Controlled,semielective, segmental resection for massive colonic hemorrhage

An aggressive diagnostic work-up to determine the site of bleeding was employed in all 25 patients requiring transfusion of over 1,500 cc of blood for colonic hemorrhage in New Haven in 1977 and 1978. A specific bleeding site that permitted segmental colectomy was found in 23 patients (92 percent). The mortality rate was zero, reflecting the rapid improvement in survival that has occurred in the last decade among patients with massive colonic hemorrhage.     

Bilateral simultaneous pleurodesis by median sternotomy for spontaneous pneumothorax

Bilateral pleurodesis by median sternotomy was performed in 26 patients with recurrent spontaneous pneumothorax. Sixteen of these patients had a history of bilateral pneumothorax. At operation, evidence of bilateral cystic abnormalities of the lungs was detected in all patients except 1.The technique and possible place of median sternotomy and bilateral pleurodesis are discussed.     

Comparison of the quality of smears in transbronchial fine-needle aspirates using two staining methods for rapid on-site evaluation

Transbronchial needle aspiration (TBNA) via flexible bronchoscopy is a well-established sampling modality for lung masses. The procedure is useful in the diagnosis of neoplastic and non-neoplastic lesions as well as for staging of bronchogenic carcinoma. Rapid on-site evaluation (ROSE) adds value as it has the advantage of triaging material during the procedure so avoiding a battery of investigations. Frequently used rapid stains are the modified Wright-Giemsa water-based stain (WG-ROSE) and the alcohol-based modified Papanicolaou stain (Pap-ROSE). Final review of laboratory-based Giemsa and Pap stains supplemented by ancillary investigations is essential for quality assurance. To investigate whether and how ROSE influenced the quantity and quality of the material submitted to the laboratory we randomized 126 patients to WG-ROSE, requiring only one pathologist on-site, or combined WG- and Pap-ROSE, requiring an additional person on-site to assist with staining. In those patients with positive TBNA we graded the laboratory-based slides of the first pass containing diagnostic material into insufficient, suspicious, adequate and excellent. The first diagnostic pass was found after 3.06 ± 1.94 (SD) passes and 3.13 ± 2.16 passes with WG-ROSE and combined ROSE (P = 0.87), respectively. Following WG-ROSE and combined ROSE 69% and 71.1% (P = 0.509) of slides were diagnostic (adequate or excellent) on laboratory-based Giemsa stains, and 93.3% and 100% (P = 0.134) were scored adequate or excellent on laboratory-based Pap stains. We concluded that the less costly and labour intensive WG-ROSE procedure is adequate for TBNA. This has cost implications especially in resource poor settings.     

盾叶薯蓣测土配方施肥试验

应用现代农业科技成果,根据盾叶薯蓣需肥种类及其配比的规律,在广西遁生地区引种工作中进行施肥试验。结果表明：通过测土配方平衡施肥,鲜薯亩产超过千斤,皂素含量也高。栽培第一年鲜薯产量达到1092～1228kg／亩,皂素含量达到2．07-2．66％;栽培第二年鲜薯产量提高到1792-2048kg／亩,皂素含量达到250-2．90％。因此,测土配方施肥是盾叶薯蓣高产高含栽培中科学、合理、有效的施肥举措。     

Dissociation of Acetabular Polyethylene Liners With a Morse Taper Design

BackgroundPolyethylene liner dissociation is an uncommon complication of hip replacement. Dissociation has been associated with particular acetabular component designs. This study reviewed acetabular liner dissociations in a specific modular cup with a Morse taper locking mechanism that has not been previously reported.MethodsThe senior author performed 655 primary total hip arthroplasties with one particular design of acetabular component using Class A polyethylene liners and metal head articulation. Cases with revision surgery performed for acetabular liner dissociation were reviewed.ResultsSeven of 655 patients with this cup underwent revision surgery for a dissociated liner. Liner dissociation occurred at a mean of 73 months postoperatively. Patients presented with new-onset hip pain or squeaking, 4 of which developed symptoms acutely. Two patients treated with polyethylene liner exchange into the same cup required a second revision surgery for recurrent dissociation.ConclusionPolyethylene liner dissociation is an infrequent but possible complication associated with modular acetabular components using a Morse taper locking. Providers should be vigilant with long-term follow-up of patients with this acetabular system for patient complaints of catching or squeaking. Patients treated for liner dissociation should not have a new liner placed into the same acetabular shell given the risk for further dissociation.     

Richard Pfeiffer’s typhoid vaccine and Almroth Wright’s claim to priority

Following the 1892 cholera pandemic, Richard Pfeiffer, Director of the science section of Robert Koch’s Institute for Hygiene in Berlin, began laboratory-based studies on the pathogenesis of the disease using an animal model. These investigations resulted in his discovery of bacterial endotoxin; recognition of the bacteriolytic properties of both animal and human immune sera; and identification of the specific nature of protective immune responses. His research led naturally from cholera to typhoid fever and in November 1896 Pfeiffer published the results of experimental studies on a typhoid vaccine. In September 1896 Almroth Wright, a professor of pathology in the British Army Medical School, published a short note entitled “Typhoid Vaccination”. It was appended to a review on the use of styptics to control defective blood coagulation: his previous research studies had a physiological basis that stemmed from earlier studies on tissue fibrinogen. In December 1895, Wright had been commissioned by the Army Medical Department to develop a typhoid vaccine and he later admitted that such work began only after he had spoken with Pfeiffer. In January 1897 Wright published a further paper in which he claimed precedence over Pfeiffer in the introduction of anti-typhoid vaccination. This self-entitlement has subsequently been accepted, primarily because the British Army approved typhoid vaccination in 1914 at the beginning of the First World War. That time has been used as their starting point by many of Wright’s biographers, but without any attempt to confirm Wright’s claim to priority. This paper concludes Richard Pfeiffer, not Almroth Wright, provided the first account of human typhoid vaccination. It also provides early examples of laboratory-based responses to pandemic and epidemic infectious diseases.     

强直性脊柱炎患者关节液特征分析

摘要：目的 观察强直性脊柱炎患者关节液特征，为治疗提供依据。方法 纳入泉州市正骨医院 ８８ 例强直性脊柱炎患者，观 察并统计分析膝关节液的一般性状、白细胞计数、形态学、生化指标检查结果。结果 ８８ 例强直性脊柱炎患者关节液中白细 胞中位数为 １９．８９×１０９ ／ Ｌ，高于同期外周血白细胞中位数 ８．６０×１０９ ／ Ｌ；中性粒细胞、淋巴细胞、单核－吞噬细胞百分比中位数分 别为 ７６．５％、１２．０％、７．０％；赖特细胞阳性率 ２８．４％（２５ ／ ８８）；赖特细胞阳性组与赖特细胞组阴性组白细胞计数中位数分别为 ２５．４８×１０９ ／ Ｌ 和１４．３０×１０９ ／ Ｌ，总蛋白中位数分别为５１．４０ 和４３．９０ ｇ ／ Ｌ，差异均有统计学意义（Ｐ 均＜０．０５）。结论 强直性脊柱 炎患者关节液中检出赖特细胞可辅助判断关节炎症反应增高。     

浆膜腔积液脱落细胞学检测在鉴别诊断恶性肿瘤中的价值(附7例病例报告)

目的:探讨浆膜腔积液脱落细胞学检测在鉴别诊断恶性肿瘤中的价值。方法:报告我院2007年11月-2010年11月确诊为恶性肿瘤的7例病例的临床资料,选用瑞氏-姬姆萨染色对浆膜腔积液的脱落细胞形态学的检查,进行回顾性分析,总结其细胞学特点。结果:7例病例具有典型价值,脱落细胞形态学及细胞结构特征与原发病灶的细胞完全相符,临床符合率100%。结论:浆膜腔积液脱落细胞形态学的常规检查在筛选恶性肿瘤方面具有较为明显的优势,对临床正确诊断具有重要价值。