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181.
OBJECTIVES: To examine the association between intraoperative cerebral microembolic signals (MES) and postoperative neuropsychological deficit in patients with valve replacement (VR) and patients with coronary artery bypass grafting (CABG). METHODS: Neuropsychological examination (10 tests) was performed 1-2 days before and 2 months after surgery (VR (n=26) and CABG (n=14)). The intraoperative number of cerebral MES were monitored from the right middle cerebral artery using transcranial Doppler. RESULTS: A higher number of cerebral MES were detected in VR patients with neurological deficit (6/26) compared with those without deficit (20/26) (MES median number 2083 v 645, p=0.04). No such difference was found in patients with CABG (2/14 v 12/14) (MES median number 50 v 112, p=0.2). CONCLUSION: A high number of MES were detected in patients with VR with neuropsychological deficit. In patients with CABG with such a deficit, a low number of MES were detected. This difference in number may be explained by relatively more gaseous emboli in the first and more solid in the second. However, the results in the patients with CABG should be interpreted with caution due to the few patients in this subgroup. 相似文献
182.
The latency of components of the auditory evoked neuromagnetic field has been shown to reflect, or encode, stimulus attributes. In particular, the M100 component, occurring approximately 100 ms post stimulus onset has a latency that depends on stimulus pitch, spectral complexity and presentation level. This study used magnetoencephalography to record neuromagnetic fields evoked by presentation of two-tone complexes consisting of various proportions of 100 Hz and 1 kHz energy. These are perceived categorically, as evidenced by classification and reaction time measurements. It is found that the M100 latency also varies categorically, that is, characterized by two plateau regions with a sharp interface. Thus, we find that not only does the M100 latency reflect acoustic attributes of a stimulus, but also such perceptual characteristics. 相似文献
183.
BACKGROUND: The objective of this paper is to illustrate the effect of a gap of 5 mm, an overlap of 5 mm and a perfect match on the dose distribution across the junction of tangential breast fields and adjacent supraclavicular and axillary fields. MATERIALS AND METHODS: For this purpose film dosimetry was applied to measure relative dose distributions in two sagittal planes in an anthropomorphic breast phantom having cork lungs, simulating a radiation therapy treatment of the breast and adjacent supraclavicular lymph nodes. Two different treatment techniques, an SSD match technique and a geometrically exact isocentric match technique, as routinely applied in the two institutes were examined. The three-dimensional treatment planning system of each institute was used to calculate the dose distribution in the match region of the supraclavicular fields and the two opposing tangential fields. The measured and calculated dose distributions were evaluated and compared along lines in two sagittal planes from the supraclavicular fields down to the tangential fields crossing the match planes. These dose distributions in the match region were extremely dependent on the set-up of the fields. RESULTS: Although the reproducibility of the film measurements was within 2%, it became clear that the set-up of the fields to achieve a gap of 5 mm, a perfect match or an overlap of 5 mm required a lot of attention, even when using a phantom. CONCLUSIONS: It can be concluded that in clinical practice, these set-up difficulties do influence the dose distribution in the match region much more than the systematic uncertainties in the dose calculation algorithms of the treatment planning systems and the type of treatment technique. 相似文献
184.
A brief history and summary of studies designed to elucidate the role of monoamine oxidase (MAO) in schizophrenia are presented. The majority of these studies have reported a decrease in the platelet enzyme activity of chronic schizophrenic patients when compared to controls. Difficulties encountered when comparing MAO activity measured in different patient populations are also considered. Finally, the significance of decreased platelet MAO activity is discussed with respect to its possible etiological role in some forms of schizophrenia. 相似文献
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Effects of small cardioactive peptide B (SCPB) on cerebral neurons which underlie prey capture in the carnivorous pteropod mollusc, Clione limacina, were investigated. SCPB in concentrations of 10 microM and higher produced direct activation of cerebral ganglion neurons underlying extrusion of buccal cones used in prey capture. SCPB in lower concentrations, between 1 and 5 microM, did not have a noticeable effect on the membrane potentials of these neurons; however, it significantly increased their responsiveness to sensory inputs from the tactile stimulation of the head, and their ability to generate afterdischarge activity. SCPB immunoreactivity was observed in cell bodies in buccal, cerebral, pedal, and intestinal ganglia, as well as in the anterior esophagus and in buccal cones where fibers stained intensely. These electrophysiological and immunohistochemical data suggest that SCPB may have a physiological role in feeding arousal in Clione. 相似文献
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Emergency physicians need to understand the potential for false reassurance in the interpretation of reflex examination data. Neurologic consultation should be sought when classic signs are lacking, but other evidence causes suspicion. Changes in teaching emphasis and acute practice are needed, since the stakes may be high and time is of the essence. We have responded to the insights gained from this study by augmenting in-service and continuing medical education teaching and by implementing guidelines to assist EPs. We have emphasized the importance of spotlighting high-risk patients, as exemplified above, and of taking advantage of neurologic or neurosurgical consultation. Where in-person consultation is less available, the use of guidelines and remote consultation should be able to help direct further examination, diagnostic formulation, and the need for imaging decisions. Given the potential for severe negative outcome if spinal emergencies are not optimally managed, we must give the teaching of these issues high priority. 相似文献
190.
TP Berezina 《Canadian Metallurgical Quarterly》1998,84(9):940-948
In cats, distention of an isolated segment of the ileum with a saline injection elicited its contraction which could be abolished with blockade of muscarinic receptors. Serotonine acting from the ileum lumen enhanced the response, whereas acting from the vascular bed induced a contractile response which could be decreased with the beta-adrenoreceptor-blocking agent propranolol. The findings suggest a possibility of the serotonine participation in realisation of peristaltic reflex, the character of its modulating effect being dependent on activation of excitatory cholinergic and inhibitory nonadrenergic neurons. 相似文献