Dual marker one day pancreolauryl test

There is a pressing need for a simple non-invasive test of exocrine pancreatic function for use in children. The pancreolauryl test has been modified by the addition of a second marker (mannitol) to achieve a single day test without the need for two timed urine collections. Six healthy subjects and nine patients with cystic fibrosis were studied. Fluorescein, fluorescein dilaurate, and mannitol were taken by mouth, alone or in combinations, followed by 10 hour urine collections in two hourly aliquots to study the comparative pharmacokinetics of these markers. Urinary fluorescein was determined spectrophotometrically and urinary mannitol enzymatically. When fluorescein dilaurate and mannitol were taken together and the results expressed as ratios of percentage fluorescein to percentage mannitol recovery (F:M ratio) (mean (SD)) there was clear discrimination between healthy subjects and those with cystic fibrosis regardless of enzyme replacement treatment (57.3 (18.2) v 3.4 (1.4) v 3.2 (1.6) respectively). The differences in F:M ratios reached statistical significance in urinary aliquots collected between two and eight hours after marker ingestion. This single day tubeless test will greatly simplify the investigation of the child with suspected exocrine pancreatic dysfunction.     

Abdominal venous system: assessment using MR

Twenty-five patients with known or suspected evidence of venous disease based on results of computed tomography, angiography, or ultrasound were imaged with magnetic resonance (MR) to determine the MR characterization of venous abnormalities. MR findings were proved by laparotomy or autopsy in 18 of 25 cases. In seven of 25 patients in whom only biopsy was performed, the MR findings were correlated with findings from other radiologic tests. On MR, the inferior vena cava (IVC), portal vein, and their major tributaries were seen in all but two cases. In those two, identification of collaterals led to the correct diagnosis of splenic vein thrombosis in one case and left renal vein thrombosis in another. MR imaging helped identify intraluminal thrombi in the IVC (12 of 12 cases), portal vein (two of two cases), renal veins (seven of seven cases), superior mesenteric vein (one case), and iliac veins (seven of seven cases). Intraluminal signal intensity secondary to slow blood flow seen in five patients was always differentiated from the thrombus. MR imaging helped identify correctly the nature of the thrombus in 11 of 16 patients. In five patients, the differentiation between tumor thrombus and blood clot thrombus was not possible. Involvement of the IVC wall by tumor was seen in four cases. MR imaging also accurately depicted slow flow in obstructed or constricted veins; encasement, compression, or displacement of veins without intraluminal occlusions; and the presence of venous collaterals. The MR imaging evaluation of venous abnormalities is accurate, easily performed, and will probably become an important application.     

间硝地平对高血压心肌肥厚老龄鼠肾和肺细胞膜二氢吡啶受体的影响

间硝地平对高血压心肌肥厚老龄鼠肾和肺细胞膜二氢吡啶受体的影响徐毅，奚涛，饶曼人（南京医科大学心血管药理研究室２１００２９）间硝地平（ｍ－ｎｉｆｅｄｉｐｉｎｅ，ｍ－Ｎｉｆ）系我国研制的二氢吡啶（ＤＨＰ）类钙拮抗剂，有扩张血管、降低血压和逆转高血压心肌肥...     

Follow-up chest radiographs in Vietnam veterans: are they useful?

Agent Orange exposure and its long-term health consequences on Vietnam veterans have been widely discussed in the past few years. Myriad physical and mental disabilities have been studied with regard to exposure to various herbicides. The number of persons potentially exposed is large, since 2.4-2.8 million U.S. military personnel served in Vietnam. A case-control study was undertaken to determine if persons who served in the U.S. military in Vietnam have either cardiovascular or pulmonary effects that can be demonstrated on long-term follow-up chest radiographs. Information regarding military service in Vietnam was obtained from interviews and, in some cases, review of military records. Vietnam veterans did not have an increased prevalence of abnormalities on follow-up chest radiographs. A subset of Vietnam veterans who had greater estimated opportunities for Agent Orange exposure also did not appear to be at greater risk than the control population.     

Dermatomyositis after interferon alpha treatment

An association between auto-immune disorders and interferon (IFN) has been reported. High levels of natural IFNα are present in the blood of patients with auto-immune disease and correlate with disease activity. In addition, IFNα treatment of humans has resulted in multiple reports of associatied auto-immune phenomena. We describe a patient who underwent resection of regionally metastatic melanoma, was given adjuvant high-dose IFNα2b, and subsequently developed dermatomyositis. To the author's knowledge this is the first report of dermatomyositis in association with IFNα treatment. We review the literature reporting associations between IFNα and auto-immune disease and discuss possible mechanisms by which IFNα may contribute to the development of auto-immune disease. High dose IFNα2b is more commonly prescribed since it was approved as an adjuvant treatment for patients with surgically resected high-risk melanoma. The potential for cases of IFN-associated autoimmune disease is therefore a clinical concern. Standard side effects of high-dose IFN therapy resemble symptoms of auto-immune diseases, which may make prompt diagnosis difficult. Therefore, it is important that auto-immune diseases such as dermatomyositis are recognized as potential side effects of treatment with high-dose IFNα.     

椎弓崩裂症的MRI诊断

目的：分析椎弓崩裂症的MRI表现，并探讨MR诊断椎弓崩裂症的价值。方法：笔者收集40例本室自1995年8月至2000年6月MR检查诊为椎弓崩裂的病例，使用SIEMENS IMPAC1．0TMR机，采用脊柱线圈，自旋回波和快速自旋回波序列扫描，结果：显示椎弓崩裂发生于腰4、5椎体，大部分双侧受累（35例），双侧受累者较单侧受累者滑脱的发生率高，椎弓崩裂均位于椎弓峡部，表现为椎弓峡部骨皮质及髓质信号均不连贯，显示如下MR征象：断裂处呈线状；断裂处上下两端分离；断裂处下端后移，部分病例成角移位。结论：MRI检查能显示椎弓崩裂的位置及上述相关的MRI征象，在日常腰椎MRI检查中，如加留意，可及早发现。