Spinal anaesthesia in a child with Job''s syndrome, pneumatoceles and empyema

We present a case of acute bowel obstruction in an immunocompromised child, who also had lobar pneumonia and a giant unilateral pneumatocele. She was successfully managed with subarachnoid anaesthesia for exploratory laparotomy to relieve a colonic obstruction. This proved to be a safe alternative to general anaesthesia with tracheal intubation in this patient and should be considered in infants and children in selected cases whenever a contraindication to general anaesthesia exists.     

Elements of psychological support in nursing care

The paper presents the results of a pilot study which involved 50 nurses from several departments of internal medicine of The State Clinical Hospital of the Collegium Medicum, Jagiellonian University in Cracow. The results are based on the Statement Response Questionnaire. They show that the most common responses of the nurses in the face of anxiety expressed by patients are cheering up the patient, collecting information about the symptom, and offering explanation of the symptom. The least common responses included expressing one's own positive emotions and showing empathy towards the patient.     

Laparoscopic repair/peritoneal toilet of perforated duodenal ulcer

Summary Laparoscopic techniques have been refined to the point where exposure, haemostasis and tissue approximation by suture approach those obtained at open access surgery. We report a patient with acute perforation of an ulcer in the first part of the duodenum who was successfully treated by laparoscopic oversewing and omental patching. The clinical indications for contemplating use of laparoscopic surgery for acute ulcer perforation, techniques employed and the areas for potential improvement of instruments, needles and sutures are discussed.     

136例阿片类药物依赖者SCL-90的评定结果分析

本文应用ＳＣＬ－９０对１３６例阿片类药物依赖者进行测评，并与正常人进行对照分析。结果显示研究组总分及各因子分与正常组相比差异有显著性。说明毒品滥用人群心理问题严重，突出表现在焦虑、抑郁等几方面，提示戒毒治疗仅进行临床脱毒治疗是远远不够的，还必须重视这一人群的心理问题，并加以矫正，才能提高工作成效     

Insights into the assessment of myocardial perfusion offered by different cardiac imaging modalities

Myocardial perfusion may be very broadly defined as the tightly regulated nutrient delivery to cardiac tissue. The different components of perfusion are myocardial blood flow, oxygen delivery, myocardial oxygen consumption, and myocardial blood volume. Historically, focus has been placed mostly on the assessment of blood flow. In many instances, knowledge of flow without information about these other aspects is inadequate. This review discusses the various cardiac imaging techniques used for the assessment of myocardial perfusion that represent diverse physiologic measures of “perfusion.” Their strengths and limitations are discussed as is their relevance to specific clinicopathologic conditions. Significant work still needs to be performed before all the aspects of myocardial perfusion can be precisely measured in human beings. Supported in part by a grant (R01-HL48890) from the National Institutes of Health, Bethesda, Md. Dr. Lindner is the recipient of a Fellowship Training Grant from the Virginia Affiliate of the American Heart Association, Glen Allen, Va. Dr. Kaul is an Established Investigator of the National Center of the American Heart Association, Dallas, Texas.     

Medical student abuse: perceptions and experience

Summary. A questionnaire containing 18 vignettes of common clinical educational situations with potentially abusive treatment of medical students and a 10-item attitude assessment about abusive behaviour were administered to the first-and fourth-year medical students at a mid-west US university medical school. The first- and fourth-year groups did not differ significantly on perceived abusiveness of most of the vignettes, although several of the individual vignettes were perceived significantly differently by the two groups. As hypothesized, the fourth-year students had experienced such situations more frequently. Attitudes towards abusive behaviour did not differ between the two groups. The authors contrast teaching interactions perceived as educationally useful and not abusive with those seen as abusive and not useful and offer explanations for the differences observed. Finally, the possible implications of the results for medical education are discussed.     

心理学研究中的科学方法与非科学方法

自心理学被界定为一门科学以来 ,对心理学的研究便十分强调研究方法的科学性。那些被认为是不科学的方法 ,如内省、思辨、假设、演绎等被长期排斥在主流心理学的研究方法之外。这虽是学科研究进步的表现 ,但也暴露出心理学研究中唯科学方法的缺陷。由于心理学研究对象的特殊性 ,非科学方法仍是心理学研究中的一种重要方法 ,心理学史上的一些重要成就表明了非科学方法的应用价值。心理学研究中的科学方法与非科学方法并不是对立的。人本主义心理学大胆引进非科学方法 ,兼收并蓄 ,其主张被越来越多的人接受。     

神经导航在经单鼻孔入路垂体腺瘤切除术的应用

目的 探讨神经导航系统在经单鼻孔入路垂体腺瘤切除术中的应用技术及对鞍区解剖结构识别的价值。方法 对39例垂体腺瘤使用StealthStation神经导航系统进行指导定位、识别入路相关的解剖结构并引导手术操作。结果 平均注册误差为2．3mm（1．6～3．3mm），肿瘤全切除32例，次全切除4例，大部切除2例。部分切除1例。未全切除病例主要是肿瘤巨大、向海绵窦侵袭性生长、质地坚硬或血供异常丰富者。结论 神经导航系统提供了准确可靠的定位，能够准确指示中线结构、鞍底和颈内动脉，有效地减轻了创伤，使之成为良好的手术辅助工具。