食管穿孔和破裂的诊断与治疗

目的 提高对食管穿孔和破裂的诊断及处理水平。方法 回顾性分析经外科处理的45例食管穿孔或破裂患的临床资料。结果 本组患经胸部平片、胸腔穿刺、上消化道造影及胃镜确诊。15例为自发性食管破裂，6例为医源性穿孔，5例为创伤性穿孔，10例为食管癌并食管支气管瘘，9例为食管憩室并食管支气管瘘。治疗予以食管修补9例；胸腔引流、空肠造瘘9例(其中1例为食管修补失败后改行此手术)；食管切除胃食管吻合术12例(其中3例为食管修补失败)；胃造瘘术4例；置入食管支架4例；食管支气管瘘切除修补3例；食管瘘口修补并肺叶切除2例；食管胃弓上短路1例，颈部引流2例；放弃治疗3例。治愈25例，好转11例，死亡6例。结论 详细了解病史和进行胸腔穿刺、上消化道造影等检查可帮助诊断。尽早手术闭合瘘口和治疗食管原发病变是治疗的关键。     

Measurement of Perceived Disruption During Rebuilding Following Hurricane Andrew

The purpose of this study was to develop and evaluate a measure of perceived disruption during rebuilding following a disaster. Two eight-item scales, which measured intensity of disruption during the entire repair phase (Intensity-RP) and intensity of disruption during the past month (Intensity-PM) were developed and administered to 135 survivors of Hurricane Andrew. At 9 to 12 months postdisaster, Intensity-RP and Intensity-PM were both significantly associated with scores on the Global Severity Index of the SCL-90-R, and with scores on the Impact of Event-Intrusion Scale; Intensity-PM alone was significantly associated with PTSD scores. Regression analyses indicated that each scale contributed significant unique variance in predicting mental health symptoms, even after controlling for relevant demographic and initial disaster exposure variables.     

Evaluation of the osmoregulatory function of taurine in brain cells

Summary Homogenous primary cultures of mouse astrocytes and cortical neurons were used to clarify the role of taurine in ion and osmoregulation in the CNS. This study indicates that both neurons and glial cells have uptake systems for taurine. The cell water content does not change during loading of cells with taurine. Chemical analysis indicates that part of the accumulated taurine is metabolized and that the product(s) are stored in the cells. Extracellular taurine (1 mM) has no effect on K⁺, Na⁺, Cl^-, or Ca²⁺ movements in astrocytes. However, astrocytes loaded to a taurine content which corresponds a concentration of 60 mM (corresponds to normal mouse cortex levels) show a 50% reduction in their K⁺ accumulation by carriers and a 100% increase in Ca²⁺ turnover rates. Movements of Ca²⁺ and K⁺ are involved in neurotransmission. It appears that taurine stored in glial cells, has an important effect on ion homeostasis in the CNS and may act indirectly on neuronal excitability.     

Poland anomaly with a limb body wall disruption defect: Case report and review

We describe a female infant with apparent Poland anomaly (PA) and limb body wall defect. Analysis of the defects suggest that a disruption of the lateral embryonic plate mesoderm may have been responsible for the observed lesions. Because of the overlap of this case with PA, we re-examined previous reports of this syndrome. We think that the lesions could be equally well explained as a mesodermal disruption, and point out a previously unrecognised discrepancy between sex and affected side in sporadic PA and inherited PA which supports this view. © 1992 Wiley-Liss, Inc.     

Theophylline disrupts diurnal rhythms of humoral factors with loss of meal cyclicity

To test the possibility that theophylline induced circadian disappearance of food intake might depend upon rhythmic disruption of blood glucose, insulin and free fatty acids (FFA), theophylline was administered chronically. This markedly lengthened postprandial intermeal intervals during the dark, and induced approximately identical intermeal intervals and identical meal sizes in the light and dark periods. In contrast to the clear light-dark dependent oscillations of serum glucose, insulin and FFA in the controls, the theophyllinized rats lost circadian fluctuation of each of these three chemical substances. Further, theophyllinized rats, unlike controls, had no time-dependent fluctuation in the levels of these substances at ? 120, ?60 or ?15 min preceding the onset of the first meal before the dark. These findings, together with previous reports, explain the disappearance of nocturnal feeding rhythm in theophyllinized rats in terms of functional destruction of circadian regulation in the hypothalamus which modulate the production of chemical determinants of food intake.     

Body fluid changes, thirst and drinking in man during free access to water

To investigate whether human thirst and drinking during ad lib access to water occur in response to body fluid deficits, we obtained blood samples and visual analog scale thirst ratings from five healthy, volunteer, young men at hourly intervals and when they were thirsty during a normal working day. Although there were significant increases in ratings of thirst, pleasantness of drinking water, mouth dryness and unpleasantness of the taste in the mouth when subjects were thirsty enough to drink compared with intervening intervals, there were no concomitant changes in body fluid variables (microhematocrit, plasma osmolality and plasma sodium, potassium, protein and angiotensin II concentrations). Subjects drank mainly in association with eating and were not overhydrated as indicated by constantly hypertonic urine and significant tubular reabsorption of free water over the experimental period. The results indicate that during free access to water humans become thirsty and drink before body fluid deficits develop, perhaps in response to subtle oropharyngeal cues, and so provide evidence for anticipatory thirst and drinking in man.     

The gene DIS2S1 is essential in Saccharomyces cerevisiae and is involved in glycogen phosphorylase activation

Summary S. cerevisiae gene DIS2S1, which codes for a protein very similar to the catalytic subunit of mammalian protein phosphatase 1, was disrupted in vitro. Diploid yeast cells were transformed and sporulated. Tetrad analysis demonstrated that disruption of DIS2S1 is lethal for the cell. Glycogen phosphorylase a and glycogen synthase activity ratio were measured in diploids carrying a disrupted allele of the gene. Phosphorylase was dramatically activated in mutant cells but, under the same conditions, glycogen synthase activity was essentially identical in both mutant and wild-type cells.     

A re-examination of variation associated with environmentally stressed organisms

Variation is an essential feature of biological systems. Populations adapt to dynamic environments, in part, because of this variation. In this review, we re-examine phenotypic variation, especially in organisms living in polluted environments. A recent goal of ecotoxicology is to understand the sublethal effects of exposure to pollutants, e.g. responses to endocrine-disrupting contaminants. While variation is an inherent quality of organisms, variance is a statistical measure of the variation of a trait. Increased variance has been associated with organisms living at the perimeter of a population's range, introduced into novel environments, or exposed to pollution. Some researchers have proposed increased phenotypic variance in exposed populations as an evolutionary mechanism, and others have suggested its use as a biomarker. While we agree that variance often increases in the exposed population, we also recognize that the opposite phenomenon occurs. That is, variance can decrease from exposure to pollution. Altered variance in the exposed population-leading to heteroscedasticity-could result in erroneous conclusions (Type II errors). We suggest that exposure to endocrine-disrupting contaminants could influence the health of populations in ways that are not always represented by measures of central tendency, and that variance and distribution should also be examined in environmentally stressed wildlife.