Coralline hydroxyapatite bone graft substitutes: preliminary report of radiographic evaluation

A new bone graft substitute made by conversion of the calcium carbonate exoskeleton of reef-building sea coral into hydroxyapatite has recently become clinically available. The normal radiographic appearance of two forms of this material is described. In the immediate postoperative period, the exoskeletal architecture of these implants is readily appreciated. With graft incorporation over the ensuing months, their intrinsic structure is gradually lost in association with poor marginal definition. Evolving radiographic findings reflect the biocompatible nature of these implants, which provides the potential for ingrowth of native bone with preservation of the coralline scaffold, resulting in enhanced biomechanical properties.     

Paramagnetic macrocyclic complexes as contrast agents for MR imaging: proton nuclear relaxation rate enhancement in aqueous solution and in rat tissues

Paramagnetic macrocyclic chelates show promise as magnetic resonance (MR) imaging contrast agents due to stability and relaxivity comparable to those of DTPA-type chelates. For the three copper and manganese macrocyclic complexes studied in aqueous solution, T1 and T2 relaxivities ranged from 0.14 to 5.88 mM-1sec-1 at 6.25 MHz. In rats, the intravenous administration of 16 mumol/kg of Mn(cyclam) caused the liver T1 relaxation rate to double at 15 minutes after injection. T1 measurements by pulsed MR imaging and manganese analyses on excised tissue showed that both relaxation rate (1/T1) and manganese content of liver and kidney increase linearly with the dosage of Mn(cyclam). The linear relationship between 1/T1 and manganese content can be considered an "in tissue" relaxivity plot for the agent. The resulting relaxivity is 54 mM-1sec-1 in liver, compared with 3.1 mM-1sec-1 in aqueous solution. Although this work is preliminary, the implication for medical MR imaging applications is that macrocyclic contrast agents can be effective at approximately one-tenth the current typical dose used for gadolinium DTPA.     

The superior laryngeal nerve loop and its surgical implications

Summary Based upon findings from 60 cadavers (120 sides), the incidence of superior laryngeal nerve loop, connecting the cervical sympathetic chain and the superior laryngeal nerve and its branches, the external and internal laryngeal nerve, was 98.3% (118 out of 120 sides). In most cases the loop connected the sympathetic chain and the external laryngeal nerve. The external laryngeal nerve was looped, and not linear as traditionally thought. The loop could be divided into three categories, V-shaped, U-shaped and mixed, and subdivided into 5 types and 17 subtypes according to morphological variation. The loop without exception innervated not only the cricothyroid muscle, but also the thyroid gland. The loop is one of the origins of the thyroid nerve. It seems that for thyroid surgery the loop, when lower in position, should be carefully separated from the superior thyroid vessels before the latter are ligated, in order to preserve a normal nerve supply to the muscle as well as to the part of the gland that remains after surgery.

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L'anse du nerf larynge supérieur, étude anatomique et applications chirurgicales

Résumé La fréquence d'une anse du nerf laryngé supérieur réalisant une anastomose entre la chaine sympathique cervicale et le nerf laryngé supérieur et/ou ses branches (rameau laryngé externe et ingerne), est de 98,3 % (118/120). Ce résultat s'appuie sur l'étude de 60 cadavres. Dans la plupart des cas, l'anastomose se fait entre la chaine sympathique cervicale et le rameau laryngé externe. Ce rameau laryngé externe a un trajet curviligne et non linéaire conformément aux données classiques. Il existe trois catégories d'anses : en "V", en "U" et mixte ; on peut également les subdiviser en 5 types et 17 sous-types en fonction des variations morphologiques. Cette anse innerve constamment non seulement le muscle cricothyroïdien mais aussi la glande thyroïde dont elle fournit une partie de l'innervation. Lors de la chirurgie thyroïdienne, si l'anse est en position basse, les nerfs doivent être soigneusement disséqués et séparés des vaisseaux thyroïdiens supérieurs avant ligature de ces derniers de façon à conserver l'innervation normale du muscle et de la partie restante de la glande.

     

消痔灵和强的松龙混合液治疗鼻息肉

0　引言　我科 1996 / 1998分别应用消痔灵与强的松龙混合液、消痔灵液、强的松龙液行鼻息肉内 ,鼻息肉蒂部注射治疗鼻息肉各 5 0例 ,并设对照组为鼻腔滴入及口服类固醇激素 5 0例 ,合计 2 0 0例 ,观察并对比其疗效 .1　对象和方法1.1　对象　男 12 8例 ,女 72例 ,年龄 8～ 78(平均 38)岁 ,病程 32 a～ 45 (平均 4.5 ) a.其中在本次治疗前做过一次鼻息肉摘除术后复发的 2 7例 ,做过 2次或 2次以上手术的 12例 .主要症状为鼻塞、流脓涕、头痛及嗅觉减退 .全部病例治疗前均行鼻窦 X线拍片 ,其中上颌窦炎 12 5例、筛窦炎 5 8例、蝶窦炎 2例、…     

Acute experimental neuronal injury in the newborn lamb: US characterization and demonstration of hemodynamic effects

Background and purpose: Microinjection into the brain with N-methyl-D-aspartate (NMDA), a synthetic analogue of glutamate, has been used as a chemical model of perinatal hypoxic-ischemic injury. Little is known about the sonographic characteristics and hemodynamic consequences of these cytotoxic lesions. An understanding of these features may be useful in the early sonographic identification of stroke in newborns.Methods: Twenty newborn lambs were anesthetized, paralyzed, and mechanically ventilated. Between 0.5 and 5 mole NMDA in 0.2 ml phosphate buffered salinen=18), or buffered saline only (n=2) was injected into the right putamen under sonographic guidance. Serial grey-scale and color Doppler images of the brain, Doppler spectra of the middle cerebral and thalamostriate arteries, cerebral blood flow (CBF) determinations using radiolabeled microspheres (n=9), and cerebral oxygen extraction (n=4) were obtained before, and at 15, 60, and 120 min after NMDA injection. Pathologic examination was obtained in 11 animals.Results: Homogeneous, well defined, moderately echogenic lesions surrounded by marked focal hyperemia on color Doppler were identified in every animal injected with 5 mole NMDA within minutes of injection. Lesions were characterized by focal areas of chromatolysis and cytoplasmic shrinkage, with scattered petechial hemorrhage. No lesions or hyperemia were observed in the animals injected with normal saline. Mean supratentorial CBF increased from 64±9 ml/min/100 g (control) to 152±30, 115±19, and 102±8 ml/min/100 g at 15, 60, and 120 min after injection respectively. The most marked increases occurred in right midbrain (467% of control), diencephalon (388%), and temporal lobe (282%), but were also observed in homotopic regions of the left hemisphere, and in pons, medulla, and cerebellum. Mean blood flow velocity in the middle cerebral artery, and thalmoperforator artery correlated well with changes in hemispheric and midbrain CBF respectively. (r=0.57–0.74,p=0.0001, andr=0.65–0.67,p=0.0001 respectively).Conclusions: Focal brain lesions may be identified by sonography within minutes after experimentally induced neuronal injury. Alterations in echotexture are primarily due to intracellular cytoplasmic changes and microscopic hemorrhage. Local intracerebral injection of NMDA in newborn lambs increases both local and global CBF.Supported in part by USPHS NIH grant NS 20020     

苦楝化学成份的研究

从苦楝(Melia azedarach L.)果中分得苦楝新醇(Ⅰ),苦楝醇(Ⅱ)、苦楝酮(Ⅲ)、苦楝二醇(Ⅳ)、香草醛(Ⅴ)和香草酸(Ⅵ)。根据波谱(IR,MS,~1HNMR,~(13)CNMR)分析和理化常数测定,确定了它们的结构。其中苦楝新醇(Ⅰ)为新化合物,对菜青小虫有一定的拒食活性。     

不同载荷作用下C（4～5）椎间孔孔径的变化

目的:分析不同载荷对C4～5椎间孔孔径变化的影响。方法:实验于2006-01/2006-05在湘南学院附属医院进行。成人新鲜尸体颈椎标本10具(自愿捐献或家属同意),节段包括C3～T1,剔除肌肉组织,保留椎间盘、韧带和关节囊结构的完整。分别测量椎间盘完整、椎间盘髓核摘除、颈人工椎间盘置换和前路钢板植骨内固定4种状态下,加压速度为5mm/min时,25,50,75,100,125和150N的分级轴向载荷加载于标本时C4～5上下径、上前后径、下前后径以及椎间孔面积的变化。结果:①轴向加载25N时,C4～5椎间孔面积椎间盘髓核摘除标本小于完整椎间盘、颈人工椎间盘置换和前路钢板植骨内固定标本[(57.26±17.65),(65.81±16.83),(75.37±17.75),(66.21±16.50)mm2,P<0.05];颈人工椎间盘置换标本大于颈椎植骨融合钢板内固定标本(P<0.05)。②轴向加载50N时,C4～5椎间孔面积椎间盘髓核摘除标本小于其他3组[(57.13±17.64),(65.72±16.85),(75.35±17.75),(66.11±16.46)mm2,P<0.05];颈人工椎间盘置换标本大于颈椎植骨融合钢板内固定标本(P<0.05)。③轴向加载75N时,上下径:C4～5椎间孔面积椎间盘髓核摘除标本小于其他3组[(55.26±17.66),(64.80±16.85),(73.32±17.74),(65.21±16.48)mm2,P<0.05];颈人工椎间盘置换标本大于颈椎植骨融合钢板内固定标本(P<0.05)。④轴向加载100N时,上下径:C4～5椎间孔面积椎间盘髓核摘除标本小于其他3组[(53.22±17.66),(63.81±16.83),(71.35±17.76),(65.27±16.46)mm2,P<0.05]。⑤轴向加载125N时,C4～5椎间孔面积椎间盘髓核摘除标本小于其他3组[(51.25±17.64),(62.82±16.83),(69.25±17.74),(65.25±16.43)mm2,P<0.05]。⑥椎间孔面积:轴向加载150N时,C4～5椎间孔面积椎间盘髓核摘除标本小于其他3组[(49.16±17.65),(61.84±16.86),(67.15±17.73),(65.24±16.42)mm2,P<0.05]结论:颈椎间盘髓核摘除后C4～5椎间孔有效空间明显减少。