Multi-impulsivity among bulimic patients in Japan

OBJECTIVE: Studies in Western world patients suggest the possible existence of a subgroup of patients with bulimia nervosa (BN) who display multiple problems with impulsivity, such as suicidal attempts. We assessed impulsive behaviors among BN patients in Japan to discuss them crossculturally. METHOD: Impulsive behaviors in 64 BN patients were assessed and multi-impulsivity (MI) was defined according to the definition proposed by Fichter, Quadflieg, and Rief (Psychological Medicine, 24, 591-604,1994). RESULTS: Nineteen patients (30%) met the definition of MI. BN patients with MI had more severe clinical features, such as concurrent depressive and anxious symptoms, global functioning, and higher prevalence of borderline personality disorder than BN patients without MI. DISCUSSION: These results showed the similarities between BN patients with MI in Japan and those patients in the Western world in clinical and psychopathological characteristics and a life-time incidence of each impulsive behavior. These findings may suggest culturally free bases for linkage between BN and MI.     

Die vierte Naht im MACS-Lift

The main drawback of the classic MACS-lift is the poor lifting effect in the medial neck and submandibular area, which results in a suboptimal aesthetic outcome in cases of severe excesses of neck skin, as well as poor outcome in cases of severe platysmal banding. To overcome these limitations, we describe a modification of the original technique, which maximizes the rejuvenation effect on the neck while keeping the proven advantage of short and less visible scars. Modifying the technique by introducing a 4^th SMAS suture to perform lateral platysma plication through a caudally extended dissection 3?C4?cm below the mandibular arch/jaw line creates a more accentuated submandibular angle resulting in a sharper, more defined jaw line. Combined with extensive submandibular liposuction/lipectomy and in some cases closed platysma myotomy, this technique creates a concave submandibular space which enables redraping of a large volume of midneck skin, often eliminating the need for additional posterior or anterior cervicoplasty (??convex becomes concave??).     

经直肠超声引导自动活检枪前列腺穿刺260例分析

目的：研究经直肠超声引导自动活检枪前列腺穿刺在诊断早期前列腺癌方面的意义。方法：患者分为两组,第1组230例为经每年一次PSA筛选,PSA＞4μg/L而进行直肠指检（DRE）和经直肠超声引导自动活检枪穿刺（TRUS）加活检的澳大利亚患者;第2组30例为DRE有可疑结节而进行TRUS加活检的国内病例。结果：经直肠超声引导自动活检枪前列腺穿刺所获标本取材全部优良,符合病理诊断的要求。第1组检出前列腺癌82例,其中T2a期以内80例,T2b2例,不典型增生19例;第2组检出前列腺癌8例,其中1例属于T2b,已行根治性前列腺切除术,另外7例至少在T3期以上。所有患者穿刺后未发生严重并发症。结论：经直肠超声引导自动活检枪前列腺穿刺是确诊早期前列腺癌的重要的方法,而且并发症少,值得推广。     

前列腺癌近距离放疗41例疗效回顾

目的 :观察早期局限性前列腺癌12 5I近距离放疗的临床效果。　方法 :对 4 1例确诊的局限性前列腺癌患者进行前列腺内12 5I植入。采用两步法 ,即治疗前进行前列腺体积研究 ,确定前列腺各部位放射量 ,处方剂量 16 0Gy;治疗中直肠超声波探头和C臂X线协助定位 ,专职护士长期随访。　结果 :获得长期随访 (3～ 4年 ) 33例(80 % ) ,其中 2例 (6 % )前列腺特异抗原 (PSA)升高者经穿刺确诊肿瘤局部复发 ,无死亡病例。早期并发症主要为尿路刺激症状 ,6个月内症状严重 ,1年以后症状消失。　结论 :前列腺近距离放疗生存率高 ,有短期尿路刺激症状 ,长期并发症少。