Arch Surg Chicago
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Comparative Study Clinical Trial
Penetrating injuries of the neck in patients in stable condition. Physical examination, angiography, or color flow Doppler imaging.
The initial assessment of penetrating injuries of the neck is controversial, with angiography remaining the gold standard for identifying vascular injuries. Recent reports suggest that physical examination might be an accurate way to evaluate these injuries. Color flow Doppler imaging has been used with promising results to assess extremity injuries, but the role of color flow Doppler imaging in neck injuries has not been studied. ⋯ The combination of a careful physical examination and color flow Doppler imaging provides a reliable way to assess penetrating neck trauma and may be a safe alternative to routine contrast angiography.
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Case Reports
Elective intraoperative intracranial pressure monitoring during laparoscopic cholecystectomy.
The effects of artificial pneumoperitoneum on intracranial pressure have not been clearly defined. Initial animal studies indicate that elevated intra-abdominal pressure might have a deleterious effect on intracranial pressure. ⋯ Initial opening intracranial pressure values were re-established on desufflation of the abdomen. Intracranial pressure monitoring should be considered when planning a laparoscopic procedure on patients with the potential for decreased intracranial compliance.
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To study the effect of a burn injury on the course of cellular and cytokine changes in a wound and the relationship of these cytokines to the amounts of protein and collagen deposited at the site of the wound. ⋯ The underlying mechanism of the impaired healing of a wound after burn injury could lie in the altered migration of inflammatory cells to the site of the wound and in the aberrant cytokine levels within the wound.
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Proteolysis and oxidant injury are important mechanisms of injury in thermal burns. The glycoprotein ulinastatin has antiprotease and free radical-scavenging properties and therefore could be useful in the treatment of these injuries. ⋯ Ulinastatin may have a therapeutic role in treating thermal injuries.