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441.
The outcome of ankylosing spondylitis: a study of 100 patients 总被引:18,自引:4,他引:14
The outcome was studied in 100 patients with adult-onset primary ankylosing
spondylitis (AS). After a mean disease duration of 16 yr, 51.5% of the
patients were employed in full-time work. Cessation of work occurred at a
mean disease duration of 15.6 yr, and was significantly associated with
female sex, low levels of education, acute anterior uveitis, 'bamboo spine'
and the co-existence of non- rheumatic diseases. Functional outcome was
studied by analysing activities of daily living, and revealed similar
findings in males and females. Most of the loss of function occurred during
the first 10 yr of disease, and correlated significantly with the
occurrence of peripheral arthritis, spinal X-ray changes of AS and
development of 'bamboo spine'. After > 20 yr of disease, > 80% of the
patients still complained of daily pain and stiffness, and > 60%
reported daily use of drugs.
相似文献
442.
Magnetic resonance (MR) imaging of the breast is currently of limited value because of lack of specificity. Enhanced MR imaging with gadolinium diethylenetriaminepentaacetic acid (DTPA) has been shown to be helpful in the further characterization of breast tissue. This prospective study attempted to differentiate benign and malignant breast disease with a dynamic enhancement technique. Bolus injection of Gd-DTPA and a short MR imaging time were used to examine 18 patients with a palpable breast mass. Construction of enhancement profiles helped effectively differentiate benign and malignant lesion (P less than .001). Dynamic MR imaging shows promise for the further characterization of breast tissue and, particularly, identification of breast carcinoma. 相似文献
443.
Sphincter preservation in patients with low rectal cancer treated with radiation therapy with or without local excision or fulguration 总被引:8,自引:0,他引:8
Twenty-six patients with small cancers limited to the lower two-thirds of the rectum were treated with conservative surgery and radiation therapy (XRT). The selection factors for this approach were age, refusal of a permanent colostomy, or the high risk of local recurrence because of inadequate surgical margin or palpable residual tumor after local surgical treatment alone. In patients treated with local excision or fulguration followed by XRT, there was a 6% local failure rate (one in 17); in 16 of 17 patients receiving radiation doses above 4,500 cGy, the local control was complete for follow-up periods of 6 months to 7 years. In nine patients treated with XRT for residual tumor, local failure occurred in five (56%). The disease-free survival for those without residual tumor versus those with residual tumor was 88% and 44%, with median follow-up periods of 20 and 23 months, respectively. Serious late complications occurred only if total doses were greater than 6,300 cGy. Local excision combined with XRT proved to be a safe alternative to radical surgery in selected patients and resulted in excellent local control while allowing preservation of anal sphincter function. 相似文献
444.
Loflin TG; Simeone JF; Mueller PR; Saini S; Stark DD; Butch RJ; Brady TJ; Ferrucci JT Jr 《Radiology》1985,157(2):457-459
Fifty-three samples of gallbladder bile were obtained at the time of cholecystectomy from patients with the clinical diagnosis of acute or chronic cholecystitis. Five bile samples from patients with clinically normal gallbladders also were obtained. Proton magnetic resonance (MR) relaxation times, protein content, and water content were determined for the bile samples, and the data were grouped according to pathologic diagnosis, which disclosed 11 cases of acute cholecystitis, 41 cases of chronic cholecystitis, and six normal gallbladders. There was no significant difference in the mean T1 and T2 values between the groups with acute and chronic cholecystitis. Patients with chronic cholecystitis were found to have more concentrated bile than those with acute cholecystitis. Protein content varied widely within both groups of patients. We conclude that T1 and T2 relaxation times do not reliably differentiate acute from chronic cholecystitis. 相似文献
445.
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448.
Mueller PR; Ferrucci JT Jr; Simeone JF; Butch RJ; Wittenberg J; White M; Brown AS 《Radiology》1985,155(3):615-618
Twelve abscesses and fluid collections in the lesser peritoneal sac were drained percutaneously using an access route across the intervening liver. This rather unusual access was chosen when other approaches were contraindicated because of surrounding colon, stomach, or spleen. All collections were drained successfully, and no specific complications such as hemorrhage, bile leak, or liver abscess occurred. Placement of an abscess drainage catheter should be done through the peripheral portion of the liver if possible. The technique offers a new, safe approach to percutaneous drainage of hitherto inaccessible collections. 相似文献
449.
Clegg CH; Rulffes JT; Haugen HS; Hoggatt IH; Aruffo A; Durham SK; Farr AG; Hollenbaugh D 《International immunology》1997,9(8):1111-1122
Expression of gp39 on activated T cells provides a co-stimulatory signal in
peripheral lymphoid tissue that regulates humoral and cell- mediated
immunity. The function of gp39 and its receptor CD40 in thymus remains
uncertain. Here we report that overexpression of gp39 in transgenic mouse
thymus caused a dose-dependent decline in thymocyte numbers (> 500
fold), loss of cortical epithelium and expansion of CD40+ medullary cells.
Transplantation of transgenic bone marrow into normal mice indicated that
gp39 significantly diminished thymocyte viability in the context of a
'normal' thymic environment. The peripheral tissues of transgenic mice also
accumulated abnormalities in a transgene dose-dependent manner that
involved inflammation and lymphoid tissue hypertrophy. Animals with the
highest transgene copy numbers acquired a lethal inflammatory bowel disease
marked by the infiltration of gp39+ T cells and CD40+ cells into diseased
tissues. Examination of cells overexpressing gp39 suggested that these
defects were caused, in part, by the saturation of a mechanism that
sequesters gp39 inside non-activated cells and thus protects the immune
system from inappropriate gp39-CD40 interaction. These results establish a
regulatory role for gp39 in thymus function and a causal relationship in
mediating chronic inflammatory disease.
相似文献
450.
Yang PJ; Knake JE; Gabrielsen TO; Latack JT; Gebarski SS; Mehta BA; Metes JJ 《Radiology》1985,154(3):683-686
The authors examined 19 patients with diffuse histiocytic lymphoma of the brain, including 8 with primary disease and 11 with secondary disease. Both primary disease and secondary disease involving the brainstem and deep nuclei exhibited the characteristic CT appearance, consisting of a large, solid, homogeneously enhanced mass with varying amounts of edema. However, most secondary lymphomas outside the brainstem and basal ganglia contained large areas of low attenuation consistent with necrosis. Multifocal lesions were seen only in patients with secondary lymphoma. Systemic chemotherapy for extracranial lymphoma had no effect on the CT appearance of intracranial lesions. The authors suggest that these "unusual" CT patterns are actually typical of a distinct subset of histiocytic lymphomas. 相似文献