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1.
The initial management of bladder outflow obstruction typically related to benign prostatic hyperplasia (BPH) falls to a large extent within the remit of general practice. Referral onwards to secondary care typically arises following the failure to respond to conservative measures or when complications have supervened; the most significant of which is urinary retention. In the hospital setting, anaesthesia, constipation and immobility are the common precipitants. What follows is a practical guide to the management of these situations and provides an overview of the conservative, medical, minimally invasive and surgical treatments available. 相似文献
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C. Schwartz A. Raye R. Petit 《European journal of orthopaedic surgery & traumatology : orthopedie traumatologie》1997,7(2):115-118
Summary 51 cases of repeat hip replacement have been reviewed, using allografts for acetabular bone loss, stages 2 and 3 (27 lyophilised and 24 deep-frozen). Mean follow-up was 4 years. Loosening was the reason for intervention; 14% of cases were septic. Massive grafts were used in 75% of cases and smaller grafts in 25% of cases. In addition a reinforcement ring was necessary in 75% of cases. Merle d'Aubigné's rating scale was used to assess results. The radiologic assessment score was that of Gross and De Lee.There was no difference between lyophilised and deep-frozen grafts. Clinical scores found 55% of excellent results; 11% were poor, the rest were good or fair. Stability was more troublesome than pain. Radiologic screening showed union between graft and host in 53% of cases but in 41% there was incomplete fusion. In the non-weight-bearing area bone lysis appeared in 14 cases out of 20. Five cases were complete failures; four of these were infected and were reoperated, the bone-graft acting as a foreign body.To date, we have no better bone replacement material than allografts. Fixation of the graft must be secure. An infected hip is not a good indication for this type of operation. Clinical results are satisfactory in more than 80% of cases, although 40% of grafts seem to be incompletely integrated. 相似文献
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Background
There is currently an unprecedented expressed need and demand for estimates of maternal mortality in developing countries. This has been stimulated in part by the creation of a Millennium Development Goal that will be judged partly on the basis of reductions in maternal mortality by 2015. 相似文献6.
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The CTLA-4 gene region of chromosome 2q33 is linked to, and associated with, type 1 diabetes. Belgian Diabetes Registry 总被引:8,自引:1,他引:8
Nistico L; Buzzetti R; Pritchard LE; Van der Auwera B; Giovannini C; Bosi E; Larrad MT; Rios MS; Chow CC; Cockram CS; Jacobs K; Mijovic C; Bain SC; Barnett AH; Vandewalle CL; Schuit F; Gorus FK; Tosi R; Pozzilli P; Todd JA 《Human molecular genetics》1996,5(7):1075-1080
Susceptibility to autoimmune insulin-dependent (type 1) diabetes mellitus
is determined by a combination of environmental and genetic factors, which
include variation in MHC genes on chromosome 6p21 (IDDM1) and the insulin
gene on chromosome 11p15 (IDDM2). However, linkage to IDDM1 and IDDM2
cannot explain the clustering of type 1 diabetes in families, and a role
for other genes is inferred. In the present report we describe linkage and
association of type 1 diabetes to the CTLA-4 gene (cytotoxic T lymphocyte
associated-4) on chromosome 2q33 (designated IDDM12). CTLA-4 is a strong
candidate gene for T cell- mediated autoimmune disease because it encodes a
T cell receptor that mediates T cell apoptosis and is a vital negative
regulator of T cell activation. In addition, we provide supporting evidence
that CTLA-4 is associated with susceptibility to Graves' disease, another
organ- specific autoimmune disease.
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