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21.
22.
In recent years there has been spectacular progress in the approach to various disorders of the spinal column. Owing to improved methods of osteosynthesis there is no longer so much need for long periods of postoperative bed rest. Of all the scolioses, idiopathic scoliosis is most common. The vast majority of these cases are not clinically significant. What is seen in the remaining cases if left untreated is a progression in the curvature during growth. Progressive idiopathic scoliosis can be effectively treated using conservative methods. Screening at school is an important part of this process. If the curvature proves progressive and skeletal growth is not complete a brace can be prescribed. Use of this strategy and form of treatment can avoid progression of the curvature and development of serious deformities. This conservative therapy has markedly reduced the need for corrective surgery. Scheuermann's disease is characterized by a fixed dorsal thoracic kyphosis. Progressive Scheuermann's kyphosis can be effectively treated using a brace. The majority of fractures of the vertebral bodies can be treated conservatively. However, serious fractures normally require surgical intervention. In the industrialised Western world, low back pain is a major health problem and the foremost cause of disability and unfitness for work. Low back pain caused by degenerative disease of the spinal column should be treated using a multidisciplinary approach. The development of advanced operative techniques and osteosynthesis methods has made it possible to treat metastases of the spine surgically. The effects of this treatment on the quality of life are encouraging. 相似文献
23.
A G protein gamma subunit-like domain shared between RGS11 and other RGS proteins specifies binding to Gbeta5 subunits 总被引:1,自引:0,他引:1
BE Snow AM Krumins GM Brothers SF Lee MA Wall S Chung J Mangion S Arya AG Gilman DP Siderovski 《Canadian Metallurgical Quarterly》1998,95(22):13307-13312
Regulators of G protein signaling (RGS) proteins act as GTPase-activating proteins (GAPs) toward the alpha subunits of heterotrimeric, signal-transducing G proteins. RGS11 contains a G protein gamma subunit-like (GGL) domain between its Dishevelled/Egl-10/Pleckstrin and RGS domains. GGL domains are also found in RGS6, RGS7, RGS9, and the Caenorhabditis elegans protein EGL-10. Coexpression of RGS11 with different Gbeta subunits reveals specific interaction between RGS11 and Gbeta5. The expression of mRNA for RGS11 and Gbeta5 in human tissues overlaps. The Gbeta5/RGS11 heterodimer acts as a GAP on Galphao, apparently selectively. RGS proteins that contain GGL domains appear to act as GAPs for Galpha proteins and form complexes with specific Gbeta subunits, adding to the combinatorial complexity of G protein-mediated signaling pathways. 相似文献
24.
X Chen DJ Kempf HL Sham BE Green A Molla M Korneyeva S Vasavanonda NE Wideburg A Saldivar KC Marsh E McDonald DW Norbeck 《Canadian Metallurgical Quarterly》1998,8(24):3531-3536
The 2-isopropyl thiazolyl group is a highly optimized P3 ligand for C2 symmetry-based HIV protease inhibitors, as exemplified in the drug ritonavir. Here we report that incorporation of this P3 ligand into a piperazine hydroxyethylamine series also yielded novel, highly potent inhibitors. In tissue culture assays, the presence of human serum was less deleterious to the activity of these inhibitors than to that of ritonavir. Furthermore, potent activity against ritonavir resistant HIV was observed. 相似文献
25.
In a Danish population-based non-Hodgkin's lymphoma registry, 2687 newly diagnosed patients were registered from 1983 to 1992. 39 had testicular involvement (TL) (incidence 0.26/10(5)/year). Median age was 71 years. 24 cases had localised and 15 had disseminated disease. Histologically, all cases were diffuse (65% diffuse centroblastic type). Of the 27 tested, 11% were of T- and 89% of B-immunophenotype. In localised cases, where surgery was supplemented by combination chemotherapy (CCT), the relapse rate was 15.4%. The relapse rate for cases with localised disease treated with other regimens (orchiectomy and/or radiotherapy) was 63.6% (P < 0.05). Median relapse-free survival was 28 and 14 months, respectively. Overall 5-year survival for all cases was 17%. Adverse prognostic factors at the univariate level were stage IV, constitutional symptoms, serum lactic dehydrogenase elevation and performance score (WHO 3-4). It is suggested that the treatment of stage IE/IIE TL should include early CCT and CNS prophylaxis. 相似文献
26.
How garments contribute to performance of the clothing system during wear is of interest, as is understanding the value of using fabric properties to inform end-use characteristics. To investigate the influences of layering upper-body garments, four fabrics were used to construct two first-layer garments (wool and polyester) and two outer-layer garments (wool and membrane laminate). Over six sessions, 10 moderately trained males wore each first-layer garment as a single layer and in combination with each outer-layer garment while resting, running and walking in cold environmental conditions (8 ± 1°C, 81 ± 4% RH). Here, the type of garment arrangement worn (fabric type or number of layers) had little influence on heart rate, core body temperature and change in body mass. Weighted mean covered skin temperature was warmer and weighted mean next-to-skin vapour pressure was typically higher (following the onset of exercise) with two layers versus one. Differences among fabrics for individual properties were typically overstated compared to differences among corresponding garments for physiological and psychophysical variables under the conditions of this study. These findings inform the interpretation of particular fabric properties and highlight issues to be acknowledged during development/refinement of fabric test methods.
Practitioner Summary: We examined the way in which selected fibre, fabric and garment (layering) characteristics contribute to performance of the clothing system during wear under cold conditions. Selected properties of the constituent fabrics were found to provide limited insight into how garments perform during wear under the conditions of this study. 相似文献
27.
Wen-I Li Michael Perzl Joachim Heyder Robert Langer Joseph D. Brain K.-H. Englmeier Ralph W. Niven David A. Edwards 《Journal of aerosol science》1996,27(8):1269-1286
The results of numerical simulations of the aerodynamics and of solid aerosol deaggregation phenomena arising in the process of airflow through various model human oropharyngeal cavities are reported. Special attention is given to the relevance of these simulations to the inhalation of dry-powder therapeutic aerosols. Several two- and three-dimensional mouth and throat geometries (terminating just beyond the larynx) are considered. Cross-sectional area-averaged viscous stress values are numerically determined as a function of distance from the mouth opening. These values, ranging from approximately 10 to 500 dyn cm−2, are compared with estimates of Van der Waals attractive forces per unit area of particle-particle contact so as to evaluate the ability of the flowing airstream to deaggregate aerosol particles that enter the mouth in an aggregated state (held together principally by Van der Waals attractive forces). Estimates of airstream viscous stress differ markedly depending on whether the geometry is two- or three-dimensional. Quantitative differences between flow in a 90°-bend model and an oropharyngeal geometry numerically reconstructed from a cast of a human mouth and throat are especially significant in regards to the ability of the airstream to break apart particle agglomerates. For all geometries it is observed that increasingly smaller particle agglomerates may potentially be separated as the airflow rate increases from 30 to 2001 min−1. At the highest airflows, aggregated particles of diameter near to or even below 1 μm may potentially be separated by the airflow. If separation of particle agglomerates is to occur, it appears far more likely to take place in the throat than in the mouth. This is especially apparent for the more physiologically faithful oropharyngeal geometries considered. 相似文献
28.
The performance of garments for outdoor activity was compared. Three fabrics, each in garments for the upper body, matched garment/wearer dimensions, were worn by 10 athletically 'well-trained' males under controlled conditions (hot 32 +/- 2 degrees C, 20 +/- 2% relative humidity (RH); cold 8 +/- 2 degrees C, 40 +/- 2% RH) with physical (instrumental) and sensory responses obtained during the trials. Differences in human responses to the fabrics/garments included heart rate, core temperature during run (hot, cold), rest (hot) and walk (cold), heat content of the body, humidity under garments during rest and run and time to onset of sweating. No such differences were identified for change in body mass, core temperature during walk (hot) and rest (cold), skin temperature, temperature of skin covered by the garment, humidity under the garments during walk or for any perceptions (thermal sensations, thermal comfort of torso, exertion, wetness). The garment in single jersey wool fabric performed best in both hot and cold conditions. Effects of garments on wearers are often related to properties of the fabrics from which the garments are made. This study shows that only some differences in fabric properties result in measurable thermophysiological and perceptual responses of the garment wearers and underlines the difficulty in predicting performance of garments/persons from laboratory tests on fabrics. 相似文献
29.
BACKGROUND: Biphasic waveforms have had a favorable impact on internal defibrillation but have seen minimal use in transthoracic defibrillation systems. The purpose of this study was to compare monophasic and biphasic waveforms for transthoracic defibrillation in swine. METHODS AND RESULTS: Three interrelated studies were performed in 19 swine to establish the relative transthoracic defibrillation efficacy of biphasic shock waveforms. In study 1, we measured voltage (V50) and energy (E50) strength-duration curves for monophasic and biphasic truncated exponential waveforms. We then independently examined the effects of phase duration and tilt on biphasic waveform defibrillation with a total waveform duration from study 1 that provided the minimum V50 (study 2) and the minimum E50 (study 3). At each pulse duration tested in study 1, biphasic waveforms defibrillated with significantly less voltage and energy than monophasic waveforms. At a duration of 12 ms, there was a voltage minimum for biphasic waveform defibrillation. At this duration, V50 was 1378 +/- 505 V for the biphasic waveform compared with 2185 +/- 361 V for the monophasic waveform, P = .01. For both monophasic and biphasic waveforms, E50 increased with pulse duration. With a total pulse duration of 12 ms, E50 was 169 +/- 101 J for the biphasic waveform compared with 414 +/- 114 J for the monophasic waveform, P = .003. In study 2, optimization of phase duration and total tilt reduced the defibrillation requirements of the 12-ms "minimum voltage" biphasic waveform to 1284 +/- 187 V and 129 +/- 36 J. In study 3, the 8-ms "minimum energy" biphasic waveform had an E50 of 115 +/- 35 J that was 11% less than the 12-ms biphasic waveform, P = .11; however, voltage requirements of 1476 +/- 239 V were 15% higher, P = .005. CONCLUSIONS: This study demonstrates the superiority of truncated biphasic waveforms over truncated monophasic waveforms for transthoracic defibrillation of swine. Biphasic waveforms should prove as advantageous at reducing voltage and energy requirements for transthoracic defibrillation as they have for internal defibrillation. 相似文献
30.
BE Stein 《Canadian Metallurgical Quarterly》1998,123(1-2):124-135
The ability to integrate information from different sensory systems is a fundamental characteristic of the brain. Because different bits of information are derived from different sensory channels, their synthesis markedly enhances the detection and identification of external stimuli. The neural substrate for such "multisensory" integration is provided by neurons that receive convergent input from two or more sensory modalities. Many such multisensory neurons are found in the superior colliculus (SC), a midbrain structure that plays a significant role in overt attentive and orientation behaviors. The various principles governing the integration of visual, auditory, and somatosensory inputs in SC neurons have been explored in several species. Thus far, the evidence suggests a remarkable conservation of integrative features during vertebrate evolution. One of the most robust of these principles is based on spatial relationships: a striking enhancement in activity is induced in a multisensory neuron when two different sensory stimuli (e.g., visual and auditory) are in spatial concordance, whereas a profound response depression can be induced when these cues are spatially discordant. The most extensive physiological observations have been made in cat, and in this species the same principles that have been shown to govern multisensory integration at the level of the individual SC neuron have also been shown to govern overt attentive and orientation responses to multisensory stimuli. Most surprising, however, is the critical role played by association (i.e. anterior ectosylvian) cortex in facilitating these midbrain processes. In the absence of the modulating corticotectal influences, multisensory SC neurons in cat are unable to integrate the different sensory cues converging upon them in an adult-like fashion, and are unable to mediate overt multisensory behaviors. This situation appears quite similar to that observed during early postnatal life. When multisensory SC neurons first appear, they are able to respond to multiple sensory inputs but are unable to synthesize these inputs to significantly enhance or degrade their responses. During ontogeny, individual multisensory neurons develop this capacity abruptly, but at very different ages, until the mature population condition is reached after several postnatal months. It appears likely that the abrupt onset of this capacity in any individual SC neuron reflects the maturation of inputs from anterior ectosylvian cortex. Presumably, the functional coupling of cortex with an individual SC neuron is essential to initiate and maintain that neuron's capability for multisensory integration throughout its life. 相似文献