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41.
The Internal Medicine Residency Program of the Raritan Bay Medical Center's Perth Amboy Division was changed in July 1987 from a full continuity-of-care system to a unit-isolation one. The authors compared patients' data from the first two months of the academic years 1986-87 and 1987-88 and were unable to observe any impact of the change on length of stay in intensive care. However, informal interviews with the house staff members indicated that the change had a positive impact on their education, because of their closer observation of the pathophysiology of individual disease states and greater enjoyment of the time spent in critical care. 相似文献
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Regulation of immunoglobulin heavy-chain gene rearrangements 总被引:1,自引:0,他引:1
Summary: Regulated assembly of antigen receptor gene segments to produce functional genes is a hallmark of B‐ and T‐lymphocyte development. The immunoglobulin heavy‐chain (IgH) and T‐cell receptor β‐chain genes rearrange first in B and T lineages, respectively. Both loci require two recombination events to assemble functional genes; D‐to‐J recombination occurs first followed by V‐to‐DJ recombination. Despite similarities in overall rearrangement patterns, each locus has unique regulatory features. Here, we review the characteristics of IgH gene rearrangements such as developmental timing, deletion versus inversion, DH gene segment utilization, ordered recombination of VH gene segments, and feedback inhibition of rearrangement in pre‐B cells. We summarize chromatin structural features of the locus before and during recombination and, wherever possible, incorporate these into working hypotheses for understanding regulation of IgH gene recombination. The picture emerges that the IgH locus is activated in discrete, independently regulated domains. A domain encompassing DH and JH gene segments is activated first, within which recombination is initiated. VH genes are activated subsequently and, in part, by interleukin‐7. These observations lead to a model for feedback inhibition of IgH rearrangements. 相似文献
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Arteriovenous malformation of the foot is very uncommon, and surgical closure after its treatment with embolization and total excision may be challenging for the foot surgeon, particularly in distally localized lesions. A popular method to cover these difficult wounds is free-tissue transfer, which is a highly demanding procedure. Alternatively, distally based regional flaps have been occasionally reported for clinical use in such distant foot defects. Herein, we present a 36-year-old female patient with a diagnosis of arteriovenous malformation arising in the distal medial plantar and dorsal surfaces of the right foot. After surgical resection of the vascular lesion preceded by a misapplied embolization procedure, an extended lateral supramalleolar flap was successfully transferred to the defect area, covering it completely. Functional and aesthetic outcome was satisfactory after 6 months follow-up. Extended lateral supramalleolar flap is a useful and reliable choice for distal foot reconstructions. 相似文献
48.
目的观察诺新康联合巴曲酶治疗进展性脑梗死的临床疗效及其可能的作用机制。方法选择我院急性进展性脑梗死的患者为研究对象,随机分成两组,治疗组和对照组各26例,对照组予以常规治疗,治疗组在常规治疗的基础上加诺新康与巴曲酶。结果治疗组对神经功能缺损的治疗效果及控制梗死进展优于对照组。结论诺新康与巴曲酶联合对进展性脑梗死具有很好的治疗效果。 相似文献
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