Ischemic necrosis of the lunate. The value of nuclear spin tomography in comparison to conventional roentgen studies

Conventional radiographs do not always make it possible to confirm a diagnosis of ischemic necrosis of the lunate in the early stages of disease. For these doubtful cases MRI is justifiable in addition, to diagnose or to rule out ischemic necrosis of the lunate.     

Effect of total parenteral nutrition on histamine in the rat brain and other tissues.

The effects of a constant infusion of total parenteral nutrition on the histamine content of the hypothalamus was studied in adult male rats. Histamine content of the stomach, kidney, liver, and heart was also determined. The relationship between tissue histamine levels and duration of the infusion was examined. Rats receiving intravenous infusions of total parenteral nutrition had significantly higher (p less than 0.001) histamine levels in the hypothalamus than did orally-fed control rats. No difference was observed in the histamine level in the remainder of the brain. Animals receiving parenterally infused nutrient solutions had a higher histamine content in the kidneys but lower histamine levels in the stomach than did the control rats. No changes in the histamine content of liver or heart were observed. It appears that increases in histamine levels in the kidney and hypothalamus of rats given total parenteral nutrition persist up to 5 days and 9 days, respectively. The mechanisms responsible for and the consequences of the alterations of histamine content of these tissues remain to be established.     

The value of flumazenil in the reversal of midazolam-induced sedation for upper gastrointestinal endoscopy

Fifty patients who underwent diagnostic upper gastrointestinal endoscopy after midazolam sedation were randomized to receive (after completion of the examination) either the benzodiazepine receptor antagonist flumazenil or an identical-looking placebo. The speed of recovery from sedation was assessed by reaction time testing, measurement of critical flicker fusion frequency, and the semi-quantitative SOCA scoring system. Measurements were made up to 6 h post examination in all subjects, and at 12 and 24 h in all in-patients (n = 20). Flumazenil-treated patients were significantly more alert than those who received placebo at 10 min, 30 min, 1 h and 2 h (P less than 0.001 in all instances). Thereafter the two groups were similar. There was no evidence of recurrence of sedation in flumazenil-treated patients, nor did this drug adversely affect the period of anterograde amnesia between the administration of midazolam and flumazenil.     

Exophytic gliomas of the spinal cord

Intradural extramedullary glial tumours of the spinal cord are rare. We report for such tumours arising from the dorsal cord. Myelography and operative findings were almost similar to that of an intradural neurofibroma. Surgical removal had resulted in rewarding neurological recovery. One of them had a recurrence after six years and was re-explored. Anterolateral attachment near the root entry zone suggests its origin probably from the spinal cord with an exophytic growth.     

Pyridoxal 5'-phosphate and pyridoxamine 5'-phosphate concentrations in blood and tissues of mice fed ethanol-containing liquid diets

The effects of chronic ethanol administration on vitamin B-6 metabolism were studied in female Long-Sleep (LS) and Short-Sleep (SS) mice. Animals were fed an ethanol containing liquid diet (AIN-76) for four weeks. Concentration of ethanol in the diet increased from 10 to 25% ethanol-derived calories (EDC) during weeks 1-3 and was maintained at 30% EDC for 1 additional week. We measured concentrations of pyridoxal 5'-phosphate (PLP) in plasma, erythrocytes and whole blood, and liver and brain PLP and pyridoxamine 5'-phosphate (PMP) in ethanol-fed and pair-fed control mice. Chronic ethanol administration significantly increased PMP and total (PLP + PMP) levels in the liver of SS mice. In LS mice ethanol feeding significantly decreased PMP and total (PLP + PMP) levels in the brain, but these values were still within normal limits. These results suggest that both control and ethanol-containing liquid diets are nutritionally adequate with respect to vitamin B-6, and that chronic ethanol administration does not adversely affect vitamin B-6 metabolism in adult mice.     

A critical reflection on the personal impact of managerial hegemony within nurse education

This paper, written by two male nurse teachers, describes and analyses their experience of working in a nurse education culture permeated by the philosophy of business management The introduction of business management practices to nurse education is discussed as a reflection of the current political hegemony of market forces and individualism The authors discuss the implications for nurse teachers of being continually exposed to these politically motivated forces which increasingly provide the paradigm for service developments within the United Kingdom health services In discussing the impact of this exposure it is argued that at the personal level individual teachers are experiencing a degree of apathy and personal dissonance which undermines their professional value system, resulting in emotional distress and a crisis of identity It provides a critical reflection on the way organizational dynamics and power relations influence the subjective sense-making of individuals The authors use a multiplicity of perspectives, including those provided by individual psychology, power relations, feminism and personhood, to argue for the need to develop an alternative paradigm which is characterized by the valuing of individual persons, empathic sensitivity and the fostering of creativity been important to us from a personal and professional