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1.
Distal humeral fractures are problematic both in children and in adults. While in children these fractures are very common and most of them have an extraarticular location, in adults their incidence is much lower and they more often compromise the joint. Good results cannot be achieved without due consideration for the complex anatomy of the elbow joint, the quality of the bone, the concomitant soft tissue lesions and the biomechanical aspects of the injury, to allow selection of appropriate therapy and a correctly structured aftertreatment. The soft tissue injuries that are frequently involved and the high rate of intra- and postoperative complications need particular attention. This paper reviews the epidemiology, the current standards in diagnosis and therapy, the possible complications and the results that can be expected in patients with fractures of this type. 相似文献
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LEE JS IM HH JUNG Y JUNG IS JANG JY CHUN YK CHO YD KIM JO CHO JY KIM YS SHIM CS & KIM BS 《Neurogastroenterology and motility》2006,18(6):493-494
Background: Recent development of extracorporeal magnetic stimulation (ECMS) which uses current‐changing magnetic fields allows the induction of electrical stimulation in the desired deep tissue. Recent study showed the sacral nerve stimulation reduces corticoanal excitability that may play a functional role in anal continence mechanisms. Preliminary study shows that ECMS of sacral nerve can modify pelvic floor function and expel rectal balloon in patients with pelvic floor dyssynergia (PFD). Aims: To evaluate the effect of ECMS compared with biofeedback therapy (BF) in patients with PFD. Methods and Materials: Thirty‐eight patients who fulfilled Rome II criteria for PFD by colon transit time and anorectal function tests, were randomly treated with 8 sessions of ECMS (2/weeks; n = 19) at prone position or BF (2/weeks; n = 19) at sitting position. Stimulation parameters were set at 50–80% of maximum intensity, 10 and 50 Hz frequency, 3 s burst length with 3 and 6 s off using arm‐typed stimulator (BioCom‐1000, Mcube Co., Korea). Symptom scores for constipation with/without anorectal function test were repeatedly measured after each treatment. Response was defined as 50% or more decreased symptom score after treatment (partial response: 30–50%, poor: <30%). Results: Fifteen patients (age 49.1 ± 13.4 years, mean ± SD; 4 men) completed 8 session of BF and 14 patients (54.5 ± 17.6 years, 3 men) completed 8 session of ECMS. Four patients of BF group discontinued treatment due to unsatisfactory therapeutic effect (n = 1) and withdrew consent (n = 3) and 5 patients of ECMS group discontinued treatment because of same reasons (n = 1, 4). Total symptom scores were significantly decreased after treatment of 8 session in both treatment groups (13.4 ± 6.6 vs. 4.3 ± 4.0 for BF, p = 0.009; 14.9 ± 5.6 vs. 3.4 ± 4.0 for ECMS, p < 0.001). Bowel movements per week were also significantly increased after treatment in both groups (median 2 vs. 7 for BF, p = 0.035; median 2 vs. 7 for ECMS, p = 0.008). Thirteen out of 15 patients showed response in BF group and 12 out of 14 showed good response in ECMS group. No adverse effects in both groups. Conclusions: ECMS is as effective as BF for the treatment of PFD. Long‐term effect of ECMS for the patients with pelvic floor dyssynergia need to be evaluated in the near future. 相似文献
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Dr. S. Fuchs Ch. Jürgens A. P. Schulz M. E. Wenzl D. Wolter 《Trauma und Berufskrankheit》2005,7(2):83-88
Zusammenfassung Winkelstabile Plattenfixateur-interne-Systeme haben in den letzten 20 Jahren zunehmend an Bedeutung gewonnen. Die aus der Winkelstabilität resultierende flächenhafte Krafteinleitung und gleichmäßigere Kraftverteilung führen zu einer besseren Knochenbruchheilung insbesondere im metaphysischen Bereich und bei Osteoporose. Bei Marknagelsystemen ist die Winkelstabilität bislang nur partiell verwirklicht. Der vorgestellte winkelstabile Tibiamarknagel realisiert an jedem einzelnen Bolzen eine Winkelstabilität mit dem einliegenden intramedullären Kraftträger. Von Februar 2002–August 2004 wurden 21 Patienten mit ihm behandelt. In 13 Fällen wurden Frakturen stabilisiert, 6 Patienten hatten Fehlstellungen, 2 Patienten Pseudarthrosen. Zum Nachuntersuchungszeitpunkt waren alle Behandlungen abgeschlossen. Postoperative Komplikationen traten nicht auf. In allen Fällen wurde eine vollständige Durchbauung erreicht. In 6 Fällen fand sich radiologisch eine verzögerte Knochenbruchheilung. Die ersten klinischen Erfahrungen mit dem winkelstabilen Tibiamarknagel zeigen, dass dieser aufgrund der höheren Primärstabilität insbesondere im metaphysären Knochenbereich mit kurzen Fragmenten sowie bei Osteoporose Vorteile gegenüber anderen nichtwinkelstabilen oder nur partiell winkelstabilen Marknagelsystemen erbringt. Die verzögerten Knochenbruchheilungen bedürfen weiterer klinischer und biomechanischer Untersuchungen. 相似文献
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Kung FT; Chen WJ; Chou HH; Ko SF; Chang SY 《Human reproduction (Oxford, England)》1997,12(8):1649-1653
We report a rare case of early-stage endometrial adenocarcinoma in a 22
year old nullipara with polycystic ovaries undergoing conservative
treatment. Pretreatment evaluation including tumour grade, depth of
myometrial invasion, tumour size, hormone receptor status and flow
cytometric analysis indicated a favourable prognosis. The patient underwent
repeat endometrial curettage and a 6 month period of therapy with megestrol
acetate and tamoxifen. A combination contraceptive pill was then prescribed
to ensure withdrawal of the menstrual cycle thereafter. Now, 1 year after
the last curettage, there is no evidence of disease. During the treatment
period, hysteroscopy allowed for a more precise approach in panoramically
examining the tumour nest in the endometrial cavity, and the subsequent
endometrial response to hormone therapy. Laparoscopy using bulldog clamps
applied to the isthmic portion of the Fallopian tubes prevented i.p. spread
of endometrial tissue from retrograde regurgitation during hysteroscopy.
Laparoscopic ovarian electrocautery resulted in the reduction of abnormal
hypervascularization on the surface of polycystic ovaries postoperatively
but caused a peri-ovarian adhesion complication. It is interesting that
this case posed a unique opportunity to demonstrate the tumour regression
under the assistance of laparoscopy and hysteroscopy.
相似文献
9.
Increased frequency of congenital chromosomal aberrations in female partners of couples undergoing intracytoplasmic sperm injection 总被引:3,自引:7,他引:3
van der Ven K; Peschka B; Montag M; Lange R; Schwanitz G; van der Ven HH 《Human reproduction (Oxford, England)》1998,13(1):48-54
We evaluated the frequency of congenital chromosomal aberrations in a
sample of 305 couples included in an intracytoplasmic sperm injection
(ICSI) programme. Twenty individuals (3.3%) with congenital chromosomal
abnormalities could be identified. The following types of abnormalities
were observed: reciprocal translocations (n = 7), Robertsonian
translocations (n = 3), inversions (n = 3), other structural aberrations (n
= 4) and sex chromosome aberrations (n = 3). The rate of chromosomally
abnormal males (10/305, 3.3%) lay within the expected range for patients
with reduced semen quality. Surprisingly, 50% (10/20) of all abnormal
karyotypes were contributed by the female partner of ICSI patients. These
data confirm the higher incidence of chromosomal aberrations in infertile
populations as compared with the baseline population risk. Additionally,
the data imply that in some cases of male factor infertility a hidden
female chromosomal factor may be present, which cannot be identified by
standard clinical evaluation. In conclusion, we recommend chromosomal
analysis in both partners of couples undergoing ICSI treatment.
相似文献
10.
Identification of a gene disrupted by a microdeletion in a patient with X-linked retinitis pigmentosa (XLRP) 总被引:2,自引:2,他引:2
Roepman R; Bauer D; Rosenberg T; van Duijnhoven G; van de Vosse E; Platzer M; Rosenthal A; Ropers HH; Cremers FP; Berger W 《Human molecular genetics》1996,5(6):827-833
The gene for the most frequent from of X-linked retinitis pigmentosa
(XLRP), RP3, has been assigned by genetic and physical mapping to a segment
of less than 1000 kbp, which is flanked by the marker DXS1110 and the
ornithine transcarbamylase (OTC) gene. In search of microdeletions, we have
screened the DNA of 30 unrelated patients with XLRP by employing a
representative set of YAC-derived DNA fragments that were generated by
restriction enzyme digestion and PCR amplification. In one of these
patients, a 6.4 kbp microdeletion was detected which was not present in the
DNA of 444 male controls. A cosmid contig spanning the deletion was
constructed and used to isolate cDNAs from retina-specific libraries. Exons
corresponding to these expressed sequences as well as other putative exons
were identified by sequencing more than 30 kbp of the critical region. So
far, no point mutations in these putative exon sequences have been
identified.
相似文献