Percutaneous catheter drainage of tension pneumatocele, secondarily infected pneumatocele, and lung abscess in children

OBJECTIVE: To describe the use of percutaneous catheter drainage of tension pneumatocele, secondarily infected pneumatocele, and lung abscess in children. DESIGN: Retrospective case series. SETTING: A 24-bed pediatric intensive care unit. PATIENTS: Patients with tension pneumatocele, secondarily infected pneumatocele, or lung abscess. Tension pneumatocele was defined as an expanding intraparenchymal cyst compressing adjacent areas of the lung. Infected pneumatocele and lung abscess were defined, respectively, as intraparenchymal thin-walled cyst or thick-walled cavity containing an air-fluid level and purulent fluid. INTERVENTIONS: Seven pneumatoceles/lung abscesses were percutaneously drained in five patients. After computed tomography of the chest was obtained to localize the optimum site for drainage, a modified Seldinger technique was used to insert an 8.5-Fr soft catheter percutaneously into the cyst/cavity. The catheter was left in place until drainage (fluid and air) stopped. MEASUREMENTS AND MAIN RESULTS: All patients had clinical and radiologic improvement and were afebrile within 24 hrs after drainage. Bacterial culture grew aerobic bacteria from three cysts/cavities, anaerobic bacteria from one, and mixed bacteria from three. One patient had three secondarily infected pneumatoceles. Four of five secondarily infected pneumatoceles were under tension in two patients receiving mechanical ventilation. In both patients, the trachea was extubated within 24 hrs of drainage after prolonged mechanical ventilation. The number of days the catheter was in place ranged from 1 to 20 days. CONCLUSIONS: Percutaneous catheter drainage of tension pneumatocele, secondarily infected pneumatocele, and lung abscess can be performed safely and effectively in children. Early drainage is helpful, both as a diagnostic and therapeutic procedure. Drainage of tension pneumatocele may assist in weaning from mechanical ventilation. Computed tomography of the chest is helpful in determining the optimum site for percutaneous drainage.     

Activities of novel aryloxyalkylimidazolines on rat 5-HT2A and 5-HT2C receptors

One impact of socioeconomic progress on populations has been to reduce the number of cases due to diseases of undernutrition and microbial contamination of food, which affected mostly infants and young children, and to increase those due to diseases of excessive food consumption, which are affecting adults and a growing number of children. This article reviews the main dietary factors which have an influence on cardiovascular disease and cancer, and discusses the link between economic development and increased rates of chronic diseases. There is evidence that the noncommunicable diseases and their risk factors have risen rapidly in countries of the WHO Western Pacific Region. Data from 29 countries and areas in the region indicate that 70% of them show lifestyle diseases in three or more of the top five causes of death. While public health measures have been implemented by some countries to prevent and control nutrition-related chronic diseases, further action is needed.     

A 6-year clinical assessment of electronic facial thermography

The authors briefly report their experience regarding the opportunities offered by the use of current ultrasound methods in carotid surgery. They describe: a system for the quantification of athcromasic plaque used to monitor non-operated patients over time; ultrasound methods used to analyse the carotid wall to establish whether it can be utilised as an index of vascular aggression in hypertension, diabetes and atherosclerosis; the use of transcranial Doppler; criteria for the definition of high risk plaque; the applications of eco-color Doppler. The paper also illustrates a new pathology identified by the authors, defined as primary intimal fibrous hyperplasia, and the evolution of the carotid wall after endarterectomy. The structural characteristics of primary hyperplasia can only be shown using ultrasound given that arteriography cannot distinguish it from atheromatic stenosis. After endarterectomy the carotid wall is subject to hematic and hemodynamic stimuli which determine the type of evolution of the wall itself. The authors therefore examine the myointimal reaction, myointimal hyperplasia, early restenosis and late restenosis as different facets of the same phenomenon.     

Regulation of K+ channel mRNA expression by stimulation of adenosine A2a-receptors in cultured rat microglia

Previous investigations suggest that the expression of K+ channels in cultured rat microglia is related to the activation status of these cells. Both, lipopolysaccharide (LPS) and agents that raise intracellular cyclic AMP have been shown to inhibit microglial proliferation. LPS also regulates the mRNA expression levels of K+ channels in cultured microglia, which led us to investigate possible regulatory interactions between K+ channels and adenosine A2a-receptors, which are coupled to the cAMP-signal transduction pathway. The selective adenosine A2a-receptor agonist CGS 21680 induced enhanced mRNA expression of both Kv1.3 and ROMK1, as well as an elevation of Kv1.3 protein. The selective adenosine A2a-receptor antagonist aminophenol (ZM 241385) and the nonselective antagonist 8-phenyltheophylline (8-PT) inhibited these effects. Elevations of cyclic AMP by use of dibutyryl cyclic AMP (dbcAMP), phosphodiesterase-inhibitor (RO 20-1724), forskolin, or cholera toxin (CTX), strongly enhanced Kv1.3-mRNA expression, but decreased ROMK1-mRNA levels. Results from experiments with actinomycin D suggest that K+ channel mRNA levels in cultured microglia were regulated by altered mRNA synthesis. Evidently, the CGS 21680-induced effects upon Kv1.3 were mediated via an increase in intracellular cyclic AMP, whereas ROMK1-mRNA expression appeared to be regulated by coupling of adenosine A2a-receptors to an alternative pathway, which involves activation of protein kinase C (PKC). It is concluded that the cyclic AMP second messenger system in microglia is not only involved in regulation of K+ channel activity, but also in regulation of de novo K+ channel synthesis.     

Mosquito-Plasmodium interactions in response to immune activation of the vector

A molecular model was built for human lecithin:cholesterol acyltransferase (LCAT) based upon the structural homology between this enzyme and lipases (Peelman et al. 1998. Prot. Sci. 7: 585-597). We proposed that LCAT belongs to the alpha/beta hydrolase fold family, and that the central domain of LCAT consists of a mixed seven-stranded beta-pleated sheet with four alpha-helices and loops linking the beta-strands. The catalytic triad of LCAT was identified as Asp345 and His377, as well as Ser181. This model is used here for the interpretation of the structural defects linked to the point mutations identified in LCAT, which cause either familial LCAT deficiency (FLD) or fish-eye disease (FED). We show that these mutations occur in separate domains of the 3D structure of the enzyme. Most mutations causing familial LCAT deficiency are either clustered in the vicinity of the catalytic triad or affect conserved structural elements in LCAT. Most mutations causing fish-eye disease are localized on the outer hydrophilic surface of the amphipathic helical segments. These mutations affect only minimally the overall structure of the enzyme, but are likely to impair the interaction of the enzyme with its co-factor and/or substrate.     

提高注射用头孢噻肟钠的成品率

在1.0g注射用头孢噻肟钠粉针制剂生产过程中,从影响成品率提高的各个环节入手,通过采取各个工序严格把关、对现有分装机缺陷进行改进等措施,1.0g注射用头孢噻肟钠成品率从97.15%提高到了98.51%.