Taiwan yi xue hui za zhi. Journal of the Formosan Medical Association最新文献

To determine the reference ranges and developmental pattern of serum gastrin in Chinese children, fasting serum samples of 362 Chinese infants and children aged from newborns to 14 years were measured by radioimmunoassay. All the participants were healthy and were without gastrointestinal disorders. The mean gastrin values for cord blood (111.55 +/- 68.05 pg/ml) and newborns (100.05 +/- 72.43 pg/ml) are higher than those for adult controls (43.85 +/- 15.59 pg/ml). The mean gastrin value achieves its highest level of 179.86 +/- 94.61 pg/ml on the 3rd day of age. Physiologic hypergastrinemia persists throughout the whole neonatal period. The mean gastrin value for infants between 6 days and 6 months of age is 96.08 +/- 50.05 pg/ml, this decreases to 76.73 +/- 44.23 pg/ml at 7 to 12 months of age, and to 75.89 +/- 43.88 pg/ml at 1 year of age. It reaches the low adult level (40-45 pg/ml) at about 2 years of age.

Lupus anticoagulant (LAC), an autoantibody, in maternal circulation is responsible for a high incidence of fetal loss. We record 2 cases of recurrent fetal loss in association with LAC. The presence of LAC was diagnosed by prolonged activated partial thromboplastin time (aPTT), but was not correctable by dilution with normal plasma. During their subsequent pregnancies, these two women were treated with prednisolone and a low dose of aspirin (100 mg/day). Normal values of aPTT were achieved in both cases after treatment. Preeclampsia developed in one of the women, and a live premature infant was delivered by cesarean section. However, a successful term pregnancy was achieved in the other case. Corticosteroid and low-dose aspirin appear to improve fetal outcome in cases with LAC.

Only limited information relating neurotransmitters to central regulation of the respiratory system exists. L-glutamic acid has been proposed as the primary neurotransmitter in the nucleus of the tractus solitarius (NTS) of cats. To test whether or not glutamic acid has an effect on the respiratory center, we microinjected L-glutamic acid (1 M, 0.1 microliter) via a 1 microliter Hamilton microsyringe into the ventrolateral area of the NTS dorsal respiratory groups (DRG) of unanesthetized, decerebrated cats at two-second intervals with continuous monitoring of tidal volume (VT), respiratory rate (f), end tidal CO2, blood pressure and heart rate. The results showed that glutamate induced the following respiratory changes: VT and f increased; VT and f decreased; and VT decreased but f increased. In addition to VT or f changes elicited by glutamate microinjection, changes in other rhythmic patterns such as apnea, apneusis and irregular respiration were observed. Glutamic acid appears to play a significant role in the modulation of the respiratory drive in the DRG. We, therefore, suggest that the excitatory amino acid L-glutamic acid may be involved in central respiratory control.

Difficulties with cell recognition are sometimes encountered in surface structural studies of biomedical specimens with scanning electron microscopy (SEM). If cells are stained and examined first by light microscopy (LM), then the specificity of their surface structures when observed by SEM can be reassured. Although other staining methods have been advocated, Riu's stain, which employs eosin yellow, methylene blue and azure I was tested in this study. A total of 28 specimens, including 10 pleural effusions, 4 ascites, 9 peripheral blood cells and 5 bronchial brushings, were collected for comparison. Free cells were fixed with 2% glutaraldehyde and allowed to form sediment on poly-L-lysine precoated plastic cover slips. They were stained with Riu's A and B solutions and observed with a light microscope. A lattice composed of cut lines made by a surgical knife served as the cell finder. Cells of interest were photographed before they were fixed in OsO4, dehydrated and dried in liquid CO2 at a critical-point temperature. Observation with a scanning electron microscope showed that the particular cells could be found within 10 minutes. Cell loss was minimal. Configuration of the cells was preserved and no distortion was detected in their fine surface structure. This study confirms that Riu's stain is suitable for comparative purposes between LM and SEM.

A review is presented summarizing the IVF-ET, GIFT and combined IVF-ET-GIFT experienced at Chang Gung Memorial Hospital. Since the building of an aseptic dust free laboratory next to the operation room, the clinical pregnancy rate has been 12.2% per embryo transfer in IVF-ET, 16.7% in the GIFT program and 30.0% in the combined IVF-GIFT program. The overall clinical pregnancy rate was 14.9%. The overall pregnancy rate appeared to be independent of the causes of infertility, be it tubal factor, endometriosis or unexplained infertility. It was lower in couples with male factor or combined factors. The different regimens for follicular stimulation were hMG-hCG, clomiphene-hMG-hCG and FSH-hMG-hCG. No one regimen showed a better pregnancy rate than the others. The methods of oocyte retrieval were laparascopy, laparotomy, transbladder ultrasound-guided, and transvaginal ultrasound-guided retrieval. There were 4.53 oocytes retrieved pertreatment cycle. The transvaginal ultrasoundguided oocyte retrieval has greatly simplified the procedures in the IVF-ET program. The patient selection was important not only for the indications but also for the methods of IVF-ET, GIET and combined IVF-GIFT.

To evaluate the therapeutic efficacy of continuous ambulatory peritoneal dialysis (CAPD) in diabetic uremic patients and compare it with that of non-diabetics, this study presents the results obtained from CAPD usage in a 3-year period. From December 1984 through December 1987, 12 non-insulin dependent diabetic patients (3 men and 9 women aged 65.5 +/- 3.4 years and with a treatment duration of 12.8 +/- 2.7 months, M +/- SE) and 11 non-diabetics (6 men and 5 women aged 45.0 +/- 5.3 years and with a treatment duration of 9.8 +/- 1.9 months) received CAPD treatment. In most of the patients, diabetes was complicated by significant cardiovascular diseases. None of them exchanged the CAPD bag by themselves. After CAPD treatment, subjective improvements were noted in both groups of patients but were more marked in the non-diabetic group. The BUN and creatinine levels were kept in an acceptable range except that higher creatinine levels were noted in the non-diabetic patients. Serum cholesterol levels rose mildly while triglyceride levels rose markedly in the diabetic patients. Albumin levels returned to normal in the non-diabetic group but remained low in the diabetic group. All patients except for one used the traditional subcutaneous route of insulin administration and blood sugar control was poor. The electrolyte profile was improved in both groups. The BP could be controlled but medication was still necessary. After CAPD most of the non-diabetic patients returned to their previous work while the diabetic patients remained dependent.(ABSTRACT TRUNCATED AT 250 WORDS)

Since the introduction of long-term total parental nutrition, it has been possible to raise the survival rate in patients with massive intestinal resection. How to increase the remaining intestinal mucosa hyperplasia in these patients has become the focus of many studies. Early postoperative enteral feeding with exogenous intraluminal nutrition was considered to be one of the most essential factors. The best enteral food pattern, however, is still not conclusive. In this study, we used the animal model of rats with 60% small intestinal resection, giving them different kinds of enteral diets through gastrostomy tubes. The monomeric diet included amino acid, glucose, disaccharide, and triglyceride. The polymeric diet included the usual source of nutrition such as protein, polysaccharide, and fat. The rats were killed three weeks later. Histopathological changes of the remaining bowel and H3 thymidine incorporation to mucosal DNa were measured. We found: (1) hyperplasia of the remaining bowel in the 60% resected rats was definitely increased more than the rats of the sham operation; (2) from the protein content, the DNA content of mucosa cells, the villus height and crypt depth points of view, the polymeric diet fed rats had a better adaptation; (3) on the 21st postoperative day, the DNA synthetic rate was still very high in polymeric diet fed rats, but returned to preoperative levels in rats fed with a monomeric diet. Our conclusion of this study is that a polymeric diet can contribute to a better intestinal mucosa regeneration than a monomeric diet in the rats with massive intestinal resection.

A 15-year-old girl suffering from acute lymphoblastic leukemia developed cytomegalovirus interstitial pneumonitis 34 days after an allogenic bone marrow transplantation. The disease was diagnosed by open lung biopsy. Histopathologic examination disclosed intranuclear and intracytoplasmic inclusion bodies, as well as, a positive cytomegalovirus antigen detected by an immunofluorescence stain using a cytomegalovirus monoclonal antibody. The virus culture also eventually produced cytomegalovirus. Because of the lack of ganciclovir in this country, antiviral therapy of a non-specific nature was given to this patient. However, the treatment was ineffective and she subsequently died. There is an association between the immunologic events of a graft-versus-host disease and the development of cytomegalovirus interstitial pneumonitis. The pathogenesis of cytomegalovirus interstitial pneumonitis in a bone marrow transplant recipient is evidence of an immunopathologic disease, rather than that of a purely infectionus disease. years, the treatment modality of cytomegalovirus interstitial pneumonitis in bone marrow transplant recipients has become a combination of specific antiviral and immune therapy.

The effect of ethanol on kinetic stages of natural killer (NK) cell activity was studied in vitro. Peripheral blood mononuclear cells (MNC) were either co-cultured or pre-incubated with various ethanol concentrations and assayed for NK cell activity with a "4-hour chromium release assay" and a "single cell cytotoxicity assay in agarose" simultaneously. Direct addition of ethanol to the assay system resulted in a dose-dependent inhibition of NK cell activity. The percentage of lysed conjugated target cells was suppressed from a control value of 21.2% to 17.0%, 15.1%, 11.8% and 10.0% with an ethanol concentration of 0.125%, 0.25%, 0.5% and 1.0%, respectively. NK cell recycling was also inhibited. A 24-hour pre-incubation with ethanol, however, resulted in NK cell activity enhancement. The enhancement was around 20% with a 0.25% ethanol concentration and around 45% with a 0.5% and a 1.0% ethanol concentrations. The enhancing effect was noted mainly at the cytolysis stage after binding of effector cell with target cells.