Allergy to pine nuts in a bird fancier

A patient is described with the bird-egg syndrome who experienced an anaphylactic reaction after eating some of her parrot's food (pine nuts: Pinus pinea ). Specific IgE against this nut and another pine nut ( P cembra ) was demonstrated by RAST. Cross-reactivity between these botanically related seeds was shown by RAST inhibition. Besides avian antigens, bird food antigens should be taken into consideration when symptoms of allergy occur on exposure to birds.     

Horizontal Interactions in Cat Striate Cortex: II. A Current Source-Density Analysis

The current source-density (CSD) analysis was used to investigate the organization of tangential synaptic connections in primary visual cortex of normally reared (NR) kittens and of NR, binocularly deprived (BD) and dark-reared (DR) adult cats. Laminar profiles of field potentials, elicited by intracortical microstimulation were measured at various distances from the stimulating electrodes. To exclude contamination by axon collaterals of antidromically stimulated thalamo-cortical fibres, these were destroyed by injecting the cytotoxin N-methyl-D-aspartate (NMDA) into the lateral geniculate nucleus 13 - 27 days before recording. The CSD profiles revealed distinct layer-specific patterns of lateral spread of activity. Invariably, the most prominent, long-lasting and far reaching responses were recorded in supragranular layers. Responses in layer IV were brief and confined to the vicinity of the stimulation site. Responses in infragranular layers spread as far as those in supragranular layers, but were of smaller amplitude. Latency considerations, the results of double shock stimulation, and the effects of translaminar cuts, suggest that these responses were monosynaptic and mediated by intracortical pathways with a conduction velocity of 0.3-5 m/s. The spatial spread of these responses changed substantially with age but was not influenced by visual deprivation. In NR adults, supra- and infragranular responses were recordable up to 2.5 mm from the stimulation site and layer IV responses up to 1 mm from the stimulation site. In kittens, the former responses spread up to 5 mm and the latter up to 2 mm from the site of stimulation. The amplitude of the responses decreased with distance from the stimulation site. This decrease was not always monotonic suggesting inhomogeneities in the tangential projections. The laminar distribution of current sinks and sources indicates that the pathways mediating tangential interactions form excitatory synapses on apical dendrites of pyramidal cells. It is concluded that the spatial spread of tangential excitatory interactions decreases with age, but that neither the laminar pattern nor the age-dependent reduction in the strength of tangential interactions are influenced by visual deprivation.     

Survival effect of systemic therapy on patients developing metastatic breast carcinoma

A multivariate analysis was performed to assess the effect of post-relapse systemic therapy on a series of patients with metastatic breast cancer who at initial presentation had no detectable metastases (M), were 70 years of age, presented with unilateral localized disease and no other associated malignancy, and were treated between 1965 and 1984 with successive protocols for primary disease and subsequently developed distant metastasis. All 760 patients analyzed relapsed with at least one metastasis, and were studied retrospectively with no selection criteria according to any specific protocol. All had recorded clinical data on menopause, stage, clinical tumor aggressiveness (PEV), initial chemo or hormonal therapy, and time to relapse, and had ongoing follow up at our Center, with salvage chemotherapy and/or hormonal therapy having been given to some but not all patients.A brief metastasis-free survival (p < 0.000001), and factors associated with electing pre-relapse chemotherapy (p < 0.000001) were associated with shortened post-relapse survival, while post-relapse therapy (chemo p < 0.0001, and hormonal p < 0.00001, replacing chemotherapy in the model) apparently increased post-relapse survival in the group overall. This result was similar in the inoperable patient group [with inflammatory breast carcinoma an additional risk factor (p < 0.0005)], as well as the operable group. However, in the operable group, when the pathologic criteria of histologic grade and nodal status were introduced into the analysis, post-relapse therapy was not seen to be an important factor for survival in any subgroup. Histograde (p < 0.000001), nodal status (p < 0.0001), metastasis-free survival (p < 0.001), and menopausal status (p = 0.03) were the only significant factors for post-relapse survival.     

《伤寒论》外治法举隅

汉·张仲景著《伤寒论》中辨证论治体系也包括外治法的内容 ,《伤寒论》中的外治法有针、灸、温覆、熏、导、温粉等治疗方法 ,在临床上用于解表、泻下、和解、清热、温里、固涩、祛湿、预防传变等若干方面。     

The development of guidelines for drug and alcohol dependence treatment: affecting policy and practice

The rationale and methodology behind the Australian Quality Assurance Project is described. The Project aimed to develop guidelines for treatment content based on three sources of information: research findings, current practice and expert opinion. The issue of the gap between research and practice is discussed, as well as the role of dissemination in altering clinician behaviour.     

Modulation of action potential duration by inhibition of the transient outward current in sheep cardiac Purkinje fibers

In sheep cardiac Purkinje fibers concentration-dependent inhibition of transient outward current (i_to) by 4-aminopyridine (4-AP, 3-1000 mol/l) was recorded with the two-microelectrode voltage-clamp technique, and correlated effects on action potential duration measured at — 70 mV (APD-70) were investigatigated.Half-maximal inhibition of i_to-amplitude occurred at 15 mol/l 4-AP. The drug exhibited no major effect on voltage-dependent control of inactivation but reduced the maximally available i_to-current. At different activation frequencies (0.05 Hz, 0.25 Hz, 1 Hz) an equal amount of i_to-current, measured as percentage of the respective control, was inhibited by 4-AP. The APD-70 was on the average increased by 4-AP (3–500 mol/l) in a concentration-dependont manner up to 151 % of control. The drug-induced prolongation, measured as percentage of the respective control, was independent of stimulation frequency (0.05 Hz, 0.25 Hz, 1 Hz). Prolongation of APD-70 was on the average more pronounced for short action potentials (APD-70<150 ms: 169 % of reference) than for longer ones (APD-70 150–300 ms: prolongation to 117 % of reference; 500 mol/l 4-AP; 0.25 Hz stimulation rate). Few long control signals (APD-70 >300 ms) were shortened by 4-AP. These results indicate that inhibition of i_to-current by appropriate drugs will result in a reduction of inhomogeneity of action potential duration.