Motor fluctuations in Parkinson's disease: pathogenetic and therapeutic studies

The response to continuous intravenous infusion of levodopa was evaluated in 23 patients with Parkinson's disease complicated by motor fluctuations. Conversion from oral to intravenous levodopa treatment resulted in an immediate and sustained stabilization of plasma levodopa levels in both the wearing-off and on-off groups. Motor variability also diminished within the first 24 hours of infusion, although to a much greater extent in patients with the wearing-off phenomenon. Over the next 5 to 11 days of intravenous treatment, further reductions in motor fluctuations occurred in both groups, at a substantially faster rate in the wearing-off group than in the on-off group. The degree of immediate stabilization of parkinsonian motor response correlated best with disease duration, whereas the rate of subsequent improvement correlated most closely with levodopa dose. The results support the view that the wearing-off phenomenon may reflect the degeneration of dopamine terminals as a consequence of natural disease progression with a resultant inability to buffer variations in levodopa availability; the on-off phenomenon may reflect additional postsynaptic changes, possibly occurring in response to the nonphysiological fluctuations in synaptic dopamine, which gradually remit during continuous levodopa administration.     

Controlled release levodopa treatment of motor fluctuations in Parkinson''s disease.

A controlled release preparation of levodopa-carbidopa, CR III, given every 4 hours to 17 Parkinsonian patients for up to 10 months reduced plasma drug variations and improved motor response fluctuations compared with standard levodopa-carbidopa given every 2 hours. The results support the value of pharmaceutical approaches to the stabilisation of circulating levodopa levels in the treatment of Parkinson's disease.     

Spinal fluid CRF reduction in Alzheimer''s disease

Abnormalities in several neurotransmitters, including neuropeptides, have been found in postmortem studies of Alzheimer's disease (AD). Recently, corticotropin-releasing factor (CRF) was found to be diminished in cerebral cortex. In this study spinal fluid CRF-immunoreactivity (CRF-I) was determined in 16 patients with mild to moderate AD and 9 age-matched controls. Mean CRF-I levels were significantly lower in Alzheimer patients compared with controls. Furthermore, a tendency for a CRF-I increment with successive spinal fluid aliquots in control subjects was absent in Alzheimer patients. CRF-I levels failed to correlate with measures of disease severity or various tests of cognitive function. These results suggest that involvement of CRF containing neurons may play a secondary rather than a primary role in the pathophysiology of AD.     

Recent patterns in chronic disease mortality in remote living Indigenous Australians

Background  

Despite the well-recognised Indigenous-non-Indigenous health disparity, some reports suggest improvements in Indigenous mortality. Our aim was to quantify Indigenous mortality in Outer Regional (OR), Remote (R), and Very Remote (VR) areas in New South Wales, Queensland, South Australia, Western Australia, and the Northern Territory and changes in mortality from 1998 to 2005.     

国家级首批线上一流课程免疫学基础与病原生物学的建设与推广

线上一流课程作为一种新型的教学课堂模式,其建设与推广不仅使教师的教和学生的学呈现多元化,而且也使教师的教学和研究水平、学生的学习兴趣和能力得到了有效提升。本团队建设与推广的国家级首批线上一流课程免疫学基础与病原生物学已经完成6个学期的运行,累计学习人数40 395人,累计选课学校84所。本文从建设背景与建设目标、整体框架与建设资源、实施过程与推广应用、教学运行与互动、教学考核与评价、思考和展望等6个方面总结该课程的建设与推广情况。     

Direct identification of Yersinia enterocolitica in blood by polymerase chain reaction amplification

Primers based on the nucleotide sequence of the virF gene in the pYV plasmid and the chromosomal ail gene were used in polymerase chain reaction (PCR) amplifications to directly identify Yersinia enterocolitica in blood. Approximately 500 bacteria seeded into 100 microL of blood can be extracted and amplified by PCR to yield positive results. PCR analyses of seven Y. enterocolitica isolates previously implicated in blood contaminations showed that only one isolate harbored the plasmid-borne virF gene; however, all seven isolates were identified effectively by the PCR product amplified from the chromosomal gene. The PCR assay has the potential for use in the identification of Y. enterocolitica contamination in stored units of blood or in the rapid diagnosis of transfusion-related bacteremia caused by Y.     

腹腔镜在小儿离断性肾盂成形术中的应用与随访

目的 探讨腹腔镜下离断性肾盂成形术的效果及适应证.方法 总结21例经腹腔途径行腹腔镜离断性肾盂成形术治疗肾盂输尿管连接部狭窄(UPJO)所致肾积水的经验,对比同期开放手术治疗的35例患儿术后影像学.结果 第一例腹腔镜肾盂成形术历时4 h 50 min,随后的20例为1 h 40 min～2 h 30 min,术中出血量5～10 ml.20例术后3～5 d出院,恢复好.1例术后7 d因患儿外伤性肾盂内出血,血块堵塞双J管,致肾盂漏尿、形成尿腹,遂行开放探查术;术中见吻合口良好,清除肾盂内血块,冲洗双J管,放置.肾造瘘管,7 d后拔除肾造瘘管出院.21例患儿术后4～6周拔除双J管.2组患儿均分别在术后1个月、3个月、6个月行B超或CTU检查.腔镜组吻合口通畅率为95.2%(20/21),开放组为100%(35/35),二者差异无显著性意义.结论 熟练掌握腹腔镜缝合技术,是圆满完成经腹腔镜离断性肾盂成形术的基础.腹腔镜下手术创伤轻微,手术效果与传统的开放手术无差别;在应用腹腔镜肾盂成形术的初期,宜选择中度以下肾盂扩张的病例,待熟练后,逐步应用于重度积水病例,确保手术效果.