The histological pattern is described as a variant of cryptogenic

The histological pattern is described as a variant of cryptogenic organizing pneumonia (COP). Although COP has been occasionally described in patients with HIV infection, the variant form, AFOP, has not been previously reported in such patients. This report describes an intriguing case of AFOP in a patient with HIV infection and Pneumocystis jiroveci pneumonia. AFOP was diagnosed after tapering of corticosteroid therapy. This case illustrates that non-infectious pulmonary infiltrates should be considered in the differential diagnosis of lung disease in patients with HIV infection.”
“Laser excision has been

used with increasing success C646 to treat oral leukoplakia. The aim of the present study was to evaluate whether clinical healing of a leukoplakia after laser surgery is associated with a normal functional status of the new epithelium and whether pathological alterations in these parameters

are related HSP990 Cytoskeletal Signaling inhibitor to the risk of local recurrence. The study population consisted of 13 consecutive patients with oral leukoplakia in which clinical healing was achieved after laser therapy using an Nd:YAG laser (Model 6000, Laser Sonics, Cooper Laser Sonics). At the end of the therapy, all patients underwent a second biopsy of the clinically healthy tissue. Epithelial cell turnover was evaluated before and after laser surgery by Ki67 protein expression, and positive staining of more than 20% was considered abnormal. All patients were followed on a monthly basis. Eight patients had abnormally high Ki67 values before laser therapy (mean 27.4 +/- 6.2%), but the levels decreased significantly after treatment (17.6 +/-

8.5%; t = 2.6, p < 0.05). High Ki67 values persisted in three patients, and local recurrences in the new epithelium was observed in two of these patients. Kaplan-Meier statistics showed that the between-group difference was statistically significant (Chi square 7.3; p < 0.01). In conclusion, this is the first prospective study to show that clinical healing of leukoplakia treated by laser surgery may be accompanied by altered cell turnover in 20% of the cases. Ki67, as a marker of proliferative status, find more may be a prognostic indicator in the mucosa replacing the lesion.”

Mitochondria are important determinants of developmental competence for oocytes and embryos owing to their central role in cellular metabolism, yet mitochondrial activity and morphometry during early porcine development have not been quantified. In this study, we examined the membrane potential Delta Sigma(m) and the surface density Sv(in,m) of the inner mitochondrial membrane in pig oocytes and pre-implantation embryos using fluorescent probes and confocal microscopy. Mitochondria and their cristae were also examined by transmission electron microscope. Delta Sigma(m) was consistently low from immature oocytes up to morulae and increased significantly in the early blastocyst before decreasing at the expanded blastocyst stage.

We hypothesized that BNP can be used as a non-invasive biomarker

We hypothesized that BNP can be used as a non-invasive biomarker to identify patients at ‘high risk’ for postoperative morbidity and mortality.

METHODS: We studied the postoperative outcome in 73 consecutive patients. Patients

were divided into three groups based on previously determined cut-off levels: BNP < 11.5, indicating normal RV function (ejection fraction [EF] >= 45%), BNP > 48.5 pmol/l, indicating RV dysfunction (right ventricular ejection fraction < 30%) and BNP 11.5-48.5 pmol/l. Postoperative ‘bad outcome’ was defined as the presence of either residual pulmonary hypertension (PH) or (all-cause) mortality.

RESULTS: Plasma BNP > 48.5 pmol/l was shown to be an independent predictor Selleck NVP-BSK805 of ‘bad outcome’. Compared with BNP < 11.5 pmol/l, BNP > 48.5 pmol/l identified patients at higher risk for (all-cause) mortality (17 vs 0%; P = 0.009) and residual PH (56 vs 20%; P < 0.004). Also, the durations of mechanical

ventilation and intensive care unit stay were significantly longer in patients Pfizer Licensed Compound Library cell assay with BNP > 48.5 pmol/ml.

CONCLUSIONS: Plasma BNP levels may be of use as a non-invasive biomarker reflecting RV dysfunction, next to other well-recognized (invasive) parameters, for better preoperative risk stratification of CTEPH patients.”
“Objective: Audiological and subjective benefits in adult bone-anchored hearing device users.

Study Design: Retrospective evaluation.

Setting: Tertiary referral center.

Patients: Thirty-eight adult subjects fitted with unilateral bone-anchored hearing device.

Interventions: Audiometric measurements included sound-field pure-tone and speech audiometries (speech reception threshold,

maximum speech discrimination). Subjective benefit was assessed by the Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire. Ipsilateral and contralateral hearing loss was considered. Comparison was drawn between Compact, A 1155463 Divino, and Intenso processors.

Main Outcome: To compare sound-field pure-tone and speech audiometries and APHAB results with and without the device adjusted for the unaided results.

Results: With the device, sound-field pure-tone audiometry results revealed an increase gain in all frequencies. Sound-field speech audiometry showed that the mean threshold of speech recognition was 20 dB lower, maximum discrimination was attained at 5 dB less, and percentage of maximum discrimination increased by 5%. Scores in the APHAB questionnaire decreased except for the aversiveness subscale. Auditory-adjusted gain showed greater benefit in subjects with ipsilateral conductive hearing loss. Subjects with contralateral normal hearing or conductive hearing loss showed greater improvement that those with contralateral mixed or sensorineural hearing loss. There were no differences between Compact, Divino and Intenso processors.

Results: Observation of video was the most costly data processing

Results: Observation of video was the most costly data processing method with total cost of (sic) 30,630, and was 1.2-fold more costly than inclinometry ((sic) 26,255), and 2.5-fold more costly than self-reported data ((sic) 12,491). Simulated scenarios showed altering design strategy could substantially impact processing costs. This was shown for both fixed parameters,

such as software development and training costs, and variable parameters, such as the number of work-shift files processed, as well as the sampling frequency for video observation. When data collection and data processing Pfizer Licensed Compound Library costs were combined, the cost difference between video and inclinometer methods was reduced to 7%; simulated data showed this difference could be diminished and, even, reversed at larger study sample sizes. Self-report remained substantially less costly under all design strategies, but produced alternate exposure metrics.

Conclusions: These findings build on the previously published data collection phase cost model by reporting costs for post-collection data processing of the same

data set. Together, these models permit empirically based study planning and identification of cost-efficient study designs.”
“Background and objective: High-altitude pulmonary oedema (HAPE) is a non-cardiogenic hydrostatic oedema involving a genetic learn more component. Considering the low incidence of HAPE, sample sizes in current reports are relatively limited. We aimed to assess the association between Selleckchem Nutlin3a the angiotensin-converting enzyme (ACE) I/D polymorphism

and HAPE via a meta-analysis of published and unpublished data.

Materials and methods: We searched PubMed, CBM, CNKI, and Cochrane Library Database before 20 November 2010. A random-effects model was applied (STATA) and study quality was assessed in duplicate.

Results: A total of five studies including 305 cases and 662 controls were meta-analysed. The summary odds ratio (OR) indicated that no significant differences in risk of developing HAPE were found between carriers of ACE D and I alleles (OR = 1.20; 95% confidence interval (CI), 0.98-1.48; p = 0.084). Lack of association persisted for genotypes under the recessive mode. However, genotype association under the dominant mode showed D allele carriers significantly conferred a 1.55-fold increased HAPE risk compared with II genotype carriers (95% CI, 1.15-2.08; p = 0.004). Funnel plot and Egger’s test suggested no evidence of publication bias.

Conclusions: Our results supported the notion that ACE D allele carriers were at significant increased risk of developing HAPE.”
“Background: Treatment duration varies with the type of therapy and a patient’s recovery speed. Including such a variation in randomized controlled trials (RCTs) enables comparison of the actual therapeutic potential of different therapies in clinical care.

(C) 2011 Published by Elsevier Masson SAS “
“Acquired von Wi

(C) 2011 Published by Elsevier Masson SAS.”
“Acquired von Willebrand’s Disease (AvWD) is a rare disease with a clinical pattern similar to the congenital disorder that typically presents later in life in patients with no prior history of prolonged bleeding. It has been shown

to be related to a number of common medical conditions including lymphoproliferative and myeloproliferative diseases, cardiovascular disease, immunological disorders, neoplasia, drugs, and miscellaneous disorders. We present 2 cases where post- and interoperative hemorrhage were the initial sign of AvWD and a previously undiagnosed hypothyroid condition was the precipitating factor. There are no similar cases reported within the dental literature. We highlight the importance of taking a medical history and bleeding history in all patients about to undergo oral surgery, periodontal surgery, or implant placement. Increased vigilance is suggested when patients, who have been otherwise well, present with abnormal bleeding problems as this may be a manifestation of an underlying undiagnosed disease. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;110:337-340)”

Design. An experimental study using a sheep cervical spine interbody fusion model.

Objective. To compare allogeneic mesenchymal precursor cells combined with hydroxyapatite and tricalcium phosphate (HA/TCP) with HA/TCP alone or iliac crest autograft (AG) for cervical interbody fusion.

Summary of Background Data. We investigated the effect of mesenchymal precursor cells on cervical fusion because of the shortcomings of using iliac crest (donor site morbidity), bone substitute SNS-032 (poor osteoinductive properties), and bone morphogenic proteins (serious complications).


Thirty ewes were divided randomly into four groups of six having C3-C4 anterior cervical discectomy and fusion using a Fidji cage packed with, AG, HA/TCP, HA/TCP containing 5 million MPCs, and HA/TCP containing 10 million MPCs. MPCs were derived from a single batch of immuno-selected and culture-expanded MPCs isolated from bone marrow LDN-193189 order of out-bred sheep. The fifth group were nonoperated controls. Safety, fusion parameters, and biomechanics were assessed.

Results. No cell-related adverse events were observed. No significant differences were found between the five or 10 million MPC groups. Evaluation of fusion by CT scan at 3 months showed that 9 of 12 (75%) MPC-treated animals had continuous bony bridging compared with only 1 of 6 AG and 2 of 6 HA/TCP (P = 0.019 and P = 0.044, respectively). By quantitative CT, density of new bone in MPC-treated animals was 121% higher than in HA/TCP (P = 0.017) and 128% higher than in AG (P < 0.0001). Functional radiology at 3 months revealed that MPC-treated animals had significantly reduced macromotion at C3/4 compared with AG and HA/TCP groups combined (P = 0.007).


Together, the results suggest the existence of additional early s

Together, the results suggest the existence of additional early signals that may control the differentiation of hyphopodia.”
“In this work, the acoustic vibrations of a circular nanowire have been studied on the basis of surface elasticity model, where both the

surface elastic property and surface inertia effect are captured. The phonon dispersion and the resonant frequencies for specific vibration modes have been calculated. It has been found from the numerical results that both the surface elastic property and the surface inertia have much effect on the vibration Protease Inhibitor Library screening behavior of the nanowire, though depending on the vibration modes. The low-frequency Raman shift has also been considered. The results reveal the surface effect is significant in nanowires, which may make it possible to use Raman scattering to determine the surface properties.

(C) 2011 American Institute of Physics. [doi:10.1063/1.3610498]“
“Electrical status epilepticus in sleep syndrome is the association of the electroencephalographic pattern and deficits in language or global cognitive function and behavioral problems. The etiology is often unknown, but genetic risk factors have been implicated. Array-based comparative genomic hybridization was used to identify copy number variations in 13 children with electrical status epilepticus in sleep syndrome to identify possible underlying risk factors. Seven copy number variations were detected in 4 of the 13 patients, which consisted XMU-MP-1 of 6 novel gains and 1 loss, the recurrent 15q13.3 microdeletion. Two patients carried a probable pathogenic copy number variation containing a gene involved in the cholinergic pathway. Genetic aberrations in patients with electrical status epilepticus in sleep syndrome can provide an entry in the investigation of the etiology of electrical status epilepticus in sleep. Autophagy 抑制剂 However, further studies are needed to confirm our findings.”
“The transcription

factor HAHB10 belongs to the sunflower (Helianthus annuus) HD-Zip II subfamily and it has been previously associated with the induction of flowering. In this study it is shown that HAHB10 is expressed in sunflower leaves throughout the vegetative stage and in stamens during the reproductive stage. In short-day inductive conditions the expression of this gene is induced in shoot apexes together with the expression of the flowering genes HAFT and HAAP1. Transgenic Arabidopsis plants expressing HAHB10 cDNA under regulation either by its own promoter or by cauliflower mosaic virus (CaMV) 35S exhibited an early flowering phenotype. This phenotype was completely reverted in a non-inductive light regime, indicating a photoperiod-dependent action for this transcription factor.

The data showed that the mean particle size of synthesized magnet

The data showed that the mean particle size of synthesized magnetite (Fe3O4) nanoparticles was about 10 nm. The diameter of the stabilized polymer coated Fe3O4 nanogels ranged from 50 to 250 nm based on polymer type. TEM micrographs proved that nanogels possess

the spherical morphology before and after swelling. These nanogels exhibited pH-induced phase transition due to protonation of AMPS copolymer chains. (C) 2011 Wiley Periodicals, Inc. J Appl Polym Sci, 2012″
“A 7-month-old girl with acute myeloid leukemia (AML) developed acute respiratory distress CAL-101 mouse syndrome (ARDS) during the pancytopenic period after induction chemotherapy. Respiratory failure did not improve despite intensive treatments. Eventually, hemophagocytic Luminespib lymphohistiocytosis (HLH) was diagnosed based on hemophagocytosis in bone marrow, and high soluble interleukin-2 receptor (sIL-2R) and ferritin levels. Even after cyclosporin A was started against HLH, she did not recover. Autopsy showed macrophage proliferation in bone marrow and lymph nodes. HLH should be considered, even in the pancytopenic period

after chemotherapy, when patients develop ARDS that does not respond to supportive therapies.</.”
“Incretin-based drugs, such as glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase 4 inhibitors, are now routinely used to treat type 2 diabetes mellitus. These agents regulate glucose metabolism through multiple mechanisms, their use is associated with low rates of hypoglycemia, and they either do not affect body weight (dipeptidyl peptidase 4 inhibitors), or promote weight loss (glucagon-like peptide-1 receptor agonists). The success of exenatide and sitagliptin, the first therapies in their respective drug classes to be based on incretins, has fostered the development MI-503 manufacturer of multiple new agents that are currently in late stages of clinical development or awaiting approval. This review highlights our current understanding of the mechanisms of action of incretin-based drugs, with an emphasis on the emerging clinical profile of new agents.”
“In this paper, different efficiency behaviors of blue LEDs fabricated on

the conventional sapphire substrate (C-LEDs) and patterned sapphire substrate (PSSLEDs) by metal organic chemical vapor deposition are investigated. Maximum external quantum efficiency (EQE) of PSSLEDs shows about 23.5 % improvement compared with that of C-LEDs. However, PSSLEDs have lower peak-efficiency-current at which the EQE reaches maximum, and suffer more serious efficiency droop. Besides, slight changes of efficiency droop for these two type LEDs in aging experiments indicate that structure defects do not play major roles for efficiency droop, and faster broadenings of the full width at half maximum of the electro-luminescence (EL) spectrum when injection current increases suggest stronger band filling effects in PSSLEDs.

PEComas have been found in many locations, but only 7 cases have

PEComas have been found in many locations, but only 7 cases have been described in the pancreas to date. Here, the authors report an additional case of this rare neoplasm and demonstrate the HMB-45 immunoreactivity of melanosomes or premelanosomes at the ultrastructural level.”
“Plants are being increasingly used in dermatological formulations, since their collateral effects are lower Selleckchem Eltanexor than those caused by synthetic products. Hydrogels represent

efficient formulations to incorporate plant extracts, providing good percutaneous absorption, non-greasy texture and easy application. Bryonia dioica Jacq. (white-bryony), Tamus communis L (black-bryony) and Lonicera periclymenum L. (honeysuckle) fruits have important applications as topical homemade remedies. The phenolic extracts of B. dioica, T. communis and L periclymenum were characterized by HPLC-DAD-ESI/MS, and further incorporated into hydrosoluble gels in order to evaluate their antioxidant potential. The hydrogels were prepared with each fruit extract at the EC50 value (obtained herein for each ethanolic extract). The antioxidant activity selleck chemicals llc of extracts and hydrogels was evaluated following different chemical and biochemical assays. Eighteen compounds were identified in honeysuckle (7 flavonols, 7 hydroxycinnamoyl derivatives

and 4 anthocyanins), fourteen in white-bryony (9 flavonols and 5 flavones) and twelve in black-bryony (7 flavonols and 5 flavones). Honeysuckle showed the highest concentrations of phenolic compounds, but the antioxidant activity was similar among the three assayed species. The obtained formulations revealed antioxidant activity close to 50% for reducing power, scavenging activity and beta-carotene/linoleate assays. The studied fruits might be considered as good source of phenolic compounds that can be used in formulations for topical application, benefiting their antioxidant effects. (C) 2013 Elsevier B.V. All rights reserved.”
“Objective: The purposes of the present study were to establish

the Standard-Chinese version of Lexical Neighborhood Test (LNT) and to examine the lexical and age effects on spoken-word recognition in normal-hearing children.

Methods: Six lists of monosyllabic and six lists of disyllabic words (20 words/list) were selected from the database of daily find more speech materials for normal-hearing (NH) children of ages 3-5 years. The lists were further divided into “”easy”" and “”hard”" halves according to the word frequency and neighborhood density in the database based on the theory of Neighborhood Activation Model (NAM). Ninety-six NH children (age ranged between 4.0 and 7.0 years) were divided into three different age groups of 1-year intervals. Speech-perception tests were conducted using the Standard-Chinese monosyllabic and disyllabic LNT.

Results: The inter-list performance was found to be equivalent and inter-rater reliability was high with 92.

Response to NAC, progression-free survival (PFS), and OS were eva

Response to NAC, progression-free survival (PFS), and OS were evaluated. By using univariate and multivariate analyses, the predicted survival rates by the factors were analyzed.

Results Median age of patients

at diagnosis were 62 years (range 33-77). The serous cell type was the most common histology (98%). The majority of patients (94%) received a combination therapy of paclitaxel and carboplatin. A median of four cycles of NAC was administered. At the end of NAC, the clinical complete response (CR) with normal clinical examination and normal serum CA 125 level was achieved in 40 patients (77%). Moreover, a radiological CR and a radiological partial response were obtained in 35 patients (67%) and in 16 patients (31%), respectively. ICS was considered standard in 45 (86%) patients. Optimal cytoreduction could ASP4786 be achieved in 43 of 52 patients (83%). selleckchem After ICS, pathological CR was established in 15 of 52 patients (29%). At the median follow-up of 25 months (range 9-102), 2-year PFS and OS were 31 and 90%, respectively. The median PFS time was 13.3 months (SE 1.1, 95% CI 11-15) and the median OS time was 47.5 months (SE 5.8, 95% CI 36.1-59). The univariate analysis showed that optimal or suboptimal cytoreduction and perioperative blood transfusion were important prognostic factors on OS for patients who received NAC. Patients treated with

optimal cytoreduction had significantly better median OS (52.5 months, 95% Cl 45-60) than patients who underwent suboptimal cytoreduction (24.2 months, 95% CI 11.3-37) (P = 0.001). Furthermore, the cytoreduction type (optimal vs. suboptimal), surgical procedure (standard vs. non-standard), and perioperative blood transfusion were independent prognostic factors of OS by multivariate analysis (chi(2) = 9.28, P A-769662 in vitro = 0.002, HR 0.28, 95% CI

0.003-0.37; chi(2) = 4.44, P = 0.035, HR 0.15, 95% CI 0.026-0.87; chi(2) = 9.24, P = 0.002, HR 0.75, 95% CI 0.014-0.79, respectively).

Conclusions This study demonstrates that NAC is associated with improved OS for patients with advanced EOC who received NAC followed by ICS. Additionally, our results showed that cytoreduction type, surgical procedure, and perioperative blood transfusion were independent prognostic indicators of OS for patients with advanced EOC who received NAC. Thereafter, NAC may be an alternative treatment to primary cytoreduction.”
“Background and aims: We aimed to determine the effect of short-term dietary sodium restriction on plasma total cholesterol, LDL-C, HDL-C, triglycerides, apolipoprotein (apo) A-I, apo B and high molecular weight (HMW) adiponectin in non-obese, normotensive young men. Glomerular filtration rate (GFR), effective renal plasma flow (ERPF), plasma renin activity (PRA) and aldosterone were also measured.

Future research is needed to identify specific factors (e g , gen

Future research is needed to identify specific factors (e.g., genetic) mediating favorable responses.”
“Vaccine development has progressed significantly and has moved from whole microorganisms to subunit vaccines that contain only their antigenic proteins. Subunit vaccines are often less immunogenic than whole pathogens; therefore, adjuvants must amplify the immune response, ideally establishing both innate and adaptive immunity. Incorporation of antigens into biomaterials, such as liposomes and polymers, can achieve

a desired vaccine response. The physical properties of these platforms can be easily manipulated, thus allowing for controlled delivery of immunostimulatory factors and presentation of pathogen-associated molecular patterns (PAMPs) that are targeted to specific immune cells. Targeting antigen to immune cells via PAMP-modified biomaterials is a selleck chemical new strategy to control the subsequent development of immunity and, in turn, effective vaccination. Here, we review the recent advances in both immunology and biomaterial engineering that have brought particulate-based vaccines to reality.”
“The ssRNA+ family Coronaviridae includes two subfamilies prototyped by coronaviruses and toroviruses

that cause respiratory and enteric infections. To facilitate the identification of new distantly related members of the family Coronaviridae, we have developed a molecular assay with broad specificity. The consensus-degenerated hybrid oligonucleotide primer (CODEHOP) strategy was modified to design primers targeting the most conserved motifs in the RNA-dependent RNA polymerase locus. They were evaluated initially on RNA

templates Nutlin-3a mw from virus-infected cells using a two-step RT-PCR protocol that was further advanced to a one-step assay. The sensitivity of the assay ranged from 10(2) to 10(6) and from 10(5) to 105 RNA copy numbers for individual corona-/torovirus templates when tested, respectively, with and without an excess of RNA from human cells. This primer set compared to that designed according to the original CODEHOP rules showed 10-10(3) folds greater sensitivity for 5 of the 6 evaluated corona-/torovirus templates. It detected 57% (32 of 56) of the respiratory specimens positive for 4 human coronaviruses, as well as stool specimens positive for a bovine torovirus. The high sensitivity and broad virus range of this assay makes it suitable for screening biological specimens in search for new viruses of the family Coronaviridae. (C) 2011 Elsevier B.V. All rights reserved.”
“A functional interaction between serotonergic and noradrenergic systems has been shown in the locus coeruleus (LC). Noradrenaline (NA) levels in the prefrontal cortex (PFC) are dependent on the firing rate of LC neurons, which is controlled by alpha(2) adrenoceptors (alpha 2ADR). The aim of the present study was to investigate the role of 5-HT3 receptors (5HT3R) in the modulation of central noradrenergic activity.

HepG2 cells were treated with three different concentrations of B

HepG2 cells were treated with three different concentrations of BBP (0, 10, or 25 M) for 24 or 48 h. Following incubation, the cells were subjected to proteomic analysis using two different pI ranges (4-7 and 6-9) and large-size two-dimensional gel electrophoresis. Results showed resolution of a total of 2776 protein spots. Of these, 29, including 19 upregulated and 10 downregulated proteins, were identified by electrospray ionization-mass spectrometry-mass spectrometry (ESI-MS/MS). Among these, the identities of cystatin C, Rho guanine nucleotide dissociation inhibitor, gelsolin, DEK protein, Raf kinase inhibitory

protein, triose phosphate isomerase, heptaglobin-related protein, inter-alpha-trypsin inhibitor heavy chain H2, and electron transfer flavoprotein subunit Forskolin mouse beta were confirmed by Western blot analysis. These proteins were found to be involved in apoptosis, signaling, Selumetinib purchase tumor progression, energy metabolism, and

cell structure and motility. Therefore, these proteins have potential to be employed as biomarkers of BBP exposure and may be useful in understanding mechanisms underlying the adverse effects of BBP.”

Few data are available on the long-term outcome of endovascular repair of abdominal aortic aneurysm as compared with open repair.


From 1999 through 2004 at 37 hospitals in the United Kingdom, we randomly assigned 1252 patients with large abdominal aortic aneurysms (>= 5.5 cm in diameter) to undergo either endovascular or open repair; 626 patients were assigned to each group. Patients were

followed for rates of death, graft-related complications, reinterventions, and resource use until the end of 2009. Logistic regression and Cox regression were used to compare outcomes in the two groups.


The 30-day operative mortality was 1.8% in the endovascular-repair selleck screening library group and 4.3% in the open-repair group (adjusted odds ratio for endovascular repair as compared with open repair, 0.39; 95% confidence interval [CI], 0.18 to 0.87; P=0.02). The endovascular-repair group had an early benefit with respect to aneurysm-related mortality, but the benefit was lost by the end of the study, at least partially because of fatal endo-graft ruptures (adjusted hazard ratio, 0.92; 95% CI, 0.57 to 1.49; P=0.73). By the end of follow-up, there was no significant difference between the two groups in the rate of death from any cause (adjusted hazard ratio, 1.03; 95% CI, 0.86 to 1.23; P=0.72). The rates of graft-related complications and reinterventions were higher with endovascular repair, and new complications occurred up to 8 years after randomization, contributing to higher overall costs.


In this large, randomized trial, endovascular repair of abdominal aortic aneurysm was associated with a significantly lower operative mortality than open surgical repair.