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171.
Episodic paroxysmal laryngospasm (EPL) is a sign of laryngeal dysfunction, often without a specific organic etiology, which can masquerade as asthma, vocal fold paralysis, or a functional voice disorder. The intermittent respiratory distress of EPL may precipitate an apparent upper airway obstructive emergency, resulting in unnecessary endotracheal intubation, cardiopulmonary resuscitation, or tracheostomy. During 27 months, seven women and three men, ages 30–76 years, were assessed by a high diagnostic index of suspicion, an intensive history including psychosocial factors, physical examination of the airways, provocative asthma testing, and swallowing studies. Videolaryngoscopy, stroboscopy, and pulmonary flow-volume loop testing were definitive. The classic appearance was paradoxic inspiratory adduction of the anterior vocal folds with a posterior diamond-shaped glottic gap. During an attack of stridor or wheezing, attenuation of the inspiratory flow rate as depicted by the flow-volume loop suggested partial extrathoracic upper airway obstruction. Swallowing evaluation by videolaryngoscopy and videoesophagography may uncover gastroesophageal reflux disease. Hallmarks of management include patient and family education by observation of laryngoscopic videos, a specific speech therapy program, psychotherapy, and medical treatment of associated disorders. Electromyography may become a valuable future adjunct. Unlike laryngeal dystonia, patients with EPL do not benefit from botulinum toxin type A. 相似文献
172.
周敏娜 《宁波大学学报(理工版)》1998,(3)
引进-环的F-正则根,具体讨论f-正则性,得到了f-正则-环的几个特征刻划以及结构定理,推广了F-正则-环的相应结果.举出vonNeumann(弱、F-、f-)正则的-环,而不是结合环的实例,并阐明上述几种正则性的区别. 相似文献
173.
Although humans have spent exactly 100 years combating Alzheimer's disease (AD), the molecular mechanisms of AD remain unclear. Owing to the rapid growth of the oldest age groups of the population and the continuous increase of the incidence of AD, it has become one of the crucial problems to modern sciences. It would be impossible to prevent or reverse AD at the root without elucidating its molecular mechanisms. From the point of view of metal-amyloid-β peptide (Aβ) interactions, we review the molecular mechanisms of AD, mainly including Cu2 and Zn2 inducing the aggregation of Aβ, catalysing the production of active oxygen species from Aβ, as well as interacting with the ion-channel-like structures of Aβ. Moreover, the development of therapeutic drugs on the basis of metal-Aβ interactions is also briefly introduced. With the increasingly rapid progress of the molecular mechanisms of AD, we are now entering a new dawn that promises the delivery of revolutionary developments for the control of dementias. 相似文献
174.
Eva K. Lee Siddhartha Maheshwary Jacquelyn Mason William Glisson 《Annals of Operations Research》2006,148(1):25-53
A simulation and decision support system, RealOpt©, for planning large-scale emergency dispensing clinics to respond to biological threats and infectious disease outbreaks is described. The system allows public health administrators to investigate clinic design and staffing scenarios quickly. RealOpt© incorporates efficient optimization technology seamlessly interfaced with a simulation module. The system's correctness and computational advantage are validated via comparisons against simulation runs of the same model developed on a commercial system. Simulation studies to explore facility layout and staffing scenarios for smallpox vaccination and for an actual anthrax-treatment dispensing exercise and post event analysis are presented. The system produces results consistent with the model built on the commercial system, but requires only a fraction of the computational time. Each smallpox scenario runs within 1 CPU minute on RealOpt©, versus run times of over 5–10 h on the commercial system. The system's fast computational time enables its use in large-scale studies, in particular an anthrax response planning exercise involving a county with 864,000 households. The computational effort required for this exercise was roughly 30 min for all scenarios considered, demonstrating that RealOpt© offers a very promising avenue for pursuing a comprehensive investigation involving a more diverse set of scenarios, and justifying work towards development of a robust system that can be widely deployed for use by state, local, and tribal health practitioners. Using our staff allocation and assignments for the Anthrax field exercise, DeKalb county achieved the highest throughput among all counties that simultaneously conducted the same scale of Anthrax exercise at various locations, with labor usage at or below the other counties. Indeed, DeKalb exceeded the targeted number of households, and it processed 50% more individuals compared to the second place county. None of the other counties achieved the targeted number of households. The external evaluators commented that DeKalb produced the most efficient floor plan (with no path crossing), the most cost-effective dispensing (lowest labor/throughput value), and the smoothest operations (shortest average wait time, average queue length, equalized utilization rate). The study proves that even without historical data, using our system one can plan ahead and be able to wisely estimate the required labor resources. The exercise also revealed many areas that need attention during the operations planning and design of dispensing centers. The type of disaster being confronted (e.g., biological attack, infectious disease outbreak, or a natural disaster) also dictates different design considerations with respect to the dispensing clinic, facility locations, dispensing and backup strategies, and level of security protection. Depending on the situation, backup plans will be different, and the level of security and military personnel, as well as the number of healthcare workers required, will vary. In summary, the study shows that a real-time decision support system is viable through careful design of a stand-alone simulator coupled with powerful tailor-designed optimization solvers. The flexibility of performing empirical tests quickly means the system is amenable for use in training and preparation, and for strategic planning before and during an emergency situation. The system facilitates analysis of “what-if'' scenarios, and serves as an invaluable tool for operational planning and dynamic on-the-fly reconfigurations of large-scale emergency dispensing clinics. It also allows for “virtual field exercises” to be performed on the decision support system, offering insight into operations flow and bottlenecks when mass dispensing is required for a region with a large population. The system, designed in modular form with a flexible implementation, enables future expansion and modification regarding emergency center design with respect to treatment for different biological threats or disease outbreaks. Working with emergency response departments, further fine-tuning and development of the system will be made to address different biological attacks and infectious disease outbreaks, and to ensure its practicality and usability. 相似文献
175.
Toshiharu Nagatsu 《Proceedings of the Japan Academy. Series B, Physical and biological sciences》2006,82(10):388-415
Catecholamines [dopamine, noradrenaline (norepinephrine), and adrenaline (epinephrine); CAs] are neurotransmitters in the central and peripheral nervous systems as well as hormones in the endocrine system. CAs in the brain play a central role in versatile functions as slow-acting neurotransmitters functioning in synaptic neurotransmission, modulating the effects of fast-acting neurotransmitters such as glutamate and γ-aminobutyric acid (GABA). In this review, I focus on recent advances in the biochemistry and molecular biology of the CA system in humans in health and disease, especially in neuropsychiatric diseases such as Parkinson’s disease (PD), in relation to the biosynthesis of CAs regulated by a pteridine-dependent monooxygenase, tyrosine 3-monooxygenase (tyrosine hydroxylase, TH) and its pteridine cofactor, tetrahydrobiopterin (BH4). 相似文献
176.
177.
H. Eugene Stanley 《Pramana》2005,64(5):645-660
One challenge of biology, medicine, and economics is that the systems treated by these sciences have no perfect metronome
in time and no perfect spatial architecture-crystalline or otherwise. Nonetheless, as if by magic, out of nothing but randomness
one finds remarkably fine-tuned processes in time and remarkably fine-tuned structures in space. To understand this ‘miracle’,
one might consider placing aside the human tendency to see the universe as a machine. Instead, one might address the challenge
of uncovering how, through randomness (albeit, as we shall see, strongly correlated randomness), one can arrive at many spatial
and temporal patterns in biology, medicine, and economics. Inspired by principles developed by statistical physics over the
past 50 years-scale invariance and universality-we review some recent applications of correlated randomness to fields that
might startle Boltzmann if he were alive today. 相似文献
178.
本文应用原子吸收光谱法检测了冠心病、糖尿病及高脂血病人血清中微量元素—铜、锌和常量元素—钙、镁。结果表明:铜,锌的代谢异常可能是冠心病,高脂血症患者发病的因素之一,而糖尿病人存在着不同程度的锌缺乏症。 相似文献
179.
We present a case of one patient with respiratory stridor that was resolved by speech therapy. Paradoxical vocal fold movements were observed by flexible fiberoptic videolaryngoscopy in this patient during episodes of wheezing and dyspnea. Otherwise, normal vocal fold movement was observed in normal conditions of breathing (out of the crisis) and during phonation. Many different terms have been used to describe this entity in the literature, and it is crucial that clinicians recognize the subtle signs of functional stridor. Paradoxical vocal fold motion has to be considered as an important cause of respiratory disease. Its recognition and treatment are discussed in this report. 相似文献
180.
Metabolism of tetrahydrobiopterin: Its relevance in monoaminergic neurons and neurological disorders
Hiroshi Ichinose Takahide Nomura Chiho Sumi‐Ichinose 《Chemical record (New York, N.Y.)》2008,8(6):378-385
(6R)‐L‐erythro‐5,6,7,8‐tetrahydrobiopterin (BH4) is an essential cofactor for aromatic amino acid hydroxylases, such as phenylalanine hydroxylase (PAH), tyrosine hydroxylase (TH), tryptophan hydroxylase, and nitric oxide synthase, which catalyze physiologically important reactions in mammals. The biosynthesis and metabolism of BH4 is usually studied mostly in the liver and only slightly in the brain, as the BH4 level in the liver is relatively high because BH4 is required for the reaction of PAH. We found that GTP (guanosine triphosphate) cyclohydrolase I, an enzyme for the biosynthesis of BH4, is a causative gene for DOPA (3,4‐dihydroxyphenylalanine)‐responsive dystonia (also called Segawa's disease), and that partial deficiency of BH4 leads to the dysfunction of the nigrostriatal dopaminergic neurons without hyperphenylalaninemia. We analyzed BH4‐deficient mice that were produced by disruption of a BH4‐synthesizing gene by a gene‐knockout technique. We found that the protein amount of TH was highly dependent on the amount of BH4, especially in nerve terminals. Our research suggests that BH4 metabolism in the brain should be different from that in the liver, and that altered metabolism of BH4 should lead to neuropsychiatric disorders including Parkinson's disease. © 2008 The Japan Chemical Journal Forum and Wiley Periodicals, Inc. Chem Rec 8: 378–385; 2008: Published online in Wiley InterScience ( www.interscience.wiley.com ) DOI 10.1002/tcr.20166 相似文献