Prevention of laryngeal webs through endoscopic keel placement for bilateral vocal cord lesions / 医学前沿

Transoral microresection for treatment of vocal cord lesions involving the anterior commissure may result in anterior glottic webs. In this study, we retrospectively reviewed 54 patients who underwent microsurgery for bilateral lesions involving the anterior commissure and categorized them into two groups. The keel placement and control groups received endoscopic keel placement and mitomycin C, respectively. During the follow-up of at least 1 year, the laryngeal web formation rate significantly decreased in the keel placement group compared with that in the control group (18.6% versus 54.5%, P < 0.05). Furthermore, the voice handicap index-10 scores for patients without web formation decreased in both the keel placement and control groups (P < 0.0001 and P < 0.001, respectively). A pseudomembrane covering the vocal cords was detected in 16.3% (7 of 43) cases after keel removal. A total of 100% (7 of 7) of these cases and 2.8% (1 of 36) of the other cases formed laryngeal webs (P < 0.0001). Endoscopic keel placement could be an effective method for preventing anterior glottic webs after surgery for bilateral vocal cord diseases involving the anterior commissure. The pseudomembrane observed at the time of keel removal may imply a high risk of web formation.

Use of Suspension Laryngoscopy CO2 Laser Combined with Placement of Silastic Keel for the Treatment of the Vocal Cords Adhesion / 听力学及言语疾病杂志

Objective To investigate the use of suspension laryngoscopy CO2 laser combined with the placement of laryngeal stent for the treatment of the vocal cords adhesion.Methods A total of 21 patients with acquired vocal cords of adhesion patients(The causes were previous vocal fold surgery for benign lesions in 16 cases,the laryngeal surgery for recurrent papilloma in 4 cases,the laryngeal trauma in 1 case)were included in this retrospective study.Under general anesthesia with intubation,following glottis exposure under suspension laryngoscopy,a CO2 laser incision was performed under microscopy on the superior face of one vocal fold,from the anterior commissure to the posterior part of the web.The keel was placed into the larynx to the appropriate location and fixed with sutures.Results The keels were removed after 3 weeks of operation in 20 patients.The keels were removed after 2 weeks of operation because of subcutaneous emphysema in 1 patient.After a follow-up of 6 months,the reformation of the web happened in 1 case,while the remaining 20 patients recovered with normal triangle shaped anterior commissure anatomy and no granulation or scar tissue were formed.Conclusion Our study shows that the use of suspension laryngoscopy CO2 laser combined with the placement of laryngeal stent is successful for the treatment of the vocal cords adhesion.This procedure has the advantages of micro trauma to patients with avoiding laryngofissure,it provides simple effective treatment of vocal cords adhesion.

Minimum 5-year Follow-up Results of Minimally Invasive Total Knee Arthroplasty Using Mini-Keel Modular Tibial Implant

PURPOSE: To evaluate the minimum 5-year mid-term clinical and radiological results of minimally invasive surgery total knee arthroplasty (MIS-TKA) using a mini-keel modular tibia component. MATERIALS AND METHODS: We retrospectively evaluated 254 patients (361 cases) who underwent MIS-TKA between 2005 and 2006. The latest clinical and radiological assessments were done in 168 cases that had been followed on an outpatient basis for more than 5 postoperative years. Clinical results were assessed using the Hospital for Special Surgery (HSS) score and Knee Society score. Radiological evaluation included measurements of knee alignment. RESULTS: The average postoperative knee range of motion and HSS score were 134.3degrees+/-12.4degrees and 92.7degrees+/-7.0degrees, respectively. The average postoperative femorotibial angle and tibial component alignment angle were 5.2degrees+/-1.7degrees valgus and 90.2degrees+/-1.6degrees, respectively. The average tibial component posterior inclination was 4.8degrees+/-2.1degrees. The percentage of cases with tibial component alignment angle of 90degrees+/-3degrees was 96.1%, and that with the femorotibial angle of 6degrees+/-3degrees valgus was 94.0%. Radiolucent lines were observed in 20 cases (12.0%): around the femur, tibia, and patella in 14 cases, 10 cases, and 1 case, respectively. However, they were less than 2 mm and non-progressive in all cases. The survival rate was 99.4% and there was no implant-related revision. CONCLUSIONS: MIS-TKA using a mini-keel modular tibial plate showed satisfactory results, a high survival rate, and excellent clinical and radiological results in the mid-term follow-up.

Novel sex-related characteristics of the longsnout seahorse Hippocampus reidi Ginsburg, 1933

This paper presents novel sex-related characteristics in Hippocampus reidi, expressed as a prominent and pigmented keel (males only), and by a row of dorsolateral spots mostly (97.4 percent) found in males. While the keel was found even in the smallest males sampled, the dorsolateral spots appear to be associated with body size. Ex situ observations revealed that during courtship males highlighted both characters by turning pale their background body colour. Understanding such colour and behavioural patterns is relevant to increase our knowledge about sexual selection in a morphologically and biologically unique group of fishes.

O presente trabalho descreve novos caracteres sexuais em Hippocampus reidi, expressos como uma quilha proeminente e pigmentada (machos apenas), e uma série de máculas dorsolaterais, encontradas principalmente (97,4 por cento) em machos. Enquanto a ocorrência da quilha foi observada mesmo nos menores machos, a presença de máculas dorsolaterais parece estar associada ao tamanho do corpo. Observações ex situ mostraram que os machos realçam ambos os caracteres durante o comportamento de corte, ao tornar pálida a cor de base do corpo. Destaca-se a relevância da compreensão de tais padrões de colorido para o avanço no conhecimento relativo à seleção sexual em um grupo de peixes de morfologia e biologia singulares.

On Self-enhancement of TCM / 浙江中医药大学学报

While tracing back the 50 years of history and achievements in higher education of TCM,it compares it with western medicine,and sets up 3 elements(research object,knowledge system and intellectual producing style)scale for a separate discipline.Chinese medicine development is slow and weak;therefore it expounds the self-enhancement path from adjusting key Chinese medicine development points,strengthening the idea of paddling its own canoe,perfecting knowledge system and improving the academic and scholar level of Chinese medicine team.