GABA对体外培养大鼠神经元GABA_A受体亚单位mRNA表达的影响

目的观察γ-氨基丁酸(GABA)对体外大鼠培养神经元GABAA受体亚单位mRNA表达的影响,探讨肝性脑病(HE)发病机制。方法采用原位杂交技术,观察GABA对体外培养新生大鼠神经元GABAA受体亚单位α1β1γ2mRNA表达的改变。结果与对照组相比,GABA组神经元GABAA受体亚单位α1及γ2(增幅14%,P<0.01)的mRNA表达显著上升,亚单位β1的mRNA表达显著减少(降幅11%,P<0.05)。结论GABA可通过影响GABAA受体亚单位的表达发挥其对肝性脑病的致病作用。     

Lipoprotein (a): Relationship to vascular disease in dialysis and renal transplantion

Summary: Serum lipids and lipoprotein (a) concentrations were measured in 91 renal transplant and 60 dialysis patients and correlations sought with clinically evident vascular disease. Serum lipoprotein (a) concentrations were greater than 300 mg/L in 24% of the renal transplant recipients and 40% of the dialysis patients. In the renal transplant recipients, low high density lipoprotein (HDL) cholesterol ( P <0.05) and high total cholesterol to HDL cholesterol ratio ( P <0.01) were more strongly associated with the presence of vascular disease than was elevated lipoprotein (a). In the dialysis patients, a low serum albumin ( P <0.05) and low serum creatinine ( P <0.001), indicative of a poor nutritional state, were associated with the presence of vascular disease. A high total serum cholesterol to HDL cholesterol ratio ( P <0.05) was indicative of ischaemic heart disease, and high total serum cholesterol ( P <0.01) and low density lipoprotein (LDL) cholesterol ( P <0.01) of cerebrovascular disease. In the subpopulation on CAPD, elevated lipoprotein (a) levels were associated with cerebrovascular disease ( P <0.01). the present study demonstrates that an elevation in serum lipoprotein (a) concentration is not as strongly associated with the presence of vascular disease in patients with end-stage renal failure as are the total serum cholesterol, HDL and LDL cholesterol and the ratio of total cholesterol to HDL cholesterol.     

Retrospective study of the epidemiology of nodular vasculitis followed up in the National Skin Centre, Singapore

A seven-year retrospective study was done on histologically proven nodular vasculitis presenting at the National Skin Centre, Singapore. We collected 25 patients and found that they differed from the classical European model. They most commonly involved the shins and did not ulcerate. A tuberculous aetiology accounted for 28% of cases. Useful indicators of tuberculosis were a past history of tuberculosis, an abnormal chest X-ray and a strongly positive Mantoux test.     

Education in Occupational Health: with Special Emphasis on Eight Asian Countries

A study project of the Asian Association of Occupational Healthin eight Asian countries (Hong Kong, Indonesia, Korea, Malaysia,the Philippines, Singapore, Sri Lanka and Thailand) was conductedin 1981-83. Among other objectives, a study on OccupationalHealth Education was included. It was found that in all thesecountries there was teaching of occupational health in medicalschools. However, there was little teaching of nurses. Few countrieshad formal training of safety engineers. Specialist trainingin occupational health was available in six countries. The findingsare compared with the known situation in other countries. Possibleways to promote more cooperation and improvements in Asia arethen discussed. Professor W. O. Phoon, Department of Social Medicine and Public Health, National University of Singapore, Outram Hill, Singapore 0316, Republic of Singapore.     

CONGENITAL DIVERTICULUM OF THE ANTERIOR URETHRA

Congenital urethral diverticulum is a rare malformation. Early recognition and treatment are essential, as the obstructive nature of the diverticulum often results in bilateral progressive hydronephrosis, repeated attacks of urinary tract infections, and finally uraemia. A case is reported which was recognized and treated in infancy. The patient has remained well for the past nine years.     

Resetting of DDD Pulse Generators due to Cold Exposure

We encountered resetting of three DDD pulse generators to the VVI mode, one at the time of implantation and two others just before implantation, and we believe this resulted from cold exposure during shipment. Consequently we analyzed the effect of cold exposure on five lithium-powered DDD pulse generators from different manufacturers. Cold exposure caused resetting of three of the five DDD pulse generators to the VVI mode. Only one of the reset pulse generators responded to application of the magnet by conversion to the asynchronous (VOOJ mode, while the other two remained in the VVI mode. All DDD pulse generators should be routinely interrogated before implantation. If found to be reset, the likelihood of cold exposure is very high and the pulse generator can generally be reprogrammed to the DDD mode. The absence of a magnet response in reset DDD pulse generators appropriately inhibited and functioning in the VVI mode should not be interpreted as component failure when no output is observed.     

The Specificity of Alternative Complement Pathway-Mediated Lysis of Erythrocytes: A Survey of Complement and Target Cells from 25 Species

Sera from 20 species of mammals were tested for their ability to lyse erythrocytes from 18 species of mammals and birds by the alternative complement pathway. Erythrocytes were not lysed by homologous complement, with one minor exception, but all erythrocytes tested were lysed by at least one complement source, and all sera tested except that of the horse lysed at least one type of erythrocyte. Control experiments indicated that lysis was via the alternative complement pathway and that antibodies were not involved. Complement from the various species could be ranked from most active to least active, and erythrocytes could be ranked from most susceptible to least susceptible. There was an inverse correlation between complement activity and erythrocyte susceptibility. The ranking of the orders of placental mammals, from strongest to weakest complement, was carnivore>oartiodactyl (ruminants and swine) > primate = armadillo > rodent > rabbit > horse. Opossum serum had activity that placed it in the centre of this range. Ferret complement, the most potent tested, lysed all erythrocytes tested except for homologous erythrocytcs, with APCH50 titres as high as 4000. Although the overall reactivity pattern was clear, there were several striking exceptions. For example, the only complement source which lysed ferret erythrocytes was sera of the mouse. The amount of sialic acid present on erythrocytes of 14 mammals was determined, and was, in general, directly correlated with resistance to alternative complement pathway lysis, although there were prominent exceptions to this correlation, involving crythrocytes of the horse, burro and human. All 20 types of complement were also tested for their ability to lyse antibody-coated human tumour cells, under conditions in which both the classical and alternative complement pathways were functional. The data obtained suggest that alternative pathway activation is, in some cases, a major factor determining the effectiveness of a particular complement source in the lysis of xenogeneic tumour cells.     

Giant Epignathus with Intracranial Teratoma in a Newborn Infant

A male newborn infant with a giant epignathus associated with intracranial teratoma and obstructive hydrocephalus detected antenatally is reported. Only 4 similar cases have been reported in the literature. This disorder is uniformly lethal. We believe this is the first reported case of epignathus with congenital intracranial teratoma diagnosed antenatally by ultrasonography.     

Pre-operative nutritional support in children with end-stage liver disease accepted for liver transplantation: An approach to management

Pre-operative nutritional support was studied in 28 children with end-stage liver disease awaiting orthotopic liver transplantation. Nasogastric supplemental administration of a standard semi-elemental enteral nutritional formula was compared with a similar formula enriched with branched chain amino acids, and with a group receiving oral nutrition only. The duration of treatment in all groups was similar (mean 90 days). Energy intakes in the supplemented groups were 120-150% of recommended daily intakes (RDI), whereas ad libitum intakes in the oral group ranged 58-100% RDI. A significant improvement in mean Z-score for body weight (denoting catch-up) was noted only in those children who received nasogastric supplements enriched with branched-chain amino acids. The standard enterally-fed group maintained their body weight and Z-scores did not change significantly. In contrast, body weight Z-scores in those fed orally declined significantly. Nutritional supportive therapy of malnourished children with end-stage liver disease can minimize or improve nutritional status in children awaiting liver transplantation. The use of nutritional formulae rich in branched-chain amino acids may have nutritional advantages in children with chronic liver disease which require further study and evaluation.