bcl～Xs基因转移联合顺氯氨铂对卵巢癌细胞生长作用的研究

目的 采用以复制缺陷型腺病毒为载体的ｂｃｌ－Ｘｓ基因（Ａｄｖ－ｂｃｌ－Ｘｓ）对卵巢癌细胞进行基因转移,同时使用顺氯氨铂,观察其对卵巢癌细胞生长的抑制作用,方法 用不同浓度的Ａｄｖ－ｂｃｌ－Ｘｓ感染卵巢癌细胞株ＮｕＴｕ－１９,同时使用顺氯氨铂,３ｄ后,用四甲基偶氮唑蓝比色法检测存活细胞,并用流式细胞仪计数细胞周期百分比。结果 Ａｄｖ－ｂｃｌ－Ｘｓ对卵巢癌细胞生长的抑制作用随病毒浓度的增加而增大,至浓     

Arteriovenous fistula of the internal maxillary artery: treatment with transarterial embolization

Six patients with arteriovenous fistulas of the internal maxillary artery were treated with transarterial embolization. The patients ranged in age from 19 to 47 years, with a mean of 26.5 years. Each had a lifelong history of symptoms suggestive of a congenital origin of symptoms. There was no history of trauma. The most common initial symptoms were bruit (83%), pulsatile mass (67%), and pain (50%). In one patient prior surgical ligation of the external carotid artery had been attempted, but it led to aggravation of headaches. All patients were treated with placement of a detachable balloon at the fistula site. In one patient the balloon migrated through the fistula, which was retreated with coils. Complete obliteration of the fistula was achieved in all patients. The follow-up ranged from 2 months to 10 years, with a mean of 5.2 years. Congenital arteriovenous fistulas of the internal maxillary artery are rare and can be treated effectively with transvascular techniques.     

Dural fistulas involving the transverse and sigmoid sinuses: results of treatment in 28 patients

Twenty-eight symptomatic dural fistulas involving the transverse and sigmoid sinuses were treated between 1978 and 1986 with a variety of treatment modalities. Occipital artery compression therapy resulted in a complete cure in two of nine patients (22%) and improvement in three of nine (33%). There were no complications from this treatment. Patients who were excluded or in whom compression therapy failed were treated with embolization alone or in conjunction with surgery. Of the 17 patients who underwent embolization alone, ten were cured and six were improved. Six patients had a combination of embolization and surgery; four patients were cured and two improved. There were three complications in this series, one related to surgery and two related to embolization.     

AIDS-MEDICOLEGAL ASPECTS

AIDS/HIV Positivity has been the most widely debated disease of this century. Reasons for this are manifold, viz-the non-availability of cure and consequent 100% mortality of a full blown case; its mode of transmission-homosexual and heterosexual activities; widespread occurrence amongst ‘main liners’; and patients receiving blood and blood products etc. These aspects have created a dreaded halo around AIDS as well as social stigma. Even the medical community is not exempt from these problems. Unfortunately, legislatures around the world, more so in India, have lagged behind in clarifying many legal issues involved by not enacting specific laws pertaining to AIDS. Consequently many legal & ethical doubts arise in the minds of doctors when confronted with a case of AIDS either in a live patient or in a dead body. In addition, the disease being incurable & 100% fatal, makes it essential to adopt effective preventive measures which in turn need thorough knowledge of social aspects of the epidemic. Certain medicolegal, and ethical aspects of the problem of AIDS are recapitulated in this article for the benefit of the medical community.KEY WORDS: Access, AIDS, Confidentiality     

Phototherapy. Short and long-term complications

Use of phototherapy for hyperbilirubinaemia in 300 consecutively treated infants has shown that minor complications are common. With a knowledge of these complications and measures taken to minimize their effects, phototherapy appears to be safe in the short term. The long-term follow-up study showed that growth, and in particular head circumference, was not affected. There was, however, a higher incidence of squints and abnormal developmental performance in those infants treated with phototherapy. This may not have been due to phototherapy usage per se. However, because of these findings, it is suggested that phototherapy should not be used indiscriminately for hyperbilirubinaemia until the results of further long-term studies are available.     

Comparison of two dengue NS1 rapid tests for sensitivity,specificity and relationship to viraemia and antibody responses

Background  

Dengue is a major public health problem in tropical and subtropical countries. Rapid and easy diagnosis of dengue can assist patient triage and care-management. The detection of DENV NS1 on rapid lateral flow tests offers a fast route to a presumptive dengue diagnosis but careful evaluations are urgently needed as more and more people use them.     

Dominantly acting ABCC8 mutations in patients with medically unresponsive hyperinsulinaemic hypoglycaemia

Flanagan SE, Kapoor RR, Banerjee I, Hall C, Smith VV, Hussain K, Ellard S. Dominantly acting ABCC8 mutations in patients with medically unresponsive hyperinsulinaemic hypoglycaemia. Recessive inactivating mutations in the ABCC8 and KCNJ11 genes encoding the adenosine triphosphate‐sensitive potassium (K_ATP) channel subunit sulphonylurea receptor 1 (SUR1) and inwardly rectifying potassium channel subunit (Kir6.2) are the most common cause of hyperinsulinaemic hypoglycaemia (HH). Most of these patients do not respond to treatment with the K_ATP channel agonist diazoxide. Dominant inactivating ABCC8 and KCNJ11 mutations are less frequent, but are usually associated with a milder form of hypoglycaemia that is responsive to diazoxide therapy. We studied five patients from four families with HH who were unresponsive to diazoxide and required a near total pancreatectomy. Mutations in KCNJ11 and ABCC8 were sought by sequencing and dosage analysis. Three novel heterozygous ABCC8 mis‐sense mutations (G1485E, D1506E and M1514K) were identified in four probands. All the mutations affect residues located within the Nucleotide Binding Domain 2 of the SUR1 subunit. Testing of family members showed that the mutations had arisen de novo with dominant inheritance in one pedigree. This study extends the clinical phenotype associated with dominant K_ATP channel mutations to include severe congenital HH requiring near total pancreatectomy in addition to a milder form of diazoxide responsive hypoglycaemia. The identification of dominant vs recessive mutations does not predict clinical course but it is important for estimating the risk of HH in future siblings and offspring.