Gastrointestinal stromal tumor in ileal neobladder

Abstract  Gastrointestinal stromal tumor (GIST) is a recently described mesenchymal tumor that can develop in any portion of the gastrointestinal tract. The occurrence of a GIST in the urinary tract is rare, but GIST can present as tumor of the urinary tract or invade the urinary tract. This is the first reported case of GIST in the ileal neobladder, which presented as a submucosal tumor. The patient underwent an open exploration and partial resection of the neobladder pouch.     

Studies on the In-vitro Percutaneous Penetration of Indomethacin from Gel Systems in Hairless Mice

The influence of co-solvents on the in-vitro percutaneous penetration of indomethacin from gel systems was studied using a simplex lattice experimental design. Gel formulations were prepared by gelling the vehicle mixture of water, either alcohol or isopropanol and either propylene glycol or PEG 400 with 1% w/w Carbomer 940. Hairless mouse skin was employed as the barrier in a Franz-type diffusion cell. The penetration rates at steady state for seven formulations were fitted to a polynomial equation based on this simple lattice method and a three-dimensional plot was constructed. The formulation having the maximal penetration rate was determined to be the vehicle with a solvent ratio of water: alcohol: propylene glycol equal to 15:33:52, and which possessed a solubility parameter of 15 and a drug solubility of around 10 mg mL^?1. When the solubility parameter of the vehicle was > 15, the drug solubility increased. However, the penetration rate decreased with an increasing solubility parameter. For those vehicles with a solubility parameter < 15, both the drug solubility and the penetration rate decreased with a decrease in the solubility parameter. There was shown to be an approximately 20-fold increase in the relative enhancement factor when using both alcohol and isopropanol, but only a threefold increase for both propylene glycol and PEG 400, when compared with water.     

Serogroup B meningococcal disease in the Norwegian armed forces: What can we learn from an inconclusive vaccine protection trial?

Military recruits serving in the armed forces were severelyaffected during the latest serogroup B meningococcal epidemicin Norway. The risk of developing systemic meningococcal disease(SMD) proved highest during the first 12 weeks of service. Adouble-blind, placebo-controlled protection trial with a meningococcalouter membrane vesicle vaccine took place between 1988 and 1991,but the number of proven SMD cases was too low to allow forany conclusions. However, the results of a parallel efficacystudy of the same vaccine among students in secondary school,cross-society examinations for asymptomatic throat carriageof meningococci and recent immunogenicity studies after two-and three-dose vaccination schedules, suggest that a basic immunizationof young teenagers followed by a booster injection at enrolmentwould contribute significantly to preventing SMD in the armedforces.     

The interleukin-5 messenger RNA expression in a patient with idiopathic hypereosinophilic syndrome

Interleukin-5 has a specific role in various eosinophilic activities. It is the predominant cytokine produces by activated T-lymphocytes isolated from patients with idiopathic hypereosinophilic syndrome. We studied a young patient suffering from idiopathic hypereosinophilic syndrome who presented with Horner's syndrome, peripheral neuropathy and skin ulcers. The IL-5 gene expression by CD4⁺ T-lymphocytes and the peripheral eosinophil count were raised. The skin ulcers continued to deteriorate despite a swift reduction of the IL-5 gene expression and peripheral eosinophil count following systemic corticosteroid treatment. We suggest that peripheral eosinophilia may not be responsible for the damage in skin lesions and more aggressive treatment may be required.     

Risk of insomnia and hypnotics use among emergency physicians

This study investigated the risk of insomnia and hypnotics use among emergency physicians. This cross-sectional study recruited physicians working in Taiwanese hospitals in 2015 and the general population as the participants. Data from 1,097 emergency physicians obtained from the National Health Insurance Research Database were grouped into the case group, whereas 14,112 nonemergency physicians and 4,388 people from the general population were categorized into the control groups. This study used logistic regression and conditional logistic regression to compare the risks of insomnia between emergency and nonemergency physicians and between emergency physicians and the general population, respectively. The prevalence of insomnia among emergency physicians, nonemergency physicians and general population was 5.56%, 4.08%, and 1.73%, respectively. Compared with nonemergency physicians and the general population, emergency physicians had a significantly higher risk of insomnia. The proportions of emergency physicians, nonemergency physicians, and general population using hypnotics were 19.96%, 18.24%, and 13.26%, respectively. Among emergency physicians who used hypnotics, 49.77%, 25.57%, and 24.66% used only benzodiazepines, only nonbenzodiazepines, and both benzodiazepines and nonbenzodiazepines, respectively. Nonpharmacological interventions to improve insomnia and reminder of safe use of hypnotics to emergency physicians can serve as references for hospitals in developing health-promoting activities.     

SALMONELLA BACTERAEMIA OCCURRING CONCURRENTLY WITH THE FIRST PRESENTATION OF SYSTEMIC LUPUS ERYTHEMATOSUS

There is increasing recognition of the association between Salmonellainfections and systemic lupus erythematosus (SLE). However,these infections have usually occurred in patients with establishedSLE who were receiving immunosuppressive therapy. We describetwo young women with previously undiagnosed SLE who developedSalmonella bacteraemia. Neither of these patients had receivedimmunosuppressive drugs. From these and two previously reportedpatients, it may be concluded that SLE per se is likely to beassociated with a defect in host defences to Salmonella bacteria. KEY WORDS: SLE, Non-typhoid Salmonella, Septicaemia     

Proteus syndrome

Abstract: This female Asian (Malay) baby had clinical features of Proteus syndrome. She had a large right facial lipolymphangioma with hyperpigmentation of the overlying skin. There was a smaller lymphangioma over the left side of her neck with excess nuchal folds, macrodactyly and bilateral talipes equinovarus. Despite the extensive hemifacial swelling, there was no evidence of upper respiratory tract obstruction. Generalized seizures developed on the sixth day of life which were controlled with phenobarbital. The lymphangiomas were excised without recurrence.     

早期清创缝合后不使用抗生素的临床分析

目的研究早期清创缝合后不预防性地使用抗生素对创口的影响。方法我科自2004年1月至2005年6月有选择性地对50例皮肤软组织挫裂伤进行了急诊清创缝合,术后未给予抗生素,并连续观察伤口的变化。结果本组所有伤口均未发生感染。结论早期清创及规范的清创缝合术后可以不必预防性地使用抗生素。