Breast augmentation with silicone implants: the role of surgical drainage—report on 502 consecutive patients

Breast augmentation is one of the most frequently performed cosmetic surgery procedures worldwide. We report on a series of 502 consecutive cosmetic breast augmentations by a single surgeon, using both the submuscular and submammary approaches. A vacuum drain was placed in the surgical pocket at the end of the procedure. The drain fluid collection was recorded immediately after the surgery and the following day before removal. A tenfold increase in the amount of fluid collection was noted in the drain’s reservoir. Thirteen patients presented with minor wound healing problems at the second postoperative follow-up, which were treated conservatively; two of them had the implant removed and replaced after 2 months. There were only two capsular contractions at 1-year follow-up. We focus our discussion on the drainage in the early postoperative period and conclude that the routine use of a surgical drainage reduces the risk for complications. Based on our findings, we advocate that short-term routine use of a surgical drain is advisable.     

原发性高血压患者微量白蛋白尿与血压及左室重塑的关系

目的探讨原发性高血压(EH)患者微量白蛋白尿(MCA)与血压及左室重塑的关系.方法 84名EH患者按24h尿微量白蛋白值分为微量白蛋白尿组(MCA组)和正常白蛋白尿组(NMCA组),进行动态血压、心脏超声检测,比较两组动态血压值、左室重量指数(LVMI)及左室重塑的特点.结果 MCA组平均收缩压、平均舒张压、脉压、平均动脉压均高于NMCA组(均P＜0.01);MCA组LVMI、左室肥厚与向心性肥厚的发生率均高于NMCA组(均P＜0.01),正常构型率低于NMCA组(P=0.01).LVMI与尿微量白蛋白值、平均收缩压、平均舒张压均呈显著的正相关(均P＜0.05).结论合并有MCA的EH患者血压较高,LVMI较大,左室肥厚与向心性肥厚的发生率较高.MCA与血压及左室重塑密切相关.     

CO2 laser in cancer surgery of the breast: a comparative clinical study

Review of the literature reveals little to no data regarding the use of the CO2 laser as a surgical modality in the local treatment of breast cancer. This study was undertaken to determine if the CO2 laser is a surgical improvement over the scalpel, influencing patient care during the surgical and postsurgical period. In the author's series, a total of 209 procedures were performed. Within this group, 105 cases were performed with CO2 laser and 104 cases performed with the scalpel. Biopsies were always performed as a separate procedure prior to definitive surgery. This study was not designed to compare cure rates, the medical follow-up period being 1 year. The results of this study demonstrate a significant improvement in patients' postoperative care, surgical technique, and hospital cost-effectiveness.     

Treatment of iatrogenic biliary obstruction by balloon dilatation of a biliary jejunal fistula

Biliary obstruction and multiple hepatic abscesses occurred in a patient after ligation of a segmental branch of the right hepatic duct. The patient was successfully managed by transhepatic biliary drainage and balloon dilatation of an internal fistula that developed between the ligated duct and a Roux limb of jejunum. Internal biliary fistulas may be dilated using interventioanl radiologic techniques to permit nonobstructed bile flow. Implications for the nonsurgical treatment' of biliary strictures are discussed.     

颈外静脉瓣膜窦段及其临床应用

经研究表明颈外静脉的瓣膜、缩窄环、瓣膜窦及窦段静脉壁共同组成一个灵敏地、高强度地抗逆流装置。本文称之为瓣膜窦段并报道189段的尸体解剖和光镜观察结果;测定尸体、活体和手术中瓣膜窦段的抗逆流功能,表明颈外静脉适于用无瓣导管作脑积水等分流途径。初步探明颈外静脉怒张的原因和消除怒张的简便方法以及术前鉴定瓣膜窦段位置和功能的方法。对2例脑积水用无瓣导管作侧脑室颈外静脉分流取得初步疗效。     

Management of adult patients with a left ventricular assist device.

The number of left ventricular assist device (LVAD) implantations is growing as a result of increased waiting periods for cardiac transplantation and the decreased availability of organ donors. Furthermore, the Food and Drug Administration (FDA) has approved permanent LVAD support. After an acute hospitalization, patients with LVADs may need prolonged convalescence in a healthcare facility because they have complex medical needs and are physically disabled. Admission criteria need to be developed as essential patient and nursing competencies need to be defined as a part of a successful LVAD program in an acute rehabilitation center. Acute rehabilitation centers can help patients with LVADs transition to a home setting.     

双侧侧脑室外引流并脑脊液置换术治疗原发性脑室出血23例

我科自1995年1月至2005年1月共收治原发性脑室出血23例，经双侧侧脑室外引流并脑脊液置换术冶疗取得较好效果，现报道如下。     

MEBO在血栓性外痔和陈旧性肛裂术后治疗中的疗效观察

目的：观察美宝湿润烧伤膏在血栓性外痔和陈旧性肛裂切除术后治疗中的疗效。方法：术毕用MEBO纱布条填塞伤口,术后24小时取出纱布条,以后用MEBO涂于伤口内,每日2次,直至痊愈。结果：48例患者无术后伤口疼痛、出血、感染及肛门狭窄。伤口愈合时间短,治愈率高。结论：美宝湿润烧伤膏是血栓性外痔、陈旧性肛裂切除术后良好的局部治疗药物。