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151.
Purpose. To estimate disease activity in patients with systemic sclerosis using contrast-enhanced MRI of the skin.
Material and Methods. In a pre-study, sequences of a low-field (0.2 T) scanner (Artoscan, Esaote, Genova, Italy) were optimized for detection of
intravenous contrast (0.1 mmol/l Gd-DTPA) in six patients with the autoimmune disease systemic scleroderma. Based on the results
of the pre-study, 17 patients with scleroderma (7 sclerotic/10 active inflammatory disease) were scanned using gradient-spoiled
3D GRE sequences (FA 90 °, TR 100 ms, TE 18 ms), which had been established as most sensitive for intravenous contrast. Contrast
enhancement of the skin was determined quantitatively by contrast-to-noise ratios (CNR), comparing post- to pre-contrast and
dynamic scans (for 6 min, 1 acquisition/min). Patients in the chronic state with sclerodactylia and active inflammation of
the hands were considered separately and compared to a control group (n = 10) matched according to age.
Results. CNR increase after intravenous contrast was significantly higher in patients with active disease (86 ± 16 % increase) than
sclerosing disease (29 ± 3 %, p < 0.05) and the control group (4 ± 2 %, p < 0.05). The dynamic examination showed a significantly slower decrease after the peak rise in the first minute in patients
with active disease (CNR 15.4 ± 0.7 to 14.2 ± 1.4) than in those with chronic disease (14.1 ± 0.5 to 11.3 ± 0.9, p < 0.05).
Discussion. Capillary leakage is the most likely explanation for the increased enhancement in patients with active scleroderma. Using
sequences optimized for contrast detection, disease activity in the course of scleroderma and response to therapy can be determined
by MRI in the future.
相似文献
152.
Die aktuelle Diskussion zur Behandlung des Magenkarzinoms betrifft vorwiegend das ad?quate Ausma? der Lymphadenektomie, also
die extra- luminale Resektion. Die bestehende Kontroverse ist auf verschiedene Multicenterstudien zu Morbidit?t und Mortalit?t
bei D1- bzw. D2- Lymphadenektomie zurückzuführen.
Ziel dieser übersicht war es, die bisher vorliegenden Daten zum luminalen und extraluminalen Resektionsausma? beim Magenkarzinom
zu bilanzieren und die m?glichen Schlu?folgerungen für den Stand im Jahre 1998 zu ziehen. 相似文献
153.
Klaus Funke Florentin Wörgötter 《Experimental brain research. Experimentelle Hirnforschung. Expérimentation cérébrale》1995,104(1):171-176
The temporal structure of spike trains recorded from optic fibers and single units of the lateral geniculate nucleus (LGN) and primary visual cortex of the cat was studied with a novel method of inter-spike interval analysis. ON type relay cells of the LGN exhibited a multimodal interval distribution preferring a distinct interval (fundamental interval) and its multiples during the sustained light response, whereas most OFF cells showed a broad, unimodal distribution. The general pattern of the interval distribution was relatively independent of stimulus size and contrast and the degree of light adaptation. Simultaneously recorded S-potentials originating from the retinal input generally produced only a single peak at the fundamental interval length. Therefore, the multimodal interval distribution of LGN cells seems to be a result of intra-geniculate inhibition. Cortical cells also showed a weak tendency to fire with spike intervals similar to LGN cells. Therefore, the regular firing pattern observed at peripheral stages of the visual pathway can persist at higher levels and might promote the occurrence of oscillatory activity. 相似文献
154.
Hans-Jürgen Möller Horst Müller Richard L. Borison Nina R. Schooler Guy Chouinard 《European archives of psychiatry and clinical neuroscience》1995,245(1):45-49
The hypothesis that differences in drug effects of risperidone and haloperidol on negative symptoms in schizophrenia are secondary to effects on positive, extrapyramidal, and depressive symptoms was investigated by means of an analysis of the data from the USA-Canada risperidone double-blind randomized clinical trial of 523 chronic schizophrenic patients. Regression analyses in the total sample and within treatment groups confirmed a strong relationship between changes in negative symptoms and the other variables studied (R2=0.50–0.51,p<0.001). Only depressive symptoms did not contribute significantly to these results (p>0.10). Path analysis showed that the greater mean change (p<0.05) of negative symptoms with risperidone compared to haloperidol could not be fully explained by correlations with favourable effects on positive and extrapyramidal symptoms. The relationship between shift in extrapyramidal symptoms and shift in negative symptoms failed to reach statistical significance; however, there was a clear tendency in the expected direction in both treatment groups. 相似文献
155.
156.
A rat model of monitoring liver allograft rejection 总被引:5,自引:0,他引:5
Timi Martelius Heikki Mäkisalo Krister Höckerstedt Eero Taskinen Irmeli Lautenschlager 《Transplant international》1997,10(2):103-108
Rat models are often used to study liver allograft rejection. We have established a model for rat liver allograft rejection,
monitored by fine needle aspiration biopsy (FNAB), in the strain combination PVG-to-BN with a mean survival time of 37 ± 20
days. In this model, we observed acute rejection with an intense peak of lymphoid blasts and lymphocyte-dominated inflammation
in the FNAB [9.1 ± 3.0 corrected increment units (CIU)], and an eventual increase in macrophages (up to 4.2 ± 4.4 CIU), together
with fibrosis and parenchymal necrosis in the graft. Markers of immune activation, such as an increase in IL-2-receptor (from
1 % ± 2 % to 21 % ± 13 %) and class II (from 20 % ± 9 % to 43 % ± 13 %) expressing lymphoid cells and induction of ICAM-1
in the graft, were consistent with the overall cellular response. The FNAB correlated well with parallel graft histology.
In this rat model, the atraumatic monitoring makes a close follow-up possible without having to sacrifice the experimental
animals. This saves work, animals, and costs in the study of liver rejection.
Received: 2 July 1996 Accepted: 28 October 1996 相似文献
157.
At our center, since 1982, a body mass index (BMI) of less than 30 has been a prerequisite for placing a patient on the waiting
list for renal transplantation. This decision was made because obese transplant recipients seemed to have a less than favorable
post-transplant outcome. The aim of this study was to evaluate whether this requirement is still justified. Forty-six patients
with a BMI above 30 underwent primary cadaveric renal transplantation between 1972 and 1993. For each of these obese patients,
five consecutive non-obese (BMI 20–25) control patients were selected. Patient and graft survival, causes of graft loss, and
acute rejection rate were evaluated for the two patient groups before and after the year 1982. Within the first 30 post-transplant
days, one patient (2 %) and 11 grafts (24 %) were lost in the group of obese patients whereas seven patients (3 %) and 36
grafts (16 %) were lost in the control group. Among the obese patients, renal circulatory complications were a major cause
of graft loss. In the period 1973–1981, the 1-year patient survival rate was 65 % among obese patients versus 75 % among controls
from 1982 to 1993, this was 90 % versus 93 %. From 1973 to 1981, the 1-year graft survival rate was 25 % among obese patients
versus 53 % among controls (P < 0.05); from 1982 to 1993, it was 68 % versus 84 % (P = NS). Multivariate analysis showed that the immunosuppressive regimen,
age of the patient, BMI, and cold ischemia time of the graft had a significant influence on graft survival. The acute rejection
rate within the first 30 days was 28 % among obese patients and 35 % among controls (P = NS). We conclude that a BMI below
or equal to 30 is still justified as a prerequisite for placement on the waiting list for renal transplantation, for despite
an overall improvement, the outcome of renal transplantation in obese patients remains worse than that in non-obese patients.
Received: 3 February 1997 Received after revision: 4 April 1997 Accepted: 8 April 1997 相似文献
158.
C. H. Siebert K. -P. Lehrbaß-Sökeland F. Rinke M. Hansis 《Archives of orthopaedic and trauma surgery》1997,116(6-7):390-395
During the time period from May 1990 to December 1992, a total of 75 tibia fractures were treated in the Department of Traumatology at the University of Bonn. Thirtyeight patients with 40 tibial fractures were managed according to a regimen including primary stabilization, usually using external fixation, soft tissue reconstruction and delayed open reduction and internal fixation using an AO compression plate. The majority of the patients had been involved in motor vehicle accidents, leading to multiple injuries in 24 instances. An open fracture was seen 18 times. The 20% complication rate is comparable to the reports following intramedullary stabilization. Only one infection, following a grade 2 open fracture, was seen after the definitive stabilization. Bony union was achieved after 15.7 weeks. In light of the complications associated with intramedullary nailing, such as fat or air embolism, heterotopic ossification and non- or malunions, use of the tibial plate does not offer just logistic advantages, but is a viable alternative for delayed stabilization of tibial fractures.No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article. No funds were received in support of this study. 相似文献
159.
Effects of enteral feedback inhibition on motility,luminal flow,and absorption of nutrients in proximal gut of minipigs 总被引:2,自引:0,他引:2
Andreas Huge Eckhard Weber Prof. Dr. Hans-Jörg Ehrlein 《Digestive diseases and sciences》1995,40(5):1024-1034
We wanted to clarify whether the postprandial intestinal feedback control activated by nutrients in the distal gut exerts different effects on motility, transit of digesta, and absorption of nutrients in the proximal gut. Additionally, interrelationships among motility, transit, and absorption were to be elucidated because these relationships have only been investigated in the fasted state. In five minipigs, a 150-cm segment of the proximal jejunum was isolated by two cannulas. Motility of the jejunal segment was recorded by multiple strain gauges and analyzed by computerized methods. Markers (Cr- and Cu-EDTA) were used for the measurement of the flow rate, transit time, and absorption of nutrients. After a meal, the test segment was perfused with 2 kcal/min of an elemental diet over a period of 90 min. A feedback inhibition was activated by infusion of nutrients into the midgut at rates of 1–4 kcal/min. Saline was infused as control. With increasing energy loads infused into the midgut, the motility index and the length of contraction waves decreased, whereas the incidence of stationary contractions increased, ie, the motility changed from a propulsive to a segmenting pattern. These modulations of motility were associated with a linear decrease in the flow rate and a linear increase in transit time. Flow and transit were linearly correlated with each other. Additionally, the reduction in flow rate and the delay in luminal transit were associated with a linear increase in the absorption of nutrients. However, the increase in absorption induced by the feedback mechanism was small (7.3–13.4%) compared to the marked inhibition of the motility parameters (54–64%), the flow rate (59%), and the delay of transit (5.8-fold). Feedback control primarily modulated motor patterns and luminal flow, whereas the small increase in absorption was only a side effect due to the longer contact time of the nutrients with the mucosa.The study was supported by the Deutsche Forschungsgemeinschaft, grant Eh 64/6-3. 相似文献
160.
H. -J. Möller H. M. van Praag B. Aufdembrinke P. Bailey T. R. E. Barnes J. Beck H. Bentsen F. X. Eich L. Farrow W. W. Fleischhacker J. Gerlach K. Grafford B. Hentschel A. Hertkorn S. Heylen Y. Lecrubier J. P. Leonard P. McKenna W. Maier V. Pedersen A. Rappard W. Rein J. Ryan M. Sloth Nielsen R. -D. Stieglitz G. Wegener J. Wilson 《Psychopharmacology》1994,115(1-2):221-228
There is little agreement about the methodology of clinical trials of antipsychotic drugs in patients with negative symptoms. A literature review revealed wide variation in experimental design, rating scales and study duration. This reflects differing views as to the definition and response to treatment of negative symptoms. Some degree of standardization would improve comparability of studies and aid the development of new compounds. Patients included in such studies should have displayed negative symptoms for at least 6 months. Depressive symptoms, positive schizophrenic symptoms and extrapyramidal signs may all influence or be confused with negative symptoms and may respond to treatment; they should be at a low level at baseline and should be measured during the study period. Studies should last at least 8 weeks. Several scales are available for measuring negative symptoms and are reviewed; a global impression score should be used additionally. 相似文献