The type and screen: a safe alternative and supplement in selected surgical procedures

For the year 1975, we examined 12,848 blood specimens using the type and screen as well as the crossmatch and detected 283 antibodies in 247 patients. Our screening reagent red blood cells were able to detect 96.11 per cent of these antibodies. If the antigen frequencies corresponding to those antibodies not detectable by our screening reagent red blood cells are taken into consideration. i.e., the incompatibility frequencies, the type and screen can be shown to be 99.99 per cent effective in preventing the transfusion of incompatible blood. Therefore, we believe that the type and screen may be safey substituted for the routine two-unit crossmatch in those operative procedures usually not requiring transfusions. Adoption of this approach would reduce patient charges, provide for more efficient distribution of our limited blood supplies, and allow for more effective utilization of blood-bank technologist time.     

Osteoid osteoma: radionuclide diagnosis

The double-density sign, seen on radionuclide bone scans, is described for diagnosing osteoid osteomas and for localizing the nidus. Its use in differentiating the nidus of an osteoid osteoma from osteomyelitis is also described. The utility of computed tomography in localization of the nidus is also illustrated. The double-density sign was helpful in diagnosing seven cases of surgically confirmed osteoid osteoma.     

Insulin Requirements in Lipodystrophic Diabetes

A ten-fold increase in daily insulin requirements during the administration of total parenteral nutrition (TPN) is described in a patient with congenital generalized lipodystrophy, insulin-requiring diabetes mellitus, and acanthosis nigricans during an episode of acute pancreatitis secondary to hypertriglyceridaemia. After a period of 13 days on TPN, insulin requirements increased dramatically to an average of 1428 units per day for a period of 12 days, to achieve a mean blood glucose level of 10.9 mmol l^?1. When the patient resumed feeding and the TPN was discontinued, the average daily insulin requirement was 104 units with a mean 24 h blood glucose of 11.8 mmol l^?1. Parenteral administration of energy substrates in a rare case of diabetes mellitus and congenital lipodystrophy complicated by acute pancreatitis resulted in a severe insulin insensitive state due to the combination of the hypermetabolism conferred by the pancreatitis plus transient impairments of the glucose disposal mechanism by the energy substrates provided.     

4-甲氧甲基芬太尼类似物的合成及其镇痛作用

本文报道了某些N-[1-(2-苯乙基)-4-甲氧甲基-4-哌啶基]-N-丙酰苯胺(4-甲氧甲基芬太尼)类似物的合成及其镇痛活性。小白鼠热板试验的结果表明,该类化合物有很强的吗啡样镇痛活性,但活性弱于相应的4-甲氧羰基芬太尼类化合物;4-N-酰基上羰基的存在对产生强效镇痛活性有重要作用。     

Use of cerebrospinal fluid gating to improve T2-weighted images. Part II. Temporal lobes, basal ganglia, and brain stem

Ungated and gated magnetic resonance images of the temporal lobes, basal ganglia, and brain stem acquired with the use of long repetition times (TRs) and long echo-delay times (TEs), were compared quantitatively. Twenty-five pairs of images obtained on a 1.5-T system were evaluated. Ungated images (TR = 2,000 msec, TE = 80 msec) were acquired in the same manner as gated images except for TR, which, for gated studies, was determined by a patient's heart rate and generally fell into the 1,500-1,800-msec range. Three image parameters were assessed: signal-to-noise ratio (S/N), object contrast, and resolving power. In both normal and abnormal brain tissue, gated images were superior to ungated images in object contrast and resolving power and equivalent in S/N. More so than in comparable studies of the spinal cord, ungated studies were susceptible to both false-positive and false-negative interpretations. As in spinal cord studies, the major benefit of gating was the elimination of phase shift images arising from basal cisterns and the third ventricle.