Characteristics of thyroidectomy in Taiwan.

BACKGROUND AND PURPOSE: Thyroidectomy is a common treatment for thyroid disorders in Taiwan, and constitutes a significant percentage of medical expenses. This study investigated the characteristics of thyroidectomy in Taiwan. METHODS: A total of 21 senior general surgeons from 16 medical centers and 5 regional hospitals participated. One surgeon from each hospital reviewed the hospital's medical records of thyroid operations performed in the year 2001. Medical records for 3846 thyroidectomies were retrospectively analyzed, including surgical indications and modalities, complications, pathology reports, and the use of antibiotics. RESULTS: Most of the patients were women (85%). Indications for surgery included proven malignancy (9%), suspicious malignancy (30%), evident compression symptoms (20%), hyperthyroidism (20%), and cosmetic reasons (12%). The majority of patients (78%) underwent a surgical procedure with lobectomy or bilateral thyroidectomy; 13% had unilateral partial thyroidectomy. Prophylactic antibiotics were administered in 46% of procedures, and continued postoperatively in 12%. Postoperative complications occurred in 12% of patients. Hypocalcemia was the most common complication (8%), and its incidence was significantly correlated with the frequency of total thyroidectomy (p < 0.01). Complete pathology reports for the thyroidectomized specimens were available in only 65% of the cases. The frequency of cosmetic reasons for surgery, unilateral subtotal resection, routine antibiotic administration, and incomplete pathology reports were significantly higher in regional hospitals than in medical centers. CONCLUSIONS: Reduction in the high rates of cosmetic reasons for surgery, unilateral partial thyroidectomy, incomplete pathology reports, and use of antibiotic prophylaxis are needed to improve the quality of thyroidectomy in Taiwan.     

Pneumocephalus after thoracoscopic excision of posterior mediastinal tumor.

Pneumocephalus is a very rare complication of video-assisted thoracoscopic surgery (VATS). A 66-year-old man developed pneumocephalus secondary to thoracoscopic excision of a neurogenic tumor in the posterior mediastinum. Pneumocephalus was diagnosed by brain computed tomography. Neurosurgical intervention was performed after conservative therapy had failed. The patient's condition had resolved without any neurologic sequelae 2 years later. When a patient has a relatively large amount of chest tube drainage and neurologic symptoms after VATS, the possibility of pneumocephalus due to cerebrospinal fluid leakage must be considered.     

Parkinson''s disease in China. Coordinational Group of Neuroepidemiology, PLA.

An epidemiological study on the incidence and prevalence of Parkinson's disease (PD) was carried out in 29 provinces, cities and autonomous regions in this country in 1986. The survey was conducted in 117 areas, and 566 patients with PD were found among 3,869,162 persons examined, giving a point prevalence for men and women of 16.9/10(5) and 12.4/10(5), with the highest prevalence after the fifth decade of age. The disease was most prevalent in the southern part of China, especially in Hunan and Guangxi provinces. The incidence was 1.5/10(5)/yr in 1986. Both the prevalence and incidence of PD in China are lower than those in the white race and Japanese.

     

Studies on Toxicity of Nitroquine-Dapsone Compound and Therapeutic Effects of Folic or Folinic Acid on Toxicated Animals

The toxic effects of nitroquine-dapsone compound(NQD)in mice and dogs were studied.The therapeutic index of NQDin mice is 1911,the greatest among the 6 antimalarials tested.Thetoxic effects of NQD(50 mg/kg/day for 3 days per os)and nitro-quine in dogs were manifested by injuries on the adrenal cortexand intestinal epithelium.When folic acid(4 mg/kg/day for 4 days)or calcium leucovorinum(0.3 mg/kg/day for 4 days)were usedconcomitantly with NQD,the death rate and the incidence of dia-rrhea in the toxicated dogs were greatly reduced,the injury on theintestinal epithelium was much milder,and the goblet cells weremuch more numerous than those without treatment.The results suggestthat folic acid and calcium leucovorinum can protect the undifferen-tiated cells in the intestinal crypts from being injured by NQD.     

世界脊髓损伤研究的代表性方向

我们现在要尽量使这些治疗方法进入临床试验证明他们的可行性现在脊髓损伤的临床试验基金很有限，所以只有很少的这些治疗方法真正用于病人主要的制药厂开始对脊髓损伤治疗产生兴趣，我们现在还有很多工作要做，但是前景方向十分清楚，我们需要努力快速的工作。     

女性减肥者的体像问题与社会支持及性格的关系

目的研究女性减肥者的体像特征及相关因素。方法采用体像障碍自评量表、社会支持量表、艾森克个性问卷调查了100例减肥门诊女性就诊者，并与100例近5年无减肥经历女性对照。结果(1)女性减肥者，体像得分明显高于正常对照组。(2)女性减肥者的体像得分与收入、P分、N分明显正相关；与社会支持得分明显负相关，与BMI无相关性。结论女性减肥者，不管是否为单纯性肥胖，都存在较多的体像问题，且与特定得人格和社会支持有关。     

无水酒精阻滞大鼠腹腔神经丛后脊髓、孤束核C-FOS和NOS-1的表达

目的:通过免疫组化的方法研究无水酒精阻滞大鼠腹腔神经丛后脊髓和延髓孤束核内CFOS和NOS1的表达。材料和方法:对70只Wistar大鼠实施手术,建立实验动物模型。分5组于术后不同时间取得脊髓和延髓样本,并用标准方法对其进行CFOS和NOS1免疫组化染色,观察脊髓和延髓孤束核CFOS和NOS1的表达。结果:无水酒精阻滞后脊髓后角、延髓孤束核神经元细胞内均有CFOS和NOS1表达。结论:无水酒精阻滞腹腔神经丛后,短时间内脊髓后角和延髓孤束核内CFOS和NOS1表达阳性,表明FOS和NOS1与内脏信息在脊髓水平的传导有关。CFOS和NOS1参与了内脏信息在孤束核内的传导。     

Expression of Anion Exchanger 1 Sequestrates p16 in the Cytoplasm in Gastric and Colonic Adenocarcinoma

p16^INK4A (p16) binds to cyclin-dependent kinase 4/6 and negatively regulates cell growth. Recent studies have led to an understanding of additional biologic functions for p16; however, the detailed mechanisms involved are still elusive. In this article, we show an unexpected expression of anion exchanger 1 (AE1) in the cytoplasm in poorly and moderately differentiated gastric and colonic adenocarcinoma cells and in its interaction with p16, thereby sequestrating the protein in the cytoplasm. Genetic alterations of p16 and AE1 were not detectable. Forced expression of AE1 in these cells sequestrated more p16 in the cytoplasm, whereas small interfering RNA-mediated silencing of AE1 in the cells induced the release of p16 from the cytoplasm to the nucleus, leading to cell death and growth inhibition of tumor cells. By analyzing tissue samples obtained from patients with gastric and colonic cancers, we found that 83.33% of gastric cancers and 56.52% of colonic cancers coexpressed AE1 and p16 in the cytoplasm. We conclude that AE1 plays a crucial role in the pathogenesis of gastric and colonic adenocarcinoma and that p16 dysfunction is a novel pathway of carcinogenesis.     

联合应用经腹腹膜前腹腔镜疝修补术和腹腔内网片植入术治疗成人腹股沟疝

目的联合应用经腹腹膜前腹腔镜疝修补术(transabdominal preperitoneal prosthetic,TAPP)和腹腔内网片植入术(intraperitoneal onlay mesh,IPOM),探讨理想的腹腔镜下腹股沟疝修补的方法。方法2006年1月~12月,对30例成人腹股沟疝行腹腔镜下修补。以腹壁下血管内侧缘为界,把疝薄弱区纵行分成内侧和外侧,内侧采用改进的TAPP方法,外侧仍用IPOM方法。沿腹壁下血管内侧缘纵行剪开腹膜后向内侧游离的区域内基本上是无血管区,亦无重要的神经,组织疏松极易游离,数分钟内即可分离出所需要的面积(7.5 cm×6.5 cm)。补片的材料亦分为内侧和外侧,内侧是聚丙烯材料,外侧应用Proceed补片。结果30例均在硬膜外麻醉下完成,手术时间单侧30~40 min,平均35 min,双侧50~60 min,平均55min,术中出血1~5 ml,术后第2天可离床活动,术后3~4天出院,术后2周均恢复工作。术后随访2~12个月,平均9个月,无粘连性肠梗阻,腹股沟部和全身无不良反应。结论联合应用TAPP和IPOM后,能体现微创的原则,易掌握,损伤少,手术时间短,恢复快,手术效果确切。