ISSN:0002-9629    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Allocation of research space often is one of the most emotional and contentious issues facing a university medical center. With decreasing dollars available for building new research laboratories in medical schools, the assignment of laboratory space to basic science and clinical departments presents a difficult problem for deans, chairmen, and faculty. In this article, the authors outline a formula in which net square feet of traditional research space (ie, wet-bench laboratories) may be allocated on the basis of research dollars, output of manuscripts and abstracts averaged over 3 years, and the number of personnel who will use the space. Caution is urged for arbitrarily applying a space formula when it does not apply, ie, nontraditional research, and when insufficient consideration has been given to the individual case. The formula is most useful when applied within a specific institution and primarily for comparative purposes. Nonetheless, once the formula is established, it provides an objective mechanism by which the need for space and the relative merits of space assignments within a department or among departments can be more effectively determined and managed.

ISSN:0002-9629    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

The authors report the development of a rapidly progressive encephalopathy marked by confusion, myoclonus, seizures, coma, and death in a group of women with renal failure who received an oral solution of citrate and aluminum hydroxide gel concurrently. Two patients were documented as having marked hyperaluminemia far exceeding blood aluminum levels encountered in the chronic state of aluminum intoxication. We ascribe the toxicity to enhanced gastrointestinal absorption of aluminum when complexed with citrate.

ISSN:0002-9629    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

The hypothesis was tested in vitro that the spontaneous degradation of atracurium leads to formation of electrophilic metabolites. Variable amounts of atracurium were incubated in saline (0.9% NaCl) for 120 minutes at pH 8.0 and 370C. Subsequently, cysteine was added to the incubation solutions and the incubation was continued at pH 7.4 and 370C. Frequent determination of the mercapto groups of cysteine revealed a progressive diminution of the mercapto groups remaining in the incubation solutions. The consumption of sulfhydryl groups was maximal at 20 minutes after the addition of cysteine and amounted to approximately twice the molar amount of atracurium. Kinetic analysis indicated that one mercapto group was consumed almost instantly, whereas the consumption of the other proceeded with a half-life of 4 minutes. No consumption of mercapto groups was observed when laudanosine was incubated with cysteine. Incubation of atracurium or of its degradation products with carboxylesterase markedly reduced the amount of reactive metabolites present in the incubation solutions. The results are compatible with the working hypothesis that spontaneous degradation of atracurium via Hofmann elimination results in generation of two equivalents of reactive electrophilic esters, probably acrylates. We propose that in vivo the portion of the aliphatic chain in the atracurium molecule that is converted to acrylates by Hofmann elimination may be eliminated in part in urine as a conjugate of mercapturic acid.

ISSN:0002-9629    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

In recent years transient primary hypothyroidism has reported with increasing frequency. Physicians are often unsure whether withdrawal of thyroid hormone to identify the transient hypothyroidism is indicated and cost-effective and in which patients this should be done. To study these questions, thyroid hormone therapy was withdrawn from 63 patients with proven primary hypothyroidism at 6 months and again at 1 and 3 years to determine if there was recovery of thyroid function. Of the 49 patients with primary hypothyroidism (PH) that was not attributable to such causes as drug therapy, surgery, iodine-131 therapy, or silent or subacute thyroiditis, only two patients recovered thyroid function. In the other 14 patients, hypothyroidism developed within 6 months postpartum. Nine of these 14 recovered thyroid function. Therefore, it appears that when PH is not related to certain specific causes or states, it is likely to be permanent. Furthermore, withdrawal of thyroid hormone therapy to assess recovery of thyroid function is unnecessary and not cost-effective.

ISSN:0002-9629    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

The peripheral vascular complications associated with percutaneous transfemoral coronary angioplasty were compared with those that occurred during conventional transfemoral cardiac catheterization. Among 644 patients undergoing percutaneous transluminal coronary angioplasty (PTCA), 6 patients (0.9%) suffered peripheral vascular complications, whereas 35 of 2904 patients having cardiac catheterizations (1.2%) had a peripheral vascular complication. The types of complications associated with both procedures were similar and included groin hematomas, false aneurysms, arterial dissection, arterial perforation, and neurological deficits. The frequency of surgical repair of these complications also was similar in the two groups (50% required repair for a PTCA complication, 34% were repaired after a catheterization complication). The PTCA-associated complications included one myocardial infarction and one death, whereas neither of these occurred in association with a catheterization-induced vascular complication. The surgical management of five of the six PTCA complications was difficult, largely because of the size of the sheath-related puncture site and the presence of active bleeding from the associated systemic anticoagulation. PTCA carries the same risk of development of a peripheral vascular complication as found in transfemoral cardiac catheterization. Care must be taken to prevent sheath-related injury to the aorta-iliac-femoral system and hemorrhagic complications at the puncture site are of particular concern and require urgent surgical attention.

ISSN:0002-9629    

出版商:OVID    

年代:1989

数据来源: OVID

ISSN:0002-9629    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

During the past two years, sporadic cases of a rickettsial-like illness were reported in humans living in the Southeastern United States. The illness was serologically similar toEhrlichia canisinfections in dogs. It resembled spotless Rocky Mountain Spotted Fever but was differentiated from this infection serologically with acute and convalescent sera showing increasing titers toEhrlichia canis. E. canisinfection should be suspected in patients with fever, headache, malaise, myalgia, gastro-intestinal symptoms, relative bradycardia, leukopenia, thrombocytopenia, and a recent exposure to either dogs or ticks. Although recovery has been observed in humans without treatment, prompt therapy with tetracycline is advised before obtaining results of serologic studies because an immunologically similar illness in untreated dogs has been lethal.

ISSN:0002-9629    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

A patient with systemic lupus erythematosus is reported whose initial clinical presentation was that of acute pancreatitis, confirmed by pancreatic isoamylase elevation and pancreatic enlargement on computerized tomography. A lack of a correlation with steroid therapy and a need to document pancreatitis in a multisystem disease like lupus with radiographic evidence as well as pancreatic isoamylase elevations is emphasized.

ISSN:0002-9629    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

Although thyroidal uptake of gallium-67 has been described in several thyroid disorders, gallium-67 scanning is not commonly used in the evaluation of thyroid disease. Thyroidal gallium-67 uptake has been reported to occur frequently with subacute thyroiditis, anaplastic thyroid carcinoma, and thyroid lymphoma, and occasionally with Hashimoto's thyroiditis and follicular thyroid carcinoma. A patient is described with progressive systemic sclerosis who, while being scanned for possible active pulmonary involvement, was found incidentally to have abnormal gallium-67 uptake only in the thyroid gland. Fine needle aspiration cytology of the thyroid revealed Hashimoto's thyroiditis. Although Hashimoto's thyroiditis occurs with increased frequency in patients with progressive systemic sclerosis, thyroidal uptake of gallium-67 associated with progressive systemic sclerosis has not, to our knowledge, been previously described. Since aggressive thyroid malignancies frequently are imaged by gallium-67 scintigraphy, fine needle aspiration cytology of the thyroid often is essential in the evaluation of thyroidal gallium-67 uptake.

ISSN:0002-9629    

出版商:OVID    

年代:1989

数据来源: OVID