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31.
A 35-year-old black man with end-stage renal disease from biopsy-proven focal segmental glomerulosclerosis developed worsening function of his renal allograft 160 days after living related donor renal transplantation. Renal biopsy showed necrotizing and crescentic glomerulonephritis (NCGN) and presence of intraglomerular viral inclusions confirmed by immunocytochemical stain and in situ hybridization techniques to be cytomegaloviral in origin. Electron microscopy showed no immune complexes, and workup for other causes of NCGN was negative. The patient was treated with ganciclovir without other changes in his immunosuppressive regimen. After 8 weeks of ganciclovir therapy, a second renal transplant biopsy showed resolution of the glomerular process and disappearance of the cytomegalovirus (CMV) inclusions. The resolution of the glomerular process with treatment for CMV infection, and without other change in therapy, strongly supports a causative link between CMV and NCGN in this patient. This case represents the first report of CMV-associated NCGN in a renal transplant patient. 相似文献
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窄蒂肋间穿支型薄皮瓣在手背创面修复中的应用 总被引:3,自引:2,他引:1
介绍一种以肋间动脉皮肤穿支为营养血管的、主要用于修复手背皮肤缺损的薄皮瓣。手术方法是以第4~9肋间血管外侧皮穿支为蒂,蒂部长和宽均为3~5cm,瓣部长宽均可达15cm,远端2/3修薄。术后第7~10天断蒂。应用此窄蒂皮瓣修复15例16只手背创面,皮瓣全部成活。随访6个月~2年,手功能恢复良好。由于手术不需分离肋间主干血管,其操作远较以往报道的岛状或游离肋间血管皮瓣简便和安全,为修复手背创面的理想皮瓣 相似文献
38.
Musculoskeletal modelling in determining the effect of botulinum toxin on the hamstrings of patients with crouch gait 总被引:2,自引:0,他引:2
NS Thompson FRCS RJ Baker PhD AP Cosgrove MD FRCS IS Corry MD FRCS HK Graham MD FRCS FRACS 《Developmental medicine and child neurology》1998,40(9):622-625
This study aimed to determine the effect of hamstring botulinum toxin A (Btx-A) injection in 10 children with crouch gait in terms of changes in muscle length and lower-limb kinematics. Before Btx-A injection limb kinematics were recorded. Maximum hamstring lengths and excursions were calculated by computer modelling of the lower limb. Data were compared with the averaged hamstring lengths of 10 control children. Hamstrings were denned as short if their length was shorter than the average maximum length minus one standard deviation. Gait analysis was repeated 2 weeks after isolated hamstring Btx-A injection. Pre- and postinjection kinematic data and muscle lengths were then compared. Four of 18 injected limbs in three subjects had short medial hamstring before injection, none of the subjects had short lateral hamstrings. Muscle excursion was significantly reduced in the short and adequate maximum muscle length groups. A significant increase in the semimembranosus and semitendinosus length in all of the injected limbs was noted. Only in the short muscle group was a significant increase in muscle excursion observed. Knee extension improved by 13° in the adequate muscle length group and by 15.6° in the short muscle length group. Pelvic tilt and hip flexion increased in both groups non-significantly. Average walking speed postinjection increased from 0.60 ms-1 to 0.71 ms-1 . Short hamstrings are over-diagnosed in crouch gait. Hamstring Btx-A injection in patients with crouch gait produces significant, repeatable muscle lengthening and improved ambulatory function. 相似文献
39.
Three different modes of lactate tests were studied. Eleven male competitive swimmers performed the tests (n.100 m, n.300 m, 2.100m + 2.400 m) within 5 days. Swimming velocity (V) vs blood lactate (BLa) and V vs heart rate (HR) curves were averaged. In V vs BLa comparisons, the BLa values of 4 mmol.l-1 in 2.400 m, 3 mmol.l-1 in n.300 m, and 2 mmol.l-1 in n.100 m modes were found to correspond to the same V. Although the resting BLa values were similar before the testing occasions, the initial BLa value in very easy swimming was lower in the n.300 m than in the n.100 m mode. The elimination of lactate most probably caused this difference. The highest BLa value was measured in the n.100 m (14.9 mmol.l-1) and 2.100 m (13.6 mmol.l-1) exercise modes demonstrating a higher rate of anaerobic energy production than in the n.300 m or 2.400 m test modes. In HR vs V comparison, the n.300 m and 2.400 m modes demonstrated similar HR values in relation to V. To measure the whole intensity area, a combination of tests should be applied by performing an incremental set with several steady-state loadings (aerobic) and one or two 100 m swims (anaerobic) in one test session. 相似文献
40.
The authors describe a magnetic resonance imaging method for examination of the glenoid labrum of the shoulder joint that utilizes a radial fast-imaging sequence. Seven shoulders were examined: a total of five in three healthy asymptomatic volunteers, one in a symptomatic patient not suspected of having a lesion of the glenoid labrum, and one in a patient with recurrent shoulder dislocation and surgical proof of an extensive tear of the labrum. The preliminary results suggest that this technique may advantageously demonstrate pathologic changes in the glenoid labrum and may contribute to the evaluation of the unstable and painful shoulder. 相似文献