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1.
The purpose of our study was the assessment of the diagnostic value of vacuum core biopsy, which promises high accuracy by minimally invasive percutaneous excision of 1-2 cm3 of tissue. The materials used were a digital stereotaxic biopsy table (Fischer Imaging) and a Mammotome-gun (Biopsys). A total of 236 patients with 261 predominantly indeterminate lesions (indeterminate: 230; suspicious: 26; malignant: 5) underwent vacuum core biopsy (VCB). Verification was as follows: (a) demonstration of complete or partial removal of the lesion or replacement of the lesion by a small hematoma by comparison of the pre- and post-VCB mammogram; (b) reexcision of 45 malignant and 6 borderline lesions; (c) radiologic-histologic correlation; and (d) 6-month-follow-up mammograms in 129 cases. Two VCBs were not possible because very fine microcalcifications could not be visualized. Two puncture errors occurred which, however, were immediately recognized and VCB was repeated. Based on the above verification a 100 % accuracy was achieved. No relevant side effects occurred. Except for 2 cases mammographically hardly any scarring was visible. Based on the excellent accuracy and excellent tolerance of the procedure VCB appears to be the future method of choice for the workup of those indeterminate mammographically detected lesions that up to now have still required surgical biopsy.  相似文献   

2.
This study identified factors associated with exercise participation and adherence in a sample of 102 sedentary, functionally limited, community-dwelling adults aged 60 to 94 years who participated in a home-based resistance training program. Stepwise regression analyses revealed that baseline physical factors (i.e., higher levels of mobility, weaker muscle strength, and fewer numbers of new medical conditions) were associated with higher rates of participation in the home program. Positive attitudes and a sense of control toward exercise, lower levels of confusion and depressive moods, and the development of fewer new medical problems during the program were related to higher levels of adherence to the program. Findings revealed that although physical health variables were the primary indicators of an older person's overall participation in the program, it was the psychological factors that were most important to adherence to this home-based program.  相似文献   

3.
Background spike activity of 235 cells of the integrative subcortical motor center, i.e., the ventrolateral nucleus of the thalamus, were analyzed in nonanesthetized human brains during stereotaxic surgery in patients with various forms of Parkinson's disease. Previous data on the existence of two major types of neurons with convergent properties in the ventrolateral nucleus were confirmed. These cell types are: 1) cells with irregular occasional activity, with a tendency for spikes to group into the frequency ranges 5 +/- 1 and 10-30 Hz (type A cells, 74%), and 2) cells with constant rhythmic (3-6 Hz) generation of short volleys of discharges, with an interval structure similar to that of low-threshold Ca(2+)-dependent volley activity (type B, 26%). This is the first report demonstrating that changes in the functional state of the brain (after repeated movement trials, in transient anesthesia) are accompanied by transiently occurring transformations of the initial irregular activity of A cells into a rhythmic, volley-like pattern whose interval structure was in some cases similar to the spike activity of B cells. Differences in the localizations of A and B neurons in the ventrolateral nucleus are described, along with differences in the correlation characteristics of their background spike activity with the pathological features of Parkinson's disease (tremor, rigidity). The nature of the two types of convergent neurons in the ventrolateral nucleus is discussed, and a basis is laid for the importance of the functional factor in understanding the transformation of their background spike activity, due to the properties of cell membranes and intercellular and interstructure interactions in conditions of the living nonanesthetized human brain.  相似文献   

4.
An ELISA sandwich for the detection of Giardia lamblia antigens in human faeces was standardized. 175 samples were studied: 77 positive, 61 negative to cysts and/or trophozoites by direct faeces test, and 19 positive to other parasite different from G. lamblia. The sensitivity of the technique was 94.8% and the specificity 98.3%. The method detects an antigen concentration of 31 ng. The procedure is simple, sensitive and specific so, it may be useful for diagnosis and in epidemiological studies.  相似文献   

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Structural and functional neuroimaging techniques have consistently demonstrated that abnormal lateralization of temporal lobes may be important in identifying the pathophysiologic processes in schizophrenia. The exact nature of these reported abnormalities has not been consistent. METHODS: We examined temporal lobe perfusion using HMPAO-SPECT in 22 individuals with schizophrenia in an effort to establish whether temporal lobe perfusion asymmetry is seen in these individuals, as compared to a group of 22 age- and sex-matched controls. RESULTS: We found that the asymmetry index, a measure of perfusion differences between two homologous compared areas, was lower (more negative) in schizophrenic individuals. The asymmetry indices of patients considered with the results from globally corrected ROI means indicated that the left temporal lobes of individuals with schizophrenia were significantly hypoperfused when compared to controls. This finding does not appear to be caused by medication effects, demographic variables, handedness, imaging artifacts or analysis techniques. CONCLUSION: In our sample, patients with schizophrenia appear to have significant left hypoperfusion relative to right of their temporal lobes. Abnormal lateralization of temporal lobe blood flow may have important clinical implications by assisting with diagnosis and appropriate treatment for individuals with schizophrenia.  相似文献   

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To explore whether the metabolic responses to trans, compared with cis, fatty acids depend on the source of dietary polyunsaturated fatty acids (PUFA), male Sprague-Dawley rats, 5 weeks old, were fed on diets containing 30 g oleic (cis) or elaidic (trans) acids/kg in combination with either 70 g perilla oil (alpha-linolenic acid) or safflowerseed oil (linoleic acid)/kg for 3 weeks in separate experiments. The dietary fats were adjusted to have the same level of total PUFA. The dietary manipulation did not influence the growth indices, but spleen weight was greater when the dietary PUFA source was perilla oil. The incorporation of trans fatty acid into liver phosphatidylcholine, phosphatidylethanolamine, phosphatidylinositol and phosphatidylserine and adipose tissue lipids, particularly phospholipids, was significantly higher when rats were fed on safflowerseed oil compared with perilla oil. However, only limited differences were observed in the effects of cis and trans fatty acids on the proportions of PUFA in liver phospholipids. Splenic production of prostaglandin E2 was reduced by trans fatty acid when safflowerseed oil was the PUFA source, but no trans effect was observed on leukotriene C4 production. Dietary PUFA significantly influenced the concentration of plasma immunoglobulins (Ig) but the effect of geometry was only seen in IgG which was increased by trans acid. Dietary trans fatty acid increased the CD4+:CD8+ T-lymphocyte ratio in the spleen, reflecting a decreasing trend of the proportion of CD8+, when combined with perilla oil. These observations indicate that the type of PUFA simultaneously ingested specifically influences the effect that trans acid exerts on PUFA metabolism, eicosanoid production and some immune indices.  相似文献   

10.
The effects of alpha-linolenic acid (ALA, 18:3n-3), eicosapentaenoic acid (EPA, 20:5n-3), and docosahexaenoic acid (DHA, 22:6n-3) on hemostatic factors were compared. Healthy subjects (29 women and 17 men aged 20-44 y) received either linseed oil (average ALA intake: 5.9 g/d) or fish oil plus sunflower oil (average EPA + DHA intake: 5.2 g/d) for 4 wk. The supplemented amount of fat was 1.19 mg/kJ (1 g/200 kcal) calculated energy expenditure. Stability of habitual diets was monitored. Blood samples were collected at baseline, at the end of the experimental period, and after a 12-wk follow-up period. Different changes in the study groups were seen only in serum cholesterol and triacylglycerols, platelet fatty acid composition, and ADP-induced platelet aggregation. The treatments did not differ in their effects on collagen-induced platelet aggregation and thromboxane production, aggregation to the thromboxane A2 mimic I-BOP, urinary excretion of 11-dehydro-thromboxane B2 and beta-thromboglobulin, bleeding time, plasma fibrinogen concentration, antithrombin III activity, factor VII coagulant activity, or activity of plasminogen activator inhibitor 1. The results indicate that supplemented ALA from vegetable oil and EPA and DHA from a marine source have largely parallel effects on hemostatic factors.  相似文献   

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The present study was undertaken to characterize the effects of ursodeoxycholic acid on biliary lipid metabolism in man. Fifteen gallstone patients were treated with ursodeoxycholic acid at a daily dosage of 15 mg per kg body weight for about 4 weeks before cholecystectomy. At operation a liver biopsy, together with gallbladder and hepatic bile, were obtained. Eighteen untreated gallstone patients undergoing cholecystectomy served as controls. During treatment with ursodeoxycholic acid, hepatic bile became unsaturated with cholesterol in all patients investigated. The total biliary lipid concentration remained unchanged. The hepatic cholesterol concentration decreased by about 20%. No significant change in the microsomal HMG CoA reductase activity was observed (38.5 +/- 6.7 pmol . min-1 . mg protein-1 vs 38.3 +/- 4.7 pmol . min-1 . mg protein-1 in the controls; means +/- SEM). Plasma concentrations of total cholesterol were reduced by about 10%, and those of high density lipoprotein (HDL) and low density lipoprotein (LDL) cholesterol by about 15%. Plasma triglyceride levels remained essentially unchanged during treatment. We conclude that, similar to chenodeoxycholic acid therapy, ursodeoxycholic acid treatment results in unsaturation of fasting hepatic bile. In contrast to the changes seen during chenodeoxycholic acid feeding, however, the unsaturation of hepatic bile during ursodeoxycholic acid treatment is not primarily related to a decreased hepatic HMG CoA reductase activity. Furthermore, while chenodeoxycholic acid tends to increase plasma LDL levels, such changes are not seen during ursodeoxycholic acid treatment.  相似文献   

13.
To clarify the clinical features of nosocomial pneumonia during mechanical ventilation (ventilator-associated pneumonia) and to select the appropriate antibiotic therapy for patients, we performed a clinical analysis of 19 patients (26 episodes) with this condition. The following results were obtained. 1, The average age of the patients was 68 years old (male 16, female 3). 2, VAP occurred three times in 2 cases, twice in 3 cases, and once in 14 cases. 3, The duration of mechanical ventilation was from 7 days to 11 years and 5 months (the average was 2.1 years). 4, The microorganism isolated from the aspiration sputum of the VAP patients was Pseudomonas aeruginosa frequently, but it was difficult to determine whether this microorganism was the causative microorganism. Ten strains of Staphylococcus aureus (MRSA seven strains and MSSA three strains) were newly isolated at the same time as VAP and especially in the cases in which these were thought to be causative microrganisms, all the patients died within a short time. 5, Antibiotics were clinically effective for 53.8% of all the VAP patients and carbapenem antibiotics (for example, IPM/CS) were also used for the effective group. 6, Regarding the risk factors for VAP, factors such as the duration of mechanical ventilation, the existence of chronic obstructive pulmonary disease, a hyponutritional state, prior antibiotics, aspiration of gastric contents, histamine-type-2 receptor antagonist, and multiple organ failure showed significant differences and were suspected to be associated with the appearance of VAP.  相似文献   

14.
Total lipid, free and esterified cholesterol and triglycerides significantly increase in concentration with increasing age. Palmitic, palmitoleic, oleic and linoleic acid behave in the same way. Free fatty acids, phospholipids and stearic acid show the same concentrations in all groups of age. C20 fatty acids demonstrate a competitive regulatory mechanism of desaturase activity in their age dependant distribution. While the 20:3(n-9), a product of the endogenous (n-9) family, increases, the 20:3(n-6) and 20:4(n-6), both desaturation and chain elongation products of the essential n-6 family, decrease. Such behavior has been demonstrated in many feeding studies (12, 13, 15, 16, 17, 29) and is interpreted as a result of competitive substrate interaction on desaturase activity.  相似文献   

15.
Essential fatty acid metabolism is impaired by diabetes mellitus and this may be important in the aetiology of peripheral nerve dysfunction. The effects of gamma-linolenic acid (omega-6) and fish oil (omega-3) alone, and in combination, on nerve function and capillarization were examined in 2-month streptozotocin-diabetic rats. Diabetes resulted in approximately 15% and 23% decreases in saphenous sensory and sciatic motor nerve conduction velocities, respectively (p < 0.001). Motor and sensory conduction velocities were in the non-diabetic range after both preventive and reversal omega-6 treatment of diabetic rats (p < 0.001). No significant changes occurred in omega-6 treated non-diabetic rats. Preventive omega-3 treatment was largely ineffective. Reversal treatment with a combination of omega-6 and omega-3 fatty acids was marginally effective and improved motor (p < 0.05), but not sensory conduction velocity. In vitro measurement of sciatic nerve resistance to hypoxic conduction failure in diabetic rats revealed a 56% increase in the time taken for the compound action potential amplitude to be reduced by 80% (p < 0.01) compared to non-diabetic rats. This was partially prevented by omega-6 treatment (29% increase, p < 0.01). Reversal omega-6 treatment had a lesser effect (37% increase, p < 0.05 compared to untreated diabetic rats). omega-3 treatment had no significant effect on conduction failure time. Sciatic endoneurial capillary density increased by 11% with preventive omega-6 treatment (p < 0.05), but was unaffected by reversal omega-6 and by omega-3 treatments.(ABSTRACT TRUNCATED AT 250 WORDS)  相似文献   

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In vitro 30 min of incubation with selenomethionine (Sm) + vitamin E multiplied by about five platelet selenium (Se) decreased significantly platelet thrombin and ADP-induced aggregation decrease. Four groups of streptozotocin-induced diabetic rats were fed with a supplemented purified diet with an Se-rich yeast (Selenion): DSel, Sm: DSm, Sm alpha-tocopherol: DSmE or unsupplemented diet: D. After 24 wk of supplementation, only a decrease in thrombin-induced aggregation in group DSel compared to DSm and DSmE and D was observed. However, after 24 wk of diet compared to 14 wk, in group D and DSm, a significant increase in thrombin-induced aggregation occurred (p < 0.0001), whereas a significant decrease in groups DSel and DSmE (p < 0.0001, p < 0.03) was noted. After 21 wk of diet, in DSmE, platelet adhesion to fibronectin was significantly decreased compared to group D (p < 0.05). These changes in DSmE were associated with a significant decrease in platelet sorbitol (p < 0.02) and a very significant increase in platelet Se (p < 0.0005). Sm associated with vitamin E would appear more efficient to prevent oxidative damage of diabetic platelet membrane and thus to modulate its hyperactivity.  相似文献   

18.
The physiopathology of experimental cerebral malaria (CM), an acute neurological complication of Plasmodium berghei ANKA (PbA) infection, involves interferon-gamma (IFN-gamma) and tumour necrosis factor-alpha (TNF-alpha), two cytokines that are known to modulate major histocompatibility complex (MHC) molecule expression. The aim of this study was to evaluate whether the genetic susceptibility to CM is related to the constitutive or IFN-gamma-induced expression of MHC molecules on brain microvessels. To this end, brain microvascular endothelial cells (B-MVEC) were isolated from CM-susceptible (CM-S, CBA/J) and resistant (CM-R, BALB/c) mice. By flow cytometry, we found that less than 5% of CM-S B-MVEC constitutively expressed MHC class I molecules, in contrast to up to 90% of CM-R B-MVEC. Upon stimulation with IFN-gamma, the percentage of positive cells for MHC class I molecules in CM-S B-MVEC became comparable to CM-R B-MVEC, but a higher fluorescence intensity existed on CM-S B-MVEC compared with CM-R B-MVEC. MHC class II molecules were not constitutively expressed on B-MVEC from either strain. IFN-gamma-induced expression of MHC class II (I-A, I-E) molecules was significantly higher in CM-S than CM-R B-MVEC both in percentage of positive cells and fluorescence intensity. These data demonstrate that absent or low MHC class I and higher inducibility of MHC class II expression on B-MVEC are associated with the genetic susceptibility to CM.  相似文献   

19.
Thirty beagles were placed on diets containing ratios of n-6 to n-3 fatty acids ranging from 5:1 to 100:1 for 12 weeks to determine the effects of these diets on platelet reactivity, coagulation screening assays, and antithrombin III activity. Although small changes were observed in adenosine diphosphate (ADP)-, collagen-, and arachidonic acid-induced platelet aggregation and 14C-serotonin release, fibrinogen concentrations, and antithrombin III activities during the 12-week study, these changes were not of clinical significance and did not correlate with the varying ratios of n-6 to n-3 fatty acids.  相似文献   

20.
We introduce an assay to measure complexed alpha 1-antichymotrypsin in human plasma. The assay works on the principle that the target proteinase cathepsin G has a very high affinity to the surface of microtiter plates, even if these surfaces are blocked with albumin and Tween 20. alpha 1-Antichymotrypsin, when complexed to cathepsin G, is thus immobilized and can be detected with specific antibodies. The mean (SD) concentration of alpha 1-antichymotrypsin in 50 healthy individuals was 1.73 (0.58) nmol/L. The detection limit was 0.84 nmol/L. The results of the assay are linear to at least 14 nmol/L. We propose to use this assay for diseases in which increased turnover of alpha 1-antichymotrypsin or cathepsin G can be expected to clarify further the function of this enzyme-inhibitor system.  相似文献   

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