Gastroesophageal reflux with drifting onset in infants: a phenomenon unique to sleep.

We have characterized the gastroesophageal reflux (GER) episodes which occurred during sleep in 28 infants with pathologic gastroesophageal reflux and 10 symptomatic age-matched controls without gastroesophageal reflux. We describe three kinds of episodes during the sleeping period-awake episodes which occur completely during electroencephalogram (EEG)-defined wakefulness associated with clinical evidence of the waking state (62 episodes), episodes occurring during EEG-defined sleep which have a rapid drop in pH at their onset (119 episodes), and episodes occurring during EEG-defined sleep in which the esophageal pH drifts down slowly over a period up to 30 min (113 episodes). Only 9 of the 10 control subjects experienced any reflux episodes during monitoring. The total number of episodes of reflux in controls (34) was less than the total number in reflux subjects (260). Controls did, however, experience all three types of reflux episode. Awake episodes all had a rapid drop in pH at their onset and were characterized by a short acid clearance time (2.0 +/- 0.3 min in reflux patients and 1.0 +/- 0.2 min in controls). The sleep episodes with rapid onset had longer mean acid clearance time than the awake episodes, significantly so in GER subjects (20.1 +/- 6.8 min in reflux subjects and 2.6 + 1.3 min in controls). Body movement was noted at the onset of 93.4% of rapid-onset sleep episodes in reflux subjects and 88.9% in controls. Body movement was also common at the termination of rapid-onset sleep episodes (77.8% of rapid-onset episodes in reflux subjects and 80.0% in controls).(ABSTRACT TRUNCATED AT 250 WORDS)     

兴奋性氨基酸受体激动剂诱导雌性大鼠青春期发生的实验研究

目的　研究兴奋性氨基酸受体激动剂对雌性大鼠青春期启动的影响。方法　 2 6日龄雌性大鼠 36只随机分为 3组 ,实验组每日皮下注射N 甲基 DL 天冬氨酸 (NMA) ,同龄青春前期大鼠 (对照 1组 )和正常青春发育大鼠 (对照 2组 ) :皮下注射生理盐水。于第一个发情前期日将大鼠处死 ,并检测其下丘脑 垂体 性腺轴启动指标。结果　实验组大鼠阴道口开放和首次发情间期较对照 2组明显提前 (33.18± 3.31dvs 39.4 7± 5 .2 4d ;36 .0 5± 3.4 3dvs 4 1.6 7± 4 .96d ,P均 <0 .0 5 ) ;两组阴道口开放后均出现规则性周期 ;对照 1组大鼠处死时阴道口尚未开放。实验组卵巢、子宫指数、卵巢黄体出现率、子宫壁厚度、血黄体生成素 (LH)和下丘脑促性腺激素释放激素 (GnRH)mRNA表达水平与对照 2组均无明显差异 (P均 >0 .0 5 ) ,与对照 1组均有明显差异 (P均 <0 .0 5 )。结论　NMA可作用于下丘脑 ,使雌性大鼠提前进入青春期 ,并表现出与正常进入青春期大鼠相同的性发育特征     

Fragile X syndrome and very early onset schizophrenia: a female case study.]

Genotype-phenotype relationship studies for psychiatric disorders in females carrying fragile X syndrome full mutation and premutation underline association with schizo-affective disorders. In female children with X fragile full mutation, only behavioural symptoms and no standardised psychiatric disorders have been systematically explored. Therefore, we report the case of a nine-year-old girl carrying the fragile X syndrome full mutation with a comorbid childhood onset schizophrenia (COS), and of her mother carrying the fragile X syndrome premutation and a comorbid schizotypal personality disorder. The impact of these associations is discussed regarding the recent literature in chromosome anomalies in COS.     

The effects of intra-uterine growth retardation and postnatal undernutrition on onset of puberty in male and female rats

The nutritional status, prenatally and early postnatally, plays a critical role in postnatal growth and development. Early malnutrition may change the original programming of organs, especially those in developmental phases, which can result in long-term changes in metabolism. The association between a low birth weight and the increased risk on type 2 diabetes, hypertension and cardiovascular disease is well known. In the present study we investigated whether intrauterine malnutrition or direct postnatal food restriction affects the onset of puberty in male and female rats. Intrauterine growth retardation (IUGR) was induced by uterine artery ligation on day 17 of gestation and postnatal food restriction (FR) by litter-enlargement to 20 pups per mother from day 2 after birth until weaning (24 d). Both models of malnutrition resulted in a persistent growth failure postnatally. The parameter of the onset of puberty was balano-preputial-separation (BPS) in the male rat and vaginal opening (VO) in the female rat. In both male IUGR (n = 26) and FR (n = 20) rats, the age at BPS was significantly delayed, with 48.1 +/- 1.9 d (p < 0.0001) and 50.4 +/- 2.9 d (p < 0. 0001), respectively, compared with controls (n = 30) with 45.8 +/- 1.4 d. In female IUGR rats (n = 37) the age at VO was significantly delayed, with 37.4 +/- 2.7 d (p < 0.04) compared with 36.1 +/- 1.5 d in controls (n = 23), but not in female FR rats (n = 18) with 36.5 +/- 2.2 d. Weight at onset of puberty did not differ between male IUGR and control rats, 194.5 +/- 20.0 g and 201.7 +/- 16.8 g, respectively, but was significantly lower in male FR rats with a weight of 175.6 +/- 17.5 g (p < 0.0001). In female IUGR as well as in female FR rats, weight at onset of puberty was significantly lower compared with controls: weight in IUGR 106.1 +/- 13.1 g (p < 0.001), weight in FR 85.3 +/- 7.6 g (p < 0.0001) and weight in controls 116.9 +/- 9.3 g. We conclude that early malnutrition, during late gestation or direct postnatally, results in a delayed onset of puberty in IUGR and FR male rats and in IUGR female rats, but not in FR female rats. The onset of puberty in these growth retarded rats as well as in controls does not depend on the achievement of a certain, crucial weight. The perinatal period appears to be a "critical time period" for the maturational process of pubertal development.