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81.
In a 4-year study we examined the longitudinal effects of deinstitutionalization programs on those who remain in institutions being downsized. Individual outcomes investigated were community access, social activities, community inclusion, family relationships, and choice. Effects of residential relocation on individual outcomes such as adaptive behavior were evaluated and total daily per-person expenditure on institutional services for participants was determined. Downsizing was associated with decreased community integration but no change in most other outcomes. Availability of therapy services fell over time, and individuals experienced many residential and day program moves within the institution. Per person expenditure on services increased substantially. Finally, no significant changes in adaptive behavior were associated with intrainstitutional moves.  相似文献   
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Randomized, prospective trials examining the effectiveness of carotid endarterectomy have given distinct information into the mechanisms and prevention of embolic strokes. The North American Symptomatic Carotid Endarterectomy Trial (NASCET) and the Asymptomatic Carotid Atherosclerosis Study (ACAS) have demonstrated the benefits of carotid endarterectomy for patients who meet the precise selection criteria and are treated according to established study protocols. The existing challenge to clinicians lies in the application of trial results to the individual patient.  相似文献   
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The effects of niflumic acid on whole-cell membrane currents and mechanical activity were examined in the rat portal vein. In freshly dispersed portal vein cells clamped at -60 mV in caesium (Cs+)-containing solutions, niflumic acid (1-100 microM) inhibited calcium (Ca2+)-activated chloride currents (IC1(Ca)) induced by caffeine (10 mM) and by noradrenaline (10 microM). In a potassium (K+)-containing solution and at a holding potential of - 10 mV, niflumic acid (10-100 microM) induced an outward K+ current (IK(ATP)) which was sensitive to glibenclamide (10-30 microM). At concentrations < 30 microM and at a holding potential of -2 mV, niflumic acid had no effect on the magnitude of the caffeine- or noradrenaline-stimulated current (IBK(Ca)) carried by the large conductance, Ca(2+)-sensitive K+ channel (BKCa). However, at a concentration of 100 microM, niflumic acid significantly inhibited IBK(Ca)) evoked by caffeine (10 mM) but not by NS1619 (1-(2'-hydroxy-5'-trifluoromethylphenyl)-5-trifluoromethyl-2(3 H) benzimidazolone; 20 microM). In Cs(+)-containing solutions, niflumic acid (10-100 microM) did not inhibit voltage-sensitive Ca2+ currents. In intact portal veins, niflumic acid (1-300 microM) inhibited spontaneous mechanical activity, an action which was partially antagonised by glibenclamide (1-10 microM), and contractions produced by noradrenaline (10 microM), an effect which was glibenclamide-insensitive. It is concluded that inhibition of ICl(Ca) and stimulation of IK(ATP) both contribute to the mechano-inhibitory actions of niflumic acid in the rat portal vein.  相似文献   
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The role of a variety of compounds including organic acids, vitamins, growth promoting substances, purines and pyrimidines in the bioconversion of cortisol with Bacillus cereus was investigated. The transformation of cortisol to prednisolone and pregn-4-en-11beta, 17alpha,20beta, 21-tetrol-3-one was affected by these compounds in different manners. The enzymatic delta1-dehydrogenation reaction was greatly induced with fumarate, menadione, and xanthine treatments. However, the enzymic reduction of the 20-carbonyl to the 20beta-ol was specifically stimulated with fumarate, nicotinic acid amide, and uracil treatments.  相似文献   
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Lymphocyte subset abnormalities have been observed in a series of patients diagnosed with Wegener's granulomatosis (WG). Fifteen patients with WG were evaluated for lymphocyte subset abnormalities by two-color immunofluorescence flow cytometry. The WG group showed a decrease in CD4+ cells and an extraordinary increase in HLA-DR+ cells. The average percentages of HLA-DR+ cells of the normal group and WG group were 11.0 +/- 4.0 and 40.5 +/- 13.9% (CD3+HLA-DR+ = 20.3 + 9.4%). Within the CD8 family, CD8+57+, CD8+38+ and CD8+HLA-DR+ cells were markedly elevated. Our findings differ from other series which reported that the lymphocyte subsets in the peripheral blood of patients with WG were normal.  相似文献   
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Every year between one and two million African children under five die of malaria. If one adds to this the contribution of malaria to all-cause infant mortality then clearly the burden of the disease is catastrophic--a disaster quietly happening each and every year. New tools are needed urgently to support those currently available for control of the disease. An effective vaccine remains elusive. This article outlines the potential contribution to malaria control services of satellite information, which is being used by resource managers in other sectors. In particular, it highlights the lessons which can be learned from early warning systems in other areas, especially those designed to respond to famine. An appendix provides a brief introduction to satellite data and their interpretation.  相似文献   
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