Psychological response to growth hormone treatment in short normal children

Indian childhood cirrhosis (ICC) is an almost uniformly fatal disease whose outcome may be modified with penicillamine if given at a sufficiently early stage. Twenty nine children with ICC seen in Pune, India, in 1980-7, who had survived at least five years from onset of penicillamine treatment, were reviewed aged 6.3 to 13 years. They were assessed clinically, biochemically, histologically, and by duplex Doppler ultrasound examination. None had symptoms suggestive of liver disease. There were no toxic effects of penicillamine other than asymptomatic proteinuria. Hepatosplenomegaly reduced significantly and liver function tests returned to normal in all. In four children, significant hepatosplenomegaly was associated with an abnormal duplex Doppler hepatic vein flow pattern and micronodular cirrhosis on biopsy. Clinical findings, growth and development, and ultrasound examination were normal in the remainder. Review of serial liver biopsy specimens showed a sequence of recovery from ICC through inactive micronodular cirrhosis to virtually normal histological appearances. The four children who still have micronodular cirrhosis beyond four years from onset remain on penicillamine treatment. In the others penicillamine was stopped after 1-7 (mean 3.5) years without relapse, strong evidence that ICC is not due to an inborn error of copper metabolism.     

6Effect of a water load test on gastric myoelectrical activity and upper gastrointestinal symptoms in patients with nausea and vomiting of pregnancy

Nausea and vomiting of pregnancy (NVP) is a common syndrome in which symptoms predominate in the first trimester of pregnancy. Symptoms range from mild to severe and afflict up to 80% of pregnant women. The underlying mechanisms of NVP remain poorly understood. Provocative gastric function testing has not been performed in these patients. Aims: The aim of this study were to determine the effects of the water load test (WLT) on gastric myoelectrical activity, nausea, and other upper gastrointestinal symptoms in pregnant women. Method: 46 women with NVP were studied prospectively. Gastric myoelectrical activity was recorded throughout the study by electrogastrography (EGG). A 15 min baseline period was followed by a WLT during which patients ingested water until full over a 5 min period. After the WLT, an additional 30 min of EGG was recorded. EGG responses were categorized into four groups: normal (2.5–3.7 cpm), bradygastria (1.0–2.5 cpm), tachygastria (3.7–10.0 cpm), and mixed gastric dysrhythmia (tachygastria and bradygastria). Nausea, bloating, stomach fullness, and abdominal discomfort were recorded before, and 10, 20, and 30 minutes after the WLT on 100 mm visual analogue scales. Results: In response to the WLT, 14% of the women exhibited normal EGG responses, while significantly more (86%) exhibited gastric dysrhythmias (p < 0.01). Of the dysrhythmic EGG responses, 57% were tachygastria, 11% were bradygastria, and 18% were mixed gastric dysrhythmia. Patients with tachygastria ingested less water (338 ml) than patients with normal (371 ml), bradygastria (415 ml), or mixed gastric dysrhythmia (394 ml) patterns, but the differences were not statistically significant. 46% of the women reported nausea at baseline; significantly more women (72%) reported nausea after the WLT (p < 0.05). At 20 min after the WLT, a significant, direct relationship was observed between nausea severity and tachygastria (p < 0.05). The other upper gastrointestinal symptoms were not significantly increased by the WLT. Conclusions: (1) 86% of the pregnant women in this sample developed gastric dysrhythmias in response to the WLT. (2) Tachygastria was the most common dysrhythmia, and increased tachygastria was correlated with increased nausea. Gastric dysrhythmias are evoked by the WLT in women with NVP, suggesting these dysrhythmias have a pathophysiological role in the mechanism of NVP, and are a target for future therapies.     

经前方颈椎体切除入路切除椎管内肿瘤一例及文献复习

后方入路对某些位于脊髓腹侧肿瘤的显露与切除仍有困难,而前方入路可能更适宜这种病例。笔者经前路切除颈椎管内肿瘤1例,结合文献复习报告如下。     

美国国家骨髓库20年回顾:捐献活动和非家族异体造血移植产品性能

异基因造血细胞移植已被广泛用于恶性血液疾病、非恶性血液疾病,以及其他疾病的治疗.自1987年来,NMDP实施了以下工作:捐献者身份确认、从匹配的捐献者采集干细胞、运输并输注给没有合适亲缘捐献者的患者.随着移植技术发展,良好的辅助医疗支持以及HLA配型的规范化,越来越多的NMDP产品应用于不同的患者.充足造血干细胞的捐献者是保证造血干细胞移植(HCT)成功的重要因素,然而,通过这些大量数据,可分析捐献者个体的捐献经验和HCT产品的特性.本文研究了NMDP捐献者的捐献活动,它包括多次BM捐献,PBSC捐献以及用于支持免疫重建、提供输血支持、治疗移植后并发症的辅助产品的捐献.本文还对影响HCT产品完整性的诸如采集袋破损、肉眼凝块的情况进行了总结.     

Lack of Efficacy of Bevacizumab Plus Irinotecan in Children with Recurrent Malignant Glioma and Diffuse Brainstem Glioma:A Pediatric Brain Tumor Consortium Study

PURPOSE:A phase Ⅱ study of bevacizumab(BVZ) plus irinotecan(CPT-11) was conducted in children with recurrent malignant glioma(MG) and intrinsic brainstem glioma(BSG).PATIENTS AND METHODS:Eligible patients received two doses of BVZ intravenously     

Passive movement therapy in patients with moderate to severe paratonia; study protocol of a randomised clinical trial (ISRCTN43069940)

Background

We studied whether the twelve-month use of a standard computer would induce complaints of upper limb pain or functional limitations in older novice computer users.

Methods

Participants between 64 and 76 of age were randomly assigned to an Intervention group (n = 62), whose members received a personal computer and fast Internet access at their homes, or a No Intervention control group (n = 61), whose members refrained from computer use during the twelve month study period.

Results

Difference scores between baseline and twelve months assessments on both complaint (SFS) and functional health scales (SF-36) did not differ between groups (all p > .05).

Conclusion

Prolonged, self-paced use of a standard computer interface does not put older persons at a risk of upper limb complaints or reduce functional health in older adults.