Ongoing challenges in pediatric hospice care

Reports have begun to proliferate throughout the world which describe various models of pediatric hospice care. While encouraging, these reports identify universal obstacles that continue to compromise effective care. Challenges persist in areas of pain management, medical ethics, program administration, cost analysis, staff development and bereavement follow-up. Cooperative efforts are encouraged to address these issues.     

褪黑素对小鼠免疫性肝损伤的保护作用

目的观察褪黑素（MT）对小鼠免疫性肝损伤的影响。方法序贯注射短小棒状杆菌和脂多糖诱导小鼠免疫性肝损伤模型;在造模不同时间注射不同剂量MT;检测血浆转氨酶、肝脏雨二醛（MDA）和谷胱甘肽过氧化物酶（GSH-px）以及脾淋巴细胞增殖状况。结果造模期间用MT（0.1～10.0mg·kg-1）能显著降低血浆转氨酶和肝脏MDA水平（P＜0.05～0.01），使肝脏GSH-px活性部分恢复（P＜0.05），并能选择性抑制刀豆蛋白A诱导的脾淋巴细胞增殖。但造模后使用MT对免疫性肝损伤无明显影响。结论MT保护免疫性肝损伤作用与其抗氧化和免疫调节作用有关。     

The pathogenesis of diabetic retinopathy

Diabetic retinopathy remains a major cause of loss of vision. The Diabetes Control and Complications Trial (DCCT) has implicated hyperglycaemia as a probable major direct causative factor in the pathogenesis of diabetic retinopathy. There are several plausible mechanisms by which high glucose concentrations could lead to the functional and later structural changes characterising diabetic retinopathy. These include increased activity of the aldose reductase pathway, increase de novo synthesis of diacylglycerol from glucose, causing protein kinase C activation, increased non-enzymatic glycation and increased oxidative damage. The demonstration of the potential roles of these pathways and the subsequent effects of growth factors in enhancing angiogenesis provide potential new approaches to the prevention and treatment of diabetic retinopathy.     

Role of anxiety in subordinate male mice sexual behavior.

Dominant and subordinate male mice behave differently when exposed to a female, with subordinates showing impairment of their sexual performance in the presence of the male antagonist. In the present study, we investigate whether these rank-related behavioral differences can be modified by an anxiolytic treatment. In a first experiment, diazepam (0.25 mg/kg) improves the performance of subordinate mice toward the female, as shown by the increase of proxemic behavior, anogenital sniffing, and social grooming of the female. Social grooming of the female is the only behavior modified by a higher dose of the anxiolytic drug (0.5 mg/kg). A second experiment, in which dominant and isolated mice are subjected to the same experimental procedure, demonstrates that social behavior of these two classes of males is not affected by the pharmacological treatment. The results are discussed in terms of the advantages of using subordinate males in such a sexual context as a model for the study of anxiolytic drugs.     

High-resolution EEG mapping of cortical activation related to working memory: effects of task difficulty, type of processing, and practice

Changes in cortical activity during working memory tasks were examined with electroencephalograms (EEGs) sampled from 115 channels and spatially sharpened with magnetic resonance imaging (MRI)-based finite element deblurring. Eight subjects performed tasks requiring comparison of each stimulus to a preceding one on verbal or spatial attributes. A frontal midline theta rhythm increased in magnitude with increased memory load. Dipole models localized this signal to the region of the anterior cingulate cortex. A slow (low-frequency), parietocentral, alpha signal decreased with increased working memory load. These signals were insensitive to the type of stimulus attribute being processed. A faster (higher-frequency), occipitoparietal, alpha signal was relatively attenuated in the spatial version of the task, especially over the posterior right hemisphere. Theta and alpha signals increased, and overt performance improved, after practice on the tasks. Increases in theta with both increased task difficulty and with practice suggests that focusing attention required more effort after an extended test session. Decreased alpha in the difficult tasks indicates that this signal is inversely related to the amount of cortical resources allocated to task performance. Practice-related increases in alpha suggest that fewer cortical resources are required after skill development. These results serve: (i) to dissociate the effects of task difficulty and practice; (ii) to differentiate the involvement of posterior cortex in spatial versus verbal tasks; (iii) to localize frontal midline theta to the anteromedial cortex; and (iv) to demonstrate the feasibility of using anatomical MRIs to remove the blurring effect of the skull and scalp from the ongoing EEG. The results are discussed with respect to those obtained in a prior study of transient evoked potentials during working memory.      

Intrathecal interferon in subacute sclerosing panencephalitis

Three patients at Stage II of subacute sclerosing panencephalitis (SSPE) were treated with semipurified alpha-interferon (IFN) using different combinations of intrathecal and intravenous routes: 1 x 10(6) IU of alpha-IFN were given every other day up to a total of 15 x 10(6) IU. Transient improvement of neurological symptoms and electroencephalogram were noted in all 3, while cognitive function slightly improved in 2 of them. Clinical benefits gradually disappeared 2 to 6 months after cessation of IFN. Intrathecal antibody production did not change substantially, but CSF Leu 3a/Leu 2a ratio appeared to increase. No significant side effects were observed, except for a mild meningeal inflammatory reaction after each intrathecal administration of IFN.     

A case-control study on lip cancer risk factors in ragusa (sicily)

Incidence rates of lip cancer in males in Ragusa (Sicily) are amongst the highest in Europe [age-standardized rate (world) for 1980-82: 7.5 per 100,000]. A case-control study was conducted on 53 male cases and 106 controls matched for sex, age (± 2 1/2 years), residence and hospital from which cases had been drawn. Individual interviews were carried out for the evaluation of ethnic, environmental, pathologic and occupational risk factors. Lip cancer was significantly associated with: fair, brown, or red hair (relative odds = 2.3), blue eyes (r.o. = 5.3), fair skin (r.o. = 8.0), sensitivity to sunburns (r.o. = 4.1), working outdoors (r.o. = 4.9), coexistence of non-specific lesions of exposed body parts (r.o. = 12,2), low socioeconomic status (r.o. = 15.8), farming (r.o. = 2.6) and working in greenhouses (r.o. = 12.0). Recall of recurrent Herpes labialis was not significantly associated; also association with tobacco smoking was not significant after adjustment for socioeconomic status. Risk increased exponentially with the number of ethnic characteristics of northern European populations.