Hepatic angiomyolipoma developing during the follow-up of ulcerative colitis: Report of a case and review of the literature

Hepatic angiomyolipoma is a rare tumor composed of spindle-shaped and epithelioid smooth muscle cells, adipose tissue, and proliferating blood vessels. We report the first documented case of this tumor developing in a patient with ulcerative colitis. A solitary tumor (7.5×7.5×7cm) was detected in the left lateral segment of the liver and a left hepatic lobectomy was performed. The diagnosis of angiomyolipoma was confirmed by a pathological examination. We also review the literature on previously reported cases of hepatic angiomyolipoma.     

一项新的水质检验——可同化有机碳测定

可同化有机碳(AOC)是一项新的水质检测指标,通过它可以评估供水系统的水中是否有足够的营养物质可使微生物再生长。由于目前尚无可行的化学方法检测 AOC,因此主要是用各种生物方法加以检测。本文介绍用荧光假单胞菌 P—17菌株和螺菌属 NOX 菌株作为测试菌,通过定量观察其在水样中的生长,如从接种到生长至最大数量,以考察其利用水中营养物质的情况,进而推算出水中 AOC 的浓度。     

薄层扫描法测定食物中胆固醇的含量

本文探讨食物中胆固醇的薄层光密度法的测定。用硅胶Ｇ与０．３％ＣＭＣ－Ｎａ按１：２．２比例制成薄层板，石油醚－乙醚－－冰醋酸（７：３：０．１）为展开剂，５％磷钼酸乙醇溶液显色，日本岛津ＣＳ－９１０型薄层扫描仪定量扫描，测得精神异系数（ＲＤＳ％）为２．９２。稳定性变异系数（ＲＳＤ％）为２．３５，加嘏率在８７．９５－９４．２９％范围内。与气相色谱法（其回收率在９２－１０３％范围）比较，结果相接近，该法简     

A preliminary study into the dental health status of multiple sclerosis patients

Multiple sclerosis (MS) is an inflammatory disease of unknown etiology involving the central nervous system. Since MS affects the whole body, orofacial aspects of the disease must be expected, particularly since loss of muscular coordination may result in a diminished ability to maintain oral hygiene. This preliminary study examined the dental health status of 22 volunteer MS patients. A questionnaire collected data regarding medical and dental histories and socieo-demographic information. Extra- and intra-oral examinations were carried out on all subjects to determine the particular dental treatment needs of this special group. The DMFT and CPITN scores for this group did not indicate that MS patients were more susceptible to dental caries or periodontal disease. However, the prevalence of trigeminal neuralgia and symptoms of TMJ dysfunction in the group studied indicated that these conditions may be manifest in MS patients and warrant further investigations.     

Dexmedetomidine Produces Similar Alterations in the Determinants of Left Ventricular Afterload in Conscious Dogs before and after the Development of Pacing-induced Cardiomyopathy

Background: The authors tested the hypothesis that intravenous dexmedetomidine produces alterations in left ventricular (LV) afterload that are deleterious to cardiac performance in conscious dogs with pacing-induced cardiomyopathy.

Methods: Dogs (n = 8) were fitted with instruments for long-term measurement of LV and aortic blood pressure, aortic blood flow, and subendocardial segment length and received dexmedetomidine (1.25, 2.5, and 5 [micro sign]g/kg) in a cumulative manner before and after 19 +/- 3 (mean +/- SEM) days of rapid LV pacing. LV afterload was measured with aortic input impedance [Zin ([Greek small letter omega]) and quantified with a three-element Windkessel model. Hemodynamics and Zin ([Greek small letter omega]) were assessed under control conditions and 5 and 60 min after administration of each dose.

Results: Dexmedetomidine caused early and late decreases in heart rate, the maximum rate of increase of LV pressure, mean aortic blood flow, and stroke volume in dogs before and after pacing. Dexmedetomidine caused similar early increases in total arterial resistance and decreases in total arterial compliance in dogs before and after pacing. Early dexmedetomidine-induced increases in resistance and decreases in compliance caused similar reductions in mean aortic blood flow in cardiomyopathic compared with healthy dogs. Resistance and compliance returned to control values, and characteristic aortic impedance decreased late after dexmedetomidine in healthy dogs. In contrast, resistance remained elevated late after dexmedetomidine in dogs with dilated cardiomyopathy.     

Transposition of the great arteries and isolated origin of the sinus node artery

We report the cases of 2 newborns who underwent at 7 days of age an arterial switch operation for transposition of the great arteries with a rare coronary anomaly: the left and right coronary arteries originated with a single ostium from sinus 1 and the sinus node artery had an isolated origin from sinus 2. The sinus node artery was reimplanted into the new aorta in both patients. Both babies were discharged in sinus rhythm. Preserving the vascularization of the sinus node may avoid the occurrence of postoperative atrial rhythm disturbances.     

主动脉瓣机械瓣置换术后交替脉

报道４例因主动脉瓣关闭不全行主动脉瓣置换术后的患者在术后早期出现脉搏交替现象，此时心电图为整齐的窦性心律，所记录的脉搏图形高低交替，如扪诊桡动脉时则会发现桡动脉搏数为心电图示心率的一半。患者术后均顺利恢复，显示这一现象为一过性的、良性的过程。推测这一现象出现的原因可能是术后早期主动脉瓣不再有回流，因而巨大的左室腔充盈不足，加之左室收缩力尚低，不能在每次收缩时都能射出同等量的血流所致     

Advancing Nursing Practice with a Unit-based Clinical Expert

Objective: To explore patterns in the practice of nursing and patient outcomes.
Design: Qualitative field research.
Population, Sample, Setting: Populations were critical care nurses and critically ill adult patients in the 10-bed medical critical care unit of a 900-bed teaching hospital. A convenience-purposive sample of 27 nurses and 31 patients was studied in 1985.
Methods: Six months of participant observation, unstructured interviews, and the constant comparison method of grounded theory.
Findings: Markedly different patterns were found in expert and nonexpert practice. The substantive theory of conversion helped explain how the majority of nonexpert nurses advanced their practice. The metaphor of catalyzed conversion captures how a unit-based expert nurse serves as a catalyst to advance the practice of nonexperts. Presence, defined as the way of being within a given clinical context, differentiated nurses.
Conclusions: (a) Expert and nonexpert practices are substantively different, (b) Expert and nonexpert practice results in different patient outcomes, (c) Conversion helps explain changes in nonexpert practice.
Clinical Implications: A unit-based expert nurse can increase patient-focused care.     

A Psychosociocultural Perspective, Part 2

Building on the foundation of understanding and comprehensive assessment of battered women, this article addresses service planning and intervention. Strategies are approached within the framework of a Crisis Paradigm developed from field research with battered women and their families. They include mechanisms such as support groups which link crisis service to the long-term needs of battered women, and systematic approaches to removing the obstacles which keep women victimized. An Assessment and Service Planning Guide (ASPG) is proposed for inclusion in routine health care of abused women. The article concludes with strategies for preventing violence at interpersonal and societal levels.