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  • 1
    ISSN: 1540-8191
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Blue toe syndrome caused by cholesterol emboli is a relatively benign disease. However, disseminated cholesterol embolism is a life-threatening condition. We describe here the case of a 71-year-old female admitted because of anterior chest pain and intermittent claudication. Following cardiac catheterization, warfarin potassium was administered. However, the patient's toes soon darkened bilaterally, and BUN and creatinine levels increased from the normal value. Skin discoloration and renal failure were improved after stopping warfarin potassium administration. The patient underwent coronary artery bypass grafting and left femoropopliteal bypass. Cerebral infarction and renal failure occurred postoperatively due to disseminated cholesterol embolism. The patient died from renal failure on the 16th postoperative day without regaining consciousness following surgery. For high risk patients, interventional procedures to the ascending aorta must be avoided. When CABG cannot be avoided for coronary revascularization, off-pump bypass and use of arterial grafts are recommended.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1540-8191
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Reports of patients with idiopathic thrombocytopenic purpura (ITP) undergoing cardiac surgery are rare, and almost all of the reported cases required platelet transfusion. ITP patients, especially those having a history of splenectomy or a history of heavy bleeding, may have to undergo multiple platelet transfusions. Such transfusions may induce al-loimmunization against the human leukocyte antigen (HLA) and result in refractoriness to subsequent platelet transfusions. We report a case of a 63-year-old female with ITP, with a history of splenectomy and multiple platelet transfusions, who underwent aortic and mitral valve replacement. Although corticosteroid administration, high-dose immunoglobulin therapy, and repeated platelet transfusion led to a temporary increase in platelet count and successful hemostasis, refractoriness to platelet transfusion occurred postoperatively because of the presence of the anti-HLA antibody. In addition, the patient showed complications of pyothorax. Corticosteroids might have exerted an inhibitory influence on the occurrence of pyothorax.
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Journal of oral pathology & medicine 19 (1990), S. 0 
    ISSN: 1600-0714
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Cyclosporin A (CSA)-induced gingival overgrowth was immunohistochemistry compared with that phenytoininduced and nonspecific inflammatory gingiva, and CSA concentration was determined for dental plaque. Leu-6+ epithelial dendric cells (EDC) were found to significantly decrease in number in CSA-induced gingival overgrowth, while the ratio of HLA-DR+ EDC to Leu-6+ EDC did not change significantly. The expression of class II major histocompatibility complex antigens, such as HLA-DR, -DP and -DQ on keratinocytes did not change by CSA-treatment. Leu-4+ mononuclear cells in CSA-induced gingival overgrowth were located primarily in the connective tissue far outside the epithelium. CSA concentration was much higher in dental plaque than in blood and other tissues. Immune response thus appears to be suppressed in the epithelial layer of CSA-induced gingival overgrowth through decrease in Leu-6+ HLA-DR+ EDC and T cell infiltration, both due to CSA in dental plaque. DNA polymerase a was detected in much fewer basal keratinocytes of CSA- and phenytoininduced gingival overgrowth. Epithelial hyperplasia may thus be not due to increased keratinocyte proliferation, but rather to enhanced keratinocyte life span.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Springer
    Surgery today 29 (1999), S. 194-195 
    ISSN: 1436-2813
    Keywords: Key Words: stent ; delayed sternal closure
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Springer
    Surgery today 29 (1999), S. 194-195 
    ISSN: 1436-2813
    Keywords: stent ; delayed sternal closure
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Delayed sternal closure following cardiothoracic surgery facilitates the treatment of heart failure and arrythmias caused by sternal closure, and also allows access to treat uncontrollable bleeding. The present study examines the use of stents made from disposable syringes for keeping the sternum open. The syringes demonstrated good strength, as well as resistance to tapping during pulmonary physical therapy and stability against body movement necessary to prevent the formation of decubitus ulcers. Thus, the proposed stent provides an inexpensive, easy, and effective method for keeping the sternum open.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1437-7772
    Keywords: oral cancer ; cisplatin ; pirarubicin ; intra-arterial infusion
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background A comparison of chemotherapy with PP (cisplatin, CDDP; and peplomycin, PEP) and TPP (4′-O-tetrahydropyranyladriamycin: THP-ADM, CDDP and PEP) in the treatment of oral cancer. Methods This study included 159 out of 199 patients who had visited the collaborating institutions' hospitals, and who had been registered in the Examination Meeting of Chemotherapy for Oral Cancer during the 2-year period from June 1990 to May 1992. Ninety-seven patients underwent PP therapy and 62 underwent TPP therapy. In PP intravenous infusion therapy, 60–80 mg of CDDP per m2 was administered on day 1, followed by infusion of 5–7.5 mg of PEP per m2 from day 2 until day 6. In the PP intra-arterial infusion therapy, in which the drugs were infused in a retrograde fashion into the superficial temporal artery, 50–70 mg of CDDP per m2 was infused on day 1, followed by infusion of 5 mg of PEP per m2 from day 2 until day 6. In both the intravenous and intra-arterial TPP therapy regimens, 20 mg of THP-ADM per m2 was infused on day 1, followed by infusion of 50 mg of CDDP per m2 on day 2, and infusion of 5 mg of PEP per m2 from day 3 until day 7. Results The response rate of TPP therapy was 64.5%, which was not significantly different from the 53.6% obtained with PP therapy. However, the complete response (CR) rate with TPP therapy was 22.6%, significantly higher than the 9.3% with PP therapy. The response rate of TPP intra-arterial infusion therapy was particularly high (92.3%), and significantly higher than that of PP therapy. The response rate of TPP intra-arterial infusion therapy was very high (100.0%) in stage I and II patients and in primary cancers of the tongue, gingiva, buccal mucosa, and hard palate. The toxicity of TPP and PP therapies resulted in a high incidence of nausea/vomiting and anorexia. Skin disorders and epilation were observed at high rates with TPP therapy, and incidences were particularly high (100.0%) in the TPP intra-arterial infusion therapy group. The incidence of leukopenia was high in patients treated with TPP therapy but was not severe. Conclusion The results of this study suggest that TPP therapy is more effective than PP therapy in the treatment of oral cavity cancer. Although TPP therapy was associated with skin abnormalities, alopecia, and leukopenia as side effects, there was no influence on subsequent treatment. TPP intra-arterial infusion therapy appears promising in the treatment of oral cancer.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1432-2013
    Keywords: Salivary gland ; Ammonium chloride ; Butyric acid ; Potassium current ; chloride current ; intracellular pH
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In acinar cells freshly dispersed from rat parotid glands, the effects of ammonium chloride (NH4Cl) on membrane currents were studied using the whole-cell clamp method. When membrane currents were recorded with command pulses to 0 mV, applied at 2-s intervals from a holding potential of −70 mV, NH4Cl (5–20 mM) transiently decreased outward currents and then slowly increased both outward and inward currents. After reaching a peak in about 40–50 s, both outward and inward currents gradually decreased in the presence of NH4Cl and, on its wash-out, the currents returned to the control level. Butyrate (5–20 mM) had little effect on the resting membrane currents, but markedly inhibited the response to NH4Cl. Tetraethylammonium (5 mM) strongly reduced both the resting and NH4Cl-induced outward currents, whereas it slightly potentiated the NH4Cl-induced inward current without affecting the membrane current at the holding potential. Without ATP in the patch pipettes, carbachol-induced membrane currents were relatively resistant to Ca2+ removal from the external medium, but NH4Cl-induced currents were quickly abolished in the absence of Ca2+. We conclude that intracellular alkalinization with NH4Cl increases Ca2+ influx and activates Ca2+-dependent outward K+ and inward Cl− currents.
    Type of Medium: Electronic Resource
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  • 8
    ISSN: 1432-2013
    Keywords: Salivary gland ; Muscarinic receptor ; Intracellular Ca ; Intracellular ATP ; Potassium current ; Chloride current ; Tetraethylammonium
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In freshly dispersed rat parotid acinar cells, 10 μM carbachol increased outward currents at 0 mV and also inward currents at −70 mV recorded with the whole-cell clamp method using patch pipettes containing 1 mM EGTA. When EGTA in the pipette was increased to 2.4 mM, carbachol increased only outward currents and a further increase of EGTA to 4 mM blocked the carbachol response. Effects of changes in external K+ and Cl− concentrations suggested that outward currents were carried by K+ and inward by Cl−. Effects of Ca2+ removal from the medium differed between experiments with 0 and 5 mM ATP in the patch pipettes. When pipettes contained no ATP, responses evoked by repeated applications of 10 μM carbachol (0.5–1 min) at 1.5–4 min intervals decreased only slowly after Ca2+ removal, outward currents being reduced to 90±6% and inward currents to 47±11% (n=6) in 10 min. On the other hand, when 5 mM ATP was included in the electrodes, Ca2+ removal abolished the carbachol responses in about 5 min (n=4). It was also found that tetraethylammonium (5 mM) strongly reduced both currents, by blocking muscarinic receptors, while Ba2+ (2.4 mM) inhibited only the outward K+ current.
    Type of Medium: Electronic Resource
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  • 9
    ISSN: 1573-8280
    Keywords: biological response modifier ; immunohistochemistry ; interleukin 1 ; neutrophil
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract On the assumption that neutrophils around the injection site of OK-432, a heat- and penicillin-treated lyophilized preparation of the Su strain ofStreptococcus pyogenes, enhance immunologic response through the production of Interleukin-1 (IL-1), OK-432 was injected into rat tongue, and specimens from the tongue were immunohistochemically investigated at various intervals after the injection, to clarify the process of inflammatory and immune responses at the injection site. Neutrophils and mononuclear cells appeared around the OK-432 injection site after 1 hour, increased to their maximum level at 24 hours, and then decreased from the 3rd to the 7th day. IL-1 was detected on neutrophils 3 hours after the injection, and OX-08-positive cells (suppressor/cytotoxic T cells and the majority of natural killer cells) remarkably increased. OX-39-positive cells (IL-2 receptor) appeared after 12 hours. These results suggest that neutrophils around the injection site of OK-432 at early phases of inflammation play a role in the expression of BRM function through IL-1.
    Type of Medium: Electronic Resource
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