The role of SDH2 gene in the environmental adaptability of Candida albicans / 药学实践杂志

Objective To investigate the role of SDH2 gene in the environmental adaptability of Candida albicans. Methods Wild-type C. albicans strain SC5314, SDH2 gene knockout mutant sdh2Δ/Δ and reintegrated strain sdh2Δ/SDH2 were used as experimental objects. Spot assay was conducted to assess the sensitivity of the WT C. albicans strain SC5314, SDH2 gene knockout mutant sdh2Δ/Δ and reintegrated strain sdh2Δ/SDH2 to external stress stimulants and antifungal drugs. The effect of SDH2 gene deletion on drug efflux ability of C. albicans was determined by rhodamine 6G efflux assay. Results After SDH2 gene deletion, C. albicans showed slight tolerance to cell wall stress stimulants caffeine, oxidative stress stimulators diamide and menadione. Notably, the sensitivity of SDH2 gene knockout mutant sdh2Δ/Δ to azole antifungal drugs was significantly increased. The drug efflux capacity of C. albicans was decreased due to the deletion of SDH2 gene. Conclusion SDH2 gene deletion lead to changes in environmental adaptability of C. albicans, including changes in response to external environmental stress and increased sensitivity to azole antifungal drugs. The development of fungal-specific inhibitor targeting SDH2 gene may lead to the discovery of new antifungal drugs which have synergistic effect with azole drugs.

The Concept of Community-based Inclusive Development (CBID) and its Application for Human Resource Development of Inclusive Society and Education of SDH / 医学教育

The multicultural coexistence with increasing number of foreigners has been promoted in Japan. In this paper, the authors introduce the concept of community-based inclusive development (CBID) and CBR Matrix as an useful tool to understand not only the situation of foreigners but low income families and social withdrawals, to visualize community resources, and to learn Social Determination of Health (SDH) which is one of the curriculum of medical education. The paper contains explanation of SDH which is included in the core model curriculum of medical education, historical background of CBID and CBR Matrix. It also includes practices in the community and educational practicum at the medical school which both are engaged by authors respectively.

Colorectal Cancer Modeling and Difference Analysis in Cold and Heat Conditions / 中国实验方剂学杂志

Objective:To explore the correlation between the occurrence of colorectal cancer and different internal environment （cold and heat）. Method:The 70 Wistar rats （male and female） were randomly divided into blank group （10 cases）， cold model group （30 cases） and heat model group （30 cases）. The cold syndrome model was made by intragastric infusion of cold water （0 ℃） and soaking in cold water （10 ℃）. The heat model was made by ethanol （30%） and capsaicin solution （0.9 g·L-1）. The blank group was given normal saline by gavage， 10 mL·kg-1·d-1， for 5 consecutive weeks. The colorectal cancer model was made by subcutaneous injection of DMH solution in the back of neck in the cold model group and heat model group at the 6th week， 25 mg·kg-1，once a week，for 12 consecutive times. During the carcinogenesis， only 30% ethanol solution was given to the heat model group， and the modeling was maintained in cold model group， 10 mL·kg-1·d-1， for 38 weeks. The general state of the rats in each group was observed， and the changes of food intake and body weight were measured. At the 27th， 29th， 32th， 35th and 38th weeks， samples were collected in batches. Intestinal tissues were subjected to hematoxylin-eosin staining （HE） and detection of sodium， potassium-adenosine triphosphate （Na+ K+-ATP）， calcium， magnesium-adenosine triphosphate （Ca2+ Mg2+-ATP） activity， lactate dehydrogenase （LDH） activity and succinate dehydrogenase （SDH） activity. Result:The symptoms of hematochezia and ascites in cold model group were earlier than those in heat model group. As compared with the blank group， the food intake and body weight were decreased in cold model group and heat model group. As compared with the blank group， the length of the large intestine was shorter in cold model group at the 32nd and 35th week （P<0.05）， the activities of Na+ K+-ATP， Ca2+ Mg2+-ATP increased significantly in heat model group at the 27th， 29th and 38th week （P<0.05， P<0.01）， the SDH enzyme activity was decreased in the cold model group at the 29th and 35th week （P<0.05， P<0.01）， the SDH enzyme activity was significantly increased in the heat model group at the 38th week （P<0.01）. At the 27th week， LDH enzyme activity was significantly reduced in cold model group （P<0.01）. The LDH activity was increased significantly in heat model group at 29th and 32nd week （P<0.05， P<0.01）. As compared with the heat model group， the large intestine texture of the cold model rats showed greater brittleness， aggravated fibrosis， more obvious fibroproliferative characteristics， higher tumor incidence， and more serious tumor differentiation. The Na+ K+-ATP， Ca2+ Mg2+-ATP enzyme activities of the cold model rats were significantly reduced at 27th， 29th， and 38th weeks （P<0.01）， the SDH enzyme activity was significantly reduced in the cold model rats at 29th and 38th weeks （P<0.01）， the LDH activity was reduced in the cold model group at 32nd week （P<0.05）. Conclusion:Cold environment for colorectal cancer promotes tumorigenesis， and the hot environment can also promote tumorigenesis in a later stage.

Modelo conceitual aplicável a estudos sobre determinantes sociais da saúde em municípios brasileiros / A conceptual model for studies on social determinants of health in Brazilian municipalities

Resumo Os modelos conceituais de determinantes sociais da saúde (DSS) disponíveis na literatura, embora úteis para compreensão dos mecanismos que afetam os resultados do sistema de saúde sobre as condições de vida das populações, apresentam limitações quanto à sua aplicação em estudos empíricos e, consequentemente, na orientação da gestão de políticas públicas de saúde. Isso ocorre porque as categorias adotadas por esses modelos não são adequadamente representadas por indicadores ou variáveis homogêneas, sujeitas a manipulações matemáticas ou estatísticas em um sistema simples de relacionamentos. Este estudo tem por objetivo contribuir para o preenchimento dessa lacuna, ao propor um modelo conceitual de DSS passível de aplicação operacional, ou seja, de ser reproduzido em modelos matemáticos ou estatísticos, a fim de subsidiar estudos e definir estratégias de saúde pública. O esforço recorre à literatura para revisar modelos conceituais consagrados, identificar um conjunto de DSS e apresentar recomendações e critérios de escolha. Na sequência, identifica fontes de dados confiáveis que disponibilizem indicadores e variáveis dispostos em séries históricas e propõe o desenho de um modelo conceitual aplicável, cuja operacionalização requer métodos e ferramentas próprios de uma abordagem sistêmica.

Abstract The conceptual models of Social Determinants of Health (SDH) available in the literature, although useful for comprehending mechanisms that affect the results of the health system on the living conditions of the population, present limitations regarding their application in empirical studies and, consequently, in guiding public health policies. This occurs because the categories adopted by these models are not adequately represented by indicators of homogeneous variables subject to mathematical or statistical manipulations in a simple relation system. This study aims to help filling this gap by proposing an operationally applicable SDH conceptual model - reproducible as a mathematical or statistical model - to support studies and define strategies concerning public health. We resorted to the literature to review previously developed conceptual models, identifying a set of SDH and presenting recommendations and choice criteria. Then we located reliable data sources supplying indicators and variables listed in historic series and proposed an applicable conceptual model, which requires specific methods and tools for a systemic approach for operationalization.

Community Diagnosis Fieldwork as Job Training for New Employees of a Community Hospital: SDH Education for an Inter-Professional Group / 医学教育

We reviewed the Community Diagnosis Field Work (CDFW) that we have been working on since 2004 at the local general hospital and examined the possibility of Social determinates of health (SDH) education. A multi-professional group consisting of 6-8 new employees, surveyed the community for several months with the help of support staff, and presented the results. Many of the previous surveys were eventually related to SDH. In the questionnaire after the presentation, many learners cited multidisciplinary learning as their own achievements, and support staff cited many studies on SDH. Among doctors, 70% felt that the experience of this CDFW was "helpful" for their medical care, and specifically mentioned that they learned "multi-professional collaboration" and "the importance of knowing the community" . "Teaching is learning" is also important in SDH education.

Curriculum to Learn Social Determinants of Health at Mie University Faculty of Medicine / 医学教育

Health disparity is an emerging issue in our society. It occurs in connection with an aging population, uneven distribution of health sectors or the collapse of medical care systems in rural communities. Accordingly, future health professionals should learn more about social determinants of health (SDH). Mie University Faculty of Medicine has conducted international health electives in Asian and African countries and education about community-based health profession all over the Mie prefecture. Moreover, a lecture entitled “Global Health and Community Medicine” was launched based on the concept that both topics share common aspects of SDH.　In this article, I will report educational programs at Mie University, that provide medical students with opportunities to learn SDH.

Teaching and Learning Social Determinants of Health (SDH) in Times of Social Disparity / 医学教育

In the Model Core Curriculum for Medical Education revised in 2016, the aim to teach "social determinants of health (SDH) " appeared for the first time. In times of social disparity, socio-economic conditions, including unemployment and low income, sometimes discourage people from doing follow up visits to the clinic due to the copay. This happens despite the universal coverage of health insurance. The socio-cultural environment also affects individual health. For example, the sexual minority suffers from depression and suicidal risk due to prejudice in our society. The WHO states that SDH are mostly responsible for health inequities and should be tackled by health professionals. In this article, we discuss why we should teach medical students SDH and how we could implement the program to an already overloaded curricula.

A Clinicopathological study of subdural membranes

Background: One of the most common neurosurgical entities is chronic subdural hematoma and its characteristic presence of enveloping subdural membranes. The membrane study acts as a rough guide to estimate the time since injury, the nature of the entity and the associated clinical condition. Aim and objectives: To study the demographics, incidence, symptomatology, neurological status, histopathology, risk factors, diagnosis, treatment and outcome of the patients presenting with subdural membranes. Materials and methods: The study was conducted in the Department of Neurosurgery, Government General Hospital (GGH), Kakinada (referral teaching hospital of Rangaraya Medical College). The study population comprised of all patients from both sexes who were diagnosed to have subdural collections with membranes that presented in GGH during the study period. Patients who met inclusion criteria had their independent variables ascertained were included in the study. The study was designed as prospective study. Neurological status, symptomatology, histopathology and Postoperative outcome were assessed immediately after surgery in the ward, and then two weeks and one month afterwards in the OPD. Relevant investigations were done as patient‘s condition dictated. Results: A total of 19 patients were included in the study for the final analysis. All the patients presenting with the diagnosis of Chronic Subdural Hematoma, or diagnosed after screening for symptoms suggestive of subdural collections were included in the study. CT/ MRI scan was used for diagnosis and preoperative evaluation of the patients. After procedure the specimen was sent for pathological evaluation. All the patients were thoroughly examined clinically and findings noted. The Pathological reports according to Nagahori, et al was followed and was noted. Surgical management was offered for all the patients. All the patients were evaluated preoperatively for any co-morbidity Premjit Ray M, Kodandagirirao D, Vijayasekhar Manda, Mahipal Rathod. A Clinicopathological study of subdural membranes. IAIM, 2018; 5(1): 70-76. Page 71 and managed accordingly, to be fit for surgical procedure. Adequate blood was reserved. Patient and attendants were explained in detail about the nature history of the disease, the prognosis and the need for surgery with its associated complications. Informed consent was obtained for surgery. Post operatively, antibiotics were given and patients observed for any CSF leaks, wound infection or meningitis. Patients were discharged after 7-9 days post-operatively. Neurological status was assessed at discharge and follow up. It was noted that most common age group affected was between 61-70 years, males were more commonly affected than females. Most common risk factors were hypertension 47.38% followed by diabetes 21.05%. Most commonly associated risk factor noted in the present study was both alcoholism with smoking. Most common presenting symptom was hemiparesis 52.6% followed by headache 29.41%. Most common type of membrane in our study was Type III 68.38% followed by Type II 15.58%. Most common type of membrane in our study was Type III 68.38% followed by Type II 15.58%. Most common type of lesion encountered in our study was chronic followed by acute on chronic. Most lesions were observed on the right side. Most common site of lesion was fronto-parietal followed by fronto-temporoparietal in location. Associated lesions were seen in 57.86% of cases. Generally outcome based on (GCS) preoperative and postoperative scores were good in about 78.90%. Generally outcome based on (GCS) preoperative and postoperative scores were good in about 78.90%. Conclusion: This study underlines that craniotomy and subtotal membranectomy is still an acceptable, safe, efficient and even a better procedure for patients presenting with subdural membranes.

Variability of Head Injury & Intracranial Hemorrhages in Relation to Sex & Different Age Groups - A study.

Background: With growing population, rapid urbanization and industrialization associated with high materialistic mind of human beings, incidence of unnatural deaths increasing in geometrical progression. Out of all unnatural deaths trauma plays the major role and head is the most vulnerable part to receive injuries in different manners. Methods: The present work was conducted in the department of Forensic Medicine & Toxicology of M.K.C.G Medical College, Berhampur during the period from 01.01.2004 to 31.12.2005 and 207 cases of head injuries brought for post-mortem examination were taken into consideration as study materials. Each individual case was analyzed thoroughly with special attention to different types of intra cranial hemorrhage with relation to nature of trauma & other modified intrinsic and extrinsic factors. Results: It was found that all types of ICH are significantly found in males in all age groups of 11- 40 years i.e. 86 Males out of total 182(47.25 %) in compare to females i.e. 20 out of 182 (10.98%) and the type of hemorrhage was the SDH followed by mixed varieties. No remarkable sex wise differences were detected in the age group of 0-10 and 70 years and above. Conclusion: The autopsy surgeons are advised to open the cranial cavity in every case and to inspect the intracranial structures in detail.

Cloning,expression and functional identification of secoisolariciresinol dehydrogenase gene from Dysosma versipellis callus / 中国中药杂志

Secoisolariciresinol dehydrogenase (SDH) is a key enzyme involved in the biosynthetic pathway of podophyllotoxin.In this study, two SDH candidate genes,SO282 and SO1223, were cloned from callus of Dysosma versipellis by homology-based PCR and rapid amplification of cDNA end (RACE).The SDH candidate genes were expressed in Escherichia coli and the subsequent enzyme assay in vitro showed that recombinant SO282 had the SDH activity. These results pave the way to the follow-up investigation of the biosynthetic of podophyllotoxin.

Reproductive toxicity of 2,4-D butylate to male mice / 中国比较医学杂志

Objective To explore the reproductive toxicity of 2,4-D butylate to the testis in male mice.Methods Forty-eight ICR male mice were randomly divided into four groups : the control group, and three 2,4-D butylate experimental groups (10, 20, 40 mg/kg), 12 mice in each group.2,4-D butylate was intragastrically administered once a day and six days per week for five weeks .At the end of the exposure, the activities of total antioxidant capacity (T-AOC), Na+ K+-ATPase, Ca+ + Mg+ +-ATPase, lactate dehydrogenase (LDH) and succinate dehydrogenase (SDH) in testis homogenate were measured by spectrophotometry .Results The activity of T-AOC was gradually decreased with the increase of doses, with a significant difference between the high dose group and other groups .The activities of LDH in the moderate and high dose groups were significantly lower than those of the low dose group and control group , and there was a significant difference between the high dose group and moderate dose group .The activities of SDH in the testis was gradually decreased with the increase of the 2,4-D butylate dose, showing significant differences between the high dose group and the moderate dose and control groups , and between the high and moderate dose groups and the low dose group . The activities of Na +K +-ATPase in the moderate and high dose groups were significantly lower than that of the control and low dose group.The activities of Ca++Mg++-ATPase was significantly lower in the experimental groups than that in the control group.Conclusion Exposure to 2,4-D butylate has certain toxic effect on the testicular tissue in male mice .

Cloning, expression, purification and assay of sorbitol dehydrogenase from "Feicheng" peach fruit (Prunus persica)

A gene encoding NAD+-dependent sorbitol dehydrogenase (SDH) in peach fruit was cloned and expressed in Escherichia coli. Recombinant SDH protein with 6×His-tagged was localized exclusively in the cytoplasmic soluble fraction of E. coli when the strains were grown for 4-5 h at 37 ºC. Highly pure protein was isolated by Ni2+-resin chromatography with 150 mM imidazole in 50 mM Tris, pH 8.0, by elution. In order to ensure that the recombinant SDH could be used for further study, the fluorescence and ultraviolet spectrum of the recombinant SDH were detected. Recombinant SDH was confirmed to be capable of oxidizing sorbitol by enzymatic activity assay. The activity of the recombinant SDH was 2.73 U mg-1min-1, which was similar with that directly extracted from peach fruits. The activities of SDH extracted from the fruits in different periods (30, 60, 90 days after flowing) were 7.75, 5.95, 3.26 U mg-1min-1, respectively.

Effect of cypermethrin on selected dehydrogenase enzymes in muscle and heart tissues of albino rats.

This study reveals significant variations in dehydrogenase enzymes on administration of oral, sublethal (41mg/kg) doses of cypermethrin as single, double and multiple doses with 48hr intervals. Glucose-6-phosphate dehydrogenase (G-6-PDH) and lactate dehydrogenase (LDH) activities were increased, whereas succinate dehydrogenase (SDH) and malate dehydrogenase (MDH) activities were significantly decreased in muscle and heart tissues of albino rats, in a dose and time dependent manner. G-6-PDH is a key enzyme of HMP pathway. This pathway serves to generate glycolytic intermediates for the production of energy to tolerate toxic stress. SDH is a vital enzyme of citric acid cycle, and catalyses the reversible oxidation of succinate to fumarate. LDH activity shows an increase during anaerobic conditions to meet the energy demands. MDH activity depends on fluctuations of oxidative metabolism, and also reflects the turnover of carbohydrates and energy output.

Effect of Medicated Serum of Lizhong Bolus on ICC / 浙江中医药大学学报

[Objective] To explore the effects of medicated serum of Lizhong Bolus on ICC.[Methods] To observe the regulatory effects of medicated serum of Lizhong Bolus on activity of Ca2+-ATPase,SDH and LDH in ICC by the methods of culture in vitro and Serum Pharmacology.[Result]The medicated serum of Lizhong Bolus could obviously improve the activity of Ca2+-ATPase and SDH in ICC(P

Effects of Xiaoyingqiangji Decoction on Mitochondria in Skeletal Muscle of Hyperthyroid Myopathy / 中国康复理论与实践

@#Objective To observe the effect of Xiaoyingqiangji decoction on mitochondria in skeletal muscle of hyperthyroid myopathy. Methods Healthy Wistar rats were randomly divided into 4 groups: the group of hyperthyroid myopathy were given L-thyroxine intraperitoneal injection for 42 d; Chinese medicine treated group were treated with Xiaoyingqiangji decoction for 30 d after L-thyroxine injection; the saline control group were given saline solution for 30 d after L-thyroxine injection; normal control group were given saline solution. Then the skeletal muscles were obtained and the succinate dehydrogenase (SDH) were measured. The ultrastructural changes were observed with TEM. Results The activity and content of SDH in the group of hyperthyroid myopathy decreased, and the cristae of mitochondria ruptured and even disappeared. After given Chinese medicine, the activity and content of SDH increased, while the mitochondria showed normal ultrastructural appearance. Conclusion Xiaoyingqiangji decoction can improve the function of skeletal muscles in hyperthyroid myopathy by recovering enzyme activity and mitochondria structure.

THE FUNCTIONAL PROPERTIES OF VERY SMALLER MYOFIGERS IN REGENERATED SKELETAL MUSCLE AFTER EXERCISE-INDUCED MUSCLE INJURY / 体力科学

Markedly smaller myofibers including branched myofibers (SF) were contained in regenerated skeletal muscles. However, its functional properties are not yet sufficiently understood. The present study examined the metabolic, contractile properties and hypertrophy of SF included in rat skeletal plantaris muscles regenerated from eccentric contraction-induced muscle injury. Succinate dehydrogenase and alpha-glycerophosphate dehydrogenase activity of SF were respectively similar to that of other normal size myofibers (NF) within regenerated muscles. The shortening velocity of skinned fibers prepared from branched myofibers isolated from regenerated muscles was slightly slower than that of control muscles. In addition, the extent of glycogen depletion in SF was similar to that of NF after exhaustive running. Therefore, SF were innervated by motoneurons and recruited during the contractile activity of the skeletal muscle. No matter when the regenerated muscle was loaded by synergistic ablation, the continued existence of SF was observed. Therefore, the ability of hypertrophy in SF may be distinct from that in NF. The physiological properties of SF were similar to that of normal myofiber, except for the ability to regulate hypertrophy.

Effect of Ovariectomy and Genistein on Hepatic Mitochondrial Function

Women with menopause or rats with ovariectomy is associated with increased body weight, body fat and insulin resistance, which are components of metabolic syndrome. Increased prevalence of metabolic syndrome after menopause might be associated with mitochondrial dysfunction, since mitochondrial oxidative and phosphorylation activity is strongly correlated with insulin sensitivity. Although estradiol replacement prevents the metabolic syndrome, harmful effect of estradiol hampers the casual usage to prevent the metabolic syndrome. It has been reported that genistein has a mild estrogenic activity, decreases fat mass in mice and has an antidiabetic role in diabetic rats. Although insulin resistance is closely related to mitochondrial functions, there has not been yet any study in regard to the effect of dietary genistein on mitochondrial function in the insulin resistant female subjects induced by ovariectomy or similar situation. The present study investigated whether the supplementation of genistein in the high fat diet affected the mitochondrial function of high fat fed ovariectomized rats. Female Sprague Dawley rats (8 weeks old) were assigned to the following groups: sham-operated + high fat diet (S, n = 6); sham-operated + high fat diet with 0.1% genistein (S + G, n = 7); ovariectomized + high fat diet (OVX, n = 8); ovariectomized + high fat diet with 0.1% genistein (OVX + G, n = 8). Ovariectomy significantly increased body weight compared with S group. Genistein consumption in ovariectomized (OVX + G) rats decreased body weight gain compared with OVX rats. Liver weights were increased by ovariectomy. The hepatic mitochondrial protein density expressed as mg per g liver was lower in the OVX group than in the S group. However, OVX + G group showed the increased mitochondrial protein density similar to the level of S group. When mRNA levels of genes related to mitochondria such as peroxisome proliferator-activated receptor gamma coactivator 1 (PGC-1) and cytochrome c oxidase subunit III (COX III) were measured, there were decreases in the mRNA levels of PGC-1 and COX III in S + G, OVX and OVX + G group. The activity of cytochrome c oxidase was not different between groups. We could observe the decrease in succinate dehydrogenase (SDH) activity per g liver in OVX rats. Genistein supplement increased SDH activity. In conclusion, genistein supplementation to the OVX rats enhanced mitochondrial function by increasing mitochondrial protein density and SDH activity. The improvement in mitochondrial function by genistein can contribute to the improvement in metabolic syndrome.

A Case Report of Acute Encephalopathy by Aluminum Intoxication with Subdural Hematoma in End Stage Renal Failure / 대한신장학회잡지

Despite of the improved water purification system, the decreased use of aluminum based phosphate binding gels and periodic determination of serum aluminum levels, aluminum accumulation cannot be eliminated. We experienced a case of acute encephalopathy in aluminum intoxication with subdural hematoma presenting myoclonic jerk and mental change in a end stage renal failure. She was treated succesfully with low dose DFO treatment for 3 month.

A Quantitative and Morphological Study on Cochlear Hair Cell Underwent Diagnostic Ultrasound Exposure in Fetal Guinea Pigs / 中国医师杂志

Objective To investigate the effect of diagnostic ultrasound on cochlear hair cells in fetal guinea pigs. Methods Diagnostic ultrasound was used to irradiate the uteri of early pregnant guinea pigs(the first 15 days of gestion) and late pregnant guinea pigs(the 40th to 45th days of gestion) for 5 minutes daily. The number of cochlear hair cells in fetal guinea pigs was calculated using succinic dehydrogenase (SDH) staining, and computer image analysis system. The morphological change of cochlear hair cells was observed with scanning electron microscope(SEM). Results Compared with non-exposed control group, the number of total hair cells obviously decreased in the two exposed groups (P

Pontine Hemorrhage after Surgical Evacuation of Nontraumatic Subdural Hematoma

Duret hemorrhage is characterized by an upper brainstem hemorrhage due to increased intracranial pressure by mass effect such as subdural hematoma or a brain tumor. The anteroposterior elongation and downward displacement of the upper brainstem by transtentorial herniation results in the compression and tearing of the paramedian perforating vessels that feed the upper brainstem tegmentum. The consequent hemorrhage that involves the upper brainstem renders recovery to be almost impossible. Following a tricuspid valve replacement surgery, a 56-year-old woman developed a left fronto-temporo-parietal nontraumatic subdural hematoma resulting in transtentorial herniation of the left mesial temporal lobe. A successful surgical evacuation of the hematoma was done with clinical improvement. Two days later, she was referred to neurology with an aggravated right side weakness, dysarthria, and a newly developed extraocular movement disturbance. A brain CT and MRI showed a pontine hemorrhage. We report a case of pontine hemorrhage, a Duret hemorrhage, after the surgical evacuation of nontraumatic subdural hematoma.