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The records of 2,377 patients with Laennec''s cirrhosis were reviewed for the period 1947-1957. The chief presenting symptom was ascites in 46 per cent, bleeding in 23 per cent, coma in 18 per cent, jaundice in 9 per cent, and both jaundice and ascites in 4 per cent. Nearly half of the patients died during the period under study—one-third from hepatic failure, one-third from gastrointestinal bleeding, and one-third from other causes, most of which were related to alcoholism.Massive gastrointestinal bleeding occurred in 21 per cent of the patients at some time in their clinical course, and in the 10 per cent of these in whom ulcer was demonstrated, one-fifth died as a result of the hemorrhage. Of those presumed to be bleeding from esophageal varices, 64 per cent died at the first hemorrhage and 10 per cent at subsequent hemorrhages; 85 per cent of all those who bled from varices were dead at the end of one year, and 91 per cent were dead at the end of three years.The survival curve of a group of patients who bled once and were good operative risks but had received no operative treatment was compared to the survival curve for entire group who survived the first hemorrhage. The three-year survival in the good risk group was 47 per cent; for the group as a whole it was 30 per cent. The difference in mortality rate was primarily due to an increased number of deaths from hepatic failure in the combined group, whereas 60 per cent of the good risk group died of recurrent gastrointestinal hemorrhage.As 86 per cent of those who were to die of gastrointestinal bleeding did so at the first hemorrhage, it was concluded that any decided improvement in the salvage rate achievable by operation must come from some means of diagnostic forecast of the likelihood of bleeding, with resort to prophylactic operation in such cases. 相似文献
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Roy H. Nyquist 《The Western journal of medicine》1965,103(6):417-419
The principal cause among 137 deaths in a series of 1,613 patients with traumatic spinal cord lesions treated at Veterans Administration Hospital, Long Beach, was renal disease attributable to the paralysis of the bladder and bladder sphincter and resultant genito-urinary tract infections. The second ranking cause was pulmonary disease. Before 1960 no deaths from cancer had occurred in this series, but between 1960 and 1962 three patients died of carcinoma of the bladder. It can be expected that as these patients reach higher age groups the incidence of neoplasms will increase. 相似文献
36.
Roy BA 《Trends in ecology & evolution》1994,9(9):335-339
Some fungi use flower-visiting insects to facilitate sexual reproduction or to disperse spores. These fungi have evolved elaborate techniques, such as floral mimicry and the invasion of extant flower parts, for attracting 'pollinators'. Recent research shows that fungal exploitation of pollinators has the potential to affect floral evolution, pollination ecology, plant life history traits, as well as disease-transmission dynamics and fungal evolution. 相似文献
37.
This study describes the genetic structure and provides estimates of mating system parameters in three natural populations of Prosopis velutina Woot. in southeastern Arizona. F statistics derived from isozyme data revealed the presence of both interpopulation and intrapopulation genetic differentiation. This population structure is discussed in relation to the ecological history of these populations that invaded the grasslands sites from adjacent riparian areas within the last 90 years, and possible modes of seed dispersal. The multilocus estimation program MLT of Ritland (Journal of Heredity 8: 235–237, 1990) was used to provide estimates of ts, tm, and the fixation index (F) of the maternal parents. Average estimates of ts ranged from 0.591 to 0.912. Estimates of tm ranged from 0.609 to 1.004, and averaged 0.758. The difference between tm and ts, which provides a measure of biparental inbreeding, averaged 0.058. This last result, together with significant heterogeneity found in pollen allele frequencies, suggests that a family structure has developed in the populations. A negative F value for one of the populations suggests selection against homozygotes between the seedling stage and maturity. 相似文献
38.
H. M. Dutta A. Nath S. Adhikari P. K. Roy N. K. Singh J. S. Datta Munshi 《Hydrobiologia》1994,294(3):215-218
This paper describes effects of a sublethal (1.2 mg 1–1) organophosphate, malathion, on the ovary of an air breathing catfish, Heteropneustes fossilis. The study focuses on microscopic changes that occur on ovigerous lamellae, oocytes at different stages of development and the nucleus of the immature oocyte. Also, change in estrogen levels in blood serum is investigated. Clumping of cytoplasm appears after 24 h of exposure to malathion. Clumping intensified after 48 h. Degeneration in the follicular cells was also observed. After 72 h exposure the number of nucleoli increased, nuclear materials shrunk, oocytes became adhered. With 96 h of exposure, nuclear materials of all the oocytes shrunk to a smaller clump. The oocytes fused together, and follicular epithelium became loose and ruptured. A few atretic oocytes were visible. Radioimmunoassay of the estrogen level in blood serum after 72 h of exposure of malathion showed a reduction in the level. This study showed that the histopathological condition of the gonad is reflected in malfunctioning of the endocrine system and hormonal disbalance. 相似文献
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Few studies have examined the potential for pathogens with complex life cycles to cause selection on their required alternate (=intermediate) hosts. Here we examine the effects of two fungal pathogens on an herbaceous mustard, Arabis holboellii. One pathogen species uses A. holboellii as a primary host, the other uses it as an alternate host. This plant-pathogen system is especially interesting because the host, A. holboellii, is apomictic; thus individuals reproduce exact copies of themselves. Despite this mode of reproduction, A. holboellii populations are surprisingly genetically diverse. Could frequency dependent selection by pathogens be maintaining clonal diversity? This study assesses the potential for selection by pathogens. In a controlled greehouse experiment we show that there is heritable variation in A. holboellii's resistance to the rust, Puccinia monoica, and that host fitness is severely reduced by P. monoica infection in both the greenhouse and under natural conditions. Field observations indicate that host clones are also differentially susceptible to the short-cycled rust, P. thlaspeos, and that host fitness is reduced by infection to this pathogen as well. Although the preconditions for pathogen-mediated selection are present, frequency-dependent selection by pathogens is unlikely to be important in structuring populations of Arabis holboellii because multiple host genotypes are susceptible to the same inoculum and the pathogen has a long generation time. 相似文献