TNF-α中和对脂多糖致急性肺损伤小鼠肺组织凋亡的影响

目的 评价TNFR-Fc通过下调炎症反应、抑制组织细胞凋亡,对脂多糖(LPS)致急性肺损伤(ALI)小鼠肺组织的保护性作用.方法小鼠随机分为LPS组、TNFR-Fc+ LPS组和对照组.气管内滴人LPS复制ALI小鼠模型,TNFR-Fc+ LPS组在滴人LPS前24 h腹膜腔注射TNFR-Fc 0.4mg/kg体质量,在滴入LPS后2h收集标本.ELISA法检测血清肿瘤坏死因子α(TNF-α)及支气管肺泡灌洗液(BALF)中TNF-α、白介素1β(IL-1β)与IL-6浓度,BCA法检测BALF中蛋白含量,qRT-PCR法检测Bax基因转录强度,末端脱氧核苷酸转移酶介导的dUTP原位切口末端标记法检测肺组织细胞凋亡率,组织病理半定量评分评价肺组织损伤程度.结果 LPS气管内滴入后,BALF中TNF-α、IL-6浓度与肺泡蛋白含量显著升高(P＜0.05),肺组织Bax基因转录强度均显著增高(P＜0.05),给予TNFR-Fc预处理显著降低血清TNF-α浓度,BALF中IL-6浓度与蛋白含量也显著下降(P＜0.05),下调Bax基因的转录强度(P＜0.05).与LPS组相比,TNFR-Fc+ LPS组小鼠肺组织细胞凋亡率、病理评分均显著降低(P＜0.05).结论 中和TNF-α能下调肺局部炎症反应强度,减少LPS致ALI小鼠肺组织细胞凋亡,降低LPS气管内滴人引起的肺组织损伤程度.     

可吸入颗粒物_(2.5)对大鼠肺纤维化的影响及糖皮质激素的干预作用

目的:观察大鼠气道内滴入PM_(2.5)引起急性肺损伤的同时,是否导致肺纤维化以及糖皮质激素对PM_(2.5)所致肺损伤和肺纤维化是否具有干预作用。方法:将150只大鼠,随机分为对照组、PM_(2.5)染毒组(实验组)、糖皮质激素干预组(干预组)。实验组:大鼠经气管内滴入PM_(2.5)(60mg/kg)染毒,每周2次,连续4周。干预组:大鼠染毒的同时,给予地塞米松(5mg·kg~(-1)·d~(-1))腹腔注射,每日1次。对照组:0.9%氯化钠液替代PM_(2.5)悬液。于第5天和28天分二批处死大鼠并留取标本。分别测定大鼠BALF及血清中IL-6、TNF-α、TP、PINP、PⅢNP的浓度;大鼠左肺组织行HE染色和Masson染色,观察肺组织的炎症程度和胶原纤维分布;大鼠右肺组织测定羟脯氨酸含量,左肺测定湿/干重比。结果:染毒后第5天,实验组与干预组大鼠血清与BALF中IL-6、TNF-α、PINP、PⅢNP浓度均较对照组有明显升高(P<0.05);与实验组大鼠相比,干预组大鼠血清与BALF中IL-6与TNF-α浓度有明显降低(P<0.05),PINP与PⅢNP水平无明显差异;三组大鼠右肺组织HYP含量无明显差异。染毒后第28天,血清与BALF中IL-6、TNF-α、PINP、PⅢNP浓度,实验组大鼠较干预组和对照组均有明显升高(P<0.05);干预组大鼠肺组织HYP含量及湿/干重比较实验组明显降低,但均较对照组明显升高(P<0.05)。结论:PM_(2.5)可导致大鼠急性肺损伤和肺纤维化,而地塞米松干预后能改善和抑制肺部炎症改变和纤维化形成。     

Hemin上调HO-1减轻急性肺损伤小鼠内质网应激及肺血管内皮功能障碍

目的探讨血红素(Hemin)对脂多糖(LPS)所致急性肺损伤小鼠肺内质网应激标志蛋白和血管内皮的影响。方法 30只雄性C57BL/6J小鼠分为对照组、模型组和治疗组。HE染色检查肺切片,BCA法检测支气管肺泡灌洗液(BALF)蛋白浓度,吉姆萨染色计数BALF总细胞和多形核白细胞(PMN),ELISA检测BALF中IL-1β、TNF-α,Western blot检测肺HO-1、GRP78、CHOP、VE-cadherin及β-catenin表达水平。结果与对照组相比,脂多糖组小鼠肺损伤明显,HO-1表达、湿/干比增高,BALF中细胞数、蛋白含量、IL-1β及TNF-α浓度明显升高,同时,GRP78、CHOP上调而VE-cadherin和β-catenin下调(P0.05);血红素干预进一步上调了HO-1,减轻了小鼠肺损伤,降低了湿/干比、BALF细胞数、炎症因子水平和蛋白浓度,抑制了GRP78和CHOP的上调,并促进了VE-cadherin和β-catenin的表达(P0.05)。结论血红素上调血红素加氧酶1,减轻急性肺损伤小鼠内质网应激及肺血管内皮功能障碍。     

Ghrelin对脓毒症小鼠肺脏炎症及JAK/STAT通路的影响

目的 通过观察生长素释放肽(ghrelin)对脓毒症小鼠肺组织炎症反应、肺组织janus激酶/信号转导通路和转录激活因子mRNA、STAT3蛋白及肺组织炎细胞因子肿瘤细胞α(TNF-α)、IL-6的表达水平的影响,探讨ghrelin在脓毒症炎症反应中的调节作用及可能的分子机制.方法 选用腹腔注射脂多糖的方法制作小鼠脓毒性模型:选取雌性小鼠54只,随机分为对照组、模型组及ghrelin干预组,对照组经腹腔注射等量生理盐水;模型组经腹腔内注射脂多糖(6 mg/kg);干预组先经腹腔注射ghrelin(200 μg/kg),30 min后再经腹腔注射脂多糖(6 mg/kg);各组分别于3、9、18h随机处死小鼠各6只,光镜下观察肺组织炎症改变;反转录聚合酶链反应(RT-PCR)法检查肺组织STAT3mRNA的基因转录水平;酶联免疫吸附测定(ELISA)法测定肺组织STAT3、TNF-α、IL-6的表达量.结果 Ghrelin可抑制肺组织STAT3mRNA基因转录活性,从而降低STAT3蛋白表达、减少炎症因子TNF-α、IL-6的分泌(P值均＜0.05);改善脓毒症小鼠肺组织病理结构损伤(充血、水肿、炎症细胞浸润).结论 ghrelin可减轻脓毒症小鼠肺脏炎症反应,其作用机制可能与抑制了janus激酶/信号转导和转录激活因子(JAK/STAT通路)、下调TNF-α和IL-6的表达有关.     

压力负荷高血压大鼠心肌组织肿瘤坏死因子-α与活性氧的关系

目的动态观察压力负荷高血压大鼠心肌组织肿瘤坏死因子α(tumor necrosis factor α,TNF-α)表达变化,并探讨其与活性氧的关系。方法 SD大鼠(n=72)按电脑随机数字法随机分为假手术(Sham)组、腹主动脉缩窄所致压力负荷(AC)组和氮乙酰半胱氨酸干预(NAC)组,根据观察时间的不同,AC组和Sham组进一步分为1周、2周、4周和8周组,每组8只大鼠。应用酶联免疫吸附试验(ELISA)动态检测心肌组织内TNF-α蛋白表达变化。采用比色法和天狼猩红染色检测心肌组织胶原含量,应用Fenton原理和细胞色素C还原实验测定心肌内活性氧(ROS)水平和还原型辅酶II(NADPH)氧化酶活性。结果腹主动脉缩窄后1周,AC组平均动脉压显著升高,与Sham组比较差异有统计学意义[(155±11)mmHgvs.(95±11)mmHg,P0.01](1mmHg=0.133kPa);2周后,左心室质量指数、心肌组织胶原含量以及胶原容积分数明显升高,与相同时间点的Sham比较,差异有统计学意义(P0.01),随着时间的延长,以上指标进一步升高。AC组压力负荷后4周、8周心肌组织TNF-α蛋白浓度明显高于相同时间点Sham组,差异有统计学意义[(14.65±3.97)pg/mg蛋白vs.(5.25±1.74)pg/mg蛋白,P0.01;(18.06±3.42)pg/mg蛋白vs.(5.38±2.37)pg/mg蛋白,P0.01]。相关分析显示,心肌组织TNF-α浓度与胶原蛋白浓度成正相关(r=0.656,P0.01)。此外,压力负荷1周时,AC组心肌组织活性氧水平和还原型辅酶Ⅱ氧化酶活性亦明显升高,与相同时间点的Sham组比较,差异有统计学意义(P0.01),此后维持在较高水平。给予氮乙酰半胱氨酸(NAC)0.2g·kg-1·d-1局部注射干预治疗后,NAC组心肌组织内TNF-α蛋白浓度[(11.4±2.87)pg/mg蛋白vs.(18.1±3.4)pg/mg蛋白P0.01,P0.01]、左心室质量指数[(2.83±0.10)mg/gvs.(3.14±0.09)mg/g,P0.01]、心肌组织胶原浓度[(4.98±0.83)μg/mg蛋白vs.(7.04±0.92)μg/mg蛋白,P0.01]以及胶原容积分数(4.35%±0.47%vs.8.18%±0.55%,P0.01)比AC组8周时明显降低,差异均有统计学意义。结论压力负荷可呈时间依赖性诱导心肌组织内TNF-α表达增加,心肌组织内活性氧水平的升高是压力负荷高血压大鼠心肌组织内TNF-α表达增加的重要分子机制之一。     

氨溴索对老年重症肌无力患者围术期调控炎症反应及肺保护的作用研究

目的 探讨氨溴索在老年重症肌无力患者围术期的肺保护作用. 方法 收集58例老年重症肌无力并胸腺疾病患者按入组编号随机分为观察组与对照组,每组29例,治疗组在围术期应用盐酸氨溴索干预,而对照组不予盐酸氨溴索干预,观察两组患者术后肺部并发症、肺通气指标、血气分析,并检测血清C反应蛋白(CRP)、肿瘤坏死因子α(TNF-α)、白介素(IL)1β和IL-10的浓度.结果 (1)治疗组患者肺部并发症(肺不张、肺炎和支气管炎)发生率低于对照组(9.4％和15.6％,P＜0.05);(2)治疗组肺通气指标气管峰压[(22.32±3.43) cmH2O和(26.54±4.81) cmH2O,P＜0.05]和气道阻力[(29.17±5.74)cmH2O·L-1·S-1和(34.47±7.94)cmH2O·L-1·S-1,P＜0.05]较对照组降低,肺顺应性较对照组升高[(106.04±14.73) ml/cmH2O和(95.11±9.50) ml/cmH2O,P＜0.05];(3)术后第2天,治疗组的动脉氧分压[(89.66±13.23) mmHg和(70.94±12.75)mmHg,P＜0.05]、血氧饱和度[(96.95±2.65)％和(89.44±2.78)％,P＜0.05]和氧合指数[(219.47±54.05)％和(187.38±37.72)％,P＜0.05]均高于对照组;(4)术后3d治疗组血清CRP[(29.37±14.87)mg/L和(43.94±21.42) mg/L,P＜0.05]、TNF-α[(35.55±4.74) μg/L和(52.80±6.63) μg/L,P＜0.05]及IL-1β[(17.06±6.85)μg/L和(28.62±7.72) μg/L,P＜0.05]均低于对照组,而血清IL-10[(132.84±12.91)μg/L和(87.18±16.37) μg/L,P＜0.05]高于对照组. 结论 盐酸氨溴索可减少老年重症肌无力患者胸腺切除术后呼吸道并发症的发生率,改善肺通气功能,有效抑制炎症反应,值得在老年重症肌无力患者围术期中推广应用.     

白介素17抗体减轻吸烟所致慢性阻塞性肺疾病模型小鼠的气道炎症

目的 研究白介素17(interhukin-17,IL-17)抗体在吸烟所致慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)模型小鼠气道炎症中的作用.方法 C67/BL6雄性小鼠随机分为COPD组(8只)、COPD+IL-17抗体干预组(简称COPD+干预组,8只)和正常对照组(10只).对支气管肺泡灌洗液(BALF)进行细胞计数、染色和分类;用酶联免疫吸附试验检测小鼠肺组织匀浆IL-17水平,观察各组小鼠气道病理改变.结果 COPD组与COPD+干预组相比肺功能差异无统计学意义.COPD组、COPD+干预组小鼠与正常对照组相比BALF细胞总数显著增高[分别为(19.64±1.89)×104/ml,(15.47±2.99)×104/ml和(5.13±1.00)×104/ml,P＜0.01];COPD+干预组较COPD组细胞总数下降(P＜0.01);中性粒细胞比例[分别为(8.58+6.77)%,(22.98±8.46)%]及绝对值[(1.28±0.96)×104/ml,(4.53±1.73)×104/ml]显著下降(P值均＜0.01).肺组织HE染色病理评分COPD+干预组(73.25±18.58)较cOPD组(106.13±36.27)炎症有所减轻(P＜0.05).COPD+干预组小鼠肺组织匀浆中IL-17含量(0.084±0.041)pg/mg pro与COPD组(0.221±0.081)pg/mg pro相比显著降低(P＜0.01).结论 吸烟所致COPD小鼠模型中IL-17参与了中性粒细胞引起的气道炎症,抑制IL-17的表达,可以减少气道内中性粒细胞的数量,减轻气道炎症.     

一氧化碳释放分子-2对小鼠急性肝功能衰竭保护作用的实验研究

目的探讨一氧化碳释放分子-2对小鼠急性肝功能衰竭(ALF)的保护作用及机制。方法雄性C57BL/6小鼠30只随机分为对照组、模型组和保护组,每组10只。通过一次性腹腔注射脂多糖/D-氨基半乳糖(LPS/D-GalN)构建小鼠ALF的动物模型,CORM-2于造模前30 min行尾静脉注射,造模后6 h分别留取血清、肝组织标本。生化分析仪检测血清中ALT、AST水平,HE观察肝脏病理改变,酶联免疫吸附法(ELISA)检测血清中TNF-α和IL-6的水平,反转录酶-聚合酶链反应(RT-PCR)检测肝组织中TNF-α和IL-6 mRNA的表达。结果保护组小鼠血清ALT[(1274.60±157.24)U/L比(3499.00±136.19)U/L]和AST[(1151.50±244.58)U/L比(4079.50±481.11)U/L]水平均明显低于模型组(均t1=33.81,t2=17.16,P0.05);与模型组比较,保护组肝组织炎性细胞浸润明显减少,肝细胞坏死程度明显减轻[(0.14±0.05)比(0.37±0.05),t=10.29,P0.05];保护组小鼠血清和肝组织中TNF-α[(139.60±28.39)pg/mL比(447.34±128.17)pg/mL、(0.31±0.03)比(0.69±0.05)]和IL-6[(215.21±85.16)pg/mL比(1461.58±244.90)pg/mL、(0.33±0.03)比(0.72±0.05)]表达水平明显低于模型组(均t1=7.41,t2=20.61,t3=15.20,t4=21.15,P0.05)。结论 CORM-2能够抑制小鼠ALF时的炎性反应,减轻肝脏病理损伤,其机制可能与抑制促炎细胞因子TNF-α和IL-6的释放有关。     

Orionin对急性肝衰竭小鼠的保护作用及其对肝组织细胞因子水平的影响

目的探讨冬凌草甲素(Oridonin)对脂多糖/D-氨基半乳糖氨(LPS/D-Gal)联合诱导的急性肝衰竭(ALF)小鼠的保护作用及其对肝组织细胞因子水平的影响。方法取150只小鼠,随机分成5组,每组30只。采用LPS/D-Gal腹腔注射建立小鼠ALF模型,设生理盐水对照组、Oridonin对照组、LPS/D-Gal诱导模型组和LPS/D-Gal处理及不同剂量Oridonin干预组。采用Real-time PCR法检测肝组织肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-1α、IL-1β和IL-6 m RNA水平。结果模型组小鼠48 h存活率为0.0%(0/30),而两个Oridonin干预组小鼠48 h存活率分别提高至64.5%(19/30)和80.6%(24/30,P0.01);组织病理学检查显示模型组小鼠肝细胞呈大块或/和亚大块坏死,肝小叶结构消失,残存肝细胞肿胀、空泡变性,肝窦肿胀充血,炎细胞浸润。Oridonin干预组小鼠肝细胞坏死、空泡变性和炎细胞浸润等较模型组有明显的改善;模型组小鼠血清ALT和AST水平分别为(345.3±54.1)U/L和(500.2±53.5)U/L,明显高于对照组的[(42.3±0.6)U/L和(117.1±9.8)U/L,P0.01],两个Oridonin干预组分别为(303.9±39.5)U/L和(340.6±2.8)U/L及[(130.2±38.3)U/L和(209.8±36.2)U/L,P0.05];模型组小鼠肝组织TNF-α、IL-1α、IL-1β和IL-6 m RNA水平显著高于正常对照组(P0.01),而两个Oridonin干预组肝组织TNF-α、IL-1α、IL-1β和IL-6 m RNA水平显著低于模型组(P0.01)。结论 Oridonin对LPS/D-Gal诱导的ALF小鼠具有显著的保护作用,其作用机制可能与降低肝组织细胞因子水平有关。     

SIRT1减弱对脂多糖致急性呼吸窘迫综合征小鼠的促炎作用

目的探讨SIRT1对脂多糖(LPS)诱导的急性呼吸窘迫综合征(ARDS)小鼠炎症反应的作用及其机制。方法采用SIRT1基因敲减小鼠SIRT1~(+/-)与野生型小鼠,qRT-PCR,Western Blot检测两种小鼠肺组织中的相关基因表达差异。两种小鼠用LPS腹腔注射法造模,同时设生理盐水对照组,观察肺组织病理形态学变化,测定肺湿干比(W/D比),BCA法测定支气管肺泡灌洗液(BALF)中总蛋白浓度,ELISA法测定BALF及血浆中炎症因子TNF-α、IL-6的含量,Western Blot检测肺组织p-p38MAPK、p38MAPK、p-ATF2的表达变化。结果与野生型小鼠相比,SIRT1~(+/-)肺组织中SIRT1在mRNA表达和蛋白表达均显著降低,差异有统计学意义(P0.01)。LPS致ARDS后,两种小鼠病理形态学观察均表现为肺组织炎症细胞浸润,肺泡结构破坏,间质水肿,肺泡间隔增厚,而SIRT1~(+/-)小鼠肺组织破坏更严重。在SIRT1~(+/-)小鼠中,肺W/D比值,BALF中总蛋白浓度,BALF及血浆中炎症因子肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)的含量,均明显高于野生型小鼠(P0.05),肺组织p-p38MAPK/p38MAPK、p-ATF2的表达增加也更显著(P0.05)。结论 SIRT1基因在LPS致伤ARDS小鼠的炎症进程中起着非常重要的作用,其机制可能与Sirt1诱导的p38 MAPK-p-ATF2信号通路的活化增强有关。     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.