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91.
A 23-year-old woman with long-standing insulin dependent diabetes presented with necrobiosis lipoidica. She was particularly troubled by the telangiectatic element of the lesion and therefore underwent test treatment with the pulsed dye laser. At low fluences minimal therapeutic effect was achieved, and at higher fluences skin breakdown occurred. This resolved with conservative management. It would appear that caution is required when attempting to treat necrobiosis lipoidica with laser. 相似文献
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93.
A temporal high-pass filtration technique for digital subtraction angiocardiography was studied, using real-time digital studies performed simultaneously with routine cineangiocardiography (cine) for qualitative image comparison. The digital studies showed increased contrast and suppression of background anatomy and also enhanced detection of wall motion abnormalities when compared with cine. This digital technique is compatible with panning the image intensifier during an injection. The digital images are comparable with, and in some cases better than, cine images. Clinical efficacy of this digital technique is currently being evaluated. Real-time display, as well as potential reductions in radiation and contrast material doses, may make digital angiocardiography an attractive technique. 相似文献
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96.
Calprotectin is an abundant neutrophil cytosolic protein released during neutrophil activation or death. The use of plasma calprotectin concentration as a marker of pulmonary inflammation was tested in 31 children with cystic fibrosis, none of whom was acutely unwell or pyrexic. Twenty three were receiving antibiotics, 21 had positive sputum cultures, but none of the traditional tests clearly diagnosed ongoing infection. Plasma calprotectin was significantly higher in the cystic fibrosis group than in matched controls. Sixteen children with cystic fibrosis had values above the control range (320-1570 micrograms/l). Their chest radiograph Northern score, an index of accumulated pulmonary involvement, and their plasma copper, an index of acute phase response, both correlated with plasma calprotectin. Plasma gamma-glutamyltransferase also correlated weakly with plasma calprotectin: thus, hepatic pathology may be a confounding variable. However, the data still suggested that plasma calprotectin is a better index of inflammation than the traditional indices in general use. 相似文献
97.
Patients with severe thalassaemia major suffer endocrine and other abnormalities before their eventual death from iron overload due to repeated blood transfusions. The endocrine status of 31 thalassaemic patients aged 2-5 to 23 years was investigated. Exact data were available on the rate and duration of blood transfusion in all of them and in many the liver iron concentration was also known. Although the patients were euthyroid, the mean serum thyroxine level was significantly lower, and the mean thyrotrophic hormone level significantly higher, compared with the values found in normal children. Forty oral glucose tolerance tests with simultaneous insulin levels were performed in 19 children, of whom 5 developed symptomatic diabetes and one had impaired tolerance. Previous tests on all 6 patients were available and some showed raised insulin levels possibly due to insulin resistance. 2 patients had clinical hypoparathyroidism and are described. The parathyroid hormone levels determined by radioimmunoassay in 25 patients were below the mean for the age group in all and outside the reference range in 16. Nonfasting plasma calcium levels were not reduced. Puberty was delayed in some patients. Concentrations of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) measured in urine from 7 girls and 5 boys showed considerable variation. In the boys there was an overall tendency for FSH and LH excretion to be low with regard to age, but with respect to puberty rating FSH exretions were normal or low and LH normal or raised. The girls showed a tendency for LH but not FSH excretion to be raised in relation to puberty rating. The severity of the endocrine changes was related to the degree of iron loading and is discussed in relation to previous work in which the iron loading has rarely been accurately indicated nor parathyroid status assessed. 相似文献
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99.
It has been reported that chloroform administered to BDF1 mice by
inhalation for 2 years at concentrations of 5, 30 or 90 p.p.m. for 6 h/day,
5 days/week induced an increase in renal cell tumors in male but not female
mice exposed to the doses of 30 and 90 p.p.m. A small increase in liver
tumors was statistically significant in the female mice at 90 p.p.m. if the
incidences of carcinomas and adenomas were combined. Because chloroform is
not a DNA reactive mutagen, a 13-week time-course and dose-response study
was conducted under conditions of the original bioassay to examine whether
regenerative cell proliferation was an underlying mechanism of
carcinogenesis. Mice were given bromodeoxyuridine via infusion during the
last 3.5 days prior to necropsy to label cells in S-phase. Chloroform
induced pathology and regenerative cell proliferation, measured as the
labeling index (LI, percentage of cells in S-phase), were assessed
microscopically and immunohistochemically. Male mice exposed to 30 and 90
p.p.m. exhibited a dose-dependent increase in regenerating tubules within
the renal cortex and up to a 31-fold increase in LI. No renal lesions or
increased LI were observed in females. Increased centrilobular to midzonal
hepatocyte degeneration and vacuolation and a 7-fold increase over controls
in the hepatocyte LI were observed in the female mice at 90 p.p.m. at 13
weeks. Males exhibited similar pathology, but the increase in LI was not
sustained. The observed correlations between cytolethality and regenerative
cell proliferation with tumor formation supports extensive evidence that
chloroform induces cancer via a non- genotoxic-cytotoxic mode of action. A
concentration of 5 p.p.m. is the no-observed-adverse-effect level for
nephrotoxicity, cell proliferation and cancer. An appropriate safety factor
applied to this value is a straightforward approach to cancer risk
assessment that is consistent with the mode of action of chloroform.
相似文献
100.