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101.
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J. Thomas Pierce 《Journal of occupational and environmental hygiene》2016,13(9):D156-D157
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106.
S. Y. Lee C. Y. Gary Kang S. C. Albert Low K. H. Pierce Chow 《Clinical journal of gastroenterology》2012,5(1):53-58
Tuberculosis (TB) of the hepatobiliary system is not uncommon, but as a cause of biliary strictures, it is very rare. It poses
difficulty in diagnosis and often requires surgical intervention to exclude underlying malignancy. To our knowledge, there
are fewer than 20 reported cases in the English literature. We report a 35-year-old Filipino woman who presented with a 3-day
history of obstructive jaundice, associated with significant weight loss and anorexia. Computed tomography (CT) revealed dilated
intrahepatic biliary system secondary to distal stricture at the confluence of the left and right bile ducts. Magnetic resonance
cholangiopancreatography characterised the lesion as an irregular stricturing at several sites in the common bile duct. Incidentally,
the scans also showed indeterminate pulmonary nodules in the right lower lobes. CT thorax confirmed bilateral involvement
of the lungs. She required percutaneous transhepatic drainage for biliary decompression. Tests on tissue from the lung lesions,
the blood, and the bile all confirmed the presence of TB. She was treated with anti-TB medication. This report emphasizes
the importance of considering TB as a possibile cause of biliary stricture, especially in South-East Asia. 相似文献
107.
Purpose: To review literature specific to the use of AAC with adults who have severe aphasia. Method: The authors reviewed studies involving AAC interventions for adults with severe aphasia. Results: Published data support the use of aided and unaided AAC with adults with severe aphasia in controlled treatment contexts. Reported gains in communication typically have not generalized to everyday settings. Conclusions: The application of AAC with persons with severe aphasia must address factors potentially limiting treatment success outside of training environments. 相似文献
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Variation in modern crocodilian and extinct thalattosuchian crocodylomorph skull morphology is only weakly correlated with phylogeny, implying that factors other than evolutionary proximity play important roles in determining crocodile skull shape. To further explore factors potentially influencing morphological differentiation within the Thalattosuchia, we examine teleosaurid and metriorhynchid skull shape variation within a mechanical and dietary context using a combination of finite element modelling and multivariate statistics. Patterns of stress distribution through the skull were found to be very similar in teleosaurid and metriorhynchid species, with stress peaking at the posterior constriction of the snout and around the enlarged supratemporal fenestrae. However, the magnitudes of stresses differ, with metriorhynchids having generally stronger skulls. As with modern crocodilians, a strong linear relationship between skull length and skull strength exists, with short‐snouted morphotypes experiencing less stress through the skull than long‐snouted morphotypes under equivalent loads. Selection on snout shape related to dietary preference was found to work in orthogonal directions in the two families: diet is associated with snout length in teleosaurids and with snout width in metriorhynchids, suggesting that teleosaurid skulls were adapted for speed of attack and metriorhynchid skulls for force production. Evidence also indicates that morphological and functional differentiation of the skull occurred as a result of dietary preference, allowing closely related sympatric species to exploit a limited environment. Comparisons of the mechanical performance of the thalattosuchian skull with extant crocodilians show that teleosaurids and long‐snouted metriorhynchids exhibit stress magnitudes similar to or greater than those of long‐snouted modern forms, whereas short‐snouted metriorhynchids display stress magnitudes converging on those found in short‐snouted modern species. As a result, teleosaurids and long‐snouted metriorhynchids were probably restricted to lateral attacks of the head and neck, but short‐snouted metriorhynchids may have been able to employ the grasp and shake and/or ‘death roll’ feeding and foraging behaviours. 相似文献
110.
The epidemiology of hyperuricaemia and gout in Taiwan aborigines 总被引:4,自引:1,他引:4
To determine the prevalence of hyperuricaemia, gout and gout-related
factors in Central Taiwan Atayal aborigines, 342 subjects over 18 yr old
were interviewed and examined. A questionnaire was designed to screen for
signs and symptoms of gout and gout-related risk factors. Serum uric acid,
triglyceride and creatinine were measured in all subjects. The prevalence
of hyperuricaemia was 41.4% and that of gout 11.7% in aborigines. The uric
acid level was 7.9+/-1.7 mg/dl in males and 5.7+/-1.5 in females, and
differed significantly under age 70 yr (P < 0.001). Significantly
increased triglyceride, creatinine and alcoholism was found in gouty
patients compared with non-gouty patients. In 40 cases with gout, 54% had
tophi and 35% of their first- degree relatives had gout. The high
prevalence of hyperuricaemia and gout in Taiwan Atayal aborigines, a
significant family predisposition, increased creatinine level and
alcoholism suggest multiple factors affecting the hyperuricaemia.
相似文献