Brain stem encephalitis due to herpes simplex virus

Abstract A 6 year old child is described with infection due to herpes simplex virus type 1 causing brain stem encephalitis. The diagnosis was established by enzyme immunosorbent assays of the cerebrospinal fluid and serum which demonstrated antibody responses to herpes simplex virus. Recovery occurred and the importance of early use of acyclovir in achieving a good outcome is emphasized.     

Influence on gallbladder volume of early postoperative gastric supply of nutrients

BACKGROUND & AIM: The gallbladder volume is a predictor of biliary stasis and the formation of biliary sludge. Biliary stasis and sludge have been recently recognized as the precursors of acute acalculous cholecystitis, as well as 'idiopathic' postoperative pancreatitis, rare but very serious complications after surgery. The aim of the study was to establish how early postoperative gastric supply of nutrients affects the gallbladder volume in patients after noncardiac and cardiac surgery. METHODS: In the two prospective, randomized studies 40 patients (study I-noncardiac surgery) treated at surgical ICU after major elective extrahepatobiliary and extragastrointestinal surgeries (7 thoracic, 19 vascular, 14 urological) and 40 patients (study II-cardiac surgery) treated at cardiosurgical ICU after CABG surgery were analyzed. In both studies the patients were divided into two groups: control group C (study I: 20 patients, age 45+/-18 yrs, male 65%; study II: 20 patients age 58+/-7 yrs, male 60%) and group E (group of early postoperative gastric supply of nutrients) (study I: 20 patients, age 52+/-17 yrs, male 50%; study II: 20 patients; age 59+/-8 yrs, male 65%). For the first 24 hours the patients in group C received only crystalloid solutions and the gallbladder volume was verified 24 hours after the surgery. In group E, postoperative gastric supply of nutrients began 18 hours after surgery (Osmolite, Ross; first 3 hours 30 ml/h and second 3 hours 50 ml/h; total 240 ml after 6 hours). In all patients sonographic measurement of gallbladder volume was performed immediately before surgery and 6 hours after the start of feeding (24 hours after surgery). The measurement was done with ultrasonographic scanner Hitachi 405 EUB (convex probe 3.5-5MHz) by the same specialist, and the volume was calculated using the ellipsoid method. RESULTS: The gallbladder volume measured by ultrasonography 24 hours after surgery in study I (noncardiac surgery) in group E amounted to 43+/-25 ml while in control group C it was significantly higher, i.e. 67+/-30 ml (P<0.05). In study II (cardiac surgery) in group E gallbladder volume amounted to 59+/-15 ml while in control group C it was also significantly higher, i.e. 71+/-11 ml (P<0.05). CONCLUSION: An early postoperative gastric supply of nutrients after both noncardiac and cardiac adult surgery diminishes the volume and probably stimulates the motility of the gallbladder, thus preventing biliary stasis and the formation of biliary sludge.     

Evidence-based approach to developmental and behavioural surveillance using parents' concerns

Half of all children with disabilities are not identified before school entrance, which precludes their participation in early intervention programs. Such programs have known value in reducing high school drop-out rates, increasing employment, delaying child-bearing and reducing criminal behaviour. Although there are many screening tests that can greatly improve detection rates, these have not been popular in primary care due to test length, difficulty managing children's behaviour, etc. An alternative is to carefully elicit and interpret parents' concerns. Research shows that parents' concerns are as accurate as quality screening tests and that parents are equally able to raise important concerns regardless of differences in education and child-rearing experience. Parents' concerns can be elicited quickly and 92% of parents can answer questions in writing while in exam or waiting rooms. Unlike screening tests, use of parents' concerns facilitates an evidenced-based approach to comprehensive surveillance and aids in making a range of other important decisions about children's developmental and behavioural needs. These include when to: offer suggestions on developmental promotion; watch children more vigilantly; screen for emotional and behavioural problems; advise families about behaviour management; offer reassurance and routine monitoring of development that is likely normal; administer a second screening test; or refer for additional testing and the kinds of testing needed.     

润喉宁抗病毒作用的研究

润喉宁（由地黄、射干、乌梅、薄荷等组成）在０．０６８９ｇ／ｍｌ的浓度时，能明显抑制流感病毒ＦＭ１株、单纯疱疹病毒Ⅰ型（ＨＳＶ－１）和腺病毒Ａ_３所致的细胞病变（ＣＰＥ）。免疫荧光试验显示，当其浓度为０．１４ｇ／ｍｌ和０．２８ｇ／ｍｌ时，均能抑制流感病毒ＦＭ１和ＨＳＶ－１在Ｈｅｐ－２细胞上的增殖。以５，１０，２０ｇ／ｋｇ·ｄ剂量ｉｇ给予小鼠，对小鼠流感病毒性肺炎及鼠肺内流感病毒的增殖量、均有明显抑制作用。     

CHARACTERIZATION OF A HUMAN HERPES VIRUS－6（HHV－6） AND EPSTEIN－BARR VIRUS（EBV） ASSOCIATED LEUKEMIC CELL LINE，J6－1

ＣＨＡＲＡＣＴＥＲＩＺＡＴＩＯＮＯＦＡＨＵＭＡＮＨＥＲＰＥＳＶＩＲＵＳ－６（ＨＨＶ－６）ＡＮＤＥＰＳＴＥＩＮ－ＢＡＲＲＶＩＲＵＳ（ＥＢＶ）ＡＳＳＯＣＩＡＴＥＤＬＥＵＫＥＭＩＣＣＥＬＬＬＩＮＥ，Ｊ６－１ＷｕＫｅｆｕ吴克复；ＪａｎｏｓＬｕｋａ；Ｓｈａｎｔ...     

A neonatal early discharge and home support programme: Shifting care into the community

Objective: The Neonatal Early Discharge and Family Support Programme (NEDP) was an initiative aimed at providing extended care for families whose infants had required neonatal special care, thereby allowing earlier discharge.
Methodology: Two groups of families were examined; one before and one after the instigation of the NEDP. Hospital and community service usage and psychosocial effects were examined.
Results: Families who received support were able to be discharged earlier and rooming-in was unnecessary as support was provided at home. Visits to family doctors for mothercraft issues were less frequent. Transport of babies from the Level 3 nursery to other nurseries in order to be closer to home was also provided by the nursing team, saving on ambulance costs and freeing their time for emergencies. There was no increase in maternal anxiety and infants were less difficult in the patient group.
Conclusions: NEDP and family support programme is a worthwhile extension of neonatal intensive care.     

Rapid and accurate method for delineating cancer lesions in laparoscopic colectomy using activated carbon injection

The aim of our study was to evaluate the clinical efficacy of preoperative injection of activated carbon in delineation of cancer location in laparoscopic colectomy. Activated carbon particles were injected during endoscopy into the normal colonic wall surrounding cancer lesions in five cases of early colon cancer, prior to laparoscopic surgery. The carbon-stained area was clearly recognizable as a blackened patch on the serosal surface of the colon. Using the carbon-stained area as a reference point, partial colectomies were successfully performed on all five patients. The preoperative injection of activated carbon assisted in the intraoperative delineation of early colonic cancer lesions. This method is recommended for the rapid and accurate delineation of early colonic cancers in laparoscopic surgery. © 1995 Wiley-Liss, Inc.     

Fetal heart rate in maternal hypoglycemic coma

In pregnancies complicated by diabetes mellitus fetal heart rate (FHR) monitoring is widely utilized to detect early fetal compromise. Never, however, was the fetal heart rate monitored during a maternal hypoglycemic coma. Such a case is here presented.     

Serology in facial paralysis caused by clinically presumed herpes zoster infection

Summary In some cases of peripheral facial palsy due to a clinically suspected varicella zoster virus (VZV) infection, the clinical diagnosis is not supported by serological tests. In a retrospective study, we examined the sera from 63 patients with clinical findings compatible with VZV infection: 57 had paired sera and 6 had single sera. In the paired-sera group, 18 cases were serologically negative initially by complement fixation (CF), while 9 of these cases were actually positive for VZV when CF was combined with ELISA. Moreover, evidence for a recent mumps virus infection was found in 6 patients and 1 patient was diagnosed as having recent mumps and cytomegalo-virus (CMV) infections. In the 6 single sera studied, the ELISA was suggestive of a recent infection with VZV (4 cases) and CMV (1 case).