Abdominal nontuberculous mycobacterial infection in a university hospital in Taiwan from 1997 to 2003.

BACKGROUND/PURPOSE: Abdominal nontuberculous mycobacterial infection is a rare condition. Continuous ambulatory peritoneal dialysis (CAPD)-associated peritonitis is the most common manifestation of infection due to nontuberculous mycobacteria (NTM). There are limited data on the clinical manifestations of nontuberculous mycobacterial infection. This study investigated the diagnostic features, clinical presentation, mycobacteriology, treatment and outcome of all abdominal NTM infections treated over a 7-year period at a major teaching hospital in Taiwan. METHODS: The medical records of all patients with a diagnosis of abdominal NTM infection from January 1997 through to December 2003 were retrospectively reviewed. RESULTS: All 11 patients with abdominal NTM infections identified during the 7-year period were included. Among these patients, six were male and five were female, with a mean age of 64.5 years. The disease manifested as peritonitis (9 patients, 82%), splenic abscess (1, 9%), or perirenal abscess (1, 9%). Most patients (73%) had underlying malignancy, most often hepatoma (45%). Immunocompromised status (liver cirrhosis, malignancy, acquired immunodeficiency syndrome) was noted in 10 patients (91%). None of our patients who developed NTM peritonitis had received CAPD. The peritoneal fluid appearance varied considerably, with no particular predominance of clear, turbid, bloody, or chylous findings. Rapidly growing mycobacteria were the major etiology (46%) of abdominal NTM infection, and Mycobacterium abscessus played a major role (27%). Overall, eight patients died, and only one patient survived longer than 1 year. Seven patients (64%) died before diagnosis. CONCLUSION: Abdominal NTM infection is frequently overlooked because of its rarity and nonspecific symptoms, with consequent delays in diagnosis and treatment. In immunocompromised patients with ascites from any cause (liver cirrhosis, malignant ascites, etc.), NTM peritonitis should be considered early in the differential diagnosis of symptoms including fever, abdominal pain and weight loss. The poor prognosis of abdominal NTM infection appears to be related to the severity of underlying conditions, most often malignancy.     

EEG source imaging: correlating source locations and extents with electrocorticography and surgical resections in epilepsy patients.

SUMMARY: It is desirable to estimate epileptogenic zones with both location and extent information from noninvasive EEG. In the present study, the authors use a subspace source localization method (FINE), combined with a local thresholding technique, to achieve such tasks. The performance of this method was evaluated in interictal spikes from three pediatric patients with medically intractable partial epilepsy. The thresholded subspace correlation, which is obtained from FINE scanning, is a favorable marker, which implies the extents of current sources associated with epileptic activities. The findings were validated by comparing the results with invasive electrocorticographic (ECoG) recordings of interictal spike activity. The surgical resections in these three patients correlated well with the epileptogenic zones identified from both EEG sources and ECoG potential distributions. The value of the proposed noninvasive technique for estimating epileptiform activity was supported by satisfactory surgery outcomes.     

膀胱癌中环氧化酶-2的表达与临床病理的关系(英文)

目的　探讨环氧化酶 - 2 (COX - 2 )表达与膀胱癌生物学行为的关系及其意义。方法　采用免疫组化SABC法检测 5 4例膀胱癌、2 9例癌旁组织和 10例正常膀胱粘膜中的COX - 2表达 ,结合临床病理资料进行分析。结果　COX - 2在不同膀胱组织中的表达差异有显著性 (P <0 .0 5 ) ,即膀胱癌组织 >癌旁组织 >正常膀胱粘膜。COX - 2表达随膀胱癌病理级和临床分期的增加而增加 (P <0 .0 5、P <0 .0 1) ,且癌组织中COX - 2表达与淋巴转移有关 (P <0 .0 5 )。结论　COX - 2表达与膀胱癌病理分级、临床分期、淋巴转移有关 ,提示它可能在胱癌的发生、发展中扮演重要角色 ,通过抑制COX - 2活性可能为膀胱癌的防治提供新途径。     

重度联合免疫缺陷小鼠的繁育及其应用初报

应用带过滤罩的透明鼠在层流柜内繁育Ｔ和Ｂ淋巴细胞缺失的重度联合免疫缺陷（ｓｃｉｄ）小鼠获得成功，１９９３年５月至１９９４年４月，共繁育ｓｃｉｄ小鼠２２１只，寿命均超过１２个月。平均每窝产仔数为５．５只，显著低于对照组ＢＡＬＢ／ｃ小鼠，不育率为１４．９％，离乳率为８８．２％，与ＢＡＬＢ／ｃ小鼠相比均无明显差异。ｓｃｉｄ小鼠４～１０周龄的体重与同龄ＢＡＬＢ／ｃ小鼠相比无明显差异，微生物学检测均符合ＳＰ     

重视患者知情同意权提高医疗服务质量

为了提高医院的医疗服务质量，保证医疗安全，避免和减少医疗纠纷，医院必须严格遵守患者知情同意原则。作者着重讨论知情同意的意义，如何规范知情同意书的范围、格式和内容，以及填写注意事项等问题。     

668颗后牙镍铬合金PFM边缘适合性的临床观察

目的：观察采用2种边缘形式的后牙烤瓷熔附金属全冠边缘适合性和对牙龈健康的影响.方法：对668颗后牙,分别采用2种边缘形式的后牙烤瓷熔附金属全冠（单冠或桥的基牙）在修复2年后进行复查,检测其边缘适合性及牙龈指数（GI）和牙周探诊深度（PD）,用统计学方法分析修复体边缘形式与牙龈病变间的关系.结果：采用羽状边缘360°金属脚边的PFM边缘适合性明显优于凹面肩台型边缘PFM,凹面肩台型边缘的PFM的牙龈病变发生率,明显高于羽状边缘360°金属脚边的PFM,而边缘适合性差者较适合性好者牙龈病变发生率显著增高.结论：后牙PFM的边缘采用羽状边缘360°金属脚边是一种好的选择.     

河北省中药混乱品种鉴别研究——6.蕲蛇及其伪品的鉴别

按照中国药典1985年版蕲蛇为蝰科动物五步蛇除去内脏的干燥体。近年在河北省的药村商品中,发现有游蛇科动物滑鼠蛇混入其中,充当蕲蛇。作者应用解剖、组织切片的方法,研究了蕲蛇与滑鼠蛇在形态组织上的鉴别特征。它们的主要区别在于:鳞片、体表花纹、牙齿、鼻骨的形态;椎骨的形态与组织特征。据此可以鉴别蕲蛇与滑鼠蛇的真伪。     

神经活素对Pc12细胞作用的初步观察

从胎脑、颌下腺、肌肉组织中制备神经活素。其性能同脑活素一样：可促进Ｐｃ１２细胞的突起生长，提高其胞浆内乳酸脱氢酶活性，电泳显示二者有相同的三条带。提示：神经活素有可能替代脑活素应用于临床。     

诺氟沙星的吸附伏安法研究

在ｐＨ＝７．４９氨－氯化铵缓冲液中，诺氟沙星在滴汞电极上产生一灵敏的还原峰，峰电位为－１．５２Ｖ（ｖｓ．ＳＣＥ）。在１．９８×１０（－７）～４．８８×１０（－６）ｍｏｌ／Ｌ之间有良好的线性关系。本文对其极谱性质和电极过程进行了研究，用于诺氟沙星的测定，方法简便，结果准确、可靠。     

浅谈如何提高医疗质量

为提高医疗质量，论述以下三点：①强调“以病人为中心”，坚持服务方向、整合优化流程、收集反馈信息；②加强医务人员思想道道修养，在加大教育、监督、管理力度三个方面下功夫；③强化引导管理模式，采取开展质量分析、狠抓环节质控、进行法律法规引导等方法收到较好效果。