Effects of selective dopamine-1 receptor activation on intraocular pressure in man

The lack of specific agonists and antagonists has, until recently, precluded investigation of a role for dopamine receptors in the control of intraocular pressure. In the present study, we have examined the effects of fenoldopam, a novel selective dopamine1 (DA1) receptor agonist, on intraocular pressure, in eight healthy human volunteers. Fenoldopam, infused intravenously at 0.5 micrograms kg-1 min-1, increased intraocular pressure from 14.6 +/- 0.9 to 17.6 +/- 1.4 mmHg (P less than 0.05) while a control saline infusion had no effect. Pupil diameter and blood pressure did not change. In the same subjects, i.v. norepinephrine or angiotensin II both increased intraocular pressure--from 13.8 +/- 1.4- to 17.6 +/- 1.4 mmHg and from 13.4 +/- 1.3- to 17.5 +/- 1.7 mmHg respectively (P less than 0.05), and mean arterial pressure by about 20 mmHg. These data suggest that: (1) DA1 receptor activation can modulate intraocular pressure; (2) the intraocular pressure effects of the DA1 receptor agonist, fenoldopam, are independent of changes in systemic blood pressure, in contrast to those of norepinephrine or angiotensin II where intraocular and systemic blood pressures increase in parallel; (3) the ability of a DA1 receptor antagonist to lower intraocular pressure merits investigation.     

Ruvalcaba-Myhre-Smith Syndrome

In 1980 a syndrome was first described in two adult males, consisting of macrocephaly, pigmented macules on the glans and shaft of the penis, and hamartomatous intestinal polyps. Since then, 10 additional cases have been identified. Herein, we present two new cases and review the cutaneous manifestations as well as additional features in patients with the Ruvalcaba-Myhre-Smith syndrome.     

C－myc反义寡聚脱氧核苷酸抑制人脑胶质瘤细胞系BT_（325）Myc蛋白合成和细胞增殖并诱导其分化的研究

目的：探讨在体外ｃ－ｍｙｃ反义核酸是否可通过阻断人脑胶质瘤细胞中ｃ－ｍｙｃ基因的表达而抑制细胞增殖并诱导分化．方法：人工合成与ｃ－ｍｙｃｍＲＮＡ起始码及其后四个密码子互补的寡聚脱氧核苷酸（简称反义核酸）片段，用它处理培养的ＢＴ３２５细胞，观察它对细胞增殖的影响．同时用免疫细胞化学方法检测细胞中Ｍｙｃ蛋白的水平以及能反映胶质瘤细胞分化的Ｓ－１００和ＧＦＡＰ两种蛋白的水平，分析这些指标的变化．结果：发现４ｕｍｏｌ／Ｌ的ｃ－ｍｙｃ反义核酸明显抑制ＢＴ３２５细胞的增殖和Ｍｙｃ蛋白的合成，且后者发生在加入反义核酸后１ｈ，并持续２４ｈ以上，而细胞增殖受抑制要到第５日才明显．从第２日到第５日细胞中Ｓ－１００和ＧＦＡＰ染色明显加深，反映细胞有分化趋势．用同样长度的无关序列寡聚脱氧核苷酸作对照，则未见上述变化，表明ｃ－ｍｙｃ反义核酸的作用是序列特异性的．结论：ｃ－ｍｙｃ反义核酸可特异地抑制ＢＴ３２５细胞中Ｍｙｃ蛋白的合成和细胞增殖，并能诱导其分化．     

Bacterio-expert: an integrated system for assisting in the validation of antibiotic sensitivity tests. Retrospective application in 4053 Staphylococcus

Bacterio-expert is a simple expert system for assisting in the validation of antibiotic sensitivity testing. This system is incorporated in a data acquisition and editing program for bacteriologic test (Bacterio program written in Turbo-Pascal for personal computer users by the same authors). The principles of this system are explained and results with 4,053 antibiotic sensitivity tests on Staphylococcus aureus isolates are reported. Approximately 10% of tests required corrections.     

THE INTRODUCTION OF PATIENT-CONTROLLED ANALGESIA INTO AN ISOLATED RURAL HOSPITAL

This study investigated the feasibility of using patient-controlled analgesia (PCA) effectively in a small 70 bed isolated rural hospital. The tirst 50 patients to use a Bard PCA 1, in the Port Lincoln Hospital, South Australia, were studied. The patients consumed morphine at a mean rate of 1.24 mg/h and used PCA for a mean of 48 h. Thirty-eight per cent of patients required treatment for nausea and other complications which is similar to the rate of those in other published series. Visual analogue pain scores showed excellent pain control, generally without evidence of oversedation; however, there was one episode of respiratory depression. Seventy-eight per cent of patients reported that their pain was relieved most or all of the time. The study demonstrated that a PCA service provided by nursing staff, the GP anaesthetist and rural surgeons is feasible in an isolated rural hospital.     

218. Perioperatives Risiko nach allgemeinchirurgischen Eingriffen: Erfahrungen mit einer Qualitätssicherung über 4 Jahre

Zusammenfassung Über 52 Monate wurden 4747 allgemeinchirurgische Planeingriffe prospektiv erfasst. Postoperative Komplikationen (Wundinfektion, Pneumonie, Revision, Letalität) wurden mit einem Punktescore bewertet, der die konkrete Zahl der zu erwartenden Komplikationen auf 10 Operationen der gleichen Art wiedergibt. Der Wert einer solchen Erfassung des Komplikationsrisikos zeigte sich in Verlaufsuntersuchungen, bei denen die postoperativen Komplikationen im 4-Monatsrhythmus aufgetragen wurden: Ursachen von Komplikationen konnten erforscht und beseitigt werden.     

Prolactinoma in the male

In a retrospective study the medical records of 13 male patients with macroprolactinomas were evaluated concerning anamnestic data, clinical, endocrinological and localisation-diagnostic findings as well as therapeutic measures. The main symptoms were disturbances of vision and impaired potency and impaired libido, respectively. The ophthalmological complaints nearly exclusively caused the patients to see the doctor. Clinically the signs of hypogonadism were found. The diagnosis was ascertained by increased serum prolactin levels, ophthalmological findings, X-ray of the sella, cranial computed tomography as well as angiography of the carotid. The operative treatment did not show any normalization of the serum prolactin levels. The rate of recidivations after exclusive operative treatment was high. An additional medicamentous therapy with dopamine agonists is nearly always necessary after operation. Whether or not bromocriptine shall be used as primary therapy, must be decided on in the individual case.     

The current status of intrapartum continuous fetal tissue pH measurements

Continuous tissue pH monitoring during labor has now been possible for 15 years. Tissue pH is measured in the intercellular fluid, and the value differs in some cases from the blood pH value because of local capillary flow and local metabolism. The fetal scalp seems to be an area where tissue pH and capillary blood pH values are very close, but in acute acidosis there may be a time lag of 10-15 min before tissue pH is equilibrated. Normal values of scalp tissue pH are 7.38 in early labor declining by 0.016 per hour during the first stage of labor and by 0.12 per hour during the second stage of labor. Tissue pH values below 7.15 are defined as pathological. The correlation coefficient to umbilical artery blood pH (0.71), success rate (67%) and electrode drift (below 0.04) from the largest study of tissue pH monitoring using glass pH electrodes (n = 337) are described.