Association of achalasia and pulmonary Mycobacterium fortuitum infection

A case of achalasia complicated by Mycobacterium fortuitum pulmonary infection and empyema is reported. This association has been documented in the medical literature. Possible mechanisms explaining this association are discussed.     

Bronchopulmonary dysplasia: radiographic appearance in middle childhood

Chest radiographs were compared for three groups of children 8-9 years old: 23 survivors of bronchopulmonary dysplasia (BPD), 33 survivors of hyaline membrane disease without BPD, and 35 survivors of premature birth without neonatal respiratory problems. Only four children in the second group and three in the third had abnormal lungs. Linear shadows, apparently representing strands of fibrosis or deep pleural fissuring, were seen more frequently (15 of 23) in the BPD group than in the others (P less than .0001). Seventeen children in the BPD group had definite pulmonary abnormalities, none of them severe. The anteroposterior dimension of the chest in survivors of BPD tended to be decreased (P less than .001 vs that of reported control subjects).     

振幅型光栅法人眼调制传递函数测定的理论分析

目的:介绍测量视网膜调制传递函数的方法和光学原理,验证振幅型正弦光栅加零级空间滤波的方法测量视网膜调制传递函数使测量仪器小型化的可行性。方法:目前测量仪器中获得两相干点光源主要是使用平行板法、双道威棱镜法和光栅法3种,从理论上分析比较3种方法的优劣性,并重点分析矩形光栅、振幅型正弦光栅的各级衍射光强分布特点。结果:①平板法和双道威棱镜法可获得两相干点光源,也是在视网膜调制传递函数测量仪中应用比较成熟的技术,其光学原理简单,获得相干点光源的相干性良好,光强稳定。另外,使用双道威棱镜法时,可以用电位带动反射镜的移动来控制两点光源的间距,易于装置的智能化控制,但所设计的仪器外观尺寸较大,移动性较差,不利于测量装置的手持式和小型化发展。②矩形光栅法可以实现仪器的小型化,但由于矩形光栅的衍射图样是单缝衍射图样与多光束干涉图样相互调制的结果,即衍射光强的多光束干涉条纹干扰测量结果。③振幅型正弦光栅的透过率函数可以实现0￣1,以余弦波形式对入射光波产生振幅调制,且衍射光强只有三级谱线(0级和±1级),且±1级谱线的光强分布具有对称性,只要进行零级空间滤波,就可以得到作为视标调制度的两个点光源。结论:振幅型正弦光栅加零级空间滤波可以获得相干性良好相干点光源,并且可以实现测量仪器的小型化。     

Factors associated with pharmacologic treatment of osteoporosis in an older home care population

BACKGROUND: A number of studies have shown low rates of osteoporosis treatment. Few, if any, have assessed a comprehensive range of functional and clinical correlates of treatment coverage. Our objective was to examine which sociodemographic, clinical, and functional characteristics are associated with pharmacotherapy for osteoporosis among community-based seniors. METHODS: The study sample included 48,689 home care clients aged >/= 65 years in Ontario, Canada. Treatment coverage (calcium and vitamin D and/or anti-osteoporotic drugs) was assessed in two subgroups, clients with a diagnosis of osteoporosis (without fracture) and those with a prevalent fracture. Sociodemographic, health, and functional measures available from the Resident Assessment Instrument for Home Care (RAI-HC) were assessed as correlates of treatment in multivariable logistic regression analyses. RESULTS: Approximately 59% of clients with a diagnosis of osteoporosis were receiving pharmacotherapy, compared with 27% of those with a prevalent fracture. For both subgroups, treatment coverage was significantly lower among clients with at least three chronic conditions, health instability, fewer than nine medications, functional impairment, and depressive symptoms and among those clients who were widowed. Among clients with a diagnosis of osteoporosis, treatment was positively associated with cognitive impairment and negatively associated with confinement to a wheelchair or bed. Men with a prevalent fracture were significantly less likely to receive treatment, particularly in the absence of an osteoporosis diagnosis. CONCLUSIONS: Many older adults with presumed osteoporosis in our study were not receiving drug therapy for this condition. Indicators of clinical instability and functional decline appear to represent influential factors in treatment decisions. Despite a lower likelihood of treatment among men with a prevalent fracture, this sex difference in treatment largely disappeared in the presence of an osteoporosis diagnosis.     

Validation of Resource Utilization Groups version III for Home Care (RUG-III/HC): evidence from a Canadian home care jurisdiction

BACKGROUND: The case-mix system Resource Utilization Groups version III for Home Care (RUG-III/HC) was derived using a modest data sample from Michigan, but to date no comprehensive large scale validation has been done. OBJECTIVES: This work examines the performance of the RUG-III/HC classification using a large sample from Ontario, Canada. METHODS: Cost episodes over a 13-week period were aggregated from individual level client billing records and matched to assessment information collected using the Resident Assessment Instrument for Home Care, from which classification rules for RUG-III/HC are drawn. The dependent variable, service cost, was constructed using formal services plus informal care valued at approximately one-half that of a replacement worker. RESULTS: An analytic dataset of 29,921 episodes showed a skewed distribution with over 56% of cases falling into the lowest hierarchical level, reduced physical functions. Case-mix index values for formal and informal cost showed very close similarities to those found in the Michigan derivation. Explained variance for a function of combined formal and informal cost was 37.3% (20.5% for formal cost alone), with personal support services as well as informal care showing the strongest fit to the RUG-III/HC classification. CONCLUSIONS: RUG-III/HC validates well compared with the Michigan derivation work. Potential enhancements to the present classification should consider the large numbers of undifferentiated cases in the reduced physical function group, and the low explained variance for professional disciplines.     

A new combined in-vitro test model for the identification of substances affecting essential sperm functions [published erratum appears in Hum Reprod 1997 Nov;12(11):2580]

Binding of mammalian spermatozoa to the zona pellucida and the induction of the acrosome reaction are prerequisites for successful oocyte fertilization. It has been postulated that xenobiotics that are released in the environment as well as exposure to pharmaceutical medications may be associated with reproductive problems in men and wildlife. Examining physiological and non-physiological effects of particular compounds on sperm functions requires high quality in-vitro test systems. We established a reliable combined in-vitro test system with bovine gametes and evaluated if aliquots of pooled post-thaw spermatozoa are suitable for examining essential sperm functions. Using cryopreserved semen, the PSA-FITC/Hoechst 33258 staining procedure was applicable to evaluate the acrosomal status and cell viability. In the bovine hemizona assay, hemizona indices revealed no differences between cryopreserved and fresh semen. Treatment of post-thaw bovine spermatozoa with progesterone (1 microM or bovine follicular fluid (20%) induced the acrosome reaction from 12% (untreated spermatozoa) to 25% (P < 0.001) and to 22% [corrected] (P < 0.01), respectively. Incubation of both compounds (1 microM progesterone and 20% follicular fluid) raised the percentage of acrosome-reacted spermatozoa to 30% (P < 0001). Our results demonstrate that cryopreserved semen can be integrated into an in-vitro screening model for reproductive toxicology testing. Pooled, cryopreserved bovine spermatozoa will thus permit reproducible experiments for clinical and basic science purposes and may also be applicable for the human system.      

参三七皂甙Rg1对实验性血栓形成的影响及其机制探讨

用大鼠动静脉血栓形成模型,研究参三七皂甙Rg₁抗血栓作用。结果表明,参三七皂甙Rg₁可明显降低实验性血栓形成,对大鼠血浆纤溶系统亦有明显作用,可升高血浆中组织纤溶酶原激活物(t-PA)活性和活性型t-PA百分比,降低组织纤溶酶原激活物抑制剂(PAI)活性。同时利用培养大鼠血管内皮细胞实验,发现Rg₁可以剂量依赖性提高血管内皮细胞一氧化氮(NO)释放。提示Rg₁抗血栓作用与增强纤溶系统活性,促进血管内皮NO释放有关。     

Expediting return of bowel function after colorectal surgery

BackgroundPostoperative ileus is the main determinant of the length of hospital stay after colorectal surgery. Our objective was to analyze modifiable factors, including polyethylene glycol administration, associated with the return of bowel function.MethodsA retrospective review of all patients who underwent elective open partial colectomy from 2004 to 2006 at a single institution.ResultsThe time to the first bowel movement with and without oral intake within 48 hours postoperatively was 76 hours versus 134 hours (P < .001); with and without polyethylene glycol administration it was 73 hours versus 94 hours (P = .001); and with and without frequent ambulation it was 78 hours versus 95 hours (P = .012). With postoperative nasogastric tube drainage, the time to the first bowel movement was 22 hours longer (P = .002).ConclusionsThese data confirm previous findings supporting no nasogastric tube drainage, early feeding, and frequent ambulation after colorectal surgery. Additionally, our data suggest a strong association (P = .001) between the use of polyethylene glycol and the early return of bowel function.