Heart rate variability response to mental arithmetic stress in patients with schizophrenia: autonomic response to stress in schizophrenia

BACKGROUND: The vulnerability-stress hypothesis is an established model of schizophrenia symptom formation. We sought to characterise the pattern of the cardiac autonomic response to mental arithmetic stress in patients with stable schizophrenia. METHODS: We performed heart rate variability (HRV) analysis on recordings obtained before, during, and after a standard test of autonomic function involving mental stress in 25 patients with DSM-IV schizophrenia (S) and 25 healthy individuals (C). RESULTS: Patients with schizophrenia had a normal response to the mental arithmetic stress test. Relative contributions of low-frequency (LF) HRV and high-frequency (HF) HRV influences on heart rate in patients were similar to controls both at rest (LF 64+/-19% (S) vs. 56+/-16% (C); HF 36+/-19% (S) vs. 44+/-16% (C), t=1.52, p=0.136) and during mental stress, with increased LF (S: 76+/-12%, C: 74+/-11%) and decreased HF (S: 24+/-12%, C: 26+/-11%) in the latter study condition. Whilst healthy persons recovered the resting pattern of HRV immediately after stress termination (LF 60+/-15%, HF 40+/-15%, F=18.5, p<0.001), in patients HRV remained unchanged throughout the observed recovery period, with larger LF (71+/-17%) and lower HF (29+/-17%) compared with baseline (F=7.3, p=0.013). CONCLUSIONS: Patients with schizophrenia exhibit a normal response to the mental arithmetic stress test as a standard test of autonomic function but in contrast with healthy individuals, they maintain stress-related changes of cardiac autonomic function beyond stimulus cessation.     

Effects of uremia and inflammation on growth hormone resistance in patients with chronic kidney diseases

Resistance to the anabolic action of growth hormone may contribute to the loss of strength and muscle mass in adult patients with chronic kidney disease. We tested this hypothesis by infusing growth hormone in patients to levels necessary to saturate hormone receptors. This led to a significant decrease of plasma potassium and amino acid levels in control and hyperkalemic patients with chronic kidney disease. These effects were completely or partially blunted in patients with elevated C-reactive protein levels. In forearm perfusion studies, growth hormone caused a further decrease in the negative potassium and protein balance of hemodialysis patients without inflammation but no effect was seen in patients with inflammation. Only IL-6 levels and age were found to be independent correlates in these growth hormone-induced variations in plasma potassium and blood amino acids. This shows that although a resistance to pharmacologic doses of growth hormone is not a general feature of patients with chronic kidney disease, there is a subgroup characterized by blunted growth hormone action. Our results support the hypothesis that uremia with inflammation, but not uremia per se, inhibits downstream growth hormone signaling contributing to muscle atrophy.     

D-cecropin B: proteolytic resistance, lethality for pathogenic fungi and binding properties.

L-Cecropin B (LCB) is a potent fungicidal peptide that is subject to proteolytic degradation by extracellular enzymes produced by Aspergillus flavus. We hypothesized that D-cecropin B (DCB), containing all D-amino acids, should resist proteolysis while retaining its fungicidal and target specificities. DCB was synthesized by solid phase methods using Fmoc chemistry. In vitro, at pH 6 x 0, DCB was lethal against the germinating conidia of A. flavus (LD90, 25 microM) and A. fumigatus (LD98, 25 microM) and for nongerminating and germinating conidia of Fusarium moniliforme (LD98, 1 x 25 microM) and F. oxysporum (LD95, 2 x 5 microM) at concentrations similar to those previously reported for LCB. It was lethal for Candida albicans with an LD98 at 12 x 5, microM. DCB was not active for the nongerminating conidia of A. fumigatus or A. flavus. Papain, trypsin, pepsin A and Staphylococcus aureus V8 protease degraded LCB but not DCB. Binding assays and circular dichroism showed DCB and LCB bound to cholesterol, ergosterol, beta-1,3-glucan, mannan and chitin. Data show that DCB retains the potent fungicidal properties of the L-form while being resistant to proteolytic enzymes that degrade the latter peptide. This study demonstrates that D-enantiomerization of cecropin B yields a novel fungicidal peptide, which resists proteolytic degradation and is lethal for pathogenic fungi.     

Roux-en-Y gastric bypass: major complications

Learning objectives To describe normal anatomy of Roux-en-Y gastric bypass (GBP) surgery. To know the spectrum of major complications, time of appearance and imaging findings. Background Roux-en-Y GBP surgery nowadays represents a successful treatment of morbid obesity. From January 1999 to June 2005, 148 patients with Roux-en-Y GBP surgery have been reviewed. Within a period of 24–72 h after surgery, upper gastrointestinal series was performed. The radiographic manifestations of normal anatomy and follow-up major complications are illustrated in this pictorial essay. We compare the CT and other imaging findings with clinical and surgical findings. Imaging findings A total of 14 follow-up major complications occurred in 9 of 148 patients. Only 3 were early complications, the other 11 were late and appeared between 1 month and 4 years. Imaging findings of stomal stenosis, gastric staple line dehiscence, leaks, jejunal and gastric wall necrosis, small bowel obstruction due to adhesions, loculated fluid collection and celiac trunk stenosis are illustrated. Conclusion It is important for the radiologist to be familiarized with the radiographic manifestations of normal anatomy and major complications after Roux-en-Y GBP. These may be life-threatening and usually appear as late complications. An adequate imaging technique and a prompt evaluation by the radiologist can help to minimize them.     

薄层扫描法测定熊胆引流物中胆汁酸含量

熊胆向以贵重药材闻名,被称之为稀有药品,为开发熊胆资源,解决熊胆奇缺问题,我校解剖教研室已成功地完成了人工引流熊胆汁技术,可随时进行人工引流获取熊胆汁。为了确定胆汁的质量指标,了解其主要成分,我们进行了引流胆汁与天然熊胆的分析。文献报道,熊胆中主要含熊去氧胆酸(ursodesoxycholic acid,UDCA)、鹅去氧胆酸(cheno desoxycholic acid,CDCA)、胆酸(cholic acid,CA)、去氧胆酸(deoxycholic,acid DCA)等。     

Iwo Jima: 50th anniversary surprise

Retained metal fragments frequently are visualized in x-ray examinations of wounded combat veterans. Retained projectiles (bullets) are seen less often because of surgical removal.