Disorders in early embryonal cellular proliferative properties distort the postnatal formation of nervous, immune, and endocrine regulation systems in a newborn

Disorders in the postnatal nervous, immune, and endocrine regulation systems were revealed in the progeny of rats irradiated during the preimplantation period of embryogenesis. These disorders persist till adult age. The direction of disorders confirms the hypothesis about memorization of changed proliferative properties of embryonal cells during the development of the (pro)endocrine system of a new organism. Memorization results in distortion of postnatal nervous immunoendocrine regulation: hypertrophy of the endocrine component and coadaptive underdevelopment of the nervous and immune components. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 126, No. 8, pp. 164–166, August, 1998     

腹腔镜在异位妊娠中的诊断和治疗价值

本文分析1982～1987年间收治的544例异位妊娠,其中270例行腹腔镜检查、274例未作腹腔镜检查。两组资料相比提示:腹腔镜检查组诊断符合率高达97.40％;由于能及早明确诊断,故该组腹腔内出血量比未作腹腔镜检查组少,平均为241m1/372ml(P<0.05),需输血例数明显减少30例(11.11％)/134例(48.90％)(P<0.01),输卵管未破裂者增高222例(82.22％)/194例(70.80％)(P<0.01)。270例无术后并发症发生。上述给年轻不孕患者作非手术治疗或输卵管保守手术以保留生育功能提供良好条件。     

食管钡餐连续摄影用于诊断早期食管癌的初步临床应用

目的 :介绍食管钡餐连续摄影用于诊断早期食管癌的初步临床应用。方法 :用德国产的数字化胃肠机检查并诊断了 6例早期食管癌病人。与常规食管双重对比造影类似 ,病人立位口服钡剂 ,同时进行连续摄影 ,速度为 2帧 s,持续约 10s。观察不同的时相 ,包括充盈相、黏膜相和双对比相。结果 :在 6例病人中可见食管功能的改变及黏膜皱襞的病变 ,用连续摄影诊断后经内镜及病理检查确诊。 4例病人有轻度扩张受限 ,2例病人有痉挛性收缩 ,1例有钡剂滞留。 6例病人中均可见增粗的或中断的黏膜。 5例病人可见小溃疡。结论 :食管钡餐连续摄影可提供更全面的信息。用此法更可提供食管功能性的改变。     

Deprivation of parenting disrupts development of homeostatic and reward systems in marmoset monkey offspring.

BACKGROUND: Early environment is a major determinant of long-term mental health, evidenced by the relationship between early-life neglect or abuse and chronically increased vulnerability to developmental psychopathology, including major depressive disorder (MDD). Animal studies can increase understanding of environmentally mediated causal risk processes. We describe how daily deprivation of biological parenting in primate infants disrupts development of homeostatic and reward systems central to MDD. METHODS: Nine breeding pairs of marmoset monkeys provided control twins (CON) and early-deprived twins (ED); the latter were socially isolated for 30-120 min/day on days 2-28. During the first year of life, basal urinary norepinephrine (NE) titers and cardiophysiologic activity were measured. At the end of year 1 (adolescence), automated neuropsychologic tests were conducted to measure responsiveness to changes in stimulus-reward association (simple/reversed visual discrimination learning) and to reward per se (progressive ratio [PR] reinforcement schedule). RESULTS: The ED monkeys exhibited increased basal urinary NE titers and increased systolic blood pressure relative to CON siblings. The ED monkeys required more sessions to reinstate stimulus-oriented behavior following reversal, suggesting increased vulnerability to perceived loss of environmental control; ED monkeys also performed less PR operant responses, indicating that reward was less of an incentive and that they were mildly anhedonic relative to CON. CONCLUSIONS: In marmoset monkeys, neglect-like manipulation of ED leads to chronic changes in homeostatic systems, similar to those in children and adolescents exposed to early-life adversity and in MDD, and to responses to environmental stimuli similar to those that characterize MDD.     

肾上腺皮质腺癌的诊断与治疗

目的 探讨肾上腺皮质腺癌的早期诊断、手术及围手术期处理。方法 回顾分析了1990年至2001年间31例肾上腺皮质腺癌临床资料．并与1978年至1989年同种病例作比较。结果 近10年患者病理分期更趋向早期，更易行根治性切除，5年的存活率明显提高。结论 影像学的发展，使患者易早期诊断；围手术期的充分准备是减少手术并发症及死亡率的关键。     

Early rapid weight gain and current overweight in relation to asthma in adolescents born with very low birth weight

Early catch-up growth and subsequent overweight are suggested to be associated with later cardiovascular diseases and later type II diabetes. However, the impact of early catch-up growth and childhood overweight on the development of asthma has been less studied, particularly in children born with very low birth weight (VLBW). A birth cohort of 74 VLBW children (birth weight < or = 1500 g) was followed from birth and investigated on asthma at 12 yr of age. Early rapid weight gain was in one way defined as an increase of weight > or =1 standard deviation score (SDS) at 6 months of corrected postnatal age. Current overweight was defined by body mass index (BMI) exceeding 21.2 and 21.7 kg/m(2), respectively, for boys and girls at 12 yr of age. Current asthma was diagnosed by a pediatrician, according to asthma ever in combination with a positive response to hypertonic saline bronchial provocation test and/or wheeze at physical examination at 12 yr old. Being overweight at 12 yr of age was associated with an increased risk for current asthma in the VLBW children [crude odds ratio (OR): 5.5, 95% confidence interval (CI): 1.3-22.2]. After adjustment for early weight gain and neonatal risk, the OR of overweight increased nearly three times (adjusted OR: 15.3, 95% CI: 2.5-90.6). Early rapid weight gain seemed to be inversely associated with current asthma (adjusted OR: 0.49 for an increase of weight equal to 1 SDS, 95% CI: 0.23-1.02, p = 0.06). In addition, early rapid weight gain was inversely associated with the magnitude of bronchial responsiveness at 12 yr (coefficient -1.15, p < 0.01). There was a strong and positive association between overweight and asthma at 12 yr of age in the VLBW children. This strong association had been reduced by early rapid weight gain, possibly via the reduction of bronchial responsiveness.     

Before-birth climatologic data may play a role in the development of allergies in infants

While an exacerbation in allergic symptoms corresponding to seasons has long been reported, few studies have investigated the association between the season of birth and allergic disorders. The aim of this study was to investigate whether the climatologic data before and after birth affected the incidence of atopic dermatitis (AD) and the results of allergy-related blood tests in early infancy. From February 1995 to January 2000, 2136 infants were tested for AD and followed for 12 months. AD patients were tested by using allergy-related blood tests. Data were compared according to the month of birth and the climatologic data using a computed statistical software package. Six hundred and thirty infants had AD before 12 months old, and significant differences were found according to the season of birth (p < 0.0001). Infants born in spring showed the lowest (22.3%) incidence, while those born in autumn showed the highest (34.6%). In 369 patients, total serum IgE levels, and serum specific IgE levels with egg white at 3 months old were also different according to the season of birth. All of these levels were lower in patients born in spring and summer, and higher in patients born in autumn and winter. Furthermore, the cumulative sunshine amount during the 3 months before and after birth was inversely correlated, while the average temperature over the 3 months before birth was positively correlated to the incidence of AD according to the month of birth. The climatologic data around birth may play an important role in whether an infant develops allergies.     

Spectral characteristics of early receptor potential in congenital red-green color blindness

The spectral response curve (amplitude versus wavelength) of the R₂ of the early receptor potential (ERP) was studied in normal, protan, and deutan subjects. The R₂ amplitude peaked at 520nm in most normal subjects. The R₂ at long wavelengths was smaller than normal in protans and larger than normal in deutans when the maximum amplitudes were normalized to 100% at the peak. The ratio of the R₂ amplitude at 460 nm to that at 600 nm clearly differed between protans and deutans. The ERP and the rapid off-response, which is mainly due to the cessation of the late receptor potential, were recorded in the same subjects. The ratio of the sensitivity of the rapid off-response at 500 nm to that at 600 nm was correlated with the ratio of the R₂ amplitude at 460 nm to that at 600nm (correlation coefficient, 0.823, p < 0.001). This study, in conjunction with our previous study, indicates that the abnormality is in the outer segments of the cones in protans and deutans.     

SUCCESSFUL ENDOSCOPIC CLOSURES OF COLONIC PERFORATIONS REQUIRING ABDOMINAL DECOMPRESSION AFTER ENDOSCOPIC MUCOSAL RESECTION AND ENDOSCOPIC SUBMUCOSAL DISSECTION FOR EARLY COLON CANCER

Endoscopic submucosal dissection (ESD) for colorectal cancer is not widely accepted because of its technical difficulty and the risk of perforation. In addition, the risk of peritonitis cannot be completely eliminated even if a perforation is closed successfully. Reported here are two cases of early colon cancer in which the patients sustained iatrogenic perforations of the ascending colon during conventional endoscopic mucosal resection and of the sigmoid colon during ESD, respectively, requiring abdominal decompression with an 18 G Medicut needle. Both of these perforations were successfully treated by endoscopic clipping. In conclusion, conservative medical management may be possible in patients who have undergone successful closure of colonic perforations using endoscopic clipping. In order to perform immediate endoscopic closure, abdominal decompression has been useful to decrease patient discomfort and colonic lumen collapse. Now, CO₂ insufflation is being used effectively for the prevention of pneumoperitoneum.