口服右旋索他洛尔生存研究(SWORD)

标题　ａ）口服左旋－Ｓｏｔａｔｏｌ治疗心肌梗死后左室功能不全患者生存研究（ＳＷＯＲＤ）：试验依据、设计和方法　　　ｂ）右旋－Ｓｏｔａｔｏｌ对亚急性和陈旧性心肌梗死后左室功能不全患者病死率的影响研究作者　ＷａｌｄｏＡＬ,ＣａｍｍＡＪ,ｄｅｒｕｙｔｅｒＨ,等ａ）ＡｍＪＣａｒｄｉｏｌ,１９９５,７５：１０２３～１０２７ｂ）Ｌａｎｃｅｔ,１９９６,３４８：７～１２　　研究疾病：充血性心力衰竭。目的：右旋－Ｓｏｔａｔｏｌ为一种具有专一性钾通道阻滞作用的抗心律失常药物。本研究将对其降低心肌梗死后左室功能不全…     

Mechanisms of in utero overgrowth

D'Ercole AJ. Mechanisms of in utero overgrowth. Acta Pædiatr 1999; Suppl 428: 31–6. Stockholm. ISSN 0803–5326
Determination of the mechanisms that lead to in utero overgrowth has proved elusive. Recently, however, our knowledge has significantly expanded as a result of the generation of experimental mouse models, engineered to disrupt the expression of one or more genes (knockout mice), and by detailed molecular and genetic analyses of infants and children with overgrowth syndromes. Studies of knockout mice have largely defined the essential roles of the insulin-like growth factors (IGF-I and IGF-II), insulin and their receptors in embryonic and fetal growth, and have provided compelling evidence that increased IGF-II gene expression and/or abundance can stimulate excessive fetal somatic growth. The IGF-II gene is usually expressed only by the paternally derived allele; however, when this imprinting is erased and IGF-II expression is biallelic, fetal overgrowth ensues. Such increased IGF-II expression would appear to explain the overgrowth in Beckwith-Wiedemann syndrome. Using the information gathered from knockout mice as a guide to human studies, detailed genetic investigations are likely to unravel the mechanisms behind other human overgrowth syndromes. □ Beckwith-Wiedemann syndrome, gene expression, imprinting, insulin, insulin-like growth factors, insulin-like growth factor receptors, insulin receptor, overgrowth syndromes     

Premature ovarian failure (POF) and fragile X premutation females: from POF to to fragile X carrier identification, from fragile X carrier diagnosis to POF association data.

Early menopause in the fragile X carriers has been well documented in several reports. All surveys demonstrated that 13-25% of fragile X carriers experienced premature ovarian failure (POF), defined as menopause before the age of 40 years. In 1995 we started screening two groups of subjects as a part of a Fragile X Research Program: 1) women previously diagnosed as fragile X carriers from the register of our center and 2) women with POF and without a family history of fragile X or other forms of mental retardation. In this study we report the preliminary data collected from 75 fragile X families; in 30 of them, POF was present in one or several subjects, all of whom had a fragile X premutation. None of the women with a full mutation experienced POF in our series of patients. We also identified 89 families without a family history of fragile X or mental retardation, and there were 108 subjects who experienced POF, of which 6.5% had a fragile X premutation. This is 70-fold higher than the background prevalence of fragile X premutation in the Italian population and suggests an association with POF. These data confirm the results of other surveys.     

How pediatricians can respond to the psychosocial implications of disasters. American Academy of Pediatrics. Committee on Psychosocial Aspects of Child and Family Health, 1998-1999

Natural and human-caused disasters, violence with weapons, and terrorist acts have touched directly the lives of thousands of families with children in the United States.1 Media coverage of disasters has brought images of floods, hurricanes, and airplane crashes into the living rooms of most American families, with limited censorship for vulnerable young children. Therefore, children may be exposed to disastrous events in ways that previous generations never or rarely experienced. Pediatricians should serve as important resources to the community in preparing for disasters, as well as acting in its behalf during and after such events.     

Quantitative comparison of technetium-99m tetrofosmin and thallium-201 images of the thyroid and abnormal parathyroid glands

The aim of the study was to quantitatively compare the scintigraphic images of the thyroid and abnormal parathyroid glands obtained with technetium-99m tetrofosmin and thallium-201 in patients with hyperparathyroidism. Forty-six patients with hyperparathyroidism underwent ²⁰¹Tl (74 MBq), ^99mTc-pertechnetate (74 MBq) and ^99mTc-tetrofosmin (555–740 MBq) scintigraphy in a single session. Image analysis included the computation of the thyroid/background ratio in the whole study population and the parathyroid/background ratio, parathyroid/thyroid ratio and diagnostic sensitivity in 17 patients who underwent parathyroid surgery. The pertechnetate subtraction technique was used. ²⁰¹Tl and ^99mTc-tetrofosmin showed a similar thyroid/background ratio (1.79±0.41 and 1.81±0.47, respectively, P=NS); however, ^99mTc-tetrofosmin showed a higher parathyroid/background ratio than ²⁰¹Tl (2.06±0.54 vs 1.79± 0.50, P=0.007). Despite the superior quality of ^99mTc-tetrofosmin images, both tracers showed identical sensitivity in detecting enlarged parathyroid glands in patients with primary hyperparathyroidism (89%) and in those with secondary hyperparathyroidism (50%).     

Quantitative analysis of cancellation tasks in neglect.

Patients with spatial neglect do not explore contralateral space effectively. Although cancellation tasks are used widely to assess this visual search deficit, their methods of analysis are not well established. We introduce logistic regression analyses for cancellation tasks in 7 patients with left neglect. We investigated the influences of spatial location, stimuli number, and target discriminability on the probability of canceling a target. As a group, neglect patients showed left and near neglect. They also explored and canceled targets further into contralateral space on arrays with fewer visual stimuli. Individual analyses revealed exceptions to these group patterns, such as two patients with far rather than near neglect. Only patients with relatively mild neglect canceled more targets when they were more easily discriminated from distracters. Logistic regression models accounted for 0.68 the variance in cancellation performances of the entire group. Shifting the unit of analysis from the proportion of targets canceled to the probability of detecting individual targets offers a powerful parametric method to analyze group and individual performances on cancellation tasks and can reveal functional dissociations in neglect.     

Increased expression of dopamine receptors on lymphocytes in Parkinson's disease.

Dopamine D1-like and D2-like receptors on peripheral blood lymphocytes (PBL) were assayed in 50 de novo patients with idiopathic Parkinson's disease (PD), in 36 neurologic control subjects (multiple-system atrophy, n = 16; essential tremor, n = 10; other neurodegenerative diseases, n = 10), and in 26 healthy control subjects by radioligand binding assay techniques using [3H]SCH 23390 and [3H]7OH-DPAT as ligands. Patients with PD revealed a higher density (Bmax) of dopamine D1-like (p <0.001) and D2-like (p <0.00001) receptors on PBL than either neurologic or healthy control subjects, whereas no differences in Bmax were observed among patients affected by other neurologic diseases and healthy control subjects. The affinity (Kd) of both radioligands was similar in the groups investigated. The pharmacologic profile of [3H]SCH 23390 and [3H]7OH-DPAT binding was consistent with the labeling of dopamine D5 and D3 receptor subtypes, respectively. Twenty-five of the 50 patients with PD were retested after 3 months of therapy with levodopa or bromocriptine. Both treatments reduced the density of D1-like (p <0.001) and D2-like (p <0.001) receptors on PBL to values comparable to those of control subjects. The increased density of D1-like and D2-like receptors on PBL in de novo PD patients may represent an upregulation mechanism resulting from the diffuse impairment of the dopaminergic system in PD.     

Dopamine D1-like receptor subtypes in human peripheral blood lymphocytes.

Molecular biology studies have shown that human peripheral blood lymphocytes express a dopamine D5 receptor, whereas no information is available on dopamine D receptor, the other dopamine D1-like receptor subtype. Radioligand binding assay investigations with the nonsubtype selective dopamine D1-like receptor antagonist [3H]SCH 23390 as radioligand have suggested the presence of a dopamine D5 receptor in human peripheral blood lymphocytes. However, so far no evidence was provided as whether or not human peripheral blood lymphocytes express a dopamine D1 receptor. In this study, we have investigated dopamine D1 and D5 receptor mRNA and the influence of antibodies against dopamine D1 and D5 receptors on [3H]SCH 23390 binding to intact human peripheral blood lymphocytes. The two receptors were also analyzed by immunocytochemistry. Dopamine D5 receptor, but not D1 mRNA, was detected in human peripheral blood lymphocytes. Anti-dopamine D5 receptor antibodies, but not anti-dopamine D1 receptor antibodies, significantly decreased [3H]SCH 23390 binding to human peripheral blood lymphocytes. A dark-brown immunoreactivity was visualized in cytospin centrifuged human peripheral blood lymphocytes exposed to anti-dopamine D5, but not to anti-dopamine D1 receptor antibodies. These data collectively indicate that dopamine D5 receptor is the only dopamine D1-like receptor subtype expressed by human peripheral blood lymphocytes.