Factors predisposing infants to lower respiratory infection with wheezing in the first two years of life.

BACKGROUND: Acute lower respiratory illness (LRI) early in life has been implicated as a factor for adverse respiratory outcomes later in life. Factors that predispose infants to LRI with wheezing have not been conclusively defined. OBJECTIVES: This prospective study assessed factors that might contribute to LRI with wheezing in the first 2 years of life. METHODS: Seventy-one healthy full-term infants (44 boys, 27 girls) completed the 2-year follow-up. Demographic and environmental factors were evaluated by questionnaire. Respiratory function was assessed by single occlusion technique and rapid thoracic compression technique. Both techniques were performed successfully in 40 infants at 2.6 (+/- 1.4) months old before they developed any episode of LRI. RESULTS: Eighteen infants (25%) developed LRI with wheezing. The first episode of LRI with wheezing occurred in the first year of life in 8 infants, and in the second year of life in 10 infants. There were no significant differences in the demographic or environmental features between infants with or without wheezing LRI, or between infants who acquired LRI with wheezing in the second year of life and those who did not acquire or acquired in the first year of life. Infants from different groups did not differ in airway resistance or maximal flow at functional residual capacity. Infants who developed LRI with wheezing had higher incidence of low values for total respiratory system compliance corrected for body weight compared with those who did not (5/30 versus 6/10, odds ratio = 7.5, 95% confidence interval: 1.53 to 36.7, P = .013). None of the variables of the pulmonary function test could differentiate infants who subsequently developed LRI with wheezing in the first year of life or did not develop any episode of LRI with wheezing from those who developed LRI with wheezing in the second year of life. CONCLUSIONS: Differences in lung function in early life may predispose infants to LRI with wheezing in the first 2 years of life.     

Detection of hepatitis B virus genome in hepatocellular carcinoma tissues with PCR-in situ hybridization.

The detection is described of hepatitis B virus (HBV)-DNA in preserved hepatocellular carcinoma tissues, which were derived from 14 HBV-seropositive patients. Detection was by polymerase chain reaction (PCR) amplification of the target sequence, followed by specific localization of the PCR product with in situ hybridization. PISH (PCR-in situ hybridization) yielded strong positive signals in most of the tumor tissues despite very low copy numbers of chromosome-integrated HBV genome, whereas no signal was detected in control samples, indicating that the signals were specific for HBV. Positive signals were sometimes detected in cirrhotic nodules surrounding the tumor regions, indicating that HBV had infected non-transformed liver cells. HBV-DNA was detected in both nucleus and cytoplasm in some specimens, possibly representing HBV at different stages of the life cycle. In one case, a gradient of viral DNA was revealed, with the highest DNA signal centered at the site of viral antigen expression. Taken together, PISH is shown to be a highly sensitive molecular detection method that is capable of detecting the presence of a low copy number viral genome in situ.     

Activation of complement receptor 3 on human monocytes by cross-linking of very-late antigen-5 is mediated via protein tyrosine kinases

Bordetella pertussis interacts with very-late antigen-5 (VLA-5) receptors on the human monocyte resulting in cross-linking of these receptors followed by activation of complement receptor 3 (CR3) and firm adhesion of B. pertussis to these monocytes. In the present study we investigated whether protein tyrosine kinases are involved in the activation of CR3 on monocytes, which was assessed by the binding of C3bi-coated erythrocytes (EC3bi). Pre-incubation of monocytes with tyrphostin-A47, a specific protein tyrosine kinase inhibitor, before adherence of the cells to an anti-VLA-5 monoclonal antibody-coated surface, or addition of tyrphostin-A47 within 10 min of the adherence to such surface, reduced the binding of EC3bi to monocytes significantly. Pre-incubation of monocytes with tyrphostin-A47 reduced the binding of B. pertussis to such monocytes as well. Inhibitors of protein kinase A and/or C had no effect on EC3bi binding to monocytes. Cross-linking of VLA-5 on monocytes resulted in tyrosine phosphorylation of several proteins. Together, these results indicate that protein tyrosine kinases are involved in the VLA-5-induced activation of CR3 on human monocytes.     

The effects of tramadol on postoperative nausea, vomiting and headache after ENT surgery. A placebo-controlled comparison with equipotent doses of nalbuphine and pethidine

Background: Opioids given as adjuncts to balanced inhalational anaesthesia augment postoperative nausea and vomiting (PONV). Tramadol, equipotent to pethidine, does not depress respiration, but can cause an increase in blood pressure and headache via its monoaminergic actions. Nalbuphine, ten times as potent as pethidine, has a ceiling respiratory depressant and ceiling analgesic effect at >0.3 mg · kg^?1. We compared the effects of equipotent doses of tramadol and nalbuphine (3.0 and 0.3 mg · kg^?1, respectively) given as analgesic with induction of anaesthesia on emesis during recovery from anaesthesia and on PONV and headache until 24 h after ENT surgery, using saline (0.2 ml · kg^?1) and an equipotent dose of pethidine (1.5 mg · kg^?1) as controls. Method: The study population (N=281) comprised 4 comparable subgroubs (N=69 to 71 each). Anaesthetic medications were standardised. Emesis during recovery from anaesthesia and nausea, vomiting, retching, headache and administrations of antiemetic and analgesics until 24 h after surgery were recorded. Results: Emesis and antiemetic requirements during recovery from anaesthesia were similar and infrequent in each group, as were the incidences of nausea alone (3 to 5%), vomiting alone (17 to 31%), and nausea with vomiting (10 to 22%) during the first 24 h after surgery. However, any complaint of PONV was least frequent in the saline and pethidine groups (32% and 37%, respectively) and most frequent in the tramadol and nalbuphine groups (49% and 52%, respectively; P<0.05 versus saline, both comparisons; P=NS versus pethidine, both comparisons). The times to onset and severity of PONV were similar in each group, but patients given nalbuphine most frequently (P<0.025) needed rescue antiemetic to treat PONV. Headache occurred with similar frequency in each group. Conclusion: It is concluded that tramadol, nalbuphine and pethidine have similar emetic effect in the doses and manner used, and that tramadol does not increase the incidence of postoperative headache when used as peroperative analgesic.     

紧张型头痛的诊断与治疗

紧张型头痛(Tension-typeHeadache,TTH),又称紧张性头痛或肌收缩性头痛、心因性头痛、压力性头痛等,是原发性头痛中最常见的一种。不同的研究显示,人的一生中,紧张型头痛的患病率从30％-700%不等,由于本病影响着病人的工作、学习和休息,从而给病人及家庭带来了极大的心理负担,亦给社会经济带来极大的影响。迄今对本病的研究仍不够深入。     

Immature articular cartilage is more susceptible to blood‐induced damage than mature articular cartilage: An in vivo animal study

Objective

Cartilage of young but skeletally mature dogs is more susceptible to blood‐induced damage than that of old dogs. The aim of the present study was to investigate whether cartilage of skeletally immature individuals is even more adversely affected by exposure to blood than that of mature individuals, as suggested by clinical practice experience with humans.

Methods

Right knees of 3 groups of 6 beagle dogs (skeletally immature, young mature, and old animals) were injected with autologous blood on days 0 and 2. On day 4, cartilage matrix proteoglycan turnover (content, synthesis, and release), synovial inflammation, and cartilage‐destructive properties of the synovial tissue were determined and compared with those of the left uninjected control knees.

Results

Subsequent to intraarticular bleeding, cartilage proteoglycan content decreased in an age‐dependent manner, with the largest decrease occurring in cartilage of immature animals. Proteoglycan synthesis per cell also decreased in an age‐dependent manner, with the largest decrease occurring in the immature animals. Cartilage proteoglycan release increased in all 3 groups, but the decrease was not age dependent. Interestingly, immature animals showed a large increase in cartilage DNA content upon exposure to blood, whereas mature animals did not. Histologic analysis showed a mild synovitis in animals of all ages, but catabolic inflammatory activity was found only in immature animals.

Conclusion

Joints of skeletally immature dogs appeared to be more susceptible than joints of mature dogs to the adverse effects of a joint hemorrhage. These data suggest that for humans, specifically young children are at risk for joint damage after a joint hemorrhage.

     

Phylogenetic analysis of parvoviruses isolated in Taiwan from ducks and geese

Two major outbreaks of parvovirus infection occurred in domestic waterfowls in Taiwan in the last two decades; the first was in 1982 and the second in 1989/1990. Parvoviruses isolated in the two outbreaks were sequenced between nucleotides 142 and 680 of the VP3 gene. Sequence comparisons reveal that these viruses could be divided into two groups respectively related to goose parvovirus (GPV) and Muscovy duck parvovirus (MDPV). Nucleotide differences between ''GPV'' and ''MDPV'' groups range from 16.2% to 19.4%. In comparison, the differences within the ''GPV'' group are only 0-6.5%, while those within the ''MDPV'' group are only 0.2-1.7%. Phylogenetic analysis reveals that parvoviruses isolated in the 1982 outbreak in Taiwan are all GPV-related, whereas those isolated in the 1989/1990 outbreak are all MDPV-related. GPV-related isolates from Taiwan were separated into two groups, Thai group and European group. In comparison, all MDPV-related isolates from Taiwan are clustered in a single group that is closely related to a French MDPV isolate. The MDPV-related infection in Taiwan occurred at almost the same time in 1989 as the MDPV outbreak in France. The close phylogenetic relationship between the ''MDPV'' Taiwanese isolates and the French MDPV isolate exhibited on the VP3 fragment investigated suggests that they should be compared more deeply, to look for a possible common origin. The MDPV-related 1985 isolate might be a candidate.     

碘对大鼠红细胞免疫功能及SOD活性的影响

目的 研究在碘缺乏和碘过多的情况下,大鼠体内红细胞免疫功能与ＳＯＤ活性变化,方法 实验利用低磺饲料和磺化钾去离子水复制了不同碘营养状态的大鼠,采用Ｃ３ｂ致敏和未致敏的酵母菌及黄嘌呤氧化酶法分别检测红细膜上的Ｃ３Ｂ受体、免疫复合物及红细胞内ＳＰＤ的活性。结果 碘过多时,大鼠红细胞Ｃ３Ｂ受体花环率、红细胞免疫复合物花环率及红细胞内ＳＯＤ活性均较对照组明显增高,磺缺乏时与对照组比较差异无显著意义。结论碘     

无C型臂条件下用迪克钉治疗胸腰椎骨折125例

目的　探讨无C型臂条件下用迪克钉治疗胸腰椎骨折的可行性。方法　通过对术前、术中X线片分析 ,来确定伤椎、向头或尾侧倾斜度、定位椎弓根、恢复脊柱高度所需迪克棒撑开的距离。结果　所有手术均成功。结论　术中拍片是手术定位及完全复位最有效的方法。了解迪克钉复位及固定原理 ,掌握正确安置方法是手术成功的关键。     

骨髓的巨大瘤细胞及其意义

我们在７例患的骨髓中发现了巨大瘤细胞及其变种,按不同的形态人为地将其分为５种,以瑞氏染色、组化染色、免疫组化染色、流式细胞仪检查、电镜观察及病理学观察均说明这些细胞类似淋巴样－单核细胞样－巨噬细胞样细胞,在骨髓增生亢进和明显病态造血现象。２例按病理观察诊断为恶性淋巴瘤。所有病例无淋巴结、肝－脾肿大或任何局部瘤块。关于预后,２例患分别于病程８个月和１７个月死亡,１例在病程１０个月时病情危重,其余