Scintigraphic diagnosis of tricuspid regurgitation

The authors describe a simple technique for diagnosis of tricuspid regurgitation. Red blood cells were labeled in vivo with 99mTc and 22 patients were studied with ECG-gated blood-pool imaging of the liver. A single region of interest was manually drawn around the liver and a time-activity curve obtained. The per cent change in liver counts during the cardiac cycle was found to be significantly higher in the 12 patients with tricuspid regurgitation (Group I) (mean, 4.04 +/- 1.6%; range, 1.3-21.4%) compared with the 10 controls (Group II) (mean, 0.35 +/- 0.16%; range, 0.013-1.3%) (p less than 0.05). Using a 1% change in liver counts as the criterion of a positive study, all 12 cases in Group I were diagnosed correctly, but there was one false positive in Group II; thus the sensitivity was 100% and the specificity 90%.     

Assessment of ventilatory thresholds during graded and maximal exercise test using time varying analysis of respiratory sinus arrhythmia

Objective: To test whether ventilatory thresholds, measured during an exercise test, could be assessed using time varying analysis of respiratory sinus arrhythmia frequency (f_RSA).

Methods: Fourteen sedentary subjects and 12 endurance athletes performed a graded and maximal exercise test on a cycle ergometer: initial load 75 W (sedentary subjects) and 150 W (athletes), increments 37.5 W/2 min. f_RSA was extracted from heart period series using an evolutive model. First (T_V1) and second (T_V2) ventilatory thresholds were determined from the time course curves of ventilation and ventilatory equivalents for O₂ and CO₂.

Results: f_RSA was accurately extracted from all recordings and positively correlated to respiratory frequency (r = 0.96 (0.03), p<0.01). In 21 of the 26 subjects, two successive non-linear increases were determined in f_RSA, defining the first (T_RSA1) and second (T_RSA2) f_RSA thresholds. When expressed as a function of power, T_RSA1 and T_RSA2 were not significantly different from and closely linked to T_V1 (r = 0.99, p<0.001) and T_V2 (r = 0.99, p<0.001), respectively. In the five remaining subjects, only one non-linear increase was observed close to T_V2. Significant differences (p<0.04) were found between athlete and sedentary groups when T_RSA1 and T_RSA2 were expressed in terms of absolute and relative power and percentage of maximal aerobic power. In the sedentary group, T_RSA1 and T_RSA2 were 150.3 (18.7) W and 198.3 (28.8) W, respectively, whereas in the athlete group T_RSA1 and T_RSA2 were 247.3 (32.8) W and 316.0 (28.8) W, respectively.

Conclusions: Dynamic analysis of f_RSA provides a useful tool for identifying ventilatory thresholds during graded and maximal exercise test in sedentary subjects and athletes.

     

Cholesterol homeostasis and the pathophysiology of Alzheimer's disease

The past 4 years have seen a growing interest in cholesterol metabolism and its relationship to Alzheimer's disease. From the first report linking cholesterol and beta-amyloid metabolisms to the recent positive report on the use of atorvastatin (Lipitor, Pfizer Inc.), a cholesterol-lowering drug, in mild-to-moderate Alzheimer's disease, this review examines the scientific progress pertaining to etiopathology of Alzheimer's disease over the past 15 years and the central role of lipids in this field of research. The role of key proteins involved in this metabolic pathway such as apolipoprotein E, lipoprotein lipase, caveolin, hydroxy-methylglutaryl Coenzyme A reductase, low-density lipoprotein receptors, cholesterol 24-hydroxylase, acyl-coenzyme A:cholesterol acyltransferase and beta-amyloid are discussed.     

Idiopathic polypoidal choroidal vasculopathy leading to blindness

Idiopathic polypoidal choroidal vasculopathy (IPCV) has recently been recognized as a distinct cause of recurrent subretinal hemorrhages and exudates as well as multiple hemorrhagic retinal pigment epithelium detachments in the macula. IPCV is usually considered to have a good visual prognosis. We report the case of a 44-year-old woman with particularly severe bilateral macular and peripheral IPCV. The patient was followed for 13 years and had final visual acuity of counting fingers in the right eye and 20/400 in the left eye. Patients with IPCV with macular choroidal neovascularization tend to have a poor visual prognosis. This case of IPCV should alert the physician to be particularly attentive to the follow-up of these patients.     

银杏叶制剂对心绞痛患者的抗氧化和抗脂质过氧化作用

目的：探讨银杏叶制剂对心绞痛患者的抗氧化和抗脂质过氧化作用。方法：检测了７８例心绞痛患者经银杏叶制剂“天宝宁”治疗前后的血浆维生素Ｃ（Ｐ－ＶＣ）、维生素Ｅ（Ｐ－ＶＥ）、β－胡萝卜素（Ｐ－β－ＣＡＲ）、过氧化脂质（Ｐ－ＬＰＯ）以及红细胞超氧化物歧化酶（Ｅ－ＳＯＤ）、过氧化氢酶（Ｅ－ＣＡＴ）、谷胱甘肽过氧化物酶（Ｅ－ＧＳＨ－ＰＸ）、过氧化脂质（Ｅ－ＬＰＯ）值。结果：与治疗前比较,治疗后的Ｐ－ＶＣ、Ｐ－     

Susceptibility to chlordecone-carbon tetrachloride induced hepatotoxicity and lethality is both age and sex dependent.

The present paper examines the susceptibility to chlordecone (Kepone, CD) and carbon tetrachloride across different ages (35, 45, and 63-days-old) in male and female Sprague-Dawley rats using different lengths of time on a CD diet (10 ppm). The principal findings are that the hepatotoxicity and mortality associated with CD-CCl4 interaction is highly age-dependent for both sexes. There was marked hepatotoxicity occurring in both sexes as they reached 45 days-of-age and females were considerably more susceptible than males to both CD-CCl4-induced hepatotoxicity and lethality. While 63-day-old females are more susceptible to the CD-CCl4 interaction than their male counterparts, the magnitude of the sex difference is diminished from that observed in 45-day-old rats. These findings challenge the hypothesis of Mehendale (1990, Med. Hypotheses 33, 289-299) that chlordecone (CD) pretreatment eliminates the well-established sex difference in CCl4-treated rats. In contrast to the CD-CCl4 findings, the sex difference in CCl4-induced hepatotoxicity was not age-dependent and was consistent over the three ages studied. The findings that CD-CCl4 interaction is highly age-dependent (within the 3 ages tested) but that CCl4-induced hepatotoxicity is not, suggest that the CD-CCl4 interaction acts via a mechanism that does not primarily involve CCl4 potentiation.     

控制和影响神经干细胞增殖分化为神经元细胞的途径及因素

目的:探讨控制和影响神经干细胞向神经元细胞转化途径的因素。资料来源:应用计算机检索Medline和cnki数据库1990-01/2006-06期间的有关神经干细胞和增殖与分化关系的文献,检索词“NSC,proliferation,differentiation”,并限定文章语言种类为English。同时计算机检索中国生物医学文献数据库1990-01/2006-06期间的相关文献,限定文章语言种类为中文,检索词“神经干细胞、增殖、分化”。资料选择:选取关于影响神经干细胞增殖与分化特别是机制方面的相关文献,删除未进行对照的试验研究的文章,然后查余下的文献全文,进一步判断是否采用对照。纳入标准:平行对照组,即未采用影响神经干细胞增殖与分化的因素或正常对照;实验组为采用干扰神经干细胞增殖与分化的因素。排除明显不随机的试验。质量评价主要考察资料的真实性,调查设计是否严密,实施过程是否严格,统计学处理是否合理。资料提炼:共检索43篇关于神经干细胞增殖与分化分别与基因调控、生长因子、细胞因子及微环境信号等因素密切相关文章,31编符合纳入标准。排除的12篇试验中,8篇是因重复的同一研究,4篇是Meta分析研究。资料综合:神经干细胞是一种具有强大的自我更新能力和多向分化潜能的细胞,它具有分化为中枢神经系统内神经元、星形胶质细胞和少突胶质细胞的能力;其增殖与分化与基因调控、生长因子、细胞因子及微环境信号等因素密切相关,基本螺旋-环-螺旋基因、凋亡相关基因Bc1-XL、sox2等参与了神经干细胞的定向分化机制,notch信号通路、过氧化物酶体增殖分化激活受体Y信号通路也影响神经干细胞的分化方向。结论:神经干细胞的增殖与分化机制尚不十分清楚,其分化及调控机制是多因素调节和多因素相互作用的结果。