糠尿病人血浆甘丙素测定的临床意义

用人甘丙素(galanin GAL)及其抗血清建立的放射免疫分析,测定了19例糖尿病患者及29例正常人血浆甘丙素水平,正常对照组血浆甘丙素9.36±5.07pg/ml,糖尿病组14.63±9.30pg/ml.糖尿病患者血浆甘丙素显著高于正常对照组(P<0.05).此外,讨论了血浆甘丙素增高在糖尿病发病机制中的意义.     

自发性高血压大鼠血浆及动脉组织甘丙素浓度的变化及巯甲丙脯酸对其影响

本工作应用放免法测定了自发性高血压大鼠(SHR)及对照组WKY大鼠血浆及胸主动脉组织甘丙素(galanin)含量,同时观察血管紧张素转换酶抑制剂一巯甲丙脯酸对其影响.结果表:SHR血浆及胸主动脉组织甘丙素含量显著高于WKY大鼠(P<0.05～0.01).滴注巯甲丙脯酸后SHR血压下降49%(P<0.05),血浆甘丙素下降33%(P<0.01),主动脉组织甘丙素下降19%.提示:甘丙素在高血压疾病中可能具有重要发病学意义.     

高血压,冠心病及合并糖尿病患者血浆甘丙素浓度的临床初步观察

用放免法检测31例原发性高血压、冠心病及冠心病合并糖尿病患者(CHDMH)血浆甘丙素水平.结果显示:病人组均高于对照组.其中以冠心病合并糖尿病组浓度最高(9.18±6.05pmol/L),单纯冠心病组最低(3.22±0.98 pmol/L),高血压病组居中(5.04±1.51 pmol/L).上述各组除单纯冠心病组外,与对用组之间经t或F-Q检验均有显著差异(P<0.01).各组血浆甘丙素水平与年龄之间相关性检验无显著意义.     

血液透析对血浆甘丙素的影响

本实验首次应用人甘丙素(GAL)及其抗血清建立了放免法,测定了30例尿毒症患者及22例原发性高血压患者GAL水平,观察了血液透析对GAL的影响,测定了正常大鼠及自发性高血压大鼠的血浆、胸主动脉组织内GAL浓度,显示尿毒症患者GAL较正常人明显增高,伴心衰、水肿和高血压者更著,血液透析后GAL明显下降,提示尿毒症患者GAL与肾小球滤过率下降有关,GAL升高可能是高血压的发病原因之一,血管紧张素Ⅱ可能参与了其升压作用.血液透析后GAL下降可能与GAL被透析掉有关.     

人酸性谷胱甘肽S－转移酶放射免疫分析

人酸性谷胱甘肽Ｓ－转移酶放射免疫分析李新萍，万军，张澜，李春海用人胎盘型谷胱甘肽Ｓ－转移酶（ＧＳＴ－π）及其抗血清，建立了血浆酸性ＧＳＴ放射免疫分析法（ＲＩＡ），并测定了５０例正常人血浆ＧＳＴ的含量．材料与方法人ＧＳＴ－π从人胎盘中提纯；羊抗人ＧＳＴ...     

急性脑血管病患者血浆内皮素1的初步研究

应用放射免疫分析法对３５例正常人、３２例急性脑梗塞和１７例脑出血患者血浆内皮素１含量进行测定。结果显示：急性期脑梗和脑出血患者血浆ＥＴ－１含量显著增高，并与神经系统的功能障碍严重程度相一致，恢复期有下降趋势。Ｅ－１可能参与急性脑血管病的病理生理过程。     

胰岛素抵抗及其危害

本世纪30年代，英国人Himsworth首先在临床上观察到个体对胰岛素的反应存在很大的差异，给糖尿病患注射相等剂量的胰岛素后，结果有些人血糖明显下降，而另一些人则反应不敏感。50年代末Yallow等人应用放射免疫分析方法测定血浆胰岛素水平，结果发现敏感的患胰岛素水.     

山莨菪碱对脑外伤后急性肺损害大鼠神经降压素含量的影响

目的 探讨山莨菪碱对重型颅脑损伤后发生急性肺损害时大鼠血浆、肺组织匀浆中神经降压素（neurotensin，NT）含量变化的影响。方法 通过放射免疫分析（RIA）方法测定大鼠脑外伤血浆及肺组织匀浆NT含量以及应用山莨菪碱后血浆、肺组织匀浆NT含量。结果 大鼠脑外伤组血浆及肺组织匀浆中NT含量明显高于正常对照组，山莨菪碱治疗组血浆及肺组织匀浆中NT含量明显降低。结论 血浆及肺组织匀浆中NT含量增高可能是参与脑外伤后急性肺损伤过程的一个重要因素，山莨菪碱通过降低血浆及肺组织中NT含量而发挥对颅脑损伤后急性肺损伤的保护作用。     

维持性血透患者血浆肾上腺髓质素水平的研究

应用放射免疫法(RIA)观察了32倒尿毒症维持性血液透析(HD)患者透析前后血浆肾上腺髓质素(AM)的变化,并测定了25例正常人进行对照,发现尿毒症患者AM较正常人明显增高,血透后无明显变化,血浆AM水平与血浆BUN、ET、ANP、TXB_2/6-酮及平均动脉压有明显的正相关关系,与ATll、TXB_2,6-酮无相关性.结果提示维持性血液透析患者AM升高可能与尿毒症患者血压增高,做为病理性修饰及某些血管活性物质平衡调节有关.     

急性颅脑伤对大鼠脑区、垂体及血浆中β－内啡肽含量的影响

急性颅脑伤对大鼠脑区、垂体及血浆中β－内啡肽含量的影响刘志敏王成海路长林赵小林林葆城为了探讨β－内啡肽免疫活性物质（ｉｒ－β－ＥＰ）与急性颅脑伤的关系，笔者应用放射免疫分析法（ＲＩＡ）系统地检测了颅脑伤后不同时程大鼠多个重要脑区、垂体和血浆中ｉｒ－β...     

The role of interventional radiology in trauma

Introduction Interventional Radiology has evolved into a specialty having enormous input into the care of the traumatized patient.In all hospitals,regardless of size,the Interventional Radiologist must consider their relationships with the trauma service in order to     

Sexual homicide: Brief review of the literature and case report involving rape,genital mutilation and human arson

The objective of the current paper is to report a new case of sexual murder involving human arson and summarize the literature on the phenomenon of sexual homicide. The present case study is unprecedented in Greece and a rarity in international literature due to the fact that the victim suffered genital mutilation and incineration while still alive. The evaluation consisted of 176 articles; 53 were reviewed by the authors. The results revealed sparse, but significant, research findings. The authors discuss the limitations regarding research, incidence of the phenomenon, crime-scene patterns, offender characteristics (killing methods, motive inferences, sociodemographic data, classifications, psychopathology, modus operandi), and victim selection. The incidence of the phenomenon is unclear (1–4%) due to non-standardized criteria. It is an expression of displaced anger or sexual sadism and/or a way to elude detection (ancillary benefit). Most offenders (in their first kill) and victims were in their late 20s to early 30s and belong to Caucasian populations. Personal weapons were commonly used against women, strangulation is the prevalent killing method against children, and firearms against men. Most of the sexual homicide perpetrators are non-psychotic at the time of the attack, but experience personality pathology, primitive defenses, pathological object relations, and withdrawal into fantasy in order to deal with social isolation.     

Extension du modèle puissance–temps limite pour estimer la production d’énergie aérobie et anaérobie lors de l’exercice intense

Aim

Examine how the modelling of the relation between power and time to exhaustion can provide an estimation of the production of aerobic and anaerobic energy during intense exercise.

Current knowledge

The hyperbolic model made it possible to define the critical power corresponding to the maximal rate of energy renewed by aerobic metabolism. A new model distinguishing the critical power from the maximal aerobic power has been built to estimate more precisely the anaerobic contribution. Data from middle distance runners and subjects tested on cycle ergometer showed a relative contribution of anaerobic metabolism arising from critical power and increasing until around 10 % of total power when aerobic energy production reaches its maximum.

Prospects

Considering the slow component of oxygen uptake would provide a more precise analysis of energy production and transformation during exercise at high intensity.     

Beziehungen zwischen Aufprallgeschwindigkeit,Fahrzeugbeschädigungen,Frakturen und „Wurfweite” bei 50 tödlichen Fußgänger-PKW-Unfällen

Zusammenfassung Aus 160 Obduktionen von Fußgängern, die durch PKW getötet worden waren, sind 50 nach folgenden Gesichtspunkten ausgewählt worden:Auffahrunfälle Erwachsener mit gesicherten Angaben in den Gerichtsakten über Fahrzeugbeschädigungen, Zusammenstoßstellen, Endlage der Fußgänger und Bremsspuren. Aus diesen Daten wurden Ausgangs- und Aufprallgeschwindigkeiten berechnet sowie die Wurfweite der Fußgänger gemessen.Die Ausgangsgeschwindigkeiten, nach der Berechnung zwischen 32 und 95 km/h, lagen meistens etwas höher als die angegebenen Geschwindigkeiten. Zwischen Ausgangs- und Aufprallgeschwindigkeiten waren die Differenzen größer. Ab 12 km/h Aufprallgeschwindigkeit kam es bereits zu tödlichen Verletzungen. Auffallend ist die zweigipfelige Verteilung der Häufigkeit sowohl bei der Einteilung nach den Aufprallgeschwindigkeiten als auch nach den Deformationsarbeiten (Aufprallgeschwindigkeit: 26% bei 51–60 km/h und 22% bei 21 bis 30 km/h; Deformationsarbeit: 34% bei 39–200 kpm und 30% bei 701–1000 kpm).Bei Aufprallgeschwindigkeiten über 50 km/h wurden doppelt so viel Knochenbrüche an der Wirbelsäule und am Becken als bei Aufprallgeschwindigkeiten unter 50 km/h festgestellt.Bei 44 Fußgängerunfällen lag ein Drittel innerhalb der Erwartungsgrenze der Wurfweite nach Fiala, je ein Drittel aber darüber bzw, darunter.Das Beschädigungsbild und die Anstoßverletzungen geben Hinweise zur Ermittlung der Aufprallgeschwindigkeit, vor allem wenn weitere Berechnungsgrundlagen fehlen.

---

Summary Fifty cases were selected from 160 autopsies performed on pedestrians who were accidentally killed by private motorcars; the cases were selected according to the following criteria:The cases were confined to impact accidents involving adults in which reliable evidence could be gathered from the Court records in relation to damage to the car, the place of collision, the final position of the injured pedestrian and the extent of skidmarks. The initial and collision speeds of the cars were calculated from these facts and the distance of projection of the pedestrians were measured.The initial speeds, calculated between 32 and 95 km/h, were, in most cases, higher than the declared speeds. The differences between initial and collision speeds were larger. Fatal injuries could arise from a collision velocity of only 12 km/h. A striking feature of the analysis was the distribution of two peaks of frequency whether these were classified according to the collision speeds or according to the deformation of the vehicle (collision speed: 26% at the speed of 51 to 60 km/h and 22% at the speed of 21 to 30 km/h; deformation work: 34% at the deformation work of 39 to 200 kpm and 30% at the deformation work of 701 to 1,000 kpm).Twice as many fractures of the vertebral column and pelvis were sustained at collision speeds over 50 km/h as were sustained under 50 km/h.In one third of 44 pedestrian accidents, the distance of projection was within the expected range described by Fiala; in one third the distance was above and in one third below the expected range.If additional data for calculation were lacking, the patterns in injury arising from the impacts gave indications from which it was possible to estimate the collision speed.

Stipendiat der Alexander v. Humboldt-Stiftung, Dozent Dr. med. S. Kamiyama, Dept. of Legal Medicine, School of Medicine, Chiba University, 313 Inohanacho, Chiba, Japan.     

Diagnóstico ecográfico del neumotórax

The ultrasonographic diagnosis of pneumothorax is based on the analysis of artifacts. It is possible to confirm or rule out pneumothorax by combining the following signs: lung sliding, the A and B lines, and the lung point. One fundamental advantage of lung ultrasonography is its easy access in any critical situation, especially in patients in the intensive care unit. For this reason, chest ultrasonography can be used as an alternative to plain-film X-rays and computed tomography in critical patients and in patients with normal plain films in whom pneumothorax is strongly suspected, as well as to evaluate the extent of the pneumothorax and monitor its evolution.     

Carbohydrate Supplementation during Exercise: Does It Help? How Much is Too Much?

KEY POINTS· Carbohydrate intake during exercise can delay the onset of fatigue and improve performance of prolonged exercise as well as exercise of shorter duration and greater intensity (e.g., continuous exercise lasting about 1h and intermittent high-intensity exercise), but the mechanisms by which performance is improved are different.     

Hip and pelvic injuries in the elderly

Fractures of the hip and pelvis are frequent and serious injuries in elderly patients. Due to the aging population, their incidence should double by 2050. Therefore, the social and economical implications of these fractures are significant. Delay in diagnosis increases the associated morbidity and mortality. The purpose is to review the imaging features of these fractures, the imaging techniques (projections, CT) to depict them and their classification based on severity.     

磁共振DWI和动态增强鉴别颅底脊索瘤和侵袭性垂体瘤的应用

目的 探讨磁共振扩散加权成像(DWI)和动态增强在颅底脊索瘤和侵袭性垂体瘤(IPA)鉴别诊断中的应用价值.方法 搜集经手术病理证实且影像学有鞍区破坏的颅底脊索瘤患者15例、向鼻咽部侵犯的IPA患者20例.测量二者的表观扩散系数(ADC)值,绘制受试者工作特征曲线(ROC),分析动态增强曲线的类型,统计达峰时间(TTP)、增强峰值(EP)和最大对比增强率(MCER),分析各个参数在鉴别诊断中的价值.结果 颅底脊索瘤的ADC值为(1.274±0.07)×10-3mm2/s,高于IPA ADC值(0.672±0.03) ×10-3 mm2/s(P ＜0.001),ADC阈值为0.964×10-3mm2/s时,ROC曲线下面积为0.997,敏感度为93.3％,特异度为100％.颅底脊索瘤时间-信号强度曲线(TIC)Ⅰ型14例,TICⅢ型1例,此例TICⅢ型者TTP约40 s;IPA TIC Ⅰ型7例,TICⅢ型13例.颅底脊索瘤和IPA的EP、MCER差异均有统计学意义(P ＜0.001).结论 ADC值和TIC的类型及其相关参数(EP,MCER)有助于颅底脊索瘤和IPA之间的鉴别.