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61.
Forty-one consecutive patients with primary knee arthroplasty and 37 with primary hip arthroplasty, all with perioperative wound infections, were followed for 50 (12-130) months. Staphylococci (coagulase negative and positive) accounted for 74% of wound infections. Mixed organisms accounted for 10%. Prosthetic infections developed in eight patients and aseptic loosening in three patients. All the prosthetic infections developed within 6 months of the primary surgery. Organisms responsible for superficial infections were responsible for prosthetic infection in five patients; no organisms were isolated in the remaining three patients. The presence or absence of wound dehiscence, wound haematoma, and postoperative pyrexia did not predict the development of deep sepsis; however, the presence of wound discharge was a significant risk factor. 相似文献
62.
Grimer RJ Belthur M Chandrasekar C Carter SR Tillman RM 《Clinical orthopaedics and related research》2002,(395):193-203
Thirty-four patients with infected massive endoprostheses had two-stage revision procedures to cure the infection and retain a useful functioning limb. An antibiotic impregnated cement spacer constructed with two cement gun liners and a Kuntscher nail provided temporary stability and also allowed a high dose of local antibiotic concentration. In three patients the infection never was controlled, and one of these patients had a successful second revision surgery. Six other patients had reinfection varying from 14 to 92 months after surgery. Risk factors for reinfection were previous radiotherapy and any additional operative intervention. The overall success rate for controlling infection was 91% at 1 year and 74% at 5 years. Six patients required amputation. The mean functional outcome for the retained limbs using the Musculoskeletal Tumor Society scoring system was 77%. Two-stage revisions seem almost as effective at controlling infection in massive endoprostheses as in conventional joint replacements, particularly if additional surgical interventions can be avoided. 相似文献
63.
Surface aneurysmal bone cysts: a pictorial review 总被引:1,自引:0,他引:1
The aim of this article is to present the imaging features of surface aneurysmal bone cysts (ABCs). Twenty-three surface ABCs were identified from of a series of 144 histologically proven ABCs treated in our unit over the past 20 years. The surface ABCs showed a high female preponderance with a predilection for the forearm bones, tibia and femur. With the use of radiographs in all cases and CT and MR imaging in 18 cases it was possible to subdivide the series into subperiosteal (11 cases), cortical (8 cases) and mixed (4 cases) categories. The imaging features distinguishing the various categories are illustrated and the differential diagnosis is discussed. 相似文献
64.
DL DSouza SB Heinze RJ Dowling 《Journal of Medical Imaging and Radiation Oncology》2006,50(3):246-248
Lung cancer is not commonly known to metastasise to the perirenal space, with only five such cases previously published. We present an unusual case of perirenal lung metastases manifesting as diffuse perinephric stranding which to our knowledge has not been described before. 相似文献
65.
Sarah E Burdall Andrew M Hanby Mark RJ Lansdown Valerie Speirs 《Breast cancer research : BCR》2002,5(2):89-7
The majority of breast cancer research is conducted using established breast cancer cell lines as in vitro models. An alternative is to use cultures established from primary breast tumours. Here, we discuss the pros and cons of
using both of these models in translational breast cancer research. 相似文献
66.
Imaging recurrent parosteal osteosarcoma 总被引:5,自引:0,他引:5
The aim of this study was to document the imaging features of recurrent parosteal osteosarcoma. The clinical and imaging
records of 33 patients with a parosteal osteosarcoma referred to an orthopaedic oncology service over a 17-year period were
retrospectively reviewed. The mode of identification of locally recurrent tumour was noted, together with the management and
clinical outcome. Five patients developed a local recurrence of their parosteal osteosarcoma ranging from 6 months to 10 years
after initial surgery. In 4 patients the recurrence was first suspected clinically due to the development of a mass. In the
fifth patient recurrence was first detected on routine follow-up radiography. In 4 patients the recurrence could be identified
on radiography as a mineralized mass. All the recurrences were readily identified on MR imaging, despite artefacts from prostheses.
The recurrences were also evident in the 3 cases in which bone scintigraphy was performed. Local recurrence of parosteal osteosarcoma
is adequately detected with a combination of clinical examination and conventional radiography. MR imaging is required to
stage local recurrence or where radiography has failed to confirm clinically suspected recurrence. The routine use of MR imaging
to follow-up patients is of doubtful value because of the frequently long time between initial surgery and relapse.
Received: 23 June 2000 Revised: 7 August 2000 Accepted: 9 August 2000 相似文献
67.
RJ Gilbertson E Harris SK Pandey P Kelly W Myers 《Archives of disease in childhood》1996,75(3):194-198
Paracetamol is the commonest agent employed in self poisoning, however it is not clear whether adolescents possess insight into the serious complications associated with its misuse. Using a one page questionnaire, the availability, usage, and knowledge of toxicity of paracetamol among 1147 American and British adolescents was assessed. Although 90% of all students recognised that paracetamol could kill, the great majority of students overestimated the lethal dose. In addition, while knowledge regarding side effects of paracetamol was poor the drug was widely available to, and used by, the study population. It is proposed that gross overestimation of the number of tablets required to kill, poor understanding of paracetamol side effects, and wide availability of the drug contribute to its frequent use in adolescent suicidal behaviour. The inclusion of some over-the-counter medications in school drug education programs in addition to tighter control of the availability of paracetamol may help reduce the problem of adolescent self poisoning. 相似文献
68.
The main purpose of this study was to compare rectal and axillary temperature measurements in African children. Altogether 573 sick children were seen in an outpatient setting in rural West Africa. Rectal and axillary temperatures were measured and the parent or guardian was asked if they thought that the child had a raised body temperature. Normal ranges were defined from an age matched population of 203 healthy children. A raised axillary temperature predicted a raised rectal temperature with a sensitivity of 98% and a specificity of 88%. The parents' impression that their child had a fever was a less sensitive (89%) and less specific (59%) indicator of raised rectal temperature. A raised axillary temperature is a good screening test for a raised rectal temperature in African children. 相似文献
69.
JR Skinner AG Stuart J O'Sullivan A Heads RJ Boys S Hunter 《Archives of disease in childhood》1993,69(2):216-220
Doppler and direct measurements of right ventricle to right atrial pressure drop were made during cardiac catheterisation on 28 occasions in 26 infants with congenital heart disease. Age was 10 days to 12 months (median 4.5 months), and weight was 3.1 to 9.0 kg (median 4.7 kg). We measured peak velocity of tricuspid regurgitation by continuous wave Doppler, and the pressure drop was calculated using the modified Bernoulli equation (delta p = 4v2). There was a high correlation (r = 0.95) between direct and Doppler measurements. Doppler values tended to underestimate the right ventricle to right atrial pressure drop, but this was not of clinical significance (mean 2 mm Hg). The 95% confidence interval for the Doppler velocity was -0.41 to +0.26 m/sec, and was consistent across the range of pressures studied. Variability between observers was tested, by two observers performing sequential paired examinations on 16 newborn babies with tricuspid regurgitation. The coefficient of repeatability was 6.3 mm Hg (95% confidence interval 4.7 to 9.5 mm Hg) or 0.26 m/sec (0.18 to 0.50 m/sec). This method of right ventricular pressure estimation, validated previously only in older children and adults, is a reproducible and accurate technique in infants with tricuspid regurgitation. 相似文献
70.
A O'Meara W Tormey RJ FitzGerald M Fitzgibbon D Kenny 《Acta paediatrica (Oslo, Norway : 1992)》1994,83(1):88-92
O'Meara A, Tormey W, Fitz Gerald RJ, Fitzgibbon M, Kenny D. Interpretation of random urinary catecholamines and their metabolites in neuroblastoma. Acta Paediatr 1994;83:88–92. Stockholm. ISSN 0803–5253
This study reports experience in the estimation of urinary catecholamines (uCATs) and their metabolites in the diagnosis and follow-up of neuroblastoma. Random urine samples were assayed for dopamine, noradrenaline and adrenaline, together with their metabolites 4-hydroxy 3-methoxyman-delic acid (HMMA) and homovanillic acid (HVA), using HPLC with electrochemical detection. Twenty of 21 patients had elevation of one or more uCATs metabolites at diagnosis. Patients were monitored serially from diagnosis and, in those patients who had delayed resection of primary tumour (n=13), particular attention was paid to levels at the pre-surgical evaluation as an indicator of persistence of viable disease at the time of surgery; dopamine proved to be the most accurate indicator of persistent disease at this time. Five of these patients developed recurrent disease, 4 of whom had elevation of two or more uCATs metabolites at the time of relapse. Several conclusions can be drawn from this study: (a) results for HMMA, HVA and dopamine in random urine samples will detect all but the most biochemically immature or inert tumours; (b) dopamine may be the most reliable indicator of persistent disease and (c) noradrenaline and adrenaline measurements were of little benefit. As results are Expressed in relation to urinary creatinine, excretion of which may be affected by dietary protein and is therefore not constant, borderline results should be repeated. 相似文献
This study reports experience in the estimation of urinary catecholamines (uCATs) and their metabolites in the diagnosis and follow-up of neuroblastoma. Random urine samples were assayed for dopamine, noradrenaline and adrenaline, together with their metabolites 4-hydroxy 3-methoxyman-delic acid (HMMA) and homovanillic acid (HVA), using HPLC with electrochemical detection. Twenty of 21 patients had elevation of one or more uCATs metabolites at diagnosis. Patients were monitored serially from diagnosis and, in those patients who had delayed resection of primary tumour (n=13), particular attention was paid to levels at the pre-surgical evaluation as an indicator of persistence of viable disease at the time of surgery; dopamine proved to be the most accurate indicator of persistent disease at this time. Five of these patients developed recurrent disease, 4 of whom had elevation of two or more uCATs metabolites at the time of relapse. Several conclusions can be drawn from this study: (a) results for HMMA, HVA and dopamine in random urine samples will detect all but the most biochemically immature or inert tumours; (b) dopamine may be the most reliable indicator of persistent disease and (c) noradrenaline and adrenaline measurements were of little benefit. As results are Expressed in relation to urinary creatinine, excretion of which may be affected by dietary protein and is therefore not constant, borderline results should be repeated. 相似文献