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71.
Factors affecting aseptic loosening of 4750 total hip arthroplasties: multivariate survival analysis
Barbara Bordini Susanna Stea Manuela De Clerico Sergio Strazzari Antonio Sasdelli Aldo Toni 《BMC musculoskeletal disorders》2007,8(1):69
Background
Total hip arthroplasty is a successful surgery, that fails at a rate of approximately 10% at ten years from surgery. Causes for failure are mainly aseptic loosening of one or both components partially due to wear of articular surfaces and partially to design. The present analysis aimed to identify risk factors and quantify their effects on aseptic failure. 相似文献72.
Michael T Fitch David E Manthey Henderson D McGinnis Bret A Nicks Manoj Pariyadath 《BMC medical education》2008,8(1):38
Background
Skin and soft tissue infections are increasingly prevalent clinical problems, and it is important for health care practitioners to be well trained in how to treat skin abscesses. A realistic model of abscess incision and drainage will allow trainees to learn and practice this basic physician procedure. 相似文献73.
Man Bok Jeong Kristina Narfström Shin Ae Park Je Min Chae Kang Moon Seo 《Documenta ophthalmologica. Advances in ophthalmology》2009,119(2):79-88
The objective of this study is to compare the effects of three different anesthetic combinations on the electroretinogram
in the same animals under similar laboratory conditions. Thiopental–isoflurane (TI), medetomidine–ketamine (MK), and xylazine–ketamine
(XK) were used on each of 12 healthy miniature schnauzer dogs (MS) with a period of at least 3 weeks in between subsequent
anesthesia protocols, using the Dog Standard Protocol. The scotopic ERGs consisted of scotopic low stimulus strength (S) responses
designated S1, S2, S3, S4, and S5, at 1, 5, 10, 15, and 20 min after dark adaptation, respectively, and scotopic standard
stimulus strength (S-ST) responses. The photopic ERGs consisted of a photopic single flash (P) response and 31 Hz flicker
(P-FL) responses. For S-ST (2.5 cd s/m2), the amplitude of the a-wave using TI was significantly lower than that using MK (adjusted P = 0.05) and XK (adjusted P = 0.03), and the implicit time of the a-wave was significantly shorter than that using MK (adjusted P = 0.04). For P (2.5 cd s/m2), the amplitude of the b-wave using XK was significantly higher than that using MK (adjusted P = 0.01). The implicit times of the b-wave using TI was significantly longer and shorter than that of MK for S1, S2 and P-FL
and for S4 and S-ST, respectively, and than that of XK for S2 and P-FL and for S5 and S-ST, respectively. The results of the
present study showed that TI affected both the amplitude and the implicit time of the a-wave for S-ST and the implicit time
of the b-wave relatively more so than was the case when using XK or MK. Therefore, it appears that either XK or MK could be
advantageous to use rather than TI for clinical studies. 相似文献
74.
Conclusion We would like to stress that we do not necessarily consider AC for SPECT MPI to be unfeasible or unworthy of scientific pursuit;
indeed, a great deal of creative scientific effort has been poured into this area of investigation over the past 3 decades,
and much of it has contributed to a better understanding of the physics, as well as the clinical aspects, of our field. However,
the great variety of available AC hardware and software “flavors,” the historical pattern of commercial release of insufficiently
validated AC implementations, and the increasingly clouded health care reimbursement horizon may have created an environment
where the envisioned users of the technology have been desensitized and discouraged from expecting it to ever come to fruition
in a standardized, validated, and costeffective form.
It has been reported as recently as 2005 that the “entire base of SPECT cameras has only 5% of systems with attenuation correction.”8
Perhaps the reports of AC’s demise are exaggerated, but it certainly seems as if the people have spoken and, after readying
themselves for the wolf one too many times, have come to the conclusion that “the future (of AC) ain’t what it used to be”
. . .at least not yet. 相似文献
75.
Michelle L. DeOliveira Timothy M. Pawlik Ana L. Gleisner Lia Assumpcaom Gaspar J. Lopes-Filho Michael A. Choti 《Journal of gastrointestinal surgery》2007,11(8):970-976
Survival after resection of colorectal liver metastases has traditionally been associated with clinicopathologic factors.
We sought to investigate whether echogenicity of colorectal liver metastasis as assessed by intraoperative ultrasound (IOUS)
was a prognostic factor after hepatic resection. Prospective data on tumor IOUS appearance were collected in 84 patients who
underwent hepatic resection for colorectal liver metastasis. Images were digitally recorded, blindly reviewed, and scored
for echogenicity (hypo-, iso-, or hyperechoic). The median tumor number was 1 and the median tumor size was 5.0 cm. At the
time of surgery, the IOUS appearance of the colorectal liver metastases were hypoechoic in 35 (41.7%) patients, isoechoic
in 37 (44.0%) patients, and hyperechoic in 12 (14.3%) patients. Traditional clinicopathologic prognostic factors were similarly
distributed among the three echogenicity groups (all p > 0.05). Patients with a hypoechoic lesion had a significantly shorter median survival (30.2 months) compared with patients
who had either an isoechoic (53.2 months) or hyperechoic (42.3 months) lesion (p = 0.005). The 5-year survival after hepatic resection of colorectal liver metastasis was also associated with the echogenic
appearance of the lesion (hypoechoic 14.4 vs isoechoic 37.4 vs hyperechoic 46.2%) (p < 0.05). Intraoperative ultrasound echogenicity should be considered a prognostic factor after hepatic resection of metastatic
colorectal cancer.
This study was presented at the 47th annual meeting of The Society for Surgery of the Alimentary Tract, Los Angeles, CA, USA,
22 May 2006. 相似文献
76.
Gastroesophageal reflux disease (GERD) is a common disease and can be successfully treated by laparoscopic fundoplication.
This article describes the technique of laparoscopic surgery for GERD with a focus on operative pitfalls. 相似文献
77.
Burkhard H. A. von Rahden Brigitte Stigler Wolfgang Weiß Hubert J. Stein 《Journal of gastrointestinal surgery》2007,11(7):945-947
Management of upper gastrointestinal bleeding because of erosion of vessels by esophageal cancer may be challenging. We present
herein the angiographic images of a 49-year-old patient who was admitted with massive bleeding from a tumor-eroded inferior
thyroid artery. Attempts to control the bleeding by means of flexible endoscopy and insertion of a Sengstaken–Blakemore tube
had failed. The diagnosis was impressively demonstrated by multislice computed tomography with intravenous contrast in the
arterial phase and multiplanar reconstructions (computed tomography angiography) and by digital subtraction angiography. The
bleeding was successfully treated with superselective catheterization and coiling of the eroded vessel. 相似文献
78.
目的 分析和探讨桡骨远端关节内骨折外固定器治疗的相关机制和原则.方法 笔者采用Orthofix外固定器和国产组合式外固定器治疗桡骨远端关节内骨折45例46肢,以齐藤英彦法对资料完整的37例38肢病例进行分型,分析其影像学表现、损伤和治疗相关机制以及特点.结果 各型复位方向和外固定腕关节位置均与致伤暴力方向相反.骨折愈合时间平均为43 d(37~62 d),平均随访时间14个月(3~56个月),按Dienst标准评估腕关节功能及疗效:优21例22肢,良10例10肢,可6例6肢.结论 闭合复位外固定能很好地解决桡骨远端关节内骨折的治疗问题,特别适用于粉碎型关节内骨折.其治疗原则是复位方向及腕关节外固定位置与损伤机制、移位情形相反,个别骨折块辅以切开复位时须强调有限切开,必须重视部分病例伴有的同侧桡骨中远段骨折和同侧尺骨远段骨折的处理. 相似文献
79.
Michael Dietrich Christoph Meier Daniela Zeller Patrick Grueninger Roger Berbig Andreas Platz 《European journal of trauma and emergency surgery》2007,33(5):512-519
Abstract
Background: Primary shoulder hemiarthroplasty is an established treatment modality for complex fractures of the proximal humerus. Long-term
functional outcome is often disappointing. However, little is known about social implications particularly in the elderly.
Methods: A single-institution case series of consecutive geriatric patients (age > 70 years) treated with shoulder hemiarthroplasty
for complex fractures of the proximal humerus between 1994 and 1997 was analysed. Postoperative morbidity, long-term function,
radiological outcome and social implications were evaluated.
Results: Seventy-seven patients fulfilled the study criteria. Median age at the time of operation was 80 years (range 70–93 years).
Systemic and local postoperative complications were observed in 8% including 2 patients (3%) with revision surgery. Postoperative
mortality was 1%. Forty-eight patients (62%) were available for follow-up (median 49 months, range 25–80 months), 22 (29%)
died from causes unrelated to hemiarthroplasty before follow-up and 7 patients (9%) did not attend follow-up examination.
Median Constant-Murley score was 41 points (range 17–77 points). Long-term results concerning pain were satisfying. The Oxford
shoulder score ranged from 14 to 40 (median 30). Forty-one patients (85%) still lived in their original environment and managed
their daily life independently despite poor shoulder function. Four patients (8%) lived in a retirement home and 3 (6%) in
a nursery home. Eighty percent of our patients were still able to use public transportation, do the daily shopping and wash
their whole body by themselves.
Conclusion: Most patients managed their daily life independently despite poor shoulder function. 相似文献
80.
Dittmar Böckler Hardy Schumacher Klaus Klemm Marcel Riemensperger Philipp Geisbüsch Drosos Kotelis Harry Rotert Jens-Rainer Allenberg 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》2007,392(6):715-723
OBJECTIVES: to report our experience with hybrid vascular procedures in patients with pararenal and thoracoabdominal aortic pathologies. METHODS: 68 patients were treated for thoracoabdominal aortic pathologies between October 1999 and February 2004; 19 patients (16 men; mean age 68, range 40-79) with high risk for open thoracoabdominal repair were considered to be candidates for combined endovascular and open repair. Aortic pathologies included five thoracoabdominal Crawford I aneurysms, one postdissection expanding aneurysm, three symptomatic plaque ruptures (Crawford IV), five combined thoracic descending and infrarenal aneurysms with a healthy visceral segment, three juxtarenal or para-anastomotic aneurysms, and two patients with simultaneous open aortic arch replacement and a rendezvous maneuver for thoracic endografting. Commercially available endografts were implanted with standardized endovascular techniques after revascularization of visceral and renal arteries. RESULTS: Technical success was 95%. One patient developed a proximal type I endoleak after chronic expanding type B dissection and currently is waiting conversion. Nine patients underwent elective, five emergency and five urgent (within 24 h) repair. 17 operations were performed simultaneously, and 2 as a staged procedure. Postoperative complications include two retroperitoneal hemorrhages, and one patient required long-term ventilation with preexisting subglottic tracheal stenosis. Thirty-day mortality was 17% (one multiple organ failure, one secondary rupture after open aortic arch repair, one myocardial infarction). Paraplegia or acute renal failure were not observed. Total survival rate was to 83% with a mean follow-up of 30 months. CONCLUSIONS: Midterm results of combined endovascular and open procedures in the thoracoabdominal aorta are encouraging in selected high risk patients. Staged interventions may reduce morbidity. 相似文献