急性胰腺炎猝死尸检分析

目的 分析塞舌尔人急性胰腺炎猝死的原因及特点。方法 收集32例急性胰腺炎猝死病例的尸检资料并进行组织病理学检查。结果 32例中,男27例,女5例。23例胰腺质量轻度增加,切面可见散在的出血坏死灶;9例胰腺缩小并广泛出血坏死及周围脂肪坏死。结论 乙醇摄入是塞舌尔人急性胰腺炎猝死的主要原因。     

Apolipoprotein C-ll deficiency syndrome due to apo C-IIHamburg: clinical and biochemical features and Hphl restriction enzyme polymorphism

We have characterized the clinical and biochemical features of three siblings of a kindred with severe hypertriglyceridaemia due to apolipoprotein C-II (apo C-II) deficiency caused by the mutation described as apo C-IIHamburg. The clinical syndrome is characterized by recurrent pancreatitis in two of three affected individuals, with discrete hepatosplenomegaly in all three patients and cholelithiasis in one. Eruptive xanthomas and lipemia retinalis were absent. Plasma lipoproteins were characterized by fasting chylomicronaemia, reduced low density lipoproteins (LDL) and low high density lipoproteins (HDL). The marked hypertriglyceridaemia could be corrected promptly by infusion of normal plasma. Apolipoprotein C-II (apo C-II) levels in homozygotes were very low (0.01 mg dl-1), and mean apo C-II levels in heterozygotes were lower (2.08 +/- 0.11 mg dl-1) than in normal family members (3.38 +/- 0.75 mg dl-1). Lipoprotein lipase and hepatic triglyceride lipase activities in post-heparin plasma were normal. Zonal ultracentrifugation revealed a marked increase in triglyceride-rich lipoproteins and reduced LDL and HDL. LDL consisted of two fractions with higher hydrated density of the main fraction compared with normals with a trend to normalization on a fat-free diet. The molecular defect in the apo C-II Hamburg gene has been previously identified as a donor splice site mutation in the second intron. This leads to abnormal splicing of the apo C-II Hamburg mRNA and apo C-II deficiency in plasma. The mutation causes the loss of an HphI restriction enzyme site present in the normal apo C-II gene.(ABSTRACT TRUNCATED AT 250 WORDS)     

Synthesis and 19F spectra of tetra-L-alanine analogs containing selectively incorporated 3-fluoro-l-alanine residues

The synthesis of analogs of tetra-l -alanine containing 3-fluoro-l -alanine selectively incorporated at each position is described. The standard procedures in the literature used to couple l -alanine peptides together were often found to lead to undesired products, or elimination reactions when corresponding 3-fluoro-l -alanine peptide analogs were used. Several modified procedures have thus been developed for the synthesis of fluorine-substituted analogs. In addition, the pH-dependence of ¹⁹F n.m.r. spectra of 3-fluoro-l -alanine and the tetrapeptide analogs is presented.     

Respiratory Distress Syndrome and the Induction of Fetal Lung Maturity by the Use of Glucocorticoids

Respiratory distress syndrome (RDS) is the major cause of death in the pediatric age group. The introduction of neonatal intensive care units has improved the chance for survival for those infants who develop RDS, while amniocentesis to determine lung maturity prior to birth can help the health care team reduce the likelihood of RDS in some circumstances. Trials are now being conducted to see if antepartum administration of steroids to women delivering prematurely can further reduce the number of infants afflicted with RDS.     

Effects of Polarity on Defibrillation Thresholds Using a Biphasic Waveform in a Hot Can Electrode System

The polarity of a monophasic and biphasic shocks have been reported to influence DFTs in some studies. The purpose of this study was to evaluate the effect of the first phase polarity on the DFTofa biphasic shock utilizing a nonthoracotomy "hot can" electrode configuration which had a 90-μF capacitance. We tested the hypothesis that anodal first phase was more effective than cathodal ones for defibrillation using biphasic shocks in ten anesthetized pigs weighing 38.9 ± 3.9 kg. The lead system consisted of a right ventricular catheter electrode with a surface area of 2.7 cm² and a left pectoral "hot can" electrode with 92.9 cm² surface area. DFT was determined using a repeated "down-up" technique. A shock was tested 10 seconds after initiation of ventricular fibrillation. The mean delivered energy at DFT was 11.2 ± 1.7 J when using the right ventricular apex electrode as the cathode and 11.3 ± 1.2 J (P = NS) when using it as the anode. The peak voltage at DFT was also not significantly different (529.0 ± 41.3 and 531.8 ± 28.6 V, respectively). We concluded that the first phase polarity of a biphasic shock used with a nonthoracotomy "hot can" electrode configuration did not affect DFT.