Effects of distention of the preterm fetal lamb lung on lung function with ventilation

Constant distending pressure when applied to the immature fetal lamb lung was reported to improve compliance and prevent the subsequent development of the respiratory distress syndrome after delivery. These experiments were designed to repeat those observations and identify the mechanism(s) responsible for the effects of constant distending pressure on subsequent lung function. The compliance of the lungs of exteriorized fetal lambs at 130 to 133 days gestational age increased 2.5-fold after 1 h of 15 cm of distending pressure. However, subsequent ventilation of the lambs exposed to distending pressure and control lambs resulted in comparable sequential compliance and blood gas and pH measurements. Severity of lung disease as reflected by the peak inspiratory pressure needed to normalize Pco2 values decreased as surfactant-saturated phosphatidylcholine pool sizes increased (r values greater than 0.90) and minimum surface tensions of alveolar washes decreased, but the distention procedure did not change these relationships. Distention of the fetal lung did result in an apparent increase in pulmonary blood flow in the fetus and an increased leak of labeled albumin from the vascular space to the lung interstitium and airways during the 1-h period of ventilation after delivery. However, the leak of protein into the lungs exposed to the distending pressures was not increased during the period of exteriorization and distention, suggesting that distention sensitized the preterm lung to leak protein with subsequent mechanical ventilation. The leak of labeled albumin out of the airways was not changed by distention, and total lung water was not changed.(ABSTRACT TRUNCATED AT 250 WORDS)     

α-Methylnoradrenaline-induced contractions in rat aorta are mediated via α1D-adrenoceptors

Summary— The subtype(s) of α-adrenoceptor-mediating contractions to α-methynoradrenaline in the rat aorta has been investigated by using α-adrenoceptor-selective competitive antagonists and the α₁-adrenoceptor selective agonist, phenylephrine, for comparison. α-Methylnoradrenaline and phenylephrine elicited concentration-dependent contractions in the endothelium-denuded and endothelium-intact aortic rings with similar potencies and maximal effects. α-Methylnoradrenaline- and phenylephrine-induced contractions in endothelium-denuded aortic rings were competitively antagonized by prazosin (pA₂ = 9.38 and 9.13; respectively) and rauwolscine (pA₂ = 7.19 and 6.60, respectively). This confirms that there is an α₁- and a non α₂-adrenoceptor response to α-methylnoradrenaline in the rat aorta. The subtype selective α_1D-adrenoceptor antagonist, BMY 7378, was found to antagonize contractions to α-methylnoradrenaline and phenylephrine competitively in endothelium-denuded and endothelium-intact aortic rings. The pA₂ values of BMY 7378 against α-methylnoradrenaline (8.39 and 8.41; endothelium-intact and endothelium-denuded, respectively) and phenylephrine (8.64 and 8.76; endothelium-intact and endothelium-denuded, respectively), are consistent with its published functional potency and clonal α_1d-adrenoceptor binding affinity. In addition, contractions to α-methylnoradrenaline and phenylephrine in endothelium-denuded aortic rings, were potently inhibited by WB 4101 with pA₂ values of 9.75 and 9.25, respectively. The high pA₂ values for WB 4101 indicate that the α_1B-adrenoceptor subtype does not seem to participate in α-methylnoradrenaline (and phenylephrine) induced contractions in this artery. These results suggest that the α_1D-subtype plays a determining role in rat aorta contractions induced by α-methylnoradrenaline.     

Patient-induced stress test of the first metacarpophalangeal joint: a radiographic assessment of collateral ligament injuries

The metacarpophalangeal (MCP) joint of the thumb is frequently injured, and the extent of soft-tissue injury is sometimes difficult to determine clinically. Routine radiographs are often normal, without evidence of a fracture. Radiographs obtained during patient-induced stress of the first MCP joint can show significant collateral ligament injury. It is important to make an early diagnosis of collateral ligament rupture.     

Drinking cup for double-contrast esophagography

A drinking cup was designed for high-quality double-contrast esophagography. The device comprises a holder for the barium, a feeding arrangement for the air, and a feed valve, which in part blocks the free discharge of barium from the cup. Upon continuous ingestion from the cup, an effective mixture of air and barium is formed without the use of any effervescent or other agents. The technique was evaluated in 72 patients, including children. The studies were successful in nearly all cases.     

黄芩苷对牙龈成纤维细胞和牙周膜细胞pro-MMP-1和MMP-3 表达的影响

目的　检测黄芩苷对白细胞介素 1β(IL 1β)诱导作用下人牙龈成纤维细胞 (HGF)分泌基质金属蛋白酶 1酶原 (pro MMP 1)的量和牙周膜细胞 (PDLCs)基质金属蛋白酶 3(MMP 3)表达的变化。方法　体外培养HGF和PDLCs,分别运用ELISA和免疫组化方法检测 pro MMP 1的量和MMP 3的表达。结果　与对照组的 (1 96 0± 0 176 ) μg/L相比 ,1μg/L的IL 1β能够显著促进HGF分泌 pro MMP 1(3 333± 0 12 3) μg/L ,且增加PDLCsMMP 3的表达 (P <0 0 0 1) ;加入黄芩苷后能降低HGF的pro MMP 1分泌量 ,其作用呈浓度 (10～ 10 0 0 μg/L)依赖性 ;黄芩苷对IL 1β诱导下PDLCs合成MMP 3的能力没有影响 ,但是能够抑制MMP 3的释放。结论　黄芩苷能够抑制由IL 1β介导的HGF分泌pro MMP 1和PDLCMMP 3的表达 ,提示黄芩苷可用于牙周病的防治。     

AS-1 red cells for neonatal transfusions: a randomized trial assessing donor exposure and safety

BACKGROUND: Despite recent optimism about the use of erythropoietin therapy to treat the anemia of prematurity, very-low-birth-weight infants who are severely ill receive multiple red cell (RBC) transfusions. Many physicians transfuse relatively fresh RBCs to newborn infants, exposing them to multiple donors and possibly increasing their risk of acquiring transfusion-transmitted infections. STUDY DESIGN AND METHODS: A randomized, single-blind clinical trial was conducted to determine, as the primary endpoint, whether RBCs collected from one dedicated donor and stored for < or = 42 days in AS-1 storage media could safely supply all small-volume RBC transfusions (15 mL/kg/dose) needed by very-low-birth-weight infants (0.6-1.3 kg) during the first 84 days of life. Secondary endpoints were the assessment of the possible adverse clinical and biochemical effects of transfusing AS- 1 RBCs stored for < or = 42 days. Control infants received identical nursery care, except they received fresh RBCs stored < or = 7 days in CPDA-1. RESULTS: Infants transfused with AS-1 RBCs were exposed to a mean of 1.6 donors,-compared with an exposure to 3.7 donors for infants given CPDA-1 RBCs (p < 0.05). Neither clinical transfusion reactions nor the results of multiple laboratory tests were significantly different in infants who received slow transfusions (15 mL/kg) of AS-1 RBCs stored for < or = 42 days and in infants who received the same volume of CPDA-1 RBCs stored < or = 7 days. CONCLUSION: AS-1 RBCs, usually from only one dedicated donor, can safely supply all RBCs needed by most very-low-birth-weight infants-a practice that decreases donor exposure and likely increases transfusion safety.     

Self-rated literacy level does not explain educational differences in health and disease

Background

Although literacy is increasingly considered to play a role in socioeconomic inequalities in health, its contribution to the explanation of educational differences in health has remained unexplored. The aim of this study was to investigate the contribution of self-rated literacy to educational differences in health.

Methods

Data was collected from the Healthy Foundation and Lifestyle Segmentation Dataset (n = 4257). Self-rated literacy was estimated by individuals’ self-reported confidence in reading written English. We used logistic regression analyses to assess the association between educational level and health (long term conditions and self-rated health). Self-rated literacy and other potential explanatory variables were separately added to each model. For each added variable we calculated the percentage change in odds ratio to assess the contribution to the explanation of educational differences in health.

Results

People with lower educational attainment level were more likely to report a long term condition (OR 2.04, CI 1.80-2.32). These educational differences could mostly be explained by age (OR decreased by 27%) and could only minimally be explained by self-rated literacy, as measured by self-rated reading skills (OR decreased by 1%). Literacy could not explain differences in cardiovascular condition or diabetes, and only minimally contributed to mental health problems and depression (OR decreased by 5%). The odds of rating ones own health more negatively was higher for people with a low educational level compared to those with a higher educational level (OR 1.83, CI 1.59-2.010), self-rated literacy decreased the OR by 7%.

Conclusion

Measuring self-rated reading skills does not contribute significantly to the explanation of educational differences in health and disease. Further research should aim for the development of objective generic and specific instruments to measure health literacy skills in the context of health care, disease prevention and health promotion. Such instruments are not only important in the explanation of educational differences in health and disease, but can also be used to identify a group at risk of poorer health through low basic skills, enabling health services and health information to be targeted at those with greater need.