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1.
Due to recent public debate and newly imposed resident work hour restrictions, we decided to investigate the relationship of resident call status to their ambulatory patients' satisfaction. Resident continuity clinic patients were asked to rate their level of satisfaction on a 10-point Likert-type scale. Using multiple regression approaches, these data were then assessed as a function of resident call status. We found that in 646 patient encounters, patient satisfaction scores were significantly less when the resident was postcall, 8.99 ± 1.8, than when not postcall, 9.31 ± 1.3. We herein discuss etiologies and implications of these findings for both patient care and medical education.  相似文献   
2.
目的:结合文献探讨腮腺导管癌的临床病理特征。方法:报道1例腮腺导管癌,就本病的临床生物学特征、病理、治疗及预后进行总结分析。结果:经手术及放疗后3个月复查,出现同侧颈部淋巴结转移。结论:腮腺导管癌是一类恶性度很高的恶性肿瘤,诊断主要依靠术后病理学及免疫组织化学检查,以局部广泛切除加颈廓清术为主,术后给予放疗。  相似文献   
3.
目的 分析81例肺鳞状细胞癌(鳞癌)临床特征,提高早期诊治率。方法 回顾性分析81例肺鳞癌诊断、手术、治疗及随访资料。结果 患者平均年龄62岁,男:女为2.2:1,有吸烟史76例(93.8%),平均26年,全组均有呼吸道症状,合并全身症状14.8%(12例)。确诊时间2~7个月。手术切除病肺63例(77.8%),术后放、化疗。未能切除18例中10例放、化疗。随访中位数5年以上。80例得到随访,1、3、5年生存率为90%(72例)、65%(52例)、47.5%(38例)。结论 肺鳞癌以老年男性多见,易误诊,手术切除率低,早期手术5年生存率高。  相似文献   
4.
Arterial spasm was induced by application of calcium chloride to the adventitial surface of the rabbit common carotid artery in vivo. Sodium chloride (NaCl) was applied to the contralateral vessel as control. Vessels were fixed in situ by intravascular perfusion after 15 min, 1 hr, or 24 hr and prepared for light and scanning electron microscopy (SEM). With SEM, the luminal surface at the site of calcium application showed severe longitudinal folding accompanied by endothelial desquamation with extensive platelet deposition on exposed subendothelium. The luminal cross-sectional area was reduced by 53 +/- 19.5% after 15 min and by 44 +/- 12% after 1 hr as compared with the contralateral control. Furthermore, the luminal area at the site of calcium application was found to be reduced by 42 +/- 8% after 1 hr when compared with segments of the same vessel distal to the site of calcium application. Blood flow rate, as measured by electromagnetic flow probe, was not reduced. Vessels examined after 24 hr showed a significant increase in luminal cross-sectional area as compared with contralateral control vessels (136 +/- 70%). Control vessels (NaCl) showed no significant change in luminal cross-sectional area and no endothelial desquamation or platelet deposition after 15 min, 1 hr, or 24 hr. Examination of histologic sections showed calcium precipitation within the attached thrombus after 15 min with calcium deposits also adherent to the adjacent luminal aspect of the internal elastic lamina (IEL). By 24 hr, this precipitation extended throughout the media. Marked deposition of leukocytes was seen after 24 hr which showed a preferential attachment for areas of endothelial damage and discontinuity of IEL.  相似文献   
5.
The effect of propranolol inhalation on sensitivity to methacholine inhalation was studied in normal and allergic rhinitis subjects to determine whether beta adrenergic blockade alters sensitivity to mediators in nonasthmatic atopic individuals. A partial beta adrenergic blockade is suggested as being instrumental in asthma. Hay fever patients studied showed similar effects and also developed asthma for the first time.  相似文献   
6.
DRw6 has been difficult to define serologically. In the present experiments we have developed T cell lines in order to characterize the components of a DRw6 haplotype. This was accomplished by priming T cells with allogeneic mononuclear cells mismatched for DRw6, Dw6, and MT2. Subsequently, three sublines with distinct reactivity patterns were derived by limiting dilution. The specificities detected by these sublines included: (a) a specificity found on a subset of cells positive for DRw6 which was inhibited by monoclonal antibodies against DS(DC), the human homologue of the murine IA-encoded molecules, (b) another DRw6-associated specificity blocked by an MT2-like antibody, and (c) an MT2-like specificity blocked by monoclonal antibodies reactive with a different MT2-associated determinant. These results show that more than one IE-like, as well as the DS/DC (IA-like) molecules, carry distinctive antigenic epitopes that can be recognized by allogeneic T cells. Primed T cell lines may be useful for a better definition of certain haplotypes which are at present difficult to characterize with serological reagents alone.  相似文献   
7.
8.
呼吸机通气模式名称的不统一或说混乱,给临床使用呼吸机带来了很大困难,严重影响了紧急情况下的抢救工作。  相似文献   
9.
A patient with ventricular extrasystoles is reported in whom Type A alternating Wenckebach periodicity in the re-entrant path of the extrasystoles is suggested for the first time. Namely, it appears that 2:1 exit block occurs at a proximal level in the re-entrant path and block of the Wenckebach form occurs at a distal level in the path. The presence of three-level block in the re-entrant path is also suggested in this patient.  相似文献   
10.
The infection control practitioner often relies on microbiologic data in order to conduct nosocomial infection surveillance and control activities. On the basis of a review of the medical literature, false positive culture and stained smear results representing pseudoinfection are being reported with greater frequency. Documented cases and clusters of pseudoinfectons are reviewed, and the epidemiologic characteristics and methods for detection and prevention of this increasingly recognized problem are discussed.  相似文献   
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