Successful surgical treatment of secondary kwashiorkor after total gastrectomy: Report of a case

We report herein the case of a 56-year-old woman who developed secondary Kwashiorkor 9 years after undergoing a total gastrectomy for early gastric cancer. Until she began developing the symptoms of Kwashiorkor, including general fatigue, edema of the face and extremities, anemia, alopecia, and weight loss, she had been leading a normal life post-gastrectomy. Her symptoms were alleviated by total parenteral nutrition (TPN) therapy, but reappeared soon after TPN therapy was discontinued. Therefore, she required several subsequent courses of TPN. In an attempt to permanently resolve the ongoing Kwashiorkor symptoms, reconstructive surgery involving transposition of the jejunum from the previous Graham method to the interposition method was performed 10 years after the initial gastrectomy. After the second operation, her malnutrition was completely alleviated, and she has been in good health for the 8 years since. To our knowledge, there has been no other report of the symptoms of secondary Kwashiorkor after total gastrectomy being alleviated by altering the procedure of reconstruction of the intestinal tract. Thus, we recommend surgical treatment to alter the digestive continuity to a more physiological pathway for selected patients with secondary Kwashiorkor syndrome.     

Primary adenocarcinoma of the fallopian tube. Review of the literature

An extensive review of the currently available literature on primary fallopian tube carcinoma is presented. The role of vaginal ultrasonography and the importance of an aggressive evaluation of every tubal deformity is stressed. A staging system which takes into account recent data on the biology of this malignancy is proposed. We emphasize the largely underestimated importance of early lymphatic spread of this disease, necessitating a thorough staging laparotomy with pelvic and para-aortic lymph node sampling in the apparent early stages. The need for adjuvant treatment is obvious, but until now no firm data exist as to what the optimal strategy should be. We recommend that until more representative studies are available, ovarian carcinoma protocols should be used in clinical practice.     

Changing helplessness to coping: an exploratory study of social skills training with individuals with long-term mental illness

The primary purpose of this study was to apply an occupational therapy programme for social skills training based on a cognitive-behavioural frame of reference to individuals with long-term mental illness. The goal of the social skills training group was to enable patients to develop verbal and non-verbal communication skills that could be generalised to everyday interpersonal encounters. A case example of the application of social skills training with a 38-year-old single male with a diagnosis of paranoid schizophrenia is described. The Group-Interaction Skills Survey developed by the author served as an outcome measure. Qualitative data confirmed the researcher's hypothesis that individuals with long-term mental illness can benefit from social skills training using a combination of role-playing, sociodrama, videotape recordings and creative media. Copyright © 1996 Whurr Publishers Ltd.     

Granular cell abrikossoff tumours of the larynx and tongue treated with the carbon dioxide (CO2) laser

Seven cases of granular cell Abrikossoff tumours of the larynx and tongue are reported: four in the tongue and three in the larynx. All of these tumours were removed with the carbon dioxide (CO₂) laser. The anatomical site of the origin and clinical features of granular cell tumours (GCT) are not specific. Histological, light microscopic, electron microscopic (EM) and immunohistochemical studies are required for diagnosis. The histogenesis and cellular derivation of GCTs is still controversial. The biological potential and lack of cellular atypia define a benign process. However, it is important to take into account that these tumours have ill-defined borders without a capsule. Radiation therapy has proved ineffective in the past. Surgical excision with a wide margin is required. Because of numerous advantages, for example, no bleeding, no oedema, minimal pain and quick recovery, CO₂ laser removal is the treatment of choice. The authors have not seen any recurrence or complications.     

偏头痛药物治疗的现状及进展

本文综述常用抗偏头痛药物的药理学特点及临床应用。新药舒马坦具有理想的选择性抗偏头痛活性,布托啡烷等的经鼻喷雾用药系统为以前不能接受治疗的偏头痛患者提供一种新的给药途径,这些新的或正在 研究中的疗法将给临床医师提供治疗偏头痛患者更广泛的选择手段。     

Nd:YAG激光虹膜透切术治疗闭角型青光眼的临床观察研究

Nd:YAG激光虹膜透切术治疗闭角型青光眼406只眼。单脉冲激光能量为3～6mJ,平均总能量为186mJ。一次虹膜透切成功者占80.0％,二次治疗成功者为17.2％,需三次治疗者仅为2.8％。治疗后随访0.5～1.0年,眼压平均下降0.78kPa(5.87mmHg)。视力有明显提高达55.5％,保持原来视力不变者为41.0％,视力微有减退者为3.5％。治疗效果显著,无严重并发症。     

环钻术治疗创伤性后尿道狭窄(附8例报告)

作者用自行设计的角膜环钻刀切除后尿道瘢痕组织,显露膜部尿道,治疗创伤性后尿道狭窄8例,术后随访7月～8年,排尿通畅,效果满意,此法简便易行。     

千捶膏配合生肌玉红膏治疗感染性伤面的临床观察

我院多年来应用千捶膏和生肌玉红膏治疗感染性伤面。千捶膏用于去腐,生肌玉红膏用于生新。据我们观察二药有较强的抗感染作用,尤其有抗绿脓感染作用。应用千捶膏可以较快地达到脱腐作用,应用生肌玉红膏可以促进肉芽增生,达到伤面早期愈合,值得推广。     

EFFECTS OF ACUTE AND CHRONIC ADMINISTRATION OF TWO ANTIBIOTICS, AZTREONAM AND GENTAMICIN, ALONE OR IN COMBINATION, ON "OPEN-FIELD TEST" IN MICE

A study aimed at investigating the behavioural effects of aztreonam and gentamicin, given separately or in combination, was carried out in mice. Animals were randomly assigned to two test conditions: acute and chronic treatment. Those receiving acute treatment had a single IP injection 60 min before the test. Those receiving chronic treatment had IP injections once daily for 5 successive days prior to the test. Behavioural patterns (ambulation, rearing, grooming and defecation) were assessed using the "open-field" test. The results indicate that, both after single and multiple dosing, aztreonam (10, 40 and 80 mg/kg IP) and/or gentamicin (10 mg/kg IP) do produce changes in the behaviour of animals. A rate increasing effect for certain behaviours (rearing, grooming and defecation) and a reduction in other behaviours (ambulation) seems to occur.     

Correlation of manual dexterity and comprehension with oral hygiene and periodontal status in mentally handicapped adults

Although there is relatively little information concerning the oral health of handicapped adults there is increasing evidence to suggest that their oral condition, particularly periodontal health, is poor. The present investigation involved assessment of 382 handicapped patients attending four different Adult Training Centres in Birmingham. The caries status, oral hygiene, and periodontal conditions were evaluated and the Community Periodontal Index of Treatment Need (CPITN) was calculated. In order to assess the manual dexterity and the comprehension of the trainees a standard test was devised. This consisted of timing each participant in carrying out simple instructions to pick up and position certain common objects. The results indicated high levels of plaque, calculus, and bleeding with a mean CPITN of 7.43. The mean time taken for the manual dexterity and comprehension test was 23.9 seconds with a range from 10 to 80 seconds, S.E.+/- 1.33. This compares with results from 34 "normal" adults of a mean time of 8.2 seconds +/- 1.8 with a range of 6 to 12 seconds. There was no significant correlation between the Manual Dexterity and Comprehension scores and the periodontal indices in the handicapped adults.