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101.
手部创伤性骨关节缺损的处理 总被引:4,自引:0,他引:4
治疗手部骨关节缺损常采用植骨内固定、关节融合、关节成形及关节置换等方法.为总结经验,对1989年以来101例手部创伤性骨与关节缺损进行分析。单纯掌、指骨缺损39例,行直接短缩对位,克氏针内固定6例,1例发主骨不连;对33例缺损较大者用自体骨块植入克氏针交叉内固定,部分病例同时植人RBX或异体骨粒,10例发生延迟愈合,余全部正常愈合。骨与关节部分或完全缺损62例,采用关节成形术46例,其中以肋软骨移植效果最好,骨膜移植次之,筋膜衬垫或硅胶膜植入法较差;行关节融合术11例.均达顺利融合;采用自体关节置换5例,均成活,术后关节活动度均>70°。我们认为:自体骨块植入克氏针交叉内固定,必要时植入RBX骨粒.是治疗手部创伤性骨缺损的有效方法。关节缺损应按关节的重要性,分别采用关节融合术、关节成形术或关节置换术。 相似文献
102.
G. J. Breur M. D. Lapierre K. Kazmierczak K. M. Stechuchak G. P. McCabe 《Calcified tissue international》1997,61(5):418-425
In this study, we tested the hypotheses that (a) both the domain volume (volume of the cell and the matrix it has formed)
and matrix volume of juxtametaphyseal hypertrophic chondrocytes in the growth plate is tightly controlled, and that (b) the
domain volume of juxtametaphyseal hypertrophic chondrocytes is a strong determinant of the rate of bone length growth. We
analyzed the rate of bone length growth (oxytetracycline labeling techniques) and nine stereologic and kinetic parameters
related to the juxtametaphyseal chondrocytic domain in the proximal and distal radial and tibial growth plates of 21- and
35-day-old rats. The domain volume increased with increasing growth rates, independent of the location of the growth plate
and the age of the animal. Within age groups, the matrix volume per cell increased with increasing growth rates, but an identical
growth plate had the same matrix volume per cell in 21- and 35-day-old rats. The most suitable regression model (R
2= 0.992) to describe the rate of bone length growth included the mean volume of juxtametaphyseal hypertrophic chondrocytes
and the mean rate of cell loss/cell proliferation. This relationship was independent of the location of the growth plate and
the age of the animal. The data suggest that the domain volume of juxtametaphyseal hypertrophic chondrocytes, as well as the
matrix volume produced per cell, may be tightly regulated. In addition, the volume of juxtametaphyseal hypertrophic chondrocytes
and the rate of cell loss/rate of cell proliferation may play the most important role in the determination of the rate of
bone length growth.
Received: 2 December 1996 / Accepted: 24 March 1997 相似文献
103.
104.
Marcel Stokkel Aeilko Zwinderman Jaap Zwartendijk Ernest Pauwels Berthe van Eck-Smit 《European journal of nuclear medicine and molecular imaging》1997,24(10):1215-1220
Between 10% and 25% of patients with newly diagnosed prostate cancer without bone metastases at the time of diagnosis will
develop metastases during follow-up. To determine the value of clinical and biochemical parameters for assessment of prognosis
at the time of diagnosis, a retrospective study was performed in 124 consecutive patients with newly diagnosed prostate cancer
without bone metastases. The mean follow-up was 41 months, during which time 36 patients died and 15 patients developed metastases.
Bone scans were classified from 0 (=normal) through 2 (=abnormal, but not typical for metastases) and were correlated with
age, alkaline phosphatase (AP), prostate-specific antigen (PSA), tumour grade, T-stage and N-stage. In patients with a class
2 scan, additional roentgenograms and follow-up were used to exclude metastases at initial stage. All parameters, including
therapy, were finally correlated with the development of metastases and survival. For survival 38 patients with proven metastases
were used as controls. For all parameters tested, no statistically significant differences were found between the three bone
scan classifications. The interval between diagnosis and the development of metastases ranged from 12 to 72 months. For the
risk of development of metastases only PSA was found to be a significant correlate (P=0.0075). However, when tumour stages were clustered in limited disease (T0–2) and extensive disease (T3–4), the incidence
of metastases was significantly higher in patients with extensive disease than in those with limited disease (P=0.0021). Finally, age, PSA and Anderson classification were found to be significant correlates of survival, but in stepwise
analysis PSA was selected as the most prognostic variable (P<0.0001). In contrast with a typical pattern of metastases on bone scintigraphy, an abnormal scan (class 1 and 2) at the time
of diagnosis is not a poor prognostic parameter of the risk of death. In conclusion, in patients with prostate cancer without
bone metastases at the time of diagnosis, pretreatment PSA and tumour stage can be used for the assessment of risk of development
of metastases during follow-up and survival. For this purpose, tumour stage should be clustered in limited and extensive disease.
Received 14 April and in revised form 9 June 1997 相似文献
105.
气功对冠心病人CM_5ST段/心率斜率的影响 总被引:1,自引:0,他引:1
37名冠心病患者随机分为气功治疗组(22人)和对照组(15人)。气功治疗组接受12周动功治疗,对照组接受安慰剂治疗,治疗前后均测定CM_5 ST段/心率斜率。结果发现动功治疗组CM_5 ST段/心率斜率减少,而对照组不变或增大,两组有显著性差异,ST段下移及常规分级运动试验其它指标在两组间无显著差异。表明CM_5ST段/心率斜率是一个敏感的心肌缺血指标。 相似文献
106.
107.
108.
抗CD25抗体预防移植物抗宿主病在儿童白血病半匹配骨髓移植中的应用 总被引:1,自引:0,他引:1
目的 探讨抗 CD2 5抗体用于预防儿童白血病半匹配未去 T细胞骨髓移植重度移植物抗宿主病 (GVHD)的疗效。 方法 10例儿童白血病患者接受 HL A2 - 3位点不合半匹配骨髓移植 ,移植方法除了供者应用粒细胞集落刺激因子 (GCSF)2 5 0μg促进骨髓及受者应用环孢素 A(CSA ) ,甲氨蝶呤 (MTX) ,抗胸腺细胞球蛋白 (ATG)和霉酚酸酯 (MMF)预防 GVHD综合措施外 ,加用抗 CD2 5单克隆抗体预防 GVHD,剂量各为 2 0 m g,在移植前 2 h和移植后第 4天应用 ,采髓后未去 T细胞输注 ,移植结果与前期未用 Simulect移植组比较。 结果 10例移植后均获造血重建 ,粒细胞大于 0 .5× 10 9/ L 中位天数是19 d,血小板大于 2 0× 10 9/ L 的中位天数是 2 2 d,骨髓植活直接证据检测证实为完全供者造血。无 1例发生急性 ~ GVHD,未用 Sim ulect对照组急性 ~ GVHD为 5 0 % ,差异有显著性意义。可评价慢性 GVHD的 8例均发生慢性 GVHD,均为局限性慢性 GVHD。中位随访 12个月 (范围 9~ 2 4个月 ) ,2例移植相关死亡 ,1例移植后 14个月复发死亡 ,实际无病生存率是 70 % ,与对照比较差异无显著性意义。 结论 本研究儿童半匹配未去 T细胞骨髓移植应用 Sim ulect,明显降低急性重症 a GVHD发生 ,减少移植相关死亡 ,临床应用安全可行。 相似文献
109.
M. Grant B. Ferrell G. M. Schmidt P. Fonbuena J. C. Niland S. J. Forman 《Quality of life research》1992,1(6):375-384
This study was designed to assess the reliability and validity of a Quality of Life (QOL) instrument on a sample of 179 allogeneic Bone Marrow Transplant (BMT) survivors. The QOL-BMT tool was developed specifically for this population and was based on the investigators' prior research and a conceptual model of Quality of Life. Patients who were at least 100 days post BMT completed the 30 item visual analogue questionnaire. The instrument measured physical symptoms (e.g., weight loss, frequent colds, skin changes, cataracts, sexual problems), psychological to illness, social concerns (e.g., relationship adjustment, return to work), and spiritual well-being (e.g., sense of control, future goals). Psychometric analysis of the instrument included measures of reliability and validity. The study findings demonstrate the unique aspects of QOL dimensions in BMT survivors and the value of QOL assessment in clinical practice and research.This study was supported by the City of Hope National Medical Center, NCI Cancer Center Core Grant, R30 CA 33572 and the City of Hope BRSG Grant Support. 相似文献
110.
Koichi Murata Yasuaki Nakagawa Takashi Suzuki Masahiko Kobayashi Seiya Kotani Takashi Nakamura 《Knee surgery, sports traumatology, arthroscopy》2007,15(10):1261-1263
Intraosseous ganglia of the glenoid are rare, and their etiology is unknown. This report describes a case of an intraosseous
ganglion about to cause fracture of the glenoid. The patient was a 61-year-old woman with a painful left shoulder with a limited
range of motion. Her symptoms did not improve after non-operative treatment. Arthroscopic examination showed a cartilage defect
and erosion in the posteroinferior portion of the glenoid, behind which computed tomography (CT) showed a cystic lesion of
the glenoid. There was no communication between the cyst and the joint space. The patient was treated by curettage and an
autogenous cancellous bone graft from the iliac crest. Two years after the operation, the patient was almost free from pain,
and CT showed good integration of the bone graft. 相似文献