Extremely rapid formation of mitral valve ring abscess in infective endocarditis

A patient with infective endocarditis (IE) due to methicillin-resistant staphylococcus aureus (MRSA) was found to have conversion of the hypoechoic region of the posterior mitral valve ring apparatus into a clearly delineated echolucent space by repeating transthoracic echocardiography at an interval of 1 week. Color Doppler showed features of blood entry into this space. Abscess formation in IE due to MRSA may be quick and repeated echocardiography may help detect the complications of IE. Semiurgent mitral valve plasty was performed for the associated prolapse of the posterior mitral leaflet using a hand-made, rolled, twisted autologous pericardial ring.     

A case of congenital midline cervical cleft with congenital heart disease

A congenital midline cervical cleft (CMCC) is a rare developmental anomaly. It may represent failure of the branchial arches to fuse in the midline and presents at birth with a ventral midline defect of the skin of the neck. Congenital heart disease along with CMCC is rarer, and most of the cases reported are associated with chest wall defects or thoracic ectopia cordis. The authors report a case of a 5-month-old girl with CMCC and an atrial septal defect (ASD) and discuss the clinical presentation, embryologic development, and treatment.     

Experimental and Clinical Studies Investigating the Efficacy of Distal Anastomosis with Patch Plasty in Bypass Operations with Expanded Polytetrafluoroethylene Grafts

Purpose: We investigated the efficiency of distal anastomosis with patch plasty (DAPP), both experimentally and clinically. Methods: In our experimental study, dogs were divided into two groups: a control group in which anastomosis was performed without DAPP (n = 7), and a DAPP group in which DAPP was performed at the distal anastomosis (n = 7). In our clinical study, 169 femoropopliteal bypasses were divided into three groups and analyzed. In one group, the saphenous vein was used (SVG group, n = 65); in one group, an expanded polytetrafluoroethylene (ePTFE) graft was used without DAPP (ePTFE group, n = 64); and in one group, an ePTFE graft was used with DAPP (DAPP group, n = 40). Results: In the experimental study, the ratio between the area of thrombus adherence and the entire area of the intraluminal surface of the graft, defined as the thrombus covering ratio, was 48.9% in the control group and 30.2% in the DAPP group. The ratio in the DAPP group was significantly lower than that in the control group. In the clinical study, although there were no significant differences among the three groups in cumulative patency rates of the femoral above-knee popliteal arterial bypasses, the patency in the DAPP group was excellent. The cumulative patency rates of the femoral below-knee popliteal arterial bypasses in the ePTFE group were significantly lower than those in the other two groups. Conclusion: There results suggest that the addition of DAPP may achieve excellent graft patency. Received: February 14, 2002 /Accepted: November 19, 2002 Reprint requests to: K. Dairaku     

The Endoventricular Circular Patch Plasty (“Dor Procedure”) in Ischemic Akinetic Dilated Ventricles

Abstract. From 1984 to 2000, 950 Left Ventricular ischemic asynergy (dyskinetic or akinetic) were operated using the endoventricular circular patch plasty technique. This allows to exclude all asynergic areas of the left ventricular wall and reshape the remaining wall. Both morphology and hemodynamic of left ventricle, are improved. Hospital mortality was below 7%. Life expectancy at 10 years reaches 80% if pre-operative L.V.E.F. is above 30%, and end systolic volume index (E.S.V.I.) below 90[emsp4 ]ml, and 60% in L.V.E.F. is below 30% and E.S.V.I. above 90[emsp4 ]ml. L.V.R. by endoventricular plasty has to be considered in the treatment of ischemic congestive heart failure.     

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Park等[1]在行二期唇裂鼻畸形整复术时,发现患侧鼻翼软骨有着正常同样的大小和厚度,只是附着和形状发生了异常。基于这一发现,鼻软骨畸形被认为是源于唇裂形成后产生的异常肌肉应力的分布,而不是由于原发的软骨畸形。     

双侧单蒂瓣法加提肌吊带成形术修复6～12个月婴儿完全性腭裂畸形

目的 探讨修复婴儿完全性腭裂畸形的最佳时机.方法 应用双侧单蒂瓣法(Bardach法)加双侧腭帆提肌吊带成形术.于婴儿6～12个月时完成腭裂修复术,并应用计算机辅助FFT(快速博立叶变换)元音声学对婴儿术前、后的发音进行分析比较.结果 本组26例婴儿腭裂伤口均一期愈合,无腭瘘等并发症发生,术后发音经计算机辅助FFT声学分析结果显示:所有患儿腭咽闭合功能均有明显改善.结论 应用双侧单蒂瓣法加双侧腭帆提肌吊带成形术,于婴儿6～12个月时完成腭裂修复术,技术安全可靠.术后发音效果良好.     

Stellenwert der Sonographie bei der Beurteilung von Spongiosatransplantaten — eine experimentelle Untersuchung

Zusammenfassung Die sonographische Verlaufskontrolle von Spongiosatransplantationen unterstützt die radiologische Diagnostik. Die guten klinischen Erfahrungen erfordern, daß der Stellenwert der Untersuchung experimentell gesichert wird. An der Tibia mit intaktem Integument werden auto und homologe Spongiosatransplantate, sowie in einem zweiten Versuch teilentkalkte Knochenspäne untersucht. Die Ergebnisse bestätigen den Einsatz, da sich gute Eindringtiefen an der teilentkalkten, aber auch an der normalen Spongiosa ergeben. Unterschiede zwischen auto- and homologer Spongiosa ergeben sich experimentell nicht.

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Position of ultrasound for judgement of spongiosa substance plasty — an experimental examination

Summary The ultrasound control after spongiosa substance plasty is, as described, a supportive method to x-ray measurement. The clinical experience and results are most encouraging. Therefore an experimental proof of this method is necessary. The model is the complete lower leg after amputation. The tibia is prepared with autologous and homologous spongiosa substance with and without gradual decalcification. For fresh spongiosa there is an ultrasound examination from three to five mm and to a higher rate for decalcified spongiosa substance. The experimental results are the verification of clinical assessment.

     

双开门椎管扩大成形与羟基磷灰石植入治疗颈椎管狭窄症22例

目的 :探讨双开门颈椎管扩大、椎板成形与羟基磷灰石植入治疗颈椎管狭窄症的临床疗效及远期效果。方法 :22例颈椎管狭窄症采用双开门椎管扩大、椎板成形 ,将羟基磷灰石特制成多孔长方形锥台体植于劈开之棘突间 ,7号丝线固定。术后随访6个月～28个月 ,平均18 6月。据手术前后X线片、CT、MRT对比其手术前后椎管矢状径、椎管指数及颈脊髓功能评价 ,随访羟基磷灰石植入后新生骨长入及骨融合情况。结果 :22例颈椎管矢状径术前 (9 8±1 32)mm ,术后 (13 8±1 30)mm颈脊髓功能 (40分平分法 )术前20 1±4 8 ,术后32 5±2 7。术后3～6个月羟基磷灰石与棘突骨性融合 ,无感染、移位、脱落。结论 :双开门椎管扩大成形与羟基磷灰石植入治疗颈椎管狭窄症不仅颈椎管扩大及颈脊髓功能改善均明显 ,脊髓减压彻底 ,并发症少 ,而且减少硬脊膜粘连 ,防止术后再关门及避免取自体髂骨     

双Z成形术矫正蹼颈畸形

目的 探讨采用双Z成形术矫正蹼颈缺陷的临床效果,并探讨该设计的原理及优越性.方法 在耳后至乳突后发际设计一个Z成形术,并在其后下缘斜方形切除一部分带毛发的皮肤,另外在肩峰内上方设计一个与上述切口不连续的Z成形术,两个Z成形术经过转位后达到延长带状条索的目的 .而部分带毛发的皮肤切除后,带状条索分别在乳突下部和锁骨中线处切断,中段向内侧回缩,与Z成形术结合从而使颈蹼消失.结果 该方法仅需要较小范围的皮下剥离和少量的皮肤切除,切口隐蔽、剥离范围小、瘢痕轻微,无肥厚性瘢痕增生.共矫正蹼颈缺陷5例,其中男性1例,女性4例.随访1～11年,医患均满意.结论 采用此方法治疗蹼颈畸形,不仅操作简便,在局部麻醉下就可以完成,而且具有美容效果.     

“井”字缝合局部皮瓣成形矫正乳头内陷

目的:探寻治疗乳头内陷的较佳手术方案。方法:2002年3月至2006年8月对29只乳头内陷畸形用"井"字缝合或加作局部"Z"字成形、乳腺真皮瓣填充矫正手术。结果:术后外形好,乳头感觉正常,切口瘢痕不明显。随访3～17个月,重度内陷畸形病例有3个乳头轻度回缩,余无复发。结论:该方法对于有哺乳要求的患者不失为一种可选择的有效方法。