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The authors have synthesized a novel fluorinated polyimide to develop a membrane material for oxygenators and fabricated polyimide hollow fibers for use in an intravascular oxygenator. A dry/wet phase inversion process has been applied to a spinning process to prepare an asymmetric polyimide hollow fiber. The outer surface of the hollow fiber consists of an ultrathin, dense skin layer, with a calculated apparent thickness of approximately 60 nm. ⋯ The blood compatibility of the polyimide hollow fiber without heparinization has been evaluated in vitro. Deformation and aggregation of platelets adherent to the fibers were not observed, and the polyimide suppressed platelet activation. The polyimide significantly reduced the production of anaphylatoxin and also suppressed complement activation.
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Postgraduate medicine · Aug 1984
Case Reports'Essential' hypertension with hypokalemia. Caused by aldosterone-secreting adrenal adenoma.
Primary aldosteronism is a potentially curable cause of hypertension; it occurs in about 1% of hypertensive patients. In the case reported here, persistent hypokalemia developed in a 72-year-old man who had been treated for 13 years for essential hypertension. ⋯ Aldosterone-secreting adenoma of the adrenal gland was diagnosed, and right adrenalectomy was performed. At a six-month follow-up examination, the patient's blood pressure and potassium level were normal.
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Postgraduate medicine · Sep 2010
Chronic hepatitis B: perceptions in Asian American communities and diagnosis and management practices among primary care physicians.
Asian Americans exhibit a high prevalence of chronic hepatitis B (CHB) compared with the general population in the United States. However, there are specific barriers to appropriate health care in the Asian American population, and CHB awareness is low. The aim of this study was to examine CHB awareness among the Asian American population and to assess the role and attitudes of primary care physicians in CHB diagnosis and treatment, particularly in relation to Asian American communities. ⋯ Improved education regarding CHB disease progression, prevention, and treatment is needed among both the Asian American community and primary care physicians to increase awareness of the seriousness of the disease and ultimately reduce the burden of CHB in the United States.
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Case Reports
Role of arterioles in management of microvascular decompression in patients with hemifacial spasm.
Although microvascular decompression (MVD) is accepted as an effective therapy for hemifacial spasm (HFS), some operations fail. While performing MVD, many surgeons focus on the large arteries but ignore the arterioles. Failure to identify involved arterioles may account for unsuccessful MVD. ⋯ After surgery, spasms ceased in all patients and no recurrence was found up to the one-year follow-up. To achieve a positive post-operative outcome, exploration of the entire CN VII is necessary, with a focus on the small arterioles. AMR can be a good adjuvant to identify the involved arterioles.
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In a consecutive series of 26 previously operated patients diagnosed with cerebral glioma, magnetic resonance spectroscopy (MRS), 2-((18)F) fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET), and perfusion MRI (MRP), were performed at follow-up to distinguish recurrence from radiation necrosis, and to identify tumour upgrading. Discrepancy between techniques was observed in 9 cases. ⋯ In the selected group of nine cases studied to differentiate viable tumour from radiation necrosis, MRS and MRP reached a PPV and a NPV of 100%, whereas for FDG-PET, PPV and NPV were 66.6% and 60%, respectively. To distinguish between viable high-grade glioma and radiation necrosis, gadolinium-enhanced MRI gives a high false-positive rate, while MRS and MRP are superior to FDG-PET in discriminating tumour recurrence, grade increase and radiation necrosis.