肺癌外科治疗技术的改进

目的 为在肺癌的外科治疗过程中减少并发症的发生率,提高手术治疗效果。方法 对前期（１９７２年２月至１９８９年２月）与后期（１９８９年３月至１９９９年２月）的１１７８例肺癌病例在麻醉方法、手术入路、肺根及癌灶的处理、手术并发症的发生率和死亡率等方面进行了分析比较。结果 手术时间由平均２１７ｍｉｎ减少至１２９ｍｉｎ;术中输血量由平均８３０ｍｌ减少至４６０ｍｌ;呼吸衰竭发生率由３．４％降至１．５％;急性     

Determination of microviscosity and location of 1,3-Di(1-pyrenyl)propane in brain membranes

We determined the microviscosity of synaptosomal plasma membrane vesicles (SPMV) isolated from bovine cerebral cortex and liposomes of total lipids (SPMTL) and phospholipids (SPMPL) extracted from SPMV. Changes in the microviscosity induced by the range and rate of lateral diffusion were measured by the intramolecular excimerization of 1,3-di(1-pyrenyl)-propane (Py-3-Py). The microviscosity values of the direct probe environment in SPMV, SPMTL and SPMPL were 38.17, 31.11 and 27.64 cP, respectively, at 37°C and the activation energies (E_a) of the excimer formation of Py-3-Py in SPMV, SPMTL and SPMPL were 8.236, 7.448 amd 7.025 kcal/mol, respectively. Probe location was measured by polarity and polarizability parameters of the probe Py-3-Py and probe analogues, pyrene, 1-pyrenenonanol and 1-pyrenemethyl-3β-hydroxy-22,23-bisnor-5-cholenate (PMC), incorporated into membranes or solubilized in reference solvents. There existed a good linear relationship between the first absorption peak of the¹L_a band and the polarizability parameter (n ²−1)/(2n ²+1). The calculated refractive index values for SPMV, SPMTL and SPMPL were close to 1.50, which is higher than that of liquid paraffin (n=1.475). The probe location was also determined by using a polarity parameter (f−1/2f¹). Here f=(ε−1)/(2ε+1) is the dielectric constant function and f'=(n ²−1)/(2n ²+1) is the refractive index function. A correlation existed between the monomer fluorescence intensity ratio and the solvent polarity parameter. The probes incorporated in SPMV, SPMTL, and SPMPL report a polarity value close to that of 1-hexanol (ε=13.29). In conclusion, Py-3-Py is located completely inside the membrane, not in the very hydrophobic core, but displaced toward the polar head groups of phospholipid molecules, e.g., central methylene region of aliphatic chains of phospholipid molecules.     

Amyloid-P-component-like immunoreactivity in β/A4-immunoreactive deposits in Alzheimer-type dementia brains

An immunohistochemical study using the mirror-image technique was performed in order to establish whether amyloid P component is involved in the mechanism of deposition of amyloid fibrils in senile plaques (SPs) in Alzheimer-type dementia (ATD). Ninety percent of /A4 protein-immunoreactive SPs were also stained by the anti-amyloid P component immunchistochemistry, and this applied to all of the diffuse, primitive and classical types of /A4 deposits. These findings may suggest an involvement of amyloid P component in the formation of amyloid fibrils in senile plaques in ATD brains.     

Belt-Fuqua operation for penile hypospadias repair

Between 1983 and 1993, 41 patients underwent a first-stage Belt-Fuqua operation for penile hypospadias repair and 39 completed the second stage. Minor complications were observed after the first stage. The primary success rate following the second stage was 82%. Major complications noted after the second stage consisted mainly of fistula formation. The surgical technique is described and alternative methods are discussed.     

Intrapulmonary gas mixing and dead space in artificially ventilated dogs

In this study we have investigated the effects of breath holding and of the physical properties of gases on four different respiratory dead spaces (V _D): the Fowler, the physiological, the washout and the inert gas dead space. The experiments were performed with dogs which were ventilated artifically with breathing patterns with different post-inspiratory breath holding times (t _a) of 0, 0.5, 1.0 and 2.0 s. Tracer amounts of acetone, ether and enflurane were infused continuously into a peripheral vein and a bolus of a mixture of krypton, Freon12 and SF₆ was introduced into the peritoneal cavity. After reaching steady state, samples of arterial blood, mixed venous blood and mixed expired air were taken simultaneously. From the partial pressures (P _a, P _¯V and P respectively) we determined the excretion (=P/P_¯V), retention (R=P_a/P_¯V) and the physiological dead space fraction (V _D,phys/V _T=(1 P/P_a) for each gas, where V _T is tidal volume. Further, we recorded the expirograms of the six tracer gases and of CO₂ from which the Fowler dead space fractions (V _D,Fowler/V _T) of the different gases were determined. Also the washout dead space fractions (V _D,washout/V _T) for He and SF₆ were determined as well as the inert gas dead space fraction (V _D,MIGET/V _T) with the use of the multiple inert gas elimination technique (MIGET).With the exception of V _D,phys/V _T for SF₆, all dead space fractions decreased with increasing t _a. V _D,phys/V _T for the poorly soluble gas SF₆ was considerably larger than V _D,phys/V _T for the remaining gases. For the highly soluble acetone V _Fowler/V _T was considerably smaller than V _D,Fowler/V _T for the other gases. V _{D,washout,SF6}/V _T was always larger than V _D,washout,He/V _T and V _D,Fowler,SF6/V _T. Further, V _D,phys/V _T was larger than V _D,Fowler/V _T for SF₆ and acetone. However, for gases with intermediate solubility in blood V _D,phys/V _T tended to be smaller than V _D,Fowler/V _T. We conclude that the respiratory dead spaces are affected by the breathing pattern and by the physical properties of gases, i.e. their diffusivity in alveolar gas and their solubility in blood or lung tissue.     

Laparoscopic bipolar strip-tease appendicectomy

Since its conception, several techniques have been described for laparoscopic appendicectomy. We describe a technique which utilizes a 5-mm bipolar forceps designed to coagulate and cut tissues at the same time; 50 pediatric patients underwent laparoscopic appendicectomy for acute appendicitis using this stripping and teasing technique. No bleeding complications occurred. There were only two postoperative abscesses in the series. We believe that the bipolar laparoscopic striptease appendicectomy technique as developed by the senior author is safe, quick, and effective, even for severe appendicitis.     

Mega-Liposuction: Analysis of 1520 Patients

Fifteen hundred and twenty cases of liposuction/liposculpture were performed at Dr. M. Erfan & Bagedo Hospitals and King Abdulaziz University Hospital in Jeddah from January 1983 to December 1994. These cases were mostly females. The age group was from 16–65 years. Multiple procedures were performed in 11.68% of these cases. The change in hemoglobin and the hematocrit ratio pre- and post-operatively, and the incidence of complications, were studied. The percentage of surface area operated upon rather than the amount of fat removed was the most important relevant factor.     

Comparison of ultrasound transmission velocity with computed metacarpal radiogrammetry and dual-photon absorptiometry

The aim of our study was to evaluate the validity of a quantitative US technique for measuring the bone density of the proximal phalanges of the nondominant hand compared with computed metacarpal radiogrammetry and dual-photon absorptiometry (DPA) of the lumbar spine. Mean US bone velocity (UBV) correlated with mean metacarpal cortical index (MCI), with mean metacarpal bone density (MBD) and with bone mineral density (BMD) of the lumbar spine, whereas it was correlated negatively with age and menopause duration. The average UBV was significantly higher in premenopausal women than in postmenopausal women, and higher in normal lumbar DPA patients than in reduced lumbar DPA patients. We conclude that the US evaluation of the nondominant hand proximal phalanges may be a new alternative way for measuring bone mass in screening of osteoporosis. Correspondence to: A. Sili Scavalli