铜针留置术治疗海绵状血管瘤

自１９９２年初至１９９３年１０月，应用铜针留置术海绵状血管瘤３１例，经术后３个月至１．５年的随访，有效率达１００％。文中较详细介绍了刺入刺入针后全身和局部的反应，血铜、Ｂ超的变化和并发症等，我们认为铜针留置术是治疗海绵状血管瘤的有效方法。     

以栓塞硬化为主综合治疗眼睑海绵状血管瘤

目的 探讨治疗眼睑海绵状血管瘤的有效方法。方法 用栓塞硬化注射术，或结合手术切除部分硬化瘤体，或结合铜针留置术。治疗眼睑海绵状血管瘤。结果 治疗患者17例，其中11例只进行栓塞硬化治疗，2例栓塞硬化后手术切除治疗，4例铜针留置后栓塞硬化治疗。所有患者治疗后眼睑瘤体缩小，未出现并发症。随访6个月至4年。治疗部位无复发，局部功能形态良好。结论以栓塞硬化为主综合治疗眼睑海绵状血管瘤，简便有效，创伤小，不易复发。     

铜针治疗体表海绵状血管瘤168例报告

采用手法触摸盲视下留置铜针治疗105例体表海绵状血管瘤，63例采用在探头频率为7．0MHz彩色多普勒超声引导下铜针留置术，5－7d为一疗程，间隔一月重要治疗，通常治疗2－3个疗程。盲视组一年后复发15例，复发率为14．3％，超声引导一年后复发2例，复发率为3．2％，铜针治疗体表海绵状血管瘤操作简便易行，超声引导下铜针留置术治疗绵海状血管瘤较盲视法操作更安全，对于组织深部及位于大主干血管，神经等重要器官周围的海绵状血管瘤尤有独到之处。     

以栓塞硬化为主综合治疗眼睑海绵状血管瘤

目的探讨治疗眼睑海绵状血管瘤的有效方法.方法用栓塞硬化注射术,或结合手术切除部分硬化瘤体,或结合铜针留置术,治疗眼睑海绵状血管瘤.结果治疗患者17例,其中11例只进行栓塞硬化治疗,2例栓塞硬化后手术切除治疗,4例铜针留置后栓塞硬化治疗.所有患者治疗后眼睑瘤体缩小,未出现并发症.随访6个月至4年,治疗部位无复发,局部功能形态良好.结论以栓塞硬化为主综合治疗眼睑海绵状血管瘤,简便有效,创伤小,不易复发.     

铜针治疗血管瘤的疗效分析

目的分析铜针的各种使用方法对血管瘤的治疗效果。方法分别应用单纯留置铜针、通电后留置铜针、铜针通电后切除病变等方法治疗蔓状血管瘤、海绵状血管瘤或脉管畸形105例，统计分析术后早、晚期的疗效及复发情况。结果早期总有效率为94．3％，晚期总有效率为88．6％，复发率为28．6％，通电后切除效果最好，通电可以缩短留针时间42．6％，P〈0．01，差异有统计学意义。结论应用铜针治疗海绵状血管瘤及脉管畸形疗效肯定，与通电方法相结合效果可以提高。     

铜针留置与硬化剂封闭联合治疗巨大海绵状血管瘤1例

铜针留置与硬化剂封闭联合治疗巨大海绵状血管瘤１例山东济南军区总医院烧伤整形科（２５００３１）刘同省，苑正太，赵桂相人体皮肤表面巨大海绵状血管瘤的临床治疗非常棘手。我们采用局部铜针留置与平阳霉素及鱼肝油酸钠交替封闭治愈一例左锁骨上巨大海绵状血管瘤，现总...     

铜针留置术治疗海绵状血管瘤16例

铜针留置术治疗海绵状血管瘤１６例李晓静宁金龙高学宏汪春兰曹东升张林海绵状血管瘤是一种较常见的面部、四肢和躯干的良性肿瘤，治疗方法颇多，但疗效均不够理想，特别是深而广的海绵状血管瘤更是临床上的难题。我科于１９９２～１９９５年对１６例面颈和四肢海绵状血管...     

铜针治疗体表血管瘤55例临床分析

目的 总结单纯铜针留置、铜针留置加瘤体缝扎、铜针留置结合平阳霉素注射、铜针直流通电治疗血管瘤的方法及临床效果.方法 1999年1月-2006年1月,采用铜针治疗体表血管瘤55例,其中男28例,女27例;年龄3～50岁,中位年龄19岁.其中海绵状血管瘤42例,蔓状血管瘤4例,混合性血管瘤9例.瘤体大小6cm×4cm～40cm×25cm.分别采用单纯铜针留置(29例)、铜针留置加瘤体缝扎(21例)、铜针留置结合平阳霉素注射(3例)、铜针直流通电(2例)治疗.结果 行铜针治疗1次50例,2次5例.术后获随访3～18个月,参照王永洁疗效评价标准,治愈15例(27.3%),好转38例(69.1%),无效2例(3.6%),总有效53例(96.4%),其中铜针留置结合瘤体缝扎或平阳霉素注射疗效显著.结论 铜针是治疗体表血管瘤的一种有效方法,采用铜针留置结合瘤体缝扎或平阳霉素注射可提高疗效.     

CT三维重建下软组织深部海绵状血管瘤的诊疗

目的 探讨CT三维重建对深部组织海绵状血管瘤治疗的临床意义.方法 自2006年9月至2010年3月,对17例海绵状血管瘤患者,通过局部多点注射造影剂并行CT扫描后三维重建,以此制定治疗方案及选择治疗方式.结果 8例行手术切除,5例行硬化治疗,4例行铜针留置术及硬化治疗.术后随访6~36个月,均取得满意效果.结论 CT扫描后三维重建,能立体、清晰地显示瘤体的营养及分支血管及骨组织侵犯情况,明确诊断并辅助临床达到有效治疗.     

铜针留置术治疗头面部巨大海绵状血管瘤3例报告

铜针留置术治疗头面部巨大海绵状血管瘤３例报告兰州军医总医院烧伤整形科（７３００５０）叶祥柏，冯光珍，刘明华１病例报告例１，男，２３岁。左面部巨大海绵状血管瘤２３年，１９９３年８月入院。查左口角及面颊部有一个１４ｃｍ×８ｃｍ×１．５ｃｍ包块，质软，呈海...     

Zinc and copper replacement therapy in children with deep burns

In 22 children with burns of between 10 and 20 per cent of the body surface zinc and copper serum levels were controlled. Supplementation with zinc sulphate (20 mg kg^?1 d^?1) and copper sulphate (0·08 mg kg^?1 d^?1) was only carried out in cases of pathological findings on admission. When both zinc and copper levels were normal, no supplementation was given. In spite of this the copper level rose spontaneously to over 40 per cent. When the copper level was normal, but zinc levels were low, copper levels remained around less than 1 per cent without supplementation. When zinc and copper levels were both abnormal and supplementation was given, the zinc levels rose by 87 per cent but the copper level by only 28 per cent, and the copper levels reached only the lowest normal values. Zinc supplementation appears to antagonize the copper absorption or to influence the serum copper level. We doubt that serum zinc and copper levels are of much help in controlling the therapeutic effect of copper supplementation.     

Effects of an Intra-Epididymal and Intra-Scrotal Copper Device on Rat Spermatozoa

The effects of implantation of an intra-epididymal (IECD) and intrascrotal (ISCD) copper device on rat testicular and epididymal spermatozoa and the copper contents in its various reproductive tissues were studied and compared with another group of animals bearing the copper device and fed supplemental ascorbic acid. The motility of cauda epididymal spermatozoa in vitro in the presence of different concentrations of copper ions was also investigated. The results revealed that the in vitro decrease in motility was more rapid with increasing concentrations of copper sulphate solutions and the addition of ascorbic acid inhibited the motility of the spermatozoa much more rapidly than the copper sulphate solution alone, probably due to the strong acidic properties of ascorbic acid which caused a rapid fall in pH.
In the copper device bearing rats, the count, motility, fertilizing capacity, and metabolism of epididymal spermatozoa were reduced which has been correlated with alterations in their morphology. An accumulation of copper occurred in several reproductive tissues, but recovery to almost normal levels was obtained by feeding ascorbic acid to copper implanted rats. The data supports the view that ascorbic acid has a beneficial effect in copper toxicity. Although the intraepididymal copper implantation was found to be a more effective male contraceptive device than the intra-scrotal, further work is necessary in terms of reversibility of the effects and easy removal of the device.     

Expression in mouse kidney of membrane copper transporters Atp7a and Atp7b

Copper is essential for activity of many enzymes, but is toxic in excess. Several copper proteins are required for copper homeostasis. ATP7A and ATP7B are genes encoding membrane copper transporters. ATP7A, defective in Menkes disease (MNK), is expressed in many tissues involved primarily in copper uptake from dietary sources. ATP7B, defective in Wilson disease (WND), is essential for copper excretion. Although MNK patients have a copper deficiency in most tissues, copper accumulates in proximal tubules in the kidney. WND patients also have copper accumulation in the proximal tubules. In some WND patients this copper accumulation may result in tubular dysfunction, resulting in the increased excretion of low molecular weight substances (e.g. amino acids and calcium). In mouse, we have demonstrated, by in situ hybridization, the expression pattern in the kidney of mouse orthologues, Atp7a and Atp7b, and have confirmed Atp7b expression by immunohistochemistry. Both Atp7a and Atp7b are expressed in glomeruli; however, Atp7b is also seen in the kidney medulla. This suggests that glomeruli are responsible for regulating copper levels in the filtrate. In WND patients, urinary copper levels are extremely high suggesting Atp7b in the loops of Henle may have a role in copper reabsorption.     

Abnormalities of zinc and copper during total parenteral nutrition.

Changes in serum zinc and copper levels were studied in 19 tumor bearing patients undergoing parenteral nutrition (TPN) for five to 42 days. Before initiation of intravenous feeding mean serum zinc and copper concentrations were within normal limits but during TPN levels decreased significantly below those measured prior to parenteral nutrition. During TPN nitrogen, zinc, and copper intake, urinary output and serum levels were studied prospectively in nine of these patients. These nine patients exhibited positive nitrogen retention based upon urinary nitrogen excretion, but elevated urinary zinc and copper excretion and lowered serum zinc and copper concentrations. Neither blood administration nor limited oral intake was consistently able to maintain normal serum levels of zinc or copper. Zinc and copper supplementation of hyperalimentation fluids in four patients studied for five to 16 days was successful in increasing serum zinc and copper levels in only two. The data obtained suggest that patients undergoing parenteral nutrition may require supplementation of zinc and copper to prevent deficiencies of these elements.     

Urinary copper excretion in type 2 diabetic patients with nephropathy

BACKGROUND/AIMS: The aim of this study was to examine the relationship between the degree of urinary copper excretion and stages of diabetic nephropathy. METHODS: Copper, ceruloplasmin and albumin concentrations were measured in serum and urine samples from 41 type 2 diabetic outpatients with different stages of nephropathy and from 10 healthy controls. The copper/albumin and copper/ceruloplasmin ratios in serum and urine were determined. Furthermore, we examined whether free copper ions are dissociated from ceruloplasmin under various pH conditions. RESULTS: Urinary copper concentrations significantly increased only in macroalbuminuric patients. The copper/ceruloplasmin and copper/albumin ratios in urine were consistently greater than those in serum which were not different between patients and healthy controls except the copper/albumin ratio in macroalbuminuric patients. The ratios in urine decreased in parallel with the progression of nephropathy. Copper was found to be released from ceruloplasmin under acidic conditions. CONCLUSION: Urinary copper excretion in healthy controls may be the result of dissociation from the albumin-copper complex of serum during its passage through the kidney. In diabetic patients with advanced nephropathy, urinary copper excretion may be due to dissociations from both copper-albumin and ceruloplasmin-copper complexes filtered through the damaged glomerulus. Overloading of urinary copper to damaged renal tubules may play some roles in the progression of nephropathy in patients with advanced nephropathy.     

Effect of intra-epididymal injection of copper particles on fertility, spermatogenesis, and tissue copper levels in rats

In male rats, a single injection of 10 mg metallic copper particles in oil into each caput epididymidis induced infertility, whilst leaving mating behaviour and blood testosterone levels unchanged. Fertility tended to recover 5.5 months after the copper treatment. Although the copper content of the caput epididymidis reached a level of around 100 times higher than control values, the serum copper concentration did not rise significantly. This finding and the observation that treated animals gained weight as fast as the controls suggest a low systemic toxicity of this method. The testicular copper concentration was significantly higher than that in controls and different degrees of damage, including vacuolation, karyorrhexis, pyknosis, and cytolysis, were seen mainly in pachytene spermatocytes and early spermatids. Clumps of foreign particles, apparently metallic copper, were found in the interstices of the caput epididymidis together with degenerative changes in the epithelial cells of the caput, suggesting a possible effect of copper on the epididymal epithelium. The viability of epididymal sperm decreased more markedly than the decrease in sperm density. It is therefore most likely that the major cause of infertility after copper injection into the caput epididymidis is a direct inhibitory effect of copper on the sperm, whilst damage to the seminiferous and epididymal epithelial may contribute.     

铜针留置治疗海绵状静脉畸形的临床应用

目的探讨一种简便、安全、有效的治疗海绵状静脉畸形的方法。方法对海绵状静脉畸形分别采取单纯铜针留置、瘤体结扎加铜针留置、铜针留置加直流电通电3种方法进行治疗。结果临床治疗78例,治愈40例,有效35例,无效3例,总有效率达96%。结论铜针留置可使血管变性、纤维化、病变结构消失,是治疗海绵状静脉畸形较好的方法之一。     

Zinc and copper metabolism in nephrotic syndrome

The effect of proteinuria on urinary zinc and copper excretion was studied in children with nephrotic syndrome (NS). Clearance, fractional excretion, and urinary excretion of zinc and copper were significantly higher in children with relapse of NS than in the same children with remission of NS or in healthy children. A linear correlation was found between proteinuria and urinary zinc and copper excretion in relapse of NS. The results of this study suggest that zinc and copper deficiency in NS may be related also to increased urinary zinc and copper losses.     

Copper

Copper is an indispensable trace element for life. Four points are fundamental: copper is combined with essential enzymatic systems (oxidases, transaminases), copper is necessary for inclusion of iron in the molecule of hemoglobin, copper has a primordial role in the metabolism of molecule of hemoglobin, copper has a primordial role in the metabolism of collagen and elastin and some vascular diseases (aneurysms) are closely related to its lack, finally, there is an increase of plasmatic copper during cancerous diseases, which is significant even at an early time and usually proportional to the evolution.