Use of computer-assisted monitoring of twin pregnancy: a case report

The authors present the use of computer-aided monitoring of pregnancy in case of twins. The computer program predicts date of delivery, birth weight and fetal maturity for single fetus pregnancy, however this values are in twins overstated. A valuable short time prediction are actual weight and biological age of each twin.     

Health outcomes in offspring of mothers with breast implants

OBJECTIVE: To examine the occurrence of esophageal disorders, connective tissue diseases, and congenital malformations in children of mothers with breast implants. METHODS: Nationwide register-based follow-up study of all offspring born during 1977 to 1992 to a cohort of 1135 women with breast implants for cosmetic reasons and to a comparison cohort of 7071 women who underwent breast reduction surgery. Cause-specific hospi-talization rates among offspring, relative to those of the general population, were calculated from the Danish National Registry of Patients. RESULTS: Among the 939 children of mothers with breast implants, higher rates of esophageal disorders were observed, but the excess was similar for those born before versus after the implant surgery. Higher than expected hospitalization rates for these conditions were also observed among 3906 children of women who underwent breast reduction surgery. No significant increases in connective tissue diseases or congenital malformations were observed in either the breast implant or breast reduction cohorts. CONCLUSIONS: This first epidemiologic cohort study provides no evidence that silicone breast implants affect risks of esophageal or other disorders in children of the implantees. Rather, the observed risk pattern suggests that a lower threshold exists among both groups of women who have undergone cosmetic breast surgery in seeking professional medical care for problems normally solved outside the hospital.     

Pediatric pneumococcal bone and joint infections. The Pediatric Multicenter Pneumococcal Surveillance Study Group (PMPSSG)

OBJECTIVE: To describe the clinical and microbiological characteristics of infants and children with bone and joint infections caused by penicillin-susceptible and penicillin-nonsusceptible strains of Streptococcus pneumoniae. DESIGN: Multicenter, prospective patient accrual; retrospective chart review of identified patients. SETTING: Eight children's hospitals in the United States. PARTICIPANTS: Forty-two children with bone and/or joint infections prospectively enrolled in the United States Pediatric Multicenter Pneumococcal Surveillance Study from September 1, 1993 to August 31, 1996. OUTCOME MEASURES: Data were collected on multiple variables, including age, gender, race, days of symptoms before and during hospitalization, antibiotic and surgical therapy, laboratory and imaging studies. RESULTS: Of the 42 children enrolled (21 bone, 21 joint infections), 14 had isolates that were not susceptible to penicillin. Eight of 16 (50%) strains isolated from children who received antibiotics within 4 weeks before hospitalization were not susceptible to penicillin, compared with 4 of 15 (27%) strains isolated from children without previous antibiotic exposure. Clinical response to therapy was similar between children infected by penicillin-susceptible strains compared with those infected by penicillin-nonsusceptible strains, including duration of hospitalization (9.1 days vs 11.2 days), days of intravenous antibiotic therapy (25.3 days vs 24.6 days), days of fever (3.6 days vs 3.1 days), and sequelae (14% vs 7%). The most commonly prescribed single agents for parenteral therapy in definitive treatment were ceftriaxone (36%), penicillin (15%), and clindamycin (15%). Oral therapy followed parenteral therapy in 56% of children. The mean (+/- standard deviation) duration of total antibiotic therapy in children with osteomyelitis was 57.5 +/- 48.6 days (range, 23-196 days) and 29.2 +/- 11.8 days (range, 12-67 days) for arthritis. Late sequelae (long-term destructive changes of the bone or joint) were documented in 5 (12%) children, 4 with osteomyelitis, and 1 with arthritis. Sequelae occurred in 30% of children with long bone osteomyelitis associated with infection in the adjacent joint. The age of children with sequelae was younger than those without sequelae (6.4 months vs 18.6 months). CONCLUSIONS: The demographic characteristics and anatomic sites of infection in our patients were similar to previously published series collected from single institutions before the emergence of significant antibiotic resistance in S pneumoniae. Our analysis suggests that children infected by penicillin-nonsusceptible strains have a similar clinical response to therapy when compared with children infected by penicillin-susceptible strains.     

Initial qualitative evaluation of computed radiography in an intensive care unit

The first computed radiography (CR) unit in Australia was installed at St Vincent's Hospital, Melbourne, in February 1994. An initial qualitative evaluation of the attitude of the intensive care unit (ICU) physicians to the CR unit was conducted in June 1994 by use of a survey. The results of the survey of ICU physicians indicated that images were available faster than under the previous system and that the use of the CR system was preferred to evaluate chest tubes and line placements. While it is recognized that a further detailed radiological evaluation of the CR system is required to establish the diagnostic performance of CR compared with conventional film, some comments on the implementation of the system and ICU physician attitudes to the CR system are put forward for consideration by other hospitals examining the possible use of CR systems.     

Surface geometry of four nanofiller and one hybrid composite after one-step and multiple-step polishing

This study assessed the surface quality of four nanoparticle composites and one hybrid composite after polishing with three different techniques. Nanocomposites Premise (KerrHawe), Tetric EvoCeram (Ivoclar Vivadent), Filtek Supreme (3M ESPE) and Ceram X Duo (Dentsply) and the hybrid composite Herculite XRV (KerrHawe) were selected. Sixty specimens 7x7 mm each were fabricated from these materials. After light curing, the specimens were treated with 600 grit sandpaper discs. Fifteen specimens of each composite were polished using flexible Sof-Lex discs (3M ESPE). The remaining 45 specimens of each material were prepared with three finishing protocols: a single 30 microm diamond (n=15), a sequence of a 30 microm and a 20 microm diamond (n=15) and a 30 microm diamond followed by a tungsten carbide finishing bur (n=15). Each series of 15 specimens was then subdivided into three groups of five and polished with the Astropol system (Ivoclar Vivadent), OptiShine brushes (KerrHawe) and the Enhance/PoGo system (Dentsply). Quantitative evaluation of surface roughness was done with the help of optical laser stylus profilometry. Average roughness (Ra) was calculated, and the effect of the materials, the finishing regimen and the polishing methods on surface roughness were analyzed by three-way and two-way Anova and Scheffé post-hoc tests. Qualitative evaluation of the surfaces was done with the help of scanning electron microscopy (PSEM 500, Phlipps). Photomicrographs were assessed with respect to surface quality in four gradings. Surface roughness after polishing was significantly influenced by three factors: composite material (p < 0.001), finishing protocol (p < 0.001) and polishing method (p < 0.001). There were strong interactions between the finishing and polishing methods (p < 0.001). Two of the nanocomposites were significantly smoother (p < or = 0.001), while the other two had a surface quality similar to that of a hybrid composite. Astropol achieved the lowest average roughness on all composites. Except for a combination of a 30 microm diamond and OptiShine brushes, which caused severe roughness, all the polishing methods produced surfaces that were significantly smoother than using the Sof-Lex discs.     

沉香螺环化合物的研究:10-甲基-螺[4.5]-癸-6-烯-6-羧酸的合成

3-甲基△~2环已烯-1-酮(4)与1,4-二溴丁烷在氨钠,液氨中或在叔丁醇钾的苯溶液中进行螺环化反应,得到螺环化合物5a 5b以及双螺环化合物6a 6b。经定量催化氢化;羰基与三甲基硅氰加成反应;硅醚水解;脱水和腈基水解,合成了10-甲基-螺[4.5]-癸-6-烯-6-羧酸(11)。药理试验表明该化合物有一定的麻醉催眠作用。     

刺楸根皮中皂甙的化学成分研究

从刺楸Kalopanox septemlobus(Thunb.)Koidz.根皮中,分离到两个皂甙单体。经光谱(IR,NMR,FAB-MS)分析和化学方法鉴定为刺楸皂甙A(kalopanax saponin A,Ⅰ)和一新的三萜皂甙,结构为3-O-(a-L-吡喃鼠李糖(1→2)-α-L-吡喃阿拉伯糖)-常春藤皂甙元-28-O-[α-L-吡喃鼠李糖(1→2)-β-D-吡喃葡萄糖(1→6)-β-D-葡萄糖]酯甙,命名为刺楸皂甙C(kalopanax saponin C,Ⅱ)。     

Effects of REM sleep deprivation on central alpha 1- and beta-adrenoceptors in rat brain

In the present experiment the effects of 'rapid-eye-movement' sleep deprivation (REMd) on cortical alpha 1- and beta-adrenoceptor binding sites in the rat brain were investigated. REMd was induced for 72 hr in two different ways: by the platform and the pendulum technique. In addition, three control groups were run. Determination of alpha 1- and beta-adrenoceptor sites in the cortex was done by 3H-prazosin and 3H-dihydroalprenolol binding studies, respectively. Both REM sleep deprived groups showed a small but significant decrease in the number of beta-adrenoceptor sites along with a small increase in affinity. On the other hand, alpha 1-adrenoceptor binding and affinity were not changed. These results agree with the effects of tricyclic antidepressant drug treatment. Common effects of REMd and tricyclic drugs are discussed in terms of modulation of tonic arousal processes.     

高效液相色谱法同时测定苯巴比妥、苯妥英钠和卡马西平血药浓度

目的：建立同时测定血清中苯巴比妥,苯妥英钠和卡马西平的浓度的高效液相色谱（ＨＰＬＣ）,方法：血清乙酸乙酯提取浓集后进样,采用Ｃ１８柱,以甲醇－水（５０：５０）为流动相,苯乙酮为内标物,在波长２１０ｎｍ处测定。     

Epidermal growth factor in human cerebrospinal fluid: reduced levels in amyotrophic lateral sclerosis

Summary Epidermal growth factor (EGF), a mitogenic peptide, is widely distributed within the brain and endocrine cells of the gastro-intestinal tract. Using EGF radioreceptor assay, the EGF level was measured in lumbar cerebrospinal fluid from five patients with amyotrophic lateral scerlosis (ALS) and seven patients with intervertebral disc disease as a control group. The patients with ALS showed reduced EGF levels to 662.4±207 pg/ml as compared with controls 1013±182.8 pg/ml (P<0.02). These results indicate a possible EGF involvement in the pathogenesis of ALS.This work is partially supported by M.Z. V/31