限制性液体复苏孕兔失血性休克对肝功能的影响

目的:探讨限制性液体复苏孕兔失血性休克对肝功能的影响。方法:制备孕兔失血性休克模型,采取两种不同输液方法使失血性休克孕兔复苏,对比各组各时间点ALT的变化,观察处死后孕兔肝脏病理检查结果。结果:孕兔失血性休克后血清ALT增高,导致肝细胞功能损害;复苏后限制性输液(PLH组)和传统输液(PNL组)的ALT随着输液抢救逐步下降;在孕兔失血性休克模型的90、180、240min时,比较PLH组与PNL组血清ALT,见PLH组的ALT下降明显,两组有极显著差异(P<0.01),PLH组在4h时ALT值已达到正常水平。病理检查表明,假休克组的肝脏未发生明显的病理改变;休克未处理组肝脏结构破坏,充血肿胀、坏死;限制性输液组肝脏组织结构正常,有少量炎性细胞浸润;传统输液组肝脏结构基本正常,部分组织充血,大量炎性细胞浸润。结论:限制性输液能有效地保护肝细胞功能,减低谷丙转氨酶,减少肝脏病理损害,是抢救孕兔失血性休克的理想复苏方法。     

Vitiligo skin types in Koreans

There is uncertainty and controversy about the relationship between skin type and development of vitiligo. The present study was undertaken to study whether vitiligo patients have a different skin type than the control group. We investigated the skin types of 201 Korean vitiligo patients and 70 healthy Korean volunteers. Skin type was determined by the skin phototyping method proposed by Fitzpatrick. Compared to normal controls, skin type II was significantly less frequent and skin type V was quite common in the vitiligo group. These results suggest that people with dark skin have a higher probability of developing vitiligo than people with light skin.     

Dermatitis herpetiformis and vitiligo: report of a case and review of the literature

We describe the case of a 53-year-old woman presenting papulous and papulovesicular lesions that were highly pruritic, localized mostly in the achromic areas of vitiligo and symmetrically distributed on the elbows, the buttocks, the shoulders and the neck. The histopathological examination performed on the elbow's lesional skin showed the presence of neutrophils and fibrin microabscesses at the tips of dermal papillae, with a few eosinophils, and small separations between the dermis and epidermis just over the infiltrate. The overlying epidermis was uninjured. The performed tests detected IgA anti-endomysium, anti-thyrogloblin, anti-smooth muscle and anti-microsomal fraction autoantibodies; DIF showed the presence of IgA granular deposits at the dermo-epidermal junction, prevalently at the tips of dermal papillae. This is the tenth case reported of an association between dermatitis herpetiformis and vitiligo. Although the two disorders both have immunological pathogeneses, we think that the topographic coexistence of both disorders is coincidental.     

Deep brain stimulation of the nucleus accumbens reduces ethanol consumption in rats

Recent studies have shown that deep brain stimulation (DBS) of the nucleus accumbens (NAcc) has an inhibitory effect on drug-seeking behaviors including reinstatement responding for cocaine. The objective of the present study was to expand on these findings by assessing the effects of DBS on behaviors related to alcohol consumption. The specific aim of this study was to determine whether DBS delivered to either the shell or core of the NAcc would reduce ETOH intake in rats using a two-bottle choice limited access procedure. Long Evans rats were induced to drink a 10% ethanol solution using a saccharin fading procedure. Bipolar electrodes were implanted bilaterally into either the core or shell of the NAcc. During testing animals received DBS 5 min prior to and during a 30-minute test session in which both ETOH and water bottles were accessible. Current was delivered at amplitudes ranging from 0 to 150 µA. ETOH consumption was significantly reduced from baseline levels at the 150 µA current for both shell and core electrode placements. A significant current effect was not found for water consumption for either site. These results provide evidence that DBS delivered either to the nucleus accumbens core or shell subregions can significantly reduce ethanol intake in the rat.     

早期使用限制性液体复苏治疗重度骨盆骨折并创伤失血性休克的疗效评价

目的 评价重度骨盆骨折并创伤失血性休克早期采用限制性液体复苏的治疗效果,以提高治愈率. 方法 总结2002年1月-2006年12月急诊收治的重度骨盆骨折并创伤出血性休克患者96例,其中常规液体复苏组55例,限制性液体复苏组41例,对其创伤严重程度、休克程度、复苏开始时间、输入液量进行统计学分析,对比两组的治疗效果. 结果 常规液体复苏组输液量为(3 432±1 156)ml,治愈率为64%,死亡率为36%;限制性液体复苏组输液量为(2 685±524)ml,治愈率为83%,死亡率为17%.两组比较,差异有统计学意义(P＜0.05). 结论 重度骨盆骨折并创伤失血性休克采用限制性液体复苏方法救治可提高治愈率.     

Quality of life and psychological adaptation of Korean adolescents with vitiligo

Aim The aim of the study was to evaluate the impact of vitiligo on the quality of life and psychological adaptation in a Korean adolescent population. Methods Fifty‐seven adolescents aged 12 to 18 years with vitiligo were evaluated using self‐report scales, namely the Skindex‐29, Piers‐Harris self‐concept, Center for Epidemiologic Studies Depression Scale (CES‐D), and Revised Children’s Manifest Anxiety Scale (RCMAS). Results Mean Skindex‐29 subscales were as follow; 21.8 (global), 16.3 (symptom), 18.6 (function) and 29.5 (emotion). Several clinical variables, such as duration of vitiligo, facial involvement, history of previous treatment, and patient‐assessed severity, affected the Skindex‐29 subscales in various ways. However, differences in Skindex‐29 scores according to the type of vitiligo, extent of involvement, and family history were not observed. The Piers‐Harris self‐concept scores showed a negative correlation with Skindex‐29 scores, while other psychological measures (CES‐D and RCMAS) were positively correlated. Conclusion The quality of life of adolescents with vitiligo is closely related to the patients’ apprehensions about their disease, psychosocial adjustment, and psychiatric morbidity, rather than the clinical severity of the condition itself. Clinicians should recognize and deal with psychological adaptation along with medical intervention when treating adolescent patients with vitiligo.     

Increased micronucleus frequency in phytohaemagglutinin-stimulated blood cells of patients with vitiligo

Background Vitiligo is a relatively common, acquired pigmentary disorder characterized by areas of depigmented skin resulting from loss of melanocytes in the epidermis. Although several hypotheses have been proposed for the aetiology and pathogenesis of vitiligo, the cause of vitiligo remains unclear. Objective To evaluate spontaneous micronucleus (MN) frequency using the cytokinesis block MN assay to determine damages at the DNA or chromosome level in phytohaemagglutinin (PHA)‐stimulated blood cells of patients with vitiligo and healthy control subjects. Methods Peripheral blood samples were obtained and cultured from 21 patients with vitiligo (mean age: 21.48 ± 9.78 years) and 21 age‐ and sex‐matched healthy control subjects (mean age: 21.52 ± 9.80 years). MN values were scored in binucleated cells obtained from whole‐blood cultures of patients and control subjects. Results MN frequencies (mean ± SD) in PHA‐stimulated blood cells of patients with vitiligo and control subjects were 0.94 ± 0.58 and 0.58 ± 0.32, respectively. Compared with control subjects, MN frequencies of patients with vitiligo were found significantly higher than those of the control subjects (P = 0.012). Conclusion Our results indicate unexpectedly some chromosomal/DNA damage in whole‐blood cultures of patients with vitiligo. We do not know, however, if these chromosome/DNA instabilities observed in the cells of vitiligo patients resulted from the cause or from the consequences of the disorder.     

Low-energy helium–neon laser induces melanocyte proliferation via interaction with type IV collagen: visible light as a therapeutic option for vitiligo

Background The treatment of vitiligo remains a challenge for clinical dermatologists. We have previously shown that the helium–neon laser (He–Ne laser, 632·8 nm) is a therapeutic option for treatment of this depigmentary disorder. Objectives Addressing the intricate interactions between melanocytes, the most important cellular component in the repigmentation scheme of vitiligo, and their innate extracellular matrix collagen type IV, the current study aimed to elucidate the effects of the He–Ne laser on melanocytes. Methods Cultured melanocytes were irradiated with the He–Ne laser. Relevant biological parameters including cell attachment, locomotion and growth were evaluated. In addition, the potentially involved molecular pathways were also determined. Results Our results show that in addition to suppressing mobility but increasing attachment to type IV collagen, the He–Ne laser stimulates melanocyte proliferation through enhanced α2β1 integrin expression. The expression of phosphorylated cyclic‐AMP response element binding protein (CREB), an important regulator of melanocyte growth, was also upregulated by He–Ne laser treatment. Using a specific mitochondrial uncoupling agent [carbonyl cyanide m‐chlorophenyl‐hydrazone (CCCP)], the proliferative effect of the He–Ne laser on melanocytes was abolished and suppression of melanocyte growth was noted. Conclusions In summary, we have demonstrated that the He–Ne laser imparts a growth stimulatory effect on functional melanocytes via mitochondria‐related pathways and proposed that other minor pathways including DNA damage may also be inflicted by laser treatment on irradiated cells. More importantly, we have completed the repigmentation scheme of vitiligo brought about by He–Ne laser light in vitro and provided a solid theoretical basis regarding how the He–Ne laser induces recovery of vitiligo in vivo.