Staphylococcus epidermidis is emerging as an increasingly important pathogen in the immunocompromised host. We report here a case of S. epidermidis necrotizing pneumonia complicated by pneumatoceles in a term male infant who had earlier undergone surgical repair of tracheo-esophageal fistula. He was treated with intravenous teicoplanin and gentamicin for four weeks followed by two weeks of erythromycin. No percutaneous aspiration or pleural drainage was required. He had complete clinical and radiologic recovery when seen at follow-up six months later. Aggressive antimicrobial therapy for this condition without surgical drainage resulted in complete resolution and avoided complications such as pneumothorax and bronchopleural fistula.

Reconstruction of contracted bladder with a segment of small or large bowel has got a wide acceptance in the urological field today The use of a sigmoid colon segment isolated from the fecal stream appears to be most feasible for replacing or enlarging the bladder because the sigmoid colon with its proximity to the bladder would be the most logical donor organ. It might even be assumed so from a functional point of view. From January. 1961 to December 1962. in the Department of General Surgery. National Medical Center there has been performed 30 sigmoidocystoplasties for contracted bladder. The purpose of this paper is to present comparative clinical features of the reconstructed bladder and post-operative complications following closed loop and cup form sigmoidocystoplasty. Material: Of 30 cases of contracted bladder, 28 were contracted T. B bladder and 2 were non-specific cystitis. All 30 cases had previously undergone nephrectomy due either to non-functioning kidney, or extensive destruction. Seventeen cases were males and 13 cases were females. Agewas ranging from 12 to 67 years Two different techniques of sigmoidocystoplasty have been employed, namely closed loop (13 cases) and cup-form (17) sigmoiducyetoplasty, therefore, it has been possible to make a comparative study between two techniques. Clinical result and Conclusion: 1) Bladder reconstruction by means of an isolated sigmoid segment resulted in producing an efficaciously functioning artificial bladder as a urinary reservoir. No mortality 2) One case which was a complete failure was a case of contracted T. B. bladder with urinary incontinence, therefore, it should be emphasized that urinary incontinence is an absolute contraindication for sigmoidocystoplasty. 3)Bladder reconstructi with cup-form sigmoidocystoplasty was superior to closed loop sigmoidocystoplasty because of; A) Shape, position and Prevention of residual urine formation of the reconstructed bladder. B) Tidal volume as closed as total bladder volume. C) Very similar cystometry curve to the normal. D) Reduction of post-operative complication. 4) Production of mucus urine causes troublesome discomfort to the patient after bladder reconstruction, therefore, it would be ideal if we can prevent mucous urine. 5) Although the serum chloride has some tendency to increase after sigmoidocyetoplagty, however, no hyperchloremic acidosis was produced if the kidney function was normal. 6) All hyperchloremic acidosis cases in this series had irreversible hydronephrosis of the remaining kidney. This might give the impression that severe hydronephrosis is a contra-indication to sigmoidocystoplasty. However, as a contracted bladder gives not only miserable urinary symptoms but also shortens the life by progressive destruction of be kidney, the indication for reconstruction of a contracted bladder, even in the presence of severe hydronephrosis, should be discussed. A non-absorbable reconstructed bladder should be most ideal artificial bladder.
Acidosis ; Colon, Sigmoid ; Cystitis ; Female ; Humans ; Hydronephrosis ; Kidney ; Logic ; Male ; Mortality ; Mucus ; Nephrectomy ; Rivers ; Tidal Volume ; Tissue Donors ; Urinary Bladder* ; Urinary Incontinence

The antiparasitic effect of cassava (Manihot esculenta Crantz) was tested in goats artificially infected with gastrointestinal parasitic nematodes. Each experimental group consisted of 6 pen-fed goats kept on a slatted floor. The treatments compared were: 1) controls fed grass only, 2) cassava replaced grass for 3 weeks from the commencement of larval dosing period, and 3) cassava replaced grass for 3 weeks after the worm infection was patent. A total of 2000 mixed-species infective nematode larvae (L3) were administered to each goat in four doses of 500 L3/day, commencing 5 weeks after removal of previously acquired infections with ivermectin. The faecal egg counts (FEC) reduced in both cassava fed groups during the time of feeding, compared to the controls. Although, FEC increased differently with time (P < 0.05), total adult worm burdens at slaughter (week 15) were not different between the treatment groups. No differences in live weight gain, or packed cell volume, between treatments were found. Whilst these results show limited evidence of an anthelmintic effect of cassava in the diet, they do suggest that feeding, or supplementation, of cassava over an extended period may prove beneficial.
week ; Feeding ; Gastrointestinal ; Cassava ; Parasites

The objective of this review was to investigate the efficacy of dental local anesthetics, as it is well known among clinicians that local anesthesia may be challenging in some circumstances. Therefore, the focus of this review was on the efficacy of the products used in dental local anesthesia. In a Pubmed database literature search conducted, a total of 8646 articles were found to be related to dental local anesthetics. After having applied the inclusion criteria (human research, performed in the last 10 years, written in English language, and focus on dental local anesthetics) and having assessed the quality of the papers, 30 were deemed eligible for inclusion in this review. The conclusion of this review is that none of the dental local anesthetic amides provide 100% anesthesia. The problem appears to be more pronounced when mandibular teeth are attempted to be anaesthetized and especially if there is irreversible pulpitis involved. The authors conclude that this finding suggest exploration of more efficient techniques to administer dental local anesthesia, especially in the mandible, to establish a 100% efficacy, is needed.
Amides ; Anesthesia ; Anesthesia, Local ; Anesthetics, Local ; Mandible ; Pulpitis ; Tooth

PURPOSE: Underactive bladder is a complex clinical condition that remains poorly understood due to limited literature. This study aimed to determine its prevalence among patients with voiding dysfunction, presenting symptoms, risk factors, urodynamic findings, and ongoing treatment. METHODS: A retrospective chart review of consecutive urodynamic studies performed on voiding dysfunction between 2012 and 2014 was conducted to identify patients with detrusor underactivity. Detrusor underactivity was defined by a bladder contractility index of less than 100. Charts and urodynamic tracings were examined for patient demographics, suspected risk factors, presenting symptoms, urodynamic parameters, and treatment undertaken. Descriptive statistics were utilized to analyze the data. RESULTS: The prevalence of detrusor underactivity in this study was 23% (79 of 343). Average age of the patients was 59.2 years (range, 19-90 years). Women represented 68.4% (54 of 79) of the patients. The most common reported symptoms were urinary urgency (63.3%), weak stream (61.0%), straining (57.0%), nocturia (48.1%), and urinary frequency (46.8%). Prior pelvic surgery and prior back surgery were noted in 40.5% and 19.0% of the patients, respectively. The most common management was intermittent self-catheterization in 54.4%, followed by observation/conservative treatment in 25.3% and sacral neuromodulation in 12.7%. CONCLUSIONS: Although underactive bladder is a common condition, its precise diagnosis and treatment remain a challenge. Its symptoms significantly overlap with those of other bladder disorders, and hence, urodynamic evaluation is particularly useful in identifying patients with impaired detrusor contractility. This will help prevent mismanagement of patients with surgery or medical therapy, as that may worsen their condition. Much work needs to be done to better understand this condition and establish optimal management of patients.
Demography ; Diagnosis ; Female ; Humans ; Lower Urinary Tract Symptoms ; Nocturia ; Prevalence ; Retrospective Studies ; Risk Factors ; Rivers ; Urinary Bladder* ; Urinary Retention ; Urodynamics*

A Cryptosporidium parvum sporozoite and oocyst lambda gt11 cDNA library was screened with a hyperimmune rabbit serum that was developed against insoluble fragments of ultrasonicated oocysts. A clone named Cp22.4.1 encoding a protein of 231 amino acids with 4 zinc-finger domains characterized by a Cys-X2-Cys-X4-His-X4-Cys motif was isolated and characterized. There was a complete match between the sequencing data of the coding region of Cp22.4.1 and the corresponding gene at chromosomal level. Cloning in a pBAD-TOPO-TA expression vector permitted to evaluate the antigenicity of the recombinant His-tagged antigen. This antigen was recognized by 2 out of 5 sera from Cryptosporidium immune calves and not by sera from parasite naive animals.
Amino Acid Sequence ; Animals ; Antibodies, Protozoan/*blood ; Antigens, Protozoan/chemistry/*immunology ; Base Sequence ; Cattle/*immunology ; Cryptosporidium parvum/*immunology ; Molecular Sequence Data ; Protozoan Proteins/chemistry/genetics ; Rabbits ; Recombinant Proteins ; Zinc Fingers/genetics/*immunology

Background: The understanding of vertical ground reaction force (VGRF) during walking and half-squatting is necessary and commonly utilised during the rehabilitation period. The purpose of this study was to establish measurement reproducibility of VGRF that reports the minimal detectable changes (MDC) during walking and half-squatting activity among healthy male adults. Methods: 14 male adults of average age, 24.88 (5.24) years old, were enlisted in this study. The VGRF was assessed using the force plates which were embedded into a customised walking platform. Participants were required to carry out three trials of gait and half-squat. Each participant completed the two measurements within a day, approximately four hours apart. Results: Measurements of VGRF between sessions presented an excellent VGRF data for walking (ICC Left = 0.88, ICC Right = 0.89). High reliability of VGRF was also noted during the half-squat activity (ICC Left = 0.95, ICC Right = 0.90). The standard errors of measurement (SEM) of VGRF during the walking and half-squat activity are less than 8.35 Nm/kg and 4.67 Nm/kg for the gait and half-squat task respectively. Conclusion: The equipment set-up and measurement procedure used to quantify VGRF during walking and half-squatting among healthy males displayed excellent reliability. Researcher should consider using this method to measure the VGRF during functional performance assessment.

Larva

本文探讨针刺对亚急性期中风治疗是否存在长期疗效。研究设立了针刺组和对照组，并考虑到两组主要参数的可比性。所有患者均接受了综合康复治疗，针刺组额外接受针刺治疗。对患者入院时、6周针刺治疗后和出院一年后分别进行评定，采用中风患者运动功能评定、SunnaasADL指数和诺丁汉健康调查表（NottinghamHealthProfile，NHP），并记录出院一年后患者的社会地位。结果显示在6周治疗内甚至随后一年里，针刺组疗效优于对照组（有非常显著意义）。针刺对亚急性期中风治疗具有长期疗效。