高压氧对小鼠脾细胞IL－2产生及反应能力的影响

Ｃ５７ＢＬ／６小鼠在０．２５ＭＰａ下吸９９．２％氧，其脾淋巴细胞白细胞介素－２（ＩＬ－２）产生能力及对ＩＬ－２反应能力变化如下：高压氧（ＨＢＯ）组均明显低于正常组小鼠，去肾上腺组、去肾上腺髓质组均明显高于ＨＢＯ组、假手术组．实验证明，高压氧可降低脾淋巴细胞ＩＬ－２的产生及对ＩＬ－２的反应能力，在这一影响中肾上腺有一定作用．     

Phenolic constituents of Amorpha fruticosa that inhibit NF-kappaB activation and related gene expression

NF-kappaB is known to play a crucial role in the regulation of genes controlling the immune system, apoptosis, tumor cell growth, and tissue differentiation. Bioassay-guided fractionation of the n-hexane-soluble fraction of a methanol extract of Amorpha fruticosa afforded four new compounds, 5, 7, 8, and 9, and eight known compounds. Their structures were elucidated by spectroscopic methods. All compounds inhibited NF-kappaB activity, and tephrosin (1), 11-hydroxytephrosin (2), and deguelin (3) were the most active, with IC50 values of 0.11, 0.19, and 0.22 microM, respectively, in TNF-alpha-stimulated HeLa cell-based reporter gene assays. Further investigations showed that compounds 1, 5, and 6 blocked NF-kappaB/DNA binding activity and suppressed the expression of NF-kappaB target genes.     

Hormonal contraception and HIV-positive women: metabolic concerns and management strategies

As HIV-positive women live longer lives, and as testing for HIV becomes more routine, clinicians can expect to see more HIV-positive women in their practices. The need to be aware of management issues particular to this population becomes increasingly important. Metabolic dysregulation is a common, long-term complication associated with HIV and is one of the most difficult to manage. Hormonal contraception also is associated with metabolic dysregulation. As more HIV-positive women choose long-term, reversible contraception, the potential for concomitant and additive side effects, and the need for careful, proactive management strategies to avoid these complications, will become more important. This article reviews research detailing the metabolic dysfunction associated with hormonal contraception and with HIV-seropositivity. It highlights reasons for concern regarding the potential, although as yet theoretical, increased risk for metabolic dysfunction when hormonal contraception is used in the presence of HIV. Suggestions for management strategies for women living with HIV who choose to use hormonal contraception are presented. These strategies should be viewed as suggestions for management until substantitive research becomes available.     

Exposure marker discovery of di-2(propylheptyl) phthalate using ultra-performance liquid chromatography-mass spectrometry and a rat model

Di-(2-propylheptyl) phthalate (DPHP) is a plasticizer and has been suggested to be a subchronic toxicant in rats. DPHP has been approved to be used in food containers and handling by the U.S. Food and Drug Administration. The use of DPHP is still increasing, and the risk of human exposure to DPHP via food may be high. Exposure markers measured in human samples are commonly used to monitor human exposure levels. Ultra-performance liquid chromatography-mass spectrometry (UPLC-MS) and a rat model were used to discover tentative DPHP exposure markers. DPHP and mono-(2-propylheptyl) phthalate (MPHP) were used as the precursors for calculating metabolite candidates using biotransformation mass changes of known enzymatic reactions. A rat model was designed to validate these metabolite candidates as tentative exposure markers. A total of 28 signals show dose–response relationships and these signals contain a few isomers. The chemical structures of 15 tentative exposure marker signals were speculated based on the product ion mass spectra from MS/MS analysis. These 15 signals included 7 chemical structures and some of them may be isomers. The different arrangement of the atoms in space of these isomers should be validated by standard compounds in the future studies. Among the 7 speculated chemical structures, 2 structures were novel tentative DPHP metabolites, and 5 structures have been previously reported in the literature. The results indicate that using UPLC-MS and a rat model can be used to identify tentative toxicant exposure markers.     

Predictors of mortality and management of patients with traumatic inferior vena cava injuries

The aim of this study was to determine factors that predict mortality in patients with traumatic inferior vena cava (IVC) injuries and to review the current management of this lethal injury. A 7-year retrospective review of all trauma patients with IVC injuries was performed. Factors associated with mortality were assessed by univariate analysis. Significant variables were included in a multivariate regression analysis model to determine independent predictors of mortality. Statistical significance was determined at P < or = 0.05. A literature review of traumatic IVC injuries was performed and compared with our institutional experience. Thirty-six IVC injuries were identified (mortality, 56%; mechanisms of injury, 28% blunt and 72% penetrating). There was no difference in mortality based on mechanism of injury. Injuries with closer proximity to the heart were associated with increased mortality (P < 0.001). Univariate analysis demonstrated that nonsurvivors had a higher injury severity scale, a lower systolic blood pressure in the emergency department, a lower Glasgow coma score (GCS), and were more likely to have thoracotomies performed in the emergency department or operating room. Multivariate analysis revealed that only GCS (P = 0.03) was an independent predictor of mortality. Typical factors predicting mortality were identified in our cohort of patients, including GCS. The mechanism of injury is not associated with survival outcome, although mortality is higher with injuries more proximal to the heart. The form of management by IVC level is reviewed in our patient population and compared with the literature.     

Noninvasive Pancreatic Cystic Neoplasms can be Safely and Effectively Treated by Limited Pancreatectomy

Background Appropriate management of cystic lesions of the pancreas is controversial. Major pancreatectomies (pancreaticoduodenectomy or distal pancreatectomy with splenectomy) are the commonly used procedures, even though most cystic lesions are noninvasive neoplasms. We tested the adequacy of limited pancreatectomies in the treatment of pancreatic cystic lesions. Methods Data from 109 patients who underwent surgical resection of a pancreatic cystic lesion at National Taiwan University Hospital from 2001 to 2007 were retrospectively reviewed. Major pancreatomies (n = 79) constituted pancreaticoduodenectomy and total/distal pancreatectomies, while other resection procedures (n = 30) represented limited pancreatectomies. Clinicopathologic features were compared between the major and limited groups. Results There were no statistically significant differences in sex, age, presence of symptoms, cyst diameter, minor or major treatment complications, or pancreatic leakage between the two groups. Cystic lesions located in the neck/body/tail rather than in the head/uncinate process were significantly more often treated with limited pancreatectomy (P = .02). Both groups had similar pathologic distribution of cystic lesions, with the exception of nine invasive neoplasms. The latter were treated with major pancreatectomy. No recurrence was noted in 100 patients with noninvasive cystic neoplasms after major or limited pancreatectomy. Conclusions Noninvasive pancreatic cystic neoplasms can be safely and effectively treated by limited pancreatectomy.     

The impact of cataract on the quantitative,non‐invasive assessment of retinal blood Flow

Purpose: The aim of the study was to determine the impact of cataract on the quantitative, non‐invasive assessment of retinal blood flow assessed by bidirectional laser Doppler flowmetry and simultaneous vessel densitometry. Methodology: Ten patients scheduled for extracapsular cataract extraction using phacoemulsification and intraocular lens implantation between the ages of 61 and 84 (mean age 73 years, SD ± 8) were prospectively recruited. Two visits were required to complete the study; one visit prior to extracapsular cataract extraction and one at least 6 weeks after the surgery to allow for sufficient postoperative recovery. The severity of cataract was documented using the Lens Opacity Classification System (LOCS, III) at the first visit. Retinal arteriolar hemodynamics were measured at both visits using the high‐intensity setting of the Canon Laser Blood Flowmeter. Results: All eyes showed no clinical signs of postoperative intraocular inflammation. The quantitative assessment of retinal arteriolar diameter and blood flow were reduced following extracapsular cataract extraction (Wilcoxon signed‐rank test, p = 0.022 and p = 0.028, respectively); however, centreline blood velocity was not significantly changed (Wilcoxon signed‐rank test, p = 0.074). Intraocular pressure was unchanged pre‐ and postcataract extraction. Conclusions: Retinal vessel densitometry assessment in the presence of cataract results in the erroneous elevation of the diameter measurement and thereby the calculation of blood flow. The bidirectional Doppler assessment of blood velocity appears to be more robust to light scatter induced by cataract. Care needs to be exercised in the interpretation of studies of retinal vessel diameter or blood flow that utilize similar densitometry techniques.     

Retinal fractals and acute lacunar stroke

This study aimed to determine whether retinal fractal dimension, a quantitative measure of microvascular branching complexity and density, is associated with lacunar stroke. A total of 392 patients presenting with acute ischemic stroke had retinal fractal dimension measured from digital photographs, and lacunar infarct ascertained from brain imaging. After adjusting for age, gender, and vascular risk factors, higher retinal fractal dimension (highest vs lowest quartile and per standard deviation increase) was independently and positively associated with lacunar stroke (odds ratio [OR], 4.27; 95% confidence interval [CI], 1.49–12.17 and OR, 1.85; 95% CI, 1.20–2.84, respectively). Increased retinal microvascular complexity and density is associated with lacunar stroke. ANN NEUROL 2010;68:107–111