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Recently, anatomic or double-bundle reconstruction of the anterior cruciate ligament (ACL) has been presented in an effort to more accurately restore the native anatomy. These techniques create 2 tunnels in both the femur and tibia to reproduce the bundles of the ACL. However, the increased number of tunnels, particularly on the femoral side, has raised some concerns among authors and surgeons. We describe a technique to reconstruct the 2 distinct bundles of the ACL by using a single femoral tunnel and 2 tibial tunnels, the “hybrid” ACL reconstruction. The femoral tunnel is drilled through an anteromedial arthroscopy portal, which allows placement in a more anatomic position. Fixation in the femur is achieved with a novel device that separates a soft-tissue graft into 2 independently functioning bundles. Once fixed in the femur, the anteromedial and posterolateral bundles of the graft are passed through respective tunnels at the anatomic footprint on the tibia. These bundles are independently tensioned, which creates a reconconstruction that is similar to the native ACL. The technique presented provides surgeons with an alternative to other double-bundle techniques involving 4 tunnels. 相似文献
4.
The syndactyly repairs of 11 hands in seven patients (average age 20.4) who had simple complete syndactyly between the third and fourth fingers were done by the use of tissue expanders in order to obtain adequate skin closure. At the first stage, a wedge type, 7 cc tissue expander was placed beneath the dorsal skin of the syndactylous digits via a vertical dorsal hand incision under local anesthesia. Inflation was begun on the 15th postoperative day. After the inflation period (average 32 days), syndactyly repair similar to the Littler technique was performed using axillary block anesthesia. During the expansion period one tissue expander became exposed and this hand was repaired by the classical skin grafting technique. In the remaining ten hands the expanded dorsal skin ensured skin closure of the digits and web reconstruction without any need for skin grafting. No complications were encountered during the postoperative period. Active and passive abduction angles, tip-to-tip length, active range of motion of the digits, and two point discrimination tests were done at follow-up (average six months). The web appearances were normal in all patients. Active abduction angles and active range of motion of the digits was always normal at the third postoperative month. Two point discrimination was 8.7 mm on the interdigital sides of the digits and there was no tip-to-tip length differences of the digits. No contractures were seen.Presented at the International Congress of Surgery of the Hand and Upper Extremity, Izmir, Turkey, September 25, 1994. 相似文献
5.
Fatoş Yalçınkaya Necmiye Tümer Nilgün Çakar Nuray Özkaya 《Pediatric nephrology (Berlin, Germany)》1997,11(3):350-352
Hypertension is one of the most important complications of erythropoietin (rHuEPO) therapy in dialysis patients. In this
study, the effect of two different dosage regiments of subcutaneous rHuEPO on blood pressure [BP] was evaluated in 20 anemic
children on continuous ambulatory peritoneal dialysis (CAPD). Patients were randomized to receive rHuEPO 50 U/kg, either once
a week (group 1, 50 U/kg per week) or three times a week (group 2, 150 U/kg per week). At the beginning of the study, 8 patients
in group 1 and 8 patients in group 2 were on antihypertensive therapy. In group 1, the hematocrit increased gradually and
significantly from 18.98%±1.79% to 30.1%±1.62% after 6 months, while in group 2 it rapidly increased from 19.53%±1.86% to
32.4%±1.11% after 3 months. A significant increase in the mean arterial BP was observed in group 2. Antihypertensive therapy
had to be increased in all of the 8 previously hypertensive patients and had to be initiated in 1 of the 2 originally normotensive
patients in the same group. None of the patients in group 1 required a change in antihypertensive medication. We conclude
that during treatment with rHuEPO pre-existing hypertension and the dose of rHuEPO are the most important risk factors for
the development or worsening of hypertension in children on CAPD, and gradual elevation of hematocrit by low-dose rHuEPO avoids
the development of severe hypertension.
Received December 11, 1995; received in revised form September 16, 1996; accepted September 19, 1996 相似文献
6.
A. Koşar K. Sarica B. Küpeli G. Alçiğir O. Süzer S. Küpeli 《International urology and nephrology》1997,29(3):351-356
Infertility may occur in patients with unilateral testicular torsion whose contralateral testis is intact. Depending on this
observation, the physicians have begun to examine the contralateral testis.
In the present prospective study we aimed to examine the histopathologic alterations occurring in the contralateral testicle
with time. Sixty adult male albino rats were included in the programme, and following experimental torsion the histopathologic
findings, especially those in the contralateral testis, were evaluated after 4–12 weeks. Long-term and high degree torsion
of the testicle led to varying degrees of deterioration in the germinal epithelium and interstitial cells of the contralateral
testicle. Histopathologic alterations were reversed in 12 weeks. Tubular diameter and testicular volume also decreased in
accordance with the histopathologic alteration.
In our opinion, orchiectomy following torsion of one testicle will limit potential histopathologic alterations in the contralateral
testicle. 相似文献
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Dr. Bektaş Açikgöz Mehmet Turgut Osman Ekin Özcan Tunçalp Özgen Beyhan Demirhan Şevket Ruacan 《Lasers in medical science》1992,7(1-4):49-53
In this study we have investigated the negative influence of CO2 and Nd-YAG laser irradiation on rapid cranial regeneration and whether it has any use in certain types of craniosynostosis.
Twenty-two newborn rats were used in the study. Both CO2 and Nd-YAG laser irradiation, which was applied to free bony edges after, suturectomies, resulted in a significant decrease
in skull regeneration. Histopathological examinations revealed severe degeneration caused by both types of laser energies. 相似文献
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