Test for decreased serotonin/tryptophan metabolite ratios in abstinent alcoholics

A segment of the population has a defect in the metabolism of tryptophan that causes a lowered concentration of serotonin in the central nervous system and indicates a predisposition towards chronic alcoholism. The metabolic defect in tryptophan metabolism is in the pathway between tryptophan and 5-hydroxyindoleacetic acid (5-HIAA) but not in the other pathways of tryptophan metabolism. A test using HPLC with amperometric detection was developed to detect the presence of an impaired serotonin metabolic pathway and therefore indicate a predisposition towards chronic alcoholism. The test used a ratio between 5-HIAA and two metabolites (indoleacetic acid and anthranilic acid) from the other pathways of tryptophan metabolism to indicate the presence or absence of an impaired serotonin metabolic pathway while correcting for variations in the concentration of urine.     

Median sternotomy and extended left anterior thoracotomy for repair of traumatic aortic transection with ruptured right atrium

A 22-year-old man presented with traumatic aortic transtion associated with rupture of the right atrium and underwent urgent median sternotomy to repair the right atrium. A T-shaped extended left anterior thoracotomy was performed, and ruptured descending thoracic aorta was repaired under total bypass. A Y-shaped connector was inserted in the arterial catheter to allow cannulation of both ascending aorta and femoral arteries. A 4-cm long Hemoshield graft was used to repair the aortic transection. The patient made a full recovery and was discharged 13 days after the accident.     

左旋氧氟沙星对小鼠结核分枝杆菌生长及细胞免疫的影响

目的探讨左旋氧氟沙星对小鼠结核分枝杆菌生长、特异性细胞免疫和病理改变的影响,探讨左旋氧氟沙星联合其他免疫治疗的可行性。方法 38只C57BL/6小鼠尾静脉注射H37Rv结核菌(1×106CFU/只),然后随机等分为两组,一组不作处理(对照组),另一组进行左旋氧氟沙星灌胃治疗(药物组),300mg/kg,每周灌5d,疗程28d。在治疗开始后不同时间点处死小鼠,计数肺组织结核分枝杆菌菌量、观察肺组织病理变化,测定脾细胞特异性细胞因子的产生情况。结果左旋氧氟沙星能有效抑制小鼠肺组织结核分枝杆菌的生长,与对照组比较,药物组小鼠服药期间细菌量减少100倍,停药后30d仍减少10倍,差别有统计学意义(P0.05)。同时药物治疗能减轻肺组织病理变化的程度。药物组小鼠脾细胞分泌卡介苗(BCG)特异性细胞因子IFN-γ、TNF-α、IL-10和IL-17水平明显高于对照组(P0.05)。结论左旋氧氟沙星能有效抑制小鼠结核分枝杆菌的生长,同时能改善肺组织的病理变化和促进小鼠脾细胞分泌特异性细胞因子。     

Oddi＇s括约肌切开成形术43例疗效分析

目的 探讨Oddi＇s括约肌切开成形术的疗效.方法 回顾分析43例括约肌切开成形术的临床资料.其中胆囊切除术后括约肌狭窄11例,胆管壶腹部结石嵌顿3例,胆总管切开取石伴胆管末端狭窄19例,复发性胆源性胰腺炎6例,内镜下括约肌切开术后4例;第1次手术24例,第2次手术19例.结果 腹部切口感染5例,短暂性胆漏2例,括约肌手术处渗血3例,37例（占86%）经5～15年随访,效果满意.结论 正确掌握手术适应证和操作方法,可取得良好效果.     

Does the severity of bilateral carpal tunnel syndrome influence the timing of staged bilateral release?

A retrospective chart analysis was performed of 66 patients with bilateral carpal tunnel syndrome (CTS) who underwent either single endoscopic carpal tunnel release (ECTR) or staged bilateral ECTR to determine the frequency and timing of contralateral surgery. Bilateral CTS patients with contralateral severe CTS underwent bilateral staged ECTR 86% of the time and the second operation was performed 6 ± 5 weeks after the initial ECTR. Patients with contralateral moderate CTS underwent bilateral staged ECTR 74% of the time with a mean of 11 ± 3 months between operations. Patients with contralateral mild CTS underwent bilateral staged ECTR 20% of the time and averaged 7 ± 3 years between procedures. For patients with bilateral CTS, the severity of CTS on the contralateral side to the initial release affects both the frequency and timing of the contralateral surgery. This information may be used to establish guidelines for treatment with bilateral simultaneous CTR.     

Interventional catheter magnetic resonance angiography with a conventional 1.5-T magnet: work in progress

Magnetic resonance contrast enhancement depends on the relative timing of image acquisition. Limited human trials have demonstrated efficacy of intra-arterial gadolinium diethylenetriaminepentaacetic acid (Gd-DTPA) in delineating vascular anatomy with X-rays. The present study assessed the ability of dynamic MR during intra-arterial Gd-DTPA administration to demonstrate vascular anatomy compared to conventional angiography as the gold standard. As interventional MR techniques using dedicated magnets proliferate, the ability to perform invasive MR angiography with a conventional magnet would be of great utility at established sites. Four subjects referred for different types of angiography underwent dynamic MR studies, including one with iliac artery stenting (Palmaz P204, Johnson and Johnson). All were examined with conventional angiography, and again after dynamic intra-arterial (IA) Gd-DTPA infusion. Coronal MRI images of the body were acquired using a 1.5-T superconducting magnet (three with a GE Signa, one with Philips NT), fast spoiled gradient echo (FSPGR); echo time (TE) = 4.2 msec, repetition time (TR) = 68-150 msec, flip = 75 degrees, 0-600 s after dilute Gd-DTPA IA bolus injection during sequential breath-hold acquisitions of 13-32 s each. All arteries were detected with dynamic MR. The FSPGR MRI with IA Gd-DTPA administration can provide adequate time and spatial resolution to demonstrate arterial anatomy and arterial stent patency.