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17 required when injecting at sites close to sensitive structures such as the carotid artery and lung apices.
Απαιτείται ιδιαίτερη προσοχή κατά την ένεση σε σηµεία κοντά σε ευαίσθητες δοµές, όπως η καρωτίδα αρτηρία και οι κορυφές των πνευµόνων.
when the stunning method does not kill the animal, the two carotid arteries or vessels from which they arise shall be systematically severed.
Όταν η μέθοδος αναισθητοποίησης δεν καταλήγει σε θανάτωση του ζώου, οι δύο αρτηρίες ή αγγεία της καρωτίδας από τα οποία προέρχονται πρέπει να κόβονται συστηματικά.
the risk of serious hypotension may be higher in patients with autonomic dysfunction, hypovolemia, left main coronary artery stenosis, stenotic valvular heart disease, pericarditis or pericardial effusions, or stenotic carotid artery disease with cerebrovascular insufficiency.
Ο κίνδυνος σοβαρής υπότασης μπορεί να είναι υψηλότερος σε ασθενείς με δυσλειτουργία του αυτόνομου νευρικού συστήματος, υποογκαιμία, στένωση του αριστερού κύριου κλάδου της στεφανιαίας αρτηρίας, στενωτική βαλβιδική καρδιοπάθεια, περικαρδίτιδα ή περικαρδιακή συλλογή ή στενωτική νόσο της καρωτίδας με αγγειοεγκεφαλική ανεπάρκεια.
changes in ecf volume are detected by sensors of pressure and distension which are located in the cardiac atria and right ventricle, the pulmonary vasculature, the carotid arteries and the aortic arch.
Όταν τα αποθέματα του σώματος σε νάτριο αυξάνονται, το νερό επίσης κατακρατείται και ο όγκος του ecf αυξάνεται· αντίθετα, αν τα αποθέματα νατρίου του σώματος μειωθούν, μειώνεται αντίστοιχα και ο όγκος του ecfι.
but 6 months later, the symptoms returned. during the course of a third operation, one half of an inch of the anterior cyst wall was removed, and 18 months later, there had been no return of the patient’s symptoms. microscopic examination of the tissue revealed a “benign cystic tumor of stratified squamous epithelium originating in an inclusion of the craniopharyngeal duct.” despite the patient’s favorable outcome, jackson described the available treatments of cyst puncture and drainage as unsatisfactory. he noted that if drainage of the cyst could be maintained or if accumulation of fluid prevented, then the patient could live for an indefinite period of time. he also acknowledged that the outlook for these tumors was decidedly gloomy since it was “practically impossible to separate the cyst wall from the surrounding brain structures.” other contemporary reports would soon appear describing in keen detail the tribulations of those involved with the care of these patients. in 1920, heurer [33] reported his experience with his frontal intracranial approach to chiasmal tumors at john hopkins. twenty-four patients underwent an intracranial operation between 1914 and 1918 with either heurer or dandy performing the surgery. in three of these cases, the tumors were described as squamous epithelial neoplasms that arose from a rest of the hypophyseal duct. the clinical diagnosis of a suprasellar mass was usually confirmed by changes in the sella or posterior clinoids that were detected with skull x-rays. the tumors were invariably large at the time of diagnosis, and they were usually approached on the side of worse vision. in the same year, duffy [36] summarized heurer’s three cases and an additional case of a rathke’s cleft cyst in his report on the pathology of hypophyseal duct tumors. up until this time, only 38 cases of hypophyseal duct tumors had been tabulated in the literature, and to this number, duffy added an additional 12 cases. heurer’s first case involved a 35-year-old male who presented with “blindness and headaches.” an x-ray revealed a flattened sella and destroyed posterior clinoids, and surgery by way of heurer’s lateral approach was performed. during the procedure, a suprasellar cyst was punctured, and during dissection of the cyst wall, the left internal carotid artery “was seriously injured.” the ensuing hemorrhage was controlled “only with the greatest difficulty” and only after ligation of the carotid artery in the neck. the patient did well initially but later collapsed and died suddenly 12 days after surgery. an autopsy revealed a “squamous epithelial papilloma arising from a rest of the hypophyseal duct” and death was attributed to cerebral edema. the second case was that of an 11-year-old girl with a similar presentation of headaches and impaired vision. an x-ray showed a suprasellar calcified mass with partial destruction of the posterior clinoids, and a craniotomy was performed. surgery with evacuation of a hypophyseal cyst was performed in april 1917. cholesterin crystals were demonstrated in the fluid removed from the
στον Κάναβελ. Προσδιόρισε μόνο τρεις αυθεντικές περιπτώσεις που είχαν αναφερθεί στο παρελθόν στις ΗΠΑ (μία υπόθεση ήταν η ae halstead's και οι άλλες δύο πιστώθηκαν στο cushing) και συνέταξε επίσης μια λίστα με 37 άλλες περιπτώσεις από τη βιβλιογραφία. Η υπόθεση του kanavel αφορούσε ένα αρσενικό 18 ετών με μετωπικούς πονοκεφάλους και αποτυχημένη όραση. Διαγνώστηκε τελικά μια κύστη της υπόφυσης και πραγματοποιήθηκε transphenoidal χειρουργική επέμβαση. Η κύστη άνοιξε, οι πονοκέφαλοι του ασθενούς υποχώρησαν και η όρασή του βελτιώθηκε. Δύο
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