单纯抽吸法巨乳缩小术

目的以往巨乳缩小术以倒“T”形手术为代表，术后遗留明显的瘢痕，为了减少手术瘢痕，应用抽吸法进行巨乳缩小术。方法 选择合适的患者，采用肿胀麻醉，经乳房下皱襞5mm小切口，用细管抽吸整个乳房和皮下脂肪组织，进行乳房缩小。结果 采用抽吸法巨乳缩小术治疗11例，手术效果满意，乳房形态良好，质地有所改善。1例发生血清肿，经多次穿利抽吸治愈。结论 抽吸法巨乳缩小术，对乳房下垂不明显以脂肪增生为主的中、轻度巨乳患者，是一种操作简便、效果良好的手术方法，特别适用于未婚女性，手术后瘢痕不明显，值得推广应用。     

反向双“V”形切除法巨乳缩小术

女性乳房肥大下垂,不但有碍美观而且影响生活、工作,并带来精神上的痛苦。我们于１９９４年１０月～１９９７年１０月用方、丁二氏［１］的反向双“Ｖ”形切除法行巨乳缩小术８例,认为该法手术设计合理,效果满意。一、临床资料本组８例,年龄２１～３６岁。其中４例未...     

介绍一种新式水平双蒂法乳房缩小术

自1985年以来,采用新式水平双蒂法行巨乳缩小术396例,取得了良好的手术效果。此法改变了原乳房缩小术的某些传统观念。通过众多病例观察发现,巨乳或严重乳房下垂患者,平仰卧时,乳头大多仍保持在第四肋水平。采用了新的乳房缩小设计图样;乳晕、乳头的血供和神经支配主要来自其下的乳腺导管系统和乳腺组织;切除的乳腺组织和保留的乳房皮肤瓣不完全一致;乳隙组织的切除是以乳晕为中心,在乳房上缘和下缘分别做“∨”和“∧”形切除;保留的乳腺组织全部和乳腺导管及乳头相通并悬吊固定於第二或第三肋骨水平的胸壁;手术过程中,乳头始终处于勃起状态。此法乳房造型好,手术操作比较简单。     

环乳晕切口腺体瓣悬吊并沿等高线环缩缝合法乳房缩小成形术

目的 介绍经环乳晕切口采用乳腺瓣悬吊，并沿等高线呈梯级环缩缝合的乳房缩小成形术的方法和经验。方法 经乳晕周缘切口，在皮下脂肪组织和乳腺腺体之间广泛分离，形成“帐篷状”皮瓣和“圆椎形”乳腺腺体；在乳腺上部形成3cm宽纵向乳腺瓣，切除乳腺瓣内、外侧部分乳腺组织，将乳腺瓣上提折叠缝合固定(或切断后重叠缝合)以悬吊乳房；将“帐篷状”皮瓣和“圆椎形”乳腺腺体沿等高线环缩缝合，缝针交替穿经皮瓣和乳腺腺体，最后环乳晕间断缝合皮肤。结果采用此法矫治轻中度巨乳房、单纯乳房下垂共8例16侧，术后乳房外形美观，效果满意。结论本术式简便易行、瘢痕不明显，对轻中度巨乳及乳房下垂者可作为理想首选术式。     

改良乳房下真皮乳腺单蒂瓣巨乳缩小术

目的为了进一步保证巨乳缩小术后乳头乳晕的血供和感觉，减少手术并发症。方法设计应用乳房下真皮单蒂瓣，并保留部分乳腺组织的垂直乳腺蒂，及切除的乳腺组织位于乳房下方两侧的巨乳缩小术，自１９９４年１月至１９９５年１１月，为６７例（１３２侧）巨乳患者在法国斯德拉斯堡欧洲美容整形诊所进行治疗。结果术后全部患者无乳头乳晕并发症，感觉正常。结论结合乳腺垂直蒂和乳房下真皮单蒂瓣的改良巨乳缩小术，不但可以确保乳头乳晕的血供，且可减少感觉损伤，降低手术并发症，及提供良好形态。     

改良双环法巨乳缩小术

目的：探讨双环法缩乳术的技术改进。用双环形切口，切除外上象限适量乳腺组织对肥大乳房进行缩小和重塑，恢复乳房正常形态。结果：23例46侧术后瘢痕不明显，乳头乳晕无坏死，感觉良好，效果满意。结论：本术式设计简单，满意度高，是治疗巨乳的好方法，有更好的应用前景。     

伴有乳房良性病变的巨乳缩小术27例

目的 探讨乳房肥大下垂同时伴有良性病变的巨乳缩小术的方法。方法：1980年11月～2001年12月，共收治乳房肥大下垂伴乳腺良性病变的患者27例52侧，根据乳腺病变的性质、部位、大小以及乳房肥大下垂的程度，选择下述不同的术式，行下方垂直蒂瓣法9例(17侧)，垂直双蒂瓣法16例(3l侧)，双环形切口乳房缩小术2例(4侧)。结果 术后外观评价良25例49侧占94．2％，差2例3侧占5．8％。术后乳房疼痛改善率为95．8％，肩、背痛，睡眠明显改善为100％，乳房下皱襞湿疹、皮炎未再发生为100％，27例患者术后着装均满意。结论 乳房缩小整形手术是治疗乳房肥大下垂，同时伴有乳腺良性病变的首选治疗方法。     

双环法反向楔形乳腺切除巨乳缩小术

目的:探讨双环法巨乳缩术中乳腺的功能性切除方法,以提高疗效,减少并发症.方法:以乳头为中心做近同心圆切口,去除两同心圆之间的表皮,形成真皮帽,在外上象限和内下象限内环外分别切除两块楔形乳腺组织,在乳腺基底适当分离后拉拢缝合乳腺.将去表皮的真皮帽边缘与乳腺基底部筋膜缝合并固定于胸大肌筋膜.环形缩拢缝合内外环皮肤.结果:本组23例患者,46侧,术后乳房形态自然挺拔、乳头乳晕对称、感觉正常;瘢痕隐蔽并且有效地保留了乳房的泌乳功能.结论:本术式行巨乳缩小,术后乳房形态良好,功能正常,是一种较理想的巨乳缩小整形方法.     

改良乳房下真皮乳腺单蒂瓣巨乳缩小术

目的为了进一步保证巨乳缩小术后乳头乳晕的血供和感觉,减少手术并发症。方法设计应用乳房下真皮单蒂瓣,并保留部分乳腺组织的垂直乳腺蒂,及切除的乳腺组织位于乳房下方两侧的巨乳缩小术,自1994年1月至1995年11月,为67例(132侧)巨乳患者在法国斯德拉斯堡欧洲美容整形诊所进行治疗。结果术后全部患者无乳头乳晕并发症,感觉正常。结论结合乳腺垂直蒂和乳房下真皮单蒂瓣的改良巨乳缩小术,不但可以确保乳头乳晕的血供,且可减少感觉损伤,降低手术并发症,及提供良好形态。     

乳房下皱襞上提法治疗巨乳缩小后乳房畸形

为矫正倒Ｔ形切口巨乳缩小术后常出现的乳头乳晕过高、乳房呈上小下大畸形，应用下胸皮瓣上推，使乳房下皱襞上提与深面肋骨膜、肋软骨膜或肋间筋膜固定的方法，共治疗４例７侧乳房，矫正良好。认为本方法是矫正Ｔ形切口巨乳缩小术后畸形的良好方法。     

"Free" and "exchangeable" or "trapped" and "non-exchangeable" water in cartilage

We repeated some of our own previous experiments, as well as some of Torzilli's recent experiments (11) on which he bases his conclusions relating to a nonexchangeable "trapped water" in cartilage. We are unable to confirm Torzilli's findings. We observed partition coefficients for 3H.HO very close to unity. That both the extrafibrillar and most of the intrafibrillar water is freely exchangeable and behaves as available water towards small solutes has been independently shown (3) for other collagenous tissues. All the different permutations of partition experiments have yielded results that are fully consistent with our original picture of the very major fraction of cartilage water being free.     

"Gas off" or "vaporizer off"

Editor—It is a common misconception that turning off thevaporizer while leaving the fresh gas flow (FGF) on, during     

"A" for Agency, "B" for Basal cell, "C" for Corticotulle, "D" for Danger

Without any proof, a governmental agency has decreed that Corticotulle was not enough efficient to be reimbursed by National Health Security. Dealing with treatment of basal cell carcinoma, another governmental agency has published recommendations which even do not follow basic rules of logic. This paper points out that economical and political methods are not scientific or medical ones.     

"Custom-fit" versus "off-the-shelf" ACL functional braces

Many sports medicine practitioners believe "custom-fit" functional braces are superior in performance to "off-the-shelf" braces for anterior cruciate ligament (ACL)-deficient knees. However, this is not well substantiated. This study compares a Donjoy custom-fit ACL brace (CE 2000), Donjoy off-the-shelf brace (Goldpoint), and an athletic taping technique to determine their role in our clinical practice. Five patients (3 men and 2 women) with isolated, unilateral, chronic ACL tears with an average age of 27 years (range: 19-35 years) were used to evaluate these three restraint systems. Anterior tibial laxity, quadriceps and hamstrings strength, endurance, standing long jump, brace migration with exercise, and pattern of muscle response to forced anterior tibial displacement were studied. Each patient was tested without a brace and then in each of the three test conditions (custom brace, off-the-shelf brace, and tape), with the order of testing randomized. The Donjoy custom-fit ACL functional brace did not reduce anterior laxity or improve standing long jump, muscle strength, endurance, or muscle response times significantly more than the off-the-shelf ACL brace. Both braces improved anterior stability over knee taping when the knee muscles were contracted under the low forces used in this study. After 1 hour of exercise, brace migration was significantly greater (P=.03) for the CE-2000 custom brace (18.6 mm) than for the Goldpoint off-the-shelf brace (4.5 mm). There appears to be no advantage to the more expensive custom-fit knee brace over the off-the-shelf brace.