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101.
Jens Hansen Marco Bianchi Maxine Sun Michael Rink Fabio Castiglione Firas Abdollah Thomas Steuber Sascha A. Ahyai Stefan Steurer Cosima Göbel Massimo Freschi Francesco Montorsi Shahrokh F. Shariat Margit Fisch Markus Graefen Pierre I. Karakiewicz Alberto Briganti Felix K.‐H. Chun 《BJU international》2014,113(3):399-407
102.
103.
Major bile duct injuries after laparoscopic cholecystectomy: A tertiary center experience 总被引:5,自引:0,他引:5
Andrea?FrillingEmail author Jun?Li Frank?Weber Nils?Roman?Frühauf Jennifer?Engel Susanne?Beckebaum Andreas?Paul Thomas?Z?pf Massimo?Malago Christoph?Erich?Broelsch 《Journal of gastrointestinal surgery》2004,8(6):679-685
Bile duct injury is a severe and potentially life-threatening complication of laparoscopic cholecystectomy. Several series
have described a 0.5% to 1.4% incidence of bile duct injuries during laparoscopic cholecystectomy. The aim of this study was
to report on an institutional experience with the management of complex bile duct injuries and outcome after surgical repair.
Data were collected prospectively from 40 patients with bile duct injuries referred for surgical treatment to our center between
April {dy1998} and December 2003. Prior to referral, 35 patients (87.5%) underwent attempts at surgical reconstruction at
the primary hospital. In77.5%of the patients, complex typeE1or typeE2BDIwas found. Concomitant with bile duct injury, seven
patients had vascular injuries. Roux-en-Y hepaticojejunostomy was carried out in 33 patients. In two patients, Roux-en-Y hepaticojejunostomy
and vascular reconstruction were necessary. Five patients, one with primary nondiagnosed Klatskin tumor, required right hepatectomy.
Two patients, both with bile duct injuries and vascular damage, died postoperatively. Because of progressive liver insufficiency,
one of them was listed for high-urgency liver transplantation but died prior to intervention. At the median follow-up of 589
days, 82.5% of the patients are in excellent general condition. Seven patients have signs of chronic cholangitis. Major bile
duct injuries remain a significant cause of morbidity and even death after laparoscopic cholecystectomy. Because they present
a considerable surgical challenge, early referral to an experienced hepatobiliary center is recommended. 相似文献
104.
Caputo M Reeves BC Rogers CA Ascione R Angelini GD 《The Journal of thoracic and cardiovascular surgery》2004,128(6):907-915
OBJECTIVE: Control charts (eg, cumulative sum charts) plot changes in performance with time and can alert a surgeon to suboptimal performance. They were used to compare performance of off-pump coronary artery bypass surgery between a consultant and four resident surgeons and to compare performance of off-pump coronary artery bypass surgery and conventional coronary artery bypass grafting within surgeons. METHODS: Data were analyzed for consecutive patients undergoing coronary artery bypass grafting who were operated on by one consultant or one of four residents. Conversions were analyzed by intention to treat. Perioperative death or one or more of 10 adverse events constituted failure. Predicted risks of failure for individual patients were derived from the study population. Variable life-adjusted displays and risk-adjusted sequential probability ratio test charts were plotted. RESULTS: Data for 1372 patients were analyzed; 769 of the procedures were off-pump coronary artery bypass operations (56.0%). The consultant operated on 382 patients (293 off-pump, 76.7%), and the residents operated on 990 (474 off-pump, 47.9%). Patients operated on by residents tended to be older, more obese, more likely to require an urgent operation, and more likely to need a circumflex artery graft but less likely to have triple-vessel disease. There were 7 conversions (consultant 5, residents 2). The overall failure rate was 8.5% (9.2% for consultant's operations and 8.2% for residents' operations), including 10 deaths (0.7%). Predicted and observed risks of failure were similar for all five surgeons. After 100 off-pump coronary artery bypass operations, performance was the same or better for the residents as for the consultant. For all surgeons, performance was the same or better for off-pump as for conventional coronary artery bypass grafting. CONCLUSIONS: Off-pump coronary artery bypass surgery can be safely taught to cardiothoracic residents. Implementation of continuous performance monitoring for residents is practicable. 相似文献
105.
Gianni Biancofiore Giorgio Della Rocca Lucia Bindi Anna Romanelli Massimo Esposito Luca Meacci Lucio Urbani Franco Filipponi Franco Mosca 《Liver transplantation》2004,10(8):986-992
With the aim of assessing whether fenoldopam can help to preserve renal function after liver transplantation, we randomized 140 consecutive recipients with comparable preoperative renal function to receive fenoldopam 0.1 microg/kg/minute (group F, 46 patients), dopamine 3 microg/kg/minute (group D, 48 patients), or placebo (group P, 46 patients) from the time of anesthesia induction to 96 hours postoperatively. There were no differences between the groups in intraoperative urinary output or furosemide administration (both P =.1). Daily recordings made during the first 4 postoperative days revealed no significant differences in urinary output (P =.1), serum creatinine (P =.5), the incidence of renal insufficiency (P =.7), the need for loop diuretics (P =.9) or vasoactive drugs (P =.8). In comparison with preoperative levels, creatinine clearance at the end of the study in the patients receiving fenoldopam remained substantially unchanged, whereas it decreased by 39 and 12.3%, respectively, in the subjects receiving placebo or dopamine (P <.001); blood cyclosporine A (CsA) levels were similar in the 3 groups (P =.1). Three subjects died in the intensive care unit (1 in each group, P =.9), 2 of them had renal failure. In conclusion, our results confirm the inefficacy of dopamine in preventing or limiting early renal dysfunction after liver transplantation, and suggest that fenoldopam may preserve creatinine clearance by counterbalancing the renal vasoconstrictive effect of CsA, as it has been reported in previous experimental studies. 相似文献
106.
Impaired in vitro growth of PHA induced T lymphocyte colonies in hemodialyzed renal failure patients
Riccardo Ghio Enrico Haupt Vito Pistoia Angela Perata Paola Minale Massimo Ratti Piero Boccaccio 《Annals of hematology》1985,50(3):135-140
Summary Using an in vitro method that allows the study of the colony forming capacity of phytohemagglutinin stimulated peripheral blood T lymphocytes, we have detected an impaired T cell colony formation in hemodialyzed renal failure patients. By contrast a near normal pattern of responses was observed in patients treated with a conservative therapy. The poor in vitro T cell responsiveness of hemodialyzed patients was not corrected by supplementing the cultures with an adherent cell contitioned medium prepared from normal donors. We conclude that an intrinsic defect of the T cell colony forming capacity exists in hemodialyzed patients. 相似文献
107.
Test‐retest reliability of the default mode network in a multi‐centric fMRI study of healthy elderly: Effects of data‐driven physiological noise correction techniques 下载免费PDF全文
Rocco Marchitelli Ludovico Minati Moira Marizzoni Beatriz Bosch David Bartrés‐Faz Bernhard W. Müller Jens Wiltfang Ute Fiedler Luca Roccatagliata Agnese Picco Flavio Nobili Oliver Blin Stephanie Bombois Renaud Lopes Régis Bordet Julien Sein Jean‐Philippe Ranjeva Mira Didic Hélène Gros‐Dagnac Pierre Payoux Giada Zoccatelli Franco Alessandrini Alberto Beltramello Núria Bargalló Antonio Ferretti Massimo Caulo Marco Aiello Carlo Cavaliere Andrea Soricelli Lucilla Parnetti Roberto Tarducci Piero Floridi Magda Tsolaki Manos Constantinidis Antonios Drevelegas Paolo Maria Rossini Camillo Marra Peter Schönknecht Tilman Hensch Karl‐Titus Hoffmann Joost P. Kuijer Pieter Jelle Visser Frederik Barkhof Jorge Jovicich 《Human brain mapping》2016,37(6):2114-2132
Understanding how to reduce the influence of physiological noise in resting state fMRI data is important for the interpretation of functional brain connectivity. Limited data is currently available to assess the performance of physiological noise correction techniques, in particular when evaluating longitudinal changes in the default mode network (DMN) of healthy elderly participants. In this 3T harmonized multisite fMRI study, we investigated how different retrospective physiological noise correction (rPNC) methods influence the within‐site test‐retest reliability and the across‐site reproducibility consistency of DMN‐derived measurements across 13 MRI sites. Elderly participants were scanned twice at least a week apart (five participants per site). The rPNC methods were: none (NPC), Tissue‐based regression, PESTICA and FSL‐FIX. The DMN at the single subject level was robustly identified using ICA methods in all rPNC conditions. The methods significantly affected the mean z‐scores and, albeit less markedly, the cluster‐size in the DMN; in particular, FSL‐FIX tended to increase the DMN z‐scores compared to others. Within‐site test‐retest reliability was consistent across sites, with no differences across rPNC methods. The absolute percent errors were in the range of 5–11% for DMN z‐scores and cluster‐size reliability. DMN pattern overlap was in the range 60–65%. In particular, no rPNC method showed a significant reliability improvement relative to NPC. However, FSL‐FIX and Tissue‐based physiological correction methods showed both similar and significant improvements of reproducibility consistency across the consortium (ICC = 0.67) for the DMN z‐scores relative to NPC. Overall these findings support the use of rPNC methods like tissue‐based or FSL‐FIX to characterize multisite longitudinal changes of intrinsic functional connectivity. Hum Brain Mapp 37:2114–2132, 2016. © 2016 Wiley Periodicals, Inc. 相似文献
108.
Abnormalities of the executive control network in multiple sclerosis phenotypes: An fMRI effective connectivity study 下载免费PDF全文
Ekaterina Dobryakova Maria Assunta Rocca Paola Valsasina Angelo Ghezzi Bruno Colombo Vittorio Martinelli Giancarlo Comi John DeLuca Massimo Filippi 《Human brain mapping》2016,37(6):2293-2304
The Stroop interference task is a cognitively demanding task of executive control, a cognitive ability that is often impaired in patients with multiple sclerosis (MS). The aim of this study was to compare effective connectivity patterns within a network of brain regions involved in the Stroop task performance between MS patients with three disease clinical phenotypes [relapsing‐remitting (RRMS), benign (BMS), and secondary progressive (SPMS)] and healthy subjects. Effective connectivity analysis was performed on Stroop task data using a novel method based on causal Bayes networks. Compared with controls, MS phenotypes were slower at performing the task and had reduced performance accuracy during incongruent trials that required increased cognitive control. MS phenotypes also exhibited connectivity abnormalities reflected as weaker shared connections, presence of extra connections (i.e., connections absent in the HC connectivity pattern), connection reversal, and loss. In SPMS and the BMS groups but not in the RRMS group, extra connections were associated with deficits in the Stroop task performance. In the BMS group, the response time associated with correct responses during the congruent condition showed a positive correlation with the left posterior parietal → dorsal anterior cingulate connection. In the SPMS group, performance accuracy during the congruent condition showed a negative correlation with the right insula → left insula connection. No associations between extra connections and behavioral performance measures were observed in the RRMS group. These results suggest that, depending on the phenotype, patients with MS use different strategies when cognitive control demands are high and rely on different network connections. Hum Brain Mapp, 37:2293–2304, 2016. © 2016 Wiley Periodicals, Inc. 相似文献
109.
Paolo Preziosa Maria A. Rocca Elisabetta Pagani Maria Laura Stromillo Christian Enzinger Antonio Gallo Hanneke E. Hulst Matteo Atzori Deborah Pareto Gianna C. Riccitelli Massimiliano Copetti Nicola De Stefano Franz Fazekas Alvino Bisecco Frederik Barkhof Tarek A. Yousry Maria J. Arévalo Massimo Filippi and the MAGNIMS Study Group 《Human brain mapping》2016,37(4):1627-1644
In a multicenter setting, we applied voxel‐based methods to different structural MR imaging modalities to define the relative contributions of focal lesions, normal‐appearing white matter (NAWM), and gray matter (GM) damage and their regional distribution to cognitive deficits as well as impairment of specific cognitive domains in multiple sclerosis (MS) patients. Approval of the institutional review boards was obtained, together with written informed consent from all participants. Standardized neuropsychological assessment and conventional, diffusion tensor and volumetric brain MRI sequences were collected from 61 relapsing‐remitting MS patients and 61 healthy controls (HC) from seven centers. Patients with ≥2 abnormal tests were considered cognitively impaired (CI). The distribution of focal lesions, GM and WM atrophy, and microstructural WM damage were assessed using voxel‐wise approaches. A random forest analysis identified the best imaging predictors of global cognitive impairment and deficits of specific cognitive domains. Twenty‐three (38%) MS patients were CI. Compared with cognitively preserved (CP), CI MS patients had GM atrophy of the left thalamus, right hippocampus and parietal regions. They also showed atrophy of several WM tracts, mainly located in posterior brain regions and widespread WM diffusivity abnormalities. WM diffusivity abnormalities in cognitive‐relevant WM tracts followed by atrophy of cognitive‐relevant GM regions explained global cognitive impairment. Variable patterns of NAWM and GM damage were associated with deficits in selected cognitive domains. Structural, multiparametric, voxel‐wise MRI approaches are feasible in a multicenter setting. The combination of different imaging modalities is needed to assess and monitor cognitive impairment in MS. Hum Brain Mapp 37:1627‐1644, 2016. © 2016 Wiley Periodicals, Inc. 相似文献
110.
Vacante Marco DAgata Velia Motta Massimo Malaguarnera Giulia Biondi Antonio Basile Francesco Malaguarnera Michele Gagliano Caterina Drago Filippo Salamone Salvatore 《BMC surgery》2012,12(1):1-8