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111.
112.
Dan Greitz 《Child's nervous system》2007,23(5):487-489
Objective This study aims to question the generally accepted cerebrospinal fluid (CSF) bulk flow theory suggesting that the CSF is exclusively
absorbed by the arachnoid villi and that the cause of hydrocephalus is a CSF absorption deficit. In addition, this study aims
to briefly describe the new hydrodynamic concept of hydrocephalus and the rationale for endoscopic third ventriculostomy (ETV)
in communicating hydrocephalus.
Critique The bulk flow theory has proven incapable of explaining the pivotal mechanisms behind communicating hydrocephalus. Thus, the
theory is unable to explain why the ventricles enlarge, why the CSF pressure remains normal and why some patients improve
after ETV.
Hydrodynamic concept of hydrocephalus Communicating hydrocephalus is caused by decreased intracranial compliance increasing the systolic pressure transmission into
the brain parenchyma. The increased systolic pressure in the brain distends the brain towards the skull and simultaneously
compresses the periventricular region of the brain against the ventricles. The final result is the predominant enlargement
of the ventricles and narrowing of the subarachnoid space. The ETV reduces the increased systolic pressure in the brain simply
by venting ventricular CSF through the stoma. The patent aqueduct in communicating hydrocephalus is too narrow to vent the
CSF sufficiently. 相似文献
113.
Christian Waydhas Dieter Nast-Kolb Steffen Ruchholtz 《European journal of trauma and emergency surgery》2007,33(2):170-175
Abstract
Objective: To define the diagnostic accuracy of clinical examination in patients with impaired consciousness or endotracheal intubation
to detect pelvic ring fractures and to identify those with severe bleeding.
Methods: Included in this prospective data collection with retrolective data analysis were a consecutive series of blunt trauma victims
with either a Glasgow Coma Scale ≤ 13 or tracheal intubation. Clinical examination comprised testing for stability of the
iliac wings.
Results: From 784 subjects (injury severity score 23.3 ± 17.4) 93 patients (11.9%) were found to have a pelvic ring fracture. Clinical
instability of the pelvic ring was found in 42 patients. There was only one false positive. Fifty-two fractures could not
be identified by clinical examination, including nine fractures (17%) that required surgical fracture stabilization (sensitivity
of clinical examination 44.1%). Seventeen fractures (18.3%) were associated with a blood loss larger than 20% of circulating
blood volume. Sixteen of those were identified by clinical instability of the pelvic ring (sensitivity 94.1%, specificity
97.0%, positive predictive value 38.1%, negative predictive value 99.9%).
Conclusions: Clinical examination for stability of the pelvis in this selected group of patients missed a significant number of pelvic
ring fractures including fractures that require surgical stabilization. The finding of a clinically unstable identifies most
of the patients with the pelvic ring fracture being a major source of bleeding. A stable pelvis makes pelvic ring fracture
as being the source of bleeding quite unlikely. 相似文献
114.
Four Chinese patients (2 boys, 2 girls), ages 4–9 years, who had episodes of perception error of body schema and objects are reported. The metamorphopsia, which had been named Alice in Wonderland syndrome, is the major presentation. All of them were proved to have acute Epstein-Barr virus infection, as documented by positive heterophil antibody test and/or positive IgM antibody to Epstein-Barr virus capsid antigen. The duration of the perception disorder ranged from 1 week to 3 months. We believe that any young child presenting with Alice in Wonderland syndrome should undergo examination for Epstein-Barr virus infection; complete recovery from the disorder can be expected. 相似文献
115.
Background
Reports on childhood cancer survivors estimated cumulative probability of developing secondary neoplasms vary from 3,3% to 25% at 25 years from diagnosis, and the risk of developing another cancer to several times greater than in the general population. 相似文献116.
��״�ٹ��ܿ������״�ٹ��ܼ��͵���������� 总被引:2,自引:0,他引:2
沈永年 《中国实用儿科杂志》2006,21(11):813-815
1甲状腺功能亢进甲状腺功能亢进(甲亢)是指由于血循环中甲状腺素过多所造成的一种综合征。其病因常见有Graves'病(格雷夫斯病)又称毒性弥漫性甲状腺肿,新生儿甲状腺毒症(neonatal thyrotoxicosis),自身免疫性甲状腺炎,选择性T4抵抗综合征,功能自主性甲状腺结节,促甲状腺素(TSH)依赖性甲亢,激活TSH受体突变等。1.1Graves'病是一种甲状腺素分泌过多的器官特异性自身免疫性疾病,<5岁儿童较少见,大多发生于10岁以后,女性发病为男性5倍,60%病例有甲状腺疾病家族史。发生率每年约0·8/10万[1],病因尚不完全明确,大多数认为在遗传基础上因感染… 相似文献
117.
118.
On genetic studies of bone loss. 总被引:3,自引:0,他引:3
Fang Yang Hui Shen Hui Jiang Hong-Wen Deng 《Journal of bone and mineral research》2006,21(11):1676-1677
119.
Birgitta Malmberg Göran Kecklund Björn Karlson Roger Persson Per Flisberg Palle Ørbaek 《BMC health services research》2010,10(1):239
Background
It is well known that physicians' night-call duty may cause impaired performance and adverse effects on subjective health, but there is limited knowledge about effects on sleep duration and recovery time. In recent years occupational stress and impaired well-being among anaesthesiologists have been frequently reported for in the scientific literature. Given their main focus on handling patients with life-threatening conditions, when on call, one might expect sleep and recovery to be negatively affected by work, especially in this specialist group. The aim of the present study was to examine whether a 16-hour night-call schedule allowed for sufficient recovery in anaesthesiologists compared with other physician specialists handling less life-threatening conditions, when on call. 相似文献120.
David Berrigan Linda W Pickle Jennifer Dill 《International journal of health geographics》2010,9(1):20