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81.
The value of different resistance parameters in distinguishing biopsy-proved dysfunction of renal allografts 总被引:3,自引:2,他引:1
Frauchiger B.; Bock A.; Eichlisberger R.; Landmann J.; Thiel G.; Mihatsch M. J.; Jager K. 《Nephrology, dialysis, transplantation》1995,10(4):527-532
The data concerning the value of duplex sonography in diagnosingparenchymatous renal allograft dysfunction are controversial.Most early studies did not take into consideration the manyfactors influencing resistance parameters. We therefore performeda prospective, biopsy-controlled study with exclusion of allknown sources of error regarding resistance parameters. Furthermorewe investigated the value of a new resistance parameter, thesystolic deceleration percentage. Forty-seven duplex sonographicstudies were performed on 43 patients (30 male, 13 female, medianage 47 years, range 770). Fourteen studies were doneon normally functioning grafts (control group) an average of33 days after transplantation. Thirty-three studies were performedon dysfunctional grafts immediately prior to biopsy. Graftswhich had been transplanted more than a year previously or withvascular findings or any other clinical or sonographic pathologyprobably explaining function deterioration were excluded. Inall patients, the resistive index (RI), pulsatility index (PI)and systolic deceleration percentage (DP) were calculated inthe main renal artery and in the interlobar artery. Of the 33grafts with dysfunction, nine had vascular rejection (VR), 11interstitial rejection (IR), 11 cyclosporin A toxicity (CAT)and two other histologies (OR). The mean RI in normal grafts(NO) was 0.71±0.06 in the main artery and 0.68±0.06in the interlobar artery, in VR 0.86±0.12 and 0.80±0.18,in IR 0.72±0.05 and 0.70±0.07, in CAT 0.67±0.06and 0.65±0.07 and in OR 0.64±0.07 and 0.60±0.01.For PI, the values were 1.45±0.23 and 1.41±0.28(NO), 3.5±2.13 and 2.92±2.16 (VR), 1.55±0.26and 1.46±0.33 (IR), 1.32±0.25 and 1.27±0.26(CAT) and 1.30±0.34 and 1.13±0.04 (OR). For DPwe calculated 28±5% and 29±6% (NO), 43±14%and 36±6% (VR), 29±9% and 27±9% (IR), 31±8%and 32±7% (CAT ) and 32±4% and 28±3% (OR).The sensitivity/specificity for VR with a cutoff mean+2 SD was0.44/1 for RI, 0.55/0.97 for PI and 0.33/0.89 for DP. It wasconcluded that:(1) despite the high selection of our patientgroup, diagnostic accuracy of duplex sonography for diagnosingparenchymatous function disorder in renal allograft remainsinsufficient; (2) in vascular rejection only, the resistanceparameters differ significantly from the values of normal allografts;(3) the higher the cutoff of resistance parameters, the betterthe specificity and the worse the sensitivity for diagnosingvascular rejection; (4) of all investigated resistance parameters,the RI is the most practical due to a simple measurement technique. 相似文献
82.
Incidence and prevalence of the sexual dysfunctions: A critical review of the empirical literature 总被引:11,自引:0,他引:11
The research which has assessed the incidence and prevalence of sexual dysfunctions is reviewed. Twenty-three studies are evaluated. Studies completed with community samples indicate a current prevalence of 5–10% for inhibited female orgasm, 4–9% for male erectile disorder, 4–10% for inhibited male orgasm, and 36–38% for premature ejaculation. Stable community estimates with regard to the current prevalence of female sexual arousal disorder, vaginismus, and dyspareunia are not available. Recent studies completed with clinical samples suggest an increase in the frequency of orgasmic and erectile dysfunction and a decrease in premature ejaculation as presenting problems. Desire disorders have increased as presenting problems in sex clinics, with recent data indicating that males outnumber females. Methodological limitations of these studies are identified and suggestions for future research are offered. 相似文献
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86.
小檗碱对大鼠阴茎海绵体磷酸二酯酶5mRNA水平的影响 总被引:3,自引:0,他引:3
目的 :检测大鼠阴茎海绵体中磷酸二酯酶 5 (PDE5 )mRNA的表达 ,进而探讨小檗碱 (berberine ,Ber)的分子作用机制。 方法 :通过逆转录酶链反应 (RT PCR)技术检测大鼠阴茎海绵体中PDE5mRNA的表达。 结果 :大鼠阴茎海绵体中有PDE5A1和PDE5A2mRNA的表达 ,以PDE5A2为主要的异构酶。与内参照 β 肌动蛋白相比 ,对照组、Ber孵育 1和 3h组的PDE5A1及PDE5A2基因mRNA的相对表达量分别为 :0 .2 2± 0 .0 2 ,0 .4 1± 0 .0 1 ;0 .1 5± 0 .0 1 ,0 .34± 0 .0 2 ;0 .1 0± 0 .0 1 ,0 .1 2± 0 .0 1。与对照组相比 ,PDE5A1、PDE5A2的mRNA表达 ,在Ber孵育 1h组降低了 32 %和 1 7%,3h组降低了 5 5 %和 71 %,其中尤以应用Ber 3h后PDE5A2的mRNA减少最为明显 (n =5 ,P <0 .0 1 )。 结论 :Ber对NO cGMP信号通路的下游关键酶 (PDE5 )具有一定的调控作用 ,尤其是抑制PDE5A2的mRNA表达 ,为Ber治疗勃起功能障碍的分子机制之一。 相似文献
87.
Martine Visser Johan Marinus Anne M Stiggelbout Jacobus J Van Hilten 《Movement disorders》2004,19(11):1306-1312
We developed a questionnaire to assess autonomic symptoms in patients with Parkinson's disease (PD) and evaluated its reliability and validity. Based on the results of a postal survey in 46 PD patients, 21 multiple system atrophy patients, and 8 movement disorders specialists, items were included according to their frequency, burden, and clinical relevance. The questionnaire was evaluated in 140 PD patients and 100 controls, and test-retest reliability was established in a sample of 55 PD patients. The SCOPA-AUT consists of 25 items assessing the following regions: gastrointestinal (7), urinary (6), cardiovascular (3), thermoregulatory (4), pupillomotor (1), and sexual (2 items for men and 2 items for women) dysfunction. Test-retest reliability was good. Autonomic problems increased significantly with increasing disease severity for all autonomic regions, except sexual dysfunction. We conclude that SCOPA-AUT is a reliable and valid questionnaire that evaluates autonomic dysfunction in PD. 相似文献
88.
89.
阴茎背深静脉包埋术治疗勃起功能障碍5例 总被引:8,自引:2,他引:6
目的 :评价阴茎背深静脉包埋术治疗勃起功能障碍 (ED)的疗效。 方法 :对 3例静脉性和 2例动静脉混合性ED病人施行阴茎背深静脉包埋术 ,术后随访疗效。 结果 :术后 2个月首次随访 ,3例静脉性ED病人获得满意性交 ,2例动静脉混合性ED病人基本能勃起 ,口服西地那非 5 0mg后可以完成性交。 5例术后随访 3~ 12个月(平均 7个月 )保持以上疗效。 结论 :阴茎背深静脉包埋术创伤小 ,几乎无并发症 ,是治疗静脉性ED的有效疗法 相似文献
90.
Shunichi Takaya MD Shunzaburo Iwatsuki Takashi Noguchi Hisaaki Koie Iman Zaghloul Raman Venkataramanan Thomas E. Starzl 《Surgery today》1989,19(1):49-56
The influence of experimentally induced hepatic dysfunction on the pharmacokinetics of Cyclosporine A (CsA) was determined
in dogs. The pharmacokinetics of oral (PO) and intravenous (IV) CsA were studied before and after 70 per cent hepatectomy
or complete bile duct ligation (CBDL). Changes in liver function were monitored by serial measurements of serum bilirubin,
and by the maximum removal rate (Rmax) and plasma disappearance rate (ICG-K) of indocyanine green (ICG). Concentrations of
CsA in whole blood were measured by HPLC. Seventy per cent hepatectomy caused significant liver dysfunction: the ICG-Rmax
decreased by 47.7±7.1 per cent (mean±SD) and the ICG-K decreased by 61.3±9.7 per cent during the first week after hepatectomy.
At the same time, the systemic clearance (CLs) of IV-CsA decreased by 43.9±8.2 per cent, the area under the concentration
curve (AUC) of IV-CsA increased by 35.4±20.8 per cent and the bioavailability of CsA decreased by 26.4±14.8 per cent. CBDL
also induced significant liver dysfunction: the ICG-Rmax decreased by 39.1±12.8 per cent and the ICG-K decreased by 65.6±3.6
per cent in the second week after the operation. During the same period, the AUC of PO-CsA decreased by 69.9±10.7 per cent
and the bioavailability of CsA also decreased markedly by 73.9±15.6 per cent. These data indicate that hepatic impairment
significantly influences the pharmacokinetics of CsA, not only by the changes in intestinal absorption, but also by those
in hepatic, metabolism. Dose adjustment is therefore necessary in the presence of hepatic dysfunction in order to maintain
an adequate blood concentration of CsA without causing side effects.
This research was performed in the Department of Surgery, University of Pittsburgh Health Center, University of Pittsburgh,
USA 相似文献