Accelerated pubertal development in patients with shunted hydrocephalus

OBJECTIVE: To evaluate pubertal development and peripheral concentrations of gonadotrophins and sex hormones in children with shunted hydrocephalus compared with healthy controls. STUDY DESIGN: 114 patients (52 females, 62 males) and 73 healthy controls (35 females, 38 males) aged 5 to 20 years were analysed for stage of puberty, age at menarche, testicular volume, basal serum follicle stimulating hormone (FSH), luteinising hormone (LH), sex hormone binding globulin (SHBG), testosterone and oestradiol concentrations, and free androgen index. RESULTS: Male gonadal and male and female pubic hair development occurred significantly earlier in the patients than in the controls. The mean age at menarche was significantly lower in the female patients than in their controls (11.7 v 13.2 years; p < 0.001), and lower than it had been for their mothers (v 13.1 years; p < 0.001). Relative testicular volume was higher in the male patients than in their controls (1.2 standard deviation score (SDS) v 0.2 SDS; p < 0.001). The prepubertal patients had higher basal LH (0.13 U/l v 0.08 U/l; p < 0.001) and SHBG (132.3 nmol/l v 109.1 nmol/l; p < 0.01) than the controls. Both the prepubertal and pubertal females had significantly higher basal FSH than their controls (1.57 U/l v 1.03 U/l; p < 0.05, and 4.0 U/l v 2.9 U/l; p < 0.01, respectively). CONCLUSIONS: Hydrocephalic children experience accelerated pubertal maturation, reflected in a younger age at menarche in females and an increased testicular volume in males. This may be because of enhanced gonadotrophin secretion, possibly resulting from unphysiological variations in intracranial pressure.     

Cardiac Tamponade,Sever Hypothyroidism and Acute Respiratory Distress Syndrome (ARDS) with COVID-19 Infection

A 21-years-old with Down syndrome presented with respiratory distress. Initial investigations revealed a cardiac tamponade. On further evaluation, he had positive coronavirus disease-2019 (COVID-19), severe chest infection and severe hypothyroidism. He responded well to urgent pericardiocentesis, levothyroxine, hydrocortisone and tocilizumab.     

Mitral Balloon Valvuloplasty as an Outpatient Procedure Using Inoue Balloon Technique

Objective: To evaluate the safety and feasibility of mitral balloon valvuloplasty (MBV) as an outpatient procedure. Background: MBV is usually done as an inpatient procedure, requiring 3–4 days of hospital admission. Only one report is available about MBV as a day case procedure in the English literature. Methods: Between October 1994 and December 1996, 128 patients underwent MBV using an Inoue balloon. Of those, 31 patients (Group I) had the procedure as outpatients and 97 patients (Group II) as inpatients. Their mean age in Group I was 29 ± 9 years and in Group II 32 ± 10 years (P < 0.3). Atrial fibrillation was present in 4 patients in Group I and in 13 patients in Group II (P < 0.99). Results: Hemodynamic study revealed that mitral valve area increased from 0.9 ± 0.2 to 1.9 ± 0.5 cm²* in Group I and from 0.8 ± 0.2 to 1.7 ± 0.5 cm²* in Group II, Left atrial pressure decreased from 24 ± 5 to 15 ±6 mm Hg* in Group I and 24 ± 6 to 16 ± 5 mmHg in Group II.* Mitral valve gradient decreased from 15 + 5 to 5 + 2 mmHg in Group I and 15 + 5 to 6 + 3 mmHg in Group II* (*P < 0.001). Patients in Group I stayed in the Preadmission Unit for a mean period of 9.5 ± 2.5 hours. Patients in Group II stayed for a mean of 2.5 days in the hospital. Severe mitral regurgitation developed in one patient in each Group and needed semiurgent mitral valve replacement without sequela. No death, convulsions, or thromboembolism were encountered, and three patients in both Groups developed minor hematoma and needed no additional treatment. Conclusion: MBV as an outpatient procedure is feasible and safe and could significantly decrease the cost of medical care.     

一种简化的去大鼠大脑方法

本文介绍一种简化的行之有效的去大鼠大脑方法。与传统方法相比,本法不需结扎颈总动脉或其分支,可简化手术程序,缩短手术时间,避免因手术操作对颈动脉窦区参与呼吸循环功能反射性调节的重要感受器及其传入神经的可能损伤。用此法去大脑后,动物的呼吸频率、心率、动脉血压等可稳定10小时以上,并能成功地进行延髓细胞内记录和标记。本法可用于研究脑干调控功能的急性动物实验。     

Interleukin-6 predicts hypoalbuminemia, hypocholesterolemia, and mortality in hemodialysis patients

Low serum albumin and low serum cholesterol levels are among the most consistent predictors of mortality in patients with end-stage renal disease (ESRD) undergoing hemodialysis. Hypoalbuminemia is often interpreted as a marker of poor nutrition, but serum albumin and cholesterol levels can also be low as part of a cytokine-mediated acute-phase reaction to acute or chronic inflammation. Here we report the results from a 900-day prospective study designed to determine whether tumor necrosis factor-alfa (TNF-alpha) and interleukin-6 (IL-6) predict serum albumin and cholesterol levels and mortality in a group of 90 ambulatory, adult hemodialysis patients with no acute infection, hospitalization or surgery, and no known acquired immunodeficiency syndrome (AIDS), malignancy, or liver disease. Measurable levels of TNF-alpha and/or IL-6 were found in 89 of 90 patients. Significant relationships were found between TNF-alpha and IL-6 and the degree of hypoalbuminemia and dyslipoproteinemia. IL-6 was the strongest predictor of mortality in univariate and multivariate analysis, followed by age, albumin level, and body mass index (BMI). Although the cause of hypercytokinemia was not addressed in this study, the data support the view that hypoalbuminemia and hypocholesterolemia are negative acute-phase responses to inflammatory stimuli. These results suggest that efforts to identify the nature of the stimuli for cytokine production and to lower cytokine levels in hemodialysis patients might be effective in improving the survival of patients undergoing hemodialysis.     

全固态乌头碱电化学检测器的研制及其在流动注射分析中的应用

报道一种新型结构的全固态乌头碱电化学检测器的研制及其在流动注射分析中的应用。采用流动注射分析法对川乌、草乌及其中成药(小活络丸)中剧毒成分(双酯型生物碱)进行了测试,方法简便快速,结果同光度法接近。本文还提出了电化学法研究乌头碱水解动力学原理。在pH 6.5,温度98℃的条件下测得乌头碱水解成苯甲酰乌头碱的速度常数为1.36×10^-2min^-1。     

CHRONIC ETHANOL CONSUMPTION AMELIORATES THE MATURITY-ONSET DIABETES-OBESITY SYNDROME IN CBA MICE

The effects of a chronic ethanol drinking schedule (20% solutionfor 6 weeks) on energy balance and carbohydrate and lipid metabolismhave been investigated in lean (32–36 g) and obesediabetic(40–44 g) CBA/Ca mice. The untreated obesediabetic miceexhibited hyperglycaemia, hypertriglyceridaemia, hyper-insulinaemiaand insulin resistance. The chronic ethanol treatment, whichyielded plasma ethanol levels of between 1 and 11 mM, loweredthe blood glucose, plasma insulin and tnacylglycerol levelstowards normal in the obese mice, but did not affect these parametersin the lean mice. The body weight of the obese mice tended toreturn to normal during the 6-week drinking period, althoughtheir total energy intake (9.2–10.0 kJ/g/week, food plusethanol-denved calories) was almost double that of the leanmice (4.8–5.4 kJ/g/week). The blood glucose response toacute insulin injection, which was significantly reduced inthe obese mice, became indistinguishable from the response ofnormal mice after chronic ethanol treatment. Soleus muscle glycogensynthesis in both lean and obese mice was not significantlyaltered by ethanol drinking, but brown adipose tissue lipogenesiswas significantly increased (by 50%) in the obese mice. It isproposed that ethanol is acting chronically to restore insulinsensitivity in the obese diabetic mice at doses which have littleor no effect in normal lean animals. This action is exerted,at least in part, at the level of brown adipose tissue lipogenesis.