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Intraoperative 3D imaging has a marked impact on the surgical treatment of articular fractures. In theory, insufficient reduction of fracture fragments and malpositioning of implants can be corrected in the same session so that unnecessary secondary imaging and revision surgery can be avoided. Current evidence on the accuracy of 3D scans, however, relies on heterogeneous preclinical data and must be interpreted with caution. Every fourth 3D scan seems to lead to a repositioning of fracture fragments or implants, despite unproven sensitivity and specificity. The interaction between diagnostic accuracy and therapeutic consequences needs exploration before any conclusions on the (additional) benefits of intraoperative 3D imaging can be drawn.  相似文献   

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Background

Sevoflurane is one of the most widely used inhalation anesthetics in pediatric anesthesia. A large number of studies have demonstrated that repeated treatment with high concentrations or long durations of sevoflurane anesthesia during the neonatal period can induce neuroapoptosis and long-term learning disability. In clinical practice, we observed that a subset of patients underwent minor surgery under sevoflurane anesthesia more than once from birth to adolescence. Therefore, this research was conducted to investigate whether a 2% concentration of sevoflurane (clinically relevant usage of sevoflurane) for 1?h (a short duration) can induce neuroapoptosis and neurocognitive dysfunction in adolescent rats that received sevoflurane (2% for 1?h) during the neonatal period.

Material and methods

Group I: neonatal rats at postnatal day 7 (PND-7) were treated with oxygen under controlled conditions and then raised to PND-60. Group II: PND-7 rats were treated with 2% sevoflurane for 1?h and then raised to PND-60. Group III: the PND-60 rats were treated with 2% sevoflurane for 1?h and in group IV the PND-7 rats were treated with 2% sevoflurane for 1?h and then anesthetized with 2% sevoflurane for 1?h at PND-60 again. The expression of caspase-3, Bax and Bcl-2 in the hippocampal dentate gyrus (DG) were measured by Western blot analysis. Neuroapoptosis in the hippocampal DG was assessed using NeuN/caspase-3 double-immunofluorescence staining. Spatial reference memory was tested by the Morris water maze test.

Results

The present data showed that sevoflurane (2% for 1?h) did not induce obvious hippocampal neuroapoptosis in the PND-7 rats and PND-60 rats; their performance in hippocampal-dependent spatial memory was not significantly impaired; however, the rats in group IV showed poor performance in the Morris water maze test and the neuroapoptosis in group IV was significantly increased.

Conclusion

Our findings suggested that sevoflurane can induce neuroapoptosis and cognitive dysfunction in adolescent rats that received repeated sevoflurane (2% for 1?h) during the postnatal period. These findings will promote further studies to investigate the effects of repeated sevoflurane exposure on the development of the central nervous system and function of learning and memory, as well as the underlying mechanisms in vitro and in vivo.
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Braunstein  M.  Kusmenkov  T.  Böcker  W.  Bogner-Flatz  V. 《Der Unfallchirurg》2019,122(12):967-976
Die Unfallchirurgie - Die Morbidität und Mortalität polytraumatisierter Patienten wird wesentlich durch das Ausmaß der posttraumatischen Inflammationsreaktion beeinflusst. In einer...  相似文献   

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Background

Arthroscopic arthrolysis is a minimally invasive but technically demanding treatment option for elbow stiffness. Prospective clinical data are limited thus far.

Objectives

The aim was to analyze the clinical short-term results of arthroscopic elbow arthrolysis and to evaluate factors predictive of the outcome.

Materials and methods

28 patients (16 men, 12 women) following arthroscopic arthrolysis were enrolled in this study. The VAS (visual analogue scale) score, range of motion (ROM), and DASH score were obtained preoperatively as well as 6 weeks and 12 months after surgery. Posttraumatic elbow stiffness was present in 15 cases, elbow stiffness was due to primary osteoarthritis in 10 cases and due to other reasons in 3 cases. Osteoarthritis was absent in 1 case, grade 1 osteoarthritis was present in 7 cases, grade 2 in 9 cases and grade 3 in 11 cases according to the Broberg and Morrey classification.

Results

The VAS score was 5.3 ± 2.4 points preoperatively and decreased to 2.8 ± 2.7 points after 6 weeks and 1.6 ± 1.8 points after 12 months (p ≤ 0.001). The ROM increased from 86± 30° to 106± 28° after 6 weeks and to 121± 18° 12 months postoperatively (p ≤ 0.01). The DASH score improved from 39.3 ± 17.8 points to 23.8 ± 15.7 points after 6 weeks and to 11.3 ± 8.7 points 12 months postoperatively (p ≤ 0.001). Sex, age, grade of osteoarthritis and cause of elbow stiffness were not predictive of the clinical outcome. Complications were seen in 2 patients (7?%).

Conclusions

Arthroscopic arthrolysis represents an effective treatment method for elbow stiffness, which increases the range of motion, decreases pain levels and thus improves the functionality of the affected extremity regardless of sex, age, severity of osteoarthritis and etiology of elbow stiffness.
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Ran-binding protein 3 (RanBP3) is a Ran-interacting protein, which participates in the Ran GTPase system in cancer cell biology. However, the expression pattern and physiological role of RanBP3 remain largely unknown. In this study, we found that RanBP3 was expressed in human testes and localised to spermatogonium and spermatocyte of germ cells. In subcellular structure, its localisation is in the nucleus and cytoplasm. Interestingly, compared with normal groups, RanBP3 expression was lower in groups of patients with Maturation Arrest (MA) and Sertoli cell-only syndrome (SCO) when considered by the Johnson Score. RanBP3 expression in the MA group and SCO groups was dramatically lower than that in the normal control group. Studies have shown that RanBP3, which is one of the helper factors of Ran, is mainly participate in the nucleocytoplasmic transport of cells. RanBP3 helps Ran to achieve some functions such as nucleocytoplasmic transport, spindle assembly during mitosis and nuclear assembly after mitosis. Consequent changes in the expression of RanBP3 may associate with human spermatogenesis disorders and male infertility. The identification and characterisation of RanBP3 enhances our understanding of the molecular mechanisms underpinning its function in human spermatogenesis and male infertility.  相似文献   

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Clinical and Experimental Nephrology - Acute kidney injury (AKI) is a worldwide concern and it leads to a poor prognosis or end-stage kidney disease. The purpose of this study was to clarify the...  相似文献   

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T DepartmentofNeurosurgery,SecondAffiliatedHospital,FujianMedicalUniverstity,Quanzhou362000,China(YangB,YangGY)raumaticlacunarinfarctioninbasalganglioninchildrenunder10yearoldismoreliabletooccur.BeforeCTwasavailable,thenatureandlocalizationofthelesi…  相似文献   

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AIM: The aim of this study was to establish the status of sentinel lymph node (SLN) biopsy procedure in cutaneous melanoma in France in 2002. MATERIAL AND METHODS: This study was based upon the statistics of the main French melanoma centers. A short questionnary was sent to Head Physician by email. The authors asked for the global attitude as far as SLN was concerned, number of cutaneous melanoma diagnosed during year 2002 and of SLN procedures performed, critters of inclusion and postoperative management in each case. Abstension could be argued in a free item. Answers were sent back by email. RESULTS: The authors collected 22 answers coming from overall territory; 64% performed SLN procedure (14 centers), 36% applied "wait and watch" policy. Staffs performing SLN diagnosed a mean of 101 (8-400) melanoma and biopsied a mean of 21 (0-53) sentinel nodes. The others diagnosed a mean of 151 (15-250) melanoma. Patients were enrolled for Breslow thickness upper to 1.5 mm in 71%, to 1 mm in 29%. Ulceration was a critter of inclusion in 93% (21 staffs), 100% enrolled patients whose tumor presented signs of regression. SLN was performed for primary sites located overall body in 71%, only in limbs and trunk in 29%. Positive node lead to regional lymph node clearance, then observation or interferon protocol. Negative node lead to "wait and watch policy" in 14%, different interferon protocols according to Breslow thickness in 86%. CONCLUSION: SLN procedure is not homogenous in France. France is divided as far as SLN is concerned. If 64% are performing SLN, more than 50% of the new melanoma are not included in the trial.  相似文献   

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Summary  

This population-based study was conducted using claims data obtained from the National Health Insurance to investigate the trend in incidence of distal radial fractures in adults in Taiwan from 2000 to 2007. Our results revealed an increasing trend, particularly among women >50 years of age.  相似文献   

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