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11.
Beclomethasone dipropionate aerosol at a dose of 100 mug four times a day was administered to 32 patients suffering from chronic perennial asthma. Twenty-three of these patients had previously received prolonged treatment with corticosteroids, causing various degrees of adrenal suppression in some patients. Almost complete recovery of adrenal function was observed within a period of six months in most patients. Treatment with beclomethasone dipropionate did not affect the hypothalamic-pituitary-adrenal axis in the other nine asthmatic patients who had not received prolonged corticosteroid therapy previously and who served as a control group. 相似文献
12.
Acute, exsanguinating hemorrhagic cystitis secondary to cyclophosphamide therapy, radiation therapy, or an infiltrating bladder tumor may be managed successfully with intravesical Formalin therapy. The indications for its use, the technique, success rates, and complications are discussed. This treatment was effective in 14 of 16 patients in the present series and 79 of 90 cases reported in the literature. Dilutions of 4% or less were as effective as a 10% dilution and were associated with far fewer complications. The early use of Formalin in the treatment of intractable hemorrhagic cystitis is recommended. 相似文献
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When the results of a reference (or gold standard) test are missing or not error-free, the accuracy of diagnostic tests is often assessed through latent class models with two latent classes, representing diseased or nondiseased status. Such models, however, require that conditional on the true disease status, the tests are statistically independent, an assumption often violated in practice. Consequently, the model generally fits the data poorly. In this paper, we develop a general latent class model with random effects to model the conditional dependence among multiple diagnostic tests (or readers). We also develop a graphical method for checking whether or not the conditional dependence is of concern and for identifying the pattern of the correlation. Using the random-effects model and the graphical method, a simple adequate model that is easy to interpret can be obtained. The methods are illustrated with three examples from the biometric literature. The proposed methodology is also applicable when the true disease status is indeed known and conditional dependence could well be present. 相似文献
15.
Erythema nodosum leprosum (ENL) is a serious complication of lepromatous (L) disease in leprosy. We have previously shown that of the four IgG subclasses, IgG1 and IgG3 Mycobacterium leprae-specific antibodies are significantly lower in leprosy patients during ENL reaction compared with untreated L patients. To see if this decrease results from a down-regulation of antibody synthesis during ENL, the frequency of antibody-secreting B cells (ABSC) in the blood compartment was determined by ELISPOT and related to serum immunoglobulin concentrations (microgram/ABSC). Control groups consisted of 16 patients with stable L disease and 32 healthy endemic controls (EC). Paired samples were analysed during acute ENLS (n = 13) and after the reaction had subsided to identify changes associated with ENL. Polyclonal (PC) IgG1 was elevated in L patients compared with EC (325 micrograms versus 180 micrograms). Interestingly, patients during acute ENL showed concentrations higher than L patients (419 micrograms), which decreased after the reaction had subsided (260 micrograms), indicating the transient nature of the antibody response. IgG2 antibodies showed the reverse trend and were lower during ENL and increased after the reaction had subsided. The mean concentrations for PC IgG3 and IgG4 antibodies were similar during ENL and after the reaction had subsided. Thus, decrease in M. leprae-specific IgG1 and IgG3 antibodies is not related to down-regulation of B cell responses. Identification of factors which regulate PC IgG1 antibody synthesis may provide additional insights into determinants of ENL reactions. 相似文献
16.
To provide the prerequisite for long-term study of the inner ear related to structural and functional integrity, tissue of stria vascularis with spiral ligament was isolated from Wistar rat cochleas and cultured using the explant-culture technique. The following culture media were used: EMEM with Hepes buffer, hydrocortisone (400 ng/ml), transferrin (5 micrograms/ml). triiodothyronine (10(-9) M), cholera toxin (10(-10) M), insulin (5 micrograms/ml), and epidermal growth factor (10 ng/ml). To characterize the cells growing out from the explant, immunofluorescence with cytokeratin (cytokeratin 18) and ultrastructural examination with SEM and TEM were performed. The marginal cell function was investigated by expression of Na+, K(+)-ATPase antisera against beta 2 subunit of rat Na+, K(+)-ATPase and P-NPPase. We were able to maintain the cultured cells for 3 weeks or more. Monolayered marginal cells were observed beyond 14 days in vitro and the expression of cytokeratin 18 was especially enhanced. The cultured marginal cells were almost identical to in vivo cells both as regards ultrastructural features and Na+, K(+)-ATPase activity. The present results suggest that the primary explant culture technique is a reliable in vitro model of strial marginal cells. However, establishment of the cell line is needed for long-term study. 相似文献
17.
JS Bradley JO Phillips JE Cavanaugh MH Metzler 《Canadian Metallurgical Quarterly》1998,26(11):1905-1909
OBJECTIVE: To evaluate the clinical utility of measuring gastric pH with a pH meter vs. pH paper in critical care patients. DESIGN: Prospective comparison of gastric pH measurements, using both pH meter and pH paper. SETTING: Surgical intensive care unit (ICU) at a rural Midwestern university medical center. PATIENTS: Fifty-one patients who received therapy for prophylaxis of stress ulcers in the surgical ICU. INTERVENTIONS: Therapy for stress ulcer prophylaxis was monitored. MEASUREMENTS AND MAIN RESULTS: The pH of 985 gastric samples, taken from 51 patients, was measured with both pH meter and pH paper. The pH meter and pH paper measures demonstrated a concordance correlation coefficient of .896. The mean difference between the two measures (pH paper - pH meter) was estimated to be between -0.4 and 1.4, suggesting a positive bias for the paper. The prevalence of events representing clinically relevant differences between the pH meter and pH paper in the measurement of the same gastric sample was calculated. The frequency with which each of the events occurred consecutively (or, in one case, two nearly consecutive events on the same day) was also calculated. Bias in a clinically relevant range was estimated. A set of \"probability profiles\" was constructed. CONCLUSIONS: A hand-held pH meter and pH paper are not interchangeable measures of gastric pH. The pH paper exhibits an appreciable positive bias compared with a hand-held pH meter in the clinically relevant range of 2 to 6. More research is needed to determine if that bias affects treatment outcomes. We recommend the use of a pH meter for patients who demonstrate pH readings of < or = 4, consecutive with readings of < or = 5. 相似文献
18.
Male genital tract obstructions may result from infections, previous inguinal and scrotal surgery (vasectomy) and congenital bilateral absence of the vas deferens (CBAVD). Microsurgery can sometimes be successful in treating the obstruction. In other cases and in cases of failed surgical intervention, the patient can be treated by microsurgical or percutaneous epididymal sperm aspiration (MESA, PESA) or testicular sperm extraction (TESE) and intracytoplasmic sperm injection (ICSI). We present the results of 39 ICSI procedures for obstructive azoospermia in 24 couples. The aetiology of the obstruction was failed microsurgery in 11 patients, CBAVD in nine and genital infections in four. Sperm retrieval was accomplished via MESA in four cases, PESA in 18 cases and via TESE in 11 cases. TESE was only applied when PESA failed to produce enough spermatozoa for simultaneous ICSI. In six patients, the ICSI procedure was performed with cryopreserved spermatozoa after an initial PESA procedure. Fertilization occurred in 47% of the metaphase II oocytes; embryo transfer was performed in 92% of procedures and resulted in a clinical pregnancy in 13/39 procedures. Ongoing pregnancy was achieved in 10/39 procedures. One pregnancy was terminated early after prenatal investigation showed a cytogenetic abnormality (47,XX+18, Edwards syndrome). The other nine pregnancies resulted in the live birth of 10 children, without any congenital abnormalities. Epididymal and testicular retrieved spermatozoa were successfully used for ICSI to treat obstructive azoospermia, and resulted in an ongoing pregnancy in 10 of 24 couples (41.6%) after 39 ICSI procedures, a success rate of 25.6% per treatment cycle and of 27.7% per embryo transfer. 相似文献
19.
J Wechsler R Willemze A van der Brule E Thomine P Joly O Verola Y Fonck P Souteyrand MH Delfau M Bagot P Gaulard 《Canadian Metallurgical Quarterly》1998,134(4):479-484
OBJECTIVE: The aim of this investigation was to report on the radiographic interpretation of the hard palate and nasal fossa floor in panoramic radiographs by studying different skulls, x-ray machines, and head positions in relationship to the Frankfort plane before and after ostectomy. STUDY DESIGN: Twenty dry human skulls were radiographed with three different panoramic x-ray machines in three different positions. Three of the skulls were submitted to different ostectomies. RESULTS: Multiple images of the hard palate and nasal fossa floor were present in 96.12% of the radiographs. Single images (3.88%) occurred only in the \"chin up\" position. CONCLUSIONS: The lower image represents the nasal fossa floor, especially its lateral and anterior limits. The upper images are double real images mainly formed by the junction of the nasal septum with the nasal fossa floor and possibly by posterior parts of the hard palate and nasal fossa floor. All images overlap in the \"chin up\" position becoming a single image. The most common shape of the anatomic landmark was wide angle \"W\" (58.33%). Other shapes present in positions \"chin up\" and \"chin down\" indicate patient positioning errors. The x-ray machines did not influence the results. 相似文献
20.