摘要:

To assess the effect of severe inactivity on the serum lipid and lipoprotein profile, 21 quadriplegic men between the ages of 24 and 47 were compared with 20 age-matched healthy control men. The group of quadriplegic men had significantly lower levels of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), HDL2-C and HDL3-C. The current recommendation for desirable TC is less than 200 mg/dl, whereas HDL-C of less than 35 mg/dl is considered a risk factor for coronary heart disease. Of the 50% (10/20) of the men in the normal control group who had a desirable TC, only 10% (1/10) had a low or undesirable HDL-C value. In comparison, although 81% (17/21) of the group of quadriplegic men had a desirable TC, 53% (9/17) of these individuals had a low HDL-C level. It is concluded that although the presence of lower TC could be beneficial in QM, the decreased values of HDL-C and HDL2-C and the increased ratio of TC/HDL-C suggest a higher risk of coronary heart disease. The findings are consistent with recent reports of an increased prevalence of coronary heart disease in spinal cord injury patients, which could be due to an abnormal lipoprotein profile related to diet, inactivity, changes in body composition, and life style. Moreover, the present data suggest that HDL-C should be measured in quadriplegic men with modifiable risk factors, even if they have desirable TC, to avoid missing an increased coronary heart disease risk status.

ISSN:0002-9629    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The effect of corticotropin-releasing hormone (CRH), independent of adrenocorticotropin hormone (ACTH), was evaluated in nine healthy individuals. Cortisol release and corresponding ACTH production were determined after separate intravenous administration of ovine-CRH (1 μg/kg BW) and insulin inducing hypoglycemia (0.1 u/kg BW). Adrenocorticotropin hormone (1–24; 250 μg intravenous bolus) revealed an adequate adrenal reserve capacity in all subjects. At the time of peak cortisol response following CRH and insulin administration, IR-cortisol increments were 14 ± 1 μg/dl and 9 ± 1 μg/dl (mean ± SE), respectively (p < .05); whereas ACTH (IR-ACTH) increments were 40 ± 10 ng/1 and 53 ± 14 ng/1, respectively. The cortisol increment/ACTH increment ratios were 0.53 ± 0.09 and 0/36 ± 0.09, respectively (p < 0.05), suggesting an ACTH-independent effect of CRH on cortisol production. The authors speculate that CRH may have a direct effect on the human adrenal gland or it may release ACTH-like factors that stimulate the human adrenal cortex.

ISSN:0002-9629    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

This study was designed to determine the prevalence and clinical significance of hyperprolactinemia in systemic lupus erythematosus (SLE) and other rheumatic diseases. Basal levels of prolactin were determined in 130 nonselected sera from patients with rheumatic diseases including 45 with SLE, 31 with rheumatoid arthritis, 23 with osteoarthritis, 18 with fibromyalgia, and 13 with polymyalgia rheumatica. Serum samples of 28 healthy subjects were used as normal controls. Serum prolactin was measured by radioimmunoassay. ANA, anti-DNA, RNP, Sm, Ro, La, and anticardiolipin antibodies were determined by standard techniques. Elevated serum levels of prolactin (PRL > 20 ng/ml) were found in a subset of SLE patients. In addition, a direct correlation with clinical disease and serological (ANA) activity was also found. These findings suggest a potential role for this immunoregulatory hormone in SLE pathogenesis.

ISSN:0002-9629    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

In a 1983 position paper, the American Board of Internal Medicine stressed the importance of teaching humanistic skills to residents; however, how to teach or measure these skills is not well defined. In this study, the content of discussion (personal and professional problems) and processing of four humanistic skills (empathy, level of regard, unconditionality, and congruence) by Bowman Gray School of Medicine first year general medicine residents was observed. Fourteen videotapes of support group meetings from 1986 to 1988 were reviewed for humanistic relationship behaviors using the Barrett-Lennard Relationship Inventory and for the types of personal and professional problems discussed using a content inventory. Barrett-Lennard Relationship Inventory scores for empathy and regard paralleled increases in the number of professional problems raised at midyear, a time of maximum stress for residents. Congruence scores became flat after an initial peak while unconditionality scores remained low. Interventions designed to improve residents' use of humanistic skills could take into account residents' need for support and education, as well as the natural flow of humanistic behaviors within residency programs.

ISSN:0002-9629    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The role of an increase in total peripheral resistance (TPR) and the contribution of angiotensin II (ANG II) to the hypertension induced by reduced uterine perfusion pressure (RUPP) was explored in pregnant rabbits. On the 22nd day of gestation, a catheter and a microthermocouple were placed in the aorta to measure mean arterial pressure (MAP) and cardiac output (CO), respectively. Three days later, RUPP was induced by a clip on the aorta proximal to the ovarian and distal to the renal arteries. Mean arterial pressure distal to the clip (uterine perfusion pressure) was reduced to 56 ± 8% (&OV0335; ± SD) of the initial level. Twenty-four hours later, MAP rose from 65 ± 3 to 84 ± 11 mm Hg; CO index decreased from 207 ± 18 to 169 ± 27 ml/min/kg; and TPR index increased from 0.32 ± 0.03 to 0.51 ± 0.08 mm Hg kg/ml/min, respectively (n = 7, all p < 0.01). Sham-operated pregnant rabbits (n = 7) and non-P rabbits (n = 5) with a comparable distal aortic pressure reduction experienced no change in MAP or CO. Infusion of a receptor antagonist of angiotensin II (Sar1, Ile8-Ang II, 1 μg/kg/min for 20 min) decreased MAP in sham-operated pregnant rabbits from 64 ± 6 to 54 ± 6 mm Hg (p < 0.01) but did not change MAP in RUPP hypertensive rabbits (86 ± 9 mm Hg before and 87 ± 8 at the end of infusion, n = 6). These data indicate that RUPP in pregnant rabbits leads to a high resistance form of hypertension in which the formation of Ang II is not increased.

ISSN:0002-9629    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Although cavernous hemangioma is the most common benign tumor of the liver, controversy persists regarding diagnosis and management of these lesions. With the development of multiple noninvasive modalities to visualize the liver, hepatic cavernous hemangiomas are recognized with increased frequency. The authors report the unusual case of a post-menopausal woman on no exogenous estrogen therapy who had a cavernous hemangioma that remained stable for approximately 10 years before dramatically increasing in size. This patient illustrates the vague symptoms associated with cavernous hemangiomas and the unpredictability of growth. Although estrogens have been reported trophic, this patient had no exogenous or endogenous estrogen supply, yet her lesion reached massive proportions. Modalities necessary to assure accurate diagnosis and factors influential in management are discussed.

ISSN:0002-9629    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Cutaneous furunculoid myiasis arises from the infestation of skin or mucous membranes with dipterous larvae. Myiasis from the botflyDermatobia hominisis a common parasitic disease of the tropics of Central and South America, and may present in the United States. With increasing travel by U.S. citizens, there is potential for increased occurrence; it is important to be able to accurately diagnose myiasis and differentiate it from entities with similar presentations, such as leishmaniasis. The authors describe four cases of myiasis fromD. hominisinfestation and review clinical features, differential diagnosis, and treatment.

ISSN:0002-9629    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Germ cell tumors usually present with symptoms that are attributed to their location. This article describes a patient who had an extragonadal tumor that was not discovered until he experienced several tumor-related complications.

ISSN:0002-9629    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

A single overnight polysomnogram usually is adequate to exclude a diagnosis of obstructive sleep apnea. We report three patients who had multiple negative polysomnograms before a diagnosis of sleep apnea was made. Factors that may cause a false-negative polysomnogram include reduced total or rapid eye movement sleep time, sleeping in the lateral posture, manifestation of the disease predominantly by hypopneas, and recent medical therapy to treat sleep apneas. In patients with a strong clinical suspicion of sleep apnea and a negative polysomnogram, sleep and clinical parameters should be reevaluated and a repeat polysomnogram may be indicated.

ISSN:0002-9629    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Myelolipomas are nonfunctioning, benign tumors of the adrenal gland composed of fat and normal bone marrow elements in varying proportions. Although rare, they should be included in the differential diagnosis of the incidentally discovered adrenal mass. The authors describe a patient with a myelolipoma diagnosed by characteristic radiological findings in whom the use of invasive procedures or surgical exploration was unnecessary.

ISSN:0002-9629    

出版商:OVID    

年代:1992

数据来源: OVID