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At least 1,711 records · Page 95Linked to original sources
PubMed2002

Telerobotic minimally invasive procedures in urology--laparoscopic radical prostatectomy.

A telerobotic device, the daVinci Surgical System (Intuitive Surgical, Inc., Mountain View, CA) is one of the recently developed, remotely operated systems for laparoscopic surgical procedures. This telemanipulation system consists of two components: a control console operated by the surgeon, and the surgical arm cart that holds a three-dimensional (3-D) 30 degrees laparoscope and two detachable laparoscopic surgical tools. The instruments are equipped with a wrist--a unique feature that provides additional dexterity. Since its clinical introduction in Europe in early 1999, this system has opened up a new era in minimally invasive surgery enhancing endoscopic vision and anastomosis suturing. For the first time, cardiac surgeons were able to perform a totally endoscopic coronary bypass procedure on a beating heart.

Aged↗
PubMed1999

Daily living abilities and work abilities of people with Parkinson's disease.

A questionaire survey was conducted on 60 items of daily living abilities linked to 13 basic work abilities such as memory, learning, planning, muscular power and concentration etc. covering a total of 133 subjects with Parkinson's disease. Results of the survey were as follows: 1. Daily living abilities and work abilities decreased in accordance with Yahr's stages and the degree of daily living abilities. 2. Daily living abilities provided clues for aging and prognosis of the Parkinson's disease. 3. "Cope well with heat and coldness", "Being confident in the strength of legs and loins" and "Keep balance in the train" were difficult to do from the early stages of the onset. 4. Audio-visual ability, memory and judgement were well maintained despite the severity of the disease. 5. All subjects showed poor endurance, while learning, planning and manual dexterity showed higher performance in those under 59.

Journal Article↗
PubMed2002

[Present status and tasks for future of point of care testing].

This paper introduces Point-Of-Care Testing(POCT) developed by Bayer, mainly focusing on urine dipstick and tests for Diabetes Mellitus. Urinalysis using a dipstick has been widely carried out as a screening test for various kinds of diseases. Ten-pad urine dipstick is commercially available at the present time, and the desktop instruments have been developed for automatic optical reading, such as the Clinitek 50/100/500 systems. More recently, Bayer developed a new urine dipstick intended for reliable detection of the early stage of kidney disease without the influence of urine condensation or dilution. The dipstick adds 2 pads to conventional urine dipsticks: one for the measurement of small amounts of protein(albumin), and the other for creatinine. A semi-quantitative urine protein-to-creatinine ratio is based on these results. There have been significant advances made in blood glucose meters for POCT in terms of reliability, simplicity of operation, sample volume, etc. And not only healthcare professionals but also patients with diabetes have used POCT meters. Dexter-ZII is available as one of these meters. DCA2000 is a portable analyzer for measuring HbA1c in 6 min. Patients could be treated and instructed on the basis of HbA1c measured by DCA2000. As one of the tasks for the future, it is preferable that some POCT systems be available as OTC for ordinary people to manage their own health. Also, I emphasize that it is important to review the usability of conventional urine dipsticks like a check for drug side effects, as well as for developing new urine analyses.

Autoanalysis↗
PubMed2002

Giant eustachian valve with echocardiographic appearance of divided right atrium.

The eustachian valve is an embryologic remnant of the valve of the inferior vena cava. It may be prominent in some individuals, but the echocardiographic appearance of a divided right atrium, as the consequence of a large eustachian valve, is extremely rare. Herein we describe an unusual giant eustachian valve with an echocardiographic appearance of a septal structure dividing the right atrium into 2 separate chambers. This abnormality should be differentiated from cor triatriatum dexter, a very rare cardiac malformation for which it could be mistaken.

Echocardiography↗
PubMed2002

[Screening of differentially expressed genes in the mouse hematopoietic stromal cells after long-term culture].

Hematopoietic stromal cells, being the essential ingredient of the hematopoietic microenvironment, play very important roles in the control and regulation of self-renewal, proliferation and differentiation of hematopoietic stem cells (HSC) via complex interactions of cell-cell, cell-humoral and cell-extracellular matrix. Evidence from in vivo experiment has proved that HSC derived from normal mice could reconstitute hematopoiesis of mice with HSC defects but failed to reconstitute hematopoiesis of those mice with microenvironment defects, showing the importance of hematopoietic microenvironment in the maintenance of hematopoiesis in vivo. A well-known long-term culture (LTC) system established by Dexter demonstrated in another way that stromal cell layer in the system could support ex vivo hematopoiesis for several months, even more than one year under the optimal conditions. It, however, has not been demonstrated that what is the key elements and in which way the ex vivo hematopoiesis could be maintained for so long time. As the inventions for the large-scale screening methodologies the suppression subtractive hybridization (SSH) was chosen for the screening differentially expressed genes expressed by LTC cultured stromal cells but not by the uncultured bone marrow cells (BMC). mRNA extracted from both cultured adherent cells (tester) and BMC (driver) were hybridized according to the protocol provided by CLONTECH. Total of 130 clones differentially expressed by cultured cells were randomly picked up and 106 ESTs were obtained after sequencing. They represent 26 identical or similar genes and 7 novel genes after the bioinformatics analysis. 5 of the novel genes with the entire open reading frame, without functional clues, have been cloned into the mammalian expression vectors and the functions of them in the control of proliferation and differentiation of HSC will be further exploring. The most interesting discovery is that 3 novel genes have signal peptides, implying the potential discovery of novel growth factors as 80% known growth factors have signal peptides. Our experimental results suggest that: (a) based on the results of subtractive efficiency, the SSH could be a reliable method to screen differentially expressed genes; (b) gene expression may be regulated by multiple factors, even conditioning-dependent, in this experiment the genes expressed by bone marrow stromal cells are LTC-cultivation inducible; (c) it is possible to find interesting genes or special gene after relatively large-scale screen.

Animals↗
PubMed2001

[Vitrectomy and photocoagulation for treatment of proliferative diabetic retinopathy].

PURPOSE: To evaluate the efficacy of vitreous surgery and photocoagulation for treatment of a series of patients with proliferative diabetic retinopathy(PDR). METHODS: A consecutive series of PDR treated with vitrectomy and photocoagulation during February 1997 to May 2000 was retrospectively analyzed. RESULTS: The series included 79 cases (38 male and 41 female) and 104 eyes [oculus dexter(OD), 26; oculus sinister(OS), 28; oculus uterque(OU), 25] with diabetic history for 0.5-37 (8.5 +/- 6.5) years and eye symptoms for 15 days to 1.5 years (1.5 +/- 1.5 years). Retinal photocoagulation was performed in 30 eyes with only once in 26 eyes before vitrectomy. Surgical techniques included standard vitrectomy, neovascular membrane peeling and fragmentation, endo--diathermy and endolaser. Silicone oil was injected in 59 eyes with active bleeding, retinal detachment, or severe ischemia. Cataract extraction was done in 63 eyes, of which 27 eyes with intraocular lens implantation. Visual acuity was light perception(LP), hand movement(HM), count fingers(CF), and > or = 0.02 in 15, 38, 22, and 29 eyes, respectively before operation. Visual improvement achieved in 84 eyes (80.8%) with > or = 0.1 in 41 eyes (39.4%). Visual acuity remained unchanged or decreased in 20 eyes (20.2%). Neovascular glaucoma occurred in two eyes after surgery. CONCLUSIONS: Although the series of patients with PDR without sufficient retinal photocoagulation before operation, vitrectomy and endolaser improved the visual outcome in the majority of eyes. Silicone oil injected in eyes with severe ischemia, active bleeding or retinal detachment may provide chance for prompt laser coagulation after surgery in order to prevent progression of PDR.

Adult↗
PubMed2001

[Index finger pollicization for congenitally deficient first finger of the hand in children].

Pollicization is a single-stage neurovascular pedicle transfer of the index digit to function as a thumb. The objective of this study is to investigate the results of index finger pollicization for correction of congenital deficiency of the first ray in pediatric hand. We have done 6 pollicizations of index fingers in 6 hands (there were 2 right hands, 2 left hands, and 1 bilaterally) in 5 patients (4 boys and 1 girl) who had absent or nonfunctioning thumbs (type III-V of Blauth's classification). Associated anomalies where numerous and included radial club hand, mirror hand and cardiovascular and urologic anomalies. The average time of Kirschner wire extraction was 32 days (30 to 36 days) and to beginning the hand rehabilitation at 5 degrees to 10 degrees day. The average age at pollicization was 5.5 years (range 2 to 8 years), and follow-up averaged 8 years (5 to 11 years). The cosmetic and functional results were excellent, with manual dexterity of prehension and opposition. Pollicization in children can be performed at least 2 years of age, to due of minor risk of neurovascular lesion but without delayed the cortical representation of the pollicized finger.

Child↗
PubMedDate not supplied

[Treatment of hemophilia by self-infusion: clinical and psychological approach (author's transl)].

Twenty-seven hemophiliacs between the ages of 12 and 17 volunteered in a self-infusion training program. An attempt was made to define a teaching method. It consisted of teaching them about the disease so as they would be able to recognise the site of their bleeding and the limitations of self-treatment. They also acquired dexterity in infusing themselves with various antihemophilic factor concentrates. Systematic clinical and psychological studies were undertaken and showed that this method of treatment gave a considerable improvement of the overall disability. At the same time the number of transfusions almost doubled. Self-treatment has been found successful among children over 13 years of age who are strongly motivated, intelligent, sensitive, and able to adapt themselves to concrete situations. This training has failed in 30% of the children in whom psychological disturbances have been found. In spite of this failure, a psychological improvement was noted.

Adolescent↗
PubMed2003

[Defects in the surgical glove barrier. Single or double gloves].

The purpose of wearing surgical gloves is to provide an antimicrobial barrier between the hands of the surgical staff and the tissues of the patient. Glove perforations are common, depending on the function of the staff member and the duration and nature of the surgery. In addition, gloves can hydrate, which is also a potential route of infection. The use of two pairs of gloves (double gloves) efficiently reduces both the perforation rate and the hydration of the glove barrier. Decreased dexterity and tactile sensitivity, however, are common objections, which keep many surgeons from wearing double gloves. Moreover, they seem to have little practical importance. Neither single nor double gloves have proved their effectiveness in terms of actual infections, but it seems rational to maintain a surgical glove barrier. Double gloves can be recommended as a simple means of improving the integrity of this barrier.

Blood-Borne Pathogens↗
PubMed2002

The hygienist's role in improving children's oral health throughout their development.

Improving oral hygiene in children is one of the most challenging aspects of the preventive dental practice because their dentition, dexterity, and emotional maturity are simultaneously developing. This article discusses the role of the hygienist in providing oral health care and education in the context of developing preventive care programs that can be tailored to meet the needs of children in different age groups. Particular attention will be given to identifying proven approaches to motivating children and their parents to respond positively to oral health advice and hygiene instruction.

Adolescent↗
PubMed2002

A practice based evaluation of a range of children's manual toothbrushes: safety and acceptance.

Toothbrushes for children have not suited all age groups. The development of a series of children's toothbrushes (Oral-B Stages toothbrushes) targeted at four age-defined groups and designed to meet their needs offers the potential to enhance oral hygiene. To obtain information regarding the specific likes and dislikes of these four children's toothbrushes, a randomized, practice based study involving children between the ages of 4 months and 11 years was conducted. Children were recruited from 25 pediatric dental practices located in the United States, Australia, and Europe. After 1 month of using the brushes, questionnaires were completed by the parents or guardians, children, and dental professionals. Eighty percent to 90% of respondents "liked" or "liked extremely" the toothbrushes with respect to overall like or dislike, cleaning ability, ease of use, and gentleness. Ninety-five percent of the dental professionals in the study concluded that they would recommend these toothbrushes to their patients and 90% thought that the toothbrushes would improve their patients' oral health. It was concluded that the four children's toothbrushes are safe and effective. The design of the brush heads should enhance plaque removal while the ergonomic design of the handles will aid dexterity.

Age Factors↗
PubMed2002

Aging successfully: oral health for the prime of life.

Aging is a worldwide phenomena. More adults, particularly those in developed countries, are living longer and healthier lives. The average US life expectancy was 47 years in 1900; by 2000, it had increased to 74 years. As the population ages, the number of adults with acute and chronic illnesses increases. The use of medications also increases with age. People over 65 years of age make up about 12% of the US population, but they consume 30% of all prescription medications, many of which can have a negative impact on oral health. Although tooth loss is declining in US adults, the need for various types of dental services in the adult population continues to increase. Data on the use of dental services has shown that dental visits by older adults correlate with the presence of teeth, not age. Research on the epidemiology of periodontal disease in older adults suggests that the disease in older adults is probably not due to greater susceptibility but, instead, the result of cumulative disease progression over time. Data on root caries has shown that exposed root surfaces, in combination with compromised health status and the use of multiple medications, can increase an older adult's risk for root caries. Oral candidiasis commonly occurs in immunocompromised individuals of any age, but in older adults, nursing home residents are particularly susceptible. Oral cancer is a disease of older adults, with a median age of 64 at diagnosis. Tobacco and alcohol use are the most common risk factors. Mental or physical impairments, such as dementing illnesses, or impaired dexterity as a result of arthritis or stroke, can impair an adult's ability to perform adequate oral self-care. Preventing oral diseases in older adults requires an understanding of the risk factors for oral diseases and how these risk factors change over time. Of particular concern are nursing home residents, who remain the most vulnerable of elders. Incorporating preventive oral health strategies into dental treatment and nursing home care will play a critical role in maintaining oral health for a lifetime. Oral health education of family, caregivers, and nursing home staff is essential if oral diseases are to be avoided later in life.

Adult↗
PubMed2003

Computer-enhanced endoscopic coronary artery bypass grafting: the da Vinci experience.

Anatomical and technical limitations as well as human factors render endoscopic coronary artery bypass surgery difficult. The da Vinci telemanipulator overcomes some of these shortcomings by restoring the dexterity and precision of a distant operator within the confined space in a closed-chest environment. Using the da Vinci system, total endoscopic coronary artery bypass grafting has evolved from a merely experimental surgical approach to a clinically applicable treatment option. Initially exclusively performed on the arrested heart, adjunct technologies such as endoscopic vacuum-assisted stabilizers now allow a single-vessel closed-chest beating heart procedure in selected patients. Despite the technical progress, endoscopic multivessel bypass grafting has yet to be achieved. The development of endoscopically applicable anastomotic devices and heart-positioning devices along with further refinements in telemanipulator technology, better optical systems, and image guided augmented reality scenarios may facilitate endoscopic bypass grafting in the future.

Cardiac Surgical Procedures↗
PubMedDate not supplied

[Effects of the composition of bone tissue growth factors on cell growth on the model of long term culture of the bone marrow].

The experimental study of the properties of the collagen- and hydroxyapatite-containing osteoplastic material HAPKOL-I by bone marrow hemopoiesis was made in comparison with existing material HAPKOL. HAPKOL-I is a working name of the material consisting of HAPKOL and composition of non-collagen bone proteins produced from xenogenic bone material. Long-term cultures of bone marrow from mice (C57B1/6xCBA)F1 of dexter type were used. Cultivation time was 7, 14, 21 and 28 days. Intensity of hemopoietic processes was assessed on the samples; absolute count of stromal and hemopoietic cells on the membrane was calculated. It was found that in long-term cultures of the bone marrow stromal and hemopoietic cells develop on the materials HAPKOL and HAPKOL-I, processes of formation of hemopoietic microenvironment provide normal hemopoiesis. On both materials there was a gradual increase of cell counts, a rise in the number of stromal and a fall in the number of hemopoietic cells. More intensive hemopoiesis on the material containing non-collagen bone proteins may be due to this factor.

Animals↗
PubMed2003

Inhaler devices for asthma and COPD: choice and technique.

Nurses caring for patients with asthma or chronic obstructive pulmonary disease need a good basic knowledge of the types of inhaler devices available and which may suit, for example, a very young child, an active young person or an elderly patient with dexterity problems. This Study describes the advantages and disadvantages of some commonly prescribed devices.

Administration, Inhalation↗
PubMed2003

[Electroneurophysiological and clinical consequences of therapy of acute lymphoblastic leukemia in children].

INTRODUCTION: A common adverse effect of the treatment employed in acute lymphoblastic leukemia (ALL) is sensomotor polyneuropathy, the course of which is most frequently mild. The aim of the study was a clinical assessment of motor dexterity and sensory disturbances, as well as electroneurographic evaluation of sensory and motor fibers in the selected peripheral nerves and electromyographic assessment of patients after completed ALL treatment. MATERIAL: The study included 30 patients aged 6-23 years (17 girls and 13 boys), in whom ALL treatment employing the New York or BFM protocols had been terminated 0.3-11 years earlier. METHODS: Each patient was subjected to a neurological examination in the course of treatment and to a follow-up neurological assessment after therapy completion. Electro-neurography (ENG) and electromyography (EMG) were also performed in all subjects. RESULTS: Clinical signs of polyneuropathy associated with chemotherapy were noted in 13 patients (43.3%) and in 11 subject (36.7%) in follow-up. Only three patients did not manifest any abnormal electro-neurophysiological signs. Electroneurographic and electromyographic abnormalities were more intense following the New York protocol in comparison to the BFM protocol and in the majority of patients were dependent on the cumulated vincristine dose. CONCLUSIONS: Clinical signs of polyneuropathy were seen in 43.3% of children on chemotherapy for ALL and in 36.7% of subjects in follow-up. Ninety per cent of patients demonstrated abnormal electroneuro-physiological signs in consequence of ALL therapy. In all patients with abnormal EMG (63.3%) muscle reinnervation was detected.

Adolescent↗
PubMed1992

An investigation of solvent-induced neuro-psychiatric disorders in spray painters.

An index case of chronic toxic encephalopathy is described in a 28 year old male spray painter with eleven years of exposure to solvents at work. The patient had progressive affective symptoms following repeated past episodes suggestive of acute solvent intoxication. He also showed impaired performance on tests of auditory memory, perceptual speed, visual scanning, and manual dexterity, as well as electromyographic evidence of prolongation of distal terminal latency and slowing of conduction velocities. The case investigation was followed up with an epidemiological study of the factory where he worked, to determine if other spray painters might have similar excessive complaints of neuropsychiatric symptoms and/or objective neurobehavioural deficits. This involved 15 other male spray painters employed for at least five years, and a sex- and age-matched group of 15 control workers not exposed to solvents. The spray painters reported significantly more numbers of neurobehavioural symptoms than the controls. There were little differences in neurobehavioural test results, except for aiming test (psychomotor co-ordination) and Benton visual retention test (visual memory). Spray painters with four or more neurobehavioural symptoms also performed more poorly on Digit Symbol (perceptual speed) compared with those with less number of symptoms. The epidemiological results provide strong circumstantial basis for the diagnosis of chronic toxic encephalopathy in the patient, and also indicates a need for vigilance of the hazards of central nervous system disorders in workers with chronic exposure to solvents in Singapore.

Adult↗