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1.
Aim
Tracheomalacia is flaccidity of the tracheal wall leading to tracheal collapse, particularly on expiration. When severe it can warrant surgical intervention. Aortopexy is one surgical option and has been described using a variety of approaches. We report outcomes of aortopexy performed via a suprasternal incision in a single centre by a single surgeon.Methods
All patients undergoing aortopexy between February 2016 and May 2018 were prospectively included. Patients were managed by a multi-disciplinary team (MDT) and underwent standardized work-up, including dynamic flexible bronchoscopy (DFB) and contrast enhanced CT. Aortopexy was performed via a suprasternal skin crease incision. Surgery was guided by intra-operative flexible bronchoscopy. Data regarding pre-operative symptoms, degree of tracheomalacia, and outcomes were recorded.Results
Twenty-two patients were included, 18 boys, median age 5?months (range 1?month–5?years). Two aortopexy sutures were used in all cases, and three patients required an additional tracheopexy suture. Median operating time was 1?h 24?min (range 47?min–2?h 35?min). Median pre-operative tracheal collapse on DFB was 85% (range 80–95%), improving to 35% (35–80%) intra-operatively. Median length of stay was 4?days (range 1–118).Conclusions
Aortopexy via a suprasternal incision is a useful treatment modality for tracheomalacia with short operating times and rapid recovery. Outcomes vary with the best results in the TOF and premature groups. Careful patient selection and MDT work-up are essential to optimize outcomes.Level of Evidence
Level 3 (Case Series). 相似文献2.
3.
Epidemic outbreaks control involving Staphylococcus aureus with reduced sensitivity to glycopeptides
Mallaval FO Carricajo A Martin I Fonsale N Grattard F Fascia P Aubert G Zeni F Lucht F Pozzetto B Berthelot P 《Pathologie-biologie》2003,51(8-9):469-473
This study describes two epidemic outbreaks involving Staphylococcus aureus with reduced sensitivity to glycopeptides, one in 2000 involving eight patients and the other in 2001-2002 involving 16 patients. These strains were detected rapidly, thanks to routine screening for the offending organisms in the bacteriology laboratory of our hospital. The clonal character of these strains was confirmed by pulsed field electrophoresis. The management of these epidemic outbreaks confirmed (i) the need for systematic adoption of standard precautions, (ii) the importance of circulating information in combating multi-resistant bacteria, as well as the difficulties in transferring colonised patients to different hospital wards, and (iii) the intermittent nature of S. aureus carriage, resulting in a need for prolonged surveillance of colonised and/or infected patients. In addition, our study underlines the value of a multi-disciplinary approach to the management of diffusion of multi-resistant bacteria. 相似文献
4.
Martin D. Hoffman Kara M. Kassay Anne I. Zeni Philip S. Clifford 《European journal of applied physiology》1996,74(6):541-547
The primary purpose of this study was to determine if the aerobic demand for production of specified power outputs is altered
by distribution of work between the arms and legs compared with when all the work is performed by the legs. Because of the
important exercise training implications, a secondary purpose of this study was to determine if the exercising muscle mass
affects the cardiorespiratory demands at specified rating of perceived exertion (RPE) levels and blood lactate concentrations.
Nine healthy adults completed leg cycling and combined arm and leg exercise on an Airdyne using a discontinuous protocol.
Repeated measures ANOVA revealed that oxygen uptake for the combined arm and leg exercise averaged 0.04 l·min−1 greater (p<0.05) than for leg cycling at the same external power outputs. However, RPE levels at specified power outputs were lower
(p<0.05) with combined arm and leg exercise than leg cycling. At specified RPE levels and blood lactate concentrations, oxygen
uptake and heart rate values were higher (p<0.05) for combined arm and leg exercise than leg cycling. From these findings we conclude that: (1) the addition of arm exercise
to leg cycling results in a reduction in RPE, but a minimal increase in oxygen consumption to perform a given power output,
and (2) if training intensity is established by RPE or blood lactate concentration, use of a muscle mass larger than that
used in leg cycling should allow a greater cardiorespiratory training effect. 相似文献
5.
Differential expression of stem cell mobilization-associated molecules on multi-lineage cells from adipose tissue and bone marrow 总被引:68,自引:0,他引:68
De Ugarte DA Alfonso Z Zuk PA Elbarbary A Zhu M Ashjian P Benhaim P Hedrick MH Fraser JK 《Immunology letters》2003,89(2-3):267-270
Our laboratory has characterized a population of stromal cells obtained from adipose tissue termed processed lipoaspirate cells (PLAs). PLAs, like bone-marrow derived mesenchymal stem cells (BM-MSCs), have the capacity to differentiate along the adipogenic, osteogenic, chondrogenic, and myogenic lineages, In order to better characterize these two multi-lineage populations, we examined the surface phenotype of both bone marrow and adipose tissue-derived cells from five patients undergoing surgery. PLA and BM-MSC cells were isolated, subcultivated, and evaluated for cell surface marker expression using flow cytometry. PLA and BM-MSC cells both expressed CD13, CD29, CD44, CD90, CD105, SH-3, and STRO-1. Differences in expression were noted for cell adhesion molecules CD49d (Integrin alpha4), CD54 (ICAM-1), CD34, and CD106 (VCAM-1). While markedly similar, the surface phenotypes of PLA and BM-MSC cells are distinct for several cell adhesion molecules implicated in hematopoietic stem cell homing, mobilization, and proliferation. 相似文献
6.
Mariotto A Zeni L Selle V Favaretti C 《International journal of technology assessment in health care》1999,15(3):473-479
OBJECTIVES: To examine the distribution of interventional cardiac catheterization laboratories, their case load, the time trends, and the regional variation of percutaneous transluminal cutaneous angioplasty (PTCA) utilization in Italy. METHODS: Analysis of data was provided by the annual reports of the Italian Group of Studies and Interventional Cardiology over the period from 1983 to 1996. RESULTS: The number of PTCA facilities and their use steadily increased, mainly in the North. In 1996 the utilization rate was 34 per 100,000 population, but only 60% of labs performed 200 or more procedures. CONCLUSIONS: Dramatic time trends and regional variations often took place without an epidemiology and technology assessment-based planning process. 相似文献
7.
This study was undertaken to compare the effect of supraphysiological doses of thyroxine (T4) on bone metabolism in SHAM
and OVX young adult rats. Female Sprague Dawley rats (220 ± 2 g, approx. 5 months of age) were divided into four groups of
eight animals each. The animals were intraperitoneally injected 6 days per week with vehicle (Vh): 0.001 N NaOH/0.9% NaCl
(SHAM+Vh and OVX+Vh) or 250 μg of thyroxine/kg/day (SHAM+T4 and OVX+T4) during a 5-week period. Serum T4 and osteocalcin (BGP),
urinary pyridinolines (Pyr), and creatinine (creat) were determined. At the beginning and at end of the experiment, skeletal
bone mineral content (BMC), bone mineral density (BMD), and area (A) of the total skeleton, femur, spine, and whole tibia,
as well as proximal, middle, and distal areas of the tibia were assessed by dual X-ray absorptiometry (DXA) in an ultra-high-resolution
mode. T4 treatment of the SHAM rats did not induce significant changes in BGP level or Pyr/creat excretion compared with the
SHAM+Vh control group. However, these two biochemical bone markers significantly increased due to T4 treatment in OVX rats
compared with both OVX+Vh and SHAM+T4 groups (P < 0.05 and P < 0.001, respectively). The OVX+T4 group had a significantly lower ΔBMD than SHAM+T4 rats in all studied regions (P < 0.05) except for the middle tibia region. OVX+T4 groups presented a significantly lower ΔBMC and ΔA compared with SHAM+T4
animals (P < 0.001). OVX+T4 rats significantly impaired the ΔBMD in the femur (P < 0.01), spine (P < 0.05), whole (P < 0.05) and middle (P < 0.05) tibia whereas T4 treatment of SHAM rats only affected, significantly, the whole (P < 0.05) and the proximal tibia region (P < 0.01). T4 treatment affects bone growth in young adult rats. The effect is significantly greater in the estrogen-depleted
than in the estrogen-repleted state. The bone site most adversely affected by T4 treatment depends on the estrogen status.
The proximal tibia (principally trabecular bone) was the most affected area in estrogen-repleted rats. Conversely, in OVX
rats, the middle tibia (principally cortical bone) presented the greatest decrease in bone density.
Received: 20 May 1999 / Accepted: 4 February 2000 相似文献
8.
Bradley M. Lamm Martin G. Gesheff Heather L. Salton Travis W. Dupuis Ferras Zeni 《The Journal of foot and ankle surgery》2012,51(6):743-748
The Dwyer calcaneal osteotomy is an effective procedure for the correction of calcaneal varus deformity. However, no intraoperative method has been described to determine the amount of bone resection. We describe a simple intraoperative method for assuring accurate bone resection and measure the realignment effects of the Dwyer calcaneal osteotomy. We also review radiographic outcomes associated with 20 Dwyer calcaneal osteotomies (in 17 patients) using the intraoperative realignment technique described in this report. Preoperative and postoperative radiographs at a mean of 2.5 (range 1.5 to 5) years taken after Dwyer osteotomy were measured and compared, which revealed a mean reduction in calcaneal varus of 18° (range 2° to 36°) (p < .001), a mean decrease in the calcaneal inclination angle of 5° (range –40° to 7°) (p < .05), a mean decrease in medial calcaneal translation of 10 (range 0 to 18) mm (p < .001) relative to the tibia, and a mean dorsal translation of 2 (range 0 to 7) mm (p = .002). In an effort to attempt to structurally realign the calcaneus to a more rectus alignment, by means of Dwyer osteotomy, we recommend the use of the intraoperative bone wedge resection technique described in this report. Our experience with the patients described in this report demonstrates the usefulness of the intraoperative method that we describe in order to accurately restore the axial tibial and calcaneal relationship. 相似文献
9.
Daniel K. White Zhichang Li Yuqing Zhang Adam R. Marmon Hiral Master Joseph Zeni Jingbo Niu Long Jiang Shu Zhang Jianhao Lin 《Archives of physical medicine and rehabilitation》2018,99(1):194-197
Objective
To describe physical function before and six months after Total Knee Replacement (TKR) in a small sample of women from China and the United States.Design
Observational.Setting
Community environment.Outcomes
Both groups adhered to the Osteoarthritis Research Society International (OARSI) protocols for the 6-minute walk and 30-second chair stand. We compared physical function prior to TKR and 6 months after using linear regression adjusted for covariates.Participants
Women (N=60) after TKR.Interventions
Not applicable.Results
Age and body mass index in the China group (n=30; 66y and 27.0kg/m2) were similar to those in the U.S. group (n=30; 65y and 29.6kg/m2). Before surgery, the China group walked 263 (95% confidence interval [CI], ?309 to ?219) less meters and had 10.2 (95% CI, ?11.8 to ?8.5) fewer chair stands than the U.S. group. At 6 months when compared with the U.S. group, the China group walked 38 more meters, but this difference did not reach statistical significance (95% CI, ?1.6 to 77.4), and had 3.1 (95% CI, ?4.4 to ?1.7) fewer chair stands. The China group had greater improvement in the 6-minute walk test than did the U.S. group (P<.001).Conclusions
Despite having worse physical function before TKR, the China group had greater gains in walking endurance and similar gains in repeated chair stands than did the U.S. group after surgery. 相似文献10.
Cristian Patrick Zeni Silzá Tramontina Thamis Aline Zeni Roberta Coelho Gabriel Pheula Julio Bernardi Ursula Maldaner Talita Lopes Silva Angélica Salatino-Oliveira Mara Hutz Luis Augusto Rohde 《Revista brasileira de psiquiatria (S?o Paulo, Brazil : 1999)》2013,35(1):44-50
ObjectivesTo assess the role of the Val66Met polymorphism at the brain-derived neurotrophic factor (BDNF) gene on the performance of children and adolescents with bipolar disorder [juvenile bipolar disorder (JBD)] on the Wisconsin Card Sorting Test (WCST).MethodsChildren and adolescents were assessed by the K-SADS-PL and a clinical evaluation for BD and comorbid conditions. Manic and depressive symptoms were assessed with the Young Mania Rating Scale and the Children Depression Rating Scale – Reviewed. The Val66Met polymorphism at the BDNF was genotyped from a blood sample. Patients’ IQ and executive functions were assessed by a standard cognitive flexibility test (WCST).ResultsFifty-three subjects were included in the study. No significant difference was observed between the Val/Val and Val/Met+Met/Met groups on any WCST scores in the MANCOVA (F48,5 = .76; p = .59; Perseverative Errors, p = .66; Nonperseverative Errors, p = .58; Categories Completed, p = .34; Attempts to Reach First Category, p=.64; and Percentage of Conceptual Level Responses, p = .99).ConclusionsOur findings from this sample of children and adolescents with BD do not replicate results from studies of adults and suggest the existence of differences in the neurobiology of this disorder across the life cycle. Investigations of larger samples are necessary to confirm these data. 相似文献