Laparoskopische Antirefluxverfahren

Zusammenfassung. Endoskopische Antirefluxchirurgie ersetzt zunehmend die traditionellen Operationsverfahren in der Behandlung der therapierefrakt?ren gastrooesophagealen Refluxkrankheit. Diese laparoskopischen Verfahren sind jedoch technisch sehr anspruchsvoll. Komplikationen k?nnen aber durch eine sorgf?ltige Auswahl der Patienten sowie durch die geeignete chirurgische Technik minimiert werden. In jüngster Zeit wurden zahlreiche Nachuntersuchungen mit guten Langzeitergebnissen und geringen Nebenwirkungen publiziert.      

ISIS 4: Clinical Controversy Regarding Magnesium Infusion, Thrombolytic Therapy, and Acute Myocardial Infarction

Magnesium (Mg) infusions over 24 hours were given to patients with suspected acute myocardial infarction (AMI) at least 2 hours after thrombolysis. Patients showed no benefit and even some increased risk in contrast to reduction in mortality obtained by Mg therapy in smaller trials. Results of all of the studies were pooled and statistically analyzed, according to a fixed-effects model that is inappropriate for studies of different protocols. The panel concluded that further study of Mg in AMI is not needed. This conclusion has been questioned.     

毛茛甙的抗诱变作用及代谢转化

研究表明,毛茛甙可显著抑制MMC和MMS等诱变剂对沙门氏菌TA_(100)和TA_(102)回复突变作用;对MMC诱发的小鼠PEC徽核抑制率达56.5%。代谢研究表明:毛茛甙抑制DNA生物合成的作用可被肝微粒体酶和胞浆液分别降低46和12%;RP-HPLC测定显示,体外毛茛甙可被肝微粒代谢转化。     

Migration of radiolabeled, adoptively transferred T-lymphocytes into the mammary gland and milk of lactating rats

The maternal component in the transfer of cellular immunity from the mother to the neonate during lactation was investigated by analyzing the migration of adoptively transferred T-lymphocytes to the mammary gland and into the milk of lactating rats. A T-enriched cell population, containing less than 2.5% of contaminating B-cells, was obtained from mesenteric and peripheral lymph node cells of donor rats by removing B-cells with a panning technique. The T-enriched cells, radiolabeled with [3H]uridine, were injected intravenously into syngeneic lactating females, between 1 and 4 days post-partum. Samples of mesenteric and cervical lymph nodes, spleen, Peyer's patches, small intestine, and mammary gland taken at 48 h and milk obtained at 24 and 48 h were processed for scintillation counting and autoradiography. A large portion of the injected T-cells migrated to T-dependent lymphoid areas (the paracortical and medullary regions of the mesenteric and cervical lymph nodes and the Peyer's patches) and a substantial number also migrated into the small intestine and mammary gland, although the frequency of cells per high-power field was lower than in the lymph nodes. However, total counts of activity recovered were significantly higher in the small intestine and mammary gland than in either the mesenteric or cervical groups of lymph nodes. The distribution of the T-cells within the mammary gland showed a relative predominance of labeled cells in the connective tissue adjacent to the alveolar secretory cells, with a small percentage of cells present within the mammary epithelium. The direct transfer of T-cells through the alveolar epithelium was demonstrated by the presence of labeled cells in milk. These results substantiate that a significant number of T-lymphocytes migrate not only to the mammary gland during lactation but also into milk. These cells may play a passive regulatory or inductive role within the mammary gland or an active role in the maternal-to-neonatal transfer of immunity.     

Medullary nephrocalcinosis and pancreatic calcifications demonstrated by ultrasound and CT in infants after treatment with ACTH

Thirteen patients who had undergone prolonged adrenocorticotropic hormone (ACTH) therapy for infantile spasms or myoclonic encephalopathy were examined with sonography. Nine patients were found to have appearances characteristic of medullary nephrocalcinosis. In each of these infants the cortical echogenicity was normal in the presence of focal areas of increased echogenicity within the renal pyramids. Five patients also showed a homogeneously increased echogenicity of the whole pancreas on sonography, and two of these showed increased density on computed tomography. Density measurements were in the range of calcific material within the papillae and pancreatic tissue. On abdominal survey radiographs, even in retrospect no calcifications could be recognized.