Long-term effect of combination glibenclamide-insulin treatment in the secondary failure of sulfonylurea therapy--results of a one-year double blind study

The long-term efficacy of combined insulin-glibenclamide treatment was investigated in 79 secondary drug failure patients by means of a double-blind, randomized placebo-controlled study. During a one-year follow-up period the patients on insulin plus glibenclamide required significantly lower exogenous insulin doses. Coincidentally, C-peptide concentrations were significantly raised in the verum versus the placebo group. Additionally, the administration of glibenclamide resulted in a decreased level of hyperglycaemia during the first six months of the observation period. Glibenclamide withdrawal after six and again after twelve months of the combined therapy provoked a deterioration of glycaemic control, as well as a lowering of the C-peptide concentrations. The findings demonstrate a prolonged beneficial effect of the combined treatment, in contrast to the solely short-term effects predicted by numerous studies. The metabolic improvement must be ascribed in part to the beta-cytotropic effect of glibenclamide. Extrapancreatic pathways via receptor/postreceptor mechanisms cannot be excluded.     

污水中汞的微波消解冷原子吸收测定法

目的 改进冷原子吸收法测定污水中汞的消解方法。方法 采用王水（1＋1）微波消解法代替KMnO4-K2S2O8消解法测定污水中的汞。结果 王水（1＋1）微波消解水样测定污水中汞，方法的线性范围为0~10.0μg／L，检出限为0.25μg／L，相对标准偏差小于2.7％，加标回收率为95.0％-102.0%。结论 与KMnO4-K2S2O8消解法相比，该方法具有较高的灵敏度和精密度，操作简单，结果可靠，适用于环境监测分析。     

Peptic ulcer and gastric carcinoma: diagnosis with biphasic radiography compared with fiberoptic endoscopy

The diagnostic value of biphasic radiographic examination of the stomach and duodenum was compared with that of fiberoptic endoscopy in a prospective, blinded study of 385 patients with dyspepsia. This investigation was directed at gastric malignancies and peptic ulcers. Methodologically there is no absolute standard for a study of this kind because histologic examination is useful for detection of cancer but inadequate for ulcers. As an alternative, kappa indexes and the sensitivity and specificity, as derived by Hui and Walter, were calculated and compared. For the detection of gastric carcinoma, radiographic and endoscopic findings had almost perfect agreement beyond chance. For gastric ulcers, radiography and endoscopy had substantial agreement, which became perfect if small ulcers (less than 5 mm) were excluded. For duodenal ulcers, radiography had a lower sensitivity than endoscopy; this disagreement disappeared if small ulcers were excluded. Both methods have equal merit; choice of the initial diagnostic procedure will therefore depend on cost, discomfort to the patient, and risk of complications.     

Influence of a moving textured background on direction selectivity of cat striate neurons

The influence of a moving textured background on direction selectivity for a moving bar was tested in 118 striate neurons and in 19 dorsal lateral geniculate neurons of anesthetized and paralyzed cats. In the standard conditions the background was a two-dimensional noise pattern, the bar moved at optimal speed, and its contrast was adjusted to the level producing 50% of the maximum response. These experiments revealed a new typology of cortical cells based on relative direction selectivity. Six different relative-direction-selectivity types are described. Two types of cells were found to have opposite kinds of relative direction selectivity: antiphase direction-selective cells (5% of the cortical sample) preferred the direction of the bar opposite to the direction of background motion, and absolutely direction-selective cells (20% of the cortical sample) kept their direction selectivity for bar motion independently of the background motion. Three types of cortical cells were direction selective for bar motion only in restricted background motion conditions: conditionally direction-selective cells (20% of cortical sample) only expressed their direction selectivity when the bar and the background moved in antiphase, differencing direction-selective cells (5% of the cortical sample) only expressed their direction selectivity when the bar and the background differed in speed, and limited direction-selective cells (20% of the cortical sample) only expressed their direction selectivity for near zero background speeds. The sixth type, relative nondirection-selective cells (30% of the cortical sample and all of the geniculate cells) were direction selective for none of the background motion conditions. These different relative-direction-selectivity types differed in RF organization, in ocular dominance, velocity sensitivity, in laminar distribution, and in distribution in the visual field. The relative-direction-selectivity types were invariant for changes in the contrast and bar speed. The construction of these relative-direction-selectivity types from the geniculate input requires some inhibitory, but mainly facilitatory, intracortical interactions. These experimental findings suggest that area 17 in the cat has the neuronal machinery to extract depth from motion (limited direction-selective cells) and to segregate visual scenes by motion cues (antiphase, conditionally and differencing direction-selective cells).     

Experimental myopia in cats reared in stroboscopic illumination

Spectacle refraction of eyes of strobe-reared animals was compared to that of normal cats. Strobe reared cats were found to be significantly more myopic than normal cats.     

Parathyroid imaging: comparison of double-tracer (T1-201, Tc-99m) scintigraphy and high-resolution US

Parathyroid scintigraphy using a double-tracer (T1-201, Tc-99m) subtraction technique depicted 17 of 23 (74%) parathyroid adenomas in patients with and without previous neck operations. High-resolution (10-MHz) ultrasound (US) depicted 18 (78%) of these adenomas. Average tumor size depicted by US was 17 X 10 X 8 mm (excluding a giant adenoma) and 19 X 10 X 9 mm by scintigraphy. Alone, neither modality was particularly sensitive in the depiction of primary hyperplasia of the parathyroid glands, but combined techniques were more effective than the use of a single modality. With both US and T1-201 scintigraphy, only two of 23 cases of parathyroid adenoma in the neck were missed, and none of the eight cases of secondary hyperplasia were missed. In 11 patients who had previously undergone neck surgery, parathyroid tumors were identified in eight by either US or double-tracer scintigraphy. Preoperative parathyroid imaging with double-tracer scintigraphy and high-resolution US is suggested for patients with hyperparathyroidism, particularly in those patients who have had previous parathyroid surgery.     

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MR imaging of facial nerve enhancement in Bell palsy or after temporal bone surgery

The authors evaluated magnetic resonance (MR) images obtained with intravenously administered gadolinium in ten patients who had facial paralysis and no facial nerve tumor. In patients with either Bell palsy (four patients) or facial paralysis after temporal bone surgery (six patients), intratemporal facial nerve enhancement was seen. Facial nerve enhancement on MR images proved to be a nonspecific finding.