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排序方式: 共有775条查询结果,搜索用时 31 毫秒
81.
Callaghan JJ Cuckler JM Huddleston JI Galante JO;Implant Wear Symposium Clinical Work Group 《The Journal of the American Academy of Orthopaedic Surgeons》2008,16(Z1):S33-S38
Osteolysis is a multifactorial process dependent on surgical technique, implant design, patient factors, and material composition. Alternative bearing surfaces, such as highly cross-linked polyethylene, ceramic-on-ceramic, and metal-on-metal articular surfaces, have been introduced in an attempt to reduce wear and osteolysis following total hip arthroplasty. Intermediate-term follow-up data available suggest that the prevalence and severity of osteolysis may be reduced with these materials compared with conventional metal-on-polyethylene bearing surface couples. However, long-term data are presently unavailable; the future performance of these bearings awaits clinical validation. 相似文献
82.
Modulation of allograft incorporation by continuous infusion of growth factors over a prolonged duration in vivo 总被引:1,自引:0,他引:1
Ma T Gutnick J Salazar B Larsen MD Suenaga E Zilber S Huang Z Huddleston J Smith RL Goodman S 《BONE》2007,41(3):386-392
Morselized cancellous allograft bone is frequently used in the reconstruction of bone defects in cases of revision total joint replacement, trauma, spine fusion and treated infection. However, the initial lack of viable bone cells in morselized allograft bone significantly slows the process of graft incorporation compared to autograft bone. This study examined the effects of prolonged local infusion of the growth factors bone morphogenic protein-7 (BMP-7 or OP-1) and fibroblast growth factor-2 (FGF-2 or basic FGF) in the process of allograft incorporation using a rabbit tibial chamber model. New bone formation was evaluated by two indices, the activity of alkaline phosphatase and the level of birefringence. The markers of osteoclast-like cells were also measured. Without the infusion of the growth factors, lower levels of new bone formation were observed in the allograft group, compared to the autograft group. Infusion of growth factors FGF-2 and OP-1, singly or in combination, for 4 weeks, diminished this difference. The numbers of osteoclast-like cells were much higher in the allograft group before the growth factors were delivered. The infusion of FGF, singly, diminished this difference. However, the infusion of OP-1 or the combination of FGF and OP-1 did not decrease the number of osteoclast-like cells to a level comparable to autograft only. Local infusion of growth factors appears to be a useful adjunct to promote the incorporation of allograft bone in vivo. 相似文献
83.
84.
85.
Pediatric lung transplantation for pulmonary hypertension and congenital heart disease. 总被引:1,自引:0,他引:1
T L Spray G B Mallory C E Canter C B Huddleston L R Kaiser 《The Annals of thoracic surgery》1992,54(2):216-23; discussion 224-5
Five children underwent lung transplantation for end-stage pulmonary hypertension and respiratory insufficiency associated with congenital heart disease. One (17 mo) had pulmonary hypertension with a patent ductus arteriosus and required two periods of preoperative extracorporeal membrane oxygenation before successful bilateral sequential lung transplantation. One (21 mo) required bilateral lung transplantation for pulmonary hypertension and bronchopulmonary dysplasia associated with iatrogenic injury to the left pulmonary artery. This child also had patent ductus arteriosus ligation and preoperative catheter closure of an atrial septal defect. Extracorporeal membrane oxygenation was required for early postoperative pulmonary support. One child underwent right single-lung transplantation and closure of an atrial septal defect for pulmonary hypertension. Two patients had single-lung transplantation for Eisenmenger's syndrome: 1 with muscular inlet ventricular septal defect closure, atrial septal defect closure, and right single-lung transplantation; 1 with ventricular septal defect closure, patent ductus arteriosus ligation, right ventricular outflow tract patch repair, and single-lung transplantation. All patients survived operation, with one late death (lymphoproliferative disease). The 4 survivors are all ambulatory without oxygen and have evidence of normal pulmonary artery pressure 9 to 12 months after transplantation. 相似文献
86.
Trabecular bone architecture in female renal allograft recipients-- assessed by computed tomography 总被引:1,自引:0,他引:1
Grotz WH; Mundinger FA; Muller CB; Rasenack J; Schulte-Monting J; Langer MF; Schollmeyer PJ 《Nephrology, dialysis, transplantation》1997,12(3):564-569
BACKGROUND: Osteopenia with decreased bone mineral density (BMD) is a
frequent finding in renal allograft recipients. Data concerning the bone
architecture in these patients do not exist, however. METHODS: We compared
the bone architecture of 33 randomly assigned women (age 49 +/- 12 years),
who had received renal allografts 5.6 +/- 5.3 years before the
investigation, with 74 women (age 50 +/- 14 years) who were admitted for
osteodensitometry. All patients underwent single-energy computed tomography
(SEQCT) and a midvertebral high-resolution tomography with
computer-assisted analysis of the trabecular vertebral body architecture.
RESULTS: Progressive alteration of bone architecture was associated with
increasing vertebral height loss of the vertebral body. Height reduction of
a vertebral body of more than 15% was associated with a significantly lower
BMD (-2.3 +/- 0.8 versus -1.1 +/- 1.1 standard deviations below normal
BMD), a lower trabecular bone area (13 +/- 8% versus 42 +/- 22%) and a
lower trabecular diameter (1.4 +/- 0.5 mm versus 2.2 +/- 0.8 mm) compared
to recipients without height reduction. In comparison to a matched group of
patients with similarly reduced BMD (1.1 +/- 1.2 versus 1.2 +/- 1.1 SD
below normal BMD), renal allograft recipients showed a lower number of
trabecular plates (5.6 +/- 3.1 versus 7.0 +/- 3.7) and a smaller
intertrabecular surface (54 +/- 116 mm versus 75 +/- 138 mm). CONCLUSIONS:
Alterations of bone architecture in renal allograft recipients were
associated with progressive vertebral height loss. Despite similar bone
mineral density, differences of bone architecture could be observed between
renal allograft recipients and patients with osteoporosis.
相似文献
87.
Taine V Pechet Maite de le Morena Eric N Mendeloff Stuart C Sweet Steven D Shapiro Charles B Huddleston 《The Journal of heart and lung transplantation》2003,22(2):154-160
BACKGROUND: End-stage lung disease is a rare complication of treatment for hematologic and solid tumors in children. When present, it is generally progressive, resulting in the patient being cured of cancer only to die of respiratory failure. Lung transplantation is believed by some to be of overly high risk in this population because of the pre-existing malignancy as well as the presumed compromised immune status. METHODS: Six children (Group 1), aged 5 to 17 years (mean 12.4 years), underwent lung transplantation at our institution because of either pulmonary fibrosis or bronchiolitis obliterans following treatment for acute leukemia (n = 5) or medulloblastoma (n = 1). All patients received chemotherapy, radiation and bone marrow transplantation in the course of treatment for their malignancies. The average forced expiratory volume in 1 second (FEV(1)) was 16% of the predicted value and forced vital capacity (FVC) was 28% of predicted. These results were compared with a similar group of 13 patients undergoing lung transplantation at our institution during the same time interval (Group 2). RESULTS: There were 2 deaths in Group 1, 1 early and 1 late, for an overall survival of 67% at a mean follow-up of 4.02 years. There were no early and 7 late deaths in Group 2 for an overall survival of 46% at a mean follow-up of 4.8 years. The acute rejection rate in the first post-transplant year was 0.2 episode/patient in Group 1 and 1.8 episode/patient in Group 2 (p <0.01). No patient in Group 1 has developed post-transplant lymphoproliferative disease or a relapse of their primary malignancy. Two patients in Group 1 developed unusual infections-Aspergillus and Mycobacterium chelonae. No such infections occurred in Group 2. CONCLUSIONS: Although this represents a small series, we believe that patients with respiratory failure following treatment of a prior malignancy are suitable candidates for lung transplantation. Although they may have some relative protection from acute rejection episodes by virtue of an already compromised immunologic status while receiving standard immunosuppression, an increased propensity for opportunistic infection may exist. 相似文献
88.
Differentiation of thrombi from slow flow in the pulmonary arteries, sometimes observed in the presence of pulmonary arterial hypertension, can be equivocal. Magnetic resonance (MR) imaging was performed in a patient with chronic pulmonary thromboembolism and pulmonary arterial hypertension using an electrocardiographically gated technique that allowed visualization of the pulmonary arteries at the end of diastole and multiple times during systole. These images were compared with those of a patient with primary pulmonary hypertension and those of healthy subjects. Thrombi were discrete structures, seen throughout the cardiac cycle on both the first and second spin-echo images, and decreased in signal intensity on the second image. Slow flow increased in signal intensity and changed in structure during the cardiac cycle and was seen best on the second image. MR may play an important role in excluding large central thrombi as the cause of pulmonary arterial hypertension. It is a noninvasive method for defining pulmonary arterial wall thickness and for direct visualization of chronic pulmonary thrombus. 相似文献
89.
R L Cooley T D Marshall J M Young A M Huddleston 《Quintessence international, dental digest》1990,21(11):919-923
Retentive-pin twist drills were subjected to four methods of sterilization and then examined to determine possible effects on resistance to fracture, cutting efficiency, and surface condition. Sterilization methods included steam autoclave, chemical vapor autoclave, dry heat, and immersion in glutaraldehyde. Although the steam and chemical vapor groups had lower mean fracture strengths after sterilization, there was no statistically significant difference among the groups. Only the steam autoclave group showed a statistically significant loss of cutting efficiency. Scanning electron microscopic evaluation revealed that only drills sterilized by steam autoclave showed changes in the surface condition or cutting edges. 相似文献
90.
Lehman RA Huddleston P Yaszemski M 《The Journal of the American Academy of Orthopaedic Surgeons》2012,20(Z1):S13-S17
The burden of injury to the axial skeleton has been substantial relative to the conflicts in Iraq and Afghanistan.A coordinated treatment algorithm is required that begins with the first encounter on the battlefield and continues through treatment at a facility in the continental United States. Translation of these spinal trauma classification systems to the battlefield requires that issues of expediency,operational limitations and restrictions, and personnel be addressed.Current staffing of far-forward echelons in theater may not include a spine-trained orthopaedic surgeon, neurosurgeon, or musculoskeletal specialist.The classification systems and treatment algorithms being used today were formed in the context of a civilian trauma setting. The ready availability of advanced medical imaging, sterile operating room theaters, and specialty-specific intensive care units in these civilian hospitals may make modern spinal trauma classification systems less applicable to a far-forward battlefield setting. However, efforts must be made to adapt current knowledge in the pursuit of a theater-specific, relevant pathway or philosophy of care for the spine-injured warrior, with implementation as far forward as feasible to ensure the best possible clinical outcome. 相似文献