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K Prabhakaran CVR Mohan PC Tripathy PK Sahoo KI Mathai 《Medical Journal Armed Forces India》2008,64(4):308-310
Background
Craniotomy and excision of tumours can produce neurological deficits if the tumour is located close to eloquent areas of the brain. One technique of overcoming this problem is to keep the patient ‘awake’ during surgery.Methods
Eight patients with intra cranial space occupying lesions (ICSOL) were operated ‘awake’, using a combination of skull block with sedation and analgesia. A mixture of 0.125% bupivacaine and 0.5% lignocaine was used for various nerve and field blocks. Midazolam, fentanyl and propofol in titrated doses were used to achieve conscious sedation.Result
The procedure was successful in all the patients. They tolerated the procedure well and were able to follow the commands intraoperatively as desired. There were no significant complications.Conclusion
Awake craniotomy with skull blocks with sedation and analgesia is a well established procedure. It requires a good rapport between surgeon, anaesthesiologist and the patient.Key Words: Awake craniotomy, Skull block, Sedation, Analgesia 相似文献33.
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血小板血浆对人牙髓细胞增殖的影响 总被引:3,自引:0,他引:3
目的:观察血小板血浆及其细化成分对人牙髓细胞增殖的影响。方法:使用因正畸而拔除的人牙的牙髓细胞,用细胞定量测定试剂盒测定细胞增殖情况。结果:5%的多血小板血浆(platelet-rich plasma,PRP)、5%和10%的洗净血小板(washed platelet,WPLT)均明显地促进了人牙髓细胞的增殖,而且WPLT的作用较PRP更显著。乏血小板血浆(platelet-poor plasma,PPP)呈浓度依赖性地抑制了人牙髓细胞增殖,5%WPLT促进人牙髓细胞增殖的作用。结论:去除血浆成分的WPLT对培养的人牙髓细胞增殖有明显的促进作用;血浆中可能存在对抗血小板生长因子作用的因子。 相似文献
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S. LEHTO P. PALOMKI H. MIETTINEN I. PENTTIL V. SALOMAA J. TUOMILEHTO M. JAUHIAINEN K. PY
RL 《Journal of internal medicine》1993,233(2):179-185
Abstract. As part of the FINMONICA project, serum total cholesterol (TC) and high density lipoprotein cholesterol (HDLC) concentrations were determined in 1216 AMI patients (937 men. 279 women) aged 35–64 years in the province of Kuopio in eastern Finland during the 5-year period 1983–87. The distributions were compared with the corresponding distributions in a representative sample of the general population of the same area (1026 men, 1021 women). The mean serum TC levels did not differ between the AMI patients and the normal population. Only the prevalence of a very high serum TC level (> 8.0 mmol l?1) among women was significantly higher in the AMI group than in the population sample. On the other hand, in both sexes the age-adjusted mean HDLC was significantly lower in the AMI group than in the population sample. Our findings emphasize the importance of HDLC measurement as a part of the assessment of the lipid risk factor profile in patients with AMI. 相似文献
39.
HARRY J.G.M. CRIJNS M.D. J. HERRE KINGMA M.D. † A.T. MARCEL GOSSELINK M.D. H.W. DALRYMPLE Ph .D. ‡ CEES D.J. De LANGEN Ph.D. KI LIE M.D. 《Journal of cardiovascular electrophysiology》1993,4(4):459-466
Sequential Bilateral BBB During Dofetilide. Introduction: I in mechanism of wide QRS complex tachycardias during dofetilide infusion was studied in a patient with atrial fibrillation.
Methods and Results: Endocardial recording from the intraventricular conduction system showed that dofetilide caused "classic" aberrant conduction (Ashman phenomenon, typical QKS morphology) at high prematurity ratios (preceding interval = 1.78 X coupling interval 290), thus mimicking ventricular ectopy. In addition, there was frequent sequential bilateral bundle branch block, caused by a significant difference in preceding bundle-to-bundle intervals (mean difference ± 1 SD: 74 ± 26 msec).
Conclusion: The present findings may prove helpful in the clinical assessment of wide QKS complex rhythms after dofetilide and possibly other "pure" Class III antiarrhythmics. 相似文献
Methods and Results: Endocardial recording from the intraventricular conduction system showed that dofetilide caused "classic" aberrant conduction (Ashman phenomenon, typical QKS morphology) at high prematurity ratios (preceding interval = 1.78 X coupling interval 290), thus mimicking ventricular ectopy. In addition, there was frequent sequential bilateral bundle branch block, caused by a significant difference in preceding bundle-to-bundle intervals (mean difference ± 1 SD: 74 ± 26 msec).
Conclusion: The present findings may prove helpful in the clinical assessment of wide QKS complex rhythms after dofetilide and possibly other "pure" Class III antiarrhythmics. 相似文献
40.
V. SALOMAA H. MIETTINEN P. PALOMKI M. ARSTILA H. MUSTANIEMI K. KUULASMAA J. TUOMILEHTO 《Journal of internal medicine》1995,237(2):151-159
Abstract. Objectives . To examine, whether the acute myocardial infarctions (AMIs) are becoming smaller. Design . Analysis of electrocardiogram (ECG) and enzyme findings of community-based AMI registers in three geographical areas of Finland during the 8-year period 1983–90. Setting . In the FINMONICA AMI Register, all suspected coronary events in persons aged 25–64 years have been registered since 1983 according to the protocol of the WHO MONICA project in the provinces of North Karelia and Kuopio in eastern Finland and Turku/Loimaa area in south-western Finland. Subjects . Each consecutive case of suspected AMI originating from the monitored populations. During the study period, 11487 definite or possible AMIs were registered. Main outcome measures . Trends in ECG findings classified as definite or probable, and trends in enzyme findings classified as abnormal or equivocal. Results . Of the registered AMIs, 8439 (73.5%) reached the hospital alive and survived ≥ 24 h from the beginning of the symptoms. They were included in the analyses of this report and divided further, to first ever AMIs (n = 5392) and to recurrent AMIs (3047). During the study period, the proportion of ECG findings classified as definite on the basis of the serial Minnesota coding declined in men 3.1% year?1 (P < 0.0001) on average for first AMIs and 1.9% year?1 (P = 0.004) for recurrent AMIs. In women, the corresponding declines were 1.9% year?1 (P = 0.007) and 1.6% year?1 (P = 0.02), respectively. Also, the proportion of enzymes classified as abnormal declined amongst men 2.2% year (P < 0.0001) for first AMIs and 2.8% year?1 (P < 0.0001) for recurrent AMIs. In women, the corresponding declines for abnormal enzymes was 1.3% year?1 (P = 0.13) and 3.0% year?1 (P = 0.02). These findings were consistent in all three areas with different registration teams and different laboratories. The proportion of definite ECG findings amongst patients hospitalized for AMI declined almost by half and the proportion of abnormal enzyme findings declined almost by one-third during the study period. Conclusions . Our findings are compatible with the clinical observation that the hospitalized AMIs are becoming smaller. The timing and magnitude of the changes suggest that they are mainly caused by decreased risk-factor levels in the population. Improved treatment of coronary heart disease and changed hospital admission policy are likely to be contributing factors. 相似文献