Quantitative evaluation of the growth of established cell lines on the surface of collagen,collagen composite and reconstituted basement membrane

Summary As a step in the development of a system for assessing growth of human urothelium and transitional cell carcinoma, the growth of two established cell lines on collagen-based membranes has been evaluated. HT1080 (metastatic human fibrosarcoma) and WI38 VA13 (virus-transformed human fibroblasts) were grown on substrates of collagen, collagen/hyaluronic acid or chondroitin sulphate and reconstituted basement membrane (Matrigel). Cell growth was quantified using a new fluorimetric assay utilizing carboxyfluorescein diacetate. There were differences in morphology between cells grown on collagen and those grown on polystyrene. There were, however, no differences in growth of the WI38 VA13 cells on collagen compared with polystyrene, but growth of the HT1080 cells was increased on membranes of collagen/2:5% hyaluronic acid and collagen/5% chondroitin sulphate, and decreased on Matrigel. Adequate growth on collagen substrates is dependent on cell line. The fluorimetric assay used was suitable for quantifying cell growth on such substrates.     

对脊柱侧凸畸形手术矫治中整体观点的探讨

根据脊柱侧凸的三个主要畸形：某段脊柱的弯曲，凸侧剃刀背的隆起，及凹侧的塌陷。作者在哈灵顿手术的基础上，进行了剃刀背部分肋骨节段切除，弯曲脊柱的撑开和凹侧肋骨的提升等手术，对改善外观有明显效果。强调在矫形手术时，必须具有整体的观点。     

MRI对椎体骨折与愈合过程的评价

目的总结与评价MRI对外伤性椎体骨折的诊断和愈合过程的诊断价值。方法回顾性分析62例椎体外伤骨折．共83个椎体．分为压缩性骨折、爆裂性骨折、隐匿性骨折。结果新鲜压缩性骨折T1WI信号，T2WI呈高信号，STIR序列呈高信号：陈旧压缩性骨折T1WI呈高信号，T2WI呈低信号，STIR序列呈低信号；爆裂性骨折T1WI呈高低混杂信号，T2WI呈高信号，STIR序列呈高信号。椎体呈分裂状：隐匿性骨折为T1wI及T2WI对应位置条状低信号，且于T1WI低信号周同见片状高信号，STIR序列呈高信号．结论MRI可以从椎体信号的变化来评价椎体外伤性骨折的程度与康复过程，且能够弥补传统X线与CT诊断椎体骨折的诸多不足之处。     

Post-tonsillectomy pain: a prospective, randomised and double-blinded study to compare an ultrasonically activated scalpel technique with the blunt dissection technique

Thirty-two patients participated in a study to compare the use of an ultrasonically activated scalpel (Harmonic scalpel) for tonsillectomy on one side and a blunt dissection tonsillectomy on the other. Pain scores at rest and on swallowing expressed as the area under curves (AUC) during the 10 h after surgery, intra-operative blood loss and the need for electrocoagulation for haemostasis were significantly higher on the blunt dissection side than on the Harmonic scalpel side (p < 0.05). However, pain scores expressed as AUC at rest, on swallowing, the day's least, average and worst levels of pain, and the day's worst otalgia during the second week after surgery were significantly higher on the Harmonic scalpel side than on the blunt dissection side. In conclusion, we found that Harmonic scalpel tonsillectomy was associated with decreased severity in pharyngeal pain on the day of the operation but increased pharyngeal pain and otalgia during the second postoperative week.     

Clinical statistics on operations for inpatients at Department of Urology, Tokai University Hospital 1975-1989]

Operations on inpatients during the 15-year period from 1975 to 1989 were analyzed statistically. A total of 3,791 operations were performed at our Department of Urology, including 717 operations on the kidney, 316 operations on the ureter, 583 operations on the bladder, 811 operations on the prostate, 136 operations on the urethra, 1,097 operations on the scrotum, 43 operations on the adrenal gland, 19 operations on the retroperitoneal space and 69 operations on other organs.     

不对称乳房美容整形治疗的探讨

目的探讨各种不同类型的不对称乳房的手术治疗方法。方法对48例不同类型的不对称乳房者，分别采用不同的乳房成形术进行矫治，其中包括两侧不同容积的乳房假体隆乳术(19例)，单侧隆乳术(11例)，切除两侧不同体积的乳房组织乳房缩小成形术(9例)，单侧乳房部分切除术(2例)，单侧乳房脂肪抽吸术(1例)，一侧巨乳房缩小成形术，一侧乳房悬吊术(3例)，一侧乳房悬吊，一侧隆乳术(2例)，单侧乳房悬吊(1例)。结果1例因乳房新皱襞下皮肤、皮下组织过多，进行了再次整复术。1例乳房悬吊术后半年，继发轻度下垂。1例因原乳腺组织切除过多且伴有乳房局部较大瘢痕，乳房前外侧稍有凹陷，形态不够满意。其余各例都取得了满意或基本满意的效果。结论对不对称乳房应针对不同的类型采用不同的术式治疗，不对称乳房的检查和测量应力求准确．以便达到尽可能的对称。     

Remifentanil and the brain

Background and aim: Remifentanil is an ultra-short-acting opioid, increasingly used today in neuroanesthesia and neurointensive care. Its characteristics make remifentanil a potentially ideal agent, but previous data have cast a shadow on this opioid, supporting potentially toxic effects on the ischemic brain. The aim of the present concise review is to survey available up-to-date information on the effects of remifentanil on the central nervous system.
Method: A MEDLINE search within the past seven years for available up-to-date information on remifentanil and brain was performed.
Results: Concise up-to-date information on the effects of remifentanil on the central nervous system was reported, with a particular emphasis on the following topics: cerebral metabolism, electroencephalogram, electrocorticography, motor-evoked potentials, regional cerebral blood flow, cerebral blood flow velocity, arterial hypotension and hypertension, intracranial pressure, cerebral perfusion pressure, cerebral autoregulation, cerebrovascular CO₂ reactivity, cerebrospinal fluid, painful stimulation, analgesia and hyperalgesia, neuroprotection, neurotoxicity and hypothermia.
Conclusion: The knowledge of the influence of remifentanil on brain functions is crucial before routine use in neuroanesthesia to improve anesthesia performance and patient safety as well as outcome.     

腹腔镜乙状结肠癌根治术15例

目的探讨腹腔镜乙状结肠癌根治术的临床价值。方法回顾性分析2008年5月至2013年5月腹腔镜下乙状结肠癌根治术15例的临床资料。结果全组15例均在腹腔镜下完成手术,其中9例经体外行端端吻合,5例经肛门行直肠-乙状结肠端端吻合,1例行降结肠端造瘘。术后无吻合口瘘、吻合口出血等并发症发生,手术时间（192．8±33．5）min,平均186．8min,术中出血量（68．5±14．6）ml,平均59．6ml,术后住院时间（8．6±2．5）d,平均9．1d。结论腹腔镜乙状结肠癌根治术手术创伤小、术后恢复快,是治疗乙状结肠癌安全、可行的方法,但术者需有丰富的腹腔镜手术和结肠外科手术经验。     

Statistics on operations at the Department of Urology, School of Medicine, Tokai University (January, 1982 to March, 1984)

A total of 794 operations were performed at the Department of Urology, Tokai University Hospital between January, 1982 and March, 1984, including 5 operations on the adrenal gland, 64 operations on the kidney, 48 operations on the ureter, 93 operations on the urinary bladder, 124 operations on the prostate, 25 operations on the urethra, 124 operations on the penis, 190 operations on the scrotum and 19 operations on other organs.     

大网膜人工窦道预防胆管引流管拔出后胆漏的动物实验研究

目的探讨采用带蒂大网膜在胆管引流管周围做成人工窦道的方法及效果。方法建立实验兔胆管引流动物模型。100只新西兰大白兔随机分为2组,即实验组及对照组。每组再随机分成5个亚组,每亚组10只,在手术后3、6、9、12、15d分别剖腹了解5亚组中一亚组胆管引流管窦道形成情况,并取部分窦道壁送病理检查。结果实验组在不同时间点,窦道完全形成动物数分别为:3d8只,6d10只,9d10只,12d10只,15d10只;对照组分别为:3d1只,6d1只,9d2只,12d3只,15d4只。两组比较差异有统计学意义(P<0.01)。结论采用带蒂大网膜在胆管引流管周围形成人工窦道的方法简单、实用,不仅可缩短留置T管的时间,而且可有效防止拔T管后胆漏的发生,值得临床推广使用。     

Incidence of and risk factors for hepatitis B virus and hepatitis C virus infection among haemodialysis and CAPD patients: evidence for environmental transmission

Hepatitis B virus (HBV) serum markers (HBsAg, anti-HBs, anti-HBc)and antihepatitis C antibody (anti-HCV) were prospectively followedin haemodialysis and CAPD patients. From January 1987 to January1990, 185 patients on haemodialysis and 124 on CAPD were analysed.Among patients susceptible to HBV (69 on haemodialysis and 70on CAPD), there were 17 HBsAg seroconversions on haemodialysis(0.19/patient-year) and 1 on CAPD (0.01/patient-year). A Coxproportional hazards model showed that haemodialysis treatmentwas the only risk factor significantly associated with HBV infection,thus suggesting transmission through the environment. Regarding hepatitis C, 83 anti-HCV-negative patients on haemodialysisand 46 on CAPD were followed. There were 18 seroconversionson haemodialysis (0.15/patient-year) and two seroconversionson CAPD (0.03/patient-year). Haemodialysis treatment was alsothe only risk factor significantly associated with a higherrisk of HCV infection. The hazard ratio for HCV infection inhaemodialysis patients was 5.7 compared to CAPD patients. Nevertheless,for one patient on CAPD treatment transfusions were the onlypossible source of HCV infection. In conclusion, both viruses were transmitted mainly throughthe haemodialysis environment, but the role of transfusionscould not be excluded.     

The influence of the loading mode on the stress distribution on the connector region of metal-ceramic and all-ceramic fixed partial denture

Abstract:  Studies pertaining to the mechanical behavior of fixed partial dentures (FPDs) frequently found the highest tensile stress values at the connector region when load is applied at the pontic central region. The connector region is considered the weakest point of the prosthesis with the greatest potential of fractures, regardless of the material used. This 2D finite element study compared the stress distribution on three-element all-ceramic and metal-ceramic FPDs with different loading conditions. Three FPD models were designed: (i) metal-ceramic FPD; (ii) all-ceramic FPD with the veneering porcelain only on the occlusal face; and (iii) all-ceramic FPD with the veneering porcelain on the occlusal and cervical face of the pontic. Loads of 100 N were applied following these simulations: (i) distributed on all working cusps; (ii) only on the abutment teeth; and (iii) only on the pontic. There is a significant change on the stress distribution and on the tensile stress values when the load configuration is changed. The stress distribution from the load applied on the abutments was significantly better compared with the other two load simulations. When the loads were applied on the pontic and distributed on all working cusps, the highest tensile stress values appeared on the cervical region of the connectors between the abutments and the pontic. However, when the load was applied on the abutment teeth, the maximum tensile stress value significantly decreased and was located on the occlusal region of the connectors. In fact, the load applied on the pontic region does not simulate the clinical situation. Studies using this load configuration have overestimated the connector regions as having the highest probability of failures.     

Titania gel reduces thrombin generation

Titanium alloy (Ti) commonly is used for long-term blood pumps as a conventional blood contacting material. Thrombus formation in the pump, however, is still a critical problem. Once thrombin is generated on the Ti surface, it activates platelets and the coagulation cascade, leading to thrombus formation. It would be expected that an inhibition of thrombin generation on a blood-contacting surface would prevent thrombus formation. In this study, the titania gel (Ti-gel) on the surface of Ti was formed with chemical modification. The surface structure and its effects on the coagulation cascade were evaluated. Scanning electron microscopic study revealed numerous cracks on the dried surface of Ti-gel, indicating a water-enriched layer. Blood coagulation on the Ti-gel was less than that on the Ti. Generated thrombin on the Ti-gel was less than that on the Ti in both the extrinsic and intrinsic pathways. There was no statistical difference of thrombin degradation. These results suggest that coagulation cascade on the Ti surface was inhibited by the Ti-gel formation. The Ti-gel may have better antithrombogenic characteristics for blood pumps because of its antiblood-coagulation effects.     

护士对排班方式评价的调查与分析

目的 了解护士对排班方式的评价及对改进排班的具体建议。方法 采用问卷调查法，随机抽取376名临床护士，调查她们对当前排班方式及6种改进方式的态度。结果 不同科室、年龄、职称、学历的护士对各种排班方式的选择各异。结论 以人为本的护理排班应考虑工作需要及护士生活需要，在不断的渐进性改进过程中实现科学排班。     

In vitro study comparing two collageneous membranes in view of their clinical application for rotator cuff tendon regeneration.

Tenocytes were isolated from the rotator cuff tendons of healthy (HT) and glucocorticoid (GC)-treated rats (GCT) and were cultured on polystyrene wells (TCP) as control, and on 2 de-cellularized collagen matrices: porcine small intestinal submucosa (SIS), and human dermal matrix (Graftjacket, GJ). At 3 and 7 days cell proliferation and synthesis were evaluated. Proliferation of HT tenocytes increased between experimental times for both tested membranes, but already at 3 days, HT tenocytes cultured on GJ showed the highest WST-1 value. The collagen-I (CICP) synthesis on GJ membrane did not change between experimental times and was significantly higher than TCP and SIS at 7 days. Proteoglycans (PG), and fibronectin (FBN) synthesis increased when HT were cultured on GJ, between experimental times, and both PG and FBN synthesis on GJ membrane were higher than TCP and SIS at 7 days. GC determined decreases in cell proliferation, CICP and PG syntheses at 3 days of culture on TCP when compared to HT tenocytes while a decrease in WST-1 was maintained at 7 days. CICP, PG and FBN (only at 3 days) syntheses were significantly higher in GCT tenocytes cultured on GJ. The negative effects on GC on GCT tenocytes cultured on membrane were particularly evident on SIS for CICP (-18%) and FBN (-67%) synthesis. The obtained results support the conclusion that GJ is more suitable than SIS as a scaffold for in situ tissue engineering and for the in vitro bioengineering of tendons to heal massive tears of the rotator cuff tendon.     

Pathological study on the relationship between C4d, CD59 and C5b-9 in acute renal allograft rejection

Abstract:  In order to evaluate the activation or inhibition of the later phases of classical complement cascade in renal allograft presenting with acute rejection, particularly with C4d deposition on the peritubular capillary (PTC), we observed the expression of CD59 and C5b-9 on the PTC. Subjective cases were divided into two groups, an acute rejection group, of 4 males and 6 females, and a normal donor group, of 5 males and 5 females. Renal biopsies were performed at the onset of acute rejection and at the transplant operation, before reperfusion. C4d deposition on PTC was found in three of 10 cases (30%) with biopsy proven acute rejection, whereas CD59 on PTC was positively expressed in all of the rejection cases. Although C5b-9 was not observed on PTC in the acute rejection group, it was intensively deposited on the tubular basement membrane (TBM) in five cases, including the three with positive C4d on PTC. In the normal donor group, CD59 on PTC was intensively observed, whereas C5b-9 was weakly expressed on TBM. CD59, a complement regulatory factor, works as an inhibitory factor against the formation of C5b-9, a membrane attack complex. From our data, we noted the dissociation between the depositions of C4d and C5b-9 on PTC. The substantially expressed CD59 on PTC may affect this dissociation between C4d and C5b-9 on PTC. The intensive deposition of C5b-9 on TBM in acute rejection cases may suggest an independent immunological injury attacking tubular cells.     

胫骨假体旋转对线技术对髌股关节生物力学影响的实验研究

[目的]探讨全膝置换术中改变胫骨假体的旋转对线技术对髌股关节生物力学的潜在影响,指导术中进行正确的胫股旋转对线,以减少术后髌股关节并发症的发生。[方法]取9个新鲜冷冻人膝关节做实验,自行设计膝关节实验架,与Instron 8501生物力学测试仪共同搭建实验平台,模拟生理状态下膝关节自站立位屈膝下蹲的动作。人工膝关节采用LPS全膝系统,手术由同一位有经验的术者实施以控制实验误差,比较以胫骨结节内、中1/3交界为标志(胫骨结节对线技术)和以股骨假体位置(ROM对线技术)确定胫骨假体旋转的2种技术所获得的髌股关节的生物力学指标,选择30°、60°、90°、120°为实验的观察角度进行各组实验,应用日本富士公司生产的超低敏感型压敏片、低敏感型压敏片测定髌股关节的接触面积和接触压,最后用FPD-305E、FPD-306E压力测定仪和电脑软件处理后得到数字化结果。[结果]人工膝关节置换术中胫骨结节对线技术组与ROM对线技术组所获得的髌股关节的平均峰值接触压、平均接触面积等指标无统计学差异(P>0.10)。[结论]全膝置换术中股骨假体参照经股骨上髁轴确定旋转方位后,采用胫骨结节对线技术抑或ROM对线技术来确定胫骨假体的旋转对线对髌股关节的生物力学未见显著差异。对于旋转限制性较高的假体,ROM技术能够在正确的胫股旋转对线和良好的髌骨轨迹之间作出平衡。     

自体动静脉内瘘局部血流动力学研究

目的探讨自体动静脉内瘘局部血流动力学特点及其影响因素。方法选择维持性血液透析（maintennance hemodialysis,MHD）患者71例,横断面分析,应用彩超测量自体动静脉内瘘瘘口直径,双侧上肢桡动脉、尺动脉、肱动脉内径及血流量,分析动静脉内瘘对双侧上肢局部血流动力学的影响。结果动静脉内瘘手术后1-144个月,术侧头静脉内径（6.67±2.18）mm;术侧肱动脉内径（5.59±1.24）mm,对侧肱动脉内径（3.81±0.72）mm;术侧桡动脉吻合口近心端内径（4.12±1.13） mm,吻合口远心端（2.84±0.90）mm,对侧桡动脉内径（1.93±0.46）mm;术侧尺动脉内径（2.21±0.86）mm,对侧尺动脉内径（1.64±0.58）mm;术侧和对侧相比,有统计学差异（P〈0.01）。术侧肱动脉血流量（2164.18±1413.06）ml/min,对侧肱动脉血流量（538.90±326.90）ml/min;术侧桡动脉血流量（1172.75±718.20）ml/min,对侧桡动脉血流量（106.50±75.83）ml/min;术侧尺动脉血流量（245.95±184.09）ml/min,对侧尺动脉近心端血流量（81.34±68.80）ml/min;术侧和对侧相比,有统计学差异（P〈0.01）。结论自体动静脉内瘘建立后,术侧肢体的肱动脉、尺动脉、桡动脉内径相应增粗,血流量增大。     

头颈椎位置对不同类型寰椎横韧带损伤影响的有限元分析

目的采用有限元方法分析受到垂直向下暴力时不同头颈椎位置对不同类型寰椎横韧带损伤的影响。方法在前期建立已经过验证有效的上颈椎有限元模型上,预设不同的头颈椎位置(中立位、屈曲位、伸展位、侧屈位及旋转位),设定加速度为80 m/s~2来模拟垂直向下暴力。计算出DickmanⅠ、Ⅱ型寰椎横韧带损伤区域的Von Mises应力值,同时将不同的应力值以不同的颜色显示,并且连接起来构成可显示各个工况下寰椎横韧带和寰椎侧块的应力云图。结果旋转位DickmanⅠ型寰椎横韧带损伤区域的Von Mises应力值最大(5.55 MPa),中立位DickmanⅠ型寰椎横韧带损伤区域的Von Mises应力值最小(1.07 MPa)。在所有工况中,横韧带实质部的左右端点和中部的应力值差别不大。侧屈位DickmanⅡ型寰椎横韧带损伤区域的Von Mises应力值最大(11.21 MPa),左侧寰椎横韧带附着点和寰椎侧块体部的Von Miss应力值均明显高于右侧。结论受到垂直向下的暴力时,头颈椎处于旋转位时容易出现DickmanⅠ型寰椎横韧带损伤,当头颈椎处于侧屈时容易出现DickmanⅡ型寰椎横韧带损伤。     

The possibility of nervus ilioinguinalis and nervus iliohypogastricus injury in lower abdominal incisions and effects on hernia formation

AIM: The aim of this study was to determine the distances of nervus ilioinguinalis and nervus iliohypogastricus to McBurney's and paramedian incisions. MATERIALS AND METHODS: This study was performed on 12 adult cadavers. Right and left inguinal regions of the cadavers were dissected by inguinal incision. The points where the nerves perforated the internal obliquus muscles were determined, and the distances of these points to the spina iliaca anterior superior (SIAS) and to the umbilicus were measured. These distances were marked over a diagram, and distances of the nerves to McBurney's and paramedian incisions were measured by illustrating these incisions on the same diagram. FINDINGS: While the distance of the iliohypogastric nerve from the SIAS was 1.5-8 cm on the right and 2.3-3.6 cm on the left, the distance of the ilioinguinal nerve from the SIAS was 3-6.4 cm on the right and 2-5 cm on the left. The distance of the ilioinguinal nerve from McBurney's incision was 0.2-6.1 cm on the right and 1.8-7.5 cm on the left, and that of the iliohypogastric nerve was 2.2-6.9 cm on the right and 2.9-6.2 cm on the left. The distances of the nerves from paramedian incision were found to be 4.6-10 cm on the right and 6.4-11.2 cm on the left for the ilioinguinal nerve and 5-11.2 cm on the right and 7.4-11.6 cm on the left for the iliohypogastric nerve. CONCLUSION: Both nerves perforate the musculus obliquus internus, scattered in a wide area. Considering the distances, the paramedian incision seems to be more reliable with respect to the risk of nerve injury. Incisions performed in the lower abdomen carry the risk of injury to the ilioinguinal and iliohypogastric nerves.