多部位一期肿胀吸脂术

目的 探讨多部位一期肿胀吸脂术及几项重要环节改进后的临床意义。方法 在大范围肿胀液注射前，诱导麻醉中速效苯二氮Zhuo类镇静诱导剂的选择使用，以及调整注液器压力、注液速度及注射层次，以达到降低疼痛反应和提高疼痛耐受性的效果。切口选择的隐蔽性与特殊保护，减少术后瘢痕形成。为了提高皮瓣平整均匀程度，采用手术后期皮瓣外加压和滑动式操作手法，根据受术者不同年龄及不同部位决定保留皮瓣的厚度，并进行将术后开放式引流改为闭式引流的尝试。结果 对73例受术者术后6～24个月随访，除1例腹部瘢痕增生外，其余均对手术效果满意。围度变化：腹部最大围减少3～24cm，大腿最大围减少2～17cm，臀部最大围减少1～3cm。结论 通过对围手术期关键步骤的改进，提高了多部位一期肿胀吸脂术的综合疗效。     

The feasibility of using an American National Board examination for the evaluation of Swiss candidates for licensure

A test in Internal Medicine of the American National Board of Medical Examiners was given to Swiss medical students as a graduating examination. This study dealing with the feasibility of such an enterprise describes the technical procedures and investigates the problems of translation and the validity of foreign made items. Comparison of item analyses for the 369 Swiss candidates and for a sample of 370 American candidates reveals that most items are of close comparability in difficulty, discrimination and pattern of response to the distractors. In a cross-national comparison of students' responses to the items no systematic content characteristics can be found for items favouring one group or the other. Swiss experts, in judging the validity of the items for testing Swiss students, could indeed identify in advance some of the items that proved to be less valid and more difficult for their—but also the American—students. It is concluded that a National Board examination can be as valid and suited to examine Swiss candidates for licensure as it is to examine American candidates.     

Klinik und Diagnostik des „Anal- und Rectumcarcinoms“

Ohne Zusammenfassung

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Fly transmission of Campylobacter

An annual increase in Campylobacter infection in England and Wales begins in May and reaches a maximum in early June. This increase occurs in all age groups and is seen in all geographic areas. Examination of risk factors that might explain this seasonal increase identifies flies as a potential source of infection. The observed pattern of infection is hypothesized to reflect an annual epidemic caused by direct or indirect contamination of people by small quantities of infected material carried by flies that have been in contact with feces. The local pattern of human illness appears random, while having a defined geographic and temporal distribution that is a function of the growth kinetics of one or more fly species. The hypothesis provides an explanation for the seasonal distribution of Campylobacter infections seen around the world.     

Sleep homeostasis in rats assessed by a long-term intermittent paradoxical sleep deprivation protocol

Numerous studies have evaluated the sleep homeostasis of rats after short- or long-periods of sleep deprivation, but none has assessed the effects of prolonged sleep restriction on the rat's sleep pattern. The purpose of the present study, therefore, was to evaluate the sleep homeostasis of rats under a protocol of chronic sleep restriction. Male Wistar rats were implanted with electrodes for EEG and EMG recordings. Using the single platform method, the animals were submitted to 18 h of sleep restriction, beginning at 16:00 h (lights on at 07:00 h), followed by a 6 h sleep window (from 10:00 h to 16:00 h) for 21 days. Immediately after this period, rats were allowed to sleep freely for 4 days (recovery period). The sleep–wake cycle was recorded throughout the entire experiment and the results showed that during the 6 h sleep window there was an increase on the percentage of sleep time, reflected by augmented time in high amplitude slow wave sleep and in paradoxical sleep, when compared to baseline sleep, whereas bouts of awakening longer than 1.5 min were greatly reduced, with the animals exhibiting a monophasic-type sleep pattern. During the deprivation period, paradoxical sleep was abolished. High amplitude slow wave sleep was also greatly affected by the protocol. Nonetheless, one day of recovery was sufficient to restore the normal sleep pattern. These findings indicate that this protocol was capable to induce many changes in the rat's sleep patterns, suggesting that during the 6 h sleep window there is a sleep adaptive homeostatic process.     

Tongue mechanical characteristics and genioglossus muscle EMG in obstructive sleep apnoea patients

The increased genioglossus muscle (GGm) activity seen in obstructive sleep apnoea syndrome (OSAS) may lead to increased fatigability or longer recovery time of the tongue. Maximal force, endurance, and recovery times of the tongue, electromyogram (EMG) absolute value, and EMG spectral analysis of the GGm obtained during submaximal contractions were compared in eight individuals without chronic snoring and eight OSAS patients. Endurance time values were not significantly different between the two groups (P = 0.40). Time to recovery of initial maximal force was significantly greater in the OSAS group (P = 0.01). Final EMG median frequency was significantly higher (P = 0.01) and the final low-frequency EMG component smaller in the OSAS patients (P = 0.02). Patients did not have changes in endurance time or fatigability but had longer recovery times and changes in spectral analysis variations. This functional investigation may be helpful in determining the presence of OSAS and the potential contribution of the tongue to pharyngeal obstruction.     

Caenorhabditis elegans as model system for rapid toxicity assessment of pharmaceutical compounds

Introduction: The model organism Caenorhabditis elegans is widely used for genetic studies as well as a living biomonitor in ecotoxicology. In this study, we investigated whether C. elegans may represent a suitable model for rapid preliminary toxicity studies of pharmaceutical compounds. Methods: For this purpose, we used the EGFR kinase inhibitors BIBU1361, BIBX1382, and an inactive chemical analogue BIBU1476. As a first parameter to score for toxicity, we determined lethality of the wild-type C. elegans strain N2 (Bristol) in the presence of the compounds. The transgenic C. elegans strain PC72 (lacZ, heat shock protein-16 [hsp-16] construct) was used as a report organism for toxic effects. PC72 expresses β-Galactosidase which is induced by hsp-16 in direct response when exposed to toxic compounds. The expression of β-Galactosidase in cells was subsequently visualized by histochemical staining with X-Gal. Results: A rank order of potency with respect to lethality was established: BIBU1361>BIBX1382>>BIB1476. The induction of β-Galactosidase was concentration-dependent for each compound and demonstrated the same order of potency as observed for lethality. Furthermore, these compounds showed the same order for lethality in rodents, the first requirement of validation. Discussion: These results indicate that wild-type C. elegans and the transgenic strain PC72 are both suitable models to determine the toxicity of pharmaceutical compounds. This approach allows for an easy and fast ranking of compound toxicity, which may lead to a more rational choice for further in vivo tests.     

Time-dependent changes in spontaneous respiratory activity in turtle brainstems in vitro

Our goal was to determine whether time-dependent changes in respiratory motor output in vitro could be minimized by altering bath solution composition. Adult turtle brainstems were bathed in standard solution, nutrient-rich Dulbecco's Eagle media (100 or 25% concentration), or standard solution with phenylbiguanide (PBG, 5-HT3 agonist which increases respiratory drive). Except for a 63% frequency increase in PBG solution, hypoglossal bursts were unaltered within 100 min of observation. Respiratory activity was abolished within 7 h in 100% Dulbecco's compared with a mean of 24-31 h in other test solutions. At 12 h, burst frequency decreased faster in standard solution and 25% Dulbecco's (-0.28+/-0.07 and -0.13+/-0.05 bursts/h, respectively) compared with PBG solution (-0.09+/-0.04 bursts/h); amplitude declined at approximately 2%/h in all solutions. The tendency for episodic discharge decreased gradually in standard solution, but was eliminated in 25% Dulbecco's and PBG solution. Certain bath solutions may minimize time-dependent frequency reductions but may also cause breathing pattern changes.