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排序方式: 共有1304条查询结果,搜索用时 15 毫秒
1.
Ángel Becerra Héctor Trujillo Lucía Valencia Aurelio Rodríguez‐Pérez 《Brazilian Journal of Anesthesiology》2019,69(2):200-203
Background and objectives
A prompt and effective management of trauma patient is necessary. The aim of this case report is to highlight the importance of intraoperative echocardiography as a useful tool in patients suffering from refractory hemodynamic instability no otherwise explained.Case report
A 41 year‐old woman suffered a car accident. At the emergency department, no abnormalities were found in ECG or chest X‐ray. Abdominal ultrasound revealed the presence of abdominal free liquid and the patient was submitted to urgent exploratory laparotomy. Nevertheless, she persisted suffering arterial hypotension and metabolic acidosis. Looking for the reason of her hemodynamic instability, intraoperative transthoracic echocardiography was performed, finding out the presence of pericardial effusion. Once the cardiac surgeon extracted pericardial clots, patient's situation improved clinically and analytically.Conclusion
Every anesthesiologist should be able to use the intraoperative echocardiography as an effective tool in order to establish the appropriate measures to promote the survival of patients suffering severe trauma. 相似文献2.
Intratemporal vascular tumors: detection with CT and MR imaging 总被引:1,自引:0,他引:1
Lo WW; Shelton C; Waluch V; Solti-Bohman LG; Carberry JN; Brackmann DE; Wade CT 《Radiology》1989,171(2):445-448
The diagnostic contributions of computed tomography (CT) and magnetic resonance (MR) imaging were compared in 12 patients with benign intratemporal vascular tumors (hemangioma or vascular malformation). The tumors included six in the internal acoustic canal and six in the geniculate ganglion region. Clinical and histologic correlations were made. Two of the six patients with tumors in the internal acoustic canal underwent CT, and both required gas cisternography to show the tumor. Five patients in that group underwent MR imaging, and all five studies showed the tumor. All six patients with geniculate ganglion tumors underwent CT. Results in one study were questionable, and five showed the tumor. Five patients in this group underwent MR imaging, but the MR findings were positive in only two cases. MR imaging should therefore be performed before CT in the evaluation of facial nerve dysfunction, as it demonstrated all tumors in the internal acoustic canal and some in the geniculate ganglion region. If MR findings are negative, CT should then be performed to rule out a possible geniculate ganglion lesion. 相似文献
3.
A S Brickman A L Trujillo M S Gutin M L Tuck 《The Journal of clinical endocrinology and metabolism》1987,64(2):297-303
ACTH-, angiotensin II (AII)-, and K+-mediated aldosterone responses in vitro are dependent on extracellular and intracellular Ca concentrations. This study examined in vivo the relationship of changes in ambient serum calcium (serum Ca) to ACTH- and AII-mediated aldosterone release in hypoparathyroid subjects. Plasma aldosterone (PA) responses to graded dose infusions of ACTH and AII were examined in hypoparathyroid (HypoPTH) patients before (n = 8) and after correction of hypocalcemia (n = 6) and compared to responses in 20 normotensive normocalcemic subjects. ACTH and AII were infused for 90 min at rates increasing from 12.5 to 50 mIU/30 min and 0.5 to 2.0 ng/kg X min, respectively. Pretreatment mean serum Ca was 6.8 +/- 0.2 (+/- SEM) mg/dl, and it rose to 9.3 +/- 0.2 mg/dl after 3-8 weeks of vitamin D administration. In the untreated HypoPTH patients, basal mean PA (5.4 +/- 1.3 ng/dl) was lower (P less than 0.01) than in the normal subjects (10.6 +/- 0.6 ng/dl) or treated HypoPTH patients (9.5 +/- 1.8 ng/dl). There was a marked reduction in PA responses to ACTH at all doses in the untreated HypoPTH patients compared to the normal subjects. With normalization of serum Ca in four patients, the mean peak PA response to ACTH (25.1 +/- 6.0 ng/dl) was not significantly different from normal (28.9 +/- 1.7 ng/dl). During graded dose AII infusion in five untreated HypoPTH patients, mean PA levels increased from 6.9 +/- 1.2 to 11.6 +/- 2.2 ng/dl; when the serum Ca was normal, the corresponding values were 8.7 +/- 1.8 and 20.2 +/- 3.61 ng/dl. There was a positive correlation (r = 0.475; P less than 0.05) between basal PA and serum Ca levels. In addition, maximum changes in mean arterial pressure in response to AII infusions were significantly greater after correction of hypocalcemia. These observations indicate that in HypoPTH patients, extracellular Ca concentrations can influence humoral aldosterone response to ACTH and AII and pressor responses to AII. 相似文献
4.
K.A. Eaton F.M. Rimini E. Zak D.J. Brookman L.M.A. Hopkins P. J. Carmell LG. Yates C. A. Morrice B.A. Lall H. N. Newman 《Journal of clinical periodontology》1997,24(3):189-197
Abstract Several previous studies have evaluated the effects of 0.12% chlorhexidine digluconate (ChD) mouthrinses on plaque and gingival inflammation. However, previously, none have been based in general dental practices. The aim of this study was to evaluate the potential to conduct controlled periodontal clinical trials in co-operation with general dental practitioners (gdps). The project took place in 5 general dental practices in the South of England. 121 healthy subjects (24 at 4 sites and 25 at the 5th). aged 18-65 years, mean 35 ± 12) years participated in a double-blind, randomised study during which they received full mouth assessments for plaque and gingival bleeding at baseline, 6 and 12 weeks. 60 subjects were randomly asigned to use the 0.12% ChD mouth wash and 6i the placebo. The assessments were carried out by 5 gpds, who had previously achieved inter-examiner κ scores of 0.78–0.85 (mean 0.81) for the plaque index (PlI), and of 0.73–0.94 (mean 0.87) for a modified gingival index (mGI), and who maintained κ scores of 0.51–0.90 for PII and of 0.73–1.00 for mGI during the 12 months required to complete the study. 98 subjects (48 ChD and 50 placebo) completed the study. Even though the baseline levels of plaque and gingivitis were low, by week 12, mean whole mouth piaque score of the ChD mouthwash users had fallen from 1.33 at baseline to 0.96 and was significantly lower (p < 0.001) than for the placebo users, 1.31 at baseline to 1.13. Whole-mouth gingival bleeding score fell from 0.56 to 0.42 in the ChD mouthwash group but was unchanged (0.54–0.55) in the placebo group. A subsidiary data analysis which considered the effects at sites indicated that within these overall differences, the ChD users experienced almost 2× the reduction from plaque score 2 at baseline at proximal molar sites over a 12-week period (50.6% ChD versus 27.6% placebo). It was concluded that 0.12% ChD mouthwash reduced plaque accumulation fay 28% and gingival inflammation by 25% over a 12–week period, that it is feasible for a group of gdps to maintain high levels of inter–examiner consistency in the use of PlI and mGI, that it is also feasible to carry out such a multicentre study in general dental practice, and that the use of mean mouth scores per subject to analyse the effects of mouthrinses may well mask variations in response throughout the mouth. 相似文献
5.
The authors present a patient with a complex vascular malformation composed of bilateral spontaneous carotid-cavernous fistulas (CCF's). The abnormality was supplied on the right side by the right external carotid artery (ECA) and the right internal carotid artery (ICA), and on the left side only by the left ICA. There was also an arteriovenous communication between the right ECA and the lateral sinus. Surgical embolization of both cavernous sinuses with oxidized cellulose was achieved on one side by direct puncture and on the other through one of its venous affluents, successfully occluding both CCF's and preserving the patency of both ICA's without any neurological deficit. The arteriovenous communication between the right ECA and the lateral sinus was occluded by embolization of the occipital artery and ligation of the right ECA. 相似文献
6.
LG Dortmund 《MedR Medizinrecht》2007,25(8):493-494
Abstrakt Vergibt ein behandelnder Arzt eine Laboruntersuchung an einen externen Laborarzt, kommt entweder direkt ein Vertragsverh?ltnis
zwischen dem Laborarzt und dem Patienten zustande oder der Patient haftet dem Laborarzt aus den Grunds?tzen der Gesch?ftsführung
ohne Auftrag. 相似文献
7.
8.
Myxoglobulosis is a rare morphologic variant of appendiceal mucocele characterized by intraluminal mucinous globules of the appendix. Most reported cases have presented clinically as an acute abdomen or as an incidental laparotomy or autopsy finding. We report a case of myxoglobulosis in a 32-year-old man who presented with an extra-appendiceal mass following a 10-year symptomatic course. Laparotomy disclosed a pericecal collection of opaque, white globules originating from a perforated appendix walled off by fibrous adhesions. The globules exhibited some histologic and staining properties at variance with those described in previous reports. These findings suggest that myxoglobulosis may be more heterogeneous pathogenetically than the distinctive gross appearance of the lesion would indicate. 相似文献
9.
Periosteal Ewing sarcoma 总被引:3,自引:0,他引:3
10.
Six established human colon carcinoma cell lines with distinct degrees of cell differentiation were inoculated into infant (less than 4 weeks) and adult (greater than 8 weeks) nude rats. The most differentiated tumor cells (group I) had nearly a 100% rate of tumor takes whether inoculated subcutaneously, intraperitoneally, or intracerebrally into adult rats; subcutaneous growth continued unabated for a 120-day observation period. Cells with intermediate differentiation (group II) had nearly an 80% incidence in tumor takes when injected subcutaneously and 14-60% when injected intraperitoneally. Subcutaneous growth continued only for about 30 days, after which time growth declined, and tumors regressed completely. Intracerebral inoculations of group II cells resulted in 64-83% tumor takes. Subcutaneous injections of cells from groups I and II into 5- to 10-day-old rats resulted in 100% tumor takes; tumors induced by group II did not regress, and after about 60 days reached volumes comparable to those originated by cells from group I. No tumors developed when cells from group III (undifferentiated) were injected either subcutaneously or intraperitoneally (and even intravenously) into adult rats. Only when the intracerebral route was employed was there a 60-71% incidence of tumor takes. Also, for one of the cell lines in this group, subcutaneous injection into infant rats resulted in 100% tumor takes. NK cell activity of infant rats against all of the colon cells (measured by the 51Cr release assay) was negligible; in adult rats, the activity varied according to the cell type, being usually highest against the less differentiated tumors. Our data on the incidence of tumor takes, and on the dynamics of tumor growth and decline suggest that successful heterotransplantation of human colon carcinoma cells into nude rats depends on the activity of host NK cells. In turn, this activity seems related to the degree of cell differentiation and the growth kinetics of the xenografted tumor cells. These observations highlight important differences in biological characteristics of human colon carcinoma with important implications for their intrinsic ability to grow and metastasize, and, possibly, their response to biological response modifiers. 相似文献