Electrical burns of the upper extremity in the pediatric population

Electrical burns of the upper extremity, particularly high-voltage injuries, are becoming more prevalent in today's society and are often times devastating to the patients' appearance and functionality. The basic tenants of flame burn reconstruction apply to electrical injuries. Namely, a patient should undergo basic trauma resuscitation, decompression and debridement within a reasonable timeframe, and definitive closure as soon as possible. Reconstruction of the 3 main areas of injury (hand, elbow, and axilla) follows the basic reconstructive ladder from least invasive, that is, local wound revision, to most extensive, that is, free tissue transfers. Whereas the role of the surgeon continues to be the creation of ingenious techniques to deal with complications, the real treatment lies in education and prevention. This article will look to do a comprehensive review of electrical injuries to the upper extremity.     

Burns of the developing breast

Burns to the pediatric population are a prevalent problem that can have long-term if not fatal consequences. Although burns to the trunk have equally negative cosmetic effects from disfigurement for both boys and girls, burns to the trunk of the developing female, particularly those involving the breast, have an additional psychologic component due to the potential loss of femininity. This article aims to comprehensively review the proper management and treatment options for these patients based on mechanism of burn injury, both from an initial management and a staged reconstruction point of view.     

Microbiology of burn wound infections

One of the most complicated issues that surgeons face, in the care of burn patients, is infection. This includes both superficial and systemic infections. Systemic infection is the leading cause of death in this population. This article will look to review the microbiology of burn wound infections with particular emphasis on classification, host response to burn wound infections, antimicrobial agents, and modern treatment practices.     

天然有机化合物质谱研究——Ⅺ.苯丙型苷快原子轰击质谱MNa+的MIKES谱

研究了六种苯丙型苷与Na⁺加合离子的快原子轰击质谱(FAB—MS)和质量分离离子动能谱(MIKES)。结果表明:在FAB谱中[M+Na]⁺加合离子的丰度要比[M+H]⁺离子高得多。由此可给出糖苷的分子量信息,[M+Na]⁺离子的MIKES谱可给出糖基序列信息。     

盐酸二氢埃托啡身体依赖性潜力的临床评价

报道了盐酸二氢埃托啡(DHE)临床替代38例海洛因成瘾者的替代抑制试验,并应用CINA量表评价海洛因成瘾者的身体依赖性程度⁽¹⁾。结果表明:盐酸二氢埃托啡可与那洛酮竞争阿片受体,对戒断症状的100%替代抑制量与海洛因成瘾者的身体依赖性强度呈正相关,剂量反应关系良好。本研究同时对啡盐酸二氢埃托啡的身体依赖性潜力进行了讨论^(3,7)。     

食管结核6例报告

０　引言　临床上原发性食管结核罕见,继发于身体其他部位结核也不多见［李益农．消化内镜学．北京：北京科学出版社,１９９５：１４８－１４９］．由于食管结核的临床表现,Ｘ线检查,内镜检查与食管其它疾病相似,临床上很容易误诊．现报告我院２０年收治的６例食管结核病例．１　临床资料　男４例,女２例,年龄１７岁～６３岁。以胸骨后疼痛就诊３例,以吞咽困难就诊３例．其中３例有长期咳嗽,咳痰病史．胸部Ｘ线检查４例有肺结核,２例未发现身体其他部位结核感染．内镜检查：３例误诊为食管癌,１例误诊为食管炎．Ｘ线钡剂检查：２…     

High-dose intradialytic urokinase to restore the patency of permanent central vein hemodialysis catheters

From November 1, 1995, to April 30, 1997, in our outpatient dialysis facility, 7,179 or 24.3% of hemodialyses were performed with soft, cuffed, intravenous catheters as blood accesses. Inadequate blood flow (pump speed < 400 mL/min) was noted in 286 instances (4.0%). Locking of catheter lumina with 5,000 to 9,000 IU urokinase was only partly successful in three of 21 cases. Infusions of 20,000 to 40,000 IU urokinase in 25 instances during dialysis restored catheter function in 10 cases. In nine instances in which blood could not be aspirated from the catheter and dialysis could not be performed, the infusion was done through the catheter while the patient remained in the chair. In eight instances, the catheter was opened, and dialysis was performed on the next shift. In 162 instances, a new method was used to open failing catheters most conveniently, efficiently, and with minimal cost. Whenever a nonpositional deterioration of blood flow was noted, 250,000 IU urokinase was infused during dialysis over 3 hours, if there were no contraindications. Full restoration of pump speed was achieved during 132 infusions; in another 21 cases, blood flow improved. In 59 cases, in which an adequate pump speed was not achieved during the next dialysis, the infusion was repeated with restoration of blood flow in 50 instances and flow improvement in six; infusion was re-repeated in the nine instances without complete restoration of flow and in one of the 50 in which restoration of flow was temporary. Adequate flow was restored in nine of these 10 cases in which re-repeated infusion was done. Routine doses of heparin were used concomitantly with urokinase in all cases. No adverse reaction to urokinase has been encountered in any case. To maintain long-term catheter patency, warfarin therapy was started in patients who required repeated urokinase infusions. Vials of 250,000 IU, 9,000 IU, and 5,000 IU urokinase cost $358.47, $77.07, and $43.76, respectively. The higher cost of high-dose intradialytic urokinase as compared with the catheter "lock" is offset by the high probability of positive results, saving of nursing and patient time, and saving on transportation expenses. The convenience and cost are even more remarkably in favor of intradialytic urokinase compared with catheter stripping ($2,433) or surgical replacement ($3,060).     

利用个人电脑系统及photoshop软件进行核型分析

0　引言　长期以来 ,染色体核型分析一直是显微摄影后 ,放大、减裁、分组、排列、粘贴、复拍 ,制成核型照片后进行 .该方法耗时费力而且容易出错的环节较多 .为此近来我们改用科室现有电脑设备进行染色体核型分析 ,取得了较为满易的效果 ,现将其方法报道如下 :1　材料和方法1.1　染色体制备　取 10例正常人的静脉血 2 m L注入含 0 .1m L 肝素的无菌试管中 ,立即混匀后 ,按每瓶 0 .4m L 接种到 5m L RPMI16 40培养液 (含 10 0 m L· L- 1 小牛血清 )的培养瓶中 .然后置 5 0 m L· L- 1 CO2 培养箱 37℃培养 72 h.终止培养前 4h加入最终…     

NO-PGI2对肝硬变门脉高压内脏血管扩张的调控作用

肝硬变门脉高压患者显示了高动力循环状态、血容量分布和神经体液调节的异常改变,这些患者往往表现出心排血量增加,动脉压下降,血浆容积扩张和外周血管阻力下降,其中外周动脉血管扩张可能发挥重要作用.后者主要与局部血管扩张剂一氧化氮(NO)和前列环素(PGI2)的调控作用有关.下面就NO和PGI2对内脏血管扩张的影响,以及两者之间的联系作一综述.