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1.
Cerebral microbleeds and cognitive decline in a hemodialysis patient: Case report and review of literature 下载免费PDF全文
Lin Li Mark Fisher Wei‐Ling Lau Hamid Moradi Alexander Cheung Gaby Thai Jason Handwerker Kamyar Kalantar‐Zadeh 《Hemodialysis international. International Symposium on Home Hemodialysis》2015,19(3):E1-E7
Cerebral microbleeds (CMBs) are small hemosiderin deposits indicative of prior cerebral microscopic hemorrhage and previously thought to be clinically silent. Recent population‐based cross‐sectional studies and prospective longitudinal cohort studies have revealed association between CMB and cognitive dysfunction. In the general population, CMBs are associated with age, hypertension, and cerebral amyloid angiopathy. In the chronic kidney disease (CKD) population, diminished estimated glomerular filtration rate has been found to be an independent risk factor for CMB, raising the possibility that a uremic milieu may predispose to microbleeds. In the end‐stage renal disease (ESRD) population on hemodialysis, the incidence of microbleeds is significantly higher compared with a control group without history of CKD or stroke. We present an ESRD patient on chronic hemodialysis with a history of gradual cognitive decline and progressive CMBs. Through this case and literature review, we illustrate the need to develop detection and prediction models to treat this frequent development in ESRD patients. 相似文献
2.
LJ Huang K Durick JA Weiner J Chun SS Taylor 《Canadian Metallurgical Quarterly》1997,94(21):11184-11189
Subcellular localization directed by specific A kinase anchoring proteins (AKAPs) is a mechanism for compartmentalization of cAMP-dependent protein kinase (PKA). Using a two-hybrid screen, a novel AKAP was isolated. Because it interacts with both the type I and type II regulatory subunits, it was defined as a dual specific AKAP or D-AKAP1. Here we report the cloning and characterization of another novel cDNA isolated from that screen. This new member of the D-AKAP family, D-AKAP2, also binds both types of regulatory subunits. A message of 5 kb pairs was detected for D-AKAP2 in all embryonic stages and in all adult tissues tested. In brain, skeletal muscle, kidney, and testis, a 10-kb mRNA was identified. In testis, several small mRNAs were observed. Therefore, D-AKAP2 represents a novel family of proteins. cDNA cloning from a mouse testis library identified the full length D-AKAP2. It is composed of 372 amino acids which includes the R binding fragment, residues 333-372, at its C-terminus. Based on coprecipitation assays, the R binding domain interacts with the N-terminal dimerization domain of RIalpha and RIIalpha. A putative RGS domain was identified near the N-terminal region of D-AKAP2. The presence of this domain raises the intriguing possibility that D-AKAP2 may interact with a Galpha protein thus providing a link between the signaling machinery at the plasma membrane and the downstream kinase. 相似文献
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Novel polyurethane insulating coatings were prepared from the reaction of glycerin‐terminated polyurethane prepolymers (GPUPs) and a blocked isocyanate curing agent (BIC). The GPUPs were prepared from the reaction of one equivalent of polycaprolactone polyol (CAPA 210) with an excess amount of 4,4′‐methylene bis(phenyl isocyanate) (MDI) and subsequent reaction of the NCO‐terminated polyurethane with glycerin. The BIC was prepared from the reaction of trimethylol propane (TMP), toluene diisocyanate (TDI) and N‐methylaniline (NMA). The polyols and curing agent were characterized by conventional methods while the curing condition was optimized via gel content measurements. The curing kinetics of the polyurethane coating were investigated and the kinetic parameters derived. The crosslink densities of the samples were determined via the equilibrium swelling method, using the Flory–Rehner equation. The relationships between the crosslink density and the electrical, physical, mechanical and dynamic mechanical properties of the coatings were also studied. Copyright © 2005 Society of Chemical Industry 相似文献
6.
BACKGROUND: There is controversy over whether colonization with drug-resistant organisms is a contraindication to lung transplantation. METHODS: We undertook a retrospective review of the results of lung transplantation for patients with cystic fibrosis (CF) at Duke University Medical Center. RESULTS: As of May 1996, 21 patients with CF underwent bilateral lung transplantation. The first patient died within 24 h of transplantation from sepsis due to Stenotrophomonas maltophilia. Of the remaining 20 patients, 17 (85%) are alive and in stable condition. The three deaths were related primarily to bronchiolitis obliterans at 4 and 18 months in two patients and to cytomegalovirus pneumonitis at 5 months in the other patient. The 17 surviving patients have been followed up for a mean of 13 months (range, 0.5 to 34 months). Most of them were colonized and infected with multidrug-resistant organisms before transplantation. Following transplantation, 11 patients had complications from infections. One patient had bacteremia due to a panresistant Burkholderia cepacia and was treated successfully. Two patients had bacteremia and wound infection due to Burkholderia gladioli, previously thought to be pathogenic only in plants. Both patients were treated successfully. Of the six patients with Aspergillus fumigatus isolated from cultures before transplantation, only one had invasive disease following transplantation and responded to treatment. CONCLUSION: The organisms present before transplantation were not the primary cause of mortality in our patient population. Our findings suggest that lung transplantation should be considered in CF patients infected with multidrug-resistant organisms. 相似文献
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At present, the preferred tool for parameter estimation in compartmental analysis is an iterative procedure; weighted nonlinear regression. For a large number of applications, observed data can be fitted to sums of exponentials whose parameters are directly related to the rate constants/coefficients of the compartmental models. Since weighted nonlinear regression often has to be repeated for many different data sets, the process of fitting data from compartmental systems can be very time consuming. Furthermore the minimization routine often converges to a local (as opposed to global) minimum. In this paper, we examine the possibility of using artificial neural networks instead of weighted nonlinear regression in order to estimate model parameters. We train simple feed-forward neural networks to produce as outputs the parameter values of a given model when kinetic data are fed to the networks' input layer. The artificial neural networks produce unbiased estimates and are orders of magnitude faster than regression algorithms. At noise levels typical of many real applications, the neural networks are found to produce lower variance estimates than weighted nonlinear regression in the estimation of parameters from mono- and biexponential models. These results are primarily due to the inability of weighted nonlinear regression to converge. These results establish that artificial neural networks are powerful tools for estimating parameters for simple compartmental models. 相似文献
8.
V Douzdjian SS Bhaskar PK Baliga KK Gugliuzza PR Rajagopalan 《Canadian Metallurgical Quarterly》1997,20(8):1310-1314
OBJECTIVE: The racial impact on graft outcome is not well defined in diabetic recipients. The purpose of this study is to analyze our experience with kidney-alone (A) and kidney-pancreas (KP) transplantation in type 1 diabetic recipients and evaluate the impact of racial disparity on outcome. RESEARCH DESIGN AND METHODS: The records of 217 kidney transplants (118 KA, 99 KP) performed on type 1 diabetic patients between 1985 and 1995 at the Medical University of South Carolina and the University of Texas Medical Branch were reviewed. RESULTS: A total of 53 (31%) white patients and 15 (33%) black patients experienced at least one episode of biopsy-proven acute rejection of the renal graft (NS). Patient survival at 1, 2, and 5 years was similar in white (92, 87, 69%) and black (91, 91, 69%) patients (NS). Kidney graft survival at 1, 2, and 5 years in the KA group was 72, 62, and 42% in blacks, compared with 79, 76, and 53% in whites (NS). Kidney graft survival at 1, 2, and 5 years in the KP group was 92, 92, and 74% in blacks, compared with 83, 77, and 58% in whites (NS). Pancreas graft survival at 1, 2, and 5 years was 81, 81, and 81% in blacks, compared with 81, 75, and 62% in whites (NS). Cox regression analysis revealed that donor age > or = 40 years increased the risk of renal graft failure 6.2-fold (P = 0.0001), whereas the addition of a pancreas transplant to a kidney and a living-related transplant decreased the risk of failure of the kidney graft 0.2 (P = 0.005) and 0.1 times (P = 0.005). CONCLUSIONS: Our results suggest that when compared with whites, there may be a trend toward an improved kidney and pancreas graft outcome in blacks undergoing KP transplants. These findings suggest that diabetes may override the risk factors that account for the pronounced disparity in outcome observed between nondiabetic white and black recipients. 相似文献
9.
JP Heiner SS Kohles PA Manley R Vanderby MD Markel 《Canadian Metallurgical Quarterly》1997,(341):233-240
In a canine model, the fixation stability of a prosthesis and proximal bone graft composite were measured relative to the distal femur. One group had the prosthesis graft composite cemented into the distal femur. The second group had the prosthesis graft composite press fit into the distal femur for biologic ingrowth. Displacements of the proximal femoral grafts relative to the host bone in each group were measured after ex vivo (acute with graft) implantation and 4 months after implantation. A third group with no osteotomy (acute intact) simulated perfect graft to host bone union. Relative displacements representing 6 degrees freedom (translation and rotation) were calculated from the displacement values measured by 9 eddy current transducers. Measurements of displacement were used to test the hypothesis that distal press fit fixation equals distal cement fixation at 4 months after implantation. In all cases the measured translations and rotations of the graft to implant construct were small and of a magnitude that should encourage bone ingrowth (< 0.05 mm and < 0.1 degree, respectively). The stability of the press fit group at 4 months was not significantly different from the cemented group in axial and transverse displacement during axial and transverse loading, respectively. There was no difference in stabilities at 4 months between distal press fit and cemented fixation in hip replacements requiring a proximal femoral graft. 相似文献
10.
Munish Agarwal Ali K. Kamrani Hamid R. Parsaei 《Journal of Intelligent Manufacturing》1994,5(4):235-249
The philosophy of group technology (GT) is an important concept in the design of flexible manufacturing systems and manufacturing cells. Group technology is a manufacturing philosophy that identifies similar parts and groups them into families. Beside assigning unique codes to these parts, group technology developers intend to take advantage of part similarities during design and manufacturing processes. GT is not the answer to all manufacturing problems, but it is a good management technique with which to standardize efforts and eliminate duplication. Group technology classifies parts by assigning them to different families based on their similarities in: (1) design attributes (physical shape and size), and/or (2) manufacturing attributes (processing sequence). The manufacturing industry today is process focused; departments and sub units are no longer independent but are interdependent. If the product development process is to be optimized, engineering and manufacturing cannot remain independent any more: they must be coordinated. Each sub-system is a critical component within an integrated manufacturing framework. The coding and classification system is the basis of CAPP and the functioning and reliability of CAPP depends on the robustness of the coding system. The proposed coding system is considered superior to the previously proposed coding systems, in that it has the capability to migrate into multiple manufacturing environments. This article presents the design of a coding and classification system and the supporting database for manufacturing processes based on both design and manufacturing attributes of parts. An interface with the spreadsheet will calculate the machine operation costs for various processes. This menu-driven interactive package is implemented using dBASE-IV. Part Family formation is achieved using a KAMCELL package developed in TURBO Pascal. 相似文献