北京、上海、广州、成都、天津、山东、浙江、辽宁、吉林、新疆、安徽、等二十九个省、市举办世界骨质疏松日活动

今年１０月２０日是世界骨质疏松日，今年的主题是：“早期诊断”。北京、上海、广州、成都、天津、山东、浙江、辽宁等二十九个省、市老年学学会骨质疏松委员会等单位分别举办了大型骨质疏松咨询活动，骨质疏松防治专家就骨质疏松的发病基理、预防措施、中老年人自我保健等内容进行了咨询。通过咨询，提高了中老年朋友对骨质疏松症的认识，积极预防治疗，提高生活质量，为进入健康化老龄社会做好准备。北京、上海、广州、成都、天津、山东、浙江、辽宁、吉林、新疆、安徽、等二十九个省、市举办世界骨质疏松日活动@李扶刚     

双下肢皮疹、发热、咳嗽、咯痰、蛋白尿

病历摘要 患者女,66岁,反复乏力、关节肌肉疼痛6年,水肿5年,加重3个月伴咳嗽、咯痰1个月于1999年1月11日入院.     

发热、腰痛、休克、心律失常

病例摘要患者,女,58岁,住院号376914。因寒战、发热、头痛、右侧腰痛5天,于1987年9月14日入院。患者于9月10日受凉后寒战、发热、头痛、右侧腰痛,但无尿频、尿急、尿痛、血尿等症状。服中药后3天病情无好转,并感心慌气急。既往有高血压病史20余年,平均血压170/100     

肝、胆、胰、脾

肝动脉化疗栓塞对原发性肝癌患者术后生存及肿瘤复发的影响;肝动脉化疗栓塞对原发性肝癌患者树突状细胞的影响;纳米材料栓塞对肿瘤组织表达CD147影响的研究;奥曲肽抑制转化生长因子α诱导肝癌细胞增殖的实验研究;供肝缺血预处理对大鼠肝移植缺血再灌注损伤的保护性作用     

肝、胆、胰、脾

血管内皮生长因子和基质金属蛋白酶-9在原发性肝细胞癌中的表达及其临床意义,门静脉高压症大鼠阻断门静脉和下腔静脉后肾脏损伤的研究，1人重组生长激素对肝硬化门脉高压患者术后早期免疫功能的影响,表阿霉素聚氰基丙烯酸正丁酯纳米粒治疗移植性肝癌[编者按]     

肝、胆、胰、脾

第二肝门肝静脉医源性异物阻塞的手术探讨；侵犯下腔静脉的肝脏恶性肿瘤手术治疗；小肝癌的射频消融治疗；肝门部海绵状血管瘤的动脉栓塞治疗；活体肝移植治疗肝母细胞瘤；切缘冷冻对原发性肝癌切除术后局部复发的预防作用[编者按]     

肝、胆、胰、脾

射频消融治疗肝脏肿瘤的初步观察；裸鼠原位肝细胞癌多药耐药模型的建立；肝细胞癌患者肝移植术后甲胎蛋白的变化与肿瘤复发；肝脏良性实性占位病变误诊分析；肝细胞生长因子及其受体c-met在肝细胞癌中的表达与预后价值；肝癌组织、外周血细胞磷脂酰肌醇蛋白聚糖3 mRNA表达的意义；RNA干扰技术靶向SMYD3基因治疗肝癌的实验研究手助腹腔镜规则肝段切除治疗肝胆管结石病     

肝、胆、胰、脾

门静脉系统的影像学检查与病理结果的对比研究；完全腹腔镜巨脾联合贲门周围血管离断术治疗门静脉高压症；胃癌手术后梗阻性黄疸的外科治疗；联合断流术术式的改进及其疗效的评价；断流术中门静脉压力变化及术后再出血的临床研究.     

Growth, morphogenesis, and differentiation during mouse prostate development in situ, in renal grafts, and in vitro

BACKGROUND: In vitro organ culture and renal grafting of the urogenital sinus (UGS) have both been used as models of prostate development. However, neither has been rigorously examined for its fidelity to replicate the canonical process of prostate differentiation in situ. METHODS: We assessed size, morphology, histology, and the mRNA expression of differentiation marker genes of the E14 male mouse UGS grown for 0-28 days as sub-renal capsule allografts in nude mice or in culture containing androgen and compared these to UGS development in situ. RESULTS: Development of grafted tissues was morphologically and histologically similar to development in situ but differentiation occurred more rapidly. UGS growth in organ culture resulted in bud formation, but did not trigger cellular differentiation. However, the potential for differentiation was maintained and could be rescued by grafting tissues into nude mice. CONCLUSIONS: In vitro organ culture and renal grafting of UGS tissues may be appropriate models for studying prostatic bud formation, but only grafting is an appropriate model for prostatic differentiation.     

Functions,responsibilities, dedication,payment, organization,and profile of the hospital transplant coordination in Spain in 2002

In Spain, the number of donors per million of population and the activity of transplantation is a direct consequence of the continued work of the hospital transplant coordinators. There are 146 procurement hospitals with approximately 534 transplant coordinators (13.6 coordinators per hospital and 12.7 per million of population). A voluntary survey of 74 Spanish transplant coordinators revealed 67.6% to be men and 32.4% women of average age 43 years with specialization of 75.7%, Intensive Care Medicine; 8.1%, Anesthesiology; 6.7%, Nephrologists; and the rest, General Surgery or without any specialization. Among the group who responded to the injury, 86.5% were doctors and 13.5%, nurses. The overall team is composed of 52% doctors, 27.7% nurses and others with 70.3% working part-time and 27%, full-time. Previous experience was noted to be less than 5 years among 51.4%, and more in the rest of the cases. The 85% work under medical direction by management. Their payment includes salary plus activity in 48.7% of the cases; 21.6%, only salary, and 18.9%, only activity. Each coordinator generates between 3 and 7 organ as well as 3 and 11 of tissue donors. In conclusion, comparing this data with the practice in the United States demonstrates the unique aspects of the Spanish system.     

Mentoring in Surgery—Mentor,Parshuram, Dronacharya,Krishan

Success in any profession has no well-defined predictors. Knowledge, skills, training, and talent come in plenty but fail at times to achieve the universal goal of success. Some attribute it to luck. Apart from the tangible ingredients of a successful career, the intangibles like luck or something ill-defined is a real challenge. The intangibles seem like a chasm, an abyss, or a phantom obstacle. Presence of a guiding spirit who can handhold you to overcome these is essential for success. The aim of a professional is to learn, earn, and yearn for creativity. Practice of surgery is an ideal career to pursue the learning, earning, and yearning. More than any other profession, the guiding handholding spirit is required in surgical profession, the concept of mentoring. Originating from the Greco-Roman times when kind Odysseus left his son Telemachus under the care of his friend, mentor, it has become a universal defining necessity for a successful career in surgery. Indian history replete with such examples of mentorship, good as in the case of Dronacharya to Kaurvas but bad as denied by an able, competent, aspiring student like Eklavya. In the medical profession, there are very few Indian role models of mentorship. One name that comes to our mind is Dr. Krishan Mahajan. The more said is less revealed about him. “Knife before wife” was his commonly spoken advice to all who sought his mentorship. “Hard work is not easy but it is fair” so said a famous boxer, Larry Holmes. It is more than true for our profession as it is better to prepare and prevent, rather than repair and repent.     

Massive, solitary, intrahepatic, extramedullary hematopoietic tumor in thalassemia

Diffuse compensatory extramedullary hematopoiesis is well known to involve the spleen and liver in certain hematologic disorders. Hematopoietic tumor masses occasionally form and usually occur paraspinally in the posterior mediastinum. A 31-year-old patient with thalassemia is described with a massive, solitary, intrahepatic hematopoietic tumor and a smaller one in the posterior mediastinum. Review of the literature indicates that presentation as a large, focal liver lesion is unique. The implications and differential diagnosis are discussed.     

Distribution, elimination, and action of d-tubocurarine in neonates, infants, children, and adults

The relation of plasma concentration of d-tubocurarine (dTc) to neuromuscular blockade, and the distribution and urinary excretion of dTc was determined in neonates (n = 4), infants (n = 6), children (n = 8), and adults (n = 8). The plasma concentration-time course curves to 24 hr are best described for all groups by three-compartment models. Both neonates and infants exhibit decreased plasma clearance (CLP), 1.1 +/- 0.08 and 1.0 +/- 0.06 ml X kg-1 X min-1, and in addition a prolonged t1/2 terminal phase, 311 +/- 44 and 306 +/- 35 (mean +/- SEM, min). The neonates' 24-hr urinary excretion, 27 +/- 2 (mean +/- SEM, % total dose) is significantly less than the adult value, 45 +/- 4% total dose. There was no significant difference seen in the log plasma concentration-evoked compound electromyogram (ECEMG) response between 20-80% paralysis for adults, children, infants, and five of the seven neonates studied. Two of the neonates had a significant shift of their log concentration-response curve to the right. There was also no significant difference between any of the groups in the time for 50% return of ECEMG stimulus height or the time required for recovery of the ECEMG from 25 to 75% of control value. for recovery of the ECEMG from 25 to 75% of control value.     

Sodium, renin, aldosterone, catecholamines, and blood pressure in diabetes mellitus

Interrelations among plasma renin activity (PRA), aldosterone and cortisole levels, 0lood volume, exchangeable sodium, urinary catecholamines, and blood pressure were studied in 35 normal subjects and 60 age-matched non-azotemic patients with diabetes mellitus (60% with hypertension, 15% with orthostatic hypotension). Basal PRA, plasma aldosterone, cortisol, blood volume, plasma potassium, and urinary electrolytes were comparable in diabetic and normal subjects. Diabetic patients, however, had a 10% increase in body sodium (P less than 0.01), and 8% of them showed normal postural PRA responses and subnormal aldosterone responses; 22% had subnormal PRA and normal aldosterone responses, and 17% had subnormal responses of PRA and aldosterone. Non-PRA-related aldosterone responses could not be explained by ACTH or electrolytes. Orthostatic decreases in blood pressure correlated (P less than 0.01) with both catecholamine excretion and basal PRA. This suggests that in diabetes mellitus, body sodium is increased. Basal PRA and plasma aldosterone are usually normal, but their postural responses are frequently impaired. Absent aldosterone responses, despite normal PRA responsiveness, may reflect an adrenal abnormality or an ineffective form of renin. Marked postural aldosterone stimulation, unrelated to PRA, ACTH, or electrolytes, points to a potent unknown factor in aldosterone control. Low levels of free peripheral catecholamines and PRA may be complementary factors contributing to postural hypotension.