多层螺旋CT三维重建工作原理及在胫骨平台骨折中的临床应用

目的:探讨多层螺旋CT多平面重建和三维重建在胫骨平台骨折中的临床应用价值。资料来源:检索Medline1999-01/2006-12与多层螺旋CT多平面重建和三维重建及胫骨平台骨折相关文章。检索词:“SpiralCT;multiplanar reformation/3D surfacere construction;tibial plateau fractures”并限定文章语言种类为“English”。同时检索万方数据库1997-01/2006-12与多层螺旋CT多平面重建和三维重建及胫骨平台骨折的相关文章,限定文章语言种类为中文,检索词“螺旋CT多平面重建和三维重建,胫骨平台骨折”。资料选择:对资料进行初审,选择关于多层螺旋CT多平面重建和三维重建原理及其在胫骨平台骨折中临床应用的临床实验和观察性文章,无论有无对照组、是否随机分组均纳入,排除重复性观察和综述文章。资料提炼:共收集到106篇关于多层螺旋CT多平面重建和三维重建在胫骨平台骨折中的临床应用的随机和未随机的文章,33篇符合纳入文章,排除73篇文章,50篇为重复性观察,23篇为综述类文章。33篇中16篇介绍多层螺旋CT多平面重建和三维重建原理和特点,17篇探讨多层螺旋CT多平面重建和三维重建在胫骨平台骨折中的临床应用价值。资料综合:多层螺旋CT能高速完成较大范围的容积扫描,图像质量好,成像速度快,具有很高的纵向分辨率和很好时间分辨率,其影像后处理方法包括多平面重建、三维表面重建、最大密度投影、仿真内镜。多层螺旋CT多平面重建与三维重建成像相结合,能全面、准确显示胫骨平台骨折的类型,骨块移位的方向和平台塌陷的程度,对临床医生相应手术方案有重要指导意义。结论:多层螺旋CT多平面和三维重建后处理功能能直观的、整体的显示胫骨平台的骨折情况。准确判断骨折的形式和程度,有利于手术方案的拟定,在骨外科的应用具有广阔前景。     

Functional dendritic cells are required for transfusion-induced sensitization in canine marrow graft recipients

Untransfused dogs given 9.2 Gy total-body irradiation and hematopoietic grafts from DLA-identical littermate donors uniformly achieve sustained engraftment, whereas dogs given three transfusions (Tx) of whole blood from the intended marrow donor 24, 17 and 10 days pretransplant uniformly reject their graft. Sensitization appears to be mediated by peripheral blood mononuclear cells and can be prevented by prior irradiation of the Tx product with UV light, known to inactivate leukocytes, in particular, cells with accessory function. In the present study we investigated which leukocyte population was responsible for Tx-induced sensitization and subsequent marrow graft rejection. Surprisingly, neither monocytes nor macrophages or dendritic cells induced sensitization, and all dogs so treated achieved engraftment; however, all four evaluable dogs transfused with UV- exposed blood to which small numbers of normal dendritic cells (12.5 x 10(3)/kg) were added rejected their marrow graft. Among five dogs given UV-exposed blood and normal monocytes (12.5 x 10(3)/kg) only one rejected its graft, and four achieved sustained engraftment. We conclude that donor dendritic cells are necessary, albeit not sufficient for in vivo sensitization. Sensitization is prevented by elimination or inactivation of dendritic cell.     

Anti-Inflammatory,Antioxidant, and Selective Antibacterial Effects of Euadenia Eminens Root Bark

Euadenia eminens Hook f. (Capparaceae) has traditional uses in the management of conjunctivitis, iritis, ophthalmia, tuberculosis, otalgia and rectal prolapse. The fruit pulp is also eaten as an aphrodisiac. In this paper, we report on the anti-inflammatory, antioxidant and antibacterial effects of its roots. A 70 % ethanol extract was tested for anti-inflammatory effect using the carrageenan-induced oedema in chicks. Free radical scavenging, total antioxidant and total phenol content were assessed spectrophotometrically. The extract was tested for antibacterial activity using the agar well diffusion method and micro dilution assays. The 70% ethanol extract gave a maximal inhibition of oedema by 74.18 % at 30 mg/kg. The total antioxidant capacity expressed in terms of ascorbic acid was 0.609 mg/g dry weight. The total phenol in terms of tannic acid was 7.25 mg/g dry weight. The extract also demonstrated free radical scavenging activity yielding IC₅₀ value of 1.175 mg/mL. The root extract however, showed selective antibacterial activity, inhibiting growth of two microorganisms; Bacillus subtilis and Bacillus thurigiensis. The MICs were 500 and 1000 µg/mL respectively. These results may account in part for the ethnopharmacological use of the plant.     

Antimicrobial and antispasmodic activity of leaf extract and fractions of Stachytarpheta cayennensis

ObjectiveTo investigate the antimicrobial activity of the methanol leaf extract (ME), n-hexane fraction (HF), ethylacetate fraction (EF) and methanol fraction (MF), of Stachytarpheta cayennensis C. Rich (verbenaceae) as well as to ascertain the antispasmodic effects of the ME and the various fractions (HF, EF and MF) on acetylcholine (Ach) and histamine (H) induced contractions on isolated guinea pig ileum.MethodsThe in vitro agar well diffusion method was used for the antimicrobial studies while the isolated tissue method was employed for the antispasmodic test. Organisms used were all clinical isolates of Bacillus subtilis, Staphylococcus aureus, Pseudomonas aeruginosa, Salmonella paratyphi, Candida albicans and Aspergillus niger.ResultsThe extract and fractions exhibited dose dependent inhibition against all the bacteria tested and also exhibited insignificant antifungal activity against Candida albicans and Aspergillus niger. The minimum inhibitory concentration (MIC) of the extract and fractions (mg/mL) on Bacillus subtilis, Staphylococcus aureus, Pseudomonas aeruginosa and Salmonella paratyphi respectively were ME 5.62, 14.12, 22.38, 2.11; EF 1.25, 6.30, 9.40, 9.40 and MF 3.98, 8.81, 39.80, 21.13. The n-hexane fraction exhibited MIC of 1.07 mg/mL against only Bacillus subtilis. The extract and fractions exhibited significant (P< 0.05) dose dependent attenuation of contractions induced by acetylcholine and histamine on isolated guinea pig ileum. Concentrations of the extract and fractions (μg/mL) which evoked 50% inhibition of maximal response exhibited by Ach were ME 0.64, HF 0.16, EF 0.08 and MF 0.15, while that of histamine included ME 5.12, HF 0.16, EF 0.04 and MF 0.64. Preliminary phytochemical studies on the extract and fractions indicated the presence of carbohydrates, alkaloids, saponins, flavonoids, steroids and terpenoids.ConclusionsThe extract and fractions of Stachytarpheta cayennensis possessed both antibacterial and antispasmodic effects confirming the claimed use in folkloric medicine for wound healing and gastrointestinal ulceration.     

Critical incidents: the respiratory system

Respiratory complications are expensive, not just in terms of the overall litigation burden faced by anaesthetists but also, and more importantly, the mortality and morbidity burden faced by our patients. Critical incidents arising in the respiratory system can cause rapid deterioration if left unchecked: trauma to airway structures can be debilitating or even life threatening; hypoxaemia may result in damage to other organ systems, most notably the brain. Each patient carries their own risk profile, as well as unique ideas, concerns and expectations of their anaesthetist. An understanding of the potential critical incidents that may befall the respiratory system, a patient-centred approach to discussing these risks, and familiarity with the procedures for mitigating harm are all necessary components of safe, effective practice in anaesthesia.