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51.
S. Sidhu L. Edwards S. Rainer T. O'Connor 《The Australian & New Zealand journal of obstetrics & gynaecology》1998,38(1):125-127
EDITORIAL COMMENT: We accepted this case report for publication because, apart from being interesting, it raises the question of the appropriate hormone replacement therapy after bilateral oophorectomy (usually with hysterectomy) has been performed when there is evidence of endometriosis. Menopausal symptoms in these women can be relieved by oestrogen therapy without return of pelvic pain or dyspareunia. The authors report a case of endometrial-like carcinoma in a woman with known endometriosis after a hysterectomy and prolonged unopposed oestrogen therapy. Although this is a solitary case report, the authors explain that there are 8 others in the literature where malignancy occurred in extraovarian endometriosis after bilateral oophorectomy associated with unopposed oestrogen. One of our reviewers commented that a combination of oestrogen and progestogen should always be considered when prescribing hormone replacement therapy in women with a known history of endometriosis, following total hysterectomy and bilateral oophorectomy. 相似文献
52.
K Schunk C D Gerharz F X Schmid H Schild 《R?ntgen-Bl?tter; Zeitschrift für R?ntgen-Technik und medizinisch-wissenschaftliche Photographie》1987,40(11):373-375
After presenting an own case of a cavernous hemangioma of the mediastinum, the clinical pattern, differential diagnosis, diagnostic procedure (computed tomography), and therapy of this rare tumor form are described. 相似文献
53.
Bacterial cultures were selected from the native flora of liquid manure in order to metabolize liquid manure substances. The mixed culture used in the growth experiments is characterized by low growth rates when maximum degradation of acetate occurs. The biomass concentration reached 2.2 g/l. 相似文献
54.
Spatial Learning Deficits in Mice with a Targeted Glucocorticoid Receptor Gene Disruption 总被引:5,自引:0,他引:5
Melly S. Oitzl E. Ron de Kloet Marian Joëls Wolfgang Schmid Timothy J. Cole 《The European journal of neuroscience》1997,9(11):2284-2296
Previous studies in rats using the Morris water maze suggested that the processing of spatial information is modulated by corticosteroid hormones through mineralocorticoid and glucocorticoid receptors in the hippocampus. Mineralocorticoid receptors appear to be involved in the modulation of explorative behaviour, while additional activation of glucocorticoid receptors facilitates the storage of information. In the present study we used the water maze task to examine spatial learning and memory in mice homozygous and heterozygous for a targeted disruption of the glucocorticoid receptor gene. Compared with wild-type controls, homozygous and heterozygous mice were impaired in the processing of spatial but not visual information. Homozygous mutants performed variably during training, without specific platform-directed search strategies. The spatial learning disability was partly compensated for by increased motor activity. The deficits were indicative of a dysfunction of glucocorticoid receptors as well as of mineralocorticoid receptors. Although the heterozygous mice performed similarly to wild-type mice with respect to latency to find the platform, their strategy was more similar to that of the homozygous mice. Glucocorticoid receptor-related long-term spatial memory was impaired. The increased behavioural reactivity of the heterozygous mice in the open field points to a more prominent mineralocorticoid receptor-mediated function. The findings indicate that (i) the glucocorticoid receptor is of critical importance for the control of spatial behavioural functions, and (ii) mineralocorticoid receptor-mediated effects on this behaviour require interaction with functional glucocorticoid receptors. Until the development of site-specific, inducible glucocorticoid receptor mutants, glucocorticoid receptor-knockout mice present the only animal model for the study of corticosteroid-mediated effects in the complete absence of a functional receptor. 相似文献
55.
56.
Ambuhl P; Wuthrich R; Korte W; Schmid L; Krapf R 《Nephrology, dialysis, transplantation》1997,12(11):2355-2364
Background: Thrombotic complications are common in
patients with endstage renal disease and contribute substantially to the
morbidity and mortality in this population. The aim of the present study
was to: I) determine the prevalence and the extent of hypercoagulability in
patients undergoing dialysis treatment by measuring parameters that
directly reflect thrombin concentrations, ii) assess changes in coagulation
status during haemodialysis (HD); iii) quantify the relative impact of
heparin, dialysis and their combined effects on coagulation status and iv)
detect factors that modify coagulation haemostasis in dialysis patients.
Method: A total of 39 patients (HD: n=29, CAPD: n=10)
was analysed for procoagulatory and fibrinolytic activity determined by
measurements of partial thromboplastin time, prothrombin fragments F1+2,
thrombin-antithrombin complexes and D-dimer concentrations. HD patients
were investigated prior to and during dialysis. A subgroup of patients was
infused heparin alone without dialysis or was dialysed without heparin
administration. Furthermore, subgroup and correlation analyses were
performed for the type of dialysis (HD vs CAPD), dialyzer and shunt, Kt/V,
underlying disease and treatment with recombinant erythropoietin (rhEPO).
Results: Baseline levels of all
parameters-procoagulatory and fibrinolytic- were substantially elevated in
all patients, but to a higher degree among those on CAPD. Moreover,
haemodialysis treatment increased procoagulatory markers even further,
suggesting stimulated coagulation and/or insufficient anticoagulation
during dialysis. However, after 3 h of dialysis thrombin concentrations,
determined by quantification of prothrombin fragments, were inversely
correlated with Kt/V. Selective heparin infusion diminished procoagulatory
activity only slightly and incompletely, whereas HD without heparin
resulted in excess thrombin accumulation. Finally, subgroup analyses
revealed more pronounced thrombin formation among patients treated with
polysulfon dialyzers, whereas erythropoietin dosage was positively related
with lower procoagulatory activity. Conclusion: A
majority of patients on dialysis are in a hypercoagulable state, which is
further aggravated by the haemodialysis procedure itself and may not be
sufficiently controlled with current anticoagulation regimens. Intensified
heparin treatment and the use of rhEPO are likely to improve coagulation
haemostasis, whereas the type of dialyzer should be considered as a
relevant procoagulatory factor. 相似文献
57.
58.
59.
Jan Stulik Tobias Rainer Pitzen Jan Chrobok Sabine Ruffing Jörg Drumm Laurentius Sova Ravel Kucera Tomas Vyskocil Wolf Ingo Steudel 《European spine journal》2007,16(10):1689-1694
Anterior cervical plate fixation is an approved surgical technique for cervical spine stabilization in the presence of anterior
cervical instability. Rigid plate design with screws rigidly locked to the plate is widely used and is thought to provide
a better fixation for the treated spinal segment than a dynamic design in which the screws may slide when the graft is settling.
Recent biomechanical studies showed that dynamic anterior plates provide a better graft loading possibly leading to accelerated
spinal fusion with a lower incidence of implant complications. This, however, was investigated in vitro and does not necessarily
mean to be the case in vivo, as well. Thus, the two major aspects of this study were to compare the speed of bone fusion and
the rate of implant complications using either rigid- or dynamic plates. The study design is prospective, randomized, controlled,
and multi-centric, having been approved by respective ethic committees of all participating sites. One hundred and thirty-two
patients were included in this study and randomly assigned to one of the two groups, both undergoing routine level-1- or level-2
anterior cervical discectomy with autograft fusion receiving either a dynamic plate with screws being locked in ap - position
(ABC, Aesculap, Germany), or a rigid plate (CSLP, Synthes, Switzerland). Segmental mobility and implant complications were
compared after 3- and 6 months, respectively. All measurements were performed by an independent radiologist. Mobility results
after 6 months were available for 77 patients (43 ABC/34 CSLP). Mean segmental mobility for the ABC group was 1.7 mm at the
time of discharge, 1.4 mm after 3 months, and 0.8 mm after 6 months. For the CSLP- group the measurements were 1.0, 1.8, and
1.7 mm, respectively. The differences of mean segmental mobility were statistically significant between both groups after
6 months (P = 0.02). Four patients of the CSLP-group demonstrated surgical hardware complications, whereas no implant complications were
observed within the ABC-group (P = 0.0375). Dynamic plate designs provided a faster fusion of the cervical spine compared with rigid plate designs after prior
spinal surgery. Moreover, the rate of implant complications was lower within the group of patients receiving a dynamic plate.
These interim results refer to a follow-up period of 6 months after prior spinal surgery. Further investigations will be performed
2 years postoperatively. 相似文献
60.
In this morphometric study, terminal villi of 22 placentas of maternal diabetes mellitus were compared with the results in terminal villi of 22 normal placentas. The results demonstrate that there is a distinct retardation in maturation, statistically significant with bigger cross sectional surfaces of the terminal villi, particularly, when classified in 3000 mu2-steps, the number of the villous vessels and number of epithelial plates. Only slightly decreased in diabetic placentas is the villous vessels cross sectional surface as well as the degree of vascularization. The correlation between the degree of histometric changes and the severity and duration of the disease was separately investigated (classification was done according to White). It could be shown, that the degree of morphologic changes in the terminal villi does not run strictly parallel to the severity and duration of diabetes. The retardation in maturation of the terminal villi increases from White group A to C. In White group D, which is the most severe stage of diabetes mellitus which we investigated, the values of measured parameters are close to the normal placentas. This observation is interpreted as a compensatory reaction of the fetal organ placenta to the reduction in utero placental blood flow in diabetes caused by the diabetic angiopathy. 相似文献