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101.
T Rinne AM Bronstein P Rudge MA Gresty LM Luxon 《Canadian Metallurgical Quarterly》1998,245(6-7):314-321
The clinical presentations and aetiologies of a series of 53 cases of bilateral vestibular failure (BVF) seen by the authors over a decade were evaluated by retrospective review of the medical records. Thirty-nine per cent of patients had associated neurological disease; 13% had a progressive cerebellar syndrome with disabling gait ataxia, abnormal eye movements and cerebellar atrophy on neuro-imaging. BVF was usually unsuspected. Nine per cent had cranial or peripheral neuropathies and in this group there was no abnormality of brain stem/cerebellar oculomotor function, but hearing loss was common. Eleven per cent revealed BVF and hearing loss secondary to meningitis, and 6% had other neurological disorders. Idiopathic BVF was found in 21% of cases, characterised by paroxysmal vertigo and/or oscillopsia, but no abnormal clinical signs. Gentamicin ototoxicity accounted for a further 17%, while autoimmune disease was present in 9% of patients. Otological or neoplastic disease was diagnosed in the remaining 13% of patients. It was concluded that neurological, audiological and ocular motor assessments allow the probable cause of BVF to be defined in approximately 80% of cases. A group of BVF related to autoimmune pathologies is reported for the first time, indicating the need for immunological screening. Idiopathic BVF may present with only minor visual or vestibular symptoms, while in patients with cerebellar degeneration, BVF may be unsuspected and, thus, underdiagnosed. 相似文献
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RB Singh H Mori J Chen S Mendis M Moshiri S Zhu SH Kim RG Sy AM Faruqui 《Canadian Metallurgical Quarterly》1996,3(6):489-494
PURPOSE: Two types of glass wool were used to remove leukocytes in semen for evaluation of reactive oxygen species production by spermatozoa in oligozoospermic patients with leukocytospermia. METHODS: Semen samples were prepared using fine-structure glass wool (SpermFertil) and coarse-structure glass wool. In each treatment group, native semen was evaluated for sperm concentration, percentage motility, viability, leukocyte concentration, and production of reactive oxygen species. RESULTS: Electron microscopically, SpermFertil showed a higher number of leukocytes attached to the fibers compared to coarse-structure glass wool. Leukocytes in native semen and after glass wool filtration as determined by peroxidase cytochemistry confirmed this observation. Reactive oxygen species decreased from 45.303 counts/10(7) viable cells in native semen to 15.806 counts/10(7) cells in coarse structure wool and 7.465 counts/10(7) cells in Spermfertil, respectively. CONCLUSIONS: Removal of leukocytes from semen of oligozoospermic patients by means of glass wool filtration is a useful method to distinguish production of reactive oxygen species by leukocytes versus sperm cells. 相似文献
105.
Tuberculous meningitis remains an important illness that can be difficult to diagnose in a timely fashion and carries significant morbidity. We present a retrospective review of the cases of tuberculous meningitis diagnosed and treated at a single institution. Fifty-eight cases were identified and stratified according to stage of disease at presentation. Four patients (7%) died; three (5%) developed severe neurological sequelae. Poor outcomes were largely confined to cases presenting in an advanced stage and at the extremes of age. Corticosteroids were administered to 56 patients and may have contributed to the comparatively good outcome in these cases. 相似文献
106.
N Kates M Craven AM Crustolo L Nikolaou C Allen 《Canadian Metallurgical Quarterly》1997,19(5):324-332
The increasingly prominent role of the family physician in delivering mental health care can be enhanced if productive and collaborative relationships can be established with local mental health services. This paper describes a Canadian program that has achieved this by bringing mental health counselors and psychiatrists into the offices of 87 family physicians in 35 practices in a community in Southern Ontario. The paper describes the program, the activities of counselors and psychiatrists within the practices, and the administrative structures set up to coordinate these activities. Data is presented from the evaluation of the first year of the program's operation (13 practices and 45 family physicians) during which time 3085 referrals were received. The program made mental health care more available and accessible, increased continuity of care, provided additional support for the family physician, offered new opportunities for continuing education, and led to a reduced and more efficient use of other mental health services. The components of the program can be adapted to most communities. 相似文献
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The purpose of this study was to examine the relationship of job satisfaction to job difficulty and worthiness, reported by the clinical psychologists who worked at medical institutions. A mail survey of 748 clinical psychologists working at hospital and clinics revealed the following results. First, job satisfaction was related more to job situation than job content. Also, job satisfaction was low among those who worked at non-university psychiatric or geriatric hospitals, who did not practice psychotherapy, and who were not in education, research, or management. In addition, compared to the high job satisfaction group, the low group perceived more incongruity between institutional climate and their psychological work, felt being less valued by other professionals, were less able to function fully as a practicing psychologist, and experienced more role ambiguity as a clinical psychologist in a hospital setting. 相似文献
110.
M Albert C Athanassopoulos LB Auerbach D Bauer R Bolton B Boyd RL Burman I Cohen DO Caldwell BD Dieterle JB Donahue AM Eisner A Fazely FJ Federspiel GT Garvey RM Gunasingha V Highland J Hill R Imlay K Johnston WC Louis A Lu AK Mann J Margulies K McIlhany W Metcalf RA Reeder V Sandberg M Schillaci D Smith I Stancu W Strossman MK Sullivan GJ VanDalen W Vernon YX Wang DH White D Whitehouse D Works Y Xiao S Yellin 《Canadian Metallurgical Quarterly》1995,51(3):R1065-R1069