Primary venous mesenterial thrombosis in three patients

Three patients, a woman aged 72, a man aged 25 and a woman aged 42 years, presented at the casualty department with a subacute form of primary venous mesenterial thrombosis. As symptoms and laboratory findings are aspecific, CT scan is the gold standard for the diagnosis of this condition. In these patients no cause or predisposing factor was detected, so the disease was considered to be primary. Treatment generally consists of anticoagulant therapy and if peritonitis is present operation is indicated. Hyperdynamic circulation and inotropica are indicated after surgery and in cases of critical illness. Based on clinical findings the third patient was treated successfully with anticoagulants only. The other two also underwent partial small intestinal resection. All three patients were discharged in good health and were prescribed lifelong anticoagulants. If a cause of venous mesenterial thrombosis can be found, this must first be treated before deciding on whether lifelong treatment with anticoagulants is indicated.     

Treatment methods for discontinuation of long-term benzodiazepine use

Treatment strategies for discontinuing long-term benzodiazepine usage can be divided into minimal interventions and gradual discontinuation programs. Minimal interventions invite patients to quit their long-term benzodiazepine usage on their own by making them aware of the adverse effects. This type of intervention is successful in about one fifth of patients. Gradual discontinuation programs are more extensive interventions in order to help those patients who are unable to discontinue benzodiazepine use on their own. These programs are successful in two-thirds of the patients and can be combined with additional pharmacological or psychological treatment. Once the withdrawal symptoms have diminished, most patients have an improved psychological functioning compared to when they were using benzodiazepines. Furthermore, no increase in medical consumption has been found.     

The complexity of external acoustic detection of defects in Björk-Shiley convexoconcave heart valves

Abstract: Fractures in Björk‐Shiley convexoconcave (BScc) heart valves have raised questions about the feasibility of early diagnosis of technical defects by means of acoustic assessment. Three laboratory tests were conducted. To establish acoustic fingerprints, 66 valves with a defect, such as single‐leg fracture (SLF) or single‐leg separation (SLS), or without a defect were connected with a contact sensor and excited by dropping a small metal ball onto the outlet strut. In the second test, we simulated the valve sound propagation within the thorax. In the third test, intact, SLF, and SLS valves were placed in a mock heart immersed in a large water tank. We observed a resonance frequency corresponding with valve size and presence of defects. The second test showed that both the chest wall and the lungs created numerous reflections. This led to a substantial overlap of the original pulse frequencies and the frequencies measured. The third test confirmed that submersion of the chest in water can significantly reduce chest wall reflections. Reliable noninvasive assessment of BScc valve clicks for the presence of defects of the outlet strut is hampered by complex sound propagation within the thorax and variability of valve excitation. Acoustic fingerprints to diagnose mechanical defects should be integrated in valve design.     

空心胶囊中残留氯乙醇的测定方法改进

目的：改进空心胶囊中残留氯乙醇的测定方法。方法：利用大口径毛细管柱的“溶剂效应”技术,进行测定。结果;色谱图重现性佳,分离效果好。结论;对氯乙醇的测定中,采用大口径毛细管柱分离效果优于固定液为聚乙二醇－１５００的填充性。     

New antimalarial and cytotoxic sungucine derivatives from Strychnos icaja roots

Reinvestigation of Strychnos icaja Baillon resulted in the isolation of vomicine, isostrychnine and of three new sungucine derivatives, named isosungucine (8), 18-hydroxy-sungucine (9) and 18-hydroxy-isosungucine (10). They were identified by detailed spectroscopic methods. The complete 1H- and 13C-NMR study of sungucine was also realized. Some of these compounds were highly active against Plasmodium falciparum in vitro and more particularly against the chloroquine-resistant strain. Compound 10 showed a selective antiplasmodial activity, with > 100-fold greater toxicity towards Plasmodium falciparum, relative to cultured human cancer cells (KB and HeLa lines) or fibroblasts (WI38).     

Multidrug resistance protein 1 protects the choroid plexus epithelium and contributes to the blood-cerebrospinal fluid barrier

Multidrug resistance protein 1 (MRP1) is a transporter protein that helps to protect normal cells and tumor cells against the influx of certain xenobiotics. We previously showed that Mrp1 protects against cytotoxic drugs at the testis-blood barrier, the oral epithelium, and the kidney urinary collecting duct tubules. Here, we generated Mrp1/Mdr1a/Mdr1b triple-knockout (TKO) mice, and used them together with Mdr1a/Mdr1b double-knockout (DKO) mice to study the contribution of Mrp1 to the tissue distribution and pharmacokinetics of etoposide. We observed increased toxicity in the TKO mice, which accumulated etoposide in brown adipose tissue, colon, salivary gland, heart, and the female urogenital system. Immunohistochemical staining revealed the presence of Mrp1 in the oviduct, uterus, salivary gland, and choroid plexus (CP) epithelium. To explore the transport function of Mrp1 in the CP epithelium, we used TKO and DKO mice cannulated for cerebrospinal fluid (CSF). We show here that the lack of Mrp1 protein causes etoposide levels to increase about 10-fold in the CSF after intravenous administration of the drug. Our results indicate that Mrp1 helps to limit tissue distribution of certain drugs and contributes to the blood-CSF drug-permeability barrier.     

Emergence of Enterobacter aerogenes as a major antibiotic-resistant nosocomial pathogen in Belgian hospitals

Objective: To study the epidemiology of Enterobacter aerogenes infections in Belgian hospitals and determine whether recent trends show an increase in incidence of E. aerogenes infections and antimicrobial resistance.
Methods: Data from the bloodstream infection component of the National Surveillance of Hospital Infections (October 1992 to September 1996 data in 45 hospitals) and from a retrospective study on E. aerogenes clinical isolates (1994 and 1995 data in 41 hospitals) were analyzed.
Results: E. aerogenes was recovered from clinical specimens with a mean incidence of 4.6 isolates per 10 000 patient-days and caused 0.20 bloodstream infections per 10 000 patient-days during the surveyed periods, respectively. Both rates increased significantly throughout the years. The proportion of E aerogenes within the Enterobacter genus was 35.4% in clinical isolates and 41.2% in bloodstream infections. Both proportions significantly increased over time. Incidence was not statistically different by hospital size but showed major differences between geographic regions. Resistance rates to third-generation cephalosporins and fluoroquinolones increased, and imipenem resistance emerged in several hospitals.
Conclusions: This report provides evidence of an increase in E. aerogenes infections in Belgian hospitals and documents an increase in antimicrobial resistance of E. aerogenes strains. These figures provide a baseline for further surveillance data.     

How concordant are the estimated rates of natural conception and in-vitro fertilization/embryo transfer success?

Knowledge of the chance to conceive for the subfertile couple is important in the process of counselling and clinical decision making. There are no data available on the reproducibility of the clinician's ability to assess the chance to conceive, both after expectant management or treatment with in-vitro fertilization and embryo transfer (IVF-embryo transfer). We evaluated this reproducibility by means of a set of case histories presented to a panel of gynaecologists and endocrinologists. A poor reproducibility would indicate a strong need for the use of prognostic models. In 1995, 57 gynaecologists and 32 reproductive endocrinologists were asked to appraise the 1 year spontaneous conception chance as well as the cumulative success rate of three cycles for IVF-embryo transfer of four couples with different medical histories. The clinical and laboratory data of these couples were presented as case histories. The difference between the estimated spontaneous pregnancy chances and the success rate of IVF-embryo transfer was also calculated. Calculation of intra-class correlation coefficients, which can be considered as measures of the reproducibility, demonstrated a substantial reproducibility of the assessment of spontaneous conception chances, but a slight to fair reproducibility of the assessment of IVF-embryo transfer success rates. We conclude that the use of reliable prognostic models for IVF-embryo transfer in the management of subfertility is warranted.     

师范院校贫困新生与非贫困新生心理健康状况的比较

目的:比较师范院校贫困新生与非贫困新生的心理健康状况。方法:于2005-10在衡阳师范学院完成调查。采用整群抽样横断面调查方法,以衡阳师范学院2005级3089名新生为调查对象,运用症状自评量表对其进行集体测查。在统一指导语下,学生根据最近1周内的自我感觉答题,独立完成,当场收卷。结果数据运用光电阅读机(OMR2000)输入计算机心理测评工具箱标准版V3.0系统进行总分和因子分的统计。量表中没有回答的项目记为"没有",5个以上项目未答者视为问卷无效以及总分低于95分的问卷因缺乏可靠性均不进行分析。所有数据输入电脑后用SPSS11.0软件进行统计分析;群体差异比较用t和Z检验。结果:共发放3089份问卷,收回有效答卷2994份,有效率为96.92%,其中贫困新生有效答卷510份,占17.03%。问卷结果显示,师范院校贫困新生在人际关系、偏执和精神病性3项因子上的得分分别为1.86±0.54,1.70±0.48和1.58±0.43,明显高于非贫困新生(1.78±0.51,1.65±0.46,1.53±0.39,t=3.34,2.02,2.92,P<0.05)。从阳性因子的人数比率来看,师范院校贫困新生在总分阳性的人数比率为0.28,明显低于非贫困新生(0.33,Z=-2.27,P<0.05);而在人际关系、偏执和精神病性3项因子阳性的人数比率分别为0.35,0.30,0.16,明显高于非贫困新生(0.31,0.24,0.13,Z=1.73,2.72,1.71,P<0.05)。结论:师范院校贫困新生的整体心理健康状况并不比非贫困新生差,但是在人际关系敏感、偏执和精神病性3个问题上明显比非贫困新生要严重。