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Hip and pelvic fractures and sciatic nerve injury 总被引:1,自引:0,他引:1
Objective:To investigate te influence of hip and pelvic fracture,especially acetanbular fracture complicated by sciatic nerve injury on clinical features and prognosis of sciatic nerve injury.Methods:From January 1987 to January 2000,17 patients(14 male and 3 female) who had hip and pelvic fractures complicated by sciatic nerve injury were treated with operative reduction and internal fixation and followed up from 10 months to 5 years.The average age was 38 years(ranging 23-56 years).The left extremities were involved in 11 patients and the right in 6.Twelve patients underwent primary exploration and neurolysis and 5 patients underwent secondary operation.Results:Preperativelys,8 patients were treated with large doses of oral narcotics to control their severe sciatic pain.Three of the 8 patients underwent patient-controlled analgesia and epidural analgesin.After operation,excellent and good rates of reduction and functional recovery of sciatic nerve were 94.1% and 88% respectively.Four patients still had sciatic pain and 2 patients failed to recover.Sciatic nerve function improved within 3-6 months after surgery in 11 patients.Conclusions:Hip and pelivic fractures can result in sciatic nerve injury,especially common peroneal nerve injury and prognosis is poor.Open reduction and internal fixation combined with nerve exploration and neurolysis should be used as early as possible for severe sciatic pain. 相似文献
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Ewa Wallin Lars Rylander Bo A. G. Jönssson Thomas Lundh Anders Isaksson Lars Hagmar 《Osteoporosis international》2005,16(12):2085-2094
The incidence of osteoporotic fractures is rising in western societies, partly due to unknown reasons. Persistent organochlorine compounds (POC) have in animal studies impaired the normal bone metabolism and resulted in increased bone fragility, which might have health implications for POC-exposed human populations. The aim of the present study was to assess whether a high dietary intake of POC through fatty fish from the Baltic may result in decreased bone mineral density (BMD) or disturbances in biochemical markers of bone metabolism. From a study base of fishermen and fishermens wives from the Swedish east coast who are considerably more POC-exposed than the general Swedish population, 196 men (median age 59 years) and 184 women (median age 62 years) participated in an examination of their forearm BMD, using dual energy x-ray absorptiometry (DXA). Further, POC exposure was assessed by analysis of lipid-adjusted serum levels of 2,2,4,4,5,5-hexachlorobiphenyl (CB-153) and 1,1-dichloro-2,2-bis(p-chlorophenyl)-ethylene (p,p-DDE). Cadmium in urine (U-Cd) was also analyzed. Biochemical markers in serum of osteoblastic (osteocalcin) and osteoclastic (CrossLaps) functions were measured. Adjustment for potential confounders was made by employing multiple regression analyses. Univariate analyses showed significant negative associations between CB-153 concentrations and BMD, but after adjustment for age and body mass index, these associations did not remain. None of the POC exposure variables were associated with CrossLaps or osteocalcin. There were no significant associations between U-Cd and BMD or any of the biochemical biomarkers. In conclusion, the results did not provide any support for the hypothesis that the current exposure levels to POC constitute a hazard for impaired bone metabolism in the general Swedish population. 相似文献
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Anthony D Harries Stephen D Lawn Haileyesus Getahun Rony Zachariah Diane V Havlir 《Journal of the International AIDS Society》2012,15(2)
Introduction
Every year, HIV-associated tuberculosis (TB) deprives 350,000 mainly young people of productive and healthy lives. People die because TB is not diagnosed and treated in those with known HIV infection and HIV infection is not diagnosed in those with TB. Even in those in whom both HIV and TB are diagnosed and treated, this often happens far too late. These deficiencies can be addressed through the application of new scientific evidence and diagnostic tools.Discussion
A strategy of starting antiretroviral therapy (ART) early in the course of HIV infection has the potential to considerably reduce both individual and community burden of TB and needs urgent evaluation for efficacy, feasibility and broader social and economic impact. Isoniazid preventive therapy can reduce the risk of TB and, if given strategically in addition to ART, provides synergistic benefit. Intensified TB screening as part of the “Three I''s” strategy should be conducted at every clinic, home or community-based attendance using a symptoms-based algorithm, and new diagnostic tools should increasingly be used to confirm or refute TB diagnoses. Until such time when more sensitive and specific TB diagnostic assays are widely available, bolder approaches such as empirical anti-TB treatment need to be considered and evaluated. Patients with suspected or diagnosed TB must be screened for HIV and given cotrimoxazole preventive therapy and ART if HIV-positive. Three large randomized trials provide conclusive evidence that ART initiated within two to four weeks of start of anti-TB treatment saves lives, particularly in those with severe immunosuppression. The key to ensuring that these collaborative activities are delivered is the co-location and integration of TB and HIV services within the health system and the community.Conclusions
Progress towards reducing HIV-associated TB deaths can be achieved through attention to simple and deliverable actions on the ground. John Donne, Meditation XVII, Devotions upon Emergent Occasions: … any mans death diminishes me because I am involved in Mankinde; And therefore never send to know for whom the bell tolls; it tolls for thee …. 相似文献4.
Ahmad Samer Al-Homsi Zhongbin Lai Tara S. Roy M. Monzr Al-Malki Nicholas Kouttab Richard P. Junghans 《Transplant immunology》2014,30(1):40-45
Impairing dendritic cell (DC) function to prevent graft versus host disease (GvHD) is an appealing concept. DC antigen presentation is NF-κB pathway-dependent and bortezomib might therefore play a role in preventing alloreactivity. We obtained DC from the blood of patients enrolled in a phase I study using post-transplant cyclophosphamide and bortezomib for prevention of GvHD. Control samples were obtained from patients receiving standard GvHD prevention regimen. Pre-treatment samples were also collected from enrolled patients. DC isolated on days + 1, + 4, and + 7 showed progressive decrease in the expression of maturation markers in comparison to control. In a DC–CD4 + mixed lymphocyte reaction (MLR) where DC isolated from the recipient blood before graft infusion were the stimulator cells, T cell proliferation measured by bromodeoxyuridine (BrdU) integration was decreased in samples obtained on days + 14 and + 21 in comparison to control group. Finally, measured by real-time PCR, the expression of IκB progressively increased while the expression of NF-κB decreased in DC on days + 1, + 4, and + 7, in comparison to pre-treatment paired controls. We conclude that our data further justify exploring the role of bortezomib in GvHD prevention and propose a novel mechanism of action of bortezomib in DC. 相似文献
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Nemeth N 《Microsurgery》2007,27(3):155-157
Can a philosophic analogy be drawn between music, a major formal area and discipline of the fine arts, and microsurgery, a branch of applied medical science and research? Is an interdisciplinary view of value? Should we look for links beyond the stated boundaries of each of these areas? These are questions that fascinate physicians who, apart from their professional scientific activity, are also involved in making music a way to enrich their lives. In this paper a medical researcher, physician, and composer gives words to his thoughts about the parallel ideas and philosophies of these two disciplines. © 2007 Wiley‐Liss, Inc. Microsurgery, 2007. 相似文献
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β-Catenin and Tcfs in Mammary Development and Cancer 总被引:7,自引:0,他引:7
Hatsell S Rowlands T Hiremath M Cowin P 《Journal of mammary gland biology and neoplasia》2003,8(2):145-158
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Objective To investigate the expression of estrogen receptor (ER) α and β in human prostate cancer (PC), peri-cancer tissue and benign prostatic hyperplasia (BPH) tissue, and to discuss the role of estrogen receptor in prostate cancer. Methods The expression of ERα and ERβ in PC (n=28), peri-cancer tissue (n=28) and BPH (n=29) were detected by immunohistochemistry with En vision method. The ERα and ERβ expression were compared among different tissues by chisquare. The relationship between ER expression and related clinicopathologic features was statistically analyzed by spearman rank collection. Results ERα was localized dominantly in the stromal cell of PC. There were significant differences of the expression of ERα in PC, peri-cancer tissue and BPH tissue (epithelial cell 0%, 14%, 24%, P<0. 05; stromal cell 57%, 68%, 31%,P<0. 05). ERβ was localized in both epithelial and stromal cell of PC. There were significant differences of the expression of ERβ in PC, peri-cancer tissue and BPH tissue (epithelial cell 39%, 64%, 29%, P<0.01; stromal cell 50%, 75%, 79%, P<0.05). There was a significant difference of the expression of ERβ in different Gleason scores of PC tissue. Conclusions ERα is localized in the stromal cell of PC tissue.ERβ is localized in both epithelial and stromal cell of PC tissue. The ERβ might be related to the tumor differentiation of PC. 相似文献
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Objective To investigate the expression of estrogen receptor (ER) α and β in human prostate cancer (PC), peri-cancer tissue and benign prostatic hyperplasia (BPH) tissue, and to discuss the role of estrogen receptor in prostate cancer. Methods The expression of ERα and ERβ in PC (n=28), peri-cancer tissue (n=28) and BPH (n=29) were detected by immunohistochemistry with En vision method. The ERα and ERβ expression were compared among different tissues by chisquare. The relationship between ER expression and related clinicopathologic features was statistically analyzed by spearman rank collection. Results ERα was localized dominantly in the stromal cell of PC. There were significant differences of the expression of ERα in PC, peri-cancer tissue and BPH tissue (epithelial cell 0%, 14%, 24%, P<0. 05; stromal cell 57%, 68%, 31%,P<0. 05). ERβ was localized in both epithelial and stromal cell of PC. There were significant differences of the expression of ERβ in PC, peri-cancer tissue and BPH tissue (epithelial cell 39%, 64%, 29%, P<0.01; stromal cell 50%, 75%, 79%, P<0.05). There was a significant difference of the expression of ERβ in different Gleason scores of PC tissue. Conclusions ERα is localized in the stromal cell of PC tissue.ERβ is localized in both epithelial and stromal cell of PC tissue. The ERβ might be related to the tumor differentiation of PC. 相似文献
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Francis Robicsek MD G. Duke Duncan PhD Harry K. Daugherty MD Joseph W. Cook MD Jay G. Selle MD Philip J. Hess MD Robert Lawhorn PA 《Annals of vascular surgery》1991,5(4):315-319
One-hundred fifty-eight patients received specially manufactured aortoiliac or aortofemoral bifurcated grafts with one limb woven, the other knitted from Dacron. During an observation period ranging from 1,567 to 2,555 days (average 2,130 days) no statistically significant difference was found in either platelet adherence (30 patients studied) or in clinical patency. According to the results of the study, the type of graft (woven or knitted) did not seem to influence either platelet adherence or patency rate in the aortoiliac or aortofemoral positions. 相似文献
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King NS 《Brain injury : [BI]》2008,22(1):1-5
A number of controversies and debates have arisen over the years surrounding the dual diagnosis of post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI). Many of these have centred around the around the degree of protection provided by TBI against developing the disorder. The following is brief review of the literature in this area to help resolve some of these issues and to address a number of specific challenges which arise when working with this patient group. 相似文献
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Vitamin D and estrogen receptor-α genotype and indices of bone mass and bone turnover in Danish girls 总被引:1,自引:0,他引:1
Cusack S Mølgaard C Michaelsen KF Jakobsen J Lamberg-Allardt CJ Cashman KD 《Journal of bone and mineral metabolism》2006,24(4):329-336
Peak bone mass is a major determinant of osteoporosis risk in later life. It is under strong genetic control; however, little
is known about the identity of the genes involved. In the present study, we investigated the relationship between polymorphisms
in the genes encoding the vitamin D receptor (VDR) (FokI, TaqI) and estrogen receptor-α (ERα) (PvuII, XbaI), and bone mineral density (BMD), bone mineral content (BMC), and markers of bone turnover in 224 Danish girls aged 11–12
years. BMD and BMC were measured by dual-energy X-ray absorptiometry. Serum osteocalcin, 25(OH)D, and parathyroid hormone
(PTH) were measured by ELISA assays and urinary pyridinium cross-links by HPLC. Physical activity, dietary calcium, and Tanner
stage were assessed by questionnaire. In general, there were no significant differences in anthropometrical variables, physical
activity, dietary calcium, serum 25(OH)D, or PTH among genotype groups. BMD or BMC of lumbar spine or whole body (adjusted
for body and bone size and pubertal status) were not associated with VDR or ERα genotypes or the combination of these genotypes.
This lack of association remained even after adjustment for dietary and environmental factors. VDR genotypes had no effect
on bone turnover markers. XX and PP ERα genotypes were associated (P < 0.05) with reduced levels of urinary pyridinium cross-links, whereas serum osteocalcin was similar among genotypes. These
findings suggest that the rate of bone resorption was influenced by ERα genotypes, even though these biochemical differences
were not evident in bone mass indices. 相似文献
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BACKGROUND AND AIM: Central pancreatectomy (CP) is an operation that allows one to resect benign or low grade malignant tumours located in the pancreatic isthmus that are not suitable for enucleation. The main advantage of this operation compared with major resections is that it permits to spare normal pancreatic parenchyma. PATIENTS AND METHODS: The operation is carried out by exposition of the pancreatic neck involved by the lesion. Thereafter, the gland is dissected from the splenic artery and porto-mesenteric axis and divided with a 1 cm clear margin. The cephalic stump is sutured, and the distal stump is anastomosed end-to-end or end-to-side with a Roux-en-Y jejunal loop. We treated 20 patients with this technique. The indications for CP were: serous cystadenoma in seven patients, mucinous in three, solid cystic papillary tumour in one, metastasis from renal cancer in one and endocrine tumour in eight patients. RESULTS: Mortality rate was 0% and morbidity rate was 35%; pancreatic fistulas occurred in 25% of the cases and were treated conservatively. Results of postoperative endocrine and exocrine function tests were normal in all controlled patients. All the patients are alive without evidence of local recurrence. CONCLUSION: CP is a safe technique for benign or low-grade malignant tumours of the pancreatic neck that allows one to cure the tumour with evident functional results without increasing the risk to the patient. 相似文献