Immunologic defects as possible causes of therapeutic failures in children with transposition of the great arteries

Summary Recurrent and severe infections and absence of thymic shadow in X-ray examination were observed in children with the transposition of the great arteries (TGA). Among 45 children (29 boys and 16 girls) with TGA whose age ranged from 3 days to 16 years and who were hospitalized during 1 year, infectious diarrhea was observed in 77.7% cases, urinary tract infections in 44.5%, respiratory tract infections in 42.2%, sepsis in 17.5%, and meningitis in 8.8%. Nine of the children died, sepsis was a cause of death in seven children, and there were postsurgical complications in two children. Immunologic abnormalities in children with TGA included a decreased level of T-lymphocytes and T_29° subpopulation, impaired mitogen-induced lymphoproliferation in vitro, and increased nitro blue tetrazolium (NBT) reduction activity of monocytes. Impaired parameters of cellular immunity correlated with worst clinical status. No disorders of humoral immunity were observed. These observations may be important for forming opinion about proper therapy and the cause of death in children with TGA.All results have been included in T. Marek-Szydowska's doctoral dissertation and were communicated at the 65th Annual Meeting of Deutsche Gesellschaft für Rechtsmedizin, St. Gallen, Switzerland, Sept. 9–13, 1986     

Anterior displacement of the mandible for better exposure of the distal segment of the extracranial carotid artery

Summary Anterior displacement of the mandible (ADM) was performed in 34 patients undergoing surgery for malformations or atheromatous lesions of the distal segment of the extracranial internal carotid artery (ICA). This procedure greatly facilitates surgical access to the upper cervical region and has several advantages over mandibulotomy-mandibulectomy, namely: A shorter operating time, sparing of the inferior alveolar nerve and of the mandibular branch of cranial nerve VII, with no need for post-operative immobilization of the mandible. ADM permits the correction of ICA lesions extending as far as the first cervical vertebra. For lesions extending into the carotid canal ADM needs to be supplemented by various other procedures via the base of the skull.     

Konsekutive Serie von 100 Colonresektionen mit einer modifizierten fortlaufenden Nahttechnik

Zusammenfassung Es wird anhand einer konsekutiven Serie über eine modifizierte fortlaufende Nahttechnik am Colon berichtet, die gerade bei älteren Patienten eine sichere und rasche Methode der Anastomosierung darstellt. Die klinisch relevante Insuffizienzrate sowie auch die Letalitätsrate betrugen in dieser Serie je 2%, wobei die Ursachen für die Letalität aber keine Folge der Insuffizienz waren. Die Komplikationsrate betrug 11%, die urologischen Komplikationen mit 6% standen hierbei im Vordergrund.

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A consecutive series of 100 resections of the colon using a modified technique of continuous (running away) suture

Summary Based on a consecutive series it is reported about a modified type of continuous suture on the colon, used especially in elderly patients for being a secure and prompt method of anastomosing. The rate of insufficiency and mortality, as far as the clinical relevance is concerned, turns out to be 2% each and there was no relation between mortality and insufficient anastomosis. The complication rate was 11%, whereby the urological complications predominated with 6% of the total.

     

Optic pit syndrome

In a study of 15 eyes with optic pits fluorescein angiography revealed that only pits associated with serous detachment of the macular retina showed fluorescence in the late venous phase, while the pits uncomplicated by detachment remained hypofluorescent throughout the test. This finding strongly supports the hypothesis that the subretinal fluid producing the macular detachment originates from leakage of vessels located in the floor of the pit. In addition a high incidence of anomalies was found to be associated with optic pits. Therefore the author suggests to call the association between optic pit and large optic disc, parapapillary chorioretinal changes, cilioretinal vessels, situs inversus and eventual other vessel abnormalities, the optic pit syndrome.     

Transplantation of Pacinian corpuscles of the rat into the brain

Summary In adult inbred rats of the AVN strain, branches of the crural interosseous nerve were dissected out from donors and transplanted into the brain of recipients, together with a cluster of Pacinian corpuscles, (either into a suction cavity or the cerebral cortex) into a slit 1–2 mm deep. The grafts were fixed and processed for electron microscopy 10 days to 6 months after the operation, and their ultrastructure was examined. Sporadic axons of small diameter grew into the nerve branches of some of the grafts from 11 days onward, and became myelinated during the 2nd month after the operation, but none of the transplanted Pacinian corpuscles became reinnervated. The corpuscles, however, survived denervation and grafting. Most of them retained a well-preserved inner core and an intact capsule, consisting of a normal complement of 29.2±1.0 (mean ±SE) capsular layers (n=8), as did the corpuscles previously examined after denervation in situ. Some of the corpuscles underwent degenerative changes, presumably due to a delayed or restricted revascularization. In this group of corpuscles, the inner core underwent disintegration and was gradually replaced by collagen fibrils, whereas the capsule remained preserved but the number of its layers eventually reduced by 40%. It is assumed that the lack of reinnervation of the grafted Pacinian corpuscles was due to the paucity of regenerating axons, and their failure to form correct projections along those Schwann cell columns connected with the corpuscles.     

香烟烟雾提取物致小鼠生殖细胞的遗传学损伤

目的：研究香烟烟雾提取物对小鼠生殖细胞染色体和精子的影响,方法：给雄性小鼠腹腔注射不同剂量的香烟烟雾提取物,观察其精原细胞染色体畸变及精子畸形的情况,结果：精原细胞染色体畸变率及精子畸形率均增高,精子畸形率增高的程度大于精原细胞染色体畸变率。结论：香烟烟雾提取物可致雄性小鼠生殖细胞染色体畸变和精子畸形。     

超微量肝素在治疗重症肺炎中的应用（附41例报告）

目的：探讨超微量肝素在重症肺炎患儿治疗中的应用。方法：对我科于1998年5月--2001年5月收治的重症肺炎共41例,随机分为常规治疗组和肝素治疗组,对两组资料进行分析并进行统计学处理。结果：肝素治疗组在热退时间、吸氧时间、肺部体征消失时间、住院天数皆明显短于常规治疗组。结论：在重症肺炎的治疗中加用超微量肝素治疗具有安全、有效、副作用少等作用,易于在临床推广。     

灌洗法一期叻除吻合术在左侧梗阻性结肠癌中的应用

目的：探讨左半结肠癌并梗阻一期切除吻合的可行性。方法：术中灌洗肠内容物,术后吻合口减压。结果：1995年至1999年所遇左侧梗阻性大肠癌中选择5例用此方法吻合成功。结论：左侧梗阻性大肠癌,只要掌握好手术指针。术中充分灌洗肠内容物,术后扩肛可一期切除吻合。     

介入联合手术治疗膀胱癌32例疗效分析

目的观察髂内动脉灌注化疗联合手术治疗膀胱癌的疗效。方法对32例中晚期膀胱癌先行介入治疗,再手术切除。结果32例膀胱癌完全缓解(CR)率为71．9％。结论介入治疗中晚期膀胱的手术提供了良好基础,对一部分原本行扩大切除术甚至全切的患实行单纯部分切除术,从而保留了膀胱生理功能,有助于提高患生活质量,延长生命。