Thoracic empyema: a study of 56 patients

Fifty seven children with thoracic empyema (37 boys and 20 girls) aged less than 12 years were seen at the University of Port Harcourt Teaching Hospital between January 1989 and December 1991. Staphylococcus aureus was the most common organism isolated from the pus of these patients (36 (63%) patients). Pseudomonas aeruginosa, the next most common organism, was isolated in 10 (18%) patients. The most common symptoms at presentation were acute illness with fever and cough (51 (89%) patients). All the patients were treated with closed intercostal tube drainage and appropriate antibiotics. Decortication was resorted to in only one patient. There were two deaths and the overall survival rate was 97%.     

Catch-up growth up to ten years of age in children born very preterm or with very low birth weight

Background  

Improved survival due to advances in neonatal care has brought issues such as postnatal growth and development more to the focus of our attention. Most studies report stunting in children born very preterm and/or small for gestational age. In this article we study the growth pattern of these children and aim to identify factors associated with postnatal catch-up growth.     

Effect of clozapine on serum leptin,insulin levels,and body weight and composition in patients with schizophrenia

OBJECTIVE: Weight gain frequently occurs during treatment with clozapine. However, the pathophysiology of clozapine-induced weight gain remains unclear. The aim of this study was to investigate the influence of clozapine on hormones leptin and insulin in relation to body weight and composition measures to determine their contribution to clozapine-induced weight gain. METHOD: Data are reported on 19 patients with schizophrenia (11 women and 8 men) who completed 10 weeks of treatment with clozapine. Insulin levels, weight measurements, body mass index (BMI), and body composition measurements were evaluated at baseline and at the end of treatment. Leptin levels were assessed at baseline and after 4 and 10 weeks of treatment. Analysis of variance with repeated measures was used to evaluate changes in weight, body composition measures, leptin, and insulin. The Pearson correlations were used to assess the relationships between changes in hormone levels and weight along with body composition measurements. The correlations of change in Positive and Negative Syndrome Scale (PANSS) score with changes in hormone levels, weight gain and body composition measures were evaluated with Pearson correlations. RESULTS: Leptin and insulin levels did not show any significant alterations across time. The use of clozapine was associated with significant increases in BMI (F=19.8, P<.001), lean muscle mass (F=8.2, P=.01), and fat mass (F=15.4, P=.001), while total body fluid percentage (F=4.1, P=.05) significantly decreased. Improvement in PANSS scores was not correlated to change in leptin, insulin, weight, BMI, or body composition measurements. The change in leptin levels was correlated to change in body fat mass. CONCLUSION: The role of leptin in weight gain induced by clozapine might be a regulatory mechanism rather than being etiologic.     

Blood Group Chimerism as a Clue to Generalized Tissue Mosaicism

Blood group studies disclosed mosaicism of the red cells in a healthy male Negro donor who was subsequently also found to have mosaicism of skin and bone marrow with respect to XX-XY chromosomal constitution and whose skin showed unequal pigmentation. The two red cell populations were unequal in numbers with a ratio of approximately 10:1. The major population was group A, Jk^a negative and showed the sickling trait in wet films and by electrophoresis. The minor population was group B, Jk^a positive, did not sickle and contained only hemoglobin A. Both red cells were Le^a positive despite the fact that the propositus was a secretor. However, only A substance was secreted and it was demonstrated by salivary studies and with the help of complete family studies, that the minor genetic product which had produced the group B erythrocytes represented the gene contribution se se and was the source of Le^a substance sufficient to coat both red cell populations. The family studies showed that the propositus had received a 2 allele contribution from each parent and was therefore the result of double fertilization of a double egg nucleus presumably an ovum and a polar body.     

骨髓单个核细胞移植对心肌修复相关因子的调节作用

目的:干细胞移植后可以通过分化为心肌细胞、减少心肌重构等方面发挥改善心功能的作用。观察急性心肌梗死后进行骨髓单个核细胞移植对相关细胞因子的调节作用,探讨干细胞发挥改善心脏重构的可能机制。方法:实验于2006-01/2007-02在福建省高血压研究所完成。①实验材料:清洁级SD大鼠由上海实验动物公司提供。②实验方法:取SD大鼠骨髓,分离出单个核细胞,以DAPI标记骨髓单个核细胞。取体质量200～250g雄性SD大鼠24只,建立急性心肌梗死模型后,随机分为2组,实验组从股静脉注入同种异体大鼠骨髓单个核细胞1.0×107,对照组注入等量的生理盐水。③实验评估:于移植后4周采用免疫组组织化学法检测DAPI阳性细胞、肌钙蛋白阳性细胞、基质细胞源性因子1、转化生长因子β及大鼠心功能改变。结果:24只大鼠均进入结果分析。移植后4周实验组基质细胞源性因子1表达较对照组明显升高,转化生长因子β表达较对照组下降;实验组在免疫荧光显微镜下可观察到DAPI和肌钙蛋白阳性细胞,心功能较对照组明显改善。结论:骨髓单个核细胞移植改善急性心肌梗死大鼠心功能的同时伴有基质细胞源性因子1表达增加及转化生长因子β表达下降。     

Cognitive dysfunctions in patients with obsessive-compulsive disorder compared to the patients with schizophrenia patients: relation to overvalued ideas

OBJECTIVE: The clinical overlaps between schizophrenia and obsessive-compulsive disorder (OCD) seem to be related to thought disorders involving obsessions, overvalued ideas, and delusions. Overvalued ideas are beliefs falling in between obsessions and delusions and are stronger than obsessions but weaker than delusions. The goal of the present study was to compare patients with OCD to those with schizophrenia in terms of cognitive functions and to relate cognition and overvalued ideas in OCD. METHODS: Twenty three patients with OCD (free of depression), 24 patients with schizophrenia, and 22 healthy subjects matched to patients in age, gender, education, and hand dominance were included in the study. All subjects were administered neurocognitive tests assessing verbal learning-memory, executive functions, verbal fluency, attention and verbal working memory. RESULTS: Patients with schizophrenia showed worse performance on cognitive tests than the OCD and control groups. The severity of overvalued ideas was significantly correlated to cognitive functions in the OCD group. There were no significant differences in cognitive functions between schizophrenia group and the OCD patients who had higher scores on the Overvalued Ideas Scale (OVIS). CONCLUSION: Overvalued ideas in OCD may be related to cognitive dysfunctions in OCD and this subtype of OCD may have similar characteristics to schizophrenia in terms of cognition.     

Proliferation of human malignant hematopoietic cells in immunodeficient mice: suppression by antibody to pluripotent K-562 leukemia cells involves direct cytolysis and effector cells

Six human hematopoetic cell lines were successfully heterotransplanted into athymic (nude) and asplenic-athymic (lasat) neonatal mice. The tumors arising from leukemia and lymphoma cells could then be serially transplanted into adult nude mice. Seven days after the fourth serial mouse passage, each mouse was treated with goat immune gamma globulin against K-562 cells. One control group was treated similarly, but with nonimmune (normal) gamma globulin, while another control group was not treated. The goat gamma globulin was not toxic for nude and lasat mice, and the immune, but not the normal, gamma globulin suppressed local subcutaneous growth of myelosarcomas, lymphosarcomas, and Burkitt lymphoma cells. On the other hand, the growth of lung, breast, and prostatic carcinomas and a melanoma of human origin were not altered by the immune gamma globulin. Since suppression of cell growth occurred equally well in decomplemented mice, a complement-mediated cytotoxicity apparently cannot be considered as responsible for the abrogation. The Fab fragment of the immunoglobulin did not suppress the growth of the myelosarcomas. We conclude that antibody suppression of the in vivo proliferation was specific for malignant hematopoietic cells and that the Fc portion of IgG is necessary for in vivo cytolysis of leukemia cells. The most probable mechanisms are direct antibody cytolysis and antibody-dependent macrophage-mediated cytotoxicity.