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11.
Holliday MA 《Pediatric nephrology (Berlin, Germany)》1999,13(9):989-995
This review highlights characteristics of extracellular fluid (ECF) that are often overlooked. ECF has, in addition to plasma
and interstitial fluid (ISF) surrounding cells, a third large compartment, the ISF of skin and connective tissue. This acts
as a reservoir that gives up ECF to plasma volume (PV) in order to sustain circulation in the event of either shock or dehydration.
While Starling forces drive filtration, ECF is returned to PV more by lymph and less by Starling forces than previously appreciated.
Lymph return to PV is dependent on physical activity and muscle contraction to overcome gravity. Regional change in metabolic
rate alters the need for oxygen and nutrients that is met by a regional increase in capillary blood flow. Blood flow is controlled
by vasoactive compounds released in response to a drop in PO2; these relax capillary smooth muscle to increase blood flow and delivery of oxygen and nutrients. Plasma proteins, including
albumin, are filtered into the interstitium through larger pores than those filtering ECF. The rate of protein filtration
is set by size and charge of these larger endothelial pores and by size and charge of proteins. Charge of these pores, hence
albumin permeability, is regulated by many of the same vasoactive compounds that control capillary flow. As a consequence,
in response to gravitational stress and other forms of shock that reduce effective circulation, albumin as well as ECF is
rapidly shifted from plasma and sequestered in ISF. When this has occurred, as in burn shock, restoration is better effected
by generous expansion of ECF with Ringer’s solution alone, rather than with Ringer’s solution supplemented with human serum
albumin or other colloid. Restoring both PV and ISF volume restores lymph circulation and returns sequestered albumin to PV.
Received: 12 November 1998 / Revised: 30 March 1999 / Accepted: 2 April 1999 相似文献
12.
MJ Stevens PD Stricker J Saalfeld PC Brenner R Kooner GFA O'Neill PJ Duval RS Jagavkar P Cross J Martland 《Journal of Medical Imaging and Radiation Oncology》2003,47(2):152-160
Combination high dose rate brachytherapy (HDRB) and external beam radiation therapy is technically and clinically feasible as definitive treatment for localized prostate cancer. We report the first large Australian experience using this technique of radiation dose escalation in 82 patients with intermediate‐ and high‐risk disease. With a median follow up of 3 years (156 weeks), complications were low and overall prostate‐specific antigen progression‐free survival was 91% using the American Society for Therapeutic Radiology and Oncology consensus definition. The delivery of hypofractionated radiation through the HDRB component shortens overall treatment time and is both biologically and logistically advantageous. As a radiation boost strategy, HDRB is easy to learn and could be introduced into most facilities with brachytherapy capability. 相似文献
13.
Screening for complement deficiency in bacterial meningitis 总被引:1,自引:0,他引:1
T Ernst PJ Späth C Aebi UB Schaad MG Bianchetti 《Acta paediatrica (Oslo, Norway : 1992)》1997,86(9):1009-1010
Seventy-seven children with bacterial meningitis were screened for complement deficiency. Both the classical and the alternate pathways were normal in 75 patients. Transiently reduced total haemolytic activity of the classical pathway was documented in a boy with meningococcal meningitis. Total haemolytic activity of both the classical and the alternate pathways were reduced in another patient with pneumococcal meningitis: individual complement components determination indicated predominant activation of the alternate pathway. 相似文献
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The major burden of preterm birth is in the developing world, where most of the increasing death and morbidity is secondary to infectious diseases such as malaria, HIV, tuberculosis, bacterial vaginosis and intestinal parasites. In some developing countries, the growth of medical care has outstripped the growth of preventive public health, with an associated increase in iatrogenic preterm births. In developed countries, more than one-third of preterm births are medically indicated because of conditions such as fulminating pre-eclampsia or severe intrauterine growth restriction. Neither of these conditions is currently preventable. One in five preterm births is associated with multiple pregnancy, and these have been greatly increased by assisted reproduction techniques. The use of tocolytics has proved disappointing perhaps because inflammation rather than spontaneous uterine activity is increasingly recognised as the final common pathway. Inappropriate antibiotics used late in pregnancy are ineffective and may have adverse effects. Currently, the most promising interventions are public health related and include reducing the transmission of communicable diseases, improvements in the management of diabetes and reduction in harmful behaviours such as smoking and drug abuse. 相似文献
18.
Jie Jin Wang Gabriëlle H.S. Buitendijk Elena Rochtchina Kristine E. Lee Barbara E.K. Klein Cornelia M. van Duijn Victoria M. Flood Stacy M. Meuer John Attia Chelsea Myers Elizabeth G. Holliday Ava G. Tan Wayne T. Smith Sudha K. Iyengar Paulus T.V.M. de Jong Albert Hofman Johannes R. Vingerling Paul Mitchell Ronald Klein Caroline C.W. Klaver 《Ophthalmology》2014
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Saskia PJ Verkleij Pim AJ Luijsterburg Sten P Willemsen Bart W Koes Arthur M Bohnen Sita MA Bierma-Zeinstra 《The British journal of general practice》2015,65(637):e530-e537