西安地区骨性II类面型青年颅面部三维测量值研究

目的:对西安地区汉族骨性II类面型青年进行颅面部软组织的三维测量,将该年龄组的骨性II类面型颅面部各器官之间的三维测量值进行研究,为临床诊断和制定治疗计划提供参考依据。方法:采用Farkas的颅面部软组织表面测量方法,对西安地区面部形态为凸面型的60名汉族青年进行54项测量,将测量结果与司新芹用同法测量的正常面型青年面部软组织三维测量值进行对比。结果:通过抽样调查发现,西安地区西安籍骨性II类面型青年相对正常面型青年在三维方向的特点是:上颌相对下颌前突,颏下点相对后缩(中面1/3弧>t-gn-t下面1/3弧,P<0.01);面下1/3较窄(下颌宽:骨性II类面型<正常面型,P<0.01)。结论:西安地区西安籍骨性II类面型青年相对正常面型青年面部软组织在三维方向上存在较大的差异。     

西安地区骨性Ⅱ类面型青年颅面部三维测量值研究

目的：对西安地区汉族骨性Ⅱ类面型青年进行颅面部软组织的三维测量,将该年龄组的骨性Ⅱ类面型颅面部各器官之间的三维测量值进行研究,为临床诊断和制定治疗计划提供参考依据.方法：采用Farkas的颅面部软组织表面测量方法,对西安地区面部形态为凸面型的60名汉族青年进行54项测量,将测量结果与司新芹用同法测量的正常面型青年面部软组织三维测量值进行对比.结果：通过抽样调查发现,西安地区西安籍骨性Ⅱ类面型青年相对正常面型青年在三维方向的特点是：上颌相对下颌前突,颏下点相对后缩（中面1/3弧＞t-gn-t下面1/3弧,P＜0.01）;面下1/3较窄（下颌宽：骨性Ⅱ类面型＜正常面型,P＜0.01）.结论：西安地区西安籍骨性Ⅱ类面型青年相对正常面型青年面部软组织在三维方向上存在较大的差异.     

西安地区骨性II类面型青年与正常人颅面部比例指数比较

目的:对西安地区汉族骨性II类面型青年进行颅面部的三维测量,将测量值相比较所得到的颅面部比例指数与正常人对比,力求发现骨性II类面型的颅面部三维特征,为治疗计划的制定提供参考。方法:采用Farkas的颅面部形态学测量方法,对60名西安地区骨性II类面型的汉族青年进行54项测量,将计算出的面部比例指数与正常面型青年进行对比。结果:通过研究发现,西安地区骨性II类面型男、女性相对正常面型男、女性有一些共同的特点:下颌宽比面宽,下唇红弧形长度比上唇红弧形长度、下唇高比上唇高、面下1/3深比面中1/3深、下颌高比面高均较正常人小。结论:西安地区骨性II类面型青年面部软组织三维结构与正常面型者有着较大差异,主要表现在面下1/3。     

西安地区骨性Ⅱ类面型青年与正常人颅面部比例指数比较

目的：对西安地区汉族骨性Ⅱ类面型青年进行颅面部的三维测量，将测量值相比较所得到的颅面部比例指教与正常人对比，力求发现骨性Ⅱ类面型的颅面部三维特征，为治疗计划的制定提供参考。方法：采用Farkas的颅面部形态学测量方法，对60名西安地区骨性Ⅱ类面型的汉族青年进行54项测量，将计算出的面部比例指教与正常面型青年进行对比。结果：通过研究发现，西安地区骨性Ⅱ类面型男、女性相对正常面型男、女性有一些共同的特点：下颌宽比面宽，下唇红弧形长度比上唇红弧形长度、下唇高比上唇高、面下1／3深比面中1／3深、下颌高比面高均较正常人小。结论：西安地区骨性Ⅱ类面型青年面部软组织三维结构与正常面型者有着较大差异，主要表现在面下1／3。     

西安地区骨性II类长短面型青年的三维测量研究

目的:对西安地区部分汉族骨性II类长短面型青年进行颅面部软组织的三维测量,将该年龄组的颅面部各器官之间的三维测量值及比例指数在长短面型之间进行对比研究,为临床诊断和制定治疗计划提供更可靠的依据。方法:采用Farkas的颅面部软组织表面测量方法,对西安地区骨性II类长短面型青年进行54项测量。结果:通过对西安地区部分汉族骨性II类长短面型患者进行颅面部软组织的三维测量,发现:1.从三维测量值中可见骨性II类长面型相对于短面型患者下颌角大(150.4°>120.8°,P<0.01)。2.从三维测量比例指数中可见骨性II类长面型相对于短面型较窄、长,前全面高较大,前上面高及前下面高均较大(P<0.01)。结论:西安地区骨性II类长短面型之间不仅面高比不同,颅面部软组织的其他三维测量值及比例指数也存在着较明显的差异。     

西安地区骨性III类长短面型患者的三维测量研究

目的:对部分西安地区汉族骨性III类长短面型青年进行颅面部软组织的三维测量,将该年龄组的颅面部各器官之间的三维测量值及比例指数在长短面型之间进行对比研究,为临床诊断和制定治疗计划提供更可靠的依据。方法:采用Farkas的颅面部软组织表面测量方法,对西安地区骨性III类长短面型患者进行54项测量。结果:通过对部分西安地区汉族骨性III类长短面型患者进行颅面部软组织的三维测量发现:①骨性III类长面型相对于短面型下颌角较大(137.9°>117.8°,P<0.01)。②骨性III类长面型相对于短面型下颌宽较窄,前全面高、前下面高均较大(P<0.01)。结论:西安地区骨性III类长短面型青年之间不仅面高比不同,颅面部软组织的其他三维测量值及比例指数也存在着较明显的差异。     

西安地区骨性Ⅱ类长短面型青年的三维测量研究

目的对西安地区部分汉族骨性Ⅱ类长短面型青年进行颅面部软组织的三维测量,将该年龄组的颅面部各器官之间的三维测量值及比例指数在长短面型之间进行对比研究,为临床诊断和制定治疗计划提供更可靠的依据.方法采用Farkas的颅面部软组织表面测量方法,对西安地区骨性Ⅱ类长短面型青年进行54项测量.结果通过对西安地区部分汉族骨性Ⅱ类长短面型患者进行颅面部软组织的三维测量,发现1.从三维测量值中可见骨性Ⅱ类长面型相对于短面型患者下颌角大(150.4°＞120.8°,P＜0.01).2.从三维测量比例指数中可见骨性Ⅱ类长面型相对于短面型较窄、长,前全面高较大,前上面高及前下面高均较大(P＜0.01).结论西安地区骨性Ⅱ类长短面型之间不仅面高比不同,颅面部软组织的其他三维测量值及比例指数也存在着较明显的差异.     

西安地区骨性Ⅲ类长短面型患者的三维测量研究

目的对部分西安地区汉族骨性Ⅲ类长短面型青年进行颅面部软组织的三维测量,将该年龄组的颅面部各器官之间的三维测量值及比例指数在长短面型之间进行对比研究,为临床诊断和制定治疗计划提供更可靠的依据.方法采用Farkas的颅面部软组织表面测量方法,对西安地区骨性Ⅲ类长短面型患者进行54项测量.结果通过对部分西安地区汉族骨性Ⅲ类长短面型患者进行颅面部软组织的三维测量发现①骨性Ⅲ类长面型相对于短面型下颌角较大(137.9°＞117.8°,P＜0.01).②骨性Ⅲ类长面型相对于短面型下颌宽较窄,前全面高、前下面高均较大(P＜0.01).结论西安地区骨性Ⅲ类长短面型青年之间不仅面高比不同,颅面部软组织的其他三维测量值及比例指数也存在着较明显的差异.     

昆明地区汉族正常青年女性眼和鼻外形测量研究

目的：对昆明地区汉族正常青年女性眼、鼻外形进行测量，了解其形态特征.方法：选择昆明籍年龄18～22岁面部形态正常的汉族青年女性120名，采用Martin人体测量方法对眼、鼻进行表面测量.结果：获得14项测量的正常值范围，与湖南等地区正常青年女性及云南彝族、傣族青年女性测量值存在一定差异.结论：眼、鼻外形表面测量值有地区和民族的差异，临床应用中应有不同的标准。     

西安地区汉族正常青年人颅面部直接测量的研究

目的：为了客观地、准确地、标准地评价颅面形态，为颅面部畸形的治疗奠定基础。材料方法：采用Farkas建立的面部形态直接测量法，对100例（男女各50名）西安地区身体健康、颅颌关系协调、牙齿排列整齐、I类He关系、正常超覆He、无任何牙病治疗及外伤史的年满18岁的汉族高中生，进行颅面部18项（头6项、面部12项）的测量。测量结果经SPSS10．0统计软件处理，并进行男女两组的t检验。结果：正常人的颅面两侧基本对称（P＞0．05），男女组间除垂直向的n-sto,sto-gn,sl-gn和矢状向的gn-go无统计学意义外（P＞0．05），其余各项均存在显著性的差异（P＜0．05）。结论：1．男女在此年龄段上的上面高、颏部和下颌骨长度基本相似；2．正常汉族成人面部软组织特征存在地区差异。     

Vasopressor hormone response following mesenteric traction during major abdominal surgery

Background : We investigated the vasopressor hormone response following mesenteric traction (MT) with hypotension due to prostacyclin (PGI₂) release in patients undergoing abdominal surgery with a combined general and epidural anesthesia. Methods : In a prospective, randomized, placebo-controlled study we administered 400 mg ibuprofen (i.v.) in 42 patients scheduled for abdominal surgery. General anesthesia was combined with epidural anesthesia (T4-L1). Before as well as 5, 15, 30, 45, and 90 min after MT we recorded plasma osmolality, hemodynamics and measured 6-keto-PGFlα (stabile metabolite of PGI₂), TXB₂ (stabile metabolite of thromboxane A₂) active renin, and arginine vasopressin (AVP) plasma concentrations by radioimmunoassay. Catecholamine levels were assessed by high-pressure liquid chromatography (HPLC) with electrochemical detection. Results : Following MT, arterial hypotension occurred along with a substantial PGI₂ release. This was completely abolished by ibuprofen administration. Although plasma levels of 6-keto-PGF_1α (1133 (708) vs. 60 (3) ng/L, median (median absolute deviation), P=0.0001, placebo vs. ibuprofen) remained significantly elevated, blood pressure was restored within 30 min after MT in the placebo group. At the same point in time plasma concentrations of TXB² (164 (87) vs. 58 (1) ng/L, P=0.0001), epinephrine (46 (33) vs. 14 (6) ng/L, P=0.001), AVP (41 ± (18) vs. 12 (7) ng/L, P=0.0004), and active renin (27 (12) vs. 12 (4) ng/L, P = 0.001) were significantly higher in placebo-treated patients. Conclusion : Under combined general and epidural anesthesia arterial hypotension following MT due to endogenous PGI₂ release is associated with enhanced release of AVP, active renin, epinephrine and thromboxane A₂, presumably contributing to hemodynamic stability within 30 min after MT.     

A Teaspoon Pump for Pumping Blood with High Hydraulic Efficiency and Low Hemolysis Potential

Abstract: Virtually all blood pumps contain some kind of rubbing, sliding, closely moving machinery surfaces that are exposed to the blood being pumped. These valves, internal bearings, magnetic bearing position sensors, and shaft seals cause most of the problems with blood pumps. The original teaspoon pump design prevented the rubbing, sliding machinery surfaces from contacting the blood. However, the hydraulic efficiency was low because the blood was able to "slip around" the rotating impeller so that the blood itself never rotated fast enough to develop adequate pressure. An improved teaspoon blood pump has been designed and tested and has shown acceptable hydraulic performance and low hemolysis potential. The new pump uses a nonrotating "swinging" hose as the pump impeller. The fluid enters the pump through the center of the swinging hose; therefore, there can be no fluid slip between the revolving blood and the revolving impeller. The new pump uses an impeller that is comparable to a flexible garden hose. If the free end of the hose were swung around in a circle like half of a jump rope, the fluid inside the hose would rotate and develop pressure even though the hose impeller itself did not "rotate"; therefore, no rotating shaft seal or internal bearings are required.     

Microspheres Based Detoxification System: A New Method in Convective Blood Purification

Abstract: A variety of protein-bound or hydrophobic substances, accumulating as a result of pathologic conditions such as exogenous or endogenous intoxications, are removed poorly by conventional detoxification methods because of low accessibility (hemodialysis), insufficient adsorption capabilities (hemosorption), low efficiency (peritoneal dialysis), or economic limitations (high-volume plasmapheresis). Combining advantages of existing methods with microspheric technology, a module-based system was designed. Major operating parameters of the latter can be modified to allow for adjustment to individual clinical situations. An extracorporeal blood circuit including a plasmafilter is combined with a secondary high-velocity plasma circuit driven by a centrifugal pump. Different microspheric adsorbers can be combined in one circuit or applied in sequence. Thus, a prolonged treatment can be tailored using specially designed selective adsorber materials. Comparing this system with existing methods (high-flux hemodialysis, molecular adsorbent recycling system), results from our in vitro studies and animal experiments demonstrate the superior efficiency of substance removal.     

Tissue perfusion in relation to cardiac output during continuous positive-pressure ventilation and administration of propranolol or verapamil

Background : Our objective was to determine whether administration of propranolol or verapamil modifies the hemodynamic adaptation to continuous positive-pressure ventilation (CPPV), in particular the regional distribution of cardiac output (CO).
Methods : General hemodynamics and regional blood flows assessed by microsphere technique (15 (μm) were recorded in 16 anesthetized pigs during spontaneous breathing (SB) and CPPV with 8 cm H₂O end-expiratory pressure (CPPV8) before and after intravenous administration of propranolol (0.3 mg · kg⁻¹ followed by 0.15 mg · kg⁻¹ · h⁻¹, n=8) or verapamil (0.1 mg · kg⁻¹ followed by 0.3 mg · kg⁻¹ · h⁻¹, n=8).
Results : CPPV8 depressed CO by 25% without shifts in its relative distribution with the exception of a noteworthy increase in adrenal perfusion. Propranolol increased arterial blood pressure, and due to a fall in heart rate, CO dropped by 25%. The kidneys and, to a lesser extent, the splanchic region and central nervous system received increased fractions of the remaining CO at the expense of skeletal muscle flow. Similar patterns were seen during SB and CPPV8 such that the combination of propranolol and CPPV8 depressed CO by 50%. The circulatory effects of verapamil were less evident but myocardial perfusion tended to increase.
Conclusions : The combination of propranolol or verapamil with CPPV does not result in any specific hemodynamic interaction in anesthetized pigs, except that the combined effect of propranolol and CPPV may severely reduce CO.     

Bariatric Surgery in Some "Central and East-European (former Eastern bloc)"Countries - Current Status and Prediction for the Next Millennium

Background: Obesity is increasing globallly, including in the formerly "Eastern Bloc" countries. Methods: A survey was made of obesity and bariatric surgery. Results: In the 8 East and Central European countries studied, with total population 300 million, roughly 43% of the population was overweight (BMI 25-30), 23% obese (BMI > 30), with about 15 million people morbidly obese (BMI > 40). From 0-10 morbidly obese individuals/100,000/year undergo bariatric surgery. Conclusion: Most countries were found to provide inadequate treatment for obesity.The majority of the morbidly obese are not treated effectively. However, health-care awareness of obesity and bariatric surgeons are slowly increasing.     

Volatile anaesthetics reduce adhesion of blood platelets under low-flow conditions in the coronary system of isolated guinea pig hearts

Background : Inhibitory effects of volatile anaesthetics on platelet aggregation have been demonstrated in several studies. However, the influence of volatile anaesthetics on intracoronary platelet adhesion has not been elucidated so far.
Methods : Isolated hearts of guinea pigs were perfused with buffer in the absence or presence of volatile anaesthetics (0.5 and 1 MAC) at constant coronary flow rates of 5 ml/min for 25 min, then 1 ml/min for 30 min and again 5 ml/min for 10 min. Before, during and after low-flow perfusion, a bolus of human platelets was applied into the coronary system. To simulate thrombogenic conditions, 0.3 U/ml human thrombin was infused during low-flow perfusion and reperfusion. The number of platelets sequestered to the endothelium was calculated from the difference between coronary in- and output of platelets. The myocardial production of lactate and consumption of pyruvate and coronary perfusion pressure were also determined.
Results : At a flow rate of 5 ml/min only about 3% of the applied platelets did not emerge from the coronary system, in any group. In contrast, 13.1±1.2% (mean±SEM) of infused platelets became adherent in low-flow perfusion in the control group without anaesthetic. The adherence was reduced with each 1 MAC isoflurane (to 6.2±1.2%), sevoflurane (to 4.4±0.9%) or halothane (to 3.2±1.5%) (each P <0.05 vs. control). Volatile anaesthetic, 0.5 MAC, did not inhibit platelet adhesion to a statistically significant extent in any case. Perfusion pressure and metabolic parameters were not statistically different between the control and the hearts exposed to anaesthetics.
Conclusion : Volatile anaesthetics in a concentration of 1 MAC can reduce the adhesion of platelets in the coronary system under reduced flow conditions. This action does not arise from vasodilation or inhibition of ischaemic stress.     

Synergistic interaction between the effects of propofol and midazolam with fentanyl on phrenic nerve activity in rabbits

Background: It has been shown that the depressive effects of both propofol and midazolam on consciousness are synergistic with opioids, but the nature of their interactions on other physiological systems, e. g. respiration, has not been fully investigated. The present study examined the effect of propofol and midazolam alone and in combination with fentanyl on phrenic nerve activity (PNA) and whether such interactions are additive or synergistic. Methods: PNA was recorded in 27 anaesthetised and artificially ventilated rabbits. In three groups, propofol, fentanyl and midazolam were administered intravenously in incremental doses to construct dose-response curves for the depressant effects of each one on PNA. In another two groups, the effect of pretreatment with either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. on the effects of propofol and fentanyl respectively on PNA were studied. Results: Propofol and fentanyl caused a dose-dependent depression of PNA with complete abolition at the highest total doses of 16 mg · kg^?1 i. v. and 32 μg · kg^?1 i. v., respectively. In contrast, midazolam in incremental doses to a total of 0.8 mg · kg^?1 reduced mean PNA by 63%, but approximately 12% of PNA remained at a total dose as high as 6.4 mg · kg^?1. The mean ED₅₀s, calculated from dose-response curves, were 5.4 mg · kg^?1, 3.9 μg · kg^?1 and 0.4 mg · kg^?1 for propofol, fentanyl and midazolam, respectively. Initial doses of either fentanyl 1 μg · kg^?1 i. v. or midazolam 0.05 mg · kg^?1 i. v. acted synergistically with subsequent doses of either propofol or fentanyl to abolish PNA at total doses of 8 mg · kg^?1 and 8 μg · kg^?1, respectively. Conclusion: Fentanyl has a synergistic interaction with both propofol and midazolam on PNA and hence potentially on respiration.     

Influence of dopexamine hydrochloride on haemodynamics and regulators of circulation in patients undergoing major abdominal surgery

Background: Catecholaminergic support is often used to improve haemodynamics in patients undergoing major abdominal surgery. Dopexamine is a synthetic vasoactive catecholamine with beneficial microcirculatory properties. Methods: The influence of perioperative administration of dopexamine on cardiorespiratory data and important regulators of macro- and microcirculation were studied in 30 patients undergoing Whipple pancreaticduodenectomy. The patients received randomized and blinded either 2 μg · kg^?1 · min^?1 of dopexamine (n=15) or placebo (n=15, control group). The infusion was started after induction of anaesthesia and continued until the morning of the first postoperative day. Endothelin-1 (ET-1), vasopressin, atrial natriuretic peptide (ANP), and catecholamine plasma levels were measured from arterial blood samples. Measurements were carried out after induction of anaesthesia, 2 h after onset of surgery, at the end of surgery, 2 h after surgery, and on the morning of the first postoperative day. Results: Cardiac index (CI) increased significantly in the dopexamine group (from 2.61±0.41 to 4.57±0.78 1 · min^?1 · m^?2) and remained elevated until the morning of the first postoperative day. Oxygen delivery index (DO₂I) and oxygen consumption index (VO₂I) were also significantly increased in the dopexamine group (DO₂I: from 416±91 to 717±110 ml/m² · m²; VO₂I: from 98±25 to 157±22 ml/m² · m²), being significantly higher than in the control group. pHi remained stable only in the dopexamine patients, indicating adequate splanchnic perfusion. Vasopressive regulators of circulation increased significantly only in the untreated control patients (vasopressin: from 4.37±1.1 to 35.9±12.1 pg/ml; ET-1: from 2.88±0.91 to 6.91±1.20 pg/ml). Conclusion: Patients undergoing major abdominal surgery may profit from prophylactic perioperative administration of dopexamine hydrochloride in the form of improved haemodynamics and oxygenation as well as beneficial influence on important regulators of organ blood flow.     

A comparison of the inhibitory effects of four volatile anaesthetics on the metabolism of chlorzoxazone, a substrate for CYP2E1, in rabbits

Background: Halothane inhibits in vitro and in vivo activity of cytochrome P-450 (CYP) 2E1. There are several fluorinated volatile anaesthetics besides halothane, and most of them are defluorinated by CYP2E1. It is unclear whether other fluorinated anaesthetics inhibit the in vivo activity of CYP2E1.
Methods: We compared the inhibitory effects of therapeutic concentrations of four inhalational anaesthetics, halothane, enflurane, isoflurane, and sevoflurane, on chlorzoxazone metabolism in rabbits receiving artificial ventilation.
Results: All four inhalational anaesthetics decreased arterial blood pressure and increased plasma chlorzoxazone concentration. However, no significant differences in the plasma chlorzoxazone concentration were found between the four anaesthetics. The estimated chlorzoxazone clearance increased after beginning inhalation with all four agents, but no significant difference in clearance was noted between agents.
Conclusions: At therapeutic concentrations, the in vivo inhibitory effect on chlorzoxazone metabolism was similar for all four inhalational anaesthetics examined, even though their chemical characteristics and extent of hepatic metabolism differ considerably.     

Systemic analgesia adapted to the children's condition

A concept of balanced analgesia using nonsteroidal anti-inflammatory drugs (NSAIDs), paracetamol (acetaminophen), opioids, and corticosteroids can also be used in patients with pre-existing illnesses. NSAIDs are the most effective treatment for acute pain of moderate intensity in children; however, these drugs should be avoided in patients at increased risk for serious side effects, e.g. patients with renal impairment, bleeding tendency, or extreme prematurity. NSAIDs can be given with minimal risks to the younger child with mild to moderate asthma, and, in these patients, the use of steroids can be encouraged; in addition to their antiemetic and analgesic action, a beneficial effect on asthma symptoms can be expected. In the non-intubated child with cerebral trauma, exaggerated sedation caused by opioids and increased bleeding tendency caused by NSAIDs must be avoided. In neonates and small infants, the oral administration of sucrose or glucose is helpful to minimize pain reaction during short uncomfortable interventions.