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排序方式: 共有687条查询结果,搜索用时 15 毫秒
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Nadim M. Zacca Neal S. Kleiman Arsenio R. Rodriguez Jacques Heibig David Warth Scott Harris Steven T. Minor Albert E. Raizner 《Catheterization and cardiovascular interventions》1992,26(2):92-97
Previous clinical use of the Rotablator(TM) In coronary artery disease has involved a sequential increase in burr sizes up to 2 mm in diameter and has often utilized balloon adjunct to achieve an optimal result. We report our experience and describe our technique using a single, large burr (2.25, 2.5, or 2.75 mm diameter) without balloon assistance. The burr size was selected to approximate 70–90 percent of the apparent normal lumen diameter. Thirty-one patients with 36 lesions of complex morphology (eccentric, irregular, calcified, ulcerated, at bends, at bifurcations, completely occluded, as well as balloon failures) were successfully treated with the Rotablator(TM). Results were assessed by computerized quantitative angiography. The percent diameter stenosis (mean ± SD) for the group was reduced from 69.8 ± 11.3% to 30.9 ± 10% (p < 0.001). The mean absolute diameter stenosis increased from 0.9 ± 0.3 mm to 2.2 ± 0.3 mm (p < 0.001). Angiographically visible dissections were seen in 4 patients and were uncomplicated in 2. One patient had a non-Q-wave myocardial infarction. A fourth patient had a presumed acute occlusion 36 hr after the procedure, necessitating emergency bypass surgery, but without Q waves on the electrocardiogram or wall-motion abnormalities on the echocar-diogram. Nitroglycerin was infused through the Rotablator(TM) catheter and has considerably lowered the degree and frequency of spasm. No other acute complications occurred. The mean procedure time using a single burr was shorter than when multiple burrs were used: 56.5 vs. 97.3 min, respectively (p < 0.05). The use of a single, large-size Rotablator(TM) burr is an effective method of treating complex coronary stenoses without balloon assistance and has an encouragingly low complication rate and short procedure time. © 1992 Wiley-Liss, Inc. 相似文献
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J. C. Masdeu R. L. Van Heertum A. Kleiman G. Anselmi K. Kissane J. Horng A. Yudd D. Luck M. Grundman 《Journal of neuroimaging》1994,4(4):177-181
Although computed tomography (CT) and magnetic resonance imaging scans often appear normal after mild head trauma, many patients experience attentional or other cognitive disturbances that are difficult to quantify by neuropsychological testing in the absence of a premorbid profile. Within 2 days of mild head trauma, 14 patients with normal-appearing brain CTs were studied with single-photon emission computed tomography (SPECT). They were compared to 15 normal control subjects and to 12 patients with mild human immunodeficiency virus (HlV) encephalopathy. Ten of 14 head trauma patients were separated from the normal control subjects by both independent readers, blinded to the clinical diagnosis. None of the SPECT results from normal control subjects were ‘read’ as trauma. Trauma could not be differentiated from HlV encephalopathy. The observed percentage agreement between raters was 0.83 (K = 0.72). SPECT is more sensitive than CT in detecting brain injury after mild head trauma. 相似文献
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The prognostic role of the extent of Y microdeletion on spermatogenesis and maturity of Sertoli cells 总被引:6,自引:0,他引:6
Kleiman SE Bar-Shira Maymon B Yogev L Paz G Yavetz H 《Human reproduction (Oxford, England)》2001,16(3):399-402
Substantial involvement of the Y chromosome in sexual development and spermatogenesis has been demonstrated. Over the last decade, varying extent of Y chromosome microdeletions have been identified among infertile patients with azoospermia or oligozoospermia. These microdeletions were clustered in three main regions named AZFa, AZFb, and AZFc. Analysis of the Y chromosome microdeletion was found to be of prognostic value in cases of infertility, both in terms of clinical management as well as for understanding the aetiology of the spermatogenesis impairment. However, the accumulated data are difficult to analyse, due to the variable extent of these deletions, the different sequence-tagged sites (STS) used to detect the microdeletions, and the non-uniformity of the histological terminology used by different investigators. This debate discusses the chances of finding testicular spermatozoa in men with a varying extent of Y chromosome microdeletions. The genotype and germ cell findings in men with AZFa microdeletions as well as those that include more than a single AZF region are reviewed, as is the effect of Y chromosome AZF microdeletions on the maturity of the Sertoli cells. 相似文献
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Richard W. M. Wahba Michael J. Tessler Simcha J. Kleiman 《Journal canadien d'anesthésie》1996,43(1):77-83
Purpose
This article examines and summarizes the published reports dealing with subcutaneous emphysema, pneumothorax and carbon dioxide (CO2) embolism during laparoscopic upper abdominal surgery. The purpose is to describe the expected clinical picture, the differential diagnosis and the management of these complications.Source
The information was obtained from a Medline literature search and the annual meeting supplements of Anesthesiology, Anesth Analg, Br J Anaesth and Can J Anaesth.Principal findings
An abrupt increase in PetCO2 is the first sign of subcutaneous emphysema and of pneumothorax. Desaturation and increased airway pressure occur with pneumothorax, but not with subcutaneous emphysema alone. Desaturation and increased airway pressure also occur with bronchial intubation. The preliminary diagnosis is made by verifying the position of the tube, examination of the patient for swelling and crepitus and auscultation for air entry. Chest radiography and paracentesis confirm the diagnosis of pneumothorax, which frequently occurs with subcutaneous emphysema but is rarely of the tension type. Pulmonary embolism due to CO2 during WAS has not been reported, but the available data suggest that small, haemodynamically inconsequential CO2 embolism occurs without change in PetCO2. Massive embolism is possible and will markedly decrease PetCO2, arterial O2 saturation (SpO2) and blood pressure.Conclusion
The immediate recognition of the three complications requires continuous monitoring of PetCO2, arterial saturation, airway pressure, and an index of pulmonary compliance. 相似文献9.
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A term parturient with documented platelet dysfunction presented to the case room for induction of labour. Since this bleeding
abnormality contraindicated the use of lumbar epidural analgesia (LEA), we elected to use an iv fentanyl patientcontrolled
analgesia (PCA) technique for pain relief during labour. The patient received a 50 μg fentanyl loading dose after which 20
μg boluses of fentanyl were self-administered every three minutes as required. The patient received a total of 400 μg of fentanyl
over the 3 1/2 hr of active labour. Mother and neonate tolerated the fentanyl without sequelae. If facilities to monitor the
neonate and mother are present, this method of analgesia is useful in those patients where LEA is contraindicated.
Au terme d’une grossesse, une patiente porteuse d’une dysfonction plaquettaire devait avoir une induction de travail au bloc
obstétrical. Ecartant l’usage d’une epidurale à cause des risques de saignement, nous avons employé du fentanyl en autoanalgésie
(PCA) pour soulager les douleurs du travail. Après une dose initiate de50 μg, la patiente s’injectait des doses de 20 μg de
fentanyl iv aux 3 minutes prn. Elle utilisa un total de 400 μg de fentanyl au cours des 3,5 heures que dura le travail. La
mère et le nouveau-né tolérèrent fort bien ce mode d’analgésie. L’autoanalgésie offre done une alternative au bloc épidural
lorsque ce dernier est contre-indiqué toutefois, nous recommandons de monitorer la mére et le nouveau-né pendant quelques
heures. 相似文献