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冠状动脉支架植入后叶酸盐治疗与支架内再狭窄

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世界核心医学期刊文摘（心脏病学分册） 2005年第1期1卷 11-11页

作者： Lange H. Suryapranata H. De Luca G. 高峰 department of Cardiology Isala Klinieken Hospital De Weezenlanden Groot Wezeland 20 8011 JW Zwolle NetherlandsDr.

BACKGROUND: Vitamin therapy to lower homocysteine levels has recently b een rec ommended for the prevention of restenosis after coronary angioplasty. We tested the effect of a combination of folic acid, vitamin B6, and vitamin B12 (referred to as folate therapy) on the risk of angiographic restenosis after coronary-st ent placement in a double-blind, multicenter trial. METHODS: A total of 636 pat ients who had undergone successful coronary stenting were randomly assigned to r eceive 1 mg of folic acid, 5 mg of vitamin B6, and 1 mg of vitamin B12 intraveno usly, followed by daily oral doses of 1.2 mg of folic acid, 48 mg of vitamin B6, and 60 μg of vitamin B12 for six months, or to receive placebo. The angiograph ic end points (minimal luminal diameter, late loss, and restenosis rate) were as sessed at six months by means of quantitative coronary angiography. RESULTS: At follow-up, the mean (±SD)-minimal luminal diameter was significantly smaller in the folate group than in the placebo group (1.59±0.62 mm vs. 1.74±0.64 mm, P=0.008), and the extent of late luminal loss was greater (0.90±0.55 mm vs. 0.7 6±0.58 mm, P=0.004). The restenosis rate was higher in the folate group than in the placebo group (34.5 percent vs. 26.5 percent, P=0.05), and a higher percent age of patients in the folate group required repeated target-vessel revasculari zation (15.8 percent vs. 10.6 percent, P=0.05). Folate therapy had adverse effec ts on the risk of restenosis in all subgroups except for women, patients with di abetes, and patients with markedly elevated homocysteine levels (15 μmol per li ter or more) at baseline. CONCLUSIONS: Contrary to previous findings, the admini stration of folate, vitamin B6, and vitamin B12 after coronary stenting may incr ease the risk of in-stent restenosis and the need for target-vessel revascular ization.

关键词：叶酸盐支架植入支架内再狭窄管腔直径血管成形术维生素疗法靶血管多中心试验亚组安慰剂

帕金森病“关”期间的步态僵硬和颞叶分辨阈值的关系研究

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世界核心医学期刊文摘（神经病学分册） 2005年第7期1卷 48-48页

作者： Lee M.-S. Kim H.-S. Lyoo C.-H. 邓剑平 department of Neurology Youngdong Severance Hospital 146-92Dogok-dong Kangnam-gu Seoul South Korea Dr.

Objective: To investigate the relationship between temporal discrimination thr eshold (TDT) and “off" period gait freezing(OGF) in patients with fluctuating P arkinson disease (PD).Methods: TDT values were measured at the dorsum of the toe s in 11 control subjects and 22 patients with PD with a wearing off phenomenon ( 16 patients with OGF and 6 patients without OGF). Results: During the L-dopa “ off" period, TDT values increased abnormally in both patient groups but were sig nificantly higher in patients with OGF than in those without OGF. A positive cor relation was found between the severity of OGF and TDT values measured by differ ent point stimulation. In patients with OGF, a single dose of L-dopa treatment normalized TDTvalues and ameliorated OGF. Conclusions: Dopa-responsive abnormal discriminative sensory processing may be a possible cause of “off" period gait freezing observed in patients with fluctuating Parkinson disease.

关键词：帕金森病步态僵硬分辨阈左旋多巴 stimulation abnormal 背侧不稳定性 fluctuating 感觉异常

视频流体压力测量法研究小儿食管动力性疾病的有效性

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世界核心医学期刊文摘（儿科学分册） 2005年第5期1卷 49-49页

作者： Kawahara H. Kubota A. Okuyama H. 宁亮 department of Pedi atric Surgery Osaka Med. Ctr. Res. Inst. M. Osaka JapanDr.

Purpose Abnormalities in esophageal motor function underlie various symptoms i n the pediatric population. Manometry remains an important tool for studying eso phageal motor function, whereas its analyses have been conducted with considerab le subjective interpretation. The usefulness of videomanometry with topographic analysis was examined in the current study. Methods Videomanometry was conducted in 5 patients with primary gastroesophageal reflux disease (GERD), 4 with posto perative esophageal atresia (EA), 1with congenital esophageal stenosis (CES), an d 1 with diffuse esophageal spasms (DES). Digitized videofluoroscopic images wer e recorded synchronously with manometric digital data in a personal computer. Ma nometric analysis was conducted with a view of concurrent esophageal contour and bolus transit. Results Primary GERD patients showed esophageal flow proceeding into the stomach during peristaltic contractions recorded manometrically, wherea s patients with EA/CES frequently showed impaired esophageal transit during defe ctive esophageal peristaltic contractions. A characteristic corkscrew appearance and esophageal flow in a to-and-fro fashion were seen with high-amplitude sy nchronous esophageal contractions in a DES patient. The topographic analysis sho wed distinctive images characteristic of each pathological condition. Conclusion s Videomanometry is helpful in interpreting manometric data by analyzing concurr ent fluoroscopic images. Topographic analyses provide characteristic images refl ecting motor abnormalities in pediatric esophageal disease.

关键词：食管疾病压力测量法先天性食管狭窄荧光图像弥漫性食管痉挛同步记录收缩功能病理生理地形分析病理情况

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普伐他汀对脑梗死和白质损伤的作用

世界核心医学期刊文摘（神经病学分册） 2005年第9期1卷 58-58页

作者： Ten Dam V.H. Van Den Heuvel D.M.J. Van Buchem M.A. 史利利 Section of Gerontology and Geriatrics Department of Internal Medicine C2-R Leiden University Medical Center PO Box 9600 2300 RC Leiden NetherlandsDr.

The authors examined the effect of pravastatin 40 mg daily on the progression of ischemic brain lesions using repeated brain MRI. After a mean treatment perio d of 33 months, there was an increase in total ischemic le... 详细信息

关键词：普伐他汀缺血损伤安慰剂

采用辅助生殖技术的双卵双胎妊娠与染色体异常、宫内失调和单绒毛膜双胎胎盘形成

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世界核心医学期刊文摘（儿科学分册） 2005年第8期1卷 39-39页

作者： Yoon G. Beischel L.S. Johnson J.P. Jones M.C. 平智广 department of Pediatrics University of California San Diego Children's Hospital MC 5031 3020 Children's Way San Diego CA 92123 United States Dr.

Assisted reproductive technology (ART) has now become a cornerstone of treatm ent for involuntary infertility. Recent studies have raised concern regarding po tential associations between ART and chromosomal aneuploidy, imprinting anomalie s, and monochorionic placentation in dizygotic (DZ) twins. We report a case of D Z twins conceived by ART in which all three problems coexist.

关键词：双卵双胎单绒毛膜双胎辅助生殖技术胎盘形成染色体异常不孕不育症双卵双生应用技术

体位性低血压和晕厥与ChiariⅠ型畸形有关

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世界核心医学期刊文摘（神经病学分册） 2005年第10期1卷 36-36页

作者： Prilipko O. Dehdashti A.R. Zaim S. Seeck M. 方伯言 Presurgical Epilepsy Evaluation Unit Department of Neurology H.eve 24 opital Cantonal Universitaire de Gen' rue Micheli-du-Crest CH-1211 Gen'eve 14 Switzerland Dr.

The Chiari type I malformation (CM1) is characterized by herniation of cerebe llar tonsils to at least 3- 5 mm below the plane of foramen magnum and can pres ent with a wide variety of clinical symptoms, frequently including occipital hea daches, secondary to bulbar and/or medullary distress. Rarely, syncopal episodes have also been described and attributed to either compression of the midbrain a scending reticular system, or vascular compromise (vertebrobasilar artery compre ssion, hypotension). We report the first case of a CM1 patient with frequently r ecurring syncope due to postural orthostatic tachycardia syndrome (POTS), a form of orthostatic intolerance, whose symptoms resolved completely after surgical i ntervention. It is important to stress that it is not clear whether the describe d association of POTS and CM1 in our patient is a fortuitous finding in an isola ted case or a reflection of a more systematic association between the two pathol ogies.

关键词： Chiari 体位性低血压小脑扁桃体疝心动过速枕骨大孔枕部疼痛基底动脉 POTS 调节中枢临床症状