平原狗急进高原途中突发急性高原肺水肿的光,电镜观察

本文采用光、电镜和组织特染等方法，对平原狗急进高原途中突发急性高原肺水肿的肺组织进行观察。结果提示：（１）肺泡腔内见淡嗜伊红肿液，肺泡隔内毛细篾这扩张充血，内皮细胞胞质微绒毛、胞人微饮泡增多，基膜变宽、模糊及较大血管壁疏松裂隙样变；（２）肺泡上皮细胞部分核间隙变宽，胞人线粒体增多，肺泡Ⅱ型上皮细胞胞质微绒毛增多，排列紊乱或脱落，胞质内板层小体增多及部分叶空圈样变；（３）肺泡隔内神经纤维呈髓鞘样变。     

影响岩斜区脑膜瘤术后生存质量的多因素分析

目的 探讨影响岩斜区脑膜瘤术后生存质量的多种因素,并对这些因素进行分析.方法 根据Karnofsky术后生存质量评分标准,采用SPSS 10.0统计软件,将具有统计学差异的筛选变量进行Logistic多元回归分析.结果 脑干水肿因素(P=0.045＜0.05),肿瘤与基底动脉关系因素(P=0.033＜0.05),肿瘤质地因素(P=0.046＜0.05),是否侵袭海绵窦因素(P=0.049＜0.05),肿瘤大小因素(P=0.033＜0.05),具有统计学意义.结论 脑干水肿、肿瘤与基底动脉的关系、质地、侵袭海绵窦程度和肿瘤大小是影响岩斜区脑膜瘤术后生存质量的重要因素.     

Kälteinduzierte Ödem- und Nekroseentwicklung im Parietalcortex von Kaninchen

Summary Combined cytometric studies and control of blood coagulation of a cold injury brain edema in the left parietal cortex (cortical layers I and II) of rabbits had the following results: a) Within the first 30 min after the lesion, a hypocoagulability was observed only in the cerebral vessels and significant correlations are limited to the changes between the nuclear size of endothelial, glial and nerve cells of the left, lesioned, cortical area. An increase, however, in the diameter of the cytoplasmic profiles of the endothelial cells and of the pericapillary glial end feet of the right cortical layer II can be interpreted as an early reaction of these cell types to the disturbed function of the lesioned cortical area. b) 60 min after the lesion there is a general hypercoagulability which is followed by a general hypocoagulability 12 hrs later. Endothelial, glial and nerve cells of the right hemisphere are more and more influenced by the increasing edema of the left hemisphere (for correlations see p. 16). It is suggested that the changes of permeability in the lesioned hemisphere locally affect blood coagulation and thus have an influence via the cerebral vessels on the function of nerve cell-glia complexes in the contralateral hemisphere.

Mit Unterstützung durch die Deutsche Forschungsgemeinschaft.     

特高海拔现场高压氧治疗对肺水肿病人肺动脉压的影响

目的　观察特高海拔地区现场高压氧 (HBO)治疗对高原肺水肿 (HAPE)病人肺动脉压的影响 ;评价HBO对HAPE的疗效 ;探讨肺动脉高压 (PH)与HAPE的关系 ;强调现场就地治疗的重要性。方法　在 4636米特高海拔 (气压 5 7.41kPa,氧分压 1 2 .OkPa)现场治疗来自海拔 4636～ 5 1 30米 (气压5 7.41～ 5 3.2 8kPa/431 .6～ 40 0 .6mmHg,氧分压 1 2 .0～ 1 1 .6kPa/90 .0～ 87.0mmHg)的HAPE 32例。治疗前后对其临床症状、X光胸片、血氧饱和度 (SaO2 )、平均肺动脉压 (MPAP)进行自身对照。结果　治疗前后 32例HAPE临床症状、体征及MPAP等各项观测指标显著改善 ,P <0 .0 0 1。结论　特高海拔现场HBO救治HAPE效果肯定 ,它能使显著增高的肺动脉压降低 ,全部病例病情迅速改善 ,其中 1 1例 ( 34.3% )基本治愈。为下送进一步治疗创造了条件。HAPE患者均有PH ,而PH者未必一定发生HAPE ;PH是机体适应缺氧环境的正常代偿 ,PH失代偿的阈值确有必要探讨     

Die Wand der primären Hydrozele des Kindes

Zusammenfassung Die primäre Hydrozele des Kindes ist charakterisiert durch ein ausgeprägtes Wandödem, als dessen Ursachen fehlende Lymphgefäße und venöse Stauung angesehen werden müssen. Die morphologischen und klinischen Unterschiede zwischen Säuglingsund Klemkindhydrozelen sprechen für die Annahme, daß das pathologisch gesteigerte Filtrat der verquollenen Lamina parietalis der Tunica vaginalis testis bei vorzeitigem Verschluß des Processus vaginalis peritonei nicht in die Bauchhöhle drainiert werden kann und somit zur Hydrozele führt.

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The wall of primary hydrocele in childhoodLight and electron microscopic findings

Summary Hydroceles of infants and children are characterized by edematous wall-thickening, caused by lacking lymph vessels and venous congestion. The morphologic and clinical differences between hydroceles of infants and children favor the following hypothesis: Pathologically increased filtration of fluid from the parietal tunica vaginalis can't be drained into the peritoneal cavity because the processus vaginalis closes too early and gives raise to hydrocele.

Fräulein B. Höltken und Frau B. Moraw danken wir für ihre Mitarbeit. Der Deutschen Forschungsgemeinschaft danken wir für Sachbeihilfe.     

基质金属蛋白酶-9与脊髓损伤后脊髓水肿的关系

目的：探讨基质金属蛋白酶-9与急性脊髓损伤后脊髓水肿的关系。方法：健康雄性SD大鼠70只，随机分为对照组和损伤组。对照组大鼠10只，仅做椎板切除术，术后6h取材；损伤组采用改良Allen法制作T8～T9节段脊髓损伤模型，分别于伤后6h、12h、1d、3d、5d、7d（每时间点10只）处死取材。采用干湿重法测定脊髓含水量，免疫组化检测基质金属蛋白酶-9的表达。结果：急性脊髓损伤后6h，损伤组脊髓含水量较对照组增多，3～5d时达到高峰。基质金属蛋白酶-9在对照组未见表达，而损伤组在损伤后6h表达增加，并在1～3d达到高峰，损伤后7d仍有表达。相关性分析显示基质金属蛋白酶-9的表达与脊髓含水量呈正相关。结论：急性脊髓损伤后，基质金属蛋白酶-9的表达与脊髓水肿的形成有关，但两者达到高峰的时间不完全一致。     

MRI features in de Quervain’s tenosynovitis of the wrist

 De Quervain’s stenosing tenosynovitis of the first dorsal extensor component is traditionally diagnosed clinically but may be encountered when performing MRI of the wrist. A retrospective review of wrist MR images was performed in cases where the diagnosis of de Quervain’s synovitis was sugggested (n=5). Imaging findings were correlated with clinical findings in four cases and with wrist arthroscopy in one case. Increased thickness of the extensor pollicus brevis and abductor pollicis longus tendons was the most reliable finding on MRI, being present in all cases. Peritendinous edema was also a reliable finding. Surrounding subcutaneous edema and increased intratendinous signal were less reliable findings in confirmed cases of de Quervain’s disease. De Quervain’s tenosynovitis may be encountered when performing MRI of the wrist. Increased tendon thickness and peritendinous edema are the most reliable imaging findings.     

Acute pulmonary edema and plasma kininogen consumption in the adrenaline-treated rat: Inhibition by acetylsalicylic acid and resistance to salicylate and indomethacin

Summary Pulmonary edema and plasma kininogen consumption caused by intravenously administered adrenaline, were inhibited in rats pretreated with acetylsalicylic acid, but not in rats pretreated with indomethacin or sodium salicylate. The possibility of a connection between this edema and mast cell-linked activation of kallikrein by adrenaline is discussed, as well as the possible role of acetylsalicylic acid acting as an acetylating inhibitor of these processes.     

Temporal profile of forced expiratory lung function in allergen-challenged Brown-Norway rats

The Brown–Norway rat is often used to study the allergic pulmonary response. However, relatively little is known about the delayed phase reactions after allergen challenge in this species. To evaluate the temporal changes in lung function and elucidate the mechanisms involved in the delayed phase response, Brown–Norway rats were sensitized and challenged to aerosolized ovalbumin and lung functions were measured by forced expiratory maneuvers and forced oscillation for up to 10 days after a single antigen challenge. Statistically significant (P < 0.05) reductions in inspiratory capacity, forced vital capacity, functional residual capacity, peak expiratory flow and maximum mid-expiratory flow and increases in respiratory system resistance and elastance were seen by 1 to 3 days after ovalbumin challenge that returned to baseline by 10 days. The reductions in lung function after ovalbumin challenge were blocked by the corticosteroid, betamethasone (1 mg/kg, p.o.). Histological evaluation of lung tissue of sensitized rats demonstrated evidence of interstitial pulmonary edema, an increase in tissue eosinophils and an increase in Periodic Acid Schiff-positive cells in the airway epithelium. Bronchoalveolar lavage fluid samples showed large numbers of eosinophils and increased mucin content up to 6 days after antigen challenge. There was also an increase in wet-to-dry lung weight ratio in the lungs of sensitized rats after antigen. These results demonstrate that prolonged reductions in lung function occur after a single antigen challenge in Brown–Norway rats that is probably due to inflammatory processes producing interstitial pulmonary edema, mucus secretion and cellular influx into the lungs.     

Effects of Different Corticosteroids on Edema and Ecchymosis in Open Rhinoplasty

A double-blind, randomized trial with placebo control was planned to evaluate the effects of corticosteroids (betamethasone, dexamethasone, methylprednisolone) in approximately equivalent doses (8 mg dexamethasone/day), and to compare their effects with that of tenoxicam, an antiinflammatory drug, on both the edema and ecchymosis in open rhinoplasty with osteotomies. For this study, 40 patients were divided randomly into five groups of 8 patients each, which received, respectively, betamethasone (group 1), dexamethasone (group 2), methylprednisolone (group 3), tenoxicam (group 4), and placebo (group 5). Open rhinoplasty with osteotomies was performed by the same surgeon with the patient under general anesthesia. Drugs were administered just before the induction of anesthesia and continued for 3 days. Only acetaminophen was used to control postoperative analgesia. Digital photographs of each patient were taken on postoperative days 1, 3, and 7. Scoring was performed separately for eyelid swelling and ecchymosis by three observers independently using a graded scale from 0 to 4. No statistically significant differences existed among the five groups in terms of age, sex, duration of surgery, amount of bleeding, and intravenous fluid administration during the surgery. On postoperative days 1, 3, and 7, no differences in the levels of ecchymosis or edema among the steroid groups, the tenoxicam group, and the control groups were observed. In conclusion, the authors observed no significant differences among the different kinds of steroids administered in equivalent doses (8 mg dexamethasone/day). Steroids used in these doses were not effective in preventing or reducing edema and ecchymosis after open rhinoplasty with osteotomies. Tenoxicam also was not effective. No complications caused by the use of steroids were observed during the 6-month follow-up period.