The retroperitoneal approach for abdominal aortic aneurysms

A gene for familial hemiplegic migraine, a subtype of migraine with aura, was assigned to chromosome 19p13. In this region, we identified a brain-specific P/Q-type calcium-channel alpha 1A-subunit gene, CACNA 1A, with 47 exons covering 300 kb. Sequencing of all exons and their flanking surroundings revealed polymorphic variations, including a (CA)n-repeat and a (CAG)n-repeat in the 3' untranslated region. In patients with familial hemiplegic migraine, we found four different missense mutations in conserved functional domains. One of the mutations has occurred on two different haplotypes in unrelated familial hemiplegic migraine families. Moreover, in episodic ataxia type 2, we found two mutations disrupting the reading frame. Thus, familial hemiplegic migraine and episodic ataxia type 2 can be considered as allelic channelopathies. Involvement of this familial hemiplegic migraine locus in migraine with and without aura was demonstrated by sib-pair analysis. We showed an increase of shared marker alleles of locus D19S394, which is tightly linked to the gene. The association between the alpha 1A calcium channel and familial hemiplegic migraine, and the increase of shared alleles in migraine-affected sib-pairs, have uncovered a new pathway for the pathophysiology of migraine. This finding may provide a rationale for the development of specific prophylactic therapy for migraine and other (paroxysmal) cerebral disorders.     

俄罗斯连续式加热炉结构的现状和改进

俄罗斯的轧钢车间里现在约有 2 40座连续加热炉在使用。 60年代末以前建的是结构简单、造价相对低廉的推钢式炉。当它们不再能满足轧钢生产要求时便开始过渡到步进底式炉(小型和线材厂 )和步进梁式炉 (轧板厂 ) ,后者虽然结构复杂还贵一些 ,但是克服了推钢式炉的缺点。70年代末除了在现有的炉子工段增建外已停止建造新的推钢式炉。新的轧钢厂只建步进式炉。 80年代前 ,冶金工业进一步发展 ,建造了一批新的轧机和新的炉子 ,但老炉子还维持原貌。 80年代中许多已老化的轧钢厂停产并改建炉子 ,到 90年代工作暂时中止。其结果是老的无下加热的甚…     

Combined resection of abdominal aorta and inferior vena cava for retroperitoneal rhabdomyosarcoma invading the aortoiliac bifurcation

The authors report on an 11-year-old boy with retroperitoneal alveolar rhabdomyosarcoma at the aortoiliac bifurcation. The tumor was resected en bloc together with the infrarenal abdominal aorta and the inferior vena cava. The aortic defect was repaired successfully with a Y-shaped Dacron graft. The authors conclude that tumor resection with aortic reconstruction can be a choice for unresectable retroperitoneal tumors in children.     

In situ autogenous reconstruction of the thoracoabdominal aorta and branches for treatment of an infected thoracoabdominal aortobifemoral bypass graft

Graft infection is an uncommon but potentially lethal complication of prosthetic aortic repair. We describe a novel technique for upper abdominal aortic and visceral revascularization after percutaneous drainage and antibiotics failed to cure a thoracofemoral prosthetic graft infection. One week after axillofemoral and femorofemoral bypass grafting, the infected thoracoabdominal graft was removed and a bifurcated iliac artery autograft was used to replace the upper abdominal aorta and revascularize the abdominal viscera. The infected graft was removed from the thorax and retroperitoneum, the infection resolved, and the patient remained well until his death of lung cancer 9 years later.     

Current status of general hospital use for patients with tuberculosis in the United States: eight-year update

Questionnaires were sent to the tuberculosis control officers in 50 states to determine the current use of general hospitals and sanatoriums for patients with tuberculosis. Replies were received from 46 states; 4 states supplied information by telephone. Fifteen states reported using both general hospitals and specialized hospitals for treatment of tuberculosis in 1980. The most common reason for the continued use of a state-operated facility for patients with tuberculosis was the lack of funds to pay for care in general hospitals. Average length of stay in general hospitals was 21 days or less; in specialized facilities, it was 60 to 90 days. The specialized hospitals usually combined care for patients with mental illness, mental retardation, other chest or chronic diseases, and tuberculosis. With one exception, there were no plans to close any of the remaining specialized facilities. No significant problems with respect to care of patients with known tuberculosis in general hospitals were documented.     

Renal water-electrolyte excretion and its control mechanisms. Current status of knowledge

The literature on hydronatriuresis control processes operating at the level of individual renal functional units and of the organ as a whole is analysed. 1) Elementary sodium salt and water tubular transport mechanisms. In converting the filtrate into urine, the kidney expends metabolic energy: this is used in the (active) transport of sodium salts; (passive) transport of water takes place along the osmotic gradients created by salt transfer. The proximal tubules reabsorb the sodium bic-rbonate actively. The reabsorption of the osmitic equivalent of water has the effect of concentrating NaCl in the tubular fluid. An important role in the reabsorption of NaCl is played by passive diffusion from the lumen to the interstitial fluid; the remainder is transferred actively, perhaps by an electrically neutral pump. With respect to the other nephronic segments, the proximal tubule has a relatively high passive permeability to water and salts: active transport here must not surmount high friction resistances nor take place against important concentration gradients. The low permeability of the distal nephron, on the other hand, increases the energy cost of salt transport; for the same reason, important electrochemical gradients are created and the composition of tubular fluid is drastically altered. 2) Elementary mechanisms of tubular potassium transport. Potassium is reabsorbed actively along the whole nephron by a luminal pump. The proximal tubules and Henle loops promote practically complete absorption of filtrated potassium. The distal tubules and collectors have the two-fold capacity of secreting and reabsorbing cation: the quantity of potassium excreted with the urine depends on the degree of excess of the secretion process. At distal tubular level, potassium secretion is a passive phenomenon dependent on the favourable transluminal gradient of the cation's electrochemical potential. 3) Renal function and volume homoeostasis of extracellular fluid. The organism's sodium content is largely controlled by renal excretion of sodium; homoeostasis of the sodium mass guarantees volume homoeostasis of the extracellular fluid through thirst and osmotic secretion of ADH. Extracellular fluid volume errors are picked up by the organism to the extent to which they translate themselves into pressure variations in the low pressure vascular system or into variations in haematic constituent concentration within the vascular sector, produced with velocities independent, at least in the short term, of the volume of extracellular fluid. In control of natriuria are the glomerular filtrate, intrarenal distribution of blood flow and tubular reabsorption of sodium; in its turn, the latter is subject to nervous and hormonal influences and influences from the physical environment surrounding the nephrons...     

The use of antibiotic-impregnated cement in infected reconstructions after resection for bone tumours

Bone mobilization, lowering of bone mineral density (BMD), and osteoporotic fractures are recognized in postmenopausal women with weight loss. Because a high-calcium intake suppresses bone loss in peri- and postmenopausal women, the present randomized, double-blind, placebo-controlled study was designed to test the hypothesis that calcium supplementation prevents net bone mobilization and consequent bone mineral loss during voluntary weight reduction in obese postmenopausal women. Subjects were placed on a moderate energy-restricted diet and either calcium supplementation (1 g/day) or placebo for 6 months. Body weight, bone turnover markers (pyridinium cross-links), osteocalcin, and parathyroid hormone (PTH) were measured at treatment weeks 1-5, 7, 10, 13, 16, 20, and 25. Total body BMD, insulin-like growth factor, 25-hydroxyvitamin D, and sex hormone binding globulin (SHBG) were measured at baseline and week 25. The calcium supplemented (n = 15; age 60.9 +/- 9.4 years, body mass index [BMI] 33.2 +/- 4.6 kg/m2) and placebo (n = 16; age 55.8 +/- 8.3 years, BMI 32.9 +/- 4.5 kg/m2) groups lost similar amounts of weight over the study interval (10.2 +/- 5.3% vs. 10.0 +/- 5.2%) and both groups increased SHBG (p < 0.001). There was a statistical effect of calcium supplementation during weight loss to suppress pyridinium cross-links, osteocalcin, and PTH (p < 0.05, < 0.01, and < 0.05, respectively). Loss of BMD tended to be greater in the placebo group by 1.4% (p < 0.08) after weight loss. One gram per day calcium supplementation normalizes the increased calcium-PTH axis activity and the elevated bone turnover rate observed during moderate voluntary energy restriction in postmenopausal women.     

黄金工业特征污染物综合治理装备现状及发展趋势

黄金工业特征污染物综合治理装备是黄金工业实现绿色、和谐、可持续发展的重要技术支撑。介绍了黄金工业特征污染物综合治理装备的分类、应用工艺、相应结构、功能实现过程与应用特点等现状,统计分析了治理装备在黄金矿山的应用状况,并对黄金工业特征污染物综合治理装备及技术的未来发展趋势进行了研讨。     

Current status of treatment for small hepatocellular carcinoma

In recent years ethanol injection therapy (PEI) and transcatheter hepatic arterial embolization (TAE) have come to be widely used in the treatment of small hepatocellular carcinoma, and the introduction of microwave coagulation therapy (MCT) more recently has made it possible to perform a variety of non-surgical treatments even in cases in which surgical resection has been indicated until now. There have also been reports based on survival rates that results comparable to those obtained by surgical resection can be achieved with non-surgical methods. The main issue is whether PEI or resection should be selected to treat small hepatocellular carcinomas. However, the recurrence rate after PEI is higher than after surgical resection, and according to our results, in patients with solitary lesions, especially when the tumor diameter is 2 cm or less, the level of malignancy in many cases is also low biologically, and postoperative survival rates (recurrence-free survival rates) are favorable [5 years : 85.0% (64.3%); 10 years: 67.9% (42.2%)]. After thoroughly evaluating liver function in these cases, while surgical resection should be considered first, it is also important to use a combination of various treatment methods rather than always resort to a single method.     

Current status of intraperitoneal therapy for ovarian cancer

Recent attention has focused on evaluating those clinical situations in which intraperitoneal drug delivery may be an appropriate treatment option for patients with ovarian cancer. When employed as a second-line strategy, approximately 20% to 30% of patients with small-volume residual disease (microscopic, largest tumor mass < or = 0.5 to 1 cm in maximum diameter) at initiation of treatment are expected to achieve a surgically documented complete response with a variety of organoplatinum-based intraperitoneal regimens. However, responses are rarely observed in such patients who have failed to demonstrate tumor sensitivity to systemically delivered organoplatinum drugs, despite the presence of small-volume residual disease. Investigators at several centers are currently exploring a possible role for regional drug delivery in the initial management of selected patients (ie, small-volume disease) with ovarian cancer. A recently reported trial of intraperitoneal taxol suggests this may be an ideal drug for regional therapy of ovarian cancer due to a major pharmacokinetic advantage associated with this route of drug delivery.     

Current status of luting agents for fixed prosthodontics

STATEMENT OF THE PROBLEM: The long-term clinical outcome of fixed prosthodontic treatment depends, in part, on the use of adhesives that can provide an impervious seal between the restoration and the tooth. There are several types of available luting agents, each possessing unique properties and handling characteristics. No one product is ideal for every type of restoration. PURPOSE: The purpose of this article is to review available dental luting agents, discuss improvements and drawbacks in newly formulated adhesives, and present the indications for their use. RESULTS: Each cement type is physically and chemically unique. A single adhesive will not suffice in modern day clinical practice.     

Current status of federal support for psychology.

Reports on federal funding for psychology. The present report is based on information obtained between December 1968 and April 1969. The data in this report, generally, come from the agency offices directly involved in the programs described, such as the National Science Foundation or the National Institutes of Mental Health. Some figures, however, are from official publications. No attempt at a detailed analysis of funding levels for specific programs supporting psychological research will be made in this report. Many agencies were unable at the time of this report to determine how much of their allocations was specifically to psychologists or for psychological research as opposed to broader categories such as behavioral scientists, behavioral research, or extramural research. In a later report from this office, a finer breakdown of funding for psychology and an interpretive analysis will be presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Current status of surgery for mediastinal tumors]

Impact of surgery on the result of mediastinal tumors is variable: In benign tumors such as teratoma, congenital cyst, intrathoracic struma and neurogenic tumor, a complete resection causes a good result. Simultaneous thoracotomy and laminectomy should be performed in the Dumbbell type of neurogenic tumor. Since complete resection of the invasive thymoma promises a good prognosis, excision of all the tumor and invading tissues followed by radiation therapy is recommended in the treatment of thymoma. In pure seminoma resection and radiation therapy is the treatment of choice, while in non-seminomatous germ cell tumor, aggressive chemo- and radiation therapy should be performed, until tumor markers such as AFP and HCG become negative. The operation is to be followed afterwards. A mass screening test for neuroblastoma in infant facilitates an early detection of this disease and promises a good result by chemotherapy, radiation therapy, and surgery. There is still a possibility that the result of treatment of the malignant mediastinal tumors would be improved by exact diagnosis and intensive treatment.