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91.
Tetsuji Kai Yang Il Kim Hirokazu Kitamura Katsunori Kawano Seigo Kitano 《Journal of Hepato-Biliary-Pancreatic Surgery》1997,4(4):423-430
There is a growing body of evidence that the cytokine, tumor necrosis factor-α (TNF-ga), plays an important role in the development
of hepatic ischemia/reperfusion injury. We found that the immunosuppressants, cyclosporine-A (CsA), azathioprine, and FK506,
have protective effects on such injury. The purpose of the present study was to elucidate mechanisms involved in these beneficial
effects of the immunosuppressant, CsA, on liver injury following cold preservation and transplantation, with special reference
to the suppression of TNF-α release. Rat livers were stored in Euro-Collins solution (EC) at 4°C for 6h and orthotopically
transplanted. The animals allotted to two groups: group A (untreated controls) and group B (CsA pretreatment of recipients).
CsA (10 mg/kg, p.o.) was given for 3 consecutive days preoperatively. CsA pretreatment of the recipients significantly improved
the 2-week survival rate (0/6 for group A, 3/6 for group B;P<0.05) and this was associated with a significant decrease in serum TNF-α levels 2h posttransplantation (group A, 69.8±15.7
pg/ml; group B, 22.8±6.8; mean±SEM;n=12 each;P<0.05) and amelioration of sinusoidal endothelial injury, assessed by electron microscopy. Plasma endotoxin levels following
reperfusion of the grafts were not altered by the CsA therapy. Morphologically, CsA pretreatment of the recipients did not
alter activation of Kupffer cells. CsA pretreatment of the recipient aids in preventing cold preservation/reperfusion injury
of the liver graft, possibly by modulating effects of TNF-α. 相似文献
92.
Frank Diesner Dr. med. Dag Moskopp Christoph Schul Hansdetlef Wassmann 《Neurosurgical review》1997,20(4):274-277
A 21-year-old man was injured by a tailboard of a truck. He suffered a severe head injury with bilateral depressed skull fractures necessitating surgical decompression. On admission to the hospital the patient showed bending to pain stimuli (Glasgow Coma Score 5). Anisocoria was noticed from the beginning. Initial intracranial pressure (ICP), measured 3 hours after injury, was 30 mm Hg, and the cerebral perfusion pressure (CPP) was 70 mm Hg. During surgical elevation of the skull fracture on the right side an unexplainable rise of ICP to values of 100 mm Hg occurred, which corresponded to the mean arterial blood pressure (MAP). At the same time both pupils were dilated and fixed indicating a lack of cerebral perfusion. Due to immediate trephination of the opposite side, the ICP was lowered to values below 20 mm Hg, and sufficient cerebral perfusion (above 50 mm Hg) was regained. The patient showed a good recovery and was transferred to a rehabilitation center 5 weeks after injury.This case report emphasizes the importance of early and continuous intracranial pressure monitoring for adequate therapy in neurosurgical emergencies. 相似文献
93.
胚胎脊髓细胞悬液植入急性成年大鼠损伤脊髓 总被引:6,自引:2,他引:4
目的:建立胚胎脊髓细胞悬液移植于脊髓损伤模型,以评价其治疗脊髓损伤的可能性。方法:42只Wistar大鼠以改良Alen法(50gcm)打击脊髓,3天后将孕14天(E14)FSCS20μl植入损伤空腔,移植后2、4、6、8、10、12周,以光、电镜、免疫组织化学观察移植物存活、分化及其与宿主之间关系。结果:移植细胞逐渐长大。充满不规则空腔,宿主NF、5-HT、CGRP纤维分别出现于移植物,GFAP纤维于宿主移植物交界处适量存在。移植成神经细胞、成少突胶质细胞、成星形细胞的细胞器日渐完善,细胞功能活跃。复杂及多样突触与细胞连接,将上述细胞与神经纤维、胶质纤维、毛细血管网在三维空间内连接成一体,并与宿主紧密嵌合。结论:(1)成年大鼠脊髓损伤3天后植入FSCS可以存活。(2)移植物进入宿主后,出现再分布,继而器官样分化。(3)长、短传导束进入移植物,显示了移植物的桥作用。(4)成少突胶质细胞的神经营救作用。(5)移植区内出现多种突触,提示移植物中继作用的可能性。 相似文献
94.
川芎嗪对脑外伤患者血栓素、前列腺环素及颅内压的影响 总被引:6,自引:0,他引:6
28例重度脑外伤患者分为川药嗪治疗组和一般治疗对照组,两组病人均于用药前和用药后3小时测定血浆和脑室内脑脊液(VCSF)中血栓素代谢产物(TXB_2)前列腺环素代谢产物6—酮—PGF_(la)(6KP)和颅内压。结果表明:两组治疗前血浆、VCSF中TXB_2及T/K均明显高于正常献血员对照组,川芎嗪能降低脑外伤患者血浆、VCSF中TXB_2及T/K值,对颅内压则无明显影响。提示川芎嗪能抑制脑外伤对血小板的激活、纠正循环血中TXA_2—PGI_2平衡失调,从而改善脑微循环。 相似文献
95.
96.
Richard Sacknoff M.D. Robert A. Novelline M.D. James T. Rhea M.D. J. Nash Lawrason M.D. Patrick M. Rao M.D. 《Emergency radiology》1997,4(2):109-111
A 36-year-old man was brought to the emergency department after being assaulted. A mandible series showed a nondisplaced fracture through the angle of the mandible extending through the left third molar tooth. Axial slices from a nonhelical computed tomographic (CT) examination of the head as well as a helical CT examination of the mandible failed to demonstrate the fracture. The fracture was well shown, however, on sagittal CT reformations. Although CT is generally regarded as more sensitive than plain radiography for the detection of fractures, fractures may be overlooked by CT if examination in only one plane is performed. 相似文献
97.
Gérald Vanzetto Marc Janier Daniel Fagret Luc Cinotti Xavier André-Fouet Michel Comet Jacques Machecourt 《European journal of nuclear medicine and molecular imaging》1997,24(2):170-178
The best test presently available to ascertain residual viability within an infarct-related area involves the use of fluorine-18
fluorodeoxyglucose (FDG) to detect the persistence of some cellular metabolism. Rest reinjection of thallium-201 is a less
accurate alternative but is easy to perform. Iodinated fatty acids, which are used with standard gamma cameras, are proposed
as markers of cellular metabolism. This study was performed to assess the value of 16-iodo-3-methyl-hexadecanoic acid (MIHA)
as a marker of the residual cellular metabolism by comparison with FDG in patients with a recent myocardial infarction, and
to evaluate its contribution compared with the201Tl stress-redistribution-reinjection technique. Stress-redistribution-reinjection201T1 imaging, rest MIHA imaging and glucoseloaded FDG imaging were performed in 22 patients with recent myocardial infarction.
Out of the 628 myocardial segments obtained from the left ventricular analysis, 400 were hypoperfused (relative uptake <0.75
of maximum uptake on stress201T1 imaging), 177 of which were severely hypoperfused (relative uptake <0.50). Receiver operating characteristic (ROC) curves
for predicting metabolic myocardial viability with FDG were derived from the results in respect of (a)201T1 activity during exercise, redistribution and reinjection and (b) MIHA up-take, using the two FDG thresholds most commonly
considered to define metabolic viability (0.50 and 0.60). Analysis of the 400 hypoperfused segments demonstrated that201T1 reinjection was the most accurate test in predicting the presence of myocardial viability (area under the ROI curves=0.85
and 0.86 at the 0.50 and 0.60 FDG thresholds, respectively;P<0.05 vs other tests). The global predictive values of MIHA and201T1 reinjection were, respectively, 0.87 and 0.89 at the 0.50 FDG threshold (NS), and 0.82 and 0.87 at the 0.60 FDG threshold
(NS). When only the 177 severely hypoperfused segments were considered,201T1 reinjection remained the most accurate test (accuracy 0.84 at the 0.50 FDG threshold and 0.82 at the 0.60 FDG threshold),
while the accuracy of MIHA decreased significantly (0.78 at the 0.50 FDG threshold and 0.73 at the 0.60 FDG threshold,P<0.05 vs201T1 reinjection). In all circumstances, MIHA was less specific than201T1 reinjection for the detection of metabolic viability. In conclusion, in patients with recent myocardial infarction, MIHA
accurately detects the persistence of metabolic viability, but is not superior to201T1. 相似文献
98.
Summary 115 traumatic extradural haematoma cases who were treated surgically at Cerrahpasa Medical Faculty Neurosurgery Department between 1987 and 1992 are evaluated.When factors affecting the outcome were examined, a strong correlation was found between the result andGlasgow coma scale (GCS) (p<0.00001). The existence of a fracture, the interval between onset of haematoma symptoms and intervention and the existence of an intracerebral haematoma together with contusion accompanying intradural haematoma, affect the outcome in a negative direction. There was no statistical correlation between the outcome and the age of patient, localization of the haematoma and aetiology. 相似文献
99.
100.
本文报告了用高压氧治疗脊髓损伤伴截瘫患者12例,肢体慢性溃疡8例。将患者置于2个大气压的单人氧舱内,每次90min。前者疗程为1周,每日2次。后者疗程为2周,每日1次。治疗结果:脊髓损伤伴截瘫患者中8例有明显而有意义的功能恢复,占66.6%。慢性溃疡患者中有3例愈合,4例好转,有效率为85%。作者认为:早期使用高压氧是治疗急性截瘫,尤其是不完全性截瘫的一种安全有效的方法。高压氧治疗可加速慢性溃疡创面的愈合,但不能取代溃疡面的局部处理。 相似文献