Aneurysmal cyst of the petrosal bone

An aneurysmal cyst of the petrosal bone presenting as hearing loss and recurrent bacterial meningitis is reported. None of the clinical or radiographic signs described previously were present. Because other diagnostic methods are not reliable, it is recommended that coronal thin section computed tomography be performed in every case of suspected malformation of the skull base and in the diagnosis of recurrent bacterial meningitis.     

酶联免疫双抗夹心法测定Ⅳ型胶原蛋白

建立血清Ⅳ型胶原蛋白(COL Ⅳ)浓度测定的酶联免疫吸附分析法(ELISA),用以辅助诊断肝硬化。应用此法观察了30例正常人和50例肝纤维化患者,结果显示COL Ⅳ浓度在20μg/L～600μg/L之间时,工作曲线最佳,最低检出限为20μg/L,批内变异系数(CV)6.098％,批间CV4.30％,高、低浓度回收率分别为95％和98％;正常人血清COL Ⅳ平均为86.7μg/L,肝纤维化患者平均水平为260.5μg/L,可见辅助诊断肝纤维化具有较高特异性和灵敏度。     

围手术期病人蛋白质能量实际供给量的研究

对90例外科围手术期病人蛋白质、能量摄入量进行研究。结果表明围手术期病人每天蛋白质实际摄入量为31.96(±22.21)g,能量为4537 KJ,远低于病人最低需要量;围手术期体格检查及生化指标显示均有不同程度的营养不良,这必然影响身体的恢复。     

桥小脑角脑神经病变显微手术510例病因分析

目的 总结桥小脑角脑神经病变510例显微手术的经验，并对病因进行分析。方法 经乙状窦后入路进入桥小脑角，在手术显微镜下对有关神经构成压迫和各种病灶分别给予相应的减压等处理。结果 桥小脑角脑神经病变510例全部治愈。术中发现因责任血管压迫者466例，占91．37％；肿瘤15例，占2．94％；蛛网膜粘连者29例，占5．69％。结论 桥小脑角脑神经病变510例，致病因素以责任血管压迫为主，部分为肿瘤压迫，而蛛网膜粘连致病者亦占相当比例；蛛网膜粘连是引起舌咽神经痛的重要因素。     

Planning for the future: the experience of implementing a children's day assessment unit in a district general hospital

A paediatric day assessment unit was opened in May 1995. An audit of the first year's activity showed that, despite an increase in emergency admissions of 8.4%, the number of children admitted as an emergency overnight was reduced by 3% in paediatrics and 7.2% in surgery. In the first year, 1731 children were assessed as an emergency of whom 658 did not require admission to the inpatient ward. Midnight occupancy fell 17.7% in paediatrics and 25.4% in surgery. The nurse staffing costs fell over Pounds 32,000 in the first year. No adverse events occurred during the first year of operation; this type of facility could lead to a more efficient use of resources in any children's unit.     

梗阻性黄疸血流动力学变化的研究及其影响因素分析

对４１例梗阻性黄疸和４１例单纯胆囊结石血流动力学变化及其影响进行观察。结果表明Ａ组ＴＢ、ＢＴＰ显著增加，ＰＶＤ、ＰＶＰ显著高于Ｂ组，而ＳＶＲ、ＭＡＰ、ＰＶＢＦ显著低于Ｂ组。相关分析显著Ａ组ＴＢ与ＢＴＰ、ＰＶＰ、ＰＶＤ呈显著正相关，ＴＢ、ＰＶＤ、ＰＶＰ、ＢＴＰ与ＰＶＢＦ呈显著负相关。逐步回归分析表明ＴＢ、ＢＴＰ是影响ＳＶＲ、ＭＡＰ的主要指标，而ＳＶＲ、ＭＡＰ下降是影响ＰＶＢＦ的关键因素。     

Milzbestrahlung und immunologische Antwort peripherer Lymphozyten von chronisch-lymphatischen Leukämien

Zusammenfassung Es wurde die immunologische Antwort von Lymphozyten aus dem peripheren Blut auf Phytohämagglutinin in Gewebekulturen bei chronischlymphatischer Leukämie vor und nach einer Milzbestrahlung untersucht. Vor der Bestrahlung trat, wie gewöhnlich bei einer chronisch lymphatischen Leukämie ein sehr geringer Prozentsatz an Blasten auf. Nach der Milzbestrahlung konnten aber wesentlich höhere Prozentsätze von Blasten-ähnlichen Zellen festgestellt werden.

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Summary Before and after irradiation of spleen immunological response of peripheral leukemic lymphocytes to phythemagglutine was studied in vitro. Before irradiation a low percentage of blast appeared. After irradiation of spleen in chronic lymphatic leukemia the percentage of blast-like cells was significantly higher.

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Vortrag auf dem 11. Kongreß der Deutschen Gesellschaft für Hämatologie, Innsbruck/Österreich.

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Diese Untersuchungen wurden mit Unterstützung von A. Nattermann, Köln-Braunsfeld, Deutschland, durchgeführt.     

Supine versus upright anterior images: comparison in T1-201 myocardial scintigraphy

In patients undergoing exercise thallium-201 myocardial scintigraphy, activity in the inferior wall on anterior images may appear diminished when the standard supine view is used, but normal when the view is acquired with the patient upright. To determine the clinical significance of this observation, the distribution of thallium-201 activity was semiquantitatively assessed in supine and upright anterior images obtained immediately after exercise in 93 patients (65 men, 28 women). The presence of inferior wall and coronary artery disease was established with coronary angiography or from documentation of previous myocardial infarction. Supine and upright images were compared with use of receiver operating characteristic curves. In male patients diagnostic accuracy for identification of both inferior wall and coronary artery disease was improved through the use of the upright anterior image. In women, there was no significant difference in reader performance with upright and supine images. Upright anterior images should be routinely obtained in men in order to reduce the frequency of false-positive identification of inferior wall defects.     

Treatment of blunt hepatic injuries: role of CT

Serial dynamic upper abdominal computed tomography (CT) studies were performed on 20 patients as part of the conservative treatment of blunt hepatic injuries (hematoma, laceration, or fracture). Fourteen of these patients had either major or minor associated hemoperitoneum. In 13 patients, hemoperitoneum was either significantly reduced or absent by 1 week. A severe delayed hemorrhage occurred in one patient 7 1/2 days after admission; a large and unchanged volume of intraperitoneal fluid had been seen on a preceding abdominal CT scan. One other patient who had a satisfactory response underwent surgery for a pancreatic laceration. Serial abdominal CT studies are an integral part of the conservative treatment of blunt hepatic injuries and seem to be useful in monitoring resorption of hemoperitoneum and the pattern of healing of intrahepatic hematomas, lacerations, and fractures.