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1.
During recent years, the former Soviet states have witnessed enormous social and cultural changes, which have also greatly influenced the field of mental health, including psychotherapy. In this article, the historical backgrounds of Russian psychotherapy and its current practice are described. Psychotherapy in Russia and in Western countries share common roots, but have developed into different directions during the 70 years of Soviet regime. In more recent years, they have begun to slowly converge again. In the West, a trend away from insight-oriented, nondirective psychotherapy is taking place in favor of more directive approaches, aimed at changing overt behavior. In contrast, there is a tendency for therapies in Russian-speaking countries to become gradually less directive and authoritarian. In these countries there is an increasing interest in psychodynamic, insight-oriented therapies.  相似文献   

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In the present multi-center study, non-submerged ITI implants were prospectively followed to evaluate their long-term prognosis in fully and partially edentulous patients. In a total of 1003 patients, 2359 implants were consecutively inserted. Following a healing period of 3-6 months, the successfully integrated implants were restored with 393 removable and 758 fixed restorations. Subsequently, all consecutive implants were documented annually up to 8 years. At each examination, the clinical status of all implants was evaluated according to predefined criteria of success. Therefore, the data base allowed the evaluation of 8-year cumulative survival and success rates for 2359 implants. In addition, cumulative success rates were calculated for implant subgroups divided per implant type, implant length, and implant location. Furthermore, the actual 5-year survival and success rates could be determined for 488 implants. During the healing period, 13 implants did not successfully integrate, whereas 2346 implants fulfilled the predefined criteria of success. This corresponds with an early failure rate of 0.55%. During follow-up, 19 implants were classified as failures due to several reasons. In addition, 17 implants (approximately 0.8%) demonstrated at the last annual examination a suppurative periimplant infection. Including 127 drop out implants (= 5.4% drop out rate) into the calculation, the 8-year cumulative survival and success rates resulted in 96.7% and 93.3%, respectively. The analysis of implant subgroups showed slightly more favorable cumulative success rates for screw type implants (> 95%) compared to hollow-cylinder implants (91.3%), and clearly better success rates for mandibular implants (approximately 95%) when compared to maxillary implants (approximately 87%). The actual 5-year survival and success rates of 488 implants with 98.2% and 97.3%, respectively, were slightly better than the estimated 5-year cumulative survival and success rates of 2359 implants indicating that the applied life table analysis is a reliable statistical method to evaluate the long-term prognosis of dental implants. It can be concluded that non-submerged ITI implants maintain success rates well above 90% in different clinical centers for observation periods up to 8 years.  相似文献   

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BACKGROUND: Atrial fibrillation (AF) is the most common arrhythmia after open heart surgery. Traditional treatment with a range of antiarrhythmic drugs and electrical cardioversion is associated with considerable side effects. The aim of this study was to examine the feasibility and efficacy of low-energy atrial defibrillation with temporary epicardial defibrillation wire electrodes. METHODS AND RESULTS: Epicardial defibrillation wire electrodes were placed at the left and right atria during open heart surgery in 100 consecutive patients (age 65+/-9 years; male to female ratio 67:23). Electrophysiological studies performed postoperatively revealed a test shock (0.3 J) impedance of 96+/-12 omega (monophasic) and 97+/-13 omega (biphasic). During their hospital stay, AF occurred in 23 patients (23%) at 2.1+/-1.3 days postoperatively. Internal atrial defibrillation was performed in 20 patients. Of these patients, 80% (16/20) were successfully cardioverted with a mean energy of 5.2+/-3 J. Early recurrence of AF (< or =60 seconds after defibrillation) developed in 8 patients. Five patients had multiple episodes of AF. In total, 35 episodes of AF were treated, with an 88% success rate. Only 6 patients (30%) required sedation. No complications were observed with shock application or with lead extraction. CONCLUSIONS: Atrial defibrillation with temporary epicardial wire electrodes can be performed safely and effectively in patients after cardiac operations. The shock energy required to restore sinus rhythm is low. Thus, patients can be cardioverted without anesthesia.  相似文献   

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The use of an HLA-compatible unrelated donor is an option for patients who require an allogeneic transplant but lack a family member match. Grafts from unrelated volunteer donors have provided long-term disease-free survival for a variable proportion of patients, depending on degree of HLA matching with the donor, patient's disease, disease stage, and age. The number of volunteers in marrow donor registries worldwide has increased to more than 2.5 million. The number of unrelated donor transplants facilitated by the US National Marrow Donor Program alone will exceed 900 this year. Progress in HLA-typing technology results in a more precise definition of donor and recipient matching and new assays have been developed with initial success to measure alloreactive T-cell precursors for selection of donors with less antihost reactivity. Prevention and treatment of graft failure, graft-versus-host disease, opportunistic infections, and Epstein-Barr virus-associated lymphoproliferative disease remain a challenge.  相似文献   

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One hundred and seventeen of 270 (43%) recipients of organs obtained from donors with malignancies had evidence of transmitted cancers. In 9 instances these were removed from renal allografts immediately prior to transplantation. Including these cases there were 45 recipients of organs in which a neoplasm involved the allograft, 6 others in whom adjacent structures were invaded, and another 66 patients who had distant metastases. Precautions to prevent cancer transmission include meticulous preoperative screening of donors, careful examination of all organs at the time of harvesting, biopsy of any suspicious lesions, and routine donor autopsy, if possible.  相似文献   

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Aspergillus fumigatus grown in submerged and surface cultures was extracted, and the extracts were analyzed separately. The submerged extract contained 31.9% protein and 8.3% carbohydrate, while the corresponding values were 17.0% and 33.3% for the surface material. With individual sera from patients with allergic asthma, SDS-PAGE combined with immunoblotting revealed that the submerged extract contained at least six strong IgE-binding components (20, 30, 38, 50, 68, and 90 kDa) in addition to several weak to medium IgE-binding components. The surface extract contained about the same number of IgE-binding components, but only one gave a strong reaction (20 kDa). The allergens present were shown to have pI between 4.5 and 5.6 as demonstrated by isoelectric focusing (IEF) combined with immunoblotting. For identification of A. fumigatus glycoprotein allergens, both extracts were treated with periodate under mild conditions. Two allergens of the submerged extract (90 and 38 kDa) partly lost their IgE-binding ability by this treatment, indicating that these components are glycoproteins and that the carbohydrate moiety is involved in the IgE binding. The IgE-binding ability of the 20-kDa allergen was not influenced by periodate. For assessment of the stability of the two allergen extracts, aqueous solutions were kept at 4 degrees C for 2, 7, and 21 d and then analyzed by SDS-PAGE and immunoblotting. The results showed that most allergens of the submerged extract were partly inactivated after 2 d. After 21 d, only the 20-kDa and 30-kDa components were still able to bind IgE. Similar results were obtained by analyzing the surface extract.(ABSTRACT TRUNCATED AT 250 WORDS)  相似文献   

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目的 分析破伤风疫苗免疫对不同性别和年龄段供血浆者抗-TT效价变化,为提高抗-TT高效价血浆采集量提供参考依据.方法 对符合规定的志愿供血浆者按不同年龄段分组,以相同的疫苗剂量和免疫程序进行免疫.采用ELISA定量检测供血浆者抗-TT效价水平,将抗-TT、效价≥8IU/ml的供血浆者列为采集特免血浆对象.结果 不同年龄段供血浆者组别间相同剂量疫苗和免疫程序产生高效价抗-TT的比率比较差异明显;21~35岁组产生高效价的比率明显高于36~45岁组,46~55岁组产生高效价比例最低,而且年龄小的抗-TT高效价持续时间较年龄大的长.结论 采用40IU吸附破伤风疫苗,0、4、4周程序免疫,38%的供血浆者可获得高效价抗-TT原料血浆,各年龄段供血浆者的破伤风抗体水平均能够达到保护的浓度.  相似文献   

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A sulfatide, O-fatty-acylated 3-sulfogalactosylceramide at C6-O on galactoside, was isolated from equine brain and the chemical structure was characterized by proton NMR and MS. The O-acylation site of the acylated sulfatide was determined by the down-field shift of protons attached to a carbon having an O-acyl group in the NMR spectrum and by analysis of a partially methylated derivative before and after acetalization of the intact sulfatide using GC-MS. The O-acyl chain length was determined by GLC, revealing that it exclusively had palmitoyl and stearoyl residues as the major fatty acids. The enzymatic conversion to the O-acyl sulfatide was further examined using equine brain microsomes as an enzyme source and different lipid substrates, resulting in O-acylation of 3-sulfogalactosylceramide from stearoyl CoA, while 6-O-acyl galactosylceramide was not O-sulfated from phosphoadenosine phosphosulfate. The results were supported by the comparably different N-linked fatty acid components between two lipid substrates, in which the component of 6-O-acyl sulfatide was mostly similar to that of sulfatide, but not to 6-O-acyl galactosylceramide.  相似文献   

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To reveal the hemodynamic effect of plasma DNA, the authors measured the concentrations of plasma DNA, the length of its molecular fragments, and hemodynamic resistance/Toms effect. The Toms effect was detected in all blood samples from 10 healthy donors and 39 patients without acute stroke caused by atherosclerosis of the head great arteries with and without arterial hypertension. There was a clear inverse relationships between the plasma concentrations of DNA which had only long-molecular fragments in healthy persons and the hemodynamic resistance of its blood flow samples. The patient blood plasma had significant increased DNA concentrations but their molecular fragments were long and short. Inverse relationships between the plasma DNA concentration and the hemodynamic resistance of the patients' blood flow samples had a less correlation coefficient due to the high proportion of short DNA molecular fragments. The Toms effect was shown in the DNA solution prepared only from human funic blood where the DNA molecular fragments were long. The Toms effect was absent in the solutions prepared from the commercial cattle or salmon sperm DNA which contained shorter DNA molecular fragments. It is concluded that plasma DNA has a hemodynamic effect and the origin of long-molecular fragments of DNA which is typical for healthy young persons and short DNA molecular fragments that additionally appear in patients with vascular disorders is different.  相似文献   

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Venous ulceration is a common problem in western countries and results in large costs to healthcare systems. A number of hypotheses of the mechanisms of development of venous ulceration have been advanced, but this question has not been fully resolved. In recent years research effort has focused on the microcirculation of the skin and many methods of investigation have been employed to study this. Some of the principal findings described in published work are reviewed in this article. It seems unlikely from the available evidence that venous ulceration is attributable solely to failure of diffusion of oxygen and other small nutritional molecules to the tissues of the skin. The microvascular changes in the skin are characterised by activated endothelium and perivascular inflammatory cells. It is much more likely that leucocytes attach themselves to the cutaneous microcirculation, become activated and produce endothelial injury. Repeated over many months or years, this chronic inflammatory process leads to be tissues changes of lipodermatosclerosis. Although there is evidence of leucocyte involvement in the pathogenesis of venous ulceration, the exact mechanisms remain to be resolved. Improved treatment for patients may be devised once a better understanding of the basic causes of this condition has been reached.  相似文献   

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BACKGROUND: During pregnancy and nursing, a baby's developing immune system is intimately exposed to the mother's antigens. To determine whether this exposure is of clinical benefit to patients who later receive an allograft as an adult, we analyzed the outcome of primary renal transplantations from sibling donors. METHODS: We retrospectively studied graft survival and rejection episodes in 205 patients who had received renal transplants at nine centers between 1966 and 1996 from sibling donors bearing maternal or paternal HLA antigens not inherited by the recipient. The sibling donors were categorized by analysis of family HLA-typing data. RESULTS: In the multicenter analysis, graft survival was higher at 5 years and at 10 years after transplantation in recipients of kidneys from siblings expressing maternal HLA antigens not inherited by the recipient than in recipients of kidneys from siblings expressing paternal HLA antigens not inherited by the recipient (86 percent vs. 67 percent at 5 years and 77 percent vs. 49 percent at 10 years, P=0.006 for both). Paradoxically, there was a higher incidence of early rejection in the former group, suggesting that fetal and neonatal exposure to maternal antigens results in immunologic priming. Pretransplantation transfusions of donor blood reduced the incidence of acute rejection while preserving the beneficial effect of tolerance to noninherited maternal antigens on graft survival. Since 1986, new immunosuppressive drugs have lessened the short-term, but not the long-term, survival advantage of grafts expressing maternal HLA antigens not inherited by the recipient. CONCLUSIONS: In the transplantation of a kidney from a sibling donor who is mismatched with the recipient for one HLA haplotype, graft survival is higher when the donor has maternal HLA antigens not inherited by the recipient than when the donor has paternal HLA antigens not inherited by the recipient.  相似文献   

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Mismatched haploidentical bone marrow transplantations from a related donor have been the topic of clinical and laboratory research for more than 20 years. During that time, new treatment strategies have been designed based on animal experiments, and, since our group introduced the megadose inoculum which combines T-cell-depleted bone marrow cells with a large number of granulocyte colony-stimulating factor-mobilized peripheral blood stem cells and a more intensive conditioning regimen, have done much to overcome the problems of graft-versus-host disease and graft rejection. As most patients have a full haplotype mismatched relative available, this technique means that a far greater number of patients with hematologic malignancies can be offered a T-cell-depleted transplantation as curative therapy.  相似文献   

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