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111.
David S. Yee Joel Gelman Douglas W. Skarecky Thomas E. Ahlering 《Journal of robotic surgery》2007,1(2):151-154
Fossa navicularis strictures following radical prostatectomy are reported infrequently. We recently experienced a series of
fossa strictures following robotic-assisted laparoscopic prostatectomy (RLP). We describe herein our experience to prevent
fossa strictures and to determine its etiologic factors. From June 2002 to May 2006, 424 patients underwent robotic-assisted
laparoscopic prostatectomy with the da Vinci surgical system. Fossa strictures were diagnosed based on the acute onset of
obstructive voiding symptoms and bougie calibration. During our series, we switched from the intra-operative use of an 18
French (F) catheter to that of a 22 F one to avoid inadvertent stapling of the urethra when dividing the dorsal venous complex.
After we observed a high incidence of fossa strictures, we reverted back to 18 F catheters during surgery. All patients had
an 18 F catheter indwelling for 1 week after surgery. Parameters were evaluated using Fisher’s exact test and Student’s t-test for means. The 18 F catheter group of patients (n = 293) developed one fossa stricture, whereas the 22 F catheter group (n = 131) developed nine fossa strictures (P < 0.01). The fossa stricture rate in the 18 F group was 0.3% versus 6.9% in the 22 F group. The two groups had no differences
in age, body mass index, cardiovascular disease, American Urological Association symptom score, urinary bother score, preoperative
prostate-specific antigen, operative time, estimated blood loss, cautery use, prostate size, or catheterization time. Based
on these results, a larger urethral catheter size – 20 F versus 18 F – during the intra-operative dissection would appear
to increase the risk for fossa stricture by more than 20-fold.
Statement of disclosure Dr. Thomas Ahlering is a meeting participant and lecturer for Intuitive Surgical Corp. The other authors have no direct or
indirect commercial financial incentives associated with publishing the article. No research or project support funding was
received. 相似文献
112.
Procalcitonin as a marker of bacterial infection in the emergency department: an observational study
Yi-Ling Chan Ching-Ping Tseng Pei-Kuei Tsay Shy-Shin Chang Te-Fa Chiu Jih-Chang Chen 《Critical care (London, England)》2003,8(1):R12
Introduction
Procalcitonin (PCT) has been proposed as a marker of infection in critically ill patients; its level is related to the severity of infection. We evaluated the value of PCT as a marker of bacterial infection for emergency department patients. 相似文献113.
114.
Claudia St?llberger Josef Finsterer Birke Schneider 《Journal of the American College of Cardiology》2006,47(7):1500; author reply 1500-1500; author reply 1501
115.
116.
Ana C Mendes M Madalena Caldeira Claudia Silva Shawn C Burgess Matthew E Merritt Filipe Gomes Cristina Barosa Teresa C Delgado Fatima Franco Pedro Monteiro Luis Providencia John G Jones 《Magnetic resonance in medicine》2006,56(5):1121-1125
Menthol glucuronide was isolated from the urine of a healthy 70-kg female subject following ingestion of 400 mg of peppermint oil and 6 g of 99% [U-(13)C]glucose. Glucuronide (13)C-excess enrichment levels were 4-6% and thus provided high signal-to-noise ratios (SNRs) for confident assignment of (13)C-(13)C spin-coupled multiplet components within each (13)C resonance by (13)C NMR. The [U-(13)C]glucuronide isotopomer derived via direct pathway conversion of [U-(13)C]glucose to [U-(13)C]UDP-glucose was resolved from [1,2,3-(13)C(3)]- and [1,2-(13)C(2)]glucuronide isotopomers derived via Cori cycle or indirect pathway metabolism of [U-(13)C]glucose. In a second study, a group of four overnight-fasted patients (63 +/- 10 kg) with severe heart failure were given peppermint oil and infused with [U-(13)C]glucose for 4 hr (14 mg/kg prime, 0.12 mg/kg/min constant infusion) resulting in a steady-state plasma [U-(13)C]glucose enrichment of 4.6% +/- 0.6%. Menthol glucuronide was harvested and glucuronide (13)C-isotopomers were analyzed by (13)C NMR. [U-(13)C]glucuronide enrichment was 0.6% +/- 0.1%, and the sum of [1,2,3-(13)C(3)] and [1,2-(13)C(2)]glucuronide enrichments was 0.9% +/- 0.2%. From these data, flux of plasma glucose to hepatic UDPG was estimated to be 15% +/- 4% that of endogenous glucose production (EGP), and the Cori cycle accounted for at least 32% +/- 10% of GP. 相似文献
117.
118.
Paolo Martinelli Giovanni Rizzo David Manners Caterina Tonon Fabio Pizza Claudia Testa Cesa Scaglione Bruno Barbiroli Raffaele Lodi 《Movement disorders》2007,22(8):1182-1185
The pathophysiology of essential tremor (ET) is unknown. PET and fMRI studies have revealed bilateral activation and (1)H-MRS studies metabolic abnormalities in the cerebellum and other functionally related brain structures in ET. Diffusion-weighted imaging (DWI) was used to search for evidence of tissue integrity abnormalities in these areas in ET patients and 10 matched controls by calculating water apparent diffusion coefficients (ADCs). Regions of interest included the left and right cerebellum, red nucleus, thalamus, caudate, putamen, pallidum, and frontal white matter. Histograms of ADCs were generated for all pixels in the infratentorial compartment and manually segmented areas corresponding to brainstem, vermis, and cerebellar hemispheres. ADC values were similar in all brain areas in patients and controls. Our study did not detect changes affecting the investigated brain regions in ET patients. These findings argue against major structural damage in the ET brain, although more subtle neurodegenerative changes cannot be ruled out. 相似文献
119.
Claudia Trenkwalder MD Heike Benes MD Ludger Grote MD Svenja Happe MD Birgit Högl MD Johannes Mathis MD Gerda M. Saletu‐Zyhlarz MD Ralf Kohnen PhD CALDIR study group 《Movement disorders》2007,22(5):696-703
We report the first large-scale double-blind, randomly assigned study to compare two active dopaminergic therapies for Restless Legs Syndrome (RLS), the dopamine agonist cabergoline (CAB) and levodopa/benserazide (levodopa). Patients with idiopathic RLS were treated with fixed daily doses of 2 or 3 mg CAB or 200 or 300 mg levodopa for 30 weeks. Efficacy was assessed by changes in the IRLS (International RLS Severity Scale) and by time to discontinuation of treatment due to loss of efficacy or augmentation. 361 of 418 screened patients (age 58 +/- 12 years, 71% females) were randomly assigned and treated (CAB: n = 178; levodopa: n = 183) in 51 centers of four European countries. Baseline IRLS total score was 25.7 +/- 6.8. The baseline-adjusted mean change from baseline to week 6 in IRLS sum score was d = -16.1 in the CAB group and d = -9.5 in the levodopa group (d = -6.6, P < 0.0001). More patients in the levodopa group (24.0%) than in the CAB group (11.9%, P = 0.0029, log-rank test) discontinued because of loss of efficacy (14.2% vs. 7.9%, P = 0.0290) or augmentation (9.8% vs. 4.0%, P = 0.0412). Adverse events (AEs) occurred in 83.1% of the CAB group and in 77.6% of the levodopa group. In both groups, most frequent AEs were gastrointestinal symptoms (CAB: 55.6%, levodopa: 30.6%, P < 0.0001). This first large-scale active controlled study in RLS showed superior efficacy of cabergoline versus levodopa after a 30-week long-term therapy. Tolerability was found more favorable with levodopa than with cabergoline. 相似文献
120.
Cheuk‐Kin Lo Colin S.H. Chu Tong Zhu Chan‐Chung Ma Kai‐Ming Ko Kwok‐Keung Ho 《Surgical Practice》2007,11(4):147-153
Aim: The prognosis of patients with disseminated colorectal carcinoma is poor except for those with single organ pulmonary or hepatic metastases. The objective of the present study was to evaluate the result of pulmonary metastasectomy for colorectal secondary and to identify the prognostic factors. Methods: This was a retrospective study of 80 patients who had pulmonary metastasectomy for pulmonary secondary from colorectal carcinoma in Queen Elizabeth Hospital, Hong Kong. Results: The overall 5‐year and 10‐year survival rates of the entire cohort were 42.5% and 35.5%, respectively. High premetastasectomy carcinoembryonic antigen (> 20 μg/dL), short disease‐free interval (< 12 months) and incomplete resection were the independent prognostic factors. Neither the characteristics of the primary colorectal tumour nor the number of metastatic nodules had a significant contribution to the long‐term survival. Six patients underwent second pulmonary metastasectomy and three were still free from tumour recurrence after the second operation. Conclusion: Patients with pulmonary metastases from colorectal carcinoma would benefit from pulmonary metastasectomy. High premetastasectomy carcinoembryonic antigen and short disease‐free interval were negative predictive factors for survival. Long‐term follow‐up study is required, as recurrence can occur more than 5 years after pulmonary metastasectomy. Also, whether the survival benefit is due to surgical treatment effect or lead‐time bias remains undecided. 相似文献