Treatment of stiff thoracic scoliosis by thoracoscopic anterior release combined with posterior instrumentation and fusion

Background  

Thoracoscopic anterior release has been shown that it can effectively improve spinal flexibility in animal and human cadaveric studies, and has been advocated for use in patients with scoliosis. This prospective case series aims to investigate the improvement of the spinal flexibility and the effectiveness in deformity correction by anterior thoracoscopic release and posterior spinal fusion.     

草珊瑚中的一个新倍半萜内酯

草珊瑚为金粟兰科植物Sarcandra glabra(Thumb.)Nakai的全株,又名接骨金粟兰、肿节风、九节风、九节茶、接骨木等。有清热祛风,散瘀接骨之功效,民间用于治疗肺炎、凤湿性关节炎等。近年来做成制剂治疗溃疡病、癌症等。已报导的化学成分有延胡索酸、琥珀酸及异白蜡树定(isofraxidin)等。今从草珊瑚叶中分得一个新的倍半萜内酯,本文鉴定其结构为(—)-istanbulin A。     

Serum Amino Acid Concentrations in Patients Receiving Total Parenteral Nutrition with an Amino Acid Plus Dextrose Mixture

The results of monitoring the serum amino acid concentrations during three infusion regimens using a 5:4 mixture of 70% glucose and the synthetic L-amino acid solution, Synthamin 17 (Travasol) are reported. Twelve stabilized patients received continuous total parenteral nutrition (TPN), eight of whom were subsequently placed on a second regimen of cyclical feeding. A separate group of five patients was infused with amino acids, both with and without simultaneous glucose. The serum amino acid concentrations indicated that the supply of valine, leucine, isoleucine, lysine, and histidine, and the synthesis of taurine from the infused methionine was suboptimal, particularly if the period of TPN was prolonged. The synthesis of tyrosine from phenylalanine appeared to be inversely proportional to the infusion rate of the TPN mixture, in particular the glucose component, resulting in depressed tyrosine and increased phenylalanine concentrations in serum during continuous iv nutrition. Cyclical infusions, on the other hand, permitted the tyrosine and phenylalanine concentrations to return to normal during the noninfusion stage of the cycle. Amino acid measurements enabled us to design an amino acids additive mixture which normalized the serum concentrations in three long-term home parenteral nutrition patients. As a result of these investigations serum amino acid measurements are used routinely to monitor the efficacy of TPN and accommodate any specific amino acid requirements of individual patients. (Journal of Parenteral and Enteral Nutrition 8: 535–541, 1984)