Use of Oral DDT in Three Human Barbiturate Intoxications: Hepatic Enzyme Induction by Reciprocal Detoxicants

Abstract

In the management of intoxications, the major goals are enhanced elimination of the toxin from the organism and prevention of further absorption. Absorption of an orally administered substance from the gastrointestinal tract can be decreased by adequate washing of the stomach. Delayed absorption of the substance from the small intestine cannot be avoided by this procedure and after the gastric lavage, a nonspecific adsorbent must be administered and diarrhea induced (1). This study demonstrates that iatrogenic diarrhea via gut lavage can also eliminate toxins already absorbed by the body.     

Bispecific antibodies engage T cells for antitumor immunotherapy

Introduction: Although considerable evidence supports the hypothesis that T cells play a critical role in the immune response against cancer, the ability to mount and sustain tumor-specific cellular responses in vivo remains a challenge. A strategy that harnesses the cytotoxic advantage of T cell therapy is the use of bispecific antibodies designed to engage and activate endogenous polyclonal T cell populations via the CD3 complex, but only in the presence of a tumor antigen. While antibody constructs with dual specificity were first described as anticancer therapeutics over 25 years ago, it was not until recently that one subclass of bispecific single-chain antibody, the bispecific T cell engager (BiTE), emerged as superior to previous iterations in achieving efficacy in animal models and early clinical trials.

Areas covered: The evolution of bispecific antibodies in antitumor immunotherapy is reviewed and the greatest hurdles impeding their clinical translation are discussed, specifically in the context of immunoprivileged sites as is the case for intracerebral malignancy.

Expert opinion: The BiTE platform has great potential in the treatment of malignant disease. Despite burgeoning interest in bispecific antibodies and permutations thereof, the issues of stability and cost-effective production persist as obstacles.     

改良抗酸染色法在结核性浆膜炎临床诊断中的价值

目的 应用改良的抗酸染色法(改良法)对确诊的结核性浆膜炎患者进行回顾性诊断,并与传统的抗酸染色法(传统法)相比较,以评估改良法对结核性浆膜炎的临床诊断价值。 方法 48例确诊结核性浆膜炎患者的浆膜腔积液同时送检改良法和传统法。其中,胸腔积液33例,腹腔积液15例。全部患者浆膜腔积液均为首次采集,采集时未经抗结核治疗(未治疗)患者28例,已进行抗结核治疗(已治疗)患者20例。 结果 48例患者改良法和传统法抗酸杆菌检出率分别为58.33%(28/48)和6.25%(3/48),两者差异有统计学意义(P=0.000);28例未治疗患者改良法抗酸杆菌检出率为71.43%(20/28),显著高于传统法3.57%(1/28,P=0.000);已治疗患者改良法抗酸杆菌检出率为40%(8/20),明显低于未治疗患者(P<0.05)。改良法和传统法阳性标本细胞外均检出抗酸杆菌,改良法检出胞内菌,传统法则均未检出。 结论 改良法显著提高了抗酸杆菌的检出率。而胞内菌的检出,对于判定细菌的存在则更具特异性。改良法极大地提高了诊断率,对于结核性浆膜炎患者的早期诊断和治疗,具有很高的临床应用价值。     

人离体牙树脂修复充填前、后漂白对边缘微渗漏的影响

目的：评价树脂充填前、后漂白对树脂修复体边缘微渗漏的影响。方法收集2015年5月至2016年1月在深圳市福田区中医院口腔科60颗离体上颌中切牙(重度牙周病患者无法保留的患牙),分别行根管治疗后,按患者就诊先后顺序随机分成3组(n=20)：A组直接树脂充填;B组牙漂白术后行树脂修复术;C组树脂充填后行牙漂白术;模拟口腔内环境处理后,在体视显微镜下观测牙漂白术对树脂修复体微渗漏的影响。结果 A组修复体边缘微渗漏率为35%,B组为90%,C组为95%,A组修复体边缘微渗漏率低于B组和C组,差异有统计学意义(P>0.05), B与C组间比较差异无统计学意义(P>0.05)。结论无论树脂充填前或充填后漂白,漂白术均会使复合树脂充填体的边缘微渗漏程度增加。     

Central pontine myelinolysis: sequele of hyponatremia during transcervical resection of endometrium

Transcervical resection of endometrium is an alternative to hysterectomy for women with menorrhagia. The procedure involves the use of cutting loop diathermy to resect the endometrium while the uterine cavity is irrigated with 1.5% glycine which can absorb consequent fluid and electrolyte shifts. Severe hyponatremia leading to central pontine myelinolysis is an extremely rare complication of this procedure. We report a case of a young female undergoing transcervical resection of endometrium for menorrhagia, who developed central pontine myelinolysis but made a complete recovery after three months.     

Pica With Paradichlorobenzene Mothball Ingestion Associated With Toxic Leukoencephalopathy

This is a case report of central nervous system toxicity associated with paradichlorobenzene (PDCB) ingestion. The patient had ingested mothballs composed of 99.99% PDCB for a period of 7 months. She was admitted for depression and had no neurologic symptoms. Later she developed an acute cerebellar syndrome followed by stupor and coma. An extensive workup was negative except for decreasing levels of PDCB in her serum. Imaging revealed a diffuse leukoencephalopathy. Her clinical picture was attributed to PDCB toxicity.     

Efferent projections of reuniens and rhomboid nuclei of the thalamus in the rat

The nucleus reuniens (RE) is the largest of the midline nuclei of the thalamus and exerts strong excitatory actions on the hippocampus and medial prefrontal cortex. Although RE projections to the hippocampus have been well documented, no study using modern tracers has examined the totality of RE projections. With the anterograde anatomical tracer Phaseolus vulgaris leuccoagglutinin, we examined the efferent projections of RE as well as those of the rhomboid nucleus (RH) located dorsal to RE. Control injections were made in the central medial nucleus (CEM) of the thalamus. We showed that the output of RE is almost entirely directed to the hippocampus and "limbic" cortical structures. Specifically, RE projects strongly to the medial frontal polar, anterior piriform, medial and ventral orbital, anterior cingulate, prelimbic, infralimbic, insular, perirhinal, and entorhinal cortices as well as to CA1, dorsal and ventral subiculum, and parasubiculum of the hippocampus. RH distributes more widely than RE, that is, to several RE targets but also significantly to regions of motor, somatosensory, posterior parietal, retrosplenial, temporal, and occipital cortices; to nucleus accumbens; and to the basolateral nucleus of amygdala. The ventral midline thalamus is positioned to exert significant control over fairly widespread regions of the cortex (limbic, sensory, motor), hippocampus, dorsal and ventral striatum, and basal nuclei of the amygdala, possibly to coordinate limbic and sensorimotor functions. We suggest that RE/RH may represent an important conduit in the exchange of information between subcortical-cortical and cortical-cortical limbic structures potentially involved in the selection of appropriate responses to specific and changing sets of environmental conditions.     

Activity of fin muscles and fin motoneurons during swimming motor pattern in the lamprey

Coordination of motoneuron activity is a fundamental prerequisite for the generation of functional locomotor patterns. We investigate the neural mechanisms that coordinate activity of motoneuron pools in the vertebrate spinal cord with differing phases of activity in the locomotor cycle in a simple motor system, the lamprey swimming network. In the region of dorsal fins the lamprey spinal cord contains two groups of motoneurons: the myotomal motoneurons that innervate the trunk muscles; and the fin motoneurons controlling muscle fibres of the dorsal fins. We investigated the activity of fin muscles during swimming in vivo and that of fin motoneurons during fictive swimming in vitro. During swimming in vivo with cycle periods of 4-8 Hz, fin muscle activity covered a broad portion of the cycle, with the peak of activity out-of-phase to the ipsilateral myotomal muscles. During fictive swimming evoked by N-methyl-d-aspartate in the isolated spinal cord, fin motoneurons expressed similar out-of-phase activity. The phase relationship of the synaptic drive to fin motoneurons was examined by recording their activity intracellular during fictive swimming. Three different forms of membrane potential oscillation with different time courses in the locomotor cycle could be distinguished. Sagittal lesions of the spinal cord in the segment where fin motoneurons are recorded and up to one segment rostral and caudal from it did not influence the out-of-phase activity pattern of the motoneurons. Our results indicate that coordination of fin motoneuron activity with the locomotor activity of myotomal motoneurons does not depend on intrasegmental contralateral premotor elements.     

Overactive bladder in Parkinson's disease: alteration of brainstem raphe detected by transcranial sonography

Urinary dysfunction is very common in idiopathic Parkinson's disease (PD) and manifests primarily with symptoms of overactive bladder (OAB). Affection of central serotonergic systems has been suggested to play a role in OAB. The objective of this study was to evaluate whether in PD patients with OAB symptoms a specific alteration of the brainstem raphe (BR), which contains serotonergic neurons, can be detected with transcranial sonography (TCS). Of 116 PD patients enrolled, 19 had PD-related OAB symptoms (OAB+) unlike remaining 97 patients (OAB−). Patients were examined by a sonographer blinded to the clinical data. Reduced echogenicity of BR was found in 12 (63%) OAB+ patients but only in 18 (19%) of 93 assessable OAB− patients (Mann–Whitney U -test, P  < 0.001). In OAB+ patients, lower raphe echogenicity score was associated with longer duration of OAB symptoms ( anova , P  = 0.033). Other TCS findings such as echogenicity of substantia nigra, thalami, lenticular and caudate nuclei, and widths of third and lateral ventricles did not differ between OAB+ and OAB− patients. TCS findings suggest a pathogenetic role of BR in OAB related to PD. Alterations may reflect disturbance of its central serotonergic system.     

Central fatigue in continuous and intermittent contractions of triceps brachii

Conflicting results have been found across studies concerning the effect of rest periods on the development of central fatigue during prolonged muscle activity. Thus, the aim of the present study was to assess differences in the development of central fatigue between continuous and intermittent elbow extension fatigue tasks in the same subjects. Force and electromyographic data were collected on eight healthy volunteers. The ability to maximally activate the triceps brachii muscle was assessed by delivering trains of electrical stimulation during maximal voluntary efforts. This was done before, during, and after three fatigue tasks involving a maximal contraction in elbow extension. One short-duration ( approximately 55-s) and two long-duration (3-min) fatigue tasks were performed by all subjects on separate sessions. One 3-min task was intermittent (5-s rests every 30 s) and the other was continuous. The main findings were that the development and extent of central fatigue were task-dependent, with a greater decrease in the ability to maximally activate triceps brachii observed for the 3-min continuous task. Also, the voluntary activation (VA) ratio was found to be a more sensitive index of central fatigue than the central activation ratio (CAR). These results suggest that, when assessing central fatigue in patients, conclusions may vary depending on the continuous/intermittent nature of the task performed and the estimate of voluntary activation used.