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31.
We prospectively studied 63 children with transient hyperglycemia to determine their risk of acquiring insulin-dependent diabetes mellitus (IDDM) and to evaluate the predictive value of immunologic markers of prediabetes and of the intravenous glucose tolerance test. Children with transient hyperglycemia were identified by a prospective systematic review of the laboratory reports of a large children's hospital and an office-based pediatric practice and by referral from pediatricians. Transient hyperglycemia occurred in 0.46% of children seen in the children's hospital and in 0.013% of children attending a pediatric office practice. Insulin-dependent diabetes mellitus developed within 18 months of identification in 32% of children in whom transient hyperglycemia was discovered in the absence of a serious illness, compared with 2.3% of children identified during a serious illness (relative risk, 13.9; 95% confidence interval, 1.56 to 123.5). Islet cell antibodies and competitive insulin autoantibodies each had a 100% positive predictive value for IDDM; the negative predictive value of islet cell antibodies and competitive insulin autoantibodies was 96% and 98%, respectively. The stimulated insulin release during an intravenous glucose tolerance test, adjusted for age, had the highest overall accuracy of prediction. All children less than 6 years of age with stimulated insulin release levels < 85 pmol/L (12 microU/ml) subsequently had IDDM, as did an 11-year-old child whose stimulated insulin release level was below the 1st percentile of 170 pmol/L (24 microU/ml). To date, no child whose stimulated insulin release level was above the 5th percentile has had IDDM. We conclude that when transient hyperglycemia occurs during a serious intercurrent illness, the risk of progression to IDDM is low. In contrast, one third of children in whom transient hyperglycemia is identified without a serious illness can be expected to have IDDM within 1 year. A combination of islet cell antibodies, competitive insulin autoantibodies, and stimulated insulin release levels during an intravenous glucose tolerance test can accurately distinguish children with prediabetes from those with presumed benign transient increases in plasma glucose concentrations.  相似文献   
32.
1. Animal studies have shown that angiotensin II has a biphasic effect on urinary sodium excretion. To examine whether this is also true in man, we studied seven salt-replete male subjects in a single-blind placebo-controlled manner. 2. While undergoing maximum diuresis, subjects were infused with 0, 1, 2, 5 or 10 ng of angiotensin II min-1 kg-1 over 80 min. Subjects were studied while seated, and stood every 20 min for urine collection. 3. Angiotensin II produced a dose-dependent antidiuretic effect. The urine flow rate, in ml/min expressed as the change from baseline with increasing dose of angiotensin, was: +3.4 +/- 1.77, -1.26 +/- 0.49 (P < 0.05), -2.75 +/- 1.23 (P < 0.05), -4.21 +/- 0.82 (P < 0.05) and -6.51 +/- 1.07 (P < 0.01). 4. In contrast, the effect of angiotensin II on sodium excretion showed a flat dose-response curve beyond 5 ng min-1 kg-1. The urinary sodium excretion, in mumol/min expressed as the change from baseline with increasing dose of angiotensin, was: 9.5 +/- 21.2, -18.9 +/- 29.6, -37.0 +/- 11.6 (P < 0.05), -67.7 +/- 19.6 (P < 0.01) and -63.8 +/- 14.3 (P < 0.01). 5. The fractional distal reabsorption of sodium, determined by using the lithium clearance technique, showed a rise with all doses of angiotensin II used and reached statistical significance with the top two doses. 6. Unlike antidiuresis, antinatriuresis after graded doses of angiotensin II in human subjects showed a flat dose-response curve beyond 5 ng min-1 kg-1. Pressor doses of angiotensin II also have a significant effect on the distal tubule in promoting sodium reabsorption.  相似文献   
33.
The interaction of different metal oxides such as Co3O4, NiO, Al2O3, Cr2O3, Fe2O3 and SiO2 with Na2SO4 at a temperature of 1100 and 1200 K in flowing oxygen has been studied. The thermogravimetric studies for each system were carried out as a function of Na2SO4 in the mixture. The presence of different constituents in the reaction products were identified by X-ray diffraction analysis and the morphologies of the reaction products were characterized using metallography and scanning electron microscopy (SEM). The formation of products was also investigated by thermodynamic computation of free energies of the reactions and the study of relevant equilibrium phase diagrams. The soluble species in the aqueous solutions of the reaction products were determined quantitatively using atomic absorption spectrophotometry. The high temperature interaction products usually contain a 3-phase structure namely, Na2O·M2O x , M2O x and metal sulphide and/or metal sulphate. The formation of Na2O·M2O x depends upon the solid state solubility of metal oxide in the molten salt at high temperatures. Under limited solubility conditions Na2O·M2O x is invariably formed, but as soon as this condition is relaxed the oxide. M2O x , precipitates and forms a separate phase.  相似文献   
34.
Twenty diabetic patients with neuropathy underwent clinical and neurophysiological evaluation together with a detailed morphometric assessment of capillary pathology in endoneurial and epineurial microvascular beds of the sural nerve. Morphological data were compared with ten non-diabetic control subjects. There were no significant differences in control subjects between basement membrane area, endothelial cell area, endothelial cell profile number or luminal area of endoneurial when compared with epineurial capillaries. In contrast, when compared with epineurial capillaries, endoneurial capillaries from diabetic patients demonstrated a significant increase in basement membrane (p < 0.001) and endothelial cell (p < 0.001) area and a significant reduction in luminal area (p < 0.001). There was no significant difference in endothelial cell profile number between endoneurial and epineurial capillaries amongst diabetic patients. Previous studies have demonstrated a good correlation between the degree of microangiopathy and measures of neuropathic severity. In the present study increased endoneurial capillary basement membrane area was significantly related to reduced peroneal nerve conduction velocity (p < 0.001), myelinated fibre density (p < 0.001) and elevated vibration (p < 0.05) and thermal (p < 0.001) perception. Increased endothelial cell area and reduced luminal size were related to a reduced peroneal nerve conduction (p < 0.05, p < 0.01, respectively), reduced myelinated fibre density (p < 0.05, p < 0.01) and elevated thermal perception (p < 0.05, p < 0.001). Epineurial capillary basement membrane, endothelial cell and luminal area failed to relate to measures of neuropathic severity.(ABSTRACT TRUNCATED AT 250 WORDS)  相似文献   
35.
This paper describes an approach, conceptual framework, and software architecture for dynamic reconfiguration of the order picking system. The research and development project was sponsored by the Material Handling Research Center (MHRC), a National Science Foundation sponsored Cooperative Industry/University Research Center. The storage configuration is assumed to be an in-the-aisle order picking system in which stockkeeping units (SKUs) can occupy variable capacity storage locations and stock-splitting is allowed among zones (clusters). The product mix may include multiple product families with different life cycles, correlated demand within families and commonality of demand across families.  相似文献   
36.
Simulation of very fast surge phenomena in a three-dimensional (3-D) structure requires a method based on Maxwell's equations, such as the finite-difference time-domain (FDTD) method or the method of moments, because circuit-equation-based methods cannot handle the phenomena. This paper uses a method of thin-wire representation of the vertical conductor system for the FDTD method which is suitable for the 3-D surge simulation. The thin-wire representation is indispensable to simulate electromagnetic surges on wires or steel frames in which the radius is smaller than a discretized space step used in the FDTD simulation. In this paper, a general surge analysis program named the virtual surge test lab based on the Maxwell's equations formulated by the FDTD method, is used to simulate the surge phenomena of a vertical conductor, including the effects of horizontal wave incidence and vertical wave incidence. Experimental results on the reduced scale model have been presented in order to compare among the simulation results by the FDTD method and the results using numerical electromagnetic code based on the MoM.  相似文献   
37.
The functional reanimation of paralyzed limbs has been a longstanding goal of neural prosthetic research, but clinically successful applications have been elusive. Natural voluntary limb movement requires four major elements: actuators (i.e., motor units), sensors (i.e., somatosensory afferents), commands (i.e., cerebral cortical activity), and control (i.e., integration of the previous three elements at various levels of the neuraxis). Prosthetic equivalents of each of these elements are, as yet, primitive and often cumbersome to deploy, but new technologies promise substantial improvements for all. This article focuses on one such technology, bionic neuon (BION) modular microimplants, and its relationship to alternative and complementary technologies. The challenge remains to select and integrate them into systems that can be tailored efficiently to the widely disparate needs of patients with various patterns of weakness and paralysis.  相似文献   
38.
Prepulse inhibition (PPI) refers to a reduction in the startle response to a strong sensory stimulus when this stimulus is preceded by a weaker stimulus--the prepulse. PPI reflects a nonlearned sensorimotor gating mechanism and also shows a robust gender difference, with women exhibiting lower PPI than men. The present study examined the eyeblink startle responses to acoustic stimuli of 59 healthy heterosexual and homosexual men and women. Homosexual women showed significantly masculinized PPI compared with heterosexual women, whereas no difference was observed in PPI between homosexual and heterosexual men. These data provide the first evidence for within-gender differences in basic sensorimotor gating mechanisms and implicate the known neural substrates of PPI in human sexual orientation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   
39.
The definition of an empirically supported treatment (EST) arguably embodies 2 untested assumptions: (a) that different manualized renditions of the same therapy are functionally equivalent and (b) that therapies can be reliably applied independently of therapist, setting, and format. These assumptions were tested as applied to cognitive therapy (CT), using process data from a large multisite study (N=235) that included 3 cognitive and 6 alternative therapies. Although the non-CTs were more variable than the CTs on 2 of 4 dimensions studied (directiveness and emotional arousal), there was considerable variation among the 3 CTs, even when implemented in the current context of rigorous training, manualization, and adherence checks. Results are discussed as related to the assumptions underlying EST criteria. (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   
40.
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