Relationship between anterior fontanelle pressure measurements and clinical signs in infantile hydrocephalus

The treatment of choice in progressive hydrocephalus is drainage of cerebrospinal fluid in order to reduce elevated intracranial pressure (ICP). Defining the right moment for surgical intervention, however, in a hydrocephalic infant on the basis of clinical signs alone can be a difficult task. Clinical signs of raised ICP are known to be unreliable and sometimes even misleading. In the present study, the relationship between long-term anterior fontanelle pressure (AFP) measurements and clinical signs was investigated in 37 infants with hydrocephalus. The decision as to whether to operate or not was based on clinical signs alone; AFP values were not taken into account. There was an overall difference between the non-operated group and the preoperative measurements in the operated group, and also between the preoperative and the postoperative measurements in the latter, in regard to both AFP measurements and clinical signs. Almost all preoperative AFP values were increased. The direct correlation () between most individual clinical signs and AFP levels, however, was low (=0.15–0.41). The clinical sign tense fontanelle showed the best correlation with the AFP levels (=0.75). Furthermore, using logistic regression analysis, no combination of clinical signs could be found which reliably predicted the AFP. The relationship between the AFP pressure variables and clinical signs was also examined. The pathological A-waves occurred only in the presence of raised (baseline) AFP, a situation in which considerably more frequent B-waves were observed as well. It was concluded that clinical signs of raised ICP in infantile hydrocephalus are not very reliable and AFP monitoring can therefore provide valuable information on intracranial dynamics in patients with dubious neurological manifestations of progressive hydrocephalus.     

Epidemiologic aspects of latent and clinically manifest carcinoma of the prostate

Summary The worldwide incidence of prostate cancer differs greatly. The black population of the USA is at the head, while the Asian populations have the lowest incidence and mortality rates. Comparative geographic-pathologic autopsy studies on frequency and growth type of latent prostate carcinomas show that in populations with a lower incidence, for example Japan and Singapore, latent carcinomatous foci are not considerably rarer than in regions with high incidence. However, obvious differences are seen when comparing the size of the foci and the growth types. In countries with low incidence and mortality rate, the foci of the latent prostate carcinoma are small and show a slight proliferating tendency, whereas in countries with high incidence and mortality rate, they are frequently larger and more aggressive. Consequently, the different incidence of prostate cancer is not based on different initiation of malignant transformation, but on different promoting factors. In histologic-bioptical specimens from regions with high incidence and mortality rate, pluriform tumor types of malignancy grade G III and G II prevail. Definite causes of prostate cancer could not be detected by case control and migration studies up to now.Supported by the campaign Kampf dem Krebs e.V. der Deutschen Krebsgesellschaft     

中医药短期对外教学的现状分析与设想

中医药短期对外教学是中医药国际化进程中的重要一步.通过分析其现状和特点,提出依托国内整体学术实力和中医药发源地的地理优势来发展高层次的中医药对外教学.同时,建立独特的教学模式,加强专业语言沟通,编写合适的外文中医药教材,采用现代化教学手段也是中医药短期对外教学中必须重视和加强的环节.     

挑刺阳性反应点治疗腰椎骨质增生38例

试用三棱针挑刺腰部阳性反应点,治疗腰椎骨质增生38例,结果有效率100%,具有疗效好,费用低,疗程短,应用方便的特点.     

ROLE OF ACULASER THERAPY IN CEREBRAL PALSY CHILDERN （INITIAL DATA ＆ RESULTS）

1　BACKGROUNDTheincidenceofCPis 0 .7per 1 0 0 0livebirths[1 ] .Becausecerebralpalsyinfluencesthewaychildrendevelop,itoftenresultsindevelop mentaldisability .Today ,more peoplehavecerebralpalsythananyotherdevelopmentaldis ability ,includingDownsyndrome,epilepsy ,andautism .Accordingtoasurveyconductedin1 986,2 .6%ofthepopulationofPakistaniaredisabled (includingbothphysicalandmentaldis abilities) .Childrenbetween 0～1 4 yearsinageconstitute 40 %ofthedisabled populationinPakistan .Routineme…     

子宫内膜癌147例临床分析

目的：探讨子宫内膜癌的治疗及预后相关因素。方法：回顾性分析我科1991～1997年收冶的147例子宫内膜癌患者的临床病理资料，并全部随访。结果：147例患者、平均年龄56．1岁；5年生存率72．8％；临床表现不规则阴道出血135例、盆腔包块81例、白带增多38例及腹痛23例；绝经前病例为39．5％，已占相当比例，有年轻化趋势；临床病理分期愈晚，预后愈差；肌层侵犯的深度与淋巴结转移及病理组织学分级密切相关，深肌层浸润者，易淋巴结转移、病理组织学分级也差；手术为主、放疗、化疗为辅助治疗的综合治疗预后好、并发症少；孕激素对改善预后有一定的价值。结论：以手术为主的综合治疗是目前治疗子宫内膜癌的首选治疗措施；绝经前后的妇女出现不规则阴道出血等非特异性的妇科症状时，必须警惕子宫内膜癌的发生；临床病理分期、肌层浸润深度、病理组织学分级、淋巴结转移情况及孕激素的应用都是影响预后的相关因素。     

结缔组织增生性小圆细胞肿瘤2例并文献复习

目的:分析结缔组织增生性小圆细胞肿瘤(DSRCT)的临床病理特征。方法:结合文献对2例相对少见的DSRCT进行临床、病理形态及免疫组化研究。结果:DSRCT由成团巢的小圆细胞和丰富的结缔组织间质组成。免疫组化:小圆形的肿瘤细胞vimentin( );desmin( );EMA( );CK( );NSE( )。结论:DSRCT为高度侵袭性肿瘤,主要累及腹腔或盆腔的腹膜,肿瘤由小圆细胞和丰富的结缔组织间质组成。     

对41例儿童旋毛虫病的临床观察

为了解儿童旋毛虫病的临床特征，对１９９２～１９９５年就诊的４１例儿童旋毛虫病进行分析。结果表明，患儿来自河南６个地区，主要因食猪肉馅饺子、烤羊肉串或食涮猪肉而感染。冬季为本病的高发季节。患儿平均年龄为８．８岁，男女之比为２．７１。长期发热和嗜酸性粒细胞增多为本病的主要表现，仅少数患儿有肌痛、胃肠道症状和皮疹。眼睑水肿仅见于发病早期。血清学检查对诊断本病有重要意义。预防本病的关键措施是加强肉检和改变不良的饮食习惯。     

环枢关节紊乱症的临床研究

环枢关节紊乱症，从发病机理到临床表现，乃是颈椎病中较复杂的疑难顽症。用常规诊治方法，疗效不佳。本研究提出新的诊断依据与治疗方法，对３２０例病者随机分为治疗组１６６例（采用改进的诊治方法），对照组１５４例（用常规诊治方法）对照进行疗效观察。结果显示：治疗组治愈率与总有效率及康复率均高于对照组。有非常显著差异，Ｐ＜０．０１。而疗程较对照组短。环枢关节紊乱症的临床研究有利于颈椎病诊治水平的提高，运用于临床，疗效好，效益高，具有推广应用价值。     

Longitudinal monthly body measurements from 1 to 12 months of age: a study by practitioners for practitioners

A longitudinal growth study with monthly measurements during the 1st year of life was conducted by nine paediatricians working in private practice in Zurich. Of 92 children, none was lost to the study and only 32 of 1104 planned visits were missed; the quality of the measurements was comparable to that of a specialised university clinic. Compared to the Zurich Longitudinal Growth Studies, children of this study were considerably heavier and taller. In 92% of the subjects, growth velocity was at least once outside the reference range (3rd–97th percentile). For weight increments, the corresponding proportion was 87%. Conclusions The data indicate that current standards for the 1st year of life for the Zurich area might no longer be appropriate and need to be updated. The currently used velocity percentiles based on 3-monthly measurements are not suitable to assess individual height and weight increments calculated from monthly measurements. Received: 9 June 1997 / Accepted in revised form: 21 November 1997