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81.
82.
Themistoklis Mikos Mariliz Chatzipanteli Grigoris F. Grimbizis Basil C. Tarlatzis 《International urogynecology journal》2017,28(7):971-978
Introduction and hypothesis
Obliterative procedures for the treatment of pelvic organ prolapse have been reported to have a recurrence rate up to 10%. We present (1) a case report of a patient with prolapse after LeFort colpocleisis and how it was managed in our department, and (2) a review of the literature regarding the types of recurrence after LeFort colpocleisis, their rate and their treatment.Methods
A 77-year-old woman was treated in our department for recurrence of prolapse through the right lateral channel 6 months after LeFort colpocleisis. A systematic review of the literature up to 2016 was performed through MEDLINE, Web of Science and the Cochrane Library.Results
The patient underwent a modified repeat colpocleisis and 6 months later was doing well with no signs of recurrence. We found 28 eligible studies including 1,810 patients, and the rate of recurrence after LeFort colpocleisis was 4.2% (76/1,810) leaving the majority of patients very satisfied. Information about the management of recurrence of prolapse after LeFort colpocleisis was provided in 17 studies including 33 patients with a 60-month follow-up. It appears that there are three major categories of recurrent prolapse after LeFort partial colpocleisis: (1) patients with a total breakdown of colpocleisis (57.6%), (2) patients with “channel prolapse” (15.2%), and (3) patients with prolapse at sites not involved in the primary partial colpocleisis (27.3%). The most frequent treatments were total colpocleisis/colpectomy (27.3%), perineorrhaphy and posterior repair (9.1%) and hysterectomy (9.1%). Almost 50% of these patients opted not to have surgical treatment.Conclusions
The rate of prolapse recurrence after LeFort colpocleisis is estimated to be 4.2%. The management of recurrences after LeFort colpocleisis depends on the time and type of recurrence. The repeat modified LeFort colpocleisis is a viable option in patients with channel prolapse; if no uterus exists, colpectomy appears to be the best option.83.
Georgios S. Papaetis Panagiotis Papakyriakou Themistoklis N. Panagiotou 《Archives of Medical Science》2015,11(3):463-482
The prevalence of type 2 diabetes (T2D) is rapidly increasing. This is strongly related to the contemporary lifestyle changes that have resulted in increased rates of overweight individuals and obesity. Central (intra-abdominal) obesity is observed in the majority of patients with T2D. It is associated with insulin resistance, mainly at the level of skeletal muscle, adipose tissue and liver. The discovery of macrophage infiltration in the abdominal adipose tissue and the unbalanced production of adipocyte cytokines (adipokines) was an essential step towards novel research perspectives for a better understanding of the molecular mechanisms governing the development of insulin resistance. Furthermore, in an obese state, the increased cellular uptake of non-esterified fatty acids is exacerbated without any subsequent β-oxidation. This in turn contributes to the accumulation of intermediate lipid metabolites that cause defects in the insulin signaling pathway. This paper examines the possible cellular mechanisms that connect central obesity with defects in the insulin pathway. It discusses the discrepancies observed from studies organized in cell cultures, animal models and humans. Finally, it emphasizes the need for therapeutic strategies in order to achieve weight reduction in overweight and obese patients with T2D. 相似文献
84.
85.
Themistoklis Mikos Alexios Papanicolaou Tryfon Tsalikis Evangelos Ioannidis 《International urogynecology journal》2009,20(7):881-884
Up to date, the connection of pelvic trauma with genital prolapse is not widely recognized. These cases could be classified
in a group where disruption of normal anatomy of the pelvis is apparent (i.e., pelvic fracture), and in a second group, where
pelvis remains unaffected by the pelvic trauma (i.e., seat belt-related injuries). The aim of the report is to describe the
management of a 39-year-old nulliparous patient presenting with stage III uterine prolapse after pelvic trauma; the patient
had a history of Mitrofanoff’s procedure for neurogenic bladder followed by closure of the bladder neck and permanent suprapubic
urinary catheter for intractable incontinence. The prolapse was managed with a mesh anterior colporraphy combined with sacrospinous
hysteropexy. At 3 months follow-up, she is well with no prolapse recurrence. 相似文献
86.
Themistoklis Mikos Tryfon Tsalikis Alexios Papanikolaou Fotios Pournaropoulos John N. Bontis 《International urogynecology journal》2008,19(3):449-452
Posterior intravaginal slingplasty (IVS) is a technique used for the treatment of apical prolapse. Type III meshes have been
mostly used with this technique. In this article, a case of bilateral gluteo-vaginal sinus tract formation that complicated
a posterior vaginal slingplasty with a type III mesh is presented. At 3 months follow-up, the patient complained for bulking
through the vagina, continuous offensive vaginal discharge, and constant pain at the buttocks. She had prolapse recurrence,
and there was defective healing at the gluteal entry points of the posterior IVS. Ten months after the initial surgery, she
underwent a laparotomic subtotal hysterectomy and sacrocervicopexy with prolene type I mesh. At the same time, the posterior
mesh was removed allowing the surgeon to discover communication of the canal of the mesh extending from gluteal incisions
to the vagina epithelium. The sinus tract was managed surgically with excision of the surrounding tissues. There was no recurrence
or other complications at 2 months follow-up. 相似文献
87.
KS Amitha Vikrama SN Keshava NRS Surendrababu V Moses P Joseph F Vyas V Sitaram 《Journal of Medical Imaging and Radiation Oncology》2010,54(1):5-8
Jejunal access loop is fashioned in patients who undergo Roux en Y hepaticojejunostomy and biliary intervention is anticipated on follow up. Post-operative study of the biliary tree through the access loop is usually done under fluoroscopic guidance. We present a series of 20 access loop cholangiograms performed in our institution between August 2004 and November 2008. We aimed to evaluate the safety and efficacy of the procedure and to highlight the role of CT guidance in procuring access. Access loop was accessed using CT (n = 13), ultrasound (n = 3) or fluoroscopic guidance (n = 4). Fluoroscopy was used for performing cholangiograms and interventions. Twelve studies had balloon plasty of the stricture at anastomotic site or high up in the hepatic ducts. Seven studies showed normal cholangiogram. Plasty was unsuccessful in one study. Technical success in accessing the jejunal access loop was 100%; in cannulation of anastomotic site and balloon plasty it was 95%. One case required two attempts. Procedure-related complications were not seen. All patients who underwent balloon plasty of the stricture were doing well for variable lengths of time. Access loop cholangiogram and interventions are safe and effective. CT guidance in locating/procuring the access loop is a good technique. 相似文献
88.
89.
Minas A. Mina Anthony J. Blazevich Themistoklis Tsatalas Giannis Giakas Laurent B. Seitz Anthony D. Kay 《Scandinavian journal of medicine & science in sports》2019,29(3):380-392
Studies examining acute, high‐speed movement performance enhancement following intense muscular contractions (frequently called “post‐activation potentiation”; PAP) often impose a limited warm‐up, compromizing external validity. In the present study, the effects on countermovement vertical jump (CMJ) performance of back squat exercises performed with or without elastic bands during warm‐up were compared. After familiarization, fifteen active men visited the laboratory on two occasions under randomized, counterbalanced experimental squat warm‐up conditions: (a) free‐weight resistance (FWR) and (b) variable resistance (VR). After completing a comprehensive task‐specific warm‐up, three maximal CMJs were performed followed by three back squat repetitions completed at 85% of 1‐RM using either FWR or VR Three CMJs were then performed 30 seconds, 4 minutes, 8 minutes, and 12 minutes later. During CMJ trials, hip, knee, and ankle joint kinematics, ground reaction force data and vastus medialis, vastus lateralis, and gluteus maximus electromyograms (EMG) were recorded simultaneously using 3D motion analysis, force platform, and EMG techniques, respectively. No change in any variable occurred after FWR (P > 0.05). Significant increases (P < 0.05) were detected at all time points following VR in CMJ height (5.3%‐6.5%), peak power (4.4%‐5.9%), rate of force development (12.9%‐19.1%), peak concentric knee angular velocity (3.1%‐4.1%), and mean concentric vastus lateralis EMG activity (27.5%‐33.4%). The lack of effect of the free‐weight conditioning contractions suggests that the comprehensive task‐specific warm‐up routine mitigated any further performance augmentation. However, the improved CMJ performance following the use of elastic bands is indicative that specific alterations in force‐time properties of warm‐up exercises may further improve performance. 相似文献
90.
目的:观察成纤维细胞生长因子对培养兔纤维环细胞转化生长因子β2表达的调节作用。方法:实验于2005-03/2006-04在华中科技大学同济医学院附属协和医院骨科实验室完成。培养4月龄雌性日本大白兔的纤维环细胞,在每次换液时加入成纤维细胞生长因子100μg/L,铺满后收集细胞,作纤维环细胞转化生长因子β2常规免疫组织化学研究,细胞呈棕黄色染色为阳性表达信号,同时为进一步明确纤维环细胞转化生长因子β2的定位进行免疫胶体金标记电镜观察。结果:光镜下细胞明显呈棕色,电镜下细胞膜表面有明显的胶金颗粒粘附。结论:成纤维细胞生长因子能促进纤维环细胞转化生长因子β2的表达。 相似文献