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51.
Steven R. Jensen M.D. Dawn R. Voegeli John C. McDermott Andrew B. Crummy 《Cardiovascular and interventional radiology》1986,9(4):202-204
Eight lymphatic fluid collections were drained percutaneously. There were no immediate or late complications. Seven patients
had follow-up; 1 required surgical drainage of a residual or recurrent lymphocele, and another had reaccumulated fluid in
a lymphocele which was detected on autopsy. The remaining lymphatic collections responded to percutaneous drainage. Percutaneous
drainage is safe and can be an effective tool in the management of lymphatic collections. 相似文献
52.
Bernard P Halloran Virginia L Ferguson Steven J Simske Andrew Burghardt Laura L Venton Sharmila Majumdar 《Journal of bone and mineral research》2002,17(6):1044-1050
To determine whether the mouse loses bone with aging and whether the changes mimic those observed in human aging, we examined the changes in the tibial metaphysis and diaphysis in the male C57BL/6J mouse over its life span using microcomputed tomography (microCT). Cancellous bone volume fraction (BV/TV) decreased 60% between 6 weeks and 24 months of age. Loss was characterized by decreased trabecular number (Tb.N), increased trabecular spacing (Tb.Sp), and decreased connectivity. Anisotropy decreased while the structure model index increased with age. Cortical bone thickness increased between 6 weeks and 6 months of age and then decreased continuously to 24 months (-12%). Cortical bone area (Ct.Ar) remained constant between 6 and 24 months. Fat-free weight reached a peak at 12 months and gradually declined to 24 months. Total mass lost between 12 and 24 months reached 10%. Overall, the age-related changes in skeletal mass and architecture in the mouse were remarkably similar to those seen in human aging. Furthermore, the rapid early loss of cancellous bone suggests that bone loss is not just associated with old age in the mouse but rather occurs as a continuum from early growth. We conclude that the C57BL/6J male mouse maybe a useful model to study at least some aspects of age-related bone loss in humans. 相似文献
53.
Physiologic mechanism and preoperative prediction of new-onset dysphagia after laparoscopic Nissen fundoplication 总被引:2,自引:0,他引:2
Dennis Blom M.D. Jeffrey H. Peters M.D. Tom R. DeMeester M.D. Peter F. Crookes M.D. Jeffrey A. Hagan M.D. Steven R. DeMeester M.D. Cedric Bremner M.D. 《Journal of gastrointestinal surgery》2002,6(1):22-28
The aim of this study was to determine whether preoperative physiologic factors can account for and be used to predict the
development of postoperative dysphagia after laparoscopic Nissen fundoplication. One hundred sixty-three patients with gastroesophageal
reflux disease underwent laparoscopic Nissen fundoplication with a median follow-up of 14 months (range 6 to 81 months). Preoperative
dysphagia was present in 37% (60 of 163) and was relieved in all but five patients (92%). Female sex (P = 0.01) and the presence of a stricture (P = 0.02) were the only preoperative variables associated with the presence of preoperative dysphagia. Eight percent (8 of
103) of patients without preoperative dysphagia developed new-onset dysphagia, and of these 63% (5 of 8) had a normal lower
esophageal sphincter (LES) (pressure >6 mm Hg; length >2 cm; abdominal length >1 cm). New-onset dysphagia was significantly
more common in patients with a normal LES (22% [5 of 23] vs. 4% [3 of 80], P = 001). Patients with a normal LES had almost a sixfold increase in the risk of developing dysphagia as those with an abnormal
LES (relative risk = 5.8). Only a preoperative normal LES (P = 0.02) or mean LES pressures (P = 0.04) were positively associated with the development of postoperative dysphagia. The severity of this dysphagia also showed
a strong positive trend of increasing with mean preoperative LES pressures (P = 0.07). Finally, preoperative LES pressure significantly correlated with postoperative LES pressure (r = 0.48, P = 0.01) and with mean residual LES (nadir) pressure (r = 0.33, P = 0.05) offering insight into the mechanism of this dysphagia. In conclusion, preoperative LES parameters play a role in
the development of dysphagia after laparoscopic Nissen fundoplication. Patients with a normal LES or high mean LES pressures
are at increased risk for developing this complication and should be informed of this before laparoscopic Nissen fundoplication.
Presented at the Forty-Second Annual Meeting of The Society for Surgery of the Alimentary Tract, Atlanta, Ga., May 20–23,
2001. 相似文献
54.
Timothy J Halligan Nathan G Russell William J Dunn Steven J Caldroney Timothy B Skelton 《Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics》2005,100(6):688-692
Scurvy is a nondiscriminatory disease process resulting from a nutritional deficiency of ascorbic acid (vitamin C). The severe vitamin deficiency produces a breakdown in the cellular structure of the body. This case report describes a middle-age woman with a history of edema, bruising of the lower extremities, anemia, and severe periodontal disease. Her presentation and medical history are classic for the signs of scurvy. Scurvy is now only uncommonly seen in developed countries, but there are still vulnerable populations whose nutritional status can lead to scurvy. The aim of this report is to help the clinician identify and treat scurvy, a disease that was once feared for its high mortality but is now easily treatable, even in cases that have progressed to multiple organ dysfunction and failure. 相似文献
55.
Heung Bae Kim James J Pomposelli Craig W Lillehei Roger L Jenkins Maureen M Jonas Laura E Krawczuk Steven J Fishman 《Liver transplantation》2005,11(11):1389-1394
Extrahepatic portal vein thrombosis (EHPVT) may occur in children or adults and usually comes to clinical attention due to complications of portal hypertension such as variceal hemorrhage. A variety of standard surgical techniques exist to manage these patients, but when these fail surgical options are limited. We describe two novel portosystemic shunts that utilize the gonadal vein as an autologous conduit. Four patients were evaluated for EHPVT with variceal bleeding. None of the patients were candidates for a standard splenorenal shunt due to prior surgical procedures. The first patient underwent a left mesogonadal shunt and the remaining 3 patients underwent a right mesogonadal shunt. Postoperative ultrasound or computed tomography (CT) scan confirmed early patency of the shunt in each patient. There have been no further episodes of variceal hemorrhage with follow-up of 3.5 years in the child who underwent the left mesogonadal shunt, and 17, 19, and 20 months in the patients who underwent the right mesogonadal shunt. Three of the 4 shunts remain patent. One shunt thrombosis occurred in a patient homozygous for the Factor V Leiden mutation despite anticoagulation with coumadin. This is the first report of the successful use of the gonadal vein as an in situ conduit for constructing a portosystemic shunt. In conclusion, the right and left mesogonadal shunts may be useful as salvage operations for patients with EHPVT who have failed standard surgical shunt procedures. 相似文献
56.
57.
Steven J Lavine 《Journal of the American Society of Echocardiography》2005,18(2):133-141
BACKGROUND: The index of myocardial performance (IMP) has been used as a prognostic systolic-diastolic index for patients with dilated cardiomyopathy and postmyocardial infarction. To date, systematic evaluation of the effect of heart rate and preload alteration on IMP has not been performed with normal or reduced left ventricular (LV) function. METHODS: We studied 14 mongrel dogs at baseline, after the induction of acute ischemic LV dysfunction, and with chronic LV dysfunction. Heart rate was altered by atrial pacing 10 and 20 beats above baseline, and volume loading was accomplished with 10 mL/kg of saline at a paced rate. Hemodynamics, and transmitral and transaortic pulsed Doppler, were obtained. RESULTS: With normal LV function, there were no changes in IMP with pacing. With acute LV dysfunction, IMP was also unchanged with pacing, although both LV ejection time (ET) (192 +/- 23 vs 208 +/- 25 milliseconds, P < .05) and isovolumic contraction time (58 +/- 25 vs 72 +/- 31 milliseconds, P < .05) declined. With chronic LV dysfunction, IMP was unchanged although LV ET declined (188 +/- 15 vs 204 +/- 18 milliseconds, P < .01). Volume loading did not alter the IMP with normal LV function although LV ET increased (208 +/- 25 vs 220 +/- 20 milliseconds, P < .001). With acute LV dysfunction, IMP decreased (0.66 +/- 0.11 vs 0.82 +/- 0.20, P < .05) because of a decrease in isovolumic relaxation time (63 +/- 33 vs 76 +/- 38 milliseconds, P < .05). With chronic LV dysfunction, IMP also declined with volume loading (0.59 +/- 0.29 vs 0.73 +/- 0.28, P < .01) because of an increase in LV ET (224 +/- 30 vs 198 +/- 22 milliseconds, P < .0001). CONCLUSION: Heart rate incrementation does not change IMP. However, volume loading reduces IMP primarily as a result of LV ET lengthening with chronic LV dysfunction. Further systematic evaluation of IMP is needed if this index is to be useful as a prognostic indicator. 相似文献
58.
Marcel J. Kooy Wouter S. Dessing Esther F. Kroodsma Steven R. J. G. Smits Esther H. Fietje Martine Kruijtbosch Peter A. G. M. De Smet 《Pharmacy World & Science》2007,29(2):81-89
OBJECTIVE: According to a report published by the federation of Dutch patients' associations, patients would like to see a pharmacist, who acts more as a personal adviser. This raised the question, how often Dutch community pharmacists have personal consultations with their patients in daily practice, on which factors this depends, and what kind of topics are discussed during these meetings. SETTING: Community pharmacies in the Netherlands. METHOD: A questionnaire was distributed among 800 randomly selected pharmacies. Questions were restricted to consultations characterized by one-to-one contact, drug therapy related content, and adequate privacy. These consultations were labelled as pharmaceutical consultations in private to distinguish them from other contacts between pharmacists and patients. MAIN OUTCOME MEASURE: Number, content, and character of consultations. RESULTS: 198 (24.8%) community pharmacies responded. The pharmacists provide an average of roughly 1.2 consultations in private per working day. The vast majority of respondents provided face-to-face and telephone consultations (94.4 and 91.9%, respectively), only a minority gave consultations by e-mail (30.8%). These consultations primarily dealt with topics related to medication safety. The mean overall time spent was 290 min per month. A relatively high frequency of personal consultations was significantly associated with the absolute number of full-time equivalent pharmacists in the pharmacy. CONCLUSION: The frequency of pharmaceutical consultations in private is low, but may be improved by reorganisation of the pharmacist's activities. The possibility of personal consultations by e-mail is not yet well-developed. Further research is needed to assess the patient's view of pharmaceutical consultations in private. 相似文献
59.
Leonard A. Jason PhD Steven B. Pokorny PhD Monica Adams MPH Annie Topliff MA Courtney Harris BA Yvonne Hunt PhD 《The American journal on addictions / American Academy of Psychiatrists in Alcoholism and Addictions》2009,18(5):367-374
This study evaluated the effects of tobacco Purchase, Use and Possession (PUP) laws on student perceptions of adolescent tobacco use within towns and schools. Twenty‐four towns were randomly assigned into two conditions, the experimental condition (E PUP) involved efforts to increase both PUP law enforcement and reduce minors' access to commercial sources of tobacco, whereas the control condition (C) focused only on efforts to reduce minors' access to commercial sources of tobacco. A hierarchical linear modeling analytical approach was selected due to the multilevel data and nested design. The present study found that over time, youth in the experimental PUP condition observed less youth tobacco usage at school and in their town, and perceived lower rates of tobacco among their peers at school and among friends than youth in the control condition. The findings suggest that PUP law enforcement might be used to strengthen community norms against youth tobacco use. 相似文献
60.