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41.
Tadeusz F. Wisniewski 《European Journal of Trauma》2004,30(2):120-123
AbstractBackground: Posterior acromioclavicular dislocation is rare.
Dislocation associated with fracture of the clavicle and
simultaneous entrapment of the lateral end of the clavicle by
trapezius muscle has not been reported. Posterior dislocation
occurs frequently owing to forceful move of the scapula
anteriorly and superiorly or from direct force applied to the
lateral end of the clavicle and this may be associated with
clavicular fracture. In acute dislocations, open reduction,
internal joint stabilization and soft tissues reconstruction
have been recommended.Case Study: Acute posterior dislocation occurred in a 32-year-old man.
The lateral end of the clavicle was displaced posteriorly and
inferiorly, and firmly entrapped in trapezius muscle. The
clavicular fracture was undisplaced. The coracoclavicular
ligaments were stretched but intact. Open reduction was secured
with two smooth Kirschner wires. The disrupted soft tissues were
repaired. The clavicular fracture was not explored. Shoulder
movement started at 6 weeks. Wires were removed. 10 years later
he had pain-free, unrestricted shoulder movement, and the
radiographs showed wellreduced, essentially normal
acromioclavicular joint.Conclusion: Open reduction, internal joint stabilization and soft
tissue reconstruction will result in return and long lasting
unrestricted pain-free function of the shoulder. 相似文献
42.
Abstract Kyphoplasty and vertebroplasty have become recognized procedures for the treatment of vertebral fractures, especially in patients
with osteoporosis. In most cases of osteoporotic spinal vertebral fracture in elderly patients, polymethylmethacrylate (PMMA)
cement is used to fill the defect and stabilize the vertebral body. The techniques of vertebroplasty and kyphoplasty differ
in the possibility of realignment and reconstruction of the vertebral body and spinal column. Long-term results in terms of
integration of the cement and bioreactivity of the vertebral body are still lacking; so, these procedures are still no options
in the treatment of younger patients. Vertebroplasty and kyphoplasty show different success in the management of fresh traumatic
spine fractures. The acute traumatic vertebral fracture has to be classified sensitively, to find the right indication for
cement augmentation. Mild acute compression fractures can be treated by vertebroplasty or kyphoplasty, severe compression
and burst fractures by combination of internal fixation and kyphoplasty. The indications for use of biological or osteoinductive
cement in spinal fracture management must still be regarded as restricted owing to the lack of basic biomechanical research
data. Such cement should not be used except in clinical studies. 相似文献
43.
Abstract
Purpose:
Evaluation of the therapeutic usefulness of
the “pelvic C–clamp” (PCC) during emergency treatment
of multiply injured patients with unstable disruption
of the posterior pelvic ring.
Patients and Methods:
The data of 28 patients with
polytrauma in combination with an unstable fracture
of the posterior pelvic ring (average Injury Severity
Score [ISS]: 49 points; average Polytrauma Score [PTS]:
41 points) were retrospectively analyzed from the
moment they were admitted to the emergency room
until 48 h after admittance. The PCC was used immediately
for primary stabilization of the pelvis after
clinical diagnosis of the unstable pelvic fracture. Main
outcome measurements: development of mean blood
pressure, development of oxygenation level, period of
time until the PCC was placed, number of blood units
needed, period of time until circulatory stabilization
occurred.
Results:
The PCC was applied in all cases within an average
of 64.7 min after trauma. Seven patients (25%) died
within the first 45 min after admission. The surviving
patients showed:• an increase in mean blood pressure of 25% 20 min after
application of the PCC,• a hemodynamic stabilization 6 h after application of
the PCC,• a stabilization of the oxygenation level 6 h after application
of the PCC,• a decrease in the number of required blood units 6 h
after application of the PCC.
Conclusion:
The present study shows, that the application
of the PCC to critically injured patients with unstable
pelvic fractures leads to stabilization of the vital parameters
within a short period of time. 相似文献
44.
45.
46.
W. B. Quay 《Journal of neural transmission (Vienna, Austria : 1996)》1981,52(1-2):107-115
Summary Quantitative aspects of the microanatomy of the pineal gland and other neuroendocrine and circumventricular structures were studied in a small, reproductively suppressed, female Naked Mole-rat from central Kenya, Africa. The atrophic pineal is the smallest in absolute size (0.002135 mm3) of any so far described in a species of rodent, and in size relative to body weight is second only to that of another tropical species. The subcommissural organ and posterior collicular recess are also relatively small and less well differentiated than those in most other examined rodent species. In contrast, the subfornical organ, OVLT and median eminence are large and well vascularized. It is concluded that the pineal in this species follows the previously described trend among rodents of relatively smaller size in species whose centers of distribution are in lower latitudes. Although the pineal is atrophic, the Naked Mole-rat still exhibits 24-hour and seasonally timed patterns of behavior and seasonal reproduction. However, in this species these events are probably cued by moisture, temperature and social factors rather than by photic information. 相似文献
47.
A. Ian Smith Catherine A. Wallace Lain J. Clarke John W. Funder 《Journal of neuroendocrinology》1989,1(5):357-362
In the sheep, unlike many other species, a significant proportion (>25%) of immunoreactive β-endorphin in the anterior pituitary is post-translationally modified to opioid-inactive, α-N-acetylated forms. In a study to determine the precise molecular nature of α-N-acetylated β-endorphin immunoreactivity, we noted a striking difference in high-performance liquid chromatography profiles of anterior pituitary extracts between sheep killed on the farm, and age-, sex- and strain-matched slaughterhouse animals. These altered patterns of a-N-acetylated β-endorphin processing were reproduced in farm animals by chronic (≤ 4 days) treatment with the synthetic glucocorticoid dexamethasone; in contrast dexamethasone had no effect on a-N-acetylated β-endorphin processing in hypothalamo-pituitary disconnected sheep. These data suggest that (1) the change in processing is a stress response, mediated by prolonged glucocorticoid exposure, (2) this effect is central, rather than a direct effect on the pituitary, and (3) the relative abundance of various peptide sequences in slaughterhouse-derived material may not reflect their abundance under more physiological conditions. 相似文献
48.
Effects of ageing on the total number of muscle fibers and motoneurons of the tibialis anterior and soleus muscles in the rat 总被引:1,自引:0,他引:1
The age-related changes in the total number of muscle fibers and motoneurons of the tibialis anterior and soleus muscles were studied using 10-, 65-, and 135-week-old rats. The number of fast twitch muscle fibers was decreased at age 65 weeks, while the numbers of slow twitch fibers and of alpha motoneurons were decreased only later, at age 135 weeks. Therefore, the degenerative process of muscle fibers differs with the fiber type. 相似文献
49.
李云侠 《眼外伤职业眼病杂志》2009,31(11):859-860
目的观察复合小梁切除术治疗青光眼的疗效。方法用青光眼复合小梁切除术54例(54眼),观察术后眼压、滤过泡及前房形成情况,随访3~24个月。结果54眼分别于术后3~15d拆除可调整缝线,术后发生浅前房3眼,发生率5.56%,眼压在18mmHg以下者52眼,控制率96.30%。结论复合小梁切除术既可避免术后早期滤过过强、眼压过低引起的并发症,又可安全的改善滤过,减少滤过区瘢痕形成,提高手术成功率。 相似文献
50.