重组人脑利钠肽对大鼠心肌梗死后心室重构及功能的影响

目的 探讨重组人脑利钠肽(rhBNP)对心肌梗死后大鼠心室重构及心功能的影响.方法 建立急性心肌梗死(AMI)雄性SD大鼠模型45只,随机分为AMI对照组、小剂量rhBNP治疗组、大剂最rhBNP治疗组,每组各15只.另设15只作假手术组.rhBNP治疗组经颈静脉输液管输注rhBNP,剂量分别为5μg/ks和15 μg/kg,1次/d,持续4周,假手术组及AMI对照组仅以等体积的生理盐水输注.4周后检测血液动力学及心功能参数,心脏标本检测左室重量及左室重量指数(LVMI)、心肌梗死面积,并检测血浆和心肌血管紧张素Ⅱ(Ang Ⅱ)水平.结果 AMI对照组左室重量、LVMI及心肌AngⅡ水平明显高于假手术组,而收缩压及左室内压最大上升和下降速率(±dp/dt)均明显低于假手术组(均P<0.01).大、小剂量rhBNP治疗组左室重量及LVMI、心肌梗死面积和心肌AngⅡ水平均明显低于AMI对照组[左室重量:分别为(492.6±34.0)mg、(498.8±47.8)mg比(570.0±24.2)mg,P<0.01;LVMI:2.0±0.2、2 0±0.2比2.3±0.1,P<0.01;心肌梗死面积:(25.3±2.9)%、(31.4±3.0)%比(46.4±3.0)%,P<0.01;Ang Ⅱ水平:(881.3±62.7)pg/L、(1186.0±94.5)pg/L比(2436.7±280.3)pg/L,P<0.05],收缩压和±dp/dt也高于AMI对照组(P<0.01或P<0.05).结论 外源性的rhBNP连续应用能限制梗死面积、减轻AMI后心室重构、保护心功能.     

联合应用心电图和超声心动图在心肌淀粉样变诊断中的价值

目的探讨心电图和超声心动图联合应用在诊断心肌淀粉样中的价值。方法入选2006年至2013年之间在北京协和医院住院期间诊断为心肌淀粉样变(CA)的患者61例,此外入选肥厚型心肌病(HCM)13例,高血压17例以及健康体检者43例。收集病历资料,进行心电图和超声心动图相关参数测定。结果 CA组肢导联低电压发生率60.7%,余3组均为0%(均为P<0.01),胸导联R波进展不良发生率CA组高于高血压和健康组(47.5%比11.8%,47.5%比11.6%,均为P<0.01),CA组左室射血分数低于其他3组[(54.31%±15.00%)比(69.55%±10.50%)、(54.31%±15.00%)比(63.82%±9.80%)、(54.31%±15.00%)比(69.07%±5.88%),均为P<0.01]。CA组室间隔的厚度小于HCM组[(13.40±2.47)mm比(18.00±5.65)mm,P<0.01],左室后壁厚度大于HCM组[(13.45±2.19)mm比(10.88±3.05)mm,P<0.01],CA组室间隔与左室后壁的厚度与高血压组相比差异无统计学意义[(13.40±2.47)mm比(14.05±3.05)mm、(13.45±2.19)mm比(14.00±2.58)mm,均为P>0.05]。CA组肢导联及胸导联最高电压均小于其他3组(均为P<0.01);与HCM或高血压组比较,CA组所有12导联的QRS波电压值、Ⅰ、a VL和V5、V6导联R波与左室后壁,或与室间隔的比值均较低(均为P<0.01)。与健康组比较,CA组QRS波电压值除a VL、V2导联外,其他导联电压均较低(均为P<0.01);CA组Ⅰ、V5、V6导联R波与左室后壁或室间隔比值均低于健康组(均为P<0.01)。应用ROC曲线得出RⅠ/LVPW曲线下面积最大,当RⅠ/LVPW<0.36时,其诊断CA的敏感度和特异度最佳,分别为96.7%和88.5%。结论心电图和超声心动图检查参数结合,对心肌淀粉样变的辅助诊断和鉴别诊断有很好的临床价值,RⅠ/LVPW具有很高的敏感度和特异度。     

大鼠持续性高尿酸血症模型复制方法探讨

将大鼠随机分为对照组、模型Ⅰ组、模型Ⅱ组、模型Ⅲ组,模型Ⅰ组喂养饲料中含次黄嘌呤(HX)100 g/kg,模型Ⅱ、Ⅲ组饲料中含HX 50 g/kg;喂养12 h后,模型Ⅰ、Ⅱ组皮下注射尿酸酶抑制剂(UI)200 mg/kg,模型Ⅲ组注射100 mg/kg,观察HX对大鼠摄食的影响;分别测定造模后0、6、12、24、36、48 h大鼠血尿酸(UA)、尿素氮(BUN)、肌酐(Cr)水平.结果与对照组比较,建模后24 h各组大鼠摄食量明显减少,从48 h起各组摄食量逐渐增加,但模型Ⅰ、Ⅱ组摄食量仍低于对照组(P<0.05、<0.01).模型Ⅰ、Ⅱ组血UA升高(P<0.01),且可维持48 h以上;模型Ⅰ组血清UA在6、24、36、48 h均高于模型Ⅱ组,模型Ⅱ组在24、36、48 h高于模型Ⅲ组(P<0.05、<0.01);模型Ⅲ组血清UA值在造模后6、12、24、36 h明显高于对照组(P<0.01),48 h恢复至正常.造模48 h内,大鼠血清BUN、Cr均显著高于对照组(P<0.01).模型Ⅰ组在造模后6、12、48 h血BUN高于模型Ⅱ组(P<0.01、<0.05).提示HX 50 g/kg饲料喂饲,并皮下注射UI 200 mg/kg可复制出理想的大鼠持续性高UA血症模型.     

小剂量多巴酚丁胺超声心动图评价急性心肌梗死存活心肌的研究

目的　探讨梗死相关血管重建后存活心肌的功能恢复与左室重塑进程和左室功能恢复的关系。方法　将心肌梗死区异常室壁运动节段中存活心肌的节段数做为量化存活心肌的指标。筛选 4 8例初次急性心肌梗死患者 ,心肌梗死后 (2 0± 12 )天成功的接受梗死相关血管的介入治疗术 ,术前 1～ 3天接受静息超声心动图和小剂量多巴酚丁胺负荷超声心动图检查 ,术后 (5 4± 1 6 )个月复查静息超声心动图。依小剂量多巴酚丁胺超声心动图负荷试验检测出的梗死相关的异常室壁节段中存活心肌的节段数 ,将 4 8例患者分为 :Ⅰ组 ,大量存活心肌 (存活心肌节段≥ 6段 ) 11例 ,Ⅱ组 ,少量存活心肌 (2段≤存活心肌节段≤ 5段 ) 2 9例 ,Ⅲ组 ,无存活心肌 (存活心肌节段 <2段 ) 8例。分别测定术前和术后静息状态下的左室舒张末容积、左室收缩末容积、左室射血分数和左室室壁节段运动积分指数。结果　重建血管术后 (5 4± 1 6 )个月随访发现梗死相关动脉血管重建后 ,梗死相关血管的异常室壁运动有不同程度的改善 ,Ⅰ组的左室收缩末容量由 (6 3± 8)ml降至 (4 7± 10 )ml(P <0 0 1) ;室壁运动积分指数由 1 4± 0 2降至 1 1± 0 1(P <0 0 1) ,左室射血分数由 (4 6± 9) %增至 (5 7± 10 ) % (P<0 0 1)。Ⅱ组的左室收缩末容量 (7     

贝那普利和氯沙坦联合治疗对自发性高血压大鼠左室重构的影响

目的探讨贝那普利和氯沙坦联合应用对自发性高血压大鼠(SHR)左心室重构的作用。方法48只55周龄SHR随机分组(n=12):空白对照组(SHRC)、贝那普利组(SHRB:10mg/kg·d)、氯沙坦组(SHRL:30mg/kg·d)、合用组(SHRB L:贝那普利10mg/kg·d 氯沙坦15mg/kg·d),另设WKY大鼠为对照组,检测尾动脉压(SBP)。12周后:(1)放射免疫法检测血浆肾素活性(PRA)、血管紧张素Ⅱ(AngⅡ)、醛固酮(Ald)水平,化学法检测血浆一氧化氮(NO)水平;(2)免疫组化法检测心肌Ⅰ、Ⅲ型胶原纤维表达;(3)病理及超微结构检测。结果与SHR对照组比较,各药物组尾动脉压显著下降(P<0.01),但用药组间无显著差异(P>0.05);SHR各组间血浆PRA无显著性差异(P>0.05)。SHR对照组血浆AngⅡ低于WKY对照组(P<0.05～0.01),贝那普利组显著降低和氯沙坦组显著升高血浆AngⅡ水平,合用组介于两组之间。与贝那普利组[Ald:(393.9±17.6)pg/mL、NO:(15.2±2.1)μmol/L]、氯沙坦组[Ald:(332.0±17.8)pg/mL、NO:(12.3±1.8)μmol/L]比较,合用组[Ald:(302.4±15.5)pg/mL、NO:(16.5±2.4)μmol/L]更显著的降低血浆Ald和升高NO水平(P<0.01);与贝那普利组(Ⅰ型胶原:6.09±1.12%、Ⅲ型胶原:9.0%±1.2%)、氯沙坦组(Ⅰ型胶原:4.3%±0.7%、Ⅲ型胶原:8.0%±1.3%)比较,合用组(Ⅰ型胶原:2.8%±0.7%、Ⅲ型胶原:6.5%±1.0%)更显著的降低心肌Ⅰ、Ⅲ型胶原纤维的表达(P<0.01);组织病理及电镜显示,合用组更显著的改善SHR左心室重构。结论贝那普利和氯沙坦均能有效的改善高血压左室重构,二者合用时更为明显。     

心衰患者心肌中NHE1 mRNA的表达与血浆内皮素及心肌胶原的相关性研究

目的:观察心力衰竭(HF)患者心肌组织中钠氢交换体1（natrium-hydrogen exchanger 1,NHE1）的表达及其与血浆内皮素-1(ET-1)及心肌胶原的相关性,探讨NHE1、ET-1在HF、心肌纤维化发生发展中的作用。方法: 采用实时荧光定量PCR（FQ-PCR）检测35例HF患者心肌组织中NHE1 mRNA的表达水平。采用放射免疫分析法分别测定受试者血浆ET-1及Ⅰ型前胶原羧基端肽Ⅰ（PⅠCP）和Ⅲ型前胶原氨基端肽（PⅢNP）的含量。同时用心脏多普勒超声检查心脏左房内径、左室射血分数（LVEF％）。结果: FQ-PCR检测心功能Ⅰ、Ⅱ、Ⅲ级组HF患者心肌组织中NHE1 mRNA的△Ct值,分别为6.29±0.66、5.01±0.60和4.40±0.74。心功能Ⅱ级、Ⅲ级组患者心肌组织中NHE1 mRNA的表达明显高于心功能Ⅰ级组（P<0.01）,心功能Ⅲ级组患者心肌组织中NHE1 mRNA的表达明显高于心功能Ⅱ级组（P<0.05）。HF组ET-1及PⅠCP、PⅢNP的含量较对照组明显升高（P<0.01）,并随着HF程度的加重而增加,心功能Ⅱ级和Ⅲ级组显著高于心功能Ⅰ级组（P<0.05,P<0.01）,心功能Ⅲ级组显著高于心功能Ⅱ级组（P<0.05）;且ET-1及PⅠCP、PⅢNP的含量与NHE1 mRNA的△Ct值（r=-0.587,P<0.01）呈显著的负相关。ET-1与PⅠCP、PⅢNP含量（r=-0.418,P<0.05）呈显著的正相关。结论: HF患者NHE1 mRNA的表达与ET-1及PⅠCP、PⅢNP的含量均密切相关。NHE1在HF、心肌纤维化的发生和发展过程中可能起着重要作用。     

贝那普利和氯沙坦联合治疗对自发性高血压大鼠左室重构的影响

目的探讨贝那普利和氯沙坦联合应用对自发性高血压大鼠(SHR)左心室重构的作用. 方法 48只55周龄SHR随机分组(n=12):空白对照组(SHR-C)、贝那普利组(SHR-B:10 mg/kg·d)、氯沙坦组(SHR-L:30 mg/kg·d)、合用组(SHR-B L:贝那普利10 mg/kg·d 氯沙坦15 mg/kg·d),另设WKY大鼠为对照组,检测尾动脉压(SBP).12周后:(1)放射免疫法检测血浆肾素活性(PRA)、血管紧张素Ⅱ(Ang Ⅱ)、醛固酮(Ald)水平,化学法检测血浆一氧化氮(NO)水平;(2)免疫组化法检测心肌Ⅰ、Ⅲ型胶原纤维表达;(3)病理及超微结构检测.结果与SHR对照组比较,各药物组尾动脉压显著下降(P<0.01),但用药组间无显著差异(P>0.05);SHR各组间血浆PRA无显著性差异(P>0.05).SHR对照组血浆Ang Ⅱ低于WKY对照组(P<0.05～0.01),贝那普利组显著降低和氯沙坦组显著升高血浆Ang Ⅱ水平,合用组介于两组之间.与贝那普利组[Ald:(393.9±17.6)pg/mL、NO:(15.2±2.1)μmol/L]、氯沙坦组[Ald:(332.0±17.8)pg/mL、NO:(12.3±1.8)μmol/L]比较,合用组[Ald:(302.4±15.5)pg/mL、NO:(16.5±2.4)μmol/L]更显著的降低血浆Ald和升高NO水平(P<0.01);与贝那普利组(Ⅰ型胶原:6.09±1.12%、Ⅲ型胶原:9.0%±1.2%)、氯沙坦组(Ⅰ型胶原:4.3%±0.7%、Ⅲ型胶原:8.0%±1.3%)比较,合用组(Ⅰ型胶原:2.8%±0.7%、Ⅲ型胶原:6.5%±1.0%)更显著的降低心肌Ⅰ、Ⅲ型胶原纤维的表达(P<0.01);组织病理及电镜显示,合用组更显著的改善SHR左心室重构.结论贝那普利和氯沙坦均能有效的改善高血压左室重构,二者合用时更为明显.     

血浆尾加压素与高血压、心肌肥厚和血管重构关系的研究

目的:观察原发性高血压、高血压合并心肌肥厚及血管重构患者血浆尾加压素Ⅱ(urotensinⅡ,UⅡ)含量的变化,探讨UⅡ在高血压病发生发展过程中的意义。方法:选择原发性高血压患者67例(高血压组),和正常人34例(正常对照组),应用超声方法检测颈动脉内-中膜厚度(IMT)、左室重量指数(LVMI),并将原发性高血压患者分为单纯性高血压组,高血压合并血管重构组及合并心肌肥厚组,采用放射免疫分析法检测血浆UⅡ含量。结果:高血压组患者血浆UⅡ含量(5.14±2.59)pg/ml,明显低于正常对照组(6.75±1.55)pg/ml及单纯性高血压组(6.54±2.00)pg/ml,P<0.01。而单纯性高血压组与正常对照组比较无显著差异,P<0.05。较之正常对照组,血管重构组患者IMT,心肌肥厚组患者LVMI、IMT明显增加;这两组血浆UⅡ含量明显减少,亦明显少于单纯性高血压组,分别为(5.08±2.47)pg/ml,P<0.05;(3.85±1.97)pg/ml,P<0.05;并且血浆UⅡ水平与IMT、LVMI呈显著的负相关(分别为r=-0.506,P<0.01;r=-0.399,P<0.01)。结论:UⅡ可能在高血压病血管重构及心肌肥厚的过程中有重要作用,但作用机制及其意义有待深入研究。     

急性高容量血液稀释联合硝酸甘油控制性降压对老年全髋关节置换术患者血流动力学指标及cTnI水平的影响

目的研究老年全髋关节置换术患者手术治疗前采用急性高容量血液稀释(AHH)与硝酸甘油控制性降压(CH)相结合对血流动力学和心肌肌钙蛋白(cTnI)的影响。方法选择择期行全髋关节置换、美国麻醉师学会(ASA)Ⅰ或Ⅱ级、排除心肺疾患、年龄65⁷8岁的患者60例。全身麻醉成功后随机分为AHH联合CH组(Ⅰ组)和单纯CH组(Ⅱ组),每组30例。Ⅰ组诱导后切皮前静脉给予6%羟乙基淀粉15 ml/kg,输注速率为30 ml/min,两组患者术中均用硝酸甘油行CH,平均动脉压(MAP)控制在6078岁的患者60例。全身麻醉成功后随机分为AHH联合CH组(Ⅰ组)和单纯CH组(Ⅱ组),每组30例。Ⅰ组诱导后切皮前静脉给予6%羟乙基淀粉15 ml/kg,输注速率为30 ml/min,两组患者术中均用硝酸甘油行CH,平均动脉压(MAP)控制在60⁷0 mmHg。分别于术前(T0)、CH后1 h(T1)、恢复正常血压后1 h(T2)、术毕(T3)时记录MAP、心率(HR)、中心静脉压(CVP)、心电图ST段水平,于T0、T1、T3、术后6 h(T4)、术后24 h(T5)抽取上肢静脉血样2 ml,查血浆cTnI,术毕记录降压期间尿量、出血量和输血量。结果两组患者MAP在T1和T2时显著低于T0时(P<0.05);Ⅰ组患者HR在T1和T2时与T0时比较无差异(P>0.05),Ⅱ组T1、T2时HR显著高于T0时(P<0.05);Ⅰ组T2、T3时CVP显著高于T0时(P<0.05),Ⅱ组T3时CVP显著高于T0时(P<0.05)。组间比较,Ⅱ组T1、T2时HR显著高于Ⅰ组(P<0.05)。两组cTnI组内、组间比较差异均无统计学意义(均P>0.05)。Ⅰ组降压期间尿量明显高于Ⅱ组(P<0.05);两组总出血量的对比无统计学差异(P>0.05),总输血量Ⅰ组相比于Ⅱ组明显减少(P<0.05)。结论对于老年患者,AHH可增加CH期间血流动力学的稳定性和安全性,且不会引起心肌损伤。     

卡维地洛对慢性心力衰竭患者心肌重构和炎性细胞因子的影响

目的探讨卡维地洛对慢性心力衰竭(心衰)患者心肌重构和血浆肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)和白细胞介素-6(IL-6)的影响。方法72例心衰患者随机分为治疗组和对照组各36例。对照组给予洋地黄、利尿剂及血管紧张素转换酶抑制剂。治疗组在此基础上加用卡维地洛。随访半年,治疗前后采用超声心动图、胸部X线和化学发光法测定心功能、心胸比率和血浆TNF-α、IL-1β和IL-6的变化。结果两组治疗后心功能改善,总有效率为77.8%和50%,P<0.01;心胸比率分别为(0.55±0.07和0.58±0.06,P<0.05)。治疗组治疗后左室舒张期末内径和左室收缩期末内径分别为(58.7±6.9)mm和(44.7±7.2)mm,显著低于对照组(61.3±2.7)mm和(50.9±9.2)mm;左室射血分数为(46.3±9.7)%,显著高于对照组(39.9±6.8)%,P<0.01;血浆TNF-α、IL-1β和IL-6分别为(46.08±13.27)pg/ml、(31.32±4.06)pg/ml和(30.26±10.59)pg/ml,显著低于对照组(59.23±18.65)pg/ml、(39.58±11.38)pg/ml和(54.96±20.21)pg/ml,P<0.01)。副作用发生率,两组相比较差异无统计学意义。结论慢性心力衰竭在常规治疗基础上加用卡维地洛安全有效,可以改善心功能,逆转心肌重构,降低血浆主要细胞因子水平。     

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.