗原组（P〈0．05），而单以CT为佐剂组脚定植密度与对照组和单纯坳抗原组差异无统计学意义（P〉0．05）。结论以壳聚糖为佐剂的坳抗原对Hp感染具有免疫保护作用，并且与CT有协同作用。     

以壳聚糖为佐剂的幽门螺杆菌疫苗诱导的细胞免疫反应

目的:探讨以壳聚糖为佐剂的幽门螺杆菌(Hp)疫苗诱导的细胞免疫反应及其在免疫保护中的作用。方法:BALB/c小鼠随机分为空白对照组(PBS溶液)、壳聚糖酸溶液组、壳聚糖颗粒组、Hp抗原组、Hp抗原 壳聚糖酸溶液组、Hp抗原 壳聚糖颗粒组、Hp抗原 霍乱霉素(CT)组、Hp抗原 壳聚糖酸溶液 CT组及Hp抗原 壳聚糖颗粒 CT组,各组于第0、7、14、21天灌胃各免疫1次,末次免疫后4周给予1×1012CFU/L的SS1Hp菌液0·5mL/只进行攻击,隔日1次,共2次。在攻击前后分批处死小鼠,采用Hp培养和病理改良Giemsa染色法检测胃黏膜内Hp感染。用定量ELISA法检测胃黏膜内IL-2、IL-4和IL-10含量;HE染色进行胃黏膜病理学检测。结果:①以壳聚糖为佐剂的Hp疫苗的免疫保护率达60%,与以CT为佐剂的Hp疫苗的免疫保护率(58·33%)相似,显著高于单纯Hp抗原组及其他不含Hp抗原组(P<0·05)。②胃黏膜内IL-2的水平攻击后含佐剂组显著高于对照组(P<0·05)。IL-10水平攻击前以壳聚糖为佐剂组高于无佐剂组,攻击后以CT 壳聚糖颗粒为佐剂组高于其他组(P<0·05)。IL-4水平攻击前以壳聚糖为佐剂组高于无佐剂组(P<0·05),攻击后以壳聚糖颗粒为佐剂组高于以CT为佐剂组(P<0·05),以壳聚糖溶液为佐剂组高于对照组、无佐剂组及佐剂中含CT组(P<0·05)。③胃黏膜炎症程度在单纯壳聚糖组和以壳聚糖颗粒为佐剂组显著低于以CT为佐剂组(P<0·05)。结论:①以壳聚糖为佐剂的Hp疫苗对Hp感染具有免疫保护作用。②以壳聚糖为佐剂的Hp疫苗可促进Th1和Th2的混合免疫反应,并逆转Hp感染所致Th2反应的抑制,使Th1和Th2反应达到平衡,从而发挥其免疫保护作用。③以壳聚糖为佐剂的Hp疫苗所致的免疫后胃炎显著低于以CT为佐剂的Hp疫苗。     

以壳聚糖为佐剂的Hp疫苗诱导的体液免疫应答及其免疫保护效应

目的：探讨以壳聚糖为佐剂的Hp疫苗的免疫保护作用及其机制。方法:BALB/c小鼠随机分为9组：①空白对照组：PBS溶液；②壳聚糖酸溶液组；③壳聚糖颗粒组；④Hp抗原组；⑤Hp抗原+壳聚糖酸溶液组；⑥Hp抗原+壳聚糖颗粒组；⑦Hp抗原+CT组；⑧Hp抗原+壳聚糖酸溶液+CT组；⑨Hp抗原+壳聚糖颗粒+CT组，各组于第0、7、14、21 d 灌胃各免疫1次，免疫后4周给予1×1012CFU/L的SS1 Hp菌液每只 0.5 mL进行攻击，隔日1次，共2次。4周后，采用定量Hp培养和病理改良Giemsa染色法检测胃黏膜内Hp感染。用ELISA法检测血清抗Hp IgG、IgG1、IgG2a及唾液和胃黏膜内抗Hp IgA，用SP免疫组织化学法检测胃黏膜内分泌型IgA（sIgA）。结果:①以壳聚糖为佐剂的Hp疫苗的免疫保护率达60%，与以CT为佐剂的Hp疫苗的免疫保护率（58.33%）相似，显著高于单纯Hp抗原组及其它不含Hp抗原组（P<0.01或P<0.05），同时以CT＋壳聚糖为佐剂的Hp疫苗的保护率为84.62%、85.71%，其Hp的定植评分显著低于无佐剂组及以CT为佐剂组（P<0.01，P<0.05）。②含佐剂的Hp疫苗所诱导产生的Hp IgG水平显著高于对照组及无佐剂组（P<0.01，P<0.05），而以CT＋壳聚糖为佐剂组所产生的抗Hp IgG水平显著高于仅以 CT或壳聚糖为佐剂组（P<0.05）。③胃黏膜内sIgA及特异性抗Hp IgA水平在壳聚糖为佐剂组与以CT为佐剂组无差别（P>0.05），显著高于无佐剂组，而壳聚糖与CT联合应用组显著高于单以CT为佐剂组（P<0.01，P<0.05）。结论:以壳聚糖为佐剂的Hp疫苗对Hp感染具有免疫保护作用，并可成功诱导黏膜局部的特异性体液免疫应答，从而发挥免疫防御作用。     

壳聚糖体内抗幽门螺杆菌作用及其对机体体液免疫反应的调节

目的研究壳聚糖体内抗幽门螺杆菌（Hp）作用，及其对机体体液免疫反应的调节作用。方法建立BALB／c小鼠Hp感染的动物模型后，随机分为8组：（1）对照组；（2）PPI组；（3）AM组；（4）AM＋PPI组；（5）壳聚糖组；（6）壳聚糖＋PPI组；（7）壳聚糖＋AM组；（8）壳聚糖＋AM＋PPI组。分别给予上述药物每日2次灌胃，共2周。停药后4周，处死小鼠，无菌条件下取胃黏膜、唾液和血清。采用定量Hp培养和病理改良Giemsa染色法检测胃黏膜内Hp感染。用ELISA法检测血清、唾液和胃黏膜内Hp抗体，用SP免疫组织化学法检测胃黏膜内分泌型IgA（sIgA）。结果以上8组的却根除率分别为0、0、41．7％、58．3％、58．3％、66．7％、83．3％、91．7％，其中（3）～（8）组的肋根除率与（1）和（2）组比较差异有统计学意义（P〈0．05）。Hp定植密度研究发现各组之间Hp定植密度差异有统计学意义（P〈0．001），坳定植密度在（3）～（8）组显著低于（1）和（2）组（P〈0．05），（7）组显著低于（3）组（P〈0．05），（8）组显著低于（4）组（P〈0．05）。血清中抗Hp　IgG、IgG1、IgG2a及唾液中抗Hp　IgA含量，各组差异无统计学意义（P〉0．05）。胃黏膜中抗Hp　IgA含量，在壳聚糖组和壳聚糖＋AM组显著高于无壳聚糖组（P〈0．05）。胃黏膜sIgA阳性腺体百分率，含壳聚糖组显著高于不含壳聚糖组（P〈0．05）。结论壳聚糖在体内有抗Hp作用，并与AM有协同作用，它与PPI和AM三者联用的Hp根除率高达91．7％，有望成为一抗Hp新药。壳聚糖可促进胃黏膜局部抗Hp　IgA和sIgA的产生，因此它在体内的抗Hp作用除了直接杀灭Hp外，其对机体免疫调节效应可能参与了抗菌机制。     

重组幽门螺杆菌疫苗免疫保护作用与免疫后胃炎

目的：研究以减毒鼠伤寒沙门菌为载体构建的幽门螺杆菌(Helicobacter pylori，Hp)疫苗的免疫保护机制。方法：将表达不同Hp抗原的减毒鼠伤寒沙门菌(Salmonella typhimurium)分别免疫小鼠，免疫4周后以Hp攻击；在攻击前及攻击后5周分批处死小鼠，比较各组小鼠Hp定植密度及各项免疫指标的变化。结果：(1)和NS(Normal salin，NS)对照组相比各免疫组的Hp定植密度显著下降。(2)和NS组相比攻击前后各免疫组血清IgG2a和胃黏膜Th1型细胞因子表达显著升高。(3)和NS组相比攻击后免疫组鼠胃黏膜出现明显的炎症反应。结论：以减毒鼠伤寒沙门菌为载体构建的重组幽门螺杆菌疫苗在小鼠体内诱导出以Th1反应为主并伴随免疫后胃炎的保护性免疫应答。     

重组耻垢分枝杆菌制剂预防幽门螺杆菌感染的作用机理的初步探讨

目的探讨重组耻垢分枝杆菌实验制剂（recombinant Mycobacterium smegmatis，rMs）预防幽门螺杆菌（Helicobacter pylori，Hp）感染的作用机理。方法实验制剂免疫BLAB／c小鼠4周，用Hp攻击后4周，取血清、胃、脾组织，RT-PCR检测小鼠胃黏膜和脾组织的TH1型细胞因子（IFN-γ、IL-2、IL-12）与TH2型细胞因子（IL-4、IL-6、IL-10）；用ELISA检测针对唧的特异性血清IgG、IgG1、IgG2a和IgA水平；用免疫组化方法检测胃黏膜固有层IgA表达；用MTT检测脾淋巴细胞增殖。结果免疫后BALB／c小鼠特异性抗体显示rMs制剂诱导Hp特异性血清IgG、IgA水平都升高，以IgG2a占优势。用Hp抗原刺激后各免疫组小鼠脾淋巴细胞均有明显增殖。免疫组化显示各免疫组小鼠胃黏膜固有层IgA阳性标记腺体数明显高于对照组。RT-PCR证实，跏攻击之前，各免疫组胃和脾组织已出现了IFN-γ、IL-12、IL-2表达而无IL-4、IL-6、IL-10表达。PBS对照组和单纯耻垢分枝杆菌（Ms）组胃黏膜和脾组织各细胞因子均无表达；Hp攻击后，PBS和单纯Ms组胃组织出现以TH1细胞IFN-γ为主的增生，IFN-γ水平显著高于rMs组（P〈0．05）；而3个rMs制剂组脾脏则出现以TH2细胞（IL-4）为主的增生，IL-4水平显著高于对照组（P〈0．05）。提示该制剂的作用机制是诱导TH1，TH2平衡型免疫应答。结论成功地建立了BALB／c小鼠的Hp感染模型，对rMs制荆的免疫保护机理研究结果显示，rMs能产生以TH1细胞和TH2细胞协同作用的保护性免疫应答。     

空肠弯曲菌pcDNA3.1(-)-peb1A壳聚糖佐剂疫苗的Th免疫应答及作用

目的:探讨以壳聚糖为佐剂的空肠弯曲菌基因疫苗免疫小鼠后的Th细胞免疫应答状态。方法:昆明小鼠随机分组:设空白对照组、空载体组、pcDNA3.1(-)-peb1A组、壳聚糖+pcDNA3.1(-)-peb1A组,各组均采用小鼠股四头肌注射法。在第0、10、20天免疫,于每次免疫后第10天采集各组小鼠血浆,间接ELISA法检测免疫后不同时间小鼠血浆中Th1、Th2细胞因子的含量。结果:Th1类细胞因子IL-2、IFN-γ,在第10、20、30天,裸DNA组、佐剂DNA组、空载体组及NS组两两相比均无显著性差异(P>0.05);Th2类细胞因子IL-4、IL-10:实验组高于两对照组,在IL-4的检测中有显著性差异(P<0.05),在IL-10的检测中裸DNA组高于空白对照组有显著性差异(P<0.05),其裸DNA组高于空载体组,仅在第20天有显著性差异(P<0.05);佐剂DNA组高于裸DNA组,在IL-4的检测中有显著性差异(P<0.05),在IL-10的检测中,仅在第10、20天有显著性差异(P<0.05);佐剂DNA组高于两对照组,有显著性差异(P<0.05)。结论:以壳聚糖为佐剂的空肠弯曲菌基因疫苗可促进Th2细胞为主的免疫反应。     

壳聚糖体内外抗幽门螺杆菌的实验研究

目的 研究壳聚糖体内外抗幽门螺杆菌（Hp）作用。方法 （1）采用打孔法检测了不同浓度、pH值、脱乙酰度壳聚糖及羧甲基壳聚糖在体外对蜘的抑菌作用。（2）建立BALB／c小鼠脚感染的动物模型后，随机分为8组：①对照组；②PPI组；③AM组；④AM＋PH组；⑤壳聚糖组；⑥壳聚糖＋PPI组；⑦壳聚糖＋AM组；⑧壳聚糖＋AM＋PPI组。分别给予上述药物每日2次灌胃，共2周。停药后4周，处死小鼠，无菌条件下取胃黏膜进行砷定量培养和石蜡包埋切片，进行Giemsa染色。结果 （1）壳聚糖和羧甲基壳聚糖在体外对3株邱标准菌株具有普遍的抑菌作用；在pH6-4范围内，随pH值降低，抗菌作用增强，差异有统计学意义（P〈0．01），最佳pH值为4；70％、88．5％脱乙酰度壳聚糖及羧甲基壳聚糖的抗伽作用差异有统计学意义（P〈0．05），抑菌强度依次为DD70壳聚糖、DD88．5，壳聚糖和羧甲基壳聚糖；在1％-5％浓度范围内羧甲基壳聚糖抗伽作用差异无统计学意义；在0．5％-2％浓度范围内70％、88．5％脱乙酰度壳聚糖抗伽作用差异也无统计学意义（P〉0．05）。（2）对饰感染的小鼠，以上8组的坤清除率分别为O％、O％、41．7％、58．3％、58．3％、66．7％、83．3％、91．7％，其中③-⑧组的坤清除率显著高于①和②组（P〈0．05），⑧组的坤清除率还显著高于③组（P〈0．05）。坤定植密度研究发现，各组之间坤定植密度差异有统计学意义（P〈0．001），饰定植密度在③一⑧组显著低于①和②组（P〈0．05）；⑥-⑧组显著低于③组（P〈0．05）；⑧组显著低于④组（P〈0．05）。结论 壳聚糖和其衍生物对坤有普遍的抑菌作用；壳聚糖及其衍生物的抗饰作用受多种因素影响，其中pH值对壳聚糖抗菌作用的影响最为明显，在pH值6—4范围内，壳聚糖的抗坤活性随着pH值的下降而显著增强；壳聚糖在体内有抗坤作用，并与AM有协同作用。     

壳聚糖包裹IL-21与PEB1核酸纳米粒子疫苗免疫应答的研究

目的研究壳聚糖包裹PEB1和IL-21核酸纳米粒子疫苗诱导小鼠免疫应答水平。方法复合物凝聚法制备壳聚糖纳米粒子,肌肉注射Balb/c小鼠,检测免疫期和感染期小鼠血清特异性Ig G水平、脾细胞悬液细胞因子水平、脾细胞增殖指数及疫苗保护率。结果扫描电镜观察纳米颗粒平均粒径在(300±23)nm左右,包封率为(91.23±3.24)%;实验组小鼠,特别是IL-21基因佐剂组,在血清特异性Ig G、脾细胞培养上清中IFN-γ和IL-4、脾细胞增殖水平和疫苗的临床保护效应上都显著高于对照组(P0.05);但壳聚糖纳米颗粒组效果不明显(P0.05)。结论 IL-21基因佐剂可以显著提高并维持小鼠稳定持久的免疫应答水平。但壳聚糖对免疫应答仅起到一定的促进作用。本研究的顺利开展,为空肠弯曲菌疫苗的临床应用提供了一定的理论支持。     

STAg和霍乱毒素不同程序滴鼻免疫小鼠诱导抗弓形虫作用

目的观察弓形虫可溶性速殖子抗原（soluble tachyzoite antigen，STAg）和霍乱毒素（cholera toxin，CT）佐剂不同程序滴鼻免疫小鼠诱导的抗弓形虫感染能力，确定STAg和CT滴鼻免疫的最佳程序。方法BALB／c小鼠随机分为3组：1次、2次和3次免疫组，用20μgSTAg＋1μgCT／只分别滴鼻免疫1次，2次或3次，前2次间隔2周，末次间隔1周。末次免疫后第14天，用4×10^4个速殖子／只灌胃攻击所有小鼠，观察小鼠健康及死亡情况，攻击后第30天处死，ELISA法检测血清IgG和粪便IgA，计数肝、脑组织内弓形虫速殖子，分离并计数派伊尔结（Peyer＇s patches，PP）和脾淋巴细胞数。结果2次和3次免疫组小鼠存活率明显高于1次免疫组（P〈0．05），肝、脑组织内虫荷显著低于1次免疫组（P〈0．001），血清IgG和粪便IgA高于1次免疫组，PP和脾淋巴细胞数无显著性变化。结论STAg和CT佐剂滴鼻免疫2次或3次能有效诱导小鼠抗弓形虫感染。     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

What will studies of Fulani individuals naturally exposed to malaria teach us about protective immunity to malaria?

There are an estimated over 200 million yearly cases of malaria worldwide. Despite concerted international effort to combat the disease, it still causes approximately half a million deaths every year, the majority of which are young children with Plasmodium falciparum infection in sub-Saharan Africa. Successes are largely attributed to malaria prevention strategies, such as insecticide-treated mosquito nets and indoor spraying, as well as improved access to existing treatments. One important hurdle to new approaches for the treatment and prevention of malaria is our limited understanding of the biology of Plasmodium infection and its complex interaction with the immune system of its human host. Therefore, the elimination of malaria in Africa not only relies on existing tools to reduce malaria burden, but also requires fundamental research to develop innovative approaches. Here, we summarize our discoveries from investigations of ethnic groups of West Africa who have different susceptibility to malaria.     

The universal muscular chain reaction,muscle spasm,Torsions, ruptures and extravasations. Chameleons of pathology and some manifestations of simple muscular disorders

Most bodily functions require the coordinated actions of complementary and supplementary paired muscle groups. Where this essential muscular cooperation is lacking, hollow organs may burst and others become literally screwed up, giving rise to many similar spastic diseases such as Torticollis, Twisted ovarian cyst, Torsion of the Testis, Volvulus of the intestines, Varicose Veins, Megacolon, Aortamegaly, Scoliosis, Erb's Palsy, Peyronie's Disease, Main-en-Griffe, Undescended Foot (Pes Cavus), Talipes, Strabismus. Spasm is “panenepidemic” and unclassified examples of Torsion Dystonia and Dyskinesia really are as common as debt and taxes.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

Hypo- und Hypermagnesämie aus kardiologischer Sicht

Zusammenfassung Eine Reihe pathologischer Zustände bedingen Magnesiummangel. Zustände mit Hypermagnesämie sind ebenfalls bekannt, doch wesentlich seltener. Für den Kardiologen beachtenswert ist, daß unter Therapie mit bestimmten Diuretica bei Herzinsuffizienz, bei Herzinfarkt, Kardiomyopathie, Digitalisintoxikation und bestimmten Herzrhythmusstörungen Hypomagnesämie beobachtet wurde. Leider kann in der klinischen Routine nur ein extracelluläres Magnesiumdefizit durch Serumbestimmungen gemessen werden; über Magnesiummangel einzelner Organe kann nichts ausgesagt werden. Hinweise für Magnesiummangel geben aber neben der Messung des Serumspiegels Anamnese, klinischer Befund, bestimmte EKG-Veränderungen wie auch evtl. Hypokalämie, ein Zustand, bei dem sich oft — besonders bei Aldosteronismus — parallele Veränderungen zeigten.Tierexperimente deuten darauf hin, daß infarktähnliche Läsionen unter Magnesiummangel entstehen, doch ob Herzinfarkt beim Menschen durch Magnesiummangel ausgelöst werden kann, ist noch ungeklärt. In Leichenherzen zeigte sich im Infarktgebiet neben Calciumakkumulation signifikanter Magnesiumverlust, wobei unklar blieb, ob sich Ursache oder Folge des Infarktes widerspiegelten. Falls ein ursächlicher Zusammenhang besteht, ist er im Myokardstoffwechsel selbst zu suchen, wie bei der Alkoholkardiomyopathie, wo myokardialer Magnesiummangel zumindest als pathogenetischer Teilfaktor anerkannt wird. Andererseits versucht man aber auch Beziehungen zwischen Atherosklerose, Blutgerinnung und Hypomagnesämie herzustellen, in der Meinung, daß Magnesiummangel auch über den coronaren Pathomechanismus des Herzinfarktes wirken könnte. Sicher scheint, daß gewisse EKG-Veränderungen und Herzrhythmusstörungen durch einen irritierten Magnesiumhaushalt bedingt sein können, da sie bei Gabe bzw. Entzug von Magnesium verschwinden. Daß Magnesiummangel die Glykosidtoleranz verringert, wird tierexperimentell bestätigt. Unter Hypomagnesämie bewirkt Acetylstrophanthidin eher und länger Rhythmusstörungen als ohne, außerdem lassen diese sich durch Magnesiumgaben eliminieren. Da in gewissen Fällen spontane und digitalisinduzierte Herzrythmusstörungen durch Magnesiuminjektionen beseitigt wurden, scheint Magnesium als Therapeuticum angebracht. Einsatz verschiedener Magnesiumsalze bei Angina pectoris, degenerativen Herzerkrankungen und Herzinsuffizienz ohne geprüften und offensichtlich gestörten Magnesiumhaushalt ist fragwürdig, weil keine eindeutigen klinischen Erfolgsbeweise vorliegen. Immerhin mag es aber larvierte, durch Serumbestimmungen nicht erfaßbare Mangelzustände geben. Allgemein erscheint es aus kardiologischer Sicht ratsam, den Magnesiumhaushalt zu überwachen und in entsprechenden Fällen auszugleichen, um möglichen Myokardläsionen oder fatalen Herzrhythmusstörungen entgegenzuwirken.     

Environmental risk factors and their role in the management of atopic dermatitis

Introduction: The etiology of atopic dermatitis (AD) is multifactorial with interaction between genetics, immune and environmental factors.

Areas covered: We review the role of prenatal exposures, irritants and pruritogens, pathogens, climate factors, including temperature, humidity, ultraviolet radiation, outdoor and indoor air pollutants, tobacco smoke exposure, water hardness, urban vs. rural living, diet, breastfeeding, probiotics and prebiotics on AD.

Expert commentary: The increased global prevalence of AD cannot be attributed to genetics alone, suggesting that evolving environmental exposures may trigger and/or flare disease in predisposed individuals. There is a complex interplay between different environmental factors, including individual use of personal care products and exposure to climate, pollution, food and other exogenous factors. Understanding these complex risk factors is crucial to developing targeted interventions to prevent the disease in millions. Moreover, patients require counseling on optimal regimens for minimization of exposure to irritants and pruritogens and other harmful exposures.     

Class II HLA in Georgia Caucasus Tbilisi Georgians and their Mediterranean ancestry: The Usko Mediterranean languages

Georgia (or Sakartvelo in its own language) is a South Caucasus Mts. country with its easternmost part is enigmatically named Iberia, like the Iberian Peninsula, which may refer to rivers “Kura” and “Ebro” or their valleys respectively. Most of their inhabitants speak Georgian which is included within Dene-Caucasian group and Usko-Mediterranean subgroup of languages. The latter includes Basque, Berber, ancient Iberian-Tartessian, Etruscan, Hittite, Minoan Lineal A and others. In the present paper, HLA class II -DRB1 and -DQB1 alleles has been studied and extended haplotypes calculated. Most frequent haplotypes are also of Mediterranean origin (i. e.: (A*02-B*51)-DRB1*11:01-DQB1*03:01, (A*02-B*51)-DRB1*13:01-DQB1*06:03, or (A*24-B*35)-DRB1*01:01-DQB1*05:01) and DA genetic distances show that closest world populations to Georgians are Mediterraneans. Georgians also show common extended haplotypes ((A*02-B*51)-DRB1*11:01-DQB1*03:01, (A*02-B*13)-DRB1*07:01-DQB1*02:01 and (A*03-B*35)-DRB1*11:01-DQB1*03:01) with Svan people, a secluded population in North Georgia mountains. We can conclude that Georgians belong to a very old Mediterranean substratum according to both linguistics (Usko Mediterranean languages) and HLA genetics.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.