骶后孔解剖学测量及临床意义

目的：通过对骶后孔位置的研究,进一步解决在针炙临床中对八穴定位不准的问题。方法：用游标卡尺对骶后孔的纵、横径及骶后孔间径进行测量,并作统计学处理。结果：测算出100例骶骨（男性54例,女性46例）骶后孔纵、横径和骶后孔中心距后正中线间横径及骶后孔中心间纵径的数值。并结合这些数值,提出比较准确的八穴的定位方法。结论：骶后孔中心距后正中线间横径及骶后孔中心间纵径对八穴的准确定位具有重要指导作用。此外,骶尾椎和腰椎骶化变异对八穴取穴也有一定影响。     

浅谈医院门诊部工作的主要特点与基本要求

翔实地阐述了门诊工作的特点：服务对象与病种的复杂性及心态的多样性;医疗质量监控缺乏系统必 ;病人就诊高峰的相对集中性;门诊诊治工作的时效性与风险性;急诊抢救工作的突发性与应性;门诊业务工作的多元性、专业性和服务保障工作的整体性;门诊部管理职能的双重性,同时提出了相应的基本要求。     

A new approach to the study of ocular chromatic aberrations

We measured the ocular wavefront aberration at six different visible wavelengths (between 450 and 650 nm) in three subjects, using a spatially resolved refractometer. In this technique, the angular deviation of light rays entering the pupil at different locations is measured with respect to a target viewed through a centered pupil. Fits of the data at each wavelength to Zernike polynomials were used to estimate the change of defocus with wavelength (longitudinal chromatic aberration, LCA) and the wavelength-dependence of the ocular aberrations. Measured LCA was in good agreement with the literature. In most cases the wavefront aberration increased slightly with wavelength. The angular deviations from the reference stimulus measured using a magenta filter allowed us to estimate the achromatic axis and both optical and perceived transverse chromatic aberration (TCA), (including the effect of aberrations and Stiles-Crawford effect). The amount of TCA varied markedly across subjects, and between eyes of the same subject. Finally, we used the results from these experiments to compute the image quality of the eye in polychromatic light.     

Orbital infarction and melting in a patient with systemic lupus erythematosus

OBJECTIVE: To present a patient with systemic lupus erythematosus who developed infarction and melting of the orbit secondary to her systemic disease. DESIGN: A case report. PARTICIPANT: A 61-year-old white woman with a 5-year history of systemic lupus erythematosus. METHODS: The patient presented with left orbital pain, limitation of extraocular movements, and a fistula from the ethmoid sinus to the upper eyelid. A detailed examination with computerized tomography, ultrasound, and a comprehensive medical evaluation with laboratory testing was performed. Histopathologic analysis with special stains of the orbital tissues was also performed. RESULTS: Histopathologic examination of the biopsy specimens revealed the features of an inflammatory process involving the orbit, similar to a panniculitis. These include a lymphocytic reaction with a predominance of plasma cells, vasculitis with occlusion, and thickening of the vessel walls, necrosis, and hyalinization of fat. CONCLUSION: This is a unique case in which infarction and melting of the entire orbital structures occurred in the presence of systemic lupus erythematosus. The underlying disease process is a lupus-related panniculitis. The authors stress that this is a very rare entity and that other diseases should be ruled out before entertaining this diagnosis.     

The a- and b-wave latencies as a prognostic indicator of neovascularisation in central retinal vein occlusion

To evaluate the prognostic value of ERG in cases of central retinal vein occlusion (CRVO) regarding the development of neovascularisation (NV), we studied 20 patients with unilateral CRVO. Half of them were allocated in the perfused group and the other 10 finally developed NV and were allocated in the non-perfused group. Flash ERG was recorded from all patients. Our findings suggest that b-wave latency is the most reliable parameter in predicting NV, followed by the a-wave latency. The b/a wave amplitude of ERG ratio does not seem to be suitable for clinical use. This revised version was published online in July 2006 with corrections to the Cover Date.     

多脏器微栓塞病细胞综合征动物实验模型──定义、判断标准、发生机制及其与临床的关系

利用健康杂交犬制作了多脏器微栓塞病细胞综合征（ＰＯＭＳ）模型,观察在不同时限、不同组织器官造成的病理生理改变。从中发现,钳夹腹主动脉阻断血流后,其供血器官都发生了ＲＯＭＳ,且不同器官的功能与结构损害有发生时间和程度的不同,但均有不同程度的微栓塞形成趋势,这有助对“多脏器衰竭”概念认识的深化。     

Effective treatment of acute hyperkalaemia in childhood by short-term infusion of salbutamol

Hyperkalaemia is a lifethreatening emergency and infusion of glucose with insulin has so far been regarded as the standard treatment of choice. Recently the -2 stimulatory drug salbutamol has been shown to be an effective agent to treat hyperkalaemia by inducing a shift of potassium into the intracellular compartment. We treated 15 children aged 0.1–14 (mean 5.2) years suffering from acute hyperkalaemia (mean level 6.6±0.54, range 5.9–7.7 mmol/l) with a single infusion of salbutamol (5 g/kg over 15 min). Serum potassium concentrations decreased significantly within 30 min to levels of 5.74±0.53 and 4.92±0.53 mmol/l after 120 min (P<0.001, respectively). No side-effects occurred other than a slight increase in heart rate in 3 patients.Conclusion A single intravenous infusion of salbutamol at a dose of 5 g/kg is a highly effective treatment for hyperkalaemia with minimal clinical side-effects. The effect lasts for at least 120 min and may reverse hyperkalaemia in some patients without further interventions so that salbutamol seems justified as the first choice treatment for this condition in childhood.     

Practical approach to recurrent respiratory infections

Respiratory diseases are a major cause of morbidity and mortality in developing countries. Recurrent respiratory infections in children pose a great challenge to the pediatrician where he has to exercise his clinical acumen and methodical, approach, for correct diagnosis and treatment. It is a fact that children should suffer 7 to 8 upper respiratory infections per year until they are 5 years of age when their immune status reaches adult level. In this situation, it is essential to find out whether the frequencies are abnormal. Whenever a child has the following, problems, then only it needs to be investigated.—(a) repeated bacterial pneumonias; (b) a child less than 3 months old having repeated respiratory infections; (c) a child of 9 months old without a history of exposure infections; (d) infections, complicating into bronchiectasis and; (e) in a child where there is no history of allergy or asthma. Once the problem is established as a true recurrent respiratory infection, the clinician should pose questions—whether it is chronic, acute or recurrent, to find out the site of pathology, seriousness of the problem, response to previous medications, to establish the possible diagnosis which fall into six categories—congenital anamolies, aspiration syndrome, genital disorders, immunological, diseases, immune deficiency disorders and allergic diseases. The author discusses quoting some examples for various categories avoiding non pulmonary causes for recurrent respiratory infections in children.     

Figures of merit to compare distributed linear inverse solutions

Summary This paper introduces the concept of the resolution matrix as the basis for an objective theoretical comparison of distributed linear inverse solutions to the neuroelectromagnetic inverse problem. In particular, we describe how figures of merit derived from the resolution matrices can be represented graphically to evaluate merits and shortcomings of the different solutions. The use of the figures of merit is illustrated with two solutions that consider minimal a priori information about the generators: Classical Minimum Norm and Backus Gilbert. We recommend to start any analysis with the individual exploration of the resolution kernel for each grid point or at least for those points where the activity is likely to occur. This analysis might help in selecting the optimal inverse for the sources that are supposed to be active in the process under study.This work was supported by a grant from the Deutsche Forschungsgemeinschaft (Klinische Forschergruppe Biomagnetismus and Biosignalanalyse). Partial support was received from Swiss National Foundation grant 4038-044081/1.