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21.
Jens Toft Birger Hesse Alan Rabøl Steen Carstensen Samir Ali 《European journal of nuclear medicine and molecular imaging》1997,24(4):409-414
Reference data files support the evaluation of myocardial perfusion single-photon emission tomography (SPET). The aim of this study was to create a large reference data base for technetium-99m sestamibi SPET, age and gender matched to the general patient population. One hundred and twenty-eight healthy volunteers (76 males and 52 females) with a likelihood of coronary artery disease of less than 5% underwent rest and maximal exercise99mTc-sestamibi SPET with a 2-day protocol and 180° elliptical rotation. The normalized activity values of99mTc-sestamibi in the inferior wall differed significantly between men and women. Age variations were found for men in the anterior wall. Normalized activity values in all four walls were strikingly similar during rest and stress. Our results suggest that the use of reference files in99mTc-sestamibi SPET requires a gender- and, for males, possibly an age-matched reference population. Different reference files at rest and during stress might not be necessary. 相似文献
22.
Seong-Woong Kim Kyu-Won Shim Nick Plesnila Yong-Oock Kim Joong-Uhn Choi Dong-Seok Kim 《Child's nervous system》2007,23(2):201-206
Objects We designed several distraction devices and applied these instruments in 14 patients with varying types of craniosynostosis.
The aim of this report is to clarify the advantages and disadvantages of these surgical methods and to discuss current concepts
for the surgical strategy in the treatment of craniosynostosis.
Methods From January 2000 to July 2005, 28 patients with craniosynostosis were retrospectively analyzed. Surgical treatment was performed
on 14 patients using the distraction method with internal distraction devices that we designed, in which 5 patients had plagiocephaly,
3 brachycephaly, and 6 scaphocephaly. All patients underwent preoperative and postoperative evaluations, which included the
patient’s neurological state, and three-dimensional CT.
Results With distraction devices, the time required for the surgery could be shortened almost 3 1/3 h; the bleeding during the surgery
was decreased with reduced requirement of more than 200 ml of blood transfusion as compared with remodeling surgery. Postoperatively
achieved distraction distances varied from 30.0 to 47.5 mm (mean, 42.99 mm). The average increased volume percent of cranium
in distraction surgery group was 20.9% (range, −11.5 to 58.9%) after full distraction.
Conclusion With distraction surgery, satisfactory cranial volume expansion and aesthetically pleasing morphological states were achieved
in all cases, and the efficacy was statistically significantly high as compared with remodeling method. 相似文献
23.
Dr. Lutz Lindemann-Sperfeld Klaus-Dieter Rudolf Michael Steen Ivan Marintschev Wieland Otto 《Trauma und Berufskrankheit》2003,5(2):198-207
Complex injuries of the foot are often overlooked, especially in the multiple injured patient, and they then lead to major loss of function. When the mechanism of injury suggests involvement of the foot, a clinical examination of the lower extremities should be included in the primary diagnostic procedures implemented in the multiply injured patient, followed by radiological examination once the patient's condition is stable. The condition of the soft tissues is of decisive importance in the prognosis of complex foot injuries, regardless of whether the damage to the foot is one component of a polytrauma or an isolated injury, which can also be life threatening. The diagnostic examinations selected should be adapted to the severity of the injuries in the particular multiply injured patient. Successful therapy involves stable internal fixation of injuries to bones and joints, though the external fixation options should be considered in the first instance, and carefully selected methods of temporary and definitive soft tissue reconstruction. The aim of treatment is the best possible reconstruction of the foot as a functional weight-bearing unit with intact soft tissue cover and a natural form. Good results can be achieved when there is close interdisciplinary cooperation between trauma (orthopedic) and plastic surgeons. Patient with severe injuries of this kind should be transferred to a trauma center as the first step toward this end. 相似文献
24.
Dr. Flemming Moesgaard M.D. Mogens Lykkegaard Nielsen M.D. Ph.D. Allan Hjortrup M.D. Peter Kjersgaard M.D. Carsten Sørensen M.D. Peter Nørgaard Larsen M.D. Steen Hoffmann M.D. 《Diseases of the colon and rectum》1989,32(1):36-38
One hundred ninety patients with peritonitis at the time of abdominal surgery were allocated at random to systemic antibiotic
treatment alone or systemic antibiotic treatment combined with topical application of antibiotics in the wound at the time
of wound closure. The overall wound infection rate was 17 percent without significant difference between the two treatment
groups (P>0.80). 相似文献
25.
Saiidy Hasham Paolo Matteucci Paul R W Stanley Nick B Hart 《British medical journal》2005,330(7495):830-833
26.
Dual blockade of the renin-angiotensin system in type 1 patients with diabetic nephropathy. 总被引:7,自引:0,他引:7
Peter Jacobsen Steen Andersen Kasper Rossing Birgitte V Hansen Hans-Henrik Parving 《Nephrology, dialysis, transplantation》2002,17(6):1019-1024
BACKGROUND: Albuminuria and hypertension are predictors of poor renal and cardiovascular outcome in patients with diabetes. Approximately 30% of type 1 patients with diabetic nephropathy (DN) have albuminuria >1 g/day, and blood pressure >135 and/or >85 mmHg despite antihypertensive therapy with recommended doses of ACE inhibitor (ACEI) and diuretics. We tested the effect of dual blockade of the renin-angiotensin system (RAS) in these patients. METHODS: We performed a randomised double blind crossover trial with 2 months treatment with Irbesartan 300 mg o.d. and placebo added on top of previous antihypertensive treatment. We included 21 type 1 patients with DN responding insufficiently to ACEI and diuretics, as defined above. At the end of each treatment period, albuminuria, 24-h blood pressure and glomerular filtration rate (GFR) were measured. RESULTS: Addition of 300 mg Irbesartan to the patients' usual antihypertensive therapy induced a mean reduction in albuminuria of 37% (95% CI 20-49, P<0.001); from 1574 mg/24 h (95% CI 1162-2132) to 996 mg/24 h (95% CI 699-1419), a reduction in 24-h blood pressure of 8 mmHg systolic (95% CI -2 to 18) and 5 mmHg diastolic (95% CI 1-9) (P=0.11 and 0.01, respectively) (from placebo, mean (SE) 146 (4)/80 (2) mmHg). GFR remained unchanged. Serum potassium increased (mean 4.3 to 4.6 mmol/l, P=0.02). Intervention to reduce serum potassium was needed in two patients with GFR <35 ml/min/1.73 m(2). Otherwise the dual blockade with Irbesartan was safe and well tolerated. CONCLUSIONS: Dual blockade of the RAS may offer additional renal and cardiovascular protection in type 1 patients with DN responding insufficiently to conventional antihypertensive therapy, including recommended doses of ACEI and diuretics. 相似文献
27.
Delineating the sites and progression of in vivo atrophy in multiple system atrophy using fluid-registered MRI. 总被引:1,自引:0,他引:1
Jonathan M Schott Jessica E Simon Nick C Fox Andrew P King M Nadeem Khan Lisa Cipolotti Dominic C Paviour John M Stevens Martin N Rossor 《Movement disorders》2003,18(8):955-958
We describe the pattern and progression of atrophy delineated using fluid registration of serial magnetic resonance imaging scans in a case of multiple system atrophy (MSA). The in vivo findings were consistent with those found at postmortem, including significant supratentorial atrophy concurrent with an unusual degree of cognitive impairment for MSA. 相似文献
28.
29.
MDArya Nick Shamie MDThomas Mroz MDPatrick Suen MDJeffrey C. Wang 《Operative Techniques in Orthopaedics》2003,13(3):202
Minimally invasive surgery offers quicker recovery and less morbidity for our patients through smaller surgical wounds and less tissue trauma. Although minimally invasive surgery has progressed in other fields of surgery for many years, spine surgeons have not previously embraced this philosophy for the various reasons discussed. However, minimally invasive spinal surgery has gained much interest in recent years. With the advent of new instrumentation, technology, and techniques, the promise of minimally invasive surgery in the spinal arena has become a reality. With the use of the microscope, navigational tools, newly developed canula for retraction, and image-guided percutenous pedicle screw systems, we can accomplish the same surgical procedures as currently used through smaller wounds and with greater precision. Nevertheless, all new technology does offer us an initial challenge of steep learning curves. Minimally invasive should not equate to minimal and inadequate treatment for our patients. Furthermore, careful analysis of this new technique is underway to assess its true advantages as compared with our current and proven techniques. 相似文献
30.
Dr. Seema A. Khan MD Nick J. Gonchoroff DrPH Linda E. Miller PhD 《Annals of surgical oncology》1997,4(6):462-469
Background: Many studies have addressed the effect of the timing of surgery for breast cancer relative to menstrual cycle phase, with
conflicting results. Explanations for the possibility that survival could be altered by the appropriate timing of breast cancer
surgery in humans remain speculative.
Methods: We examined the expression of three estrogen related proteins (c-erbB-2, cathepsin D, pS2) in the breast tumors from 69 premenopausal women sampled in different phases of the menstrual cycle.
Data on S-phase fraction and hormone receptor expression were also analyzed. Immunohistochemical assays were used to measure
the proteins of interest. S-phase fraction was determined by flow cytometry. Analyses were performed based on fraction of
cells staining positive for the protein, density of stain, and a histoscore that combined both fraction of positive cells
and density.
Results: We found no differences in c-erbB-2, cathepsin D, hormone receptor, or S-phase levels in tumors sampled in the follicular versus luteal phase, or perimenstrual
versus periovulatory phase. The exception was pS2, which was expressed at greater levels during the luteal than during the
follicular phase of the cycle (p<0.01); but there was no difference in pS2 expression when the patients were classified as
periovulatory versus perimenstrual.
Conclusions: Our findings do not support a variation in c-erbB-2, cathepsin D, S-phase fraction, or receptor expression as an explanation for the differences in breast cancer prognosis
when surgery is timed by menstrual cycle phase. The finding that pS2 (an indicator of hormone sensitivity, and possibly better
prognosis) is expressed at higher levels in tumor samples during the luteal phase suggests that the biologic profile of breast
tumors may vary with the menstrual cycle and that these variations deserve further study. 相似文献