Buried Bumper Syndrome: A common complication of levodopa intestinal infusion for Parkinson disease

BackgroundPercutaneous endoscopic gastrostomy (PEG) is required for Levodopa/Carbidopa Intestinal Gel (LCIG) delivery in patients with advanced Parkinson's disease (PD) as well as for enteral feeding in a variety of neurological disorders. Buried Bumper Syndrome (BBS) is a serious complication of PEG. The frequency of BBS in patients receiving LCIG treatment has never been reported.ObjectivesTo compare the frequency of BBS in patients on LCIG treatment or on enteral feeding over the past 12 years and identify possible risk factors.MethodsWe reviewed prospectively recorded data from 2009 to 2020 on two case-series: LCIG-treated PD patients and non-PD patients on enteral nutrition. We identified all BBS incidences. Patients’ characteristics, clinical manifestations, BBS management, possible risk factors and outcomes were analyzed.ResultsDuring the 12 years, 35 PD patients underwent PEG insertion for LCIG infusion, and 123 non-PD patients for nutritional support. There were eight cases of BBS in six PD patients (17.1%). Six of them were effectively managed without treatment discontinuation. Of the enteral feeding patients, only one developed BBS (0.8%) (p < 0.001). We identified inappropriate PEG site aftercare, weight gain, early onset PD, longer survival, treatment duration, dementia and PEG system design as potential risk factors for BBS development.ConclusionsBBS occurs more frequently in LCIG patients than in patients receiving enteral feeding. If detected early, it can be successfully managed, and serious sequalae or treatment discontinuation can be avoided. Regular endoscopic follow-up visits of LCIG-treated patients and increased awareness in patients and clinicians are recommended.     

苯作业工人白细胞降低者的总估校正现患率

选择乡镇工业苯作业工人４次外周血白细胞计数中的间隔半年的两次数据，应用俘获再俘获法，计算其白细胞降低者的总估校正现患率（ＡＣＰＲ）。结果苯接触组为３６．８ｌ％（２９．１４％～４４．４８％），对照组为１２．７１％（７．２０％～１８．２２％）具有显著差异，其相对危险度为２，９。用常规法求得的４次检出率分别是：苯接触组为２６．３７％，１８．７３％，２７．９３％，３６．７６％；对照组为６。８５％，７．３８％，７．９４％，１５．００％。均在其ＡＣＰＲ之９５％可信限内，可见ＡＣＰＲ计算方法简便、结果准确，值得推广。对于稳定的人群，可用其每年一次的健康监护资料计算ＡＣＰＲ。     

职业性慢性轻度苯中毒诊治分析

目的 对长期慢性接触苯及同系物患者进行职业病诊断.方法 依据卫生部《职业健康监护管理办法》中的《职业健康检查项目及周期》中的要求,对患者进行职业健康检查,依据GBZ68-2002《职业性苯中毒诊断标准》的有关规定对患者进行复查.结果 该患者在3个月内每1～2周复查1次全血,白细胞计数持续低于4×109/L并常有头晕、头痛、乏力、失眠、记忆力减退等症状,依据GBZ68-2002《职业性苯中毒诊断标准》诊断为职业性慢性轻度苯中毒.结论 长期慢性接触苯可引起造血系统损害.     

Cancellous Bone Structure in the Growing and Aging Lumbar Spine in a Historic Nubian Population

There is abundant data on cancellous bone in the aging human spine, but little relating to the growing vertebral cancellous bone in childhood and adolescence. The purpose of this study was to map vertebral cancellous bone in a growth and age series of historic skeletal samples and to make comparisons with data published on recent material. Lumbar vertebral bodies were collected from 65 skeletons (0–60 years) from a medieval Nubian population. Ethnohistoric information was collected to interpret conditions that might have influenced bone structure and metabolism. The cancellous bone was studied three dimensionally, using stereophotography and scanning electron microscopy and morphometrically by performing a semiautomatic structural analysis on digitized backscattered electron images of polymethacrylate-embedded material. The cancellous bone structure in the children consisted mainly of a densely packed, uniform network of small rodlike trabeculae. The greatest bone volume fraction with small, more platelike trabeculae was observed during adolescence. In young adults, larger platelike trabeculae were present in the central zone and smaller trabeculae in the superior and inferior zones, as described for modern skeletal material. Structural changes associated with aging were observed much sooner than in modern man. By the estimated age of approximately 50–60 years, the predominant architectural elements were slender rarified rods in both sexes. The ethnohistorical data suggest that this was essentially a black African population of physically active peasants, not likely to suffer Vitamin D insufficiency or deficient calcium intake. Thus an earlier onset of the biological age changes in cancellous bone found in modern populations was probably prevalent. Received: 1 March 1996 / Accepted: 31 December 1996     

Occupational exposure of deck crews to carcinogenic agents on crude oil tankers

Occupational exposure to carcinogenic agents on the decks on six Norwegian crude oil tankers was examined in five harbors. The purpose of the study was to evaluate the need for improving the working environment on deck on these tankers. Technical arrangments and the work itself on the deck were observed during loading or unloading. Occupational monitoring was performed by active sampling of benzene, polyaromatic hydrocarbons, and some aldehydes. The crew answered a questionnaire concerning their work, use of protective equipment, and occurrence of acute symptoms. The levels of air-borne carcinogenic agents were low, probably due to closed loading systems on all tankers. However, the seamen reported discomfort during the work that may be related to other chemical agents in the cargo. The seamen were frequently painting with lead chromate paint without using personal protective equipment. This type of chemical exposure should be evaluated.     

Interpretation of functional series expansions

While much research has been devoted to the implementation and application of Volterra and Wiener functional series expansions in the identification and characterization of biological systems, little effort has been focused on the fundamental problem of interpreting the resulting kernels. This paper describes the application of the series to the components of a known model of the human pupil control system. As more complicated elements are put together, insight into kernel interpretation is built up incrementally until the total system is identified. Practical limitations and methods are also discussed.     

Synthesis and cytotoxic activity of new alkyl[3-(2-chloroethyl)ureido]benzene derivatives

Several alkyl[3-(2-chloroethyl)ureido] (CEU) benzene derivatives were prepared as potential anticancer agents. These new compounds were readily prepared in good yields by addition of anilines to 2-chloroethylisocyanate. Their cytotoxic activity was evaluated on human breast cancer (MDA-MB-231), human colon adenocarcinoma (LoVo) and mouse lymphocytic leukemia (P388D₁) tumor cell lines. Several new CEUs were significantly more cytotoxic than the nitrogen mustard chlorambucil. The biological activity of these aromatic urea derivatives seems to be related to the nature and position of the alkyl substituents on the aromatic ring. Substitution by branched alkyl groups on position 4 of the aromatic ring led to cytotoxic molecules which are up to 5 times more potent than the standard chlorambucil.     

Restricted field of view magnetic resonance imaging of a dynamic time series.

A restricted field of view (rFOV) approach for imaging a dynamic time series of volumes of limited spatial extent within a larger subject is described. The shorter readout with rFOV-MRI can be exploited to either limit image artifacts or increase spatial resolution. To accomplish rFOV imaging of a multislice volume for a dynamic series, an outer volume suppression (OVS) preparation that saturates signal external to a cylinder through the subject is followed by slice-selective excitation and a spiral readout. The pass- and stopband efficiencies of the OVS in an agar gel phantom were 97% (+/-1.5%) and 3% (+/-1%), respectively. Profiles of the temporal signal-to-noise ratio (SNR) were measured in a phantom and an adult brain. The rFOV sequence reduced distortions from off-resonance signal and T2*-induced blurring compared to a conventional sequence. Sequence utility is demonstrated for high-resolution rFOV functional MRI (fMRI) in the visual cortex. The rFOV sequence may prove to be useful for other multislice dynamic and high-resolution imaging applications.     

庆余肾气丸,复方丹参片中农药多残留分析

采用气相色谱法测定庆余肾气丸、复方丹参片中六六六，ＤＤＴ残留含量，以六六六，ＤＤＴ各异构体和代谢物衡量，方法的检测极限可达１．８×１０－４～８．０×１０－３μｇ／ｇ；方法回收率总均值分别在９１．４３％±１．７％，和９０．８８％±２．８４％；检测变异系数为０．２７％～９．９３％。样品测定结果显示，庆余肾气丸、复方丹参片中有机氯农药残留量皆低于世界各国的限量标准。     

急性苯中毒对小鼠末梢血象和骨髓细胞构成的影响

取３２只２～３个月的ＢＡＬＢ／Ｃ小白鼠，随机分为４组，每组８只，第１组为对照组，其余３个组为实验组，实验组小白鼠左腿皮下注射苯０．３ｍｌ（１５ｍｌ／ｋｇ体重）．注射后分别于２４ｈ，４８ｈ，７２ｈ脱颈处死。观察中毒前、后末梢血象、骨髓细胞、骨髓细胞构成的变化。结果表明，苯中毒时骨髓变化先于末梢血象的变化，骨髓的病变为造血细胞变性、坏死，大量毛细血管扩张、充血，骨髓细胞构成降低，而且骨髓细胞构成中细胞成分降低早于外周血粒细胞减少。