病毒性心肌炎心肌组织中MIP-1β和MCP-1的表达及其意义

为了研究病毒性心肌炎 (VMC )心肌组织中MIP 1β和MCP 1的表达及其意义 ,以B3型柯萨奇病毒 (CVB3)腹腔注射BALB/c小鼠建立VMC小鼠模型 ,RT PCR实时定量分析正常对照组和VMC组心肌组织中CC家族趋化因子MIP 1β和MCP 1的表达 ,图像分析定量心肌组织切片浸润细胞数 ,以TCID50 分析心肌组织中CVB3载量变化 ,速率法检测血清CK MB水平。结果显示 :(1)MIP 1β和MCP 1在正常组均有表达 ,在VMC组MIP 1β和MCP 1的表达显著高于正常组 (P <0 0 1)。与 0天基础表达量相比 ,MIP 1β的表达在感染后第 4天达高峰 ,第 7、 9天下降。MCP 1在感染后第 4天上调表达 ,第 7、 9天时表达量持续升高 ,第 9天到高峰 ;(2 )在感染后第 4天时 ,心肌组织中开始出现单个核细胞浸润 ,7～ 9d浸润的单个核细胞逐渐增加。而正常心肌组织中未见明显的细胞浸润 ;(3)MCP 1的表达分别与浸润的单个核细胞数及CK MB水平相关 (均P >0 0 5 )、MIP 1β未呈明显相关。MIP 1β和MCP 1的表达与心肌组织中CVB3载量未呈明显相关性。说明MCP 1可能参与VMC心肌组织中单个核细胞的浸润。提示MCP 1可能与心肌组织中浸润细胞的效应功能发挥有关。     

抑制miR-21减轻BALB/c小鼠病毒性心肌炎

目的:探讨抑制mi R-21可否减轻CVB3诱导的BALB/c小鼠心脏微血管损伤,阻断致病因子向靶器官迁移,从而减轻靶器官组织病变。方法:3~4周龄雄性BALB/c小鼠CVB3腹腔注射后饲养1周诱导急性病毒性心肌炎(VMC)模型;BALB/c小鼠每月腹腔注射CVB3 1次共饲养3个月,诱导为慢性VMC模型。注射CVB3同时尾静脉注射抗mi R-21质粒以敲低mi R-21表达。结果:急性VMC小鼠外周血mi R-21表达增加,心肌Bcl-2和CVB3-VP1表达增加。小鼠体内注射anti-mi R-21质粒后,外周血mi R-21表达降低,心肌caspase-3活性和CVB3-VP1表达下降,Bcl-2表达增加,HE染色心肌组织及心脏微血管病变减轻,TUNEL染色心肌细胞凋亡减少。慢性VMC小鼠心肌胶原表达增加,微血管密度减少,心功能下降。敲低mi R-21增加慢性VMC小鼠心肌微血管密度,减少胶原沉积,改善小鼠心功能。体外过表达mi R-21诱导CMVECs凋亡,减少心脏微血管新生。结论:靶向抑制mi R-21可能通过抑制CMVECs凋亡,阻断致病因子向靶器官迁移,降低心肌病毒载量、减轻心肌炎心肌病变。慢性VMC小鼠中,可能是通过减少胶原沉积、减轻心肌纤维化,增加微血管新生,改善心功能。因此,mi R-21可能是治疗病毒性心肌炎的新靶点。     

CVB3感染通过MCP-1介导病毒性心肌炎小鼠单个核细胞迁移

目的:研究B3型柯萨奇病毒(CVB3)感染与病毒性心肌炎(VMC)炎症细胞迁移的关系及机制。方法:采用差异贴壁法分离小鼠心肌细胞;趋化试验分析心肌细胞培养上清对VMC小鼠外周血单个核细胞(PMNC)的趋化性;实时定量RT PCR分析心肌细胞MCP 1的表达。结果:( 1)CVB3感染心肌细胞培养上清对VMC小鼠PMNC的趋化性明显增强。( 2 )CVB3感染2小时后MCP 1的表达开始升高,至6小时达到高峰,8小时下降;随着CVB3感染量的增加,MCP 1的表达明显升高。( 3)2 5 μg/ml抗MCP 1抗体处理后,CVB3感染心肌细胞培养上清对VMC小鼠PMNC的趋化性下降5 4 % (P <0 0 1) ;5 μg/ml抗MCP 1抗体处理后,趋化性下降的幅度与2 5 μg/ml抗MCP 1抗体处理的相比未见明显差异(P >0 0 5 )。结论:CVB3感染通过MCP 1介导VMC小鼠单个核细胞迁移,这可能是CVB3感染诱发心肌组织炎症细胞浸润的重要机制之一     

苦参碱对病毒性心肌炎小鼠蛋白激酶B表达的影响

目的 评价苦参碱对柯萨奇B3型病毒（CVB3）感染的病毒性心肌炎（VMC）小鼠心肌组织蛋白激酶B（Akt）表达的影响,以探讨苦参碱保护心肌的作用机制.方法 实验采用雄性Balb/c小鼠连续3 d腹腔注射0.2ml 100TCID50的CVB3的方法制备VMC的动物模型.分为6组：苦参碱每日80 mg/kg、40 mg/kg、20 mg/kg治疗组,利巴韦林组、病毒组及正常对照组.药物于末次注射病毒的60 min后开始,连续腹腔注射10 d,正常组给予同体积的生理盐水.分别于给药后第5天和第10天处死小鼠,应用Tunel标记法检测各组心肌细胞凋亡情况;于给药后第10天应用免疫组化及Western Blot法检测心肌组织磷酸化AktSer-473蛋白的表达.结果 与正常组比较,病毒组心肌组织凋亡明显增加（P＜0.05）;与病毒组比较,苦参碱各剂量组心肌组织凋亡明显减少（P＜0.05）.于给药后第10天,苦参碱每日40 mg/kg组磷酸化AktSer-473蛋白的表达明显上调（P＜0.05）.结论 苦参碱可能通过促进磷酸化AktSer-473蛋白的表达,抑制CVB3感染的VMC小鼠心肌组织凋亡.     

黄芪对心肌炎小鼠心肌穿孔素mRNA和CVB3m mRNA表达的影响

目的探讨黄芪注射液治疗小鼠柯萨奇B3(CVB3)病毒性心肌炎(VMC)的疗效及其机制。方法BALB/c小鼠24只腹腔感染柯萨奇病毒B3亲心肌细胞株(CVB3m)后,随机等分为两组:黄芪治疗组(黄芪注射液每天10g/kg腹腔注射)和对照组。实验第8天留取心肌,分别进行心肌病理检查,心肌穿孔素(perforin,PFP)mRNA和CVB3m mRNA逆转录多聚酶链反应(RT-PCR)分析,并对心肌组织PFP mRNA和CVB3m mRNA表达水平进行相关性分析。结果(1)心肌组织病理改变:黄芪治疗组明显轻于对照组;(2)心肌PFP mRNA表达水平RT-PCR半定量:黄芪治疗组心肌PFP mRNA的表达明显低于对照组(1.10±0.07与1.31±0.12,P<0.01);(3)心肌CVB3m mRNA表达水平RT-PCR半定量:黄芪治疗组心肌CVB3m mRNA表达明显低于对照组(1.07±0.04与1.18±0.02,P<0.01);(4)心肌PFP mRNA水平与CVB3mmRNA水平呈显著正相关(r=0.68,P<0.01)。结论PFP介导的细胞毒性作用在病毒性心肌炎的发病中起重要作用。黄芪对小鼠急性心肌炎模型中心肌组织CVB3m病毒复制有明显的抑制作用,心肌组织中PFP mRNA表达水平与心肌组织CVB3m mRNA的表达水平的变化具有同步性,黄芪对CVB3m诱导的小鼠急性心肌炎模型有显著的治疗作用。     

抗Fas的抗体在实验性病毒性心肌炎中作用机制的研究

目的探讨中和型抗Fas的抗体对小鼠柯萨奇病毒性心肌炎的治疗作用及作用机制。方法60只BAIB/c小鼠随机分为4组：1组空白对照组，2组病毒对照组、3组IgG对照组、4组抗Fas抗体治疗组。于接种后第10天每组随机处死小鼠8只，心肌组织切片HE染色了解心肌损伤情况，电镜技术及原位末端标记法（TUNEL）检测心肌细胞凋亡情况，免疫组化方法检测casimse-3的表达，逆转录．聚合酶链反应（RT-PCR）检测心肌组织中easpase-3的mRNA表达。实时定量PCR（RQ-PCR）定量心肌柯萨奇病毒B3（CVB3）mRNA拷贝数。结果（1）病毒对照组可见caspase-3表达和心肌细胞凋亡，且均与心肌病变积分成正相关（r=0．81，P〈0．01；r=0．73，P〈0．05）。（2）抗Fas抗体治疗组小鼠心肌组织病变积分、心肌细胞凋亡率、caspase-3蛋白和mRNA表达及心肌内CVB3 mRNA拷贝数均明显低于病毒对照组（P〈0．05）和IgG对照组（P〈0．05）。结论Fas/FasL途径介导的心肌细胞凋亡参与了病毒性心肌炎的发病过程，凋亡是导致病毒性心肌炎心肌损伤的重要机制之一，抗Fas抗体可降低caspase-3活化和mRNA表达，减少心肌细胞凋亡，降低心肌细胞内病毒复制，使心肌损伤明显减轻。     

RSV 感染诱导的 RANTES、FKN、IP-10表达及 PPARγ激动剂抑制作用的体外研究

目的研究A549细胞呼吸道合胞病毒（ RSV）感染12 h、24 h、48 h后调节激活正常T细胞表达和分泌细胞因子（RANTES）、分形趋化因子（FKN）、干扰素诱导蛋白-10（IP-10） mRNA和蛋白水平的变化及不同剂量过氧化物酶体增殖物激活受体γ（PPARγ）激动剂15-脱氧前列腺素J2（15d-PGJ2）和罗格列酮及其拮抗剂（ GW9662）的干预作用。方法建立RSV感染A549细胞的体外模型，将传代培养的细胞随机分成5组：A组（15d-PGJ2＋RSV组），B组（罗格列酮＋RSV组）、C组（DMSO＋RSV组）、D组（ GW9662＋罗格列酮＋RSV组）、E组（细胞对照组）。各组分别在培养12 h、24 h、48 h收获细胞及上清液待测。应用ELISA检测各组上清液RANTES、FKN、IP-10蛋白水平，实时荧光定量RT-PCR检测各组RANTES、FKN、IP-10 mRNA表达。结果与细胞对照组相比， RSV感染组RAN-TES、FKN、IP-10 mRNA和蛋白的表达在12 h、24 h和48 h均明显升高（P均＜0．05），其中RANTES、FKN、IP-10 mRNA的表达量在24 h达高峰，48 h有所下降，与12 h的表达量比较差异无统计学意义（P均＞0．05）；而3种趋化因子蛋白的表达量均在48 h达高峰，与12 h、24 h比较差异有统计学意义（P均＜0．05）。在同一作用时间点上，随着15d-PGJ2和罗格列酮药物浓度的增加，RANTES、FKN、IP-10 mRNA和蛋白的表达量均呈剂量依赖性下降，与 RSV 感染组相比差异有统计学意义（ P 均＜0．05），其中以20μmol/L 15d-PGJ2和30μmol/L罗格列酮干预后RANTES、FKN和IP-10 mRNA和蛋白的表达量最低。结论 RSV感染可导致RANTES、FKN和IP-10 mRNA及蛋白表达升高，其中mRNA水平在感染后24 h达到高峰，蛋白的表达自感染后48 h达到高峰；而PPARγ激动剂能以剂量依赖性方式抑制上述趋化因子mRNA和蛋白的表达，从而起到减轻炎症的作用。     

B组柯萨奇病毒诱导的细胞焦亡在心肌损伤中的作用

目的利用caspase-1抑制剂抑制焦亡,评价细胞焦亡在B组柯萨奇病毒（Coxsackievirus B,CVB）所致心肌损伤中的作用,确定CVB能否通过诱导细胞焦亡导致心肌炎症。方法Balb/c乳鼠分为四组：对照组、CVB3感染组（腹腔注射CVB3）、1次抑制剂组（CVB3感染乳鼠后注射1次caspase-1抑制剂）和3次抑制剂组（CVB3感染乳鼠后在1、3、5天分3次注射caspase-1抑制剂）,Western blot检测各组乳鼠心肌组织中的caspase-1表达,HE染色观察各组乳鼠心肌组织病理变化。HeLa细胞分为8组,前4组用CVB3感染不同时间,后4组CVB3感染的同时分别加入不同剂量caspase-1抑制剂,检测CVB3病毒蛋白表达量。结果CVB3感染组的乳鼠心肌组织中激活的caspase-1含量增加,与CVB3组相比,注射caspase-1抑制剂的小鼠心肌组织中激活的caspase-1含量明显减少。正常对照组乳鼠心肌细胞组织状态正常,CVB3感染组乳鼠心肌组织大面积变性、坏死,CVB3＋caspase-1抑制剂组乳鼠心肌组织发生病理变化但程度较轻。HeLa细胞中caspase-1与CVB3蛋白含量随caspase-1抑制剂剂量增大而降低。结论抑制细胞焦亡可有效减轻CVB3所致心肌损伤,CVB诱导的焦亡参与心肌致病过程。     

Th1-Th2-Th17 细胞因子在小鼠慢性心肌炎中的表达

目的:观察Th1-Th2-Th17细胞因子在小鼠慢性心肌炎(VMC)模型中的表达,探究其在慢性VMC中的作用及其意义。方法:用柯萨奇病毒B3(CVB3)建立BALB/c VMC小鼠模型,实验组(n=15)腹腔注射磷酸缓冲液(Phosphate-buffered saline,PBS)0.1 ml,含102TCID50 CVB3病毒液;对照组(n=10)腹腔注射PBS 0.1 ml,不含病毒液。在注射后的第8周,心肌HE染色观察其病理形态特征;Masson's染色法观察心肌组织纤维化程度;检测血浆中Th1-Th2-Th17细胞因子含量及心肌组织中上述细胞因子的mRNA表达情况。结果:病毒感染8周后心肌病理符合慢性VMC病理特征;与对照组比较,血浆及心肌中IL-2、IL-5、IL-10、IL-13、IL-17、IL-6、IL-22、IL-21及TGF-β均明显升高(P均0.05)。结论:Th1-Th2-Th17细胞因子失衡导致的免疫紊乱可能在慢性VMC发病机制中起重要作用。     

小鼠急性病毒性心肌炎心肌HO-1mRNA及其蛋白表达

目的：探讨小鼠急性病毒性心肌炎（viral myocarditis,VMC）心肌细胞血红素氧合酶-1（heme oxygenase-1, HO-1）基因及其蛋白表达的动态变化。方法:72只清洁级近交系4-6周龄雄性BALB/c小鼠随机分为2组：心肌炎组（V组）40只（腹腔注射 CVB3病毒），实验对照组（C组）32只。于病毒接种后第4 d、8 d、15 d、21 d分别采血后处死小鼠并留取心脏标本。采用免疫组化法和原位杂交法检测心肌HO-1蛋白及mRNA表达，分光光度计法分间接测定COHb含量，光镜及透射电镜观察心肌组织病理及细胞超微结构改变。结果: （1）心肌炎组可见炎症细胞浸润，心肌细胞可见大面积坏死，晚期可见钙化灶形成；电镜下可见肌原纤维溶解断裂，线粒体膜消失，含溶酶体丰富的单核巨噬细胞浸润，对照组小鼠心肌未见上述变化。（2）血COHb含量变化：心肌炎组小鼠血COHb含量在第8 d和第15 d均较对照组明显增高，2组差异显著（0.047±0.005和0.031±0.004；0.076±0.006和0.030±0.005，P<0.01）。（3）血清cTnI含量变化：V组小鼠血清cTnI含量与C组比较除第21d无明显差别外，其余各时点均高于C组，差异有统计学意义，P<0.01。（4）HO-1免疫组化结果：心肌炎组HO-1蛋白均成阳性表达，各时点心肌HO-1平均吸光度值均高于对照组（P<0.01）。 （5）HO-1mRNA原位杂交结果：心肌炎组HO-1mRNA原位杂交染色各时点均呈阳性表达，各时点吸光度值均高于对照组（P<0.01）。结论:病毒性心肌炎可诱导心肌组织HO-1mRNA及其蛋白的表达，可能是受损心肌发挥自我保护作用机制之一。     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.     

Guidelines for the Validation and Use of Immunoassays for Determination of Introduced Proteins in Biotechnology Enhanced Crops and Derived Food Ingredients

Recent advancements in agricultural biotechnology have created a need for analytical techniques to determine introduced proteins in crops enhanced through modern biotechnology techniques. These proteins are expressed in plant tissues and may be present in food ingredients. Immunoassays are ideally suited for protein detection and may be used as both quantitative and threshold methods. Microplate ELISA and lateral flow devices are two of the most commonly used immunoassay formats for agricultural biotechnology applications. This paper provides general background information and a discussion of criteria for the validation and application of immunochemical methods to the analysis of proteins introduced into plants and food ingredients using biotechnology methods. It is the result of a collaborative effort of members of the Analytical Environmental Immunochemical Consortium. This collaborative effort represents the combined expertise of several organizations to reach consensus on establishing guidelines for the validation and use of immunoassays. Further, the paper offers developers and users a consistent approach to adopting the technology as well as aid in producing accurate and meaningful results.     

HLA in North Colombia Chimila Amerindians

HLA-A,-B,-C,-DRB1 and -DQB1 alleles have been studied in Chimila Amerindians from Sabana de San Angel (North Colombian Coast) by using high resolution molecular typing. A frequent extended haplotype was found:HLA-A*24:02-B*51:10-C*15:02-BRB1*04:07-DQB1*03:02 (28.7%) which has also been described in Amerinndian Mayos Mexican population (Mexico, California Gulf, Pacific Ocean). Other haplotypes had already been found in Amerindians from Mexico (Pacific and Atlantic Coast), Peru (highlands and Amazon Basin), Bolivia and North USA. A geographic pattern according to HLA allele or haplotype frequencies is lacking in Amerindians, as already known. Also, five new extended haplotypes were found in Chimila Amerindians. Their HLA-A*24:02 high frequencies characteristic is shared with aboriginal populations of Taiwan; also, HLA-C*01:02 high frequencies are found in New Zealand Maoris, New Caledonians and Kimberly Aborigines from Australia. Finally, this study may show a model of evolutionary factors acting and rising one HLA allele frequency (-A*24:02), but not in others that belong to the same or different HLA loci.     

Ultracryotomy: development and application (with examples from the yeast cytology) (author's transl)

The preparation steps usually necessary for obtaining ultrathin frozen sections of biological material (chemical prefixation, enclosing, cryoprotective treatment, freezing, sectioning, and post-staining the sections for transmission electron microscopy) are submitted to a critical analysis. The application of cryo-ultramicrotomy, in particularly for cytochemical purposes, is reviewed. Fundamental considerations of chemical prefixation and poststaining are supported by examples from yeast cytology. Furthermore, the efficiency of the cryo-ultramicrotomy (electron optical resolution of ultrastructural details) is demonstrated on yeast cells and protoplasts.     

The universal muscular chamber. A basic unit of the genitourinary, cardiovascular, gastro-intestinal, skeletal, cutaneous, respiratory and other systems, endocameral hypertension; and spasm, the key to their idiopathic diseases and arthropathies

Starting with the integument, we see many organs are contractile sacs or multiples thereof, which tubes or bags constitute the major part of the entire body. Recognition of this basic unit and its characteristics sheds new light, individually and collectively, on many disorders previously considered unrelated. Muscular tears and perforations develop in the walls of these chambers, being no way peculiar to those organs, wherein, hydrochloric acid occurs. So, it is not necessary to explain the absence of excessive acid from patients who exhibit holes in the gastric, uterine, aortic, duodenal, rectal, pulmonary, retina, and other walls. Muscle, not acid is the great common factor relating idiopathic disorders in the gastrointestinal tract to each other and to similar diseases in other systems. When the units are linked together, the lesions tend to appear as arthropathies, i.e. at the joints. Rephrasing common-place observations, frees us from conventional, conceptual cul-de-sacs. An observation is only as good as its interpretation, so all possibilities must be considered, otherwise, we will remain blinded by our misconceptions.     

Der Einfluß von Nahrungsmitteln und Rauchen auf die klinisch-chemische Diagnostik von Phäochromozytom,Neuroblastom und Karzinoid-Syndrom

Zusammenfassung Der Einfluß von verschiedenen Nahrungsmitteln auf Methoden zur Bestimmung von Adrenalin (AD), Noradrenalin (NA), Vanillinmandelsäure (VMS), Metanephrinen (MN), Homovanillinsäure (HVS) und 5-Hydroxyindolessigsäure (5-HIE) im 24 h-Harn zur Diagnose des Phäochromozytoms bzw. Karzinoid-Syndroms wurde untersucht. Die in die Untersuchung einbezogenen Nahrungsmittel waren: Tee, Kaffee, Mandeln, Ananas, Käse, Walnüsse, Vanillepudding, Bananen, Tomaten und Milchschokolade. Außerdem wurde der Einfluß des Zigarettenrauchens auf die Bestimmung von AD, NA, VMS und MN untersucht.Walnüsse führten zu einer starken Erhöhung der 5-HIE-Ausscheidung. Bananen erhöhten die Ausscheidung von AD, NA, VMS, MN und 5-HIE. Kaffee und Ananas bewirkten eine geringe Zunahme der MN-Werte. Rauchen von 20–30 Zigaretten/Tag beeinflußte keine der vier Variablen.Wenn die beschriebenen Methoden benutzt werden, sollte lediglich auf den Verzehr von Bananen und Walnüssen vor und während der Harnsammelperioden verzichtet werden, da die oberen Normgrenzen im Harn überschritten werden könnten. Ein Verzicht auf Kaffee und Ananas in normalen Mengen ist nicht erforderlich. Es besteht kein Anlaß, weiterhin die bisherigen umfangreichen Restriktionen der übrigen Nahrungsmittel beizubehalten.