A Case of Variant Congenital Dyserythropoietic Anemia Revisited

A patient with congenital dysterythropoietic anemia was described in 1975 as variant type II because of negative acidified lysis tests using 12 different fresh sera. Subsequent tests with 2 additional normal sera have been strongly positive.     

Incidence of Acute Leukaemia in Norway 1957–1981

The study is based on the material of acute leukaemia in Norway 1957-81 from the Cancer Registry of Norway. The age-adjusted incidence rates for both sexes have been unchanged. For childhood leukaemias (0–14 years at diagnosis) the age-specific incidence rates have been constant for both sexes and there has been an almost constant incidence for the 5 year birth cohorts 1950-69. Among adults there has been virtually unchanged age-specific incidence rates for most age-groups between 15 and 74 for both sexes. Among those older than 75 years, an increase is seen, most probably due to better diagnostic procedures. No geographic differences were found in age-specific incidence rates.     

Effects of divalent cations and various vasoactive and haemostatically active agents on the integrity of monolayers of cultured human endothelial cells

Injury to human endothelial cells in primary culture was evaluated by a ⁵¹Cr-release assay, phase contrast microscopy and the trypan blue exclusion test. Over a period of 24 hours incubation with either normal human serum or standard culture medium, the normal integrity of the confluent endothelium was maintained and total ⁵¹Cr-release showed a slow, linear increase. If Tris-buffered saline was used as incubation medium considerable contraction and detachment of cells and accelerated ⁵¹Cr-release were observed. This evidence of injury was markedly reduced by the addition of small amounts of Ca⁺⁺ ions, while Mg⁺⁺ had no effect. Among 4 haemostatically active agents investigated (ADP, thrombin, endotoxin and sodium polyanethol sulfonate) only thrombin induced morphological evidence of injury accompanied by accelerated release of ⁵¹Cr. These effects of thrombin were inhibited by hirudin. Five vasoactive agents (adrenaline, noradrenaline, histamine, bradykinin and serotonin) had no appreciable effect on endothelial morphology and did not accelerate ⁵¹Cr-release.     

Scintigraphic demonstration of myocardial perfusion and ischaemia associated with coronary artery bypass grafting

OBJECTIVES: To assess if myocardial perfusion scintigraphy (MPS) at rest can be of value in elucidating myocardial perfusion, ischaemia and perioperative myocardial infarction (PMI) associated with coronary artery bypass graft (CABG) surgery. DESIGN: This was a prospective randomized study of patients undergoing elective CABG. Forty-eight patients in the control group underwent serial ECG recordings and measurements of CK-MB and cTnT. Fifty-four patients in the study group were additionally examined with MPS preoperatively and 2-4 days and 6 weeks postoperatively. RESULTS: The study showed a highly significant (p < 0.001) improvement in myocardial radionuclide uptake from preoperatively to 2-4 days postoperatively. Judged from ECG and enzymatic changes, two control patients and one study patient only had PMI and no additional cases of PMI were demonstrated by MPS. CONCLUSION: MPS at rest showed that CABG significantly improved myocardial perfusion, by demonstrating an increase in radionuclide uptake. In diagnosing PMI, we found that MPS provided no additional information beyond cardiac biochemical markers and ECG changes.     

Nonadherent,stationary organ culture of human respiratory mucosa

Summary Fragments of human adenoid tissue were grown in a tissue culture system where all artificial tissue handling, except for the explanation procedures and tissue culture condition in itself, was excluded. The fragments formed spheroids that were covered by a pseudostratified, ciliated epithelium. The epithelium rested on a basement membrane. The central parts of the spheroids consisted of fibroblasts and collagen fibers. This structure remained unchanged for the 40 days the fragments were observed in culture.     

抗高血压药物与罹患癌症的风险:324168例参与随机临床试验病人的荟萃分析和试验序贯分析

长期以来,一直存在抗高血压药物是否有致癌作用的争议.自从在年龄>50岁的妇女中使用萝芙碱提取物造成乳腺癌发病率增加的报道后[1],这一争议已持续了30年.Sipahi和同事们最近的研究显示:血管紧张素受体拮抗剂(angiotensin receptor-blockers,ARB)有较高的致癌风险.这一发现再次引发了抗...     

A new microsurgical instrument--a suction tube combined with a microdissector

A microsurgical suction tube with an attached ball probe has been developed. It functions as a microdissector when the ball probe is in its extended position, creating a larger working field than an ordinary sucker. When the ball probe is in the repose position, it does not interfere with the suction capacity, and the suction tube serves as a regular sucker. By adding the properties of the microdissector to the suction tube, dissection of exquisitely fine and subtle structures, including arachnoidal membranes, is facilitated. The ball probe is easily dismantled from the suction tube and the whole instrument conveniently cleaned.     

Treatment of isolated systolic hypertension in diabetes mellitus type 2

Age-related arterial stiffness is more pronounced in diabetics compared to non-diabetics, which could explain the prevalence of isolated systolic hypertension (ISH, systolic blood pressure > or =140 mmHg and diastolic blood pressure <90 mmHg) being approximately twice that of the general population without diabetes. Large-scale interventional outcome trials have also shown that diabetics usually have higher pulse pressure and higher systolic blood pressure than non-diabetics. Advanced glycation end-product formation has been implicated in vascular and cardiac complications of diabetes including loss of arterial elasticity, suggesting possibilities for new therapeutic options. With increasing age, there is a shift to from diastolic to systolic blood pressure and pulse pressure as predictors of cardiovascular disease. This may affect drug treatment as different antihypertensive drugs may have differential effects on arterial stiffness that can be dissociated from their effects on blood pressure. While thiazide diuretics are associated with little or no change in arterial stiffness despite a robust antihypertensive effect, angiotensin converting enzyme inhibitors, angiotensin II receptor blockers and calcium-channel blockers have been shown to reduce arterial stiffness. However, combination therapy is nearly always necessary to obtain adequate blood pressure control in diabetics. There are no randomized controlled trials looking specifically at treatment of ISH in diabetics. Recommendations regarding treatment of ISH in diabetes mellitus type 2 are based on extrapolation from studies in non-diabetics, post-hoc analyses and prespecified subgroup analysis in large-scale studies, and metaanalysis. These analyses have clearly demonstrated that blood pressure lowering in ISH confers improved prognosis and reduced cardiovascular and renal outcomes in both diabetics and non-diabetics.     

Are All the Hypertensives Made Equal?

Blood pressure lowering in hypertensive patients is of significant importance. The complex pathophysiology makes the therapeutic targets many, and extensive research has provided us with many antihypertensive drugs. However, data indicate that the proportion of patients with controlled blood pressure is far from satisfying. This may partly be explained by a lack of individualized treatment. Present guidelines for management of hypertension emphasize that a thorough evaluation of the patient is necessary before initiating treatment. Based on information about gender, age, ethnicity, family history, clinical examination and concomitant diseases like diabetes mellitus, coronary heart disease, heart failure, cerebrovascular disease and gout, the physician is able to provide the best treatment. However, most patients need two to three drugs to control the blood pressure. Thus, we need methods to predict blood pressure responses to the various drugs in the individual patients. Possibly, in the future treatments may be based upon genetic variants. Until now, several polymorphisms in genes regulating blood pressure have been located, and these may influence responses to drugs. However, the results are heterogeneous and contradictory, and we are yet not capable of determining the best treatment based on genetic properties. Coming years challenge us to further clarify these potentially important aspects of treatment. Meanwhile, physicians are obligated to individualize the treatment by other means, based on disease history, concomitant diseases and clinical examination.