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41.
42.
Twenty patients, aged 4 months to 58 years, were evaluated for liver transplantation by duplex sonography, and 15 transplantations were completed; 42 postoperative examinations were performed. Sonographic findings were correlated with seven preoperative and five postoperative angiographic evaluations. Preoperative duplex US findings included tumors, portal vein occlusion, varices, biliary obstruction, and variant vascular anatomy. Postoperative findings included hepatic artery occlusion, portal vein occlusions (one with cavernous transformation), portal vein stenosis, biliary obstruction, intrahepatic and extrahepatic fluid collections, and air in the portal vein due to ischemic bowel. Use of angiography allowed confirmation of the vascular abnormalities and demonstrated evidence of rejection in patients with normal Doppler waveforms. Duplex sonography is a valuable portable technique for evaluating these patients and can be used in triage of patients requiring angiography. 相似文献
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We examined differences in approaches to HIV-related infection control practices in two university teaching hospitals in the United States and Nigeria. Health care workers (n = 202 in Nigeria and 186 in the USA) responded to a previously validated measure of infection control practices. There were significant differences in the estimated probability of treating a person with HIV disease (higher in USA), and a greater probability of peer ridicule as a way of enforcing group norms on infection control in Nigeria. Peer enforcement of norms was significantly lower in the USA. In both countries, more precautions would be taken if it was known that the patient was HIV infected. Infection control practices were more likely to be followed in the USA compared with Nigeria if they were praised for this activity, if appropriate facilities (sharps containers, gloves, etc.) were nearby, and if they felt that infection control procedures were effective. These data point to the importance of normative social pressures in Nigeria and of knowing the patient is HIV infected in the USA and feeling that infection control procedures are effective ways of avoiding occupational HIV infection. The role of normative pressures and assumptions about HIV infection status as well as cues and availability of facilities for infection control appear to differ between these health care workers in Nigeria and the USA. 相似文献
45.
Role of radiology in the treatment of malignant hilar biliary strictures 1: Review of the literature
Malignant strictures of the biliary tree are an uncommon cause of obstructive jaundice. There are a number of pathological subtypes, but tumours in this region tend to have similar clinical and diagnostic features and therapeutic and prognostic implications. We review the published literature on this topic discussing diagnostic modalities and treatment options with a focus on radiological intervention. Diagnosis currently is best achieved using a range of procedures. Direct cholangiography remains the gold standard in delineating anatomy, but the invasiveness of this procedure limits its use as a purely diagnostic tool. Magnetic resonance technology, in particular magnetic resonance cholangiopancreatography, has an increasing role as accessibility is improved. Treatment of these tumours is difficult. Surgical resection and palliative biliary enteric bypass are the most common methods used with endoscopic and percutaneous therapies reserved for palliating patients not fit for surgery. There is little firm evidence to suggest that any one palliative modality is superior. Interventional radiology is particularly suitable for palliative management of difficult and expansive lesions as the anatomy can preclude easy access by surgical or endoscopic techniques. Good palliative results with minimal mortality and morbidity can be achieved with percutaneous stenting . 相似文献
46.
阿片受体拮抗剂在TNF-α所致体温升高中的作用 总被引:1,自引:0,他引:1
为探索细胞介素TNF-α升体温效应与下丘脑前部、视前区(POAH)中的阿片受体的关系。应用脑神经核团微量注射方法给自由状态下的雄性SD大鼠POAH区微量注射TNF-α致热源。给药前30min分别用通常阿片受体拮抗剂Nal(10~20μg)和特异性阿片受体μ、δ和κ的拮抗剂CTAP(1.0~2.5μg)、NTI(0.25~0.5μg)和nor-BNI(0.1~3μg)对POAH做预处理。结果:单独给TNF-α可致剂量相关的体温升高△T(1℃~1.4℃);经Nal10μg,CTAP1.0μg和NTI0.5μg处理后使TNF-α的升体温效应减弱;用Nal20μg,CTAP2.5μg和NTI0.25μg处理后可完全阻断TNF-α所致的体温升高;nor-BNI(0.1~3μg)对TNF-α的升体温效应无影响。 相似文献
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48.
Long-term follow-up of autoantibody profiles in black female lupus patients and clinical comparison with Caucasian and Asian patients 总被引:5,自引:4,他引:1
The aim was to determine whether the autoantibody profile in Black female
lupus patients is associated with clinical subsets, fluctuates over time
and/or reflects disease activity. A clinical comparison with Caucasian and
Asian patients matched for age of onset and disease duration was also
undertaken. Up to seven serial bleeds from Black female lupus patients who
had been followed up for periods of 3.15 yr were tested for antibodies to
Ro/SSA, La SSB. Sm, RNP and ribosomal P using ELISA research assays.
Significant differences in both clinical and serological profiles between
the ethnic groups were found. Varying aspects of disease activity were
linked to anti-DNA (renal, cardiovascular, global score), anti-ribosomal P
(musculoskeletal, haematology) and anti-Sm (general) antibodies. There are
differences in clinical and serological profiles amongst systemic lupus
erythematosus patients of different ethnic origin. However, using the BILAG
system, relatively few antibodies were found to reflect disease activity
accurately in serial measurements.
相似文献
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