Trigeminally innervated iron-containing structures in the beak of homing pigeons, and other birds

The ophthalmic nerve in the upper beak was labelled with cholera toxin B-chain, and iron was identified using the Prussian Blue reaction. Iron deposits were found in the caudal part of the beak, and some were concentrated in cells that clustered in encapsulated structures densely innervated by ophthalmic nerve fibres. Such structures could form the anatomical basis of a type of mechanoreceptor that transmits magnetic sense information to the brain.     

Prospective controlled trial of a standardized meal stimulation test in the detection of pancreaticoduodenal endocrine tumours in patients with multiple endocrine neoplasia type 1

BACKGROUND: Use of a standardized meal stimulation test has been recommended for the early diagnosis of pancreaticoduodenal endocrine tumours (PETs) in patients with multiple endocrine neoplasia type 1 (MEN 1). The diagnostic value of this test was re-evaluated. METHODS: In a prospective, controlled trial 58 standardized meal stimulation tests (563 kcal) were performed in 12 patients with MEN 1 and histologically, biochemically and/or radiologically confirmed PETs (group 1), 11 carriers of an MEN 1 mutation with no evidence of PETs (group 2) and in 27 healthy controls (group 3). Serum pancreatic polypeptide (PP) and gastrin concentrations were measured before and during the test meal. RESULTS: Patients in group 1 had significantly higher mean basal serum PP and gastrin concentrations than patients in group 2 and controls (P < 0.05). In all three groups an increase in serum PP was observed after meal stimulation, but there was no significant difference between the groups. No increase in gastrin level was found in any of the groups after meal stimulation. CONCLUSION: The standardized meal stimulation test does not reliably indicate the presence of PETs in patients with MEN 1, whereas raised basal serum PP and gastrin levels do. The expensive and time-consuming meal test can be excluded from MEN 1 screening programmes.     

Perceived vulnerability to alcohol-related harm in young adults: independent effects of risky alcohol use and drinking motives

Perceived vulnerability to negative outcomes can motivate heavy drinkers to adopt health-protective behavior, but little is known about determinants of perceived vulnerability to alcohol-related harm. University students (N = 286) were assessed to determine epidemiological risk status on a standardized problem drinking measure, typical reasons for drinking and cutting down, and perceived risk of experiencing alcohol-related harm. Results showed a positive relationship between problem drinking status and perceived risk of experiencing harm. However, at-risk drinkers believed that they were less likely to personally experience harm than comparable peers (p < .001), whereas not-at-risk drinkers showed no self-other differences in perceived vulnerability. Drinking motives significantly improved the prediction of perceived vulnerability when epidemiological risk status was controlled. Perceived vulnerability to alcohol-related harm is affected by problem drinking status and (independently) by the psychological functions that drinking serves.     

Treating alcohol problems with self-help materials: a population study

OBJECTIVE: An experimental trial was used to assess the effectiveness of a self-help book and a personalized assessment-feedback intervention, both separately and in combination with each other, in a general population survey. METHOD: Participants (N = 86; 66.3% male) were recruited through a random digit dialing telephone survey conducted by the Centre for Addiction and Mental Health, Toronto, Ontario, Canada. Respondents were randomly assigned to one of four conditions in a two-by-two factorial design: "no-intervention" control group, "personalized feedback only," "self-help book only" and "both personalized feedback and self-help book." Respondents were followed up in 6 months' time, and differences in drinking status were compared between experimental conditions using a multivariate analysis of covariance with baseline drinking severity as the covariate. RESULTS: Support was provided for an interaction hypothesis in which respondents who received both interventions reported significantly improved drinking outcomes at 6-month follow-up, compared with respondents who received just one of the interventions or who received no intervention. CONCLUSIONS: Because respondents were recruited from a representative sample of the general population into a randomized trial with a no-intervention control group, this research design maximized both external and internal validity in examining the effectiveness of self-help interventions.     

Platelet-activating factor improves intrauterine insemination outcome

OBJECTIVE: Our purpose was to investigate intrauterine insemination pregnancy rates after human spermatozoa exposure to platelet-activating factor. STUDY DESIGN: Spermatozoa were incubated with platelet-activating factor in sperm-washing medium before intrauterine insemination. Patients whose sperm were incubated with sperm-washing medium alone served as controls. Pregnancy outcome was determined by ultrasonography (fetal heartbeat). RESULTS: Patients whose sperm were treated with exogenous platelet-activating factor had a significantly (P <.05) higher pregnancy rate (40%) than patients (20%) not receiving treatment. CONCLUSION: Inclusion of platelet-activating factor into a semen processing protocol, before intrauterine insemination, will significantly improve pregnancy rates. Platelet-activating factor may have a stimulatory effect on centriole-intact spermatozoa, enhancing their motility and fertilization success and resulting in improved pregnancy rates. Additional studies will elucidate the reproductive significance of platelet-activating factor activity in spermatozoa and its role in the establishment of pregnancy.     

Diagnostic confusion in mild traumatic brain injury (MTBI). Lessons from clinical practice and EFNS--inquiry. European Federation of Neurological Societies

A 1997 inquiry of 130 neurosurgeons throughout Germany, dealing with diagnosis and therapy of patients with mild traumatic brain injury showed a mainly inhomogeneous picture. The European Federation of Neurological Societies inquiry form 'Management of Patients with Mild Head Injury' was sent on behalf of the German Society of Neurological Surgeons to every leading neurosurgeon in Germany, of whom only 74 (57%) answered. The diagnosis 'mild brain injury' is used by 63%, 'commotio cerebri' by 49%, and 'brain concussion' by 4% of the institutions. GCS is used for classification by 60%, PTA 48%, retrograde amnesia by 50%, and LOC by 63% of institutions. Guidelines are used in 78%. Diagnostic x-ray of the skull is used in 77%, cervical spine in 62%, CT in 66%, MRT in 7%; and routine EEG in 35%. Fourteen per cent of the patients are not admitted; home observation is used in 45% of institutions, full bedrest in 19%, working pause in 48%, pain medication in 27%, control in 51%. Seperate guidelines for children in 54% of those departments.     

阿德福韦耐药的乙肝病毒与病毒反跳及肝功能失代偿有关

背景和目的:在体外实验中,耐阿德福韦乙肝病毒突变体的敏感性较野生株仪下降3-10倍,提示病毒复燃和临床恶化的可能性很小。本研究将阐述乙肝病毒阿德福韦耐药感染者的临床发病过程。方法:采用线性探针分析法和直接测序法检测耐阿德福韦HBV-P基因。对阿德福韦具有次优应答或病毒复燃的 HBV感染者进行阿德福韦耐药突变体的检测。     

Correction of length discrepancies and angular deformities of the leg by Blount's epiphyseal stapling

The management of leg length difference (LLD) and angular deformities of the leg remains controversial. Numerous treatment options have been proposed over the past years depending on the patient's general condition, skeletal age, function, and degree and configuration of the deformity. Our retrospective study consisted of 48 patients with 58 legs treated between 1970 and 1991 by Blount's epiphyseal stapling to equalise length or correct angular deformity. After an average follow-up of 16.5 years, all patients with idiopathic bow-legs or knock-knees (n=12) and 71% of LLD caused by overgrowth (e.g. Klippel-Trenaunay syndrome) showed good and excellent results at skeletal maturity, whereas the results of the treatment of LLD with undergrowth of the leg and angular deformities due to trauma, infection or general dysplasia and malformation were fair to poor because of the difficulty in prediction of growth development and growth potential, allowing only for partial correction of the deformity. Besides the restriction of the stapling procedure due to the aetiology of the deformity, the age of the patients at the time of surgery is important, as it determines the complication rate of this technique (loosening or dislocation of staples). Thus Blount's epiphyseodesis should not be performed before the age of 9 years in girls and 11 years in boys. CONCLUSION: Blount's epiphyseal stapling can be recommended as a safe procedure with predictably good results in idiopathic angular deformities of the leg and leg length difference caused by overgrowth.     

苯二氮类药物中毒患者的实验诊断

目的 :对苯二氮类药物急性中毒患者进行快速的定性和定量分析。方法 :采用广谱药物分析系统 (REMEDiHS)分析了 2 34例疑为苯二氮类药物中毒患者的血液、尿液或胃液等 ;另外 ,还利用REMEDiHS对苯二氮类药物快速金标检测板的检测能力进行了评价。结果 :在被检测的2 34例患者中 ,实验确诊 173例为苯二氮类药物中毒 ,检测结果与临床完全吻合 ,确诊率达10 0 %。检测出的药物按频率高低排序 ,依次为艾司唑仑、地西泮、去甲西泮、阿普唑仑、氯氮、劳拉西泮、氯硝西泮、三唑仑和氟硝西泮 ;用金标检测板定性检测本类药物 ,结果有假阳性 (1/ 9)或假阴性 (3/ 4 5 )。结论 :REMEDiHS能较好地对苯二氮类药物进行快速的定性和定量分析 ,适合于本类药物中毒的诊断。苯二氮类药物金标检测板的检测结果对临床有一定的参考作用 ,但要考虑可能存在的假阳性或假阴性