Discriminant factors affecting early outcome of radioiodine treatment for Graves' disease

Pretreatment clinical, biochemical, iodine-131 (131I) scan and tracer-kinetic parameters were studied in 827 Chinese patients with Graves' disease treated with radioactive iodine. One year after 131I therapy, 56.7% were euthyroid, 33.9% were still thyrotoxic and 9.4% were hypothyroid. Discriminant analysis of all pretreatment variables identified thyroid mass, presenting free thyroxine index and 4 h 131I uptake as the three variables most helpful in discriminating the early outcome group of 131I therapy. The findings suggest that patients with large goitres and severe disease may require higher doses of 131I for treatment of Graves' disease.     

游泳训练对小鼠脾脏淋巴细胞亚群的影响

小鼠经1-3周游泳训练后,脾脏中单个核细胞数量减少,T淋巴细胞比例下降,B淋巴细胞比例增加,CD_2~+T细胞比例减少以及C_4~+/CD_3~+比值增加。表明运动训练会改变脾脏淋巴细胞亚群的分布,从而影响机体免疫状态。     

Evaluation of results in flexor tendon repair: a critical analysis of five methods in ninety-five digits

The development of an internationally accepted system of assessment of results after flexor tendon repair is important. In a prospective study of ninety-five digits, gross discrepancies were demonstrated between five popular methods of assessment: Buck-Gramcko, linear measurement, Grossman, American Society for Surgery of the Hand, and Strickland. The relative merits of each systems were studied and modifications for the Buck-Gramcko system are suggested.     

C-peptide in non-alcoholic cirrhosis and hepatocellular carcinoma

Fourteen normal controls, eleven patients with non-alcoholic cirrhosis, twenty-nine with hepatocellular carcinoma (HCC) and six with HCC and hypoglycemia were studied. The tests performed include iv glucose tolerance test (25 g) and glucagon challenge test (2 mg). In cirrhosis, glucose intolerance and insulin resistance were demonstrated. The fasting hyperinsulinemia in cirrhosis is the result of decreased degradation as shown by the normal fasting C-peptide. The increased insulin responses to glucose, despite a normal C-peptide response, further supports the importance of impaired degradation in the pathogenesis of hyperinsulinemia after challenge. Despite a strong etiological association between cirrhosis and HCC, patients with HCC do not have significant hyperinsulinemia or glucose intolerance. This provides metabolic evidence to support the clinico-pathological observation that HCC occurred when cirrhosis was not advanced or in a precirrhotic stage. In HCC patients with clinically overt hypoglycemia, the fasting glucose, insulin and C-peptide were very low. The C-peptide responses to glucose and glucagon challenges were suppressed despite pharmacologic stimulation. This can be explained by the suppression of insulin secretion by a circulating substance secreted by hepatoma. The results support the pathogenetic importance of insulin-like activities recently detected in HCC patients with hypoglycemia.     

Responses of single cortical neurones to noradrenaline and dopamine.

The technique of microelectrophoresis was used in order to compare the actions of noradrenaline and dopamine on single cortical neurones in the rat. Both excitatory and depressant responses could be evoked by both catecholamines; every neurone studied responded in the same direction to the two drugs. In the case of both excitatory and depressant responses, noradrenaline consistently appeared to be more potent than dopamine; this potency difference was presumably of biological origin, since the transport number of dopamine was somewhat higher than that of noradrenaline. Excitatory responses to both catecholamines could be antagonized by the α-adrenoceptor antagonist. phenoxybenzamine, and by the neuroleptics, haloperidol and α-flupenthixol. However, phenoxybenzamine had a more pronounced effect on responses to noradrenaline than on responses to dopamine, whereas the neuroleptics showed a greater antagonistic effect on responses to dopamine than on responses to noradrenaline. Responses to acetylcholine were not affected by the antagonists. β-Flupenthixol was a much less effective and a less specific antagonist of responses to dopamine than was α-flupenthixol. These findings suggest that excitatory responses of cortical neurones to the catecholamines may be mediated by two populations of receptors: α-adrenoceptors and excitatory dopamine receptors.