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51.
J. L. Frederiksen H. B. W. Larsson P. Christiansen J. Olesen 《European journal of neurology》1997,4(6):561-566
To evaluate various MRI criteria we studied a representative group of 149 consecutive patients below 50 years with acute monosymptomatic optic neuritis (AMON), a frequent first manifestation of multiple sclerosis (MS). The presence, number, size, and localization of areas of increased signal (AIS) on T2-weighted brain MRIs obtained at 1.5 T were described and compared with findings in 71 healthy persons aged 21–50 years without diabetes, cerebrovascular or neurologic diseases. MRI was performed within 2–145 days, median 16 days from onset of AMON and showed from 0 to 26 AIS, sized 2–30 mm, in 79 of 149 (53%) patients compared to 0–18 AIS, sized 2–12 mm, in 31 of 71 (44%) healthy persons. In patients, AIS were significantly more frequent in women than in men (χ2 = 4.67, p > 0.05). Periventricular AIS were revealed in 70 (47%) patients and in 14 (20%) healthy persons. Subcortical AIS were present in 5 (3%) patients and in 18 (25%) healthy persons. Infratentorial AIS were present in only 3 (2%) patients. The sensitivity and specificity of previously proposed diagnostic MRI criteria for MS were unsatisfactory in our group of patients and have previously only been validated in definite MS. We therefore constructed and tested four new sets of criteria. The set with the best relation between sensitivity (e.g. 41%) and specificity (e.g. 93%) was the following: presence of two or more AIS, of which at least one is periventricular or infratentorial, combined with the absence of subcortical AIS. These criteria are recommended for patients with AMON and might be used in other patients with possible or probable MS. 相似文献
52.
目的 探讨可溶性白细胞介素 2受体 (sIL 2R)和可溶性白细胞介素 6受体 (sIL 6R)在多发性硬化(MS)发病过程中的作用。方法 采用双体夹心ELISA法对 2 9例MS急性期患者及 2 0例炎性神经病患者、39例非炎性神经病患者、2 0例健康对照者脑脊液和血清中sIL 2R和sIL 6R的含量进行检测。结果 MS患者血清和脑脊液中sIL 2R、sIL 6R含量明显高于非炎性神经病组 (P <0 .0 5 )及健康对照组 (P <0 .0 1) ;MS组sIL 2R和血清sIL 6R含量与炎性神经病组比较 ,无显著性差异 ,但脑脊液中sIL 6R水平明显低于炎性神经病组 (P <0 .0 1)。结论 sIL 2R和sIL 6R在MS急性期患者体内明显升高 ,进一步证实了MS有关免疫学的发病机制 ,并为临床诊断MS提供了具有参考价值的实验室指标 相似文献
53.
健康志愿者10名,随机交叉口服硫酸吗啡控释片(CRMS)30mg(30mg×1)和硫酸吗啡普通片(IRMS)20mg(10mg×2),分别于服药前后各时点取静脉血,用GCMS测定血浆中吗啡含量。以药代软件程序处理,分别求得CRMS和IRMS的Cmax为19.38±3.80和21.27±6.21ng/ml;tmax为2.36±0.37h和0.55±0.16h;t1/2β为3.53±0.87h和3.03±0.74h,曲线下面积AUC为145.15±17.65和93.08±16.65ng·h/ml。癌症病人多次口服硫酸吗啡至稳态,CRMS和IRMS的峰浓度分别为27.43±0.33ng/ml,22.68±0.16ng/ml;谷浓度分别为19.45±1.44ng/ml;18.14±0.49ng/ml。 相似文献
54.
Pike G. B. 《The Italian Journal of Neurological Sciences》1997,18(6):359-365
While conventional magnetic resonance imaging (MRI) measures signal primarily from the hydrogen nuclei of water, magnetization transfer (MT) MRI indirectly detects macromolecular associated hydrogen nuclei via their magnetic interaction with the observable water. In the normal adult CNS, white matter exhibits the largest MT effect due to the macromolecular content of the highly structured and lipid rich myelin. Pathologies which alter the structural integrity and the relative macromolecular-water composition, such as multiple sclerosis (MS), therefore show abnormal MT. Conventional MRI, which has a high MS lesion detection sensitivity but poor specificity in terms of differentiating the pathological state of a plaque, can thus be supplemented by MT to provide more specific information on the extent of demyelination and axonal loss. In this paper we review the basic concepts of MT imaging and its role in MS lesion characterization.Financial support was provided by the Medical Research Council of Canada, Fonds de la Recherche en Santé du Québec, and the Killam Foundation. 相似文献
55.
Background: Three acid-reducing operations have recently been described for the laparoscopic treatment of peptic ulcer disease. These
consist of a posterior truncal vagotomy combined with either (1) an anterior seromyotomy (SERO), (2) an anterior highly selective
vagotomy (AHSV), or (3) a linear stapled lesser curvature excision (STAP). The purpose of this study was to investigate the
physiologic effects of these procedures in terms of basal and maximal acid outputs.
Methods: Fifty New Zealand rabbits were prospectively randomized into five open laparotomy groups (n= 10): a control group without vagal manipulation (CON), a bilateral truncal vagotomy with pyloromyotomy group (VP), a SERO
group, an AHSV group, and a STAP group. All animals underwent placement of a gastrostomy tube for subsequent gastric secretory
analysis. On postoperative day 6, basal acid outputs (BAO) and maximal acid outputs (MAO) following IV pentagastrin stimulation
(30 μg/kg/h) were measured. Results were compared statistically using the ANOVA method.
Results: Pentagastrin stimulation was associated with a significant increase in MAO in the CON group (p < 0.05 vs BAO); however, this response was effectively blunted in all the experimental groups. There were no differences
in BAO or MAO between any of the vagotomized groups (SERO, HSV, STAP, VP).
Conclusions: We conclude that the three acid-reducing procedures modified for laparoscopy are equally efficacious in reducing gastric
acid secretion and that they compare favorably with VP. To our knowledge, this is the first report comparing basal and stimulated
gastric acid secretion between these new acid-reducing techniques.
Received: 27 March 1996/Accepted: 17 July 1996 相似文献
56.
Yoshihiko Tsuji Hiroaki Ohue Hiroshi Ikuta Osamu Kinoshita Fumio Shibagaki 《Surgery today》1997,27(5):387-391
Between January 1985 and September 1994, 21 patients with psychiatric disorders underwent various forms of surgery at our
hospital. There were 12 men and 9 women with an average age of 57.6 years. The coexisting psychiatric disorders were schizophrenia
in 15 patients, depression in 2, dementia in 2, mental retardation with epilepsy in 1, and Parkinson's disease in 1. All the
patients had been receiving neuroleptic medications for a long period. The indications for surgery were: cholelithiasis in
6 patients, acute appendicitis in 4, perforation of the small intestine in 3, incarceration of an inguinal hernia in 2, and
esophageal cancer, stomach cancer, bleeding from a gastric ulcer, perforation of a duodenal ulcer, strangulating ileus, and
burns in 1 patient each, respectively. All of the patients who underwent elective surgery were given epidural anesthesia with
or without general anesthesia. Antipsychotic medications were given until just prior to surgery and recommenced concurrent
with the first meal. Abnormal behavior was observed in 11 patients (52.4%) postoperatively, but all the patients were discharged
in accordance with recovery from their surgical disorder. Intra- and postoperative hypotension resistant to intravenous catecholamine
administration was recognized in 9 patients (42.9%), and this peculiar complication should be borne in mind when patients
with psychiatric disorders require surgical management.
Presented at the 94th annual meeting of the Japanese Surgical Society, held in Tokyo in March, 1994 相似文献
57.
58.
在急救中心开展多发伤一体化救治分析 总被引:16,自引:5,他引:11
目的 探讨提高多发伤救治成功率的措施。方法 回顾性总结2002年6月~2003年6月间中山市急救中心开展多发伤救治的效果,分析多发伤一体化救治的模式和关键点。结果 共收治135例,抢救成功107例,成功率79.3%;死亡28例,死亡率20.7%。结论 (1)住急救中心实施多发伤一体化救治是提高其成功率的有效途径,也是多发伤救治的发展趋势,(2)在急救中心实施多发伤一体化救治的模式:急救中心设立创伤中心、建立成套的创伤急救体系,培养高素质专业人员.多发伤的诊治由急救中心医师实施或组织实施。(3)严重多发伤救治的关键点:抓好院前、院内急救——抢救生命;开展急诊手术——尽早修复损伤器官,消除致死致残因素;重视重症监护及治疗——进一步治疗原发损伤,保护各脏器功能,促进机体恢复,防止并发症。 相似文献
59.
The present paper reports 11 cases of light chain disease (LCD) sequently found in several citles over Fujian province, Immunological classification of this group of LCD ww as follows: six of me cases belonged to type λ, four of them were type κ, and another one was a double LCD. We found that LCD was common in Fujlan only next to multiple myeloma (MM) of IgG class and accounted for 20% of the total 55 MM cases found in recent yean.It to well known that In matt patients of LCD M protein or Bence Jones proteinemia (BJPemia) to not detectable by conventional electro-phoresis. Our studies show that by making serum protein along with urinary BJP electrophoresis on the same one gel plate the sltuation can be greatly Improved It not only favour* the recognition of smail and faint band or bands of free light chain in serum, but also provides a repid and sensitive way, i. e. , immunofixation, to directly detect urinary light chain on the gel plate Immediately after electrophresis has been run. 相似文献
60.
Yossi Gilgun-Sherki Yael Barhum Daphne Atlas Eldad Melamed Daniel Offen 《Journal of molecular neuroscience : MN》1996,27(1):125-135
Accumulating data from experimental studies indicate that oxidative stress has a major role in the pathogenesis of multiple
sclerosis (MS). It has been suggested that local production of reactive oxygen species, probably by macrophages, mediates
axonal damage in both MS patients and the mouse model experimental autoimmune encephalomyelitis (EAE). We have shown previously
that our novel brain-penetrating antioxidant, N-acetylcysteine amide (AD4), reduces the clinical and pathological symptoms, including inflammation and axonal damage in myelin
oligodendrocyte glycoprotein (MOG)-induced chronic EAE in mice. The aim of this study was to examine the molecular mechanism
by which AD4 exerts protection in MOG-induced EAE mice. Therefore, we analyzed gene-expression profile in the spinal cords
of MOG-induced chronic EAE mice and compared them with MOG-induced mice treated with AD4, using a cDNA microarray. We found
that MOG treatment up-regulated genes encoding growth factors, cytokines, death receptors, proteases, and myelin structure
proteins, whereas MOG- and AD4-treated mice demonstrated gene expression profiles similar to that seen in na?ve healthy mice.
In conclusion, our study shows that chronic AD4 administration suppresses the induction of various pathological pathways that
play a role in EAE and probably in MS. 相似文献