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71.
We have developed a technique to render knitted Dacron prostheses totally impervious to blood leak by impregnating the cloth with collagen. These grafts were prepared by the manufacturer, sterilized, and have an indefinite shelf life. The objective of this study was to determine whether collagen impregnation has a deleterious effect on surface thrombogenicity and graft healing. The infrarenal aortas of 30 mongrel dogs were replaced with 6 cm X 6 mm Dacron grafts (15 collagen-impregnated and 15 control). The collagen-impregnated prostheses were visibly indistinguishable from the control. After blood flow was restored, no interstitial bleeding occurred in the collagen grafts, in contrast to the control grafts that initially leaked profusely. When they recovered, the dogs were divided into three groups: group I (five collagen, five control), group II (five collagen, four control), and group III (five collagen, three control). The grafts were harvested at 3, 6, and 9 months, respectively. Retroperitoneal healing response, capsular thickness and adherence, completeness of neointimal healing, surface fibrinolytic activator activity, and sections taken for light and scanning electron microscopy were studied and compared in a blinded fashion. In a separate set of experiments, experimental and control grafts were compared for in vivo surface thrombogenicity. The healing data were identical in the experimental and control prostheses in all parameters. Of particular interest was that initial capsule adherence was better and surface thrombogenicity less in the collagen-impregnated prosthesis. We conclude that collagen impregnation of a knitted Dacron prosthesis has no deleterious effect for the term of observation of this experiment. 相似文献
72.
The cause and mechanism of post-carotid endarterectomy hypertension remains unknown. To determine the influence of the sympathetic and renin-angiotensin system, we measured cranial and peripheral plasma levels of catecholamine and renin in patients undergoing carotid endarterectomy. Baseline samples were drawn just before carotid clamping (sample I) and compared with study samples drawn immediately after clamp release (sample II), 2 to 6 hours after surgery (sample III), and then 18 to 24 hours after surgery (sample IV). The patients with post-carotid endarterectomy hypertension had an associated increase of cranial and peripheral norepinephrine levels in the postoperative hypertensive period whereas the patients without post-carotid endarterectomy hypertension did not. This association was most pronounced and statistically significant in cranial samples II (p = 0.032) and III (p = 0.005). Epinephrine and dopamine values did not correlate with post-carotid endarterectomy hypertension. Renin values were higher in cranial than in peripheral samples at time period 2 (p = 0.011), suggestive of a central nervous system Goldblatt phenomenon. However, the renin values did not correlate with post-carotid endarterectomy hypertension. We conclude that post-carotid endarterectomy hypertension is associated with elevated cranial norepinephrine levels, suggestive of a central nervous system sympathomimetic mechanism. Optimal prevention and treatment of this brief but frequently occurring hypertension should include a central-acting sympatholytic agent. 相似文献
73.
74.
Quantitation of benzo(a)pyrene and 7,12-dimethylbenz(a)anthracene binding to nuclear macromolecules in human and rat mammary epithelial cells 总被引:2,自引:0,他引:2
Our laboratory has developed virtually identical techniques for the isolation and culture of mammary epithelial cells (MEC) from rats and humans. In a cell-mediated mutagenesis assay, rat MEC activated 7,12-dimethylbenz(a)anthracene (DMBA) but not benzo(a)pyrene [B(a)P] to mutagenic forms, and the opposite pattern was found with human MEC. These species-specific patterns were not readily explained by either qualitative or quantitative differences in Phase I metabolism of these compounds. In contrast, relative levels of covalent binding of these compounds to DNA in the human and rat cells under identical assay conditions generally parallel the pattern of the mutagenesis results, while not reflecting the absolute levels of metabolism in each system. The ability of the rat MEC to bind relatively higher levels of DMBA than B(a)P to nuclear DNA, and the reversed pattern in human MEC, was found at all incubation times tested between 6 and 48 h. Culture density was found to exert a greater effect on the levels of PAH-DNA binding in rat than in human cells, but in neither case did it affect the ratio of DMBA to B(a)P binding within a species. C2SO4 gradient separation of nuclear macromolecules from PAH-treated MEC revealed that the relative DNA binding levels of DMBA and B(a)P did not correlate with relative levels of nuclear protein binding. For both species, nuclear (DNA + protein) binding levels of B(a)P were approximately 2-fold higher than DMBA. However, these binding levels were 4 to 5-fold higher for both carcinogens in the human than in the rat MEC. The species-specific patterns of PAH activation shown by these cells suggest that caution should be used in extrapolating rodent carcinogenesis data to humans, for either quantitative or qualitative purposes. 相似文献
75.
Rhabdomyosarcoma of the head and neck is rare in adults, and past reports indicate that it is a more aggressive disease than that which is found in children. We report the case of a 63-year-old woman with an alveolar type of rhabdomyosarcoma located on the mandibular alveolar ridge. Rhabdomyosarcoma of the oral cavity appears to carry a particularly poor prognosis, especially when bone is involved. Multimodal treatment with surgery, radiation therapy, and chemotherapy is indicated in all patients. 相似文献
76.
Radiographs and clinical records of 61 patients with calcaneal fractures were studied. Twenty-one patients had diabetes mellitus, and 40 were nondiabetic. All diabetic patients were insulin dependent for more than 5 years and had clinically evident peripheral neuropathy. Eighteen of the diabetic patients had no history of significant trauma. Fourteen had calcaneal insufficiency avulsion (CIA) fractures limited to the posterior third of the calcaneus. The fracture pattern in this group occurred in the same plane as a fatigue-type calcaneal fracture. Fragments of the posterior tuberosity were usually displaced 10-30 mm and were frequently rotated. The mean time from diagnosis of diabetes mellitus to CIA fracture was 20 years. Fractures in the nondiabetic group and in the three diabetic patients with a history of trauma did not resemble the CIA pattern. In the nondiabetic group, there were no insufficiency fractures; 39 fractures occurred with significant force (eg, motor vehicle accident or fall from height), and 33 had extension to subtalar or calcaneocuboid joints. 相似文献
77.
Computer-assisted instruction in mixed dentition analysis 总被引:1,自引:0,他引:1
A computer-assisted instruction (CAI) tutorial in the basics of mixed dentition analysis was developed and evaluated as a substitute for a one-hour lecture segment on the same topic. The instructional effectiveness of the program was evaluated using an experimental CAI-lecture group design. A posttest included in the final examination for the course served to compare learning outcomes of 24 students instructed via the computer with 28 students instructed by the traditional lecture method. The results of this investigation revealed that: the CAI group performed significantly better on the posttest than did the lecture group, there was no significant correlation between posttest scores and the time used to view the program for students in the computer groups, and student attitude toward the use of this CAI program was favorable. 相似文献
78.
Rebecca Knight MD Erick R Ratzer MD FACS Michael E Fenoglio MD FACS John T Moore MD 《Journal of the American College of Surgeons》1997,185(5):481-485
Background:Most abnormal parathyroid glands can be removed through a standard cervical incision; even those in the superior mediastinum. Those located in certain areas of the mediastinum, for example posteriorly or in the aortopulmonic window, historically have required excision through a median sternotomy or thoracotomy. Angioablation is a nonsurgical alternative to management of these lesions.Study Design:We present two case reports of mediastinal parathyroid adenomas that were excised thoracoscopically, and review the literature regarding the management of mediastinal parathyroid adenomas.Results:Both patients who underwent precise localization and thoracoscopic excision of their mediastinal parathyroid adenomas had resolution of their hypercalcemia with minimal associated morbidity and shortened recovery periods.Conclusions:We suggest that thoracoscopic excision of mediastinal parathyroid adenomas is the better means of controlling hypercalcemia secondary to parathyroid adenoma in those patients considered for either median sternotomy, thoracotomy or angiographic ablation where the exact location of the lesion can be established preoperatively. 相似文献
79.
A polyclonal anti-idiotype was raised in rabbits following immunization with a murine monoclonal antibody which recognized a 250,000 MW antigen of Plasmodium chabaudi-infected erythrocytes. The monoclonal antibody, NIMP M23 (clone 3,) has been shown to protect mice against homologous parasite challenge. Following purification, the anti-idiotype was shown to bind only the immunizing idiotype and to recognize antigen-binding site-associated anti-idiotype. Mice primed with anti-idiotype and challenged with live parasites had an altered course of infection, with significant reduction in their peak parasitaemia levels. Anti-idiotype priming did not induce an antigen-reactive antibody response in vivo but a population of T cells capable of proliferating in vitro to P. chaubaudi-infected red cells was stimulated. These data are discussed in the context of possible idiotypic interaction in murine malaria. 相似文献
80.
Jeffrey T Cope MD Michael C Mauney MD David Banks BS Oliver A.R Binns MD Christopher L Moore BS Jeffrey J Rentz BS Kimberly S Shockey MS R.Christoper King MD Irving L Kron MD Curtis G Tribble MD 《The Annals of thoracic surgery》1997,63(6)
Background. Hypoxia and warm ischemia produce severe injury to cardiac grafts harvested from non–heart-beating donors. To potentially improve recovery of such grafts, we studied the effects of intravenous phenylephrine preconditioning.Methods. Thirty-seven blood-perfused rabbit hearts were studied. Three groups of non–heart-beating donors underwent intravenous treatment with phenylephrine at 12.5 (n = 8), 25 (n = 7), or 50 μg/kg (n = 7) before initiation of apnea. Non–heart-beating controls (n = 8) received saline vehicle. Hypoxic cardiac arrest occurred after 6 to 12 minutes of apnea, followed by 20 minutes of warm in vivo ischemia. A 45-minute period of ex vivo reperfusion ensued. Nonischemic controls (n = 7) were perfused without antecedent hypoxia or ischemia.Results. Phenylephrine 25 μg/kg significantly delayed the onset of hypoxic cardiac arrest compared with saline controls (9.6 ± 0.5 versus 7.7 ± 0.4 minutes; p = 0.00001), yet improved recovery of left ventricular developed pressure compared with saline controls (57.1 ± 5.3 versus 41.0 ± 3.4 mm Hg; p = 0.04). Phenylephrine 25 μg/kg also yielded a trend toward less myocardial edema than saline vehicle (p = 0.09).Conclusions. Functional recovery of nonbeating cardiac grafts is improved by preconditioning. We provide evidence that the myocardium can be preconditioned with phenylephrine against hypoxic cardiac arrest.(Ann Thorac Surg 1997;63:1664–8) 相似文献