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61.
Percutaneous US guided nephrostomy is the simplest and most direct technique to drain an obstructed kidney. The indications are included in two groups: temporary drainage and permanent drainage; the former is indicated in the non endoscopically superable ureteral obstruction, in pyonephrosis, in pregnant women and in transplanted kidneys (due to the easier access), the latter is exclusively reserved to neoplastic obstructions. The only real contraindication to the method, besides a documented allergy to local anaesthetics, is represented by a severe coagulopathy. Positioning techniques are the "one shot" technique, in which dilation and positioning are synchronous (it can avoid fluoroscopy but it is more traumatic) and angiographic derived Seldinger's technique, that utilizes fluoroscopy and an instrumentation including a guidewire and a set of Amplatz dilators. Complications are due to the access route; the choice of an intercostal access is always inadvisable, due to the risk of pneumothorax or pulmonary injury; the most frequent complications are vascular (hemorrhage, retroperitoneal hematoma) and usually well controlled; more severe lesions (renal artery laceration and arteriovenous fistula) may require intervention or embolization, but the incidence of nephrectomies due to vascular injury accounts for one per thousand. 相似文献
62.
Whereas most liver resections can be performed within 60 min, the period of vascular clamping and resulting ischemia may prove too short to allow complex major liver resections (MLR) especially on diseased livers. To overcome this problem, cooling of the liver with 4 degrees C preservations solution routinely used in liver transplantation may be used in three different approaches to MLR: I "In situ": the liver remains in the abdomen and integrity of afferent and efferent vessels is conserved. II "Ex situ-in vivo": the liver exteriorized from the abdomen by transecting all hepatic veins, remains connected to the porta hepatis. III "Ex vivo": the liver being removed from the abdomen, the MLR is performed extracorporeally. Of 15 MLR reported here, 11 were performed "in situ" and 4 "ex situ-in vivo"/Nowadays, the liver surgeon's "toolbox" must contain hypothermic liver perfusion. In carefully selected cases, these techniques allow MLR on diseases livers or mandating complex vascular procedures. 相似文献
63.
R. PearceAuthor Vitae T. IakimovM. AnderssonAuthor Vitae L. HultmanAuthor VitaeA. Lloyd SpetzAuthor Vitae R. YakimovaAuthor Vitae 《Sensors and actuators. B, Chemical》2011,155(2):451-455
Epitaxially grown single layer and multi layer graphene on SiC devices were fabricated and compared for response towards NO2. Due to electron donation from SiC, single layer graphene is n-type with a very low carrier concentration. The choice of substrate is demonstrated to enable tailoring of the electronic properties of graphene, with a SiC substrate realising simple resistive devices tuned for extremely sensitive NO2 detection. The gas exposed uppermost layer of the multi layer device is screened from the SiC by the intermediate layers leading to a p-type nature with a higher concentration of charge carriers and therefore, a lower gas response. The single layer graphene device is thought to undergo an n-p transition upon exposure to increasing concentrations of NO2 indicated by a change in response direction. This transition is likely to be due to the transfer of electrons to NO2 making holes the majority carriers. 相似文献
64.
DC Miller 《Canadian Metallurgical Quarterly》1993,5(1):33-46
In the free-running circadian rhythms of 14 human subjects (4 females, 10 males) who lived singly in an isolation unit without temporal clues, locomotor activity was recorded by means of contact plates installed below the carpet in the main room. During sleep, movements in bed were picked up by spring contacts attached to the mattress. In all subjects, the hourly means of locomotion during wakefulness (alpha) were negatively correlated with the duration of alpha to such an extent that the total amount of locomotion per cycle remained constant when alpha varied from 14 to 23 hr. The hourly values of movements in bed were independent of the duration of sleep (rho), so that the total number of movements was almost proportional to rho. The "homeostatic control" of locomotion during wake time is considered as a means to conserve energy when the duration of wakefulness increases. 相似文献
65.
66.
The development of healthy schools to support and nature the well-being of students, teachers, and staff is proposed as a first step toward the goal of comprehensive health education. A focus on healthy schools incorporates elements of an expanded concept of comprehensive health education that demands careful consideration of the physical, psychological, and social environment of the nation's schools--worksite to 51 million (students, teachers, and staff). The active participation of all stakeholders in environmental assessments, health and safety audits, and restructuring of schools is an essential part of the school reform movement. A healthy worksite concept supports the transformation of the school environment to increase "productivity" by enhancing the ability of teachers, staff, and students to function well. 相似文献
67.
The syndrome of parainfectious encephalomyelitis evolves from an antecedent infection. Several etiologic agents have been associated with this complication, although the pathogenesis in each instance may prove to be more uniform. Considerable evidence suggests that the syndrome is mediated immunologically. The seven cases reported here were clinically similar, although the infectious etiologies were diverse. Leptospirosis antedated the neurologic syndrome in two cases, and a "viral" illness preceded the other five cases. The evolution of the syndrome was slowly progressive in each case, and six patients had prominent involvement of rhombencephalic structures. The progressive course was reversed rapidly with eventual full recovery in each instance after initiation of corticosteroid therapy. Our experience with these cases coupled with a review of the literature suggests that corticosteroid therapy should be considered in the subacute or chronic cases of parainfectious encephalomyelitis. 相似文献
68.
A new method for evaluating antiarrhythmic drug efficacy 总被引:1,自引:0,他引:1
M Sami H Kraemer DC Harrison N Houston C Shimasaki RF DeBusk 《Canadian Metallurgical Quarterly》1980,62(6):1172-1179
To develop standards for distinguishing antiarrhythmic drug effect from spontaneous variability of premature ventricular complexes (PVCs), 21 males (mean age 56 +/- 8 years) with chronic ischemic heart disease and PVCs underwent symptom-limited treadmill exercise testing and 24-hour ambulatory monitoring before and after 2 weeks of placebo medication. Linear regression analysis was used to describe the relationship between baseline and placebo PVC frequency for various indexes of ventricular ectopic activity and to establish 95% and 99% one-tailed confidence intervals for this relationship within the group of 21 patients. The lower limit of baseline PVC frequency for which the procedure could distinguish a placebo from a true drug response, termed the "sensitivity threshold," was an average frequency of 2.2 PVCs/hour for ambulatory electrocardiographic monitoring and 1.2 PVCs/min for treadmill exercise testing. All patients exceeded the sensitivity threshold on baseline ambulatory ECGs, but only 38% of patients did so on baseline treadmill exercise tests. To establish antiarrhythmic efficacy with 95% confidence, the minimal percent reduction of PVCs between baseline and placebo visits was 68% for treadmill exercise testing and 65% for ambulatory electrocardiography. Although these standards were developed in patients with chronic ischemic heart disease, the model can be used to establish antiarrhythmic drug efficacy in any patient group. 相似文献
69.
Christian Bur Peter Reimann Mike Andersson Anita Lloyd Spetz Andreas Schütze 《Microsystem Technologies》2012,18(7-8):1015-1025
A silicon carbide based enhancement type metal insulator field effect transistor with porous gate metallization has been investigated as a total NO x sensor operated in a temperature cycling mode. This operating mode is quite new for gas sensors based on the field effect but promising results have been reported earlier. Based on static investigations we have developed a suitable T-cycle optimized for NO x detection and quantification in a mixture of typical exhaust gases (CO, C2H4, and NH3). Significant features describing the shape of the sensor response have been extracted and evaluated with multivariate statistics (e.g. linear discriminant analysis) allowing quantification of NO x . Additional cleaning-cycles every 30?min improve the stability of the sensor further. With this kind of advanced signal processing the influence of sensor drift and cross sensitivity to ambient gases can be reduced effectively. Measurements have proven that different concentrations of NO x can be detected even in a changing mixture of other typical exhaust gases under dry and humid conditions. In addition to that, unknown concentrations of NO x can be detected based on a small set of training data. It can be concluded that the performance of GasFETs for NO x determination can be enhanced considerably with temperature cycling and appropriate signal processing. 相似文献
70.
Two new methods of activation were developed to graft enzymes on collegen films. They involved chemical modifications of surface groups of collagen either by Woodward's reagent "K" or by EDC, a water-soluble derivative of carbodiimide. EDC was a better coupling agent and a detailed study was conducted with this agent. It could be used either in a global method of activation and coupling, or in a two-step procedure of activation of collagen, followed by spontaneous coupling of enzyme. All enzymes tested were successfully bound: malate dehydrogenase, lactate dehydrogenase, aspartate aminotransferase, urease, creatine kinase, hexokinase. The influence on the yield of grafted enzyme, of pretreatment of films, time and temperature of EDC activation, concentration of EDC and enzyme, protecting agents was studied. Stability of enzyme activity on storage was greatly increased after grafting. A co-grafted dual system creatine kinase/heoxkinase, was achieved which exhibited a good efficiency. A striking renaturing process at 0-4degreesC after thermal denaturation, was observed with hexokinase. 相似文献