Computed tomographic angiographic images were reviewed in a blind fashion, and anatomic classification of emboli was
made. Patients with central thrombus, defined by location medial to the lateral mediastinal boundaries (ie, involving the main, primary, or both branch pulmonary arteries), were classified as having type A pulmonary emboli (n = 107), whereas those with peripheral pulmonary emboli located beyond these boundaries LXH254 clinical trial were classified as having type B pulmonary emboli (n = 672). Four patients with type A pulmonary emboli treated with catheter embolectomy were excluded from the analysis.
Results: Of the 103 patients with type A pulmonary emboli, 15 (14%) were treated with immediate surgical pulmonary embolectomy, and 88 (85%) were treated medically. Patients with type A pulmonary emboli treated surgically had similar 30-day mortality compared with those treated medically (13% vs 17%, P = .532). At a mean of 24 +/- 18 months’ follow-up (range, 1-82 months), survival at 1, 3, and 5 years for BAY 63-2521 patients with
type A pulmonary emboli treated surgically was significantly better than that in the patients with type A pulmonary emboli treated medically (P = .0001).
Conclusions: For patients with type A pulmonary emboli, immediate surgical intervention appears to offer superior midterm survival compared with medical treatment alone. Although the medical and surgical groups were substantially different and the differences might have affected survival, this simplified classification for pulmonary emboli might help direct optimal treatment strategies. (J Thorac Cardiovasc
Surg 2011;142:1423-9)”
“When a cell divides, it must not only accurately duplicate its genome, but also restore its previous levels of gene expression. The information determining gene expression is often not directly encoded Digestive enzyme in the DNA and is hence termed ‘epigenetic’. The molecular basis of epigenetic memory remains a subject of intense debate, but is likely to arise from the collaboration of several mechanisms, including histone post-translational modifications, transcription factors, DNA methylation and noncoding RNAs. In this article, we look at how these mechanisms interact to generate robust epigenetic states. We then consider recent observations that mitotic inheritance of stable gene expression can be compromised by interruption of DNA replication. We discuss how these data may provide direct evidence for a central role for histone modifications in transcriptional memory and how they could potentially provide an explanation for the some of the widespread alterations in transcription seen in cancer cells.”
“A tacit but fundamental assumption of the theory of signal detection is that criterion placement is a noise-free process.