Oxidative breakdown of octanoic acid is maintained in patients with cirrhosis despite advanced disease

As an octanoic acid 13CO2 breath test is frequently used to test gastric emptying of solid food, the purpose of the present study was to study whether oxidative breakdown of octanoic acid is affected by severe liver disease. The design of our study was twofold. First, cirrhotic patients (n = 82) of varying severity were compared with healthy controls (n = 17). Values of half-time, time point of maximal expiration and cumulative recovery of octanoic acid breath tests (OBT) were not significantly different between them. Secondly, cirrhotic patients (n = 10) were studied before placement of transjugular intrahepatic portosystemic shunt, 4-7 days later and 1-2 months later. Values of half-time, time point of maximal expiration and cumulative recovery of consecutive OBTs did not change significantly. The OBT may therefore be a suitable test in the future to detect delayed gastric emptying of solids in cirrhotic patients with reduced liver function and portal hypertension.     

Controversies in tuberculosis

Tuberculous infection among children continues to be a significant cause of morbidity. The symptom complex are so variable among children that the final diagnosis often rests on the laboratory tests. Proper interpretation of the tests, specially tuberculin test and radiographic studies, are necessary for establishing correct diagnosis. The usefulness of tuberculin test in both unimmunized and BCG vaccinated children is highlighted. BCG accelerated response as a test should be reserved for identifying serious form of pulmonary disease or CNS tuberculosis when the tuberculin test is negative. Radiographic assessment may be sensitive in some instances but not always specific and hence needs cautious interpretation. Tuberculosis among BCG vaccinated children though not uncommon, needs proper documentation. Current trends in the management of tuberculosis including CNS forms are briefly outlined.     

Prolactin responses to haloperidol in drug-free and treated schizophrenic patients

Summary The prolactin response to 5 mg haloperidol i.m. was studied in 12 schizophrenic patients in a drug-free state and after a month treatment with haloperidol, as a possible index of dopamine receptor sensitivity and occupancy. Blood samples were taken at times 0, 60, 90 and 120 minutes. The increase in PRL observed in the drug-free state disappeared after drug treatment. The PRL plasma levels after treatment with 60 mg haloperidol per os were higher than the maximal PRL responses after 5 mg i.m. The increases in baseline PRL caused by the treatment correlated positively to the reduction in the BPRS score. The test was also performed in a group of 11 patients chronically treated with haloperidol during a daily dose of 60 mg, and 15 days after reduction of the dose to 30 mg. PRL increases after 5 mg haloperidol i.m. were observed only after reduction of the dose. It is suggested that the prolactin response to haloperidol is an index of the occupancy of receptors that are involved in the PRL releasing mechanisms, and could be used to verify their blockade by the neuroleptics, especially in patients that do not respond positively to drug treatment.     

关节液检查的临床意义

检查30例关节炎患者的关节液,结果示类风湿性关节炎患者关节液中白细胞数为330～72600/mm~3,粒细胞为9～97％,结合关节液的其它物理性质,对类风湿关节炎的诊断有一定参考价值。并观察到类风湿关节炎患者血清中IgG、IgA、IgM和关节液中IgG高于其它类型关节炎。     

再论妊娠期糖尿病与胎儿生长发育

目的 研究妊娠期糖尿病与胎儿生长发育中糖代谢特点的关系。方法 选择妊娠期糖尿病25例（GDM组），正常孕妇20例（对照组），分别测孕妇空腹血糖、糖耐量、C肽、IGF－I、新生儿出生2h内空腹血糖，并依据新生儿出生体重分为大于胎龄儿组（LGA组，≥4000g），适于胎龄儿组（AGA组，2500－3999g)。结果 C肽及新生儿出生2h内空腹血糖GDM组与对照组差异有显著性；糖耐量各时点血糖值餐后2h血糖值LGA和AGA组差异有显著性。结论 血糖始终是影响胎儿生长发育的重要因素，孕妇餐后2h血糖水平与巨大儿的发生呈正相关。     

应用3H-TdR掺入法对SMMC-7721细胞株药敏试验条件的探讨与应用

目的探讨3H-TdR掺入法在进行SMMC-7721系细胞肿瘤药敏试验实验时的最佳实验条件.方法确定出3H-TdR掺入法药敏实验时的最适细胞浓度、最适实验药物浓度、3H-TdR掺入最适时间;在最适条件下采用3H-TdR掺入法测定肝癌SMMC-7721细胞株对临床常用的9种抗癌药物的敏感性.结果应用3H-TdR掺入法检测肝癌SMMC-7721细胞株药敏试验的最适实验细胞浓度为1×104个/孔,最适试验药物浓度为1×PPC,3H-TdR最适掺入时间为收集细胞前8 h;肝癌SMMC-7721细胞株对DDP、ADM、5-FU、CPT高度敏感,对MTX、VP-16、MMC、NVB低度敏感,对PYM不敏感.结论 3H-TdR掺入法可用于肿瘤药物敏感性测定并确定出它的最适实验条件.     

全国细菌药敏试验的室间质量评价

目的：了解全国大中型医院细菌药敏试验（AST）状况，提高检测水平和质量。方法：定期向全国各参加评价实验室发放冻干标本，要求在规定时间内报告可疑感染的病原菌及其药敏结果，对回报结果给予数据统计、分析和评价。结果：2000年全国489个细菌室对常见耐药菌的检测正确率分别为：超广谱β－内酰胺酶63％（ESBLs)；苯唑西林敏感金黄色葡萄球菌（MSSA）74％；苯唑西林耐药凝固酶阴性葡萄球菌（MRSCoN)48％；对青霉素不敏感肺炎链球菌7％；氨基糖苷类高水平耐药肠球菌95％；产β－内酰胺酶流感嗜血杆菌正确率35％。结论：通过细菌药敏试验的室间质量评价反映出我国的细菌耐药性检测水平急待提高。     

The spermatozoal volume as indicative of the plasma membrane integrity (modification of the hypoosmotic swelling test). I. Methods

Summary. The aim of the present study was to establish a more differentiating indicator of plasma membrane integrity of spermatozoa than the classic version of the hypoosmotic swelling test according to Jeyendraan. Spermatozoa were prepared by density gradient centrifugation (90% Percoll) to select 'fertilization competent' spermatozoa only. After a second washing procedure sufficiently pure sperm cell suspensions were obtained. The volume distributions of these sperm cells were measured with a Coulter Counter at 25 °C after adaptation in 300 mosmolar NaCl solution resp. 150 mosmolar NaCl solution for 5 min. These volume distributions showed significantly different patterns for the isotonic and hypotonic stress situation in the simple salt solution. Moreover, the comparison of the response to hypoosmotic stress showed more than four reproducible characteristic patterns, promising well differentiated results for different sperm populations. The new method for the detection of hypoosmotic swelling effect might be a real and valuable functional parameter.     

Effect of temperature variation (22˚C- 44˚C) on halothane and caffeine contracture testing in normal humans

Background: Malignant hyperthermia (MH) susceptibility is diagnosed using halothane-caffeine contracture testing of a muscle sample maintained at 37˚C. However, there has not been a systematic study that examines the effect of different temperatures on the response of normal muscle to halothane and caffeine. We hypothesized that altering bath temperature would modify the contracture responses.
Methods: We obtained muscle samples from 20 patients undergoing surgical procedures of the lower extremities. The samples were dissected into 245 bundles and the bundles were exposed to halothane 3% or incremental caffeine, according to the North American MH group protocol. Several bundles from each patient were simultaneously studied at four different temperatures (22˚C, 30˚C, 37˚C and 44˚C). Each bundle was studied at only one temperature, the muscle samples of 3 patients were simultaneously studied at all four temperatures for halothane and caffeine.
Results: Maximum contracture to caffeine (32 mM) was highest at 37˚C; however, at lower caffeine concentrations (2–4 mM), there was no consistent effect of temperature on contracture response. Likewise, temperature did not alter contracture responses to halothane. The extremes of temperature (22˚C and 44˚C) were associated with lack of twitch in response to electrical stimulation. For the bundles exposed to halothane at 22"C, the absence of a twitch was associated with the presence of a contracture, although these were never above the diagnostic threshold.
Conclusions: We conclude that temperature has little effect on responses of normal muscle to halothane and caffeine.     

Visual assessment of urethrovesical junction mobility

The aim of the study was to compare visual assessment of anterior vaginal wall descent with the Q-tip test in evaluating urethrovesical junction mobility. One hundred and eleven patients with prolapse and/or urinary incontinence were examined in the supine lithotomy position with an empty bladder. Maximum straining Q-tip tests and maximum descent of the anterior vaginal wall were measured. Using each centimeter of descent as a cutoff value, the sensitivities, specificities and positive and negative predictive values were compared to those of the Q-tip test. As the cutt-off points were moved distally, specificity increased at the expense of sensitivity. There was no single cut-off point that provided adequate sensitivity and specificity to be clinically useful to replace the Q-tip test. It was concluded that visual assessment of anterior vaginal wall descent does not provide diagnostic accuracy and acceptable sensitivity and specificity to determine urethrovesical junction mobility. Other methods should be employed to assess support.Editorial Comment: Many clinicians claim that they can assess urethrovesical junction mobility visually and thus avoid employing other means, such as the Q-tip test, ultrasonography, bead-chain cystography or fluoroscopy. Montella et al. evaluate a technique of visual assessment of urethrovesical junction mobility based on the International Continence Society's Standardization of Terminology of Female Organ Prolapse and Pelvic Floor Dysfunction as compared to evaluation with the Q-tip test. Their results clearly indicate that this technique (measurement of the descent of point Aa) does not provide adequate sensitivity or specificity in determining urethrovesical junction descent compared to the Q-tip test. Although this technique was only compared to the Q-tip test and not all other modalities available, it is doubtful that visual assessment of anterior wall descent at any level would correspond to urethrovesical junction mobility, as is discussed very succinctly by the authors.