A “tricky” subarachnoid hemorrhage

To the editor:We report a tricky subarachnoid haemorrhage (SAH).Our patient was a 59-year-old woman with generalized headache for 1 day,which was constricting in nature and rated grade 6/10.Her symptoms were aggravated by lying flat and improved with vomiting.The Glasgow coma scale was full,blood pressure was 142/83 mmHg and pulse 75 beats/min.There was neither neck stiffness nor focal neurological deficit.Fundoscopic examination was normal.She was noted to have hyponatremia (sodium (Na) 122 mmol/L) with serum osmolarity 263 mmol/kg,urine osmolarity 582 mmol/kg,urine Na 117 mmol/L,normal thyroid stimulating hormone and cortisol level.Plain computed tomography (CT) brain was normal (Figure 1A).Lumbar puncture (LP) was performed on day two,and multiple attempts were required.     

Facial approximation: evaluation of dental and facial proportions with height

Background

Fabrication of complete dentures requires the use of certain guidelines which are placed on the bite blocks to assist the clinician to have the maxillary anterior teeth restored to optimal dento-labial relations, in harmony with the overall facial appearance.

Objective

To explore if any relationship exists between dental and facial proportions as well as the height of the individuals.

Methods

Two hundred and four dental students of the Obafemi Awolowo University volunteered to participated in the study. The lower facial height, inter incisal, inter canine, and intercommisure distances, as well as the height of the participants were measured. The data were imputed, analyzed, and reported as simple frequency, means and standard deviations using the SPSS vs 11. Statistical significance was inferred at p<0.05.

Result

The mean values of all the parameters measured were significantly higher in males than females. None of the mean values measured were coincident. However, a significant correlation exists between intercanine and interincisal distances(r=0.8) while a weak but significant negative correlation exists between the intercanine distance and the difference of the intercommisural and intercanine distances (r=−0.4)

Conclusion

The study showed no relationship between intercanine distance, interincisal distance, lower facial height, and the height of the participants with the intercommissural distance. Hence, intercommissural distance may not be used in marking canine line during bite registration procedure. At best, 1.75–2.45 cm should be subtracted from the intercommissural distance to determine the intercanine distance.     

Helicobacter pylori acquistion of metronidazole resistance by natural transformation in vitro

AIM: To study whether Helicobacter pylori is naturally transformable.METHODS: Transformation was performed in BHI broth supplemented with horse serum and yeast extract. Genomic DNA extracted from a metronidazole resistant H.pylori strain was added to H. pylori broth culture. The mixture was incubated at microaerophilic atmosphere. The DNA-treated cells were plated on blood agar containing 8 mg/L metronidazole to select for transformants. Sterile distilled water was used as a negative DNA control. The DNA profiles of transformants were compared with that of their parent strains by randomly amplified polymorphic DNA (RAPD) fingerprinting.RESULTS: Transformation of H. pylori with DNA from a metronidazole resistant strain as a marker was demonstrated. Out of the 12 strains of H. pylori tested, 9 (75%) strains were found to be transformable. The transformation frequencies ranged from 3.4 × 10^-6 to 2.4 × 10^-4. By RAPD, DNA fingerprints of the transformants and their parent strains showed no change in DNA profiles though transformants were all resistant to metronidazole as compared with their metronidazole-sensitive parent strains.CONCLUSION: Helicobacter pylori is naturally transformable which might be one of the ways that H. pylori develops resistance to metronidazole.     

Aggressive Posterior Retinopathy of Prematurity Treated with Intravitreal Bevacizumab: Late Period Fluorescein Angiographic Findings

Graefe's Archive for Clinical and Experimental Ophthalmology - To evaluate vascularization end limit of the peripheral retina and describe vascular development patterns of patients at the late...     

Inflammatory fibroid polyp presenting with intestinal invagination: Sonographic and correlative imaging findings

We report a case of a large inflammatory fibroid polyp of the small bowel presenting with intussusception in a 22‐year‐old man. Sonography demonstrated a solid, mobile, homogeneous, echogenic mass surrounded by the typical mural layers of an invaginated ileum. CT demonstrated a well‐defined intraluminal solid mass with an attenuation of 17 HU. The pathologic diagnosis after segmental ileal resection was ileal inflammatory fibroid polyp. © 1999 John Wiley & Sons, Inc. J Clin Ultrasound 27:89–91, 1999.     

鹿茸多肽的纯化和鉴定(英文)

应用凝胶过虑和离子交换层析等技术,从鹿茸(pilose antler or Cervus nipponTemminck)中分离纯化出一种多肽(peptide of pilose antler,PAP)。经高效液相色谱和N-末端氨基酸分析鉴定为单一多肽,氨基酸组成分析证明,PAP是由68个氨基酸组成,分子是为7200。药理研究证明,PAP对大鼠角叉菜胶性足肿胀具有明显的抑制作用并呈现良好的量—效关系。     

氯胺酮麻醉前不同时间肌内注射阿托品对小儿呼吸道的影响

目的探讨氯胺酮麻醉前不同时间肌内注射阿托品对小儿呼吸道的影响。方法将2012年1月至2013年6月在廊坊市第四人民医院住院的100例患儿按随机数字表法分为两组:A组(50例)于氯胺酮麻醉前30~60 min肌内注射阿托品(0.02 mg/kg),B组(50例)阿托品(0.02 mg/kg)与氯胺酮同时间肌内注射。两组患儿均于氯胺酮肌内注射2~4 min后入室准备手术,术中观察记录两组患儿呼吸道和肺部的听诊变化及脉搏血氧饱和度(Sp O2)变化。结果 A组Ⅰ级(即呼吸道未受影响)44例,Ⅱ级以上(即呼吸道受到不同程度影响)6例,阳性率为12%(6/50);B组Ⅰ级33例,Ⅱ级以上17例,阳性率为34%(17∕50)。两组患儿呼吸道受影响程度的比较,差异有统计学意义(P<0.01)。结论小儿氯胺酮麻醉前30 min肌内注射阿托品,能有效降低氯胺酮对患儿呼吸道的影响,提高术中患儿的安全系数。     

Axis inhibition protein 2 (AXIN2) polymorphisms and tooth agenesis

Tooth agenesis is a common congenital disorder that affects almost 20% of the world's population. A number of different genes have been shown to be associated with cases of tooth agenesis including AXIN2, IRF6, FGFR1, MSX1, PAX9, and TGFA. Of particular interest is AXIN2, which was linked to two families segregating oligodontia and colorectal cancer. We studied two collections of families affected with tooth agenesis and tested them for association with AXIN2. Significant association between tooth agenesis and AXIN2 was found (p = 0.02) in cases with at least one missing incisor. Our work further supports a role of AXIN2 in human tooth agenesis and for the first time suggests AXIN2 is involved in sporadic forms of common incisor agenesis. Future studies should identify which specific tooth agenesis sub-phenotypes are consequence of AXIN2 genetic variations. A sub-set of these cases could have an increased susceptibility for colon cancer or other types of tumours and this knowledge would have significant clinical implications.     

Relationships of sleep duration with sociodemographic and health‐related factors,psychiatric disorders and sleep disturbances in a community sample of Korean adults

The aim of this study is to examine relationships of sleep duration with sociodemographic and health‐related factors, psychiatric disorders and sleep disturbances in a nationwide sample in Korea. A total of 6510 subjects aged 18–64 years participated in this study. Logistic regression was used to calculate the odd ratios and 95% confidence intervals of the covariates, psychiatric disorders and sleep disturbances across the following sleep duration categories: 5 h or less, 6, 7, 8 and 9 h or more per day. Low levels of education, unemployment and physical illness were associated with sleeping for 5 h or less and 9 h or more. Being older and widowed/divorced/separated, high levels of physical activity, pain/discomfort, obesity and high scores on the General Health Questionnaires were associated with sleeping for 5 h or less. Female, being younger and underweight were associated with sleeping for 9 h or more. Alcohol dependence, anxiety disorder and social phobia were associated significantly with sleeping for 5 h or less and 9 h or more. Other psychiatric disorders were more common in subjects who slept for 5 h or less (e.g. alcohol use disorder, mood disorder, major depressive disorder, dysthymic disorder, obsessive‐compulsive disorder and specific phobia) or 9 h or more (e.g. post‐traumatic stress disorder). In addition, subjects who slept for 5 h or less reported more sleep disturbances than did subjects who slept for 7 h. Short or long sleep is associated with psychiatric disorders and/or sleep disturbance, therefore attention to the mental health of short or long sleepers is needed.