Severe odontogenic infections

Background : Severe odontogenic infections are serious potentially lethal conditions. Following the death of a patient in the authors' institution this study was initiated to determine the risk factors, management and outcome of a consecutive series of patients.
Methods : All patients admitted to the Royal Adelaide Hospital under the care of the Oral and Maxillofacial Surgery Unit with odontogenic infections in calendar year 2003 were investigated. Detailed information relative to their pre-presentation history, surgical and anaesthetic management and outcome was obtained and analysed.
Results : Forty-eight patients, 32M, 16F, average age 34.5, range 19 to 88 years were treated. All presented with pain and swelling, with 21 (44 per cent) having trismus. Forty-four (92 per cent) were as a result of dental neglect and four (8 per cent) were regular dental patients having endodontic treatment which failed. Of those known to have been treated prior to presentation, most had been on antibiotics. Most patients had aggressive surgical treatment with extraction, surgical drainage, high dose intravenous antibiotics and rehydration. The hospital stay was 3.3 (range 1–16) days. Patients requiring prolonged intubation and high dependency or intensive care (40 per cent) had longer hospitalization. No patient died and all fully recovered.
Conclusion : Severe odontogenic infections are a serious risk to the patient's health and life. Management is primarily surgical with skilled anaesthetic airway management. Antibiotics are required in high intravenous doses as an adjunct and not as a primary treatment.     

Outpatient Initiation of Insulin: A Nurse Practitioner Protocol

Noninsulin dependent diabetes (type II diabetes) is a chronic disease characterized by hyperglycemia. Clients can generally be controlled by diet and exercise or a combination of diet, exercise, and oral hypoglycemic agents. When this therapy is not effective in controlling the hyperglycemia, the health care provider must choose to initiate insulin therapy. Outpatient initiation of insulin is an alternative to hospitalization in the type II diabetic client. Clinical guidelines for the initiation of insulin on an outpatient basis and management of the diabetic client are presented.     

特发性震颤的临床特点分析

目的探讨特发性震颤（essential tremor,ET）的临床特点。方法回顾性分析98例ET患者的临床资料。结果98例ET中男56例,女42例。发病年龄6～72岁,平均43．08±18．18岁。病程1～48年,平均14．04±11．39年。48例（48．98％）患者有阳性家族史。临床主要表现为单症状的姿势性震颤,累及部位依次为手98例（100％）、头38例（38．78％）、下肢28例（28．57％）、咽喉部16例（16．33％）、下颏10例（10．20％）等。64例患者做了饮酒试验,其中58例（90．63％）有酒精反应。84．62％的患者服用盐酸阿罗洛尔治疗有效。结论特发性震颤的临床表现以单症状姿势性震颤为主,手及头部受累明显,多数患者对酒精有反应,盐酸阿罗洛尔治疗有效。     

Foreign metallic pellet in the heart

Foreign bodies in the heart are a rare but serious form of cardiac injury. The objects usually are sharp pointed. Such as acupuncture needles,sewing needles, coat hangers, fragments of Kirschner wires, pins, etc. 1 We report a patient with a metallic pellet lodged in the heart, which was accurately diagnosed and successfully removed.     

含链霉素短程化疗方案的痰结核菌转阴时间观察

目的对比短程化疗含链霉素(SM)、乙胺丁醇(EMB)两组方案在抗结核治疗中的效果。方法选初治菌阳肺结核100例,予含SM方案(2HRZS/7HR)化疗50例,含EMB方案(2HRZE/7HR)化疗50例。每月检查痰结核菌一次(涂片三次,培养一次)。停药后继续追踪两年。结果痰菌2个月内转阴者,SM组29例,占63%;EMB组18例,占38%,p<0.05,有显著性差异。需延长强化期者:SM组16例,占35%;EMB组26例,占55%,p<0.05,有显著性差异。复发病例,SM组2例,占4%;EMB组3例,占6%,p>0.05,无显著性差异。结论使用含SM方案化疗的病例其痰菌转阴时间比含EMB方案短。     

树突状细胞在胆囊癌组织内浸润的研究

目的通过对胆囊癌组织中树突状细胞浸润情况的研究,阐述树突状细胞与肿瘤免疫之间的关系。方法采用免疫组化SP法。结果树突状细胞在胆囊癌组织的浸润程度与年龄、性别和病理组织学类型无关,与病理分化程度呈负相关关系(P<005)。结论树突状细胞在胆囊癌组织的浸润程度与病理分化程度、Nevin分期、肝浸润及淋巴结转移存在密切的关系。树突状细胞的定量检测可作为估计胆囊癌预后的标志。     

评“McCall观察方法”——对一种色谱系统分配效果观察方法的商榷

本文通过理论分析和文献数据的分析,对McCall提出的色谱系统分配效果的观察方法提出了不同的看法,认为McCall方法中的所谓logK并不是常数。McCall的方法无论在理论上和实践上都是不妥的。     

三氧化二砷诱导肺癌细胞凋亡及对细胞周期的影响

目的 :探讨三氧化二砷 (As2 O3 )对人肺癌细胞株 (Spc- A1)诱导凋亡的机制 ,为抗肿瘤药物的筛选和用药方式提供理论依据。方法 :体外培养 Spc- A1细胞株与不同浓度的 As2 O3 进行作用 ,应用 MTT比色法、流式细胞仪技术、电子显微镜技术观察细胞增殖率、细胞周期率、细胞凋亡率及亚细胞水平变化。结果 :As2 O3 能够抑制 Spc- A1细胞的增殖 ,且呈时间剂量依赖性 ,Spc- A1细胞凋亡率与药物浓度和时间呈依赖关系。电镜观察细胞线粒体肿胀、空泡 ,染色质浓缩、核碎裂。结论 :As2 O3 可诱导 Spc- A1细胞凋亡 ,细胞周期延长 ,线粒体变性。     

大鼠原生殖细胞的形态学及分化特性

目的 研究大鼠胚胎原生殖细胞（Primordial germ cells, PGCs）的形态及其分化特性。方法 取受精后10.5 d的大鼠胚胎作HE染色,取受精后11.0~12.5 d的大鼠胚胎生殖嵴进行PGCs原代培养,光、电镜观察PGCs及其分化细胞的微细结构,碱性磷酸酶 (ALP) 染色检测细胞的分化程度。结果 大鼠PGCs位于卵黄囊内胚层深部的间充质内,体积大,呈椭圆形或不规则形;核大,染色质细密,含1~2个核仁。体外培养可见PGCs大而圆,散在分布,或聚集成团,胞质中含有椭圆形的线粒体和丰富的核糖体,ALP反应呈阳性;培养4~5 d,PGCs形态不规则,有伪足,ALP反应减弱,进一步分化可形成神经元样细胞、表皮细胞、心肌细胞、分泌细胞以及类似血管、心脏的管腔样结构等。由PGCs分化来的细胞ALP反应均呈阴性。结论 大鼠生殖嵴来源的PGCs是一种具有发育全能的、可分化形成3个胚层衍生物的胚胎多能干细胞。