Annales chirurgiae et gynaecologiae最新文献_第5页

Management of malignant melanoma. 恶性黑色素瘤的治疗。

Annales chirurgiae et gynaecologiae Pub Date : 2000-01-01

B B Kroon, O E Nieweg

{"title":"Management of malignant melanoma.","authors":"B B Kroon, O E Nieweg","doi":"","DOIUrl":"","url":null,"abstract":"The following guidelines are recommended in the management of malignant melanoma. An excisional biopsy is the appropriate diagnostic procedure for a skin lesion suspected of being a melanoma. The advised margin for diagnostic excision is 2 mm of macroscopically normal skin around the lesion; the margins for therapeutic excision are 1 cm of normal skin for a lesion with a Breslow thickness of < 2 mm and 2 cm when the Breslow thickness is > 2 and < or = 4 mm. A margin of at least 2 cm also appears to be justified for thicker melanomas. Elective lymph node dissection is not recommended. Sentinel node biopsy appears to be a promising method to detect occult metastases in the regional lymph nodes. If regional lymph node metastases are present, therapeutic regional lymph node dissection must be conducted. Isolated regional perfusion is indicated for inoperable tumour growth in an extremity. Radiotherapy can be applied palliatively or postoperatively (if non-radical resection is suspected). Adjuvant systemic therapy is still experimental. There is no standard treatment for patients with haematogenic metastasis and they should be entered in trials whenever possible. A follow-up period of 5 years is sufficient for patients with a melanoma of < or = 1.5 mm Breslow thickness and of 10 years when the Breslow thickness is > 1.5 mm. The patients should be actively involved in the follow-up (inspection, palpation). Regular routine blood tests and radiological examinations are not considered to be worthwhile. There is no evidence that the growth of micro-metastases is stimulated by hormonal changes during pregnancy or contraceptive pill use. Excessive exposure to ultraviolet radiation should be discouraged.","PeriodicalId":75495,"journal":{"name":"Annales chirurgiae et gynaecologiae","volume":"89 3","pages":"242-50"},"PeriodicalIF":0.0,"publicationDate":"2000-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21906472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Surveillance on mutation carriers of DNA mismatch repair genes. DNA错配修复基因突变载体的监测。

Annales chirurgiae et gynaecologiae Pub Date : 2000-01-01

H J Järvinen, M Aarnio

引用次数: 0

Current trends in bladder cancer treatment. 膀胱癌治疗的最新趋势。

Annales chirurgiae et gynaecologiae Pub Date : 2000-01-01

D L Lamm, M Allaway

引用次数: 0

Treatment of subcapital femoral neck fractures with bioabsorbable or metallic screw fixation. A preliminary report. 生物可吸收或金属螺钉内固定治疗股骨颈下骨折。初步报告。

Annales chirurgiae et gynaecologiae Pub Date : 2000-01-01

K Jukkala-Partio, E K Partio, P Helevirta, T Pohjonen, P Törmälä, P Rokkanen

{"title":"Treatment of subcapital femoral neck fractures with bioabsorbable or metallic screw fixation. A preliminary report.","authors":"K Jukkala-Partio, E K Partio, P Helevirta, T Pohjonen, P Törmälä, P Rokkanen","doi":"","DOIUrl":"","url":null,"abstract":"Background and aims: Cancellous bone fractures and arthrodeses have been treated successfully with bioabsorbable polyglycolide and poly-L-lactide implants. In this study bioabsorbable poly-L-lactide lag screws and metallic screws were compared in the fixation of subcapital femoral neck fractures.Patients and methods: Forty patients with femoral neck fractures were treated by internal fixation using three bioabsorbable self-reinforced poly-L-lactide (SR-PLLA) lag screws of 6.3 mm in diameter and 38 patients using three metallic screws of 7 mm in diameter. In addition, one patient was operated on using two and one using four metallic screws. The patients did not differ in age, body weight or primary dislocation of the fracture. There were six males in the lactide group versus 14 in the metallic fixation group. There were two Garden Stage I, 27 Garden Stage II, nine Garden Stage III, and two Garden Stage IV fractures in both groups.Results: In the Garden I and II fractures there were 5/29 redislocations after SR-PLLA fixation and 8/29 after metallic fixation. In the Garden III fractures there were 4/9 and in the Garden IV fractures 2/2 redislocations in both groups. The ability to walk and the range of movement were better after bioabsorbable fixation.Conclusion: Self-reinforced poly-L-lactide lag screws can be used safely to fix subcapital femoral neck fractures in Garden Stage I and II fractures and in younger patients in Garden III fractures.","PeriodicalId":75495,"journal":{"name":"Annales chirurgiae et gynaecologiae","volume":"89 1","pages":"45-52"},"PeriodicalIF":0.0,"publicationDate":"2000-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21639236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Video-assisted thoracoscopic surgery in the diagnosis of lung disease. The Cretan experience. 电视胸腔镜在肺部疾病诊断中的应用。克里特岛的经历。

Annales chirurgiae et gynaecologiae Pub Date : 2000-01-01

I E Petrakis, A Katsamouris, S J Vassilakis, N Vrachassotakis, I Drossitis, G Chalkiadakis

{"title":"Video-assisted thoracoscopic surgery in the diagnosis of lung disease. The Cretan experience.","authors":"I E Petrakis, A Katsamouris, S J Vassilakis, N Vrachassotakis, I Drossitis, G Chalkiadakis","doi":"","DOIUrl":"","url":null,"abstract":"Background: Video-assisted thoracoscopic surgery (VATS) has been recently utilised in the diagnosis and management of thoracic diseases. In this report we reviewed our VATS experience for biopsy of diffuse or localised lung diseases in 51 cases focusing on indications, operative procedures, complications or failures rates.Patients and methods: Over the last 5 years we performed 51 VATS procedures for diagnostic purposes in 32 men and 19 women. The specific indications for VATS were lung biopsy for undiagnosed diffuse or localised lung disease. In all patients the postoperative pain was controlled with the use of non-narcotic analgesics and was measured according the visual analogue scale (VAS).Results: There was no operative mortality. Postoperative non-fatal complications were seen in 3 cases (6%). The overall median duration of chest tube drainage was 2 days and the mean postoperative stay 3 days. In the diffuse lung disease a tissue diagnosis was obtained in all the cases. Conversion to thoracotomy was needed in 1 case (2%), owing to extensive adhesions. All patients expressed a postoperative pain control effect of less than 50% of VAS.Conclusions: VATS should be considered as a safe and effective procedure, with low postoperative pain and morbidity. Should be recommended in patients who require a histological diagnosis of diffuse or localised lung diseases.","PeriodicalId":75495,"journal":{"name":"Annales chirurgiae et gynaecologiae","volume":"89 1","pages":"24-7"},"PeriodicalIF":0.0,"publicationDate":"2000-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21639956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Functional results of anterior levatorplasty and external sphincter plication for faecal incontinence. 前提肛成形术和外括约肌牵拉术治疗大便失禁的疗效观察。

Annales chirurgiae et gynaecologiae Pub Date : 2000-01-01

P Aitola, K M Hiltunen, M Matikainen

{"title":"Functional results of anterior levatorplasty and external sphincter plication for faecal incontinence.","authors":"P Aitola, K M Hiltunen, M Matikainen","doi":"","DOIUrl":"","url":null,"abstract":"Background and aims: The aim of this study was to assess results of anterior levatorplasty combined with external anal sphincter plication for faecal incontinence.Material and methods: The study involved 44 female patients, 27 with idiopathic and 17 with traumatic faecal incontinence. All underwent anterior levatorplasty and external sphincter plication in our institution between 1986 and 1997. The patients were followed up clinically for a mean 12 (range 2-54) months and 39 (89%) patients also underwent pre-and postoperative anal manometry.Results: In the idiopathic group 5 patients (19%) estimated that the result of the operation had been good and another 18 (67%) reported feeling better than before; the corresponding figures in the traumatic group were 4 (24%) and 10 (59%). The Wexner incontinence score decreased significantly after the operation in both groups. Nineteen patients (70%) in the idiopathic and 14 (82%) in the traumatic group showed improvement of one or more scores on the Kirwan scale. Three patients regained continence completely, one in the traumatic and two in the idiopathic group. There were no significant improvements in mean resting anal pressure or functional anal canal length in either group. Mean squeeze pressure improved significantly only in the traumatic group.Conclusions: Although the results of anterior levatorplasty combined with external sphincter plication are not perfect, the approach seems to be a valuable alternative in the treatment of patients with idiopathic or traumatic faecal incontinence. Complete continence is seldom achieved, but the grade of incontinence is reduced in the majority of patients.","PeriodicalId":75495,"journal":{"name":"Annales chirurgiae et gynaecologiae","volume":"89 1","pages":"29-32"},"PeriodicalIF":0.0,"publicationDate":"2000-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21639957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Molecular genetics of prostate cancer. 前列腺癌的分子遗传学。

Annales chirurgiae et gynaecologiae Pub Date : 1999-01-01

T Visakorpi

引用次数: 0

Emergency surgery of non-ruptured abdominal aortic aneurysm. 未破裂腹主动脉瘤的急诊手术。

Annales chirurgiae et gynaecologiae Pub Date : 1999-01-01

S Soisalon-Soininen, J A Salo, V Perhoniemi, S Mattila

{"title":"Emergency surgery of non-ruptured abdominal aortic aneurysm.","authors":"S Soisalon-Soininen, J A Salo, V Perhoniemi, S Mattila","doi":"","DOIUrl":"","url":null,"abstract":"Background and aims: The pain of an abdominal aortic aneurysm (AAA) is believed to signify rupture, and emergency surgery for symptomatic AAA is a widely accepted practice to prevent rupture. To clarify the benefit of emergency surgery we evaluated the clinical course of emergency treated patients with non-ruptured AAAs.Material and methods: 110 patients (90 men, mean age 69, range 49-93; 20 women, mean age 75, range 63-89) underwent emergency repair of non-ruptured AAA between 1970 and 1992 at the Department of Thoracic and Cardiovascular Surgery of Helsinki University Central Hospital (HUCH). Survival rates after surgery were analysed using product-limit-survivorship method. The survival rates after age-stratification were compared with those of patients undergone elective surgery (n=599) or emergency surgery because of ruptured AAAs (n=363) during the same period. Risk factors affecting early and late survival rates after operation were analysed by logistic regression analysis and Cox proportional hazard model.Results: Thirty-day operative mortality rates were 18 % (20/110) in the emergency non-ruptured group, compared with 7 % (42/599) in the elective group and 49 % (179/363) in the ruptured group (p<0.05). Thirty day survival rate was not changed among the nonruptured emergency group from 1970 to 1992, whereas the rates of ruptured and elective groups became better during the study period. Late survival rates for 30-day postoperative survivors were clearly reduced among the non-ruptured emergency group, without difference between the emergency operated ruptured and non-ruptured groups. Coronary artery disease was decreasing significantly early and late survival rates after emergency surgery for non-ruptured AAAs (p<0.05, logistic regression and p<0.001 Cox proportional hazard).Conclusions: Early and late mortality risk is significantly higher (p<0.001) after emergency surgery for haemodynamically stable non-ruptured AAA than after elective surgery, mainly because of coronary artery disease.","PeriodicalId":75495,"journal":{"name":"Annales chirurgiae et gynaecologiae","volume":"88 1","pages":"38-43"},"PeriodicalIF":0.0,"publicationDate":"1999-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21101059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bioassayed demineralized bone matrix and calcium sulfate: use in bone-grafting procedures. 生物测定脱矿骨基质和硫酸钙:用于植骨手术。

Annales chirurgiae et gynaecologiae Pub Date : 1999-01-01

R M Wilkins, C M Kelly, D E Giusti

{"title":"Bioassayed demineralized bone matrix and calcium sulfate: use in bone-grafting procedures.","authors":"R M Wilkins, C M Kelly, D E Giusti","doi":"","DOIUrl":"","url":null,"abstract":"Background and aims: A combination product of bioassayed, demineralized bone matrix (AlloGro, AlloSource, Denver CO) and calcium sulfate pellets (OsteoSet, Wright Medical Technology, Arlington TN) was utilized in a prospective clinical study in 50 patients in need of bone-grafting procedures. It was proposed that the osteoinductive activity of the demineralized bone matrix combined with the osteoconduction and rapid dissolution of the calcium sulfate pellets would complement each other in promoting bone formation.Materials and methods: The patients were evaluated clinically and radiographically at regular intervals post-operatively by an independent clinician. A total 10-point healing score was used to determine healing characteristics and progress. Fifty patients (24 males and 26 females) were treated for benign bone lesions (35), nonunion (11), osteomyelitis (3), and acute fracture (1). The average age was 33 years (range, 3-64 years). Lesions were located in the femur (16), tibia (15), humerus (7), and other sites (12).Results: The average length of follow-up was 14 months (range, 6-32 months). Forty-nine of 50 patients healed their lesions (98%), requiring an average time to heal of 11.8 weeks (range, 3-48 weeks). There were no graft-related complications.Conclusions: The results of this preliminary clinical study suggest that a combination of bioassayed demineralized bone matrix and calcium sulfate is very effective in treating benign lesions of bone, as well as nonhealing fractures, which is comparable to grafting with autograft. Future studies have been undertaken utilizing this combination in all acute operative settings and fracture management situations.","PeriodicalId":75495,"journal":{"name":"Annales chirurgiae et gynaecologiae","volume":"88 3","pages":"180-5"},"PeriodicalIF":0.0,"publicationDate":"1999-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21395084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Histological evaluation of poly(L-lactide/epsilon-caprolactone) membrane implanted subcutaneously in rats. 大鼠皮下植入聚l -丙交酯/ ε -己内酯膜的组织学评价。

Annales chirurgiae et gynaecologiae Pub Date : 1999-01-01

N Ashammakhi, A Papp, R Sayed, M Ruuskanen, M Kallioinen, M Kellomäki, T Waris, J Seppälä, P Törmälä

{"title":"Histological evaluation of poly(L-lactide/epsilon-caprolactone) membrane implanted subcutaneously in rats.","authors":"N Ashammakhi, A Papp, R Sayed, M Ruuskanen, M Kallioinen, M Kellomäki, T Waris, J Seppälä, P Törmälä","doi":"","DOIUrl":"","url":null,"abstract":"Background: Poly(L-lactide/epsilon-caprolactone) [P(L-LA/epsilon-CL)] 50/50 membranes is an absorbable membrane which has been developed recently for possible use in tissue engineering.Aims: To look at histological tissue reactions to the membrane and its behaviour upon its in vivo implantation in rats.Material and methods: P(L-LA/e-CL) 50/50 membranes, 0.4 mm thick, were implanted subcutaneously in the dorsal neck of 20 Wistar rats. The rats were followed-up for 1, 3, 6, 12 and 28 months. After sacrifice, subcutaneous tissues with implants were taken as specimens, inspected for any gross abnormality and histological examination was carried out.Results: No significant macroscopic changes were noticed except for two implants that were grossly rounded. Histologically, the membranes had undergone cracking, fragmentation and progressive degradation. Cracks appeared initially at the periphery of the implant. Large cracks progressed mainly in longitudinal planes. Cracks occurred in the middle of implants and led to membrane bending in some cases. \"Neomembrane\" formation, comprised of fibrous tissue and the implant, was seen. The foreign-body reaction to the membrane involved macrophages and foreign-body giant cells. In one case an acute type of polymorphonuclear cell reaction was observed and in a second case a predominantly lymphocytic reaction was seen at three months. They were thought to be the results of infection. No other adverse effects were seen.Conclusions: P(L-LA/e-CL) 50/50 membrane was found to be biocompatible when implanted subcutaneously in rats. It was degraded to a great extent but not completely in 28 months.","PeriodicalId":75495,"journal":{"name":"Annales chirurgiae et gynaecologiae","volume":"88 4","pages":"313-7"},"PeriodicalIF":0.0,"publicationDate":"1999-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21516676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0