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1.

Objectives

Post-thoracotomy pain leads to patient discomfort, pulmonary complications, and increased analgesic use. Intercostal nerve injury during thoracotomy or its entrapment during closure can contribute to post-thoracotomy pain. We hypothesized that a modified technique of posterolateral thoracotomy and closure, preserving the intercostal neurovascular bundle, would reduce acute and chronic post-thoracotomy pain.

Methods

We randomized 90 patients undergoing posterolateral thoracotomy for pulmonary resection at a tertiary level oncology center to standard posterolateral (control arm) or modified nerve-sparing thoracotomy. All patients received morphine via patient-controlled analgesia pumps. The primary outcome was the worst postoperative pain score in the first 3 postoperative days. Secondary outcomes included the average pain score and analgesic requirements in the first 3 postoperative days and the incidence of post-thoracotomy pain 6 months after surgery.

Results

No significant differences were seen between the groups in acute or chronic post-thoracotomy measured by the numeric rating scale. There was no difference seen in the worst (mean) postoperative pain scores (3.71 vs 3.83, difference 0.12; 99% confidence interval [CI], ?0.7 to +0.9; P = .7), average (mean) pain scores in the first 3 postoperative days (1.77 vs 1.85, difference 0.08; 99% CI, ?0.4 to +0.6; P = .69), mean consumption of morphine (mg/kg) (1.45 vs 1.40, difference ?0.05; 99% CI, ?0.4 to +0.3; P = .73), or incidence of chronic postoperative pain (37.8% vs 40%, difference 4.9%; 99% CI, ?22.8 to +30.7%; P = .73).

Conclusions

The modified nerve-sparing thoracotomy technique does not reduce post-thoracotomy pain compared with standard posterolateral thoracotomy.  相似文献   
2.
The aims of this study were to evaluate the weekly and annual cumulative radiofrequency-electromagnetic field (RF-EMF) exposure attributed to mobile phone (MP) use, and assess whether a novel app (Quanta Monitor?) could be employed in a small human sample to characterise the RF-EMF exposures associated with the use of MPs. Ten participants provided their two months’ daily objective data on their MP exposures (i.e. transmitted and received power densities) attributed to different modes of MP usage such as cellular calls, cellular data and Wi-Fi. The results demonstrated that total transmitted power density (cellular phone calls, data and Wi-Fi surfing) could be many orders of magnitude higher than that from the total received power density. Of the total transmitted power density, cellular data use contributed the largest portion. Our study showed that Quanta Monitor? could be employed in prospective assessment of exposures to MPs in epidemiological studies.  相似文献   
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The changes in the periodontal tissues either due to pathologic processes on external forces have been investigated from histologic, histochemical, biochemical, physiologic, and bioelectrical (bony response) and biochemical viewpoint. However, because of the complexity of stress analysis or experimental techniques, no information is available on the stress induced in the periodontal tissues. The Finite Element Method (FEM), which is introduced as one of the methods for numerical analysis, has become a useful technique for stress analysis in biologic systems. The FEM makes it possible to analytically apply various force systems at any point and in any direction. From the periodontal point of view, FEM would provide different stress levels in periodontal structures based on the biomechanical principle, which in turn may prompt occlusal correction at an earlier date.  相似文献   
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As indicated by several recent studies, magnetic susceptibility of the brain is influenced mainly by myelin in the white matter and by iron deposits in the deep nuclei. Myelination and iron deposition in the brain evolve both spatially and temporally. This evolution reflects an important characteristic of normal brain development and ageing. In this study, we assessed the changes of regional susceptibility in the human brain in vivo by examining the developmental and ageing process from 1 to 83 years of age. The evolution of magnetic susceptibility over this lifespan was found to display differential trajectories between the gray and the white matter. In both cortical and subcortical white matter, an initial decrease followed by a subsequent increase in magnetic susceptibility was observed, which could be fitted by a Poisson curve. In the gray matter, including the cortical gray matter and the iron‐rich deep nuclei, magnetic susceptibility displayed a monotonic increase that can be described by an exponential growth. The rate of change varied according to functional and anatomical regions of the brain. For the brain nuclei, the age‐related changes of susceptibility were in good agreement with the findings from R2* measurement. Our results suggest that magnetic susceptibility may provide valuable information regarding the spatial and temporal patterns of brain myelination and iron deposition during brain maturation and ageing. Hum Brain Mapp 35:2698–2713, 2014. © 2013 Wiley Periodicals, Inc .  相似文献   
9.
A 20-year-old man with chronic granulomatous disease (CGD) and who was receiving granulocyte transfusions for a refractory liver abscess was studied to compare the kinetics of 111In-labeled granulocytes with those of two functional granulocyte assays, nitroblue tetrazolium reduction and chemiluminescence. Transfused granulocytes were eliminated in both rapid and slow phases. Peak recovery was noted in the first sample, which was obtained 10 minutes after transfusion for each assay. The elimination kinetics were similar over 24 hours. These results confirm the value of using 111In-labeled granulocytes as a marker of transfused granulocytes. These data also confirm that the oxidative metabolic function of granulocytes prepared by continuous-flow leukapheresis remains intact while in the recipient's circulation. The response of the patient adds support for the use of granulocyte transfusions in certain patients with CGD.  相似文献   
10.
Journal of NeuroVirology - HIV-1 subtype C (HIV-1C) shows reduced Tat protein chemoattractant activity compared with HIV-1B. The impact of HIV-1C Tat on the chemotaxis of the main lymphocyte...  相似文献   
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