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991.
我们对30例住院病人用荧光分光光度法测定了不同烧伤时间、不同烧伤指数(BI)血儿茶酚胺类(CA)释放量,以期了解病人的应激状况,同时测血糖(BS)和用放射免疫法测血胰岛素(SI)。结果表明烧伤后CA类释放是持续性的,且有休克和感染两个高峰(P<0.05,P<0.01);CA类释放主要是去甲肾上腺素(NE)的持续性增加,是正常量的两倍以上。休克期CA类释放如不增加,脓毒症阶段肾上腺素(E)与去甲肾上腺素从高值骤然下降,且低于休克期。提示:交感-肾上腺系统已处于衰竭状态,死亡似不可避免,而胰岛素分泌正常或相对不足。因此我们认为,CA类释放增加、糖原异生、胰岛β细胞分泌受抑制,是烧伤后全过程内分泌变化的主要原因。扩容纠酸、早期切痂预防感染以及使用抗CA类药物是防治的主要措施。 相似文献
992.
993.
Claude Clément MD Roberto Ruiz MD Bogdan Costa-Foru MD Hubert Nicaise MD 《Annals of vascular surgery》1990,4(3):305-308
Extrinsic compression of the renal artery due to a fibromuscular band originating from the diaphragm was encountered in a 26-year-old patient who had systemic hypertension associated with stenosis and kinking of one of her renal arteries. After surgical decompression, the renal artery assumed a normal expansion with disappearance of hypertension. Six other cases of extrinsic compression of the renal artery have been found in the literature. Surgical treatment is mandatory in all cases because the mechanism that causes the lesion makes percutaneous transluminal angioplasty illusory. 相似文献
994.
Yasuo Miyoshi Seigoh Mizumoto MD Hideo Akashi Eiji Kurokawa Hideyuki Mishima Keisuke Iihara Kohji Takami Masayuki Ohue Yukitoshi Aoki 《Surgery today》1990,20(6):711-714
A rare case of jejunal carcinoma coexisting with adenoma, situated 120 cm distal to the ligament of Treitz in a 53 year old
male, is reported herein. We also review cases of adenoma and carcinoma in the jejunum and ileum from the Japanese literature,
and discuss the histogenesis of carcinoma of the jejunum and ileum. 相似文献
995.
996.
John D. Hughes MD Changyi Chen MD Samer G. Mattar MB ChB Ayten Someren MD Beverly Noe BS Carolyn R. Suwyn BS Alan B. Lumsden MD 《Annals of vascular surgery》1996,10(2):123-130
Hypothermia and preservative perfusates have been used to decrease ischemic renal injury. This study was performed to identify the preservative function of perfusates independent of the effects of hypothermia. Rats underwent 45 minutes of renal ischemia. Rectal and renal parenchyma temperatures were monitored and maintained within 1° C of normal. Perfusates were University of Wisconsin solution (UW), Euro-Collins solution, normal saline solution, and Ringer's lactate solution. A nonperfused ischemic control and a nonischemic control group were also evaluated. Parameters evaluated included serum creatinine and blood urea nitrogen levels, renal ischemic injury grade, renal weight, and gross appearance of the injured kidney. Rats treated with UW solution were found to have a significantly lower creatinine, blood urea nitrogen, and injury grade than the other three perfused groups. The external gross appearance of the UW-treated kidneys was normal, whereas that of the other groups demonstrated moderate to severe injury. Although the mean right/left renal weight difference of the UW-treated group was lower than that of the other three groups, this was not statistically significant. Under normothermic conditions in rats, UW solution affords significant renal protection from ischemia. Euro-Collins, normal saline, and Ringer's lactate solutions display no significant protective effect.Presented at the Twentieth Annual Meeting of the Peripheral Vascular Surgery Society, New Orleans, La., June 10, 1995. 相似文献
997.
998.
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
999.
A 73-year-old woman presenting with persistent swelling of the right knee 30 months after total joint arthroplasty was found to have a Candida parapsilosis infection. Treatment with fluconazole resulted in full recovery. 相似文献
1000.
LAUREL MELLIN MA RD MARY CROUGHAN-MINIHANE PhD LARRY DICKEY MD MSW MPH 《Journal of the American Dietetic Association》1997,97(10):1133-1138
This study describes changes observed during a 2-year period in participants enrolled in The Solution Method, a developmental skills training program for adult weight management. This Intervention is the adult application of a model of treatment previously used only in the management of pediatric obesity (The Shapedown Program). Developmental skills training integrates understandings and methods from developmental, family systems, biomedical, genetic, and behavioral theories of the etiology of obesity. Twenty-two subjects (mean age=43.4±8.5 years and mean body mass index=33.1+5.3) completed a group intervention based on this method, which was conducted by a registered dietitian and a mental health professional. Questionnaire responses indicated the extent to which their weight was a medical and/ or psychosocial risk. Subjects attended 2-hour weekly sessions for an average of 18 weeks during which they were trained in six developmental skills: strong nurturing, effective limits, body pride, good health, balanced eating, and mastery living. Data, which were collected at the beginning of treatment and at 3, 6, 12, and 24 months, included weight, blood pressure, 7-day exercise recalls, and responses to depression and functioning (psychosocial, vocational, and economic) questionnaires. Participants’ weights decreased throughout the 2-year period of the study: mean weight change was −4.2 kg (3 months), −6.0 kg (6 months), −7.0 kg (12 months), and −7.9 kg (24 months). In addition, compared with baseline values, systolic and diastolic blood pressure, exercise, and depression improved throughout the study period. These improvements were statistically significant at 24 months for weight (p<.01), systolic blood pressure (p<.02), diastolic blood pressure (p<.001), and exercise (p<.001); the results were not statistically significant for depression. Most participants reported improvement in a broad range of aspects of functioning. We conclude that this application of developmental skills training for adult weight management may produce significant long-term beneficial effects. J Am Diet Assoc. 1997;97:1133–1138. 相似文献