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The synthesis of all the four stereomers of the alkaloid woodinine ( 12a )1) is described and the stereochemical conclusions of Païs3) and Still6) are discussed. The absol. configurations of woodinine ( 12a ) and its diastereomer 8b are unequivocally deduced from the pertinent piperazinediones 16 and 17 . 相似文献
95.
M A Levison D D Thomas R G Wiencek R F Wilson 《The Journal of trauma》1990,30(3):247-51; discussion 251-3
The records of 239 patients surviving more than 24 hours with full-thickness intraperitoneal colonic injuries over a 7-year period were reviewed. During the first 3 years, 29% (31/106) of the patients were managed by primary repair without colostomy. In the next 4 years, almost twice as many patients, 56% (75/133), with similar colonic trauma were treated without fecal diversion (p less than 0.05). Although there was no difference in the mean Trauma Score in the patients with primary repair in the two time periods, the Injury Severity Score (mean +/- sd) in the patients without colostomy in the later periods was significantly higher (17.8 +/- 2.1 vs. 20.2 +/- 5.1) (p less than 0.001). No patient suffered because of the increased incidence of primary repairs. These patients had five abdominal abscesses and only one leak, whereas the patients with colostomy had 15 intraperitoneal abscesses. Because of the safety when primary repair is performed, more liberal use of primary colonic repair following penetrating trauma is warranted. 相似文献
96.
A 50 year old man with a two month history of upper abdominal pain and a one month history of anorexia and weight loss, presented
with icterus and evidence of peritonitis. Laparotomy revealed biliary peritonitis which had been caused by a rupture of the
fundus of the gallbladder. The common bile duct was dilated and there was a large growth in the head of the pancreas with
multiple hepatic metastases. A cholecysto-jejunostomy and gastrojejunostomy were done and the patient had an uneventful recovery. 相似文献
97.
Minor Psychiatric Morbidity, Its Prevalence and Outcome in a Cohort of Civil Servants A Seven-year Follow-up Study 总被引:1,自引:0,他引:1
Jenkins R.; Harvey S.; Butler T.; Lloyd Thomas R. 《Occupational medicine (Oxford, England)》1996,46(3):209-215
During the years 1979–1986, a cohort of direct entrantexecutive officers in the Civil Service were followed up toexamine the prevalence and outcome of minor psychiatric morbidityin an occupational setting. All studies using epidemiologicalstandardized research methods agree, that prevalence rates arehigh in occupational settings. As in primary care settings,half of the illness episodes followed a chronic course, whichemphasizes the need for early detection and prompt managementof these conditions, and for evaluative studies of interventionstrategies. 相似文献
98.
The effect of Cyclosporin A (CsA) on prostaglandin E2 (PGE2 ) production in human gingival fibroblasts challenged with tumor necrosis factor alpha (TNF-α) was studied. TNF-α (1-100 ng/ml) dose-dependently stimulated PGE2 ; formation in 24 h cultures. CsA (1-100 ng/ml) did not induce PGE2 ; formation itself but potentiated TNF-α induced PGE; formation in gingival fibroblasts in a manner dependent on the concentrations of both CsA and TNF-α. TNF-α (10 ng/ml) stimulated the release of [3 H]-arachidonic acid (A.A) from prelabelled fibroblasts that was potentiated by CsA (100 ng/ml). Addition of exogenous unlabelled AA (5-20 μM/ml) to the cells resulted in enhanced PGE2 : formation that was not potentiated by CsA (100 ng/mi). Furthermore. CsA (100 ng/ml) did not further increase the level of cyclooxygenase-2 mRNA induced by TNF-α (10 ng/ml). although PGE2 formation was enhanced. The results indicate that CsA and TNF-α act in concert on PGE2 formation in gingival fibroblasts. which may be of importance in the pathogenesis of gingival overgrowth induced by the drug. 相似文献
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100.
Examined are several measures currently used in the assessment of child abuse, sexual abuse, and trauma. These measures include
structured clinical interviews, self report measures, screening inventory, symptom checklist, and some measures that include
decision making properties. Issues and implications for clinical practice are explored. 相似文献