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1.
Rev. bras. cir. plást ; 39(1): 1-8, jan.mar.2024. ilus
Article in English, Portuguese | LILACS-Express | LILACS | ID: biblio-1552822

ABSTRACT

Introdução: Os estudos de anatomia em cadáveres permitiram um melhor entendimento das estruturas da face e, consequentemente, mais segurança ao explorar os planos profundos da região facial. Uma boa técnica deve ser segura, reprodutível e respeitar os pontos anatômicos. O objetivo deste trabalho é desmistificar a técnica de deep plane facelifting por meio da dissecção de cadáveres e exposição das estruturas faciais. Método: A reprodução da técnica de "deep plane facelifting" foi realizada em 14 hemifaces de 7 peças de cadáveres frescos no Instituto de Treinamento de Cadáver em Curitiba no ano de 2021. A técnica cirúrgica foi realizada conforme nossa prática clínica e reproduzida no cadáver. Após o procedimento, as estruturas anatômicas faciais foram dissecadas para correlacionar seu posicionamento junto aos espaços anatômicos da face. Foram avaliados os posicionamentos dos ligamentos da face, vascularização e os ramos do nervo facial. Resultados: Foram identificados os espaços anatômicos relevantes à técnica de deep plane facelifting, como os espaços massetéricos inferior e superior, espaço pré-zigomático, espaço bucal e espaço cervical. Os ramos do nervo facial foram identificados no plano subSMAS e correlacionados com os espaços e planos anatômicos. Conclusão: A técnica de deep plane facelift pode ser reproduzida com segurança desde que sejam respeitados dois parâmetros. O primeiro é a entrada correta nos espaços a fim de respeitar a anatomia. O segundo é o uso de descoladores rombos para dissecção nos planos profundos da face a fim de evitar lesão nervosa dos ramos do nervo facial.


Introduction: Anatomy studies on cadavers have allowed a better understanding of the structures of the face and, consequently, greater safety when exploring the deep planes of the facial region. A good technique must be safe, reproducible, and respect anatomical points. The objective of this work is to demystify the deep plane facelifting technique through the dissection of cadavers and exposure of facial structures. Method: The reproduction of the "deep plane facelifting" technique was performed on 14 hemifaces of 7 pieces of fresh cadavers at the Instituto de Treinamento de Cadáver (Cadaver Training Institute) in Curitiba in 2021. The surgical technique was performed according to our clinical practice and reproduced on the cadaver. After the procedure, the facial anatomical structures were dissected to correlate their positioning with the anatomical spaces of the face. The positioning of the facial ligaments, vascularization, and branches of the facial nerve were evaluated. Results: The anatomical spaces relevant to the deep plane facelifting technique were identified, such as the inferior and superior masseteric spaces, prezygomatic space, buccal space, and cervical space. The facial nerve branches were identified in the sub-SMAS plane and correlated with the anatomical spaces and planes. Conclusion: The deep plane facelift technique can be reproduced safely as long as two parameters are respected. The first is the correct entry into spaces to respect the anatomy. The second is the use of blunt detachers for dissection in the deep planes of the face to avoid nerve damage to the branches of the facial nerve.

2.
International Eye Science ; (12): 307-311, 2024.
Article in Chinese | WPRIM | ID: wpr-1005400

ABSTRACT

AIM: To investigate the differences in varying stages of non-proliferative diabetic retinopathy(NPDR)using optical coherence tomography angiography(OCTA).METHODS: Cross-sectional study. A total of 77 cases(77 eyes)of diabetic patients were included, and they were divided into non-diabetic retinopathy(NDR; 23 eyes)and non-proliferative diabetic retinopathy(NPDR; 54 eyes)groups, further subdivided into mild NPDR(20 eyes), moderate NPDR(20 eyes), and severe NPDR(14 eyes). Foveal avascular zone(FAZ)area, superficial and deep capillary plexus densities(SSP and DSP), and visual acuity(LogMAR)were compared between NDR and NPDR groups. Furthermore, the visual acuity, FAZ area and levels of SSP and DSP were compared in different degrees of NPDR. Correlation analysis were conducted to elucidate relationships between FAZ area, visual acuity, SSP, DSP, and severity of the disease.RESULTS: Compared with the NDR group, the visual acuity(LogMAR)and macular FAZ area increased, while SSP and DSP were decreased in the NPDR group(P<0.05); there were significant differences in visual acuity, FAZ area and SSP and DSP levels in different degrees of NPDR(P<0.05). Visual acuity(LogMAR)and FAZ area displayed a positive correlation with the severity of disease, while SSP and DSP showed a negative correlation.CONCLUSION: With the progression of NPDR, the visual acuity(LogMAR)and FAZ area increased, and the SSP and DSP decreased.

3.
Journal of Sun Yat-sen University(Medical Sciences) ; (6): 297-309, 2024.
Article in Chinese | WPRIM | ID: wpr-1016452

ABSTRACT

ObjectiveThis study aims to explore the effect of ultrasound-guided superficial parasternal intercostal plane block on the quality of recovery and postoperative analgesia in patients undergoing sternotomy cardiac surgery. MethodsA total of 64 patients undergoing sternotomy cardiac surgery were selected for this study. They were randomly divided into two groups: one group received a superficial parasternal intercostal plane block with ropivacaine (the ropivacaine group), while the other was given normal saline (the normal saline group). The primary outcome was the Quality of Recovery-15 (QoR-15) score on postoperative day 1 in both groups, accompanied by a comparative analysis of the pain score and opioid usage. ResultsCompared with the normal saline group, the ropivacaine group exhibited a significantly higher QoR-15 score on postoperative day 1[(89.60±13.24) vs (81.18±12.78), P=0.012]. The numerical rating scale at rest was significantly lower[(3.03±0.72) vs (4.26±0.93), P<0.001], and the numerical rating scale during coughing was also significantly reduced [(4.40±0.89) vs (5.44±1.05), P<0.001]. Concurrently, the cumulative morphine equivalent consumption during the initial 24 h postoperatively was significantly lower in patients who were administered the ropivacaine [14.15 (4.95~30.00) mg vs 40.50 (19.25~68.18) mg, P=0.002], and there was also a notable decrease in the rescue analgesia [0.00 (0.00~0.00) mg vs 0.00 (0.00~100.00) mg, P=0.007]. ConclusionUltrasound-guided superficial parasternal intercostal plane block can significantly enhance the overall quality of recovery in patients undergoing sternotomy cardiac surgery on postoperative day 1. The technique contributes to improved postoperative analgesic effects and a reduction in opioid usage, thereby facilitating early postoperative recovery.

4.
Rev. méd. hered ; 34(3)jul. 2023.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1530291

ABSTRACT

El Dermatofibrosarcoma Protuberans es un tumor cutáneo fibrohistiocítico, extremadamente raro y representa menos del 1% de los tumores mamarios. Se caracteriza por un lento crecimiento, pero con comportamiento infiltrante con altas tasas de recidiva local. Se puede sospechar clínicamente, la confirmación es histopatológica y se debe complementar con inmunohistoquímica. El tratamiento de elección es quirúrgico. Se presenta el caso de una mujer de 23 años con Dermatofibrosarcoma Protuberans de mama derecha, sometida a tumorectomía y reconstrucción inmediata de colgajo de dorsal ancho. La paciente tuvo evolución satisfactoria, sin evidencia de enfermedad.


SUMMARY Dermatofibrosarcoma protuberans is a fibro histiocytic cutaneous tumor extremely rare that accounts for less than 1% of all breast cancers, and it is characterized by slow growing but locally invasiveness with high recurrence rates. Confirmation of the diagnosis is with histopathology with immunohistochemistry. Treatment of choice is surgical resection with latissimus dorsalis reconstruction. We present the case of a 23-year-old woman with dermatofibrosarcoma protuberans of the right breast in whom a tumorectomy followed by latissimus dorsalis reconstruction was performed. The patient had a favorable clinical evolution remaining free of disease.

5.
Arq. gastroenterol ; 60(2): 208-216, Apr.-June 2023. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1447386

ABSTRACT

ABSTRACT Background: Esophageal endoscopic submucosal dissection (EESD) is a complex and time-consuming procedure at which training are mainly available in Japan. There is a paucity of data concerning the learning curve to master EESD by Western endoscopists. Objective: This study aimed to assess the learning curve effect on patient's clinical outcome for EESD. Methods: This is a retrospective observational study. Enrolling patients that underwent EESD from 2009 to 2021. The analysis was divided into two periods; T1: case 1 to 49 and T2: case 50 to 98. The following features were analyzed for each group: patients and tumors characteristics, en-bloc, complete and curative resection rates, procedure duration and adverse events rate. Results: Ninety-eight EESD procedures were performed. Mean procedure time was 111.8 min and 103.6 min for T1 and T2, respectively (P=0.004). En bloc resection rate was 93.8% and 97.9% for T1 and T2, respectively (P=0.307). Complete resection rate was 79.5% and 85.7% for T1 and T2, respectively (P=0.424). Curative resection rate was 65.3% and 71.4% for T1 and T2, respectively (P=0.258). Four patients had complications; three during T1 period and one during T2 period. Overall mortality rate: 0%. Conclusion: The esophageal endoscopic submucosal dissection could be performed effectively and safely by an adequately trained Western endoscopist.


RESUMO Contexto: A dissecção endoscópica da submucosa do esôfago (DSEE) é um procedimento complexo, cujo treinamento está disponível principalmente no Japão. Há uma escassez de dados sobre a curva de aprendizado para se capacitar na realização da DSEE por endoscopistas ocidentais. Objetivo: Este estudo teve como objetivo avaliar o efeito da curva de aprendizado no resultado clínico dos pacientes submetidos a DSEE. Métodos: Trata-se de um estudo observacional retrospectivo. Foram incluídos pacientes submetidos a DSEE no período de 2009 a 2021. A análise foi dividida em dois períodos; T1: caso 1 a 49 e T2: caso 50 a 98. Os seguintes parâmetros foram analisados para cada grupo: características clínicas dos pacientes e dos tumores de esôfago, taxas de ressecção em bloco, completa e curativa, duração do procedimento e taxa de eventos adversos. Resultados: Noventa e oito procedimentos de DSEE foram realizados. O tempo médio do procedimento foi de 111,8 min e 103,6 min nos períodos T1 e T2, respectivamente (P=0,004). A taxa de ressecção em bloco foi de 93,8% e 97,9% nos períodos T1 e T2, respectivamente (P=0,307). A taxa de ressecção completa foi de 79,5% e 85,7% nos períodos T1 e T2, respectivamente (P=0,424). A taxa de ressecção curativa foi de 65,3% e 71,4% para T1 e T2, respectivamente (P=0,258). Quatro pacientes tiveram complicações; três durante o período T1 e um durante o período T2. Taxa de mortalidade geral: 0%. Conclusão: A DSEE pode ser realizada de forma eficaz e segura por um endoscopista ocidental adequadamente treinado.

6.
Int. j. morphol ; 41(2): 548-554, abr. 2023. ilus
Article in Spanish | LILACS | ID: biblio-1440318

ABSTRACT

Los avances en el área de la salud, con el desarrollo de nuevos procedimientos diagnósticos y quirúrgicos, requieren un conocimiento cada vez más preciso de la anatomía humana. La difusión de la disposición variable de la anatomía resulta primordial no sólo en el campo de la especialización o el postgrado, sino por sobre todo, en el pregrado, desde donde se formarán los especialistas que luego desarrollarán esas nuevas prácticas clínicas y quirúrgicas que requerirán una sólida formación anatómica. Es por esto que la aplicación correcta de técnicas anatómicas en las muestras anatómicas es fundamental para que esta enseñanza en el pregrado pueda desarrollarse de manera eficiente, teniendo la plastinación un rol fundamental en este sentido. El objetivo de este trabajo consistió en dar a conocer el hallazgo de variaciones anatómicas arteriales en los miembros superiores de una muestra humana sometida al proceso de plastinación para fomentar, por un lado, la importancia del conocimiento anatómico en el pregrado, el postgrado y las especialidades, como así también la relevancia de la preservación a largo plazo de material biológico para la difusión continua de la anatomía.


SUMMARY: Advances in the area of health with the development of new diagnostic and surgical procedures require an increasingly precise knowledge of human anatomy. The diffusion of the variable arrangement of anatomy is essential not only in the field of specialization or postgraduate, but above all, in the undergraduate, from where the specialists will be trained who will later develop these new clinical and surgical practices that will require a solid anatomical background. This is why the correct application of anatomical techniques in anatomical samples is essential for this undergraduate teaching to be developed efficiently, plastination having a fundamental role in this regard. The aim of this work was to report the discovery of anatomical variations in the upper limbs of a human sample subjected to the plastination process to promote, on one hand, the importance of anatomical knowledge in undergraduate, postgraduate and specialties, as well as the relevance of long- term preservation of biological material for the continued dissemination of anatomy.


Subject(s)
Humans , Ulnar Artery/anatomy & histology , Radial Artery/anatomy & histology , Upper Extremity/blood supply , Anatomic Variation , Plastination
7.
Acta odontol. latinoam ; 36(1): 40-46, Apr. 2023. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1447074

ABSTRACT

ABSTRACT During ceramic veneer luting, resin cement polymerization is performed with interposition of the dental ceramic. Aim: To evaluate how and how much the photoactivation time affects the Vickers hardness of resin-based cements with interposed ceramic. Materials and Method: A total 24 specimens H mm in diameter and 1 mm thick were made from Paracore White Coltene (PC), Densell Resin Duo Cement (DC), 3MRelyX Veneer (RX) and Coltene Fill Up! (FU), interposing VitablockMarkII (Vita Zahnfabrik) feldspathic ceramic 0.6 mm thick during photoactivation. The materials were polymerized using 100% and 25% of the times indicated by the manufacturers with a Coltolux LED ((Coltene) light with intensity 1200 mW/cm2. Each polymerization time group consisted of three specimens of each material, which were stored dry in darkness at 37 °C for 7 days. Three Vickers microhardness measurements were made on the top and bottom surfaces of each specimen using a Vickers Future Tech FM300 microhardness tester (300 g, 5 s). The values were averaged, and the bottom/top ratios calculated. Results were analyzed by ANOVA. (p<0.05) complemented with multiple comparisons using Tukey's test (p<0.05). Results: Different photoactivation times were found to have a significant effect on hardness values of the cements evaluated, with significant differences between some of the cements. No statistically significant difference was found for the effect of photoactivation time on bottom/top microhardness ratio in those materials. Conclusions: Under the experimental conditions employed, it can be concluded that photopolymerization for shorter times and the interposition of restorative material significantly affectpolymerization quality as evaluated by microhardness, but the bottom/top ratio was unaffected by differences in polymerization time.


RESUMEN Durante la fijación de una carilla cerámica, la polimerización del cemento a base de resinas se realiza con la interposición de la cerámica dental. Objetivo: evaluar en qué forma y magnitud afecta el tiempo de fotoactivación en la dureza Vickers de los cementos a base de resinas con la cerámica interpuesta. Materiales y Método: se confeccionaron 24 probetas de 11 mm de diámetro y 1 mm de espesor con: Paracore White Coltene (PC), Resin Duo Cement de Densell (DC), RelyX Veneer de 3M (RX) y Fill Up! De Coltene (FU) interponiendo 0,6 mm de espesor de cerámica feldespática Vitablock Mark II (Vita Zahnfabrik) durante la fotoactivación. Se polimerizó utilizando el 100% y el 25% del tiempo indicado por el fabricante con lámpara Coltolux LED ((Coltene) con 1200 mW/cm2 de intensidad. Cada grupo quedó conformado con tres probetas de cada material que se almacenaron a oscuras y en seco a 37 °C durante 7 días. Se registraron tres mediciones de microdureza Vickers de las superficies top y bottom de cada probeta con un microdurómetro Vickers Future Tech FM300 (300 g, 5 s) y se calculó su promedio, así como la relación entre los valores registrados en cada una de sus caras. Los resultados fueron analizados por medio de la prueba de ANOVA. (p<0.05). complementada con comparaciones múltiples por medio de la prueba de Tukey (p<0.05). Resultados: se encontró un efecto significativo de la modificación del tiempo de fotoactivación en los valores de dureza de los cementos evaluados con diferencias significativas entre algunos de ellos. Simultáneamente no se encontró significación estadística en el efecto de ese factor sobre la relación microdureza bottom/top registrada en esos materiales. Conclusiones: en las condiciones experimentales empleadas puede concluirse que la fotopolimerización en menor tiempo e interposición de material restaurador afecta significativamente la calidad de polimerización evaluada mediante los valores de microdureza, pero la proporción bottom/ top no fue afectada en la variación en el tiempo de polimerización.

8.
Article | IMSEAR | ID: sea-222298

ABSTRACT

Transient focal neurological episodes, also called amyloid spells occur as recurrent, transient episodes of spreading paresthesia seen in 14% of cerebral amyloid angiopathy (CAA) patients. An 81-year-old gentleman with coronary artery disease and a left ventricular clot was on anticoagulant treatment. He presented with three episodes of tingling in the left fingers spreading to the left arm and left leg, each lasting for 10 min. Magnetic resonance imaging of the brain with susceptibility imaging showed convexity hemorrhage, and curvilinear blooming in sulcal spaces of the right cerebral convexity and left precuneus. Warfarin was stopped. He was treated with clobazam, aspirin, and atorvastatin. He improved, so was discharged after 2 days. Amyloid spells can be confused with transient ischemic attack (TIA) or its mimics and the treatment given for TIA can lead to intracranial hemorrhage in CAA patients. Radiological features aid in the diagnosis of CAA and antiplatelets need to be administered cautiously in patients with suspected TIA.

9.
Rev. Flum. Odontol. (Online) ; 1(60): 112-126, jan.-abr. 2023. tab
Article in Portuguese | LILACS, BBO | ID: biblio-1411346

ABSTRACT

A descoloração ou perda de translucidez dos materiais cerâmicos usados em odontologia ainda hoje é um problema, especialmente pelo comprometimento estético. Com o objetivo de comparar a estabilidade de cor, blocos de dissilicato de lítio (IPS e.max CAD HT) e de silicato de lítio reforçado com zircônia (Vita Suprinity HT) fresados no desenho de um disco com dimensões de 1,5 × 7 × 12 mm3 (n = 120) foram preparados usando 3 procedimentos de acabamento de superfície: glaze, polimento mecânico e coloração externa e glaze. Em seguida, cada grupo foi dividido em 2 subgrupos de armazenamento, chá preto e café (n = 10/grupo). As mensurações de cor foram medidas com espectrofotômetro (VITA Easyshade) no estágio inicial e após 1 semana, 2 semanas, 1 mês, 2 meses de armazenamento. As alterações de cor (ΔE) foram calculadas e analisadas estatisticamente usando ANOVA (α < 0,05). Observamos que, para ambos os materiais cerâmicos, o procedimento de glaze apresentou valores de mudança de cor estatisticamente menores do que os outros grupos (p < 0,05) após o armazenamento em ambas as bebidas. Os grupos de dissilicato de lítio apresentaram valores de alteração de cor estatisticamente menores em relação aos grupos de silicato de lítio reforçados com zircônia. Conclui-se que, o glaze sozinho levou a uma maior estabilidade de cor em relação ao polimento mecânico e coloração externa o dissilicato de lítio apresentou maior estabilidade de cor em comparação com o silicato de lítio reforçada com zircônia.


The discoloration or loss of translucency of ceramic materials used in dentistry is still a problem today, especially due to aesthetic compromise. In order to compare color stability, lithium disilicate (IPS e.max CAD HT) and zirconia-reinforced lithium silicate (Vita Suprinity HT) blocks were milled into a disc design with dimensions of 1.5 × 7 × 12 mm3 (n = 120). The specimens were prepared using 3 surface finishing procedures: glaze, mechanical polishing and external staining and glaze. Then, each group was divided into 2 storage subgroups, black tea and coffee (n = 10/group). Color measurements were measured with a spectrophotometer (VITA Easyshade) at the initial stage and after 1 week, 2 weeks, 1 month, 2 months of storage. Color changes (ΔE) were calculated and statistically analyzed using ANOVA (α < 0.05). We observed that, for both ceramic materials, the glaze procedure presented statistically lower color change values ​​than the other groups (p < 0.05) after storage in both beverages. The lithium disilicate groups showed statistically lower color change values ​​than the zirconia-reinforced lithium silicate groups. It is concluded that, glaze alone led to greater color stability compared to mechanical polishing and external staining, lithium disilicate showed greater color stability compared to zirconia-reinforced lithium silicate.


Subject(s)
Beverages , Ceramics , Computer-Aided Design , Color , Dental Polishing/methods , Lithium , Silicates
10.
Chinese Journal of Reparative and Reconstructive Surgery ; (12): 1259-1265, 2023.
Article in Chinese | WPRIM | ID: wpr-1009054

ABSTRACT

OBJECTIVE@#To explore the feasibility of using indocyanine green angiography in mapping the superficial temporal vessels and assisting design and harvesting of the superficial temporal artery based forehead flap.@*METHODS@#A clinical data of 14 patients with facial soft tissue defects repaired with superficial temporal artery based forehead flaps between October 2015 and November 2022 was retrospectively analyzed. There were 9 males and 5 females with a median age of 9.5 years (range, 3-38 years). The forehead flaps were used to reconstruct facial soft tissue defects following excision of facial scar (8 cases) or congenital melanocyte nevus (6 cases). The size of defects ranged from 3 cm×2 cm to 24 cm×9 cm. Before operation, the indocyanine green angiography was used to map the superficial temporal artery and vein, and to analyze the relationship of the arteries and veins. The forehead flaps with unilateral superficial temporal fascia as the pedicle was transferred to repair the small facial defect in 2 cases. The facial pedicle contained the frontal branch of the superficial temporal artery and 2 cm of the superficial temporal fascia around the vessel, and the tiny accompanying vein of the frontal branch of the superficial temporal artery was used as the outflow of the flap. The forehead flaps with the skin pedicle including bilateral or unilateral superficial temporal fascia and the overlying skin was pre-expanded and transferred to repair the large facial defect in 12 cases. The skin pedicle contained the frontal branch of superficial temporal artery and one of main branches of superficial temporal vein. Among the 12 cases, the frontal branch of superficial temporal vein was used as the outflow in 4 cases, and the parietal branch was used as the outflow in 8 cases. The size of the flaps ranged from 3 cm×2 cm to 30 cm×13 cm. The skin pedicles were divided at 3 weeks after the flap transfer.@*RESULTS@#Indocyanine green angiography could clearly showed the course and branching of the superficial temporal artery and vein. Individual differences existed in the location where the frontal branch of the superficial temporal artery entered the forehead. The superficial temporal vein had great variability and did not follow the artery. One patient had expander-related complication, which resulted in 3-cm flap necrosis. The necrotic tissue was debrided and repaired with skin grafting. The other flaps totally survived and the incisions healed by first intention. All patients were followed up 2-24 months, with a median of 11.5 months. The color, texture, and thickness of the flaps matched well with those of recipient sites. Hypertrophic scar was not observed in recipient or donor site. All patients were satisfied with the reconstructive outcomes.@*CONCLUSION@#Indocyanine green angiography can clearly visualize the course and the branches of the superficial temporal arteries and veins, which can help surgeons understand the position, distribution, and concomitant relationship of the superficial temporal vessels, and make a rational surgical plan of the forehead flap.


Subject(s)
Male , Female , Humans , Child, Preschool , Child , Adolescent , Young Adult , Adult , Temporal Arteries/surgery , Indocyanine Green , Forehead/surgery , Retrospective Studies , Skin Transplantation , Angiography , Soft Tissue Injuries/surgery , Perforator Flap/blood supply , Treatment Outcome
11.
Kampo Medicine ; : 16-19, 2023.
Article in Japanese | WPRIM | ID: wpr-1007184

ABSTRACT

We herein report a patient who complained persistent exudate at navel in spite of adequate antibiotics therapy after laparoscopic cholecystectomy was successfully treated with Kampo therapy. The pharmacological effect of this Kampo formulation i.e. senkinnaitakusan is still unknown, but this formulation has been used for persistent infectious diseases. According to the description in the classic textbook, this formulation is suggested to encourage metabolic function and exhibit anti-inflammatory function. There have been no reports of Kampo therapy for the superficial incisional site infection associated with laparoscopic surgery. The authors propose that Kampo medicine is another promising option in the management of surgical site infection (SSI).

12.
Journal of Xi'an Jiaotong University(Medical Sciences) ; (6): 271-274, 2023.
Article in Chinese | WPRIM | ID: wpr-1005755

ABSTRACT

【Objective】 To investigate the clinical effect of optical coherence tomography angiograph (OCTA) applied in retinal microvascular screening in patients with non-proliferative diabetic retinopathy (NPDR). 【Methods】 Thirty patients with NPDR (NPDR group) diagnosed at The Third Affiliated Hospital of Soochow University and 30 healthy volunteers (control group) were selected to receive OCTA examination. The area, perimeter, and circularity of the fovea avascular zone (FAZ) were measured and blood flow density in the superior, inferior, nasal, temporal quadrants of the macular superficial retinal capillary layer (SCP) and the peripapillary radial capillary layer (RPC) of the optic disc were quantified. 【Results】 In NPDR group, blood flow density in the four quadrants of macular SCP and RPC were decreased significantly compared with that in control group (43.68±3.03 vs. 46.98±3.04, 42.79±3.17 vs. 50.45±2.25, 43.21±2.67 vs. 47.44±2.42, 44.21±3.22 vs. 51.72±5.32, 46.43±3.54 vs. 53.02±2.62, 45.97±3.67 vs. 52.53±2.82, 44.63±2.73 vs. 48.19±3.67, 41.73±3.15 vs. 45.12±3.31) (all P<0.01). The area and perimeter of FAZ in NPDR group were significantly higher than those in control group [(0.50±0.06 vs. 0.43±0.47) mm2, (3.10±0.21 vs. 2.87±0.22) mm]. The circularity of FAZ was significantly lower in NPDR group than in control group [(0.63±0.05 vs. 0.67±0.05)%, P<0.01]. 【Conclusion】 OCTA can detect early retinal microstructure changes in NPDR, and thus can be used as an auxiliary screening of NPDR to provide information for early diagnosis and treatment.

13.
Chinese Journal of Reparative and Reconstructive Surgery ; (12): 601-604, 2023.
Article in Chinese | WPRIM | ID: wpr-981639

ABSTRACT

OBJECTIVE@#To explore the effectiveness of folded transverse superficial epigastric artery perforator flap in repairing the large penetrating defect after buccal carcinoma resection.@*METHODS@#Between January 2019 and June 2021, 12 patients with buccal squamous cell carcinoma were treated. There were 6 males and 6 females with an average of 66.9 years (range, 53-79 years). The pathological stage was T3a-T4b, and the preoperative mouth opening was (3.08±0.46) cm. The disease duration ranged from 6 to 24 months, with an average of 15 months. After buccal carcinoma radical resection and neck lymph node dissection, the penetrating defects in size of 8 cm×6 cm to 16 cm×8 cm and in depth of 0.5-1.5 cm were remained. The transverse superficial epigastric artery perforator flap in size of 8 cm×6 cm to 14 cm×8 cm were harvested and folded to repair the penetrating defects. The donor site was sutured directly.@*RESULTS@#All 12 skin flaps survived after operation, and the wounds healed by first intention. No internal or external fistula complications occurred. All incisions at the recipient site healed by first intention. All patients were followed up 12-18 months (mean, 14 months). There was no obvious abnormality in the color and texture of the flap, the oral and facial appearances were symmetrical, and there was no obvious swelling in the cheek. At last follow-up, the patient's mouth opening was (2.89±0.33) cm, which was not significantly different from that before operation ( t=1.879, P=0.087). The subjective satisfaction scores of 12 patients were 6-8 points, with an average of 7.3 points. Significant scars remained at the donor site but concealed in location.@*CONCLUSION@#The folded transverse superficial epigastric artery perforator flap can be used as a surgical method for repairing large penetrating defects after the buccal carcinoma resection, with a good recovery of facial appearance and oral function.


Subject(s)
Male , Female , Humans , Plastic Surgery Procedures , Perforator Flap/blood supply , Skin Transplantation/methods , Epigastric Arteries/surgery , Soft Tissue Injuries/surgery , Carcinoma, Squamous Cell/surgery , Treatment Outcome
14.
Sichuan Mental Health ; (6): 340-346, 2023.
Article in Chinese | WPRIM | ID: wpr-987344

ABSTRACT

BackgroundChronic superficial gastritis (CSG) is a common clinical disease in children. The emotional behavior of CSG children is susceptible due to them suffering from such disease at young age. ObjectiveTo explore the impact of coping strategies on emotional behavior and the effect of family function in children with CSG, and to provide references for clinical intervention in CSG children with emotional behavior problems. MethodsA total of 177 children with CSG admitted to Anhui Children's Hospital from June 2019 to January 2023 were selected as the research subjects. Investigation on family function, emotional and behavioral problems and coping strategies of children was conducted by employing the Family APGAR index (APGAR), the Strengths and Difficulties Questionnaire (SDQ) and Coping Strategies Questionnaire (CSQ). The structural equation model was used to test the mediating effect of family function between coping strategies and emotional behaviors. ResultsThe APGAR score was negatively correlated with both SDQ score and negative coping strategies score (r=-0.507, -0.551, P<0.01), but was positively correlated with positive coping strategy score (r=0.579, P<0.01). The positive coping strategy score was negatively correlated with SDQ score (r=-0.539, P<0.01), while the negative coping strategy score was positively correlated with SDQ score (r=0.543, P<0.01). The result showed that family function played a partial mediating role between positive coping strategies and emotional behavior [indirect effect was -0.133 (95% CI: -0.256~-0.079, P<0.01), accounting for 29.40% of the total effect]. The same mediating effect happened between negative coping strategies and emotional behavior [indirect effect was 0.093 (95% CI: 0.198~0.045, P<0.01), accounting for 28.50% of the total effect]. ConclusionCoping strategies of CSG children can affect emotional behavior directly and indirectly with family function playing a partial intermediary effect.

15.
Journal of Pharmaceutical Practice ; (6): 625-628, 2023.
Article in Chinese | WPRIM | ID: wpr-996920

ABSTRACT

Objective To investigate the pathogenesis of superficial mycosis among naval trainees, and observe the efficacy of a novel antifungal drug. Methods A questionnaire survey was conducted on the onset, medication and recurrence of superficial fungal infection among the trainees from January, 2020 to July, 2020. At the same time, the new antifungal drug sulconazole nitrate spray was provided for treatment and the drug efficacy was observed. Results The participants generally lacked understanding and attention to superficial fungal infections. The incidence rate of superficial fungal infection was 52%, of which 76.2% of patients had recurrence of superficial fungal infection. The sulconazole nitrate spray showed great effect against these infections. Conclusion The trainees should understand the causes of superficial fungal infection through health education and seek medical treatment and medication in time. The cure rate of superficial fungal infections could only be improved through the collaborative management of the school, hospital, and trainees to reduce the impact of these infections on naval trainees’ work and life.

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Chinese Journal of Ocular Fundus Diseases ; (6): 649-656, 2023.
Article in Chinese | WPRIM | ID: wpr-995678

ABSTRACT

Objective:To observe and analyze the superficial retinal blood flow density and its related influencing factors in the macular area of adolescents with different types of non-pathological high myopia (HM).Methods:A retrospective clinical study. From March to August 2022, 117 eyes of 117 adolescents who were admitted to Liaocheng Aier Eye Hospital due to myopia were included in the study. According to equivalent spherical degree (SE) and corneal curvature, subjects were divided into mild myopia or emmetropia group (control group), HM group, occult HM (OHM) group, and super HM (SHM) group, with 30 eyes, 28 eyes, 35 eyes, and 24 eyes, respectively. All subjects underwent medical optometry, intraocular pressure, optical coherence tomography (OCT), OCT angiography (OCTA), axial length (AL) and corneal curvature measurements. The diopter was SE. OCTA instrument was used to scan the macular region in the range of 6 mm×6 mm, and the software automatically divided it into three concentric circles centered on the fovea of the macular, namely, the central area with a diameter of 1 mm, the inner ring area with a diameter of 1-3 mm, and the outer ring area with a diameter of 3-6 mm. The superficial retinal vascular density (SRVD), vascular perfusion density (SBPD), the area, perimeter (PERIM), avascular index (AI) of foveal avascular area (FAZ) and retinal thickness were measured in the macular region as a whole and in different regions. One-way analysis of variance was used to compare the data among groups, and the least significant difference t-test was used to compare the data among groups. The correlation of AL, corneal curvature and intraocular pressure with SRVD and SBPD in macula was analyzed by Pearson correlation analysis. Results:There were significant differences in SRVD and SBPD in the central, inner and outer regions of macula in control group, HM group, OHM group and SHM group ( P<0.05). There were statistically significant differences in the thickness of the retina above, below and on the temporal side of the central and outer ring regions ( P<0.05). However, no statistically significant difference was in the thickness of the retina on the nasal side ( P>0.05). There was no significant difference in PERIM ( P>0.05). There were significant differences in FAZ area and AI ( P<0.05). Correlation analysis showed that AL was negatively correlated with SRVD and SBPD in macular whole and central, inner and outer ring regions ( P <0.05). Corneal curvature and SE were positively correlated with the SRVD and SBPD of macular whole, central area and outer ring area ( P<0.05). AL was negatively correlated with retinal thickness in the outer ring region ( P<0.05). SE was positively correlated with the thickness of the retina above, below and temporally in the outer ring region ( P<0.05). AL was negatively correlated with FAZ area and AI ( P<0.05). SE was positively correlated with FAZ area and PERIM ( P<0.05). Retinal thickness was positively correlated with SRVD and SBPD ( P<0.05). Conclusions:The SRVD and SBPD of different types of HM in adolescents decreases to different degrees. The thickness of the retina in the central region is thicker, and the retina in the outer ring region is thinner. With the decrease of SRVD, the retinal thickness gradually is thinner.

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Chinese Journal of Microsurgery ; (6): 260-266, 2023.
Article in Chinese | WPRIM | ID: wpr-995500

ABSTRACT

Objective:Exploring the clinical efficacy of using ultra-thin lobulated anterolateral thigh perforator flap(ALTPF) with retrograde separation of perforating vessels from the superficial and deep junction layer of the superficial fascia to repair large soft tissue defects in the foot.Methods:From August 2021 to November 2022, 8 patients (5 males and 3 females) were admitted to the Second Department of Hand and Foot Surgery, the Affiliated Central Hospital of Dalian University of Technology. The patients were 28 to 52 years old in age. The soft tissue defects were located in dorsal and plantar foot. At the plantar foot, the wound involved the weight-bearing area with explosion of bone, tendon or internal fixtures. The area of soft tissue defects was 6.0 cm × 5.0 cm - 16.0 cm × 8.0 cm, and the sizes of ALTPF were 8.0 cm ×5.5 cm - 18.0 cm × 8.5 cm. Preoperative high frequency CUD combined with CTA angiography were employed to locate the 2 flap perforator vessels. By keeping the perforator vessels at center and according to the soft tissue defect area and the wound shape, an ALTPF with a proper size and shape was designed in anterolateral thigh. The perforator were separated in the boundary layer between superficial and deep fascia, where it helped to obviously thin the flap. After the flap was harvested, it was further lobulated between the 2 perforators into 2 lobes after having confirmed the effective blood supply. Finally the lobulated ALTPF was transferred to covered the defect in foot. Cautions should be taken to ensure that the flap covered the weight-bearing area of foot. All the donor sites were directly sutured. Postoperative follow-up was conducted to observe the survival of flaps and the functional recovery of the reconstructed site, also to evaluate the clinical effect. Postoperative follow-up included outpatient visits and reviews over WeChat or telephone. Recovery of the ankle motor function was evaluated according to the American Orthopedic Foot and Ankle Societ (AOFAS) ankle-hind foot score scale.Results:All 8 ALTPF survived. Over 6 to 18 months (10.8 months in average) of follow-up, the transferred flaps had good blood supply, soft in texture, with good elasticity and thin in appearance. Appearance and function of donor sites recovered well, except 1 patient who had mild scar hyperplasia. The plantar flap had good abrasion resistance. No flap damage, bleeding or granulation tissue hyperplasia occurred when walking. The mean score of AOFAS ankle-hind foot score achieved 95.6.Conclusion:The application of ultra-thin lobulated ALTPF with retrograde separation of perforating vessels from the superficial fascia at the junction layer for repairing large soft tissue defects in the foot has good clinical efficacy.

18.
Chinese Journal of Microsurgery ; (6): 179-184, 2023.
Article in Chinese | WPRIM | ID: wpr-995493

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Objective:Verstaile free superficial circumflex iliac artery perforator flap(SCIAPF) were adopted for various reconstructive scenarios, and its clinical effect and value was evaluated.Methods:Retrospective analysis was performed on 42 patients with tissue defects admitted in the Department of Orthopeadic of the Second Affiliated Hospital of Wenzhou Medical University from January 2015 to May 2019. Nine patients had injury in the foot, 8 in ankle, 8 in calf, 7 in forearm, 9 in hand, and 1 in the mouth. All of the defects were repaired by SCIAPF, including 28 single soft tissue defect wounds, 8 multiple soft tissue defect, and 6 composite defects. The size of soft tissue defect were 1.2 cm×1.8 cm-14.0 cm×20.8 cm. The size of flaps were 1.5 cm×2.0 cm-15.3 cm×22.3 cm. The patients entered follow up by outpatient clinic visit and telephone reviews to observe the survival of the flaps, functional recovery and complications.Results:In this series, there were 28 flaps, including 18 pedicled with superficia branch of superficial circumflex iliac artery, 2 pedicled with deep branch of superficial circumflex iliac artery, and 8 pedicled with 2 branches. Six were chimeric flaps. Among them, 4 flaps were iliac bone flaps with superficial branch of superficial circumflex iliac artery flaps, and 2 were superficial iliac circumflex artery flap with sartorius muscle flap. Eight cases were resurfaced with lobulated SCIAPF. Arterial anastomoses: end-to-side in 35 arteries and end-to-end in 7 arteries. Venous anastomosis: end-to-end in 27 veins and end-to-side in 15 veins. Venous return through superficial iliac circumflex vein in 25 flaps, through venae comitantes in 12 flaps and through both in 5 flaps. All flap donor sites were sutured directly. All flaps survived uneventfully except for one that compromised with end-to-side anastomotic dehiscence and bleeding, and survived after re-anastomosis. All flaps and donor sites healed primarily. During the follow-up of 6-24(mean, 11.5) months, the pliable flaps were ruddy in colour and soft in texture, without obvious bloatness and pigmentation. The donor site healed well with linear scars in 35 cases and mild scar hyperplasia in 7 cases. The donor hip function were normal. Three patients suffered a numbness of the thigh caused by intraoperative injury lateral femoral cutaneous nerve and it disappeared completely after 3 months.Conclusion:New applications of lobulated or chimeric SCIAPF, based on the SCIA vasculature or its branches, can meet most of the clinical repair requirement.

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Chinese Journal of Microsurgery ; (6): 174-178, 2023.
Article in Chinese | WPRIM | ID: wpr-995492

ABSTRACT

Objective:To investigate the effect of chimeric flap pedicled with superficial branch of superficial iliac circumflex artery in repair of soft tissue defect of dorsal hand combined with metacarpal bone defect.Methods:From May 2015 to January 2022, 34 patients(28 males and 6 females) of soft tissue defects of dorsal hand with metacarpal bone defects were treated in the Department of Orthopedics of Yibin Third People's Hospital. The age of patients ranged from 22 to 51 years old, with an average age of 37 years old. The areas of soft tissue defects after debridement were 2.5 cm×5.0 cm-4.5 cm×9.0 cm, and the defects were all in dorsal hand and dorsal wrist. The lengths of metacarpal bone defect were 1.8-4.1 cm. All the patients had only single metacarpal bone defect, among which: 14 patients had defects in first metacarpal bone, 7 in second metacarpal bone, 4 in third metacarpal bone, 8 in fourth metacarpal bone and 1 in fifth metacarpal bone. All the patients were repaired by chimeric flap pedicled with superficial branch of superficial iliac circumflex artery. The size of flaps were 3.6 cm×5.4 cm-5.2 cm×9.5 cm. Anticoagulation, thermal preservation and plaster fixation were applied for 4-6 weeks after surgery. Postoperative follow-ups included regularly outpatient clinic visit, telephone or Wechat reviews. Follow-up items covered: the feeling and appearance of flaps in recipient sites, healing of the donor sites and recovery of hand functions.Results:All the 34 chimeric flaps survived. Regular follow-up lasted for 3 to 15(average, 10) months. All incisions in the donor sites of hip healed in stage I. TPD of the flaps was 5.1-7.3(mean, 6.4) mm. Appearance of flaps in the receiving area were satisfactory without swelling. Movement of wrists and metacarpophalangeal joints met the basic requirement of movement. The healing time of metacarpal defect was 2-3 months with an average of 2.8 months. Hand functions were evaluated at excellent in 6 patients and good in 28, according to the Evaluation Standard of Upper Limb Partial Functional of Hand Surgery of Chinese Medical Association.Conclusion:The chimeric flap pedicled with superficial branch of superficial iliac circumflex artery is an ideal flap to repair the soft tissue defect in dorsal hand combined with metacarpal bone defect. It has advantages of less donor site damage, good blood supply of flap, simple surgical procedure, and one-stage repair of a combined soft tissue and metacarpal bone defects.

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Chinese Journal of Microsurgery ; (6): 168-173, 2023.
Article in Chinese | WPRIM | ID: wpr-995491

ABSTRACT

Objective:To explore the efficacy of digital and 3D printing technologies on design of superficial iliac circumflex artery flap for coverage the donor site of anterolateral thigh flap(ALTF).Methods:Clinical data of 8 patients were studied retrospectively for treatment of soft tissue defects of hand in the Department of Hand Surgery, Wuxi NO.9 People's Hospital Affiliated to Soochow University, from April 2017 to October 2021. The patients were 6 males and 2 females, aged from 29 to 59 years(mean, 45.8 years). Cause of injury: 3 patients were crushed, 2 by hot pressing, and 3 by machine strangulation. Site of injury included: 5 cases were dorsal hand defects and 3 cases were palm defects. All the wounds were contaminated to varying degrees with soft tissue defects. The areas of soft tissue defect ranged from 11 cm×10 cm to 22 cm×14 cm. Four patients had combined injuries of open fracture of metacarpals and phalanges and 3 with tendon defects. All wounds were repaired by free ALTF transplantation. And the donor sites in the thigh were repaired by superficial iliac circumflex artery flaps. The secondary wounds caused by flap harvesting on abdominal wall were closed directly. The targeted perforator vessels were detected preoperatively by CTA combined with CDU. 3D printed models of the affected hand were obtained before operation for individualised repairs according to the shape and area of the wounds. After the operation, all patients entered scheduled follow-ups at the outpatient clinic and via internet by observing the flap shape and testing the recovery of sensory and movement of adjacent joint.Results:The shapes and sizes of the wounds and the flaps were found basically in accordance with those in the preoperative simulative designs. All flaps in 8 patients survived and the wounds healed completely. All patients entered follow-ups for 8 to 24(average, 17.5) months. The donor thighs presented good appearance and colour, pliability without bloating. The range of motion of the hips and knees was not affected. Only linear scars remained in the abdominal donor sites, with natural colour and appearance.Conclusion:Digital and 3D printing technologies in preoperative design of flaps can help to locate the perforator vessels intraoperatively and guide the individualised design of the flaps with improved operation efficiency and satisfactory appearance of the flaps.

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