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51.
Summary The incidence of high cervical disc lesions is extremely rare, and the mechanism of their development is unclear. We report
these three cases, and discuss the possible mechanisms. We also describe surgical strategies for these lesions.
The first and second cases were an 82-year-old male and an 84-year-old male with retro-odontoid disc hernia. The third was
an 83-year-old female with a herniated disc at C2/C3. To investigate Aetiological mechanisms of these lesions, we examined
the findings on cervical images in extension and flexion, and compared the results in a younger than 80-year-old group and
an older than 80-year-old group.
The patients underwent surgery via a posterolateral intradural approach. Wide laminectomy and incision of the dentate ligaments
enabled access to the ventral space of the upper cervical spinal canal and sufficient decompression. All patients became ambulatory
postoperatively without special fixation of the cervical spine. In the younger group, the level mostly loaded during cervical
movement was C5/6, however, the levels in the older group were C2/3 and C3/4.
In elderly patients, less mobilization of the middle and/or lower cervical spine due to spondylotic change causes overloading
at higher levels resulting in high cervical disc lesions. Retro-odontoid disc lesions can be caused by a herniated disc at
C2/C3, which migrates upward. Regarding surgical strategy, the posterolateral intradural approach is less invasive and more
advantageous for these lesions. 相似文献
52.
The effect of smoking at different life stages on bone mineral density in elderly men and women 总被引:6,自引:2,他引:4
D. P. Kiel MD Y. Zhang M. T. Hannan J.J Anderson J. A. Baron D. T. Felson 《Osteoporosis international》1996,6(3):240-248
To assess the effect of smoking on bone mineral density (BMD) at different life stages, to examine whether the effect of smoking differs between men and women, and to discover whether its effect in women differs according to history of estrogen use, a cohort study was carried out with single cross-section measurement of BMD by single and dual photon absorptiometry. The setting was the Framingham Study, a population-based cohort study with over 40 years prospectively collected data on smoking. Subjects (n=1164) consisted of cohort members participating in the 20th biennial Framingham examination (1988–1989). The measurements included in the study were BMD measured at the hip, spine and radius, smoking history ascertained at all Framingham Study examinations since 1948, and other factors affecting BMD (age, weight, estrogen use, caffeine use, alcohol use and physical activity). Neither current smoking, recent (last 10 years) smoking, nor early adulthood smoking resulted in significantly lower BMD at any skeletal site among women who had not taken estrogen. Among women who had taken estrogen, BMD at most sites was lower among current or recent smokers, although the small numbers of smokers made it difficult to find significant differences at all skeletal sites. Among men, a consistently lower BMD at all skeletal sites was observed for smokers regardless of when in their life they smoked (4–15.3% lower), although the effect of smoking during early adulthood was of a lesser magnitude (4–8% lower). Former male smokers who had quit <10 years ago had lower BMD than men who had quit 10 years ago. In conclusion, in women who had used estrogen, BMD was lower in current or recent smokers than it was in non-smokers. In men, smoking at any stage of life had adverse effects on the skeleton that was independent of weight, alcohol or caffeine use, implying other mechanisms for smoking's effect on bone. 相似文献
53.
M. Tomonaga 《Acta neuropathologica》1981,53(2):165-168
Summary The presence of Lewy body and neurofibrillary tangle in the locus ceruleus neurons of aged brain is described. Ultrastructural study revealed that in some Lewy bodies the presence of twisted tubules or paired helical filaments amongst the filaments of the Lewy body. A quantitative analysis of serial sections of locus ceruleus from aged brain, incidences of the Lewy body and neurofibrillary change were 0.07% (9/11,515) and 6.6% (15/11,515), respectively. The incidence of neurons containing both structures was 0.008% (1/11,515). 相似文献
54.
目的 确定老年性痴呆患者 (seniledementiaoftheAlzheimer′sdisease ,AD)有无周围性听功能障碍及其与认知障碍的关系。方法 利用纯音测听、言语识别率、声导抗、听觉脑干反应检测AD患者 43例 ,健康老年人 50例 ,评定受试者测听可信度 ,统计测试结果 ,并将上述结果同受试者简易精神状态量表 (mini mentalscaleofequastionnaire ,MMSE)得分进行对照分析 ,寻找二者之间的关系。结果 受试者两耳间周围听力差异无显著性 ,以右耳听力结果 ( x±s)进行统计。AD组纯音听阈为 (2 6 3± 8 5)dBHL和 (2 9 1± 8 7)dBHL ,言语识别率为 (85 5± 5 5) % ;对照组纯音听阈为 (2 3 2± 1 0 6)dBHL和 (2 6 2± 1 1 8)dBHL ,言语识别率为 (87 6± 6 8) %。虽然AD组周围听功能检查结果低于对照组 ,但无统计学意义 (P >0 0 5)。测听可信度、声导抗和ABR阈值两组间差异无显著性 (P >0 0 5)。结论 老年性痴呆患者纯音听阈和言语识别率与老年聋相似 ,其周围听功能障碍与MMSE认知量表得分无关。 相似文献
55.
不同麻醉方法用于老年病人上腹部手术的对比研究 总被引:4,自引:2,他引:4
目的 比较 3种麻醉方法用于老年病人上腹部手术的优缺点。方法 6 0例择期行胃癌根治术的老年患者 ,随机分为 :A(单纯硬膜外 )、B(单纯全麻 )、C(硬膜外复合全麻 ) 3组 (每组 2 0例 )。硬膜外阻滞选择T8、T9椎间隙穿刺置管 ,局麻药用 1%利多卡因 +0 .2 5 %布比卡因混合液 ;全麻采用静吸复合 ;术中连续有创监测桡动脉压、心率 ;分别于不同时间点抽取外周静脉血测定胰岛素、皮质醇、肾上腺素和血糖浓度。结果 3组术中血皮质醇、血糖浓度均升高 ,但C组低于A、B两组 (P <0 .0 5 ) ;切皮后 12 0分钟时均达高峰 ;血胰岛素水平术中呈上升趋势 ,组间比较无显著性差异 ;A、B组术中肾上腺素水平明显高于C组 (P <0 .0 5 ) ;C组全麻诱导后MAP下降较A、B组明显 ,但麻醉维持期较A、B组稳定 ;拔管时B组MAP、HR升高幅度较C组显著。结论 3种麻醉方法均不能完全阻断手术创伤性刺激导致的应激反应。硬膜外阻滞复合全麻用于老年患者行上腹部手术 ,应激反应小 ,全麻药用量小 ,利于保持各系统功能的稳定和术后镇痛。 相似文献
56.
三维适形低分割放射治疗老年非小细胞肺癌疗效观察 总被引:19,自引:1,他引:19
目的 探讨三维适形低分割放射治疗老年非小细胞肺癌的疗效。方法 4 5例患者均采用低分割治疗 ,处方剂量为 4~ 5Gy,隔日 1次 ,总量 4 8~ 5 5Gy。结果 CR 2 3例 ( 5 1.1% ) ,PR 15例( 33.3% ) ,NC 5例 ( 11.1% ) ,PD 2例 ( 4 .4 % ) ,RR 38例 ( 84 .4 % )。 1、2、3年生存率分别为 6 6 .7%、4 8.9%、39.1%。结论 三维适形放射治疗对于老年非小细胞肺癌是一种反应较小 ,痛苦较轻 ,安全有效的治疗措施 相似文献
57.
58.
59.
目的观察直接经皮冠状动脉成形术(PTCA)治疗老年(≥70岁)急性心肌梗死的临床疗效。方法对70例发病时间12h以内,70岁及以上急性心肌梗死患者行直接PTCA(必要时冠脉内植入支架);并随机选择同期72例发病时间12h以内,未行溶栓或PTCA的70岁及以上急性心肌梗死患者进行比较和1年随访。结果治疗组中68例患者术后即刻血流皆达TIMIⅡ~Ⅲ级,手术成功率97.14%,治愈率98.57%,1年内梗塞后心绞痛发生率18.57%,因心脏原因再住院率21.43%;对照组死亡9例,治愈率87.50%,1年内梗塞后心绞痛发生率33.33%,因心脏原因再住院率43.06%,两组差异有显著意义。1年随访治疗组心功能明显较对照组为优。结论直接PTCA治疗老年(≥70岁)急性心肌梗死治愈率高,能更好地消除梗塞后心绞痛,保护患者心功能,减少心血管事件。 相似文献
60.