Acute subarachnoid haemorrhage: A rare presentation of cerebral dural sinus thrombosis

We report a case of cerebral dural sinus thrombosis presenting as acute subarachnoid haemorrhage and clinically mimicking an aneurysmal bleed. Awareness of this rare initial presentation of cerebral venous thrombosis is important and should be considered in the diagnostic work‐up of acute subarachnoid haemorrhage. The radiologist plays a crucial role in making this often unsuspected but important diagnosis to enable prompt appropriate treatment.     

Mitomycin-C induced hemolytic uremic syndrome: a case report and literature review

Hemolytic uremic syndrome spontaneously arises in a few patients with advanced cancer, but it is more commonly related to the use of certain chemotherapeutic agents. Mitomycin-C is, etiologically, the most common causative agent inducing hemolytic uremic syndrome, in a dose dependent manner. We report this syndrome, attributable to mitomycin-C at a cumulative dose of 40 mg/m2, in a gastric cancer patient. A 42-year-old female with stage III gastric cancer underwent radical gastrectomy and was given mitomycin-C at 10 mg/m2 intravenously every four weeks as adjuvant therapy. Hemolytic uremic syndrome was diagnosed three months after the last dose of mitomycin-C administration. The most prominent symptoms included pallor, hypertension and anasarca, with laboratory evidence of microangiopathic hemolytic anemia, azotemia and hyperkalemia. Her disease was progressive, but fortunately stabilized after staphylococcus column A dialysis. Her disease remained in remission for 24 months from the time of diagnosis, and then relapsed in the form of peritoneal carcinomatosis with partial intestinal obstruction.      

Prevalence and aetiology of neurological impairment in extremely low birthweight infants

Objective : To determine the prevalence and perinatal predictors of cerebral palsy, intellectual impairment, visual impairment and deafness in a cohort of extremely low birthweight (ELBW) infants at two years of age.
Methodology : The study population comprised 199 of the 224 (89%) ELBW infants managed at the Mater's Mothers Hospital, Brisbane, between July 1977 and February 1990 and who survived to two years. The prevalence of cerebral palsy, intellectual impairment, blindness and deafness was measured by clinical, psychometric and audiological assessment and the association with 24 risk factors examined.
Results : Cerebral palsy occurred in 20 children (10%). Risk of cerebral palsy was associated with ventricular dilatation, intraventricular haemorrhage, necrotizing enterocolitis and multiple birth, though only ventricular dilatation (OR 4.41; 95% Cl 1.32-14.8) remained significant in the adjusted analysis. Intellectual impairment occurred in 20 children (10%) and was independently associated with ventricular dilatation (OR 15.0; 95% Cl 2.2-102.8), ventilation F _iO₂ >80% (OR 3.4; 95% Cl 1.01-11.5), vaginal delivery (OR 3.5; 95% Cl 1.09-11.4) and male sex (OR 6.1; 95% Cl 1.67-22.3). No perinatal predictor was statistically associated with risk of deafness. Retinopathy of prematurity (OR 36.9; 95% Cl 2.8-495.5) was associated with risk of later visual impairment.
Conclusions : Intellectual impairment was associated with a broad range of perinatal variables. Cerebral palsy was associated with fewer variables, all of which were also associated with intellectual impairment. Neurologic injury was associated with male sex and multiple birth, which are not biological insults themselves, but may be markers of susceptibility to injury.     

套管针连续臂丛阻滞行断指(肢)再植手术35例

０　引言　臂丛阻滞是上肢手术常用的麻醉方法［１］．但这种阻滞方法作用时间短,对于较长时间的上肢手术,因反复穿刺而造成局部损伤较大,神经损伤率增高,患者痛苦增加．断指（肢）再植手术［１］是上肢手术中时间较长者,要求阻滞作用完善．为探讨一种阻滞时间灵活、损伤小、作用确切的麻醉方法,我们受连续硬膜外麻醉的启发［１］,摸索出连续臂丛阻滞方法,现介绍如下．１　对象和方法１．１　对象　急诊断指（肢）再植手术３５（男２８,女７）例,年龄１８岁～４７岁,均因锐器伤而造成指体离断和上肢远端离断,其中１指离断５例,…     

多发性大动脉炎的麻醉

０引言多发性大动脉炎尤其侵及双侧颈总动脉、双锁骨下动脉及无名动脉罕见,我院心脏外科及血管外科近日联合手术１例该病例,现简述其麻醉特点及特殊处理．１临床资料女性,３０岁,５０ｋｇ,头晕,头昏伴心悸,出汗,双上肢冰凉,麻木,查血压右上肢０／０ｋＰａ,右下...     

去氢紫堇碱对兔血小板TXB2及主动脉6-keto-PGF1PGF1α含量的影响

Dehydrocorydaline (DHC) was shown to reduce the production of thromboxane B₂ (TXB₂)in platelets and 6-keto-prostaglandin F_1α (6-keto-PGF_1α in the aorta of rabbits in vitro. The effect of DHC increased with the increase of dose.DHC 0.41 mg was found to inhibit the formatiom of TXB₂ markedly while not reduce the content of 6-keto-FCF_1α. DHC also exhibited obvious inhibitory effect on the arachidonic acid (0.66mmol/L) induced formation of platelet malondialdehyde (MDA). These effects were similiar to the specific cycloxygenase inhibitor, aspirin (0.03 mg/ml). The results suggest that (1) DHC reduced both contents of TXA₂ and PGI₂ in vitro. (2) DHC markedly inhibited the system of cycloxygenase in cell microsomes. (3) As to whether TXA₂ synthetase or cycloxygenase was inhibited in these experiments is still to be elucidated.     

黄柏及中成药中小檗碱和巴马亭的高效液相色谱法测定

本文以正相高效液相色谱法,用窗口图解技术对色谱条件进行了优化。对黄柏及其中成药中的有效成分——小檗碱、巴马亭的提取、测定条件、标准曲线进行了研究。并对两种含黄柏的中成药样品进行了分析。其中小檗碱的回收率均在97%以上,巴马亭的回收率均在96%以上。