毛发单元移植行前额发际美人尖再造

目的探索应用一种高密式毛发单元移植技术,进行前额美人尖再造的新方法。方法切取近后发际区域处含有完整毛发毛囊的条形头皮组织,借助于手术放大镜,将之分割,制备成毛发单元(每单元含毛发1～3根),即显微毛发移植物。然后,在前额按个性化设计出弓尖形发际线,采用高密式移植技术,将毛发移植物移植至该区域内的预制洞穴中。结果本组58例患者,术后随访1年以上,其再造的前额美人尖毛发生长良好,美人尖形态、走向自然,其发际内无可见的瘢痕形成。毛发的成活率平均达98%。结论高密式毛发单元移植技术再造的前额美人尖,其手术方法简便,创伤小,外形自然美观,是目前美容性前额美人尖再造的理想方法。     

毛发单元移植行眉毛美容性修复再造

目的 探索应用毛发单元移植技术治疗各种原因所引起的眉毛永久性缺损。方法 切取后近发际区域处含有完整毛发毛囊的条形头皮组织，在手术放大镜下，将其分割，制备成毛发单元（每单元含1-3根毛发）即显微毛发移植物。然后，将这些植物按眉的自然走向植入到眉毛脱失区内预制的洞穴中。结果 自1998年4月至2000年2月，共完成了32例48侧眉的美容性再造。所有患者一期手术均取得满意的美容效果。经1年以上的临床随访再造眉毛生长良好。即使在瘢痕区域内，成活率也可达到95%，再造的眉形态走向较自然，接近于正常的眉毛。结论 毛发单元移植技术再造的眉毛与其它方式相比，手术方法简便，创伤小，更加自然，是目前眉毛美容性再造的理想方法。     

针具打孔法单株毛发移植行眉毛美容性再造

目的:探索一种单株毛发移植修复眉毛永久性缺损的技术。方法:切取近后发际区域处含有完整毛发毛囊的条形头皮组织,借助于手术放大镜,将之分割,制备成单株毛发移植物待用。然后在预先设计的眉缺失区域内,以医用注射针具制备孔洞。继之,将这些待用之移植物按眉的自然走向植入到眉区预制的孔洞之中。结果:自2005年至2006年6月,共完成了52例89侧眉的美容性再造。所有患者一期手术均取得满意的美学修复效果。经术后6个月以上的临床随访见:再造的眉毛生长良好,成活率可达到98.5%。再造的眉形态走向较自然,较接近于正常的眉毛。从患者对术后再造眉的形态评价来看,非常满意者占84.6%;满意者占15.4%。结论:针具打孔法单株毛发移植技术手术方法简便快捷,出血少,手术野较清洁,再造的眉毛更加自然优美,是目前眉毛美容性再造较为理想的方法。     

自动毛发移植系统结合毛发移植器修复毛发缺损

目的：探讨应用毛发移植治疗秃发、眉毛稀疏、阴毛缺损。方法：首先从两耳之间枕后切取一条含毛发的头皮组织，将头皮条切成薄片，然后借助2倍手术放大镜，分割成显微毛发移植物(含1～3根毛发)和微小毛发移植物(含4～5根毛发)，显微毛发移植物通过植发器植入，用于修复发际、眉毛和阴毛，其他秃发部位先用自动毛发移植系统动力手柄打孔(直径为1．5mm)，然后用植发手柄植入微小移植物。结果：2001年1O月～2004年1月，将此技术应用于43例男性型秃发、5例瘢痕性秃发、3例阴毛缺损和5例眉毛稀疏的病人，术后效果较满意，毛发移植成活率约90％。结论：根据不同的受区，结合应用毛发移植器和自动毛发移植系统技术，可取得较好的治疗效果。     

手术去毛法在低发际小耳畸形者耳廓再造中的应用

目的：探讨低发际者以手术去毛后的皮肤再造耳廓的方法。方法：对于发际特低型小耳畸形患者，以手术去毛洗去除其耳后带毛皮肤的部分毛囊和真皮，使之形成皮片后回植。半年后再扩张此区皮肤，以扩张皮瓣覆盖耳支架的方法再造耳廓。对于发际稍低型小耳畸形患者，经扩张耳后带毛皮肤后以手术去毛发去除部分毛囊，然后再造耳廓。结果：经手术去毛发后的皮肤扩张过程顺利，再造耳廓外形良好，皮肤上仅再生出很少短细的浅色毛发。结论：在低发际小耳畸型的耳廓再造中，手术去毛法是有效可行的方法。     

自体显微毛发单元移植治疗瘢痕性秃发

目的探索显微毛发单元移植治疗因各种原因引起的瘢痕性秃发的新技术。方法选择头部健康有浓密毛发的头皮为供区，切取含有完整头发的条形头皮组织，分割成显微毛发单元移植物，植入秃发区内预制的相应孔洞中。自2003年2月至2005年12月，应用该项技术治疗71例瘢痕性秃发患者。行工期手术成功治疗了52例患者，行Ⅱ期手术成功治疗了19例患者。结果术后随访患者6～12个月，移植的毛发生长自然、密集、发质良好，平均成活率为90％，外观效果均满意。结论显微毛发单元移植技术具有手术创伤小，恢复快，毛发生长自然、密集，发质良好等优点，是治疗瘢痕性秃发的一种较好的手术方法。     

单位毛囊和单株毛囊移植修复发际缺陷

目的探索毛发移植技术修复发际线轮廓缺陷的应用效果。方法术前仔细设计发际线和计算所需移植毛发的数量。切取枕后带发皮片，在4～5倍放大镜下精细分割，制备成不同粗细的单株毛囊和单位毛囊。根据受区毛发的走行及自然生长方向，用1．5mm蓝宝石裂隙刀制备微小裂隙，将制备好的单株毛囊和单位毛囊间隔插入裂隙。结果临床随访6个月显示，发际处移植毛发生长良好，与原有毛发融为一体，成活率达到95％。403名发际缺陷患者中有361例对美容效果表示满意，但是仍有部分颞额角脱发明显和瘢痕严重的患者需要二期加密手术。结论用单株毛囊和单位毛囊移植技术改善发际线缺陷，对毛囊分离技术的要求较高，手术设计合理，术后恢复迅速，外观自然、逼真，是较理想的治疗手段。     

显微自体毛发单位移植治疗毛发缺失

目的:研究应用显微外科技术进行自体毛发单位移植治疗毛发缺失的临床疗效。方法:切取耳后或头枕部条形头皮组织,低温下,手术显微镜配合将头皮分离成单株和多株移植物,并按需要将移植物移植入受区。结果:42例患者,60个毛发种植区完成手术。经6～12个月随访,移植后的毛发能覆盖受区皮肤,形态自然,效果满意,毛囊成活率90%～95%。结论:在显微外科设备辅助下,进行毛胚单位的移植,提高了毛囊移植过程中的解剖精度,减少损伤,提高成活率。该方法值得在毛发移植手术中推广应用。     

高密度毛发移植治疗瘢痕性秃发

目的 探索高密度毛发移植治疗因各种因素所引起的瘢痕性秃发的新技术。方法 于头颅的后、侧部优势供区内，切取含有完整毛发的条形头皮组织。分割成微小毛发移植物（含4－6根毛发）和显微毛发移植物（含1－3根毛发）。然后，植入头皮瘢痕脱发区内预制的相应孔洞中。结果 1998年4月－2000年2月，将此项技术，应用于96例128个瘢痕性秃发区。32例仅需一期手术；64例需行二期手术完成治疗。术后12个月以上的远期随访，恢复快，毛发生长自然、密集，即使在瘢痕区域的受体上移植的毛发常常也能良好地生长，是治疗瘢痕性秃发的又一理想手段。     

双刃宝石刀打孔法毛囊移植术行眉毛修复再造

目的：探索应用双刃宝石刀打孔法毛囊移植术行眉毛修复再造的临床效果。方法：切取近后发际区条形头皮，在医用放大镜下，分离出单株毛发移植物。运用双刃宝石刀在预先设计的眉毛种植区内打孔，再将筛选后的单株毛发植入孔洞内。结果：81例149只眉毛术后取得良好效果，经术后大于6个月时间随访56例，结果为Ⅰ级92例，占61．7％；Ⅱ级49例，占32．9％；Ⅲ级8例，占5．4％；Ⅳ级无病例。随机抽样50只眉毛，平均成活率达98．1％。结论：双刃宝石刀打孔法毛囊移植术是修复再造眉毛缺失较为理想的手术方法。     

The Metabolism of Vitamin D3 in Response to Testosterone

Summary : Sex steroids were suggested as regulators of vitamin D metabolism. While considerable data is available regarding interaction between estradiol and vitamin D, very little is known about interactions between testosterone and vitamin D. A similar gap exists with regard to the involvement of the vitamin D endocrine system in the pathogenesis of the female versus the male osteoporosis syndrome. In the present study we studied the effect of long-term treatment with testosterone on the metabolism of vitamin D in vitamin D₃ replete sexually immature male chicks. We were able to show that under this treatment, circulating levels of 1,25-dihydroxy vitamin D₃ (1,25(OH)₂D₃) are significantly reduced, but intestine and bone concentrations are significantly increased. The increased concentration of 1,25(OH)₂D₃ in bone was accompanied by an increase in the ash content of this tissue. The reduction in serum 1,25(OH)₂D₃ was not dependent on reduced activity of the renal 25-hydroxy vitamin D₃ - 1α - hydroxylase. Based on these findings it is proposed that testosterone is involved in the stimulation of the biological response to vitamin D in the classical target-organs, such as intestine and bone, and this observation may provide partial explanation to the pathogenesis of osteoporosis in hypogonadal men.     

Hemodialysis catheter survival and complications in children and adolescents

. Venous catheters have become an indispensable form of hemodialysis access. We evaluated catheter performance as temporary and long-term access in children with end-stage renal disease (ESRD). We assessed the survival rates and causes of catheter failure in 78 catheters used for hemodialysis access in 23 pediatric patients (aged 10 months to 22 years) with ESRD over a 5-year period. Median survival was 31 days for 56 uncuffed catheters. One- and 2-month actuarial survival was 69% and 48%, respectively. Reasons for removal were: elective (39%), kinking (36%), trauma (11%), infection (7%), and other (5%). Smaller catheters (7 or 9 French) were more likely to be removed for kinking (P = 0.003). One-year actuarial survival for 22 cuffed catheters was 27%. Cuffed catheters were removed due to: infection (36%), kinking (14%), elective (9%), trauma (9%) and other (9%). Twelve catheters were removed for infection. Infection rates leading to removal were 0.58 and 0.71 per patient-year for uncuffed and cuffed catheters, respectively. Staphylococcus species were cultured most commonly. We conclude that uncuffed catheters function well for short-term hemodialysis access of up to 2 months’ duration and cuffed catheters are successful for long-term access in children and adolescents with ESRD. Received April 1, 1996; received in revised form and accepted August 1, 1996     

Postexercise albuminuria in children with different duration of type-1 diabetes mellitus

. About 30% of diabetic patients develop progressive renal failure. We studied albumin, IgG, and transferrin excretion during exercise in diabetic children without signs of nephropathy to investigate proteinuria under these conditions: 39 patients with insulin-dependent diabetes mellitus and 21 healthy children undertook a bicycle exercise test. Albuminuria measured by nephelometry was calculated as the albumin excretion rate (AER) and albumin-to-creatinine ratio before and after exercise. The diabetic group was divided into three subgroups according to disease duration (DI<5 years, DII 5 – 10 years, DIII>10 years). No significant difference in metabolic control (hemoglobin A_1c) was detected between the diabetic groups (median hemoglobin A_1c: DI 7.2%, DII 7.6%, DIII 8.6%). There was no increase in AER in the healthy children after exercise. Before exercise the diabetic groups had an AER similar to controls. No significant increase in albuminuria after exercise was seen in group DI. Both groups with a disease duration of more than 5 years had a significant increase in albuminuria [median before/after: DII 7.8/16.7 (P< 0.05), DIII 0/57.9 (P< 0.05) μg/min per 1.73 m²). Of these patients, 43% also had a measurable urinary excretion of IgG and transferrin, indicating structural glomerular damage. There was no correlation of albuminuria and parameters of metabolic control or renal function. We conclude that in diabetic children an exercise test unveils albuminuria in certain patients, while their AER may be normal at rest. Received September 22, 1995; received in revised form and accepted January 24, 1996     

Transgenic animal models as tools for studying renal developmental physiology

. Transgenic animal technology, which allows the germline insertion of exogenous genes or the alteration or disruption of endogenous genes, has emerged as a powerful tool for the in vivo analysis of gene function. Since the primary strategy of transgenic techniques is to examine the biological results of lifetime overproduction or underproduction of particular gene products, perhaps no field is better suited for such technology than developmental biology. Indeed, many new phenotypes observed in novel transgenic models involve the alteration of some aspect of development or growth. Considerable information regarding genes involved in the regulation of renal developmental physiology and pathophysiology has emerged from the use of transgenic technology over recent years. We will review the use of traditional transgenic approaches and the resulting animal models, as well as describe more recent advances that allow tissue-specific, cell-specific, and temporal control of genes involved in kidney development. Received June 11, 1996, received in revised form and accepted July 9, 1996     

Trends in management of the small renal mass in renal transplant recipient candidates: A multi-institutional survey analysis

Introduction

Patients with end-stage renal disease are under increased risk for renal cell carcinoma development, and radical nephrectomy is the preferred treatment in this setting. Owing to the increased surgical morbidity and mortality, active surveillance (AS) may be a valid option for treatment of small renal masses (SRM). As there is a lack of high-level evidence for treatment recommendations, we performed a survey analysis to analyze the treatment patterns of transplant surgeons.

The expanding repertoire of targets for immune checkpoint inhibition in bladder cancer: What lies beneath the tip of the iceberg,PD-L1

Over the last decade, a new understanding of tumor-immune system interplay has been ushered in, lead in large part by the discovery of immune checkpoints mediated through B7-CD28 family interactions. Therapeutic blockade of the PD-L1 immune checkpoint pathway has already shown great success as a cancer immunotherapy for advanced urothelial carcinoma, leading to durable clinical remissions in an otherwise incurable disease. There are newly described members of the B7-CD28 family including B7-H3, B7x, and HHLA2. These ligands are thought to play an essential role in suppressing T-cell response, leading to immune tolerance of tumors. This feature makes them attractive targets for novel immunotherapy treatment paradigms. Here, we review the literature of current strategies and future directions of immune checkpoint blockade therapy for bladder cancer.     

Recent developments in the management of bladder cancer: Introduction

An upsurge of advances in the management of bladder cancer has rapidly occurred over the past 2 years. In this issue, recent developments in the management of bladder cancer will be discussed, including the emerging role of immunotherapy, biomarkers, and advanced imaging.     

Identification of men with low-risk biopsy-confirmed prostate cancer as candidates for active surveillance

Background

A combined clinical cell-cycle risk (CCR) score that incorporates prognostic molecular and clinical information has been recently developed and validated to improve prostate cancer mortality (PCM) risk stratification over clinical features alone. As clinical features are currently used to select men for active surveillance (AS), we developed and validated a CCR score threshold to improve the identification of men with low-risk disease who are appropriate for AS.