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Gamma knife was installed at the PD Hinduja National Hospital and Medical Research Centre, Mumbai, India, in January 1997. In the first year of gamma-knife radiosurgery to January 1998, we treated 110 patients, of whom six had medically refractory trigeminal neuralgia. Seven treatments were administered to this group of six patients (one had bilateral neuralgia). This report evaluates the effectiveness of radiosurgery treatment in these patients. The median age of the patients was 56 years and there were five males and one female. Following Leksell stereotactic frame fixation, a magnetic resonance imaging scan was done in all. The Leksell gamma plan was used for planning. A radiosurgery dose of 70–80 Gy was delivered to the trigeminal root entry zone, 2–4 mm anterior to the junction of the pons and trigeminal nerve with a single 4 mm collimator helmet. Complete pain relief was achieved in four patients. Two had partial relief. No patient developed any radiosurgery related morbidity during the follow-up period of 5–16 months. Radiosurgery seems to be an effective approach for medically or surgically refractory trigeminal neuralgia.  相似文献   
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多发性大动脉炎的麻醉   总被引:1,自引:0,他引:1  
0引言多发性大动脉炎尤其侵及双侧颈总动脉、双锁骨下动脉及无名动脉罕见,我院心脏外科及血管外科近日联合手术1例该病例,现简述其麻醉特点及特殊处理.1临床资料女性,30岁,50kg,头晕,头昏伴心悸,出汗,双上肢冰凉,麻木,查血压右上肢0/0kPa,右下...  相似文献   
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The effect of three kinds of moderate physical loads on the tremor of the middle finger was studied in eight males: cycling 15 min on an ergometer at a heart rate of 140 beats/min (general dynamic load); lifting a mass of 1 kg by the middle finger at a rate of 30 times/min for 5 min (local dynamic load); and carrying in each hand a 15 kg mass for 5 min. Few effects were observed: 10% decrease of RMS acceleration after local dynamic load and some changes in the power spectrum after general dynamic load. It is concluded that the effect of recent, short time physical load of moderate extent can be neglected as a disturbing factor in the study of the effects of toxic exposure on postural tremor. The inter- and intra-individual variation (over 4 weeks) in nine males and nine females also was studied. The intra-individual variation ranged from 4% for the mean frequency to 35% for the 0-4 Hz band of the power spectrum. The inter-individual variation ranged from 8% for the mean frequency to more than 60% for some frequency bands of the power spectrum. It is concluded that the mean frequency possibly is a sensitive parameter in epidemiologic studies on effects of external toxic exposure on tremor.  相似文献   
85.
The action of a water soluble benzodiazepine, chlordiazepoxide (CDZ) on the stimulatory effect of adenosine on glucagon secretion from the isolated pancreas of the rat perfused in presence of 2.8 mM glucose was studied. CDZ 10(-7) and 10(-6) M had no effect per se on glucagon secretion under our experimental conditions. In contrast, CDZ 10(-6) M (but not 10(-7) M) markedly reduced the peak of glucagon secretion provoked by adenosine, 2-chloroadenosine (1.65 C 10(-6) M) and by a stable analogue, 5'-N-ethylcarboxamidoadenosine or NECA (1.65 X 10(-8) M). This peripheral interaction between CDZ and adenosine seemed to be specific, since CDZ did not modify the peak of glucagon secretion induced by (-)isoproterenol (10(-8) M). Our results demonstrate an inhibitory effect of CDZ on adenosine-stimulated glucagon secretion.  相似文献   
86.
Serial pulmonary imaging has proved to be effective in the evaluation of patients undergoing total joint arthroplasty. A clinical dilemma arises in asymptomatic patients whose postoperative pulmonary images differ from the preoperative images. The authors prospectively evaluated 403 patients with serial imaging to determine the significance of changed postoperative images in asymptomatic patients undergoing total hip or knee arthroplasty. Twenty-two (5.5%) patients had significant changes on postoperative images. Seventeen were asymptomatic; all but one underwent pulmonary angiography. Documented pulmonary emboli were demonstrated in 100% of patients whose postoperative images changed to indicate a high probability of pulmonary embolism, 71% whose images changed to a moderate probability, and 0% whose images changed to indeterminate probability. Overall, pulmonary emboli occurred in 76% of all asymptomatic patients with significantly change postoperative images. Asymptomatic pulmonary embolism is a significant occurrence after total hip or knee repair, and a changed lung scan with appropriate clinical evaluation is an accurate indicator of pulmonary emboli in asymptomatic postarthroplasty patients.  相似文献   
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