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Relation between Early CT Signs and Ischaemic Core Size on DWI MR in Stroke Patients at the 2nd Affiliated Hospital of Dalian Medical University

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Relation between Early CT Signs and Ischaemic Core Size on D...

作者： george William stanley 大连医科大学

学位级别：硕士

背景与目的:在全球范围内,脑卒中是成年人致死的第三大死因,也是最常见的致残原因。因此,脑卒中给患者家庭、社会及政府带来了沉重的经济负担,并在世界大多数国家、尤其是发达国家的卫生预算中占据了很大一部分。脑卒中最常见的类型是... 详细信息

背景与目的:在全球范围内,脑卒中是成年人致死的第三大死因,也是最常见的致残原因。因此,脑卒中给患者家庭、社会及政府带来了沉重的经济负担,并在世界大多数国家、尤其是发达国家的卫生预算中占据了很大一部分。脑卒中最常见的类型是缺血性脑卒中,其中大脑中动脉(MCA)受累是最为严重的。阿尔伯塔脑卒中计划早期诊断项目评分(ASPECTS)是一个描述大脑中动脉(MCA)梗死区域梗死程度的一种具有可靠性、一致性和可重复性的半定量方法。缺血中心区面积为影像学最早测量到的脑实质不可逆缺血损伤的指标。本研究主要目的是使用回顾性地分析方法判断早期缺血性脑卒中ASPECTS法非对比增强CT征象(NCCT/NECT)和磁共振弥散加权成像(DWI)间的关系。非对比增强CT(或CT平扫)是急性脑卒中的首选检查方法,扫描方便,禁忌症少,同时较MRI检查更为廉价、快速。因此,非对比增强CT的ASPECTS评分法将有可能是判断脑卒中患者病变程度和预后的一种快速、可靠、全天候的工具。此外,DWI在大部分的三级医疗机构已经得到了广泛的应用。但是,在没有先进的影像设备和(或)后处理软件(如:灌注成像等)的地区,非对比增强CT的ASPECTS评分将有可能有助于脑卒中患者的治疗、护理方案的制定。方法:本次实验回顾性地研究了2015年大连医科大学附属第二医院内同时进行了非对比增强ct和磁共振弥散加权成像检查的缺血性脑卒中患者24例。实验对象为首次发病的mca供血区缺血性脑卒中(包括大脑半球卒中)患者,在发病的12小时内进行非对比ct评估(ncct)并在发病后1-5天内进行磁共振弥散加权成像(dwimri),随访过程中包括磁共振血管造影(mra)图像。患者的排除标准包括:出血性脑卒中、腔隙性梗死和持续性的血管狭窄或闭塞。24例患者进行非对比增强ct扫描和磁共振弥散加权成像检查,并分别对缺血中心区平均周长进行测量。以磁共振弥散加权成像中作为识别脑梗死区的影像学参考点与金标准。使用spss23.0统计学软件对患者年龄、非对比增强ct以及dwi的aspects评分、缺血中心平均周长、非对比增强ctaspects评分的敏感性、aspects评分≤7组与>7组之间梗死区周长、非对比增强ctaspects评分与dwi缺血灶周长的相关性进行统计学分析,p7组梗死中心周长间存在统计学差异;而在非对比增强CT ASPECTS评分与和DWI ASPECTS评分间不在统计学差异。在急性MCA梗死患者中非对比增强CT ASPECTS评分与DWI中缺血中心周长之间尚不能认为存在相关性,因此,非对比增强CT ASPECTS评分并不能替代缺血中心面积在判断梗死程度及预后中的作用。在以后的实验中,我们将采用更大的样本量,采用不同CT的扫描方位进行ASPECTS评分,在DWI对平均周长的测量中考虑扫描间距,并且进行前瞻性的设计。

关键词：脑卒中 ASPECTS指数大脑中动脉供应区域强化,非增强CT 弥散加权成像缺血核心区

Left Atrial Volume Index in Patients with Dilated Cardiomyopathy—Correlation with Left Ventricular Function

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World Journal of Cardiovascular Diseases 2016年第9期6卷 312-319页

作者： stanley.george Department of Cardiology Pariyaram Medical College Kannur Kerala 670503 India

Background: The aim of this study was to determine the relation of left atrial (LA) volume and LA volume index with left ventricular function and to determine the association of duration of symptoms and left atrial volume index in patients with dilated cardiomyopathy. Materials and Methods: This was an observational, single centre study conducted in India. A total of 50 patients who were admitted to department of cardiology from July, 2008 to February, 2009 with diagnosis of dilated cardiomyopathy and an ejection fraction of <40% were included. Results: Of the 50 patients, 34 (68%) were males. 27 (54%) patients were in NYHA class II and 23 (46%) patients were in NYHA class III. LA volume was found to be ≥40 ml in all patients. LV function and LA volume were found to be correlated (r = -0.789, p < 0.01). Similarly, there was a correlation between LV function and LA volume index (r = -0.826, p < 0.01). There was no correlation between LA volume index and duration of symptoms (r = 0.04). Conclusion: It can be concluded that there is a strong inverse correlation between LA volume and left ventricular function and also between LA volume index and left ventricular function. The patients with NYHA class III were having larger left atrial volume than those with NYHA class II. Moreover, the duration of symptoms has no correlation with left atrial volume index.

关键词： Ejection Fraction Dilated Cardiomyopathy Left Atrial Volume Index Left Ventricular Function

Angiographic Profile and Treadmill Test Relationship of Women with Chest Pain Suggestive of Coronary Artery Disease

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World Journal of Cardiovascular Diseases 2017年第8期7卷 225-232页

作者： stanley.george Department of Cardiology Pariyaram Medical College Kannur India

Aim: The aim of present study was to analyze the prevalence and pattern of coronary artery disease (CAD) among women who underwent coronary angiography (CAG) and Treadmill Test (TMT). Methods: A total of 100 consecutive women patients for coronary angiogram were studied at Department of Cardiology, Government Medical College, Kottayam, Kerala, India on over a period of 6 months from February 2008. Total 65 women completed TMT stress test. The patients were subjected to CAG and TMT. Data were analyzed by using SPSS 20.0 software. Results: A total of 100 women patients were included. Among that 66% patients had hypertension and 47% patients had diabetes mellitus. The CAG revealed the presence of 17%, 13% and 15% of single vessel disease, double vessel disease, and triple vessel disease respectively. Vessel involvements were notably higher in positive TMT values during stress test. The sensitivity and specificity of TMT for detecting coronary artery disease in women were 61% and 69% respectively. Conclusion: It is concluded that, the findings of the present study effectively demonstrated higher predictive value of TMT in women with chest pain suggestive of CAD.

关键词： Coronary Angiography Coronary Artery Disease Treadmill Test

Predictors of survival in autoimmune liver disease overlap syndromes

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World Journal of Hepatology 2024年第9期16卷 1269-1277页

作者： Dujinthan Jayabalan Yi Huang Luis Calzadilla-Bertot Malik Janjua Bastiaan de Boer John Joseph Wendy Cheng Simon Hazeldine Briohny W Smith Gerry C MacQuillan Michael C Wallace george Garas Leon A Adams Gary P Jeffrey Medical School University of Western AustraliaNed-lands 6009Western AustraliaAustralia Department of Hepatology Sir Charles Gairdner HospitalNedlands 6009Western AustraliaAustralia Department of Anatomical Pathology PathWest Laboratory MedicineNedlands 6009Western AustraliaAustralia Department of Gastroenterology and Hepatology Royal Perth HospitalPerth 6000Western AustraliaAustralia Department of Gastroenterology and Hepatology Fiona Stanley HospitalMurdoch 6150Western AustraliaAustralia Medical School University of Western AustraliaNedl-ands 6009Western AustraliaAustralia

BACKGROUND Survival in patients with autoimmune liver disease overlap syndromes(AILDOS)compared to those with single autoimmune liver disease is *** To investigate the survival of patients with AILDOS and assess the accuracy of non-invasive serum models for predicting liver-related *** Patients with AILDOS were defined as either autoimmune hepatitis and primary biliary cholangitis overlap(AIH-PBC)or autoimmune hepatitis and primary sclerosing cholangitis overlap(AIH-PSC)and were identified from three tertiary centres for this cohort ***-related death or transplantation(liver-related mortality)was determined using a population-based data linkage *** scores for liver-related death were compared for accuracy[including liver outcome score(LOS),Hepascore,Mayo Score,model for end-stage liver disease(MELD)score and MELD incorporated with serum sodium(MELD-Na)score].RESULTS Twenty-two AILDOS patients were followed for a median of 3.1 years(range,0.35-7.7).Fourteen were female,the median age was 46.7 years(range,17.8 to 82.1)and median Hepascore was 1(range,0.07-1).At five years post enrolment,57%of patients remained free from liver-related mortality(74%AIH-PBC,27%AIH-PSC).There was no significant difference in survival between AIH-PBC and *** was a significant predictor of liver-related mortality(P<0.05)in patients with AIH-PBC(n=14)but not AIH-PSC(n=8).A LOS cut-point of 6 discriminated liver-related mortality in AIH-PBC patients(P=0.012,log-rank test,100%sensitivity,77.8%specificity)(Harrell's C-statistic 0.867).The MELD score,MELD-Na score and Mayo Score were not predictive of liver-related mortality in any *** Survival in the rare,AILDOS is *** current study supports the LOS as a predictor of liver-related mortality in AIH-PBC *** trials investigating predictors of survival in AILDOS are required.

关键词： Autoimmune liver disease overlap syndromes Liver outcome score Liver-related death Hepascore Autoimmune hepatitis Primary biliary cholangitis Primary sclerosing cholangitis

A comparison study of two breathing exercise techniques in tetraplegics

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Health 2009年第2期1卷 88-92页

作者： stanley John Winser Jacob george Priya stanley.george Tharion 不详

Objective: To compare the effectiveness of ab-dominal weights and incentive spirometry for improving the strength of diaphragm in tetra-plegics. Setting: Department of Physical Medicine and Rehabilitation, Christian Medical College, Vel-lore, Tamil Nadu, India. Study Design: Two group comparison study Methods: Seventeen patients who fulfilled the inclusion criteria were assigned into an ABW or INS treatment groups using judgment sampling after obtaining an informed consent. Evaluation of the chest, respiratory status, vital signs and strength of diaphragm were done during initial assessment. ABW group underwent diaphrag-matic strengthening using Abdominal weights (ABW) and INT group with Incentive Spirometer (INS) for 15 minutes daily, 6 days a week, for a period of 6 weeks. The pre and post training values of peak amplitude in electro myogram (EMG) of the diaphragm, intercostals and ster-nocleidomastoid muscles were measured. Statistical analysis: The analysis was done using SPSS 11. The pre and post-training values of peak EMG amplitudes of the diaphragm, inter- costals and sternocleidomastoid were com- pared within the groups using Wilicoxon’s sign test and between the two groups using Mann- Whitney’s test. Results: The peak EMG of diaphragm of ABW group raised from 1.1289 to 1.3036 milli-volts with a significance of p<0.001, whereas it fell from 1.7001 to 1.0441 milli-volts among INS group subjects with a significance of p<0.001. Comparison between the 2 groups showed sta-tistically significant improvement in diaphrag-matic strength among the ABW group. Conclusion: The results of this study sug-gests that, in the pulmonary rehabilitation of motor complete tetraplegic subjects abdominal weighted training of the diaphragm has better results in improving the strength of the ***: Fluid research grant of Christian Medical College, Vellore.

关键词： Spinal Cord Injury Tetraplegia Diaphragmatic Exercise Surface EMG Abdominal Weights Incentive Spirometer

Respiratory rehabilitation with abdominal weights: a prospective case study

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Health 2010年第5期2卷 407-411页

作者： stanley John Winser Priya stanley.george Tarion 不详

Objective: Abdominal weights was used to strengthen the diaphragm of a C6 ASIA (A) tetraplegic subject with the aim of studying the long term effect of the technique as a part of respiratory rehabilitation. Setting: Department of Physical Medicine and Rehabilitation, Christian Medical College, Vellore, Tamil Nadu, India. Study Design: Prospective case study. Material and methods: The peak EMG amplitude of the diaphragm (DIA), intercostals (INT) and sternoclidomastiod (SCM) were assessed using a surface EMG and inspired lung volume (ILV) was assessed using an adjustable portable spirometer. The measurements were repeated after 3, 6, 9 and 12 months of inspiratory muscle training for a period of 15 minutes daily, 6 days a week for 12 months. Results and discussion: Peak amplitudes recorded by the EMG of DIA and SCM muscles showed a progressive increase, INT muscle did not show a consistent change. INV showed a gradual rise from 1772ml to 2760 ml over the study period. These values have the following significance: 1) Use of abdominal weights as a part of respiratory rehabilitation has beneficial long term effects;2) In patients with tetraplegia, respiratory muscles in particular the diaphragm, are trainable in terms of muscle efficiency;3) The improvement in the muscle efficiency obtained during the early rehabilitation can be maintained or improved using simple non sophisticated exercises like abdominal weights post discharge. Conclusions: Abdominal weights can be used as an effective adjunct to pulmonary rehabilitation in improving the efficiency of diaphragm on a long term basis, thereby reducing the risks associated with pulmonary complications.

关键词： Tetraplegia Abdominal Weights EMG

Clinical Profile and In-Hospital Outcome of Patients with Right Ventricular Myocardial Infarction

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International Journal of Clinical Medicine 2014年第8期5卷 459-463页

作者： stanley.george Mansi Patel Ashok Thakkar Department of Cardiology Medical College Kottayam India Department of Clinical Trials Sahajanand Medical Tech. Pvt. Ltd. Surat India Department of Pharmacology Ramanbhai Patel College of Pharmacy Charotar University of Science and Technology Campus Changa India

Objectives: Right ventricular myocardial infarction as assessed by various diagnostic methods accompanies inferior wall myocardial infarction in 30% to 50% of patients. Acute right ventricular myocardial infarction is associated with higher in-hospital morbidity and mortality related to life-threatening hemodynamic compromise and arrhythmias. Since there is scarcity of literature regarding epidemiology of clinical profile as well as in-hospital outcomes of patients with right ventricular myocardial infarction in the Indian population, this study is carried out with a goal of identifying the same in our hospital setting, to fulfill this void. Methods: We examined the incidence of risk factors in patients (n = 100) with inferior wall myocardial infarction and 100 patients with inferior wall myocardial infarction having right ventricular involvement. Results: The mortality rate was found to be 12% in patients with inferior wall myocardial infarction and 28% in patients having right ventricular involvement in inferior wall myocardial infarction. Conclusions: From the above study, it can be concluded that patients with inferior wall myocardial infarction who have right ventricular myocardial involvement are at an increased risk of death, and cardiogenic shock.

关键词： Inferior Wall Myocardial Infarction Right Ventricular Myocardial Infarction Epidemiology Clinical Profile Mortality

2-D eddy resolving simulations of flow past a circular array of cylindrical plant stems

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Journal of Hydrodynamics 2018年第2期30卷 317-335页

作者： Kyoungsik Chang george Constantinescu Sanghyun Park School of Mechanical Engineering Ulsan University Ulsan Korea Civil and Environmental Engineering Department IIHR-Hydroscience and Engineering Stanley Hydraulics Laboratory The University of Iowa Iowa City USA Korea Aerospace Research Institute Daejeon Korea

In the present study, 2-D large eddy simulations（LES） are conducted for flow past a porous circular array with a solid volume fraction（SVF） of 8.8%, 15.4% and 21.5%. Such simulations are relevant to understanding flow in natural streams and channels containing patches of emerged vegetation. In the simulations discussed in the paper, the porous cylinder of diameter D contains a variable number of identical solid circular cylinders（rigid plant stems） of diameter d= 0.048 D. Most of the simulations are conducted at a Reynolds number of 2 100 based on the diameter D and the velocity of the steady uniform incoming flow. Though in all cases wake billows are shed in the regions where the separated shear layers（SSLs） forming on the sides of the porous cylinder interact, the effect of these wake billows on the mean drag is different. While in the high SVF case（21.5%）, the total drag force oscillates quasi-regularly in time, similar to the canonical case of a large solid cylinder, in the cases with a lower SVF the shedding of the wake billows takes place sufficiently far from the cylinder such that the unsteady component of the total drag force is negligible. The mean amplitude of the oscillations of the drag force on the individual cylinders is the largest in a streamwise band centered around the center of the porous cylinder, where the wake to wake interactions are the strongest. In all cases the maximum drag force on the individual cylinders is the largest for the cylinders directly exposed to the flow, but this force is always smaller than the one induced on a small isolated cylinder and the average magnitude of the force on the cylinders directly exposed to the flow decreases monotonically with the increase in the SVF. Predictions of the global drag coefficients, Strouhal numbers associated with the wake vortex shedding and individual forces on the cylinders in the array from the present LES are in very good agreement with those of 2-D direct numerical simulations conduc

关键词： Vegetation eddy resolving simulation solid volume fraction porous cylinder bleeding flow

Soil-Water Charateristics of Tropical Clay Soil under High and Low Suction Conditions

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Journal of Geoscience and Environment Protection 2020年第11期8卷 162-175页

作者： Bamitale Dorcas Oluyemi-Ayibiowu Taiwo Olawale Akinleye Olaolu george Fadugba Ayodeji stanley Olowoselu Department of Civil Engineering The Federal University of Technology Akure Nigeria

Tropical clay soil was compacted at different moisture conditions (dry, wet and optimum) and compactive efforts (Reduced proctor, Standard proctor, West African standard and Modified proctor). Experimental Soil-Water Characteristics (SWC) of the soil was derived using the pressure plate extractor equipment and SWC Curves (SWCC) plotted as gravimetric water content versus logarithm of matric suction. The Air Entry Values (A.E.V) obtained from experimental work ranged from 21 kPa to 59 kPa and compared favourably well with those estimated from predictive models with values of 23 kPa to 52 kPa. Specimens compacted with greater compactive effort (Modified proctor) and at optimum moisture content produced the largest air entry value of 59 kPa and reduced air voids. Changes observed in the shape of the SWCC were consistent with changes in pore size which occurred by varying compaction conditions. The shape of the soil-water characteristics curve was found to depend on the soil structure, compactive water content and compactive effort and not solely on the percentage of fine particles.

关键词： Soil-Water Characteristics Tropical Clay Soil Compaction Water Content Compactive Efforts Soil-Water Characteristics Curve