953 resultados para partial nephrectomy
Resumo:
AIM: To test whether humoral immune reaction against mycobacteria may play a role in anti-Saccharomyces cerevisiae antibodies (ASCA) generation in Crohn's disease (CD) and/or whether it correlates with clinical subtypes. METHODS: The dominant ASCA epitope was detected by Galanthus nivalis lectin (GNL)-binding assay. ASCA and IgG against mycobacterial lysates (M avium, M smegmatis, M chelonae, M bovis BCG, M avium ssp. paratuberculosis (MAP)] or purified lipoarabinomannans (LAM) were detected by ELISA. ASCA and anti-mycobacterial antibodies were affinity purified to assess cross-reactivities. Anti-mycobacterial IgG were induced by BCG-infection of mice. RESULTS: GNL bound to different extents to mycobacterial lysates, abundantly to purified mannose-capped (Man) LAM from M tuberculosis, but not to uncapped LAM from M smegmatis. Fifteen to 45% of CD patients but only 0%-6% of controls were seropositive against different mycobacterial antigens. Anti-mycobacterial IgG correlated with ASCA (r = 0.37-0.64; P = 0.003-P < 0.001). ASCA-positivity and deficiency for mannan-binding lectin synergistically associated with anti-mycobacterial IgG. In some patients, anti-mycobacterial antibodies represent cross-reactive ASCA. Vice-versa, the predominant fraction of ASCA did not cross-react with mycobacteria. Finally, fistulizing disease associated with antibodies against M avium, M smegmatis and MAP (P = 0.024, 0.004 and 0.045, respectively). CONCLUSION: Similar to ASCA, seroreactivity against mycobacteria may define CD patients with complicated disease and a predisposition for immune responses against ubiquitous antigens. While in some patients anti-mycobacterial antibodies strongly cross-react with yeast mannan; these cross-reactive antibodies only represent a minor fraction of total ASCA. Thus, mycobacterial infection unlikely plays a role in ASCA induction.
Resumo:
Does there exist a Steiner Triple System on v points, whose blocks can be partitioned into partial parallel classes of size m, where m ≤ [v⁄3], m | b and b is the number of blocks of the STS(v)? We give the answer for 9 ≤ v ≤ 43. We also show that whenever 2|b, v ≡ 3 (mod 6) we can find an STS(v) whose blocks can be partitioned into partial parallel classes of size 2, and whenever 4|b , v ≡ 3 (mod 6), there exists an STS(v) whose blocks can be partitioned into partial parallel classes of size 4.
Resumo:
In 1970 Clark Benson published a theorem in the Journal of Algebra stating a congruence for generalized quadrangles. Since then this theorem has been expanded to other specific geometries. In this thesis the theorem for partial geometries is extended to develop new divisibility conditions for the existence of a partial geometry in Chapter 2. Then in Chapter 3 the theorem is applied to higher dimensional arcs resulting in parameter restrictions on geometries derived from these structures. In Chapter 4 we look at extending previous work with partial geometries with α = 2 to uncover potential partial geometries with higher values of α. Finally the theorem is extended to strongly regular graphs in Chapter 5. In addition we obtain expressions for the multiplicities of the eigenvalues of matrices related to the adjacency matrices of these graphs. Finally, a four lesson high school level enrichment unit is included to provide students at this level with an introduction to partial geometries, strongly regular graphs, and an opportunity to develop proof skills in this new context.
Resumo:
Metanephric adenoma (MA) is a rare renal neoplasm present at any age. Usually, a total nephrectomy is performed. Some successful partial nephrectomies or selective tumor resections are described in adults but not in children. We present here the case of a 15-month-old boy, the youngest patient yet to be reported with an MA. We performed a local resection of the tumor. Today, 2 1/2 years after surgery, we can document a favorable clinical course and normal ultrasound findings in the follow-up of the operated kidney. This case gives further evidence that organ-sparing resection of MA is feasible in selected cases. A close clinical and ultrasound follow-up is mandatory for this approach.
Resumo:
On one side, prosthodontic reconstructions compensate for the sequelae of negative changes in the oral cavity; on the other side, they often enhance or accelerate them. As a consequence of negative changes in the oral cavity over time, treatment planning for RPDs becomes highly complex. A set of reliable criteria is necessary for decision-making and problem management It appears that the majority of published data on RPDs does not depict high effectiveness of this treatment modality. From a strict point of view of evidence-based dentistry, the level of evidence is low if not missing for RPDs. Randomized controlled trials on RPDs are difficult to design, they are not feasible for some questions due to the complexity of the material, or may remain without clinical relevance. The literature rarely gives information on the denture design, tooth selection, and management of the compromised structural integrity of teeth. So far treatment outcomes with RPDs must be considered under the aspect of bias due to the bias in indication and patient selection for RPDs. Better clinical models should be elaborated with more stringent concepts for providing RPDs. This encompasses: risk analysis and patient assessment, proper indications for maintenance or extraction of teeth, strategic placement of implants, biomechanical aspects, materials, and technology. Although there is a tendency to offer fixed prostheses to our patients, this might change again with demographic changes and with an increase in the ageing population, an increase in their reduced dentition, and low socioeconomic wealth in large parts of the world.
Resumo:
The aim of this research was to study the impact of loading on partial dentures within the supporting soft tissue with respect to different attachment techniques. A finite element model was developed to calculate the stress and strain distribution in this tissue. The model consisted of the left half of a mandible with three remaining teeth that had suffered an atrophy in the anterior region, and a partial denture over the toothless area that was connected at the left mandibular canine using an attachment system. Resulting stress/strain distributions are presented for different load cases using a commercially available prefabricated attachment system.
Resumo:
Dynamic, unanticipated adaptation of running systems is of interest in a variety of situations, ranging from functional upgrades to on-the-fly debugging or monitoring of critical applications. In this paper we study a particular form of computational reflection, called unanticipated partial behavioral reflection, which is particularly well-suited for unanticipated adaptation of real-world systems. Our proposal combines the dynamicity of unanticipated reflection, i.e. reflection that does not require preparation of the code of any sort, and the selectivity and efficiency of partial behavioral reflection. First, we propose unanticipated partial behavioral reflection which enables the developer to precisely select the required reifications, to flexibly engineer the metalevel and to introduce the meta behavior dynamically. Second, we present a system supporting unanticipated partial behavioral reflection in Squeak Smalltalk, called Geppetto, and illustrate its use with a concrete example of a web application. Benchmarks validate the applicability of our proposal as an extension to the standard reflective abilities of Smalltalk.
Resumo:
Osteotomy and revascularization have both been used for many years in the therapy of partial aseptic necrosis of the femoral head in the adult. We first attempted a combination of the two techniques in 1978. Stress on the necrotic sector was relieved by intertrochanteric osteotomy, and the necrotic part of the bone was revascularized with a pedicled iliac crest bone graft based on the deep circumflex iliac vessels. Long-term results are now available in 45 hips in 38 patients, with a mean follow-up time of 32 months. Clinically, 71% of the hips were rated very good or good, and among those classed as stage II before surgery the results were rated as very good or good in as many as 90%. Subjective evaluation of the hips by the patients confirmed these results: 85% of the hips were judged to be optimal or markedly improved compared with before operation. Radiological evaluation showed further flattening of the femoral head in one case. A segmental collapse of the femoral head, i.e. stage III lesion according to Ficat, occurred in 2 hips with stage II preoperatively. In 6 hips with stage III necrosis preoperatively secondary arthritis developed. Computerized tomograms taken of all 25 hips from which metal implants had been removed showed signs of integration of the graft in 68%. Scintigraphy with 99-Tc-diphosphonate showed a homogeneous uptake in 42.8% and a non-homogeneous uptake in the remaining 57.2% of the cases. So-called photopenia was not observed in any of the hip joints treated.(ABSTRACT TRUNCATED AT 250 WORDS)
Resumo:
PURPOSE To analyse the clinical outcome after salvage lumpectomy and multi-catheter brachytherapy (MCB) for ipsilateral breast tumour recurrence (IBTR). MATERIAL AND METHODS Between 09/00 and 09/10, 217 patients presenting an IBTR underwent lumpectomy and MCB (low, pulsed, or high-dose rate). Survival rates without second local recurrence (2nd LR), distant metastasis (DM), and overall survival (OS) were analysed as well as late effects and cosmetic results. Univariate and multivariate analyses (MVA) based on IBTR data were performed to find prognostic factors for 2nd LR, DM, and OS. RESULTS Median follow-up after the IBTR was 3.9 years [range: 1.1-10.3]. Five and 10-year actuarial 2nd LR rates were 5.6% [range: 1.5-9.5] and 7.2% [range: 2.1-12.1], respectively. Five and 10-year actuarial DM rates were 9.6% [range: 5.7-15.2] and 19.1% [range: 7.8-28.3], respectively. Five and 10-year actuarial OS rates were 88.7% [range: 83.1-94.8] and 76.4% [range: 66.9-87.3], respectively. In MVA, histological grade was prognostic factor for 2nd LR (p=0.008) and OS (p=0.02); while tumour size was prognostic factor for DM (p=0.03). G3-4 complication rate was 11%. Excellent/good cosmetic result was achieved in 85%. CONCLUSION This study suggests that in case of IBTR, lumpectomy plus MCB is feasible and effective in preventing 2nd LR with an OS rate at least equivalent to those achieved with salvage mastectomy.
Resumo:
This paper studied two different regression techniques for pelvic shape prediction, i.e., the partial least square regression (PLSR) and the principal component regression (PCR). Three different predictors such as surface landmarks, morphological parameters, or surface models of neighboring structures were used in a cross-validation study to predict the pelvic shape. Results obtained from applying these two different regression techniques were compared to the population mean model. In almost all the prediction experiments, both regression techniques unanimously generated better results than the population mean model, while the difference on prediction accuracy between these two regression methods is not statistically significant (α=0.01).
Resumo:
Reconstruction of shape and intensity from 2D x-ray images has drawn more and more attentions. Previously introduced work suffers from the long computing time due to its iterative optimization characteristics and the requirement of generating digitally reconstructed radiographs within each iteration. In this paper, we propose a novel method which uses a patient-specific 3D surface model reconstructed from 2D x-ray images as a surrogate to get a patient-specific volumetric intensity reconstruction via partial least squares regression. No DRR generation is needed. The method was validated on 20 cadaveric proximal femurs by performing a leave-one-out study. Qualitative and quantitative results demonstrated the efficacy of the present method. Compared to the existing work, the present method has the advantage of much shorter computing time and can be applied to both DXA images as well as conventional x-ray images, which may hold the potentials to be applied to clinical routine task such as total hip arthroplasty (THA).