PREDICTION AND PREVENTION OF FISTULAE AFTER MAJOR HEAD AND NECK SURGERY A PRELIMINARY REPORT

A method of checking the integrity of mucosal repair after head and neck surgery using wound amylase levels is described. A low wound amylase concentration allows early resumption of oral intake; an increasing amylase concentration is a strong predictor of subsequent wound breakdown and fistula formation. A regimen has been developed which has prevented fistulae from developing in the small number of patients studied thus far.     

Picosecond optical breakdown: tissue effects and reduction of collateral damage

The effects of picosecond laser-induced optical breakdown on tissue were investigated using high-intensity 40 ps Nd:YAG laser pulses at 1.06 microns. Tissue damage was evaluated using the corneal endothelium in vitro as a model system. Systematic studies were performed to determine the scaling of the tissue damage and damage range with pulse energy. For suprathreshold lesions, the radius of the damage zone varies as the cube root of the pulse energy, in agreement with simple physical scaling laws. A minimum damage range of less than 100 microns was observed for pulse energies of 8 muJ. Damage morphology was investigated by scanning electron microscopy. Three different damage patterns were observed; cell damage, cell removal, and rupture of Descemet's membrane. Different irradiation geometries were used to study damage mediated by either the shock wave or the cavitation bubble. Comparative studies using 10 ns pulses demonstrated that picosecond pulses yielded a significant reduction in collateral tissue damage.     

Complement Activation During Low-Density Lipoprotein Apheresis

Complement system activation was investigated in two girls with familial homozygous hypercholesterolemia undergoing two monthly sessions on LA15 or LA40 (Kaneka liposorber). We determined blood levels of C3c and C3a, leukocyte counts, and plasma levels of C3c and C3a in the extracorporeal circulation device at the start of the sessions and 15 and either 60 or 120 min into them. Sequential eluates were collected from LA40 at the end of the sessions (0.5M NaCl, 1M hydroxylamine). Anaphylatoxin C3a increased throughout, especially with LA40. As previously reported, C3a was trapped in the dextran column but was noticeably present in efferent plasma. Besides many proteins, nonnative complement fragments bearing C3a and C3d antigens were detected in almost all the eluates, suggesting possible in situ complement activation. Practically, complement activation induced by the first filter is a risk; long-term side effects may arise from this extracorporeal circulation device.     

Laser-induced fluorescence used in localizing atherosclerotic lesions

We have investigated laser-induced fluorescence frompost mortem human arteries in order to find spectroscopic properties allowing discrimination between normal and atherosclerotic vessel wall. A pulsed nitrogen laser emitting light at a wavelength of 337.1 nm was used as an excitation source. The fluorescence spectrum from 370 to 700 nm was captured and analysed by an optical multichannel analyser. Dimensionless contrast functions were formed by using characteristic spectral features at 390, 415, 480, 580 and 600 nm. All samples were investigated in scans across a region where normal as well as diseased vessel wall appeared. The types of plaque were histopathologically divided into four groups, of which three could be singled out using one or more of our spectroscopic criteria. We also investigated the different layers of the normal and diseased vessel wall in order to determine the various contributions to the fluorescence signal. Furthermore, plasma emission spectra were recorded while ablating the normal as well as the diseased vessel wall with an excimer laser, emitting radiation at 308 nm, thus detecting the change in spectral characteristics during the ablation process down into deeper layers.     

Primary action of steroid hormone at the surface of amphibian oocyte in the induction of germinal vesicle breakdown

An insoluble steroid derivative was prepared by the coupling of desoxycorticosterone with aminoethylated agarose beads. When the naked full-grown Xenopus oocytes were incubated in contact with the steroid-bound agarose beads, the dissociation of oocyte nuclei or the initial step in the maturation of amphibian oocyte was induced in 30–100% of total oocytes. The induction did not occur in the oocytes covered with follicle cells and when the naked oocytes were placed apart from the steroid-bound agarose beads in the medium. The above findings confirmed that the oocyte surface was a primary site for this particular steroid action, eliminating the possibility of participation of free steroid artifactually released from the agarose. The 105,000g supernatant fraction of oocytes showed no sign of the presence of steroid receptor. This was not inconsistent with the assumption mentioned above.     

Clinical studies on the efficiency of high power laser radiation upon some structures of the anterior segment of the eye

A series of pathological conditions such as pupillary block glaucoma, angle block glaucoma, acoria, pupillary membranes and goniosynechias of various origins have been treated successfully by means of pulses emitted from a Nd: YAG Q-switched laser above optical breakdown threshold. Since linear absorption is not required, non-pigmented or entirely transparent structures are easily dissected by this method. We have also opened the supraciliary and suprachoroidal space in a series of cases of wide angle glaucomas. In all cases however, the clefts closed by secondary wound reactions. This method may be applied to extracapsular cataract surgery for opening the anterior capsule before lens extraction and to the hydrophthalmic eye.Work supported by the Swiss National Science Foundation, the Swiss Commission for the Promotion of Scientific Research and the ASUAG.     

Postoperative wound breakdown caused by pyoderma gangrenosum after bilateral simultaneous total knee arthroplasty

Pyoderma gangrenosum is a noninfective necrosis of dermal tissues. Rarely, it occurs after surgery or trauma. However, lack of awareness and its striking similarity to a clinical picture of sepsis usually delay diagnosis and initiation of the correct management. We describe a unique case of its occurrence in both surgical wounds after bilateral total knee arthroplasty and discuss the differential diagnoses and management.     

The adaptation of Rice yellow mottle virus to the eIF(iso)4G-mediated rice resistance

The rymv1-3 allele of the eIF(iso)4G-mediated resistance to Rice yellow mottle virus (RYMV) is found in a few Oryza glaberrima cultivars. The same resistance-breaking (RB) mutations emerged in the central domain of the VPg after inoculation of isolates of different strains. The RB mutations were fixed, often sequentially, at codons 41 and 52 which paralleled an increase in virus accumulation. RB mutations also emerged after inoculation of an avirulent infectious clone, indicating that they were generated de novo in resistant plants. Only virus isolates with a threonine at codon 49 of the VPg broke rymv1-3 resistance, those with a glutamic acid did not. A small subset of these isolates overcame rymv1-2 resistance, but following a specific pathway. Comparison with the RB process of rymv1-2, a resistance allele found in a few Oryza sativa cultivars, showed similarities in the mode of adaptation but revealed converse virulence specificity of the isolates.     

简析雅培五分类血液分析仪CELL-DYN3700及维修经验总结

雅培CD3700五分类血细胞分析仪采用独一无二的四角度全激光细胞分类(MAPSS),技术领先,推广迅速,应用广泛。简单介绍了这款仪器的技术特点及常见故障的维修经验,提供了维修CD3700的参考思路。