BACKGROUND: Metabotropic glutamate receptors (mGlus) may be involved in the pathophysiology of schizophrenia. Group II mGlus (mGlu2 and mGlu3) have attracted considerable interest since the development of potent specific agonists that exhibit atypical antipsychotic-like activity and reports of a genetic association between the mGlu3 gene and schizophrenia. METHODS: In this postmortem study, mGlu3 protein levels in Brodmann area 10 of prefrontal cortex from schizophrenic (n = 20) and control (n = 35) subjects were analyzed by western immunoblotting using a novel specific mGlu3 antibody and an antibody for the vesicular glutamate transporter 1 (VGluT1). RESULTS: We report a significant decrease in the dimeric/oligomeric forms of mGlu3 in schizophrenic patients compared with control subjects, whereas total mGlu3 and VGluT1 levels were not altered significantly. CONCLUSIONS: This is the first experimental evidence that mGlu3 receptor levels are altered in schizophrenia and supports the hypothesis that neurotransmission involving this particular excitatory amino acid receptor is impaired in schizophrenia. 相似文献
Background: Measuring the work of breathing of patients undergoing spontaneous assisted ventilation can be useful to monitor and titrate ventilatory support. The aim of this study was to obtain measurements of the pressure generated by the respiratory muscles (PMUSC) and the derived pressure-time product (PTP; a good indicator of the metabolic work of breathing), performing the rapid interrupter technique with a commercial ventilator.
Methods: A Draeger Evita 4 ventilator (Draeger Medical, Lubeck, Germany) was controlled by a personal computer to rapidly interrupt the airway flow at different times and volumes of the respiratory cycle during pressure-support ventilation. From the airway pressure tracing after the occlusion, the authors estimated the alveolar pressure and PMUSC; the integration of PMUSC values over the inspiratory time yields the measurement of PTP. Esophageal pressure measurements were used as a reference. After a bench study of the valves' performance, the authors performed 11 measurement sequences in eight patients.
Results: The closure times for the inspiratory and expiratory valves were 74 +/- 10 and 61 +/- 13 ms, respectively. The interrupter technique provided a reliable estimate of PMUSC (PMUSC, occl = 1.00 [middle dot] PMUSC, pes + 0.19; r = 0.88; 95% confidence interval for agreement, +5.49/-5.32 cm H2O). PTPoccl tightly correlated with PTPpes (PTPoccl = 0.95 [middle dot] PTPpes + 0.13; r = 0.96; 95% confidence interval, 1.94/-1.61 cm H2O [middle dot] s). 相似文献
Abstract
The aim of this study was to evaluate the short- to medium-term results (up to 2 years) of conservative and surgical treatments
of patients with symptomatic lumbar stenosis. To our knowledge, no previous study has provided strict indications for conservative
or surgical treatment. We retrospectively studied 184 patients, who were divided into 3 groups according to JOA (Japanese
Orthopaedic Association) score. A cutoff JOA score was arbitrarily fixed at 7.
Patients with a score ≤7 (n=12; group A) underwent surgery, while patients with a score >7 (n=172) were conservatively treated.
Group A included patients surgically treated within two months from diagnosis. Group B consisted of 144 patients who received
conservative treatment, while group C (28 patients) represented patients who underwent surgery after a period of failed conservative
treatment. The outcomes of surgical and conservative treatments were evaluated after 12 and 24 months, and were rated as satisfactory,
not totally satisfactory, not satisfactory or totally unsatisfactory. Conservative treatment consisted of physical, orthotic
and drug therapy, whereas surgical treatment included spinal decompression and instrumentation (if indicated), either rigidly
or dynamically performed. Surgery was indicated in 22% of all patients and we obtained excellent results in 85% of them. Operative
treatment provides excellent results for patients with severe clinical presentation (JOA score ≤7), while individuals with
mild to moderate spinal stenosis (JOA score >7) should receive conservative treatment. 相似文献
Tibial plateau fractures are complex injuries which, if not adequately treated, can lead to invalidating sequelae. They constitute
on average about 1% of all fractures, and up to 8% in patients over 65 years, and can be caused by both high- and low-energy
trauma. Unlike in younger subjects, treatment of tibial plateau fractures in the elderly is not univocal and depends on the
patient’s functional needs, bone quality and systemic comorbidities. In this retrospective study, 49 patients with a mean
age of 72 years, who underwent surgical treatment of a tibial plateau fracture, were assessed by the Rasmussen’s clinical
and radiological grading systems. Clinical and radiographic outcomes were satisfactory in 75.5 and 59.1% of cases, respectively.
Data were also analyzed, in terms of fracture type, age and gender, to detect any statistically significant correlation between
these parameters and clinical and radiographic outcomes. 相似文献
Bisphosphonate-related osteonecrosis of the jaws (BRONJ) is mainly observed in patients with multiple myeloma and bone metastasis
from solid tumors receiving iv bisphosphonate therapy. The reported incidence of BRONJ is significantly higher with the iv
preparations zoledronic acid and pamidronate while the risk appears to be minimal for patients receiving oral bisphosphonates.
Currently available published incidence data for BRONJ are based on retrospective studies and estimates of cumulative incidence
range from 0.8 to 12%. The mandible is more commonly affected than the maxilla (2:1 ratio), and 60–70% of cases are preceded
by a dental surgical procedure. The signs and symptoms that may occur before the appearance of clinical evident osteonecrosis
include changes in the health of periodontal tissues, non-healing mucosal ulcers, loose teeth and unexplained soft-tissue
infection. Although the definitive role of bisphosphonates remains to be elucidated, the inhibition of physiologic bone remodeling
and angiogenesis by these potent drugs impairs the regenerative capacity of the bone causing the development of BRONJ. Tooth
extraction as a precipitating event is a common observation. The significant benefits that bisphosphonates offer to patients
clearly surpass the risk of potential side effects; however, any patient for whom prolonged bisphosphonate therapy is indicated,
should be provided with preventive dental care in order to minimize the risk of developing this severe condition. This article
provides an update review of current knowledge about clinical, pathological and management aspects of BRONJ. 相似文献
Liver transplantation is one of the main therapeutic options for hepatocellular carcinoma (HCC) occurring in cirrhotic patients; an accurate diagnosis and staging of this cancer is crucial to selecting the candidates for this treatment. Although the best diagnostic strategy is debated, the guidelines proposed by the European Association for the Study of the Liver (EASL) are used by many centers. We report 2 cases of cirrhotic patients with hepatic splenosis, a rare condition that may be misinterpreted as HCC. In conclusion, the application of the EASL guidelines in the first case would have led to an incorrect staging of the cancer and in the second case would have led to a false diagnosis of HCC. 相似文献
OBJECTIVE: Our purpose was to investigate immunosuppressive acidic protein in the prognostic characterization of advanced ovarian cancer. STUDY DESIGN: Serum levels of immunosuppressive protein were prospectively measured in 80 patients with untreated ovarian carcinoma. To evaluate the prognostic significance of immunosuppressive acidic protein levels, cutoff points were studied every 50 μg/ml between 450 and 1350 μg/ml. RESULTS: Pretreatment immunosuppressive acidic protein levels were not significantly associated with stage, histotype, grade of differentiation, postoperative residual tumor, and response to chemotherapy. The most significant association with survival was observed at a cutoff value of 1100 μg/ml (p = 0.0089). In the univariate analysis for overall survival, International Federation of Gynecology and Obstetrics stage and immunosuppressive acidic protein status were found to have a role in predicting ovarian cancer prognosis. In the multivariate analysis only immunosuppressive acidic protein status was significantly associated with survival. A statistical correlation was found between serum levels and overall survival (p = 0.0104, χ2 6.56), including immunosuppressive acidic protein as a continuous variable. CONCLUSION: Our data suggest that immunosuppressive acidic protein assay is a potentially useful tool in the prognostic characterization of advanced ovarian cancer. (Am J Obstet Gynecol 1996;175:1606-10.) 相似文献