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Ultrasonographic evaluation of multicystic dysplastic kidney. 多囊性发育不良肾的超声评价。
S J Han, C Y Yu, G C Liu, W J Yao, T Lee

Eleven cases of multicystic dysplastic kidney (MCDK) in children were diagnosed over an 11 year period. All underwent postnatal ultrasound (US) studies. Four different patterns of MCDK were recognized: (1) Six cases presented with the classic sonogram of multicystic components. (2) Three cases had hydronephrotic form; correct diagnosis between hydronephrotic form of MCDK and hydronephrosis was difficult as there was a medially-located, large, lobulated cyst and there was connection between the large cyst and neighboring small cysts. (3) One case initially presented with normal renal sonogram but a small cyst appeared on follow up sonogram and there was also decreased renal size and increased echogenecity. (4) One case had only two moderate-sized cysts but no identifiable renal parenchyma. Two cases had follow-up US examination and one dysplastic kidney decreased in renal size on follow-up sonogram. Intravenous urography and radionuclide study revealed both these dysplastic kidneys to be nonfunctioning. Nine children had surgical resection of the diseased kidneys. Contralateral renal anomalies were detected in five children, which included ureteropelvic junction stenosis, ureterovesical junction stenosis, distal ureteral stenosis and polycystic kidney disease. Two of three hydronephrotic forms of MCDK had contralateral ureteral stenosis. Two of six classic forms of MCDK had contralateral ureteral stenosis. The proportion of contralateral ureteral stenosis was higher in the group of hydronephrotic forms of MCDK. Ultrasonography is beneficial for conclusive diagnosis of MCDK; however, a differential diagnosis of simple hydronephrosis needs to be considered.

11例儿童多囊性发育不良肾(MCDK)在11年期间被诊断。所有患者均接受了产后超声(US)检查。发现四种不同的MCDK模式:(1)6例具有典型的多囊成分超声图。(2)肾积水3例;MCDK肾积水型与肾积水的正确诊断比较困难,因为它是一个位于中间的分叶状大囊肿,并且大囊肿与邻近的小囊肿有联系。(3) 1例患者最初表现为肾脏超声正常,但在随访超声检查中发现一个小囊肿,肾脏体积减小,回声增强。(4) 1例仅有2个中等大小囊肿,未见肾实质。2例随访超声检查,1例肾发育异常,超声检查显示肾大小减小。静脉尿路造影和放射性核素检查显示这两个发育不良的肾脏没有功能。9名儿童接受了病变肾脏的手术切除。对侧肾脏异常5例,包括输尿管肾盂连接处狭窄、输尿管膀胱连接处狭窄、输尿管远端狭窄和多囊肾病。三种肾积水形式的MCDK中有两种有对侧输尿管狭窄。6例典型MCDK中有2例对侧输尿管狭窄。肾积水型MCDK组对侧输尿管狭窄比例较高。超声检查有助于MCDK的明确诊断;然而,单纯性肾积水的鉴别诊断需要考虑。
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引用次数: 0
The use of right gastroepiploic artery for the bypass of left anterior descending coronary artery--case reports. 右胃网膜动脉搭桥左冠状动脉前降支1例。
Pub Date : 1995-07-01 DOI: 10.6452/KJMS.199507.0416
D. Chang, Y. F. Chen, C. Chiu, H. Yen
The right gastroepiploic artery (RGEA), a branch of the gastroduodenal artery, supplies the greater curvature of the stomach. It is capable of easily reaching the posterior and lateral surface of the heart as a reliable arterial conduit when appropriately harvested. In the previous reports, it has usually been anastomosed to the right coronary artery (RCA) or left circumflex coronary artery (LCX). Here, we present two cases of ischemic heart disease undergoing coronary revascularization. The RGEA was anastomosed to the left anterior decending coronary artery (LAD), which is the most important coronary artery in terms of patient outcome. Thallium-201 myocardial scintigraphy has proven that the RGEA can provide sufficient blood flow to the territory of the LAD. Thus, in coronary artery bypass grafting (CABG), the RGEA is a reliable arterial conduit for LAD revascularization.
右胃网膜动脉(RGEA)是胃十二指肠动脉的一个分支,供应胃的大弯曲。它能够很容易地到达心脏的后表面和外侧表面作为一个可靠的动脉导管,当适当的收获。在以往的报道中,它通常与右冠状动脉(RCA)或左旋冠状动脉(LCX)吻合。在此,我们报告两例接受冠状动脉血运重建术的缺血性心脏病。RGEA与左冠状动脉前降支(LAD)吻合,这是对患者预后最重要的冠状动脉。铊-201心肌显像证实RGEA可以为LAD的区域提供足够的血流量。因此,在冠状动脉旁路移植术(CABG)中,RGEA是LAD血运重建的可靠动脉导管。
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引用次数: 0
Molecular diagnosis of thalassemia in Taiwan. 台湾地区地中海贫血的分子诊断。
J G Chang, H J Liu

Thalassemia is an autosomal recessive disease characterized by absent or decreased synthesis of the globin chain. This disease is very common in Taiwan area. It mainly consists of alpha- and beta-thalassemia. The diagnosis of these entities depends on hemoglobin electrophoresis, mean corpuscular volume (MCV), or mean hemoglobin concentration of red blood cell and excludes the disease of iron deficiency anemia. However, these tests are not reliable. The definite diagnosis is to check the hemoglobin genes directly. In recent years, we have developed several molecular techniques to solve these problems. This review focuses on the techniques which are used recently in Taiwan area.

地中海贫血是一种常染色体隐性遗传病,其特征是珠蛋白链合成缺失或减少。这种病在台湾地区很常见。它主要由-地中海贫血和-地中海贫血组成。这些实体的诊断依赖于血红蛋白电泳、平均红细胞体积(MCV)或红细胞平均血红蛋白浓度,排除缺铁性贫血的疾病。然而,这些测试并不可靠。明确的诊断是直接检查血红蛋白基因。近年来,我们开发了几种分子技术来解决这些问题。本文就台湾地区近年来所采用的技术作一综述。
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引用次数: 0
[Investigation on the parasites of alien laborers in Kaohsiung]. 高雄市外籍劳工寄生虫调查。
C M Yen, L T Tsen, S N Leu, L Y Chung, H C Hsieh, E R Chen

In the past year, stool specimens of 1,732 alien laborers were examined for intestinal parasites. There was no significant difference in the positive rate between males and females. All alien laborers were examined in 3 hospitals and the positive rates were 24.8% (191/769), 13.6% (109/804) and 12.6% (20/159). Broken down by nationality, the positive rates in laborers from Thailand, Indonesia, the Philippines and Malaysia were 23.9% (192/803), 20.3% (62/305), 12.1% (60/498) and 4.8% (6/126) respectively. Of all alien laborers, 17.2% (297/1,732) had single infections of parasites and 1.3% (23/1,732) had multiple infections. Opisthorchis viverrinii was the most prevalent parasite found in infected alien laborers. 91.5% of alien laborers were aged from 21 to 40-years-old and had positive rates of parasites reaching 91.0%. The time of arrival in Taiwan had an effect in all alien laborers examined for parasites. The positive rate in laborers arriving during April to June was 22.7% which was significantly higher than the 16.3% for laborers arriving in other months.

在过去的一年里,对1732名外劳的粪便样本进行了肠道寄生虫检查。男性和女性之间的阳性率无显著差异。外籍劳工在3家医院接受检查,阳性率分别为24.8%(191/769)、13.6%(109/804)和12.6%(20/159)。按国籍分,泰国、印尼、菲律宾和马来西亚的阳性率分别为23.9%(192/803)、20.3%(62/305)、12.1%(60/498)和4.8%(6/126)。17.2%(297/ 1732)外劳有单一感染,1.3%(23/ 1732)有多重感染。在受感染的外籍劳工中发现的寄生虫最多。91.5%的外劳年龄在21 ~ 40岁之间,寄生虫阳性率达91.0%。抵达台湾的时间对所有外来劳工的寄生虫检查都有影响。4 ~ 6月的阳性率为22.7%,明显高于其他月份的16.3%。
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引用次数: 0
The use of right gastroepiploic artery for the bypass of left anterior descending coronary artery--case reports. 右胃网膜动脉搭桥左冠状动脉前降支1例。
D S Chang, Y F Chen, C C Chiu, H W Yen

The right gastroepiploic artery (RGEA), a branch of the gastroduodenal artery, supplies the greater curvature of the stomach. It is capable of easily reaching the posterior and lateral surface of the heart as a reliable arterial conduit when appropriately harvested. In the previous reports, it has usually been anastomosed to the right coronary artery (RCA) or left circumflex coronary artery (LCX). Here, we present two cases of ischemic heart disease undergoing coronary revascularization. The RGEA was anastomosed to the left anterior decending coronary artery (LAD), which is the most important coronary artery in terms of patient outcome. Thallium-201 myocardial scintigraphy has proven that the RGEA can provide sufficient blood flow to the territory of the LAD. Thus, in coronary artery bypass grafting (CABG), the RGEA is a reliable arterial conduit for LAD revascularization.

右胃网膜动脉(RGEA)是胃十二指肠动脉的一个分支,供应胃的大弯曲。它能够很容易地到达心脏的后表面和外侧表面作为一个可靠的动脉导管,当适当的收获。在以往的报道中,它通常与右冠状动脉(RCA)或左旋冠状动脉(LCX)吻合。在此,我们报告两例接受冠状动脉血运重建术的缺血性心脏病。RGEA与左冠状动脉前降支(LAD)吻合,这是对患者预后最重要的冠状动脉。铊-201心肌显像证实RGEA可以为LAD的区域提供足够的血流量。因此,在冠状动脉旁路移植术(CABG)中,RGEA是LAD血运重建的可靠动脉导管。
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引用次数: 0
Hypersensitivity to mosquito bite: a case report. 蚊虫叮咬过敏1例报告。
Pub Date : 1995-07-01 DOI: 10.6452/KJMS.199507.0420
P. Fan, H. N. Chang
Severe hypersensitivity to mosquito bites is very rare. A 18-year-old girl student has had multiple hemorrhagic bullae with atrophic scars on both limbs and left side of the face due to mosquito bites for 16 years. When she was seven years old, she noticed a severe local reaction with bloody bullae formation, chills, and fever several hours after the mosquito bite. The bullae developed into ulcers which finally became scars. This patient was confirmed to be hypersensitive to mosquito bites by the mosquito bite test. This case is the first record of mosquito allergy in Taiwan.
对蚊虫叮咬严重过敏是非常罕见的。一名18岁的女学生由于蚊虫叮咬,在四肢和左脸有多处出血性大疱和萎缩性疤痕,已经持续了16年。当她七岁时,她注意到在蚊子叮咬数小时后出现严重的局部反应,有血泡形成、寒战和发烧。大疱发展成溃疡,最后变成疤痕。经蚊虫叮咬试验证实该患者对蚊虫叮咬过敏。这是台湾第一例蚊子过敏病例。
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引用次数: 15
Ultrasonographic evaluation of multicystic dysplastic kidney. 多囊性发育不良肾的超声评价。
Pub Date : 1995-07-01 DOI: 10.6452/KJMS.199507.0383
S. J. Han, C. Yu, G. C. Liu, W. Yao, T. Lee
Eleven cases of multicystic dysplastic kidney (MCDK) in children were diagnosed over an 11 year period. All underwent postnatal ultrasound (US) studies. Four different patterns of MCDK were recognized: (1) Six cases presented with the classic sonogram of multicystic components. (2) Three cases had hydronephrotic form; correct diagnosis between hydronephrotic form of MCDK and hydronephrosis was difficult as there was a medially-located, large, lobulated cyst and there was connection between the large cyst and neighboring small cysts. (3) One case initially presented with normal renal sonogram but a small cyst appeared on follow up sonogram and there was also decreased renal size and increased echogenecity. (4) One case had only two moderate-sized cysts but no identifiable renal parenchyma. Two cases had follow-up US examination and one dysplastic kidney decreased in renal size on follow-up sonogram. Intravenous urography and radionuclide study revealed both these dysplastic kidneys to be nonfunctioning. Nine children had surgical resection of the diseased kidneys. Contralateral renal anomalies were detected in five children, which included ureteropelvic junction stenosis, ureterovesical junction stenosis, distal ureteral stenosis and polycystic kidney disease. Two of three hydronephrotic forms of MCDK had contralateral ureteral stenosis. Two of six classic forms of MCDK had contralateral ureteral stenosis. The proportion of contralateral ureteral stenosis was higher in the group of hydronephrotic forms of MCDK. Ultrasonography is beneficial for conclusive diagnosis of MCDK; however, a differential diagnosis of simple hydronephrosis needs to be considered.
11例儿童多囊性发育不良肾(MCDK)在11年期间被诊断。所有患者均接受了产后超声(US)检查。发现四种不同的MCDK模式:(1)6例具有典型的多囊成分超声图。(2)肾积水3例;MCDK肾积水型与肾积水的正确诊断比较困难,因为它是一个位于中间的分叶状大囊肿,并且大囊肿与邻近的小囊肿有联系。(3) 1例患者最初表现为肾脏超声正常,但在随访超声检查中发现一个小囊肿,肾脏体积减小,回声增强。(4) 1例仅有2个中等大小囊肿,未见肾实质。2例随访超声检查,1例肾发育异常,超声检查显示肾大小减小。静脉尿路造影和放射性核素检查显示这两个发育不良的肾脏没有功能。9名儿童接受了病变肾脏的手术切除。对侧肾脏异常5例,包括输尿管肾盂连接处狭窄、输尿管膀胱连接处狭窄、输尿管远端狭窄和多囊肾病。三种肾积水形式的MCDK中有两种有对侧输尿管狭窄。6例典型MCDK中有2例对侧输尿管狭窄。肾积水型MCDK组对侧输尿管狭窄比例较高。超声检查有助于MCDK的明确诊断;然而,单纯性肾积水的鉴别诊断需要考虑。
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引用次数: 3
Hypersensitivity to mosquito bite: a case report. 蚊虫叮咬过敏1例报告。
P C Fan, H N Chang

Severe hypersensitivity to mosquito bites is very rare. A 18-year-old girl student has had multiple hemorrhagic bullae with atrophic scars on both limbs and left side of the face due to mosquito bites for 16 years. When she was seven years old, she noticed a severe local reaction with bloody bullae formation, chills, and fever several hours after the mosquito bite. The bullae developed into ulcers which finally became scars. This patient was confirmed to be hypersensitive to mosquito bites by the mosquito bite test. This case is the first record of mosquito allergy in Taiwan.

对蚊虫叮咬严重过敏是非常罕见的。一名18岁的女学生由于蚊虫叮咬,在四肢和左脸有多处出血性大疱和萎缩性疤痕,已经持续了16年。当她七岁时,她注意到在蚊子叮咬数小时后出现严重的局部反应,有血泡形成、寒战和发烧。大疱发展成溃疡,最后变成疤痕。经蚊虫叮咬试验证实该患者对蚊虫叮咬过敏。这是台湾第一例蚊子过敏病例。
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引用次数: 0
[Study of myoblast culture and myoblast transfer therapy in dystrophic mice]. [营养不良小鼠成肌细胞培养及成肌细胞转移治疗的研究]。
H J Jong, S S Chen, Y H Chuang, T J Chen

In this report, we study the suitable conditions for myoblast cultures through analysis of myoblast growth and differentiation, and then try to develop a mouse model for myoblast transfer therapy (MTT). Recently, some research has indicated that Muscular Dystrophy Murine Mice (MDX) have an X-linked recessive dystrophin deficiency which is caused by dystrophin gene point mutation at the X chromosome. Therefore, MDX mice are usually used for MTT models of muscular dystrophy disease. Control mice, C57BL10/SCSN (B-10) were chosen as a source of normal myoblasts. Myoblasts isolated from the hindlimb muscle tissues of two- to three-day-old neonatal B-10 mice were cultured in vitro for one to seven days. Through our modifyied techniques of isolation and culturing conditions, a myoblast purity of 70% could be achieved, with fibroblast the only contaminating cell type. The proliferative capacity and the doubling time of myoblasts were counted from analysis of growth kinetics. While differentiative capacity was analyzed morphologically, we found the fusion of myoblasts was time-dependent. Immunostaining myoblasts of different stages with anti-dystrophin antibody showed that purified myoblasts with the capacity of fusion can express dystrophin and can be utilized as a donating source in MTT. In the MTT experiment, eight young MDX mice were injected with normal myoblasts at a concentration of 1 x 10(6) cells. All transplated mice received daily cyclosporine A injection for immunosuppression. Two to three months later, dystrophin was found in the myoblast-transferred muscles while staining immunocytochemically. The result suggests that we successfully transferred the normal dystrophin gene from the normal myoblasts into the MDX mice since their myoblast-injected muscle could express dystrophin.

本文通过对成肌细胞生长和分化的分析,探讨成肌细胞培养的适宜条件,并尝试建立成肌细胞转移治疗(MTT)的小鼠模型。最近,一些研究表明,肌营养不良小鼠(MDX)具有X连锁隐性肌营养不良蛋白缺乏症,这是由X染色体上的肌营养不良蛋白基因点突变引起的。因此,MDX小鼠通常用于肌营养不良病的MTT模型。选择C57BL10/SCSN (B-10)作为正常成肌细胞来源的对照小鼠。从2 ~ 3日龄新生B-10小鼠后肢肌肉组织中分离成肌细胞,体外培养1 ~ 7天。通过我们改进的分离和培养条件技术,成肌细胞纯度可以达到70%,成纤维细胞是唯一的污染细胞类型。通过生长动力学分析,计算成肌细胞的增殖能力和倍增时间。在形态学分析分化能力的同时,我们发现成肌细胞的融合具有时间依赖性。用抗肌营养不良蛋白抗体对不同时期的成肌细胞进行免疫染色,结果表明纯化的具有融合能力的成肌细胞能够表达肌营养不良蛋白,可以作为MTT的供源。在MTT实验中,8只年轻的MDX小鼠注射了1 × 10(6)个细胞浓度的正常成肌细胞。所有移植小鼠每天注射环孢素A进行免疫抑制。2 ~ 3个月后,免疫细胞化学染色发现成肌细胞转移的肌肉中有肌营养不良蛋白。结果表明,我们成功地将正常的肌萎缩蛋白基因从正常的成肌细胞转移到MDX小鼠中,因为它们的成肌细胞注射的肌肉可以表达肌萎缩蛋白。
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引用次数: 0
Using a titanium mesh plate to reconstruct the orbital floor after an incompletely reduced zygomaticomaxillary complex fracture. 应用钛网板重建颧骨-腋窝复合体不完全复位骨折后的眶底。
Pub Date : 1995-06-01 DOI: 10.6452/KJMS.199506.0359
H. Z. Wang, S. Lai, C. H. Chang
A 30 year-old male came to us for correcting his severe left enophthalmos five months after a facial trauma in a traffic accident. CT scan of his left orbit showed a greatly increased orbital volume, which was resulted from the incomplete reduction of left zygomaticomaxillary complex (ZMC) fracture, unrepaired medial and lateral walls, and improper restoration of the orbital floor with a silicone sheet. Also, the decreased ocular volume, due to the evisceration of the ruptured eyeball with intraocular silicone ball implantation, contributed to the patient's enophthalmos. Because the patient refused any kind of osteotomy for his incompletely reduced and malunion ZMC fracture in the procedures of orbital reconstruction, correction of his severe enophthalmos became very difficult if not impossible. Therefore, we used a piece of titanium mesh plate about 2.5 x 4 cm in size, and folded it into an L shape. The shorter part of the L-shaped plate was used to fix the whole plate by screwing it into the anterior surface of the inferior orbital rim. The longer part of the plate was used as a new orbital floor. To hold and push the intraocular implant upward and anteriorly, the longer part of the plate was adjusted to a level higher than the original floor level, and was bent upward gently in the posterior part. Postoperatively, the severe enophthalmos was markedly improved, and the patient was satisfied although an evident supratarsal sulcus was still present. After a follow-up of 18 months, no complication of migration, infection, or extrusion of the titanium mesh plate occurred.
一位30岁的男性来我们这里矫正他严重的左眼内陷,五个月前他在一次交通事故中面部受伤。左眼眶CT扫描显示,由于左颧腋复合体(ZMC)骨折复位不全,内侧壁未修复,眶底硅胶片修复不当,导致眼眶体积大幅增加。此外,眼内硅胶球植入术切除破裂眼球,导致眼球体积减小,导致患者眼球内陷。由于患者在眶重建术中因ZMC骨折未完全复位和不愈合而拒绝任何形式的截骨,因此矫正其严重的眼内陷变得非常困难,如果不是不可能的话。因此,我们使用了一块尺寸约为2.5 x 4cm的钛网板,并将其折叠成L形。将l型钢板较短的部分旋入下眶缘前表面,固定整个钢板。板的较长部分被用作新的轨道底板。将钢板较长的部分调整到高于原底水位线的水平,并在后部轻轻向上弯曲,使眼内植入物向上向前固定和推动。术后严重眼内陷明显改善,患者满意,但仍有明显的跖骨上沟存在。随访18个月后,未发生钛网板移位、感染或挤压等并发症。
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引用次数: 1
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Gaoxiong yi xue ke xue za zhi = The Kaohsiung journal of medical sciences
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