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François Lavigne P. Culpan T. Judet P. Piriou 《European journal of orthopaedic surgery & traumatology : orthopedie traumatologie》2009,19(5):321-325
Objective Stiffness and severe deformity pose a major challenge in total knee arthroplasty. Numerous techniques have been described
to gain exposure and improve knee flexion. Tibial tubercle osteotomy provides excellent and safe exposure of the joint, although
mechanical and wound complications have been reported.
Materials and methods We present a series of 32 consecutive complex primary total replacements where an osteotomy of the tibial tubercle was utilised.
Results The patients had a mean follow-up of 2 years and 11 months. Following the procedure, with the exception of one case complicated
with deep infection, all of the patients had improved clinically. The mean postoperative range of motion had increased to
102° (give P value < 0.005) and there were no cases of delayed union or non-union. A mechanical complication related to technique occurred
in one patient; there were no other cases with a postoperative extension lag.
Conclusion In this challenging population group, we have found a tibial tubercle tuberosity osteotomy to greatly facilitate exposure
without compromising the clinical and radiographic outcome. 相似文献
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Frau Dr. K. Sternberg C. Selent N. Hakanßon J. Töllner T. Langer H. Seiter K.-P. Schmitz 《Der Urologe. Ausg. A》2004,43(10):1200-1208
The scope of our research is the development of polymer-based bioabsorbable stents for urologic applications and in vitro testing of tissue reactions of cultured ureteral and urethral segments induced by implanted polymer stent prototypes. For these purposes a tissue cultivation model was developed using selected techniques of tissue engineering. Essential advantages of degradable over nondegradable urethral stents are elimination of the adverse extraction of epithelialized stents and the potential for recovery of organ-specific functionality. Moreover, the biocompatibility of a degradable urethral stent could potentially reduce the risk of restenosis due to hyperplasia and could be used, even repeatedly, for the treatment of a number of subvesical obstructions. For the treatment of tumor-induced strictures, application of degradable polymer stents coated with cytostatic drugs may be possible. The mechanical effect of the drug-loaded stent as a “place holder” could be complemented by adjuvant or palliative approaches such as local chemotherapy. We have developed and tested in vitro a degradable urethral stent incorporated with the model drug methotrexate for local drug delivery (LDD) by diffusion and during stent degradation. 相似文献
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G. Lallement Didier Clarençon Catherine Masqueliez Dominique Baubichon Monique Galonnier Marie-France Burckhart Michel Peoc’h Jean Claude Mestries 《Archives of toxicology》1997,72(2):84-92
Organophosphorus nerve agents are still in use today in warfare and as terrorism compounds. Classical emergency treatment
of organophosphate poisoning includes the combined administration of a cholinesterase reactivator (an oxime), a muscarinic
cholinergic receptor antagonist (atropine) and a benzodiazepine anticonvulsant (diazepam). However, recent experiments with
primates have demonstrated that such treatment, even when administered immediately after organophosphate exposure, does not
rapidly restore normal electroencephalographic (EEG) activity and fails to totally prevent neuronal brain damage. The objective
of this study was to evaluate, in a realistic setting, the therapeutic benefit of administration of GK-11 (gacyclidine), an
antiglutamatergic compound, as a complement to the available emergency therapy against organophosphate poisoning. GK-11 was
injected at a dose of 0.1 mg/kg (i.v) after a 45-min latency period to heavily intoxicated (8 LD50) primates. Just after intoxication, man-equivalent doses of one autoinjector containing atropine/pralidoxime/diazepam were
administered. The effects of GK-11 were examined on survival, EEG activity, signs of toxicity, recovery after challenge and
central nervous system histology. The present data demonstrate that treatment with GK-11 prevents the mortality observed after
early administration of classical emergency medication alone. EEG recordings and clinical observations also revealed that
GK-11 prevented soman-induced seizures and motor convulsions. EEG analysis within the classical frequency bands (beta, theta,
alpha, delta) demonstrated that central activity was totally restored to normal after GK-11 treatment, but remained profoundly
altered in animals receiving atropine/pralidoxime/diazepam alone. GK-11 also markedly accelerated clinical recovery of soman-challenged
primates. Lastly, this drug totally prevented the neuropathology observed 3 weeks after soman exposure in animals treated
with classical emergency treatment alone. GK-11 represents a promising adjuvant therapy to the currently available emergency
polymedication to ensure optimal management of organophosphate poisoning in man. This drug is presently being evaluated in
a human clinical trial for a different neuroprotective indication.
Received: 16 June 1997 / Accepted: 23 September 1997 相似文献