Removal of silicone breast implants and review of literature

Silicone breast implants have a finite life span and may need changing over the lifetime of the patient. The experience with removing first- and second-generation implants is frustrating, because thick capsules often form, in association with rupture and spread of the silicone gel into the surrounding tissue. Different techniques have been employed to try and avoid an unnecessarily large incision, yet still control the dissection so that entire capsule and contained silicone can be removed en bloc. The authors describe a technique that facilitates atraumatic removal using an effective and time-saving vacuum principle.     

New universal precaution aspiration tray

A new tray has been designed for use during procedures involving needles and other sharp objects. The tray includes a foam adhesive pad, marked into 10 sections, into which the sharp objects can be placed point first. After the procedure, the objects can be safely withdrawn by their handles and then discarded. The tray has been used in more than 250 procedures.     

Unzulässige Vermischung von Werbung und Funktion bei einer Arztsoftware

Zusammenfassung  1. Der Anforderungskatalog der Kassen?rztlichen Bundesvereinigung an Datenbanken und Software für Vertragsarztpraxen als Grundlage für eine wirtschaftliche Verordnungsweise bewegt sich in dem ihm vom Gesetz vorgegebenen Rahmen. 2. Eine doppelt belegte Funktionstaste einer Arztsoftware zur Verordnung von Arzneimitteln, die bei Eingabe des Codes für die diagnostische Erkrankung die ?ffnung eines Werbefensters mit einem Verordnungsvorschlag für das beworbene Medikament ausl?st, vermischt in unzul?ssiger Weise Werbung und Funktion.     

Tongue and oropharynx: findings on MR imaging

Ten healthy subjects and 44 patients with diseases of the tongue or oropharynx were studied with magnetic resonance (MR) imaging. Axial, coronal, and sagittal images with a thickness of 4 mm were obtained with a pixel size of 0.75 X 0.75 mm on a 256 matrix. Nineteen of the patients underwent computed tomography (CT). Nine of those patients later had surgery, and the specimens were obtained for organ sectioning. These three studies as well as clinical history and physical examination findings were correlated. MR imaging was equal to or better than CT in those patients having both examinations. However, neither CT nor MR allowed recognition of histologic features or detection of microscopic spread of disease. Direct coronal and sagittal imaging planes on MR imaging allowed visualization of intrinsic tongue musculature, not possible with CT; this was important in recognizing subtle tumor extension. For these reasons, MR is the imaging method of choice for studying diseases of the tongue and oropharynx.     

A pulsating coronary vessel phantom for two- and three-dimensional intravascular ultrasound studies

The evaluation of new techniques for 2-D and 3-D intravascular ultrasound (US) imaging (IVUS) often requires the use of a pulsating coronary phantom. This study describes the design, construction and evaluation of a phantom simulating the pulsation of a human coronary artery for IVUS studies. Polyvinyl alcohol (PVA) cryogel was used as a tissue mimic for the coronary vessel, which was incorporated in a custom-built assembly. The phantom was programmed to pulsate under servomotor control, to model the pulsation of a normal coronary artery and 2-D IVUS images were obtained using an IVUS imaging catheter. To evaluate the performance of the phantom, the lumen area variation of the phantom was determined and compared with the programmed pulsation waveforms. Our results showed that phantom pulsation correlated well with the programmed pulsation waveform (r = 0.97). The deviation of the least squares line from the line of identity was calculated to be < 4%.     

NOD鼠腹腔巨噬细胞肿瘤坏死因子α和白细胞介素水平变化与吡格列酮的干预效应

目的:观察含0.02%吡格列酮的饲料对NOD鼠糖尿病发病率的影响,分析巨噬细胞在吡格列酮预防NOD鼠糖尿病中的作用。方法:实验于2003-01/2005-01在中南大学湘雅二医院动物实验室及中心实验室完成。4周龄NOD雌鼠56只,随机数字表法分为吡格列酮组(n=25)和对照组(n=26),分别摄食含0.02%吡格列酮的混合饲料和普通营养饲料。自10周龄开始,每周测尿糖1次,尿糖阳性后用血糖仪测血糖,连续两次血糖≥16.7mmol/L即诊断为糖尿病。两组各取12周龄NOD雌鼠15只,处死前4d腹腔注射30g/L的硫代乙醇酸钠2mL,麻醉后摘除眼球法处死小鼠后腹腔灌洗收集巨噬细胞,加入脂多糖共同培养24d后收集上清,ELISA法测细胞因子肿瘤坏死因子α、白细胞介素6水平。结果:小鼠56只全部进入糖尿病发病率分析;进入腹腔巨噬细胞肿瘤坏死因子α、白细胞介素6的水平结果分析20只。①30周龄时,对照组25只小鼠有20只发生了糖尿病,发病率80.0%,平均发病时间为(139.2±38.2)d;吡格列酮组26只中有14只发生了糖尿病,发病率为53.8%,平均发病时间为(153.0±28.1)d,与对照组相比,吡格列酮组发病率明显降低(P<0.05)。②12周龄时对照组NOD鼠腹腔巨噬细胞肿瘤坏死因子α、白细胞介素6水平与吡格列酮组差异无显著性意义[(537.4±112.49),(448.9±92.18)ng/L;(551.2±108.23),(461.7±80.49)ng/L,P>0.05]。结论:吡格列酮在一定程度上预防和延缓NOD鼠糖尿病的发生;吡格列酮对NOD鼠糖尿病和胰岛炎的预防作用可能与巨噬细胞无明显关系。     

Quantitation of CD62, soluble CD62, and lysosome-associated membrane proteins 1 and 2 for evaluation of the quality of stored platelet concentrates

BACKGROUND: Platelets become activated during storage, which results in secretion of granules, vesiculation of microparticles, secretion of protein, and a number of other biochemical and morphologic processes that decrease the utility of platelet concentrates stored for transfusion. STUDY DESIGN AND METHODS: To evaluate the quality of stored platelet concentrates, the cell surface expression of specific activation-dependent antigens (CD62 and lysosome-associated membrane proteins 1 and 2 [LAMP-1, LAMP-2]) on platelets stored in a hospital blood bank over a 7-day period was examined. Relative microparticle counts and the expression of CD62 by microparticles, as well as platelet concentrate supernatant levels of soluble CD62, were determined. RESULTS: The percentage of platelets expressing CD62 increased significantly from Day 1 to Day 5 (p < 0.05) of storage; the mean fluorescence values for CD62 did not. In contrast, the mean fluorescence values of LAMP-1 and LAMP-2 rose significantly (p < 0.01 and p < 0.05, respectively) between Days 1 and 5. Significant declines in CD62, LAMP-1, and LAMP-2 percent expression and mean fluorescence were seen on Day 6 of storage (p < 0.001). Microparticle numbers increased significantly during storage and correlated with levels of CD62 protein (free and membrane-bound) (r = 0.95 vs. Day 2, p < 0.05; r = 0.88 vs. Day 5, p < 0.05). CONCLUSION: Flow cytometric evaluations of the expression of cell surface CD62, LAMP-1, and LAMP-2 are complementary tests that, especially when used in conjunction with the quantitation of CD62 protein, provided a simple and effective means of evaluating the quality of platelet concentrates stored for transfusion.     

Red cell alloimmunization in multitransfused HLA-typed patients

The authors studied retrospectively the formation of clinically significant red cell (RBC) alloantibodies in 958 HLA-typed, multiply transfused patients receiving kidney (603 patients) or liver (263 patients) transplants or plateletpheresis transfusions (92 patients). RBC alloantibodies were found in 91 (9.5%) of these patients and multiple antibodies in 35 (3.7%). Rh (D, C, c, and E) antibodies accounted for 49 percent of the total and Kell antibodies for 31 percent. Antibodies were found in 15 percent of apheresis recipients and in 8.6 percent of renal and 9.5 percent of liver transplantation patients. No association was found between any HLA-A, HLA-B, or HLA-DR phenotype and the presence of RBC alloantibodies, either in general or when analyzed according to the specific antibody. Renal transplant patients with RBC alloantibodies were somewhat more broadly HLA-alloimmunized than were those without RBC alloantibodies. Patient gender did not affect these results. The authors concluded that the immune response to RBC alloantigens is independent of HLA type but is associated with an increased level of HLA antibody formation.