房室瓣骑跨的形态分析

本文对10例先天性畸形心脏的房室瓣骑跨进行形态分析,其中7例为三尖瓣骑跨,2例为二尖瓣骑跨和1例为两侧房室瓣均有骑跨。9例为完全性骑跨和1例为不完全性骑跨。除去瓣骑跨外,本文1例还伴有房室瓣的瓣裂、降落伞形、囊状副瓣、异位乳头肌和异常腱索等畸形.     

Combined mortality and morbidity of direct surgical treatment of abdominal aortic aneurysm

Two hundred aneurysms of the abdominal aorta were treated surgically from 1980 to 1987 by the same surgeon. There were 187 men and 13 women whose mean age was 66.1 years. Nine patients were 80-years-old or more. Eighty-seven percent of patients had preoperative risk factors, 30% of which were coronary artery disease. The operative approach was through a transverse laparotomy in 188 patients compared to 11 midline incisions and one lumbotomy. An aortoaortic tube was inserted in 87 patients, a bifurcated prosthesis in 99, and a tube bypass in 14. Five patients (2.5%) died within the 30 day perioperative period. Death was due to colonic necrosis, right heart chamber thrombosis, renal failure after repeat operation for acute lower limb ischemia, and myocardial infarction associated with renal and respiratory failure. The morbidity rate was 15.7% (31 patients) and included seven neurologic accidents, four respiratory complications, five ischemic events of the lower limbs requiring reoperation and one amputation, four cardiac complications, two renal failures, one reversible colonic ischemia, one revision for incomplete hemostasis, one phlebitis, one sliding syndrome, and five minor infections or cutaneous complications. Mean duration of hospital stay was 10.9 days. These results confirm that direct operation on aortic aneurysms can be performed in patients from all age groups and even with associated diseases. A rapid, simple technique based on a transverse approach, minimal dissection and insertion of aortoaortic tubes, whenever feasible, appears to reduce combined mortality-morbidity.Presented at the Annual Meeting of the Societé de Chirurgie Vasculaire de Langue Française, May 20–21, 1988, La Grande Motte, France.     

二尖瓣狭窄的外科治疗(附85例报告)

本文报告1972年8月至1987年8月我院85例风湿性二尖瓣(犭央)窄或伴有轻度关闭不全病人的外科手术疗效。80例行闭式扩张术,5例行直视扩张术。贵州地区病人体型较小,瓣膜损害较重。瓣口扩张2.8～3.5cm,较一般要求偏小。手术后近期疗效较好。     

Reactions in rat gluteal muscle to titanium implants

A new approach to the analysis of tissue-implant interaction is presented using rat gluteal muscle as implantation site and using monoclonal antibodies to identify and quantify cells around the implant. The method can be used for comparative studies on biocompatibility. In this methodological investigation, pure titanium (Ti) was studied, revealing an initial response of macrophages, followed by the formation of a fibrous membrane, in which, even at 50 and 70 d, la-expressing cells and suppressor T-lymphocytes were present.     

Peripheral Seeding of Mycotic Aneurysms from an Infected Aortic Stent Graft

Aortic stent graft infection is rare and there are no reported cases of seeded peripheral mycotic aneurysms complicating this condition. We describe the case of a 54 year old man who developed a late stent graft infection at three years, resulting in the peripheral seeding of three mycotic aneurysms with two incidents of rupture. He was successfully treated with extra-anatomic bypass of the aorta and both surgical and endovascular repair of his peripherally seeded mycotic aneurysms.     

Prosthetic valve endocarditis due to candida albicans treated successfully with medical treatment alone

Prosthetic valve endocarditis (PVE) caused by Candida species is associated with high morbidity and mortality. A combination of surgical resection and antifungal drug therapy is the golden standard for treatment, yet surgical intervention is not possible in all cases of Candida PVE. We report a case of PVE due to Candida albicans cured by medical treatment alone. This case suggests that, in some instances, Candida PVE can be managed medically with antifungal therapy. Such a conservative approach should be applied with caution and necessitates very close follow-up on a long-term basis.     

The long-term results of meniscus transplantation for articular cartilage defects in the knee joint

The purpose of this study was to examine the long-term clinical results of meniscus transplantation for articular cartilage defects in the knee joint. The type of study was case series. From October 1990 to June 1995, eight cases underwent allogenic or autogenic meniscus transplantations for articular cartilage defects, and seven cases were available for follow-up evaluations. The age at surgery ranged from 14 to 42 years of age (average 22.5). In one case, transplantation of tissue-engineered cartilage was performed due to pain 5 years after surgery. The other six cases were followed up for 8–13 years (average 10.1). The size of the cartilage defect ranged from 1.0 to 6.3 cm² (average 2.8 cm²). Patients were evaluated with the Lysholm score and MR images. We also performed arthroscopic examinations in three cases at the final evaluation. This study leads to the conclusion that meniscus transplantation for articular cartilage damage is not comparable to autologous chondrocyte transplantation. Two cases showed a good clinical outcome but the tissue remained as fibrocartilage tissue in the long-term.     

缺血预处理对心脏瓣膜置换手术围术期甲状腺激素代谢的影响及临床意义

目的 :了解缺血预处理对心脏瓣膜置换手术围术期甲状腺激素 (TH)代谢的影响及临床意义。方法 :选取 16例风湿性心脏病 (风心病 )瓣膜置换手术患者 ,随机均分为实验组 (IP组 )及对照组 (C组 ) ,IP组采取缺血预处理方案 ,对照组不采取预处理 ,其余同IP组。分别于术前、转流中 (最低温 )、再灌注后 5min ,停机、术后 2 ,2 4 ,4 8h采取血样 ,测定血清总三磺甲状腺原氨酸 (TT3 )、总四碘甲状腺原氨酸 (TT4)、游离三磺甲状腺原氨酸 (FT3 )、游离四碘甲状腺原氨酸 (FT4)、促甲状腺激素 (TSH)浓度 ,组内各时点与术前 ,两组之间各时点进行配对比较。结果 :TT3 和FT3 水平在转流最低温时降至最低点 ,术后 4 8h仍低于术前 ,但IP组术后 2 4～ 4 8h二者水平明显高于对照组 (均P <0 .0 5 ) ,两组T4,FT4水平术后 2 4h已恢复术至前水平 ,各时点间无明显差异 ;TSH水平术后 4 8h两组均低于术前 ;IP组无严重并发症发生 ,对照组有 2例发生低心排。结论 :风心病瓣膜置换手术围术期呈现低T3 综合征 ;缺血预处理可以减轻瓣膜置换手术围术期低T3 综合征的严重程度 ,有利于心功能的恢复