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1.
J UOEH ; 43(3): 349-353, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34483194

RESUMO

A 60-year-old woman with a 37-year history of rheumatoid arthritis (RA) had a sudden onset of headache. Head MRI showed acute multiple infarctions in the vertebrobasilar region, and MR angiography showed stenosis of the right vertebral artery (VA). 3D-CT angiography of the craniovertebral junction showed atlantoaxial subluxation and stenosis of the right VA just distal to the transverse foramen of C2, which was due to osteophytes and degenerative changes secondary to RA. Digital subtraction angiography clearly demonstrated occlusion of the right VA during rightward head rotation. Based on those findings, rotatory instability at C1-2 was considered as the primary cause of the vertebrobasilar infarctions, and Bow Hunter's syndrome was diagnosed. The patient underwent C1-5 posterior fixation, and brain infarction has not recurred.

2.
Microsurgery ; 41(6): 550-556, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34213025

RESUMO

INTRODUCTION: In flap transfer with perforator to perforator anastomosis (FTPPA), encountering poor pulsation and blood flow in a recipient perforator intraoperatively often makes FTPPA impossible. This study sought to identify color and spectral Doppler ultrasonography (CSDUS) parameters that can aid reliable preoperative selection of a recipient perforator artery. PATIENTS AND METHODS: The study enrolled 38 patients with lower extremity lymphedema who underwent vascularized lymphatic tissue transfer with perforator to perforator anastomosis for physiological lymphatic flow reconstruction. In all cases, three candidate recipient perforators were searched in each lower extremities, and vessel diameter and peak systolic flow velocity (PSFV) were measured. The inclusion criteria for candidates were a vessel diameter of >0.5 mm and a PSFV of >10 cm/s. These measures were compared with intraoperative findings, diameters and if there was pulsation and visible spurting evident. RESULTS: A total of 114 candidates were selected, and 52 of the candidates were dissected until suitable perforators were found. PSFV (cm/s) on CSDUS was ≥20.0 in 32 perforators (84.2%) and was 15.0-19.9 in 6 perforators (15.8%) in the group with pulsation and visible spurting evident, and 15.0-19.9 in one perforator (7.1%) and ≤ 14.9 in 13 perforators (92.9%) in the group without pulsation and visible spurting evident. There was a statistically significant correlation between preoperative PSFV and intraoperative pulsation and visible spurting evident after dissection (P = 0.021 × 10-3 ). The flap survival rate was 92.1%. CONCLUSION: PSFV is an important preoperative determinant of the suitability of a recipient perforator artery for FTPPA.


Assuntos
Retalho Perfurante , Procedimentos Cirúrgicos Reconstrutivos , Anastomose Cirúrgica , Artérias/diagnóstico por imagem , Humanos , Ultrassonografia Doppler em Cores
3.
Phys Rev Lett ; 127(3): 033401, 2021 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-34328775

RESUMO

We investigate the problem of an infinitely heavy impurity interacting with a dilute Bose gas at zero temperature. When the impurity-boson interactions are short-ranged, we show that boson-boson interactions induce a quantum blockade effect, where a single boson can effectively block or screen the impurity potential. Since this behavior depends on the quantum granular nature of the Bose gas, it cannot be captured within a standard classical-field description. Using a combination of exact quantum Monte Carlo methods and a truncated basis approach, we show how the quantum correlations between bosons lead to universal few-body bound states and a logarithmically slow dependence of the polaron ground-state energy on the boson-boson scattering length. Moreover, we expose the link between the polaron energy and the spatial structure of the quantum correlations, spanning the infrared to ultraviolet physics.

4.
J Cardiothorac Surg ; 16(1): 128, 2021 May 12.
Artigo em Inglês | MEDLINE | ID: mdl-33980268

RESUMO

BACKGROUND: The aim of this study was to assess the ability of using mean computed tomography (mCT) values to predict non-small cell lung cancer (NSCLC) tumor recurrence. METHODS: A retrospective study was conducted on 494 patients with stage IA NSCLC. Receiver operating characteristics analysis was used to assess the ability to use mCT value, C/T ratio, tumor size, and SUV to predict tumor recurrence. Multiple logistic regression analyses were performed to determine the independent variables for the prediction of tumor recurrence. RESULTS: The m-CT values were - 213.7 ± 10.2 Hounsfield Units (HU) for the recurrence group and - 594.1 ± 11.6 HU for the non-recurrence group (p < 0.0001). Recurrence occurred in 45 patients (9.1%). The tumor recurrence group was strongly associated with a high CT attenuation value, high C/T ratio, large solid tumor size, and SUV. The diagnostic value of mCT value was more accurate than the C/T ratio, excluding the pure ground-glass opacity and pure solid (0 < C/T ratio < 100) groups. The SUV and mCT are independent predictive factors of tumor recurrence. CONCLUSIONS: The evaluation of mCT values was useful for predicting recurrence after the limited resection of small-sized NSCLC, and may potentially contribute to the selection of suitable treatment strategies.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/diagnóstico por imagem , Carcinoma/diagnóstico por imagem , Neoplasias Pulmonares/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Recidiva Local de Neoplasia/diagnóstico por imagem , Pneumonectomia , Tomografia Computadorizada por Raios X , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma/patologia , Carcinoma/cirurgia , Carcinoma Pulmonar de Células não Pequenas/patologia , Carcinoma Pulmonar de Células não Pequenas/cirurgia , Feminino , Seguimentos , Humanos , Modelos Logísticos , Pulmão/patologia , Pulmão/cirurgia , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/cirurgia , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/patologia , Estadiamento de Neoplasias , Valor Preditivo dos Testes , Curva ROC , Estudos Retrospectivos , Medição de Risco , Resultado do Tratamento
5.
Lymphat Res Biol ; 2021 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-33794104

RESUMO

Introduction: Treatment for patients with comorbid lymphedema and varicose veins is controversial. Surgical options for these patients are limited. The study was aimed to investigate the validity of combined lymphovenous anastomosis (LVA) and great saphenous vein stripping (GSVS) for comorbid lymphedema and varicose veins. Patients and Methods: Thirteen patients were involved in the study, and the detail was 21 edematous lower limbs (with coexisting varicose veins and lymphedema; the varicose vein and lymphedema [VL] group) who underwent combined GSVS and LVA therapy. Fifteen patients (with 30 edematous lower limbs and lymphedema only; the lymphedema [L] group) who underwent LVA only were included as a control group. GSVS was performed before LVA in the VL group. Results: No significant differences were seen between the groups at baseline. There were no cases indocyanine green (ICG) lymphography pattern deteriorated after GSVS. No significant difference was seen in lymphatic detection rate; 129.71% ± 58.27% (67%-333%) in the VL group and 122.27% ± 39.47% (50%-250%) in the L group (p = 0.59 > 0.05), respective lymphatic diameters 0.66 ± 0.13 (0.45-0.9) mm and 0.75 ± 0.17 (0.45-1.0) mm (p = 0.07 > 0.05), and respective lymphedema improvement rate 12.17% ± 7.35% (0%-27.4%) and 12.65% ± 7.43% (3.7%-22.3%) (p = 0.86 > 0.05). Discussion: In this study, stripping surgery does not cause lymphatic impairment, at least to the extent that would impede the success of an LVA procedure. Comorbid varicose veins and lymphedema can be treated surgically by a combination of LVA and GSVS.

6.
Ann Nucl Med ; 35(5): 589-599, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33751364

RESUMO

OBJECTIVE: Non-uniform attenuation correction using computed tomography (CT) improves the image quality and quantification of single-photon emission computed tomography (SPECT). However, it is not widely used because it requires a SPECT/CT scanner. This study constructs a convolutional neural network (CNN) to generate attenuation-corrected SPECT images directly from non-attenuation-corrected SPECT images. METHODS: We constructed an auto-encoder (AE) using a CNN to correct the attenuation in brain perfusion SPECT images. SPECT image datasets of 270 (44,528 slices including augmentation), 60 (5002 slices), and 30 (2558 slices) cases were used for training, validation, and testing, respectively. The acquired projection data were reconstructed in three patterns: uniform attenuation correction using Chang's method (Chang-AC), non-uniform attenuation correction using CT (CT-AC), and no attenuation correction (No-AC). The AE learned an end-to-end mapping between the No-AC and CT-AC images. The No-AC images in the test dataset were loaded into the trained AE, which generated images simulating the CT-AC images as output. The generated SPECT images were employed as attenuation-corrected images using the AE (AE-AC). The accuracy of the AE-AC images was evaluated in terms of the peak signal-to-noise ratio (PSNR) and the structural similarity metric (SSIM). The intensities of the AE-AC and CT-AC images were compared by voxel-by-voxel and region-by-region analysis. RESULTS: The PSNRs of the AE-AC and Chang-AC images, compared using CT-AC images, were 62.2, and 57.9, and their SSIM values were 0.9995 and 0.9985, respectively. The AE-AC and CT-AC images were visually and statistically in good agreement. CONCLUSIONS: The proposed AE-AC method yields highly accurate attenuation-corrected brain perfusion SPECT images.

7.
EMBO Rep ; 22(4): e51400, 2021 04 07.
Artigo em Inglês | MEDLINE | ID: mdl-33655692

RESUMO

In mouse oocytes, acentriolar MTOCs functionally replace centrosomes and act as microtubule nucleation sites. Microtubules nucleated from MTOCs initially assemble into an unorganized ball-like structure, which then transforms into a bipolar spindle carrying MTOCs at its poles, a process called spindle bipolarization. In mouse oocytes, spindle bipolarization is promoted by kinetochores but the mechanism by which kinetochore-microtubule attachments contribute to spindle bipolarity remains unclear. This study demonstrates that the stability of kinetochore-microtubule attachment is essential for confining MTOC positions at the spindle poles and for limiting spindle elongation. MTOC sorting is gradual and continues even in the metaphase spindle. When stable kinetochore-microtubule attachments are disrupted, the spindle is unable to restrict MTOCs at its poles and fails to terminate its elongation. Stable kinetochore fibers are directly connected to MTOCs and to the spindle poles. These findings suggest a role for stable kinetochore-microtubule attachments in fine-tuning acentrosomal spindle bipolarity.


Assuntos
Cinetocoros , Fuso Acromático , Animais , Camundongos , Centro Organizador dos Microtúbulos , Microtúbulos , Oócitos
8.
J Med Chem ; 64(6): 3075-3085, 2021 03 25.
Artigo em Inglês | MEDLINE | ID: mdl-33719429

RESUMO

BACE1 is an attractive target for disease-modifying treatment of Alzheimer's disease. BACE2, having high homology around the catalytic site, poses a critical challenge to identifying selective BACE1 inhibitors. Recent evidence indicated that BACE2 has various roles in peripheral tissues and the brain, and therefore, the chronic use of nonselective inhibitors may cause side effects derived from BACE2 inhibition. Crystallographic analysis of the nonselective inhibitor verubecestat identified explicit water molecules with different levels of free energy in the S2' pocket. Structure-based design targeting them enabled the identification of propynyl oxazine 3 with improved selectivity. Further optimization efforts led to the discovery of compound 6 with high selectivity. The cocrystal structures of 7, a close analogue of 6, bound to BACE1 and BACE2 confirmed that one of the explicit water molecules is displaced by the propynyl group, suggesting that the difference in the relative water displacement cost may contribute to the improved selectivity.


Assuntos
Secretases da Proteína Precursora do Amiloide/antagonistas & inibidores , Ácido Aspártico Endopeptidases/antagonistas & inibidores , Inibidores Enzimáticos/química , Inibidores Enzimáticos/farmacologia , Doença de Alzheimer/tratamento farmacológico , Doença de Alzheimer/enzimologia , Secretases da Proteína Precursora do Amiloide/química , Secretases da Proteína Precursora do Amiloide/metabolismo , Ácido Aspártico Endopeptidases/química , Ácido Aspártico Endopeptidases/metabolismo , Desenho de Fármacos , Humanos , Oxazinas/química , Oxazinas/farmacologia , Relação Estrutura-Atividade , Água/química
9.
J Plast Reconstr Aesthet Surg ; 74(9): 2050-2058, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33541824

RESUMO

INTRODUCTION: For successful lymphaticovenous anastomosis (LVA), it is important to create anastomoses with high flow to maintain patency. To ensure that this can be achieved, we compared the efficacy of a modified intraoperative distal compression (IDC) technique with the conventional no compression (NC) method for lower limb lymphedema. PATIENTS AND METHODS: In the IDC group, compression was applied to an area of the foot distal to the first LVA site. After completion of the first LVA, the distal compression was extended over the first LVA site to the distal end of the second LVA site. RESULTS: There was no significant difference between the IDC (n = 25) and NC (n = 25) groups in detection rate. However, significant differences were observed in lymphatic vessel diameter and LVA success rate. No intraoperative anastomotic obstruction was seen at the conclusion of surgery. Intraoperative congestion with blood was detected in lymphatic vessels in 8 of 79 anastomoses (10.1%) in the NC group, but not in any cases in the IDC group (p = 0.002). There was a significant between-group difference in the rate of improvement in lymphedema between the IDC (16.1±3.6) and NC groups (14.0±3.4; p = 0.03). DISCUSSION: IDC during LVA is thought to increase lymph flow in larger caliber lymphatics, leading to a high success rate and a low rate of venous reflux. IDC is beneficial when performing LVA.

10.
Chem Commun (Camb) ; 57(6): 725-728, 2021 Jan 26.
Artigo em Inglês | MEDLINE | ID: mdl-33411858

RESUMO

We developed a system to directly produce gold nanoparticles in cells by intracellular mineralization in lower concentration than conventional methods using a peptide consisting of a cell-penetrating sequence and a gold ion-binding sequence. Furthermore, we could control the uniquely shaped gold nanostructures that were produced by changing peptide structures.


Assuntos
Peptídeos Penetradores de Células/química , Ouro/química , Nanopartículas Metálicas/química , Sítios de Ligação , Células HeLa , Humanos , Íons/química , Tamanho da Partícula
11.
Surg Today ; 51(5): 836-843, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-32926236

RESUMO

PURPOSE: The present study investigated whether the pulmonary intersegmental planes could be identified with the intravenous injection of vitamin B2 using a fluorescent camera and whether this method can be used instead of the inflation-deflation technique or the intravenous indocyanine green (ICG) method. METHODS: In experiment 1, the vitamin B2 was intravenously injected to visualize the pulmonary intersegmental plane and perform segmentectomy, and the visualized pulmonary intersegmental line was then compared to the inflation-deflation line in six pigs. In experiment 2, using six pigs, the fluorescent area and duration of fluorescence were compared after the intravenous injection of vitamin B2 and ICG in the same animals. RESULTS: In all animals in experiment 1, it was possible to clearly detect yellow-green fluorescence in the lung, in segments other than the one intended for resection, for at least 60 min. Moreover, the line visualized with vitamin B2 fluorescence matched the inflation-deflation line in all animals. In experiment 2, the area of vitamin B2 fluorescence corresponded to the area of ICG fluorescence in each animal. CONCLUSIONS: The visualization of fluorescence after the intravenous injection of vitamin B2 using a fluorescent camera was a simple, safe, and accurate method for detecting intersegmental planes in a pig model. This method can be an alternative to the inflation-deflation technique and the intravenous ICG method.

12.
Asian J Endosc Surg ; 14(1): 136-139, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32207227

RESUMO

Previous reports have described laparoscopic mesh repair for lumbar hernia due to iliac crest bone harvest, but there have been no reports of reoperation with laparoscopic mesh repair for recurrent cases after laparoscopic mesh repair. Here, we describe the case of a 72-year-old Japanese woman with lumbar hernia recurrence 6 years after laparoscopic mesh repair for lumbar hernia due to iliac crest bone harvest. We performed a successful reoperation with laparoscopic mesh repair. Laparoscopic surgery should be considered to elucidate the mechanism of recurrence, previous mesh position, and the area that must be covered to prevent recurrence again.

13.
Biochem Biophys Res Commun ; 534: 79-85, 2021 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-33310192

RESUMO

Epigenetic transcriptional regulation is essential for the differentiation of various types of cells, including skeletal muscle cells. DNA methyltransferase 1 (Dnmt1) is responsible for maintenance of DNA methylation patterns via cell division. Here, we investigated the relationship between Dnmt1 and skeletal muscle regeneration. We found that Dnmt1 is upregulated in muscles during regeneration. To assess the role of Dnmt1 in satellite cells during regeneration, we performed conditional knockout (cKO) of Dnmt1 specifically in skeletal muscle satellite cells using Pax7CreERT2 mice and Dnmt1 flox mice. Muscle weight and the cross-sectional area after injury were significantly lower in Dnmt1 cKO mice than in control mice. RNA sequencing analysis revealed upregulation of genes involved in cell adhesion and apoptosis in satellite cells from cKO mice. Moreover, satellite cells cultured from cKO mice exhibited a reduced number of cells. These results suggest that Dnmt1 is an essential factor for muscle regeneration and is involved in positive regulation of satellite cell number.


Assuntos
DNA (Citosina-5-)-Metiltransferase 1/metabolismo , Músculo Esquelético/fisiologia , Regeneração/fisiologia , Células Satélites de Músculo Esquelético/fisiologia , Animais , Células Cultivadas , DNA (Citosina-5-)-Metiltransferase 1/genética , Regulação da Expressão Gênica , Masculino , Camundongos Endogâmicos C57BL , Camundongos Knockout , Músculo Esquelético/lesões , Fator de Transcrição PAX7/genética , Células Satélites de Músculo Esquelético/citologia
14.
Plast Reconstr Surg Glob Open ; 8(5): e2860, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-33133910

RESUMO

Although patients with obesity-induced lymphedema can be treated by weight loss therapy, they find it difficult to lose the required amount of weight. The aims of this study were to clarify the characteristics of the lymphatic vessels in patients with obesity-induced lymphedema and to determine the feasibility and efficacy of lymphovenous anastomosis (LVA) in these patients. Methods: Twenty-two patients (44 edematous lower limbs) with a body mass index (BMI) >35 kg/m2 (obese group) and 91 patients with lymphedema (141 edematous lower limbs) and BMI <25 kg/m2 were enrolled as a control group (nonobese group) and underwent LVA. The diameter and depth of lymphatics and the effect of LVA were compared. Results: Lymphatics were detectable within 10-mm depth in the nonobese group and the obese group (3.0 ± 1.4 mm versus 3.5 ± 2.1 mm; P < 0.01). The lymphatic diameter was significantly greater in the obese group than in the nonobese group (0.79 ± 0.30 mm versus 0.54 ± 0.22 mm; P < 0.01). There was no significant difference in the rate of improvement in lymphedema after LVA between the nonobese group (9.1% ± 9.2%) and the obese group (8.9% ± 7.3%; P = 0.84). There was no correlation between the improvement rate of lymphedema and that of BMI in the obese group (P = 0.57). Conclusions: LVA is a feasible procedure even in morbidly obese patients. Considering that substantial weight loss is a difficult and time-consuming task for patients, LVA combined with not gaining weight is a good option for these patients.

15.
BMJ Open ; 10(11): e037282, 2020 11 24.
Artigo em Inglês | MEDLINE | ID: mdl-33234616

RESUMO

OBJECTIVES: The primary objective of this study was to develop the Japanese version of the Patient Centred Assessment Method (PCAM) and its user guide. The secondary objective was to examine the validity and reliability in the primary care setting. DESIGN: Cross-sectional study. SETTING: Three family physician teaching clinics located in urban residential areas in Tokyo, Japan. PARTICIPANTS: Patients who were aged 20 years or older, and who had an appointment with physicians at the three participating clinics. MAIN OUTCOME MEASURES: Patient complexity measured by PCAM and complexity/burden level measured by a Visual Analogue Scale (VAS). RESULTS: Although confirmatory factor analysis using a model described in a previous study revealed that the indices did not meet the criteria for good fit, exploratory factor analysis revealed a new three-factor structure of 'Personal well-being,' 'Social interaction' and 'Needs for care/service.' Cronbach's alpha of PCAM was 0.86. Spearman's rank correlation coefficients between PCAM scores and VAS scores were 0.51 for complexity (p<0.001) and 0.41 for burden (p<0.001). There were 42 patients (14.3% of total patients) with PCAM scores greater than its mean of 16.5 but with complexity VAS scores less than its mean of 20.8. CONCLUSIONS: The Japanese version of PCAM and its user guide were developed through Japanese translation and cultural adaptation by cognitive debriefing. PCAM is a valid and reliable tool to assess patient complexity in the primary care settings in Japan. Additionally, although the correlation between total PCAM scores and complexity/burden as assessed by VAS was moderate, PCAM can more precisely identify patient complexity than skilled physician's intuition.


Assuntos
Traduções , Adulto , Estudos Transversais , Feminino , Humanos , Japão , Psicometria , Reprodutibilidade dos Testes , Inquéritos e Questionários , Tóquio , Adulto Jovem
17.
Genes Cells ; 25(10): 685-694, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32865279

RESUMO

Chromosome segregation requires the formation of a bipolar spindle. The timely bipolarization of the acentrosomal spindle during meiosis I in mouse oocytes depends on the antiparallel microtubule crosslinker Prc1. How Prc1 is regulated in oocytes remains poorly understood. In this study, we show that the kinase Cdk1 negatively regulates the spindle localization of Prc1 in mouse oocytes. The acute inhibition of Cdk1 activity led to excessive localization of Prc1 at the spindle and kinetochores, whereas the overactivation of Cdk1 had opposite effects. The overexpression of Prc1 carrying mutations at Cdk1-mediated phosphorylation sites increased its localization to the spindle, accelerated spindle bipolarization and caused spindle-checkpoint-dependent arrest at metaphase I. Overactivation of Cdk1 delayed spindle bipolarization, which was reversed by the overexpression of a phospho-mutant form but not the wild-type form of Prc1. These results suggest that Cdk1-mediated phosphorylation negatively regulates Prc1 localization to ensure the timely bipolarization of the acentrosomal spindle during meiosis I in mammalian oocytes.


Assuntos
Proteína Quinase CDC2/metabolismo , Proteínas Associadas aos Microtúbulos/metabolismo , Fuso Acromático/metabolismo , Animais , Proteína Quinase CDC2/genética , Proteínas de Ciclo Celular/metabolismo , Segregação de Cromossomos , Feminino , Cinetocoros/metabolismo , Masculino , Metáfase , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Endogâmicos DBA , Microtúbulos/metabolismo , Oócitos/metabolismo , Fuso Acromático/genética
19.
J Cardiothorac Surg ; 15(1): 166, 2020 Jul 08.
Artigo em Inglês | MEDLINE | ID: mdl-32641164

RESUMO

BACKGROUND: Dynamic chest radiography (DCR) is a flat-panel detector (FPD)-based functional X-ray imaging, which is performed as an additional examination in chest radiography. DCR provides objective and quantifiable information, such as diaphragm movement, pulmonary ventilation and circulation, and is reasonable for detecting tumor invasion or adhesion. CASE PRESENTATION: We present a case of Solitary Fibrous Tumor of Pleura (SFTP), preoperatively predicted visceral pleura origin using Dynamic chest radiography (DCR) and surgically resected through single-access (uniportal) video-assisted thoracoscopic surgery (UVATS). CONCLUSIONS: UVATS may be a suitable surgical option for pedunculated SFTPs. Dynamic chest radiography provides information, such as tumor invasion or adhesion and helpful for predicting origin of the tumor.


Assuntos
Neoplasias Pleurais/cirurgia , Radiografia Torácica/métodos , Tumor Fibroso Solitário Pleural/cirurgia , Cirurgia Torácica Vídeoassistida/métodos , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias Pleurais/diagnóstico por imagem , Neoplasias Pleurais/patologia , Ventilação Pulmonar , Tumor Fibroso Solitário Pleural/diagnóstico por imagem , Tumor Fibroso Solitário Pleural/patologia
20.
J Vasc Surg Cases Innov Tech ; 6(3): 340-343, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32715167

RESUMO

We describe a dementia patient with comorbid recurrent cellulitis and lymphedema in the left lower limb who was treated successfully for recurrent cellulitis by lymphaticovenular anastomosis (LVA). The patient, an 83-year-old woman, suffered from recurrent cellulitis three times a year on average for 15 years. Compression therapy was impossible because of dementia. After LVA, there has been no recurrence of cellulitis for 2 years. It is difficult to administer decongestive lymphatic therapy in some patients, such as patients with dementia. LVA is a promising treatment for recurrent cellulitis in a dementia patient with lymphedema.

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