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51.
Anterior Cruciate Ligament Reconstruction:
State of the Art 总被引:2,自引:0,他引:2
Abstract The rupture of the Anterior cruciate ligament (ACL)
belongs to the most common ligament injuries of the
human knee joint. ACL rupture results in an increased
anterior translation and internal rotation of the tibia.
Untreated knee instability causes a disintegration of
the roll and sliding movement and a high incidence of
secondary meniscus and chondral damages with consecutive
or advanced arthritic changes.
For deciding on a conservative or operative therapy, it is
necessary to develop a high-risk profile. Elderly, inactive
patients without instability symptoms can be treated
conservatively; younger, active people and complex
ligament injuries should receive an ACL replacement.
The goal is to eliminate instability by maintaining the
physiological kinematics of the knee.
Anterior cruciate ligament may be reconstructed
arthroscopically assisted by autologous tendons. Predominantly,
hamstring- and bone-patellar-tendon
grafts are used. No significant differences in knee laxity,
clinically and functionally, were observed between
both grafts. Various reconstruction techniques, single-
or double-bundle techniques, were described. Successful
replacement depends on a correct tunnel placement
and reconstruction of the physiological band
tension, a sufficient mechanical stability of fixation, an
impingement-free range of motion and an adequate
rehabilitation.
A high degree of patient satisfaction in clinical and
functional outcome could be evaluated. 相似文献
52.
53.
Emilie Balasse Gregory Gatouillat Dominique Patigny Marie Christine Andry Claudie Madoulet 《Vaccine》2009
Malignant melanoma causes significant health problems. The identification of tumour-associated antigens has led to novel approaches to increase T cell mediated anti-tumour immune response. Melan-A/MART-1 has been use as target antigen for several T cell based immunotherapeutic treatments. More recently, the critical role of CD4+ T cells in inducing and maintaining anti-tumour immunity has been increasingly recognized. In order to optimize tumour immunotherapy, greater efforts have been concentrated on the identification of tumour antigens presented by MHC class II molecules to CD4+ T cells. In a publication, Tiwari et al. (2004) [1] have identified by a computational approach the 15-mer amino-acid sequence 101–115 (PPAYEKLSAEQSPPP) of the Melan-A/MART-1 as a good target for a vigorous and safe immunotherapy. Therefore, we have investigated the in vivo anti-tumour activity of this peptide in a murine melanoma model. For the prophylactic treatment, 20 μg or 50 μg peptide was subcutaneously injected in mice once a week during 3 weeks before tumour induction. Treatment with 50 μg peptide significantly affected tumour development. Thus, our preliminary data demonstrate potential in vivo prophylactic activity of the 101–115 peptide-based vaccine to control melanoma growth. 相似文献
54.
Tobias von Lukowicz Michela Silacci Matthias T Wyss Eveline Trachsel Christine Lohmann Alfred Buck Thomas F Lüscher Dario Neri Christian M Matter 《Journal of nuclear medicine》2007,48(4):582-587
Targeting proteins that are overexpressed in atherosclerotic plaques may open novel diagnostic applications. The C domain of tenascin-C is absent from normal adult tissues but can be inserted during tumor progression or tissue repair into the molecule by alternative splicing. We tested the ability of the human antibody G11, specific to this antigen, to reveal murine atherosclerotic plaques ex vivo. The antibody directed against the extra domain B of fibronectin (L19) was used as a reference. METHODS: We intravenously injected (125)I-labeled G11 or L19 antibodies into apolipoprotein E-deficient (ApoE(-/-)) mice and harvested the aortae 4 or 24 h later. En face analyses of distal aortae and longitudinal sections of the aortic arch were performed to compare antibody uptake using autoradiography with plaque staining using oil red O. Plaque macrophages were detected by immunohistochemistry (anti-CD68 staining). Biodistribution of injected antibodies was investigated in aortae and blood at 4 and 24 h. RESULTS: En face analyses revealed a significant correlation between radiolabeled G11 and fat-stained areas, increasing from 4 to 24 h, with a correlation coefficient of 0.92 (P < 0.0001) and an average signal-to-noise ratio of 104:1 at 24 h. Plaque imaging using L19 showed similar results (r = 0.86; P < 0.0001; signal-to-noise ratio, 72:1 at 24 h). Uptake of radiolabeled antibodies in histologic sections colocalized with fat staining and activated macrophages in aortic plaques. Biodistribution analyses confirmed specific accumulation in aortic plaques as well as rapid blood pool clearance of the antibodies 24 h after injection. Immunofluorescence analyses revealed increased expression of tenascin and fibronectin isoforms in macrophage-rich plaques. CONCLUSION: The antibody G11, specific to the C domain of tenascin-C, visualizes murine atherosclerotic plaques ex vivo. In conjunction with the increased expression of the C domain of tenascin-C in macrophage-rich plaques, the colocalization of G11 uptake with activated macrophages, and the favorable target-to-blood ratio at 24 h, this antibody may be useful for molecular imaging of advanced atherosclerotic plaques in the intact organism. 相似文献
55.
Neal R. Barshes Timothy C. Lee Ian W. Udell Christine A. O'Mahoney Beth A. Carter Saul J. Karpen John A. Goss 《American journal of transplantation》2005,5(8):2047-2051
Split liver transplantation (SLT) benefits society by increasing the total number of transplants that can be performed, but it is yet unknown if a decreased post-transplant survival (in comparison to whole liver transplantation) would make participation in SLT less appealing to adult liver transplant candidates. A 20-item questionnaire was administered to 50 adult candidates to assess attitudes toward SLT and organ sharing. The overall attitudes of 60% of participants were classified as utilitarian (maximizing benefit to greatest number of candidates), while 26% were classified as self-preserving (maximizing individual benefit) and 14% were undecided. Ninety percent of participants would be willing to share even if expected survival was less than that of whole liver transplantation, and 69% felt that pediatric candidates should have priority over adult candidates. In conclusion, attitudes toward graft sharing and the possibility of compromised survival benefit are not barriers to SLT for most adult liver transplant candidates. 相似文献
56.
57.
58.
59.
Gregory C Gray Troy McCarthy Mark G Lebeck David P Schnurr Kevin L Russell Adriana E Kajon Marie L Landry Diane S Leland Gregory A Storch Christine C Ginocchio Christine C Robinson Gail J Demmler Michael A Saubolle Sue C Kehl Rangaraj Selvarangan Melissa B Miller James D Chappell Danielle M Zerr Deanna L Kiska Diane C Halstead Ana W Capuano Sharon F Setterquist Margaret L Chorazy Jeffrey D Dawson Dean D Erdman 《Clinical infectious diseases》2007,45(9):1120-1131
BACKGROUND: Recently, epidemiological and clinical data have revealed important changes with regard to clinical adenovirus infection, including alterations in antigenic presentation, geographical distribution, and virulence of the virus. METHODS: In an effort to better understand the epidemiology of clinical adenovirus infection in the United States, we adopted a new molecular adenovirus typing technique to study clinical adenovirus isolates collected from 22 medical facilities over a 25-month period during 2004-2006. A hexon gene sequence typing method was used to characterize 2237 clinical adenovirus-positive specimens, comparing their sequences with those of the 51 currently recognized prototype human adenovirus strains. In a blinded comparison, this method performed well and was much faster than the classic serologic typing method. RESULTS: Among civilians, the most prevalent adenovirus types were types 3 (prevalence, 34.6%), 2 (24.3%), 1 (17.7%), and 5 (5.3%). Among military trainees, the most prevalent types were types 4 (prevalence, 92.8%), 3 (2.6%), and 21 (2.4%). CONCLUSIONS: For both populations, we observed a statistically significant increasing trend of adenovirus type 21 detection over time. Among adenovirus isolates recovered from specimens from civilians, 50% were associated with hospitalization, 19.6% with a chronic disease condition, 11% with a bone marrow or solid organ transplantation, 7.4% with intensive care unit stay, and 4.2% with a cancer diagnosis. Multivariable risk factor modeling for adenovirus disease severity found that age <7 years (odds ratio [OR], 3.2; 95% confidence interval [CI], 1.4-7.4), chronic disease (OR, 3.6; 95% CI, 2.6-5.1), recent transplantation (OR, 2.7; 95% CI, 1.3-5.2), and adenovirus type 5 (OR, 2.7; 95% CI, 1.5-4.7) or type 21 infection (OR, 7.6; 95% CI, 2.6-22.3) increased the risk of severe disease. 相似文献
60.