title stringlengths 0 1.13k | abstract stringlengths 1 15.7k | PMID int64 22 36.5M |
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"Curettage and aspiration dissection technique" using PMOD for liver resection. | To introduce a special dissection technique named "Curettage and Aspiration Dissection Technique" (CADT) using a versatile instrument called Peng's Multifunction Operative Dissector (PMOD) for liver resection. PMOD is an electrosurgical pencil with an inline suction, bearing four functions: electric cutting, coagulation, aspiration and dissection, The above-mentioned functions can be achieved simultaneously or sequentially during liver resection. The purpose of this study was to evaluate this technique and the special electrosurgical device in hepatic surgery. From June 2005 to December 2006, 70 consecutive patients with segmentectomy or major hepatectomy were performed with this dissection technique by the same surgeon. Peri-operative data and the technical aspect of this device and dissection technique for various types of liver resection were summarised. Forty-nine of 70 cases with various degrees of cirrhosis. Median blood loss were 470 ml (100-2400 ml), the bleeding and mortality within one month postoperatively was zero. There were postoperative complications in 20 patients: bile leak occurred in five cases, nine cases with right pleural effusion and six with ascites. No relative complications with this method were found. The CADT and PMOD can achieve better dissection and hemostasis. It possible is a much more valuable alternative to other devices currently used for liver surgery. | 18,773,106 |
Effects of a bicarbonate-alkaline mineral water on digestive motility in experimental models of functional and inflammatory gastrointestinal disorders. | This study investigates the effects of Uliveto, a bicarbonate-alkaline mineral water, in experimental models of diarrhea, constipation and colitis. Rats were allowed to drink Uliveto or oligomineral water (control) for 30 days. Diarrhea and constipation were evoked by 16,16-dimethyl-prostaglandin E(2) (dmPGE(2)) or loperamide, respectively. Colitis was induced by 2,4-dinitrobenzenesulfonic acid (DNBS) or acetic acid. Gastric emptying, small-intestinal and colonic transit were evaluated. dmPGE(2)-induced diarrhea reduced gastric emptying and increased small-intestinal and colonic transit. In this setting, Uliveto water enhanced gastric emptying, and this effect was prevented by L-365,260 (gastrin receptor antagonist). Loperamide-induced constipation reduced gastric emptying, small-intestinal and colonic transit, and these effects were prevented by Uliveto water. L-365,260 counteracted the effects of Uliveto on gastric emptying, while alosetron (serotonin 5-HT(3) receptor antagonist) blunted the effect of Uliveto on colonic transit. Gastric emptying, small-intestinal and colonic transit were reduced in DNBS-induced colitis, and Uliveto water enhanced gastric emptying and normalized small-intestinal and colonic transit. Gastric emptying, small-intestinal and colonic transit were also reduced in acetic acid-induced colitis, and Uliveto increased both gastric emptying and small-intestinal transit. In conclusion, Uliveto water exerts beneficial effects on gastrointestinal motility in the presence of bowel motor dysfunctions. The effects of Uliveto water on gastric emptying depend on gastrin-mediated mechanisms, whereas the activation of serotonergic pathways accounts for the modulation of colonic functions. | 18,773,120 |
Fronto-ethmoidal encephalocele in a historical skull with artificial deformation and no signs of chronic elevated intracranial pressure. | The intentional deformation of human skulls in the living being was one of the most curious rituals performed in historical and ancient times. It is thought that these practices cause chronic elevated intracranial pressure and subsequent symptoms of cognitive impairment. In this report, we examine such an artificially deformed skull dating from the sixteenth century that in addition shows a fronto-ethmoidal encephalocele. However, although the mild encephalocele was already manifest at birth and deformation practices were performed over years, the encephalocele did not progress into a more severe status. We conclude that the intentional deformation of skulls does not lead to chronic elevated intracranial pressure and mental retardation. | 18,773,138 |
[From basic research to the clinic. Obstacles and options for stem cell therapies]. | Translation from the laboratory to the clinic is one of the key problems of stem cell research. One reason for this is that stem cell science is ethically charged and therefore its successful therapeutic application would support its social legitimacy and further funding. We discuss translation both theoretically and with reference to an example, namely efforts regarding the creation of cardiomyocytes from embryonic stem cell lines with the aim to regenerate a patient's myocardium post trauma. Using this case we explain the facts that need to be established scientifically and the subsequent steps that need to be taken in order to develop and implement clinical application. We also discuss aspects of current scientific development related to the moral charge of the research, in particular emerging methods aimed at the derivation of pluripotent cells, such as the hybridization of human DNA and animal egg cells, or the genetic modification of adult somatic cell nuclei in culture to induce pluripotency. | 18,773,172 |
Evaluation of outpatient cystoscopy in urogynaecology. | Prospective evaluation of outpatient cystoscopy in a Urogynaecology Unit. Prospective observational series. St. George's Hospital, London. Department of Pelvic Reconstructive Surgery and Urogynaecology. A total of 131 consecutive women, who underwent outpatient rigid cystoscopy over a 24-month-period. Prospective data collection included cystoscopic findings, microbiology data, uroflowmetry and radiological results. An Immediate Feedback Questionnaire was completed at the end of the procedure. Success rates of the procedure, cystoscopy findings, requirements for additional investigations, including inpatient cystoscopy and patient satisfaction rates. The mean age was 56.4 years (range 20-87 years). A total 126 women (96.2%) had a successful outpatient cystoscopy. In five (3.8%) women the procedure had to be abandoned because of inability to insert the cystoscope. Eleven women (8.7%) experienced pain but were able to tolerate the discomfort. Fifty-three (42.7%) women had abnormalities detected at cystoscopy. Thirty-seven women had trabeculations. Focal vesical lesions were found in 21 women. Thirty-nine (30.9%) women did not require any additional treatment. Six (6.9%) women were scheduled for repeat cystoscopy under general anaesthetic to facilitate a bladder biopsy. Fifteen women (17.2%) were referred for urodynamics or renal imaging. Three women (3.4%) were referred to a urologist. More than 75% reported high satisfaction with the care they received. Four women had symptoms of UTI and two had positive urinary cultures and required antibiotics. The benefits of outpatient cystoscopy include high levels of tolerability and patient satisfaction, shorter waiting time, quicker implementation of treatment strategies, avoidance of the risks of general anaesthesia and lower procedural cost. | 18,773,215 |
A cDNA resource for the cephalochordate amphioxus Branchiostoma floridae. | Cephalochordates are the basal invertebrate chordates within the phylum Chordata. They are widely used as a model system for research in evolutionary developmental biology (EvoDevo) to understand the basic patterning mechanisms for the chordate body plan and the origin of vertebrates. Recently, the genome of the cephalochordate Branchiostoma floridae was sequenced, which further brings this organism to the front for comparative genomic studies. In this paper, we report the generation of large-scale 5'- and 3'-expressed sequence tags (ESTs) from B. floridae and the complementary deoxyribonucleic acid (cDNA) resource for this species. Both 5'- and 3'-ESTs were sequenced for approximately 140,000 cDNA clones derived from five developmental stages, and the cDNA clones were subsequently grouped into independent clusters using 3'-EST sequences. We identified 21,229 cDNA clusters, and each corresponds to a unique transcript species from B. floridae. We then chose 24,020 cDNA clones representing all of these 21,229 clusters to generate the "Branchiostoma floridae Gene Collection Release 1." We also constructed a database with a searchable interface for this EST dataset and the related information on "Branchiostoma floridae Gene Collection Release 1." This set of cDNA clones along with our cDNA database will serve as an important resource for future research in this basal chordate. This Gene Collection and the original 140,000 individual cDNA clones are available to the research community upon request. | 18,773,220 |
Regulatory genes in the ancestral chordate genomes. | Changes or innovations in gene regulatory networks for the developmental program in the ancestral chordate genome appear to be a major component in the evolutionary process in which tadpole-type larvae, a unique characteristic of chordates, arose. These alterations may include new genetic interactions as well as the acquisition of new regulatory genes. Previous analyses of the Ciona genome revealed that many genes may have emerged after the divergence of the tunicate and vertebrate lineages. In this paper, we examined this possibility by examining a second non-vertebrate chordate genome. We conclude from this analysis that the ancient chordate included almost the same repertory of regulatory genes, but less redundancy than extant vertebrates, and that approximately 10% of vertebrate regulatory genes were innovated after the emergence of vertebrates. Thus, refined regulatory networks arose during vertebrate evolution mainly as preexisting regulatory genes multiplied rather than by generating new regulatory genes. The inferred regulatory gene sets of the ancestral chordate would be an important foundation for understanding how tadpole-type larvae, a unique characteristic of chordates, evolved. | 18,773,221 |
Proximal STA to proximal PCA bypass using a radial artery graft by posterior oblique transzygomatic subtemporal approach. | The aim of the present study was to investigate the use of a radial artery graft (RAG) for bypass of the proximal superficial temporal artery (STA) to proximal posterior cerebral artery (PCA) by posterior oblique transzygomatic subtemporal approach as an alternative to the external carotid artery (ECA) to PCA anastomosis. We conducted an anatomical and technical study at a university hospital. Five adult cadaveric specimens were dissected. A preauricular vertical skin incision was used. The trunk of STA was identified. A 30 degrees oblique posterior zygomatic arch osteotomy and microcraniotomy was performed. The dura of the middle cranial fossa was then opened. The temporal lobe was retracted, the interpeduncular and ambient cisterns were opened, and the P2 segment of the PCA was exposed. The proximal side of the RAG was anastomosed with the proximal STA and the distal side was anastomosed with the P2 segment. The mean caliber of the proximal STA was 2.25 +/- 0.35 mm. The mean diameter of the P(2) was 2.2 +/- 0.2 mm. The average length of the RAG was 56 +/- 3.2 mm. The mean caliber of the proximal and the distal sides of the graft was 2.5 +/- 0.25 mm and 2.3 +/- 0.15 mm, respectively. Because the proximal STA to proximal PCA bypass uses a short RAG and their calibers are over 2 mm, this bypass technique can provide a sufficient blood flow and may be a reasonable alternative over ECA to PCA bypass using long grafts. | 18,773,233 |
A conflict-resolution model for the conjunctive use of surface and groundwater resources that considers water-quality issues: a case study. | The conjunctive use of surface and groundwater resources is one alternative for optimal use of available water resources in arid and semiarid regions. The optimization models proposed for conjunctive water allocation are often complicated, nonlinear, and computationally intensive, especially when different stakeholders are involved that have conflicting interests. In this article, a new conflict-resolution methodology developed for the conjunctive use of surface and groundwater resources using Nondominated Sorting Genetic Algorithm II (NSGA-II) and Young Conflict-Resolution Theory (YCRT) is presented. The proposed model is applied to the Tehran aquifer in the Tehran metropolitan area of Iran. Stakeholders in the study area have conflicting interests related to water supply with acceptable quality, pumping costs, groundwater quality, and groundwater table fluctuations. In the proposed methodology, MODFLOW and MT3D groundwater quantity and quality simulation models are linked with the NSGA-II optimization model to develop Pareto fronts among the objectives. The best solutions on the Pareto fronts are then selected using YCRT. The results of the proposed model show the significance of applying an integrated conflict-resolution approach to conjunctive use of surface and groundwater resources in the study area. | 18,773,238 |
Evaluating ascorbate oxidase as a plant defense against leaf-chewing insects using transgenic poplar. | Ascorbate is the major water-soluble antioxidant in plants and animals, and it is an essential nutrient for most insect herbivores. Therefore, ascorbate oxidase (AO) has been proposed to function as a plant defense that decreases the availability of ascorbate to insects. This hypothesis was tested by producing transgenic poplar (Populus tremula x Populus alba; Salicaceae) with 14- to 37-fold higher foliar AO activities than control (wild type) leaves and feeding these leaves to Lymantria dispar L. (Lepidoptera: Lymantriidae) caterpillars and Melanoplus sanguinipes (Fabricius) (Orthoptera: Acrididae) grasshoppers. To examine potential mechanisms of activity of AO in these insects, ascorbyl radical and/or ascorbate levels were measured in gut contents. No significant changes in ascorbyl radical or ascorbate levels were found in the midgut contents of L. dispar larvae that ingested the leaves of the AO-overexpressing genotypes compared to the control genotype, and no significant decreases in ascorbate levels were found in the foregut or midgut contents of M. sanguinipes. Treatment of control leaves with commercial AO also produced no changes in the midgut biochemistry of L. dispar larvae, as measured by levels of ascorbyl radicals. Likewise, no increase in oxidative stress was observed in L. dispar that consumed tannin-treated AO-overexpressing leaves compared with tannin-treated control genotype leaves. Performance experiments were carried out on first- and fourth-instar L. dispar larvae on leaf disks and on third instars feeding on intact leaves on trees. In no case was a significant difference found in the contrast between the control and three AO-overexpressing genotypes for relative consumption rate, relative growth rate, or nutritional indices. We conclude that elevated levels of AO in poplar are unlikely to serve as a defense against herbivores such as L. dispar or M. sanguinipes and that the low oxygen levels commonly found in the guts of caterpillars and grasshoppers may limit the activity of ingested AO in these leaf-chewing insects. | 18,773,241 |
The LLA23 protein translocates into nuclei shortly before desiccation in developing pollen grains and regulates gene expression in Arabidopsis. | We have isolated the LLA23 gene in the pollen of Lilium longiflorum. The LLA23 gene encodes an ASR (named after abscisic acid, stress and ripening) protein that has a nuclear localization sequence at the C terminus. The gene is interrupted by one single intron and possesses a long 5'-untranslated region. Southern blots of lily genomic DNA indicated that LLA23 is a member of a small gene family. We examined the link between LLA23 location and the desiccation that naturally occurs in developing anthers using immunogold labeling. When pollen reached maturity, a significant increase in LLA23 labeling was observed in the nuclei of both vegetative and generative cells from 10- to 12-cm buds and thereafter. This clearly demonstrates that a marked increase in LLA23 translocation from the cytoplasm to both nuclei of pollen grains occurs in 12-cm buds, a stage shortly before the commencement of desiccation during anther development. In addition, microarray analysis showed that 410 (206 up-regulated and 204 down-regulated) genes have altered expression in LLA23-overexpressing plants. Quantitative PCR analysis confirmed the changes in mRNA levels observed in our microarray analysis. This genome-wide overview of gene expression supports the theory that LLA23 acts as a regulator. | 18,773,257 |
Comparison of central corneal thickness measurements by Orbscan II and Pentacam after corneal refractive surgery. | To compare the accuracy of postoperative pachymetry between Orbscan II (Bausch & Lomb) scanning-slit corneal topography/pachymetry and the Pentacam (Oculus) rotating Scheimpflug camera. Central corneal thickness (CCT) was determined in 24 patients (48 eyes) before and after laser in situ keratomileusis (LASIK) or Epipolis LASIK (Epi-LASIK) procedures. All eyes were examined by Orbscan II and Pentacam prior to refractive surgery and at the first, fourth, and twelfth week postoperatively. The residual CCT (RCCT) measured by each instrument was compared to the theoretical RCCT. On the first, fourth, and twelfth week after the refractive surgery, the mean RCCT measurements by Orbscan II were 413 +/- 72, 435 +/- 65, and 440 +/- 69 microm, respectively. Those of Pentacam were 434 +/- 51, 436 +/- 53, and 438 +/- 50 microm, respectively. Orbscan II measurements at the postoperative first and fourth week were significantly smaller than the theoretical RCCT (P < 0.01, P < 0.01, paired t test). There was no statistical difference between the theoretical RCCT and the Pentacam measurements at any stage. The Orbscan II measurement values of postoperative corneas tended to be thinner than the theoretical values, but not those of the Pentacam. | 18,773,260 |
Pathological findings of multifocal choroiditis with panuveitis and punctate inner choroidopathy. | To compare the pathological findings between multifocal choroiditis with panuveitis (MCP) and punctate inner choroidopathy (PIC). Fourteen eyes of 14 patients clinically diagnosed as having MCP or PIC who underwent surgical excision of choroidal neovascularization (CNV) were studied. Immunohistochemical findings of the excised CNV in MCP (eight eyes) and PIC (six eyes) cases were compared. Antibodies against vascular endothelial growth factor (VEGF), CD68, CD3, and CD20 were used as primary antibodies. Expression of VEGF and CD68 in the CNV was observed in all MCF and PIC cases. In three of eight eyes with MCP, intraocular inflammatory findings were found clinically, while immunohistochemical study demonstrated infiltration of CD20-positive B lymphocytes in the CNV. No B lymphocyte infiltration was found in the six eyes with PIC. No differences in pathological findings were found between the five MCP eyes without intraocular inflammation and the six PIC eyes, with all eyes showing no B lymphocyte infiltration. In MPC cases showing clinical inflammatory findings, infiltration of B lymphocytes was also observed histopathologically, suggesting that the presence of inflammatory cells in the anterior chamber or vitreous body clinically is an indicator of active inflammatory CNV. However, this study clarifies that MCP eyes without intraocular inflammation and PIC eyes are not different in histopathological findings. | 18,773,266 |
Metastatic carcinoma of the breast: a case with the unusual presentation of unilateral periorbital edema. | Metastasis of mammary cancer involving the orbit is common, and it typically presents with enophthalmos and restrictions of ocular motility. We report a case of mammary cancer with the unusual presentation of unilateral periorbital edema only. The possible mechanisms of unilateral periorbital swelling are discussed. Metastasis of breast cancer involving unilateral eyelid edema was diagnosed in a 66-year-old woman. A biopsy was performed to confirm the etiology after vague neuroimaging findings. The diagnosis was based on the histopathologic features of carcinomatous cells in the excised specimen. Insidious, progressive unilateral upper and lower eyelid swelling of the right eye disappeared after one cycle of palliative chemotherapy. Neither restriction nor proptosis developed in the whole course. Possible metastasis should be considered as a possible etiology of unilateral eyelid edema, even without a palpable mass or limitation of ocular motility. A biopsy should be performed in cases of unexplained eyelid edema. | 18,773,269 |
Terbium sensitized luminescence for the determination of ketoprofen in pharmaceutical formulations. | This paper explores an ultra-sensitive luminescence method for the determination of Ketoprofen (KP) in pharmaceutical formulations. The technique is indirect and exploits the luminescence enhancement of terbium (Tb(3+)) by complexation with KP (Tb(3+)-KP), which was monitored at respective excitation and emission wavelengths of lambda(ex) = 258 nm and lambda(em) = 549 nm. The effect of varying the Tb(3+) concentration and using multiple solvents was examined to determine optimal experimental conditions. Maximum sensitization was accomplished in the presence of methanol where the most favourable condition for the formation of the complex was recorded at a level of 1.0 x 10(-5) M of Tb(3+). Under these optimum experimental conditions, linear calibration curve was obtained in the range of 2.8 x 10(-7)-3.1 x 10(-6) M with a detection limit of 8.7 x 10(-8) M. The technique was validated with 'working' reference standards and produced relative standard deviations < 2% indicating that the reproducibility was highly acceptable. The proposed method was successfully applied to assays of KP in pharmaceutical formulations with average recoveries of 92-98%. The results were found to be in good agreement with those obtained by HPLC. The method is highly suited for general applications of this nature. | 18,773,282 |
Induced apoptotic action of recombinant trichosanthin in human stomach adenocarcinoma MCG803 cells. | Trichosanthin (TCS), is purified from the Chinese medicine, exerts antitumor activities by inducing apoptosis in many different tumor cell lines. The cDNA of trichosanthin was cloned and TCS was purified. The results showed that the proliferation of MCG803 cells were significantly suppressed by TCS in a dose-dependent manner at the concentration ranging from 20 to 100 microg/ml. The result of sequencing analysis indicates we obtained the TCS whole length gene. MTT assay was adopted to measure the growth inhibition ratio of MCG803 cells treated with TCS and apoptosis was assayed by agarose gel electrophoresis. DNA agarose gel electrophoresis showed a gradient, which confirmed that TCS could induce MCG803 cells apoptosis. The proportion of the periodic tumor cells were altered by TCS. Sub-G(1) curves were displayed by flow cytometry analysis. Results of Northern and Western blots showed that the transcription and expression of P21, was gradually up-regulated as treatment time increased. On the contrary, the transcription and expression of p53, was down-regulated. These data provided powerful evidences for the first time that recombinant TCS can induce the apoptosis of the MCG803 cells. | 18,773,305 |
Secure base representations for both fathers and mothers predict children's secure base behavior in a sample of Portuguese families. | Relations between fathers' and mothers' representations of attachment (independently assessed using an attachment script representation task) and children's secure base behavior (assessed using the Attachment Q-sort; AQS) were studied in 56 Portuguese families (mean age of child = 31.9 months). Each parent's secure base script representation score predicted AQS security scores for the child with that parent at approximately equivalent degrees of association. However, both parental secure base script scores and AQS security scores were positively correlated across parents. A hierarchical regression predicting AQS security with father from both parent's scriptedness scores and from the AQS score with mother showed a unique, significant influence of father's scriptedness score and the AQS score with mother, but mother's scriptedness score did not uniquely add to the prediction. Difficult temperament was ruled out as a mediator of the cross-parent association for AQS security scores. | 18,773,318 |
Childhood temporary separation: long-term effects of the British evacuation of children during World War 2 on older adults' attachment styles. | This study investigates long-term effects on adult attachment due to temporary childhood separation as a result of the British evacuation of children during World War 2. A total of 859 respondents, aged 62-72 years, were recruited who had childhood homes in the county of Kent during the war. Of these, 770 had been evacuated and 89 remained at home and formed a non-evacuated control group. They participated in this retrospective survey of possible associations between childhood experiences of the evacuation, early upbringing, and later life-course variables, with adult attachment style assessed by the Relationship Questionnaire (Bartholomew & Horowitz, 1991). Reflecting the wartime concerns of Bowlby, male and female respondents evacuated between the ages of 4 and 6 years showed low incidences in secure attachment style of 38% and 27%, compared to those not evacuated at 64% and 44%, respectively, with a corresponding increase in the fearful category. The quality of care received during evacuation and the frequency of parental visits were also found to be significantly associated with attachment style for female respondents. Irrespective of experience of evacuation, both male and female respondents who reported poor home nurture showed a similar low incidence of secure attachment of 23% compared to those from homes with good quality care of 45% and 43%, respectively, with concomitant increases in proportions in the dismissing category for males and the fearful category for females. The clinical implications of the study are briefly discussed. | 18,773,319 |
Household smoking and childhood asthma in the United States: a state-level analysis. | The reason for the substantial geographic variation in the prevalence of childhood asthma is not known. To investigate the association between exposure to cigarette smoking in the home and childhood asthma at the state-level, toward improving current understanding of geographic variation in childhood asthma rates. Data were drawn from the National Children's Health Survey (NCHS, 2003), a representative sample (n = 102,000) of youth 0 to 17 years of age in the United States. Household smoking and asthma in children were reported by parents. Air quality for each state was obtained from Environmental Protection Act (EPA) reports, and state-level poverty reports were obtained from the US Department of Agriculture. Household smoking was associated with a statistically significant increase in risk of asthma among children at the state level (p = 0.026). This association did not appear to be influenced by outdoor air quality at the state level or socioeconomic position. These results are the first to show a link between cigarette smoking in the home and childhood asthma at a state-level in the United States. | 18,773,335 |
[Results after revision surgery for carpal tunnel release]. | The aim of this study was to assess the clinical results of revision surgery due to persistent neurological disturbances after carpal tunnel release. In a previous study we showed the reasons for persisting neurological symptoms after carpal tunnel release on the basis of the intraoperative findings in 200 patients who underwent revision surgery in the years 2001 - 2003. We classified them into four groups (1: incomplete release of the retinaculum flexorum, 2: traction neuropathy, 3: real recurrent carpal tunnel syndrome, and 4: nerve lesions). 122 of these patients have been investigated regarding the clinical results using two questionnaires in the year 2004. We used the DASH questionnaire as well as an additional self-assessment questionnaire asking about remaining symptoms of median nerve irritation and the subjective results of revision surgery. The completely filled-out forms were assigned to the four groups, analysed and the results compared with each other. Within group 1 (incomplete release), 78 % reported only one persistent neurological symptom, 89 % described a benefit from revision surgery and 84 % were satisfied with a median DASH score of 11. Within group 2 83 % complained about at least one persistent neurological problem and only 60 % reported on an improvement following revision surgery. The DASH score within group 2 averaged 30. 87 % of group 3 patients reported of an improvement following the revision operation (DASH score 24), whereas this was the case for only 55 % (DASH score 37) of group 4 patients. The incomplete release of the flexor retinaculum is the most common reason for revision surgery. In most of these patients the clinical symptoms can be resolved with revision surgery leading to a very high satisfaction of the patients. A similarly high satisfaction can be expected following revision surgery of a true recurrent carpal tunnel syndrome although in most patients a significant degree of functional deficit will remain. Revision surgery due to fibrotic adhesions of the median nerve, leading to a traction neuropathy, or iatrogenic nerve lesions during the primary surgery will definitely lead to unsatisfactory overall results. | 18,773,389 |
Should we use one-, or multi-compartment models to describe (13)C incorporation into animal tissues? | Understanding rates of isotopic incorporation and discrimination factors between tissues and diet is an important focus of ecologists seeking to use stable isotopes to track temporal changes in diet. We used a diet-shift experiment to measure differences among tissues in (13)C incorporation rates in house sparrows (Passer domesticus). We predicted faster incorporation rates in splanchnic than in structural tissues. We also assessed whether isotopic incorporation data were better supported by the one-compartment models most commonly used by ecologists or by multi-compartment models. We found large differences in the residence time of (13)C among tissues and, as predicted, splanchnic tissues had faster rates of isotopic incorporation and thus shorter retention times than structural tissues. We found that one-compartment models supported isotopic incorporation data better in breath, excreta, red blood cells, bone collagen, and claw tissues. However, data in plasma, intestine, liver, pectoralis muscle, gizzard, and intestine tissues supported two-compartment models. More importantly, the inferences that we derived from the two types of models differed. Two-compartment models estimated longer (13)C residence times, and smaller tissue to diet differences in isotopic composition, than one-compartment models. Our study highlights the importance of considering both one- and multi-compartment models when interpreting laboratory and field isotopic incorporation studies. It also emphasizes the opportunities that measuring several tissues with contrasting isotopic residence times offer to elucidate animal diets at different time scales. | 18,773,411 |
Characterization of TRIM31, upregulated in gastric adenocarcinoma, as a novel RBCC protein. | To explore the molecules associated with gastric adenocarcinoma, we used the gene expression profile database of various human tissues and identified TRIM31 upregulated in both patients with chronic gastritis and stomach cancer. TRIM31 is a new member of RBCC proteins composed of RING finger, B-box and coiled-coil domains. We characterized TRIM31 biochemically and found it possess properties in common with other RBCC proteins, such as occurrence of alternative splicing transcripts, in vitro autoubiquitylating activity and a tendency to homo-oligomerize. The primary localization site of TRIM31 is the cytoplasm but some fraction is potentially associated with the mitochondria. TRIM31 overexpression suppresses colony formation of HCT116 cells while knockdown of its expression with short interfering RNAs (siRNAs) consistently tends to enhance growth of AsPC-1 cells slightly. Thus, TRIM31 is a characteristic RBCC protein with the ability to regulate cell proliferation negatively and may be a potential biomarker of gastric cancer as it is overexpressed from the early stage of gastric carcinogenesis. | 18,773,414 |
Immobilization of cellulose phenylcarbamate onto silica gel via in termolecular polycondensation of triethoxysilyl groups introduced with (3-glycidoxypropyl)triethoxysilane. | Cellulose 3,5-dimethylphenylcarbamate was successfully immobilized onto bare silica gel for HPLC through the intermolecular polycondensation of triethoxysilyl groups, which were introduced onto the cellulose derivative via epoxide ring-opening reaction under acidic conditions. The immobilized-type chiral packing material (CPM) exhibited high chiral recognition ability and could be used with various eluents, which are incompatible with the conventional CPMs prepared by coating the derivative onto silica gel. | 18,773,418 |
Performance of electrospun nanofibers for SPE of drugs from aqueous solutions. | A novel extraction technique was reported. The solid phase material, nanofiber, was prepared by electrospinning using polystyrene. Twenty different drugs (10 microg/L in water) were extracted using 1 mg of nanofibers within 5 min. The analytes can be desorpted from the fibers with 50 microL of the methanol and then monitored by LC coupled to a UV detector. Packed-fiber SPE (PFSPE) provide high recoveries (>50%) for some relatively non-polar drugs (log P >1.5) (n-octanol-to-water partition ratio), and relatively low recoveries (9.9-39.8%) for the drugs within the log P window below 1. Experimental optimization of the technique has been carried out using seven representative drugs, edaravone, cinchonine, quinine, voriconazole, chlordiazepoxide, verapamil, and rutonding. Except for edaravone, the maximum yields of seven drugs (0.2 microg/L) from water samples were approximately 100%, and were 33.7-88.2% from human plasma. The advantageous aspect of the technique encompasses high throughput, high sensitivity, simplicity, low cost, and green chemistry. | 18,773,420 |
Fine-needle aspiration biopsy of metastatic malignant melanoma resembling a malignant peripheral nerve sheath tumor. | We report a case of metastatic malignant melanoma resembling a malignant peripheral sheath tumor, which posed a significant diagnostic challenge. The patient is a 76-year-old male, who presented in the emergency room with bilateral chest pain exacerbated by inspiration. The pain was present for 3 week and was not exacerbated by physical exercise. The diagnostic workup revealed bilateral parenchymal pulmonary infiltrates. The CT-scan guided fine-needle aspiration and the core biopsies of the largest pulmonary lesion revealed high-grade spindle cell neoplasm with individual cell apoptosis and necrosis. The immunohistochemical profile on the cell block showed that the cells are positive for Vimentin. The S-100 stain showed only focal positivity. The immunohistochemical stains for HMB45, Melan A, pancytokeratin, and smooth muscle actin were negative. Five years ago the patient was diagnosed with melanoma on the back with Clark level of IV. The melanoma was excised with clear margins and sentinel lymph nodes were negative. Careful examination of patient's previous slides revealed an area of spindle cell melanoma adjacent to a nodular type melanoma. Based on the patient's previous history, current clinico-pathologic presentation and immunohistochemical profile, the diagnosis of metastatic malignant melanoma resembling peripheral nerve sheath tumor was favored over the diagnosis of metastatic malignant spindle cell neoplasm of unknown primary site, which by itself is very rare clinical scenario. | 18,773,432 |
Cytologic features of primary chondroid tumors of bone in crush preparations. | Fine-needle aspiration biopsy can be utilized effectively in the diagnosis of many bone lesions. Often, these lesions are suspected to be foci of metastatic disease based on clinical and/or radiographic findings. On occasion, microscopic examination of the aspirate yields a diagnosis of a primary neoplasm of chondroid origin. We discuss the cytologic features observed in crush preparations of the most frequently seen primary chondroid tumors of bone and how these lesions can be differentiated from each other and from metastatic lesions. | 18,773,433 |
Microdissection molecular copy-number counting (microMCC)--unlocking cancer archives with digital PCR. | Most cancer genomes are characterized by the gain or loss of copies of some sequences through deletion, amplification or unbalanced translocations. Delineating and quantifying these changes is important in understanding the initiation and progression of cancer, in identifying novel therapeutic targets, and in the diagnosis and prognosis of individual patients. Conventional methods for measuring copy-number are limited in their ability to analyse large numbers of loci, in their dynamic range and accuracy, or in their ability to analyse small or degraded samples. This latter limitation makes it difficult to access the wealth of fixed, archived material present in clinical collections, and also impairs our ability to analyse small numbers of selected cells from biopsies. Molecular copy-number counting (MCC), a digital PCR technique, has been used to delineate a non-reciprocal translocation using good quality DNA from a renal carcinoma cell line. We now demonstrate microMCC, an adaptation of MCC which allows the precise assessment of copy number variation over a significant dynamic range, in template DNA extracted from formalin-fixed paraffin-embedded clinical biopsies. Further, microMCC can accurately measure copy number variation at multiple loci, even when applied to picogram quantities of grossly degraded DNA extracted after laser capture microdissection of fixed specimens. Finally, we demonstrate the power of microMCC to precisely interrogate cancer genomes, in a way not currently feasible with other methodologies, by defining the position of a junction between an amplified and non-amplified genomic segment in a bronchial carcinoma. This has tremendous potential for the exploitation of archived resources for high-resolution targeted cancer genomics and in the future for interrogating multiple loci in cancer diagnostics or prognostics. | 18,773,450 |
Retroviral vector silencing during iPS cell induction: an epigenetic beacon that signals distinct pluripotent states. | Retroviral vectors are transcriptionally silent in pluripotent stem cells. This feature has been potently applied in studies that reprogram somatic cells into induced pluripotent stem (iPS) cells. By delivering the four Yamanaka factors in retroviral vectors, high expression is obtained in fibroblasts to induce the pluripotent state. Partial reprogramming generates Class I iPS cells that express the viral transgenes and endogenous pluripotency genes. Full-reprogramming in Class II iPS cells silences the vectors as the endogenous genes maintain the pluripotent state. Thus, retroviral vector silencing serves as a beacon marking the fully reprogrammed pluripotent state. Here we review known silencer elements, and the histone modifying and DNA methylation pathways, that silence retroviral and lentiviral vectors in pluripotent stem cells. Both retroviral and lentiviral vectors are influenced by position effects and often exhibit variegated expression. The best vector designs facilitate full-reprogramming and subsequent retroviral silencing, which is required for directed-differentiation. Current retroviral reprogramming methods can be immediately applied to create patient-specific iPS cell models of human disease, however, future clinical applications will require novel chemical or other reprogramming methods that reduce or eliminate the integrated vector copy number load. Nevertheless, retroviral vectors will continue to play an important role in genetically correcting patient iPS cell models. We anticipate that novel pluripotent-specific reporter vectors will select for isolation of high quality human iPS cell lines, and select against undifferentiated pluripotent cells during regenerative medicine to prevent teratoma formation after transplantation. | 18,773,452 |
The anatomy of the cardiac conduction system. | All the myocytes within the heart have the capacity to conduct the cardiac impulse. A population of myocytes is specialized so as to generate the cardiac impulse and then to conduct it from the atrial to the ventricular chambers. This population has become known as the conduction system. Anatomists who seek to demonstrate the location of the components of this system must contend with the fact that the components of the system cannot be distinguished from the working myocardial elements by gross dissection. In important presentations to the German Pathological Society in 1910, rules were suggested for the histological distinction of these conducting cells. These rules proposed that the myocytes, to be considered as part of the conduction system, should be histologically discrete, traceable from section to section in serially prepared material, and if to be considered as tracts, should be insulated by fibrous tissue from the adjacent myocytes. Immunohistochemical techniques have now been developed that better demonstrate the distinction between the cells specialized to conduct from working myocytes. These new techniques, for the most part, confirm the accuracy of the initial descriptions. They also reveal additional areas with the characteristics of conduction tissues. These additional areas are located in a paranodal area adjacent to the sinus node, in the vestibules of both atrioventricular valvar orifices, and in a partial ring around the aortic root. In this review, we describe all these features, emphasizing the relationship of the newly recognized components to the established parts of the cardiac conduction system, and how the new findings need to be assessed in the light of the old criteria. | 18,773,472 |
Anatomic study of human laryngeal ganglia: number and distribution. | We have studied 12 laryngeal nerves: six internal branches of the superior laryngeal nerve (ILN) and six recurrent laryngeal nerves (RLN) from three human adult larynges (two males and one female). After dissection of each individual laryngeal nerve using a surgical microscope, the nerves were preserved in 10% formalin, embedded in paraffin wax, serially sectioned transversely at a thickness of 10 microm and stained with hematoxylin and eosin. We found 2-4 ganglia associated with the ILN. At least two ganglia were always present (six out of six cases), the largest one being associated with the branch of the nerve innervating the vestibule and the smallest one associated with the branch innervating the aryepiglottic fold. Other ganglia were found associated with the branches for the glosso-epiglottic fold and vallecula (four out of six cases) and interarytenoid muscle (three out of six cases). The RLN showed from two to six ganglia, all of them located in its anterior terminal division. Two of the ganglia were located in the part of the nerve between the origin of the branches for the interarytenoid and lateral cricoarytenoid muscles (three out of six cases). The remaining ganglia were located close to or at the origin of the muscular branches innervating the intrinsic laryngeal muscles. The cytology of the ganglia reported suggests that they were all autonomic in nature, probably parasympathetic. | 18,773,473 |
Induction of fibroblast growth factor 10 (FGF10) in the ileal crypt epithelium after massive small bowel resection suggests a role for FGF10 in gut adaptation. | We have previously reported that fibroblast growth factor 10 (FGF10) is crucial for the survival and proliferation of progenitor cells during embryonic gastrointestinal development. We sought to characterize the potential role of FGF10 signaling in the adaptive response following small bowel resection. Adult wild-type and Fgf10(LacZ) mice underwent 50% small bowel resection (SBR) or sham operation. Tissues were harvested 24 or 48 hr after surgery for histology, immunohistochemistry, and in situ hybridization. After SBR, Fgf10 expression was demonstrated in the epithelium at the base of the crypts. Moreover, there was a statistically significant increase in proliferating cells and goblet cells after SBR. In vitro studies using rat intestinal epithelial crypt (IEC-6) cells exposed to medium with or without recombinant FGF10 showed increased proliferation and phosphorylation of Raf and AKT with the addition of FGF10. Our results suggest that FGF10 may play a therapeutic role in diseases involving intestinal failure. | 18,773,490 |
Synthesis and characterization of beta-cyclodextrin inclusion complex containing di(8-hydroxyquinoline) magnesium. | The beta-cyclodextrin (beta-CD) inclusion complex containing di(8-hydroxyquinoline)magnesium was prepared. The product was characterized by NMR, IR, differential thermal thermogravimetric analysis (DT-TGA), spectrofluorimetry, and elemental analysis, indicating the formation of inclusion complex in which the quinoline rings of the guest were encapsulated within the beta-CD cavities. The Job's method provided 2:1 stoichiometry for the inclusion complex between beta-CD and di(8-hydroxyquinoline)magnesium. The association constant calculated with the modified Benesi-Hildebrand equation at 25 degrees C was determined. And the mean association constant was 3577 (L/mol)2, R.S.D. was 2.58%. The thermal stability and solubility of di(8-hydroxyquinoline)magnesium were improved when forming inclusion complex. | 18,773,515 |
Service learning within the University of Connecticut Master of Public Health Program. | Since 2005, the University of Connecticut Master of Public Health Program has administered its required service-learning practicum through coordinated activities of second-year students assigned to examine a pressing public health issue in Connecticut. The initiative underscores our program's commitment to preparing students for careers as leaders in applied practice and our emphasis on collaboration. Our thematic approach links content across the core curriculum, provides a venue where students demonstrate mastery of academic principles, and affirms values of public responsibility and common purpose. Projects have focused on public health concerns associated with childhood obesity, health literacy, and living with disabilities. Working together and with community-based preceptors, students estimate service needs, assess available program/service capacity, and recommend policy options. Results are compiled within a written report that accompanies a state legislative hearing. This article presents the rationale and organization of our service-learning practicum, and describes how the experience affects the education and personal growth of students and contributes positively to the community at large. | 18,773,522 |
Revisiting physician employment. | All too many trustees remember the last time hospitals employed large numbers of physicians--and the resulting large financial losses they absorbed. Now some hospitals are employing physicians without fearing a repeat of the mistakes from the 1990s. | 18,773,558 |
Endometrial sampling in patients with trophoblastic disease after suction curettage. | To determine intrauterine pathology in patients with postmolar gestational trophoblastic neoplasia (GTN) and hydatidiform mole after suction curettage. Safety profiles of endometrial sampling in this setting are also evaluated. In this prospective study, 24 cases with persistent GTN or postevacuation hydatidiform mole were recruited. Endometrial pathology was evaluated by Endocell. Clinical characteristics, safety of the instrument and pathology results were analyzed. During August 2006 to July 2007, 15 cases with postmolar GTN and 9 cases of postevacuation mole were recruited. Of 15 cases of postmolar GTN, 2 (13%) showed molar tissue. All 9 cases of postevacuation hydatidiform mole showed benign endometrial tissue or normal trophoblast in endometrial sampling pathology. No patients in this study had severe vaginal bleeding or infection after endometrial sampling. Analysis of endometrial sampling pathology as a diagnostic test for GTN showed a sensitivity of 0.133 (95% CI 0.037-0.379). Endometrial sampling by Endocell is safe in patients with gestational trophoblastic disease. Although the pathology findings from endometrial sampling had low sensitivity in diagnosing GTN, we encourage a larger prospective trial to confirm this result. | 18,773,630 |
Regional perspectives on gestational trophoblastic disease in Turkey. | Studies in Turkey are hospital based, and there is a wide variation in reported incidences that necessitate population based-studies to determine the real incidence of gestational trophoblastic diseases (GTDs). According to hospital-based studies, the frequency of GTD is generally very high and there are also regional differences. Epidemiologic study was performed to determine the frequency of hydatidiform mole (HM) in a rural part of Turkey. According to this study, the frequency of HM was lower than the frequencies reported by most of the hospital-based studies. In a national study, an inquiry form related to the approach to GTD was sent to obstetrics and gynecology departments. According to this study, a clinical classification system was used for gestational trophoblastic neoplasia by 60% of the hospitals. Methotrexate was the single-agent chemotherapy used most frequently. With regard to first-line combined chemotherapy, MAC (methotrexate, actinomycin, chlorambucil) was the preferred combination. EMA-CO (etoposide, methotrexate, actinomycin D, cyclophosphamide, Oncovin) was the most commonly used second-line chemotherapeutic regimen. From more recent studies, EMA-CO is the first-line combination chemotherapy. There is no national registry system for GTD in Turkey. There appears to be a need to conduct properly designed community-based studies with well-established case registry system in Turkey. | 18,773,631 |
[Review of identified factors influencing contraceptive use]. | It is necessary to know the factors that influence contraceptive behavior in order to overcome obstacles of contraceptive use by implementing modern family planning programs that have to be based on logistic management and directed to the client. The factor isolated till now are systematized into the two groups: the socio-demographic factors--to a greater extent associated with developing countries and the psychological factors--mainly related to developed countries. SOCIO-DEMOGRAPHIC FACTORS OF THE CONTRACEPTIVE USE: The most significant socio-demographic determinants of contraceptive behavior appear to be the age, women's educational level but even the educational level of the husband/partner, occupation, environment (urban/rural), some cultural factors, and high price of contraceptives. In the group of psychological variables that influence contraceptive use it is possible to distinguish: the presence of illusion of fertility control, locus of control, level of Ego maturity, femininity and masculinity, i.e. the accepted gender roles, level of self-acceptance. The majority of the factors show that the presence of personal initiative and assertiveness are associated with higher level of contraception use. | 18,773,691 |
Rectal cancer: possibilities of MRI in detection of local recurrence. | Treatment of rectal cancer, which includes periodic evaluations, may lead to earlier identification of recurrent local infiltration. Differentiation between local recurrence and other post radiation changes is frequently rather difficult. Pelvic MR examination was performed in 30 patients (20 men, 10 women) at the Institute of oncology, Sremska Kamenica. All patients underwent surgical resection of rectal cancer at the same institution. Preoperative or postoperative radiation therapy was administrated in 29 patients (93%). Criteria for detection of local recurrent tumours were based on morphologic changes, such as the presence of tumour inflltration, size increase of the mass and the change of the mass shape. Recurrent tumor inflitration was detected in 50% patients. Tumours of low differentiation histological type was predominantly found within 10 months after surgery, while moderately differentiated and high differentiated types were detected within 20 months and after 20 months after resection, respectively. Pelvic MR examination represents important diagnostic modality for recurrent rectal cancer identification. | 18,773,692 |
[Evaluation of myocardial function in the presence of left ventricular hypertrophy in athletes and hypertensive patients]. | Myocardial hypertrophy of the left ventricle may be of physiological or pathological nature. Distinction of these two types of hypertrophy is sometimes not easy and represents a diagnostic challenge. The aim of the study was to assess global diastolic and regional systolic and diastolic myocardial function in the presence of left ventricular hypertrophy in athletes and hypertensive patients. In 18 male hypertensive patients and 14 male athletes global diastolic left ventricular function and regional systolic and diastolic myocardial function of septum and posterior wall were investigated by pulsed wave tissue Doppler imaging. Ejection fraction and left ventricle mass index did not differ significantly between two groups. Hypertensive patients were found to have diastolic dysfunction while athletes had normal left ventricular diastolic function (the difference between the groups was P < 0.00001). Index of regional diastolic function of septum as well as of the posterior wall was significantly less in hypertensive patients than in athletes (P < 0.00001 for both). In spite of the normal global systolic function the regional systolic function of septum and posterior wall was significantly less in hypertensive patients than in athletes (P < 0.02 for both). The present results show significantly less global and regional diastolic function of hypertrophied myocardium in hypertensive patients than in athletes. In the presence of preserved left ventricular systolic function, the quantification of myocardial velocity revealed significantly lower regional systolic function of septum and posterior wall in hypertensive patients than in athletes. | 18,773,696 |
[Congenital adrenal hyperplasia due to 21 hydroxylase deficiency--case report]. | A girl with congenital adrenal hyperplasia due to 21 hydroxylase (CYP 21, p450c21) deficiency is the reviewed case. The clinical features (virilisation, clitoromegaly, rapid somatic growth, accelerated skeletal maturation) and laboratory findings (high levels of plasma 17hydroxy-progesterone, corticotrophin--ACTH, testosterone and dehydroepiandrostenedione--DHEA, low level of plasma cortisol, high level of urine 17-ketosteroids, synacthen and luteinising hormone releasing hormone--LHRH test) and the response to hydrocortisone therapy pointed at heterosexual gonadotrophin independent puberty due to irregular production of cortisol caused by 21 hydroxylase deficiency that leads to elevated ACTH and 17-hydroxy progesterone secretion and makes congenital adrenal hyperplasia as entity. The six-month therapy resulted in the clinical and laboratory findings improvement, such as the decreased annual growth of body height and the stagnation in the development of the secondary sexual features. | 18,773,697 |
Mexican patient satisfaction in a rural Minnesota primary care clinic. | The Latino population in rural Minnesota has grown significantly in recent years. Despite the increase, few studies have considered whether these newcomers are satisfied with the care they receive from local medical clinics. This article describes the results of a pilot study that assessed 20 Mexican patients' satisfaction with care they received in a primary care clinic in rural central Minnesota. Participants were interviewed using questions from Stewart's Interpersonal Care Survey and open-ended questions. Results showed the patients were generally satisfied with their health care. However, they suggested improvements in the areas of communication and involvement in decisions. Answers to the open-ended questions suggested that even though patients seemed satisfied with their care, they still strongly desired a bilingual physician. | 18,773,710 |
Vibrotactile--auditory interactions are post-perceptual. | Vibrotactile stimuli can elicit compelling auditory sensations, even when sound energy levels are minimal and undetectable. It has previously been shown that subjects judge auditory tones embedded in white noise to be louder when they are accompanied by a vibrotactile stimulus of the same frequency. A first experiment replicated this result at four different levels of auditory stimulation (no tone, tone at detection threshold, tone at 5 dB above threshold, and tone at 10 dB above threshold). The presence of a vibrotactile stimulus induced an increase in the perceived loudness of auditory tones at three of the four values in this range. In two further experiments, a 2-interval forced-choice procedure was used to assess the nature of this cross-modal interaction. Subjects were biased when vibrotaction was applied in one interval, but applying vibrotaction in both intervals produced performance comparable to conditions without vibrotactile stimuli. This demonstrates that vibrotaction is sometimes ignored when judging the presence of an auditory tone. Hence the interaction between vibrotaction and audition does not appear to occur at an early perceptual level. | 18,773,733 |
Harnessing vision for computation. | Might it be possible to harness the visual system to carry out artificial computations, somewhat akin to how DNA has been harnessed to carry out computation? I provide the beginnings of a research programme attempting to do this. In particular, new techniques are described for building 'visual circuits' (or 'visual software') using wire, NOT, OR, and AND gates in a visual 6modality such that our visual system acts as 'visual hardware' computing the circuit, and generating a resultant perception which is the output. | 18,773,734 |
Recent trends in Gleason grading of prostate cancer: I. Pattern interpretation. | Histologic grading remains the most useful tissue-based predictor of prognosis of prostate cancer. The Gleason system is now the only grading system recommended by the World Health Organization (WHO) for prostatic carcinoma. In recent years, there has been a gradual shift of how the Gleason grading is applied in practice. There has been a general trend toward upgrading of prostate cancer. A consensus conference was organized in 2005 by the International Society of Urological Pathology with the purpose to standardize both the perception of histologic patterns and how grade information is compiled and reported. The recommendations regarding pattern interpretation are summarized and discussed in this review. | 18,773,736 |
[Obesity and hypertension]. | A significant association between hypertension and obesity has been noted in several epidemiological studies. In particular, a progressive increase has been demonstrated, both in men and women, in the prevalence of hypertension in relation to the different measures of obesity. Such association is independent of age, gender, and also probably the ethnic group. It has also been shown that obesity may antedate and predict the development of hypertension. Even among subjects with normal or optimal blood pressure, the obese subjects are more likely to develop high blood pressure levels in the following years. The opposite can also be true. Hypertensive subjects are more likely to develop obesity than normotensive ones. It has been suggested that initial sympathetic hyperactivity may lead to high blood pressure and progressive hyperstimulation, followed by down-regulation, of beta-adrenergic receptors, with subsequent development of obesity because of the lesser beta-adrenoceptor that induces dissipation of calories. Visceral obesity seems to be more important than subcutaneous obesity with respect to high blood pressure. Finally, in addition to the well established relation between low weight at birth and adult hypertension, it has also been shown that any transient increases in body weight may be paralleled by increases in blood pressure at any time in life. Obesity may be associated with hypertension through an increased sympathetic tone, increased fluid retention and insulin resistance. Animal models of hypertension associated with obesity may be suitable to investigate in detail the pathophysiological mechanisms of such association. In this setting decreased nitric oxide production and resistance to leptin have been identified as important determinants of obesity in hypertension. From a therapeutic standpoint, it is well known that weight reduction is associated with a drop in blood pressure. Unfortunately, however, obese hypertensive subjects who loose weight in the short term often do not succeed to maintain the weight loss, with consequent new gain in body weight and blood pressure. Thus, weight reduction should be maintained in the long term to elicit a sustained and effective antihypertensive efficacy. | 18,773,751 |
Case-finding in the community: the results 2. | Improving the health and well-being of the population is at the centre of policy development, and the vision is to involve individuals, families and communities. The Case-finding in the Community Project was designed to build upon the established relationship between district nursing and the local community of East Belfast, working together to improve the health of adults in the community using a case-finding approach. The aims were to improve the early detection of long-term conditions, to increase access to primary care and the specialist nursing services, and to further develop the working partnership with East Belfast Community Health Information Project. Between September 2006 and March 2007, 351 people attended 17 health fairs in East Belfast at a range of venues. There were 115 people with identified risk factors for respiratory, cardiac, diabetes and hypertension. From the results of this project, there is a need for 'case-finding' patients with the potential to develop chronic disease management. | 18,773,759 |
Malodorous fungating wounds: how dressings alleviate symptoms. | Fungating wounds are unlikely to heal and therefore, the prime consideration should be the treatment and, where possible, the elimination of symptoms such as malodour. Malodour is the byproduct of bacteria and the fatty acids that are part of necrotic tissue. Application of dressings that block the odour, such as charcoal, or dressings that are antimicrobial, will reduce or remove the malodour that has such a negative effect on the patient's quality of life. | 18,773,764 |
"Bashing" of medical specialties: students' experiences and recommendations. | Exposure to non-constructive criticism of medical specialties is believed to be fairly common among medical students. Better understanding of this "bashing" phenomenon is needed to promote greater professionalism in medical education and student interest in primary care careers. This study examines exposure and reactions to bashing among third-year medical students in a public university. A survey assessing amount, sources, targets, and nature of perceived bashing was completed by 105 students. Three open-ended questions elicited students' experiences, opinions, and recommendations. Students perceived that bashing of other specialties occurred during all clerkships; the most were perceived during the surgery clerkship, for which 87.5% reported such bashing. Specialties perceived as the object of bashing were family medicine (72%), general internal medicine (40%), psychiatry (39%), and general surgery (36%). Sixty-seven percent of students reported personally receiving non-constructive criticism about their preferred specialty. Seventy-nine percent believed bashing was unprofessional behavior. Strategies suggested by respondents to decrease bashing included increasing awareness, highlighting the interdisciplinary nature of medicine, and evaluating professionalism. Medical students perceived bashing of medical specialties, recognized it as unprofessional behavior, and would be receptive to interventions to reduce bashing. Findings suggest a need to address bashing as part of professionalism curricula in medical training. | 18,773,777 |
[Major influential factors of the micturition alert device dedicated to neurogenic bladders]. | To study major influential factors of the micturition alert device dedicated to neurogenic bladders for the product design and clinical application of the device. One ferrite permanent magnet with thickness and diameter of 3 mm and 10 mm, respectively, and three NdFeB permanent magnets with the thickness of 3 mm and diameter of 10, 15 and 20 mm, respectively, were used. The effects of thickness of the abdominal wall as well as the position and type of permanent magnets on the micturition alert device dedicated to neurogenic bladders were measured in vitro simulated test, when the abdominal wall was set to 2, 3, 4, 5, 6, 7, 8 and 9 cm, respectively, and the position of permanent magnets was 0, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11 and 12 cm, respectively. The effect of the geomagnetic field on the device was measured under the condition that the thickness of the simulated abdominal wall was set to 2, 3, 4 and 5 cm, respectively, and the position of permanent magnets was 2, 3, 4, 5, 6, 7, 8, 9 and 10 cm, respectively. The value showed in the warning unit was positively correlated with the position of the ferrite permanent magnet only when the thickness of the simulated abdominal wall was 2 cm (r=0.632, P < 0.05). The correlation between the value of the warning unit and the position of NdFeB permanent magnets was significant (r > 0.622, P < 0.05), which was intensified with the increasing diameter of NdFeB permanent magnets, but weakened with the increasing thickness of the simulated abdominal wall. The effect of the geomagnetic field was correlated with the exposition of the body, the position of the permanent magnet and the thickness of the abdominal wall. The major influential factors of the micturition alert device dedicated to neurogenic bladder include the magnetism and location of the permanent magnet, the thickness of the abdominal wall and the geomagnetic field. These factors are correlated with and affect each other. Reasonable allocation of these factors may optimize the device. | 18,773,815 |
[The EVREST plan: establishing an observatory through an occupational health questionnaire]. | The constant evolution of working conditions requires occupational health and exposure indicators in order to highlight problems at the collective level with the aim of carrying out research to explore and find equally collective solutions. The monitoring system Evrest is an observatory via questionnaire. Using a prevention lens, its aim is the dynamic study of different aspects of the work and health of wage earners, based on quantitative indicators developed from data gathered during the occupational health medical examinations. After its use for several years in a large industrial corporation and a test phase in the Nord-Pas de Calais region by voluntary occupational health teams, this monitoring system is being expanded and applied to other French regions. | 18,773,829 |
[Psychosocial risks, perceived health status and working conditions of a local council's employees]. | The aim of this study was to evaluate the working conditions of employees in a local council as well as their possible relationships to health, particularly to psychosocial risks--an emerging occupational risk which causes physical and mental illness. Between November 2004 and October 2005, 919 employees were asked to fill out a self-administered questionnaire about their working conditions, their self-perceived health status, and sociodemographic characteristics. The exposure to psychosocial risk (job strain) was evaluated using the Job Content Questionnaire developed by Karasek. A total of 625 employees responded to the survey (participation rate = 68%). Their self-perceived health status was good overall, but the prevalence of job strain reached 22%, and was associated with an accrued frequency of work dissatisfaction, strong perception of stressful work and the desire and intent to change job positions. | 18,773,834 |
[Lower urinary tract infections: bacterial epidemiology and recommendations]. | Lower urinary tract infection remains frequent particularly in women, despite improvement in therapeutic means. It seems likely to revisit bacterial epidemiology and therapeutic available strategies. To analyze elements in presence i.e. infecting bacteria and antibiotics still active or identification of acquired resistance mechanisms should permit to establish the evolution during the last 10 years. The study shows that bacterial epidemiology in urinary tract infection has not changed significantly, despite antibiotic selective pressure expected from overused antibiotics. However few enterobacteriaceae more resistant than Escherichia coli have emerged, but the latter remains predominant. Development of resistance has concerned Negram, amoxicillin and Augmentin, but several active molecules such as ciprofloxacin, Monuril remain available. Duration of treatments are still discussed but there is a tend toward short durations and even mono-doses. The control of lower urinary tract infections remains relatively easy provided that a good therapeutic choice is based on well documented bacteriologic data (infecting species susceptible to the available antibiotics). | 18,773,847 |
[The National Occupational illness surveillance and Prevention Network (RNV3P) and health monitoring]. | The National Occupational Illness Surveillance and Prevention Network (RNV3P) established in 2002 as a network of experts from 29 university hospitals as well as occupational physicians records and monitors occupational health problems (OHPs) based on Soccupational health consultations in university hospitals in mainland France and in occupational medical health services (approximately 5000 OHPs/year for patients seen in hospital consultations). The OHP data are collected systematically according to a standardised code which is attributed based on main variables of interest: disease and co-morbidity (CIM-10), 1-5 impact codes (INRS), an occupational code (ILO) and a code for the type and domain of professional activity (NAF-93). For certain problems recorded, the clinician also reports a degree of imputance for attributing the level of certainty for the problem's relationship to the S main illness (weak, probable, strong). At present, 30,000 OHPs diagnosed and recorded in occupational illness consultation centers have been recorded in the information database and have been utilised for epidemiological surveillance. The surveillance activity of the network is carried out on two levels. First, a planned epidemiological health activity is programmed which focuses on estimating the incidence of illness--predefined problems. In a parallel fashion, research is developed to explore the tools which can be used to highlight emerging illness and develop methodologies to detect the relationships of unknown problems to the incidence of these illnesses--including those that present a communicable nature (either temporarily or over the long term), in certain professions or sectors. | 18,773,844 |
Intraoral flap depilation using the long-pulsed alexandrite laser. | A multitude of skin flaps are used to reconstruct defects following the surgical resection of head and neck cancers. Skin imported from distant sites to provide intraoral coverage often contains hair-bearing skin, which can create a problem following reconstruction of the oropharynx. Patients with hairy intraoral flaps often present with irritation, pooling of saliva and trapping of food. In this article, we report, for the first time, a treatment for the removal of hair from intraoral flaps using a long-pulsed alexandrite laser. | 18,773,876 |
Drosophila C-terminal binding protein, dCtBP is required for sensory organ prepattern and sharpens proneural transcriptional activity of the GATA factor Pnr. | The peripheral nervous system is required for animals to detect and to relay environmental stimuli to central nervous system for the information processing. In Drosophila, the precise spatial and temporal expression of two proneural genes achaete (ac) and scute (sc), is necessary for development of the sensory organs. Here we present an evidence that the transcription co-repressor, dCtBP acts as a negative regulator of sensory organ prepattern. Loss of dCtBP function mutant exhibits ectopic sensory organs, while overexpression of dCtBP results in a dramatic loss of sensory organs. These phenotypes are correlated with mis-emerging of sensory organ precursors and perturbated expression of proneural transcription activator Ac. Mammalian CtBP-1 was identified via interaction with the consensus motif PXDLSX(K/R) of adenovirus E1A oncoprotein. We demonstrated that dCtBP binds directly to PLDLS motif of Drosophila Friend of GATA-1 protein, U-shaped and sharpens the adult sensory organ development. Moreover, we found that dCtBP mediates multivalent interaction with the GATA transcriptional activator Pannier and acts as a direct co-repressor of the Pannier-mediated activation of proneural genes. We demonstrated that Pannier genetically interacts with dCtBP-interacting protein HDAC1, suggesting that the dCtBP-dependent regulation of Pannier activity could utilize a repressive mechanism involving alteration of local chromatine structure. | 18,773,887 |
Litebamine, a phenanthrene alkaloid from the wood of Litsea cubeba, inhibits rat smooth muscle cell adhesion and migration on collagen. | Smooth muscle cells (SMCs) play an important role in the development of atherosclerosis and restenosis after angioplasty and coronary bypass grafting. The pathogenesis of these vascular diseases includes the abnormal production of extracellular matrix (ECM) proteins by SMCs and their interactions with this newly synthesized and preexisting ECM. Litebamine, a natural phenanthrene alkaloid from the wood of Litsea cubeba, has been shown to inhibit platelet aggregation and thromboxane B(2) formation, suggesting its antithrombotic activity. In the present study we examined litebamine effects on vascular SMC adhesion and migration. Our results indicated that litebamine inhibited rat aortic SMCs (RASMCs) and A10 thoracic SMCs adhesion to collagen but not to other matrix proteins, suggesting its specificity on collagen. This inhibition was possibly resulted from that litebamine attenuated immobilized collagen-induced focal adhesion kinase (FAK) phosphorylation and actin cytoskeleton reorganization in RASMCs, as determined by Western blotting and immunofluorescence microscopy. In a functional study, litebamine also inhibited platelet-derived growth factor (PDGF)-induced RASMC migration but did not affect PDGF-induced matrix metalloproteinases (MMPs) secretion. Strikingly, among the tested kinases involved in PDGF-induced migration, only PDGF-induced phosphatidylinositol-3 kinase (PI-3K) activation was inhibited by litebamine. Taken together, we demonstrated here that litebamine can functionally inhibit vascular SMC adhesion and migration and elucidated its possible mechanisms of action. As SMC adhesion and migration are critical events in disease-related vascular remodeling, this compound may have beneficial effects in preventing cardiovascular diseases. | 18,773,889 |
A new paradigm for the reversible blockage of whisker sensory transmission. | The objective of this study was to explore a paradigm that would allow a temporary deprivation of whisker information lasting for a few hours. An additional requirement was to be non-invasive in order to be usable in awake chronically implanted rats without inducing stress. With that aim, electrophysiological recordings from the barrel cortex of anesthetized rats were obtained. The pressure of an air-puff (5-10 ms) delivered to the whiskers was adjusted to evoke a consistent response of around 100 microV (extracellular) or approximately 5 mV (intracellular) in the contralateral cortex. Lidocaine was then locally applied in different forms (cream, local injection, aerosol, drops) and concentrations (2-10%) to the base of the whiskers. The stimulus-induced response was monitored once every 5s for several hours (3-6h) in order to characterize its course of action. Local injection of lidocaine induced the fastest and most complete blockage, but was ruled out for being invasive. Out of the remaining forms of application, a lidocaine drop (0.4 ml, 10%) to the base of the whiskers was found to induce a reliable blockage (to an average 9% the original response). The maximum effect was reached after 150-200 min, and the response was totally recovered approximately 300 min after lidocaine application. This characterization should be useful to induce an efficient, short term and reversible blockage of whisker sensory transmission in both anesthetized and awake preparations, while not causing stress in an awake animal. | 18,773,921 |
Housing supplementation decreases the magnitude of inflammation-induced nociception in rats. | Previous reports have demonstrated that pain is influenced by environmental factors. This investigation examined the effects of housing supplementation, via the inclusion of objects to the home cage environment, on inflammation-induced nociceptive behaviors. The degree of thermal hyperalgesia was significantly lower in rats housed in a supplemented home cage environment, as compared to rats housed in basic cages. These data indicate that environmental enrichment significantly affects nociceptive responses. | 18,773,924 |
Comparison of myocardial tissue velocities measured by two-dimensional speckle tracking and tissue Doppler imaging. | Myocardial velocities have prognostic implications, and transmitral E wave to mitral annular early diastolic tissue velocity ratio (E/Em) is utilized to estimate left ventricular (LV) end-diastolic pressure (EDP). There are no reference values for 2-dimensional (2D) speckle tracking myocardial velocities (S2D, E2D, A2D), and it is unknown if they are comparable with color tissue Doppler imaging (TDI). Predictors of E/E2D ratios are unknown and E/E2D has not been validated with LVEDP. The myocardial velocities of 142 subjects were measured by TDI and 2D speckle tracking. Mean E/Em and E/E2D were calculated as transmitral E wave to mean 6 basal early diastolic myocardial velocities using TDI and 2D speckle tracking respectively, and compared with LVEDP during catheterizations (n = 20). Mean E2D was lower but mean S2D and A2D were higher than TDI (all p <0.001). When TDI sample volume was tracked throughout the cardiac cycle, this directional difference was no longer apparent with S2D, E2D, and A2D higher than TDI (all p <0.05). Age, systolic blood pressure, LV ejection fraction, and mean S2D were independent correlates of E/E2D. Receiver-operator characteristic analysis showed E/E2D (p = 0.03), not E/Em, identified elevated LVEDP (> or =12 mm Hg). E/E2D of 11.6 had 83% sensitivity and 70% specificity to predict elevated LVEDP. In conclusion, TDI and 2D speckle tracking myocardial velocities are not comparable due to angle independency and ability for tissue tracking with the latter. LV systolic function, age, and afterload are independent correlates of E/E2D. Only E/E2D identifies elevated LVEDP, and an E/E2D of 11.6 has the optimal sensitivity and specificity. | 18,774,007 |
The role of electrophysiology study in risk stratification of sudden cardiac death. | Patients with ischemic heart disease and left ventricular systolic dysfunction are at high risk of sudden cardiac death. However, most of these high-risk patients will never develop potential fatal ventricular arrhythmias. Thus, modalities that stratify patients according to their risk of sudden cardiac death are needed. The electrophysiology study has, for decades, been used to prognosticate on patients' risk of sudden cardiac death. Recent data from the Multicenter Unsustained Tachycardia Trial (MUSTT) and Multicenter Automatic Defibrillator Implantation Trial II (MADIT II) demonstrate that in patients with ischemic heart disease and left ventricular systolic dysfunction, an electrophysiology study can help identify patients who are at high risk of sudden cardiac death. However, in these patient populations, the prognostic ability of an electrophysiology study is only modest and the negative predictive value is poor. In the future, combining the results of noninvasive modalities with invasive electrophysiology testing may improve our prognostic ability. Furthermore, expanding the role of the electrophysiology study to include therapeutic ablations may alter a patient's future risk of sudden cardiac death. | 18,774,009 |
Cardiac magnetic resonance for risk stratification: the sudden death risk portrayed. | Risk stratification of patients with structural heart disease remains problematic. While patients with low ejection fractions have been shown to be at significant risk for sudden cardiac death, a risk that can be decreased by ICD implantation, the sensitivity and specificity of ejection fraction for predicting sudden death are sub-optimal. Contrast enhanced magnetic resonance imaging (CMRI) has been shown to carefully delineate the extent and morphology of myocardial scar. Recent studies have suggested that the extent of myocardial scar and potentially its heterogeneity can help risk stratify patient with coronary artery disease. Ongoing clinical studies will help determine the utility of incorporating CMRI into a risk prediction algorithm. | 18,774,012 |
Receiver operating characteristic analysis of leukocyte counts in operations for suspected appendicitis. | There has been no clear-cut value of the white blood cell (WBC) count in differential diagnosis of acute appendicitis in emergency medicine. Therefore, the aim of this study was to assess the preoperative WBC counts in 3 groups of patients operated on for a clinical suspicion of acute appendicitis with different findings at appendectomy: uninflamed appendix, uncomplicated acute appendicitis, or complicated acute appendicitis. The medical records of 540 patients who underwent appendectomy for suspected acute appendicitis during a 17-month period were retrospectively reviewed. Data for 3 groups of patients were analyzed to calculate the sensitivity and specificity of the WBC count in the diagnosis of acute appendicitis, and we calculated likelihood ratios for 2 cut-points with either high sensitivity or high specificity. Receiver operating characteristic curves were used to evaluate the WBC count in relation to the true diagnosis and severity of acute appendicitis. We were able to identify patients with appendicitis on a statistically significant level using receiver operating characteristic curves of WBC counts (area under the curve = 0.756, P < .001), but the WBC count had no diagnostic value in differentiating between uncomplicated and complicated groups (area under the curve = 0.55, P = .086). Likelihood ratio ranged from 1.79 (95% confidence interval, 1.17-2.3) for WBC count of more than 10,500 cells/mm(3) to 3.20 (95% confidence interval, 2.72-3.24) for WBC count of more than 14,300 cells/mm(3). White blood cell count is helpful in the diagnosis and exclusion of appendicitis. However, there is no value to differentiate advanced appendicitis. | 18,774,040 |
The approach to optimizing stroke care. | Stroke is a leading cause of death, disability, and dependence. Treatment of patients with acute stroke requires an integrated, systematic approach with thrombolysis, if indicated, and aggressive supportive care. Subacute treatment of patients with ischemic stroke should focus on the initiation of antithrombotic therapy and prevention of secondary stroke by risk factor modification. Treatment by emergency medicine physicians, who initiate thrombolysis and begin antiplatelet agents, and modification of preexisting risk factors are critical to patient outcome. Because few patients seen in the emergency department are eligible for thrombolysis because of the narrow timeframe for receiving treatment, most patients require antithrombotic therapy with aspirin, clopidogrel, or aspirin in combination with extended-release dipyridamole (ER-DP). Although aspirin, clopidogrel, and aspirin plus ER-DP effectively reduce the risk for recurrent stroke, according to treatment guidelines, clopidogrel alone (particularly in patients allergic to aspirin) and aspirin plus ER-DP are recommended over aspirin alone. Emergency medicine physicians should be aware of the available antiplatelet agents and the importance of antithrombotic therapy for prevention of secondary stroke. | 18,774,049 |
Herbst appliance in lingual orthodontics. | The aims of this article were to outline a technique for attaching Herbst telescopes to a customized lingual orthodontic (LO) appliance and to demonstrate the treatment phases and outcome with a case report. The interface between the LO appliance and the telescopes consists of a computer-aided design/computer-aided manufacturing (CAD/CAM), custom-made labial pivot base connected to the custom-made bands of the maxillary molars and mandibular canines. The individual CAD depiction of the interface ensures an optimal 3-dimensional tube-and-plunger position for correct and smooth function of the telescope mechanism. Because of the lingual location of the brackets, a small buccal tooth-to-telescope distance can be achieved, increasing patient comfort. Various options of anchorage are possible with only 1 device. After bite jumping, the telescopes and pivot bases can be removed easily without debonding the bands or removing the archwires. Experience from the first patient suggests that the Herbst-LO appliance facilitates treatment control during all phases, decreases the risk of interface breakage and mandibular incisor flaring, and might reduce overall treatment time. These initial clinical observations justify further research to provide evidence about the efficacy of Herbst-LO appliances. | 18,774,090 |
Orthodontic treatment for oral rehabilitation after multiple maxillofacial bone fractures. | We present the orthodontic treatment of a patient with occlusal dysfunction after plastic surgery for multiple maxillofacial bone fractures caused by a traffic accident. The patient had mandibular deviation to the right because of inappropriate repositioning and fixation of the fractured bone and complete avulsion of both mandibular central incisors. The bilateral mandibular incisors, canines, and premolars were also suspected of partial avulsion or alveolar bone fracture. Several tests, including percussion and dental computed tomography, were performed on these teeth to rule out ankylosis and confirm tooth movement. Camouflage orthodontic treatment was carried out with expansion of the maxillary arch, alignment of both arches, and space closure between the mandibular lateral incisors to improve the occlusion. Good occlusion and interdigitation were obtained. Orthodontic treatment is useful for the rehabilitation of occlusal dysfunction caused by multiple maxillofacial bone fractures. | 18,774,091 |
Pressure alopecia from orthodontic headgear. | Pressure alopecia is a form of nonscarring hair loss that occurs because of chronic pressure. This article reports the appearance of an unusual area of pressure alopecia in a patient who wore headgear. Early diagnosis of this rare pathology is fundamental to obtaining total regression of the disease; although pressure alopecia is initially nonscarring, scarring can develop over time. Orthodontists should be aware that alopecia in predisposed patients can be caused by headgear. | 18,774,092 |
Atrial fibrillation propagates through gaps in ablation lines: implications for ablative treatment of atrial fibrillation. | It has been hypothesized that atrial lesions must be transmural to successfully cure atrial fibrillation (AF). However, ablation lines often do not extend completely across the atrial wall. The purpose of this study was to determine the effect of residual gaps on conduction properties of atrial tissue. Canine right atria (n = 13) were isolated, perfused, and mounted on a 250-lead electrode plaque. The atria were divided with a bipolar radiofrequency ablation clamp, leaving a gap that was progressively narrowed. Conduction velocities at varying pacing rates and AF frequencies were measured before and after ablations. AF was induced with an extra stimulus and acetylcholine. Gap widths from 11.2 to 1.1 mm were examined. Conduction velocities through gaps were dependent cycle length (P = .002) and gap size (P <.001). Overall, 253 (97%) of a total of 260 gaps allowed paced propagation; 51 (91%) of 56 gaps 1-3 mm in width permitted paced propagation, as did 202 (99%) of 204 gaps >or=3.0 mm. Similarly, 253 (97%) of a total of 260 gaps allowed propagation of AF. For AF, 51 (93%) of 55 gaps 1-3 mm allowed AF to pass through, as did 202 (99%) of 205 gaps >or=3.0 mm. Gaps as small as 1.1 mm conducted paced and AF impulses. Conduction velocities were slowed through residual gaps. However, propagation of wave fronts during pacing and AF occurred through the majority of residual gaps, down to sizes as small as 1.1 mm. Leaving viable tissue in ablation lines for the treatment of AF could account for failures. | 18,774,106 |
Pituitary autoimmunity: 30 years later. | Pituitary autoimmunity encompasses a spectrum of conditions ranging from histologically proven forms of lymphocytic hypophysitis to the presence of pituitary antibodies in apparently healthy subjects. Hypophysitis is a rare but increasingly recognized disorder that typically presents as a mass in the sella turcica. It mimics clinically and radiologically other non-functioning sellar masses, such as the more common pituitary adenoma. Hypophysitis shows a striking temporal association with pregnancy, and it has been recently described during immunotherapies that block CTLA-4. Several candidate pituitary autoantigens have been described in the last decade, although none has proven useful as a diagnostic tool. This review summarizes the advances made in the field since the publication of the first review on pituitary autoimmunity, and the challenges that await clarification. | 18,774,118 |
Urinary metabolite concentrations of organophosphorous pesticides, bisphenol A, and phthalates among pregnant women in Rotterdam, the Netherlands: the Generation R study. | Concern about potential health impacts of low-level exposures to organophosphorus (OP) pesticides, bisphenol A (BPA), and phthalates among the general population is increasing. We measured levels of six dialkyl phosphate (DAP) metabolites of OP pesticides, a chlorpyrifos-specific metabolite (3,5,6-trichloro-2-pyridinol, TCPy), BPA, and 14 phthalate metabolites in urine samples of 100 pregnant women from the Generation R study, the Netherlands. The unadjusted and creatinine-adjusted concentrations were reported, and compared to National Health and Nutrition Examination Survey and other studies. In general, these metabolites were detectable in the urine of the women from the Generation R study and compared with other groups, they had relatively high-level exposures to OP pesticides and several phthalates but similar exposure to BPA. The median concentrations of total dimethyl (DM) metabolites was 264.0 n mol/g creatinine (Cr) and of total DAP was 316.0 n mol/g Cr. The median concentration of mono-ethyl phthalate (MEP) was 222.0 microg/g Cr; the median concentrations of mono-isobutyl phthalate (MiBP) and mono-n-butyl phthalate (MnBP) were above 50 microg/g Cr. The median concentrations of the three secondary metabolites of di-2-ethylhexyl phthalate (DEHP) were greater than 20 microg/g Cr. The data indicate that the Generation R study population provides a wide distribution of selected environmental exposures. Reasons for the relatively high levels and possible health effects need investigation. | 18,774,129 |
The development and genetic diversity of H5N1 influenza virus in China, 1996-2006. | Since it was first detected in 1996, the Goose/Guangdong/1/1996 (Gs/GD) H5N1 influenza virus and its reassortants have spread to over 60 countries, with over 20 distinct genetic reassortants previously recognized. However, systematic analysis of their interrelationship and the development of genetic diversity have not been explored. As each of those reassortants was first detected in China, here 318 full-length H5N1 virus genomes isolated from 1996 to 2006 in this region were phylogenetically analyzed. Our findings revealed two major group reassortment events in 2001 and 2002 that were responsible for the generation of the majority of the 44 distinct Gs/GD genotypes identified, excepting those 1997 variants. Genotype replacement and emergence occurred continually, with 34 transient genotypes detected while only 10 variants were persistent. Two major replacements of predominant genotypes were also observed: genotype B replaced by Z in 2002 and then genotype Z replaced by the now predominant genotype V in 2005. | 18,774,155 |
Comparing ecotoxicological effect concentrations of chemicals established in multi-species vs. single-species toxicity test systems. | Most ecological effect assessment methodologies use effect concentrations derived from single-species testing (ECx,single-species-test) as the basis to estimate 'safe' environmental concentrations (such as environmental quality criteria). Here, we examined to what extent such ECx,single-species-test are representative for population-level effect concentrations in a community setting (ECx,multi-species-test). Data from USEPA's ECOTOX database revealed the existence of considerable scatter around the relationship between ECx,single-species-test (endpoint: mortality) and ECx,multi-species-test (endpoint: population abundance). However, we demonstrate that this scatter is reduced when ECx,single-species-test and ECx,multi-species-test are determined simultaneously and by the same research group. Indeed, if these conditions are fulfilled, the quotient of both ECx values for invertebrates approaches 1 for chemicals that directly target invertebrates. Unfortunately, comparable data for other classes of chemicals and/or taxonomic groups were not found. However, theoretical ecosystem model simulations, which confirmed the results based on the above-mentioned analysis of the ECOTOX database, indicated that for phytoplankton, EC10,single-species-test>EC10,multi-species-test, for chemicals that directly target invertebrates. For chemicals that directly target phytoplankton, the ecosystem model simulations suggest that ECx,single-species-test>ECx,multi-species-test for both phytoplankton and invertebrates. Hence, our observation based on the analysis of existing experimental data that the ECx,single-species-test is similar to the ECx,multi-species-test may be biased by the fact that only data were available for invertebrates and for chemicals targeting invertebrates. Experimental research is required to test the predictions made by the model simulations for phytoplankton as well as for chemicals directly targeting phytoplankton. | 18,774,172 |
Prenatal dopamine and neonatal behavior and biochemistry. | Depressed pregnant women (N=126) were divided into high and low prenatal maternal dopamine (HVA) groups based on a tertile split on their dopamine levels at 20 weeks gestation. The high versus the low dopamine group had lower Center for Epidemiological Studies-Depression Scale (CES-D) scores, higher norepinephrine levels at the 20-week gestational age visit and higher dopamine and serotonin levels at both the 20- and the 32-week gestational age visits. The neonates of the mothers with high versus low prenatal dopamine levels also had higher dopamine and serotonin levels as well as lower cortisol levels. Finally, the neonates in the high dopamine group had better autonomic stability and excitability scores on the Brazelton Neonatal Behavior Assessment Scale. Thus, prenatal maternal dopamine levels appear to be negatively related to prenatal depression scores and positively related to neonatal dopamine and behavioral regulation, although these effects are confounded by elevated serotonin levels. | 18,774,177 |
Multivariate analyses reveal common and drug-specific genetic influences on responses to four drugs of abuse. | Vulnerability to abused drugs is influenced by multiple genes unique to each drug and to risk genes for polydrug abuse. If several inbred mouse strains respond to different drugs similarly, this implies the action of a common group of genes. Simultaneous analysis of multiple responses to multiple drugs has been attempted infrequently. We performed multivariate analyses of published strain responses to four drugs. Genetic similarity in responses did not simply track pharmacological class. Withdrawal severity and preference for ethanol and diazepam were affected by many genes in common, although inversely. We focused on behavioral responses, but there is a growing archival database of physiological, pharmacological and biochemical strain traits. The genomics community is increasingly focusing on single-nucleotide polymorphism and haplotype-based gene mapping approaches, for which inbred strain data are also useful. Thus, similar analyses should be applicable to other laboratories, traits and genotypes. | 18,774,184 |
Extension of the anaerobic digestion model No. 1 (ADM1) to include phenolic compounds biodegradation processes for the simulation of anaerobic co-digestion of olive mill wastes at thermophilic temperature. | This paper describes for the first time the extension of the anaerobic digestion model No. 1 (ADM1) to handle and simulate the anaerobic degradation processes of phenol compounds and homologues in olive mill wastewater (OMW) and olive mill solid waste (OMSW) at thermophilic temperature (55 degrees C). The general structure of the ADM1 was not changed except for the modifications related to the inclusion of phenolic compounds degradation processes into acetate and further into methane and CO(2). The effect of soluble phenolic compounds upon pH was taken into account in the pH simulation equations. The inhibitory effect of phenolic compounds on the fermenting process and methanogenic sub-populations was accounted for by the use of non-competitive inhibition functions. The most sensitive and new phenolic parameters were calibrated and validated using experimental data from our previous study dealing with the thermophilic anaerobic co-digestion of OMW with OMSW in semi-continuous tubular digesters. The simulation results indicated that the extended ADM1 was able to predict with reasonable accuracy effluent phenol concentrations and gas flow rates and effluent pH of various influent concentrations digested at hydraulic retention times (HRTs) of 36 and 24 days. | 18,774,218 |
Remediation of phenol-contaminated soil by a bacterial consortium and Acinetobacter calcoaceticus isolated from an industrial wastewater treatment plant. | Time-course performance of a phenol-degrading indigenous bacterial consortium, and of Acinetobacter calcoaceticus var. anitratus, isolated from an industrial coal wastewater treatment plant was evaluated. This bacterial consortium was able to survive in the presence of phenol concentrations as high as 1200mgL(-1) and the consortium was more fast in degrading phenol than a pure culture of the A. calcoaceticus strain. In a batch system, 86% of phenol biodegradation occurred in around 30h at pH 6.0, while at pH 3.0, 95.2% of phenol biodegradation occurred in 8h. A high phenol biodegradation (above 95%) by the mixed culture in a bioreactor was obtained in both continuous and batch systems, but when test was carried out in coke gasification wastewater, no biodegradation was observed after 10 days at pH 9-11 for both pure strain or the isolated consortium. An activated sludge with the same bacterial consortium characterized above was mixed with a textile sludge-contaminated soil with a phenol concentration of 19.48mgkg(-1). After 20 days of bioaugmentation, the remanescent phenol concentration of the sludge-soil matrix was 1.13mgkg(-1). | 18,774,223 |
Efficacy of specific egg yolk immunoglobulin (IgY) to bovine mastitis caused by Staphylococcus aureus. | The objective of this study was to estimate the efficacy of specific egg yolk immunoglobulin (IgY) to bovine mastitis caused by Staphylococcus aureus. Eighteen lactating cows with clinical mastitis and 18 lactating cows with experimental mastitis (1 quarter per cow) were randomly assigned to three treatments: IgY (20mg/ml) infusion, penicillin (100mg/ml) infusion and no infusion. Treatments for clinical mastitis and experimental mastitis were performed by a 6-day course of intramammary infusion with a dosage of 10ml at an interval of 12h. Milk samples were collected at morning milking time for testing color, clot, somatic cell counts (SCC) and bacterial count. For most of the cows treated with IgY and penicillin, the milk color and clot recovered to normal form during the therapy course. The milk SCCs and bacterial counts of treated cows decreased compared to those of untreated cows (p<0.05). The cure rates by IgY for experimental and clinical mastitis were 83.3% and 50%, respectively, and those by penicillin were 66.7% and 33.3%, respectively. These results showed the potential of specific IgY to be an alternative therapy for mastitis caused by S. aureus. | 18,774,241 |
Citric acid cycle biomimic on a carbon electrode. | The citric acid cycle is one of the main metabolic pathways living cells utilize to completely oxidize biofuels to carbon dioxide and water. The overall goal of this research is to mimic the citric acid cycle at the carbon surface of an electrode in order to achieve complete oxidation of ethanol at a bioanode to increase biofuel cell energy density. In order to mimic this process, dehydrogenase enzymes (known to be the electron or energy producing enzymes of the citric acid cycle) are immobilized in cascades at an electrode surface along with non-energy producing enzymes necessary for the cycle to progress. Six enzymatic schemes were investigated each containing an additional dehydrogenase enzyme involved in the complete oxidation of ethanol. An increase in current density is observed along with an increase in power density with each additional dehydrogenase immobilized on an electrode, reflecting increased electron production at the bioanode with deeper oxidation of the ethanol biofuel. By mimicking the complete citric acid cycle on a carbon electrode, power density was increased 8.71-fold compared to a single enzyme (alcohol dehydrogenase)-based ethanol/air biofuel cell. | 18,774,285 |
Mycobacterial glycoconjugates as vaccine candidates against tuberculosis. | There is an urgent need for an efficient vaccine against tuberculosis. Here, we explore the potential role of carbohydrate antigens as part of a new tuberculosis vaccine. Emphasis is placed on carbohydrate-protein conjugate vaccines, using the arabinomannan portion of lipoarabinomannan, a major structural surface component of Mycobacterium tuberculosis covalently conjugated to (mycobacterial) protein antigens. Such conjugate vaccines show good protective efficacy in mice and guinea pigs in terms of prolonged survival and reduced pathology. Special attention is paid to the immunology underlying their protective capacity. Conjugate vaccines induce both cellular and humoral responses and, although antibody responses have been thought to be the main protective component, cellular responses - possibly through the CD1 pathway - are also likely to be involved. | 18,774,297 |
MAG-PGSTE: a new STE-based PGSE NMR sequence for the determination of diffusion in magnetically inhomogeneous samples. | A new stimulated echo based pulsed gradient spin-echo sequence, MAG-PGSTE, has been developed for the determination of self-diffusion in magnetically inhomogeneous samples. The sequence was tested on two glass bead samples (i.e., 212-300 and <106 microm glass bead packs). The MAG-PGSTE sequence was compared to the MAGSTE (or MPFG) (P.Z. Sun, J.G. Seland, D. Cory, Background gradient suppression in pulsed gradient stimulated echo measurements, J. Magn. Reson. 161 (2003) 168-173; P.Z. Sun, S.A. Smith, J. Zhou, Analysis of the magic asymmetric gradient stimulated echo sequence with shaped gradients, J. Magn. Reson. 171 (2004) 324-329; P.Z. Sun, Improved diffusion measurement in heterogeneous systems using the magic asymmetric gradient stimulated echo (MAGSTE) technique, J. Magn. Reson. 187 (2007) 177-183; P. Galvosas, F. Stallmach, J. Kärger, Background gradient suppression in stimulated echo NMR diffusion studies using magic pulsed field gradient ratios, J. Magn. Reson. 166 (2004) 164-173, P. Galvosas, PFG NMR-Diffusionsuntersuchungen mit ultra-hohen gepulsten magnetischen Feldgradienten an mikroporösen Materialien, Ph.D. Thesis, Universität Leipzig, 2003, P.Z. Sun, Nuclear Magnetic Resonance Microscopy and Diffusion, Ph.D. Thesis, Massachusetts Institute of Technology, 2003] sequence and Cotts 13-interval [R.M. Cotts, M.J.R. Hoch, T. Sun, J.T. Marker, Pulsed field gradient stimulated echo methods for improved NMR diffusion measurements in heterogeneous systems, J. Magn. Reson. 83 (1989) 252-266] sequence using both glass bead samples. The MAG-PGSTE and MAGSTE (or MPFG) sequences outperformed the Cotts 13-interval sequence in the measurement of diffusion coefficients; more interestingly, for the sample with higher background gradients (i.e., the <106 microm glass bead sample), the MAG-PGSTE sequence provided higher signal-to-noise ratios and thus better diffusion measurements than the MAGSTE and Cotts 13-interval sequences. In addition, the MAG-PGSTE sequence provided good characterization of the surface-to-volume ratio for the glass bead samples. | 18,774,320 |
The ABA receptors -- we report you decide. | The plant hormone abscisic acid (ABA) has been implicated in a variety of physiological responses ranging from seed dormancy to stomatal conductance. Recently, three groups have reported the molecular identification of three disparate ABA receptors. Unlike the identification of other hormone receptors, in these three cases high affinity binding to ABA rather than the isolation of ABA insensitive mutants led to these receptor genes. Interestingly, two of the receptors encode genes involved in floral timing and chlorophyll biosynthesis, which are not considered traditional ABA responses. And the third receptor has been clouded in issues of its molecular identity. To clearly determine the roles of these genes in ABA perception it will require placing of these ABA-binding proteins into the rich ABA physiological context that has built up over the years. | 18,774,332 |
A comparison of laboratory measures of escape and avoidance behavior. | Escape and avoidance of the onset of pain and exacerbations of pain can be difficult to distinguish in certain circumstances. This investigation compared measures of participants' (N = 61, 50.8% women) escape and avoidance behavior during an ischemic pain task. Instructions for the ischemic task were manipulated so that one group stopped the task whenever they wanted (eg, before the onset of pain) and another group endured the ischemic pain to tolerance. Delay time before beginning the task and willingness to complete the task were not related to self-reported escape/avoidance (r = -.21, P = .10; r = -.14, P = .30). Also, they were not predicted by fear, anxiety, or catastrophizing. Task duration with the unrestricted stop rule was not related to self-reported escape/avoidance (r = -.13, P = .50) and was not predicted by fear, anxiety, or catastrophizing. However, task duration with the tolerance stop rule was associated with self-reported escape/avoidance (r = -.40, P = .02) and was predicted by catastrophizing (t(29) = -2.92, P < .01). Thus, evidence for the validity of task duration with a tolerance stop rule as a measure of escape from pain or avoidance of pain exacerbation was found. Measures of avoidance of pain onset were not supported. However, task duration was a valid measure of escape from pain or avoidance of pain exacerbation with tolerance stop rules. Other measures of escape/avoidance behavior and participants' perceptions of stable or increasing pain level throughout a pain task should be examined. | 18,774,344 |
Day-care attendance, position in sibship, and early childhood wheezing: a population-based birth cohort study. | There are conflicting data on the effect of day-care attendance and position in sibship on the development of wheezing. To investigate the relationship between day-care attendance and position in sibship with early childhood wheeze. Prospective population-based birth cohort. At age 5 years, we collected information on parentally reported symptoms (n = 922); lung function was ascertained using plethysmography (n = 745) and allergic sensitization by skin testing (n = 815). Participants were assigned into categories according to the age of entry to day-care (0-6, 6-12, >12 mo) and number of older siblings (0, 1, 2, >2). Current wheeze was reported by 203 participants (22%); 224 (28%) were sensitized. In the multivariate model, sensitization (odds ratio, 2.47; 95% CI, 1.66-3.67), male sex (1.49, 1.01-2.20), maternal asthma (1.72, 1.10-2.68), and maternal smoking during pregnancy (2.15, 1.26-3.66) significantly increased the risk of wheezing. Entering day-care between 6 and 12 or after 12 months of age was significantly and inversely associated with current wheeze (0.25, 0.11-0.60; and 0.65, 0.44-0.98, respectively). Entry into nursery between 6 and 12 months reduced the risk of persistent wheezing (P = .04). We found no association between day-care attendance and lung function. Entering nursery in the first 6 months of life was associated with increased risk of atopy (2.47, 1.23-4.95). Having older siblings was associated only with rhinoconjunctivitis (0.72, 0.54-0.97). Day-care attendance was associated with a reduced risk of current wheezing in 5-year-old children. The protective effect appeared strongest for children who entered day-care between the ages of 6 and 12 months. | 18,774,386 |
Test of a single-item posttraumatic stress disorder screener in a military primary care setting. | Posttraumatic stress disorder (PTSD) is prevalent in primary care, frequently goes undetected and can be highly debilitating when untreated. We assessed the operating characteristics of a single-item PTSD screener (SIPS) for primary care and compared it to a commonly used four-item primary care PTSD screener (PC-PTSD). The SIPS asks: "Were you recently bothered by a past experience that caused you to believe you would be injured or killed ... not bothered, bothered a little, or bothered a lot?" A total of 3,234 patients from three Washington, DC, area military primary care clinics completed the SIPS. Independent, blinded assessments using a structured diagnostic PTSD interview were completed in 213 of these patients. The SIPS yielded a reasonable range of likelihood ratios, suggesting capacity to discriminate between low- and high-probability PTSD patients. However, the SIPS sensitivity was only 76% for those reporting "bothered a little" and the four-item PC-PTSD yielded significantly better test characteristics on Receiver-Operator Curve analysis. A single, user-friendly primary care PTSD screening question with three response options, while sensible and worth further investigation, failed to offer sound test characteristics for PTSD screening. Ways of improving SIPS performance are discussed. | 18,774,421 |
The 1995 Kikwit Ebola outbreak: lessons hospitals and physicians can apply to future viral epidemics. | This article looks at lessons learned from the 1995 Kikwit Ebola outbreak and suggests how modern hospitals should apply these lessons to the next lethal viral epidemic that occurs. The 1995 Kikwit Ebola outbreak in the Democratic Republic of the Congo (formally Zaire) is one of the most well studied epidemics to have occurred to date. Many of the lessons learned from identifying, containing and treating that epidemic are applicable to future viral outbreaks, natural disasters and bioterrorist attacks. This is due to Ebola's highly contagious nature and high mortality rate. When an outbreak occurs, it often produces fear in the community and causes the basic practice of medicine to be altered. Changes seen at Kikwit included limited physical examinations, hesitance to give intravenous medications and closure of supporting hospital facilities. The Kikwit Ebola outbreak also provided beneficial psychological insight into how patients, staff and the general community respond to a biological crisis and how this will affect physicians working in an epidemic. General lessons from the outbreak include the importance of having simple, well-defined triage procedures; staff who are flexible and able to adapt to situations with unknowns; and the need to protect staff physically and emotionally to ensure a sustained effort to provide care. | 18,774,428 |
Measurement matters in the association between early adolescent depressive symptoms and body mass index. | The objectives of this study were to examine associations between depressive symptoms and body mass over 1 year during early adolescence and to assess how the associations might differ depending upon whether self-reported or directly measured height and weight were used. Participants were 446 sixth-grade Seattle students. Depressive symptoms were assessed using the Mood and Feelings Questionnaire. Regression models were used to examine whether baseline depression status was associated with 12-month body mass index (BMI; using self-reported height and weight) and whether baseline overweight status was associated with 12-month depressive symptom score. Analyses were rerun among a subsample (n=165) who had height and weight directly measured. Using BMI derived from self-reported values, depressed males had a significantly lower BMI than nondepressed males, while depressed females had a significantly higher BMI than nondepressed females, after adjusting for covariates. Among a subsample using measured height and weight values, however, depression was no longer associated with BMI in either gender. Baseline overweight status did not predict 12-month depression score. Observed associations between depression and subsequent BMI were explained by differential misclassification of self-reported height and weight by depression status and gender. Direct measurement of height and weight may be necessary to ensure validity in studies of adolescent depression and weight-related outcomes. | 18,774,430 |
Quality of life, anxiety and depression in sarcoidosis. | This study sought to evaluate the quality of life and the presence of psychiatric disorders in patients with sarcoidosis. Data were collected from 80 consecutive outpatients with sarcoidosis presenting to the Sarcoidosis Center of the Respiratory Diseases Division at the University of Siena, Italy. Forty-four percent of the subjects endorsed at least one psychiatric DSM-IV axis I diagnosis. Specifically, 25% of subjects met the criteria for Major Depressive Disorder, 6.3% for Panic Disorder, 6.3% for Bipolar Disorder, 5% for Generalized Anxiety Disorder and 1.3% for Obsessive Compulsive Disorder. Statistically significant correlations were found between Forced Expiratory Volume in the first second (FEV(1)), Forced Vital Capacity (FVC) and several domains of the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) questionnaire. Subjects with multi-systemic involvement, with asthenia and with a more severe radiographic stage and subjects receiving steroids, reported a poorer quality of life. Sarcoidosis is associated with a high rate of psychiatric comorbidity and may contribute to a poorer quality of life. A referral for a psychiatric or psychological evaluation and counseling should be considered for many of the sarcoidosis patients. | 18,774,427 |
Assessing the impact of ease of administration and tolerability on treatment choices in Parkinson's disease. | Historically Parkinson's disease (PD) has been treated primarily with oral agents, with patients learning quickly that their clinical response is tied closely to their level of medication compliance. Studies, however, have found that compliance is less than ideal, and erratic medication consumption is commonplace. When prescribing antiparkinsonian therapies, the clinician should consider ease of administration, tolerability, and efficacy, along with other factors that are likely to contribute to optimal compliance by the patient. | 18,774,442 |
Australian women seeking counseling have higher use of health services. | Despite a high prevalence of psychological distress and poor mental health in the Australian community, use of counseling services is very low. There has been only limited research examining the profile of those who do access counseling services, mainly in terms of demographic and health behavior variables. To extend our understanding of those who currently access counseling services, this study aimed to examine the broader pattern of health service utilization by women who consulted counselors, psychologists, or social workers in the past year compared with those who did not among a population-based sample of middle-aged Australian women, and to determine whether health service utilization was independently associated with use of counseling services, controlling for other known predictors. The cross-sectional population-based mail survey data for this study came from the third survey of the mid-aged cohort of the Australian Longitudinal Study on Women's Health, conducted in 2001. The sample comprised 11,201 women aged 50-55. The main study variable was a question asking whether they had consulted a counselor/psychologist/social worker in the past year. Only 6.9% of women had consulted a counselor/psychologist/social worker in the past year. After controlling for self-reported mental health status, health behaviors and demographic variables in multivariate analysis, consulting a counselor/psychologist/social worker in the past year was significantly and positively associated with consultations with general practitioners (> or =5 consultations; odds ratio [OR], 4.14; 95% confidence interval [CI], 2.35-7.27; p < .0001), specialist (> or =3 consultations; OR, 2.09; 95% CI, 1.66-2.63; p < .0001), and hospital doctor (OR, 1.35; 95% CI, 1.10-1.66; p = .004). Use of counseling services was not associated with use of other allied and complementary health services in multivariate analyses. Further research is needed to determine whether the strong independent link between self-reported use of counseling and other medical and health services among middle-aged women is best explained by general practice referral patterns, availability of services, economic factors, or different help-seeking patterns among women. | 18,774,457 |
Current status of prostate-sparing cystectomy. | Radical cystoprostatectomy includes en bloc excision of the prostate due to a high incidence of occult prostatic malignancy in patients with bladder cancer. Radical cystectomy has a considerable incidence of functional morbidity, and concerns regarding morbidity can delay initiation of cystectomy by the patient or physician, thereby affecting long-term prognosis. Some investigators have advocated prostate-sparing cystectomy to improve postoperative continence and potency rates, and enhance patient acceptance of timely cystectomy. While these prostate-sparing series describe excellent postoperative functional results, concerns are raised regarding the oncologic efficacy of this procedure. Prostate-sparing cystectomy is arguably one of the most controversial topics in the field of urology today. | 18,774,460 |
What is the best approach for screen-detected low volume cancers?--The case for observation. | The case for active surveillance as the optimal therapy for screen detected, low volume, low grade prostate cancer is presented. This is based on data from recent long term studies of conservative management, the prostate cancer prevention trial (PCPT), the Swedish trial of radical prostatectomy vs. observation, and several large Phase 2 trials of active surveillance. These studies indicate convincingly that (1) widespread screening results in a diagnosis of prostate cancer in many patients with clinical insignificant disease, (2) that these patients can be identified with reasonable accuracy, (3) that delayed intervention does not appear to put those patients who reclassify as higher risk over time at significant risk, and (4) that the psychological burden of surveillance is acceptable. | 18,774,462 |
The "male lumpectomy": focal therapy for prostate cancer using cryoablation results in 48 patients with at least 2-year follow-up. | The use of breast sparing surgery, i.e., "lumpectomy", revolutionized management of breast cancer. Lumpectomy confirmed that quality of life issues can successfully be addressed without compromising treatment efficacy. Complications of prostate cancer treatment, including impotence and incontinence, affect the male self image no less than the loss of a breast does a woman. Traditional thinking held that prostate cancer was multifocal and therefore not amenable to a focal treatment approach. Recent pathology literature indicates, however, that up to 25% of prostate cancers are solitary and unilateral. This raises the question of whether these patients can be identified and treated with a limited "lumpectomy" or focal cancer treatment. Focal cryoablation was planned to encompass the area of known tumor based on staging biopsies. PSAs were obtained every 3 months for 2 years and then every 6 months thereafter. Forty-eight patients with at least 2-year follow-up had focal cryoablation. Follow-up ranged from 2 years 10 years with a mean of 4.5 years; 45 of 48 patients (94%) have stable PSAs [American Society of Therapeutic Radiology and Oncology (ASTRO) criteria] with no evidence for cancer, despite 25 patients being medium to high risk for recurrence. Of the 24 patients with stable PSAs who were routinely biopsied (n = 24) all were negative. No local recurrences were noted in areas treated. Potency was maintained to the satisfaction of the patient in of 36 of 40 patients who were potent preoperatively. Of the 48, all were continent. These preliminary results indicate a "male lumpectomy" in which the prostate tumor region itself is destroyed, appears to preserve potency in a majority of patients and limits other complications (particularly incontinence), without compromising cancer control. If confirmed by further studies and long-term follow-up, this treatment approach could have a profound effect on prostate cancer management. | 18,774,463 |
Oligodendrogliomas in relation to astrocytes differentiation. Clinicopathologic and immunohistochemical study. | Oligodendroglioma usually arise in adults and rarely in children. The objective of the current study was to evaluate the immunoexpression of glial fibrillary acidic protein (GFAP) and heat shock proteins (HSP70), endothelial vascular growth factor (EVGF), and endothilial vascular growth factor receptor type II (EFGF-R) expression in relation to the proliferation labeling index (proliferating cell nuclear antigen [PCNA]) and vascular density in patients with oligodendroglioma. We studied 28 cases of oligodendrogliomas--20 (71.4%) were oliodendrogliomas (grade II), and 8 (28.6%) cases were anaplastic oligodendroglioma (grade II according to World Health Organization classification). Eleven cases were male (39.28%) and 9 (32.14%) cases were female. Mitosis were found in grade II (0.35 +/- 1.14) and grade III (3.88 +/- 1.81) (P = .0001*) and pleomorphism in grade II (4.40 +/- 0.99) and grade III (9.50 +/- 9.20) (P = .028). The GFAP was positive in grade II (1.45 +/- 0.60) and grade III (2.63 +/- 0.52) (P = .000); HSP70 was immunoreactive in grade II (1.35 +/- 0.59) and grade III (2.50 +/- 0.53) (P = .001); and EVGF was immunoreactive in grade II (22.70 +/- 6.10) and grade III (36 +/- 1.63) (P = .043). The EVGF-RII was immunoreactive in grade II, 18.30 +/- 6.11 and 31.63 +/- 4.93 (P = .045). The microvascular density labeling index rates were 20.70 +/- 4.34 (grade II) and 33.38 +/- 5.29 (P = .000), and the PCNA labeling index rates were 32.95 +/- 5.89 (grade II) and 56.88 +/- 5.62 (grade III) (P = .045). We observed astrocyte differentiation in oligodendrogliomas grade III. We found a higher PGAF, HSP70, EVGF, and EFGF-R expression in relation with the PCNA and vascular density (CD34) in patients with oligodendroglioma grade III than in oligodendroglioma grade II. There was a significant relationship between mitosis, glial fibrillary acidic protein (GFAP), HSP70, EVGF, EVGF-receptor II expression, and the histologic grade and size of the tumor. For that reason, we suggest that the correlation between GFAP and HSP70 could have a relationship with the protection mechanism of the tumor itself. | 18,774,492 |
Myxoid adrenal cortical neoplasms. | Myxoid adrenal cortical neoplasms are rare, and to our knowledge, only about 23 cases have been reported in the literature, including 13 carcinomas and 10 adenomas. We recently experienced 4 cases of myxoid adrenal cortical neoplasms (3 benign and 1 borderline malignancy) and studied the clinical, histopathological, and immunohistochemical features of these neoplasms. There were 2 male and 2 female patients (age range, 37-61 years, mean, 48 years). All but 1 patient had hormone-related symptoms. The tumors weighed from 24.1 to 94 g (size, 4.1-9.8 cm). They were variably encapsulated with areas of hemorrhage. Histologically, the tumor cells were arranged in delicate arborizing cords or trabecula with myxoid areas varying from 30% to 70%. Three tumors were benign and 1 was of borderline morphology with mitoses of 3/10 high-power fields and mild to moderate nuclear pleomorphism. Two cases contained areas of myelolipomatous component. The tumor cells were positive for vimentin, synaptophysin, and inhibin but negative for cytokeratin. All patients are alive with no recurrence of their tumors or evidence of metastasis (follow-up of 14-20 months). Myxoid changes in adrenal cortical neoplasms are rare but can be seen in both an adenoma and a tumor of uncertain malignant potential. Because of prominent myxoid changes, other myxoid tumors occurring in the retroperitoneum should be excluded. The usual clinical and histological features can be applied to classify the lesions as benign, borderline tumor, or malignant. In our series, there was no case with frank malignant tumor. | 18,774,497 |
Compound nevus with congenital features and balloon cell changes--an immunohistochemical study. | Balloon cell nevi and balloon cell changes in nevi have rarely been reported in the literature. We describe a compound nevus showing focal balloon cell changes in a 20-year-old man. The melanocytic nature of the balloon cells is confirmed by an immunohistochemical study. The findings are compared with those in balloon cell melanomas. | 18,774,500 |
Multicentric transitional cell carcinoma of the vagina and the ureter. | Primary transitional cell carcinoma (TCC) of the vagina represents an extremely rare neoplasm and is associated with multicentric TCC of the urinary tract in all described cases. A case of multicentric TCC of the vagina and the left ureter in a 73-year-old woman is reported. Immunohistochemical analysis of cytokeratin expression was performed. Immunohistochemistry proved to play an important role in the differential diagnosis of vaginal TCC, supported the morphological diagnosis of TCC, and largely excluded the diagnosis of vaginal papillary carcinoma with transitional features as a morphological variant of squamous cell carcinoma. Subsequent urological examination revealed multicentric TCC of the left ureter. During the follow up, the metastases of the vaginal TCC into the regional inguinal lymph nodes were diagnosed, suggesting that indolent clinical course is not a rule in this type of tumor. | 18,774,501 |
Live birth sex ratios are not influenced by blastocyst-stage embryo transfer. | To analyze the sex ratio of infants born after blastocyst-stage transfer of embryos with normal preimplantation FISH genetic screening. Retrospective cohort analysis. Large academic assisted reproductive technology center. Two hundred twenty-eight patients undergoing fresh IVF cycle with blastocyst transfer. Preimplantation genetic screening for sex complement. Sex ratio in liveborn infants following blastocyst transfer. One thousand thirteen embryos were normal by preimplantation genetic screening of chromosomes 13, 15, 16, 17, 18, 21, 22, X, and Y. Four hundred ninety-eight normal embryos were transferred to 228 patients with an overall live birth rate of 41.7%. Transferred blastocysts were selected based upon morphologic assessment. When controlling for the sex of the blastocyst embryo, there was no difference in the male-to-female delivery rate per embryo transferred (27.3% vs. 21.4%) (relative risk =1.28, confidence interval 0.93-1.74). Of the live births 51.7% were male and 48.3% were female (P=.61). Subanalysis revealed no difference in male-to-female delivery rates in groups with a 1:1 ratio of male:female embryos transferred, a non 1:1 ratio transferred, or single-sex transfers. Blastocyst-stage embryo transfer does not influence the live birth sex ratio of embryos with normal preimplantation FISH genetic screening. | 18,774,561 |
Activated caspases in thawed epididymal and testicular spermatozoa of patients with congenital bilateral absence of the vas deferens and intracytoplasmic sperm injection outcome. | To analyze the expression of activated caspases and membrane permeability in thawed epididymal and testicular spermatozoa of patients with congenital bilateral absence of the vas deferens (CBAVD). Retrospective study. Biology and medicine of reproduction in University hospital. Eight CBAVD patients. Staining of activated caspases and viability (propidium iodide, PI); intracytoplasmic sperm injection (ICSI). Proportion of viable (Casp-/PI-) or dead (Casp-/PI+) spermatozoa without activated caspases, viable (Casp+/PI-) or dead (Casp+/PI+) spermatozoa with activated caspases. ICSI results. Higher percentage of dead (Casp+/PI+; 84.0% vs. 57.5%) and viable (Casp+/PI-; 12.0% vs. 0) spermatozoa with activated caspases were observed in testicular than in epididymal samples. No significant difference was observed between the percentage of total testicular and epididymal spermatozoa permeant for PI. The outcome of ICSI fertilization (67.5% vs. 57.4%), good morphology embryo at day 2 (75.9% vs. 61.3%), clinical pregnancy (26.7% vs. 15.4%), and implantation (15.6% vs 9.5%) rates were better when ICSI were performed with epididymal sperm samples. These results support the hypothesis of an abortive apoptotic process and demonstrate that combined staining of the activated caspases and membrane permeability provide complementary measurements for the evaluation of viable and functional spermatozoa to better understand ICSI outcomes with epididymal and testicular spermatozoa. | 18,774,565 |
Ultrasonographer experience does not impact outcomes following ultrasound-guided embryo transfer. | To determine the effect of sonographer experience during ultrasound guided embryo transfer on pregnancy outcomes. Retrospective chart review. A university-based academic practice. A total of 319 women who underwent in vitro fertilization and embryo transfer (IVF-ET) from the site-specific clinic. A total of 118 women (37%) underwent embryo transfers with a medical assistant (inexperienced ultrasonographer) performing ultrasound guidance, and 201 women (63%) underwent embryo transfers by an REI fellow (experienced ultrasonagrapher) performing the US guidance. Real-time transabdominal ultrasound guidance during IVF-ET. Respective biochemical, clinical, and live birth rates following ultrasound-guided IVF-ET performed by either experienced or nonexperienced sonographers. The two groups were similar in baseline characteristics or treatment response. Pregnancy outcomes were similar in both groups, with the MA cohort demonstrating clinical pregnancy rate of 43.2% and a live birth rate of 35.6%, and the REI fellow group yielding a clinical pregnancy rate of 44.8% and a live birth rate 35.8%, respectively. The clinical experience of the person performing ultrasound guidance during IVF-ET does not have an effect on clinical outcome. Thus, the use of an assistant without formal ultrasound training during IVF-ET is a reasonable option. | 18,774,570 |
Ionic liquid-based microwave-assisted extraction of phenolic alkaloids from the medicinal plant Nelumbo nucifera Gaertn. | An ionic liquid-based microwave-assisted extraction (ILMAE) approach has been successfully applied to the effective extraction of the phenolic alkaloids present in samples of the medicinal plant Nelumbo nucifera Gaertn. The ionic liquids investigated comprised a range of four anions, four 1-alkyl-3-methylimidazolium derivatives differing in hydrophobic chain length. The results indicate that varying the anion has apparent effects on the overall extraction efficiency. In addition, the influence of some microwave parameters, such as irradiation power, extraction time and solid-liquid ratio, are also investigated. Under the optimized conditions, the proposed approach has been evaluated in comparison with the conventional heat-reflux extraction (HRE) and regular MAE. The reduction of the extraction times (from 2h to 90s) and remarkable higher efficiency (20-50% improved) supports the suitability of the proposed approach. In addition, the proposed method is validated by the recovery, correlation coefficient (R(2)), and reproducibility (RSD, n=5), which are in the range of 98-105%, 0.9994-0.9998, and 1.2-5.4%, respectively. | 18,774,575 |
The inhibition of experimentally induced visceral hyperalgesia by nifedipine - a voltage-gated Ca(2+) channels blocker (VGCCs) in sheep. | Present study examined the effect of VGCC L-type blocker - nifedipine given i.c.v. (0.25, 0.5, 1 and/or 2mg in toto) on the development of nociceptive behavior, clinical symptoms, plasma catecholamin concentration and reticulo-rumen motility following 5 min lasting mechanical duodenal distension (DD) in sheep. After 24h of fasting, all animals received i.m. ketamine analgesia (20 mg kg(-1)B.W) and anesthetized with pentobarbital (20 mg kg(-1)B.W., i.v. infusion) The permanent stainless steel cannula 29 mm in length and 2mm in diameter was inserted into the lateral cerebral ventricle (controlled by cerebro-spinal efflux) 10mm above the bregma and 5mm laterally from the midline sutures using stereotaxic method. Under the same general anesthesia/analgesia a T-shaped silicon cannula (inside diameter of 21 mm), was inserted into the duodenum (12 cm from pylorus). Second identical cannule was inserted into the dorsal sac of the rumen, a previously described. After surgery each animal was kept in individual boxes for 10 days prior to experiment and was treated i.m. with benzyl procaine penicillin 30,000 I.U kg(-1)B.W.)+dihydrostreptomycine sulfate (10 g kg(-1)B.W.)+prednisolone acetate (1.2 mg kg(-1)B.W.) combination and i.m. ketamine (20 mg kg(-1)B.W.) every day by seven consecutive days. Experimental DD was conducted by insertion and then distension of rubber balloon (containing 40 ml of warm water) inserted into sheep duodenum. Duodenal distension produced a significant increase in behavioral pain manifestations, tachycardia, hyperventilation, inhibition of reticulo-ruminal contractions rate (from 87.2 to 38.0% during 15-20 min), an increase of plasma catecholamine concentration (over 6.4-fold increase of epinephrine during 2h following DD, 2-times norepinephrine and 84% increase of dopamine). Nifedipine infusion administered 10 min prior to DD decreased intensity of visceral pain manifestations such as: behavioral changes, hyperventilation, reticulo-rumen motility and efficiently prevent appearance of catecholamine release. These data demonstrated that the development and persistence of duodenal hyperalgesia depends on the activation of Ca(2+) ion flux leading to neurotransmitters release and modulation of membrane excitability. It seems that nifedipine given i.c.v. 10 min prior to DD (as a source of visceral pain), inhibited specific receptors 1 subunits of VGCCs in target tissues, prevented depolarization of cell membranes and release of neurotransmitters responsible for pain sensitivity in sheep. The observed antinociceptive action of VGCCs type L blockers suggest that these channels play a crucial role in the modulation of acute visceral hyperalgesia in sheep. | 18,774,578 |
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