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51.
Overview Excess spasticity leads to disability that is marked by impaired locomotion, handicapping deformities and, if not controlled,
discomfort and pain. Selective peripheral neurotomy in the child is indicated for severe focal spasticity, when botulinum
toxin injections cannot delay surgery any longer.
Materials and methods Preoperative motor blocks mimicking the outcome of the surgical procedure are essential to establish the objectives of neurotomy.
In the lower limb, obturator neurotomy is indicated for spasticity in the adductor muscles, hamstring neurotomy for the knee flexion and tibial
neurotomy for the spastic foot. Anterior tibial neurotomy is indicated for the extensor hallucis spasticity and femoral neurotomy
for spasticity in the quadriceps. In the upper limb, neurotomy of the pectoralis major and teres major nerves is indicated for spasticity of the internal rotators of the shoulder.
Neurotomy of the musculocutaneous nerve is indicated for spasticity of the flexors of the elbow, and neurotomy of median and
ulnar nerves are indicated for spasticity of the pronators and flexors of the wrist and fingers.
Conclusion Selective peripheral neurotomy is a valuable neurosurgical procedure in well-trained surgical hands for severe focalised spasticity. 相似文献
52.
悬浮阵列技术在研究与临床中的应用 总被引:3,自引:2,他引:1
悬浮阵列技术是一种以荧光编码微球为核心,集流式细胞、激光分析、高速数字信号处理等多种技术于一体的多指标并行分析技术平台,可一次同时准确定量检测100种不同的生物分子;具有高通量、高灵敏度,并行检测等特点;常用于免疫分析、核酸研究、酶学分析、受体、配体识别分析等研究. 相似文献
53.
Farsin Hamzei Michel Rijntjes Joystone Gbadamosi Kornelius Fuchs Cornelius Weiller Alexander Münchau 《Movement disorders》2003,18(8):959-961
We report on a woman with a an 8-year history of multiple system atrophy with predominance of parkinsonism who developed jaw-locking oromandibular dystonia within hours after insertion of ill-fitting dentures. Dystonia spread rapidly to involve other facial muscles and the larynx causing stridor with respiratory failure necessitating crush intubation. 相似文献
54.
Walter Daghino MD Luigi Milano MD Sergio Ronco MD Giorgio Ronco MD Angelo Dettoni MD Massimo Cartesegna MD 《The Journal of foot and ankle surgery》2003,42(3):155-160
This article is a retrospective study comparing the efficacy of Regnauld arthroplasty to first ray osteotomies for the treatment of hallux valgus. One hundred consecutive cases of Regnauld arthroplasties were compared with 100 consecutive first ray osteotomies. One hundred fourty-one patients were available for follow-up, and based on clinical/radiographic examinations, 72 were treated with the osteotomy protocol (group A) and 69 with Regnauld arthroplasty (group B). Age at surgery, clinical symptoms, and preoperative radiologic findings were similar for the 2 groups; there was a preponderance of female patients (90%). The average follow-up was 49 months in group A and 51 months in group B. Clinical evaluation showed in the osteotomy group a more stable correction (79% v 49%), greater pain reduction (measured in a visual analog scale from 0 = pain free to 10 = deep intolerable pain), increased residual articular excursion of the first metatarsophalangeal joint (27 degrees of active dorsiflexion from neutral position v 8 degrees ), and less presence of central metatarsalgia (15% v 34%) (P <.05). The radiographic evaluation expressed more stable correction values in group A for the following parameters: joint preservation, sesamoid position, intermetatarsal angle (7 degrees v 12 degrees ), abduction angle of the hallux (14 degrees v 20 degrees ), and proximal articular set angle (8 degrees v 18 degrees ) (P <.05). 相似文献
55.
护理人员工作中被针刺伤调查及对策 总被引:129,自引:14,他引:115
目的:了解护理人员被针刺伤的情况,为采取职业防护措施提供科学依据。方法:采用问卷调查法调查护理人员被针头伤的有关情况。结果:不同职称护理人员被针刺伤的情况存在差异高度显著性,P<0.01;不同科室护理人员被针刺伤的操作环节比较均存在差异高度显著性,P<0.01,绝大多数护理人员对针刺伤后的处理不规范。结论:护理人员应主动增强职业防护意识,加强职业防护管理;改进废弃的一次性医疗用品管理方法和尽快采用防刺性护理用具。 相似文献
56.
MOTOYOSHI NOMIZU YOSHIMASA INAGAKI TAKEYOSHI YAMASHITA AKO OHKUBO AKIRA OTAKA NOBUTAKA FUJII PETER P. ROLLER HARUAKI YAJIMA 《Chemical biology & drug design》1991,37(2):145-152
A new two-step deprotection/cleavage procedure for t-butoxycarbonyl (Boc) based solid phase peptide synthesis is reported. First the protective groups are removed from 4-(oxymethyl)-phenylacetamidomethyl (PAM) resin attached peptide with the weak hard acid, trimethylsilyl bromide-thioanisole/trifluoroacetic acid (TFA). In the second step, the peptide is cleaved from the resin with a stronger hard acid such as trimethylsilvl trifluoromethanesulfonate in TFA or with HF. The method is also shown to deformylate Nin-formyltryptophan moiety efficiently. The usefulness of this procedure for practical solid phase peptide synthesis is demonstrated by comparison with other deprotection methods in the synthesis of urotensin II and human endothelin. 相似文献
57.
A 32-year-old man with distal skeletal manifestations of Marfan's syndrome had experienced shortness of breath and orthopnea for one month. Physical examination showed the presence of severe aortic regurgitation. Both noninvasive and invasive studies revealed that the aortic regurgitation was induced by previously undescribed peculiar and unusual etiology: diastolic prolapse of a circumferentially dissected tubular intimal flap into the left ventricle. The patient underwent surgical repair with striking clinical improvement. 相似文献
58.
Combined percutaneous antegrade and cystoscopic retrograde approach in the treatment of distal ureteric fistulae 总被引:1,自引:1,他引:0
Thierry de Baere Alain Roche Christine Lagrange Alban Denys Bernard Court Joël Isapoff Paris Pappas 《Cardiovascular and interventional radiology》1995,18(6):349-352
Purpose To determine the efficacy of a cystoscopic approach, as definitive treatment of ureteral fistulae, after failure of antegrade ureteral stent insertion.Methods Of 43 ureter fistulae encountered over 4 years, 10 postoperative and/or postradiotherapy fistulae could not be stented via an antegrade approach alone. A cystoscopic approach was used, with the antegrade approach available as back-up, if necessary.Results In two patients the ureteral orifice could not be visualized cystoscopically, thus precluding the retrograde approach. In the eight remaining patients, the retrograde approach alone never allowed successful stenting. In six patients, combined antegrade and retrograde approaches permitted stent insertions. In three of those six patients, a complex catheterization procedure was necessary. In two patients the combined approach failed altogether. Therefore, 6 of 10 patients underwent a successful stenting procedure with the combined approach; all ultimately closed the fistula.Conclusion Antegrade stent insertion remains the treatment of choice for ureteral leaks. If the antegrade approach fails, the retrograde approach alone is not likely to be successful. Instead, a combination of both approaches often does succeed. 相似文献
59.
I.J. Clifton A.M. Morton N.S. Ambrose D.G. Peckham S.P. Conway 《Journal of cystic fibrosis》2004,3(4):273-275
We report a case of a patient with CF who had a long history of recurrent distal intestinal obstruction syndrome. She had been treated with conventional treatment including gastrografin, n-acetyl cysteine, Klean prep and Picolax. She underwent a modified antegrade continence enema procedure. She currently irrigates her conduit every 2-3 days. She has had no further symptoms of distal intestinal obstruction syndrome. 相似文献
60.
支撑捆扎法在腹腔镜下全直肠系膜切除超低位结肠-直肠/肛管吻合术中的应用 总被引:2,自引:0,他引:2
目的 介绍支撑捆扎法在腹腔镜下对低位直肠癌进行全直肠系膜切除(TME)超低位结肠.直肠/肛管吻合的手术方法。方法 应用超声刀在腹腔镜下对11例低位直肠癌患实施TME原则的根治性切除,用支撑捆扎法完成超低位结肠.直肠/肛管吻合术。结果 11例患术中直肠系膜切除完整。超低位结肠-直肠/肛管吻合成功,吻合时间15—30min;吻合口距齿状线小于2cm8例。结肠与齿状线处肛管吻合的3例。术后恢复顺利。肛门括约肌功能、排尿功能良好,未发生吻合口瘘与吻合口狭窄。结论 腹腔镜结合支撑捆扎法可以对低位直肠癌行TME切除后进行超低位结肠-直肠/肛管吻合术。 相似文献