米索前列醇用于晚期妊娠引产127例分析

目的 :探讨一种晚期妊娠安全、简便、有效的引产方法。方法 :选择正常单胎头位足月妊娠具有引产指征而无禁忌证的妇女 12 7例 ,随机分为二组 ,米索组用米索前列醇 2 5 μg置于阴道后穹窿 ,催产素组用催产素 2 .5IU加入 5 %葡萄糖 5 0 0ml内静滴。对引产有效率分娩时间和剖宫产率进行了对比观察。结果 :引产有效率 :米索前列醇组明显高于催产素组。 (P <0 .0 5 )分娩时间米索前列醇组和催产素组有显著差异 (P <0 .0 5 )。剖宫产率两组有明显差异 (P <0 .0 5 )。结论 :米索前列醇用于晚期妊娠计划分娩安全、简便、有效。     

米索前列醇用于晚期妊娠引产随机对照研究

为探讨米索前列醇用于晚期妊娠引产的效果及安全性 ,采用随机对照研究的方法对 2 85例足月孕妇 (孕周 38～ 42 )进行观察研究 ,米索前列醇组 140例 ,用 2 5μg米索前列醇 (以下简称米索 )阴道后穹隆上药 ;对照组 145例 ,催产素静脉滴注引产。结果 :米索引产组 (实验组 )引产成功率 97.14% ,明显高于对照组 82 .75 % (P<0 .0 5 ) ;实验组诱导产兆时间及总产程的时间明显短于应用催产素的对照组 ,差异有统计学意义 (P<0 .0 1)。两组的胎儿、新生儿情况、产后出血、产道撕伤、产后感染均无显著性差异。结论 :2 5μg米索阴道用药用于晚期妊娠引产的方法简单、可靠、安全 ,值得推广。     

孕妇要求的不合理剖宫产的影响因素分析

目的 分析孕妇要求剖宫产的原因。方法 通过配对病例对照研究及问卷调查的方法,分析３９３例不合理剖宫产孕妇的“剖宫产指征”,其中孕妇要求作剖宫产者２２６例,根据第一例要求剖宫产孕妇的妊娠及分娩情况选择配对的阴道分娩孕妇,对两组孕妇进行问卷调查,寻找孕妇要求剖宫产原因。结果 孕妇对分免的认识、对分免疼痛的恐惧、分娩的信心以及入院后医生交代病情对孕妇的影响在两组间差异有显著意义（Ｐ〈０．０５）。结论孕妇     

异氟醚分娩镇痛对母体及胎儿母体循环中cGMP水平的影响

目的;探讨镇痛浓度的异氟醚对母体及胎儿－母体循环中环磷酸鸟苷水平的影响。     

分娩镇痛的临床观察

目的 探讨布比卡因硬膜外自控镇痛和罗湃卡因蛛风膜下腔－硬膜外自控镇痛用于分娩的效果及对产程、母婴的影响。方法 ９０例初产妇分为３组,布比卡因硬膜外自控镇痛组（Ａ组,ｎ＝３０）、罗哌卡因蛛网膜下腔－硬膜外自控镇痛组（Ｂ组,ｎ＝３０）和对照组（Ｃ组,ｎ＝３０,未行分娩镇痛）,观察各组镇痛效果、产程时间、分娩方式血清皮质醇及新生儿Ａｐｇａｒ评分情况。结果 Ａ,Ｂ组镇痛效果满意,以Ｂ组为佳两组 产程未血清     

异氟醚分娩镇痛对母体血液动力学的影响

目的：前瞻性研究异氰醚分娩镇痛对母体血液动力学的影响。方法：应用国产无创性血液动力学测试仪,对分娩活跃期异氟醚分娩镇痛和对照组产妇共３０例的血液动力学状况进行检测。结果：;实验前后,各组母体血液动力学参数;心率（ＨＲ）,每搏量（ＳＶ）,每搏指数（ＳＩ）,心输出量（ＣＯ）,心脏指数（ＣＩ）,左室有效泵力（ＶＰＥ）,平均动脉压（ＭＡＰ）和总外周阻力（ＴＰＲ）均无显著差异;两组间无显著差异。     

Apolipoprotein E phenotypes in healthy normal controls and demented subjects with Alzheimer's disease and vascular dementia in Mie Prefecture of Japan

In order to clarify the association between apolipoprotein E4 (ApoE4) and the pathogenesis of Alzheimer's disease (AD), we analyzed the distribution of the apolipoprotein E (ApoE) phenotypes and the frequency of the apo E alleles epsilon2, epsilon3, and epsilon4 in Japanese healthy controls (n = 1090, an average age of 51.2+/-12.6 years) and demented patients (n=103, mean age of 73.6+/-9.2 years). Demented subjects were divided into three subgroups: early-onset AD group (EOAD; n=25, mean age 63.0+/-6.2 years), late-onset AD group (LOAD; n=33, mean age 79.3+/-5.1 years), and vascular dementia group (VD; n=45, mean age 75.3+/-8.0 years). The apolipoprotein E phenotype was determined by isoelectric focusing and immunoblotting. There were no significant differences in the distribution of the apo E phenotypes by gender or age, and the estimated frequencies of epsilon2, epsilon3 and epsilon4 were 0.05, 0.86 and 0.09, respectively, in the normal controls. There was a significant difference in the distribution of the apo E phenotypes between LOAD and elderly controls aged more than 65 years (P<0.0001). The distribution of the apo E phenotypes in EOAD was the same as that in LOAD. The frequency of the epsilon4 allele was significantly higher in LOAD (0.35, P<0.0001) and EOAD (0.28, P<0.0001) than that in the control subjects (0.07), but not in VD (0.12, P=0.1630). The present findings suggest that ApoE4 is related with both EOAD and LOAD, but not with VD, and support the hypothesis that it is a genetic risk factor of AD.     

Relationships of plasma tryptophan availability to course of illness and clinical features of alcoholism: a preliminary study

Rationale: Serotonergic (5-HT) mechanisms may be involved in impulse control (including anti-social behavior) across psychiatric syndromes. Age of onset may differentiate alcoholics on psychopathological characteristics associated with impulse control, especially mood disturbance, hostility, and a broad range of antisocial behaviors. Thus, there may be a predictable relationship between markers of 5-HT function and age of onset-related characteristics. Objective: We tested the hypothesis that there would be a predictable relationship between the ratio of plasma tryptophan to large neutral amino acids (i.e. TRYP/LNAA ratio), a marker of 5-HT function, age of onset and related psychopathological characteristics associated with impulse control. Methods: Fifty-eight male and female DSM-IV diagnosed alcoholics attending an outpatient treatment center completing a comprehensive psychopathological assessment, and from whom blood samples were obtained. Results: Plasma TRYP/LNAA ratio was positively correlated with symptoms of dysphoria, and negatively associated with harm avoidance on Cloninger’s Temperament and Character Inventory. Low tryptophan availability was associated with antisocial-type personality characteristics. Interestingly, the few (nine) subjects who had both early onset alcoholism and antisocial personality disorder had a higher plasma tryptophan but similar TRYP/LNAA ratio to the others. Conclusions: These data suggest that a low plasma TRYP/LNAA ratio is associated with susceptibility to anxiety, antisocial-type personality characteristics, and an early age of onset for alcoholism. In contrast, a high plasma TRYP/LNAA ratio is associated with a later onset of alcoholism and dysphoria. Received: 26 May 1998/Final version: 24 November 1998     

Epilepsies with astatic seizures of late onset.

In 17 patients with a long course of epilepsy astatic seizures became apparent after the age of 14 years. In the patients' childhood astatic seizures had not been observed. The patients suffered from epilepsies with absences and awakening grand mal or psychomotor fits and sleeping grand mal. The EEG revealed spike-wave variant and spike-and-wave complexes as in the Lennox-Gastaut syndrome. Age dependency of Lennox-Gastaut syndrome is discussed. The described type of epilepsy can be understood as a "Lennox-Gastaut syndrome of late onset".     

Mechanisms underlying the slow onset of action of a new dihydropyridine,NZ-105, on a cultured smooth muscle cell line

Summary The inhibitory effect of a new dihydropyridine derivative, (±)-2-[benzyl(phenyl)amino]ethyl-1,4-dihydro-2,6-dimethyl-5-(5,5-dimethyl-2-oxo-1,3,2-dioxaphosphorinan-2-yl)-4-(3-nitrophenyl)-3-pyridinecarboxylate hydrochloride (NZ-105), on whole cell Ca²⁺ current (I_Ca) in cultured vascular smooth muscle cells was investigated with the patch clamp technique. NZ-105 blocked I_Ca in a concentration-dependent manner when the command pulse ranged from +10 mV to –50 mV. The inhibitory effect of NZ-105 appeared at concentrations higher than 10 mol/l and it blocked I_Ca completely at a concentration of 1 nmol/l. The concentration which produced the half-maximal inhibitory effect was estimated to be around 20 mol/l. NZ-105 (500 pmol/l) completely blocked I_Ca elicited by depolarization to + 10 mV at a holding potential of –40 mV, whereas it blocked I_Ca by only 67% at a holding potential of –90 mV. NZ-105 (100 mol/l) shifted the steady-state inactivation curve by 40 mV to more negative potentials without affecting its slope factor. The blocking time constant of 500 mol/l NZ-105 was 57.6 + 9.9 s at a holding potential of –70 mV. These results indicate that NZ-105 has characteristics typical of dihydropyridines and binds to Ca²⁺ channels of vascular smooth muscle cells with a high affinity. They also suggested that the slow onset of its action is due to the slow binding of the drug to Ca²⁺ channels. Send offprint requests to S. Kokubun at the above address