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991.
OBJECTIVE: To establish if there is a role for gabapentin or nortriptyline in the treatment of chronic orchialgia. METHODS: Twenty-six consecutive patients with chronic orchialgia were seen in the chronic pain clinic by a multidisciplinary team. A pain questionnaire was completed prior to commencing either gabapentin or nortriptyline. They were reviewed at 3 months and a repeat questionnaire completed. A 50% improvement in pain was considered successful. RESULTS: Complete data was available for 19 patients. Overall, 61.5% of patients commenced on gabapentin and 66.6% of patients commenced on nortriptyline had a greater than 50% improvement in pain. Patients with post-vasectomy testicular pain were considered as a subgroup. None of these patients had a greater than 50% improvement in pain. However, 80% of patients in the subgroup with idiopathic chronic orchialgia had a greater than 50% improvement in pain. CONCLUSION: Although this is a small study, it appears that gabapentin and nortriptyline are effective in the treatment of idiopathic chronic orchialgia but not post-vasectomy pain. 相似文献
992.
P. G. Ngan S. Jayagopal E. N. George D. McGeorge A. Juma 《European journal of plastic surgery》2007,30(4):189-194
A survey was carried out to ascertain the preference for donor site scar orientation in patients undergoing pedicled latissimus
dorsi breast reconstruction and their views on breast reconstruction in general. One hundred twelve women (59 Chinese, 53
Western) completed the questionnaire. Participants were asked to state their preferred scar orientation (i.e., oblique, horizontal,
or vertical) based on photographs showing the position of the scars. Demographic information and views on issues surrounding
breast reconstruction in general were also collected. Data was analyzed non-parametrically with chi-square test and t test. The mean age of participants was 39.5 years (20–73 years). Seventy-seven percent of the participants would opt for
an immediate breast reconstruction if offered (p < 0.001). Eighty-six percent would have objection to the use of silicone implant as a whole or part of a reconstruction (p < 0.001). Vertical and horizontal scars were the preferred orientation, with no women choosing the oblique orientation as
their first choice (p < 0.001). The non-Chinese of 40 years or older, as well as Chinese women from all age groups, preferred the horizontal scar
(p < 0.05). We demonstrated that both culture and age impact on the preferred scar orientation in breast reconstruction. Women
in the age group we commonly reconstruct favored the horizontal scar. However, the younger women of non-Chinese origin tended
to favor the vertical scar. 相似文献
993.
Tarek A. Amer Tarek F. Elwakil Mahmoud S. Elbasiouny 《European journal of plastic surgery》2007,30(2):67-73
Haemangiomas are the most common tumours of infancy. They typically proliferate then involute with considerable variation
as regards to their rates of proliferation and involution. Haemangioma of the nasal tip is a lesion of special characteristics.
During proliferation, it expands, contracts and deviates the nasal cartilages. Particularly, it regresses slowly and frequently
involutes incompletely. That is why excision of the lesion is frequently suggested. The present study was conducted to evaluate
open rhinoplasty after initial non-excision treatment modalities namely, intra-lesional corticosteroid injections and laser
treatment, as a protocol of treatment for nasal tip haemangiomas. Twelve patients with nasal tip haemangiomas were included
in the present study. Patients of both sexes, of different ages, with deep and mixed haemangiomas were studied. Disfigurement
was the constant presenting symptom. Initial non-excision treatment reported different responses as denoted by the regression
of the lesions’ size. Haemangiomas constantly extended between the medial crura of the alar cartilages as noted by the constant
widening of the columella pre-operatively and the obvious separation of the nasal cartilages intra-operatively. This separation
was constantly found to require approximation by sutures. The results of the present study concluded that whenever an early
presentation with nasal tip haemangioma could be established, initial non-excision treatment followed by open rhinoplasty
could be a useful protocol of treatment. Within the limitations of the present study, this protocol could achieve an early,
safe and effective treatment for nasal tip haemangiomas with provisionally acceptable cosmetic outcomes so far. 相似文献
994.
Marlene S. See M. R. Foxton N. A. Miedzianowski-Sinclair C. E. Roberts C. Nduka 《European journal of plastic surgery》2007,29(8):387-393
The nasolabial fold is a significant facial landmark. Its size, shape, and symmetry are important in facial reanimation surgery,
while effacement is an important goal in rejuvenation surgery. However, quantitative data for the nasolabial fold volume (NLFV)
and depth is still unavailable. We present a new method of measurement using 3D color speckle stereophotogrammetry and its
application in the assessment of NLFV. The VECTRA-3D system was validated to determine its minimum resolution and accuracy.
Normal volunteers aged 13–84 years (n = 87) were imaged in repose. Mother–daughter pairs (n = 15, aged 13–61) were imaged in the upright and supine positions. All data were processed using custom software and analyzed
by linear regression and nonparametric tests as appropriate. NLFV varied from 0.0026 to 0.2306 ml. There was significant correlation
between NLFV and age (r = 0.7269, p < 0.0001). Men had significantly higher NLFV than women across all ages. There was no significant difference between the
left and right NLFV. NLFV altered significantly from upright to supine in all subjects (p = 0.0012). However, the mothers increased their NLFV by 32% from supine to upright postures, which was a greater change than
observed in their daughters. We have demonstrated a rapid, objective, and non-invasive assessment tool for facial reanimation
and rejuvenation surgery. We have quantified the effects of age and posture on NLFV, and the efficacy and longevity of rejuvenation
procedures are currently under investigation. 相似文献
995.
S. A. R. Nouraei C. B. Singh M. S. Ferguson K. Young D. Roy J. M. Philpott 《European journal of plastic surgery》2007,30(4):153-157
The objective of this study is to assess the results of repairing septal perforations with a vascularized pedicled alar cartilage
island flap. Using the external rhinoplasty approach, a vascularized flap of alar cartilage, harvested as a cephalic trim
and pedicled on the ascending columellar branches of the superior labial artery was raised. Bilateral mucoperichondrial septal
flaps were elevated and the alar flap was transposed and secured within the defect and bilaterally overlaid with temporalis
fascia. Silastic sheets were placed and remained in situ until the grafts were revascularized from the peripheries of the
defect as well as centrally from the alar flap. The revascularized temporalis fascia acted as a scaffold for nasal remucosalization.
The alar flap also increased the long-term structural robustness of the repair. Between 1999 and 2003, 14 patients with septal
perforations ranging from 10 to 31 mm underwent septal reconstruction using this technique. There were nine males and five
females. The flap was successfully raised in all cases and long-term closure was maintained in 12 patients (86%). The alar
cartilage flap is an effective technique for repairing septal perforations in selected patients. It provides vascularized
tissue which nourishes the grafts during remucosalization, and a cartilaginous framework, which affords long-term structural
support to the repair. It also obviates the need to transpose nasal mucosa and create a secondary defect. The rhinoplasty
approach furthermore permits additional nasal deformities to be corrected at the same time.
Presented at the British Association of Plastic Surgeons Summer Scientific Meeting, Sheffield, UK (12 July 2006). 相似文献
996.
G Fitze J Cramer A Serra M Schreiber D Roesner H K Schackert 《Zeitschrift für Kinderchirurgie》2003,13(3):152-157
Hirschsprung disease (HSCR) is considered a model for a complex inheritance disorder. Several genes, including the major HSCR-susceptibility RET proto-oncogene, play an aetiological role in the development of HSCR. Genetic linkage analysis in familial HSCR with both long- and short-segment phenotypes has demonstrated a tight linkage to the RET locus, while the phenotype within a HSCR family is characterised by an incomplete penetrance or a variable extension of the aganglionosis. Therefore, additional genetic alterations of RET are postulated in the aetiology or modification of the HSCR phenotype. In this study, the coding region of all 21 exons of the RET proto-oncogene, including the flanking intronic sequences, were investigated by direct DNA sequencing in a HSCR population. We genotyped the c.135 G/A polymorphism and resolved haplotypes comprising the mutation locus and the c.135 G/A polymorphism. Twenty different mutations were detected in 18 of 76 HSCR patients. In ten families the mutations were inherited from the parents, while only four patients had a positive family history for the disease. Moreover, in all ten families an incomplete penetrance of the HSCR phenotype was observed. We have investigated the effect of the non-mutated wild-type allele as well as the c.135 G/A polymorphism on the phenotype within the HSCR families. Our findings support the notion that both RET alleles are involved in the pathogenesis of a subgroup of HSCR patients in a dose-dependent fashion. Additionally, we have shown a modifying effect of the c.135 G/A polymorphism on the HSCR phenotype within HSCR families. 相似文献
997.
Summary During studies on the helminth fauna of wolves inhabiting natural ecosystems of Poland, 86 scats were examined. All the samples
were collected in the autumn of 2005. Spirocerca lupi was detected with decantation and flotation techniques. The prevalence was 2.32 %. This is the first record of the parasite
from Poland and the third case of its occurrence in the wolf (Canis lupus L.) within its distribution range. 相似文献
998.
Jamshid Shirani Jagat Narula William C. Eckelman Navneet Narula Vasken Dilsizian 《Journal of nuclear cardiology》2007,14(1):100-110
Conclusions Noninvasive imaging of neurohumoral upregulation in remodeled myocardium suggests that an imaging strategy can be developed
for predicting the rate of remodeling and likelihood of HF development. This should allow a more judicious use of neurohumoral
antagonists especially in subjects who do not have manifest HF.74 In others specific targeted imaging may allow timely selection of individualized treatment strategies and ensure optimization
of therapeutic intervention. Similar to ACE and AII receptors, multiple other targets in the hormonal cascades can identify
the likelihood of adverse and favorable remodeling.74 相似文献
999.
Wing‐Hong Li Moon‐Tong Cheung Candace N.S. Ho Ting‐Pong Fung Kai‐Ming Ko Kelvin K.W. Yau 《Surgical Practice》2007,11(4):138-143
Aim: To examine the survival benefit of liver and lung resection for colorectal metastasis and the potential prognostic factors that affect patient survival. Methods: All patients who had resection of lung or liver metastasis for colorectal metastasis in Queen Elizabeth Hospital, Hong Kong from 1995 to 2004 were retrospectively reviewed. The overall and disease‐free survival was analysed, in particularly between liver and lung metastasis. All factors that may have affected the survival were entered into Cox's proportional hazards regression model to identify significant variables associated with survival. Results: At 5 years, the overall survival of patients who had resection of lung and liver metastasis was 44% and 38%, respectively; the disease‐free survival was 26% and 24%, respectively. Overall and disease‐free survival of patients with resection of lung metastasis was comparable to those with resection of liver metastasis. The differentiations of primary tumour and time to metastasis were shown to be significant prognostic factors influencing overall survival. Those patients with systemic chemotherapy after resection of colorectal metastasis demonstrated a significantly higher probability of overall survival. Conclusion: Resection of lung and liver metastases from colorectal origin was safe and both procedures improved survival. The use of chemotherapy after resection of metastasis significantly improved the overall survival. 相似文献
1000.