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61.
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RM Bologa DM Levine TS Parker JS Cheigh D Serur KH Stenzel AL Rubin 《American journal of kidney diseases》1998,32(1):107-114
Low serum albumin and low serum cholesterol levels are among the most consistent predictors of mortality in patients with end-stage renal disease (ESRD) undergoing hemodialysis. Hypoalbuminemia is often interpreted as a marker of poor nutrition, but serum albumin and cholesterol levels can also be low as part of a cytokine-mediated acute-phase reaction to acute or chronic inflammation. Here we report the results from a 900-day prospective study designed to determine whether tumor necrosis factor-alfa (TNF-alpha) and interleukin-6 (IL-6) predict serum albumin and cholesterol levels and mortality in a group of 90 ambulatory, adult hemodialysis patients with no acute infection, hospitalization or surgery, and no known acquired immunodeficiency syndrome (AIDS), malignancy, or liver disease. Measurable levels of TNF-alpha and/or IL-6 were found in 89 of 90 patients. Significant relationships were found between TNF-alpha and IL-6 and the degree of hypoalbuminemia and dyslipoproteinemia. IL-6 was the strongest predictor of mortality in univariate and multivariate analysis, followed by age, albumin level, and body mass index (BMI). Although the cause of hypercytokinemia was not addressed in this study, the data support the view that hypoalbuminemia and hypocholesterolemia are negative acute-phase responses to inflammatory stimuli. These results suggest that efforts to identify the nature of the stimuli for cytokine production and to lower cytokine levels in hemodialysis patients might be effective in improving the survival of patients undergoing hemodialysis. 相似文献
63.
Robertson RT; Gallardo KA; Claytor KJ; Ha DH; Ku KH; Yu BP; Lauterborn JC; Wiley RG; Yu J; Gall CM; Leslie FM 《Cerebral cortex (New York, N.Y. : 1991)》1998,8(2):142-155
The role of basal forebrain-derived cholinergic afferents in the
development of neocortex was studied in postnatal rats. Newborn rat pups
received intraventricular injections of 192 IgG-saporin. Following survival
periods ranging from 2 days to 6 months, the brains were processed to
document the cholinergic lesion and to examine morphological consequences.
Immunocytochemistry for choline acetyltransferase (ChAT) and in situ
hybridization for ChAT mRNA demonstrate a loss of approximately 75% of the
cholinergic neurons in the medial septum and nucleus of the diagonal band
of Broca in the basal forebrain. In situ hybridization for glutamic acid
decarboxylase mRNA reveals no loss of basal forebrain GABAergic neurons.
Acetylcholinesterase histochemistry demonstrates a marked reduction of the
cholinergic axons in neocortex. Cholinergic axons are reduced throughout
the cortical layers; this reduction is more marked in medial than in
lateral cortical areas. The thickness of neocortex is reduced by
approximately 10%. Retrograde labeling of layer V cortico-collicular
pyramidal cells reveals a reduction in cell body size and also a reduction
in numbers of branches of apical dendrites. Spine densities on apical
dendrites are reduced by approximately 20-25% in 192 IgG- saporin-treated
cases; no change was detected in number of spines on basal dendrites. These
results indicate a developmental or maintenance role for cholinergic
afferents to cerebral cortical neurons.
相似文献
64.
Andrew KC Lam Ken KH Cheng Rex K Lam Christina FC Lau SY Yau 《Clinical & experimental optometry》1996,79(4):167-172
Myopic crescent, refractive error and axial length were previously investigated in Hong Kong Chinese subjects. The myopic crescent was found to correlate with axial length and myopic refraction. In this study, three groups of Hong Kong Chinese with different degrees of myopia were assessed for optic disc ovalness, refractive error and axial length. The axial length was significantly correlated with the degree of myopia, indicating that the myopia was axial in nature. The regression line shows that 0.44 mm of axial elongation would give about one dioptre of increase in myopia. The elliptical ratio of the optic disc was defined as the maximal disc diameter divided by the minimal disc diameter. All three groups showed an oval disc with vertical axis greater and an increased ovalness for the high myopic group with an elliptical ratio from 1.11 in low myopia to 1.29 in high myopia. There is a small amount (about four degrees) of temporal rotation of this vertical oval orientation, which is independent of the amount of myopia. This result shows an association between axial elongation of the globe and optic disc ovalness, in addition to the previously described temporal myopic crescent. Therefore, in myopic subjects, a vertically oval disc may be associated with a myopic refraction rather than glaucoma. 相似文献
65.
Artificial neural network for predicting intracranial haemorrhage in preterm neonates 总被引:1,自引:0,他引:1
B Zernikow K Holtmannspoetter E Michel M Theilhaber W Pielemeier KH Hennecke 《Acta paediatrica (Oslo, Norway : 1992)》1998,87(9):969-975
Intraventricular haemorrhage (IVH) incidence is used to assess peri-/neonatal therapy, and to make intra-and inter-hospital quality assessments. Unbiased assessment is complicated by the amount of confounding factors. Is an artificial neural network (ANN) able to early and accurately forecast the occurrence of severe IVH in an individual patient? Is it superior to classic multiple logistic regression? We conducted an observational study on pre-existing routine data. Admission data were available from 890 preterm neonates (gestational age < 32 weeks, birthweight < 1500 g). Patients were randomly assigned to either a training, or a validation set (50%/50%). Using the training set data an ANN was trained. A second predictive model was developed by stepwise multiple logistic regression analysis. Using the validation set input data both models delivered estimates of the probability for severe IVH to occur in each individual patient. Receiver operating characteristic (ROC) curves were used to compare prognostic performance. The optimal ANN processed 13 input variables, whereas stepwise logistic regression analysis only identified five independent predictor variables. The area under the ROC curve was 0.935 for the ANN and 0.884 for the logistic regression model (p= 0:001). Adjusted for 95%, 90%, 85%, 80% and 75% specificity, the sensitivity of the ANN was significantly superior to that of the logistic regression model. Due to its ability to give an accurate prognosis based solely on admission data, a trained ANN qualifies as a tool for local quality control. 相似文献
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Blood samples from 304 children aged 6 months to 16 years were tested by radioimmunoassay for antibodies to hepatitis A virus (anti-HAV). Of several factors examined for a possible association with the prevalence of anti-HAV--age, sex, race, geographic location and presence of malignant disease--only age showed a positive correlation with the prevalence of these antibodies. 相似文献
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