Electroconvulsive treatment reduces long-term potentiation in rat hippocampus

The effect of repeated electroconvulsive treatment (ECT) was investigated on long-term potentiation (LTP) in the rat hippocampal slice. Extracellular, recordings of population spikes and excitatory postsynaptic potentials (EPSP) were made from the pyramidal cell layer of CA1 in response to stimulation of the stratum radiatum. LTP was induced by 5 high-frequency trains of stimuli. ECT (10 treatments, 1 treatment every day for 20 days) markedly inhibited LTP of the population spike and EPSP. Thus LTP of the 25% maximum population spike was 104% in control, and 20% in rats 24 h after ECT. LTP of the EPSP was 35% in control and 12% after ECT.     

肝细胞癌与肝内胆管癌间基因表型差异分析

目的：通过对肝细胞癌（HCC）和肝内胆管癌（ICC）之间抑癌基因（tumor suppressor gene,TSG）和微卫星（ni-crosatellite,MS）变异谱特点进行对比分析，了解这两种肝脏最常见恶性肿瘤在基因发生路径上的差异。方法：采用微组织切割法，从石蜡包埋的组织切片中提取基因组DNA进行直接测序，对33例信息处（杂合性）HCC和22例ICC进行了6种TSG杂合性缺失（loss of heterozygosity,LOH）的检测，并对其中10例HCC和全部22例ICC做7个MS的LOH分析。结果：6种TSG的变异情况在HCC依次为：p53(4/5,80.0%)、OGG1(2/4,50.0%）、（5/12，41.7%）、RB1(1/5,20.0%）、DCC（0/4，0%）、MCC（0/3，0%）；在ICC为：APC（11/16，68.8%）、DCC（6/13，46.2%）、OGG1（5/12，41.7%）、p53(6/16,37.5%)、RB1（2/9，22.2%）、MCC（1/7，14.3%）。HCC和ICC中7个MS的LOH发生率分别为30.0%(3/10)和59.1%（13/22）。7个MS在HCC中仅有2个发生LOH，而在ICC中则全部出现LOH，其中与p16/MTS-1和MXI-1基因连锁的4个MS仅在ICC中出现LOH。结论：HCC和ICC之间TSG和MS存在着明显不同的LOH谱，推测两者在发生过程中可能沿循各自不同的分子路径。对LOH基因谱成员的分析，有助于进一步认识HCC和ICC发生的分子机制。     

Pregnancy in women with Type 2 diabetes: who takes metformin and what is the outcome?

AIMS: To review pregnancy outcomes in women with Type 2 diabetes (Type 2 DM), comparing women treated with those not treated with metformin. METHODS: Data were collected by case-note review for all pregnancies in women with Type 2 DM over a 6-year period (1998-2003) at the National Women's Hospital. Two hundred and fourteen pregnancies were included, metformin was taken in 93 pregnancies and continued until delivery in 32; the remaining 121 pregnancies comprised the control group. The principal outcome measures were preeclampsia, perinatal loss and neonatal morbidity. RESULTS: Baseline characteristics differed between groups: women in the metformin group had greater mean (SD) body mass index [35.5(7.6) vs. 33.5(6.6) kg/m2, P < 0.05], more chronic hypertension (19% vs. 7%, P < 0.05) and higher mean (SD) first trimester glycated haemoglobin (HbA1c) levels [8.3(1.9)% vs. 7.5(1.7)%, P < 0.005]. There was no difference between metformin and control groups, respectively, in the rate of preeclampsia (13% vs. 14%, P = 0.84), perinatal loss (3% vs. 2%, P = 0.65) or neonatal morbidity, including rate of prematurity (23% vs. 22%, P = 0.7), admission to the neonatal unit (40% vs. 48%, P = 0.27), respiratory distress (9% vs. 18%, P = 0.07) and treatment with intravenous dextrose (20% vs. 31%, P = 0.08). CONCLUSIONS: Pregnant women with Type 2 DM who were treated with metformin had more risk factors for adverse pregnancy outcomes, but no differences in outcomes were seen compared with women not taking metformin. We need randomized trials to address potential benefits of metformin treatment in this population that may be masked by current practice.     

Accuracy of CT in detection of persistent or recurrent ovarian carcinoma: correlation with second-look laparotomy

Computed tomographic (CT) studies in 39 patients with advanced ovarian carcinoma were retrospectively evaluated to assess their accuracy in detection of persistent or recurrent disease as seen at second-look laparotomy (SLL). Twenty patients were studied before June 1983 (group 1), and 19 patients were studied afterward (group 2). There were 16 true-positive, ten true-negative, two false-positive, and 11 false-negative examinations. Five false-negative studies resulted from microscopic disease found at SLL. In group 1, there were eight false-negative studies. In five, macroscopic disease was not recognized. In group 2, there were three false-negative studies; in one, macroscopic disease was not recognized. Statistical analysis showed an observable improvement in the accuracy in group 2. The differences included use of faster scanners, routine use of thin sections for the pelvis, and air-contrast colonic opacification in group 2. These results suggest that carefully performed scanning on state-of-the-art equipment may have a higher accuracy in documenting persistent or recurrent macroscopic tumor.     

Daytime intensive monitoring: comparison with prolonged intensive and ambulatory monitoring

We evaluated daytime (6- to 8-hour) intensive monitoring in a consecutive series of 166 studies. Overall success rate in answering clinical questions posed by referring physicians was 67%, and attacks were recorded in 55%. Daytime intensive monitoring provides a useful, cost-effective alternative to prolonged inpatient monitoring and ambulatory monitoring.     

The bacteriological quality of hospital-prepared infant feeds

Twenty-four pasteurized infant feeds, prepared in a Glasgow hospital, were examined microbiologically. All produced a satisfactory total aerobic mesophilic count of ≤ 1·0 × 10⁴ cfu/g (mean 6·3 × 10¹ cfu/g) within 1 h of preparation. Bacillus cereus was detected in two infant feeds immediately after preparation and one of these had a B. cereus count of 1·4 × 10³ cfu/g exceeding the recommended safety limit of ≤ 1·0 × 10³ cfu/g. Subsequent storage over a 14 h period at 25 °C or greater resulted in the appearance of B. cereus in a further eight feeds, the majority of which exceeded the safety limit of 10³ cfu/g. The microbiological quality of each infant feed depended on the type and number of organisms initially present, and on the temperature and duration of storage. Incubation of feeds at ≤ 10 °C for 14 h did not alter the microbiological quality (P = 0·05). While Bacillus licheniformis and Bacillus subtilis were the predominant organisms isolated within 8 h of incubation (45·8 and 20·8% of feeds, respectively), additional storage resulted in the emergence of B.cereus I (25%) and II (20·8%) as dominant Bacillus spp. The addition of glucose polymers and other supplements to infant formulae did not affect the type and number of organisms present (P = 0·05). Diarrhoeal enterotoxin was detected in three of the five formulations which supported the growth of B. cereus II via the B. cereus enterotoxin reverse phase latex agglutination test BCET-RPLA system. Although the infant feeds were of similar microbiological quality (P = 0·05), the majority of Bacillus spp. isolated have been previously implicated in either foodborne illnesses and/or opportunist infections.     

Balloon catheter dilation of ureteroenteric strictures: long-term results

Balloon catheter dilation of benign ureteroenteric anastomotic strictures has been proposed as an alternative to either surgical revision or chronic ureteral stenting, with moderately successful short-term results reported by several groups in a limited number of patients. However, the authors' experience with 29 patients exhibiting 37 benign ureteroenteric strictures treated over the past 7 years revealed that in the majority of cases (23 patients, 26 strictures [70%]), strictures recurred within 6 months of balloon catheter dilation/ureteral stent therapy. Furthermore, of the 11 strictures that appeared to have been successfully dilated at a follow-up interval of 6 months, five restenosed within 1 year. Therefore, only six of 37 (16%) ureteroenteric stricture dilations could be considered successful when viewed at least 1 year after interventional therapy. Furthermore, repeat dilations have often been required to maintain ureteral patency in these patients.     

Ocular and cerebral metastases in the VX2 rabbit tumor model: contrast- enhanced MR imaging

Ocular and cerebral metastases developed after the inoculation of a VX2 tumor cell suspension into the internal carotid artery of 15 rabbits. The hematogenous spread of tumor cells resulted in ocular metastases in 13 of 15 animals (86.7%) and cerebral system metastases in 14 of 15 animals (93%). Magnetic resonance (MR) imaging with Gd-DTPA demonstrated early disruption of the blood-ocular barrier and blood-brain barrier 5-7 days after infusion of tumor cells. Quantitative assessment of contrast enhancement revealed a mean increase in signal intensity of 145% +/- 51% in the anterior chambers, 102% +/- 70% for choroidal metastases, and 51% +/- 29% for central nervous system (CNS) metastases. These results indicate that contrast-enhanced MR imaging can be used to demonstrate a loss of blood-ocular barrier integrity that is similar to the breakdown of the blood-brain barrier associated with metastatic tumors to the CNS and eye.     

COMPOUND OPIOID/PARACETAMOL ANALGESICS: MISUSE AND DEPENDENCE

SUMMARY Ten cases of individuals with a history of chronic compound opioid/paracetamol misuse are described. Potentially useful indicators of toxicity are suggested.