Assessment of changes in 1-second forced expiratory volume in bronchial provocation testing

The question of whether functional residual capacity (FRC) falls in infants during active sleep has been clouded by studies using different subject groups and techniques for measurements of lung volume and determination of sleep state. Twenty healthy full-term infants within the first week of life participated in the present study. Neurophysiological and behavioral criteria were used to define sleep state, and measurements of FRC were made using a specially constructed closed-circuit helium dilution system. Regularity of respiration was recorded using magnetometers on the chest and a modified respirator monitor. Results showed that no significant changes in FRC occurred, related either to sleep state or to regularity of respiration. In addition, we failed to detect any differences in FRC between the sexes. Pediatr Pilmonol. 1989; 7:71–77 .     

Validity and ethics of penile circumference measures of sexual arousal: A reply to McConaghy

McConaghy (1989) argued that the validity of penile circumference responses (PCRs) is at best unestablished and that penile volume responses (PVRs) have been demonstrated to be clearly superior indices of sexual arousal and orientation. In his critique, McConaghy stated that (i) penile erection has been incorrectly identified with sexual arousal, (ii) that PCRs have not been shown to accurately discriminate between divergent patterns of sexual arousal (including paraphilias), (iii) that the methodologies used to compare the two types of transducers are inappropriate, and (iv) that PCRs should not be used for diagnostic and treatment decisions. In this paper, McConaghy's criticisms are reviewed in the context of the existing literature on the subject. Although PCRs and PVRs involve different methodologies, they generally yield results that bear more similarities than differences. Furthermore, there is an extensive and growing literature on the use of PCR measures with various paraphilias. Several of McConaghy's arguments should be considered tentative while others are clearly unsubstantiated. Most of McConaghy's concerns over the validity and uses of PCR measures are empirical questions. Suggestions for future research are offered.     

Influence of ileal pouch capacity and anal sphincteric function on the clinical outcome after ileal pouch-anal anastomosis

This study was designed to determine the influence of ileal pouch capacity and anal sphincteric function on the clinical outcome after ileal pouch-anal anastomosis. A total of 24 patients who had undergone ileal pouch-anal anastomosis (J pouch) for ulcerative colitis were studied. The 24-hour stool frequency was found to be inversely correlated with the sensitivity threshold volume (STV), maximal tolerance volume (MTV), and distensibility, but was independent of the maximal resting pressure and maximal squeeze pressure. Patients experiencing nocturnal fecal incontinence had maximal resting pressures that were significantly lower than those of nocturnally continent patients. Among the patients with fecal incontinence, those with frequent soiling had lower resting pressures, STV, and distensibility than the patients with intermittent spotting. In addition, the STV in patients needing nocturnal evacuation were lower than those of patients who did not evacuate after falling asleep. The conclusions are as follows. Both stool frequency and the need for nocturnal pouch evacuation correlated directly with pouch volume. Anal incontinence was more common in patients with low internal sphincteric function. In addition, frequent and gross nocturnal incontinent patients demonstrate a worse function in both the anal sphincter and reservoir than those with intermittent spotting.     

In-vivo studies on Haemaccel-fibronectin interaction in man

An enzyme-linked immunoassay has been recently set up for direct measurement of the binding capacity of plasma fibronectin to gelatin. This binding capacity could be completely inhibited in vitro by an eight-fold excess of gelatin, of Haemaccel, but not of Geloplasma. On the contrary, the levels of immunoreactive fibronectin measured by laser nephelometry did not change, in presence of 10 to 1000 micrograms ml-1 of gelatin, of Haemaccel or of Geloplasma. When infused into normal volunteers, Haemaccel provoked a strong and immediate inhibition of the plasma fibronectin binding capacity to gelatin. This inhibition was dose-dependent and maximal after infusion of 500 ml of Haemaccel. Twenty-four hours after this infusion, there was a progressive recovery of the gelatin-binding capacity, which was almost completely achieved 96 h later. The formation of complexes between Haemaccel and fibronectin was demonstrated by gel filtration chromatography and by affinity chromatography. Immunoreactive plasma fibronectin levels remained unchanged up to 24 h after infusion of 500 ml of Haemaccel. A transient decline to 50% of its initial value then occurred the second day after the infusion. Therefore, a delay existed between the formation of fibronectin-Haemaccel complexes and their elimination from the bloodstream. This delay decreased when smaller volumes of Haemaccel were infused, which strongly suggests that plasma fibronectin is cleared by means of Haemaccel and does not seem to play a role of opsonin in these conditions.(ABSTRACT TRUNCATED AT 250 WORDS)     

Bladder filling by autologous urine production during cystometry: a urodynamic pitfall!

AIMS: The rate of autologous urine production should not have a major disturbing influence on cystometric urodynamic parameters such as first filling sensation, normal desire to void, strong desire to void, and cystometric bladder capacity. Instructions to patients and drinking behavior can have considerable impact, especially if filling cystometry is preceded by free uroflowmetry. We studied the influence of autologous urine production during filling cystometry on total bladder volume. METHODS: Urodynamic investigations performed between September of 2000 and February of 2001 were analyzed. Only those urodynamic investigations for which total bladder capacity could be calculated were taken into account (i.e., catheterization before and after cystometry and no urine loss during the investigations). RESULTS: After screening, 186 investigations were used for further analysis. Mean filled volume (external infusion plus autologous urine production) was 346 +/- 152 mL, but mean real bladder capacity (i.e., voided volume + residual urine) was 391 +/- 170 mL. In all patients, 14% extra urine was produced due to autologous urine production (mean filling rate, 6.1 mL/min). In 42% of the investigations, the real bladder capacity was more than 110% of the infused volume. In 18% of the patients, the contribution of natural bladder filling was more than 25% of the infused volume. CONCLUSIONS: Natural bladder filling plays a substantial role during filling cystometry and has a disturbing influence on calculated urodynamic parameters. Attention should be paid to patient instructions before the urodynamic investigation. The combination of free uroflowmetry followed by filling cystometry should be avoided. This avoidance is especially important if interventional studies are performed. Careful interpretation of studies depending on bladder capacity parameters is mandatory, and such parameters should be corrected for autologous bladder filling.     

电针对糖尿病大鼠学习记忆的影响

目的：探讨电针对糖尿病所致学习记忆损害的防治作用。方法：采用四氧嘧啶腹腔注射法制备糖尿病大鼠模型，观察电针6周后糖尿病大鼠血糖、体重的变化，并用Morris水迷宫法观察电针对糖尿病大鼠学习记忆的影响。结果：（1）治疗后电针组与模型组的体重均明显低于正常组，电针组体重明显高于模型组（P＜0．05）；（2）电针组治疗前后血糖差异非常显（P＜0．01），但仍然高于正常组（P＜0．01）；（3）模型组的逃避潜伏期较正常组明显延长，P＜0．01。电针组的逃避潜伏期较模型组明显缩短，P＜0．05，与正常组比较，其逃避潜伏期仍较长，但两之间差异无显性，P＞0．05。与正常组比较，模型组大鼠每天的逃避潜伏期均较正常组延长，差异有显意义，P＜0．05或P＜0．01。与模型组比较，电针组第1、2、4、5天的每天逃避潜伏期均较模型组明显缩短，P＜0．05或P＜0．01；电针组第3天的逃避潜伏期较模型组有所缩短，但差异无显意义，P＞0．05。与正常组比较，电针组大鼠每天逃避潜伏期均较正常组延长，但差异无显意义，P＞0．05。结论：（1）电针能够降低糖尿病大鼠血糖并增加其体重。（2）电针能够改善糖尿病大鼠的学习记忆能力。     

低浓度5-Fu24-小时持续化疗对BEL-7402肝癌细胞株的细胞周期的影响

目的研究低浓度5-Fu 24-小时持续化疗和高浓度5-Fu短时间化疗对BEL-7402肝癌细胞株的细胞周期的影响：方法用低浓度(1000．0μg/L)的5．Fu对BEL-7402肝癌细胞株进行持续24小时的培养(A组)，用高浓度(50000．0μg/L)的5-Fu对BEL-1 7402肝癌细胞株进行2小时培养(B组)，在培养后的不同时间点用流式细胞技术检测细胞周期的变化。结果A组结果显示：0h、4h、8h、12h、16h、20h和24h的S期细胞的百分数分别为25.23％、32．35％、39．28％、41．05％、46．02％、47．00％及47．14％。B组结果显示：0h、4h、8h、12h、16h、20h和24h的S期细胞的百分数分别为24．68％、68．43％、46．67％、43．67％、35．42％、33．22％及32．96％。结论5-Fu引起的S期细胞周期阻滞不但和浓度相关，也和作用时间相关。低浓度(1000．0μg/L)的5-Fu持续化疗较高浓度(50000．0μg/L)的5-Fu短时间(2小时)化疗更容易引起BEL-7402肝癌细胞株S期阻滞。     

The Effect of Cuts in Medicare Reimbursement on Hospital Mortality

Objective. To determine if patients treated at hospitals under different levels of financial strain from the Balanced Budget Act (BBA) of 1997 had differential changes in 30-day mortality, and whether vulnerable patient populations such as the uninsured were disproportionately affected.
Data Source. Hospital discharge data from all general acute care hospitals in Pennsylvania from 1997 to 2001.
Study Design. A multivariate regression analysis was performed retrospectively on 30-day mortality rates, using hospital discharge data, hospital financial data, and death certificate information from Pennsylvania.
Data Collection. We used 370,017 hospital episodes with one of four conditions identified by the Agency for Healthcare Research and Quality as inpatient quality indicators were extracted.
Principal Findings. The average magnitude of Medicare payment reduction on overall net revenues was estimated at 1.8 percent for hospitals with low BBA impact and 3.6 percent for hospitals with a high impact in 1998, worsening to 2 and 4.8 percent, respectively, by 2001. Operating margins decreased significantly over the time period for all hospitals ( p <.05). While unadjusted mortality rates demonstrated a disproportionate rise in mortality for patients from high impact hospitals from 1997 to 2000, adjusted analyses show no consistent, significant difference in the rate of change in mortality between high-impact and low-impact hospitals ( p =.04–.94). Similarly, uninsured patients did not experience greater increases in mortality in high-impact hospitals relative to low-impact hospitals.
Conclusions. An analysis of hospitalizations in the Commonwealth of Pennsylvania did not find an adverse impact of increased financial strain from the BBA on patient mortality either among all patients or among the uninsured.     

绿脓杆菌MSHA菌毛株菌苗与白血病免疫应答反应

绿脓杆菌(MSHA)菌苗是一种具有广谱抗感染效果的免疫调节剂。我们观察了20例白血病患者多次疫苗主动免疫的免疫应答反应,14例病人血中广谱抗体效价升高,临床上有很好的治疗反应,6例抗体效价无变化,而临床症状加重,最后均死于败血症。上述结果提示白血病病人对疫苗的免疫应答反应,在白血病缓解中起着重要作用,对临床早期准确判断白血病患者的预后很有意义。