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951.
952.
The aim of this research was to develop a method of local production of collagen graft materials which are presently imported. The following methods were used to produce collagen membrane and sponge from human placentas and rat tail tendons. Collagen type I was isolated from human placenta and rat tail tendon by acetic acid extraction and characterised by SDS-PAGE. The collagen sponge was prepared by dissolving the collagen in HCl. The resulting dispersion was poured into a glass container, freeze-dried and then cross-linked by immersion in glutaraldehyde solution. It was then washed with distilled water and freeze-dried again. The collagen membrane was also similarly prepared by dispersing lyophilized collagen in HCl but then mixed with glutaraldehyde, exposed to U.V. light and later air dried.  相似文献   
953.
The basic tenet of continuous quality improvement is that there is always room for additional improvement in the clinical care provided to patients. The opportunities for this improvement come from the analysis of information collected during the ongoing monitoring of important elements of care. The provision of clinical psychiatric care is seen as a complex process that is dependent on the effective functioning of all of the health and mental health care organization. The concept of continuous quality improvement is the most recent stage in a long process of defining and redefining the basic goals and tenants of medical and psychiatric quality assurance. The determination of the actual improvement of psychiatric and mental health care due to quality assurance is a substantial and important technical problem. The determination of the value of this improvement in mental health care is an even greater ethical and social problem.  相似文献   
954.
OBJECTIVE: To know the variability in the interpretation (normal/pathological) of posteroanterior view chest radiograph and the associated factors between a medical primary care community and a Gold Standard (GS) from 3 reference radiologists. DESIGN: Crossover study. SETTING: Primary care. Teaching health centers of Elche. METHODS: Interobserver percentage agreement (IPA) and Kappa statistic (K) were used to analyse the interobserver agreement (IA) between the GS and every of the participants in interpretation of 100 radiographs. Intraobserver variability was assessed with a second review. Using uni and multivariant analysis some possibly associated factors were studied. RESULTS: Overall IPA and K were 71.3% (CI 95%: 69.2-73.3) and 0.41 (CI 95%: 0.36-0.46) respectively. Time employed in radiographs reading and time passed after medicine studies finished were independently and significantly associated to higher and lower interobserver agreement results respectively, whereas recent professional experience, permanent job and age were not associated. Professional training is the variable that most explain the inter and intraobserver variability. CONCLUSIONS: Overall IA is acceptable. The IA showed by the participants trained under the MIR system is good but the IA achieved by the rest of participants is not acceptable. It is necessary a training which increase the clinical competence, as it does MIR training.  相似文献   
955.
Ciprofibrates (racemate and both enantiomers, Raccip, R- and Scip) were administered orally in doses of 1 and 10 mg/kg once daily over 28 days to male inbred Fischer 344 rats, age 90-110 days at the beginning of the experiment. Body mass gain was observed in all groups. The 1 mg groups showed almost no difference to the control group. The 10 mg groups exhibited less body mass gain, most pronounced in the Scip group. Liver masses were increased in a dose dependent manner up to more than 200%, only the 10 mg Scip group was not significantly different from the 1 mg group which exhibited an increase in liver weight to about 175%. Also the kidney weights increased to 130%, whereas thymus and spleen weights were decreased in the high dose groups. Liver microsomal cytochromes P450 (P450) concentrations were not altered in the 1 mg groups and distinctly lowered in the 10 mg groups. Ethoxyresorufin and ethoxycoumarin O-deethylations were lowered in all experimental groups in a dose dependent manner, after administration of the high doses down to 30% of the control levels or less. Pentoxyresorufin O-depentylation, however, was increased in all 1 mg groups. In the high dose groups it was not altered. Ethylmorphine N-demethylation was decreased after administration of the high doses by about 50%, but only Scip decreased this reaction also after administration of the low dose. NADPH/Fe2+-stimulated microsomal luminol and lucigenin amplified chemiluminescence was increased, whereas hydrogen peroxide formation was depressed even by the low doses to 50% of the normal values, to about 25% by the high doses. Microsomal lipid peroxidation, however, was only slightly or not influenced. Glutathion concentrations (in the reduced and the oxidized form) were increased in a dose dependent manner by about 20 to 30%, the concentration of lipid peroxides was not significantly influenced. Thus, the effects of the enantiomers were not different and were similar to those of the racemate. In serum, cholesterol and triglycerides were only moderately lowered. Albumin concentrations were significantly enhanced in all groups, total proteins after 1 mg/kg Raccip only. Serum bilirubins were not altered, and among the indicator enzymes for liver damage only ALAT, alkaline phosphatase and the dehydrogenases were increased, in no case higher than twofold. Histologically distinct effects were seen after administration of both doses, more pronounced after 10 mg/kg, but with no differences between the enantiomers and Raccip: marked hypertrophy of the hepatocytes, reduced staining of the nuclei, strongly acidophilic granulated cytoplama, no basophilia of the cell bodies, loss of glycogen. These changes were most pronounced around the central veins. Hepatocyte apoptoses also were observed. By immunohistochemistry an increased staining was seen for all P450 isoforms tested (1A1, 2B1, 2E1, 3A2 and 4A1), predominantly perivenously and most pronounced after administration of the high doses without differences between Rcip, Scip or Raccip (preliminary results). By electron microscopy a moderate proliferation of peroxisomes after treatment with 1 mg/kg Cips with a ratio between mitochondria and peroxisomes of about 1:1 (controls: 10:1) was observed, and the peroxisomes were a more heterogeneous population. The relative portions of glycogen and both forms of the ER decreased. Treatment with 10 mg/kg Rcip, Scip or Raccip led to a strong increase in the number of peroxisomes, in some hepatocytes the ratio between mitochondria and peroxisomes was 1:3 with an increased heterogeneity among the peroxisomes evidenced by a broad range of electron densities. Most peroxisomes lacked a nucleoid. Thus, the biochemical effects differed only slightly and the morphological effects of the enantiomers were not different and were similar to those of the racemate.  相似文献   
956.
Retrobulbar hematoma is a rare complication of blunt periorbital trauma with the potential disastrous consequence of visual impairment and blindness. The preoperative assessment, diagnostic symptoms and signs, as well as the treatment of this condition are reviewed. The patients presented as well as a review of the literature confirm that although retrobulbar hematoma is a rare complication of blunt periorbital trauma, irreversible visual sequelae can be prevented by prompt diagnosis and immediate surgical and pharmacological therapy.  相似文献   
957.
958.
The coincidence of neuronal stress induced by intoxication and an overexpression of amyloid precursor protein (APP) in the brains of children was examined. Brains of ten children accidentally intoxicated by poisonous mushroom were studied by means of immunohistochemical methods using monoclonal antibodies generated against different domains of APP and glial cell markers. Overexpression of APP was found in the brain neurons of all intoxicated children. Neurons were immunopositive with the antibodies generated against the middle (amyloid beta protein) domain of APP. No extracellular deposits were found in the tissue. Our results provided, for the first time, the evidence that overexpression of APP concomitant with the neuronal stress is age-independent phenomenon appearing not only in the brain of adults but in very young individuals as well.  相似文献   
959.
BACKGROUND: Interview studies which employ qualitative methodology are often concerned with classifying behaviours or attitudes and an ideal sample of research subjects displays variety in the attitudes or behaviours under scrutiny. OBJECTIVE: This paper describes the development of a questionnaire which measures GPs' attitudes towards discussing smoking with patients with the intention of using this instrument to select GPs with diverse views for a qualitative interview study. METHOD: Thirteen attitude statements with an accompanying Likert-type scale were completed by 327 GPs in one FHSA area. Factor analysis of responses produced two subscales: 'perceived efficacy' and 'enthusiasm'. Reliability and validity of these were examined. RESULTS: Each subscale had good internal reliability and preliminary exploration of construct validity supported the notion that the subscales were valid. CONCLUSION: The use of this type of instrument in sampling GPs for qualitative studies could be effective for selecting subjects with a diversity of views towards the research topic.  相似文献   
960.
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