Inhibition of intimal thickening of the carotid artery of rabbits and of outgrowth of explants of aorta by probucol.

The effect of administration of probucol in preventing intimal thickening of rabbit carotid artery after balloon catheter injury and the mechanism of action of the drug were studied. Groups of 6 male New Zealand-White rabbits were given normal diet (Group I), high cholesterol diet (Group II) or high cholesterol diet plus probucol (Group III) for 4 weeks. Balloon catheter injury was made in week 2 and animals were killed in week 4. No significant differences in the total cholesterol levels in Groups II and III were found in week 4. The medians of areas of the intimal layer in cross-sections of the carotid arteries of Groups I, II and III were 0.237, 0.475 and 0.309 mm2, respectively. Thus high-cholesterol diet increased the thickness of the intimal layer and probucol reduced its effect. There were no significant differences in the areas of the medial layers in these 3 groups. For the examination of the mechanism of the effect of probucol, rabbits were given chow containing 0.5% cholesterol with and without 0.5% probucol (7 rabbits each) and then the numbers of explants from their aortas showing outgrowth were compared. The plasma total cholesterol levels of these two groups were the same. The probucol concentrations in the plasma and aorta of the former group were 18.6 +/- 13.2 micrograms/ml and 7.3 +/- 5.4 micrograms/g wet tissue, respectively. The number of explants showing outgrowth on day 14 was suppressed by 34% in the probucol-treated group.(ABSTRACT TRUNCATED AT 250 WORDS)     

Effectiveness of early invasive strategy of treatment of angina of new onset

Aim of the study was to assess effectiveness of early invasive strategy of treatment of angina of new onset (ANO). We conducted comparative assessment on invasive and noninvasive risk estimation in 106 patients admitted to N.V.Sklifosofsky Institute of Urgent Aid in 2003-2007. Percutaneous coronary interventions (PCI) on symptom related artery (SRA) within single procedure were carried out in 74 cases (70%), indications to coronary artery bypass surgery were detected in 16 cases (15%), in 16 more cases conservative treatment was used. The data obtained showed that it is rational to consider ANO as unstable angina in all cases including those without progression. Visualization of coronary arteries gives possibility to define significance of SRA and zone at risk of injury, determine indications to myocardial revascularization, and avoid inadequacy of noninvasive assessment of risk and choice of treatment tactics. The method of choice in the treatment of patients with ANO is PCI performed during single procedure. Detection of indications to coronary artery bypass surgery in low risk patients and in absence of progression confirm necessity of routine use of invasive strategy which provides timely pathogenetic treatment. Absence of indications to myocardial revascularization detected in sporadic cases provides possibility to avoid groundless hospitalizations.     

胰岛素瘤的解剖分布特点分析

目的胰岛素瘤是最常见的胰腺神经内分泌肿瘤，因其临床表现多样，导致诊断困难。影像学诊断尤其是超声内镜(EUS)在胰岛素瘤的诊断中起着重要作用，拥有较高的敏感性和特异性。本研究拟通过明确胰岛素瘤的解剖分布特点，以期有助于提高影像学的诊断准确率和降低漏诊率，尤其是在教育和培训实践中对于EUS的学习者更具有指导价值。 方法回顾性分析解放军总医院第一医学中心病案资料数据库1993年1月至2019年11月经外科手术、病理确诊为胰岛素瘤的患者的临床资料，检索方法采取搜索术后病理诊断为"胰岛素瘤"的病例，通过查阅病例的方法，提取出胰岛素瘤的大小和解剖分布等数据，进一步分析其特点。 结果共检索到确诊为胰岛素瘤的患者116例，其中，男45例、女71例，年龄13～76岁，平均年龄(44.4±14.85)岁。胰岛素瘤单发110例(94.8%)、多发6例(5.2%)。位置分布：头颈部46例(39.7%)，单发45例、多发1例；体尾部68例(58.6%)，单发65例、多发3例；全胰腺多发2例(1.7%)。病变大小特点：最大径0.4～3.4 cm，平均大小(1.53±0.58)cm。≤1 cm 29例、>1 cm而≤1.5 cm41例、>1.5 cm而≤2.0 cm28例，≤3 cm 15例，>3 cm 3例。年龄与肿瘤的大小相关，≤44岁患者肿瘤平均大小为(1.36±0.51)cm、>44岁患者肿瘤平均大小为(1.70±0.60)cm，P<0.05。头颈部的肿瘤大于体尾部的肿瘤，头颈部肿瘤平均大小(1.66±0.63)cm，体尾部(1.42±0.52)cm，P<0.05。 结论胰岛素瘤在胰腺体尾部较头颈部更好发；绝大多数单发，但可以全胰腺多发；多数小于1.5 cm，肿瘤的大小与患者年龄和肿瘤的解剖分布相关。     

Comparison of effectiveness of thyrotropin-suppressive doses of d- and l-thyroxine in treatment of hypercholesterolemia

In an attempt to compare the cholesterol-lowering effects of equivalent doses of d- and l-thyroxine, 10 euthyroid, hypercholesterolemic subjects were treated with graded doses of each medication in a cross-over design using thyrotropin suppression following thyrotropin-releasing hormone administration as the end-point. The mean thyrotropin-suppressive dose of d-thyroxine was 2.4 ± 0.66 mg per day, which resulted in mean reductions of 10 percent in total plasma cholesterol, 10 percent in plasma low-density lipoprotein cholesterol, and 11 percent in plasma high-density lipoprotein cholesterol. The mean thyrotropin-suppressive dose of l-thyroxine was 135 ± 46 μg per day, which resulted in mean reductions of 7 percent in total plasma cholesterol, 6 percent in plasma low-density lipoprotein cholesterol, and 14 percent in plasma high-density lipoprotein cholesterol. The reductions in total, low-density, and high-density cholesterol achieved with d-thyroxine were not significantly different from those achieved with l-thyroxine. Neither medication produced a significant increase in heart rate or ventricular ectopy as determined by Holter monitoring. These data do not support the belief that d-thyroxine has a preferential cholesterol-lowering effect in humans when compared with equivalent doses of l-thyroxine. In addition, both d- and l-thyroxine reduced plasma high-density lipoprotein cholesterol.     

A method of measuring the severity of a series of cases of hemolytic disease of the newborn

1. The hemoglobin concentration in the cord blood of infants affected withhemolytic disease is very closely related to their chance of survival. If the hemoglobin concentration is plotted against the chance of survival, a sigmoid curve isobtained. Probit analysis can be applied and the results of treatment can then besummarized in terms of the severity of the cases treated. For example, in thepresent series the cord hemoglobin concentration corresponding to a 50 per centchance of survival was 8.09 Gm./100 ml.

2. Application of probit analysis makes it possible to compare results obtainedin different centers, for due allowance is made for any difference in severity in thecases included in the different series.

3. In the present series, despite uniform treatment (exchange transfusion),over-all mortality fell from 37 percent in 1947 and 1948 to 3 per cent in 1950. It isshown that this can be entirely explained by a decrease in the number of severelyaffected infants.

4. Predictions of survival based on the cord hemoglobin concentration and cordbilirubin concentration combined are not significantly better than predictionsbased on cord hemoglobin concentration alone.

5. Infants with positive direct Coombs tests whose cord hemoglobin concentrations exceed 15.5 Gm./100 ml. have some risk (approximately 1 in 12) of developing kernicterus, if untreated.

Submitted on March 29, 1951 Accepted on April 18, 1951     

Time of onset of symptoms of acute myocardial infarction

Several studies have observed an increased occurrence of acute myocardial infarction (AMI) in the morning based on subjective self-reports and objective confirmation. Evidence has also been collected to suggest a circadian variation in the onset of sudden cardiac death and silent myocardial ischemia. No published reports have examined the time of onset of AMI in relation to time after awakening. The present study examines the times of onset of AMI in relation to awakening in 137 patients with confirmed AMI. Information concerning time of awakening on the day of AMI revealed a marked increase in the onset of initial AMI symptoms within the first hour after awakening. Of the patients studied, approximately 23% reported onset of the initial symptoms of AMI within 1 hour after awakening. An increased onset of symptoms of AMI soon after awakening was also observed when patients in whom the acute cardiac symptoms were known to or may have caused awakening were excluded from consideration. This was also noted in subgroups of AMI patients classified according to age, order and location of AMI. These results extend previous observations of the circadian morning increase of AMI onset and assist in narrowing the search for potential triggers of the circadian variation of onset of AMI to physiologic changes that may occur soon after awakening.     

Endocrinology of anorexia of ageing

Appetite and food intake decrease with normal ageing, predisposing to the development of under-nutrition. Under-nutrition is common in older people and has been implicated in the development and progression of chronic diseases commonly affecting the elderly, as well as in increasing mortality. An understanding of the factors that contribute to the physiological and pathological declines in food intake in older people is likely to aid in the development of effective forms of prevention and treatment. Ageing affects many of the endocrine factors involved in the control of appetite and feeding but few studies have been performed in humans to clarify these changes. Possible hormonal causes of the anorexia of ageing include increased activity of cholecystokinin, leptin and various cytokines and reduced activity of ghrelin and testosterone.     

Investigation of mode of action of biofeedback in treatment of fecal incontinence

A study was carried out in 25 incontinent patients to evaluate some of the factors thought to be responsible for the success of retraining for fecal incontinence. Subjects were initially allocated to one of two groups; one group was trained to perceive small rectal volumes (active retraining), the other group carried out the same maneuvers but were not given any information or instruction. Active sensory retraining reduced the sensory threshold from 32 +/- 8 to 7 +/- 2 ml (P less than 0.001), corrected any sensory delay that was present (P less than 0.004), and reduced the frequency of incontinence from 5 +/- 1 to 1 +/- 1 episodes per week (P less than 0.01). Sham retraining caused a modest reduction in the sensory threshold (from 29 +/- 9 to 20 +/- 8; P less than 0.05) but did not significantly reduce the frequency of incontinence. Subsequent strength and coordination training did not significantly improve continence, although at the end of the study, 50% of patients had no incontinent episodes at all and 76% of patients had reduced the frequency of incontinence episodes by more than 75%. This improvement in continence was not associated with any change in sphincter pressures or in the continence to rectally infused saline but was associated with significant improvements in rectal sensation. The functional improvement was sustained over a period of two years in 16 of the 22 patients available for follow-up. In conclusion, the results support the use of retraining in the management of fecal incontinence and suggest that retraining may work by enhancing rectal sensitivity and instilling confidence.     

Seroepidemiological study of toxoplasmosis in different sections of population of Union Territory of Chandigarh

Infections with Toxoplasma gondii in humans are usually asymptomatic or in the form of mild febrile illness. Primary infection in pregnant women may result in congenital toxoplasmosis while infection in immunocompromised subjects like AIDS patients may cause potentially fatal toxoplasma encephalitis. In India, only a few studies in hospital based patients have shown prevalence of toxoplasmosis to be between 1.5 and 21%. No field study involving general population is available. The present study investigates the prevalence of toxoplasmosis in subjects from rural, urban and urban slum populations of Union Territory, Chandigarh. Serum samples from 500 subjects from each group were collected and antitoxoplasma IgM and IgG was detected by conventional micro ELISA technique using soluble Toxoplasma gondii tachyzoite antigen. Overall 5.4% subjects were positive for IgM while 4.66% showed IgG antitoxoplasma antibodies. Amongst the three groups, significantly higher number of subjects in slum area (7.8%) showed IgM antibodies as compared to urban and rural areas (4.2% each). There was no significant difference in IgG positivity between three study areas. Prevalence of T. gondii specific IgG antibodies was significantly higher amongst females of both slum (7.31%) and rural area (8.44%) as compared to the males (2.85% and 3.27% respectively) in the same areas (p<0.05) and also to females of the urban area (2.98%, p<0.05). Prevalence of IgM antibodies was significantly higher (p<0.05) in females in the slum area (10.5%) as compared to females in the urban area (2.55%). In both urban and slum areas, highest IgM seropositivity was observed in age group 6-12 years (10% and 13.3% respectively), while in the rural area the highest IgM seropositivity was seen in the age group > or = 5 years (17.7%). These data indicate that majority of children are exposed to toxoplasma before 12 years of age and particularly in rural areas higher number of subjects acquire Toxoplasma gondii infection early in childhood probably as a result of higher exposure due to farming, poor hygiene and handling of animals.     

769株钩端螺旋体菌型鉴定报告

本文报告1980～1989年鉴定的769株钩端螺旋体,分属14个血清群35个血清型,其中有5个国际新型:Javanica群Mongma、Zhenkang、Dehong,Pyrogenes 群 Monglian,tarassovi群 Yunxian 型。国内新型 1株 tarassovi 群 moldaviae。从患者分离鉴定 241株,18种动物分离鉴定 528株。首次从丽江地区永胜县病人分离到 1株 Pomona 群 Kunming-pomona 型。从临沧地区黄麂分离到 1 株 Hebdomadis 群 Hebdomadis 型,鳝鱼分离到 1株 Autumnalis 群 bangkinag 型。从红河州个旧市蝙蝠分离到 1 株 Grippotyphosa 群 grippotyphosa 型。     

Case of spontaneous regression of metastatic lesions of leiomyosarcoma of the esophagus

A rare case of spontaneous regression of esophageal leiomyosarcoma is reported. A 63-year-old woman underwent esophagectomy and reconstruction at our hospital after diagnosis of leiomyosarcoma. Nineteen months after esophagectomy, a coin lesion was detected in the right lung and right thoracotomy revealed pleural dissemination. The lesion in the right lung was resected and was confirmed histologically as recurrence of leiomyosarcoma. During further surgery, metastatic lesions were found in the spleen and pleura. However, all metastatic lesions were found to decrease without any anti-cancer therapy.     

Influence of spasmolytic analgesics on motility of sphincter of oddi

The effects on the sphincter of Oddi of intravenous administration of dipyrone, 2.5 g; tramadol, 50 mg; indomethacin, 75 mg;N-butylscopolamine, 20 mg; and nitroglycerin, 1 mg, in comparison to physiological saline were assessed in a single-blind study in 36 patients hospitalized with upper abdominal pain. Basal sphincter pressure and sphincter motility were measured for a 5-min period after treatment by endoscopic manometry. Nitroglycerin and dipyrone both caused a significant fall in basal sphincter pressure, whileN-butylscopolamine and nitroglycerin produced a significant decrease in contraction frequency. Therefore, dipyrone, in contrast to tramadol and indomethacin, exhibits spasmolytic activity in addition to analgesia in biliary pain.This study was sponsored by Hoechst AG, Frankfurt/M., Germany     

肌红蛋白在克山病诊断中的意义

目的 通过比较不同类型克山病患血清中肌红蛋白（Mb）的变化，探讨了肌红蛋白在诊断克山病心肌坏死中的意义。方法 采用固相酶免疫微量法。结果 不同类型克山病患的血清中Mb含量有所改变，但是只有亚急型克山病组与对照组相比差异显，随心肌坏死程度加重，Mb含量也随之增高。结论 血清中肌红蛋白含量变化可作为克山病急性心肌坏死早期诊断指标。     

辽宁省城市体检人群代谢综合征肾脏损害调查研究

目的:探讨沈阳市代谢综合征(MS)人群肾脏损害情况。方法:选取辽宁省城市体检人群与社区人群进行分层抽样调查,共调查2000人,其中体检人群1000人,社区人群1000人(来自辽宁省各城市)。根据MS的诊断标准,研究对象被分为超重肥胖组(460人)和正常体重组(1540人),高血糖组(140人)和正常血糖组(1860人),高血压组(399人)和正常血压组(1601人),血脂异常组(486人)和血脂正常组(1514人),比较各分组间肾脏损害的患病率。结果:调查人群中肾脏损害患病率为15%,男性与女性之比为1:1。超重肥胖组和非超重肥胖组肾脏损害患病率分别为10%和1%;高血糖组和正常血糖组肾脏损害患病率分别为10%和1%;高血压组和正常血压组肾脏损害患病率分别为10%和2%;血脂异常组和血脂正常组肾脏损害患病率分别为10%和1%,以上两组间比较差异均有显著性(P0.01)。结论:辽宁省城市代谢综合征患者的肾脏损害患病率较正常人群显著升高。     

Study of mechanism of autoregulatory system of corticosteroid metabolism in liver

A direct correlation between the elevation of blood levels of corticosteroids and the increase in the metabolism of corticosteroids by the liver was observed in vitro and in vivo. The mechanism of this auto-regulatory system of corticosteroid metabolism by the liver, secondary to fluctuation of their blood levels, was studied. The rate of corticosteroid metabolism in the liver was greater at higher levels of nonprotein-bound corticosteroids in serum than that obtained at lower levels. This suggests an important role of the activity of steroid hydrogenases in this regulatory system. In addition, the serum protein binding of corticosteroids plays a role in this regulatory system. The nonprotein-bound corticosteroids in serum were more rapidly metabolized in the liver than the protein-bound corticosteroids. Under the physiologic conditions where the total steroid level in serum was below the binding capacity of serum protein, at lower corticosteroid levels a proportionally greater amount of corticosteroids in the blood was bound to serum protein, and relatively less available to the liver for metabolism than would obtain at higher corticosteroid levels. Thus, the serum protein binding of corticosteroids plays a role in the regulation of corticosteroid metabolism in the liver. An autoregulatory system of corticosteroid metabolism in the liver plays a role in controlling the concentration of blood corticosteroids supplementary to the control by the regulation of adrenal cortical secretion.     

Dependence of thermodynamic efficiency of proton pumps on frequency of oscillatory concentration of ATP.

In order to evaluate the utilization of variable ATP concentration produced by an oscillatory reaction (as in anaerobic glycolysis), we analyze the thermodynamic efficiency of power output of a cyclic, ATP-driven proton pump found in the plasma membrane of plant cells. The model used includes the coupling of potassium and calcium ion transport. Oscillations in the concentration of ATP can lead to either increases or decreases in efficiency compared to that at constant ATP concentration, with corresponding decreases and increases in dissipation in the irreversible processes of the proton pump, depending on the frequency of the oscillations. Variations of imposed frequencies induce, in the periodic response, variations of phase shifts between the components of the total membrane current, which consist of the pump's proton current and the currents of potassium and calcium ions. Increases in efficiency are attained when the phase shifts are such that maxima (or minima) in the proton pump current and membrane potential occur simultaneously.     

Insulinemia--a marker of early diagnosis and control of efficacy of treatment of type II diabetes

Metabolic Syndrome X defined by Reaven is caused by peripheral insuline receptor resistance, leads to hyperinsulinemia regarded as a cause of secondary dyslipidemia, hypertension, hemostatic disturbances, atherosclerosis and insulin as a growth factor takes part in carcinogenesis. Depending on a contribution of the primary risk factors of type 2 Diabetes Mellitus (2-DM) mainly genetic factors and obesity--an independent cause of insulin receptor resistance--glucose intolerance and 2-DM may overlap the Syndrome X. The aims of these studies were to determine in cross-sectional investigation a plasma insulin concentration in subjects aged over 35 years and to assess the clinical usefulness of insulinemia in early diagnosis of diabetes type 2. Investigations were carried out in Krakow town's district with 200,000 inhabitants, out of those 3060 randomly selected subjects (1720 females and 1340 males aged over 35 years) took part in the Polish Multicenter Study on Diabetes Epidemiology (PMSDE) with protocol and methods previously presented. Glucose concentration was determine by enzymatic method, insuline in plasma by IRMA method using ready kits produced by the Swierk-Poland. Logistic multiple regression model was used to estimate the effect of risk factors on the development of glucose intolerance, Chi square test, Fisher test and Mann-Whitney test were used for statistical analysis by means of statistical package BMPD. Fasting insulinemia in persons with normal glucose tolerance and body weight (BMI < 25 and glycemia < 6.1 mmol/l) in subpopulation aged over 35 years was 5.73 (SD = 3.99) in men and 7.05 (SD = 4.67) microU/ml in women. These values were positively correlated with BMI and at the range 25-30 and > 30 increased by 50 and 100% responsively and in 2-nd h in OGTT by five-times. In the persons with glucose intolerance and new-diagnosed 2-DM insulinemia increased 2-3 fold depending on BMI, and gender. In the subgroup with 2-DM and BMI > 30, insulinemia in 2 h-OGTT treated values 152 (SD = 90) in women and 112 (SD = 83.4) microU/ml in men. Obesity and insulinemia in 2 h-OGTT in multiple analysis have been identified as a strong predictors and risk factors of impaired glucose intolerance (IGT) 2-DM fasting insulinemia may be useful as an indicator of the peripheric insulin receptor resistance. The results lead to the conclusions that determination of the plasma insulin concentration may be useful in early diagnosis of IGT and diabetes type 2, and should be monitored in the course of non-pharmacological and pharmacological treatment 2-DM. One of the main goals in the course of treatment of obesity and early phases of the 2-DM should be normalization or at least reduction of hyperinsulinemia. Insulinemia may be regarded also as an important criterion for selection of the oral antidiabetic drugs.     

Clinico-pathologic manifestations of ruptured aneurysm of the sinus of Valsalva

The clinical files from the National Institute of Cardiology "Ignacio Chávez" were reviewed, we found 26 corroborated cases of ruptured aneurysms Valsalva's sinus. There is predominance of the male sex in proportion 3:1 and the median age when the diagnosis was made was 22 years. 77% of these cases were in N.Y.H.A. clinical class I or II and the main symptom was dyspnoea on exertion. On the physical examination a continuous murmur or sistolo-diastolic murmur was heard over precordium in 92% of the cases and a hyperkinetic circulatory regimen. Only in 23% of these patients the diagnosis was suspected and the more common confusion was with the V.S.D. associated with aortic incompetence. On the E.K.G. we found data with volumetric overload of the right heart in 15 cases. The hemodynamic study confirmed the diagnosis only in 60%. The aortic valve was substituted for associated incompetence in 12 cases and the pathological study revealed fibromixoid degeneration in 9 cases and only fibrosis in the remaining 3. The sinus of Valsalva more affected was the right coronary and the chamber where the rupture was more frequent was the right ventricle in 73% of the cases. We conclude that the ruptured aneurysms of the Valsalva's sinus is rather frequent among the congenital heart diseases and has particular clinical data and special features in making a precise diagnosis.     

An evaluation of some theories of the mechanism of aging.

Two theories of aging are considered in this review. Although there exists substantial experimental evidence in support of the somatic mutation and error catastrophe hypotheses, several experiments have been published which are extremely difficult to reconcile with these models, at least in their simplest forms. These include the observation that biochemical and morphological degenerative changes observed in fibroblasts aged in vitro do not resemble alterations observed in cells obtained from aged donors, and the fact that tissues transplanted serially through different hosts do not decline in vigor in the manner predicted by the somatic mutation theory. Although biochemical and mutational alterations appear to accumulate in fibroblasts aged in vitro (in support of the error catastrophe model), there are substantial problems with the interpretation of such experiments, and some observations (such as the lack of increase in translational error in hemoglboin synthesis as a function of age) seem to argue directly against the error catastrophe theory. Some alternative theoretical and experimental possibilities are discussed, including the concept of programmed aging as the cause of senescence.     

Usefulness of supernatant of pancreatic juice for genetic analysis of K-ras in diagnosis of pancreatic carcinoma

AIMS: To ascertain whether analysis of K-ras mutations at codon 12 (KRM) in the supernatant of pure pancreatic juice (PPJ) is more useful for the diagnosis of pancreatic carcinoma (PCa) than that in sediment, the authors analyzed KRM in DNA extract from not only the sediment but also the supernatant of PPJ and compared the results. METHODOLOGY: PPJ was collected endoscopically from 19 patients with PCa and 25 patients with chronic pancreatitis (CP). DNA was extracted from the supernatant and the sediment of PPJ. Mutant allele-specific amplification (MASA) was performed for KRM analysis with the DNA extracts from these samples. RESULTS: The incidence of KRM in the supernatant of PPJ was 89% (17 of 19) in patients with PCa and 28% (7 of 25) in patients with CP, whereas that in the sediment was 79% (15 of 19) in patients with PCa and 20% (5 of 25) in patients with CP. Although there was no significant difference in KRM incidence between supernatant and sediment, the positive rate of KRM was higher in the former. Additionally, with regard to the PCa cases, KRM were found in the supernatant alone in four cases and in the sediment alone in two cases. Consequently, by a combination assay, all of the patients with PCa showed KRM in either the supernatant or sediment of PPJ. Although there was no relation between the incidence of KRM in PPJ and the location and size of tumor, and clinical stage of carcinoma in the patients with PCa, two patients with clinical stage I disease showed KRM in the supernatant. CONCLUSION: These results suggest that the positive rate of KRM in the supernatant is not lower than that in the sediment, and simultaneous analysis of KRM in the supernatant and sediment of PPJ enhances the genetic diagnosis of PCa.