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51.
The utilization of microsurgical techniques in the surgical disciplines is now accepted worldwide, and many surgeons should receive the opportunity of learning these techniques. To meet this requirement, microsurgical courses have been organized and comprise both theoretical aspects and, especially, practical demonstrations. A one-week course usually allows attending surgeons to get familiar with magnification and to perform microvascular anastomoses, vasovasostomy, tubal reconstruction, sciatic nerve suture, and end-to-side portacaval shunt, a useful exercise before dealing with rodent organ transplantation. It is important to underline that the skill supplied by these microsurgical courses is not enough to start clinical applications of microsurgery; to this end, training must continue long after the course has been finished. © 1998 Wiley-Liss, Inc. MICROSURGERY 18:449–453 1998  相似文献   
52.
In order to achieve perfusion of both lobes of the liver for hepatic arterial infusion chemotherapy, several surgical techniques can be used when the right hepatic artery arises from the superior mesenteric artery. Three of these techniques (utilization of cystic artery, end-to-side anastomosis between the right hepatic artery and proper hepatic artery, and insertion of a fine-tipped special catheter in the right hepatic artery) often require microsurgery applications. © 1998 Wiley-Liss, Inc. MICROSURGERY 18:476–478 1998  相似文献   
53.
Despite advances in surgical methods, postsurgical adhesions (PSA) remain a significant clinical challenge affecting millions of patients each year. These permanent fibrous connections between tissues result from the bridging of wounded internal surfaces by an extended fibrin gel matrix (FGM). Adhesion formation is a result of a systems level convergence of wound healing pathways, complicating the design of materials that could inhibit their occurrence. In this study, a systematic approach that identifies key material properties required for functional performance optimization was used to design a new fibrin-targeted PSA prevention material. A series of multifunctional polymers with varied molecular architectures was synthesized to investigate the effect of changing polymer structural parameters on the ability to disrupt the formation of an extended FGM. Initial studies in a murine adhesion model demonstrated a statistically significant reduction in the degree of PSA formation, demonstrating the potential value of this systematic approach.  相似文献   
54.
The numerous intervention strategies that comprise cognitive-behavioral therapy (CBT) reflect its complex and integrative nature and include such topics as extinction, habituation, modeling, cognitive restructuring, problem solving, and the development of coping strategies, mastery, and a sense of self-control. CBT targets multiple areas of potential vulnerability (eg, cognitive, behavioral, affective) with developmentally guided strategies and traverses multiple intervention pathways. Although CBT is often considered the "first-line treatment" for many psychological disorders in youth, additional work is necessary to address nonresponders to treatment and to facilitate the dissemination of efficacious CBT approaches.  相似文献   
55.
The primary aim of this paper was to explore whether provider’s understanding of patient’s social context is associated with screening uptake, independent of provider’s recommendation. Baseline data were collected in 2004–2005 from a cluster randomized control trial in 12 low-income housing sites. Participants included 695 low-income, multiethnic adults aged 50 years and over who were primarily insured (97%). Provider’s recommendation was significantly associated with current adherence to colorectal cancer (CRC) screening. Provider’s understanding of patient’s social context, as operationalized by how well participants felt that their provider knew (a) their responsibilities at work, home, or school; (b) their worries about health; and (c) them as a person and their values and beliefs, was also significantly associated with current adherence to screening, independent of provider’s recommendation. Participants who reported that their provider knew them well on two or three items were significantly more likely to be current with CRC screening compared to those who reported their provider knew them well on only one or none of the items (odds ratio = 1.56; 95% confidence interval = 1.06, 2.29). Our findings indicate that provider’s understanding of patient’s social context, independent of provider’s recommendation for CRC screening, contributed to adherence to CRC screening in this low-income, multiethnic population.  相似文献   
56.

Background

Dietary treatment is often recommended as the first line of treatment for women with mild iron deficiency. Although it is well established that ascorbic acid enhances iron absorption, it is less clear whether the consumption of ascorbic acid rich foods (such as kiwifruit) with meals fortified with iron improves iron status. The aim of this study is to investigate whether the consumption of ZESPRI® GOLD kiwifruit (a fruit high in ascorbic acid and carotenoids) with an iron fortified breakfast cereal meal increases iron status in women with low iron stores.

Methods/Design

Eighty nine healthy women aged 18-44 years with low iron stores (serum ferritin (SF) ≤ 25 μg/L, haemoglobin (Hb) ≥ 115 g/L) living in Auckland, New Zealand were randomised to receive an iron fortified breakfast cereal (16 mg iron per serve) and either two ZESPRI® GOLD kiwifruit or a banana (low ascorbic acid and carotenoid content) to eat at breakfast time every day for 16 weeks. Iron status (SF, Hb, C-reactive protein (CRP) and soluble transferrin receptor (sTfR)), ascorbic acid and carotenoid status were measured at baseline and after 16 weeks. Anthropometric measures, dietary intake, physical activity and blood loss were measured before and after the 16 week intervention.

Discussion

This randomised controlled intervention study will be the first study to investigate the effect of a dietary based intervention of an iron fortified breakfast cereal meal combined with an ascorbic acid and carotenoid rich fruit on improving iron status in women with low iron stores.

Trial registration

ACTRN12608000360314
  相似文献   
57.
Pomegranate is a rich source of polyphenols. Laboratory studies suggest polyphenols may exert breast cancer preventive effects through modulation of endogenous sex hormone levels. The aim of this study was to determine the effect of pomegranate juice consumption on serum levels of estradiol, estrone, testosterone, androstenedione, and sex hormone binding globulin (SHBG). Sixty-four healthy postmenopausal women were randomly assigned to drink 8 ounces of either 100% commercial pomegranate juice (intervention) or apple juice (control) for 3 weeks. Overall, women in the intervention group did not experience any significant decline in serum sex hormones or SHBG compared to women in the control group. In subgroup analyses restricted to 38 normal weight women, women in the intervention group compared to control group had a significant decline in estrone (pg/mL) and testosterone levels (pg/mL): pomegranate: ?61.6 [95% confidence interval (CI): ?175.8 to 52.6), apple: 1.1 (95% CI: ?5.4 to 7.7), P = 0.05, and pomegranate: ?289.1 (95% CI: ?630.7 to 52.5), apple: 79.6 (95% CI: ?77.8 to 236.9), P = 0.03, respectively. Because of several study limitations, results should be considered preliminary. Additional larger trials would be needed to determine effects in normal versus overweight/obese women.  相似文献   
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OBJECTIVES: Tissue engineering has the potential to make a significant impact on improving tissue repair in the craniofacial system. The general strategy for tissue engineering includes seeding cells on a biomaterial scaffold. The number of scaffold and cell choices for tissue engineering systems is continually increasing and will be reviewed. DESIGN: Multilayered hydrogel systems were developed to coculture different cell types and develop osteochondral tissues for applications including the temporomandibular joint. EXPERIMENTAL VARIABLE: Hydrogels are one form of scaffold that can be applied to cartilage and bone repair using fully differentiated cells, adult and embryonic stem cells. OUTCOME MEASURE: Case studies represent an overview of our laboratory's investigations. RESULTS: Bilayered scaffolds to promote tissue development and the formation of more complex osteochondral tissues were developed and proved to be effective. CONCLUSION: Tissue engineering provides a venue to investigate tissue development of mutant or diseased cells and potential therapeutics.  相似文献   
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