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991.
J. D. Schaafsma Y. Balash T. Gurevich A. L. Bartels J. M. Hausdorff N. Giladi 《European journal of neurology》2003,10(4):391-398
To assess the effect of levodopa on distinct freezing of gait (FOG) subtypes in patients with 'off' FOG. Nineteen patients (12 men, mean age 62.0 +/- 8.4 years) with Parkinson's disease and clinically significant FOG during 'off' states were videotaped whilst walking 130 m during 'off' and 'on' states. Three independent observers characterized the type, duration, and clinical manifestations and quantified FOG by analyzing the videotapes. Their combined mean scores were used for statistical analysis. The intra-class correlation coefficient assessed inter-observer reliability. Wilcoxon and Friedman tests evaluated differences in mean frequencies of FOG characteristics. During 'off' states, FOG was elicited by turns (63%), starts (23%), walking through narrow spaces (12%) and reaching destinations (9%). These respective values were only 14, 4, 2 and 1% during 'on' states (P < 0.011). Moving forward with very small steps and leg trembling in place were the most common manifestations of FOG; total akinesia was rare. Most FOG episodes took <10 s and tended to be shorter during 'on' states. Levodopa significantly decreased FOG frequency (P < 0.0001) and the number of episodes with akinesia (P < 0.001). Distinction amongst FOG subtypes enables evaluation of distinctive therapeutic response. Levodopa helps in reducing the frequency and duration of 'off'-related FOG. 相似文献
992.
Dopamine transporter density is decreased in parkinsonian patients with a history of manganese exposure: What does it mean? 总被引:2,自引:0,他引:2
Y Kim J-M Kim J-W Kim C-I Yoo C R Lee J H Lee H K Kim S O Yang H K Chung D S Lee B Jeon 《Movement disorders》2002,17(3):568-575
Manganese (Mn) exposure can cause parkinsonism. Pathological changes occur mostly in the pallidum and striatum. Two patients with a long history of occupational Mn exposure presented with Mn-induced parkinsonism. In one patient, magnetic resonance imaging (MRI) showed findings consistent with Mn exposure, and Mn concentration was increased in the blood and urine. However, this patient's clinical features were typical of idiopathic Parkinson disease (PD). Previous pathological and positron emission tomography studies indicate that striatal dopamine transporter density is normal in Mn-induced parkinsonism, whereas it is decreased in PD. Therefore, we performed [(123)I]-(1r)-2 beta-carboxymethoxy-3beta-(4-iodophenyl)tropane ([(123)I]-beta-CIT) single-photon emission computed tomography. Severe reduction of striatal beta-CIT binding was indicated, which is consistent with PD. We propose three interpretations: (1) the patients have PD, and Mn exposure is incidental; (2) Mn induces selective degeneration of presynaptic dopaminergic nerve terminals, thereby causing parkinsonism; or (3) Mn exposure acts as a risk of PD in these patients. Our results and careful review of previous studies indicate that the axiom that Mn causes parkinsonism by pallidal lesion may be over-simplified; Mn exposure and parkinsonism may be more complex than previously thought. Further studies are required to elucidate the relationship between Mn and various forms of parkinsonism. 相似文献
993.
We assessed the feasibility and psychometric properties of two commonly used health status questionnaires in Parkinson's disease (PD): the generic Nottingham Health Profile (NHP) and the disease-specific 39-item Parkinson's disease Questionnaire (PDQ-39), from a cross-sectional postal survey of PD patients (N = 81), using traditional and Rasch measurement methodologies. Overall response rate was 88%. Both questionnaires were found feasible, although the NHP performed less well. The PDQ-39 had fewer floor effects and was better able to separate respondents into distinct groups than the NHP, whereas the latter exhibited less ambiguous dimensionality and better targeting of respondents with non-extreme scores. Reliability and validity indices were similar, and potential differential item functioning by age and gender groups was found for both questionnaires. PDQ-39 response alternatives indicated ambiguity. With few exceptions, questionnaire scales were unable to meet recommended standards fully. While preliminary, this study illustrates the need for thorough evaluation of outcome measures and has implications beyond the questionnaires used here. Although promising, both questionnaires warrant further developmental work and stronger support of measurement validity before they could be considered fully suitable for valid use in PD, in particular in earlier stages of the disease. 相似文献
994.
Summary
The compartment syndrome (cs) is characterized by an increased tissue pressure in a limited space. Pathophysiologically, it
is a multifactorial disease that is potentially induced by an initial trauma and develops according to the existence of cofactors.
Cofactors are, for instance, the circulation of the patient and the initial treatment of the impending cs. In particular,
the microcirculation is altered with endothelial destruction, development of a capillary leak, protein loss from intravasal
space and the development of an interstitial and intracellular third space. An impaired drainage of the lymphatic and venous
system causes a venous infarction. An arterial infarction results if the tissue pressure exceeds the arteriolar pressure.
An accompanying ischemia reperfusion mechanism increases the trauma load. In disadvantageous cases, the patients are in danger
of developing a multi-organ deficiency syndrome (MODS) by an uncontrolled inflammatory reaction, by intravasal volume loss
and by a myonephropathic systemic reaction. Clinically, the patients suffer a disproportionate amount of pain, followed by
neurological signs. Especially in noncompliant patients, tissue pressure measurement is useful. Resuscitation of the circulation
as well as splitting of casts is important. In case of a manifest cs, dermatofasciotomy has to be performed as an emergency
operation. Even if cs is diagnosed early and fasciotomy is carried out early, the development of sequellae cannot be avoided
in every single case.
相似文献
995.
Frédéric Bruckert Eric de Kerviler Anne-Marie Zagdanski Jean-Michel Molina Isabelle Casin A. Guermazi Janine Bédrossian Jacques Frija 《Skeletal radiology》1997,26(7):431-433
Bartonella henselae, previously called Rochalimaea henselae, is the causative agent of cat scratch disease (CSD) in immunocompetent subjects and bacillary angiomatosis in immunocompromised
ones. Bone lesions are common in bacillary angiomatosis, but not in CSD. We present the case of a patient with a renal transplant
treated by immunosuppressive therapy who developed a sternal abscess with a histological pattern of CSD. The CT pattern was
that of a lytic bone lesion with adjacent fluid collection. The diagnosis was made on the basis of a polymerase chain reaction
amplification performed on bone material. Bartonella henselae is a newly described bacteria that causes CSD in a normal host and bacillary angiomatosis in immunocompromised patients. We
report a case of an osteolytic lesion of the sternum with adjacent fluid collection related to CSD, which occurred in a patient
with a renal transplant. 相似文献
996.
B. Bernardi C. Fonda E. Franzoni E. Marchiani E. Della Guistina R. A. Zimmerman 《Neuroradiology》1994,36(6):477-479
A case of infantile Krabbe's disease was first recognised as areas of relatively increased density on CT in the thalamus lateral geniculate body and dentate nucleus. These sites were subsequently shown on MRI to have a paramagnetic effect, being characterised by short T2 and T1. Subsequent examinations showed development of atrophy and high signal in white matter. 相似文献
997.
作者采用询问交谈的方法对精神病患者家属的心理状态进行了调查分析,大多数精神病患者家属存在着焦虑、急躁、自卑、厌恶、矛盾、无能为力等心理。同时,针对性地提出了以安慰、鼓励、心理启发、支持为主的护理方法和措施。 相似文献
998.
G. Miragliotta R. Del Prete R. Sabato A. Cassano N. Carnimeo 《European journal of epidemiology》1992,8(5):748-749
In October 1990 pneumonia due toLegionella pneumophila was diagnosed in two employees working in the area of Apulia, southern Italy, where artesian wells were in construction. Although the exposure to excavation has been associated with Legionnaires' disease, in our investigation the illness occurred only in those employees who were present when the water emerged from the ground under high pressure. On the basis of this report, water appears as the most likely reservoir of the organism and the main route of infection.Corresponding author. 相似文献
999.
1000.
We reviewed ninety-three patients who had one hundred and seven complete fractures of the femur between them and were treated over a twenty-five year period in Western Australia and South Australia. Operative surgical management of complete fractures in the middle and distal thirds was usually successful. In contrast, fractures proximal to the middle third were regularly associated with non-union, implant failure and requirement for revision surgery. In view of this significant difference in outcome after fracture of the pagetic femur in different sites, a comprehensive surgical management strategy is recommended in order to avoid complications. 相似文献