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The effects of 3 day fasting on liver prolactin and growth hormone receptors have been investigated in male and female rats. Fasting caused a significant fall in serum immunoreactive insulin (67% decrease), while receptor-reactive somatomedin fell by 82% when measured in whole serum and by 72% when measured in serum fractions following gel chromatography at low pH. Tracer ovine prolactin binding to liver microsomal membranes was reduced by 55% on fasting in females, but unchanged in males. Tracer bovine growth hormone binding fell significantly in both sexes. Analysis of competitive binding curves showed the decreased binding to be due to a loss of prolactin receptors in females, and of high affinity (but not low affinity) growth hormone receptors in males and females. Significant correlations were seen between serum insulin and tracer prolactin (females) and growth hormone (males and females) binding to liver membranes. Correlations between serum insulin and liver high affinity growth hormone binding sites were particulary significant (r = 0.899 in females, r = 0.910 in males). It is proposed that the hypoinsulinemia of fasting causes a loss of high affinity growth hormone receptors in the liver, which could result in a relative hepatic resistance to growth hormone and a decreased hepatic generation of somatomedin. 相似文献
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J Blomfield J A Simson A M Martinez J R Martinez 《Experimental and molecular pathology》1983,38(2):170-182
Rat submandibular gland tissue pieces were stimulated in vitro for 30 min with a beta-adrenergic agent or a cyclic AMP analog to stimulate protein secretion, or with alpha-adrenergic or cholinergic agents or a Ca2+ ionophore to stimulate fluid secretion. Acinar cells were examined by transmission electron microscopy. In control tissue, acinar cells showed little evidence of secretory activity. The Golgi apparatus was sparse and was associated with a few small, immature secretory granules with fine fibrillar contents. Following secretory granule discharge stimulated by isoproterenol or dibutyryl cyclic AMP, acinar cells were constricted, and had extensive basolateral membrane folding and tightly packed rough endoplasmic reticulum. Golgi complexes were prominent and had multiple small granules with filamentous contents. After stimulation of fluid secretion by alpha-adrenergic agents (epinephrine, phenylephrine), or cholinergic agents (acetylcholine, carbachol, pilocarpine), or a Ca2+ ionophore (A23187), the Golgi apparatus had compact concave cisternae enclosing aggregates of tubulovesicles. Acinar cells were distended, basolateral membranes were expanded, and rough endoplasmic reticulum was dilated and vesiculated. 相似文献
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Objective
The purpose of this study was to compare findings at presentation and surgical outcomes in patients in whom abdominal aortic aneurysms (AAAs) ruptured after endovascular repair and in patients in whom AAAs ruptured before any treatment during a defined period at a single center.Methods
This is a retrospective analysis of consecutive patients who presented to Royal Prince Alfred Hospital with ruptured AAA from September 2003 to September 2014. Medical records of each patient were reviewed to retrieve demographics, findings at presentation, and surgical outcome. Comparison of the outcomes between those occurring after endovascular repair (group 1) and those occurring without previous endovascular treatment (group 2) was made using the data collected and combining the results obtained by a previous study that analyzed the same findings between 1992 and 2003 from the same center to provide a total 22-year experience (1992-2014) at a single quaternary referral center.Results
From May 1992 to September 2014, there were 1921 elective repairs of intact infrarenal AAAs, with 1288 endovascular and 633 open repairs. During 22 years, 40 of the 1288 patients (3.1%) who underwent endovascular repair for AAA had rupture. The proportion of patients with hypotension at presentation in group 1 (13/40) was significantly less than in group 2 (108/138; P < .01). The difference in perioperative 30-day mortality rate in group 1 (8/40 [20%]) compared with group 2 (68/138 [49%]) was significant (P < .01).Conclusions
This study confirmed that endovascular AAA repair does not prevent rupture in all patients. The data suggest that rupture, when it does occur, may not be accompanied by such major hemodynamic changes and higher mortality rate as with rupture of an untreated AAA. Strict surveillance and follow-up are required, especially in patients with relatively large initial AAA diameter or presence of endoleak and graft migration, to reduce the rate of ruptures after endovascular repair. Complete prevention will remain challenging because rupture may occur without any predisposing abnormalities. With the advent of new-generation devices, continuous larger long-term studies are required to document reduction in rupture rates after endovascular aneurysm repair. 相似文献14.
介绍了国外护理专家对2050年护理发展前景的展望,从以理论为基础的实践、卫生保健和文化等方面进行综述。 相似文献
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Shane R. Stecklein Simona F. Shaitelman Gildy V. Babiera Isabelle Bedrosian Dalliah M. Black Matthew T. Ballo Isadora Arzu Eric A. Strom Valerie K. Reed Tomas Dvorak Benjamin D. Smith Wendy A. Woodward Karen E. Hoffman Pamela J. Schlembach Steve M. Kirsner Christopher L. Nelson Jinzhong Yang William Guerra Elizabeth S. Bloom 《Practical radiation oncology》2019,9(1):e4-e13
Purpose
This study aimed to prospectively characterize toxicity and cosmesis after accelerated partial breast irradiation (APBI) with 3-dimensional conformal radiation therapy (CRT) or single-entry, multilumen, intracavitary brachytherapy.Methods and materials
A total of 281 patients with pTis, pT1N0, or pT2N0 (≤3.0 cm) breast cancer treated with segmental mastectomy were prospectively enrolled from December 2008 through August 2014. APBI was delivered using 3-dimensional CRT (n = 29) or with SAVI (n = 176), Contura (n = 56), or MammoSite (n = 20) brachytherapy catheters. Patients were evaluated at protocol-specified intervals, at which time the radiation oncologist scored cosmetic outcome, toxicities, and recurrence status using a standardized template.Results
The median follow-up time is 41 months. Grade 1 seroma and fibrosis were more common with brachytherapy than with 3-dimensional CRT (50.4% vs 3.4% for seroma; P < .0001 and 66.3% vs 44.8% for fibrosis; P = .02), but grade 1 edema was more common with 3-dimensional CRT than with brachytherapy (17.2% vs 5.6%; P = .04). Grade 2 to 3 pain was more common with 3-dimensional CRT (17.2% vs 5.2%; P = .03). Actuarial 5-year rates of fair or poor radiation oncologist-reported cosmetic outcome were 9% for 3-dimensional CRT and 24% for brachytherapy (P = .13). Brachytherapy was significantly associated with inferior cosmesis on mixed model analysis (P = .003). Significant predictors of reduced risk of adverse cosmetic outcome after brachytherapy were D0.1cc (skin) ≤102%, minimum skin distance >5.1 mm, dose homogeneity index >0.54, and volume of nonconformance ≤0.89 cc. The 5-year ipsilateral breast recurrence was 4.3% for brachytherapy and 4.2% for 3-dimensional CRT APBI patients (P = .95).Conclusions
Brachytherapy APBI is associated with higher rates of grade 1 fibrosis and seroma than 3-dimensional CRT but lower rates of grade 1 edema and grade 2 to 3 pain than 3-dimensional CRT. Rates of radiation oncologist-reported fair or poor cosmetic outcomes are higher with brachytherapy. We identified dosimetric parameters that predict reduced risk of adverse cosmetic outcome after brachytherapy-based APBI. Ipsilateral breast recurrence was equivalent for brachytherapy and 3-dimensional CRT. 相似文献16.
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《Journal of the American Dental Association (1939)》2022,153(10):989-995
BackgroundThe safety of dental radiography performed on pregnant patients has been a controversial topic since the 1960s. This review synthesizes and consolidates findings, from 1957 through 2021, of the effects dental ionizing radiation could have on a pregnant patient and in utero birth defects.Types of Studies ReviewedUsing PubMed, the following key words were searched: pregnancy, radiology, radiograph, radiation dose, fetus, x-ray, and dental. Criteria evaluation was done on the basis of availability, completeness, quality, relevance, technicality (that is, dental radiography), topicality (that is, pregnant patients), and usability. These results were then filtered on the basis of quantitative and qualitative data as well as the period (decades within the historical framework). The final selection of relevant literature consisted of various studies including cohort studies, systematic reviews, meta-analyses, case reports, and other narrative reviews.ResultsIf properly performed, the amount of ionizing radiation produced during dental radiographic procedures is so low that it is unlikely to reach the teratogenic threshold. Thus, dental ionizing radiation is unlikely to cause in utero birth defects because it has been detected to have a deterministic (not stochastic) effect. With this information and historical context, this article shows that necessary dental radiography is safe at any stage during pregnancy, as long as proper safety equipment is appropriately used.Conclusions and Practical ImplicationsAs technology advances, more research can further clarify ionizing radiation safety for pregnant patients and its potential effects on in utero birth defects, improving overall oral health care. The dental community must remain educated about current ionizing radiation safety guidelines to make better-informed decisions and successfully provide proper oral health care to pregnant patients. 相似文献
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Amelogenesis imperfecta is a genetic disorder that affects the structure of enamel and consequently the function, esthetics, and psychology of young patients. Restoring the dentition of a child with minimal tooth preparation is achievable with polymer-infiltrated ceramics. The treatment of a 12-year-old child presenting with amelogenesis imperfecta is described. An in-office computer-aided design and computer-aided manufacturing (CAD-CAM) system and polymer-infiltrated ceramic blocks were used in a noninvasive procedure. The definitive clinical outcome showed a major esthetic improvement and allowed for the normal eruption of the permanent dentition. 相似文献
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