Chemical composition and cytotoxic activity of the leaf essential oil of <Emphasis Type="Italic">Eugenia zuchowskiae</Emphasis> from Monteverde,Costa Rica

The leaf essential oil of Eugenia zuchowskiae from Monteverde, Costa Rica, has been obtained by hydrodistillation and analyzed by GC–MS. The principal constituents of E. zuchowskiae leaf oil were α-pinene (28.3%), β-caryophyllene (13.2%), α-humulene (13.1%), and α-copaene (8.1%). The leaf essential oil of E. zuchowskiae showed pronounced in-vitro cytotoxic activity against MCF-7, MDA-MB-468, and UACC-257 human tumor cell lines. The major components showed cytotoxic activities comparable to doxorubicin (LC₅₀ 14–70 μg/ml).     

原发性胆汁性肝硬化伴系统性硬化症的临床特点与预后

背景与目的：原发性胆汁性肝硬化（PBC）伴系统性硬化症（SSc）的预后仍不十分清楚，该研究拟对其临床特点及预后进行评估。方法：从一个含580例患者的PBC数据库中选出43例PBC伴SSc患者，同时为每例PBC—SSc患者匹配2例单纯PBC患者作为对照，监测初次就医时的血清胆红素浓度。结果：局限皮肤型SSc者40例（93％）。诊断PBC时的中位年龄为49．7岁，胆红素浓度为17μmol／L，白蛋白水平为40．5g／L。24例（56％）患者于SSc后在中值为4．9年发生PBC。配对患者诊断PBC时的中位年龄为53．2岁、胆红素浓度为12μmol／L、白蛋白水平为41g／L。两组患者中位随访时间相似：PBC—SSc组为3．16年，单纯PBC组为4．8年。PBC—SSc患者南于较少接受移植手术（HR0．068；P：0．006），在校正性别、年龄、胆红素对数及碱性磷酸酶等因素后，其移植术或死亡风险（HR0．116；P=0．01）均明显降低，同时胆红素上升的比例亦较低（P=0．04）。     

Synthesis and polymerization of epoxymethacrylates, 1. Catalysis and kinetics of the addition reaction of methacrylic acid and 2,2-bis[4-(2,3-epoxypropoxy)phenyl]propane

The kinetics of the addition reaction of methacrylic acid (1) and 2,2-bis[4-(2,3-epoxypropoxy)-phenyl]propane catalyzed by tertiary aliphatic amines, aromatic N-heterocycles and quaternary ammonium salts, respectively, was studied in bulk with equimolar amounts of functional groups from room temperature to 120°C. A reaction order of 1,5 with regard to the conversion of epoxy as well as carboxylic groups was observed. This can be explained assuming the formation of an ammonium alkoxide ion pair by the equilibrium reaction of an epoxy group with ammonium carboxylate and the irreversible consecutive reaction of the ion pair with (1) under formation of 2-hydroxyester groups and regeneration of ammonium carboxylate. The reaction rate constants increase linearly with the concentration of the catalyst and increase with increasing basicity of alkylpyridines. The advantage of the aromatic N-heterocyclic catalysts consists in their stability to peroxides which are ingredients of preparations together with the epoxy methacrylate Bis-GMA, e. g. in dental composites and adhesives.     

Predominance of staphylococcal organisms in infections occurring in a burns intensive care unit.

To assess the sites, incidence, and bacteriology of infections in intensive care burn patients, a prospective survey of all admissions to a tertiary care institution burn unit was carried out over a 12-month period. One hundred and sixteen patients were admitted, 106 with a diagnosis of thermal burns. Forty patients developed 90 infections. Only two deaths occurred, one in a patient with sepsis. In order of frequency, pneumonia, burn infection, UTI and primary bacteraemia were most common. Staphylococcal species accounted for a majority of infections at all body sites except UTI (47 per cent of all infections, including 11 of 14 bacteraemic infections). Staph. aureus sepsis was more common in those carrying the organism on admission. Strain typing of paired admission and subsequent clinical isolates in 19 patients with Staph. aureus sepsis indicated that eight (42 per cent) became infected with a strain they carried on admission. Further reductions in septic complications of burns in our center would be best directed at staphylococcal species, particularly Staph. aureus. Both eradication of carrier state, and prevention of acquisition of Staph. aureus strains could be explored.     

Asynchronous blepharospasm, facial and cervical dystonia, and bilateral asynchronous hemifacial spasm.

We present a patient with a facial movement disorder that has characteristics of both blepharospasm and bilateral asynchronous hemifacial spasm. Because of the increased incidence of blepharospasm in patients with hemifacial spasm, our patient's clinical presentation is probably not a chance occurrence, but rather a manifestation of some predisposition for these two movement disorders. This unusual constellation of signs and symptoms challenges the current diagnostic criteria and suggests that some of these facial movement disorders may lie on a spectrum, rather than represent distinct entities.     

Outcome of surgery for failed endoscopic extraction of common bile duct stones in elderly patients.

Endoscopic sphincterotomy (ES) is the treatment of choice for common bile duct stones in elderly patients. For those in whom endoscopic clearance of the common bile duct fails the treatment options include stenting, dissolution therapy and lithotripsy. Surgery is often avoided because of the reported high morbidity and mortality in elderly patients. We have reviewed the outcome of patients referred for surgery after failed endoscopic clearance of common bile duct stones. Over a 3-year period, 100 patients with common bile duct stones were referred specifically for endoscopic clearance of the common bile duct (median age 69 years, range 19-97 years). In seven patients duct clearance was possible without ES and in five patients ES was considered inappropriate. ES was attempted in 88 patients and was successful in 75 (85%). Of the 13 patients failing ES or stone removal, surgery was performed in nine and four were stented. Of patients having successful ES (n = 75), ten were referred for surgery because of incomplete duct clearance. Surgery was performed to obtain duct clearance in 19 patients (eight male, 11 female, median age 77 years, range 47-90 years). Of the 19, eight had previously undergone a cholecystectomy (42%) and 17 of the 19 had biliary tract drainage preoperatively (90%). The procedures performed consisted of choledocholithotomy in all plus cholecystectomy (11), choledochoduodenostomy (7) and choledochojejunostomy (7). There were no deaths and only one major complication. The median total inpatient stay was 26 days (range 14-75 days) and the median postoperative stay was 12 days (range 7-50 days). We would conclude that open surgery can be performed safely and effectively in elderly patients with retained bile duct stones.