Treatment of the Breast’s Lateral Pole: Adjuvant Maneuver to Pitanguy’s Technique

Surgical procedures for the mammary region currently are assuming an important role in body-contouring surgery. Enhancement of results is a constant challenge to the plastic surgeon. A simple and efficient maneuver for resection of the breast’s lateral pole based on the mammoplasty technique of Professor Ivo Pitanguy is described. This study realized at the Private Clinic Sérgio Carreir?o, Rio de Janeiro, RJ, Brazil.     

梗阻性脑积水侧脑室及室周脑组织生物力学响应的有限元分析

目的运用有限元方法对梗阻性脑积水进行计算机模拟,研究分析侧脑室及室周脑组织的生物力学响应及其所产生的病理生理影响。方法依据正常国人颅脑MRI轴位T2加权图像获取解剖信息,在有限元软件ANSYS中生成包含侧脑室前、后角和体部的半侧脑层面的二维有限元模型。模拟脑组织为固、液两相物质组成的线性多孔弹性材料,设定生物力学特性参数及边界条件和初始条件,施加载荷,运用有限元软件ABAQUS进行计算求解,以云图形式输出结果。结果有限元模型动态模拟了梗阻性脑积水侧脑室各部的扩张过程,直观显示出各个时间步室周脑组织内的应力类型及分布、各部的应变和位移。结论膨胀性应力集中引起角部脑水肿;梗阻性脑积水早期侧脑室角部形态变化最明显;体部附近脑组织结构容易受压移位。这些生物力学响应是室内压增高的结果,也与侧脑室的解剖形态密切相关。     

Arthroscopic treatment of lateral epicondylitis: Indication, technique and early results

The purpose of this study is to present the results of the arthroscopic treatment of lateral epicondylitis. Twenty patients with lateral epicondylitis (mean age 42 years) were treated arthroscopically. The average duration of symptoms prior to surgery was 14 months. The arthroscopic joint inspection showed an intact capsule in seven patients (type-I lesion), in eight patients a linear capsule tear (type-II lesion) and in six patients a complete rupture of the capsule (type-III lesion). An associated intraarticular pathology was documented in eight patients. Within an average follow-up period of 1.8 years, local pain and function were documented and analyzed. Subjective pain at rest was reduced from 5.0 to 0.5 points, pain at daily living activities from 6.0 to 1.0 points and pain at athletic activities from 7.3 to 1.2 points in the VAS score. Function increased from 5.2 to an average value of 10.9 (max. 12 points). Patients returned back to work after 3.2 weeks. In conclusion, the arthroscopic release in patients with radial epicondylitis is a reproducible method with a marked postoperative increase in function within a short rehabilitation period.     

股前外侧区穿支动脉的形态学研究及皮瓣设计

目的探讨以旋股外侧动脉降支为蒂的皮瓣设计方法，以便增加术前多普勒定位的准确性。方法6具动脉灌注明胶-氧化铅混悬液的新鲜成人整尸标本，解剖观测股前外侧区穿支，通过血管造影术和拍摄X线片测量其直径、行程、分支和定位。用3D—doctor和Scion Image软件分别测量穿支供血的趋向性、三维重建和单穿支供血面积。结果股前外侧区共有外径大于0．5mm穿支16支，平均外径0．8mm，平均供血面积45．61cm^2，其中20％为肌间隙穿支，80％为肌皮穿支。平均蒂长为（3．15±1．43）cm。自旋股外侧动脉降支发出的穿支在浅筋膜中的平均长度为2．63cm。结论改良的氧化铅-明胶灌注技术可以为皮动脉和穿支皮瓣的研究提供高质量的血管造影图像。本研究发现股前外侧单穿支皮瓣的最大供血面积是30cm×20cm。以股前外侧区穿支设计的穿支皮瓣可以移植到下肢或身体其他部位。     

An analysis of the paradoxical effect of morphine on runway speed and food consumption

A previously reported paradigm in which rats run down a runway for food reward followed by morphine injection was analyzed to assess the utility of the paradigm in studies of opiate reinforcement. One experiment replicated the original report that post-trial morphine caused both an increase in runway speed and a decrease in food consumption (taste aversion) over successive trials, and showed in addition that the increase in runway speed did not occur as a result of food deprivation alone, but required the animals to have consumed food in the goal box. A second study using the quaternary opiate antagonist methyl naltrexone to block the peripheral effects of morphine suggested that the increase in runway speed has a peripheral locus while the taste aversion has a central one. A third experiment in which morphine was microinjected into either the lateral ventricle or the ventral tegmental area supported these observations, in that intracranial morphine failed to result in an increased runway speed, but did produce taste aversion after microinjection into either site. These findings also suggest that the increase in runway speed caused by post-trial morphine in this experiment has a peripheral locus of effect, which is probably distinct from the central effect that supports morphine self-administration and conditioned place preference. Offprint requests to: W.A.CorrigallThe views expressed in this publication are those of the authors and do not necessarily reflect those of the Addiction Research Foundation     

扩大的椎板间开窗治疗腰椎间盘突出伴侧隐窝狭窄（附140例报告）

本组采用的扩大的椎板开窗术治疗腰椎间盘突出合并侧隐窝狭窄140例。结果全部优良，与适应症严格选择和手术损伤小有关。强调切除卡压神经根的侧隐窝后壁外侧，即上关节突的冠状面．不失其脊椎三柱系统的三角结构。俯卧位头低足高，可减少硬膜囊张力避免负损伤。切除棘突下椎板时，用神经拉勾代替神经剥离器易于分离黄韧带，用90度的椎板咬骨钳斜向棘突方向，可满意地切除该部份椎板黄韧带，并可刮切椎板内层。神经根周围滴入醋酸炎舒松A2-3ml，术后疼痛锐减。减压窗口置盖明胶海绵有其争议，作者实践体会放置害处不大，要求病人有“护腰”意识。     

Differences in the temporal dynamics of the visual ON and OFF pathways

The temporal structure of spike trains recorded from optic fibers and single units of the lateral geniculate nucleus (LGN) and primary visual cortex of the cat was studied with a novel method of inter-spike interval analysis. ON type relay cells of the LGN exhibited a multimodal interval distribution preferring a distinct interval (fundamental interval) and its multiples during the sustained light response, whereas most OFF cells showed a broad, unimodal distribution. The general pattern of the interval distribution was relatively independent of stimulus size and contrast and the degree of light adaptation. Simultaneously recorded S-potentials originating from the retinal input generally produced only a single peak at the fundamental interval length. Therefore, the multimodal interval distribution of LGN cells seems to be a result of intra-geniculate inhibition. Cortical cells also showed a weak tendency to fire with spike intervals similar to LGN cells. Therefore, the regular firing pattern observed at peripheral stages of the visual pathway can persist at higher levels and might promote the occurrence of oscillatory activity.     

次侧切术治疗期肛裂前后肛门直肠压力对比分析

目的 :探讨次侧切开内括约肌治疗肛裂术前、术后肛门直肌压力的变化。方法 :采用自行设计的次侧方内括约肌切开加双缘结扎术治疗 期肛裂 6 0例 ,测定手术前后肛门直肠压力 ,并与 6 0例正常人肛压比较 ,评价新术式治疗 期肛裂的临床疗效及其对肛门功能的影响。结果 :显示术后患者肛管静息压显著降低 ,与术前比较有显著性差异 (P <0 .0 1) ,与正常人比较无显著性差异 (P>0 .0 5 ) ;肛管最大收缩压与术前及正常人比较无显著性差异 (P>0 .0 5 )。结论 :次侧方内括约肌切开加双缘结扎术能有效地解除内括约肌痉挛 ,从根本上消除高肛压 ,从而彻底治愈肛裂 ,而且不影响肛门功能。     

极外型腰椎间盘突出症的临床特点与神经节位置的相关性研究

目的 探 讨极 外 型腰 椎间 盘 突出 症患 者 的临 床特 点 与神 经节 位 置的 相关 性 方 法:通过 术前 神 经根 造影 : 。确定 受压 神 经根 的背 根 神经 节的 位 置,根 据 其神 经节 的 位置 ,将 27 例极 外侧 腰 椎间 盘突 出 症患 者 分为 三 组 :椎管内 组,5 例;椎间 孔内 组 ,15 例 ;椎 间孔 外组 ,7 例 。分 别比 较神 经 节的 位置 与 临床 参数 ,如 受压 神 经根 的水 平 ,直腿 抬高 试 验的 度数 ,术 前和 术 后症 状(腿痛 ,下 腰痛 和 行走 能力 )及 体 征(感 觉 和运 动障 碍 )的 严重 程 度 及 与恢复率 之间 的 关系 。结 果:与椎 管 内和 椎间 孔 内组 相比 ,椎 间孔 外 组患 者直 腿 抬高 试验 的 度数 较低 ,下 腰 痛的 程度较轻 ,术 前的 腿痛 明 显重 ,而 行走 能 力低 于椎 管 内和 椎间 孔 组。 背根 神 经节 的位 置 与术 前的 感 觉和 运 动 障 碍以及手 术效 果 没有 明显 差 异。结论 :神 经节 的 位置 会影 响 极外 型腰 椎 间盘 突出 患 者根 性症 状 (腿痛 和 行走 能力 )的严重 程度 。     

Pineal atrophy and other neuroendocrine and circumventricular features of the naked mole-rat,heterocephalusglaber (Rüppell), a fossorial,equatorial rodent

Summary Quantitative aspects of the microanatomy of the pineal gland and other neuroendocrine and circumventricular structures were studied in a small, reproductively suppressed, female Naked Mole-rat from central Kenya, Africa. The atrophic pineal is the smallest in absolute size (0.002135 mm³) of any so far described in a species of rodent, and in size relative to body weight is second only to that of another tropical species. The subcommissural organ and posterior collicular recess are also relatively small and less well differentiated than those in most other examined rodent species. In contrast, the subfornical organ, OVLT and median eminence are large and well vascularized. It is concluded that the pineal in this species follows the previously described trend among rodents of relatively smaller size in species whose centers of distribution are in lower latitudes. Although the pineal is atrophic, the Naked Mole-rat still exhibits 24-hour and seasonally timed patterns of behavior and seasonal reproduction. However, in this species these events are probably cued by moisture, temperature and social factors rather than by photic information.