检索结果-南通市图书馆

大部分海马硬化性痴呆患者可表现为额颞性痴呆

在线全文

学校读者我要写书评

暂无评论

世界核心医学期刊文摘（神经病学分册） 2005年第1期1卷 56-56页

作者： Hatanpaa K.j. Blass D.M. Pletnikova O. 高方 Department of Pathology UT Southwestern Medical School 5323 Harry Hines Blvd. Dallas TX 75390- 9073 United States Dr.

Hippocampal sclerosis dementia (HSD) is a disease of unknown etiology and pathogenesis. To determine whether HSD cases could be reclassified as variants of frontotemporal dementia (FTD), a heterogeneous group of disorders, 18 brain autopsy cases previously diagnosed as HSD were re evaluated. In 11 cases, ubiquitinated neuronal inclusions, similar to those of motor neuron disease inclusion dementia (MNDID), were found. Brain levels of soluble and insoluble tau were normal. Most patients with pathologic findings of HSD may actually have the MNDID variant of FTD.

关键词：额颞性痴呆硬化性运动神经元病变异型例生不可溶性包涵体尸检结果机能紊乱发病机制

卵巢低度恶性潜在肿瘤的保留生殖力的手术治疗

在线全文

学校读者我要写书评

暂无评论

世界核心医学期刊文摘（妇产科学分册） 2005年第11期1卷 40-40页

作者： Skinner E.N. Gehrig P.A. j.O. Schorge 刘亦恒 Division of Gynecologic Oncology Department of Obstetrics and Gynecology University of Texas Southwestern Medical Center 5323 Harry Hines Boulevard J7.124 Dallas TX 75390-9032 United States

Objective. Ovarian low malignant potential (LMP) tumors have an excellent prognosis when treated by surgical resection. Conservative management usually involves leaving behind the uterus and contralateral adnexa to allow future childbearing. The purpose of this study was to determine the outcome of women treated with fertility-sparing surgery. Methods. All patients diagnosed with ovarian LMP tumors between 1984 and 2003 were identified at three institutions. Data were retrospectively extracted from clinical records. Results. Thirty eight (15% ) of 249 women with LMP tumors underwent fertility-sparing surgery. Twenty-three were nulliparous and four primiparous. Thirty-three (87% ) underwent unilateral salpingo-ophorectomy and five (13% ) cystectomy. Fourteen patients also had contralateral cystectomy or biopsy. Thirty four (89% ) were stage Ⅰ , one (3% ) stage Ⅱ and three (8% ) stage Ⅲ . Most tumors had serous (55% ) or mucinous (42% ) histology. No patients received adjuvant therapy. Six (16% ) of 38 recurred after a median follow-up of 26 months: five in the remaining ovary were salvaged with surgical resection alone, and none died from recurrent LMP tumor. Five women delivered six term infants during post-treatment surveillance. Conclusion. Fertility-sparing surgery for ovarian LMP tumors is an option for motivated patients. Preservation of the contralateral adnexa increases the risk of recurrence, but surgical resection is usually curative.

关键词：生殖力黏液性囊肿切除术恶性潜能单侧输卵管临床记录组织活检未产妇医疗机构

在线全文

学校读者我要写书评

暂无评论

低恶性卵巢肿瘤的手术分期

世界核心医学期刊文摘（妇产科学分册） 2005年第9期1卷 36-36页

作者： Skinner E. Gehrig P.A. j.O. Schorge 张丽娟 Division of Gynecolo gic Oncology Department of Obstetrics Univ. Texas Southwestern Med. Ctr. 5323 Harry Hines Boulevard Dallas TX United States Dr.

OBjECTIVE: Women diagnosed with ovarian tumors of low malignant potential ha ve an excellent prognosis. Because few will receive adjuvant therapy, the benefit of surgical staging has recently been challenged. The purpose of this study was to compare the outcome of surgically staged patients with low malignant potentia l tumors with those who were not staged. METHODS: Between 1984 and 2003, all wom en with ovarian low malignant potential tumors were identified at 3 institutions . Data were extracted from clinical records. RESULTS: One hundred eighty-three (74%) of 248 women were surgically staged. Forty of 183 staged patients had cli nically obvious extraovarian disease. Forty (28%) of the remaining 143 women wi th disease apparently confined to the ovary were upstaged. Cytologic washings we re positive in 28 cases, 10 had microscopic implants detected by peritoneal or o mental biopsy, and 2 were upstaged to stage IIIC solely on the basis of nodal me tastases. One hundred eighteen women underwent pelvic node dissection (median: 5 nodes), and 86 underwent paraaortic node dissection (median: 2 nodes). Overall, 9 (1%) metastases were detected in 832 submitted pelvic nodes. All 314 paraaor tic nodes were negative. Intraoperative blood loss (P juvant platinum-based che motherapy, but neither of the women upstaged to IIIC based on the results of the ir nodal dissection were treated. Fifteen (6%) recurrences developed and 1 (0.4 %) death occurred after a median follow-up of 28 (range, 1-208) months. CONCL USION: Routine pelvic and paraaortic lymph node dissection is not necessary in t he majority of women with ovarian low malignant potential rumors.

关键词：恶性卵巢肿瘤手术分期盆腔淋巴结清扫临床病历辅助化疗淋巴结转移术中失血量医疗机构中有

在线全文

学校读者我要写书评

暂无评论

剖宫产手术麻醉并发症

世界核心医学期刊文摘（妇产科学分册） 2005年第11期1卷 59-59页

作者： Bloom S.L. Spong C.Y. Weiner S.j. 杨晓梅 Department of Obstetrics University of Texas Southwestern Medical Center 5323 Harry Mines Boulevard Dallas TX 75390-9032 United States Dr.

Objective: To quantify anesthesia-related complications associated with cesarean delivery in a well-described, prospectively ascertained cohort from multiple university-based hospitals in the United States and to evaluate whether certain factors would identify women at increased risk for a failed regional anesthetic. Methods: A prospective observational study was conducted of women (n = 37,142) with singleton gestations undergoing cesarean delivery in the centers forming the National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Detailed information was collected regarding choice of anesthesia and procedure-related complications, including failed regional anesthetic and maternal death. Potential risk factors for a failed regional anesthetic were analyzed. Results: Of the women studied, 34,615 (93% ) received a regional anesthetic. Few (3.0% ) regional procedures failed, and related maternal morbidity was rare. Increased maternal size, higher preoperative risk, rapid decision-to-incision interval, and placement later in labor were all significantly related to an increased risk of a failed regional procedure. Of the general anesthetics, 38% were administered when the decision-to-incision interval was less than 15 minutes. Women deemed at the greatest preoperative risk (American Society of Anesthesiologists score ≥ 4) were approximately 7-fold more likely to receive a general anesthetic (odds ratio 6.9, 95% confidence interval 5.83-8.07). There was one maternal death, due to a failed intubation, in which the anesthetic procedure was directly implicated. Conclusion: Regional techniques have become the preferred method of anesthesia for cesarean delivery. Procedure-related complications are rare and attest to the safety of modern obstetric anesthesia for cesarean delivery in the United States.

关键词：剖宫产手术麻醉并发症局部麻醉麻醉选择麻醉相首次妊娠前瞻性队列研究于术医疗网络潜在危险因素

利用组织培养的人羊膜上皮细胞的非外科移植术进行眼表重建

在线全文

学校读者我要写书评

暂无评论

世界核心医学期刊文摘（眼科学分册） 2006年第5期2卷 12-12页

作者： Parmar D.N. Alizadeh H. Awwad S.T. j.P. McCulley 潘佳鸿 Department of Ophthalmology University of Texas Southwestern Medical Center at Dallas 5323 Harry Hines Blvd Dallas TX 75390-9057United States Dr.

PURPOSE: To assess the effect of tissue-cultured human amniotic epithelial cells (AECs) in restoring the ocular surface, transplanted using a collagen shield seeded with AECs supported by a soft contact lens. DESIGN: Prospective interventional single-institutional case series with crossover controls. METHODS: Three eyes in three patients were identified with persistent corneal epithelial defects (PEDs) refractory to medical therapy. Two cases were secondary to neurotrophic keratopathy, while one case was attributable to longstanding alkali injury. AECs were isolated from serologically screened donor human placenta, seeded onto collagen corneal shields, and incubated in tissue culture medium for 7 days. These collagen shields were placed over the PED and supported by an overlying soft contact lens. The collagen shields dissolved by 72 hours, and the contact lenses were removed after this time. This cycle was repeated every week until healing was achieved. As a crossover control, collagen shields without AECs were placed in the same eye 1 week before placing collagen shields containing AECs. The PED was assessed by vital staining and slit-lamp color photography. RESULTS: The PEDs had a mean duration of 4 months and involved 20%to 37%of the corneal surface area, one case secondary to longstanding alkali injury and two cases attributable to neurotrophic keratopathy. No change in PED size was observed in those control eyes receiving collagen shields without AECs. Complete resolution of the PED was seen after two cycles of AEC-seeded collagen shield in one case, and four cycles in two cases, from 7 to 12 weeks following treatment in all patients. No loss of visual acuity was seen and clinical improvement was maintained in all cases, with a mean follow-up of 6.3 months. CONCLUSIONS: Nonsurgical transplantation of tissue-cultured AECs on a collagen shield provides a promising approach to restoring the ocular surface in cases of PED.

关键词：羊膜上皮细胞组织培养液眼表重建移植术软性接触镜角膜胶原外科角膜上皮神经营养性临床研究

在线全文

学校读者我要写书评

暂无评论

一项终止早产妇女住院治疗的随机试验

世界核心医学期刊文摘（妇产科学分册） 2005年第11期1卷 49-49页

作者： Yost N.P. Bloom S.L. McIntire D.D. Leveno K.j. 程金湘 University of Texas Southwestern Medical Center Department of Obstetrics 5323 Harry Hines Boulevard Dallas TX 75390-9032 United States Dr.

Objective: To determine whether hospitalization of women with arrested preterm labor has an effect on delivery at 36 weeks or greater when compared with women discharged home. Methods: All women with a singleton gestation and a diagnosis of arrested preterm labor with intact membranes between 24 and 33 weeks, 4 days of gestation were randomly assigned to home or hospital management. Upon completion of a dexamethasone course, women assigned to outpatient management were promptly discharged, and women in the inpatient group were advised to continue hospitalization until 34 weeks. Decreased activity was encouraged in both groups. Bed rest was not strictly enforced. The primary outcome was delivery at 36 weeks or greater. Results: A total of 101 women of a planned 188 were enrolled at the time of an interim analysis. There was no difference in the primary study outcome between the 2 groups and the trial was terminated. Among the hospitalized women, 71% reached 36 weeks or greater, compared with 72% of those discharged home (P =.89). The mean cervical dilatation in hospitalized women was 2.7 ± 0.5 cm, compared with 2.6 ± 0.5 cm in women discharged home (P =.16). The overall length of hospital stay for the women allocated to hospitalization was 16 ± 13 days. Conclusion: Compared with hospitalization, outpatient management of women with arrested preterm labor and intact membranes had no effect on the rate of preterm birth.

关键词：住院治疗单胎妊娠随机试验家庭治疗随机分配宫颈扩张门诊治疗

1例早产儿在阿昔洛韦抑制治疗期间的单纯疱疹病毒性脑炎潜伏期中的应用

在线全文

学校读者我要写书评

暂无评论

世界核心医学期刊文摘（儿科学分册） 2006年第11期2卷 41-41页

作者： Fonseca-Aten M. Messina A.F. jafri H.S. Snchez P.j. 王经纬 Department of Pediatrics University of Texas Southwestern Medical Center 5323Harry Hines Blvd Dallas TX 75390-9063 United States Dr.

Cutaneous herpes simplex virus type 2 (HSV-2) infection was recognized at 19 days of age in a 1415-g female infant born at 31 weeks of gestation. Cerebrospinal fluid (CSF) HSV polymerase chain reaction (PCR) was negative, and MRI of the brain was normal. After a 14-day course of high-dose intravenous acyclovir, the infant developed a cutaneous recurrence at 38 days of age. CSF HSV PCR again was negative. She was subsequently begun on oral acyclovir to prevent cutaneous reactivation of HSV. At 3 months of age, the infant developed HSV encephalitis as manifested by fever, seizures, abnormal CSF indices, abnormal brain MRI, and positive CSF HSV PCR. No cutaneous disease was present. It is not known whether the HSV encephalitis in our patient represented reactivation of previously unrecognized central nervous system infection or new onset of central nervous system disease as a result of spread from other tissue or site to the brain. The failure of oral acyclovir to prevent such an occurrence, however, highlights gaps in our understanding of the pathogenesis of neonatal HSV disease and questions the use of acyclovir suppression to prevent neurologic sequelae.

关键词：抑制治疗神经系统后遗症聚合酶链反应出生后预防复发单纯疱疹病毒发病机制生时