Objective To introduce a modified method to correct type I and type II cup ear and to evaluate the effectiveness. Methods Between May 2006 and November 2011, 23 patients with type I or type II cup ear (27 ears, type I in 6 ears and type II in 21 ears according to Tanzer’s criteria) were treated. There were 14 males and 9 females with an average age of 10 years (range, 7-16 years). The unilateral ear was involved in 19 cases and bilateral ears in 4 cases. The main clinical manifestations included the flat helix and scapha and ptosis of upper 1/3 auricle. The arc incision was adopted in the auriculocephalic angle, elevation of the dis-clothing-like flap in the front and rear of the auricular cartilage, relocation of the craniofacial initiation site of the scapha and the cavity of auricular concha, correction of deformational auricular cartilage and reconstruction of smooth helix, antihelix, superior and inferior antihelix crus. Results All the incisions healed by first intention without any hematoma, postoperative infection, or flap necrosis. All patients were followed up 9 months-6 years (median, 36 months). No auricle ptosis, deformity contour, or atrophy was observed. The structure of the helix, scapha, and antihelix were clear, natural, and excellent. The scars at the local site were limited and unconspicuous. Conclusion Modified method can almost correct all the anatomic defects of cup ear. It is an ideal method to treat type I and type II cup ear.
目的 探討應用傳統器械經臍行改良單孔腹腔鏡闌尾切除術的臨床價值。方法 回顧性分析筆者所在醫院2010年1月至2012年2月期間行經臍單孔腹腔鏡闌尾切除術的52例闌尾炎患者的臨床資料，總結手術經驗。結果 52例患者均順利完成手術，平均手術時間為39.2min （18～70min），術后平均住院時間為5d （3～12d）。其中，45例患者成功完成經臍單孔腹腔鏡闌尾切除術，2例中轉開腹，2例行兩孔LA術，3例行三孔LA術。術后2例患者發生切口感染。29例患者獲訪，隨訪時間4～18個月，平均12個月，無出血、切口疝、腹腔殘余感染、粘連性腸梗阻、闌尾殘端瘺等并發癥發生。結論 應用傳統器械經臍行改良單孔腹腔鏡闌尾切除術簡單、安全、可行、患者恢復快、并發癥少、美容效果較好，但操作難度相對更高。應嚴格掌握手術適應證，必要時及時增加戳孔或中轉開腹。
Objective To seek for a method of constructing the tissue microarray which contains keloid, skin around keloid, and normal skin. Methods The specimens were gained from patients of voluntary donation between March and May2009, including the tissues of keloid (27 cases), skin around keloid (13 cases), and normal skin (27 cases). The specimens were imbedded by paraffin as donor blocks. The traditional method of constructing the tissue microarray and section were modified according to the histological characteristics of the keloid and skin tissue and the experimental requirement. The tissue cores were drilled from donor blocks and attached securely on the adhesive platform which was prepared. The adhesive platform with tissue cores in situ was placed into an imbedding mold, which then was preheated briefly. Paraffin at approximately 70℃ was injected to fill the mold and then cooled to room temperature. Then HE staining, immunohistochemistry staining were performed and the results were observed by microscope. Results The constructed tissue microarray block contained 67 cores as designed and displayed smooth surface with no crack. All the cores distributed regularly, had no disintegration or manifest shift. HE staining of tissue microarray section showed that all cores had equal thickness, distinct layer, manifest contradistinction, well-defined edge, and consistent with original pathological diagnosis. Immunohistochemistry staining results demonstrated that all cores contained enough tissue dose to apply group comparison. However, in tissue microarray which was made as traditional method, many cores missed and a few cores shifted obviously. Conclusion Applying modified method can successfully construct tissue microarray which is composed of keloid, skin around keloid, and normal skin. This tissue microarray will become an effective tool of researching the pathogenesis of keloid.