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11.
J. M. Bellón N. García-Honduvilla N. Serrano M. Rodríguez G. Pascual J. Buján 《Hernia》2005,9(4):338-343
The component of a composite prosthesis, which makes contact with the visceral peritoneum, can be reabsorbable or non-reabsorbable,
and laminar or reticular. This study was designed to determine whether the composition of this second, barrier component could
improve its behavior at this interface. Abdominal wall defects in rabbits were repaired using a polypropylene prosthesis (PP),
or the composites Sepramesh (PP+h) or Vicryl (PP+v). Fourteen days after surgery, the implants were evaluated by light and
scanning electron microscopy, and immunohistochemistry. Prosthetic areas occupied by adhesions (PP: 71.08±5.09, PP+h: 18.55±4.96,
P+v: 69.69±16.81%), neoperitoneal thickness (PP: 256.17±21.68, PP+h: 83.11±19.63, PP+v:213.72±35.90 μm) and macrophage counts
(PP: 8.73±1.16, PP+h: 27.33±4.13, PP+v: 31.24±3.08%) showed significant differences (P<0.05). The tested biomaterials induced an optimal recipient tissue infiltration. Least adhesion formation was observed on
the PP+h implants. This suggests that the second component, although reabsorbable, should be smooth in structure. 相似文献
12.
目的:报告不同类型的肌腱损伤的手术方法和效果,为临床工作提供参考依据。方法:2002年2月-2005年12月对98例不同类型的肌腱损伤进行显徼手术修复,平均随访17.5个月(6~24个月),根据术后功能恢复对术后效果进行评定。结果:优:58例(占59.2%);良:32例(占32.7%);差6例(占6.1%);失败:2例(占2%)。优良率:92%。结论:对不同类型的肌腱损伤,早期及时明确诊断正确选择术式修复,正确选择修补材料,术后积极功能锻炼,是治疗成功的关键。 相似文献
13.
Objective: Two major changes have occurred in inguinal hernia repair during the last two decades: (i) the use of tension‐free mesh repair; and (ii) the application of laparoscopic technique for repair. The aims of the present study were to study: (i) how inguinal hernia repair was carried out; and (ii) the outcome of inguinal hernia repair in Hospital Authority (HA) hospitals. Methodology: This was a retrospective analysis on 8311 elective inguinal hernia repairs performed in 16 HA hospitals from January 2001 to December 2003. The mean age was 63.9 ± 14.2 years, and the male to female ratio was 22.0 : 1.0. Among these, 869 (10.5%) repairs were performed with the laparoscopic approach and 7442 (89.5%) repairs with the open approach. The proportion of laparoscopic hernia repair increased from 8.7% to 12.6%. Results: For open repair, 39% of cases were carried out with regional anaesthesia, 32% with general anaesthesia and 29% with local anaesthesia (LA). Furthermore, mesh repair was used in 88% of the patients. For laparosocpic repair, 98.4% of cases were carried out under general anaesthesia, and all patients had mesh repair using the totally extraperitoneal approach. A significantly higher proportion of bilateral repair and recurrent hernia repair was performed with the laparoscopic approach (P = 0.000). For primary unilateral repair, there was no significant difference in the postoperative length of stay (LOS) and the total LOS between the laparoscopic and the open surgery groups. No difference in LOS was found in recurrent hernia repair between the two groups. With respect to bilateral repair, both the preoperative LOS (P = 0.036) and total LOS (P = 0.039) were shorter in the laparoscopic group. Furthermore, a significantly higher proportion of day‐surgery patients was observed in the laparoscopic group than the open surgery group (21.3%vs 16.9%, P = 0.001). Nevertheless, when only the results of 2003 were analyzed, the postoperative LOS (P = 0.000) and total LOS (P = 0.000) were significantly shorter in the laparoscopic group than the open surgery group. The LOS parameters were significantly shorter in the open surgery LA subgroup compared with the non‐LA subgroup (P = 0.000), and they were not different from those in the laparoscopic group. Conclusions: The open mesh repair is the predominant approach for inguinal hernia repair in HA hospitals. The originally described local anaesthetic approach was under utilized, although it resulted in good outcome. The use of laparoscopic hernia repair is increasing and a learning curve was recently observed with improved outcome. 相似文献
14.
Long Fibre Growth by Axons of Embryonic Mouse Hippocampal Neurons Microtransplanted into the Adult Rat Fimbria 总被引:1,自引:0,他引:1
We have described a method for the microtransplantation of a suspension of a few thousand cells from mid to late embryonic mouse hippocampi into the fimbria of immunosuppressed adult rat hosts. There was close graft-to-host contact, across a non-scarred interface. The transplanted cells included CA3 type pyramids, and were enclosed within the host myelinated fibre tract, whose glial framework was largely undisturbed. Immunohistochemistry of two species-specific markers (M6 and Thy-1.2) showed that the donor mouse neurons grew fine (<0.5 μm diameter) axons which extended singly or in fascicles through the rat host fimbria for a maximum distance of at least 10 mm. The donor axons were intimately integrated among and closely aligned to the host tract axons and to the interfascicular glial rows of the host tract. The axons travelled (i) laterally through the ipsilateral fimbria, (ii) medially across the midline in the ventral hippocampal commissure to reach the contralateral fimbria and alveus, and (iii) rostro-medially to the septum. On approaching the terminal fields appropriate to hippocampal CA3 pyramidal cell axons, the transplant axons gave rise to fine preterminal branches which were continuous with a reticular or amorphous immunoreactivity in the stratum oriens and stratum pyramidale of the ipsilateral hippocampus, and in the lateral and triangular septal nuclei. The donor axons extended along the host fimbria at a rate of ∼ 1 mm per day, reaching their terminal field destinations by ∼1–2 weeks. At 7 weeks the projections were maintained, but with little further extension. These observations indicate that the microenvironment of myelinated adult fibre tracts is permissive for an abundant and rapid growth of axons from transplanted embryonic cell suspensions. These axons can leave host tracts to invade appropriate terminal fields. 相似文献
15.
应用标准微电极技术,研究了关附甲素对豚鼠右心室乳头肌动作电位最大除极速率(Vmax)的频率依赖性抑制作用(RDB),并与美西律,奎尼丁,劳卡尼进行了比较. 在相同刺激间隔(300 ms),产生50%左右RDB的药物浓度下,美西律的RDB开始最快,其第2个Vmax所产生的抑制已占RDB的64%,奎尼丁,劳卡尼和关附甲素的RDB开始速率常数分别为每个动作电位0.165, 0.076和0.136. 美西律,奎尼丁,劳卡尼和关附甲素产生RDB的恢复时间常数分别为1.4, 9.0, 18.2和44.0 s,而且它们的恢复时间常数是不依赖于药物浓度而变化的,结果提示,关附甲素是一个慢动力学钠通道阻滞剂. 相似文献
16.
刘达恩 《中国修复重建外科杂志》1997,11(2):83-85
总结胸腹轴型皮瓣早期修复上肢不同部位的深度蛇伤溃疡的经验,评价其应用价值。本组16例,胸脐皮瓣2例,侧胸腹皮瓣1例,髂腰皮瓣5例,下腹皮瓣6例,下腹分叶皮瓣1例,髂腰加下腹Y形皮瓣1例。术后1例皮瓣远端坏死,3例轻度感染,16例断蒂后全部成活。随访3个月~7年,皮瓣质地和弹性均好,手功能基本恢复。认为,带蒂胸腹轴型皮瓣是修复上肢深度蛇伤溃疡理想的方法。 相似文献
17.
Symptomatic and Clinical Improvement in Morbidly Obese Patients with Gastroesophageal Reflux Disease Following Roux-en-Y Gastric Bypass 总被引:3,自引:0,他引:3
Background: Patients who suffer with gastroesophageal reflux Disease (GERD) endure a worsening of symptoms as their weight
increases. When medical treatment of this condition in the morbidly obese patients fails, surgical intervention may be indicated.
Choosing a procedure which not only helps achieve weight control but which also relieves symptoms and complications of GERD
is the goal. We present a review of patients who have undergone Roux-en-Y Gastric Bypass (RYGBP) and related procedures for
this disease. Methods: One hundred eighty-eight patients undergoing surgery for morbid obesity and for GERD in 1992-1996 were
contacted by mail or phone. All of these patients had undergone preoperative esophagogastroduodenoscopy to grade the severity
of their disease. Their preoperative symptoms were compared to those experienced postoperatively. Results: One hundred thirty
patients underwent a RYGBP with modified Hill fundopexy, 22 patients underwent a distal gastrectomy with modified Hill fundopexy,
8 patients underwent distal gastrectomy alone and 28 patients underwent RYGBP alone. There have been no deaths. There were
nine surgical complications, eight early and one at 2.5 years postoperation. Follow-up is 4-48 months. The average BMI dropped
from 43 to 30.2 kg/m2. Whereas all patients were on some form of medical therapy before surgery, only 14 reported the need for medication postoperatively.
Conclusions: Surgical intervention for weight control and treatment of GERD has been highly successful in our experience both
with respect to weight control and to the reduction of reflux symptoms. Depending upon endoscopic and operative findings a
RYGBP with or without an antireflux procedure can provide dramatic improvement. Gastrectomy with antireflux modifications
is appropriate in selected cases. 相似文献
18.
目的:为了更完全地切除中颅凹底内外沟通性肿瘤。方法:采用经过改良的Mickey额颞颞下窝入路。其改良主要是将额骨瓣连同其表面附着的颞肌以及游离后的眶颧骨块一并向下翻开,并将手术程序作了相应改变。结果:成功切除了13例肿瘤。术后3例恢复了轻工作,6例能自主生活,3例生活仍需别人照顾,1例复发未再次手术。结论:采用改良的额颞颞下窝入路对中颅凹底内外沟通性肿瘤暴露充分,切除广泛。Mickey入路改良的优点:颞肌血运的保留,有利于骨瓣与正常颅骨的早期融合。同时颞肌附着点的保留,有利于咀嚼功能。 相似文献
19.
20.