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921.
Summary An 81-year-old woman underwent a colonoscopy because of a sigmoiditis poorly responding to conservative therapy. A rod-shaped foreign body found in the sigma proved impossible to remove conventionally. Irradiation with a low laser energy caused the foreign body to break apart, after which its extraction was straightforward. The further clinical course was uncomplicated. In this case a partial sigmoidectomy would have been indicated had the laser-supported extraction not been successful. The authors suggest that a similar procedure could be helpful in the management of foreign bodies in the esophagus.  相似文献   
922.
DIOMED激光治疗下肢静脉曲张的初步报告   总被引:23,自引:1,他引:22  
目的:初步评价DIOMED激光治疗下肢静脉曲张的临床应用。方法:20例病人共26条患肢均行激光或激光结合手术治疗,主要应用4种手术治疗方式:①单纯激光治疗;②激光治疗加高位大隐静脉结扎术;③激光治疗加合股浅静脉瓣膜包窄术和大隐静脉高位结扎术;④激光治疗加大隐静脉高位结扎和交通支结扎术。结果:经随访2~14个月,所有病人都恢复正常生活自理或工作,无局部复发表现,疗效满意。结论:静脉内激光治疗是一种安全、有效、微创、不遗留手术疤痕、操作简便和疗效好的新治疗方法,还可联合手术治疗。  相似文献   
923.
924.
Summary One of the latest techniques advocated for total lower lip reconstruction is thegate flap described by Fujimori in 1980 [3]. This technique has been modified and used in two patients. With this modification, it is no longer necessary for the lateral margins of resection to extend beyond the commissure for technical purposes, and the shape of the resection does not have to be rectangular. Thus, unnecessary resection of normal tissue and macrostomia are prevented. Widely used reconstruction techniques for large lower lip defects were compared and an attempt was made to explain how to choose the proper technique for a given defect.  相似文献   
925.
Thirty-one patients with severe low back pain were treated by continuous epidural block for 18±3 (mean±SEM) days. Motor nerve conduction velocity (MCV) of the common peroneal nerve was measured before and after the treatment. After the treatment, the visual analogue scale score (VAS) and straight leg-raising (SLR) test were markedly reduced (P<0.01), and MCV was increased significantly (P<0.001). A significant correlation (P<0.01) between the SLR test and MCV was found before the treatment. A significant correlation (P<0.001) between VAS and MCV was demonstrated after treatment. However, in three patients who showed no reduction in VAS even after the treatment, MCV became significantly (P<0.05) slower in spite of nearly normal SLR test results. These results suggest that epidural block treatment improves not only pain but also MCV, and that two parameters, SLR test and pain intensity, are related closely to the MCV.  相似文献   
926.
吻合一组血管的联合皮瓣移植临床应用探讨   总被引:4,自引:1,他引:3  
目的探讨吻合一组血管的联合皮瓣修复巨大组织缺损的临床应用价值。方法创面经彻底清创后,根据皮肤缺损伴骨裸露、创面具体情况,选用吻合一组血管的联合皮瓣移植修复,皮瓣最长为70cm,皮瓣面积最大为42cm×24cm。临床应用26例。结果皮瓣全部成活,创面全部得到覆盖,骨折愈合,保住了肢体,为功能恢复创造了条件。结论吻合一组血管的联合皮瓣能代替吻合多组血管的组合皮瓣临床应用,节时、成功率高,易于应用与推广。  相似文献   
927.
卞栋 《淮海医药》2003,21(6):446-447
目的 探讨急性肢体动脉栓塞的病因、治疗及影响其预后的因素。方法 回顾性总结 16例急性肢体动脉栓塞患者临床治疗的资料。结果 手术处理 15例占 93.75 % ;非手术处理 1例 ;肢体挽救率 10 0 %。结论 急诊手术对绝大多数急性肢体动脉栓塞的患者有效。该病预后取决于早期诊断和及时治疗 ,对不同情况采取不同的处理措施。总的原则是尽快恢复缺血组织的血供 ;减少毒素吸收并注意保护多器官功能  相似文献   
928.
In this study, the brain potentials related to voluntary, self-paced plantarflexions of the left toes, flexion of the right knee and isometric extensions of the left hip were examined in 3 groups of 10 subjects each. In the first half of the foreperiod, the Bereitschaftspotential (BP) or readiness potential for all movements was symmetrically distributed over both hemispheres. For toe and knee movements, an ipsilateral preponderance of the BP developed in the later foreperiod, which was statistically significant for toe movements. For hip movements, BP topography was symmetrical during the entire foreperiod including its second half. Since finger, hand or shoulder movements of previous experiments show a strong contralateral preponderance of the BP, the results are discussed as further support of the hypothesis that the lateralisation of the BP is due to the orientation of the precentral electrical field vector generated by an active source in the MI motor cortex. Thus, part of the somatotopic representation of the human precentral gyrus can be mapped by this non-invasive means: upper limb movements are located on the convexity; toe, foot and knee movements are generated on the mesial cortex between the hemispheres; and hip movements seem to be located at the mantle edge.  相似文献   
929.

Background

Somatosensory impairment of the upper limb (UL) occurs in approximately 50% of adults post-stroke, associated with loss of hand motor function, activity and participation. Measurement of UL sensory impairment is a component of rehabilitation contributing to the selection of sensorimotor techniques optimizing recovery and providing a prognostic estimate of UL function. To date, no standardized official French version of a measure of somatosensory impairment has been established.

Objective

To develop and validate a French version of the Erasmus modified Nottingham Sensory Assessment somatosensory (EmNSA-SS) and stereognosis (EmNSA-ST) component for evaluating the UL among adults with stroke.

Methods

This study is a single-center observational cross-sectional study. A French version of the EmNSA for UL was developed by forward-backward translation and cross-cultural adaptation. Fifty stroke patients were recruited to establish concurrent-criterion-related validity, internal consistency, intra- and inter-rater reproducibility with intracorrelation coefficients (ICCs) for reliability and the minimal detectable change with 95% confidence interval (MDC95) for agreement, as well as ceiling and floor effects. Criterion validity was assessed against the Fugl-Meyer Assessment-Sensory (FMA-S) for the UL.

Results

The median (range) EmNSA-SS score was 41.5 (1–44). The Spearman rank correlation coefficient between EmNSA-SS and FMA-S total scores was moderate (rho = 0.74, P < 0.001). The EmNSA-SS/ST internal consistency was adequate across subscales; with Cronbach α ranging from 0.82–0.96. For the EmNSA-SS total score, intra- and inter-rater reliability was excellent (ICC = 0.92 in both cases), with MDC95 of 12.3 and 14.6, respectively. EmNSA-SS/ST total scores demonstrated no ceiling or floor effects.

Conclusions

The French EmNSA is a valid and reproducible scale that can be used for comprehensive and accurate assessment of somatosensory modalities in adults post-stroke. Taking less than 30 min to administer, the instrument has clinical utility for use in patients with cognitive comorbidities and at various stages of recovery in multidisciplinary clinical practice and research settings.  相似文献   
930.
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