Genetic study of indirect inguinal hernia

We performed a genetic analysis of 280 families with congenital indirect inguinal hernia ascertained in Shandong province. The multifactorial threshold model and segregation analysis were applied to these families to investigate the mode of inheritance of congenital indirect inguinal hernia. Our results indicate that congenital indirect inguinal hernia is not compatible with a multifactorial threshold model, and the frequent vertical transmission and high segregation ratio suggest autosomal dominant inheritance with incomplete penetrance and sex influence. Through further pedigree analysis of the multiple case families with at least two closely related affected members, we noted preferential paternal transmission of the disease gene, which might suggest the role of genomic imprinting in the aetiology of this condition.

[Restriction fragment length polymorphism of Bam HI and Rsa I loci in the retinoblastoma gene]

The retinoblastoma (Rb) gene probe p123 M1.8 and p68 Rs2.0 were used to study the frequencies of the Bam HI and Rsa I restriction fragment length polymorphisms (RFLPs) in the RB gene among the population of Han nationality in Guangdong province. The result showed that the heterozygote rate of the Rsa I locus was only 55.0%, remarkably different from reports in the literature. Linkage study of the Bam HI and the Rsa I RFLPs demonstrated that 10.5% of the Rsa I polymorphic loci were heterozygous for the Bam HI RFLP. Thus the combined use of the two RFLPs can give information for about 65.5% of the population.

Changes of plasma concentrations of interleukin-1 alpha and interleukin-6 with neuroleptic treatment for schizophrenia

A significant difference of plasma interleukin (IL)-1 alpha concentration was found between schizophrenic patients taking neuroleptic drugs (n = 38) and those not taking them (n = 14; P < 0.02); Kruskal-Wallis analysis revealed a significant difference of plasma IL-6 concentration among the patients taking neuroleptic drugs, those not taking them, and healthy control subjects (H = 7.1, d.f. = 2, P < 0.05); also, there was a significant difference of plasma IL-6 concentration between the patients taking neuroleptic drugs (n = 32) and those not taking them (n = 13; P < 0.01). No significant differences were found between the three groups in the concentrations of IL-1 beta, IL-2 and tumour necrosis factor (TNF)-alpha. The present results suggest that neuroleptic treatment may change IL-1 alpha and IL-6 production in schizophrenic patients.

Increased serum IgE in schizophrenic patients who responded poorly to neuroleptic treatment

Total serum IgE and plasma Interleukin (IL)-4 have been determined in patients with schizophrenia, 26 neuroleptic-free, and 81 neuroleptic-treated, and in 46 healthy control subjects. The total serum IgE was significantly higher in the patients who responded poorly to neuroleptic treatment compared with the other four groups (F = 4.27, df = 4, 148, P < 0.003). No significant changes were found in plasma IL-4 levels between any of the five groups. It is possible that raised serum IgE levels may characterise a subgroup of schizophrenia.

[Clinical and experimental study on effects of ji shen mixture for infantile acute glomerulonephritis]

33 cases of acute glomerulonephritis treated with Ji Shen Mixture (JSM) were studied with 31 cases treated with Western medical therapy (WM) for comparison and 34 healthy subjects as controls. The levels of lipo-peroxide (LPO), glutathione peroxidase (GSH-Px), superoxide dismutase (SOD), theromboxane B2 (TXB2), 6-keto-PGF1 alpha and TXB2/6-keto-PGF1 alpha ratio were examined before and after treatment. Compared with healthy controls, the levels of LPO, TXB2, TXB2/6-keto-PGF1 alpha of patients increased and that of GSH-Px, 6-keto-PGF1 alpha decreased significantly, whereas SOD activity had no significant difference. After treatment, the level of LPO reduced and GSH-Px activities raised significantly, but the effect of JSM group was better than that of WM group. It indicated that JSM was more effective in clearing the free radicals. The TXB2, TXB2/6-keto-PGF1 alpha dropped and 6-keto-PGF1 alpha elevated significantly after treatment, the effects of JSM were markedly better than those of WM. Furthermore, JSM was more potent in raising the clearing rate of hematuria and proteinuria.

The role of cyclic AMP and phosphodiesterase activity in the mechanism of action of tetramethylpyrazine on human and dog cardiac and dog coronary arterial tissues

The aim of the present experiments was to explore the underlying cellular mechanisms responsible for the actions of tetramethylpyrazine (TMP) on atrial, ventricular and coronary arterial tissues. Transmembrane potentials of cardiac tissues were detected by means of the glass microelectrode technique and contractile tension by a force transducer. Tissue cyclic (c) AMP level was determined by protein binding assay. Results show that in human atrial and dog Purkinje fibres, high concentration of TMP (3 mM) induced a persistent positive inotropic effect only in the presence of adrenaline. Also, 3 mM TMP increased the cAMP level of the atrial muscle fibres, especially in the presence of adrenaline. Determination of the activity of cAMP-phosphodiesterase revealed that 0.3 and 3 mM TMP inhibited the phosphodiesterase activity of dog coronary artery and human atrial tissues in a concentration-dependent manner. When compared at the lower concentration (0.3 mM), the inhibitory effect of TMP was about 60% that of theophylline. The above findings indicate that the cardiovascular effects of TMP are related to the inhibition of phosphodiesterase activity and the subsequent elevation of the cAMP concentration.

Smith-Fineman-Myers syndrome: report on a large family

Smith-Fineman-Myers syndrome is considered an X-linked mental retardation (XLMR) syndrome. Three families have been reported to date. However, none presented a typical pattern of X-linked inheritance. Here we reported on 5 males with Smith-Fineman-Myers syndrome with similar phenotypic expression as in those cases reported previously; they were distributed in 4 sibships of one large maternal kindred. This finding adds strong support to the hypothesis of the Smith-Fineman-Myers syndrome being a rare XLMR syndrome.

Studies on neurochemical heterogeneity in healthy parents of schizophrenic patients

Serum homovanillic acid (HVA), norepinephrine (NE), phenylalanine (Phe) and tyrosine (Tyr) have been examined in 80 healthy parents of schizophrenic patients and 26 normal control subject. Analysis of variance revealed a significant difference in serum HVA concentration among the three groups: the parents whose ill offspring became fairly well after neuroleptic treatment for more than three months (n = 33), those whose offspring were still actively ill after neuroleptic treatment (n = 33), and normal control subjects (F = 3.98, df = 2, 89, p < 0.05). The t-test showed that serum HVA was significantly higher in the parents whose ill offspring became fairly well after neuroleptic treatment (11.8 +/- 5.0 ng/ml) than in normal control subjects (8.7 +/- 3.5 ng/ml, p < 0.01), but was not significantly higher in the parents whose offspring were still actively ill (10.5 +/- 3.7 ng/ml, p > 0.05). There was a significant difference between the serum NE concentrations of the parents of female patients (515 +/- 224 pg/ml, n = 21) and those of male patients (401 +/- 186 pg/ml, n = 55, p < 0.05). No significant differences were found in the serum concentrations of Phe and Tyr. These results suggest that there may be neurochemical heterogeneity in the parents of schizophrenic patients, which may be involved in the response of schizophrenic offspring to neuroleptic treatment and in the gender differences of schizophrenia.

Concentrations of homovanillic Acid and gonadal hormones in the serum of male schizophrenic patients

The concentrations of serum homovanillic acid (HVA), luteinizing liormone (LH), follicle-stimulating hormone (FSH) and testosterone (T) were examined in 20 male schizophrenic patients not taking neuroleptic drugs, 44 treated with neuroleptic drugs, and 15 male healthy control subjects. Kurskal-Wallis analysis of variance showed no significant difference among the three groups in serum HVA, FSH, LH or testosterone although high concentrations were found in tlte patients not taking neuroleptic drugs. There was a significant positive correlation between serum HVA and FSH in the patients not taking neuroleptics. The present results suggest that the change of gonadal hormones may be related to the pathogenesis of schizophrenia.

The pedigree chart analysis of centenarians in Shanghai City

The sex, occupation and pedigree charts of 57 centenarians in Shanghai City were investigated. There were 10 (17.5%) males and 47 (82.5%) females. Of the males, 4 were office workers (40%) and 6 were manual workers (60%). Among the females, 1 was an office worker (2.1%), 3 were manual workers (6.4%) and 43 were housewives (91.5%). Forty of the centenarians (70.2%) belonged to long-lived families, 17 (29.8%) did not. The age of centenarians' spouses influenced the mortality and age of their sons and daughters.

Persistent vegetative state--clinical and electrophysiologic observations of 5 cases

Five patients who met the criteria of the persistent vegetative state (PVS), were studied for ten years. Among them, two had fallen into a deep coma after cardiopulmonary resuscitation, and the other three cases were due to cerebrovascular disorders. Four patients died within 10 years. Clinically, all five cases showed characteristic features of wakefulness without cognitive function and movement of the extremities. The brain stem reflexes, such as light reflexes of the pupils and corneal reflexes, were present. The electroencephalograms showed ample low amplitude and nonspecific slow waves. None revealed an isoelectric pattern. Brain stem auditory evoked potential (BAEP) studies were normal or slightly abnormal. Median nerve somatosensory evoked potential (SSEP) studies showed absence of a cortical response. These features suggest that the damage in PVS patients is mainly located in the cerebral cortex. Although electrophysiologic examinations are useful diagnostic procedures for PVS, clinical observation remains the basis of the diagnosis.

Psychobehavioral treatment in cardiac rehabilitation

This article reviews the empirical evidence for the use of behavioral and psychological therapies in the rehabilitation of patients with coronary disease. Exercise training, Type A modification, psychological counseling, smoking cessation, and dietary modification are considered. It is concluded that psychobehavioral therapies offer considerable promise to coronary patients in improving quality and quantity of life.

Retinoic acid-induced differentiation of a human neuroblastoma cell line alters muscarinic receptor expression

Muscarinic receptor density increased by approximately 36% after differentiation induced by retinoic acid (Bmax, control = 126 +/- 13 fmol/mg protein; Bmax, retinoic acid-treated = 170 +/- 17 fmol/mg protein; P < 0.05), corresponding to a 170% increase in receptor content per cell. The affinity of [3H]NMS for the receptors was somewhat lower in the retinoic acid-treated cells (Kd, control = 0.14 +/- 0.04 nM; Kd, retinoic acid-treated = 0.25 +/- 0.04 nM; P < 0.05). Reverse transcriptase/polymerase chain reaction analysis using subtype-specific primers revealed that undifferentiated Sk-N-SH cells transcribed mRNA for all 5 receptor subtypes; this pattern was not affected by retinoic acid treatment. [3H]NMS displacement curves with subtype selective receptor ligands (pirenzepine, m1; AFDX-116, m2; 4-DAMP, m3) indicated the predominant expression of m3 and m1 receptor subtypes, and differentiation did not affect the pharmacological profile of the expressed receptor populations. The present results indicate that differentiation induces selective changes in the expression and activity of muscarinic receptors in a neuronal cell line.

De Vega's semicircular annuloplasty for tricuspid valve regurgitation

Moderate to severe functional tricuspid regurgitation was found in 26% of cardiac surgical patients with mitral or aortic valvular disease at Tri-Service General Hospital in Taiwan. Almost all patients were able to receive de Vega's annuloplasties. After a mean follow-up period of 20 months, none of the 63 patients had moderate or severe tricuspid regurgitation. There was no heart block or right atrial thrombosis; the single late death was not related to the heart disease. De Vega's tricuspid annuloplasty is considered to be a safe, effective, and durable procedure in the treatment of functional tricuspid regurgitation. Compared with tricuspid valve replacement and other types of annuloplasty, the de Vega is the first choice here.

Studies on concentrations of NA and HVA and activity of DBH in the serum from schizophrenic patients, first-degree relatives and normal subjects

The serum noradrenaline (NA), homovanillic acid (HVA) and dopamine beta-hydroxylase (DBH) have been examined in neuroleptic-free and -treated patients, healthy first-degree relatives of the patients and normal subjects. Analysis of variance (ANOVA) revealed significant differences in the concentrations of serum NA(F = 2.91, p < 0.05) and HVA (F = 3.58, p < 0.05), and in the activity of serum DBH (F = 2.77, p < 0.05) among the four groups. The serum NA was significantly higher in neuroleptic-free patients (475 +/- 220 pg/ml, n = 18), than in healthy first-degree relatives (343 +/- 189 pg/ml, n = 37, p < 0.05) or in normal subjects (354 +/- 111 pg/ml, n = 17, p < 0.05), and it also was significantly higher in neuroleptic-treated patients (442 +/- 223 pg/ml, n = 58) than in healthy first-degree relatives (p < 0.05) or in normal subjects (p < 0.05). There was a trend towards high serum HVA in neuroleptic-free patients (11.3 +/- 6.3 ng/ml, n = 17) compared with the other three groups. The serum DBH activity was high in neuroleptic-free patients (31.2 +/- 15.6 nmol/min/ml, n = 17), and significantly in comparison with those treated with neuroleptic drugs (21.6 +/- 10.9 nmol/min/ml, n = 56, p < 0.05). There was a significant negative correlation between HVA concentration and DBH activity in the serum from neuroleptic-free patients (r = -0.64, n = 16, p < 0.01), and there appeared to be three subgroups with alterations of serum DBH activity and HVA concentration.(ABSTRACT TRUNCATED AT 250 WORDS)

Transesophageal color Doppler flow imaging in the evaluation of prosthetic cardiac valves

To determine the value of transesophageal echocardiography in the assessment of prosthetic cardiac valves, 11 patients with clinically suspected cardiac prosthetic valve dysfunction were studied by transesophageal two-dimensional imaging, as well as by color Doppler flow mapping. Among these 11 patients, there were 10 with biological tissue valves and 3 with metallic valves (1 Bjork-Shiley, 2 St. Jude). Nine patients had replacement of mitral valves alone. The remaining two had received both mitral and aortic prostheses. The degree of mitral regurgitation was graded by transesophageal color Doppler according to the area of the regurgitant jet visualized. The degree of aortic regurgitation was graded by the jet height/left ventricular outflow height ratio method. All transesophageal studies were performed without complication and all were well tolerated. The pathological morphology of the cardiac prosthesis was clearly visualized by transesophageal two-dimensional imaging and subsequently proven at surgery. Of those tested, one patient was found to have a torn leaflet, one had a dislodged leaflet, one patient had paravalvular leakage, four had cusp vegetations, and five patients had prosthetic degeneration for other reasons. Mitral regurgitation was graded as absent in one patient, mild in two patients, moderate in two patients, and severe in six patients. Aortic regurgitation was graded as severe in both patients with aortic prostheses. We conclude that in patients with clinically suspected cardiac prosthetic dysfunction, transesophageal two-dimensional imaging combined with color Doppler can provide reliable information that corresponds to surgical findings.

A new procedure for management of extrahepatic portal obstruction. Proximal splenic-left intrahepatic portal shunt

For management of obstruction of the extrahepatic portal trunk in patients with healthy livers, we designed an end-to-side anastomosis between the proximal splenic vein and the umbilical portion of the left intrahepatic portal vein and performed a splenectomy to relieve portal hypertension, treat hypersplenism, and restore hepatic portal flow. To our knowledge, no other procedure more adeptly restores original hepatic blood flow. Creation of an anastomosis between the coronary vein and umbilical portion of the left intrahepatic portal vein is an alternative method.

[Saponins in the fruit pedicels of Panax notoginseng (Burk.) F.H. Chen (continue)]

Six saponins were isolated from the fruit pedicels of Panax notoginseng. Five of them were identified as gypenoside-XVII, -XV, ginsenoside-Rb1, and notoginsenoside-Fc, -Fa on the basis of chemical methods, spectroscopic analysis and comparison with authentic standards. Quantitative determination of the major saponins in fruit pedicels from the plant was made by thin layer chromatography-densitometry.

Significantly higher frequency of the MspI 2.2 kb allele of the Duchenne muscular dystrophy intragenic probe P-20 in the Chinese population

The P-20 intragenic marker was used to test for restriction fragment length polymorphisms in unrelated Chinese patients with Duchenne or Becker muscular dystrophy or X-linked mental retardation. In addition to polymorphism at the 6.0/3.5 kb MspI allelic site, we found an independent and high frequency of polymorphism at the 2.2/1.8 kb site. This differs from results found with other populations.

[Treatment of 100 children with infantile nephrotic syndrome by integrated traditional Chinese medicine and Western medicine]

For ten years (1979-1989), 150 cases of infantile nephrotic syndrome were treated by integrated TCM and Western medicine (WM). The WM group (50 cases) was treated by conventional WM drugs (prednisone, CLB, etc) and the TCM-WM group (100 cases) was treated by the above-mentioned WM plus treatment according to Syndrome Differentiation with decoction of Chinese medicinal herbs. Wulin San, Zhenwu Tang and Zhibai Dihuang Tang were selected in treating Spleen-Qi Deficiency distressed by Dampness, both Spleen-Kidney Yang Deficiency and both Liver-Kidney Yin Deficiency Syndrome respectively. The total effective rate was 100%, and the efficacy of TCM-WM group was higher than that of WM group (P < 0.005). The efficacy of TCM-WM treatment of nephritic nephropathy was far better than that of simple nephropathy (P < 0.05). Also the efficacy of TCM-WM was superior in raising plasma albumin and reducing blood cholesterol than that of WM (P < 0.001). The cellular immunity function and plasma cortisol of TCM-WM group were significantly improved than that of WM, P < 0.01 and 0.001 respectively. The result showed that the curative effect of the TCM-WM group in treating nephrotic syndrome was much better than that of WM alone.

[Chemical constituents of Actinidia kolomikta (Rupr. et Maxim.) Planch]

Two crystalline components I and II were isolated from the roots of Actinidia kolomikta. I was identified as delta 7-stigmasterol and II was named alpha-kolomiktriose and elucidated as 2, 3-di-0-beta-D-galactopyranosyl-alpha-D-galactopyranose on the basis of spectral data (13C NMR, 1H NMR, IR and EI-MS).

Changes of brain response induced by simulated weightlessness

The characteristics change of brain response was studied during 15 degrees head-down tilt (HDT) comparing with 45 degrees head-up tilt (HUT). The brain responses evaluated included the EEG power spectra change at rest and during mental arithmetic, and the event-related potentials (ERPs) of somatosensory, selective attention and mental arithmetic activities. The prominent feature of brain response change during HDT revealed that the brain function was inhibited to some extent. Such inhibition included that the significant increment of "40Hz" activity during HUT arithmetic almost disappeared during HDT arithmetic, and that the positive-potential effect induced by HDT presented in all kinds of ERPs measured, but the slow negative wave reflecting mental arithmetic and memory process was elongated. These data suggest that the brain function be affected profoundly by the simulated weightlessness, therefore, the brain function change during space flight should be studied systematically.

Isolation and identification of hepatitis E virus in Xinjiang, China

This paper describes isolation and identification of a virus (termed strain 87A) which has the cytopathic effect and haemagglutination properties of hepatitis E virus (HEV). This virus was isolated by tissue culture from the faeces of a patient with acute non-A, non-B enteric hepatitis in Xinjiang, China. The isolated virus was neutralized by acute phase sera obtained from other patients with acute non-A, non-B enteric hepatitis. The virus particles also could be specifically aggregated with acute phase sera from patients with known HEV hepatitis in China, Burma, India and the U.S.S.R., and with acute and convalescent sera from an HEV-infected chimpanzee. Crystalline arrangements of virus particles in the cytoplasm were observed by electron microscopy in ultrathin sections of infected cells. The sedimentation coefficient of the strain 87A virus particles in sucrose gradients was 176S. Purified virus particles revealed a protein band of about 76K on SDS-PAGE and Western blotting. The evidence indicates that the strain 87A virus is an HEV. Our ability to propagate HEV in cell culture should facilitate research on this hepatotropic virus.

[Isolation and identification of Leclercia adecarboxylate in clinical isolates in China]

1987, 3 strains of gram-negative straight rods were examined from 3 cases of patients with diarrhea. It's producing yellow pigment, fermentative metabolism of carbohydrates, oxidase test negative and motility with the help of peritrichous flagella. Through systematic biochemical identification, calculation of G+C mol% and homology of DNA/DNA, the species of Leclercia adecarboxylate are identified. While the susceptibility to certain antibiotics and the pathogenicity for white mice are tested, and relation of these microorganisms to clinical diarrhea is discussed.

The pairing of the separated A and B chains of insulin and its derivatives, FTIR studies

From the amide I bands of their deconvolved FTIR spectra, the S-thiomethyl derivatives of the insulin A, B, despentapeptide(26-30) B and desoctapeptide(23-30) B chains all contain significant amounts of ordered secondary structure. The intact B chain is considerably more ordered than either the A or the truncated B chains. Comparison of the spectra of the separated and mixed intact chains of insulin suggests further folding upon mixing of the chains leading to significant increases in ordered secondary structures, presumably because of stabilization by interaction of the chains. The interactions of the A chain with the DPI B chain appear to be weaker as compared to that with the intact B chain. The above results suggest that only the intact A and B chains contain sufficient structural information to recognize each other and interact to form a native-like structure which make the correct formation of the disulfide linkages possible.

[Saponins in fruits pedicels of Panax notoginseng (Burk.). F.H. Chen]

Six saponins were isolated from the fruit pedicels of Panax notoginseng for the first time. They were identified as ginsenoside-Rc, -Rb3, -Re, notoginsenoside-Fe, -R1 and gypenoside IX by chemical and spectroscopic analysis.

Increase of plasma IL-6 concentration with age in healthy subjects

The present study demonstrated that plasma IL-6 concentration was higher in older subjects than in younger ones and significantly in the male group (P = 0.02); Spearman rank correlation showed that plasma IL-6 concentration was positively correlated with age (r = 0.28, N = 55, P < 0.05); there was a highly significant correlation between the concentrations in plasma IL-6 and IL-1 alpha (r = 0.51, N = 52, P < 0.001). These findings suggest the possibility that age-related changes of plasma IL-6 and IL-1 alpha may provide a pathological basis for the susceptibility to such illness as commonly occurs in elderly people, especially Alzheimer's disease as the two interleukins can induce the production of alpha 1-antichymotrypsin and beta-amyloid protein precursor.

Traumatic sinus of Valsalva fistula

Two rare cases of nonpenetrating trauma-induced fistula from the right sinus of Valsalva to the right heart chambers are reported. Both were diagnosed preoperatively and operated on successfully. A transverse tear was found in the right sinus of Valsalva, just below the right coronary ostium, in both patients. The ragged inlet and a rough fistula tract were noted during operation. The tears were closed with direct sutures or with a Dacron patch. Coronary artery bypass grafting was needed in 1 patient. The results of operation were excellent.

Perfusion scan in pulmonary tumor microembolism: report of a case

A 76-year-old male patient was admitted to our hospital with the chief complaint of dyspnea. A chest CT scan showed pericardial effusion, mediastinal lymphadenopathy and a tumor in the right ventricle with invasion to the main trunk of the pulmonary artery. A 99mTc MAA perfusion lung scan revealed multiple small subsegmental peripheral defects and a "fissure sign", while the 133Xe ventilation scan was normal. After the chest CT scan and scans of both lungs, tumor microembolism was highly suspected. Open chest surgery was performed. A huge tumor in the right ventricle involving the main trunk of the pulmonary artery was found. In addition, multiple tumor thrombi in the pulmonary arteries and veins were also noted. The pathology was metastatic squamous cell carcinoma. Thereafter, the primary lesion was found by bronchoscopy. The final diagnosis was squamous cell carcinoma of the right lower lobe bronchus with metastases to the right ventricle and pulmonary vessels, and in association with pulmonary tumor microembolism. We present this uncommon case and describe the pulmonary perfusion pattern of the tumor microembolism.

The effect of the acetylcholine transport blocker vesamicol on central cholinergic pressor neurons

Vesamicol (AH5183) inhibits the uptake of acetylcholine into cholinergic neuronal storage vesicles. Earlier in vitro studies have demonstrated that such inhibition can lead to a failure of transmission, particularly in peripheral cholinergic tissues. The present study was designed to determine whether vesamicol could inhibit central cholinergic transmission in conscious freely moving rats. Central (lateral cerebroventricular) injection of 20 micrograms of vesamicol significantly reduced the hypertensive and bradycardic response to subsequent central injection of physostigmine in spontaneously hypertensive rats. Inhibition of the pressor response was greatest when physostigmine was administered 1 hr after vesamicol. Acetylcholine and choline levels were determined in three brain regions derived from rats treated one hr earlier with either vehicle or vesamicol. Acetylcholine levels were found to be unaltered after vesamicol treatment, although choline levels were significantly higher in two brain regions. These results are consistent with the ability of vesamicol to inhibit the function of central cholinergic cardiovascular regulatory neurons. The mechanism for this inhibition is not related to depletion of total brain acetylcholine content but may be due to depletion of a small critical pool of transmitter.

Electropharmacological effects of sandostatin in human atrial fibers

We studied the actions of sandostatin (0.1-1000 nM), an analogue of somatostatin, on human atrial tissues obtained from hearts of 20 patients undergoing corrective cardiac surgery. In 3 preparations showing fast response action potential in normal [K]0 Tyrode solution, sandostatin induced little effect, even at the highest concentration (1 microM). In 10 preparations showing a slow rate of phase-0 depolarization when atrial fibers were depolarized (maximum diastolic potential near -40 mV) in high [K]0 (27 mM), sandostatin at concentrations as low as 1 nM decreased significantly the velocity of the upstroke, and the amplitude of slow response of the action potential as well as the force of contraction. In 6 experiments on spontaneously active atrial fibers (maximum diastolic potential = -53.8 +/- 2.7 mV), sandostatin increased the spontaneous cycle length in a fashion dependent upon concentration. The decrease in spontaneous rate of firing was associated with an inhibition of the late diastolic slope, a change also induced by somatostatin. A longer period of washout, however, (30 min or longer) was required for complete recovery from the depressant effects. Sandostatin (0.1-100 nM) also depressed triggered activity induced by cardiotonic agents. The present findings indicate that sandostatin induces a prolonged action in human atrial cells. Sandostatin may depress abnormal automatic rhythms through an inhibition of transmembrane influx of calcium.

Unusual cardiac malformations in Holt-Oram syndrome: report of two cases

The Holt-Oram syndrome is a hereditary disease which associated with upper limbs anomalies and cardiac defects such as secundum type atrial septal defect. Two cases of this syndrome with unusual cardiac findings are reported: One has an unroofing coronary sinus type atrial septal defect and preexcitation syndrome, the other has pentalogy of Fallot.

Depressant effect of adenosine in isolated human and canine atrial fibres

STUDY OBJECTIVE0--he aim was to explore the cellular mechanisms responsible for the depressant effects of adenosine in human atrial tissues.

DESIGN

Conventional microelectrode technique was used to record transmembrane action potential of human atrial tissues obtained at cardiac surgery. Effects of adenosine (0.1-100 microM) on action potential characteristics and contractile force of human atrial fibres in the absence and presence of an adenosine receptor antagonist (DPSPX) were evaluated. Results were then compared with those obtained from the canine atrial tissues.

EXPERIMENTAL MATERIAL

Atrial tissues obtained from hearts of 25 patients undergoing corrective cardiac surgery were used. Seven mongrel dogs were anaesthetised and strands of atrial muscle were removed and used for comparison.

MEASUREMENTS AND MAIN RESULTS

In human atrial fibres showing fast response action potential (mean dV/dtmax around 100 V.s-1) in normal [K]o (4 mM) Tyrode solution, adenosine (1 nM-10 microM) did not induce consistent effects on the action potential characteristics. When the fibres were depolarised in high [K]o (27 mM) or in atrial fibres showing slow response action potential (dV/dtmax less than 50 V.s-1), however, 10 microM adenosine reduced the upstroke velocity and the amplitude of action potential significantly and markedly depressed the contractile force. In atrial fibres spontaneously active in normal Tyrode solution (maximum diastolic potential around -50 mV), adenosine inhibited rate of spontaneous discharge in a concentration dependent manner. Delayed afterdepolarisation and aftercontraction induced by adrenaline or/and high [Ca]o were also suppressed. The depressant effects of adenosine were blocked after pretreatment with 50 microM DPSPX, a specific antagonist for adenosine receptor.

CONCLUSIONS

These findings show that adenosine may abolish abnormal automatic rhythms and triggered activity in human atria.

[Gluco, lipometabolic and trace elements alteration in bile with acute purulent cholangitis]

Analysis was made of the gluco, lipometabolic materials and trace elements in bile from patients. The specimens were collected in 11 cases with acute purulent cholangitis and 13 cases of selective biliary surgery at both inter-operational time, at which the bile were got by needling from the common bile duct, and post-operational time, at which the bile was obtained from T tube drainage bile before the extraction of the T tube or discharge from hospital. It was found that lactic acid and glucose markedly decreased and LDH activity increased in the cholangitis group at inter-operational time. Lifted hepatic glyconeogenesis and gluco-consumption and hepatic cellular damage were indicated. At the same time, most of the lipo-materials and lipase activity increased, as compared with the selective group, which showed that lipolysis was encouraged and that lipo-materials had flowed into the bile because of hepatic cellular damage. At the time of acute cholangitis, the Zn and Fe in bile markedly increased but the Cr in bile decreased, and the mechanism was not clear.

[The role of hemorheologic changes in the pathogenesis of acute hemorrhagic necrotizing pancreatitis]

The hemorheologic alterations were studied in experimental acute hemorrhagic necrotizing pancreatitis (AHNP) which was induced by injection of 5% sodium taurocholate into the main pancreatic duct. The results showed that during the early stage of AHNP, all of hemorheologic parameters were significantly elevated, and continually increased at the rest intervals. The authors suggested that the blood viscosity and hematocrit increase, red blood cells tend to aggregate, and erythrocyte deformation decrease are the causation of pancreatic microcirculatory disturbances and promoting pancreatic progressive necrosis. After using low molecular dextran and Salvia miltiorrhizae, the hemorheologic alterations in AHNP were recovered, and the histologic observation improved. Our data indicate the hemorheologic disturbances is one of the key factors in the pathogenesis of AHNP.

Reconstruction of superior vena cava in invasive thymoma

Aggressive en-bloc resection of the superior vena cava was performed in a 50-year-old man who had superior vena caval syndrome caused by invasive thymoma. After the superior vena cava was resected, a Gore-Tex vascular graft was used to reconstruct the lower end of the right innominate vein and lower end of the superior vena cava. The patient was treated with postoperative radiotherapy to the mediastinum and has been asymptomatic for 14 months following surgery.