Pneumothorax: appearance on lateral chest radiographs

The appearance of pneumothorax on lateral radiographs obtained with the patient erect were reviewed in 100 patients (122 total examinations). A pneumothorax could be seen on the lateral projection in 89% of the examinations (109 of 122). The displaced pleural line was most frequently identified anteriorly or posteriorly and was less commonly identified at the lung apex or in a subpulmonic location. In 11 cases, an air-fluid level was the only recognizable finding of a pneumothorax on the lateral projection. Although in 27% of examinations (32 of 122) the pneumothorax was either not seen (11%) (n = 13) or was a subtle finding (16%) (n = 19), in 14% of examinations (17 of 122) the lateral projection provided helpful information to supplement the posteroanterior projection.     

Cervical Disc Replacement for Spondylotic Myeloradiculopathy

Background

Cervical disc replacement is a newer concept and rapidly developing surgical treatment. A prospective study was conducted to determine, if accurately implanted Bryan''s cervical disc prostheses can provide relief from objective neurological symptoms and signs, stability and normal range of motion in cases of cervical disc prolapse with myeloradiculopathy.

Material and Method

Twenty patients underwent Bryan cervical disc replacement from Jan 2002 to Dec 2003. Young patients between age groups 21 to 50 years with degenerative cervical disc prolapse at C3-C7 with myeloradiculopathy were included in this study. Patients with significant facet joint arthropathy, unstable spine, trauma, tumour, osteoporosis and active infection were excluded from this study. Nurick''s grading was used for quantifying the neurological deficit. Patients were operated by anterior cervical approach using a specially designed Bryan''s cervical discectomy system. Neurological and radiological outcome was assessed post operatively and at 2,6,12 and 24 months follow up. Outcome analysis was carried out using modified Odom''s criteria. The radiographic results were assessed by taking antero posterior (AP) and lateral radiographs of cervical spine to find range of motion and device position.

Results

The patients were in the age group of 31 to 50 years. There were 14 (70%) male and 6 (30%) female in this study. Neck pain and brachialgia were the presenting symptoms in all cases, 12 (60%) had radiculopathy and 8 (40%) had myelopathy. Single level disc prolapse was present as per Magnetic Resonance Imaging (MRI) in four (20%) at C4-C5, 12 (60%) at C5-C6 and 4 (20%) at C6-C7. Bryan''s disc size 15 was used in 8 (40%) and size 17 was used in 12(60%) patients. During post-operative, 02, 06, 12, and 24 months follow up, the clinical outcome was excellent in 16 (80%) and good in 4 (20%) as per modified Odom''s criteria. There was demonstrated improvement in flexion, extension and rotation clinically and radiologically during follow up. There was no migration or displacement of device.

Conclusion

Cervical disc replacement for cervical disc prolapse with myeloradiculopathy represents an exciting new technology. Patients treated with the Bryan cervical disc prosthesis for single level cervical disc prolapse showed good to excellent improvement in neurological deficit. Clinically and radiologically maintenance of motion was found during follow up. More patients with longer follow up and post operative MRI to find out the protection to adjacent discs from abnormal stress will be required before this prosthesis is accepted as a treatment option.Key Words: Spondylotic myeloradiculopathy, Cervical disc replacement     

新型抗日本血吸虫病口服有效药物

最近一年多来,我們在寻找非銻剂抗血吸虫病药物方面,合成了一大类具有下列通式的化合物。在合成了的几百个这类型的化合物中,不少在动物試驗有显著的杀日本血吸虫效力。此类型的药物的化学通式为:     

血吸虫病化学治疗的研究 Ⅱ.α-取代-β-(5-硝基-2-呋喃)丙烯酰胺及酯类衍生物的合成

本文报导α-取代-β-(5-硝基-2-呋喃)丙烯酰胺及酯类衍生物85个的合成。这类化合物系分别以糠醛或硝基糠醛与相应的羧酸钾盐经Perkin反应缩合后,按一般方法制成酰胺及酯;或以相应的硝基呋喃丙烯酰胺经溴化;或通过氮内酯中间体经水解、醇解和氨解而制备。经动物篩选后发现有13个化合物对感染日本血吸虫小白鼠有作用,其中α—甲基—β-(5-硝基-2-呋喃)丙烯酰正丁胺(I₆,F-30058),α-甲基-β-(5-硝基-2-呋喃)丙烯酰乙醇胺(I₁₀,F-30141)及α-甲基-β-(5-硝基-2-呋喃)丙烯酰-2′-羟基丙胺(I₁₁,F-30111)三个具有较好抑制作用。