Bile duct stones: percutaneous transhepatic removal

Percutaneous transhepatic intervention for transduodenal removal of biliary stones was performed 38 times in 34 patients with obstructive jaundice, biliary colic, and cholangitis. The technique entailed the percutaneous transhepatic placement of a modified Dormia basket in the common duct with the flexible tip in the duodenum. The stones were passed into the duodenum and were crushed, or were crushed in the common duct and passed as fragments into the duodenum. In addition to the snare procedure, monooctanoin was used 18 times to dissolve remaining fragments of stone and sludge that could not be snared and passed into the duodenum. The average time for completion of the procedure was 10 days. There were no deaths from the procedure. The complication rate was 21%--probably no greater than would occur with surgery in a similar patient population. The procedure can be performed when endoscopic retrograde cholangiopancreatography and sphincterotomy with stone removal is technically impossible or refused, and in patients who have previously undergone choledochojejunostomy.     

Movement disorders as sequelae of central pontine myelinolysis: report of three cases.

In three survivors of central pontine myelinolysis, dystonia (in two patients) and rest tremor (in one) were sequelae. The onset of these movements occurred 3 weeks to 5 months after the initial presentation with central pontine myelinolysis. Magnetic resonance imaging revealed basal ganglia lesions suggestive of extra-pontine myelinolysis in all three patients. We propose that the movement disorders seen in our cases are clinical correlates of extra-pontine myelinolysis.     

Growth in children with steroid sensitive nephrotic syndrome

Background: Nephrotic syndrome in children usually has an onset between 2–8 years of age and steroids form the mainstay of management. Therapy may affect growth in children with relapsing nephrotic syndrome. This study was carried out to correlate growth with the cumulative dose of steroids in children with steroid sensitive nephrotic syndrome (SSNS).     

Annular subvalvular left ventricular aneurysm in a North American infant

A case of suspected annular submitral left ventricular aneurysm in a 6-month-old Negro infant is reported and the pertinent literature reviewed. The occurrence of this abnormality in an individual of this age as well as race indicates a developmental origin of the disease entity.     

Outpatient lumbar myelography. Initial results in 79 examinations using a low-dose metrizamide technique

Seventy-nine patients underwent lumbar myelography on an outpatient basis, with a low (3.75 g) dose of metrizamide as the radiocontrast agent and a 25-gauge spinal needle used for lumbar puncture. No patient experienced significant neurotoxicity following the examination; 70.8% (56 of 79) experienced minimal (23%) or no (48%) side effects. Three patients (3.8%) were admitted to the hospital for management of common side effects (headache, nausea/vomiting, back pain). We obtained postmyelographic computed tomographic scans on 96% (76 of 79) of the patients. Our initial results suggest that outpatient lumbar myelography is safe and can be performed with a very acceptable incidence of side effects.     

苯甲吗啉类药物的代谢及代谢产物的研究

本文报道苯甲吗啉类药物的气相色谱与气质联用检测方法。用HP-5890A气相色谱仪、氮专属性检测器,对服药后不同时间排尿中原型药及主要代谢产物,以内标法定量测定,绘制尿累积排泄曲线.醚提取物用三氟醋酐衍生化、气相色谱、气质联用分析比较衍生化前后保留时间及质谱数据,鉴定主要代谢产物苯甲吗啉,微量代谢产物去甲麻黄素、去甲伪麻黄素、麻黄素和伪麻黄素,方法灵敏、结果可靠,适用于此类药物的临床监测与运动员尿样检测。