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11.
Summary
The compartment syndrome (cs) is characterized by an increased tissue pressure in a limited space. Pathophysiologically, it
is a multifactorial disease that is potentially induced by an initial trauma and develops according to the existence of cofactors.
Cofactors are, for instance, the circulation of the patient and the initial treatment of the impending cs. In particular,
the microcirculation is altered with endothelial destruction, development of a capillary leak, protein loss from intravasal
space and the development of an interstitial and intracellular third space. An impaired drainage of the lymphatic and venous
system causes a venous infarction. An arterial infarction results if the tissue pressure exceeds the arteriolar pressure.
An accompanying ischemia reperfusion mechanism increases the trauma load. In disadvantageous cases, the patients are in danger
of developing a multi-organ deficiency syndrome (MODS) by an uncontrolled inflammatory reaction, by intravasal volume loss
and by a myonephropathic systemic reaction. Clinically, the patients suffer a disproportionate amount of pain, followed by
neurological signs. Especially in noncompliant patients, tissue pressure measurement is useful. Resuscitation of the circulation
as well as splitting of casts is important. In case of a manifest cs, dermatofasciotomy has to be performed as an emergency
operation. Even if cs is diagnosed early and fasciotomy is carried out early, the development of sequellae cannot be avoided
in every single case.
相似文献
12.
2003年12月30日一辆装载7.28t苯胺的槽车从宁波开往温州的路上在甬台温高速公路温岭市境内翻车,造成5.3t左右的苯胺泄漏在高速公路旁的环境中,除少量的液体被清除外,绝大部分渗入地下,造成了水井污染.从12月31日开始我们对周围的水井开展了监测,现将监测结果分析如下: 相似文献
13.
Buket Pene Nilgn Atakan Sevin Akkaya Aytac Gkz 《Journal of the European Academy of Dermatology and Venereology》1994,3(4):484-489
In recent years, research on the aetiology of psoriasis has focused on immune aetiopathogenesis. However, in the last few years, research on the immunoloogical changes in psoriasis has failed to mention the lymphatics. Also, studies emphasizing the importance of the dermal lymphatics have neglected the lymphatic changes seen in psoriasis. Therefore, we decided to put this matter back on the agenda. Skin biopsies from 20 patients with psoriasis vulgaris were examined lymphatically by light microscopy using the orcein stain. We found a considerable increase in both number and dilatation in the lymphatics of psoriatic plaques, compared with both the clinically uninvolved skin of the psoriatic patients and also the skin of the control group. 相似文献
14.
Björn-Christian Link Emre F. Yekebas Dean Bogoevski Asad Kutup Gerhard Adam Jakob R. Izbicki Gerrit Krupski 《Journal of gastrointestinal surgery》2007,11(2):166-170
Symptomatic biliary leakage following major upper abdominal surgery is a severe complication resulting in increased morbidity
and mortality. Treatment options usually include either endoscopic intervention or surgical revision. These options may be
burdened by a high perioperative risk for the patient (e.g., patients with severe disease) or simply may not be possible (e.g.,
nonpreserved gastroduodenal passage). In the past, percutaneous transhepatic cholangiodrainage did only seem to be a viable
option for patients with dilated bile ducts. Here, we present our experience in a consecutive series of patients with symptomatic
biliary leakage following major upper abdominal surgery and without dilation of the biliary system that underwent percutaneous
transhepatic cholangiodrainage. Percutaneous transhepatic cholangiodrainage was feasible in 15 of 18 patients (83.3%). The
procedure was technically not possible in three patients (16.7%). In 10 of the 15 patients (66.6%) with feasible percutaneous
transhepatic cholangiodrainage, biliary leakage was definitely controlled without the need for surgical revision. Depending
on the experience with the interventional procedure, percutaneous transhepatic cholangiodrainage should be considered as an
alternative for treatment of symptomatic biliary leakage instead of immediate reoperation.
Presented at the Digestive Disease Week 2005 (DDW), Chicago, IL, May 14–19, 2005 (poster presentation). 相似文献
15.
16.
目的 研究葡萄糖转运蛋白1(GLUT1)在胃癌组织及转移淋巴结中的表达特点,探讨其与肿瘤生物学特征和患者预后之间的关系.方法 采用免疫组织化学方法对79例胃癌组织及癌旁正常胃组织GLUT1表达特征进行分析,并分析其预后与GLUT1表达的关系.结果 高、中、低分化腺癌患者GLUT1表达阳性率分别为56.5%、33.3%和36.0%;黏液腺癌和印戒细胞癌GLUT1表达阳性率分别为1/6和7.7%(1/13).GLUT1表达阳性率与肿瘤最大直径(P<0.01)、有无淋巴结转移(P=0.032)和胃癌临床分期(P=0.007)等因素相关.转移淋巴结GLUT1阳性表达率为12.6%.GLUT1阳性组和阴性组1年生存率分别为64.3%和90.2%(P=0.035).结论 GLUT1表达与胃癌的侵袭性指标相关,可能是胃癌预后不良的一个标志. 相似文献
17.
术中淋巴染色对早期乳腺癌前哨淋巴结判定作用的研究 总被引:3,自引:1,他引:2
目的:探讨术中淋巴染色在早期乳腺癌前哨淋巴结判定中的作用。方法:62例Ⅰ、Ⅱ期乳腺癌,术中向乳腺肿块或其周围组织内注入1%亚甲蓝注射液4ml,术后将腋淋巴结按部位统计每例染色淋巴结的数量、转移度,计算用染色淋巴结判断腋淋巴结转移情况的敏感性、特异性、准确性和漏诊率。结果:62例淋巴染色均而获成功。23例腋淋巴结查见转移癌,其中20例染色淋巴结查见转移癌。判断腋淋巴结有无转移敏感性为87.0%(20/23),特异性为100%(39/39),准确性为93.7%(59/62),漏诊率为13.0%。染色淋巴结的转移度34.8%(39/112),与总体淋巴结及未染色淋巴结的转移度(27.5%、29.7%)差异没有统计学意义。结论:采用亚甲蓝作为术中淋巴染色剂,对早期乳腺癌病人有较高的成功率,应用染色淋巴结作为前哨淋巴结来判断腋淋巴结转移情况有较高的漏诊率,其应用价值尚待进一步大样本的研究评价。 相似文献
18.
Chien-Huang Lin Feng-Nien Ko Hisahi Ishii Tsutomu Ishikawa Ih-Sheng Chen Che-Ming Teng H.-P. Kuo 《Naunyn-Schmiedeberg's archives of pharmacology》1997,355(2):210-216
We investigated the effects of a novel platelet-activating factor (PAF) receptor antagonist, CIS-19 [cis-2-(3, 4-dimethoxyphenyl)-6-isopropoxy-7-methoxy-1-(N-methylformamido)-1,
2, 3, 4-tetrahydronaphthalene], on PAF-, histamine-, substance P- and antigen-induced bronchoconstriction and microvascular
leakage, as well as PAF- and antigen-induced bronchial hyperreactivity to methacholine in urethane-anesthetized guinea-pigs.
Administration of CIS-19 (0.5–5 mg/kg, i.v.) inhibited the increase in lung resistance induced by PAF (30 ng/kg, i.v.) in
a dose-dependent manner, but failed to inhibit the increase induced by histamine (30 μg/kg, i.v.) or substance P (6.5 μg/kg,
i.v.). CIS-19 (5 mg/kg, i.v.) did not inhibit the increase in lung resistance induced by ovalbumin (2 mg/kg, i.v.) in actively
sensitized guinea-pigs. PAF (30 ng/kg, i.v.)-induced microvascular leakage, measured by the extravasation of Evans blue dye,
was dose-dependently inhibited by CIS-19 (0.5–5 mg/kg, i.v.) in the trachea, main bronchi and intrapulmonary airways, but
it did not affect histamine (30 μg/kg, i.v.)- or substance P (6.5 μg/kg, i.v.)-induced microvascular leakage at all airway
levels. CIS-19 (2.5 and 5 mg/kg) did not affect ovalbumin (2 mg/kg, i.v.)-induced microvascular leakage in all airway levels
in actively sensitized guinea-pigs. CIS-19 (2.5 and 5 mg/kg, i.v.) significantly inhibited PAF-induced enhancement of the
bronchial response to methacholine, but had no effect on ovalbumin (0.05 mg/kg, i.v.)-induced bronchial hyperreactivity in
actively sensitized guinea-pigs. It is concluded that CIS-19 is a potent PAF receptor antagonist which inhibits PAF- but not
antigen-induced bronchoconstriction, microvascular leakage and bronchial hyperreactivity. These results suggest that PAF plays
little or no role in early airway responses following antigen challenge.
Received: 29 April 1996 / Accepted: 10 October 1996 相似文献
19.
Age, hematopoietic growth factors, cyclosporin A, mode of bone marrow transplantation (BMT) (autologous, allogeneic-related,
unrelated), and underlying disease were assessed as potential risk factors for capillary leakage syndrome (CLS) in 96 patients
after BMT. CLS was defined as unexplained weight gain of >3% within 24 h and nonresponsiveness to furosemide. CLS occurred
in 9/21 patients after unrelated compared with 2/33 after allogeneic-related BMT (p=0.0017) for hematopoietic disorders (n=54) and in 6/7 patients after allogeneic-related compared with 3/35 after autologous BMT (p=0.0001) for solid tumors (n=42). Hematopoietic growth factors and cyclosporin A were no signficant risk factors on their own. We conclude that unrelated
BMTs or high-intensity conditioning regimens used in combination with allogeneic-related BMT are the main risk factors for
CLS.
Received: 6 January 1997 / Accepted: 10 March 1997 相似文献
20.
David M. Warshauer Richard C. Semelka Susan M. Ascher 《Journal of magnetic resonance imaging : JMRI》1994,4(4):553-557
Small nodular lesions in the liver and spleen have been reported as an infrequent manifestation of sarcoidosis. Five patients with this appearance on either dynamic contrast material—enhanced computed tomographic (CT) or ultrasound scans underwent magnetic resonance (MR) imaging with and without dynamic gadolinium enhancement. The lesions were relatively uniform in size, ranging from 0.5 to 1.5 cm. On CT scans, they were hypoattenuating relative to surrounding parenchyma. On MR images, the lesions were hypointense relative to background parenchyma with all sequences. No substantial enhancement was observed in the lesions, although lesion conspicuity decreased over time on serial postcontrast images. Lesion conspicuity was greatest on either T2-weighted fat-suppressed (T2FS) images or early-phase dynamic contrast-enhanced images. Abdominal adenopathy was seen in three of the five patients and was hyperintense relative to liver on T2FS images in two and intermediate in intensity in one patient. 相似文献