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31.
Deficiency of platelet membrane glycoprotein Ia associated with a decreased platelet adhesion to subendothelium: a defect in platelet spreading 总被引:14,自引:5,他引:14
A bleeding disorder with absent collagen-induced platelet aggregation and adhesion has been described in a patient whose platelets failed to express surface glycoprotein Ia. We studied the interaction of her platelets with subendothelium in an annular perfusion chamber and the interaction with purified human collagen type III in a rectangular perfusion system under flow conditions. Platelet adherence was almost completely absent both at low and high shear rates. The few platelets which adhered remained in the contact stage without subsequent spreading and aggregate formation. Addition of a monoclonal antibody, which was directed against the von Willebrand moiety of FVIII-VWF, to the blood, completely abolished platelet adherence at high shear rates and had a partial effect at low shear rates. These data indicate that von Willebrand factor plays a role in the initial attachment (contact stage) of platelets to subendothelium. We conclude that the bleeding disorder and excessively prolonged bleeding time in our patient are caused by a new specific defect of the platelet-vessel wall interaction. 相似文献
32.
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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Chul Lee Barbara S. Stonestreet William Oh Eugene W. Outerbridge William J. Cashore 《Brain research》1995,689(2):233
The postnatal maturation of the blood-brain barrier (BBB) for unbound bilirubin was studied in 2-day- and 2-week-old piglets. Hyperbilirubinemia was induced by bolus infusion of bilirubin at 25 mg/kg followed by continuous infusion of 20 mg/kg/h for 3 h. During the study period, arterial blood pH and blood gas tensions, serum osmolarity, and mean arterial blood pressures were within the physiologic range. Brain bilirubin content and the brain/blood distribution ratio for bilirubin were higher in the 2-day-old than in the 2-week-old piglets. In both age groups, regional brain bilirubin concentration and brain/blood ratios were higher in subcortical regions (cerebellum and brainstem) than in the cerebral cortex. We conclude that in the newborn piglets the blood-brain barrier for unbound bilirubin matures with increasing postnatal age and that irrespective of maturity the relative permeability of the BBB for bilirubin appears higher in subcortical than in cortical regions. 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
40.
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