Persistent reversed end diastolic flow in the fetal middle cerebral artery: an ominous finding

Fetal persistent middle cerebral artery reversed end diastolic flow is a rare and ominous finding. Previous cases have been associated with intracranial hemorrhage, growth restriction, anaemia, and hepatic anomaly. Intrauterine demise or early neonatal death is a common outcome. We report the case of persistent middle cerebral artery reversed end diastolic flow in a well-grown fetus at 32 weeks’ gestation resulting from acute, severe anaemia due to a large feto-maternal hemorrhage. An emergency cesarean section was performed and the neonate required advanced resuscitation and immediate blood transfusion. Postnatal magnetic resonance imaging confirmed a hemorrhagic parietal infarct and bilateral ischaemic changes in the basal ganglia. This provides further evidence that persistent middle cerebral artery reversed end diastolic flow in any fetus is an ominous finding warranting urgent diagnostic evaluation and/or delivery.     

Interleukin-3 treatment of rhesus monkeys leads to increased production of histamine-releasing cells that express interleukin-3 receptors at high levels

To understand the hematopoietic and nonhematopoietic responses to interleukin-3 (IL-3), expression of cell-surface IL-3 receptors (IL-3R) was examined on bone marrow (BM) cells and peripheral blood (PB) cells of rhesus monkeys during the course of in vivo IL-3 treatment. Whereas IL-3R expression is low in untreated monkeys, IL-3 administration led to a gradual increase in both low- and high-affinity binding sites for IL-3. This increase reflected the total number of cells expressing IL- 3Rs, as detected by flow cytometry using biotinylated IL-3. Most of these IL-3R+ cells in both BM and PB could be characterized as basophilic granulocytes that contained high levels of histamine. In contrast to the effect on these differentiated cells, IL-3 administration did not significantly alter the low level IL-3R expression on immature, CD34+ cells. Further flow cytometric analysis using biotinylated growth factors showed that the IL-3R+ basophils also expressed receptors for granulocyte-macrophage colony-stimulating factor (GM-CSF), but not for IL-6 or Kit ligand. These findings indicated that the IL-3R+ cells included neither monocytes, which express GM-CSFRs and IL-6Rs abundantly, nor mast cells, which express c- kit. By combining flow cytometric and Scatchard data, it was calculated that the basophils contain as many as 1 to 2 x 10(3) high-affinity IL- 3Rs and 15 to 30 x 10(3) low-affinity sites. The finding that in vivo IL-3 treatment leads to the production of large numbers of cells that express high levels of IL-3R and are capable of producing histamine provides an explanation for the often severe allergic reactions that occur during prolonged IL-3 administration. It also indicates that IL- 3, in addition to its direct effects on hematopoietic cells, may also stimulate hematopoiesis through the release of secondary mediators such as histamine by IL-3-responsive mature cells.     

Expanding the role of the genetic counselor

The basic components of genetic counseling are informational and educational. The patient's cognitive and emotional presentation and the needs and concerns of the patient are seldom addressed. Females who carry the FMR1 pre and full gene mutation may present with learning, cognitive, and/or emotional difficulties and family members of those diagnosed with fragile X syndrome have ongoing needs and concerns. As a result, genetic counseling for fragile X syndrome offers a unique opportunity within which to expand the role of the genetic counselor. Q-methodology, by using the q-sort, is centered on the family to reproduce the needs and concerns that are consistent with the patient's own experience. Used for sociological research, the q-methodology with specially constructed q-sort items is easily adapted to the genetic counseling setting © ^{1995 Flynn & Gane} and can be used for directly assessing the patient's needs and concerns. For our pilot study, 16 items were physically sorted and ranked interdependently by the patient (subject). Thirty-seven patients (29 females and 8 males) participated in our pilot study. Preliminary results show that the age of the proband, length of time of the diagnosis, and parental sex at the time the q-sort is administered impacts the ranking of items thus differentiating needs and concerns. Results have shown that specific items are missing from the lives of subjects. From the information obtained from the q-sort, the genetic counselor can identify needs and concerns of the patient and combine this information with the clinical presentation to work with the patient in a more effective manner. © 1996 Wiley-Liss, Inc.     

Creatine supplementation improves muscular performance in older men

PURPOSE: Creatine supplementation has been shown to enhance muscle strength and power after only 5-7 d in young adults. Creatine supplementation could therefore benefit older individuals because aging is associated with a decrease in muscle strength and explosive power. METHODS: We examined the effects of 7 d of creatine supplementation in normally active older men (59-72 yr) by using a double-blind, placebo-controlled design with repeated measures. After a 3-wk familiarization period to minimize learning effects, a battery of tests was completed on three occasions separated by 7 d (T1, T2, and T3). After T1, subjects were matched and randomly assigned into creatine (N = 10) and placebo (N = 8) groups. After T2, subjects consumed supplements (0.3 g x kg(-1) x d(-1)) for 7 d until T3. All subjects were tested for maximal dynamic strength (one-repetition maximum leg press and bench press), maximal isometric strength (knee extension/flexion), upper- and lower-body explosive power (6 x 10-s sprints on a cycle ergometer), and lower-extremity functional ability (timed sit-stand test and tandem gait test). Body composition was assessed via hydrostatic weighing, and blood samples were obtained to assess renal and hepatic responses and muscle creatine concentrations. RESULTS: No significant increases in any performance measures were observed from T1 to T2 with the exception of isometric right-knee flexion in the placebo group indicating stability in the testing protocols. Significant group-by -time interactions indicated the responses from T2 to T3 were significantly greater (P 相似文献   

Early pregnancy complications: endovaginal sonographic findings correlated with human chorionic gonadotropin levels

Endovaginal sonography results were compared with quantitatively determined human chorionic gonadotropin (hCG) levels in 84 women referred for early pregnancy complications. Of the 27 with normal intrauterine pregnancies, an intrauterine gestational sac was prospectively identified in one of five cases (20%) in which hCG levels were below 500 IU/L (Second International Standard), four of five (80%) with hCG levels of 500-1,000 IU/L, and all 17 with hCG levels above 1,000 IU/L. In comparison, 17 of the 26 women with ectopic pregnancies (65%) had hCG levels greater than 1,000 IU/L, and none of the 26 had an intrauterine gestational sac. Endovaginal sonography demonstrated an adnexal mass and/or a gestational sac-like structure in 16 of the 17 cases (94%) in which hCG levels were above 1,000 IU/L, compared with only three of the nine (33%) with lower hCG levels (P less than .01). These findings indicate that an intrauterine gestational sac should be normally visualized with endovaginal sonography when the hCG level exceeds 1,000 IU/L, and that visualization of an extrauterine gestational sac and/or adnexal mass is significantly more likely in ectopic pregnancies when the hCG level exceeds 1,000 IU/L.     

A comparison of energy expenditure during rowing and cycling ergometry

Metabolic and cardiorespiratory responses of healthy adults were compared at similar incremental power outputs during a variable-resistance rowing exercise and a fixed-resistance cycle ergometer exercise. Repeated measurements of power (watts), VEBTPS, VO2 STPD, and HR were obtained on 60 men and 47 women ranging in age from 20 to 74 yr. Average maximal power output for the men was significantly higher (P less than 0.05) for cycling than rowing: 207 +/- 5.2 W vs 195 +/- 58 W (mean +/- SE). A similar difference was also observed for women favoring cycling: 135 +/- 4.1 W vs 126 +/- 4.9 W (mean +/- SE). VEBTPS, VO2 STPD, and HR were significantly higher at all power increments during the rowing graded exercise test (RGXT) when compared with the same exercise intensity during the cycle graded exercise test (CGXT). Consistent linearity was found between VEBTPS and VO2 STPD and between HR and VO2 STPD for both exercises. The linear relationship between VEBTPS and VO2 STPD for men during RGXT was r = 0.976, P less than 0.001, slope = 44.6 +/- 1.03, and for women during RGXT it was r = 0.990, P less than 0.001, slope = 19.6 +/- 0.36. The relationship between HR and VO2 STPD for men during rowing was r = 0.989, P less than 0.001, slope = 29.1 +/- 0.76, and for women during rowing it was r = 0.971, P less than 0.001, slope = 35.7 +/- 0.89. The linear relationship between VEBTPS and VO2 STPD for men during CGXT was r = 0.991, P less than 0.001, slope = 31.1 +/- 0.98, and for women it was r = 0.959, P less than 0.991, slope = 29.6 +/- 0.87. The relationship between HR and VO2 STPD for men during CGXT was r = 0.997, P less than 0.001, slope = 28.1 +/- 0.83, and for women it was r = 0.990, R less than 0.001, slope = 35.9 +/- 0.96. Results indicated that energy costs for rowing ergometry was significantly higher than cycle ergometry at all comparative power outputs including maximum levels. It was concluded that rowing ergometry could be an effective alternative activity for physical fitness and exercise rehabilitation programs.     

马兜铃酸的倍半萜的酯类化合物VI.绵毛马兜铃中马兜铃酸萜酯I的结构鉴定

从绵毛马兜铃(Aristolocha mannisima Hance)中分得一个马兜铃酸倍半萜的酯类化合物,经红外、紫外、高分辩质谱和多种一维和二维核磁共振谱鉴定,确定了其骨架结构及顺反构型,命名为马兜铃酸萜酯I。