儿童陈旧性肱骨髁上骨折手术治疗

作者对２４例儿童陈旧性肱骨髁上骨折畸形愈合、影响肘关节功能恢复的病人经手术治疗，发现影响关节功能活动的主要原因是鹰咀窝及冠状窝部位的骨痂增生及骨折近端前下方移位，妨对肘关节屈伸功能。认为：清除该二部位增生分痂以及使骨折得以满意复位是治疗成功的关键。     

A breathing lung phantom for 81mKr lung ventilation studies its use in dosimetry and quality control

The construction of a breathing lung phantom that can be used to measure the amount of radioactive gas in the lungs as well as to determine the absorbed dose is described. For a lung ventilation study that consists of 6 views of 300 kents each, an effective dose equivalent of 50 Sv was calculated. The phantom is also suitable for comparison of different generator systems.     

Consequences of vanishing twins in IVF/ICSI pregnancies

BACKGROUND: Spontaneous reductions are a possible cause of the increased morbidity in IVF singletons. The aim of this study was to assess incidence rates of spontaneous reductions in IVF/ICSI twin pregnancies and to compare short- and long-term morbidity in survivors of a vanishing co-twin with singletons and born twins. METHODS: We identified 642 survivors of a vanishing co-twin, 5237 singletons from single gestations and 3678 twins from twin gestations. All children originated from pregnancies detected by transvaginal sonography in gestational week 8. By cross-linkage with the national registries the main endpoints were prematurity, birth weight, neurological sequelae and mortality. RESULTS: Of all IVF singletons born, 10.4% originated from a twin gestation in early pregnancy. Multiple logistic regression analyses adjusted for maternal age, parity and ICSI treatment showed for birth weight <2500 g an odds ratio (OR) of 1.7 [95% confidence interval (CI) 1.2-2.2] and for birth weight <1500 g OR 2.1 (95% CI 1.3-3.6) in singleton survivors of a vanishing twin versus singletons from single gestations; corresponding figures were seen for preterm birth. This increased risk was almost entirely due to reductions that occurred at >8 weeks gestation. We found no excess risk of neurological sequelae in survivors of a vanishing co-twin versus the singleton cohort; however, OR of cerebral palsy was 1.9 (95% CI 0.7-5.2). Furthermore, we observed a correlation between onset of spontaneous reduction, i.e. the later in pregnancy the higher the risk of neurological sequelae (r = -0.09; P = 0.02). Adjusted OR of child death within the follow-up period was 3.6 (95% CI 1.7-7.6) in the survivor versus the singleton cohort. CONCLUSIONS: One in 10 IVF singletons originates from a twin gestation. Spontaneous reductions that occur at >8 weeks gestation are one of the causes for the higher risk of adverse obstetric outcome in IVF singletons.     

Survival rates during the first trimester of multiple gestations achieved by ICSI: a report of 1448 consecutive multiples

BACKGROUND: The purpose of this study was to determine the rate of spontaneous gestational sac loss during the first trimester in women achieving multiple pregnancies by ICSI. METHODS: A retrospective analysis was performed of 1448 consecutive multiple pregnancies conceived by ICSI. RESULTS: Of the cohort of 1448 pregnancies, twin gestations constituted 59.6% (864), triplets 30.2% (438) and quadruplets 10.0% (146). During the first trimester, 69 (4.7%) patients miscarried, while 179 (12.3%) continued their pregnancies and had fewer gestational sacs at the end of the first trimester than at the beginning. The overall loss rate of any gestational sac during the first trimester in these multiple pregnancies was 10.1%. There was a significant difference in the frequency of spontaneous reduction to twin or singleton pregnancies in the first trimester between women carrying triplets (11.7%) and those carrying quadruplets (3.5%) [P = 0.004; odds ratio (OR) 3.5; 95% confidence interval (CI) 1.3-9.1]. The frequency of gestational sac loss was significantly greater among women >35 years old (20.9%) than in women less than 35 years old (15.9%) (P = 0.03; OR 1.4; 95% CI 1.0-1.9). CONCLUSION: In multiple pregnancies there is a significant risk of spontaneous loss of any embryo during the first trimester. These findings should be considered prior to any decision about selective embryo reduction.     

Efficiency of work performance and contraction velocity in isotonic tetani of frog sartorius

Mechanical work, ATP, ADP, PC, free creatine and lactate concentrations were determined on IAA poisoned frog sartorii tetanically stimulated in humidified N, at 10°C in isotonic conditions (0.25 or 0.45 P₀). Tetanus duration was 0.35 s, number of tetani was varied from 0 (rest) to 25 (exhaustion). The mechanical work performed per mole ATP+PC split (W _P ^* ) amounted on the average to 16.7 kJ/mol. It was observed, however, that w _p ^* increased from about 13 to about 24 kJ/mol with decreasing ATP concentration from about 2 (resting value) to about 1 mol/g and that this decrease in ATP was associated with a decrease of the shortening (and relaxation) speed of the muscle to about 30% of the values observed on the first tetanus. It is concluded that the thermodynamic efficiency of muscle contraction, calculated from the ratio of w _P ^* (measured) to the thermodynamic affinity (free energy change) of ATP hydrolysis (estimated) increases from about 0.3 to about 0.5 with decreasing ATP concentration and shortening speed.This work was supported by the Fonds National Suisse de la Recherche Scientifique, Grants 3.332.78 and 3.364.0.82     

EEG enhancement during electrosurgery using an optical fibre

The paper considers the limiting factors in EEG enhancement in the presence of electrosurgery interference and presents a design for a useful fibre-optic EEG monitoring instrument which is free from such problems as electrical shock (micro and macroshock), patient burns and susceptibility to electrosurgery interference associated with conventional EEG monitors.     

The functional organization of the intraparietal sulcus in humans and monkeys

In macaque monkeys, the posterior parietal cortex (PPC) is concerned with the integration of multimodal information for constructing a spatial representation of the external world (in relation to the macaque's body or parts thereof), and planning and executing object-centred movements. The areas within the intraparietal sulcus (IPS), in particular, serve as interfaces between the perceptive and motor systems for controlling arm and eye movements in space. We review here the latest evidence for the existence of the IPS areas AIP (anterior intraparietal area), VIP (ventral intraparietal area), MIP (medial intraparietal area), LIP (lateral intraparietal area) and CIP (caudal intraparietal area) in macaques, and discuss putative human equivalents as assessed with functional magnetic resonance imaging. The data suggest that anterior parts of the IPS comprising areas AIP and VIP are relatively well preserved across species. By contrast, posterior areas such as area LIP and CIP have been found more medially in humans, possibly reflecting differences in the evolution of the dorsal visual stream and the inferior parietal lobule. Despite interspecies differences in the precise functional anatomy of the IPS areas, the functional relevance of this sulcus for visuomotor tasks comprising target selections for arm and eye movements, object manipulation and visuospatial attention is similar in humans and macaques, as is also suggested by studies of neurological deficits (apraxia, neglect, Bálint's syndrome) resulting from lesions to this region.     

Genetic obestiy: estrogenic influences on the body weight and food intake of lean and obese adult Zucker (fa/fa) rats

The effects of chronic estrogen withdrawal and subsequent hormone replacement on the feeding and body weight of adult lean and genetically obese Zucker rats were investigated. Following confirmation of a delay in the vaginal canalization of the fatty rat, subgroups of each genotype received either ovariectomy or sham surgery (Experiment 1). One hundred days later all subjects were injected subcutaneously (SC) with 1.0 microgram of estradiol benzoate (EB) daily for 16 treatment days (Experiment 2A). A second series of daily 2.0 microgram EB injections was administered intraperitoneally (IP) for 1 week (Experiment 2B). The first experiment revealed that ovariectomy produced overeating and similar weight gains in both genotypes. In the second experiment, SC hormone treatment completely reversed ovarian obesity in lean animals but failed to alter the food intake or weight gain of fatty rats. IP administration of EB depressed the feeding of fatty and lean animals to a comparable degree but a reduction in weight gain was observed only in the lean rats. These findings are discussed in light of current theories of estrogenic modulation of energy balance.     

An Experimental Comparison of Flat-Panel Detector Performance for Direct and Indirect Systems (Initial Experiences and Physical Evaluation)

The purpose of this work was to compare direct and indirect detectors in terms of their system linearity, presampled modulation transfer function (MTF), Wiener spectrum (WS), noise equivalent quanta (NEQ), and power spectrum. Measurements were made on two flat-panel detectors, GE Revolution XR/d (indirect) and Shimadzu Safire (direct) radiographic techniques. The system linearity of the systems was measured using a time-scale method. The MTF of the systems was measured using an edge method. The WS of the systems was determined for a variable range of exposure levels by two-dimensional Fourier analysis. The NEQ was assessed from the measured MTF, WS, and estimated ideal signal-to-noise ratios. Power spectrum analyzed the chest phantom within artificial lesions. System linearity was excellent for the direct systems. For the direct system, the MTF was found to be significantly higher than that for the indirect systems. For the direct system, the WS was relatively uniform across all frequencies. In comparison, the indirect system exhibited a drop in the WS at high frequencies. At lower frequencies, the NEQ for the indirect system was noticeably higher than for the direct system. Power spectrum for the direct system was relatively flat and similar to that for white noise. The indirect system exhibited significant reduction at high spatial frequencies. In general, the direct systems exhibit improved image quality over indirect systems at comparable exposure dose.