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排序方式: 共有4433条查询结果,搜索用时 140 毫秒
31.
32.
Ji Min Choi Changhyun Lee Yoo Min Han Minjong Lee Young Hoon Choi Dong Kee Jang Jong Pil Im Sang Gyun Kim Joo Sung Kim Hyun Chae Jung 《Surgical endoscopy》2014,28(9):2649-2655
Background
Self-expandable metallic stents (SEMS) are now regarded as an effective and safe intervention for malignant colorectal obstruction (MCO). However, manipulation of the tumor might lead to the spillage of tumor cells and result in distant metastases. We aimed to compare the long-term oncologic outcomes of SEMS as a bridge to surgery with those of emergency surgery for MCO.Methods
Between June 2005 and December 2011, 60 patients who underwent elective curative resection after endoscopic SEMS insertion were included in the “SEMS group”. The SEMS group was matched to 180 patients who underwent emergency curative surgery for MCO during the same period [“Emergency surgery (ES) group”]. The clinicopathologic characteristics, recurrence-free survival (RFS), and overall survival (OS) were compared between the two groups.Results
There were no significant differences in demographics, tumor stage, location, and histology between the SEMS group and the ES group. The median follow-up times were 41.4 months (IQR, 22.2–60.0 months) for the SEMS group and 45.0 months (IQR, 20.9–68.1 months) for the ES group. The proportions of patients who received postoperative adjuvant chemotherapy were comparable (SEMS group vs. ES group, 68.3 % vs. 77.8 %; P = 0.210). The long-term prognosis did not significantly differ between two groups in either the 5-year RFS rate (79.6 % vs. 70.2 %; P = 0.218) or the 5-year OS rate (97.8 % vs. 94.3 %; P = 0.469).Conclusions
Long-term oncologic outcomes of SEMS insertion as a bridge to surgery were comparable to those of primary curative surgery. 相似文献33.
34.
Ronghua Jin Pan Wu Jon Kee Ho Xingang Wang Chunmao Han 《Burns : journal of the International Society for Burn Injuries》2018,44(1):210-217
Background
The incidence of liquefied petroleum gas (LPG)-related burns has increased over recent years, and it has become a serious public health issue in developing countries such as India and Turkey. This paper aims to investigate the epidemiological characteristics of LPG-related burns to provide assistance and suggestions for planning prevention strategies.Methods
A 5-year retrospective study was conducted in patients with LPG-related burns admitted to the Department of Burns & Wound Care Center, Second Affiliated Hospital of Zhejiang University, College of Medicine, between 1st January 2011 and 31st December 2015. Information obtained for each patient included age, gender, education status, occupation, medical insurance, average hospital cost, length of hospital stay, monthly distribution of incidence, place of burns, mechanism of burns, extent of burns, site of burns, accompanying injuries, and treatment outcomes.Results
For the first 4 years (2011–2014), the yearly incidence of LPG-related burns was at approximately 10% of all burns; however, in the fifth year (2015) alone, there was a surge to 26.94%. A total of 1337 burn patients were admitted during this period. Of these, 195 patients were admitted because of 169 LPG-related accidents; there were 11 accidents involving more than one victim. LPG-related burns occurred most frequently in patients aged 21–60 years (73.85%). The majority of injuries occurred from May to August (56.41%), and the most common place was home (83.08%, 162 patients). Gas leak (81.03%) was the main cause of LPG-related burns, followed by inappropriate operation (7.69%) and cooking negligence (2.05%). The mean burn area was 31.32 ± 25.40% of TBSA. The most common sites of burns were the upper extremities (37.47%), followed by the head/face and neck (24.80%) and lower extremities (19.95%). The most common accompanying injuries included inhalation injury (23.59%), shock (8.71%), and external injury (7.18%). The average hospital stay was 22.90 ± 19.47 days (range 2–84 days). Only 48 patients (24.62%) had medical insurance, while 124 patients (63.59%) had no medical insurance. The average hospital cost of the no medical insurance group was significantly higher (p < 0.0001) than that of the medical insurance group. In addition, 72.73% of patients who left against medical advice (LAMA) were uninsured. The number of patients who recovered at our hospital was 165 (84.62%), while 22 patients (11.28%) LAMA. The overall mortality rate was 4.10% (8 patients).Conclusion
Our study shows that the exponential increase in LPG-related burns is alarming. This calls for rigorous precautions. Because gas leak was the main cause of LPG-related burns, any part of LPG stove system that shows signs of weathering should be replaced regularly. In addition, we also found that most of the LAMA patients were uninsured. Thus, comprehensive medical insurance should be involved early in the recovery process to assure a safe and adequate discharge. 相似文献35.
Yong Liu Pan Wu Jon Kee Ho Haiping Hua Haojiao Chen Ying Cen Songxue Guo Chunmao Han Xingang Wang 《Burns : journal of the International Society for Burn Injuries》2018,44(4):995-999
Objective
This study analyses the epidemiological characteristics of bus fires in mainland China over the past 10 years to develop prevention strategies and emergency procedures for such incidence and the resulting casualties.Methods
We collected reports on bus fires from the media and news websites and looked up on Medline, PubMed, and Chinese National Knowledge Infrastructure databases for relevant publications in English or Chinese from January 1, 2006 to December 31, 2015.Results
In the past 10 years, there were 382 bus fires in mainland China. The frequency of fires was markedly higher in 2013 and 2014. The vast majority (89.1%) of the fires were caused by spontaneous combustion, followed by arson (5.0%). There were reports of casualties in 41 (10.7%) of the bus fires, including 144 deaths and 567 injuries. The fires leading to casualties resulted from spontaneous combustion in 22 (53.7%) incidents, arson in 12 (29.3%) incidents, and traffic accidents in 7 (17.1%) incidents. Arson caused the most casualties, including 91 deaths and 323 injuries.Conclusions
This epidemiological study presents characteristic findings related to bus fires in China mainland. The general trend of bus fires showed a gradual increase but with a fluctuation in several years. The regional distribution of bus fires revealed some specific characteristics, and most of bus fires happened in those regions locating in the eastern area of China mainland. The largest number of bus fires were caused by spontaneous combustion. Bus fires caused by arson accounting for only 5% of the total bus fires resulted in the most severe casualties. Most of bus arson occurred in the morning and evening rush hours. 相似文献36.
37.
Seil Sohn Chun Kee Chung Inbo Han Sung Bae Park Hyejin Kim 《Journal of clinical densitometry》2018,21(1):68-74
We aim to compare the bone mineral density (BMD) in a group of patients with cervical or thoracic diffuse idiopathic skeletal hyperostosis (DISH) with that in a matched control group. We also investigated the prevalence of osteoporosis in the two groups and determined the correlation between BMD and the extent of spinal DISH. From 1999 to July 2015, 65 patients with DISH underwent dual-energy X-ray absorptiometry at our institute. The control group was matched with regard to age, sex, and body mass index to the patient group on a 1:1 basis. BMD was measured at the lumbar spine (L1–L4), femur neck, and femur total areas using dual-energy X-ray absorptiometry. The BMDs of the DISH and control groups were significantly different at the lumbar spine (L1–L4) and the femur neck (p?=?0.005, 0.001). The rates of patients with osteopenia and osteoporosis were lower in the DISH than in the control group for the lumbar spine (L1–L4) (p?=?0.05). A positive correlation was observed between the lumbar spine (L1–L4) BMD and the number of spine levels affected by DISH (p?=?0.04). The BMDs of the lumbar spine and femur neck were found to be higher in the DISH group than in a matched control group, when patients with lumbar DISH involvement were excluded. The rates of osteopenia and osteoporosis tended to be lower in the DISH group than in the control group. Lumbar spine BMD is significantly correlated with the number of spine levels affected by DISH. 相似文献
38.
39.
Justine Yun Yu Lee Tamara Soh Tet Sen Howe Joyce Suang Bee Koh Ernest Beng Kee Kwek David Thai Chong Chua 《Acta orthopaedica》2015,86(5):622-623
Background and purpose
The current definition of atypical femoral fractures (AFFs) associated with bisphosphonate use includes only de novo fractures. However, in recent years reports of bisphosphonate-associated periprosthetic fractures involving stemmed arthroplasty implants have emerged. In a case series of peri-implant fractures in femurs with plate/screw constructs, we aimed to assess similarities with classical AFFs and how their location may have implications for the pathogenesis and management of AFFs.Patients and methods
We retrospectively identified 10 patients with 11 peri-implant fractures.Results
The patients were ambulant women, mean age 80 (70–92) years. Mean duration of bisphosphonate use was 5 (1–10) years. The peri-implant fractures were sustained an average of 4 years (6 months to 9 years) from the time of index surgery. They were all associated with low-energy mechanisms. 8 fractures occurred near the tip of a plate, while 3 traversed the penultimate screwhole of a plate. The peri-implant fractures showed clinical and radiological features of atypicality such as lateral cortical thickening, simple fracture pattern, and lack of comminution. The patients underwent revision surgery, with bone grafting used in all but 1 case. Radiological union was evident after 2–4 months.Interpretation
Atypical peri-implant fractures of the femur associated with bisphosphonate use may be a new entity. Stress lesions and atypical fractures may tend to develop over stress risers along the operated femur. This finding has implications for the pathogenesis and clinical management of AFFs.Bisphosphonates form the cornerstone of antiresorptive therapy in the management of post-menopausal osteoporosis. They are used in the treatment of malignant and osteoclast-mediated metabolic bone disease. Their use in patients who have undergone total joint arthroplasty of the lower limb is associated with higher periprosthetic bone mineral density and longer implant survival (Bhandari et al. 2005). Bisphosphonates exert their therapeutic effect by reducing bone turnover and increasing overall mineralization. This translates to increased bone mineral density and bone strength, corresponding clinically to reduced risk of vertebral and non-vertebral fragility fractures (Black et al. 1996).In recent years, several published reports have described atypical femoral fractures (AFFs) of the proximal femoral diaphysis and subtrochanteric region, in association with bisphosphonate use (Goh et al. 2007, Neviaser et al. 2008, Isaacs et al. 2010). Bisphosphonates are associated with a higher age-adjusted relative risk of AFF in women than in men, which is higher in alendronate users than in risedronate users (Schilcher et al. 2015). Bisphosphonates may cause changes in bone matrix composition and bone mechanical properties, increasing the propensity for accumulation of microdamage. Impaired target remodeling would contribute to the progression of macrocracks. High interfragmentary strain from physiological loads at a thin fracture line may be a mechanical factor in lack of bone healing (Aspenberg et al. 2010).Periprosthetic/peri-implant fractures are currently excluded from the definition of AFFs. We suggest that peri-implant fractures of the femur with features of atypicality may be linked to bisphosphonate use and that they should be recognized as a clinical entity. 相似文献40.
Jong Hun Baek Young Soo Chun Kee Hyung Rhyu Wan Keun Yoon Yoon Je Cho 《Anatomical science international / Japanese Association of Anatomists》2018,93(2):262-268
The contribution of the ligamentum teres to the stabilization of the hip joint and the clinical influence of a compromised ligamentum teres are not well known. This study aimed to investigate joint stability and cartilage damage in a rabbit model by surgically inducing a complete ligamentum teres tear. Twenty adult New Zealand rabbits were used in this study. Rabbits were divided into complete ligamentum teres tear with capsulotomy (n = 9, group I) and capsulotomy only (n = 10, group II) groups. Unilateral surgery was performed on the left hip. Joint instability was assessed by measuring the preoperative and postoperative acetabulofemoral (A-F) distances. Rabbits were euthanized to assess cartilage damage at 24 weeks postoperatively. The median postoperative A-F distance of the operated side in group I [0.68 cm (0.37–1.04 cm)] was larger than that in group II [0.50 cm (0.30–0.65 cm)] (p = 0.041). The median postoperative A-F distance was larger in the operated side [0.68 cm (0.37–1.04 cm)] compared to the nonoperated side [0.45 cm (0.30–0.75 cm)] in group I; it also was larger in the operated side [0.50 cm (0.30–0.65 cm)] compared to the nonoperated side [0.44 cm (0.32–0.67 cm)] in group II, but only group I showed a significant difference (p = 0.016 and 0.395, respectively). Articular cartilage damage was detected at the apex of the femoral head in two rabbits (22.2%) in group I only. Rabbits with a complete ligamentum teres tear showed significant instability at the hip joint and articular cartilage damage in our rabbit model, supporting the potential clinical importance of ligamentum teres as a hip joint stabilizer. 相似文献