ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1986.tb01145.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

AbstractThe clinical and pathological features of 28 patients with mitochondrial myopathy were reviewed. The cases were divided into a group with involvement of the extra‐ocular muscles alone or with limb muscle involvement, and a group with a facioscapulohumeral syndrome or generalised weakness without extra‐ocular muscle involvement. Cardiac and central nervous system manifestations occurred particularly in the first group which included six patients with multisystemic features and two with the complete Kearns‐Sayre syndrome. Diabetes mellitus occurred in the second group only. Quantitative histology on limb muscle biopsies showed a higher proportion of fibres with abnormal mitochondrial aggregates in the second group. No one type of mitochondrial inclusion or other ultrastructural change was specific for either group of cases. The findings illustrate the clinical heterogeneity of cases of mitochondrial myopathy and the lack of specificity of any of the myopathological changes for different subgroups of pat

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1986.tb01146.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

AbstractChanges in serum and urine biochemical indices have been studied in ten normal subjects in the four hours following the ingestion of four proprietary calcium supplements. Each was taken in a dose containing 1 gram of elemental calcium. The four preparations were ranked according to the amount of calcium absorbed in the order Spar‐Cal and Calcium Sandoz>Os‐Cal>Ossopan.There were no significant differences between the four preparations in the changes in parathyroid hormone (PTH) and urine hydroxyproline levels. For this reason, the four results from each subject were averaged. Following the calcium load there was a reduction in mean PTH from 0.16 ± 0.01 to 0.10 ± 0.02 μg/l (p<0.001) and a decline in urine hydroxyproline/creatinine ratio from 20 ± 1 to 17 ± 1 (p<0.02), suggesting that bone resorption responds immediately to dietary calcium intake.There was a rise in urine sodium excretion which correlated with the indices of calcium absorption (r= 0.63,p<0.01) but not with the sodium content of the calcium preparations. This effect could be important, particularly in elderly patients on borderline sodium

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1986.tb01147.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

AbstractThe columnar lined (Barrett's) esophagus is an acquired condition resulting from chronic gastroesophageal reflux. The clinical spectrum of 50 consecutive cases of endoscopically consistent, histologically proven Barrett's esophagus was reviewed. The mean age of patients was 65.9 ± 12.4 (SD) years with only four patients younger than 50 years. The predominant presenting symptoms were dysphagia, heartburn, and regurgitation. At endoscopy, the columnar lined segment extended over 6.5 ± 3.0 cm of the lower esophagus. Specialised columnar (intestinal) epithelium was the most frequent histological type identified. Radiologic or endoscopic evidence of a hiatal hernia was present in the majority. Complications were present at endoscopy in 38 (76%) patients. Reflux esophagitis (56%) was present at the area of the squamo‐columnar junction. Stricture formation (38%) and ulceration (36%) were located either at the squamo‐columnar junction or more distally within the columnar epithelium. Two patients (4%) had adenocarcinoma arising in a segment of Barrett's esophagus at presentation. Treatment included physical measures, dilatation, and cimetidine. Bougienage in 20 patients was successful in alleviating dysphagia but multiple treatment sessions were often necessary. Although esophagitis readily resolved with cimetidine therapy, ulceration was generally resistant to medical therapy. Indeed, by two months, healing was achieved in only five of 12 patients. Endoscopic surveillance of 12 patients who received cimetidine (1 g/day) for at least 12 months showed no regression of the metaplastic m

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1986.tb01148.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

AbstractA double‐blind comparative trial of the effectiveness and antigenicity of semisynthetic human insulin (Novo) and highly purified (Monocomponent) porcine insulin was performed over a 12 month period in 20 diabetic subjects newly treated with insulin. Human insulin was shown to be indistinguishable from porcine insulin of comparable purity with respect to plasma glucose and glycosylated hemoglobin levels and insulin dose requirements. Human insulin was no less antigenic than porcine insulin; significant IgG‐associated insulin binding activity was detected in six of the ten patients in the human insulin treated group and four of the ten patients in the porcine insulin treated group. In all patients, the binding activity was of low capacity. No adverse reactions to human insulin were noted.It is concluded that semisynthetic human insulin, like purified porcine insulin, is safe and effective. Although there may be advantages for human insulin in the setting of insulin allergy, this study does not indicate that human insulin has advantages over purified porcine insulin with respect to elicitation of antibodies of the IgG cl

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1986.tb01149.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

AbstractDuring a 28 month period, 77 Hickman catheters were inserted in 66 patients with hematological disorders. Complete follow‐up was possible for 72 catheter insertions. Catheters remainedin situfor a median period of 77 days (range 5–474 days). Fourteen (19%) catheters required removal because of complications which included sepsis, blockage, or displacement. Catheter‐related infection was the major complication andStaphylococcus epidermidisand diphtheroids (Corynebacterium species) were the organisms most commonly iso

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1986.tb01150.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

Book reviewed in this article:CLOSED HEAD INJURY: PSYCHOLOGICAL, SOCIAL, AND FAMILY CONSEQUENCES. Edited by D. Neil Brooks

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1986.tb01151.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

AbstractThree hundred and one consecutive lung scans were reviewed to determine the frequency of the different ventilation perfusion scan patterns and their use in the management of suspected pulmonary embolism. Based on the original report, an accurate diagnosis was possible in 99 patients (33%). Within this group pulmonary embolism was excluded by a normal lung scan in 35 (12%), and confirmed in 64 (21%) patients having a high probability pattern. There were 194 (64%) patients with a low probability scan, but in only 24 of these (12%) was venous thromboembolism objectively confirmed or excluded by additional investigations. Although the low probability scan is non‐specific, the scan result was used as the sole objective test to determine therapy in 170 patients (56%). The clinical decision was to withhold anticoagulants in 143 patients and to treat 27 patients. Probability estimates using Bayes' Theorem have been applied to evaluate these management decision

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1986.tb01152.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

Book reviewed in this article:FLEXIBLE SIGMOIDOSCOPY. By Ronald M. Katon, Emmet B. Keefe and Clifford S. Melnyk

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1986.tb01153.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

AbstractA 16 year old girl with the rare syndrome characterised by hypertension, hyperkalemia, and acidosis was treated with a range of drugs, including thiazides, frusemide, and beta‐adrenoceptor antagonists. None of the agents normalised the hypertension and biochemical abnormalities. Best results were obtained with methyclothiazide in full dosage, which normalised the blood pressure, serum potassium level, and bicarbonate level in the face of increased plasma renin activity. Empirical treatment with thiazides is the most satisfactory method for long term managemen

ISSN:0004-8291    

DOI:10.1111/j.1445-5994.1986.tb01154.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY