共查询到20条相似文献,搜索用时 31 毫秒
1.
Serhat Avcu Mehmet Deniz Bulut Alpaslan Yavuz Aydın Bora Mehmet Beyazal 《Japanese journal of radiology》2014,32(1):6-13
Purpose
The purpose of our study was to assess the efficiency of diffusion-weighted magnetic resonance imaging (DW-MRI) and the quantification of apparent diffusion coefficient (ADC) values in differentiating colorectal carcinoma from colonic inflammatory bowel disease (IBD) in cases with isolated colonic wall lesions and uncertain clinical and radiologic diagnostic criteria.Methods
The study comprised 58 patients with segmental or focal isolated colonic wall thickening. All lacked satisfactory clinical–radiological findings for etiology determination. The mean ADC values of the thickened colonic walls were retrospectively compared with final histopathologic diagnoses. Receiver operating characteristic (ROC) curve analysis was used to determine the ADC cutoff value for differentiation.Results
Mean ADC value in the colorectal carcinoma group was significantly lower than that in the IBD group: n = 27, 1.02 ± 0.26 × 10?3 mm2/s; and n = 31, 1.53 ± 0.19 × 10?3 mm2/s, respectively (P < 0.001). Cutoff ADC value for differentiating colorectal carcinoma from IBD was calculated as 1.39 × 10?3 mm2/s, with 83.9 % sensitivity and 85.2 % specificity.Conclusion
ADC measurement of the involved colonic wall segments with DW-MRI has the potential to differentiate isolated colonic IBD from colorectal carcinoma in cases in which clinical–radiologic findings are insufficient for a definitive diagnosis. 相似文献2.
Koray Kilic Gonca Erbas Murat Ucar Koray Akkan Nil Tokgoz Mehmet Arac Sedat Isik 《Japanese journal of radiology》2014,32(2):90-97
Purpose
The aim of this study was to assess the effectiveness of the modified test-bolus (mTB) method in computed tomography pulmonary angiography (CTPA).Materials and methods
The Institutional Review Board approved this retrospective study. We reviewed 24 patients (nine men, 15 women; age range, 21–88 years) in whom CTPA was performed either by Bolus-Tracking (BT) (n = 12) or mTB (n = 12) methods. Pulmonary transit time (PTT) was used to determine scan delay time and contrast volume in the mTB group. The contrast volume, radiation dose, quantitative measures, and qualitative scores of enhancement were compared. The chi-squared test, Mann–Whitney U test, and κ statistics were used. The significance level was 0.05.Results
The effective dose (P = 0.028) and contrast volume (P < 0.001) was significantly lower in the mTB group than those in the BT group. The difference in the quantitative measures and qualitative scores of enhancement between groups was statistically insignificant (P = 0.729, P = 0.635, respectively). Significantly fewer artefacts were observed in the mTB group (P = 0.024).Conclusion
By taking into account PTT, mTB appears to be a promising method for tailoring CTPA to the patient with the use of less contrast material and resulting in fewer artifacts. 相似文献3.
Marc Philippon Christopher Dewing Karen Briggs J. Richard Steadman 《Knee surgery, sports traumatology, arthroscopy》2012,20(12):2585-2589
Purpose
Reduction in anterior cruciate ligament (ACL) injuries in young, active individuals continues to be a major goal in sports medicine. The purpose of this study was to determine the head–neck offset, as measured by AP pelvis alpha angles, in patients presenting to a single surgeon with isolated ACL and non-ACL knee injuries.Methods
In a group of 48 patients with complete, primary ACL rupture and 42 controls with non-ACL injury (i.e., meniscus tear, cartilage defect), a single surgeon, blinded to the diagnosis, took radiographic measures of the AP alpha angle of both hips and the weight-bearing line at both knees. All knee pathology was confirmed with knee arthroscopy. Inclusion criteria included no previous hip or knee surgery, and long-leg standing alignment radiographic series completed at index visit.Results
There was no difference in gender distribution, height, BMI or age between groups. ACL-injured patients had a significantly higher alpha angle (mean = 84, SD = 14) on the injured side than the controls (mean = 59, SD = 7, p < 0.0001). Ninety-four percent of the ACL-injured group had alpha angles over 60°, while only 35% of the non-ACL-injured group had alpha angles over 60° (p = 0.001). Those patients with alpha angle over 60° were 27 times more likely (95% CI 6.4–131) to be in the ACL injury group than those patients with alpha angle 60° or less (p = 0.001).Conclusion
Our findings establish an important preliminary correlation between ACL injury and diminished femoral head–neck offset, as characterized by abnormal, elevated alpha angles.Level of evidence
Prognostic study, Level III. 相似文献4.
Doo-Sup Kim Chang-Ho Yi Ki-Yeon Kwon Jin-Rok Oh 《Knee surgery, sports traumatology, arthroscopy》2013,21(2):430-437
Purpose
This study aimed to evaluate the relationship between the extent of the labral lesion and the frequency of glenohumeral dislocation in patients with shoulder instability.Methods
Ninety-three patients, who underwent surgical treatment at our clinic for chronic anterior shoulder dislocation, were selected and divided into 3 groups (group I: only Bankart lesion; group II: Bankart and SLAP lesions; group III: circumferential-labral lesion). The pre-operative frequency of dislocation, intraoperative findings, operation time, post-operative clinical score, and range of motion 2 years after surgery were analysed and compared among the 3 groups.Results
The time interval from the initial dislocation to operation was significantly shorter in group III than in groups I and II (P = 0.034 and P = 0.046, respectively). The median number of preoperative dislocations was also significantly less in group III than in groups I and II (P = 0.025 and P = 0.044, respectively). In all groups, the clinical scores (Constant, Rowe, and visual analogue scale) improved significantly post-operatively, and there were no significant differences in the scores between the different groups. All patients returned to work, and most patients returned to their preoperative sports activity levels.Conclusion
The extent of the labral lesion is not always related to the number of dislocations; therefore, treatment should not be based on this.Level of evidence
Retrospective comparative study, Level III. 相似文献5.
Gun Woo Lee Soo-Jin Jang Young Choi Jung-Hwan Son 《Knee surgery, sports traumatology, arthroscopy》2013,21(5):1043-1049
Purpose
To evaluate the clinical and radiological results of arthroscopic PCL reconstruction using an accessory anterolateral portal for femoral tunneling and to compare these results with those of the conventional technique.Methods
We retrospectively reviewed the clinical and radiological results for 57 patients who underwent PCL reconstruction, including 31 patients who underwent arthroscopic PCL reconstruction with an accessory anterolateral portal (group A) and 26 patients who underwent conventional arthroscopic PCL reconstruction (group B). Lysholm score, IKDC score, simple radiographs (AP and lateral), and posterior drawer test results were evaluated preoperatively and at 3 years postoperatively.Results
No major complication was observed in group A. However, posterior cortical disruption due to improper placement of the femoral tunnel was observed in one patient in group B. The mean Lysholm knee scores increased from 41.5 ± 4.8 preoperatively to 92.5 ± 6.2 at final follow-up in group A (P < 0.001), and from 43.5 ± 3.4 preoperatively to 88.5 points ± 3.7 in group B (P = 0.002). Posterior stress radiographs with a KT-1000 showed that the mean side-to-side differences improved from 13.79 ± 5.1 mm preoperatively to 3.1 ± 0.7 mm postoperatively in group A and from 12.68 ± 6.3 mm preoperatively to 3.5 ± 0.5 mm postoperatively in group B. The sensitivity and specificity of the placement and direction of the femoral tunnel were significantly higher in group A than group B (P = 0.002).Conclusion
Arthroscopic PCL reconstruction with an accessory anterolateral portal can provide a better surgical view than the conventional technique, and this can minimize the problems associated with femoral tunneling, such as inappropriate and inconsistent placement of the tunnel, abnormal angulation, and sliding of the guide tip. Moreover, this approach may have a shorter operative time and a better functional recovery than the conventional technique.Level of evidence
Retrospective comparative study, Level IV. 相似文献6.
Keerati Chareancholvanich Chaturong Pornrattanamaneewong Rapeepat Narkbunnam 《Knee surgery, sports traumatology, arthroscopy》2014,22(6):1415-1423
Purpose
High tibial osteotomy (HTO) is a surgical procedure used to correct abnormal mechanical loading of the knee joint; additionally, intra-articular hyaluronic acid injections have been shown to restore the viscoelastic properties of synovial fluid and balance abnormal biochemical processes. It was hypothesized that combining HTO with intra-articular hyaluronic acid injections would have benefit to improve the cartilage volume of knee joints.Methods
Forty patients with medial compartment knee osteoarthritis (OA) were randomly placed into 1 of 2 groups. The study group (n = 20) received 2 cycles (at 6-month intervals) of 5 weekly intra-articular hyaluronic acid injections after HTO operation. The control group (n = 20) did not receive any intra-articular injections after HTO surgery. Cartilage volume (primary outcome) was assessed by magnetic resonance imaging (MRI) pre-operatively and 1 year post-operatively. Treatment efficacy (secondary outcomes) was evaluated with the Western Ontario and McMaster Universities OA Index (WOMAC) and by the comparison of the total rescue medication (paracetamol/diclofenac) used (weeks 6, 12, 24, 48).Results
MRI studies showed a significant increase in total cartilage volume (p = 0.033), lateral femoral cartilage volume (p = 0.044) and lateral tibial cartilage volume (p = 0.027) in the study group. Cartilage volume loss was detected at the lateral tibial plateau in the control group. There were significant improvements after surgery in both groups for all subscales of WOMAC scores (p < 0.001) compared to the baseline. However, no difference was found between the two groups. The study group had significantly lower amounts of diclofenac consumption (p = 0.017).Conclusion
Based on the findings of the present study, intra-articular hyaluronic acid injections may be beneficial for increasing total cartilage volume and preventing the loss of lateral tibiofemoral joint cartilage after HTO.Level of evidence
Therapeutic study, Level I. 相似文献7.
Patel NK Bucknill A Ahearne D Denning J Desai K Watson M 《Knee surgery, sports traumatology, arthroscopy》2012,20(6):1152-1158
Purpose
Acute knee injury is common, and MRI is often only used when non-operative management fails because of limited availability. We investigated whether early MRI in acute knee injury is more clinically and cost-effective compared to conventional physiotherapy and reassessment.Methods
All patients with acute indirect soft tissue knee injury referred to fracture clinic were approached. Recruited patients were randomised to either the MRI group: early MRI within 2 weeks or the control group: conventional management with physiotherapy. Patients were assessed in clinic initially, at 2 weeks and 3 months post-injury. Management costs were calculated for all patients until surgical treatment or discharge.Results
Forty-six patients were recruited: 23 in the MRI and 23 in the control group. Male sex and mean age were similar in the two groups. The total management cost of the MRI group was £16,127 and control group was £16,170, with a similar mean cost per patient (NS). The MRI group had less mean physiotherapy (2.5 ± 1.9 vs. 5.1 ± 3.5, p < 0.01) and outpatient appointments (NS). Median time to surgery and time off work was less in the MRI group (NS). The MRI group had less pain (p < 0.05), less activity limitation (p = 0.04) and better satisfaction (p = 0.04).Conclusions
Early MRI in acute knee injury facilitates faster diagnosis and management of internal derangement at a cost comparable to conventional treatment. Moreover, patients had significantly less time off work with improved pain, activity limitation and satisfaction scores.Level of evidence
II. 相似文献8.
Jinlin Wang Shiyue Li Yunxiang Zeng Ping Chen Nuofu Zhang Nanshan Zhong 《Annals of nuclear medicine》2014,28(3):276-284
Objectives
To retrospectively investigate the role of 18 F–fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) for the diagnosis and therapeutic response in relapsing polychondritis (RP) patients.Methods
18F-FDG PET/CT findings were reviewed in six RP patients. The initial scans were performed for all patients, follow-up scans were performed during steroid therapy for five patients. Changes in the abnormal lesions and the maximal standard uptake value (SUVmax) were analyzed.Results
The initial PET/CT scans revealed intense FDG uptake in the cartilages for all six patients. The lesions of abnormal FDG uptake were tracheal/bronchial cartilage (n = 4), costicartilage (n = 4), nasal cartilage (n = 3), cricoid cartilage (n = 3), auricular cartilage (n = 3), arytenoid cartilage (n = 3), thyroid cartilage (n = 2), hyoid cartilage (n = 1) and mediastinum lymph node (n = 1). The mean visual score and the mean SUVmax were 2.96 ± 0.20 and 4.10 ± 0.6. The intense uptake reduced or disappeared during steroid therapy for five patients, the mean visual score and the mean SUVmax were 1.58 ± 1.4 and 1.51 ± 1.4.Conclusions
18F-FDG PET/CT enables the acquisition of both morphologic and glucose metabolic of the related cartilage structures. It plays a valuable role in assessing almost all cartilage and detecting RP, which is a better selection of a biopsy site as well as therapeutic response monitoring. 相似文献9.
M. T. Hirschmann L. Keller A. Hirschmann L. Schenk R. Berbig U. Lüthi F. Amsler N. F. Friederich M. P. Arnold 《Knee surgery, sports traumatology, arthroscopy》2013,21(3):740-747
Purpose
The purpose of the study was to evaluate the clinical and radiological outcomes after medial/lateral collagen meniscus substitution (CMI) at 12 months postoperatively.Methods
Sixty-seven patients (m:f = 47:20, mean age 36 ± 10 years) underwent arthroscopic CMI after previous subtotal medial (n = 55) or lateral meniscectomy (n = 12) due to persistent joint line pain (n = 25) or to prophylactic reasons (n = 42). Clinical follow-up consisted of IKDC score, Tegner score, Lysholm score, and visual analog scale for pain and satisfaction (preinjury, preoperatively, and 12 months postoperatively; follow-up rate 90 %). MRI scans were analyzed according to the Genovese criteria.Results
Nineteen patients (29 %) showed a normal (A), 35 nearly normal (B), 5 abnormal (C), and 1 patient severely abnormal total IKDC score (D). The median Tegner preinjury score was 7 (range 2–10) and at follow-up 6 (range 2–10). The mean Lysholm score before surgery was 68 ± 20 and 93 ± 9 at follow-up. Preoperatively, the mean VAS pain was 4.4 ± 3.1 and 2.0 ± 1.0 at follow-up. Clinical failure of the CMI occurred in 3 patients (n = 1 infection, n = 1 failure of the implant, n = 1 chronic synovitis). On MRI, the CMI was completely resorbed in 3 patients (5 %), partially resorbed in 55 (92 %), and entirely preserved in 3 (5 %) patients. In 5 patients (8 %) the CMI was isointense, in 54 (90 %) slightly and 1 (2 %) highly hyperintense. 43 (72 %) patients showed an extrusion of the CMI implant of more than 3 mm.Conclusions
Significant pain relief and functional improvement throughout all scores at 1 year was noted. The CMI undergoes significant remodeling, degradation, resorption, and extrusion in most of the patients. No difference in outcomes between the medial and lateral CMI was observed.Level of evidence
Prospective therapeutic study, Level IV. 相似文献10.
Svend Ulstein Asbjørn Årøen Jan Harald Røtterud Sverre Løken Lars Engebretsen Stig Heir 《Knee surgery, sports traumatology, arthroscopy》2014,22(6):1207-1215
Purpose
To compare long-term functional and radiological outcome following microfracture technique (MF) versus osteochondral autologous transplantation (OAT) mosaicplasty for treating focal chondral lesions of the knee.Methods
Twenty-five patients (mean age 32.3 years, SD 7.7) with a full-thickness (International Cartilage Repair Society grade 3 or 4) chondral lesion of the articulating surface of the femur were randomized to either MF (n = 11) or OAT mosaicplasty (n = 14). At a median follow-up of 9.8 years (range 4.9–11.4), the patients were evaluated using Lysholm score (n = 25), Knee Injury and Osteoarthritis Outcome Score (KOOS, n = 25), isokinetic quadriceps measurement and hamstring strength measurement (n = 22) and standing radiographs (n = 23).Results
There were no significant differences in Lysholm score, KOOS, isokinetic muscle strength or radiographic osteoarthritis between MF-treated patients and OAT mosaicplasty-treated patients at follow-up. Mean Lysholm score at follow-up was 69.7 [95 % confidence interval (CI), 55.1–84.4] for the MF group and 62.6 (95 % CI, 52.6–72.6) for the OAT mosaicplasty group.Conclusion
At long-term follow-up, there were no significant differences between patients treated with MF and patients treated with OAT mosaicplasty in patient-reported outcomes, muscle strength or radiological outcome.Level of evidence
Therapeutic study, Level II. 相似文献11.
Koichi Yokoyama Osamu Ikeda Koichi Kawanaka Yutaka Nakasone Yoshitaka Tamura Seijiro Inoue Fumi Sakamoto Morikatsu Yoshida Shinya Shiraishi Yasuyuki Yamashita 《Cardiovascular and interventional radiology》2014,37(5):1306-1311
Purpose
To compare computed tomography (CT)-guided percutaneous biopsy with and without registration of prior positron emission tomography (PET)/CT images in the diagnosis of mediastinal tumors.Methods
We performed clinically indicated percutaneous biopsy in 106 patients with mediastinal tumors in the anterior (n = 61), posterior (n = 21), middle (n = 16), and superior mediastinum (n = 8). The final diagnosis was based on surgical outcomes, or imaging findings and the results of at least 6-month follow-up. The patients underwent CT-guided percutaneous biopsy with (group 1, n = 56) or without (group 2, n = 50) registration of prior PET/CT images obtained no more than 22 days earlier. The registered images were used to plan the procedure and help target the tumors.Results
CT-guided percutaneous needle biopsy yielded adequate samples in 101 of 106 (95 %) patients (group 1, n = 53; group 2, n = 48); in 95 patients (94 %), the diagnosis was confirmed by specific histological typing (group 1, n = 51; group 2, n = 44). The diagnostic accuracy of CT-guided percutaneous biopsy with and without the registration of prior PET/CT images was not statistically different (group 1, 96 %; group 2, 93 %, p = 0.324).Conclusion
CT-guided percutaneous biopsy is an easy and safe procedure that can provide a precise diagnosis in the majority of mediastinal tumors. PET/CT-guided biopsy yielded no special diagnostic advantages. 相似文献12.
Antonio Vadalà Raffaele Iorio Angelo De Carli Matteo Ferretti Daniele Paravani Ludovico Caperna Carlo Iorio Andrea Gatti Andrea Ferretti 《Knee surgery, sports traumatology, arthroscopy》2013,21(4):824-829
Purpose
The purpose of this study was to evaluate the efficacy of platelet-rich plasma (PRP) in reducing femoral and tibial tunnel enlargement in patients operated on for anterior cruciate ligament reconstruction with hamstrings.Methods
Forty male patients, in which both femoral and tibial 9-mm tunnels were performed because of the graft size, were enrolled in this prospective study. They were randomly assigned to group A (20 patients, PRP group) and group B (20 patients, control group). All patients were followed up at a median of 14.7 months (range 10–16 months), with a physical examination, the Tegner, Lysholm and objective IKDC scoring scales, and with the KT-1000 arthrometer. Moreover, they underwent a CT evaluation in order to assess the amount of tunnel enlargement.Results
Femoral tunnel diameter increased from 9.0 ± 0.1 mm to 9.8 ± 0.3 mm in group A (p = 0.032) and from 9.0 ± 0.1 mm to 9.4 ± 0.5 mm in group B (p = 0.043). Tibial tunnel diameter increased from 9.0 ± 0.2 mm to 10.9 ± 0.2 mm in group A (p = 0.029) and from 9.1 ± 0.1 mm to 10.1 ± 0.4 mm in group B (p = 0.028). Physical examination as well as the evaluation scales used showed no differences between the two groups.Conclusions
The use of PRP does not seem to be effective in preventing tunnel enlargement.Level of evidence
Therapeutic study, Level II. 相似文献13.
Hui Jun Kang Yan Ling Su Hui Jian Cao Fei Wang Da Hai Yu Zhi Min Zheng Ying Ze Zhang 《Knee surgery, sports traumatology, arthroscopy》2013,21(9):2066-2071
Purpose
The objective of present study was to introduce a modified double-layer bone-patellar tendon-bone (BPTB) allograft for arthroscopic single-bundle ACL reconstruction and investigate the clinical outcomes.Methods
From 2007 to 2009, a total of 136 patients underwent arthroscopic single-bundle ACL reconstructions with BPTB allograft. Of which, 66 patients were with double-layer BPTB allograft (Group 1), and 70 patients were with conventional BPTB allograft (Group 2). Clinical outcomes including Lachman and pivot-shift tests, KT-1000 arthrometer measurements, and Lysholm and Tegner activity scores were compared between the two groups at a 2-year minimum follow-up.Results
Forty-six patients in each group were at a two-year minimum follow-up. The mean side-to-side difference on the KT-1000 arthrometer was 1.2 ± 1.2 mm for group 1 and 2.1 ± 1.9 mm for group 2, with significant difference between the two groups (p = 0.017). The knee function was significantly better for group 1 than for group 2, because the mean Lysholm score was 94.2 ± 4.8 points versus 86.6 ± 7.1 points (p = 0.000), and the median Tegner score was 8 (range 5–10) points versus 6 (range 4–10) points (p = 0.001).Conclusions
On the basis of the KT-1000 arthrometer evaluation and clinical measures, single-bundle ACL reconstruction with double-layer BPTB allograft achieves significantly lesser anterior laxity and better knee function than a single-layer allograft reconstruction.Level of evidence
Therapeutic, retrospective comparative study, Level III. 相似文献14.
Amalia Peix MD DSc Lázaro O. Cabrera MD Flor Heres MD Lydia Rodríguez BSc Alexander Valdés MD Juan Valiente MD Raymid García MD Manuel Licea MD Vladimir Mendoza MD Francisco Gárciga MD Yaquelin Rodríguez BSc Regla Carrillo NMT Erick Mena BSc Yoel Fernández BSc Minerva Montero PhD Maurizio Dondi MD PhD 《Journal of nuclear cardiology》2011,18(3):398-406
Background
Coronary artery disease is a leading cause of death among diabetics, and silent ischemia is a major concern in patients with diabetes mellitus (DM).Methods
To detect the prevalence of ischemia in diabetics by myocardial perfusion imaging (MPI), and compare it to a control group without DM but with coronary risk factors, as well as to explore the relationship between silent ischemia, endothelial dysfunction, and coronary calcium, 59 patients (Group I) and 42 controls (Group II) were included. All underwent clinical and laboratory evaluations, gated MPI, brachial artery vasodilation measured by ultrasonography, and coronary calcium score (CCS).Results
Twenty diabetics showed perfusion defects, vs seven controls (P = .04). There was no significant difference between both groups regarding the brachial artery vasodilator responsiveness: 4.49% ± 4.26% (diabetics) vs 4.70% ± 4.98% (controls). Mean CCS was 74 in diabetics vs five in controls (P = .01). The only risk factor significantly associated with an abnormal MPI was the presence of diabetes (P = .03). In the whole population of patients and in diabetics, the abnormal endothelium-dependent vasodilation, the CCS >100, and the cholesterol/HDL ratio >4, showed an OR >1. CCS exhibited the higher OR among the whole population: OR 2.15 [95% CI 0.42-10.99]; while for diabetics it was the cholesterol/HDL ratio: OR 3.95 [95% CI 0.71-21.84].Conclusions
Reversible perfusion defects and coronary calcium are more frequent in diabetics. CCS, abnormal endothelium-dependent vasodilation, and cholesterol/HDL ratio higher than 4, showed an association with perfusion abnormalities in asymptomatic diabetics. 相似文献15.
Bin Yang Wen-Hui Chen Xiao-Feng Zhang Zhong-Rao Luo 《Japanese journal of radiology》2013,31(5):328-335
Purpose
To describe MDCT findings in adult patients of midgut malrotation and to correlate the types of adult midgut malrotation with its complications.Materials and methods
CT scans were performed on 14 adult patients with midgut malrotation. The images were reviewed retrospectively by one radiologist. Abnormal intestinal location, mesenteric vascular arrangement, extraintestinal anomalies and complications were evaluated and correlated with patterns of adult midgut malrotation.Results
The 14 cases of adult midgut malrotation revealed the following CT findings: intestinal malposition (n = 14), abnormally oriented mesenteric vessels (n = 8), extraintestinal anomalies (n = 14). These cases were classified into six types: complete nonrotation (n = 3), nonrotated duodenum and partially rotated colon (n = 6), isolated nonrotation of the duodenum (n = 2), partial rotation of the duodenum and colon (n = 1), partially rotated duodenum (n = 1) and isolated colonic partial rotation (n = 1). Four of these patients had accompanying complications, including volvulus (n = 2), right paraduodenal hernia (n = 1) and gastroduodenal intussusception (n = 1), respectively.Conclusion
Imaging features of adult midgut malrotation are characteristic. Adult midgut malrotation has various manifestations, and types of midgut malrotation may be closely related to their complications. 相似文献16.
Yuo-Chen Kuo Maureen P. Kohi David M. Naeger Ricky T. Tong K. Pallav Kolli Andrew G. Taylor Jeanne M. Laberge Robert K. Kerlan Jr. Nicholas Fidelman 《Cardiovascular and interventional radiology》2013,36(5):1336-1343
Purpose
To compare treatment response after transarterial chemoembolization (TACE) for hepatocellular carcinoma (HCC) in patients with and without a transjugular intrahepatic portosystemic shunt (TIPS).Materials and Methods
A retrospective review of patients who underwent conventional TACE for HCC between January 2005 and December 2009 identified 10 patients with patent TIPS. From the same time period, 23 patients without TIPS were selected to control for comparable Model for End-Stage Liver Disease and Child–Pugh–Turcotte scores. The two groups showed similar distribution of Barcelona Clinic Liver Cancer and United Network of Organ Sharing stages. Target HCC lesions were evaluated according to the modified response evaluation criteria in solid tumors (mRECIST) guidelines. Transplantation rate, time to tumor progression, and overall survival (OS) were documented.Results
After TACE, the rate of complete response was significantly greater in non-TIPS patients compared with TIPS patients (74 vs. 30 %, p = 0.03). Objective response rate (complete and partial response) trended greater in the non-TIPS group (83 vs. 50 %, p = 0.09). The liver transplantation rate was 80 and 74 % in the TIPS and non-TIPS groups, respectively (p = 1.0). Time to tumor progression was similar (p = 0.47) between the two groups. OS favored the non-TIPS group (p = 0.01) when censored for liver transplantation.Conclusion
TACE is less effective in achieving complete or partial response using mRECIST criteria in TIPS patients compared with those without a TIPS. Nevertheless, similar clinical outcomes may be achieved, particularly in TIPS patients who are liver-transplantation candidates. 相似文献17.
Motoki Nakai Morio Sato Hirotatsu Sato Hinako Sakaguchi Fumihiro Tanaka Akira Ikoma Hiroki Sanda Kouhei Nakata Hiroki Minamiguchi Nobuyuki Kawai Tetsuo Sonomura Yoshiharu Nishimura Yoshitaka Okamura 《Japanese journal of radiology》2013,31(9):585-592
Purpose
To investigate the midterm results of abdominal aortic aneurysm repair (EVAR) and compare the endoleak (EL) and abdominal aortic aneurysm (AAA) prognoses between instruction-for-use (IFU) patients and non-IFU patients.Materials and methods
Of 124 patients (104 men, 20 women; mean age 76.2 years; age range 58–93 years) with AAA who underwent EVAR with the Zenith (68 patients) or Excluder device (56) and were analyzed, 86 were IFU and 38 non-IFU.Results
The mean absorbed dose of radiation exposure was 1907 mGy in the IFU group and 2283 mGy in the non-IFU group (p = 0.013). Thirty-five patients experienced EL: 8 (6.5 %) type I and 27 (21.8 %) type II. Type I ELs were observed in 3 patients in the IFU group (3.5 %) and 5 patients in the non-IFU group (13.2 %). Of the 14 patients with AAA diameter expansion of ≥5 mm, 6 (6/86, 7.0 %) belonged to the IFU group and 8 (8/38, 21.1 %) to the non-IFU group (p = 0.027).Conclusion
The frequency of AAA expansion ≥5 mm was higher in non-IFU patients than in IFU patients. Therefore, careful follow-up is necessary for non-IFU patients rather than IFU patients. 相似文献18.
Sang Hak Lee Kye-Youl Cho Sumit Khurana Kang-Il Kim 《Knee surgery, sports traumatology, arthroscopy》2013,21(11):2611-2617
Purpose
The objective of this prospective randomized controlled trial was to assess the efficacy and safety of simultaneous application of tranexamic acid and indirect factor Xa inhibitor following total knee arthroplasty (TKA).Methods
Seventy-two primary osteoarthritis patients undergoing unilateral TKA using fondaparinux as a basic thromboprophylaxis were randomized to receive either placebo (36 patients) or tranexamic acid (36 patients). Prophylaxis against venous thromboembolism in all patients was administered with subcutaneous doses of 2.5 mg fondaparinux for 5 days post-operatively. Post-operative retransfusion volume, allogenic transfusion volumes and drain amount were recorded for each patient. Level of haemoglobin, prothrombin time, activated partial thromboplastin time and D-dimer were also assessed. Doppler ultrasonography was performed preoperatively and 7 days after surgery.Results
The rate of transfusion was lower in the tranexamic acid group than in the placebo group (p = 0.007). The drained blood volume during the initial 24 h and until drain removal was smaller in the tranexamic acid group than in the placebo group (p < 0.001). However, the haematologic laboratory results did not show any significant differences between the two groups. The prevalence of deep-vein thrombosis (DVT) was 4 (11.1 %) in the placebo group and 3 (8.3 %) in the tranexamic acid group (p = n.s.). There was no proximal DVT and no symptomatic pulmonary embolism in either group.Conclusion
The use of tranexamic acid could reduce acute blood loss significantly without any adverse effect resulted from drug interaction with concomitant use of indirect factor Xa inhibitor following TKA. Therefore, simple combination of these drugs can be recommended to reduce post-operative blood loss as well as to reduce DVT following TKA.Level of evidence
Therapeutic, Level I. 相似文献19.
Alejandro Lizaur-Utrilla Francisco A. Miralles-Muñoz Fernando A. Lopez-Prats 《Knee surgery, sports traumatology, arthroscopy》2014,22(7):1585-1590
Purpose
The aim of this study was to compare the outcomes of tibial fixation with either a cemented or cementless with screw augmentation component in young patients with non-inflammatory arthritis.Methods
Ninety-three patients aged 55 or younger with non-inflammatory arthritis were randomized to compare outcomes between cemented tibial fixation (48 patients) and cementless fixation with screw augmentation (45 patients). The femoral component was cementless in both groups. Post-operative evaluation was assessed by the clinical and radiological criteria of The Knee Society and WOMAC questionnaire.Results
The median follow-up was 6.7 (5–12) years. Significant differences were found for knee score (p = 0.02), range of motion (p = 0.04), and WOMAC score (p = 0.03). In the cemented group, there was one deep wound infection, four tibial aseptic loosening, and one polyethylene wear, all of which were revised. In the cementless group there was one tibial aseptic loosening and one polyethylene wear, both being revised. There was no difference in revision rate, and the cumulative survival at 9-year for aseptic reason was 93.7 % (95 % CI, 82–100 %) in the cementless group and 90.0 % (95 % CI, 80–100 %) in the cemented group (n.s.).Conclusions
Cementless total knee arthroplasty was found to be a reliable option in younger patients with osteoarthritis. Although the revision rate and survival were similar in both groups, better clinical outcomes were obtained with cementless tibial components.Level of evidence
I. 相似文献20.
Akira Ikoma Motoki Nakai Morio Sato Hirotatsu Sato Hinako Takeuchi Fumihiro Tanaka Hiroki Sanda Kouhei Nakata Hiroki Minamiguchi Tetsuo Sonomura Yoshiharu Nishimura Yoshitaka Okamura 《Japanese journal of radiology》2014,32(6):347-355