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53.
Klaus-Dietrich Wolff Sami Swaid Dirk Nolte Roland A B?ckmann Frank H?lzle Christian Müller-Mai 《Journal of cranio-maxillo-facial surgery》2004,32(2):71-79
BACKGROUND: A carbonated apatite cement (NORIAN SRS) was used as a bone mineral substitute for the calvaria or viscerocranium in 27 patients. It has the consistency of a paste and hardens at physiologic pH and body temperature due to dahllite crystallization, which has the stoichiometric formula Ca(8.8)(HPO(4))(0.7)(PO(4))(4.5)(CO(3))(0.7)(OH)(1.3). MATERIAL AND METHODS: The cement was used for posttraumatic bone defects in the orbital, periorbital or malar regions (nine patients), posttraumatic deformities of the frontal bone (six patients), tumour-dependent bony defects of the calvaria (two patients) and posttraumatic or cystic defects of the mandible (five patients). In another five patients, the material was used to augment the atrophic anterior mandible in combination with the insertion of dental implants. Follow-up varied between 6 and 40 months (mean: 29 months). RESULTS: There was no inflammatory reaction surrounding the implanted material. There was no sign of infection in any of the patients and only one case of partial wound dehiscence with superficially exposed material. The defect fillings and augmentations were successful in all patients. None of the 19 dental implants which were inserted in combination with the material showed any sign of infection or loosening. Also, there was no loosening of the implants after loading (mean follow-up: 15 months). From the check-up radiographs, the material could be seen as a dense, radio-opaque structure. There were no material fractures or dislocations. Radiologically, the material seemed to be completely replaced by bony tissue after 30 months. CONCLUSION: Our 5-year clinical experience suggests that the material is a suitable bone mineral substitute for cranio-maxillofacial surgery especially for moderate-sized defects of the calvaria and forehead bone. It has advantages over preformed, solid bone substitute materials, and, due to its initial plasticity and eventual great compressive strength, it can also stabilize dental endosseous implants in the atrophic mandible. 相似文献
54.
Erkki Lotspeich Markus Schoene Heinz Gerngroß Roland Schmidt Reinhard Steinmann Marco Ramadani Susanne Gansauge 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》2007,392(5):559-566
Introduction Postoperative treatment for colorectal cancer depends on tumor stage as defined by the International Union Against Cancer
(UICC). Adjuvant chemotherapy is not recommended in patients without lymph node involvement (UICC stages I and II). As many
as 20–30% of these patients, however, will develop recurrence.
Aims and objectives We conducted this study to determine the presence of disseminated tumor cells in the lymph nodes by quantitative real-time
polymerase chain reaction (QRT-PCR) for cytokeratin 20 (CK20) in an attempt to provide supplementary information compared
to histopathological findings.
Materials and methods Using a standard QRT-PCR assay, we examined primary tumors and 391 lymph nodes from 31 patients with completely resected colorectal
cancer.
Results Of the 31 primary tumors, 29 were positive for CK20 by QRT-PCR.
Discussion An examination of the lymph nodes from the 29 patients with CK20-positive primary tumors revealed that 35 (92.1% sensitivity)
of the 38 histopathologically positive lymph nodes and 54 (16.7%) of the 324 histopathologically negative lymph nodes were
positive by molecular analysis. CK20 expression was detected in 10 (100%) of 10 patients with a histopathologically positive
lymph node status (pN1). In 9 (47.4%) of 19 patients with negative histopathological results (pN0), we detected a CK20 mRNA
signal in at least one lymph node. Whereas eight patients with histopathologically negative lymph nodes could be upstaged
on the basis of the molecular findings, no patient would be downstaged.
Conclusion Our results suggest that QRT-PCR for CK20 is a useful tool for the quantitative detection of micrometastases in the regional
lymph nodes. We introduce a standardized procedure that integrates a molecular diagnostic technique in the clinical staging. 相似文献
55.
Although the concept of receiving MR signal using multiple coils simultaneously has been known for over two decades, the technique has only recently become clinically available as a result of the development of several effective parallel imaging reconstruction algorithms. Despite the success of these algorithms, it remains a challenge in many applications to rapidly and reliably reconstruct an image from partially-acquired general non-Cartesian k-space data. Such applications include, for example, three-dimensional (3D) imaging, functional MRI (fMRI), perfusion-weighted imaging, and diffusion tensor imaging (DTI), in which a large number of images have to be reconstructed. In this work, a systematic k-space-based reconstruction algorithm based on k-space sparse matrices (kSPA) is introduced. This algorithm formulates the image reconstruction problem as a system of sparse linear equations in k-space. The inversion of this system of equations is achieved by computing a sparse approximate inverse matrix. The algorithm is demonstrated using both simulated and in vivo data, and the resulting image quality is comparable to that of the iterative sensitivity encoding (SENSE) algorithm. The kSPA algorithm is noniterative and the computed sparse approximate inverse can be applied repetitively to reconstruct all subsequent images. This algorithm, therefore, is particularly suitable for the aforementioned applications. 相似文献
56.
Stéphane Aubert Roland Henaine Olivier Raisky Nicolas Chavanis Jacques Robin René Ecochard Jean Ninet 《European journal of cardio-thoracic surgery》2005,28(2):223-228
OBJECTIVE: We consider the short- and long-term outcomes of the repair of the isolated partial atrioventricular (AV) septal defect to determine the role played by the atypical forms on the initial AV valve replacement and on the risk of reoperation. METHODS: Two hundred and eight patients underwent an operation for this malformation between 1974 and 2001. Clinical and echocardiographic examinations were performed on all patients, the AV valve regurgitation was graded from 1 to 4 and a residual interatrial shunt was sought. Median age at the intervention was 5.8 years (3 months to 67 years). RESULTS: Median follow-up time was 7.5 years (range 0-22.6 years). The cumulative 30-day, 5- and 20-year survival rates were 96.5, 95.4 and 94.6%, respectively. AV valve replacement was associated with a high mortality (P<0.001). A reoperation was performed on 12 patients (5.7%) including six patients within less than a 30-day period, especially to repair residual AV valve regurgitation. We performed four AV valve repairs by annuloplasty and six AV valve replacements. Two patients who had initially undergone an AV valve replacement underwent a reoperation for valve thrombosis. The cumulative 30-day, 5- and 20-year rates of freedom from reoperation were 96.5, 93.6 and 83%, respectively. An atypical form was present in 24 patients (11.5%) and was a risk factor for initial AV valve replacement (P<0.001) and for reoperation (P<0.001). A complete AV block occurred in 13 patients (6.2%), all of them within a 30-day period. The AV valve replacement was a high risk factor for a complete AV block (P<0.001). At the end of our study 180 patients (96%) were in NYHA I and 8 in NYHA II. CONCLUSIONS: The morbi-mortality of the isolated partial AV septal defect is primarily perioperative and is linked with the presence of an atypical form of the lesion. This atypical form was the main reason for reoperation for AV valve regurgitation. The AV valve replacement was associated with a high mortality and with the occurrence of complete AV block. Using a standardized technique, the AV septal defect can be repaired with excellent long-term clinical and echographic results. 相似文献
57.
Reed Jon A.; Nador Roland G.; Spaulding David; Tani Yoichi; Cesarman Ethel; Knowles Daniel M. 《Blood》1998,91(10):3825-3832
58.
Roland S. G. Jones 《Hippocampus》1994,4(3):335-353
Layer II of the entorhinal cortex (EC) provides the first step in the hippocampal trisynaptic loop via the perforant path projection to the dentate gyrus. While a great deal is known about this projection and the properties of the dentate granule cells, much less information is available concerning the properties of and synaptic inputs to the cells of origin of the pathway in layer II. The present experiments have employed a slice preparation of the rat EC to study the intrinsic membrane properties and synaptic organization of layer II neurons. Two types of neurons could be identified electrophysiologically. The majority were designated type I and displayed a pronounced time-dependent inward rectification in the hyperpolarizing direction. Type II displayed little evidence of this characteristic. However, morphological examination suggested that both types were spiny stellate neurons projecting via the perforant path. Synaptic responses of both types displayed evidence of excitatory inputs mediated by both N-methyl-D-aspartate (NMDA) and non-NMDA glutamate receptors. In general, however, at low frequencies the responses were dominated by inhibitory inputs mediated by both GABAA and GABAB receptors. At higher frequencies the bias was shifted much more toward excitation. The contribution of synaptic and intrinsic properties of layer II neurons to the processing capabilities of the EC is discussed. © 1994 Wiley-Liss, Inc. 相似文献
59.
60.
Andreas Machner Harry Merk Roland Becker Kerstin Rohkohl Heiko Wissel G za Pap 《Acta orthopaedica》2003,74(1):85-88
A proprioceptive deficit is an important determinant of disability in various shoulder disorders, such as instability and osteoarthrosis. In 15 patients with impingement syndrome stage II (Neer 1983), who were treated by arthroscopic subacromial decompression, we measured movement sense by determining threshold levels for the perception of motion of the shoulder. The patients were placed in a specially designed chair allowing continuous passive motion of the shoulder joint, while avoiding cutaneous, auditory and visual stimuli. To assess movement detection thresholds, passive abduction movements of the shoulder were performed at a starting angle of 60°, an amplitude of 10° and an angular velocity of 1.3°/s. Before surgery, all patients had higher threshold levels for the perception of motion in their affected shoulders then in the other side. After decompression, proprioception had improved on the decompressed side, but was unchanged on the other side. 相似文献