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91.
92.
Rob Cincotta Alan Balloch Jack Metz Judith E. Layton Graham J. Lieschke 《American journal of hematology》1995,48(4):288-288
A patient with neutropenia and life-threatening infections secondary to T-γ lymphoproliferative disease, who did not respond to treatment with recombinant human G-CSF (filgrastim), was treated with filgrastim plus cyclosporine A (CyA). The patient achieved a good response in the absolute neutrophil count and subsequently required a dose reduction in the filgrastim. The patient was eventually discontinued from the CyA but continues on filgrastim alone. While on therapy, the large granular lymphocytes disappeared from the circulation and the beta-TCR rearrangement, which was present prior to beginning therapy, became undetectable. The patient had no significant toxicity to the CyA or the filgrastim and he has not experienced any serious infections or required hospitalization. Filgrastim has proven to be relatively nontoxic and of some benefit to patients with this disease and should probably be utilized first when treatment is necessary. However, if improvement is not observed, these findings suggest that a trial of the combination of CyA plus filgrastim may be beneficial. 相似文献
93.
A wireless device for the assessment of tardive dyskinesia by means of digital image processing is presented. Four skin-cream dots placed around the subjects' mouth are recorded by a video camera. The image is passed to a framegrabber with a signal processor, where it is converted from analogue to digital. A fast spot-detecting algorithm implemented on the signal processor tracks the dots and passes the information to a personal computer, where a Fourier transformation is performed to calculate the frequency spectrum of the movements. The device provided detailed information on the magnitude and on the frequencies of the movements. Data from a longitudinal investigation suggest a higher sensitivity and reliability than conventional rating scales to detect and evaluate abnormal perioral movements. The device might be useful for the early detection, for the longitudinal assessment (p.e. clinical trials) and in some cases for the differential diagnosis of tardive dyskinesia, thus providing a tool for both research and clinical purposes. 相似文献
94.
Magnetic resonance imaging (MRI) provides a non-invasive means to evaluate a large fraction of marrow in less than one hour. Marrow disorders produce non-specific changes in marrow signal intensities which primarily reflect changes in proportions of fat and cellular elements. The pattern of these signal changes narrows the differential diagnosis, and the combination of these features with the clinical context allows interpretations which are clinically useful in many ways. These include: I) the diagnosis of avascular necrosis (and its distinction from other causes of joint pain), 2) detection of osteomyelitis, 3) differential diagnosis of hypo-plastic disorders, 4) staging of lymphomas and myeloma, 5) selection of patients for autolo-gous bone marrow transplant, 6) objective measures of marrow response to therapy, 7) detection of leukemic transformation, and 8) improved detection of marrow disease (primary or secondary) in patients with otherwise unexplained bone pain. 相似文献
95.
So far, laparoscopic approaches to kidney and adrenal have been limited because of their retroperitoneal location. We here report eight renal and adrenal endoscopic procedures performed in seven patients: two adrenalectomies for hyperaldosteronism, one adrenalectomy for isolated metastasis from an adenocarcinoma of the lung; two nephrectomies for end-stage infected hydronephrosis, two partial nephrectomies for small circumscribed lesions of the kidney, and one endoscopic resection for pain relief of a voluminous cyst at the kidney. The approach was transperitoneal in two cases and retroperitoneal in five cases using the retropneumoperitoneum insufflation technique. One patient was operated by a combined approach using the retro- and transperitoneal routes. All procedures were successfully completed endoscopically. The retroperitoneoscopic approach of the kidney is safe and does not interfere with the peritoneal organs. Its working space is tenuous, but allows a direct access on the kidney with good exposure of its pedicle. For adrenal surgery, the retroperitoneoscopic dissection is more difficult, because movements of instruments are often impaired by the closeness of the costal margin and the iliac crest. However, in case of difficulties we found it very convenient to switch from a retroperitoneal endoscopic approach to a combined coelioscopic and retroperitoneoscopic operation. Far from excluding each other, both approaches are complementary, particularly for difficult situations (i.e., previous peritoneal or retroperitoneal surgery). 相似文献
96.
Friedrich Manz Hermann Kalhoff Thomas Remer 《Pediatric nephrology (Berlin, Germany)》1997,11(2):231-243
In early infancy, complex disorders of acid base metabolism are more frequent than in any other age group, with a predisposition
to metabolic acidosis due to an age-related low renal capacity for acid excretion and an unphysiologically high actual renal
acid load in nutrition with common formulas. Recently in preterm and small-for-gestational-age infants, persistent maximum
renal net acid excretion (NAE) with subnormal or normal blood acid base status, impaired weight gain, and adaptive hormonal
reactions have been observed. Incipient late metabolic acidosis is one example of a mixed disorder of acid base metabolism
with maximum renal NAE in early infancy. Alkali therapy is highly effective and can be realized both on an individual basis,
using urine pH screening as a diagnostic criterium for maximum renal acid stimulation, or on a general preventive level using
modified standard formula with a reduced actual renal NAE similar to that seen on alimentation with human milk. From an integrated
point of view, the low glomerular filtration rate and renal capacity for acid excretion beyond the developmental age of more
than 44 weeks, may well be interpreted as the result of a specific adaptation to breast feeding sparing energy, and thus an
evolutionary advantage for the survival of mother and child.
Received July 10, 1996; received in revised form and accepted October 7, 1996 相似文献
97.
Richard J. Lederman 《Muscle & nerve》1994,17(6):569-577
Over the past 10–15 years, there has been increasing interest in the health problems of performing artists. In this review, I will discuss the major playing-related disorders seen in instrumental musicians. Among the 672 instrumentalists evaluated, the major diagnoses identified included musculoskeletal disorders in 64%, peripheral nerve problems in 22.5%. and focal dystonia in 7%. Sixty percent of instrumentalists were female although males predominate in the group with focal dystonia. The average age of those evaluated was 32 years. Among musculoskeletal disorders overuse syndrome is the most common. Frequent peripheral nerve disorders include thoracic outlet syndrome, carpal tunnel syndrome, and ulnar neuropathy. A characteristic distribution of symptoms and signs is identified for each instrument group. Electrodiagnostic studies are an important part of the evaluation of these disorders. With carefully designed treatment, the majority of instrumental musicians can be returned to full and pain-free playing activities. The success rate is highest in some entrapment neuropathies but remains low in focal dystonia. © 1994 John Wiley & Sons, Inc. 相似文献
98.
S. Dietze D. Winkelmann R. Garve T. Blens J. Fanghnel P. Proff T. Gedrange S. Maile 《Annals of anatomy》2007,189(3):304-308
Numerous ritual acts involving the skull result in orofacial changes. The present study focuses on ritual acts of Brazilian Zoé Indians. A distinct deformation effect of the ritual act (wearing a lip-plug) on the morphology of the orofacial system is demonstrated and documented using jaw models. The studies show that the lip-plug significantly influences tooth position and jaw growth. While the maxilla displays palatal displacement of the lateral incisors and elevation of the palate, retraction occurs in the mandible depending upon plug size. Additionally, both the plug and the nutritional habits of the Indians induce marked abrasion of all teeth. Moreover, it is shown that the duration of lip-plug wear is an essential determinant of sustained orofacial changes. 相似文献
99.
C. J. English W. M. Maclaren C. Court-Brown S. P. F. Hughes R. W. Porter W. A. Wallace R. J. Graves A. J. Pethick C. A. Soutar 《American journal of industrial medicine》1995,27(1):75-90
To make a preliminary assessment of whether upper limb soft tissue disorders might be associated with activities at work, we have conducted a case-control study of subjects attending orthopedic clinics in three cities. All subjects between the ages of 16 and 65 years, in whom defined soft tissue conditions of the upper limb were diagnosed by the participating orthopedic surgeons, were invited to take part. Controls were subjects attending the same clinics within the same age range whose clinical diagnosis did not include disease of the upper limb, cervical or thoracic spine. Information concerning repetitive movements of the upper limbs at work was elicited by questionnaire. Five hundred eighty cases and 996 controls were studied, representing 96% and 93%, respectively, of those invited to participate. The diagnoses of the cases included soft tissue conditions affecting the shoulder, elbow, forearm, wrist, thumb, hand, and fingers. The diagnoses of the controls included traumatic, degenerative, and inflammatory conditions, mostly of the legs and lower back. Women predominated among the cases (70%) and men among the controls (56%). Of 221 female cases with injury to the wrist and forearm, 32 were cleaner/domestics (14.5%) compared to 35 of 439 controls (8%), a difference statistically significant at the 2 1/2% level. Other jobs significantly overrepresented (5% level) among female cases with injuries at various anatomical sites included hairdressers, secretary/temps, assembly line workers, and machine operators (type unspecified). Among male cases, electricians were significantly overrepresented (5% level). Jobs for which there was a suggestion (p < 0.1) of overrepresentation among cases included butchers and teacher/ lecturers (both males only) and the combined job groups (chosen a priori for analysis) of keyboard operators, machine operators, and music teachers (all three jobs, females only). 相似文献
100.
We report on a patient with pathologically proven variant Creutzfeld-Jakob disease in whom chorea was a presenting feature of the disease, and was unaccompanied by the typical prodrome of psychiatric disturbance or sensory symptoms. 相似文献