Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Hereditary hemorrhagic telangiectasia is a rare, hereditary fibrovascular dysplasia. We report a case associated with hepatolithiasis. Hepatolithiasis, relatively common in East Asia, is rare in the West. The association of the two conditions has not been previously reported. In this case, vascular malformations in the liver gave rise to arteriovenous and arterioportal fistulas, causing arteriovenous shunting and protal hypertension, respectively. Abnormal blood flow is the proposed mechanism for the hepatic fibrosis and nodular regeneration. Hepatic fibrosis, by causing stenosis of large intrahepatic bile ducts, bile stasis, and secondary infection, is the hypothesized mechanism for calculus formation. Hepatolithiasis ultimately caused death from acute bacterial cholangitis and septicemia.
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PMID:Hepatolithiasis in hereditary hemorrhagic telangiectasia. 232 2

Thirty-two patients were treated with colectomy, mucosal proctectomy, and straight ileoanal anastomosis. Mucosal dissection was performed from the abdominal side, and an anal mucosal brim of 1-2 cm was preserved. Diverting ileostomy was not used, and four patients developed anastomotic leak with pelvic sepsis. Three patients had take-down of the anastomosis for reasons related to the operative method. The remaining patients are all completely continent day and night and have a median stool frequency of 6/24 h 1 year after the operation. The frequency was significantly higher in patients with ulcerative colitis (UC) than in patients with familial polyposis (FP). No dysplasia, ulceration, or stricture formation was found in the preserved mucosa in the UC patients. Regrowth of polyps in the mucosal brim occurred in 10 of 13 FP patients, with atypia in 1. The FP patients had more late complications attributed to extracolonic manifestations of the FP disease.
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PMID:Straight ileoanal anastomosis with preserved anal mucosa for ulcerative colitis and familial polyposis. 284 98

Sonographic characteristics and percutaneous catheter drainage of thigh abscesses in 18 patients are described. Most of these patients had underlying diseases including osteomyelitis, trauma, diabetes mellitus, rheumatoid arthritis, leukemia, lymphoma, sepsis, bleeding dyscrasia, and autoimmune disease. Previous procedures on these thigh collections included seven operations and 12 nondiagnostic ward aspirations. All collections were shown by sonography to be either anterior or anterolateral. Two cases referred for drainage were posteromedial; sonography showed these to be mycotic pseudoaneurysms. The abscesses were either anechoic or hypoechoic, and occasionally had debris and septations. Abscesses associated with underlying osteomyelitis abutted the femur; those related to other causes generally were more superficial within muscle or fascial layers. Sonographically guided catheter drainage successfully cured all patients, even those in whom ward aspiration or formal surgery had been unsuccessful. Sonography is a simple and inexpensive method of imaging and guiding the drainage of thigh abscesses. Percutaneous catheter drainage is the treatment of choice in cases in which simple emergency room or ward incision and drainage are inadequate.
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PMID:Sonography of thigh abscess: detection, diagnosis, and drainage. 330 56

One hundred porous surface replacements (PSR) were performed in 92 patients (63 men and 29 women) with a mean age of 53 (range 17-76). Follow-up times range from 1 to 4 years, with 48 patients having a follow-up of at least 2 years. Preoperative diagnoses were osteoarthritis (OA) 63, osteonecrosis (ON) 13, dysplasia 9, rheumatoid-ankylosing spondylitis 6, and other 9. Seventeen hips had metal-backed acrylic-fixed THARIES acetabular sockets, nine hips had a porous cobalt chrome hemispheric beaded acetabular component with adjuvant fixation screws and externally protruding screw hubs, and 74 hips had a porous chamfered cylinder-design acetabulum. Pain relief had been immediate and more complete than with acrylic-fixed or biologic-ingrowth stem-type replacement with comparable walking and function improvements. There have been no major systemic complications, sepsis, or loosening. There have been two transient peroneal nerve palsies and three trochanteric fibrous unions. There have been three reoperations, one for subluxation, one for "metalosis" due to mesh pad loosening, and one femoral neck fracture. Examination of one removed femoral surface component which has been histologically sectioned revealed excellent (90%) bone in-growth. Circumferential progressive radiolucencies developed at the bone-cement interface by 1 year in all of the 17 acrylic-fixed acetabular components. Reaming or seating defects were noted in 25% of the ingrowth components on postoperative radiographs. Radiographic analysis of immediate postoperative films of the chamfered cylinder design acetabular components frequently demonstrated bone-component interface radiolucencies which represented component seating defects. These initial interface radiolucencies became progressively more narrow over the first six months postoperatively suggesting "healing" of the reamed bone-component interface with trabecular bone around the chamfered cylinder acetabular components. Partial healing of initial interface voids with residual narrow radiolucencies were typical of the nine hemispheric-design acetabula with adjuvant screws and screw hubs. This new porous surface replacement (PSR) of the hip using porous ingrowth fixation avoids the major disadvantages of acrylic-fixed SR: excessive acetabular reaming and difficulty with acetabular revision. (When conversion to stem-type replacement is necessary the modular polyethylene socket liner can be exchanged.) The PSR has the prospect of enhanced fixation and improved longterm durability.
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PMID:Porous surface replacement of the hip with chamfered-cylinder component. 335 70

Fifty-seven porous surface replacements (PSR) were performed in 53 patients (36 men and 17 women) with a mean age of 54 years (range, 19-75 years). Follow-up examination times ranged from one year to 2.5 years with 33 patients having follow-up periods of at least two years. Preoperative diagnoses were osteoarthritis (OA), 37; osteonecrosis (ON), six; dysplasia, nine; rheumatoid ankylosing spondylitis, three; and other, two. Sixteen hips had metal-backed acrylic-fixed THARIES (total hip articular replacement by internal eccentric shells) acetabular sockets, nine hips had a cobalt chrome hemispherical beaded acetabular component with adjuvant screws, and 32 hips had a chamfer-cylinder designed acetabulum. Pain relief has been immediate and more complete than with acrylic-fixed or biologic-in-growth stem-type replacements with comparable walking and function improvements. There have been no major systemic complications, sepsis, or loosening. There have been two transient peroneal nerve palsies and three trochanteric fibrous unions. There has been one subluxation requiring reoperation. Histologic sections of the removed femoral surface component showed excellent (90%) bone ingrowth. Circumferential progressive radiolucencies developed at the bone-cement interface by one year in all of the 16 acrylic-fixed acetabular components. Reaming or seating defects were noted in 25% of the patients on postoperative radiographs. Serial radiographic analyses demonstrate progressive narrowing of all of the chamfered cylinder design and less in hemispherical design with screw fixation. These observations are encouraging and suggest healing of the bone-component interface with bony trabeculae in the porous-coated acetabular design. This new surface replacement (SR) of the hip uses porous-ingrowth fixation to overcome the major disadvantages of acrylic-fixed SR which are as follows: (1) excessive acetabular reaming, (2) poor long-term fixation, and (3) difficulty with acetabular revision.
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PMID:Porous surface replacement of the hip with chamfer cylinder design. 362 14

Adults who have osteoarthritis that is secondary to mild congenital dysplasia can be treated with total hip replacement using customary techniques. Those who have severe acetabular dysplasia or total congenital dislocation usually require augmentation of acetabular bone stock in order to carry out the total hip replacement. We reviewed the results of forty-seven total hip replacements in thirty-eight patients (age range, sixteen to sixty-eight years; average age, forty-seven years) who required autogenous grafting with bone from the femoral head for severe acetabular deficiency. The average length of follow-up was 7.1 years (minimum, five years). All grafts united. The average preoperative Harris hip rating was 46 points and the average postoperative rating was 74 points. Five hips (approximately 10 per cent) had a failure that required reoperation; four hipshad aseptic loosening of the acetabular component and in the fifth sepsis developed after a reoperation to reattach the greater trochanter. For the remaining forty-two hips, the average postoperative Harris hip rating was 78 points. Six additional sockets (approximately 15 per cent) were definitely loose by radiographic criteria, making a total of ten hips (approximately 20 per cent) with definite aseptic loosening of the acetabular component. The major factors that contributed to this aseptic loosening were complexity of the surgical procedure, necessity for a graft, lack of a small-sized metal-backed acetabular component, young age, obesity, lack of posterior support, and resorption of the graft. Dislocation was common, occurring in five (approximately 10 per cent) of the hips.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Femoral head autografting to augment acetabular deficiency in patients requiring total hip replacement. A minimum five-year and an average seven-year follow-up study. 377 5

Thirty-nine cadaveric renal allografts were performed in 28 children under 6 years of age. Common primary renal diseases were glomerulonephritis, dysplasia/hypoplasia, and reflux/obstructive nephropathy. After a mean follow-up of 40 months of patients with surviving grafts, 19 patients had functioning grafts, 3 had returned to dialysis, and 6 had died. These children required an extraordinary amount of care postoperatively because of anorexia, diarrhea, and ileus. Their psychomotor and physical development was retarded prior to transplant; this reversed dramatically after transplant, but catch-up growth occurred in only 4 patients. Many patients were noticeably more active and distractible for 1 to 2 years post-transplant. Major causes of graft failure were primary nonfunction of 5 donor kidneys (4 from donors under 1 year old) and renal vessel thrombosis in 5 recipients (3 with native kidneys in place who received kidneys from donors over 10 years old). Other causes were recurrence of hemolytic uremic syndrome and Wilms tumor, rejection, and sepsis. Kidneys from donors under 1 year old proved unsatisfactory, and large donor kidneys in small children tended to thrombose, especially when native kidneys with high urine output were left in situ.
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PMID:Cadaveric renal transplants in children under 6 years of age. 636 47

Between January 1978 and December 1982 successful sequential chromosome analyses were carried out on bone marrow cells of five patients previously treated for Hodgkin's lymphoma (HL) presenting unexplained cytopenia or pancytopenia during follow-up. All patients had concurrent morphological examination of bone marrow specimens showing signs of dysplasia and/or hypoplasia, without leukaemic infiltrate. Six other patients treated for HL who had normal haematological parameters served as controls. All the patients with unexplained cytopenias had clonal chromosome abnormalities; monosomy for chromosome No. 5 was the most frequent. No abnormalities were detected in the control group. Two patients have evolved to resistant leukaemia, one died of sepsis before leukaemic conversion while severely neutropenic, and two are in full marrow and cytogenetic recovery after aggressive anti-leukaemic treatment in the pre-leukaemic phase. Our data suggest that cytogenetic studies may be of crucial value in detecting therapy-induced preleukaemia (t-PL) at an early stage of its evolution and in planning appropriate therapy before the establishment of overt leukaemia.
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PMID:Therapy-induced preleukaemia in patients treated for Hodgkin's lymphoma: clinical and therapeutic relevance of sequential chromosome banding studies. 646 72

The immune system was studied in 30 cases of local infection (pneumonia) and 56 cases of generalized infection (sepsis). Predominantly children with immunologic deficiency of the humoral type (77% of the cases) characterized by unscheduled fatty transformation of the thymus, underdevelopment of B-zones of lymphoid organs, low level of IgM production and the lack of IgG and IgA production were found to die with pneumonia, whereas children with physiological immaturity of the immune system and in smaller numbers (41% of the cases) with deficiency of immunity of the cellular and phagocytic type as confirmed by immaturity of the thymic tissue or its dysplasia with hypoplasia of lymphoid organs died with sepsis. Immunological deficiency of the humoral type is accompanied by suppurative destructive lesions of the respiratory organs, immunodeficiency of the cellular and phagocytic type by necrotic changes in the septic focus and mucous membranes of the organs contacting the environment.
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PMID:[The immune system and its relation with infection process in children]. 660 38

Sixty-six patients were revised for aseptic loosening of their conventional hip arthroplasties; follow-up periods ranged from one to nine years. In comparing them with an overall conventional arthroplasty series, there was a higher failure rate with dysplasia and post-traumatic patients, and a lower incidence in osteoarthritic and rheumatoid patients. The average time to revision was four years. The patients were eight years younger than those in the overall UCLA conventional hip arthroplasty series. Forty-two per cent had undergone hip surgery prior to the original hip arthroplasty that failed. The average improvement, as well as the follow-up pain, walking, and function ratings, and the postoperative flexion arc were less than those in the overall conventional arthroplasty series. The quality of femoral and acetabular fixation obtained at revision was considerably inferior to that of the primary surgery. Six patients (9%) have already required re-revision of their hip arthroplasties. In a further 20%, the radiolucencies progressed substantially in extent and width, and are radiographically loose. Although these patients are relatively asymptomatic, prognosis is guarded. Forty-four per cent had no complications and are radiographically well fixed. Other complications included trochanteric migration (7.6%), dislocation (10.6%), and peroneal nerve palsy (7.6%), but there were no deaths or other serious medical complications and only one case (1.5%) of sepsis.
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PMID:Revision of aseptic loose total hip arthroplasties. 712 49


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