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排序方式: 共有1173条查询结果,搜索用时 15 毫秒
1.
Tiberiu Ezri Islam Zahalka Deeb Zabeeda Zeev Feldbrin Alexander Eidelman Reuven Zimlichman Benjamin Medalion Shmuel Evron 《Journal canadien d'anesthésie》2006,53(2):139-145
BACKGROUND: We hypothesized that the incidence of hypotension during total knee replacement (TKR) surgery is lower in patients given combined spinal-epidural (CSE) anesthesia vs those receiving epidural anesthesia alone. METHODS: In a prospective study, 80 American Society of Anesthesiologists I-II patients (aged 40-80 yr), undergoing elective TKR surgery were randomly assigned to either CSE anesthesia (CSE, n = 40) or epidural anesthesia alone (Epidural, n = 40). Hemodynamic measurements included oscillometric mean arterial blood pressure (MAP), heart rate (HR), and cardiac index (CI) as determined by thoracic bioimpedance; systemic vascular resistance (SVR) was calculated. Our primary endpoint (outcome) was the number of hypotension episodes (defined as MAP < 70 mmHg). RESULTS: Using univariate analysis, we found no differences between the groups in regards to MAP, HR, CI, or SVR during the perioperative period. The incidence of hypotension was similar in both groups (two patients in each group), as was the incidence of bradycardia (12 patients in CSE, 7 in Epidural; P = 0.2). There were no differences between groups in other hemodynamic measurements including CI and calculated SVR. Analgesia supplementation with fentanyl was more frequently required in the Epidural group (20 vs 6 patients - P = 0.03). CONCLUSION: Combined spinal-epidural anesthesia and epidural anesthesia alone during TKR surgery are associated with the same incidence of hypotension with statistically and clinically similar hemodynamic responses. 相似文献
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Ofer Gemer Benjamin Piura Shmuel Segal Ilana Yanai Inbar 《International journal of gynecological pathology》2003,22(4):398-400
Chondroid syringoma of the vulva is an extremely rare tumor. Of the previously reported cases, only one was clinically malignant. The authors describe a case of chondroid syringoma of the right labium majus from which arose a papillary adenocarcinoma. A right inguinal lymph node was replaced with metastatic adenocarcinoma. 相似文献
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Wolff N Yannai S Karin N Levy Y Reifen R Dalal I Cogan U 《The Journal of allergy and clinical immunology》2004,114(5):1151-1158
BACKGROUND: The increased consumption of foods containing sesame seeds is paralleled by an increase in reported sesame-induced allergic reactions. OBJECTIVE: This study aimed at identifying and characterizing the linear B-cell epitopes of the 14-kd beta-globulin, the major allergen of sesame seed. METHODS: A peptide containing 71 amino acids (peptide B) was previously identified by us as the IgE-binding region on beta-globulin. To determine the amino acid sequence of the IgE-binding sites on peptide B, we synthesized overlapping peptides 20 and 10 amino acid residues long that span the entire length of peptide B, which were offset from each other by 10 and 2 amino acid residues, respectively. Sera from 20 subjects given diagnoses of allergy to sesame beta-globulin served to identify the epitopes by using the dot-blot test. RESULTS: At least 9 different IgE-recognition sites were identified on peptide B. Three of them, numbers 2, 3, and 13 (corresponding to amino acids 46-55, 48-57, and 76-86, respectively, in the beta-globulin sequence), appeared to be immunodominant IgE-binding epitopes. Also, these peptides were best recognized in terms of intensity of response. There was no obvious sequence motif shared by the 9 different IgE-binding epitopes of beta-globulin. However, approximately 60% of the amino acids represented in the epitopes are hydrophobic residues. CONCLUSION: Identification of the IgE-binding epitopes might provide a better understanding of the functional role the allergens play in the disease and might have implications for immunodiagnosis and probably immunotherapy. 相似文献
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Background
Physicians' awareness of their important role in defusing the obesity epidemic has increased. However, the number of family practitioners who treat obesity problems continues to be low. Self-efficacy refers to the belief in one's ability to organize and execute the courses of action required to produce given attainments. Thus, practitioners who judge themselves incapable of managing obesity do not even try. We hypothesized that practitioners' self-efficacy and motivation would be enhanced as a result of participating in an interactive course designed to enrich their knowledge of obesity management. 相似文献8.
Goldberg I Gilburd B Kravitz MS Kivity S Chaim BB Klein T Schiffenbauer Y Trubniykovr E Brenner S Shoenfeld Y 《Clinical & developmental immunology》2005,12(1):85-90
Background: There are several mechanisms to describe allergic drug
reactions yet the methods to diagnose them are limited.
Objective: To compare several conventional clinical and laboratory
methods to diagnose skin reactions to drugs
to a new method of diagnosing drug reactions by the CellScan system.
Methods: The study entailed 21 patients who were diagnosed as
suffering from drug eruptions, and 105 healthy controls with no history of drug
allergy. The drugs were classified into two groups according to suspicion of
causing drug allergy: high and low. Most of the patients were on more than
one drug, leading to 41 patient-drug interactions (assays). Histamine
releasing test (HRT), interferon (INF)-γ releasing test and CellScan
examination were performed on lymphocytes of the patients and controls.
Results: The HRT was interpreted as positive in 9 out of 18 (50%)
patients and in 13 out of 35 (37%) assays. Based on the INF-γ releasing test,
positive results were observed in 16 out of 21 (76%) patients and in 24 out of 41
(59%) assays. In the CellScan test (CST), positive results were observed in 17
out of 21 (81%) patients and in 29 out of 41 (71%) assays. The rate of identifying
the drug for eruption in the high suspicion level drugs was 9 out of 22 (41%)
assays in the HRT, 20 out of 24 (83%) assays in the INF-γ releasing test, and 21
out of 24 (87%) studies with the CellScan method. The rate of determining of
the drug that caused the eruption in the low suspicion level drugs was 4 out of
13 (31%) in the HRT, 4 out of 17 (24%) assays in the INF-γ releasing test, and 8
out of 17 (47%) analyses in the CST. When examined
in the CellScan, 99 out of 105 (94%) controls were interpreted as negative.
Conclusion: This preliminary study indicates that the CellScan seems to
be an easy and promising method for the detection of drugs responsible for
adverse skin reactions. In contrast to the HRT and to the Interferon-γ secretion
test, the CellScan method is characterized by its ability to track and monitor
the reaction of individual cells. By measuring the kinetic parameters of selected
cells before and after adding the suspected drug, we were able to identify
the culprit drug. The CellScan method had the highest sensitivity, and the
interferon-γ secretion test had the highest specificity for detection of the culprit
drug. In contrast, the analysis of 105
normal control sera disclosed a high specificity of 94% for the CellScan method. 相似文献
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Kessel A Rosner I Rozenbaum M Zisman D Sagiv A Shmuel Z Sabo E Toubi E 《Journal of clinical immunology》2004,24(1):30-36
Our objectives were (1) to compare lymphocyte subpopulation apoptosis rates in SSc patients versus healthy controls and (2) to compare Bcl-2 and NF-kappa B expression in cultured CD8 lymphocytes of SSc patients versus controls. Peripheral blood samples were obtained from 27 SSc patients meeting the American College of Rheumatology criteria for SSc and 28 healthy individuals. Mononuclear cells were isolated by Ficoll-Hypaque density gradient separation and cultured for 48 hr. For determination of apoptosis within specific cell populations, samples were labeled with PE-conjugated monoclonal antibody to CD8, CD4, and a FITC-conjugated monoclonal antibody to Annexin V. Flow cytometry was carried out with a FACS operating with Cellquest software. CD8+ lymphocytes were positively selected with magnetic microbeads conjugated to antihuman CD8. CD8 T cells were separated, then incubated with activation for 48 hr, and NF-kappa B and Bcl-2 analysis was carried out using Western immunoblotting. The CD4:CD8 ratio was increased in SSc compared to controls (2.6 +/- 1.13 vs.1.87 +/- 0.76; P = 0.018). The spontaneous apoptosis rate of SSc CD8 lymphocytes was increased compared to that of controls of (21.9 +/- 13.7 vs. 13.3 +/- 9.9; P = 0.019). No difference was found in the rate of CD4 apoptosis of SSc patients versus controls (9.8 +/- 5.2 vs. 7.18 +/- 4.89%; P = ns). The expression of NF-kappa B in SSc CD8 lymphocytes was decreased compared with that of CD8 lymphocytes from healthy controls (144 +/- 13 vs. 188 +/- 11; P = 0.018). Whereas expression of Bcl-2 was similar in activated CD8+ T cells of SSc patients and healthy controls, CD8+ T cell apoptosis rate was found to be in reverse correlation with expression of NF-kappa B in these cells ( r = - 0.53, P = 0.029). The increased CD4:CD8 ratio in SSC may result from increased CD8+ T cell apoptosis. Increased SSc CD8 T cell apoptosis is associated with low levels of NF-kappa B. 相似文献