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1.
目的由于卒中风险随着狭窄严重程度的增加而升高,因此认为颈内动脉(ICA)接近闭塞患者的卒中风险很高。在现有的随机试验中,还没有专门针对这种情况进行探讨,因此其处理尚存在争汶。方法:对相关文献进行系统评价。结果:对ICA接近闭塞患者的处理还存在争议:一些学者支持进行干预,而另一些学者则认为存在风险或没有益处而反对进行干预。在ICA接近闭塞的有症状患者中进行一项比较外科治疗与最佳内科治疗的多中心前瞻性随机试验似乎非常困难,因为这类研究需要大量的患者。尽管如此,基于目前的证据,似乎很难拒绝手术治疗。结论:由于目前对ICA接近闭塞患者的最佳处理方案仍存在着争议,因此需要前瞻性观察性研究以证实其在有症状和无症状人群中的患病率以及相关的卒中风险。基于目前的证据,大多数医疗中心选择手术治疗,但它相对干内科治疗的特粱尚右待证章. 相似文献
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Rupture of the distal biceps tendon: evaluation with MR imaging 总被引:2,自引:0,他引:2
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As flap prefabrication becomes a more commonly used clinical tool, it is necessary to investigate the limitations of this technique. Reconstructive procedures of the face often require “custom fitted” flaps to satisfy esthetic demands. This study examines and compares the safety of manipulating thin prefabricated skin flaps versus established axial pattern skin flaps. Twenty-seven New Zealand white rabbits were used to determine if prefabricated flaps can be folded 180° around the edge of the rabbits' ears. The survival of these folded prefabricated flaps was compared with the survival of axial pattern flaps sutured into an identically recipient site. In addition, flaps prefabricated in the same manner were sutured onto a straight recipient bed to evaluate the viability of the newly vascularized tissue. The folded prefabricated flaps had reduced survival (56%) compared to equivalent folded axial pattern flaps (85%), P<0.005. The nonmanipulated prefabricated flaps and axial pattern flaps survived completely. © 1994 Wiley-Liss, Inc. 相似文献
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The authors compared two methodological approaches, Jackknife ROC and JAFROC, in analyzing data ascertained during FROC (free-response receiver operating characteristics) type studies. Observer rating data obtained from two observer performance studies were analyzed. During the first study, seven radiologists interpreted 120 mammography examinations depicting 57 masses under five different conditions with and without the results of computer-aided detection (CAD). In the second study, eight radiologists interpreted 110 examinations depicting 51 masses under six different display conditions with and without CAD results. Readers rated the detection task in a FROC type response. Jackknife ROC (using the software of LABMRMC with the highest rating per case) and JAFROC were used to compute differences, if any, in summary performance levels among all reading modes in each study as well as for all paired data sets. The results of the different analytical approaches are compared. The overall results for all modes were significantly different for the first study (p < 0.05) and not significant (p > 0.05) for the second study using either analytical approach. In the first study, the performance levels represented by three paired data sets were significantly different (p < 0.05) when computed using LABMRMC and four pairs were significantly different (p < 0.05) using JAFROC. In eight of ten pairs, JAFROC produced lower p values than LABMRMC. In the second study, LABMRMC showed no significant differences for any paired data sets and JAFROC showed a significant difference for one pair. In 15 of 16 pairs, p values computed by JAFROC were lower than those computed by LABMRMC. 相似文献
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Androgen receptor YAC transgenic mice carrying CAG 45 alleles show trinucleotide repeat instability 总被引:1,自引:15,他引:1
La Spada AR; Peterson KR; Meadows SA; McClain ME; Jeng G; Chmelar RS; Haugen HA; Chen K; Singer MJ; Moore D; Trask BJ; Fischbeck KH; Clegg CH; McKnight GS 《Human molecular genetics》1998,7(6):959-967
X-linked spinal and bulbar muscular atrophy (SBMA) is caused by a CAG
repeat expansion in the first exon of the androgen receptor (AR) gene.
Disease-associated alleles (37-66 CAGs) change in length when transmitted
from parents to offspring, with a significantly greater tendency to shift
size when inherited paternally. As transgenic mice carrying human AR cDNAs
with 45 and 66 CAG repeats do not display repeat instability, we attempted
to model trinucleotide repeat instability by generating transgenic mice
with yeast artificial chromosomes (YACs) carrying AR CAG repeat expansions
in their genomic context. Studies of independent lines of AR YAC transgenic
mice with CAG 45 alleles reveal intergenerational instability at an overall
rate of approximately 10%. We also find that the 45 CAG repeat tracts are
significantly more unstable with maternal transmission and as the
transmitting mother ages. Of all the CAG/CTG repeat transgenic mice
produced to date the AR YAC CAG 45 mice are unstable with the smallest
trinucleotide repeat mutations, suggesting that the length threshold for
repeat instability in the mouse may be lowered by including the appropriate
flanking human DNA sequences. By sequence-tagged site content analysis and
long range mapping we determined that one unstable transgenic line has
integrated an approximately 70 kb segment of the AR locus due to
fragmentation of the AR YAC. Identification of the cis - acting elements
that permit CAG tract instability and the trans -acting factors that
modulate repeat instability in the AR YAC CAG 45 mice may provide insights
into the molecular basis of trinucleotide repeat instability in humans.
相似文献
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We have developed a Joint Photographic Experts Group (JPEG) compatible image compression scheme tailored to the compression of digitized mammographic images. This includes a preprocessing step that segments the tissue area from the background, replaces the background pixels with a constant value, and applies a noise-removal filter to the tissue area. The process was tested by performing a just-noticeable difference (JND) study to determine the relationship between compression ratio and a reader's ability to discriminate between compressed and noncompressed versions of digitized mammograms. We found that at compression ratios of 15∶1 and below, image-processing experts are unable to detect a difference, whereas at ratios of 60∶1 and above they can identify the compressed image nearly 100% of the time. The performance of less specialized viewers was significantly lower because these viewers seemed to have difficulty in differentiating between artifact and real information at the lower and middle compression ratios. This preliminary study suggests that digitized mammograms are very amenable to compression by techniques compatible with the JPEG standard. However, this study was not designed to address the efficacy of image compression process for mammography, but is a necessary first step in optimizing the compression in anticipation of more elaborate reader performance (ROC) studies. 相似文献