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1.
Perceptual asymmetry on a series of four specially constructed dichotic word tests was found to change as a function of the emotional quality of the words in the tests (P = 0.05). This was most pronounced in the case of positively valued words which produced an increase in asymmetry consistent with facilitated left-hemisphere function (P less than 0.004). Changes in asymmetry with emotion differed as a function of personality characteristics of the subjects, with repressors and high anxious subjects showing an increase with emotion while true low anxious subjects showed a decrease (P less than 0.02). Personality groups also differed in asymmetry on an emotionally neutral test (P less than 0.04) and in changes in asymmetry over time independent of emotion (P less than 0.001). These data suggest that emotion mediated activation of the left hemisphere may facilitate information processing within that hemisphere. Moreover, they indicate that dichotic listening tests may provide a non-invasive and inexpensive method for assessing emotion mediated changes in brain state that are clinically relevant. 相似文献
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Variations in length of stay and outcomes for six medical and surgical conditions in Massachusetts and California 总被引:15,自引:1,他引:14
P D Cleary S Greenfield A G Mulley S G Pauker S A Schroeder L Wexler B J McNeil 《JAMA》1991,266(1):73-79
OBJECTIVES.--To determine the extent to which interinstitutional variations in length of stay are explained by differences in patient characteristics and to determine whether patients in hospitals with shorter lengths of stay had worse outcomes. DESIGN.--We reviewed patients' medical records and surveyed patients between 3 and 12 months after hospital discharge using a questionnaire. SETTING.--Six teaching hospitals in California and Massachusetts. PATIENTS.--A cohort of 2484 selected patients who had been hospitalized for acute myocardial infarction or to rule out acute myocardial infarction, coronary artery bypass graft surgery, total hip replacement, cholecystectomy, or transurethral prostatectomy. Between 73% and 84% of the patients with each condition completed a follow-up questionnaire. OUTCOME MEASURES.--In-hospital complications, deaths, length of stay, functional status after hospital discharge, readmission, and patient satisfaction with hospital care were analyzed. RESULTS.--Significant interinstitutional differences in length of stay were noted for all conditions except rule-out acute myocardial infarction. Statistical adjustment for case-mix differences accounted for most of the interinstitutional differences in length of stay for total hip replacement but explained little of the differences in the other conditions. When we controlled statistically for other predictors, length of stay did not have a significant impact on deaths, functional status after hospital discharge, the probability of readmission, or patient satisfaction with hospital care. CONCLUSION.--More research is needed to determine the medical practices that are related to variations in lengths of stay. Routinely available outcome data may help preserve quality in the face of efforts to decrease costs by effecting more standardized practices of care. 相似文献
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A L Usala I Wexler A Posch M K Gupta 《American journal of diseases of children (1960)》1992,146(9):1074-1077
OBJECTIVE--To determine the course of maternally derived elevations in thyrotropin-binding inhibitory immunoglobulins in a neonate. DESIGN--Case report. SETTING--University pediatric endocrinology clinic and endocrine immunology laboratory in Ohio. PARTICIPANTS--An infant with elevated thyrotropin levels but near-normal total thyroxine levels, and her mother. INTERVENTIONS--None. MEASUREMENTS/MAIN RESULTS--Thyroid hormone, thyrotropin, and thyrotropin-blocking immunoglobulin concentrations were serially measured in a woman and her infant, who was found to have elevated thyrotropin levels (234 mU/L) and borderline low thyroxine levels (95 nmol/L). As infant thyroxine concentrations remained normal (125 to 145 nmol/L), no thyroxine supplementation was given. Thyrotropin levels decreased concomitantly with thyrotropin-blocking inhibitory immunoglobulin levels, and normalized by day 56 of life. The apparent elimination half-life of thyrotropin-blocking immunoglobulins was 7.5 days. CONCLUSIONS--The observed parallel elimination kinetics suggest that the thyrotropin receptor antibody acts as a thyrotropin antagonist, resulting in compensatory thyrotropin elevations. The duration of such elevations may be predicted on the basis of such elimination. 相似文献
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Padmaja Yalamanchili Eric Wexler Megan Hayes Ming Yu Jody Bozek Mikhail Kagan Heike S. Radeke Michael Azure Ajay Purohit David S. Casebier Simon P. Robinson 《Journal of nuclear cardiology》2007,14(6):782-788
Background
BMS-747158-02 is a novel fluorine 18-labeled pyridazinone derivative designed for cardiac imaging. The uptake and retention
mechanisms of F-18 BMS-747158-02 in cardiac myocytes were studied in vitro, and the biodistribution of F-18 BMS-747158-02
was studied in vivo in mice.
Methods and Results
Fluorine 19 BMS-747158-01 inhibited mitochondrial complex I (MC-I) in bovine heart submitochondrial particles with an IC50 of 16.6±3 nmol/L that was comparable to the reference inhibitors of MC-1, rotenone, pyridaben, and deguelin (IC50 of 18.2±6.7 nmol/L, 19.8±2.6 nmol/L, and 23.1±1.5 nmol/L, respectively). F-18 BMS-747158-02 had high uptake in monolayers
of neonatal rat cardiomyocytes (10.3%±0.7% of incubated drug at 60 minutes) that was inhibited by 200 nmol/L of rotenone (91%±2%)
and deguelin (89%±3%). In contrast, an inactive pyridaben analog, P-0 (IC50 value>4 μmol/L in MC-1 assay), did not inhibit the binding of F-18 BMS-747158-02 in cardiomyocytes. Uptake and washout kinetics
for F-18 BMS-747158-02 in rat cardiomyocytes indicated that the time to half-maximal (t1/2) uptake was very rapid (approximately 35 seconds), and washout t1/2 for efflux of F-18 BMS-747158-02 was greater than 120 minutes. In vivo biodistribution studies in mice showed that F-18 BMS-747158-02
had substatial myocardial uptake (9.5%±0.5% of injected dose per gram) at 60 minutes and heart-to-lung and heart-to-liver
ratios of 14.1±2.5 and 8.3±0.5, respectively. Positron emission tomography imaging in the mouse allowed clear cardiac visualization
and demonstrated sustained myocardial uptake through 55 minutes.
Conclusions
F-18 BMS-747158-02 is a novel positron emission tomography cardiac tracer targeting MC-I in cardiomyocytes with rapid uptake
and slow washout. These characteristics allow fast and sustained accumulation in the heart. 相似文献
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Cardiac magnetic resonance (MR) imaging has developed rapidly to rival echocardiography as a noninvasive imaging modality. Anatomic detail may exceed that currently available using echocardiography techniques, and the ability to image moving protons may compete with Doppler color flow mapping in detecting valvular diseases and shunts. Because of the considerable clinical experience with echocardiography, as angled MR imaging planes become available as standard software packages, it may be useful for MR cardiac imaging to use standard, accepted echocardiographic nomenclature and imaging planes. This article describes the principles used to obtain long and short axis MR images that are comparable with echocardiographic imaging planes. Diagrams and illustrations are provided to orient the viewer using nomenclature common to echocardiography. These views may eventually be useful for functional analysis of the left ventricle and for detection and evaluation of valvular heart disease and intracardiac shunts. 相似文献
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