Blood loss and replacement in total hip arthroplasty: a multicenter study. The Preoperative Autologous Blood Donation Study Group

To determine blood loss, the number of transfusions, and the hemoglobin levels achieved in patients via transfusion in the course of total hip arthroplasty, 324 patient records from 1987 through 1989 were reviewed at three university and three community hospitals. Calculated blood loss was 3.2 +/- 1.3 units in primary procedures and 4.0 +/- 2.1 units in revision procedures (mean +/- SD). Of 777 red cell units transfused, 455 (59%) were autologous units. Transfused patients received 2.0 +/- 1.8 units for primary procedures and 2.9 +/- 2.3 units for revision procedures (mean +/- SD). The maximum number of units given to 95 percent of the transfused patients was 4 for primary procedures and 6 for revision procedures. The mean postoperative hemoglobin level after all transfusions was 103 to 110 g per L, regardless of patient age group of physical status, autologous donor status, or hospital. No difference in length of hospital stay was observed for patients less than 65 years old with hemoglobin concentrations of 80 to 139 g per L at discharge.     

老年人的疼痛问题

何为"老"?理解衰老的最好办法是将其视为一种从生到死的过度和渐变过程.在人们眼中,一旦到了80岁,身体就会变得很衰弱,易受伤,易残疾.但凡事都有例外,最典型的例子就是著名的黑人领袖纳尔逊.曼德拉,他虽年事已高(88岁),但他的才学、智慧、饱经磨难和乐观豁达都是少有人能及的.     

Palmar Type of Median Artery as a Source of Superficial Palmar Arch: A Cadaveric Study with Its Clinical Significance

The superficial palmar arch (SPA) and its contributing arteries are highly variable. The palmar type of median artery (PMA) can be involved in the formation of the SPA by replacing the superficial palmar branch of the radial artery (RA) or the ulnar artery (UA). The present study was undertaken to investigate the presence of the PMA and its contribution in the formation of SPA in 42 cadavers (84 upper limbs) of Indian origin. When there was a PMA, its outer diameter was measured in the carpal tunnel. The PMA was found in 13 upper limbs (15.4%), and of these ten incidences (11.9%), the PMA took part in the formation of SPA, and in three instances (3.5%), the PMA did not make up part of the SPA. Out of the ten cases in which the PMA contributed to the formation of SPA, in six cases (7.1%), the PMA anastomosed with the UA; in three cases (3.5%), the PMA anastomosed with both the UA and the RA, and in one incidence (1.1%), the PMA joined the arteria radialis indicis (deep branch of the RA) to complete the SPA. The outer diameters of the median arteries varied between 0.8 and 2.6 mm with the mean value of 1.7 mm. The present study concludes that the median–ulnar type of SPA was the most common type of SPA when the PMA was encountered as a source of superficial arterial arcade of the hand, followed by the radial–median–ulnar type. The vascular patterns found in this study are important to hand surgeons. The present study of PMA origin, course, and its contribution to the SPA will add to the existing knowledge of the vascular anatomy of forearm and hand.     

止泻散敷脐治疗婴幼儿腹泻100例

0　引言　腹泻乃小儿最常见病 ,尤以 2岁以下婴幼儿最为常见 .年龄越小 ,发病率越高 ,且多在夏、秋季发病 .小儿患病后惧怕打针 ,服药以及输液 ,给治疗带来一些困难 . 12 a来 ,我们用自拟的止泻散敷脐治疗婴幼儿泄泻 ,效果良好 .1　对象和方法1.1　对象　 1998- 0 6 / 1999- 10婴幼儿腹泻发病高峰期门诊病例 10 0 (男 6 6 ,女 34 )例 ,年龄 2月龄～ 5岁 .肠炎 5 8例 ,单纯消化不良 42例 . 6 7例曾多次治疗 ,33例初诊 .凡接受治疗之患儿 ,一律停止用其他药物 .1.2　方法　药物组成 :川椒 12 g,干姜 12 g,小茴香 12 g,白芷 2 0 g,吴茱萸 5 g,…     

Synthesized MR images: comparison with acquired images

Synthesized and directly acquired spin-echo images were compared in order to assess the validity of magnetic resonance (MR) image synthesis as a method enabling retrospective formation of images by interactive manipulation of scan parameters. Synthetic images subjectively compared favorably in both accuracy and precision with acquired images when formed for the same values of echo (TE) and repetition times (TR) and for interpolated and extrapolated values of both TE and TR. Plots of synthetic and acquired signals within the same pixel sectors quantitatively showed comparable values for several regions of interest in the brain. Percent error and noise-normalized differences between acquired and synthetic images were tested as a quantitative measure of accuracy. Percent error was consistently less than 5% for brain parenchyma, and synthetic signals were accurate to within four times the noise level at acquisition. The apparent signal-to-noise ratio of synthetic images was comparable, superior, or inferior to similar acquired images, depending on the values of TE and TR. Total acquisition time required for synthetic formation of images for arbitrary values of TE and TR was equivalent to that of a single direct acquisition with a TR of 2,500 msec.     

Excretory urography with iohexol: evaluation in children

A multicenter clinical study was conducted using iohexol, a second-generation nonionic contrast medium, for excretory urography performed in 130 children. Doses of iohexol (300 mg iodine/ml) ranged between 150 and 660 mgI/kg (0.5 and 2.2 ml/kg). Iohexol was tolerated well, and no significant adverse reactions occurred. Sixty-five iohexol urograms were evaluated to determine the minimum dose for adequate visualization of the kidneys and collecting systems. A dose greater than 300 mgI/kg (1.0 ml/kg) always resulted in a urogram of diagnostic quality, while visualization was insufficient for diagnosis in 10% of studies done with doses of 150-300 mgI/kg (0.5-1.0 ml/kg). Another 65 iohexol urograms were compared in a blinded manner with a similar number of studies performed using iothalamate meglumine at comparable iodine concentration and dose. Visualization of calyces and pelvoinfundibular structures achieved with iohexol was rated better with statistical significance, but there was no difference in visualization of the renal parenchyma or ureters. Use of iohexol in excretory urography may be advantageous in children who are at greatest risk for an adverse reaction to contrast media or in those most likely to benefit from use of a low osmolality contrast agent.