Comparison of physiological responses to maximal arm exercise among able-bodied, paraplegics and quadriplegics

A comparison of pulmonary, cardiovascular and metabolic responses was made in 32 subjects consisting of 11 able-bodied, 8 paraplegics (T4-L3 lesions) and 13 quadriplegics (C5-C8 lesions) during maximal arm cranking exercise. A progressive continuous arm cranking test, modified for each group, was employed to elicit maximal responses with pulmonary and metabolic determinations made with open circuit spirometry and selected cardiovascular measurements made by impedance cardiography. Additionally, non-exercise static and dynamic lung function assessments were made. Quadriplegics had significantly lower (p less than 0.05) tidal volumes, vital capacities, forced expiratory volumes at 1 seconds, and maximal breathing capacities than the other two groups. The mean peak VO2 during maximal arm cranking was 28.2, 25.3 and 12.0 ml/kg.min for the able-bodied (AB), paraplegics (PP) and quadriplegics (QP), respectively. Furthermore, reduced cardiovascular function was observed in the QP as evident in the low peak HR (109 b/min), peak SV (52 ml/b) and peak Q (5.7 l/min). Values for the QP were 64% and 64% peak HR, 89% and 50% peak SV and 54% and 33% peak Q of values observed for the PP and AB groups, respectively. The peak SV and Q values were significantly lower (P less than 0.05) for the PP group when compared with the AB group. Although not statistically significant the estimated a-v O2 difference was higher for both spinal cord injured groups (14.0 and 14.6 ml O2/100 ml, PP and QP respectively). The impaired work capacity and reduced oxygen transport and utilisation of the QP group can be attributed to impaired sympathetic cardiac stimulation and a smaller available active muscle mass.     

Gene expression of LDL receptor, HMG-CoA reductase, and cholesterol-7 alpha-hydroxylase in chronic renal failure

BACKGROUND: Chronic renal failure (CRF) is associated with an atherogenic lipid profile and an increased risk of ischaemic cardiovascular disease. The associated hyperlipidaemia is reportedly ameliorated by erythropoietin (Epo) therapy. According to a recent report, rats studied 3 weeks after 5/6 nephrectomy and fed a high- protein diet exhibited increased activities of hepatic HMG-CoA reductase (HMG-CoAR) and cholesterol 7 alpha-hydroxylase (Ch-7 alpha- H), despite normal corresponding mRNA values. DESIGN AND METHODS: This study was designed to examine the effects of naturally progressing CRF of longer duration as well as those of Epo therapy on gene expressions of the key factors involved in hepatic cholesterol metabolism, i.e., LDL receptor (LDLR), HMG-CoAR, and Ch-7 alpha-H. Sprague-Dawley rats were randomized to the CRF group (5/6 nephrectomy), Epo-treated CRF group (given Epo 150 U/kg/twice weekly) and sham-operated, placebo- treated normal controls. They were allowed free access to regular rat chow and studied 6 weeks after surgery. Liver mRNAs and protein mass or activities of the above factors were studied. RESULTS: Plasma cholesterol concentration was significantly increased in the CRF group (P < 0.001) and was modestly lowered (P < 0.05) by Epo therapy. However, microsomal cholesterol concentration and LDLR, HMG-CoAR, and Ch-7 alpha-H mRNA as well as HMG-CoAR activity, and Ch-7 alpha-H and LDLR protein mass measurements were virtually identical in the three groups. Thus, hepatic LDLR, HMG-CoAR, and Ch-7 alpha-H mRNA and protein measurements in rats with CRF were similar to those of the normal control group representing an inappropriate response to the associated hypercholesterolemia. Epo therapy led to partial amelioration of CRF- associated hypercholesterolaemia with no discernible effect on hepatic tissue expression of the above factors.      

提高卫生院管理水平改善卫生院服务质量--陕西省项目区卫生服务管理水平分析

目的对陕西省世界银行贷款卫生Ⅷ项目利用日本赠款改善乡镇卫生院基本卫生服务情况进行分析。方法采用访谈、参与性评估以及资料复习等。结果项目县的卫生院服务供给状况得到了改善．提高了卫生院管理水平．增强了卫生服务能力，提高了服务效率，特困人口医疗救助(MFA)实施效果得到提高。但是存在配套资金不到位的问题，应加大特困人口医疗救助工作的宣传力度。建议加大项目管理力度，完善项目监督机制，推广示范点经验。     

Distal arthrogryposis with autosomal dominant inheritance and reduced penetrance in females: the Gordon syndrome

Ioan DM, Belengeanu V. Maximilian C, Fryns JP. Distal arthrogryposis with autosomal dominant inheritance and reduced penetrance in females: the Gordon syndrome.
Clin Genet 1993: 43: 300–302. © Munksgaard, 1993
A family is reported in which camptodactyly, club foot, pectus excavatum and undescended testes are transmitted as an autosomal dominant with reduced penetrance and variable expressivity, affecting 13 members through five generations. Penetrance is more reduced in females than in males and asymptomatic carriers are always females. Similar findings were previously described in two other families reported by Gordon et al. (1962) and Halal & Fraser (1979).     

Haemoptysis in healthy children due to unsuspected foreign body

Abstract: Haemoptysis in otherwise healthy children is an uncommon event. Two cases of massive haemoptysis, subsequently requiring lobectomy, are discussed. In each case, foreign vegetable matter was identified despite previously normal bronchoscopy and minimal changes on chest radiograph.     

Non-invasive detection of fecal protein kinase C betaII and zeta messenger RNA: putative biomarkers for colon cancer

We have developed a non-invasive method utilizing feces, containing sloughed colonocytes, as a sensitive technique for detecting diagnostic colonic biomarkers. In this study, we used the rat colon carcinogenesis model to determine if changes in fecal protein kinase C (PKC) expression have predictive value in monitoring the neoplastic process. Weanling rats were injected with saline or azoxymethane (AOM) and 36 weeks later fecal samples and mucosa were collected, poly A+ RNA isolated, and quantitative RT-PCR performed using primers to PKC betaII and zeta. Fecal PKC betaII and zeta mRNA levels were altered by the presence of a tumor, with tumor-bearing animals having a 3-fold higher (P < 0.05) PKC betaII expression as compared with animals without tumors. In addition, AOM-injection increased mucosal PKC betaII mRNA expression compared with saline controls. No effect of tumor incidence on mucosal PKC betaII expression was observed. In contrast, fecal PKC zeta expression was 2.5-fold lower (P < 0.05) in animals injected with azoxymethane versus saline. Since tumor incidence exerts a reciprocal effect on fecal PKC betaII and zeta mRNA expression, data were also expressed as the ratio between PKC betaII and zeta. The isozyme ratio was strongly related to tumor incidence, i.e. ratio for animals with tumors was 2.18 +/- 1.25, animals without tumors was 0.50 +/- 0.16, P = 0.025. We demonstrate that the expression of fecal PKC betaII and zeta may serve as a noninvasive marker for development of colon tumors. A sensitive technique for the detection of colon cancer is of importance since early diagnosis can substantially reduce mortality.