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11.
Paul Devakar Yesudian MD Srivilliputtur G.S. Krishnan MBBS Muriugaiya Jayaraman MD Vanakampadi R. Janaki MD Patrick Yesudian FRCP 《International journal of dermatology》1997,36(3):194-196
Background Pemphigus is a group of vesiculobullous disorders in which the blisters usually heal with hyper- or hypopigmentation. The appearance of acanthomata at sites of previous blisters has been noted in some cases. Methods All cases of pemphigus admitted to the Madras Medical College hospitals during a 2-year period from March 1993 to March 1995 were taken into the study and screened for the presence of acanthomata. Results Fifty-two cases of pemphigus were identified, 47 of pemphigus vulgaris and five of pemphigus foliaceus; and of these 13 developed acanthomata when the blisters healed. Ten of these cases were of pemphigus vulgaris and three were of pemphigus foliaceus; biopsy of these lesions showed hyperkeratosis, acanthosis, papillomatosis, and intraepidermal clefting. Immunofluorescence carried out in two of these acanthomata also showed intercellular fluorescence. Conclusions The occurrence of acanthomata in healed lesions of pemphigus is not uncommon; because histopathologic and immunofluorescence evidence of disease activity is present, cases of this sort require careful follow-up. 相似文献
12.
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
13.
U.M. Hodges BSc Hons MBBS FRCA S. Berg BSc MBBS FRCA S.K. Naik FRCS S. Bower MBChB PhD A. Lloyd-Thomas MBBS FRCA M. Elliot MD FRCS 《Journal of cardiothoracic and vascular anesthesia》1994,8(6)
Modified ultrafiltration after cardiopulmonary bypass in children has been shown to be associated with an increase in arterial blood pressure. As part of a series of studies to investigate the possible causes of this blood pressure elevation, the hypothesis that if filtration was removing a significant amount of fentanyl, then the increase in blood pressure might be due to pain was proposed. Ten children, aged between 0.5 and 9.3 years (median 3.8 years), weighing 5.9 to 25..5 kg (median 15.7 kg), underwent corrective cardiac surgery (incorporating modified ultrafiltration). A standard anesthetic protocol was followed, with up to 78 μg/kg of fentanyl given prebypass for analgesia. After completion of cardiopulmonary bypass, modified ultrafiltration was commenced at 100 mL/min until a hematocrit of 35% was reached. Samples were taken of arterial blood (prefiltration, 3, 10, and 20 minutes postfiltration), the venous reservoir blood (prefiltration) and the filtrate (5 and 10 minutes into filtration). Hemodynamic data were recorded both prefiltration and postfiltration. The hemodynamic data showed the expected rise in both systemic arterial pressure and cardiac index after ultrafiltration. The plasma fentanyl concentrations did not significantly change after ultrafiltration: 1.59 to 12.39 ng/mL (median 6.27 ng/mL) prefiltration and 2.05 to 15.59 ng/mL (6.29 ng/mL) at 3 minutes, 2.22 to 12.64 ng/mL (6.87 ng/mL) at 10 minutes, and 1.83 to 11.52 ng/mL (5.85 ng/mL) at 20 minutes postfiltration. The concentration of fentanyl in the venous reservoir, 2.06 to 11.64 ng/mL (7.04 ng/mL), was not significantly different from the plasma levels. The level of fentanyl in the filtrate was significantly less than the plasma levels, 0.243 to 1.87 ng/mL (0.894 ng/mL) at 5 minutes and 0.385 to 1.688 ng / mL (0.952 ng / mL) at 10 minutes into filtration; (P < 0.02 by the Wilcoxon signed-rank method). The data show that the plasma fentanyl concentration was not significantly reduced by modified ultrafiltration. The fentanyl levels found prefiltration were maintained postfiltration, and the observed changes in systemic arterial pressure were not due to an acute fall in the plasma concentration of analgesic drug. 相似文献
14.
John F. Fraser MBChB ; Leila Cuttle BSc ; Margit Kempf BmedLSci ; Gael E. Phillips MBBS ; Peter K. O'Rourke PhD ; Kelvin Choo MBBS ; Mark T. Hayes PhD ; Roy M. Kimble MBChB 《Wound repair and regeneration》2005,13(2):189-197
Early to mid-term fetuses heal cutaneous incisional wounds without scars; however, fetal response to burn injury has not been ascertained. We present a fetal model of thermal injury and subsequent analysis of fetal and lamb response to burn injury. A reproducible deep dermal burn injury was created in the fetus by application of water at 66 degrees C for 7 seconds, and at 82 degrees C for 10 seconds to the lamb. Macroscopically, the area of fetal scald was undetectable from day 7 post injury, while all lamb scalds were readily identified and eventually healed with scarring. Using a five-point histopathology scoring system for alteration in tissue morphology, differences were detected between control and scalded skin at all stages in lamb postburn, but no difference was detected in the fetal model after day 7. There were also large differences in content of alpha-smooth muscle actin and transforming growth factor-beta1 between control and scalded lamb and these differences were statistically significant at day 14 (P < 0.01). This novel model of fetal and lamb response to deep dermal injury indicates that the fetus heals a deep burn injury in a scarless fashion. Further elucidation of this specific fetal process of burn injury repair may lead to improved outcome for patients with burn injury. 相似文献
15.
JOSHUA W. SALVIN MD MPH PETER C. LAUSSEN MBBS RAVI R. THIAGARAJAN MBBS MPH 《Paediatric anaesthesia》2008,18(12):1157-1162
Extracorporeal membrane oxygenation (ECMO) is increasingly used to support postcardiotomy cardiorespiratory failure in children with congenital heart disease. We report on survival outcomes and factors associated with survival for postcardiotomy ECMO patients. 相似文献
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Lymphatic drainage from the skin of the back to retroperitoneal and paravertebral lymph nodes in melanoma patients 总被引:4,自引:1,他引:3
Dr. Roger F. Uren MBBS Robert Howman-Giles MD John F. Thompson MD 《Annals of surgical oncology》1998,5(4):384-387
Background: Preoperative lymphoscintigraphy (LS) with99mTc antimony sulphide colloid is now part of the routine management of patients with intermediate thickness melanoma at the
Sydney Melanoma Unit. Over a 13-year period, 1375 patients have been examined using LS, and we have observed many unusual
lymphatic drainage pathways, including direct drainage through the body wall to retroperitoneal and paravertebral lymph nodes
from the skin of the back. The aim of this study was to determine the incidence of such drainage in the 542 patients who had
primary melanoma sites on the posterior trunk.
Methods: The lymphoscintigrams performed on these patients were examined for the presence of direct lymphatic drainage through the
posterior body wall to sentinel nodes in the retroperitoneal and paravertebral regions.
Results: Lymphatic drainage directly through the body wall to such lymph nodes occurred in 14 of these 542 patients.
Conclusions: Preoperative knowledge of the presence of this lymph drainage pattern may influence surgical management, and follow-up investigations
in these patients can be tailored to ensure that the relevant areas are examined with anatomic imaging or F18-FDG PET scans. 相似文献
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