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21.
Hyponatremia     
The serum sodium concentration reflects the osmolality of the extracellular fluid and provides no direct information about total body sodium content. Patients with hyponatremia may have decreased, normal, or increased total body sodium content. The first step in the approach to the patient with hyponatremia is measurement of plasma osmolality. Hyponatremia with normal plasma osmolality results from hyperlipemia or hyperproteinemia, whereas hyponatremia with increased plasma osmolality results from hyperglycemia or mannitol infusion. Patients with hyponatremia and decreased plasma osmolality may be hypovolemic, hypervolemic, or normovolemic. The volume status of the patient is best determined by history, physical examination, and a few ancillary tests (e.g., total plasma protein concentration, hematocrit, blood pressure, central venous pressure). The clinical signs of hyponatremia are related more to the rapidity of onset than to the severity of the associated plasma hypoosmolality and reflect influx of water into the central nervous system. The main goals of treatment in hyponatremia are to diagnose and manage the underlying disease and, if necessary, to increase serum sodium concentration and plasma osmolality.  相似文献   
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1. The presence of dye coupling between striatal neurons was investigated using in vivo intracellular recording and dye injection in adult rats. In 17% of the cases in which a single striatal neuron was injected with Lucifer yellow, more than one labeled neuron was recovered. In control rats, this dye coupling was observed only between single pairs of medium spiny neurons and only when the neuron injected exhibited the Type II response profile as defined by paired-pulse stimulation of corticostriatal afferents. 2. After intravenous administration of the D1/D2 agonist apomorphine at a behaviorally effective dose (i.e., 0.1-0.3 mg/kg), an increase in the incidence (from 17% to 82% of injected cells) and extent (from 2 cells to 3-7 cells labeled per injection) of dye coupling was observed. This effect was mediated by D2 receptor stimulation because administration of the D2 agonist quinpirole caused similar alterations in the incidence and extent of dye coupling (66% coupled). In contrast, administration of the D1 agonist SKF 38393 or the D1 antagonist SCH 23390 did not result in any significant alteration in dye coupling. 3. In control rats, the entire somatodendritic regions of dye-coupled neurons were found to be localized within single matrix compartments of the striatum. However, after intravenous administration of apomorphine or quinpirole, clusters of dye-coupled neurons were found to extend across the patch/matrix boundary. Moreover, dye coupling was observed after injecting cells exhibiting either the Type I or the Type II response profile. 4. In response to D2 receptor stimulation, both the extent and the pattern of coupling between striatal neurons is altered, resulting in direct coupling between neurons that are otherwise functionally and anatomically segregated in the control animal.  相似文献   
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The ratio of the thermal oxidation parameter to the decomposition point (T p/T m) is of the order of 0 85 for Y9Co7, indicating a high degree of chemical binding. The persistence of high values of this ratio has been investigated with respect to (a) other compounds in the Y-Co system, (b) replacement of cobalt in Y9Co7 by other d-e!ements, and (c) replacement of yttrium by other rare-earth elements. High ratios are found for (a) Y-Co compounds where Y/Co > 0.5, (b) Y-3d compounds with cobalt and niche! only, end (c) RE-Co compounds generally. However, there are differences in level of the ratio amongst the rare-earth compounds, from which it is inferred that the highest values coincide with full electron shells, that is, without participation of 4f electrons. Additional work is described on an effect of preparation arc-melting current 0n theT p value for Y9Co7, and on compounds of the same pattern where both components are changed.  相似文献   
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Modelling of fatigue damage progression and life of CFRP laminates   总被引:1,自引:0,他引:1  
A progressive fatigue damage model has been developed for predicting damage accumulation and life of carbon fibre‐reinforced plastics (CFRP) laminates with arbitrary geometry and stacking sequence subjected to constant amplitude cyclic loading. The model comprises the components of stress analysis, fatigue failure analysis and fatigue material property degradation. Stress analysis of the composite laminate was performed by creating a three‐dimensional finite element model in the ANSYS FE code. Fatigue failure analysis was performed by using a set of Hashin‐type failure criteria and the Ye‐delamination criterion. Two types of material property degradations on the basis of element stiffness and strength were applied: a sudden degradation because of sudden failure detected by the fatigue failure criteria and a gradual degradation because of the nature of cyclic loading, which is driven by the increased number of cycles. The gradual degradation of the composite material was modelled by using functions relating the residual stiffness and residual strength of the laminate to the number of cycles. All model components have been programmed in the ANSYS FE code in order to create a user‐friendly macro‐routine. The model has been applied in two different quasi‐isotropic CFRP laminates subjected to tension–compression (T–C) fatigue and the predictions of fatigue life and damage accumulation as a function of the number of cycles were compared with experimental data available in the literature. A very good agreement was obtained.  相似文献   
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Because T cells appear to modulate the severity of murine Borrelia burgdorferi infections, we decided to examine the possible involvement of T cell-associated cytokines in disease outcome. Comparison of in vitro B. burgdorferi Ag-induced cytokine production in disease-susceptible and -resistant strains revealed striking differences; spleen cells from susceptible C3H mice produced significantly higher levels of IL-2 and IFN-gamma and lower levels of IL-4 than spleen cells from resistant BALB/c mice. Lymph node responses were even more divergent, with C3H mice producing high levels of IFN-gamma, and BALB/c mice producing little or none. This apparent Th1/Th2 cytokine imbalance was also reflected in vivo, since serum from C3H had significantly higher levels of B. burgdorferi-specific IgG2a Ab and lower levels of IgG1 Ab than serum from BALB/c mice. In vivo studies confirmed the importance of IL-4 in early control of spirochete growth, since treatment of either strain with neutralizing anti-IL-4 mAb led to increased joint swelling and higher spirochete burdens in joints compared with those in control mAb-treated mice. In contrast, IFN-gamma may hinder early control of spirochete growth in susceptible C3H mice, since treatment of mice with neutralizing anti-IFN-gamma mAb reduced both joint swelling and joint spirochete burdens compared with those in control mAb-treated mice. These studies indicate opposing roles for IL-4 and IFN-gamma in the modulation of spirochete growth and disease development in B. burgdorferi-infected mice and suggest that differential cytokine production early in infection may contribute to strain-related differences in susceptibility.  相似文献   
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This study examined risk factors associated with incisor injury in 3396 third and fourth grade school children in Alachua County, Florida. One of six orthodontists completed a standardized examination form for each child to assess severity of incisor injury, gender, age, race, skeletal relationships, morphologic malocclusion, incisor exposure, interlabial gap, TMJ sounds, chin trauma, and history of lower facial trauma. One in five (19.2%) exhibited some degree of incisor injury. This was limited to a single tooth in 73.1% of those with injury, while enamel injury predominated (89.4%). The majority of the injuries (75.4%) were localized in the maxillary arch, with central incisors the most frequently traumatized. Chi-square tests of association indicated that gender, race, school, orthodontist, history of lower facial trauma, chin trauma, profile, and maxillary and mandibular horizontal positions were associated with incisor injury (P < 0.05). Wilcoxon rank sum tests identified differences in age, overjet, time of screening, and interlabial gap between those with and without injury (P < 0.05). Results of logistic regression analyses indicated risk of incisor injury was greater for children who had a prognathic maxilla, a history of trauma, were older, were male, and had greater overjet and mandibular anterior spacing.  相似文献   
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