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K Ouriel CK Shortell KA Illig RK Greenberg RM Green 《Canadian Metallurgical Quarterly》1999,29(1):82-7; discussion 87-9
PURPOSE: With a diminishing rate of cardiac and neurologic events after carotid endarterectomy, intracerebral hemorrhage is gaining increasing importance as a cause of perioperative morbidity and mortality. To date, information has been largely anecdotal, and there has been no comparison with a control group of patients. METHODS: The records of all patients experiencing symptomatic intracerebral hemorrhage after carotid endarterectomy were reviewed and compared with data from 50 randomly selected patients who did not experience intracranial bleeding. Univariate analyses were performed, using the Fisher exact test for dichotomous data and the Student t test for continuous data. RESULTS: During a 6-year period, symptomatic intracranial hemorrhage developed in 11 (0.75%) of 1471 patients undergoing carotid endarterectomy, accounting for 35% of the 31 total perioperative neurologic events. Hemorrhage occurred a median of 3 days postoperatively (range, 0 to 18 days). Signs and symptoms included hypertension in all 11 patients, headache in 7 conscious patients (64%), and bradycardia in 6 patients (55%). Massive hemorrhage with herniation and death occurred in 4 patients (36%). Moderate hemorrhage developed in 5 patients (45%); 3 of these patients had partial recovery, and 2 had complete recovery. Petechial hemorrhage occurred in the remaining 2 patients (18%), 1 with partial and 1 with complete recovery. In comparison with the control group, there were no differences in respect to sex, indication for operation, smoking or diabetic history, and antiplatelet therapy or perioperative heparin management. Patients with intracranial hemorrhage were, however, younger, more frequently hypertensive, had a higher degree of ipsilateral and contralateral carotid stenosis, and had a higher rate of contralateral carotid occlusion. CONCLUSION: Intracranial hemorrhage occurs with notable frequency after carotid endarterectomy and accounts for a significant proportion of neurologic morbidity and mortality. Younger patients, hypertensive patients, and patients with severe cerebrovascular occlusive disease appear to be at greatest risk for the complication. 相似文献
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We have developed a new detection method for measuring distributions of energy depositions from particles characterized by low linear energy transfers (LETs). In particular, we have developed a detection system to measure energy depositions produced by electrons and photons on nanometer scales. The detector is based upon the operational principles of the superheated drop detector (SDD). SDDs consist of tiny droplets of superheated liquid suspended within a gel-like emulsion. The SDDs in this study are fabricated using Freon-115 and a glycerol-based gel as the superheated liquid and host medium. This SDD configuration is operated as a threshold temperature-dependent detector for measuring nanoscopic distributions of energy depositions from low-LET particles. Measured results are compared to the calculated distributions of energy depositions along an electron track. A new electron track code, ESLOW3.1, is used to perform the computational study. Measurements show good agreement with computational results in the energy deposition range of 40-200 eV. 相似文献
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Mullenbach GT; Chiu CY; Gyenes A; Blaney J; Rosenberg S; Marlowe CK; Brown S; Stratton-Thomas J; Montelione GT; George-Nascimento C; Stauber G 《Protein engineering, design & selection : PEDS》1998,11(6):473-480
Six mutants of human epidermal growth factor (EGF), which carry single
point substitutions within a surface patch proposed to juxtapose the bound
receptor, were prepared and characterized for receptor affinity and
mitogenicity. Receptor affinities relative to EGF are G12Q > H16D >
Y13W > Q43A approximately = H16A approximately = EGF >> L15A.
Notably, the reduced receptor affinity of mutant L15A indicates that Leu15
probably contributes substantially to receptor binding whereas unaltered
receptor affinities observed for analogs H16A and Q43A indicate that
neither His16 nor Gln43 contributes significantly to this interaction. On
the other hand, the observed enhanced receptor affinities of analogs G12Q,
Y13W and H16D highlight surface loci where additional productive
receptor-binding contacts can be introduced. Interestingly, at acidic pH
analog H16A reveals substantially greater receptor affinity than that of
EGF, a property which may offer enhanced therapeutic utility in acidic
environments in vivo.
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Periportal lesions were detected on ultrasound in two cases of Langerhans cell histiocytosis with liver involvement. Hypoechoic or hyperechoic lesions were detected in different stages of evolution. Hyperechoic lesions probably corresponded to periportal inflammation whilst hyperechogenicity suggested xanthomatous change. 相似文献