Adverse Cerebral Outcomes after Coronary Bypass Surgery

ABSTRACT Background Acute changes in cerebral function after elective coronary bypass surgery are a difficult clinical problem. We carried out a multicenter study to determine the incidence and predictors of — and the use of resources associated with — perioperative adverse neurologic events, including cerebral injury. Methods In a prospective study, we evaluated 2108 patients from 24 U.S. institutions for two general categories of neurologic outcome: type I (focal injury, or stupor or coma at discharge) and type II (deterioration in intellectual function, memory deficit, or seizures). Results Adverse cerebral outcomes occurred in 129 patients (6.1 percent). A total of 3.1 percent had type I neurologic outcomes (8 died of cerebral injury, 55 had nonfatal strokes, 2 had transient ischemic attacks, and 1 had stupor), and 3.0 percent had type II outcomes (55 had deterioration of intellectual function and 8 had seizures). Patients with adverse cerebral outcomes had higher in-hospital mortality (21 percent of patients with type I outcomes died, vs. 10 percent of those with type II and 2 percent of those with no adverse cerebral outcome; P0.001 for all comparisons), longer hospitalization (25 days with type I outcomes, 21 days with type II, and 10 days with no adverse outcome; P0.001), and a higher rate of discharge to facilities for intermediate- or long-term care (47 percent, 30 percent, and 8 percent; P0.001). Predictors of type I outcomes were proximal aortic atherosclerosis, a history of neurologic disease, and older age; predictors of type II outcomes were older age, systolic hypertension on admission, pulmonary disease, and excessive consumption of alcohol. Conclusions Adverse cerebral outcomes after coronary bypass surgery are relatively common and serious; they are associated with substantial increases in mortality, length of hospitalization, and use of intermediate- or long-term care facilities. New diagnostic and therapeutic strategies must be developed to lessen such injury. (N Engl J Med 1996;335:1857-63.)

A Honeycomb Proportional Counter for Photon Multiplicity Measurement in the ALICE Experiment

A honeycomb detector consisting of a matrix of 96 closely packed hexagonal cells, each working as a proportional counter with a wire readout, was fabricated and tested at the CERN PS. The cell depth and the radial dimensions of the cell were small, in the range of 5-10 mm. The appropriate cell design was arrived at using GARFIELD simulations. Two geometries are described illustrating the effect of field shaping. The charged particle detection efficiency and the preshower characteristics have been studied using pion and electron beams. Average charged particle detection efficiency was found to be 98%, which is almost uniform within the cell volume and also within the array. The preshower data show that the transverse size of the shower is in close agreement with the results of simulations for a range of energies and converter thicknesses.Comment: To be published in NIM

The STAR Photon Multiplicity Detector

Details concerning the design, fabrication and performance of STAR Photon Multiplicity Detector (PMD) are presented. The PMD will cover the forward region, within the pseudorapidity range 2.3--3.5, behind the forward time projection chamber. It will measure the spatial distribution of photons in order to study collective flow, fluctuation and chiral symmetry restoration.Comment: 15 pages, including 11 figures; to appear in a special NIM volume dedicated to the accelerator and detectors at RHI

Particle density fluctuations

Event-by-event fluctuations in the multiplicities of charged particles and photons at SPS energies are discussed. Fluctuations are studied by controlling the centrality of the reaction and rapidity acceptance of the detectors. Results are also presented on the event-by-event study of correlations between the multiplicity of charged particles and photons to search for DCC-like signals.Comment: Talk presented at Quark Matter 2002, Nantes, Franc

Integrating coronary atherosclerosis burden and progression with coronary artery disease risk factors to guide therapeutic decision making (vol 136, page 260, 2023)

Cardiolog

Molecular velocity auto-correlation of simple liquids observed by NMR MGSE method

The velocity auto-correlation spectra of simple liquids obtained by the NMR method of modulated gradient spin echo show features in the low frequency range up to a few kHz, which can be explained reasonably well by a $t^{-3/2}$ long time tail decay only for non-polar liquid toluene, while the spectra of polar liquids, such as ethanol, water and glycerol, are more congruent with the model of diffusion of particles temporarily trapped in potential wells created by their neighbors. As the method provides the spectrum averaged over ensemble of particle trajectories, the initial non-exponential decay of spin echoes is attributed to a spatial heterogeneity of molecular motion in a bulk of liquid, reflected in distribution of the echo decays for short trajectories. While at longer time intervals, and thus with longer trajectories, heterogeneity is averaged out, giving rise to a spectrum which is explained as a combination of molecular self-diffusion and eddy diffusion within the vortexes of hydrodynamic fluctuations.Comment: 8 pages, 6 figur

High-p_T pion and kaon production in relativistic nuclear collisions

High-p_T pion and kaon production is studied in relativistic proton-proton, proton-nucleus, and nucleus-nucleus collisions in a wide energy range. Cross sections are calculated based on perturbative QCD, augmented by a phenomenological transverse momentum distribution of partons (``intrinsic k_T''). An energy dependent width of the transverse momentum distribution is extracted from pion and charged hadron production data in proton-proton/proton-antiproton collisions. Effects of multiscattering and shadowing in the strongly interacting medium are taken into account. Enhancement of the transverse momentum width is introduced and parameterized to explain the Cronin effect. In collisions between heavy nuclei, the model over-predicts central pion production cross sections (more significantly at higher energies), hinting at the presence of jet quenching. Predictions are made for proton-nucleus and nucleus-nucleus collisions at RHIC energies.Comment: 26 pages in Latex, 19 EPS figure

Search for DCC in 158A GeV Pb+Pb Collisions

A detailed analysis of the phase space distributions of charged particles and photons have been carried out using two independent methods. The results indicate the presence of nonstatistical fluctuations in localized regions of phase space.Comment: Talk at the PANIC99 Conference, June 9-16, 199

Present Status and Future of DCC Analysis

Disoriented Chiral Condensates (DCC) have been predicted to form in high energy heavy ion collisions where the approximate chiral symmetry of QCD has been restored. This leads to large imbalances in the production of charged to neutral pions. Sophisticated analysis methods are being developed to disentangle DCC events out of the large background of events with conventionally produced particles. We present a short review of current analysis methods and future prospects.Comment: 12 pages, 5 figures. Invited talk presented at the 13th International Conference on Ultrarelativistic Nucleus-Nucleus Collisions (Quark Matter 97), Tsukuba, Japan, 1-5 Dec 199

Central Pb+Pb Collisions at 158 A GeV/c Studied by Pion-Pion Interferometry

Two-particle correlations have been measured for identified negative pions from central 158 AGeV Pb+Pb collisions and fitted radii of about 7 fm in all dimensions have been obtained. A multi-dimensional study of the radii as a function of kT is presented, including a full correction for the resolution effects of the apparatus. The cross term Rout-long of the standard fit in the Longitudinally CoMoving System (LCMS) and the vl parameter of the generalised Yano-Koonin fit are compatible with 0, suggesting that the source undergoes a boost invariant expansion. The shapes of the correlation functions in Qinv and Qspace have been analyzed in detail. They are not Gaussian but better represented by exponentials. As a consequence, fitting Gaussians to these correlation functions may produce different radii depending on the acceptance of the experimental setup used for the measurement.Comment: 13 pages including 10 figure