摘要:

Studies are presented on a 20-year-old man with congenital giant hemangioma occupying the whole left side of the body, with alterations in the clotting system characteristic of a consumption-coagulopathy with “defensive” fibrinolysis. There were also changes in red cell morphology, consistent with “traumatic hemolytic anemia”; the platelet and red cell half-time survival were shortened to 1.8 and 15 days, respectively. Total blood volume was 10.3 liters. Following treatment with continuous IV heparin, abnormalities of the clotting mechanism were corrected including a rise in platelets from 46,000 to 330,000/mm3 fibrinogen from45 to 300 mg% and factor VIII from 20 to 120% Hemolytic parameters also improved as demonstrated by a fall in reticulocyte count and concentration of free hemoglobin in plasma. Heparin administration restored the hemostatic defenses and permitted extensive surgical intervention. After healing by first intention, heparin was discontinued and the consumption-coagulopathy with “defensive” fibrinolysis reappeared.

ISSN:0002-9629    

出版商:OVID    

年代:1971

数据来源: OVID

摘要:

Reactive hypoglycemia may result from a variety of causes and therapy often is not satisfactory Six patients with reactive hypoglycemia were treated with sulfonylurea agents. This therapy alleviated their symptoms, corrected their hypoglycemia, and restored their abnormal insulin responses to normal. The hypoglycemia in two of these patients appears to be related to alimentary factors, in three to diabetes mellitus, and in one patient to an isolated growth hormone deficiency.

ISSN:0002-9629    

出版商:OVID    

年代:1971

数据来源: OVID

摘要:

Repeated culture surveys were made on 13 patients undergoing major elective surgery. All patients had an endotracheal tube in place during operation only, and all used sonic form of respiratory assistance in the postoperative period. Ten patients received prophylactic antibiotics.Five patients had gram-negative bacilli in the preoperative nose, throat, and sputum cultures; and 11 of the 13 had these organisms present in the respiratory flora at some lime in the postoperative period. The cause of the unusually high incidence of these organisms may be related to illness, hospital environment, endotracheal intubation, surgery, or the use of systemic antibiotics. This frequency of respiratory colonization may be one factor contributing to the general increase in gram-negative sepsis.

ISSN:0002-9629    

出版商:OVID    

年代:1971

数据来源: OVID

摘要:

Left ventricular function was studied before and after production of acute myocardial infarction by selective mercury embolization of the circumflex coronary artery in 8 closed chest dogs lightly anesthetized with morphine and chloralose. Ventricular function curves relating stroke volume, stroke work and mean stroke power to left ventricular end-diastolic pressure were determined. Stroke volume was obtained by an indicator dilution method with the heart rate kept constant by pacing. Left ventricular end-diastolic pressure was acutely increased by three 100 cc infusions of dextran before and 45 minutes after embolization. With dextran infusion before embolization, the mean right atrial pressure and the left ventricular end-diastolic pressure increased linearly; following embolization the left ventricular end-diastolic pressure increased out of proportion to the right atrial pressure. After embolization, the slope of the ventricular function curves was depressed consistently. However, the cardiac output post-embolization could be increased with dextran infusion up to a left ventricular Filling pressure of 19–20 mm Hg beyond which the curves relating output to filling pressure flattened or actually decreased. Thus, left ventricular function was measurably diminished following acute myocardial infarction in this experiment.

ISSN:0002-9629    

出版商:OVID    

年代:1971

数据来源: OVID

摘要:

Myocardial necrosis was induced in 200 male rats by administration of isoproterenol. Seventy-two of the 139 survivors were treated with dimethylsulfoxide and 67 received no further drugs. Animals from each group were killed 2, 7, and 14 days after induction of necrosis, along with 10 control rats. Hexosamine and hydroxyproline determinations were made on the hearts, and the values obtained were compared between groups. A transient rise in cardiac hexosamine of similar degree was found in both the dimethylsulfoxide-treated and untreated groups as compared to the controls. A marked elevation in cardiac hydroxyproline levels was noted at all three times in both groups with cardiac necrosis. The levels in the dimethylsulfoxide-treated groups were, however, significantly lower than those of the untreated group. These studies indicate that, although the early myocardial lesions in the treated and untreated groups were of equal severity, dimethylsulfoxide modified the healing process so as to result in a reduced area of myocardial scarring.

ISSN:0002-9629    

出版商:OVID    

年代:1971

数据来源: OVID

摘要:

Thyroid hormone deficiency may not be the immediate cause of severely impaired consciousness in myxedema. Review of published cases identifies four pathological stales associated with myxedema which may be directly responsible. These are hypoxia, hypercarbia, hyponatremia, and hypopituitarism. Some myxedematous patients are on the verge of cerebral hypoxia; intercurrent heart disease (myocardial infarction or congestive heart failure) or hypotension (overwhelming infection or gastrointestinal hemorrhage) may readily lead to coma in these patients. Others have mild alveolar hypoventilation which may proceed to severe hypercarbia, particularly in the presence of ventilation-perfusion inequalities (pneumonia) or following respiratory depression (drug administration). Severe hyponatremia occasionally accompanies myxedema and may be responsible for altered stales of consciousness. Patients with secondary myxedema may present with vascular collapse consequent to pan-hypopituitarism. Undue emphasis on thyroid replacement regimens may divert attention from these immediate causes of impaired consciousness and delay institution of specific therapy.

ISSN:0002-9629    

出版商:OVID    

年代:1971

数据来源: OVID

ISSN:0002-9629    

出版商:OVID    

年代:1971

数据来源: OVID