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61.
IgM class antibodies against the ganglioside GM1 have been found in a subgroup of patients with lower motor neuron syndromes and multifocal motor neuropathies (MMN). The pathogenic relevance of these antibodies is still unclear, but some MMN patients with IgM antibodies against GM1 seem to profit from immunosuppressive therapy. A reliable test for IgM antibodies against GMl may be useful for identifying these patients. We have assessed the comparability of the ELISA tests used for the determination of IgM against GM1 by sending coded serum samples to nine laboratories. In three samples high-titre IgM antibodies against GM1 were detected by all laboratories. This result was confirmed by dot blot immunodetection and thin-layer chromatography immuno-overlay. Seven samples were read as negative by nearly all laboratories. Major discrepancies between laboratories were noted in the analysis of one sample with results ranging from negative to high titre.
Participating laboratories: N. Baumann and A. Ben Younes-Chennoufi, Neurobiologie cellulaire moleculaire et clinique, INSERM U134, Hôpital de la Sâpetrière, Paris, France; P. Fredman and L. Svennerholm, Department of Psychiatry and Neurochemistry, Goteborg University, Sweden; N. Gregson and R. A. C. Hughes, Department of Neurology, Guy's and St. Thomas's Medical and Dental School, London, UK; A. A. Ilyas, Department of Neurosciences, University of Medicine & Dentistry of New Jersey, New Jersey Medical School, Newark, N. J., USA; A. Pestronk, Division of Neuromuscular Diseases, Washington University School of Medicine, St. Louis, Mo., USA; A. J. Steck, Service de Neurologie, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland (current address: Department of Neurology, University of Basle); H. Willison, Department of Neurology, University of Glasgow, Glasgow, UK 相似文献
62.
Many clinical reports have described vocal cord paralysis after general anaesthesia. In most cases, paralysis was attributed
to tracheal tube insertion. In this report we describe one patient in whom gastric tube insertion was strongly suspected as
the cause of paralysis. The patient was a 47-yr-old man who underwent left hepatic lobectomy. Just after the operation he
complained of hoarseness and a diagnosis of complete right vocal cord paralysis was made, from which he recovered after eight
weeks. In this patient, insertion of the gastric tube seemed to have injured the anterior ramus of the right recurrent laryngeal
nerve directly. Although there have been several reports of vocal cord paralysis induced by gastric tubes, none has noted
such an acute onset and direct nerve injury. Therefore we would like to report this rare case and elucidate the mechanism
of vocal cord paralysis. Careful attention should be paid in inserting a gastric tube to patients under general anaesthesia
and, sometimes, the use of the soft tube may be indicated.
Plusieurs publications portent sur la paralysie des cordes vocales après une anesthésie générale. Dans la plupart des cas,
on attribue la paralysie à l’insertion du tube endotrachéal. Ce compte-rendu se rapporte à un cas où l’insertion d’une sonde
gastrique est fortement mise en cause dans l’étiologie de la paralysie. Un patient de 47 ans subit une hépatectomie. Immédiatement
après l’intervention, il se plaint de raucité de la voix et une paralysie de la corde vocale droite est diagnostiquée. La
récupération s’effectue en huit semaines. Chez ce patient, la sonde gastrique semble avoir endommagé directement le rameau
antérieur du nerf récurrent laryngé. Bien que plusieurs observations identiques de paralysie des cordes vocales provoquée
par une sonde gastrique aient été publiées, aucune ne rapporte un début aussi soudain avec lésion nerveuse directe. Nous décrivons
ici ce cas rare et tenterons d’expliquer le mécanisme de la paralyse de la corde vocale. Il faut être très prudent lorsqu’on
insère un tube gastrique sous anesthésie générale et il est parfois préférable d’utiliser un tube mou. 相似文献
63.
Z. Milutinović 《European archives of oto-rhino-laryngology》1995,252(8):491-494
There are numerous surgical procedures now available to manage bilateral abductor paralyses of the vocal folds. These procedures have various success rates but mostly do not offer reliable and predictable postoperative results, and usually require ,tracheotomy. The technique described in this report is based on a trial study to obtain a safe airway for an affected patient and avoid tracheotomy, if possible. Submucosal cordectomy was used with lateral fixation of one vocal fold and preservation of the arytenoid. The procedure was performed by using continuous intravenous anesthesia, which does not require intubation of the patient's airway. Seven patients were operated with this technique with excellent postoperative results. The glottal airway was largely improved in all patients, with only minor temporary complications. 相似文献
64.
65.
A. Lukić-grlić A. Baće R. Lokar-Kolbas D. Loffler-badžek V. Draženović J. Božikov G. Mlinarić-galinović 《European journal of epidemiology》1999,15(4):359-363
This paper has analyzed respiratory syncytial virus lower respiratory tract infections in 201 hospitalized children. In children with wheezing, erythrocyte sedimentation rate (ESR) was significantly higher in those with pneumonia than with syndroma pertussis, while the white blood cell (WBC) count was significantly lower in patients with bronchitis than in those with bronchiolitis and syndroma pertussis. Bronchodilatators were applied in 75.6% and corticosteroids in 20% of patients. Ten patients were ventilated. Fatal disease outcome was observed in one infant. Twelve consecutive-year study of respiratory syncytial virus (RSV) infections showed that 27.3% of these diseases were bronchiolitis and pneumonia. 相似文献
66.
Y. Fukuda Yoshihisa Fukuta Raita Higashino Masayuki Ogishima Kenji Yoshida Hajime Tamaki Mineo Takei 《Naunyn-Schmiedeberg's archives of pharmacology》1999,359(6):433-438
The effects of Z-350, (S)-4-[3-(4-{1-(4-methylphenyl)-3-[4-(2-methoxyphenyl)piperazine-1-yl]propoxy} benzoyl)indole-1-yl]butyric
acid hydrochloride, a newly synthesized compound possessing α1-adrenoceptor antagonistic and steroid 5α-reductase inhibitory actions, were studied in vitro. In functional experiments,
Z-350 shifted the concentration/response curve for the phenylephrine-induced contraction of rabbit prostate, urethra and aorta
to the right with pA2 values of 8.04, 7.57 and 7.13, respectively. The binding affinity of Z-350 for α1-adrenoceptors in rabbit prostate, urethra and aorta were estimated by the displacement of [3H]prazosin. The pK
i values for this action of Z-350 were 7.53, 7.95 and 7.62 for the prostate, urethra and aorta, respectively. α1-Adrenoceptor subtype selectivities were studied in the submaxillary gland (α1A) and liver (α1B) of rat. Z-350 inhibited the specific binding of [3H]prazosin to α1A and α1B-adrenoceptors with pK
i values of 7.82 and 7.29, respectively. Z-350 inhibited rat prostatic steroid 5α-reductase non-competitively with a pIC50 of 8.42. These results indicate that Z-350 is a α1-adrenoceptor antagonist and is a steroid 5α-reductase inhibitor. It is expected that Z-350 will be a candidate drug for the
treatment of benign prostatic hyperplasia.
Received: 26 January 1999 / Accepted: 2 March 1999 相似文献
67.
The purpose of this study was to examine whether cardiorespiratory responses to combined rhythmic exercise (60 contractions · min–1) was affected by different combinations of upper and lower limb exercise in seven healthy women. Six different rhythmic exercises were compared: 6-min rhythmic handgrip at 10% of isometric maximal voluntary contraction (MVC) (H10); 6-min rhythmic plantar flexion at 10% MVC (P10); exhausting rhythmic handgrip at 50% MVC (H50); exhausting rhythmic plantar flexion at 50% MVC (P50); H50 was added to P10 (P1OH50); and P50 was added to H10 (H10P50). Exercise duration, after handgrip was combined with plantar flexion (P10H50), was shorter than that of H50, although the exercise duration of HIOP50 was not significantly different from P50. No significant difference was found between the difference from rest in oxygen uptake (
O2) during H10P50 and the sum of
O2 during H10 and P50. Also, the differences from rest in forearm blood flow ( FBF) and calf blood flow ( CBF) during H10P50 were not significantly different from FBF in H10 and from CBF in P50. In contrast,
O2 in P10H50 was lower than the sum of
O2 in P10 and H50 (P < 0.05), and J FBF in P10H50 was lower than that in H50 (P < 0.05) , while CBF was not significantly different between P1OH50 and P10. The changes in heart rate from rest (d HR) during the combined exercises were lower than the sums of HR in the corresponding single exercises (P < 0.05). These results demonstrated an inhibitory summation of several cardiorespiratory responses to combined exercise resulting in a reduction in exercise performance which would seem to occur easily when upperlimb exercise is added to lower limb exercise. 相似文献
68.
目的:探讨子宫下段剖宫产术不缝合腹膜对手术后效果影响。方法:对2000年7月~2001年7月在我院行改良式腹壁横切口子宫下段剖宫产168例,分成缝合腹膜组与不缝合腹膜组,在手术时间、术后镇痛药使用、肛门排气时间、术后发热、术后切口愈合方面进行观察和总结。结果:不缝合腹膜组在手术后发热,腹壁切口延期愈合方面与缝合腹膜组差异无显著性,在手术时间、术后肛门排气时间、术后镇痛药使用上比缝合腹膜组少。结论:施行子宫下段剖宫产,不缝合腹膜具有手术时间短、术后排气早、疼痛轻等优点,不会增加腹腔脏器粘连。 相似文献
69.
70.
通关利窍针法治疗中风致假性延髓麻痹临床观察 总被引:8,自引:0,他引:8
目的 观察通关利窍针法治疗中风致假性延髓麻痹的疗效。方法 将 10 0例患者随机分为治疗组和对照组各 5 0例 ,治疗组采用通关利窍针法 ,对照组采用康复训练法 ,均 14次为 1个疗程 ,疗程间休息 3日 ,2个疗程后评定疗效。结果 治疗组总有效率 96 .4 % ,对照组 2 4 % ,两组差异有显著性意义 (P<0 .0 5 ) ,治疗组疗效和年龄、病程、病情轻重有关。结论 通关利窍针法治疗中风后假性延髓麻痹优于康复训练法 相似文献