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1.
Jamaal L. Benjamin MD PhD Rebecca Dennis DO Stacy White Jr MD David Munson MD Sudha A. Anupindi MD Maciej Piskunowicz MD Kassa Darge MD PhD Ami Gokli MD Misun Hwang MD 《Journal of ultrasound in medicine》2020,39(5):1031-1036
Bowel diseases of prematurity, including necrotizing enterocolitis, are dreaded ailments of neonates. Early diagnosis is difficult, with clinical and radiographic findings often inconclusive. We present a novel use of contrast-enhanced ultrasound in detection of pediatric bowel disease. Early identification of compromised blood flow or an at-risk bowel can be quantitatively detected and monitored. This ability has implications for guidance of emerging therapies, allowing targeting of inflammation. These findings represent an advancement in detection of bowel disease in neonates. 相似文献
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M Kurimoto N Hayashi H Kamiyama S Nagai T Shibata T Asahi N Matsumura Y Hirashima S Endo 《Minimally invasive neurosurgery》2004,47(5):278-283
Neuronavigation has become an effective therapeutic modality and is used routinely for intra-axial tumor removal. This retrospective study was conducted to evaluate the clinical impact of neuronavigation and image-guided extensive resection for adult patients with supratentorial malignant astrocytomas. Between 1990 and 2002, 76 adult patients with pathologically confirmed malignant astrocytomas underwent craniotomy and removal of the tumors at the Toyama Medical and Pharmaceutical University Hospital. Of these 76 patients, 42 were treated using neuronavigation with conventional microneurosurgery and the other 34 were treated with conventional microneurosurgery alone. Postoperative early MRI with contrast enhancement was done, and gross total resection was defined as the complete absence of residual tumor. Survival time was analyzed with the Kaplan-Meier method. Prognostic factors were obtained from the Cox proportional hazards model. In univariate analysis, age (< 65), grade 3, preoperative KPS (>/= 80), use of neuronavigation, and gross total resection were significantly associated with longer survival. However, when the data were submitted to multivariate analysis, grade 3, preoperative KPS (>/= 80), and gross total resection were independent prognostic factors. The median survival periods of patients receiving gross total resection (vs. partial resection) and neuronavigation (vs. no neuronavigation) were 16 (vs. 9) months and 16 (vs. 10) months, respectively. The percentage of a gross total resection was significantly higher in the neuronavigation group compared to that in the no-navigation group (64.3 % vs. 38.2 %, p < 0.05). Neurological deterioration occurred in 4 of 42 (9.5 %) and in 6 of 34 (17.6 %) patients after surgery with neuronavigation and surgery without neuronavigation, respectively, although this difference was not statistically significant. Our results showed that neuronavigation increases the radicality in the resection of malignant astrocytomas and is objectively useful for improving survival time. 相似文献
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Bombings and explosion incidents directed against innocent civilians are the primary instrument of global terror. In the present
review we highlight the major observations and lessons learned from these events. Five mechanisms of blast injury are outlined
and the different type of injury that they cause is described. Indeed, the consequences of terror bombings differ from those
of non-terrorism trauma in severity and complexity of injury, and constitute a new class of casualties that differ from those
of conventional trauma. The clinical implications of terror bombing, in treatment dilemmas in the multidimensional injury,
ancillary evaluation and handling of terror bombing mass casualty event are highlighted. All this leads to the conclusion
that thorough medical preparedness to cope with this new epidemic is required, and that understanding of detonation and blast
dynamics and how they correlate with the injury patterns is pivotal for revision of current mass casualty protocols. 相似文献
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Menahem Neuman Boris Friedman Avi Stein A. Ami Sidi Alexander Tsivian 《Gynecological surgery》2007,4(3):175-178
The objective of the study was to compare the clinical outcomes at the short-term follow-ups of two novel transobturator mid-urethral
sling procedures – the transobturator tape (TOT) procedure and the tension-free vaginal tape (TVT)-obturator procedure. The
study cohort consisted two groups of 40 women with urodynamically proven stress urinary incontinence (SUI). The patients in
one group underwent the TOT procedure, performed according to Delorme (Prog Urol 11:1306–1313, 2001); those in the second
group underwent the TVT-obturator operation, performed according to de Leval (Eur Urol 44:724–730, 2003). Intra-operative
diagnostic cystoscopy was not performed with either the TVT-obturator or the TOT procedures. The average follow-up was 12 months.
The two patient groups were similar in terms of demographic and therapeutic criteria, except for patient age, which was significantly
younger in the TVT-obturator group. Previously reported TVT-related operative complications, such as bladder penetration,
intra-operative bleeding, field infection and post-operative pelvic floor relaxation, were not observed in patients of either
group. Bowel and urethral injuries were also not recorded. The therapeutic failure rates were 10% for the TOT procedure and
5% for the TVT-obturator procedure. Urinary frequency and urgency post-operatively were reported in 25% of the TOT patients
and 19% of the TVT-obturator patients, pelvic or vaginal pain affected 10% of the TOT and 5% of the TVT-obturator patients,
while post-operative voiding difficulty was experienced by 12.5% of the TOT and 7.5% of the TVT-obturator patients. None of
the above-mentioned differences between the two patient groups were of statistical significance. The TVT-obturator and TOT
procedures, both minimally invasive, novel, mid-urethral sling procedures, seem to be safe, easy-to-perform and effective
in treating female SUI. The patients of both study groups suffered less intra- and post-operative surgical complications than
previously been reported in connection with the TVT operation. The TVT-obturator patients had fewer therapeutic failures,
less post-operative urinary frequency and urgency, less pelvic pain and less voiding difficulty. All of these findings, however,
had no statistical significance; consequently, long-term comparative data collection will be required before solid conclusions
can be drawn on the superiority of either of these two operative techniques. 相似文献
8.
Ontogenesis of the cerebellofugal projection was studied in the rat by the tract-tracing method with WGA-HRP. The projection, forming a uniform front of compact fibre bundle tipped by growth cones, began entering the brainstem on embryonic day 17 (E17), grew rapidly and orderly with no random extension of fibers, and arrived at the most rostral part of the thalamus already by E18, distributing dense terminals to various brainstem and thalamic nuclei. The course and termination of this projection in prenatal animals was largely similar to normal adult projection although differences were found. Some projections increased postnatally, whereas some projections which were existent in embryos regressed with age and finally disappeared completely. The adult pattern of the projection was attained by 3 weeks of age. It is worth noting that the projections which appeared transiently are similar to those reported as aberrantly regenerated projections in kittens which are born in more mature state than rats and have no such projections at birth. 相似文献
9.
Nobuyoshi Kawaharada Kiyofumi Morishita Johji Fukada Yoshikazu Hachiro Yasuaki Fujisawa Tatsuya Saito Yoshihiko Kurimoto Tomio Abe 《European journal of cardio-thoracic surgery》2005,27(4):622-625
OBJECTIVE: The risk of stroke caused by dislodgment of loose atheromatous plaque or mural emboli is increased by cross-clamping of the aorta. Some patients undergo descending thoracic aortic aneurysm repair with proximal aortic cross-clamping between the left common carotid artery and the left subclavian artery. The objective of this study was to determine the influence of proximal aortic cross-clamping in arteriosclerotic aneurysm or dissecting aneurysm repair. METHODS: Between May 1984 and May 2003, 81 patients underwent elective surgery for distal arch or descending aortic aneurysm repair with proximal aortic cross-clamping between the left common carotid artery and the left subclavian artery. To evaluate the influence of the proximal aortic cross-clamping, patients were divided into two groups: patients who had undergone arteriosclerotic aneurysm repair (group I, n=25) and patients who had undergone dissecting aneurysm repair (group II, n=56). RESULTS: Eight (9.9%) of the 81 patients had a stroke. Six strokes occurred in operations for arteriosclerotic aneurysm repair group I and two strokes occurred in operations for dissecting aneurysm repair group II (24 vs 3.6%; p=0.009). In-hospital mortality rates were 12% in group I and 8.9% in group II (p=0.70). Major postoperative complications included renal failure requiring hemodialysis (in 4.2% of the patients in group I and in 8.3% of the patients in group II, p=0.99) and pulmonary complication (in 20% of the patients in group I and in 16% of the patients in group II, p=0.67). CONCLUSION: Cross-clamping between head vessels should be avoided if at all possible when operating on patients who have arteriosclerotic descending thoracic aneurysms. 相似文献
10.