The “Biplanar” forehead lift

A new technique of forehead rhytidectomy is presented that combines the best features of the coronal incision with those of the anterior hairline incision. The plane of dissection is formed by an anterior subcutaneous plane dissecting a lateral subgaleal plane. This approach is particularly valuable in patients with high foreheads, severe static wrinkling, and asymmetrical eyebrows.Presented in part at the Annual Meeting of the American Society of Aesthetic Plastic Surgeons, Boston, MA, 1984     

氩激光治疗中心性浆液性脉络膜视网膜病变

应用氩绿激光光凝治疗中心性浆液性脉络膜视网膜病变36例41只眼。结果视力≥1.0者从术前的17.1％增加到术后的63.5％,而视力≤0.6者从术前的61％降低到术后14.6％,术后1周至1月,多数患眼视网膜下液全部吸收,部分患眼中心凹反光重显。结果还显示术后视力与病程长短有关,但术后视力与渗漏点的方位、渗漏点中心凹距离以及神经上皮脱离的大小无关。     

Molecular oncogene markers and their significance in cutaneous malignant melanoma

Background: Oncogenes and other molecular tumor markers that predict tumor aggressiveness may allow individualization and optimization of surgical therapy of intermediate-thickness malignant melanoma. We examined the expression of selected markers, including the HLA-DR antigen, the heat shock protein-70 (HSP-70), and the c-myc oncogene in primary melanoma and regional nodes and related these findings to metastatic potential and survival. Methods: Forty patients with primary melanoma (1.5–4.0 mm) were studied, all of whom had prophylactic lymph node dissection and were followed for 18 months to 7 years. The primary tissue and nodes were examined using immunohistochemical techniques for the presence of HLA-DR antigen and HSP-70 protein and the expression of the c-myc oncogene. Results: Of 40 patients, there were 23 with lesions 1 to 2.9 mm thick and 17 with lesions 3 to 4 mm thick. Nodal metastases were present in 25 of the 40 patients who had elective node dissection. HLA-DR antibody stained the primary tumor in 10 patients (25%), but there was no correlation with survival in this group. HLA-DR antibody stained the stroma and cellular infiltrates surrounding the primary tumor in 28 of 40 patients; in this group there was a correlation of HLA-DR staining of the peritumoral stroma with improved survival overall. HLA-DR staining of the peritumoral stroma also influenced survival when patients were stratified by tumor thickness groups 1 to 2.9 mm and 3 to 4 mm and presence of nodal metastases. HSP-70 was demonstrated in the primary tumor in 25% of patients, who were also shown to have significantly improved survival when compared with those whose primary tumor did not stain with HSP-70. C-myc was expressed in the primary tumor in 25%, but showed no correlation with survival. None of these proteins correlated with or predicted the presence of nodal metastases. Conclusion: We conclude that the use of specific molecular-oncogene markers in intermediate-thickness primary melanoma may identify patients at high risk for conventional treatment failure and reduced survival who may profit from more aggressive surgery, adjuvant therapy, or both.Presented at the 48th Annual Cancer Symposium of The Society of Surgical Oncology, Boston, Massachusetts, March 23–26, 1995.     

自体动静脉内瘘血栓形成的影响因素

目的：了解动静脉内瘘血栓形成的原因，提出防治措施。方法：81例维持性血液透析患有15例内瘘发生血栓形成。分析病因、性别、年龄、血压、血脂对血栓形成的影响。结果：在内瘘使用的早期(三年内)易发生血栓，内瘘血栓发生率为18．52％。老年、男性、糖尿病、血压低、血脂高的患内瘘易发生血栓．结论：定时监测血管通路，适量使用促红索，缓慢提高血红蛋白，恰当地应用抗凝治疗；减慢透析超滤速度，防止透后低血压；采取阶梯式穿刺法，透析后采取点状压迫，防止力量过大，压迫时问过长和对患及家属进行保护内瘘的宣教均是预防内瘘发生血栓的重要措施。     

Retropharyngeal lymph node metastasis from olfactory neuroblastoma: a report of two cases

Olfactory neuroblastoma is a rare, malignant neoplasm arising from the olfactory epithelium. It has an aggressive biological behavior that is characterized by local recurrence, atypical distant metastasis, and poor long-term prognosis. The incidence of cervical lymph node metastasis in olfactory neuroblastoma is variable, and treatment modalities are controversial. Moreover, few reports have been published concerning retropharyngeal lymph node metastasis from olfactory neuroblastoma. We present two cases of olfactory neuroblastoma with retropharyngeal lymph node metastasis. In addition, we provided a review of the current literature regarding olfactory neuroblastoma and retropharyngeal lymph node metastasis from olfactory neuroblastoma.     

兔孤束核区微量注射γ-氨基丁酸的降压效应

在53只乌拉坦麻醉家兔身上,观察到延髓孤束核(NTS)区注射γ-氨基丁酸(GABA)使血压显著下降,安定(DZ)有相似的降压效应,荷包牡丹碱(BIC)和印防己毒素(PIC)则使血压升高;促甲状腺素释放激素(TRH)和甲硫脑啡肽(MTP)对血压无明显影响;延髓的另一些区域应用GABA等药物后血压变化不明显;提示GABA能神经递质系统参与心血管活动的抑制性中枢调节,NTS区是其作用部位之一。     

胃癌切除术中、术后亚甲蓝染色检测前哨淋巴结

目的探讨胃癌前哨淋巴结(SLN)定位技术的可行性,并比较术中、术后不同方法定位SLN技术的利弊。方法使用亚甲蓝染料,对68例胃癌D2根治术标本分组进行术中、术后SLN定位。结果术中SLN的阳性判断值、阴性判断值、敏感性和特异性分别为100%(8/8)、91.7%(22/24)、80.0(8/10)和100%(22/22);术后SLN的阳性判断值、阴性判断值、敏感性和特异性分别为100%(10/10)、98.9%(22/23)、90.9(10/11)和100%(22/22)。结论胃癌SLN定位技术是可行的,对提高胃癌临床病理分期的精确性有一定价值。     

覆膜支架治疗Ⅲ型主动脉夹层

目的探讨覆膜支架治疗Ⅲ型主动脉夹层的方法和疗效。方法对14例Ⅲ型主动脉患者行爱膜支架治疗。术前强化CT检查明确诊断。术中先行主动脉造影，明确内膜破口位置，分辨真假腔，然后根据病变血管近端正常血管直径加上其直径的15％～20％选择支架型号。沿腹股沟下方约2cm处横行切开，游离股动脉并切开，插入支架输送器，硝普钠降收缩压至70～90mmHg，于破口位置缓慢释放支架，封闭主动脉内膜破口，重新造影，观察支架位置，是否有内漏．．结果14例均成功植入支架，患者疼痛症状消失。升主动脉造影示真腔扩大，假腔消失12例，小内漏2例（经球囊扩张后仍有）。术后1周，1、6个月行强化CT检查示真腔扩大，假腔内血栓形成并缩小，远断血运改善，无截瘫、左上肢缺血及支架移位等并发症．结论覆膜支架治疗Ⅲ型主动夹脉层创伤小，操做简单，手术死亡率低，并发症少．恢复快，近期效果好．