Mandibular stability and condylar changes following orthognathic surgery in mandibular hypoplasia patients associated with preoperative condylar resorption

Clinical Oral Investigations - To evaluate postoperative mandibular stability and condylar changes in patients with mandibular hypoplasia and preoperative condylar resorption (CR) undergoing...     

金属硫蛋白对大鼠肝脏线粒体氧自由基损伤的保护作用

目的：研究金属硫蛋白（ＭＴ）对氧自由基损伤线粒体的保护作用以探讨其细胞保护机制。方法：采用ＦｅＳＯ４／抗坏血酸自由基发生系统直接损伤线粒体，测定Ｃａ（２＋）－Ｍｇ（２＋）－ＡＴＰａｓｅ活性和Ｃａ（２＋）摄入的变化。结果：ＭＴ能够直接拮抗氧自由基对线粒体Ｃａ（２＋）－Ｍｇ（２＋）－ＡＴＰａｓｅ活性和Ｃａ（２＋）摄入的抑制作用（Ｐ＜０．０１）。结论：ＭＴ对氧自由基损伤线粒体有明显保护作用，ＭＴ对细胞器线粒体的保护作用可能是细胞保护机制之一。     

Das primäre mediastinale Seminom

Zusammenfassung Die seltenen primären extragonadalen Seminome sind mit in die Differentialdiagnose des unklaren Mediastinaltumors einzubeziehen. Die Symptomatik ist uncharakteristisch, die Diagnose wird in den meisten Fällen durch eine Thoracotomie bzw. Sternotomie gestellt. Therapeutisch steht das chirurgische Vorgehen mit kurativer Zielsetzung oder palliativer Tumorverkleinerung im Vordergrund. Bei makroskopisch vollständig entferntem Tumor ist die Nachbestrahlung des Mediastinums zu diskutieren, bei metastasierendem Tumor sollte postoperativ eine Chemotherapie mit Cisplatin enthaltenden Kombinationen durchgeführt werden.

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Primary mediastinal seminoma

Summary Primary mediastinal seminoma is an uncommon lesion and should be included in the differential diagnosis of mediastinal tumors. Symptoms and signs may not be clear and in most cases the diagnosis is made by sternotomy or thoracotomy. Our recommendation is that patients with primary mediastinal seminoma should undergo curative resection or reductive surgery. Curative resection should be followed by radiation therapy. Chemotherapy with cisplatin-containing combinations should be reserved for patients who have metastases at the time of diagnosis.

     

Transanal endoscopic microsurgery

Transanal endoscopic microsurgery (TEM) has emerged as a minimally invasive means of resecting rectal tumors. Developed in Germany and now being used with increasing frequency in the United States, TEM utilizes a 40-mm operating rectoscope, which is sealed with an airtight facepiece. Carbon dioxide is constantly infused, thereby distending the rectum and maintaining visibility. A variety of instruments, such as tissue graspers, a high-frequency knife, suction, and needle holders, are inserted through the facepiece. Adenomas that are small, large, or even circumferential, as well as selected carcinomas up to 24 cm, can be removed with TEM instrumentation. The optics provide sixfold magnification, and this, combined with the constantly distended operative field, allows for a precise excision of the tumor as well as closure of the wound. For lesions in the mid and upper rectum, TEM is an alternative to a transsacral or transabdominal approach, with subsequently shorter hospital stay and fewer complications.     

Ethylene oxide allergy in dialysis patients

DESIGN OF STUDY: Two groups of patients undergoing long-term dialysis were studied in order to evaluate the importance of ethylene oxide (EtO) in causing allergic reactions during dialysis. The first group of 50 subjects had never shown any hypersensitivity reactions related to dialysis, whereas the second group of 20 subjects had previously complained of reactions. All the patients underwent a prick test with a standard kit of aeroallergens in order to assess the presence of atopy (in doubtful cases a RAST test was carried out with the same aeroallergens). A blood sample for the investigation of EtO specific IgE antibodies was taken from all the patients; the immunoenzymatic method was used. RESULTS: Sensitivity to EtO is significantly higher in the group of patients with previous allergic reactions during dialysis (55 vs 6% in the control group).      

Ruptured spleen in children--15-year evolution in therapeutic concepts.

This is a 15-year retrospective study of 64 pediatric surgical patients with traumatic rupture of the spleen from 1976 to 1990. The overall mortality was 14% (9/64). All non-survivors had severe multiple traumata and no fatalities were attributable to splenic injury. During the first 5 years of the study, the traditional surgical approach of immediate laparotomy and splenectomy was employed. During the next 5 years we practised laparotomy with subtotal splenectomy and repair. During the final 5 years conservative management with clinical and ultrasonographic monitoring became predominant (1 splenectomy, 4 repair, 23 conservative treatments). Among the 55 survivors, 11 had splenectomy, 14 had splenic repairs and 30 were treated non-operatively. All survivors had excellent outcomes and there was only one complication: a local abscess following splenic repair. Based on a very strict protocol in conservative management, the total amount of transfused blood could be reduced remarkably during the last period. Splenectomized patients received pneumococcal vaccine and prophylactic antibiotic coverage was prescribed for febrile episodes. None of the splenectomized patients experienced septic episodes or increased rates of infection. Based on our experience, ultrasonographically monitored conservative management is the treatment of choice in most patients with splenic injury in childhood.