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1.
Percutaneous transluminal angioplasty (PTA) has been well described in the treatment of mesenteric artery stenoses but has met with limited success in ostial lesions. The authors describe a case of a 79-year-old woman diagnosed with chronic mesenteric ischemia associated with a 22-pound weight loss and postprandial pain. The celiac axis and inferior mesenteric artery were occluded. A high-grade, calcified stenosis was present in the proximal superior mesenteric artery. This was treated with primary stent placement using a Palmaz stent deployed from an axillary approach. A brief discussion of mesenteric ischemic and visceral artery PTA is included.  相似文献   

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We examined the effects of systemic or oral ad libitum monosodium glutamate (MSG) administration on glutamate levels in plasma, and on glutamate release from the arcuate nucleus of the hypothalamus (estimated using brain microdialysis). Systemic MSG administration (0.25, 0.5, 1 or 2 g/kg, i.p.) to adult rats caused dose-dependent increases in glutamate levels within arcuate nucleus dialysates. These levels increased during the initial 20 min after systemic MSG administration, and peaked during the second 20-min interval (maximally to 116 +/- 7%, 146 +/- 15%, 790 +/- 191% and 1230 +/- 676% of basal values, respectively). Plasma glutamate levels, measured simultaneously, were increased maximally during the initial 20 min after MSG administration. These increases were 10-, 13-, 76- and 163-fold after doses of 0.25, 0.5, 1 and 2 g/kg, i.p., respectively. In feeding experiments, consumption of 2.3 g/kg of MSG by previously-trained rats during an 1-h period increased plasma glutamate levels to 352 +/- 61% of basal values 140 min after the start of the feeding period. No changes were observed in glutamate levels of arcuate nucleus dialysates. These findings may explain why ad libitum dietary consumption of MSG apparently lacks neurotoxic potential.  相似文献   

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BACKGROUND AND AIMS: Injuries caused by ischaemia and ischaemia/reperfusion in the small intestine have been widely accepted as resulting in necrosis. The aim of this study was to ascertain whether apoptosis also occurs. METHODS: Intestinal epithelium from rats subjected to ischaemia (15-90 minutes) and ischaemia/reperfusion (15 minutes ischaemia followed by 15-75 minutes of reperfusion) was studied using histological, immunohistochemical, and molecular biological methods as well as FACS. RESULTS: Mucosal injury was induced by both ischaemia and ischaemia/reperfusion. Detachment of epithelial cells from the villous stroma was an early morphological change indicating mucosal injury. More than 80% of the detached cells exhibited characteristic morphological features of apoptosis (condensation of chromatin and nuclear fragmentation). The remainder demonstrated necrotic features. The apoptotic cells eventually underwent spontaneous degeneration with membrane rupture, a process morphologically identical to necrosis. DNA fragmentation was also confirmed by immunohistochemical methods and agarose gel electrophoresis. CONCLUSION: Apoptosis is a major mode of cell death in the destruction of rat small intestinal epithelial cells induced by ischaemia and ischaemia/reperfusion injury. Disruption of epithelial cell-matrix interactions ("anoikis") may play an important part in induction of apoptosis in detached enterocytes.  相似文献   

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Platelet membrane glycoproteins (GP) IIb/IIa and rap1b, a 21 kDa GTP binding protein, associate with the triton-insoluble, activation-dependent platelet cytoskeleton with similar rates and divalent cation requirement. To examine the possibility that GPIIb/IIIa was required for rap1b association with the cytoskeleton, experiments were performed to determine if the two proteins were linked under various conditions. Chromatography of lysates from resting platelets on Sephacryl S-300 showed that GPIIb/IIIa and rap1b were well separated and distinct proteins. Immunoprecipitation of GPIIb/IIIa from lysates of resting platelets did not produce rap1b or other low molecular weight GTP binding proteins and immunoprecipitation of rap1b from lysates of resting platelets did not produce GPIIb/IIIa. Finally, rap1b was associated with the activation-dependent cytoskeleton of platelets from a patient with Glanzmann's thrombasthenia who lacks surface expressed glycoproteins IIb and IIIa. Based on these findings, we conclude that no association between GPIIb/IIIa and raplb is found in resting platelets and that rap1b association with the activation-dependent cytoskeleton is at least partly independent of GPIIb/IIIa.  相似文献   

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Measured binocular eye alignment in 20 2–6 mo old infants under both binocular and monocular viewing conditions. Corneal photography was used to assess whether Ss converged to a target presented at a 15-cm viewing distance. Ss at all ages showed reliable convergence under both binocular and monocular viewing conditions. The presence of convergence during monocular viewing indicates that an accommodative-convergence link is present at an early age. The implications of this early synergistic relationship between accommodation and convergence are discussed both with respect to the influence of early visuomotor experience on the developing visual system and the onset of various ocular anomalies during infancy. (French abstract) (23 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   

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Mandibular advancement splints are successful in managing obstructive sleep apnoea (OSA) in selected subjects. For these to be effective, some improvement in the dimensions of the oropharyngeal airway must occur. Twenty subjects with proven obstructive sleep apnoea were examined using lateral cephalometric radiography and a fluoroscopic technique. Cephalograms were analysed, and assessed for both skeletal and soft tissue abnormalities known to be present in OSA subjects. On the basis of these, a prediction was made as to whether the subject's oropharyngeal airway would increase during mandibular protrusion. From the fluoroscopic sequences, the narrowest antero-posterior dimensions of the post-palatal and post-lingual airways were recorded as the mandible moved from the intercuspal position into maximal protrusion. The changes in airway size were noted and these were compared with the predictions made from the static films. In nine subjects, fluoroscopy indicated that the airway opened well during mandibular protrusion, seven did not improve and in four the changes were minimal. Post-palatally the mean airway increase was 2.6 mm, whilst behind the tongue a mean improvement of 3.1 mm was seen. In all but two instances, the cephalometric prediction agreed exactly with the outcome demonstrated by fluoroscopy. All subjects whose airways clearly increased were correctly identified by the cephalogram alone. Cephalometric features associated with a good airway response to protrusion were a reduced lower facial height, low maxillomandibular planes angle and a high hyoid position, accompanied by a normal anteroposterior relationship of the jaws, relatively normal mandibular body length and soft palate area. The more abnormal the skeletal and soft tissue dimensions, the poorer the prognosis. Thus, whilst a single radiograph could indicate whether a positive mandibular response to protrusion could be expected, where doubt existed, a fluoroscopic analysis could provide a useful adjunct to diagnosis.  相似文献   

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An analytical study of the renin-angiotensin-aldosterone system was made in 124 individuals with essential hypertension, aged from 25 to 55 years. The results obtained, with rigorous control to posture and sodium balance, indicate the existence of a number of subgroups of hypertensive subjects related to their renin activity and plasma aldosterone in the upright position. This classification thus makes possible comparison with patients suffering from secondary hypertension.  相似文献   

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Previous studies show that the pecking rate of naive 3-day-old chicks increases after ingestion of food and decreases after ingestion of sand, but these changes have not been specific to the stimulus that was ingested. In the present experiments with a total of 450 Burmese Red Junglefowl chicks, Exps I and II showed that neither 1 nor 4 10-min simultaneous-choice tests were sufficient for discrimination to be shown between food and sand. Exp III showed that many hours of experience with food or sand were sufficient for discrimination if Ss were tested for 10 min with only 1 stimulus at a time. Similar results were found in Exp IV in which Ss had only 10 min of experience with food or sand. Pecking rates to food and sand were the same during the 1st 2 min of the test and only later diverged. These results imply that the discrimination is based on feedback that develops 2-3 min after ingestion but develops only if chicks have had previous experience with food or sand. (15 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   

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One hundred and eighty-four patients underwent complete lipid analysis (total cholesterol, HDL and LDL cholesterol, triglycerides, apolipoproteins A1 and B, lipoprotein (a)) and coronary angiography, in order to evaluate the discriminant value of the lipoprotein (a). Subjects with non-significant coronary stenoses (< 50% of the lumen) were used as a control group (n = 84). The others were considered to be pathological. The total cholesterol, HDL cholesterol and triglycerides were measured by an enzymatic colorimetric method. The LDL cholesterol was calculated by Friedewald's formula. The apolipoprotein A1 and B were measured by immunoturbidimetry and the lipoprotein (a) by an Elisa. The results showed a relationship between the different lipid levels, especially between high lipoprotein (a), and the severity of the coronary disease. A quantitative and qualitative study showed no significant influence of the other risk factors on the mean lipoprotein (a) level. Gender and age had no influence. Therefore, the higher the lipoprotein (a) level, the greater was the coronary risk, independently of the other associated risk factors.  相似文献   

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Seven experiments examined the development of taste aversion learning to novel cues contained in mother's milk in 176 laboratory and 377 Sprague-Dawley pups. Ss receiving distinctive milk by experimenter-delivered oral infusions followed by toxicosis formed an aversion to the dam's diet. Robust aversions were learned as early as Day 10 and were retained for at least 11 days. When the same distinctive milk was obtained directly from a foster mother through nursing, only weanling-age Ss formed an aversion. X-ray analysis of nipple location in the mouths of suckling Ss suggested that they receive milk at a similar tongue locus between the ages of 10 and 21 days; flavored milk was then delivered at specific time intervals in controlled quantities through tongue cannulas implanted at loci corresponding to the nipple position. Cannulated preweanling Ss that were attached to a nipple during mild delivery failed to associate the taste cue with illness, whereas both preweanlings off the nipple and weanlings on the nipple acquired aversions to the taste cue in the milk. Results suggest that pups of all ages are incapable of expressing a taste aversion in a nursing situation and that preweanling pups in particular are also deficient in acquiring aversions within a suckling context. The inability of preweanling pups to acquire taste aversions in a nursing situation appears to result from a failure to associate taste cues with illness rather than a failure to detect taste cues obtained from a nipple. (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   

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The clinical medical students on the Cambridge Community-Based Clinical Course (CCBCC) derive part of their training by taking part in consultations between patients and their general practitioners. Patients' attitudes to this arrangement and their support for student training in a general practice setting are an important factor in the development of community-based education. A postal questionnaire seeking information from patients achieved an 84% response rate. Both the numerical results and the patients' comments are presented. Patients proved generally supportive of the community-based course and some identified positive benefits to themselves from this provision. The large majority of patients did not mind the presence of medical students during consultations, although there are some areas in which patients are less willing to involve students.  相似文献   

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OBJECTIVE: To assess the efficacy of unopposed estrogen, and three estrogen/progestin regimens on selected heart disease risk factors among adherent women and to contrast those results with efficacy among all women in the PEPI study. DESIGN: A 3-year, multicenter, randomized, double-blinded, placebo-controlled clinical trial. PARTICIPANTS: A total of 847 healthy postmenopausal women aged 45 to 64 years of age with no known contraindication to hormone therapy, who attended their 36 month clinical visit. INTERVENTION: Participants were randomized in equal numbers to one of the following treatments: (1) placebo; (2) conjugated equine estrogen (CEE) 0.625 mg daily; (3) CEE 0.625 daily plus medroxyprogesterone acetate (MPA) 10 mg, days 1-12; (4) CEE 0.625 daily plus MPA 2.5 mg daily; or (5) CEE 0.625 daily plus micronized progesterone (MP) 200 mg, days 1-12. ANALYSIS: Analyses are based on adherent women, where adherence is defined as taking at least 80% of pills at each 6-month visit. RESULTS: Adherence rates were high in all groups except women with a uterus assigned to unopposed CEE. The difference in HDL-C levels resulting from the CEE vs. CEE+MP was approximately three times larger than in the intent-to-treat analyses, reaching statistical significance (P < 0.05). In each active treatment, LDL-C decreased 10-15%. Triglycerides increased 15-20% in each opposed CEE arm and over 25% in the CEE only arm; this difference was not statistically significant. Fibrinogen increased by 7% among placebo adherers, but decreased or remained fairly stable among the active arm adherers. Systolic blood pressure increased 3-5% in all treatment arms. Women adherent to the CEE+MPA arms had twice the increase of 2 h glucose levels as women adherent to CEE only, or CEE+MP (8-9% vs. 3-4%). Two-hour insulin levels decreased 3-12% for all arms. The patterns of change for fibrinogen, SBP, 2 h glucose and insulin were similar to those from the intent-to-treat analyses. CONCLUSIONS: In analyses limited to adherent women, all active treatments, compared to placebo, continued to have similar and favorable effects on LDL-cholesterol and fibrinogen and no significant effects on blood pressure or insulin levels. Given the overall high adherence rates in PEPI, the results are similar to the intent-to-treat analyses, as expected. Only the trend of HDL-C to have a larger increase in the CEE only arm (in the intent-to-treat analyses) gained statistical significance in analyses restricted to adherers.  相似文献   

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