Synthetic or natural surfactants

Surfactant replacement therapy is one of the most studied interventions in neonatal medicine, with many thousands of infants having been enrolled in randomized clinical trials. It is clear that surfactant therapy reduces neonatal mortality and the risk of pulmonary air leaks in babies with or at risk of developing respiratory distress syndrome. Yet some doubts linger over other aspects of this therapy, despite it having been an acceptable and proven therapy for the past 7–10 years. As regards timing of treatment, the earlier the better, with true prophylaxis being reserved for babies of less than 28 weeks' gestation. Natural surfactant preparations containing surfactant proteins B and C act more rapidly than their synthetic protein-free counterparts and probably also have a greater impact on reducing neonatal mortality and pulmonary air leaks. Fears raised about immunological effects, prion transmission and chemical contamination of natural surfactants have not been substantiated. Long-term follow-up studies do not show any differences in outcome between treated and non-treated infants, except that the incidence and severity of retinopathy of prematurity might be reduced by treatment with natural surfactant. Further research is needed and this will include more detailed follow-up studies, newer indications for surfactant therapy and the testing of newer preparations with synthetic peptides or protein analogues added.     

Orthotopic cardiac transplantation: evaluation with CT

As cardiac transplantation has become widely available, computed tomography (CT) of the chest has played a useful role in the examination of patients after heart transplantation. To determine anatomic features related to the procedure, the authors evaluated 59 scans in 46 patients who had undergone orthotopic cardiac transplantation. Aortic anastomosis (seen in 98% of scans) and altered spacing between the great vessels (83%) proved to be the most common and most reliable findings. Other features including atrial anastomosis, high main pulmonary artery segment, remnant superior vena cava, and cardiac reorientation were also seen. Accurate interpretation of adenopathy, mediastinal abscess, and pericardial effusion will be enhanced in these patients through a better understanding of the cardiovascular-pericardial complex, which is afforded by CT.     

Experiences of special gynaecological services for children and adolescents: a descriptive study

Gynaecological examination of girls during childhood is undertaken somewhat infrequently. These genital examinations should not be taboo or a frightening experience for the girl, for her parents or for the physician. Studies of children suspected of sexual abuse have paid attention to the wide variety of gynaecological conditions already present in childhood. In 1988 we founded a special gynaecological outpatient clinic for girls under 16 y of age at a university hospital to develop the special knowledge and skills needed in children's gynaecology. In this gynaecological clinic for children and adolescents we were able to gain and offer expert knowledge of the problems of this age group. In this special clinic for children, gynaecological examination by special techniques and sonography led to a diagnosis in 71% of the patients without any instrumentation. Children and adolescent girls in need of special gynaecological care should be recognized specifically. Particular attention should be paid to the gynaecological care of victims of child sexual abuse and mentally or physically handicapped girls. In good co-operation with the girl, a gynaecological examination can become a positive experience during the development of female identity.     

Magnetic resonance imaging following unilateral occlusion of the renal circulation in rabbits

Magnetic resonance studies at 0.12 T were performed following acute unilateral occlusion of the renal artery or vein in rabbits. Prior to occlusion, in vivo and in vitro relaxation times of the renal cortex and outer medulla were similar. After venous occlusion, T1 and T2 were prolonged on the occluded side, while the contralateral side remained unchanged. After arterial occlusion, the outer medulla of both the occluded and contralateral kidney exhibited prolonged relaxation times. There was a significant linear correlation between T1, T2, and the water content of the tissue. The authors conclude that quantitative in vivo relaxation times may eventually prove to be useful in diagnosis, although at present they are less reliable than those obtained in vitro.     

基于受体结构的药物分子设计系统:维甲类分子与其结合蛋白之间相互作用的研究

大分子解剖程序,配体分子契合适配和DOCK程序,以及计算化学的其它程序等,已集成为基于受体结构和分子间相互作用的进行分子设计的软件系统,定名为BIOS(Biomolecularinteractionsandorientationsimulator)。BIOS软件可在普通的微机上运行。使用BIOS分别剥离了细胞浆维甲结合蛋白(CRBP)和副睾维甲酸结合蛋白(E-RABP)两种蛋白的配体结合腔,剥离是围绕配体以同样的分子距离进行的。从而得到了芳香性残基分布相似的两个结合腔,其结合位点的几何排布却有相当差别。揭示出的结合腔已用于一系列的维甲类化合物的DOCK研究。E-RABP的结合腔可做为设计新维甲类分子的模板。     

The contribution of risk factors to the effect of early otitis media with effusion on later language, reading, and spelling

A cohort of 946 children who were screened for otitis media with effusion (OME) from the ages of 2 to 4 were studied for language, reading, and spelling at 7 years of age. The effects of OME in combination with single risk factors and with increasing numbers of risk factors were investigated. An interaction with an additional risk factor was found only for gender and OME, with boys' spelling influenced negatively by a history of OME. OME in combination with preterm birth and low birthweight also appears to put children at risk for later langauage and educational problems. Although a negative linear relation between the number of risk factors and later functioning was found, it is suggested that OME, even when combined with a number of other risk factors, produces only minor effects on later language, reading, and spelling.     

人工牛黄的光解

人工牛黄是广泛用于中成药配方的中药代用品。本文用漫反射光谱法研究了人工牛黄样品在人工光源照射下发生颜色变化的光解规律:在三种光源下,其光解均属二步表观一级反应动力学,即光解曲线是由两段斜率不同的直线组成,初期的光解速度较其后的快2倍左右;不同光源下,紫外灯光解速度最快,荧光高压汞灯次之,碘钨灯最慢;表观光解常数与光波长有关,但基本不随光强度和照射时间乘积改变。而光解时间则与光强度成反比。从得到的动力学方程可预测不同条件下的褪色时间。研究表明,人工牛黄复方中,发生光解的主要成分是胆红素,其余成分不发生引起颜色变化的光解,但在第二步反应中对胆红素的光解有明显影响。