OBJECTIVETo evaluate a long-term effect on pronunciation and maxillary growth of elder patients with wide isolated cleft palate after bibuccinator myomucosal island flap palatoplasty.

METHODSTwelve patients over eight years old with wide isolated cleft palate were selected in experiment group, who received bibuccinator myomucosal island flap palatoplasty. The common group comprised 20 age-matched patients with isolated cleft palate receiving traditional palatoplasty named double-flap method. Simultaneously, 30 randomly selected age-matched noncleft children were included in control group. Both preoperative and postoperative effects over five years on pronunciation and maxillary growth were evaluated using professional, clinical pronunciation system and cephalometric measurement between former two groups. The data of former two groups were compared with control group statistically.

RESULTSThe incisions of all patients in experiment group healed perfectly. After 5-years' follow-up, the patients' mouths opening were normal, no secondary hole on the palate, the flap tissue was softer and more colorful than palate mucosa. The long-term pronunciation effects of patients in experiment group were significantly better than that of preoperation (P < 0.05) and the common group (P < 0.05). The status of maxillary growth of patients in experiment group excelled that in common group significantly (P < 0.05), but no significant difference contrast to that in the control group (P > 0.05).

CONCLUSIONBibuccinator myomucosal island flap palatoplasty is a good operative method for elder patients with wide isolated cleft palate to improve their pronunciation and decrease the affect on maxillary growth.

Aged, 80 and over ; Cephalometry ; Cleft Palate ; Humans ; Maxilla ; Mouth Mucosa ; Surgical Flaps

ObjectiveTo explore the efficacy of constraint-induced movement therapy (CIMT) on motor function of upper extremity of chronic stroke patients.MethodsFifteen chronic stroke patients with hemiparesis (course of diseases more than 13.5 months) were treated by CIMT, involving restriction of movement of the intact upper extremity by placing it in a sling for 90% of waking hours for 12 days and training (by shaping) of the more affected extremity for 6 hours on the 10 workdays during that period. The therapeutic effect was evaluated with upper extremity function test (UEFT) and simple test for evaluating hand function (STEF).ResultsPatients showed a significant and very large degree of improvement after treatment on UEFT and STEF (ES, 0.8 and 0.5, respectively).ConclusionCIMT may be an efficacious method for improvement of the affected arm function of chronic stroke patients.

OBJECTIVETo determine the incidence of post-operative delirium after oral and maxillofacial surgery under general anesthesia in elderly patients, and to examine its association with plasma concentrations of beta amyloid protein 1-40 (Abeta1-40).

METHODSFifty patients underwent elective oral and maxillofacial surgery were divided into two groups: Group C (n=20) aged from 20 to 60 years old, and Group T (n=30) aged from 62 to 78 years old. The two group received the same general anesthesia. Delirium rating scale-revised-98 (DRS-R-98) was used as an instrument to diagnose and access the postoperative delirium of the two groups. The scores of DRS-R-98 were recorded before operation (T0) and at 24 h (T1), 48 h (T2), 72 h(T3) and 96 h(T4) after the operation. Serial measurements of serum concentrations of Abeta1-40 were also performed at the same time.

RESULTSThe incidence of post-operative delirium after oral and maxillofacial surgery in Group T was 20.0%. The concentrations of plasma Abeta1-40 in group T were much higher than group C at TO, T1, T2 and T3 significantly (P < 0.01). The concentrations of plasma Abeta1-40 at T1 and T2 were higher than those at TO in the same group (P < 0.05). The scores of DRS-R-98 in Group T at T3 and T4 were much higher than those at T1 and Group C significantly (P < 0.01).

CONCLUSIONThe constant increase of plasma Abeta1-40 may be one of the important factors related to post-operative delirium in elderly patients underwent oral and maxillofacial surgery.

Aged ; Amyloid beta-Peptides ; Delirium ; Female ; Humans ; Male ; Peptide Fragments ; Surgery, Oral

OBJECTIVETo compare the suppressive effects of tramadol and low-dose ketamine on postoperative hyperalgesia after remifentanil-based anaesthesia.

METHODSA total number of sixty ASA I - II adult patients who undergone the operation of cranio-cervical region were assigned to three groups randomly, controlled group (Group C), tramadol group (Group T) and low-dose ketamine group (Group K). Before the end of surgery, Group T was given tramadol 0.3 mg/kg, Group K was given ketamine 0.5 mg/kg and Group C wasn't given any medicine. When the visual analogue scale (VAS) score of the group C was over five, tramadol 0.3 mg/kg was given to the patients. The four-level verbal rating scale after trachea extubation, VAS score, the time of requiring analgesia again by patients and adverse drug reactions such as nausea, vomit, diplopia and hallucination were recorded for 24 hours after surgery.

RESULTSAfter operation, the VAS score of Group C was much higher than that of Group K in the first 4 hours and Group T was higher than Group K during 2, 3 and 4 hours (P < 0.05). The time of requiring analgesia by patients in Group C and Group T was earlier than Group K. The adverse drug reaction showed no significant difference in three groups.

CONCLUSIONLow-dose ketamine had significant suppressive effect on patients with postoperative hyperalgesia and acute opioid tolerance after remifentanil-based anaesthesia.

Adult ; Analgesics, Opioid ; Anesthesia ; Humans ; Hyperalgesia ; Ketamine ; Male ; Middle Aged ; Pain, Postoperative ; Piperidines ; Postoperative Period ; Tramadol

OBJECTIVETo investigate the role of PGE(2) and cAMP in the postburn change in granulopoiesis in bone marrow in burned mice with endotoxemia.

METHODSOne hundred and seventy eight mice were randomly divided into burn with LPS administration, simple burn, simple LPS administration and control (injection of normal saline) groups. The COX-2 expression and the contents of PGE(2) and cAMP in myeloid cells in injured mice in all groups were determined by RIA (radioimmuno-assay) within 1 postburn week and immunohistochemistry methods. At the same time the change in granulopoiesis was dynamically observed.

RESULTSThe granulopoiesis was enhanced slightly at the early stage of burn and with endotoxin challenge, followed by suppression. The COX-2 expression in myeloid cells the contents of PGE(2) on supernatant of marrow cells and intracellular cAMP in the myeloid cells was increased at 12 postburn hour (PBH) up to 5 postburn day (PBD). Furthermore, the change in the cAMP was evidently and positively correlated with that of PGE(2) (r = 0.978, P < 0.01), but was negatively correlated with that of CFU-GM (r = -0.971, P < 0.01)

CONCLUSIONPGE(2) might play pivotal roles in the postburn granulopoiesis suppression in bone marrow during endotoxemia. This effect might be accomplished by its ligating to its special receptor and to activate adenylate cyclase so as to increase the intracellular content of cAMP in bone marrows.

Animals ; Bone Marrow Cells ; pathology ; Burns ; complications ; metabolism ; Cyclic AMP ; metabolism ; Cyclooxygenase 2 ; metabolism ; Dinoprostone ; metabolism ; Endotoxemia ; etiology ; metabolism ; Granulocytes ; pathology ; Male ; Mice ; Mice, Inbred Strains

OBJECTIVETo compare the influence of propofol and isoflurane on pro-inflammatory and anti-inflammatory cytokine response to perioperative period of tongue cancer surgery.

METHODSTwenty-four adult patients undergone the operation of tongue cancer were assigned to two groups randomly, propofol group (Group P) and isoflurane group (Group I). In group P, anesthesia was induced with fentanyl 2-3 microg/kg, propofol 2 mg/kg, atracurium 0.6 mg/kg and maintained with propofol 5-8 mg x kg(-1) x h(-1) and inhalation of 50% nirous oxide (N2O:O2=50%:50%). In group I, anesthesia was induced with 3%-4% isoflurane, fentanyl 2-3 microg/kg, diazepam 0.06-0.1 mg/kg, atracurium 0.6 mg/kg and maintained with inhalation of 50% N2O and isoflurane (ended-tidal isoflurane was maintained at 0.6%), in two groups atracurium was given intermittently. Blood samples were taken from peripheral vein before anesthesia (TO), at the end of operation (T1), 24 h (T2) and 48 h (T3) after operation for determination of serum IL-6 and IL-10 concentrations. The mean arterial pressure (MAP) and body temperature in two groups were recorded.

RESULTSIL-6 and IL-10 levels increased significantly in two groups at T1, T2 and T3 compared with T0 (P < 0.01). The increasing trend of IL-6 and IL-10 levels were similar in both groups, whereas the level of IL-6 at T1 in propofol group was lower than that of isoflurane group significantly (P < 0.01), however the level of IL-10 was much higher in propofol group than that of isoflurane group at T1 and T2 (P < 0.05).

CONCLUSIONThe influence of total intravenous anesthesia of propofol on post-operation inflammatory response is much gentler than isoflurane.

Adult ; Anesthesia, Intravenous ; Cytokines ; Female ; Humans ; Interleukin-10 ; Interleukin-6 ; Isoflurane ; Male ; Middle Aged ; Neoplasms ; Perioperative Period ; Postoperative Period ; Propofol

AIM AND METHODSTo investigate the effect of 2 mg/kg and 10 mg/kg losartan intraperitoneally (i.p) on arterial blood pressure (AP) and heart rate (HR) in rat and the involvement in the activity of habenulas neurons. Glass micropipette was used to record any changes of unit discharging of neurons in LHb and MHb before and after losartan was intraperitoneally injected.

RESULTSAP and HR were not significantly changed by 2 mg/kg losartan (i.p). However, AP was apparently decreased by 10 mg/kg losartan (i.p), but HR was unchanged. After 10 mg/kg losartan (i.p), 66.66% (12/18) unit discharging of neurons in LHb were increased in frequency, and 61.90% (13/21) in MHb were decreased.

CONCLUSIONAP of rat was significantly decreased by 10 mg/kg losartan (i.p). Depressor effect of losartan (i.p) was involved in the excision of neurons in LHb and the inhibition in MHb.

Animals ; Blood Pressure ; drug effects ; Habenula ; drug effects ; physiology ; Losartan ; pharmacology ; Neurons ; drug effects ; physiology ; Rats ; Rats, Wistar

OBJECTIVETo review the applications of magnetic resonance imaging (MRI) techniques in assessing treatment response to gamma knife radiosurgery for brain tumors.

DATA SOURCESPublished articles about assessing treatment response to gamma knife radiosurgery for brain tumors were selected using PubMed. The search terms were "MRI", "gamma knife" and "brain tumors".

STUDY SELECTIONArticles regarding the MRI techniques using for early assessment of treatment response of gamma knife were selected.

RESULTSMRI techniques, especially diffusion weighted imaging, perfusion weighted imaging, magnetic resonance spectroscopy, are useful for early assessment of treatment response of gamma knife by detecting the hemodynamic, metabolic, and cellular alterations. Moreover, they can also provide important information on prognosis.

CONCLUSIONSDiffusion weighted imaging, perfusion weighted imaging and magnetic resonance spectroscopy can provide early assessment of treatment response of gamma knife for brain tumors, and also information of tumor progression or recurrence earlier than conventional MRI. But there are still many questions to be answered which should be based on the development and advancement of MRI and related disciplines.

Brain Neoplasms ; pathology ; surgery ; Diffusion Magnetic Resonance Imaging ; Humans ; Magnetic Resonance Imaging ; methods ; Magnetic Resonance Spectroscopy ; Radiosurgery

Objective To evaluate the value of positron emission tomography(PET)-CT imaging combined with continual detection of CA_(125)in serum for diagnosis of early recurrent ovarian epithelial carcinoma.Methods Twenty six patients received PET-CT imaging,who were all diagnosed as primary epithelial ovarian cancer of stage Ⅱ-Ⅳ and had complete remission after cytoreductive surgery and multiple courses of chemotherapy in Shandong Provincial Cancer Hospital.After a steady period,all patients experienced progressive rising of CA_(125)values 3 times in 2 months.But no positive lesion was found by CT, or although suspicious positive focus was found,the recurrent and(or)metastatic extent was not definite. Out of 26 patients,16 were delivered rechemotherapy and(or)radiotherapy,and 10 received re- cytoreductive surgery.Results(1)Of 26 patients,the value of CA_(125)was more than 35 kU/L in 17,and in 14 of 17,pelvic or abdominal cavity recurrence was diagnosed by CT and PET-CT,and 4 showed simuhaneously distant metastasis on PET-CT.In the remaining 3 patients of which CT findings were negative,2 had pelvic and abdominal cavity recurrence,and one had bone metastasis on PET-CT.Of 9 patients with progressive rising CA_(125)levels but the value was less than cut-off(

ObjectiveTo determine the efficacy of constraint-induced movement therapy(CIMT) on different severity of the motor deficit of upper extremity after stroke.Methods27 stroke patients who had upper-limb hemiparesis and learned nonuse were allocated either to the moderate group(n=12) or the severe group(n=15) according to severity of initial motor deficit of upper extremity by Upper Extremity Function Test(UEFT).The two group patients were given CIMT,involving restriction of movement of the intact upper extremity by placing it in a sling for 90% of waking hours for 12 days and training(by repetitive practice,shaping) of the more affected extremity for 6 hours on the 10 weekdays during that period.Outcome were measured with UEFT.ResultsThere was no significant difference in treatment gain on the UEFT between the moderate patients and the severe patients(P>0.05).However,the Effect Size for the severe patients(ES=2.2) was larger than for the moderate patients(ES=1.8) at the quality of movement(UEFT).ConclusionCIMT is an effective rehabilitation technique for different severity of the motor deficit of upper extremity after stroke,especially in severe stroke patients.