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1.
Seventy patients, aged 1–20 years, were seen at Jordan University Hospital with high blood pressure (BP) over a 3-year period. BP values ranged from 140 to 230 mmHg for systolic pressure and from 90 to 130 mmHg for diastolic pressure. Essential hypertension was seen in only 6 patients (8.6%); secondary hypertension (n=64 or 91.4%) was due to renal parenchymal diseases (RPD) in 46 patients (65.7%), reno-vascular lesions in 8 (11.4%), renal transplantation in 5 (7.2%), teenage pregnancy in 4 (5.7%), and phaeochromocytoma in 1 patient (1.4%). The aetiologies of RPD were as follows: end-stage renal disease requiring dialysis in 14 patients, acute glomerulonephritis in 14, idiopathic nephrotic syndrome in 10, chronic renal insufficiency in 5, and polycystic kidney in 3 patients. Surgical cure of hypertension was achieved in 5 of the children with reno-vascular lesions and in the patient with phaeochromocytoma. 相似文献
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B. Nordlinger B. Jeppsson W. El-Khoury L. Hannoun P. Frileux C. Huguet M. Malafosse R. Parc 《HPB surgery》1992,5(2):123-133
A retrospective review of 56 patients operated upon for tumours of Oddi was performed in order to
determine optimal diagnostic and therapeutic procedures.
Common presenting symptoms were jaundice (86%) and anemia (21%). Mean size of the tumour was
2.3 cm. Five tumours were benign and 51 were malignant. According to the classification of Martin, five
were grade I: 10 grade II; 18 grade III; and 18 grade IV. Forty-seven patients underwent resection of the
tumour: three local excisions for small benign tumors, six ampullectomies (followed in three by a
Whipples’ procedure for recurrence) and 41 Whipples’ procedures. The hospital mortality was 5.3%,
minor complications appeared in 21%.
The overall five years survival was 41%. It was 75% in grade I, 50% in grade II, 40% in grade III and
10% in grade IV. The patients who received ampullectomies were alive with a follow-up of one, two and
three years. All patients operated upon for a benign tumour were alive except one who died of cardiac
failure. Ultrasonography and duodenoscopy are the most useful tests for the diagnosis of tumours of
Oddi. Prognosis depends on the degree of infiltration of the duodenal wall and the presence of positive
lymph nodes. Whipples’ procedure is best but ampullectomy can be used in elderly or poor risk patients.
Malignant tumours of the ampullary region are infrequent and reported to constitute betwee 0.02 and
five percent of all cancers of the digestive tract. With wider application of endoscopic techniques, there
has been an increasing interest in this group of tumours during recent years. In the literature tumours of
Oddi are usually reported in the group of periampullary tumours, including tumours of the ampulla
itself, duodenal wall surrounding the ampulla, the distal part of the common bile duct and head of the
pancreas. We have wanted to distinguish specifically the tumours of the ampulla of Vater and have
adopted the term tumour of Oddi introduced by Marchal and Hureau.The sphincter of Oddi exactly
delineates the junction between the bile duct, pancreatic duct and duodenum. We wanted to avoid using
the anatomic term ampulla of Vater, since this structure rarely appears as an ampulla. This then
excludes tumours in the head of pancreas, common bile duct above ths phincter of Oddi and tumours of
the duodenal wall adjacent to the papilla. These tumours seem to behave differently from other
pancreatic tumours, as they carry a different prognosis and need special attention. We have therefore
reviewed retrospectively 56 patients with tumours of Oddi with special reference to diagnosis,
histopathologic examination and surgical therapy. 相似文献
4.
El-Khoury AE Pereira PC Borgonha S Basile-Filho A Beaumier L Wang SY Metges CC Ajami AM Young VR 《The American journal of clinical nutrition》2000,72(1):122-130
BACKGROUND: We proposed previously that the mean lysine requirement value is approximately 30 mg * kg(-)(1) * d(-)(1) rather than the proposed 1985 FAO/WHO/UNU estimate of the upper range of the requirement, which is 12 mg * kg(-)(1) * d(-)(1). OBJECTIVE: Our objective was to explore the 24-h pattern and rate of whole-body lysine [l-(13)C]oxidation and status of whole-body lysine balance in healthy, young adults given an L-amino acid diet supplying either a low lysine intake (14-15 mg * kg(-)(1) * d(-)(1)) or an intermediate lysine intake (29 mg * kg(-)(1) * d(-)(1)) for 6 d before a continuous tracer study with L-[1-(13)C]lysine. DESIGN: Five subjects received the low lysine intake, 6 subjects received the intermediate intake, and all were studied by using a standard 24-h oral tracer protocol that was described earlier for studies at a generous lysine intake. RESULTS: The rate of lysine oxidation was not significantly different between the 12-h fasted and 12-h fed states. The daily oxidation rate (f1.gif" BORDER="0"> +/- SD) was 27. 9 +/- 8.8 and 27.3 +/- 17.6 mg lysine * kg(-)(1) * d(-)(1) for the low- and intermediate-intake groups, respectively (NS). Daily lysine balance was -12.4 +/- 92 and 1.8 +/- 17.7 mg * kg(-)(1) * d(-)(1), respectively (P < 0.025), for the low and intermediate intakes. The balance was significantly less than zero (P < 0.001) for the low intake. CONCLUSION: The FAO/WHO/UNU lysine requirement value is not sufficient to maintain lysine homeostasis in healthy adults. From the results of this and tracer studies done by others, the mean lysine requirement of healthy adults was determined to be 30 mg * kg(-)(1) * d(-)(1). 相似文献
5.
Contribution of individual projections alone and in combination for radiographic detection of ankle fractures 总被引:4,自引:0,他引:4
Brandser EA Berbaum KS Dorfman DD Braksiek RJ El-Khoury GY Saltzman CL Marsh JL Clark WA 《AJR. American journal of roentgenology》2000,174(6):1691-1697
OBJECTIVE: We wanted to determine whether the standard three-view ankle radiographic series could be replaced by a two-view combination, and if so, which two-view combination (anteroposterior with lateral or mortise with lateral) would be superior. MATERIALS AND METHODS: During a 12-month period, we retrospectively reviewed 556 consecutive ankle radiographic studies consisting of anteroposterior, mortise, and lateral views. One hundred twenty patients with at least one ankle fracture were paired with 140 healthy control subjects. Each image in the three-view examination was separated and sorted by view and studied independently; all images were reviewed by two skeletal radiologists and two orthopedic surgeons. Each radiograph was evaluated for fracture of the medial, lateral, and posterior malleoli and the foot using a five-point confidence rating. Performance of each view and modeled two- and three-view combinations of views was evaluated with modified receiver operating characteristic analysis. RESULTS: The data provide little support for preferring either two-view combination (anteroposterior-lateral or mortise-lateral) for any type of fracture. The three-view combination does detect significantly more fractures than some two-view combinations in some locations, and there is a statistically significant cost in diagnostic accuracy for eliminating the anteroposterior or mortise view. CONCLUSION: Reducing the ankle radiographic series from three to two views would result in a small but significant decrease in the detection of fractures of the ankle and foot. Both two-view combinations are equivalent for fracture detection. 相似文献
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8.
Riyad El-Khoury Kia K Kemppainen Eric Dufour Marten Szibor Howard T Jacobs Pierre Rustin 《British journal of pharmacology》2014,171(8):2243-2249
Mitochondrial disorders are nowadays recognized as impinging on most areas of medicine. They include specific and widespread organ involvement, including both tissue degeneration and tumour formation. Despite the spectacular progresses made in the identification of their underlying molecular basis, effective therapy remains a distant goal. Our still rudimentary understanding of the pathophysiological mechanisms by which these diseases arise constitutes an obstacle to developing any rational treatments. In this context, the idea of using a heterologous gene, encoding a supplemental oxidase otherwise absent from mammals, potentially bypassing the defective portion of the respiratory chain, was proposed more than 10 years ago. The recent progress made in the expression of the alternative oxidase in a wide range of biological systems and disease conditions reveals great potential benefit, considering the broad impact of mitochondrial diseases. This review addresses the state of the art and the perspectives that can be now envisaged by using this strategy.
Linked Articles
This article is part of a themed issue on Mitochondrial Pharmacology: Energy, Injury & Beyond. To view the other articles in this issue visit http://dx.doi.org/10.1111/bph.2014.171.issue-8 相似文献9.
Riyad B. Abu-Laban MD Kendall Ho MD Ron M. Walls MD 《The Journal of emergency medicine》1995,13(6):857-861
Mesenteric ischemia usually occurs in elderly patients, especially those with predisposing factors. It has also been described in young patients using oral contraceptive pills or illicit drags. We present a case of a middle-aged woman who developed acute focal ischemia of the small intestine without predisposing factors. The unusual presentation of this patient, combined with her relative youth, obscured the diagnosis, which was ultimately made at laparotomy. The diagnosis of mesenteric ischemia should be considered in patients of any age presenting with recurrent or severe abdominal pain, particularly when no alternative cause is apparent. The definitive study to diagnose mesenteric ischemia is angiography. Unless identified early in its course, the condition may progress to frank infarction with a significant increase in morbidity and mortality. Because of this, an aggressive approach to the diagnosis and therapy of mesenteric ischemia is essential. 相似文献
10.
Thoracoscopic sympathectomy: endobronchial anesthesia vs endotracheal anesthesia with intrathoracic CO2 insufflation 总被引:1,自引:0,他引:1
El-Dawlatly A Al-Dohayan A Riyad W Thalaj A Delvi B Al-Saud S 《Journal of anesthesia》2002,16(1):13-16
Purpose. To compare clinical advantages and hemodynamic and respiratory changes during one lung-collapsed ventilation (OLCV) using
a double-lumen tube (DLT) or a single-lumen tube (SLT) with intrathoracic CO2 insufflation, in patients undergoing thoracic sympathectomy (TS) under general anesthesia.
Methods. One hundred and twenty-five patients (94 men and 31 women) undergoing TS for the treatment of palmar hyperhidrosis (PH)
were randomly allocated to two groups: group A (68 patients; age, 29 ± 6 years) in whom DLT was used, and group B (57 patients;
age, 32 ± 3 years) in whom SLT with intrathoracic CO2 insufflation at a rate of 0.5–1 l·min−1 and sustained intrathoracic pressure at 6 mmHg insufflation were used. Anesthesia was maintained with 1 minimum alveolar
concentration (MAC) isoflurane in 50% nitrous oxide in oxygen with incremental doses of sufentanil and atracurium when required.
Arterial blood gases were measured in 10 patients in group B. Hemodynamic and respiratory parameters were obtained perioperatively.
Results. There were no significant differences in hemodynamic and respiratory parameters between the two groups during the study
phases, except for the arterial oxygen saturation (SpO2). The times required for anesthesia and surgery were significantly shorter in the SLT group than in the DLT group. SpO2 during OLCV was 95 ± 1% with DLT and 98 ± 1% with SLT, with a significant difference. Three patients had an SpO2 of less than 90% in the recovery room, where the chest tube position was readjusted, with no further sequelae.
Conclusion. General anesthesia with SLT and intrathoracic CO2 insufflation provides optimal operating conditions, adequate oxygenation, and perfect hemodynamic stability during TS.
Received: November 28, 2000 / Accepted: August 8, 2001 相似文献