Physiological stress in captive Greater rheas (Rhea americana): Highly sensitive plasma corticosterone response to an ACTH challenge

Up to the present no studies have been conducted either on baseline concentrations of adrenal hormones or on hormonal responses to stress in Greater rhea (Rhea americana) and most ratite species. The aims of this work were to assess the presence of corticosterone in plasma of Greater rhea, to validate a corticosterone ¹²⁵I-radioimmunoassay for determining corticosterone levels in plasma samples and to study the activation of the adrenal gland after an adrenocorticotrophic hormone (ACTH) challenge. Six captive Greater rhea juveniles of 10 months of age received an intravenous ACTH injection. Blood samples were taken at 0 min (baseline pre-ACTH levels), and post-injection at 15, 30, 60 min and at 24 and 48 h. The high pressure liquid chromatography (HPLC) analysis of pooled plasma showed that corticosterone is the glucocorticoid found in the plasma of Greater rhea. Biochemical assays of standard validation (e.g., parallelism, exogenous corticosterone recovery) showed that measurements of corticosterone present in the plasma of the Greater rhea provided by commercial corticosterone ¹²⁵I-radioimmunoassay were accurate and precise. ACTH challenge induced a more than 40-fold increase in plasma corticosterone at 60 min post-ACTH (from 4.0 to 166.5 ng/ml, on average). The corticosterone response to ACTH in Greater rhea was higher than is usual in birds, an apparently typical characteristic of ratites.     

高频电波刀治疗前庭大腺囊肿与脓肿36例临床分析

目的:探讨高频电波(Leep)刀治疗前庭大腺囊肿与脓肿的方法及疗效。方法:对36例前庭大腺囊肿与脓肿用Leep刀行造口及切开引流的资料进行回顾性分析,并分组进行对照治疗。对照组用传统方法治疗,观察组用Leep刀治疗。结果:观察组36例与对照组33例平均手术时间差异有显著性(P<0.01)。观察组术后无红肿、疼痛不适,均于术后4～5天愈合,无疤痕形成。对照组术后有轻微的疼痛伴外阴不适,术后7～10天愈合。结论:Leep刀可能成为治疗前庭大腺囊肿与脓肿的理想方法。     

超重人群皮下和网膜脂肪组织中脂联素基因表达的研究

目的:探讨脂联素(APN)在皮下(SC)和网膜(OM)脂肪组织中的mRNA表达水平与肥胖的关系。方法:实时荧光定量PCR法检测48例超重[体质量指数(BMI)≥25kg/m2)]和40例正常体质量人群(BMI<25kg/m2)腹部SC和OM脂肪组织中APN mRNA的表达,并测定血糖、胆固醇和HOMA-IR等生化指标。结果:在整体人群中,OM脂肪组织APN mRNA表达量均明显高于SC脂肪组织(P<0.05);OM脂肪组织APN mRNA表达量与BMI、腰臀比(WHR)和胆固醇(TC)水平呈负相关(r分别为-0.249、-0.143、-0.148,P<0.05);SC脂肪组织APN mRNA表达量与BMI、WHR、TC和三酰甘油(TG)水平呈负相关(r分别为-0.281、-0.180、-0.247、-0.172,P<0.05),并与同一个体的OM脂肪组织APN mRNA表达量呈正相关(r=0.192,P<0.05)。结论:APN的基因表达量内脏高于外周,提示循环APN可能主要来源于内脏脂肪组织。     

人大网膜乳斑与胃癌腹膜种植性转移的相关性研究

目的探讨大网膜乳斑在胃癌腹膜种植性转移中的作用。方法用CH40悬浮液标记大网膜乳斑,于大网膜乳斑区及非乳斑区各切取1 cm×1 cm大网膜组织10块,制成HE染色病理切片,观察乳斑区及非乳斑区癌微转移灶情况。结果51例进展期胃癌患者中30例患者大网膜存在癌微转移灶,此30例中乳斑区均见癌微转移灶,而非乳斑区存在癌微转移灶者仅为3例,乳斑区与非乳斑区相比癌微转移灶的数目有显著差异。结论大网膜乳斑是胃癌腹膜种植性转移的主要部位。     

Omental free flap reconstruction in complex head and neck deformities

BACKGROUND: Microvascular free flaps continue to revolutionize coverage options in head and neck reconstruction. This article reviews our 25-year experience with omental free tissue transfers. METHODS: All patients who underwent free omental transfer to the head and neck region were reviewed. RESULTS: Fifty-five patients were included with omental transfers to the scalp (25%), craniofacial (62%), and neck (13%) region. Indications were tumor resections, burn wound, hemifacial atrophy, trauma, and moyamoya disease. Average follow-up was 3.1 years (range, 2 months-13 years). Donor site morbidities included abdominal wound infection, gastric outlet obstruction, and postoperative bleeding. Recipient site morbidities included partial flap loss in four patients (7%) total flap loss in two patients (3.6%), and three hematomas. CONCLUSIONS: The omental free flap has acceptable abdominal morbidity and provides sufficient soft tissue coverage with a 96.4% survival. The thickness \and versatility of omentum provide sufficient contour molding for craniofacial reconstruction. It is an attractive alternative for reconstruction of large scalp defects and badly irradiated tissue.     

Idiopathic segmental infarction of the greater omentum successfully treated by laparoscopy: Report of case

(Received for publication on Feb. 12, 1999; accepted on Nov. 11, 1999)     

大网膜滤泡树突状细胞肉瘤临床病理观察

目的:探讨大网膜滤泡树突状细胞肉瘤的临床与病理学特点、诊断和鉴别诊断,提高对其诊治水平。方法:运用组织病理学、免疫组织化学观察1例大网膜滤泡树突状细胞肉瘤的特点并结合文献加以分析。结果:肿瘤位于大网膜,镜下肿瘤由束状、片状、旋涡状排列的短梭形、卵圆形或多边形瘤细胞组成,具有围绕血管呈同心圆样排列的特征,部分区域类似脑膜瘤形态,其周可见较多混杂的小淋巴细胞。肿瘤内可见凝固性坏死灶。免疫表型:瘤细胞表达CD21、CD23、CD68,EMA弱表达。结论:滤泡树突状细胞肉瘤是一种罕见的低度恶性肿瘤,发生于大网膜者极为罕见,其诊断与鉴别诊断主要依赖组织病理学及免疫组化标记。     

应用带蒂大网膜修补食管癌切除术后胸胃穿孔

总结８例食管癌术后胸胃穿孔的治疗。自１９７９年４月至１９９４年３月共进行食管癌切除术１０５２例，术后发生胸胃穿孔８例（０．８％），均急诊行二次开，应用带蒂大网膜修补穿孔。６例治愈，２例术后死于其它并发症。作者认为应用带蒂大网膜修补食管癌切除术后胸胃穿孔是一种简单可行的手术方法。     

Soft tissue injury related to choice of entry point in antegrade femoral nailing: piriform fossa or greater trochanter tip

Intramedullary nailing through the piriform fossa results in some cases in loss of abduction strength and persistent pain. Nail insertion at the tip of the greater trochanter may be favourable. The aim of this study was to assess (possible) iatrogenic injury to the abductor and external rotator musculature, branches of the superior gluteal nerve and branches of the MFCA in relation to the two different entry points. In 10 fresh human cadaver femurs, five unreamed femoral nails (UFN) were inserted through the piriform fossa and five AO prototype nails (AFN) through the trochanteric tip. The iatrogenic injury at each nailing procedure was assessed. Various muscles and tendons, branches of the MFCA along with the hip joint capsule were injured or largely at risk during nail insertion through the piriform fossa. Most of these structures were not exposed during insertion through the trochanteric tip. The reported clinical morbidity after nailing through the piriform fossa may find its origin in direct soft tissue injury and may be reduced by choosing a lateral nail entry point.     

Malignant tumor,of the gastrointestinal stromal tumor type,in the greater omentum

We report herein a rare case of gastrointestinal stromal tumor (GIST) type, arising from the greater omentum. A 65-year-old man who had a large abdominal tumor was referred to our hospital. Ultrasonography (US) and computed tomography (CT) scans showed a mass occupying almost the entire abdomen anterior to the bowel loops. Abdominal angiography showed that the main feeding artery of the tumor was the right gastroepiploic artery. The preoperative diagnosis was suspected gastric leiomyosarcoma. Laparotomy revealed a large mass arising from the greater omentum, and the tumor seemed to be completely excised. Histopathological and immunohistochemical studies indicated the tumor had the same characteristics as GIST. Twelve months after the operation, the tumor recurred in the peritoneal cavity at the site of the stomach, and was associated with multiple liver metastases. The patient died of hypovolemic shock. Necropsy revealed that rupture of one of the metastatic liver tumors had resulted in a massive intraperitoneal hemorrhage.