Percutaneous angioplasty of carotid artery stenoses

Summary Percutaneous angioplasty is a well-established method of treating arterial stenoses and occlusions in various regions. In the carotid area this technique is still under discussion. The successful application of angioplasty in eight patients with carotid artery stenoses is reported.Adapted from a paper presented at XII European Congress for Neuroradiology in Prague, 27–29 September, 1984     

130例二尖瓣置换术同期行三尖瓣成形术的方法及意义

目的 探讨二尖瓣置换术(MVR)同期行三尖瓣成形术(TVP)的手术方法和意义。方法 191例二尖瓣病变同时伴有功能性三尖瓣关闭不全(T1)的患者，其中130例于MVR手术同期行TVP。70例轻度TI中，有7例行Kay氏法二瓣化成形术，2例行DeVega瓣环成形术；中度和重度TI均同期行TVP：其中中度TI 92例，行DeVega瓣环成形术57例，Kay氏法二瓣化成形术33例，人工瓣环固定术2例；重度TI 29例，行DeVega瓣环成形术6例，人工瓣环固定术23例。结果 130例中死亡3例，127例康复出院。122例随访29～112月，发现32例有轻度或极轻度三尖瓣返流(TR)，7例中度TR，3例重度TR。结论二尖瓣病变同时伴有功能性TI的患者，在施行MVR同时，应行TVP，尤其是中重度TI更要积极处理。选择适当的手术方式，能有效纠正TI，阻止轻度TR加重，减少严重TR的发生率。     

经皮肾镜下气压弹道碎石联合超声碎石术治疗复杂性肾结石疗效观察

目的：评价经皮肾镜下气压弹道碎石联合超声碎石术处理复杂性肾结石的疗效。方法：自2003年9月～2004年4月采用经皮肾镜下气压弹道碎石联合超声碎石术Ⅰ期治疗肾结石38例42侧。结果：平均手术时间85min，结石处理时间62min，结石清除率88．1％；5例多发性结石或铸形结石患者经皮通道小角度的肾盏内有直径小于1cm结石残留，辅助施行体外冲击波碎石治疗。随访1～3个月，无严重手术并发症。结论：经皮肾镜下气压弹道碎石联合超声碎石术处理大的复杂性肾结石具有高效、安全的特点，结石清除率高，值得临床推广应用。     

经皮穿刺氩氦刀冷冻治疗肝癌56例临床分析

目的　探讨氩氦刀冷冻治疗肝脏恶性肿瘤的临床意义。方法　 2 0 0 1年 7月～ 2 0 0 2年6月 5 6例肝脏恶性肿瘤在B型超声引导下行经皮穿刺氩氦刀冷冻治疗。术后患者定期复查血清肿瘤标记物、B型超声检查及CT或MRI。结果　患者肝功能ChildA级 5 0例 ,ChildB级 5例 ,ChildC级 1例。原发性肝癌 4 6例 ,转移性肝癌 10例。小肝癌 (直径≤ 5cm)甲胎蛋白阳性者治疗后转阴占80 % ,甲胎蛋白阴性者治疗后CT或MRI复查病灶完全坏死达 6 1.5 %。转移性肝癌治疗后瘤标降至正常或CT、MRI提示病灶完全坏死者占 6 0 %。结论　氩氦刀冷冻治疗肝脏恶性肿瘤是一种微创、安全、疗效可靠的新方法。对于不适宜行手术治疗的肝脏恶性肿瘤患者是一种有效的微创外科治疗方法。     

Autoperfusion balloon catheter for treatment of vertebral artery stenosis

Percutaneous transluminal angioplasty (PTA) of the vertebral artery was performed with an autoperfusion balloon catheter in five patients. There were no complications in the form of embolic episodes or neurological deficits due to brain ischaemia during inflation. In critical cases with insufficient collateral circulation during temporary occlusion, the use of an autoperfusion balloon catheter may expand the indications for PTA in patients with ischaemic cerebrovascular disease.     

Portal vein stenosis after liver transplantation: treatment with percutaneous transhepatic angioplasty

We used transhepatic percutaneous transluminal angioplasty to treat two patients who developed a severe anastomic portal vein stricture 7 months and 4 years respectively after liver transplantation. All signs of portal hypertension (pressure gradient, massive venous collateral circulation) disappeared following the procedure and remained absent 12 months later. Our results suggest that percutaneous transhepatic angioplasty should be considered for treatment of liver transplant recipients with anastomotic portal vein strictures. Correspondence to: P. Legmann     

In vitro absorption of some chlorinated paraffins through human skin

The in vitro absorption of chlorinated paraffins, Cereclor S52 and Cereclor 56L (present in a cutting fluid), has been measured through human skin. During 56 h continuous skin contact no Cereclor S52 was detected to have been absorbed and only a very slow rate of Cereclor 56L absorption (mean rate, 0.04 g/cm/h) was measured. This rate was only apparent after more than 7 h continuous skin contact. These chlorinated paraffins were very poorly absorbed through human skin and human dermal exposure should not cause significant systemic levels.     

Early clinical evaluation of the Cosgrove-Edwards prosthetic heart valve ring

 We discuss the usefulness of the Cosgrove-Edwards ring from our early clinical results from 25 rings in 24 patients who underwent mitral annuloplasty (MAP) or tricuspid annuloplasty (TAP) between June 1999 and December 2000. In the MAP group, the posterior mitral annulus between the anterior and posterior fibrous trigones was reinforced with the prosthetic ring. In the TAP group, the annuli of the anterior and posterior leaflets were splinted with the ring. The prosthetic ring was attached by pledgeted U-sutures. Cardiologists performed echocardiography pre- and postoperatively. Thirteen of the 14 in the MAP group showed mitral valve regurgitation of grade 0 or I. Six of the 11 in the TAP group showed tricuspid regurgitation of grade 0 or I, and 5 patients with regurgitation equal to or greater than grade II who remained in atrial fibrillation postoperatively recovered without further clinical symptoms. No patient has required reoperation during a follow-up period of up to 2 years. Cosgrove-Edwards ring-related complications, such as valve stenosis, ring detachment, and arrhythmia, have been not recognized in these patients. In conclusion, for mitral and tricuspid annuloplasty, the Cosgrove-Edwards prosthetic ring showed excellent early clinical results, particularly in patients maintained in sinus rhythm. Received: November 5, 2001 / Accepted: May 30, 2002 Correspondence to:Y. Misawa     

Microcirculation in the upper trapezius muscle during varying levels of static contraction,fatigue and recovery in healthy women —a study using percutaneous laser-Doppler flowmetry and surface electromyography

Summary Microcirculation in the upper portion of the trapezius muscle was measured percutaneously by continuous laser-Doppler flowmetry (LDF) during two 10-min series of alternating 1-min periods of static contraction and rest determined electromyographically (EMG). Stepwise increased contraction was induced by keeping the arms straight and elevated at 30, 60, 90 and 135°, which was repeated with a 1-kg load carried in each hand. Thereafter, fatigue and recovery were recorded while the subject kept her arms straight and elevated at 45° carrying the 1-kg hand load as long as possible, followed by rest with arms hanging and no load. A group of 16 healthy women of different ages was studied. Signal processing was done on line using a 386 SX computer. The LDF- and root-mean-square (rms) EMG signals were normalized. Spectrum analyses of EMG mean power frequency (MPF) and median spectrum frequency were performed. The rms-EMG increased significantly with an increase in the calculated shoulder torque (r=0.75). Accumulated local fatigue was indicated by a decrease in MPF with increased shoulder angle and added load (r = –0.54). Blood flow increased with increased shoulder angle (r=0.82, with hand loadr=0.62) and with increased shoulder torque (r=0.72), and also showed a significant increase with increased EMG activity (r=0.74). The LDF showed a negative correlation to MPF (r= –0.67), with increased values when MPF was lowered. During the endurance test, a moderate increase of LDF occurred which reached its maximum during the 1st min of recovery. Then, a slow return to the base level was recorded. The ability to increase the flow in the microcirculation with increasing muscle load was not diminished with age.     

经皮锁定加压钢板固定胫骨多段骨折21例疗效分析

目的探讨经皮锁定加压钢板(locking compression plate,LCP)手术治疗胫骨多段骨折的临床疗效。方法将2010年6月~2011年12月收治的胫骨多段骨折患者,根据AO分类方法筛选出C2型骨折21例:左侧9例,右侧12例;男性14例,女性7例;年龄15~71岁,平均(44±2.1)岁。入选病例均采用微创经皮插入LCP钢板手术内固定治疗。结果随访8~15个月,术后3~4月骨折线变模糊,术后6~9月骨折处出现大量骨痂;膝关节屈曲为(147±3.2)°,伸直为(0±0.5)°;踝关节背伸(9±1.2)°,跖屈(43±2.1)°;Johner-Wruhs评分标准:优17例,良3例,可1例,差0例;优良率95.24%。结论经皮LCP钢板固定胫骨多段骨折安全、有效,是值得推广的手术方式。