Is Minimal Residual Lymph Node Disease in Papillary Thyroid Cancer of Prognostic Impact? An Analysis of The Epithelial Cell Adhesion Molecule EpCAM in Lymph Nodes of 40 pN0 Patients

This study was aimed to assess the extend of nodal microdissemination in patients with pN0 papillary thyroid carcinoma (PTC) using immunohistochemical analysis. In early stage PTC both, systematic lymphadenectomy as well as radio iodine treatment, aimed to eliminate occult nodal tumor involvement, are under controversial debate, since little is known about the extend of lymphatic microdissemination in these patients. Formalin embedded samples of the resected lymph nodes were systematically screened for the presence of disseminated tumor cells using immunohistochemistry (monoclonal antibody Ber-EP4). Clinical and histopathological parameters as well as the post-operative course were recorded. Survival data were analysed by the Kaplan-Meier method and the log rank test. Overall 321 lymph nodes of 40 patients were screened immunohistochemically. In 12.5 % of the patients disseminated occult tumor cells were diagnosed. In addition to tumor resection 90 % of the patients underwent adjuvant radio-iodine treatment. The mean observation period in our collective was 72 months. The detection of disseminated tumor cells did not correlate with clinicopathologic risk parameters and did not have significant influence on the prognosis of these patients. Immunohistochemical analysis enables the detection of disseminated tumor cells in patients with pN0 PTC. This finding seems to support the application of adjuvant radio iodine, even in early tumor stages.     

间接测热法测定并比较不同疾病机械通气患者的静息能量消耗

目的:传统的公式计算不能客观、正确地评定疾病状况下的能量消耗,所以利用间接测热法测定并分析机械通气的慢性阻塞性肺疾病患者与其他机械通气患者的静息能量消耗特点,并进行相关因素探讨。方法:于2007-02/07,用美国Med Graphic公司CCM/D能量代谢测试系统测定华西医院ICU病房的21例慢性阻塞性肺疾病和24例非慢性阻塞性肺疾病的机械通气患者静息能量消耗,并比较其差异,观察血浆白蛋白、动脉血氧分压、动脉血二氧化碳分压和全天能量供给与静息能量消耗和呼吸商的相关性。结果:45例患者进入结果分析。①慢性阻塞性肺疾病患者静息能量消耗高于非慢性阻塞性肺疾病患者(P<0.05),而两组患者的呼吸商比较差异无显著性意义(P>0.05)。②静息能量消耗和呼吸商与白蛋白、动脉血氧分压、动脉血二氧化碳分压均无明显相关性(P>0.05),呼吸商与全天能量供给存在显著的相关性(P<0.05),但静息能量消耗与全天能量供给无明显相关性。结论:机械通气患者中,慢性阻塞性肺疾病患者的静息能量消耗比其他机械通气患者高,全天能量供给对呼吸商有影响,但不能用呼吸商指导营养支持。     

Measurement of sleep and quality of life before and after coronary artery bypass grafting: A pilot study

Edéll-Gustafsson UM, Hetta JE, Arén CB & Hamrin EKF. International Journal of Nursing Practice 1997; 3 : 239–246
Measurement of sleep and quality of life before and after coronary artery bypass grafting: A pilot study
The aim of this study was to: (i) test different instruments that focused on sleep, quality of life and personal adjustment in order to evaluate the usefulness of these instruments in a larger study; and (ii) to describe self perceptions of sleep and life situation by patients who had undergone coronary artery bypass grafting (CABG). A one-group pre-test repeated post-test design was used. Six men aged between 51 and 70 years were interviewed, and 24  h polysomnographic recordings were performed before and after the operation. The interviews indicated disturbed sleep and changes in behaviour and mental state immediately postoperatively. Postoperatively the polysomnographic recordings revealed a significant decrease in mean duration of sleep, mean percentage of stage 3–4 sleep and mean rapid eye movement (REM) sleep. One month after surgery the quality of life was improved, while moderate anxiety and sensation of incisional pain persisted. The measurements used in this pilot study provide valuable information into the understanding of altered sleep, quality of life and personal adjustment following CABG.     

DIAGNOSIS AND MANAGEMENT OF HYPERLIPIDAEMIA

Hyperlipidaemia is acknowledged as the major risk factor for coronary heart disease and atheroma progression. This review considers the strategies that should be followed to reduce overall cardiovascular risk in patients with hyperlipidaemia and deals with the identification and management of treating both polygenic and monogenic lipid disorders in the presence or absence of overt cardiovascular disease.