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排序方式: 共有10000条查询结果,搜索用时 9 毫秒
981.
Henry Ahn Payam Mousavi Lee Chin Sandra Roth Joel Finkelstein Alex Vitken Cari Whyne 《European spine journal》2007,16(8):1171-1178
A biomechanical study comparing simulated lytic vertebral metastases treated with laser-induced thermotherapy (LITT) and vertebroplasty
versus vertebroplasty alone. To investigate the effect of tumor ablation using LITT prior to vertebroplasty on biomechanical
stability and cement fill patterns in a standardized model of spinal metastatic disease. Vertebroplasty in the metastatic
spine is aimed at reducing pain, but is associated with risk of cement extravasation in up to 10%. Six pairs of fresh-frozen
cadaveric thoracolumbar spinal motion segments were tested in axial compression intact, with simulated metastases and following
percutaneous vertebroplasty with or without LITT. Canal narrowing under load, pattern of cement fill, load to failure, and
LITT temperature and pressure generation were collected. In all LITT specimens, cement filled the defect without extravasation.
The canal extravasation rate was 33% in specimens treated without LITT. LITT and vertebroplasty yielded a trend toward improved
posterior wall stability (P = 0.095) as compared to vertebroplasty alone. Moderate rises in temperature and minimal pressure generation was seen during
LITT. In this model, elimination of tumor by LITT, facilitates cement fill, enhances biomechanical stability and reduces the
risk of cement extravasation. 相似文献
982.
Intussusception after open Roux-en-Y gastric bypass procedure (RYGBP) is a rare complication. We present a retrospective review
of three cases of antegrade intussusception occurring after laparoscopic RYGBP. To our knowledge, these are the first documented
cases of intussusception after laparoscopic RYGBP. We describe the clinical presentation and our management of these three
cases. Furthermore, we believe that the initial clinical presentation, radiographic findings, and management of these patients
may be different than those patients who have undergone an open RYGBP. With increasing popularity of laparoscopic RYGBP, we
are likely to see more of this entity. 相似文献
983.
Takao M Komatsu F Oae K Miyamoto W Uchio Y Ochi M Matsushita T 《Archives of orthopaedic and trauma surgery》2007,127(8):685-690
Introduction Flat foot and/or metatarsal primus varus are the major causes of hallux valgus, and it is important to correct these deformities
in order to prevent the recurrence of this condition. We demonstrate the clinical and radiological assessment of the correction
of hallux valgus, metatarsal primus varus, and flat foot after proximal oblique-domed osteotomy of the metatarsus with distal
soft tissue reconstruction.
Materials and methods Twenty-seven feet of 22 patients with moderate or severe hallux valgus who had undergone proximal oblique-domed osteotomy
were studied. After the adductor hallucis tendon was cut at the attachment of the proximal phalanx and at the sesamoid bone,
the osteotomy was performed 3 cm dorsal-distal to the metatarsocuneiform joint to transfer distal fragment approximately 5 mm
in the plantar direction, and rotated laterally decreasing the first–second intermetatarsal angle to 5 degrees.
Results The mean AOFAS score was 54.1 ± 2.8 points at pre-operation and 92.8 ± 4.8 points at the most recent follow-up (P < 0.0001). Significant improvement was seen between the hallux valgus angle (P < 0.0001), first–second intermetatarsal angle (P < 0.0001), first–fifth intermetatarsal angle (P < 0.0001), talar pitch (P = 0.0032), and calcaneal plantar angle (P = 0.0327) before surgery and at one year after surgery. The average improvement of the talar pitch and calcaneal plantar
angle was 2.6 ± 1.4 and 2.4 ± 1.5 degrees, respectively.
Conclusion This study suggest that proximal oblique-domed osteotomy of the metatarsal as a surgical procedure for the treatment of moderate
or severe hallux valgus with flat foot can be recommended to correct the longitudinal arch of the foot and the first–second
intermetatarsal angle. 相似文献
984.
Since 1996, the original technique of superior pedicle vertical scar mammaplasty described by Lejour has been modified by
decreasing skin and glandular undermining, limiting liposuction, avoiding tight glandular stitches, and adding a small horizontal
scar for very large breasts. Between 1996 and 2002, 115 consecutive patients underwent a bilateral reduction mammaplasty of
more than 500 g per breast using the modified Lejour technique. The early, late, and delayed complications were studied according
to four parameters: glandular resection, age, smoking habits, and body mass index (BMI). There was no difference in terms
of complications according to the glandular resection. Patients with a high BMI were found to have a higher rate of wound
dehiscence. The occurrence of partial areolar necrosis proved to be related to smoking habits. Patients younger than 20 years
presented a lower rate of seroma. The modified Lejour technique has proved to be safe and effective for large breasts. 相似文献
985.
Background: Epidemiological evidence confirms that risk of developing type 2 diabetes is related to weight gain. Weight reduction
is beneficial as relative risk is reduced to 0.13 for weight loss >20 kg. This raises the question of effectiveness of bariatric
surgery on 1) weight loss and 2) diabetes-related outcomes in morbidly obese patients.
Methods: We reviewed the literature using Medline. Only 2 meta-analyses reporting on both outcomes were included, as well
as 50 systematic reviews or primary studies.
Results: Meta-analyses mainly based on case series data as well as controlled studies confirm that bariatric surgery is highly
effective in obtaining weight reduction in morbidly obese patients up to 60% of the excess weight, along with resolution of
preoperative diabetes in more than 75% of cases. Among bariatric surgery techniques, malabsorptive procedures (biliopancreatic
diversion and gastric bypass) appear to be more effective on both outcomes than restrictive procedures (gastroplasty and gastric
banding).
Conclusion: Even if more studies are needed to confirm current evidence, bariatric surgery is effective for controlling diabetes.
It appears as an efficient strategy from economic modeling due to savings from reduction in diabetes-related costs. 相似文献
986.
This study investigated the effect of rifampin on the thickness of capsules around silicone implants by bactericidal activity
against Stapylococcus epidermidis. Silicone blocks (1 × 1 cm) were placed into pockets created for each of the 40 rats included in the study. In group 1, the
operation was performed under aseptic conditions. In group 2, standard S. epidermidis was inoculated into the pocket, whereas rifampin and S. epidermidis were applied in group 3. In group 4, only rifampin was applied topically on implants. After 12 weeks, the peri-implant capsules
were removed and examined under a photomicroscope and a scanning electron microscope. The mean thickness of the capsules was
63.307 μm in group 1, 111.538 μm in group 2, 43.076 μm in group 3, and 30.384 μm in group 4. The differences between groups
2 and 3 and groups 2 and 4 were found to be statistically significant (p < 0.001). Rifampin appears to be an agent for preventing peri-implant capsule formation. 相似文献
987.
Background We have developed a new technique for treatment of intramucosal carcinoma
which exceeds the standard indication for endoscopic mucosal resection and carcinoma invading the submucosa without lymph
node metastasis that are located in the posterior wall of the stomach, which we refer to as laparoscopic intragastric full-thickness
excision (LIFE) under flexible endoscopic control.
Surgical Technique Three pigs were used for the study. Three trocars were used. The first trocar (trocar # 1) was placed in the subumbilical
region to introduce the videoscope, whereas the second and third trocars (trocar # 2 and trocar # 3) were punctured percutaneously
into the abdominal cavity. A straight needle with 3-0 silk suture was attached to a T-bar on the wire side and inserted into
the abdominal cavity. An area adjacent to the lesion in the posterior wall of the stomach was pierced by the straight needle,
which was then pulled into the stomach using the forceps of the endoscope. The T-bar, after being passed through the abdominal
wall, was fixed outside the gastric wall, and trocar # 3 was repositioned in the stomach by the percutaneous transgastric
route. The posterior wall of the stomach was pulled inward by the T-bar, and the lesion was removed by several excisions with
laparoscopic stapling devices inserted through trocar # 3; extraction of the specimen was achieved through trocar # 3. The
gastrotomy site was suture-closed using instruments positioned through trocar # 2 and trocar # 3 under laparoscopy.
Conclusions Based on a feasibility study in pigs, the LIFE procedure can be performed for lesions of the posterior wall of the stomach. 相似文献
988.
989.
Sudo T Murakami Y Uemura K Hayashidani Y Hashimoto Y Ohge H Sueda T 《World journal of surgery》2007,31(11):2230-2235
Background Preoperative biliary drainage (PBD) is associated with bacterial contamination of bile, but the effects of PBD on morbidity
after pancreatoduodenectomy remain controversial. The aim of this study was to characterize bile contamination to develop
successful specific antibiotic prophylactic strategies for pancreatoduodenectomy.
Methods Ninety-one consecutive patients who underwent pancreatoduodenectomy for periampullary tumor were prospectively evaluated.
Prophylactic antibiotics were selected based on preoperative bile cultures. Bile cultures and postoperative complications
were compared in 46 patients who underwent PBD (drainage group) versus 45 patients who did not (nondrainage group).
Results The incidence of positive bile cultures was higher in the drainage group (78%) than in the nondrainage group (36%) (P < 0.001). In the drainage group, positive bile cultures were frequently polymicrobial (61%) and demonstrated resistance to
several antibiotics, including cefazolin (83%), cefmetazole (72%), and cefpirome (64%). Overall morbidity (30% and 22%) and
infectious morbidity (13% and 11%) did not differ significantly between the drainage and nondrainage groups, respectively.
Conclusions PBD had a notable influence on bile microbial contamination, including a higher rate of antibiotic resistance. Therefore,
specific antibiotic prophylaxis based on bile culture is required for preventing infectious complications in pancreatoduodenectomy
patients who undergo PBD. 相似文献
990.
Özgür Aydin 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》2007,392(1):105-109
Introduction Scar endometriosis develops in and is adjacent to surgical scars at the site of previous abdominal operations. The most frequent
clinical presentation of the disease is that of a palpable subcutaneous mass near surgical scars associated with cyclic pain
and swelling during menses. Endometriosis of the surgical scar is often referred to the general surgeons because the clinical
presentation suggests an incisional hernia or other conditions related to the general surgery. Cyclical symptoms such as pain
and swelling, in relation to surgical scars, which worsen at the time of menstruation, are nearly pathognomonic of scar endometriosis.
However, often the diagnosis of endometriosis is not suggested until after histology has been performed.
Case report We present two cases of cutaneous endometriosis that has occurred on the site of previous cesarean section scar area. 相似文献