头位难产的诊断及处理

头位难产（以头为先露的难产）约占总难产发生率的65％，其原因考虑与孕妇活动少、流产引起宫颈损伤至疤痕形成、骨盆狭窄、产力差等有关。头位难产很难在产前明确诊断。因此及早识别头位难产的征象，查明原因，做出正确处理，降低孕产妇及胎婴儿的损伤非常关键。

Template Guided Live Wire and Its Application on Automatic Extraction of Tongue in Digital Image

In this paper, we propose a novel automatic object extraction algorithm, named the Template Guided Live Wire, based on the popularly used live-wire techniques. We discuss in details the novel method’s applications on tongue extraction in digital images. With the guides of a given template curve which approximates the tongue’s shape, our method can finish the extraction of tongue without any human intervention. In the paper, we also discussed in details how the template guides the live wire, and why our method functions more effectively than other boundary based segmentation methods especially the snake algorithm. Experimental results on some tongue images are as well provided to show our method’s better accuracy and robustness than the snake algorithm.

Teat Length and Lactation Period as A Predisposition Factor of Subclinical Mastitis in Dairy Cattle in Bandung, Indonesia

In order to improve the practical approach to clinical diagnosis of subclinical mastitis, 72 dairy cattle from KPSBU Lembang Bandung Regency was used in this research. The purpose of this research was to study the correlation between udder length and lactation period with the profile of subclinical mastitis. Lactation period data was collected from interviews with farmers. Subclinical mastitis testing by IPB-1 Mastitis Test reagent and udder length measured using measuring tape （cm）. Data was analyzed using Duncan test and logistic regression. The highest correlation of subclinical mastitis occurred to dairy cattle with average udder length of 7.5 cm and was in the third and forth lactation period. This result shows that udder length and lactation period of dairy cattle is a predisposing factor for subclinical mastitis. This finding is important to improve the milking management as well as a way to diagnose subclinical mastitis.

FDG-PET AS A ROUTINE SURVEILLANCE TOOL IN HEAD AND NECK CARCINOMA SIX MONTHS AFTER TREATMENT

Objective To evaluate prospectively the impact of fluorodeoxyglucose-fluorine-18 positron emission tomography (FDG-PET) in the detection of recurrence, second primary cancers, and distant metastases in head and neck squamous cell carcinoma (HNSCC) 6 months after treatment. Methods A total of 41 patients without any clinical element for recurrence, second primary cancer, or distant metastases received a whole-body FDG-PET as a routine surveillance tool 6 months after initial combined curative therapy for HNSCC. Results There were 35 negative PET results and 6 positive. One patient with abnormal FDG-PET did not have recurrent HNSCC (false positive). Five had true positive results: proven recurrence in 2 patients, second primary cancer in 2, and distant metastasis in 1. The sensitivity and specificity of FDG-PET for the diagnosis of HNSCC recurrence, second tumor, and distant metastases were 100% (5/5) and 97.2% (35/36), respectively. The positive predictive value was 83.3% (5/6). The negative predictive value was 100% (35/35). The overall accuracy was 97.6% (40/41). FDG-PET had a therapeutic impact in 5 of 41 patients (12.2%). There was no impact of FDG-PET on management in other 36 patients. Conclusion FDG-PET is useful as primary method for detecting nodal recurrence and distant metastases in HNSCC as well as second cancer in subclinical patients as it had a high effectiveness. But systematic FDG-PET performed at 6 months in patients without any clinical suspicion of local recurrence was scarcely useful.

Local resection for tumor of papilla of Vater: an analysis of 25 cases

Objective: To investigate the clinical features, diagnostic methods, and treatment choice of tumor of the papilla of Vater. Methods: The clinical data of 25 patients with tumor of the papilla of Vater treated by local resection in our hospital from December 1983 to May 2006 were retrospectively analyzed. Results: The morbidities of abdominal pain, jaundice and recurrent cholangitis were 84%, 80% and 48%, respectively. The accordant rate for preoperative duodenoscopic biopsy and post-operative pathological diagnosis was 80%. Intraoperative frozen section examination accurately predicted the final pathological results in all the patients. The post-operative complication rate was 20% and the operative mortality rate was 4%. The 5-year survival rates of local resection for benign tumors and malignant tumors were 75% and 28.5%, respectively. Conclusion: Abdominal pain, jaundice and recurrent cholangitis are the main symptoms and signs of tumor of the papilla of Vater. Duodenoscopy is the principal preoperative diagnostic method and intraoperative frozen section examination is reliable in assessing the operative specimens. Selective local resection is an effective treatment option for tumor of the papilla of Vater.

DETECTION OF E6, E7 AND CELL-TYPE SPECIFIC ENHANCER OF HUMAN PAPILLOMAVIRUS TYPE 16 IN BREAST CARCINOMA

Objective To detect HPV16 E6, E7 genes and cell-type specific enhancer （CTSE） of long control region （LCR） in breast carcinoma （BC）. Methods HPV16 E6 ,E7 genes and CTSE were detected in 40 BCs and 20 normal breast tissue （NBT） using polymerase chain reaction （PCR）. Results The positive rates of HPV16 E6 , E7genes and CTSE were 60% （ 24/40 ） , 55% （ 22/40 ） and 67. 5% （ 27/40 ） respectively in BCs, whereas only 5% （1/20）, 5% （1/20） and 15% （3/20） in NBTs （ P 〈 O. 05）. There exited significant correlation between E6 gene and CTSE in BCs （ P 〈0. 05） , as well as E7 gene and CTSE. The infection of HPV16 E6, E7 and CTSE had no statistic relationship with pathological features. Conclusion There were HPV16 E6 , E7 genes and CTSE together in BCs and CTSE may play an important role in pathogenesis of BC.

Color doppler ultrasound in the application of breast intraductal papilloma

Objective:The aim of this study was to evaluate the application value of high-frequency color Doppler ultrasound in the diagnosis of intraductal papilloma (IDP). Methods:A retrospective analysis of 64 IDP cases was done, the pathology proven by surgery with 89 lesions. According to the ultrasonic performance, the lesions were divided into different types and the solid focal were evaluated according to the classification BI-RADS-US standard. Results:There were 47 patients corresponds with the 64 cases of surgical pathology, the accuracy was 73.4%, according to the ultrasonic performance could be divided into two types, named catheter type and solid type, catheter diagnostic accuracy was 22/25 (88%), compared the morphological features of the solid type, grouped according to their size (≥ 2 cm or < 2 cm lesions), discovered there was no statistically significant difference between the benign and malignant lesions by BI-RADS-US grading standard. Conclusion:Two-dimensional ultrasound and Color Doppler flow imaging (CDFI) can make a definite diagnosis and positioning for IDP, but there are still some limitations to differentiate the benign and malignant, it need to pay more attention to the clinical application of substantive IDP and improve the understanding, provide more relevant information for clinic, the focal will be earlier treated to reduce the possibility of malignant happened change.

头皮脓癣误诊脓肿切开8例分析

目的:提高对头皮脓癣的认识,减少误诊。方法:对误诊为脓肿而行切开术的8例头皮脓癣患儿进行回顾性分析。结果:本组8例患者均因误诊而行切开术,伤口长期不愈,经正确诊断治疗,效果良好。结论:关键是提高对本病的认识,注意详细询问病史,仔细查体,进行病发真菌镜检及培养,切忌盲目切开引流,给患者造成不必要的痛苦及经济负担。