Punch technique--an alternative approach to the repair of pierced earlobe deformities

The punch technique of repairing pierced earlobe deformities is a practical and simplified alternative to the usual method of repair. The procedure can easily be performed in any dermatology office since the instruments required are very basic. The technique is presented in a series of illustrations, and the results are cosmetically acceptable.     

Production and characterization of genetically engineered antibody molecules

Expression of antibody heavy- and light-chain genes by transfection permits the production of monoclonal antibodies with improved biological and antigen-binding properties. The immunoglobulin genes are placed in vectors containing a gene for encoding a protein that provides a biochemically selectable function in eukaryotic cells; these vectors are transfected into myeloma and hybridoma cells. Selection of drug-resistant cells permits the efficient isolation of the rare cells that express the transfected DNA. By placing heavy and light chains on plasmids with different selectable markers, one can deliver heavy- and light-chain genes simultaneously to the same cell. The transfected immunoglobulin genes are efficiently expressed and the proteins produced are a faithful mirror of the genes that were introduced. Using the standard techniques of genetic engineering and gene transfection, we can now produce antibodies of widely varying structures, including chimeric antibodies with segments derived from different species. These antibodies provide useful reagents to study structure-function relationships within the antibody molecule. Ultimately it will be possible to produce a new generation of antibody molecules with improved antigen-binding properties and effector functions.     

Effect of exercise on repetitive nerve stimulation studies: new appraisal of an old technique.

Repetitive nerve stimulation (RNS) is a simple and rapid method for evaluation of neuromuscular transmission defects. Although the effect of exercise in conjunction with RNS is well recognized, it has not been standardized in actual patient and control groups. In a prospective study over a period of 1 year, the authors evaluated the effect of exercise in conjunction with RNS in comparison with conventional 3-Hz RNS at rest in the clinical setting. Fifty-four patients who were referred for possible neuromuscular transmission disorders, in addition to 35 healthy control subjects, were studied. Amplitude and area decremental responses with RNS at rest and after 20 seconds of maximal exercise at 1-minute intervals up to 3 minutes were evaluated. The use of RNS with exercise resulted in additional diagnostic yield of up to 36.4% compared with conventional 3-Hz RNS at rest. The standardized use of exercise with RNS is advocated for increasing its diagnostic yield in the neurophysiologic laboratory.     

Nucleotide polymorphism in colicin E1 and Ia plasmids from natural isolates of Escherichia coli.

We examined DNA sequence polymorphism for the colicin gene clusters of seven ColE1 and six ColIa plasmids obtained from natural isolates of Escherichia coli. These gene clusters harbor levels of nucleotide diversity ranging from 0.006 (ColIa) to 0.054 (ColE1). This level of diversity is similar to that observed for chromosomally encoded E. coli genes. However, the variance associated with these estimates is severalfold higher for the plasmid-encoded genes. This increased variance may be due to the differing plasmid population sizes. The pattern of colicin gene cluster polymorphism suggests that the two colicins are evolving in different fashions. ColE1 accumulates polymorphism at an elevated rate in the central domain of the colicin protein, while ColIa polymorphism is distributed evenly along the gene cluster. Comparison of the patterns of divergence between colicin and related proteins of ColIa and Ib and patterns of polymorphism within ColIa suggest that this gene cluster is not evolving in a neutral fashion. These data lend support to the hypothesis that colicin gene clusters may evolve under the influence of diversifying selection.     

Anesthesia and/or Sedation for Pulsed Dye Laser Therapy

One of the most exciting developments in pediatric dermatology has been the use of the flashlamp-pumped, 585-nm, pulsed dye laser for treatment of vascular birthmarks. In many cases the results are miraculous. The increase in self-esteem and happiness of many children and adolescents has been overwhelming; for some, depression has been lifted, stuttering has ceased, social involvement has increased, and antidepressants have been discontinued. There are many success stories to tell.
Despite the remarkable effects of the pulsed dye laser and the medical and psychosocial indications for its use, the issue of pain control remains significant. We have no perfect outpatient pediatric anesthetic. Most methods carry either some risk or, if not hazardous, often are not very effective for controlling pain. Needless to say, a diversity of opinions exist on how to manage discomfort from this treatment modality. Therefore, we thought it would be useful to share the experiences and opinions of several dermatologists who have extensive experience with the pulsed dye laser.     

用结合^131碘和化疗药物的明胶微球作肝动脉...

Nine patients with inoperable hepatoma were treated by using hepatic arterial embolization 131I and chemotherapeutic agent gelatin microsphere (131I-CA-GM). The emission CT after operation detected that the microspheres were concentrated on tumor area. The ratio between the radioactivity in tumor and that in liver was 4.1:1. A case died of ictopic embolization; the others survived 3, 4, 5, 19, 24, 7, 8, and 12 months respectively. Three of them were still alive. 131I-CA-GM has triple anticarcinogenic actions, including the arterial occlusion, targeting chemotherapy and internal radiation. The microspheres can selectively accumulate in the tumor artery and can be easily traced by gamma-camera or emission CT. 131I-CA-GM is a hopeful embolic agent for the treatment of liver cancer, but some problems about ectopic arterial embolization should be further studied.     

Spastic paraparesis associated with portal-systemic venous shunting due to congenital hepatic fibrosis.

We report a case of progressive spastic paraparesis in a 45-year-old man with total portal-systemic shunting, which developed spontaneously due to congenital hepatic fibrosis. Cellular functions of the liver, except for an elevated blood ammonia level, were within normal limits, as is usual in congenital hepatic fibrosis. This case shows that spastic paraparesis following portal-systemic shunting may occur without liver failure.     

广西中小学生营养调查与评价

本文报道了广西２市４县２９所中小学样１２４９８名学生营养调查结果。调查表明：广西学生蛋白质和能量供应不足，平均值分别供给量标准的５７．２２％￣８２．９０％和６６．３７％￣８０．４４％；城市学生身高、体重发育优于农村学生（Ｐ〈０．０１），有１０．３０％的学生患有不同程度的营养缺乏症，且绝大多数是农村学生；学生贫血率为２５．４６％，城市学生以小细胞性贫血为主，占７４．８７％，而农村学生的大细胞和小细胞