Hearing outcome of sudden sensorineural hearing loss: long-term follow-up.

OBJECTIVE: To evaluate the time-dependent progress and delayed improvement in patients who were treated with combination therapy including oral corticosteroid for idiopathic sudden sensorineural hearing loss. STUDY DESIGN AND SETTING: This retrospective study at a secondary referral and university-based center included 156 patients who were treated by 10-day course of admission therapy and followed for at least three months. RESULTS: Of 121 patients who recovered over three months of follow-up, 45.5% showed a delayed recovery after the end of 10-day course of therapy. Of these 55 patients, 78.2% recovered within one month, 5.5% recovered within one to two months, 12.7% recovered in two to three months, and 3.6% recovered later than three months after discharge. CONCLUSIONS: This study describes the long-term results for a three-month retrospective series of 156 patients diagnosed with idiopathic sudden sensorineural hearing loss, although this result should be further studied by additional research.     

MR imaging of pineal cysts

Identification of pineal cysts with imaging modalities other than magnetic resonance (MR) has been infrequent, despite a reported autopsy incidence of as high a 40%. We recently identified 15 patients in whom pineal cysts were seen on MR. These cysts ranged from 5 to 15 mm in maximum diameter. The cyst walls were thin, usually measuring less than 2 mm. The signal characteristics of the fluid within the cysts paralleled that of CSF, although it differed somewhat in signal intensity from CSF collections in which there was pulsatile motion. All lesions were midline in location. There was no significant mass effect, although mild flattening of the superior colliculi could be seen. Two cases were operated on; at operation, typical pineal cysts were found, with one containing hemosiderin-laden proteinaceous material, which accounted for its markedly higher signal intensity. It is important that this entity be recognized so that these lesions are not confused with pineal tumors.     

Renal function and urinary prostaglandins in rats given an adenine diet

The glomerular filtration rate (GFR), renal plasma flow (RPF) and renal blood flow (RBF) were all markedly decreased in rats given an adenine diet as the period of adenine administration lengthened. Concurrently, the urinary excretions of prostaglandin E2 (PGE2) and 6-keto-prostaglandin F1 alpha(6-keto-PGF1 alpha) decreased gradually in parallel with the renal function parameters, whereas the urinary excretion of thromboxane B2 (TXB2) increased markedly. These findings suggest the involvement of prostaglandin in the renal circulation.     

Animal model of acute pericarditis and its progression to pericardial fibrosis and adhesions: Ultrastructural studies

To study the evolution of pericardial inflammation, we have developed a model of pericarditis in sheep by surgically injecting heat-killed staphy-lococci and Freund's adjuvant into the pericardial cavity under sterile conditions. The pericarditis evolved through the following phases: (1) inflammatory response, (2) mesothelial cell injury and desquamation, and (3) fibrotic phase. At 3–24 hr there was increased microvascular permeability, which resulted in the exudation of fluid, neutrophils, macrophages, ami fibrin into the pericardial cavity and the pericardial intersti-tium. By 72 hr, large numbers of inflammatory cells were aggregated on the mesothelial surfaces and dispersed throughout the pericardial cavity, either as free-floating cells or located between strands of fibrin. At 6 days, fibrinolysis was apparent along the mesothelial surfaces; and newly formed collagen fibrils were deposited throughout the interstitial spaces and among the aggregated cells. These fibrils provided a matrix for the growth of new blood and lymphatic vessels into new connective tissue on both parietal and visceral pericardial surfaces. At 2 weeks, intrapericardial fibrosis had produced focal adhesions between the pericardial surfaces. By 1 month, extensive areas of the pericardial cavity were obliterated. By 9 months, there was a marked reduction in the numbers of cells and blood vessels and increased deposition of collagen and elastic fibers. The intrapericardial injection of heat-killed staphylococci and adjuvant provides a reproducible animal model to study the time course of pericardial inflammation.     

Modulatory role of serotonin on GABA-elicited inhibition of cerebellar Purkinje cells

The present study was designed to directly examine the postsynaptic actions of serotonin on GABA-mediated inhibition of cerebellar Purkinje cells. The findings indicate that serotonin at currents that produced minimal effects on the spontaneous firing rates of Purkinje cells modified GABA effects in a biphasic manner. Serotonin initially decreased GABA-mediated inhibitions followed secondarily by either continued inhibition or, in the majority of cases, augmentation of GABA responses. When a comparison was made of the secondary effects of serotonin on GABA-mediated inhibition with the initial spontaneous firing rates of the Purkinje cells, the group in which serotonin augmented GABA actions had a significantly higher initial firing frequency than the group in which serotonin attenuated GABA-mediated inhibition. Furthermore, with increasing firing rates, the proportion of cells showing augmentation of GABA inhibition increased, and the proportion of cells displaying attenuation of GABA effects decreased. Serotonin affected beta-alanine-mediated inhibitions in a manner similar to that seen with GABA, whereas glycine was differentially altered. This study identifies another neuromodulatory role of serotonin on Purkinje cells in the cerebellum. Furthermore, the effects of serotonin on GABA inhibition seem to be governed by some intrinsic property of the Purkinje cell, which is apparently related to the firing rate of the cell.     

影响α-淀粉酶分离液澄清度的因素

本文根据凝聚和絮凝原理,研究了无机盐和高分子絮凝剂加入量对枯草杆菌BF 7658α-淀粉酶分离液澄清度的影响。实验结果表明,氯化钙可使α-淀粉酶发酵液的ζ电位降低,分离液的澄清度增加,用氯化钙和磷酸氢二钠来处理发酵液,则其分离液的澄清度较单用氯化钙为大,阴离子型高分子絮凝剂如海藻酸钠加入量对分离液澄清度也有一定影响。实验中还发现,澄清的发酵液在10℃下贮存可保持澄清透明状态。     

The pathogenesis and clinical significance of traumatic subdural hygroma

Subdural hygroma (SDG) is a common post-traumatic lesion. Despite its common occurrence, the pathogenesis and clinical significance are uncertain. The author reviewed the literature to clarify the present knowledge on the pathogenic, diagnostic and therapeutic aspects of this controversial lesion. A trivial trauma can cause a separation of the dura-arachnoid interface, which is the basic requirement for the development of a SDG. If the brain shrinks due to brain atrophy, excessive dehydration or decreased intracranial pressure, fluid collection may develop by a passive effusion. Most SDGs resolve when the brain is well expanded. However, a few SDGs become chronic subdural haematomas, when the necessary conditions persist over several weeks. Since the majority of patients with a SDG do not show a mass effect, surgery is rarely required. Outcome is closely related to the primary head injury not to the SDG itself. The complexity of SDG depends on various factors including the dynamics of absorption and expansion, duration of observation, and indication and rate of surgery, besides variety of the primary head injury in types and severity. SDG is a common epiphenomenon of head injury.     

Identification of the phenotype in psychiatric genetics

Summary Statistical procedures and molecular genetic techniques have attained a fine degree of resolution. Their ability to find disease genes has revolutionized medicine and raised hopes for breakthroughs in psychiatry. However, such breakthroughs may require an equally discriminating nosology. A psychiatric genetic nosology seeks to classify patients into categories that correspond to distinct genetic entities by addressing the problem of diagnostic accuracy: the degree to which a diagnosis correctly classifies people with and without a putative genetic illness. We review methods that deal with misclassification in genetic studies. These are clinical and epidemiological approaches that deal directly with how to define the observable manifestation of a putative genotype. We discuss two groups of methods: those that use known phenotypes and those that design new phenotypes.     

刺五加制剂对老年人恒定负荷下运动耐力的影响

以１３名５０～５７岁志愿者为试验对象，研究了刺五加制剂对人体运动能力的影响。结果表明服用刺五加制剂后，在４５０ｋｇ．ｍ／ｍｉｎ（７５Ｗ）持速恒定功率负荷运动时呼吸商由０．９６下降至０．８８，使运动时脂肪供能增加２７．２％；心率下降８．７％，每博摄氧量增加１６．１８％。结果均提示刺五加制剂能提高人体摄氧能力，节省肌糖元，从而发挥抗疲劳作用