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When free flaps are not the first choice: is the distally based peroneus brevis still an option for foot and ankle reconstruction in the era of microsurgery?

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Plastic and Aesthetic Research 2018年第7期5卷 26-34页

作者： Raymund E.Horch Ingo LudoIph marweh Schmitz anja m.boos UIrich Kneser Justus P.Beier Andreas Arkudas1 Department of Plastic and Hand Surgery University Hospital ErlangenFriedrich-Alexander University Erlangen-Nuernberg FAUErlangen D-91054Germany Department of Hand Plastic and Reconstructive Surgery-Burn Center-BG Trauma Center LudwigshafenDepartment of Plastic SurgeryUniversity of HeidelbergLudwigshafen D-67071Germany Department of Plastic Hand and Burn Surgery University Hospital RWTHAachen D-52074Germany

Aim: Soft tissue defects with or without exposed bones in the lower extremity, ankle and the foot-with or without bone defects or exposed hardware-often require coverage with vascularized flaps. Free flaps, which add healthy tissue especially to the lower extremity instead of further injuring a limb, are the first choice in high volume microsurgical centres. Nevertheless, in some instances pedicled flaps may have indications when free flaps are not suitable. methods: The distally based peroneus brevis flap is harvested from the lateral compartment of the leg based on the distal perforating arterial supply and covered with split skin. Results: We performed a total of 69 peroneus flaps between 2003 and 2017. minor flap necroses at the distal tip were noted in 8% of the peroneus brevis reconstructions. Total flap loss occurred in 1 peroneus flap. Defect etiology and patient age were not associated with surgical outcome. Conclusion: While nowadays the first choice of lower extremity reconstruction is an appropriate free flap solution,the peroneus brevis muscle flap can also be seen as a valuable tool to reconstruct small to medium sized defects at the ankle, distal tibia, and the heel with an acceptable donor site morbidity. Despite the easily available variety of free flaps to achieve this purpose, still proper indications remain where a local flap can be a viable option in the hand of experienced plastic surgeons. However, caution is advisable in patients with peripheral arterial occlusive disease or venous insufficiency.

关键词： Free flaps peroneus brevis muscle flap lower extremity reconstruction

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Risk and benefit from clinical trials in minors:making the case for transparent and consistent publications

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Open Journal of Pediatrics 2013年第2期3卷 151-164页

作者： Andreas Dirk Henschel Lillian Geza Rothenberger Dominik Schrey Joachim Gerβ Georg Hempel Joachim.boos Department of Pharmaceutical and medical Chemistry—Clinical Pharmacy University of MünsterMünsterGermany Department of Paediatric Haematology and Oncology University Children’s Hospital MünsterMünsterGermany Institute of Ethics and History in medicine Center for MedicineSociety and PreventionUniversity of TuebingenGermany The Royal marsden Hospital Department of Paediatric OncologySurreyUK Institute for Biostatistics and Clinical Research University of MuensterGermany Department of Pediatric Hematology and Oncology University Children’s HospitalMuenster Albert-Schweitzer-CampusMuensterGermany

Rationale, aim and objectives: The European (EU) regulation on medicinal products for pediatric use (EC 1901/2006), which became effective in 2007, aimed to stimulate the clinical testing of medications in minors in order to reduce off-label use. In consequence, the number of minors taking part in randomized controlled clinical trials (RCTs) is likely to increase. Clinical trials in minors require a complex methodological design, a careful consideration of risks and benefits and a high level of ethical reflection. Unfortunately, as to the quality of clinical trials and their publications in minors little is known. Therefore, we assessed published reports of randomized, controlled clinical trials in minors, focusing on a common disease (asthma) and a defined spectrum of lifethreatening diseases (malignant diseases). method: In an exploratory design, we scanned the publications for methodological aspects as well as indicators of ethical soundness, e.g., statements that informed consent had been obtained before the start of the trial or that a Data and Safety monitoring Board ensured the patients’ safety during the trial. We also looked for passages reflecting the debate on equipoise or other forms of weighing risks and benefits. Results: We found that many of these aspects, which according to the scientific literature and generally acknowledged guidelines are essential to ensure good-quality trials and trial reports, were not considered in the publications analyzed. Conclusion: Therefore, we call for a more transparent and consistent presentation of the trials, especially of safety aspects, relying on a more critical and transparent ethical reflection.

关键词： Clinical Trials minors SIGN CONSORT Ethics

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透视下经皮刷片细胞学检查、钳夹活检及联合应用对恶性胆道梗阻的诊断价值

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国际医学放射学杂志 2018年第2期 243-243页

作者： J.boos R.J.Yoo J.Steinkeler G.Ayata m.Ahmed A.Sarwar 张琪 Department of Radiology Beth Israel Deaconess Medical Center Harvard Medical School

摘要目的评估透视下经皮刷片细胞学检查、钳夹活检及联合应用对恶性胆道梗阻的诊断价值。方法对2010年1月—2014年9月间做过胆道刷片细胞学检查和钳夹活检的

关键词：细胞学检查恶性胆道梗阻联合应用诊断价值

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几种有机多硫化物的摩擦膜和热膜的XANES分析

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科学通报 2006年第16期51卷 1875-1880页

作者：易红玲曾祥琼曹燕任天辉 m. Kasrai G. m. Bancroft 上海交通大学化学化工学院上海200240 Department of Chemistry University of Western Ontario London Ontario N6A5B7 Canada

采用X射线吸收精细结构光谱(XANES)对烷基、苄基以及两种酰基有机多硫化物与钢表面反应生成的摩擦膜和热膜的化学特征进行了分析.结果表明,热氧化条件下,4种多硫化物与钢表面反应生成的热膜的主要成分是FeSO4,酰基多硫化物boos形成的热... 详细信息

采用X射线吸收精细结构光谱(XANES)对烷基、苄基以及两种酰基有机多硫化物与钢表面反应生成的摩擦膜和热膜的化学特征进行了分析.结果表明,热氧化条件下,4种多硫化物与钢表面反应生成的热膜的主要成分是FeSO4,酰基多硫化物boos形成的热膜的次表面和本体中还含有少量烷基二硫化物.生成的摩擦膜中,多硫化物的结构不同呈现出不同的特征,其中烷基多硫化物最外层表面以烷基二硫化物为主,苄基多硫化物最外层表面以FeSO4为主,两者摩擦膜的次表面主要是FeSO4,FeS2和亚砜的混合物,本体是FeSO4;而两种酰基多硫化物摩擦膜的最外层表面都是以烷基二硫化物为主,次表面和本体主要是FeS2.

关键词：有机多硫化物 XANES 摩擦膜热膜

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