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A Shaked S V McDiarmid R E Harrison H A Gelebert J O Colonna R W Busuttil 《Surgery》1992,111(4):462-465
Early hepatic artery thrombosis after orthotopic liver transplantation results in massive injury to hepatocytes and the bile duct epithelium. In the fulminate form, impaired liver synthetic function is expressed by encephalopathy and coagulopathy. Ischemic bile duct injury is associated with the disruption of the biliary anastomosis, bile duct strictures, and intrahepatic bilomas. The inability of the liver macrophages to clear translocated portal blood intestinal pathogens results in persistent bacteremia and sepsis. The major radiologic finding is the radiographic evidence of gas gangrene of the liver graft. Early recognition and correct interpretation of the radiologic findings, immediate removal of the liver graft, and placement of the patient on venous-venous bypass or total hepatic devascularization while a new liver is being procured and retransplantation are the only hope for survival. 相似文献
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Kaysi Eastlick Kushner Margaret J Harrison 《Revue canadienne de recherche en sciences infirmières》2002,34(1):47-65
This critical feminist grounded theory study examined how employed mothers coped with the stress of managing multiple responsibilities in family, health, and paid work. Over a 2-year period, 20 mothers employed as support staff in a large, publicly funded institution participated in repeated individual in-person and telephone interviews and in a focus group. Interviews were transcribed and analyzed using constant comparative methods. The women experienced stress from continuous demands in paid and family health work compounded by time constraints, inflexible expectations, conflicting demands, compromised personal resources, and inadequate support. Most of their coping strategies were individual, such as focusing on priorities, but some women used shared family decision-making. Findings support both individual and family stress and coping theory, yet underscore the need to explicate social-ecological influences such as relational power. Strategies that can enhance coping and reduce stress are described for nurses who work with women and families. 相似文献
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The swab count has traditionally used a swab rack. A new alternative 'bag' method involves placing used swabs in batches of five into plastic bags which are sealed and stored in a bin. A randomized prospective study was carried out to compare these two methods. Twenty consecutive ear, nose and throat cases were randomized to rack or bag collection. Swab-related activities were divided into three categories and analysed by formal time-and-motion criteria. Blood contamination of operating theatre and circulating personnel was recorded. The time involved in all three swab-related activities was significantly less using the bag technique. There was no theatre blood contamination using this method, but significant contamination occurred using the rack. Circulating theatre personnel were minimally contaminated in two cases using the bag method but were grossly contaminated in all ten cases using the rack method. The bag technique is therefore safe and time efficient. 相似文献
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利用乙型肝炎病毒DNA开放框架上的BamHI和HpaI位点,酶切消化质粒载体PEcob6(含双拷贝HBVDNA),得到约900bp的HBV-S基因片断。将其插入到噬菌粒载体PBluescriptsk+的SmaI位点上。然后通过体外寡核苷酸介导的人工定点突变获得一系列(共12种)S基因“免疫逃避”突变型。再通过EB病毒真核表达载体pMEP4上的BamHI和Kpnl位点将噬菌粒pBluescripsk+上的S基因突变型片断定向克隆到PMEP4上,从而构建了含乙肝S基因突变型的重组质粒pMEP4HBSM。用其转染人肝癌传代细胞系HepG2,经潮霉素选择,三周后获得抗性细胞克隆。经用抗HBs单克隆抗体(含针对HBsAg“a”抗原决定簇)检测除含变异体145(即145位上甘氨酸为精氨酸替代)外其余抗变异体HBsAg均为阳性。经Westernblot证实变异体145,在分子量约为23KD处有一特异HBsAg蛋白带。 相似文献
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High resolution computed tomography as a predictor of lung histology in systemic sclerosis 总被引:2,自引:0,他引:2 下载免费PDF全文
A U Wells D M Hansell B Corrin N K Harrison P Goldstraw C M Black R M du Bois 《Thorax》1992,47(7):508-512
Background The relative proportions of fibrosis and inflammation seen by open lung biopsy examination is a predictor of disease outcome in fibrosing alveolitis. This study was designed to assess the ability of high resolution computed tomography to predict the histological appearance of open lung biopsy specimens from patients with systemic sclerosis. 相似文献
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Urologists remain divided as to the need for routine irrigation following transurethral prostatectomy (TURP). This randomised prospective study compared a policy of irrigation with that of no irrigation in a consecutive group of 200 patients undergoing TURP. In the irrigation group, a mean of 15 litres of irrigating fluid was used in each patient and one-third of patients required at least one bladder washout. In the no irrigation group, although two-thirds of the patients required at least one bladder washout, only one-third required more than one washout. No significant difference in blood loss, electrolyte balance, infection rate or recovery was seen in the 2 groups. This study led to a local change in practice, converting from a policy of routine irrigation to one of no irrigation. 相似文献