Thoracic empyema: management with image-guided catheter drainage

Forty-three patients with thoracic empyema were treated by means of image-guided catheter drainage. In 40 patients, image-guided catheter drainage was the primary treatment method; in three it was used after conventional, surgical chest tube placement failed. Drainage was performed with ultrasound guidance in 30 patients (69.8%), computed tomography in eight (18.6%), and fluoroscopy in five (11.6%). A combination of guidance modalities was used in six patients. Image-guided catheter drainage alone was successful in 31 of 43 patients (72.1%). In three patients (7%), empyemas were initially drained, but a thoracotomy was ultimately required because of a persistent pleural peel. In eight patients (18.6%), the procedure failed, predominantly due to tube clogging, persistent pneumothorax, or progressive development of a pleural peel. In one patient, drainage was successful but he died 10 days later of complications of renal failure. No major complications were encountered. Treatment of these patients requires a thorough understanding of the pathogenesis of pleural space infection, principles of empyema drainage, techniques of abscess drainage under image guidance, and the use of a pleural drainage system.     

COMBINED SPINAL AND EPIDURAL ANAESTHESIA FOR ABDOMINAL SURGERY: A NEW TECHNIQUE

Combined spinal and epidural anaesthesia was used in 50 patients undergoing abdominal surgery. A fixed dose of 1.0 mL of 5 per cent lignocaine was injected intrathecally in all cases followed by 10 mL of 0.5 per cent bupivacaine epidurally, using “needle through needle” technique in the same lumbar intervertebral space. Subsequently epidural catheter was passed for top-up doses and postoperative analgesia. The advantages of this technique observed were immediate onset of intense block of prolonged, controllable duration and no incidence of post-spinal headache. Five cases developed intraoperative hypotension which required correction. No patient developed any complications of spinal and epidural anaesthesia.KEY WORDS: Anaesthesia epidural, Anaesthesia spinal     

Medical management of interstitial ectopic pregnancy: a case report and literature review

Recent reports describe successful treatment of interstitial ectopic pregnancies using methotrexate. While the number of reported cases is increasing, no consensus exists regarding the management of this complication of pregnancy. We present the successful use of combined systemic and direct intrasac injection of methotrexate for an interstitial pregnancy with the highest yet reported initial beta-human chorionic gonadotrophin concentration (102,000 mIU/ml). We also describe the use of Doppler ultrasound for monitoring treatment progression. Through a review of the current literature, we propose to facilitate management decisions and increase outcome success by summarizing previously reported treatment regimens and by describing enhanced parameters for patient selection and monitoring.      

Compensatory structural and functional adaptation after radical nephrectomy for renal cell carcinoma according to preoperative stage of chronic kidney disease. Choi DK,Jung SB,Park BH,Jeong BC,Seo SI,Jeon SS,Lee HM,Choi HY,Jeon HG.J Urol. 2015 Oct;194(4):910-5. [Epub 2015 Apr 28]. doi: 10.1016/j.juro.2015.04.093.

Purpose

We investigated structural hypertrophy and functional hyperfiltration as compensatory adaptations after radical nephrectomy in patients with renal cell carcinoma according to the preoperative chronic kidney disease stage.

重组日本血吸虫副肌球蛋白的表达与纯化

用基因重组技术 ,将日本血吸虫副肌球蛋白 (rSj97)基因亚克隆至表达载体pQE30上。在IPTG诱导下 ,重组日本血吸虫副肌球蛋白在大肠杆菌中得以高效表达。通过快速蛋白质液相色谱仪 (FPLC) ,经TALON柱和离子交换柱两步分离纯化 ,获得大量高纯度的重组日本血吸虫副肌球蛋白 ,为水牛现场试验提供了充足的抗原     

利用放射性核素示踪技术对镉及铬与毛发结合机制的研究

目的 利用放射性核素示踪方法研究内外源性镉、铬与毛发结合的机制，从分子水平探讨目前常用的头发预处理方法能否有选择地清除外源性而保留毛发中内源性镉、铬的含量。方法 提取含有内源性的放射性核素镉、铬的大白鼠鼠毛及外源性放射性核素镉、铬的人发蛋白质，利用柱层析将毛发蛋白质分组，分别测定不同蛋白组分中的放射性镉、铬的活度来确定与镉、铬相互结合的毛发蛋白组分。比较与内外源性镉、铬相结合的蛋白组分来分析核素与毛发结合机制。结果 内外源性镉、铬核素均以与毛发蛋白质相互结合的方式存在于毛发中，而且所结合的蛋白质组分的相对分子量相同。lAEA法和海鸥洗涤剂对内外源性的镉、铬有轻度地洗脱，但Ⅱ玎AN啦和稀硝酸溶液对两种核素有强力的清除效力。结论 由于内外源性镉、铬核素与毛发蛋白质结合的相似性，实验中头发样品的预处理方法在清除外源性核素的同时，在一定程度上也影响头发内源性的核素的含量。