激光脱毛后痤疮样变化的发生率

近年来激光已成为脱毛最流行的手段。常用的激光器有翠绿宝石激光器、Nd：YAG激光器、红宝石激光器、二极管激光器。激光主要通过毛干中生色团黑素选择性吸光产热，最终损伤毛囊。而表皮中的黑素也会吸光产热，有可能造成表皮的热损伤。有研究表明，激光脱毛的主要不良反应有起疱、结疤、色素异常，此外还有异常毛发生长，网状青斑等。痤疮样变化尚未引起特别的关注。本研究的目的是结合皮肤类型、激光类型、治疗部位、多囊卵巢综合征病史、年龄、性别等来准确评价激光脱毛后痤疮样变化的发生率。     

PCV21 Cost Consequences of Acute Myocardial Infarction in Diabetic Patients-The First Year

Bolus formulations of new thrombolytic agents for the treatment of acute myocardial infarction (AMI) may offer benefits in efficiency of administration, door-to-needle time, quality improvement, and costs.
METHODS: A telephone survey of 23 experienced emergency room (ER) staff at community and urban hospitals encompassed the "hassle" involved with thrombolytic administration. Nurses were asked to compare a hypothetical single bolus with an infusion formulation of rt-PA under assumptions of equal efficacy and safety. A "hassle" analysis examined the differences in aspects such as protocol complexity, interference with other tasks, potential for error, and training requirements.
RESULTS: In all aspects, bolus injection was associated with significantly less hassle than infusion (p < .001). In particular, bolus injection was perceived as less problematic for nurses in terms of following the protocol, interference with timely performance of other tasks, distraction from other tasks, and hassle associated with the thrombolytic procedure. The results also suggested that bolus injections may reduce door-to-needle time.
CONCLUSION: A single bolus thrombolytic may offer promise for improved ease of care, quality patient management, and incremental reductions in door-to-needle time. Direct observational studies are needed to more precisely measure the potential reductions in door-to-needle time using bolus injection.     

Anatomic and radiologic bases of surgery of the thoracic aorta

Summary Lesions of the thoracic aorta create problems related to their site and relations with the main aortic branches. The aim of surgery must be to treat the lesion while ensuring perfusion of the tissues excluded by clamping during the operation. Anatomic study of the aortic lesions is based on imaging. Angiography is still often the basic examination though it shows only the lumen and course of the aorta. However, CT and MRI visualise the aortic wall and especially the relations of the aorta to the mediastinal structures. A comparison of anatomic and imaging studies was made on 10 fresh subjects coming from the anatomy department of the Saints-Pères and from the school of surgery of Fer à Moulin. Sections were made every 3 to 5 mm in 3 planes (sagittal, coronal and axial) after CT localisation of the plane of section. This anatomic study was correlated with CT and MR images made on healthy volunteers. The choice of surgical management of a lesion of the thoracic aorta is based on preoperative anatomic assessment by imaging applied not only to the aorta but also to its branches and the territory supplied.

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Bases anatomo-radiologiques de la chirurgie de l'aorte thoracique

Résumé Les lésions de l'aorte thoracique posent le problème de leur siège et de leurs rapports avec les principales collatérales de l'aorte. La stratégie chirurgicale doit permettre de traiter la lésion et d'assurer pendant l'intervention la perfusion des tissus exclus par le clampage. L'étude anatomique des lésions de l'aorte repose sur l'imagerie. L'angiographie reste encore souvent l'examen de base bien qu'elle ne montre que la lumière et le trajet de l'aorte. En revanche, la tomodensitométrie et l'IRM visualisent la paroi aortique mais surtout les rapports de l'aorte avec les structures médiastinales. Une confrontation anatomie - imagerie a été entreprise sur 10 sujets frais du Laboratoire d'Anatomie des Saints-Pères et de l'Ecole de Chirurgie du Fer à Moulin coupés tous les 3 à 5 mm dans les 3 plans (sagittal, coronal et axial) après repérage tomodensitométrique (TDM) du plan de coupe. Cette étude anatomique a été correlée à l'imagerie tomodensitométrique et l'imagerie par résonance magnétique (IRM) obtenues sur des volontaires sains. Devant une lésion de l'aorte thoracique, le choix de la stratégie chirurgicale repose sur le bilan anatomique pré-opératoire (imagerie) qui doit tenir compte de l'aorte mais aussi de ses collatérales et du territoire vascularisé.