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1.
J Back Musculoskelet Rehabil ; 30(5): 1141-1145, 2017 Sep 22.
Artigo em Inglês | MEDLINE | ID: mdl-28946529

RESUMO

BACKGROUND AND OBJECTIVE: Nowadays, pulsed radiofrequency (PRF) is being used to control several types of musculoskeletal pain. Herein, we report a successful application of ultrasound (US)-guided PRF for a patient with refractory sciatic neuropathic pain. CASE REPORT: We applied US-guided PRF to a 50-year-old man, suffering from refractory neuropathic pain on the left foot following sciatic neuropathy for a period of approximately 6 months. We performed PRF on the level of piriformis muscle because the lesion of the sciatic nerve was presented digitally from the level of piriformis muscle on the magnetic resonance images. Under US guidance, the catheter needle was placed close to the left sciatic nerve, and dysesthesia and tingling sensation were reported to be less than 0.2 V. The PRF treatment was administered at 5 Hz and 5 ms pulsed width for 360 seconds at 45 V. After PRF on the left sciatic nerve, pain intensity - based on a numeric rating scale - decreased from 8 to 2. The reduction of pain was sustained for at least 6 months after the PRF procedure. CONCLUSION: We concluded that the PRF treatment is a very useful treatment technique for patients with refractory sciatic neuropathy.


Assuntos
Neuralgia/terapia , Tratamento por Radiofrequência Pulsada/métodos , Nervo Isquiático , Ultrassonografia/métodos , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neuralgia/diagnóstico , Neuralgia/fisiopatologia , Manejo da Dor
2.
Clin Imaging ; 41: 59-64, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-27816877

RESUMO

The metaphyseal locations of tubular bones with osteoid mineralization in young patients are important diagnostic radiologic features of osteosarcoma. The pelvic bones are an unusual location of osteosarcoma. Although osteosarcoma occurring in pelvic bones is not common, the osteoid matrix may be a critical finding for differentiating osteosarcoma from other common pelvic bone tumors. Therefore, the possibility of osteosarcoma in pelvic bones may be considered in the presence of osteoid matrix even in the old age group.


Assuntos
Neoplasias Ósseas/diagnóstico por imagem , Imagem por Ressonância Magnética , Osteossarcoma/diagnóstico por imagem , Ossos Pélvicos/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adolescente , Adulto , Idoso , Neoplasias Ósseas/patologia , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteossarcoma/patologia , Ossos Pélvicos/patologia , Adulto Jovem
3.
J Orthop Surg Res ; 11(1): 160, 2016 Dec 08.
Artigo em Inglês | MEDLINE | ID: mdl-27931231

RESUMO

BACKGROUND: The objective of this study was to investigate serial changes for histology of joint capsule and range of motion of the glenohumeral joint after immobilization in rats. We hypothesized that a rat shoulder contracture model using immobilization would be capable of producing effects on the glenohumeral joint similar to those seen in patients with frozen shoulder. METHODS: Sixty-four Sprague-Dawley rats were randomly divided into one control group (n = 8) and seven immobilization groups (n = 8 per group) that were immobilized with molding plaster for 3 days, or for 1, 2, 3, 4, 5, or 6 weeks. At each time point, eight rats were euthanized for histologic evaluation of the axillary recess and for measurement of the abduction angle. RESULTS: Infiltration of inflammatory cells was found in the synovial tissue until 2 weeks after immobilization. However, inflammatory cells were diminished and fibrosis was dominantly observed in the synovium and subsynovial tissue 3 weeks after immobilization. From 1 week after immobilization, the abduction angle of all immobilization groups at each time point was significantly lower than that of the control group. CONCLUSIONS: Our study demonstrated that a rat frozen shoulder model using immobilization generates the pathophysiologic process of inflammation leading to fibrosis on the glenohumeral joint similar to that seen in patients with frozen shoulder. This model was attained within 3 weeks after immobilization. It may serve as a useful tool to investigate pathogenesis at the molecular level and identify potential target genes that are involved in the development of frozen shoulder.


Assuntos
Bursite/etiologia , Bursite/patologia , Modelos Animais de Doenças , Imobilização/efeitos adversos , Animais , Masculino , Distribuição Aleatória , Ratos , Ratos Sprague-Dawley
4.
Clin Imaging ; 40(1): 1-12, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26490092

RESUMO

There are various causes of calf pain. The differential diagnoses affecting the lower leg include cystic lesions, trauma-related lesions, infection or inflammation, vascular lesions, neoplasms, and miscellaneous entities. Ultrasound (US) provide detailed anatomical information of the calf structures, and it offers the ability to confirm, other calf abnormalities, particularly when deep vein thrombosis (DVT) is ruled out. The purpose of this article is to review the causes of a painful calf presenting as DVT and incidental findings found as part of the work-up of DVT, and to provide a broad overview of US findings and clinical features of these pathologies.


Assuntos
Perna (Membro)/diagnóstico por imagem , Doenças Musculares/diagnóstico por imagem , Dor/etiologia , Neoplasias de Tecidos Moles/diagnóstico por imagem , Doenças Vasculares/diagnóstico por imagem , Animais , Diagnóstico Diferencial , Humanos , Achados Incidentais , Doenças Musculares/complicações , Neoplasias de Tecidos Moles/complicações , Ultrassonografia , Doenças Vasculares/complicações
5.
Ultrasonography ; 34(3): 217-25, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25868733

RESUMO

In this article, I would like to define "oops lesions" as soft tissue mass-like lesions that involve surprise or embarrassment for radiologists following the final diagnosis. Examples of "oops lesions" include malignant tumors that appear benign, malignancy-mimicking benign tumors, incorrect identification of epidermal inclusion cysts, and soft tissue pseudotumors. Ultrasonography (US) findings are very helpful in the diagnosis of soft tissue tumors; however, the diagnosis of soft tissue tumors on the basis of US findings alone has some limitations. Therefore, clinical findings, laboratory data, findings from additional imaging modalities, and demographic data of patients should be considered together with US findings.

6.
Ultrasonography ; 34(3): 195-205, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25971901

RESUMO

Ultrasonography of the postoperative musculoskeletal system plays an important role in the accurate diagnosis of abnormal lesions in the bone and soft tissues. Ultrasonography is a fast and reliable method with no harmful irradiation for the evaluation of postoperative musculoskeletal complications. In particular, it is not affected by the excessive metal artifacts that appear on computed tomography or magnetic resonance imaging. Another benefit of ultrasonography is its capability to dynamically assess the pathologic movement in joints, muscles, or tendons. This article discusses the frequent applications of musculoskeletal ultrasonography in various postoperative situations including those involving the soft tissues around the metal hardware, arthroplasty, postoperative tendons, recurrent soft tissue tumors, bone unions, and amputation surgery.

7.
Korean J Radiol ; 15(3): 370-5, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24843242

RESUMO

Periosteal osteosarcoma is an extremely rare chondroblastic osteosarcoma in the flat bone. There were authors reporting of two cases of periosteal osteosarcoma in the highly unusual sites. One of them arose from the rib, in a 17-year-old male, which appeared as a hypodense juxtacortical mass with periosteal reaction on CT. The other one arose from the scapula, in a 17-year-old female, which showed the intermediate signal intensity (SI) on T1-weighted image (WI), heterogeneous high SI on T2WI, and rim-enhancement on contrast-enhanced T1WI with cortical destruction on MRI.


Assuntos
Neoplasias Ósseas/diagnóstico por imagem , Osteossarcoma/diagnóstico por imagem , Costelas/diagnóstico por imagem , Escápula/diagnóstico por imagem , Adolescente , Meios de Contraste , Feminino , Humanos , Masculino , Radiografia
8.
J Phys Ther Sci ; 26(2): 215-8, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24648634

RESUMO

[Purpose] The purpose of this study was to examine the changes in brain waves between action observation and motor imagery of stroke patients and normal subjects, and to compare them. [Methods] Twelve stroke patients and twelve normal persons participated in this research. Each group executed action observation and the motor imagery training for 3 minutes, and before and during each intervention the brain waves were measured for 3 minutes, and the relative alpha power and relative beta power analyzed. [Results] Both normal persons and stroke patients showed significant differences in relative alpha power during action observation, but no significant difference in relative alpha power was found during motor imagery. The relative beta power increased similarly in both groups but it was more significantly different during action observation than during motor imagery. [Conclusion] Both action observation and motor imagery can be used as a therapeutic method for motor learning. However, action observation induces stronger cognitive activity, so for the stroke patients who have difficulty with fine motor representation, action observation might be a more effective therapy.

9.
Gut Liver ; 8(1): 70-8, 2014 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-24516704

RESUMO

BACKGROUND/AIMS: This study investigated the role of single nucleotide polymorphisms (SNPs) near the interleukin-28B (IL28B) gene with respect to clinical outcomes and the antiviral response in hepatitis C virus (HCV) infection to suggest the practical utility of IL28B genotyping in Korea. METHODS: Two SNPs near IL28B, rs12979860 and rs8099917, were analyzed using an allelic discrimination assay in a total of 454 individuals, including 147 health-check examinees and 307 patients with HCV infection. RESULTS: The CC genotype frequency was significantly higher in the spontaneous recovery group than in the chronic infection group and was higher in the chronic hepatitis group than in the liver cirrhosis or hepatocellular carcinoma group, suggesting its favorable role in the clinical outcome. Multivariate analysis revealed that the rs12979860 CC genotype was an independent predictor of sustained virologic response (SVR) in genotype 1 HCV infection. During the currently used response-guided therapy, IL28B genotyping was most helpful for the patients who exhibit early virologic responses without rapid virologic responses, as those patients exhibiting the non-CC type did not achieve SVR, although they represented approximately one-third of the total patients. CONCLUSIONS: The IL28B SNP is an independent predictor of SVR. Our results may be helpful if the findings are carefully applied to select patients in Korea.


Assuntos
Carcinoma Hepatocelular/genética , Hepatite C Crônica/genética , Interleucinas/genética , Cirrose Hepática/genética , Neoplasias Hepáticas/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Interferons , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Prognóstico , República da Coreia , Estudos Retrospectivos
10.
J Med Virol ; 85(10): 1724-33, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23813472

RESUMO

The epidemiological and clinical features of hepatitis C virus (HCV) infection in South Korea were examined in a prospective, multicenter cohort study that included 1,173 adult patients with positive results for anti-HCV antibody who completed a questionnaire survey on the risk factors for HCV infection from January 2007 to December 2011 at five university hospitals. The HCV cohort had a mean age of 55.4 years with 48.3% men, and diagnostic categories of acute hepatitis (n = 63, 5.3%), past infection (n = 37, 3.2%), chronic hepatitis (n = 777, 66.2%), cirrhosis of the liver (n = 179, 15.3%), and hepatocellular carcinoma (n = 117, 10.0%). The major HCV genotypes were genotype 1 (52.7%) and genotype 2 (45.3%). Liver biopsy was performed in 301 patients (25.7%), and 42.8% of the subjects received antiviral therapy against HCV. The behavioral risk factors possibly related to HCV infection were intravenous drug use (5%), needle stick injury (7%), blood transfusion before 1995 (19%), sexual relationship with more than three partners (28%), piercings (35%), tattoos (36%), surgery (43%), acupuncture (83%), diagnostic endoscopy (85%), and dental procedures (93%). Age, intravenous drug use, needle stick injury, transfusion before 1995, and tattoos were the independent risk factors of HCV infection.


Assuntos
Hepatite C/epidemiologia , Hepatite C/patologia , Adulto , Idoso , Carcinoma Hepatocelular/epidemiologia , Carcinoma Hepatocelular/patologia , Carcinoma Hepatocelular/virologia , Estudos de Coortes , Feminino , Genótipo , Hepacivirus/classificação , Hepacivirus/genética , Hepacivirus/isolamento & purificação , Hepatite C/complicações , Hepatite C/virologia , Anticorpos Anti-Hepatite C/sangue , Hospitais Universitários , Humanos , Cirrose Hepática/epidemiologia , Cirrose Hepática/patologia , Cirrose Hepática/virologia , Neoplasias Hepáticas/epidemiologia , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/virologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , República da Coreia/epidemiologia , Fatores de Risco , Inquéritos e Questionários
11.
Pediatr Emerg Care ; 29(7): 826-8, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23823262

RESUMO

We report on an infant presenting with acute cardiogenic shock. She was eventually diagnosed with pseudohypoparathyroidism, which is a heterogeneous group of disorders characterized by severe hypocalcemia, hyperphosphatemia, and increased parathyroid hormone. The patient responded dramatically to calcium and vitamin D supplementation; left ventricular systolic function was normalized within days of treatment. Although the diagnosis of pseudohypoparathyroidism is rare, this case is a reminder of the importance of obtaining calcium levels in patients presenting in acute cardiogenic shock.


Assuntos
Insuficiência Cardíaca/etiologia , Pseudo-Hipoparatireoidismo/complicações , Choque Cardiogênico/etiologia , Calcitriol/uso terapêutico , Cálcio/sangue , Gluconato de Cálcio/uso terapêutico , Cardiomiopatia Dilatada/sangue , Cardiomiopatia Dilatada/etiologia , Cardiotônicos/uso terapêutico , Terapia Combinada , Feminino , Insuficiência Cardíaca/sangue , Insuficiência Cardíaca/terapia , Humanos , Hipocalcemia/tratamento farmacológico , Hipocalcemia/etiologia , Lactente , Hormônio Paratireóideo/sangue , Fosfatos/sangue , Pseudo-Hipoparatireoidismo/sangue , Pseudo-Hipoparatireoidismo/diagnóstico , Pseudo-Hipoparatireoidismo/tratamento farmacológico , Indução de Remissão , Respiração Artificial , Choque Cardiogênico/sangue , Choque Cardiogênico/terapia , Disfunção Ventricular Esquerda/etiologia
12.
Congenit Heart Dis ; 8(5): 440-9, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23602004

RESUMO

OBJECTIVES: We report a single institute experience of transcatheter pulmonary valvotomy using the soft end of a guidewire followed or not by a systemic-pulmonary shunt in patients with pulmonary atresia with intact ventricular septum (PAIVS) or critical pulmonary stenosis (CPS). In addition, we compare patients with or without an additional source of flow to support the pulmonary circulation after successful pulmonary valvotomy. METHODS: All neonates with PAIVS or CPS who underwent primary transcatheter pulmonary valvotomy between January 2004 and December 2010 were reviewed retrospectively. Some of them needed an additional source of flow to support the pulmonary circulation. We performed a comparison between those who required an additional source of pulmonary flow and those who did not. RESULTS: The initial procedure was successful in 20 out of 22 patients (seven of nine with PAIVS; all of 13 with CPS), but 10 of them needed an additional source of flow to support the pulmonary circulation: nine had arterial duct stenting and one had surgical Blalock-Taussig shunt. There were no deaths or major acute complications, except for femoral artery occlusion in three patients. The bipartite right ventricular morphology, the tricuspid z-score of ≤-0.74, the tricuspid to mitral valve ratio of ≤ 0.9, and the z-score of the diastolic interventricular septal thickness ≥ 2.37 in preprocedural examination showed more tendency of needing shunt placement. CONCLUSION: Transcatheter pulmonary valvotomy using the soft end of a guidewire followed or not by the arterial duct stent implantation was an effective approach in those patients. The angiographic distinction between CPS and PAIVS did not affect anything in this study including the procedural method, success, and odds for reintervention. The degree of right ventricle cavity hypoplasia provided the main restriction to forward flow after pulmonary valvotomy.


Assuntos
Valvuloplastia com Balão , Cateterismo Cardíaco , Cardiopatias Congênitas/cirurgia , Atresia Pulmonar/cirurgia , Estenose da Valva Pulmonar/cirurgia , Cardiopatias Congênitas/diagnóstico por imagem , Cardiopatias Congênitas/fisiopatologia , Ventrículos do Coração/anormalidades , Ventrículos do Coração/diagnóstico por imagem , Ventrículos do Coração/fisiopatologia , Ventrículos do Coração/cirurgia , Humanos , Lactente , Recém-Nascido , Atresia Pulmonar/diagnóstico por imagem , Atresia Pulmonar/fisiopatologia , Valva Pulmonar/diagnóstico por imagem , Valva Pulmonar/fisiologia , Valva Pulmonar/cirurgia , Estenose da Valva Pulmonar/diagnóstico por imagem , Estenose da Valva Pulmonar/fisiopatologia , Radiografia , Estudos Retrospectivos , Stents , Resultado do Tratamento , Função Ventricular Direita/fisiologia
13.
Clin Mol Hepatol ; 19(1): 45-50, 2013 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-23593609

RESUMO

BACKGROUND/AIMS: The distribution of hepatitis C virus (HCV) genotypes varies geographically. In Korea, genotypes 1 and 2 comprise more than 90% of HCV infections, while genotype 6 is very rare. This study compared the clinical and epidemiological characteristics of patients with genotype 6 HCV infection with those infected with HCV genotypes 1 and 2. METHODS: This was a prospective, multicenter HCV cohort study that enrolled 1,173 adult patients, of which 930 underwent HCV genotype analysis, and only 9 (1.0%) were found to be infected with genotype 6 HCV. The clinical and epidemiological parameters of the genotypes were compared. RESULTS: The patients with genotype 6 HCV had a mean age of 41.5 years, 77.8% were male, and they had no distinct laboratory features. A sustained virologic response (SVR) was observed in four (67%) of six patients who received antiviral therapy. Risk factors such as the presence of a tattoo (n=6, 66.7%), more than three sexual partners (n=3, 33.3%), and injection drug use (n=3, 33.3%) were more common among genotype 6 patients than among genotypes 1 or 2. CONCLUSIONS: The epidemiology and treatment response of patients infected with genotype 6 HCV differed significantly from those with genotypes 1 or 2, warranting continuous monitoring.


Assuntos
Hepacivirus/genética , Hepatite C Crônica/diagnóstico , Adulto , Antivirais/uso terapêutico , Grupo com Ancestrais do Continente Asiático , Estudos de Coortes , Feminino , Genótipo , Hepatite C Crônica/tratamento farmacológico , Hepatite C Crônica/epidemiologia , Humanos , Fígado/patologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , RNA Viral/sangue , República da Coreia , Fatores de Risco , Comportamento Sexual , Transtornos Relacionados ao Uso de Substâncias/complicações , Tatuagem
14.
Anesth Analg ; 117(1): 114-8, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-23477957

RESUMO

BACKGROUND: The effects of maneuvers to increase intrathoracic pressure and of Trendelenburg position on the cross-sectional area (CSA) of the subclavian vein (SCV) and the relationship between the SCV and adjacent structures have not been investigated. METHODS: In ultrasonography-guided SCV catheterization (N = 30), the CSA of the SCV and the distance between the SCV and pleura (DSCV-pleura) were determined during 10-second airway opening, and 10-second positive inspiratory hold with 20 cm H2O in the supine position (S-0, and S-20) and the 10° Trendelenburg position (T-0, and T-20). In addition to a statistical significance of P < 0.05, CSA and DSCV-pleura differences of ≥15% were defined as clinically relevant changes. RESULTS: CSA (mean [95% confidence interval]) in S-20, T-0, and T-20 (1.02 [0.95-1.14] cm(2), 1.04 [0.95-1.15] cm(2), and 1.14 [1.04-1.24] cm(2), respectively) was significantly larger than a CSA in S-0 (0.93 [0.86-1.00] cm(2), all P < 0.001). However, only the increase of CSA in T-20 vs S-0 (0.21 cm(2), 23.2%) was clinically meaningful (≥15%). The number of patients who showed CSA increase ≥15% was more in S-0 to T-20 (57%) compared with those in S-0 to S-20 (23%) and S-0 to T-0 (27%). DSCV-pleura measurements (mean) in S-20 and T-20 (0.61 and 0.60 cm) were significantly shorter than those in S-0 (0.70 cm, all P < 0.001), but the reductions of DSCV-pleura were not clinically meaningful (≥15%). CONCLUSIONS: The combined application of inspiratory hold and Trendelenburg position provided a greater and more relevant degree of CSA increase without compromising DSCV-pleura, which may facilitate SCV catheterization. Further investigations are needed to determine whether these results affect the success rate of catheterization and the risk of procedural injury.


Assuntos
Anatomia Transversal/métodos , Anestesia Geral/métodos , Cateterismo Venoso Central/métodos , Decúbito Inclinado com Rebaixamento da Cabeça , Pleura/diagnóstico por imagem , Veia Subclávia/diagnóstico por imagem , Adulto , Idoso , Feminino , Decúbito Inclinado com Rebaixamento da Cabeça/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Ultrassonografia
15.
J Korean Med Sci ; 27(11): 1371-7, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23166420

RESUMO

The risk factors related to hepatitis C virus (HCV) infection showed geographic and temporal differences. We investigated HCV-related risk factors in Korea where intravenous drug use (IVDU) is uncommon. The HCV-related risk factors were investigated in a prospective, multicenter chronic HCV cohort (n = 711) using a standardized questionnaire in four university hospitals. The results were compared with those of 206 patients with chronic liver diseases not related to either of HCV or hepatitis B virus infection (comparison group). The IVDU was found in 3.9% and remote blood transfusion (≥ 20 yr ago) in 18.3% in HCV cohort group, while that in comparison group was in none and 5.3%, respectively. In a multivariate logistic analysis, transfusion in the remote past (odds ratio [OR], 2.99), needle stick injury (OR, 4.72), surgery (OR, 1.89), dental procedures (OR, 2.96), tattooing (OR, 2.07), and multiple sexual partners (2-3 persons; OR, 2.14, ≥ 4 persons; OR, 3.19), were independent risk factors for HCV infection. In conclusion, the major risk factors for HCV infection in Korea are mostly related to conventional or alterative healthcare procedures such as blood transfusion in the remote past, needle stick injury, surgery, dental procedure, and tattooing although multiple sex partners or IVDU plays a minor role.


Assuntos
Atitude Frente a Saúde , Comportamentos Relacionados com a Saúde , Hepatite C Crônica/etiologia , Adulto , Idoso , Transfusão de Sangue , Estudos de Casos e Controles , Estudos de Coortes , Feminino , Hospitais Universitários , Humanos , Injeções Intravenosas , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Ferimentos Penetrantes Produzidos por Agulha/complicações , Razão de Chances , Estudos Prospectivos , República da Coreia , Fatores de Risco , Parceiros Sexuais , Inquéritos e Questionários , Tatuagem , Odontopatias/complicações
16.
Korean J Gastroenterol ; 59(6): 414-22, 2012 Jun 25.
Artigo em Coreano | MEDLINE | ID: mdl-22735874

RESUMO

BACKGROUND/AIMS: The aim of this study was to compare polyethylene glycol (PEG) 4 L, split method of PEG 4 L and PEG 2 L plus sodium phosphate (NaP) in the aspect of bowel preparation quality, safety, patients' compliance and preference. METHODS: Total 249 subjects were prospectively enrolled and received bowel preparation for colonoscopy from August to October in 2010; PEG 4 L (93 subjects), split method of 4 L PEG (74 subjects) and PEG 2 L plus NaP 90 mL group (82 subjects). To investigate the completion, preference for bowel preparation and safety, a questionnaire survey was conducted before colonoscopy. RESULTS: There were no significant intergroup differences in the aspect of completion of preparation, cecal intubation time and success rate. Satisfaction and preference were higher in PEG 2 L plus NaP 90 mL and split method of 4 L PEG compared with PEG 4 L. In the aspect of the bowel preparation quality PEG 4 L showed significantly higher quality in the morning colonoscopy (p<0.001). However, in the afternoon colonoscopy PEG 2 L plus NaP 90 mL showed better result than PEG 4 L (p=0.009). Hyperphosphatemia was most frequently observed in PEG 2 L plus NaP 90 mL, but no severe adverse events occurred (p<0.001). CONCLUSIONS: PEG 4 L showed better result than split method of 4 L PEG or PEG 2 L plus NaP 90 mL in the aspect of bowel preparation quality and safety.


Assuntos
Catárticos/farmacologia , Colo/efeitos dos fármacos , Fosfatos/farmacologia , Polietilenoglicóis/farmacologia , Adulto , Idoso , Catárticos/efeitos adversos , Colo/anatomia & histologia , Colonoscopia , Feminino , Humanos , Hiperfosfatemia/etiologia , Masculino , Pessoa de Meia-Idade , Cooperação do Paciente , Fosfatos/efeitos adversos , Polietilenoglicóis/efeitos adversos , Estudos Prospectivos , Inquéritos e Questionários , Fatores de Tempo
17.
Knee Surg Sports Traumatol Arthrosc ; 20(10): 1971-7, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-22207026

RESUMO

PURPOSE: To investigate the postoperative analgesic effect of subacromial patient-controlled analgesia (SA-PCA) with ropivacaine in comparison with intravenous patient-controlled analgesia (IV-PCA) after arthroscopic rotator cuff repair. METHODS: Sixty patients were prospectively randomized into one of the two types of analgesics for 48 h after the operation. In the SA-PCA group, patients received 0.5% ropivacaine at a rate of 2 ml/h with a patient-controlled bolus dose of 2 ml. In the IV-PCA group, patients received intravenous patient-controlled analgesia. Pain relief was regularly assessed using visual analog scale (VAS) for 48 h, and side effects were noted. RESULTS: The postoperative pain VAS at 1 h after the operation was lower for the SA-PCA group (4.3 ± 2.7) than for the IV-PCA group (6.3 ± 2.6, P = 0.009). The frequency of requested bolus doses by patients in the IV-PCA (19 ± 19) was higher than in the SA-PCA (7 ± 10, P = 0.04). Rescue opioid or NSAID requirements were not different. More patients in the IV-PCA (17/30) experienced nausea than in the SA-PCA (7/30, P = 0.03). Patient satisfaction was higher in the SA-PCA than in the IV-PCA [6.7 (3-10) vs. 5.6 (0-8), P = 0.04]. The mean total venous plasma concentration of ropivacaine at 8 and 24 h was below the maximum tolerated venous plasma concentration, and symptoms of systemic toxicity were not noted during 48 h in the SA-PCA. CONCLUSIONS: The analgesic effect of subacromial patient-controlled analgesia with ropivacaine was better than intravenous analgesia during the immediate postoperative period with fewer side effects. LEVEL OF EVIDENCE: Therapeutic study, Level I.


Assuntos
Amidas/administração & dosagem , Analgesia Controlada pelo Paciente/métodos , Anestésicos Locais/administração & dosagem , Artroscopia , Dor Pós-Operatória/tratamento farmacológico , Lesões do Manguito Rotador , Traumatismos dos Tendões/cirurgia , Acrômio , Adulto , Idoso , Amidas/uso terapêutico , Anestésicos Locais/uso terapêutico , Feminino , Humanos , Infusões Parenterais , Masculino , Pessoa de Meia-Idade , Medição da Dor , Satisfação do Paciente/estatística & dados numéricos , Estudos Prospectivos , Ropivacaina , Manguito Rotador/cirurgia , Resultado do Tratamento
18.
Acta Radiol ; 52(8): 875-80, 2011 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-21835889

RESUMO

BACKGROUND: Chondromyxoid fibroma is a rare benign primary bone tumor of cartilage. Despite a characteristic radiographic appearance, chondromyxoid fibroma with atypical radiographic findings may mimic more common tumors. PURPOSE: To describe the MR findings of chondromyxoid fibroma. MATERIAL AND METHODS: MR images of 19 histopathologically confirmed chondromyxoid fibromas were retrospectively analyzed for signal intensity, periosteal reaction, adjacent abnormal bone marrow and soft tissue signal, and patterns of contrast enhancement. RESULTS: All cases of chondromyxoid fibroma showed hypointense to intermediate signal intensity and internal hyperintense foci were observed in seven (37%) cases on T1-weighted images. On T2-weighted images, all lesions were hyperintense: peripheral intermediate signal band with central hyperintense signal in 11 (58%) of 19 lesions, whereas diffusely hyperintense with heterogeneous pattern in eight (42%). Periosteal reaction was observed in 11 (58%) of 19 cases. Adjacent abnormal bone marrow or soft tissue signal was observed in 12 (63%) or 14 (74%) of 19 cases, respectively. On contrast-enhanced T1-weighted images, peripheral nodular enhancement was observed in 69% (11/16) and diffuse contrast enhancement was observed in 31% (5/16) with homogeneous (n = 3) or heterogeneous (n = 2) patterns. Among the cases with peripheral nodular enhancement, the peripheral nodular enhancing portion generally corresponded to the peripheral intermediate signal band on T2-weighted images, although the peripheral enhancement was not as wide as a band of intermediate signal intensity. On the other hand, the central non-enhancing portion generally corresponded to the central hyperintense signal intensity on T2-weighted images. CONCLUSION: The helpful features of chondromyxoid fibroma are the peripheral intermediate signal band and central hyperintense signal on T2-weighted images, generally corresponding to the peripheral nodular enhancement and central non-enhancing portion on contrast-enhanced T1-weighted images, respectively.


Assuntos
Neoplasias Ósseas/patologia , Condroma/patologia , Fibroma/patologia , Imagem por Ressonância Magnética/métodos , Adolescente , Adulto , Idoso , Criança , Meios de Contraste , Feminino , Gadolínio DTPA , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
19.
Skeletal Radiol ; 40(11): 1421-6, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-21190020

RESUMO

OBJECTIVE: The purpose of this article was to evaluate the radiologic findings of adult pelvis and appendicular skeletal Langerhans cell histiocytosis (LCH), emphasizing the CT and MR findings. MATERIALS AND METHODS: The images of nine patients with pathologically proven LCH (five men and four women; mean age, 37.11 years) were retrospectively reviewed. Imaging analysis was confined to the long and flat bones. CT scans were performed in five patients and MR imaging was performed in eight. Images were assessed for the following features on CT and MRI: the location and number of lesions; the presence of cortical destruction, endosteal scalloping, and a periosteal reaction on CT or MRI; the margin of soft tissue masses, the presence of bone marrow edema, and a "budding" appearance on MRI; and the presence of sclerotic margins or septations on CT. RESULTS: The involved skeletal sites were the pelvis (seven), femurs (five), humeri (two), tibias (two), fibula (one), clavicle (one), scapula (one), and sternum (one). Endosteal scalloping, a periosteal reaction, and a budding appearance were common on MRI or CT images. Although cortical destruction and the soft tissue lesion formation were rare, soft tissue masses had well-defined margins. CONCLUSIONS: Endosteal scalloping and a budding appearance with a periosteal reaction on CT and MRI may be helpful signs for differentiation of LCH from malignant tumors in adults.


Assuntos
Doenças Ósseas/diagnóstico por imagem , Ossos da Extremidade Superior/diagnóstico por imagem , Histiocitose de Células de Langerhans/diagnóstico por imagem , Ossos da Perna/diagnóstico por imagem , Ossos Pélvicos/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adulto , Doenças Ósseas/diagnóstico , Ossos da Extremidade Superior/patologia , Feminino , Histiocitose de Células de Langerhans/diagnóstico , Humanos , Ossos da Perna/patologia , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Ossos Pélvicos/patologia
20.
Radiographics ; 30(6): 1621-36, 2010 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-21071379

RESUMO

Various types of tumors can affect the subungual space, including benign solid tumors (glomus tumor, subungual exostosis, soft-tissue chondroma, keratoacanthoma, hemangioma, lobular capillary hemangioma), benign cystic lesions (epidermal and mucoid cysts), and malignant tumors (squamous cell carcinoma, malignant melanoma). Imaging plays an important role in the detection and differentiation of subungual tumors because of their small size, nonspecific clinical manifestations, and functional significance. Ultrasonography (US)-in particular, high-resolution US with color Doppler studies-provides useful information regarding tumor size, location, shape, and internal characteristics (cystic, solid, or mixed), but it is limited in the further characterization of tissue. Magnetic resonance (MR) imaging has an important role in categorizing tumors according to their anatomic location, pathologic origin, and signal characteristics. There is some overlap between the US and MR imaging features of subungual tumors; however, certain features can allow accurate diagnosis and expedite management when correlated with clinical and pathologic findings.


Assuntos
Neoplasias Ósseas/diagnóstico , Tumor Glômico/diagnóstico , Imagem por Ressonância Magnética/métodos , Doenças da Unha/diagnóstico , Neoplasias de Tecidos Moles/diagnóstico , Ultrassonografia/métodos , Neoplasias Ósseas/diagnóstico por imagem , Condroma/diagnóstico , Condroma/diagnóstico por imagem , Diagnóstico Diferencial , Cisto Epidérmico/diagnóstico , Cisto Epidérmico/diagnóstico por imagem , Dedos , Tumor Glômico/diagnóstico por imagem , Hemangioma/diagnóstico , Hemangioma/diagnóstico por imagem , Humanos , Ceratoacantoma/diagnóstico , Ceratoacantoma/diagnóstico por imagem , Tumor Mucoepidermoide/diagnóstico , Tumor Mucoepidermoide/diagnóstico por imagem , Doenças da Unha/diagnóstico por imagem , Neoplasias de Tecidos Moles/diagnóstico por imagem , Dedos do Pé
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