Lack of Chemoprevention Effects of the Monoterpene d-Limonene in a Rat Multi-organ Carcinogenesis Model

Modifying effects of dietary administration of the monoterpene d -limonene were examined using a multi-organ carcinogenesis model. Groups of twenty F344 male rats were treated sequentially with N -diethylnitrosamine (DEN, i.p.), N -methyl- N -nitrosourea (MNU, i.p.), 1,2-dimethylhydrazine (DMH, s.c.), N -butyl- N -(4-hydroxybutyl)nitrosamine (BBN, in drinking water) and dihydroxy-di- N -propylnitrosamine (DHPN, in drinking water) during the first 4 weeks (DMBDD treatment), and then ( d -limonene was administered in the diet, at the dose of 2.0, 1.0 or 0.5%. The maximal tolerable dose was 2.0% under the present conditions. Further groups were treated with DMBDD or 2.0% d -limonene alone as controls. All surviving animals were killed at week 28, and major organs were examined histopathologically for development of preneoplastic and neoplastic lesions. The incidences and/or multiplicities of renal atypical tubules and adenomas were increased in animals fed 2.0% d -limonene. The immunohistochemical reactivity for α_2u-globulin in the proximal tubules was greater in rats fed d -limonene than in the carcinogen alone group. No enhancing or inhibitory effect was noted for tumor development in other organs. The present results indicate a lack of any chemopreventive effect of ( d -limonene in any organ of male rats under the present experimental conditions.     

Pancreatitis: critical care update

Severe acute pancreatitis (SAP) is a common pathology requiring critical care input. Patients often present with evidence of physiological dysfunction that may require organ support for optimization. Various scoring systems are available which can help in identifying those most at risk of morbidity and mortality. Complications can be significant, and may require surgical intervention for management. As such these patients should be managed with full multidisciplinary input to ensure appropriate targeted treatment. Underlying causes for SAP should be aggressively investigated to reduce the potential for recurrent episodes and where appropriate allow for secondary preventative measures. These patients often require prolonged and recurrent intensive care stays. Of those who are discharged, ongoing issues with chronic pain and nutrition are not uncommon and can lead to significant psycho-social challenges in the community.     

腹腔镜联合手术的应用体会

目的:探讨应用腹腔镜技术诊治胆囊合并腹腔多脏器疾病的应用价值.方法:回顾分析2003年9月至2010年10月为56例患者施行腹腔镜联合手术的临床资料.结果:本组56例腹腔镜联合手术均获成功,无中转手术及并发症发生.肠蠕动恢复时间5～24h,术后下床活动时间6～20 h.术后穿刺孔局部疼痛轻,持续1～3h,均未使用止痛药...     

Reduction in mortality in severely injured patients following the introduction of the “treatment of patients with severe and multiple injuries” guideline of the German society of trauma surgery – a retrospective analysis of a level 1 trauma center (2010–2012)

Objective

The German society of trauma surgery published the “Treatment of Patients with Severe and Multiple injuries” guideline in 2011. This achieved the highest level of recommendation for guidelines published in Germany. This study investigated if there was an improvement in the survival rates of severed injured patients following the introduction of the guideline in clinical treatment.

Methods

All patients with an injury severity score ≥16 on primary admission to hospital between January 2010 and December 2012 (a total of 373 patients) were included in this study. The data for these patients were collected from the German Trauma Registry and from patients’ hospital records. Patients who were treated in 2010 were compared with patients who were treated in 2011 and 2012, following the introduction of the “treatment of patients with severe and multiple injuries” guideline in the authors’ clinic at the beginning of 2011.

Results

Significant differences were found in ISS, RTS, New ISS, and TRISS between 2010 and 2011/2012. No differences were found in the severity of injury when classified by different body regions. Major differences were found in the total volume replacement, the length of emergency surgery, the length of surgery performed within the first 24 h and the rate of whole-body computed tomography. The mortality rate dropped from 32.48% in 2010 to 18.75% in 2011/2012 (p = 0.003).

Conclusions

The introduction and use of a guideline-based medical care regime for severely injured patients might reduce the rate of mortality.     

Effects of X-Irradiation on N-Methyl-N-nitrosourea-induced Multi-organ Carcinogenesis in Rats

The effects of X-irradiation on N-methyl-N-nitrosourea (MNU)-induced multi-organ carcinogenesis were examined in both sexes of ACI/N rats. At 6 weeks of age, rats in groups 1 (25 males, 25 females) and 3 (24 males, 23 females) received a single i.p. injection of MNU (25 mg/kg body weight), while those in groups 2 (25 males, 26 females) and 4 (25 males, 25 females) were administered the carcinogen at a dose of 50 mg/kg body weight. At 10 weeks of age, groups 3 and 4 were X-irradiated at a dose of 3 Gy. Group 5 (24 males, 24 females) received X-irradiation alone. Group 6 (21 males, 21 females) served as an untreated control. As a result, neoplasms developed mainly in the digestive tract, kidney, uterus, and hematopoietic organ in groups 1–5. The incidences of adenocarcinoma in small and large intestines of male rats of group 4 (50 mg/Ag MNU and X-irradiation) (small intestine: 48%, large intestine: 32%) were significantly higher than those of group 2 (50 mg/kg MNU) (small intestine: 17%, P<0.05; large intestine: 8%, P<0.05), and also the frequency of adenocarcinoma in the large intestine of males of group 3 (25 mg/kg MNU and X-irradiation) (22%) was significantly greater than that of group 1 (25 mg/kg MNU) (0%, P<0.O5). These results indicated that X-irradiation enhanced the development of intestinal neoplasms induced by MNU in male ACI/N rats.     

Congenital fulminant Kaposiform hemangioendothelioma of the leg

Kaposiform hemangioendothelioma is a rare locally aggressive vascular tumor associated with Kasabach Merritt syndrome. We present a case of congenital Kaposiform hemangioendothelioma of the leg in a female infant who was born to a mother treated with various medications including etanercept, a TNF antagonist, due to rheumatoid arthritis. The neonate suffered from a fulminant form of Kasabach Merritt syndrome with disseminated intravascular coagulation (DIC) resulting in multi-organ failure which led to her demise.     

新生儿窒息非生命器官血流动力学变化的观察

应用美国Ultramark－9型彩色多普勒超声诊断仪，于1995年8月～1996年7月，对新生儿窒息非生命器官（肾、肝、脾、胃、大肠、小肠）血流动力学变化进行了有对照组的前瞻性研究.结果证实新生儿窒息后备非生命器官血液灌流量均减少，且重于生命器官，舒张期减少更明显；并发现各脏器血流速度减慢的程度与低氧血症的程度至高度正相关（γ＝0．39～O．96。P＜0．0005）。证实血流量减少是新生儿窒息各脏器损伤和功能障碍的主要原因。     

Peritoneal dialysis for acute renal failure in children

Fifty infants and children with acute renal failure were treated with acute peritoneal dialysis between 1987 and 1990. The patients were dialyzed using either a catheter introduced percutaneously over a guide-wire (n=40) or a Tenckhoff catheter (n=10). The cause of the acute renal failure was primary renal disease in 17 children, cardiac disease in 19, and trauma/sepsis in 14. Peritoneal dialysis succeeded in controlling metabolic abnormalities, improving fluid balance, and relieving the complications of uremia. The procedure had few major complications. Overall mortality was 50%, reflecting the serious nature of the underlying diseases. We conclude that acute peritoneal dialysis is a safe and effective treatment in most pediatric patients with acute renal failure. Our series of patients treated with acute peritoneal dialysis serves as a basis of comparison for the evaluation of new modalities of therapy in childhood acute renal failure.