классический высокий

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классический высокий

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  1. Chemical modification of carotid body chemoreception by sulfhydryls.

    PubMed

    Lahiri, S

    1981-05-29

    Sulfhydryl reagents cause striking augmentation of the chemoreceptor responses of the carotid body to hypoxia. This indicates that a cellular plasma membrane protein with a reactive sulfhydryl group is a constituent part of the chemoreceptor architecture and provides a means of identification, localization, and isolation of the protein.

  2. Differential modulation by extracellular ATP of carotid chemosensory responses.

    PubMed

    Spergel, D; Lahiri, S

    1993-06-01

    The possibility that the carotid body has ATP surface receptors that mediate O2 chemoreception was tested. To distinguish between the event(s) initiating chemoreception and those at the neurotransmitter level, we also tested the chemosensory response to nicotine before and after ATP administration. Carotid bodies from cats anesthetized with pentobarbital sodium were perfused and superfused in vitro with modified Tyrode solution (PCO2 < 1 Torr, pH 7.4, 36 degrees C) equilibrated at PO2 > 400 or approximately 150 Torr while chemosensory discharge was recorded extracellularly. ATP and adenosine 5'-[gamma-thio]triphosphate stimulated discharge with similar dose dependence, whereas adenosine had little effect. ATP infusion for > or = 2 min evoked an initial stimulation of discharge followed by a decline to baseline (desensitization). Desensitization did not affect the response to hypoxia (perfusate flow interruption) but inhibited the response to nicotine (4-nmol pulse). Therefore, 1) the carotid body has surface ATP receptors that may mediate the chemosensory response to nicotine but not to hypoxia and 2) nicotinic receptors are not required for carotid body O2 chemoreception.

  3. Unusual presentation of traumatic extracranial internal carotid artery aneurysm.

    PubMed

    Bradbury, P G; Lambert, C D

    1978-07-01

    A young man presented with apparent transient ischemic attacks following a motorcycle accident in which he sustained minor injuries only. Computerized axial tomography demonstrated a small right frontal infarct, and angiography revealed an aneurysm of the right internal carotid artery in its extracranial course. This was thought to be traumatic in origin.

  4. Activation of calpain-1 in human carotid artery atherosclerotic lesions

    PubMed Central

    Gonçalves, Isabel; Nitulescu, Mihaela; Saido, Takaomi C; Dias, Nuno; Pedro, Luis M; e Fernandes, José Fernandes; Ares, Mikko PS; Pörn-Ares, Isabella

    2009-01-01

    Background In a previous study, we observed that oxidized low-density lipoprotein-induced death of endothelial cells was calpain-1-dependent. The purpose of the present paper was to study the possible activation of calpain in human carotid plaques, and to compare calpain activity in the plaques from symptomatic patients with those obtained from patients without symptoms. Methods Human atherosclerotic carotid plaques (n = 29, 12 associated with symptoms) were removed by endarterectomy. Calpain activity and apoptosis were detected by performing immunohistochemical analysis and TUNEL assay on human carotid plaque sections. An antibody specific for calpain-proteolyzed α-fodrin was used on western blots. Results We found that calpain was activated in all the plaques and calpain activity colocalized with apoptotic cell death. Our observation of autoproteolytic cleavage of the 80 kDa subunit of calpain-1 provided further evidence for enzyme activity in the plaque samples. When calpain activity was quantified, we found that plaques from symptomatic patients displayed significantly lower calpain activity compared with asymptomatic plaques. Conclusion These novel results suggest that calpain-1 is commonly active in carotid artery atherosclerotic plaques, and that calpain activity is colocalized with cell death and inversely associated with symptoms. PMID:19538725

  5. Initial Experience Using the Gore Embolic Filter in Carotid Interventions.

    PubMed

    Hornung, Marius; Franke, Jennifer; Bertog, Stefan C; Gafoor, Sameer; Grunwald, Iris; Sievert, Horst

    2016-08-01

    This is the first clinical report on experience in the use of the Gore embolic filter in carotid interventions. It was designed as a guidewire and embolic protection system in carotid, peripheral, and coronary interventions. The ability to capture debris is driven by the frame of the filter, which is designed to improve vessel wall apposition and allows a short landing zone. We report the results of the first 20 consecutive patients undergoing carotid artery stenting using the Gore embolic filter in our institution. We analyzed technical success as well as the occurrence of transient ischemic attack (TIA), stroke, or death periprocedurally and through 30 days of follow-up. Mean patient age was 72 years and 12 patients (60%) were male. Seven patients were symptomatic and 4 patients suffered recurrent neurological events. Technical success was achieved in all procedures. In 1 patient, the retrieval catheter was caught between the proximal struts of the stent and required further retrieval maneuvers. Within 30 days of follow-up, 1 patient had a TIA. No stroke, death, or myocardial infarction occurred. This initial experience suggests that the Gore embolic filter device can be used safely for distal embolic protection during carotid stenting procedures with high technical success.

  6. A Parallel Lattice Boltzmann Model of a Carotid Artery

    NASA Astrophysics Data System (ADS)

    Boyd, J.; Ryan, S. J.; Buick, J. M.

    2008-11-01

    A parallel implementation of the lattice Boltzmann model is considered for a three dimensional model of the carotid artery. The computational method and its parallel implementation are described. The performance of the parallel implementation on a Beowulf cluster is presented, as are preliminary hemodynamic results.

  7. Envy's pathology: Historical contexts.

    PubMed

    Minou, Lina

    2017-01-01

    This article is concerned with the physicality of envy primarily in early -modern, but also in eighteenth-century health contexts. The discussion brings together descriptions of the effects of envy on the body of the envier, mainly from works of physiology and health preservation, but also from literary and spiritual writings. These depictions of envy are studied beyond their symbolism and with a view to establish whether they are meaningful according to the medical theories of the time in which they occur. The discussion begins by acknowledging the status of envy as a 'disease' and looks to the specific ways in which the discourse of envy conveys this sense. I find that in the early modern discourse envy is always pathological, that is, it is experienced as disease and signifies disease in general and several diseases in particular. Moreover, envy is uniquely placed to convey pathology on account of its being connected to inherently pathogenic elements of the humoural theory. Specifically, envy is physiologically connected to melancholy, and the way it is presented comes close to attributes assigned to black bile. In addition, envy realizes pathology, the occurrence of disease in the body, by impairing the vital process of digestion and thus depriving the person from proper nourishment and sustenance. The analysis further considers how this impairment of the body fits with the physiological manifestation of envy as 'corrosion' and 'consumption'. Finding commonalities with other maladies mediated by these physiological signs the article concludes by considering the function of pathology in the conception of early modern envy.

  8. Envy's pathology: Historical contexts

    PubMed Central

    Minou, Lina

    2017-01-01

    This article is concerned with the physicality of envy primarily in early –modern, but also in eighteenth-century health contexts. The discussion brings together descriptions of the effects of envy on the body of the envier, mainly from works of physiology and health preservation, but also from literary and spiritual writings. These depictions of envy are studied beyond their symbolism and with a view to establish whether they are meaningful according to the medical theories of the time in which they occur. The discussion begins by acknowledging the status of envy as a ‘disease’ and looks to the specific ways in which the discourse of envy conveys this sense. I find that in the early modern discourse envy is always pathological, that is, it is experienced as disease and signifies disease in general and several diseases in particular. Moreover, envy is uniquely placed to convey pathology on account of its being connected to inherently pathogenic elements of the humoural theory. Specifically, envy is physiologically connected to melancholy, and the way it is presented comes close to attributes assigned to black bile. In addition, envy realizes pathology, the occurrence of disease in the body, by impairing the vital process of digestion and thus depriving the person from proper nourishment and sustenance. The analysis further considers how this impairment of the body fits with the physiological manifestation of envy as ‘corrosion’ and ‘consumption’. Finding commonalities with other maladies mediated by these physiological signs the article concludes by considering the function of pathology in the conception of early modern envy. PMID:28748219

  9. Communication of inwardly projecting neovessels with the lumen contributes to symptomatic intraplaque hemorrhage in carotid artery stenosis.

    PubMed

    Horie, Nobutaka; Morofuji, Yoichi; Morikawa, Minoru; Tateishi, Yohei; Izumo, Tsuyoshi; Hayashi, Kentaro; Tsujino, Akira; Nagata, Izumi

    2015-11-01

    Recent studies have demonstrated that plaque morphology can contribute to identification of patients at high risk of carotid artery atherosclerosis as well as the degree of stenosis in those with carotid atherosclerosis. Neovascularization of carotid plaques is associated with plaque vulnerability. However, the mechanism of neovascularization in intraplaque hemorrhage (IPH) and its clinical contribution remain undetermined. In this study, the authors aimed to clarify the characteristics of neovessel appearance with a focus on inwardly projecting neovessels, which are reportedly important in plaque advancement. Consecutive patients with moderate to severe carotid atherosclerosis who underwent carotid endarterectomy were prospectively analyzed from 2010 to 2014. The neovessel appearance was categorized into 3 groups based on intraoperative indocyanine green (ICG) videoangiography: early appearance of neovessels from the endothelium (NVe), late appearance of neovessels from the vasa vasorum (NVv), and no appearance of vessels. Each neovessel pattern was evaluated with respect to clinical, radiological, and pathological findings including IPH, neovascularization, hemosiderin spots, and inflammation. Of 57 patients, 13 exhibited NVe, 33 exhibited NVv, and 11 exhibited no neovessels. Overall, the interobserver and intraobserver reproducibilities of neovessel appearance were substantial for ICG videoangiography (κ=0.76) and at 7 days postoperatively (κ=0.76). There were no significant differences in baseline characteristics among the 3 groups, with the exception of a higher percentage of symptomatic presentations in patients with NVe (artery-to-artery embolic infarction in 61.5% and transient ischemic attack in 23.1%). Moreover, patients with NVe exhibited larger infarctions than did those with NVv (9675.0±5601.9 mm3 vs 2306.6±856.9 mm3, respectively; p=0.04). Pathologically, patients with NVe had more severe IPH (47.2±8.3 mm2 vs 19.8±5.2 mm2, respectively; p<0

  10. Resection of recurrent neck cancer with carotid artery replacement.

    PubMed

    Illuminati, Giulio; Schneider, Fabrice; Minni, Antonio; Calio, Francesco G; Pizzardi, Giulia; Ricco, Jean-Baptiste

    2016-05-01

    The management of patients with recurrent neck cancer invading the carotid artery is controversial. The purpose of this study was to evaluate overall survival rate, primary patency of vascular reconstructions, and quality-adjusted life-years (QALYs) after en bloc resection of the carotid artery and tumor with in-line polytetrafluoroethylene (PTFE) carotid grafting, followed by radiotherapy. From 2000 to 2014, 31 consecutive patients with recurrent neck cancer invading the carotid artery underwent en bloc resection and simultaneous carotid artery reconstruction with a PTFE graft, which was associated in 18 cases with a myocutaneous flap. The primary tumor was a squamous cell carcinoma of the larynx in 17 patients and of the hypopharynx in 7, an undifferentiated carcinoma of unknown origin in 4, and an anaplastic carcinoma of the thyroid in 3. All of the patients underwent postoperative radiotherapy (50-70 Gy), and 10 of them also underwent chemotherapy (doxorubicin and cisplatin). None of the patients died or sustained a stroke during the first 30 days after the index procedure. Postoperative morbidity consisted of 6 transitory dysphagias, 3 vocal cord palsies, 2 wound dehiscences, 1 transitory mandibular claudication, and 1 partial myocutaneous flap necrosis. No graft infection occurred during follow-up. Fifteen patients (48%) died from metastatic cancer during a mean follow-up of 45.4 months (range, 8-175 months). None of the patients showed evidence of local recurrence, stroke, or thrombosis of the carotid reconstruction. The 5-year survival rate was 49 ± 10%. The overall number of QALYs was 3.12 (95% confidence interval, 1.87-4.37) with a significant difference between patients without metastasis at the time of redo surgery (n = 26; QALYs, 3.74) and those with metastasis (n = 5; QALYs, 0.56; P = .005). QALYs were also significantly improved in patients with cancer of the larynx (n = 17; QALYs, 4.69) compared to patients presenting with other types of

  11. Management of Carotid Bifurcation Tumors: 30-Year Experience.

    PubMed

    Torrealba, Jose Ignacio; Valdés, Francisco; Krämer, Albrecht H; Mertens, Renato; Bergoeing, Michel; Mariné, Leopoldo

    2016-07-01

    The carotid bifurcation can host a variety of tumors requiring complex surgical management. Treatment requires resection and, in some cases, vascular reconstruction that may compromise the cerebral circulation. The most frequent lesion at this location is the carotid body tumor (CBT). CBT are classified according to Shamblin in 3 types depending on the degree of carotid vessels encasement. Our main objective was to report our clinical experience managing carotid bifurcation tumors throughout the last 30 years. Between 1984 and 2014, we treated 30 patients with 32 carotid bifurcation tumors. There were 21 women and 9 men (2.3:1), with a mean age of 45.5 years (18-75). The most frequent presentation was an asymptomatic neck swelling or palpable mass localized at the carotid triangle (86.7%). Thirty of 32 tumors were resected. Since 1994, computed tomography scan has been the most frequently used diagnostic imaging tool (80%), followed by magnetic resonance imaging. Angiography was used mainly during the first 10 years of the study period. Mean size of the tumor was 44.6 mm (20-73 mm). Nineteen (63%) were classified as Shamblin II and 6 (20%) as Shamblin's III. All specimens were analyzed by a pathologist; 28 tumors (93%) were confirmed as paragangliomas, 2 (7%) were diagnosed as schwannomas. Two patients underwent preoperative embolization of the CBT; 5 patients (17%) required simultaneous carotid revascularization, all of them Shamblin III. Mean hospitalization time was 4.5 days (1-35 days). Transient extracranial nerve deficit was observed in 7 patients (23.3%). Three patients (Shamblin III) required red blood cells transfusion. One patient (Shamblin III) underwent a planned en bloc excision of the vagus nerve. There was no perioperative mortality or procedure-related stroke. No malignancy or tumor recurrence were observed during follow-up. CBTs can be diagnosed on clinical grounds requiring vascular imaging confirmation. These infrequent lesions are

  12. Nicotine and pathological angiogenesis.

    PubMed

    Lee, Jieun; Cooke, John P

    2012-11-27

    This paper describes the role of endothelial nicotinic acetylcholine receptors (nAChR) in diseases where pathological angiogenesis plays a role. An extensive review of the literature was performed, focusing on studies that investigated the effect of nicotine upon angiogenesis. Nicotine induces pathological angiogenesis at clinically relevant concentrations (i.e. at tissue and plasma concentrations similar to those of a light to moderate smoker). Nicotine promotes endothelial cell migration, proliferation, survival, tube formation and nitric oxide (NO) production in vitro, mimicking the effect of other angiogenic growth factors. These in vitro findings indicate that there may be an angiogenic component to the pathophysiology of major tobacco related diseases such as carcinoma, atherosclerosis, and age-related macular degeneration. Indeed, nicotine stimulates pathological angiogenesis in pre-clinical models of these disorders. Subsequently, it has been demonstrated that nicotine stimulates nAChRs on the endothelium to induce angiogenic processes, that these nAChRs are largely of the α7 homomeric type, and that there are synergistic interactions between the nAChRs and angiogenic growth factor receptors at the phosphoproteomic and genomic levels. These findings are of potential clinical relevance, and provide mechanistic insights into tobacco-related disease. Furthermore, these findings may lead to novel therapies for diseases characterized by insufficient or inappropriate angiogenesis. Copyright © 2012. Published by Elsevier Inc.

  13. Optical detection of structural changes in human carotid atherosclerotic plaque

    NASA Astrophysics Data System (ADS)

    Korol, R. M.; Canham, P. B.; Finlay, H. M.; Hammond, R. R.; Quantz, M.; Ferguson, G. G.; Liu, L. Y.; Lucas, A. R.

    2005-08-01

    Background: Arterial bifurcations are commonly the sites of developing atherosclerotic plaque that lead to arterial occlusions and plaque rupture (myocardial infarctions and strokes). Laser induced fluorescence (LIF) spectroscopy provides an effective nondestructive method supplying spectral information on extracellular matrix (ECM) protein composition, specifically collagen and elastin. Purpose: To investigate regional differences in the ECM proteins -- collagen I, III and elastin in unstable plaque by analyzing data from laser-induced fluorescence spectroscopy of human carotid endarterectomy specimens. Methods: Gels of ECM protein extracts (elastin, collagen types I & III) were measured as reference spectra and internal thoracic artery segments (extra tissue from bypass surgery) were used as tissue controls. Arterial segments and the endarterectomy specimens (n=21) were cut into 5mm cross-sectional rings. Ten fluorescence spectra per sampling area were then recorded at 5 sites per ring with argon laser excitation (357nm) with a penetration depth of 200 μm. Spectra were normalized to maximum intensity and analyzed using multiple regression analysis. Tissue rings were fixed in formalin (within 3 hours of surgery), sectioned and stained with H&E or Movat's Pentachrome for histological analysis. Spectroscopy data were correlated with immunohistology (staining for elastin, collagen types I, III and IV). Results: Quantitative fluorescence for the thoracic arteries revealed a dominant elastin component on the luminal side -- confirmed with immunohistology and known artery structure. Carotid endarterectomy specimens by comparison had a significant decrease in elastin signature and increased collagen type I and III. Arterial spectra were markedly different between the thoracic and carotid specimens. There was also a significant elevation (p<0.05) of collagen type I distal to the bifurcation compared to proximal tissue in the carotid specimens. Conclusion: Fluorescence

  14. Exposure of the intracavernous carotid artery in aneurysm surgery.

    PubMed

    Ohmoto, T; Nagao, S; Mino, S; Ito, T; Honma, Y; Fujiwara, T

    1991-02-01

    The pterional intradural approach was used in five cases of large and giant carotid-ophthalmic aneurysms and in two cases of intracavernous aneurysms that arose from the anterior siphon knee in the cavernous sinus (CS) and extended into the carotid cistern. In four cases of large carotid-ophthalmic aneurysms removal of the anterior clinoid process and the roof of the optic canal gave easy access to the pericarotid ring. The anteromedial part of the pericarotid ring was dissected to expose the extradural portion of the internal carotid artery (ICA) proximal to the neck and to make enough room between the wall of the CS and the extradural portion of the ICA, thus allowing easy clipping of the neck. In one case of a giant carotid-ophthalmic aneurysm extending into the CS with an extradural origin of the ophthalmic artery and in two cases of an intracavernous aneurysm arising from the siphon knee, neck clipping was performed by opening the lateral wall and roof of the CS after removal of the optic strut. The opening of the lateral wall anterior to the 3rd nerve facilitated wide exposure of the anterior siphon knee. The horizontal portion of the intracavernous ICA as well as the whole aspect of the aneurysm could be exposed as a result of the extended opening of the cavernous roof anterior to the posterior clinoid process. Successful operative results were obtained in all seven patients. A visual field detect as an operative complication was noted in one patient. No disturbance of ocular movements was noted.

  15. Cerebral hemodynamic changes and electroencephalography during carotid endarterectomy

    SciTech Connect

    Algotsson, L.; Messeter, K.; Rehncrona, S.; Skeidsvoll, H.; Ryding, E. )

    1990-05-01

    Some patients undergoing endarterectomy for occlusive carotid artery disease run a risk of brain ischemia during cross-clamping of the artery. The present study of 15 patients was undertaken to evaluate changes in cerebral blood flow (CBF), as measured with an intravenous (IV) tracer (133Xenon) technique, and to relate CBF changes to changes in the electroencephalogram (EEG). CBF was measured before and after induction of anesthesia, during cross-clamping of the carotid artery, after release of the clamps, and at 24 hours after the operation. All the patients were anesthetized with methohexitone, fentanyl, and nitrous oxide and oxygen. EEG was continuously recorded during the operation. Carotid artery shunts were not used. In 8 patients, cross-clamping of the carotid artery did not influence the EEG. In this group of patients, induction of anesthesia caused a 38% decrease in CBF, which presumably reflects the normal reaction to the anesthetic agent given. There were no further changes in CBF during cross-clamping. In 7 patients, the EEG showed signs of deterioration during the intraoperative vascular occlusion. In these patients, anesthesia did not cause any CBF change, whereas cross-clamping the artery induced a 33% decrease in CBF. In individual patients, the severity of EEG changes correlated with the decrease in CBF. The absence of a change in CBF by anesthesia and a decrease due to cross-clamping of the carotid artery may be explained by the presence of a more advanced cerebrovascular disease and an insufficiency to maintain CBF during cross-clamping.

  16. Vascular Balloon Injury and Intraluminal Administration in Rat Carotid Artery

    PubMed Central

    Zhang, Wei; Trebak, Mohamed

    2014-01-01

    The carotid artery balloon injury model in rats has been well established for over two decades. It remains an important method to study the molecular and cellular mechanisms involved in vascular smooth muscle dedifferentiation, neointima formation and vascular remodeling. Male Sprague-Dawley rats are the most frequently employed animals for this model. Female rats are not preferred as female hormones are protective against vascular diseases and thus introduce a variation into this procedure. The left carotid is typically injured with the right carotid serving as a negative control. Left carotid injury is caused by the inflated balloon that denudes the endothelium and distends the vessel wall. Following injury, potential therapeutic strategies such as the use of pharmacological compounds and either gene or shRNA transfer can be evaluated. Typically for gene or shRNA transfer, the injured section of the vessel lumen is locally transduced for 30 min with viral particles encoding either a protein or shRNA for delivery and expression in the injured vessel wall. Neointimal thickening representing proliferative vascular smooth muscle cells usually peaks at 2 weeks after injury. Vessels are mostly harvested at this time point for cellular and molecular analysis of cell signaling pathways as well as gene and protein expression. Vessels can also be harvested at earlier time points to determine the onset of expression and/or activation of a specific protein or pathway, depending on the experimental aims intended. Vessels can be characterized and evaluated using histological staining, immunohistochemistry, protein/mRNA assays, and activity assays. The intact right carotid artery from the same animal is an ideal internal control. Injury-induced changes in molecular and cellular parameters can be evaluated by comparing the injured artery to the internal right control artery. Likewise, therapeutic modalities can be evaluated by comparing the injured and treated artery to the

  17. Investigation of cerebral hemodynamics and collateralization in asymptomatic carotid stenoses.

    PubMed

    AlMuhanna, Khalid; Zhao, Limin; Kowalewski, Gregory; Beach, Kirk W; Lal, Brajesh K; Sikdar, Siddhartha

    2012-01-01

    Stroke is the second leading cause of death in the world, and one of the major causes of disability. Approximately 30% of ischemic strokes are due to plaque rupture in the carotid arteries. The most popular diagnostic method uses Doppler ultrasound to find the percent stenosis. However, other factors, such as the hemodynamics around the plaque may play a larger role in identifying the risk of plaque rupture. It has been shown previously in simulations that non-collateral flow in the circle of Willis (COW) could cause an increase of the intraluminal velocity around carotid plaque. This added strain may increase the vulnerability of the plaque to rupture. We investigated asymmetries in flow waveforms in the middle cerebral artery (MCA) in asymptomatic patients with carotid artery stenosis. We compared clinical results of velocity waveforms in the MCA, acquired using transcranial Doppler (TCD), with a simple linear simulation model of the intra- and extracranial arterial network to investigate the relationship between contralateral and ipsilateral flow profiles in the MCA for patients with asymptomatic carotid stenosis. In 17 out of 23 patients we found waveforms consistent with those predicted for a collateralized COW, with minimal differences in delay, velocity magnitude and resistivity index. In 6 cases, some unexpected findings were noted, such as large delays for 2 patients ≤ 50% stenosis, and a large velocity difference with low delay for 4 patients. More studies are needed to elucidate the role of incomplete intracranial collateralization on the hemodynamics around carotid plaque and to use imaging of the COW to corroborate our results.

  18. Does A Contralateral Carotid Occlusion Adversely Impact CAS Outcomes?

    PubMed Central

    Keldahl, ML; Park, MS; Garcia-Toca, M; Wang, E; Kibbe, MR; Rodriguez, HE; Morasch, MD; Eskandari, MK

    2011-01-01

    Background Carotid artery stenting (CAS) has grown as a possible alternative for the treatment of extracranial cerebrovascular disease in the past decade. A pre-existing contralateral carotid artery occlusion has been described as a risk factor for inferior outcomes following carotid endarterectomy (CEA), yet its impact on CAS outcomes is less understood. Methods Retrospective review of 417 CAS procedures from May 2001 through July 2010 at a single center using self-expanding nitinol stents and mechanical embolic protection devices. Patients were divided into those with a pre-existing contralateral carotid occlusion (Group A, n=39) versus those without a contralateral occlusion (Group B, n=378). Patient demographics and co-morbidities as well as 30-day and late death, stroke, and myocardial infarction (MI) rates were analyzed. Mean follow-up was 4.0 years (range 0–9.4 years). Results Overall mean age of the 314 men and 103 women was 70.5 years. In Group A there were 2 (5.1%) octogenarians and 9 patients (23.1%) with symptomatic disease as compared to Group B with 53 (14.0%) octogenarians and 121 (32.0%) patients with symptomatic disease. The overall 30-day death, stroke, and MI rates were 0.5%, 1.9%, and 0.7%. When comparing Group A to Group B these results were not significantly different: death (0% vs 0.5%), stroke (2.6% vs 1.9%), and MI (0% vs 0.8%). Long-term outcomes for Groups A and B were not significantly different: death (25.6% vs 22.2%), stroke (5.3% vs 3.4%), and MI (15.4% vs 14.0%) (p=NS). Conclusion A pre-existing contralateral carotid artery occlusion does not appear to adversely impact CAS outcomes. PMID:21963325

  19. The 2-Year Outcomes Comparison between Ischemic Stroke Patients with Intracranial Arterial Stenosis without Significant Extracranial Carotid Stenosis and Patients with Extracranial Carotid Stenosis.

    PubMed

    Methawasin, Kulthida; Suwanwela, Nijasri C; Phanthumchinda, Kamnnant

    2015-10-01

    The risk of recurrent ischemic stroke and acute coronary syndrome increased in the large artery atherosclerotic subtype. The purpose of this study was to compare 2-year outcomes between the ischemic stroke patients with intracranial arterial stenosis without significant extracranial carotid stenosis and the patients with extracranial carotid stenosis. This study prospectively compared 123 ischemic stroke patients: 71 patients with intracranial arterial stenosis without significant extracranial carotid stenosis and 52 patients with extracranial carotid stenosis. Neurologic and radiologic investigations were performed at the beginning of the study. All of them were treated as regular outpatients of the neurology unit with a mean follow-up of 24 months. Recurrent stroke, myocardial infarction, and death were recorded. Fifteen patients of the extracranial carotid stenosis group and eighteen patients ofthe intracranial arterial stenosis without significant extracranial carotid stenosis group developed recurrent stroke during follow-up (p = 0.40). Acute coronary syndrome occurred in eight patients of the extracranial carotid stenosis group and only one of the intracranial arterial stenosis without significant extracranial carotidstenosis group (p = 0.004). Causes of death were end stage cancers, stroke and related conditions, and acute coronary syndrome. The multivariate analysis showed that symptomatic extracranial carotid stenosis is an important risk factor of the acute coronary syndrome (p = 0.03, OR = 10.81, 95% CI 1.23-94.77). There was no significant difference of recurrent ischemic stroke and recurrent stroke between patients with intracranial arterial stenosis without extracranial carotid stenosis and patients with extracranial carotid stenosis. On the other hand, patients with extracranial carotid stenosis had more incidences of acute coronary syndrome significantly than patients with intracranial arterial stenosis.

  20. American Society for Clinical Pathology

    MedlinePlus

    ... ASCP Selects ArborMetrix to Drive Patient-Centric National Pathology Quality Registry ePolicy News August 2017 July 2017 ... Measure Copyright © 2017 by American Society for Clinical Pathology. All Rights Reserved. Terms of Use About ASCP ...

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