A new method for measurement of blood flow,pH, and transmucosal potential difference in rat gastroduodenal mucosa by endoscopy

A method was developed to measure the mucosal blood flow (BF), mucosal pH (pH), and transmucosal potential difference (PD) in various sites from the oral cavity to the duodenum without surgical operation or damage to the subject rats. These measurements were carried out by using three indicator electrodes, which were attached to the various sites through the suction channel of an endoscope. The hydrogen gas clearance method was used for the measurement of BF. BF values obtained at the fundic, pyloric, and duodenal regions were 119±17, 69.9±8.8, and 114±18 ml/min/100 g (mean±se), respectively. The pH values were lowest at the cardiac portion and the forestomach and highest at the duodenum. PD showed higher values at the stomach and lower values at the pharynx and duodenum. Using this technique, it was possible to measure the BF, pH, and PD repeatedly and safely at various sites in the same rat. Therefore, it was suggested that this method is useful in studying the physiological functions of the stomach and duodenum and the pathogenesis of gastroduodenal ulceration and that this method is applicable to measure the change of the above parameters in the healing process of gastric ulcer in rats.     

Fundoplication for gastroesophageal reflux disease: regional variability and factors predicting operative approach

We have recently shown that the majority of patients undergoing fundoplication in the United States are women. Based on these findings, we hypothesized that nonbiological factors contribute to the decisions on surgical reflux therapy. Using State Inpatient Databases of the Agency for Healthcare Research and Quality, we extracted annual fundoplication rates, sex distribution, age cohorts, racial background, and insurance coverage. To account for potential differences in state populations, the results were normalized and correlated with Census data, adult obesity rates, median income, poverty rates, and physician workforce within the state. Fundoplication rates varied fivefold between states, ranging from 4.1 ± 0.1 per 100 000 in New Jersey to 21.8 ± 0.4 per 100 000 in Oregon. Higher poverty rates and a higher fraction of Caucasians within a state independently predicted higher fundoplication rates. While the majority of operations were performed laparoscopically, surgical approaches also differed between states with rates of laparoscopic ranging from 52.3 ± 1.8% in Oklahoma to 87.4 ± 1.7% in Hawaii. A lower number of pediatric and Medicaid‐insured patient and a higher fraction of privately insured patients best predicted higher rates of laparoscopic surgery. Our study shows significant regional variation in surgical reflux management, which cannot be explained by differences in disease mechanisms. Insurance coverage and racial background influenced the likelihood of surgery, suggesting a role of financial incentives.     

Sex differences in anxiety and depression clinical perspectives

Sex differences are prominent in mood and anxiety disorders and may provide a window into mechanisms of onset and maintenance of affective disturbances in both men and women. With the plethora of sex differences in brain structure, function, and stress responsivity, as well as differences in exposure to reproductive hormones, social expectations and experiences, the challenge is to understand which sex differences are relevant to affective illness. This review will focus on clinical aspects of sex differences in affective disorders including the emergence of sex differences across developmental stages and the impact of reproductive events. Biological, cultural, and experiential factors that may underlie sex differences in the phenomenology of mood and anxiety disorders are discussed.     

上颌中切牙冠修复体的口腔色差容忍度研究

目的：研究上中切牙冠修复体在口内环境下的色差容忍度（包括察觉度和接受度）,为提高配色技术成功率提供数据依据。方法：使用专业牙科比色仪器ShadepilotTM,测定66例单侧上颌中切牙冠修复体与对应天然牙的色差数据△E,以及各色度参数差△L＊、△C＊、△a＊、△b＊,根据每个患者在修复体戴入口腔后对其色差的主观感受,将病例分成三组：A组：不存在色差,效果满意;B组：存在色差,但效果满意;C组：存在色差,效果不满意。C组修复体在进行外部染色后再次进行色差测定,数据归入A组或B组,总色差与各参数色差分别进行统计分析,研究色差察觉度和接受度。结果：口腔环境中,上中切牙冠修复体色差察觉度约为1．6（△E单位）,色差接受度平均为4．06（△E单位）;当修复体的明度L＊及饱和度C＊高于天然牙时,其色差容忍度相对较高,而修复体明度L＊及饱和度低于天然牙时,色差容忍度较低;色调差异△a＊的存在对色差容忍度的影响均比较显著。结论：口腔修复体的色差容忍度,不仅与肉眼观察生理特征相关,与心理因素也有着一定的关系,若能充分了解人们对修复体色彩的审美倾向,将色差容忍度定量运用于比色技术中,将对提高修复体配色成功率十分有利。