Experimental approach to the pathogenesis of the anomalies of amniotic disease

By intra-adnexal injection of glucose in the rabbit embryo, we were able to stimulate all the anomalies associated with "Amniotic Disease". Since we were even able to obtain amniotic bands, this study provides an excellent experimental model of this disease. Resulting lesions occur early in development, corresponding to the first trimester of human gestation. All of the anomalies can ultimately be explained by the destruction of the most superficial cells: epiblastic cells of the embryo and the amnion, subjacent mesenchyme, and endothelial cells. The subsequent lack of interaction between these cells and the importance of the anatomical localizations of resulting hematomas can lead to the pathogenetic approach to this disease. In light of the present study, the disease appears to be caused by an external factor within the amniotic fluid. The exact nature of the destructive agent(s) remains a mystery in man.     

Effects of sodium and temperature on tension in isolated canine coronary artery

The effects of sodium and temperature on tension of isolated canine coronary arterial strips were studied.In 20mEq·l ^–1 K solution, the strength of tension was inversely related to the Na concentration. At 37°C, the tension was significantly increased at 70mEq·l ^–1 Na and below. The tension was gradually suppressed by lowering of the temperature from 37°C to 10°C. At 10°C, tension did not developed significantly at Na concentrations between 127mEq·l ^–1 and 12mEq·l ^–1.It was concluded that the decrease in Na concentrations increased the tension of the canine coronary artery and the lowering of temperature supressed the tension inducted by the decrease in Na concentrations.(Yoshida K, Fujii Y, Ina H, et al.: Effects of sodium and temperature on tension in isolated canine coronary artery. J Anesth 5: 56–59, 1991)     

Plastic and Reconstructive Body Contouring in the Post-vertical Banded Gastroplasty Patient: a retrospective review

Class IV obesity (body mass index > 40) is associated with an increased risk of a variety of health problems, many of them potentially life-threatening or life-shortening. Vertical banded gastroplasty (VBG) is currently the most frequently performed surgical procedure used to restrict food intake and assist with weight loss. After massive weight loss, however, redundant abdominal and breast tissue can result in physiological and psychological problems related to an unusual body habitus. Patients complain of difficulties with daily activities, choice of clothing, social acceptance, etc. Body contouring has proven to be an important part of the rehabilitation of the morbidly obese patient, and we have therefore reviewed the records of 55 patients who experienced massive weight loss following VBG and then underwent abdominoplasty with or without mammoplasty/mastopexy, in order to assess the parameters which will be seen more frequently in the future by plastic surgeons as bariatric surgery becomes more widely accepted and performed.     

Prefrontal cortical projections to the cholinergic neurons in the basal forebrain

The prefrontal cortex (PFC) projections to the basal forebrain cholinergic cell groups in the medial septum (MS), vertical and horizontal limbs of the diagonal band of Broca (VDB and HDB), and the magnocellular basal nucleus (MBN) in the rat were investigated by anterograde transport of Phaseolus vulgaris leuco-agglutinin (PHA-L) combined with acetylcholinesterase (AChE) histochemistry or choline acetyltransferase (ChAT) immunocytochemistry. The experiments revealed rich PHA-L-labeled projections to discrete parts of the basal forebrain cholinergic system (BFChS) essentially originating from all prefrontal areas investigated. The PFC afferents to the BFChS display a topographic organization, such that medial prefrontal areas project to the MS, VDB, and the medial part of the HDB, whereas the orbital and agranular insular areas predominantly innervate the HDB and MBN, respectively. Since the recurrent BFChS projection to the prefrontal cortex is arranged according to a similar topography, the relationship between the BFChS and the prefrontal cortex is characterized by reciprocal connections. Furthermore, tracer injections in the PFC resulted in anterograde labeling of numerous "en passant" and terminal boutons apposing perikarya and proximal dendrites of neurons in the basal forebrain, which were stained for the cholinergic marker enzymes. These results indicate that prefrontal cortical afferents make direct synaptic contacts upon the cholinergic neurons in the basal forebrain, although further analysis at the electron microscopic level will be needed to provide conclusive evidence.     

Left Ventricular Anomalous Muscle Band and Electrocardiographic Repolarization Changes

A child with considerable electrocardiographic (ECG) repolarization abnormalities is reported in whom, after clinical and hemodynamic evaluation, only a large muscular false tendon within the left ventricular cavity was found. The genesis of the ECG changes in such cases is discussed, and the differential diagnosis from apical hypertrophic cardiomyopathy is analyzed.     

膝前框形钢丝内固定治疗髌骨骨折

目的探讨采用钢丝环扎 膝前方框形张力带钢丝内固定法治疗髌骨骨折的经验和临床效果.方法对35例髌骨骨折应用此方法治疗,基中男性24例,女性11例,30例获得3～24个月随访.结果优19例,良10例,可1例,优良率96.7%.术后未出现骨折再移位,无伤口感染.愈合时间6～12周.结论该方法符合生物力学原理,操作简便,适应证广,能早期关节活动,是治疗髌骨骨折的理想方法之一.     

套扎和硬化夹心联合与单纯硬化治疗食管静脉曲张出血的对比研究

目的了解套扎与硬化夹心联合法治疗食管静脉曲张出血(EVB)能否获得优于单纯硬化(EIS)的疗效。方法84例肝硬化EVB患者随机接受夹心法或单纯EIS治疗(夹心法组43例,EIS组41例)。EIS组硬化剂采用血管旁、内的联合注射法,夹心法组每条曲张静脉结扎2个皮圈,并于其间曲张静脉内注射1～3mL硬化剂。间隔7～12d重复1次内镜治疗,直至静脉曲张消除。结果夹心法组与EIS组静脉曲张消除率相似(93.0%比92.7%),但夹心法组达到消除的平均治疗次数明显减少(1.8±0.6比3.8±1.1),所需平均时间显著缩短[(17.1±7.1)d比(36.5±15.7)d],再出血率与并发症率明显下降(9.3%比31.7%;8.4%比26.8%)。随访期内两组静脉曲张复发率比较差异无显著性(11.6%比14.6%)。结论内镜下套扎与硬化夹心联合法治疗食管静脉曲张出血的疗效优于单纯硬化治疗的疗效。     

聚髌器与改良张力带治疗髌骨粉碎性骨折疗效比较

为比较两种不同内固定方式在治疗髌骨粉碎性骨折中的临床疗效,将60例病人采用随机分组方法分成两组,分别采用镍钛记忆合金聚髌器(Niti-Patellar Concentrator NT-PC)(A组)和改良张力带钢丝内固定(B组)治疗,并对手术时间、术后骨折复位情况、骨折愈合时间、术后功能锻炼开始时间、膝关节屈曲达到90°的时间、手术后膝关节功能完全恢复时间及术后的并发症等结果进行比较.结果显示A组在手术时间、术后膝关节功能锻炼开始时间、膝关节屈曲达到90°和完全恢复的时间及骨折愈合的时间均早于B组,术后骨折复位比B组好(P＜0.05),手术后无并发症.表明治疗髌骨粉碎性骨折NT-PC比改良张力带钢丝内固定有更广泛的适应症与更理想的效果.     

经皮穿刺空心钉张力带固定选择性治疗髌骨骨折

2000年1月～2005年1月,我们采用经皮穿刺空心拉力螺丝钉＋钢丝张力带微创技术治疗62例髌骨骨折,治疗效果良好,骨折全部愈合,功能恢复满意。     

心脏扭转运动的研究进展

心脏扭转运动形式不但影响心脏正常的收缩功能,而且还能促进舒张早期心室充盈。不正常的扭转运动形式,提示心肌结构和功能改变。因此心脏扭转角度是临床一个非常有价值的诊断指标。本文就心脏扭转的解剖基础、检测方法及其意义作一综述。