骨关节炎股骨头的血管供应和髋关节表面置换

引言 随着金属对金属承重而假体的应用，存世界范围内对年龄较小的成年患者施行髋关肯表面置换的例数不断增加。据估计，新一代低磨损金属对会属假体表面置换的应用解决了笫一代金属对聚乙烯表丽假体聚乙烯磨损碎屑导致的溶骨问题。[第一段]     

Multiple Hypersonographic Spots in Basal Cell Carcinoma

BACKGROUND: High-frequency ultrasound is a useful method to obtain preoperative information regarding extension of basal cell carcinoma. Its contribution to diagnosis is generally limited, however. Recently, we observed hypersonographic spots in some cases of basal cell carcinoma. OBJECTIVE: The present study was performed to determine the diagnostic value of this finding in this type of tumor. MATERIALS AND METHODS: We conducted a retrospective study of archived sonographic images with a 30- or 15-MHz scanner and histology specimens of a total of 85 lesions, consisting of 29 basal cell carcinomas and 56 melanomas. RESULTS: The findings were classified into four patterns as follows: Type A, multiple (more than five spots/lesion) hypersonographic spots (14 cases, 48%); Type B, sparse (3-5 spots/lesion) hypersonographic spots (7 cases, 24%); Type C, multiple moderate sonographic spots (3 cases, 10%); and Type D, sparse moderate sonographic spots (5 cases, 17%). Three of 56 melanoma lesions examined as controls showed the Type D pattern, but none showed Type A, B, or C patterns. Histopathologically, these hypersonographic spots in BCCs seemed to correspond to calcification, horn cysts, or clusters of apoptotic cells in the centers of nests of basal cell carcinoma. CONCLUSION: Multiple hypersonographic spots might become a useful finding for differential diagnosis between basal cell carcinoma and melanoma.     

Survey of the living conditions and psychosomatic states of the elderly in Japan who receive home help

Abstract The living conditions and psychosomatic states of 2828 elderly people receiving care from home helpers were investigated. The physical condition of men was significantly lower than that of women. With regard to daily life (i.e. eating, sitting, standing, excretion, dressing, bathing, walking, tidiness) 70% were rated as being self-supporting. Eighty per cent of subjects were judged as having normal intelligence. Twenty-two per cent of subjects had more than one psychiatric symptom (e.g. memory impairment, insomnia, talking to oneself, and delusions). Among the various medico-welfare supports, home help was recommended most often.     

Electronic Templates versus Dictation for the Completion of Mohs Micrographic Surgery Operative Notes

BACKGROUND: Operative notes can be generated electronically by manual input of the entire note, free-form oral dictation, or using either an electronic template or a template for dictation. There are few studies that have directly compared these modalities in terms of speed, accuracy, and completeness. OBJECTIVE: The objective was to determine whether electronic templates are more efficient and reduce errors compared to free-form oral dictation for the completion of Mohs micrographic surgery operative notes. METHODS: Operative notes for 110 consecutive Mohs micrographic surgery cases were completed either by oral dictation or by electronic template. The time to dictate or complete the template was recorded for each note. Notes were subsequently edited, recording the number and type of errors as well as the time required to edit each note. RESULTS: Compared with dictation, operative notes completed with the electronic template had fewer errors (5.8% vs. 81%), took less time to complete (175.5 seconds vs. 240.0 seconds), took less time to review and edit (41.6 seconds vs. 201.1 seconds), and were completed and signed in a more timely fashion (0.115 days vs. 20.7 days). CONCLUSION: Electronic templates are a more accurate and rapid method compared to free-form oral dictation for the completion of Mohs micrographic surgery operative notes and have the advantage of being immediately available to review and sign.