眩晕的诊断和治疗

眩晕是由于前庭系统（几乎总是周围性）疾病引起的一种旋转幻觉，任病也方面需要与晕厥的状态、癫痫和惊恐发作相鉴别。持续≥1d的急性孤立性自发性眩晕的单次发作通常由前庭神经炎或小脑梗死所致，两者的鉴别需熟练掌握转头试验（head impulse test）。反复发作性眩晕多见丁良性阵发性位置性眩晕（BPPV）、Meniere病和偏头痛。根据可靠的痫史、位置性试验、听力图和温度试验，一股可以鉴别以上3种疾病。BPPV是最常见的反复发作性眩晕的原因，颗粒复位法通常能够使之立即治愈。后循环缺血极少会导致孤立性眩晕发作，其导致的眩晕是短暂和反复发作的，且病程较短。     

The number of receptors for factor VII correlates with the ability of cultured cells to initiate coagulation

Previously, we showed that cells derived from nonvascular tissues initiate clotting primarily by markedly increasing the activity of coagulation factor VII. Cells derived from vascular tissue do not normally exhibit this property (tissue factor activity). In this study, we have characterized the relationship between the tissue factor activity of cultured cells derived from normal tissues and the number of receptors they possess for coagulation factor VII. Only cultured nonvascular cells expressed tissue factor activity or possessed receptors for 125I-factor VII. Fetal lung cells, the nonvascular tissue with the largest amount of procoagulant and tissue factor activity, possessed the most receptors for 125I-factor VII (880,000/cell). Bovine corneal endothelial cells, the nonvascular tissue possessing the fewest number of receptors (2,400/cell), had the least amount of procoagulant or tissue factor activity. The affinity of nonvascular cells for 125I- factor VII varied for the cells studied (Kd congruent to 1.3-90 X 10(- 10) M). Vascular cells expressed no tissue factor activity, nor did they bind 125I-factor VII. 125I-factor VII and unlabeled factor VII bound to cells had identical procoagulant activities. These results indicate that the ability of cultured cells to initiate coagulation may be regulated in part by the number of receptors they possess for factor VII.     

Peritoneal dialysis treatment in children and parental stress

The burden placed on the parents of a child in dialysis treatment can induce negative effects on the medical treatment and on the psychological development of the child. To identify which families are at risk, both parents of 14 out of 16 eligible patients in continuous ambulatory peritoneal dialysis (CAPD) answered an extensive questionnaire three times during one year. Large differences were found between the families with regard to the amount of stress experienced. Parents of older children (< 5 years) (and particularly parents of children with a failed transplantation) experienced significantly more stress. The nature of the stress was determined more by the psychological aspects than by the medical aspects of the treatment. Concern about the future contributed most to the stress experienced. Therefore, emotional support as well as practical help for families at risk is recommended.