Rotator cuff tears: preliminary application of high-resolution MR imaging with counter rotating current loop-gap resonators

A new class of radio frequency (RF) coils for magnetic resonance (MR) imaging and spectroscopy is introduced. The coils consist of two loop-gap resonators of equal diameters positioned along a common axis. They are tuned to the mode in which the current in the two loops flows in opposite directions. These coils are "decoupled" from a uniform excitation field of arbitrary orientation (including circularly polarized fields) by intrinsic decoupling and by means of back-to-back fast recovery diodes. Measurements made with the coils and a phantom saline tank indicate that the signal-to-noise ratio obtainable with these coils is almost identical to that obtained with single loops. Imaging of several anatomic areas, including knee, wrist, and shoulder, has been performed with a 1.5-T MR system that uses circularly polarized RF. A small series of patients with torn rotator cuffs underwent imaging. Difficulties in establishing the diagnosis with MR imaging because of anatomic complexity are illustrated. The value of pulse sequences with long repetition times to increase the signal intensity of fluid in the joint is shown.     

辣椒素局部应用抑制鼻息肉复发的疗效观察

目的 :评价辣椒素局部应用对鼻息肉术后复发的抑制作用。方法 :从 5 1例鼻息肉摘除加筛窦开放术患者中 ,随机选取 2 9例 ,术后 2周起 ,于鼻腔手术部位 ,置入直径 2 cm左右 ,浸有溶于 70 %乙醇的 3× 10 -6mol辣椒素的棉片 1块 ,2 0 min后取出 ,每周 1次 ,5次为 1疗程 ;其余 2 2例术后局部放置浸有 70 %乙醇的棉片作为对照。采用临床客观检查结合患者主观症状评级 ,综合评价疗效。结果 :治疗后平均 9个月和平均 5 5个月两次随访显示 :辣椒素局部应用能有效改善鼻通气 ( P <0 .0 1)。辣椒素组临床有效率分别为 86.2 %和 69.0 % ;对照组有效率分别为 45 .4%和 3 6.4%。两组相比较 ,差异具有显著性 ( P <0 .0 1)。结论 :辣椒素局部治疗有抑制或延缓鼻息肉术后复发的作用     

The decline in US teen pregnancy rates, 1990-1995

OBJECTIVES: Estimate pregnancy, abortion, and birth rates for 1990 to 1995 for all teens, sexually experienced teens, and sexually active teens. DESISN: Retrospective analysis of national data on pregnancies, abortions, and births. Participants. US women aged 15 to 19 years. OUTCOME MEASURES: Annual pregnancy, abortion, and birth rates for 1990 to 1995 for women aged 15 to 19 years, with and without adjustments for sexual experience (ever had intercourse), and sexual activity (had intercourse within last 3 months). RESULTS: Approximately 40% of women aged 15 to 19 years were sexually active in 1995. Teen pregnancy rates were constant from 1990 to 1991. From 1991 to 1995, the annual pregnancy rate for women aged 15 to 19 years decreased by 13% to 83.6 per 1000. The percentage of teen pregnancies that ended in induced abortions decreased yearly; thus, the abortion rate decreased more than the birth rate (21% vs 9%). From 1988 to 1995, the proportion of sexually experienced teens decreased nonsignificantly. CONCLUSIONS: After a 9% rise from 1985 to 1990, teen pregnancy rates reached a turning point in 1991 and are now declining. Physicians should counsel their adolescent patients about responsible sexual behavior, including abstinence and proper use of regular and emergency contraception.     

SPECTRUM OF ACUTE RENAL FAILURE IN A SERVICE HOSPITAL

A prospective study of 82 patients with acute renal failure was carried out over the last 2 years. Mean age of the patients was 35.6 years (8-82 years). Male to female ratio was 3.5:1. The etiological factors were septicaemia in 18 patients (21.95%), aminoglycoside toxicity in 16 patients (19.51%), open heart surgery in 8 patients (9.76%), volume depletion and blood loss in 12 patients (14.63%), glomerulonephritis in 4 patients (4.88%), renal allograft dysfunction in 4 patients (4.88%), and miscellaneous causes in 20 patients (24.39%). Non-oliguric renal failure was observed in 39.02 per cent cases. Dialysis support was required in 65.8 per cent of the cases; with average 5.6 (4 to 11) dialysis sessions. Four patients of acute renal failure following open heart surgery were given continuous arterio-venous haemofiltration. Overall mortality was 32.5 per cent, septicaemia accounting for 60 per cent of the deaths.KEYWORDS: Antibiotics, Aminoglycoside, Renal failure acute, Septicemia     

结肠上皮内CD4+CD8-/CD4-CD8-αβ T淋巴细胞及细胞因子在sGVHD发生发展中的改变

目的探讨自身或同基因型骨髓移植后用环孢霉素A(CsA)短期治疗诱导的移植物抗宿主病(GVHD)及用于预防白血病复发的机制. 方法从小鼠同基因型GVHD的主要靶器官--结肠分离上皮内淋巴细胞(IEL),分析其细胞表型和细胞因子在GVHD诱导、发生中的改变,以探讨CsA诱导同基因型GVHD的机制. 结果 GVHD时IEL中CD4+ CD8-αβ T细胞明显增加,而CD4-CD8-双阴性αβ T细胞明显降低(P＜0.001),CD4+CD8-αβ/CD4-CD8-αβ T细胞的比例从正常的1.0～1.5增加到13～25,此时,细胞因子IL-12、IFN-γ、TNF-α表达明显增高.CD4+CD8-αβ/CD4-CD8-αβ T细胞的比例失调及细胞因子的改变始于CsA诱导后第3周,但γδ T细胞无明显改变. 结论结肠上皮内CD4+αβ/CD4-CD8-αβ T细胞的平衡对肠道的稳定是非常重要的,CsA诱导sGVHD导致结肠损伤的原因可能是干扰这种平衡.     

达托霉素在中性粒细胞减少伴发热成人肿瘤患者中的药动学

达托霉素为第一个环脂肽类抗菌药,体外对万古霉素耐药肠球菌、甲氧西林耐药葡萄球菌及糖肽类耐药金葡菌等革兰阳性菌具有杀菌活性。作者报道了在29例中性粒细胞减少伴发热成人肿瘤患者中进行达托霉素的药动学研究结果。给予29例中性粒细胞减少伴发热肿瘤患者单剂30min内静脉滴注达托霉素6mg／kg,并分别留取用药前及用药结束后0、0．5、1、2、4、8、12和24h血样。     

Age differences in posttraumatic stress disorder, psychiatric disorders, and healthcare service use among veterans in Veterans Affairs primary care clinics.

OBJECTIVE: To expand our understanding of posttraumatic stress disorder (PTSD) prevalence, its psychiatric characteristics, and service use among elderly veterans in Veterans Affairs (VA) primary care clinics. METHODS: A cross-sectional, epidemiological design (N = 745) incorporating self-report measures, structured interviews, and chart reviews was used to obtain relevant information for analyses. RESULTS: The oldest group of veterans (>or=65 years; N = 318) had lower prevalence of most psychiatric diagnoses than the youngest (18-44 years; N = 69) and middle-aged (45-64 years; N = 358) groups. Despite having higher rates of combat exposure, veterans in the oldest group (6.3%) had one-third the prevalence of PTSD than those in the middle-aged group (18.6%). A similar pattern was found across other psychiatric diagnoses. For example, those in the oldest group (7.5%) had one-third the prevalence of major depression as those in the two younger groups (21.7% and 22.9%). These differences were maintained after controlling for relevant demographic covariates (race, sex). Results from examination of VA health care service use across the three groups were consistent with the findings that the oldest veteran group is functioning significantly better across mental health domains. CONCLUSION: Elderly veterans who use VA primary care services evidence lower rates of PTSD and other psychiatric disorders, and they use significantly less VA mental health services. They also do not appear to show evidence of worse physical health functioning or use VA health care services or disability benefits at a meaningfully higher rate than their younger counterparts.     

Sitosterol xanthomatosis

BACKGROUND: Sitosterolaemia is a lipid disorder in which plasma plant sterol levels are extremely elevated. Sitosterolaemia is clinically characterized by tuberous and tendon xanthomas, premature vascular disease and arthritis. OBJECTIVE: To report a case of sitosterolaemia diagnosed by cutaneous manifestations and to review this rare disease. METHODS: We report the case of a 60-year-old woman who presented with cutaneous xanthomas, arterial hypertension and polyarthralgias. The patient had had hypercholesterolaemia for many years without reduction of serum cholesterol, despite treatment with fenofibrate. RESULTS: Ezetimibe therapy was started, decreasing sitosterol plasmatic levels and tuberous xanthomas after 3 months of treatment. CONCLUSION: It is important to detect levels of sitosterol in plasma in patients with premature vascular disease, presence of xanthomas, and uncontrolled hypercholesterolaemia. Ezetimibe therapy is effective.