A cost comparison of balloon angioplasty and stenting versus endarterectomy for the treatment of carotid artery stenosis

PURPOSE: Percutaneous transluminal angioplasty with stenting (PTAS) of the carotid artery has been advocated as an alternative treatment for high-grade stenosis. Rationale for this approach includes less morbidity, shorter recovery, and lower cost when compared with carotid endarterectomy (CEA). METHODS: The clinical results and hospital charges of patients who underwent elective treatment for carotid stenosis were reviewed. During a concurrent 14-month period, 218 patients were admitted 229 times for 234 procedures for the treatment of 239 carotid bifurcation stenoses, 109 by PTAS and 130 by CEA. Hospital charges were reviewed for each hospitalization and were categorized according to radiology, operating room, cardiac catheterization laboratory, and all other hospital charges. RESULTS: The combined incidence of postprocedure strokes and deaths were: PTAS, eight strokes (7.7%) and one death (0.9%); CEA, two strokes (1.5%) and two deaths (1.5%). Total hospital charges per admission for the two groups were $30,140 for PTAS and $21,670 for CEA. The average postprocedure length of stay for PTAS was 2.9 days (median, 2 days) and for CEA was 3.1 days (median, 3 days). Cardiac catheterization laboratory charges for the PTAS group were $12,968, whereas the operating room charges for the CEA group were $4263. When hospitalizations that were extended by complications were excluded, the average total charges for the PTAS group (n = 84) dropped to $24,848 (mean length of stay, 1.9 days) and for the CEA group (n = 111) to $19,247 (mean length of stay, 2.6 days). CONCLUSIONS: After evaluating hospital charges, PTAS for the treatment of carotid stenosis cannot currently be justified on the basis of reduced costs alone. With future cost-containing measures, total hospital charges can be reduced in both groups.     

Murine thymic lymphoma is associated with a species-specific hematopoietic progenitor cell subpopulation

Many strains of laboratory mouse are uniquely susceptible to the development of T cell lymphoma/leukemia, either spontaneously or as a result of chemical or radiation exposure. In contrast, T cell leukemias or lymphomas which are relatively uncommon in human populations, are not easily induced by radiation, and are not generally associated with chemotherapy or chemical exposure. Evidence is presented to suggest that differences in the susceptibility to the development of these malignancies is related to subtle but important variations in the regulation of hematopoietic stem cell differentiation between these two species.     

DIRECT RESONANCE OF TURBULENT BOUNDARY LAVER OVER COMPLIANT WALLS

１．　ＩＮＴＲＯＤＵＣＴＩＯＮＴｈｅｍａｉｎｇｏａｌｏｆｔｈｉｓｐａｐｅｒｉｓｔｏｅｘｐｌｏｒｅｔｈｅｐｏｓｓｉｂｉｌｉｔｙｔｏｌｅａｒｎｍｏｒｅａｂｏｕｔｔｈｅｍｅｃｈａｎｉｓｍｏｆｔｕｒｂｕｌｅｎｔｂｏｕｎｄａｒｙｌａｙｅｒｆｌｏｗｉｎｔｅｒａｃｔｉｏｎｓａｎｄｉｔｓｅｆｆｅｃｔｓｏｎｃｏｍｐｌｉａｎｔｗａｌｌｐｅｒｆｏｒｍａｎｃｅ．Ｔｈｅｒｅａｒｅｃｅｒｔａｉｎｐｒｅｒｅｑｕｉｓｉｔｅｃｏｎｄｉｔｉｏｎｓｔｏｆｕｒｔｈｅｒｔｈｅｓｔｕｄｙｏｎｔｈｅｍｅｃｈａｎｉｓｍ，ｉ．ｅ．ｔｈｅｃｏ…     

trans-2-phenylcyclopropylamine is a substrate for and inactivator of horseradish peroxidase

Horseradish peroxidase (HRP) is well known for mediating the electron-transfer oxidation of electron-rich aromatic 'donors' such as phenols and anilines, but has not been described to oxidize aliphatic amines. We here confirm the inability of HRP to oxidize typical aliphatic amines, even those which would exist significantly as free bases at the operative pH. In contrast, trans-2-phenylcyclopropylamine (2-PCPA) is both a substrate (turnover product is cinnamaldehyde) and a time-dependent inactivator of HRP. These activities of 2-PCPA are consistent with either a concerted or rapid sequential one-electron-oxidation/ring-opening to give an intermediate capable of covalent binding to the enzyme. 2-PCPA is the first known example of a simple aliphatic amine which serves as a substrate for HRP under turnover conditions.     

Identification of glycoprotein 330 as an endocytic receptor for apolipoprotein J/clusterin

Glycoprotein 330 (gp330) is a member of a family of endocytic receptors related to the low density lipoprotein receptor. gp330 has previously been shown to bind a number of ligands in common with its family member, the low density lipoprotein receptor-related protein (LRP). To identify ligands specific for gp330 and relevant to its localization on epithelia such as in the mammary gland, gp330-Sepharose affinity chromatography was performed. As a result, a 70-kDa protein was selected from human milk and identified by protein sequencing to be apolipoprotein J/clusterin (apoJ). Solid-phase binding assays confirmed that gp330 bound to apoJ with high affinity (Kd = 14.2 nM). Similarly, gp330 bound to apoJ transferred to nitrocellulose after SDS-polyacrylamide gel electrophoresis. LRP, however, showed no binding to apoJ in either type of assay. The binding of gp330 to apoJ could be competitively inhibited with excess apoJ as well as with the gp330 ligands apolipoprotein E, lipoprotein lipase, and the receptor-associated protein, a 39-kDa protein that acts to antagonize binding of all known ligands for gp330 and LRP. Several cultured cell lines that express gp330 and ones that do not express the receptor were examined for their ability to bind and internalize 125I-apoJ. Only cells that expressed gp330 endocytosed and degraded radiolabeled apoJ. Furthermore, F9 cells treated with retinoic acid and dibutyryl cyclic AMP to increase expression levels of gp330 displayed an increased capacity to internalize and degrade apoJ. Cellular internalization and degradation of radiolabeled apoJ could be inhibited with unlabeled apoJ, receptor-associated protein, and gp330 antibodies. The results indicate that gp330 but not LRP can bind to apoJ in vitro and that gp330 expressed by cells can mediate apoJ endocytosis leading to lysosomal degradation.     

A two-year measurement of rainfall attenuation of CW microwaves inSingapore

The authors present two-year statistics on the rainfall attenuation of 21.225 GHz vertically polarized CW microwave signals in Singapore. The CCIR recommendation is found to underestimate the microwave specific attenuation (dB/km) per path average rain rate (mm/h) as well as the accumulated time of attenuation exceeding preset levels. A negative exponential raindrop size distribution based on spherical droplets is constructed from the measured data     

The near-zone field characteristics of an E-polarization plane wavepenetrating through cylindrical multiple apertures (non) coated withlossy and lossless media

The direct integral equation is formulated for describing the current on the multiple perfectly conducting strips in cylindrical geometries for an E-polarization plane wave of normal incidence. By using the Galerkin's method, the surface currents on the conducting strips are expanded in the form of a series of Chebyshev polynomials of the first kind, while the unknown expanding coefficients are solved by a set of matrix equations of finite order with a fast convergence rate and a high accuracy. Furthermore, numerical results are presented to demonstrate the variation of the penetrated near-zone field in the presence of one, two, three, four and six cylindrical apertures, and the hybrid effects of both aperture number and aperture angular widths on the penetrated fields are investigated in detail     

Equivalent circuit model of on-wafer CMOS interconnects for RFICs

This paper investigates the properties of the on-wafer interconnects built in a 0.18-/spl mu/m CMOS technology for RF applications. A scalable equivalent circuit model is developed. The model parameters are extracted directly from the on-wafer measurements and formulated into empirical expressions. The expressions are in functions of the length and the width of the interconnects. The proposed model can be easily implemented into commercial RF circuit simulators. It provides a novel solution to include the frequency-variant characteristics into a circuit simulation. The silicon-verified accuracy is proved to be up to 25 GHz with an average error less than 2%. Additionally, equivalent circuit model for longer wires can be obtained by cascading smaller subsections together. The scalability of the propose model is demonstrated.     

Prediction and quality control of the melt index during production of high-density polyethylene

In polyolefin processes the melt index (MI) is the most important control variable indicating product quality. Because of the difficulty in the on-line measurement of MI, a lot of MI estimation and correlation methods have been proposed. In this work a new dynamic MI estimation scheme is developed based on system identification techniques. The empirical MI estimation equation proposed in the present study is derived from the 1 ^st -order dynamic models. Effectiveness of the present estimation scheme was illustrated by numerical simulations based on plant operation data including grade change operations in high density polyethylene (HDPE) processes. From the comparisons with other estimation methods it was found that the proposed estimation scheme showed better performance in MI predictions. The virtual sensor model developed based on the estimation scheme was combined with the virtual on-line analyzer (VOA) to give a quality control system to be implemented in the actual HDPE plant. From the application of the present control system, significant reduction of transition time and the amount of off-spec during grade changes was achieved