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1.
The thermolability of amylase was measured in saliva, pancreatic juice, urine, adult and neonatal sera. The mean percentage thermolability from these fluids was 100%, 99%, 87%, 44% and 23% respectively. In patients with acute pancreatitis and mumps the amylase was 84% and 83% thermolabile during the acute phase. On resolution of the pancreatitis this dropped towards normal. Patients with a pancreatic pseudocyst showed a high mean percentage thermolability (82%). These results could suggest that a component of amylase in human serum is not of pancreatic or salivary origin. In addition, this simple technique may be helpful in the diagnosis of pancreatic pseudocyst.  相似文献   

2.
We examined temperature dependency of thermodynamic parameters in the interactions between hen egg-white lysozyme (HEL) and anti-HEL antibody, D1.3, and two mutant antibodies. The DeltaH degrees values appeared to decrease biphasically in the temperature range from 10 to 45 degrees C with the apparent inflection point around 30 degrees C. The DeltaG degrees calculated from the KA values showed only small differences because of entropy and enthalpy compensation. It has been argued that large negative values of heat capacity change (DeltaCp degrees), if observed, are mainly derived from hydrophobic interactions. However, the observed DeltaCp degrees values were too high to be ascribed only to hydrophobic interactions. Moreover, addition of methanol did not cause a decrease in the absolute value of DeltaCp degrees.  相似文献   

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BACKGROUND: Early diagnosis and treatment of intra-abdominal pathology in critically ill intensive care unit (ICU) patients remains a clinical challenge. The objective of this study is to assess the feasibility of portable, bedside diagnostic laparoscopy (DL) in the ICU for patients suspected of intra-abdominal pathology, and to contrast its accuracy with diagnostic peritoneal lavage (DPL). METHODS: All adult ICU patients for whom a general surgery consultation was requested were eligible. Patients with a recent laparotomy or obvious peritonitis were excluded. All procedures were performed in the ICU. RESULTS: Over a consecutive 16-month period, 12 patients underwent DPL/DL. Ages ranged from 28 to 88 (mean, 72) years. Causative findings were disclosed by DL in five patients, (42%) including intestinal ischemia in two. Perforated diverticulitis, thickened terminal ileum, and nonpurulent peritonitis were found in one patient each. All patients with findings by DL had a positive DPL (WBC > 200 cells/mm3), and one negative laparoscopy was positive by lavage. The average length of time to perform DPL was 14 min, and to complete DL 19 min. One patient underwent laparotomy based on DPL/DL and survived along with three others with negative DPL/DL. Eight patients died (67%), four from their surgically untreated intra-abdominal pathology. One patient sustained a procedure-related complication of bradycardia and high ventilatory airway pressures. Peak airway pressures increased an average of 8 mmHg and were significantly higher (p < 0. 001) than pre-DL pressures without any significant change in end-tidal CO2 or pCO2. There were no statistically significant hemodynamic changes based on mean arterial pressure (MAP), central venous pressure (CVP), or pulmonary artery diastolic pressure (PADP). CONCLUSIONS: Bedside laparoscopy can be performed rapidly and safely in the ICU. In predicting the need for laparotomy, DL was more accurate than DPL.  相似文献   

5.
We aimed to audit nosological inaccuracies in death certification in Northern Ireland and to compare performance of hospital doctors and general practitioners. Nosology is the branch of medicine which treats of the classification of disease. 1138 deaths were registered in Northern Ireland in a 4-week period commencing 3/10/94. 195 of these were either registered by HM Coroners (HMC) or required further investigation by their staff; these cases were excluded from the study. The remaining 943 were analysed for wording and formulation inaccuracies according to the revised notes (1974), Northern Ireland Medical Certificate of Cause of Death. These are issued in book form by the Registrar of Births and Deaths. The commonest inaccuracies in death certification occur in the areas of poor terminology, sequence errors and unqualified mode. One or more inaccuracies were found in 317 (33.6%) of cases. In 13 of these (4%) cases, the inaccuracies were serious enough to warrant referral by the Registrar of Deaths to HM Coroner. The numbers of general practitioners and hospital doctors were recorded, with general practitioners being responsible for 122 (38%) and hospital doctors being responsible for 195 (62%) of inaccuracies.  相似文献   

6.
Levels of biopterin derivatives in urine, serum, milk, cerebrospinal fluid, brain, and liver have been measured with the Crithidia fasciculata assay. Normal levels in serum and urine have been given and compared with those in a number of benign and malignant proliferative disorders, phenylketonuria, kidney disease, Parkinson's disease, schizophrenia, controlled epilepsy, rheumatoid arthritis, and pernicious anaemia. The active component of Crithidia factor in serum was 7,8-dihydrobiopterin. Tissue, urine, and some serum samples contained two active materials, the principal one being 7,8-dihydrobiopterin; a minor constituent was probably tetrahydrobiopterin. Serum biopterin levels following methotrexate administration were raised and subsequent administration of folic acid and 5-formyltetrahydrofolic acid further increased serum levels of biopterin derivatives; this was in contrast to the total absence of response to oral folates without prior methotrexate and to 5-methyltetrahydrofolic acid either with or without methotrexate being given.  相似文献   

7.
Comments on Robert Carson's article titled The status of diagnostic testing (see record 2005-07925-004). The article focuses on the importance of psychodiagnostic testing states very clearly and consistently a position shared by many in our profession, but one which is predicated on a number of assumptions which--as value judgments--lack empirical validity and, in fact, serve to engender and perpetuate interprofessional rivalry, professional mediocrity, and scientific stagnation. This writer does not deny the right to hold to and express value judgments per se; rather, he wishes to suggest alternatives to those underlying Carson's argument. Three assumptions are implied in the latter: (a) the "tripartite organization" of professions, i.e., psychiatry, clinical psychology, and psychiatric social work, constitutes a satisfactory state of affairs and should endure; (b) unique contributions to the service endeavor must arise from each profession and will obtain in the case of psychology via the psychodiagnostic enterprise; and (c) the service function (treatment?) is implemented, facilitated, or benefited as a result of the psychodiagnostic activity (testing) of psychologists. The commenter responds to the assumptions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   

8.
Repeated determination for antinuclear antibody (ANA) were negative in a patient with systemic lupus erythematosus (SLE) and severe multisystem involvement including diffuse proliferative glomerulonephritis and the nephrotic syndrome. However, concentration of urinary protein, of pleural fluid and subsequently of serum revealed ANA. This case demonstrates another cause of a false negative ANA in SLE--a low concentration of the antibody in serum and loss in body fluids.  相似文献   

9.
通过冷冻-解冻循环方法制备出聚乙烯醇(PVA)水凝胶人工髓核材料,研究了其在生理盐水和Hanks溶液两种模拟体液及去离子水中的压缩蠕变性能并进行了蠕变黏弹性模型分析.PVA水凝胶在不同模拟体液中都表现出良好的黏弹性能,达到蠕变平衡的快慢和应变量大小都与体液中的离子含量有关.等时线法的研究表明,水凝胶的力学行为符合线性黏弹性行为,选取的Kelvin-Voigt模型能够很好地模拟PVA水凝胶蠕变行为.拟合结果表明:体液中的一些盐离子抑制了水凝胶内部小尺寸单元的运动,蠕变平衡时间延长;体液中的Na+盐离子会促进水凝胶内部大尺寸单元的运动,使其快速达到蠕变平衡,满足临床医学使用要求.  相似文献   

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Reports on the distribution, metabolism and origins of free D-amino acids in vertebrate tissues and body fluids are reviewed. The transient emergence of D-aspartic acid during the development of brain and peripheral organs or early stages of life is reported. D-Serine in brain is postulated to be a potentiator for the N-methyl-D-aspartate (NMDA) receptor. Some D-amino acid concentrations in human serum, such as D-Ser and D-Ala, are suggested to correlate with damage to renal function.  相似文献   

12.
Nucleophiles activated the catalytic actions of beta-galactosidases with neutral or positively charged substitutions for Glu-461. Aliphatic carboxylic acids increased the rate of hydrolysis of o-nitrophenyl beta-D-galactopyranoside if the pKa values of the carboxyl groups were > approximately 3.5. Amino compounds activated if their pKa values were < approximately 8.5. Imidazole, azide, and 2-mercaptoethanol also activated. Nucleophiles with high pKa values were able to activate the catalysis if the pH was high, and this showed that the lack of activation at pH 7.0 was because of protonation. Kinetic analysis showed that most of the nucleophiles that activated were bound to the active site, since the activation followed Michaelis-Menten type saturation kinetics. The binding seemed to be dependent upon the hydrophobicity; the longer the aliphatic chain, the stronger the binding. Gas-liquid chromatographic analysis showed that adducts of some type were formed during the reactions in the presence of many of the nucleophiles. Three of these adducts were purified and the nucleophiles were found beta-linked to D-galactose. This indicates that if an intermediate covalent bond is formed in the mechanism of beta-galactosidase action and if the nucleophile reacts to displace it, the intermediate covalent bond must have the alpha configuration and involve a group other than Glu-461.  相似文献   

13.
To determine the risk of exposure to body fluids potentially contaminated with infectious organisms we instituted a prospective study of all urological procedures performed at our institution. Urological procedures were divided into 3 categories: open, cystoscopic and endoscopic surgical (transurethral resection of the prostate or bladder tumor, ureteroscopy and percutaneous procedures). We have complete data analysis on 594 consecutive patients who underwent an operation at our institution: 77 (13%) underwent an open procedure, 75 (13%) underwent an endoscopic surgical procedure and the remaining 442 (74%) underwent cystoscopic procedures. All procedures were performed by supervised house staff using universal precautions. The operating surgeon was exposed to potentially contaminated body fluids in 173 of 594 cases overall (29%). There was exposure in 17% of all open procedures, 41% of all endoscopic surgical procedures and 29% of all cystoscopic procedures. Urologists must consider themselves at high risk for exposure to potentially contaminated body fluids and take appropriate precautions.  相似文献   

14.
An immunoaffinity capillary electrophoresis (ICE) system for rapidly quantifying recombinant cytokines in human body fluids has been developed. Cytokines within biological fluids were labeled with a red light emitting fluorochrome and injected into the capillary. Selected cytokines were captured by immobilized antibodies on the internal surface of the capillary, and held while unbound materials were purged. The cytokines were then eluted electrophoretically in acidic buffer. Individual cytokine peaks were detected by on-line laser-induced fluorescence detection coupled to a computerized fiber-optic spectrometer, and analyzed by integration of the eluted peaks. The comparison of the results of ICE to routine assays used for these cytokines demonstrates that ICE provides a fast and accurate procedure for defining these cytokines in complex biological samples. Immunoaffinity separations can be used for any material to which a specific antibody can be raised, making this procedure applicable to a wide range of molecules of biomedical interest.  相似文献   

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A gas chromatographic procedure for the determination of dimethyl sulfoxide in serum, plasma, urine, and CSF is described. Features of the method include simple sample preparation, excellent accuracy, linearity, and precision. Results obtained on patient samples following intravenous administration are presented.  相似文献   

17.
Familial dysautonomia (FD), a recessively inherited disease, has been mapped to chromosome 9q31. Highly polymorphic dinucleotide repeat markers flanking the genetic locus and at the same genetic location have been identified. We describe the prenatal diagnosis of FD using linkage and linkage disequilibrium analyses with these markers. Twelve families were analysed for informativeness and of these, seven went on to have prenatal testing (a total of eight fetuses tested). All of these fetuses were predicted to be heterozygous unaffected (FD carriers). Seven fetuses have come to term and are normal. In the absence of a recombinant proband, a panel of three proximal and three distal markers is sufficient to provide informative flanking markers and an 87-96 per cent likelihood of a highly predictive test. In an additional family at 1:4 risk for FD, no DNA was available from the propositus. This family was analysed using linkage disequilibrium to the #18 allele of the tightly linked marker D9S58 in conjunction with linkage analysis using data from two unaffected children. Prenatal diagnosis in this family indicated an affected fetus.  相似文献   

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Micalite (microcapsulated lithium carbonate with a retarded action) was used for the treatment of manic states and the prevention of attacks of manic-depressive psychosis in 40 patients. The preparation was administered once daily. This provided the necessary concentration of lithium in the blood on a stable level. According to its therapeutical effectiveness and the frequency of side-effects micalite does not differ from other lithium preparations with a simgle daily administration of micalite there are much less distubrances in the treament regime.  相似文献   

20.
In this era of evidence-based medicine, diagnostic tests cannot escape close scrutiny of their effectiveness. Sensitivity and specificity have up till now played a central role in the evaluation of diagnostic tests. These terms are not without their shortcomings when it comes to the characterisation of a test's true worth for patients. Randomised clinical trials are increasingly used for evaluation of medical tests and outlining of strategy. The indirect relationship between test results and health outcome creates additional challenges for designers of such trials.  相似文献   

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