Diclofenac and post-tonsillectomy haemorrhage

The authors noticed a marked increase in the incidence of reactionary post-operative haemorrhage after tonsillectomy during the course of 1992. This increase appeared to be related to the introduction of diclofenac as a post-operative analgesic. A retrospective review of casenotes of patients having tonsillectomy under the care of the senior author (P. M. R.) in 1992 revealed that four of the 73 patients (5.5%) receiving diclofenac at induction of anaesthesia suffered reactionary haemorrhage requiring operative control, as compared with two of 293 (0.7%) receiving other analgesics.     

Factors determining the performance of medical students of the Faculty of Medicine, University of Kuwait

An investigation was undertaken to determine the factors influencing performance of medical students at the Faculty of Medicine, University of Kuwait. Data were collected for the first batch of 42 candidates who successfully passed the 7-year medical programme. Results showed high correlations between high-school admission grades and subsequent performance during the medical programme. Similar results were also obtained with English proficiency. A partial correlation controlling for English proficiency, however, showed a systematic decline in the magnitude of the correlations between high-school grades and performance during the medical programme. In fact the relationship between high-school GPA and clinical GPA was non-significant. A prominent influence of English proficiency on performance is indicated.     

Oesophageal Vent-Laryngeal Mask to prevent aspiration of gastric contents

The use is described of a prototype device to prevent regurgitationof gastric contents in 16 patients, three of whom appeared tohave been at risk of regurgitation. The "Oesophageal Vent-LaryngealMask" consists of a laryngeal mask attached to an oesophagealtube that has a balloon at the distal end, allowing drainageof any fluid in the oesophagus. (Br. J. Anaesth. 1994; 72: 52–54) Present address: Department of Anaesthesia, King's College Hospital,Denmark Hill, London SE5 9RS.     

ANEURYSM OF SINUS OF VALSALVA DISSECTING INTO THE INTERVENTRICULAR SEPTUM – ECHOCARDIOGRAPHIC DIAGNOSIS (A Case Report)

Aneurysm of sinus of Valsalva dissecting into interventricular septum is a rare entity. We report one such case who was incidentally diagnosed by echocardiography to have this abnormality during evaluation of a clinically suspected isolated aortic regurgitation.KEY WORDS: Aneurysm – dissecting – sinus of Valsalva, Echocardiography     

Quantitative Whole Body Autoradiographic Disposition of Glycol Ether in Mice: Effect of Route of Administration

Glycol ethers such as ethylene glycol monomethyl ether (EGME)are common solvents used in many industrial products. A largenumber of individuals are exposed to EGME through differentexposure routes. We investigated the differential distributionof EGME following various routes of administration using wholebody autoradiographic (WBA) techniques. Male B6C3F1 mice weretreated with tracer iv or oral doses of [2-¹⁴C]EGME.(4.05 µgEGME/kg equivalent to 0.8 mCi/kg) and euthanized at 1 and 24hr following treatment. In both groups of animals the highestlevels of radioactivity were detected in the liver, urinarybladder, bone marrow, kidney, and epididymis, at 1- and 24-hrtime periods. Computer-assisted quantitation of WBA indicatedthat there was markedly higher deposition of [2-¹⁴ and/or itsmetabolites in various tissues of the orally treated animalsthan in animals treated intravenously. Our studies also suggestthat [2-¹⁴C]EGME is rapidly distributed either from blood orstomach to various tissues. Preferential deposition of radioactivityin the peripheral tissues of the bone, with a progressive inwardaccumulation in the bone marrow, was observed. Selective permeabilityof EGME and/or its metabolites was indicated by the higher uptakeby the epididymis than that by testis. The high levels of radioactivityin biosynthetically active tissues, e.g., the liver, bone marrow,and gastric mucosa, is an indication of persistent interactionof the compound with cellular components of these tissues. Theseinteractions may lead to EGME toxicity.     

The Fungicide Benomyl (Methyl 1 -(Butylcarbamoyl)-2-benzimidazolecarbamate) Causes Testicular Dysfunction by Inducing the Sloughing of Germ Cells and Occlusion of Efferent Ductules

The Fungicide Benomyl (Methyl 1-(Butylcarbamoyl)-2-benzimidazolecarbamate)Causes Testicular Dysfunction by Inducing the Sloughing of GermCells and Occlusion of Efferent Ductules. HESS, R. A., MOORE,B. J., FORRER, J., LINDER, R. E., ABUEL-ATTA, A. A. (1991).Fundam. Appl. Toxicol 17, 733–745. Adult male Sprague-Dawleyrats (100 days of age) were given single oral doses of the fungicidebenomyl (methyl 1-(butylcarbamoyl)-2-benzimidazolecarbamate)in dosages ranging from 25 to 800 mg/kg body weight. The testisand excurrent ducts were examined at 2 and 70 days posttreatmentto determine the chemical effects on spermatogenesis and theepididymis. Primary effects seen at 2 days postexposure weretesticular swelling and occlusions of the efferent ductules.Mean testis weight peaked with 400 mg/kg. Premature releaseof germ cells (sloughing), detected even with the lowest dosage(25 mg/kg), was the most sensitive short-term response to benomyl.Sloughing was found primarily in Stage VII of the spermatogeniccycle at the lower dosages, but at higher dosages sloughingextended into all stages except for Stages VIII-XI. Occlusionsof the efferent ductules of the testis were dose-dependent andcorrelated with testis weight. Sperm and sloughed germ cellswere compacted in the ductal lumen of occluded ductules, whichwere surrounded by two to four layers of polymorphonuclear leukocytesand other inflammatory cells. Although the caput epididymidiscontained sloughed germ cells and appeared swollen, evidenceof permanent occlusion was not found. The long-term (70 days)effects of benomyl were decreased testis weight (at 400 mg/kg),dose-dependent increases in seminiferous tubular atrophy, andincreases in the number of reproductive tracts containing occludedefferent ductules. Fibrosis, granulomas, and abnormal growthwere long-term consequences of occluded ductules, which werepresent 100% of the time in testes containing 26–100%seminiferous tubular atrophy. Only a few testes were found tobe completely regressed. Occlusion of efferent ductules anddisruption of the seminiferous epithelium by sloughing of germcells are overlapping dose-dependent mechanisms responsiblefor short- and long-term effects of benomyl on the rat testis.     

THE ARABIC SCALE OF DEATH ANXIETY (ASDA): ITS DEVELOPMENT,VALIDATION, AND RESULTS IN THREE ARAB COUNTRIES

The Arabic Scale of Death Anxiety (ASDA) was constructed and validated in a sample of undergraduates (17–33 yrs) in 3 Arab countries, Egypt (n = 418), Kuwait (n = 509), and Syria (n = 709). In its final form, the ASDA consists of 20 statements. Each item is answered on a 5-point intensity scale anchored by 1: No, and 5: Very much. Alpha reliabilities ranged from .88 to .93, and item-remainder correlations ranged between .27 and .74; the 1-week test-retest reliability was .90 (Egyptians only), denoting high internal consistency and stability. The correlations between the ASDA and Templer's DAS ranged from .60 to .74 denoting high convergent validity of the ASDA against the DAS in the 3 Arab countries. Four factors were extracted in the Egyptian sample and labeled “Fear of dead people and tombs”, “Fear of postmortem events”, “Fear of lethal disease”, and “death preoccupation”. The first two factors were almost completely identical in the three countries. The item, “I fear the torture of the grave”, had a very high mean score. There were significant correlations between the ASDA and death depression, death obsession, reasons for death fear, and general anxiety, depression, obsession-compulsion, neuroticism, and being a female. All female groups attained significantly higher mean ASDA scores than their male counterparts. Kuwaitis had higher mean ASDA total scores, in comparison with their Egyptian and Syrian counterparts, whereas female Syrians attained the lowest mean ASDA total score in proportion to their female peers.     

Electrophysiologic Spectrum of Atrioventricular Nodal Behavior in Patients with Atrioventricular Nodal Reentrant Tachycardia Undergoing Selective Fast or Slow Pathway Ablation

AV Nodal Behavior After Ablation. Introduction; The objective of this report is to delineate the atrioventricular (AV) nodal electrophysiologic behavior in patients undergoing fast or slow pathway ablation for control of their AV nodal reentrant tachycardia (AVNRT).
Methods and Results: One hundred sixteen consecutive patients with symptomatic AVNRT were included. Twenty-two patients underwent fast pathway ablation with complete abolition of AVNRT in all and development of complete AV block in five patients. Of 17 patients with intact AV conduction postablation, 12 had demonstrated antegrade dual pathway physiology during baseline study, which was maintained in three and lost in nine patients postablation. Two patients with successful fast pathway ablation developed uncommon AVNRT necessitating a slow pathway ablation. Twenty-one patients demonstrated both common and uncommon forms of AV nodal reentry during baseline study. The earliest site of atrial activation was close to the His-bundle recording site (anterior interatrial septum) during common variety and the coronary sinus ostium (posterior interatrial septum) during the uncommon AV nodal reentry in all 21 patients. Ninety-six patients underwent successful slow pathway ablation. Among these, the antegrade dual pathway physiology demonstrable during baseline study (60 patients) was maintained in 25 and lost in 35 patients postablation.
Conclusion: These data suggest that: (1) dual pathway physiology may persist after successful ablation, which might be a reflection of multiple reentrant pathways in patients with AVNRT: and (2) the retrograde pathways during common and uncommon AVNRT have anatomically separate atrial breakthroughs. These findings have important electrophysiologic implications regarding the prevailing concept of the AV nodal physiology in patients with AVNRT.     

新辅助化疗治疗头颈部骨肉瘤单中心临床效果回顾

目的:评价新辅助化疗在头颈部骨肉瘤治疗中的效果.方法:回顾2007-2015年于上海交通大学医学院附属第九人民医院口腔颌面-头颈肿瘤科接受治疗的头颈部骨肉瘤患者的基本信息、围术期治疗信息、影像学信息、病理学信息以及随访记录,采用SPSS 17.0软件包对数据进行统计学分析.结果:最终纳入患者157例,男68例,女89例...