Characterization of carbohydrates in commercial infant formulae

Human milk has always been the reference parameter for the preparation of commercial formulae. The advent of more advanced technologies has enabled increasingly precise information on the composition of human milk to be obtained. Our knowledge in the field of carbohydrates also has improved considerably in the last few years following the pioneering studies of Montreuil (1, 2). From a quantitative point of view it has been demonstrated that in the different phases of lactation, in addition to lactose, human milk contains a consistent amount of oligosaccharides (about 20 g/1 in colostrum and 10–13 g/l in mature milk) (3, 4), whereas monosaccharides make up only about 1% of the total carbohydrates (4). More than 100 different types of oligosaccharides have been identified so far in human milk (5–7), mostly tri-octasaccharides (8). From a biochemical point of view, oligosaccharides are constituted by glucose, galactose, N -acetyl-glucosamine, fucose and sialic acid, and present a linear or branching structure (5). Little is known yet about their physiological role or metabolic fate (9); nevertheless, it has been demonstrated that, in addition to their nutritional function, they participate also in the regulation of the intestinal ecosystem, encouraging the growth of bifid flora (10) and contributing to the defense mechanisms against pathogens in various organs (11–13).     

A case of primary pulmonary hypertension

Primary lung hypertension (PLH) is a rare disease of unknown etiology seen largely in young persons. PLH shows rapid progression with lethal outcome 3-5 years after registration of the first symptoms. Early diagnosis of the disease is difficult. A case described in the article illustrates real difficulties in PLH diagnosis and treatment. The patient several times lost consciousness for a short time at insignificant exercise. This phenomenon has not been described in the literature so far.     

~(99m)TcO_4~-甲状腺显像定量分析在甲状腺疾病中的应用

目的:探讨99mTcO4-甲状腺显像定量分析在甲状腺疾病诊断中的临床价值。方法:采用Marconi Fx810 SPECT仪对38例正常对照者和189例Graves病、亚急性甲状腺炎、单纯性甲状腺肿及甲状腺功能减退者进行99mTcO4-甲状腺动静脉态双时相显像,测定颈动脉与甲状腺显影时间差(Td)及20分钟时甲状腺与颈部软组织像素的平均放射性比值(UI)。结果:①Graves病组表现为Td缩短,UI值明显增高,且UI值恢复速度滞后于体外甲功指标的恢复(P<0.01)。②亚甲炎组甲状腺摄锝功能降低(P<0.01),静态显像表现为放射性普遍稀疏或局限性稀巯。③单甲肿组、甲减组Td、UI值与正常组无明显差异(P>0.05)。④对照组、Graves病、亚甲炎及单甲肿组24小时吸131I率与UI值有良好的相关性。结论99mTcO4-甲状腺显像定量分析法操作简便,误差小,适用范围广,在常见甲状腺疾病的诊断中具有重要价值。     

Gangrene of the lung: successful medical management of three patients

Three patients with massive pulmonary gangrene who have survived without recourse to surgery are presented. In 2 cases, anaerobic organisms were suspected as being the causative pathogens although this was not proved. With resolution the radiological appearances of the involved lobe varied from no more than segmental to almost complete loss of the whole lobe.     

Analysis with antiidiotype antibody of a patient with chronic lymphocytic leukemia and a large cell lymphoma (Richter's syndrome)

A murine monoclonal antibody made against an idiotypic determinant (Id) of surface IgM/IgD lambda molecules on chronic lymphocytic leukemia (CLL) cells of a 71-year-old woman was used for clonal analysis by two- color immunofluorescence. The anti-Id antibody identified IgM+/IgD+/lambda+ B cells as the predominant cell type of her CLL clone. In addition, substantial proportions of the IgG and IgA B cells and most of the IgM plasma cells in her bone marrow and blood were Id+. Six years after diagnosis, the patient died of respiratory failure due to infiltration of lungs by malignant cells. Autopsy revealed a dramatic change in the tumor cell morphology. The lungs, hilar nodes, and liver were infiltrated by a diffuse large cell lymphoma admixed with the leukemic cells. By immunohistologic staining these anaplastic lymphoma cells were IgM+/IgD-/lambda+ B cells expressing the same Id noted earlier on the CLL cells. The immunoglobulin gene rearrangement pattern on Southern blot analysis was also the same in leukemic blood cells and in the tissues involved by the lymphoma. Thus, the combination of antiidiotype and immunoglobulin gene analyses in this patient with Richter's syndrome revealed that a CLL clone, seemingly "frozen" in differentiation, was actually undergoing isotype switching, differentiation into plasma cells, and evolution into a rapidly growing and fetal lymphoma.     

Factors determining prognosis of patients with stable ischemic heart disease (results of a five years prospective study)

Risk stratification seems to be very important in patients with stable coronary artery disease (CAD). However, the prognostic scales are now available only for the early risk assessment in patients with acute coronary syndromes and in patients undergoing percutaneous coronary interventions. Aim of the study was to assess the frequency of cardiovascular events (CVE) during 5 years of follow-up in patients with stable CAD and to construct a long-term risk prediction model for these patients. 503 patients (mean age 59.4 years) were included in the study. The follow-up period ranged between 3.0 and 7.5 years (mean 5.0 years). Main end points were fatal and non-fatal cardiovascular events: cardiovascular death, acute coronary syndromes, ischemic stroke, transient ischemic attack, peripheral arterial thrombosis, and need for revascularization in any affected vascular area. Total frequency of events was 31.0% (5.7/100 patient years). Independent predictors of events were: severity of angina, three vessel coronary disease, previous myocardial infarction, previous stroke/ transient ischemic attack, peripheral arterial disease, obesity, chronic kidney disease and history of erosive gastritis. The presence of more or equal 3 risk factors was significantly associated with increased frequency of CVE.     

CEREBRAL VENOUS THROMBOSIS OCCURRING DURING AN ECTOPIC PREGNANCY AND COMPLICATED BY INTRACRANIAL HYPERTENSION

Thrombosis of the cerebral dural sinuses and veins has been described since the early 19th century.^1,2 Clinically the process is characterised by diverse symptomatology and physical findings and in spite of advances in diagnostic radiological techniques it remains an under-recognised condition. It has been most commonly associated with sepsis, trauma, pregnancy, the puerperium and many other hypercoagulable states. We describe an apparently unique case of sagittal sinus thrombosis occurring during an ectopic pregnancy. This was subsequently complicated by intracranial hypertension in spite of clinical improvement and magnetic resonance imaging (MRI) evidence suggesting a return of venous patency. The clinical presentation, radiological features and management is discussed.