Ultrasound study of the spleen

The sonography is the method of choice for the determination of the size of the spleen. Normally, this has, represented from the left flank, a size of 12 x 5 cm (length and thickness) and a regular structural pattern. Splenomegalies with diffusely changed echo-structure are found in infections, congestion spleens as well as haemoblastoses. Focal lesions are typical for cysts, abscesses and haematomas of the spleen. The sonography of the spleen plays a particular role in the staging of malignant lymphomas, whereas metastatic changes of the spleen may more infrequently be stated sonographically. The authors deal with the great importance of the sonography of the spleen in abdominal traumas.     

Anatomical study of the pulmonary lymphatics

As the result of anatomical as well as histological investigations on the lymphatics of the human lung, the authors have arrived at the following conclusions: 1. According to the distribution and the direction of lymph flow, pulmonary lymphatics are classified into two systems and four groups. 2. The lymphatics cannot be found in the interalveolar septum. 3. The extravascular fluid pathway system plays an important role for cleaning particles in the most peripheral part of the respiratory tract where no lymphatics are found. 4. Efferent lymph flow reaches the venous angles via two routes on both sides respectively.     

Section 14 Criticisms of the study

After examination of the major criticisms of the VA Cooperative Study we conclude that the patients in the VA study are representative of patients with stable angina seen in everyday practice; the surgical results are quite comparable with those of the European study and large, non-VA medical centers during the 1972 to 1974 period; the angiograms of the 1972 to 1974 cohort are of acceptable quality; the percentage of medical crossovers without left main disease over a 5-year period (20%) was not excessive compared to other randomized studies, and no evidence was found that the crossovers were at higher risk at entry than those patients who adhered to medical therapy. Finally, it would be ingenuous not to mention that much of the early adverse criticism of the VA study came from those who were reluctant to accept a negative effect of surgery. These critics welcomed the report of surgical benefit for the subgroup with left main disease, but faulted the study a year later when the finding of no surgical benefit for patients without left main disease was published because it did not support popular claims.     

Clinical study of the postphlebitic syndrome

The syndrome is approached from the diagnostic and developmental point of view. The clinical examination remains of paramount importance, for it is necessary to differentiate between the primary varices and the post-phlebitic varices which have the same functional symptoms. The main trophic complications are listed, principally: oedema, hypodermititis, ochrodermititis and leg ulceration, which is the most formidable complication and which still occurs very frequently. Ulceration is likely to occur more frequently following sural phlebites rather than those higher up. The main topographical areas of varices are described, without forgetting the collateral circulation in the abdominal and subpudendal region. The developmental aspect of post-phlebitic syndrome is difficult to predict as sequels appear after varying lengths of time, and in varying ways. Finally, venous functional investigations have a practical advantage. They make it possible to assess the functional state of the limb by indicating precisely the state of the deep and superficial circulation. They can thus make it possible to assess the importance of venous stasis and the nutritional state of the tissues.     

Integrating the MicroRNome into the study of lung disease

Over the last 15 years, investigators have identified small noncoding RNAs as regulators of gene expression. One type of noncoding RNAs are termed microRNAs (miRNAs). miRNAs are evolutionary conserved, approximately 22-nucleotide single-stranded RNAs that target genes by inducing mRNA degradation or by inhibiting translation. miRNAs are implicated in many critical cellular processes, including apoptosis, proliferation, and differentiation. Furthermore, it is estimated that miRNAs may be responsible for regulating the expression of nearly one-third of the human genome. Despite the identification of greater than 500 mature miRNAs, very little is known about their biological functions and functional targets. In the last 5 years, researchers have increasingly focused on the functional relevance and role that miRNAs play in the pathogenesis of human disease. miRNAs are known to be important in solid organ and hematological malignancies, heart disease, as potential modulators of the immune response, and organ development. It is anticipated that miRNA analysis will emerge as an important complement to proteomic and genomic studies to further our understanding of disease pathogenesis. Despite the application of genomics and proteomics to the study of human lung disease, few studies have examined miRNA expression. This perspective is not meant to be an exhaustive review of miRNA biology but will provide an overview of both miRNA biogenesis and our current understanding of the role of miRNAs in lung disease as well as a perspective on the importance of integrating this analysis as a tool for identifying and understanding the biological pathways in lung-disease pathogenesis.     

Rats as models for the study of obesity

Gerontologists are concerned about obesity for two reasons. First, adiposity increases in humans with increasing age. Secondly, there is a strong possibility that the interaction between obesity and aging is deleterious. Since rats are a widely used animal model for the study of aging, it is likely that rats will be utilized in experiments designed to study the interactions between adiposity and aging. The object of this review is to provide the basic information needed for utilizing rats in such studies. To this end, changes in adipose tissue mass that occur during the life span of normal rats are described as are the types of rat models that have been used in the study of obesity. In addition, the characteristics of each of these obesity models are detailed.     

Leprosy of the larynx: a clinicopathological study

Ten established cases of lepromatous leprosy with laryngeal involvement are reported, and their clinical and histopathological findings are discussed with a brief review of the literature.     

The applicability of the concept of recruitment to the communications study of a nursing home: an ethnographic case study

A perspective for studying institutional procedures for assigning incoming patients to available wards, and for transferring patients between and among wards, is developed. Ethnographic data collected in one extended-care facility are presented. Staff-patient and patient-patient interactions surrounding ward assignments and transfers are discussed.     

The videoendoscopic swallowing study: An alternative and partner to the videofluoroscopic swallowing study

A new, physical examination-based videoendoscopic method of evaluation can enhance considerably the understanding and efficiency of clinicians working with patients with swallowing difficulties. Using the fiberoptic nasolaryngoscope, evaluation of structure and function of palate, pharynx, and larynx, along with sensation of the laryngopharynx, is carried out. Next, patients' swallowing capabilities are assessed as they ingest various food consistencies. This method, formerly called videoendoscopic evaluation of dysphagia (VEED), but perhaps more appropriately termed videoendoscopic swallowing study (VESS) has particular value for patients who cannot undergo the videofluoroscopic swallowing study (VFSS)—for example, because they are bedfast-or those whose swallowing function is changing so rapidly (after a stroke or surgery) as to call for frequent reassessments. This technique is often useful during the initial consultation with new patients complaining of dysphagia, as a stand alone method of diagnosis and management. Less frequently, VESS findings, along with patient history, will indicate when VFSS should also be obtained. VESS will orient the examiner to the nature and severity of the problem even in this latter circumstance. In follow-up circumstances, VESS is generally more useful than the VFSS. Case presentations are utilized to illustrate the usefulness of VESS as compared to VFSS.     

Randomized trials in the study of antihypertensive drugs

Heterogeneity in response to antihypertensive drugs can be addressed by randomized trials in individual subjects. In such a trial a patient receives pairs of treatment periods (one period of each pair active drug, one matched placebo, in random order); patient and clinician are blinded to allocation, and treatment targets are monitored. These trials can optimize antihypertensive therapy in clinical practice and facilitate the investigation of new drugs and the study of pathophysiology. Such trials also have potential in helping decide whether common, nonspecific symptoms reported by patients are really drug related.     

N-Glycan profiling in the study of human aging

Most secreted proteins produced by the human body are modified by glycosylation. It is well known that the oligosaccharides (glycans) of glycoproteins are important for initiation of various cellular recognition signals that are essential for the maintenance of the ordered social life of each cell within a multi-cellular organism. The sugar chains can be altered by the physiological or pathophysiological condition of the cell. We describe a detailed protocol for the analysis of N-linked glycans in blood via DNA sequencing equipment-Fluorophore Assisted Carbohydrate Electrophoresis (DSA-FACE). The key features of this technique are its robustness, high throughput, high sensitivity and reliable quantification. Based on DSA-FACE technology, we previously reported that N-glycan profiling of the human serum shows substantial changes with increasing age in three major N-glycan structures. We proposed that measurement of the N-glycan level changes could provide a surrogate marker for general health or for age-related disease progression, and for monitoring the improvement of health after therapy.     

Slicing the health service cake: the Islington study

BACKGROUND: Little is known about the factors that are associated with receipt of care in older people. This study aims to describe the pattern and predictors of service usage, by a representative sample of people aged 65 and over. METHOD: We assessed psychiatric and physical morbidity, formal and informal care and prescribed medication by standardized questionnaires. RESULTS: 1085 people were interviewed at home. Having dementia was a negative predictor of GP and hospital consultation (both P<0.001). Depressed participants were most likely to consult with GPs (P<0.05); 13.1% were on antidepressants. People with dementia use health services less than their counterparts. The presence of co-resident informal caregivers predicts less use of social services but no increase in health consultations. CONCLUSIONS: Carers give compensatory care rather than act as bridges to link people with dementia with the health care system. People with dementia need advocates. Older people with depression are high users of all services. They remain under-treated pharmacologically.     

Biotechnological methods on the study of nematodes

During the past several years, a great many advances have been made in obtaining a better understanding of the biology of nematode parasites. Much of the information obtained has been with the use of tools developed in the expanding field of biotechnology, or more specifically, the use of biochemistry, genetics or molecular biology. Advances are being made on speciation of parasites, their function and pathogenesis. Some nematode parasites indigenous to Southeast Asia have been studied, but much more should be done. There is a large group of parasites in Southeast Asia that could be studied. In the past, emphasis has been on human nematodes, but there are many interesting parasites of lower animals that should be investigated. Furthermore, future parasitologists must first be trained in basic parasitology and then be exposed to new technology in order to apply these tools to further our knowledge of round worms.     

Experimental study on the function of cardiomyocytes

This paper aimed at investigating the properties of cultured cardiomyocytes using microcirculatory and molecular technology to culture cardiomyocytes from different parts of the neonate Wistar rat's heart and record their spontaneous pulsation under time-lapse video microscopy, then analyze their activity and inspect their survival rate and apoptotic rate under natural and nitric oxide conditions. The pulsation frequency in cardiomtocytes of different parts in heart are: 78.5+/-11.0 beats/min in the atrium, 88.4+/-6.3 beats/min in the left ventricle, 90.3+/-7.9 beats/min in the right ventricle and 115.3 +/-11.4 beats/min in the cardiac apex, respectively, with an average frequency of 81.3 beats/min. Different concentrations of nitric oxide showed no effect on the frequency of cardiomyocyte pulsation. The survival rates of the above cardiomyocytes are 96.0%, 95.0%, 95.0%, and 95.3% respectively and 95.0% for the whole heart. The apoptotic rates are 1.3%, 1.1%, 4.8%, and 1.8% respectively and 5.1% for the whole heart. Different concentrations of nitric oxide had no effect on these results. Our study showed that cultured myocardial cells from different parts of the heart displayed various pulsation frequencies, and the frequency of the cardiac apex is the highest while the atrium is lowest. We also found that there is no statistically significant difference in the survival rates and apoptotic rates of different parts of the heart, and that nitric oxide has no effect on the beating frequency, survival rates or apoptotic rates of the cardiomyocytes in vitro.     

Contrast-induced nephropathy: the VIKISAFE study group statement

Contrast-induced nephropathy (CIN) has undergone a significant evolution over the years in terms of epidemiology and diagnostic criteria. At present it is defined as CI-AKI (contrast-induced acute kidney injury) and represents a pathologically relevant event for different disciplines. Thus, a multidisciplinary approach is needed to propose and deploy a common strategy to reduce the incidence of CI-AKI. It seems that the use of isoosmolar non-ionic contrast media such as iodixanol can reduce the nephrotoxic effects. However, since these - still controversial - results have been obtained using various diagnostic criteria, they are difficult to compare and pool together. Common criteria are therefore required. The term acute renal failure has been replaced by acute kidney injury (AKI). Thanks to consensus groups such as ADQI (Acute Dialysis Quality Initiative) and AKIN (Acute Kidney Injury Network) and the development of guidelines by KDIGO, the diagnostic criteria for AKI are well defined. Nevertheless, the possibility to utilize new biomarkers of structural kidney damage such as neutrophil gelatinase-associated lipocalin (NGAL) or cystatin C has introduced the concept that AKI may be diagnosed even in the absence of creatinine elevation or decreased urine output. A re-evaluation of the epidemiology of CI-AKI based on new diagnostic criteria is required. In this paper the results of a collaborative multidisciplinary study group are reported from the perspective of different disciplines including nephrology, cardiology, radiology and pharmacology. The findings in a cohort of cardiac patients undergoing imaging procedures using exclusively the isoosmolar non-ionic contrast medium iodixanol are evaluated according to the RIFLE/AKIN criteria.     

The program of the cooperative study of the Veterans Administration.

A computer program for the automatic analysis of the electrocardiogram is described with details about wave recognition, measurements, and the calculation of the posterior probabilities of each diagnosis. The advantages and disadvantages of this multivariate statistical procedure are discussed. Classification statements result from separate analysis of the QRS-T complex, P wave, and ST segment. Criteria for inclusion of the patients forming the data base are given, with tables of measurements, means and standard deviation, as well as investigation of agreement between calculated and observed probabilities. Estimated error rates are given in the form of misclassification matrices, computed from large numbers of tracings collected by a Veteran Administration Cooperative Study, where the correct diagnoses are taken from clinical, laboratory, and autopsy information.     

神经氨酸酶抑制剂的研究进展

流感病毒感染所致的急性呼吸道疾病(流感)是一种严重危害人类健康的传染病,在全世界范围流行,患病率和病死率均居高不下.由于流感病毒抗原变异性和特异性的疫苗研制的滞后性,常规的疫苗不能有效地预防流感暴发与流行.因此,抗病毒药物就成为了抗病毒的第一道防线.目前被批准上市的抗病毒药物有M2离子通道阻滞剂和神经氨酸酶抑制剂(neuraminidase inhibitors,NAIs)两大类.M2离子通道阻滞剂不良反应大,且只能防治甲型流感病毒,对乙型流感病毒无效;NAIs可以抑制高致病性的甲型和乙型流感病毒,已成为目前抗病毒药物研究的热点.目前已经上市的NAIs有奥司他韦、扎那米韦和帕拉米韦.本文介绍了NAIs的作用机制、药效学、药动学并着重对NAIs的临床研究进展进行综述.     

肝树突状细胞研究进展

肝树突状细胞属于抗原递呈细胞。由于肝树突状细胞数量少、分离困难,既往对它的特性认识不多。近年来认识到肝树突状细胞与其他部位的树突状细胞有不同的特性,并在肝炎、肝癌和肝移植免疫排异等疾病的发生、发展过程起重要作用。现就肝树突状细胞的研究进展作一综述。