Oral maxillofacial reconstruction: 25 years'''' experience

Purpose: To make a retrospective analysis of the reconstructive cases with oral maxillofacial defects of 25 years in the department.     

张奇文治疗五迟五软医案1则

五迟是立迟、行迟、齿迟、发迟、语迟,五软即头项软、口软、手软、足软、肌肉软。究其病因病机多系孕期调护不当,饮食、精神、起居等因素损伤胎元之气或父母精血虚损等,致先天精髓不充,脏气虚弱,筋骨肌肉失养而出现五迟五软。治以扶正补虚,固本培元为主。五迟、五软从预后来讲,疗程较长,及早诊断、及时治疗往往能改善预后,年龄在3个月内效果更佳。     

Klinik und Therapie des Merkelzelltumors

Zusammenfassung Es wird über vier Fälle eines Merkelzelltumors mit unterschiedlichem klinischen Verlauf und Lokalisation im Gesicht und am Stamm berichtet. Bezüglich der Klinik wurden 339 Fälle eines Merkelzelltumors aus der Literatur ausgewertet. Beim Merkelzelltumor handelt es sich um einen von den Merkelschen Zellen ausgehenden neuroendokrinen Hauttumor. Er findet sich zu 47% im Kopf-Halsbereich, hat eine durchschnittliche Größe von 25 mm, liegt typischerweise über dem Hautniveau und zeichnet sich klinisch durch seine rötlich-livide Farbe aus. Aufgrund der Metastasierung und des infiltrativen Wachstums ist er als maligne einzuordnen. In 27% bestehen Lymphknotenmetastasen, in 51 % kommt es zu Lokalrezidiven und in 32% treten Fernmetastasen auf. Die Therapie der Wahl besteht in einer frühzeitigen Excision mit einem Sicherheitsabstand, wie er bei malignen Hauttumoren üblich ist. Eine Strahlensensibilität liegt vor; ob auch eine chemotherapeutische Beeinflußbarkeit besteht, ist jedoch nicht sicher.

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Merkel cell tumor: Clinical feature and therapy

Summary Four cases of Merkel cell tumor located in the face or on the trunk are presented. In a literature review 339 cases were found and analysed. The Merkel cell tumor is a neuroendocrine tumor of the skin derived from the Merkel cells. It is located most often in the face and neck area. Typically, it is an exophytic node, has a red-blue color and measures 25 mm in diameter on the average. Since it is metastasizing it is a malignant tumor. Regional node metastases were found in 27%, local recurrences occur in 51%, and distant metastases were seen in 32% of the cases. The best therapy is excision with wide margins as is the rule for a malignant skin tumor. While the tumor reacts to radiotherapy, chemotherapy seems to be of no help.

Die histologische Begutachtung der Operationspräparate erfolgte im Institut für Pathologie des Universitätskrankenhauses Eppendorf (Direktor: Prof. G. Seifert)     

血型抗原在亲子纠纷案中的应用

本文报告用白细胞抗原(HLA)和红细胞抗原(ABO,MN,P和 Rh)测定技术,判定亲子纠纷案六起,此六起亲子纠纷案全部可根据单独白细胞抗原的测定结果作判定,其中有五起也可根据白细胞抗原和红细胞抗原两个系统测定的结果进行判定,说服力更强,无一案是单独根据红细胞抗原测定结果判定的。血型抗原在亲子纠纷案鉴定中的意义,以白细胞抗原的测定为最重要,红细胞抗原测定结果侧重于排除作用。当然以采用多系统联合鉴定为最佳,本文报告之六起亲子纠纷案,经过多系统联合鉴定所判断的结果,被指控人均已向公安局承认,说明判定结果全部正确。     

典型类风湿煤矽肺6例报告

报告典型类风湿性煤矽肺6例。病例诊断具备有粉尘接触史,X线胸片的尘肺改变和Caplan结节或RP的肺部改变,类风湿关节炎,血清RF阳性;有的病例免疫球蛋白增高和发现皮下类风湿小结。研究RP有利于对尘肺发病机制作深入的阐述,并为预防病变发展提供理论依据。     

中学优生与后进生时间管理倾向的比较研究

目的：比较中学优生和后进生在时间管理倾向上的差异,为中学培养优生,转化后进生提出教育建议。方法：采用黄希庭、张志杰编制的青少年时间管理倾向量表对成都433名中学生(优生175名,后进生258名)进行问卷调查。结果：中学优生和后进生在时间管理倾向量表总分及其子维度上的差异显著,优生平均得分高于后进生;时间管理倾向量表总分及其子维度上的年级效应显著,但不存在性别差异。结论：中学优生的时间管理水平高于后进生．前者是呈起伏发展．而后者的发展呈逐渐下降趋势。     

Tracheal intubation using a new CCD camera-equipped device: a report of two cases with a difficult intubation

In two patients, one with Klippel-Feil syndrome and one with fibrous dysplasia of the maxilla, no part of the larynx could be visualized by direct laryngoscopy. In both cases, the use of an intubation device equipped with a charge-coupled device camera, the endotracheal intubation device (EID), allowed smooth tracheal intubation.     

Evaluation of the airway of the SimMan full-scale patient simulator

BACKGROUND: SimMan is a full-scale patient simulator, capable of simulating normal and pathological airways. The performance of SimMan has never been critically evaluated. METHODS: Sixty subjects (anesthesiologists, nurse anesthetists, and anesthesia residents) performed mask ventilation, laryngeal mask insertion and endotracheal intubation on SimMan. The simulator's airway was evaluated using visual analog scales (VAS) and by measuring the subject's performances. RESULTS: The SimMan full-scale patient simulator's airway is generally acceptably realistic but it significantly differs from the human airway in important aspects. Mask seal was more difficult than in humans whereas Laryngeal mask (LMA) insertion and function was acceptable. The distance from the teeth to the vallecula was too short. Cervical spine mobility was significantly reduced in the 'reduced neck movement' mode but the intubation was only slightly more difficult than in the 'normal' mode. CONCLUSION: The SimMan full-scale patient simulator's airway is generally acceptably realistic but it significantly differs from the human airway in important aspects. The user must be aware of these aspects in order to obtain maximum benefit from training and evaluation scenarios and when using the simulator for testing new equipment and techniques.     

Cancer of unknown primary site: review of consecutive cases at the National Cancer Center Hospital of Japan

Background Cancer of unknown primary (CUP) is not a rare clinical entity, accounting for 3%–5% of all solid malignancies. Methods We retrospectively reviewed 86 (38 male/48 female) patients with a diagnosis of CUP (exclusive of female patients with adenocarcinoma involving the axillary lymph nodes alone and patients with squamous cell carcinoma of the cervical lymph nodes) who were referred to the National Cancer Center Hospital between April 1996 and October 2002. Results The median interval between the first visit to a local community hospital and referral to our hospital was 1 month (range, 1 to 45 months). The histological diagnosis was adenocarcinoma in 61 patients (71%), poorly differentiated carcinoma in 18 patients (21%), and squamous cell carcinoma in 4 patients (5%). Twenty-three female patients had peritoneal carcinomatosis of adenocarcinoma. Seventy-eight patients (91%) received platinum-containing chemotherapy. Sixty-one of the 86 patients (71%) were categorized as a subgroup of CUP without a specific therapy, and 55 of these 61 patients (90%) received platinum-containing regimens. The median survivals of all 86 patients and the 61 patients in the subgroup without a specific therapy in this series were 13 months and 11 months, respectively. Conclusion In this series, the survival of the patients in the CUP subgroup without a specific therapy did not seem worse than that in previous reports. Empirical chemotherapy with platinum-containing regimens may benefit some CUP patients in a subgroup without a specific chemotherapy.