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81.
A 78-year-old woman is described who presented with a diaphragmatic hernia through the foramen of Morgagni. A definitive
diagnosis was confirmed by a sagittal view on magnetic resonance imaging prior to surgery. The hernia was repaired laparoscopically
under an abdominal wall lifting technique without pneumoperitoneum, and her symptoms completely resolved postoperatively with
no evidence of recurrence. The laparoscopic repair was considered a suitable and safe procedure for the treatment of a Morgagni
hernia.
Received: 3 April 1996/Accepted: 3 May 1996 相似文献
82.
Bilateral continuous paravertebral block used for postoperative analgesia in an infant having bilateral thoracotomy 总被引:3,自引:0,他引:3
We describe the successful postoperative pain management in an 11-month-old infant who underwent bilateral thoracotomy, using continuous infusions of bupivacaine into two directly placed paravertebral catheters. Haemodynamic parameters and pain scores were measured 1–2 h for 60 h while the infusions were continued and, intermittently, blood samples were taken for subsequent measurement of serum bupivacaine concentrations. The technique provided effective pain relief and the infant required no other analgesia postoperatively. There were no adverse haemodynamic consequences or complications relating to either catheter placement or drug infusions. Serum concentrations of bupivacaine remained below toxic levels throughout the study period, though accumulation did occur. 相似文献
83.
Success of meniscal repair with early or immediate motion depends on the ability of the suture fixation to withstand the loads applied. Vertical and horizontal mattress suture techniques were tested using 2-0 Ethibond, and 0-PDS and 1-PDS sutures (Ethicon, Somerville, NJ). Mulberry knot technique was tested with 0-PDS and 1-PDS sutures. Twenty menisci (60 sutures) were tested for each suture material. Sutures were placed 3 to 4 mm from the peripheral edge of the meniscus with double barreled cannulas for vertical and horizontal mattress techniques or a spinal needle for the mulberry knot technique, reproducing clinical techniques of meniscal repair. Mechanical testing of suture fixation was performed to failure at a rate of 10 mm/min on a MTS material testing system (MTS Systems Corp. Minneapolis, MN). Suture pullouts were reported as the load displacement to failure from the inner fragment only, because clinical failure would ensue should a suture pull through the inner fragment of a tear. Vertical mattress technique with 1-PDS suture had significantly greater load to failure than any other combination (P < .05). Analysis of variance showed that the vertical mattress technique had statistically superior pullout strength (P < .0001) compared with the horizontal mattress and mulberry knot techniques, which were statistically similar. There were significant differences (P < .0001) between suture types, with 1-PDS proving best compared with 0-PDS, which was stronger than 2-0 Ethibond. Selection of suture material had the greatest impact on vertical mattress load to failure and was not important to the strength of the other techniques. 相似文献
84.
Summary. We present a case of primary plasmocytoma of the left upper bronchus. Occlusion led to atelectasis of the left upper lobe
and subsequent poststenotic pneumonia. Therapy consisted of local excision of the bronchus and postoperative radiotherapy.
This type of lung-conserving therapy in a case of primary plasmocytoma has not been described before.
相似文献
85.
Patch testing was carried out in 851 atopic patients; 181 atopic dermatitis (AD) patients were additionally tested with 50% dilutions of the test substances. The occurrence of allergic and irritant reactions was frequent, being 57% and 33% for AD patients aged 28-41 years and 19-27 years, respectively. Among age-matched allergic rhinitis (AR)/allergic conjunctivitis (AC) or asthma (A) patients, the number of allergic reactions varied from 25 to 30%, and for irritant reactions was 24%. In all groups, nickel, fragrance-mix, balsam of Peru and neomycin were the commonest allergens. Contact allergy to ingredients of topical medicaments was common among AD patients and patients with severe and long-lasting dermatitis were most frequently sensitized. However, sensitivity to multiple substances was not common among those patients. The number of irritant reactions was considerable, but 50% dilution of the test substances did not solve the problem. 相似文献
86.
We present our approach to the preoperative preparation and anaesthetic management for awake craniotomy in a 12-year-old boy. Management included conscious sedation with a propofol infusion plus local anaesthetic infiltration of the scalp, periosteum, and dura. The complications which may be encountered during such procedures and their treatments are reviewed. 相似文献
87.
显微神经外科技术及翼点入路在鞍区肿瘤手术的应用 总被引:1,自引:0,他引:1
目的:总结98例鞍区肿瘤患者经翼点入路显微手术治疗及翼点入路应用体会。方法:按照翼点入路各项操作步骤行鞍区肿瘤切除98例,介绍了操作方法并讨论显微神经外科技术在鞍区肿瘤手术中的应用,及不同部位肿瘤作相应手术操作调整的方法。结果:鞍区肿瘤应用翼点入路进行显微手术操作可良好显露鞍区及肿瘤各显微解剖结构以及手术操作平台,使其肿瘤全切率及患者预后得到明显提高。结论:显微神经外科技术及翼点入路手术操作的掌握和熟练程度的提高是显微神经外科技术的关键及获得良好手术效果的基础。 相似文献
88.
89.
目的:探讨原发性肝癌(PHC)患者乙肝病毒(HBV)感染模式与血清甲胎蛋白(AFP)水平的关系。方法:应用酶免疫检测法(ELISA)、聚合酶链反应(PCR)及放射免疫技术分别测定100例原发性肝癌患者血清乙型肝炎病毒指标(HBV-M)及AFP。结果:100例PHC患者中,HBV-M阳性88例(88%),阴性12例(12%),HBV-M阳性者AFP水平高于阴性者147 ng/mL,二者有非常显著性意义(P<0.01),且HBV-M阳性者AFP升高(68.4%)的比例明显高于HBV-DNA阴性者(31.6%)(P<0.01)。PHC患者HBV感染模式分析中,HBsAg、HBeAb、HBcAb阳性和HBV-DNA阳性最多,为56例(63.6%),其次为HBsAg、HBeAg、HBcAb和HBV-DNA阳性,为9例(10.2%)。结论:HBV是原发性肝癌发生的重要原因,在PHC患者中,AFP升高与HBV感染、复制相关。 相似文献
90.
Sung-Jae Kim M.D. In-Seop Park M.D. Yong-Min Cheon M.D. Sang-Wook Ryu M.D. 《Arthroscopy》2004,20(10):481-1094
Recently, attention has been given to the double-bundle technique for treating the posterior cruciate ligament (PCL)-deficient knee. We present an arthroscopic PCL reconstruction using a double-bundle technique with 3-stranded tibialis posterior (TP) allograft that has not been described before. The anterolateral bundle of the PCL is reconstructed using 2-stranded TP allograft and the posteromedial bundle using 1-stranded TP allograft. Three-stranded TP allograft will be an alternative graft choice for PCL reconstruction. 相似文献