重度卵巢过度刺激综合征1 3例临床分析

目的：总结重度卵巢过度刺激综合征（ovarian hy-perstimulation syndrome,OHSS）临床表现、发病机制及相应的治疗方法。方法：回顾性分析13例重度OHSS的临床资料。结果：重度OHSS发生在超排卵治疗后，临床表现为腹胀、恶心、腹水、胸水、少尿、血液浓缩、水电解质及酸碱平衡紊乱、氮质血症。经严密观察、输白蛋白、扩容及放胸腹水等治疗后治愈。移植日已出现OHSS者将胚胎冷冻保存。结论：防治重度OHSS的关键在于预防，一旦发生OHSS，经严密观察和及时治疗可治愈；迟发OHSS与妊娠有关。     

Effects of magnesium sulfate aerosol on indices of external respiration in patients with bronchial asthma

Plethysmography and pneumotachography were applied to measure bronchial permeability, and reactivity of the bronchi in 10 patients with pre-asthma and 17 with asthma upon administration of magnesium sulfate aerosol (solution osmolality 260 mmol/l, pH-6.6). Though the drug inhalation did not induce bronchial dilatation, it diminished both hypersensitivity and hyperreactivity of the bronchial tree to acetylcholine. These properties of magnesium sulfate in the absence of unwanted sequelae when introduced endobronchially allow its advocating in combined treatment of asthma and pre-asthma.     

Mosaicism in sporadic neurofibromatosis 2 patients

More than half of neurofibromatosis 2 (NF2) patients represent de novo mutations which could have occurred at either pre-zygotic or post- zygotic stages. A post-zygotic mutation can result in mosaicism. In four sporadic NF2 patients, we found NF2 mutations in only a portion of corresponding leukocytes. In two other sporadic patients, no mutations were found in leukocytes but constitutional NF2 mutations were suggested by identical mutations in different tumors from each patient. We screened leukocyte DNA from a total of 16 inherited and 91 sporadic NF2 patients, and found NF2 mutations in 13 (81%) of the former and in 46 (51%) of the latter cases. The 30% difference in the rate of detection of mutations ( P = 0.051) might be partially explained by mosaicism in a portion of sporadic NF2 patients who carry the mutations in such a fashion that their leukocytes are unaffected. Among sporadic cases, we found mutations more frequently in patients with severe phenotypes (59%) than in patients with mild phenotypes (23%) (difference of 36%, P = 0.007). Mosaicism might be more common in the latter patient group since small populations of mutation-bearing cells can in some cases result in mild phenotypes and can also lead to difficulties in identifying mutations. No mutations were found in eight patients suspected of having NF2. Mosaicism with an extremely small population of affected cells may explain the incomplete phenotypes in some of these patients and the lack of mutations in their leukocytes. These findings suggest that mosaicism is relatively common in NF2 and may have important implications for diagnosis, prognosis and genetic counseling.      

The role of a cutaneous cut in safe covering of a receiver-stimulator in cochlear implantation

The aim of the study was to compare efficacy of cutaneous cuts of various length in placement of a receiver-stimulator behind the ear. Conditions for ligature fixation of the cochlear implant receiver-stimulator as well as the state of soft tissues at the site of the intervention in the postoperative period are analysed. Cochlear implantation was made in 55 patients using implants CI 22M, 24M, Combi 40+. Group 1 included 38 patients (21 children aged 1 year 9 months to 14 years, mean age 7.07 +/- 0.9 years, and 17 adults) operated with an U-cut in the endaural variant, 17 patients (age 1 year 8 months to 15 years, mean age 7.06 +/- 1.2 years) operated with a vertical cut in addition of original subcutaneous flaps entered group 2. The number of complications related to soft tissues and postoperative suture in children of group 1 was significantly higher than in group 2 (p<0.05, t=2.0).     

Prevalence of bronchial asthma and allergic rhinitis in the adult population of St. Petersburg

AIM: To evaluate prevalence of bronchial asthma (BA) and allergic rhinitis (AR) among adult population of St-Petersburg. MATERIAL AND METHODS: Responders to ECRHS and B. Sibbald & E. Rink questionnaires who gave at least one positive answer were examined clinically, functionally and allergologically. A total of 3634 responders aged 16 to 98 years participated in the study. RESULTS: By the answers of the responders prevalence of BA was 7.2%, of AR--9.9%. Such figures were much higher than official statistics. Atopic BA was most frequent among other types--64%. CONCLUSION: It became evident that BA and AR in many cases are diagnosed late or are not recognized at all. This leads to growing number of patients with moderate and severe course of these diseases and deteriorates effectiveness of BA and AR treatment.