Spontaneous growth in Chinese patients with Turner's syndrome and influence of karyotype

The pretreatment mixed cross-sectional and longitudinal height measurements of 203 patients with Turner's syndrome (TS) were analysed. Only one observation was included per year per child and a total of 858 observations formed the basis of the growth study. The mean and SD values were fitted separately by a second-degree polynomial function, giving smoothed growth curves. The spontaneous growth pattern of Chinese girls with TS runs parallel to published Caucasian TS growth curves. The mean final height of Chinese patients with TS was 142 cm compared to 147 cm and 139 cm observed in Northern European and Japanese patients, respectively. Patients with the 46, X, i(Xq) karyotype were found to be significantly shorter, whereas children with the 45, X/46, XY and 46, X, del(Xq) karyotypes were significantly taller among this group of patients. Patients with TS who were disomic for Xp are significantly taller than patients who were monosomic for Xp. Our results suggest that karyotype can have a significant effect on the growth of children with TS.     

Differences Among Obstetricians in Caesarean Section Rates

EDITORIAL COMMENT: The editor was once engaged in what was said to be the longest ever running case of medical investigation in Australia against an obstetrician whose Caesarean section rate was claimed to be excessive. The leading expert witnesses on both sides of the case were required to table the Caesarean section rates in their private practices. Who will be surprised to learn that both, including the editor, reported a rate above 20%. We are all charitable to ourselves when relating the high-risk nature of our private practices, with many women referred with previous Caesarean section or poor perinatal result. This paper is carefully restricted to low-risk nulliparas. In Melbourne, for a time, it was practice to notify each consultant of his/her Caesarean section rate and each was provided with an anonymous list of his/her colleagues' rates. In the Mc Bride case referred to above, the Judge asked the expert witness - 'do not the doctors in your institution with notification of low Caesarean rates fear accusation of malpractice?'
Summary: This retrospective study examined the Caesarean section rates of 15 obstetricians at 1 hospital delivering 5,559 nulliparas with a single cephalic baby of birth-weight ≥ 2,500 g. There was a wide variation in obstetricians' Caesarean rates, whether considering all their deliveries (5.5% to 20.1%), deliveries of their own patients (8.9% to 28.2%), or deliveries of their colleagues' patients (4.5% to 17.9%). There was no relation between Caesarean rates and perinatal outcome. The different Caesarean section rates among the obstetricians could not be explained by institutional factors, physician convenience, patient differences, or self-serving economic incentives.     

Pathologic response and microdosimetry of Y microspheres in man: Review of four explanted whole livers

INTRODUCTION: Radioactive microsphere (90)Y therapy is increasingly used for primary and metastatic solid tumors in the liver. We present an analysis of 4 explanted livers previously treated with (90)Y microsphere agents (glass or resin). One tumor nodule was analyzed with submillimeter three-dimensional microdosimetry. METHODS AND MATERIALS: Four patients received hepatic artery delivery of (90)Y microspheres for unresectable hepatocellular and colon cancers. Whole livers were explanted as part of lifesaving cadaveric transplant in 2 patients with hepatoma. These patients had received glass microspheres as a procedural bridge to transplant. Autopsy was performed on 2 patients with colon cancer who died of progressive metastatic disease and who had been treated with resin microspheres. Complete pathologic review was performed on each whole liver, including estimation of the response of the tumor to therapy, distribution of microspheres in the tumor and normal liver tissues, and normal-tissue radiation response. A biopsy taken from the edge of a tumor nodule was sectioned serially for three-dimensional radiation dosimetry analyses. Three-dimensional microsphere coordinates within the biopsy specimen were used to calculate dosage using a three-dimensional dose kernel. Isodose coverage of tumor and normal liver areas and total dose delivered were determined. RESULTS: Preferential and heterogeneous deposition of microspheres was noted at the edge of tumor nodules compared with the center portion of the tumor or normal liver parenchyma. Both glass and resin microspheres delivered high cumulative doses to the tumor, which varied from 100 Gy to more than 3000 Gy. No veno-occlusive disease or widespread radiation hepatitis was seen. CONCLUSION: Microsphere ((90)Y) therapy delivers high numbers of spheres with resulting high total doses of radiation, preferentially in the periphery of tumors. Normal liver parenchyma showed little radiation effect away from the tumors. Heterogeneous high-dose regions in the tumor were produced by both glass and resin microspheres.     

Measuring the occupational balance of people with insomnia in a Chinese population: Preliminary psychometric evidence on the Chinese version of the Occupational Balance Questionnaire

BackgroundOccupational balance, a fundamental concept in occupational therapy, is the arrangement of right amount and variety of occupations contributes to a person’s health and well-being. This study was aimed to investigate the reliability and validity of the Chinese version of the Occupational Balance Questionnaire (OB-Quest) for people with insomnia.MethodsThe OB-Quest was translated into traditional Chinese and reviewed by an expert panel for content validity, cultural relevance and translation accuracy. Internal consistency, factor analysis and convergent validity, as well as test–retest reliability, were explored.ResultsThe participants (n = 205), 115 adults with insomnia and 90 adults without insomnia, completed a survey of demographic background, the Chinese version of OB-Quest and the Chinese Insomnia Severity Index (C-ISI). The Chinese version of OB-Quest demonstrated excellent test–retest reliability (ICC= 0.98) and good internal consistency (Cronbach’s α  =  0.80). Factor analysis indicated that a single-factor solution explained 42% of the variance, and 9 out of 10 items had a factor loading of 0.4 or above. The Chinese version of OB-Quest had significant correlations with C-ISI (r = –0.88; p < 0.001). A significant difference was found in occupational balance between groups with different levels of insomnia severity and without insomnia (F = 169.72; p < 0.001). As in a previous study, age, living environment and life role had no significant relationship with occupational balance.ConclusionThe Chinese version of OB-Quest is a short, easy to understand and culturally relevant assessment for Chinese. It demonstrates satisfactory psychometric properties and had significant correlations with insomnia.     

新生儿心脏直视手术5例围术期的监护

0　引言　先天性心脏病是先天畸形中常见的一种,由于胎儿的心脏在母体内发育有缺陷或部分停顿所造成.随着外科手术及术后监护技术的提高,近些年先心病在新生儿即施行手术根治,我院1998-11/1999-10共为5例新生儿实施心脏直视手术,术后患儿顺利康复.1　临床资料　本组5(男4,女1)例,年龄7～27(20±4)d,均为足月顺产,体质量3～5(3.6±1.1)kg.有4例为室间隔缺损、房间隔缺损、肺动脉高压,1例为法乐三联症,1例合并有动脉导管未闭.其中术前2例患儿出生后发育差,产后即合并新生儿肺炎,抗菌素治疗肺炎控制后转入我科,在全麻中低温体外循环下行心脏直…     

Partial, combined cortical and medullary nephrocalcinosis: US and CT patterns in AIDS-associated MAI infection

An unusual pattern of nephrocalcinosis associated with Mycobacterium avium-intracellulare infection and asymmetrically involving the renal cortex and medulla in a patient with acquired immunodeficiency syndrome (AIDS) is reported. This pattern, "partial nephrocalcinosis," differs from the increased parenchymal echogenicity seen on ultrasound and the parenchymal calcification noted on computed tomography that result from other causes. Partial nephrocalcinosis should suggest an infection such as one caused by M. avium-intracellulare.     

有机硒氰类化合物的合成及其对肿瘤的化学抑制作用

目的：有机硒氰化合物的合成和肿瘤抑制作用研究。方法：通过苄基卤代、硒氰酸钾的取代反应制备了１５个苄基硒氰化合物,并对Ａ－５４９人肺腺癌细胞和Ｐ３８８小鼠白现肿瘤细胞生长进行了抑制试验。结果：１５个苄基硒氰化合物４的结构都经过了分析确证;目标化合物对Ａ－５４９人肺腺癌细胞和Ｐ３８８小鼠白血病肿瘤细胞的生长都有抑制作用。结论：其中一些化合物活笥较好值得进一步研究。     

双波长分光光度法测定复方萘替芬霜的含量

用双波长等吸收点法测定复方萘替芬霜中萘替芬和酮康唑的含量。方法：萘替芬测定在２８３ｎｍ和３０１ｎｍ进行。酮康唑测定在２４２ｎｍ的２６５ｎｍ进行。结果：该法线性良好,精密度高。结论：该法可用于复方萘替芬霜的含量测定。     

Secondary changes in diabetes mellitus with particular reference to retinopathy and neuropathy

It has previously been suggested (1) that respiratory modulation of the action of insulin on glucose metabolism may contribute to macrosomia in neonates from diabetic mothers. It was proposed that this was due to a relative hypoxaemia which resulted in an increase in glucose metabolised through the hexose monophosphate shunt pathway in fetal adipocytes. This could be understood on the basis of the Crabtree-Pasteur Effects. It is now suggested that a similar mechanism may lead, in certain tissues, to an increase in the metabolism of glucose through polyol pathways and that this may play a role in the development of diabetic sequelae.