title stringlengths 0 1.13k | abstract stringlengths 1 15.7k | PMID int64 22 36.5M |
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In situ gamma-radiation: one-step environmentally benign method to produce gold-palladium bimetallic nanoparticles. | Synthesis of gold-palladium bimetallic nanoparticles using in situ radioactivity from (198)Au isotope is reported in this paper. Gold solution spiked with (198)Au(III) has been mixed with PdCl2 solution in measured proportions in 50% polyethylene glycol solution. Au(III) and Pd(II) are reduced, and nanoparticles are formed due to radiolysis of the polymer solution. The solution has been characterized by UV-visible spectra, and the actual size has been determined using transmission electron microscopy in conjugation with energy dispersive X-ray measurements. | 18,729,470 |
Control of ion distortion in field asymmetric waveform ion mobility spectrometry via variation of dispersion field and gas temperature. | Field asymmetric waveform ion mobility spectrometry (FAIMS) has emerged as an analytical tool of broad utility, especially in conjunction with mass spectrometry. Of particular promise is the use of FAIMS and 2-D ion mobility methods that combine FAIMS with conventional IMS to resolve and characterize protein and other macromolecular conformers. However, FAIMS operation requires a strong electric field, and ions are inevitably heated by energetic collisions with buffer gas molecules. This may induce ion isomerization or dissociation, which distort the separation properties of FAIMS (and subsequent stages) or reduce instrumental sensitivity. As FAIMS employs a periodic waveform, whether those processes are controlled by ion temperature at maximum or average field intensity has been debated. Here we address this issue by measuring the unfolding of compact ubiquitin ion geometries as a function of waveform amplitude (dispersion field, E(D)) and gas temperature, T. The field heating is quantified by matching the dependences of structural transitions on E(D) and T: increasing E(D) from 12 to 16 or from 16 to 20 kV/cm is equivalent to heating the (N2) gas by approximately 15-25 degrees C. The magnitude of field heating for any E(D) can be estimated using the two-temperature theory, and raising E(D) by 4 kV/cm augments heating by approximately 15-30 degrees C for maximum and approximately 4-8 degrees C for average field in the FAIMS cycle. Hence, isomerization of ions in FAIMS appears to be determined by the excitation at waveform peaks. | 18,729,473 |
Systematic investigation of optimal aptamer immobilization for protein-microarray applications. | Aptamers are short single-stranded DNA or RNA oligonucleotides that can bind to a wide range of target molecules with high affinity and specificity. As nucleic acids, aptamers can undergo denaturation, but the process is reversible. As a result of this stability and the possibility of automated selection of aptamers, these oligonucleotides are highly promising capture molecules in microarray formats. In this study, his-tagged proteins and an aptamer directed against the his-tag were chosen as a model system. Different factors affect the activity of aptamers immobilized on a solid support like a microarray surface. The orientation of the immobilized aptamer plays an important role in correct aptamer folding and, thus, in effective binding of the corresponding target. Other important parameters identified in this work are the microarrays' surface charge as well as the length of the spacer between aptamer and solid support. These parameters were investigated systematically, resulting in the development of an aptamer-based microarray for detection of his-tagged proteins. The general applicability of the developed immobilization strategy was demonstrated by utilization of three different aptamers. | 18,729,475 |
Advances in molecular design and synthesis of regioregular polythiophenes. | Regioregular poly(3-alkylthiophene)s (rrP3ATs) are an important class of pi-conjugated polymers that can be used in plastic electronic devices such as solar cells and field-effect transistors. rrP3ATs can be ordered in three dimensions: conformational ordering along the backbone, pi-stacking of flat polymer chains, and lamellar stacking between chains. All of these features lead to the excellent electrical properties of these materials. Creative molecular design and advanced synthesis are critical in controlling the properties of the materials as well as their device performance. This Account reports the advances in molecular design of new functional polythiophenes as well as the associated polymerization methods. Many functionalized regioregular polythiophenes have been designed and synthesized and show fascinating properties such as high conductivity, mobility, chemosensitivity, liquid crystallinity, or chirality. The methods for the synthesis of rrP3ATs are also applicable to other functional side chains. Di- and triblock copolymers consisting of rrP3AT and polyacrylate or polystyrene have also been successfully synthesized, which can facilitate the assembly of the polythiophene segments. The synthesis of rrP3ATs has evolved into a simple and economical system in which the synthesis can be carried out quickly at room temperature and is thus suitable for large-scale manufacturing. Intensive study has revealed that the regioregular polymerization of 3-alkylthiophenes proceeds by a chain-growth mechanism and can be made into a living system. This feature enables precise control of the molecular weight and facile end-group functionalization of the polymer chains, leading to tailor-made regioregular polythiophenes for specific applications. In addition, researchers have recently designed and synthesized regiosymmetric polythiophenesthese are regioregular but not coupled in a head-to-tail fashionby various methods. These reports indicate that these regiosymmetric polymers show very high mobilities when used in field-effect transistors due to their highly ordered structure. The remarkable performance of regioregular polythiophenes in recent years has allowed for the rapid development in printable electronics and seems destined to lead to further advances in this field. | 18,729,480 |
Adsorption hysteresis in self-ordered nanoporous alumina. | We performed systematic adsorption studies using self-ordered nanoporous anodic aluminum oxide (AAO) in an extended range of mean pore diameters and with different pore topologies. These matrices were characterized by straight cylindrical pores having a narrow pore size distribution and no interconnections. Pronounced hysteresis loops between adsorption and desorption cycles were observed even in the case of pores closed at one end. These results are in contrast with macroscopic theoretical models and detailed numerical simulations of the adsorption in a single pore. Extensive measurements involving adsorption isotherms, reversal curves, and subloops carried out in closed-bottom pores suggest that the pores do not desorb independently from one another. | 18,729,482 |
Interaction forces between silica surfaces in aqueous solutions of cationic polymeric flocculants: effect of polymer charge. | Three cationic polymers with molecular weights and charge density of 3.0 x 10(5) g/mol and 10% (D 6010), 1.1 x 10(5) g/mol and 40% (D6040), and 1.2 x 10(5) g/mol and 100% (D6099) were investigated in aqueous NaCl solutions in the presence of silica. The atomic force microscope (AFM) colloidal probe technique was used to determine silica interparticle interaction forces, which were compared to macroscopic information on the strength of interactions such as compressive yield stress measurements. It was found that in 30 mM NaCl solution the 10% charged polymer produced steric repulsion upon approach and long-range adhesion with multiple pull off events upon retraction at the optimum flocculation concentration. This suggests that the polymer was adsorbed in a conformation where segments extend from the surface, resulting in bridging flocculation. The 40 and 100% charged polymers produced attraction upon approach and strong adhesion with snap out from contact upon separation at optimum polymer dosages. This suggests that these polymers are adsorbed with flat conformations and is typical of charge neutralization or patch attraction. The attractions for 40 and 100% charged polymers measured with the AFM are significantly larger than for the 10% charged polymer. The polymer dose that produced the optimum flocculation and the maximum compressive yield stress typically corresponded to the polymer concentration that produced the maximum adhesion for each polymer. It was found that the magnitude of the adhesive force was more significant in determining the compressive yield stresses of the silica particle sediments than the aggregate size and structure. | 18,729,484 |
Structural and dynamical properties of hydrogen fluoride in aqueous solution: an ab initio quantum mechanical charge field molecular dynamics simulation. | The novel ab initio quantum mechanical charge field (QMCF) molecular dynamics simulation at the Hartree-Fock level has been employed to investigate hydration structure and dynamics of hydrogen fluoride in aqueous solution. The average H-F bond length of 0.93 A obtained from the QMCF MD simulation is in good agreement with the experimental data. The HHF...Ow distance of 1.62 A was evaluated for the first hydration shell, and 2.00 A was observed for the FHF...Hw distance. The stability of hydrogen bonding is more pronounced in the hydrogen site of hydrogen fluoride, with a single water molecule in this part of the first hydration shell. A wide range of coordination numbers between 3 and 9 with an average value of 5.6 was obtained for the fluorine site. The force constants of 819.1 and 5.9 N/m were obtained for the HHF-FHF and HHF...Ow interactions, respectively, proving the stability of the nondissociated form of hydrogen fluoride in aqueous solution. The mean residence times of 2.1 and 2.5 ps were determined for ligand exchange processes in the neighborhood of fluorine and hydrogen atoms of hydrogen fluoride, respectively, indicating a weak structure-making effect of hydrogen fluoride in water. The corresponding H-bond lifetimes attribute this effect to the H atom site of HF. | 18,729,507 |
Poly(ethylene glycol) monolayer formation and stability on gold and silicon nitride substrates. | Poly(ethylene glycol) (PEG) self-assembled monolayers (SAMs) are extensively used to modify substrates to prevent nonspecific protein adsorption and to increase hydrophilicity. X-ray photoelectron spectroscopy analysis, complemented by water contact angle measurements, is employed to investigate the formation and stability upon aging and heating of PEG monolayers formed on gold and silicon nitride substrates. In particular, thiolated PEG monolayers on gold, with and without the addition of an undecylic spacer chain, and PEG monolayers formed with oxysilane precursors on silicon nitride have been probed. It is found that PEG-thiol SAMs are degraded after less than two weeks of exposure to air and when heated at temperatures as low as 120 degrees C. On the contrary, PEG-silane SAMs are stable for more than two weeks, and fewer molecules are desorbed even after two months of aging, compared to those desorbed in two weeks from the PEG-thiol SAMs. A strongly bound hydration layer is found on PEG-silane SAMs aged for two months. Heating PEG-silane SAMs to temperatures as high as 160 degrees C improves the quality of the monolayer, desorbing weakly bound contaminants. The differences in stability between PEG-thiol SAMs and PEG-silane SAMs are ascribed to the different types of bonding to the surface and to the fact that the thiol-Au bond can be easily oxidized, thus causing desorption of PEG molecules from the surface. | 18,729,528 |
Cross-linked polynorbornene-coated gold nanoparticles: dependence of particle stability on cross-linking position and cross-linker structure. | This paper describes the preparation of cross-linked polynorbornene coated gold nanoparticles. The polymer was grown radially from the particle surface using a ring opening metathesis polymerization of norbornene and an electrophilic norbornene ester, which was cross-linked using a variety of diamines. The stability of the cross-linked nanoparticles toward oxidative etching by cyanide was evaluated. The rate of etching decreases as diamines with fewer degrees of conformational freedom are used as cross-linkers. The distance of the cross-linking block from the nanoparticle surface was systematically varied. Nanoparticles with the cross-linked block furthest from the surface were etched most slowly. This is suggested to arise as a result of the polymers adopting a mushroom conformation when the cross-linking block is close to the particle surface, while more distal cross-linking results in more rigid polymer chains that are less permeable to the cyanide etchant. These results provide new insight into how fine-tuning the polymer cross-linking architecture can modulate nanoparticle stability. | 18,729,530 |
Structure of microemulsion-ABA triblock copolymer networks. | Structural equilibrium properties of transient networks formed by microemulsion droplets and ABA triblock copolymers in solution have been studied by Monte Carlo simulation. The droplets were represented by soft spheres, and the polymers were represented by junctions connected by harmonic bonds with an angular potential regulating the intrinsic chain stiffness. The interaction parameters were selected such that the end A-blocks were localized inside the droplets and the middle B-block in the continuous phase. The influence of (i) the polymer concentration, (ii) the polymer stiffness, and (iii) the contour length of the middle B-block on the formation and the structure of the microemulsion-polymer network were investigated using polymer end-to-end separation probability distribution functions, droplet radial distribution functions, droplet-droplet nearest-neighbor probability distribution functions, and network connectivity indicators. An increase of the polymer-droplet number ratio had a strong impact on the network formation. Under typical conditions and at an intermediate polymer-droplet number ratio, (i) the fraction of polymers forming bridges between droplets increased from essentially zero to unity and (ii) the fraction of polymers that were forming loops decreased as the ratio of the polymer end-to-end separation and the surface-to-surface separation between neighboring droplets for a hypothetical homogeneous droplet distribution was increased from 0.5 to 2. For long and flexible polymers, a mesoscopic segregation triggered by a depletion attraction between droplets appeared, and, furthermore, for sufficiently stiff chains, only bridge conformations occurred. The percolation probability could be represented as a function of the average droplet cluster size only, across all systems. | 18,729,531 |
Pharmacological management of primary open-angle glaucoma: second-line options and beyond. | Glaucoma is one of the leading causes of blindness worldwide. Increased intraocular pressure (IOP) is considered to be the most important risk factor. Major outcome studies from recent years have shown that lowering IOP is beneficial in primary open-angle glaucoma and ocular hypertension. The introduction of new classes of IOP-lowering drugs (alpha(2)-adrenoceptor agonists, topical carbonic anhydrase inhibitors and hypotensive lipids) in the last decade has contributed to a change in the drug prescription pattern. Together with beta-adrenoceptor antagonists (beta-blockers), these drugs are now considered to be first-choice classes, giving ophthalmologists ample opportunities to choose from a broad spectrum of IOP-lowering drugs. The number of possible medical treatment combinations has increased likewise.We review medical treatment combinations of two, three or four drugs from the four major first-choice glaucoma drug classes and provide an overview of the scientific evidence for IOP efficacy of second-line medical options when first-line therapy has been effective but additional IOP lowering is necessary. A systematic search of the literature initially revealed 2729 publications. After a thorough selection process, 42 studies were found to be eligible for inclusion in the review. Publications were excluded if the primary endpoint of the study was not IOP or if glaucoma topics other than IOP lowering of drugs were studied. In addition, studies that reported results for monotherapies only were excluded. The vast majority of study arms reported on combinations of a beta-blocker with either a carbonic anhydrase inhibitor or a hypotensive lipid. For a number of treatment combinations no eligible studies were available or could be included.This review shows that combining drugs from the different first-choice classes results in an additional IOP decrease. The exact magnitude of this additional decrease and the patients to whom it applies remain unclear. In many studies, no information on IOP before the run-in phase was available. However, such data are important in order to determine whether patients with high untreated IOP or patients non-responsive to the run-in drug(s) were preferentially included. Another issue that hampers interpretation is the fact that the timepoints of measurements of IOP before and after adding a drug should be related to the peak and trough times of the drugs. Finally, differences between concomitant use and fixed combined use of drugs may have consequences for the interpretation of results. | 18,729,546 |
Aortoduodenal fistulas after endovascular stent-graft repair of abdominal aortic aneurysms: single-center experience and review of the literature. | To report a single-center experience with aortoduodenal fistula (ADF) after successful endovascular aneurysm repair (EVAR) of an infrarenal abdominal aortic aneurysm (AAA). Five patients (all men; mean age 68.4 years, range 60-75) developed an ADF between 18 days to 1 year after successful EVAR using 3 types of commercially available endografts: 1 bifurcated Anaconda, 1 unibody Powerlink, and 3 EndoFit stent-grafts in a tubular (n=1) or aortomonoiliac configuration (n=2). The internal iliac artery was not occluded in any of the cases. Hematemesis and diffuse abdominal pain constituted the main symptoms leading to the diagnosis of ADF, which was confirmed on computed tomography. Infection was the etiology of the ADF in 3 patients; all underwent emergency surgical exploration, but 1 died in hospital; the other 2 have survived from 1 to 3 years after an emergency procedure. The other 2 ADFs developed in patients with large type I endoleaks; 1 patient died before surgery could be performed and the other one 18 hours after laparotomy. All stent-grafts were removed; none displayed any defects. ADF is a rare but dangerous complication of EVAR. The sequela may be primarily attributed to graft infection, as seen in this series. However, the exact pathogenesis of the pathology remains largely unknown. Prompt diagnosis and intervention are crucial to avoid a fatal outcome. | 18,729,556 |
Prevalence of carotid stent fractures in a single-center experience. | To assess the prevalence of carotid stent fractures and quantify any associated restenosis or clinical events in a single-center experience. Seventy-eight consecutive patients were recorded in a prospective database between 2003 and 2007. Nearly two thirds (51, 65%) were available for follow-up, which included magnified multiplanar radiography and selective duplex ultrasonographic studies to evaluate fracture and restenosis in 53 self-expanding stents (49 open-cell and 4 closed-cell designs). The images were assessed independently by 2 vascular radiologists blinded to the patients' clinical data. There was 1 (1.9%) stent fracture with no associated adverse events or restenosis. Six (11%) stents had an irregular "fish-scale" appearance that was easily confused for fracture and seen only in the open-cell stents. Stent fractures do occur in the carotid artery; however, they are rare and, in our experience, have no clinical sequelae. Radiological assessment should be incorporated into clinical and ultrasound surveillance protocols. | 18,729,560 |
In vivo imaging of abdominal aortic aneurysms: increased FDG uptake suggests inflammation in the aneurysm wall. | To study the potential of integrated positron emission tomography and computed tomography (PET/CT) to identify aneurysm wall inflammation. The level of F18-fluorodeoxyglucose (FDG) uptake was studied in aneurysmal and normal-sized aortas of 34 male patients [17 with abdominal aortic aneurysm (AAA) and 17 age-matched controls] identified in a database of 278 consecutive patients evaluated for staging of primary lung cancer. The maximal standardized uptake value (SUV) was calculated to quantify FDG uptake in the AAA wall. AAAs showed significantly higher FDG uptake than the normal-sized aorta in age-matched controls (SUV 2.52+/-0.52 versus 1.78+/-0.45, respectively; p<0.001). The level of FDG uptake did not correlate with maximal aneurysm diameter (r=0.09; 95% CI -0.42 to 0.56; p=0.7). FDG-PET/CT is a promising technique to identify inflammation of the aneurysm wall. Irrespective of aneurysm diameter, asymptomatic AAAs show more FDG uptake and more inflammatory activity in the wall than the non-dilated abdominal aorta of sex/age-matched controls. Future studies will be directed at the predictive value of increased FDG uptake for aneurysm wall strength, rupture risk, and the utility of FDG-PET/CT in assessing the effect of medical interventions. | 18,729,562 |
False recognition of facial expressions of emotion: causes and implications. | This article examines the importance of semantic processes in the recognition of emotional expressions, through a series of three studies on false recognition. The first study found a high frequency of false recognition of prototypical expressions of emotion when participants viewed slides and video clips of nonprototypical fearful and happy expressions. The second study tested whether semantic processes caused false recognition. The authors found that participants made significantly higher error rates when asked to detect expressions that corresponded to semantic labels than when asked to detect visual stimuli. Finally, given that previous research reported that false memories are less prevalent in younger children, the third study tested whether false recognition of prototypical expressions increased with age. The authors found that 67% of eight- to nine-year-old children reported nonpresent prototypical expressions of fear in a fearful context, but only 40% of 6- to 7-year-old children did so. Taken together, these three studies demonstrate the importance of semantic processes in the detection and categorization of prototypical emotional expressions. | 18,729,583 |
Investigating models of affect: relationships among EEG alpha asymmetry, depression, and anxiety. | The approach-withdrawal and valence-arousal models both predict that depressive and anxious profiles will be associated with relatively reduced left frontal and increased right frontal activity respectively, while the valence-arousal model also proposes a dissociation by lower and higher right parietotemporal activity, respectively. Recent work further suggests that subtypes of anxiety disorders may be characterized by distinctive patterns of activity depending on their type of arousal (anxious arousal/apprehension). The aim of this study was to investigate the relationships among nonclinical depression/anxiety and lateralized frontal/parietotemporal activity by categorizing participants (N=428) on the basis of both negative mood and alpha EEG. Key findings include: (i) greater right frontal lateralization in anxious participants, symmetrical frontal activity in depressed/comorbid, and left frontal lateralization in healthy controls; (ii) right frontal lateralization in anxious arousal participants, left frontal and right parietotemporal lateralization in anxious apprehension; (iii) bilateral increase in frontal and increased right parietotemporal activity in depressed/comorbid participants. Findings support predictions for frontal but not posterior regions. Grouping on the basis of EEG may not be reciprocally predictive of negative mood groupings, suggesting involvement of additional factors. | 18,729,586 |
Emotional expression modulates perceived gaze direction. | Gaze perception is an important social skill, as it portrays information about what another person is attending to. Gaze direction has been shown to affect interpretation of emotional expression. Here the authors investigate whether the emotional facial expression has a reciprocal influence on interpretation of gaze direction. In a forced-choice yes-no task, participants were asked to judge whether three faces expressing different emotions (anger, fear, happiness, and neutral) in different viewing angles were looking at them or not. Happy faces were more likely to be judged as looking at the observer than were angry, fearful, or neutral faces. Angry faces were more often judged as looking at the observer than were fearful and neutral expressions. These findings are discussed on the background of approach and avoidance orientation of emotions and of the self-referential positivity bias. | 18,729,587 |
Variation in the serotonin transporter gene modulates selective attention to threat. | The 5-HTTLPR is an insertion/deletion polymorphism in the promoter region of the serotonin transporter gene. Prior research has revealed associations between the short-allele variant of this polymorphism, enhanced self-reported negative emotionality, and hypersensitivity of fear relevant neural circuits. In a sample of 50 healthy women we examined the role of 5-HTTLPR for cognitive-affective processing of phylogenetical fear-relevant stimuli (spiders) in a dot probe task. In contrast to homozygote long-allele carriers (ll), participants carrying at least 1 short allele (ss and sl) selectively shifted attention toward pictures of spiders, when these were presented for a duration of 2,000 ms. These results argue for an involvement of 5-HTTLPR in cognitive processing of threatening stimuli and thus, underpin its general role for individual differences in negative affect. | 18,729,589 |
Does heightened affect make smoking cues more salient? | Negative affect (NA) states are robustly related to relapse. However, the mechanisms for this relationship are not well understood. Whereas most models have proposed that NA directly promotes lapsing, some models suggest that NA may promote lapses indirectly by increasing reactivity to smoking cues. This hypothesis was tested in secondary analyses of a study in which 248 smokers used ecological momentary assessment to self-monitor affective valence, smoking cues, and lapses during an attempt to quit smoking. The smoking cues the authors examined were others' smoking and consumption of alcohol or coffee. The odds of lapsing when exposed to smoking cues were compared across conditions of positive affect, neutral affect, and NA. Consistent main effects of affective valence were seen but not the hypothesized interaction. Indeed, analyses showed that the effect of cues was typically diminished under conditions of NA. No evidence was found to support the hypothesis that smoking cues and lapsing are more closely linked under NA conditions. | 18,729,613 |
Suicidal ideation and its recurrence in boys and men from early adolescence to early adulthood: an event history analysis. | Occurrence and recurrences of suicidal ideation (SI) were modeled among boys/men assessed annually from ages 12 to 29 years. Multiple-spell discrete-time event-history analyses permitted (a) determination of whether risk for SI escalates with prior experiences of SI (spell effects), while (b) accounting for changes in risk with time (period effects) and (c) controlling for vulnerability factors. Self-reported SI (presence/absence in past week), depressive symptoms, alcohol/substance use, antisocial behavior, and official arrest records were collected annually from 205 boys recruited on the basis of community risk for delinquency. Parents' self-reported psychopathology and SES were collected in childhood. Period effects supported decreasing risk for SI over time. Spell and time-varying 1-year lagged substance use and depressive symptoms independently predicted increased risk for SI. Models involving SI with intent were explored. Consistent with interpersonal psychological theory, risk for young men's SI increases with past experience of SI, even with key propensities controlled. However, risk also decays over time. Targeting conditions that confer risk for SI is essential. Preventing and delaying SI occurrence and recurrence may represent independent mechanisms by which prevention efforts operate. | 18,729,614 |
A possible role for protein synthesis, extracellular signal-regulated kinase, and brain-derived neurotrophic factor in long-term spatial memory retention in the water maze. | Hippocampal protein synthesis is dependent upon a number of different molecular and cellular mechanisms that act together to make previously labile memories more stable and resistant to disruption. Both brain-derived neurotrophic factor (BDNF) and extracellular signal-regulated kinase (ERK) are known to play an important role in protein synthesis-dependent memory consolidation, via the mitogen-activated protein-kinase (MAP-K) signaling pathway during the transcription phase of protein synthesis. The current study investigates the influence of protein synthesis inhibition (PSI) by cycloheximide on spatial learning and memory. In an initial experiment, the authors utilized two doses of cycloheximide (0.5 mg/kg and 1.0 mg/kg, intraperitoneally) to determine the dose at which long-term (>24 hours) memories are impaired. A second experiment was designed to investigate the effect of PSI on the formation of cue-platform associations in the watermaze, and on BDNF and ERK expression in the hippocampus. At the higher dose (1.0 mg/kg) cycloheximide resulted in impaired retention of the water maze. BDNF and ERK expression was also down-regulated in animals injected with this dose of cycloheximide. Our results demonstrate a role of protein synthesis in spatial memory retention, along with a possible relationship between protein synthesis and hippocampal BDNF/ERK expression. | 18,729,634 |
Functional cortico-muscular coupling during upright standing in athletes and nonathletes: a coherence electroencephalographic-electromyographic study. | We tested the hypothesis that functional cortico-muscular coupling of brain rhythms is implied in the control of lower limb muscles for upright standing. Electroencephalographic (EEG; Be-plus Eb-Neuro) and electromyographic (EMG) data were recorded in 18 fencing and 19 karate elite athletes, 14 karate amateurs, and 9 non-athletes, during quiet upright standing with open and closed eyes conditions. Cortico-muscular coupling was evaluated by computing EEG-EMG spectral coherence and directed transfer function (DTF). Body sway area did not differ among the groups. In non-athletes, the EEG-EMG coherence (gastrocnemius lateralis) at centro-parietal and parasylvian alpha rhythms (about 8-12 Hz) was higher during the open than closed eyes condition. This was not true in the elite athletes. At the same alpha rhythms, the sport amateurs presented values halfway between the non-athletes and elite athletes. Finally, the DTF was higher for cortico-muscular than muscular-cortical direction. These results suggest that visual information affects cortico-muscular coherence at 8-12 Hz in non-athletes and amateur athletes but not in elite athletes. In elite athletes, this might be due to a long training for the control of equilibrium based on proprioceptive and tactile inputs. | 18,729,645 |
Mechanisms and evolution of synchronous chorusing: emergent properties and adaptive functions in Neoconocephalus katydids (Orthoptera: Tettigoniidae). | Synchronous interactions arise in various animal species that rhythmically broadcast acoustic, vibratory, and visual signals. These interactions are characterized by a coincidence in both rate and phase of the rhythms of neighboring signalers. Theory predicts several ways in which synchronized rhythms may specifically benefit the interacting signalers. However, synchrony may also arise as an emergent property, a default phenomenon that is neither preferred by conspecific receivers evaluating the signals nor advantageous to the signalers themselves. Here, we examine several well-studied cases of acoustic synchrony in Neoconocephalus katydids (Orthoptera: Tettigoniidae), a New World genus wherein males broadcast loud advertisement songs. We report that call synchrony found in N. spiza and N. nebrascensis results from two rather different mechanisms of rhythm adjustment. Moreover, synchrony in the former species appears to represent an incidental byproduct of signal competition between evenly matched males, whereas in the latter species synchrony functions as a specific adaptation in which cooperating males ensure that critical call features can be perceived by females. We discuss the separate evolutionary trajectories that may have led to similar outcomes, synchronous chorusing by advertising males, in these closely related species. | 18,729,657 |
Behavioral and emotional problems among Italian international adoptees and non-adopted children: father's and mother's reports. | This study intends to fill the gap in empirical research carried out in Italy regarding international adoptees' behavioral and emotional problems. Assuming a multi-informant approach, it aims to compare parents' reports of behavioral problems of adopted and non-adopted children and to examine parental agreement. The sample was composed of 186 adoptive couples and 195 biological couples with the target child between ages 7 and 11 years. The mother and father filled in the Child Behavior Checklist (CBCL) separately. Analysis of the CBCL revealed that adopted children are perceived by their parents as having more Total and Externalizing Problems than are their non-adopted counterparts. Moreover, they are more likely to demonstrate attention difficulties and aggressive behavior. The agreement between parents turned out to be moderate for adoptive parents and slightly lower for the biological ones. Consistent with most adoption research, the results confirm the higher risk of behavioral problems among adopted children. They also shed light on the significant perceptual discrepancy between mothers and fathers, underlining the importance of considering both parents' reports in the study of adopted children's adjustment. | 18,729,668 |
The transportability of multisystemic therapy to Sweden: short-term results from a randomized trial of conduct-disordered youths. | This randomized clinical trial assessed the effectiveness of multisystemic therapy (MST) for 156 youths who met the diagnostic criteria for conduct disorder. Sweden's 3 largest cities and 1 small town served as the recruiting area for the study. A mixed factorial design was used, with random allocation between MST and treatment as usual groups. Assessments were conducted at intake and 7 months after referral. With an intention-to-treat approach, results from multiagent and multimethod assessment batteries showed a general decrease in psychiatric problems and antisocial behaviors among participants across treatments. There were no significant differences in treatment effects between the 2 groups. The lack of treatment effect did not appear to be caused by site differences or variations in program maturity. MST treatment fidelity was lower than that of other studies, although not clearly related to treatment outcomes in this study. The results are discussed in terms of differences between Sweden and the United States. One difference is the way in which young offenders are processed (a child welfare approach vs. a juvenile justice system approach). Sociodemographic differences (e.g., rates of poverty, crime, and substance abuse) between the 2 countries may also have moderating effects on the rates of rehabilitation among young offenders. (PsycINFO Database Record (c) 2008 APA, all rights reserved). | 18,729,669 |
Psychological symptoms and marital satisfaction in spouses of Operation Iraqi Freedom veterans: relationships with spouses' perceptions of veterans' experiences and symptoms. | Much research has shown that spouses of combat veterans with posttraumatic stress disorder (PTSD) have higher rates of psychological and marital distress than do spouses of veterans without PTSD; however, very few studies have examined potential mechanisms of this increased vulnerability. The current study examined spouses of National Guard soldiers recently returned from deployments in Iraq. In addition to documenting elevated levels of psychological symptoms in these spouses, the authors found that spouses experienced greater symptom severity when they perceived high levels of symptoms in soldiers but the soldiers endorsed low levels of symptoms. Furthermore, spouses' marital satisfaction was negatively linked to soldiers' self-reported symptom severity only when spouses perceived that soldiers had experienced low levels of combat activity while deployed. When spouses perceived high levels of such activity, soldiers' self-reported symptoms had no relationship with spouses' marital satisfaction. These findings highlight the importance of interpersonal perceptions in intimate relationships and are consistent with the notion that uncontrollable attributions for a relative's mental health problems may provide a buffer against relationship distress. (PsycINFO Database Record (c) 2008 APA, all rights reserved). | 18,729,672 |
The coregulation of daily affect in marital relationships. | This study examined whether changes in individuals' affective states are associated with their partners' affect when spouses come together in daily life after having spent time apart while pursuing individual activities, as well as whether such associations are moderated by individual differences in interpersonal insecurity and perspective taking. For 7 consecutive days, spouses from 166 married couples reported their affect 6 times per day on 2 dimensions, hard affect (angry-calm) and soft affect (sad/depressed-upbeat/content). Within-couple analyses indicated that spouses' changes in hard affect covaried, particularly when they scored high on interpersonal insecurity. Moreover, husbands' changes in soft affect covaried with their wives' soft affect when the husbands scored high on perspective taking. The results emphasize the interconnectedness of spouses' feelings when they reunite, and they identify key individual difference variables that strengthen interpersonal transmission of emotion in close relationships. | 18,729,673 |
Who drives divergence? Identity signaling, outgroup dissimilarity, and the abandonment of cultural tastes. | People often diverge from members of other social groups: They select cultural tastes (e.g., possessions, attitudes, or behaviors) that distinguish them from outsiders and abandon tastes when outsiders adopt them. But while divergence is pervasive, most research on the propagation of culture is based on conformity. Consequently, it is less useful in explaining why people might abandon tastes when others adopt them. The 7 studies described in this article showed that people diverge to avoid signaling undesired identities. A field study, for example, found that undergraduates stopped wearing a particular wristband when members of the "geeky" academically focused dormitory next door started wearing them. Consistent with an identity-signaling perspective, the studies further showed that people often diverge from dissimilar outgroups to avoid the costs of misidentification. Implications for social influence, identity signaling, and the popularity and diffusion of culture are discussed. | 18,729,697 |
The attachment system in fledgling relationships: an activating role for attachment anxiety. | Is it sensible to study attachment dynamics between potential romantic partners before they share a full-fledged attachment bond? The present data indicate that such an approach may reveal novel insights about initial attraction processes. Four studies suggest that the state-like experience of attachment anxiety has functional implications within fledgling (i.e., desired or undeveloped) romantic relationships, well before the formation of an attachment bond. Studies 1 and 3 reveal that attachment anxiety directed toward a particular romantic interest is elevated before (in comparison with after) participants report being in an established relationship. Studies 2 and 3 demonstrate that such partner-specific attachment anxiety predicts attachment-relevant outcomes in fledgling relationships, including proximity seeking, safe haven, secure base, passionate love, and other approach behaviors. These associations were reliable above and beyond (and were typically as strong as or stronger than) the effect of sexual desire. Finally, Study 4 presents evidence that partner-specific attachment anxiety may cause several of these attachment-relevant outcomes. Attachment anxiety seems to be a normative experience and may signal the activation of the attachment system during the earliest stages of romantic relationships. | 18,729,699 |
Self-expansion and flow in couples' momentary experiences: an experience sampling study. | The self-expansion model of close relationships posits that when couples engage in exciting and activating conjoint activities, they feel connected with their partners and more satisfied with their relationships. In the present study, the experience sampling method was used to examine the predictions of the self-expansion model in couples' momentary experiences. In addition, the author generated several new hypotheses by integrating the self-expansion model with existing research on flow. Over the course of 1 week, 20 couples were signaled at quasi-random intervals to provide data on 1,265 unique experiences. The results suggest that the level of activation experienced during an activity was positively related to experience-level relationship quality. This relationship was consistent across free-time and nonfree-time contexts and was mediated by positive affect. Activation was not found to predict later affect unless the level of activation exceeded what was typical for the individual. Also examined was the influence of interpersonal context and activity type on self-expansion. The results support the self-expansion model and suggest that it could be considered under the broader umbrella of flow. | 18,729,702 |
Searching for and finding meaning in collective trauma: results from a national longitudinal study of the 9/11 terrorist attacks. | The ability to make sense of events in one's life has held a central role in theories of adaptation to adversity. However, there are few rigorous studies on the role of meaning in adjustment, and those that have been conducted have focused predominantly on direct personal trauma. The authors examined the predictors and long-term consequences of Americans' searching for and finding meaning in a widespread cultural upheaval--the terrorist attacks of September 11, 2001--among a national probability sample of U.S. adults (N=931). Searching for meaning at 2 months post-9/11 was predicted by demographics and high acute stress response. In contrast, finding meaning was predicted primarily by demographics and specific early coping strategies. Whereas searching for meaning predicted greater posttraumatic stress (PTS) symptoms across the following 2 years, finding meaning predicted lower PTS symptoms, even after controlling for pre-9/11 mental health, exposure to 9/11, and acute stress response. Mediation analyses suggest that finding meaning supported adjustment by reducing fears of future terrorism. Results highlight the role of meaning in adjustment following collective traumas that shatter people's fundamental assumptions about security and invulnerability. | 18,729,704 |
Dawn and dusk "chorus" in visually communicating Jamaican anole lizards. | A key hypothesis explaining the existence of dawn and dusk choruses in acoustically communicating animals centers on the need to advertise continued territorial occupancy after and before a period of nocturnal inactivity. If this hypothesis is correct, it follows that similar dawn and dusk choruses should occur in territorial animals exploiting other signal modalities. Adult male Anolis lizards defend territories by using elaborate head-bobbing displays and extensions of a throat fan or dewlap. Males are inactive at night and return to their territories at dawn, remaining there until dusk. I quantified the production of visual displays as a function of time of day for four species on the island of Jamaica: Anolis lineatopus, Anolis sagrei, Anolis grahami, and Anolis opalinus. All exhibited dawn and/or dusk peaks in display behavior. These patterns have remarkable parallels with the dawn and dusk choruses reported for many acoustically communicating animals. | 18,729,743 |
Evaluation of unmanned airborne vehicles and mobile robotic telesurgery in an extreme environment. | As unmanned extraction vehicles become a reality in the military theater, opportunities to augment medical operations with telesurgical robotics become more plausible. This project demonstrated an experimental surgical robot using an unmanned airborne vehicle (UAV) as a network topology. Because battlefield operations are dynamic and geographically challenging, the installation of wireless networks is not a feasible option at this point. However, to utilize telesurgical robotics to assist in the urgent medical care of wounded soldiers, a robust, high bandwidth, low latency network is requisite. For the first time, a mobile surgical robotic system was deployed to an austere environment and surgeons were able to remotely operate the systems wirelessly using a UAV. Two University of Cincinnati surgeons were able to remotely drive the University of Washington's RAVEN robot's end effectors. The network topology demonstrated a highly portable, quickly deployable, bandwidth-sufficient and low latency wireless network required for battlefield use. | 18,729,752 |
SMS application using EMG signal of clenching teeth for e-health communication. | A proposed system using a Short Message Service (SMS) application based on electromyography (EMG)-controlled human-computer interface method by clenching teeth was evaluated. This system consists of an EMG signal processing device and SMS Software module on the PC. We can use SMS by a simple combination of two clenching patterns. The purpose of this study is to evaluate easy and comfortable communication methods for the disabled and rehabilitation patients as an e-health tool. | 18,729,760 |
Bart's familiar quotations: the enduring biological wisdom of George A. Bartholomew. | George A. Bartholomew was one of the most influential organismal biologists of the twentieth century. His insights and research were fundamental to the establishment and growth of physiological ecology and evolutionary physiology. In the process of fostering that area of science, he created a body of literature that is striking in the clarity of its thought and presentation. Here we present some of his most insightful and important quotations, group them thematically, and comment on their original context and their continuing relevance. | 18,729,766 |
Latitudinal distribution, migration, and testosterone levels in birds. | Tropical bird species usually have lower testosterone (T) levels during breeding than temperate species. However, the potential mechanisms behind the positive interspecific correlation between T and latitude remain unexplored. In a comparative study of more than 100 bird species, we examined whether social constraints during male-male competition arising from migration and breeding synchrony are responsible for the latitude effects. Species that breed at higher latitudes are more likely to migrate and experience more intense intrasexual competition upon spring arrival than nonmigrant species from lower latitudes. Additionally, species from higher latitudes cope with shorter breeding seasons and thus with more synchronous breeding, which selects for high T titers via increased male-male conflicts. Accordingly, peak T levels were associated with migration and the duration of the egg laying period that reflects breeding synchrony. Because migration and breeding synchrony were related to latitudinal distribution, they appear to be important components of the latitude effects on T. A multivariate model controlling for covariation of predictor variables revealed that latitude remained the strongest predictor of peak T. Therefore, selection due to migration and breeding synchrony may partially cause the latitude effect, but other geographically varying factors may also play a role in mediating peak T levels at different latitudes. | 18,729,776 |
Mannose-binding lectin concentrations, MBL2 polymorphisms, and susceptibility to respiratory tract infections in young men. | Mannose-binding lectin (MBL) is an important component of innate immunity, and its deficiency is associated with susceptibility to recurrent infections. This exploratory study investigated the association of serum MBL concentrations and MBL2 gene polymorphisms with respiratory tract infections in young men. We genotyped 6 single-nucleotide polymorphisms (SNPs) in the promoter region (alleles H/L, X/Y, and P/Q) and exon 1 (variant alleles B, C, and D and wild-type allele A) of the MBL2 gene by real-time polymerase chain reaction and measured serum MBL concentrations in 111 Finnish military recruits with asthma and 362 without. An MBL level below the median concentration was a significant risk factor for infections (asthma status-adjusted odds ratio [OR], 2.5 [95% confidence interval {CI}, 1.4-4.5]). Among the 6 SNPs, there was a significant association between the promoter Y/Y genotype and infections (OR, 2.3 [95% CI, 1.2-4.4]) and a borderline significant association between exon 1 variant alleles and infections (OR, 1.7 [95% CI, 0.9-3.1]), after adjustment for asthma status. These preliminary results suggest, for the first time, an association between MBL level and respiratory tract infections in young men and a possible association between infections and MBL2 polymorphisms. | 18,729,778 |
Host cell mobilization for in situ tissue regeneration. | Although small, localized injuries can be healed through the body's normal reparative process, large traumatic injury overwhelms this system and may result in a deficit of functional recovery, despite the use of conventional reconstructive modalities. Cell-based approaches using tissue engineering and regenerative medicine techniques have offered new opportunities for treatment. Although the fundamental principles of cell-based therapies have been demonstrated clinically on multiple tissue systems, usually a donor tissue biopsy and ex vivo cell manipulation prior to implantation in vivo are necessary. The goal of the present study was to investigate whether host biologic resources and environmental conditions could be used for in situ tissue regeneration, which may eliminate the need for donor cell procurement and subsequent in vitro cell manipulation. To address this aim, we implanted a common biomaterial into mice and characterized the infiltrating cells to determine their regenerative potential. We showed that host cell infiltrates are not entirely comprised of inflammatory and fibroblast-like cells and the normal inflammatory process can be altered by incorporating anti-inflammatory agents that influence the formation of scar tissue. In addition, the infiltrating cells are capable of differentiating into multiple cell lineages, including osteogenic, myogenic, adipogenic, and endothelial lineages, if appropriate conditions are provided. These results suggest that it is possible to recruit a predominance of cells with multilineage potential into a biomaterial scaffold. Therefore, it may be possible to enrich the infiltrate with such cell types and control their fate, provided the proper substrate-mediated signaling can be imparted into the scaffold for in situ tissue regeneration. | 18,729,807 |
[The problem of complications of percutaneous coronary interventions. Part III. Optimal hemostasis]. | Successes in interventional cardioangiology allowed to widen area of application of percutaneous interventions. After broadened anticoagulant and antiplatelet therapy introducers are often withdrawn several hours after procedure. As a consequence exended compression of puncture site is required. This results in increase of procedure time, rate of development of complications, as well as patient s discomfort. Devices elaborated for puncture site closure allow shortening of introducer presence in an artery, hemostasis duration, and length of hospitalization. However the use of these devices is associated with higher cost and possibility of complications related to their placement. Aim of the present review is comparison of various types of closure devices with each other and with manual compression as well as assessment of their effect on rate of development of peripheral complications. | 18,729,841 |
MOZ/TIF2-induced acute myeloid leukaemia in transgenic fish. | The inv(8)(p11q13) chromosomal abnormality, described in acute myeloid leukaemias (AML), fuses the histone acetyl-transferase (HAT) MYST3 (MOZ) gene with another HAT gene, NCOA2 (TIF2). We generated a transgenic zebrafish in which the MYST3/NCOA2 fusion gene was expressed under control of the spi1 promoter. An AML developed in 2 of 180 MYST3/NCOA2-EGFP-expressing embryos, 14 and 26 months after injection of the fusion gene in a one-cell embryo, respectively. This leukaemia was characterised by an extensive invasion of kidneys by myeloid blast cells. This model, which is the first zebrafish model of AML, demonstrates the oncogenic potency of MYST3/NCOA2 fusion gene. | 18,729,850 |
Group psychotherapy with adolescents. | In working in a large general hospital with groups of disturbed adolescent patients from economically and emotionally deprived walks of life, therapists worked out a plan of outpatient group therapy that in general has had good results as measured by effective living and functioning in school, at home and with peers. Groups were limited to eight patients and meetings were held once a week with two co-therapists of different sexes. Therapists usually did not try to turn discussions in one direction or another. More active than in usual group work, the therapists did not hesitate to be didactic or educational as the topic or problem indicated.At termination of the group sessions, usually at the end of a school year as a natural time of leave-taking, the members who had benefited sufficiently faced the departure with little emotional wrench; those who had not were resentful, anxious, disappointed or relieved. | 18,730,009 |
THE NEWER ANTIBIOTICS IN DERMATOLOGY. | From the experimental and clinical observations published to date it appears that three new antibiotics, polymyxin, chloramphenicol and aureomycin, will prove to be highly efficacious against many of the infectious dermatoses and venereal diseases. | 18,731,681 |
WHO ARE PROSPECTIVE NEUROTICS? | Emotions of any kind and experienced at any age are etiologic factors of neuroses only in predisposed persons. Predisposed persons are those of neuropathic and psychoneuropathic constitution. This is characterized by excessive excitability and abnormal reactivity of the nervous system. This involves, in various degree and proportion, the autonomic nervous system as well as the higher cerebral functions including associative and emotional mental reactions. Objective signs of autonomic nervous imbalance can be detected by physical examination. In the mental sphere, psychoneurotic constitution can be recognized by emotional imbalance, excessive, inadequate, untimely reactions ("psychic dysmetry").Neuropathic and psychoneuropathic constitution per se is compatible with perfect health. It deserves attention, however, in that its carriers may play an important role in cultural and social life and so exert a great suggestive influence on the mass of people. The type of neurosis or psychoneurosis and the symptoms of it depend chiefly on the constitutional morbid predisposition (constitutional biologic inferiority) of certain organs or organ systems and on the kind of emotional situations which the patient is unable to cope with. The great number of neuroses, psychoneuroses and psychosomatic diseases among patients consulting them makes it imperative that internists and general practitioners be capable of making the correct diagnosis and of carrying out the indicated treatments by "minor psychotherapy." | 18,731,682 |
MEDICAL GROUP PRACTICE IN CALIFORNIA. | A 1950 study of group practice in California reveals 52 "true general medical groups" among 123 medical organizations surveyed, involving 634 full-time and 215 part-time physicians. The groups, in contrast to the national patterns, tend to be larger, younger and more urban. There is also a greater tendency toward unit hospital affiliation (30 groups) and operation of group prepayment plans (10 groups). In general similarity to the national scene, California groups are most frequently organized as private partnerships with a salary method of remuneration sometimes augmented by a share of net earnings. The range of medical and technical services offered varies widely with the size of the group. The combination of group prepayment, medical group practice, and coordinated medical-hospital centers seems to offer special opportunities for satisfactory practice and adequate medical care. | 18,731,820 |
MENINGOENCEPHALITIS AND PNEUMONITIS DUE TO WESTERN EQUINE VIRUS. | In a series of 20 cases here presented in a study of Western equine encephalitis, only ten were conclusively proven by serological or histopathological methods, while the other ten were presumptively cases of that disease. Involvement of the spinal cord was of relatively low incidence. In only one case of four in which autopsy was done could the Western equine virus be demonstrated in the cerebral tissues. There was a rather high incidence of involvement of the respiratory tree. A high proportion of patients had complaints referable to the respiratory tract. Physical signs denoting disease of both the upper and lower respiratory tract, x-ray evidence showing bronchial and pulmonary involvement, and autopsy evidence of bronchopneumonia were noted frequently. All patients had fever as well as symptoms and physical signs of central nervous system disease. Differential diagnosis posed many interesting and challenging problems. The clinical features were those of meningoencephalitis and never a "flu-like" syndrome, although in several of the cases diagnosis could not be made with certainty for several days, until meningeal signs developed, and usually the patients were treated with one or several antibiotics during that time. In all cases in which a neutralization test for the Western equine virus was done, the result was either positive or inconclusive. Results of complement fixation tests were significant in only six cases. In seven of 13 cases in which x-ray films of the chest were made, streaks of increased density were noted. | 18,732,027 |
C.M.A. President Testifies in Forand Bill Hearings. | Following is the testimony of T. Eric Reynolds, M.D., President of the California Medical Association, before the Ways and Means Committee of the U. S. House of Representatives concerning H.R. 4700 (the Forand bill) July 14, 1959: | 18,732,230 |
CORNEAL CONTACT LENSES-Special Value in Severe Anisometropia in Children. | Careful selection of patients and skillful fitting result in a high rate of success with corneal contact lenses-over 96 per cent in 339 patients treated in the present series. The lenses were especially valuable in anisometropia in children (11 cases). Children can be taught to care for contact lenses and insert and remove them for themselves. | 18,732,296 |
A PROGRAM FOR MENTAL HYGIENE IN CALIFORNIA. | While the Department of Mental Hygiene cannot undertake to meet all the mental health needs of the citizens, it should make the best possible use of all its own resources, and at the same time help others to make the most of theirs. To these ends it should* Give encouragement and assistance to persons engaged in prevention of mental disorders, without trying to operate such services.* Encourage and help persons engaged in the preservation of the human strengths that increase resistance to mental breakdown, without trying to operate such services.* Encourage and help persons outside the department who diagnose, treat and rehabilitate patients with mental disorders if these services meet the requirements of modern psychiatric treatment.* Continue operating hospitals at current level of bed capacity, clinics and related services for diagnosis, treatment and rehabilitation, moving toward levels of service in keeping with modern psychiatric standards and the growing population of the state.* Continue research and training within the Department and assist others in such programs outside the Department. | 18,732,349 |
THE PREVENTION OF LUNG CANCER-Applications of Some Current Theories. | The rapid increase in the incidence of bronchogenic carcinoma, the difficulties in early diagnosis and the infrequency of successful treatment emphasize the importance of attempts at its prevention. Much has been learned regarding the role of a variety of environmental factors in the genesis of this disease, although further studies are to be desired. The complete elimination of exposures to excessive irradiation or the inhalation of radioactive substances, to inorganic, organic or animate particles which may be responsible for chronic pulmonary diseases, and especially to automobile exhaust and cigarette smoke, occupational irritating or carcinogenic air pollutants and other predisposing conditions may require extensive changes in industry, government and society. A number of practical personal precautions are available, however, which may greatly reduce the hazard for the individual observing them. | 18,732,424 |
MILK LET-DOWN-The Use of Intranasal Oxytocin for Nursing Mothers. | A study was carried out to determine whether intranasal spraying with a solution of oxytocin was an effective way to increase flow of milk in mothers who wished to breast-feed their babies.A hundred such women were given the drug intramuscularly for two days before they were to begin nursing. Then administration by that means was discontinued and 50 of the hundred were given oxytocin nasal spray kits for use at home. In general the patients receiving the spray kits were those who were apprehensive about sufficient lactation, those who had had previous difficulty and those who had flat, inverted or tender nipples. Results were not much different between the 50 women who used the spray and the 50 controls, but since the former group included the "difficult" cases, some benefit may be attributed to the aerosol therapy. Ninety per cent of those who used it said they would be willing to use it again. | 18,732,437 |
Administration of Blood By Registered Nurses-Joint Statement by California Medical Association, California Hospital Association and California Nurses' Association. | After several years of favorable experience with registered nurses giving intravenous injections of fluids under the criteria set out in a joint statement by the California Medical Association, the California Hospital Association and the California Nurses' Association, it was proposed that it would be appropriate for registered nurses to administer blood. Careful study of current experience in various places with registered nurses giving blood transfusions convinced a joint committee that it recommend the adoption of the following statement which was approved by the associations indicated. | 18,732,475 |
PRESENT STATUS OF DERMABRASION. | The use of dermabrasion for cosmetic purposes is becoming less popular due to limitations inherent in the method despite the fact that it is still the best method available for the minimizing of acne scarring. Planing for precancerous skin is increasing in demand because of definite benefits to be gained from its use. While the method has not attained universal acceptance for the latter purpose, 80 per cent of dermatologists who have tried this approach, and who answered a questionnaire, rate the benefits obtained as excellent or good. Only 3.5 per cent considered the results as poor. In a five-year period between two questionnaires, there was in general a trend away from enthusiasm for this modality, but esteem for it as a way of dealing with precancerous skin held up better than opinion of its use for cosmetic purposes. | 18,732,604 |
Participation of California Physicians in Emergency Medical Care Panels, Report of Bureau of Research and Planning. | Over 40 per cent of all California physicians belonged to some type of emergency medical care panel during 1961. Of these physicians, almost 60 per cent were affiliated with hospital panels and 27 per cent with County Society panels. Other findings indicate the following facts about physician participation in emergency care panels:...84 per cent of physicians who participate do so on a voluntary basis, with 16 per cent belonging to panels on a compulsory basis....higher than average per cents of physicians belong to such panels in rural areas....compulsory membership is more prevalent in hospital panels than in County Society panels. | 18,732,621 |
ROSACEA-LIKE DEMODICIDOSIS. | Rosacea-like demodicidosis is an entity resembling acne rosacea which is caused by infestation with an abnormally large number of the mite Demodex folliculorum, usually in association with improper cleansing of the face. This condition responds promptly to external treatment consisting of daily cleaning of the face with soap and water and the application of a compound sulfur ointment over a period of a few weeks. Occasional instances of a mixed-type of rosacea are encountered in which internal factors are involved. | 18,732,637 |
Side effects of dextroamphetamine therapy of hyperactive children. | Dextroamphetamine, prescribed in the treatment of hyperactive children, was associated with significant personality deterioration in five of 26 treated cases. Discontinuance of the drug and, in some cases, substitution of others was followed by lessened symptoms of disorganization or of toxicity. In general, children being treated with psychostimulants should be kept under careful observation for untoward reactions. | 18,747,313 |
Emergency medicine-important advances in clinical medicine: verapamil and supraventricular tachycardia. | The Scientific Board of the California Medical Association presents the following inventory of items of progress in emergency medicine. Each item, in the judgment of a panel of knowledgeable physicians, has recently become reasonably firmly established, both as to scientific fact and important clinical significance. The items are presented in simple epitome and an authoritative reference, both to the item itself and to the subject as a whole, is generally given for those who may be unfamiliar with a particular item. The purpose is to assist the busy practitioner, student, research worker or scholar to stay abreast of these items of progress in emergency medicine that have recently achieved a substantial degree of authoritative acceptance, whether in his own field of special interest or another.The items of progress listed below were selected by the Advisory Panel to the Section on Emergency Medicine of the California Medical Association and the summaries were prepared under its direction. | 18,749,275 |
Dermatology-important advances in clinical medicine: sunscreens. | The Scientific Board of the California Medical Association presents the following inventory of items of progress in dermatology. Each item, in the judgment of a panel of knowledgeable physicians, has recently become reasonably firmly established, both as to scientific fact and important clinical significance. The items are presented in simple epitome and an authoritative reference, both to the item itself and to the subject as a whole, is generally given for those who may be unfamiliar with a particular item. The purpose is to assist busy practitioners, students, research workers or scholars to stay abreast of these items of progress in dermatology that have recently achieved a substantial degree of authoritative acceptance, whether in their own field of special interest or another.The items of progress listed below were selected by the Advisory Panel to the Section on Dermatology of the California Medical Association and the summaries were prepared under its direction. | 18,749,379 |
General and family practice: changing role of digoxin in chronic heart failure. | The Scientific Board of the California Medical Association presents the following inventory of items of progress in general and family practice. Each item, in the judgment of a panel of knowledgeable physicians, has recently become reasonably firmly established, both as to scientific fact and important clinical significance. The items are presented in simple epitome and an authoritative reference, both to the item itself and to the subject as a whole, is generally given for those who may be unfamiliar with a particular item. The purpose is to assist busy practitioners, students, research workers, or scholars to stay abreast of these items of progress in general and family practice that have recently achieved a substantial degree of authoritative acceptance, whether in their own field of special interest or another.The items of progress listed below were selected by the Advisory Panel to the Section on General and Family Practice of the California Medical Association and the summaries were prepared under its direction. | 18,750,532 |
General surgery: advances in liver transplantation. | The Scientific Board of the California Medical Association presents the following inventory of items of progress in general surgery. Each item, in the judgment of a panel of knowledgeable physicians, has recently become reasonably firmly established, both as to scientific fact and important clinical significance. The items are presented in simple epitome and an authoritative reference, both to the item itself and to the subject as a whole, is generally given for those who may be unfamiliar with a particular item. The purpose is to assist busy practitioners, students, research workers, or scholars to stay abreast of these items of progress in general surgery that have recently achieved a substantial degree of authoritative acceptance, whether in their own field of special interest or another.The items of progress listed below were selected by the Advisory Panel to the Section on General Surgery of the California Medical Association, and the summaries were prepared under its direction. | 18,750,622 |
The effectiveness of glucocorticoids in treating croup: meta-analysis. | To determine the effectiveness of glucocorticoid treatment in children with croup. Meta-analysis of randomized controlled trials that examine the effectiveness of glucocorticoid treatment in children with croup. Score on scale measuring severity of croup,use of co-interventions (epinephrine, antibiotics, or supplemental glucocorticoids), length of stay in the emergency department or the hospital, and rate of hospitalization. Twenty-four studies met the inclusion criteria. Glucocorticoid treatment was associated with an improvement in the croup severity score at 6 hours with an effect size of -1.0 (95% confidence interval [CI] -1.5 to -0.6) and at 12 hours -1.0 (-1.6 to -0.4); at 24 hours, this improvement was no longer significant (-1.0, -2.0 to -0.1). There was a decrease in the number of epinephrine treatments needed in children treated with glucocorticoids: a decrease of 9% (95% CI 2% to 16%) among those treated with budesonide and of 12% (4% to 20%) among those treated with dexamethasone. There was also a decrease in the length of time spent in the emergency department (-11 hours, 95% CI -18 to 4 hours) and, for inpatients, hospital stay was reduced by 16 hours (-31 to 1 hour). Publication bias seems to play a part in these results. Dexamethasone and budesonide are effective in relieving the symptoms of croup as early as 6 hours after treatment. Fewer co-interventions are used, and the length of time spent in the hospital is decreased in patients treated withglucocorticoids. | 18,751,187 |
[The influence of lithotripsy methods on the incidence of auxilary procedures after ureteric stone desintegration]. | Localization of ureteric stones and the difference in disintegration success are the most important but not the only factors in choosing the first treatment approach to ureteric stones. The aim of the study was to investigate the incidence of auxiliary procedures after different ureteric stones lithotripsy modalities. In a prospective bicentric study 260 patients with ureteric stones were analyzed. The patients weve divided into two groups: group I--120 patients subjected to extracorporeal shock ware lithotripsy (ESWL) treatment and group II--140 patients treated endoscopicly with ballistic lithotripsy using "Swiss" Lithoclast. Endoscopic treatment of all distal ureteric stones was significantly more successful than ESWL, but not significantly more successful than ESWL regarding proximal ureteric stones except for stones larger than 100 mm2 that were significantly better treated with endoscopic method. There was no general significant difference in auxiliary procedures rate after lithotripsy between the two groups. In the group I auxiliary procedures were significantly more performed than in the group II after the lithotripsy of stones larger than 100 mm2, calcium-oxalat-monohydrate stones and highly significantly more performed after the treatment of stones located in the iliac ureteric portion and impacted stones. After the lithotripsy of lumbar ureteric stones and multiple stones situated in different ureteric portions additional procedures were highly significantly more necessary in the goup II than in the group I. Being significantly more successful comparing to ESWL, ureteric stone treatment with "Swiss" Lithoclast should be considered the first therapeutic option for all, especially impacted stones located in iliac and pelvic ureter. In spite of a statistically significant difference in success rate, ESWL should be performed as the first treatment option in all cases of lumbar stones as well as multiple stones located in different ureteric portion because of lower auxiliary procedures rate except for stones larger than 100 mm2 that should be primarily treated endoscopicly. | 18,751,343 |
[Outcomes of ophtalmologic surgical procedures of esotropia in children and adolescents]. | Esotropia is the most common manifestation form of strabism accompanied by refraction deviations and amblyopia. The aim of this prospective study was to present the outcomes of surgical treatment of esotropia in children and adolescents. Within the period from January 1st 2006 to February 1st 2007 at the Clinic for Ophtalmology, Military Medical Academy, Belgrade a total of 25 patients with esotropia (34 eyes) and previously corrected refraction anomaly and treated amblyopia were operated on. The patients were 4-19-year of age. All of the patients were submitted to a complete ophtalmologic and orthoptic examination prior to the surgery, and a month, three months and six months after the surgery. The surgery was performed under general anesthesia. Out of the total number of the patients nine were operated on both eyes, while 16 patients on one eye with amblyopia or frequent esodeviation. Nine patients were submitted to retroposition of the inner straight muscle, two to myectomy of the outer straight muscle, while in 14 of the patients a combination of retroposition and myectomy was performed. The patients were divided into three groups according to the preoperative angle at the distance and followed-up accordingly after the surgery. Deviation angle at the distance in the group I was 18-25 DP, in the group II 26-35 PD, while in the group III it was 36-60 PD. The most numerous, group I (12 patients; 48%), a month following the surgery showed angle reduction by 55.58%, after three months 63.25%, and after six months 63.92%. The group II consisted of 8 patients (32%) showed angle reduction by 70.75% a month following the surgery, by 76% after three months, and by 79.12% after six months. The group III (5 patients; 20%) showed angle reduction by 72.20% a month following the surgery, 79.20 after three months, and 80.12% after six months following the surgery. The best postoperative outcomes after a month, three and six months were obtained in the group of patients with the highest esodeviation angle at the distance solved by the surgery on both eyes. Timely surgical treatment befell into major precondition for developing and maintaining the elements of binocular vision in the operated on patients. | 18,751,344 |
Dual targeting of tumor vasculature: combining Avastin and vascular disrupting agents (CA4P or OXi4503). | This study evaluated the therapeutic efficacy of combining vascular disrupting agents with antiangiogenic agents. Human clear cell renal carcinoma (Caki-1) tumors were established in nude mice. Treatments consisted of Avastin (2 mg/kg) administered twice a week; CA4P (100 mg/kg) or OXi4503 (25 mg/kg) administered 3 times a week for a period of 2 weeks; or a combination of Avastin and CA4P or OXi4503. Tumor response was assessed by growth delay. The tumor growth delays were 8, 6, and 18 days for Avastin, CA4P, and OXi4503, respectively. When the two therapies were combined, there was a significantly greater tumor response than what was achieved with single-agent treatments. For example, Avastin plus CA4P led to a growth delay of 13 days, and 27 days for Avastin plus OXi4503. Vascular-directed therapies that include both antiangiogenic and vascular disrupting therapeutics can result in significantly enhanced antitumor effects. | 18,751,370 |
Regulation of inflammation- and angiogenesis-related gene expression in breast cancer cells and co-cultured macrophages. | Tumor-associated macrophages (TAMs) secrete key modifiers of tumor progression and their modification has been proposed as a therapeutic strategy. Phenotypic changes that may render TAMs selectively vulnerable to anti-cancer agents were examined. Gene arrays, reverse transcription-polymerase chain reaction and Western blotting were used to study inflammation- and angiogenesis-related gene expression in co-cultured breast cancer cells and macrophages and to determine how their interactions were affected by tamoxifen and aspirin. MCF-7 (mammary adenocarcinoma) cells down-regulated macrophage migration inhibitory factor (MIF), but tamoxifen-pretreated MCF-7 cells up-regulated MIF in co-cultured macrophages. Two molecular variants of MIF were observed in the co-cultured MCF-7 cells. Aspirin induced IL-10 expression in the macrophages, MCF-7 and tamoxifen-pretreated MCF-7 cells. Aspirin-pretreated macrophages potently induced IL-10 expression in the MCF-7 cells. Because MIF is a determinant of the M1 macrophage activation state, the MCF-7-induced ablation of MIF in TAMs is suggestive of partial M2 polarization. Tamoxifen modulates MCF-7 regulation of TAM gene expression and aspirin alters macrophage regulation of MCF-7 gene expression. | 18,751,381 |
Efficacy of the third-generation bisphosphonate risedronate alone and in combination with anticancer drugs against osteosarcoma cell lines. | Bisphosphonates (BPs) are currently the most important class of inhibitors of osteoclast-mediated bone resorption and are widely used in the treatment of osteoporosis and other osteoclast-mediated bone diseases. Recently, there has been increasing evidence that BPs also exhibit direct anti-tumor activity against several cancer cell lines. However, the efficacies of BPs against osteosarcoma have not yet been fully elucidated, and the anti-osteosarcoma activity of the potent new-generation BP risedronate, which is widely used clinically, has not been determined. The anti-proliferative effects of the nitrogen-containing BP risedronate on seven osteosarcoma cell lines (LM8, SaOS2, U2OS, HOS, KHOS, MG63 and OST) were studied. The cell viability was determined by MTT assay. Prenylation of Rap1A and Ras and phosphorylation of Erk1 and 2 were examined by Western blot analysis. Genomic DNA fragmentation and TUNEL staining assay were performed to determine whether risedronate induced apoptosis of the osteosarcoma cells. The anti-tumor activities of risedronate in combination with carboplatin, doxorubicin, vincristine or etoposide were assayed with CalcuSyn (Biosoft). Risedronate inhibited both prenylation of Rap1A and Ras and phosphorylation of Erk 1 and 2 at a dose of 50 microM for 48 h. Treatment with risedronate induced significant time- and dose-dependent cytotoxicity in the LM8 cell line. Risedronate treatment also increased intranucleosomal genomic DNA fragmentation. The TUNEL assay showed that 10 microM and 50 microM risedronate clearly induced apoptosis of osteosarcoma cells. Risedronate also clearly inhibited LM8, SaOS2 and KHOS cell growth in a time- and dose-dependent fashion, but only weakly inhibited that of MG63 and U2OS cells. Risedronate augmented the effects of carboplatin, doxorubicin, vincristine and etoposide synergistically across a wide range of fractions affected (Fa) values. The nitrogen-containing bisphosphonate risedronate induces apoptosis and inhibits the growth of osteogenic sarcoma through a mechanism involving the down-regulation of protein prenylation and may be a candidate for combined use with carboplatin, doxorubicin, vincristine or etoposide. | 18,751,388 |
Follow-up of HPV DNA copy number in cidofovir therapy of recurrent respiratory papillomatosis. | Cidofovir is a cytosine nucleoside analogue antiviral drug given as an adjuvant therapy in recurrent respiratory papillomatosis (RRP). Intralesional cidofovir therapy was given to a 14-year-old male patient. The papilloma severity score (PSS) of Derkay et al. was used for follow-up. Serial fresh-frozen biopsies were taken from the lesions in the larynx and soft palate prior to therapy and during its course. After human papillomavirus (HPV) typing and the determination of the genomic physical state, the HPV DNA copy number was estimated with real-time PCR. All the papillomas harboured HPV 11 DNA in episomal form. Prior to therapy, the HPV copy number fluctuated with time. In the initial treatment period with 2-week-intervals both the viral load and the PSS decreased and a transient complete remission was observed. Subsequently, when the injections were given at longer intervals, the viral load returned to the initial values or greated, fluctuations reappeared and the RRP recurred at a controlled rate. The initial treatment period was successful, as the viral load decreased, and long-term effects of cidofovir might account for the controlled disease as the injection intervals were prolonged. | 18,751,391 |
The growth-promoting action of individual women's sera on mammary carcinoma cells. | In vitro studies concerning the growth-stimulating effect of hormones, especially of estradiol and its metabolites, have mainly been performed using pure substances and breast cancer cell lines. In order to take into account the metabolism of inactive into active hormones or drugs and vice versa which occurs in several tissues, the influence of individual patients' sera on the growth of breast cancer cells in vitro was tested. Besides measuring the growth promoting action of several hormone replacement therapies, the antiestrogenic effect was determined by measuring the effect of 10(-10) M estradiol added to the culture medium (E2-sensitivity). Influence on proliferation and stimulatability was similar in MCF-7 and T47-D cells. Growth-promoting potential correlated significantly with patient age, being higher in young ladies than in older ones. The converse was true for E2 sensitivity. From the different steroid hormones tested, only higher estradiol levels were associated with increased growth stimulation and diminished E2 sensitivity. Hormone replacement therapy (HRT) of different types did not significantly increase growth potential of serum, however these results are preliminary. Treatment with tamoxifen of breast cancer patients led to a decrease of E2 sensitivity, whereas growth potential was not affected significantly. For the aromatase inhibitor Arimidex, a tendency towards growth inhibition and increased E2 sensitivity was observed. Our in vitro system allows identifying differences between individual persons and groups of women of different age or treatment with respect to stimulation of growth or influence on estrogen sensitivity of breast cancer cells by serum. It is speculated that results might reflect the personal risk or the risk under treatment to develop breast cancer. | 18,751,397 |
PET-CT in recurrent ovarian cancer: impact on treatment planning. | Positron emission tomography-computed tomography (PET-CT) is currently not established in the management of recurrent ovarian cancer. Here, its value in diagnosis and therapy planning was evaluated. Seventy patients received PET-CT for suspicion of recurrent ovarian cancer. PET-CT and surgery were reviewed to analyze the accuracy in the diagnosis of recurrence and prediction of full resectability. PET-CT showed disease relapse in 63 of 70 patients, with full sensitivity and specificity. Thirty cases were operated on. PET-CT indicated full resectability in 24, but in fact only incomplete resection was possible in three cases. Thus sensitivity and specificity for the identification of full resectability were 100% and 66%, respectively. Seven negative results in PET-CT were confirmed by a relapse-free follow-up of 1 year. PET-CT offers reliable detection of recurrent ovarian cancer. Although diagnostic accuracy in the prediction of full resectability is limited, surgical planning is improved by identifying sites of intraperitoneal involvement. | 18,751,410 |
Craniofacial reconstructions with bone-anchored epithesis in head and neck cancer patients--a valid way back to self-perception and social reintegration. | Patients with advanced head and neck cancer often require radical and mutilating surgery resulting in severe impairment of their aesthetic self-perception and social life. Cosmetically satisfying results associated with high aesthetic self-perception and social reintegration are possible with bone-anchored epithesis representing a serious alternative to craniofacial reconstructive techniques using regional and free tissue transfer. Five head and neck cancer patients treated in our Ear, Nose and Throat Department in the years 2003-2004 were evaluated after epithesial reconstruction. Three out of the five patients scored self-perception after epithesial reconstruction as "very good", while social integration was scored as "very good" by three and as "satisfactory" by two patients. Daily getting along was scored as "very good" by four and as satisfactory by one patient. One patient had a very good acceptance of the epithesis as a part of the body and for four patients it was satisfactory. For the first time, the high degree of satisfaction in head and neck cancer patients receiving epithesial reconstruction in the maxillofacial region is demonstrated. | 18,751,417 |
A complete remission of sclerosing rhabdomyosarcoma with multiple lung and bone metastases treated with multi-agent chemotherapy and peripheral blood stem cell transplantation (PBSCT): a case report. | A case of sclerosing rhabdomyosarcoma (RMS) in a young adult with multiple lung and skip bone metastases is reported. Complete remission was achieved with this patient by treatment with multi-agent chemotherapy and peripheral blood stem cell transplantation (PBSCT) based on the pathological diagnosis of RMS using a specimen obtained during an open biopsy at the first consultation. He is still alive and has been continuously disease free for 12 years after surgery. This is a very rare case with successful treatment using PBSCT for a sclerosing RMS that presented with multiple distant metastases at the first consultation. | 18,751,419 |
The significance of gastrectomy in advanced gastric cancer patients with non-curative factors. | The role of gastrectomy in the treatment of advanced gastric cancer patients with non-curative factors remains controversial. We investigated prognostic factors and evaluated the role of gastrectomy in such patients. Eighty-eight advanced gastric cancer patients with non-curative factors were prospectively studied. The patients were categorized into the following two groups: Group A: 52 patients who underwent gastrectomy and subsequently received chemotherapy, Group B: 36 patients who received chemotherapy alone. The median survival times of group A and B patients were 351 and 182 days, respectively (p=0.008). Multivariate analysis showed that gastrectomy was the only positive independent prognostic factor, with no effect on the results of chemotherapy. There was no significant difference in the duration of hospital stay between patients of the two groups, while significantly longer maintenance of oral intake was observed for group A. In advanced gastric cancer patients with non-curative factors, gastrectomy was beneficial for survival with longer maintenance of oral intake. | 18,751,422 |
Early and long-term outcome of mitral valve repair with a Cosgrove band combined with coronary revascularization in patients with ischemic cardiomyopathy and moderate-severe mitral regurgitation. | Clinical and echocardiographic results were investigated to evaluate mitral valve repair in patients undergoing coronary artery bypass grafting (CABG) for ischemic cardiomyopathy (ICM) with moderately severe mitral regurgitation (MR). A total of 78 patients (21 women, 57 men; mean age 69.5 +/- 7.8 years) with ischemic mitral regurgitation underwent mitral valve repair and CABG. The mean left ventricular ejection fraction (LVEF) was 42.4 +/- 12.4%. Among the patients, 19 (24.4%) had preoperative congestive heart failure (CHF). This surgery constituted a second such operation in five patients (6.4%). The MR was grade 3+ in 28 patients (35.9%) and 4+ in 50 (64.1%). The mean number of grafts was 3.6 per patient. Hospital mortality was 11.5% (n = 9). Risk factors for early mortality were preoperative NYHA class > or = III (p = 0.014), preoperative heart failure (p <0.001) and reoperation (p = 0.002). The five-year survival was 82.6 +/- 5.9%, and freedom from grade > or =2+ MR was 93.1 +/- 4.1%. Postoperatively, 66 patients (89.6%) were in NYHA class I and seven (9.4%) in class II, demonstrating a statistically significant improvement (p = 0.03). Late echocardiography showed a significant improvement in LVEF (from 42.4 +/- 12.4% to 51.7 +/- 10.9%; p = 0.01) and a reduction in pulmonary artery pressure (from 37.6 +/- 11.9 mmHg to 29.3 +/- 7.4 mmHg; p = 0.004). It is concluded that in patients with ICM, mitral valve repair combined with CABG provides a dramatic improvement in ejection fraction and in CHF, with excellent long-term survival, even in patients with a low LVEF. | 18,751,469 |
Etiology of stroke after mechanical heart valve replacement--results from a ten-year prospective study. | In patients carrying mechanical valve prostheses it is assumed that cardioembolic strokes account for 70 - 90 % of clinically diagnosed thromboembolic complications. The etiology of stroke especially in older patients with mechanical heart valves may thus be multiple and not prosthetic valve-related in a substantial percentage. It was the aim of this prospective study to analyze the etiology of stroke in consecutive patients, who had mechanical heart valve replacement before. During a 10-year period, 89 consecutive patients were hospitalized at the authors' institution late (> 90 days) after mechanical valve replacement with definite stroke according to the WHO Monica criteria for stroke registers. CCT or MRI revealed cerebral bleedings in 69 (77.5 %) patients, which were small in 42 (60.9 %), intermediate in 24 (34.8 %), and massive in three (4.3 %). Non-embolic, lacunary infarctions were documented in seven (8 %) and embolic strokes in 13 (17%) patients. According to the findings by CCT/ MRI and duplex sonography of the carotid arteries, stroke was considered atherothrombotic in seven of these 13 patients with embolic strokes (53.8 %). Six of these seven patients (86 %) had recurrent neurologic symptoms. In the other four, prosthesis-related stroke was most likely due to a yet undiagnosed active prosthetic valve endocarditis. In only two (2.3%) of the 89 stroke patients, was etiology probably prosthesis-related. Patients with an INR > 5.0 had ischemic stroke in three, and bleedings in four, patients with an INR < 1.8 ischemic strokes in one, and bleedings in three cases. In conclusion, the vast majority of strokes after mechanical valve implantation in our cohort study were hemorrhagic rather than ischemic in origin, irrespective of the intensity of the oral anticoagulation. For proper treatment decisions, it is therefore essential to discriminate the underlying etiology of stroke. | 18,751,471 |
Cryopreserved amniotic fluid-derived cells: a lifelong autologous fetal stem cell source for heart valve tissue engineering. | Fetal stem cells represent a promising cell source for heart valve tissue engineering. In particular, amniotic fluid-derived cells (AFDC) have been shown to lead to autologous fetal-like heart valve tissues in vitro for pediatric application. In order to expand the versatility of these cells also for adult application, cryopreserved AFDC were investigated as a potential life-long available cell source for heart valve tissue engineering. Human AFDC were isolated using CD133 magnetic beads, and then differentiated and analyzed. After expansion of CD133- as well as CD133+ cells up to passage 7, a part of the cells was cryopreserved. After four months, the cells were re-cultured and phenotyped by flow cytometry and immunohistochemistry, including expression of CD44, CD105, CD90, CD34, CD31, CD141, eNOS and vWF, and compared to their non-cryopreserved counterparts. The stem cell potential was investigated in differentiation assays. The viability of cryopreserved AFDC for heart valve tissue engineering was assessed by creating heart valve leaflets in vitro. After cryopreservation, amniotic fluid-derived CD133- and CD133+ cells retained their stem cell-like phenotype, expressing mainly CD44, CD90 and CD105. This staining pattern was comparable to that of their non-cryopreserved counterparts. Moreover, CD133- cells demonstrated differentiation potential into osteoblast-like and adipocyte-like cells. CD133+ cells showed characteristics of endothelial-like cells by eNOS, CD141 and beginning vWF expression. When used for the fabrication of heart valve leaflets, cryopreserved CD133- cells produced extracellular matrix elements comparable to their non-cryopreserved counterparts. Moreover, the resulting tissues showed a cellular layered tissue formation covered by functional endothelia. The mechanical properties were similar to those of tissues fabricated from non-cryopreserved cells. The study results suggest that the use of cell bank technology fetal amniotic fluid-derived stem cells might represent a life-long available autologous cell source for heart valve tissue engineering, and also for adult application. | 18,751,475 |
Salpingectomy for ruptured ectopic pregnancy. | Not much more than a century ago, a ruptured ectopic pregnancy was a death sentence. In 1876, John Parry wrote in his book on this subject: 'Here is a wife in the most useful period of her existence, which good authorities have said is never cured; and for which, even in this age when science and art boast of such high attainments, no remedy, either medical or surgical, has been tried with a single success'. When we read that eminent authorities were advising the use of electric shocks, injection of narcotics into the sac and copious and frequent bleeding, one is hardly suprised. Parry himself suggested that the only remedy would be to open the abdomen and either tie the bleeding vessels or remove the sac entirely. | 18,751,495 |
Pharmacokinetics and bioequivalence study of clindamycin hydrochloride formulations after single-dose administration in healthy Chinese male volunteers. | The aim of the present study was to compare the bioavailability of clindamycin (CAS 18323-44-9) from three clindamycin hydrochloride (CAS 21 462-39-5) capsules (clindamycin 75 mg capsule as test 1 preparation, 150 mg capsule as test 2 preparation and a commercially available original 150 mg capsule of the drug as reference preparation) in 24 Chinese healthy male volunteers, aged between 22 and 28. The study was conducted according to a randomized, double-blind, 3-period, 3-treatment, 3-sequence, single-dose, crossover design with a wash-out phase of 7 days. Blood samples for pharmacokinetic profiling were taken up to 14 h post-dose, and clindamycin plasma concentrations were determined with a validated liquid chromatography-electrospray ionization-mass spectrometry (LC-ESI-MS) method. Maximum plasma concentrations (C(max)) of 3.06 +/- 1.10 microg/mL (test 1), 3.10 +/- 1.59 microg/mL (test 2) and 3.06 +/- 1.15 microg/mL (reference) were achieved. Areas under the plasma concentration-time curve (AUC(0-infinity)) of 10.73 +/- 4.29 microg x h/mL (test 1), 10.54 +/- 4.10 microg x h/ mL (test 2) and 11.29 +/- 4.98 microg x h/mL (reference), AUC(0-t) of 10.32 +/- 4.09 microg x h/ mL, 10.26 +/- 3.96 microg x h/mL, 10.94 +/- 4.86 g x h/mL were calculated. The median T(max) was 0.80 +/- 0.52 h, 0.77 +/- 0.37 h, 1.01 +/- 0.6 h for test 1, test 2 and reference formulation, respectively. Plasma elimination half-lives (t1/2) of 2.72 +/- 0.58 h (test 1), 2.39 +/- 0.37 h (test 2) and 2.63 +/- 0.66 h (reference) were determined. Both primary target parameters, AUC(0-infinity) and AUC(0-t) were tested parametrically by analysis of variance (ANOVA) and relative bioavailabilities were 98.0 +/- 16.2% (test 1) and 97.2 +/- 20.3% (test 2) for AUC(0-infinity), 97.5 +/- 16.3% (test 1) and 97.8 +/- 20.2% (test 2) for AUC(0-t). Bioequivalence between test and reference preparation was demonstrated for both parameters, AUC(0-infinity) and AUC(0-t). The 90% confidence intervals of the T/R-ratios of logarithmically transformed data were in the generally accepted range of 80%-125%. That means that the two test formulations are bioequivalent to the reference formulation for clindamycin. | 18,751,503 |
Interrupted aortic arch: an eight-year experience. | Interrupted aortic arch (IAA) is a rare congenital heart defect with a high mortality rate in the neonatal period. Surgical correction of associated intracardiac anomalies can be performed in a one-stage (primary) or two-stage approach. Case review of children with IAA operated in our center and to evaluate the surgical outcomes and the occurrence of complications. A retrospective chart review of children operated from June 1998 to October 2006. Twelve children (nine girls and three boys) were operated. Nine patients had ventricular septal defect with septal malalignment, two had univentricular hearts and two had transposition of the great arteries. Primary correction was performed in eleven patients (aged between two and 38 days), including two Norwood procedures. There was no early mortality. The follow-up time ranged from 30 days to six years (median 2.6 years), with late mortality of 33%. Two children required reintervention for aortic arch restenosis, which was successfully treated by catheterization. Our experience is that early primary repair of IAA has low early and late mortality and is the method of choice most situations. Late mortality depends the severity of associated anomalies. | 18,751,507 |
Functionally relevant microorganisms to enhanced biological phosphorus removal performance at full-scale wastewater treatment plants in the United States. | The abundance and relevance ofAccumulibacter phosphatis (presumed to be polyphosphate-accumulating organisms [PAOs]), Competibacter phosphatis (presumed to be glycogen-accumulating organisms [GAOs]), and tetrad-forming organisms (TFOs) to phosphorus removal performance at six full-scale enhanced biological phosphorus removal (EBPR) wastewater treatment plants were investigated. Coexistence of various levels of candidate PAOs and GAOs were found at these facilities. Accumulibacter were found to be 5 to 20% of the total bacterial population, and Competibacter were 0 to 20% of the total bacteria population. The TFO abundance varied from nondetectable to dominant. Anaerobic phosphorus (P) release to acetate uptake ratios (P(rel)/HAc(up)) obtained from bench tests were correlated positively with the abundance ratio of Accumulibacter/(Competibacter +TFOs) and negatively with the abundance of (Competibacter +TFOs) for all plants except one, suggesting the relevance of these candidate organisms to EBPR processes. However, effluent phosphorus concentration, amount of phosphorus removed, and process stability in an EBPR system were not directly related to high PAO abundance or mutually exclusive with a high GAO fraction. The plant that had the lowest average effluent phosphorus and highest stability rating had the lowest P(rel)/HAc(up) and the most TFOs. Evaluation of full-scale EBPR performance data indicated that low effluent phosphorus concentration and high process stability are positively correlated with the influent readily biodegradable chemical oxygen demand-to-phosphorus ratio. A system-level carbon-distribution-based conceptual model is proposed for capturing the dynamic competition between PAOs and GAOs and their effect on an EBPR process, and the results from this study seem to support the model hypothesis. | 18,751,532 |
Metarhiziopsis microspora gen. et sp. nov. associated with the elongate hemlock scale. | A sporodochial fungus collected from the elongate hemlock scale, Fiorinia externa (Ferris) in Coventry, Connecticut, is described. This fungus has characteristics of both Metarhizium and Myrothecium but develops setae surrounding white to buff sporodochia and dry conidia in chains, a combination of characters found in neither genus. Phylogenetic analyses of the complete small subunit ribosomal DNA (ssu), partial ef1-alpha, and complete 5.8S ribosomal DNA and internal transcribed spacers (ITS) 1 and 2 shows that the fungus is allied with a subclade within Cordyceps including the species C. agriota, which places this fungus in the Hypocreales, Clavicipitaceae sensu lato or the newly erected Ophioclavicipitaceae. Morphological observation and molecular analysis indicate that this fungus is sufficiently different from Metarhizium and Myrothecium to warrant the erection of a new anamorphic genus. Therefore Metarhiziopsis microspora gen. et sp. nov. is proposed. | 18,751,553 |
Prefrontal EEG asymmetry as a potential biomarker of antidepressant treatment response with transcranial magnetic stimulation (TMS): a case series. | We review studies that have used EEG as a response biomarker in depression, and then present preliminary EEG change data from an ongoing TMS depression treatment trial. These data in 4 depressed subjects over 3 weeks of treatment suggest but do not prove that there may be asymmetry changes that occur both within a daily TMS session and over the course of several weeks that may be associated with antidepressant response. EEG shows potential as a biomarker of response for depression treatments, particularly the brain stimulation devices, which, unlike medications, can focally interact with neural tissue in specific frequency patterns. | 18,751,561 |
A re-examination of the phylogenetic relationship between the causal agents of carrot black rot, Alternaria radicina and A. carotiincultae. | The phylogenetic relationship between Alternaria radicina and A. carotiincultae was reexamined based on morphology, sequence analysis of rDNA (ITS and mitochondrial small subunit [mtSSU]), protein coding genes (actin [ACT], beta-tubulin, chitin synthase [CHS], translation elongation factor [EF-1a], Alternaria allergen a1 [Alt a1], and glyceraldehyde-3-phosphate dehydrogenase [gpd]), and RAPD and ISSR analysis of total genomic DNA. Although some morphological characters overlapped to a degree, with A. radicina isolates expressing moderate variation and A. carotiincultae isolates being highly uniform, A. carotiincultae could be differentiated from A. radicina based on significantly greater growth rate on potato dextrose agar (PDA) or acidified PDA (APDA) and average number of transverse septa per conidium. Sequence of rDNA and two protein coding genes, ACT and CHS, were invariant between species. However polymorphism with the EF-1a, beta-tubulin, and Alt a1 gene strictly separated the population of A. radicina and A. carotiincultae as distinct lineages, as did RAPD and ISSR analysis. The polymorphic gpd gene did not strictly separate the two species. However isolates of A. radicina encompassed several haplotypes, one of which was the exclusive haplotype possessed by A. carotiincultae isolates, suggesting evidence of incomplete lineage sorting. The results suggest that A. carotiincultae is closely related to A. radicina but is a recently divergent and distinct lineage, which supports its status as a separate species. | 18,751,557 |
State of the science on postacute rehabilitation: setting a research agenda and developing an evidence base for practice and public policy. An introduction. | The Rehabilitation Research and Training Center on Measuring Rehabilitation Outcomes and Effectiveness along with academic, professional, provider, accreditor, and other organizations sponsored a 2-day State of the Science of Post-Acute Rehabilitation Symposium in February 2007. The aim of this symposium was to serve as a catalyst for expanded research on post-acute care (PAC) rehabilitation so that health policy is founded on a solid evidence base. The goals were to (1) describe the state of our knowledge regarding utilization, organization, and outcomes of postacute rehabilitation settings, (2) identify methodologic and measurement challenges to conducting research, (3) foster the exchange of ideas among researchers, policymakers, industry representatives, funding agency staff, consumers, and advocacy groups, and (4) identify critical issues related to setting, delivery, payment, and effectiveness of rehabilitation services. Plenary presentation and state-of-the-science summaries were organized around four themes: (1) the need for improved measurement of key rehabilitation variables and methods to collect and analyze this information, (2) factors that influence access to postacute rehabilitation care, (3) similarities and differences in quality and quantity of services across PAC settings, and (4) effectiveness of postacute rehabilitation services. The full set of symposium articles, including recommendations for future research, appear in Archives of Physical Medicine and Rehabilitation. | 18,751,580 |
Increasing incidence and severity of coccidioidomycosis at a naval air station. | Increasing rates of coccidioidomycosis among the general population are being described. Given the large number of military personnel stationed and training in endemic areas, data regarding infection trends among military members would be informative. We performed a retrospective epidemiological study concerning the incidence and severity of clinical cases of coccidioidomycosis at a naval base located in an endemic area in California. Eighty-two military beneficiaries at the base were diagnosed with coccidioidomycosis from January 2002 to December 2006. Among active duty personnel, the rate of coccidioidomycosis rose 10-fold during the 5-year study period: 29.88 to 313.71 cases per 100,000 person-years. The incidence of coccidioidal infections occurring in active duty members was higher than other military beneficiaries at the base. The median age of patients with a coccidioidal infection was 28 years, and 73% were male. Sixty-six had primary pulmonary disease and 14 had disseminated disease; data were unavailable for two cases. The number of disseminated cases increased significantly over time; by 2006, 30% of the diagnosed cases were disseminated disease. Among cases of dissemination, 43% occurred among Caucasian/non-Hispanics. Disseminated disease was associated with high complement fixation titers and a more recent year of diagnosis. Although the sample size was small, we found no differences in rates of disseminated disease by race, likely due to the large number of cases among Caucasians. Coccidioidomycosis incidence rates have significantly increased during the last 5 years among military beneficiaries. Active duty members were more likely to develop coccidioidomycosis than dependents or retirees, perhaps related to the number and intensity of exposures in this group. | 18,751,595 |
Brugada syndrome in an active duty Air Force senior pilot. | Brugada syndrome describes a subgroup of patients at risk for polymorphic ventricular tachycardia, ventricular fibrillation, and sudden cardiac death and is likely underdiagnosed among aviators. A 40-year-old male pilot presented to the clinic for his physical. He denied any symptoms on initial questioning. Subsequent electrocardiogram (ECG) revealed premature ventricular couplets with ST-segment elevation in V1 and V2 of the precordial leads with T-wave abnormalities. Special care must be taken if ECG demonstrates a Brugada pattern-especially in patients with a history of syncope or a family history of sudden death. Recent studies have confirmed a significant risk reduction in symptomatic patients with type 1 Brugada to as low as 0.8% to 3% with an implantable cardioverter defibrillator. Symptomatic patients displaying type 1 Brugada ECG (spontaneous or after sodium channel blockade) should receive an implantable cardioverter defibrillator and must be permanently disqualified. The Aeromedical Consultation Service should review all cases of Brugada syndrome and render a return to fly for asymptomatic nondiagnostic Brugada types. | 18,751,603 |
[Venous thromboembolism risk in medical inpatients]. | Venous thromboembolism is one of the main causes of morbidity and mortality in many diseases, either in medical or in surgical wards. The aim of this study is to determine its frequency in a medical ward and to find all the patients who need a prophylaxys. We examined all the inpatients admitted in our Department during a period of three years, selecting all subjects affected by venous thromboembolism. Patients affected by metastatic cancer, namely pancreatic one, or congestive heart failure showed higher risk to develope venous thromboembolism. A prompt heparinic prophylaxys could reduce thromboembolic events. Male gender could be a further risk factor. | 18,751,614 |
Impact of ethnicity and MTHFR genotype on age at onset of coronary artery disease in women in Israel. | The C677T mutation in the methylenetetrahydrofolate reductase (MTHFR) gene is associated with early onset of coronary artery disease in some populations with certain ethnic backgrounds. However, data on its effect on CAD development in women are limited and conflicting. To investigate the effects of the MTHFR C677T mutation and ethnicity on the development and age at onset of CAD in women in Israel. The sample included 135 Jewish women with well-documented CAD (62 Ashkenazi, 44 Oriental and 29 of other origins) in whom CAD symptoms first developed at age < or = 65 years. DNA samples from 235 women served as the control. CAD symptoms developed later in Ashkenazi than in Oriental women or women of other origins (51.0 +/- 7.0 years vs. 48.3 +/- 7.5 and 46.3 +/- 7.7 years, respectively, P= 0.024). Among Ashkenazi women, the T/T genotype was less common in patients in whom CAD symptoms appeared after age 50 (6.4%) than in patients with earlier CAD symptoms (25.8%, P= 0.037) and Ashkenazi control subjects (23.3%, P= 0.045). Among women from other origins, these differences were not significant. On logistic regression analysis, the T/T genotype was associated with a nearly fourfold increase in the risk of early onset (age < 45 years) of CAD (odds ratio 3.87, 95% confidence interval 1.12-13.45, adjusted for risk factors and origin) and a trend towards an influence of ethnicity (P= 0.08). Compared to Ashkenazi women, the risk of early development of CAD associated with the T/T genotype among Oriental ones was 0.46 (95%CI 0.189-1.114) and in women of other origins, 5.84 (95%CI 1.76-19.34). Each additional risk factor increased the risk of earlier onset of CAD by 42% (OR 1.42, 95%CI 1.06-1.89). The age at onset of CAD in Israeli women is influenced by the MTHFR genotype, ethnic origin and coronary risk factors. | 18,751,630 |
High-resolution multicontrast-weighted MR imaging from human carotid endarterectomy specimens to assess carotid plaque components. | The American Heart Association modified classification for atherosclerotic plaque lesions has defined vulnerable plaques as those prone to rupture. The aim of our study was to assess the sensitivity and specificity of 1.5-T magnetic resonance imaging (MRI) in the evaluation of the characteristics of plaque components. Twelve carotid endarterectomy specimens were imaged by ex-vivo high-resolution 1.5-T MRI. Thirty-four cross-section axial images were selected for pixel-by-pixel basis analysis to demonstrate the most significant tissue features. Data were then submitted for histopathological examination and each specimen analysed in the light of the histological components (lipid core, fibrous tissue, fibrous/loose connective tissue, calcifications). The overall sensitivity and specificity rates for each tissue type were, respectively, 92% and 74% for the lipid core, 82% and 94% for the fibrous tissue, 72% and 87% for the fibrous/loose connective tissue, and 98% and 99% for calcification. The use of 1.5-T MRI appears to be a reliable tool to characterise plaque components and could help in the screening of patients with high risk of plaque rupture. The possibility of applying MRI in clinical daily practice may change the non-invasive approach to carotid artery diagnostic imaging, thus allowing an early identification of patients with vulnerable plaques. | 18,751,713 |
Immune privilege of allogeneic neuroretinal transplants in the subconjunctival space. | The extent of site and tissue-associated immune privilege is of great interest in transplantation experiments involving the CNS. In the present paper we have explored neuroretinal immune privilege by transplantation to a non-immune privileged site. Fetal and adult full-thickness rabbit neuroretinal grafts were placed in the subconjunctival space of immunocompetent rabbit hosts. Morphological examination was performed after 2-31 days (fetal grafts, n = 46), and after 8 days (adult grafts, n = 4). Hematoxylin and eosin-stained sections and immunohistochemistry directed against microtubule-associated protein 2 (MAP2) revealed surviving grafts containing retinal neurons in the majority of eyes with fetal grafts. In all specimens, a mild inflammatory reaction was evident as seen with major histocompatibility complex class II (MHC-II) labeling. Short-term grafts survived well and displayed lamination and rosette formation whereas older grafts appeared more disorganized and were more often rejected. Müller cell fibers labeled with glial fibrillary acidic protein (GFAP) were present in grafts from 15 days and onwards. Adult grafts were destroyed after 8 days. Allogeneic fetal full-thickness neuroretinal transplants can survive for several weeks in a non-immune privileged environment in which adult grafts are rapidly rejected. Fetal grafts gradually shrink, lose their architecture and go through a glial transformation accompanied by low-grade inflammation. The rabbit neuroretina thus appears to enjoy partial immune privilege, the extent of which depends on the development state of the tissue. The characterization of neuroretinal immune privilege will hopefully influence future clinical trials of retinal transplantation. | 18,751,716 |
Functional features of the C-terminal region of yeast ribosomal protein L5. | The aim of this study was to analyze the functional importance of the C-terminus of the essential yeast ribosomal protein L5 (YrpL5). Previous studies have indicated that the C-terminal region of YrpL5 forms an alpha-helix with a positively charged surface that is involved in protein-5S rRNA interaction. Formation of an YrpL5.5S rRNA complex is a prerequisite for nuclear import of YrpL5. Here we have tested the importance of the alpha-helix and the positively charged surface for YrpL5 function in Saccharomyces cerevisiae using site directed mutagenesis in combination with functional complementation. Alterations in the sequence forming the putative alpha-helix affected the functional capacity of YrpL5. However, the effect did not correlate with a decreased ability of the protein to bind to 5S rRNA as all rpL5 mutants tested were imported to the nucleus whether or not the alpha-helix or the positively charged surface were intact. The alterations introduced in the C-terminal sequence affected the growth rate of cells expressing mutant but functional forms of YrpL5. The reduced growth rate was correlated with a reduced ribosomal content per cell indicating that the alterations introduced in the C-terminus interfered with ribosome assembly. | 18,751,732 |
Fear, fatalism and breast cancer screening in low-income African-American women: the role of clinicians and the health care system. | African-American women have the highest breast cancer death rates of all racial/ethnic groups in the US. Reasons for these disparities are multi-factorial, but include lower mammogram utilization among this population. Cultural attitudes and beliefs, such as fear and fatalism, have not been fully explored as potential barriers to mammography among African-American women. To explore the reasons for fear associated with breast cancer screening among low-income African-American women. We conducted four focus groups (n = 29) among a sample of African-American women at an urban academic medical center. We used trained race-concordant interviewers with experience discussing preventive health behaviors. Each interview/focus group was audio-taped, transcribed verbatim and imported into Atlas.ti software. Coding was conducted using an iterative process, and each transcription was independently coded by members of the research team. Several major themes arose in our exploration of fear and other psychosocial barriers to mammogram utilization, including negative health care experiences, fear of the health care system, denial and repression, psychosocial issues, delays in seeking health care, poor health outcomes and fatalism. We constructed a conceptual model for understanding these themes. Fear of breast cancer screening among low-income African-American women is multi-faceted, and reflects shared experiences within the health care system as well as the psychosocial context in which women live. This study identifies a prominent role for clinicians, particularly primary care physicians, and the health care system to address these barriers to mammogram utilization within this population. | 18,751,758 |
Diffuse abdominal and port site pain caused by the connecting tube in gastric banding. | Laparoscopic adjustable gastric banding is an effective treatment for morbid obesity and has become the most widespread bariatric operation. Complications such as stomach slippage, band erosion or dislocation, pouch dilatation and port complications have been widely reported and discussed. We report two similar cases of women who had had recurrent diffuse abdominal pain and tearing pain at the port site. X-ray examinations showed the small bowel wrapped around the silicone tube, pulling it to the right lower quadrant. Laparoscopic relief and repositioning were performed in both patients. | 18,751,761 |
Body contouring surgery following bariatric surgery and dietetically induced massive weight reduction: a risk analysis. | This study analyzed the impact of weight reduction method, preoperative, and intraoperative variables on the outcome of reconstructive body contouring surgery following massive weight reduction. All patients presenting with a maximal BMI >/=35 kg/m(2) before weight reduction who underwent body contouring surgery of the trunk following massive weight loss (excess body mass index loss (EBMIL) >/= 30%) between January 2002 and June 2007 were retrospectively analyzed. Incomplete records or follow-up led to exclusion. Statistical analysis focused on weight reduction method and pre-, intra-, and postoperative risk factors. The outcome was compared to current literature results. A total of 104 patients were included (87 female and 17 male; mean age 47.9 years). Massive weight reduction was achieved through bariatric surgery in 62 patients (59.6%) and dietetically in 42 patients (40.4%). Dietetically achieved excess body mass index loss (EBMIL) was 94.20% and in this cohort higher than surgically induced reduction EBMIL 80.80% (p < 0.01). Bariatric surgery did not present increased risks for complications for the secondary body contouring procedures. The observed complications (26.9%) were analyzed for risk factors. Total tissue resection weight was a significant risk factor (p < 0.05). Preoperative BMI had an impact on infections (p < 0.05). No impact on the postoperative outcome was detected in EBMIL, maximal BMI, smoking, hemoglobin, blood loss, body contouring technique or operation time. Corrective procedures were performed in 11 patients (10.6%). The results were compared to recent data. Bariatric surgery does not increase risks for complications in subsequent body contouring procedures when compared to massive dietetic weight reduction. | 18,751,762 |
The Hospital for the Ruptured and Crippled moves east on 42nd Street 1912 to 1925. | In 1912, the Hospital for the Ruptured and Crippled (R & C) moved to its third location since its founding in 1863. It was a newly constructed six-story building on 42nd Street between Second Avenue and First Avenue. At the time Dr. Virgil Gibney, the second Surgeon-in-Chief, was 65 years of age and had already served 25 years in that position. The building housed a New York City public school since the length of stay of the children, many afflicted with tuberculosis and poliomyelitis, might be over 1-2 years. The large number of immigrants in the city led to very challenging social conditions that saw changes made in the first two decades of the twentieth century. When this country entered World War I in 1917, the physician staff was significantly affected as many volunteered for military service. Soldiers, sailors, and marines were treated at R & C, and military physicians were educated in orthopedics and hernia care on the wards and in the outpatient department. Because of declining health in 1924, Dr. Gibney retired and was replaced as Surgeon-in-Chief by his long-term friend and colleague, Dr. William B. Coley in January 1925. | 18,751,783 |
Prevalence of major life events among patients and community dwellers. | Life events have been shown to be associated with health and illness. We studied the number of life events experienced by hip fracture patients, nonfracture rheumatology patients, and community-dwelling asymptomatic residents in the year before interview. Fifty-four hip fracture patients, 63 ambulatory patients, and 115 community-dwelling residents participated in the study. All were older than 65 years. Descriptive statistics and nonparametric analyses were performed. The number of events reported in the previous 12 months was higher for hip fracture patients than for community participants (p = 0.02). At least one bereavement was reported by 32% of hip fracture patients, 27% of ambulatory patients, and 26% of community dwellers (p = 0.8). Ten percent of all respondents reported experiencing more than one bereavement. This has important consequences when considering the care of these patients and the mental distress they may be experiencing, especially in the aftermath of local disasters or trauma. Medications may not always be the best treatment, and better psychosocial assessments and delivery systems are needed. | 18,751,810 |
What is the role of magnetic resonance imaging in the evaluation of total hip arthroplasty? | MRI has been shown to be an extremely effective instrument in the management of painful hip arthroplasty. Its superior soft tissue contrast and direct multiplanar acquisition compared to computerized tomography (CT) and radiographs allows for reproducible visualization of periacetabular osteolysis, demonstrating compression of neurovascular bundles by extracapsular synovial deposits. In addition, MRI can often elucidate etiology of neuropathy in the perioperative period and is further helpful in evaluating the soft tissue envelope, including the attachment of the hip abductors, short external rotators and iliopsoas tendon. A further advantage of MRI over CT is its lack of ionizing radiation. Most importantly, MRI can disclose intracapsular synovial deposits that precede osteoclastic resorption of bone. | 18,751,814 |
A shearing osteochondral fracture of the humeral head following an anterior shoulder dislocation in a child. | A dislocation of the shoulder joint is rare in children with an open physis. The fractures associated with an anterior dislocation generally reported in the literature have been Hill-Sachs lesions, avulsions of the greater tuberosity and glenoid fractures. We present a case of a previously unreported shearing osteochondral fracture, which is distinct from a classic Hill-Sachs lesion of the humeral head, in 12-year-old boy. The patient suffered a traumatic anterior shoulder dislocation with a spontaneous reduction along with this associated fracture. The fracture subsequently healed with no further evidence of persistent instability. | 18,751,816 |
Effect on deep venous thrombosis with flexion during total knee arthroplasty. | This study investigates the relationship between intraoperative extreme flexion and tibia-femoral dislocation during total knee arthroplasty on the prevalence of postoperative deep venous thrombosis. Knees were randomized into two groups. The control group underwent the procedure according to normal protocol, which kept the knee in extreme flexion and maintained dislocation for the duration of the exposure, whereas the variable group underwent the procedure modified to minimize the total amount of time the knee was hyperflexed and dislocated. Venograms were positive in 42% (39/92) of the control knees and 38% (30/79) of the modified group (p = 0.6). Proximal deep venous thrombosis were found in 12% (11/92) of the control knees and in 16% (13/79) of the modified knees (p = 0.4). No statistical difference could be detected between the two techniques in regards to the incidence of deep venous thrombosis. | 18,751,828 |
Histological and molecular structure characterization of annular collagen after intradiskal electrothermal annuloplasty. | The mechanism of pain relief of intradiskal electrothermal annuloplasty (IDET) in the treatment of lumbar diskogenic pain is uncertain. Theories include sealing of annular fissures via collagen denaturation and contraction. Prior studies offer conflicting qualitative data on the ability of IDET to denature collagen. The objective of the present study is to evaluate IDET treatment effect on annular collagen using quantitative data supplied by Fourier-transform infrared imaging spectroscopy. The posterior annulus of disks (n = 3) from an intact human cadaveric spine at room temperature were treated with two different radiothermal catheters using standard intradiskal electrothermal annuloplasty (IDET) heating protocols. Disks were dissected free with catheters in place and fixed in formalin. Channels created by the catheters were marked and catheters were removed. Tissue samples of treated areas adjacent to the channels and internal control areas from the same disk were stained for light microscopy and placed on barium sulfate windows for Fourier transform infrared imaging spectroscopy (FT-IRIS) analysis. Treated areas showed evidence of disruption in the fibrillar organization of annular collagen by light microscopy compared to intact stroma from control areas. Quantitative FT-IRIS analysis compared ratios of wavenumber regions known to be sensitive to collagen denaturation. Mean values for the ratios amide II/1,338 cm(-1) (137.21 +/- 25.84 treated, 76.94 +/- 16.77 control) and 1,640/1,660 cm(-1) (0.98 +/- 0.03 treated, 0.89 +/- 0.03 control) were significantly different between treated and control samples (p < 0.001), indicating a breakdown in collagen integrity. Separate analysis by catheter type suggests that catheter design may impact treatment effect. | 18,751,846 |
The Eftekhar and Kerboul classifications in assessment of developmental dysplasia of the hip in adult patients. Measurement of inter- and intraobserver reliability. | To measure the inter- and intraobserver reliability of two radiologic classification systems in the evaluation of severity of osteoarthritis secondary to developmental dysplasia of the hip in adult patients and to compare these systems to historically published data on two more commonly used classification systems described by Crowe and by Hartofikakidis. Eighty-six dysplastic hips on 66 anteroposterior standard pelvic x-rays were rated according to the criteria of Eftekhar and Kerboul by three observers with different levels of clinical training. To assess intraobserver reliability, the measurement was repeated 3 months later. Statistical analysis was performed by calculating the weighted kappa correlation coefficient and the overall kappa coefficient. Both classification systems showed a sufficient interobsever reliability, reaching a kappa coefficient of 0.73 for the system according to Eftekhar and 0.716 for the Kerboul classification system. Intraobserver reliability revealed a kappa coefficient of 0.778 for the Eftekhar system and 0.697 for the classification according to Kerboul. Both systems showed good inter- and intraobserver reliability for use in daily practice. However, they did not reach the known reliability of the grading systems published by Crowe and by Hartofikakidis. Because these systems are more frequently used, we would recommend one of them to grade the severity of osteoarthritis secondary to developmental dysplasia of the hip in adult patients instead of the ones described by Eftekhar or by Kerboul. | 18,751,859 |
The one year incidence of postoperative myocardial infarction in an orthopedic population. | The diagnosis of a postoperative myocardial infarction (PMI) is important in the orthopedic population because these events can be associated with significant cardiac morbidity. Plasma troponin I (cTnI) analysis has markedly increased our ability to detect myocardial damage. Using cTnI analysis for evidence of a PMI, we prospectively assessed all of our patients for (1) the 1-year incidence of PMI, (2) the clinical consequences of a PMI in relation to the level of the cTnI release, and (3) 6-month follow-up for cardiac complications. During a 12-month period, patients at risk for perioperative myocardial ischemia were assessed for a PMI by serum cTnI levels and daily serial ECGs. Patients with cTnI levels above the reference level (> or = 0.4 ng/ml) were also assessed for new cardiac regional wall motion abnormalities with an echocardiogram and 6-month postdischarge adverse cardiac events. Of the 758 patients who were assessed for a PMI, 49 patients had detectable cTnI levels (> or = 0.4 ng/ml); the incidence of a PMI was 0.6% of all surgical cases and 6.5% of those patients were at risk for a cardiac event. A PMI was more common after hip arthroplasty than other orthopedic procedures. Twenty-three patients had a cTnI level >3.0 ng/ml, and 74% these patients (17/23) had anginal symptoms and/or ischemic ECG changes. Nine of these patients (9/23) had new postoperative echocardiographic changes, five (5/23) required emergency transfer to a cardiac care unit, and 10 (10/23) had postoperative cardiac complications. In contrast, 15 patients with levels of cTnI <3.0 ng/ml and without ischemic ECG changes and/or anginal symptoms had no postoperative cardiac complications. Fourteen patients (14/47) had cardiac complications 6 months after discharge, including four cardiac deaths, one fatal stroke, and four patients with unstable anginal episodes that required a change in medical management, and six patients required coronary revascularization. Orthopedic surgical patients with cTnI level <3 ng/ml and without symptoms or ECG changes suggestive of myocardial ischemia (15/49) may have different risks than those with higher-level cTn1. | 18,751,868 |
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