100 Short Cases for the MRCP最新文献_第7页

Down's Syndrome 唐氏综合症

100 Short Cases for the MRCP Pub Date : 2020-10-14 DOI: 10.1201/9781003058915-10

K. Gupta, P. Carmichael, A. Zumla

引用次数: 0

Titubation 蹒跚

100 Short Cases for the MRCP Pub Date : 2020-10-14 DOI: 10.1201/9781003058915-25

K. Gupta, P. Carmichael, A. Zumla

引用次数: 0

Choroidoretinitis 脉络膜视网膜炎

100 Short Cases for the MRCP Pub Date : 2020-10-14 DOI: 10.1201/9781003058915-74

K. Gupta, P. Carmichael, A. Zumla

引用次数: 0

Hyperthyroidism 甲状腺机能亢进

100 Short Cases for the MRCP Pub Date : 2020-10-14 DOI: 10.1201/9781003058915-5

K. Gupta, P. Carmichael, A. Zumla

{"title":"Hyperthyroidism","authors":"K. Gupta, P. Carmichael, A. Zumla","doi":"10.1201/9781003058915-5","DOIUrl":"https://doi.org/10.1201/9781003058915-5","url":null,"abstract":"QRAVES' Disease -or Hyperthyroidism has presented many problems, the solution of which has demanded the activity of all departments of scientific medicine, and to which each has. contributed its quota of valuable information. The internist has of late years been especially interested in the study and detection of mild grades of the conditions causing more or less pronounced invalidism and simulating other diseases. The chief problem affecting the surgical treatment has been, however, the development of a pre-operative preparation, an operative technique; and a postoperative care by which the margin of safety to the patient has been progressively increased. Biological chemis. try in the study of metabolism now permits empiric expe'rience to be interpreted in terms of scienttific exactitude. In Kocher's epochal work upon goitre we view the efforts of this master surgeon and clinician to discover a safe criterion for operation upon goitre cases associated with hyperthyroidism and the enunciation of definite rules of surgical procedure. Kocher recognized the value of refrigeration; employed exercise as a test of myocardial stability; sought in the differential leucocyte count an index of the gravity of the toxoemia; and resolutely set his face against the use of inhalation ancesthesia. Although the differentiation between cases of Graves' disease and toxic adenoma had not clearly emerged, Kocher furthdr found by experience that the radical operation of that day (lobectomy) could not be undertaken safely as a routine, and advocated vascular ligation, first practised by Wolfier, as a preliminary measure in the more serious cases. Barker of University College Hospital, London, measurably advanced upon Kocher's cocaine analgesia by using beta eucaine and an improved method of infiltration. Still the mortality following operation remained high. The severe and often fatal reactions following operation were variously ascribed t'o (1) nervous shock; (2) compression of the glantd during operation; (3) absorption of liberated thyroid secretion from the divided surfaces of the gland; (4) haemorrhage; and (5) infection. Crile met all these conditions with a technique which eliminated the unexpected, the chief cause of nervous excitation; reduced traumatism to the irreducible minimum; and advocated combined local and gas-oxygen anaesthesia. As a result the mortality figures rapidly declined. The latest and greatest advance is due to the clinical application of important laboratory discoveries. The names of Lavoisier, Rubner, Benedict, DuBois, and Tissot are closely associated with the development of apparatus and technique for the estimation of the basal metabolic rate in animals and man, and for substantiating what has long been assumed, that the thyroid is the chief regulator of chemical activity with-","PeriodicalId":143714,"journal":{"name":"100 Short Cases for the MRCP","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133681931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Coarctation of the Aorta 主动脉缩窄

100 Short Cases for the MRCP Pub Date : 1958-05-01 DOI: 10.1201/9781003058915-38

De Andrade Ma, Coelho Ca, Carneiro Rd

{"title":"Coarctation of the Aorta","authors":"De Andrade Ma, Coelho Ca, Carneiro Rd","doi":"10.1201/9781003058915-38","DOIUrl":"https://doi.org/10.1201/9781003058915-38","url":null,"abstract":"The relatively bad prognosis in cases of aortic coarctation seemed to. be sufficient ju'stification for making an attempt at surgical treatment in these patients. One of us (Crafoord), during work with patent ductusarteriosus and as the result of both experimental and-clinical 'studies of the circulatory conditions existing when the aorta is shut off at differentlevels, gradually came to the conclusion that the surgical risk would not be too-great. In experimental studies on dogs, Crafoord (1939) demonstrated that the flow of blood to all the organs could remain suspended for as long as twenty to twenty-five minutes without any subsequent sign of organic damage, provided an' adequate flow to the brain was secured. This circulation to the brain -was maintained by creating anastomoses between the carotid and jugular vessels on one side in the animal under operation with the corresponding vessels in a dog of the same size lying beside it. On the strength of this observation Crafoord toQk the risk, in certain patients with a patent ductus arteriosus, of placing clamp forceps on the aorta above and below the point of entry of the duct into this artery and of keeping them attached during the time necessary to divide the duct and suture the aorta. In one of the patients this part-of the operation took no less than 27 minutes to perform. In spite of this long period, during which the aorta was shut off just below the point where the subclavian artery arises, no noticeable disturbances were subsequently observed in the patient's internal organs. As far as we -have been able to ascertain from the literature, the only other investigator besides Crafoord who has considered the possibility of relieving coarctation of the aortic isthmus by a surgical intervention is Blalock (Blalock and.Park, 1944; Blalock and Taussig, 1945). The latter, however, approached the problem .in. a more conjectural manner and from a different standpoint, having considered some fo'rm of anastomosing operation or plastic reconstruction","PeriodicalId":143714,"journal":{"name":"100 Short Cases for the MRCP","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1958-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127916957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 9