Surgical emphysema: an unusual complication of punch biopsy

Punch biopsies are frequently used in the diagnosis of oral disease and are associated with few complications. We report a case of surgical emphysema following this procedure.     

支气管动脉栓塞术后并发症的预防及护理

0　引言　大咯血原因很多 .炎症、支气管扩张、肺癌、肺结核、肺动静脉瘘等 .但因支气管动脉畸形引起的大咯血尚未见专题报道 .现将我院 1992年 10月份以来行数字减影血管造影 (DSA )检查 ,确诊支气管动脉畸形行支气管动脉栓塞(BAE)治疗大咯血术后并发症的预防与护理报道如下 :1　临床资料　 6 (男 5 ,女 1)例大咯血患者 ,年龄 16～ 5 9岁 .均因无明显诱因 ,反复咯血而多次保守治疗 ,一次或 2 4h内咯血量为 40 0～ 10 0 0 m L ,病程最长 13a.入院后行 CT、纤维支气管镜、支气管碘油造影等栓查 ,均未见明显异常 ,后因保守治疗无效时行 D…     

Influence of Adrenergic Agonists and Antagonists on Urethral Pressure, Bladder Pressure and Detrusor Hyperactivity in Children with Myelodysplasia

ABSTRACT. In children with myelodysplasia and a low lumbar or sacral level of spinal cord lesions detrusor hyperactivity with pressure fluctuations is an almost constant phenomenon contributing to incontinence. In thirteen children with this type of dysfunction the effect of adrenergic agonists and antagonists on bladder and urethral pressures were studied by means of intravesical and urethral pressure recordings during the normal bladder-filling phase. Intravenous infusion of noradrenaline during the bladder-filling phase slightly reduced detrusor hyperactivity and the urethral pressure was increased. Following i.m. injection of the alpha-adrenergic antagonist pheatolamine both the intravesical and proximal urethral pressures were reduced to about the same extent and the detrusor hyperactivity decreased. It is concluded that noradrenaline mainly changed urethral pressure while alpha-adrenergic blockade caused decreased tone in both the detrusor and the urethra as well as decreased detrusor hyperactivity.     

Progressive idiopathic cholestasis presenting with profuse watery diarrhoea and recurrent infections (Byler''s disease)

The second child of healthy unrelated parents presented with chronic diarrhoea since the age of two months, initially associated with non-characteristic liver involvement. Recurrent infections, severe failure to thrive and various metabolic deficiencies complicated the further course, as well as profuse watery diarrhoea with elevated regulatory gut peptides, responding only to somatostatin analog treatment. At 22 months of age, intermittent cholestasis with permanently normal serum gamma-glutamyltransferase was evident. The child died of fulminant purulent meningitis at the age of three years six months. Liver histology showed intrahepatic cholestasis, bile duct paucity with focal proliferation as well as slight portal and intralobular fibrosis. The clinical, biochemical and histopathological findings were indicative of Byler's disease.     

Cardiovascular effects of carbon dioxide in ventilated preterm infants

Sick preterm infants may, under certain conditions, demonstrate blood pressure passive cerebral blood flow in response to changes in arterial carbon dioxide tension. Blood pressure in turn depends on cardiac output and peripheral resistance. A Doppler technique for assessing cardiac output compared favourably in terms of reproducibility to a thermodilution technique in a group of infants undergoing cardiac catheterization for congenital heart disease. Doppler was subsequently used to monitor changes in cardiac output following an increase in arterial carbon dioxide tension of 1 kPa in 25 ventilated preterm infants. Blood pressure increased significantly (p = 0.006). However, heart rate did not change significantly (p = 0.16) and, in addition, both stroke and minute volume decreased (p = 0.023, p = 0.02, respectively). This suggests that accompanying changes in components of peripheral resistance exert important effects on blood pressure in the preterm neonate in response to changes in arterial carbon dioxide tension.     

What 'outliers' tell us about missed opportunities for tuberculosis control: a cross-sectional study of patients in Mumbai,India

Background  

India's Revised National Tuberculosis Control Programme (RNTCP) is deemed highly successful in terms of detection and cure rates. However, some patients experience delays in accessing diagnosis and treatment. Patients falling between the 96^th and 100^th percentiles for these access indicators are often ignored as atypical 'outliers' when assessing programme performance. They may, however, provide clues to understanding why some patients never reach the programme. This paper examines the underlying vulnerabilities of patients with extreme values for delays in accessing the RNTCP in Mumbai city, India.     

Early amniocentesis for prenatal cytogenetic evaluation

Early amniocentesis at 11-14 weeks gestation was evaluated in 100 consecutive patients to see how this technique compares with later amniocentesis. There were no complications as a consequence of the procedure or related pregnancy losses of chromosomally normal fetuses. Samples obtained from three (3%) patients showed insufficient cell growth; two of these patients elected a repeat procedure, which yielded a normal karyotype in each case. There were five abnormal karyotypes, one of which was a culture artifact; in the latter case, repeat amniocentesis at 15 weeks yielded a normal result. Of the 95 pregnancies with normal karyotypes, 94 were progressing normally at follow-up, and one patient elected pregnancy termination because of maternal indications. It appears that early amniocentesis may be an attractive alternative to traditional amniocentesis, in that it provides results at an earlier gestational age and may avoid certain disadvantages of chorionic villus sampling.     

瞬时性受体电位通道香草酸受体5、6与骨代谢的关系

目的:探讨瞬时性受体电位通道香草酸受体5、6与骨代谢的关系。资料来源:应用计算机检索PubMed数据库1999-01/2006-07相关瞬时性受体电位通道方面的文献,检索词“TRPV”,限定文献语言种类为English。资料选择:对资料进行初审,选取包括瞬时性受体电位通道香草酸受体5、6的文献,开始查找全文。纳入标准:对两者及瞬时性受体电位通道家族进行研究的文章。排除标准:研究内容局限于瞬时性受体电位通道香草酸受体1～4的文章。资料提炼:共检索到106篇关于瞬时性受体电位通道香草酸受体的文献,最终纳入30篇符合标准的文献。资料综合:瞬时性受体电位通道香草酸受体5、6是瞬时性受体电位通道超家族中的成员,是专门的上皮样钙离子通道。目前研究已经证明它们在肠道和肾脏等组织中有表达,并对跨细胞钙离子转运起着关键性调控作用。但在骨组织中表达情况相关报道较少,在骨代谢机制上的研究更少,本文针对目前两者与骨代谢的关系进行综述。结论:深入研究瞬时性受体电位通道香草酸受体5、6钙离子通道在骨代谢中的作用,对于那些与骨代谢相关疾病的治疗将能从分子水平上找到解决的方法。