Treatment of blunt hepatic injuries: role of CT

Serial dynamic upper abdominal computed tomography (CT) studies were performed on 20 patients as part of the conservative treatment of blunt hepatic injuries (hematoma, laceration, or fracture). Fourteen of these patients had either major or minor associated hemoperitoneum. In 13 patients, hemoperitoneum was either significantly reduced or absent by 1 week. A severe delayed hemorrhage occurred in one patient 7 1/2 days after admission; a large and unchanged volume of intraperitoneal fluid had been seen on a preceding abdominal CT scan. One other patient who had a satisfactory response underwent surgery for a pancreatic laceration. Serial abdominal CT studies are an integral part of the conservative treatment of blunt hepatic injuries and seem to be useful in monitoring resorption of hemoperitoneum and the pattern of healing of intrahepatic hematomas, lacerations, and fractures.     

Plasma proteins and lymphocyte phenotypes in long-term plasma donors

BACKGROUND: The possible effects of long-term plasma donation remain unknown, but it is important to investigate them so that donor safety is ensured. The purpose of this study was to determine if long-term plasma donation alters plasma proteins or lymphocyte phenotypes. STUDY DESIGN AND METHODS: Two groups of long-term plasma donors, source plasma donors (n = 20) and Rh immune globulin plasma donors (n = 26), were compared with whole blood donors (n = 29) and nondonor controls (n = 30). Blood samples were obtained prior to donation. Serum protein, albumin, globulin, and immunoglobulin levels were determined. In an assay using whole blood, lymphocyte phenotypes were characterized with a panel of single- and dual-labeled monoclonal antibodies and subsequent analysis by flow cytometry. RESULTS: As compared to the nondonor controls and/or whole blood donors, the mean values for serum protein, globulin, and IgG levels were lower in both plasma donor groups, with a significant negative correlation between donation frequency and serum protein values for the source plasma donors. Albumin levels were within normal ranges for both groups of plasma donors. No significant differences existed among the donor groups in total white cell counts, the percentage or absolute number of lymphocytes, T (CD3) cells, or helper T (CD4) cells. However, there were increased percentages of B (CD19) cells and decreased percentages of suppressor T (CD8+/CD11b+) cells and natural killer cells in both groups of plasma donors as compared to nondonor controls. CONCLUSION: Many plasma donors have low levels of serum protein, globulin, and IgG. In addition, they have increased percentages of B cells and decreased percentages of suppressor T and natural killer cells. The clinical significance of these findings warrants further investigation.     

Simple renal cysts in infants

Two cases of renal cysts in infants less than one year of age are presented. In both instances percutaneous puncture of the cyst aided in establishing the diagnosis without the need for an operative procedure.     

肝靶向抗病毒药NGA-ACV的制备及其趋肝性

以无唾液酸糖蛋白受体(asialoglycoprotein receptor,ASGP-R)的特异性配体——半乳糖基拟糖白蛋白(neoglycoalbumin,NGA)为载体,通过丁二酰基桥将抗病毒药无环鸟苷(acyclovir,ACV)与NGA偶联,得到肝靶向抗病毒药NGA-ACV。差热分析和高效液相色谱分析结果表明,NGA-ACV是共价键偶联物,且在血液中稳定性很好。将偶联物用¹³¹I标记后进行家兔放射性显像比较研究。结果,高、低药密度NGA-ACV的肝脏放射性分别是全身放射性的81.6%和86.6%,其趋肝性无明显差别。研究小鼠体内高药密度¹³¹I-NGA-ACV的分布,在5min时肝脏放射性达到峰值,为注入量的81.7±10.4%。受体竞争抑制实验表明NGA-ACV的肝靶向机理为受体介导的主动靶向过程。初步体外抗乙肝病毒比较研究表明,NGA-ACV较ACV的抗病毒剂量有明显降低。     

Thyrotoxicosis secondary to acute suppurative thyroiditis induced by a chicken bone

Acute bacterial thyroiditis is uncommon. Recently we had encountered a case of retropharyngeal abscess following chicken bone ingestion and complicated by thyrotoxicosis due to acute infective thyroiditis. We believed this is the first reported case of thyrotoxicosis induced by foreign body impacted at the upper digestive tract.      

A quick guide to survey research

Questionnaires are a very useful survey tool that allow large populations to be assessed with relative ease. Despite a widespread perception that surveys are easy to conduct, in order to yield meaningful results, a survey needs extensive planning, time and effort. In this article, we aim to cover the main aspects of designing, implementing and analysing a survey as well as focusing on techniques that would improve response rates.