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排序方式: 共有3411条查询结果,搜索用时 15 毫秒
1.
RE Vlietstra 《Canadian Metallurgical Quarterly》1993,16(10):2073-2074
2.
A cost comparison of balloon angioplasty and stenting versus endarterectomy for the treatment of carotid artery stenosis 总被引:1,自引:0,他引:1
WD Jordan GD Roye WS Fisher D Redden HA McDowell 《Canadian Metallurgical Quarterly》1998,27(1):16-22; discussion 22-4
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. 相似文献
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The phenotypic characteristics of three Serpulina pilosicoli strains isolated from humans with diarrhoea (WesB, Kar, Hrm7) and two porcine S. pilosicoli strains isolated from pigs with intestinal spirochaetosis (1648, 3295), were compared with the type strain of the species P43/6/78T (T = type strain) and other intestinal spirochaetes within the genus Serpulina. All S. pilosicoli strains had a characteristic ultrastructural appearance, displayed similar growth rates, hydrolysed hippurate, lacked beta-glucosidase activity, utilised D-ribose as a growth substrate, and had similar sensitivities to rifampicin and spiramycin. The only consistent phenotypic characteristic that differentiated human strains from porcine strains of S. pilosicoli was that the human strains all utilised the pentose sugar D-xylose. These distinguishing phenotypic traits appear useful for identifying S. pilosicoli. 相似文献
5.
RF Speck K Wehrly EJ Platt RE Atchison IF Charo D Kabat B Chesebro MA Goldsmith 《Canadian Metallurgical Quarterly》1997,71(9):7136-7139
The chemokine receptor CCR5 acts as an essential cofactor for cell entry by macrophage-tropic human immunodeficiency virus type 1 (HIV-1) strains, whereas CXCR4 acts as an essential cofactor for T-cell-line-adapted strains. We demonstrated that the specific amino acids in the V3 loop of the HIV-1 envelope protein that determine cellular tropism also regulate chemokine coreceptor preference for cell entry by the virus. Further, a strong correlation was found between HIV-1 strains classified as syncytium inducing in standard assays and those using CXCR4 as a coreceptor. These data support the hypothesis that progressive adaptation to additional coreceptors is a key molecular basis for HIV-1 phenotypic evolution in vivo. 相似文献
6.
Comparison of two methods of surfactant administration and the effect on dosing-associated hypoxemia
M Nelson JJ Nicks MA Becker LA Vrlenich V Bhatt-Mehta RE Schumacher 《Canadian Metallurgical Quarterly》1997,17(6):450-454
OBJECTIVE: The purpose of our study was to test the hypothesis that surfactant dosing through a proximal sideport adapter on an endotracheal tube leads to more dosing-associated hypoxemia compared with a method of dosing that uses a double-lumen endotracheal tube. STUDY DESIGN: Using adequate sample size to compare significant changes in O2 saturation (power > 0.8, alpha < 0.05) we enrolled 36 infants with respiratory distress syndrome in this randomized trial. A 10% change in O2 saturation was considered clinically significant. Nineteen infants received 38 doses of surfactant through the sideport adapter. Seventeen infants received 31 doses of surfactant through the nonventilation lumen of a double-lumen endotracheal tube. Two main outcome measures were assessed: time-averaged O2 saturation values 30 minutes after dosing and the largest absolute fall in O2 saturation for each patient. RESULTS AND CONCLUSIONS: Time-averaged O2 saturation measures were higher in the proximal sideport group (p = 0.02), but the magnitude of difference was probably not clinically significant. No significant difference was detected between groups when we compared largest absolute drop in O2 saturation. Secondary analyses found no effect of birth weight or dose number (second vs third dose) on either outcome measure. 相似文献
7.
RE Rada 《Canadian Metallurgical Quarterly》1997,16(4):94, 96, 98-94, 96, 99
Vital bleaching can be a relatively unpredictable treatment. Photographs of previous cases and cosmetic imaging, although useful, may lead to unrealistic expectations on the part of the patient. The high-tech mystique of computer imaging and viewing one's own teeth has a significant impact on the dental patient. Whether imaged by the dentist or an auxiliary, patients must be aware of alternatives that may exist both before and during treatment. Cosmetic imaging should be used as an adjunct to, not as the prime motivator for, treatment planning in bleaching cases. Excellent communication between the practitioner and patient is the most important factor in assuring positive bleaching results and patient satisfaction. 相似文献
8.
RE Shaddy 《Canadian Metallurgical Quarterly》1997,8(10):617-621
Apoptosis, or programmed cell death, is a mechanism of cell death that plays a major role during development, homeostasis, and in many disease states. The interaction of the cell membrance protein, Fas, with its ligand, Fas ligand, induces apoptosis in Fas-bearing cells. Several factors induce apoptosis in mammalian cardiomyocytes, including reperfusion injury, hypoxia, mechanical stretch, myocardial infarction, rapid ventricular pacing, and hypertensive heart failure. Although studies in the transplanted hearts of rodents and humans have shown the presence of Fas, Fas ligand, and apoptosis in the myocardium, there is controversy regarding which cells in the myocardium are actually undergoing apoptosis after heart transplantation. It is even less clear what type of relationship, if any, apoptosis has to allograft rejection or post-transplant graft coronary vasculopathy. This review summarizes the current knowledge regarding apoptosis in the transplanted heart and discusses some of the controversies surrounding this new and rapidly expanding area of investigation. 相似文献
9.
Discrimination of simple visual attributes can improve significantly with practice. We have trained human observers to perform peripherally presented tasks involving the localization of short line segments and examined the specificity of the learning for the visual location, orientation, and geometric arrangement of the trained stimulus. Several weeks of training resulted in dramatic threshold reductions. The learning was specific for the orientation and location of the trained stimulus, indicating the involvement of the earliest cortical stages in the visual pathway where the orientation and location of stimuli are mapped with highest resolution. Furthermore, improvement was also specific for both the configuration of the trained stimulus and the attribute of the stimulus that was under scrutiny during training. This degree of specificity suggests that the learning cannot be achieved by cortical recruitment alone, as proposed in current models, but is likely to involve a refinement of lateral interactions within the cortex and possibly a gating of lower level changes by attentional mechanisms. 相似文献
10.
Cancer invasion and metastasis are associated with matrix degradation. We describe a novel in vivo model of invasion by squamous epithelial neoplastic cells derived from transgenic mice grown on acellular human dermis. Human dermis was subjected to multiple freeze-thaw cycles to render it acellular, maintaining the basement membrane of the former dermal-epidermal junction. Cells representing discrete stages of a multistep transgenic mouse model of epidermal carcinogenesis (neonatal transgenic keratinocytes, moderately/poorly differentiated squamous cell carcinoma, and lymph node metastasis) were seeded onto the basement membrane surface, grown in culture for 4 days, grafted in a subpannicular pocket of athymic mice, and harvested after 3 weeks. Histological analysis demonstrated that neonatal transgenic keratinocytes did not degrade the basement membrane or invade the underlying dermis. In contrast, malignant cells derived from both a moderately differentiated squamous carcinoma and a lymph node metastasis were highly invasive. Immunohistochemical analysis revealed collagenase only in nests of invading malignant cells in contact with the dermal matrix, but not in the tumor mass remaining above the basement membrane, suggesting that this proteinase may be required for stromal invasion. This novel model recapitulates the events seen in malignant invasion: transgenic keratinocytes are unable to penetrate the dermis while cells from a moderately differentiated carcinoma and from lymph node metastasis consistently invade. 相似文献