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101.
OBJECTIVES: The aim of this study was to determine (a) whether delay in femur fracture stabilization beyond twenty-four hours in patients with head injury increased the risk of pulmonary complications and (b) whether immediate (up to twenty-four hours) femur fracture stabilization increased the risk of central nervous system (CNS) complications. DESIGN: Retrospective analysis. MATERIALS AND METHODS: Thirty-two patients with femur fracture and head injury were identified. Fourteen underwent immediate stabilization of their fractures, and eighteen underwent delayed (four-teen patients) or no (four patients) stabilization of their fractures. RESULTS: In the immediate stabilization group, five patients had severe head injuries [Glasgow Coma Score (GCS) < or = 8] and nine had mild head injuries (GCS > 8). In the mild head injury group, no patient had a pulmonary complication and one had a CNS complication. In the severely head-injured group, one patient had a pulmonary complication and no patient had a CNS complication. In the delayed stabilization group, six patients had mild head injuries (GCS > 8) and twelve had severe head injuries (GCS < or = 8). In the mildly head injured group, one patient had a pulmonary complication, two patients had CNS complications, and one patient died. In the severely head injured group, nine patients had pulmonary complications, three patients had CNS complications, and one patient died. Logistic regression identified delay in femur stabilization as the strongest predictor of pulmonary complication (p = 0.0042), followed by severity of chest Abbreviated Injury Score (AIS; p = 0.0057) and head AIS (p = 0.0133). Delaying fracture stabilization made pulmonary complications forty-five times more likely. Each point increase in the chest AIS and head/neck AIS increased the risk of pulmonary complication by 300 percent and 500 percent, respectively. A statistically significant predictor of CNS complications could not be identified by using logistic regression. CONCLUSION: Delay in stabilization of femur fracture in head-injured patients appears to increase the risk of pulmonary complications. However, due to selection bias in this patient sample, this question cannot be definitively answered. Early fracture stabilization did not increase the prevalence of CNS complications.  相似文献   
102.
This study describes the isolation and characterization of zebrafish homologues of the mammalian Pax3 and Pax7 genes. The proteins encoded by both zebrafish genes are highly conserved (>83%) relative to the known mammalian sequences. Also the neural expression patterns during embryogenesis are very similar to the murine homologues. However, observed differences in neural crest and mesodermal expression relative to mammals could reflect some functional divergence in the development of these tissues. For the zebrafish Pax7 protein we report the first full-length amino acid sequences in vertebrates and show the existence of three additional isoforms which have truncations in the homeodomain and/or the C-terminal region. These novel variants provide evidence for additional isoform diversity of vertebrate Pax proteins.  相似文献   
103.
The deoxidation reaction of aluminum in liquid iron has been investigated thermodynamically using Al2O3 crucible at 1873 K under Ar atmosphere as a fundamental study for the accurate control of inclusions in the ladle refining process. In addition to the equilibrium constant log KA1 for the aluminum deoxidation reaction, the first-order and second-order interaction parameters between aluminum and oxygen were experimentally determined in the concentration range of aluminum up to 1 %. The temperature dependence of the equilibrium constant and the first-order interaction parameter eA1 was also obtained: log KA1 = 12.32 - 47400/T, eA1 = 15.57 - 36500/T. The equilibrium relation between aluminum and oxygen contents in the aluminum deoxidized iron by applying interaction parameters and the equilibrium constant determined in this work satisfies fairly well the equilibrium data over the whole concentration range of aluminum considered.  相似文献   
104.
The Morningness-Eveningness Questionnaire and Life Habits Inventory were administered to 622 Japanese workers matched for sex and age. We investigated the distributions of the scores on the Morningness-Eveningness Questionnaire and sleep-wake habits by age and sex. Subjects were classified into five age groups and three chronotypes. The distributions and mean scores on the questionnaire advanced slightly toward the Morning type from the young to the aged group. The habitual bedtimes and waking times were significantly earlier in all the chronotypes from the young to the aged group, and the preferred bedtimes and waking times were also clearly earlier from the young to the aged group. The length of sleep was shorter for the Evening than the Morning types, especially in the group below 24 yr. The differences in habitual and preferred sleep length were greater than 1 hour for all age groups, especially the two groups under 34 yr. The number of awakenings during night sleep increased from the young to the aged group for all chronotypes. The older Evening type tended more toward frequent napping and longer naptime. The variabilities of bedtime and sleep length were larger for the young and Evening type than for the old group and Morning types. Further, the mood upon waking and satisfaction with sleep length were better in the aged Evening type than the young Morning type. The women under 44 yr. woke up earlier than the men of the same age, and the women of the 35-54 yr. groups had a shorter length of sleep than others. These may be related to childcare and housework. These results indicated that the phase of circadian rhythms had moved forward from the young to the aged group, and the individual's rhythm, of those that were aged Morning types, showed better agreement with sleep-wake rhythms than did others.  相似文献   
105.
106.
We report herein the case of a 59-year-old woman who developed a local recurrence of rectal cancer which showed extremely rapid growth. The patient had undergone a curative low anterior resection with total mesoexcision, and was discharged on postoperative day 25 after an uneventful recovery. However, 2 months after the operation, she developed bleeding from the rectum during defecation, the quantity of which gradually increased. A colonoscopy performed during the fifth postoperative month revealed a circular tumor at the suture line. The tumor was unresectable because it had firmly invaded not only the sacrum, but also the right ureter. Despite the administration of 5-fluorouracil and leucovorin, the patient died of cancer 18 months after her initial surgery. Considering that local recurrence of rectal cancer does not usually occur within 1 year after surgery, this case is unusual because the local recurrence developed very early and showed extremely rapid growth, occupying the entire lumen of the rectum by the time it was detected by colonoscopy during the fifth postoperative month.  相似文献   
107.
BACKGROUND: The purpose of this study was to evaluate whether the chest radiograph is a reliable tool to assess response to radiotherapy. MATERIALS AND METHODS: Pre- and post-treatment chest radiographs and computed tomographs (CT) of 63 patients with nonsmall cell lung cancer (NSCLC) treated by radiotherapy were reviewed by four observers with regard to suitability for tumor measurement, and response. Suitability for tumor measurement was expressed as the number of measurable diameters. In addition, the consequences to clinical outcome were studied by survival analysis. RESULTS: The CT turned out to be more suited for tumor measurement before as well as after radiotherapy, resulting in an increase of the number of measurable cases. The number of measurable cases with CT was 52 (83%) as compared to 28 (44%) with chest radiography. Especially in case of centrally localized tumors, the presence of an atelectasis, or squamous cell carcinoma, CT contributed to a higher rate of measurable cases. The interobserver agreement with regard to response using chest radiograph was good (mean kappa = 0.74). In 25 of 28 cases (89%) measurable with CT as well as with chest radiograph, response was equally classified. When CT was used, the median survival of the responders was 14.2 months as compared to 6.8 months of the nonresponders. When chest radiograph was used, the median survival of these groups was 12.0 and 6.6 months respectively, which was not significantly different when response was assessed by CT. CONCLUSION: We conclude that CT is more suited for tumor measurement because more measurable lesions can be found and more evaluable lesions on chest radiograph become measurable on CT. The chest radiograph does have a valuable role to play in those lesions that are measurable because of the good interobserver agreement with regard to the response classification, the high overall agreement between CT and chest radiograph in case of measurable cases, and the lack of important differences with regard to survival.  相似文献   
108.
The solution structure of a synthetic ET(B) selective agonist, ET-1[Cys(Acm)(1,15), Ala3, Leu7, dAsp8, Aib11] has been solved by 1H NMR and molecular modelling studies. Such solution structures of linear modified peptides in aqueous methanol are being used in an ongoing program of research designed to assist in an understanding of the basic structural requirements for the biological activity of vasoconstrictors. The resulting structure of this peptide is characterised by an alpha-helical conformation between residues Leu6-His16 and by N- and C-termini which assume no defined conformation. A knowledge of the solution structures of this and related peptides, which are ET(B) selective agonists, are proving to be important in the understanding of how they interact with the ET(B) receptor.  相似文献   
109.
110.
Strain compensated InGaAs-GaAsP-InGaP laser   总被引:1,自引:0,他引:1  
The performance characteristics of InGaAs-GaAsP-InGaP strain compensated laser emitting near 1 /spl mu/m are reported. The ridge waveguide lasers have room temperature threshold current of 18 mA and differential quantum efficiency of 0.45 W/A/facet. The linewidth enhancement factor is smaller and gain coefficient is larger for these strain compensated lasers compared to that for conventional strained layer laser. This may be due to higher effective compressive strain in the light emitting layer of these devices which reduces the effective mass. The observed larger gain coefficient is consistent with the measured larger relaxation oscillation frequency of these lasers compared to that for a conventional strained layer laser.  相似文献   
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