42例晚期糖尿病肾病的血液透析治疗

目的:探索出晚期糖尿病肾病患者在血液透析过程中,如何减少并发症,提高对并发症的疗效,延长存活寿命,提高生活质量.方法:除应用一般性碳酸盐透析外,采用不同透析技术,重点对充血性心力衰竭、心包炎、高血压、低血压、贫血以及胰岛素的使用提出了特殊治疗方案.结果:经采取不同透析技术,提高了对并发症的疗效,提高了病人生活质量,降低了死亡率.结论:对晚期糖尿病肾病患者,尽量做到早透析,透析个体化,根据病情采取不同治疗方案,这是减少并发症提高存活率的关键.     

Growth of diploid cells from breast cancers

Cell cultures were derived from normal and cancerous breast tissues and from metastases by methods that selected for relatively adherent epithelial aggregates. Karyotypic analyses of first or second passage cultures yielded predominantly normal diploid cells. Nonclonal aberrations were more common in tumor-derived than in normal cultures. Three of the cultures that originated from metastases were characterized by abnormal clones. These results support observations based on DNA content, which indicate that a considerable fraction of breast cancers are composed predominantly of diploid cells. They differ greatly from chromosomal findings in long-term cultures of tumor effusions and thus emphasize the karyotypic diversity that can be found in tumors from a single tissue of origin--the breast.     

Variant Philadelphia chromosome translocations in two patients with chronic myelogenous leukemia

Two patients with chronic myelogenous leukemia and new variant Philadelphia chromosome translocations are reported. In one case, a 41-year-old male, a 10;22 translocation was found in all bone marrow cells examined. Furthermore, the Y chromosome was missing in 90% of the analyzed metaphase cells. In the second patient, a 22-year-old male, all the marrow cells contained a complex rearrangement involving chromosomes No. 2, 9, and 22.     

The aniridia-Wilms tumor association: The critical role of chromosome band 11p13

The role of del (11)(p13) as a cause of aniridia, with and without Wilms tumor, is strengthened by demonstration of this chromosome aberration in 3 patients: monozygous twin girls, both of whom have aniridia and mental retardation and one of whom has a Wilms tumor; and an unrelated boy with aniridia and ambiguous genitalia. The break points defining the interstitial deletion for the twins are 11p13 and 11p15.1, while for the boy they are 11p1302 and 11p14.1. These patients and their karyotypes substantiate the critical importance of chromosome band 11p13 (or its hemizygous representation) in the development of aniridia and an associated Wilms tumor diathesis, as had been suggested previously (Riccardi VM, Sujansky E, Smith AC, Francke U, (1978): Pediatrics 61, 604-610).     

慢性肾功能不全患者血清及尿液超氧化物歧化酶含量的变化

用放射免疫分析测定７５例肾病患者血清和尿液含铜锌离子超氧化物歧化酶（Ｃｕ－Ｚｎ－Ｓｕｐｅｒｏｘｉｄｅｄｉｓｍｕｔａｓｅ，简称Ｃｕ－Ｚｎ－ＳＯＤ或ＳＯＤ－１）的含量，并与５１名健康人对比。结果显示，慢性肾功能不全（ＣＲＦ）血透组患者血清ＳＯＤ－１含量显著增高（Ｐ＜０．０１），随着血液透析期的延长，其含量有渐升趋势；非血透组略有降低（Ｐ＞０．０５；其它肾病组明显降低（Ｐ＜０．０１）。三组患者尿液ＳＯＤ－１含量呈不同程度增高（Ｐ均＜０．０１），并随着病变的严重程度而增幅更明显，血／尿ＳＯＤ－１比值也随之降低。本文初步分析了这些变化的原因及意义。     

Membrane-associated proteins of T4-infected Escherichia coli

During the prereplicative period after the infection of Escherichia coli by phage T4, more than 50 proteins are synthesized. Many of them have been identified with their corresponding genes. Among them, at least 13 are selectively enriched in the membrane preparation. They include the products of the two rII genes, genes 39, 52 (DNA-delay), and others not yet identified. The majority of these proteins (90%) are extractable by the detergent, sarkosyl, and are possibly associated with the inner or cytoplasmic membrane. Based on their electrophoretic migration in SDS-polyacrylamide gels and on their tryptic fingerprints, these proteins are found to be phage induced. Two of the newly synthesized proteins that are selectively enriched in the cell wall or outer envelope fraction are found to be identical with two envelope proteins of the host cell. They are continually synthesized after phage infection although general host protein synthesis is shut off.     

IL-4–BATF signaling directly modulates IL-9 producing mucosal mast cell (MMC9) function in experimental food allergy

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A low molecular weight heparin in hemodialysis

Summary The purpose of our study was to check whether the dosage recommended for the low molecular weight heparin tested here, i.e., 50% of the corresponding unfractionated heparin dose, is adequate to prevent clot formation in the extracorporeal system. Sixteen dialysis treatments of 4–5 h were given to each of six chronic dialysis patients. In dialyses 1, 2, 15 and 16 unfractionated heparin (initial dose 35 IU/kg, continuous dose 20 IU/kg/h) was given, and in dialyses 3–14 low molecular weight heparin (initial dose 17.5 anti-Xa U/kg, continuous dose 10 anti-X U/kg/h). At these dose levels of low molecular weight heparin, clot formation occurred in the extracorporeal system in five of the six patients, despite the fact that the plasma anti-Xa level of 0.5 U/ml recommended by the manufacturer had been attained. For this reason the continuous dose of low molecular weight heparin had to be raised to approx. 80% of the corresponding continuous dose of unfractionated heparin. A plasma anti-Xa level of 0.7 U/ml is necessary to prevent extracorporeal clot formation.Abbreviations anti-Xa U Anti-factor Xa unit - aPTT Activated partial thromboplastin time - AT III Antithrombin III - IU International unit - LMWH Low molecular weight heparin - UFH Unfractionated heparin     

Increased brain natriuretic peptide and atrial natriuretic peptide plasma concentrations in dialysis-dependent chronic renal failure and in patients with elevated left ventricular filling pressure

Brain natriuretic peptide (BNP) and atrial natriuretic peptide (ANP) plasma concentrations were measured in patients with dialysis-dependent chronic renal failure and in patients with coronary artery disease exhibiting normal or elevated left ventricular end-diastolic pressure (LVEDP) (n = 30 each). Blood samples were obtained from the arterial line of the arteriovenous shunt before, 2 h after the beginning of, and at the end of hemodialysis in patients with chronic renal failure. In patients with coronary artery disease arterial blood samples were collected during cardiac catheterization. BNP and ANP concentrations were determined by radioimmunoassay after Sep Pak C₁₈ extraction. BNP and ANP concentrations decreased significantly (P < 0.001) during hemodialysis (BNP: 192.1 ± 24.9, 178.6 ± 23.0, 167.2 ± 21.8 pg/ml; ANP: 240.2 ± 28.7, 166.7 ± 21.3, 133.0 ± 15.5 pg/ml). The decrease in BNP plasma concentrations, however, was less marked than that in ANP plasma levels (BNP 13.5 ± 1.8%, ANP 40.2 ± 3.5%; P < 0.001). Plasma BNP and ANP concentrations were 10.7 ± 1.0 and 60.3 ± 4. 0 pg/ml in patients with normal LVEDP and 31.7 ± 3.6 and 118.3 ± 9.4 pg/ml in patients with elevated LVEDP. These data demonstrate that BNP and ANP levels are strongly elevated in patients with dialysis-dependent chronic renal failure compared to patients with normal LVEDP (BNP 15.6-fold, ANP 2.2-fold, after hemodialysis; P < 0.001 or elevated LVEDP (BNP 6.1-fold, ANP 2.0-fold, before hemodialysis; P < 0.001), and that the elevation in BNP concentrations was more pronounced than that in ANP plasma concentrations. The present results provide support that other factors than volume overload, for example, decreased renal clearance, are also involved in the elevationin BNP and ANP plasma levels in chronic renal failure. The stronger elevation in BNP concentrations in patients with chronic renal failure and in patients with elevated LVEDP and the less pronounced decrease during hemodialysis suggest a different regulation of BNP and ANP plasma concentrations.[/ p]Abbreviations ANP atrial natriuretic peptide - BNP brain natriuretic peptide - LVEDP left ventricular end-diastolic pressure Correspondence to: C. Haug     

Conversion of nonfusing mumps virus infections to fusing infections by selective proteolysis of the HN glycoprotein

Mumps virus strains differ in their ability to induce cell fusion following an infection: strains with activeneuraminidase (NANase) fail to cause cell fusion, while strains with less active NANases cause cell fusion. When chymotrypsin is added to infected cells, cell fusion is amplified in a concentration-dependent manner for all mumps virus strains. Virions produced in such infections do not express HN glycoprotein-associated activities. Chymotrypsin treatment of purified mumps virus in vitro results in sequential cleavage into two glycopolypeptides, HNc1 (32K) and HNc2′ (41K), with concomitant loss of hemagglutinating and NANase activities, and infectivity. Further incubation with chymotrypsin causes complete degradation of HNc1 and digestion of HNc2′ to HNc2 (13K–19K). Both HNc2′ and HNc2 contain the [³H]palmitic acid label found in the HN polypeptide, which suggests that these fragments are associated with the viral membrane. Analyses of infected cells and released virions indicate that chymotrypsin acts similarly on HN exposed at the cell surface. Exogenous NAnase does not abolish the protease-augmented cell fusion though it does reduce cell fusion of untreated fusing strain infections. These results confirm that mumps virus HN glycoprotein is critically linked to cell fusion cytopathology and show that cyrptic cell fusion activity in nonfusing strain infections can be unmasked by the proteolytic removal of the HN glycoprotein.