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Dopaminergic agents and carbidopa/levodopa have become the preferred treatment for both the restless legs (RL) syndrome and for periodic limb movements in sleep (PLMS). For once-nightly treatments with carbidopa/ levodopa, a problem with morning end-of-dose rebound increases in leg movements has been reported to occur in the about one-fourth of the patients. In our clinical studies a previously unreported but far more significant problem of markedly augmented RL symptoms occurred in the afternoon and the evening prior to taking the next nightly dose. A systematic prospective evaluation of this augmentation in 46 consecutive patients treated with carbidopa/ levodopa for RL syndrome or PLMS disorder found this augmentation to be the major adverse effect of treatment. Augmentation occurred for 31% of PLMS patients and 82% of all RL patients. It was greater for subjects with more severe RL symptoms and for patients on higher doses (> or = 50/200 mg carbidopa/levodopa) but was unrelated to gender, age or baseline severity of PLMS. This augmentation was severe enough to require medication change for 50% of the RL patients and 13% of PLMS patients. Augmentation resolved with cessation of the medication and could be minimized by keeping the dose low.  相似文献   
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Recurrent erosion of the corneal epithelium has been treated successfully by phototherapeutic keratectomy when convention therapy has failed. We present a case of recurrent corneal erosion occurring 1 year after photorefractive keratectomy in a 55-year-old myopic woman. No corneal abnormalities were previously identified in either the affected or the fellow eye. This case demonstrates the potential for ineffective healing of the corneal epithelial basement membrane complex after excimer laser photorefractive keratectomy.  相似文献   
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The silver-staining technique for nucleolar organizer regions (AgNOR) of Ploton et al., as popularized by Crocker, is being widely used for evaluation of nucleolar function, especially in neoplasia. It suffers from limited reliability, background staining, precipitates, and fading of the sections. Factors were identified that affect these problems. The oxidation-reduction level and gelatin used are particularly important. An improved procedure is presented which incorporates pre-reduction of the sections, selection of an optimal gelatin, and post-treatment of the sections to produce a permanent preparation. It is compatible with many fixatives and with other stains used before or after the silver stain.  相似文献   
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Physical parameters of fiber affecting passage from the rumen   总被引:1,自引:0,他引:1  
Our objective was to review the factors that affect fiber passage from the rumen. Rumen residence time and passage from the rumen are important in control of intake, digestibility, protein metabolism, and protein escape. Physical factors associated with particle size and particle specific gravity affect passage from the rumen. Although particles of 5 cm may pass through the reticulo-omasal orifice, most particles leaving the rumen are smaller than 1 mm. Polypropylene ribbon cut into 7-cm lengths, introduced into the rumen, markedly reduced intake and were ruminated to fine particle size before being passed. Materials with specific gravity less than 1.0 are ruminated extensively and are passed slowly. As specific gravity of plastic particles increase, rumination of particles is decreased and passage is increased. Particles with specific gravities between 1.17 and 1.42 pass most rapidly. Increasing specific gravities further results in a decline in passage and a further lowering of rumination of particles. Natural hay and fresh forages are hydrated in the rumen, which causes functional specific gravity to increase. Some factors that affect rate of change of functional specific gravity of forages have been investigated. Small particle size, autoclaved rumen fluid, buffer solutions, and specific salts increased the rate of change of functional specific gravity of particles. Understanding of these factors may enable us to make better decisions in managing ruminant productions systems.  相似文献   
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The technique of immunocytochemistry was used to identify myoglobin in kidney, confirming a diagnosis of neuroleptic malignant syndrome following an otherwise obscure autopsy in a decomposed body. The features of neuroleptic malignant syndrome are reviewed with a differential diagnosis of myoglobin renal casts. The report emphasizes a thorough and detailed assessment of deaths which occur during treatment with neuroleptic drugs.  相似文献   
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