Search

Objective: To compare the performance of an 18-gauge nonfenestrated catheter (18-NFC) with a 22-gauge fenestrated catheter (22-FC) for cardiac CT angiography (CCTA) in patients with suspected coronary heart disease. Subjects and methods: 74 consecutive patients imaged on a 2nd generation dual-source CT with arterial phase CCTA were included in this retrospective investigation to either an 18-NFC or 22-FC. In comparison to the 18-NFC, the 22-FC has three additional perforations for contrast agent dispersal proximal to the tip. We examined the two groups for differences in their average attenuation in the right and left ventricles (RV, LV) and in the atrium (RA, LA) as well as in the proximal right coronary artery (RCA) and the left main coronary artery (LM). The averages were calculated for both the 18-NFC and 22-FC. Results: Catheters were successfully placed on the first attempt 97% (36/37) for 18-NFC and 95% (35/37) for the 22-FC. The following enhancement levels were measured: 22-FC (in Hounsfield-Units (HU)): RV = 203±29, LV = 523±36, RA = 198±29, LA = 519±38, RCA = 547±26, LM = 562±25; 18-NFC: RV = 146±26, LV = 464±32, RA = 141±24, LA = 438±35, RCA = 501±23, LM = 523±23; RV (p = 0,03), LV (p = 0.12), RA (p = 0.02), LA (p = 0.04), RCA (p = 0.3), LM (p = 0.33). Conclusion: No significant differences in attenuation levels as well as in image quality of the coronary arteries were found between NFC and FC. Nevertheless, the 22-gauge FC examinations showed significantly higher attenuation in the left and right atrium as well as the right ventricle. Patients with poor venous access may benefit from a smaller gauge catheter that can deliver sufficiently high flow rates for CCTA. [ABSTRACT FROM AUTHOR]

The article discusses the main claims, proofs and consequences of philosophical hermeneutics or the study of the principle of interpretation. Topics include the history of hermeneutics, the development of philosophical hermeneutics by philosophers Martin Heidegger and Hans-Georg Gadamer and its use in the analysis of pragmatist thinkers Richard Rorty, Stanley Fish and Richard Shusterman.

The question how to optimize consumption and portfolio choice over the life cycle has been widely discussed in the literature so far. In this paper we concentrate on a retiree's optimal consumption and portfolio selection over his remaining years of life. We apply the logistic model of mortality thus modeling the empirically observed increase of mortality during the retirement period. The optimal consumption strategy and portfolio choice are established by reducing the Hamilton-Jacobi-Bellmann equation to the explicit solution of an ordinary differential function (ODF) that includes the mortality rate. A general finding is that the Merton-Samuelson result of constant portfolio choice for a constant mortality is confirmed for arbitrary mortality. The portfolio choice is only influenced by risk and return of assets and the retirees’ risk aversion. To get the specific optimal consumption strategy in a realistic situation the logistic model of mortality has been fitted to the data of the Statistical Yearbook for the Federal Republic of Germany 2006/2008. The optimal initial value for the ODF is obtained by numerical methods. The solution provides a large increase in the ratio of optimal consumption to wealth up to about 92 years followed by a sharp decrease. A bequest motive dampens the magnitudes of the ups and downs of the consumption ratio but does not change the basic shape. [ABSTRACT FROM PUBLISHER]