Lokalrezidive von Weichteilsarkomen an Extremitäten und Rumpf

Soft tissue sarcomas (STS) tend to recur locally. In a series of 140 patients operated on during the past two decades with STS of the extremities and trunk, prognostic factors influencing local recurrence were determined. Statistical significance was evaluated for the quality of surgical resection (P<0.001), regional positive lymph nodes (P=0.03), and adjuvant radiotherapy (P=0.01) [for resection without wide margins (R1) and low-grade (G3) tumors]. In 1988, the surgical procedure was standardized. After 1987, local recurrence decreased significantly (P < 0.001). In subfascial tumors, local recurrence occurred far less in cases of compartmental resection than with wide excision. These data indicate that the course of patients with STS can be beneficially influenced by optimal therapy. Resection with wide margins in all three dimensions is the aim of sarcoma surgery. Postoperative radiation therapy is indicated in the case of R1 resection.

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Lokalrezidive von Weichteilsarkomen an Extremitäten und Rumpf

Zusammenfassung Weichteilsarkome neigen zur Ausbildung von Lokalrezidiven. In einer Studie von 140 Patienten der letzten 20 Jahre mit Sarkomen an Extremitäten und Rumpf wurde untersucht, welche Faktoren das Auftreten von Lokalrezidiven beeinflussen. Statistische Signifikanz ergab sick fur die Qualität der chirurgischen Re sektion (R) (p<0,001), den regionalen Lymphknotenstatus (p=0,03) sowie eine adjuvante Strahlentherapie (p=0,01) [bei marginal resezierten (RI), niedrig differenzierten (G3) Tumoren]. 1988 wurde das chirurgische Vorgehen standardisiert. In der Zeit danach traten signifikant weniger Rezidive auf als davor (p < 0,001). Bei subfaszialer Lage traten Rezidive nach Kompartmentresektion wesentlich seltener auf als nach weiter Resektion. Der Krankheitsverlauf von Weichteilsarkomen ist also durchaus therapeutisch beeinflußbar. Ein dreidimensional weiter Sicherheitsabstand ist das entscheidende Therapieziel, eine Bestrahlung in R1-Situationen indiziert.

     

保肝解毒胶囊对雷公藤多甙片所致小鼠急性肝损伤保护作用的实验研究

目的：运用新建雷公藤多甙致小鼠急性肝损伤模型，探讨保肝解毒胶囊对该模型肝损伤保护作用的效果和机理。方法：连续5d给小鼠灌服保肝解毒胶囊制剂，而后以雷公藤多甙片造小鼠急性肝损伤模型，检测小鼠血清谷丙转氨酶(ALT)、谷草转氨酶(AST)、还原型谷胱甘肽(GSH-Px)、超氧化物歧化酶(SOD)，肝匀浆中过氧化物(LPO)含量，并取肝组织作病理检查。结果：保肝解毒胶囊可以对抗肝损伤，其疗效和剂量有关；保肝解毒胶囊保护肝细胞的机理与对抗脂质过氧化反应有关。结论：保肝解毒胶囊具有保护肝脏的作用，     

Sarcomas of head and neck — A 10 yrs experience

38 cases of sarcoma of head and neck region were analysed in a retrospective way in relation to age, anatomic location, histological, clinical profile, and surgical approaches. Compared to other types of head and neck neoplasms, such as squamous cell carcinoma, soft tissue sarcomas have low rates of regional metastases. However the biological behaviour of soft tissue sarcoma is more aggressive specially in paediatric age group. In the present series, CT scan was considered as the primary modality of investigation. Surgery generally has been recommended as the primary method of treatment for achieving local control, except in those high-grade tumours arising in sites not amenable to resection. 3-year and 5-year survival rates in this present series 50% and 31.6% respectively.     

Surface movement errors in shank kinematics and knee kinetics during gait

The movement of surface mounted targets (SMT) on a shell at the mid-shank and of bone mounted targets attached to the distal shank using a Percutaneous Skeletal Tracker (PST) were simultaneously measured during free-speed walking of three adult subjects having different body types. Surface movement errors in shank kinematic estimates were determined by expressing the segmental motion derived from the SMT relative to the PST-based segment coordinate system (SCS) located at the segment center of gravity. The greatest errors were along and around the shank longitudinal axis, with peak magnitudes of 10 mm of translation and 8° of rotation in one subject. Estimates of knee joint center locations differed by less than 11 mm in each SCS direction. Differences in estimates of net knee joint forces and moments were most prominent during stance phase, with magnitudes up to 39 N in the shank mediolateral direction and 9 N.m about the mediolateral axis. The differences in kinetics were primarily related to the effect of segment position and orientation on the expression of joint forces and on the magnitude and expression of joint moments.     

关于软腭下降机制的肌电图学研究

目的探讨软腭的下降机制。方法将腭舌肌、腭咽肌设定为软腭下降肌,用肌电图学的方法进行验证。结果在软腭下降时腭舌肌、腭咽肌都出现了肌活动电位,另外,腭舌肌、腭咽肌在讲话时也参与了构音运动。结论腭舌肌收缩使软腭下降、鼻咽腔开放,腭咽肌由于具有咽绞扼功能,不但可使软腭下降,还与咽腔闭锁密切相关。     

X-linked hypophosphatemia: Normal renal function despite medullary nephrocalcinosis 25 years after transient vitamin D2-induced renal azotemia

Nephrocalcinosis (NC) detected by ultrasound is a recognized abnormality for some patients with X-linked hypophosphatemia (XLH) who received vitamin D₂ and inorganic phosphate therapy, but is commonly observed in XLH patients treated with 1,25-dihydroxyvitamin D₃ and inorganic phosphate supplementation. Nevertheless, long-term follow-up of kidney function in XLH patients with NC detected ultrasonographically has not been reported. We investigated two women with XLH, ages 31 (patient 1) and 39 (patient 2) years, each of whom had suffered at least one documented episode of vitamin D₂-induced hypercalcemia and renal azotemia during childhood. Patient 2 had also been treated with inorganic phosphate. No medications for XLH had been taken during adulthood. Renal ultrasonography at our institution demonstrated marked bilateral medullary NC in both women. No other explanation was found for their NC that apparently occurred several decades earlier from medical therapy for XLH. Detailed studies (including creatinine clearance, β₂-microglobulin excretion, and fasting urinary osmolality and acidification) revealed no impairment of kidney function in either patient. Our findings indicate that subradiographic medullary NC acquired during medical therapy for XLH may persist for decades, but with no adverse renal sequelae. Definitive (long-term) assessment of kidney function in the XLH population with NC, however, will be necessary to fully understand the risk of current medical treatment for this most common heritable form of rickets.     

舒肤特治疗痤疮疗效观察

目的　探讨舒肤特对座疮的治疗作用。　方法　病人随机分为治疗组和对照组。治疗组 45例 ,男 2 8例 ,女 17例 ;对照组 45例 ,男 2 5例 ,女 2 0例。年龄 14～ 42岁 ,平均 2 4岁。病程 2周～ 6年。治疗组用舒肤特 ,对照组用2 5 %氯霉素酊 ,每日 2次 ,4～ 8周为 1疗程。每周复诊 1次。　结果　治疗组痊愈率 3 7 8% ,总有效率 84 5 % ,对照组痊愈率 17 8% ,总有效率 62 2 % ,治疗组痊愈率优于对照组 ( χ2 =10 0 2 ,P <0 0 1) ,两组总有效率差异有显著性 ( χ2=11 42 8,P <0 0 1) ,　结论　舒肤特是中西药复方制剂 ,其用于治疗痤疮效果较好 ,无明显副作用。     

复方肾华治疗大鼠改良慢性血清病肾炎的实验研究

目的　观察复方肾华胶囊对改良大鼠慢性血清病肾炎模型的治疗作用。方法　采取传统大鼠慢性血清病肾炎模型制作方法加上切除大鼠一侧肾脏、隔日饮饲牛血清白蛋白 (BSA)酸化水、腹腔注射大肠杆菌内毒素 (LPS)等措施 ,制作肾炎模型 ,与西药蒙诺作对照 ,观察中药肾华对肾炎大鼠尿蛋白、血生化、凝血指标、肾功能、病理、免疫荧光以及增殖细胞核抗原 (PCNA)表达的作用。结果　肾华胶囊能够显著减轻肾炎大鼠肾脏重量及肾重指数、降低肾炎大鼠尿蛋白、升高血清蛋白、降低胆固醇、甘油三酯、改善肾功能、纠正凝血功能紊乱、减轻肾脏病理改变、减轻免疫荧光变化、减弱PCNA的表达。结论　中药肾华胶囊对大鼠慢性血清病肾炎模型有较好的治疗作用     

Fluid-fluid levels in cavernous hemangioma of soft tissue

Five cases of cavernous hemangioma with fluid-fluid levels on magnetic resonance imaging and/or computed tomography are reported. The signal characteristics were those of blood and histological analysis of the fluid-fluid levels showed that they were blood-filled cavities in the tumor. Although this finding itself is not specific, it may help in confirming the diagnosis of cavernous hemangioma.     

软组织复发及多发性平滑肌肉瘤的临床病理、免疫组织化学及电镜研究

本组报告软组织复发及多发性平滑肌肉瘤22例(多发性2例),进行了组织学、免疫组织化学及电镜观察。本组20例复发性平滑肌肉瘤复发次数为1～5次,间隔时间为2月～12年,病理可分为高分化型、低分化型、中度分化型及临界型平滑肌肉瘤。临界型易被忽略,应进行随访。