Quarterly Journal of Medicine最新文献_第8页

Delayed cerebral radiation necrosis. 迟发性脑放射性坏死。

Quarterly Journal of Medicine Pub Date : 1994-02-01 DOI: 10.1093/OXFORDJOURNALS.QJMED.A068900

J. Morris, P. Grattan-Smith, P. Panegyres, P. O'neill, Y. S. Soo, A. Langlands

{"title":"Delayed cerebral radiation necrosis.","authors":"J. Morris, P. Grattan-Smith, P. Panegyres, P. O'neill, Y. S. Soo, A. Langlands","doi":"10.1093/OXFORDJOURNALS.QJMED.A068900","DOIUrl":"https://doi.org/10.1093/OXFORDJOURNALS.QJMED.A068900","url":null,"abstract":"The clinical features and long-term outcome of seven patients with delayed cerebral radiation necrosis (DCRN) are described. Radiotherapy had been given for pituitary tumour (1), astrocytoma (2), pinealoma (2), craniopharyngioma (1) and parotid carcinoma (1). The mean latency to onset of the first neurological symptoms was 22 months (range 6-40 months), and mean duration of follow-up was 86 months (range 60-126). Three patients died at a mean of 84 months after radiotherapy (range 62-98). A fourth patient probably died from metastatic disease. Three patients remain alive, albeit severely disabled, after 5-10 years. The illness typically ran a stepwise course, with fits and stroke-like episodes occurring against a background of progressive dementia and somnolence. CT and MRI scans showed progressive ventricular dilatation associated with cerebral atrophy and diffuse or focal changes in the white matter. Four patients had had two or more neurosurgical procedures after the radiotherapy. In only one of the seven patients was the diagnosis made at presentation. DCRN produces a distinctive clinical picture, yet remains a poorly recognized complication of cranial irradiation.","PeriodicalId":54520,"journal":{"name":"Quarterly Journal of Medicine","volume":"11 1","pages":"119-29"},"PeriodicalIF":0.0,"publicationDate":"1994-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/OXFORDJOURNALS.QJMED.A068900","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61292219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 51

Involvement of the kidneys in Mediterranean spotted fever and murine typhus. 地中海斑疹热和鼠斑疹伤寒对肾脏的影响。

Quarterly Journal of Medicine Pub Date : 1994-02-01

Y Shaked, O Shpilberg, Y Samra

引用次数: 0

Localization of metastatic gastroenteropancreatic tumours by somatostatin receptor scintigraphy with [111In-DTPA-D-Phe1]-octreotide. [111In-DTPA-D-Phe1]-奥曲肽生长抑素受体显像定位转移性胃肠胰腺肿瘤

Quarterly Journal of Medicine Pub Date : 1994-02-01

P J Hammond, A Arka, A M Peters, S R Bloom, S G Gilbey

{"title":"Localization of metastatic gastroenteropancreatic tumours by somatostatin receptor scintigraphy with [111In-DTPA-D-Phe1]-octreotide.","authors":"P J Hammond, A Arka, A M Peters, S R Bloom, S G Gilbey","doi":"","DOIUrl":"","url":null,"abstract":"Most gastroenteropancreatic tumours express somatostatin receptors, allowing imaging using radiolabelled somatostatin analogues. Octreotide can be modified by coupling a DTPA moiety to the N-terminal D-phenylalanine to allow labelling with In111. We studied the comparative effectiveness of this radiopharmaceutical in identifying tumour extent. Twenty-two patients with metastatic gastroenteropancreatic tumours were scanned using [111In-DTPA-D-Phe1]-octreotide. In 11 patients with the carcinoid syndrome, one of six primary lesions was identified by CT scanning and by [111In-DTPA-D-Phe1]-octreotide scanning. Hepatic metastases were present in all patients, 9 of whom had positive scintigraphy. Two other sites of intra-abdominal uptake and four distant sites, not previously identified, were demonstrated. Five other distant sites were confirmed to be carcinoid metastases. All 11 patients with other gastroenteropancreatic tumours had positive scans, demonstrating 7/9 primary lesions, 12 intra-abdominal lesions, including hepatic metastases in all cases, and one distant lesion, all previously identified. Thus [111In-DTPA-D-Phe1]-octreotide imaging effectively identified the extent of metastatic disease from gastroenteropancreatic tumours, and confirmed lesions whose significance was uncertain following previous imaging procedures.","PeriodicalId":54520,"journal":{"name":"Quarterly Journal of Medicine","volume":"87 2","pages":"83-8"},"PeriodicalIF":0.0,"publicationDate":"1994-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19144702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Postinfectious glomerulonephritis--is there a link to alcoholism? 感染后肾小球肾炎——与酒精中毒有关吗?

Quarterly Journal of Medicine Pub Date : 1994-02-01 DOI: 10.1093/OXFORDJOURNALS.QJMED.A068906

C. Keller, K. Andrassy, R. Waldherr, Eberhard Ritz

引用次数: 54

Liposomal amphotericin B (AmBisome) in Mediterranean visceral leishmaniasis: a multi-centre trial. 脂质体两性霉素B (AmBisome)在地中海内脏利什曼病:一项多中心试验。

Quarterly Journal of Medicine Pub Date : 1994-02-01 DOI: 10.1093/OXFORDJOURNALS.QJMED.A068903

Robert N. Davidson, L. D. Martino, L. Gradoni, Raffaella Giacchino, R. Russo, Giovanni Battista Gaeta, R. Pempinello, S. Scott, Francesco Raimondi, Antonio Cascio, Tullio Prestileo, L. Caldeira, Robert J. Wilkinson, A. Bryceson

引用次数: 188

Issues in Huntington's disease testing. 亨廷顿氏病检测中的问题

Quarterly Journal of Medicine Pub Date : 1994-02-01 DOI: 10.1093/OXFORDJOURNALS.QJMED.A068902

D. Rubinsztein, D. Barton, M. Ferguson-Smith

引用次数: 4

Hyperinsulinaemia in ischaemic heart disease: the importance of myocardial infarction and left ventricular function. 缺血性心脏病的高胰岛素血症:心肌梗死和左心室功能的重要性。

Quarterly Journal of Medicine Pub Date : 1994-02-01

R A Wright, A D Flapan, F Stenhouse, C Simpson, L Flint, N A Boon, K G Alberti, R A Reimersma, K A Fox

{"title":"Hyperinsulinaemia in ischaemic heart disease: the importance of myocardial infarction and left ventricular function.","authors":"R A Wright, A D Flapan, F Stenhouse, C Simpson, L Flint, N A Boon, K G Alberti, R A Reimersma, K A Fox","doi":"","DOIUrl":"","url":null,"abstract":"Elevated circulating insulin levels have been reported in ischaemic heart disease, and may be of aetiological importance. Previous studies have not considered the potential influence of heart failure or of previous myocardial infarction, as opposed to stable angina. We therefore measured the insulin response to a 75 g oral glucose tolerance test in five groups with normal glucose tolerance, comparing normal male controls to men with chronic stable angina, men with recent myocardial infarction (two groups, 3 weeks and 3 months post infarction), and men with chronic severe heart failure. Only patients with chronic heart failure had fasting hyperinsulinaemia, probably reflecting associated neuroendocrine abnormalities. Stimulated hyperinsulinaemia was present in all patient groups, but was less pronounced and of shorter duration in patients with angina. At 120 min, only patients with heart failure or previous myocardial infarction were hyperinsulinaemic. The degree of stimulated hyperinsulinaemia was not influenced by the presence of heart failure or by the length of time from infarction. Hyperinsulinaemia is associated with impaired peripheral muscle glucose uptake and metabolism, and might contribute to muscular fatigue on exertion in patients with previous myocardial infarction or heart failure.","PeriodicalId":54520,"journal":{"name":"Quarterly Journal of Medicine","volume":"87 2","pages":"131-8"},"PeriodicalIF":0.0,"publicationDate":"1994-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19144066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Liposomal amphotericin B (AmBisome) in Mediterranean visceral leishmaniasis: a multi-centre trial. 脂质体两性霉素B (AmBisome)在地中海内脏利什曼病:一项多中心试验。

Quarterly Journal of Medicine Pub Date : 1994-02-01

R N Davidson, L Di Martino, L Gradoni, R Giacchino, R Russo, G B Gaeta, R Pempinello, S Scott, F Raimondi, A Cascio

引用次数: 0

Urinary sodium excretion in patients with nephrotic syndrome, and its circadian variation. 肾病综合征患者尿钠排泄及其昼夜变化。

Quarterly Journal of Medicine Pub Date : 1994-02-01

M G Koopman, G C Koomen, B A van Acker, L Arisz

{"title":"Urinary sodium excretion in patients with nephrotic syndrome, and its circadian variation.","authors":"M G Koopman, G C Koomen, B A van Acker, L Arisz","doi":"","DOIUrl":"","url":null,"abstract":"We analysed sodium excretion and its circadian variation in 70 patients with nephrotic syndrome and 19 healthy controls over 1-3 days, with a regimen of bed rest and constant sodium intake around the clock. We sampled urine and blood and took their blood pressure every 3 h. We also scored 60 renal biopsies for presence of interstitial fibrosis and tubular atrophy. Peripheral oedema was estimated in 37 patients. Fifty-nine patients excreted > 10 mmol sodium per 24 h, in equilibrium with dietary intake. In group A (n = 24), sodium excretion followed a normal circadian rhythm, with a daytime peak. In group B (n = 35), 29 had reversed circadian rhythm with a night-time peak, and 6 had no apparent rhythm. Nephrotic syndrome was more severe in group B than in A (serum albumin 19.5 vs. 24.1 g/l, p < 0.05; oedema 7.0 vs. 3.8 kg, p < 0.01). Group B also had signs of more advanced renal disease (GFR 49 vs. 99 ml/min; number of biopsies with tubulo-interstitial damage: 20/28 vs. 4/23; p < 0.001). Reversed sodium rhythm was associated with reversed circadian rhythms for GFR, effective renal plasma flow and urine flow, and blunting or reversal of the day-night differences in blood pressure and plasma renin activity. Eleven patients had urinary sodium excretion < 1 mmol/24 h. With respect to severity of nephrosis, they resembled group B, but GFR and incidence of tubulointerstitial lesions were like group A. Half of the patients with nephrotic syndrome had reversed circadian rhythm for sodium excretion.(ABSTRACT TRUNCATED AT 250 WORDS)","PeriodicalId":54520,"journal":{"name":"Quarterly Journal of Medicine","volume":"87 2","pages":"109-17"},"PeriodicalIF":0.0,"publicationDate":"1994-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"19144935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

An audit of cardiac surgery in patients aged over 70 years. 70岁以上患者心脏手术的审计。

Quarterly Journal of Medicine Pub Date : 1994-02-01 DOI: 10.1093/OXFORDJOURNALS.QJMED.A068905

A. Parry, N. Giannopolous, O. Ormerod, R. Pillai, S. Westaby

{"title":"An audit of cardiac surgery in patients aged over 70 years.","authors":"A. Parry, N. Giannopolous, O. Ormerod, R. Pillai, S. Westaby","doi":"10.1093/OXFORDJOURNALS.QJMED.A068905","DOIUrl":"https://doi.org/10.1093/OXFORDJOURNALS.QJMED.A068905","url":null,"abstract":"With an increasingly aged population, the number of patients requiring treatment for cardiovascular diseases will rise. Previous expectations of cardiac surgery in the over-seventies have been poor, with surgery being very much a last resort. We decided to test whether this was appropriate, and to determine whether the priority of surgery affected the outcome. Three hundred and six patients over the age of 70 were operated on in our unit in a 4 1/2-year period, 210 as elective operations and 96 as emergencies. Eighty-nine per cent were in NYHA class III-IV pre-operatively and half had other significant medical problems. Most (46%) underwent coronary artery surgery. The methods used were identical to those used for the younger patients in both operative approach and post-operative management. The overall mortality was 6.9%; 1.9% for elective procedures and 16.7% for emergencies (12.3% when catastrophic pathologies are excluded). However, the morbidity was not significantly different between the two groups and the length of post-operative ventilation and hospital stay were likewise not significantly different. Follow-up of the survivors showed no late deaths, and 87% were in NYHA class I and II. Of the others, 25 have required additional hospital admissions for associated cardiac problems. One required another invasive procedure (a PTCA), but none has required further surgery. The findings of low mortality for elective cardiac surgery in this age group are in agreement with other reports. If early referral prevents emergency surgery, it should be avidly pursued, in view of the improved outcome for elective surgery.(ABSTRACT TRUNCATED AT 250 WORDS)","PeriodicalId":54520,"journal":{"name":"Quarterly Journal of Medicine","volume":"87 2 1","pages":"89-96"},"PeriodicalIF":0.0,"publicationDate":"1994-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1093/OXFORDJOURNALS.QJMED.A068905","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61292207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 12