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991.
A postmortem histopathologic investigation of temporal bones of patients with the acquired immunodeficiency syndrome (AIDS) was performed after microslicing, acid decalcification of the slices and paraffin embedding. Histopathologic changes in 49 temporal bones from 25 patients included severe otitis media in five patients (20%), low-grade otitis media in fifteen (60%), labyrinthine cryptococcosis in two, Kaposi's sarcoma deposit in the eighth nerve of one, and cytomegalovirus (CMV) inclusion-bearing cells in the inner and middle ear of six (24%). It was possible to identify the CMV genome by in situ hybridization in only two bones and expression of CMV antigen by immunohistochemistry in none, probably because of prolonged decalcification in acid. The ear is no less susceptible to AIDS-associated diseases than any other organ, and is particularly prone to CMV infection.  相似文献   
992.
993.
The majority of pituitary tumors are of monoclonal origin; however, the molecular basis for their formation is poorly understood. Somatic mutations in the alpha-subunit of the GTP-binding protein, Gs alpha (gsp oncogene) have been found in about one third of GH-secreting tumors. Mutations in another alpha-subunit of a GTP-binding protein, Gi2 alpha (gip mutations) have been described in other endocrine tumors. In this study, we examined 21 nonfunctioning pituitary tumors and 4 macroprolactinomas for gsp mutations and 27 nonfunctioning tumors and 4 macroprolactinomas for gip mutations. Using the polymerase chain reaction and denaturing gradient gel electrophoresis, 2 nonfunctioning pituitary tumors displayed migration abnormalities when the Gs alpha-gene was analyzed. Sequence analysis of these abnormally migrating polymerase chain reaction products revealed two previously known gsp mutations: arginine at codon 201 altered to cysteine, and glutamine at codon 227 changed to leucine. No gip mutations could be demonstrated. These findings emphasize the monoclonal origin of nonfunctioning pituitary tumors and suggest that cAMP may play a role in tumorigenesis of nonfunctioning pituitary tumors.  相似文献   
994.
OBJECTIVE: To measure the magnitude and timing of seasonal variation of blood pressure and related factors in the elderly living in the community, and to assess their potential impact on cardiovascular risk. DESIGN: Prospective study; from January 1991 to February 1992 blood pressure and other variables were measured at 2-monthly intervals in each subject in their own homes. SUBJECTS: Ninety-six men and women, age range 65-74 years, recruited from a single group general practice in Cambridge. MAIN OUTCOME MEASURES: Seasonal variation of blood pressure, seasonal variation of prevalence of hypertension, seasonal variation of ambient temperature and body mass index. RESULTS: Both systolic (SBP) and diastolic blood pressure (DBP) were greatest during the winter across the whole distribution of blood pressure. There was a fourfold increase in the proportion of subjects with blood pressures > 160/90 mmHg in winter compared with in summer. Regression analysis revealed highly significant seasonal differences in both SBP and DBP. After adjustment for confounding seasonal effects, a 1 degree C decrease in living-room temperature was associated with rises of 1.3 mmHg in SBP and 0.6 mmHg in DBP. CONCLUSIONS: Seasonal variation of blood pressure is heightened in older adults and may partly explain the greater cardiovascular disease mortality of elderly subjects during the winter. The blood pressures of elderly people may be inversely related to the ambient temperature. The public health implications of these findings deserve further investigation.  相似文献   
995.
996.
BACKGROUND: Recently, investigators have reported the use of endoscopic myotomy in the treatment of esophageal achalasia. As with the open operation, considerable disagreement exists regarding the appropriate length of the myotomy and the need for a concomitant antireflux procedure. METHODS: Patients presenting with symptomatic achalasia between 1993 and 1997 were included in this prospective study. Preoperative studies included barium upper gastrointestinal study, endoscopy, and esophageal manometry. Laparoscopic myotomy was completed in all 20 patients; 18 had concomitant Toupet fundoplication. RESULTS: Operative times ranged from 95 to 345 minutes (mean 216). Blood loss ranged from 50 to 300 cc (mean 100 cc). There were 7 minor complications (5 mucosal injuries repaired laparoscopically, 1 bile leak and 1 splenic capsular tear). Nine patients began a liquid diet on the first day postoperatively; 19 were tolerating liquids by postoperative day 3. Hospital stay ranged from 2 to 20 days (mean 5). Eighteen patients had complete relief of dysphagia, with less than one reflux episode per month. One individual continues to have mild persistent solid food dysphagia. Another patient initially did well but subsequently developed mild recurrent dysphagia and reflux. One patient required laparoscopic take-down of the wrap because of recurrent dysphagia and now has no problems swallowing, but does complain of mild reflux. Two other patients also have mild reflux, 1 of whom did not undergo fundoplication. CONCLUSIONS: Laparoscopic Heller myotomy can be performed safely with excellent results in patients with achalasia. Adding a partial fundoplication appears to help control postoperative symptoms of reflux. This procedure should be considered the procedure of choice in patients with symptomatic esophageal achalasia.  相似文献   
997.
Oral health care providers have taken various positions toward the concept of correct behavior toward and management of patients who are seropositive for human immunodeficiency virus. Several tribunal judgments and articles have discussed and analyzed this subject. This article presents a new detailed report and analysis and decision issued by a dental profession panel (tribunal) in Ontario, Canada. The concepts of universal precautions and antidiscriminatory acts are discussed.  相似文献   
998.
The ENTOREL Database for radiation stressed electronic components and systems has been established to collate data on high doses (aiming at Mega Grays) which meet the requirements of advanced teleoperators working in hazardous or disordered nuclear environments within the frame of a European telerobotics programme for the nuclear industry. The ENTOREL Database holds data from 614 tests on total dose effects  相似文献   
999.
Effective removal of unwanted particles from a molten metal alloy by flotation relies on purging a gas into the melt through a rotating impeller. This device is commonly known as a rotary degasser. Unwanted particles in the melt attach to the rising gas bubbles and rise to the slag layer where they are removed from the metal bulk. In addition, the turbulence created by the rotating impeller causes the randomly distributed solid particles to agglomerate into relatively large clusters. These clusters float up or settle down due to the difference between their density and that of the melt. A mathematical model has been developed to describe the particle dynamics and particle agglomeration that occur during the rotary degassing of aluminum melts. While previous investigations addressed particle collisions in low intensity turbulent fields where the size of the colliding particles is smaller than the Kolmogorov length scale, this model is more encompassing as it considers both low intensity and high intensity turbulence. Consequently, this model is more representative of a typical industrial rotary degassing operation.  相似文献   
1000.
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