Burns during pregnancy: a gloomy outcome

The effect of burns on fetal and maternal survival is known to be detrimental. This prospective study describes the performance of pregnant burned patients who were managed and followed up for fetal and maternal outcomes at Ain Shams University's burn unit and Maternity Hospital during the period from October 1995 to September 1996. During the 12-month period, 27 pregnant burned patients were managed. Fetal and maternal mortality correlated with the total body surface area (TBSA) burned, the mortality rate being 63 per cent for both mothers and fetuses in the 25–50 per cent TBSA group. A fetal loss of 56 per cent with no maternal loss were recorded in the 15–25 per cent TBSA group. Experience in dealing with pregnant burned patients proves that early surgical excision and skin grafting, with timely termination of pregnancy are the best lines of treatment. Prevention or minimizing the effects of the burns may be achieved by proper education and guidance of the pregnant woman.     

臀、会阴及其周围Ⅲ度烧伤的早期切痂治疗体会

目的　总结臀、会阴及其周围Ⅲ度烧伤的早期切痂治疗的经验。方法　对 3 2例臀、会阴Ⅲ度烧伤患者于伤后 3～ 7d内行切痂 ,嵌皮、大张皮片或皮瓣修复创面的资料进行回顾分析。结果　本组病例皮瓣、皮片大部分成活好 ,外观、功能恢复满意。结论　臀、会阴及周围Ⅲ度烧伤早期切痂治疗可缩短疗程 ,减少外观及功能障碍 ,近远期效果好     

INDICATIONS FOR ENDOSCOPIC MUCOSAL RESECTION FOR EARLY COLORECTAL CANCER: SHOULD THEY BE STRICT OR SHOULD THEY BE EXPANDED?

Endoscopic technologies have been developed greatly. As for early gastric cancer, the indications for endoscopic mucosal resection for early colorectal cancer have been widened recently. Technological advances can support wider and deeper resections using endoscopy but the remaining problem for the endoscopic management of cancer is lymph node metastasis. I discuss here the indication for endoscopic mucosal resection for early colorectal cancer to bring into focus the risk factors for metastasis to lymph nodes.     

Reversal of dexfenfluramine-induced anorexia and c-Fos/c-Jun expression by lesion in the lateral parabrachial nucleus

The external subdivision of the lateral parabrachial nucleus (LPBE) shows strong Fos-like immunoreactivity (FLI) following anorectic doses of the indirect serotonin agonist dexfenfluramine (DFEN). In an effort to determine the contribution of the LPBE to DFEN-induced anorexia, bilateral ibotenate lesions were made in the LPBE, and the effects of the lesion on DFEN-induced anorexia and FLI as well as c-June-like immunoreactivity (JLI) were examined. It was found that LPBE lesion significantly attenuated DFEN anorexia: in a 1-h food intake test following 24-h food deprivation, DFEN (2 mg/kg) suppressed food intake by 60% in intact rats but only 34% in rats with LPBE lesions. In addition to this behavioral change, LPBE lesion completely abolished DFEN-induced FLI and JLI in the lateral subdivision of the central nucleus of the amygdala (CeL) and laterodorsal subdivision of the bed nucleus of stria terminalis (BSTLD), both of which showed strong FLI and JLI in intact rats. DFEN-induced FLI and JLI in other brain regions were not affected by LPBE lesion, including the ventromedial and lateral hypothalamus, caudate-putamen, and the nucleus of the solitary tract (NST). The parallel loss of DFEN-induced anorexia and FLI/JLI following LPBE lesion raises the novel possibility that LPBE-CeL/BSTLD pathway may be involved in DFEN anorexia.     

Early diagnosis of n-hexane–caused neuropathy

n-Hexane neuropathy was studied in 20 workers exposed for prolonged periods to this solvent, and with urinary 2, 5-hexanedione concentrations exceeding the biological exposure index recommended by the American Conference of Governmental Industrial Hygienists (5 mg/L) with a mean of 11.02 mg/L (range 5.3—24.2 mg/L). Although neurological examination did not detect significant anomalies in any of the patients, and the conduction velocity and F waves of all the nerves tested were normal, neurographic studies revealed significant differences in the amplitude of sensory nerve action potentials (SNAP) recorded from the sural (mean 14.0 μV), median (mean 17.3 μV), and ulnar (mean 7.9 μV) nerves when compared with normal values from healthy adults of the same age range, examined under identical conditions. The amplitude of the SNAP in sural and median nerves correlated significantly with the number of years worked. The notable decrease in mean amplitude of the SNAP appeared to reflect the primary neurotoxic effects of 2,5-hexanedione. © 1994 John Wiley & Sons, Inc.     

腹腔镜胆囊切除术开展初期质量控制的临床研究

目的探讨如何控制腹腔镜胆囊切除术（LC）开展初期的并发症及中转率。方法制定八条质量控制措施，总结分析568例LC临床资料。结果并发症6例，仅占1．2％，中转手术8例，中转率仅1．6％。结论在开展LC初期只要加强质量控制，完全可以避开高并发症、高中转率这种所谓的自然规律。     

指伸肌腱修复术后的早期控制下活动

目的 防治指伸肌腱修复术后因制动所致的并发症。方法 对15例Ⅴ～Ⅷ区指伸肌腱损伤修复术后设计活动支具，早期行控制下活动。结果 术后3—6个月随访，按TAM标准评定疗效，优良率100％，无1例发生肌腱断裂。结论 指伸肌腱修复术后早期行控制下活动，是防治术后并发症的有效方法。     

双炔失碳酯或丙睾配伍dl-15甲基PGF_(2α)抗早孕的临床比较

本文报告65例双炔失碳酯配伍d1-15甲基PGF_(2α)(以下简称PG)抗早孕结果并与33例丙睾配伍PG抗早孕结果进行比较。结果显示,双炔失碳酯组完全流产59例,占90%;不全流产3例,占5%;失败3例,占5%;总有效率95%。丙睾组完全流产27例,占82%;不全流产6例,占18%;总有效率100%。两组总有效率无显著差异;完全流产率无显著差异;但不全流产率有明显差异(P<0.05)。药流后点滴出血天数,双炔失碳酯组平均为8.1±5.0天;丙睾组平均为18.9±19.1天;两组有明显差别(P<0.05)。双炔失碳酯经阴道给药后无一例发生心、肝、肾功能变化。