A case of Kleine-Levin syndrome examined with SPECT and neuropsychological testing

A case of Kleine-Levin syndrome with typical periodic hypersomnia and bulimia was diagnosed. On examination with single photo emission tomography (SPECT) (CERETEC) during a relapse period and 2 weeks later there was marked cortical hypoperfusion of the frontal and temporal lobes, especially on the left side as well as in the right parietal lobe. Neuropsychological testing performed 1 week after a relapse showed a reduction in encoding to memory function of verbal learning indicating neocortical damage of the left fronto-temporal region. A follow-up 2 months later after the patient had spontaneously recovered showed only a slight left fronto-temporal disturbance. CT and MRI of the brain were normal although the MRI showed a large and asymmetric mamillary body. Neuropsychological testing 6 years after recovery showed pronounced reduction in short-time verbal and visual memory. Seven years after recovery SPECT demonstrated a normalized frontal perfusion but still a slight hypoperfusion in the left temporal lobe. Our results correlate to autopsy findings in two cases described previously.     

Interpretation and classification of microvolt T wave alternans tests

Measurement of microvolt-level T wave alternans (TWA) during routine exercise stress testing now is possible as a result of sophisticated noise reduction techniques and analytic methods that have become commercially available. Even though this technology is new, the available data suggest that microvolt TWA is a potent predictor of arrhythmia risk in diverse disease states. As this technology becomes more widely available, physicians will be called upon to interpret microvolt TWA tracings. This review seeks to establish uniform standards for the clinical interpretation of microvolt TWA tracings.     

Rh genotyping: avoiding false-negative and false-positive results among individuals of African ancestry

High homology, variant alleles, and silent alleles have made the development of completely reliable genotyping assays for the RHD and RHC alleles difficult. An RHD pseudogene (RHDPsi) possessing a 37-bp insertion within exon 4 is common among serologically RhD-negative individuals of African descent and generates false-positive results in previously reported RhD genotyping assays. Genotyping RhC is problematic due to exon 2 homology between RHD and RHC; however, an RHC-specific 109-bp insertion within intron 2 has been reported useful for genotyping. Primers flanking the exon 4 insertion point were used for detection of RHD and RHDPsi among a total of 231 serotyped individuals: 134 African American, 85 Caucasian, and 12 RhD serotype-negative/genotype-positive, D-sensitized women. Primers flanking the RHC-specific intron 2 insertion were used to genotype 282 serotyped individuals (128 African American, 154 Caucasian) and were compared to RHC genotyping using the exon 1 RhC-specific nt48 cytosine polymorphism. Complete correlation was observed between genotyping with the RHDPsi primer pair and serotyping among 219 individuals and 10/12 previous RHD false-positive genotyping results were resolved. RHDPsi was detected in 19% (n = 4/21) of RhD seronegative African Americans and 4.4% (n = 5/113) of RhD seropositive African Americans. When using the 109-bp intron 2 insertion for genotyping of RHC, a 23.9% (n = 11/46) false-negative rate was observed among African American RhCc serotyped heterozygotes. Utilization of the exon 1 nt48 cytosine for indirect genotyping of RHC yielded a 7.2% (n = 4/55) and 56.3% (n = 45/80) false-positive rate among Rhcc Caucasians and African Americans, respectively. We conclude that these additional reactions, though not sufficient alone, can be useful supplements to existing Rh genotyping assays.     

Minimally invasive parathyroidectomy using the 'focused' lateral approach. II. Surgical technique

Background : This paper describes the technique of minimally invasive parathyroidectomy. The technique is based on a thorough understanding of the anatomy of the fascial planes in neck, the surgical pathology and embryology of parathyroid glands and precise anatomical interpretation of preoperative localization studies. Methods : Tissue trauma is minimized by using a 2.0 cm incision placed directly over the abnormal parathyroid gland and by removing the adenoma, without compromising the basic endocrine surgical principles of identification and preservation of recurrent laryngeal nerve, avoidance of any capsular breech, and ligation of the vascular pedicle. Results/Conclusions : With proper patient selection, this technique results in a failure rate of less than 4% and ensures that the incidence of complications, such as recurrent laryngeal nerve injury, remains comparable with that of standard open parathyroidectomy.     

心电图与运动平板对冠心病的诊断价值探讨

目的评估心电图、运动平板对冠心病的诊断价值。方法选择有症状疑诊冠心病的病例60例,每例患者均在2个月内做心电图、运动平板及冠脉造影检查,以冠脉造影为对照。结果在心电图阳性15例中冠脉造影阳性8例,心电图阴性45例中冠脉造影阳性22例;在运动平板试验阳性38例中冠脉造影阳性31例。冠脉3支以上严重病变的运动时间、运动量较1、2支病变和非冠心病小,运动达阳性时平均心率低。结论普通心电图诊断冠心病阳性率低,运动心电图诊断冠心病阳性率高,其运动时间、运动量和最大心率值对冠脉病变程度有一定的评估作用。     

成人直立倾斜试验90例临床特点分析

目的 多方面探讨直立倾斜试验阳性患者的临床特征，评价直立倾斜试验在疑诊为心脏病患者中的诊断价值。方法 研究对象分为直立倾斜试验阳性组（n=48）及阴性组（n=42），t检验对比二组临床化验指标的差异；计数资料采用X^2检验。结果 以晕厥为主要症状者占62例（68．9％），倾斜试验阳性占54．8％；以胸闷、胸痛或心悸等循环系统症状为主要表现者28例（31．1％），其中倾斜试验阳性50．0％。直立倾斜试验阳性组与阴性组患者临床症状表现比率无统计学差异（P〉0．05）；晕厥患者与循环系统症状患者相比，各直立倾斜试验阳性率之间无统计学差异（P〉0．05）。直立倾斜试验阳性组伴有心电图ST-T改变患者22例（45．8％），77．3％为Ⅱ、Ⅲ、avF导联及（或）V4-6导联ST-T改变。结论 在严格排除心、脑器质性疾患后，应重视以胸闷、胸痛或心悸等循环系统症状为主要表现患者的直立倾斜试验检查，这类患者极有可能为血管迷走性晕厥。     

乳腺X射线机泄漏射线测试方法探讨

乳腺X射线机使用频率极高。由于在进行诊断时．受检者的头部紧靠近X射线管组件，因此泄漏的X射线会严重影响受检者。介绍的办法是，首先对放置在乳腺X射线机管组件周围的胶片进行曝光．定性判断泄漏X射线的位置，然后通过辐射剂量仪进行准确测定。     

2004年山东省部分HIV抗体自愿检测者相关指标检测结果

[目的]做好即将全面开展的艾滋病自愿咨询检测工作,指导艾滋病预防控制工作。[方法]对山东省疾病预防控制中心艾滋病确认实验室2004年HIV抗体自愿检测人员血清抗HIV及相关指标检测结果进行分析。[结果]检测258人,抗HIV阳性者1例,阳性率为0.39%;乙肝表面抗原(HBsAg)、丙肝病毒抗体(抗HCV)和梅毒螺旋体抗体(抗TP)阳性率分别为5.04%、1.55%、1.55%。[结论]在自愿检测人群中检出1例HIV抗体阳性者;HBsAg、抗HCV阳性率不高,抗TP阳性率略高。     

TK6和WTK1细胞体外微核试验比较研究

目的：比较5种诱变剂诱导人类淋巴母细胞TK6和WTK1的微核反应。方法：用人的类淋巴母细胞TK6和WTK1进行体外微核试验，评价5种诱变剂的染色体损伤效应。结果：5种受试物均可诱导两种细胞微核率显著升高，但在大多数剂量和采样时间，受试物诱导的TK6细胞微核率均不同程度地高于WTK1细胞微核率。结论：TK6细胞对受试物诱导的染色体损伤更为敏感。     

Inhibitory effects of the ferment liquids on sarcoma

Objective： To study the anti-tumor effects of the ferment liquid （FL） and to explore the anti-mutagenic effects induced by cyclophosphamide （CP）. Methods： Anti-tumor effects and Anti-mutagenic effects induced by cyclophosphamide （CP） of the ferment liquid were observed in tumor-bearing mice in vivo. Spleen lymphocytes proliferation of mice was stimulated by ConA and NK cell activity was analyzed by the lactate dehydrogenase （LDH） release assay. Results： FL Ⅰ,FL Ⅱ and FL Ⅲ of 16.7, 33.3 and 66.6 ml/kg inhibited growth of Sarcoma 180 sighificanth by 11.6%, 24.2%, 28.0%, 4.8%, 15.2%, 2.2% and 2.1%, 8.5%, 5.2% respectively. Polychromatic erythrocytes （PCE） at all doses of FL Ⅰ and FL Ⅱ were greatly decreased compared with control group （ P 〈 0.05）, but FL Ⅲ has no inhibition effents（ P 〉 0.05）. Production of IL-2 showed no significant difference between all treatment groups. The NK cell killing activity in all treated mice increased by FL Ⅰ and FL Ⅱ was significantly potentiated compared to controls （ P 〈 0.05）. Lymphocytes proliferation of ICR mice were stimulated by ConA 2.5 ml/L and there were no differences between groups. Conclusion： The present data suggested that three kinds of ferment liquid used as health drink have anfi-mutagenesis, immune enhancement effects and showed certain inhibitory effects on S180 tumor growth in vivo.