Treatment of the infected pseudoarthrosis of the tibia by the Harmon method]

The principles of treatment of tibial pseudoarthroses complicated by skin and soft tissue loss with the use of cancellous bone grafts from posterolateral approach to the tibia by Harmon method were discussed. The detailed surgical technique was presented. Management of 3 patients that resulted in bone union was described.     

Ethanol-induced inhibition of testosterone biosynthesis in rat Leydig cells: role of mitochondrial substrate shuttles and citrate

The mechanisms by which ethanol inhibits testicular testosterone synthesis in rats were studied in vitro using isolated rat Leydig cells. The ethanol-induced inhibition was reversed by 4-methylpyrazole, an alcohol dehydrogenase inhibitor, suggesting that ethanol metabolism was responsible for this inhibition. L-glutamate and pyruvate, when added to the Krebs-Ringer incubation medium, reversed the inhibition by ethanol. The membrane glutamate receptor agonists kainic acid and quisqualic acid had no effects, indicating metabolic mechanisms for the L-glutamate action. This was verified also by observations that the metabolic transaminase inhibitors aminooxyacetate and cycloserine inhibited testosterone synthesis. In the amino acid supplemented Krebs-Ringer, pyruvate could not fully prevent inhibition by ethanol alone, but addition of L-glutamate to this medium abolished ethanol-induced inhibition. Experiments performed using a new inhibitor of testosterone biosynthesis in intact Leydig cells, triethylcitrate, indicated that active citrate metabolism, and/or efflux from mitochondria, was essential for the steroidogenic pathway from pregnenolone to testosterone in the smooth endoplasmic reticulum. The early steps of hCG stimulation before pregnenolone formation were most sensitive to its effect. Our results indicate that the inhibition of steroidogenesis by ethanol results from decreased availability of the metabolites involved in the substrate shuttles maintaining the NAD(P)H redox states between the mitochondrial and the smooth endoplasmic reticulum compartments, and that the inhibition can be overcome by a proper selection of exogenous sources for these metabolites.     

松龄血脉康抑制肺动脉高压的实验研究

为观察松龄血脉康胶囊对肺动脉高压大鼠肺动脉压的影响，取１００只健康Ｗｉｓｔａｒ大鼠，其中６０只背部注射野百合碱ｍｏｎｏｃｒｏｔａｌｉｎｅ，ＭＣＴ８０ｍｇ／ｋｇ复制出肺动脉高压模型。再将其分为两组，各３０只，其中一组以标准饲料喂养，另一组加用松龄血脉康胶囊１．５ｇ·ｋｇ－１·ｄ－１。其余４０只健康大鼠做为正常对照组，在实验当天、７天、１４天、２１天、２８天、３５天从各组中随机抽取５只行右心导管测肺动脉压。结果：注射ＭＣＴ后肺高压组２８天时达高峰，但加用松龄血脉康组上升幅度明显小于未用药组。结论：松龄血脉康有显著抑制大鼠肺动脉高压发展的作用     

改良哈氏棒治疗胸腰段脊柱不稳定骨折

本文报告了作者研制的改良哈氏棒治疗胸腰段脊柱不稳定骨折的临床效果。１９９１年１月～１９９４年１０月，治疗２６例，伤椎椎体前缘高度从４１．９１％，恢复至９５．５７％，椎体后缘高度从８１．０３％恢复至１００％，后凸畸形（Ｃｏｂｂ氏法）从２６°恢复至５°，有５例恢复前凸８°～１０°，神经功能恢复１．８级（Ｆｒａｎｋｅｌ分级）。作者认为回复生理前凸的纵轴上纵向撑开力，更有助于胸腰段脊柱骨折的解剖复位。     

Intracerebroventricular injection of choline increases plasma oxytocin levels in conscious rats

In the present study, we examined the effect of intracerebroventricularly (i.c.v.) injected choline on both basal and stimulated oxytocin release in conscious rats. I.c.v. injection of choline (50–150 μg) caused time- and dose-dependent increases in plasma oxytocin levels under normal conditions. The increase in plasma oxytocin levels in response to i.c.v. choline (150 μg) was greatly attenuated by the pretreatment of rats with atropine (10 μg; i.c.v.), muscarinic receptor antagonist. Mecamylamine (50 μg; i.c.v.), a nicotinic receptor antagonist, failed to suppress the effect of 150 μg choline on oxytocin levels. Pretreatment of rats with 20 μg of hemicholinium-3 (HC-3), a specific inhibitor of choline uptake into nerve terminals, greatly attenuated the increase in plasma oxytocin levels in response to i.c.v. choline injection. Osmotic stimuli induced by either oral administration of 1 ml hypertonic saline (3 M) following 24-h dehydration of rats (type 1) or an i.c.v. injection of hypertonic saline (1 M) (type 2) increased plasma oxytocin levels significantly, but hemorrhage did not alter basal oxytocin concentrations. The i.c.v. injection of choline (50, 150 μg) under these conditions caused an additional and significant increase in plasma oxytocin concentrations beyond that produced by choline in normal conditions. These data show that choline can increase plasma oxytocin concentrations through the stimulation of central cholinergic muscarinic receptors by presynaptic mechanisms and enhance the stimulated oxytocin release.     

Factors determining the relationship between renal and hepatic excretion of xenobiotics

Relation between kidney and liver in the excretion of drugs depends on the physicochemical properties of each substance tested. The calculations of this relationship are based on a so-called rank coefficient (0-100) calculated from molecular weight, lipophilicity, degree of dissociation under physiological conditions, and protein binding rate. The results of the correlation between one of these physicochemical values and drug elimination were stochastically. Experiments were performed with 9 test substances which were distinctly different concerning their physicochemical features. Substances with a rank coefficient less than 20 (low molecular weight, low lipophilicity, preferentially ionic at pH 7.4) are eliminated effectively via the kidney. Compounds having an intermediate rank coefficient (40-60) were quantitatively excreted into urine as well. For drugs with high ranks greater than 60 (high values of molecular weight, protein binding, and lipophilicity, almost exclusively nonionic), renal excretion can be neglected. Quite inverse relations between ranks and hepatic excretion have been found: low ranks indicate an ineffective secretion of the respective drug into bile. With increasing ranks (40-60), biliary excretion increases and reaches a maximum (approximately 40% of supply). This maximum is caused by limited hepatic blood flow and by the capacity of hepatic uptake carriers. Blockade of one elimination pathway (bilateral nephrectomy or bile duct ligation) is followed by a sufficient compensation of drug excretion via the alternative elimination route only, if the test substance belongs to the intermediate group (ranks between 40 and 60). For substances with high or low ranks a compensation of drug excretion can be excluded.     

Late toxic effects of long-term exposure to lindane in peripheral blood cells in rabbits. II. Erythrocyte changes.

After lindane administration in daily doses of 0.1 LD50 for one month (total dose 2.0 LD50) changes in the erythrocytes were found persisting for up to 4 months after withdrawal of the pesticide. A significant increase in the number of echinocytes, a greater per cent of reticulocytes, significantly raised level of denatured haemoglobin, and an increased number of erythrocytes of higher sensitivity to oxidating factors in relation to control group was observed.     

Retinal detachment. A study of a population-based patient material in Sweden 1971-1981. IV. Prediction of surgical outcome

The association between the outcome of 531 surgically treated retinal detachments (RD) and preoperative findings was studied by logistic univariate and multivariate analysis. The following factors were significantly, and negatively associated with the surgical results: 1) previous RD in the same eye, 2) pre-operative visual acuity less than 2/60, 3) cloudy ocular media and/or a poorly dilated pupil, 4) an RD area of more than three quadrants, and 5) no retinal breaks detected. In the multivariate analysis no significant association was found for 9 factors: open angle glaucoma, interval of more than 2 months between symptoms and surgery, aphakia, pre-operative hypotony, absence of demarcation lines, posterior retinal breaks, pre-operative proliferative vitreo-retinopathy, sex and age. The significant factors combined with aphakia were studied in all conceivable combinations. The estimated probability of failure varied between 4 and 93%, indicating that the most important factors were observed.     

不同剂量辛伐他汀对肾病综合征高脂血症的近期疗效

目的 :观察辛伐地他汀 -舒降之对肾病综合征高脂血症的近期疗效及安全性 ,比较不同剂量辛伐他汀的降脂作用。方法 :72例均系肾综合并高脂血症的患者 ,随机分治疗组 (5 6例 )和对照组 (16例 ) ,在积极治疗原发病的同时 ,治疗组给予服辛伐他汀每晚 5～ 2 0mg ,14例混合性高脂血症患者同时服用非诺贝特 ;对照组未用降脂药。观察治疗前及治疗后 1周、2周血脂全套 (TC ,TG ,LDL和HDL)、肝功能 (AST ,ALT ,TP和ALB)、肾功能 (BUN ,Scr)、及尿蛋白定量的变化。结果 :辛伐他汀每晚 2 0mg服用 1周可使 6 3%的患者总胆固醇 (TC)下降 33% ,服用 2周可使 84%的患者血TC降至正常 ;单用辛伐他汀在降低TC的同时 ,可使甘油三酯 (TC)下降 43.16 % ,若与非诺贝特合用可使TG下降达 6 4.2 2 % ,未见不良反应发生 ;辛伐他汀的降脂作用与剂量及用药时间密切相关 ,2 0mg >10mg >5mg ,每晚服用 5mg共 2周仅能使 6 0 %的患者TC下降 12 .5 %。结论 :辛伐他汀 (每晚 2 0mg)能安全、快速有效降低肾病综合征患者的高脂血症 ,而对减少尿蛋白、改善肾功能近期无作用