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1.
Summary Total parotidectomy causes a significant postoperative concave deformity in the retromandibular, preauricular, and infra-auricular regions of the face; many patients are concerned about this defect. Frey's syndrome (gustatory sweating) is also a well-recognized postoperative entity following parotid surgery. The incidence of Frey's syndrome ranges from 10–90%, depending on the type and complexity of the investigation used to diagnose it [5, 11]. Numerous methods have been described to correct these problems. Patients requiring total parotidectomy were recently offered the option of immediate reconstruction of the contour defect with microvascular transfer of a tailored gracilis muscle flap. Four patients are included in this preliminary series; all are extremely satisfied with the postoperative result. The defect following total parotidectomy can be reconstructed immediately with gratifying cosmetic results, a hidden donor site scar, and to date no operative morbidity. 相似文献
2.
In the past morphological changes, caused by uni-axial drawing of flexible polymers have been studied mostly under conditions, quite different from the drawing conditions. This could give rise to certain artefacts, leading to mis-interpretations. Up to now very little was known about this possibility. Therefore, X-ray patterns obtained by conventional drawing studies and by real-time X-ray drawing studies are compared in this paper. It will be shown, that although some results on melt-crystallized polyethylene discussed here show indeed small differences, conventional X-ray studies can be used without any problem for qualitative studies. However, studies of deformation phenomena in elastic deformable regions as well as quantitative X-ray studies require real-time measurements. 相似文献
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Aims/hypothesis
In early type 1 diabetes mellitus, renal salt handling is dysregulated, so that the glomerular filtration rate becomes inversely proportional to salt intake. The salt paradox occurs in both humans and rats and, with low salt intake, results in diabetic hyperfiltration. We tested whether increased salt intake could reduce the susceptibility to injury of non-clipped kidneys in diabetic rats with pre-existing Goldblatt hypertension. 相似文献6.
Thijs R. van Oudheusden MD Hidde J. Braam MD Simon W. Nienhuijs MD PhD Marinus J. Wiezer MD PhD Bert van Ramshorst MD PhD Misha D. Luyer MD PhD Valery E. Lemmens PhD Ignace H. de Hingh MD PhD 《Annals of surgical oncology》2014,21(8):2621-2626
Background
When peritoneal carcinomatosis (PC) is diagnosed during emergency surgery for colorectal cancer (CRC), further treatment with curative intent may seem futile given the known poor prognosis of both PC and emergency surgery. The aim of the current study was to investigate the feasibility and effectiveness of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) for CRC patients who previously underwent emergency surgery in the presence of PC.Methods
All patients with synchronous PC of CRC referred to two tertiary centers between April 2005 and November 2013 were included in this study. Operative, postoperative and survival details were compared between patients presenting in an emergency or elective setting.Results
In total, 149 patients with synchronous PC underwent CRS and HIPEC. Amongst these patients, 36 (24.2 %) initially presented with acute symptoms requiring emergency surgery. Acute presentation did not result in a longer interval between the initial operation and HIPEC (2.2 vs. 2.1 months; P = 0.09). When comparing operative outcomes, no significant differences were found in blood loss (P = 0.47), operation time (P = 0.39), or completeness of cytoreduction (P = 0.97). In addition, complication rates, degree and types of complication did not differ between the groups. Median survival was 36.1 months for emergency presentation compared with 32.1 in the elective group (P = 0.73).Conclusion
CRS + HIPEC may be performed safely in patients with PC of colorectal origin presenting with acute symptoms requiring emergency surgery. More importantly, the 5-year survival rate in these patients was equal to elective cases. This should be regarded as promising and therefore considered for these patients. 相似文献7.
Unilateral and Multilateral Congenital Coronary‐Pulmonary Fistulas in Adults: Clinical Presentation,Diagnostic Modalities,and Management With a Brief Review of the Literature 下载免费PDF全文
8.
Functional disability and death wishes in older Europeans: results from the EURODEP concerted action
Madeleine Mellqvist Fässberg Svante Östling Arjan W. Braam Kristoffer Bäckman John R. M. Copeland Manfred Fichter Sirkka-Liisa Kivelä Brian A. Lawlor Antonio Lobo Halggrimur Magnússon Martin J. Prince Friedel M. Reischies Cesare Turrina Kenneth Wilson Ingmar Skoog Margda Waern 《Social psychiatry and psychiatric epidemiology》2014,49(9):1475-1482
Purpose
Physical illness has been shown to be a risk factor for suicidal behaviour in older adults. The association between functional disability and suicidal behaviour in older adults is less clear. The aim of this study was to examine the relationship between functional disability and death wishes in late life.Methods
Data from 11 population studies on depression in persons aged 65 and above were pooled, yielding a total of 15,890 respondents. Level of functional disability was trichotomised (no, intermediate, high). A person was considered to have death wishes if the death wish/suicidal ideation item of the EURO-D scale was endorsed. Odds ratios for death wishes associated with functional disability were calculated in a multilevel logistic regression model.Results
In total, 5 % of the men and 7 % of the women reported death wishes. Both intermediate (OR 1.89, 95 % CI 1.42; 2.52) and high functional disability (OR 3.22, 95 % CI 2.34; 4.42) were associated with death wishes. No sex differences could be shown. Results remained after adding depressive symptoms to the model.Conclusions
Functional disability was independently associated with death wishes in older adults. Results can help inform clinicians who care for older persons with functional impairment. 相似文献9.
Termorshuizen Fabian Smeets Hugo M. Braam Arjan W. Veling Wim 《Social psychiatry and psychiatric epidemiology》2014,49(7):1093-1102
Social Psychiatry and Psychiatric Epidemiology - Recent studies have shown increased incidence of non-affective psychotic disorders (NAPD) among ethnic minorities compared to the native population,... 相似文献
10.
Three patients diagnosed with primary hypertension suddenly developed hard-to-treat blood pressure after several years of stable blood pressure. One patient, a man aged 48 years, had developed a renal artery stenosis, which had not been present five years earlier. The other two patients, a man aged 57 years and a woman aged 27 years, were diagnosed with an aldosterone-producing adenoma of the left adrenal gland and a pheochromocytoma, respectively. In patients with previously stable blood pressure, sudden derangement may be due to secondary hypertension on top of the pre-existing primary hypertension. A thorough history and physical examination together with limited laboratory investigations usually leads the way to the correct diagnosis. 相似文献