血管紧张素Ⅱ及牛磺酸对体外培养乳鼠肥大心肌细胞心律失常发生的作用

在培养72h的乳鼠心肌细胞,血管紧张素Ⅱ(angiotensinⅡ,AgnⅡ)1,10,100和1000nmol·L^-1时,可浓度依赖性地增加细胞搏动频率;而牛磺酸5,10和20mmol·L^-1不影响心肌细胞搏动频率,但能浓度依赖性地拮抗AngⅡ100nmol·L^-1加快心肌细胞搏动频率的作用。AngⅡ100nmol·L^-1连续作用7d引起的培养乳鼠肥大心肌细胞搏动频率加快,动作电位APA升高,APD₅₀和APD90延长,SCL缩短;哇巴因50nmol·L^-1诱发的心肌细胞搏动节律失常发生率高于常规培养组。牛磺酸20mmol·L^-1可抑制AngⅡ引起的上述改变,并降低哇巴因诱发的心律失常发生率。     

Roentgenologic diagnosis of primary corticotropin-producing carcinoid tumors of the mediastinum

A study was undertaken of five patients with Cushing syndrome due to adrenocorticotropin (ACTH) production by thymic carcinoid tumor (primary mediastinal APUDomas), including two recent patients examined by computed tomography (CT) of the chest. Plain roentgenography of the chest initially failed to detect tumor in four of the five patients, while CT of the chest yielded definitive diagnostic information in both patients in whom it was employed. For one of these patients, a mediastinal tumor could be seen retrospectively on plain roentgenograms of the chest, although it had been missed on the first examination. One of the tumors appeared to be partially calcified on CT scan, a finding not previously reported. Blastic osseous metastasis, which is common when malignant carcinoid tumors spread to bone, was seen in one patient. Our data suggest that in patients with suspected ectopic ACTH production, CT scanning of the mediastinum should be performed early in order to avoid delay in diagnosis of an ACTH-secreting carcinoid tumor of the mediastinum.     

Pseudarthrosis of the humeral shaft. Apropos of 58 cases]

We report 58 cases of humeral shaft non union following 28 times an orthopaedic treatment where persisted a space between the two fragments and 30 times an osteosynthesis but only 6 where satisfying. The sery contains 2 infected non union, dried in several months and 3 pseudarthrosis we did not operate because they were not inconvenienced. Among the 53 aseptic pseudoarthrosis the union has been to obtained after one operation for 42, two operations for 6 and three operations for 5. We analyse the consecutive mistakes having brought to the failures. We confirm that only an osteosynthesis not sufficient and that an associate graft is necessary. It could be an osteoperiosteum decortication, a spongious graft or a tibial graft (this last one is more safe but reserved to the iterative cases of the one with a big defect). The long evolution (more than a year for half at the cases) explains the fragment repercussions on shoulder or elbow.     

Das individuelle Überbißverhalten zwischen Milch- und bleibendem Gebiß

Zusammenfassung In Lehrbüchern und einschlägigen Publikationen wird vielfach der Eindruck erweckt, als ob die entwicklungsbezügliche Herausbildung des vertikalen Überbisses im Schneidezahnbereich ein einfach überschaubarer Prozeß sei. Im Rahmen der Erfassung von 108 Probanden durch Gebißabformungen sowohl im Milchgebiß als auch 13 Jahre später mit jugendlichem bleibendem Gebiß wurde eine mathematisch-statistische Analyse von objektiv meßbaren morphologischen Kriterien des Gebisses durchgefürhr. Die im Zusammenhang mit dem Überbiß in der Literatur diskutiert werden. Es zeigt sich, daß weder vom Ausmaß des Überbisses in der ersten Dentition noch von anderen Merkmalen eine Voraussage auf die Größe des endgültigen Überbisses im bleibenden Gebiß abgeleitet werden kann. Änderungen im Überbißverhalten sind vorherrschend. Es gibt nur geringe korrelative Zusammenhänge gebißbezüglicher Symptome, die bei klinischen Untersuchungen rasch und einfach zur Prognose herangezogen werden können. Zur Einschätzung des Entwicklungstrends sind individuumbezogene longitudinale Beobachtungen erforderlich.

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Summary Manulas and relevant publications give rise to the impression that the formation of the overbite in the incisor region throughout its development is a process easy to overlook. Impressions of 108 cases were taken, one of the deciduous dentition and one of the permanent dentition 13 years later. A mathematic-statistical analysis of objective measurable morphological dentition criterions were made and discussed. This shows that neither from the degree of overbite nor from any other feature of the deciduous dentition a prognosis concerning the extent of the final overbite of the permanent dentition can be derived. Changes throughout the development of the overbite are predominant. There are only little correlative coherencies among the morphological symptoms that can be applied quickly and easily for the prognosis in the clinical inspection. For estimating the development tendency longterm individualized observations are necessary.

     

Epilepsy with affective symptomatology: three case reports

Disagreeable affect of fear or anxiety can form the essential of the epileptic critical semiology. The centrum seat is most often found to be temporal and in some rare cases frontal. This form of epilepsy makes it sometimes difficult to establish a differential diagnosis specially when confronted with panic attack. A careful semiologic analysis is needful. Some clinical criteria are in favor of an epileptic etiology like the shortness of the crises, the stereotyped characteristic of the semiology or the association with some other epileptic symptoms. The assumption of neurophysiologic substratum common to both entities is put forward by the authors. Indeed, the current researches are moving towards the likelihood that the limbic structures are stimulated by the epileptic discharge. These structures are taking a part in the pathogeny of the anxiety troubles. Three clinical vignettes are illustrating the difficulties in diagnosing this form of epilepsy.     

Heart-specific localization of emerin: new insights into Emery-Dreifuss muscular dystrophy

Emery-Dreifuss muscular dystrophy (EDMD) is an X-linked inherited disease characterized by early contracture of the elbows, Achilles tendons and post-cervical muscles, slow progressive muscle wasting and weakness and cardiomyopathy presenting with arrhythmia and atrial paralysis: heart block can eventually lead to sudden death. The EDMD geneencodes a novel ubiquitous protein, emerin, which decorates the nuclear rim of many cell types. Amino acid sequence homology and cellular localization suggested that emerin is a member of the nuclear lamina-associated protein family. These findings did not explain the role of emerin nor account for the skeletal muscle- and heart-specific clinical manifestations associated with the disorder. Now we report that emerin localizes to the inner nuclear membrane, via its hydrophobic C-terminal domain, but that in heart and cultured cardiomyocytes it is also associated with the intercalated discs. We propose a general role for emerin in membrane anchorage to the cytoskeleton. In the nuclear envelope emerin plays a ubiquitous and dispensable role in association of the nuclear membrane with the lamina. In heart its specific localization to desmosomes and fasciae adherentes could account for the characteristic conduction defects described in patients.      

Proton magnetic resonance spectroscopy in the brain: report of AAPM MR Task Group #9

AAPM Magnetic Resonance Task Group #9 on proton magnetic resonance spectroscopy (MRS) in the brain was formed to provide a reference document for acquiring and processing proton (1H) MRS acquired from brain tissue. MRS is becoming a common adjunct to magnetic resonance imaging (MRI), especially for the differential diagnosis of tumors in the brain. Even though MR imaging is an offshoot of MR spectroscopy, clinical medical physicists familiar with MRI may not be familiar with many of the common practical issues regarding MRS. Numerous research laboratories perform in vivo MRS on other magnetic nuclei, such as 31P, 13C, and 19F. However, most commercial MR scanners are generally only capable of spectroscopy using the signals from protons. Therefore this paper is of limited scope, giving an overview of technical issues that are important to clinical proton MRS, discussing some common clinical MRS problems, and suggesting how they might be resolved. Some fundamental issues covered in this paper are common to many forms of magnetic resonance spectroscopy and are written as an introduction for the reader to these methods. These topics include shimming, eddy currents, spatial localization, solvent saturation, and post-processing methods. The document also provides an extensive review of the literature to guide the practicing medical physicist to resources that may be useful for dealing with issues not covered in the current article.     

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.