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1.
The incorporation of the total subapical osteotomy as an alternative surgical technique to augment standard bilateral sagittal split osteotomy in facilitating establishment of the profile objectives in the surgical-orthodontic treatment of a patient with skeletal sagittal discrepancy, is presented in this case report. Esthetic considerations, as well as risks involved in this type of a combined surgical approach, are also discussed.  相似文献   

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An electromyographic study of nonmimetic skeletal muscles was carried out in 8 normal adults and 4 patients with spastic hemiparesis during all stages of sleep for a total of 21 nights. All normal subjects showed absence of tonic electromyographic activity in all nonmimetic skeletal muscles in all stages of sleep. Also, during quiet, relaxed wakefulness, tonic muscle discharges disappeared in the normal subjects. Three patients with upper motor neuron spasticity demonstrated results during sleep similar to those obtained in the normal subjects. In the fourth patient, tonic muscle discharges persisted into stage 2 non-REM sleep, disappeared within 30 to 240 seconds following the onset of stage 2 sleep, and were absent during stages 3 and 4 sleep and REM sleep.  相似文献   

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STUDY OBJECTIVE: To establish the quantitative effects on the diameter of cerebral arteries following controlled changes in arterial carbon dioxide tension (PaCO2). DESIGN: Nonrandomized interventional study. SETTING: Angiography suite of a tertiary referral hospital. PATIENTS: 12 anesthetized patients suffering from a cerebral arteriovenous malformation undergoing endovascular treatment. INTERVENTION: Induced hypocapnia by hyperventilation and induced graded hypercapnia by the administration of carbon dioxide to the anesthetized patient's breathing circuit. MEASUREMENTS AND MAIN RESULTS: A digital angiography computer was used to make computerized measurements and calculations of the diameter of deep and small cortical arteries outside the vascular territory of cerebral arteriovenous malformations following controlled and standardized changes in PaCO2. Cardiovascular parameters were simultaneously measured and cardiac output (CO) calculated. No statistically significant changes in the diameter of cerebral arteries down to a size of 0.57 mm, which was the smallest artery studied, could be observed following changes in PaCO2 in the range between 28 +/- 4 mmHg and 74 +/- 4 mmHg. However, there was a 64% change in cardiac index following the above change in PaCO2. CONCLUSION: Deep cortical cerebral arteries down to a diameter of 0.57 mm seem to act merely as conductance vessels. The observed dramatic increase in CO following an increase in PaCO2 may offer an explanation for the changes in cerebral blood flow and cerebral flow velocity recorded by others and usually attributed to cerebral vasodilatation, which we were unable to demonstrate in this study.  相似文献   

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The term dyshidrosis describes a nonspecific tissue pattern reaction characterized by a noninflammatory, pruritic (and sometimes burning) intraepidermal vesicular dermatosis involving selected areas of the fingers, palms, and soles. It should be distinguished from various pustular and vesicular dermatoses of the palms and soles with or without associated lesions elsewhere. When dyshidrotic lesions appear in areas where friction or pressure from the handling or wearing of sport gear occurs, the discomforting symptoms are noticeably accentuated and can thus interfere with the participant's effectiveness in the performance of the sport. A composite approach of dermatologic therapeutic acumen and physician-sponsored emotional support is essential in effectively handling this problem so that dyshidrosis does not "handicap" the patient.  相似文献   

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The effect of fatigue was studied on rat skeletal muscle efficiency during maximal dynamic exercise of 10s duration. After the initial 4s of exercise, power output decreased rapidly to 46.2 +/- 6.7% (mean +/- SD; n = 6) after 6s of stimulation and further to 17.5 +/- 5.8% in the last contraction. Both the rates of total work output and high-energy phosphate consumption decreased with increasing exercise duration. As a result muscle efficiency was not affected by exercise time in the present experiments. This result indicates that fatigue in severe maximal exercise is induced by a feed-back mechanism, which in the case of high ATP utilisation rates will reduce ATP splitting probably by reducing Ca(2+)-release from the sarcoplasmic reticulum.  相似文献   

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Earlier studies have shown a stimulatory effect of diabetic serum on the growth of rabbit aortic medial cell cultures. Growth media supplemented with normal serum with added insulin (50-2,000 muU./ml. serum) did not enhance the growth of the medial cell cultures. Control media containing serum from recent diabetics with low insulin concentration stimulated the growth (2p less than 0.01). Supplementation of normal serum with human growth hormone (final concentration 1-5 ng./ml. medium) resulted in a significant enhancement of growth (2p less than 0.005). The growth-promoting effect of growth hormone was not detectable with lower concentrations (0.5 ng. and 0.1 ng./ml. medium). The growth effect of the low concentration of growth hormone could not be augmented by increasing the concentration of glucose in the incubation medium. Growth hormone in an amount of 1 ng./ml. medium increased both the number of 3H-thymidine-labeled cells as identified by autoradiography and the number of mitotic bodies (2p less than 0.005 and 2 p less than 0.025). The present results demonstrate that the growth-stimulating factor(s) in diabetic human serum described earlier is not insulin but may well be growth hormone.  相似文献   

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The rate of capillary filtration in the lower limbs after hydroxyethylrutosides administered in various doses and by different routes was studied in patients with chronic venous insufficiency. Capillary filtration rate decreased immediately after intravenous and from 55 to 85 minutes after oral administration, depending on the dose. The slow-release tablets produced a definite falt in capillary filtration 240 minutes after administration.  相似文献   

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Cholesterol absorption measurements were carried out in a free-living out-patient population by a plasma isotope-ratio method previously validated for in-patients (Samuel, P., J. R. Crouse and E. H. Ahrens, Jr., 1978. J. Lipid Res. 19: 82-93). To test the reproducibility of the method in out-patients, 18 patients were tested twice: the mean intra-assay variability was +/- 6.0%. The method was then applied in 150 hyperlipidemic male out-patients, ingesting a standardized diet containing 250mg cholesterol per day, who had been randomized into four different drug-treatment groups: 1) no medication, 2) clofibrate, (2g/day), 3) cholestyramine (16g/day), or 4) both clofibrate and cholestyramine. Cholesterol absorption (as percent of the oral dose) was increased in patients receiving cholestyramine (P < 0.02) and decreased in those receiving clofibrate (P < 0.02); the group on the combined medication had the same pecent absorption as the control group. In twelve patients receiving cholestyramine, a second test of cholesterol absorption was performed 30 min after each patient had received 8g of cholestyramine. The pre-test administration of cholestyramine caused a 38% decrease in cholesterol absorption (P < 0.001), compared to results obtained when medication was withheld prior to testing. These results demonstrate that the isotope-ratio method of measuring cholesterol absorption is a reproducible procedure applicable to a free-living out-patient population, and that the hypolipidemic drugs, clofibrate and cholestyramine, significantly affect cholesterol absorption in man. The data also show that the results of measurements of cholesterol absorption can be profoundly altered by the type and timing of medication in relationship to the test meal of labeled cholesterol.  相似文献   

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In a previous investigation by our group it was suggested that the stimulating effect of 1-alpha-hydroxycholecalciferol (1-alpha-OH-D3) on the tubular reabsorption of phosphate is mediated via the parallel suppression of the parathyroid hormone (PTH). A direct effect of 1-alpha-OH-D3 on the renal tubule could however not be completely excluded. Therefore, the effect of 1-alpha-OH-D3 was studied in 5 totally parathyroidectomized patients, in whom concomitant suppression of PTH would not occur. TmP/GFR, i.e. the ratio between the maximal tubular reabsorption of phosphate (TmP) and the glomerular filtration rate (GFR), was used as an indicator of the renal handling of phosphate. Estimation of TmP/GFR was performed 1) when the patients were vitamin D depleted and hypocalcemic, and 2) after 14-27 days of treatment with 1-alpha-OH-D3 to obtain stable normocalcemia. In patients with absent parathyroid function, no effect of 1-alpha-OH-D3 on TmP/GFR could be demonstrated. It is therefore concluded that 1-alpha-OH-D3 exhbits no antiphosphaturic effect in the absence of PTH and that the previously demonstrated antiphosphaturic effect of 1-alpha-OH-D3 in man is mediated via a concomitant suppression of PTH.  相似文献   

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PURPOSE: The study contained herein was undertaken to demonstrate that mesenteric desmoid tumors can cause significant symptoms other than by a mass effect and that surgery can be effective in treating these symptoms. METHODS: The medical records of patients with intra-abdominal desmoid disease in the David G. Jagelman Inherited Colorectal Cancer Registry were reviewed. Four cases are described in which intramesenteric desmoid tumors adjacent to the bowel caused mucosal ischemia in patients with familial adenomatous polyposis. RESULTS: In one patient with an ileorectal anastomosis, this was manifest by multiple small-bowel strictures and treated by multiple strictureplasties. The other three patients had ileal pouches and presented with bleeding and pain from mucosal ulceration. All pouches needed to be removed. CONCLUSION: Intra-abdominal desmoid tumors may cause problems other than by mass effect. Patients with familial adenomatous polyposis and symptoms suggestive of desmoid disease but with no detectable mass should not be denied surgery.  相似文献   

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The n-3 fatty acids (FA) from marine sources are known to exert antiinflammatory effects on monocyte function. There is still controversy whether n-3 FA may increase the susceptibility to infections. The present study was designed to assess the effect of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) on monocyte phagocytosis and respiratory burst activity. Fifty-eight healthy men were randomized to take a daily supplement of 3.8 g highly purified EPA (n = 20), 3.6 g DHA (n = 19), or corn oil (n = 19) for 7 wk. Mononuclear leukocytes were collected, isolated, and cryopreserved prior to and after dietary supplementation. Paired samples were analyzed in the presence of autologous serum in a crossover design. Monocyte phagocytosis and respiratory burst activity were measured by flow cytometry after ingestion of Escherichia coli. Monocytes retained their phagocytic ability and respiratory burst activity after supplementation. No reduction in internalization of bacteria was registered. Dietary n-3 FA and particularly EPA improved bacterial adherence to the monocyte surface. In the crossover experiments, there was an adverse effect of serum enriched with n-3 FA on bacterial adherence. We conclude that monocytes retain their phagocytic potential after supplementation with purified EPA and DHA.  相似文献   

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Six subjects were studied for an 8-week period that consisted of a 3-week control period, followed by a 3-week period during which their daily diets were supplemented with 3 oz of a high fiber breakfast food, All-bran, and a final 2 weeks on their regular diet. Daily diet records of food intake were recorded and analyzed for seven dietary constituents; carbohydrates, proteins, fats, cholesterol, fiber, alcohol, and total calories. The most significant change in eating behavior due to the fiber food supplementation was a decrease in eating eggs, butter, and breakfast meats. These foods were most often replaced because all six subjects chose to eat the major portion of All-bran during breakfast. An increase in milk and fruit also occurred during the supplemented feeding. These particular foods were added to make All-bran more palatable and served to increase carbohydrate and protein intake. Five subjects added the supplement to the between meal-time intake and thus caused an increase in total daily caloric intake. At lunch and dinner few foods were altered with no particular pattern of substitution. Notwithstanding the knowledge that increased fiber content may have beneficial effects, none of the subjects modified his eating behavior to include even 1 oz of a high fiber food daily after the experimental period was concluded. Thus behavior modification by forced diet intake of a high fiber breakfast food resulted in definite diet pattern changes that did not persist following the experimental period.  相似文献   

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