torsion

扭转
  • 文章类型: Case Reports
    肺隔离症伴扭转是一种罕见的疾病。我们描述了一个七个月大的婴儿,由于扭转导致肺隔离症而过度哭泣。对比增强胸部计算机断层扫描显示右下胸部后内侧有椭圆形肿块,没有明显的全身动脉供应.质量的边缘显示出轻微的线性增强,它的内部没有加固。进行了胸腔镜节段切除术,组织学证实肺隔离症伴扭转。
    Pulmonary sequestration with torsion is a rare condition. We describe a seven-month-old baby presenting excessive crying for pulmonary sequestration with torsion. Contrast-enhanced chest computed tomography demonstrated an oval-shaped mass in the posteromedial right lower chest, no systemic arterial supply was evident. The edge of the mass showed slight linear reinforcement, and its interior had no reinforcement. Thoracoscopic segmentectomy was carried out and histology confirmed pulmonary sequestration with torsion.
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  • 文章类型: Case Reports
    扭转和破裂是小角妊娠中危及生命的紧急情况,一种极为罕见的异位妊娠.本病例报告旨在分享患者的诊断和治疗,在一个环境中扭转和破裂的角妊娠,有限的资源。它强调了面临的挑战以及为确保适当护理而采取的策略。一个38岁的女人,gravida2,第1段,提交给妇产科(HiwotFana大学医院OBGYN部门,诊断为子宫破裂,持续1天的胎动减少,并伴有突然和严重的下腹疼痛和腹胀。选择了保守的管理层,但是症状恶化需要紧急剖腹手术,确认破裂的原始角妊娠并手术切除角。伴有扭转的残角破裂妊娠是一种极为罕见且危险的产科急诊,需要迅速诊断和手术干预。对于晚期原始角妊娠,开腹手术联合去除角仍然是治疗的金标准。医疗保健提供者可以通过促进多学科合作和拥抱创新,改善患者的治疗效果并减轻危及生命的疾病的负担。技术先进的技术。
    Torsion and rupture are life-threatening emergencies in rudimentary horn pregnancy, an extremely rare type of ectopic pregnancy. This case report aims to share the diagnosis and treatment of a patient, with torsion and ruptured horn pregnancy in a setting, with limited resources. It highlights the challenges faced and the strategies employed to ensure appropriate care. A 38-year-old woman, gravida 2, para 1, presented to the Obstetric and Gynaecology (OBGYN Department of Hiwot Fana University Hospital with a diagnosis of uterine rupture after she presented with a complaint of pushing down pain of 1 h, decreased fetal movement of 1-day duration, and with sudden and severe lower abdominal pain and distension. Conservative management was chosen, but deteriorating symptoms necessitated an emergency laparotomy, confirming a ruptured rudimentary horn pregnancy and surgically excising the horn. Ruptured rudimentary horn pregnancy with torsion is an extremely uncommon and perilous obstetric emergency that necessitates swift diagnosis and surgical intervention. For advanced primitive horn pregnancy, laparotomy combined with horn removal continues to be the gold standard of therapy. Healthcare providers can improve patient outcomes and alleviate the burden of life-threatening conditions by promoting multidisciplinary collaboration and embracing innovative, technologically advanced techniques.
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  • 文章类型: Journal Article
    目前对下腰痛(LBP)患者的临床检查主要依赖于静态的临床检查,很少代表患者在日常活动中采取的动态姿势。要获得动态运动学的概述-一天中的动力学变化,在24小时内测量无症状个体和LBP患者的腰椎背部运动学,并估算了被动抵抗的弯曲和扭转力矩。分析了208名无症状受试者(115名女性)和116名LBP患者(71名女性)。与静态直立相比,无症状受试者的平均腰椎前凸在日常生活中显着下降了21°(p<0.01)。在L2-L3处估计的最大弯矩为44.0-50.6Nm。LBP患者在约16°的日常生活中表现出显著较低(p<0.01)的腰椎扁平化。在L3-L4处发现27-52Nm的最大弯矩。LBP人群的初始静态直立腰椎前凸明显较低(下降6°),导致两组在日常活动中平均腰椎形状几乎相似。L1-L2的扭转运动最大为2.2°,与性别无关(p=0.19)和LBP(p=0.54),力矩为6-16Nm。日常生活中的腰椎轮廓和相关的内部力矩与临床检查期间记录的差异很大。LBP患者在快照评估中表现出明显较低的前凸,并且在日常生活中明显较低的运动变化和内部力矩。只有动态的长期评估揭示了LBP人群不太弯曲的姿势。显然,这种减少的动态弯曲姿势表明缓解疼痛的代偿习惯。
    Current clinical examination of low back pain (LBP) patients primarily relies on static clinical examinations, which rarely represent the dynamic postures patients adopt during daily activities. To gain an overview on the dynamic kinematics-kinetics changes over a day, the lumbar back kinematics of asymptomatic individuals and LBP patients were measured over 24 h, and the passively resisted bending and torsional moments were estimated. 208 asymptomatic subjects (115 females) and 116 LBP patients (71 females) were analysed. Compared to static upright standing, the mean lumbar lordosis of asymptomatic subjects drops significantly by 21° during everyday life (p < 0.01). Maximum bending moments of 44.0-50.6 Nm were estimated at the L2-L3. LBP patients showed significantly lower (p < 0.01) lumbar flattening during daily life of about 16°. Maximum bending moments of 27-52 Nm were found at the L3-L4. The initial static upright lumbar lordosis was significantly lower in LBP population (by 6°) resulting in almost similar average lumbar shapes during daily activities in both groups. The torsional movements were with 2.2° greatest in L1-L2 independent of sex (p = 0.19) and LBP (p = 0.54) with moments of 6-16 Nm. The lumbar profile and associated internal moments during daily life differ substantially from those recorded during clinical examinations. LBP patients demonstrates significantly lower lordosis at the snapshot assessment and significantly lower movement variations and internal moments during daily life. Only the dynamic long-term assessments unravelled a less flexed posture in LBP population. Apparently, such a reduced dynamic flexed posture indicates a compensatory habit for pain relief.
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  • 文章类型: Case Reports
    游荡的脾脏(WS),其特征是由于其韧带松弛而导致的异常活动,是一种罕见的疾病,经常带来诊断挑战。其并发症,如扭转和梗塞,需要及时识别和管理,以防止危及生命的结果。
    方法:我们报告一例45岁女性急性腹痛,便秘,右髂窝有明显的肿块.成像显示一个游荡的脾脏扭转,尽管有十年的症状,但由于诊断延迟而加剧了这种罕见的情况。
    诊断成像,包括腹部超声和CT扫描,在确认异位脾和指导手术干预中起着至关重要的作用。立即剖腹手术显示,由于不可行,脾脏扭曲,需要进行脾切除术。
    结论:该病例强调了在急性腹痛的鉴别诊断中考虑脾脏游走的重要性,尤其是有慢性间歇性症状的患者。手术干预仍然是最终的治疗方法,强调保守管理在预防并发症方面的风险。
    UNASSIGNED: Wandering spleen (WS), characterized by abnormal mobility due to laxity of its ligaments, is a rare condition often presenting diagnostic challenges. Its complications, such as torsion and infarction, necessitate prompt recognition and management to prevent life-threatening outcomes.
    METHODS: We report a case of a 45-year-old female presenting with acute abdominal pain, constipation, and a palpable mass in the right iliac fossa. Imaging revealed a torsion of a wandering spleen, a rare occurrence exacerbated by delayed diagnosis despite a decade of symptoms.
    UNASSIGNED: Diagnostic imaging, including abdominal ultrasound and CT scan, played a crucial role in confirming the ectopic spleen and guiding surgical intervention. Immediate laparotomy revealed a twisted spleen necessitating splenectomy due to non-viability post-detorsion attempt.
    CONCLUSIONS: This case underscores the importance of considering wandering spleen in the differential diagnosis of acute abdominal pain, especially in patients with chronic intermittent symptoms. Surgical intervention remains the definitive treatment, emphasizing the risks associated with conservative management in preventing complications.
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  • 文章类型: Case Reports
    背景:腹膜后平滑肌瘤(RL)是罕见的良性肿瘤,可发生在盆腔和/或腹部顶叶腹膜后。一旦扭转发生,它会导致急性腹痛,甚至会导致坏疽等严重后果,腹膜炎,如果未发现并及时治疗,则会出现腹膜和休克。因此,需要更好地了解RL扭转的特点。这里,我们介绍了后腹膜急性椎弓根扭转的病例,随后进行了文献综述。
    方法:这里,我们报告了一例42岁女性患者的RL扭转。患者到我院就诊,抱怨下腹痛6天。盆腔检查显示子宫上有一个压痛的肿块。盆腔磁共振成像(MRI)显示子宫前肿块,多发性子宫肌瘤和轻微盆腔积液。MRI提示子宫前壁浆膜下肌瘤变性的可能性。术中探查发现后腹膜有10厘米的带蒂肿块,椎弓根被扭转了两次。病理检查证实了一个扭曲的RL。
    结论:在盆腔包块并发急腹症的情况下,应考虑扭转的可能性。
    BACKGROUND: Retroperitoneal leiomyomas (RLs) are rare benign tumours that can occur in the pelvic and/or abdominal parietal retroperitoneum. Once torsion occurs, it causes acute abdominal pain and can even lead to serious consequences such as gangrene, peritonitis, haemoperitoneum and shock if not identified and treated promptly. Therefore, a better understanding of the characteristics of RL torsion is needed. Here, we present a case of acute pedicle torsion of an RL in the posterior peritoneum followed by a literature review.
    METHODS: Herein, we report the case of a 42-year-old woman with RL torsion. The patient visited our hospital complaining of lower abdominal pain for 6 d. Pelvic examination revealed a tender mass superior to the uterus. Pelvic magnetic resonance imaging (MRI) revealed an anterior uterine mass, multiple uterine fibroids and slight pelvic effusion. MRI suggested the possibility of a subserosal myoma of the anterior uterine wall with degeneration. Intraoperative exploration revealed a 10 cm pedunculated mass arising from the posterior peritoneum, with the pedicle torsed two times. Pathological examination confirmed a torsed RL.
    CONCLUSIONS: In the case of a pelvic mass complicated with acute abdomen, the possibility of torsion should be considered.
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  • 文章类型: Case Reports
    背景:平滑肌瘤扭转是一种非常罕见的实体。由于临床症状和放射学发现之间的相关性差,因此通常是术中诊断。我们报告了一例术中诊断为扭曲的子宫肌瘤。
    方法:我们的患者46岁,未生育的女人,因急性盆腔疼痛三天被送往急诊科。在体检时,明显有一个坚硬而柔软的骨盆肿块,延伸到脐带下面,提示子宫起源。实验室调查显示炎症反应。超声检查发现子宫右侧有一个巨大的腹部-盆腔肿块,多普勒检查没有检测到血流。鉴于诊断的不确定性,进行了探查性腹腔镜检查。诊断为带蒂的平滑肌瘤扭转伴急性阑尾炎。最初,我们进行了肌瘤切除术,然后进行了子宫肌瘤切除术和阑尾切除术。
    浆膜下平滑肌瘤的血管蒂扭转可导致缺血性坏疽和腹膜炎,这可能会导致死亡。导致肌瘤扭转的风险因素包括大小,有蒂肌瘤的茎,必须又细又长,才能进行旋转和扭转。没有可靠地指示诊断的特定临床体征或成像模式。诊断性腹腔镜检查在诊断怀疑的情况下最常见。手术可能包括子宫肌瘤切除术或子宫切除术。
    结论:对于任何表现为腹内和盆腔包块并伴有急腹症的女性,在鉴别诊断中考虑扭转平滑肌瘤的可能性是很重要的。
    BACKGROUND: Leiomyoma torsion is an incredibly rare entity. Diagnosis is frequently intraoperative due to poor correlation between clinical symptoms and radiological findings. We report a case of a twisted uterine leimyoma diagnosed intraoperatively.
    METHODS: Our patient was 46 years old, nulliparous woman, presented to the emergency department with three days of acute pelvic pain. On physical examination, a firm and tender pelvic mass was palpable, extending below the umbilicus, suggestive of uterine origin. Laboratory investigations revealed an inflammatory response. Ultrasound identified a large abdomino-pelvic mass adherent to the right side of the uterus, with no detectable blood flow on Doppler examination. Given the diagnostic uncertainty, exploratory laparoscopy was performed. The diagnosis of a pedunculated Leiomyoma torsion with acute appendicitis was confirmed. Initially we performed a fibroid detorsion then a myomectomy and appendectomy were performed.
    UNASSIGNED: The torsion of the vascular pedicle of a subserous leiomyoma can lead to ischemic gangrene and peritonitis, which can cause mortality. The risk factors that contribute to the fibroid torsion include the size, the stalk of the pedunculated myoma that must be thin and long in order for it to undergo rotation and torsion. There are no specific clinical signs or imaging modalities that reliably indicate the diagnosis. A diagnostic laparoscopy is most often indicated in case of diagnostic doubt. Surgery may consist in myomectomy or hysterectomy.
    CONCLUSIONS: It is important to consider the possibility of torsed leiomyoma in the differential diagnosis in any woman presenting with an intra-abdominal and pelvic mass with acute abdomen.
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  • 文章类型: Case Reports
    在这个案例报告中,我们在10个月大的阿拉伯雌马的肠系膜根部周围出现了不寻常的左结肠顺时针扭转,突出临床表现,诊断方法和成功的手术干预。一只10个月大的阿拉伯雌马,体重约250公斤,有急性腹痛的迹象。历史揭示了厌食症,前一天开始的躁动和严重的腹痛。当地医生以前曾服用氟尼辛葡甲胺,镇痛药,但事实证明它在缓解疼痛方面无效。在体检时,雌马流汗,体温为38.5°C,心动过速(每分钟65次)和呼吸急促(每分钟25次呼吸)。由于绞痛的严重程度和对保守治疗缺乏反应,手术干预被认为是必要的。进行了探索性中线切开术以评估腹部器官。在考试期间,在评估的器官中未发现明显的原发性病变。然而,观察到左结肠长度外切的限制。进一步检查发现,左结肠有一个不寻常的顺时针扭转,在肠系膜根部周围从左向右移位;因此,骨盆屈曲位于正常解剖位置,长度短。据我们所知,这是马的第一个顺时针扭转和左半结肠不典型移位的病例。成功进行了移位的手术矫正。雌马在手术后显示出改善,并且在恢复期未出现任何并发症。
    In this case report, we present an unusual clockwise torsion of left colon around mesenteric root in a 10-month-old Arab filly, highlighting the clinical presentation, diagnostic approach and successful surgical intervention. A 10-month-old Arab filly weighing approximately 250 kg was referred with signs of acute abdominal pain. The history revealed anorexia, restlessness and severe abdominal pain that had begun the previous day. The local practitioner had previously administered flunixin meglumine, an analgesic, but it proved ineffective in relieving the pain. Upon physical examination, the filly exhibited sweating, a body temperature of 38.5°C, tachycardia (65 beats per minute) and tachypnea (25 breaths per minute). Due to the severity of the colic and the lack of response to the conservative treatments, surgical intervention was deemed necessary. An exploratory midline celiotomy was performed to evaluate the abdominal organs. During the examination, no obvious primary lesions were identified in the evaluated organs. However, a restriction in exteriorizing the left colon\'s length was observed. Further examination revealed an unusual clockwise torsion of the left colon that displaced in left to the right side around the mesenteric root; thereby, pelvic flexure was located in the normal anatomical position with a short length. To the best of our knowledge, this is the first reported case of clockwise torsion and an atypical displacement of the left colon in horses. The surgical correction of the displacement was successfully performed. The filly showed improvement post-surgery and did not exhibit any complications during the recovery period.
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  • 文章类型: Journal Article
    二维材料的设计空间通过非平衡配置的层的堆叠而经历显著的扩展。然而,缺乏对扭曲动力学的定量见解阻碍了这种异质结构的发展。在这里,我们利用原子力显微镜悬臂的横向力灵敏度和专门设计的旋转轴承结构来测量石墨和MoS2接口的扭矩。虽然提取的扭转能量在所有角度失配配置中几乎为零,石墨和MoS2的相应界面的特征分别为0.1533和0.6384N-m/m2。此外,我们测量了石墨和MoS2的粘附能,以阐明扭曲和滑动之间的相互作用。对于石墨界面,粘附能超过扭转能,表明在超级滑动前有扭曲的趋势。相反,MoS2显示出超过其粘附能的增加的扭转能。因此,我们的发现表明MoS2和石墨界面处的滑动至扭转动力学之间存在根本差异。
    The design space of two-dimensional materials is undergoing significant expansion through the stacking of layers in non-equilibrium configurations. However, the lack of quantitative insights into twist dynamics impedes the development of such heterostructures. Herein, we utilize the lateral force sensitivity of an atomic force microscope cantilever and specially designed rotational bearing structures to measure the torque in graphite and MoS2 interfaces. While the extracted torsional energies are virtually zero across all angular misfit configurations, commensurate interfaces of graphite and MoS2 are characterized by values of 0.1533 and 0.6384 N-m/m2, respectively. Furthermore, we measured the adhesion energies of graphite and MoS2 to elucidate the interplay between twist and slide. The adhesion energy dominates over the torsional energy for the graphitic interface, suggesting a tendency to twist prior to superlubric sliding. Conversely, MoS2 displays an increased torsional energy exceeding its adhesion energy. Consequently, our findings demonstrate a fundamental disparity between the sliding-to-twisting dynamics at MoS2 and graphite interfaces.
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    文章类型: Journal Article
    睾丸是男性生殖腺,是女性卵巢的同源物,具有关键功能。病理状况可能是由睾丸引起的,并且钝化或完全消除了这些功能,导致临床上明显或隐蔽的后遗症。这项研究的目的是研究2012年1月至12月31日在乔斯大学教学医院的组织学诊断的睾丸疾病与临床特征的关系。2021年。
    本研究是对所有睾丸活检病例的回顾性分析。所有组织学诊断的睾丸病变均从科室记录和进一步从病历科患者文件夹获得的临床数据中确定。
    看到四百三十(430)个活检,其中304例(70.7%)为睾丸切除标本。最常见的组织学诊断为睾丸萎缩,占328例(76.3%)。其次是睾丸扭转42例(9.8%)。一起,炎症状况占36例(8.4%),其中肉芽肿性炎症占52.3%。有16例(3.7%)肿瘤疾病都是恶性的,其中6例(37.5%)为精原细胞瘤。年龄范围,意思是,中位年龄和模态年龄为1-90岁,53.4+21.3年,分别为60年和70年。双侧睾丸切除术形式的前列腺癌治疗是手术的主要指征。
    在我们的地区,大多数睾丸病变是萎缩症,这些病变中的大多数是作为用于治疗前列腺癌的睾丸切除术获得的。
    UNASSIGNED: The testes are the male reproductive glands and the homolog of the ovary in females performing critical functions. Pathologic conditions could arise from the testes and blunt or completely obliterate these functions leading to clinically overt or covert sequelae. The aim of this research is to study the pattern of histologically diagnosed testicular disease in relation to clinical features at the Jos University Teaching Hospital between January 2012 and December 31st, 2021.
    UNASSIGNED: This study is a retrospective analysis of all cases of testicular biopsies. All histologically diagnosed testicular lesions were identified from the departmental records and clinical data obtained further from the patients\' folder at the Medical Records Department.
    UNASSIGNED: Four hundred and thirty (430) biopsies were seen, of which 304 (70.7%) were orchidectomy specimens. The commonest histological diagnosis was testicular atrophy accounting for 328(76.3%) cases. Testicular torsion is followed by 42(9.8%) cases. Together, inflammatory conditions accounted for 36(8.4%) cases out of which granulomatous inflammation made up 52.3% of cases. There were 16(3.7%) neoplastic conditions all of which were malignant, out of which 6(37.5%) were seminomas. The age range, mean, median and modal age was 1-90 years, 53.4 +21.3years, 60 years and 70 years respectively. Prostatic carcinoma therapy in the form of bilateral orchidectomy was the major indication for surgery.
    UNASSIGNED: The majority of testicular lesions in our locality are atrophies and most of these lesions are obtained as orchidectomies for therapy of prostatic cancer.
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  • 文章类型: Journal Article
    双心室心脏的左心室(LV)旋转力学异常与不良后果有关;然而,对于具有功能单心室的心脏,这些特征较差。
    本研究的目的是表征Fontan循环中的心室旋转力学及其与结果的关系。
    单中心,对329例Fontan患者(15[IQR:10-21]年)和42例对照者进行磁共振检查的回顾性分析.分析了心室电影短轴叠加以得出扭转指标。扭转计算为根尖和基底旋转之间的差异,标准化为心室长度。
    Fontan患者的心室舒张末期容积指数较高(97mL/体表面积1.3vs72mL/体表面积1.3),降低射血分数(53%vs60%),基础顺时针旋转的比例较低(62%对93%),顶端逆时针旋转(77%对95%),和正扭转(82%vs100%);所有P<0.001。在中位3.9年的随访时间内,31例(9%)患者出现死亡或心脏移植的复合结局。扭转指标与结果相关;尽管,在多变量分析中,仅右心室(RV)形态和心室舒张末期容积指数是独立相关的.负扭转的LV,和RV,无论扭转模式如何,与具有正扭转的LV相比,结果更差(P=0.020)。
    Fontan循环中的单个心室表现出异常的扭转力学,对于RV形态更明显。异常扭转与死亡或需要心脏移植有关。具有LV形态和保留的扭转的Fontan患者表现出最高的无移植存活率,并且扭转可能在该组患者中提供增量的预后数据。
    UNASSIGNED: Abnormal left ventricular (LV) rotational mechanics in biventricular hearts are associated with adverse outcomes; however, these are less well characterized for hearts with functionally single ventricles.
    UNASSIGNED: The purpose of this study was to characterize ventricular rotational mechanics in the Fontan circulation and their relationship to outcomes.
    UNASSIGNED: Single-center, retrospective analysis of magnetic resonance examinations for 329 Fontan patients (15 [IQR: 10-21] years) and 42 controls. The ventricular cine short-axis stack was analyzed to derive torsion metrics. Torsion calculated as the difference between apical and basal rotation normalized to ventricular length.
    UNASSIGNED: Fontan patients had higher indexed ventricular end-diastolic volume (97 mL/body surface area1.3 vs 72 mL/body surface area1.3), lower ejection fraction (53% vs 60%), and lower proportion of basal clockwise rotation (62% vs 93%), apical counterclockwise rotation (77% vs 95%), and positive torsion (82% vs 100%); P < 0.001 for all. A composite outcome of death or heart transplant-listing occurred in 31 (9%) patients at a median follow-up of 3.9 years. Torsion metrics were associated with the outcome; although, on multivariate analysis only right ventricular (RV) morphology and indexed ventricular end-diastolic volume were independently associated. LVs with negative torsion, and RVs regardless of torsional pattern, had worse outcomes compared to LVs with positive torsion (P = 0.020).
    UNASSIGNED: Single ventricles in a Fontan circulation exhibit abnormal torsional mechanics, which are more pronounced for RV morphology. Abnormal torsion is associated with death or need for heart transplantation. Fontan patients with LV morphology and preserved torsion exhibit the highest transplant-free survival and torsion may offer incremental prognostic data in this group of patients.
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