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81.
Shao-Chieh Lin Po-Chuan Chen Chung-Ta Lee Hong-Ming Tsai Peng-Chan Lin Helen HW Chen Yuan-Hwa Wu Bo-Wen Lin Wen-Pin Su Jenq-Chang Lee 《World journal of gastroenterology : WJG》2013,19(11):1797-1804
AIM:To investigate the 10-year results of treating low rectal cancer by a single surgeon in one institution.METHODS:From Oct 1998 to Feb 2009,we prospectively followed a total of 62 patients with cT2-4 low rectal cancer with lower tumor margins measuring at 3 to 6 cm above the anal verge.All patients received neoadjuvant chemoradiation(CRT) for 6 wk.Among them,85% of the patients received 225 mg/m2/d 5-fluorouracil using a portable infusion pump.The whole pelvis received a total dose of 45 Gy of irradiation in 25 fractions over 5 wk.The interval from CRT completion to surgical intervention was planned to be approximately 6-8 wk.Total mesorectal excision(TME) and routine defunctioning stoma construction were performed by one surgeon.The distal resection margin,circumferential resection margin,tumor regression grade(TRG) and other parameters were recorded.We used TRG to evaluate the tumor response after neoadjuvant CRT.We evaluated anal function outcomes using the Memorial Sloan-Kettering Cancer Center anal function scores after closure of the defunctioning stoma.RESULTS:The median distance from the lower margin of rectal cancer to the anal verge was 5 cm:6 cm in 9 patients,5 cm in 32 patients,4 cm in 10 patients,and 3 cm in 11 patients.Before receiving neoadjuvant CRT,45 patients(72.6%) had a cT3-4 tumor,and 21(33.9%) patients had a cN1-2 lymph node status.After CRT,30 patients(48.4%) had a greater than 50% clinical reduction in tumor size.The final pathology reports revealed that 33 patients(53.2%) had a ypT3-4 tumor and 12(19.4%) patients had ypN1-2 lymph node involvement.All patients completed the entire course of neoadjuvant CRT.Most patients developed only Grade 1-2 toxicities during CRT.Thirteen patients(21%) achieved a pathologic complete response.Few post-operative complications occurred.Nearly 90% of the defunctioning stomas were closed within 6 mo.The local recurrence rate was 3.2%.Pathologic lymph node involvement was the only prognostic factor predicting disease recurrence(36.5% vs 76.5%,P = 0.006).Ne 相似文献
82.
Claas MJ de Vries LS Bruinse HW van Haastert IC Uniken Venema MM Peelen LM Koopman C 《Early human development》2011,87(3):183-191
Background
Extremely low birth weight (ELBW) infants are at risk of cognitive impairment and follow-up is therefore of major importance. The age at which their neurodevelopmental outcome (NDO) can reliably be predicted differs in the literature.Aims
To describe NDO at 2, 3.5 and 5.5 years in an ELBW cohort. To examine the value of NDO at 2 years corrected age (CA) for prediction of NDO at 3.5 and 5.5 years.Study design
A retrospective cross-sectional and longitudinal cohort study.Subjects
101 children with a BW ≤ 750 g, born between 1996 and 2005, who survived NICU admission and were included in a follow-up program.Outcome measures
NDO, measured with different tests for general development and intelligence, depending on age of assessment and classified as normal (Z-score ≥ − 1), mildly delayed (− 2 ≤ Z-score < − 1) or severely delayed (Z-score < − 2).Results
At 2, 3.5 and 5.5 years 74.3, 82.2 and 76.2% had a normal NDO. A normal NDO at 2 years CA predicted a normal NDO at 3.5 and 5.5 years in 92% and 84% respectively. Of the children with a mildly or severely delayed NDO at 2 years CA the majority showed an improved NDO at 3.5 (69.2%) and 5.5 years (65.4%) respectively.Conclusions
The majority of the children with a BW ≤ 750 g had a normal NDO at all ages. A normal NDO at 2 years CA is a good predictor for normal outcome at 3.5 and 5.5 years, whereas a delayed NDO at 2 years CA is subject to change with the majority of the children showing a better NDO at 3.5 and 5.5 years. 相似文献83.
Seventeen compounds having the structure of 2,3-diacetoxy-1,4-bis(3′,5′- dioxo-N4′-substituted piperazinyl methyl)benzene were designed and synthesized based on chelation hypothesis. Their antitumor activities on P388 cells,Hep cells and SGC 7901 cells in vitro were tested. Preliminary results showed that compound 4e has potent antitumor effect against P388 cells and.Hep cells in vitro. 相似文献
84.
Anti-phospholipid antibodies such as the lupus anticoagulant and anti-cardiolipin antibodies, are antibodies directed at negatively charged phospholipids and have received much attention in the last decade. Their presence has been associated with a thrombotic tendency, leading to a variety of clinical symptoms. In the pregnant woman, the presence of these antibodies may have consequences for management, since retrospective reports have established a correlation between the lupus anticoagulant or anti-cardiolipin antibodies with intrauterine fetal death, probably due to placental thrombosis. This article reviews current knowledge on anti-phospholipid antibodies in relation to pregnancy loss, focusing on clinical aspects. 相似文献
85.
86.
目的探索内镜下经扩大鼻蝶入路显露斜坡区的可行性,为切除斜坡区病变提供解剖学参考。方法在10例成人头部固定标本上,内镜下模拟扩大经鼻蝶手术入路显露斜坡区,观察有关显微解剖标志。结果扩大经鼻蝶内镜入路可磨除从鞍后到斜坡、枕骨大孔前缘的骨性结构;可显露斜坡区腹侧硬膜下的椎基底动脉及其分支、后交通动脉及其与大脑后动脉汇合处、动眼神经、脑干腹侧等结构。此入路的手术标志主要包括:蝶筛隐窝、蝶窦开口、视神经隆突、颈内动脉隆突与颈内动脉视神经隐窝、咽结节、枕骨大孔前缘。结论内镜下扩大经鼻蝶手术入路可充分显露鞍后-斜坡区的腹侧硬膜下结构,适用于此区病变的手术治疗。 相似文献
87.
Schroeder HW Nehlsen M 《中国神经肿瘤杂志》2009,7(1):49-49
To compare the image quality of a standard definition (SD) three-chip camera with a new high-definition (HD) three-chip camera. In five neurosurgical interventions, an SD three-chip camera and an HD three-chip camera were used with the same endoscopic equipment. Both cameras were used while performing one endoscopic third ventriculostomy, one endoscope-assisted microvascular decompression, one endoscope-assisted removal of a vestibular schwannoma, and two endonasal pituitary surgeries. To provide comparable conditions, the outputs of both cameras were displayed on the same fiat screen and were recorded on hard disk with an appropriate workstation using a visually lossless codec. 相似文献
88.
Henriette Jorien van Brummen Hein W. Bruinse Geerte van de Pol A. Peter M. Heintz C. Huub van der Vaart 《International urogynecology journal》2007,18(2):133-139
A prospective cohort study was undertaken to evaluate the effect of pregnancy and childbirth in nulliparous pregnant women.
The focus of this paper is on the difference in the prevalences and risk factors for lower urinary tract symptoms (LUTS) between
woman who delivered vaginally or by cesarean and secondly the effect of LUTS on the quality of life between these two groups
was analyzed. Included were 344 nulliparous pregnant women who completed four questionnaires with the Urogenital Distress
Inventory and the Incontinence Impact Questionnaire (IIQ). Two groups were formed: vaginal delivery group (VD), which included
spontaneous vaginal delivery and an instrumental vaginal delivery and cesarean delivery group (CD). No statistical significant
differences were found in the prevalences of LUTS during pregnancy between the two groups. Three months after childbirth,
urgency and urge urinary incontinence (UUI) are less prevalent in the CD group, but no statistical difference was found 1 year
postpartum. Stress incontinence was significantly more prevalent in the VD group at 3 and 12 months postpartum. The presence
of stress urinary incontinence (SUI) in early pregnancy is predictive for SUI both in the VD as in CD group. A woman who underwent
a CD and had SUI in early pregnancy had an 18 times higher risk of having SUI in year postpartum. Women were more embarrassed
by urinary frequency after a VD. After a CD, 9% experienced urge urinary incontinence. Urge incontinence affected the emotional
functioning more after a cesarean, but the domain scores on the IIQ were low, indicating a minor restriction in lifestyle.
In conclusion, after childbirth, SUI was significantly more prevalent in the group who delivered vaginally. Besides a vaginal
delivery, we found both in the VD and in the CD group that the presence of SUI in early pregnancy increased the risk for SUI
1 year after childbirth. Further research is necessary to evaluate the effect of SUI in early pregnancy on SUI later in life.
Women were more embarrassed by urinary frequency after a vaginal delivery. UUI after a CD compared to a vaginal birth limited
the women more emotionally; no difference was found for the effect of SUI on the quality of life between the two groups. 相似文献
89.
Baker HW 《国外医学(计划生育.生殖健康分册)》2010,29(3):225-226,238
陆金春等^[1]所著的“中国118家实验室精液分析状况的调查”一文主要回顾了当前在中国采用的精液分析方法。调查使用的是作者自己设计的包括36个问题的“男科实验室精液分析调查表”。给145家精液实验室发放了调查表,收回118份答卷。调查表均由实验室专业技术人员填写。 相似文献
90.
Milani Junior R; Jorge MT; de Campos FP; Martins FP; Bousso A; Cardoso JL; Ribeiro LA; Fan HW; Franca FO; Sano-Martins IS; Cardoso D; Ide Fernandez C; Fernandes JC; Aldred VL; Sandoval MP; Puorto G; Theakston RD; Warrell DA 《QJM : monthly journal of the Association of Physicians》1997,90(5):323-334
The jararacucu, one of the most dreaded snakes of Brazil, southern Bolivia,
Paraguay and northeastern Argentina, is a heavily-built pit viper which may
grow to a length of 2.2 m. Up to 1000 mg (dry weight) of highly-lethal
venom may be milked from its venom glands on a single occasion. It has
accounted for 0.8% to 10% of series of snake bites in Sao Paulo State,
Brazil. We examined 29 cases of proven jararacucu bites recruited over a
20-year period in two Sao Paulo hospitals. Severe signs of local and
systemic envenoming, (local necrosis, shock, spontaneous systemic bleeding,
renal failure) were seen only in patients bitten by snakes longer than 50
cm; bites by shorter specimens were more likely to cause incoagulable
blood. Fourteen patients developed coagulopathy, six local necrosis
(requiring amputation in one) and five local abscesses. Two became shocked
and four developed renal failure. Three patients, aged 3, 11 and 65 years,
died 18.75, 27.75 and 83 h after being bitten, with respiratory and
circulatory failure despite large doses of specific antivenom and
intensive-care- unit management. In two patients, autopsies revealed acute
renal tubular necrosis, cerebral oedema, haemorrhagic rhabdomyolysis at the
site of the bite and disseminated intravascular coagulation. In one
survivor with chronic renal failure, renal biopsy showed bilateral cortical
necrosis; the patient remains dependent on haemodialysis. Effects of
polyspecific Bothrops antivenom were not impressive, and it has been
suggested that anti-Bothrops and anti-Crotalus antivenoms should be given
in combination.
相似文献