EXPERIENCE WITH VIPERINE ENVENOMATION

Two hundred and twenty one cases of viperine envenomation, who presented to hospital without specific treatment, seen over an twenty five years period, have been presented. Mild, moderate and severe envenomation was encountered in 33 per cent, 47 per cent and 20 per cent respectively. Bites on feet and ankles were seen in 85.5 per cent of cases. The average time interval between bite and hospitalisation was 4.8 hours, range being 15 minutes to 7 days. Local swelling was observed in 97.7 per cent, hematuria in 62 per cent, mucosal haemorrhages in 24.8 per cent and haematemesis in 19 per cent of patients. Average Antisnake Venom (ASV) required in mild, moderate and severe envenomation was 50 ml, 147.5 ml and 324 ml respectively. Major complications observed were renal failure in 10, intracompartmental syndrome in 3, intracerebral bleed and septicaemia in 2 each. One patient each developed finger gangrene, osteomyelitis, perirenal haematoma, sinus bradycardia and uncontrolled bleeding. Blood transfusion was required in 32 patients. Reactions to ASV were seen in 12 patients and overall there were 5 deaths.KEY WORDS: Antisnake venom, Viperine envenomation     

Immunotherapy and Targeted Therapy for Small Cell Lung Cancer: There Is Hope

Small cell lung cancer (SCLC) is a devastating and aggressive neuroendocrine carcinoma of the lung. It accounts for ~15% of lung cancer mortality and has had no improvement in standard treatment options for nearly 30 years. However, there is now hope for change with new therapies and modalities of therapy. Immunotherapies and checkpoint inhibitors are entering clinical practice, selected targeted therapies show promise, and “smart bomb”-based drug/radioconjugates have led to good response in early clinical trials. Additionally, new research insights into the genetics and tumor heterogeneity of SCLC alongside the availability of new tools such as patient-derived or circulating tumor cell xenografts offer the potential to shine light on this beshadowed cancer.     

Axial synergies during human upper trunk bending

Upper trunk bending movements were accompanied by opposite movements of the lower body segments. These axial kinematic synergies maintained equilibrium during the movement performance by stabilizing the center of gravity (CG), which shifted on average across all the subjects by 1±4 cm in the anteroposterior direction and thus always remained within the support area. The aim of the present investigation was to provide an insight into the central control responsible for the performance of these synergies. The kinematic analysis was performed by the method of principal components (PC) analysis applied to the covariation between ankle, knee and hip joint angles and compared with CG shifts during upper trunk bending. Subjects were asked to perform backward or forward upper trunk bending in response to a tone. They were instructed to move as fast as possible or slowly (2 s), with high or low movement amplitudes. PC analysis showed a strong correlation between hip, knee and ankle joint changes. The first principal component (PC1) representing a multijoint movement with fixed ratios between joint angular changes, accounted, on average, for 99.7%±0.2% of the total angular variance in the forward trunk movements and for 98.4%±1.4% in the backward movements. The instructed voluntary regulation of the amplitude and velocity of the movement was achieved by adapting the bell-shaped profile of the velocity time course without changes in interjoint angular relations. Fixed ratios between changes in joint angles, represented by PC1, ensured localization of the CG within the support area during trunk bending. The ratios given by PC1 showed highly significant dependence on subjects, suggesting the adaptability of the central control to each subject’s biomechanical peculiarities. Subject’s intertrial variability of PC1 ratios was small, suggesting a stereotyped automatic interjoint coordination. When changing velocity and amplitude of the movement, the ratios remained the same in about half the subjects while in others slight variations were observed. A weak second principal component (PC2) was shown only for fast movements. In forward movements PC2 reflected the early knee flexion that seems related to the disturbances caused by the passive interaction between body segments, rather than to the effect of a central command. In fast backward movements, PC2 reflected the delay in hip extension relative to the movement onset in the ankle and knee that mirrors intersubject differences in the initiation process of the axial synergy. The results suggest that PC1 reflects the centrally controlled multijoint movement, defining the time course and amplitude of the movement and fixing the ratios between changes in joint angles. They support the hypothesis that the axial kinematic synergies result from a central automatic control that stabilizes the CG shift in the anteroposterior direction while performing the upper trunk bending. Received: 8 August 1996 / Accepted: 7 July 1997     

The UTX gene escapes X inactivation in mice and humans

We recently have identified a ubiquitously transcribed mouse Y chromosome gene, Uty , which encodes a tetratricopeptide repeat (TPR) protein. A peptide derived from the UTY protein confers H-Y antigenicity on male cells. Here we report the characterization of a widely transcribed X-linked homologue of Uty , called Utx , which maps to the proximal region of the mouse X chromosome and which detects a human X-linked homologue at Xp11.2. Given that Uty is ubiquitously transcribed, we assayed for Utx expression from the inactive X chromosome (Xi) in mice and found that Utx escapes X chromosome inactivation. Only Smcx and the pseudoautosomal Sts gene on the mouse X chromosome have been reported previously to escape inactivation. The human UTX gene was also found to be expressed from Xi. We discuss the significance of these data for our understanding of dosage compensation of X-Y homologous genes in humans and mice.      

L1 knockout mice show dilated ventricles, vermis hypoplasia and impaired exploration patterns

L1 is a neural cell adhesion molecule mainly involved in axon guidance and neuronal migration during brain development. Mutations in the human L1 gene give rise to a complex clinical picture, with mental retardation, neurologic abnormalities and a variable degree of hydrocephalus. Recently, a transgenic mouse model with a targeted null mutation in the L1 gene was generated. These knockout (KO) mice show hypoplasia of the corticospinal tract. Here we have performed further studies of these KO mice including magnetic resonance imaging of the brain, neuropathological analysis and behavioral testing. The ventricular system was shown to be abnormal with dilatation of the lateral ventricles and the 4th ventricle, and an altered shape of the Sylvius aqueduct. Additionally, the cerebellar vermis of the KO mice is hypoplastic. Their exploratory behavior is characterized by stereotype peripheral circling reminiscent of that of rodents with induced cerebellar lesions.      

常用抗高血压药物对血压的时间生物学特征的影响

目的 :探讨 3类常用抗高血压药物对非杓型的高血压病患者BP的时间生物学特征的影响。方法 :共入选非杓型BP分布的高血压病患者 16 1例 ,将其随机分为 3组 ,分别给予赖诺普利 (10mg·d-1) ,非洛地平 (2 5mg·d-1) ,或氢氯噻嗪 (5 0mg·d-1) ,并于治疗前后行 2 4h动态BP监测。采用余弦拟合方法分析治疗前后患者BP时间生物学特征的改变。结果 :赖诺普利组与非洛地平组治疗后 2 4hBP均值明显降低 ,但其振幅、峰值相位无变化 ;氢氯噻嗪治疗降压效果不甚理想 ,但显著增加了患者BP的夜间降低幅度 ,使患者BP由非杓型转变为杓型分布。结论 :氢氯噻嗪治疗可能使非杓型分布的高血压病患者的BP转变为杓型分布 ,从而有助于降低患者相关并发症的发生率。