Laparoscopic versus open appendectomy

BACKGROUND: Clinical manifestations and course of sickle-cell anemia are variable. Knowledge about the factors, possibly geographic, that influence prognosis are still scanty. POPULATION AND METHODS: Data of hospitalization and management of children with sickle-cell disease were studied during two years (1992-1993) in the Pediatric Unit of Libreville Hospital. They concerned 205 admissions of 171 children and 131 outpatients. RESULTS: The main causes of hospitalization were: acute anemia (36 cases before the age of 5 years); painful crisis whose frequency increased with age (23% before 5 years, 35% between 5 and 10, 42% after 10 years); infections, essentially pulmonary occurring early, and bone infections at any age. Eight children died (because a complication of their disease). Among the 131 outpatients, half were detected because pyrexia, anemia and/or more often "hand-foot syndrome". More than 60% had hepatomegaly, one third still had splenomegaly after five years of age and more than one third was icteric. More than half children older than ten years had growth disorders. Mean hemoglobin level was 7 g/dL. 21 of the 83 tested children for HBsAg were positive and only one out of 79 was positive for HIV. CONCLUSIONS: Clinical manifestations and course of sickle-cell anemia in our patients are similar to those reported in Congolese children. Genetic and environmental factors may be responsible for differences with children from other, in particular French, cohorts.     

Prophylactic efficacy of tilmicosin for bovine respiratory tract disease

The prophylactic administration of injectable tilmicosin for pneumonia in weaned beef calves was investigated in 1,806 animals. Comparisons were made among calves receiving an "on-arrival" injection of tilmicosin, calves receiving a single injection of long-acting oxytetracycline, and calves receiving no prophylaxis. Morbidity and mortality attributable to pneumonia, morbidity and mortality attributable to all causes, and case fatality were significantly lower in the group of calves that received tilmicosin, compared with calves that received long-acting oxytetracycline and calves that received no prophylactic antibiotic. Mean time to initial pneumonia treatment was significantly extended in calves that received prophylaxis, compared with those that received no antibiotic on arrival at the feedlot. Calves that received tilmicosin gained significantly more weight than calves that received oxytetracycline. Calves that were not treated for pneumonia during the trial period gained significantly more weight than did those calves that were treated for pneumonia regardless of experimental group. The majority of mortalities were attributable to fibrinous pneumonia (31/34). Important bacterial isolates (Pasteurella spp, Haemophilus somnus, Actinomyces pyogenes) obtained at necropsy did not have resistance to tilmicosin in association with administration of tilmicosin as prophylaxis for pneumonia. However, bacterial resistance to trimethoprim/sulfonamide and to oxytetracycline were commonly found in these postmortem isolates.     

The turnover and distribution of labelled corticosterone during post-natal development of the duckling (Anas platyrhynchos)

During 6 months of post-natal development in the laboratory, the weight of the adrenal gland relative to body weight decreases exponentially. In the 3 day-old duckling a single intravenous dose of labelled corticosterone becomes distributed in a very large apparent volume and an "extracellular" pool that is greater than the extracellular fluid volume and the pattern of disappearance of labelled hormone from plasma is biphasic. Later during development the volumes of distribution decrease and the biphasic pattern of disappearance becomes less distinct until at 6 months only one phase of disappearance can be detected with confidence. No significant change in plasma corticosterone concentration occurs during this period of development in the laboratory. Estimations of the corticosterone secretory rates, however, indicate that whereas the adrenal weight-specific rate os secretion increases during the first 3 weeks and declines therafter, the bodyf weight-specific secretory rate continues to decline throughtout the period of increasing body weight.     

弱碱三元复合驱与强碱三元复合驱的对比

三元复合驱即将成为大庆油田的主导开发技术,为了推荐出合适的三元复合驱类型,对比研究了弱碱三元复合驱与强碱三元复合驱。研究表明,弱碱三元复合驱可以比水驱提高采收率20%以上,与强碱三元复合驱相当;弱碱三元复合驱与强碱三元复合驱乳化液粘度都超过100 mPa.s,两种类型三元复合乳化能力相差不多,甚至弱碱三元复合驱乳化能力还略强一些;在注采能力、采油速度方面,弱碱三元复合驱甚至高于强碱三元复合驱;特别是在结垢程度上,弱碱三元复合驱比强碱三元复合驱弱,对生产井的影响较小。因此,在三元复合驱推广应用时应当选用弱碱三元复合驱。     

基矛电磁波的低流速测量中干扰因素分析研究

介绍了电磁渡测量流速的基本原理一多普勒效应．分析了影响低流速测量的主要干扰因素一发射泄漏干扰和旁瓣干扰。根据接收信号中发射泄漏干扰不变的特性,提出了去均值滤波的方法来消除干扰,对数据进行预处理;根据旁瓣干扰的信号特性,提出了通过频谱加窗和二次加权平均法构造频域带通滤波器来抑制干扰的方法,在仿真比较完各个窗函数的性能之后...     

O6-alkylguanine-DNA alkyltransferase inactivation by ester prodrugs of O6-benzylguanine derivatives and their rate of hydrolysis by cellular esterases

To modulate the bioavailability and perhaps improve the tumor cell selectivity of O6-alkylguanine-DNA alkyltransferase (AGT) inactivators, pivaloyloxymethyl ester derivatives of O6-benzylguanine (BG) were synthesized and tested as AGT inactivators and as substrates for cellular esterases. The potential prodrugs examined were the 7- and 9-pivaloyloxymethyl derivatives of O6-benzylguanine (7- and 9-esterBG), and of 8-aza-O6-benzylguanine (8-aza-7-esterBG and 8-aza-9-esterBG) and the 9-pivaloyloxymethyl derivative of 8-bromo-O6-benzylguanine (8-bromo-9-esterBG). The benzylated purines were all potent inactivators of the pure AGT and of the AGT activity in HT29 cells and cell extracts. Each ester was at least 75 times less potent than the corresponding benzylated purine against the pure human AGT. In contrast, the activities of esters and their respective benzylated purine were similar in crude cell extracts and in intact cells. The increase in potency of esters in cellular extracts could be explained by a conversion of the respective prodrug to the more potent benzylated purine in the presence of cellular esterases. The apparent catalytic activity (Vmax/Km) of liver microsomal esterase for 8-azaBG ester prodrugs was 70-130 times greater than for BG prodrugs and 10-20 times greater than for 8-bromo-9-esterBG. Tumor cell hydrolysis of the esters varied considerably as a function of cell type and prodrug structure. These data suggest that these or related prodrugs may be advantageous for selective AGT inactivation in certain tumor types.     

A study of postoperative wound management in nursing

Wound management has changed considerably over the past decade. The change from dry to moist healing is the result of new scientific evidence. The number and variety of wound care products available on the market have increased, along with the importance of the acceptability of a particular type of product to individual patients' lifestyles. Annual worldwide expenditure on wound care is estimated to be in the region of $7 billion (US). The implications of efficient and effective wound healing for both the patient and the economy, therefore, are massive. This article presents the results of a study of postoperative wound management. The need for consistent and regular wound assessment is demonstrated and linked with length of hospital stay.     

Comparison of factor VIII-related antigen and erythrocyte sedimentation rate in outpatient management of vasculitis

Electroimmunodiffusion (Laurell rocket) determinations of factor VIII-related antigen in plasma were ordered to determine the cost/benefit ratio for factor VIII-related antigen as a putative test for endothelial damage in suspected vasculitis. Twenty-seven consecutive patients referred for vasculitis or suspected vasculitis were identified and followed up for an average of 9.1 +/- months (range: one to thirty-three months) in a prospective, unblinded study performed in a clinic, associated with a 1054-bed inner-city university hospital. There was no difference in Westergren erythrocyte sedimentation rate (WESR) in patients with final diagnosis of systemic vasculitis (SV) (38 +/- 12 mm/hour) compared to those without vasculitis (NV) (27 +/- 7) as the final diagnosis. The mean plasma concentration of factor VIII-related antigen was significantly elevated in SV (344 +/- 100%) when compared with NV (147 +/- 39%) (P < 0.016). The factor VIII-related antigen test in this study was 2.56 times more likely (crude odds ratio) than the WESR to contribute to a change in diagnosis or therapy (P = 0.016). Positive and negative predictive values (PPV and NPV) for factor VIII-related antigen (abnormal at greater than 220% of the normal value) were both 70%. PPV and NPV for WESR were 56% and 86%, respectively. The factor VIII-related test was less cost-effective than the WESR in the follow-up period unless it was important to define complete remission or differentiate vasculitis flare from infection. The authors conclude that factor VIII-related antigen is a useful test in the initial diagnosis of vasculitis.     

Transient central hypothyroidism as a cause of failure to thrive in newborns and infants

The course of two neonates and one 4-month-old infant with laboratory and clinical evidence of central hypothyroidism is described. All three presented with failure to thrive and improved after L-T4 therapy. Early recognition and treatment of newborns and infants with central hypothyroidism is important to maximize the potential for growth and development. Two of the three infants have been documented to have transient central hypothyroidism of hypothalamic origin, not previously reported.