Phrenic nerve conduction studies in acute organophosphate poisoning

Phrenic nerve conduction studies were performed within 48 h of admission and subsequently in 29 patients (14 of whom required mechanical ventilation) with acute organophosphate (OP) poisoning. The mean (+/-SD) amplitude of the diaphragmatic compound muscle action potential (CMAP) in patients requiring mechanical ventilation (119.09 +/- 173.85 microV) was significantly lower than in those not requiring mechanical ventilation (461.63 +/- 138.69 microV) (P < 0.0001). Diaphragmatic CMAP amplitudes in ventilated patients increased with time during the course of hospitalization and were normal in 5 (36%) patients and only mildly reduced in another 6 (43%) patients prior to discontinuation of mechanical ventilation, which was undertaken 4-18 days (mean 7 +/- 3 days) after poisoning. Eleven patients (79%) were successfully weaned from mechanical ventilation at the first attempt. In the 3 (21%) remaining patients, mechanical ventilation had to be reestablished because of weaning failure. The mean (+/-SD) diaphragmatic CMAP amplitude, prior to discontinuation of ventilatory assistance, was 242.6 +/- 94.1 microV in these 3 patients. After ventilatory discontinuation, it fell to 95.5 +/- 105.8 microV. Thus, reduced diaphragmatic CMAP amplitudes correlate with the need for mechanical ventilation in acute OP poisoning.     

消化道胶囊内镜——从三级医疗中心到初级保健

1907年，布鲁日开始应用第一台内镜来观察人的上消化道，最初是硬的直管内镜，需要全身麻醉。40年后，可屈式内镜诞生，只需要局部麻醉或轻度镇静就可以进行内镜检查。随后20年的技术进步催生了第一台肠镜的出现。1999年，又实现了一个巨大的飞跃，胶囊内镜可以全面观察整个小肠。胶囊被咽下后，在肠道的蠕动推进下经过所有肠道，胶囊内镜具有成像装置，可将肠道内的影像传输给腹部的接收装置。     

Absorption studies after massive small bowel resection and antiperistaltic colon interposition in rhesus monkeys

An experimental model of massive (80%) small bowel resection and antiperistaltic colon interposition in between the remnant jejunum and ileum was created in rhesus monkeys. The gastrointestinal functions were assessed preoperatively and at different periods after the operation. Progressive increase in the transit time and enhanced absorption ofd-xylose and vitamin B ₁₂ was observed in these animals. The transit time marginally increased till three months postoperatively, and a significant increase was observed later (4–12 months) in the colon autografted monkeys. After three months, thed-xylose absorption in the colon interpositioned animals was nearly equal to that of normal monkeys. There was no significant difference in the vitamin B ₁₂ absorption in the normal and operated animals up to three months, but a significant rise was observed in the latter group after this period. The fecal fat excretion was 33–44% initially, and it gradually decreased to near normal values after nine months. The antiperistaltic colon interposition was effective in improving the early postoperative survival in animals after massive small bowel resection and enhanced the bowel absorption considerably.This investigation was supported by grant from the Indian Council of Medical Research, New Delhi.     

Protective effects of zinc on oxidative stress enzymes in liver of protein-deficient rats

Persons afflicted with protein malnutrition are generally deficient in a variety of essential micronutrients like zinc, copper, iron, and selenium, which in turn affects number of metabolic processes in the body. To evaluate the protective effects of zinc on the enzymes involved in oxidative stress induced in liver of protein-deficient rats, the current study was designed. Zinc sulfate at a dose level of 227 mg/L zinc in drinking water was administered to female Sprague-Dawley normal control as well as protein-deficient rats for a total duration of 8 weeks. The effects of zinc treatment in conditions of protein deficiency were studied on rat liver antioxidant enzymes, which included catalase, glutathione peroxidase (GPx), glutathione reductase (GR), superoxide dismutase (SOD), glutathione reduced (GSH), and glutathione-S-transferase (GST). Protein deficiency in normal rats resulted in a significant increase in hepatic activities of catalase, glutathione peroxidase, glutathione reductase, and glutathione-S-transferase and the levels of lipid peroxidation. A significant inhibition in the levels of reduced glutathione and the enzyme activity of superoxide dismutase has been observed after protein deficiency in normal rats. Interestingly, Zn treatment to protein-deficient animals lowered already raised activity catalase, glutathione peroxidase, and glutathione-S-transferase and levels of lipid peroxidation to significant levels when compared to protein-deficient animals. Also, Zn treatment to the protein-deficient animals resulted in a significant elevation in the levels of GSH and SOD activity as compared to their respective controls, thereby indicating its effectiveness in regulating their levels in adverse conditions. It has also been observed that concentrations of zinc, copper, iron, and selenium were found to be decreased significantly in protein-deficient animals. However, the levels of these elements came back to within normal limits when zinc was administrated to protein-deficient rats. This study concludes that zinc has the potential to regulate the activities of oxidative stress enzymes as well as essential hepatic elements.     

New anatomic repair of midline abdominal wall incisions extending to suprapubic region

This article describes a new technique to close infraumbilical midline abdominal wall incisions extending to the suprapubic region. This repair is technically easy to perform, saves time, reduces the risk of bowel and bladder injury and takes into consideration the anatomical landmarks of the peritoneum, the rectus sheath and the arcuate line. Abdominal wall closure with this repair is especially useful in obese patients. Furthermore, with this repair the pelvic cavity is lined with smooth peritoneum, which may reduce postoperative adhesions in the pelvis. Technically easy to perform and saves time Very useful technique for obese patients Reduced risk of bowel and bladder injury Anatomical in nature Potentially minimizes postoperative adhesions.     

Glycogen-rich Clara cell-type bronchiolo-alveolar carcinoma: light and electron microscopic study.

A clear cell type of bronchiolo-alveolar carcinoma removed from the lung of a 63-year-old man was studied by light and electron microscopy. The tumor was composed exclusively of Clara cells identified by the presence of secretory granules, an abundance of granular endoplasmic reticulum, a moderate number of mitochondria and prominent Golgi complexes. The tumor cells were tall columnar and had clear cytoplasm due to the presence of large pools of intracytoplasmic glycogen. This feature has not heretofore been described. Ultrastructural features distinguishing this tumor from benign clear cell tumors of the lung and clear cell carcinomas of the kidney are described.