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111.
Background: Laparoscopic adjustable gastric banding (LAGB) has usually been performed as an inpatient procedure with an average
hospital stay of 2-4 days. The aim of this study was to assess the feasibility of LAGB as an ambulatory procedure in selected
patients. Methods: Potential candidates for ambulatory LAGB were recruited from patients consulting for obesity surgery. The
main inclusion criteria were BMI >35 kg/m2 with co-morbid conditions, living within a reasonable distance from the hospital, and adult company at home. The patients
were admitted at 0700 hours on the day of surgery, underwent laparoscopic placement of a Lap-Band? system and were discharged home that evening. Results: 9 women and 1 man underwent outpatient LAGB. Mean age was 36 (range
18-52) years and mean BMI was 38.4 kg/m2 (range 35.1-43.3). Co-morbidities included functional dyspnea (6), osteoarthritis (4), arterial hypertension (4), type 2
diabetes (2) and dyslipidemia (1). 7 patients had undergone previous abdominal surgery: cesarian section (4), appendectomy
(3), cholecystectomy (1) and hysterectomy (1). All patients had an American Society of Anesthesiologists (ASA) classification
of II. The average operating time was 87 minutes (range 65-115). The mean time lapse between the end of the operation and
discharge from hospital was 9.6 hours. There were no readmissions, and no complications were noticed at 1 month postoperatively.
The patients' satisfaction with the ambulatory LAGB procedure was high. Conclusion: The present study demonstrates that LAGB
for obesity may be performed on an ambulatory basis without complications. 相似文献
112.
Hajer El Oussini Hanna Bayer Jelena Scekic-Zahirovic Pauline Vercruysse Jérôme Sinniger Sylvie Dirrig-Grosch Stéphane Dieterlé Andoni Echaniz-Laguna Yves Larmet Kathrin Müller Jochen H. Weishaupt Dietmar R. Thal Wouter van Rheenen Kristel van Eijk Roland Lawson Laurent Monassier Luc Maroteaux Anne Roumier Philip C. Wong Leonard H. van den Berg Albert C. Ludolph Jan H. Veldink Anke Witting Luc Dupuis 《Acta neuropathologica》2016,131(3):465-480
113.
Brain‐derived neurotrophic factor prevents dendritic retraction of adult mouse retinal ganglion cells 下载免费PDF全文
Kate E. Binley Wai S. Ng Yves‐Alain Barde Bing Song James E. Morgan 《The European journal of neuroscience》2016,44(3):2028-2039
We used cultured adult mouse retinae as a model system to follow and quantify the retraction of dendrites using diolistic labelling of retinal ganglion cells (RGCs) following explantation. Cell death was monitored in parallel by nuclear staining as ‘labelling’ with RGC and apoptotic markers was inconsistent and exceedingly difficult to quantify reliably. Nuclear staining allowed us to delineate a lengthy time window during which dendrite retraction can be monitored in the absence of RGC death. The addition of brain‐derived neurotrophic factor (BDNF) produced a marked reduction in dendritic degeneration, even when application was delayed for 3 days after retinal explantation. These results suggest that the delayed addition of trophic factors may be functionally beneficial before the loss of cell bodies in the course of conditions such as glaucoma. 相似文献
114.
Wim P. Ceelen MD PhD FACS Yves Van Nieuwenhove MD PhD Simon Van Belle MD PhD Hannelore Denys MD PhD Piet Pattyn MD PhD 《Annals of surgical oncology》2012,19(7):2352-2359
Background
Limited data are available on the use of cytoreductive surgery with hyperthermic intraperitoneal chemoperfusion (HIPEC) in patients with recurrent stage III ovarian cancer.Methods
Patients with recurrent, heavily pretreated ovarian cancer were enrolled onto a phase II multimodal protocol consisting of extensive cytoreduction followed by HIPEC.Results
Forty-two women were treated from October 2002 until January 2009. Chemoperfusion was performed with cisplatin in 59% and oxaliplatin in 41% of patients. A macroscopically complete resection was achieved in 50% of patients. No mortality occurred, and the major morbidity rate was 21%. After a mean follow-up of 21?months, median overall survival (OS) was 37?months (95% confidence interval 12.2?C61.8) and median progression-free survival was 13?months (95% confidence interval 6.9?C19.1). In univariate analysis, OS was influenced by completeness of cytoreduction, type of chemoperfusion drug, nodal status, and tumor grade. In a Cox regression model, only completeness of cytoreduction (hazard ratio 0.06?C0.8, P?=?.022) and tumor grade (hazard ratio 1.23?C12.6, P?=?.021) were independent predictors of OS.Conclusions
In selected patients with heavily pretreated recurrent ovarian cancer, cytoreduction combined with HIPEC may provide a meaningful OS with acceptable morbidity. Optimal results are achieved in patients with a macroscopically complete resection and biologically favorable disease. 相似文献115.
Gouillat C Denis A Badol-Van Straaten P Frering V Tussiot J Campan P Aulagnier G Costamagna V Ain JF Portet R Roche M Esso C Molasoko JM Claret Y Desplantez J Le Page S Blanchet MC Robert M Jaisson-Hot I 《Obesity surgery》2012,22(4):572-581
Background
Although laparoscopic adjustable gastric banding (LAGB) is a popular metabolic/bariatric procedure, few prospective studies have assessed its outcomes. This study aimed to prospectively assess LAGB safety and effectiveness outcomes using the MIDBAND? (MID, Dardilly, France).Methods
Between May 2005 and September 2006, 262 morbidly obese patients underwent primary gastric banding with pars flaccida technique in 13 French medical centers. Excess weight loss and change in body mass index (BMI, kilogram per square meter), percentage of patients with comorbidities, and obesity-related complications were recorded. Patients were followed at 6-month intervals for 3?years. A multivariable individual growth model was used to analyze weight change over time and determine potential predictors of weight loss.Results
The majority of patients were female (n?=?233, 89%), with mean age of 36.4?±?9.7?years. At 3?years, LAGB with MIDBAND resulted in significant decrease in mean BMI from 41.8?±?4.2 to 30.7?±?5.8 (p?0.0001). Median excess weight loss and excess BMI loss were 61% and 68%, respectively. The prevalence of obesity-related comorbidities had significantly decreased from 71% to 15% (p?0.0001). Complications were observed in 26 patients (10%); device-related complications occurred in 20 patients (8.2%), requiring band removal in 8 (3.3%), and port revision in 8 (3.3%). Individual growth analysis identified significant predictors of weight loss including the number of follow-up visits.Conclusion
Prospective outcomes demonstrate the safety and efficacy of gastric banding over time using the MIDBAND. Individual growth modeling demonstrated that postoperative weight loss is strongly related to the frequency and consistency of follow-up visits. 相似文献116.
Cochlear implant benefits in deafness rehabilitation: PET study of temporal voice activations. 总被引:1,自引:0,他引:1
Arnaud Coez Monica Zilbovicius Evelyne Ferrary Didier Bouccara Isabelle Mosnier Emmanuèle Ambert-Dahan Eric Bizaguet André Syrota Yves Samson Olivier Sterkers 《Journal of nuclear medicine》2008,49(1):60-67
Cochlear implants may improve the medical and social prognosis of profound deafness. Nevertheless, some patients have experienced poor results without any clear explanations. One correlate may be an alteration in cortical voice processing. To test this hypothesis, we studied the activation of human temporal voice areas (TVA) using a well-standardized PET paradigm adapted from previous functional MRI (fMRI) studies. METHODS: A PET H(2)(15)O activation study was performed on 3 groups of adult volunteers: normal-hearing control subjects (n = 6) and cochlear-implanted postlingually deaf patients with >2 y of cochlear implant experience, with intelligibility scores in the "Lafon monosyllabic task" >80% (GOOD group; n = 6) or <20% (POOR group; n = 6). Relative cerebral blood flow was measured in 3 conditions: rest, passive listening to human voice, and nonvoice stimuli. RESULTS: Compared with silence, the activations induced by nonvoice stimuli were bilaterally located in the superior temporal regions in all groups. However these activations were significantly and similarly reduced in both cochlear implant groups, whereas control subjects showed supplementary activations. Compared with nonvoice, the voice stimuli induced bilateral activation of the TVA along the superior temporal sulcus (STS) in both the control and the GOOD groups. In contrast, these activations were not detected in the POOR group, which showed only left unilateral middle STS activation. CONCLUSION: These results suggest that PET is an adequate method to explore cochlear implant benefits and that this benefit could be linked to the activation of the TVA. 相似文献
117.
Automatic prediction of infarct growth in acute ischemic stroke from MR apparent diffusion coefficient maps 总被引:1,自引:0,他引:1
Montiel NH Rosso C Chupin N Deltour S Bardinet E Dormont D Samson Y Baillet S 《Academic radiology》2008,15(1):77-83
RATIONALE AND OBJECTIVES: We introduce a new approach to the prediction of final infarct growth in human acute ischemic stroke based on image analysis of the apparent diffusion coefficient (ADC) maps obtained from magnetic resonance imaging. Evidence from multiple previous studies indicate that ADC maps are likely to reveal brain regions belonging to the ischemic penumbra, that is, areas that may be at risk of infarction in the few hours following stroke onset. MATERIALS AND METHODS: In a context where "time is brain," and contrarily to the alternative-and still-debated-perfusion-diffusion weighted image (PWI/DWI) mismatch approach, the DWI magnetic resonance sequences are standardized, fast to acquire, and do not necessitate injection of a contrast agent. The image analysis approach presented here consists of the segmentation of the ischemic penumbra using a fast three-dimensional region-growing technique that mimics the growth of the infarct lesion during acute stroke. RESULTS: The method was evaluated with both numerical simulations and on two groups of 20 ischemic stroke patients (40 patients total). The first group of patient data was used to adjust the parameters of the model ruling the region-growing procedure. The second group of patient data was dedicated to evaluation purposes only, with no subsequent adjustment of the free parameters of the image-analysis procedure. Results indicate that the predicted final infarct volumes are significantly correlated with the true final lesion volumes as revealed by follow-up measurements from DWI sequences. CONCLUSION: The DWI-ADC mismatch method is an encouraging fast alternative to the PWI-DWI mismatch approach to evaluate the likeliness of infarct growth during the acute stage of ischemic stroke. 相似文献
118.
Yves Louagie Jacques Jamart Serge Broka Edith Collard Vincent Scavée Manuel Gonzalez 《European journal of cardio-thoracic surgery》2002,22(4):552-558
OBJECTIVE: The objective of this study was to assess improved myocardial protection by performing coronary artery bypass grafting (CABG) on the beating heart. A case-matched study was conducted among patients who underwent CABG either on-pump (group 1), or off-pump (group 2). METHODS: Forty-five pairs of patients, having a similar clinical profile, were selected on the basis of five variables: age, gender, body surface area, ejection fraction, extent of coronary disease. Operative risk predicted by the The Society of Thoracic Surgeons national database was 1.80+/-0.35% in group 1, and 1.89+/-0.37% in group 2 (NS). Cold blood cardioplegia and 28 degrees C cardiopulmonary bypass were used in group 1. In group 2, beating heart coronary grafting was achieved with the Octopus 1 and 2 stabilizers. The average number of distal anastomoses was 2.8+/-0.1 in group 1 and 2.3+/-0.1 in group 2 (P=0.015). RESULTS: There was no significant difference among the groups regarding the trend in cardiac index, left and right ventricular stroke work indexes, and systemic and pulmonary vascular resistance indexes. However, heart rate trend was slower in group 2 (P=0.05). Pharmacological support was required in 65% of the patients in group 1, and in 33% in group 2 (P<0.001). The total amount of Dobutamine and/or Dopamine administered during the first 48 h was 3914+/-1306 gamma/kg in group 1 and 1645+/-697 gamma/kg in group 2 (P=0.049). Release of creatine kinase MB mass isoenzyme (CK-MB mass) was markedly reduced in group 2 (P<10(-4)). CONCLUSIONS: Hemodynamic outcome following off-pump CABG is similar to on-pump CABG but the need for inotropic support is significantly reduced and CPK-MB mass release is markedly lower. 相似文献
119.
Mecklinger A Gruenewald C Besson M Magnié MN Von Cramon DY 《Cerebral cortex (New York, N.Y. : 1991)》2002,12(11):1115-1123
Previous work using single-cell recordings in monkeys and neuro-imaging studies in humans has shown that perceiving an object or imaging the action associated with the object recruits the same brain regions in the ventral premotor cortex as performing an action with the object. We used functional magnetic resonance imaging (fMRI) for examining whether similar brain regions are also activated while maintaining information about manipulable objects in working memory. Holding information about manipulable objects in working memory activated the left ventral premotor cortex and the left inferior frontal gyrus (Broca's area). Conversely, non-manipulable objects to be held in working memory co-activated Broca's area and the left angular gyrus. When contrasted directly, manipulable relative to non-manipulable objects activated the left ventral premotor cortex and the anterior intraparietal sulcus, a circuitry that is assumed to mediate the transformation of movement-relevant object properties into hand actions. These results indicate that visual working memory for manipulable objects is based on motor programmes associated with their use. Similar to speech motor programmes in verbal memory tasks, hand motor programmes may allow the maintenance of objects in working memory over short intervals. 相似文献
120.
Bart D. Maes Wim Lemahieu Dirk Kuypers Pieter Evenepoel Willy Coosemans Jacques Pirenne Yves F. CH. Vanrenterghem 《American journal of transplantation》2002,2(10):989-992
Diarrhea is the most frequently reported adverse event in patients treated with mycophenolate mofetil. Twenty-six renal transplant patients on a mycophenolate mofetil-based immunosuppressive regime with persistent afebrile diarrhea were examined. Diarrhea caused a significant rise in FK-506 trough levels despite intake of stable doses, necessitating FK-506 dose reductions of 30% to obtain pre-diarrhea trough levels. In contrast, trough levels of cyclosporine A remained stable without dose adjustments. This suggests that absorption and/or metabolism is differentially altered for FK506 compared with cyclosporine A in patients with diarrhea. In nine patients mycophenolate mofetil was reduced or stopped because of persistent diarrhea without identifiable cause. This resulted in end-stage renal disease because of chronic rejection in two patients, and in acute rejection in two patients, all taking FK506 and steroids. Therefore, dose adjustments of FK506 in patients with diarrhea must be carefully monitored, especially when doses of mycophenolate mofetil are also reduced. 相似文献