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Valentina Becherucci Stefano Ermini Luisa Piccini Silvia Bisin Valentina Gori Francesca Gentile Riccardo Ceccantini Elena De Rienzo Barbara Bindi Paola Pavan Vanessa Cunial Elisa Allegro Francesca Brugnolo Daniela Maggio Daniela Calzolari Erika Maccarelli Silvia Galli Sonia Muricci Marco Berchielli Veronica Tintori Iacopo Sardi Franco Bambi 《Journal of clinical apheresis》2020,35(5):406-412
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《中国整形与重建外科(英文)》2020,2(2):69-77
BackgroundThe corresponding author's experience and recent methods employed in autologous costal cartilage grafts combined with expanded polytetrafluoroethylene (ePTFE) in Asian rhinoplasty were presented in this study.ObjectivesThe purpose of this study was to assess the outcomes of rhinoplasty performed on patients using autogenous costal cartilage grafts combined with an ePTFE implant.MethodsSeventy-five rhinoplasty cases with autologous costal cartilage grafts and an ePTFE implant were retrospectively reviewed. Graft types, complications associated with the graft itself or graft harvesting, surgical outcomes, and patient satisfaction were assessed.ResultsThe mean follow-up time post-operation was 13.5 months. A total of 42/75 patients underwent revision surgeries. Graft-related complications were found in 8% of cases, including two warped graft and four infection cases. Three individuals with infections had mild graft resorption. One patient with an infection removed the implant. Graft exposure, mobility, and substantial resorption were not recorded. A total of two cases underwent revision procedures for infection and perforation, respectively. Chest incision lengths for graft harvesting averaged 2.1 cm. No pneumothorax or significant donor-site pain was found. Donor-site scars were negligible, although two cases had hypertrophic chest scars. In general, functional and esthetic outcomes were mostly satisfactory among the assessed patients.ConclusionsRhinoplasty using autologous rib cartilage provides adequate support and sufficient cartilage amounts for correcting nasal contouring. Meanwhile, ePTFE alone for nasal dorsum augmentation safely achieves satisfactory outcomes. Rib cartilage rhinoplasty performed by an experienced surgeon yields excellent, long-lasting results with minimal risk; however, the potential for infection should be considered following revision surgery. 相似文献
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Annika Mutanen Meredith Barrett Yongjia Feng Jouko Lohi Raja Rabah Daniel H. Teitelbaum Mikko P. Pakarinen 《Journal of pediatric surgery》2019,54(3):511-516
Background
Although serial transverse enteroplasty (STEP) improves function of dilated short bowel, a significant proportion of patients require repeat surgery. To address underlying reasons for unsuccessful STEP, we compared small intestinal mucosal characteristics between initial and repeat STEP procedures in children with short bowel syndrome (SBS).Methods
Fifteen SBS children, who underwent 13 first and 7 repeat STEP procedures with full thickness small bowel samples at median age 1.5 years (IQR 0.7–3.7) were included. The specimens were analyzed histologically for mucosal morphology, inflammation and muscular thickness. Mucosal proliferation and apoptosis was analyzed with MIB1 and Tunel immunohistochemistry.Results
Median small bowel length increased 42% by initial STEP and 13% by repeat STEP (p = 0.05), while enteral caloric intake increased from 6% to 36% (p = 0.07) during 14 (12-42) months between the procedures. Abnormal mucosal inflammation was frequently observed both at initial (69%) and additional STEP (86%, p = 0.52) surgery. Villus height, crypt depth, enterocyte proliferation and apoptosis as well as muscular thickness were comparable at first and repeat STEP (p > 0.05 for all). Patients, who required repeat STEP tended to be younger (p = 0.057) with less apoptotic crypt cells (p = 0.031) at first STEP. Absence of ileocecal valve associated with increased intraepithelial leukocyte count and reduced crypt cell proliferation index (p < 0.05 for both).Conclusions
No adaptive mucosal hyperplasia or muscular alterations occurred between first and repeat STEP. Persistent inflammation and lacking mucosal growth may contribute to continuing bowel dysfunction in SBS children, who require repeat STEP procedure, especially after removal of the ileocecal valve.Level of evidence
Level IV, retrospective study. 相似文献7.
目的:自体骨髓移植联合MHC单倍体相合淋巴细胞治疗急性髓性白血病的治疗效果和安全性。方法:以40例急性髓性白血病患者作为研究对象,随机分为两组各20例,研究组患者使用自体骨髓移植联合MHC单倍体相合淋巴细胞进行治疗,对照组单用自体骨髓移植进行治疗。结果:两组患者的造血系统都得到重建,重建时间以及并发症的发生均没有显著差异。而研究组患者复发率显著降低,且复发时间明显地长于对照组患者。研究组患者3年累积无病生存率明显地高于对照组患者,且差异具有统计学意义。结论:自体骨髓移植联合MHC单倍体相合淋巴细胞治疗能够有效控制急性髓性白血病病情,降低其复发,延长患者生存期。 相似文献
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目的:观察非霍奇金淋巴瘤(non-Hodgkin's lymphoma,NHL)患者自体造血干细胞移植(autologous hematopoietic stem cell transplantation,ASCT)术后应用重组人α-2b干扰素(α-2b IFN)进行早期干预治疗的临床疗效。方法:选取18例行ASCT的NHL患者为研究对象,移植前疾病评估均未达到完全缓解(complete remission,CR),试验组血象恢复后给予IFN 3 000 000 U次/隔日干预治疗,3个月后停用;对照组未行干扰素干预治疗,分析总体疗效及两组对比的生存情况。结果:随访中位时间为34(10~50)个月,患者中位生存时间为37(31~45)个月,3年总体无进展生存(progressive free survival,PFS)、总生存(overall survivial,OS)分别为54.7%、66.8%。ASCT后试验组1年内无疾病复发,2年内复发率为12.5%;对照组1年内复发率为20%,2年内复发率为30%。结论:NHL患者在ASCT后给予重组人α-2b IFN早期干预治疗,患者耐受性好,可能降低移植后早期复发率。 相似文献
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目的:探讨超高CD34+采集的动员方案后序贯二次自体造血干细胞移植治疗难治性霍奇金淋巴瘤的疗效和安全性。方法:对1例经过多疗程一线、二线、新药、免疫等均难治的霍奇金淋巴瘤患者,予以IA+C方案化疗+G-CSF动员干细胞后采集出超高水平CD34+细胞,之后行自体造血干细胞移植,移植后获得完全缓解,再予序贯第二次自体造血干细胞移植进行巩固治疗。结果:总计输注单个核细胞数13.67×108/kg,CD34+细胞48.68×106/kg,第一次自体造血干细胞移植术后第7天造血功能恢复,复查全身PET-CT提示获得完全缓解,第二次自体造血干细胞移植术后第8天造血功能恢复,两次自体造血干细胞移植相关并发症均在可控范围内。结论:超高CD34+细胞采集的IA+C方案化疗+G-CSF动员可以让患者有机会进行多次自体造血干细胞移植,是临床动员的创新方案。对于难治性霍奇金淋巴瘤,序贯二次自体造血干细胞移植可达到更深层次缓解,且安全性较高,延长患者无疾病生存期及总生存期,为难治性霍奇金淋巴瘤治疗提供更多临床依据。 相似文献