Smooth muscle relaxant effect of dehydroindicolactone

Dehydroindicolactone, a novel linear furanocoumarin with an 8-substituted side chain carrying a 5-member ring lactone, showed spasmolytic activity in a number of smooth muscle preparations. The spasmolytic activity seems to lie in its ability to block the dihydropyridine-sensitive calcium channel.     

Preliminary characterization of the procoagulant material in human ascites

Disseminated intravascular coagulation invariably accompanies placement of peritoneovenous (LeVeen) shunts, which suggests that ascitic fluid contains procoagulant material capable of activating blood coagulation. In this study, we identified thrombogenic activity in human ascites and the hemostatic pathway by which it acts. Peritoneal fluid was removed percutaneously from patients with ascites due to various causes. Four fractions were prepared by centrifugation: cells, a low-speed, cell-free fluid, a high-speed supernatant, and the precipitate from the high-speed centrifugation. Cellular fractions from all ascitic fluids shortened a one-stage clotting time of normal pooled plasma by 68% in comparison with saline solution and endotoxin controls. Similarly, the cell-free fluids also shortened the clotting time of normal pooled plasma by 41%. The cellular and cell-free fractions shortened the clotting time of factor VIII-deficient plasma but failed to demonstrate procoagulant activity in factor VII-deficient plasma. These fractions had no effect on platelet aggregation or the platelet release reaction. The high-speed precipitate was dissociated by ethylenediaminetetra-acetate (EDTA) into fluid phase and precipitate, both of which demonstrated procoagulant activity. Furthermore, high-speed precipitate contained protein, phospholipid, and sterol in proportions similar to those of plasma membranes and contained membrane-bound vesicles as identified by means of electron microscopy. This material could be rendered inactive by heating to 100 degrees C for 2 minutes or by incubation with phospholipase C for 15 minutes. Finally, the ability of the high-speed precipitate to shorten the clotting time was prevented by preincubation with a monoclonal antibody, which is known to inhibit the procoagulant activity of human tissue factor. We suggest that several entities contribute to the procoagulant properties of human ascites, with procoagulant material deriving at least in part from peritoneal cells. The sedimentable procoagulant factor appears to be associated with cellular membranes or membrane fragments and is thromboplastin-like in its chemical composition, immunoreactivity, and substrate specificity.     

Informed consent policies governing medical students' interactions with patients

When medical students become involved in patient care, concerns are raised that have ethical and possibly legal implications. In order to determine compliance with the guidelines of the U.S. government and the Joint Committee on Accreditation of Hospitals pertaining to informed consent, the authors conducted a study of hospital administrators, medical school department chairpersons, and medical school deans (with response rates ranging from 82.3 to 95.1 percent) concerning policies on student involvement in patient care. The results show that only 37.5 percent of all responding teaching hospitals specifically informed patients that students would be involved in care. Only 51 percent of the responding medical schools that specifically gave their students instruction or guidance on initial patient interaction as a matter of policy insisted that their students introduce themselves as students and clarify their role in patient care. The authors conclude that medical educators' compliance with the ethical requirements of informed consent is incomplete.     

Efficacy of anti-digoxin antibodies in a premature neonate

Through the case report of severe digitalis intoxication in a premature born after 27 weeks of gestation with a birthweight of 800 g, the authors show that anti-digoxin antibodies constitute a very efficacious therapeutic tool which, up to the present, has not been used in prematures.     

Pinhole collimator scintigraphy in differential diagnosis of metastasis, fracture, and infections of the spine

The informational gains obtained by the use of pinhole collimator scintigraphy (PCS) have been well documented. The present study has been undertaken to prospectively investigate its efficacy in diagnosing several commonly occurring spinal diseases. Patient material consisted of metastatic cancer (39 vertebrae), compression fractures (33 vertebrae), tuberculous spondylitis (17 vertebrae), and pyogenic spondylitis (six vertebrae). PCS findings were characterized in terms of localization, appearance, and homogeneity of abnormal radionuclide accumulation. Thus, metastatic cancer manifested as diffusely or focally homogeneous accumulation within the vertebral body or as a typical short-segmental accumulation along the end-plate, whereas compression fracture manifested as characteristic board-like accumulation along the entire length of end-plates. Tuberculous spondylitis, on the other hand, revealed homogeneous accumulation throughout the vertebral body, and pyogenic spondylitis revealed accumulation at the end-zone of opposing vertebral bodies giving sandwich-like appearance. The disk space at the affected level was not narrowed in the former two diseases but it was narrowed in the latter two. It was concluded that PCS may be useful in differentiating metastatic cancer, compression fracture, tuberculous spondylitis, and pyogenic spondylitis.     

Human placental glutathione transport mechanism

The placental transport mechanism of glutathione (GSH) was investigated using microvillous membrane vesicles prepared from human term placenta. Using (3H-glycine)-labeled-GSH, it was clarified that GSH in the extravesicular compartment of placental microvillous membranes was rapidly degraded by gamma-GTP (gamma-glutamyltranspeptidase) and resulting amino acid, and 3H-labeled-glycine was actively transported via a sodium cotransport system. AT-125 treated microvillous membrane vesicles almost entirely lost its gamma-GTP activity, and showed intact GSH transport. Using AT-125 treated microvillous membrane vesicles, it was revealed that GSH was transported across the microvillous membrane as an anion via a membrane potential-dependent mechanism. These results indicated that gamma-GTP which existed in microvillous membrane played a role in GSH metabolism and that intracellular GSH was translocated out of the syncythiotrophoblast cell into the maternal blood space via a specific carrier in microvillous membrane because the GSH concentration was higher in intracellular than extracellular and extracellular membrane potential was positively charged.     

Nouveautés sur la sclérose en plaques de l''enfant

Pediatric MS is better understood after a series of epidemiological studies including the French cohort following almost 500 children since more than 7 years. Pediatric MS may have an onset as early as 2 years but symptoms are different than those at adolescence. Its evolution towards a motor handicap is slower than in adults but cognitive impairment have to be evaluated carefully. Interferon beta treatment can be use, if needed, even before the age of 10. Several environmental factors might increase its risk, especially early EBV infection or passive smoking. HBV vaccination does not increase significantly its risk of occurrence.     

围产儿与儿童胸腺的病理改变

The most outstanding pathological changes of perinatal babies and children, based on the review of the autopsy files in the 1st Affiliated Hospital of West China University of Medical Sciences, are lymphocytic depletion, and reticuloepithelial cell swelling and/or fusiform malformation in the cortex, while in the medulla apoptosis is more prominent. We suppose that these alterations are due to immaturity of cortical thymocytes, and in the diseased condition, they are easily affected by extraordinary factors, especially the influence of corticosterone inducing acute severe necrosis, so the number of lymphocytes are obviously diminished. But, in the medulla, as intact mature lymphocytes exist, physiological phenomenon such as apoptosis is rather prominent in it. While in the medulla, Hassall's corpuscles have various characteristic changes, such as cornification, calcification, fusion, cystic change and disintegration. Besides, we observed a new alteration in the thymus defined as vacuolization. All the above pathological changes reached the peak in the 28- day group; there after, they might become either worse or better according to the condition of the disease and growth of the body. However, these are still problems to be further studied separately.