人类项韧带的精细解剖结构

目的:观察人类项韧带的精细解剖结构及形态。方法:实验于2004-09/2005-04在大连医科大学解剖教研室及大连医大生物塑化有限公司科研部完成。观察对象为4具成人尸体的颈部,均有完整的颈部(椎)全段,包括颅骨后枕外隆突。其中1具尸体进行肉眼大体解剖;3具尸体取寰椎到C7水平,制作成P45(聚酯树脂)生物塑化薄片。所有标本及材料均由大连医大生物塑化有限公司及大连医科大学解剖教研室提供。观察大体标本及P45断层塑化薄片标本,记录各种新发现。最后将两部分的观察及影像结果合并,利用断层解剖知识,标注项韧带组织名称并进行分析。结果:在颈椎的不同平面,项韧带的浅层、背侧部和腹侧部分别由斜方肌、头夹肌、小(大)菱形肌和上后锯肌的腱膜纤维组成的一个整体,且绝大部分纤维走向为横行。结论:①项韧带的结缔组织纤维不是全部纵向走行的,是以横向走行为主的肌腱腱膜组织纤维。②P45生物塑化薄片技术的应用使项韧带精细解剖结构的全貌更直观。     

CARDIOPROTECTIVE EFFECT OF l-GLUTAMATE IN OBESE TYPE 2 DIABETIC ZUCKER FATTY RATS

• 1 Because diabetic hearts have an increased threshold for cardioprotection by ischaemic preconditioning (IPC), we hypothesized that protection by l ‐glutamate during reperfusion is restricted in Type 2 diabetic hearts. Previously, we found that l ‐glutamate‐mediated postischaemic cardioprotection mimics IPC.
• 2 Rat hearts were studied in a Langendorff preparation perfused with Krebs’–Henseleit solution and subjected to 40 min global no‐flow ischaemia, followed by 120 min reperfusion. l ‐Glutamate (0, 15 and 30 mmol/L) was added to the perfusate during reperfusion of hearts from non‐diabetic (Wistar‐Kyoto) and diabetic (Zucker diabetic fatty (ZDF)) rats, studied at 16 weeks of age. The infarct size (IS)/area‐at‐risk (AAR) ratio was the primary end‐point. Expression of l ‐glutamate excitatory amino acid transporter (EAAT) 1 (mitochondrial) and EAAT3 (sarcolemmal) was determined by quantitative polymerase chain reaction and immunoblotting.
• 3 The ISS/AAR ratio did not differ between control hearts from Wistar‐Kyoto and ZDF rats (0.52 ± 0.03 and 0.51 ± 0.04, respectively; P = 0.90). l ‐Glutamate (15 mmol/L) significantly reduced the IS/AAR ratio in non‐diabetic hearts, but not in diabetic hearts, compared with their respective controls. The higher concentration of l ‐glutamate (30 mmol/L) reduced infarct size in diabetic hearts to the same degree as in non‐diabetic hearts (IS/AAR 0.35 ± 0.03 (P = 0.002) and 0.34 ± 0.03 (P = 0.004), respectively). The mitochondrial l ‐glutamate transporter EAAT1 was downregulated in hearts from ZDF rats at both the mRNA and protein levels (P < 0.0005 and P < 0.0001, respectively). However, there was no change in EAAT3 expression at the protein level. Myocardial l ‐glutamate content was increased by 43% in diabetic hearts (P < 0.0001).
• 4 Hearts from obese diabetic rats have an elevated threshold for metabolic postischaemic cardioprotection by l ‐glutamate. These findings may reflect underlying mechanisms of inherent resistance against additional cardioprotection in the diabetic heart.

     

Congenital gastrointestinal defects in Down syndrome: a report from the Atlanta and National Down Syndrome Projects

We report Down syndrome (DS)-associated congenital gastrointestinal (GI) defects identified during a 15 year, population-based study of the etiology and phenotypic consequences of trisomy 21. Between 1989 and 2004, six sites collected DNA, clinical and epidemiological information on live-born infants with standard trisomy 21 and their parents. We used chi-squared test and logistic regression to explore relationships between congenital GI defects and infant sex, race, maternal age, origin of the extra chromosome 21, and presence of a congenital heart defect. Congenital GI defects were present in 6.7% of 1892 eligible infants in this large, ethnically diverse, population-based study of DS. Defects included esophageal atresia/tracheoesophageal fistula (0.4%), pyloric stenosis (0.3%), duodenal stenosis/atresia (3.9%), Hirschsprung disease (0.8%), and anal stenosis/atresia (1.0%). We found no statistically significant associations between these defects and the factors examined. Although not significant, esophageal atresia was observed more often in infants of younger mothers and Hispanics, Hirschsprung disease was more frequent in males and in infants of younger mothers and blacks, and anal stenosis/atresia was found more often among females and Asians.     

Comparative evaluation of gustatory function between postmenopausal women and age‐matched men

Oral Diseases (2010) 16 , 469–475 Objective: The aim of the study was to compare the gustatory function between postmenopausal women and age‐matched men. Subjects and methods: During a period of 4 months, 30 postmenopausal women and 30 age‐matched men were prospectively evaluated for gustatory function. Each subject was given a symptoms questionnaire for self‐assessment of taste function. Then, whole mouth taste test was performed in which the quality identification and intensity ratings of taste solutions were measured. Results: Regarding correct quality identification, the results were statistically non‐significant (P > 0.05). As far as the intensity judgments are concerned, significant difference exists between postmenopausal women and age‐matched men. Intensity of taste perception for sucrose was significantly lower in postmenopausal women than intensity of taste perception for other tastes (P < 0.05). One of the noticeable findings is that 15 (50%) postmenopausal women reported a change in dietary habits; all expressed liking for sweeter food. Conclusion: Postmenopausal women appeared to have a reduced perception of sucrose, which can alter eating habits, such as intake of more sweet foods, whereas no significant difference is observed in taste perception of NaCl, citric acid and quinine hydrochloride between postmenopausal women and age‐matched men. Fifteen (50%) postmenopausal women stated fondness for sweet taste.     

MANAGEMENT OF CONGENITAL ATRESIA EAR

A total of 3 out of 5 cases of major congenital ear malformation seen in out patient department in two years in 1997 and 1998 were operated for functional reconstruction of external auditory canal, middle ear and ossicular chain. 2 cases of bilateral malformation of auricle grade 2 were advised otoplastic repair prior to tympanoplasty. Out of the 3 cases operated by anterior transatretic bone approach, 2 cases had good hearing improvement in air conduction threshold of up to 30 db hearing level (averages of 0.5,1.2 and 3 khz). One case developed external canal stenosis by six months post operatively and drop in hearing. There was no facial nerve injury in any of the cases. This paper analyses the importance of facial nerve delineation preoperatively based on its embryological development and its relationship with temporal bone and membranous labyrinth. It also focuses on the various parameters like timing of surgery, importance of (CT) scanning, use of facial nerve monitor and surgical expertise and experience which govern the surgical intervention and its results in congenital ear atresia.KEY WORDS: Congenital ear atresia, Facial nerve, Transatretic bone approach     

Long‐term high‐physiological‐dose growth hormone reduces intra‐abdominal fat in HIV‐infected patients with a neutral effect on glucose metabolism

Objectives

The aim of the study was to investigate the effect of long‐term high‐physiological‐dose recombinant human growth hormone (rhGH) therapy on fat distribution and glucose metabolism in HIV‐infected patients.

Methods

Forty‐six HIV‐infected Caucasian men on highly active antiretroviral therapy (HAART), with an age range of 21–60 years and no significant comorbidity, were included in this randomized, placebo‐controlled, double‐blind, single‐centre trial. Twenty‐eight subjects were randomized to 0.7 mg/day rhGH, and 18 subjects to placebo, administered as daily subcutaneous injections between 1 and 3 pm for 40 weeks. Endpoints included changes in visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), limb fat mass, percentage of limb fat, plasma lipids, insulin resistance and glucose tolerance.

Results

VAT and trunk fat mass decreased significantly in the GH group compared with the placebo group [−19 cm² (−11%) vs. 12 cm² (6%), P=0.03, and −548 g (−9%) vs. 353 g (6%), P<0.01, respectively]. The beneficial fat redistribution in the GH group occurred without concomitant changes in subcutaneous fat at the abdomen or extremities. rhGH therapy was well tolerated. Insulin resistance, glucose tolerance, and total plasma cholesterol and triglycerides did not significantly change during intervention.

Conclusions

Daily 0.7 mg rhGH treatment for 40 weeks reduced abdominal visceral fat and trunk fat mass in HIV‐infected patients. This treatment appeared to be safe with respect to glucose tolerance and insulin sensitivity.

     

Prevalence and risk factors of erectile dysfunction in Niger delta region, Nigeria

Background

Erectile Dysfunction (ED) is one of the major social problems causing significant distress in men. Despite the increasing difficulty in management, knowledge, and understanding of factors responsible for its development are important for prevention and care.

Objectives

To assess the prevalence and risk factors for ED among men in Niger Delta Region of Nigeria, in order to determine its contextual variables.

Methods

Subjects included 400 male patients attending the general outpatients'' clinic (GOPC) of the University of Uyo Teaching Hospital. Respondents completed the abridged version of the International Index of Erectile Function (IIEF-5).

Results

A total of 166 (41.5%) subjects had ED; 66 (16.5%) had mild; 32 (8.0%) mild to moderate; 24 (6.0%) moderate; while 45 (11.3%) had severe 37 (9.2%) resulted from hypertension and its medications; 29 (7.3%) from diabetes; 49 (12.2%) from a combination of both and their therapies (P=0.044); 24 (6.0%) had history of previous surgery; while for 27 (6.8%) it was from undiagnosed medical conditions (p=0.001). The ED increases with age and is more among married and educated men.

Conclusion

ED is a common problem among men in Niger Delta region. Therefore, efforts must be made to reduce the incidence by dealing with the factors responsible for its development.