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21.
Significance and mechanism of thoracic and lumbar spine injuries in traffic accidents 总被引:1,自引:0,他引:1
An analysis of 96 persons who sustained injuries to dorsal and lumbar vertebrae during traffic accidents, established that spinal injuries (sustained by 3.8% of the 96 persons) are quite rare. Pedestrians, the elderly, and polytraumatized persons with extensive head injuries as accompanying trauma following particularly serious accidents are at especially high risk. The most frequent spinal injuries are compression fractures, which especially often give rise to the injury pattern found in the spine of motorcycle riders, pedestrians, and car passengers not wearing seat belts. In these cases a so-called "pushing-further" mechanism is quite often assumed as the biomechanical cause. In comparison, ruptures of the transverse process have often been established for car passengers wearing seat belts, which can be attributed causally to a psoas effect resulting from an overstretching movement of the body and muscular strain. Basically three different biomechanical movement patterns were established in this study: sliding mechanism, shearing effect and psoas effect; which of these is are involved depends on the capacity in which the person affected takes part in street traffic. All the spinal fractures examined can be classed as trauma sustained while travelling at high speed. They are not observed following collisions at low or moderate speed. 相似文献
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23.
After a hyperthyroidism of Graves' disease with strongly positive antithyroid antibodies treated sufficiently by radioiodine therapy a 46-year old woman developed a consecutive bifocal autonomous nodule within 13 years. This phenomenon is known as Marine-Lenhart-syndrome. In this particular case it seems that autonomous nodules are a consequence of Graves' disease treatment with radioiodine. Our case report is a 18 year follow up. In contrast to most studies known today the simultaneous occurrence of active Graves' disease and active autonomous nodules could be demonstrated by means of serology and suppressive scintigraphy, respectively. In addition, this case shows the possible dependence of an acute beginning of Graves' disease and the occurrence of autonomous nodules. 相似文献
24.
Parieto-occipital hypoperfusion in late whiplash syndrome: first quantitative SPET study using technetium-99m bicisate (ECD) 总被引:2,自引:0,他引:2
Andreas Otte Thierry Ettlin Lukas Fierz Jan Mueller-Brand 《European journal of nuclear medicine and molecular imaging》1996,23(1):72-74
Brain single-photon emission tomography (SPET) withN,N-1,2-ethylene-diylbis-l-cysteine diethyl ester dihydrochloride (ECD) was performed on ten patients with a clinically high grade late whiplash syndrome and on 11 controls. Two independent readers blinded to the clinical diagnosis were able to separate the ten patients from normal controls. All these patients had qualitative bilateral parieto-occipital hypoperfusion. To confirm this, the perfusion rate of parieto-occipital over global (perfusion index) was calculated after drawing elliptical regions of interest in transversal-oblique slices. The perfusion indices in patients were significantly lower than in controls as tested by the Mann-WhitneyU test. This quantitative study proves our recent qualitatively analysed observation (Lancet 1995; 345: 1513–1514). 相似文献
25.
Thomas C Neylan Maryanne Lenoci Melissa L Maglione Nicholas Z Rosenlicht Thomas J Metzler Christian Otte Frank B Schoenfeld Rachel Yehuda Charles R Marmar 《Neuropsychopharmacology》2003,28(9):1666-1676
Metyrapone blocks cortisol synthesis, which results in the stimulation of hypothalamic cortiocotropin-releasing factor (CRF) and a reduction in delta sleep. We examined the effect of metyrapone administration on endocrine and sleep measures in male subjects with and without chronic PTSD. We hypothesized that metyrapone would result in a decrease in delta sleep and that the magnitude of this decrease would be correlated with the endocrine response. Finally, we utilized the delta sleep response to metyrapone as an indirect measure of hypothalamic CRF activity and hypothesized that PTSD subjects would have decreased delta sleep at baseline and a greater decrease in delta sleep induced by metyrapone. Three nights of polysomnography were obtained in 24 male subjects with combat-related PTSD and 18 male combat-exposed normal controls. On day 3, metyrapone was administered during normal waking hours until habitual sleep onset preceding night 3. Endocrine responses to metyrapone were measured in plasma obtained the morning following sleep recordings, the day before and after administration. Repeated measures ANOVAs were conducted to compare the endocrine and sleep response to metyrapone in PTSD and controls. PTSD subjects had significantly less delta sleep as indexed by stages 3 and 4, and total delta integrated amplitude prior to metyrapone administration. There were no differences in premetyrapone cortisol or ACTH levels in PTSD vs controls. PTSD subjects had a significantly decreased ACTH response to metyrapone compared to controls. Metyrapone caused an increase in awakenings and a marked decrease in quantitative measures of delta sleep that was significantly greater in controls compared to PTSD. The decline in delta sleep was significantly associated with the magnitude of increase in both 11-deoxycortisol and ACTH. The results suggest that the delta sleep response to metyrapone is a measure of the brain response to increases in hypothalamic CRF. These data also suggest that the ACTH and sleep EEG response to hypothalamic CRF is decreased in PTSD. 相似文献
26.
Susanna Hegewisch-Becker Katharina Braun Markus Otte Aneta Corovic Djordje Atanackovic Axel Nierhaus Dieter K Hossfeld Klaus Pantel 《Clinical cancer research》2003,9(6):2079-2084
PURPOSE: Combining heat with antineoplastic drugs has produced evidence of antitumor synergism. An increasing number of trials are investigating whole body hyperthermia (WBH) in combination with chemotherapy in patients with advanced malignancies. Here we investigated whether the hyperdynamic state of the circulation as a consequence of WBH may stimulate dissemination of malignant cells. EXPERIMENTAL DESIGN: WBH in combination with chemotherapy was administered by a radiant heat device to 20 consecutive patients with advanced epithelial malignancies. One WBH session lasted for approximately 4 h (90 min heating time, 60 min plateau at 41.8 degrees C, and 60-80 min cooling). Peripheral blood was drawn before WBH treatment (baseline), at the end of the plateau (1 h), and 24 h and 48 h thereafter. After removal of leukocytes using anti-CD45 magnetic beads, circulating tumor cells were detected immunocytochemically using the monoclonal antibody A45-B/B3, which binds to a common epitope present on various cytokeratins. RESULTS: The method used to detect tumor cells in the peripheral blood proved to be specific and very sensitive (detection limit 1 tumor cell per 1.7 x 10(5) peripheral blood mononuclear cell). Before WBH, 6 of 20 patients had cyto-keratin-positive cells in their blood. A treatment-induced increase in the number of circulating tumor cells became statistically significant at 24 h after WBH (P = 0.043) and was detected in a total of 9 patients, 5 of whom had no detectable malignant cells at baseline. There was no evidence of a correlation between an increase in the number of circulating tumor cells and increased metastasis frequency. CONCLUSIONS: Our findings suggest that WBH might induce a temporary release of tumor cells into the circulation, but this spread appears to be clinically not significant in patients with advanced malignancies. 相似文献
27.
J. B. Otte J. de Villede Goyet R. Reding L. Van Obbergh F. Veyckemans M. A. Carlier M. De Kock S. Clement de Clety P. Clapuyt E. Sokal J. Lerut I. Delbeke V. Dierick M. Janssen R. Rosati F. Libert 《Pediatric surgery international》1998,13(5-6):308-318
Between 1984 and 1996, the authors performed 499 liver transplants in 416 children less than 15 years old. The overall patient survival at 10 years was 76.5%. It was 71.3% for the 209 children grafted in 1984–1990; 78.5% for biliary atresia (n =?286), 87.3% for metabolic diseases (n?=?59), and 72.7% for acute liver failure (n?=?22). The 5-year survival was 73.6% for the 209 children grafted in 1984–1990 and 85% for the 206 grafted in 1991–1996. Scarcity of size-matched donors led to the development of innovative techniques: 174 children who electively received a reduced liver as a first graft in our center had a 5-year survival of 76% while 168 who received a full-size graft had a survival of 85% (NS). Results of the European Split Liver Registry showed 6-month graft survival similar to results obtained with full-size grafts collected by the European Liver Transplant Registry. Extensive use of these techniques allowed the mortality while waiting to be reduced from 16.5% in 1984–1990 to 10% in 1991–1992. It rose again to 17% in 1993, leading the authors to develop a program of living related liver transplantation (LRLT). The legal and ethical aspects are analyzed. Between July 1993 and October 1997, the authors performed 53 LRLTs with 90% survival. In elective cases, a detailed analysis was made of the 45 children listed for LRLT between July 1993 and March 1997 and the 79 registered on the cadaveric waiting list during the same period. Mortality while waiting was 2% and 14.5% for the LRLT and cadaveric lists, respectively. The retransplantation rate was 4.6% and 16.1% for LRLT and cadaveric transplants, respectively. Overall post-transplant survival was 88% and 82% for children who received a LRLT or a cadaveric graft, respectively. Overall survival from the date of registration was 86% and 70% (P?<?0.05) for LRLT or cadaveric LT respectively. The 2-year post-transplant survival in children less than 1?year of age at transplantation was 88.8% and 80.3% with a LRLT or cadaveric graft, respectively; patient survival after 3 months post-transplant was 95.8% and 91.9% for stable children waiting at home, 93.7% and 93.7% in children hospitalized for complications of their disease, and 89.5% and 77.7% for children hospitalized in an intensive care unit at the time of transplantation for children who received a LRLT or cadaveric graft, respectively. It is concluded that LRLT seems to be justified for multidisciplinary teams having a large experience with reduced and split liver grafting. 相似文献
28.
Dr. S. von Otte B. Schöpper S. Al Hasani R. Felberbaum K. Diedrich 《Der Gyn?kologe》2004,37(8):701-709
The ability to rescue oocytes and mature them in vitro would provide invaluable information about folliculogenesis and oocyte maturation and could provide oocytes for infertile women. In vitro growth (IVG) of follicles and in vitro maturation (IVM) of oocytes are challenging especially in the human because folliculogenesis is a lengthy process with many complex cellular changes in the oocyte and its surrounding follicle cells. Reports have been published on live births in mice after maturation and fertilization. This technique is still in its infancy especially for use in humans. A few live births have resulted from IVM of immature human oocytes aspirated from small antral follicles. Furthermore, it is possible to grow primordial follicles to preantral stages in slices of ovarian tissue and support antrum formation in isolated preantral follicles. Today we are still a long way from growing and maturing preantral follicles to preovulatory stages in vitro, but these techniques may revolutionize assisted reproduction in the future. 相似文献
29.
Dr. S. von Otte R. Voigt G. Griesinger A. Schultze-Mosgau K. Diedrich 《Der Gyn?kologe》2006,39(8):591-600
Genetic aspects are becoming more and more important in the diagnostics, patient counselling and therapy of assisted reproduction. Compared to spontaneously conceiving patients, genetic disturbances can be found with a higher incidence in patients requiring these techniques, a fact which is not only due to the greater age of such patients. In several cases, genetic disturbances contribute to or even explain infertility. New insights in the field of pharmacogenetics demonstrate that genetic dispositions influence the success of hormonal stimulation. Furthermore, growing knowledge of potential associations between genomic imprinting and assisted reproduction (ART) demands further attention, especially due to the uncovering of new potential risks of ART itself. Performing genetic diagnosis in oocytes or embryos (preimplantation genetic diagnosis, PGD) warrants further evaluation before it becomes a routine technique. 相似文献
30.
Dr. M. Montag V. Isachenko E. Isachenko M. von Wolff S. von Otte A. Schultze-Mosgau S. Al-Hasani 《Gyn?kologische Endokrinologie》2006,4(4):205-210
In vitro maturation (IVM) is a technique which allows the maturation of oocytes from the germinal vesicle stage up to the stage of the fertilization-competent metaphase-II oocytes. Immature oocytes are primarily retrieved from small antral follicles. Their successful maturation is usually documented by formation of the first polar body as an indicator of completion of the first meiotic division. The quality of in vitro matured oocytes can now be judged by polarisation microscopy. This technique allows better quality assessment and is hence a unique instrument for optimising existing IVM protocols. In combination with the now realistic option of successful cryopreservation of mature and immature oocytes by the technique of vitrification, IVM will soon enter new fields of application. 相似文献