oalib
Search Results: 1 - 10 of 100 matches for " "
All listed articles are free for downloading (OA Articles)
Page 1 /100
Display every page Item
Refuerzo vertebral percutáneo: vertebroplastia y cifoplastia. Procedimiento técnico Percutaneous vertebral augmentation: vertebroplasty and kyphoplasty. Operative technique  [cached]
J.V. Martínez-Qui?ones,J. Aso-Escario,R. Arregui-Calvo
Neurocirugía , 2005,
Abstract: Las técnicas de refuerzo vertebral, vertebroplastia y cifoplastia, consisten básicamente en la introducción de un cemento óseo -polimetilmetacrilato (PMMA)- en un cuerpo vertebral fracturado, para aliviar el dolor mediante la estabilización de la fractura vertebral. En ocasiones, previamente a la administración del cemento, a nivel de la vértebra colapsada, se inserta un balón que se insufla con la finalidad de restaurar la altura del cuerpo vertebral y reducir la deformidad cifótica; en estos casos hablamos de cifoplastia o de vertebroplastia mediante balón. Las indicaciones de la vertebroplastia y cifoplastia han ido evolucionando, pasando de la estabilización de una fractura vertebral osteoporótica dolorosa, al refuerzo de un colapso vertebral secundario a metástasis. En el presente trabajo se revisan los principales aspectos técnicos de la vertebroplastia y de la cifoplastia, a la luz de nuestra experiencia en el tratamiento de las fracturas vertebrales. Se necesitan más estudios que permitan definir el papel de cada procedimiento dentro del arsenal terapéutico de la cirugía de columna. The intravertebral injection of acrylic resin cement -usually polymethylmethacrylate (PMMA)- into a fractured vertebral body, constitutes the basis of the so called “vertebral augmentation techniques”, “vertebroplasty” and “kyphoplasty”, to manage pain and to strengthen and stabilize the compromised vertebra. In some ocassion, prior to the PMMA injection, an inflatable bone tamp was inserted into both pedicles of the fractured vertebra with the aim of restoring vertebral height to correct the kyphosis deformation. This procedure is called kyphoplasty (balloon-assisted vertebroplasty). The indications for vertebroplasty and kyphoplasty are evolving, from stabilization of painful osteoporotic vertebral fractures to vertebral collapse secondary to spinal metastases. In this paper we review the technical basis of both procedures, according to our experience in the treatment of vertebral fractures. Further studies are required to define the role for each techniques in the spinal surgery’s armamentarium.
Experiencia preliminar en el tratamiento combinado de metástasis vertebrales mediante radiofrecuencia y cifoplastia en sesión única Preliminary experience in the treatment of vertebral metastases by radiofrequency and Kyphoplasty combined in one single session  [cached]
G. Buitrago,E. Castro,J. C. Garrido,P. Fernández-García
Revista de la Sociedad Espa?ola del Dolor , 2013,
Abstract: Objetivos: Describir nuestra experiencia preliminar en el tratamiento de metástasis vertebrales mediante radiofrecuencia y cifoplastia combinadas en sesión única. Material y métodos: Se trataron cuatro pacientes con metástasis vertebral única confirmada histológicamente (mama, próstata, pulmón y mieloma en D12, L1, L5 y D12, respectivamente). La indicación en todos los casos fue el dolor con una mala respuesta al tratamiento médico habitual. Todos los pacientes presentaban dolor en el rango 6-7 de la escala visual analógica (EVA). En dos casos existía lesión lítica del muro posterior. Tras la obtención del consentimiento informado se realizó el procedimiento bajo sedación e infiltración anestésica local. Se efectuó abordaje transpedicular bilateral con sistemas de punción ósea 11G. Se insertaron de forma coaxial dos agujas de radiofrecuencia para efectuar un ciclo de ablación por cada pedículo. Durante el ciclo de ablación la punta del dispositivo correspondiente se situó en la unión del tercio medio con el tercio anterior del cuerpo vertebral, empleando la segunda aguja como sensor térmico, con su extremo a la altura del muro posterior. La duración de cada ciclo de ablación fue de 8 minutos, alcanzando temperaturas intratumorales de 70-80 oC. A continuación se realizó cifoplastia transpedicular. Resultados: No se registraron complicaciones intra-periprocedimiento, con alta domiciliaria en las 24 horas siguientes. En todos los pacientes hubo una mejoría inmediata del dolor tras el procedimiento (con dolor de intensidad 1-2 de la EVA). En tres pacientes se retiró progresivamente la medicación analgésica, sin evidencia en ninguno de ellos de progresión local de la enfermedad ni recurrencia-aumento del dolor en el seguimiento (dolor de intensidad 1 de la EVA en un seguimiento en el rango de 8-14 meses). En un paciente no se pudo efectuar seguimiento clínico-radiológico posterior al alta. Conclusión: El empleo de radiofrecuencia asociada a cifoplastia en la enfermedad metastásica vertebral puede contribuir al manejo del dolor refractario al tratamiento médico y al control local de la enfermedad. Objectives: Describe our preliminary experience in the treatment of vertebral metastases by radiofrequency and Kyphoplasty combined in one single session. Material and methods: Four patients with histologically confirmed single spinal metastasis (breast, prostate, lung and myeloma in L1, L5, D12, D12, respectively) were treated. The indication in all cases was pain with a poor response to medical treatment. All patients had pain in the range 6-7 visual analogue scale
Two years results of unilateral lateral rectus recession on moderate intermittent exotropia  [cached]
Hossein Attarzadeh,Alireza Zandi,Kobra Nasrollahi,Ali Akbar Mortazavi
Journal of Research in Medical Sciences , 2008,
Abstract: BACKGROUND: This survey was performed to determine the effect of unilateral lateral rectus recession in treatment of moderate angle intermittent exotropia. However, this type of operation and its long term results in patients with moderate angle exotropia have not yet been studied in Iran. METHODS: Forty patients with basic type intermittent exotropia with moderate angle deviation (25-30.D) were included in this study. All patients underwent unilateral lateral rectus recession (8 mm) in the relatively non-dominant eye. Patients were visited and examined after operation, 1 day, 1 week and 1 month later and then, every 6 months up to 3 years. Data were analyzed by t-paired test. RESULTS: Before operation all patients had 25-30.D basic type intermittent exotropia. Two months after operation perfect orthophoria was observed in 33 (82.5%) subjects, 95.D undercorrection in 4 (10%) patients and 6-10.D undercorrection in 3 (7.5%) ones. At the last visit, findings included perfect orthophoria in 30 (75%) patients, 95.D undercorrection in 5 (12.5%) subjects and 6-10.D undercorrection in 5 (12.5%) patients. Preoperatively, none of the patients had fine stereopsis, 25 patients had moderate to good stereopsis and 15 patients had fair to poor stereopsis. Postoperatively, the data were changed to fine stereopsis in 18 patients, moderate to good in 18 patients and fair stereopsis in 4 patients. CONCLUSIONS: Results of this study indicated high effectivity of unilateral lateral rectus recession on moderate angle intermittent exotropia. KEYWORDS: Intermittent exotropia, lateral rectus recession, strabismus, stereopsis.
Unilateral Lateral Entorhinal Inactivation Impairs Memory Expression in Trace Eyeblink Conditioning  [PDF]
Stephanie E. Tanninen, Mark D. Morrissey, Kaori Takehara-Nishiuchi
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0084543
Abstract: Memory in trace eyeblink conditioning is mediated by an inter-connected network that involves the hippocampus (HPC), several neocortical regions, and the cerebellum. This network reorganizes after learning as the center of the network shifts from the HPC to the medial prefrontal cortex (mPFC). Despite the network reorganization, the lateral entorhinal cortex (LEC) plays a stable role in expressing recently acquired HPC-dependent memory as well as remotely acquired mPFC-dependent memory. Entorhinal involvement in recent memory expression may be attributed to its previously proposed interactions with the HPC. In contrast, it remains unknown how the LEC participates in memory expression after the network disengages from the HPC. The present study tested the possibility that the LEC and mPFC functionally interact during remote memory expression by examining the impact of pharmacological inactivation of the LEC in one hemisphere and the mPFC in the contralateral hemisphere on memory expression in rats. Memory expression one day and one month after learning was significantly impaired after LEC-mPFC inactivation; however, the degree of impairment was comparable to that after unilateral LEC inactivation. Unilateral mPFC inactivation had no effect on recent or remote memory expression. These results suggest that the integrity of the LEC in both hemispheres is necessary for memory expression. Functional interactions between the LEC and mPFC should therefore be tested with an alternative design.
CIFOPLASTIA PERCUTANEA CON BALóN EN FRACTURAS POR COMPRESIóN DE ETIOLOGíA NO TRAUMáTICA EN COLUMNA TORáCICA Y LUMBAR PERCUTANEOUS BALLOON KYPHOPLASTY IN NON-TRAUMATIC LUMBAR AND THORACIC SPINAL COMPRESSION FRACTURES  [cached]
Luz María Atlagich G,Pablo Herrera C,Leopoldo Díaz,Carla Olavarría L
Revista Chilena de Radiología , 2009,
Abstract: Propósito: Describir nuestra experiencia en cifoplastía percutanea con balón en fracturas vertebrales debidas a compresión no traumática. Material y Métodos: Se intervinieron 25 vértebras en 10 pacientes, 15 lumbares y 10 torácicas, entre marzo 2007 y junio 2008. La etiología de las fracturas fue osteoporótica en 10 casos y tumoral en 15. Se evaluó el compromiso vertebral mediante tomografía computada o resonancia magnética, según el caso. La técnica fue percutanea; se insertaron balones en el cuerpo vertebral, que se inflaron, creando así una cavidad que se relleno inyectando polimetilme-tacrilato (PMMA), que redujo y estabilizó la fractura, disminuyendo así el dolor. Resultados: La técnica fue realizada satisfactoriamente en todos los casos. La intensidad del dolor medida según la Escala Visual Análoga (EVA), antes y después del procedimiento, varió entre 4 y 7 niveles por paciente. El EVA de ingreso promedio fue de 7, y el de egreso de 1.2. La disminución del dolor fue en promedio 5.8 niveles por intervención. Hubo complicaciones en 7 niveles: 3 casos de extravasación torácica y 4 en columna lumbar, todas asintomáticas. No hubo complicaciones severas. Conclusiones: La cifoplastía con balón es una buena alternativa analgésica al manejo conservador en fracturas vertebrales por compresión. Purpose: To describe our experience with percutaneous balloon kyphoplasty for the treatment of non-traumatic vertebral compression fractures. Material and Methods: Between March 2007and June 2008, 25 vertebrae interventions were performed in 10 patients. Ten cases corresponded to osteoporotic fractures, while fifteen of them revealed a tumoral etiology. Vertebral compromise was evaluated via CT scan or MRI, as appropriate. We applied a percutaneous technique. Balloons were inserted into the vertebral body, and then inflated to create a cavity to be filled with polymethylmethacrylate (PMMA), which reduces and stabilizes the fracture, thus reducing pain. Results: The technique was performed successfully in al I cases. Pain intensity assessed by Visual Analogue Scale (VAS) before and after the procedure showed a variation ranging from 4 to 7 levels per patient. The mean inicial VAS score was 7, whereas average final VAS was 1.2. The decrease in pain levels averaged 5.8 per intervention. Complications occurred in 7 levels: 3 cases of thoracic extravasations and 4 cases in lumbar spine. All of them were asymptomatic. No severe complications were reposed. Conclusions: Percutaneous balloon kyphoplasty offers a good alternative treatment to conservative pain management in ver
Papel del refuerzo vertebral mediante cifoplastia en el tratamiento de las fracturas dorsolumbares de índole no osteoporótico: Revisión del tema y análisis de 40 casos Vertebral reinforcement by means of kyphoplasty in the treatment of non-osteoporotic thoraco-lumbar fractures: Study of 40 cases and review of the literature  [cached]
R. Arregui,J.V. Martínez-Qui?ones,J. Aso-Escario,J. Aso-Vizan
Neurocirugía , 2008,
Abstract: Objetivo. Presentamos una serie de pacientes con fracturas toraco-lumbares agudas en los que se ha practicado un refuerzo vertebral mediante cifoplastia, bien de forma aislada (cifoplastia percutánea) bien combinada con una fijación transpedicular posterior (cifoplastia abierta). Analizamos la posibilidad de ampliar el uso de la cifoplastia a las fracturas vertebrales de causa no osteoporótica, así como combinarla a los métodos tradicionales de fusión posterior. Método. En nuestro servicio, entre los a os 2003 y 2005, se trataron 138 pacientes afectos de una fractura aguda toraco-lumbar. En 87 casos se apreció una fractura a un nivel; en 34 a 2 niveles y, en los 17 restantes en más de dos. Un tratamiento conservador (reposo en cama, fisioterapia y movilización progresiva con corsé), fue realizado en 65 pacientes (47%). Los 73 pacientes restantes fueron tratados quirúrgicamente, realizándose un refuerzo mediante cifoplastia percutánea en 25 casos (18%), ó una cifoplastia asociada a fusión vertebral posterior en otros 15 (11%). Diferentes modalidades de fijaciones atornilladas se realizaron en los 33 pacientes restantes (24%). Este último grupo no ha sido objeto del presente estudio. La estancia media hospitalaria de los pacientes tratados conservadoramente fue de 29 días. Siete de ellos (11%) experimentaron una mala evolución, mostrando en las secuencias T2 del control de resonancia magnética una persistencia de hiperintensidad en el soma vertebral, sugerente de edema local. Todos los pacientes que fueron tratados mediante cifoplastia aislada (percutánea) o combinada (abierta) mantenían una integridad neurológica; fueron clasificados en dos grupos: "Grupo a": Tratados mediante cifoplastia percutánea (n=25). El índice medio sagital de este grupo fue de 11o (6o-15o). En 9 pacientes, el acu amiento vertebral superaba el 25%. La estancia media hospitalaria de este grupo fue de 14 días. "Grupo b": Tratados mediante cifoplastia combinada a fijación transpedicular (n=15): El índice medio sagital fue de 23o (13o-40o). Todos los casos presentaron un acu amiento vertebral superior al 25% junto a una alteración del muro vertebral posterior. La estancia media hospitalaria de este grupo fue de 35 días. Resultados. El resultado clínico de los 40 pacientes sometidos a cifoplastia fue medido en base al estado laboral, la restricción en las actividades físicas y el uso de analgesia. 36 pacientes regresaron a su trabajo previo con excepción de 4 casos del "Grupo b". En 11 casos se registró una restricción ligera de la actividad física. El seguimiento medio del "Grupo a" fu
Fuga intrarraquídea de cemento biológico tras cifoplastia. Evolución a largo plazo: Presentación de un caso y revisión de la literatura Biological cement extravasation into the spinal canal following kyphoplasty: Long-term follow-up. Report of one case and review of the literature  [cached]
J.V. Martínez-Qui?ones,J.M. Medina-Imbroda,J. Aso-Escario,J. Pons Bosque
Neurocirugía , 2011,
Abstract: Introducción: La vertebroplastia y la cifoplastia son técnicas percutáneas mínimamente invasivas indicadas en el tratamiento de ciertas fracturas somáticas vertebrales. Ambas se basan en la introducción dentro del cuerpo vertebral de una sustancia llamada genéricamente cemento, el cual puede ser acrílico o biológico. Son técnicas no exentas de riesgos, destacando como principal complicación la extravasación del cemento. Dada la corta experiencia en el uso de cementos biológicos, existen hoy en día muchas dudas sin resolver acerca de su comportamiento a largo plazo, especialmente en caso de que se produzca una fuga del material de refuerzo vertebral. Objetivo: Presentamos un caso de extravasación intrarraquídea de cemento biológico durante una cifoplastia en un varón de 23 a os y su evolución a largo plazo (3 a os), realizando una revisión de la literatura publicada al respecto. Conclusiones: La mayoría de los estudios publicados tratan sobre la evolución del material de refuerzo dentro de un ambiente óseo, pero no hacen referencia a cómo evolucionaría el mismo fuera del espacio vertebral. Hemos apreciado, en nuestro caso, que el cemento extravasado no está siendo sustituido por hueso, sino que está sufriendo un proceso de reabsorción. La extravasación del material de refuerzo vertebral es una complicación importante y potencialmente grave de las técnicas de refuerzo vertebral percutáneo. Para evitarla se requiere una rigurosa técnica quirúrgica bajo control radioscópico. Los cementos biológicos tienen la ventaja de ser biocompatibles, biodegradables y osteoconductivos. La elección del cemento dependerá de las características de la interacción balón-trabécula. Backgroun: Vertebroplasty and kyphoplasty are minimally invasive percutaneous techniques indicated in the treatment of some somatic vertebral fractures. Both are based on the introduction of a substance, called cement, inside the vertebral body. We can choose acrylic or biological cement. These techniques are not risk-free, cement extravasation being the main complication. Due to the short experience in the use of the biological cements, nowadays there are a lot of unresolved doubts about the long-term behaviour of these materials, especially in the case of leakage. Purpose: We report a case of biologic cement extravasation into the spinal canal during a kyphoplasty in a 23 year old man and its long-term follow-up (3 years), performing a review of the scientific literature related to the topic. Conclusions: Most of the papers in the literature discuss the behaviour of the reinforcement material ins
Bilateral Nerve Alterations in a Unilateral Experimental Neurotrophic Keratopathy Model: A Lateral Conjunctival Approach for Trigeminal Axotomy  [PDF]
Takefumi Yamaguchi, Aslihan Turhan, Deshea L. Harris, Kai Hu, Harald Prüss, Ulrich von Andrian, Pedram Hamrah
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0070908
Abstract: To study bilateral nerve changes in a newly developed novel mouse model for neurotrophic keratopathy by approaching the trigeminal nerve from the lateral fornix. Surgical axotomy of the ciliary nerve of the trigeminal nerve was performed in adult BALB/c mice at the posterior sclera. Axotomized, contralateral, and sham-treated corneas were excised on post-operative days 1, 3, 5, 7 and 14 and immunofluorescence histochemistry was performed with anti-β-tubulin antibody to evaluate corneal nerve density. Blink reflex was evaluated using a nylon thread. The survival rate was 100% with minimal bleeding during axotomy and a surgical time of 8±0.5 minutes. The blink reflex was diminished at day 1 after axotomy, but remained intact in the contralateral eyes in all mice. The central and peripheral subbasal nerves were not detectable in the axotomized cornea at day 1 (p<0.001), compared to normal eyes (101.3±14.8 and 69.7±12.0 mm/mm2 centrally and peripherally). Interestingly, the subbasal nerve density in the contralateral non-surgical eyes also decreased significantly to 62.4±2.8 mm/mm2 in the center from day 1 (p<0.001), but did not change in the periphery (77.3±11.7 mm/mm2, P = 0.819). Our novel trigeminal axotomy mouse model is highly effective, less invasive, rapid, and has a high survival rate, demonstrating immediate loss of subbasal nerves in axotomized eyes and decreased subbasal nerves in contralateral eyes after unilateral axotomy. This model will allow investigating the effects of corneal nerve damage and serves as a new model for neurotrophic keratopathy.
The Effect of Unilateral Testicular Blunt Trauma and Protective Effect of Zinc on Spermatogenesis of Contra Lateral Testis of Pre-pubertal Wistar Rat  [cached]
GH Saki
Qom University of Medical Sciences Journal , 2012,
Abstract: Background and Objectives There has so far been controversy among researches about the effect of unilateral blunt testis trauma on structure and function of contra lateral testis. This study was designed to evaluate the effect of unilateral blunt testicular trauma after a time span of spermatogenesis (40 days) on the number of round and elongated spermatic cells, spermatogonia, primary spermatocyte, sertoli and leydig cells of contra-lateral testis as well as to assess the protective effect of zinc on unilateral blunt testicular trauma. Methods In this experimental study 30 pre-pubertal male Wistar rats (age 7 weeks) were divided into three equal groups (n=10). Group 1(control) underwent a sham operation of the left testis under general anesthesia. Rats in group II and group III (with blunt testicular trauma) were subjected to left blunt testicular trauma to rupture the tunica albuginea. In group III just after the trauma, 30 mg/kg zinc sulfate were given intra-peritoneally followed by admission of Zn for 40 days at a dose of 500 parts per million (ppm) /day orally. Later on, all rats were sacrificed and their right testes were removed and after histological processing and staining by H & E method the samples were evaluated by counting round and elongated spermatid cells, spermatogonia, primary spermatocyte, sertoli and leydig cells and also by cell structures study. Data were analyzed using ANOVA, Tukey and Duncan's tests and pvalue of <0.05 was considered as statistically significant. Results There were no significant differences in the number of round and elongated spermatid, spermatogonia, sertoli and leydig cells of testis of the three groups(P>0.05). Histological changes in sertoli and leydig cell were seen. Therefore, the protective effect of zinc was not significant on germ cell proliferation and structure. Conclusion The results suggest that unilateral blunt testis trauma after time course of 40 days has no effect on germ cell layers and leydig and sertoli cells proliferation. This study suggests long term evaluation of testes after blunt trauma with use of electron microscope.
The Effect of Unilateral Testicular Blunt Trauma and Protective Effect of Zinc on Spermatogenesis of Contra Lateral Testis of Pre-pubertal Wistar Rat
Gh. Saki,K. Radan,Sh. M. Radmard,I. Rashidi
Qom University of Medical Sciences Journal , 2009,
Abstract: Background and ObjectivesThere has so far been controversy among researches about the effect of unilateral blunt testis trauma on structure and function of contra lateral testis. This study was designed to evaluate the effect of unilateral blunt testicular trauma after a time span of spermatogenesis (40 days) on the number of round and elongated spermatic cells, spermatogonia, primary spermatocyte, sertoli and leydig cells of contra-lateral testis as well as to assess the protective effect of zinc on unilateral blunt testicular trauma.MethodsIn this experimental study 30 pre-pubertal male Wistar rats (age 7 weeks) were divided into three equal groups (n=10). Group 1(control) underwent a sham operation of the left testis under general anesthesia. Rats in group II and group III (with blunt testicular trauma) were subjected to left blunt testicular trauma to rupture the tunica albuginea. In group III just after the trauma, 30 mg/kg zinc sulfate were given intra-peritoneally followed by admission of Zn for 40 days at a dose of 500 parts per million (ppm) /day orally. Later on, all rats were sacrificed and their right testes were removed and after histological processing and staining by H & E method the samples were evaluated by counting round and elongated spermatid cells, spermatogonia, primary spermatocyte, sertoli and leydig cells and also by cell structures study. Data were analyzed using ANOVA, Tukey and Duncan's tests and pvalue of <0.05 was considered as statistically significant.ResultsThere were no significant differences in the number of round and elongated spermatid, spermatogonia, sertoli and leydig cells of testis of the three groups(P>0.05). Histological changes in sertoli and leydig cell were seen. Therefore, the protective effect of zinc was not significant on germ cell proliferation and structure. ConclusionThe results suggest that unilateral blunt testis trauma after time course of 40 days has no effect on germ cell layers and leydig and sertoli cells proliferation. This study suggests long term evaluation of testes after blunt trauma with use of electron microscope.Keywords: Unilateral Blunt Trauma; Testis; Zinc; Rat; Spermatogenesis.
Page 1 /100
Display every page Item


Home
Copyright © 2008-2017 Open Access Library. All rights reserved.