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排序方式: 共有7591条查询结果,搜索用时 140 毫秒
1.
F. Giovanardi F. Nudo Q. Lai M. Garofalo A. Consolo E. Choppin De Janvry G.A. Arroyo Murillo P. Ursi D. Stabile F. Melandro P.B. Berloco R. Pretagostini L. Poli 《Transplantation proceedings》2019,51(1):128-131
Background
Arterial vascular anomalies in patients undergoing kidney transplantation (KT) are correlated with a higher incidence of early surgical complications, potentially causing graft loss. Arterial reconstruction allows patients to overcome these surgical challenges, thus minimizing the risk of poor outcomes. The aim of the present study is to retrospectively investigate the safety and effectiveness of the multiple arterial reconstruction technique with a Teflon patch in case of an unavailable aortic patch: to do so, surgical complications, graft function, and patient survival were evaluated.Methods
During the period January 2009 to August 2016, 202 adult deceased-donor KTs were performed at our center. Group A (n = 27; reconstruction of multiple arteries) and Group B (n = 175; control group) were compared.Results
No differences were observed between the 2 groups in terms of early postoperative course, with no vascular complication observed in Group A. No vascular patch infections were reported, nor longer cold ischemia time rates. Similarly, long-term survival rates were similar between the 2 groups.Conclusions
The Teflon-patch arterial reconstruction technique appears to be safe and effective, with an acceptable balance of benefits and potential risks of using a prosthetic material. Studies based on larger series are needed to further validate this approach. 相似文献2.
A. Montalto V. Piazza F. Albi R. Gherli C. Contento A. Palermo F. Musumeci 《Transplantation proceedings》2019,51(1):206-209
Background
Pump speed optimization in patients implanted with a ventricular assist device represents a major challenge during the follow-up period. We present our findings on whether combined invasive hemodynamic ramp tests and cardiopulmonary exercise testing (CPX) can help optimize patient management.Methods
Eighteen patients implanted with a HeartMate 3 (HM3) device underwent ramp tests with right heart catheterization (including central venous pressure [CVP], pulmonary artery pressure, pulmonary capillary wedge pressure [PCWP], and blood pressure) and echocardiography. Data were recorded at up to 4 speed settings. Speed changes were in steps of 200 revolutions/min (rpm). Evaluation of functional capacity by CPX was conducted according to the modified Bruce protocol.Results
Only 30% of patients had normal PCWPs at their original rpm settings. In going from lowest to highest speeds, cardiac output improved by 0.25 ± 0.35 L/min/step (total change, 1.28 ± 0.3 L/min), and PCWP decreased by 1.9 ± 0.73 mm Hg/step (total change, 6 ± 1.6 mm Hg). CVP and systolic blood pressure did not change significantly with rpm. The rpm assessment was adjusted based on test results to achieve CVPs and PCWPs as close to normal limits as possible, which was feasible in all patients. On CPX, all patients demonstrated good performance (peak VO2, 16.8 ± 3.5 mL/kg/min).Conclusion
Hemodynamic ramp testing provides an objective means of optimizing rpm, and has the potential to provide good exercise tolerance. 相似文献3.
《Clinical neurophysiology》2019,130(9):1562-1569
ObjectiveConventional deep brain stimulation (DBS) systems with ring-shaped leads generate spherical electrical fields. In contrast, novel directional leads use segmented electrodes. Aim of this study was to quantify the impedance variations over time in subjects with the directional Cartesia-Boston® system.MethodsImpedance records, programming settings, and clinical data of 11 consecutive Parkinsonian patients implanted with DBS directional leads in two Italian centers (Udine and Vicenza) were retrospectively evaluated. Data were collected before starting stimulation (in the operating room and at days 5 and 40) and after switching stimulation on at the successive follow-up visits (1, 6 and 12 months).ResultsDirectional leads have significantly higher impedance than ring leads. Stimulated contacts had always lower impedance compared to non-stimulated contacts. Before DBS-on, all contacts had higher impedance in the operating room, with an initial decrease five days post-surgery and a subsequent increase at day 40, more evident for directional contacts. The impedance of directional leads increased post-implantation at 1 and 6 months with a plateau at 12 months.ConclusionsThere was a significant difference between the directional and ring leads at baseline (before activation of DBS) and during follow-up (chronic DBS).SignificanceOur study reveals new information about the impedance of segmented electrodes that is useful for patient management during the initial test period, as well as during long-term DBS follow-up. 相似文献
4.
I. Fouzas C. Papanikolaou G. Katsanos N. Antoniadis N. Salveridis K. Karakasi S. Vasileiadou A. Fouza E. Mouloudi G. Imvrios V. Papanikolaou 《Transplantation proceedings》2019,51(2):416-420
Aims
Variations of the anatomy of donor hepatic arteries increase the number of arterial anastomoses during liver transplantation and, possibly, the incidence of hepatic artery thrombosis (HAT). In this study, we describe the arterial anatomic variations in liver grafts procured and transplanted by a single center in Greece, the techniques of arterial anastomosis, and their effect on the incidence of early HAT.Materials and Methods
From January 2013 to December 2017, the arterial anatomy of 116 grafts procured for liver transplantation were recorded, as well as the technique of arterial anastomosis and the incidence of early hepatic artery thrombosis (HAT <30 days).Results
A single hepatic artery was recorded in 72.41% of the procured grafts, an aberrant left hepatic artery (accessory or replaced) in 18 grafts (15.52%), and an aberrant right hepatic artery (accessory or replaced) in 17 grafts (14.66%), while other variations were observed in less than 1% of the procured livers. Of the 116 primary liver transplantations, 6 patients (5.17%) developed early HAT <30 days. Two of these patients (1.72%) had 1 anastomosis of the hepatic artery and 4 (3.45%) had 2 anastomoses due to anatomic variations.Conclusions
Anatomic variations of the hepatic artery in liver grafts is a common finding and increase the incidence of early HAT but not to a degree to make these grafts unusable. 相似文献5.
B. Davido R. Batista H. Fessi H. Michelon L. Escaut C. Lawrence M. Denis C. Perronne J. Salomon A. Dinh 《Médecine et maladies infectieuses》2019,49(3):214-218
Objective
A rapid and worrying emergence of vancomycin-resistant enterococci (VRE) gut colonization is occurring worldwide and may be responsible for outbreaks, especially in healthcare facilities. While no efficient decolonization strategies are recommended, we assessed fecal microbiota transplantation (FMT) to eradicate VRE colonization.Patients and method
Our main objective was to measure the impact of FMT on decolonization of VRE carriers, confirmed by at least two consecutive negative rectal swabs at one-week interval during a 3-month follow-up period. Patients received no antibiotic prior to the FMT.Results
After a month only three patients remained colonized with VRE. Decolonization was associated with 87.5% (n = 7) of success after three months as only one patient remained colonized.Conclusion
Our first results confirm that the FMT seems to be safe, with an impact on VRE colonization over time that may help control outbreaks. 相似文献6.
人间充质干细胞免疫原性研究 总被引:1,自引:0,他引:1
目的探讨人间充质干细胞(hMSCs)特性及免疫原性,为进一步研究hMSCs移植特性提供实验依据。方法免疫组化方法鉴定hMSCs表面HLA-ABC、HLA-DR、CD80、CD86分子;流式细胞术检测其含量;RT-PCR检测HLA-ABC、HLA-DRmRNA基因片断;外周血淋巴细胞杀伤试验及 CCK-8比色法规察淋巴细胞增殖反应;将表达绿色荧光蛋白(GFP)的DNA复合物导入hMSCs进行大鼠脑内移植,观察hMSCs在脑内的存活情况。结果 hMSCs表面少量表达HLA-ABC分子,不表达 HLA-DR、CD80、CD86分子;有少量HLA-ABC mRNA基因片断存在,未发现HLA-DR mRNA基因片断;外周血淋巴细胞杀伤试验没有发现淋巴细胞增殖反应;大鼠脑内移植hMSCs一个月后仍可见有细胞存活。结论 hMSCs具有较弱的免疫原性。 相似文献
7.
人脐带间充质干细胞移植对大鼠脊髓损伤神经功能恢复的评价 总被引:8,自引:0,他引:8
目的 观察人脐带间充质干细胞(human umbilical cordmesenchymal stem cell,hUCMSC)移植对大鼠脊髓损伤神经功能恢复的影响。方法 SD大鼠70只,随机分为3组:脊髓半切+hUCMSC组(n=30)、脊髓半切+PBS组(n=30)和假手术组(n=10)。脊髓半切+hUCMSC组和PBS组又分为头侧注射、尾侧注射和头尾两侧注射三个亚组。移植后1、7、14、21、28d观察大鼠神经功能恢复情况,应用免疫组化检测移植到脊髓的hUCMSC胶质纤维酸性蛋白(GFAP)和神经元特异性烯醇化酶(NSE)表达情况。结果 大鼠脊髓半切损害后,hUCMSC组动物较PBS组有明显的神经功能恢复。植入后28d在宿主脊髓中存活的hUCMSC细胞MABl281(mouse antiuman nuclei monoclonal antibody)染色阳性,免疫组化双标染色显示MABl28l阳性细胞亦分别有NSE或GFAP表达并向损伤部位迁移,hUCMSC来源的GFAP阳性细胞可见明显的树突生长。结论 hUCMSC移植到宿主损伤脊髓后可以存活、向损伤部位迁移,并向神经元样和星形胶质细胞分化,且可促进大鼠脊髓损伤后神经功能恢复。hUCMSC作为一种来源广泛的干细胞用于治疗脊髓损伤可能具有重要的价值。 相似文献
8.
移植人羊膜细胞对大鼠创伤性脑损伤的实验研究 总被引:6,自引:2,他引:4
目的 探究大鼠TBI后脑内移植人羊膜细胞(HACs)对大鼠运动功能的影响。方法 HACs经分离、Hoechst33342标记后重悬调整细胞浓度为10^5/μl;采用改进的Feeney自由落体法打击大鼠脑皮层后肢运动区域,损伤后24h经微量注射器和立体定向仪将Hoechst33342标记的HACs 10μl分别移植于挫伤灶中心和挫伤灶边缘;在TBI后的28d内采用钉板平衡木行走测试大鼠运动功能变化,运动功能检测结束后取出脑组织行组织学检测。结果 治疗组滑落脚步数明显少于对照组(P〈0.05);移植的HACs呈蓝色荧光;部分移植HACs可见MAP-2阳性表达。结论 移植HACs使大鼠TBI后运动功能明显改善。 相似文献
9.
游离腓骨皮瓣移植Ⅰ期修复胫骨创伤性骨髓炎骨皮缺损 总被引:1,自引:1,他引:0
[目的]探讨游离腓骨皮瓣移植Ⅰ期修复胫骨创伤性骨髓炎合并骨皮缺损的方法和疗效。[方法]对156例胫骨创伤性慢性骨髓炎合并骨皮缺损患者,在行病灶清除的基础上行游离腓骨皮瓣移植,Ⅰ期修复骨皮缺损。[结果]经术后6—60个月的随访,皮瓣全部成活,发生静脉危象6例,再次吻合成功;伤口Ⅰ期愈合140例,Ⅱ期愈合13例,遗留窦道3例;骨髓炎复发2例。移植腓骨全部愈合,愈合时间2—6个月,平均3.2个月。[结论]慢性骨髓炎合并骨皮缺损可应用显微外科技术Ⅰ期修复。但是在感染的基础上进行手术,有一定的风险,严格掌握适应证。 相似文献
10.
Eduardo Krajewski Ian S Soriano Jorge Ortiz 《JSLS, Journal of the Society of Laparoendoscopic Surgeons》2006,10(4):426-431
BACKGROUND: Solid-organ transplantation has become the treatment of choice for patients with end-stage renal disease, end-stage liver failure, and some patients with type 1 diabetes mellitus. Similarly, surgical expertise and mechanical improvements have led to significant advances in laparoscopic surgery. Laparoscopic interventions are sometimes not pursued in transplant recipients due to the lack of strong supporting evidence for the use of laparoscopic techniques in these patients. METHODS: Using an extensive literature search, we review herein the available data on the utility of laparoscopic interventions in transplant recipients, with particular attention to the risks and benefits, indications, and contraindications for this complex patient population. RESULTS: Although randomized trials are few, multiple case reports indicate that many transplant recipients have benefited from laparoscopic interventions. CONCLUSION: The well-known benefits of laparoscopy could be extended to transplant recipients. 相似文献