Burden of injuries and diseases in Yunnan Tin Miners

The burden of injuries is underestimated to an even greater extent in developing countries than in industrialized countries. The objective of this paper is to analyze injuries and diseases in the monitored work place of the world's largest tin mining operation in Yunnan, South China.     

Cyclosporin for the treatment of severe inflammatory bowel disease

A pilot study was performed to assess the role of cyclosporin in the management of severe inflammatory bowel disease. Twelve patients with Crohn's disease and 12 with ulcerative colitis were admitted to hospital with a severe attack. They were treated with an intravenous regimen of corticosteroids for 5 days followed by oral therapy. In addition, they received a 6-week course of oral cyclosporin, initially 15 mg kg-1 day-1 reduced to 7.5 mg kg-1 day-1. In comparison with historical controls, the addition of cyclosporin to standard corticosteroid therapy appeared to have no benefit. Adverse effects were common but minor. The expression of Class II molecules on the inflamed epithelium was rapidly reversed by cyclosporin therapy which may indicate a potential therapeutic benefit over longer periods of time.     

Paramagnetic macrocyclic complexes as contrast agents for MR imaging: proton nuclear relaxation rate enhancement in aqueous solution and in rat tissues

Paramagnetic macrocyclic chelates show promise as magnetic resonance (MR) imaging contrast agents due to stability and relaxivity comparable to those of DTPA-type chelates. For the three copper and manganese macrocyclic complexes studied in aqueous solution, T1 and T2 relaxivities ranged from 0.14 to 5.88 mM-1sec-1 at 6.25 MHz. In rats, the intravenous administration of 16 mumol/kg of Mn(cyclam) caused the liver T1 relaxation rate to double at 15 minutes after injection. T1 measurements by pulsed MR imaging and manganese analyses on excised tissue showed that both relaxation rate (1/T1) and manganese content of liver and kidney increase linearly with the dosage of Mn(cyclam). The linear relationship between 1/T1 and manganese content can be considered an "in tissue" relaxivity plot for the agent. The resulting relaxivity is 54 mM-1sec-1 in liver, compared with 3.1 mM-1sec-1 in aqueous solution. Although this work is preliminary, the implication for medical MR imaging applications is that macrocyclic contrast agents can be effective at approximately one-tenth the current typical dose used for gadolinium DTPA.     

The superior laryngeal nerve loop and its surgical implications

Summary Based upon findings from 60 cadavers (120 sides), the incidence of superior laryngeal nerve loop, connecting the cervical sympathetic chain and the superior laryngeal nerve and its branches, the external and internal laryngeal nerve, was 98.3% (118 out of 120 sides). In most cases the loop connected the sympathetic chain and the external laryngeal nerve. The external laryngeal nerve was looped, and not linear as traditionally thought. The loop could be divided into three categories, V-shaped, U-shaped and mixed, and subdivided into 5 types and 17 subtypes according to morphological variation. The loop without exception innervated not only the cricothyroid muscle, but also the thyroid gland. The loop is one of the origins of the thyroid nerve. It seems that for thyroid surgery the loop, when lower in position, should be carefully separated from the superior thyroid vessels before the latter are ligated, in order to preserve a normal nerve supply to the muscle as well as to the part of the gland that remains after surgery.

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L'anse du nerf larynge supérieur, étude anatomique et applications chirurgicales

Résumé La fréquence d'une anse du nerf laryngé supérieur réalisant une anastomose entre la chaine sympathique cervicale et le nerf laryngé supérieur et/ou ses branches (rameau laryngé externe et ingerne), est de 98,3 % (118/120). Ce résultat s'appuie sur l'étude de 60 cadavres. Dans la plupart des cas, l'anastomose se fait entre la chaine sympathique cervicale et le rameau laryngé externe. Ce rameau laryngé externe a un trajet curviligne et non linéaire conformément aux données classiques. Il existe trois catégories d'anses : en "V", en "U" et mixte ; on peut également les subdiviser en 5 types et 17 sous-types en fonction des variations morphologiques. Cette anse innerve constamment non seulement le muscle cricothyroïdien mais aussi la glande thyroïde dont elle fournit une partie de l'innervation. Lors de la chirurgie thyroïdienne, si l'anse est en position basse, les nerfs doivent être soigneusement disséqués et séparés des vaisseaux thyroïdiens supérieurs avant ligature de ces derniers de façon à conserver l'innervation normale du muscle et de la partie restante de la glande.

     

消痔灵和强的松龙混合液治疗鼻息肉

0　引言　我科 1996 / 1998分别应用消痔灵与强的松龙混合液、消痔灵液、强的松龙液行鼻息肉内 ,鼻息肉蒂部注射治疗鼻息肉各 5 0例 ,并设对照组为鼻腔滴入及口服类固醇激素 5 0例 ,合计 2 0 0例 ,观察并对比其疗效 .1　对象和方法1.1　对象　男 12 8例 ,女 72例 ,年龄 8～ 78(平均 38)岁 ,病程 32 a～ 45 (平均 4.5 ) a.其中在本次治疗前做过一次鼻息肉摘除术后复发的 2 7例 ,做过 2次或 2次以上手术的 12例 .主要症状为鼻塞、流脓涕、头痛及嗅觉减退 .全部病例治疗前均行鼻窦 X线拍片 ,其中上颌窦炎 12 5例、筛窦炎 5 8例、蝶窦炎 2例、…     

EFFECTS OF VARYING INSPIRATORY FLOW WAVEFORM AND TIME IN INTERMITTENT POSITIVE PRESSURE VENTILATION II: VARIOUS PHYSIOLOGICAL VARIABLES

In artificial ventilation with alteration in inspiratory flowwaveforms and time, there were statistically significant differencesin a number of physiological variables. Tidal volume and respiratoryfrequency were kept constant and inspiratory time and waveformboth varied independently. With shortening of inspiratory timephysiological deadspace to tidal volume ratio (VD/VT) increased,total dynamic and lung compliance decreased, Pa_O2, decreased,Pa_CO2 increased and mean airway and oesophageal pressures decreased.There was no change in alveolar to arterial P_O2 difference (PA_O2–Pa_O2),in cardiac output, or in chest wall compliance. The most favourableflow waveform for most variables was the reversed ramp waveformwhich resulted in decreased VD/VT and Pa_CO2, and increased Pa_O2,and total dynamic and lung compliance, when compared with theramp waveform. The effects of sine and top-hat waveforms couldnot be separated statistically but were significantly differentfrom ramp and reversed ramp waveforms, having effects betweenthese two. The reversed ramp waveform produced the greatestmean airway and oesophageal pressures, and the ramp waveformthe least. No differences were found for chest wall complianceand (PA_O2–Pa_O2) and the cardiac output changes were equivocal(but with the suggestion of waveform effects with ramp waveformallowing the best output and reversed ramp and top-hat waveformsthe poorest). Pulmonary venous admixture increased with shorteningof inspiratory time, and ramp flow waveform, and decreased withthe reversed ramp flow waveform. ^*Present addresses:Department of Anaesthesia, University ofOtago, New Zealand. Present addresses: St Vincent's Hospital, Melbourne, Australia.