The anaesthetic management of bone marrow harvest for transplantation

The anaesthetic management of 217 donors undergoing 236 operative procedures to donate bone marrow for allogeneic transplantation or for autologous grafting is described. The procedures were those performed between November 1979 and the end of October 1982.     

Simultaneous complementary idiotypic responses: absence of reciprocal regulation

Complementary antibodies, i.e. antibodies having combining site structures which are at least partially directed against each other, were induced in A/He mice by immunization with phosphorylcholine (Pc) coupled to keyhole limpet hemocyanin or with the Pc-binding IgA myeloma protein, HOPC-8 (H8). Both responses were monitored by enumerating plaque-forming cells and assaying serum antibody levels to Pc and H8. Prior immunization with H8 markedly suppressed subsequent immunization with Pc and vice versa; neither plaque-forming cell response was diminished, however, when mice were immunized simultaneously with Pc and H8. Experiments were designed to determine if the absence of reciprocal regulation was due to change in idiotypes. This was determined by measuring inhibition of plaque formation using complementary antibody. Plaque formation by cells was equally inhibited by high dilutions of the appropriate complementary antibody whether cells were from mice immunized with one, the other, or both antigens. Thus, the absence of regulation could not be accounted for by emergence of different idiotypes. Interestingly, sera from mice immunized to have high responses to both antigens were relatively ineffective in inhibiting plaque formation or suppressing immunization to Pc. However, such sera contained complexes of the complementary antibodies; apparently antibody to Pc in such sera quenches or neutralizes the activity of anti-H8 antibody. But the formation of complexes, at least measurable levels of circulating complexes, must be a result rather than the cause for the absence of reciprocal regulation, since regulation was also absent when immunization to Pc was manipulated so that responses were too low to result in detectable levels of circulating antibody to Pc. It is proposed that simultaneous complementary responses may occur in nature to other antigens and antibodies, and that such simultaneous responses may cause pathologic changes.     

高原肺心病患者血液中HMGB1检测及与痰液中相关因子的关系研究

目的 探讨高原慢性肺心病患者血液中高迁移率族蛋白1(high mobility group box 1,HMGB1)变化及与痰液中相关因子的关系.方法 选择慢性肺心病急性期患者48例,健康查体自愿者18人作为对照组.在肺心病患者急性期及治疗病情缓解后1周,检测外周血HMGB1表达及痰液中HMGB1表达、TNF-α水平、SOD活性、MDA水平变化.结果 肺心病组急性期患者外周血HMGB1阳性率显著高于缓解期,缓解期显著高于对照组,与痰液HMGB1表达正相关.血液HMGB1表达阳性组痰液TNF-α水平及MDA水平显著高于阴性组.结论 HMGB1有助于反映高原慢性肺源性心脏病支气管局部炎症反应.     

Genetic and environmental influences on expression of recurrent headache as a function of the reporting age in twins.

Neurology. 2002;58(9 suppl 6):S3-S9.
That migraine is significantly underdiagnosed in the United States and other countries is well established. New data from a follow-up survey to the American Migraine Study II reveal that the presence of concomitant headache types and co-morbid conditions significantly affects the ability to detect and diagnose migraine. This article describes these data and explores the contribution of concomitant headache types and co-morbidities to the problem of underdiagnosis of migraine. Migraine continues to be underdiagnosed because of failure to recognize it (missed diagnosis) and because of misdiagnosis of migraine as another headache type. First, a diagnosis of migraine may be missed in the presence of other headache types that occur proportionally more frequently than migraine and thereby overshadow migraine. Second, migraine may be misdiagnosed when health-care providers inappropriately interpret specific symptoms and co-morbid conditions as indicators of the presence of a non-migraine headache type such as sinus or tension. By becoming aware of these diagnostic pitfalls and being more judicious and deliberate in diagnosing migraine and other headache types, health-care providers can improve the diagnosis of migraine and patients to receive appropriate therapy.
Comment: The diagnosis of migraine is less likely to be made if the patient has several types of headache presentations over time. Thus, a patient with the full spectrum of migraine, from episodic tension-type through migrainous (probable migraine) headache and on to migraine per se is far less likely to receive a diagnosis of migraine than a patient who experiences attacks of "pure" migraine. SJT