A cross‐sectional study of psychological morbidity in patients with acne,psoriasis and atopic dermatitis in specialist dermatology and general practices

Background There is considerable evidence for an association of skin diseases with psychological morbidity. This relationship is best established for acne, psoriasis and atopic eczema. Previous studies have mostly been performed in specialist dermatological practice, and there is a lack of studies that include patients from general practice and a lack of controlled studies employing multivariate analysis. Aims/objectives This study aims to examine the relationship of acne, psoriasis and atopic eczema with psychological morbidities in patients recruited from general practice as well as specialist dermatology practice. Methods and subjects In this cross‐sectional study, 108 patients from general and specialist dermatology practices with the three diseases had disease severity assessed and completed measures of minor psychological disturbance (General Health Questionnaire‐12), anxiety and depression (Hospital Anxiety and Depression Scale), public self‐consciousness and social anxiety (Fenigstein Self‐Consciousness Scale), and neuroticism and extraversion/introversion (Eysenck Personality Inventory). Demographic data were also collected, along with self‐ratings of disease severity. Control subjects were 96 patients without skin disease recruited from the same general practices as the subjects. Results On univariate analyses, patients with skin disease had higher levels of minor psychological disturbance, public self‐consciousness and neuroticism than did controls. There were no differences in psychological measures between specialist and general practice patients or between patients with different skin diseases. On multivariate analyses, the significant differences did not persist. Conclusions This study demonstrates confounding in the relationship of skin diseases with psychological morbidity. The complex relationship of skin disease and psychological morbidity should be re‐examined.     

环氧乙烷对雄性大鼠精子形成影响的研究

用光镜和电镜观察环氧乙烷（ＥｔＯ）对精子形成的影响。Ｗｉｓｔａｒ雄性大鼠，静式吸入染毒，浓度为０、９０、３６０和８００ｍｇ／ｍ３，２ｈ／日，６日／周，连续染毒１３周或９周。结果表明，ＥｔＯ引起睾丸重量减轻，附睾尾精子数及活精率降低。低浓度（９０ｍｇ／ｍ３）组，电镜下可见少数异常形态结构的精子细胞和畸形精子尾丝。３６０ｍｇ／ｍ３组，染毒１３周，光镜下可见睾丸边缘部分曲细精管出现空泡，生精细胞减少，偶见多核巨细胞。电镜下观察，部分精细胞和支持细胞中线粒体受损及许多各种不同变态发育阶段的畸形精细胞，附睾尾精子畸形率明显升高。高浓度（８００ｍｇ／ｍ３）ＥｔＯ染毒９周，停止染毒４周后，生精细胞严重变性、坏死，曲细精管明显萎缩，生精细胞大部分消失。电镜下观察，所有精细胞崩解，附睾尾少精、死精或无精。结果提示，亚慢性吸入８００ｍｇ／ｍ３ＥｔＯ时，引起睾丸萎缩，出现死精或无精，损伤是不可恢复的。长期吸入低浓度ＥｔＯ对大鼠精子形成有影响，其中最敏感的是精细胞变态发育成精子的发育阶段。     

How to standardize vasomotor tone in serial studies based on quantitation of coronary dimensions?

In patients with coronary artery disease including those after coronary bypass graft operation and heart transplantation intervention studies based on serial quantitative coronary angiography, in part combined with intravascular ultrasound, are of increasing relevance. Since vasomotor tone of epicardial coronary arteries is influenced by a variety of factors, angiographic follow-up studies require standardization of coronary tone by induction of maximal dilation. We reviewed the effects of the most potent coronary vasodilatory drug groups, calcium antagonists and nitrocompounds, on coronary diameters. Intravenous or intracoronary injections of verapamil, diltiazem, nifedipine, nicardipine, and nisoldipine can cause profound coronary dilation which has been shown to be maximal with verapamil and nisoldipine. Shortcomings of calcium antagonists include short or unknown duration of action after bolus administration, severe drop in blood pressure, and lack of commercial availability of solutions for injection of many substances. Isosorbide dinitrate induces profound coronary dilation; however, after sublingual administration marked blood pressure decrease can occur, and the duration of action and ideal dose of intracoronary isosorbide dinitrate has not been investigated yet. Injections of molsidomine and its active metabolite, SIN-1, cause longlasting, reproducible, maximal coronary dilation, although only after a waiting period of at least 10 minutes; unfortunately, SIN-1 is only commercially available in France. Nitroglycerin induces reproducible maximal coronary dilation and is easy to administer sublingually or as intracoronary bolus injection with rapid onset of action and no major side effects. The short duration of action may require repeated administrations. To date, repeated intracoronary bolus injections of 0.1 mg nitroglycerin every 10 minutes seem to be the optimal known regimen for standardization of coronary vasomotor tone in serial angiographic studies. Further investigations in this field with old and new vasodilatory drugs are recommendable.     

罗库溴铵与琥珀胆碱对脑血管血流动力学的影响及比较

研究罗库溴铵与琥珀胆碱对脑血管血流动力学的影响，以进一步证明作为全麻诱导用药，前者取代后者的合理性。方法：４６例择期病人随机分成两组，罗库溴铵组（Ｒ组）２１例，琥珀胆碱组（Ｓ组）２５例。全麻诱导应用芬太尼和硫喷妥钠后，Ｒ组静注罗库溴铵０．９ｍｇ／ｋｇ，Ｓ组静注琥珀胆碱１．５ｍｇ／ｋｇ。分别于全麻诱导前后，静注肌松药后１、５、１０分钟时检测ＣＶＤＩ。结果：（１）两组全麻醉诱导后平均，最小脑血流量（Ｑ     

Clinically and mammographically occult invasive ductal carcinoma diagnosed by ultrasound: The focally dilated duct

A case of clinically and mammographically occult invasive ductal carcinoma presenting as a focally dilated duct on ultrasound is reported. The features of ductal dilatation in benign and malignant conditions on ultrasound are highlighted.