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91.
Prof. Paul Bonnevialle Yves Bellumore Michel Mansat 《Operative Orthopadie und Traumatologie》1996,8(4):243-251
Summary
Goal of Surgery Stable internal fixation of extraarticular proximal humeral fractures.
Indications Extraarticular fractures angulated more than 30° which can be reduced closely or through a small incision.
Epiphysiolysis.
Fracture-dislocation of the humeral head.
Contraindications Pathological fractures.
Four part fractures.
Segmental fractures of the humerus.
Positioning and Anaesthesia Supine; the affected shoulder overhanging the edge of the table and supported by a radiolucent board.
General or regional anaesthesia.
Surgical Technique Closed pinning of two part and certain three part fractures of the proximal humerus being displaced, unstable, and mainly
at the metaphyseal level.
Introduction of Kirschner wires through a diaphyseal window and advancement into the proximal fragments after reduction which
is controlled by image intensification.
Postoperative Management Temporary immobilization in a sling.
Passive and active assisted movements after a few days.
Active movements after 2 weeks.
Removal of wires after 3 months.
Possible Complications Fracture of the humerus at the site of the cortical window. Injury to the radial nerve.
Results 32 patients, mean age 49 years, 30 two part fractures and 2 three part fractures. Number of Kirschner wires used: 3 to 6,
mean 4. Two out of 3 patients complained of pain at the site of wire insertion. All fractures consolidated. No avascular necrosis
nor infection.
Complications: Partial loss of internal fixation in 3 patients. One fracture of the humeral shaft. Sympathetic reflex dystrophy
in 3 patients. Half of the patients had a normal range of motion. Time of follow-up: 6 to 24 (mean 10) months.
Division of Orthopaedics and Traumatology, Purpan Hospital, Toulouse, France. 相似文献
92.
介绍中指近节背侧岛状皮瓣的应用解剖,该皮瓣的营养动脉为第2掌背动脉,位置表浅,解剖容易,安全可靠。自1990年11月以来,应用该皮瓣修复手部软组织缺损共6例,均获成功。 相似文献
93.
Jens Chr Møller 《Virchows Archiv : an international journal of pathology》1987,410(2):153-158
Summary The study was carried out to determine the proximal tubular length, surface area and length of peritubular capillaries and the nephron numbers in kidneys with chronic nephropathy and varying increase in the cortical interstitial volume. Kidneys of pigs with varying chronic obstructive nephropathy were used for the experiments. Two subgroups of ureterobstructed kidneys were defined arbitrarily according to the volume of cortical interstitium. One subgroup (I) comprised kidneys with a volume fraction of cortical interstitium less than 30% (mean 17.2%; mean of controls 9.7%). The other subgroup (II) consisted of kidneys with severe chronic nephropathy and with a volume fraction of interstitium more than 30% (mean 44.5%). Proximal tubular length and length and surface area of peritubular capillaries were assessed by conventional morphometric techniques on 1 m thick sections of plastic embedded material. Nephron numbers were determined by a stereological method for counting glomeruli.The results demonstrated that proximal tubular length and capillary dimensions were significantly reduced in subgroup II, whereas no significant changes were observed in subgroup I. The mean number of glomeruli was not significantly different from control values in any of the subgroups.The results are in line with observations from previous quantitative analyses of proximal tubular cross-sections indicating that proximal tubular dimensions become reduced mainly at advanced stages of chronic nephropathy. The results also indicate that shortening of individual tubules rather than loss of entire nephrons is responsible for the observed reduction in total length of proximal tubules. Finally, the present observations suggest that reduced dimensions of the cortical capillary network may have pathogenetic significance for ongoing proximal tubular atrophy in chronic renal desease. 相似文献
94.
Arterial endothelial function in a porcine model of early stage atherosclerotic vascular disease 总被引:2,自引:0,他引:2
Turk JR Henderson KK Vanvickle GD Watkins J Laughlin MH 《International journal of experimental pathology》2005,86(5):335-345
Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in the United States and is projected to become the leading cause of mortality in the world. Atherosclerosis is the most important single factor contributing to this disease burden. In this study, we characterize relationships between endothelial dysfunction and vascular disease in an animal model of diet-induced, early-stage atherosclerotic vascular disease. We tested the hypothesis that hypercholesterolaemia induces vascular disease and impairs endothelium-dependent relaxation (EDR) in conduit arteries of adult male Yucatan pigs. Pigs were fed a normal fat (NF) or high fat cholesterol (HFC) diet for 20-24 weeks. Results indicate that, while the HFC diet did not alter EDR in femoral or brachial arteries, EDR was significantly decreased in both carotid and coronary arteries. Sudanophilic fatty streaks were significantly present in the abdominal aorta and common carotid artery. Histopathology revealed increased intima-media thickness (IMT) and foam cell accumulation in Stary Stage I-III lesions in the abdominal aorta, common carotid artery and femoral arteries. In the coronary arteries, the accumulation of foam cells in Stary Stage I and II lesions resulted in a trend for increased IMT. There was no evidence of vascular disease in the brachial arteries. These results indicate that early stages of CVD (Stary Stage I-III) precede decreases in EDR induced by HFC diet, because femoral arteries exhibited foam cell accumulation and an increased IMT but no change in endothelial function. 相似文献
95.
采用成年狗正常股动脉段6例,测定其拉伸后的压力一容积关系,并求出其顺应性。另取狗股狗股动脉段30例拉伸固定后,观测其形态结构变化。发现狗股动脉段拉伸后的P-V曲线可用抛物线来拟合,狗股动脉段拉伸15%后顺应性明显下降,其形态结构无明显改变,拉伸30%后才出现明显的结构改变。狗股动脉拉伸后顺应性变化的出现较形态结构变化早。 相似文献
96.
背景:随着疾病治疗模式的改变,人们已经意识到中医药在激素性股骨头坏死治疗过程中的重要性,因此利用生物信息学从分子水平分析激素性股骨头坏死的发病机制,构建疾病风险模型,并预测具有潜在治疗作用的中药,为后期中医药治疗激素性股骨头坏死提供一定的理论依据。目的:基于生物信息学挖掘激素性股骨头坏死的竞争性内源RNA(ceRNA)调控网络,分析其在激素性股骨头坏死中的分子调控机制,预测相关疾病靶点并构建疾病风险模型,同时预测具有潜在治疗作用的中药。方法:检索GEO数据库,下载激素性股骨头坏死的矩阵文件GSE123568和基因注释文件GPL15207。借助R语言等软件分析得到差异表达的长链非编码RNA与mRNA,并通过公共数据库预测与差异表达长链非编码RNA关联的miRNA-mRNA,再将预测到的mRNA与差异表达mRNA取交集,整合得到ceRNA网络。随后采用STRING数据库和Cytoscape软件筛选关键基因,利用R语言分析关键基因的功能与相关通路,并挖掘关键ceRNA网络。最后根据关键基因构建激素性股骨头坏死的风险模型,并进行中药预测。结果与结论:(1)与健康对照相比,激素性股骨头坏死患者共有7个长链非编码RNA和1763个mRNAs存在差异表达;(2)筛选出STAT3、KAT2B、AGO4、JAK2、JAK1、PTGS2共6个关键基因;(3)关键基因所富集的功能包括对肽激素的反应、白细胞介素6介导的信号通路、细胞对白细胞介素6的反应等生物学过程,涉及JAK-STAT、脂肪细胞因子、催乳素等信号通路;(4)4种mi RNAs(mi R-135a-5p、mi R-137、mi R-17-5p、miR-20b-5p)和2种长链非编码RNA(SNHG11、C20orf197)可能在导致激素性股骨头坏死发生发展过程中发挥关键作用;(5)KAT2B最有可能是激素性股骨头坏死发生发展的风险因子;(6)郁金、淫羊藿、黄芪具备治疗激素性股骨头坏死疾病靶点的可能。通过对激素性股骨头坏死相关长链非编码RNA介导的ceRNA网络进行分析,识别出潜在的疾病靶点、信号通路及潜在治疗中药,为进一步阐明其发病机制,并为后续的实验研究提供参考依据。 相似文献
97.
John M. Opitz Gunnar B. Stickler James F. Reynolds 《American journal of medical genetics. Part A》1987,27(4):971-975
We report on a consanguineous Brazilian couple whose 2 children had tibial aplasia-ectrodactyly. Femoral bifurcation was present in one of the affected children. The relationship of tibial aplasia-ectrodactyly to the Gollop-Wolfgang complex is discussed. Clinical and genetic aspects of the conditions involving tibial aplasia and femoral bifurcation are discussed. 相似文献
98.
J. Schnermann H. Valtin K. Thurau W. Nagel M. Horster H. Fischbach M. Wahl G. Liebau 《Pflügers Archiv : European journal of physiology》1969,306(2):103-118
Summary Micropuncture studies were carried out on rats with hereditary hypothalamic diabetes insipidus, in order to measure net sodium and water reabsorption in proximal convolutions and short loops of Henle during water diuresis and ADH-induced antidiuresis. Intravenous infusion of 0.15 mU ADH per minute reduced urine flow from 74.5 l per kidney per minute to 10.8 l, and increased urine osmolality from 117 to 605 mOsm/kg. These changes could be reversed by stopping ADH.ADH did not alter the fractional reabsorption of fluid or the reabsorptive capacity for sodium in the proximal tubules. Nor did it change glomerular filtration rates of single superficial nephrons or of the entire kidney.Fractional reabsorption of the glomerular filtrate up to the early distal convolution was significantly higher (82.0%) in water diuresis than in antidiuresis (74.4%). Since this reabsorption remained unchanged in the proximal convolutions, the decreased reabsorption during antidiuresis must have occurred in the short loops. Fractional reabsorption of sodium up to the early distal tubule was essentially identical during water diuresis and antidiuresis, indicating that ADH does not enhance urinary concentration by increasing the reabsorption of sodium from short loops.On leave of absence from the Department of Physiology, Dartmouth Medical School, Hannover, N. H., from January to June, 1967. Recipient of USPHS Research Career Program Award 5-K3-GM-21, 786. 相似文献
99.
为探讨细胞外间质主要成分透明质酸(HA)与层粘连蛋白(LN)在缺血性股骨头坏死(INFH)中的生理病理过程及临床价值,采用放射免疫分析法对45例不同病因的INFH患者进行了血清HA与LN的定量分析,并与30例正常人对照。结果显示,INFH患者血清HA含量极显著地高于对照组(t=3-29;P<0-01)。尤以激素性INFN增高最为显著(t=3-62;P<0-01)。INFH患者LN含量亦明显高于对照组(t=2-84;P<0-01)。同时,HA与LN含量增高与病程发展密切相关。故定量检测HA与LN可作为INFH早期诊断及判断预后的良好指标 相似文献
100.
[摘要] 目的 对比分析人工肱骨头置换术和肱骨近端锁定钢板治疗老年复杂肱骨近端骨折的近期疗效。方法 回顾性分析本院骨科2012年1月~2014年6月采用人工肱骨头置换术和肱骨近端锁定钢板治疗的老年(年龄>65岁)NeerⅢ、Ⅳ部分肱骨近端骨折患者54例,人工肱骨头置换治疗(置换组)30例,肱骨近端锁定钢板内固定治疗(内固定组)24例。比较分析两组手术时间、术中出血量、随访Neer评分及Constant-Murley评分来评定两组临床疗效。结果 两组随访时间相仿,平均随访时间为19.5个月(12~36个月)。内固定组手术时间(101±13)分钟,术中出血量(237.9±32.4)mL,Neer评分(82.5±3.2),Constant-Murley评分(71.7±5.0);置换组手术时间(98±11)分钟,术中出血量(246.0±39.8)mL,Neer评分(82.9±4.5),Constant-Murley评分(73.5±5.0)。两组手术时间、术中出血量、随访Neer及Constant-Murley评分比较差异均无统计学意义(P>0.05)。内固定组有1例出现肩关节半脱位,肱骨头置换组有2例出现肩关节半脱位,通过三角巾悬吊后关节脱位均得到纠正。有1例四部分骨折患者,行内固定术后出现内固定松动、肱骨头坏死,改行人工肱骨头置换术。结论 人工肱骨头置换术和肱骨近端锁定钢板治疗老年肱骨近端复杂骨折的近期临床疗效相似,对不可修复的肱骨近端骨折宜行肱骨头置换术。 相似文献