早期康复训练对脑卒中患者肢体运动功能的影响

探讨早期康复训练对脑卒中患者肢体运动功能的影响对２６例脑卒中患者进行早期康复训练，采用Ｆｕｇｌ－Ｍｅｙｅｒ运动功能评定，并与２８例对照组患者比较，结果表明，康复组肢体运动功能明善（Ｐ＜０．０１），但随着年龄增加，功能积分逐渐减少。说明早期康复治疗对脑卒中患者者肢体运动功能的恢复具有重要的作用。     

Successful Endoscopic Treatment of Diffuse Antral Vascular Ectasia and Early Gastric Carcinoma in an Aged Patient

Diffuse antral vascular ectasia and a lla type early gastric cancer were detected in an 83-year-old male patient through an endoscopy during treatment for iron deficiency anemia. Monopolar electrocoagulation was effective for eradication of red spots which represented ectatic vessels. Five sessions of the therapy resulted in the ablation of almost all of the vascular lesions, negative fecal occult blood tests and improvement of his anemia. The lla lesion was endoscopically resected from the posterior wall of the upper body. Histologic examination demonstrated well differentiated adenocarcinoma confined to the mucosal layer. Both the vascular ectasia and carcinoma did not show any sign of recurrence after a year and a half.     

Effects of lipoprotein(a) on mesangial cell proliferation and viability

BACKGROUND: Lipoprotein abnormalities are considered to accelerate glomerularinjury in various forms of renal disease, probably by affectingmesangial proliferation. Serum levels of the atherogenic Lipoprotein(a)(Lp(a)) are elevated in patients with nephrotic syndrome andLp(a) deposits have been identified in diseased glomeruli. Sofar, the influence of Lp(a) on mesangial cell function has notbeen defined. METHODS: The influence of Lp(a) on mesangial cell proliferation was assessedin a rat mesangial cell culture model by direct measurementof cell growth as well as analysis of DNA-synthesis and mRNAlevels of c-fos and c-myc, two growth-associated ‘immediateearly response genes’. RESULTS: Lp(a) triggered a biphasic response on DNA synthesis: ³H-thymidineuptake was increased when cells were incubated with Lp(a) (2.5–10µg/ml) for 24 h. The response was dose dependent, a maximaleffect was seen for Lp(a) 5 µg/ml. The stimulatory propertiesof Lp(a) were comparable to 10% fetal calf serum (FCS). No additiveeffect of 10% FCS and Lp(a) on DNA synthesis was observed. Cellproliferation was moderately stimulated (120±9% of control)by low levels of Lp(a) in the presence of small amounts of FCS.Messanger RNA levels for c-fos and c-myc were upregulated asearly as 15 min after incubation with Lp(a) 5 µg/ml, amaximum response was observed after 30 and 240 min respectively.Stimulation of DNA synthesis was partly blunted when cells wereincubated with Lp(a) in the presence of catalase 100 U/ml andsuperoxide dismutase 10^–7M (SOD) but not in the presenceof SOD alone. Lp(a) in concentrations above 10 µg/ml depressedDNA-synthesis and elicted signs of cytotoxicity. The cytotoxiceffects of Lp(a) were not blunted by oxygen radical scavengers.The stimulatory and cytotoxic effects of Lp(a) were not restrictedto a specific isoform. CONCLUSION: Low concentrations of Lp(a) stimulated growth of mesangial cells,whereas higher concentrations had antiproliferative or toxiceffects. The stimulation of mesangial cell proliferation aswell as the cytotoxic effects causes by Lp(a) are both likelyto have a negative impact on the course of renal disease.     

周围血管损伤10例分析

对１０例周围血管损伤进行分析，其中股动、静脉伤３例，胭动、静脉伤１例，股动脉伤２例，股静脉伤、髂外静脉伤、颈总动脉伤及桡动脉伤各１例。合并休克５例。诊断依据外伤史、外出血、搏动性肿块及远端肢体缺血征象。伤后迅速止血，补充血容量，防治休克，尽快重建血管，恢复肢体血液循环是急救的基本原则。治疗以外科手术为主，强调Ⅰ期彻底手术处理，遵循血管外科技术原则，选择正确术式并及时、正确处理好各种合并伤。     

早期肝硬化的临床特点与诊断

目的：认识早期肝硬化的临床特点并作出诊断。材料与方法：对经病理确诊的早期肝硬化及慢活肝各１３０例临床资料进行对照分析。结果：早期肝硬化与慢活肝在蜘蛛痣、肝掌、慢性肝病面容、Ａ／Ｇ异常、γ＞０．２５及ＨＢＶ感染的家庭聚集等方面存在差异（Ｐ＜０．０２５～０．００ｌ）。结论：掌握早期肝硬化的临床特点，可对其作出正确的诊断。     

Morphology of single, physiologically identified retinogeniculate Y-cell axons in the cat following damage to visual cortex at birth

It has been reported previously that neurons in the dorsal lateral geniculate nucleus (LGN) of cats with neonatal damage to visual cortex (KVC cats) have receptive fields that are abnormally large and that the receptive fields of these neurons sometimes do not appear to conform to the normal retinotopic order in the LGN. A primary aim of this study was to determine if these physiological abnormalities are related to inappropriate patterns of retinogeniculate connections. We therefore have analyzed the terminal arbors of retinogeniculate axons in adult cats that had received a lesion of visual cortex (areas 17, 18, and 19) on the day of birth. Single retinogeniculate axons were characterized physiologically and injected intracellularly with horseradish peroxidase. Consistent with earlier reports that neonatal removal of visual cortex results in a retrograde loss of retinal X-cells, all of the retinogeniculate axons that we recorded were from Y-cells. While the visual responses of these Y-cell axons were normal, the morphology of their terminal arbors in the LGN was abnormal. Retinal Y-cell axons in KVC cats have terminal fields in the A laminae of the LGN that are as large or larger than those of normal Y-cells. However, since the LGN in KVC cats is severely degenerated, single Y-cell arbors occupy a proportional volume of the LGN that is 12 times greater than normal. Thus an early lesion of visual cortex produces a severe mismatch between retinogeniculate axon arbor size and target size. Also, despite the normal size of retinogeniculate axon arbors in KVC cats, the number and density of terminal boutons are greatly decreased. Thus our morphological results suggest that the unusually large receptive fields of LGN cells in KVC cats and the relative lack of retinotopic precision in the LGN are due, at least in part, to anomalies in the relative size and distribution of retinogeniculate axon arbors that develop after neonatal removal of visual cortex.     

Metrics Comparing Simulated Early Concentration Profiles for the Determination of Bioequivalence

Purpose. To compare the effectiveness of various metrics which evaluate bioequivalence in the early phase of concentration-time profiles. Methods. Two-period crossover trials were simulated with increasing assumed ratios of the true absorption rate constants of the two formulations, and with various kinetic models. Kinetic sensitivities (KS) and standard errors (SE) of the various metrics were recorded and the percentage of trials accepting bioequivalence (the statistical power) was evaluated. The principal metrics included the partial AUC (AUC _P) the intercept obtained by linear extrapolation of the ratios of the lower over higher concentrations (C) measured for the two formulations (I _{L /H}), and the ratios of intercepts extrapolated from logarithmic C/ time values of the two products (M _log). For comparison, also properties of C _maxand an ideally evaluated measure (Id) were determined. Results. M _logshowed generally the highest statistical power and KS, and also the largest SE, closely followed by I _{L /H}. Partial AUC exhibited lower power and KS, but also smaller SE than the intercept procedures. The three methods had much higher power, KS and SE than C _max. These comparisons were maintained over various kinetic conditions and experimental designs. The effective evaluation of bioequivalence in the early phase of studies is assured with 3 (or more) measurements until the population average peak of the reference formulation. Conclusions. The three principal methods assess bioequivalence very effectively in the early phase of a concentration-time profile. M _loghad the highest statistical power, closely followed by I_{L /H}and then by partial AUC.     

Differential time course and spatial expression of Fos,Jun, and Krox-24 proteins in spinal cord of rats undergoing subacute or chronic somatic inflammation

We have used the evoked expression of both immediate early gene (IEG)-encoded proteins (Krox-24, c-Fos, Fos B, Jun D, Jun B, c-Jun), and dynorphin to monitor sensory processing in the spinal cords of rats undergoing subacute or chronic somatic inflammation (i.e., subcutaneous inflammation of the plantar foot and monoarthritis, respectively). Behavioral and immunocytochemical approaches were conducted in parallel up to 15 weeks postinjection in order to detect possible relationships between clinical evolution and spatiotemporal pattern of IEG-encoded protein expression. Each disease had specific characteristics both in terms of their clinical evolution and pattern of evoked protein expression. All IEG proteins were expressed in both cases. Most of the staining was observed in both the superficial layers of the dorsal horn and deep dorsal horn (laminae V–VII and X). Monoarthritis was distinguished by a high level of total protein expression. Staining was especially dense in the deep dorsal horn. More labelled cells were observed at 1–2 days and at 2 weeks postinjection, corresponding to the initiation and progressive phases of the disease, respectively. Subcutaneous inflammation was characterized by a moderate level of total IEG expression. More labelled cells were observed in the first day following injection. It is the relative degree of expression of each IEG-encoded protein with regard to the others that characterized the progression of the diseases. Early stages of the diseases coincided with the expression of all Fos and Jun proteins, while late stages showed an increase in Jun D and Fos B involvement; Krox-24 was induced mostly during the early phases and/or periods of paroxysm of the diseases. Persistent stimulation was characterized by a predominant expression in deep versus superficial layers of the dorsal horn. Evoked expression of c-Jun in motoneurons was only observed in monoarthritis. The peak of dynorphin expression was late in regard to both the induction of inflammation and period of maximal IEG-encoded protein expression. The present work indicates that the neural processing that takes place during progression of these diseases can be monitored well at the spinal cord level by using the expression of an array of IEG-encoded proteins. Study of long term evolutive diseases and especially those that evolve into chronicity can largely benefit from such an approach. © 1993 Wiley-Liss, Inc.     

Changes of intracranial pressure during the rupture of intracranial aneurysms: Prognosis for survival

The intracranial pressure at the time of rebleeding from an intracranial aneurysm was recorded in 4 patients who were undergoing conservative treatment pending clinical improvement. Two died of severe hemorrhages and the remaining two recovered. In the deceased patients, repeated rapid increases in the intracranial pressure in a short time caused by rupture of the intracranial aneurysm were observed. In the surviving patients, the intracranial pressure increased only once, owing to the rupture of the intracranial aneurysm. We suggest that sudden death following the rupture of an intracranial aneurysm may result from frequent, repeated bleeding causing an intracerebral hematoma or severe brain swelling, or both.     

Fracture-Suspending Effect of the Patellar-Tendon-Bearing Cast

In order to evaluate the fracture-suspending effect of the patellar-tendon-bearing cast, experiments using a load cell under the heel were carried out on four subjects. Measurements were made using a conventional below-knee cast, the PTB cast, and an above-knee cast. There were no differences between the forces transmitted by the same subject wearing the three types of casts in turn and consequently the choice of cast must be based on other factors.