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41.
Riyaz Bhikoo MBChB Rachael L Niederer PhD MBChB Richard Hart FRANZCO Trevor Sherwin PhD Charles NJ McGhee PhD FRCS FRANZCO 《Clinical & experimental optometry》2013,96(4):430-432
We describe the corneal microstructural changes in a patient with spheroidal degeneration using in vivo confocal microscopy. Multiple hypo‐ and hyper‐reflective spherical lesions were observed in the anterior corneal stroma and Bowman's layer ranging from 45 to 220 μm in size. The corneal epithelium, posterior stroma and endothelium were otherwise unaffected. In vivo confocal microscopy demonstrates good correlation with excised histological samples in climatic droplet keratopathy. It provides a non‐invasive technique to examine the living cornea for degenerative disease and acts as a bridge between clinical and laboratory observations. 相似文献
42.
Christina N Grupcheva MD Jennifer P Craig PhD Trevor Sherwin PhD Charles NJ McGhee PhD FRCOphth FRACO 《Clinical & experimental ophthalmology》2001,29(3):133-137
The purpose of this study was to demonstrate microstructural differences between clinically similar, but aetiologically different, cases of corneal oedema in four subjects. In vivo confocal microscopy highlighted oedema of the basal epithelium, prominent nerve–keratocyte interactions, and typical ‘epithelialization’ of the endothelium in a case of iridocorneal endothelial syndrome; however, a similar microstructural appearance was observed in a case of presumed herpetic disciform keratitis. The latter diagnosis was subsequently revised on this basis. Confocal examination of Fuchs’ endothelial dystrophy demonstrated oedema of the basal epithelium, prominent wing cells, anterior stromal alterations, fibrosis of Descemet’s membrane and a typical ‘strawberry’ appearance of the endothelium. In contrast, in vivo microstructural examination of bilateral keratoconus with hydrops confirmed oedema mainly involving the epithelium and anterior stroma. In vivo confocal microscopy allows the clinician to observe the living cornea at a microstructural level and to better diagnose and differentiate borderline or unusual cases of corneal oedema. 相似文献
43.
S. K. BRÆKKAN E. B. MATHIESEN I. NJØLSTAD T. WILSGAARD J. STØRMER J. B. HANSEN 《Journal of thrombosis and haemostasis》2008,6(11):1851-1857
Summary. Background: Recent studies indicate that arterial cardiovascular diseases and venous thromboembolism (VTE) share common risk factors. A family history of myocardial infarction (MI) is a strong and independent risk factor for future MI. Objectives: The purpose of the present study was to determine the impact of cardiovascular risk factors, including family history of MI, on the incidence of VTE in a prospective, population‐based study. Patients and methods: Traditional cardiovascular risk factors and family history of MI were registered in 21 330 subjects, aged 25–96 years, enrolled in the Tromsø study in 1994–95. First‐lifetime VTE events during follow‐up were registered up to 1 September 2007. Results: There were 327 VTE events (1.40 per 1000 person‐years), 138 (42%) unprovoked, during a mean of 10.9 years of follow‐up. In age‐ and gender‐adjusted analysis, age [hazard ratio (HR) per decade, 1.97; 95% confidence interval (CI), 1.82–2.12], gender (men vs. women; HR, 1.25; 95% CI, 1.01–1.55), body mass index (BMI; HR per 3 kg m?2, 1.21; 95% CI, 1.13–1.31), and family history of MI (HR, 1.31; 95% CI, 1.04–1.65) were significantly associated with VTE. Family history of MI remained a significant risk factor for total VTE (HR, 1.27; 95% CI, 1.01–1.60) and unprovoked VTE (HR, 1.46; 95% CI, 1.03–2.07) in multivariable analysis. Blood pressure, total cholesterol, HDL‐cholesterol, triglycerides, and smoking were not independently associated with total VTE. Conclusions: Family history of MI is a risk factor for both MI and VTE, and provides further evidence of a link between venous and arterial thrombosis. 相似文献
44.
45.
Hall RM; Unsworth A; Wroblewski BM; Siney P; Powell NJ 《Rheumatology (Oxford, England)》1997,36(1):20-26
Charnley prostheses, retrieved at revision surgery, were studied to assess
the effects of friction on the total hip replacement procedure. Frictional
resistance was measured using the Durham hip function simulator under both
dry and lubricated conditions. The friction factor values (f) for the
explanted prostheses were found to have a non- Gaussian distribution with
medians of 0.13 [inter-quartile range (IQR) 0.10-0.16] and 0.06 (IQR
0.005-0.08) for dry and lubricated (n = 0.01 Pa s) regimes, respectively.
New Charnley prostheses had values of f equal to 0.11 +/- 0.025 and 0.04
+/- 0.01 under the same conditions, and showed no large deviation from a
Gaussian distribution. There was found to be a statistically significant
difference in the medians of the friction factors for new and retrieved
prostheses in the lubricated regime. Ingression of cement into the worn
region of the cup was found to increase the friction factor significantly
under dry conditions. There was no evidence of an increase in the friction
factor or torque for those joints that had a loose socket with respect to
those that were fixed at revision. A decrease in the frictional torque
against number of cycles undergone by the joint in vivo may indicate that a
fatigue-type process may have a role in the loosening of the socket.
However, this relationship was found not to be significant for friction
measured under lubricated conditions and it seems unlikely that the
frictional torque generated in this type of prosthesis will contribute
significantly to the long-term loosening of the socket.
相似文献
46.
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48.
Since the NHS reforms, health authorities have been purchasing health care and have been advised that publichealth considerations must inform all NHS activities, and that the Director of Public Health must be supported by a team of qualified support staff. This survey of directors of public health and health authority chief executives in England shows the skills currently available to support health authority purchasing, and the perceived importance of this wide range of skills to the purchasing process. Future models of purchasing will need to ensure access by purchasers to public health and multi-disciplinary advice. 相似文献
49.
Counts of Pick bodies (PB), Pick cells (PC), senile plaques (SP) and neurofibrillary tangles (NFT) were made in the frontal and temporal cortex from patients with Pick's disease (PD). Lesions were stained histologically with hematoxylin and eosin (HE) and the Bielschowsky silver impregnation method and labeled immunohistochemically with antibodies raised to ubiquitin and tau. The greatest numbers of PB were revealed by immunohistochemistry. Counts of PB revealed by ubiquitin and tau were highly positively correlated which suggested that the two antibodies recognized virtually identical populations of PB. The greatest numbers of PC were revealed by HE followed by the anti-ubiquitin antibody. However, the correlation between counts was poor, suggesting that HE and ubiquitin revealed different populations of PC. The greatest numbers of SP and NFT were revealed by the Bielschowsky method indicating the presence of Alzheimer-type lesions not revealed by the immunohistochemistry. In addition, more NFT were revealed by the anti-ubiquitin compared with the anti-tau antibody. The data suggested that in PD: (i) the anti-ubiquitin and anti-tau antibodies were equally effective at labeling PB; (ii) both HE and anti-ubiquitin should be used to quantitate PC; and (iii) the Bielschowsky method should be used to quantitate SP and NFT. 相似文献
50.
Quantitative liver function in patients with rheumatoid arthritis treated with low-dose methotrexate: a longitudinal study 总被引:4,自引:0,他引:4
Beyeler C; Reichen J; Thomann SR; Lauterburg BH; Gerber NJ 《Rheumatology (Oxford, England)》1997,36(3):338-344
The objectives were to determine quantitative liver function prospectively
in patients with rheumatoid arthritis (RA) treated with low-dose
methotrexate (MTX), to search for risk factors for a loss of quantitative
liver function and to assess the relationship between quantitative liver
function and histological staging. A total of 117 patients with RA (ACR
criteria, 85 women, mean age 59 yr) had measurements of galactose
elimination capacity (GEC), aminopyrine breath test (ABT) and liver enzymes
[aspartate amino transferase (AST), alanine amino transferase (ALT),
alkaline phosphatase (AP), 7-glutamyl transferase (GGT), bile acids,
bilirubin, albumin] before treatment with weekly i.m. MTX injections and
every year thereafter. In 16 patients, liver biopsies were performed.
Before the introduction of MTX, mean GEC was 6.6 mg/min/kg [5th to 95th
percentile (5-95 PC) 5.1- 8.5; reference range 6.0-9.1] and mean ABT was
0.80% kg/mmol (5-95 PC 0.42-1.30: reference range 0.6-1.0). During
treatment with MTX [mean weekly dose 11.8 mg (5-95 PC 5.4-20.2), mean
observation period 3.8 yr (5-95 PC 0.4-6.9)], significant declines of GEC
(-0.12 mg/min/kg per year. t = 3.30, P < 0.002) and ABT (-0.06% kg/mmol
per year, t = 4.81, P < 0.001) were observed. Negative correlations were
found between the annual change in GEC and GEC at baseline (Rs = -0.40, P
< 0.0001), and the annual change in ABT and ABT at baseline (Rs = -0.43,
P < 0.0001). No correlations were found between the annual change in GEC
or ABT and weekly MTX dose, age or percentage of increased liver enzymes,
and no effect of a history of alcohol consumption > 30 g/week became
evident. Two patients with Roenigk grade III had impaired quantitative
liver function, while 14 patients with Roenigk grades I and II exhibited a
high variability of GEC and ABT from normal to abnormal values. The
continuous declines in GEC and ABT observed deserve attention in patients
with prolonged treatment. Patients with a low GEC or ABT at baseline seem
not to be at increased risk for a further loss of quantitative liver
function. An impaired GEC or ABT does not necessarily concur with hepatic
fibrosis on histological examination.
相似文献