培养心肌细胞牵张刺激装置的建立及应用

1　方法　牵张刺激装置的制作如模式图 1.制作实验模型采用材料为有机玻璃板、2 4孔培养板、硅胶膜 (厚度 0 .2 2 μｍ) .硅胶膜从平面圆形变为球形时 ,面积扩大的百分比 =(Ｓ球 -Ｓ园 ) /Ｓ园 ,其中Ｓ球 =ＡＤ2 ,Ｓ园 =ｒ2 ,而ＡＤ2 =ｈ2 +ｒ2 ,其中ｒ为孔的半径 ,ｈ为膜升高的高度图 2 .通过控制ｈ的大小 ,可控制膜被牵拉的强度 .本实验采用使膜面积扩大 2 0 %的强度 ,故ｈ =4ｍｍ[1] .参照Ｋａｓｓｉｒｉ等[2 ,3 ] 方法进行心肌细胞的分离培养 .生长有贴壁心肌细胞的 2 4孔板被固定于牵张装置 ,缓慢充气使硅胶膜向上凸起 4ｍｍ ,分别维持…     

Recurrent chest pain as the presenting manifestation of spinal meningioma

We report the case of a 9-year-old boy with a spinal cord meningioma whose only manifestations were recurrent episodes of chest pain lasting for 2 years. This case shows that spinal cord meningioma should be considered among the possible causative factors of chronic chest pain in childhood. Chest pain, meningioma, spinal tumors     

Bladder cancer: race differences in extent of disease at diagnosis

BACKGROUND: Blacks are less likely than whites to develop bladder cancer; although once diagnosed, blacks experience poorer survival. This study sought to examine multiple biological and behavioral factors and their influence on extent of disease. METHODS: A population-based cohort of black bladder cancer patients and a random sample of frequency-matched white bladder cancer patients, stratified by age, gender, and race were identified through cancer registry systems in metropolitan Atlanta, New Orleans, and the San Francisco/Oakland area. Patients were ages 20-79 years at bladder cancer diagnosis from 1985-1987, and had no previous cancer history. Medical records were reviewed at initial diagnosis. Of the patients selected for study, a total of 77% of patients was interviewed. Grade, stage, and other variables (including age, socioeconomic status, symptom duration, and smoking history) were recorded. Extent of disease was modeled in 497 patients with urothelial carcinoma using logistic regression. RESULTS: Extent of disease at diagnosis was significantly greater in Blacks than in Whites. Older age group, higher tumor grade, larger tumors, and presence of carcinoma in situ were related to greater extent of disease in blacks and in whites. Large disparities between blacks and whites were found for socioeconomic status and source of care. Blacks had greater symptom duration and higher grade. Black women were more likely to have invasive disease than white women; this difference was not seen among men. Blacks in unskilled occupational categories, perhaps reflecting socioeconomic factors, were at much higher risk for muscle invasion than whites. CONCLUSIONS: While specific relationships between variables were noted, an overall pattern defining black and white differences in stage did not emerge. Future studies should examine the basis upon which occupation and life style factors operate by using biochemical and molecular methods to study the genetic factors involved.     

The primary care pediatrician's influence on medical student's performance of smoking assessments and counseling

BACKGROUND: American medical schools lack significant educational programs for teaching medical students about counseling parents and children on smoking prevention and cessation. Thus, the objectives of this study were to describe medical student's self-reported behaviors in the assessment of parents and children's use of tobacco and to compare these practices with well-accepted pediatric activities: injury prevention and developmental assessment. METHODS: Third year medical students in a pediatric clerkship at Boston University, all of whom spend part of their clerkship with pediatricians in their offices, completed six weekly surveys (2001-2002) recording their clinical activities in counseling parents and children about smoking, injury prevention, and performing developmental assessments. RESULTS: Of the 150 third year students completing the pediatric orientation, 108 (72%) completed all six feedback surveys and the general cancer prevention survey. Of the 108 students, 77% completed smoking assessments with at least one family per week during their 6-week clerkship compared with performance of injury prevention (85%, P = 0.09) and developmental assessment (91%, P = 0.006). Among all smoking cessation and prevention recommendations, students were most likely to discourage parents from smoking in the house and least likely to offer tips for parents to counsel their children about smoking. All variables related to primary care pediatricians' role modeling and feedback for optimal tobacco counseling practices were significantly associated with student counseling practice. CONCLUSIONS: Third year medical students were less likely to complete smoking assessments than those for developmental assessment and injury prevention counseling. However, primary care pediatricians' strong expectations and modeling of smoking counseling were uniformly associated with improved self-perceived student performance. Future educational activities should engage the primary care pediatrician preceptors of students completing pediatric rotations.     

Correction of Lower Limb Deformities Using Ilizarov's Technique

Background

India accounts for approximately 10 million orthopaedically handicapped children and adults with limb deformity. Ilizarov ring fixator could treat most of these deformities.

Methods

Twenty cases of deformities of lower limb managed with Ilizarov technique during period between March 2001 and February 2003 were studied.

Results

55% were in the age group of 11-30 years. Out of the 20 cases studied, 6 were congenital talipes equino varus, 8 were fixed flexion deformity of knee, 4 were equines deformity of the ankle and 2 were malunited fracture shaft of tibia.4 patients who had recurrence were operated for fixed flexion deformity of the knee. The main complication encountered was pin tract infection, which was seen in 15(75%) cases. In 16(80%) cases, the results were excellent with no recurrence of deformity and patients were able to walk independently. In 4 (20%) cases, recurrence was mild to moderate (10 to 20) but all of them were able to ambulate idependently and carry out their routine activities.

Conclusion

Ilizarov ring fixator is a superior compared to conventional methods for correction of deformities of lower limb.Key Words: Ilizarov method, Ligamentotaxis, Distraction     

Complex Pediatric Elbow Injury: An Uncommon Case

Background  

There is paucity of literature describing complex elbow trauma in the pediatric population. We described a case of an uncommon pediatric elbow injury comprised of lateral condyle fracture associated with posterolateral dislocation of elbow.