A Simple Dressing Technique Following Dermofasciectomy and Full Thickness Skin Grafting of the Fingers in the Treatment of Severe Dupuytren’s Contracture

Dupuytren’s disease with severe finger contractures and recurrent contractures following previous surgery often have extensive skin involvement. In these severe cases, excision of the diseased chord along with the involved skin is a good option to reduce the risk of recurrance. The resulting skin defect can be covered with a full thickness skin graft (FTSG) or a cross finger flap. Cross finger flaps have donor finger morbidity and hence a full thickness graft is usually preferred. The FTSG extending to the midlateral margins on both sides of the finger reduces the risk of joint contracture due to graft shrinkage. Once the FTSG is sutured in place, the standard practice is to compress and secure the graft to its recipient bed with a tie-over dressing and this can be time consuming. We present a simple dressing technique to secure the FTSG without the need for a tie-over dressing.     

下腹部Joel—Cohen切口术后切口愈合临床观察

目的探讨肥胖患者下腹部手术采用Joel—Cohen切口对预防非感染性切口裂开的临床效果。方法选择切口部位皮下脂肪层厚达4—5cm的妇产科手术患者90例，随机分为观察组44例，采用Joel—Cohen切口；对照组46例，采用下腹正中直切口。观察切口愈合和脂肪液化情况。结果观察组切口甲级愈合率显著高于对照组（P〈0．01）；脂肪液化切口裂开率显著低于对照组（P〈0．05）。结论脂肪组织厚达4—5cm以上下腹部手术切口，采用Joel—Cohen切口可以减少脂肪液化，切口愈合显著优于下腹直切口，值得临床推广应用。     

气象因素与霍乱发病关系的生态学研究

目的探讨气象因素与霍乱发病的关系.方法将绍兴地区1991～2001年霍乱各年6～11月份月平均发病率数据进行正态化处理后,再利用方差分析、回归分析对可能影响霍乱发病的气温、气压、相对湿度、日照时数、降水量等5项研究变量进行单因素相关分析和多元逐步回归分析.结果霍乱的发病与气温呈显著性正相关,与气压呈显著性负相关.结论霍乱发病与高气温、低气压有关.     

小切口手术治疗肾囊肿14例体会

目的分析讨论应用小切口手术治疗单纯性肾囊肿的临床特点及体会。方法总结自1996年1月至2004年10月14例应用小切口手术行囊肿去顶术的临床资料。结果小切口手术组14例,囊肿单发均位于肾中下极及中部背侧,手术时间30~90m in,术后未发生并发症,住院日5~8d。随访半年~1年均无复发。结论小切口手术治疗单纯肾囊肿具有手术操作简便、创伤小、恢复快、降低住院日等优点,适用于肾中下极及肾中部背侧的单纯肾囊肿。     

单纯性肥胖及2型糖尿病儿童胰岛素受体底物-1的研究

目的:探讨单纯性肥胖及2型糖尿病儿童胰岛素受体底物-1(IRS-1)表达的改变。方法:对20例单纯性肥胖儿童,20例2型糖尿病儿童及20例对照组儿童,采用细胞免疫技术进行白细胞染色,运用图像分析软件计算光密度值,从而定量分析白细胞中IRS-1的含量变化。结果:肥胖组、2型糖尿病组白细胞中IRS-1表达下降,且与对照组相比有统计学意义(P<0.05)。结论:肥胖组、2型糖尿病组白细胞中IRS-1表达下降,与对照组相比有统计学意义(P<0.05),提示肥胖组与2型糖尿病组儿童胰岛素信号传递中受体后作用的关键底物缺陷,影响了胰岛作用的发挥。提示IRS-1与胰岛素抵抗有关,有利于进一步理解2型糖尿病的发病机制,指导临床治疗。     

综合疗法治疗儿童单纯性肥胖症31例

目的探讨综合疗法治疗儿童肥胖症的疗效。方法对31例儿童肥胖症患者进行综合治疗，包括大黄膏身体各部位按摩，用内分泌治疗仪或用远红外线灯照射全身穴位，女患儿加用太空衣治疗，然后采用电脑减肥治疗仪在全身各部位进行治疗。同时制定饮食处方和运动处方并进行行为指导。结果治疗组体重减少5～10k，有效率93．5％；对照组体重减少2～4kg，有效率46．7％。同时腰围明显减小。结论综合疗法治疗儿童肥胖症是很有效的。且无任何不良反应。     

DNA fingerprinting of Ascochyta rabiei with synthetic oligodeoxynucleotides

Summary The ascomycete fungus Ascochyta rabiei, an important pathogen of the grain legume crop chickpea (Cicer arietinum L.) in the Mediterranean region, has not been adequately characterized in molecular terms. We therefore used DNA fingerprinting, with synthetic oligodeoxynucleotides complementary to simple repetitive sequences, to pathotype different isolates of the fungus. Six single-spored A. rabiei isolates were first categorized using a host differential set of nine chickpea genotypes. Seedlings were inoculated under controlled environmental conditions, and disease severity was recorded 9 days after inoculation. DNA was extracted from in vitro-grown mycelia of the six purified fungal isolates, restricted with EcoRI, HinfI, MboII and TaqI, and fingerprinted with radiolabeled (GATA)₄, (GTG)₅, (CA)₈, and (TCC)₅, respectively. High levels of polymorphism were detected with optimal enzyme/probe combinations that allow one to discriminate between the isolates. The potential of DNA fingerprinting with simple repetitive sequences can thus be expanded to the identification of fungal races and pathotypes. The characterization of the geographic distribution and genetic variability of pathotypes will facilitate the selection of suitable host cultivars to be grown in specific regions.     

Osteotomy around the knee: Assessment of quality,content and readability of online information

BackgroundAs knee osteotomy surgery becomes increasingly accessible, more patients may turn to the Internet for information. This study examined the source, quality, content and readability of online information regarding osteotomy around the knee.MethodsThe first 70 websites returned by the top four search engines were identified using the key words: “knee osteotomy” and “high tibial osteotomy.” The websites were categorised by type and assessed using the DISCERN score, Journal of the American Medical Association (JAMA) benchmark criteria and a novel Knee Osteotomy-Specific Score (KOSS). The presence of the Health On the Net (HON) code accreditation seal was noted. Readability of each website was assessed using eight readability formulae. The mean reading grade level (RGL) was compared to the 6th and 8th grade reading levels. The mean RGL of each category was also compared.ResultsOf the 45 unique websites analysed, the majority were Physician (33%) and Journal websites (31%). The mean DISCERN score was 36.7 (±8.9) which is classified as ‘poor.’ The mean JAMA benchmark criteria score was 2.04 (±1.5) and Physician websites were most likely to be scored zero. The mean KOSS was 15.4 (±5.7). The highest scoring website was a Commercial site but, overall, Journal category sites provided the best quality information. Websites that bore the HONcode seal obtained higher DISCERN, JAMA benchmark criteria and Knee Osteotomy - Specific Scores.The cumulative mean RGL was 13.2 (±2.2) which exceeded the 6th grade level by an average of 7.2 grade levels and the 8th grade level by an average of 5.2 grade levels. No website (0%) was written at or below either the 6th or the 8th grade reading levels. The mean Flesch Reading Ease Score of all websites was 41.13 (±14.7) which is classified as ‘difficult.’ Journal websites had the highest RGL.ConclusionThe information available online regarding osteotomy around the knee varies tremendously in quality and completeness. Physician sites predominate, but these were among the lowest scoring of all websites. Even where high quality information is available, it is set at too high a level to be easily understood.Level of evidenceSurvey of materials – Internet.     

Differential responsiveness of simple and complex cells in cat striate cortex to visual texture

Summary The responsiveness of 254 simple and complex striate cortical cells to various forms of static and dynamic textured visual stimuli was studied in cats, lightly anaesthetised with N₂O/O₂ mixtures supplemented with pentobarbitone.Simple cells were unresponsive to all forms of visual noise presented alone, although about 70% showed a change in responsiveness to conventional bar stimuli when these were presented on moving, rather than stationary, static-noise backgrounds. Bar responses were depressed by background texture motion in a majority of cells (54%), but were actually enhanced in a few instances (16%).In contrast, all complex cells were to some extent responsive to bars of static visual noise moving over stationary backgrounds of similar texture, or to motion of a whole field of static noise. The optimal velocity for noise was generally lower than for bar stimuli.Since moving noise backgrounds were excitatory for complex cells, they tended to reduce specific responses to bar stimulation; in addition, directional bias could be modified by direction and velocity of background motion.Complex cells fell into two overlapping groups as regards their relative sensitivity to light or dark bars and visual noise. Extreme examples were insensitive to conventional bar or edge stimuli while responding briskly to moving noise.In many complex cells, the preferred directions for motion of noise and of an optimally oriented black/white bar were dissimilar.The ocular dominance and the degree of binocular facilitation of some complex cells differed for bar stimuli and visual texture.Preliminary evidence suggests that the deep-layer complex cells (those tolerant of misalignment of line elements; Hammond and MacKay, 1976) were most sensitive to visual noise. Superficial-layer complex cells (those preferring alignment) were less responsive to noise.Only complex-type hypercomplex cells showed any response to visual noise.We conclude that, since simple cells are unresponsive to noise, they cannot provide the sole input to complex cells. The differences in the response of some complex cells to rectilinear and textured stimuli throw a new light on their rôle in cortical information-processing. In particular, it tells against the hypothesis that they act as a second stage in the abstraction of edge-orientation.     

Spatial arrangements of responses by cells in the cat visual cortex to light and dark bars and edges

Summary Detailed examination is made of the responses of visual cortical cells (area 17, border 17–18 and adjacent area 18) in the anaesthetized cat to stationary flashing bars and to bars (lines) and edges moving at their optimal velocities. Particular attention is given to the receptive field organization of cells in the simple family. While there is good general agreement between the main receptive field subregions revealed by stationary and moving stimuli, the responses to moving light and dark bars, supplemented by the responses to moving light and dark edges, provide a much more rapid, accurate and complete guide to the spatial organization of the receptive fields than do the response profiles to a stationary flashing bar. Moving light and dark bars between them generally reveal more subregions in the receptive fields of simple cells than is evident from the response profiles to a stationary flashing bar, particularly when the receptive fields have many subregions. In addition the responses to moving edges provide a rapid guide to spatial summation across the width of a subregion and the possible antagonistic effects of the next subregion in sequence.Two subclasses of cells in the simple family have been recognized: ordinary simple and fast simple cells. Two cell classes (A-cells and silent periodic cells) having properties intermediate between simple and complex types are discriminated and their properties described.