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191.
Kenichi Okubo Masashi Kobayashi Hiromasa Morikawa Eiichi Hayatsu 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2006,54(7):268-272
Objective: Induction chemoradiotherapy followed by anatomical resection is a current therapeutic strategy for non-small-cell lung cancer
with mediastinal node involvement. Dense peritracheal fibrosis and sclerosis after chemoradiotherapy cause difficult mediastinal
node dissection. We evaluated a novel technique to make the mediastinal node dissection easier after induction therapy. Methods: At the end of mediastinoscopic node biopsy for staging of lung cancer, cotton-type collagen was inserted anterior and lateral
to the trachea in patients with pathologically confirmed mediastinal node involve-ment (n=45). The induction therapy consisted
of concurrent use of platinum-based chemotherapy and hyperfractionated radiotherapy. After the chemoradiotherapy all patients
underwent a pulmonary resection with complete mediastinal node dissection 7–12 weeks after the collagen insertion. Surgical
findings of the mediastinum and the time for node dissection were compared with those without collagen insertion at mediastinoscopy
after chemoradiotherapy (n=5). Results: All five patients without collagen insertion showed sclerotic and fibrotic change of mediastinal nodes with severe adhesion
to the trachea. In 42 of 45 patients with collagen insertion (93.3%) the collagen remained unabsorbed and separated the mediastinal
nodes from the trachea. Mediastinal node dissection was easily accomplished by removing mediastinal tissues lateral and anterior
to the collagen. The rate of mediastinal node separation was significantly higher with collagen insertion than without (p<
0.0001). The times for node dissection in patients with and without collagen insertion showed no significant difference. Conclusion: Cotton-type collagen insertion at staging mediastinoscopy for lung cancer separates the mediastinal nodes from the trachea
and makes the node dissection easier after induction chemoradiotherapy. 相似文献
192.
Baher Husain Christian Kuehne Christian Waydhas Ulrike Lewan Claudia Ose Dieter Nast-Kolb Steffen Ruchholtz 《European Journal of Trauma》2006,32(6):548-554
Abstract
Background: Does there exist a difference in the outcome of severely injured children and severely injured healthy adults?
Methods: The data of 1,566 severely injured patients, treated between May 1998 and December 2002 in our emergency department of the
University Essen/Germany, were analyzed. Patients with an injury severity score (ISS) > 24 were included in the present study.
Patients younger as 18 (17) years were located to the children group c. Patients aged 18 and up to the age of 54 were included
in the adult group a.
Results: Fifty-four children and 252 adults met the selection criteria. ISS and the Glasgow coma scale (GCS) before intubation were
not statistically different in both groups. Seriously injured children stayed significantly shorter on the intensive care
unit, required significantly less ventilator days. Furthermore, the incidence of single organ failure (SOF) and multiple organ
failure (MOF) was significantly lower in the children group. Mortality in the children group (29.6%) was lower than that in
the adult group (33.7%). There was no death due to MOF in the children group as compared to 2.4% (n = 6) in the adults.
Conclusion: The incidence of SOF and MOF was significantly lower in the children group although there was no difference in ISS, GCS and
injury patterns. The prognosis of severely injured children was found to be better than those of adults. Moreover, there was
no death due to MOF in the children group. 相似文献
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目的探讨应用电解可脱性弹簧圈(GDC)栓塞治疗颅内动脉瘤的临床效果。方法2002年6月-2004年6月我们采用GDC栓塞颅内动脉瘤126例(其中4例有2个动脉瘤,共130个)。前交通动脉瘤42个,后交通动脉瘤53个,颈内动脉瘤6个,大脑中动脉瘤10个,大脑后动脉瘤8个,大脑前动脉瘤6个,小脑后下动脉瘤2个;基底动脉瘤3个。按Hunt-Hess分级:Ⅰ级38例,Ⅱ级54例,Ⅲ级23例,Ⅳ级11例。必要时辅以篮筐技术、重塑技术、支架技术、双微导管或连环技术、蚕食技术。结果成功栓塞126例动脉瘤,其中103例为100%栓塞,21例为95%,2例为90%。12例在栓塞后6~18个月进行造影随访,所栓塞动脉瘤均未见复发征象。结论GDC栓塞颅内动脉瘤是安全、有效和微创的治疗手段。联合运用多种栓塞技术有助于减少术后并发症,提高治愈率。 相似文献
198.
INTRODUCTION Alzheimer disease can be classified into familial Alzheimer disease (FAD) and sporadic Alzheimer disease (SAD)[1]. Among FAD, ear- ly-onset FAD(EOFAD) is a familialform in which the onset ofsymptoms occurs before the age of 60 to 65 years, an… 相似文献
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200.
Yasuyuki Suzuki Kazuyuki Daitoku Masahito Minakawa Kozo Fukui Ikuo Fukuda 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2006,54(1):44-46
We report the case of a 4-year-old girl who had quadricuspid aortic valve regurgitation with tetralogy of Fallot and pulmonary
atresia. This combination is very uncommon. Aortic valve replacement was performed successfully due to aortic regurgitation
which had progressed one year after the total repair. The dilated aortic annulus plus quadricuspid aortic valve may result
in progressive aortic regurgitation for a short period. 相似文献