冠心病患者冠状动脉病变与糖耐量变化的关系

目的　探讨冠心病患者糖耐量变化与冠脉病变之间的关系。方法　 193例冠心病患者根据WHO(1985 )和美国糖尿病学会 (1997)糖尿病诊断标准分为单纯冠心病〔糖耐量正常 (NGT)〕组12 2例 ,冠心病合并糖耐量异常 (IGT)组 39例 ,冠心病合并 2型糖尿病 (DM)组 32例 ,所有研究对象均行冠脉造影 (CAG)和口服 75克葡萄糖耐量试验 ,检测血糖、胰岛素、血脂。冠脉病变程度应用CAG分析 ,冠脉狭窄程度根据美国心脏学会分类标准评价 ,冠脉病变的危险因素应用多元逐步直线回归分析。结果　 (1)冠心病合并IGT组多支冠脉病变的发生率明显高于单纯冠心病组 (6 6 .5 %vs 35 .1% ,P <0 .0 5 ) ,冠脉狭窄程度 (8.9± 3.6vs 6 .5± 3.9,P <0 .0 5 )及钙化的程度 (6 .3± 3.6vs 3.9± 4 .1,P <0 .0 5 )明显高于单纯冠心病组 ,冠脉远端的病变发生率明显高于单纯冠心病组 (40 .8%vs 13.1% ,P<0 .0 5 )。 (2 )冠心病合并IGT组与冠心病合并DM组相比 ,多支冠脉病变的发生率、冠脉粥样硬化及钙化的程度及冠脉远端的病变发生率差异无显著性。 (3)血脂、胰岛素、血压与冠脉粥样硬化程度有明显相关性。结论　与冠心病合并DM患者相似 ,冠心病合并IGT患者多支冠脉病变的发生率高 ,病变多呈弥漫性狭窄 ,远端血管病变发生率较高 ,程度严重。血     

Recurrent pneumococcal meningitis in a patient with transient IgG subclass deficiency

We report the case of a 3 year old boy who exhibited recurrent serious infections with a transient imbalance of IgG subclass in the second year of life. He suffered from pneumococcal meningitis at 3 months, hepatitis at 9 months, and purulent arthritis at 11 months of age. The second episode of pneumococcal meningitis occurred at 14 months. Serum IgG level was normal for age. Low level of IgG2, undetectable level of IgG4 and negligible level of pneumococcus-specific IgG1-G2 antibodies were found. No other primary immunodeficiency was apparent. Serum IgG2-G4 levels but not pneumococcus-specific IgG1-G2 titers increased by the age of 30 months. At that time, he was inoculated with a polyvalent pneumococcal vaccine along with acellular diphtheria-pertussis-tetanus vaccine. He acquired the immunity against these agents, and had no episodic infections in the following 2 years. This observation stresses the existence of transient IgG subclass deficiency associated with delayed development of the anti-polysaccharide antibody response.     

Oral findings and a proposal for a dental health care program for patients with Duchenne type muscular dystrophy

A total of 43 patients with muscular dystrophy of the Duchenne type were separated into the three groups by calendar and dental age. Oral examinations, questionnaires, and observations of dental behavior were recorded to propose a dental health management program for the particular problems associated with these patients. Three general conclusions were drawn from this study.     

Japanese dreams: culture and cosmology

Abstract Attitudes to dream evaluation vary depending on culture. Dreams are considered important, real, and public in some cultures, but absurd, irrational and personal in others. Japan has its own history of dreaming, which can be well reconstructed due to rich sources of archeological and documentary material. In this paper dream evolution in Japan is described. Phase 1 is the prehistoric Jomon period, where people believed dreams were part of reality. From Phase 2, the sophisticated philosophies of Confucianism, Buddhism and Taoism were introduced and changed the social and mental system of Japan in phase 3. At phase 4, the amalgamation of local and alien cultures occurred and supernatural beliefs prevailed. In this society dreams played a very important role. Phase 5 is the period when the Samurai class ruled Japan. The pragmatic thinking of the Samurai succeeded in fostering good preconditions for the receipt of scientific Western culture in phase 6. The importance of dreams in Japan evolved in such a way. However, the elements of each phase continued and accumulated similar layers. Thus, a majority of the phases seemed to retain animism from the Jomon period.     

Granular Cell Myoblastoma of the Gallbladder

A case of granular cell myoblastoma of the gallbladder in a 39-year old Japanese female is presented. Granular cell myoblastomas arising in the biliary tract are a rare occurrence. This tumor has not yet been reported in the gallbladder.     

Current topics in childhood lupus nephritis

Lupus nephritis is a major predictor of the prognosis of systemic lupus erythematosus (SLE). The present paper discusses lupus nephritis from clinical and immunopathological points of view. Although recent advances in diagnosis and treatment improve the prognosis of children with SLE, there remain many unsolved clinical problems. One of the current topics in the treatment for SLE is intermittent intravenous cyclophosphamide therapy which is effective even for the steroid-resistant patients with severe lupus nephritis, at least for short-term observation. Immunopathologically, the following issues are discussed: (i) The C5b-9 terminal complement complex plays an important role in the pathogenesis of lupus nephritis. The possible interaction of vitronectin and SP-40,40 is also mentioned; (ii) A semi-quantitative analysis of the charge barrier of the glomerular basement membrane reveals that the charge barrier dysfunction plays an important role in the pathogenesis of proteinuria in lupus nephritis. This study also demonstrates that the charge of immune deposits is important for the initiation of glomerular injury in lupus nephritis; (iii) It is demonstrated that the histopathological diversity of lupus nephritis is based on biological properties of nephritogenic autoantibodies in murine lupus models.     

HIV-1 V2区突变对CD4结合位点中和抗体识别的影响

目的 探讨HIV-1病毒包膜蛋白gp120的V2区突变对其他结构域的中和抗体识别的影响。 方法 使用假病毒构建系统包装野生型和V2区突变型的HIV-1假病毒,分别测试抗CD4结合位点中和抗体和CD4诱导的中和抗体对两种病毒的中和作用。使用双抗体夹心ELISA法测试CD4结合位点中和抗体和CD4诱导的中和抗体对gp120野生型和突变型蛋白的亲合力。结果 CD4结合位点中和抗体和CD4诱导的中和抗体均无法中和野生株JR-FL WT假病毒,但2种中和抗体对V2突变株的中和活性显著提高,在低浓度下即可中和该病毒。野生株和突变株gp120单体与抗CD4结合位点中和抗体的结合力无明显差异,而gp120单体与CD4诱导的中和抗体的结合实验ELISA曲线却明显分离,CD4诱导的中和抗体与突变型JR-FL L175P gp120的结合强度均明显高于它们与野生型JR-FL WT gp120的结合强度。结论 HIV-1 V2区突变可影响中和抗体的抗病毒效果。     

Hypogammaglobulinemia during antipsychotic therapy

Abstract Hypogammaglobulinemia in a 22-year-old woman with brief psychotic disorder developed during antipsychotic therapy. Severe decreases in immunoglobulin IgM, IgG, and IgA concentration in serum were observed 4 months after the treatment with chlorpromazine (CPZ) and the other types of antipsychotics. Neither physical diseases nor family history for immunological disturbances was seen. No clinical symptoms in relation to immunological disturbances (i.e. infectious disease), were noted. Gammaglobulin levels in serum returned to a normal range after a replacement of chlorpromazine to timiperone. The hypogammaglobulinemia in the present case was considered to be due to the inhibition of gammaglobulin synthesis by CPZ.     

Toxic Effects on the Visual System of Diaminodiphenoxybutane, Quinine, and Ethambutol in Conscious Dogs

Toxic Effects on the Visual System of Diaminodiphenoxybutane,Quinine, and Ethambutol in Conscious DOGS. SATO, S. (1985).Fundam Appl. Toxicol. 5, 777–784. The effects of diaminodiphenoxybutane(DAPB), quinine, and ethambutol (EB) on the electroretinogram(ERG) and the visual evoked potential (VEP) were examined inconscious dogs. In dogs receiving repeated oral doses of 100mg/kg/day for 4 days or a single iv dose of 30 mg/kg of DAPB,the amplitudes of the ERG a- and b-waves were markedly depressedand the peak latency of the VEP first wave was prolonged. Thereafter,ophthalmoscopic changes consisted of mottled discoloration ofthe fundus, loss of visual placing reaction, and dilatationof the pupils with reduction of the pupillary light reflex wereobserved. These abnormal signs disappeared even though the markeddepression in amplitudes of the ERG a- and b-waves and the prolongationin latency of the VEP first wave continued. A single iv doseof quinine at 50 mg/kg caused a slight depression of the amplitudeof the ERG, whereas the VEP remained relatively unaffected.In a dog receiving a single iv dose of quinine at 100 mg/kg,both the ERG and VEP were depressed, and a slight dilatationof the pupils with reduction of the pupillary light reflex andan impairment of visual placing reaction were observed transiently.There was no abnormality in the ocular fundus in either animalreceiving quinine. The dogs receiving repeated sc doses of EBat 100, 200, and 400 mg/kg/day for 4 weeks each, for a totalof 12 weeks, showed extensive decoloration of the tapetal fundus.However, neither the ERG nor VEP showed any significant abnormalities,and no behavioral signs of visual disturbance were observed.These results indicate that DAPB and quinine directly damageretinal function and the decoloration of the tapetal funduscaused by EB is not directly related to retinal function. Inaddition, the procedure used in this study to record the ERGand VEP was found to be reliable for assessing the visual toxicityof drugs in conscious dogs.