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1.
Hans-Eric Rosberg Derya Burcu Hazer Rosberg Illugi Birkisson Lars B. Dahlin 《Journal of orthopaedic science》2017,22(5):915-918
Background
Digital nerve injuries in children are not common, but they are considered to have an excellent prognosis, compared to adults, after nerve injury and repair. In studies including both children and adults age have been found to have an effect on outcome after nerve repair.Methods
We investigated in a retrospective follow up study the long-time result after digital nerve injury and repair in children, 1–16 years of age (n = 38), and evaluate if age influences outcome. A group with young children, 1–10 years of age (n = 18), was compared with a group with older children, 11–16 years of age (n = 20). A clinical evaluation to evaluate sensation and grip strength was performed and questionnaires were used [Disability of the Arm, Shoulder and Hand (DASH), Cold Sensitivity Severity Scale (CISS), VAS-function and VAS-cosmetic] in median 40 months (range 12–131 months) after the injury and repair.Results
All patient regained normal sensation. No correlations between age and monofilaments were found. Twenty children (52%) reported some problems with cold intolerance (i.e. CISS), but no other abnormal disability was found (i.e. DASH, VAS); again with no differences between the two groups.Conclusions
Children have an excellent long-term recovery after a digital nerve repair and without any influence of age. 相似文献2.
Tatsuo Mae Konsei Shino Ryo Iuchi Kazutaka Kinugasa Ryohei Uchida Shigeto Nakagawa Hideki Yoshikawa Ken Nakata 《Journal of orthopaedic science》2017,22(5):886-891
Purpose
To clarify 1) the force sharing between two portions of BTB graft in anatomic rectangular tunnel (ART) reconstruction and 2) the knee stability in ART technique under anterior tibial load.Methods
Eleven fresh cadaveric knees were used. First, anterior-posterior (A-P) laxity was measured with Knee Laxity Tester® in response to 134 N of A-P tibial load at 20° on the normal knees. Then ART ACL reconstruction was performed with a BTB graft. For graft, the patellar bone plug and tendon portion was longitudinally cut into half as AM and PL portions. After the tibial bone plug was fixed at femoral aperture, AM/PL portions were connected to the tension-adjustable force gauges at tibial tubercle, and were fixed with 10 N to each portion at 20°. Then the tension was measured 1) under anterior tibial load of 134 N at 0, 30, 60, and 90°, and 2) during passive knee extension from 120 to 0°. Next the graft tension was set at 0, 10, 20, 30, or 40 N at 20°, and the A-P laxity was measured by applying A-P load of 134 N. By comparing the laxity for the normal knee, the tension to restore the normal A-P laxity (LMP) was estimated.Results
The AM force was significantly smaller at 0° and larger at 90° than the PL force under anterior load, while the force sharing showed a reciprocal pattern. During knee extension motion, the tension of both portions gradually increased from around 5 N to 20–30 N with knee extended. And the LMP was 1.6 ± 1.0 N with a range from 0.3 to 3.5 N.Conclusion
The pattern of force sharing was similar to that in the normal ACL in response to anterior tibial load and during passive knee extension motion. LMP in this procedure was close to the tension in the normal ACL.Level of evidence
Level IV, a controlled-laboratory study. 相似文献3.
Masashi Uehara Jun Takahashi Shugo Kuraishi Masayuki Shimizu Shota Ikegami Toshimasa Futatsugi Hiroki Oba Hiroyuki Kato 《Journal of orthopaedic science》2017,22(2):218-223
Study design
A retrospective single-center and single-surgeon study.Objectives
This study investigated the clinical and radiological results of skip pedicle screw fixation for adolescent idiopathic scoliosis (AIS).Summary of background data
At present, the generally used technique for pedicle screw fixation for the surgical correction of AIS entails inserting a pedicle screw into every segment on the corrective side and into every or every other segment on the supportive side. To reduce operation time, blood loss, and cost, we developed skip pedicle screw fixation to achieve correction of AIS using fewer pedicle screws.Methods
We evaluated 62 consecutive patients who had undergone computer-assisted skip pedicle screw fixation from August 2005 to June 2014. All patients were followed up for at least two years. We investigated the clinical results of skip pedicle screw fixation for AIS.Results
The mean number of fused vertebrae was 10.3 ± 2.0, the mean surgical time was 242 ± 78 min, and the mean blood loss volume was 1060 ± 688 ml. The mean Cobb angle of main thoracic (MT) curve two years after surgery improved significantly compared with that before surgery (p < 0.01). The mean correction rate of MT curve immediately after surgery was 62.4 ± 12.4% and correction loss of MT curve at two years after surgery was 1.9 ± 5.8°. The SRS-22 subtotal score two years after surgery improved significantly compared to that before surgery (p < 0.01). Although no patients experienced major complications, eight (12.9%) encountered minor complications (two [3.2%] had massive blood loss [>3000 ml], three [4.8%] had a broken screw, one [1.6%] had a set-screw that dropped out, one [1.6%] experienced deep vein thrombosis, one [1.6%] experienced acute renal failure, and one [1.6%] experienced intercostal neuralgia). Revision surgery was not performed.Conclusions
Subjects with AIS who underwent skip pedicle screw fixation had significantly improved clinical and radiological parameters at two years after surgery, indicating that skip pedicle screw fixation could be used to successfully treat AIS.Level of evidence
Level 4 相似文献4.
Takaki Imai Masafumi Gotoh Tsuyoshi Tokunaga Jyunichi Kawakami Yasuhiro Mitsui Keiji Fukuda Misa Ogino Takahiro Okawa Naoto Shiba 《Journal of orthopaedic science》2017,22(3):438-441
Background
The Japanese Orthopaedic Association shoulder score cutoff values were calculated in patients with rotator cuff repair using the University of California at Los Angeles shoulder score.Methods
Overall, 175 patients with rotator cuff repair were subjects in this study. The University of California at Los Angeles and Japanese Orthopaedic Association shoulder scores were evaluated before surgery and at 3, 6, 9, and 12 months after surgery. The cutoff value of the Japanese Orthopaedic Association shoulder score was determined using the 4-stage criteria of the University of California at Los Angeles shoulder score and a University of California at Los Angeles shoulder score of 28 points, which is the boundary between an excellent/good group and a fair/poor group.Results
Both the JOA shoulder and UCLA shoulder scores showed significant improvement at 6, 9, and 12 months from the preoperative scores (p < 0.0001). There was a strong correlation between the total values of the two scores (r = 0.85, p < 0.0001). The cutoff value of the Japanese Orthopaedic Association shoulder score based on the highest accuracy from receiver operating characteristic curve analysis was 83 points.Conclusion
A Japanese Orthopaedic Association shoulder score cutoff value of 83 was equivalent to a University of California at Los Angeles shoulder score cutoff value of 28 for distinguishing between excellent/good and fair/poor outcomes after rotator cuff repair. 相似文献5.
W.M. Bennett E.L. Simonich A.M. Garre K.M. McEvoy M.A. Farinola T.D. Batiuk 《Transplantation proceedings》2017,49(8):1779-1782
Introduction
Between January 2013 and September 2015, 135 consecutive renal transplant patients were screened prospectively with ultrasound for renal cell carcinoma (RCC).Results
Eighteen ultrasound abnormalities were identified with 4 solid lesions detected. Fifty-six other patients were screened retrospectively by referring nephrology groups, with 6 additional malignancies found.Conclusion
As a result of our data, we recommend and have instituted annual ultrasound screening of native kidneys in all renal transplant patients. 相似文献6.
Background
Renal artery aneurysms are increasingly being detected incidentally during diagnostic imaging using magnetic resonance imaging, computed tomography, or angiography performed for evaluation of other diseases. Our understanding of their natural history and surgical management has evolved significantly during the past two decades.Patients and Methods
Three patients with incidentally identified renal artery aneurysms have been referred to our renal transplantation program in the last 3 years. All three had aneurysms located at renal artery branches making endovascular repair challenging and thus underwent hand-assisted laparoscopic nephrectomy with ex vivo aneurysmectomy, with heterotopic autotransplantation in two cases and allotransplantation in the third case.Results
All three cases resulted in successful renal artery aneurysm repair and reimplantation and good renal function of the implanted kidney.Conclusions
Laparoscopic nephrectomy with ex vivo aneurysm repair and reimplantation can be a successful approach to surgical management, especially in cases where the aneurysm involves multiple artery branches and endovascular repair is challenging. Given the excellent results with this surgical approach, living and deceased donor kidneys with aneurysms should be strongly encouraged if deemed reparable. 相似文献7.
Atsunori Murase Masahiro Nozaki Masaaki Kobayashi Hideyuki Goto Masahito Yoshida Sanshiro Yasuma Tetsuya Takenaga Yuko Nagaya Jun Mizutani Hideki Okamoto Hirotaka Iguchi Takanobu Otsuka 《Journal of orthopaedic science》2017,22(5):874-879
Background
Recently several authors have reported on the quantitative evaluation of the pivot-shift test using cutaneous fixation of inertial sensors. Before utilizing this sensor for clinical studies, it is necessary to evaluate the accuracy of cutaneous sensor in assessing rotational knee instability. To evaluate the accuracy of inertial sensors, we compared cutaneous and transosseous sensors in the quantitative assessment of rotational knee instability in a cadaveric setting, in order to demonstrate their clinical applicability.Methods
Eight freshly frozen human cadaveric knees were used in this study. Inertial sensors were fixed on the tibial tuberosity and directly fixed to the distal tibia bone. A single examiner performed the pivot shift test from flexion to extension on the intact knees and ACL deficient knees. The peak overall magnitude of acceleration and the maximum rotational angular velocity in the tibial superoinferior axis was repeatedly measured with the inertial sensor during the pivot shift test. Correlations between cutaneous and transosseous inertial sensors were evaluated, as well as statistical analysis for differences between ACL intact and ACL deficient knees.Results
Acceleration and angular velocity measured with the cutaneous sensor demonstrated a strong positive correlation with the transosseous sensor (r = 0.86 and r = 0.83). Comparison between cutaneous and transosseous sensor indicated significant difference for the peak overall magnitude of acceleration (cutaneous: 10.3 ± 5.2 m/s2, transosseous: 14.3 ± 7.6 m/s2, P < 0.01) and for the maximum internal rotation angular velocity (cutaneous: 189.5 ± 99.6 deg/s, transosseous: 225.1 ± 103.3 deg/s, P < 0.05), but no significant difference for the maximum external rotation angular velocity (cutaneous: 176.1 ± 87.3 deg/s, transosseous: 195.9 ± 106.2 deg/s, N.S).Conclusions
There is a positive correlation between cutaneous and transosseous inertial sensors. Therefore, this study indicated that the cutaneous inertial sensors could be used clinically for quantifying rotational knee instability, irrespective of the location of utilization. 相似文献8.
Tetsutaro Fukuhara Teruhisa Mihata Bong Jae Jun Masashi Neo 《Journal of orthopaedic science》2017,22(5):852-857
Background
Inconsistent tension distribution may decrease the biomechanical properties of the rotator cuff tendon after double-row repair, resulting in repair failure. The purpose of this study was to compare the tension distribution along the repaired rotator cuff tendon among three double-row repair techniques.Methods
In each of 42 fresh-frozen porcine shoulders, a simulated infraspinatus tendon tear was repaired by using 1 of 3 double-row techniques: (1) conventional double-row repair (no bridging suture); (2) transosseous-equivalent repair (bridging suture alone); and (3) compression double-row repair (which combined conventional double-row and bridging sutures). Each specimen underwent cyclic testing at a simulated shoulder abduction angle of 0° or 40° on a material-testing machine. Gap formation and tendon strain were measured during the 1st and 30th cycles. To evaluate tension distribution after cuff repair, difference in gap and tendon strain between the superior and inferior fixations was compared among three double-row techniques.Results
At an abduction angle of 0°, gap formation after either transosseous-equivalent or compression double-row repair was significantly less than that after conventional double-row repair (p < 0.01). During the 30th cycle, both transosseous-equivalent repair (p = 0.02) and compression double-row repair (p = 0.01) at 0° abduction had significantly less difference in gap formation between the superior and inferior fixations than did conventional double-row repair. After the 30th cycle, the difference in longitudinal strain between the superior and inferior fixations at 0° abduction was significantly less with compression double-row repair (2.7% ± 2.4%) than with conventional double-row repair (8.6% ± 5.5%, p = 0.03).Conclusions
Bridging sutures facilitate consistent and secure fixation in double-row rotator cuff repairs, suggesting that bridging sutures may be beneficial for distributing tension equally among all sutures during double-row repair of rotator cuff tears. 相似文献9.
Hong-Geun Jung Dong-Oh Lee Sang-Hun Lee Joon-Sang Eom 《Journal of orthopaedic science》2017,22(3):468-473
Background
Moderate to severe midfoot–forefoot varus deformities are commonly found in several conditions. However, few techniques are available to correct these deformities. So, we evaluated the clinical and radiological outcomes of patients who underwent midfoot derotational osteotomy to achieve plantigrade foot.Methods
From 2006 to 2014, 6 patients (7 feet) underwent midfoot derotational osteotomy. A visual analog scale (VAS) pain and the American Orthopedic Foot & Ankle Society (AOFAS) functional score were evaluated. Radiographic parameters, including tibiocalcaneal angle (TCA) and navicular height (NH), were assessed.Results
The mean patient age at surgery was 48.0 years (37–58). From before the operation to the final follow-up, the mean VAS score decreased from 6.5 (2–9) to 1.3 (0–4) and the mean AOFAS score improved from 42.7 (34–58) to 77 (68–87). All patients were satisfied with outcomes. The mean TCA significantly improved from 33.8° (9.9–66.7) to 12.7 (5.1–27.6) (p = 0.018)and the mean NH decreased from 46.7 mm (32.8–67) to42.6 (30.1–60.8) (p = 0.018).Conclusion
Severe midfoot–forefoot varus deformities can be efficiently corrected by midfoot derotational osteotomy resulting in favorable clinical and radiological outcomes and high patient satisfaction.Level of evidence
IV, case series. 相似文献10.
S.-C. Kuo C.-C. Lin A. Elsarawy Y.-H. Lin S.-H. Wang Y.-J. Wu C.-L. Chen 《Transplantation proceedings》2017,49(8):1870-1874
Background
Ventral incisional hernia (VIH) is not uncommon following liver transplantation. Open repair was traditionally adopted for its management. Laparoscopic repair of VIH has been performed successfully in nontransplant patients with evidence of reduced recurrence rates and hospital stay. However, the application of VIH in post-transplantation patients has not been well established. Herein, we provide our initial experience with laparoscopic repair of post-transplantation VIH.Methods
From March 2015 to March 2016, 18 cases of post-transplantation VIH were subjected to laparoscopic repair (laparoscopy group). A historical control group of 17 patients who underwent conventional open repair (open group) from January 2013 to January 2015 were identified for comparison. The demographics and clinical outcomes were retrospectively compared.Results
There were no significant differences among basic demographics between the 2 groups. No conversion was recorded in the laparoscopy group. Recurrence of VIH up to the end of the study period was not noted. In the laparoscopy group, the minor complications were lower (16.7% vs 52.9%; P = .035), the length of hospital stay was shorter (3 d vs 7 d, P = .007), but the median operative time was longer (137.5 min vs 106 min; P = .003).Conclusions
Laparoscopic repair of post-transplantation VIH is a safe and feasible procedure with shorter length of hospital stay. 相似文献11.
Hiroki Oba Jun Takahashi Takahiro Tsutsumimoto Shota Ikegami Hiroshi Ohta Mutsuki Yui Hidemi Kosaku Takayuki Kamanaka Hiromichi Misawa Hiroyuki Kato 《Journal of orthopaedic science》2017,22(4):641-646
Background
Lumbar decompression surgery is often used to treat neurological symptoms of the lower extremity as a result of lumbar disease. However, this method also leads to the improvement of the accompanying low back pain (LBP). We studied the extent of LBP improvement after lumbar decompression surgery without fusion and the associated preoperative factors.Methods
Patients (n = 140) with lumbar spinal stenosis (n = 90) or lumbar disc herniation (n = 50) were included. To evaluate the change in LBP, VAS scores and the Oswestry disability index scores were measured before surgery and 2 weeks, 3 months, and 6 months after surgery. The predictors of residual LBP were investigated using logistic regression analyses.Results
In total, 140 patients were examined. The VAS scores for LBP before surgery and 2 weeks, 3 months, and 6 months after surgery were 4.4 ± 3.0 (mean ± standard deviation), 1.1 ± 1.5, 1.3 ± 1.8, and 1.9 ± 2.2, respectively. LBP significantly improved 2 weeks after surgery (P < 0.001), stabilized between 2 weeks and 3 months after surgery, but was significantly aggravated 3–6 months after surgery (P < 0.001). At 6 months after surgery, 67 (47.9%) patients had a VAS score of >1. The predictors of residual LBP included severe preoperative LBP, degenerative scoliosis and the size of the Cobb angle. The independent predictors, determined by multivariate analysis were degenerative scoliosis and the size of the Cobb angle.Conclusions
LBP was alleviated at 2 weeks after lumbar decompression surgery for lumbar disc herniation and lumbar spinal stenosis. The predictors of residual LBP after decompression included more severe LBP at baseline, degenerative scoliosis and the size of Cobb angle.Level of evidence
Level 3. 相似文献12.
Matthew R. Schill Farah N. Musharbash Vivek Hansalia Jason W. Greenberg Spencer J. Melby Hersh S. Maniar Laurie A. Sinn Richard B. Schuessler Marc R. Moon Ralph J. Damiano 《The Journal of thoracic and cardiovascular surgery》2017,153(5):1087-1094
Objective
Most patients with atrial fibrillation (AF) undergoing cardiac surgery do not receive concomitant ablation. This study reviewed outcomes of patients with AF undergoing Cox-maze IV (CMIV) procedure with radiofrequency and cryoablation and coronary artery bypass grafting (CABG) at our institution.Methods
Between the introduction of radiofrequency ablation in 2002 and 2015, 135 patients underwent left- or biatrial CMIV with CABG. Patients undergoing other cardiac procedures, except mitral valve repair, or who had emergent, reoperative, or off-pump procedures were excluded. Eighty-three patients remained in the study group after exclusion criteria were applied. Freedom from atrial tachyarrhythmias (ATAs) was ascertained using electrocardiogram, Holter monitor, or pacemaker interrogation at 1 to 5 years postoperatively.Results
Operative mortality was 3%. Freedom from ATAs at 1 year in the CMIV group was 98%, with 88% off antiarrhythmia drugs. Freedom from ATAs and antiarrhythmia drugs was 70% at 5 years.Conclusions
The addition of CMIV to CABG resulted in excellent freedom from ATAs at 1 to 5 years. These patients are at increased risk for nonfatal complications compared with others undergoing concomitant surgical ablation. 相似文献13.
Luca A. Vricella William A. Ravekes Eloisa Arbustini Robert D.B. Jaquiss Constantine Mavroudis Harry C. Dietz Marshall L. Jacobs Narutoshi Hibino Duke E. Cameron 《The Journal of thoracic and cardiovascular surgery》2017,153(2):399-403
Background
In pediatric patients with connective tissue disorders (CTDs), early cardiac presentation often involves severe mitral regurgitation (MR) associated with severe bileaflet prolapse and, less frequently, aortic root enlargement. We adopted a simplified repair to address MR and prevent systolic anterior motion (SAM) in this unique group of patients.Materials and Methods
Retrospective review of clinical and echocardiographic data of all pediatric patients (age < 18 years) with CTD and MR undergoing simplified repair at 3 institutions (2000-2014).Results
Eighteen children who underwent surgery for severe MR and bileaflet prolapse were identified. All were treated with ring annuloplasty and Alfieri edge-to-edge repair. Median age and weight were 8.2 years (range, 0.4-17.2 years) and 24.9 kg (5.6-63.3 kg), respectively. Median left ventricular end diastolic dimension median z score was 4.9 (2.1-11.9). One patient died (5.6%), and there were no other major complications. Among survivors, 94.4% had mild regurgitation or less, with no stenosis or SAM at median clinical follow-up of 2.4 years (range, 0-13.9 years). Median left ventricular end-diastolic dimension z score regressed to 1.3 (?0.5 to 4.3).Conclusions
In pediatric patients with CTD and severe MR, a simplified approach is associated with intermediate-term competence, absence of SAM or significant stenosis, and regression of left ventricular enlargement. 相似文献14.
Toshiyuki Miyawaki Keigo Kumamoto Kaori Shimoda Fusae Tozato Tsutomu Iwaya 《Journal of orthopaedic science》2017,22(2):339-344
Background
Locomotive disorders are one of the main causative pathologies for the condition requiring assistance on activities of daily living (ADL). Although psychological concerns such as feeling of depression and anxiety are prevalent in elderly people, the causal relation among motor function, ADL disability, and psychological concerns is controversial.Purpose
Purpose of this study was to investigate causal relationship among motor function, ADL disability, and psychological concerns in elderly people with locomotive disorders.Methods
The data for this study were from a community-dwelling sample of 314 elderly persons with locomotive disorders aged 65 and older who visited orthopedic clinics and/or affiliated institutions. Motor function was assessed by one-leg standing time with eyes open, leg extension power and grip power. We assessed ADL disability using the 25-question Geriatric Locomotive Function Scale (GLFS-25), and psychological concerns by three self-reported questions. We constructed two models and tested fitness of the models to the data using a structural equation modeling (SEM). Model 1: motor function affects ADL disability and ADL disability affects psychological concerns, Model 2: motor function affects psychological concerns and psychological concerns affects ADL disability.Results
The fit indices were chi-square = 23.152 (p = 0.081), RMSEA = 0.042, GFI = 0.981, AGFI = 0.955, CFI = 0.987 for Model 1, and chi-square = 84.583 (p < 0.001), RMSEA = 0.119, GFI = 0.935, AGFI = 0.854, CFI = 0.892 for Model 2. These fit indices indicated a good fit of the model 1 and inadequate fit of model 2 to the data.Conclusion
Decline of motor function contributed toward psychological concerns via ADL disability in elderly people with locomotive disorders. 相似文献15.
Vincent V.G. An Brahman S. Sivakumar Kevin Phan Yadin David Levy Warwick J.M. Bruce 《Journal of orthopaedic science》2017,22(1):116-120
Introduction
The technical objective of total knee arthroplasty (TKA) is to restore normal mechanical parameters to the knee. Patient-specific instrumentation (PSI) was developed to streamline the operative process and improve accuracy. PSI produces individualized cutting guides based on three-dimensional models of the patient's anatomy acquired from computed-tomography (CT) or magnetic-resonance imaging (MRI). However, the superiority of one modality over the other remains unclear. Therefore, we aimed to compare the accuracy of patient-specific cutting guides produced from MRI or CT imaging methods in TKA.Methods
Electronic databases were systematically searched using relevant keywords and MeSH terms for original-data English-language publications comparing the accuracy of CT and MRI-based PSI cutting guides in TKA. Data was extracted from the text, tables and figures of studies and meta-analysed.Results
MRI-based PSI cutting guides produced a lower proportion of coronal plane outliers (>3°) with regard to overall limb mechanical axis (OR 2.75, p = 0.01). There were no significant differences between the two in terms of sagittal femoral and tibial component placement, or coronal femoral and tibial placement, or femoral component axial rotation. Tibial rotation was not analysed in the literature.Conclusions
MRI-based patient-specific cutting guides produced a lower proportion of outliers in the overall coronal alignment of the limb compared to CT, with no significant difference between the two in terms of femoral or tibial component placement. Future studies should investigate the differences in resource usage and operative time between the two to inform surgeons' decision making when choosing an ideal imaging modality for PSI TKA.Study design
Meta-analysis.Level of evidence
III, systematic review of cohort and comparative studies. 相似文献16.
N. Nakamura M. Tanaka M. Tsukamoto Y. Shimano M. Yasuhira J. Ashikari 《Transplantation proceedings》2017,49(1):16-25
Background
Kidneys from non–heart-beating donors are thought to be marginal, and careful evaluation is required. Mass analyzed data are limited, and each transplant surgeon must evaluate these organs on the basis of their own experience.Methods
We analyzed the data of 589 kidneys used for kidney transplantation from 304 non–heart-beating donors from January 2002 through December 2013 at the Japan Organ Transplant Network West Japan Division. The age of the donors, cause of death, and total ischemic time of more than 24 hours were factors that influenced the graft survival of the organs.Results
On the other hand, the final serum creatinine level before donation (maximum, 12.4 mg/dL), the presence and duration of anuria (maximum, 92 hours), and the presence of cannulation did not influence the graft survival rate.Conclusions
In multivariate analysis of Cox proportional hazards regression analysis, graft survival was significantly related to the age of the donor (over 70 years of age), cause of death (atherosclerotic disease), and total ischemic time of more than 24 hours. 相似文献17.
Background
De novo gastric cancer is a rare complication of liver transplantation.Methods
Surgical treatments of 16 cases with different outcomes were reported in the English literature.Results
De novo gastric cancer (stage II) was diagnosed as the result of epi-gastric discomfort in a recipient 10 years after liver transplantation. The patient received chemotherapy alone and remained well for 26 months.Conclusions
De novo gastric cancer of liver transplantation recipients is a severe complication; early detection and relevant intervention will benefit these recipients. 相似文献18.
Leena Ristolainen Jyrki A. Kettunen Urho M. Kujala Ari Heinonen Dietrich Schlenzka 《Journal of orthopaedic science》2017,22(4):652-657
Background
There is no data available on the radiographic development of the Scheuermann's deformity. Our purpose was to investigate radiographic deformity progression and the relation between kyphosis progression and clinical outcome in patients with untreated Scheuermann's kyphosis.Methods
Thoracic kyphosis (Th4-Th12) was measured from standing lateral radiographs in 19 patients at baseline and after mean 46-year follow-up. Mean age at baseline was 19.2 and at follow-up 64.7 years. At follow-up, height, weight, hand grip strength, and hamstring tightness were measured, and sit-to-stand and walking tests were performed. Additionally general health and quality of life questionnaires were administered.Results
The mean thoracic kyphosis increased from 46° (range 25°–78°) at baseline to 60° (34°–82°) (p < 0.001) at follow-up. Mean of the vertebrae wedge increased from 8.8° to 9.9° (p = 0.046). There was no correlation between extent of kyphosis progression and function at follow-up.Conclusions
Among patients with Scheuermann's disease the degree of radiographic deformity progressed slightly during long-term follow-up. Progression did not predict symptoms. 相似文献19.
Richard J. Hanly Salman K. Marvi Sarah L. Whitehouse Ross W. Crawford 《The Journal of arthroplasty》2017,32(9):2712-2716
Background
It is increasingly apparent that the effect of obesity in arthroplasty is joint-specific. This study evaluates the effects of morbid obesity on primary total knee arthroplasty by comparing short-term outcomes between a morbidly obese (body mass index ≥40 kg/m2) and a normal weight (body mass index 18.5-<25 kg/m2) cohort at our institution between January 2003 and December 2010.Methods
One hundred seventeen morbidly obese patients were compared with 94 normal weight patients. Operative time, length of stay, complications, 30-day readmission, and readmission length were compared.Results
Morbid obesity conveyed no significant increase in 30-day readmission. Operative time was increased at 100 minutes in the morbidly obese group, compared with 90.5 minutes (P = .026).Conclusion
Morbid obesity conveyed no increased risk of length of stay or readmission in this cohort. 相似文献20.
Omar A. Behery Sean M. Kearns Justin M. Rabinowitz Brett R. Levine 《The Journal of arthroplasty》2017,32(5):1510-1515