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81.
82.
Tetralogy of Fallot and absent pulmonary valve (T-APV) is associated with massively dilated pulmonary arteries that cause tracheobronchial compression in the newborn and heart failure and cyanosis in older patients. Corrective operations have been attended by high mortality rates due to pulmonary insufficiency causing right heart failure (RHF) and pulmonary complications. Pulmonic valve insertion (PVI) with complete repair has resulted in improved survival. During the last 5 years, 152 patients with tetralogy were corrected. Of these, 10 patients (ages 51 days to 34 years) had absent pulmonary valve. One patient (age 51 days) presented with severe RHF and pulmonary insufficiency and 9 patients presented with mild RHF and cyanosis. Chest roentgenograms showed increased cardiothoracic ratio and pulmonary prominence in all. Arteriography revealed massively enlarged pulmonary arteries with a mean ratio of 2:1 for size of pulmonary artery to aorta. Associated pulmonic stenosis and insufficiency was present in all. Seven patients underwent closure of ventricular septal defect (VSD) and PVI. Of these, 3 had PVI (2 tissue and 1 prosthetic) with outflow patch and 4 had right ventricle to pulmonary artery (RV-PA) tissue valved conduits. Two patients had repair without PVI, and 1 had repair with a monocusp pericardial valve patch. Nine patients have done well with no episodes of thromboembolism or infection. Death occurred in a 51-day-old infant who had VSD closure and relief of pulmonic stenosis. Pulmonary valve insertion seems to be indicated in these patients because it lowers peak pulmonary artery pressure and, thus, reduces compression effects on the trachea and bronchi. When PVI was used, RHF did not occur post-operatively. 相似文献
83.
Three cases of combined pregnancy are described after gonadotropin therapy; two cases after human pituitary gonadotropin and one after human menopausal gonadotropin administration. In each case the intrauterine gestation was a multiple pregnancy. After salpingectomy, two of the women have proceeded to the delivery of healthy infants; the third woman aborted. In each case the gonadotropin stimulation regimen was ceased at the appropriate stage when the estriol excretion was between 60 and 125 micrograms/day, but the subsequent rate of rise of estriol was 2.3- to 3.2-fold during the coasting phase before the human chorionic gonadotropin trigger when the estriol excretion rate was 140 to 350 micrograms/day. 相似文献
84.
S H McConaughy C Stanger T M Achenbach 《Journal of the American Academy of Child and Adolescent Psychiatry》1992,31(5):932-940
Quantitative and categorical indices of psychopathology are reported for a nationally representative longitudinal sample assessed via eight empirically derived cross-informants syndromes, internalizing, externalizing, and total problems. Results showed medium to large stabilities for parents' ratings during a 3-year interval on all comparable scales. Predictive correlations between time 1 parents' ratings and time 2 teacher and self-ratings were weaker than parent-to-parent correlations. Classification of children as deviant showed weaker predictive relations than did quantitative scores. Odds ratios showed that children classified as deviant by parents' time 1 ratings were much more likely to be deviant at time 2 on corresponding parent, teacher, and self-ratings than were children initially classified as nondeviant. 相似文献
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目的:观察中药健骨二仙丸对体外培养人工关节假体周围界膜白细胞介素6表达的抑制作用,为健骨二仙丸防治人工关节假体周围骨溶解提供科学依据。方法:实验于2006-09/12在深圳市中医院中心实验室(国家级P2实验室)完成。①体外界膜组织培养:将备用的人工关节假体周围界膜(20g,取自右股骨颈骨折人工关节置换术后11年出现假体无菌性松动来深圳市中医院行翻修术患者,女性,74岁,对实验知情同意并经医院伦理委员会批准)放入Hank’s液中清洗后置于RPMI培养液中,然后将界膜标本用眼科剪剪成1mm3大小组织悬浮液。②含药血清制备:按每日中药健骨二仙丸生药12.0g/kg大鼠体质量灌胃(相当于临床剂量的6.25倍),每日固邦用量为1.04mg/kg体质量(相当于临床剂量的6.25倍)。2次/d,间隔5h,连续灌胃3d。末次灌药1h后,从腹主动脉取血,离心获取血清。③分组:取24孔培养板2块,分空白对照组、健骨二仙丸组、固邦组,各组又分别分100g/L,200g/L两个质量浓度亚组,共计6个组,每组8个培养孔。100g/L质量浓度组相应加入0.9mL组织悬液和0.1mL空白血清或健骨二仙丸、固邦含药血清。200g/L质量浓度组相应加入0.8mL组织悬液和0.2mL空白血清或健骨二仙丸、固邦含药血清。④实验评估:各组添加空白血清或含药血清后在体积分数为0.05CO2、37℃饱和湿度下培养72h,取上清液,用酶联免疫吸附法测定白细胞介素6的含量。上述界膜组织标本同时做细菌培养。结果:48个培养孔中的组织培养均成功,全部进入结果分析。①白细胞介素6水平:100g/L与200g/L空白对照组比较差异无显著意义[(97.113±11.989),(96.275±13.087)ng/L,P>0.05]。100g/L健骨二仙丸组[(92.288±10.397)ng/L]与空白对照组相比差异无显著性(P>0.05);200g/L健骨二仙丸组[(82.263±9.580)ng/L]低于空白对照各组(P<0.05)。100g/L与200g/L固邦组[(83.300±9.039),(79.338±11.118)ng/L]低于空白对照各组(P<0.05和P<0.01)。200g/L健骨二仙丸组与100g/L和200g/L固邦组比较,差异无显著性。②人工关节周围界膜组织细菌培养结果为阴性。结论:健骨二仙丸能够抑制磨损颗粒诱导的人工关节假体周围界膜细胞因子的分泌,进而阻止假体周围破骨细胞性骨溶解,对人工关节假体无菌性松动可能具有较好的防治作用。 相似文献
88.
Stanger O Semmelrock HJ Wonisch W Bös U Pabst E Wascher TC 《The Journal of pharmacology and experimental therapeutics》2002,303(1):158-162
Hyperhomocysteinemia is associated with arterial hypertension and endothelial dysfunction in healthy humans. Placebo-controlled vitamin intervention studies cannot distinguish intrinsic actions of homocysteine (tHcy) and folate concentrations on the endothelium. The present two-period crossover study investigates the effects of tHcy lowering through oral folic acid on antioxidant status and resistance vessel reactivity in patients with established coronary artery disease (CAD). We investigated 27 male patients with angiographically documented multivessel CAD aged 50 (range 46-56) years. Resistance vessel reactivity was assessed by measurement of postischemic reactive hyperemia (RH) in the forearm using venous occlusion plethysmography at baseline, after 6 weeks of treatment with 5 mg of oral folic acid, and after a washout period of another 6 weeks. Plasma folate increased 3.49-fold with a mean tHcy reduction of 21.3%. Peak reactivity of resistance vessels improved significantly (18.97-23.60 ml/min(-1) per 100 ml; P = 0.01) with unchanged total antioxidant status (TAS; 0.912-0.944 microM; P = 0.4). This effect was limited to subjects (n = 14) with a tHcy reduction >2 microM (median reduction, 14.4-9.6 microM, P < 0.001). In the 13 subjects with a below-median reduction, tHcy remained unaltered (9.7-9.6 microM, P = 0.88) and TAS increased significantly (0.923-1.055 microM, P = 0.006), whereas RH peak flow was not affected (20.22-22.99 ml/min(-1) per 100 ml, P = 0.28). Homocysteine lowering >2 microM through folic acid supplementation improves resistance vessel reactivity in patients with CAD. Our data support the hypothesis that homocysteine lowering may have intrinsic vasoprotective effects largely independent of folate. 相似文献
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90.
This review considers the potential of certain dietary supplements, including garlic, Ginkgo biloba, ginger, ginseng, fish oil, and vitamin E, to interfere with hemostasis. Dietary supplements are common components of the diet in the United States, with about half the US adult population taking some type of dietary supplement regularly. It has been suggested that some supplements could adversely affect coagulation when taken alone or in combination with antiplatelet medications. Supplements could alter hemostasis by a variety of mechanisms, such as reducing platelet aggregation or inhibiting arachidonic acid, a cellular signaling messenger and inflammatory intermediate. To conduct this review, multiple databases were searched using a variety of search terms to ensure relevant papers were located. Moderate to severe adverse events, such as spinal epidural hematoma, spontaneous intracerebral hemorrhage, retrobulbar hemorrhage, subarachnoid hemorrhage, spontaneous hyphema, and postoperative bleeding, have occasionally been anecdotally associated with consumption of dietary supplements. However, the number of controlled studies in the literature is too limited to demonstrate consistent anticoagulant effects of dietary supplements alone or in combination with drug therapy. 相似文献