High serum erythropoietin levels are normalized during treatment of congestive heart failure with enalapril

Eighteen patients with dilated cardiomyopathy (three female, mean age 57 years), were treated for 48 weeks with enalapril added to digoxin and diuretic therapy for congestive heart failure of New York Heart Association (NYHA) functional class II (three patients). III (eight patients) and IV (seven patients), respectively. Serum levels of erythropoietin (EPO) were raised at the start (37 +/- 12.8 pmol 1(-1); mean +/- SD) and were normalized during enalapril treatment (17.5 +/- 9.9 pmol 1(-1) at 48 weeks; P less than 0.001). Serum EPO correlated at the start with NYHA functional class (r = 0.68; P less than 0.05). Normalization of elevated serum EPO concentrations during treatment with enalapril paralleled clinical and haemodynamic improvement, and probably reflected relief from renal hypoxia.     

小鼠照射后小肠粘膜的髓外造血

本实验观察到小鼠屏蔽两后肢10Gy照射后21和30天,在小肠壁粘膜固有层出现了髓外造血,以十二指肠粘膜最为常见,其次为回肠,空肠粘膜内则未见到.其主要表现是在固有层见到红系、粒系和红粒混合等三种造血灶.文中对照射后小肠壁粘膜出现髓外造血的时间、分布及其发生机理进行了讨论.     

The upper urinary tract following a ureteroneocystostomy (UNC) in animal experiments: I. Functional findings

Summary A ureteroneocystostomy (UNC) was carried out on 32 dogs. A standardised measurement of flow across the ureterovesical anastomosis revealed a significant obstruction on the day of the operation itself and on the first 5 days after the operation. On the 1st, 7th and 28th day after the operation there was no significant reduction in either tubulosecretory or glomerular function on the operated and non-operated kidneys.     

一般二阶线性分布参数系统的传递函数研究

本文研究了一般平稳二阶线性分布系统在两种边界条件下的传递函数问题。先用方程系数恒值化方法将原系统加以近似。对第一种边界条件,根据二阶系统本身的性质来导出传递函数表达式。第二种边界条件下的传递函数则被表示为一组递推公式的结果。     

Cinefluoroscopic study of long-term changes of bolus position and chewing cycle duration after fixed prosthetic treatment

Abstract— Some chewing parameters were studied in 12 patients with a complete maxillary denture and a 12-unit fixed mandibular denture anchored to the two canines. Registration by means of fluoroscopy were made before, 1 month after, and in four patients 13 yr after treatment. The mean velocity of the mandible during chewing increased after the prosthetic treatment and remained stable for meat during the observation period. At the first registration, before treatment, the bolus was most frequently located in the anterior region. After completion of the prosthetic rehabilitation, the bolus was mainly located to the lateral segments during chewing of the test foods, namely meat and bread. The recordings were almost identical 13 yr later. Despite a very reduced periodontal support, posterior cantilevered segments were satisfactorily used in comminution and the patients seemed to be unaware of the forces exerted on the remaining teeth.     

Dilated episcleral veins with secondary open angle glaucoma

We report a case of dilated episcleral vein with secondary open angle glaucoma. A 65-year-old female presented with redness of both the eyes without any prior systemic history. Her ocular examination revealed dilated episcleral veins and a high intraocular pressure (IOP) of 38 mm Hg in the right eye. Systemic examination was negative for carotid cavernous fistula, low-grade dural arteriovenous fistula, dysthyroid ophthalmopathy, and primary pulmonary hypertension. During follow-up, her IOP remained in high thirties despite maximum medications. She underwent right eye trabeculectomy with partial thickness sclerectomy with sclerotomy. In the beginning, the sclerotomy incision was not deepened into the suprachoroidal space. She developed choroidal effusion during surgery and the sclerotomy was deepened into suprachoroidal space and straw color fluid was drained. Postoperatively, she developed choroidal effusion, which resolved with conservative management. This case highlights the importance of sclerotomy in such cases of high episcleral venous pressure.     

The altered cortical connectivity during spatial search for facial expressions in major depressive disorder

To characterize the altered directed connectivity within a distributed cortical network, as is associated with the impaired attention modulation involved in the manifestation of mood disorder in depression, short-window partial directed coherence (PDC) combining with the event-related brain potentials (ERPs) was applied in this study. ERPs were recorded from 13 normal subjects and 12 depressed patients during visual search for facial expressions. The evoked N2 component of ERPs by responding to all neutral faces (F(1,22) = 5.51, P < 0.05) and the positive face was reduced in the depressed patients as compared to the normal subjects (F(1,22) = 5.71, P < 0.05), while the evoked N2 component by detecting the negative face showed no significant between-group effect (F(1,22) = 2.10, P = 0.16). The reduced N2 amplitude reflected deficits in effortful attentional modulation in depression. Obtained PDC values within the N2 time-window (150-300 ms post stimulus) showed weaker intra-frontal and intra-central directed interactions and enhanced occipital information output when responding to all neutral faces in depression relative to those in the normal group. Few decreased intra-frontal directed interactions were observed when detecting the emotional face in depression. The altered cortical directed connectivity contributed to the impairment occurring in the effortful attention modulation in depression. Our findings supported that the impaired attention modulation processing in depression was associated with the altered cortical connectivity.     

Teaching diagnostic approach to a patient through cinema

Films are produced with the aim of entertaining people, but recently there has been increasing use of films to educate medical trainees about various disorders, symptoms of these disorders, patient–therapist interactions, and various other medical and psychiatric issues. Discussions in academic circles have moved from criticism of negative portrayals of mental illness in earlier films to their use in teaching sessions. Films can be used either in full length or clip format to conduct training modules. Use of the film Stigmata to train residents about diagnostic dilemmas and taking a diagnostic approach to patients is discussed.