Objective To investigate the molecular mechanism of Klebsiella pneumoniae resistant to carbapenem. Methods The minimal inhibitory concentrations ( MICs) of the antimicrobial agents were determined by E-test. The 23 β-lactamase genes and 2 porin genes were amplified by polymerase chain reaction (PCR) , then the products were purified and their sequences were analyzed. Results The MICs of piperacillin, piperacillin/sulbactam, amoxicillin/clavulanic acid, cefoperazone/sulbactam, cefotaxime, cefepime and aztreonam to 5 strains of Klebsiella pneumoniae were all higher than 128 μg/mL, and those of imipenem or meropenem were higher than 32 μg/mL. All isolates carried blaTEM-1 and blaDHA-1 genes. Deletion of ompK35 and ompK36 were observed in Kp01 and Kp03, and the deletion of ompK35 was also observed in Kp02 and Kp05. Base insertion of ompK36 occurred in Kp02, Kp04 and Kp05. Compared with GenBank (GU945384) , ompK35 gene mutations of G→C at base 465 and T → C at base 466 in Kp04 lead to Gln to His substitution at position 155 and Tyr to its substitution at position 156, and it might be a new subtype. Conclusion The production of DHA-1 β-lactamase combined with the loss of OmpK36 or OmpK35 in porin genes may contribute to high-level carbapenem resistance in Klebsiella pneumoniae.

BACKGROUND:Hyperbaric oxygen as a wel-recognized therapy for ischemic and hypoxic diseases has to be combined with other treatments. OBJECTIVE:To study the effects of hyperbaric oxygen combined with neural stem cel transplantation via tail vein in chronic stress depression rats. METHODS:Of 60 Sprague-Dawley rats, 15 rats randomly selected were given no treatment as normal group, and the rest 45 ones were used to establish a rat model of depression and randomly divided into three groups:model group (n=15, without giving any treatment), neural stem cel group (n=15, injection of 1 mL neural stem cel suspension (3×106) via the tail vein) and combined group (n=15, hyperbaric oxygen treatment plus neural stem cel injection). Hyperbaric oxygen treatments were carried out four times per day, for 1 week, and al the treatments were given 24 hours after modeling. Rats in each group were subjected to body mass measurement and sugar water consumption test 1 and 2 weeks after treatment, and open field test within 5 minutes after treatment to observe rat behavior changes. The survival and distribution of CM-Dil labeled neural stem cel s were observed by fluorescence microscopy. The changes in the size, morphology and number of hippocampus neurons in rat were detected by the method of nylon staining. TUNEL method was used to measure the apoptosis of nerve cel s. RESULTS AND CONCLUSION:Compared with the normal group, in the model group, rat’s body weight, sucrose water preference and open field test scores were significantly lower, reduced number of hippocampal neurons with intact structure was found and TUNEL results showed more apoptosis (P<0.05). Compared with the model group, the body weight, sucrose preference and open field test score increased significantly (P<0.05), the number of hippocampal neurons was increased, while the number of apoptotic cel s was reduced significantly in the neural stem cel and combined groups (P<0.05). Compared with the neural stem cel group, these indexes were improved more significantly in the combined group (P<0.05). More CM-Dil positive cel s were found in the combined group than the neural stem cel group (P<0.05). Additional y, the number of hippocampal neurons was higher in the combined group than the neural stem cel group, but lower than the normal group. To conclude, transplantation of neural stem cel s combined with hyperbaric oxygen can improve the depression behavior and apoptosis in the hippocampal neurons in chronic stress depression rats.

BACKGROUND: With respect to the risk of developing diabetic vascular complications, the central purpose of most screening and detection program, is to identify people with diabetes at early stage so they might have advantages of early treatment to prevent complication of the disease. Oral glucose tolerence test(OGTT) is widely used for diagnosis of diabetes and impaired glucose tolerence, bit the performance of a complete OGTT is not only time consuming and expensive but physically demanding on the individual being tested. Determination of HbA1 and more recently of glycosylated total serum proteins(fructosamine) has been proposed as an alternative method of screening and diagnosis. The aim of our cross-sectional study is to compare the values of fructosamine and HbA1, for the ourpose of diabetes diagnosis with the OGTT as reference method. METHODS: In the study, from January 1996 to August 1996, we included 55 consecutive subjects in Kyeungssang Hospital. Blood samples for HbA1 and fructosamone determination were drawn at the same time as a fasting plasma glucose sample, and then all subjects underwent a standard 2-hour OGTT according to the World Health Organization recom-mandations, The subjects were classified according to the American Diabetes Association classification. RESULTS: In our study, we observed fasting plasma glucose of 145.32+/-75.00mg/deciliter, two-hour plasma glucose of 245.83+/-155.22mg/deciliter, HbA1 of 7.06+/-2.77%, and fructosamine of 308.77+/-128.23 micromol/liter. The correlation coefficient between FPG and HbA1 was 0.9098(p<.05), between FPG and fructosamine 0.7953(p Blood Glucose ; Classification ; Cross-Sectional Studies ; Diabetic Angiopathies ; Diagnosis* ; Diagnostic Tests, Routine ; Fasting ; Fructosamine* ; Glucose ; Glucose Tolerance Test ; Hemoglobin A, Glycosylated* ; Mass Screening ; ROC Curve ; World Health Organization

No abstract available.

We have experienced early extubation after 20 consecutive open heart surgeries for congenital heart disease between May 19 th and May 30 th this year. Eighteen of those 20 had the tracheal tube removed in the operating room immediately after operation. The reanlts were good and satisfactory. Two required postoperative ventilatory support for several hours at RICU. Sufentanil (Sufenta) 10-15 ug/kg was used intravenously as a major narcotic anesthetic for 18 podiatric patients and Fentanyl 50 ug/kg used for 2 adult Patients. The advantages of early extubation are as follows ; It is more physiologic, more comfortable, psychologically leas anxiety provoking for the patients and has less chance of pulmonary infection and less chance of ventilator mishaps arid it also shortens RICU stay and hospitalization. It is concluded that early extubation after open heart surgery for congenital heart disease has minimal risk and definite advantages in carefully selected patients.
Adult ; Anxiety ; Fentanyl ; Heart Defects, Congenital ; Heart Diseases* ; Heart* ; Hospitalization ; Humans ; Operating Rooms ; Sufentanil ; Thoracic Surgery* ; Ventilators, Mechanical

No abstract available.
Adenoma, Pleomorphic*

Subclavian vein catheterization is a well estab1ished technique in adults for central venous pressure monitoring and the infusion of irritant solutions. Its use in small children is less common, preaumably because of technical difficulties in inserting the catheter and the disk of major complications. During cardiac surgery heparinization potentially adds to the risk of hematoma forma-tion. But it is often preferred becauae of the greater stability of the catheter on the anterior chest wall and allows a greater freedom of the neck and upper limb movement. We have experienced 62 open heart surgeries for congenital heart disease between April 14th and Oecember 31th 1986. In 47 children ranging in age from 11 months to 15 years, there was a high succes rate and no morbidity. It is concluded that infraclavicular subclavian vein catheterization is a useful means of measuring central venous presaure and establishing a central infusion line in children undergoing open heart surgery.
Adult ; Catheterization ; Catheters ; Central Venous Pressure ; Child* ; Freedom ; Heart ; Heart Defects, Congenital ; Hematoma ; Heparin ; Humans ; Neck ; Subclavian Vein* ; Thoracic Surgery* ; Thoracic Wall ; Upper Extremity

No abstract available.
Animals ; In Situ Hybridization* ; Linoleic Acid* ; Mice*

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

Pain in an extremity that develops following trauma, infection, thrombophlebitis and many other leaions has been recognized for years and designated by a variety of names. These syndromes appear to have the same physiopathology and response to therapy. All of them are characterized by exeessive unduly prolonged pain, vasomotor and other autonomic disturbances, delayed recovery of function and trophic changes. We have treated two cases of reflex sympathetic dystrophy. One case was only treated by stellate gangUon block repeated 26 times and the other case required surgical thoracic sympathectomy for complete recovery after 60 repeated stellate ganglion blocks. We report these two cases of reflex sympathetic dystrophy and review the literature.
Extremities ; Recovery of Function ; Reflex Sympathetic Dystrophy* ; Reflex* ; Stellate Ganglion ; Sympathectomy ; Thrombophlebitis