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1.
BASIS: Fractures of the talus or calcaneus with accompanying soft tissue damage require precisely planned treatment to prevent infection of the wound over time, especially in severely injured patients. MATERIAL AND METHODS: Seven patients with fractures of the talus or calcaneus and accompanying 2nd and 3rd degree open or 3rd degree closed soft tissue injuries were followed up retrospectively. These patients were operated on between January 1999 and January 2006 with free fasciocutaneous scapular or parascapular flaps. The average age was 34 (range 16-54). Follow-up was at 6-36 months. RESULTS: Osteosynthesis was primarily in six cases, post-primarily in one, and in four cases exterior fixation was used additively. Temporary vacuum therapy was performed for a mean of 28 days (6-42). Parascapular, scapular, and Latissimus dorsi flap coverage was performed six, one, and one times, respectively. Six flaps healed without complication. One necrosis of a parascapular flap occurred and made a Latissimus dorsi flap necessary. In one case of donor-site wound dehiscense, a local rotation flap became necessary. There was no joint infection or osteomyelitis. Bony consolidation was achieved within all fractures. CONCLUSION: Traumatic soft tissue damage must be taken into account when primary or secondary internal fixation is performed and should influence the choice of implant. Free fasciocutaneous parascapular or scapular flaps are a powerful tool for preventing infection if local flaps are not sufficient to achieve stable soft tissue coverage. 相似文献
2.
Bone mineral density (BMD, g/cm2) was measured using dual-photon absorptiometry (DPA) in selected areas of the proximal tibia following uncemented PCA knee prosthesis. In nine patients with 14 alloplastic operations, measurements were taken at 3-6-month intervals for the first 3 1/2 years after operation. There was a significant increase in BMD of about 15% during the first 6 months after operation. The following year it remained increased, although not significantly, compared with the initial values, then gradually diminished. Increased bone density after arthroplasty may be explained mainly by stimulation of bone formation from weight bearing due to improved walking ability. Stress shielding of the proximal part of the supporting tibial bone did not seem to occur. 相似文献
3.
Neuroimaging in Pineal Tumors 总被引:4,自引:0,他引:4
F Reis MD AV Faria MD PhD VA Zanardi MD PhD JR Menezes MD F Cendes MD PhD LS Queiroz MD PhD 《Journal of neuroimaging》2006,16(1):52-58
BACKGROUND AND PURPOSE: The authors report radiological findings in 11 tumors in the pineal region, which were histologically diagnosed as germinomas, pineocytomas pineoblastomas, ependymomas, teratomas, and astrocytomas. METHODS: Computed tomography (CT) was performed in seven patients and magnetic resonance imaging (MRI) was performed in all patients. RESULTS: CT showed a solid or solid/cystic mass with variable contrast enhancement. MRI showed a heterogeneous mass, with hypointense signal on T1 and iso/hyperintense signal on T2-weighted images (WI) and gadolinium enhancement. Extension to adjacent structures occurred in five patients and spread through the cerebral spinal fluid (CSF) in two. CONCLUSIONS: Pineal region tumors have no pathognomonic imaging pattern. MRI and CT are complementary in diagnosis and are important to determine localization, extension, and meningeal spread. 相似文献
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Is the outcome of in-vitro fertilization and embryo transfer treatment improved by spontaneous or surgical drainage of a hydrosalpinx? 总被引:4,自引:7,他引:4
Sowter MC; Akande VA; Williams JA; Hull MG 《Human reproduction (Oxford, England)》1997,12(10):2147-2150
A pilot study was designed to examine whether the outcome of embryo
transfer in women with a hydrosalpinx might be improved by surgical
drainage of the hydrosalpinx at the time of oocyte collection for in- vitro
fertilization treatment. A comparative, controlled but retrospective
analysis of the results was performed of all women with infective tubal
damage aged <40 years old, who had ovulatory cycles, a normal uterus and
a partner with normal spermatozoa. A standardized treatment regimen was
used. A maximum of three embryos were transferred. Hydrosalpinx was defined
by prior hysterosalpingography and/or laparoscopy with transcervical dye
injection. A total of 237 embryo transfer cycles in women with
hydrosalpinges (tubal distension not visible in 151, visible but not
drained in 30 and drained in 56) were compared with 705 embryo transfer
cycles in women with tubal disease but no hydrosalpinx. Results were
analysed in the first three cycles but also separately in the first cycle
to check for bias. Success rates were higher in the first cycle, but did
not significantly influence overall differences. Implantation rates were
significantly reduced overall in the hydrosalpinx group (8.0 versus 13.2%
for controls; P < 0.001), being 8.3% (P < 0.01) in the subgroup
without evident tubal distension and 7.5% (not significant) in the drained
hydrosalpinx group. This study shows that tubal damage with distal
occlusion is associated with a marked reduction in embryo implantation,
even in the absence of obvious fluid distension. Surgical drainage of
distended hydrosalpinges appears to offer no benefit.
相似文献
7.
Enhanced repair of pyrimidine dimers in coding and non-coding genomic sequences in CHO cells expressing a prokaryotic DNA repair gene 总被引:5,自引:0,他引:5
We have previously demonstrated that the active dihydrofolatereductase (DHFR) gene is efficiently repaired in Chinese hamsterovary (CHO) cells which remove only a small fraction of u.v.-inducedpyrimidine dimers from the overall genome. Preferential DNArepair of essential genes may explain why the u.v. resistanceof normal CHO cells is as high as that of fully repair-proficientnormal human cells. In this report, we have studied the removalof pyrimidine dimers in a CHO cell line expressing the cloneddenV gene from bacteriophage T4 which codes for the pyrimidinedimer specific enzyme T4 endonuclease V (T4 endo V). This cellline was derived from a u.v.-sensitive excision deficient mutantof a CHO wild type line by transformation with the denV gene,and partial restoration of u.v. resistance was achieved. Wehave examined an important aspect of the u.v. excision repairin these denV+ cells by studying the repair efficiencies inthe active DHFR gene and in a non-coding sequence located downstreamfrom it. In the u.v.-sensitive CHO mutant cell line from whichthe denV+ was derived, we detected no pyrimidine dimer removalfrom the gene or from the downstream sequence after irradiationof the cells with 20 J/m2 u.v. (254 nm) light. In the wild typeCHO cells, 50% of the pyrimidine dimers were removed from asequence in the DHFR gene within 8 h, whereas none were removedfrom the downstream sequence in that period. This representsthe normal pattern of preferential DNA repair of active genes,which we have described in previous communications. In the denV+cells, 70% of the pyrimidine dimers were removed from both theDHFR gene and from the downstream sequence; these cells thusrepair both coding and non-coding regions of the genome andshow no pattern of preferential repair. The endogenous activitythat initiates excision repair in normal CHO cells is evidentlymuch more restricted in its accessibility to DNA lesions inchromatin than is the activity in cells containing substantialamounts of the small T4 endo V enzyme. 相似文献
8.
目的对十年前后精神分裂症患者用药情况的变化进行调查分析.方法对十年前后两个五年段的各500份符合精神分裂症诊断标准的病历进行回顾性调查,并对各项指标进行对比分析.结果两组折算用药剂量经t检验差异无显著性(P>0.05);两组合并用药、合并抗胆碱药及疗效经χ2检验差异有显著性(P<0.01);十年后非典型抗精神病药物氯氮平在临床上的应用比例明显增大并上升为首位.结论十年前后两组抗精神病药的应用发生了明显变化,疗效好、副作用轻的非典型抗精神病药的应用比例明显增加. 相似文献
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10.
Saroj Neupane M.D. Naga VA Kommuri M.D. Noora Kazanji D.O. Pertha Chowdhury M.D. F.A.C.C. 《Echocardiography (Mount Kisco, N.Y.)》2016,33(11):1788-1789
Development of left ventricular pseudoaneurysm is a rare complication of mitral valve surgery and requires urgent surgical intervention. We describe a case of pseudoaneurysm of membranous septum following repeat mitral valve replacement with the use of multimodality imaging. 相似文献