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21.
    
BACKGROUND AND PURPOSE: The available data on low-dose oral contraceptive pill (OCP) use and stroke risk in US women are limited by small numbers. We sought more precise estimates by conducting a pooled analysis of data from 2 US population-based case-control studies. METHODS: We analyzed interview data from 175 ischemic stroke cases, 198 hemorrhagic stroke cases, and 1191 control subjects 18 to 44 years of age. RESULTS: For ischemic stroke, the pooled odds ratio (pOR) adjusted for stroke risk factors for current use of low-dose OCPs compared with women who had never used OCP (never users) was 0.66 (95% confidence interval [CI], 0.29 to 1.47) and compared with women not currently using OCPs (nonusers) the pOR was 1.09 (95% CI, 0.54 to 2.21). For hemorrhagic stroke, the pOR for current use of low-dose OCPs compared with never users was 0.95 (95% CI, 0.46 to 1.93) and compared with nonusers the pOR was 1.11 (95% CI, 0.61 to 2.01). The pORs for current low-dose OCP use and either stroke type were not elevated among women who were >/=35 years, cigarette smokers, obese, or not receiving medical therapy for hypertension. pORs for current low-dose OCP use were 2.08 (95% CI, 1. 19 to 3.65) for ischemic stroke and 2.15 (95% CI, 0.85 to 5.45) for hemorrhagic stroke among women reporting a history of migraine but were not elevated among women without such a history. Past OCP use (irrespective of formulation) was inversely related to ischemic stroke but unrelated to hemorrhagic stroke. CONCLUSIONS: Women who use low-dose OCPs are, in the aggregate, not at increased risk of stroke. Studies are needed to clarify the risk of stroke among users who may be susceptible on the basis of age, smoking, obesity, hypertension, or migraine history.  相似文献   
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Tuberculosis of the breast is a rare disease. Tubercular abscesses predominantly affecting the soft tissues are also very infrequent. A case of chest wall tuberculosis secondarily involving the breast presenting as a hard, fixed lump simulating mammary carcinoma is presented here. There was no evidence of pleural or pulmonary tuberculosis.  相似文献   
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The aims of this study were to establish a working rabbit heart model of regional myocardial ischaemia in which electrophysiologic parameters and arrhythmogenesis could be correlated and to explore the mechanisms underlying the antiarrhythmic activity of lignocaine. Monophasic action-potential duration (MAPD90), effective refractory period (ERP), and conduction delay were measured at three ventricular sites in isolated hearts paced at 3.3 Hz. The hearts were treated before and throughout 30 min of ischaemia and 15 min of reperfusion with a vehicle or 20 microM lignocaine. In both groups, ischaemia produced a similar shortening in MAPD90. Lignocaine decreased ERP shortening during ischaemia from -56+/-4 to -32+/-6 ms. An ischaemia-induced increase in conduction delay was greater in the lignocaine than the control group (49+/-7 vs. 11+/-2 ms). Ischaemia-induced dispersion of repolarisation was reduced by lignocaine from 66+/-4 to 32+/-7 ms, and dispersion of refractoriness was decreased from 57+/-6 to 16+/-3 ms. Lignocaine decreased inducibility of ventricular fibrillation (VF) during ischaemia from 86 to 25%. We conclude that, in this model, the antiarrhythmic activity of lignocaine during regional ischaemia is associated with an increase in ischaemia-induced conduction delay and reduced dispersion of repolarisation and refractoriness.  相似文献   
24.
    
Time-dependent thrombolytic resistance is a critical problem in thrombolytic therapy for acute myocardial infarction. Platelets have been regarded as the main source of plasminogen activator inhibitor-1 (PAI-1) found in occlusive platelet-rich clots. However, endothelial cells are also known to influence the fibrinolytic capacity of blood vessels, but their ability to actively mediate time-dependent thrombolytic resistance has not been fully established. We will show that, in vitro, tumor necrosis factor-alpha-stimulated endothelial cells secrete large amounts of PAI-1 over a period of hours, which then binds to fibrin and protects the clot from tissue plasminogen activator-induced fibrinolysis. In vivo, endothelial cells covering atherosclerotic plaques are influenced by cytokines synthesized by plaque cells. Therefore, we propose that continuous activation of endothelial cells in atherosclerotic blood vessels, followed by elevated PAI-1 secretion and storage of active PAI-1 in the fibrin matrix, leads to clot stabilization. This scenario makes endothelial cells a major factor in time-dependent thrombolytic resistance.  相似文献   
25.
    
The present work analyzes the clinical results obtained at the Istituto del Radio in Brescia, Italy, using radiotherapy in the treatment of T2N0 glottic carcinomas. The analysis covers a sampling of 127 patients who had been treated using fixed field with 60Co or linear accelerator (high energy photons) technique delivering a minimum target dose of 60 Gy over the course of a 6-week period; 200 cGy a day. The purpose of the present study was to evaluate: treatment response 3 months after treatment was suspended using the WHO nomenclature; Overall Survival Rate and Actuarial Disease-Free Survival Rate at five and ten years from the end of treatment comparing the results obtained in cases of T2a and T2b; biological cost of treatment in terms of late recurrences. Three months after treatment had ended, a complete response was seen in 95% of the patients. The overall survival was 85% at five years while the NED survival was 67% at five years. Surgical salvage made it possible to treat 44% of those who did not respond to radiotherapy or who had a recurrence. Late recurrence rate was 4.7%. The clinical results are slightly lower than those obtained in the literature for surgical series in terms of survival probability. They were, however, certainly better in terms of good vocal preservation.  相似文献   
26.
    
The general epidemiological acceptability of prevalence, or incidence, for assessing risk of radiation cataract development has dictated an almost exclusive dependence on cataract onset as a measure of cataractogenicity for given doses of radiation. The advent of instrumentation capable of acquiring images amenable to quantitative analyses offers the possibility of exploiting \"relative opacification\" as an added, if not exclusive, parameter. This development is particularly important in efforts to assess populations such as that in the Altai, which are temporally far removed from their exposure and among whom there exists a large subset with extant cataracts. The new technologies, Scheimpflug and retroillumination imaging, combined with the application of the appropriate analytical algorithms can not only provide quantitative and nonsubjective assessment of lens transparency, but also serve as a means to immortalize the state of the pathology at the time of acquisition. Highly relevant to the assessment of an aging exposed population is the use of lens epithelial fragments as potential dosimeters. The material is routinely available as a result of cataract extraction procedures and is amenable to the application of a modified micronucleus (MN) assay. The MN assay in the lens has tremendous advantages over its use in other tissues for a number of reasons, not least of which is that lens MNs are extremely long-lived. Given the relative ease of application and its potential as a radiation bioindicator, the lens MN assay should be considered in any follow-up of populations exposed to ionizing radiation.  相似文献   
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Previously developed micromechanical methods for stiffness and strength prediction are adapted for analysis of multi-layer plain weave textile composites. Utilizing the direct micromechanics method (DMM) via finite element modeling, three methods are presented: (a) direct simulation of a multi-layer plain weave textile composite; (b) micromechanical analysis of a single layer of interest from the force and moment resultants acting on that layer; and (c) application of the previously developed quadratic stress-gradient failure theory to the layer of interest. In comparison to direct modeling, the other two techniques show only 5% difference over a number of random test cases. Several practical design examples of strength prediction are included to illustrate the importance and accuracy of method implementation.  相似文献   
30.
In many reinforced composite manufacturing processes it is necessary to compact the fiber materials to obtain the desired fiber/resin ratio in the finished part. Detailed knowledge of applied surface force versus material fiber volume is particularly important in processes such as pultrusion, resin transfer molding, and compression molding. The force required to compact a stack of reinforcing material is strongly dependent on the type of fiber used and its material form. Complicated interactions are possible, particularly when mixtures of unidirectional, oriented cloth and random fiber mats are used. This paper will present results of an experimental and analytical investigation of the response of various dry reinforcing materials subjected to compressive forces applied normal to their principle plane. Experiments were conducted by applying up to 8.6 MPa normal force to thick stacks of E-glass, graphite cloth, mat and unidirectional material and combinations of two different fiber orientation. Pressure versus fiber volume data were generated for both individual materials and various combinations. Experimental results were compared to analytical predictions. Data showed that the force versus deformation is very strongly dependent on the details of the fiber form or forms being used. There is structural relaxation during fiber compression. Relaxation is very related to fiber orientation, span length, and fiber breakage during compaction. Relaxation behavior decreases with fiber alignment. Random mats and 0/90 cloth show much more relaxation than unidirectional fibers. Data of relaxation is very well fitted with a Maxwell-Wiechert viscoelastic model.  相似文献   
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