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排序方式: 共有2118条查询结果,搜索用时 15 毫秒
161.
Rainer Mittermayr MD ; Tatjana Morton MSc ; Martina Hofmann MD ; Sam Helgerson PhD ; Martijn van Griensven MD PhD ; Heinz Redl PhD 《Wound repair and regeneration》2008,16(4):542-550
This study investigated (1) the release of recombinant human vascular endothelial growth factor ([rh]VEGF165 ) from an in vitro fibrin matrix, (2) the effects of (rh)VEGF165 released from an in vivo fibrin matrix on ischemic flap necrosis in the rat dorsal skin flap model, and (3) the effects of (rh)VEGF165 released from an in vivo fibrin matrix on VEGF-R2 expression in transgenic VEGF-R2/luc mice. In vitro fibrin matrices were spiked with (rh)VEGF165 and demonstrated (rh)VEGF165 release over 88 hours with 66% recovery. Ischemic dorsal flaps were treated with a fibrin sealant (FS), FS spiked with (rh)VEGF165 , or left untreated. Flaps treated with FS spiked with (rh)VEGF165 showed greater viability than controls as measured by planimetric analysis. Immunohistochemical analyses revealed stronger neovascularization than that exhibited by controls. Transgenic mice implanted with FS spiked with (rh)VEGF165 had significant increases in VEGF-R2 expression relative to controls at days 5–13 after implantation. Conclusions drawn from this work are that (1) (rh)VEGF165 is released from an in vitro fibrin matrix at clinically appropriate times, (2) (rh)VEGF165 increases the viability of tissue flaps in vivo, and (3) (rh)VEGF165 induces the expression of VEGF-R2 expression. This work demonstrates the clinical ability of sprayed FS to locally deliver growth factors to ischemic tissue of patients. 相似文献
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Nenad Ivančević Dejan Radenković Vesna Bumbaširević Aleksandar Karamarković Vasilije Jeremić Nevena Kalezić Tatjana Vodnik Biljana Beleslin Nataša Milić Pavle Gregorić Miloš Žarković 《Langenbeck's archives of surgery / Deutsche Gesellschaft fur Chirurgie》2008,393(3):397-403
Background and aims The present study attempted to identify the diagnostic significance of procalcitonin (PCT) in acute abdominal conditions as
well as the range of concentrations relating to diagnosis of abdominal sepsis.
Materials and methods This was prospective clinical study. The study included 98 consecutive patients with acute abdominal conditions, divided in
sepsis and systemic inflammatory response syndrome (SIRS) group.
Results PCT concentrations on admission were significantly higher in the sepsis group than in the SIRS group (median [interquartile
range] 2.32 [7.41] vs 0.45 ng/ml [2.62]). A cutoff value of 1.1 ng/ml yielded 72.4% sensitivity and 62.5% specificity. In
a group of patients with abdominal symptoms lasting for more than 24 h, a cut-off value of 1.1 ng/ml yielded higher sensitivity
(82.9%) and higher specificity (77.3%).
Conclusion Our results suggest that PCT measurements may be useful for early, preoperative diagnosis of abdominal sepsis. 相似文献
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Juergen Falkensammer Tatjana Stojakovic Kurt Huber Angelika Hammerer-Lercher Ingrid Gruber Hubert Scharnagl Gustav Fraedrich Wolfram Santner Michael Schocke Andreas Greiner 《Clinical chemistry and laboratory medicine》2007,45(4):535-540
BACKGROUND: Ischemia-modified albumin (IMA) is an emerging marker of ischemia. To investigate the applicability of IMA for the diagnosis of skeletal muscle ischemia, we examined IMA changes as measured by the albumin-cobalt binding test, in a group of healthy volunteers after standardized exercise-induced calf muscle ischemia. METHODS: A total of 12 healthy volunteers underwent standardized exercise on a plantar flexion pedal. Ischemic conditions were achieved by inflating a femoral blood pressure cuff at incremental pressures of 0, 60, 90, 120 and 150 mm Hg. Calf muscle ischemia was identified by synchronous 31P magnetic resonance spectroscopy, measuring intracellular concentrations of phosphocreatine (PCr) and inorganic phosphate (Pi). In addition, IMA, serum albumin, lactate, troponin T (TnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were measured at baseline and at 5, 10, 30, 360 and 720 min after cuff release. RESULTS: Magnetic resonance spectroscopy showed calf muscle ischemia in all participants upon exercise and cuff inflation. Circulating IMA concentrations increased significantly after cuff release (p=0.03) and returned to baseline within 30 min. While we found a significant negative correlation with albumin, there was no association of IMA levels with lactate or intracellular levels of PCr or Pi in samples obtained at baseline and post-ischemia. TnT and NT-proBNP remained within the normal range throughout the observation period in all participants. CONCLUSIONS: IMA may represent a clinical marker for skeletal muscle ischemia, although its lack of specificity requires careful clinical interpretation of data. The short period of IMA elevation after ischemic exercise requires standardized conditions for use as a diagnostic tool and hints at IMA applicability as a marker of prolonged or chronic ischemia. 相似文献
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OBJECTIVE: To determine the etiology of hemorrhagic fever with renal syndrome (HFRS) in the north-eastern part of Slovenia (Pomurje region) together with demographic, epidemiological and clinical data on 25 patients from this region who were diagnosed and treated at the General Hospital in Murska Sobota between 1986 and 2003. METHODS: Medical records of patients with a discharge diagnosis of HFRS who were either hospitalized or referred to an infectiologist as outpatients were included in this retrospective study. Data on demographic characteristics, clinical manifestations and laboratory parameters were collected from the patients' records. In addition, all available follow-up records were examined and information on general health, blood pressure, basic blood and biochemical examination and urine analysis was collected. RESULTS: Infection with Puumala virus (PUUV) was indicated in 23 patients and Dobrava virus (DOBV) infection in two patients. The median age of patients was 39 years; 19 were male. The patients primarily had outdoor occupations. Most of the HFRS cases occurred between May and August. The most common findings were fever, vomiting, headache, myalgia, chills, cough, back and abdominal pain, and blurred vision. The most prominent laboratory abnormalities were elevated erythrocyte sedimentation rate and C-reactive protein concentration, thrombocytopenia, and leucocytosis with neutrophilia. The signs of renal dysfunction were observed in 24 of the 25 patients. Oliguric renal failure was seen in 13 of 23 (57%) PUUV-infected patients. Six of 23 (26%) patients infected with PUUV and one of two (50%) patients from the DOBV group had hypotension or developed signs of shock. Seven out of 15 (47%) patients had elevated protein concentration in cerebrospinal fluid (CSF). Sinus bradycardia was documented in 7 of 17 (41%) patients with PUUV infection. CONCLUSIONS: HFRS is endemic in the north-eastern part of Slovenia; PUUV and DOBV infections coexist, with PUUV being the main causative agent of HFRS. Demographic, clinical and laboratory findings in our patients with HFRS caused by PUUV were mostly in accordance with those published previously, but the ratio of patients with sinus bradycardia, oliguric renal failure and mildly elevated CSF protein concentration was rather high. 相似文献
170.
Wilkening A Zeschky M Ziegenbein M Pfefferer-Wolf H Harms E Lübbe G Bläsing R Albert M Machleidt W Calliess IT 《Wiener klinische Wochenschrift》2007,119(21-22):654-662
BACKGROUND: Quality management is an important management tool in modern health care systems. This applies also to the mental health care system, where in the past decade many concepts have been developed on how to implement quality management appropriately and successfully. However, for the German speaking countries there are only very few studies on the evaluation of therapy outcome in psychiatric inpatient populations available, furthermore they deal primarily with diagnostic subgroups. The aim of this study was to develop a method to assess the quality of therapy on regular psychiatric admission wards. An important aspect was to include all diagnostic subgroups of a psychiatric inpatient population. METHODS: In an explorative field study and by means of a specially designed evaluation method, therapy courses of a psychiatric inpatient population were assessed. Indicators of therapy outcome were: psychopathology, level of psychosocial functioning, motivation of the patient for therapy, suicide attempts, legal status of the patient, patient violence and coercive treatment of the patient. The following assessment and rating scales were used: Brief Psychiatric Rating Scale (BPRS), Hamilton Depression Rating Scale (HAMD), Global Assessment of Function (GAF), Social and Occupational Functioning Assessment Scale (SOFAS) and the Symptom-Checklist SCL-9. RESULTS: Changes in the courses of therapy of a psychiatric inpatient population in all diagnostic subgroups in the dimensions psychopathology and level of social functioning could be reproduced significantly using BPRS, HAMD and GAF scales. Difference values T(1)-T(2) were 6.6 +/- 6.9 (p = 0.019) in BPRS, 5.1 +/- 8.1 (p = 0.029) in HAMD and -5.5 +/- 10.1 (p = 0.028) in GAF. The entire battery of rating scales was successfully applied in 32% of all patients (drop out rate: 68%). In the subgroup of immigrant patients the entire battery of rating scales could be applied only in 17.4%, which accounts for a significantly higher drop out rate (82.6%; p = 0.067). DISCUSSION: Using the presented evaluation system therapy outcome and quality of therapy are easy to assess. The results of the quality assessment can be used in further therapeutic processes. 相似文献