ISSN:0022-5282    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Previously, we documented that bacterial translocation occurs in rats fed an elemental liquid diet (4.25% amino acids plus 28% glucose) for 7 days. Since controversy exists over the protective effect of glutamine on diet-induced bacterial translocation, we compared the effect of two elemental diets, one containing 0% and the other 30% of amino acids as glutamine. After 7 days on the test diets or chow (307 kcal/kg/day), the rats were killed and half the animals had their organs cultured for translocating bacteria; immune function was quantitated in the other half by measuring the blood, splenic, and mesenteric lymph node (MLN) blastogenic responses to the T-cell mitogens phytohemagglutinin (PHA) and concanavalin A (ConA). The incidence of bacterial translocation was higher in the rats fed the glutamine (88%) or nonglutamine (75%) elemental diets than in the chow-fed rats (13%) (p< 0.05). Both elemental diets equally reduced the blastogenic response of lymphocytes harvested from all three lymphoid compartments (blood, spleen, MLN) (p< 0.01 vs. chow). The percentage of reduction averaged 30% to 40% when PHA was used as the test mitogen and 50% to 70% when ConA was used. These results indicate that glutamine does not prevent elemental diet-induced bacterial translocation or immune suppression.

ISSN:0022-5282    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

The purpose of this study was to analyze changes in plasma endothelin-1 levels during hemorrhagic shock. Thirty-two mongrel dogs were divided into four equal groups with group I as the controls and groups II through IV as experimental groups. The dogs in the experimental groups underwent hemorrhagic procedures. The mean blood pressure was kept at the level of 65 mm Hg in group II, 50 mm Hg in group III, and 40 mm Hg in group IV. Blood samples were collected from each dog under the following conditions: (1) after induction of anesthesia, when the animals were hemodynamically stable, before the start of shock; (2) 1 minute after the mean arterial pressure dropped to the level designed for each group (shock 1); (3) 15 minutes after shock 1; (4) 30 minutes after shock 1; (5) 1 hour after shock 1; (6) 2 hours after shock 1; (7) 4 hours after shock 1; and (8) 8 hours after shock 1. Plasma endothelin-1 levels both in arterial and venous blood were analyzed in each dog. The results showed that (1) arterial endothelin-1 concentrations were considerably lower than venous concentrations at the baseline level; (2) after the shock-1 point; plasma endothelin-1 concentrations increased, first markedly and then evenly throughout the oligemic period; (3) elevation of plasma endothelin-1 levels was significantly linearly correlated with the amount of blood loss at the time of 2 hours after shock and thereafter; (4) the arterial/venous ratio of plasma endothelin-1 levels during the oligemic period was higher than that in the control group. The elevation of plasma endothelin-1 concentrations during hemorrhagic shock is a combined result of the activation of stress hormones and the coagulation cascade and the decrease of blood flow in the kidneys and the lungs. The arteriovenous differences in plasma endothelin-1 levels during the oligemic period occur as a result of decreases in pulmonary and renal clearance, and the hypersecretion of endothelin-1 from vascular endothelial cells. Since endothelin-1 can exert vasconstrictive as well as a direct inotropic effect on the myocardium, it is postulated that endothelin released during hemorrhagic shock functions as a reactive substance and plays an important role in maintaining the vascular tonus and the perfusion pressure of the vital organs.

ISSN:0022-5282    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

It has been shown that the intravenous infusion of saline solution in a dog with stabilized cardiac tamponade produced an increase in pericardial pressure. To demonstrate that this pressure increase is the result of bleeding into the pericardial sac, an experimental study was conducted, consisting of the injection of red cells marked with51Cr during the intravenous infusion of saline solution in dogs with and without progressive tamponade. The results showed that in the dogs without progressive tamponade, both the pericardial pressure and the red cell count in the pericardial cavity remained stable during the infusion of saline solution, whereas in dogs with progressive tamponade, the numbers of marked cells and the pericardial pressure increased significantly, following a similar pattern.

ISSN:0022-5282    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Motor and sensory recovery were determined in five patients with ischemic myelopathy associated with traumatic laceration or surgical manipulation of the thoracic aorta. The neurologic level of injury was between T-2 and T-10. All patients had an anterior spinal artery pattern of incomplete spinal cord injury consisting of relatively greater loss of motor function than sensation and preservation of sacral sensation. None of the three patients with zero lower extremity motor function at 30 days regained any motor function at 1 year. Two patients with partial motor function 1 month after infarction had further motor recovery at 1 year. One of these two indivviduals was able to ambulate independently with a reciprocal gait using orthoses.

ISSN:0022-5282    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

The airbag restraint system has been described as a means of reducing fatalities in frontal crashes. This conclusion is based on crash investigations and statistical extrapolation, but few data exist to document specific fracture patterns and injuries after airbag depolyment. Seven cases of driver's side airbag depolyment after motor vehicle crashes were studied for extent of injury, Unrestrained (non-seatbeited) drivers demonstrated flexion injuries of the cervical and thoracic spine and direct impaction fractures of the face and sternum. One restrained (lap-shoulder belt) driver demonstrated an extension injury of the upper cervical spine. What may emerge from further study is a decrease in fatalities, but also a pattern of fractures specific to airbag use.

ISSN:0022-5282    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

One hundred five trauma patients admitted to three trauma centers with Injury Severity Scores of 20 or greater had lymphocyte phenotypic subsets characterized throughout their hospital course. Total lymphocytes, pan-T (CD2), helper T (CD4), suppressor T (CD8), pan B (CD20), and DR expressing lymphocytes were quantitated by monoclonal antibodies and flow cytometric analysis. Results were analyzed between three patient groups: uninfected, uneventful recovery (n = 64); major infection (n = 26); and dead (n = 15; 7 with sepsis). A significant lymphopenia, maximal at 3 days, occurred in the first postinjury week compared with controls (p< 0.05), which recovered over the study period. A hierarchical distribution was found between the three outcome groups with the lowest numbers of several lymphocyte phenotypes in those who died. T helper and suppressor cells were similarly affected, but lowest in patientsdestinedto develop infection or die. The helper-suppressor ratio, however, was similar in all three outcome groups. Therefore, modulation early after injury aimed at restoring these subsets may reduce the risk of subsequent infection.

ISSN:0022-5282    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Cultured epidermal allografts have been successfully used to treat a wide variety of skin defects ranging from burns to leg ulcers. Their postulated mechanism of action is through release of multiple cytokines that stimulate epithelialization from the wound periphery as well as from remnant epidermal appendages. A randomized, controlled clinical trial was undertaken to compare the efficacy of cryopreserved cultured allograft dressings (CCAD) with tulle-gras dressings in the treatment of splitskin graft donor sites. Five patients were enrolled in the study and in each patient, half of the donor site was allografted and the other half was treated with tulle-gras control. The mean time to complete healing was 6.2 days for CCAD compared with 9.6 days (p= 0.035) for the tulle-gras controls. Patient assessment of pain with dressing changes was also significantly lower at the CCAD treated sites than at the control sites (p= 0.001). The results indicate that cultured allografts offer greater patient comfort and earlier maturation of regenerated skin.

ISSN:0022-5282    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

Intracranial aneurysms are rare complications of head injury. Clinical and pathologic features as well as the surgical treatment of patients harboring traumatic intracranial aneurysms are presented. The latest neuroradiologic procedures as they relate to traumatic aneurysms are discussed. An illustrative case report is followed by a review of the literature.

ISSN:0022-5282    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

The cases of seven children treated from 1980 through 1991 with blunt renal artery injuries were reviewed to determine (1) if computed tomography alone could eliminate the need for intravenous pyelography (IVP) or arteriography (ART); and (2) the causes of management delays. The diagnosis of arterial occlusion was suggested by the lack of renal contrast enhancement in six patients with CT scans and in two patients with IVP. In three patients ART was merely confirmatory. The diagnosis was suggested by IVP or CT scan within a mean of 4.7 hours of injury, but ART added an additional mean 2.3 hours to the diagnostic workup. There was an additional 3.9-hour average delay in the operating room before revascularization. Six patients underwent revascularization. Four had minimal function by postoperative renal scans. Renal artery occlusion is rapidly detected by contrast-enhanced CT scanning without IVP or ART. The time period from diagnosis to revascularization must be expedited to improve renal outcome.

ISSN:0022-5282    

出版商:OVID    

年代:1993

数据来源: OVID