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81.
Zusammenfassung
Bei einer 37 j?hrigen, bisher gesunden Patientin entwickelte sich eine über 2 Monate progrediente Dyspnoe. Radiologisch und
echokardiographisch zeigte sich eine massive Dilatation s?mtlicher Herzh?hlen mit biventrikul?ren Thromben und eine stark
herabgesetzte Kontraktilit?t. Die Endomyokardbiopsien wurden von 2 Instituten als Myokarditis eingestuft. Im weiteren Verlauf
entwickelten sich thrombembolische Komplikationen und ein therapierefrakt?res Pumpversagen, in dem die Patientin schlie?lich
verstarb. Bei der Obduktion fand sich au?er einem dilatierten 600 g schweren Herzen mit biventrikul?ren Thromben ein klinisch
bisher unbekanntes Ph?ochromozytom der linken Nebenniere. Die eingehende histologische und immunhistologische Aufarbeitung
des Herzmuskelgewebes einschlie?lich Reevaluierung der Endomyokardbiopsien führte zur Revision der ursprünglichen Diagnose:
Das Krankheitsbild der 37 j?hrigen Patientin war durch eine katecholamininduzierte dilatative Kardiomyopathie verursacht worden.
相似文献
82.
As clinical experience with patients with ZES has grown, increasing recognition has been made of the broad spectrum of symptoms associated with gastrinomas. Diarrhea and acid-induced esophageal injury have taken their place alongside chronic peptic ulcer disease as indications for screening for gastrinoma. Diagnostic testing should begin with fasting serum gastrin levels and should include intravenous secretin infusion if fasting serum levels of gastrin are nondiagnostic and the patient is not found to be hypochlorhydric. Tumor localization is critical to aid in the identification of patients with potentially curable localized disease. Preoperative evaluation utilizing CT scanning with intravenous contrast should be done early and should be supplemented by other imaging modalities as necessary. Exploratory laparotomy, including a thorough examination of the duodenum and perhaps intraoperative ultrasound, should be performed in all patients with sporadic gastrinoma who lack evidence of extensive metastatic disease on preoperative evaluation. By utilizing this approach, it is likely that at least 20% of patients with ZES can be cured. With the availability of the highly effective H(+)-K(+)-ATPase inhibitor omeprazole, excellent control of symptoms related to gastric acid hypersecretion can be expected. Patients with unresectable gastrinoma may thus avoid potentially morbid antisecretory surgery and be managed with a fairly simple medical regimen. Further developments in the chemotherapeutic management of these patients with unresectable disease should be forthcoming in the future. 相似文献
83.
Biochemical changes during clomipramine treatment of childhood obsessive-compulsive disorder 总被引:1,自引:0,他引:1
M F Flament J L Rapoport D L Murphy C J Berg C R Lake 《Archives of general psychiatry》1987,44(3):219-225
Peripheral measures of serotonergic and noradrenergic function were obtained in 29 obsessive-compulsive adolescents and 31 age- and sex-matched controls, as well as in a subsample of 22 patients after five weeks of treatment with clomipramine hydrochloride (134 +/- 33 mg/d) (mean +/- SD) given in a double-blind placebo-controlled trial. Drug-free obsessive-compulsive subjects did not differ from controls on measures of platelet serotonin and monoamine oxidase (MAO) activity, nor on plasma epinephrine or norepinephrine concentrations at rest and after a standard orthostatic challenge procedure. Compared with placebo, treatment with clomipramine was clinically effective and produced a marked decrease in platelet serotonin concentration, a trend toward a reduction in platelet MAO activity, and a rise in standing plasma norepinephrine. Clinical improvement during drug therapy was closely correlated with pretreatment platelet serotonin concentration and MAO activity, as well as with the decrease in both measures during clomipramine administration. This suggests that the effects of clomipramine on serotonin uptake may be essential to the antiobsessional action observed. 相似文献
84.
Fabienne Rauw Bénédicte Lambrecht Achille Fran?ois Patrick Langlois Thierry van den Berg 《Journal of interferon & cytokine research》2007,27(2):111-118
In this study, a replicative fowl adenovirus serotype 1 (CELO) recombinant expressing chicken interferon-gamma (ChIFN-gamma) was constructed. In the engineered recombinant, the ChIFN-gamma gene was placed under the control of cytomegalovirus (CMV) promoter. The ChIFN-gamma expression cassette was inserted in the right end of the CELO genome (D fragment), which was able to carry the largest insertion of foreign DNA without affecting the replication functions of the vector. The recombinant ChIFN-gamma (rChIFN-gamma) produced in the CELO-virus expression system was characterized by comparing its biologic activities with that of rChIFN-gamma produced via the baculovirus expression system (Bac-ChIFN-gamma). CELO-ChIFN-gamma inhibited the replication of cytolytic virus in chicken embryo fibroblasts (CEFs) and activated macrophages in a better manner than did Bac-ChIFN-gamma . Moreover, the in vitro and in vivo stability of the CELO-derived rChIFN-gamma was considerably higher than that of the Bac-ChIFN-gamma. The CELO-ChIFN-gamma recombinant vector was able to replicate in vitro in the loghorn male hepatoma (LMH) hepatocyte cell line and to produce detectable levels of recombinant cytokine in supernatant as early as 90 min post-infection. Therefore, the CELO-virus expression system is an appropriate system for high-level expression of biologically active and stable ChIFN-gamma. 相似文献
85.
86.
The influence of white matter lesions on neuropsychological functioning in demented and non-demented 85-year-olds 总被引:3,自引:0,他引:3
I. Skoog S. Berg B. Johansson B. Palmertz L.-A. Andreasson 《Acta neurologica Scandinavica》1996,93(2-3):142-148
White matter lesions on computed tomography of the head were studied in relation to neuropsychological functioning in subjects from a representative sample of non-demented ( n = 134) and demented ( n = 98) 85-year-olds. Non-demented subjects with white matter lesions ( n = 46) scored significantly lower in tests of verbal ability (Synonyms), spatial ability (Block Design, Clock Test), perceptual speed (Identical forms), secondary memory (Thurstone Picture Memory), basic arithmetic (Coin Test) and the global cognitive screening test Mini-Mental State Examination than non-demented subjects without white matter lesions ( n = 88). Demented subjects with white matter lesions ( n = 67) scored significantly lower in tests of spatial ability (Block Design and Clock Test) and secondary memory (free recall in the MIR memory test, Ten-word memory test I and II) and in the Mini-Mental State Examination than demented subjects without white matter lesions ( n = 31). It is concluded that white matter lesions contribute to cognitive decline in both non-demented and demented elderly subjects. 相似文献
87.
Weeranuj Yamreudeewong Pharm.D. James V. Johnson M.D. Thomas G. Cassidy M.D. Jean T. Berg R.N. 《Pharmacotherapy》1996,16(6):1159-1165
Warfarin is a commonly used oral anticoagulant that is usually initiated after the definitive diagnosis of a certain thromboembolic disorder or disease. Warfarin therapy will usually be prescribed for 6–12 weeks or more, and some patients may continue therapy throughout life, depending on the type of thromboembolic disorder. Major problems associated with warfarin therapy include adverse effects such as bleeding complications and drug-drug or drug-food interactions. In addition, thromboembolic complications may occur due to subtherapeutic dosages of warfarin. The laboratory reference standards for monitoring warfarin therapy are the prothrombin time (PT) and the International Normalized Ratio (INR). While both the PT or INR will reflect the clinical response in the patient, results reported as INR values have been shown to be more accurate than those reported as PT values. Thirty-two patients were enrolled in this study. Our objectives were to compare INR values measured by both the Coumatrak and conventional laboratory method, and to demonstrate the effects of pharmacist intervention on managing patients receiving warfarin therapy. Results from our study reveal that INR monitoring by Coumatrak is similar to the conventional laboratory method. In addition, our study indicates that patients receiving warfarin therapy can be monitored and managed effectively by pharmacists. 相似文献
88.
Papapoulos S. E.; Berg H. v.d.; Frolich M.; Valentijn R. M. 《Nephrology, dialysis, transplantation》1988,3(5):647-650
The formation of 1.25-dihydroxycholecalciferol (1.25-(OH)2D3after single intravenous injections of 1-hydroxycholecalciferol(1-OHD3) was examined in four patients with chronic renal failureon regular haemodialysis. Following 13µg 1-OHD3administered at weekly intervals, 1.25-(OH)2D3 appeared in thecirculation within 1 h, and peak concentrations were reachedbetween 2 h and 5 h. By 8 h serum 1.25-(OH)2D3 concentrationshad started declining and by 44 h they had returned to baselineafter 1µg 1-OHD3 but they were still above basal after2 and 3 µg by an average of 30 pmol/l. One week afterinjections, concentrations were back to basal in all patientsstudied. The serum 1,25-(OH)2D3 dose response to injected la-OHDwas linear, indicating ample capacity of the liver 25-hydroxylaseto further hydroxylate 1-OHD. However, examination of the individualresponses revealed lower increments in serum 1.25-(OH)3 concentrationsin the patients with the highest basal serum 25-hydroxyvitaminD concen trations. Intravenous 1-OHD3 may be useful in the furtherstudy of the interactions between 1.25-(OH)23 calcium and PTHin chronic renal failure, as well as of the hepatic metabolismof vitamin D. 相似文献
89.
T. J. T. P. van den Berg B. Boltjes H. Spekreijse 《Documenta ophthalmologica. Advances in ophthalmology》1988,69(3):307-314
It is generally accepted that the pattern electroretinogram for very large spatial elements is the result of local luminance stimulation. Responses due to the luminance differences between elements may be assumed to be relatively unimportant because in the case of large elements only few retinal units are stimulated by gradients. With decreasing pattern element size one wonders to what extent the electroretinogram continues to be based on the local luminance stimulation. We investigated this question using 8 Hz checkerboard reversal and compared the pattern recordings with the recordings resulting from the same stimulus field modulated homogeneously (focal electroretinogram). A 100% modulated checkerboard at retinal level may be considerably less modulated because of imperfect optics of the eye. So the pattern electroretinogram should be compared with homogeneous field stimulation of correspondingly lower modulation depth. On the basis of the optical transfer properties of the eye we compared by subtracting the proper focal electroretinogram from the pattern electroretinogram. The difference response was virtually zero for check sizes larger than 120. For checks from 60 down the difference response was of the same order of magnitude as the adjusted focal recording. This difference response for eyes with normal optics is largest around 30; its wave form was found to be rather invariant with check size. 相似文献
90.
In the present study, 192 extremely anxious dental patients were asked for the factors which may have influenced their dental anxiety. The results showed that a traumatic dental experience, personality and professional behaviour of the dentist, persons in the direct environment, and psychological background all played an important role. Almost all extremely anxious dental patients had more than one negative experience with the dental treatment. Most patients acquired their anxiety at an early age. 相似文献