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1.
Van Landeghem G; Haese P; Lamberts L; Barata J; DeBroe M 《Nephrology, dialysis, transplantation》1997,12(8):1692-1698
Background: The association between aluminium and
dialysis encephalopathy and deterioration of the neurological state during
desferrioxamine treatment of dialysis patients is well established. At
present little is known about the speciation and the mechanisms underlying
the element's neurotoxicity. Methods. Aluminium speciation was performed in
cerebrospinal fluid samples of acutely aluminium-intoxicated dialysis
patients using a recently developed high-performance liquid
chromatographic/electro-thermal atomic absorption spectrometric hybrid
method. Results: Baseline cerebrospinal fluid
aluminium levels of samples taken shortly after the intoxication were low
but elevated (5.0±2.0 &mgr;g/l, n=3) as compared to subjects
with normal renal function (<1 &mgr;g/l). In contrast to the
situation noted in serum and to the iron speciation in cerebrospinal fluid,
aluminium was not bound to transferrin but appeared as two distinct
compounds, the main fraction eluting at the elution volume of aluminium
citrate/silicate. The second compound was not identified. Forty-four hours
after desferrioxamine administration the cerebrospinal fluid aluminium
levels had increased up to a concentration of 10.3±2.5
&mgr;g/l (n=3). This was accompanied by a change in the speciation
profile with aluminium appearing at the elution volume of aluminoxamine.
Conclusion: Our findings may contribute to a better
understanding of the neurotoxic effects of aluminium and its
desferrioxamine chelate in dialysis patients. 相似文献
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3.
International primary care classifications: the effect of fifteen years of evolution. 总被引:6,自引:0,他引:6
To better understand the development of primary care classifications over the past 15 years, 10 primary care databases have been retrospectively analysed using the structure of the International Classification of Primary Care (ICPC) as the basis. All datasets were based on routine data collection using different classification systems by several family physicians during all encounters with their patients over considerable periods of time, in most cases one year. The prevalences or the rates of the available diagnostic--and reason for encounter--classes were distributed over four frequencies. With a few exceptions the distribution of diagnostic labels referring to common diseases is surprisingly similar. The use of ICPC however results in a quantum leap in the use of symptom and complaint diagnoses. Because of this shift primary care physicians now have available a classification with 400 diagnostic classes used with a prevalence of > or = 1/1000 patient-years or per 1000 visiting patients per year. The classification of reasons for encounter allows the physician to identify over 300 reasons for encounter used > or = 1/1000 patient years or per 1000 visiting patients per year. Family physicians have been successful in the development of new primary care classifications. Rag bag rubrics which are the result of the structure of ICPC are used relatively often and deserve more attention from primary care taxonomers. 相似文献
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Anulus fibrosus in bulging intervertebral disks 总被引:1,自引:0,他引:1
In this investigation the association of radial tears of the anulus fibrosus and bulging of the intervertebral disk was studied. An index of disk bulging was measured in sagittal anatomic sections in 149 lumbar disks from 31 cadavers. The indexes of disk bulging were correlated with stages of disk development and the presence of an annular tear. The largest disk-bulging indexes were always associated with radial tears of the anulus. Eighty-four percent of the disks with radial tears had disk-bulging indexes greater than 2.5 mm. Most normal adult disks had an index of less than 2.5 mm. The results challenge the concept that the anulus fibrosus is intact in bulging disks, although ruptured in herniated disks. 相似文献
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F. Jockenhövel S. Lederbogen T. Olbricht H. Schmidt-Gayk E. P. Krenning S. W. J. Lamberts D. Reinwein 《Journal of molecular medicine (Berlin, Germany)》1994,72(2):127-133
A 52-year-old female with metastatic glucagonoma secreting glucagon and chromogranin A was treated with the somatostatin analogue octreotide for 2 years without any additional tumor-reducing interventions. Before therapy plasma glucagon was above 8 g/l (normal <0.2) and within 2 days 3 × 200 g octreotide daily suppressed plasma glucagon to 2.2–2.5 g/l. Concomitantly, chromogranin A dropped from 0.85 mg/l (normal <0.1) to 0.2. After 3 weeks the preexisting disabling necrolytic migratory erythema had vanished completely, and weight loss was temporarily stopped. During therapy chromogranin A and plasma glucagon rose, exceeding pretreatment levels after 3 and 14 months, respectively. After 1 year the erythema recurred, responding only transiently to increasing doses of octreotide. The patient died after 2 years of therapy of tumor cachexy despite very highdosesof octreotide (4 × 600 g/day). Throughout treatment octreotide did not prevent tumor growth, as demonstrated by computed tomography and sonography. Determination of immunoreactive glucagon before and during octreotide therapy in fractions of plasma samples subjected to gel chromatography revealed a reduction in the ratio of glucagon to preproglucagon from 1.83 (before) to 0.56 (during therapy), indicating inhibition of posttranslational processing of preproglucagon by octreotide, thereby reducing circulating bioactive glucagon. In summary, octreotide induced a remission of clinical symptoms by inhibiting posttranslational conversion of preproglucagon to glucagon but did not prevent tumor growth. Therefore, octreotide is a valuable therapy for rapid relief of clinical symptoms, thereby improving the possibilities for other tumor-reducing therapies.Abbreviations CGA
chromogranin A
- IRG
immunoreactive glucagon
- OC
octreotide
Correspondence to: D. Reinwein 相似文献
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