Biochemical Changes after Vertical Banded Gastroplasty for Morbid Obesity

A prospective study of biochemical changes after vertical banded gastroplasty for morbid obesity, in 94 patients (10 males and 84 females, ages ranging from 18 to 59 years) has been carried out. Liver function tests and electrolyte estimations were performed preoperatively, during hospitalisation for surgery, at 6 weeks and at 6 months postoperatively, and demonstrated no significant changes in liver function in these patients 6 months after surgery. The study concludes that there is no increase in the risk of liver damage or electrolyte disturbance after vertical gastroplasty, but that there may be subtle hepatic changes present as gall bladder disease developed in 18 patients postoperation (19%).     

Aesthetics of feminizing the male face by craniofacial contouring of the facial bones

The forceful and macho look of a prototypical man may not be unduly appealing to others whom he meets. This forceful look might not even appeal to the individual himself. In order to soften this appearance, a series of operative procedures has been devised for use on the craniofacial skeleton. These surgical steps can be done in a single operation or as a series of multiple operative procedures. Moreover, the needs of some patients may require that only special segments of these procedures be performed. This article presents these operative procedures and describes the feasibility with which they can be performed. Complications and unfavorable outcomes, when they occur, are usually related to unrealistic expectations on the part of the patient. The surgical steps routinely performed are those that contour the forehead, orbits, malar eminence, cheeks, chin, angle of the mandible, and larynx. Three categories of patients are described: the female with a male face; the male with a forceful look; and the patient requesting a gender identity change. The psychosocial, psychological, and behavioral problems leading to the decision for surgery will be the basis of final patient selection.Presented at the 9th Congress of the International Society of Aesthetic Plastic Surgery, New York City, October 1987     

应用彩色多普勒超声诊断结节性甲状腺病变

目的 探讨彩色多普勒超声鉴别诊断结节性甲状腺病变的意义。方法 回顾性分析病理或细胞学证实的结节性甲状腺病变74例二维超声和彩色多普勒超声（CDFI）表现。结果 结节性甲状腺肿、甲状腺腺瘤和腺癌超声和血流图像表现有一定规律性,定位准确,敏感性强。结论 彩色多普勒超声是诊断结节性甲状腺病变首选检查方法。     

伴嗜酸性粒细胞增多性血管淋巴样增生的临床病理分析

目的：探讨伴嗜酸性粒细胞增多性血管淋巴样增生的临床病理学特征。方法：对我科1950-1999年期间所诊治的伴嗜酸性粒细胞增多性血管淋巴样增生的7名患者的病理标本重新切片,进行病理学上的分析。结果：伴嗜酸性粒细胞增多性血管淋巴样增生在病理学上有其特征,形态学上的改变主要表现在以下3个方面：①真皮内大量毛细血管增生;②血管内皮细胞增生肿大,似“墓碑”状突入血管腔;③病变处有淋巴细胞、嗜酸性粒细胞混合浸润。结论：伴嗜酸性粒细胞增多性血管淋巴样增生是一种良性局限性血管增生,其病因及发病机制尚不清楚。熟悉这一疾病的组织学改变对避免误诊为其他类拟疾病有重要意义。     

Macromorphology and histology of intramuscular hemorrhages in cases of drowning

In a prospective autopsy series of 39 cases of fatal drowning, the detailed dissection of the skeletal muscles of the neck, anterior / posterior trunk and the upper extremities in layers revealed intramuscular hemorrhages of different size and shape in 20 cases (51.3 %). Light microscopy examination showed a premortal (vital/agonal) type of muscular alteration in 7 (50 %) out of 14 macroscopical hemorrhage-positive cases. These hemorrhages and histological muscle alterations are attributed to agonal convulsions, hypercontraction and overexertion of the affected muscle groups. As long as no cutaneous or subcutaneous hematomas above the hemorrhages can be found, these autopsy findings (with special reference to histology) can serve as an additional criterion concerning the differentiation of drowning and another cause of death. Received: 31 July 1998 / Received in revised form: 31 August 1998     

Exercise induces a change in plasma fibrinogen concentration: fact or fiction?

This study examined the effect of exercise on plasma fibrinogen concentrations with simultaneous measurements of plasma volume changes. Eight moderately active males aged 26.6±3.6 years (mean±SD) completed maximal (VO₂max) and submaximal (75% VO₂max for 30 minutes) exercise trials separated by 7 days. Venous blood samples were obtained at rest, immediately postexercise, and following 30 minutes of recovery. Whole blood was analysed for haematocrit and haemoglobin, while citrated plasma was assayed for fibrinogen levels. Values of haematocrit and haemoglobin before and after exercise were utilised for the estimation of plasma volume changes. Plasma volume decreased (p<0.05) immediately following both maximal (−17.7±5.1%) and submaximal (−14.3±4.1%) exercise. Exercise resulted in decreased plasma fibrinogen levels (maximal exercise: from 266.3±14.5 to 222.2±23.9 mg·dL⁻¹; submaximal exercise: from 239.5±45.4 to 209.7±42.4 mg·dL⁻¹) only when postexercise raw data were corrected for the contraction of plasma volume. It is concluded therefore that changes in plasma volume in response to exercise should be taken into account when interpreting exercise effects on plasma fibrinogen concentration.     

Respiratory health and fluoride exposure in different parts of the modern primary aluminum industry

Objective: The aim of this cross-sectional study was to investigate possible acute and long-term respiratory health effects of work at different working places in the primary aluminum industry. Method: A cross-sectional study was carried out on 78 potroom workers, 24 foundry workers, and 45 carbon-plant workers (n = 147, exposed group), and 56 control workers (watchmen, craftsmen, office workers, laboratory employees) of a modern German prebake aluminum plant. The survey consisted of pre- and postshift spirometric and urinary fluoride measurements. Results: Potroom workers had significantly lower preshift results with regard to forced vital capacity (FVC, 99.5% versus the 107.2% predicted; P < 0.05) and peak expiratory flow (PEF, 85.2% versus the 98.4% predicted; P < 0.01) as compared with controls. In a multiple regression model a small but significant negative correlation was found between postshift urinary fluoride concentrations and FVC, FEV₁, and PEF. Across-shift spirometric changes were observed only in FVC among carbon-plant workers (103.0 ± 13.3% predicted preshift value versus 101.2 ± 13.6% predicted postshift value; P < 0.05). Conclusions: The results suggest that lung function impairment in the modern primary aluminum industry may be only partly due to fluoride exposure and that working in aluminum carbon plants may cause acute lung function changes. Received: 8 July 1998 / Accepted: 31 October 1998     

24例卵巢交界上皮性肿瘤的临床及病理分析

目的 :探讨卵巢交界上皮性肿瘤的临床及病理特征。方法 :对 1 975年至 1 998年天津市南开医院及天津市二中心收治的 2 4例卵巢交界性上皮肿瘤的病理学改变、临床分期及手术范围对预后的影响进行分析。结果 :在 2 4例卵巢交界性上皮性肿瘤中浆液性 8例 ,粘液性 1 5例 ,混合性 1例 ,在本组 1 4例 I期患者中 ,保留生育功能占 64.3%。 期 5例 ,均行全子宫加双附件切除术 , 、 期全部给予腹腔及静脉化疗。术后随访复发率 1 6.6%。结论 :手术是交界性上皮肿瘤的主要治疗方式。 I期患者可采用单纯保守性手术 ,对 期以上患者应力求手术干净。而预后与术式及化疗关系不密切 ,但与期别及术后有无肿瘤的残留有关     

Laboratory data in healthy volunteers: reference values, reference changes, screening and laboratory adverse event limits in Phase I clinical trials

Objective: Laboratory data are key evaluation procedures for Phase I clinical pharmacology for two reasons. Firstly, laboratory data are used within the screening process to exclude subjects with asymptomatic diseases, which could result in increased danger to themselves or confuse interpretation of the study results. Secondly, during study implementation, safety evaluation and in particular maximum tolerated dose determination have to be done by a case-by-case analysis, sometimes using laboratory adverse events (LAEs). Thus, relevant limits are needed to discriminate between a usual common variation and a significant abnormality, which is considered to be a LAE. This report presents laboratory data distribution, reference values and reference changes and, based on previously published new methods, suggests inclusion limits at screening and laboratory adverse event limits for analysis during study implementation. Subjects and methods: Nine hundred and twenty-seven young healthy male volunteers were recruited in one centre (Association de Recherche Thérapeutique). A standard screening process was carried out. Protocols were approved by the local ethics committee. Blood sampling was performed in the same conditions. Reference values (at screening and at baseline) were determined by a non-parametric procedure selecting 2.5% and 97.5% of the distribution of data. Reference changes were also defined as the 2.5–97.5% interval of distribution of the variations between the end of treatment and baseline. Inclusion limit and LAE limit methods of determination used had been specified in previous articles. Results: Detailed results of laboratory data distribution, reference values at screening and at baseline, reference changes, inclusion limits and LAE limits are presented in tables with number of subjects, mean, median, standard deviation, minimal and maximal values and the 2.5–97.5% interval for each laboratory parameter. Conclusion: The key aims of this paper are to provide clinical pharmacologists with data, reference values or changes obtained in the real conditions of Phase I study implementation, and to propose relevant limits, either for screening as inclusion limits, or during studies as LAE limits. Thus, these data, reference values and specific limits improve the capacity to screen healthy volunteers and to analyse LAEs during Phase I studies. Received: 30 July 1998 / Accepted in revised form: 25 November 1998     

A loudspeaker-driven system for rapid and multiple solution exchanges in patch-clamp experiments

A new and inexpensive system allowing rapid and synchronized changes of solutions around a membrane patch or a cell under voltage-clamp conditions is described. Four plastic capillary tubings (OD 640 m; ID 430 m) were glued together horizontally and attached to a coil of a commercially available loudspeaker. Servo-control of the position of the coil allowed the mouth of any of the capillaries to be positioned near the pipette tip within 6 ms. A high flow speed of the test solution was crucial to achieve rapid solution exchange. At a flow speed of 5 cm/s, complete exchange of the external environment of a frog ventricular cell was achieved within 20–30 ms. The time course of solution change was found to be 3–5 times faster at the tip of an open patch pipette. To preserve the physical integrity of the cell, the cell was usually perfused by a control capillary at a slow velocity (0.2 –0.4 cm/s) and test solutions flowing out of adjacent capillaries at high velocity (4–5 cm/s) were applied to the cell only for short periods. Determination of the three-dimensional contamination profile around the mouth of the control capillary allowed the optimal conditions for the use of the system to be established and possible sources of contamination to be avoided between adjacent capillaries with unmatched flow speeds. Successive and multiple changes in external solutions could be easily synchronized with voltage-clamp depolarizations to examine the time course of the effect of drugs on voltage-operated ion channels. An example of this application is given with rapid applications of the dihydropyridine agonist (-)BayK 8644 to the L-type Ca²⁺ channel current in frog ventricular myocytes.