Experimental evaluation of various available contrast agents for use in the gastrointestinal tract in case of suspected leakage. Effects on pleura

Intrapleural injections of seven contrast agents were carried out in experimental rats in order to find a safe contrast agent to use in the radiological examination of the upper gastrointestinal tract in cases where leakage outside the upper gastrointestinal tract into the pleural space could be suspected, particularly post-operatively. The contrast agent in such cases could enter the mediastinum, pleura, peritoneum or lungs and bronchi. Hexabrix (May and Baker) and Gastrografin (Schering AG) produced the least tissue reaction in the pleura. Due to the potential risk of aspiration in such cases Gastrografin is not suitable as it is known to produce significant reaction in the lungs and may even prove to be fatal. Hexabrix, therefore, appears to be the safest contrast agent where leakage into the pleural space may be suspected.     

新疆铁路工人1001名体质状态相关分析

目的:调查新疆铁路工人的体质状况,并分析体质量指数和血糖、血脂及肝胆疾病之间的关系。方法:调查于2006-02/03进行。选择新疆乌鲁木齐铁路局公务段(盐湖-乌西)铁路职工1001人,测量其身高、体质量,计算体质量指数(<18.5kg/m2为体质量过低,18.5～24.9kg/m2为正常,25.0～29.9kg/m2为超重,>30kg/m2为肥胖);检测血脂(总胆固醇≥5.7mmol/L为高胆固醇血症;三酰甘油≥1.7mmol/L为高三酰甘油血症)、空腹血糖(≥7mmol/L为高血糖);B超观察肝、胆、脾、肾等器官。结果:受试者1001人全部进入结果分析。①体质量指数、三酰甘油、胆固醇、血糖值男女间未见差异。②体型正常者598人(59.74%),超重和肥胖者385人(38.46%)。③高三酰甘油症检出率:肥胖组明显高于体质量过低和正常组(58.33%,23.08%,7.32%,P<0.01);女性明显高于男性(23.95%,3.41%);体型正常者中女性明显高于男性(25.63%,0.68%)。④高胆固醇症、高血糖检出率男女比较差异不显著(P>0.05);超重者中女性高血糖检出率高于男性(10.14%,3.61%,P<0.05)。⑤脂肪肝检出率肥胖者最高为53.84%,体质量过低者最低5.56%;男性脂肪肝检出率高于女性(22.28%,16.81%,P<0.05);胆囊炎、胆结石检出率男女比较差异不显著。结论:①1001名铁路工人中体型异常者占40.36%,其中超重和肥胖者占38.66%。②随体质量指数增加,脂肪肝、高血脂检出率明显增加。     

Intraperitoneal toxicity of Hytrast: an experimental study

The toxic effects of Hytrast were studied on the peritoneum of laboratory rats in order to define the lethal dose and possible causes of toxicity. The results show that Hytrast, due to its toxicity, should not be used in any clinical situation where gastrointestinal tract perforation or leakage is a possibility.     

PGE1 abolishes the mitochondrial-independent cell death pathway induced by D-galactosamine in primary culture of rat hepatocytes

Background and Aim:  PGE₁ reduces in vivo and in vitro D-galactosamine (D-GalN)-induced cell death in hepatocytes. The present study was undertaken to elucidate the intracellular pathway by which D-GalN induces cell death in cultured hepatocytes. In addition, we evaluated if PGE₁ was able to modulate different parameters related to D-GalN-induced apoptosis in cultured rat hepatocytes.
Methods:  Hepatocytes were isolated from male Wistar rats (225–275 g) by the classical collagenase procedure. PGE₁ (1 µM) was administered 2 h before D-GalN (5 mM) in primary culture of rat hepatocytes. Apoptosis was determined by DNA fragmentation and caspase-3, -6, -8 and -9 activation in hepatocytes. Caspase activation was evaluated by the detection of the related cleaved product and its associated activity. Cell necrosis was determined by the measurement of lactate dehydrogenase (LDH) activity in culture medium. To elucidate the role of mitochondria, we measured neutral (nSMase) and acid (aSMase) sphingomyelinase, as well as the expression of cytochrome c in mitochondria and cytoplasm fractions from D-GalN treated hepatocytes.
Results:  D-GalN induced caspase-3 activation and DNA fragmentation in hepatocytes. This apoptotic response was not associated with the activation of caspase-6, -8 or -9. The use of specific inhibitors confirmed that only caspase-3 was involved in D-GalN-induced apoptosis. D-GalN did not modify nSMase and aSMase activities, nor mitochondrial cytochrome c release in hepatocytes.
Conclusions:  D-GalN induced apoptosis through caspase-3 activation but without modification of the activity of caspase-6, -8, -9, SMases or cytochrome c release. PGE₁ appears to prevent D-GalN-induced apoptosis by a mitochondria-independent mechanism.     

Demographics of extra-articular calcaneal fractures: including a review of the literature on treatment and outcome

Introduction  Extra-articular calcaneal fractures represent 25–40% of all calcaneal fractures and an even higher percentage of up to 60% is seen in children. A disproportionately small part of the literature on calcaneal fractures involves the extra-articular type. The aim of this study was to investigate the incidence of extra-articular calcaneal fractures in a Level 1 trauma centre, define the distribution of the various types of fractures and compare patient demographics between extra- and intra-articular calcaneal fractures. In addition the literature was reviewed for the most common types of extra-articular calcaneal fractures with regard to incidence, treatment and clinical outcome. Methods  The radiological records between 2003 and 2005 were reviewed for intra- and extra-articular calcaneal fractures. Patient gender-distribution and age were compared. A literature search was conducted for the treatment of extra-articular calcaneal fractures. Results  In this 3-year study period a total of 49 patients with 50 extra-articular calcaneal fractures and 91 patients with 101 intra-articular fractures were identified. The median age for the first group was 32.7 years, and for the second group 40.3 years; P = 0.04. Male predominance was significantly less pronounced for extra-articular (63%) compared with intra-articular fractures (79%; P = 0.04). Conclusion  One-third of all calcaneal fractures are extra-articular. Significant differences exist between the intra- and extra-articular groups, in terms of lower age and male–female ratio. The literature study shows inconsistencies in treatment options, but most extra-articular fractures are well manageable conservatively.