149例围产儿死亡原因分析

目的：探讨围产儿死亡原因及降低围产儿死亡率的措施。方法：对1994年1月－2001年12月在我院住院分娩的149例死亡围产儿的临床资料进行回顾性分析。结果：围产儿死亡率为22．74‰，死胎率为9．77‰，死产率为3．36‰，早期新生儿死亡率为9．62‰，占42．28％。围产儿死亡原因：缺氧占47．65％，早产占21．15％，出生缺陷占12．08％。结论：加强孕期保健、规范系统产前检查及监护、积极预防治疗妊娠并发症、防治早产、实施正确的新生儿窒息复苏方法、建立NICU等是降低围产儿死亡率的重要环节。     

The Frictional Behavior of Coated Guiding Archwires

Background: The vast range of orthodontic wires made of different alloys makes it increasingly difficult for orthodontists to judge them. Coated orthodontic wires form a group of innovative guiding archwires. Material and Methods: In the present in vitro study the frictional behavior of eight coated wires of different dimensions was investigated in archwire-guided canine retraction in the upper jaw. For this purpose five superelastic nickel titanium alloy wires (Titanol^/reg; Low Force River Finish Gold and Gold 2: Forestadent^®, Pforzheim Germany; Titanol^® Superelastic tooth Sentalloy Ionguard™: GAC, Central Islip, NY, USA; NITI Imagination™: GAC, Central Islip, NY, USA), two #-titanium wires (TMA^® Low Friction Ionguard: Ormco, Glendora, CA, USA; TMA^® Low Friction Ionguard Purple: Ormco, Glendora, CA, USA) and one steel wire (Stainless steel Imagination™: GAC, Central Islip, NY, USA) were selected. The coatings were made of Teflon^® or polyethylene, and by ion implantation. Three uncoated archwires (Rematitan^® Lite Dimple; Dentaurum, Pforzheim, German; Titanol^® Low Force River Finish: Forestadent^®, Pforzheim, Germany; BioForce Sentalloy™: GAC, Central Islip, NY, USA) were used for comparison purposes. The force losses due to friction were measured using the Orthodontic Measurement and Simulation System (OMSS). Results: The results indicated that all coatings can reduce frictional losses compared with an uncoated reference wire by the same manufacturer. Measured frictional losses ranged from 48.3-6.1% with the Teflon^® coatings reducing the frictional losses to less than 10% in some cases. Conclusion: An unequivocal correlation between the surface roughness and frictional forces of the wires could not be verified by scanning electron microscopy. Zusammenfassung Hintergrund: Die Vielzahl an orthodontischen Drähten aus diversen Legierungen macht es die Kieferorthopäden immer schwerer, sie zu beurteilen. Eine Gruppe von neu angebotenen Führungsbögen stellen die beschichteten orthodontischen Drähte dar. Material und Methode: In der vorliegenden In-vitro-Studie wurde das Reibungsverhalten von acht beschichteten Drähten unterschiedlicher Dimension bei den bogengeführten Eckzahnretraktion im Oberkiefer untersucht. Neben fünf Nickel-Titan-Drähten (Titanol^® Low Force River Finish Gold und Gold 2: Fa. Forestadent^®; Titanol^® Superelastic zahnfarben: Fa. Forestadent^®; BioForce Sentalloy Ionguard™: Fa. GAC; NiTi Imagination™: Fa. GAC) wurden zwei #-Titan- (TMA Low Friction Iongard: Fa. Ormco; TMA Low Friction Ionguard Purple: Fa. Ormco) und ein Stahldraht (Stainless Steel Imagination™: Fa. GAC) ausgewählt. Die Beschichtungen bestanden aus Teflon^®, Polyethylen oder Ionenimplantation. Als Referenz wurden drei unbeschichtete Drähte (Rematitan^® Lite Dimple: Fa. Dentaurum; Titanol^® Low Force River Finish: Fa. Forestadent^®; BioForce Sentalloy™: Fa. GAC) in die Untersuchung einbezogen. Die Reibungsverluste wurden mit dem Orthodontischen Mess- und Simulations-System (OMSS) bestimmt. Ergebnisse: Die Ergebnisse zeigten, dass alle Beschichtungen, verglichen mit einem unbeschichteten Referenzdraht desselben Herstellers, eine Reduktion der Reibungsverluste bewirken. Die gemessenen Reibungsverluste lagen zwischen 48,3% und 6,1%, wobei bei Teflon^®-Beschichtungen der Reibungsverlust zum Teil auf unter 10% sank. Schlussfolgerung: Ein eindeutiger Zusammenhang zwischen der Oberflächenrauheit und den Friktionswerten der Drähte konnte anhand von rasterelektronenmikroskopischen Aufnahmen nicht bestätigt werden.     

心脏移植术后急性排异反应的监测

目的 总结原位心脏移植术后急性排异反应的监测。方法 2000－01／2002－04施行11例原位心脏移植手术，结合临床表现、心电图、超声心动图、化验检查及心内膜活栓等检查，对心脏移植术后急性排异反应的监测进行分析。结果 采用临床症状＋心电图＋超声心电图＋心肌血清学检测综合判断有6次急性排异反应，行心内膜活检证实Ⅰb级2次，Ⅲa级3次；术后常规行心内膜活检21次，仅发现急性排异反应Ⅰa或Ⅰb级5次。结论 急性排异反应是关系到心脏移植术后患者康复及愈后的重要因素，因此要及时、有效地进行监测；心内膜心肌活检是诊断急性排异反应敏感可靠的方法，但为有创性检查，有一定的并发症风险，其他多项无创性检查可作辅助指标，因此急性排异反应监测应把无创性检查与心内膜心肌活检有机地结合起来。     

Effect of cordarone on the eye (results of long-term follow-up of the treatment and prevention of arrhythmia)

Thirty-one patients who received a prolonged maintenance therapy with cordarone to treat and prevent cardiac arrhythmias underwent an ophthalmologic examination. The treatment lasted 1.5 to 51 months. The signs of keratopathy were detected in 24 (77.4%) patients using a slit lamp biomicroscopy. There is a relationship between the severity of keratopathy and a daily dose of cordarone: in most cases signs of stage I keratopathy were detectable when the daily dose was up to 200 mg. Keratopathy appears to be reversible after the drug has been discontinued.     

Deriving relative risks from aggregate data. 2. An application to the relationship between unemployment and suicide.

In Part 1 of this study, the mathematical relations between micro and macro measures of effect were derived. The formulas thus obtained can be used for cross level comparisons of findings concerning the effect of some specific risk factor on, eg, mortality. The approach is illustrated by means of an empirical example relating to the association between unemployment and suicide. This relationship is estimated on micro data as well as on aggregate time series data. The findings from the two levels are fairly consistent.     

Psychosomatic medicine--a chance for integrated medicine. Position, definition, trends

Issuing from the international level of the psychosomatic medicine a critical estimation of the achievements in the GDR is done. The chances for a higher degree of cooperation resulting from the organisational structure of our public health service are illustrated and with the attempt of a preliminary definition for the psychosomatic medicine at the same time a graduated way of education is indicated. The cogent reasons for the acquisition of knowledge and qualification for results and trends of psychosocial medicine derive themselves from the changed development of morbidity in the developed industrial country GDR and immediately need aimed integration.     

Ectopic bone formation after total hip arthroplasty

Ectopic bone formation (EBF) is a well-known complication of total hip arthroplasty (THA). The etiology and pathogenesis are still obscure. An analysis of 119 consecutive patients with 129 primary THAs was performed to identify factors predisposing to ectopic bone formation, its frequency, and its effect on the results. Gender (male) and the duration of the operative procedure were statistically significant factors in the development of ectopic bone, which occurred in 63% of hips. The effect of grade III EBF on THA was a limited range of movement. Both local and systemic factors seem to play a role in the development of ectopic bone. Gentle handling of tissues may be important if the rate of ectopic bone is to be reduced.