精神分裂症和神经症患者心理防御机制的对照研究

目的：探讨精神分裂症患者和神经症患者在心理防御机制的使用上与正常人的差别。为临床提供辅助诊断。方法：采用心理防御方式问卷对48例精神分裂症、64例神经症患者进行测试，并与129例健康人对照。结果：精神分裂症患者和神经症患者与正常对照组相比较，多使用不成熟的防御机制，较少使用成熟防御机制；精神分裂症组与神经症组相比，更多使用分裂，而在其它防御机制的使用上无明显差异；神经症患者较少掩饰性。结论：精神分裂症病人和神经症病人在心理防御机制的使用上与正常人不同，神经症病人与精神分裂症病人使用大致相同的心理防御机制。     

Myasthenia gravis with thymoma is not associated with an increased incidence of non-muscle autoimmune disorders.

Three groups of thymectomized patients with myasthenia gravis (MG) were selected for study, 16 with thymoma, 16 with thymic atrophy and 32 with follicular hyperplasia of the thymus. All 16 patients with thymoma, 15/16 with thymus atrophy and 30/32 with follicular hyperplasia had AChR antibodies. Non-receptor muscle (CA) antibodies were found in sera of 15/16 patients with thymoma, 3/16 with thymus atrophy and in none of the sera from patients with follicular hyperplasia. There were 2 patients with thymoma and polymyositis, but none of the thymoma patients had rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) or other autoimmune disorders. Among the 32 patients with follicular hyperplasia of the thymus were 2 with SLE, 2 with RA and 1 with juvenile diabetes mellitus. In this study, there was an increased incidence of non-muscle autoimmune disorders among MG patients with follicular hyperplasia of the thymus but not among MG patients with thymoma.     

The birth prevalence of malformation syndromes in Tokyo infants: A survey of 14,430 newborn infants

A survey of the birth prevalence of congenital anomalies among newborn infants in Japan is under way at a large maternity hospital in Tokyo. Of 14,430 consecutive newborn babies (7,455 M; 6,975 F), 33 had a multiple congenital anomalies (MCA) syndrome. These included 2 with trisomy 13 (including a mosaic), 3 with trisomy 18 (including 1 mosaic), 16 with trisomy 21 (including 1 mosaic), 1 with cri-du-chat syndrome, 1 with 5p partial trisomy, 1 with Hallermann-Streiff syndrome, 1 with Treacher-Collins syndrome, 1 with achondroplasia, 2 with arthrogryposis multiplex congenita, 1 with hemihypertrophy, 1 with Wiedemann-Beckwith syndrome, 1 with asplenia syndrome, 1 with Klippel-Trenaunay-Weber syndrome, and 1 with probable Marfan's syndrome. Except for one infant with Ullrich-Turner syndrome, cases with sex-chromosome aberrations could not be diagnosed neonatally on a clinical basis.     

Activity in vitro of twelve antibiotics against clinical isolates of extended-spectrum beta-lactamase producing Escherichia coli

Twelve beta-lactam and non-beta-lactam antibiotics were evaluated against 115 clinical isolates of extended-spectrum beta-lactamase-producing (ESBLs) Escherichia coli using a broth microdilution test in accordance with the CLSI guidelines. Susceptibility was 100% with imipenem, ertapenem and amikacin, 95.7% with piperacillin-tazobactam, 91.3% with cefoxitin, 87% with tobramycin, 81.7% with amoxicillin-clavulanate, 80% with cefepime, 67.8% with ceftazidime, 27.8% with ciprofloxacin, 27% with levofloxacin and 13% with ceftriaxone. Ertapenem was the antibiotic with the lowest minimum inhibitory concentrations (MICs) for all isolates. There were no clinically relevant differences in the activity of the antibiotics in the presence of CTX-M-9 or SHV enzymes.     

Elevated BAFF levels in the cerebrospinal fluid of patients with neuro-Behçet's disease: BAFF is correlated with progressive dementia and psychosis

Neuro‐Behçet’s disease (NBD) is a serious complication of Behçet’s disease. Generally, NBD patients with a chronic course are refractory to immunosuppressive treatment, resulting in the deterioration of personality. In this study, levels of B cell‐activating factor belonging to the TNF family (BAFF) were measured in the cerebrospinal fluid (CSF) from 18 patients with NBD, 27 patients with epidemic aseptic meningitis (AM), 24 patients with multiple sclerosis (MS) and 34 healthy controls. BAFF levels in patients with NBD were significantly elevated compared with healthy controls, but showed no statistically significant elevation compared with either of the disease controls. In contrast, CSF IL‐6 levels were slightly elevated in patients with NBD and significantly elevated in patients with AM and MS compared with healthy controls. Patients with NBD were subdivided into two groups according to their clinical course (eight patients with a slowly progressive course presenting with psychosis and dementia and 10 patients with an acute course including aseptic meningitis, brainstem involvement and myelopathy). BAFF levels were significantly increased in those with a slowly progressive course compared with those with an acute course. CSF BAFF levels did not correlate with serum BAFF levels, CSF cell counts or CSF IL‐6 levels in patients with NBD. These data suggested that BAFF was produced within the central nervous system and may be associated with the development of NBD, particularly with a progressive course.     

Targets and dimensions of social comparison among people with spinal cord injury and other health problems

The present research examined comparison targets and comparison dimensions among two Spanish samples of individuals facing serious illnesses and diseases. In Study 1, 90 older patients (mean age 66.36) with various age‐related diseases, particularly cardiovascular diseases and diabetes, indicated that they compared themselves most often with others with the same disease, next with others with another disease and least with people without health problems. They compared themselves more often on their mental state, symptoms and physical activities than on their social activities. Social comparison orientation (SCO) as an individual difference characteristic was associated with more frequent comparisons with particularly similar targets, and with more frequent comparisons of one's symptoms and physical activities. Neuroticism was correlated only with more comparisons of one's symptoms. Study 2 was conducted in a sample of 70 relatively young patients (mean age 43.97) with spinal cord injury (SCI). Overall, they compared themselves more often with others than the participants in Study 1, and they compared themselves to a similar extent with people with SCI as with people with another disease and with people without health problems. While they felt on average better off than people with other diseases and other people with SCI, people with SCI felt on average worse off than people without health problems. They compared themselves more often on physical activities than on any other dimension. Higher levels of stress and uncertainty were associated with more frequent comparisons with people without SCI, and with more frequent comparisons of one's mental state, one's symptoms and one's future perspectives. The discussion focuses on the theoretical relevance of the results for social comparison theory, and on the practical relevance of the findings for interventions.     

3067例遗传咨询患者的遗传代谢病筛查

本文应用尿筛查试验、尿氨基酸双相纸层析、尿粘多糖双向电泳和糖醛酸测定，对3067例遗传咨询患者进行遗传代谢病筛查。诊断苯丙酮尿症199例，粘多糖沉积症2l例，同型胱氨酸尿症3例，巨幼细胞贫血伴同型胱氨酸尿症、甲基丙二酸尿症3例，胱氨酸尿症1例，亚氨基甘氨酸尿症1例，Hartnup病1例，一过性酪氨酸血症1例。     

Serum concentrations of nitrite in patients with HIV-1 infection.

AIMS: To measure circulating concentrations of nitrite in patients with HIV-1 infection. METHODS: Nitrite concentrations were measured using the Griess reaction adapted to microtitre plates in the serum of 10 asymptomatic HIV-1 positive patients, 33 patients with AIDS with cerebral disorders, 17 patients with AIDS with pulmonary involvement, and in eight patients with AIDS with other disorders. Nitrite concentrations were also measured in bronchoalveolar lavage (BAL) fluid and cerebrospinal fluid (CSF) of patients with AIDS with pulmonary involvement and cerebral disorders, respectively. RESULTS: Increased serum concentrations of nitrite were observed in patients with pulmonary involvement, and in particular in serum and in BAL samples of patients with interstitial pneumonia (36.2 (26.2) mumol/l and 0.3 (0.4) mumol/l, respectively). Increased serum concentrations of nitrite were also noted in patients with retinitis caused by infection with cytomegalovirus. Serum nitrite concentrations were also raised in patients with cerebral toxoplasmosis, whereas normal serum concentrations were found in patients with HIV-1 encephalopathy and cryptococcal meningitis. Nitrite concentrations in CSF were not raised in patients with cerebral disorders. CONCLUSIONS: These results suggest that production of nitrite in patients with AIDS with concomitant opportunistic infections may be part of the host defense against opportunistic organisms.     

Association between IgE levels and asthma severity among African American, Mexican, and Puerto Rican patients with asthma

BACKGROUND: High levels of IgE are associated with asthma. Whether higher levels of IgE are associated with more severe asthma is still unclear. OBJECTIVE: To determine whether IgE is associated with asthma severity among Latino and African American subjects with asthma. METHODS: We assessed lung function and asthma severity among African American, Mexican, and Puerto Rican patients with asthma with high IgE levels (> or =100 IU/mL; n = 492) and compared these values to those of patients with asthma with low IgE levels (<100 IU/mL; n = 247). We also examined IgE as a continuous variable among these groups. RESULTS: Patients with asthma with high IgE had a lower mean FEV(1) (87.6 +/- 17.1, percent of predicted) than patients with asthma with low IgE (91.5 +/- 17.0; P = .031). Regardless of race and ethnicity, baseline FEV(1), forced expiratory flow, and FEV(1)/forced vital capacity were lower among subjects with high IgE than among subjects with low IgE (P = .031, P < .0001, P = .0001, respectively). In addition, 54.7% of patients with asthma with high IgE had been previously hospitalized, compared with 44.1% of patients with asthma with low IgE (odds ratio, 1.33; 95% CI, 1.04-1.71). CONCLUSION: Higher IgE is associated with lower baseline lung function and more severe asthma among these populations. CLINICAL IMPLICATIONS: Among patients with asthma from 3 ethnically distinct groups, total IgE levels are inversely correlated with baseline lung function and asthma severity.     

重症肌无力患者HLA-DPB1等位基因与自身抗体的关联研究

对 2 9例重症肌无力 (MG )患者同时进行了HLA DPB1分型 (聚合酶链反应 限制性片段长度多态性多酶共同消化法 )及AchRAb、Pre SmAb (ELISA )测定 ,籍以探讨MG患者HLA DPB1与AchRAb及Pre SmAb的相关关系。结果表明AchRAb阳性患者与DPB1 0 5 0 1、 2 70 1及 3 60 1密切相关 ,而AchRAb阴性患者与DPB1 3 60 1及 0 10 1相关 ;Pre SmAb阳性患者与DPB1 0 5 0 1、 3 60 1、 2 70 1相关外 ,还与 0 10 1相关 ,而Pre SmAb阴性患者与这些等位基因无明显相关关系。上述结果提示HLA DPB1与MG的AchRAb和Pre SmAb关联     

Hauttumoren als Markerläsionen hereditärer Tumorsyndrome

A number of hereditary tumor syndromes are associated with characteristic dermal neoplasms and knowledge and early diagnosis of these lesions may facilitate the diagnostic of the underlying syndrome. These syndromes include Muir-Torre syndrome, associated with cystic sebaceomas, Cowden syndrome, associated with multiple tricholemmomas, Carney complex associated with multiple superficial angiomyxomas, Birt-Hogg-Dubé syndrome associated with multiple fibrofolliculomas, tuberous sclerosis associated with multiple facial angiofibromas and so-called Koenen tumors, patients with renal cell cancer associated with pilar leiomyomatosis and uterine leiomyomas, Gardner syndrome associated with Gardner fibromas and nevoid basal cell carcinoma associated with multiple basal cell carcinomas in young patients.     

Recognition of conjugated and native peptide determinants. II. Enhancement of antibodies with sequential specificity in anti-TMV sera by preimmunization with conjugated peptide antigens

Rabbits which were preimmunized with the C-terminal peptides of TMV protein conjugated to cross-linked bovine serum albumin were stimulated with native TMV. All animals responded with a striking titer increase of antibodies with sequential specificity versus the C-terminal peptides of TMV compared with animals which had not been preimmunized with the conjugated peptide antigens. The same degree of antibody enhancement with sequential specificity was obtained when the animals were stimulated with TMV for a second time after an interval of 255 days. The class distribution of 19 S and 7 S antibodies with sequential, as well as with conformational specificity, versus TMV was determined.     

Sm14 of Schistosoma mansoni in fusion with tetanus toxin fragment C induces immunoprotection against tetanus and schistosomiasis in mice

We have constructed vectors that permit the expression in Escherichia coli of Schistosoma mansoni fatty acid-binding protein 14 (Sm14) in fusion with the nontoxic, but highly immunogenic, tetanus toxin fragment C (TTFC). The recombinant six-His-tagged proteins were purified by nickel affinity chromatography and used in immunization and challenge assays. Animals inoculated with TTFC in fusion with or coadministered with Sm14 showed high levels of tetanus toxin antibodies, while animals inoculated with Sm14 in fusion with or coadministered with TTFC showed high levels of Sm14 antibodies. In both cases, there were no changes in the type of immune response (Th2) obtained with the fusion proteins compared to those obtained with the nonfused proteins. Mice immunized with the recombinant proteins (TTFC in fusion with or coadministered with Sm14) survived the challenge with tetanus toxin and did not show any symptoms of the disease. Control animals inoculated with either phosphate-buffered saline (PBS) or Sm14 died with severe symptoms of tetanus after 24 h. Mice immunized with the recombinant proteins (Sm14 in fusion with or coadministered with TTFC) showed a 50% reduction in worm burden when they were challenged with S. mansoni cercariae, while control animals inoculated with either PBS or TTFC were not protected. The results show that the expression of other antigens in fusion at the carboxy terminus of TTFC is feasible for the development of a multivalent recombinant vaccine.     

Antinuclear Antibodies and Anti-DNA Antibodies in Scleroderma

Antinuclear antibodies (ANA), including anti-DNA antibodies, and rheumatoid factors (RAT, Waaler-Rose) were determined prospectively during a 3-year period in 40 patients with localized scleroderma (LS) compared with 77 patients with generalized scleroderma (GS). ANA were increased in 26% of patients with LS, and in 47% with GS, anti-DNA antibodies in 23% of patients with LS, and in 34% with GS. Thus, the anti-DNA antibody level was lower compared with the known level in systemic lupus erythematosus. Rheumatoid factors were present in 6-7% of patients with LS, and in 14-15% of patients with GS. Increased antinuclear antibodies were not associated with any specific type of localized scleroderma, nor with internal disorders, and no case of clinical overlap to discoid or systemic lupus erythematosus was observed. However, six patients with localized scleroderma and complaints of arthralgia all presented increased antibodies, and one patient showed overlap to rheumatoid arthritis. It is suggested that increased ANA and anti-DNA antibodies in localized scleroderma, associated with joint manifestations, represents a systemic component in this type of scleroderma, with activation of the immune system and similarities with generalized collagen diseases.     

Specificity of immunoglobulin E in coccidioidomycosis and correlation with disease involvement.

Serum immunoglobulin E (IgE) antibodies were quantitated in 26 patients with active pulmonary coccidioidomycosis, 59 patients with active disseminated disease, 12 patients in clinical remission, and 91 healthy subjects. Significant differences were obtained in IgE serum levels of patients with active disease versus healthy subjects (P less than 0.0001). Patients with pulmonary coccidioidomycosis did not differ in their IgE levels when compared with patients with disseminated disease. However, serum IgE levels were significantly increased in patients with disease involving two or more organ systems when compared with patients with pulmonary disease or extrapulmonary disease involving a single organ system (P less than 0.02). Total serum IgE correlated with anti-Coccidioides IgE (P less than 0.001), but with only six exceptions, patients with anti-Coccidioides IgE also exhibited IgE antibodies to 1 or more of 12 common allergens. The correlation between hyperproduction of IgE and disease severity coupled with the depressed cell-mediated immune status of patients with this disease suggests a defect(s) in the T-lymphocyte population which functions to regulate IgE synthesis.     

Mania, glutamate/glutamine and risperidone in pediatric bipolar disorder: a proton magnetic resonance spectroscopy study of the anterior cingulate cortex

BACKGROUND: The purpose of this study was to investigate the anterior cingulate cortex (ACC) glutamate/glutamine (Glx) to creatine ratio (Glx/Cr) in two groups of children with Bipolar Disorder (BPD): those exhibiting manic symptoms requiring treatment and those being stably treated with the atypical antipsychotic risperidone. Atypical antipsychotics have been shown to increase serum glutamate levels and ACC Glx/Cr in subjects with schizophrenia. In this study, we hypothesized that the children with BPD in need of treatment would have lower Glx/Cr compared with the children with BPD being stably treated with risperidone. METHODS: Proton MR spectra were acquired, at 1.5 T, from the ACC of eighteen subjects with a DSM-IV diagnosis of BPD: ten (11.10+/-3.48 years; five female) were manic and not medicated with any antipsychotic and eight (10.88+/-2.99 years; one female) were medicated with the atypical antipsychotic risperidone. RESULTS: Children with BPD exhibiting manic symptoms requiring treatment had lower Glx/Cr than children with BPD being stably treated with the atypical antipsychotic risperidone. The children treated with risperidone also had significantly lower YMRS and CGI-Mania scores than the children not treated with risperidone. Both YMRS and CGI-Mania scores correlated negatively with ACC Glx/Cr levels. LIMITATIONS: The cross-sectional design, small sample size, the use of Glx rather than glutamate or glutamine and the use of Cr ratios rather than absolute concentrations are limitations of this study. CONCLUSIONS: Children with mania have lower Glx/Cr levels than children with BPD being stably treated with the atypical antipsychotic risperidone. Mania may be associated with reduced glutamate/glutamine levels in the ACC: other imaging studies have shown mania associated with hypometabolism in the ACC. These reductions in glutamate/glutamine may be increased following successful treatment with glutamatergic agents.     

动态脑电图对晕厥患者的诊断意义

目的:探讨动态脑电图(AEEG)在晕厥患者中的诊断价值。方法:采用十六导联动态脑电图分析仪连续监测24小时的脑电活动。结果:242例晕厥发作患者中AEEG结果示:28例为正常脑电图,95例为轻度异常脑电图,97例为中度异常脑电图,22例为重度异常脑电图,中、重度异常脑电图的异常率为49.2%。而REEG结果示:191例为正常脑电图,38例为轻度异常脑电图,13例为轻-中度异常脑电图,有异常表现者51例,异常率为21.1%。结论:AEEG较REEG在对脑源性晕厥患者的中有明显的优势,对临床诊疗有很大的价值。     

Presence of autoantibody against nasal mucosal cells in patients with Wegener's granulomatosis

We examined whether or not patients with Wegener's granulomatosis have autoantibodies against the respiratory tract and kidney, by using the direct avidin-biotin-glucose oxidase complex method. On immunostaining, the IgG fractions obtained from the sera of 2 patients with Wegener's granulomatosis and of 7 controls were coupled with biotin, and each couple was used as the primary antibody. The serum IgG sample from 1 patient with Wegener's granulomatosis definitely reacted with epithelial cells of the nasal mucosa, with the strongest reaction in basal layer. The sample from another patients with Wegener's granulomatosis showed a similar but weaker reaction. Control sera showed negative reactions in 6 subjects (3 with rheumatoid arthritis, 1 with allergic granulomatous angiitis and 2 normal volunteers) and a very weak reaction in 1 patient with poly-arteritis nodosa. These observations suggest the presence of an autoantibody reacting with some cell components of the nasal epithelium in patients with Wegener's granulomatosis.     

Time structure analysis of leg movements during sleep in REM sleep behavior disorder

STUDY OBJECTIVES: To compare the time structure of leg movements (LM) during sleep of patients with rapid eye movement (REM) sleep behavior disorder (RBD) with that of patients with restless legs syndrome (RLS) or control subjects. DESIGN: The polysomnographically recorded tibialis anterior activity during sleep was analyzed by means of a new approach able to consider duration, intermovement interval, sleep stage and time of night distribution, and periodicity. PATIENTS AND PARTICIPANTS: Twenty patients with idiopathic RBD, 37 with idiopathic RLS and 14 age-matched control subjects were consecutively recruited. MEASUREMENTS AND RESULTS: Most patients with RBD (85%) presented periodic leg movements during sleep (PLMS). PLMS occurred more frequently during non-REM sleep in patients with RLS and during REM sleep in patients with RBD. PLMS were shorter in duration, less often bilateral, and with a higher intermovement interval in patients with RBD compared to those with RLS. The number of PLMS decreased across the night in patients with RBD and in those with RLS, but not in control subjects. In all subjects, LM periodicity clearly depended on sleep state, with higher values during non-REM than during REM sleep. Patients with RBD showed a lower LM periodicity, compared with patients with RLS, in each of the sleep states. CONCLUSIONS: Significant differences, together with some similarities in LM time structure, were observed between patients with RBD and those with RLS; for this reason, our approach seems to indicate that their phenotype might be dependent on 2 factors: disease and sleep stage.     

骨水泥结合钢板固定对猪股骨远端不同大小骨缺损的生物力学研究

目的 探讨研究钢板、骨水泥对股骨远端不同骨缺损的生物力学影响,为临床合理选择修复股骨远端骨缺损的手术方法提供生物力学依据.方法 将50根猪股骨随机分为10组,M组为正常股骨,D1、C1、P1组为1/4骨缺损,D2、C2、P2组为2/4骨缺损,D3、C3、P3组为3/4骨缺损.D1、D2、D3组不重建,C1、C2、C3组单纯骨水泥填充重建,P1、P2、P3组骨水泥填充联合钢板固定重建.对各组行生物力学压缩试验.结果 骨水泥填充修复1/4骨缺损组与骨水泥填充联合钢板固定修复1/4骨缺损组差异无统计学意义(P=0.421),骨水泥填充修复2/4骨缺损组与骨水泥填充联合钢板固定修复2/4骨缺损组有显著差异(P=0.008)及骨水泥填充修复3/4骨缺损组与骨水泥填充联合钢板固定修复3/4骨缺损组有显著差异(P=0.023).结论 骨水泥填充修复股骨远端1/4骨缺损无需钢板固定,骨水泥填充修复股骨远端2/4骨缺损及其以上骨缺损需钢板固定.