腹部外科常见感染性疾病的病原菌及药敏试验研究

为了了解本地区本医院腹部外科感染性疾病病原菌的构成比和药物敏感率的变化,指导临床用药,我们采用美国BD公司生产的6B和7D两种增菌瓶采集标本和培养细菌,并用该公司生产的生化板和药敏板,对1994～1996年269例常见的普外科感染性疾病患者的手术标本进行前瞻性的细菌培养和药敏试验研究.     

Evaluation of BBL CHROMagar orientation medium for detection and presumptive identification of urinary tract pathogens.

The microbiological performance of BBL CHROMagar Orientation medium and CPS ID2 agar was compared to that of Columbia agar with 5% sheep blood and MacConkey agar without crystal violet for the enumeration and presumptive identification of bacteria responsible for urinary tract infections. Of a total of 658 clinical urine specimens, 118 specimens yielded no growth, 402 specimens yielded growth with cell counts of > or = 10(5) CFU/ml, and 138 specimens yielded growth with cell counts of < 10(5) CFU/ml. Of the specimens with cell counts of > or = 10(5) CFU/ml, 163 were pure cultures and 239 were mixed cultures. A total of 266 Escherichia coli organisms were isolated on both chromogenic media, 260 were isolated on blood agar, and 248 were isolated on MacConkey agar. One strain (0.4%) failed to develop the expected pink color on CHROMagar Orientation medium, and 23 strains (8.7%) failed to develop the expected pink color on CPS ID2 agar. Enterococci (CHROMagar Orientation medium, n = 266; CPS ID2 agar, n = 265) produced small blue-green colonies on both chromogenic media. Fifty of the mixed cultures contained enterococci that were detected only on the chromogenic media. The Klebsiella-Enterobacter-Serratia (KES) and the Proteus-Morganella-Providencia (PMP) groups could be identified on both chromogenic media. Of 66 isolates of the KES group, 63 grew with the expected color on CHROMagar Orientation medium and 58 of 64 isolates grew with the expected color on CPS ID2 agar. Other microorganisms required further identification. The use of chromogenic medium formulations offers a time-saving method for the reliable detection, enumeration, and presumptive identification of urinary tract pathogens. One of the greatest advantages of these media is the easy recognition of mixed cultures.     

Activation of human monocytes by both human β1H and C3b

We tested whether highly purified human β1H and C3b, two proteins of the alternative pathway of complement activation, could exert an influence on the activity of human monocytes (M). The activation process of M was assessed by measurements of the respiratory burst in terms of nitro blue tetrazolium (NBT) reduction and by chemiluminescence (CL) tests. In NBT reduction experiments, we found a tendency for β1H to increase NBT reduction, while C3b was found to be rather inhibitory. In CL measurements, both β1H and C3b displayed a stimulatory effect on M, showing different time- and dose-dependency. For β1H, the maximum stimulation occurred after 15 min, whereas for C3b after 45 min. Zymosan particles which served as a positive control also showed the highest stimulation after 45 min. In dose—response experiments, β1H reached a plateau ranging from 30 to 80 μg/ml. In contrast, using C3b up to 170 μg/ml, no plateau was reached. M-depletion and enrichment studies suggested at M as being responsible for the stimulatory effects found.

The differences between NBT reduction and CL could possibly be explained by the measurement of only cell-bound reductive potentials by NBT reduction, while in CL measurements, products of the extracellular space are also assessed. Our results suggest that both human β1H and C3b are appropriate stimuli for human monocytes.

     

Untersuchungen zur Methodik der Aktivitätsbestimmung der Kreatinphosphokinase

Zusammenfassung Es wurden eingehende Untersuchungen über die Methodik der Aktivitätsbestimmung der Kreatin-Phosphokinase mit Hilfe von reiner Kreatinphosphokinase und kreatinphosphokinase-haltigem Serum durchgeführt. Neben der Aktivitätsbestimmung über das in einer bestimmten Zeit aus Kreatinphosphat gebildete Kreatin wird vor allem die Bestimmung mit Hilfe des erstmals vonTanzer u.Gilvarg angegebenen DPNH-verbrauchenden optischen Testes empfohlen. Die Abhängigkeit der Reaktionsgeschwindigkeit im optischen Test von verschiedenen Faktoren wie Temperatur, ATP-, Magnesium-und Kreatinkonzentration und Anwesenheit von reduziertem Glutathion wurde geprüft und ein zur Bestimmung der Kreatin-Phosphokinase-Aktivität im Serum geeigneter Testansatz angegeben.Abkürzungen KPK Kreatinphosphokinase - HK Hexokinase - G-6-PDH Glucose-6-Phosphat-Dehydrogenase - PK Pyruvatkinase - LDH Lactatdehydrogenase - ATP Adenosintriphosphat - ADP Adenosindiphosphat - AMP Adenosinmonophosphat - PEP Phosphoenolpyruvat - GSH reduziertes Glutathion - DPN oxydiertes Diphosphopyridinnucleotid - DPNH reduziertes Diphosphopyridinnucleotid - TPN oxydiertes Triphosphopyridinnucleotid - TPNH reduziertes Triphosphopyridinnucleotid - TRAP Triäthanolamin-Hydrochlorid-NaOH-Puffer - TRIS Tris(hydroxymethyl)-amino-methan-HCl Puffer - EDTA Äthylendiaminotetraessigsäure, di-Na-Salz     

Computed tomography diagnosis of tracheobronchopathia osteochondroplastica

Tracheobronchopathia osteochondroplastica (TO) is a rare benign disease characterized by the presence of osseous and cartilaginous submucosal nodules projecting into the tracheobronchial tree. Most cases are asymptomatic and discovered incidentally at post‐mortem. We identified a case of TO on thoracic spiral CT and confirmed the diagnosis on bronchoscopy. This article reviews the imaging characteristics of TO, and shows the 3‐D virtual bronchoscopic and multiplanar reconstruction appearances of TO.     

Diagnosis of pulmonary embolism: Ventilation perfusion scintigraphy versus helical computed tomography pulmonary angiography

The present study compared the accuracy of ventilation perfusion scintigraphy (VQS) and CT pulmonary angiography (CTPA) for the diagnosis of pulmonary embolism. This was a prospective observational study of 112 patients with suspected pulmonary embolism (PE) who could be studied with both investigations within 24 h. Results were compared to final diagnosis at completion of 6-month follow up, using receiver operating characteristic (ROC) analysis. Pulmonary embolism was diagnosed in 27 referred patients (24%). The sensitivity and specificity of VQS and CTPA were similar to that reported from the literature. A normal VQ scan had the highest negative predictive value (100%), while a high-probability VQ scan had the highest positive predictive value (92%). There was no overall difference (area under the ROC curve (AUC)) between VQS (AUC (95% CI) = 0.82 (0.75,0.89)) and CTPA (AUC = 0.88 (0.81,0.94)) for the diagnosis of PE. Among patients with abnormal chest X-rays, CTPA (AUC 0.90 (0.83,0.97)) appeared somewhat better than VQS (AUC 0.78 (0.68,0.88)) but this difference did not reach statistical significance. In this instance, CTPA is at least as accurate as VQS and may provide an opportunity to make alternative diagnoses.