Effect of chronic oral domperidone therapy on gastrointestinal symptoms and gastric emptying in patients with parkinson's disease

This study investigated whether domperidone could improve gastrointestinal symptoms in patients with Parkinson's disease who were receiving levodopa therapy. A total of 11 patients were studied. Following a baseline gastric emptying test, patients were treated with a starting dose of domperidone 20 mg p.o. q.i.d. A follow-up gastric emptying test was repeated at least 4 months after starting domperidone therapy. At the beginning and at each 3-month follow-up visit, symptoms of nausea, vomiting, anorexia, abdominal bloating, heartburn, regurgitation, dysphagia, and constipation were evaluated and scored on a scale of 0–3. The overall mean follow-up period was 3 years. Compared with their baseline evaluation, patients experienced a significant improvement in all symptoms (p < 0.05) except dysphagia and constipation. Gastric emptying of an isotope-labeled solid meal was significantly faster, with a baseline result of 60.2 ± 6.4% retention of isotope 2 h after the meal compared with 37.0 ± 2.2% retention during domperidone therapy (p < 0.05). Patients' global assessment of Parkinson's disease remained stable or improved. Serum prolactin was elevated in all patients after domperidone therapy (p < 0.05). Domperidone therapy significantly reduces upper gastrointestinal symptoms and accelerates gastric emptying of a solid meal, but does not interfere with response to antiparkinsonism treatment.     

Retrograde air insufflation in MRI: A technical note

Retrograde air insufflation was employed to distend the colon and the ileum in 18 patients and five volunteers for magnetic resonance examination. Good and moderate marking of the ileum was obtained in 18 cases. The colon was nearly completely distended in every case. Intraluminal tumor, mural thickening, and extraluminal lesion were outlined by intraluminal air and surrounding air-distended bowel. This study shows that retrograde air insufflation is a useful method to mark the colon and most parts of the ileum.     

豚鼠胃肠道粘膜下层内神经节丛与血管的伴行现象

对豚鼠胃肠道各段的研究发现,在胃体、胃底和幽门的粘膜下层内,血管仅由神经纤维束伴行。除小肠粘膜下层可见神经节丛与血管伴行外,在盲肠粘膜下层,亦可见神经节丛与小动、静脉伴行,尤以血管始段及第一分支段最明显。某些神经节丛还发出神经纤维束投射到血管壁上。在结肠和直肠均未见到神经节丛与血管的伴行现象。     

家兔实验性减压病时血浆中血拴素A_2及前列环素含量的变化

实验观察了“安全”减压和不适当减压条件下家兔减压病(DCS)的发病情况、Doppler超声以及血浆中TxB_2和6-keto-PGF_(1a)的变化;还观察了消炎痛对DCS的预防怍用。结果显示:减压愈不当,DCS发病愈重,Doppler超声气泡探测仪检测到的级别愈高。血浆TxB_2、6-keto-PGF_(1α)值在濒死动物中明显升高(P<0.01);存活动物中,TxB_2经历了下降、再恢复的过程(P<0.01),而6-keto-PGF_(1α)值未见明显变化。消炎痛在抑制血浆TxB_2升高的同时,有效地降低了DCS发病率。此结果表明:TxA_2、PGI_2参与了重型DCS的发病过程,消炎痛的顶防作用与抑制花生四烯酸代谢物的生成有关。     

Staging-laparoscopy

Summary. The so-called extended diagnostic laparoscopy (EDL) facilitates the comprehensive exploration of the abdominal cavity, thus improving the precision of the pretherapeutic tumor staging in gastrointestinal malignancies. EDL comprises visual inspection with a specific preparation of all relevant sites, laparoscopic sonography and retrieval of samples for biopsy and cytology. Additional relevant therapeutic information was obtained through EDL in 40.5 % of gastric cancer patients. EDL could be of similar importance for diagnosing esophageal, hepatobiliary and pancreatic malignancies.      

Open surgery of giant paraclinoid aneurysms improved by intraoperative angiography and endovascular retrograde suction decompression

Summary In three consecutive cases of giant left sided paraclinoid aneurysms we employed an endovascular retrograde suction decompression technique in combination with intra-operative angiography. A double-lumen balloon catheter was placed in the left internal carotid artery by the transfemoral route. After balloon inflation and placement of a temporary clip distal to the aneurysm blood was aspirated and the aneurysm collapsed. Thus further dissection of the aneurysm could easily be achieved and clips could be placed. Afterwards real-time digital subtraction angiography was performed. Intra-operative angiography led to clip repositioning in all cases either due to a clip induced stenosis of the parent vessel, or because of incomplete aneurysm obliteration. Afterwards successful clipping could be confirmed in all cases. Outcome was excellent in one case, good in the other. The third case, extremely complicated by an accompanying craniopharyngioma, showed a satisfactory outcome, but presented new neurological deficits.     

消化道恶性肿瘤确诊初期患者社会支持与生命质量的调查

目的 调查消化道恶性肿瘤确诊初期的患者半年中的社会支持和生命质量变化。方法 采用社会支持评定量表和CARES-SF对146名患者的社会支持和生命质量进行为期半年的追踪调查。结果 消化道恶性肿瘤确诊初期患者的生命质量为中等，其中婚姻关系维度、性关系维度得分半年后下降。患者所获得的社会支持最多的是情感支持，其次是实际支持，信息支持为第三位。情感支持大多来源于家庭成员，信息支持大多来源于医务人员。患者大多很少参与社交活动。在半年中情感支持、实际支持、信息支持的变化模式不一。诊断初期的患者不能有效地利用社会支持。结论 应对确诊初期患者加强咨询，以充分识别和利用社会资源。应持续评估患者的生命质量和社会支持，并制订干预方案，提高消化道恶性肿瘤确诊初期患者的社会支持程度，最终提高其生命质量。