A case of maple syrup urine disease misdiagnosed as Tetanus neonatorum on admission

A case of Maple Syrup Urine Disease (MSUD) is presented with clinical signs and symptoms on admission resembling neonatal tetanus. Diagnosis had to be differentiated between MSUD and other metabolic disorders and neonatal infections (especially neonatal tetanus because of severe opisthotonos) and generalized seizures of the patient. Early diagnosis of the MSUD patient is very important for effective therapy and better long-term prognosis as well as genetic counselling and prenatal diagnosis for future pregnancies.     

Facet joint arthrography in lumbar spondylolysis: anatomic basis for spread of contrast medium

Facet arthrograms in patients with lumbar spondylolyses show spread of contrast medium through pars interarticularis defects into the adjacent ipsilateral facet joint space and across the midline into the contralateral joint space. Transverse and sagittal sections of facet joints from 141 postmortem lumbar spines were studied. Five examples of spondylolysis were found. Anatomic studies of the relationship of the joint recesses to the pars interarticularis demonstrated the basis for the patterns of spread of contrast medium observed radiographically in this and previous series. The pars interarticularis forms the only boundary between the inferior recess of one facet joint and the superior recess of the adjacent joint. Fracture through the pars interarticularis establishes communication between adjacent ipsilateral joints and opens a communication to the retrodural space, through which contrast medium can track to the contralateral joint.     

The effect on the safety of intravenous immunoglobulin of testing plasma for antibody to hepatitis C

BACKGROUND: The safety of intravenous immunoglobulin (IGIV), manufactured from units testing negative for antibody to hepatitis C virus (anti-HCV), was investigated. STUDY DESIGN AND METHODS: A study involving five chimpanzees was performed to determine whether the safety of IGIV would be compromised if units of plasma that reacted for anti-HCV were withheld from pools from which IGIV is manufactured. In the first phase of the experiment, two chimpanzees were infused with 25 mL per kg of unprocessed, pooled plasma from 2887 donors who did not react for anti-HCV in single-antigen (c100-3) enzyme-linked immunosorbent assays. In the second phase, each of three chimpanzees was infused with 1000 mg per kg of IGIV manufactured from the same plasma units. The immunoglobulin was made by seven United States- licensed manufacturers, each using its own approved method. Each chimpanzee received an equal dose of each manufacturer's IGIV. RESULTS: The two chimpanzees that received anti-c100-3-nonreactive, unprocessed pooled plasma became infected with HCV. The three chimpanzees infused with IGIV did not show any evidence of infection with HCV 15 months after inoculation. Two of these animals were challenged with human non- A,non-B hepatitis-infectious plasma, and both subsequently showed evidence of HCV infection. CONCLUSION: These studies demonstrate that, as determined by infectivity for chimpanzees, 1) the withholding of plasma units that react for anti-c100-3 from pools from which plasma products are manufactured does not render the source material noninfectious, and 2) the safety of IGIV manufactured from such plasma pools is not compromised by withholding the units that react for anti- c100-3.     

Complications experienced in the rehabilitation of zone I flexor tendon injuries with dynamic traction splinting

A retrospective review of all flexor tendon repairs done between January 1985 to June 1987 determined the complication rate with our method of rehabilitation. One hundred sixty-three flexor tendon lacerations in 83 patients were reviewed. Follow-up ranged from 6 to 42 months. All patients participated in the same 12-week rehabilitation protocol. All patients had passive motion exercises of the interphalangeal joints in the first 2 weeks. We believe that passive stretching of zone I injuries during the first 2 weeks contributed to the zone I complication rate. Of the 20 patients with zone I tendon-to-tendon repairs, 7 patients had significant complications. The 35% complication rate found with zone I injuries has prompted us to modify our postoperative rehabilitation protocol in zone I injuries.     

高效液相色谱法测定4－［4″－（2″，2″，6″，6″－四甲基哌啶氮氧自由基）氨基］－4＇－去甲表鬼臼毒素大鼠血浆浓度及药代动力学参数

建立了大鼠血浆中４－［４″－（２″，２″，６″，６″－四甲基哌啶氮氧自由基）氨基］－４＇－去甲表鬼臼毒素（ＧＰ－７）浓度的ＨＰＬＣ测定方法。用ＯＤＳ柱分离，甲醇－水－冰醋酸（５９：４１：０．６）为流动相，检测波长２８５ｎｍ。血浆甲乙醚－二氯甲烷混合液萃取，４５℃水浴蒸干，残渣用流动相溶解进样，内标法定量；血药浓度在２～２００μｇ·ｍｌ－１范围内呈线性关系，ｒ＝０．９９９７，血浆最低检测浓度０．２μｇ·ｍｌ－１，方法回收率９４％～１００％，日内、日间ＲＳＤ２．２９％～７．７０％。大鼠ｉｖＧＰ－７１０，２０，３０ｍｇ·ｋｇ－１，药代动力学过程符合二室开放模型，消除半衰期为３９．８±１０．８ｍｉｎ。     

Using Cluster Analysis to Examine Dietary Patterns: Nutrient Intakes, Gender, and Weight Status Differ Across Food Pattern Clusters

Objective This study explored the usefulness of cluster analysis in identifying food choice patterns of three groups of adults in relation to their energy intake.Design Food frequency data were converted to percentage of total energy from 38 food groups and entered into a cluster analysis procedure. Subjects in the emerging food group patterns were compared in terms of weight status, demographics, and the nutrition composition of their usual diet.Setting Data were collected as part of three studies in two US metropolitan areas using identical protocols. Participants were university employees (103 women and 99 men) who volunteered for a reliability study of health behavior questionnaires and moderately obese volunteers (223 women and 101 men) to two weight-loss studies who were recruited by newspaper advertisements.Statistical analysis performed Subjects were clustered according to food energy sources using the FASTCLUS procedure in the Statistical Analysis System. One-way analysis of variance and χ² analysis were then performed to compare the weight status, nutrient intakes, and demographics of the food patterns.Results Six food pattern clusters were identified. Subjects in the two clusters associated with high consumption of pastry and meat had significantly higher fat intakes (P=.0001). Subjects in two other clusters, those associated with high intake of skim milk and a broad distribution of energy sources had significantly higher micronutrient levels (P=.0001). Body mass index and the distribution of gender were also significantly different across clusters.Conclusions The success of cluster analysis in identifying dietary exposure categories with unique demographic and nutritional correlates suggests that the approach may be useful in epidemiologic studies that examine conditions such as obesity, and in the design of nutrition interventions. J Am Diet Assoc. 1997:97:272–279.     

Orbit: initial experience with surface coil spin-echo MR imaging at 1.5 T

Fifty-nine cases in which surface coil MR imaging of the orbit was performed were reviewed. MR imaging was performed with spin-echo techniques at 1.5 T with both short repetition time/echo time (TR/TE) and long TR/TE sequences in all cases. In all patients short TR/TE images were obtained with small-diameter surface coils; long TR/TE images were usually obtained with a standard head coil. Surface coil MR appears to be an important adjunct in state-of-the-art orbital imaging. Orbital MR imaging may be most useful, providing information not available on computed tomography (CT), in identifying lesions in the orbital apex, superior orbital fissure, and optic canal; differentiating inflammatory pseudotumor from malignancy in clinically similar patients; characterizing lesions containing hemorrhage or other paramagnetic material; defining the posterior extent of optic pathway gliomas; and detecting abnormal flow in intraorbital vascular structures. CT seems to be superior to MR imaging in the evaluation of small perioptic meningiomas, especially those that are calcified.     

马缨丹根的三萜成分研究

从马缨丹(Lantana camara L.)根中分离到八个三萜成分,通过光谱(UV,IR,¹HNMR,¹³CNMR,MS)分析和理化常数测定,分别鉴定为lantanolic acid(Ⅰ),22β-O-angeloyl-lantanolic acid(Ⅱ),oleanolic acid(Ⅲ),22βO-angeloyt-oleanolic acid(Ⅳ),22β-O-senecioyl-oleanolic acid(Ⅴ),22β-hydroxy-oleanolic acid(Ⅵ),19α-hydroxyursolic acid(Ⅶ),3β-isovaleroyl-19α-hydroxyursolic acid(Ⅷ)。Ⅱ系首次从植物中分离到。Ⅷ是新化合物,命名为lantaiursolic acid。     

Carnitine deficiency: a possible cause of gastrointestinal dysmotility

An infant with delayed development and peripheral myopathy, nourished on a soy-based liquid diet deficient in carnitine, had gastrointestinal dysmotility manifested by postprandial vomiting, oral drooling, delayed gastric emptying and infrequent bowel movements. Oesophageal manometry showed a reduced lower oesophageal sphincter pressure for age with abnormal distal motility. Serum carnitine concentration was 9.9 mumol l-1. After dietary supplementation of carnitine the gastrointestinal symptoms resolved, oesophageal manometry returned to normal, and serum carnitine increased to 37.2 mumol l-1. Dietary carnitine deficiency in infancy may be a cause of smooth muscle dysmotility of the gastrointestinal tract.