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301.
Summary A retrospective analysis of 183 consecutive patients operated on for ruptured cerebral aneurysms and surviving at least one year revealed appearance of postoperative epilepsy in 14 cases (8 per cent) on an average of 10 months (range 0–23 months) after the operation. Factors associated with the development of secondary epilepsy were localization of the aneurysm on the middle cerebral artery, temporary clipping intraoperatively, wrapping technique to treat the aneurysm, and vasospasm seen on the postoperative control angiogram. Intraoperative and/or postoperative ischaemia seems to be the crucial phenomenon favouring the development of epilepsy. Identification of the risk factors may help to focus the anti-epileptic prophylaxis in cases prone to develop seizures. 相似文献
302.
303.
B. Bagolini M. R. Zanasi R. Bolzani 《Documenta ophthalmologica. Advances in ophthalmology》1986,62(4):309-324
Esotropic patients whose angle of strabismus has been corrected by prisms frequently increase their angle deviation to compensate for the prismatic correction. This sensorio-motorial reaction to prism correction has been given the name of anomalous movements (a.m.). Quantification of a.m. has been made according to the amount of prisms that an esotropic patient is capable of compensating for (progressive prism compensation test - p.p. test). Some esodeviation does not compensate for any prisms at all since a.m. have not yet developed. Other cases compensate for as much as 40 or 60 prism diopters and more of over-correction of the angle deviation and they therefore have powerful a.m. The interference of these innervational forces acting on the medial recti to corrective surgery has been studied in 126 operated esotropic patients. A significant decrease from the expected surgical result (p < 0.001) has been found in patients having powerful a.m., as can be judged by the p.p. test. It is believed that a.m. are an important drawback contributing to vitiate any formula on the amount of muscle surgery to be performed in patients having no possibilities of restoring normal binocular vision.Practical advice on how to eliminate this drawback and theoretical reasoning on the significance of a.m. are offered. 相似文献
304.
本文报道了肠系膜上静脉与下腔静脉侧侧分流术7例,并介绍了手术的体会,认为应解剖、暴露肠系膜上静脉“外科干”与相应平面的下腔静脉,清除两者间的增生组织,缩短两者的间距,才易取得手术成功。本术既可使门静脉压下降适中,又对门静脉向肝血流干扰较小,且对组织损伤较轻。 相似文献
305.
无框架MRI导航下的内镜经蝶鞍区肿瘤切除术 总被引:1,自引:0,他引:1
目的探讨无框架MRI导航系统在内镜经蝶垂体腺瘤和颅咽管瘤切除术中的作用.方法对8例垂体腺瘤和2例颅咽管瘤病人在无框架MRI影像导航引导内镜下经蝶入路切除肿瘤.结果机器定位误差平均1.5mm,重要结构和病变定位满意,导航注册时间平均5 min,手术时间平均50min,术后病人症状均减轻.结论在内镜经蝶鞍区手术治疗中,无框架影像导航使重要结构及病变定位准确,可在手术中发挥重要作用. 相似文献
306.
Resection of pulmonary metastases following chemotherapy for high stage testicular tumors 总被引:2,自引:0,他引:2
SAADETTIN Y ESKICORAPCI SINAN EKICI M NECMETTIN ATSU RIZA DOGAN HALUK OZEN 《International journal of urology》2004,11(8):634-639
BACKGROUND: Our objective was to analyze retrospectively our experience with 19 patients who had metastatic germ cell testicular tumor and had undergone resection of pulmonary metastases following chemotherapy. We wished to determine the necessity of thoracic surgery on these patients. METHODS: Of 103 patients in need of postchemotherapeutic surgery for metastatic germ cell testicular tumors, 19 patients (mean age 31) underwent surgery for thoracic masses following cis-platin based chemotherapy. Resection of pulmonary metastases was performed on patients with normal tumor markers after chemotherapy, who did not achieve complete radiological remission. Histopathological findings, correlation with the pathology of abdominal surgery and probable prognostic factors for disease-free and overall survivals were evaluated. RESULTS: Disease-free and overall survival rates were 14/19 (73%) and 16/19 (84%), respectively, within a median follow-up time of 30 months (15-212 months). Patients with and without viable tumor cells in their thoracic histopathological specimen had 40% and 85% disease-free survival rates, respectively (P < 0.05). Eight patients had both abdominal and thoracic postchemotherapy surgery. Only two (25%) of these patients had the same histopathological features at both sites. CONCLUSIONS: All patients with residual thoracic masses must be considered candidates for surgery, because there are no predictive factors to determine the thoracic pathology without surgery. With the resection of the pulmonary metastases only, surgery can be performed without significant morbidity and is essential to select patients for further chemotherapy, to remove all visible masses and to provide histopathological confirmation. Patients with viable tumor cells in the thoracic surgical specimen have a poor prognosis. 相似文献
307.
Combined large cell neuroendocrine carcinoma 总被引:1,自引:0,他引:1
Toshiya Bessho Keiya Yokochi Teruhisa Sakurai 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2004,52(9):426-428
We report a case of combined large cell neuroendocrine carcinoma. A 78-year-old man with vertigo was referred to our hospital
where chest X-ray revealed a tumor shadow in the right lung. A transbronchial lung biopsy specimen verified a diagnosis of
non-small cell lung carcinoma (cT1N0M0). Right lower lobectomy with mediastinal lymph node dissection (#7,8,9) was performed.
A postoperative histological diagnosis was combined large cell neuroendocrine carcinoma of a component of squamous cell carcinoma
[pT4 (pm) N2M0]. The patient received concurrent chemoradiotherapy due to upper mediastinal lymph node metastasis 4 months
after surgery. The chemoradiotherapy well responded and the patient remains well 9 months after surgery. 相似文献
308.
目的 探讨鼻窦CT扫描在内窥镜鼻窦手术中的应用价值。方法 回顾性对80例慢性鼻窦炎患者鼻窦CT扫描与手术中所见进行分析总结。结果 冠状位CT扫描鼻窦病变发现率高,辅以水平CT扫描,鼻窦精细结构、病变范围和程度能够清楚地显示,符合术中所见。结论 鼻窦CT扫描能精确显示鼻窦结构及病变,能正确指导鼻窦内窥镜手术。 相似文献
309.
儿童白内障术后远期结果的研究进展 总被引:1,自引:1,他引:0
本文对近几年一些学者对儿童白内障远期随访结果进行了综述和评价。手术时机选择、儿童特殊的屈光变化以及如何精确测定儿童植入人工晶状体性能及屈光度都对儿童白内障术后远期视功能产生影响。慢性青光眼是儿童白内障术后远期丧失视力的主要原因。长期弱视治疗是获得手术成功的保证之一。因此,要真正获得有用的视功能,应重视儿童白内障手术后的后续治疗,并提议应建立完善的白内障术后追踪随访和弱视治疗机构。 相似文献
310.
Fredrik Ghosh Karl Engelsberg Robert V. English Robert M. Petters 《Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie》2007,245(6):835-846
Background The purpose of this study was to explore neuroretinal transplantation in a large animal model of severe retinitis pigmentosa
and to establish graft development, long-term survival, graft-host integration, and effects on the host retina.
Methods Rhodopsin transgenic pigs, aged 6 months, received in one eye a fetal full-thickness neuroretinal sheet in the subretinal
space by means of vitrectomy and retinotomy. Six months postoperatively, eyes were studied in the light microscope and with
immunohistochemical markers. Full-field electroretinography (ERG) was performed at 4 and 6 months.
Results Laminated grafts with well-organized photoreceptors, rod bipolar cells, and Müller cells were found in five of six eyes. Neuronal
connections between graft and host retina were not seen. In the five eyes containing a graft, the number of surviving rods
in the host retina was significantly higher compared with unoperated eyes. The ERG did not reveal any significant difference
in b-wave amplitude between operated and control eyes, but the cone-derived response in operated eyes increased significantly
from 4 to 6 months while the rod response in control eyes decreased significantly.
Conclusions Fetal full-thickness neuroretina can be transplanted safely to an eye with severe retinal degeneration. In their major part,
the transplants develop a normal laminated morphology and survive for at least 6 months. Graft and host retinal neurons do
not form connections. Retinal function in the host is reduced initially by the surgical trauma, but the presence of a well-laminated
graft counteracts this effect and rescues rods from degeneration.
Supported by The Foundation Fighting Blindness (grant# C-NC02-798-0078), The Faculty of Medicine, University of Lund, The
Swedish Research Council, The Princess Margaretas Foundation for Blind Children, The 2nd ONCE International Award for New
Technologies for the Blind. 相似文献