Comparison of Sputum and Serum Eosinophil Cationic Protein (ECP) Levels in Nonatopic Asthma and Chronic Obstructive Pulmonary Disease

The aim of the present study was to investigate whether sputum eosinophil cationic protein (ECP) concentrations could be a useful marker in the differential diagnosis between intrinsic asthma and chronic obstructive pulmonary disease (COPD). For this purpose total blood eosinophil counts were obtained and concentrations of serum and sputum ECP from 10 nonatopic asthmatics with a mild attack and 9 COPD patients with acute exacerbation were measured by radioimmunoassay. Mean serum ECP concentration was 54.3 ± 23.0 g/L in the asthmatic group and 83.3 ± 79.2 g/L in the COPD group (p: n.s.). In the group of asthmatics mean sputum ECP level was 984.5 ± 1245.5 mg/L/g sputum and in the COPD group it was 417.5 ± 363.5 mg/L/g sputum. There was no significant difference in sputum ECP levels between patients with asthma and COPD. We conclude that neither sputum nor serum ECP levels are useful markers in differential diagnosis of asthma attack and acute exacerbation of COPD.     

Utility of pulmonary function testing in the management of chronic obstructive pulmonary disease

This study sought to measure the effect of pulmonary function testing (PFT) data on the decisions made by generalist physicians in the management of chronic obstructive pulmonary disease (COPD). 148 physicians were randomly assigned to two groups, both of which were asked to manage two identical fictitious but representative cases of COPD, which included history, physical, x-ray, and laboratory results. The experimental group received PFT results in addition. No significant difference was noted between the two groups in management based on availability of PFT data. The optimum utility of PFT data in the management of COPD may be exaggerated and has yet to be determined. Received from the Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin. Presented at the Annual Scientific Meeting of the American College of Chest Physicians, October 28, 1992, Chicago, Illinois.     

Intraparenchymal fetal striatal transplants and recovery in kainic acid lesioned rats

Striatal kainic acid (KA) lesions induce behavioral and biochemical deficits which resemble symptoms encountered in patients suffering from Huntington's disease. In rats with KA lesions, fetal striatal transplants have shown to reverse the pervasive nocturnal hyperactivity induced by the lesion. In the present study 4.6 mm3 of fetal striatal tissue were delivered bilaterally into the anterodorsal portion of the lesioned caudate nucleus. Care was taken to deliver the transplant within the host parenchyma and away from the lateral ventricles. Locomotor behavior analyzed using the Digiscan animal activity monitors before and after the transplants demonstrated a reversal of the hyperactivity following transplants in 70% of lesioned animals. Microinjections of horseradish peroxidase delivered into the globus pallidus and substantia nigra of a small group of functionally recovered transplanted animals, did not reveal evidence for reinnervation between host nigra or pallidum and the transplant at 10 weeks post-transplantation. Other laboratories have reported anatomical connections by 6 months post-transplantation. Ventricular/brain ratios demonstrated that intraparenchymal transplants significantly reduced the ventricular dilation following KA lesion. These results suggest that functional recovery can be obtained when the transplant is immersed into the host's striatal parenchyma regardless of the existence of long-range anatomical connections.     

Cardia: study design, recruitment, and some characteristics of the examined subjects

In 1984, a prospective cohort study, Coronary Artery Risk Development in Young Adults (CARDIA) was initiated to investigate life-style and other factors that influence, favorably and unfavorably, the evolution of coronary heart disease risk factors during young adulthood. After a year of planning and protocol development, 5,116 black and white women and men, age 18-30 years, were recruited and examined in four urban areas: Birmingham, Alabama; Chicago, Illinois; Minneapolis, Minnesota, and Oakland, California. The initial examination included carefully standardized measurements of major risk factors as well as assessments of psychosocial, dietary, and exercise-related characteristics that might influence them, or that might be independent risk factors. This report presents the recruitment and examination methods as well as the mean levels of blood pressure, total plasma cholesterol, height, weight and body mass index, and the prevalence of cigarette smoking by age, sex, race and educational level. Compared to recent national samples, smoking is less prevalent in CARDIA participants, and weight tends to be greater. Cholesterol levels are representative and somewhat lower blood pressures in CARDIA are probably, at least in part, due to differences in measurement methods. Especially noteworthy among several differences in risk factor levels by demographic subgroup, were a higher body mass index among black than white women and much higher prevalence of cigarette smoking among persons with no more than a high school education than among those with more education.     

Combined percutaneous antegrade and cystoscopic retrograde approach in the treatment of distal ureteric fistulae

Purpose To determine the efficacy of a cystoscopic approach, as definitive treatment of ureteral fistulae, after failure of antegrade ureteral stent insertion.Methods Of 43 ureter fistulae encountered over 4 years, 10 postoperative and/or postradiotherapy fistulae could not be stented via an antegrade approach alone. A cystoscopic approach was used, with the antegrade approach available as back-up, if necessary.Results In two patients the ureteral orifice could not be visualized cystoscopically, thus precluding the retrograde approach. In the eight remaining patients, the retrograde approach alone never allowed successful stenting. In six patients, combined antegrade and retrograde approaches permitted stent insertions. In three of those six patients, a complex catheterization procedure was necessary. In two patients the combined approach failed altogether. Therefore, 6 of 10 patients underwent a successful stenting procedure with the combined approach; all ultimately closed the fistula.Conclusion Antegrade stent insertion remains the treatment of choice for ureteral leaks. If the antegrade approach fails, the retrograde approach alone is not likely to be successful. Instead, a combination of both approaches often does succeed.     

A continuous striatal infusion of 6-hydroxydopamine produces a terminal axotomy and delayed behavioral effects

Rat models of Parkinson's disease typically employ a rapid nigral injection of 6-hydroxydopamine (6-OHDA) to produce a near-complete loss of nigrostriatal dopamine neurons, and thus model end stage disease. The present report describes the use of a continuous, low dose infusion of 6-OHDA into the striatum which produces a terminal axotomy of nigrostriatal dopamine neurons and protracted behavioral response. A solution of 6-OHDA in 0.4% ascorbate, delivered at 37°C from osmotic minipumps, was stable for 8 days as determined by its retained toxicity to a dopaminergic neuroblastoma cell line. The continuous infusion of 0.2 μg 6-OHDA per h did not affect the striatal uptake of [³H]GABA, [³H]choline, or [³H]glutamate but reduced [³H]dopamine uptake by 55% within 1.5 days after the start of the infusion. The striatal infusion of 6-OHDA produced a dose-dependent reduction of striatal dopamine and DOPAC levels but did not alter HVA, 5-HT, or 5-HIAA. An increase in amphetamine-induced ipsiversive rotations occurred within 1.5 days after the acute striatal injection of 20 μg or 30 μg of 6-OHDA but required 4 days to develop with the continuous 6-OHDA infusion. The topography of the lesion mapped by [³H]mazindol binding showed that, begining by 1.5 days, a diffuse depletion of terminals encompassed much of the striatum in the 30 μg acute injection group, whereas in the continuously infused rats, the lesion was apparent only by 4 days and was restricted to a smaller and more completely lesioned area. Unlike acutely lesioned animals, continuously infused rats revealed no obvious loss of dopamine neurons in the pars compacta by 5 weeks after 6-OHDA. The continuous striatal infusion of 6-OHDA can produce a topographically limited terminal axotomy of dopamine neurons and a protracted behavioral impairment.     

血脂代谢紊乱与冠状动脉病变严重程度的关系

目的:分析血脂代谢异常与冠状动脉狭窄程度的关系.方法:对366例因胸痛而就诊的患者行选择性冠状动脉造影,按冠状动脉狭窄程度分为正常对照组、单支病变组、双支病变组、多支病变组.同时观察患者血脂各成分,并对各组指标进行统计学分析.结果:总胆固醇(TC)、甘油三脂(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C),在各组之间存在差异,尤其多支病变组与正常组之间差异显著(P＜0.01).TC、TG、LDL-C随冠状动脉病变加重而增加,HDL-C随冠状动脉病变加重而减少,LDL-C与冠状动脉狭窄程度呈正相关,HDL-C与冠状动脉狭窄程度呈负相关.结论:血脂代谢紊乱与冠状动脉狭窄的发生发展有内在的联系,对于预测有无冠状动脉病变及其进展有一定临床意义.     

14年间住院病人主要病因和死因变化趋势

目的　探讨 1990～ 2 0 0 3年住院病人的主要病因和死因及变化趋势的方向、强度。方法　分析我院 1990～ 2 0 0 3年录入广东省卫生厅“广东省医院统计病案管理系统”的统计资料 ,计算住院病人主要疾病、死亡病因 1990～ 1999年、2 0 0 0～ 2 0 0 3年两个阶段的年均构成比 ,观察顺位变化 ,用回归分析的方法计算变化趋势。结果　 1) 1990～ 1999年主要住院病因顺位是消化系统疾病 (15 .6 2 % )、损伤和中毒 (13.16 % )、循环系统疾病 (11.2 4 % )、呼吸系统疾病 (10 .4 7% )、恶性肿瘤 (10 .4 3% ) ;2 0 0 0～ 2 0 0 3年顺位是循环系统疾病 (16 .4 1% ) (其中缺血性心脏病占 2 2 .98% ,脑血管病占 39.6 8% ) ,损伤和中毒(12 .80 % )、消化系统疾病 (11.76 % )、呼吸系统疾病 (9.5 3% )、恶性肿瘤 (8.73% ) ,循环系统疾病呈显著上升趋势 (B =4 .2 6 ,P <0 .0 5 ) ,消化系统疾病呈显著下降趋势 (B =- 3.17,P <0 .0 5 ) ;2 ) 1990～ 2 0 0 3年住院死因顺位为恶性肿瘤 (2 9.2 9% )、循环系统疾病 (2 5 .91% )、损伤和中毒 (12 .6 3% )、呼吸系统疾病(6 .18% ) ,消化系统疾病 (5 .77% ) ;2 0 0 0～ 2 0 0 3年恶性肿瘤呈显著下降趋势 (B =- 3.88,P <0 .0 5 ) ,循环系统疾病呈上升趋势但无显著性 (B =0 .84 ,P >0     

血液透析患者C-反应蛋白与心血管疾病的关系

目的:探讨血液透析患者的慢性炎症与心血管疾病的关系.方法:对64例稳定的血液透析患者进行统计分析慢性炎症的标志物-血C-反应蛋白(C-reactive protein,CRP)和心血管疾病(心肌梗死、心绞痛及心力衰竭)的关系.结果:64例患者中有28.1%(18/64)的患者CRP超过正常值(正常值为＜5 mg/L),平均血CRP12.61 mg/L±4.81 mg/L(5.90 mg/L～21.4 mg/L).其中有心血管疾病患者27例,无心血管疾病患者37例.心血管疾病组的CRP(7.79 mg/L±6.61 mg/L)明显高于无心血管疾病组(2.14 mg/L±3.59 mg/L)(P＜0.01).多元Logistic逐步回归分析证实:CRP是心血管疾病的独立致病因素.结论:血液透析治疗的患者确实存在慢性炎症;慢性炎症与心血管疾病有关.     

中药聪脑汤治疗老年性痴呆的临床研究

目的:比较聪脑汤和双益平(石衫碱甲)片剂治疗老年性痴呆(阿尔茨海默病,Alzheimerdisease,AD)的疗效。方法:35例AD病人随机分为2组,聪脑汤组20例,双益平组15例;分别给予聪脑汤50ml,口服,日3次和双益平片剂0.15mg,口服,日2次,两组疗程均为8w。结果:与治疗前相比,两组长谷川痴呆量表(HDS-R)积分均有显著性改善(P<0.05),聪脑汤组和双益平组总有效率分别为75%和73.4%,两组比较差异无显著性。结论:聪脑汤对AD临床症状有一定改善作用。