小剂量氟哌啶醇结合支持性心理治疗抽动-秽语综合征疗效观察

目的：　探讨抽动-秽语综合征(TS)治疗方法。方法：　观察组26例,采用小剂量氟哌啶醇,(起始剂量每日0.025mg/kg,最大剂量≤2mg/d)结合支持性心理治疗,并与21例单纯小剂量氟哌啶醇组(剂量同前)及28例常规剂量治疗组(起始量每日0.05mg/kg,最大剂量≤6mg/d)作对照。结果：　观察组疗效显著高于单纯小剂量组(P<0.01),与常规剂量组相近(P>0.05);而药物毒副反应观察组(11.5%)明显低于常规剂量组(46.4%) (P<0.05)。结论：　小剂量氟哌啶醇结合心理干预是治疗TS一个疗效好且安全的方法。     

利培酮与氟哌啶醇治疗抽动-秽语综合征疗效对比研究

目的　对比利培酮与氟哌啶醇治疗Tourette综合征 (TS)的疗效与安全性。方法　将深圳市人民医院 2 0 0 1年 1月至 2 0 0 3年 7月小儿神经专科门诊 4 2例TS患者随机分为 2组 ,分别给予利培酮与氟哌啶醇治疗 ,应用《耶鲁抽动程度综合量表》(YGTSS)及治疗时出现的症状量表 (TESS)于治疗前及治疗后第 8、16周末评价其疗效及副反应。结果　两组治疗后第 8周、第 16周与治疗前比较YGTSS量表的运动抽动及发声抽动各项评分差异均有显著性 (P <0 0 5 ) ,治疗 16周后利培酮组运动抽动各项评分均显著低于氟哌啶醇组 (P <0 0 5 ) ,利培酮组第 8、16周末TESS总分均显著低于氟哌啶醇组 (P <0 0 5 )。结论　利培酮治疗TS疗效较氟哌啶醇好 ,副作用较氟哌啶醇轻。     

托吡酯治疗Tourette综合征大鼠的疗效及机制研究

目的：目前研究认为Tourette综合征（TS）的发病与多巴胺（DA）、兴奋性氨基酸（EAA）等神经递质障碍有关。近年报道托吡酯等抗癫癎药对此综合征有一定的疗效,但其具体的作用机制尚不十分清楚。该研究通过测定亚氨基二丙腈（IDPN）诱发的头部抽动大鼠模型脑内游离DA和血浆EAA含量的改变,探讨TS发病与神经递质异常之间的关系并探讨托吡酯对该模型的作用。方法：将48只Sprague-Dawley大鼠随机分为空白对照组、模型组、氟哌啶醇组（0.5 mg/kg)、 托吡酯I组（5 mg/kg）、 托吡酯 II组（10 mg/kg）、托吡酯 III组（20 mg/kg)。采用腹腔注射IDPN （每日150 mg/kg,1次/d,连续7 d）诱导大鼠头部抽动作为Tourette综合征动物模型。托吡酯或氟哌啶醇给药35 d后分别采用ELISA法和HPLC法测定脑组织游离DA和血浆EAA的含量。结果：与空白对照组相比,IDPN诱导的头部抽动大鼠脑组织游离DA含量明显降低、血浆EAA含量明显升高（P<0.05）;与模型组相比,中、大剂量托吡酯给药35 d后能明显减少IDPN所致的大鼠头部抽动行为（P<0.05）,升高脑内游离DA的含量;同时大剂量托吡酯组还伴随着血浆EAA水平的降低（P<0.05）,作用效果与阳性对照药氟哌啶醇一致。结论： TS的发生可能与中枢DA受体超敏感和血浆EAA的过度作用有关。托吡酯可减轻IDPN诱导的大鼠抽动行为,其作用机制可能与其抑制脑内DA与DA受体的结合以及抑制血浆EAA的释放和分泌有关。     

四氢小檗碱治疗抽动-秽语综合征的临床观察

四氢小檗碱(tetrahydroberberine,THB)是新型多巴胺阻滞剂。我们于1982年以来应用该药治疗抽动-秽语综合征106例,以氟哌啶醇(haloperi-dol,HAL)为对照,效果满意,报告如下。临床疗效观察一、治疗对象:本组均系专业门诊患儿,具有典型症状、体征,出现慢性、波动性、多发性运动肌抽搐,并伴有不自主发声或秽语。病初多见颜面部肌肉抽搐样动作,如眨眼、扬眉、噘咀、摇头、斜颈,渐     

可乐定透皮贴剂治疗儿童抽动-秽语综合征的疗效观察

目的：目前对儿童抽动-秽语综合征（TS）的治疗主要以口服药物为主,但鉴于药物的不良反应及每日1~2次口服药物不方便,导致患儿依从性差。该文探讨可乐定透皮贴剂治疗TS的临床疗效和安全性。方法：将119例5～17岁TS患儿分为两组,治疗组65例采用可乐定透皮贴剂;对照组54例给予氟哌啶醇口服。4周后观察两组的疗效。疗效评定采用耶鲁大体抽动严重程度量表（YGTSS）测定。结果贴剂治疗组YGTSS减分率（61.5±7.5）%,对照组减分率（41.0±6.3）%,两组减分率通过χ2检验差异有显著性（P<0.05）。贴剂治疗组53例有效,有效率为81.5%,对照组36例有效,有效率为67.5%,差异无显著性。贴剂治疗组1例出现血压下降、头晕反应,停药后恢复。对照组2例出现轻度的颈肌张力增高,4例出现轻度嗜睡,疲乏。结论 可乐定透皮贴剂对治疗儿童TS有明显疗效,且不良反应少而轻微,方便,易于接受。［中国当代儿科杂志,2009,11（7）：537-539］     

托吡酯治疗小儿Tourette综合征疗效的初步观察

Tourette综合征（TS）,又称多发性抽动,以多种运动性抽动和（或）发声性抽动为主要表现,常伴有多动、强迫等行为和情绪障碍,是一种复杂的慢性神经心理障碍。多巴胺D2受体阻滞剂氟哌啶醇是最古老和使用最广泛的治疗TS药物,报道有效率一般在70％～80％,但由于其副作用大,许多患儿不能耐受长时间的用药,因此目前作为第一线药的地位已经动摇。寻找一种更有效、更安全的治疗方法和药物,解决这些难治病例,一直是我们研究的课题。我们从2001年11月份开始将托吡酯用于一些TS的治疗,取得了较为满意的疗效,现将治疗体会报告如下。     

氟哌啶醇对多发性抽动症患儿血和尿β2-微球蛋白的影响

目的 探讨氟哌啶醇治疗对多发性抽动症患儿血和尿β2-微球蛋白(β2-MG)的影响.方法 对34例用氟哌啶醇治疗的多发性抽动症患儿,在治疗前和治疗1年后用放射免疫法分别测定其血和尿的β2-MG,同时常规检测血尿素氮(BUN)、肌酐(Cr),并进行治疗前后比较.结果 氟哌啶醇治疗前、后血β2-MG浓度分别为(1.56±0.52)μg/ml、(3.19±1.30)μg/ml(P<0.001);尿β2-MG浓度治疗前、后分别为(39.16±18.82)ng/ml、(88.35±39.89)ng/ml(P<0.001);血Cr浓度治疗前、后分别为(41.51±8.18)μmoI/L、(40.43±8.03)μmol/L(P>0.05);血BUN浓度治疗前、后分别为(4.02±1.70)mmol/L、(3.60±0.93)mmol/L(P>0.05).结论 应用氟哌啶醇治疗小儿多发性抽动症时对小儿的血和尿β2-MG有一定的影响,加强治疗期间血和尿β2-MG动态检测有助于了解肾脏早期损害及监控治疗药物反应.     

甘氨酸对坏死性肠炎鼠血清IL-1和IL-6水平的影响(英文)

目的：探讨甘氨酸对内毒素和缺氧诱导的坏死性肠炎(NEC)鼠血清炎性因子IL-1与IL-6的作用。方法：40只SD大鼠随机分为甘氨酸+LPS组和NS+LPS对照组。甘氨酸组大鼠静脉给予甘氨酸1 g/kg,5min后给予内毒素2 mg/kg,NS对照组用等量的生理盐水代替甘氨酸,内毒素剂量同前。所有大鼠注射LPS 90min后氧吸入浓度从21％降至5％,继续机械通气至鼠死亡或存活180 min,实验结束时采血样和小肠标本。用双抗夹心ELISA法测定血清IL-1与IL-6的含量,肠组织做病理检查并进行NEC分度。结果：甘氨酸组的存活时间(159.25±22.78)min长于NS对照组(138.75±19.05)min,差异有显著性(P<0.01)。甘氨酸组小肠病理损伤程度明显明显低对照组(P<0.01)。甘氨酸组血清IL-1的含量为(149.1±76.1)ng/L,显著低于对照组(472.1±505.6)ng/L(P<0.01);血清IL-6的含量为(204.8±163.5)ng/L,亦显著低于对照组(585.8±574.5)ng/L(P<0.01)。结论：甘氨酸可降低内毒素和缺氧诱导的坏死性肠炎(NEC)鼠血清IL-1和IL-6含量水平,减轻肠病理损伤。     

新生小鼠兴奋毒性脑损伤的神经行为功能研究

目的：探讨兴奋毒性脑损伤模型小鼠神经行为功能改变情况,为围生期脑损伤的神经保护研究提供新的实验方法。方法：生后5日ICR种小鼠55只,采用完全随机的方法分为空白组、生理盐水组和鹅膏蕈氨酸（ibotenic acid,IA）组,用IA建立兴奋毒性脑损伤模型,小鼠生后第6,7,8,9,10日进行平面翻正实验、生后第8,10,12日进行游泳实验、生后第33和34日进行Y-迷宫分辨学习实验。结果：IA组小鼠生后第6～10日翻正实验时间为2.12±0.61、1.86±0.65、1.50±0.51、1.28±0.29、1.01±0.15,明显长于空白组和生理盐水组（P<0.05）,生后第8～12日游泳实验评分为6.33±0.98、6.87±0.74、7.13±0.64,明显低于空白组和生理盐水组（P<0.05）;IA组Y-迷宫分辨学习实验“学会”次数为19.79±2.42,明显多于空白组和生理盐水组的 16.29±2.48,16.30±2.37（P<0.05）、正确反应率86.7%,明显低于空白组和生理盐水组的96.5%,95.0%（P<0.05）。结论：新生小鼠兴奋毒性脑损伤模型发育反射和学习记忆功能都受到损伤,可以用行为学的方法对兴奋毒性脑损伤小鼠早期发育反射和远期行为进行评估。［中国当代儿科杂志,2009,11（3）：191-193］     

肌苷对Tourette综合征大鼠脑组织多巴胺D2受体和多巴胺转运蛋白的影响

目的 研究肌苷对Tourette综合征(TS)大鼠脑组织多巴胺D2受体(DRD2)和多巴胺转运蛋白(DAT)的影响,探讨肌苷治疗TS可能的作用机制.方法 将40只SPF级雄性SD大鼠随机分为正常对照组、模型组、阳性对照组(氟哌啶醇0.5 mg·kg-1)、联合用药组(氟哌啶醇0.25 mg·kg-1+肌苷320 mg·kg-1)、肌苷组(肌苷320 mg·kg-1),每组8只.采用亚氨基二丙腈(IDNP)腹腔注射法建立TS大鼠模型.氟哌啶醇和(或)肌苷给药28 d后通过大鼠刻板行为评分、酶联免疫吸附法、原位杂交法,研究肌苷对TS模型大鼠刻板行为、大鼠脑组织DRD2、DAT水平的影响以及DRD2 mRNA表达情况.结果 1.肌苷组大鼠刻板行为评分低于模型组(P<0.01),高于阳性对照组(P<0.01),与联合用药组之间比较差异无统计学意义(P>0.05).2.DRD2阳性细胞广泛分布于大脑皮质、海马、纹状体等处,以模型组DRD2阳性细胞分布最为密集.3.肌苷组DRD2水平低于模型组(P<0.01),高于阳性对照组和联合用药组(Pa<0.01),而与正常对照组之间比较差异无统计学意义(P>0.05).4.肌苷组DAT水平高于正常对照组、模型组及阳性对照组(Pa<0.01),与联合用药组之间比较差异无统计学意义(P>0.05).结论 肌苷改善TS模型大鼠的刻板行为的作用机制可能是通过促进多巴胺释放和转运,起到类似于DRD2拮抗剂的作用.     

Dopamine penetrates to the central nervous system in developing rats

BACKGROUND: The purpose of this study was to evaluate whether or not dopamine (DA) can penetrate to the central nervous system (CNS) from the blood in the infantile period in rats. METHODS: In a preliminary experiment, we administered a 50 mg/kg dose of DA hydrochloride, intraperitoneally, to 7-day-old rats (DA 50 mg/kg group), obtaining cerebrospinal fluid (CSF) both before and at 5, 10, 20, 30, 60 and 120 min after administration. The CSF levels of DA and its main metabolites, 3,4-dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA), were then measured. Next, we investigated the DA transfer from blood to the CNS by administering doses of 1, 5, 10 and 30 mg/kg DA hydrochloride (DA 1, 5, 10 and 30 mg/kg groups). In these groups, CSF samples were obtained only at 10 and/or 60 min after DA administration, based on the results of the DA 50 mg/kg group. RESULTS: The DA concentrations in CSF significantly increased compared with values before DA administration in the DA 50 mg/kg group. The DA concentrations in the DA 30 mg/kg group, DOPAC concentrations in the DA 5, 10 and 30 mg/kg groups, and HVA concentrations in all groups were significantly higher than in the control (saline injection) group. CONCLUSIONS: These findings suggest easy DA transfer from blood to the CNS and immaturity of the blood-brain barrier for DA in the infantile period in rats.     

Alendronate treatment for infants with osteogenesis imperfecta: demonstration of efficacy in a mouse model

Recent non-placebo-controlled studies of the bisphosphonate pamidronate have shown it to be effective in reducing fractures and improving bone density in infants and children with osteogenesis imperfecta (OI). To evaluate the effects of bisphosphonate treatment in a controlled study, the oim/oim mouse model of OI was studied. Nursing infant mouse pups (approximately 2 wk old) with moderate to severe OI (oim/oim mouse) and age- and background-matched control mice (+/+) were treated either with the third-generation bisphosphonate alendronate (ALN), or with saline. Fracture risk, bone quality, and growth were evaluated over a 12-wk treatment period. ALN at a dose of 0.03 mg/kg/d or saline was administered via s.c. injection to infant oim/oim and wild-type (+/+) mice from 2 to 14 wk of age (n = 20 per subgroup). The average number of fractures sustained by the ALN-treated oim/oim mice was reduced significantly compared with the untreated oim/oim mice (0.7 +/- 0.7 fractures/mouse versus 2.0 +/- 0.2 fractures/mouse). Bone density increased significantly in the femur and the spine with treatment (2.0 +/- 0.5 versus 1.2 +/- 0.5 in femur and 2.1 +/- 0.5 versus1.6 +/- 0.5 in spine). Histologic evaluation revealed the percentage of metaphyseal tibial bone increased significantly with treatment in both +/+ and oim/oim mice. Mechanical testing revealed an increase in structural stiffness for both treated +/+ and oim/oim mice compared with untreated animals. None of the material properties examined were significantly altered with treatment, nor was spinal curvature affected. Weight gain and long bone growth were comparable in the treated and untreated oim/oim mice. In wild-type mice, femur lengths were significantly shorter in the treated mice compared with untreated counterparts. This animal study demonstrates that treatment of OI in mice as early as 2 wk of age with ALN appears to be effective in reducing fractures and increasing bone properties. Based on the data from this study, ALN therapy in infants with OI should prove to be effective.     

The role of nitric oxide in dilating the fetal ductus arteriosus in rats.

Prostaglandin E is a major dilator of the fetal ductus arteriosus (DA), but the role of nitric oxide in fetal ductal dilation has not been established. We studied the effects of a potent nitric oxide synthase inhibitor, Nomega-nitro-L-arginine methyl ester (L-NAME), on the fetal DA in rats. L-NAME was injected into the dorsum of pregnant rats, and fetal DA was studied 4 h later with a rapid whole body freezing method. The inner diameters of the DA and the main pulmonary artery were measured on a freezing microtome. The inner diameter ratio of DA to main pulmonary artery (DA/PA) was 1.02+/-0.03 (mean +/- SEM; number of fetuses [n], 21) in normal near-term fetuses. The effect of prostaglandin synthesis inhibition was studied after orogastric administration of indomethacin to pregnant rats. In near-term rats on the 21st day of gestation (term, 21.5 d), a large dose of L-NAME (100 mg/kg) caused only mild ductal constriction, with DA/PA reduced to 0.83+/-0.05 (n = 20). Indomethacin (1 mg/kg) caused moderate ductal constriction, and DA/PA was decreased to 0.65+/-0.05 (n = 21). Combined administration of L-NAME (10 mg/kg) and indomethacin (1 mg/kg) caused severe ductal constriction, with DA/PA of 0.26+/-0.03 (n = 16). In preterm rats on the 19th day of gestation, a moderate dose of L-NAME (10 mg/kg) caused severe ductal constriction, with a DA/PA of 0.32+/-0.05 (n = 24). Indomethacin (1 mg/kg) alone caused only mild ductal constriction, with DA/PA 0.86+/-0.02 (n = 16). In conclusion, prostaglandin has a major role and nitric oxide has a minor role in dilating the DA in the near-term fetal rat. In contrast, nitric oxide has a major role and prostaglandin has a minor role in dilating the DA in preterm fetal rats.     

L-精氨酸对宫内发育迟缓胎鼠胰岛素样生长因子及其结合蛋白表达的影响

目的：宫内发育迟缓(IUGR)儿常有脑发育的异常,L精氨酸具有舒张血管、增加胎盘血流的作用,可用于改善胎盘缺氧状态,促进胎儿生长发育。用被动吸烟法制作孕鼠IUGR模型,孕8～20d给予不同剂量L精氨酸,了解其对宫内发育迟缓胎鼠脑内胰岛素样生长因子及其结合蛋白表达的影响,并探讨L精氨酸的作用机制。方法：孕鼠随机分为4组:对照组、模型组、L精氨酸小剂量和大剂量防治组,每组9只。孕21d剖宫取胎,应用酶联免疫吸附法检测各组胎鼠脑组织胰岛素样生长因子Ⅰ(IGFⅠ)、胰岛素样生长因子Ⅱ(IGFⅡ)、胰岛素样生长因子结合蛋白(IGFBP3)含量,应用荧光定量RTPCR法检测各组胎鼠脑组织IGFⅠmRNA表达。结果：与对照组相比较,模型组胎鼠脑组织中IGFⅠ(0.789±0.062ng/mgvs0.947±0.042ng/mg)、IGFⅡ(0.270±0.020ng/mgvs0.374±0.015ng/mg)含量均比对照组明显降低,IGFBP3(0.253±0.011ng/mgvs0.089±0.015ng/mg)含量比对照组明显升高,IGFⅠmRNA表达量(13.12±1.39)×104cps/μgRNAvs(21.28±3.54)×104cps/μgRNA比对照组明显降低,差异均有显著性(P<0.01)。与模型组相比较,小剂量和大剂量L精氨酸防治组IGFⅠ含量明显增高,分别为0.937±0.067ng/mg和0.858±0.077ng/mg,IGFⅡ含量明显增高,分别为0.318±0.018ng/mg和0.354±0.021ng/mg,IGFBP3含量明显降低,分别为0.132±0.006ng/mg和0.146±0.009ng/mg差异有显著性(P<0.01或<0.05)。同时小剂量和大剂量L精氨酸防治组IGFⅠmRNA表达量也明显增高,分别为(19.24±2.48)×104cps/μgRNA和(17.35±2.30)×104cps/μgRNAvs(13.12±1.39)×104cps/μgRNA,差异均有显著性(P<0.01)。结论：L精氨酸可增加被动吸烟致宫内发育迟缓胎鼠脑内IGFⅠ、IGFⅡ含量和IGFⅠmRNA的表达,降低IGFBP3含量。L精氨酸防治IUGR的机制与其对胰岛素样生长因子及其结合蛋白表达的影响有关。     

Association of tumor necrosis factor, interleukin-6 and cyclooxygenase pathway with lipopolysaccharide-induced intussusception.

INTRODUCTION: Many factors and mechanisms have been proposed as causes for intussusception (IN); however, the etiology remains unclear. Inflammatory mediators such as tumor necrosis factor (TNF) and interleukin-6 (IL-6), which are elevated during infectious diseases, can significantly affect gastrointestinal motility. Motility changes caused by these agents might contribute to the development of IN. The aim of this experimental study was to determine the preventive effects of indomethacin on lipopolysaccharide (LPS)-induced IN in mice and to investigate the role of TNF and IL-6 on intussusception. MATERIALS AND METHODS: Seventy-eight mice were divided into five groups. In the Control group (n=6), no procedure was done. In the Sham group (n=6), 1 ml saline, in the Indomethacin group (n=6), 10 mg/kg of indomethacin, in the LPS group (n=30), 12 mg/kg of LPS was administered intraperitoneally (IP). In the Treatment group (n=30), 10 mg/kg of indomethacin was administered IP following 12 mg/kg of LPS. All animals were laparotomized 6 hours following IP injections. The existence of IN was noted and blood specimens were obtained. TNFalpha and IL-6 plasma level measurements were performed by standard ELISA for mice. The results were compared using the Mann-Whitney U test and one-way ANOVA test. A value of p<0.05 was considered significant. RESULTS: Five mice (1 in the control, 2 in the LPS, 2 in the Treatment group) were excluded from the study. IN was observed in 6 (20%) mice in the LPS group, whereas it was not found in any mice in the Treatment group. Mean TNFalpha and IL-6 levels were statistically higher in the LPS group (394.72+/-403.79; 195.18+/-218.37 pg/ml, respectively) compared to all other groups, including the Treatment group (p<0.05 for each comparison). Within the LPS group of mice, the levels were higher in animals with IN compared to the mice without IN. CONCLUSION: Increased TNFalpha and IL-6 levels induced by LPS correlated well with the occurrence of IN, and a decrease in these levels via cyclooxygenase (COX) inhibition by indomethacin prevented IN from forming in this experimental model.     

Early treatment of acute stress disorder in children with major burn injury.

OBJECTIVE: This study examines retrospectively the response rate of pediatric burn survivors with acute stress disorder to either imipramine or fluoxetine. METHODS: On retrospective chart review, 128 intensive care unit patients (85 boys, 43 girls) with 52%+/- 20% total body surface area burn, length of stay of 32.8+/- 25.2 days, mean age of 9.1+/- 4.7 yrs, and age range of 13 months to 19 yrs met criteria for acute stress disorder after >or=2 days of symptoms and were treated with either imipramine or fluoxetine. If significant improvement did not occur within 7 days, the medication was either increased or switched to the other class. RESULTS: Initially, 104 patients were treated with imipramine and 24 with fluoxetine. A total of 84 patients responded to imipramine: seven of these patients required a higher dose. A total of 18 patients responded to initial fluoxetine treatment. Of 26 nonresponders to the initial medication, 13 imipramine failures and one fluoxetine failure refused further treatment. The other 12 responded to the second medication. Therefore, 114 of 128 treated patients (89%) responded to either fluoxetine (mean dose, 0.30+/- 0.14 mg/kg) or imipramine (mean dose, 1.30+/- 0.55 mg/kg). Response was independent of sex and age but was less for those with burns of >60% total body surface area. The side effects of each medication were not significant. Most patients continued treatment for >or=3 months; some required 6 months of treatment before successful discontinuation. CONCLUSIONS: Early treatment of acute stress disorder with either imipramine or fluoxetine is often able to reduce its symptoms. This is a review of a single hospital's experience in managing psychiatric distress in this very high-risk group of burned children. Additional clinical studies are needed before generalizing these findings.     

Prolactin and dopamine concentrations in the cerebrospinal fluid during the neonatal period.

Prolactin (PRL) has been detected in the cerebrospinal fluid (CSF) in humans and the absolute level appears to reflect the serum PRL concentration. Because PRL is thought to be involved in the regulation of brain water and electrolyte content attempt has been made to determine CSF and plasma PRL and dopamine (DA) concentrations, osmolality, and sodium level in 21 newborn infants undergoing lumbar punction because of apneic spells, fever, or perinatal asphyxia. The mean of gestational age was 36.5 weeks (range: 31-41) and birthweight was 2572 g (range: 1140-3550). The lumbar puncture was performed at the 8.3 postnatal day (range: 1-38). The plasma concentration of PRL was 106.52 +/- 14.43 ng/ml, significantly higher than the CSF PRL level (43.24 +/- 7.39 ng/ml, p < 0.01). This elevated level was observed in all individual cases. DA concentration in the plasma was much higher than the value detected in the CSF (64.75 +/- 13.83 vs 8.64 +/- 0.72 ng/ml, p < 0.01). No difference was observed between the sodium content of the CSF and plasma (138.94 +/- 1.28 vs 138.04 +/- 1.03 mmol/l), however, the osmolality of the plasma tended to be higher than the CSF osmolality (286.7 +/- 3.81 vs 276.76 +/- 2.19 mosm/kg, p < 0.05). In the CSF osmolality, PRL, DA, and sodium concentrations did not show any correlation. In conclusion: in the CSF PRL probably does not play a primary role in controlling the osmolality and sodium content. PRL in CSF seems to be independent from CSF DA concentration.     

Furosemide effect on mineral status of parenterally nourished premature neonates with chronic lung disease

In this study, the effect of prolonged furosemide administration on calcium and phosphorus homeostasis was examined in 16 parenterally nourished very low birth weight infants with chronic lung disease. Patients received one of three different dosages of phosphorus: low, 0.91 +/- 0.06 mmol/kg per day; moderate, 1.24 +/- 0.02 mmol/kg per day; and high, 1.64 +/- 0.06 mmol/kg per day. All furosemide-treated patients had high levels of urinary calcium (12.1 +/- 2.2 mg/kg per day), phosphate (19.1 +/- 2.7 mg/kg per day), and cyclic 3'5'-adenosine monophosphate (76.8 +/- 6.7 nmol/kg per day) excretion, independent of their phosphorus intake. Parathyroid hormone concentrations were high in furosemide-treated patients (0.95 +/- 0.15 ng/mL) compared with patients not treated with furosemide and receiving either moderate (0.49 +/- 0.05 ng/mL) or low (0.42 +/- 0.07 ng/mL) phosphorus intakes. Furosemide administration may lead to secondary hyperparathyroidism.