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541.
542.
AG Pitman J Van Dijk NJ Cunningham 《Journal of Medical Imaging and Radiation Oncology》2008,52(5):463-470
The radiologist is likely to be the first medical practitioner on the scene for contrast reactions, anaphylaxis and other common medical emergencies that occur in radiology departments and stand‐alone practices. Until 2007, the Royal Australian and New Zealand College of Radiologists (RANZCR) did not provide resuscitation training as a CPD service for fellows, and the need for such a service has not been gauged. In 2007, the authors ran the first RANZCR large‐group resuscitation refresher training workshop at the Melbourne 2007 annual scientific meeting. The workshop maximized audience participation and knowledge transfer in a constrained time, disseminated guidelines, and collected feedback on the need for further resuscitation training for radiologists. Of the 100 feedback forms, 82 were returned. All the 82 responses wanted the workshop repeated at future annual scientific meetings, and 71 wanted RANZCR to provide hands‐on refresher training. Sixty‐six responders indicated when they had their most recent resuscitation training: six in the past 12 months, 25 in the past 3 years and 35 longer than 3 years. Sixty‐nine responded on availability of resuscitation training at their workplace: 33 indicated ‘Yes’ and 36 ‘No’. There is a definite need to provide resuscitation training for radiologists in Australia. At the end of this article, we reproduce the currently applicable guidelines as a service to our readers. 相似文献
543.
544.
Background
Juvenile systemic sclerosis (JSS) is a multisystem connective tissue disease characterized by skin fibrosis and internal organ involvement. It has a low prevalence, even in a tertiary facility setting. The purpose of the present study is to describe and analyze the clinical and laboratory characteristics of a group of children with JSS followed in a single center. 相似文献545.
New mutations in acetylcholine receptor subunit genes reveal heterogeneity in the slow-channel congenital myasthenic syndrome 总被引:6,自引:2,他引:6
Engel AG; Ohno K; Milone M; Wang HL; Nakano S; Bouzat C; Pruitt JN nd; Hutchinson DO; Brengman JM; Bren N; Sieb JP; Sine SM 《Human molecular genetics》1996,5(9):1217-1227
Mutations in genes encoding the epsilon, delta, beta and alpha subunits of
the end plate acetylcholine (ACh) receptor (AChR) are described and
functionally characterized in three slow-channel congenital myasthenic
syndrome patients. All three had prolonged end plate currents and AChR
channel opening episodes and an end plate myopathy with loss of AChR from
degenerating junctional folds. Genetic analysis revealed heterozygous
mutations: epsilon L269F and delta Q267E in Patient 1, beta V266M in
Patient 2, and alpha N217K in Patient 3 that were not detected in 100
normal controls. Patients 1 and 2 have no similarly affected relatives; in
Patient 3, the mutation cosegregates with the disease in three generations.
epsilon L269F, delta Q267E and beta V266M occur in the second and alpha
N217K in the first transmembrane domain of AChR subunits; all have been
postulated to contribute to the lining of the upper half of the channel
lumen and all but delta Q267E are positioned toward the channel lumen, and
introduce an enlarged side chain. Expression studies in HEK cells indicate
that all of the mutations express normal amounts of AChR. epsilon L269F,
beta V266M, and alpha N217K slow the rate of channel closure in the
presence of ACh and increase apparent affinity for ACh; epsilon L269F and
alpha N217K enhance desensitization, and epsilon L269F and beta V266M cause
pathologic channel openings in the absence of ACh, rendering the channel
leaky, delta Q267E has none of these effects and is therefore a rare
polymorphism or a benign mutation. The end plate myopathy stems from
cationic overloading of the postsynaptic region. The safety margin of
neuromuscular transmission is compromised by AChR loss from the junctional
folds and by a depolarization block owing to temporal summation of
prolonged end plate potentials at physiologic rates of stimulation.
相似文献
546.
547.
This study was designed to evaluate the response of medial joint line pain in the knees of middle-aged subjects to perimeniscal corticosteroid and local anaesthetic injection. The response to local anaesthetic alone was assessed in a control group of patients. Patients with recurrent effusions or mechanical symptoms were excluded. Sixty-seven orthopaedic out-patients were recruited, of whom 50 completed the 6-month study. The patients were randomly allocated to the two groups. Initial symptoms, mean ages and sex distribution were similar in the two groups. Assessment by clinical review and completion of linear analogue scales indicating the severity of pain and tenderness was performed before—and 1, 3 and 6 months after — injection.
At 6 months, 19 (73%) of the 26 patients receiving steroid were asymptomatic compared with eight (33%) of the 24 receiving local anaesthetic alone (P < 0.01). 相似文献
548.
Embryo morphology or cleavage stage: how to select the best embryos for transfer after in-vitro fertilization 总被引:11,自引:15,他引:11
Ziebe S; Petersen K; Lindenberg S; Andersen AG; Gabrielsen A; Andersen AN 《Human reproduction (Oxford, England)》1997,12(7):1545-1549
This retrospective study of 1001 in-vitro fertilization (IVF) cycles
included a consecutive series of single transfers (n = 341), dual transfers
(n = 410) and triple transfers (n = 250) where all the transferred embryos
in each cycle were of identical quality score and identical cleavage stage.
In our 2 day culture system, transfer of 4- cell embryos resulted in a
significantly higher implantation rate and pregnancy rate (23 and 49%)
compared with 2-cell embryos (12 and 22%) and 3-cell embryos (7 and 15%).
Furthermore, the transfer of 4-cell embryos resulted in a significantly
higher pregnancy rate compared with embryos that had cleaved beyond the
4-cell stage (28%). The implantation rate (21%) and pregnancy rate (43%)
after transfer of embryos of score 1.0 were significantly higher than after
transfer of embryos of score 2.0 (14 and 32% respectively). Transferring
embryos of score 2.1 resulted in significantly higher implantation rates
(26%) and similar pregnancy rates compared with score 1.0. Transferring
embryos of score 2.2-3.0 resulted in a significantly lower implantation
rate (5%) and pregnancy rate (15%). A striking finding was that embryos of
quality score 2.0 had a significantly lower implantation rate compared with
embryos of quality score 1.0 and 2.1 and a significantly lower pregnancy
rate compared to embryos of quality score 1.0. We also found a lower
implantation rate and pregnancy rate when transferring 3-cell embryos.
These findings may indicate periods of increased sensitivity to damage
during the cell cycle. In conclusion, these results substantiate the idea
of the superiority of 4-cell embryos and demonstrate that minor amounts of
fragments in the embryo may not be of any importance. These findings may
call for a shift when weighing the two main morphological components
(quality score and cleavage stage) in the sense that reaching a 4-cell
cleavage stage even with the presence of a minor amount of fragments should
be preferred to a 2-cell embryo with no fragments.
相似文献
549.
Fukuda M; Fukuda K; Andersen CY; Byskov AG 《Human reproduction (Oxford, England)》1998,13(6):1590-1594
The present study was undertaken to evaluate whether the site of ovulation
affects the following follicular phase length and pre-embryo development
during infertility treatment with ovarian stimulation using clomiphene
citrate. A total of 363 cycles in 97 patients undergoing infertility
treatment (182 intrauterine insemination (IUI) cycles in 60 patients and
181 in-vitro fertilization (IVF) cycles in 52 patients) were studied. The
cycles were divided into two main groups: preceding unilateral ovulation
(PUO) and preceding bilateral ovulation (PBO). In the PUO group, the cycles
were subdivided into contralateral ovulation, bilateral ovulation and
ipsilateral ovulation. In IVF cycles alone, bilateral ovulations were
further divided into bilateral ovulation- contralateral side and bilateral
ovulation, ipsilateral side. Contralateral ovulations were seen in 134 of
240 cycles (56%), excluding bilateral ovulation and PBO. The follicular
phase length in contralateral ovulation (16.2 +/- 2.6 days, mean +/- SD)
was significantly (P < 0.05) shorter than that of ipsilateral ovulation
(16.9 +/- 2.8). There were no significant differences of follicular phase
length among contralateral ovulation, bilateral ovulation and PBO. Of IVF
cycles including contralateral ovulation-ipsilateral ovulation and
bilateral ovulation a total of 107 preovulatory follicles was assessed in
the contralateral side (contralateral ovulation + bilateral
ovulation-contralateral side) and 97 in the ipsilateral side (ipsilateral
ovulation + bilateral ovulation, ipsilateral side). The oocyte retrieval
rate (88%), fertilization rate (84%), cleavage rate (95%), embryo transfer
rate (70%) of contralateral follicles were higher than those of ipsilateral
follicles (71, 62, 86, 38% respectively) and those of PBO (76, 62, 87, 41%
respectively). The total pregnancy rate of both IUI and IVF did not differ
among contralateral ovulation (15%), ipsilateral ovulation (8%), bilateral
ovulation (11%) and PBO (10%). The results confirm and extend our previous
findings in natural cycles, suggesting that local ovarian factors, e.g.
from corpus luteum, affect the health of preovulatory follicle and the
enclosed oocyte in the same ovary (ipsilateral) negatively. Contralateral
selection of preovulatory follicles in the succeeding cycle shortens the
follicular phase length and favours pre- embryo development. The chance of
conceiving during ovarian stimulation with clomiphene citrate may thus be
affected by the site of ovulation in the previous cycle.
相似文献
550.
Laina Knorr Julie D Fox Peter AG Tilley Jasmine Ahmed-Bentley 《BMC infectious diseases》2006,6(1):62-12