患者,女性,59岁.主因劳累后出现四肢麻木、乏力,逐渐加重伴心悸、头晕3天住院.查体:体温36℃,脉搏78次/min,呼吸12次/min,血压170/100 mm Hg(1 kPa=7.5 mm Hg).神清,精神欠佳,额肌及面肌运动减弱,眼睑闭合无力,双侧周围性面瘫,左侧咽反...患者,女性,59岁.主因劳累后出现四肢麻木、乏力,逐渐加重伴心悸、头晕3天住院.查体:体温36℃,脉搏78次/min,呼吸12次/min,血压170/100 mm Hg(1 kPa=7.5 mm Hg).神清,精神欠佳,额肌及面肌运动减弱,眼睑闭合无力,双侧周围性面瘫,左侧咽反射消失,右侧咽反射迟钝,心、肺、腹无异常,四肢肌张力减退,双上肢近端肌力Ⅳ级,远端肌力Ⅱ级,双下肢肌力Ⅱ级,腱反射消失,左巴氏征阳性.深浅感觉正常.实验室检查:血常规、血生化及电解质均在正常范围.甲状腺功能正常.脑脊液:蛋白0.956 g/L,未见白细胞,糖、氯化物正常.头颅CT未见异常,心电图正常.展开更多
Human growth hormone（GH）is a single-chain polypeptide of 191 amino acids that is involved in the regulation of various physiological processes,such as growth and metabolism.GH is synthesized and secreted by somatotr...Human growth hormone（GH）is a single-chain polypeptide of 191 amino acids that is involved in the regulation of various physiological processes,such as growth and metabolism.GH is synthesized and secreted by somatotropic cells in the anterior pituitary gland.Its secretion is primarily regulated by a balance between growth hormone-releasing hormone and growth hormone-inhibiting hormone,展开更多
Background: Long term follow up of the Optic Neuritis Treatment Trial (ONTT) cohort to evaluate brain magnetic resonance imaging (MRI) in patients who have not developed clinically definite multiple sclerosis. Objecti...Background: Long term follow up of the Optic Neuritis Treatment Trial (ONTT) cohort to evaluate brain magnetic resonance imaging (MRI) in patients who have not developed clinically definite multiple sclerosis. Objective: To determine th e proportion of patients with monosymptomatic optic neuritis who manifest new br ain MRI lesions without having developed clinically definite multiple sclerosis 10 to 14 years after enrollment in the ONTT. Design: Observational study. Settin g: Fourteen clinical centers. Participants: One hundred eight ONTT patients who had not developed clinically definite multiple sclerosis 10 to 14 years after st udy enrollment. Main Outcome Measure: Development of new T2 lesions on follow u p brain MRI. Results: At least 1 T2 lesion 3 mm or larger was observed on follow up MRIs in 27 (44%) of 61 patients with normal baseline MRIs. Additional lesi ons (≥3 mm) were present on follow up MRIs in 26 (74%) of 35 patients with ab normal baseline MRIs. Conclusions: A subset of patients with monosymptomatic opt ic neuritis manifest neither clinical signs nor MRI evidence of demyelination af ter more than 10 years of follow up. In other cases followed up for this length of time, MRI signal abnormalities may accumulate without causing new clinical m anifestations of multiple sclerosis. This information is useful in counseling pa tients who develop first episode optic neuritis.展开更多
文摘患者,女性,59岁.主因劳累后出现四肢麻木、乏力,逐渐加重伴心悸、头晕3天住院.查体:体温36℃,脉搏78次/min,呼吸12次/min,血压170/100 mm Hg(1 kPa=7.5 mm Hg).神清,精神欠佳,额肌及面肌运动减弱,眼睑闭合无力,双侧周围性面瘫,左侧咽反射消失,右侧咽反射迟钝,心、肺、腹无异常,四肢肌张力减退,双上肢近端肌力Ⅳ级,远端肌力Ⅱ级,双下肢肌力Ⅱ级,腱反射消失,左巴氏征阳性.深浅感觉正常.实验室检查:血常规、血生化及电解质均在正常范围.甲状腺功能正常.脑脊液:蛋白0.956 g/L,未见白细胞,糖、氯化物正常.头颅CT未见异常,心电图正常.
基金supported by grants from the Korea Health 21 R&D Project(HI14C2348)the National Research Foundation of Korea(NRF2014R1A2A1A11051520)
文摘Human growth hormone（GH）is a single-chain polypeptide of 191 amino acids that is involved in the regulation of various physiological processes,such as growth and metabolism.GH is synthesized and secreted by somatotropic cells in the anterior pituitary gland.Its secretion is primarily regulated by a balance between growth hormone-releasing hormone and growth hormone-inhibiting hormone,
文摘Background: Long term follow up of the Optic Neuritis Treatment Trial (ONTT) cohort to evaluate brain magnetic resonance imaging (MRI) in patients who have not developed clinically definite multiple sclerosis. Objective: To determine th e proportion of patients with monosymptomatic optic neuritis who manifest new br ain MRI lesions without having developed clinically definite multiple sclerosis 10 to 14 years after enrollment in the ONTT. Design: Observational study. Settin g: Fourteen clinical centers. Participants: One hundred eight ONTT patients who had not developed clinically definite multiple sclerosis 10 to 14 years after st udy enrollment. Main Outcome Measure: Development of new T2 lesions on follow u p brain MRI. Results: At least 1 T2 lesion 3 mm or larger was observed on follow up MRIs in 27 (44%) of 61 patients with normal baseline MRIs. Additional lesi ons (≥3 mm) were present on follow up MRIs in 26 (74%) of 35 patients with ab normal baseline MRIs. Conclusions: A subset of patients with monosymptomatic opt ic neuritis manifest neither clinical signs nor MRI evidence of demyelination af ter more than 10 years of follow up. In other cases followed up for this length of time, MRI signal abnormalities may accumulate without causing new clinical m anifestations of multiple sclerosis. This information is useful in counseling pa tients who develop first episode optic neuritis.
