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991.
Jensen E Sandström K Andréasson S Nilsson K Berggren H Larsson LE 《Paediatric anaesthesia》2000,10(3):297-302
The aim of this study was to evaluate changes in concentrations of the neurospecific protein S-100 in relation to cardiac surgery with cardiopulmonary bypass (CPB) and noncardiac general surgery in children below 3 years of age. Seventeen children underwent surgery for congenital heart disease and all survived without clinical signs of neurological complications. Samples for plasma concentrations of S-100 in these patients were taken on three occasions in connection with surgery: before the start of surgery, after CPB and finally 16-20 h after CPB. In the noncardiac group of 31 children, S-100 concentrations were measured on two occasions: before surgery and during surgery. In both groups, a significant increase in S-100 concentrations was observed during surgery, although the increase in the CPB group was significantly higher than in the noncardiac group. The CPB group included four children with Down's syndrome who had higher mean S-100 concentrations on all sampling occasions compared to the remaining patients. The peak S-100 concentrations after cardiac surgery were related to the duration of CPB, the time from the termination of CPB to the first post-CPB sample, as well as mean arterial pressure and cerebral arteriovenous lactate difference during rewarming. All the children studied (Down's patients excluded) had age-dependent plasma concentrations of S-100 measured before surgery. It can be concluded that CPB initiates a marked but transient release of S-100 into the systemic circulation during open heart surgery in children who are not developing clinical signs of neurological sequelae. 相似文献
992.
Lönnqvist PA Westrin P Larsson BA Olsson GL Lybeck A Huledal G Bielenstein M 《British journal of anaesthesia》2000,85(4):506-511
We studied the pharmacokinetics after caudal block of ropivacaine(2 mg ml1, 1 ml kg1) performed in 20 childrenaged 18 yr undergoing subumbilical surgery, in this open,non- comparative, multicentre study. Venous blood samples werecollected up to 1236 h. The mean (SD) peak plasma concentration,0.47 (0.16) mg litre1, was achieved after 12249min. The free fraction was 5% and the highest individual peakplasma concentration of free ropivacaine was 0.04 mg litre1.Clearance was 7.4 (1.9) ml min1 kg1 and the terminalhalf-life 3.2 (0.8) h. Thus, the free plasma concentrationsof ropivacaine were well below those associated with toxic symptomsin adults and the capacity to eliminate ropivacaine seems tobe well developed in this age group. In this open study of 20patients, ropivacaine was well tolerated and provided satisfactorypostoperative pain relief without observable motor block. Br J Anaesth 2000; 85: 50611
* Corresponding author: Paediatric Anaesthesia and Intensive Care,KS/Astrid Lindgrens Childrens Hospital, SE-17176 Stockholm, Sweden 相似文献
993.
Marstrand JR Rostrup E Rosenbaum S Garde E Larsson HB 《Journal of magnetic resonance imaging : JMRI》2001,14(4):391-400
Changes in cerebral blood flow (CBF) induced by Acetazolamide (ACZ) were measured using dynamic susceptibility contrast MRI (DSC-MRI) with both spin echo (SE) EPI and gradient echo (GE) EPI, and related to changes in internal carotid artery (ICA) flow measured by phase-mapping. Also examined was the effect of repeated bolus injections. CBF, cerebral blood volume (CBV), and mean transit time (MTT) were calculated by singular value decomposition (SVD) and by deconvolution using an exponential function as kernel. The results showed no dependency on calculation method. GE-EPI measured a significant increase in CBF and CBV in response to ACZ, while SE-EPI measured a significant increase in CBV and MTT. CBV and MTT change measured by SE-EPI was sensitive to previous bolus injections. There was a significant linear relation between change in CBF measured by GE-EPI and change in ICA flow. In conclusion, GE-EPI under the present condition was superior to SE-EPI in monitoring cerebral vascular changes. 相似文献
994.
Lunsjö K Ceder L Thorngren KG Skytting B Tidermark J Berntson PO Allvin I Norberg S Hjalmars K Larsson S Knebel R Hauggaard A Stigsson L 《Acta orthopaedica Scandinavica》2001,72(2):133-140
We compared the efficacy of the Medoff sliding plate (MSP) with 3 other screw-plate systems for fixation of unstable intertrochanteric fractures in a randomized multicenter trial of 569 elderly patients. The MSP has biaxial dynamic capacity along both the neck and the shaft of the femur unlike the other systems, which lack dynamic capacity along the shaft. 268 fractures were operated on with the MSP, and 301 with the dynamic hip screw (DHS), with or without a trochanteric stabilizing plate (DHS/TSP) or with the dynamic condylar screw (DCS). The MSP had recently been shown to the surgeons.The patients in the groups were similar as regards age, domestic situation, preinjury walking ability and type of fracture. We followed the patients clinically and radiographically for at least 1 year. There was no significant difference in walking ability at follow-up or rate of return to home. Fixation failure occurred in 18/268 fractures operated on with the MSP, in 8/238 with the DHS, in 3/49 with the DHS/TSP and in 1/14 with the DCS. The difference in the rate of fixation failure was not statistically significant when the MSP group was compared to the 3 other groups. In 14 of the 18 fixation failures in the MSP group, the biaxial dynamic capacity of the MSP had not been used due to technical errors by surgeons, unfamiliar with the new method. No selection bias was found regarding fracture types in the 2 subgroups of patients with correct or inadequate biaxial dynamization. Extramedullary fixation of unstable intertrochanteric fractures with these implants showed a low failure rate. When using the MSP, biaxial dynamization must be correctly performed. 相似文献
995.
Rapid appearance and onset of action of insulin aspart in paediatric subjects with type 1 diabetes 总被引:2,自引:0,他引:2
The pharmacokinetics of the novel, rapid-acting insulin aspart were compared with those of soluble human insulin following
subcutaneous administration in nine children (aged 6–12 years) and nine adolescents (aged 13–17 years) with stable type 1
diabetes. The study had a randomised, double-blind, two-period crossover design. Each patient received a single subcutaneous
dose of insulin aspart or human insulin (0.15 IU/kg body weight) 5 min before breakfast and the plasma insulin and glucose
concentrations were measured at intervals during the following 5 h. The pharmacokinetic profile of insulin aspart differed
significantly from that of human insulin with a higher mean maximum serum insulin (Cmax ins), 881 ± 321 (SD) pmol/l versus 422 ± 193 pmol/l for human insulin (P < 0.001); and with a shorter median serum insulin t
max ins, 40.0 min (interquartile range: 40–50 min) versus 75.0 min (interquartile range: 60–120 min) for human insulin, (P < 0.001). An age-related effect on Cmax ins and area under the curve (AUC0–5h ins) was observed with higher values in adolescents than in children for both insulin aspart and human insulin. Postprandial
glycaemic control was improved with insulin aspart; the baseline-adjusted ΔCmax glu being lower for insulin aspart compared with human insulin (increase of 7.6 ± 5.1 versus 9.4 ± 4.4 mmol/l respectively, P < 0.05). The incidence of adverse events was similar for the two insulin types.
Conclusion The more rapid onset of action of insulin aspart versus human insulin, previously observed in adults, is confirmed in a paediatric
population with type 1 diabetes.
Received: 30 June 1999 and in revised form: 20 September 1999 and 23 November 1999 /Accepted: 9 December 1999 相似文献
996.
Carina A Thorstensson Jenny Mathiasson Barbro Arvidsson Anders Heide Ingemar F Petersson 《BMC health services research》2008,8(1):231
Background
Objective was to describe variations in how social insurance officers conceive the cooperation with the health care in their daily work with sick leave. 相似文献997.
Sue-Chu M Karjalainen EM Laitinen A Larsson L Laitinen LA Bjermer L 《Respiration; international review of thoracic diseases》2000,67(4):417-425
BACKGROUND: Asthma-like symptoms, methacholine hyperresponsiveness, use of inhaled steroids, airway inflammation, and increased tenascin expression in the reticular basement membrane have been reported in competitive cross-country skiers. OBJECTIVE: To investigate the effect of inhaled budesonide, 400 mug twice daily, on indices of airway inflammation in 'ski asthma', defined as asthma-like symptoms within the previous year and bronchial hyperresponsiveness to methacholine. METHODS: A randomised double-blind placebo-controlled parallel-group bronchial biopsy and bronchoalveolar lavage (BAL) study of 25 (19 male) competitive cross-country skiers (mean age 18 (16-20) years for a mean (range) treatment period of 22 (10-32) weeks over the competitive season. RESULTS: No changes were seen regarding cellular inflammation in the bronchial mucosa or tenascin expression. In the BAL fluid, both groups had a significant decrease in activated T-suppressor (CD8) lymphocytes and an increase in macrophages, with no differences across the groups. Within the budesonide group, there was a decrease in IL2 receptor-activated T-helper lymphocytes and an improvement in FEV(1). Asthma-like symptoms were unchanged in 17 (68%) skiers. Methacholine provocation test was negative in 15 subjects, and remained positive in 5 subjects in each group. The improvement in bronchial responsiveness occurred in both groups and was not accompanied by a decrease in cellular inflammation. CONCLUSIONS: We were unable to show any clear beneficial effect of budesonide in 'ski asthma'. As changes in training intensity probably accounted for the spontaneous improvement in bronchial responsiveness, more attention should be directed at reducing environmental stress to the airways than at attempting pharmacological modulation of induced inflammatory changes. 相似文献
998.
Barbro Eriksson Mats Bergstr m Anders Lilja H kan Ahlstr m Bengt L ngstr m Kjell
berg 《Acta oncologica (Stockholm, Sweden)》1993,32(2):189-196
Positron emission tomography (PET) makes it possible to study effects of medical treatment in vivo. Carcinoid tumors with liver metastases, especially those of midgut origin, produce serotonin via the precursors tryptophan and 5-hydroxytryptophan (5-HTP) and this overproduction contributes to the clinical symptoms of the carcinoid syndrome. Seven patients with histopathologically verified neuroendocrine tumors and liver metastases, five of whom with ileal carcinoids, one a lung carcinoid and one an endocrine pancreatic tumor, were included in the study. All patients had elevation of urinary 5-HIAA with the exception of one patient with a solitary liver metastasis of midgut origin. After an intravenous injection of 11C-5-HTP, PET was performed and the uptake of radioactivity in tumor tissue, normal liver and plasma were compared. All patients with elevated urinary 5-HIAA and also the patient with a solitary liver metastasis and normal urinary 5-HIAA had high accumulation and signs of a high rate of binding of 5-HTP in the liver metastases. The uptake was relatively homogeneous in midgut carcinoid liver metastases but in large necrotic metastases the radioactivity was localized to the periphery. In three patients PET examination was repeated after 3 months of interferon treatment and in agreement with circulating tumor markers and ultrasonography the uptake of 5-HTP was unchanged. Another patient who the somatostatin analog somatuline progressed on treatment and accordingly the uptake of 5-HTP also increased. The experience with PET in neuroendocrine gastrointestinal tumors is very limited. Our results so far indicate that 5-HTP can be used to visualize serotonin-producing neuroendocrine tumors and furthermore it might prove to be of value to monitor the effects of treatment, possibly also as an early predictive test of the outcome of treatment. 相似文献
999.
Nils Mandahl Bo Baldetorp Mrten Fern Mns kerman Anders Rydholm Sverre Heim Helena Willn Dick Killander Felix Mitelman 《International journal of cancer. Journal international du cancer》1993,53(3):358-364
Samples from 48 benign and 102 malignant bone and soft-tissue tumors were analyzed cytogenetically and by DNA flow cytometry. Clonal chromosome abnormalities were found in 82 tumors and normal karyotypes in 68; 61 tumors were DNA-non-diploid and 89 were diploid. The cytogenetically abnormal tumors were used for comparison between the 2 types of investigation; 45 of these tumors were DNA-diploid and 37 were DNA-non-diploid. There was, with few exceptions, good correspondence between the quantitative estimates of genomic changes by the 2 methods, indicating that the cells cytogenetically analyzed from short-term cultures are representative of the in vivo cell populations. Discrepancies were primarily found in cases with indexes above 1.5, in which the DNA index was higher than the chromosome index. The chromosome analysis suggested that skewed stemline (G0/G1) peaks in the diploid region in DNA histograms indicate the presence of cell populations with small net quantitative genomic changes, although not all such populations were detected by DNA flow cytometric analysis. The view that one of the peaks in bimodal stemline DNA histograms with narrow peaks represents a non-diploid cell population was also corroborated. On average, the cell populations giving rise to double stemlines in DNA histograms showed quantitatively larger genomic changes than those that gave rise to broad or skewed diploid G0/G1 peaks. The findings indicate that these histogram profiles are not artifactual but reflect chromosomal changes in the tumor parenchyma. 相似文献
1000.
LO Larsson MW Bentzon K Berg Kelly L Mellander B-E Skoogh I-L Strannegård A Lind 《Acta paediatrica (Oslo, Norway : 1992)》1994,83(10):1091-1094
We studied 3592 Swedish schoolchildren, 8 or 9 years old, examined for palpable submandibular, cervical and supraclavicular lymph nodes. All children were skin tested with 2 TU PPD RT23 and with 0.1 μ g of Mycobacterium avium sensitin or 0.1 μ g of M. scrofulaceum sensitin. A total of 991 children had palpable lymph nodes in any of the three locations. Among them, 811 had lymph nodes in one location, 162 in two locations and 18 in three. In 312 children, the lymph nodes were ± 5 mm in size in any location. The most common location was submandibular. Boys had a significantly higher prevalence of palpable lymph nodes than girls. There was also seasonal variation. Children infected by atypical mycobacteria (sensitin reaction ±6 mm) did not have a higher prevalence of palpable lymph nodes than those not infected. 相似文献