Sternocostoclavicular hyperostosis: a review and report of 11 cases

Sternocostoclavicular hyperostosis is a benign ossifying diathesis of unknown etiology characterized by hyperostosis and soft-tissue ossification between the clavicles, anterior portion of the upper ribs, and manubrium, with variable hyperostosis or ankylosis in the spine and sacroiliac joints. Our cumulative experience with 11 cases is reported, with emphasis on radiographic features of the condition. Scintigraphic results in five patients and computed tomographic findings in one patient are presented. A review of the literature and our own material indicates that sternocostoclavicular hyperostosis may be more common than has been previously recognized.     

Intrinsic neurosecretory neurons of the rat heart atrioventricular junction: possibility of local neuromuscular feed back loops

The microanatomy and ultrastructure of rat heart atrioventricular junction were studied on serial sections of both paraffin and epoxy embedded samples. The animals were pretreated with 5-hydroxy-dopamine in order to differentiate the adrenergic component of the terminal nerve plexus. Two kinds of ganglia could be identified throughout the interatrial septum by the optical microscope. The first was composed of large pale cells with voluminous nuclei. The other resembled acini-like clusters of osmophilic cells. Another small ganglion was invariably present between right and left branches of the bundle of His. The electron microscopic examination of this structure revealed, apart from small pale neurons (10 microns in diameter), several large 5-hydroxy-dopamine contrasted neurosecretory cells (up to 30 microns) with abundant electron dense vesicles typical for sympathetic neurons. Numerous glomeruli with dendrodendritic and axodendritic connections, some of which exhibit the same 5-hydroxy-dopamine loaded vesicles, could be found in the vicinity of the specialized conducting tissue. The functional implications of the above morphological data are not clear. However, the intrinsic neurosecretory component can be expected to modulate both specialized cells and neighbouring neurons. The heterogeneity of neuro-neuronal and neuro-muscular relations, such as perinodal mechanoreceptors, may suggest that the terminal nerve plexus not only distributes the efferent stimuli, but that it also has an integrative function which is the necessary prerequisite for a local feed back autoregulation.     

Significant others benefit from preoperative information

Little attention has been given to the preparation of the patient's family prior to surgery, even though nurses' clinical experience suggests that family members are often more anxious than the patient. This study explored the knowledge and anxiety of spouses and significant others of patients preparing for cardiac surgery. The subjects were selected by convenience from a preoperative class offered at the hospital where surgery was to occur. Before and after the class, the subjects completed a cardiac-surgery knowledge test and an anxiety test. The significant others were significantly more anxious than the patients prior to the class. The anxiety level of significant others was significantly reduced after the class. There were no statistically significant differences between patients and significant others on the cardiac-surgery knowledge test. These results suggest that significant others may benefit from preoperative instruction.     

脱氢氯甲睾酮人体内代谢研究

本文叙述了用GC-MS联用技术研究脱氢氯甲睾酮人体内代谢的方法。尿样中的甾体化合物经大孔树脂吸附提取后,酶解。浓缩并衍生化,进行GC-MS分析。在服药后8～30h的尿样中,检出了脱氢氯甲睾酮原型,并发现了七个代谢产物。分析色谱和质谱数据,得到了这些代谢物的结构及其浓度变化趋势,推测了脱氢氯甲睾酮可能的体内代谢模式,确定了筛检尿中脱氢氯甲睾酮的特定代谢物和特征检测离子,比较了不同的样品处理方法对分析结果的影响。     

Attention-Deficit/Hyperactivity Disorder: A Neurodevelopmental Approach

TOPIC. Attention-deficitlhyperactivity disorder is frequently overdiagnosed when a complete evaluation by a knowledgeable clinician is not undertaken. Because of the recent negative media campaign regarding psychos t im ulan t medication, it becomes more imperative that a thorough and accurate evaluation be completed before starting children and adolescents on psychostimulant medications.
PURPOSE. To describe the neurodevelopmental perspective in the assessment and treatment of ADHD.
SOURCES. Published literature and clinical experience.
CONCLUSION. It is useful in practice to conceptualize the dmelopmental path of children with ADHD not as disordered but as delayed, and to build on each child's strengths. The neurodmeloprnental approach provides the child psychiatric nurse a child-focused framework for assessment and development of individualized interventions.