屈指肌腱修复术后弹性橡皮条制动疗效观察

目的 探讨58例Ⅱ区屈指肌腱离断修复术后用弹性橡皮条动力性制动的疗效。方法 离断肌腱用改良Kessler法修复，于指甲末端用丝线缝合连接橡皮条。前臂至指端用背侧石膏托固定。橡皮条固定于前臂下段掌侧，使手指指间关节屈曲。术后48h开始行主动伸指，依靠弹性橡皮条作被动屈指练习3周。结果 随访3～6个月，手指伸屈功能正常。结论 屈指肌腱吻合术后用弹性橡皮条制动疗效佳。     

Undesirable effects from latex gloves in hospital health-care personnel

The high incidence of occupational hand dermatitis in hospital employees and the increased number of reports on cutaneous, mucosal and systemic reactions connected with a widespread USE: OF GLOVES induced us to investigate the prevalence of undesirable effects caused by latex gloves and the possible risk factors. We distributed a self-administered questionnaire, elaborated by us. to 1030 Perugia Monteluce Hospital employees who usually used latex gloves at work. The questionnaire was returned by 922 (476 females and 446 males; mean age. 38.7 years). The subjects who reported atopy and/or undesirable glove reactions were interviewed and clinically examined. Of these, 128 (13.9%) had presented or still had glove problems and therefore were submitted to skin tests (patch and prick tests) and when negative, to use test. Our results showed that the large majority of skin complaints from gloves was caused by irritation rather than by allergy. Predisposing factors of irritant contact dermatitis (CD), which was present in 13.1% of the subjects investigated, were female sex. age under 31 years, cleaning activity mainly when carried out in the Held of internal medicine, and atopie constitution. The most common causative factors, investigated with two substitute latex gloves in 64 of the 120 patients affected by irritant CD, were cornstarch powder and perhaps latex proteins. Even if allergic skin disorders from latex gloves were rare in our unselected group (allergic CD: 0.5%-, contact urticaria: 0.3%), more attention should be given to IgE-mediated disorders since they may be a life threatening problem.     

Rubber Tube versus Silicone Tube at the Osteotomy Site in External Dacryocystorhinostomy

Background: In external dacryocystorhinostomy a large bony window is created in the lateral nasal wall and a mucosal anastomosis is created between the lacrimal sac and the nasal cavity. The success of the operation depends on the surgical anastomosis remains patent and converting to a wide enough epithelial-lined passage.

Objective: To compare the efficacy of using rubber versus silicone tubes at the osteotomy of Dacryocystorhinostomy

Design: Prospective, randomized, hospital-based study.

Subjects and Methods: 46 patients diagnosed with primary acquired nasolacrimal duct obstruction were assigned randomly to rubber, silicone or control group. The surgical procedures in the three groups were the same except that in patients of rubber and silicone groups, rubber or silicone tubes were placed at osteotomy opening and removed after 3 months. Transnasal endoscopic findings were recorded at the completion of surgery and at 3 months, 6 months and 9 monthes after surgery for the 3 groups. A computer aided digitizer was used to calculate the surface area of the osteotomy site.

Results: After removal of their tubes, 3 patients in the rubber group had recurrent epiphora (78.0% success), one patient in silicone group (92.86% success) and 4 patients in control group (77.8% success). The average final surface area of the osteotomy opening of patients with rubber group at the end of follow-up was (9.85?mm²) in the silicone group was (17.47?mm²), whereas in the control group was (8.56?mm²).

Conclusion: Silicone tube is better than rubber one in maintaining effective larger osteotomy after Dacryocystorhinostomy. This can improve the long-term success of the operation.     

橡皮障在根管预备过程中降低根管内微生物污染的效果

目的探讨在根管预备过程中使用橡皮障技术降低根管内厌氧菌数量的效果。方法选取医院牙体牙髓科需要对双侧下颌第一磨牙进行根管预备的患者40例,在知情同意的基础上,将治疗中同一患者使用橡皮障的患牙(n=40)作为实验组,将未使用橡皮障的对侧患牙(n=40)作为对照组,根管预备前后进行根管内菌落采样计数,并进行统计学分析。结果所有的牙齿经根管治疗后患牙内厌氧菌数目明显减少(p<0.001)。实验组术后菌落计数大大低于对照组,具有统计学意义(p<0.001)。结论在根管预备过程中使用橡皮障能有效降低根管内微生物污染效果,对口腔感染控制起到非常重要的作用。     

火焰原子吸收法快速测定食品用橡胶制品中溶出锌

目的建立火焰原子吸收法快速测定食品用橡胶制品中溶出锌含量的方法。方法取4%冰乙酸浸泡液直接用火焰原子吸收法测定其锌含量。结果 0.1～2.0mg/L范围内线性良好,相关系数为0.9998,方法检出限为0.0084mg/L。试样测定的相对标准偏差均小于2%（n=6）,回收率在95.0～103.8%之间。结论本方法操作简便快速,灵敏度高,结果准确可靠,适于实验室进行食品用橡胶制品中锌的测定。     

Incidence of immediate allergy to latex gloves in hospital personnel

Latex surgical gloves may cause contact urticaria and serious allergic reactions in sensitized persons, but the frequency of this allergy is not known. In the present study, 512 hospital employees were screened with a latex-glove scratch-chamber test; 23 (4.5%) were suspected and 15 (2.9%) were proven allergic with latex prick and use tests. All of them were doctors and nurses, and 12 had had contact urticaria but no serious symptoms. They could continue their routine work using cotton or vinyl undergloves or special latex surgical gloves. Atopy, hand eczema and surgical work seemed to be predisposing factors. In operating units, 7.4% of the doctors and 5.6% of the nurses were allergic; the frequency was lower in non-operating units and among laboratory personnel. The high frequency of latex glove allergy, especially in operating units, focuses attention on the quality of surgical latex gloves.     

Medically unexplained symptom reports are associated with a decreased response to the rubber hand illusion

Objective

Medically unexplained symptoms (MUS) have been hypothesized to result from a distortion in perception, whereby top-down factors influence the process of body representation. Perceptual illusions provide a novel method of investigating this hypothesis. This study aimed to investigate whether self-reported unexplained symptoms are associated with altered experience of the rubber hand illusion (RHI).

Methods

A non-clinical MUS group with high scores on the Somatoform Dissociation Questionnaire (SDQ), and a control group with low scores on this scale, were exposed to the RHI. Illusion experience was measured by self-reports and by proprioceptive alteration.

Results

After controlling for somatosensory amplification and trait anxiety, the low-SDQ group responded significantly more strongly to the RHI on both questionnaire and proprioceptive measures of the illusion. In contrast, the high-SDQ group scored significantly higher on the Perceptual Aberrations Scale, a measure of bodily distortions in daily life.

Conclusion

These findings support the proposed link between MUS and disturbances in body representation, and suggest that a decreased reliance on current sensory inputs may contribute to symptom experience in susceptible individuals.     

Telephone follow-up following office anorectal surgery

INTRODUCTION

Patients with minor anorectal conditions are frequently reviewed at an 8-week out-patient appointment (OPA). This study was designed to assess whether telephone follow-up could reduce OPA numbers whilst maintaining patient satisfaction.

PATIENTS AND METHODS

Over an 11-month period, 46 patients (23 male) underwent banding of haemorrhoids and 14 were prescribed medical treatment for fissure-in-ano (3 male). All were telephoned at 6 weeks and were offered an 8-week OPA if they had continuing problems. Patients were telephoned at a later date by a member of the hospital''s patient panel to assess satisfaction.

RESULTS

Overall, 88% were contacted at 6 weeks, 60% at the first attempt; 40% required two or more attempts. Of those who underwent banding, 68% were asymptomatic, 17% requested an OPA for re-banding and 15% requested an OPA for a different problem. Of fissure patients, 25% were cured; the remainder were prescribed either second-line medical treatment (8%), anorectal physiology (42%) or surgery (25%). All avoided an OPA. Of a potential 60 OPAs, 47 were saved by telephone follow-up. None of 7 non-contactable patients accepted a written offer of an OPA. Overall, 89% of patients were contacted by the patient panel; of these patients, 93% reported a high level of satisfaction.

CONCLUSIONS

Telephone follow-up can reduce the number of OPAs following out-patient treatment of minor anorectal conditions whilst maintaining a high level of patient satisfaction. However, it requires considerable consultant time. This process could be developed into either a nurse-led service with booked telephone appointments or a patient-led service to a dedicated hotline.     

Development and validation of HPLC methods for the determination of potential extractables from elastomeric stoppers in the presence of a complex surfactant vehicle used in the preparation of parenteral drug products

HPLC methods were developed and validated for potential extractables [zinc dithiocarbamate, 2,6-di-tert-butyl-para-cresol (BHT), octylated diphenylamine antioxidant, sulfur, pentylphenol, and tetrakis(methylene(3,5-di-tert-butyl-4-hydroxyhydro cinnamate))methane] from commercial elastomeric stoppers in a complex surfactant matrix. These stoppers were proposed to be part of the container-closure system for experimental formulations containing the surfactant, polyoxyethylated Castor oil (USP/NF) (POE Castor oil) and ethanol. The presence of POE Castor oil in the formulation posed unique challenges to the development and validation of the HPLC methods. POE Castor oil, also known as Cremophor, is a viscous and complex solubilizing agent with a number of uncharacterized fractions. Hence the goal was to identify HPLC conditions that would be suitable for the separation, detection, and quantitation of the potential stopper extractables in the presence of such a complex drug product matrix. A number of experiments were performed to evaluate the effects of different columns, mobile phase composition, injection volume, and gradient profile on the separation and detection of the potential stopper extractables. The quantitation limits of these stopper extractables are between 1 and 10 ppm. The methods demonstrate good linearity, acceptable accuracy, and precision.     

MODIFICATION OF THE LOWRY METHOD FOR ANALYSIS OF SOLUBLE LATEX PROTEINS

Proteins from natura lrubber latex (NRL) can cause local and systemic reactions in people who are allergic to it. Reducing the total protein in NRL products to minimize the allergenic potential requires methods of accurately estimating the amount of protein. Previous work in this laboratory and others has indicated that, of the colorimetric assays, a modified Lowry method performs best. The American Society for Testing Materials (ASTM) has adopted the modified Lowry method for analysis of soluble NRL proteins.This method, although the best currently available, lacks sufficient reproducibility and sensitivity. In anattempt to improve the method, we address in this article the importance of various extraction conditions and additional approaches to eliminate interfering substances that may cause the false-positive values in the test. Depending on the chemical composition of the accelerants added during manufacturing processes, different means may be employed to remove or to account for the presence of these small organic molecules. The best general way to remove these chemical compounds is the partitioning of the latex extracts with ethyl acetate followed by acid precipitation. Although there is no one perfect method for all NRL proteins and products, the data presented here indicate that changes in the standard protocol of the Lowry method may result in more reproducible and reliable results.