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1.
Milton G. Mutchnick MD Horchang H. Lee MD 《Alcoholism, clinical and experimental research》1988,12(1):155-158
Concanavalin A-induced lymphocyte proliferation was studied in 25 patients with alcoholic hepatitis or compensated alcoholic cirrhosis. Nine alcoholics without evidence of liver disease were also evaluated. A nonlinear correlation equation, which was natural logarithmic, was applied to individual dose-response proliferation curves and permitted comparisons between patient groups and controls. The proliferative response in all patient groups was significantly lower when compared to healthy controls and was independent of the presence or absence of liver disease. This suggests that some changes in immune function observed in alcoholics may be linked to the direct effects of alcohol on the immune system rather than to the associated liver disease. 相似文献
2.
Hua Tan Jena Derrick Jin Hong Corneliu Sanda William M Grosse Howard J Edenberg Milton Taylor Scott Seiwert Lawrence M Blatt 《Journal of interferon & cytokine research》2005,25(10):632-649
A role for type II interferon (IFN-gamma) in resolving viral infection is suggested by the correlation of hepatitis C virus (HCV) clearance with enhancement of IFN-gamma-producing activated T cells in the resolution of acute HCV infection. Using vesicular stomatitis virus (VSV), a synergistic direct antiviral effect was documented using IFN-gamma1b and a potent, consensus type I IFN (IFN alfacon-1). Global expression profiling following EC50 exposure to IFN alfacon-1, IFN-gamma1b, or a cocktail of the two allowed the antiviral state to be correlated with induction of a subset of IFN-stimulated genes (ISGs). Genes identified through this analysis corresponded to classic antiviral components, ISGs more recently associated with direct antiviral functions, as well as expressed sequence tags (ESTs) and hypothetical proteins. The magnitude of these antiviral EC50-correlated expression events in human hepatoma (Huh7) cells exposed to clinically relevant doses of IFN alfacon-1, IFN-gamma1b, or a cocktail of the two was also probed because the standard of care for patients with chronic hepatitis C is type I IFN-containing regimens. Relative to type I IFNs used alone, the addition of type II IFN caused enhanced expression not only of many of the genes correlated with the direct antiviral state but also of genes involved in (1) antigen presentation to cytotoxic T lymphocytes (CTLs), (2) macrophage, natural killer (NK), and T helper 1 (Th1) cell recruitment and activation, (3) complement system function, (4) apoptosis, and (5) ISGs with unknown functions. As many of these processes are correlated clinically with resolution of chronic HCV infection, the combined use of these IFNs could display a beneficial effect on viral clearance in patients infected with HCV and other viruses through enhancement of one of these processes or of the direct antiviral state. 相似文献
3.
One of the important steps on the road to becoming expert in a motor skill occurs when the individual can perform the movements in a seemingly effortless and automatic fashion. The authors review two lines of investigations, namely, fMRI and mathematically guided studies of the dynamics of skill acquisition, that suggest that this road to automatic involves two steps: (1) an increasing reliance on the self-regulatory aspects of the motor task, and (2) a minimization of the role of mechanisms based on intentionally directed corrective movements. The interplay between these two mechanisms implies that, at a given skill level, performance decreases whenever intention intervenes. The observation that psychological factors may be as important as mechanical repetition for the development of expertise has important implications for the design of neurorehabilitative strategies. 相似文献
4.
BackgroundThe incidence of strictures developing after gastrojejunostomy has been reported to range from 3% to 31%. We found an unacceptably high stricture rate (13%) using a 21-mm circular stapler. Attempts to use the 25-mm circular stapler were frustrated by disparities between the size of the instrument and the patient's anatomy. We, therefore, modified the technique to accomplish the anastomosis with the linear stapler and hand sewing (LSA) at community hospitals in Southern California.MethodsA total of 124 anastomoses were accomplished with the circular stapler (CSA) followed by 100 anastomoses using the LSA technique. Drains were used routinely with the CSA technique but were used only selectively with the LSA technique. Stricture was defined as that requiring endoscopic dilation for symptoms. Leaks were confirmed radiologically or surgically, and bleeding was defined as the need for transfusion. Our analysis used the Student t test and Fisher's exact test, with P <.05 considered statistically significant.ResultsNo patient died. The LSA technique was faster and resulted in significantly fewer postoperative strictures and complications compared with the CSA technique.ConclusionThe results of our study have shown that the LSA technique, as described, is preferable to the CSA technique. 相似文献
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Milton J. Guiberteau MD Pamela A. Wilcox RN MBA Sandra Bjork RN JD 《Journal of the American College of Radiology》2004,1(2):92-97
Clinical practice guidelines have emerged as a reality for medical practitioners over the past 20 years. Although virtually all groups interested in the development of practice guidelines hope for improvements in patient care, secondary expectations vary widely among those using them. Their use in daily practice by physicians has met with resistance from barriers including concerns of “cookbook” medicine, a loss of autonomy, and increased professional liability. The recent experience of the ACR in addressing these challenges illustrates that physicians are receptive to steps perceived to mitigate the risks accompanying the use of guidelines as well as to efforts to increase their understanding of implementing guidelines in clinical practice. The experiences of other medical societies and an inventory of future trends reveal additional challenges associated with the use of practice guidelines, as third parties look to guidelines as points of reference for gauging the performance of health care providers. 相似文献
8.
Milton K Erman 《Psychiatric Clinics of North America》2006,29(4):947-67; abstract viii-ix
Sleep disorders, including restless legs syndrome and periodic limb movement disorder, sleep apnea syndrome, and narcolepsy, are prevalent medical conditions, likely to be seen by practicing psychiatrists. Awareness of these conditions and their presentations, pathophysiology, and treatment allows psychiatrists to treat these conditions where appropriate, to minimize complications and health consequences associated with delayed diagnosis, and to reduce the burden of disease that these conditions may place on patients already experiencing primary psychiatric disorders. 相似文献
9.
Detailed Diurnal Rhythm of Sensitivity to Melatonin Injections in Turkish Hamsters, Mesocricetus brandti 总被引:1,自引:0,他引:1
A diurnal rhythm of sensitivity to exogenous melatonin was defined in adult male Turkish hamsters, Mesocricetus brandti. Melatonin was administered daily by subcutaneous injections (15 micrograms in 0.1 ml 10% ethanolic saline) for 10 weeks in animals exposed to 16 L:8 D. As in golden and Djungarian hamsters, two periods of melatonin sensitivity were identified. The first, in late afternoon, persisted for 6 hr, from 7 hr to 1 hr before lights off. The second period was briefer, of only 2 hr duration in the late night, terminating at the time of lights on. Melatonin injections given during these sensitive periods promoted testicular regression in most animals; melatonin administered at other times of the day was without effect on testicular function in most animals of these groups. Gonadal regression induced by properly timed melatonin injections was rapid, in many groups nearly complete in 6 to 7 weeks. The results are discussed in relation to the function of pineal melatonin in photoperiodic time measurement in hamsters. 相似文献
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