Perforátorový DIEAp lalok se stává široce používanou operační technikou k rekonstrukci prsů. Přestože je lalok běžně používán v rekonstrukční chirurgii, postup preprace není dosud zcela založen na důkazech a je více či méně intuitivní. Stále neexistuje dosatek důkazů o vztahu mezi počtem a rozměrem perforátorů a predikcí přežívání laloku. Dobře známá technika cévního delay fenoménu může být velmi užitečná jako záchranný postup, pokud je zhoršená vaskularizace laloku.
The deep inferior epigastric artery perforator (DIEAp) flap is becoming a widely used method of autologous breast reconstruction. Despite the huge use of the DIEAp flap in reconstructive field, an evidenced based approach in perforator selection has not yet been developed. Unfortunately there is no clear evidence about the relation between the number and dimension of the perforator vessel and the prediction of flap survival in a living model. An old technique like the vascular delay could be extremely useful as a lifeboat procedure when the vascularization of the flap after the dissection is inadequate.
- MeSH
- Epigastric Arteries MeSH
- Time Factors MeSH
- Adult MeSH
- Skin blood supply MeSH
- Humans MeSH
- Mammaplasty * MeSH
- Microcirculation MeSH
- Tissue and Organ Harvesting MeSH
- Perforator Flap * blood supply transplantation MeSH
- Graft Survival MeSH
- Regional Blood Flow MeSH
- Graft Rejection prevention & control MeSH
- Reperfusion * MeSH
- Check Tag
- Adult MeSH
- Humans MeSH
- Female MeSH
- Publication type
- Case Reports MeSH
- MeSH
- Acute Disease MeSH
- Time Factors MeSH
- Myocardial Infarction mortality therapy MeSH
- Quality of Health Care MeSH
- Humans MeSH
- Primary Health Care MeSH
- Check Tag
- Humans MeSH
- Geographicals
- Slovakia MeSH
European urology, ISSN 0302-2838 vol. 40, suppl. 2, October 2001
30 s. : il., tab. ; 28 cm
- MeSH
- Prostatic Neoplasms epidemiology prevention & control therapy MeSH
- Prostate-Specific Antigen MeSH
- Publication type
- Collected Work MeSH
- Conspectus
- Patologie. Klinická medicína
- NML Fields
- urologie
- onkologie
Pozitivní vliv zpožděné zpětné sluchové vazby na řeč koktavých je znám od roku 1951 (tzv. Lee-efekt podle jména objevitele, či DAF z anglického Delayed Auditory Feedback). Předpokládá se nesoulad mezi zpětnou proprioceptivní a sluchovou vazbou, který se právě vlivem zpožděné akustické aferentace vyrovnává. Jako optimální délka zpoždění se udává délka 55 ms, v naší studii jsme použili i zpoždění kratší (dříve totiž nebylo možné z technických důvodů tato zpoždění vyšetřovat). Náš soubor obsahoval 41 pacientů. Zjistili jsme, že u 16 pacientů (39 %) došlo ke zlepšení plynulosti řeči při délce zpoždění 55 ms, což je ve shodě s předchozími studiemi. U osmi pacientů (19 %) však došlo k výraznému zlepšení plynulosti řeči i pod vlivem délky zpoždění 40 ms, zejména pak ve skupině balbutiků do 15 let. Plynulost řeči tedy lze zlepšit i při užití zpoždění kratších než 55 ms. U 13 pacientů (32 %) byl zaznamenán pozitivní vliv až do délky zpoždění 110 ms a u čtyř pacientů jsme nezaznamenali zlepšení plynulosti řeči pod vlivem DAF. Zajímavé je, že ne vždy dochází ke shodě mezi subjektivním hodnocením samotného pacienta a hodnocením objektivním. Lee-efekt se využívá nejen k diagnostickým, ale i terapeutickým účelům.
Stuttering is a serious health and social problem, which is reflected in socialising processes and job opportunities. It is a generalised discoordinative disorder of muscle groups, that take part in motor realisation of speech. The prevalence in population differs according to various authors from 1 % to 3%, of which men prevail. The opinions on etiology and therapy differ a lot, causes can be either somatic, functional or psychogenic. A positive effect of delayed auditory feedback (DAF) on speech in stutterers has been known since 1951 (so called Lee effect, named after its discoverer). There is supposed to be a disharmony between proprioceptive and auditory feedback, which is corrected by delayed auditory feedback. The optimal interval of DAF should be 55 ms. Considering that the former technologies were not able to study shorter intervals, we focused our study on intervals shorter than 55 ms and we tried to find an optimal interval of DAF. Most of previous research studied the influence of DAF on reading. Considering that severity of fluency disorder is usually smaller when reading than in spontaneous speech, we decided to study the influence of DAF using description of standard pictures. Our group of patients consisted of 41 stutterers (35 women and 6 men), aged from 8 to 35, the mean age was 15 years. We found out that 16 patients (39%) improved in speech fluency under the influence of DAF with delay speed 55 ms, which is in good accord with previous studies. However, in 8 patients (19%) speech fluency was improved using delay speed 40 ms especially in patients aged up to 15 years.We proved then that speech fluency in stutterers can be improved by using intervals shorter than 55 ms. In 13 patients (32%) we observed positive effect from delay 110 ms, mostly in patients with severe form of stuttering. Four patients (10%) did not improve at all. Normal fluency under the influence of DAF was reached by 10 patients (24%) who had mild or medium stuttering. We also observed self evaluation of patients which is not always in accordance with objective evaluation. From the group of 23 patients the accordance was reached in 7 patients, another delay interval was subjectively more pleasant in 10 patients, for 5 patients DAF was not pleasant at all and one patient was not able to assess subjectively improving or worsening. We can use the positive effect of DAF in treatment. At present there exist not only large- sized devices using DAF but also miniature devices that look like behind the ear hearing aids.We usually use table devices as an aid during speech therapy.
- MeSH
- Time Factors MeSH
- Mass Media MeSH
- Myocardial Infarction MeSH
- Humans MeSH
- Physician's Role MeSH
- Emergency Medical Services MeSH
- Patient Education as Topic MeSH
- Check Tag
- Humans MeSH
- Publication type
- Review MeSH
