Morphological types of ganglion cells in the dog and wolf retina.

The morphological types of ganglion cells in the dog and wolf retina were studied by intracellular staining with Lucifer Yellow. These retinae contain a range of ganglion cell types that closely correspond to those found in cat retina: alpha cells with large somata and large, relatively densely branched dendritic trees; beta cells with medium-sized somata and small, densely branched dendritic trees; and a variety of other types with smaller somata and varying dendritic branching patterns and dendritic field sizes. The correspondence of canine and cat ganglion cell types strengthens the view that there is a common set of ganglion cell types in carnivores. Alpha and beta cell dendritic trees of dog and wolf are monostratified in either the inner or the outer part of the inner plexiform layer, suggesting an on/off dichotomy in the response to light. Dendritic field sizes of dog alpha and beta cells increase from the central area to peripheral retina: alpha cell fields from 160-200 microns to about 1,100 microns diameter, and beta cell fields from 25 microns to about 360 microns diameter. These sizes are quantitatively very similar to those found in cat retina. The close qualitative and quantitative morphological correspondence of cat and dog ganglion cells suggests that they are also functionally very similar. It is likely that dog alpha cells have brisk-transient (Y), and dog beta cells brisk-sustained (X) concentric receptive fields. From the smallest beta cell sizes it is concluded that the visual acuity of the dog may be as good as that of the cat.     

The callous elbow and aging of the upper arm

The author describes his surgical approach to the problems of the aging upper arm and elbow region. Surgery at an appropriate age can prevent the progressive wrinkling of the elbow which is further aggravated by aging of the upper arm. The author's operation is aimed at correcting both portions of the arm anatomy at the same time.     

A review of incisional hernia repairs: preoperative weight loss and selective use of the mesh repair

At the Shouldice Clinic pre-operative weight loss is used prior to incisional hernia repairs. Mesh repair is selectively used, based on specific hernia characteristics. A series of 236 patients were reviewed and followed up for 36 months. Data were available on 188 patients (80%). There were 15 recurrences (8%). The number of obese patients was reduced from 67 (35.6%) to 25 (13.3%) through the weight loss program. The hernia diameter, gastrointestinal complications, and surgical site infection were significantly related to recurrence but not the type of repair, obesity, location, or previous recurrences. The risk factors of incisional hernias include size, intestinal complications and infections. A selective use has a comparable result to the exclusive use of mesh repair. Weight reduction has yet to be shown to affect the rate of recurrence, and further prospective studies are required.     

Breast augmentation with silicone implants: the role of surgical drainage—report on 502 consecutive patients

Breast augmentation is one of the most frequently performed cosmetic surgery procedures worldwide. We report on a series of 502 consecutive cosmetic breast augmentations by a single surgeon, using both the submuscular and submammary approaches. A vacuum drain was placed in the surgical pocket at the end of the procedure. The drain fluid collection was recorded immediately after the surgery and the following day before removal. A tenfold increase in the amount of fluid collection was noted in the drain’s reservoir. Thirteen patients presented with minor wound healing problems at the second postoperative follow-up, which were treated conservatively; two of them had the implant removed and replaced after 2 months. There were only two capsular contractions at 1-year follow-up. We focus our discussion on the drainage in the early postoperative period and conclude that the routine use of a surgical drainage reduces the risk for complications. Based on our findings, we advocate that short-term routine use of a surgical drain is advisable.     

小脑延髓池的显微外科解剖研究

目的研究小脑延髓池的显微外科解剖特征,探讨其临床意义.方法选择经10%福尔马林固定成人头颈标本15例,显微镜下(5～25倍)模拟枕下极外侧入路、颈-乳突入路和耳前颞下窝入路的手术操作,分别自后、侧和前方显露小脑延髓池内结构,详细观测其神经血管结构的形态特征.结果小脑延髓池位于延髓外侧,上至桥延沟,下达枕骨大孔,侧方沿枕骨形成蛛网膜袖套进入颈静脉孔和舌下神经管.舌咽神经、迷走神经和副神经的根丝自上而下起自橄榄体背侧、延髓和脊髓的后外侧沟,根丝逐级汇合后分别进入舌咽神经道和迷走神经道.椎动脉于小脑延髓池的下端入颅后经该池行向前上内进入延髓前池.小脑下后动脉(PICA)可分为延髓前段、延髓侧段、扁桃体延髓段、脉络膜扁桃体段和皮质段.主要的静脉有小脑延髓裂内静脉、延髓静脉、小脑岩面下组静脉和岩下桥静脉.结论小脑绒球和Luschka孔脉络丛复合体及颈静脉孔硬膜返折可作为辨认舌咽神经脑池段的解剖标志,深刻认识小脑延髓池的蛛网膜界限对手术处理累及小脑延髓池的不同性质病变,保护重要神经功能意义重大.     

外科手术切口脂肪液化的诊疗体会

目的 探讨外科手术切口病因及预防措施.方法 回顾分析我科自2001年5月～2005年7月施行大、中手术后发生切口脂肪液化的60例病例.结果 肥胖,术中皮下脂肪层使用电刀,术中切口器械挤压时间长,大块组织钳夹,老年人、糖尿病等可引发切口脂肪液化.结论 手术切口脂肪液病因较多,肥胖、术中使用电刀、器械挤压时间长、老年人糖尿病均为重要影响因素.     

游离背阔肌皮瓣修复四肢肿瘤切除后创面

我院骨科组于1985年5～10月份为4例患下肢高分化低度恶性肿瘤的病人,在化疗的配合下施行肿瘤局部大块切除,吻合血管的背阔肌肌皮瓣移植修复创面等综合治疗,早期获得了满意的效果.4例病人中有2例患小腿软骨肉瘤,1例小腿脂肪肉瘤和1例髋部纤维肉瘤.背阔肌肌皮瓣较适用于修复软组织缺损大的创面,其大而扁平的肌肉部分几乎能完全覆盖缺损,外形亦常较满意.     

游离腓骨皮瓣结合交锁髓内钉治疗前臂复合组织缺损

目的 探讨应用游离腓骨皮瓣结合交锁髓内钉治疗前臂复合组织缺损的可行性与疗效.方法 对5例前臂骨(尺骨和/或桡骨)和软组织缺损的患者,应用同侧/对侧游离腓骨皮瓣移植,同时应用Smith-Nephew交锁髓内钉对游离腓骨进行固定.供区植皮.结果 5例皮瓣全部存活.根据Anderson评分标准评定:优1例,良3例,可1例.骨折愈合时间为12～17周,平均14.6周,术后无骨不连与感染发生.结论 游离腓骨皮瓣结合交锁髓内钉是治疗前臂复合组织缺损的可行方法.