手术在治疗先天性脉管畸形中的作用

手术是脉管性病变治疗的一种手段,其主要作用是与放射治疗及各种药物治疗协同作用。对于血管瘤患者,手术仅限于普萘洛尔治疗无效,出现并发症及位于眼部的病变。整形手术可使血管瘤消退后遗留的面部畸形得到改善。对于一些范围较小的局灶性病变,手术往往可以取得满意的效果;对于巨大、多发的血管瘤,手术治疗往往作用有限,常常为减瘤术。手术患者一般在术前均经过栓塞硬化治疗,这样可以大大减少术中出血。手术无法治愈脉管性疾病,是一种辅助     

Tongue contractions during speech may have led to the development of the bony geometry of the chin following the evolution of human language: a mechanobiological hypothesis for the development of the human chin

One of the most fundamental yet unanswered questions of human evolution is that of the development of the chin. Whereas it is known that the chin, or mentum osseum, is an unique anatomical feature of modern humans that emerged during the Middle and Late Pleistocene, its origin and biomechanical significance are the subjects of intense controversy. Theories range from the suggestion that the chin evolved as a result of progressive reduction of the dental arch, which left it as a protrusion, to the hypothesis that it provided resistance to mandibular bending during mastication. Until now however, no accepted functional explanation of the human chin has emerged. Here, we develop the hypothesis that the actions of the tongue and non-masticatory orofacial muscles may have played a significant role on the development of the human chin. We report numerical simulations of the forces and resultant stresses developed in hypothetical chinned and non-chinned mandibles. Using empirical data and estimates of the forces generated by the human tongue during speech, our hypothesis suggests that the chin might in fact have developed as a result of the actions of the tongue and perioral muscles, rather than as a buttress to withstand masticatory induced stress. This provides a new perspective on the generation of the chin and importantly, suggests that its appearance may be causally related to the development of the human language.     

Facteurs associés aux perdus de vue des patients sous traitement antirétroviral dans un centre de traitement ambulatoire du VIH à Conakry,Guinée

Background

Late or inadequate therapeutic management increases the risk of mortality associated with HIV/AIDS. The aim of this study was to analyze the proportion and factors associated with loss of follow-up in HIV patients who receiving antiretroviral therapy at Conakry.

Highly cross-linked versus conventional polyethylene inserts in total hip arthroplasty,a five-year Roentgen stereophotogrammetric analysis randomised controlled trial

BACKGROUND Polyethylene(PE) particles produced by wear of the acetabular insert are thought to cause osteolysis and thereby aseptic loosening of the implant in total hip arthroplasty(THA). As highly cross-linked polyethylene(HXLPE) is presumed to give lower wear rates, in vivo studies are needed to confirm this.AIM To compare the wear of REXPOL, a HXPLE, with conventional PE within the first five years after implantation using Roentgen stereophotogrammetric analysis(RSA).METHODS Patients were randomised to receive either a HXLPE(REXPOL) or a conventional PE insert during primary THA. RSA images were obtained directly postoperative and after 6 wk, 12 wk, 6 mo, 12 mo, 24 mo and five years. Functional outcomes were assessed using the Hip Injury and Osteoarthritis Outcome Score and Harris Hip Score at baseline and five years after surgery.RESULTS The HXLPE(REXPOL) showed less wear in the latero-medial direction. Significant wear rates of conventional PE were seen in the latero-medial and center-proximal direction and in volume and corrected volume, whereas the REXPOL did not show these outcomes over time. Improvement from baseline in functional outcome did not significantly differ.CONCLUSION Total 3 D wear is less in THAs inserted with a REXPOL inlay than a conventional PE inlay after five years. This study confirms, for the first, that the REXPOL HXLPE inlay is preferred to standard PE.     

"Stem cell" origin of the hematopoietic defect in dyskeratosis congenita

We have used the long-term bone marrow culture (LTBMC) system to analyze hematopoiesis in three patients with dyskeratosis congenita (DC), two of whom had aplastic anemia, and the third had a normal blood count (apart from mild macrocytosis) and normal BM cellularity. Hematopoiesis was severely defective in all three patients, as measured by a low incidence of colony-forming cells and a low level of hematopoiesis in LTBMC. The function of the marrow stroma was normal in its ability to support the growth of hematopoietic progenitors from normal marrows seeded onto them in all three cases, but the generation of hematopoietic progenitors from patients marrow cells inoculated onto normal stromas was reduced, thus suggesting the defect to be of stem cell origin. The parents and unaffected brother of one of the families have also been studied in LTBMC and all showed normal hematopoietic and stromal cell function. From this study we speculate that there are some similarities between DC and the defect in the W/Wv mouse.     

CALLA-positive myeloma: an aggressive subtype with poor survival

Detailed immunotyping was carried out on 21 direct myeloma bone marrow aspirates and eight human myeloma cell lines. Four previously untreated common acute lymphoblastic leukemia antigen (CALLA)-positive myeloma patients were identified and six of eight cell lines (75%) were also positive. CALLA positivity, as part of an immature B phenotype, was found to correlate with very aggressive clinical disease: median survival six months v 56 months for the CALLA-negative group.     

[11C]5-HTP and microPET are not suitable for pharmacodynamic studies in the rodent brain

The PET tracer [¹¹C]5-hydroxytryptophan ([¹¹C]5-HTP), which is converted to [¹¹C]5-hydroxytryptamine ([¹¹C]5-HT) by aromatic amino acid decarboxylase (AADC), is thought to measure 5-HT synthesis rates. But can we measure these synthesis rates by kinetic modeling of [¹¹C]5-HTP in rat? Male rats were scanned with [¹¹C]5-HTP (60 minutes) after different treatments. Scans included arterial blood sampling and metabolite analysis. 5-HT synthesis rates were calculated by a two-tissue compartment model (2TCM) with irreversible tracer trapping or Patlak analysis. Carbidopa (inhibitor peripheral AADC) dose-dependently increased [¹¹C]5-HTP brain uptake, but did not influence 2TCM parameters. Therefore, 10 mg/kg carbidopa was applied in all subsequent study groups. These groups included treatment with NSD 1015 (general AADC inhibitor) or p-chlorophenylalanine (PCPA, inhibitor of tryptophan hydroxylase, TPH). In addition, the effect of a low-tryptophan (Trp) diet was investigated. NSD 1015 or Trp depletion did not affect any model parameters, but PCPA reduced [¹¹C]5-HTP uptake, and the k₃. This was unexpected as NSD 1015 directly inhibits the enzyme converting [¹¹C]5-HTP to [¹¹C]5-HT, suggesting that trapping of radioactivity does not distinguish between parent tracer and its metabolites. As different results have been acquired in monkeys and humans, [¹¹C]5-HTP-PET may be suitable for measuring 5-HT synthesis in primates, but not in rodents.     

Correction to: Endovascular stroke treatment’s impact on malignant type of edema (ESTIMATE)

Journal of Neurology - The original keywords were not sufficiently precise in describing the article content. Therefore, the key words were amended to include hemicraniectomy and malignant edema.     

Abdominal aortic ectasia resulting from peripheral traumatic arteriovenous fistulization

A 61-year-old World War II fighter pilot sustained a gunshot injury to the right fibula and an arteriovenous fistula subsequently developed. Angiographic examination 44 years later for evaluation of an abdominal aortic aneurysm showed an unusually shaped aneurysm and the right arteriovenous fistula with antegrade dilation of the ipsilateral arterial system in continuity with the aneurysm. We hypothesize that this arteriovenous fistula, which involved the peroneal and anterior tibial arteries of the right leg of 44 years' duration, was responsible for the development of this man's abdominal aortic aneurysm.     

Biomechanical comparison of four double-row speed-bridging rotator cuff repair techniques with or without medial or lateral row enhancement

Background  

Biomechanical comparison of four different Speed-Bridge configurations with or without medial or lateral row reinforcement. Reinforcement of the knotless Speed-Bridge double-row repair technique with additional medial mattress- or lateral single-stitches was hypothesized to improve biomechanical repair stability at time zero.