共查询到14条相似文献,搜索用时 15 毫秒
1.
Yoshiyuki Yahagi Takanori Iriuchishima Takashi Horaguchi Makoto Suruga Yasuaki Tokuhashi Shin Aizawa 《Knee surgery, sports traumatology, arthroscopy》2018,26(2):455-461
Purpose
The purpose of this study was to evaluate the difference in the center position of the ACL footprint based on grid placement using the quadrant method according to the morphological variations of the Blumensaat’s line.Methods
Fifty-nine non-paired human cadaver knees were used. The ACL was cut in the middle, and the femoral bone was cut at the most proximal point of the femoral notch, and the digital images were evaluated using Image J software. The femoral ACL footprint was periphery outlined and the center position was automatically measured. Following Iriuchishima’s classification, the morphology of the Blumensaat’s line was classified into straight, small hill, and large hill types. From the images, grid quadrants were placed as: Grid (1) without consideration of hill existence and not including the chondral lesion. Grid (2) without consideration of hill existence and including the chondral lesion. Grid (3) with consideration of hill existence and not including the chondral lesion. Grid (4) with consideration of hill existence and including the chondral lesion.Results
The straight type consisted of 19 knees, the small hill type 13 knees, and the large hill type 27 knees. Depending on the quadrant grid placement, significant center position difference was observed both in the shallow–deep, and high–low direction. When hill existence was considered, the center position of the ACL was significantly changed to a high position.Conclusion
The center position of the ACL footprint exhibited significant differences according to Blumensaat’s line morphology. For clinical relevance, when ACL surgery is performed in knees with small or large hill type variations, surgeons should pay close attention to femoral tunnel evaluation and placement, especially when using the quadrant method.2.
Saule Svediene Audrius Andrijauskas Juozas Ivaskevicius Andrius Saikus 《Knee surgery, sports traumatology, arthroscopy》2013,21(3):641-645
Purpose
Optimal postoperative analgesia after anterior cruciate ligament repair remains challenging. The objective of this prospective experimental clinical study was to compare the postoperative analgesic efficacy of two infusion regimens of 0.1 % bupivacaine administered via perineural femoral catheter.Methods
Forty adult ASA I and II patients undergoing anterior cruciate ligament reconstruction were enrolled. Surgery was performed under spinal anesthesia combined with femoral nerve block. A perineural femoral catheter was connected to the patient controlled analgesia infusion pump filled with 0.1 % bupivacaine for postoperative pain control. Subjects were assigned to one of two groups according to the bupivacaine infusion regimen: (1) 5 mL/h basal infusion with on-demand 5 mL boluses and 30-min refractive periods, and (2) only on-demand 5 mL boluses and 15-min refractive periods. Quality of postoperative analgesia, adjunctive analgesic consumption, and overall patient satisfaction were recorded for 48 h.Results
Pain control was better in Group I on the day of surgery (P = 0.001) and on the first postoperative day at rest and during mobilization (P = 0.02 and P = 0.009). On the second postoperative day, only pain control during mobilization was better in Group I (P = 0.047). Adjunctive analgesic consumption and patient satisfaction were similar.Conclusion
Perineural femoral infusion of on-demand 5 mL boluses of 0.1 % bupivacaine combined with 5 mL/h basal infusion was more efficient than on-demand regimen alone for postoperative pain management after reconstruction of anterior cruciate ligament of the knee.Level of evidence
II. 相似文献3.
4.
Frederic Paternostre Pierre-Emmanuel Schwab Emmanuel Thienpont 《Knee surgery, sports traumatology, arthroscopy》2014,22(12):3054-3059
Purpose
Aligning the femoral component in the axial plane parallel to the surgical epicondylar axis (SEA) has been generally recommended. In this retrospective study on the axial anatomy of the distal femur, as determined by the patient-specific instruments (PSI) planning tool based on MRI and 3D reconstructions, the different rotational axes were compared. The purpose of this study was to compare the impact of posterior axial anatomy on anterior anatomy and to compare the different angles of rotation obtained by a PSI-planning engineer.Methods
The preoperative planning of 77 PSI patients with a mean (SD) age of 65.6 (9.6) years undergoing primary total knee replacement for osteoarthritis was analysed for rotational anatomy of the distal femur. The angles between the posterior condylar line (PCL) and the SEA called posterior condylar angle (PCA), between Whiteside’s line and the SEA and finally between Whiteside’s line and the PCL, were retrieved from the PSI axial rotation planning screen.Results
The mean (SD) PCA was 3.2° (1.4°). The mean (SD) angle between Whiteside’s line and the SEA was 91.4° (2.2°), and the mean (SD) angle between Whiteside’s line and the PCL was 94.5° (2.3°). No significant difference for this last rotational parameter was found in between varus and valgus knees.Conclusion
Patient-specific instrument’s preoperative planning found consistent angles to describe the distal femoral anatomy as previously published in the literature. The angle between Whiteside’s line and the PCL as measured on PSI planning is a mean angle of 94.5° (2.3°) for both varus and valgus knees. Setting a fixed PCA of 5° of external rotation referenced of the PCL makes this planning repeatable during conventional surgery.Level of evidence
Therapeutic study, Level III. 相似文献5.
Vladimir Živković Dragan Babić Slobodan Nikolić 《Forensic science, medicine, and pathology》2013,9(2):177-183
Purpose
Bodies recovered from water often present as a difficult problem in forensic pathology. The aim of this study was to examine the presence and amount of free liquid in the sphenoid sinus in cases of freshwater drowning, and to compare this to the amount found in putrefied bodies recovered from freshwater, as well as in putrefied bodies found in an indoor environment.Methods
Free liquid from the sphenoid sinuses was aspirated using a syringe and a needle, after piercing the hypophyseal fossa. Non-putrefied drowning cases were also examined for hemolytic staining of the intima of the aortic root.Results
In 29 non-putrefied cases of freshwater drowning there was 1.36 ± 1.48 ml in the sphenoid sinuses, with 21 of them having hemolytic staining of aortic intima. In putrefied bodies recovered from freshwater (22 cases) there was 1.26 ± 1.40 ml within the sphenoid sinuses, and in putrefied bodies found in an indoor environment (52 cases), there was significantly less—0.57 ± 0.92 ml.Conclusions
Free liquid in the sphenoid sinuses (Svechnikov’s sign) may be considered a vital reaction in drowning non-putrefied cases. Hemolytic staining of the aortic intima could be a significant sign of freshwater drowning. In putrefied bodies recovered from water, an amount of 0.55 ml of free liquid in the sphenoid sinuses may imply that the victim was alive upon their contact with the water, but the presence of free liquid in the sphenoid sinuses does not necessarily indicate that drowning had been the cause of death. 相似文献6.
We present a 70-year-old woman with pre-B acute lymphoblastic leukemia in whom serial imaging studies showed the development
of multiple vertebral collapse, and communicating superior and inferior Schmorl’s nodes creating a longitudinal channel (”tunneling”
Schmorl’s nodes) through the anterior aspect of T12 to L3 vertebral bodies of her osteoporotic thoracolumbar spine. This was
observed after achieving complete remission of the disease and during maintenance therapy. The finding is felt to be secondary
to iatrogenic exacerbation of osteoporosis.
Received: 26 May 2000 Revision requested: 23 June 2000 Revision received: 10 July 2000 Accepted: 13 July 2000 相似文献
7.
8.
Thomas BA Erlandsson K Modat M Thurfjell L Vandenberghe R Ourselin S Hutton BF 《European journal of nuclear medicine and molecular imaging》2011,38(6):1104-1119
Purpose
Alzheimer’s disease (AD) is the most common form of dementia. Clinically, it is characterized by progressive cognitive and functional impairment with structural hallmarks of cortical atrophy and ventricular expansion. Amyloid plaque aggregation is also known to occur in AD subjects. In-vivo imaging of amyloid plaques is now possible with positron emission tomography (PET) radioligands. PET imaging suffers from a degrading phenomenon known as the partial volume effect (PVE). The quantitative accuracy of PET images is reduced by PVEs primarily due to the limited spatial resolution of the scanner. The degree of PVE is influenced by structure size, with smaller structures tending to suffer from more severe PVEs such as atrophied grey matter regions. The aims of this paper were to investigate the effect of partial volume correction (PVC) on the quantification of amyloid PET and to highlight the importance of selecting an appropriate PVC technique. 相似文献9.
10.
Louise H. Naylor Angela L. Spence Stijn C.M. Donker Dick H.J. Thijssen Daniel J. Green 《Journal of Science and Medicine in Sport》2021,24(7):635-640
ObjectivesExercise places physiological demands upon the cardiovascular system, subsequently leading to adaptations in structure and function. Different exercise modalities (endurance, strength and power) lead to distinct hemodynamic demands and, possibly, different patterns of adaptation. Our aim was to assess and compare brachial and femoral artery function and structure in elite level athletes engaged in endurance, strength and power sports.Designcross sectional comparison.Methods30 male elite athletes (runners n = 10, powerlifters n = 11, weightlifters n = 9) and 23 healthy controls were recruited. Brachial and femoral arterial diameters were assessed using ultrasound. Arterial function (brachial and femoral arteries) was determined using the flow mediated dilation (FMD) technique and body composition using body mass index (BMI) and body surface area (BSA).ResultsWeightlifters had significantly larger brachial arterial diameters compared to controls (4.39 ± 0.34 vs 3.86 ± 0.42 mm, p < 0.01). As weightlifter and power athletes had significantly higher body mass, BMI and BSA, we adjusted diameter for BSA. BSA-correction ameliorated differences in brachial artery resting diameters between athletes and controls. However, BSA-corrected femoral artery diameter was significantly larger in runners compared to controls (3.51 ± 0.28 vs 3.25 ± 0.34 mm, p < 0.05). There were no differences in brachial FMD between groups. Femoral artery FMD was significantly higher in runners and weightlifters compared to controls (p < 0.05 for both groups).ConclusionsHeterogeneous, limb-specific structural and functional vascular adaptation is evident in athletes, which may be influenced by exercise modality. Further, vascular remodelling relates to differences in body shape, specifically body composition, which should be accounted for when comparing athletes. 相似文献
11.
Sung-Jae Kim Chong Hyuk Choi Sung-Hwan Kim Su-Keon Lee Wonyong Lee Taeyup Kim Min Jung 《Knee surgery, sports traumatology, arthroscopy》2018,26(9):2568-2579
Purpose
The present study aimed to compare 2- and 5-year outcomes of ACL reconstruction between patients with and without generalized joint laxity and to perform comparative evaluation between two types of grafts used for ACL reconstruction in patients with generalized joint laxity.Methods
Two hundred and thirty-seven patients who underwent ACL reconstruction from 2001 to 2008 were included. Patients were classified into two groups according to the presence or the absence of generalized joint laxity, and further subdivided into two subgroups based on the type of graft used: bone–patellar tendon–bone (BPTB) or hamstring. Generalized joint laxity was assessed with the Beighton and Horan criteria using a point scoring system. Stability reflected by the Lachman test, pivot-shift test, and anterior translation measured with KT-2000, and functional outcomes reflected by Lysholm knee score, and International Knee Documentation Committee (IKDC) subjective score were investigated. IKDC objective grade and radiographic grade were also assessed. Clinical assessments were conducted preoperatively and at 2 and 5 years after operation.Results
Two-year follow-up results showed that patients with generalized joint laxity receiving hamstring grafts had poorer outcomes than those without generalized joint laxity. Five-year follow-up results showed that patients with generalized joint laxity experienced poorer outcomes than patients without generalized joint laxity, irrespective of the type of graft. Comparison of grafts used showed that, in patients with generalized joint laxity, BPTB graft provided significantly better stability and functional outcomes than hamstring graft at both 2- and 5-year follow-ups. Comparisons between serial outcomes measured at 2 and 5 years demonstrated that stability and functional outcomes deteriorated over time in patients with generalized joint laxity.Conclusions
Less satisfactory stability and functional outcomes were noted in patients with generalized joint laxity, compared to patients without generalized joint laxity. Comparisons of stability and functional outcomes after ACL reconstruction in patients with generalized joint laxity between two different grafts demonstrated that BPTB graft achieves better results than hamstring graft.Level of evidence
III, a retrospective cohort study.12.
Giuseppe Lo Re Maria Cappello Chiara Tudisca Massimo Galia Claudia Randazzo Antonio Craxì Calogero Cammà Andrea Giovagnoni Massimo Midiri 《La Radiologia medica》2014,119(9):658-666
Purpose
Few studies have correlated computed tomography enterography (CTE) findings with Crohn’s disease (CD) clinical and biochemical activity. The aim of this study was to evaluate correlations between CTE findings with CD activity.Materials and methods
The CTE datasets from 62 patients were retrospectively reviewed for different parameters: bowel wall thickening and hyperenhancement, mesenteric alterations, abdominal free fluid and complications related to the disease (fistulas, strictures, abscesses). Activity was assessed using the Crohn’s Disease Activity Index (CDAI) and some biochemical markers (C-reactive protein, erythrocyte sedimentation rate, alpha 2-globulins, fibrinogen, platelets, haemoglobin). Correlations between CTE parameters, clinical activity score and laboratory parameters were assessed by logistic regression.Results
CDAI was significantly correlated with increased fat density (p = 0.03) and intestinal strictures (p = 0.04). Platelet counts were elevated in patients with enlarged mesenteric lymph nodes (p = 0.009) and the comb sign (p = 0.05). Serum alpha 2-globulins were higher in the presence of the comb sign (p = 0.03).Conclusion
The CTE finding of perienteric inflammation (increased fat density) and vascular engorgement of the vasa recta in CD patients suggest that the disease is clinically active and that these patients may require more aggressive treatment than patients without these findings. 相似文献13.
Recently, reliable and clear evidence for the usefulness of 123I-MIBG scintigraphy in the diagnosis of Parkinson's disease (PD) has been accumulated and it has become increasingly popular as one of the most accurate means of diagnosing the disease. PD, one of the most common neurodegenerative disorders, is characterized by resting tremor, rigidity, bradykinesia or akinesia, and postural instability. The disease is characterized pathologically by distinctive neuronal inclusions called Lewy bodies in many surviving cells of dopaminergic neurons of the substantia nigra pars compacta and other specific brain regions. Furthermore Lewy body type degeneration in the cardiac plexus has been observed in PD. In PD, cardiac MIBG uptake is reduced markedly even in the early disease stages; therefore, MIBG imaging can be used as an indicator of the presence of PD rather than disease severity. Other parkinsonian syndromes such as multiple system atrophy, progressive supranuclear palsy, and corticobasal degeneration demonstrate normal cardiac MIBG uptake or only mild reduction of MIBG uptake, indicating that MIBG imaging is a powerful method to differentiate PD from other parkinsonian syndromes. Dementia with Lewy bodies (DLB) also shows severe reduction of MIBG uptake, whereas Alzheimer's disease (AD) demonstrates normal MIBG uptake, permitting differentiation of DLB from AD using MIBG scintigraphy. In pure autonomic failure, which shares similar pathological findings with PD and is thought to be associated with diffuse loss of sympathetic terminal innervation, cardiac MIBG uptake also decreases markedly. Considering all the data together, marked reduction of cardiac MIBG uptake seems to be a specific marker of Lewy body disease and thus extremely useful in the differentiation from other diseases with similar symptoms without Lewy bodies. 相似文献
14.
Gregory S. Thomas S. James Cullom Therese M. Kitt Kathleen M. Feaheny Karthikeyan Ananthasubramaniam Robert J. Gropler Diwakar Jain Randall C. Thompson 《Journal of nuclear cardiology》2017,24(3):788-802