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31.
Anthony J Linz 《The Journal of asthma》2007,44(5):347-355
The differential diagnoses of persistent nonproductive cough include numerous pulmonary and nonpulmonary organic disorders as well as functional illnesses. Many diseases can cause cough, and several studies have shown asthma among the most common etiologies associated with chronic cough in adult nonsmokers, as well as children. Psychogenic cough and its relationship to asthma and other asthma-like illnesses is complex since distinct maladies with similar features may coexist individually or in combination in any given patient. While chronic cough may occur as a sole presenting manifestation of bronchial asthma in all age groups, recent findings suggest that most children with persistent cough without other respiratory symptoms do not have asthma. Since several organic, as well as functional diseases, may present with persistent cough as their sole manifestation in either adults or children, cough should not be used as a single or major determinant to diagnose and treat asthma, especially when empirically focused therapy trials fail. Given the range of illnesses causing cough, no single management guideline can be expected to be universally effective. 相似文献
32.
Patrick Ambrosetti Karim Francis Dominique Weintraub Jonathan Weintraub 《Journal of gastrointestinal surgery》2007,11(6):767-772
We performed a prospective study to analyze the functional results following elective laparoscopic sigmoidectomy for computed
tomography (CT)-proven diagnosis of acute diverticulitis and review the literature. Forty-three of 45 available patients (96%)
who had laparoscopic sigmoidectomy for CT-proven acute diverticulitis answered, after a mean time of 40 months, a questionnaire
exploring new abdominal symptoms, bowel function, and the patient’s own judgement of the surgical outcome. Surgical technique
aimed at removing all the sigmoid by taking down the splenic flexure and do a colorectal anastomosis. Four patients (9%) complained
of new abdominal pain. Bowel function was reported as better for 24 patients (56%), unchanged for 16 patients (37%), and worse
for 3 (7%). Twenty patients (47%) considered their final result as excellent to good, 17 patients (40%) as satisfying, and
6 patients (13%) as mediocre. Male gender, absence of preoperative history compatible with an irritable bowel syndrome, length
of resected sigmoid and residual acute inflammation on histology are statistically predictive of a better postoperative degree
of satisfaction. After elective laparoscopic sigmoidectomy for CT-proven diverticulitis, a great majority of patients are
very satisfied with their postoperative general comfort. 相似文献
33.
Although the concept of receiving MR signal using multiple coils simultaneously has been known for over two decades, the technique has only recently become clinically available as a result of the development of several effective parallel imaging reconstruction algorithms. Despite the success of these algorithms, it remains a challenge in many applications to rapidly and reliably reconstruct an image from partially-acquired general non-Cartesian k-space data. Such applications include, for example, three-dimensional (3D) imaging, functional MRI (fMRI), perfusion-weighted imaging, and diffusion tensor imaging (DTI), in which a large number of images have to be reconstructed. In this work, a systematic k-space-based reconstruction algorithm based on k-space sparse matrices (kSPA) is introduced. This algorithm formulates the image reconstruction problem as a system of sparse linear equations in k-space. The inversion of this system of equations is achieved by computing a sparse approximate inverse matrix. The algorithm is demonstrated using both simulated and in vivo data, and the resulting image quality is comparable to that of the iterative sensitivity encoding (SENSE) algorithm. The kSPA algorithm is noniterative and the computed sparse approximate inverse can be applied repetitively to reconstruct all subsequent images. This algorithm, therefore, is particularly suitable for the aforementioned applications. 相似文献
34.
基于Lyapnuov泛函方法,研究了满足匹配条件的不确定性时滞系统的鲁棒稳定性及具有稳定度β〉0鲁棒稳定性,给出了已有结果不能推出的新判据。这些新判据对已有结果难以使用的情况下也可有是有效的,或有时减少了已有结果的保守性。 相似文献
35.
The Barthel Index (BI), the Modified Barthel Index (MBI) and the Functional Independence Measure (FIM) are all widely used by occupational therapists as assessment tools for clinical decision-making and outcome measurement. All of these tools have demonstrated validity and the BI and the FIM have demonstrated inter-rater reliability. The MBI has been modified to increase sensitivity; however, there have been no publications on the inter-rater reliability of this tool following the changes. The purpose of this research was to examine the inter-rater reliability of two versions of the Barthel Index, and draw some comparisons between this assessment tool and the FIM. Twenty-five patients with neurological and orthopaedic conditions were assessed by three occupational therapists using the three tools. The method of analysis selected was percentage agreement and intraclass correlation coefficient. The results indicated that both the original and modified versions of the Barthel Index possess good inter-rater reliability. As all three tools have demonstrated adequate reliability and validity, it is suggested that clinicians select the most sensitive tool that best meets their clinical needs, and use this assessment tool in its standardized format. 相似文献
36.
92例跟骨骨折后足部畸形功能障碍治疗探讨 总被引:6,自引:1,他引:5
本文对92例106足波及距下关节的跟骨骨折治疗后1~6年遗留足畸形、功能障碍的病例(PALey:舌型17足,中央压陷型53足,严重粉碎型36足)进行了分析和总结。作者强调解剖复位、牢靠固定、一期植骨、早期关节持续被动运动及不过早负重是预防跟骨骨折众多并发症的重要措施。 相似文献
37.
Deep brain stimulation for Parkinson's disease dissociates mood and motor circuits: a functional MRI case study. 总被引:2,自引:0,他引:2
Taresa Stefurak David Mikulis Helen Mayberg Anthony E Lang Stephanie Hevenor Peter Pahapill Jean Saint-Cyr Andres Lozano 《Movement disorders》2003,18(12):1508-1516
Behavioral disturbances have been reported with subthalamic (STN) deep brain stimulation (DBS) treatment in Parkinson's disease (PD). We report correlative functional imaging (fMRI) of mood and motor responses induced by successive right and left DBS. A 36-year-old woman with medically refractory PD and a history of clinically remitted depression underwent uncomplicated implantation of bilateral STN DBS. High-frequency stimulation of the left electrode improved motor symptoms. Unexpectedly, right DBS alone elicited several reproducible episodes of acute depressive dysphoria. Structural and functional magnetic resonance imaging (fMRI) imaging was carried out with sequential individual electrode stimulation. The electrode on the left was within the inferior STN, whereas the right electrode was marginally superior and lateral to the intended STN target within the Fields of Forel/zona incerta. fMRI image analysis (Analysis of Functional NeuroImages, AFNI) contrasting OFF versus ON stimulation identified significant lateralized blood oxygen level-dependent (BOLD) signal changes with DBS (P < 0.001). Left DBS primarily showed changes in motor regions: increases in premotor and motor cortex, ventrolateral thalamus, putamen, and cerebellum as well as decreases in sensorimotor/supplementary motor cortex. Right DBS showed similar but less extensive change in motor regions. More prominent were the unique increases in superior prefrontal cortex, anterior cingulate (Brodmann's area [BA] 24), anterior thalamus, caudate, and brainstem, and marked widespread decreases in medial prefrontal cortex (BA 9/10). The mood disturbance resolved spontaneously in 4 weeks despite identical stimulation parameters. Transient depressive mood induced by subcortical DBS stimulation was correlated with changes in mesolimbic cortical structures. This case provides new evidence supporting cortical segregation of motor and nonmotor cortico-basal ganglionic systems that may converge in close proximity at the level of the STN and the adjacent white matter tracts (Fields of Forel/zona incerta). 相似文献
38.
功能性矫治器是正畸临床中常用的一种矫治器,作者从口腔正畸学理论基础出发,探讨了功能性矫治器在正畸矫治作用中存在的伦理道德问题,主要有(1)不能正确的诊断、制定周密的矫治计划。(2)操作不规范、不细致、缺乏敬业精神。(3)态度简单,粗曝,缺乏与患者良好的交流。并提出解决方法(1)刻苦学习专业知识,不断提高诊疗水平及个人修养。(2)建立高度的道德责任感,以严谨的作风,规范的操作为病人服务。(3)尊重、善待青少年,建立良好的医患关系。 相似文献
39.
Joachim H?chel D?rte Lehmann Claudia Fehrenberg Volker Unger David A Groneberg Christian Grosse-Siestrup 《Nephrology, dialysis, transplantation》2003,18(9):1748-1754
BACKGROUND: The isolated perfused canine kidney has been established as a valid model for conducting both renal physiology and transplantation research. This model is of particular importance for developing new strategies to improve graft function after renal transplantation. In the present study, a newly developed method using isolated haemoperfused porcine kidneys was adapted for use in canine kidneys. In contrast to haemoperfusion, synthetic perfusion media can be standardized and can prevent the initiation of blood-mediated reperfusion reactions. Thus, an additional aim was to determine whether blood could be replaced by synthetic cell-free perfusion solutions. METHODS: Canine kidneys (n = 30) were harvested from donors euthanized in veterinary practices for causes unrelated to the present study. The kidneys were isolated and perfused with autologous blood or cell-free synthetic electrolyte buffer (Tyrode solution). During perfusion, we monitored renal perfusate flow (RPF), glomerular filtration rate (GFR), electrolyte and glucose reabsorption, oxygen consumption and urine concentration. RESULTS: Changes in perfusion medium did not affect the RPF. In contrast, GFR, urine concentration and oxygen consumption were significantly higher, whereas fractional excretion of sodium and glucose were significantly lower in blood- than in Tyrode-perfused kidneys. CONCLUSIONS: This system offers a simple model for studying whole-organ functional alterations after acute renal ischaemia. Renal function indicators were below values reported during in vivo physiological conditions. These functions were better conserved when kidneys were perfused with autologous blood than with Tyrode. 相似文献