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81.
G. Th. H. Van Kempen Dr. P. C. Molenaar 《Journal of neural transmission (Vienna, Austria : 1996)》1992,87(3):193-197
Summary Clinical evidence suggests that endocrinal factors are involved in fluctuations of the symptoms of women with myasthenia gravis. We studied the effect of estradiol and progesterone in an animal model for myasthenia gravis in rats. Although it was found that the mass of muscles was dependent on sex, and in female rats affected by estradiol, the number of acetylcholine receptors in these muscles was independent of sex and hormone administration. Sex hormones failed to influence the severity of muscle weakness in myasthenic rats. 相似文献
82.
Hitoshi Taguchi Koh Yamada Hideo Matsumoto Akira Kato Toshihiro Imanishi Koh Shingu 《Journal of anesthesia》1997,11(3):173-178
Purpose Several case reports indicate critical respiratory complications in relation to the double-lumen endobronchial tube (DLT).
A prospective survey for the airway problems in using the DLT is presented.
Methods One hundred adult patients undergoing thoracotomy for lung cancer were investigated. Tube malposition and airway obstruction
were searched using a fiber-optic scope. The endobronchial cuff was positioned just below the trachcal carina while the trachea
was intubated with a DLT (Rüsch). The distances of displacement, from the tracheal carina to the bronchial cuff, were measured
during anesthesia using an epidural catheter, which had marks every 5 mm. The distances for correcting the tube position were
measured at both the bronchial cuff and the level of the teethPaO2,PaCO2 andSPO2 were also measured.
Results Malposition (displacement over 5 mm from the correct position) was found in 42 patients, and 40 of them were in a withdrawal
direction, occurring at the postural change and during one-lung ventilation, especially during manipulation of the lung hilum.
Correcting distances at the level of the teeth were 15.3–3-times longer than those at the bronchial cuff. Airway deformities
and gradual withdrawal of the bronchial cuff were found in association with surgical manipulation. Obstruction occurred at
the tips of the tracheal tube in four patients and the bronchial tube in six patients, and at the tip of both in two patients.
Hypoxemia (PaO2<60 mmHg) occurred in four patients and hypercapnea (PaCO2>60 mm Hg) in two patients.
Conclusion Most of the DLT obstructions were associated with withdrawal malposition. Great attention to DLT displacement and airway deformity
is advised. 相似文献
83.
Minerva Giménez y Ribotta Christelle Roudet Françoise Sandillon Alain Privat 《Brain research》1996,707(2):245
The synaptic connections established by grafted noradrenergic (NA) neurons into the lesioned adult rat spinal cord were analysed using immunocytochemistry at the electron microscopic level. An embryonic cell suspension of the locus coeruleus region from E-13 rat embryos was transplanted into the spinal cord following either: (1) spinal cord transection or (2), partial selective denervation by 6-hydroxy dopamine (6-OH DA). One month after grafting, the NA-neurons established, in the two models, an innervation pattern similar to that found in the intact spinal cord. In both models, the transplanted NA-immunoreactive neurons formed extensive synaptic contacts with dendrites, spines and perikarya. The proportion of axodendritic and axospinous contacts was inverse in the two models. The first model thus reproduced more closely the normal synaptic pattern prefering dendritic targets, which could correspond to a better integration of the graft. In the second model, a partially NA-denervated spinal cord, there existed a competition between residual intrinsic and grafted neuron-derived fibres, which presumably affects synaptogenesis. In conclusion, the present study illustrate the complexity of cell interations conducting to the formation of a specific circuitry. Recognition phenomenon are likely modulated by space constraints, which ultimately shape-up the geometry of synaptic contacts. 相似文献
84.
85.
Summary Obturator hernias comprise a rare group of abdominal hernias. They are often diagnosed when the small bowel has become obstructed
and the patients are operated on without the causes of the obstruction being known. Although many techniques for closure of
the defect are available, there is no agreement at the present time as to which is the procedure of choice. 相似文献
86.
报道显微手术治疗10例延颈髓交界处髓内肿瘤(ITCJ),肿瘤全切除6例,次全切除4例,无手术死亡,70%病例术后好转。ITCJ可分为颈延型和延颈型两大类型。MRI是诊断本病的主要方法,并且具有指导手术的重要意义。结果也表明,显微手术方法和术后呼吸功能监护很有必要。 相似文献
87.
下尿路梗阻性肾积水患者逼尿肌功能变化 总被引:1,自引:1,他引:0
目的:探讨下尿路梗阻性肾积水患者逼尿肌功能变化。方法:对20例(3.5-73岁)下尿路梗阻导致的肾积水组和10例(13-67岁)无肾积水的对照组进行膀胱压力容积测定与压力-流率测定,并记录不同膀胱灌注量的逼尿肌基础压力。结果:下尿路梗阻性肾积水组逼尿肌-括约肌协同失调(DSD)11例(55%),逼尿肌功能过度活跃5例;而对照组仅发现1例(10%)DSD,未发现有逼尿肌功能过度活跃。下尿路梗阻性肾积水组平均膀胱顺应性显著低于对照组(P<0.05),而下尿路梗阻性肾积水组平均逼尿肌基础压力,平均逼尿肌最大收缩压和残余尿量均显著高于对照组(P<0.05),且下尿路梗阻性肾积水组在灌注量逐渐增加时高逼尿肌基础压力发生率逐渐增加。结论:下尿路梗阻性肾积水多伴有逼尿肌功能异常,提示膀胱逼尿肌功能改变与下尿路梗阻性肾积水的形成及发展有一定的相关性。 相似文献
88.
Background: For patients with incurable malignant gastric outlet obstruction and cholestasis, laparoscopic gastrojejunostomy combined
with endoscopic biliary stent placement seems to offer a minimally invasive palliation.
Methods: We retrospectively analyzed the data of 16 patients submitted to laparoscopic gastrojejunostomy. Laparoscopic gastroenterostomy
was performed as an antecolic, side-to-side gastrojejunostomy with enteroenterostomy. In 12 patients cholestasis was relieved
preoperatively by stent placement via endoscopy (n= 6, 37.5%), percutaneous access (n= 5, 31%) or bilioenteric anastomosis (n= 1, 6.25%). One patient needed a percutaneous Yamakawa prosthesis postoperatively.
Results: Mean operative time was 126 min. There were no intraoperative complications. In one patient conversion to open surgery became
necessary because of extensive adhesions. The only postoperative complication was bleeding from a trocar site requiring reintervention;
there was no mortality. Median postoperative hospital stay was 7 days. Delayed gastric emptying was observed in 3 (18.7%)
patients. Median survival was 87 days after the operation. All patients died from their primary disease but could maintain
oral intake during the remaining survival time.
Conclusions: We conclude that laparoscopic gastrojejunostomy and endoscopic or percutaneous biliary stenting provide a good functional
result while impairing the quality of life only to a minimal extent.
Received: 7 May 1996/Accepted: 12 December 1996 相似文献
89.
Acetylcholinesterase Adaptation to Voluntary Wheel Running is Proportional to the Volume of Activity in Fast, but not Slow, Rat Hindlimb Muscles 总被引:4,自引:0,他引:4
Victor Gisiger Manon Bélisle Phillip F. Gardiner 《The European journal of neuroscience》1994,6(5):673-680
Chronic enhancement of neuromuscular activity by forced exercise training programmes results in selective adaptation of the G4 acetylcholinesterase (AChE) molecular form in hindlimb fast muscles of the rat, with only minor and non-selective AChE changes in the soleus. In order to shed further light on the physiological significance of this G4 adaptation to training, we turned to a voluntary exercise model. The impact of 5 days and 4 weeks of voluntary wheel cage running on AChE molecular forms was examined in four hindlimb fast muscles and the slow-twitch soleus from two rat strains. Inbred Fisher and Sprague– Dawley rats, placed in live-in wheel cages, exercised spontaneously for distances which progressively increased up to an average of ∼3 and 18 km/day, respectively, by the end of week 4. Fast muscles responded to this voluntary activity by massive G4 increases (up to 420%) with almost no changes in A12 , so that by week 4 the tetramer became the main AChE component of these muscles. The additional G4 was composed primarily of amphiphilic molecules, suggesting a membrane-bound state. The G4 content of fast muscles was highly correlated with the distance covered by the rats during the 5 days before they were killed ( r = 0.850-0.879, P < 0.001 in three muscles). The soleus muscle, in turn, responded to wheel cage activity by a marked selective reduction of its asymmetric forms—up to 45% for A12 . This A12 decline, already maximal by day 5 of wheel cage running, showed no relationship with the distance covered. The present results constitute strong new evidence suggesting that the role of AChE in neuromuscular transmission is not limited solely to the rapid inactivation of just-released acetylcholine. 相似文献
90.
162例气管插管患者的气道管理 总被引:16,自引:2,他引:14
笔者通过报道162例气管插管患者的气道管理,阐述痰痂形成的原因:(1)气道干燥,湿化不够。(2)吸痰管插入深度不够,吸痰不彻底。管理措施:(1)用金霉素眼膏润滑吸痰管,使之易于插入,保证吸痰管插入深度超过插管远端3-5cm。(2)预防气道干燥,注重湿化效果,重视吸痰环节。认为气囊不需定时放气,只需不定时调整气囊压力。 相似文献