他莫昔芬对急性脊髓损伤模型大鼠的神经保护

BACKGROUND:Tamoxifen has been found to exert neuroprotection by reducing cerebral hemorrhage and edema surrounding the injured site of the spinal cord. OBJECTIVE:To investigate the neuroprotective effect of tamoxifen on rat acute spinal cord injury and the underlying mechanism. METHODS: Sixty Sprague-Dawley rats were equivalently randomized into five groups, and modeled into spinal cord injury at T10 level using modified Allen’s weight-drop method (70 g/cm), except those in sham operation group. At 30 minutes after modeling, all rats were given the intraperitoneal injection of 2.5, 5.0 and 10 mg/kg tamoxifen or same amount of normal saline, once daily. Basso, Beattie, Bresnahan (BBB) scores were recorded at 24, 48 and 72 hours after surgery. The injured spinal cord was removed at 72 hours to observe its edema. Meanwhile, the levels of interleukin-1β, interleukin-10 and tumor necrosis factor-α, as well as Caspase-3 activity were detected by ELISA; the protein levels of nuclear factor-κB p65, phosphorylated I-κBα and Caspase-3 were detected by western blot assay. RESULTS AND CONCLUSION: Compared with the model group, the hind limb function in the tamoxifen groups was significantly improved. Tamoxifen significantly decreased the water content in the rat spinal cord and inhibited spinal cord edema at 72 hours after surgery. ELISA results showed that tamoxifen significantly reduced the activity of interleukin-1β, interleukin-10, tumor necrosis factor-α and Caspase-3 (P < 0.05). Western blot assay revealed that tamoxifen significantly downregulated the expression levels of nuclear factor-κB p65, phosphorylated I-κBα and Caspase-3. These results suggest that tamoxifen protects against spinal cord injury via suppressing inflammatory response and apoptosis-associated proteins. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

脊髓损伤胶质瘢痕形成及星形胶质细胞作用的研究与转化意义

BACKGROUND: Glial scar and cavity formation following spinal cord injury inhibits axonal entrance, so limited axonal regeneration, less secretion of neurotrophic factor and inhibitors in the microenvironment of axonal growth are considered as major impediments for impacting functional recovery of patients with spinal cord injury. OBJECTIVE: To analyze literatures home and abroad related to the biological characters of astrocytes and glial scar hyperplasia after spinal cord injury, and to provide a theoretical basis for the mechanism underlying glial scar formation following spinal cord injury. METHODS: PubMed and Wanfang databases were retrieved using the keywords “astrocytes, reactive astrogliosis, glial scar, spinal cord injury” in English and Chinese, respectively. Finally 62 literatures were selected for overview. RESULTS AND CONCLUSION: Currently, studies concerning the biological characters of astrocytes, reactive astrogliosis and glial scar formation following spinal cord injury have achieved some progresses. Studies mainly focus on the sole impediment for spinal cord injury, and treatment also aims at inhibiting single factor, but interactions among factors have not been confimed. In addition, the regulatary mechanisms of specific intracellular and extracellular signal molecule in the astrocytes, and effective control and interference of glial scar formation following spinal cord injury still need in-depth study. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

分区式脊髓导管联合骨髓基质干细胞修复脊髓横断损伤模型大鼠

BACKGROUND: There is a high morbidity after spinal cord injury, and the therapeutic strategy is limited to early surgical intervention, medication and post-treatment exercise that only can improve the motor function slightly. However, there is no effective cure method.OBJECTIVE: To study the effect of partition-type spinal cord catheter combined with bone marrow stromal stem cells on T₈ spinal cord transection damage in rats.METHODS: Fifty rats were randomized into five groups (n=10 per group): group I, T₈ spinal cord transection    (5 mm) was made in rats with no treatment; group II, the partition-type tube was inserted into the injured site after modeling; group III, partition-type tube combined with bone marrow stromal stem cells was implanted into the injured site after modeling; group IV, partition-type tube combined with polyglycolic acid fibers was implanted into the injured site after modeling; group V, partition-type tube combined with bone marrow stromal stem cells and polyglycolic acid fibers was implanted into the injured site after modeling. RESULTS AND CONCLUSION: At 2 and 12 weeks postoperatively, Basso, Beattie and Bresnahan scores were significantly higher in the groups III and IV than the groups I, II, IV (P < 0.05). At 12 weeks postoperatively, the latency of motor evoked potential below the injury plane was significantly decreased in group V compared with groups I, II, III, IV (P < 0.05). Immunohistochemical results displayed that in the groups III and V, regenerated nerve fibers grew positively and arranged orderly among the tubes, and there was no obvious winding phenomenon. Under transmission electron microscopy, a certain number of myelinated nerve fibers were found as bridges among groups. These findings indicate that the partition-type chitosan tube combined with bone marrow stromal stem cells has a good connection with the injured spinal cord a good connection to restore part of electrophysiological properties, accelerate the axon regeneration, recover the motor function, thereby providing a new direction for the treatment of spinal cord injury.  中国组织工程研究杂志出版内容重点：干细胞;骨髓干细胞;造血干细胞;脂肪干细胞;肿瘤干细胞;胚胎干细胞;脐带脐血干细胞;干细胞诱导;干细胞分化;组织工程     

Responses to spinal microstimulation in the chronically spinalized rat and their relationship to spinal systems activated by low threshold cutaneous stimulation

We describe the responses evoked by microstimulation of interneuronal regions of the spinal cord in unanesthetized rats chronically spinalized at T10–T12. One to three weeks after spinalization, sites in the lumbar spinal cord were stimulated using trains of low current microstimulation. The isometric force produced by stimulation of a spinal site was measured at the ankle. Responses were reliably observed from stimulation of a region within the first 1250 μm from the dorsal surface of the spinal cord. These responses were clearly not due to direct motoneuronal activation and were maintained after chronic deafferentation. The force evoked by microstimulation and measured at the ankle varied smoothly across the workspace. Simultaneous stimulation of two sites in the spinal cord produced a response that was a simple linear summation of the responses evoked from each of the sites alone. Microstimulation generally produced a highly non-uniform distribution of response directions, biased toward responses which pulled the limb toward the body. Within these distributions there appeared to be two main types of responses. These different types of responses were preferentially evoked by microstimulation of different rostrocaudal regions of the spinal cord. This anatomical organization paralleled the spinal cutaneous somatotopy, as assessed by recording cutaneous receptive fields of neurons at sites to which the microstimulation was applied. This relationship was maintained after chronic deafferentation. The findings described here in the rat spinal cord in large part replicate those previously described in the frog. Received: 27 July 1998 / Accepted: 15 June 1999     

Significance of peripheral feedback in the generation of stepping movements during epidural stimulation of the spinal cord

Acute experiments on decerebrate and spinal cats were performed to study the role of the peripheral afferent input from hindlimb receptors in forming the locomotor pattern during epidural stimulation of the spinal cord. Evoked electromyographic activity in the muscles of the hindlimbs was analyzed, along with the kinematic parameters of stepping movements. Epidural stimulation (20–100 μA, 5 Hz) of segments L4–5 of the spinal cord was found to elicit well coordinated walking in the hindlimbs on a moving treadmill band. When the support conditions were changed (non-moving treadmill, unsupported position), epidural stimulation initiated walking with an unstable rhythm. This was associated with a change in the overall nature of the locomotor pattern and the internal structure of the stepping cycle. Alteration of the direction of movement of the treadmill band led to the appearance of backward walking. An increase in the speed of movement of the treadmill band increased the stepping frequency, mainly due to decreases in the extensor phase. Epidural stimulation applied 2–4 h after complete transection of the spinal cord at the T8–T9 level could elicit stepping movements, but only when the treadmill was moving. The role of peripheral feedback in generating the locomotor pattern in conditions of complete disconnection from supraspinal control increased significantly. These data show that peripheral feedback during epidural stimulation of the spinal cord can define the properties of the motor output. __________ Translated from Rossiiskii Fiziologicheskii Zhurnal imeni I. M. Sechenova, Vol. 91, No. 12, pp. 1407–1420, December, 2005.     

有氧运动改善血管性痴呆大鼠认知功能的皮质机制研究： 随机对照实验方案

BACKGROUND:Research on the mechanism underlying aerobic exercise improving cognitive function of rats with vascular dementia mainly focuses on behavioral observation and indicator detection in the hippocampus in vitro; however, there is a lack of in vivo experiments in view of the sensory and prefrontal cortex. METHODS/DESIGN: A randomized controlled animal experiment has been designed. Based on the synchronous nerve electrophysiology recording developed by our research group, the experiment is designed as follows: rats are trained firstly to make different reactions to different sounds, and are then modeled into vascular dementia. There are normal, vascular dementia, and vascular dementia undergoing short-, median-, and long-term aerobic exercise (treadmill/wheel) rats. Afterwards, the implantable microelectrodes are implanted into the auditory and prefrontal cortex, followed by the cognitive behavior training. The characters of rat cognitive behavior are observed, the electrical activity of sensory and prefrontal cortical neurons are recorded synchronously, the cortical experiment at molecular level is performed and the ultrastructure of brain tissue is observed. RESULTS AND CONCLUSION:This study investigates the cortical mechanism by which aerobic exercise improves the cognitive function of vascular dementia rats utilizing etiology, electrophysiology, molecular biology and histological technologies, aiming at providing feasible ideas for the diagnosis and treatment of relative mental and nervous system diseases. ETHICAL APPROVAL: This study was approved by the Ethics Committee of Shenyang Sport University. The disposal of rats was in line with the Guideline for the Care and Use of Laboratory Animals and the Guideline of USA National Institutes of Health. 中国组织工程研究杂志出版内容重点：组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松;组织工程     

Expression and clinical significance of protein disulfide-isomerase a3 in a rabbit model of spinal cord ischemia/reperfusion injury北大核心

BACKGROUND: At present, spinal cord ischemia/reperfusion injury is considered as the main reason for “secondary paralysis” after spinal decompression, and to control the levels of stress-related proteins and excitatory amino acids plays an important role in the treatment of spinal cord ischemia/reperfusion injury. OBJECTIVE: To investigate the expression level of protein disulfide-isomerase A3 (PDIA3) after spinal cord ischemia/reperfusion injury in rabbits. METHODS: Thirty-six New Zealand white rabbits were enrolled, the models of spinal cord ischemia/reperfusion injury were established using Zivin’s method, and were then randomized into six groups (n=6 per group). The rabbit abdominal aorta in control group was exposed without vascular occlusion and then the abdominal cavity was closed 30 minutes later. In experimental groups, the abdominal aorta was blocked for 30 minutes, followed by 0, 6, 12, 24 and 48 hours of reperfusion, and then the abdominal cavity was closed. The neurological function was evaluated with a modified Tarlov score. The L3-5 lumbar vertebrae were removed, and PDIA3 was screened by two-dimensional fluorescence differential gel electrophoresis combined with mass spectrometry, and then its temporal and spatial changes in the spinal cord were detected by western blot assay and immunohistochemistry. RESULTS AND CONCLUSION: The function of hind limbs was improved in all the experimental groups after spinal cord ischemia/reperfusion injury, and the modified Tarlov scores reached the peak at 24 hours after schemia/reperfusion injury, and decreased slightly at 48 hours. The expression of PDIA3 in the control group showed clear imprinting, which was slightly strengthened at 0 hour, became more strengthened at 6-12 hours, significantly reduced to the minimum level at 24 hours, and returned to the level of 6-12 hours at 48 hours after ischemia/reperfusion. Immunohistochemical results showed that there was visible PDIA3 in the cytoplasm of neurons, and the expression level in the interneurons was significantly higher than that in the motor neurons. These results suggest that upregulated PDIA3 appears in the development and progression of spinal cord ischemia/reperfusion injury, indicating that PDIA3 is closely related to spinal cord ischemia/reperfusion injury, which can be used as a new diagnosis and treatment target. © 2017, Journal of Clinical Rehabilitative Tissue Engineering Research. All rights reserved.     

Electroacupuncture for chronic pain in a model of knee arthritis北大核心

BACKGROUND: Acupuncture has been found to be effective for alleviating low back pain and acute pain due to knee arthritis, but its effect on chronic pain is under discussion. OBJECTIVE: To investigate the mechanism underlying electroacupuncture (EA) alleviating chronic pain in a New Zealand rabbit model of knee arthritis. METHODS: (1) Thirty-two New Zealand rabbits were selected, and the knee osteoarthritis model was established by injecting 4% papain into the knee articular cavity of rabbit’s bilateral hind limbs. The model rabbits were randomly divided into four groups (n=8 per group): normal saline plus EA, normal saline plus sham EA, nor-Binaltorphimine (nor-BNI) plus EA, and nor-BNI plus sham EA groups. The dosage of nor-BNI was 1 mg/kg, once daily, for consecutive 3 days. 30-minute EA was given at 2 hours after administration, once daily, until the day the rabbits were killed. Sham EA indicated no given electric current. The behaviors of the lower limbs were evaluated by Basso, Beattie, Bresnahan scores. The rabbits were respectively killed at 1, 3, 5 and 7 days after administration, the spinal cord was separated, and then fixed with formaldehyde. The expression levels of interleukin-17, interleukin-17 receptor A and NR1 in the spinal cord tissues were detected by immunofluorescence. (2) The other 24 New Zealand rabbits were randomly divided into model and control groups (n=12 per group), and the knee osteoarthritis model was established in the former group. Afterwards, the two groups were randomized into two subgroups, followed by given the intrathecal administration of normal saline, or 2 μg interleukin-17 antibody serum dissolved in 10 μL normal saline, once daily, for consecutive 3 days. The behaviors of the lower limbs were evaluated by Basso, Beattie, Bresnahan scores, and the expression levels of p-NR1 and interleukin-17 receptor were detected by western blot assy. RESULTS AND CONCLUSION: The Basso, Beattie, Bresnahan scores in the nor-BNI plus EA group were significantly increased, while the expression levels of interleukin-17, interleukin-17 receptor A and NR1 in the spinal cord tissues were significantly decreased (P < 0.05). The expression level of NRI did not differ significantly between nor-BNI plus EA and nor-BNI plus sham EA groups (P > 0.05). After administration of interleukin-17 antibody serum, the Basso, Beattie, Bresnahan scores in the model group was significantly increased, and the expression levels of interleukin-17 and NR1 in the spinal cord tissues were significantly decreased, but still significantly higher than those in the control subgroups (P < 0.05). These results suggest that chronic pain in knee arthritis is the result of an increase in the expression level of NRI induced by interleukin-17. EA can remarkably improve the pain in the model rabbits of knee arthritis by downregulating interleukin-17 in the spinal cord tissues, rather than interleukin-17 receptor. © 2017, Journal of Clinical Rehabilitative Tissue Engineering Research. All rights reserved.     

立体定向脑内移植神经干细胞改善颅脑损伤大鼠的神经运动功能

BACKGROUND: Cell replacement therapy as an effective strategy for reconstruction of the central nervous system has very broad application prospects. OBJECTIVE: To investigate the effect of stereotactic transplantation of neural stem cells into the brain on the neuromotor function of craniocerebral trauma rats. METHODS: Twenty male Sprague-Dawley rats were equivalently randomized into study and control groups. Animal models of craniocerebral trauma were made using the improved free-fall method in the rats. Then, model rats in the study and control groups were given parenchymal transplantation of embryonic neural stem cells and the same volume of culture medium with no stem cells at 1 day after injury, respectively. Neuromotor function of rats was assessed based on the neurological severity scores. At 2 weeks after transplantation, brain tissues were taken for hematoxylin-eosin staining, anti-BrdU, glial fibrillary acidic protein, β-tubulin III and tyrosine hydroxylase immunohistochemistry staining. RESULTS AND CONCLUSION: The neurological severity scores in the study group were significantly lower than those in the control group at 1 and 2 weeks after injury (P < 0.05). In the study group, there were many BrdU-positive neural stem cells in the brain tissues, some of which were positive for glial fibrillary acidic protein, β-tubulin III and tyrosine hydroxylase; while in the control group, there was no BrdU-positive cell in the brain tissues. Experimental findings show that neural stem cells stereotactically transplanted into the brain can proliferate and differentiate in the brain lesion, and thereby notably improve the neuromotor function of rats with craniocerebral trauma.  中国组织工程研究杂志出版内容重点：干细胞;骨髓干细胞;造血干细胞;脂肪干细胞;肿瘤干细胞;胚胎干细胞;脐带脐血干细胞;干细胞诱导;干细胞分化;组织工程      

脐带间充质干细胞在颅脑损伤模型鼠体内的迁徙与定位

BACKGROUND: Choosing an effective means to label and trace the distribution, differentiation and migration of cells in vivo help to further explore the specific mechanism of cells that exert a therapeutic effect.OBJECTIVE: To understand the migration and localization of BrdU-labeled human umbilical cord mesenchymal stem cells in brain injury model rats.METHODS: Human umbilical cord blood samples were obtained, and the isolation of human umbilical cord mesenchymal stem cells was carried out. The primary and passage culture were performed. The phenotype of cells was detected by flow cytometry. Passage 3 human umbilical cord mesenchymal stem cells were labeled using BrdU, and the cell proliferation was detected using MTT method. BrdU-labeled cells were injected into brain injury rats via the tail vein. At 14 days after transplantation, brain tissues in the injury region were cut into sections and the migration and location of the umbilical cord mesenchymal stem cells were observed under inverted fluorescence microscope.RESULTS AND CONCLUSION:Cell surface specific markers CD45 and CD34 were detected by flow cytometry, but the cells could not express CD44, CD105 and CD29. Based on the cell growth curve, the cells came into a conditioning period at 1-3 days of seeding and came into a logarithmic phase at 3-5 days. BrdU-positive cells were visible at the injury region after 14 days, indicating that in the rats, transplanted human umbilical cord mesenchymal stem cells migrated from the peripheral blood to the site of brain injury to achieve the effective repair of injured parts.  中国组织工程研究杂志出版内容重点：干细胞;骨髓干细胞;造血干细胞;脂肪干细胞;肿瘤干细胞;胚胎干细胞;脐带脐血干细胞;干细胞诱导;干细胞分化;组织工程     

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.     

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.     

The universal muscular chain reaction,muscle spasm,Torsions, ruptures and extravasations. Chameleons of pathology and some manifestations of simple muscular disorders

Most bodily functions require the coordinated actions of complementary and supplementary paired muscle groups. Where this essential muscular cooperation is lacking, hollow organs may burst and others become literally screwed up, giving rise to many similar spastic diseases such as Torticollis, Twisted ovarian cyst, Torsion of the Testis, Volvulus of the intestines, Varicose Veins, Megacolon, Aortamegaly, Scoliosis, Erb's Palsy, Peyronie's Disease, Main-en-Griffe, Undescended Foot (Pes Cavus), Talipes, Strabismus. Spasm is “panenepidemic” and unclassified examples of Torsion Dystonia and Dyskinesia really are as common as debt and taxes.     

'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.     

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.     

Hypo- und Hypermagnesämie aus kardiologischer Sicht

Zusammenfassung Eine Reihe pathologischer Zustände bedingen Magnesiummangel. Zustände mit Hypermagnesämie sind ebenfalls bekannt, doch wesentlich seltener. Für den Kardiologen beachtenswert ist, daß unter Therapie mit bestimmten Diuretica bei Herzinsuffizienz, bei Herzinfarkt, Kardiomyopathie, Digitalisintoxikation und bestimmten Herzrhythmusstörungen Hypomagnesämie beobachtet wurde. Leider kann in der klinischen Routine nur ein extracelluläres Magnesiumdefizit durch Serumbestimmungen gemessen werden; über Magnesiummangel einzelner Organe kann nichts ausgesagt werden. Hinweise für Magnesiummangel geben aber neben der Messung des Serumspiegels Anamnese, klinischer Befund, bestimmte EKG-Veränderungen wie auch evtl. Hypokalämie, ein Zustand, bei dem sich oft — besonders bei Aldosteronismus — parallele Veränderungen zeigten.Tierexperimente deuten darauf hin, daß infarktähnliche Läsionen unter Magnesiummangel entstehen, doch ob Herzinfarkt beim Menschen durch Magnesiummangel ausgelöst werden kann, ist noch ungeklärt. In Leichenherzen zeigte sich im Infarktgebiet neben Calciumakkumulation signifikanter Magnesiumverlust, wobei unklar blieb, ob sich Ursache oder Folge des Infarktes widerspiegelten. Falls ein ursächlicher Zusammenhang besteht, ist er im Myokardstoffwechsel selbst zu suchen, wie bei der Alkoholkardiomyopathie, wo myokardialer Magnesiummangel zumindest als pathogenetischer Teilfaktor anerkannt wird. Andererseits versucht man aber auch Beziehungen zwischen Atherosklerose, Blutgerinnung und Hypomagnesämie herzustellen, in der Meinung, daß Magnesiummangel auch über den coronaren Pathomechanismus des Herzinfarktes wirken könnte. Sicher scheint, daß gewisse EKG-Veränderungen und Herzrhythmusstörungen durch einen irritierten Magnesiumhaushalt bedingt sein können, da sie bei Gabe bzw. Entzug von Magnesium verschwinden. Daß Magnesiummangel die Glykosidtoleranz verringert, wird tierexperimentell bestätigt. Unter Hypomagnesämie bewirkt Acetylstrophanthidin eher und länger Rhythmusstörungen als ohne, außerdem lassen diese sich durch Magnesiumgaben eliminieren. Da in gewissen Fällen spontane und digitalisinduzierte Herzrythmusstörungen durch Magnesiuminjektionen beseitigt wurden, scheint Magnesium als Therapeuticum angebracht. Einsatz verschiedener Magnesiumsalze bei Angina pectoris, degenerativen Herzerkrankungen und Herzinsuffizienz ohne geprüften und offensichtlich gestörten Magnesiumhaushalt ist fragwürdig, weil keine eindeutigen klinischen Erfolgsbeweise vorliegen. Immerhin mag es aber larvierte, durch Serumbestimmungen nicht erfaßbare Mangelzustände geben. Allgemein erscheint es aus kardiologischer Sicht ratsam, den Magnesiumhaushalt zu überwachen und in entsprechenden Fällen auszugleichen, um möglichen Myokardläsionen oder fatalen Herzrhythmusstörungen entgegenzuwirken.     

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.     

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.