Morbid obesity treated by gastroplasty: radionuclide gastric emptying studies

Mechanisms by which gastroplasty for morbid obesity causes weight loss are poorly understood. We studied the role of altered gastric emptying in 50 patients before surgery, 1-4 weeks after surgery, and 2-24 months after surgery using technetium-99m pentetate in water for liquid meals and a Tc-99m styrene divinylbenzene copolymer resin in oatmeal for semisolid meals. We determined the emptying half-times of the stomach before and after surgery in the proximal and distal compartments. The proximal compartment emptied promptly in the early and late postoperative periods. The distal compartment emptied liquids at rates similar to those before surgery, while the late postoperative emptying of semisolids was significantly faster. The stoma connecting the two compartments thus permits rapid transit of liquids and semisolids without delay of distal compartment emptying. No correlation was seen between the emptying half-times or changes thereof and eventual weight loss. Delayed gastric emptying is therefore not the mechanism for satiety and weight loss after gastroplasty has been performed.     

腹腔镜在小儿离断性肾盂成形术中的应用与随访

目的 探讨腹腔镜下离断性肾盂成形术的效果及适应证.方法 总结21例经腹腔途径行腹腔镜离断性肾盂成形术治疗肾盂输尿管连接部狭窄(UPJO)所致肾积水的经验,对比同期开放手术治疗的35例患儿术后影像学.结果 第一例腹腔镜肾盂成形术历时4 h 50 min,随后的20例为1 h 40 min～2 h 30 min,术中出血量5～10 ml.20例术后3～5 d出院,恢复好.1例术后7 d因患儿外伤性肾盂内出血,血块堵塞双J管,致肾盂漏尿、形成尿腹,遂行开放探查术;术中见吻合口良好,清除肾盂内血块,冲洗双J管,放置.肾造瘘管,7 d后拔除肾造瘘管出院.21例患儿术后4～6周拔除双J管.2组患儿均分别在术后1个月、3个月、6个月行B超或CTU检查.腔镜组吻合口通畅率为95.2%(20/21),开放组为100%(35/35),二者差异无显著性意义.结论 熟练掌握腹腔镜缝合技术,是圆满完成经腹腔镜离断性肾盂成形术的基础.腹腔镜下手术创伤轻微,手术效果与传统的开放手术无差别;在应用腹腔镜肾盂成形术的初期,宜选择中度以下肾盂扩张的病例,待熟练后,逐步应用于重度积水病例,确保手术效果.     

Effects of Three Anthelmintic Regimes on Milk Yield of Ewes and Growth of Lambs

Forty ewes were allocated into one of four groups (n = 10) and were treated with albendazole (ALB) (3.8 mg kg⁻¹) before lambing (group A), with ALB before and after lambing (group B), with moxidectin (MXD) (0.2 mg kg⁻¹) before lambing (group C) or were untreated controls (group D). Counts of nematode eggs in faeces and coprocultures were carried out during the study, as well as ewes’ milk yield measurements and lamb weighings. Pre‐treatment mean eggs per gram (epg) counts were 640, 715, 625 and 630 for groups A, B, C and D, respectively (P > 0.05); respective counts 21 days after treatment were 5, 0, 0 and 690 epg, whilst 70 days after treatment they were 380, 145, 40 and 1120 epg. Mean lactation milk yield was 3527.5, 3893.5, 3786.4 and 3285.9 ml for groups A, B, C and D, respectively; no significant difference was evident among the four groups in milk yield collected during the suckling period, although subsequently, group B or C ewes yielded significantly more milk than controls (P < 0.05). Mean birthweight of lambs were 3.56, 3.45, 3.59 and 3.26 kg for groups A, B, C and D, respectively (P = 0.045); subsequently, lambs from treated ewes were significantly heavier than lambs from control animals (P < 0.001). We conclude that anti‐parasitic treatment during the last month of pregnancy contributed to an increased birthweight of lambs of treated ewes, whilst the cumulative effect of two doses of ALB or the long persistent efficacy of MXD provided a longer protection of animals against new parasitic infections and contributed to a lactation persistence.     

Delayed hepatic CT scanning: increased confidence and improved detection of hepatic metastases

Fifty oncologic patients with suspected hepatic metastases were prospectively evaluated by dynamic sequential hepatic computed tomography (DSHCT) and by delayed iodine hepatic computed tomography (DICT) scanning. DICT scanning was performed 4-6 hours following administration of 60 g of intravenous iodine. Both techniques were evaluated for lesion definition relative to the adjacent hepatic parenchyma and for numbers of metastases detected. Metastases were detected by both techniques in 26 patients. Fifteen patients (58%) had lesions better defined by DICT. DICT scanning detected more metastases in seven of these 15 patients. In eight patients (31%), there was no difference between the two techniques in numbers of masses detected or lesion definition. In three cases (11%), metastases were more confidently identified on the initial or DSHCT scan. DICT scanning, as described, is useful in defining and detecting hepatic metastases, especially where there is questionable hepatic involvement or better quantification of size is necessary.     

Recent patterns in chronic disease mortality in remote living Indigenous Australians

Background  

Despite the well-recognised Indigenous-non-Indigenous health disparity, some reports suggest improvements in Indigenous mortality. Our aim was to quantify Indigenous mortality in Outer Regional (OR), Remote (R), and Very Remote (VR) areas in New South Wales, Queensland, South Australia, Western Australia, and the Northern Territory and changes in mortality from 1998 to 2005.     

国家级首批线上一流课程免疫学基础与病原生物学的建设与推广

线上一流课程作为一种新型的教学课堂模式,其建设与推广不仅使教师的教和学生的学呈现多元化,而且也使教师的教学和研究水平、学生的学习兴趣和能力得到了有效提升。本团队建设与推广的国家级首批线上一流课程免疫学基础与病原生物学已经完成6个学期的运行,累计学习人数40 395人,累计选课学校84所。本文从建设背景与建设目标、整体框架与建设资源、实施过程与推广应用、教学运行与互动、教学考核与评价、思考和展望等6个方面总结该课程的建设与推广情况。     

Direct identification of Yersinia enterocolitica in blood by polymerase chain reaction amplification

Primers based on the nucleotide sequence of the virF gene in the pYV plasmid and the chromosomal ail gene were used in polymerase chain reaction (PCR) amplifications to directly identify Yersinia enterocolitica in blood. Approximately 500 bacteria seeded into 100 microL of blood can be extracted and amplified by PCR to yield positive results. PCR analyses of seven Y. enterocolitica isolates previously implicated in blood contaminations showed that only one isolate harbored the plasmid-borne virF gene; however, all seven isolates were identified effectively by the PCR product amplified from the chromosomal gene. The PCR assay has the potential for use in the identification of Y. enterocolitica contamination in stored units of blood or in the rapid diagnosis of transfusion-related bacteremia caused by Y.