Bacteriology of the appendix and the ileum in health and in appendicitis

The bacteriology of the ileum and the appendix in appendicitis patients with or without perforation and compared with patients who had "incidental appendectomy" was studied. Of 42 appendicitis patients, 24 (57%) of them had anaerobic bacteria in the appendix compared with two of eight (25%) with normal appendix. Anaerobes were found in the ileal aspirates of 20 of 42 (47.6%) appendicitis patients and two of eight (25%) in normal persons. This suggests that anaerobic bacteria increasingly colonize the appendix and the ileum in cases of appendicitis.     

Interventions in the disturbances in the motor and sensory environment

Treatment of peripheral nervous system (PNS) pathology presents intervention challenges to every therapist. Many of the current and future interventions will be directed at restoring the normal anatomy, function, and biomechanical properties of the PNS, restoring normal neural physiology and ultimately patient function and quality of life. Present interventions use mechanical (movement) or electrical procedures to affect various properties of the peripheral nerve. The purpose of this article was to apply basic science to clinical practice. The pathology and accompanying structural and biomechanical changes in the PNS will be presented in three specific areas commonly encountered in the clinic: nerve injury and laceration; compression neuropathies; and neuropathic pain and neural tension dysfunction. The intent is to address possible interventions exploring the clinical reasoning process that combines basic science and evidence-based best practice. The current lack of literature to support any one intervention requires a strong foundation and understanding of the PNSs' structure and function to refine current and develop new intervention strategies. Current evidence will be presented and linked with future considerations for intervention and research. During this interlude of development and refinement, best practice will rely on sound clinical reasoning skills that incorporate basic science to achieve a successful outcome when treating these challenging patients.     

国产与进口6%羟乙基淀粉130/0.4注射液容量治疗疗效和安全性的对比研究

目的 与进口6%羟乙基淀粉130/0.4注射液进行对比性研究,评价国产6%羟乙基淀粉130/0.4注射液的有效性及安全性.方法 患者随机分为研究组123例,对照组117例,术中输注研究药物或对照药物10 ml·kg-1·h-1,输注时间 2 h,期间观察患者生命体征,记录液体出入量与合并用药,比较术前和输注后血常规、血电解质、凝血功能、肝肾功能、尿常规指标变化;并记录术中不良事件发生与处理.结果 两组患者用药期间BP、HR、SpO2均能维持正常,BP和HR的变化率两组间差异无统计学意义.两组患者术中出入量、应用血管活性药物及应用血液制品人数与用量组间差异无统计学意义.输注后两组Hct、Hb下降幅度一致,血K+、Na+略低于应用前,血Cl-高于应用前,血糖有升高,PT、APTT时间延长,TT时间略缩短.肝功能ALT、AST超过正常值1.5倍的两组各有4例.肾功能BUN、Cr研究组有11例,对照组7例高于正常.结论 国产6%羟乙基淀粉130/0.4注射液用于全麻下非心脏外科手术患者术中容量治疗扩容效果安全可靠,与进口6%羟乙基淀粉130/0.4注射液作用相似.     

Innervation density in the stroma and the muscular tunica in biopsies of the normal and pathologic bladder

Twenty-eight open urinary bladder biopsies were stained using a peroxidase-antiperoxidase technique for S100 to demonstrate the innervation pattern in three different patient groups. The nerve profiles in the subepithelial stroma and in the musculosa were counted and compared. There was a definite correlation between nerve density in both layers. Examination of superficial bladder biopsies is reliable in the assessment of the innervation pattern of neurogenic and non-neurogenic bladder disorders.     

Primary and coupled motions in the intact and the ACL-deficient knee: an in vitro study in the goat model.

Quadrupeds are commonly used as animal models to study healing of anterior cruciate ligament (ACL) reconstructions. While rabbits, dogs, goats, and sheep have been used, goats and sheep are increasingly being employed because of the larger joint size that facilitates surgery, ease of availability, and lower expense to maintain in the farm environment. In spite of this, little is known about the function of the ACL in controlling primary and coupled motions in the quadruped. We report here on the measurements of these motions in goats, with the application of anterior-posterior forces, varus-valgus moments, and internal-external moments in the intact and ACL-deficient knee. Sectioning the ACL caused significant increases in primary anterior translation, and in varus-valgus and internal rotations. The increases in anterior translation were similar in amount and dependence on flexion angle to those seen in human knees. The increase in varus averaged 7 degrees and did not depend on flexion angle, whereas the increase in valgus was significant only in the flexed knee. The increases in internal tibial rotation were greatest in extension, whereas the increases in external rotation were small and independent of flexion angle. When the ACL was cut, coupled internal rotation increased with an anterior force as well as a valgus moment. Large increases were seen in coupled anterior translation with the application of varus and valgus moments, whereas smaller increases were seen with internal and external moments. These findings demonstrate that the ACL restrains multiple motions in the goat knee. This study also provides baseline data for future studies of ACL reconstruction.     

Uptake of47Ca and85Sr in the tibia and the femur in rats

The ratio between the uptake of⁸⁵Sr and⁴⁷Ca was measured in the tibiae and femora of rats 24 h after injection of the tracers. There was a significant difference between shafts and ends but not between the different bones; in healed tibial fractures, 7 weeks old, the ratio was identical to that of normal tibial shafts. The findings were interpreted to be related to qualitative rather than quantitative differences in mineralization between cortical and trabecular bone.

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Zusammenfassung Das Verhältnis zwischen der Abnahme von⁸⁵Sr und⁴⁷Ca wurde von der Tibia und Femur 24 Std nach der Injektion bei Ratten gemessen. Man fand einen signifikanten Unterschied zwischen den Schaften und den Enden, aber nicht zwischen den verschiedenen Knochen. In 7 Wochen alten, verheilten Tibiafrakturen war das Verhältnis genau so wie in einem normalen Tibiaschaft. Das Resultat berechtigte zu der Annahme, daß der Unterschied in dem Mineralisierungsprozeß zwischen corticalen und spongiösen Knochen wahrscheinlich qualitativ und nicht quantitativ ist.

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Résumé La relation entre la résorption du⁸⁵Sr et du⁴⁷Ca était mesuré au tibia et fémur des rats 24 heures après l'injection. La différence entre les manches et les bouts était, remarquable, mais pas entre les os séparates; en les tibiae, qui etait fracturé depuis 7 semaines et guéries, la relation etait identique à celui des tibiae manches normals. On a présumé que la découverte était due à des différences qualitatives plustot que quantitatives entre les procédé de minéralisation dans l'os cortical et trabeculair.

     

Fall prevention in the elderly: analysis and comprehensive review of methods used in the hospital and in the home

Falls in the elderly are a significant problem both in and out of the hospital. The Deficit Reduction Act of 2005 and the Fiscal Year 2009 Inpatient Prospective Payment System Final Rule, as outlined by the Centers for Medicare & Medicaid Services, placed on hospitals the financial burden of fall prevention for falls (ie, hospital-acquired conditions) that could have been prevented by following evidence-based guidelines. Multifaceted and individualized programs have been created to prevent falls in the elderly. Many of these interventions are based on expert opinion and statistical trends. Our review of the literature revealed that the risk of fall is only slightly greater in the hospital environment than in the home and that there is no medical evidence that evidence-based guidelines are effective in fall prevention.     

Selected Topics in the Pathology of the Thyroid and Parathyroid Glands in Children and Adolescents

The goals of this chapter in keeping with the overall general themes of this special edition will be (1) to highlight aspects of development of the thyroid and parathyroid glands with particular focus on the role and contribution of the neural crest (or not) and how this may impact on the pathology that is seen, (2) to emphasize those lesions particularly more commonly arising in the pediatric population that actually generate specimens that the surgical pathologist would encounter, and (3) highlight more in depth specific lesions associated with heritable syndromes or specific gene mutations since the heritable syndromes tends to manifest in the pediatric age group. In this light, the other interesting areas of pediatric thyroid disease including medical thyroid diseases, congenital hypothyroidism, anatomic variants and aberrations of development that lead to structural anomalies will not be emphasized here.