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91.
P. P. Fleming A. K. Chan M. G. O’Brien G. C. O’Sullivan M.Ch. FRCSI 《Irish journal of medical science》1997,166(1):13-15
Laparoscopic appendicectomy has been the subject of several encouraging reports, but has not as yet gained widespread acceptance. We present a series of 159 consecutive laparoscopic appendicectomies performed, over a 4 yr period, in both adults and children. We find the procedure as safe as its open counterpart, with patients fit to leave hospital within the same time period. Perforated appendices were amenable to this procedure, and the location of the appendix did not alter the outcome. Children responded as well as adults post-operatively. Obesity may be an indication for this form of treatment. Removal of displaced faecoliths associated with perforated appendicitis is a difficult technical problem in less than 5 per cent of patients. 相似文献
92.
Post-transplantation diabetes is better controlled after conversion from prednisone to deflazacort: a prospective trial in renal transplants 总被引:2,自引:0,他引:2
Yu Seun Kim Myoung Soo Kim Soon Il Kim Seung Kil Lim Ho Yung Lee Dae Suk Han Kiil Park 《Transplant international》1997,10(3):197-201
It is well known that long-term use of steroids plays a decisive role in the development of glucose intolerance and diabetes
mellitus (DM). Deflazacort, an oxazoline derivative of prednisolone, has been introduced as a potential substitute for conventional
steroids in order to ameliorate glucose intolerance. We initiated a randomized study of conversion from prednisone to deflazacort
in kidney transplantation (Tx) recipients presenting with pre-Tx or post-Tx DM to ascertain whether or not the switch to deflazacort
would ameliorate the diabetic state. Forty-two recipients in the conversion group were compared with 40 patients on prednisone
(the control group) in a prospective manner. The dose reduction of insulin or oral blood glucose-lowering agents, the adequacy
of glucose control, and the development of side effects were the criteria for evaluating outcome. In the conversion group,
patients were switched to deflazacort at a dose ratio of 6 mg deflazacort to 5 mg prednisone. During the mean follow-up period
of 13.2 months, neither graft dysfunction nor acute rejection developed in the conversion group. Improvement in blood glucose
control in the conversion group was noted. When the conversion group was stratified into pre- or post-Tx DM, promising effects
were clearly evident in the post-Tx DM patients. More than 50 % dose reduction of blood glucose-lowering agents was possible
in 42.3 % of post-Tx DM patients. In conclusion, it was readily possible to control blood glucose better in post-Tx DM recipients
without seriously affecting the immunosuppressive activity after conversion to deflazacort.
Received: 20 August 1996 Received after revision: 25 November 1996 Accepted: 6 December 1996 相似文献
93.
Dr. Adil Kabeer M.B.B.Ch. Sigurdur Gunnlaugsson M.D. Charles Coren M.D. 《Diseases of the colon and rectum》1995,38(8):866-872
PURPOSE: A retrospective, 12-year review of neonatal necrotizing enterocolitis was undertaken at a county hospital, with emphasis on presentation signs and symptoms. METHODS: Eighty-two patients with presence of intramural air were included in the study. The following signs and symptoms were studied: evidence of respiratory distress, use of umbilical catheters, white blood cell count and temperature at presentation, time interval from birth to diagnosis and time interval from diagnosis to operative intervention, presence of intramural air, air in biliary tree or free air, changes in abdominal girth, and presence of occult or gross blood in stools. Comparison was done among infants who had surgical or medical treatment, premature and full-term infants, and infants who had neonatal necrotizing enterocolitis less than or more than 20 days after birth. RESULTS: Eleven patients had a fatal outcome, with an overall survival of 87 percent. Sixty-four patients were treated medically and 18 had operative treatment. Mortality of the surgically treated group was 44 percent. Neonates who had surgical intervention had a left shift of the white blood cell count more commonly present, and all had documented abdominal distention. There were 62 premature and 20 full-term neonates in the group. Full-term neonates developed neonatal necrotizing enterocolitis earlier after birth (5.3 days compared with 15.3 days in the premature neonate group). Full-term neonates had a better prognosis in our series. Presentation of symptoms more than 20 days after birth did not change outcome. CONCLUSION: Our results reflect the experience of a community-based hospital. Clinical acumen remains the cornerstone of diagnosis and management. 相似文献
94.
Tumor recurrence in prostatic urethra following simultaneous resection of bladder tumor and prostate 总被引:4,自引:0,他引:4
A comparative retrospective study was performed on 100 patients who had undergone transurethral resection of a superficial bladder tumor (Ta-Tl) with no associated carcinoma in situ (group 1) and 100 patients who had undergone simultaneous transurethral resection of a superficial bladder tumor (Ta-Tl), with no associated carcinoma in situ, and benign prostatic hyperplasia (group II). Evaluation of the recurrences of prostatic urethral tumors in both groups showed that they appeared in 10 patients (12 recurrences) in group I and 10 patients (14 recurrences) in group II (p = not significant). These data enabled us to rule out the influence of simultaneous transurethral resection in cases of recurrences of prostatic urethral tumors. 相似文献
95.
G. Lallement Didier Clarençon Catherine Masqueliez Dominique Baubichon Monique Galonnier Marie-France Burckhart Michel Peoc’h Jean Claude Mestries 《Archives of toxicology》1997,72(2):84-92
Organophosphorus nerve agents are still in use today in warfare and as terrorism compounds. Classical emergency treatment
of organophosphate poisoning includes the combined administration of a cholinesterase reactivator (an oxime), a muscarinic
cholinergic receptor antagonist (atropine) and a benzodiazepine anticonvulsant (diazepam). However, recent experiments with
primates have demonstrated that such treatment, even when administered immediately after organophosphate exposure, does not
rapidly restore normal electroencephalographic (EEG) activity and fails to totally prevent neuronal brain damage. The objective
of this study was to evaluate, in a realistic setting, the therapeutic benefit of administration of GK-11 (gacyclidine), an
antiglutamatergic compound, as a complement to the available emergency therapy against organophosphate poisoning. GK-11 was
injected at a dose of 0.1 mg/kg (i.v) after a 45-min latency period to heavily intoxicated (8 LD50) primates. Just after intoxication, man-equivalent doses of one autoinjector containing atropine/pralidoxime/diazepam were
administered. The effects of GK-11 were examined on survival, EEG activity, signs of toxicity, recovery after challenge and
central nervous system histology. The present data demonstrate that treatment with GK-11 prevents the mortality observed after
early administration of classical emergency medication alone. EEG recordings and clinical observations also revealed that
GK-11 prevented soman-induced seizures and motor convulsions. EEG analysis within the classical frequency bands (beta, theta,
alpha, delta) demonstrated that central activity was totally restored to normal after GK-11 treatment, but remained profoundly
altered in animals receiving atropine/pralidoxime/diazepam alone. GK-11 also markedly accelerated clinical recovery of soman-challenged
primates. Lastly, this drug totally prevented the neuropathology observed 3 weeks after soman exposure in animals treated
with classical emergency treatment alone. GK-11 represents a promising adjuvant therapy to the currently available emergency
polymedication to ensure optimal management of organophosphate poisoning in man. This drug is presently being evaluated in
a human clinical trial for a different neuroprotective indication.
Received: 16 June 1997 / Accepted: 23 September 1997 相似文献
96.
Naloxone administration following operant training of sucrose/water discrimination in the rat 总被引:2,自引:0,他引:2
E. O’Hare J. Cleary D. T. Weldon C. J. Billington A. S. Levine P. J. Bartz 《Psychopharmacology》1997,129(3):289-294
The suppression of food intake observed following naloxone administration has often been ascribed to palatability or taste.
Unfortunately, many confounds become apparent when attempts are made to isolate such factors in the investigation of ingestive
behaviors. In the present study, rats (two groups) were trained to discriminate either a 10% or 5% sucrose solution from water
(0.1 ml). These mildly food deprived subjects (95% of free-feeding weight) were trained to press the appropriate lever in
a two-lever operant chamber following sampling of sucrose or water; successful responding was reinforced by delivery of a
45 mg grain food pellet. Following random exposure to reduced sucrose concentrations tested under extinction, a sucrose concentration
gradient (1.0, 0.5, 0.1, 0.05, 0.01 and 0.005% sucrose solution) was established for both training groups under IP saline
administration. Data collected under IP saline were then compared to those collected following random IP naloxone administration
(3.0, 1.0, 0.3 and 0.1 mg/kg). No significant differences were observed between the sucrose concentration gradients obtained
under saline and those obtained under naloxone, suggesting that the anorectic effect of naloxone is not primarily determined
by discrimination of sweet taste.
Received: 4 September 1996 / Final version: 16 October 1996 相似文献
97.
Modafinil is a new drug used in the treatment of narcolepsy. Its administration in mice induced a dose-dependent increase in locomotor activity. The effects of modafinil were compared with those of dexamphetamine on three tests that assessed the anxiety level (drugs were used at doses which induced a roughly similar stimulation of locomotor activity). Dexamphetamine increased the latency of exploration of a white compartment, increased thigmotaxis in an open-field and decreased the time spent in the open arms of an elevated plus-maze. None of these responses was significantly modified by modafinil. We conclude that modafinil does not share the anxiogenic effects of dexamphetamine. 相似文献
98.
J. O’Byrne S. Eustace M. M. Stephens M. N. M. R. Farahat G. Yanni R. Posten G. S. Panayi S. Sant R. Costello M. Barry J. Hassan C. Feighery B. Bresnihan A. Whelan F. Coakley A. M. de Paor R. B. Reilly E. B. Casey V. J. Tormey G. Kearns K. Gaffney P. J. Freyne M. Callaghan O. FitzGerald D. Veale E. O’Nuallain D. Reen D. Veale M. Farrell O. FitzGerald S. Rogers L. Barnes R. J. Coughlan C. McCarthy M. McDermott D. Hourihane C. O'Morain S. O'Reilly P. Hartley E. Casey L. Clancy F. Mulcahy N. Hall A. Murphy C. Breen D. Kelleher M. Abuzakouk C. O'Farrelly 《Irish journal of medical science》1992,161(6):438-442
99.
100.
Peter Van Gelder Sergey Lebedev Wai Hon Tsui 《Experimental brain research. Experimentelle Hirnforschung. Expérimentation cérébrale》1997,116(2):201-215
Smooth pursuit typically includes corrective catch-up saccades, but may also include such intrusive saccades away from the
target as anticipatory or large overshooting saccades. We sought to differentiate catch-up from anticipatory and overshooting
saccades by their peak velocities, to see whether the higher velocities of visually rather than nonvisually guided saccades
in saccadic tasks may be found also in saccades in pursuit. In experiment 1, 12 subjects showed catch-up, anticipatory, and
overshooting saccades to comprise 70.4% of all saccades in pursuit of periodic, 30°/s constant-velocity targets. Catch-up
saccades were faster than the others. Saccadic tasks were run as well, on 19 subjects, including the 12 whose pursuit data
were analyzed, with target-onset, target-remaining (saccade to the remaining target when the other three extinguish), and
antisaccade tasks. For 17 of the 19 subjects, antisaccade velocities were lower than for either target-onset or target-remaining
tasks. Velocities for the target-remaining task were near those for target onset, indicating that target presence, not its
onset, defines visually guided saccades. Error and reaction-time data suggest greater cognitive difficulty for target remaining
than for target onset, so that the cognitive difficulty of typical nonvisually guided saccade tasks is not sufficient to produce
their lowered velocity. To produce reliably, in each subject, catch-up and anticipatory saccades with comparable amplitude
distributions, nine new subjects were asked in experiment 2 to make intentional catch-up and anticipatory saccades in pursuit,
and were presented with embedded target jumps to elicit catch-up saccades, all with periodic target trajectories of 15°/s
and 30°/s. Velocities of intentional anticipatory saccades were lower than velocities of intentional catch-up saccades, while
velocities of intentional and embedded catch-up saccades were similar. Target-onset and remembered-target saccadic tasks were
run, showing the expected higher velocity for the target-onset task in each subject. Both experiments demonstrate higher peak
velocities for catch-up saccades than for anticipatory saccades, suggesting that cortical structures preferentially involved
in nonvisually guided saccades may initiate the anticipatory and overshooting saccades in pursuit.
Received: 1 December 1995 / Accepted: 25 February 1997 相似文献