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     

慢性硬脑膜下血肿的CT诊断和治疗

报告80例经CT诊断的慢性硬脑膜下血肿，其中低密度血肿39例，等密度23例．混合密度16例，高密度2例。混合密度中有11例具有沉积征象，虽然这一征象仅仅见于一小部分病人，但这一特征说明病人有再出血和预示病情恶化的可能。等密度血肿不易识别，容易漏诊或误诊，增强扫描及血管造影将有助于等密度血肿的确诊。     

胃癌单克隆抗体-丝裂霉素C结合物的制备及其细胞毒特征

作者报道胃癌单克隆抗体MG11-丝裂霉素C(MMC)结合物的制备及其对肿瘤细胞的杀伤作用。首先用戊二酐处理MMC,于MMC上引入羧基,MMC衍生物与N羟基琥珀酰亚胺及2,2′-二环已基碳二亚胺反应,得到MMC活性酯,后者与抗体反应将MMC引入抗体中。经测定,每克分子抗体中引入约6～7克分子药物,结合物对人胃癌细胞KATⅢ具有较强的选择性杀伤作用,在0.56μg/ml水平(药物浓度)对肿瘤细胞杀伤牢达60％,优于游离药物(51％)及无关抗体结合物(9.3％),提示选用的胃癌单抗对MMC具有较好的导向作用。     

Pulsed dye laser (577 nm) treatment of portwine stains: ultrastructural evidence of neovascularization and mast cell degranulation in healed lesions

Portwine stains were examined before, immediately after, and 1 yr after successful clearance by a pulsed dye laser (577 nm) using ultrastructural techniques. Dilated vascular channels and mast cell hypoplasia characterized lesional skin before treatment. Immediately after treatment, widespread selective vessel necrosis, similar to changes previously described, was observed. One year after laser irradiation, the abnormally ectatic portwine stain vessels had been replaced by small venules and arterioles, similar in number and diameter to blood vessels in normal skin; the only difference noted was that these new vessels were surrounded by easily identifiable mast cells. Many of these mast cells exhibited evidence of activation and degranulation. We conclude that mast cells may play an important role in the neovascularization of portwine stains treated by 577-nm dye laser irradiation.     

Penicillin treatment for gonorrhoea in relation to early syphilis in prostitutes.

A retrospective study of prostitutes in Singapore showed that they had received less antigonorrhoeal treatment with penicillin derivatives during the three month period before early syphilis was diagnosed than in other three month periods when they had not developed syphilis. This suggests that penicillin derivatives in doses sufficient to treat gonorrhoea will abort coincidental early syphilis.