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71.
72.
Ulf Kristoffersson Sverre Heim Nils Mandahl Lennart Sundkvist Jan Szelest Inga Hägerstrand 《Clinical genetics》1987,32(3):169-171
A child with multiple anomalies, including growth retardation, a left-sided diaphragmatic hernia with lung hypoplasia, and cerebral malformations is described. Cytogenetic investigation demonstrated a deletion of the distal part of one chromosome 15, del(15)(q24qter), an aberration not previously described. Family studies revealed that the mother had a balanced translocation, t(6;15)(p25;q24). Two of her subsequent pregnancies resulted in abortions after prenatal diagnosis: one fetus was trisomic for 15q24→qter, while the other had monosomy 15q24→qter and a left-sided diaphragmatic hernia similar to the first child. 相似文献
73.
M. E. De Paepe Konstantinos Papadakis Brian D. Johnson Francois I. Luks 《Virchows Archiv : an international journal of pathology》1998,432(1):7-16
Tracheal occlusion in utero has been shown to cause accelerated fetal lung growth and is now being considered as a therapeutic
modality for pulmonary hypoplasia. We report the effects of tracheal ligation on the surfactant-producing type II pneumocyte
population. Three groups of fetal lambs underwent tracheal ligation of 2 weeks’, 4 weeks’ and 6 weeks’ duration, respectively,
and all were sacrificed at 136 days’ gestation (9 days pre-term). Nonoperated twins served as controls. The type II pneumocyte
population was studied morphometrically using a combination of anti-surfactant protein B immunohistochemistry and computer-assisted
stereologic morphometry at light and electron microscopic levels. Single-factor ANOVA was used for statistical analysis. Two
weeks of tracheal ligation resulted in doubling of the total lung volume as a result of airspace distension and, to lesser
extent, growth of the tissue compartment. With increasing duration of tracheal ligation, there was no additional lung growth.
However, more prolonged tracheal occlusion was found to result in significant reduction of the surfactant system, as reflected
in the marked decrease of total pneumocyte type II volume (3.14 cm3, 0.95 cm3, and 0.46 cm3, after 2, 4, and 6 weeks of ligation, compared with 5.96 cm3 for controls) and total pneumocyte type II number (13.9 × 109, 3.8 × 109, and 2.4 × 109, compared with 53.2 × 109 for controls). Ultrastructural analysis of the type II cells in obstructed lungs showed vacuolar degenerative changes that,
after 6 weeks of ligation, were apparently irreversible. In utero tracheal ligation causes fetal lung hyperplasia, but results
in reduction of and injury to the surfactant-producing cell population. Before tracheal occlusion can find widespread clinical
application, its pathophysiology needs to be further elucidated.
Received: 30 April 1997 / Accepted: 10 July 1997 相似文献
74.
75.
Respiratory failure from pulmonary hypoplasia continues to be the major cause of death in newborn infants with diaphragmatic hernia. Recent investigations have suggested that postnatally induced pulmonary injury can result from excessive positive or negative intrathoracic pressure and contribute to the respiratory deterioration. Therefore, the method of thoracic drainage on the side of the diaphragmatic hernia is critical in controlling and maintaining normal intrathoracic pressure in both intrathoracic spaces. No chest tube or an ipsilateral chest tube connected to water seal, can result in either excessive negative or positive intrathoracic pressure and, therefore, both methods should be avoided. Recently, we employed a "balanced" intrathoracic drainage system which maintains the ipsilateral intrathoracic pressure within the normal physiologic range of +2 to -8 cm H2O regardless of the degree of pulmonary hypoplasia, presence of an ipsilateral pulmonary air leak, straining by the infant, or mechanical ventilation. This system is simple, requires no suction apparatus, and is easily assembled with equipment readily available within the hospital. This technique has been utilized in 18 newborn infants with diaphragmatic hernia and pulmonary hypoplasia. There have been no complications which specifically could be related to the balanced drainage system. 相似文献
76.
苏宏伟 《中国卫生标准管理》2021,(7):165-168
目的探析腹腔镜与传统手术治疗小儿腹股沟斜疝的临床效果。方法集合本院2016年1月-2019年9月期间接收小儿腹股沟斜疝(年龄<13周岁)234例,以实际治疗术式来分组,传统手术组201例,腹腔镜组33例,对比组行传统手术,腹腔镜组予以腹腔镜手术治疗,对比两组术中失血量、住院时间、初次下床活动时间、术后禁食时长、治疗费用,统计术后并发症并行组间对比。结果此次研究显示腹腔镜组术中失血量更少、术后禁食时长及初次下床活动时间更短(P<0.05),住院时间及、治疗费用组间对照中,腹腔镜组住院时间显著更短但治疗费用显著更高(P<0.05),术后并发症统计显示,腹腔镜组并发症发生率显著更低(P<0.05)。结论在小儿腹股沟斜疝治疗中腹腔镜手术虽费用较高,但患儿术后并发症更少,恢复更快,可优先选用。 相似文献
77.
目的:探讨腰椎间盘突出症合并神经根管狭窄的临床诊断和手术治疗。方法:对1996-1999年间,因腰椎间盘突出症合并神经根管狭窄38例行手术治疗,术中均行神经根管探查并彻底松解受压神经根。结果:术后随访38例,优20例,良15例,一般2例,差1例,优良率92.11%。结论:神经根管扩大和神经根探查彻底减压是手术成功的关键。 相似文献
78.
79.
Akin Calisir Ilhan Ece Huseyin Yilmaz Husnu Alptekin Bayram Colak Serdar Yormaz Murat Gul Mustafa Sahin 《Andrologia》2021,53(2):e13947
Pain during sexual activity and ejaculation are the unspoken long-term complications of groin hernia repair. Laparoscopic surgical techniques are associated with decreased post-operative pain and earlier return to daily activities, but its effect on these complications is unclear. This study aims to investigate the effect of transabdominal preperitoneal repair (TAPP) on de-novo pain during sexual intercourse and ejaculation and to compare with open repair. For this reason, two groups were determined according to the surgical technique: the Lichtenstein repair and the TAPP groups and a questionnaire was sent to the patients a minimum of 6 months following the surgery. A total of 317 patients included, as 115 in TAPP and 202 in Lichtenstein repair group. No significant difference was observed concerning pre-operative pain during sexual activity and ejaculation in both groups (p = .75, p = .56). Following the surgery, the number of patients experiencing painful sexual activity was significantly higher in the Lichtenstein repair group compared to the TAPP group (19.3% vs. 11.3%, respectively, p = .03). The post-operative painful ejaculation rate was also significantly lower for the TAPP group (p = .04). The lower rates of post-operative dysejaculation and pain during sexual activity can be achieved with the advantage of laparoscopic surgery. 相似文献
80.
Matthew J. Reilly Nicholas K. Larsen Swati Agrawal Finosh G. Thankam Devendra K. Agrawal Robert J. Fitzgibbons 《American journal of surgery》2021,221(5):942-949
BackgroundIncisional hernias (IH) following a laparotomy, on average, occur in 10–20% of patients, however, little is known about its molecular basis. Thus, a better understanding of the molecular mechanisms could lead to the identification of key target(s) to intervene pre-and post-operatively.MethodsWe examined the current literature describing the molecular mechanisms of IH and overlap these factors with smoking, abdominal aortic aneurysm, obesity, diabetes mellitus, and diverticulitis.ResultsThe expression levels of collagen I and III, matrix metalloproteinases, and tissue inhibitors of metalloproteases are abnormal in the extracellular matrix (ECM) of IH patients and ECM disorganization has an overlap with these comorbid conditions.ConclusionUnderstanding the pathophysiology of IH development and associated risk factors will allow physicians to identify patients that may be at increased risk for IH and to possibly act preemptively to decrease the incidence of IH. 相似文献