Clinical study in epidural injection with lappaconitine compound for post-operative analgesia

In this study, the effect and side-effect of epidural injection with lappaconitine compound for post-operative analgesia was observed. One hundred and twenty patients were randomly divided into 4 groups. Lappaconitine compound (LB) consisted of 12 mg of lappaconitine and 22.5 mg of bupivacaine, was given to group A (the group of observation), and lappaconitine 12 mg, bupivacaine 22.5 mg and morphine 2 mg to group B, C and D respectively for control. All were given by epidural injection with single blind method during post-operative pain of incision operation. Result showed that the initiating of analgesia was quicker in group A and C than that in group B and D, and the efficacy was group D > A > C > B. There was significant difference between group A and B in the above two parameters, P < 0.01 and P < 0.05. The analgisia maintenence time of single injection was D > A > B > C, that of group D was significantly longer than that of group A (P < 0.01). It indicated that the epidural injection with LB was more rapid and potent than that with lappaconitine alone in post-operative analgesia, and the former had no side-effect, it was safer than morphine.     

A case-mix classification system for medical rehabilitation

Dissatisfaction with Medicare's current system of paying for rehabilitation care has led to proposals for a rehabilitation prospective payment system, but first a classification system for rehabilitation patients must be created. Data for 36,980 patients admitted to and discharged from 125 rehabilitation facilities between January 1, 1990, and April 19, 1991, were provided by the Uniform Data System for Medical Rehabilitation. Classification rules were formed using clinical judgment and a recursive partitioning algorithm. The Functional Independence Measure version of the Function Related Groups (FIM-FRGs) uses four predictor variables: diagnosis leading to disability, admission scores for motor and cognitive functional status subscales as measured by the Functional Independence Measure, and patient age. The system contains 53 FRGs and explains 31.3% of the variance in the natural logarithm length of stay for patients in a validation sample. The FIM-FRG classification system is conceptually simple and stable when tested on a validation sample. The classification system contains a manageable number of groups, and may represent a solution to the problem of classifying medical rehabilitation patients for payment, facility planning, and research on the outcomes, quality, and cost of rehabilitation.     

Conventional drug therapy in inflammatory bowel disease

The conventional treatment of inflammatory bowel disease should center around the liberal use of one of the many available forms of 5-ASA. Sulfasalazine should be used initially with the newer mesalamine-only containing drugs being reserved for sulfasalazine-intolerant patients or for those patients who require larger doses of medication. The choice of the delivery method should be made with the knowledge of the extent of disease and the potential coverage areas of the individual delivery methods. Systemic and topical glucocorticoids are an invaluable adjunct to 5-ASA therapy, but their use must be directed with the goal of remission induction. The tapering of glucocorticoids should be as prompt as the maintenance of remission allows, with a useful general guideline of decreasing the dose by 1 mg per day. Immunosuppressive therapy, including azathioprine and 6-mercaptopurine, holds promise for refractory cases of inflammatory bowel disease and for their potential steroid sparing properties; antibiotic therapy with metronidazole and ciprofloxacin in the absence of documented infectious disease offers additional routes to control disease. The majority of patients require a combination of drugs to attain remission. Only further study will reveal the ideal regimen for each of the different subsets of inflammatory bowel disease.     

Selection of rainbow trout resistant to viral haemorrhagic septicaemia virus and transmission of resistance by gynogenesis

In 1984 a programme of selection for resistance to viral haemorrhagic septicaemia virus (VHSV) in rainbow trout was initiated. The progenies of 14 males were submitted to a VHSV waterborne challenge. The mortality ranged from 30 to 95% and the heritability of resistance was estimated to be 0.63 +/- 0.26. One male consistently provided the most resistant offspring, and the second generation was produced from sires and dams selected among these families. The mean resistance improved and several females giving birth to resistant offspring were identified (0-10% mortality while the mortality in the controls was from 70 to 90%). The meiotic gynogenetic progeny of these females also demonstrated high resistance (mortality less than 10%). The role of superficial tissues in the resistance was confirmed and there was a striking difference in the growth of VHSV in fins excised and infected in vitro. The fins from resistant fish replicated the virus poorly as compared with the fins of susceptible fish.     

Phenotypic analysis of antigen-specific T lymphocytes

Identification and characterization of antigen-specific T lymphocytes during the course of an immune response is tedious and indirect. To address this problem, the peptide-major histocompatability complex (MHC) ligand for a given population of T cells was multimerized to make soluble peptide-MHC tetramers. Tetramers of human lymphocyte antigen A2 that were complexed with two different human immunodeficiency virus (HIV)-derived peptides or with a peptide derived from influenza A matrix protein bound to peptide-specific cytotoxic T cells in vitro and to T cells from the blood of HIV-infected individuals. In general, tetramer binding correlated well with cytotoxicity assays. This approach should be useful in the analysis of T cells specific for infectious agents, tumors, and autoantigens.     

Controlling orthopoxvirus infections--200 years after Jenner's revolutionary immunization

An 11-year global WHO campaign for eradication of smallpox finished in October 1977 as the result of Edward Jenner's primary success in 1796, who for the first time applied human vaccination against variola virus (VARV). The 200th anniversary of this happening is a good occasion to summarize the current status of the knowledge about the role of B and T lymphocytes in the control of orthopoxvirus infections. This short review concentrates on general characteristics of orthopoxviruses and the immune response to infection, mainly by vaccinia virus (VV) and ectromelia virus (EV).     

Heat destruction of Salmonella in poultry feed: effect of time, temperature, and moisture

Presentation of our experience in three cases of urocolpos (acquired pudendal lip fusion), a series numerically equivalent to the total number of cases published until now. All patients in our series were older women and presented complete fusion of the small pudendal lips, with only a small pointed puncture in the lower part of the vulva. The main clinical signs and symptoms in our series were: urinary infection in 100%, false incontinence in 66% due to output of urine retained in the vagina, a symptom that has not been described earlier, and acute urine retention in 33%. All patients were successfully treated by means of surgical loosening of the fusioned lips and application of topical estrogens. An analysis is made of clinical and pathoanatomical features which differentiate this entity from the sclerotic and atrophic lichen. Finally, an etiopathogenic hypothesis is raised to explain the fusion acquired by the small pudendal lips in the urocolpos.