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991.
T. BICHEL MD I. SPAHR-SCHOPFER MD M. BERNER MD E. JAEGGI MD Y. VELKOVSKI MD B. FRIEDLI MD A. KALANGOS PhD MD B. FAIDUTTI MD & J.-C. ROUGE MD 《Paediatric anaesthesia》1997,7(4):335-339
Two cases of very difficult weaning from cardiopulmonary bypass after cardiac surgery in children with pulmonary hypertension and ventricular dysfunction are reported. Children fail to respond to conventional therapy combining nitrovasodilators and inotropic support and react successfully to combined inhaled nitric oxide (NO) and epinephrine or left atrial infused norepinephrine. Postoperative NO inhalation must be prolonged and no toxicity appears. Pulmonary endothelial function recovers only after several days. 相似文献
992.
Stephen S. Burkhart MD 《Operative Techniques in Sports Medicine》1997,5(4):204-214
Arthroscopic repair of rotator cuff tears is now possible. By using the biomechanical principles of margin convergenceand the balance of force couples, even large cuff defects can be repaired. Suture anchors are particularly suitable for arthroscopic repairs, and a corkscrew anchor design lends itself to a trans-tendon approach 相似文献
993.
Dr. Harvey I. Pass MD Karen Kranda RN Barbara K. Temeck MD Irwin Feuerstein MD Seth M. Steinberg PhD 《Annals of surgical oncology》1997,4(3):215-222
Background: We analyzed morbidity and mortality, sites of recurrence, and possible prognostic factors in 95 (78 male, 17 female) patients
with MPM on phase I–III trials since 1990. A debulking resection to a requisite, residual tumor thickness of ≤ 5 mm was required
for inclusion.
Methods: Preoperative tumor volumes were determined by three-dimensional reconstruction of chest computerized tomograms. Pleurectomy
(n=39) or extrapleural pneumonectomy (EPP; n=39) was performed. Seventeen patients could not be debulked. Preoperative EPP
platelet counts (404,000) and mean tumor volume (491 cm3) were greater than that seen for pleurectomy (344,000, 114 cm3).
Results: Median survival for all patients was 11.2 months, with that for pleurectomy 14.5 months, that for EPP 9.4 months, and that
for unresectable patients 5.0 months. Arrhythmia (n=14; 15%) was the most common complication, and there were two deaths related
to surgery (2.0%). Tumor volume of >100 ml, biphasic histology, male sex, and elevated platelet count were associated with
decreased survival (p<0.05). Both EPP and pleurectomy had equivalent recurrence rates (27 of 39 [69%] and 31 of 39 [79%],
respectively); however, 17 of 27 EPP recurrences as opposed to 28 of 31 pleurectomy recurrences were locoregional (p2=0.013).
Conclusions: Debulking resections for MPM can be performed with low operative mortality. Size and platelet count are important preoperative
prognostic parameters for MPM. Patients with poor prognostic indicators should probably enter nonsurgical, innovative trials
where toxicity or response to therapy can be evaluated.
Presented at the 49th Annual Cancer Symposium of The Society of Surgical Oncology, Atlanta, Georgia, March 21–24, 1996. 相似文献
994.
KAREN ROETMAN MD LEILA WELBORN MD RAAFAT HANNALLAH MD ROBERT FINK MD JANET NORDEN MSN & REGINA O'DONNELL BA 《Paediatric anaesthesia》1997,7(5):391-397
This study compared recovery characteristics and postoperative ventilatory function when halothane, fentanyl or combination of halothane and fentanyl in addition to N2O were used for intraoperative anaesthesia in term infants undergoing hernia repair as outpatients. Sixty-six full term ASA PS I infants ages 1–12 months were studied. All received inhalation induction with N2O, O2 and halothane, followed by intravenous atropine and atracurium, tracheal intubation, and controlled ventilation. For anaesthesia maintenance, patients were randomized into one of three groups. Group I received 70% N2O, 30% O2 and halothane. Group II received 70% N2O, 30% O2, halothane and 2 μg·kg?1 fentanyl. Group III received 70% N2O, 30% O2 and 10 μg·kg?1 fentanyl. Awakening times were similar in all three groups, however, Group I patients had significantly shorter recovery and discharge times than those of Group II and III. None of the patients experienced postoperative apnoea or periodic breathing. One patient in Group III experienced two brief episodes of bradycardia not associated with apnoea or arterial desaturation (Spo 2 >90% for greater than 30 s). Decreased Spo 2 occurred less frequently in Group I (5.9%) compared to Group II (22.7%) and Group III (19.0%) patients, however, the group differences were not significant. Transcutaneous CO2 (TcCO2) values were not statistically different among the three groups. Pain scores were initially lower in Groups II and III, but at 120 min the differences were not significant. Postoperative apnoea was not observed in this study. Spo 2 <90% and TcCO2 >9 kPa (70 mmHg) was more common in infants receiving 2 and 10 μg·kg?1 fentanyl than in infants receiving halothane and nitrous oxide anaesthesia. Infants <3 months old did not have a higher incidence of Spo 2 <90% or significantly higher TcCO2 values when compared to infants >3 months old. Fentanyl in doses used in this study did not prolong awakening time but did prolong recovery and discharge times in outpatient infants. 相似文献
995.
996.
997.
P Emery MD FRCP R Luqmani MD MRCP C Gordon MA MRCP 《International journal of clinical practice》1994,48(2):82-86
SUMMARY Disease-modifying antirheumatic drugs are used in virtually all patients with established rheumatoid arthritis. An increasingly large number of new drugs is now available. Furthermore, old therapies are being used in novel ways. Treatment is now begun earlier and patients are rarely left untreated. This report summarises recent developments regarding the drugs currently in use and those that may be available in the near future. 相似文献
998.
999.
A multivariate study of protective effects of Zn and Cu against nephrotoxicity induced by cadmium metallothionein in rats. 总被引:3,自引:0,他引:3
X Y Liu T Y Jin G F Nordberg S R?nnar M Sj?str?m Y Zhou 《Toxicology and applied pharmacology》1992,114(2):239-245
Factorial experimental design was used to study the protective effects of Zn and Cu on cadmium-metallothionein(CdMT)-induced nephrotoxicity in male Wistar rats. In the factorial design two levels of Zn (0 and 25 mg/kg body weight), two levels of Cu (0 and 12.5 mg/kg), and two levels of CdMT (0.1 and 0.4 mg of Cd/kg) were used as varied factors. The factorial design was complemented with a center point with all three variables at an intermediate setting, i.e., Zn at 12.5 mg/kg, Cu at 6.25 mg/kg, and CdMT at 0.25 mg Cd/kg. Each of the nine combinations of settings was administered to one of nine groups with six rats in each. Zn and Cu were injected sc 24 hr prior to the injection of CdMT. The concentrations of protein and Ca in urine and Ca in renal cortex were used as effects. The relationship between the experimental design settings and the effects were modeled with multiple regression. The multiple regression analysis revealed that for the high dose of CdMT (i) the enhanced values of protein in urine caused by CdMT injection could be more efficiently reduced by Zn than by Cu, and (ii) excessive Ca in urine and renal cortex could be more efficiently reduced by Cu than by Zn. No significant synergism or antagonism between Cu and Zn was found. These models can be used to estimate the dose levels of Zn and Cu which will reduce the toxic effects of CdMT. The treatment of 20.4 mg/kg Zn, for example, will reduce the effects of 0.4 mg Cd/kg as CdMT on protein in urine, and 2.8 mg/kg Cu will reduce the Ca in urine to the levels of those caused by 0.25 mg Cd/kg (no Zn and Cu). Similarly, the effect of 0.4 mg Cd/kg on Ca level in renal cortex can be reduced to that of 0.28 mg Cd/kg as CdMT by 7.98 mg Cu/kg, which is three times as efficient as Zn. The obtained results might be of importance in understanding the mechanism of cadmium toxicity and the potential risk to the health of the population exposed to cadmium occupationally or environmentally. 相似文献
1000.