外科病例

Here we present a case of 21 year-old male who suffered from recurrent swelling in left side of mandible which had received surgery for ossifying fibroma in another hospital when he was 19 years old. Obvious facial asymmetry was noted but no sensory dysfunctions were detected. The lesion showed well-demarcated, multilocular radiolucency but radiopacity centrally. We applied segmental resection via extra-oral approach and reconstructed with anterior iliac crest bone graft. After removal of MMF in six week, the wound healed well and joint function was good without malocclusion. After follow-up of one year, no recurrences were noted.

本病例为－21岁之男性，在19岁时因为左下颚骨角区肿大在某医院接受外科手术处理，术后病理报告为骨化纤维瘤，因为复发的肿胀而来本院寻求治疗，临床检查并无疼痛及下唇区感觉异常的问题，放射线影像为周界清晰，多腔室放射透过性合并中央放射不透过性之不规则小块，手术方式为从口外颚下切线，做下颚骨片段式切除，并以肠骨脊海绵骨移植修补骨缺损加以颚间固定六周，术后伤口恢复及愈合良好，颚骨关系稳定无咬合异常的情况，无张口受限的问题。

Results:ISS couldn't show the difference between single and mu ltiple maxillofacial fracture in injury severity (P＞0.5),but RISS could (P ＜0.000 5).Conclusion:RISS is more accurate in evaluation of maxil lofacial fracture severity than ISS.Key words Jaw;Face;Injuries of maxillofacial region;Injury severity score

本文在对大量颌面创伤病案回顾性研究的基础上〔2〕，重新对我院颌面外科近来收治的116例颌面创伤病例进行了研究，以简明损伤定级法(abbrevia ted injury scale，AIS)为蓝本〔3〕，提出一种改进计算颌面部创伤严重度评分的方法(revised injury severity score，RISS)。

No revisions were required for aseptic loosening. Survivorship free of additional surgical procedures was 97% at 5 years.

与其他外科医生设计的系列病例组相比，假体有优良的生存率但是有较高的外侧松解率。

In some cancers, the last treater may be the surgeon or the radiation oncologist, but in most cases where there is treatment with a curative intent, the last treater is the medical oncologist, and usually this is the physician who should take on the responsibility."However, this is a problem, as many oncologists tell us that they do not have the time to take on this additional task," Dr. Ganz commented,"but we need to educate them, and to use a carrot — maybe offer a new payment for this task." This may be possible, she added, as healthcare plans are realizing the benefit of having such summary plans."I have been billing in my practice for years for this — this is not insurance fraud, this is cognitive delivery rather than doing procedure," she added.

就某些癌症而言，最后一位治疗者或许是外科医师或放射科医师，但大部分的病例在治疗时是以痊愈为目标，最后一位治疗者即为肿瘤科医师，通常这位医师应负起责任；然而，Ganz医师指出，这是个问题，因为许多肿瘤科医师告诉我们，他们没时间负起这额外的责任，我们得教育他们，以利诱的方式，或许是为了要他们做这件事而加薪；她补充道，这是有可能的，因为健康照护计画单位正理解到有著如此的概要计画能带来益处，她表示，多年来她已在这方面申报请款，这并不是讹诈保费，而是取之有道。

Objective:To evaluate the use of laparoscopic exploration on patients with diagnostic impression of atypic appendicitis in primary hospital.

目的：探讨在基层医院对于临床诊断怀疑但不能确诊的急性阑尾炎病例，应用腹腔镜外科技术处理的价值。

Althought this surgery has been reported by a few doctors recently, the safety and effectiveness need to be evaluated in further studies. In our study, the approach of the chorioretinal venous anatomosis in the model eyes with branch retinal vein occlusion, are induced by different surgical anastomosis procedures, in order to invest the effectiveness and safety and make a pilot clinic treatment exploration. Methods and materials The study was divided two ports: animal experiment and clinical study.

这种治疗方法的可行性和疗效评价，在激光诱导脉络膜视网膜静脉吻合术治疗非缺血型CRVO病人中得到证实；而对缺血型CRVO，由于病情严重，晚期新生血管并发症产生的危险性高，或者已有产生，因此最近开展的用玻璃体切除联合手术吻合脉络膜视网膜静脉的外科治疗作为最新的探索性治疗方法，在国外已见少数病例报告，但是尚需要进一步的研究观察来评价其可行性、安全性和疗效。

In this article, a case of cleidocranial dysplasia of a 25-year-old Taiwanese female is reported. She visited Taichung Veterans General Hospital Department of Dentistry for the treatment of dental caries in March, 2005. Her abnormalities were diagnosed by Oral and Maxillofacial Surgeon, and was later certified by physician of Genetic Consultation and radiologist.

本文报告一位25岁台湾女性颅锁骨发育不全病例於民国94年三月至台中荣总牙科部寻求龋齿诊治，经口腔颚面外科医师临床及影像检查后，初步臆断为颅锁骨发育不全症候群，后经遗传谘询及放射线部医师确定诊断为颅锁骨发育不良。

Methods A intramedullary melanotic ependymoma patient was treated in the Neurosurgery Department of Beijing Tiantan Hospital. The data were analyzed and literature was reviewed.

分析北京天坛医院神经外科收治的1例椎管内黑色素性室管膜瘤病例，并复习相关文献。

An intact ossicular chain was found in 72% of the cases and could often be presered at surgery.

有72％病例可见完整的听小骨链，并且通常能在外科手术中予以保存。

Methods Sixty-five patients with palindromic intracranial tumor in department of neurological surgery of The Second Affiliated Hospital of Guangzhou TCM University during the recent 7-year period were reviewed, and the measures to prevent its recurrence and problems about operation once again were analyzed.

回顾我院神经外科7年间的65例颅内肿瘤术后复发的病例资料，分析预防术后复发的措施和再次手术的问题。

As she looked at Warrington's manly face, and dark, melancholy eyes, she had settled in her mind that he must have been the victim of an unhappy attachment.

每逢看到沃林顿那刚毅的脸，那乌黑、忧郁的眼睛，她便会相信，他一定作过不幸的爱情的受害者。

Maybe they'll disappear into a pothole.

也许他们将在壶穴里消失