White-matter lesions in MR imaging of clinically healthy brains of elderly subjects: possible pathologic basis

Patchy white-matter lesions occur in the magnetic resonance (MR) imaging brain studies of 20%-30% of neurologically healthy elderly subjects. To determine the frequency of histologically verifiable white-matter lesions at autopsy in such subjects the authors examined serial, microscopic, whole brain sections from 15 clinically healthy subjects aged 52-72 years. Small white-matter lesions were found in 12. In these 12, zones of atrophic perivascular demyelination were present in eight brains. These are not the familiar thrombotic, embolic, or ischemic vascular lesions that produce acute necrosis. This mild vascular insufficiency produces atrophy, which has been recognized in the pathology literature but whose clinical significance remains unknown. Other lesions seen were small vascular malformations in the centrum ovale in four brains, diverticula of the lateral ventricle extending into the white matter in three, and an isolated central white-matter infarction in one. All of these lesions are probably the basis of the patchy white-matter lesions seen on MR imaging studies in the neurologically healthy elderly population.     

Uterine rupture after use of a prostaglandin E2 vaginal insert during vaginal birth after cesarean. A report of two cases.

BACKGROUND: Prostaglandin E2, when used for cervical ripening, often initiates labor. Single dosing and ease of removal contribute to the common use of a commercially available prostaglandin E2 vaginal insert. We describe two cases of uterine rupture among 57 pregnancies undergoing attempted vaginal birth after cesarean section. CASES: Two cases of women attempting vaginal birth after a single low transverse cesarean section were treated with the insert either at 41 weeks, 4 days, or 39 weeks, 3 days, for postdatism or preeclampsia. Signs of uterine rupture included persistent suprapubic pain and repetitive fetal heart rate variable decelerations followed by bradycardia. Infant outcomes were favorable, and tears along the prior low transverse uterine scar were repaired without additional morbidity. CONCLUSION: This prostaglandin compound is not exempt from being associated directly or indirectly with uterine rupture and requires informed consent and continuous monitoring.     

蛋白质组学及其相关技术在运动人体科学中的应用

目的:对蛋白组学及蛋白芯片技术发展现状进行综述,为该技术在运动医学中的应用提供参考资料。资料来源:应用计算机检索PubMed2003-01/2006-12期间相关蛋白组学及蛋白芯片技术方面的文章,检索词“exercise AND protein chip,protein microarray”,并限定文章语言种类为English。同时计算机检索万方数据库2003-01/2006-12期间相关蛋白组学及蛋白芯片技术方面的文章,检索词“蛋白质,运动锻炼,运动医学”,并限定文章语言种类为中文。资料选择:对资料进行初审,并查看每篇文献后的引文。纳入标准:文章所述内容应与蛋白质组学及蛋白质芯片技术的研究相关。排除标准:重复研究或Meta分析类文章。资料提炼:共收集到312篇相关文献,32篇文献符合纳入标准,排除的280篇文献为内容陈旧或重复。资料综合:蛋白组学研究已成为基因组学研究后生命科学发展的大方向之一。它研究的主要内容包括:蛋白质分离与鉴定、蛋白质功能的确定、蛋白质翻译后修饰及相互作用、各种疾病或疲劳标志物的筛选与疾病诊断、生物信息学及药物开发等方面。文章在对蛋白质组学的发展及其相关技术在运动人体科学中的应用现状进行综述的基础上,对运动人体科学未来的发展方向进行了展望。由于蛋白质组学的建立以及蛋白质芯片技术的逐步完善,对运动人体科学的研究及其发展将起到很好的促进作用。结论:未来将从分子水平上阐明运动与人体适应的分子生物学机制,研究热点将集中于从运动营养蛋白质组学、反兴奋剂的蛋白质芯片技术、运动员机能评定的蛋白质芯片研究等方面。     

Glucagon and diabetes.

We have considered the evidence, first, that the presence of glucagon is essential in the pathogenesis of the full syndrome that results from complete insulin deficiency; second, that in the diabetic in whom insulin levels are relatively fixed, a rise in glucagon concentration contributes to endogenous hyperglycemia; and, third, that conventional methods of treatment of diabetes do not fully correct either the abnormal glucagon levels or the hyperglycemia, but when insulin therapy is supplemented with somatostatin, an agent which suppresses both glucagon and growth hormone, both hyperglycemia and hyperglucagonemia are corrected. These facts may one day provide a rationale for therapeutic efforts to suppress excess glucagon secretion in the management of diabetes in man.     

重组人粒细胞-巨噬细胞集落刺激因子乳酸链球菌表达载体的构建

目的:构建重组人粒细胞-巨噬细胞集落刺激因子乳酸链球菌表达载体,为进一步研究人粒细胞-巨噬细胞集落刺激因子在乳链菌的表达及其治疗价值奠定基础。方法:实验于2005-04/2006-03在南方医科大学南方医院消化病研究所完成。①载体pNCSF的构建:将质粒集落刺激因子及含有P59启动子、USP45蛋白信号肽的pNBC1000质粒分别加入BamH Ⅰ和Pst Ⅰ进行双酶切,并用Apa Ⅰ、Sac Ⅰ进行双酶切鉴定,重组质粒命名为pNCSF。②SDGFP的TA克隆及载体pNCSFGFP的构建:将经过优化适合在乳链菌表达的人粒细胞-巨噬细胞集落刺激因子基因克隆于含有P59启动子、USP45蛋白信号肽的pNBC1000载体,得到重组质粒pNCSF;同时设计上下游引物经PCR扩增增强荧光表达蛋白(EGFP),TA克隆后经测序验证,再连接于pNCSF获得重组质粒pNCSFGFP。③载体pTRCSF、pTRCSFGFP的建立:将获得的pNCSF和pNCSFGFP进一步克隆于穿梭载体pTR1001c,以获得人粒细胞-巨噬细胞集落刺激因子乳链菌表达载体pTRCSF及pTRCSFGFP。结果:①载体pNCSF构建结果:酶切鉴定产物经1.0%的琼脂糖凝胶电泳后,发现有(含启动子P59、信号肽USP45、人粒细胞-巨噬细胞集落刺激因子)720bp的目的片段。②SDGFP的TA克隆及载体pNCSFEGFP的构建结果:SDGFP阳性克隆产物经EcoRⅠ酶切鉴定得到775bp目的片段。pNCSFEGFP酶切鉴定产物经1.0%的琼脂糖凝胶电泳后,发现有(含启动子P59、信号肽USP45、人粒细胞-巨噬细胞集落刺激因子、SDGFP)1495bp的目的片段。③穿梭质粒pTRCSF、pTRCSFGFP酶切鉴定结果:经Xba Ⅰ、Sac Ⅰ进行双酶切鉴定,分别得到约717bp、1492bp大小目的片段。结论:获得了人粒细胞-巨噬细胞集落刺激因子乳链菌表达载体pTRCSF及pTRCSFGFP,并经酶切鉴定和测序证实。     

Wegener's Granuloma. A Series of 265 British Cases Seen Between 1975 and 1985. A Report by a Sub-committee of the British Thoracic Society Research Committee

In order to describe the British experience of Wegener's granuiomatosisHospital Activity Analysis was used to collect cases diagnosedin England, Wales and Scotland between 1975 and 1985. Wherepossible clinical details, histological material and chest radiographswere obtained. Two hundred and sixty five patients were consideredto have Wegener's granuiomatosis. In 109 a single pathologistconfirmed the diagnosis by finding both granulomas and vasculitisin biopsy material. The diagnosis was made on clinical groundsor clinical grounds together with histological diagnosis inthe local hospital in 156 patients. Wegener's granuiomatosiswas confined to the lung or upper respiratory tract in 22 percent of patients and renal disease occurred in 58 per cent.Laboratory tests showed a pattern of mild anaemia, polymorphleucocytosis, eosinophilia and an elevated ESR and hypergammaglobulinaemia,with no specific pattern of changes. Histological confirmation was most frequently obtained by examinationof nasal biopsy specimens, but multiple biopsies were oftenrequired. Renal biopsies showed focal proliferative glomerulonephritisbut granulomatous glomerulonephritis was uncommon. Of availablechest radiographs 61 per cent were abnormal, large opacitiesbeing most common. Small irregular opacities were found lessoften and other abnormalities were uncommon. Treatment varied widely and 10 per cent of patients receivedno drug therapy. This large series illustrates that even withoutspecific treatment, patients with Wegener's granuiomatosis cansurvive for several years and with modern treatment survivalfor more than a decade is possible. Conclusions about the effectivenessof the various therapies cannot be drawn from this restrospectivestudy. Renal failure and disseminated vasculities were the commonestcauses of death; death was considered to result from complicationsof treatment with cytotoxic drugs or prednisolone in 6 per centof patients.     

USE OF SOLVENTS TO DISPERSE EAR WAX

SUMMARY In this test a course of 4 drops twice a day for 5 days of ear wax solvents, a cerumenolytic, sodium bicarbonate, or sterile water significantly increased the clearance of wax from ears by natural expulsion and eliminated the requirement for ear syringing in 50% of cases.     

Large-volume leukapheresis in pediatric patients: processing more blood diminishes the apparent magnitude of intra-apheresis recruitment

Background: Recruitment of progenitors during a large-volume collection, as defined by increasing relative and absolute numbers of progenitors (colony-forming units-granulocyte-macrophage [CFU-GM] of CD34+ cells), has been reported previously. Study Design and Methods: To ascertain whether intra-apheresis recruitment occurs in pediatric patients who have undergone mobilization with chemotherapy and granulocyte-colony-stimulating factor (G-CSF), each hour's portion of a 4-hour leukapheresis was collected into separate bags, and assessed by complete blood count, CFU-GM, and CD34+ cell assays. Seven pediatric patients (median age, 7; range, 2–19) were studied in connection with 2 to 4 collections each, for a total of 21 collections (with hourly samples). The collections lasted for 4 hours, at an inlet rate of 1 to 3 mL per kg per minute, for daily processing totals of 5 to 12 blood volumes. (One blood volume [mL] is estimated by the patient's weight in kg × 70 mL/kg.) Smaller (younger) patients had inlet rates exceeding 2 mL per kg per minute, and larger (older) patients had rates of 1 to 1.5 mL per kg per minute. CFU-GM and CD34+ cell counts obtained each hour of the collection and divided by the first hour's value were compared by nonparametric repeated-measures ANOVA. Results: Second-, third- and fourth-hour CD34+ progenitor cell counts were arithmetically higher than first-hour counts, but the trend did not reach significance (p = 0.1561). Second-hour counts were higher than first-hour counts in the overall analysis (mean ± standard error [SE], 1.00 and 1.39 ± 0.1, respectively; p = 0.0525) and in children older than 5 years (1.00 vs. 1.70 ± 0.30, respectively; p = 0.0259), but not in children younger than 5 years (p = 0.8125). CFU-GM counts did not differ among the 4 hours of collection (p = 0.1717) or between the first and second hour (p = 0.9587). Conclusion: In larger (older) patients, from whom fewer blood volumes were collected, there is a trend toward intra-apheresis recruitment, although less than reported previously. In the smaller (younger) patients, from whom more blood volumes were collected, no trend was observed. Lack of (or submaximal) prior mobilization in previously reported studies may have facilitated intracollection recruitment. Alternatively, the larger number of blood volumes collected from the smaller (younger) patients may have masked intra-apheresis recruitment. The study documents the feasibility of large-volume, 4-hour leukapheresis in pediatric patients.