Minilaparoscopy without General Anesthesia for the Diagnosis of Acute Appendicitis

The timely diagnosis of intra-abdominal pathology continues to be an elusive problem. Delays in diagnosis and therapeutic decision making are continuing dilemmas in patients who are females of childbearing age, elderly, obese or immunosuppressed. Minilaparoscopy without general anesthesia potentially can provide an accurate, cost-effective method to assist in the evaluation of patients with acute abdominal pain.Laparoscopy without general anesthesia is not a new technique, but with the combination of two emerging factors— 1) the introduction of new technology with the development of improved, smaller laparoscopes and instruments, and 2) the shifting of emphasis on healthcare to a more cost-effective managed care environment--its value and widespread utilization is being reconsidered.We report the case of a 22 year old female with an acute onset of increasing abdominal and pelvic pain. Despite evaluation by general surgery, gynecology, emergency room staff, as well as, non-invasive testing, a clear diagnosis could not be made. In view of this, minilaparoscopy without general anesthesia was performed and revealed an acute, retrocecal appendicitis. The diagnosis was made with the assistance from the conscious patient. The utilization of this technique greatly expedited the treatment of this patient. Full-sized laparoscopic equipment was then used to minimally invasively remove the diseased appendix under general anesthesia. Both procedures were well tolerated by the patient.     

吸入与呼气末氧浓度差用于肺通气监测的临床观察

以１７例全身状态良好，在全身麻醉控制呼吸（ＩＰＰＶ）下行中上腹部手术患者为对象，观察肺通气量减少时吸入与呼气末氧浓度差（Ｉ－ＥｔＯ２）改变，并与呼气末二氧化碳分压进行比较。     

全麻下空气灌肠治疗小儿急性肠套叠

为了提高小儿急性肠套叠复位的成功率，近年来我们试行在基础全麻下实施空气灌肠治疗小儿急生套叠１５例收到了良好效果，全部病例皆治愈。结果提示，全麻下空气灌肠治疗小儿急性肠套叠优于单纯空气灌肠     

顶空气相色谱连续监测鼠伤寒沙门氏菌致突变试验研究

在密闭的液体培养体系中，以ＣＯ２为指标用气相色谱分析法连续监测致突变剂ＮａＮ３和敌克松对鼠伤寒沙门氏菌组氨酸缺陷型菌株ＴＡ１００、ＴＡ９８的致突变作用，研究了回复突变菌数、致突变剂的剂量与ＣＯ２产生量之间的关系，在此基础上提出了致突变性的评价指标。用本方法测得ＮａＮ３和敌克松的最低诱变剂量分别为０．０５０μｇ／瓶和０．０８０μｇ／瓶，灵敏度显著高于Ａｍｅｓ试验。     

重复多次硬膜外阻滞效果分析

本文分析重复多次硬膜外阻滞１８４例，（１）根据硬膜外阻滞的重复次数分为：Ｉ组（重复二次）优良率占８２．９％，Ⅱ组（重复三次）占６１．５％，Ⅲ组占５７．１％，Ｉ组与Ⅱ、Ⅲ组比较有显著性差异（Ｐ〈０．０５）。硬外腔用药量Ｉ组１３．８ｍｌ／ｈ，Ⅱ组８．９ｍｌ／ｈ，Ⅲ组７６．ｍｌ／ｈ，Ｉ组与Ⅱ、Ⅲ组相比较有非常显著性差异（Ｐ〈０．０１），Ⅱ组与Ⅲ组比较没有显著性差异（Ｐ〉０．０５）。（２）按重复间隔时间分     

八通道气体智能测控仪

将单片机及计算技术引入气敏法测量中,实现了气体的多通道多功能智能测控。针对多通道结构和气敏传感器的特点,设计了多种软件,减弱了气敏测量中温漂、时漂的影响,实现了一机适用多种气体和传感器的可置换性。研制了预测技术,克服了响应中的滞后现象。仪器还具备浓度数据贮存,事故数据记忆,群控及测量传感器响应与恢复特性等功能。     

Gas chromatography-mass spectrometry in forensic chemistry for identification of substances isolated from tissue

Summary The use of combined gas chromatography-mass spectrometry in forensic chemistry is demonstrated in 13 cases where various substances had to be isolated and identified, the substance was present in small amounts in some samples while in others the sample available was very small. In other instances a rapid and certain identification was important. The results are compared with data obtained by conventional procedures. The advantage of this method is discussed and it is emphasized that a collection of mass spectra of all common substances searched in forensic chemistry simplifies the indentification. Reference mass spectra of some drugs are given.

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Zusammenfassung Die Anwendung einer kombinierten gaschromatographischen und massenspektrophotometrischen Methode in der gerichtlichen Chemie wurde anhand von 13 untersuchten Fällen diskutiert. Verschiedene Substanzen, z.T. in kleinsten Mengen, wurden isoliert und identifiziert. Die erhaltenen Ergebnisse werden mit den Resultaten der konventionellen Methoden verglichen, zudem wird anf die Vorteile der GC-MS-Kopplung hingewiesen. Gleichzeitig werden einige Massenspektren wiedergegeben.Eine Massenspektrensammlung von den in der gerichtlichen Chemie häufig anzutreffenden Substanzen ist für eine rasche und einfache Identifizierung erforderlich.

     

Fatal combined anileridine-pethidine poisoning. A gas chromatography,thin layer chromatography and mass spectrometry investigation

Summary Anileridine and pethidine were established by gas and thin layer chromatography and mass spectroscopy. In the mass spectrum the main peak of anileridine is found at m/e 246 and that of pethidine at m/e 71. The determination was made by gas chromatography from the blood, urine, liver, muscle and stomach contents.

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Zusammenfassung Anileridin und Pethidin wurden mittels Gas- und Dünnschicht-chromatographie sowie massenspektroskopisch festgestellt. Im Massenspektrum liegen die Hauptspitze von Anileridin bei m/e 246 und diejenige von Pethidin bei m/e 71. Die Bestimmung erfolgte gaschromatographisch aus Blut, Harn, Leber, Muskel und Mageninhalt.

     

Evaluation of dopamine metabolism in rat striatum by a gas chromatographic technique

Dopamine metabolism in rat striatum was evaluated by gas chromatographic quantitation of 3,4-dihydroxy-phenylacetic acid (DOPAC) and homovanillic acid (HVA). The level of DOPAC (5.21 nmoles/g ± 0.40 S.E.M., N = 12) exceeded that of HVA (3.63 nmoles/g ± 0.25 S.E.M., N = 12). 2 hr following administration of probenecid (200 mg/kg i.p.) the level of striatal HVA was approximately doubled whereas the level of DOPAC was not significantly elevated. Parggline (75 mg/kg i.p.) produced a rapid depletion of DOPAC and HVA. The rate of disappearance of DOPAC (t^1/2 = 10 min) exceeded that of HVA (t^1/2 = 18 min). Rates of metabolite formation were computed assuming steady state kinetics. The rate of formation of DOPAC (20.5 nmoles/g/hr) was much greater than that of HVA (10.1 nmoles/g/hr). We conclude that DOPAC is the major dopamine metabolite in rat striatum and that its measurement may provide the best index of functional of neuronal activity in this species.