Neuronal adrenergic and muscular cholinergic contractile hypersensitivity in canine jejunum after extrinsic denervation

Extrinsic denervation may be responsible for motor dysfunction after small bowel transplantation. The aim of this study was to examine the role of extrinsic innervation of canine jejunum on contractile activity. An in vitro dose response of cholinergic and adrenergic agonists was evaluated in canine jejunal strips of circular muscle at 0, 2, and 8 weeks in a control group and after jejunoileal extrinsic denervation (EX DEN). Neurons in circular muscle were quantitated by means of immunohistochemical techniques. Adrenergic and cholinergic responses did not differ at any time in the control group. However, at 2 and 8 weeks, extrinsic denervation caused an increased sensitivity to the procontractile effects of the cholinergic agonist bethanechol at the level of the smooth muscle cells, and increased sensitivity to the inhibitory effects of the adrenergic agent norepinephrine mediated at the level of the enteric nervous system. Immunohistochemical analysis showed a reduction in all neurons and a complete lack of adrenergic fibers in the EX DEN group after 2 and 8 weeks. Extrinsic denervation induces enteric neuronal cholinergic and adrenergic smooth muscle hypersensitivity in canine jejunal circular muscle. Presented in part at the annual meeting of the American Gastroenterological Association, Orlando, Florida, May 18, 1999 (poster presentation), and published as an abstract in Gastroenterology 116:A1075, 1999. Supported by United States Public Health Service grant DK39337 from the National Institutes of Health (M.G.S.); the Swiss National Science Foundation; the Swiss Society of Gastroenterology and Hepatology; the Swiss Foundation for Medical and Biological Science; the Novartis Foundation; Astra Zeneca Pharmaceuticals, Switzerland; and the Department of Visceral and Transplantation Surgery, University of Bern, Switzerland.     

氨基酸、有机酸、碱基核苷类化合物的双向色谱多相同步分析

30余种氨基酸、40余种非挥发性有机酸和20余种碱基核苷类化合物在一块薄层板上完成多相同步色谱分析；用紫外灯-吖啶试剂-镉茚三酮试剂实行组合显色定位分析。改善了尿液中非挥发性有机酸的溶剂萃取法，尿中三类化合物提取物的同步多相色谱分离效果良好。     

235例神经症患者就诊途径及心理分析

研究目的探讨神经症的就诊途径及心理治疗措施。研究方法分析研究对5例神经症患者的就诊途径、就诊心理、治疗方法和治疗效果。结果对住院治疗的对5例神经症进行分析研究，结果表明，正确的就诊途径，合理的治疗方法，使神经症治疗时间明显缩短，疗效显著提高，有效230例，占97.9％。结论本研究明确了就诊途径、治疗方法在神经症治疗中的重要作用，以及普及精神卫生知识的重要性，为神经症的防治工作提供了重要依据。     

Prolactin,growth hormone and insulin-like growth factor-l in newborn children of smoking mothers*

OBJECTIVE Since maternal smoking causes fetal circulatory abnormalities, as well as disturbances of the maternal endocrine equilibrium, we measured the PRL, hGH and insulin-like growth factor-l (IGF-I) concentrations in the cord and venous blood of neonates of smoking mothers to determine whether or not the tobacco smoke affects the endocrine status of the neonate. DESIGN The above hormones were measured in the cord blood of the newborns of both smoking and non-smoking mothers. Also, PRL and hGH were determined at 24 and 72 hours after birth in newborns of both groups. PATIENTS Fifty-three newborns of smoking and 47 newborns of non-smoking mothers were investigated. Seventeen of the newborns of the smoking and 21 of the nonsmoking mothers were preterm. The remainder were full-term. MEASUREMENTS PRL was measured with a solid-phase immunoradiometric assay, hGH with a solid-phase two-site immunoradiometric assay and IGF-I with a solid-phase radioimmunoassay after extraction with acid-etha-nol. RESULTS The median value of PRL in the 17 preterm newborns of smoking mothers was 4941 mU/l (range 1322-7230), whereas in the 21 preterm newborns of nonsmoking mothers it was 2013 mU/l (range 243-4740) (P = 0 0002). The median hGH value in the above subjects was 1020 mU/l (range 35 2-208 4) and 59 8 mU/l (range 11 6-134-2), respectively (P = 0 0039). The median IGF-I was 580 7 U/l (range 253 2-4851 1) and 530 6 U/l (range 239 6-3591 5), respectively (P = 0 429). In the 36 full-term newborns of smoking mothers the median PRL value was 5171 mU/l (range 2074-7530), whereas in the 26 full-term newborns of non-smoking mothers it was 5081 (range 244-6540) (P = 0 048). The median hGH was 69 6 mU/l (range 42 3-280 0) and 32 2 mU/l (range 6 2-200 0), respectively (P = 0 0031). Also, the median IGF-I value was 926 3 U/l (range 348 5-5344 7) and 462 1 U/l (range 250 2-1578 7), respectively (P = 00024). On the 3rd day the PRL in the preterm neonates of both smoking and non-smoking mothers showed the same 16-5% drop, and thus the difference between the groups was maintained. A similar reduction in the hormone levels was observed in the full term neonates. CONCLUSIONS The findings indicate that the maternal tobacco-smoking causes disturbances of the endocrine status of the fetus, as shown by the increased levels of PRL, hGH and IGF-I, which are more pronounced between 30 and 37 weeks of gestation than at term.     

Physiotherapy rehabilitation of the smile after long-term facial nerve palsy using video self-modeling and implementation intentions.

OBJECTIVE: To improve smiling after long-term facial nerve palsy (FNP). Physiotherapy rehabilitation of an adapted (more symmetrical) smile was investigated in FNP subjects 1 year post-onset, using video self-modeling (video replay of only best adapted smiles) and implementation intentions (preplanning adapted smiles for specific situations). STUDY DESIGN AND SETTING: Prospective, blinded clinical trial. Facial-Nerve-Palsy Clinic. RESULTS: After video self-modeling: 1) reaction time (RT) to initiation of adapted smiles became 224 ms faster whereas RT for everyday (asymmetrical) smiles became 153 ms slower; 2) adapted smiles were completed 544 ms faster; 3) adapted smiles had higher overall quality, movement control, and symmetry ratings; and 4) Facial Disability Index scores also improved. Implementation intentions after video self-modeling ensured transfer of adapted smile to everyday situations. CONCLUSION: Following intervention the smile improved, with significant changes in availability, execution speed, and quality. SIGNIFICANCE: This study supports these rehabilitation techniques to maximize quality of smiling following FNP. EBM rating: B-2b.     

Resolution of skin fibrosis and joint contractures in aggressive diffuse systemic sclerosis using autologous stem cell transplantation

The use of haematopoietic stem cell transplantation (HSCT) has now expanded beyond the domain of haematological diseases. Increasingly, the benefits of intense immunosuppression in the management of severe autoimmune diseases are being recognized. In diffuse systemic sclerosis (SSc), there has been increasing evidence of the efficacy of HSCT in improving morbidity and mortality. We present the first Australian patient to undergo autologous HSCT for SSc and review the current literature in the use of HSCT in SSc. Remarkably, the patient had complete resolution of skin disease (modified Rodnan skin score 27/51–0/51), tenosynovitis, synovitis and myositis.     

Acetazolamide in hemodialysis patients: a rational use after ocular surgery.

Acetazolamide is a weak diuretic used to decrease production of aqueous humor in the eye. Hemodialysis patients undergoing ocular surgery may benefit from acetazolamide; however, no pharmacokinetic data are available for this group of patients. We report a patient who received acetazolamide 250 mg every 6 hours after ophthalmic surgery and developed reversible neurological side effects associated with very high plasma concentrations. Using pharmacokinetic analysis, we suggest an alternate administration of acetazolamide for end-stage renal patients.     

海风藤酚、甲基海风藤酚、海风藤醇A和海风藤醇B对兔血小板聚集的影响

海风藤酚、甲基海风藤酚、海风藤醇Ａ和海风藤醇Ｂ均有抑制血小板激活因子（ＰＡＦ）诱导的兔血小板聚集作用，ＩＣ_（５０）分别为１７．９、９．２、１４２．０、１４．０μｍｏｌ·Ｌ~（－１）。经阿司匹林（ＡＳＡ）、磷酸肌酸／磷酸肌酸激酶（ＣＰ／ＣＰＫ）预处理的兔洗涤血小板，甲基海风藤酚和海风藤醇Ｂ仍能抑制ＰＡＦ诱导的兔血小板聚集，ＩＣ_（５０）为９．０、１６．５μｍｏｌ·Ｌ~（－１）。同时，４种成分对于二磷酸腺苷（ＡＤＰ），花生四烯酸（ＡＡ）诱导的血小板聚集抑制作用较弱，海风藤Ｂ能使ＰＡＦ诱导血小板聚集量－效曲线平行右移，ＥＣ_（５０）由１．５９ｎｍｏｌ·Ｌ~（－１）升为２０．６ｎｍｏｌ·Ｌ~（－１）。结果表明：４种成分能选择性拮抗ＰＡＦ对兔血小板的聚集作用。     

LIMITATIONS OF RADIOTHERAPY IN THE DEFINITIVE TREATMENT OF SQUAMOUS CARCINOMA OF THE TONSILLAR FOSSA

Between 1970 and 1990, 104 patients with squamous cell carcinoma (SCC) of the tonsil were treated. The median age was 58 years and 80% of patients were males. Distribution among clinical stages was: stage I, 19 patients; stage II, 12 patients; stage III, 23 patients; and stage IV, 48 patients. More than 70% of patients had initial radiotherapy as definitive treatment irrespective of stage, reflecting the treatment philosophy over much of this period. The overall survival rate was 26% at 5 years, with survival being significantly affected by T stage, clinical stage and age. Clinical node status did not significantly affect survival rates. Good local control of T₁N₀ cancers was achieved with radiotherapy alone, but patients with more advanced cancers did poorly. We have now moved away from a non-selective policy and use initial surgery combined with postoperative radiotherapy in most patients, reserving radiotherapy alone for mainly early tonsil cancers.