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101.
Abstract One hundred eighty-one consecutive patients with fulminant hepatic failure (FHF) presenting in a 2-year period were reviewed. In this cohort we examined the impact of pretransplant renal failure on mortality and morbidity following orthotopic liver transplantation (OLTx). Twenty-seven patients (18 female, 9 male) with a median age of 43.5 years (range 19–65 years) underwent OLTx. FHF was due to idiosyncratic drug reaction ( n = 4), paracetamol overdose ( n = 3), seronegative hepatitis ( n = 17), hepatitis B ( n = 1), veno-occlusive disease ( n = 1), and Wilson's disease ( n = 1). Renal failure was present in 14 patients, 7 of whom died (whereas there was 100 % survival in patients without renal failure). Pretransplant renal failure was associated with prolonged mechanical ventilation (13 days vs 6 days, P = 0.05), prolonged intensive care stay (17 days vs 8 days, P - 0.01) and prolonged hospital stay (27 vs 21 days, P = NS). Pretransplant renal failure did not predict renal dysfunction at 1 year after OLTx. We conclude that the survival of patients transplanted for FHF is inferior to that of patients transplanted for chronic liver disease (67 % vs 88 % 1-year survival in Birmingham). For patients with FHF undergoing transplantation, pretransplant renal failure strongly predicts poor outcome with significantly greater consumption of resources. 相似文献
102.
刘达恩 《中国修复重建外科杂志》1997,11(2):83-85
总结胸腹轴型皮瓣早期修复上肢不同部位的深度蛇伤溃疡的经验,评价其应用价值。本组16例,胸脐皮瓣2例,侧胸腹皮瓣1例,髂腰皮瓣5例,下腹皮瓣6例,下腹分叶皮瓣1例,髂腰加下腹Y形皮瓣1例。术后1例皮瓣远端坏死,3例轻度感染,16例断蒂后全部成活。随访3个月~7年,皮瓣质地和弹性均好,手功能基本恢复。认为,带蒂胸腹轴型皮瓣是修复上肢深度蛇伤溃疡理想的方法。 相似文献
103.
G. Dewasmes B. Bothorel A. Hoeft V. Candas 《European journal of applied physiology》1993,66(6):542-546
Summary Thermoregulatory sweating [total body (m
sw,b), chest (m
sw,c) and thigh (m
sw,t) sweating], body temperatures [oesophageal (T
oes) and mean skin temperature (T
sk)] and heart rate were investigated in five sleep-deprived subjects (kept awake for 27 h) while exercising on a cycle (45 min at approximately 50% maximal oxygen consumption) in moderate heat (T
air andT
wall at 35° C. Them
sw,c andm
sw,t were measured under local thermal clamp (T
sk,1), set at 35.5° C. After sleep deprivation, neither the levels of body temperatures (T
oes,T
sk) nor the levels ofm
sw, b,m
sw, c orm
sw, t differed from control at rest or during exercise steady state. During the transient phase of exercise (whenT
sk andT
sk,1 were unvarying), them
sw, c andm
sw, t changes were positively correlated with those ofT
oes. The slopes of them
sw, c versusT
oes, orm
sw, t versusT
oes relationships remained unchanged between control and sleep-loss experiments. Thus the slopes of the local sweating versusT
oes, relationships (m
sw, c andm
sw, t sweating data pooled which reached 1.05 (SEM 0.14) mg·cm–2·min–1°C–1 and 1.14 (SEM 0.18) mg·cm–2·min–1·°C–1 before and after sleep deprivation) respectively did not differ. However, in our experiment, sleep deprivation significantly increased theT
oes threshold for the onset of bothm
sw, c andm
sw, t (+0.3° C,P<0.001). From our investigations it would seem that the delayed core temperature for sweating onset in sleep-deprived humans, while exercising moderately in the heat, is likely to have been due to alterations occurring at the central level. 相似文献
104.
Hilary Eadon Marlene Rose Richard O'Neill Neil Leaver Magdi Yacoub 《Transplant international》1995,8(1):35-40
Pharmacokinetic profiles were obtained for 16 heart or lung recipients following the administration of identical doses of cyclosporin as oral solution and capsules on consecutive days. A comparison of pharmacokinetic parameters (AUC, Cmax, Cmin and tmax) showed that there were no significant differences between the two formulations except for the tmax, which was significantly longer for the capsules. The mean variation in day-to-day trough levels produced by the two different forms was 25.6%. A retrospective study was carried out of consecutive cyclosporin levels in patients at steady state on oral solution. The mean variation in day-to-day trough levels was 32.3%. This was not significantly different from the variation in consecutive trough levels seen in the oral solution/capsule comparison. This study shows that cyclosporin capsules can be substituted for oral solution without causing acute changes in cyclosporin blood levels, and that the pharmacokinetics of the two formulations are similar.This work was carried out in partial fulfillment of the requirements for the Master of Science Degree in Clinical Pharmacy, University of London 相似文献
105.
J. Pepke-Zaba T. W. Higenbottam A. T. Dinh Xuan J. P. Scott T. A. H. English J. Wallwork 《Transplant international》1990,3(1):108-112
Abstract. Twenty-one patients were studied at rest and during exercise after heart transplantation to compare cardiac output measured by thermodilution and impedance cardiography. Exercise was performed on a bicycle ergometer over a limited range of work load (25 and 50 watt) whilst metabolic gas exchange was recorded. One patient was studied at rest whilst his circulation was maintained by a Jarvik-7 artificial heart. The values of cardiac output measured by impedance cardiography corresponded closely with the flow rate from the artificial heart. There was also close agreement between the impedance and thermodilution measurements of cardiac output at rest and during exercise. Both measurements followed the changes in heart rate and oxygen consumption. Both thermodilution and impedance cardiography methods elicited good reproducibility of cardiac output measurements at rest and during exercise. These observations suggest that the noninvasive and continuous record of cardiac output obtained by impedance cardiography can be used for the postoperative monitoring of heart transplant recipients. 相似文献
106.
Treatment of rat heart grafts with PUVA, the combination of the photosensitizer 8-methoxypsoralen and longwave ultraviolet light, leads to a prolonged transplant survival in allogeneic recipients. A PUVA treatment of the recipient rats, performed for 7 consecutive days after transplantation, prolonged graft survival even more effectively. This may be due to the systemic immunomodulatory effects of PUVA in the recipient. One of the mediators is urocanic acid, which is transformed by ultraviolet light in the skin from its trans- to the cis-isomer, which, in turn, acts as a mediator on the immune system. An injection of cisurocanic acid into graft recipients for 7 consecutive days after transplantation resulted in prolonged graft survival; in 40% of the rats, permanent graft acceptance was observed. The significance of these results for clinical organ transplantation is discussed. 相似文献
107.
真皮下血管网岛状皮瓣抗菌力的实验研究 总被引:2,自引:0,他引:2
为研究真皮下血管网薄皮瓣用于感染创面的可行性,在家猪臀部两侧分别形成以旋髂深血管主干分支为蒂的传统岛状皮瓣和远侧50%修薄的真皮下血管网岛状皮瓣。用细菌计数、吖啶橙荧光染色测定白细胞吞噬指数和白细胞内杀菌率,应用激光多普勒、墨汁灌注、透明标本等方法,对两种皮瓣的抗菌力作自身对照研究。结果表明,真皮下血管网岛状皮瓣的抗菌力明显降低,可能与皮瓣修薄后血供减少,白细胞功能相应降低有关。 相似文献
108.
109.
目的探讨前列腺素E1(PGE1)应用于尸体肾移植术后肾功能延迟恢复(DGF)患者对移植肾功能恢复的影响.方法回顾性分析因急性排斥(AR)和急性肾小管坏死(ANT)导致DGF的127例临床资料,其中应用PGE1治疗56例(PGE1组),未用PGE1者71例(对照组).比较两组在出现DGF后的透析治疗时间、肾功能恢复情况、彩超的移植肾血流阻力指数(RI)及6个月内AR发生率.结果与对照组比较,PGE1组透析治疗时间明显缩短(P<0.05),移植肾的血肌酐下降速度快(P<0.05),RI及6个月内AR发生率低(P<0.05).结论PGE1有利于尸体肾移植术后DGF患者移植肾功能的早期恢复,并能降低AR的发生率. 相似文献
110.
BACKGROUND: Recalcitrant gingival erythematous lichen planus/lichenoid lesions comprise a considerable therapeutic problem. The objective of this study was to evaluate the therapeutic effect of grafting keratinized oral palatal mucosa to the sites of gingival lichen. METHODS: In 12 patients 20 grafts were transplanted to buccal gingival lesions. Mean age of the patients was 59.8 +/- 7.1 years (range 46-71 years). The mean observation time was 32 +/- 32.7 months (range 5-97 months). RESULTS: On a 4-point clinical grade scale (0-3), 12 (60%) transplants showed complete healing grade 3, six (30%) grade 2 and two (10%) grade 1. CONCLUSIONS: Using oral mucosal grafts from the palatal mucosa for the treatment of recalcitrant erythematous gingival lichen planus/lichenoid lesions seems to be a promising treatment modality. 相似文献