Sympathetic vasomotor changes induced by manual and electrical acupuncture of the Hoku point visualized by thermography

Considerable evidence implicates sympathetic neural activity in acupuncture analgesia. However, the exact nature of these effects has not been specified in detail, and many experimental findings are contradictory. This study evaluated in normal conditions the specific sympathetic effects of both manual and electrical acupuncture applied to the same hand (Hoku) point. Thermographic measures of superficial skin temperature were used to assess sympathetic vasomotor tone in the face, hand and foot of 19 normal subjects. Baseline assessment, manual acupuncture and electrical acupuncture were performed in 3 separate sessions in a well controlled, 23 degrees C environment. Superficial skin temperature decreased slowly in the control condition. Both manual and electrical acupuncture produced a generalized long-lasting warming effect, indicating reduced sympathetic activity (sympatholytic effect). In addition, electrical acupuncture induced a localized short-term cooling effect, indicating a transient segmental increase in sympathetic activity (sympathomimetic effect).     

心理护理在改善艾滋病患者主观症状中的应用

目的探讨心理护理协助艾滋病患者改善主观症状的效果。方法选择传染科住院治疗的艾滋病患者133例,入院后应用症状评估量表（MSAS）对患者主观症状进行评价,并对其进行心理护理,出院后每月进行随访,6个月后再次用MSAS评价患者的症状,比较患者在心理护理前后症状的改善。结果心理干预前后,133例患者在MSAS的32项指标中,注意力不集中[（1．1±1．3）分比（0．7±0．9）分]、疼痛[（1．3±1．2）分比（0．8±0．9）分]、乏力[（1．8±1．5）分比（1．3±1．0）分]等11项指标得到改善,差异有统计学意义（x2分别为4．222,4．531,4．682;P〈0．01）;患者主观症状发生率比较,差异无统计学意义（P〉0．05）。结论心理护理对艾滋病患者的症状改善有益,而对症状发生的比例没有影响。     

Histoplasma capsulatum fungemia documented using the DuPont Isolator System

A patient with disseminated histoplasmosis is described in whom blood cultures were negative using conventional media but positive for Histoplasma capsulatum using the DuPont Isolator system. Fungal blood culture methods are discussed.     

Determination of noradrenaline and adrenaline in plasma by a radioenzymatic assay using high pressure liquid chromatography for the separation of the radiochemical products.

Plasma catecholamines are determined by a radioenzymatic assay using high pressure liquid chromatography for the separation of the labelled radiochemical products. Noradrenaline and adrenaline are converted to their O-methylated analogues, normethanephrine and metanephrine, by the enzyme catechol O-methyltransferase in the presence of tritiated S-adenosyl-L-methionine. Non-radioactive carriers are added, whereupon the metanephrines are extracted in an organic phase and re-extracted in an aqueous phase. The aqueous phase is dried, the residue taken up in a phosphate solution and chromatographed. The normetanephrine and metanephrine peaks are collected, converted to vanillin and assayed for radioactivity. The detection limit for noradrenaline is 32 ng/l plasma and for adrenaline 16 ng/l plasma. Intra- and interassay variables are respectively 6.2 and 10% for noradrenaline and 5.3 and 8.8% for adrenaline. The mean supine levels of noradrenaline and adrenaline in normal subjects are 355 and 61 ng/l plasma, respectively. This highly specific procedure takes two days for one person to assay 45 blood samples and can be reduced to one day if the chromatography step is automated.     

Comparison of the Lewis phenotypes among the different population groups of Taiwan

Summary. In Caucasians, three red cell Lewis phenotypes are observed, namely Le (a+b-), Le (a-b+) and Le (a-b-). For Chinese living in Taiwan the Le (a+b-) phenotype is replaced by the Le (a+b+) phenotype so that the three red cell Lewis phenotypes observed in Chinese are Le (a+b+), Le (a-b+) and Le (a-b-). In addition, Chinese individuals with Le (a-b-) red cells can be subdivided into two groups, namely those who secrete both ABH and Lewis substances in saliva and those who secrete only ABH substances in saliva.
However, four red cell Lewis phenotypes Le (a+b-), Le (a+b+), Le (a-b+) and Le (a-b-) are observed among some of the indigenous groups living in Taiwan. Red cell Le (a+b-) individuals among these indigenous groups can also be subdivided into at least two groups, namely those with Le^aand Le^bin saliva (plus varying amounts of ABH substances) and those with just Le^ain saliva. The former are most likely a weak form of the red cell Le (a+b+) phenotype while the latter appear to be similar to the Caucasian red cell Le (a+b-) phenotype. There was also one red cell Le (a+b-) individual whose saliva had a small amount of A substance as well as Le^asubstance and therefore appeared to be intermediate between the above two forms of the Le (a+b-) phenotype.     

Daily variation of lipids and hormones in sera of healthy subjects.

The physiological day-to-day variation of selected hormone and lipid concentration values in sera of healthy subjects was studied. We drew blood specimens from 14 healthy volunteers, aged 22 to 40 years, (8 male and 6 female) at 0800 h on six separate days over a ten day interval. On one occasion all the twelve specimens from each subject (6 days X 2 replicates) were assayed for the hormones: thyroxine and cortisol; and the lipips: cholesterol and triglyceride which were analyzed by enzymatic methods. The assays were performed on one occasion in order to eliminate the batch-to-batch analytical variation which would tend to blur the physiological day-to-day variation. Using an analysis of variance technique, the total variation was separated into the physiological intraindividual day-to-day variation, the biological inter-individual variation, and the within-batch analytical variation. The mean physiological day-to-day variations in terms of percent coefficient of variation were 7.5% for thyroxine, 26.6% for cortisol, 4.8% for cholesterol, , and 25.0% for triglycerides.     

Intrathecal normal saline without preservative does not have a local anesthetic effect

The effects of intrathecally administered normal saline (preservative-free) were studied in patients undergoing differential spinal block anesthesia for evaluation of chronic pain below the waist. The injection of 5 ml saline did not significantly change the sensitivity to pinprick measured in the lower back and both lower extremities. Temperature measurement in both the lower extremities and psycho-galvanic skin reflex did not show evidence of sympathetic block; the psychogalvanic skin reflex was abandoned because of inconsistent results. These findings refute the earlier conclusion of Urban and McKain who found that normal saline acts as a weak local anesthetic when injected intrathecally. We recommend use of normal saline (preservative-free) in 5 ml doses as a placebo for differential spinal block anesthesia.     

癌症患者症状群发生状况的调查研究与管理对策

目的:调查并分析癌症患者症状的发生率、严重程度和症状群。方法:采用中文版记忆症状评估量表(MSAS-Ch)对973名癌症患者进行问卷调查。结果:癌症患者存在5个症状群,共能解释总变异的60.12%,分别为乏力-厌食-胃肠道症状群、病态行为症状群、心理症状群、体重下降-便秘症状群和治疗相关的症状群。结论:癌症患者存在不同的症状群,了解症状群有助于临床医务人员制定出有针对性的干预措施,以减轻患者的症状。     

The analgesic efficacy of intrathecal D-Ala2-D-Leu5-enkephalin in cancer patients with chronic pain

D-Ala-D-Leu-enkephalin (DADL) is a pentapeptide which, compared to morphine, preferentially binds to the delta receptor. We compared the analgesic and side effects of intrathecal (i.t.) DADL and i.t. morphine sulfate (MS) in 10 tolerant cancer patients with chronic pain at or below the T12 level who were receiving inadequate relief or unacceptable side effects from systemic opiates. These patients were given i.t. DADL and i.t. MS in a randomized, double-blind, cross-over study on separate days at least 1 day apart. I.t. DADL produced analgesia in all patients tested. Total pain relief was greater with DADL than MS in 6 patients, equal in 1 patient and less with DADL in 3. Side effects, most commonly drowsiness, were similar with both MS and DADL and suggest supraspinal effects by both drugs. At the doses given i.t. DADL produced effective pain relief in patients tolerant to systemic opiates although no significant difference in analgesic efficacy between MS and DADL was observed. Studies of the relative analgesic potency of i.t. DADL in man are necessary to fully assess its value in those patients tolerant to systemic or i.t. opiates.     

Acupuncture and chronic pain mechanisms.

Forty patients with chronic pain below the waist level not amenable to conventional medical and/or surgical treatment were randomly assigned to one or two different methods of acupuncture, after studying the underlying pain mechanisms using a Multidisciplinary Pain Clinic approach and the differential spinal block (DSB). One group received acupuncture needling in the classical acupuncture points referred to as meridian loci needling (MLN) and the other group received tender area needling (TAN) with needles inserted in the dermatomal distribution of the painful areas. The responses between the two groups showed no significant difference. Results were then related to the predetermined somatopsychological basis of the individual's pain problems as classified by the DSB. A group of patinets in whom pain relief occurred upon subarachnoid injection of 0.25% procaine followed by sympathetic blockade or 0.5% procaine injection followed by hypalgesia without motor loss, also reported maximum subjective improvement in their pain level following acupuncture therapy performed at a later time. The other group of patients in whom pain persisted despite sensory and motor blockade (1% procaine) responded very poorly to acupuncture therapy. DSB was found to be complimentary to acupuncture therapy in that it facilitated patient selection for the therapy.     

Cell culture studies of Menkes kinky hair disease

The dose response as well as kinetics of uptake and retention of copper and cadmium of normal and Menkes kinky hair disease (MKHD) cultured fibroblasts are described. In basal culture medium, intracellular copper concentration in MKHD fibroblasts was approximately 3 times that of control cultures. The intracellular copper concentration of MKHD cells was significantly higher than that of normal fibroblasts at medium copper concentrations below 20 microgram/ml. Death of MKHD cells occurred at medium copper concentrations between 15 and 20 microgram/ml with an intracellular copper level 3 times that at basal medium. Normal cells died at medium copper concentration above 30 microgram/ml with an intracellular copper concentration 19 times that at basal medium. These observations suggested the existence of a regulatory mechanism for maintenance and control of intracellular copper in normal fibroblasts which is effective at medium copper concentrations below 30 microgram/ml. This system is defective in MKHD fibroblasts. In basal medium MKHD and normal fibroblasts had similar intracellular cadmium concentrations; however, at higher medium cadmium concentrations MKHD cells had increased intracellular cadmium levels. The uptake of both 64Cu and 109Cd was significantly higher in MKHD cells than in normal cells, indicating that the uptake of 64Cu and 109Cd is not impaired in MKHD cells. A higher retention of 64Cu was observed in MKHD cells at both 37 degrees C and 4 degrees C. No obvious trend, however, was observed in the difference of retention of 109Cd between MKHD and normal cells. An impairment of egress of copper in MKHD cells is implicated by these results.     

Isolation and characterization of a polyamine-peptide conjugate from human amniotic fluid.

Significant amounts of the diamine putrescine and the polyamines spermidine and spermine could be detected in human third-trimester amniotic fluid only after acid hydrolysis. This observation was interpreted to mean that these amines existed only in conjugated form in this biological fluid. Upon fractionation by ultrafiltration 90--10% of the putrescine was associated with the 1000--10 000 dalton fraction. Spermine was identified in this fraction and in a low-molecular weight fraction presumably representing acetylated derivatives. Spermidine was entirely associated with the 10 000--30 000 dalton fraction. The putrescine conjugate was purified to homogeneity by column chromatography on Biogels P10 and P6 followed by ion-exchange chromatography on DEAE-Sephadex A-25. Molecular weight by gel exclusion using peptide standards was estimated to be approx. 4600. The UV absorption spectrum of the putrescine conjugate conformed to that expected for a polypeptide. This putrescine conjugate contained 39 identified amino acids with a combined molecular weight of 4713. Putrescine was detectable by high pressure liquid chromatography only after acid hydrolysis of the conjugate. No other polyamines were detected in these hydrolyzates, nor were any polyamines demonstable in hydrolyzates of control peptides nor in pooled column washes. The identity of the putrescine determined by high pressure liquid chromatography was confirmed by a two-dimensional thin-layer chromatography method. These results establish the in vivo production of a putrescine--polypeptide conjugate in man. Such molecular species may constitute yet another metabolic pathway for polyamines or may reflect another mode of post-translational modification of polypeptide structure and function. The qualitative and quantitative analysis of polyamine conjugate in human aminotic fluid may prove to be useful in the detection of abnormalities in fetal development.     

Decreased sialic acid and altered binding to lectins of purified alpha 2-macroglobulin from patients with cystic fibrosis.

Purified preparations of plasma alpha 2-macroglobulin from patients with cystic fibrosis are shown to have normal amounts of total hexose but as much as 40% decrease in their sialic acid content. The binding of these preparations to concanavalin A and wheat-germ agglutinin was markedly reduced as compared to normal values in controls. Intermediate values were found in obligate heterozygotes. These results suggest a possible alteration in the carbohydrate moiety of alpha 2-macroglobulin in cystic fibrosis, presumably due to a defective posttranslational process.     

Familial hypertryptophanemia,tryptophanuria and indoleketonuria

Two patients presenting with mental subnormality and severe emotional lability were examined for possible inborn errors of metabolism. Amino acid and organic acid analyses of their plasma and urine revealed a novel and grossly abnormal metabolism of tryptophan. Basal levels of plasma tryptophan were ten times that of controls and the 24-hour urinary excretion of tryptophan was up to 50 times greater than normal. Both patients excreted about 100 times the normal amounts of indoleacetic, indolelactic and indolepyruvic acids. Administration of oral antibiotic to one of the patients to eliminate intestinal bacteria did not result in any reduction in the excretion of the indoleic acids. The results are interpreted in terms of a possible congenital defect in the normal conversion of tryptophan to kynurenine.