Hematological malignancy and pregnancy: a single‐institution experience of 21 cases

The incidence of hematological malignancies during pregnancy is low, and treatment in this setting is problematic. This study observed 21 pregnancies in 18 patients with hematological malignancies. Patients’ ages were between 19 and 43 (median 25) years. Two pregnancies ended with spontaneous abortion, one pregnancy ended with in utero death, three therapeutic abortions were carried out, and 15 infants were born alive but three of them died later. The median birth weight was 2.47 kg. Twelve babies survived to a median age of 36 (range 4–117) months. Eight babies were exposed to chemotherapy during the in utero period. One baby was exposed to chemotherapy during all the trimesters and was born prematurely and later died because of intracranial bleeding. Four babies were exposed to chemotherapy during the first trimester, one of them had low birth weight and floating thumb malformation, two of them had only low birth weight, and one was born healthy, but died at 3 months of age as a result of severe gastroenteritis. Two babies were exposed to chemotherapy during the second and third trimesters; one of them had low birth weight, and the other pregnancy ended in in utero death. One infant was exposed to chemotherapy during the third trimester and was born at term, but died because of pulmonary hemorrhage. We concluded that chemotherapy during all trimesters of pregnancy carries a significant risk for an unfavorable outcome.     

2008年奥运会帆船赛食品安全保障中HACCP体系的建立

目的对2008年奥运会帆船赛（奥帆赛）食品安全卫生保障中实施HACCP管理体系进行初步探讨。方法根据奥帆赛餐饮食品加工流程图和HACCP体系基本原理,对奥帆赛餐饮食品加工过程中可能造成食品污染的各种危害因素进行系统分析,确定关键控制点,在关键控制点对危害因素进行控制,并对控制效果进行监控。结果奥帆赛餐饮食品加工过程中原料接收、储藏、预处理、烹调及烹调后保藏和餐具消毒为关键控制点,需重点监控。结论在奥帆赛餐饮服务中建立HACCP管理体系,不仅可以减轻卫生监督部门保障的压力,提高服务商的餐饮管理水平,而且为提升青岛市的食品安全保障水平累积了经验。     

The effect of partial unilateral ureteral obstruction release and allopurinol on the renal malondialdehyde and glutathione levels

PURPOSE: The aim of the present study was to evaluate whether relief of partial unilateral ureteral obstruction (PUUO) with or without antioxidant drug affect renal tissue malonedialdehyde (MDA) and glutathion (GSH) levels. MATERIALS AND METHODS: A total of 25 rats were used in this PUUO study. Partial unilateral ureteral obstruction was created by the burial of the upper one-third of the left ureter in the psoas muscle. The rats were sacrificed on 28th day following PUUO. Relief of the obstruction was performed twenty minutes before sacrifice by cutting the proximal ureter in reperfusion group. 50 mg/kg intraperitoneal allopurinol was administered 20 minutes before relief of obstruction in the antioxidant group. Renal tissue MDA and GSH levels were measured in both kidneys. RESULTS: At the end of the study 5, 7 and 7 rats could only be interpreted in sham, reperfusion and antioxidant groups, respectively. While the mean left and right renal MDA and GSH levels were statistically different from each other in reperfusion group (P < 0.001), there were no significant differences in the sham (P > 0.05) and antioxidant (P > 0.05) group. Both the mean sham group left and right renal tissue MDA or GSH levels were significantly different from reperfusion group, but only the mean sham group left renal tissue MDA and right renal tissue GSH levels were not statistically different from antioxidant group (P < 0.05). The mean left or right renal MDA and GSH tissue levels of the antioxidant group were statistically different from reperfusion group (P < 0.05) except for the right renal tissue GSH level (P > 0.05). CONCLUSION: Partial unilateral ureteral obstruction leads to oxidative injury by relief of obstruction in both kidneys. The antioxidant allopurinol has a beneficial effect on renal MDA and GSH levels in both kidneys.     

Bilateral ureteral fibroepithelial polyps and review of the literature

Despite being the most common forms of benign ureteral neoplasms, ureteral fibroepithelial polyps are rare and their etiology is still unknown. To our knowledge, we report the fourth case of bilateral fibroepithelial polyps in the English literature with a discussion of clinical features and etiology.     

Hemorrhage Due to Retrograde Prolapse of Stomach

A case of recurrent hemorrhage due to localized gastric mucosal congestion from retrograde prolapse during severe retching is described. Historically, this condition may mimic the "Mallory-Weiss syndrome" and endoscopically, this lesion may be mistaken for "gastritis". This rarely recognized condition may be an explanation for some cases of cryptic hematemesis.     

“Spontaneous Twiddler's” Syndrome: The Importance of the Device Shape

Twiddler's syndrome is caused by patient manipulation of the cardiac implantable device (CID) around its central axis within the pocket, resulting in retraction and dislocation of the electrodes. There are, however, some reports that Twiddler's syndrome may occur spontaneously without the patient's manipulation. This remains contentious as it may be argued that patients may not want to admit to manipulating the CID or may have been unaware of their actions. Recently, we have observed three very similar cases with a “spontaneous” Twiddler's syndrome resulting in lead displacement. All of the three patients denied device manipulation and were not prone to somnambulism or repetitive involuntary motor behaviors. It, therefore, seems highly unlikely that all patients could have manipulated the device in exactly the same way to result in the same postrotational position within the implant pocket. The fact is that the same device was implicated in all these cases in a relatively similar time sequence from implant to recognition of the implantable cardiac defibrillator rotation. We postulate that the unique elongated decision of the Fortify Assura (St. Jude Medical, Minneapolis, MN, USA) ICD makes this device prone to spontaneous rotation as is exemplified by our case series.