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11.
The Chiari type II malformation is the leading cause of death in infants with myelomeningocele. The authors report 17 cases of symptomatic Chiari type II malformation occurring in two distinct age dependent population. In Group I, 13 neonates and infants in the first year of life presented with cranial nerve and brain stem dysfunction characterized by vocal cord paralysis, apnea, dysphagia and laryngeal stridor. In Group II, 4 patients developed signs and symptoms after the first year of life. In this group, the presentation was more insidious and included neck pain and cerebellar manifestations. The surgical treatment consisted initially in shunt implantation or revision and when there was no improvement, posterior fossa decompression was performed. The response to the surgical treatment differed considerably between the two groups: older patients improved promptly after surgery and there was no casualties; in newborn and infants, especially those under 6 months of age, the mortality rate was 46.1%. The authors stress that prompt diagnosis and surgical intervention should be performed in order to produce a favorable outcome.  相似文献   
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AIMS: To compare the outcome in in vitro fertilisation (IVF) children (after fresh embryo transfer) from multiple and singleton births with one another, and with normally conceived control children. METHODS: A cohort of 278 children (150 singletons, 100 twins, 24 triplets and four quadruplets), conceived by IVF after three fresh embryos had been transferred, born between October 1984 and December 1991, and 278 normally conceived control children (all singletons), were followed up for four years after birth. They were assessed for neonatal conditions, minor congenital anomalies, major congenital malformations, cerebral palsy and other disabilities. Control children, all born at term, were matched for age, sex and social class. RESULTS: The ratio of male:female births was 1.03. Forty six per cent of IVF children were from multiple births; 34.9% were from preterm deliveries; and 43.2% weighed less than 2500 g at birth. The IVF singletons were on average born one week earlier than the controls, weighed 400 g less, and had a threefold greater chance of being born by caesarean section. The higher percentage of preterm deliveries was largely due to multiple births and they contributed to neonatal conditions in 45.0% of all IVF children. The types of congenital abnormalities varied: 3.6% of IVF children and 2.5% of controls had minor congenital anomalies, and 2.5% of IVF children and none of the controls had major congenital malformations. The numbers of each specific type of congenital abnormality were small and were not significantly related to multiple births. IVF children (2.1%) and 0.4% of the controls had mild/moderate disabilities. They were all from multiple births, including two children with cerebral palsy who were triplets. CONCLUSIONS: The outcome of IVF treatment leading to multiple births is less satisfactory than that in singletons because of neonatal conditions associated with preterm delivery and disabilities in later childhood. A reduction of multiple pregnancies by limiting the transfer of embryos to two instead of three remains a high priority.  相似文献   
13.
A questionnaire survey was carried out to examine the attitudes and practices of Australian and New Zealand intensivists with regard to brain death and organ donation. A return rate of 82.5% was achieved. Fifty-eight per cent had written evidence of their own wishes to donate organs and 94% would agree to donation from a dependent. At least one intensivist is involved in certifying brain death on 95% of occasions. Intensivists are involved in the request for organ donation over 90% of the time although one-third do not believe that it is their role to request organ donation. Although two-thirds believe that the family should always be approached for organ donation, another 52 out of 254 indicated that it was their (the intensivist's) role to decide if families should be asked for organ donation. Possible reasons for not requesting are language or other communication problems, perceptions of cultural differences and degrees of family distress. Twenty per cent of respondents do not provide haemodynamic support before brain death confirmation. Australian and New Zealand intensivists overwhelmingly support the concept of brain death, current methods of confirmation of brain death, organ donation and transplantation. Possible reasons behind loss of potential donors include decisions not to resuscitate both before and after brain death is confirmed. Perceptions of family grief and cultural differences clearly inhibit requests for organ donation. A very few units have an effective policy on approaching families about organ donation. Intensivists have almost exclusive control over requests for organ donation and thus bear a full professional responsibility for this element of hospital practice.  相似文献   
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BACKGROUND: This study examines the relationship between income, health insurance, and usual source of care characteristics and screening and management of hypertension. METHODS: This is a secondary analysis of data from the 1987 National Medical Expenditure Survey. Adult survey respondents constitute a sample representative of the total adult noninstitutionalized US population. Screening, follow-up care, and pharmacologic treatment for hypertension were examined among low income individuals, the uninsured, those without a usual source of care place, and those without a particular usual source of care physician. RESULTS: The uninsured, individuals without a usual source of care place, and those without a particular usual source of care physician received less screening, follow-up care, and pharmacologic treatment for hypertension. Income did not affect receipt of hypertensive care. CONCLUSIONS: Lack of health insurance and lack of a usual source of care are barriers to hypertensive care. Policies that increase access to health insurance or to usual source of care physicians may enable more individuals to attain control of hypertension.  相似文献   
16.
A novel strategy was utilised to assess the risk to health from exposure to polycyclic aromatic hydrocarbons (PAHs). Ambient monitoring was carried out by personal sampling. Urinary thioethers (UTh) and urinary 1-hydroxypyrene (1-HP) were utilised for biological monitoring. Urinary d-glucaric acid (UDGA) and sister chromatid exchange (SCE) in peripheral blood lymphocytes were used as biological effect markers. The population was categorised into exposed and control groups according to the external dose of PAHs. The excretion of 1-HP in the controls over the 3-day period showed a relatively stable baseline, while the exposed showed a significant increase over the same period of time. SCE frequency in the exposed population was significantly different from controls.  相似文献   
17.
本文着重对图象多分辨率技术进行分析,并提出了相应的系统结构成框架,同时还探讨了以图象多分辨率处理为核心,采用了 新的压缩编码的可能性。  相似文献   
18.
OBJECTIVE: The purpose of this study was to compare click-evoked otoacoustic emissions (COAEs) of subjects having similar auditory thresholds but different age ranges. It is well known that elevated hearing thresholds are common with increasing age and that deterioration of outer hair cells is often noted in cases of hearing loss due to increased age. It has also been reported that evoked otoacoustic emissions (EOAEs) decrease with increased age. However, there is still some question whether changes in EOAEs with aging are associated with the increased hearing threshold or whether there is some additional effect of aging that enfluences EOAEs. DESIGN: COAE input/output functions and synchronized spontaneous OAEs (SSOAEs) were measured in two groups of subjects having similar auditory thresholds, one ranging in age from 19 to 29 yr, the other ranging in age from 40 to 61 yr. Mixed-model ANOVAs were performed to determine whether there were any statistically significant differences in COAEs based on age group. RESULTS: There were no statistically significant differences in COAE level or COAE threshold between age groups. Significant differences in COAEs were found for subjects based on whether they had measurable SSOAEs, regardless of age. CONCLUSIONS: Age does not significantly reduce COAE level nor increase COAE threshold. Other factors, such as presence of SSOAEs and hearing loss, undoubtedly have more influence on COAEs than the factor of age.  相似文献   
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Although the good appearance and biocompatibility of dental porcelains, failures are still of considerable concern because of the limited properties to all ceramic system. Physical properties that might be considered ideal include high strength, resistance to abrasion, and resistance to the hostile oral environment. Porcelain has been considered by many of its physical characteristic are similar to those of enamel. In 1983 a new modality of treatment, the etched porcelain restoration was introduced by Simonsen and Calamia. Numerous investigations have shown the strength of the etched porcelain bonded to composite resin and also the clinical success of this porcelain to be used as laminated veneers and etched inlays and onlays.  相似文献   
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