Childhood diabetic neuropathy: a clinical and electrophysiological study

Clinical diabetic neuropathy in childhood is rare, but electrophysiological involvement of the peripheral nerve is more frequent. We assessed clinically and electrophysiologically the peripheral nervous system of 69 children and adolescents suffering from diabetes mellitus (DM). The mean age of the patients was 12.8 years and the mean age at onset of DM was 6.8 years with a mean disease duration of 6.3 years. Seven patients (10%) had clinical neuropathy of which ankle jerk reflex abolition was the most frequent sign. Twenty patients (29%) had a neurophysiological neuropathy prevalently affecting the lower limbs. Peripheral neuropathy was correlated with patient age, older age at onset, duration of DM, height and poor glycaemic control.     

糖尿病高渗状态横纹肌溶解症回顾性分析

目的了解糖尿病高渗状态诱发横纹肌溶解情况。方法回顾了16例（男9例，女7例）糖尿病高渗状态住院病例，其中6例（37．50％）生化指标提示横纹肌溶解。将横纹肌溶解组与非横纹肌溶解组的临床及生化指标进行比较。结果横纹肌溶解组血清肌酸磷酸激酶（CK）及肌红蛋白（Mb）分别是非横纹肌溶解组的30倍与50倍。血清葡萄糖（BG）、钠（Na^＋）水平及有效血浆渗透压明显高于非横纹肌溶解组（P〈0．05）。与之相反，血清钾（K^＋）及磷（P2^-）水平明显低于非横纹肌溶解组（P〈0．05）。两组肾功能衰竭差异无统计学意义（100．00％比60．00％。P=0．0736），但尿素氮（BUN）及肌酐（Cr）水平明显高于非横纹肌溶解组（P〈0．05）。无一例在住院期间被诊断横纹肌溶解。结论横纹肌溶解症在糖尿病高渗状态并非罕见，常被忽略。建议对糖尿病高渗状态患者入院后，常规进行有关肌酶尤其CK、Mb检测，以早期发现横纹肌溶解症，及时治疗。     

主动脉内球囊反搏在急性心肌梗死合并心源性休克中的应用

目的探讨主动脉内球囊反搏(IABP)在介入治疗急性心肌梗死合并心源性休克患者中的作用.方法回顾性分析19例急性心肌梗死合并心源性休克患者IABP辅助治疗的临床效果.结果 19例患者IABP使用时间平均为93.6 h,其中13例成功地进行介入治疗(13/14,92.9%),2例成功接受外科搭桥,2例在等待搭桥术过程中死亡,1例药物治疗.三支血管病变10例(占52.6%),二支病变(前降支+回旋支)1例(占5.3%),单纯前降支5例(占26.3%),单纯左主干2例(占10.5%).住院期间总死亡4例(4/19,21.1%),介入治疗病人死亡2例(2/14,14.3%),未介入或搭桥治疗死亡2例(2/3,66.7%).结论 IABP支持下急诊行冠脉介入治疗,可显著提高急性心肌梗死伴心源性休克患者的生存率,未能介入治疗和左主干病变经介入治疗后血液动力学仍不稳定者应及时采取外科搭桥治疗.     

Tuberculous mesenteric lymphadenitis: a case report

The authors report a case of mesenteric tuberculous lymphadenitis which mimic a pancreatic cystadenoma. They emphasize ultrasound and CT scan features which lead to the recognition of tuberculosis and permit a percutaneous fine needle biopsy. Laparotomy seems the most reliable method for a positive diagnosis. The place of different imaging methods is discussed.     

Apigenin inhibits pancreatic cancer cell proliferation through G2/M cell cycle arrest

Background  

Many chemotherapeutic agents have been used to treat pancreatic cancer without success. Apigenin, a naturally occurring flavonoid, has been shown to inhibit growth in some cancer cell lines but has not been studied in pancreatic cancer. We hypothesized that apigenin would inhibit pancreatic cancer cell growth in vitro.     

Leptin and leptin receptor polymorphisms are associated with increased risk and poor prognosis of breast carcinoma

Background  

Leptin (LEP) has been consistently associated with angiogenesis and tumor growth. Leptin exerts its physiological action through its specific receptor (LEPR). We have investigated whether genetic variations in LEP and LEPR have implications for susceptibility to and prognosis in breast carcinoma.     

Study of overweight and obesity in a population of urban school children in Sousse, Tunisia]

AIM: The aim of this study was to assess the prevalence of obesity and overweight and their relationship with cardiovascular disease risk factors. METHODS: Epidemiological survey based on a representative sample of 1569 urban school children of Sousse, Tunisia. RESULTS: Overweight (BMI > or = 25) was significantly higher in girls (16.1%) than in boys (11.6%); (chi 2 = 8.2; p = 0.004). Obesity (BMI > or = 30) was slightly higher in girls (3.7%) than in boys (2.7%); (chi 2 = 0.89; p = 0.34). Girls had significantly higher BMI, diastolic blood pressure, cholesterol and HDL cholesterol levels than boys who had however significantly higher levels of systolic blood pressure. Overweight was significantly higher in children who did not practice sport at school: 22 versus 13.1% (p < 0.002), in groups of youngsters who were not affiliated to school sport or city associations. Overweight children had a significantly higher levels of cholesterol, HDL cholesterol and means of systolic and diastolic blood pressures. CONCLUSION: These results will serve to set up a regional program of health promotion at schools.     

A disseminated form of Langerhans histiocytosis associated with diabetes insipidus and diabetes mellitus

INTRODUCTION: Langerhans' cell histiocytosis is a rare disorder of unknown etiology characterized by a wide clinical spectrum and varied behavior. Diabetes insipidus is a relatively common feature in Langerhans' cell histiocytosis. The presence of both diabetes insipidus and mellitus associated with histiocytosis in an adult is rare. To our knowledge, only three previous cases have been reported. EXEGESIS: We report the clinical presentation, pathologic findings and clinical progress in an adult female who had disseminated Langerhans' cell histiocytosis (hypothalamic infiltration, multifocal bone involvement) associated with both diabetes insipidus and mellitus. CONCLUSION: The pathogenesis of diabetes mellitus in such an association will be discussed.     

Immunoreactivity for the group III metabotropic glutamate receptor subtype mGluR4a in the superficial laminae of the rat spinal dorsal horn

Studies indicate that metabotropic glutamate receptors (mGluRs) may play a role in spinal sensory transmission. We examined the cellular and subcellular distribution of the mGluR subtype 4a in spinal tissue by means of a specific antiserum and immunocytochemical techniques for light and electron microscopy. A dense plexus of mGluR4a-immunoreactive elements was seen in the dorsal horn, with an apparent accumulation in lamina II. The immunostaining was composed of sparse immunoreactive fibres and punctate elements. No perikaryal staining was seen. Immunostaining for mGluR4a was detected in small to medium-sized cells but not in large cells in dorsal root ganglia. At the electron microscopic level, superficial dorsal horn laminae demonstrated numerous immunoreactive vesicle-containing profiles. Labelling was present in the cytoplasmic matrix, but accretion of immunoreaction product to presynaptic specialisations was commonly observed. Axolemmal labelling was confirmed by using a preembedding immunogold technique, which revealed distinctive deposits of gold immunoparticles along presynaptic thickenings with an average centre-to-centre distance of 41 nm (41.145 +/- 13.59). Immunoreactive terminals often formed synaptic contacts with dendritic profiles immunonegative for mGluR4a. Immunonegative dendritic profiles were observed in apposition to both mGluR4a-immunoreactive and immunonegative terminals. Diffuse immunoperoxidase reaction product was also detected in dendritic profiles, some of which were contacted by mGluR4a-immunoreactive endings, but only occasionally were they observed to accumulate immunoreaction product along the postsynaptic density. Terminals immunoreactive for mGluR4a also formed axosomatic contacts. The present results reveal that mGluR4a subserves a complex spinal circuitry to which the primary afferent system seems to be a major contributor.