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51.
人皮质骨矿化基质中骨盐框架结构 总被引:2,自引:0,他引:2
目的:研究人皮质骨矿化基质中骨盐的框架结构及框架中骨微间隙。方法:应用透射电镜、场发射扫描电镜观察、电脑图像分析及能谱分析,分析无骨病成人长骨、扁骨200例骨盐分布特征。结果:骨盐框架结构由微柱、微梁、微小梁、弓状梁、致密点、隔板和骨微间隙构成。骨微间隙由洞、内衬和壁组成,洞平均直径为84.4±75.6nm,与骨小管相比有显著差异(P值<0.001),平均密度为11~17个/μm2,与骨小管之比超过10:1。骨盐分针形结晶和微颗粒结晶。结论:骨盐框架结构及骨微间隙是骨盐在人皮质骨矿化基质中的存在形式,可能与骨盐吸收、沉着有关。 相似文献
52.
P D Clouston C B Saper T Arbizu I Johnston B Lang J Newsom-Davis J B Posner 《Neurology》1992,42(10):1944-1950
We studied nine patients with a subacute onset of a pancerebellar syndrome. Six had known cancer (three small-cell carcinoma of the lung [SCLC], one metastatic small-cell carcinoma, one small-cell carcinoma of the prostate, and one non-Hodgkin's lymphoma). Six of eight who had neurophysiologic testing, including the three patients without detectable cancer, had coexistent Lambert-Eaton myasthenic syndrome (LEMS). In two of the patients, LEMS was discovered only by neurophysiologic testing. We looked for anti-Purkinje cell autoantibodies in all patient's sera and in four patients' CSF. We also looked for autoantibodies to voltage-gated calcium channels (VGCCs) in seven patients' sera and two patients' CSF, using the 125I-omega-conotoxin radioimmunoassay. We were unable to detect anti-Purkinje cell autoantibodies in any patients' serum or CSF. However, there were raised titers of anti-VGCC autoantibodies in five of seven patients' serum, including one patient with SCLC who did not have LEMS, and in the CSF of one of two patients. We conclude that the frequency of presentation of a pancerebellar syndrome with LEMS is higher than expected by chance and is usually associated with cancer. In some of these patients, LEMS may be clinically occult. The presence of LEMS and raised titers of anti-VGCC autoantibodies in some patients with subacute cerebellar degeneration is suggestive of an autoimmune etiology even though anti-Purkinje cell antibodies could not be detected. Anti-VGCC autoantibodies are not confined to LEMS. They may be found at high titer in CSF as well as serum. 相似文献
53.
Zusammenfassung. Die Auswirkungen einer Immunsuppression auf perioperative pathophysiologische Vorg?nge stellen besondere Anforderungen sowohl
in bezug auf die Indikationsstellung zu einem operativen Eingriff als auch an das perioperative Management. Eine immunsuppressive
Therapie kann ein ver?ndertes oder v?llig fehlendes Abwehrverhalten bei entzündlichen Prozessen bewirken, so da? die hierfür
typischen klinischen Anzeichen nur schwach oder gar nicht ausgepr?gt werden. Dies kann zu einer gef?hrlichen Latenz in der
Diagnostik akut lebensbedrohlicher Erkrankungen bei immunsupprimierten Patienten führen. Darüber hinaus tragen die ver?nderte
Reaktivit?t des Patienten auf Stre?, eine verz?gerte und verminderte Wundheilung sowie insbesondere die erh?hte Infektanf?lligkeit
zu einem gesteigerten Operationsrisiko bei. Perioperativ sind daher eine konsequente klinische überwachung des Patienten und
ein lückenloses Monitoring der Immunsuppression unverzichtbar. Für den klinischen Umgang mit immunsupprimierten Patienten
ergeben sich hieraus 2 unterschiedliche Pr?missen hinsichtlich der Indikationsstellung bei Elektiv- und Notfalleingriffen.
W?hrend unter Elektivbedingungen eine sorgf?ltige Operationsplanung unter besonderer Berücksichtigung der m?glichen Risiken
für Patient und Transplantat unabdingbar ist, so lassen die oftmals gro?en diagnostischen Unsicherheiten bei entzündlichen
Vorg?ngen sowie die erheblichen Risiken eines verz?gerten Therapiebeginns eine eher etwas gro?zügigere Indikationsstellung
zur operativen Intervention in Zweifelsf?llen berechtigt erscheinen. Operativ technisch ist generell auf ein gewebeschonendes
und atraumatisches Vorgehen zu achten, weiterhin sollte eine besondere Sorgfalt bei Anastomosenn?hten und Wundverschlu? bestehen.
Darüber hinaus sind von Seiten des Chirurgen die Einflu?m?glichkeiten auf den postoperativen Verlauf begrenzt.
相似文献
54.
55.
D. P. Southall M.D. M.R.C.P. V. A. Stebbens B.Sc. Research Assistant R. Mirza B.Sc. Research Assistant M. H. Lang B.Sc. Research Assistant C. B. Croft M.B. Ch.B. F.R.C.S E. A. Shinebourne M.D. F.R.C.P 《Developmental medicine and child neurology》1987,29(6):734-742
Six of 12 children with Down syndrome (DS) tested by means of long-term tape-recordings of oxygen saturation, breathing movements and expired CO2 were found to have previously undetected and severe upper airway obstruction during sleep. In five cases the obstruction occurred in the pharynx and in the sixth it was due to bilateral choanal stenosis. When compared with age-matched controls, overnight tape-recordings showed episodes of abnormal arterial hypoxaemia and an abnormally elevated end-tidal CO2. Episodes of obstruction were most marked during sleep associated with a non-regular breathing pattern. Abnormal episodes of hypoxaemia were associated with continued breathing movements. Sometimes there was no airflow (complete obstruction); at other times airflow continued normally or was reduced in amplitude (partial obstruction). During episodes of partial or complete airway obstruction the inspiratory waveform showed a characteristic shape. These results show sleep-related upper airway obstruction to be an often undetected complication of DS and all necessary measures should be taken to overcome the obstruction when it reaches the stage of producing abnormal hypoxaemia. Choanal dilatation and tracheostomy were successful in treating two of the children. Tonsillectomy and adenoidectomy were successful for one child, but only of marginal benefit for two others. 相似文献
56.
Antonietta C. Rouget MD Reuben A. Lang PhD Michel R. Joffres MD 《Sexual abuse : a journal of research and treatment》1988,1(1):95-114
The prevalence of abnormal physical signs (e.g., bleeding, scars, or bruises) and genital infections, notably Chlamydia Trachomatis, Neisseria Gonorrhea, and Herpes Simplex Genitalis was studied in 219 female children with validated sexual abuse. They were compared to 113 nonabused female children. The average abused child was 8.3 years old, with 69% having been abused on multiple occasions. Most offenders were family members (65%) or a close family friend (22%). Stranger-perpetrated sexual assault, in the sample, was low (9.1%). Few children had severe vaginal tears, though 56% showed signs of subtle anatomical injury to their genitalia. No similar anatomical abnormalities were present in nonabused children. Among the sexually abused children and adolescents, 35% were colonized with a pathogen or a potential pathogen, compared to a prevalence rate of 18.5% in non-abused children. The proportion of abused children colonized with Ureaplasma Urealyticum and Mycoplasma Hominis was not significantly different from that found in nonabused children. At present, Neisseria gonorrhea and Chlamydia Trachomatis remain the only conclusive markers for sexual abuse. It is recommended that routine cultures of the pharyngeal, rectal, and vaginal areas be taken in all cases of suspected child sexual abuse, regardless of clinical findings. 相似文献
57.
急性心肌梗塞早期静脉溶栓治疗后,一些溶栓再通患者中,可见早期降低的ST段再度出现抬高现象。本文回顾溶栓成功者81例,其中早期出现ST段再度抬高者21例(占35%),与ST段非再度抬高者相比,CPK、CPK-MB峰值,心功能及院内死亡率等无显著差异。笔者认为,此现象也为再通的标志之一。因此,急性心肌梗塞溶栓治疗的早期连续监测心电图对确认再通与否非常重要 相似文献
58.
目的探讨血压正常老年患者和老年高血压患者24h动态血压波动规律及与靶器官损害的关系.方法采用无创伤袖带式动态血压监测仪检测36例中年人(对照组),50例血压正常老年患者,60例老年高血压患者的动态血压.结果血压正常老年患者较中年血压正常者24h动态血压呈杓型曲线的比例明显下降.血压正常老年患者,血压昼夜波动曲线与心、脑、肾损害无相关性.老年高血压患者,血压曲线呈非杓型者比例增高,血压昼夜节律消失较节律正常的高血压患者有更显著的靶器官损害.结论对于非高血压患者,随年龄的增加,血压昼夜节律消失者增多,血压曲线变化与心、脑、肾损害无关,可能与原发病有关.对于高血压患者,血压昼夜节律紊乱可作为靶器官损害的预测因子. 相似文献
59.
E Lang 《Zeitschrift für Gerontologie》1988,21(6):352-358
The potential of rehabilitation for geriatric patients depends on physiological considerations about the aging organism, as well as diseases, accompanied by the natural aging process. A common feature of the aging process of human organs is a general loss of adaptability that contributes to hypocirculation. The potential for rehabilitation may be considerably limited by diseases which burden the circulatory system (atherosclerosis, coronary heart disease, hypertension, and hypotension). Cardiac arrhythmias occurring during rehabilitation procedures call for special care. Mode and intensity of the rehabilitation program will be determined by cardiac and circulatory reactions following active rehabilitation procedures. Isometric exercise stress in conjunction with pressure breathing leads to an excessive rise of blood pressure in systemic and pulmonary circulation. Therefore dynamic muscle actions should be preferred as the most reasonable active training, but there is the possibility of heart-circulation problems arising, depending on the intensity of training. 相似文献
60.
Self-report questionnaires completed by young adults with Type I diabetes were examined to determine if individuals differing in recent metabolic control (Poor, Moderate or Very Good) or disease duration (Long, Short) also vary in either occurrence or type of life events during the past year or occurrence of recent emotional distress. Subjects in Poor control reported more positive and neutral life events during the past year, suggesting even those life changes individuals view benignly may be associated with metabolic control difficulties. Individuals in Poor control also reported more recent symptoms of depression, anxiety and hostility than did individuals in Moderate or Very Good control--symptomatology which may further impair their ability to adhere to a complex self-care regimen. Individuals with Long disease duration reported more positive and negative recent life experiences than did subjects with Short disease duration, but did not evidence concomitant disruptions in metabolic control. The role experience with a chronic disease may play in this finding was unclear, however. Although more research is required to clarify the exact relation of psychosocial variables and diabetic control, these findings suggest that clinically relevant subgroup parameters, subjects' perceptions of life change, and demographic variables may be important factors to assess. 相似文献