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101.
BACKGROUND: Several recent studies have added significant information regarding the benefit of screening mammography, especially in the 40-49-years age group. This new information makes it important to reassess the cost-effectiveness of screening. METHODS: A Markov model was used to study the cost-effectiveness of 4 age-related screening strategies: 1) annually from ages 40-79 years; 2) annually from ages 40-64 years and biennially from ages 65-79 years; 3) annually from ages 40-49 years and biennially from ages 50-79 years; and 4) annually from ages 40-79 years in high risk women (10%) and biennially from ages 40-49 years followed by annually from ages 50 -79 years in normal risk women (90%). An additional strategy simulating hormone status and estrogen exposure was evaluated. Cost-effectiveness was expressed as marginal cost per year-life saved (MCYLS). RESULTS: The MCYLS varied from $18,800 to $16,100. For all strategies this was within the range of other generally acceptable diagnostic and therapeutic medical procedures. There was a 14% decrease in MCYLS from the least cost-effective to the most cost-effective strategy. CONCLUSIONS: Cost-effectiveness of four age-related mammographic screening strategies was evaluated. The MCYLS for all strategies was within a generally accepted range. With increasing concerns regarding the cost of health care, this information may be useful in health policy decision-making. 相似文献
102.
BL King G Sirugo JH Nadeau TJ Hudson KK Kidd BM Kacinski M Schalling 《Canadian Metallurgical Quarterly》1998,9(5):392-393
BACKGROUND: Accommodation-convergence spasm (spasm of the near reflex) is usually bilateral, resulting in increased myopia, convergence, and miosis. Unilateral spasm of accommodation has rarely been reported. PATIENTS: We investigated three females (age range 10-19 years) referred for investigations of retrobulbar optic neuritis (2 cases) and decompensated esophoria (1 case). RESULTS: They all presented unilateral spasm of accommodation with visual loss due to increased myopia (-3.5 to -11.75 diopters). Apart from that, results of neuro-ophthalmological examination were normal. CONCLUSIONS: Unilateral accommodation spasm is rare and can mimic retrobulbar optic neuritis and convergent strabismus. The three components of the accommodation-convergence spasm may not always be present simultaneously. Recognizing such an entity is important to prevent the patient from useless, costful and potentially harmful investigations. 相似文献
103.
The feasibility of generating substituted phenyl radicals and biradicals (with a charged substituent) in the gas phase by laser photolysis was examined by using a Fourier-transform ion cyclotron resonance mass spectrometer. The precursors were generated by ipso-substitution of a halogen atom in the radical cation of a di- or trihalobenzene by various nucleophiles. Photolytic cleavage of the remaining carbon-halogen bond(s) with 266-nm radiation was found to produce many substituted phenyl radicals in greater yields than the earlier employed method, sustained off-resonance irradiated collision-activated dissociation (SORI-CAD). Furthermore, ion generation by photolysis leads to isomerization less often than collisional activation. Finally, not only phenyl-bromine and phenyl-iodine but also certain phenyl-chlorine bonds can be cleaved by photolysis, whereas the synthetic utility of SORI-CAD appears to be largely limited to the cleavage of phenyl-iodine bonds. Hence, laser photolysis greatly expands the variety of substituted phenyl radicals and biradicals that can be synthesized inside a mass spectrometer. 相似文献
104.
AV Gasparian KK Laktionov MS Belialova NA Pirogova AG Tatosyan IB Zborovskaya 《Canadian Metallurgical Quarterly》1998,77(10):1604-1611
The mapping of allelic loss on the short arm of chromosome 1 has been performed in non-small-cell lung cancer. We used a set of 11 microsatellite loci spanning 1p to examine the frequency of allelic imbalance in a panel of 58 tumours. Fifty-one of 58 (87.9%) cases have shown somatic allelic loss at one or more loci tested. The two shortest regions of the overlap (SRO) of the deletions have been identified: SRO 1 at 1p13.1 and SRO 2 at 1p32-pter. Allelic losses at these regions have been compared among adenocarcinoma and squamous cell carcinoma and no difference has been found. In contrast to SRO 1, deletions at SRO 2 significantly correlated with advanced stage of the disease as well as post-operative metastasizing and relapse. These data may suggest that SRO 1 and SRO 2 can harbour tumour-supressor genes (TSGs) involved in different stages of NSCLC development. SRO 2 is still quite large and its refined mapping should help attempts to clone and identify the putative TSG(s). Microsatellite instability (replication errors) affecting only 6 (10.3%) of 58 tumour samples is an infrequent genetic alteration at the loci tested. 相似文献
105.
Pancreas transplantation with bladder drainage of exocrine secretions may be associated with significant urologic complications. Stapled and hand-sewn duodenocystostomies were compared in 61 recipients of simultaneous pancreas-kidney transplants. Both methods resulted in similar urologic complication and allograft survival rates. Duodenal segment leaks were associated with significant morbidity and decreased patient and allograft survival. 相似文献
106.
The naturally occurring monoterpene d-limonene has been found to inhibit various stages of tumorigenesis in a number of animal models and is now being evaluated as a chemopreventive agent in humans. To date, there are little or no preclinical pharmacokinetics available nor is there a sensitive assay methodology. In this study, d-limonene and its dideuterium-labeled internal standard, limonene-d2, in whole rat blood were extracted with n-pentane which was then concentrated on a Kuderna-Danish concentrator. The residue was analyzed by an ion-trap GC -MS under ammonia chemical ionization. The detection limit of d-limonene was 1.0 ng if injected in pure form; however, due to the presence of endogenous d-limonene levels (probably from diet), the routine quantitation limit was set at 1.0 microgram ml-1. The monitored assay linearity range from 1.0 to 30 micrograms ml-1 within-day CV values of 8.0%, 2.4%, and 2.0% at 1.0, 3.0 and 10.0 micrograms ml-1, respectively (all at n = 8), and corresponding accuracy of 100%, 100%, and 101%. The between-day CV values were 12.3, 8.0, and 7.5% at 1, 6, and 20 micrograms ml-1, respectively (all at n = 8). Using this assay, pharmacokinetics of d-limonene were studied in Sprague-Dawley rats following intravenous and oral administration at 200 mg kg-1 each. Blood concentration-time profiles after intravenous administration showed a biphasic decline with a mean initial t1/2 of 12.4 min and a terminal t1/2 of 280 min. The plasma:red blood cell partition was found to be 0.84. Plasma protein binding of d-limonene was found to be 55.3% at 20 microgram ml-1. The mean total clearance was 49.6 ml min-1 kg-1, the volume of distribution at steady-state 11.7 1 kg-1, and median residence time 263 min. The blood concentration-time decline following oral administration also showed a biphasic decline with a mean initial t1/2 of 34 min and terminal t1/2 of 337 min. The oral bioavailability of d-limonene was 43.0%. 相似文献
107.
108.
E Lee KK Park JM Lee KS Chun JY Kang SS Lee YJ Surh 《Canadian Metallurgical Quarterly》1998,19(8):1377-1381
There have been considerable efforts to search for naturally occurring substances for the intervention of carcinogenesis. Many components from dietary or medicinal plants have been identified that possess substantial chemopreventive properties. An example is curcumin (Curcuma longa Linn., Zingiberaceae), which has been shown to inhibit tumor promotion in experimental carcinogenesis. Alpinia oxyphylla Miquel, another plant of the ginger family used in oriental herbal medicine, contains diarylheptanoids whose structures are analogous to that of curcumin. In the present study, we have tested A.oxyphylla for its ability to suppress tumor promotion. Thus, topical application of the methanolic extract of dried fruits of A.oxyphylla significantly ameliorated 12-O-tetradecanoylphorbol-13-acetate (TPA)-induced skin tumor promotion as well as ear edema in female ICR mice. In another study, treatment of HL-60 cells with the methanolic extract of A.oxyphylla significantly reduced the viability of the cells and also inhibited DNA synthesis. Microscopic examination of the treated cells showed characteristic morphology of apoptosis. Furthermore, cells treated with the extract of A.oxyphylla exhibited internucleosomal DNA fragmentation in time- and concentration-dependent manners. TPA-stimulated generation of superoxide anion in differentiated HL-60 cells was also blunted by A.oxyphylla. Taken together, these findings suggest that A.oxyphylla possesses potential chemopreventive and antitumorigenic activities. 相似文献
109.
1. Sparteine and mephenytoin phenotyping tests were carried out in 327 healthy Danish subjects. Two weeks later each subject took 25 mg imipramine followed by urine collection for 24 h. The urinary content of imipramine, desipramine, 2-hydroxy-imipramine and 2-hydroxy-desipramine was assayed by h.p.l.c. 2. The medians of the hydroxylation ratios (i.e. 2-hydroxy-metabolite over parent compound) were 6 to 14 times higher in 300 extensive metabolizers of sparteine (EMs) as compared with 27 poor metabolizers (PMs), but none of the ratios separated the two phenotypes completely. 3. There were 324 EM of mephenytoin (EMM) and three PM (PMM) in the sample. The demethylation ratios between desipramine, 2-hydroxy-desipramine and their corresponding tertiary amines showed statistically significant correlations with the mephenytoin S/R isomer ratio (Spearman's rs: -0.20 and -0.27, P < 0.05). 4. The demethylation ratios were higher in 80 smokers than in 245 non-smokers. This indicates that CYP1A2, which is induced by cigarette smoking, also catalyzes the N-demethylation of imipramine. 5. CYP2D6 genotyping was carried out by PCR in 325 of the subjects, and the D6-wt allele was amplified in 298 EMs, meaning that they were genotyped correctly. One PMs was D6-wt/D6-B, another PMs had the genotype D6-wt/ and hence both were misclassified as EMs. The remaining 25 PMs were D6-A/D6-B (n = 5), D6-B/ (n = 18) or D6-D/D6-D (no PCR amplification, n = 2).(ABSTRACT TRUNCATED AT 250 WORDS) 相似文献
110.
Recent studies have reported that mutant genomic cystic fibrosis (CF) transmembrane conductance regulator ( CFTR ) sequences can be corrected in transformed CF airway epithelial cell lines by targeted replacement with small fragments of DNA with wild-type sequence. To determine if the observed genotype modification following small fragment homologous replacement (SFHR) was limited to transformed CF cell lines, further studies were carried out in both transformed and non-transformed primary normal airway epithelial cells. The endogenous genotype of these normal cell lines was modified following liposome or dendrimer transfection using DNA fragments with DeltaF508 CFTR sequence (488 nt, complementary single strands) designed to also contain a unique restriction enzyme cleavage site (Xho I). Replacement at the appropriate genomic locus by exogenous DeltaF508 CFTR DNA and its expression as mRNA was demonstrated by PCR amplification of genomic DNA and mRNA-derived cDNA as well as Xho I digestion of the PCR products. These studies show that SFHR occurs in both transformed and non-transformed primary human airway epithelial cells and indicate that single base substitution (the silent mutation giving rise to the Xho I site) and deletion or insertion of at least three consecutive bases can be achieved in both normal and CF epithelial cells. Furthermore, these studies reiterate the potential of SFHR as a strategy for a number of gene targeting applications, such as site-specific mutagenesis, development of transgenic animals, development of isogenic cell lines and for gene therapy. 相似文献