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Clinical outcome after surgery on schwannomas in the extremities

World Journal of Orthopedics 2021年第10期12卷 760-767页

作者： Andreas Saine Granlund Michala Skovlund Sørensen Claus Lindkær Jensen Birthe Højlund Bech Michael Mørk Petersen Musculoskeletal Tumor Section Department of Orthopedic SurgeryCopenhagen University HospitalRigshospitaletCopenhagen 2100Denmark Department of Orthopedic Surgery Copenhagen University HospitalCopenhagen 2200Denmark Musculoskeletal Tumor Section Department of Orthopedic SurgeryUniversity of CopenhagenCopenhagen 2100Denmark Department of Radiology RigshospitaletUniversity of CopenhagenCopenhagen 2100Denmark

BACKGROUND Schwannoma is a benign,encapsulated and slowly growing tumor originating from Schwann cells and is rarely seen in the peripheral nerve *** symptoms are soreness,radiating pain and sensory loss combined with a soft tissue *** To evaluate pre-and postoperative symptoms in patients operated for schwannomas in the extremities and investigate the rate of malignant *** In this single center retrospective study design,all patients who had surgery for a benign schwannoma in the extremities from May 1997 to January 2018 were *** location of the tumor in the extremities was divided into five groups;forearm,arm,shoulder,thigh and leg including *** locations of the tumor in the nerves were also categorized as either;proximal,distal,minor or major *** the pre-and postoperative clinical evaluation,symptoms were classified as paresthesia,local pain,radiating pain,swelling,impairment of mobility/strength and asymptomatic tumors that were found incidentally(with magnetic resonance imaging).The patients were evaluated after surgery using the following categories:Asymptomatic or symptomatic patients(radiating and/or local pain)and those with *** follow up period was from the time of surgery until last examination of the particular *** logistic regression analysis was performed to identify independent prognostic factors for postoperative significant symptoms at *** We identified 858 cases from the institutional pathology *** excluded cases with duplicate diagnoses(n=407),pathology not including schwannomas(n=157),lesions involving the torso,spine and neck(n=150)leaving 144 patients for further *** this group 99 patients underwent surgery and there were five complications recorded:2 infections(treated with antibiotics)and 3 nerve palsies(2 involving the radial nerve and one involving the median nerve)that recovered *** the end of follow-up,1.4

关键词： Schwannoma extremities Surgery Removal Symptoms Outcome

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MRI Findings and Diagnostic Significance of Soft Tissue Schwannomas in the extremities

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Journal of Clinical and Nursing Research 2024年第8期8卷 31-36页

作者： Guoping Zhang Xiaoli Chen Center of Diagnostic Medical Imaging Shaanxi Provincial People’s HospitalXi’an 710068Shaanxi ProvinceChina Department of Neurology Shaanxi Provincial People’s HospitalXi’an 710068Shaanxi ProvinceChina

Objective:To analyze the MRI features and rare manifestations of schwannomas of the extremities to improve ***:Retrospective analysis of 23 cases of schwannomas in the extremities confirmed by surgical pathology,summarizing its signs,signal characteristics and MRI ***:Among the 23 cases,20 were single lesions,and 3 were multiple lesions,resulting in a total of 28 *** distribution of these lesions included 7 in the thigh,9 in the calves,4 in the armpits,3 in the hips,and 4 each in the upper arms and ***,there was one lesion located in the *** T1-weighted imaging(T1WI),the lesions showed iso-intensity or *** T2-weighted imaging(T2WI),they appeared slightly hyperintense or *** lesions exhibited multiple small vesicle-like higher signals,cystic changes,and fiber spacing on ***,one lesion showed a liquid-liquid ***“target sign”was observed in 18 lesions(64.3%)and“neuropathic signs”were present in six lesions(21.4%).Finally,it was noted that on MRI enhancement,the lesions demonstrated uniform or uneven *** lesions were uniformly or unevenly enhanced on MRI ***:The MRI findings of schwannoma in the extremities exhibit specific *** cystic changes on T2WI also display distinct *** of rare MRI findings,such as cystic changes,liquid-liquid plane and septum,should be emphasized to enhance the accuracy of pre-diagnosing schwannomas.

关键词： Schwannomas extremities Magnetic resonance imaging

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Ongoing Blood Pressure Change in Both Upper extremities: An Unusual Presentation of Aortic Dissection

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International Journal of Clinical Medicine 2011年第4期2卷 463-468页

作者： Hung Yi Chen 不详

Aortic dissection is a critical condition requiring immediate assessment and management. Patients with this condition usually present with severe chest pain and high blood pressure. However, because of the variety of presenting symptoms and features, it is a challenge to identify this condition, and patients are frequently misdiagnosed. The potentially critical course of aortic dissection can result in tragedy. We present the case of a 46-year-old woman who initially presented with a light headache and sensory loss in her right upper limb. She had a medical history of hypertension without regular medication, and her blood pressure (BP) was 110/67 mmHg on arrival. Four days later, she was sent to the emergency department again because she experienced transient loss of consciousness lasting for a few minutes. Her BP was 94/57 mmHg in the right arm and 89/54 in the left arm. She was admitted to the hospital, and the pulses in both upper limbs were impalpable on the following day. Chest magnetic resonance imaging (MRI) was arranged, and subsequently, aortic dissection was diagnosed. The case presented with unusual characteristics, which increased the difficulty in immediate correct diagnosis.

关键词： Aortic Dissection Blood Pressure Pulseless Upper extremities

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Structural bone allografts with intramedullary vascularized fibular autografts for the treatment of massive bone defects in extremities

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Journal of Medical Colleges of PLA(China) 2007年第5期22卷 298-302页

作者：杨运发张光明徐中和王建炜侯之启温世锋 Department of Orthopedics Guangzhou First Municipal People's HospitalGuangzhou Medical College

Objective:To report the clinical outcome of repairing massive bone defects biologically in limbs by homeochronous using structural bone allografts with intramedullary vascularized fibular autografts. Methods: From January 2001 to December 2005, large bone defects in 19 patients (11 men and 8 women, aged 6 to 35 years) were repaired by structural bone allografts with intramedullary vascularized fibular autografts in the homeochronous period. The range of the length of bone defects was 11 to 25 cm (mean 17.6 cm), length of vascularized free fibular was 15 to 29 cm (mean 19.2 cm), length of massive bone allografts was 11 to 24 cm (mean 17.1 cm). Location of massive bone defects was in humerus(n=1), in femur(n=9) and in tibia(n=9), respectively. Results: After 9 to 69 months (mean 38.2 months) follow-up, wounds of donor and recipient sites were healed inⅠstage, monitoring-flaps were alive, eject reaction of massive bone allografts were slight, no complications in donor limbs. Fifteen patients had the evidence of radiographic union 3 to 6 months after surgery, 3 cases united 8 months later, and the remained one case of malignant synovioma in distal femur recurred and amputated the leg 2.5 months, postoperatively. Five patients had been removed internal fixation, complete bone unions were found one year postoperatively. None of massive bone allografts were absorbed or collapsed at last follow-up. Conclusion: The homeochronous usage of structural bone allograft with an intramedullary vascularized fibular autograft can biologically obtain a structure with the immediate mechanical strength of the allograft, a potential result of revascularization through the vascularized fibula, and accelerate bone union not only between fibular autograft and the host but also between massive bone allograft and the host.

关键词： massive bone defects repair bone grafts extremities

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The Effects of Chinese Medicines on Micro-circulation of Nail Folds and Blood Flow Velocity of Limbs in the Patients with Arteriosclerotic Obliteration

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Journal of Traditional Chinese Medicine 2003年第2期23卷 87-89页

作者：葛辛葛芃彭玉清陈云翔段树民 Peripheral Vessel Department Oriental Hospital Affiliated to Beijing University of Traditional Chinese MedicineBeijing 100078

The effects of Chinese medicines on micro-circulation and blood flow velocity in arteries of the lower limbs were observed in 33 patients with arteriosclerotic obliteration(ASO).The results showed that the integral values of micro-circulation after treatment were obviously higher than those before treatment (P<0.05 or P<0.01).Blood flow velocity in arteries of the lower limbs determined with the color Doppler ultrasound detecting method after treatment were also obviously higher than those before treatment (P<0.05 or P<0.01).In tbis series of 33 ASO patients,the markedly effective rate was 36.36%,and the total effective rate was 63.64%.The observation indicates that the recipe prescribed according to the principle of supplementing qi and activating blood circulation can effectively improve micro-circulation in ASO patients,and accelerate blood flow in arteries of the lower limbs.

关键词： Phytotherapy Aged Arteriosclerosis Obliterans Blood Flow Velocity Drugs, Chinese Herbal extremities Female Humans Male Microcirculation Middle Aged Nails

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Resection and reconstruction of pelvic and extremity soft tissue sarcomas with major vascular involvement: Current concepts

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World Journal of Orthopedics 2016年第5期7卷 293-300页

作者： Niall P Mc Goldrick Joseph S Butler Maire Lavelle Stephen Sheehan Sean Dudeney Gary C O'Toole National Sarcoma Service Department of Trauma and Orthopaedic Surgery St Vincent’s University Hospital Department of Histopathology St Vincent’s University Hospital Department of Vascular Surgery St Vincent’s University Hospital

Soft tissue sarcoma accounts for approximately 1% of all cancers diagnosed annually in the United States. When these rare malignant mesodermal tumours arise in the pelvis and extremities, they may potentially encase or invade large calibre vascular structures. This presents a major challenge in terms of safe excision while also leaving acceptable surgical margins. In recent times, the trend has been towards limb salvage with vascular reconstruction in preference to amputation. Newer orthopaedic and vascular reconstructive techniques including both synthetic and autogenous graft reconstruction have made complex limb-salvage surgery feasible. Despite this, limb-salvage surgery with concomitant vascular reconstruction remains associated with higher rates of post-operative complications including infection and amputation. In this review we describe the initial presentation and investigation of patients presenting with soft tissue sarcomas in the pelvis and extremities, which involve vascular structures. We further discuss the key surgical reconstructive principles and techniques available for the management of these complex tumours, drawn from our institution's experience as a national tertiary referral sarcoma service.

关键词： Sarcoma extremities Vascular surgical procedures Limb salvage Reconstruction

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Portable ultrasonography in mass casualty incidents:The CAVEAT examination

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World Journal of Orthopedics 2010年第1期1卷 10-19页

作者： Stanislaw Peter Stawicki James M Howard John P Pryor David P Bahner Melissa L Whitmill Anthony J Dean Department of Surgery Division of Critical CareTraumaand BurnThe Ohio State University Medical CenterColumbusOH 43210United States Department of Surgery Division of Traumatology and Surgical Critical CareUniversity of Pennsylvania School of MedicinePhiladelphiaPA 19104United States Department of Emergency Medicine The Ohio State University Medical CenterColumbusOH 43210United States Department of Emergency Medicine University of Pennsylvania School of MedicinePhiladelphiaPA 19104United States

Ultrasonography used by practicing clinicians has been shown to be of utility in the evaluation of time-sensitive and critical illnesses in a range of environments,including pre-hospital triage,emergency department,and critical care *** increasing availability of lightweight,robust,user-friendly,and low-cost portable ultrasound equipment is particularly suited for use in the physically and temporally challenging environment of a multiple casualty incident(MCI).Currently established ultrasound applications used to identify potentially lethal thoracic or abdominal conditions offer a base upon which rapid,focused protocols using hand-carried emergency ultrasonography could be *** a detailed review of the current use of portable ultrasonography in military and civilian MCI settings,we propose a protocol for sonographic evaluation of the chest,abdomen,vena cava,and extremities for acute *** protocol is two-tiered,based on the urgency and technical difficulty of the sonographic *** addition to utilization of well-established bedside abdominal and thoracic sonography applications,this protocol incorporates extremity assessment for long-bone *** of the proposed protocol will need to be conducted to determine its utility in simulated and actual MCI settings.

关键词： Focused Assessment with Sonography in Trauma Chest,abdomen,vena cava,and extremities for acute triage Ultrasonography Disaster Field triage Pre-hospital care Mass casualty incident

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保留腓肠神经的腓肠神经营养血管皮瓣修复小腿下部及足部大面积组织缺损的研究

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浙江医学 2009年第10期31卷 -页

作者：谢俊明郭恩琪谢庆平浙江省中医院外科杭州310006 浙江省人民医院手外科

目的探讨采用保留腓肠神经的腓肠神经营养血管皮瓣修复小腿下部及足部大面积组织缺损.方法在腓肠神经营养血管皮瓣解剖过程中保留腓肠神经干,经远端筋膜蒂旋转120°～150°修复小腿下部及足部大面积组织缺损30例(其中足背部缺损15例... 详细信息

目的探讨采用保留腓肠神经的腓肠神经营养血管皮瓣修复小腿下部及足部大面积组织缺损.方法在腓肠神经营养血管皮瓣解剖过程中保留腓肠神经干,经远端筋膜蒂旋转120°～150°修复小腿下部及足部大面积组织缺损30例(其中足背部缺损15例、足踝足背复合缺损4例、足踝足底复合缺损3例、小腿下部及足踝部复合缺损8例).结果术后随访1～3个月,皮瓣全部存活,患肢足踝部或足底外侧皮肤感觉正常;淀粉-碘试验显示患侧腓肠神经的自主神经功能与健侧相比无显著差异;骨折愈合过程中踝关节主、被动功能恢复良好.结论保留腓肠神经的腓肠神经营养血管皮瓣修复小腿下部和足部缺损可避免足踝部或足底外侧感觉和自主神经功能障碍等并发症,在值得在临床上推广可广泛应用.

关键词：腓肠神经营养血管皮瓣修复小腿足部面积组织缺损 lower extremities 自主神经功能障碍复合缺损足踝部足底足背部愈合过程显著差异术后随访皮肤感觉皮瓣解剖功能恢复神经干

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Effects of Ving Tsun sticking-hand training on upper-limb sensorimotor performance in community-dwelling middle-aged and older adults: A randomized controlled trial

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International Journal of Nursing Sciences 2020年第1期7卷 29-34页

作者： Joanne W.Y.Chung Shirley S.M.Fong Yang Gao Timothy T.T.Yam Yvonne T.C.Chak Joyce C.Y.Leung Thomas K.S.Wong Department of Health and Physical Education Education University of Hong KongHong KongChina School of Nursing and Healthcare Hong Kong Nang Yan College of Higher EducationHong KongChina Hong Kong Martial Arts Institute Hong KongChina School of Public Health University of Hong KongHong KongChina Department of Sport and Physical Education Hong Kong Baptist UniversityHong KongChina Hong Kong Christian Service Hong KongChina School of Nursing and Health Studies Open University of Hong KongHong KongChina Department of Social Work and Social Administration University of Hong KongHong KongChina

Objective:To evaluate the effects of Ving Tsun(VT)sticking-hand training on upper-limb joint position sense and muscular performance in community-dwelling middle-aged and older ***:Thirty-three adults were randomly allocated to either a VT group or a control *** VT group received VT sticking-hand training twice per week for 3 *** were taken before and after the intervention *** primary outcome was elbow-joint repositioning error,which was measured by an elbow-joint passive positioning and active repositioning test using a universal *** outcomes were upper-limb muscles'peak force and time taken to reach peak force as measured by a hand-held ***:No significant time,group or time-by-group interaction effects were found for elbow-joint repositioning error or upper-limb muscle peak force *** flexor time to peak force decreased by 33.8%from pre-test to post-test in the VT group(P=0.007).Shoulder abductor,internal and external rotator,and elbow extensor times to peak force decreased by 30.0%-35.9%in the VT%roup(P<0.05)and by 30.4%-37.1%in the control group(P<0.05).Conclusions:VT sticking-hand training does not improve elbow-joint position sense or the maximum strength of upper-limb muscles in middle-aged and older ***,VT can improve shoulder flexor muscles'time to reach peak force in these *** had no obvious effect on the time required to reach peak force in other shoulder muscles and elbow extensors.

关键词： Aged Exercise movement techniques Joint position sense Middle aged Muscle strength Upper extremities

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Management of limb fractures in a teaching hospital： comparison between Wenchuan and Yushu earthquakes

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Chinese Journal of Traumatology 2013年第1期16卷 16-21页

作者： MIN Li TU Chong-qi LIU Lei ZHANG Wen-li YI Min SONG Yue-ming HUANG Fu-guo YANG Tian-fu PEI Fu-xing Department of Orthopaedics West China HospitalSichuan University Chengdu 610041 China

Objective： To comparatively analyze the medical records of patients with limb fractures as well as rescue strategy in Wenchuan and Yushu earthquakes so as to provide references for post-earthquake rescue. Methods： We retrospectively investigated 944 patients sustaining limb fractures, including 891 in Wenchuan earthquake and 53 in Yushu earthquake, who were admitted to West China Hospital （WCH） of Sichuan University. Results： In Wenchuan earthquake, WCH met its three peaks of limb fracture patients influx, on post-earthquake day （PED） 2, 8 and 14 respectively. Between PED 3-14, 585 patients were transferred from WCH to other hospitals out- side the Sichuan Province. In Yushu earthquake, the maxi- mum influx of limb fracture patients happened on PED 3, and no one was shifted to other hospitals. Both in Wenchuan and Yushu earthquakes, most limb fractures were caused by blunt strike and crush/burying. In Wenchuan earthquake, there were 396 （396/942, 42.0%） open limb fractures, includ- ing 28 Gustilo I, 201 Gustilo II and 167 Gustilo III injuries. But in Yushu earthquake, the incidence of open limb fracture was much lower （6/61, 9.8%）. The percent of patients with acute complications in Wenchuan earthquake （167/891,18.7%） was much higher than that in Yushu earthquake （5/53, 3.8%）. In Wenchuan earthquake rescue, 1 018 surgeries were done, composed of debridement in 376, internal fixation in 283, external fixation in 119, and vacuum sealing drainage in 117, etc. While among the 64 surgeries in Yushu earthquake rescue, the internal fixation for limb fracture was mostly adopted. All patients received proper treatment and sur- vived except one who died due to multiple organs failure in Wenchuan earthquake. Conclusion： Provision of suitable and sufficient medi- cal care in a catastrophe can only be achieved by construc- tion of sophisticated national disaster medical system, pre- diction of the injury types and number of injuries, and con- flrmation of participating hospit

关键词： Earthquakes extremities Fractures, bone Disaster medicine

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