* Immediate allergic reactions to amoxicillin

A large group of patients with suspected allergic reactions to (β-lactam antibiotics was evaluated. A detailed clinical history, together with skin tests, RAST (radioallergosorbent test), and controlled challenge tests, was used to establish whether patients allergic to β-lactam antibiotics had selective immediate allergic responses to amoxicillin (AX) or were cross-reacting with other penicillin derivatives. Skin tests were performed with benzylpenicilloyl-poly-L-lysine (BPO-PLL), benzylpenicilloate, benzylpenicillin (PG), ampicillin (AMP), and AX. RAST for BPO-PLL and AX-PLL was done. When both skin test and RAST for BPO were negative, single-blind, placebo-controlled challenge tests were done to ensure tolerance of PG or sensitivity to AX. A total of 177 patients were diagnosed as allergic to β-lactam antibiotics. We selected the 54 (30.5%) cases of immediate AX allergy with good tolerance of PG. Anaphylaxis was seen in 37 patients (69%), the other 17 (31%) having urticaria and/or angioedema. All the patients were skin test negative to BPO; 49 of 51 (96%) were also negative to MDM, and 44 of 46 (96%) to PG. Skin tests with AX were positive in 34 (63%) patients. RAST was positive for AX in 22 patients (41%) and to BPO in just 5 (9%). None of the sera with negative RAST for AX were positive to BPO. Challenge tests with AX were performed in 23 subjects (43%) to establish the diagnosis of immediate allergic reaction to AX, and in 15 cases (28%) both skin test and RAST for AX were negative. PG was well tolerated by all 54 patients. We describe the largest group of AX-allergic patients who have tolerated PG reported so far. Diagnosis of these patients can be achieved only if specific AX-related reagents are employed. Further studies are necessary to determine the exact extent of this problem and to improve the efficacy of diagnostic methods.     

Varicocele: effect on sperm functions

Despite the numerous studies published over the past decade, the role of varicocele in male infertility is still controversial. Although more frequent in infertile men, its influence on sperm production or function has not, as yet, been determined. Moreover, the exact mechanism of varicocele action is not clear. We have surveyed the literature, the correlation of varicocele to sperm parameters and to sperm function tests, such as binding capacity, hypo-osmotic swelling test, presence of reactive oxygen species, and in particular, the correlation to fertility potential. Almost every subject examined had contradictory results. Larger control studies may possibly elucidate and clarify the cases in which varicocele is associated to sperm function, and where treatment may improve fertility.     

Antibodies against the extracellular enveloped virus B5R protein are mainly responsible for the EEV neutralizing capacity of vaccinia immune globulin

In the event of smallpox bioterrorism, widespread vaccination may be required. Vaccinia immune globulin (VIG) has been used to treat complications from the smallpox vaccine. While the potency of VIG was defined by its ability to neutralize intracellular mature virus, a second form of vaccinia called the extracellular enveloped virus (EEV) is critical for virus spread in the host. The B5R-protein is one of many EEV-specific proteins. Immunoprecipitation and ELISA revealed that VIG recognizes the B5R-protein. An EEV plaque-reduction assay using a recombinant vaccinia that lacks the majority of the extracellular domain of B5R showed that the ability of VIG to neutralize EEV is principally directed at B5R. In addition, absorbing out the anti-B5R antibody present in VIG through the addition of recombinant B5R protein abrogated VIG's ability to significantly neutralize wild-type EEV. This work demonstrates the prominent role of B5R as a target of EEV-neutralizing activity of human antibodies.     

腹主动脉瘤应力模型的建立及其应用

本研究用螺旋CT扫描腹主动脉瘤获得的断层图像合成腹主动脉瘤几何模型，通过设定瘤壁组织生物力学参数和边界条件，使用有限元分析的方法分析腹主动脉瘤瘤壁的应力分布。结果标明，本例腹主动脉瘤应力峰值位于远端分叉部位，瘤体应力峰值位于后壁，均小于瘤壁的承受极限。本研究所得结果对腹主动脉瘤应力模型有助于分析个体化腹主动脉瘤的破裂部位和生长方向，对研究疾病进程提供依据。     

Long-term evaluation of usefulness of skin and incremental challenge tests in patients with history of adverse reaction to local anesthetics

A variety of adverse reactions to local anesthetics has been described, some of which are thought to be allergic. Different protocols of prick and intradermal skin tests as well as subcutaneous challenge tests are used to select a local anesthetic which can safely be used. Their long-term effectiveness has not yet been assessed. Twenty-eight patients with a history of adverse reaction to local anesthetics were evaluated over a 3-year period. Loss of consciousness occurred in eight patients, skin reaction in nine, and vagal symptoms in eight. Various reactions were recorded in the remaining three patients. Rapid spontaneous recovery was the rule, suggesting that immediate allergic reaction and, in particular, anaphylactic reaction were unlikely. Investigation allowed the selection of a tolerated anesthetic in all cases. Reexposure occurred in 19 patients 16–50 months after evaluation and 6.8 ± 5.5 years after the first reaction. No patient presented a second reaction. In conclusion, adverse reactions to local anesthetics seem to be, in most cases, not allergic in nature. Evaluation protocols are effective in selecting an agent susceptible to tolerance, but are time consuming. However, they probably contribute to an important reassurance effect that is likely to increase tolerance to subsequent local anesthetic administration. Simplification of the protocols and better patient selection are proposed.     

122例急性戊型肝炎重叠感染患者的肝功能及临床特点分析

目的 比较分析单纯急性戊型肝炎与重叠感染患者的肝功能指标和临床特点.方法 以40例单纯急性戊型肝炎为对照,回顾性分析了122例重叠感染戊型肝炎患者的肝功能指标、临床资料.结果 单纯戊肝组、甲戊重叠感染组、乙戊重叠感染组,三组之间ALT、AST、TBIL、DBIL差异均无统计学意义(P0.05),急性戊肝组与乙戊重叠感染组,甲戊重叠感染组与乙戊重叠感染组的白蛋白、球蛋白有统计学差异(P<0.01);甲戊重叠感染、乙戊重叠感染与单纯戊肝相比较临床合并症多、并发症重.结论 戊型肝炎重叠感染,特别是乙戊重叠感染患者,要加强临床监测,提高早期预防并发症的意识,以降低病死率.     

大鼠再生肝对二乙基亚硝胺启动作用的敏感性

目的比较再生肝和正常肝对二乙基亚硝胺（ＤＥＮ）启动作用的敏感性。方法以２／３肝叶切除后８周末的大鼠为实验组,正常大鼠为对照组,作如下比较：肝重、常规组织学检查及３Ｈ－ＴｄＲ掺入试验;用修改的Ｓｏｌｔ－Ｆａｒｂｅｒ模型,通过对ＧＧＴ阳性癌前病灶的体视学测量,观察肝脏对ＤＥＮ的启动效应;在体内和体外（无血清原代培养肝细胞）经ＤＥＮ攻击后,以核酸原位缺口标记方法观察肝细胞ＤＮＡ的损伤程度。结果２／３肝叶切除后８周末的实验组肝脏的修复过程已完成,未见肝细胞继续增生的表现;经ＤＥＮ攻击后,实验组肝癌前病灶在数密度和体积密度上都显著高于对照组;无论在体内或体外接受ＤＥＮ攻击后,实验组肝细胞ＤＮＡ的损伤程度都显著大于对照组。结论即使再生过程已经完成,再生肝仍比正常肝具有较高的致癌敏感性,这与再生肝肝细胞在ＤＥＮ攻击后其ＤＮＡ损伤较重相关。     

122例急性戊型肝炎重叠感染患者的肝功能及临床特点分析

目的 比较分析单纯急性戊型肝炎与重叠感染患者的肝功能指标和临床特点.方法 以40例单纯急性戊型肝炎为对照,回顾性分析了122例重叠感染戊型肝炎患者的肝功能指标、临床资料.结果 单纯戊肝组、甲戊重叠感染组、乙戊重叠感染组,三组之间ALT、AST、TBIL、DBIL差异均无统计学意义(P0.05),急性戊肝组与乙戊重叠感染组,甲戊重叠感染组与乙戊重叠感染组的白蛋白、球蛋白有统计学差异(P<0.01);甲戊重叠感染、乙戊重叠感染与单纯戊肝相比较临床合并症多、并发症重.结论 戊型肝炎重叠感染,特别是乙戊重叠感染患者,要加强临床监测,提高早期预防并发症的意识,以降低病死率.     

兔眼虹膜组织力学特性的实验研究

利用我们创建的将兔眼蝉孔水密缝合后，模拟眼内前后房压强差，对虹膜整体进行加压的实验方法，对兔眼虹膜的力学特性进行了实验研究。结果表明：兔眼虹膜是典型的粘弹性物质；面积模量与前后方压强差之间基本成线性关系。实验结果可为青光眼致盲机制解释和瞳孔阻滞力的估算提供参考。     

Can subjects with a positive allergen skin test be selected by a short questionnaire?

The objective was to evaluate a postal questionnaire screening procedure for selection of subjects with positive reactions to skin prick tests with common allergens. The project consisted of a screening, with subsequent skin prick test of two selected groups. The setting was the Glostrup Population Studies institute in Copenhagen, Denmark. Participants in the screening included 8000 subjects, aged 15–69 years. The subjects were randomly selected from the population of western Copenhagen County, Denmark. From the 6998 respondents (87.5%), 793 subjects were randomly selected (Random Group), and 788 subjects were chosen on the basis of their answers to the questionnaire (Symptom Group). Both groups were invited to take skin prick tests. Attendance rates were 75.5% (Random Group) and 80.6% (Symptom Group).
The main outcome measures were responses (yes or no) to the specific questions and the subjects' skin reaction (positive or negative). The association between symptoms and skin reactivity, adjusted for the effects of sex and age, was summarized by odds ratios. Symptoms on exposure to allergens were highly associated with positive skin reactivity. In the Symptom Group the percentage of subjects with at least one positive skin reaction was 57.7%, which was twice as much (28.4%) as in the Random Group. The results show that it was possible to select a group with high skin reactivity on the basis of the symptoms reported in the screening. Questions about exposure to allergens were the most appropriate for selection of this group.