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排序方式: 共有172条查询结果,搜索用时 15 毫秒
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Total anorectal reconstruction with a double dynamic graciloplasty after abdominoperineal reconstruction for low rectal cancer 总被引:7,自引:3,他引:4
Bastiaan P. Geerdes M.D. Frans A. N. Zoetmulder M.D. Ph.D Erik Heineman M.D. Ph.D. Egbert J. Vos M.Sc. Mart -Jan Rongen M.D. Cor G. M. I. Baeten M.D. Ph.D. 《Diseases of the colon and rectum》1997,40(6):698-705
PURPOSE: Total anorectal reconstruction with a double dynamic graciloplasty was performed after abdominoperineal reconstruction
(APR) for low rectal cancer. In four patients an additional pouch was constructed to improve neorectal motility and capacity.
The aim of this study was to evaluate the results in the first 20 patients and to report on the preliminary results of patients
with an additional pouch. METHODS: Twenty patients with a mean age of 52 (range, 25–71) years and a rectal tumor at a mean
of 3 (range, 0–5) cm from the anal verge were treated. In 14 patients the Miles resection, colon pull-through, and construction
of a neosphincter were performed in one session. Six patients had the double graciloplasty at an average of 4.1 (range, 1.1–8.8)
years after APR. In four patients a pouch was constructed with an isolated segment of distal ileum. RESULTS: After a mean
follow-up of 24 (range, 1–60) months after APR, none of the patients developed local recurrence, whereas four patients developed
distant metastasis. Fifteen of 20 patients were available for evaluation, and 5 patients were still in training. Of these
15 patients, 8 patients were continent (53 percent), 2 patients were incontinent, and in 5 patients the perineal stoma was
converted to an abdominal stoma. Failures were attributable to necrosis of the colon stump (n=2) and incontinence (n=3). At
26 weeks mean resting pressure was 44 (standard deviation (SD), 28) mmHg, and mean pressure during stimulation was 90 (SD,
46) mmHg at a mean of 35 (SD, 1.2) volts at 52 weeks. Mean defecation frequency was three times per day (range, 1–5). Of the
eight patients who were continent, six used daily enemas. Mean time to postpone defecation was 11 (range, 0–30) minutes. CONCLUSION:
In experienced hands, the double dynamic graciloplasty is an oncologically safe procedure that can have an acceptable functional
outcome in a well-selected group of patients. However, to improve the outcome, further modifications will be necessary. So
far, the addition of a pouch has not resulted in improved outcome.
Supported by the Profileringsfonds of the Maastricht University Hospital, The Netherlands, and by the Stichting Fondsenwervingsactie
Volksgezondheid, Amsterdam, The Netherlands.
Read in part at the meeting of The American Society of Colon and Rectal Surgeons, Seattle, Washington, June 9 to 14, 1995. 相似文献
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Oscillatory motion of the normal cervical spinal cord 总被引:2,自引:0,他引:2
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JY Nagata TF Rocha‐Lima BP Gomes CC Ferraz AA Zaia FJ Souza‐Filho A De Jesus‐Soares 《Australian dental journal》2015,60(3):416-420
Immature avulsed teeth are not usually treated with pulp revascularization because of the possibility of complications. However, this therapy has shown success in the treatment of immature teeth with periapical lesions. This report describes the case of an immature replanted tooth that was successfully treated by pulp revascularization. An 8‐year‐old boy suffered avulsion on his maxillary left lateral incisor. The tooth showed incomplete root development and was replanted after 30 minutes. After diagnosis, revascularization therapy was performed by irrigating the root canal and applying a calcium hydroxide paste and 2% chlorhexidine gel for 21 days. In the second session, the intracanal dressing was removed and a blood clot was stimulated up to the cervical third of the root canal. Mineral trioxide aggregate was placed as a cervical barrier at the entrance of the root canal and the crown was restored. During the follow‐up period, periapical repair, apical closure and calcification in the apical 4 mm of the root canal was observed. An avulsed immature tooth replanted after a brief extra‐alveolar period and maintained in a viable storage medium may be treated with revascularization. 相似文献
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Mutations in the LEMD3 gene were recently incriminated in Buschke–Ollendorff syndrome (BOS) and osteopoikilosis, with or without melorheostosis. The relationship of this gene with isolated sporadic melorheostosis is less clear. We investigated LEMD3 in a two-generation BOS family showing an extremely variable expression of the disease, in a sporadic patient with skin features of BOS, and in an additional subject with isolated melorheostosis. We identified two different mutations, both resulting in a premature stop codon, in the two cases of BOS. The mutation (c.2564G>A) reported in the familial case is novel, while that observed in the sporadic case (c.1963C>T) has been previously reported in an American woman with osteopoikilosis and melorheostosis who had a family history of isolated osteopoikilosis. The search for mutations in DNA extracted from the peripheral blood, as well as skin and bone biopsies of the patient with melorheostosis failed to identify any pathogenic change. Our results further expand the LEMD3 mutation repertoire, corroborate the extreme interfamilial and intrafamilial clinical variability of LEMD3 mutations, and underline the lack of a clear phenotype–genotype correlation in BOS. The present study supports the general conclusion that LEMD3 mutations do not contribute to isolated sporadic melorheostosis. The genetic or epigenetic influences that are responsible for the development of melorheostosis require further investigation. 相似文献
8.
J Termote NE Schalij-Delfos BP Cats D Wittebol-Post BR Hoogervorst HAA Brouwers 《Acta paediatrica (Oslo, Norway : 1992)》1996,85(12):1491-1496
To assess the effect of surfactant replacement therapy (SRT) on the prevalence and severity of retinopathy of prematurity (ROP), we compared data from 160 SRT-treated preterm infants with data from 230 historic controls. The prevalence of ROP was 30.6% in the treatment group and 23.4% in the control group. Severe ROP (stages 3-4) was seen in 6.1% of the infants with ROP in the treatment group and 20.3% of the ROP patients in the control group. Surfactant therapy had no influence on the prevalence of ROP (odds ratio 1.4, 95% confidence interval 0.797-2.459, p = 0.242). However, SRT was associated with a decreased risk for severe ROP, compared to mild ROP (odds ratio 0.226, 95% confidence interval 0.056-0.905, p = 0.036). These data suggest that SRT is associated with a decreased risk for severe ROP. 相似文献
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