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1.
H. D. Tagare K. W. Elder D. M. Stoner R. M. Patterson C. L. Nicodemus S. F. Viegas Dr. G. R. Hillman 《Annals of biomedical engineering》1993,21(6):715-726
The carpal regions of ten cadaver extremities were imaged by CT. The images were combined into a 3-dimensional model of the
carpus using a technique based on a dynamic programming algorithm to find an optimal estimate of the location of the bone
boundaries in the CT images. The resulting set of surface points on each bone was used to compute volumes and principal and
antipodal axes for the bones. A spatial coordinate system was established based on the positions of the centroids of three
bones in the distal carpal row. The angular orientations of all carpal bones were determined with respect to this system.
The principal axes for the same bone among ten wrist specimens proved to be more widely dispersed than the antipodal axes
for the same bones. The antipodal axes also correspond more closely to an intuitive notion of the “longest axis” of the bones.
We conclude that the antipodal axis is a more reliable and useful measure of bone orientation than the principal axis. 相似文献
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3.
Benign intracranial hypertension and recombinant growth hormone therapy in Australia and New Zealand
PA Crock JD McKenzie AM Nicoll NJ Howard W Cutfield LK Shield G Byrne 《Acta paediatrica (Oslo, Norway : 1992)》1998,87(4):381-386
Benign intracranial hypertension (BIH) is reported in three children from Australia and one from New Zealand, who were being treated with recombinant human growth hormone (rhGH). Three males and one female, aged between 10.5 and 14.2 y, developed intracranial hypertension within 2 weeks to 3 months of starting treatment. A national database, OZGROW, has been prospectively collecting data on all 3332 children treated with rhGH in Australia and New Zealand from January 1986 to 1996. The incidence of BIH in children treated with growth hormone (GH) is small, 1.2 per 1000 cases overall, but appears to be greater with biochemical GHD (<10IUml -1 ), i.e. 6.5/1000 (3 in 465 cases), relative risk 18.4, 95% confidence interval 1.9-176.1, than in all other children on the database. The incidence in patients with Turner's syndrome was 2.3/1000 (1 in 428 cases). No cases in patients with partial GHD (10–20 IUml -1 ) or chronic renal failure were identified. Possible causative mechanisms are discussed. The authors'practice is now to start GH replacement at less than the usual recommended dose of 14IUm-2 week-1 in those children considered to be at high risk of developing BIH. Ophthalmological evaluation is recommended for children before and during the first few months following commencement of rhGH therapy and is mandatory in the event of peripheral or facial oedema, persistent headaches, vomiting or visual symptoms. The absence of papilledema does not exclude the diagnosis. 相似文献
4.
Non-operative management of malignant intestinal obstruction 总被引:1,自引:0,他引:1
W H Isbister P Elder L Symons 《Journal of the Royal College of Surgeons of Edinburgh》1990,35(6):369-372
Intestinal obstruction is a relatively common clinical problem in patients with advanced cancer, particularly those with colorectal and ovarian tumours. A proportion of patients have a non-malignant cause for their obstruction, but in the remaining patients obstruction will be caused by advanced malignancy itself. In the past, most patients were either managed surgically or by nasogastric intestinal decompression and intravenous hydration. Surgery in patients with advanced cancer is associated with high mortality and morbidity. Effective surgical decompression is difficult. We have managed 24 patients with advanced abdominal malignancy and previous operative or radiological evidence of intestinal obstruction without operation. The technique is only appropriate for patients in whom a solitary or correctable obstructing lesion can be excluded. The patient is encouraged to take free fluid and a diet low in fibre. Intestinal colic is managed with morphine, the dose required being titrated for each individual patient against background pain and colic. Vomiting is controlled by the parenteral administration of antiemetic drugs. To simplify drug administration, morphine and metoclopramide are mixed in the same syringe and infused subcutaneously simultaneously. In our 24 patients the mean survival rate after the onset of complete obstruction was 29.2 days. The mean dose of morphine infused was 9.2 mg/h, and the mean dose of metoclopramide was 6.9 mg/h. The case of an 82-year-old male patient is presented. We commend the technique to surgeons contemplating surgery in these very difficult patients. It is simple, relatively non-invasive and saves the patients the pain, discomfort and complications of unproductive surgery. 相似文献
5.
Growth and invasion of human melanomas in human skin grafted to immunodeficient mice. 总被引:8,自引:3,他引:5 下载免费PDF全文
I. Juhasz S. M. Albelda D. E. Elder G. F. Murphy K. Adachi D. Herlyn I. T. Valyi-Nagy M. Herlyn 《The American journal of pathology》1993,143(2):528-537
An orthotopic model of human melanoma was developed in which malignant cells were injected into human skin grafted to nude and SCID mice. Melanoma cells proliferated and invaded the human skin grafts with characteristic patterns. Three of six melanomas grew as multiple nodules and infiltered the grafts without major architectural changes in the dermis, whereas the others invaded the dermis along collagen fibers with prominent endothelial vessels. By contrast, melanoma cells inoculated into mouse skin grew as diffusely expanding nodules that did not invade the murine dermis. In human skin grafts, human melanoma cells were angiogenic for human blood vessels, and murine vessels were only found at the periphery of grafts. Tumor cells invaded the human vessels, and four out of seven cell lines metastasized to lungs, suggesting that this model is useful to determine in vivo the interactions between normal and malignant human cells. 相似文献
6.
S R Dager A Khan D Cowley D H Avery J Elder P Roy-Byrne D L Dunner 《Psychopharmacology bulletin》1990,26(3):273-278
Mixed-panic disorder patients (16/60, 27%) randomly assigned to receive blind placebo during a 40-week treatment study were defined as placebo responders based on combined criteria of Hamilton Anxiety Scale score percentage decreases below the median point (-42%), moderate to marked improvement on both clinician and patient Clinical Global Impressions scores, and panic-free at final treatment visit. These criteria applied separately also resulted in a similar clinical grouping and pattern of response. Differential patterns of response between responders and nonresponders occurred across most clinical measures of panic/anxiety. Responders experienced early improvement within the first week of double-blind treatment. This response progressed during treatment and tended to persist during taper and at followup 1 month later. Post-hoc analysis of demographic and clinical features at entrance into the study failed to characterize this stringently defined group of placebo responders. 相似文献
7.
8.
Mitral balloon valvuloplasty for patients aged over 70 years: an alternative to surgical treatment 总被引:1,自引:0,他引:1
We report the results and one-year follow-up of 20 elderly patients (age range 70-82 years) with severe rheumatic mitral stenosis treated by mitral balloon valvuloplasty (MBV). All 20 were breathless at rest despite treatment with diuretics and digoxin. At cardiac catheterization, successful dilatation was achieved in 17 patients: mean transvalvular mitral gradient fell by 45%, mean cardiac output rose by 24% and mean valve area increased by 76%. There was no procedure-related mortality. At one month, 15 patients had experienced an improvement in symptoms of at least one New York Heart Association class and, at one year, ten had maintained this improvement. Three patients proceeded to mitral valve replacement because of a suboptimal symptomatic result. Mitral balloon valvuloplasty can be successfully performed with significant symptomatic benefit in frail elderly patients unfit for surgery and may also be offered to other selected elderly patients as an alternative to surgical treatment. 相似文献
9.
J R Elder 《Australian and New Zealand journal of ophthalmology》1987,15(4):325-328
Office-based intraocular surgery has been carried out for three years and over 1400 procedures have been performed. There have been no systemic complications or infections. The establishment of an office-based facility is a complex venture. Apart from medicolegal, ethical and financial considerations there are regulations relating to structural requirements, sterilisation of instruments, air-conditioning, electrical hazards and other technical matters. Office-based surgery is convenient for both the patient and the surgeon. The patient remains calm and relaxed from the time of initial counselling to the end of postoperative convalescence. We have borrowed systems used in the United States for management of ambulatory surgical patients, in particular the counselling techniques. This, in our opinion, has been a significant factor for calm relaxed surgery. Patient acceptance and preference for ambulatory surgery will ensure that it is here to stay. A case can be made out for an economic and ethical obligation for this form of surgery to be implemented on a more widespread basis. It is not, however, the universal solution to ocular surgery. There are still specific indications and contraindications, in terms of both the doctor and the patient. At a time when government involvement is being felt more and more in the practice of medicine, any proven alternative method of health care delivery, provided entirely by the private sector, must be worthy of serious consideration. 相似文献
10.