胸段硬膜外麻醉对神经肽Y的影响

为探讨胸段硬膜外麻醉对患者血浆ＮＰＹ的影响,本文采用放射免疫分析法测定了３１ 例择期上腹部手术病人胸段硬膜外麻醉前后血浆ＮＰＹ的含量。结果显示：麻醉后平均动脉压较麻醉前显著下降（ Ｐ＜０－０１） ,血浆ＮＰＹ则无显著变化（ Ｐ＞ ０－０５）。提示患者处于硬膜外麻醉状态下体内ＮＰＹ 含量的变化与交感神经系统调节具有一定的关系。     

臂丛下干的应用解剖观察

目的了解斜角肌间隙内臂丛下干与邻近组织结构及胸１神经干与第１肋的关系,为临床诊治臂丛下干卡压症提供解剖学依据。②方法在２１具４２侧成人标本上观测臂丛下干与邻近结构的位置关系。③结果在４２侧标本的斜角肌间隙内,有３３侧在前斜角肌的后内侧存在孤立的肌束,臂丛下干分别从其前下方（２３侧）或后上方（１０侧）通过;组成臂丛下干的胸１神经干在斜越第１肋前内侧面时部分穿行于骨纤维管内。④结论该肌束的压迫或拱抬均可成为臂丛下干受压的因素之一;组成臂丛下干的胸１神经干在越过第１肋时易受压迫。     

戈米辛J和异型南五味子丁素对大鼠胸主动脉的作用

目的研究由南五味子属药用植物分离的戈米辛Ｊ（ｇｏｍｉｓｉｎＪ,ＧＪ）和异型南五味子丁素（ｈｅｔｅｒｏｃｌｉｔｉｎＤ,ＨＤ）对血管平滑肌的作用。方法采用离体大鼠胸主动脉标本,观察他们对高钾去极化收缩和对ＣａＣｌ２、ＮＡ量效曲线的影响。结果ＧＪ和ＨＤ能抑制ＫＣｌ所致的收缩,其ＩＣ５０（９５％可信限）分别为３．８（２．４～５．９）和７．５（１．４～３９）μｍｏｌ／Ｌ;ＧＪ和ＨＤ能使ＣａＣｌ２量效曲线右移,最大效应降低,其ｐＤ′２值分别为５．１３±０．０７和４．７７±０．１８;ＧＪ和ＨＤ也可使ＮＡ量效曲线右移和最大效应降低,其ｐＤ′２值分别为３．７２±０．２３和３．３１±０．２７。结论ＧＪ和ＨＤ能抑制ＫＣｌ、ＣａＣｌ２和ＮＡ产生的血管收缩,而且对ＣａＣｌ２的致缩作用强于对ＮＡ的收缩作用,提示他们具有钙拮抗活性。     

The long-term results of upper dorsal sympathetic ganglionectomy and endoscopic thoracic sympathectomy for palmar hyperhidrosis

To assess and compare the long-term results of upper dorsal sympathetic ganglionectomy (UDS) and endoscopic thoracic sympathectomy (ETS), we examined 84 patients who underwent UDS and 71 patients who underwent ETS for the treatment of palmar hyperhidrosis. The period of follow-up ranged from 37 to 228 months. The immediate success rate was 100% in the UDS group and 98.6% in the ETS group. Troublesome compensatory hyperhidrosis occurred in 67.8% of the UDS patients and 84.8% of the ETS patients; however, 55% of the UDS patients and 63% of the ETS patients felt satisfied with their operation. The main reasons for dissatisfaction were recurrence and compensatory hyperhidrosis. Interestingly, simultaneous cure of plantar hyperhidrosis occurred in 28 (40%) of the UDS patients and 28 (44%) of the ETS patients with concomitant plantar hyperhidrosis. ETS required both a shorter operation time and hospital stay than UDS. Thus, we now perform ETS as the treatment of choice because of its excellent illumination and adequate magnification via a minimally invasive approach. The use of ETS as the first choice of treatment for palmar hyperhidrosis is supported not only by the immediate results, complications, and cure of plantar hyperhidrosis, but also by the long-term results. Nevertheless, compensatory hyperhidrosis was also a major complication after ETS.     

Thoracic Aortic Aneurysms: Role of Echocardiography

This article describes the evolving role of echocardiography for the detection and evaluation of thoracic aortic aneurysms. A brief summary of the clinical, anatomical, and pathological features of the etiologic categories of thoracic aneurysms is presented. The advantages and limitations of echocardiography and its comparison with other techniques (computed tomographic scanning, magnetic resonance imaging, and aortography) are discussed.     

Bilateral traumatic abducens nerve paralysis with cervical spine flexion injury

Bilateral traumatic abducens nerve palsy is a rare condition. We report a case associated with cervical spine flexion injury. This may be the first such case report, as no similar case was found in our review of the literature. The mechanisms of injury in this case are relevant to theories that explain hyperextension injuries.     

Repair of a ruptured aortic arch aneurysm complicated by postoperative paraplegia: Report of a case

We report herein the rare case of a 79-year-old man who suffered permanent paraplegia after undergoing an otherwise successful total arch replacement for a ruptured aortic arch aneurysm. During cardiopulmonary bypass, perfusion to the distal aorta was maintained from the femoral artery, and postoperative aortography showed intact tributaries from the aorta including the intercostal arteries. Postoperative paraplegia is an extremely rare complication of operations on the aortic arch; however, we speculate that the paraplegia in this patient could be attributed either to a steal phenomenon involving the radicular artery, or to the anatomical particularity of the spinal cord artery described by Cole and Gutelius as the segmental system.     

Bilateral subcapital loss of arms following high-voltage electrical injury in the child: a new method for stump distalisation

Summary Bilateral loss of arms following high-voltage electrical injury results in severe problems for prosthetic replacement. To allow a unilateral myoelectric prosthetic fitting directed by contralateral contact switches, stump construction was achieved by bilateral tissue expansion and free non-vascularized double-fibula transplantation. Indications, technical details and functional results are presented.     

Inhibition of mixed lymphocyte reaction by thoracic duct lymph: removal of inhibitory effect by thoracic duct drainage in lung cancer.

The inhibitory effect of the thoracic duct lymph of a patient with lung cancer on the "one-way" mixed lymphocyte reaction without cytoxicity is unequivocally demonstrated. The effect seems to be dose related. A moderate inhibition of mixed lymphocyte reaction is still observed, even if the responding cells are preincubated in the thoracic duct lymph for 1 hr only prior to the addition of stimulating cells. The inhibitory effect of thoracic duct lymph on the mixed lymphocyte reaction is no longer evident when the material is added 1-4 days after the beginning of culture. These observations suggest that the mechanism of the inhibitory effect of thoracic duct lymph may be a simple attachment of inhibitory factors to the receptor sites on the responding lymphocytes, causing interference in cell to cell interaction. The inhibitory effect of thoracic duct lymph collected 1 week after the thoracic duct drainage on mixed lymphocyte reaction is significantly lower than that of thoracic duct lymph collected at the beginning of the procedure. This indicates that the blocking effect of thoracic duct lymph can be easily removed by this technique; which is technically feasible in man. The interrelationship of the tumor-specific blocking factor, thoracic duct drainage, and tumor growth pattern are discussed with respect to the potential usefulness of this procedure as adjuvant immunotherapy in the management of patients with neoplastic diseases.     

多沙唑嗪及其手性对映体对离体兔血管α_1 受体的拮抗特性(英文)

目的　分析α1 肾上腺素受体阻断药多沙唑嗪手性对映体对兔胸主动脉和颈总动脉的选择性作用 ,以探讨作为良性前列腺增生症治疗药物的可能性。方法　测定去甲肾上腺素 (NE)诱发兔离体胸主动脉和颈总动脉收缩反应 ,并采用Schild作图法计算rac 多沙唑嗪、R 多沙唑嗪和S 多沙唑嗪的pA2 值。结果　在兔胸主动脉和颈总动脉 ,0 .0 3 ,0 .1和 0 .3μmol·L-1 的rac 多沙唑嗪、R 多沙唑嗪和S 多沙唑嗪均使NE诱发的血管收缩反应量效曲线平行右移 ,Emax不变 ;由Schild作图法计算得到的多沙唑嗪及其手性对映体的斜率值 ,经统计学分析符合竞争性拮抗。3种拮抗剂pA2 值的强度顺序为 :R 多沙唑嗪 >rac 多沙唑嗪 >S 多沙唑嗪。结论　与多沙唑嗪及其手性对映体对人前列腺组织作用的报道结果不同 ,S 多沙唑嗪对兔胸主动脉和颈总动脉α1 肾上腺素受体拮抗作用的选择性显著低于rac 多沙唑嗪和R 多沙唑嗪