Comfortable suture angle with optimized trocar position aids renorrhaphy during retroperitoneal laparoscopic partial nephrectomy

BackgroundThis study investigated a comfortable suture angle (CSA) with optimized trocar position for closing the defect during renorrhaphy in retroperitoneal laparoscopic partial nephrectomy (LPN). The feasibility, usefulness, and safety of achieving the CSA with modified trocar position were determined for different tumor types.MethodsTwo optimized trocar positions were introduced for different tumor types. A suture angle was based on the tumor plane of the superficial parenchyma defect and the line formed by the needle holder. Preliminary surgical simulations determined a CSA that combined the least suture time with the greatest ease of performance. Achieving the CSA was attempted during renorrhaphy of 106 enrolled patients undergoing retroperitoneal LPN. Patients’ characteristics, operative features, and follow-up information were collected and analyzed.ResultsFor 89 (83.96%) patients, a CSA was successfully reached and parenchyma recovered. The remaining 17 patients were successfully sutured, but the attempt to achieve a CSA failed. For the CSA group, the suture, clamping, and overall operative times were significantly less than that of the non-CSA patients. The groups were similar regarding estimated blood loss, positive surgical margin, and rates of glomerular filtration reduction and complications. Univariable analyses determined that tumor location, growth pattern, and R.E.N.A.L. nephrometry score (RNS) may influence the success of this approach. Multivariable analyses indicated that only tumor location and RNS were independent factors affecting successful achievement of the CSA.ConclusionsThrough different kidney position changes, the CSA could be used to ease the suture process. It is feasible and safe to perform a CSA with optimized trocar position during LPN. Tumor location and RNS may influence the approach to get a CSA.     

Typical and partial cat eye syndrome: identification of the marker chromosome by FISH

Three children are reported with typical cat eye syndrome (CES) and three more children with partial CES because of absence of coloboma, in which the supernumerary marker chromosome was studied by FISH. Using a genomic library, and also a centromeric and particularly a cosmid probe of 22q11, partial tetrasomy was shown in all cases.     

Patients'' complaints and satisfaction 5 years after complete denture treatment

This study is based on an evaluation of patients' opinions of their dentures by means of a questionnaire. The patients had been provided with complete dentures at a university clinic. Of the original sample (n = 139) a test group of 92 patients remained available for the actual study 5 yr after treatment. The replies in the questionnaire were subjected to statistical processing and interpretation. Six clusters could be defined and these were introduced as "scales" representing the patients' score on a specific type of complaint. Apart from the six scales a score was achieved for each patient's overall satisfaction. The correlations between the various scales were calculated with the aid of a computer program. Finally, cross-tabulation was used to see if any significant (inter)correlations could be proved between complaints, satisfaction, and some of the patients' social data. It could be concluded that a correlation exists between complaints of pain and of functional aspects on the one hand and vague complaints on the other hand. There is also a correlation between complaints of looseness of the maxillary denture and complaints about aesthetic factors. Well-fitting and well-functioning dentures, absence of pain, and a socially acceptable appearance contribute much to the patients' satisfaction with dentures. Social variables such as type of insurance (public or private) and marital status influence denture appreciation to a certain extent.     

RPI卡环受力分析与临床应用

本文讨论了常规设计的游离端义齿存在的问题,并对Kratochvil提出的RPI卡环,结合力学知识,提出了RPI卡环在游离端义齿应用中的优缺点,并通过典型病例介绍和对20名病例随访分析表明,用RPI卡环修复游离端牙齿缺失,可获得较好的临床效果。     

胃粘膜内pH值测定在危重病人中的预警价值

目的 :观察在危重病患者中反映组织水平氧代谢的胃粘膜内 p Hi,与反映全身氧代谢的指标间的关系以及胃粘膜内p Hi的预警价值。方法 :用胃张力计测定危重病患者入科即刻及治疗 2 4h后胃粘膜内 p Hi,并测定 p Ha ,Pa O2 / Fi O2 ,行 APACHE 评分。结果 :死亡组入科即刻 p Hi( 7.13 3± 0 .3 74)较存活组 ( 7.3 89± 0 .0 62 )显著降低 ( P<0 .0 1) ,治疗 2 4小时后胃粘膜内 p Hi死亡组( 6.911± 0 .496)较存活组 ( 7.43 4± 0 .0 5 1)降低更显著 ( P<0 .0 0 1) ;入科即刻 p Hi≤ 7.3 2的患者病死率为 75 .0 %,治疗 2 4h后胃粘膜内 p Hi≤ 7.3 2的患者病死率为 88.9%。结论 :作为局部组织氧合指标的 p Hi在常规的全身氧代谢指标未改变之前就发生了明显的变化 ;p Hi的降低与病死率有明显的相关性。     

PT和APTT标本留存时间与结果稳定性关系

目的探讨标本的待测时间对凝血酶原时间（PT）和活化部分促凝血酶原时间（APTT）试验结果的影响。方法：在室温下分别于采样后即刻、2、4、6、24h测定了40例志愿者的PT、AFTT,同时进行了血浆留存和全血留存结果的比较。结果：6h内无论全血留存标本还是血浆留存标本,其PT值和APPT值与初始值相比均无明显变化（P＞0．05）;24h全血留存标本PT值略升高（P＞0．05）,血浆留存标本较初始值延长14％,有显著差异（P＜0．05）。APTT值两类标本在6h内与初始值相比也无明显变化（P＞0．05）,24h均明显延长（P＜0．05）。结论：血浆留存标本或全血留存标本PT或APTT测定宜在采集标本后6h内完成。     

胃选择性迷走神经切断对大鼠肝再生的影响——肝细胞体积、数量和DNA含量的研究

探讨胃选择性迷走神经切断对大鼠再生肝细胞体积、数量和ＤＮＡ含量的影响。分别测定大鼠胃选择性迷走神经切断加肝叶大部分切除及肝叶大部分切除术后７ ｄ 再生肝ＤＮＡ含量、肝细胞数和体积。用多功能显微图像测量仪测定切片中肝细胞和肝细胞核面积及肝细胞核直径。按体视学方法测算整个肝脏的肝细胞数。用细胞分光光度技术测定切片中单个肝细胞ＤＮＡ 含量。结果表明, 胃选择性迷走神经切断加肝叶大部分切除组大鼠肝细胞ＤＮＡ含量、数量及体积均较单纯肝叶切除组增加 （Ｐ＜ ０．０５）。提示胃选择性迷走神经切断对大鼠肝再生过程有一定的促进作用。     

An angiographically occult arteriovenous malformation in the medial parietal lobe presenting as seizures of medial temporal lobe origin

We present an unusual case of a patient who was diagnosed with temporal lobe epilepsy and whose seizures were reduced markedly after excision of an angiographically occult arteriovenous malformation (AVM) located in the left medial parietal lobe. A 38-year-old man had complex partial seizures characterized by motionless staring with oroalimentary and behavioral automatisms since the age of 15 years. Magnetic resonance imaging (MRI) demonstrated a small lesion extending from the left posterior cingulate gyrus to the precuneus. There was no MRI evidence of mesial temporal sclerosis. Intracranial EEG recordings showed ictal onset from the left medial parietal lobe propagating to the medial temporal lobes. Clinical signs appeared when these discharges reached the temporal lobes. After excision of the lesion (which was histologically confirmed as an AVM), together with the marginal cortex, seizures were reduced significantly. Careful diagnostic evaluation of lesions such as the this one may reveal an epileptogenic lesion (zone) far from the region where scalp ictal discharges seem to arise. In our case, we hypothesize that false localization was due to propagation of ictal discharges from the parietal focus through the limbic system.     

Application of the Electrotopological State Index to QSAR Analysis of Flavone Derivatives as HIV-1 Integrase Inhibitors

Purpose. A QSAR study based on electrotopological state (E-state) indices was conducted for a series of flavone HIV-1 integrase inhibitors to guide drug design. Methods. E-state indices formulated to encode electronic and topological information for each skeletal atom in a molecule (Kier and Hall Pharm. Res. 7:801–807 (1990)) were calculated using the Molconn-X program, and partial least squares (PLS) multivariate regression was used to derive QSAR models. Results. Predictive models with correlation coefficients (r²) of 0.98 (3 PLS components) and 0.99 (5 PLS components) and corresponding cross-validated correlation coefficients (c.v. r²) of 0.51 and 0.73, were obtained for inhibition of cleavage and integration, respectively, with one molecule omitted from the analysis. Conclusions. E-state indices at C6, C3, C5, C5, and O4 were found to be more important for prediction of activity than those for any of the other 12 flavone skeletal atoms that are common to the molecules in the data set.