Percutaneous retrieval of an impacted ureteric T-tube

An impacted ureteric T-tube was removed percutaneously, using an Amplatz goose-neck snare. This new snare has advantages over conventional snares, particularly in situation where atraumatic manipulation is essential. Correspondence to: R. D. Edwards     

New anastomosis technique for (laparoscopic) instrumental small-diameter anastomosis

This study presents a new technique for visceral anastomosis. The principle consists of connecting the two parts to be anastomosed around a reabsorbable stent which is transluminally introduced into a small-diameter viscus, where it is fixed. Advancing a larger tube along the axis of the machine, the larger, perforated viscus is inverted and pulled over the stent, and finally a rubber band pops off the machine endoluminally in order to fix the intestinal walls in seroserosal contact onto the stent. To evaluate this micro anastomosis, a biliary bypass (choledochojejunostomy and roux-en-y-loop) was performed in ten pigs. Nine of ten animals showed biliary bypass with good runoff in contrast radiography and completely reabsorbed stent after a 3-month follow-up. Weight gain, bilirubin, and alkaline phosphatase were normal. This technology demonstrates a safe and quick way to perform instrumental micro anastomosis without remnant foreign material.Presented as a poster at the annual meeting of the Society of American Gastrointestinal Endoscopic Surgeons (SAGES), Nashville, TN, USA, 18–19 April 1994     

Anxiety and perceptive functioning of infertile women during in-vitro fertilization: exploratory survey of an Italian sample

The aim of this study was to study the emotional impact of in-vitro fertilization (IVF) and any possible influence due to the type of diagnosis, duration of infertility, number of cycles and type of responses to treatment. The study was carried out on 200 patients admitted to hospital for the final stages of IVF (oocyte retrieval and embryo transfer). The psychological measures taken into consideration were: state and trait anxiety levels (Stait-Trait Anxiety), unconscious and symptomatic anxiety, perception of self and of others (EWI). Monitoring of anxiety levels during hospitalization highlighted significant differences with respect to the state anxiety values (P < 0.01) and general anxiety (P < 0.05), but not with respect to trait anxiety. The level of state anxiety of women with a diagnosis of infertility was significantly lower (P < 0. 05). Women who have experienced infertility of medium to long duration presented a significantly lower state anxiety value (P < 0. 01). The failure of oocyte fertilization determines a significant increase in state anxiety level (P < 0.01) There were no significant differences in anxiety values with respect to the cycle number. Perceptive functioning was normal.     

Ovarian tissue grafting: Lessons learnt from our experience with 55 grafts

Purpose

Uncertainties remain regarding the clinical efficacy of ovarian tissue cryopreservation and grafting. We report a retrospective analysis of reproductive outcomes and lessons learnt following 55 ovarian tissue transplant procedures at our center from 2006 to 2019.

Methods

We analyzed variables related to graft success such as tissue volume, follicular density, total follicular volume, and age on the duration of graft function.

Results

Follicular density and total follicular volume correlate positively with duration of graft function. All clinical pregnancies in our cohort occurred in women who were aged 35 or less at the time of ovarian tissue cryopreservation.

Conclusion

Graft success, as determined by eventual pregnancy and the longevity of graft function, may be impacted by factors including age at cryopreservation, follicular density, and total follicular volume.

     

Helical computed tomography of liver injuries: A trial of dual phase imaging

This study was performed to evaluate whether consecutive arterial phase and portal venous phase scans of the upper abdomen are contributory in the evaluation of the liver in patients with blunt abdominal trauma. The purpose of the study was to determine whether such dual acquisition using helical computed tomography (HCT) provides improved definition of injuries and significant information about the dynamics of posttraumatic hemorrhage.During a 10-month period, all patients referred for evaluation of blunt abdominal trauma were scanned using a dual phase imaging technique. Two consecutive and comparable scan clusters were programmed to study the upper abdomen, with a slice collimation of 10 mm and a 11 pitch. Intravenous contrast medium was delivered at a rate of 2 ml/sec for a total of 125 ml, with scan delays of 30 and 70 seconds (arterial and venous phases of hepatic enhancement).Thirty-two patients with hepatic lacerations were encountered, and the images from both acquisitions were compared and graded according to lesion conspicuity. The presence of contrast medium extravasation associated with parenchymal injuries was also recorded.In 23 (72%) of the 32 patients, the liver injuries were better defined in the portal venous phase, and in eight (25%) patients, the lesions were equally shown in both phases. In only one case, the lesion was better demonstrated in the arterial phase. Contrast medium extravasation was noted in two patients at the site of liver laceration. In three additional cases, contrast medium extravasation was also noted in associated splenic injuries. In all of these patients, the extravasation (bleeding laceration) was seen only in the images corresponding to the portal venous phase.Dual phase HCT of the upper abdomen does not provide significant additional information in the evaluation of patients with liver injuries resulting from blunt abdominal trauma. With a single scan cluster through the upper abdomen after a 70-second injection-scan delay, lesion definition is optimal, and vascular opacification remains adequate.     

Digital psychiatry

The American managed care movement has been viewed as a big experiment and is being watched closely by the rest of the world. In the meanwhile, computer-based information technology (IT) is changing the practice of medicine, much more rapidly than managed care. A New World of digitized knowledge and information has been created. Although literature on IT in psychiatry is largely absent in peer-reviewed psychiatric journals, IT is finding its way into all aspects of medicine, particularly psychiatry. Telepsychiatry programs are becoming very popular. At the same time, medical information sites are flourishing and evolving into a new health-care industry. Patient-physician information asymmetry is decreasing as patients are gaining easy access to medical information hitherto only available to professionals. Thus, psychiatry is facing another paradigm shift, at a time when most attention has been focused on managed care. In this new digital world, knowledge and information are no longer the sole property of professionals. Value will migrate from traditional in-person office-based therapy to digital clinical products, from in-person library search and classroom didactic instruction to interactive on-line searches and distance learning. In this time of value migration, psychiatrists have to determine what their 'distinctive competence' is and where best to add value in the health-care delivery value chain. The authors assess the impact of IT on clinical psychiatry and review how clinical practice, education and research in psychiatry are expected to change in this emerging digital world.     

正交设计优选黄柏中小檗碱的提取工艺

目的：优选黄柏中小檗碱的提取工艺。方法：以小檗碱的含量为指标，应用正交试验设计筛选黄柏的最佳提取工艺条件。结果：最佳提取工艺为D2A2B3C2，即用7倍量的70%乙醇热回流提取2次，2h/次。结论：优选得到的工艺稳定可行。     

正交试验法考察黄芪的提取工艺

目的：优选黄芪提取工艺。方法：采用单因素水平试验考察溶媒对黄芪甲苷提取量的影响；采用正交试验，以出膏率和黄芪甲苷含量考察水提工艺条件。结果：以水为溶媒提取最佳。水提取的最佳工艺为药材用8倍量水提取3次，每次1h。3批验证结果，出膏率30．82％，黄芪甲苷含量0．0672mg／g。结论：上述实验结果可为黄芪提取工艺的确定提供实验依据。     

甲硝唑阴道泡腾片生产工艺的研究

目的　简化甲硝唑阴道泡腾片 (Ⅰ )的生产工艺。方法　采用非水制粒法 ,酸碱组分混合制备Ⅰ ,并按照《中国药典》2 0 0 0年版稳定性实验指导原则进行稳定性考察。结果　用非水制粒法制备的Ⅰ通过稳定性加速实验后仍符合《中国药典》2 0 0 0年版的质量要求。结论　用非水制粒法制备Ⅰ是简便可行的。     

中药DNA分子鉴定技术的发展与应用

概述了近年来中药DNA分子鉴定技术在国内外的发展与应用。分析了RFLP、RAPD、DNA序列分析等常用技术的特点及在动、植物药材鉴定中的应用情况，展望了DNA分子鉴定技术在中药鉴定中的前景。