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1.
A 43-year-old alcoholic presented in coma with ketoacidosis, after three days of nausea and feeling generally unwell, which had been preceded by a prolonged three-week period of heavy alcohol consumption with poor dietary intake. The acidosis responded rapidly to intravenous dextrose. This is the first Scottish report of a case of alcoholic ketoacidosis. 相似文献
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3.
Early cardiovascular changes with ibopamine: evidence for a biphasic haemodynamic action. 总被引:1,自引:1,他引:0 下载免费PDF全文
K J Hogg R S Hornung C A Howie W S Hillis 《British journal of clinical pharmacology》1987,24(4):435-442
1. The haemodynamic effects of ibopamine, an oral dopamine derivative, were studied in eight patients with left ventricular dysfunction using invasive catheterisation techniques. 2. An early rise was seen in the mean right atrial pressure (P less than 0.05), the mean capillary wedge pressure (P less than 0.01) and the mean pulmonary arterial pressure (P less than 0.001) which occurred at 15 min and persisted for 30 min. 3. A second, later, positive chronotropic effect was seen as an increase in the heart rate (P less than 0.05) at 45 min with an increased cardiac output (P less than 0.05) persisting above baseline values at 1 h, but with no change in stroke volume. 4. These results support a biphasic mode of action for ibopamine which may be explained by a time phase difference in alpha- and beta-adrenoceptor stimulatory effects. 相似文献
4.
目的:探讨抗人热休克蛋白60或抗分枝杆菌热休克蛋白65抗体是否能够预测因急性心源性胸痛入院的患者一年预后不良。设计:前瞻性观察研究。地点:教学医院。患者:连续588例急诊收治的疑似急性心源性胸痛患者。主要观察指标:测定入院后晨起血样的抗人热休克蛋白60和抗分枝杆菌热休克蛋白65效价。出院后终点为冠心病死亡、非致死性心肌梗死、冠状动脉搭桥术、经皮穿刺腔内冠状动脉成形术、血管造影或因心脏缺血性胸痛加重再次入院。 相似文献
5.
Donor-specific transfusion was performed with and without cyclosporine between haplomismatched relatives prior to living-donor renal transplantation. Red cell antigen mismatching was not taken as a contraindication to DST. Of 80 patients included in the trial; eleven were ABO-mismatched, 15 were Rh(D)-mismatched, and a further 11 were transfused in the presence of atypical red cell antibodies (anti-D, -C, -Fya, -Kell -N, -H/I -I, -P1, -Wra). Patients were randomized to receive cyclosporine (10 mg/kg) daily during DST or not (control group). The presence of atypical red cell antibodies, with the exception of Rh anti-D, did not appear to influence DST or renal transplantation. DST did not act as a primary stimulus to Rh anti-D production but stimulated preexisting anti D levels. ABO mismatching did not appear to influence DST or subsequent renal transplantation except in one group A [corrected] patient who received group O [corrected] blood and cyclosporine. This patient developed a severe, but self-limiting, autoimmune hemolytic anemia due to auto-anti A antibodies. A similar group A patient in the control group developed an auto-antibody with no clinical sequelae. The influence of cyclosporine on the development of this auto-antibody is uncertain. We conclude that, with the exception of preexisting anti-D antibodies, minor red cell antigen disparities should not preclude pretransplant conditioning with donor-specific transfusions. 相似文献
6.
Where do semantic errors come from? 总被引:14,自引:0,他引:14
A Caramazza A E Hillis 《Cortex; a journal devoted to the study of the nervous system and behavior》1990,26(1):95-122
We report the performance of two brain-damaged subjects (RGB and HW) whose frequent errors in spoken production are nearly always semantically related to the target word. Both subjects show similar, high rates of these "semantic" errors in oral naming and oral reading; yet neither subject makes semantic errors in comparable written tasks. Further, results of a variety of lexical tasks with the same stimuli demonstrate unimpaired comprehension of printed or spoken words, including those that are orally produced as semantic errors. These patterns of performance are interpreted as resulting from damage to the phonological output lexicon. The postulated deficit is contrasted to the hypothesis of impairment to the lexical-semantic component, required to explain performance by brain-damaged subjects described elsewhere who make seemingly identical types of oral production errors to those of RGB and HW, but, in addition, make comparable errors in writing and comprehension tasks. 相似文献
7.
E D Flores R A Lange R G Cigarroa L D Hillis 《Journal of the American College of Cardiology》1990,16(1):74-79
Cocaine increases myocardial oxygen demand and paradoxically decreases oxygen supply by reducing coronary blood flow. Such "inappropriate" vasoconstriction also occurs with exercise, which causes intense vasoconstriction of coronary artery segments narrowed by atherosclerosis. This study was done to assess the cocaine-induced change in vasomotor tone of diseased and nondiseased coronary artery segments. In 18 patients (15 men, 3 women, aged 35 to 67 years), coronary artery areas in diseased and nondiseased segments were quantitated before and 15 min after administration of intranasal saline solution (6 patients) or cocaine (2 mg/kg body weight) (12 patients). No variables changed after intake of the saline solution. In response to cocaine, the luminal areas of diseased and nondiseased segments decreased, but the magnitude of vasoconstriction was greater in the diseased segments (mean +/- SD 29 +/- 23% versus 13 +/- 8%, p less than 0.05). Thus, cocaine causes vasoconstriction of diseased and nondiseased coronary artery segments, but its effect is particularly marked in the former. 相似文献
8.
Monitoring of streptokinase resistance titre in acute myocardial infarction patients up to 30 months after giving streptokinase or anistreplase and related studies to measure specific antistreptokinase IgG 下载免费PDF全文
R Fears H Ferres E Glasgow R Standring K J Hogg J D Gemmill J M A Burns A P Rae F G Dunn W S Hillis 《Heart (British Cardiac Society)》1992,68(2):167-170
Objective—To examine the induction of antistreptokinase antibodies after giving streptokinase or anistreplase to patients with acute myocardial infarction.Design—Patients were randomly allocated to receive either 1·5 × 106 IU, streptokinase or 30U anistreplase in a double blind study. Blood samples were collected immediately before treatment and subsequently at intervals up to 30 months; plasma samples were assayed for streptokinase resistance titre (functional assay) and streptokinase binding by IgG (microradioimmunoassay).Setting—Cardiology department in a general hospital.Patients—128 consecutive eligible patients. Samples were collected for up to one year according to a prospective design: a subsection of 47 patients was selected for intensive study over the first 14 days. After one year, all available patients (67) were sampled on one further occasion.Results—Antibody responses to streptokinase and anistreplase were similar. Streptokinase resistance titres exceeded pretreatment concentrations five days after dosing, and values peaked at 14 days. By 12 months after dosing, 92% of resistance titres (n = 84) had returned to within the pretreatment range. Antistreptokinase IgG concentrations also exceeded baseline concentrations within five days and peaked at 14 days. Half of the individual values had returned to within the pretreatment range by 12 months (n = 84) and 89% by 30 months (n = 18).Conclusion—Although we cannot be sure of the clinical significance, because of the increased likelihood of resistance due to antistreptokinase antibody, streptokinase and anistreplase may not be effective if administered more than five days after an earlier dose of streptokinase or anistreplase, particularly between five days and 12 months, and increased antistreptokinase antibody may increase the risk of allergic-type reactions. 相似文献
9.
Symptomatic, electrocardiographic, metabolic, and hemodynamic alterations during pacing-induced myocardial ischemia 总被引:2,自引:0,他引:2
Roy V. Markham Jr. MD Michael D. Winniford MD Brian G. Firth MD DPHIL Pascal Nicod MD Gregory J. Dehmer MD Samuel E. Lewis MD L.David Hillis MD 《The American journal of cardiology》1983,51(10):1589-1594
Atrial pacing has been used to assess the physiologic impact of coronary artery disease (CAD). Several variables have served as markers of pacing-induced myocardial ischemia, but their specificities and sensitivities are unknown. Accordingly, in 28 patients, incremental atrial pacing was performed. Of the 28, 10 had no CAD. The left ventricular ejection fraction (LVEF) (by gated equilibrium blood pool scintigraphy) increased in this group (0.60 ± 0.11 [mean ± standard deviation] before pacing to 0.67 ± 0.13 at peak-pacing, p = 0.002). In no patient did left ventricular end-diastolic pressure increase by > 5 mm Hg. No patient had lactate production, and 2 (20%) had electrocardiographic S-T segment depression ≥0.1 mV. Four (40%) had chest pain with atrial pacing. In the remaining 18 patients with CAD, atrial pacing caused a decrease in LVEF ≥0.05 (0.46 ± 0.10 to 0.33 ± 0.09, p < 0.001) and new segmental wall motion abnormalities in all, indicating pacing-induced myocardial ischemia. Only 8 (44%) had an increase in left ventricular end-diastolic pressure of > 5 mm Hg, and only 9 (50%) had lactate production. Ten (56%) had ischemic electrocardiographic changes, and 12 (67%) had chest pain. Thus, the electrocardiographic, metabolic, and hemodynamic alterations that may accompany pacing-induced ischemia are specific but relatively insensitive markers of ischemia. In contrast, chest pain during atrial pacing is a nonspecific occurrence, appearing with similar frequency in normal subjects and patients with CAD and pacing-induced ischemia. 相似文献
10.
Neither "prominent" right atrial V waves nor an elevated mean right atrial pressure reliably predicts the presence of moderate or severe tricuspid regurgitation. On the other hand, the absence of prominent right atrial V waves and an elevated mean right atrial pressure are relatively specific for the absence of moderate or severe tricuspid regurgitation. 相似文献