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41.
BACKGROUND/PURPOSE: Abdominal nontuberculous mycobacterial infection is a rare condition. Continuous ambulatory peritoneal dialysis (CAPD)-associated peritonitis is the most common manifestation of infection due to nontuberculous mycobacteria (NTM). There are limited data on the clinical manifestations of nontuberculous mycobacterial infection. This study investigated the diagnostic features, clinical presentation, mycobacteriology, treatment and outcome of all abdominal NTM infections treated over a 7-year period at a major teaching hospital in Taiwan. METHODS: The medical records of all patients with a diagnosis of abdominal NTM infection from January 1997 through to December 2003 were retrospectively reviewed. RESULTS: All 11 patients with abdominal NTM infections identified during the 7-year period were included. Among these patients, six were male and five were female, with a mean age of 64.5 years. The disease manifested as peritonitis (9 patients, 82%), splenic abscess (1, 9%), or perirenal abscess (1, 9%). Most patients (73%) had underlying malignancy, most often hepatoma (45%). Immunocompromised status (liver cirrhosis, malignancy, acquired immunodeficiency syndrome) was noted in 10 patients (91%). None of our patients who developed NTM peritonitis had received CAPD. The peritoneal fluid appearance varied considerably, with no particular predominance of clear, turbid, bloody, or chylous findings. Rapidly growing mycobacteria were the major etiology (46%) of abdominal NTM infection, and Mycobacterium abscessus played a major role (27%). Overall, eight patients died, and only one patient survived longer than 1 year. Seven patients (64%) died before diagnosis. CONCLUSION: Abdominal NTM infection is frequently overlooked because of its rarity and nonspecific symptoms, with consequent delays in diagnosis and treatment. In immunocompromised patients with ascites from any cause (liver cirrhosis, malignant ascites, etc.), NTM peritonitis should be considered early in the differential diagnosis of symptoms including fever, abdominal pain and weight loss. The poor prognosis of abdominal NTM infection appears to be related to the severity of underlying conditions, most often malignancy. 相似文献
42.
目的:探讨氨苯砜综合征的诊治要点:方法:对6例氨苯砜综合征患者的临床资料进行回顾性分析。结果和结论:6例氨苯砜综合征患者均为中青年,从服药到出现症状的时间较长,为9~55日.6例患者均以高热起病,起病急骤、凶险,病初均有麻疹紫癜样皮疹,皮疹多形,严重者出现尼氏征阳性或阴性的大疱和(或)全身性红皮病样皮疹;均有浅表淋巴结肿大;多数患者有血液系统损害;并均有肝损害:确诊后及时停氨苯砜,给予足量肾上腺皮质激素和(或)大剂量免疫球蛋白静脉注射,以及支持对症处理,住院12~80(中位数53)日,4例痊愈,1例病情得到控制,另1例因治疗第2日自动出院放弃治疗,死于肝功能衰竭?提示氨苯砜综合征需要及时、正确处理,否则预后不良. 相似文献
43.
44.
目的 观察自体角膜缘上皮移植联合贝复舒对角膜缘上皮修复的作用。方法 随机选择翼状胬肉患者98例(98只眼),治疗组为自体角膜缘上皮移植联合贝复舒,对照组为翼状胬肉切除联合贝复舒。术后每日观察角膜上皮缺损区的修复情况,并随诊观察复发情况。结果 治疗组角膜缘上皮平均修复时间为3.1天,对照组4.2天,有显著差异性。随诊6个月发现对照组有一例复发,均未发现感染。结论 自体角膜缘上皮移植联合贝复舒可使角膜缘上皮修复时间快于翼状胬肉切除联合贝复舒。复发率均较低,表明自体角膜缘上皮移植联合贝复舒治疗翼状胬肉可以加快角膜缘上皮修复,减少复发及感染的机会。 相似文献
45.
The complete sequence (22 kilobases) of murine coronavirus gene 1 encoding the putative proteases and RNA polymerase 总被引:52,自引:0,他引:52
46.
The purpose of this study is to develop an evaluation instrument with high feasibility and acceptability, and to quantify the outcome of evaluation, in order to set up an efficient evaluation system. Teaching evaluation with questionnaire by students has been carried out in National Yang-Ming Medical College for two years. With the support of both teachers and students, the system has been established and conducted on a regular basis. The most important purpose of evaluation is to improve the quality of teaching. During the two academic years (Sep. 1986-June 1988) of the program, the overall response rate was 44.5%, the Department of Nursing had the highest response rate, followed by Dentistry, Medicine-Post Graduate, Medical Technology, and Medicine. Taking into consideration of the year and the class size, the regression analysis found that higher year or smaller size of the class had better response rate. The response rates dropped significantly after the first academic year regardless of department or year. A total of 23 classes were included in the evaluation program and 99 courses were evaluated. All questions in the questionnaire used a 0 to 4 ordinal scale, in which 0 (improvement needed) was the low end and 4 (excellent) the high end. The mean score of the seven questions of teaching evaluation was 2.47. As a whole, the students were satisfied with the teaching. As to the categories of courses, clinical courses had better mean score than basic medical courses, and basic medical courses had better mean score than common required courses. To evaluate the effectiveness of the teaching, students' achievement was used as the outcome variable. The most important predictive variable was the method of instruction, followed by the content of lecture such as degree of difficulty of the lecture and cognitiveness of the contents. The above 3 variables explained 76% of the variation of the students' achievement. However, the significant of teachers' speech, performance and attitude were not so influential. Analysis based on the characteristics of the teachers (sex, age, position, and teaching experience), the characteristics of students (department and year), teaching environments (time and place), and the 3 categories of courses (clinical, basic medical and common required courses) showed that all the above variables only explained less then 10% of the variation of the students' achievement. 相似文献
47.
细脚拟青霉对大鼠血液蛋白质水平及其生长的影响 总被引:3,自引:0,他引:3
用10%细脚拟青霉水煎剂1.0ml·d(-1)给大鼠灌胃,连续21d,对ip环磷酰胺(20mg·kg(-1)×7d)所致免疫抑制大鼠血液中血红蛋白、血清总蛋白、球蛋白水平下降及体重减轻等均有显著的保护和逆转作用;对正常大鼠血液中血红蛋白水平也有显著提高。提示:细脚拟青霉可改善机体的营养状况,促进生长,逆转免疫抑制作用。 相似文献
48.
急性脑血管病患者血清及脑脊液髓鞘碱性... 总被引:14,自引:2,他引:12
Myelin basic protein (MBP) was measured in the serum and CSF of patients with acute cerebrovascular disease (CVD, 34 cases), demyelinating disorders (DMD, 30 cases) and other neurological diseases (OND, 26 cases) by using a double antibody radioimmunoassay (RIA). Patients with acute CVD had a mean serum MBP concentration and positivity rate much higher than those with DMD and OND. The differences were significant (P < 0.05). In CSF, MBP levels in patients with acute CVD and patients with DMD were significantly greater than those in OND patients (P < 0.05). The results also show that there was a linear relationship between the CSF MBP levels and the serum MBP levels in patients with acute CVD (r = 0.72, P < 0.01), but no such relationship in patients with DMD and OND. The amount of serum MBP was also significantly correlated to the severity of acute CVD, to the level of consciousness disorder and limb paralysis, and to the extent and site of the cerebral lesion at CT-scan (P < 0.05). This study shows that the measurement of brain specific MBP in serum as a marker of cerebral damage may have clinical value in the diagnosis and prognosis of patients with CVD. 相似文献
49.
重症肌无力病人乙酰胆碱受体抗体的测定及临床意义 总被引:7,自引:0,他引:7
用ELISA(固相酶联免疫吸附)法测定172例MG病人血清乙酰胆碱受体抗体(AchRab),结果显著高于健康献血员组和非MG病人组。不同性别、病程及临床类型与AchRab无相关性,但41~50岁组的显著高于其他年龄组。67例类固醇激素治疗组、22例大剂量两种球蛋白治疗组、12例胸腺切除术组及3例MG危象病人24次血浆交换疗法(PE)组,治疗后伴随肌无力症状的好转,AchRab均显著低于治疗前。结果表明:AchRab测定为MG诊断提供了可靠的实验依据,为类固醇激素、大剂量丙种球蛋白、胸腺切除术和PE等治疗MG提供理论依据和疗效评定的实验指标,进一步证实了MG免疫学发病机理。 相似文献
50.
3,5-diBr-PADAP直接光度法测定血清锌 总被引:2,自引:0,他引:2
目的 建立一种不去除血清蛋白、简便灵敏的直接光度法测定血清锌。方法 以新的有机试剂2 -(3 ,5 二溴 -2 -吡啶偶氮 ) -5 -二乙氨基酚 (3 ,5 diBr -PADAP)为显色剂 ,在有表面活性剂存在的Tris-HC1介质中 ,手工分析法和自动分析法测定血清锌。结果 该法线性范围 0~ 80 μmol/L ,手工分析法和自动分析法平均回收率为 99 9%和 10 0 2 % ,批内变异系数 (CV)和批间变异系数分别为 0 0 18、 0 0 17和 0 0 2 8、0 0 2 6,与原子吸收分光光度法比较具有良好的相关性 ,线性回归方程和相关系数分别为Y =1 0 0 4X -0 12 6,r=0 9912和Y =1 0 0 6X -0 195 ,r =0 0 992 8。 89例健康人血清锌含量分别为 8 96~ 2 2 5 2 μmol/L和 8 63~2 2 43 μmol/L (x± 2s)。结论 用 3 ,5 diBr-PADAP直接光度法测定血清锌方法简便、灵敏可靠 ,适合临床应用。 相似文献