AIRWAY OBSTRUCTION IN CHILDREN

Seventeen children presenting with airway obstruction have been studied to highlight the similar clinical features of different etiological conditions, their diagnostic limitations, and the importance of early bronchoscopy. There were 8 patients with foreign body in lower airway, out of which 6 were vegetable foreign bodies. Few rarer conditions like membranous laryngotracheobronchitis, subglottic hemangioma and acyanotic congenital heart disease producing airway obstruction have been highlighted. There were 2 deaths in the study unrelated to endoscopic procedure.KEY WORDS: Airway obstruction, Bronchoscopy     

金艾康合并化学药物治疗肿瘤临床疗效观察

目的：探讨金艾康（汉防己甲素片）合用化学药物治疗肿瘤的临床增效作用。方法：通过比较治疗组与对照组（金艾康合并化学药物者为治疗组,单用化学药物者为对照组,每组各为３０例）的总缓解率与毒副反应来评价金艾康对化疗药物的增效作用。结果：治疗组与对照组的总缓解率分别为８０％与６６．７％,其中部分毒副反应如消化道反应与肢端订木症状等治疗组明显低于对照组。结论：金艾康具有对化学药物治疗肿瘤增效作用,其作用机理可     

Switch movements and the myosin crossbridge stroke

The myosin II motor from Dictyostelium discoideum has been engineered to contain single tryptophan residues at strategic locations to probe movements of switch 1 and switch 2. The tryptophan residue at W501 probes movement of the relay helix and indirectly reports on switch 2 movement. This probe suggests that there is an equilibrium between the switch 2 open- and closed-states when the γ-phosphate position is occupied. Actin does not appear to greatly affect this equilibrium directly, but has indirect influence via switch 1. The latter region has been probed by introducing tryptophan residues at positions 239 and 242. The kinetics of the actomyosin ATPase in solution is discussed with respect to recent crossbridge models based on high-resolution crystal structures. To whom correspondence should be addressed: Tel.: +44-(0)-116-229-7048; Fax: +44-(0)-116-229-7018; E-mail: crb5@le.ac.uk     

Immune privilege induced by cotransplantation of islet and allogeneic testicular cells

Objective To induce islet allograft long- term survival through cotransplantation of islet cells with sertoli cells. Methods Testicular sertoli cells were prepared by digestion with collagenase, trypsin an d DNase, and were cultured for 48 hours. Collagenase digested and Ficoll purifi ed donor (Wistar rat) islets were cotransplanted with allogeneic sertoli cells i n the absence of systemic immunosuppression. Terminal deoxynucleotidyl transfer ase- mediated X- dUTP nick- end labeling (TUNEL) was used to label apoptosis of lymphocytes surrounding the islet graft. Results Cotransplantation of islets and 1×10(7) sertoli cells reversed the diabetic sta te for more than 60 days in 100% (6/6) of the chemically diabetic Sprague Dawley rats. Grafts consisting of islets alone or islets plus 1×10(5) sertoli cells survived only for 5-6 days. Apoptosis of lymphocytes surrounding the islets was quite clear. Conclusion Cotransplantation of islets with FasL［+］ sertoli cells induces local immune priv ilege and allows long- term graft survival without systemic immunosuppression.     

Prevalence of osteoporosis and incidence of hip fracture in women - secular trends over 30 years

Background  

The number of hip fractures during recent decades has been reported to be increasing, partly because of an increasing proportion of elderly women in the society. However, whether changes in hip fracture annual incidence in women are attributable to secular changes in the prevalence of osteoporosis is unclear.     

Anthropometric and Dietary Evaluations in a Sample of “Healthy” Mexican Older Adults

The purpose of this study was to describe anthropometric, metabolic, and nutritional characteristics in healthy elderly adults in a primary health care setting. It was conducted through a cross-sectional study of 80 subjects 60 years of age and older. After confirming healthy status, clinical, biochemical, dietetic, and anthropometric evaluations were performed. The findings indicated 22% had anemia, 22% had impaired glucose tolerance, 46% had hypertriglyceridemia, and 51% had hypercholesterolemia. More than 50% had obesity, and almost 80% had a high risk waist circumference measure. Mean energy intake was normal; however, more than 50% of participants did not have adequate intakes of potassium, calcium, magnesium, zinc, folic acid, and vitamins B₁₂ and A. Inadequate food intakes were common. Specific examples are that 16% of the subjects ate no meat/egg, 31% ate no dairy products, 56% ate no legumes, 22% ate no fruits, and 41% ate no vegetables. Additionally, 31% consumed soft drinks. Therefore, we can conclude that elderly people otherwise considered as “healthy” nonetheless had a high proportion of obesity and cardiovascular risk factors. Inadequate dietary patterns were also observed and corresponded with poor micronutrient intake.     

2型糖尿病患者强化降糖治疗的效果和预测指标

为观察2型糖尿病患者强化降糖治疗的预测指标,强化降糖对糖化血红蛋白（HbA1c）、体重、焦虑／抑郁症状、健康状况的影响,以及强化降糖使HbA1c得到改善的患者的特点,研究者收集来自TRIAD（Translating Research into Action for Diabetes）的数据并分析,对起初采用饮食、运动、口服降糖药治疗、HbA1c〉7．2％、持续治疗或强化治疗（开始或增加口服降糖药种类或开始胰岛素治疗）超过18个月的患者进行检查。     

Fluconazole compared with endoscopy for human immunodeficiency virus- infected patients with esophageal symptoms

BACKGROUND & AIMS: The best initial treatment of human immunodeficiency virus (HIV)-infected patients with esophageal symptoms is unknown. The outcome, including safety and cost-effectiveness, of fluconazole compared with endoscopy as a treatment strategy for HIV-infected patients with new-onset esophageal symptoms was evaluated. METHODS: During a 53-month period, 134 HIV-infected patients with esophageal symptoms were randomized prospectively to groups receiving either standard doses of fluconazole or endoscopy. RESULTS: Among the 68 patients in the fluconazole group, a complete symptomatic response was observed in 56 patients (82%), usually within 1 week. The most common endoscopic findings in the 66 patients in the endoscopy group included Candida esophagitis alone in 42 patients (64%) and ulcerative esophagitis in 10 patients (15%). Patients responding to empirical antifungal therapy or who had Candida esophagitis alone at endoscopy were less like to have severe symptoms (P = 0.027) or odynophagia as the only symptom (P < 0.001) but more frequently had odynophagia and dysphagia (P = 0.007) and thrush (P = 0.002). Empirical fluconazole was cost-effective, saving $738.16 per patient. CONCLUSIONS: Empirical oral antifungal therapy with fluconazole is highly efficacious, safe, and cost-effective for HIV-infected patients with new-onset esophageal symptoms. (Gastroenterology 1996 Jun;110(6):1803-9)