腹水型晚期血吸虫病患者脑电图和智能测验分析

目的 分析腹水型晚期血吸虫病患者的脑电活动和智能测验特点.方法 89例腹水型晚期血吸虫病患者(病例组)和45例健康人(对照组)均为脑电图(EEG)检测对象,其中将病例组按肝功能改良child分级法分为A、B、C级组进行EEG比较.同时将病例组患者按脑电图检测状况分为正常、轻度异常、中度异常、重度异常四组进行智力测验结果分析.所有数据用卡方检验进行统计学处理.结果 病例组EEG异常率(57.3%)明显高于对照组(15.6%),差异有显著性意义(X2=21.22,P＜0.01).肝功能改良child分级A、B、C级组EEG异常率分别为27.3%、54.8%和69.4%.病例组智能测验总异常率为52.8%.病例组按脑电图正常、轻、中、重度异常分组的智能验测异常率分别为23.6%、52.4%、85.O%和90.0%.四组间差异有显著性意义(X2=25.589,P＜0.01).结论 EEG异常程度与肝功能损害程度呈正相关,智能测验异常率与脑电图异常程度呈平行关系.脑电图和智能检测是早期诊断腹水型晚期血吸虫病患者轻微肝性脑病(MHE)的重要辅助诊断方法和反映病情程度的客观指标.     

Accumulation of newly synthesized mRNAs in response to human fibroblast (beta) interferon

Treatment of human fibroblast cells with human fibroblast (beta)interferon for up to 8 hr resulted in the accumulation of at least four mRNAs. The mRNAs were isolated from cellular polysomes and characterized by stimulation of translation in a wheat germ cell-free protein synthesis system. The mRNAs appear as early as 2 hr after exposure to interferon and can be translated in vitro into proteins having molecular weights of 61,000, 62,000, 64,000, and 68,000. The response is not elicited by mouse interferon or insulin and does not occur in the presence of actinomycin D. Chase experiments indicated that the induced mRNAs remain ribosome-associated for at least 3 hr after their synthesis. The appearance of the induced mRNAs correlated directly with the onset of an antiviral state. Velocity sedimentation of the induced mRNAs on sucrose gradients demonstrated that each of the four induced proteins are encoded by different-sized mRNAs.     

Prevalence and prognostic value of quantified electroencephalogram (EEG) alterations in cirrhotic patients

BACKGROUND/AIMS: The electroencephalogram (EEG) is frequently altered in cirrhotic patients. We, therefore, performed a study to ascertain the features and the prognosis of cirrhotic patients without current overt hepatic encephalopathy (OHE) who have EEG alterations. METHODS: A series of 296 consecutive cirrhotic patients who had undergone quantified-EEG was studied. The median follow-up was 442 days, 128 patients had bouts of OHE and 78 patients died from liver-related causes. Another group of 124 cirrhotic patients with a median follow-up of 223 days was examined to validate the prognostic model. RESULTS: EEG alterations were detected in 38% of the patients. The prevalence of EEG alterations was associated with the severity of cirrhosis (class B: odds ratio (OR) = 2.3, 95% confidence interval (CI) = 1.2-4.7; class C: OR = 3.5, 95% CI = 1.6-7.7), but not with the aetiology (alcoholic vs. non-alcoholic: OR = 0.9; 95% CI = 0.5-1.5). The EEG predicted the occurrence of OHE (chi2 = 26; P < 0.001) and mortality (chi2 = 34; P < 0.001), also adjusting for Child-Pugh class by a multivariate analysis. In the patients with a Child-Pugh score of > or = 8, the EEG discriminated between those patients with a higher 1-year risk of OHE (hazard ratio (HR) = 3.3, 95% CI = 1.8-6.1) and death (HR = 3.1, 95% CI = 1.7-5.6). CONCLUSIONS: In conclusion, quantified-EEG had a prognostic value for the occurrence of bouts of OHE and mortality in cirrhotic patients.     

Severe aplastic anemia (SAA): response to cyclosporin A (CyA) in vivo and in vitro

The aim of the present study was to test the effect of cyclosporin A (CyA) in vitro on CFU-GM growth from patients with severe aplastic anemia (SAA). For this purpose, bone marrow (BM) cells from 9 SAA patients and 5 healthy individuals were incubated with or without CyA and then cultured for CFU-GM growth in the presence of exogenous recombinant human GM-CSF (30 ng/ml). SAA patients were tested before or after treatment with CyA, or after treatment with antilymphocyte globulin (ALG). In 3 patients responding to CyA, the addition of CyA in vitro enhanced colony growth from 13 +/- 10 to 40 +/- 20/10(5) BM cells (p = 0.01) - the median increment of colony formation was 2.4-fold. In 5 ALG responders, CyA produced no increment of CFU-GM growth (from 14 +/- 26 to 15 +/- 16/10(5) BM cells, p = 0.1). CyA did not enhance significantly CFU-GM growth in normal controls (from 57 +/- 45 to 58 +/- 81/10(5) BM cells, p = 0.9). In conclusion, it would appear that some patients with SAA can respond to CyA in vivo and in vitro, and ALG responders are not necessarily among these. This is in keeping with different mechanisms of action of CyA and ALG and possibly with the existence of distinct pathogenetic pathways in SAA.     

The role of interleukin-1 beta (IL-1beta) in the normal human colon in vitro

BACKGROUND/AIMS: The possibility that interleukin-1 beta (IL-1beta) is a neuromodulator of the non-adrenergic non-cholinergic (NANC) inhibitory nerves which may be mediated by nitric oxide (NO) was recently reported from animal experiments. To clarify the physiological significance of the relationship between IL-1beta and NO in the normal human colon, enteric nervous responses to IL-1beta in the normal colon muscle strips were investigated. METHODOLOGY: Normal colon muscle strips derived from patients who underwent colon resection for left-sided colon cancers (14 cases) were used. The subjects consisted of 8 men and 6 women, aged from 44 to 65 years with a mean age of 56.8 years. A mechanographic technique was used to evaluate in vitro colon muscle responses to IL-1beta of adrenergic and cholinergic nerves before and after treatment with various autonomic nerve blockers and N(G)-nitro-L-arginine (L-NNA). RESULTS: IL-1beta concentration dependently caused a relaxation reaction before and after the blockade of the adrenergic and cholinergic nerves. The frequency of relaxation responses after blocking the adrenergic and cholinergic nerves was higher than that before blocking, but there was no significant difference between them. Both tetrodotoxin and L-NNA inhibited the relaxation reaction in response to IL-1beta in the human colon. CONCLUSIONS: These findings suggest that IL-1beta plays an important role in regulating relaxation of the normal human colon via nitregic nerves, and that NO plays a role as a neurotransmitter in the NANC inhibitory nerves.     

A comparison of in vivo and in vitro human airway reactivity to histamine

To examine for a relationship between in vivo nonspecific bronchial reactivity to histamine and in vitro smooth muscle response to histamine, we performed inhalation dose-response curves prior to lung surgery in 12 patients and compared this with their bronchial smooth muscle response in vitro. In vivo reactivity was assessed by the provocative concentration of histamine resulting in a 20% fall in forced expiratory volume in one second (PC20), and in vitro reactivity was measured by the negative log of the molar concentration of histamine producing 50% maximal contraction (pD2) as well as maximal tension generated (Tmax). In addition, morphometric analysis was performed on the in vitro tissue to quantitate the amount of smooth muscle present. A wide range of in vivo responses was found in the 12 subjects (PC20-0.065 lead to 16). There was less in vitro variability and no correlation between PC20 and in vitro reactivity assessed by pD20 or Tmax or between PC20 and the percent of smooth muscle.     

A novel beta-Thalassemic allele due to a two nucleotide deletion: beta76 (-GC)

We have identified and characterized a novel beta-thalassemic mutation in a North African adult. The molecular defect consists of a two nucleotide (nt) deletion in the beta-globin gene at codon 76 [beta76 (-GC), c.229-230delGC]. This frameshift mutation generates a TGA stop codon at position 89. The carrier presented with mild microcytic anemia (Hb 12.8 g/dL, MCV 60 fL), no detectable Hb F, an elevated Hb A2 level (5.5%) with no other mutation in the beta-globin gene and none of the more common known deletions in the alpha-globin cluster. No abnormal hemoglobin (Hb) was present in routine electrophoresis or in high performance liquid chromatography (HPLC) analyses. Pathologic inclusions were absent in both mature red cells and in reticulocytes. This observation reinforces the hypothesis that nonsense and frameshift mutations that result in a premature stop codon in exon 1 or exon 2 inherited in the heterozygous state do not generate dominant beta-thalassemia (thal). This is the first example of a premature stop codon at position 89.     

Defective platelet response to arachidonic acid and thromboxane A(2) in subjects with Pl(A2) polymorphism of beta(3) subunit (glycoprotein IIIa)

The membrane complex alpha(IIb)beta(3) is the major receptor for fibrinogen and is involved in platelet adhesion and aggregation. Evidence has been presented that the Pl(A2) allele of the beta(3) Pl(A1/A2) gene polymorphism might be an independent risk factor for coronary thrombosis, but the matter is still controversial. We investigated the relationship between this polymorphism and possible alterations of platelet functions in vitro. The platelet adhesion to fibrinogen-coated microplate wells and the aggregation induced by several different agonists were tested in 63 healthy volunteers, among them, 49 subjects with Pl(A1/A1) polymorphism, 12 subjects with Pl(A1/A2) polymorphism and two subjects with (PlA2/A2) polymorphism. Subjects with PlA1/A2 polymorphism or with Pl(A2/A2) polymorphism showed significantly lower platelet responses as compared with Pl(A1/A1) subjects when either arachidonic acid or the thromboxane A(2) analogue, U46619, were used as agonists. In resting condition and after thrombin or ADP stimulation, platelet function was normal in all the subjects. An increased sensitivity to the anti-aggregatory effect of acetylsalicylic acid was observed in platelets from subjects with the Pl(A2) allele. Finally, using a flow-cytometric evaluation and determining the beta-thromboglobulin plasma levels, we did not find any evidence of a Pl(A2) platelet hyper-reactivity ex vivo. Our findings are not consistent with the hypothesis that the purported increase of cardiovascular risk in these subjects may be as a result of platelet hyperactivation. On the contrary, the Pl(A2) allele is associated with a platelet functional deficiency, specifically linked to the activation of the fibrinogen receptor by thromboxane A(2).     

A transition-state analogue inhibitor of human renin (H.261): test in vitro and a comparison with captopril in the anaesthetized baboon

H.261, a new transition state inhibitor of human renin with an IC50 of 6.9 X 10(-10) M, was given by intravenous infusion to six anaesthetized baboons. The inhibitor was infused first at 0.1 mumol/kg/h for 15 min, then at 1.0 mumol/kg/h for a further 15 min. After a recovery period of 2 h in which the animals received 5% dextrose, they were infused with captopril, 25 mumol/kg/h for 15 min. At both rates of infusion H.261 markedly and significantly reduced the enzymatic action of renin in plasma, the blood concentration of angiotensin I, the plasma concentration of angiotensin II and mean arterial pressure. All changes reverted towards or to control values in the subsequent control period. Captopril also lowered plasma angiotensin II concentration and mean arterial pressure markedly and significantly but, as expected for an inhibitor of the angiotensin I-converting enzyme, plasma active renin concentration and blood angiotensin I concentration increased. The changes of angiotensin II and arterial pressure were similar with captopril and H.261.     

MPEG digital compression and analogue videotape: a comparison of moving images and electroencephalogram data in epileptic patients

PRIMARY OBJECTIVES: The objective of this study was to compare the clinical usefulness, in the field of epileptology, of digital moving images and electroencephalogram (EEG) waveforms by Motion Pictures Expert Group compression algorithms (MPEG-1 and MPEG-2) to that of conventional analogue recording. RESEARCH DESIGN AND METHODS: Three epileptic seizure scenes consisting of moving images and the corresponding EEG waveforms in an epileptic patient were selected as the images to be evaluated. Each scene was recorded using MPEG-1, MPEG-2 and videotape. Ten doctors used six criteria to evaluate the quality of moving images, EEG data and audio. MAIN OUTCOMES: Analysis of variance and Bonferroni tests indicated that the image quality of MPEG-2 was superior to that of MPEG-1 or videotape for all criteria. Furthermore, MPEG-2 obtained much higher scores in EEG waveform quality than did the other modalities. CONCLUSIONS: Our findings suggested that data from MPEG-2 images will lead to more precise diagnosis and treatment decision-making than data from analogue videotape recordings.     

A central mechanism is involved in the secretion of ACTH in response to IL-6 in rats: comparison to and interaction with IL-1 beta.

The cytokines interleukin-1 beta (IL-1 beta), interleukin-6 (IL-6) and tumor necrosis factor-alpha are known to be potent effectors of ACTH secretion. Some of the peripheral effects of IL-1 beta appear to be related to the secretion of IL-6 induced by IL-1 beta. Thus, we evaluated the effect of IL-6 on ACTH secretion and its interaction with IL-1 beta. Rats received recombinant human (rhIL-6) or murine (rmIL-6) IL-6 through indwelling jugular cannulae. rhIL-6 (200 ng or 2 micrograms/rat) produced peak plasma ACTH levels which were 3- to 4-fold greater than basal levels. rmIL-6 produced similar responses. Neither species of IL-6 affected plasma prolactin levels. Comparison of rhIL-1 beta (200 ng) to rhIL-6 (200, 100 or 50 ng) showed that IL-6 elevated ACTH in a dose-dependent manner and that IL-1 beta was significantly more effective. IL-1 beta was also administered concomitantly with or 10 min after IL-6. Delivered together, IL-1 beta (100, 30 or 10 ng) and IL-6 (100 ng) produced significantly higher ACTH levels than when given alone. This additivity was also evident when IL-6 was given 10 min prior to IL-1 beta. The coadministration of IL-6 (2 micrograms) with corticotropin-releasing factor (CRF, 1 micrograms/kg, b.w.) also had an additive effect on ACTH secretion (at 20 min: 300 +/- 40 pg/ml for CRF; 320 +/- 83 pg/ml for IL-6; and 540 +/- 44 pg/ml for CRF + IL-6), whereas a higher dose of CRF (10 micrograms/kg b.w.) yielded ACTH levels of 1,000 +/- 107 pg/ml at 20 min, with no further enhancement by IL-6. Incubation of pituitary cells with IL-6 alone (0.1, 1.0 or 3.0 nM) produced a slight but significant stimulation of ACTH secretion within 2 h in response to the higher doses of IL-6 only (p < 0.05), but did not modify the effect of CRF in vitro. To determine if the action of IL-6 was at a site(s) within the brain, IL-6 (30 or 100 ng/0.5 microliters) was injected into the third cerebroventricle of alert rats. 100 ng IL-6 elicited peak plasma ACTH levels (300 +/- 65 pg/ml) within 30 min; these were significantly higher than the buffer responses (90 +/- 25 pg/ml, p < 0.01), and lower than the responses to 30 ng IL-1 beta (530 +/- 50 pg/ml, p < 0.001). 30 ng IL-6 was ineffective.(ABSTRACT TRUNCATED AT 400 WORDS)     

Plasticity of the cochleotopic (frequency) map in specialized and nonspecialized auditory cortices

Auditory conditioning (associative learning) causes reorganization of the cochleotopic (frequency) maps of the primary auditory cortex (AI) and the inferior colliculus. Focal electric stimulation of the AI also evokes basically the same cortical and collicular reorganization as that caused by conditioning. Therefore, part of the neural mechanism for the plasticity of the central auditory system caused by conditioning can be explored by focal electric stimulation of the AI. The reorganization is due to shifts in best frequencies (BFs) together with shifts in frequency-tuning curves of single neurons. In the AI of the Mongolian gerbil (Meriones unguiculatus) and the posterior division of the AI of the mustached bat (Pteronotus parnellii), focal electric stimulation evokes BF shifts of cortical auditory neurons located within a 0.7-mm distance along the frequency axis. The amount and direction of BF shift differ depending on the relationship in BF between stimulated and recorded neurons, and between the gerbil and mustached bat. Comparison in BF shift between different mammalian species and between different cortical areas of a single species indicates that BF shift toward the BF of electrically stimulated cortical neurons (centripetal BF shift) is common in the AI, whereas BF shift away from the BF of electrically stimulated cortical neurons (centrifugal BF shift) is special. Therefore, we propose a hypothesis that reorganization, and accordingly organization, of cortical auditory areas caused by associative learning can be quite different between specialized and nonspecialized (ordinary) areas of the auditory cortex.     

Release of human pancreatic polypeptide and gastrin in response to intraduodenal stimuli: a case report.

A recent clinical case afforded an opportunity to study the effects of duodenal stimulation on plasma human pancreatic polypeptide and gastrin concentrations, independent of gastric stimulation. A distension stimulus was provided by rapid injection of 100 ml of water and saline via a T-tube into an isolated duodenal afferent limb. In a third experiment, the saline contained 200 pg/ml of heptadecapeptide human gastrin. Within 2 min after each injection, a rapid rise in circulating human pancreatic polypeptide levels appeared that fell promptly towards basal thereafter. Injections of 100 ml of Flexical, a supplemental tube feeding, resulted in a biphasic human pancreatic polypeptide response, the initial peak comparable to that seen following distension with water, saline, or saline containing gastrin, and a second peak of much greater magnitude and duration followed the initial peak. Plasma gastrin concentrations were not influenced following any of the stimuli. Duodenal distension alone may induce an early transient increase in plasma human pancreatic polypeptide concentrations, while intraduodenal nutrients per se may induce a later increment of greater magnitude and duration.     

A comparison in vitro of human and rabbit distal colonic muscle responses to inflammatory mediators

The present study compared in vitro the motor responses of human and rabbit distal colonic longitudinal and circular muscle to acetylcholine, histamine, leukotrienes B4 and D4, and prostaglandins E2 and F2 alpha. The active and passive mechanical properties of these muscles were also evaluated. All muscle types were contracted by acetylcholine and histamine. Longitudinal muscle from both species was contracted by prostaglandin E2 and prostaglandin F2 alpha, although rabbit muscle was more sensitive. Prostaglandin E2 relaxed the majority of both human and rabbit circular muscle preparations that were studied. Prostaglandin F2 alpha first relaxed and then contracted circular muscle from both species. Leukotriene B4 had no effect on any tissue studied. Leukotriene D4 caused transient relaxations in a proportion of all muscle types, but the relaxations were not concentration-related. Contractile responses did not differ under isotonic recording conditions, but relaxations were much more clearly defined. Based on experiments using atropine, phentolamine and propranolol, and pyrilamine or tetrodotoxin, it was concluded that the responses of both human and rabbit distal colonic muscles to these inflammatory mediators have a similar pharmacological basis. All muscle types exhibited low passive tension and developed active tension in the range 0.8-1.2 Lo. These data strongly support the belief that after the onset of an induced colitis, the rabbit colon has value as a predictive model for the study of inflammatory mediator-induced colonic motility changes in humans.     

A comparison of cardiovascular and catecholamine responses to three stimuli in mild hypertension

In five males with mild essential hypertension, simultaneous hemodynamic and arterial and venous plasma catecholamine responses to three stimulation tests (mental arithmetic, isometric handgrip exercise, and cold) were studied. Plasma norepinephrine (NE), epinephrine (EPI), and dopamine (DA) were measured radioenzymatically. Isometric exercise was the best stimulus for systolic and diastolic blood pressure and NE. Mental arithmetic produced the highest levels of plasma EPI, but there was great intersubject variability. Dopamine levels did not increase with any of these stimuli. Consistent arterio-venous differences across the forearm were seen for EPI but not NE, consistent with local production of NE. Isometric exercise produced the closest correlations between peripheral plasma catecholamine levels, blood pressure, and heart rate. Good correlations were seen with mental arithmetic, but with the stimulus of cold correlation was poor.     

Species-specific vesicular monoamine transporter 2 (VMAT2) expression in mammalian pancreatic beta cells: implications for optimising radioligand-based human beta cell mass (BCM) imaging in animal models

Aims/hypothesis

Imaging of beta cell mass (BCM) is a major challenge in diabetes research. The vesicular monoamine transporter 2 (VMAT2) is abundantly expressed in human beta cells. Radiolabelled analogues of tetrabenazine (TBZ; a low-molecular-weight, cell-permeant VMAT2-selective ligand) have been employed for pancreatic islet imaging in humans. Since reports on TBZ-based VMAT2 imaging in rodent pancreas have been fraught with confusion, we compared VMAT2 gene expression patterns in the mouse, rat, pig and human pancreas, to identify appropriate animal models with which to further validate and optimise TBZ imaging in humans.

Methods

We used a panel of highly sensitive VMAT2 antibodies developed against equivalently antigenic regions of the transporter from each species in combination with immunostaining for insulin and species-specific in situ hybridisation probes. Individual pancreatic islets were obtained by laser-capture microdissection and subjected to analysis of mRNA expression of VMAT2.

Results

The VMAT2 protein was not expressed in beta cells in the adult pancreas of common mouse or rat laboratory strains, in contrast to its expression in beta cells (but not other pancreatic endocrine cell types) in the pancreas of pigs and humans. VMAT2- and tyrosine hydroxylase co-positive (catecholaminergic) innervation was less abundant in humans than in rodents. VMAT2-positive mast cells were identified in the pancreas of all species.

Conclusions/interpretation

Primates and pigs are suitable models for TBZ imaging of beta cells. Rodents, because of a complete lack of VMAT2 expression in the endocrine pancreas, are a ‘null’ model for assessing interference with BCM measurements by VMAT2-positive mast cells and sympathetic innervation in the pancreas.     

Targeted identification of glucocorticoid-attenuated response genes: in vitro and in vivo models

Glucocorticoids attenuate the induction of numerous inflammatory mediators. We hypothesized that a targeted screening for genes with these regulatory characteristics, called glucocorticoid-attenuated response genes (GARGs), would be an efficient way to identify genes participating in glucocorticoid-sensitive inflammatory processes. An initial application of this idea, using an in vitro model, identified 12 cDNAs induced by LPS and attenuated by dexamethasone, including a new chemokine designated LIX. In vivo studies demonstrated that endotoxemia-induced lung mRNA expression of LIX, but not of two related chemokines, is markedly enhanced by adrenalectomy and attenuated by dexamethasone. This work provided the basis for an in vivo screening project that identified 36 GARG cDNAs induced in the lung during endotoxemia. The majority represent genes of unknown function, or genes not previously implicated in the pulmonary response to inflammation. Four encode previously undescribed proteins, including a chemokine, a member of a family of guanylate-binding proteins, a 2'-5' oligoadenylate synthetase-like protein, and a novel lung-inducible Neuralized-related C3HC4 RING protein (LINCR). Our results indicate that glucocorticoid-attenuated response genes are much more diverse than originally anticipated. Future studies using microarrays in this and other inflammation models may identify many additional glucocorticoid-regulated genes potentially important in inflammatory diseases.