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11.
Georgios Amoiridis Ludwig Gutmann Dennis E. Wilkins Raja Sawaya Alain Lagueny Roger Marthan Philippe Schuermans Philippe Le Collen Xavier Ferrer Jean Julien Reha Kuruoglu Shin J. Oh Brian Thompson A. Aggarwal L. Gutmann A. Gutierrez Okifumi Nakazato Russel Johnsen Philip Morling B. A. Kakulas 《Muscle & nerve》1994,17(2):245-253
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PURPOSE: The gum elastic bougie (GEB) has been in use for a long time and allows tracheal intubation in most cases of difficult direct laryngoscopy. Use of the GEB when anatomical landmarks of the upper airway are not recognizable has not been reported. We describe our experience of airway management with the GEB in cases of severe upper airway distortion. CLINICAL FEATURES: Four patients with severe respiratory distress caused by upper airway distortion secondary to various non-malignant causes were managed with the GEB. For these four patients, a rapid sequence induction of anesthesia was performed with a surgeon present during the procedure. The GEB was used as the initial intubating technique in all cases and allowed a rapid and successful tracheal intubation in spite of non-recognizable anatomical structures. The distal hold-up feeling after GEB insertion confirmed, in all cases, the correct intratracheal position of the GEB. CONCLUSION: The GEB can be a valuable tool in cases of difficult airway management caused by upper airway distortion. The lack of visualization of normal pharyngeal structures did not prevent the successful insertion of the GEB in the trachea in the four patients reported. 相似文献
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Bernhard Z?llner Heinz-Hubert Feucht Martina Sterneck Hansj?rg Sch?fer Xavier Rogiers Lutz Fischer 《Liver transplantation》2006,12(8):1283-1289
Hepatitis B virus (HBV) DNA is detectable in a number of liver transplant candidates who are negative for hepatitis B surface antigen (HBsAg). After liver transplantation (LT), such patients may have molecular and/or serologic evidence of HBV replication. However, clinical disease from reactivation of occult HBV infection after LT has not been described. We report a patient who underwent LT for cryptogenic cirrhosis and had to be retransplanted twice for hepatic artery thrombosis. The patient was negative for HBsAg and positive for anti-hepatitis B core (HBc) and anti-HBs before all LT procedures and developed acute hepatitis B shortly after receiving the third graft. The HBV strain isolated at that time exhibited an unusual in frame insertion of a CAG motif within the HBV polymerase (HBV(INS+)). HBV(INS+) was detected retrospectively as a minor species in pretransplantation sera and the explanted native liver by insertion-specific polymerase chain reaction. This case in an occult HBV carrier shows that clinically apparent, endogenous reinfection of the graft may occur with minor HBV variants that are not detectable in pretransplantation samples by standard diagnostic procedures. This has implications for the analysis of sources of acute hepatitis B in patients after LT and possibly for consideration of antiviral prophylaxis in anti-HBc/anti-HBs/HBV DNA-positive patients. 相似文献
17.
Mònica Gratacòs Juan R González Josep M Mercader Rafael de Cid Mikel Urretavizcaya Xavier Estivill 《Neuropsychopharmacology》2007,61(7):911-922
BACKGROUND: There is an increasing recognition that the pathophysiology of mental disorders could be the result of deregulation of synaptic plasticity with alterations of neurotrophins. The valine (Val)66-to-methionine (Met) variant, located in the pro brain-derived neurotrophic factor (BDNF) sequence, has been extensively studied through linkage and association approaches in several psychiatric disorders. METHODS: We performed a meta-analysis restricted to individual case-control studies in different categories of mental disorders and BDNF Val66Met polymorphism. We included data from 39 case-control studies encompassing psychiatric phenotypes: eating disorders, substance-related disorders, mood disorders, and schizophrenia, among others. RESULTS: The association of Val66Met was confined to three diagnoses: substance-related disorders, eating disorders, and schizophrenia. The Val/Met and the Met/Met genotypes increase the risk for eating disorders up to 33%, while these same genotypes confer a 21% protective effect in substance-related disorders. The homozygous carriers Met/Met showed a 19% increased risk of schizophrenia with respect to the heterozygous state. CONCLUSIONS: The study confirms the association of Val66Met to substance-related disorders, eating disorders, and schizophrenia. It remains to be determined if other variants in tight linkage disequilibrium with Val66Met could configure an extended functional haplotype that would explain observed discrepancies in risk estimations across studies. 相似文献
18.
Permanent access to the portal system for cellular transplantation using an implantable port device.
Ahmed A Darwish Etienne Sokal Xavier Stephenne Mustapha Najimi Jean de Ville de Goyet Raymond Reding 《Liver transplantation》2004,10(9):1213-1215
A novel application of the implantable Port-a-Cath (PAC) system is described in the context of cellular transplantation. A silicone catheter was inserted in a collateral branch of the portal vein and connected to a port device positioned subcutaneously on the left thoracic cage. This permanent vascular access allowed iterative intraportal infusions of allogenic hepatocytes without the need of repeated transhepatic catheterization of the portal vein. Using this technique, repeated infusions of cryopreserved and / or fresh hepatocytes were successfully carried out in 3 children with inborn errors of liver metabolism, with the aim of progressively providing a sufficient mass of transplanted liver cells to stabilize the metabolic condition of the patients. We suggest that this technique might also be valuable in pancreatic islet cell transplantation. 相似文献
19.
Marc Tey Joan C. Monllau Josep M. Centenera Xavier Pelfort 《Knee surgery, sports traumatology, arthroscopy》2007,15(10):1235-1239
The purpose of this work was to describe the posterior ankle impingement syndrome related to the posterolateral tubercle of
the talus bone and to present a retrospective analysis of our results after arthroscopic plasty of the tubercle in 15 ankles
with a mean 3-year follow-up. Fifteen cases of posterior ankle impingement (PAI) underwent arthroscopic excision of an impinging
bone spur. All the patients (13) were retrospectively evaluated at an average of 36 months after index surgery. There were
seven women (bilateral in two of them) and six men. Ten were involved in different kinds of sport and three were professional
ballet dancers. Preoperative symptoms included pain localized in the posterior ankle, limitation of motion, weakness and swelling.
All patients had failed a course of conservative therapies. Surgery was performed through posterolateral and posteromedial
portals as described by van Dijk. After soft tissue debridement, partial resection of the posterolateral process was performed
until there was complete plantar flexion without bone impingement. Postoperatively, all patients followed the same rehabilitation
protocol. Improvement in their impingement symptoms was recorded in all of them according to AOFAS score. One of them (7%)
still had occasional discomfort. The results suggest that arthroscopic bone decompression of the posterolateral tubercle in
cases of PAI resistant to non-surgical therapies is an effective treatment. 相似文献
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