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81.
Barry Finkelstein DPM Ravi Kamble DPM Edward Ferdinando DPM Neville Mobarakai MD 《The Journal of foot and ankle surgery》2003,42(6):366-370
Gas-producing diabetic foot infections are limb-threatening emergencies commonly encountered by foot and ankle surgeons. Appropriate treatment includes aggressive surgical debridement, parenteral antibiotics, and postoperative wound care. The authors present a unique case of a patient who refused treatment for a deep-space gas-producing infection, resulting in autoamputation of the foot. The authors also discuss the confusion surrounding the definition of gas gangrene. 相似文献
82.
Background: The gastric bypass operation has evolved since 1966 when it was first introduced. The purpose of this study was
to determine the present state of gastric bypass by consensus among the members of the American Society for Bariatric Surgery
(ASBS). Method: A questionnaire was sent to all members of the ASBS. Forty-three percent responded reporting over 41,200 cases.
Results: Results were analyzed by using χ2 tests with a null hypothesis. Surgeons agreed on several technical aspects, preferring a vertical to a horizontal stapleline;
estimating, rather than measuring, the pouch volume at an average of 22 cc. Few surgeons divide the short gastric vessels,
and only 25% of surgeons polled use a restrictive ring or band proximal to the gastroenterostomy. Most surgeons calibrate
the gastroenterostomy, reporting a preferred average diameter of 12.3 cm. There was no consensus regarding forming the gastroenterostomy,
58% preferring hand-sewn and 42% stapled anastomoses. There was no consensus regarding dividing the gastric pouch from the
bypassed stomach: Conclusion: The preferred gastric bypass is vertical, with the pouch estimated at 20-25 cc, and the gastroenterostomy
calibrated at 12 mm diameter. The short gastric vessels need not be divided, and restrictive bands or rings are not preferred.
This technique of gastric bypass should be used as the control procedure when modifications are tested in future trials. Randomized
prospective studies are suggested to probe the benefits of division of the stomach pouch from the bypassed stomach. 相似文献
83.
84.
Meningeal hemangiopericytoma of the posterior fossa and thoracic spinal epidural space: case report.
The rare combination of spinal and intracranial meningeal hemangiopericytomas in the same patient is reported. The coexistence of cerebral and spinal meningiomas of all histological subtypes is distinctly uncommon with only nine cases found in the literature. 相似文献
85.
Sidestream versus mainstream carbon dioxide analyzers 总被引:1,自引:0,他引:1
86.
B.H. Lim MRCOG FRNZCOG C.L. Barry MBBS G.H. Brown MRCOG 《The Australian & New Zealand journal of obstetrics & gynaecology》1991,31(1):20-21
We describe a case of preeclampsia with the HELLP (Haemolysis, Elevated Liver enzymes, Low Platelets) syndrome and highlight the delayed diagnosis due to its nonspecific presentation. This syndrome is associated with significant maternal and perinatal mortality and morbidity and we discuss the importance of early recognition of the condition, aggressive management and a multidisciplinary approach. 相似文献
87.
Subcutaneous melatonin implants were administered to castrated hand-reared male red deer (Cervus elaphus) during a 63 d period in spring, after which effects on voluntary feed intake (VFI), rumen pool size, rumen capacity (i.e. volume) and heart rate were measured on four occasions, evenly spread over a 12-month period, with the deer individually fed indoors on a diet of lucerne (Medicago sativa) chaff. Blood samples for hormone determinations were taken at intervals throughout the study. Day-time plasma melatonin concentration was approximately 5 pg/ml in control animals, whereas during melatonin administration it increased to 60-150 pg/ml and declined to 30 pg/ml by 142 d after the last implantation. Melatonin administration markedly depressed plasma prolactin concentration during the period of implantation, but thereafter plasma prolactin concentration rose in the treated animals during autumn and winter, whilst it declined in control animals over this period. VFI, rumen pool size and heart rate in control animals attained highest values in summer and lowest values in winter, showing a pronounced seasonal cycle. Melatonin administration depressed all these values in late spring and summer and increased all the values in autumn and winter, relative to control animals, and appeared to move the cycles by approximately 6 months. Melatonin-treated animals showed maximum values for all these measurements during winter. The castrated male deer showed little seasonal change in live weight, which was not affected by melatonin administration. The findings support the view that melatonin probably mediates the effect of daylength on digestive function in red deer. Rumen capacity remained relatively constant throughout the year, but rumen pool size as a proportion of rumen capacity increased with increasing VFI. 相似文献
88.
Ten patients with DSM-III-R obsessive-compulsive disorder (OCD) underwent the desipramine (DMI) growth hormone (GH) stimulation test as well as the dexamethasone suppression test (DST). The results were compared with the responses in a group of matched healthy controls. The GH response to DMI did not differ between patients and controls and 9 of 10 patients showed cortisol suppression in response to dexamethasone. The data suggest that neither alpha 2 adrenergic dysfunction nor DST non-suppression are features of primary OCD. 相似文献
89.
90.
The presence of depression was evaluated in a cross-section of 50 outpatients with dementia using the self-rated Geriatric Depression Scale and the clinician-rated Cornell Depression Scale. Impaired insight, as manifested by unawareness of dementia, correlated with dementia severity and discriminated a group of patients in whom the self-rated scale failed to show evidence of depression. Discrepancy between the two types of scales occurred among mildly as well as moderately demented patients when insight was impaired. Recognition of this discrepancy suggests that reliance on self-ratings may underestimate the presence and degree of depression among patients with dementia. 相似文献