[Malformations of chorda tympani nerve].

OBJECTIVE: To analyze the characteristics of anomalies of chorda tympani nerve. METHOD: Chorda tympani nerve and its adjacent structure were investigated during microsurgery in 667 cases of congenitally malformed external-middle ear. RESULT: Anomalies of chorda tympani nerve were found in 433 cases (64.91%). In the group of isolated middle ear malformation of chorda tympani nerve was 16/147 (10.88%); in the group of stenosis of external auditory canal 22/95 (23.15%); and in the group of atresia 394/394 (100%). In 385 cases (97.7%) chorda nerve were not discovered during operations; It were situated at atresia plate (far from malleoincudal interspace) in 9 cases (2.28%). Different feature were found such as: elongation of chorda tympani posterior canaliculus, high or low position, reduplication of chorda tympani nerve, significant low position of chorda tympani nerve in the atresia plate. CONCLUSION: Malformation of chorda tympani nerve is related to the embryologic development of the facial nerve, ossicle, oval window et. It is imparative to identify and to protect the ectopic chorda tympani nerve during operation early.

[Outcome of HCV infection in intravenous drug addicts and influential factors].

A total of 154 intravenous drug addicts with antibody to hepatitis C virus (Anti-HCV) were followed up for 6 and 15 months, respectively. The corresponding negative conversion rates of anti-HCV were 11.0% (17/154) and 33.3% (29/87), respectively. The data were analysed by logistic curve fitting. Results showed that marriage and income status have significant influence on negative conversion rate of anti-HCV.

Vasectomy and prostate cancer risk in China.

Vasectomy has been reported to be associated with an increased risk of prostate cancer in western countries. A hospital-based case-control study was conducted in 12 cities in China to evaluate the relationship between vasectomy and prostate cancer risk in China, a low-risk country with rising incidence and increasing use of vasectomy. Interviews were conducted with 138 histologically confirmed prostate cancer cases diagnosed during 1989-1992 and 638 controls (158 hospital cancer, 158 hospital noncancer, and 322 neighborhood controls) of similar ages. Vasectomy at least 10 years prior to interview was reported by 10% of the cases versus 3% of the controls. Odds ratios for prostate cancer associated with vasectomy were 2.0 (95% confidence interval, 0.7-6.1), 3.3 (95% confidence interval, 1.0-11.3), and 6.7 (95% confidence interval, 2.1-21.6), respectively, when hospital cancer, hospital noncancer, and neighborhood controls were used for comparison. Although detection bias is of concern, the data suggest that in China, men with a history of vasectomy may experience an increased risk of prostate cancer.

PIP: This paper reports the findings of a hospital-based case-control study that was conducted at major teaching hospitals in 12 cities in China. China reports the lowest incidence in prostate cancer of over 100 registries reporting cancer incidence. This investigation evaluated the relationship between vasectomy and prostate cancer and attempted to identify any etiological factor. A total of 138 study patients (index cases) were identified. Controls used in this study included a cancer control and a noncancer control from the same hospital, and 2 neighborhood controls. Chances of having prostate cancer were statistically determined by logistic regression analysis with age group adjustments made. The analysis reviewed 138 cases and 638 controls. Results indicate that, regardless of the variable control used for comparison, an increased risk of prostate cancer was associated with having had a vasectomy. Statistical odds ratio was 2.0 for hospital cancer controls (95% confidence interval [CI]; 0.7-6.1); 3.3 for hospital noncancer controls (95% CI; 1.0-11.3); and 6.7 for neighborhood controls (95% CI; 2.1-21.6). The authors conclude that, as reported for men in Western countries, Chinese men who have had a vasectomy are at significantly increased risk for developing prostate cancer compared to men who never have had a vasectomy. They report a near 2-fold increase in risk (vasectomy vs. non-vasectomy) in developing the disease. Conclusions about cause and effect are premature, but these findings warrant further investigation of several issues. These include: changes in the endocrine system due to vasectomy; systematic and local immunity changes after vasectomy; and other possible biochemical factors that enhance/inhibit cancer growth in the prostate gland.

CT evaluation of malformed external and middle ear and its surgical correlation.

This study evaluated the diagnostic value of high resolution CT (HRCT) for atresia of the external auditory meatus (EAM) and isolated middle ear malformation. CT scan of the temporal bone was done in 33 patients with such disorders and 5 patients with otosclerosis etc. were studied in the same way for comparison. Coronal HRCT clearly showed conditions of the atresia plate and malformation of the malleus, incus, abnormal course of facial canal and changes in the vestibular window. The axial HRCT is useful to demonstrate the articulations in between the malleus, incus, stapes and the cochlear window. All the HRCT findings were confirmed during operation. Axial and coronal HRCT for external and middle ear deformation is highly valuable for decision making and surgical planning.

[Prognostic evaluation of severe viral hepatitis].

The Cox's regression model is used for analysis of registered survival data of severe viral hepatitis. The final regression model showed six covariates, i.e. grade of coma, prothrombin time, the interval between jaundice to bleeding, the interval between jaundice to coma, LDH, and pathological scores as well as the recurrence frequency were associated with survival significantly. The final model can be presented as a "pocket chart" by which a prognostic index (PI) for a new subject can easily be obtained. By a simple graph, the PI can be translated to estimates of the probability of surviving within a given time and the median survival time. A small sample of prospective study showed the predicted survival length did not differ from the observed survival length significantly.

Total reconstruction of the ear with auditory function: a two stage procedure.

The rational treatment of severe microtia or anotia should be to restore not only the form but also the auditory function of the ear. To achieve this aim it is obvious that plastic surgeons must co-operate closely with an otologist: yet this degree of co-operation is seldom seen. This paper describes a two-stage procedure for total ear reconstruction with auditory function. In stage I, a tympanoplasty is performed before transplantation of the carved cartilage framework. Stage II consists of elevation of the reconstructed auricle and transplantation of a full-thickness skin graft to the post-auricular defect. Certain modifications of the operative techniques that we have found useful are discussed in detail.