大肠杆菌内毒素所致肺血管收缩部位及山莨菪碱的作用

将动、静脉阻断法用于恒速灌流的在体山羊左肺,使其总压力降区分为动脉端、静脉端及中间段三部分。大肠杆菌内毒素主要升高肺静脉端压力降及肺毛细血管压;山莨菪碱可显著缓解内毒素所致的改变,但对正常肺血管各段压力降无明显影响。5-羟色胺主要升高肺动脉端压力降,对肺静脉端及毛细血管压无明显影响。去甲肾上腺素及组胺主要升高肺静脉端压力降及肺毛细血管压,但对肺动脉端无明显影响。去甲肾上腺素和组胺可能介导内毒素性肺动脉高压。     

Sleep apnea--an overview

Though distressing and potentially dangerous, sleep apnea may be an under-recognized disease in many countries. The obstructive type, which usually presents with loud snoring and excessive daytime sleepiness, is by far the commonest form. It causes a great deal of medical, social and psychological morbidity as well as an increased mortality. Doctors of different specialties have an important role in detecting and referring suspected patients for early assessment and treatment. Multidisciplinary management in a general hospital and accurate assessment with polysomnography are essential as modern and sometimes effective methods of treatment are becoming available.     

Effect of etodolac on the prostaglandin concentrations in the kidney of the normal rat

The effect of acute and subchronic dosing with etodolac on the renal PGE₂ and 6-keto-PGF_1α concentrations in the normal rat were studied. Etodolac and other nonsteroidal antiinflammatory drugs (NSAIDs) were administered orally, at equieffective antiinflammatory doses, to normal rats either as a single dose or as seven daily doses. Whole kidney prostaglandin (PG) concentrations were measured. In the acute study, etodolac (3 mg/kg) did not significantly lower the PGE₂ levels for up to 4 hr postdosing. In contrast, naproxen (3 mg/kg) and piroxicam (0.5 mg/kg) significantly decreased the PGE₂ levels to about 20% and 60% of control, respectively. Similar reductions in 6-keto-PGF_1α concentrations were observed. In the subchronic study, etodolac (3 mg/kg/day) did not lower either PGF₂ or 6-keto-PGF_1α concentrations whereas naproxen (3 mg/kg/day), piroxicam (0.5 mg/kg/day), indomethacin (1 mg/kg/day), and aspirin (300 mg/kg/day) significantlydecreased both PGs. In both studies, the effect of etodolac was significantly different from that of the NSAIDs. It is concluded that etodolac possesses only a very weak capacity to lower renal PGs, and therefore is unlikely to cause any renal complications related to PG biosynthesis inhibition.     

A population-based study of repeat hospital admissions due to interpersonal violence for children aged 0–9 years

To assess the magnitude and nature of interpersonal violence resulting in hospitalisation of children and to identify subgroups at risk of repeat hospital admissions, a population-based, retrospective study of all violence hospitalisations in Western Australia for children aged 9 years or less was undertaken, using the 1990–2004 linked data retrieved from the Western Australian Mortality Database and the Hospital Morbidity Data System.
Of the 747 patients aged <10 years incurring 834 hospitalisations for the consequences of violence during the study period, 570 (76%) were less than 4 years of age. A total of 43 deaths from violence were recorded and 74 (9%) patients were admitted for more than one episode of violence. Victims aged 0–4 years from rural (hazard ratio [HR] = 2.72; 95% confidence interval [CI] 1.35, 5.43) and remote parts (HR = 2.79; 95% CI 1.25, 6.25) of the state were at increased risk of a subsequent admission for violence compared with those residing within the metropolitan area. Indigenous children aged 5–9 years were significantly more likely (HR = 3.57; 95% CI 1.14, 11.13) to incur a second hospitalisation for violence than their non-Indigenous counterparts. The identification of young victim subgroups at high risk of repeat hospitalisations is important for developing intervention strategies to reduce the burden of interpersonal violence. Young children aged 0–4 years living in rural and remote locations and Indigenous children aged 5–9 years should be specifically targeted for attention.     

Spontaneous disappearance of a suprasellar arachnoid cyst: case report and review of the literature

Introduction Suprasellar arachnoid cysts are uncommon developmental anomalies that are most often diagnosed in childhood. Because the natural history and pathogenesis of these remain poorly defined, optimal treatment guidelines are not yet established.Case report We report a case of spontaneous disappearance of a suprasellar arachnoid cyst that persisted after a ventriculoperitoneal shunt performed 10 years earlier. A 5-year-old boy presented with impaired visual acuity and urinary incontinence. Magnetic resonance (MR) imaging showed a large suprasellar cyst with noncommunicating hydrocephalus. A ventriculoperitoneal shunt was put in place to alleviate current aggravation of hydrocephalus symptoms. Because of the persistent size of the cyst and signs of brainstem compression on a repeat computed tomography (CT), we recommended surgical exploration and decompression. However, the boy’s parents declined any further surgical treatment, and the patient was subsequently lost to follow-up for 10 years. When the patient returned to our clinic at the age of 15 years, a repeat MR scan showed a complete disappearance of the cyst. His family denied any significant interval history.Discussion This case represents only the third reported case of spontaneous disappearance of a suprasellar arachnoid cyst. We discuss possible mechanisms and clinical characteristics of the disappearance of the arachnoid cyst with review of the literature.