Electroencephalography and magnetic resonance imaging in neurological decompression sickness.

The purpose of this study was to evaluate the use of electroencephalography (EEG) and magnetic resonance imaging (MRI) in the clinical evaluation of acute decompression sickness (DCS) in the central nervous system (CNS). Twenty-one patients treated because of acute DCS in the CNS during 1999-2001 were included, 15 patients with clinical cerebral DCS and five with clinical spinal cord DCS. Seven patients had abnormalities in their EEG, five with cerebral DCS and two with spinal cord DCS. MRI showed high intensity lesions in the spinal cord in four patients with clinical spinal cord DCS and in one with clinical cerebral DCS. Cerebral lesions were not identified by MRI in any patient. In conclusion, EEG showed unspecific abnormalities in only one third of the cases. Conventional MRI with a 1.5 T scanner may be of help in the diagnosis of DCS in the spinal cord, but not in the brain. EEG and MRI have low sensitivity in the diagnosis of acute DCS in the CNS. Recompression treatment of DCS should still be guided by clinical neurological examination and assessment of symptoms.     

Reduced health-related quality of life in former North Sea divers is associated with decompression sickness

BACKGROUND: Diving is associated with long-term effects on several organ systems. AIM: The objective was to investigate the impact of decompression sickness (DCS) and diving exposure on health-related quality of life (HRQL) in former Norwegian North Sea divers. METHODS: HRQL was recorded by a questionnaire in the cohort of 375 Norwegian North Sea divers registered before 1990. Demographic data, relevant health data and data on diving education, history of DCS and SF-36 were recorded in 230 divers. RESULTS: All SF-36 sub-scores were significantly reduced compared with Norwegian norms. Reduced scores were seen for all scales among divers who reported previous DCS compared to those without DCS. A decreasing trend in scores was seen when comparing no DCS, skin or joint DCS and neurological DCS. There was a decreasing trend in scores related to number of days in saturation and maximal depth. Stratification on DCS showed that the impact of saturation diving was present only in divers with DCS. CONCLUSIONS: HRQL was reduced in this study sample of divers. Having had DCS during the diving career contributed significantly to the reduction in all SF-36 scales, and apparently neurological DCS has the most pronounced impact. Cumulative diving exposure including days in saturation and maximal depth contributed to a reduced HRQL.     

Fructan supplementation and infection affect food intake, fever, and epithelial sloughing from Salmonella challenge in weanling puppies

Our objective was to examine the effects of fructan supplementation on the immune response of weanling puppies subjected to bacterial challenge. Previous studies in bacterial challenged neonatal piglets have reported benefits of fructan supplementation. Thirty hound-cross puppies (12 wk of age) were used in a 2 x 3 factorial randomized complete block design. Following a 7-d baseline period, puppies were assigned to diets containing: 1) no prebiotic, 2) 1% short-chain fructooligosaccharides (scFOS), or 3) 1% inulin. After 14 d on treatment diet, dogs received an oral gavage of: 1) Salmonella typhimurium DT104 (5 x 10(8) colony forming units) or 2) 0.9% saline. Food intake, fecal and activity scores, body temperature, body weight, blood chemistry, intestinal nutrient transport, intestinal morphology and pathology, and gut microbiota were measured. Food intake decreased (P < 0.01) and body temperature increased (P < 0.05) in infected puppies. However, the decrease in food intake was less (P < 0.05) in those consuming fructans. Infected puppies consuming fructans also had decreased (P = 0.05) severity of enterocyte sloughing than those fed the control diet. Ileal Na+-dependent glucose transport was decreased (P = 0.02) in infected vs. noninfected puppies consuming CON, whereas no changes occurred in fructan-supplemented animals. Puppies consuming inulin also had increased fecal acetate (P = 0.03) and total short-chain fatty acid (P = 0.06) concentrations than scFOS-fed puppies and controls. Finally, puppies fed inulin had an increase (P = 0.05) in Lactobacillus concentrations compared with scFOS and CON. In summary, fructan supplementation appeared to attenuate some of the negative responses associated with Salmonella challenge and may provide protection against infection in weanling puppies.     

The association between psychosocial work environment,attitudes towards older workers (ageism) and planned retirement

Purpose  

The aim of this study was to examine the association between psychosocial factors (in particular ageism) at the workplace and older workers’ retirement plans, while taking health and workability of the employee into account.     

Characterization of a human trypsin resistant to Kunitz soybean trypsin inhibitor. Studies of duodenal juices after tube instillation of raw soybean extract.

Human duodenal juices collected during tube instillation of raw soybean extract into the duodenum contained free trypsin and free Kuntiz soybean trypsin inhibitor (KTI) in the simultaneous presence of trypsin-KTI complexes. It has previously been suggested that this KTI-non-inhibitable trypsin has a general resistance to serine protease inhibitors. Four different trypsin forms have been found and partly characterized by sodium dodecyl sulphate-polyacrylamide gel electrophoresis and isoelectric focusing followed by Western immunoblotting or enzyme staining. In addition, crossed immunoelectrophoresis and affinity chromatography with antibody-coupled gels have been used for identification of free and inhibitor-complexed trypsin.     

Characterization of a monoclonal antibody ITI-Pl 1 directed against human platelet membrane glycoprotein IIb using extracts of whole platelets and platelet surface and intracellular membranes

A monoclonal antibody (mAb) termed ITI-Pl 1 has been prepared by the hybridoma procedure. Using immuno-absorption and crossed immunoelectrophoresis of Triton X-100 extracts of untreated and EDTA-treated human platelets it was shown to be directed against the surface membrane glycoprotein IIb (GP IIb). This mAb binds to whole platelets independently of ADP-stimulation and the presence of Ca2+-ions. It saturates at around 870 ng/10(8) cells corresponding to approximately 35,800 molecules/platelet. ITI-Pl 1 did not significantly inhibit GP IIb-IIIa dependent functions such as platelet aggregation or fibrinogen binding. Immunofluorescence could be demonstrated using ITI-Pl 1 and intact normal platelets, but not with platelets from a Glanzmann's thrombasthenia patient. Crossed immuno-electrophoresis with platelet extracts from four different thrombasthenic patients gave a line precipitate in the intermediate gel with 125I-labelled ITI-Pl 1 and autoradiography indicating trace amounts of free GP IIb or the GP IIb-IIIa complex. The epitope on GP IIb detected by ITI-Pl 1 is not destroyed by neuraminidase treatment. Thus the mAb also interacts with neuraminidase-treated GP IIb-IIIa complex in highly purified platelet surface membrane fractions as well as with GP IIb-IIIa from untreated internal membranes isolated by continuous flow electrophoresis.     

Arthroskopie des Handgelenks

Background

The increasing use of arthroscopy in the diagnosis and treatment of acute and chronic injuries of the wrist has also led to an increase in new knowledge. In fresh fractures of the wrist, accompanying soft tissue injuries are often only first discovered and treated by arthroscopy and repositioning of articular fragments by optical control is more accurate than by radiological imaging. However, due to the large number of distal radius fractures and the various types of extra-articular and intra-articular fractures there is currently a broad and very controversial discussion about the indications for arthroscopy.

Objectives

This study was carried out investigate whether criteria for distal radius fractures with the varied injury situations can be found which are appropriate to establish the indications for arthroscopy of the wrist based on an algorithm.

Methods

Following a selective literature review and taking our own results from a collective of 50 patients with distal radius fractures and arthroscopically assisted fracture treatment into account, possible criteria for the indications for arthroscopy of the wrist in distal radius fractures were established and are demonstrated using case examples.

Results

Based on this study an algorithm has been created for the treatment of distal radius fractures with the integration of arthroscopy as an essential diagnostic and therapeutic procedure.

Conclusions

Numerous well-known radiological findings can be used to justify the indications for arthroscopy in distal radius fractures and an improvement of the therapeutic results is expected due to increased use of arthroscopy.     

Epidemiology of perforated peptic ulcer:Age-and gender-adjusted analysis of incidence and mortality

AIM:To investigate the epidemiological trends in inci-dence and mortality of perforated peptic ulcer(PPU)in a well-defined Norwegian population. METHODS:A retrospective,population-based,single-center,consecutive cohort study of all patients diag-nosed with benign perforated peptic ulcer.Included were both gastric and duodenal ulcer patients admitted to Stavanger University Hospital between January 2001 and December 2010.Ulcers with a malignant neoplasia diagnosis,verified by histology after biopsy or resection,were excluded.Patients were identified from the hospitals administrative electronic database using pertinent ICD-9 and ICD-10 codes(K25.1,K25.2,K25.5, K25.6,K26.1,K26.2,K26.5,K26.6).Additional searches using appropriate codes for relevant laparoscopic and open surgical procedures(e.g.,JDA 60,JDA 61,JDH 70 and JDH 71)were performed to enable a complete identification of all patients.Patient demographics,presentation patterns and clinical data were retrieved from hospital records and surgical notes.Crude and adjusted incidence and mortality rates were estimated by using national population demographics data. RESULTS:In the study period,a total of 172 patients with PPU were identified.The adjusted incidence rate for the overall 10-year period was 6.5 per 100 000 per year(95%CI:5.6-7.6)and the adjusted mortality rate for the overall 10-year period was 1.1 per 100 000 per year(95%CI:0.7-1.6).A non-significant decline in ad-justed incidence rate from 9.7 to 5.6 occurred during the decade.The standardized mortality ratio for the whole study period was 5.7(95%CI:3.9-8.2),while the total 30-d mortality was 16.3%.No difference in in-cidence or mortality was found between genders.However,for patients≥60 years,the incidence increased over 10-fold,and mortality more than 50-fold,compared to younger ages.The admission rates outside office hours were high with almost two out of three(63%) admissions seen at evening/night time shifts and/or during weekends.The observed seasonal variations in admissions were not statisti