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巨大脑动静脉畸形(AVM)指最大直径>6cm、具有高流量特征的一类特殊脑动静脉畸形(AVM)。大多数巨大AVM患者Spetzler-Martin分级为Ⅳ~Ⅴ级。巨大AVM是一类较为少见的AVM,致残率和病死率极高。对巨大AVM的治疗仍是神经外科面临的一个挑战。文章对巨大AVM的自然史、血流动力学特征和治疗做了综述。 相似文献
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目的研究巨大脑动静脉畸形(AVM)手术切除后的脑皮质血流变化,指导临床降压治疗及血压监测等。方法AVM直径〉6cm的患者26例,用激光多普勒血流仪(LDF)分别记录切除AVM前、术后即刻、术后1d、术后2d、术后3d的脑血流值,比较血流变化情况,观察术后脑血流稳定和再灌注水平下降所需时间。结果巨大脑AVM切除后脑局部的皮层血流较术前立即增高(P〈0.05),术后2d与术后1d、术后即刻比较均无明显改变(P〉0.05);术后3d较术后2d有所降低(P〈0.05)。讨论巨大AVM切除后局部脑组织的血流明显增加,术后2d达最高,术后3d开始有明显的下降,但尚未达到术前的水平。 相似文献
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血管内栓塞联合手术切除治疗脑动静脉畸形 总被引:3,自引:0,他引:3
文章通过分析目前血管内栓塞治疗脑动静脉畸形(AVM)的进展及疗效评价和栓塞治疗给AVM带来的变化,综述了血管内栓塞联合手术切除治疗脑AVM的优点和对AVM治疗方法的选择。 相似文献
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α-氰基丙烯酸正丁酯血管内栓塞脑动静脉畸形的临床疗效分析 总被引:2,自引:0,他引:2
脑动静脉畸形(AVM)是临床上比较常见的颅内血管畸形。近年来随着微导管技术和栓塞材料的发展,脑动静畸形经血管内治疗的指征不断被拓展,α-基丙烯酸正丁酯(NBCA)经血管内栓塞已成为治疗脑AVM的成熟方法之一。作者就近5年来安徽医科大学第一附属医院神经外科采用NBCA栓塞治疗32例脑AVM的临床资料及临床疗效报道如下。 相似文献
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文章通过分析目前血管内栓塞治疗脑动静脉畸形(AVM)的进展及疗效评价和栓塞治疗给AVM带来的变化,综述了血管内栓塞联合手术切除治疗脑AVM的优点和对AVM治疗方法的选择。 相似文献
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影响脑动静脉畸形手术效果的临床因素 总被引:3,自引:0,他引:3
脑动静脉畸形(AVM)是常见的脑血管畸形。目前公认AVM切除术是AVM外科治疗中最为理想的 方法,是否采取手术治疗主要取决于手术所引起的死亡和严重病残率是否低于AVM的自然史。 相似文献
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目前,血管内栓塞已经成为脑动静脉畸形(AVM)的重要治疗手段,栓塞技术也迅速得到推广应用。现作一概述。 相似文献
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影响脑动静脉畸形手术效果的临床因素 总被引:4,自引:0,他引:4
脑动静脉畸形(AVM)是常见的脑血管畸形。目前公认AVM切除术是AVM外科治疗中最为理想的方法,是否采取手术治疗主要取决于手术所引起的死亡和严重病残率是否低于AVM的自然史。 相似文献
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王茂德 《国际脑血管病杂志》1995,(1)
文章综述了脑动静脉畸形(AVM)的病理、解剖、血流动力学特征、分级以及诊断和治疗进展状况。众多的治疗结果显示,脑AVM的显微外科切除是首选的治疗方法。 相似文献
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脑动静脉畸形(AVM)是一类由畸形脑血管相互交织的先天发育不良性疾病,在脑血管畸形疾病中占有较大比例.由于AVM的血管结构错综复杂,相互关系难以把握,MRI、CT等影像学检查存在不能切换视角和无法直观地了解AVM空间构筑学特征等缺陷.而3D打印技术作为一种可立体化显示人体组织内部复杂解剖结构的技术,可将复杂的脑AVM的... 相似文献
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The immunoneuroendocrine role of melatonin 总被引:19,自引:0,他引:19
Georges J. M. Maestroni 《Journal of pineal research》1993,14(1):1-10
Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ. 相似文献
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Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage. 相似文献
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Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland 总被引:2,自引:0,他引:2
Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland. 相似文献
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Martinez-Cecilia D Arjona-Sanchez A Gomez-Alvarez M Torres-Tordera E Luque-Molina A Valenti-Azcarate V Briceno-Delgado J Padillo FJ Lopez-Cillero P Rufian-Pena S 《World journal of gastroenterology : WJG》2008,14(12):1949-1951
Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs. 相似文献
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H.P.J.M. Noteborn P.P. van Balen A.A. van der Gugten I.C. Hart I. Ebels C.A. Salemink 《Journal of pineal research》1993,14(1):11-22
Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the Mr range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [125I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (Ka of 4.7 ± 0.2 × 109 M-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of Mr 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL. 相似文献
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Gary S. Goldberg B.A. Bruce A. Orkin M.D. Lee E. Smith M.D. 《Diseases of the colon and rectum》1994,37(5):439-443
PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae
(16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum
was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy. 相似文献