Transvaginal sonography in the morphological and functional assessment of segmental dilation of the distal ureter.

Primary megaureter presents a spectrum of findings ranging from mild, clinically unimportant, stable ureterectasis to severe, progressive obstructive hydroureteronephrosis. We report a patient with a double uterus and ipsilateral renal dystrophy. A previous imaging study had revealed a double uterus and obstructed left hemivagina, into which a single vaginal ectopic ureter inserted. On follow-up intravenous urography 8 years later, the left kidney was non-functioning, and there was segmental dilation of the distal right ureter. Transvaginal sonography with real-time scanning and Doppler were useful in exploring the morphological and functional status of this dilated distal ureter.     

The significance of a rapid cold hemagglutination test for detecting mycoplasma infections in children with asthma exacerbation.

BACKGROUND AND PURPOSE: Mycoplasma pneumoniae infection is a frequent cause of community-acquired respiratory infections in children and adults. However, standardized, rapid, specific methods for its diagnosis are lacking. The relationship between M. pneumoniae infection and asthma exacerbation has been recently discussed in the literature. We investigated the accuracy of rapid detection of mycoplasma infection by cold hemagglutination test compared to conventional enzyme immunoassays. The clinical characteristics of mycoplasma infection seen during emergent visits in asthmatic children were reviewed. METHODS: We retrospectively reviewed medical records of patients with asthma exacerbation visiting the Department of Pediatric Emergency, National Taiwan University Hospital, over a 12-month period. Subjects 2-18 years of age diagnosed with asthma at our outpatient clinic were included in this study. Patients with immunodeficiency, congenital anomalies, neurological diseases and irregular follow-up were excluded. RESULTS: A total of 269 children (174 males and 95 females) with a mean (+/- standard deviation) age of 6.15 +/- 3.08 years were included. The prevalence of asthma exacerbation in regular follow-up patients was 13.4%, and as many as 19.6% of cases (74/378 person-times) required hospitalization. Asthma attacks were most prevalent during December. 126 patients had both rapid cold hemagglutination testing and mycoplasma immunoglobulin M titers determined using acute blood samples drawn in the emergency room; 46 (36.5%) of these patients demonstrated mycoplasma infection. Sensitivity and specificity of the rapid cold hemagglutination test was 78.3% and 41.3%, respectively. The positive predictive value was 43.4%. Comparison of patients with or without mycoplasma infection revealed no differences in gender, age, chest X-ray findings, and most symptoms/signs and laboratory data, except that more signs of fever and auscultatory rales were seen in the non-mycoplasma infection group. CONCLUSIONS: Mycoplasma infections could be an exacerbating factor for asthma, and the rapid cold hemagglutination test should not be a guideline for prescribing macrolides in the emergency room.     

Activity of temocillin and other penicillins against beta-lactamase-inducible and -stably derepressed enterobacteria

MICs of temocillin, carbenicillin, ticarcillin, mezlocillin, piperacillin and ampicillin were determined for mutant series of Enterobacter cloacae, Citrobacter freundii, Proteus vulgaris, Morganella morganii and Serratia marcescens with inducible, stably derepressed or basal expression of chromosomal Class I beta-lactamases. Ampicillin was inactive (MIC greater than 256 mg/l) both against beta-lactamase-inducible organisms (except C. freundii) and their stably derepressed mutants, whereas basal mutants were sensitive (MIC 2-8 mg/l). Carbenicillin, ticarcillin, mezlocillin, piperacillin (and ampicillin for C. freundii) were active against both inducible and basal organisms (MIC less than 16 mg/l), but inactive against the derepressed mutants (MICs usually greater than 64 mg/l). Temocillin inhibited all the organisms, including the stably derepressed mutants, at 16 mg/l. Derepressed S. marcescens, M. morganii and Pr. vulgaris were as susceptible as the inducible strains and basal mutants. MICs of temocillin for derepressed mutants of E. cloacae and C. freundii were 4-16 fold above those for their inducible parent strains, but remained within the clinical range.     

Malignant melanoma metastatic to the stomach: upper G-I endoscopic finding--report of a case

a 54-year-old male was presented with huge, black, ulcerative and painless tumor of the sole of left foot. Malignant melanoma was proved by biopsy, but patient refused any treatment. He visited our hospital again when bloody vomitus was noted two months later. Chest P-A revealed multiple lung metastases, and marked liver metastasis was also found by abdominal echo. Upper gastrointestinal (UGI) panendoscopy revealed multiple melanotic nodules with ulcerations at the tip, scattering diffusely on the fundus and upper body of the stomach. Metastatic malignant melanoma was proved by endoscopic biopsy. Metastatic tumor of the stomach was rare, and the endoscopic finding of the malignant melanoma with gastric metastasis was more rarer in the literature in Taiwan. So we would like to present the very rare finding of the endoscopy.     

米非司酮作用于兔输卵管收缩活动与Ca^2＋关系的研究

通过“结合化学分离与原子吸收分光光度法”对Ca^2 含量测定和离体输卵管肌条收缩记录方法，研究米非司酮（Ru486)对增加假孕（4d)兔输卵管平滑肌收缩频率，而不改变其收缩张力和振幅时与Ca^2 之间的关系，结果提示：（1）Ru486对输卵管分泌液和组织内Ca^2 的含量分布无明显影响；（2）Ru486具有降低细胞外液高Ca^2 浓度促Ca^2 内流，而使收缩增强的效应，且能协同Ca^2 通道阻断剂（Verapamil)抑制细胞外Ca^2 内流，而致收缩减弱的效应。     

Non-invasive stimulation of the P6 (Neiguan) antiemetic acupuncture point in cancer chemotherapy.

The beneficial effects of transcutaneous electrical stimulation of the P6 antiemetic point (Neiguan) as an adjuvant to standard antiemetics was studied in over 100 patients in whom chemotherapy-induced sickness was not adequately controlled by antiemetics alone. Although the results were not quite as good as with invasive acupuncture, more than 75% patients achieved considerable benefit from what was a non-toxic procedure. The use of large diffuse low impedence electrodes simplifies the technique. The 2 hourly application of Sea Bands prolongs the antiemetic action. Best results were obtained from the 2 hourly self-administration of 5 min of transcutaneous electrical stimulation of P6 using a simple battery-operated TENS machine (15 Hz) to activate a large, easy-to-place surface electrode and increasing current until Qi is elicited.     

Biomechanics of lumbosacral spinal fusion in combined compression-torsion loads

The current study investigates the stabilizing effects of three different types of spinal fusion to the juxta-free motion segments and to the fused segment of the lumbosacral spine under combined compression-torsion loads. Sixteen fresh human cadaver lumbosacral spines were tested under a simulated physiologic loading condition. The relative movements of the motion segments, as well as the angular rotations and the center of rotation were then computed and analyzed. The average torsional stiffness of the unfused three-motion segment was found to be 2.35 nm/degree. After fusion, the torsional stiffness did not increase significantly. Under the compression-torsional load, the anterior and bilateral-lateral fusions provided adequate stabilizing effect on the fused segment. The posterior fusion provided the least amount of stabilizing effect. These findings are similar to the results of the compression-bending experiment. Whereas the compression-bending loads produced significantly increased stress at the juxta-free segments, the compression-torsional loads did not produce any significant amount of increase in torsional stress at the juxta-free segments.