Case Report: Giant choledochal cyst

We report an adult female with a rare giant choledochal cyst. The patient presented following a normal pregnancy with the classical triad of an abdominal mass associated with jaundice and right upper quadrant abdominal pain. The cyst was excised using an intramural technique and biliary reconstruction achieved with a Roux-en-Y hepaticojejunostomy. Our patient has remained well with no evidence of malignancy over a 12 year review period. The aetiology and current management of this condition are discussed.     

各型成人高原心脏病的临床特点

本文报告了303例各型成人高原心脏病的临床分析结果。成人高原心脏病单纯型比混合型具有发病急、心脏传导系统损害重、病变累及全心及治疗反应较好的特点。混合型系继发于高原红细胞增多症与高原高血压的慢性心脏损害。其消化系统与神经系统损害重。心高型以左心损害为主,左室扩大、左室肥厚、主动脉增宽弯曲及心律失常率分别高于心红型(P<0.05～0.01);心红型以右心损害为主,右室扩大、右室肥厚、肺动脉段与圆锥隆突率分别高于心高型(P<0.05～0.01);心红高型全心损害常见而且严重。根据各型成人高原心脏病的病理机制而采用不同治疗方法对提高该病的治愈率有重要意义。     

Glial cell line-derived neurotrophic factor (GDNF) gene expression in the human brain: A post mortem in situ hybridization study with special reference to Parkinson's disease

Summary Glial cell line-derived neurotrophic factor (GDNF) is a potent neurotrophic factor for dopaminergic neurons. Since dopaminergic neurons degenerate in Parkinson's disease, this factor is a potential therapeutical tool that may save dopaminergic neurons during the pathological process. Moreover, a reduced GDNF expression may be involved in the pathophysiology of the disease. In this study, we tested whether altered GDNF production may participate in the mechanism of cell death in this disease. GDNF gene expression was analyzed by in situ hybridization using riboprobes corresponding to a sequence of the exon 2 human GDNF gene. Experiments were performed on tissue sections of the mesencephalon and the striatum from 8 patients with Parkinson's disease and 6 control subjects matched for age at death and for post mortem delay. No labelling was observed in either group of patients. This absence of detectable expression could not be attributed to methodological problems as a positive staining was observed using the same probes for sections of astroglioma biopsies from human adults and for sections of a newborn infant brain obtained at post-mortem. These data suggest that GDNF is probably expressed at a very low level in the adult human brain and its involvement in the pathophysiology of Parkinson's disease remains to be demonstrated. GDNF may represent a powerful new therapeutic agent for Parkinson's disease, however.     

Distributive profiles of free and protein-incorporated tryptophan and valine in cerebral cortex slices from adult and 2-day-old rats

The distribution of the specific radioactivity and the incorporation into protein of [³H]-tryptophan and [³H]valine at varying layers from surface to centre were measured in incubated slices of cerebral cortices from infant and adult rats. Specific radioactivity in free amino acids was in both age groups highest in the intact surface layer. Incorporation of tryptophan into protein was even in slices from adult rats but much less than the average in the surface layers in slices from infant rats. Incorporation of valine exhibited similar heterogeneity in both age groups. The results suggest in brain slice preparations a zonal compartmentation of amino acid and protein metabolism which varies for different amino acids.     

新生鼠和成年鼠脑7种微量元素含量的比较

利用高频电感耦合等离子体原子发射光谱法（ICP－AES）测定Sprunge－Dawley大鼠新生期大脑皮层、海马、小脑、间脑和脑桥等部位的锌、铁、铜、锰、铬、锶、钼等7种微量元素的含量，并与成年动物做了比较。结果表明：（1）新生期大鼠全脑7种微量元素含量的多寡依次为：锌、铁、铬、锶、锰、铜、钼；成年期时钢跃居第四位，总含量低于新生期。（2）脑内不同部位微量元素的含量不同。新生大鼠海马和小脑内多数元素含量高于其他脑区，钼在间脑和海马中含量较高。成年鼠皮层、海马微量元素含量较高，皮层内铜、锶、钼含量最低。     

服用抗精神病药物的老年人与成年人心电图比较

目的：观察老年与成年精神病人服用抗精神病药物后的心电图（ＥＣＧ）改变。方法：８４例老年精神病病人（男性３５，女性４９例，年龄６３±ｓ３ａ）与１００例成年精神病病人（男性５０例，女性５０例，年龄４０±１０ａ），服用抗精神病药物前及服２ｍｏ以上的首次ＥＣＧ资料进行比较。抗精神病药包括吩噻嗪类、丁酰苯类及三环类抗抑郁剂和抗躁狂药等。结果：８４例老年病人中ＥＣＧ异常６３例（７５％），１００例成年人中ＥＣＧ异常４６例（４６％）（Ｐ＜０．０５）。结论：由于老年人服抗精神病药后易发生ＥＣＧ异常，因此开始剂量宜低，增量要小，严密监测心脏功能。     

成人先天性巨结肠症的诊断和治疗

目的成人先天性巨结肠症的诊断和手术方法的探讨。方法对本院31例成人先天性巨结肠症的临床表现,诊断和手术方法,进行了回顾性分析。结果 29例行 Swenson 手术,1例 Duhamel 手术,术后并发吻合口瘘5例(16.7%)。早期吻合口狭窄2例,28例获得随访,完全恢复正常排便功能23例(78%),4例轻度排便失禁,1例完全排便失禁。结论成人巨结肠症手术后并发症较婴幼儿高。全结肠显著肥厚扩张时,保留回盲部的手术,术后并发吻合口瘘的发生率高;采用全结肠直肠切除回肠直肠末端吻合,并作预防性回肠造瘘术,可预防吻合口瘘的发生。     

Adult adjustment of persons with severe/profound mental disabilities: A longitudinal study

The parents of 14 individuals with severe/profound mental disabilities were interviewed one and three years after their children graduated or aged out of high school. Two categories of information were sought concerning the adult adjustment of these individuals. General status variables included marital status, place of residence, agencies contacted concerning employment opportunities, financial resources, leisure activities, means of transportation, sources of help in resolving problems, and amount of postsecondary training. Employment variables included location of employment, wages, number of hours worked per week, and job benefits received. Results indicated that three years after exiting high school, all participants were very dependent upon others for housing, transportation, and financial assistance. Ten of the 14 individuals were employed 3 years after exiting high school, all in sheltered workshops.