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Kinds of Ca Terms modified by Ca Selected AbstractsMyocardial Perfusion As Assessed by Positron Emission Tomography During Long-Term Mechanical Circulatory SupportCONGESTIVE HEART FAILURE, Issue 2 2006George V. Letsou MD Although mechanical circulatory support (MCS) can improve myocardial function in patients with advanced heart failure, its effects on relative myocardial perfusion are unclear. Using positron emission tomographic imaging techniques, the authors assessed relative myocardial perfusion in patients with ischemic or idiopathic cardiomyopathy who were receiving chronic MCS with a left ventricular assist device (pulsatile HeartMate [n=2] [Thoratec Corporation, Pleasanton, CA] or nonpulsatile Jarvik 2000 [n=4] [Jarvik Heart, Inc., New York, NY]). Relative myocardial perfusion was compared at lower and higher levels of MCS (50 vs. 100,110 ejections/min for the HeartMate and 8000 vs. 12,000 rpm for the Jarvik 2000). The size and severity of perfusion defects at rest and after dipyridamole stress were measured objectively and subjectively by computer algorithms and visual inspection, respectively. Relative myocardial perfusion increased >5% from baseline in only one of six patients when MCS was increased. No change in relative myocardial perfusion of >5% was seen in any of the other five patients, even after subsequent dipyridamole stress positron emission tomographic imaging. These pilot study findings suggest that the decreased metabolic requirements induced by ventricular unloading correspondingly decreased blood flow requirements to physiologically inactive myocardium. [source] Tumor imaging in small animals with a combined micro-CT/micro-DSA system using iodinated conventional and blood pool contrast agentsCONTRAST MEDIA & MOLECULAR IMAGING, Issue 4 2006Cristian T. Badea Abstract X-ray based micro-computed tomography (CT) and micro-digital subtraction angiography (DSA) are important non-invasive imaging modalities for following tumorogenesis in small animals. To exploit these imaging capabilities further, the two modalities were combined into a single system to provide both morphological and functional data from the same tumor in a single imaging session. The system is described and examples are given of imaging implanted fibrosarcoma tumors in rats using two types of contrast media: (a) a new generation of blood pool contrast agent containing iodine with a concentration of 130,mg/mL (FenestraÔ VC, Alerion Biomedical, San Diego, CA, USA) for micro-CT and (b) a conventional iodinated contrast agent (Isovue®-370,mg/mL iodine, trademark of Bracco Diagnostics, Princeton, NJ, USA) for micro-DSA. With the blood pool contrast agent, the 3D vascular architecture is revealed in exquisite detail at 100,µm resolution. Micro-DSA images, in perfect registration with the 3D micro-CT datasets, provide complementary functional information such as mean transit times and relative blood flow through the tumor. This imaging approach could be used to understand tumor angiogenesis better and be the basis for evaluating anti-angiogenic therapies. Copyright © 2006 John Wiley & Sons Ltd. [source] Observation of Mode like Coherent Structures in Curved Magnetic Fields of a Simple Magnetized TorusCONTRIBUTIONS TO PLASMA PHYSICS, Issue 4 2004F. Greiner Abstract The spatio-temporal dynamics of large-scale structures in curved magnetic field of simple magnetized torus (SMT) are presented. The experiments are performed in the SMT BLAAMANN and employ the techniques of conditional averaging (CA) and cross-correlation (CCF) of Langmuir probe data. By means of a detailed comparison of radio-frequency and thermionic discharges, it is shown that general features of the observed large-scale structures are independent of the discharge mechanism. Further, the observed large scale structures have a pronounced spatio-temporal periodicity, which suggests a description as mode-like. The conjectured relationship between the observed coherent structures and the inverse energy cascade is therefore questioned again. (© 2004 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [source] Hospital Disaster Preparedness in Los Angeles CountyACADEMIC EMERGENCY MEDICINE, Issue 11 2006Amy H. Kaji MD Background There are no standardized measures of hospital disaster preparedness or hospital "surge capacity." Objectives To characterize disaster preparedness among a cohort of hospitals in Los Angeles County, focusing on practice variation, plan characteristics, and surge capacity. Methods This was a descriptive, cross-sectional survey study, followed by on-site verification. Forty-five 9-1-1 receiving hospitals in Los Angeles County, CA, participated. Evaluations of hospital disaster plan structure, vendor agreements, modes of communication, medical and surgical supplies, involvement of law enforcement, mutual aid agreements with other facilities, drills and training, surge capacity (assessed by monthly emergency department diversion status, available beds, ventilators, and isolation rooms), decontamination capability, and pharmaceutical stockpiles were assessed by survey. Results Forty-three of 45 hospital plans (96%) were based on the Hospital Emergency Incident Command System, and the majority had protocols for hospital lockdown (100%), canceling elective surgeries (93%), early discharge (98%), day care for children of staff (88%), designating victim overflow areas (96%), and predisaster "preferred" vendor agreements (96%). All had emergency medical services,compatible radios and more than three days' worth of supplies. Fewer hospitals involved law enforcement (56%) or had mutual aid agreements with other hospitals (20%) or long-term care facilities (7%). Although the vast majority (96%) conducted multiagency drills, only 16% actually involved other agencies in their disaster training. Only 13 of 45 hospitals (29%) had a surge capacity of greater than 20 beds. Less than half (42%) had ten or more isolation rooms, and 27 hospitals (60%) were on diversion greater than 20% of the time. Thirteen hospitals (29%) had immediate access to six or more ventilators. Less than half had warm-water decontamination (42%), while approximately one half (51%) had a chemical antidote stockpile and 42% had an antibiotic stockpile. Conclusions Among hospitals in Los Angeles County, disaster preparedness and surge capacity appear to be limited by a failure to fully integrate interagency training and planning and a severely limited surge capacity, although there is a generally high level of availability of equipment and supplies. [source] In Vitro Resistance to Degradation of Hyaluronic Acid Dermal Fillers by Ovine Testicular HyaluronidaseDERMATOLOGIC SURGERY, Issue 2010DEREK JONES MD BACKGROUND Although adverse events are uncommon with hyaluronic acid (HA) fillers, the use of hyaluronidase permits the reversal of treatment complications or overcorrection. OBJECTIVE This study sought to determine an in vitro dose-response relationship between ovine testicular hyaluronidase (OTH) and three HA dermal fillers (24-mg/mL smooth gel, 20-mg/mL particulate gel, and 5.5-mg/mL particulate gel with 0.3% lidocaine). METHODS AND MATERIALS The dose response of each was measured after incubation for 30 minutes in concentrations ranging between 5 and 40 U of OTH. Timed responses for the 24-mg/mL and 20-mg/mL HA fillers were obtained after incubation with 20 U of OTH for 15 to 120 minutes. RESULTS After all dose responses and timed-interval tests, the 24-mg/mL HA smooth gel filler exhibited more resistance against in vitro enzymatic degradation to OTH than the 20- and 5.5-mg/mL HA particulate gels. CONCLUSION This resistance to degradation in vitro may be attributed to the higher HA content of the 24-mg/mL HA smooth gel, the degree of crosslinking, and the cohesive property of the gel filler. This study was funded by a grant from Allergan, Inc., Santa Barbara, CA. Derek Jones, MD, is a consultant, investigator, advisory board member, and speaker for Allergan, Inc. He received no compensation for this study. Drs. Tezel and Borrell are employed by Allergan, Inc., Santa Barbara, CA. Editorial assistance was provided by Health Learning Systems, a part of CommonHealth, Parsippany, NJ. [source] Current Evidence on the Unit Equivalence of Different Botulinum Neurotoxin A Formulations and Recommendations for Clinical Practice in DermatologyDERMATOLOGIC SURGERY, Issue 1 2009SYRUS KARSAI MD BACKGROUND The unit equivalence between the two main Botulinum neurotoxin A (BoNTA) preparations, Dysport (Ipsen Ltd., Slough, Berkshire, UK) and BOTOX (Allergan Inc., Irvine, CA), is a matter of discussion. The UK assay used to test Dysport is more sensitive than the U.S. assay used for BOTOX, resulting in a different efficacy per unit in both formulations. Ratios ranging from 6:1 to 1:1 can be found in the literature, but the more recently published literature suggests that 1 unit of BOTOX is equivalent to approximately 2 to 4 units of Dysport (ratio 2:1,4:1). OBJECTIVE Because the number of BoNTA treatments is constantly increasing, these differences warrant a systematic review of published evidence about the unit equivalence of UK and U.S. formulations. METHODS The review is based on a detailed literature research in all relevant databases (MEDLINE, PubMed, Cochrane Library, specialist textbooks). RESULTS The present review supports the recent assumption that dose ratios of less than 3:1 (e.g., 2.5:1 or even 2:1) between Dysport and BOTOX are probably more suitable. CONCLUSIONS The current evidence is still insufficient, and further investigation of lower dose ratios is recommended. [source] Mohs Micrographic Surgery in the Treatment of Rare Aggressive Cutaneous Tumors: The Geisinger ExperienceDERMATOLOGIC SURGERY, Issue 3 2007CHADWICK JOHN THOMAS MD BACKGROUND Mohs micrographic surgery (MMS) offers high cure rates and maximum tissue preservation in the treatment of more common cutaneous malignancies, but its effectiveness in rare aggressive tumors is poorly defined. OBJECTIVE Evaluate the effectiveness of MMS in the treatment of six rare aggressive cutaneous malignancies as seen by Mohs surgeons working at a referral center. METHODS Retrospective chart review of 26,000 cases treated with MMS at the Geisinger Medical Center Department of Dermatology during a 16-year period with the following diagnoses: poorly differentiated squamous cell carcinoma (PDSCC), dermatofibrosarcoma protuberans (DFSP), microcystic adnexal carcinoma (MAC), extramammary Paget's disease (EMPD), Merkel cell carcinoma (MCC), and sebaceous carcinoma (SEB CA). Patient demographic data, tumor measurements, treatment characteristics, and marginal recurrence rates were compiled and evaluated. RESULTS The mean numbers of cases identified per year for each tumor type were as follows: PDSCC, 6.19; DFSP, 2.44; MAC, 1.63; and EMPD, 0.63. For PDSCC, 85 cases were available for follow-up with a local recurrence rate of 6% at a mean follow-up time of 45 months. For DFSP, there were 35 cases with no local recurrence at a mean follow-up of 39 months. For MAC, there were 25 cases with a local recurrence rate of 12% at a mean follow-up of 39 months. For EMPD, there were 10 cases with no local recurrences at a mean follow-up of 34 months. CONCLUSIONS Collectively, our data on PDSCC, DFSP, MAC, and EMPD, combined with other studies in the literature, show that MMS is the most effective therapy for these rare aggressive cutaneous malignancies. [source] Near Painless, Nonablative, Immediate Skin Contraction Induced by Low-Fluence Irradiation with New Infrared Device: A Report of 25 PatientsDERMATOLOGIC SURGERY, Issue 5 2006JAVIER RUIZ-ESPARZA MD BACKGROUND Nonablative radiofrequency (NARF) has been the only method for producing noninvasive skin tightening. Nevertheless, significant pain during the procedure is an important downside of this technology. A new nonablative medical device, Titan (Cutera, Inc., Brisbane, CA, USA), capable of fluences much lower than those possible with NARF, was tested as a less painful alternative. OBJECTIVES To produce skin contraction leading to lifting of eyebrows and/or improvement of lower face and neck skin laxity using fluences below pain levels. PATIENTS AND METHODS Twenty-five patients were treated. Standardized photographs were obtained preoperatively, after a few days, a few weeks, and up to 12 months after the procedure. RESULTS Immediate changes were obtained in 22 of 25 patients. Examination of photographs revealed that the initial improvement was maintained throughout the follow-up period. CONCLUSION Immediate true skin contraction persisting through the immediate, intermediate, and long-term follow-up was found in the vast majority of patients in this group. Edema as an artifact simulating immediate improvement was excluded by serial photographs taken during the follow-up period. Skin contraction occurred at low fluences, below the threshold of pain. This, to the best of our knowledge, has not been previously described in the medical literature. [source] Mohs Micrographic Surgery for Lentigo Maligna and Lentigo Maligna Melanoma using Mel-5 Immunostaining: University of Minnesota ExperienceDERMATOLOGIC SURGERY, Issue 5 2006SACHIN S. BHARDWAJ MD BACKGROUND Mohs micrographic surgery (MMS) continues to become a more common and accepted treatment for lentigo maligna (LM) and lentigo maligna melanoma (LMM). The primary difficulty encountered lies in the accurate identification of atypical single melanocytes to determine tumor-free margins. Numerous methods have been used to better visualize single melanocytes, with varying results. We present our experience using Mel-5 immunostaining in MMS of LM and LMM. METHODS Two hundred patients with primary or recurrent LM or LMM were treated using MMS from 1999 to 2003 at the University of Minnesota. The initial clinical margins were determined by Wood's light examination, and an initial debulk specimen was taken and sent for formalin fixation and later reviewed by a dermatopathologist. The first Mohs layer was then taken, and staining with hemotoxylin and eosin as well as Mel-5 immunostaining was performed. All patients were followed up to evaluate for recurrence, with a mean follow-up time of 38.4 months. RESULTS Of the 200 patients treated, only one recurrence was noted. This patient had been treated with excision followed by radiation before MMS. Use of Mel-5 immunostaining added approximately 40 minutes to each stage. Use of the Autostainer Immunostaining System (DAKO, Carpenterina, CA, USA) shortened the added time to 20 minutes. CONCLUSIONS MMS with Mel-5 immunostaining yielded excellent results in the treatment of LM and LMM, with only one recurrence noted in 200 patients. When an automated immunostainer was used, minimal time was added to each Mohs stage. [source] The Treatment of Melasma with Fractional Photothermolysis: A Pilot StudyDERMATOLOGIC SURGERY, Issue 12 2005Cameron K. Rokhsar MD Background. Melasma is a common pigmentary disorder that remains resistant to available therapies. Facial resurfacing with the pulsed CO2 laser has been reported successful but requires significant downtime, and there is a risk of adverse sequelae. Objective. To determine if melasma will respond to a new treatment paradigm, fractional resurfacing. Methods. Ten female patients (Fitzpatrick skin types III,V) who were unresponsive to previous treatment were treated at 1- to 2-week intervals with the Fraxel laser (Reliant Technologies, Palo Alto, CA, USA). Wavelengths of 1,535 and 1,550 nm were both used, and 6 to 12 mJ per microthermal zone with 2,000 to 3,500 mtz/cm2 were the treatment parameters. Four to six treatment sessions were performed. Responses were evaluated according to the percentage of lightening of original pigmentation. Two physicians evaluated the photographs, and each patient evaluated her own response. Results. The physician evaluation was that 60% of patients achieved 75 to 100% clearing and 30% had less than 25% improvement. The patients' evaluations agreed, except for one patient, who graded herself as 50 to 75% improved as opposed to the physician grading of over 75%. There was one patient with postinflammatory hyperpigmentation and no patient with hypopigmentation. No downtime was necessary for wound healing. Conclusions. Fractional resurfacing affords a new treatment algorithm for the treatment of melasma that combines decreased risk and downtime with significant efficacy. This treatment modality deserves further exploration to maximize benefits. RELIANT technologies LOANED THE FRAXEL LASER FOR THE STUDY. RICHARD E. FITZPATRICK, MD, IS A PAID CONSULTANT FOR RELIANT AND A STOCKHOLDER. [source] The Effect of Full-Face Broadband Light Treatments Alone and in Combination With Bilateral Crow's Feet Botulinum Toxin Type A ChemodenervationDERMATOLOGIC SURGERY, Issue 3 2004Jean Carruthers MD Background. Broadband light (BBL; Intense Pulsed Light; Lumenis Ltd., Yokneam, Israel) is a powerful, nonablative, light-based technology that targets melanin and hemoglobin and stimulates the formation of collagen and elastin. Botulinum toxin type A (BTX-A; BOTOX; Allergan Inc., Irvine, CA) treatment of the lateral periocular region relaxes the vertical fibers of the orbicularis oculi and results in softening of the lateral orbital crow's feet rhytides and widening of the palpebral aperture. Objective. To compare the effects of full-face BBL in combination with BTX-A and BBL alone in female subjects with Fitzpatrick I,III skin types, Glogau II,III rhytides, and significant associated facial lentigines and telangiectasia. Methods. This was a prospective, randomized study of 30 women with moderate to severe crow's feet rhytides. Half of the subjects were treated with BTX-A and BBL and the other half with BBL alone. Their response was assessed clinically and photographically. Skin biopsies of the temporal skin were taken from two subjects in each group and were stained with Masson trichrome. Results. Patients treated with a combination of BTX-A and BBL experienced a better response to treatment, both at rest and on maximum smile, as well as a slightly improved response in associated lentigines, telangiectasia, pore size, and facial skin texture compared with patients who received BBL treatment alone. Skin biopsies showed an increase in dermal collagen in each group. Conclusions. The patients in this study benefited from both treatments. Although BBL led to a remarkable improvement in full-face telangiectasias, lentigines, and skin texture, the improvement increased in all categories with combination therapy. In addition, an added improvement in the full-face aesthetic with both BTX-A and BBL therapy combined was obvious. These results suggest that both treatments,although evidently complementary,may also act synergistically to produce optimal clinical effects, revolutionizing the treatment of facial aging. [source] Hand augmentation with Radiesse® (Calcium hydroxylapatite)DERMATOLOGIC THERAPY, Issue 6 2007Mariano Busso ABSTRACT:, The hand has remained a considerable treatment challenge, as new soft tissue fillers have arrived in the esthetic marketplace. The challenge has been the result of both the multiple visits required for treatment in, for example, autologous fat grafting and the simple management of pain in the innervated areas of the hand between the bones. This paper introduces a novel, noticeably less painful approach to treatment of the hand with calcium hydroxylapatite (CaHA; Radiesse®, BioForm Medical, San Mateo, CA). Anesthetic is added to the compound prior to injection, resulting in a homogenous admixture of CaHA and anesthetic. A bolus of the mixture is injected into the skin, using tenting, and then spread throughout the hand. The result of this approach , mixing anesthetic with CaHA , is treatment that is easier to massage and disseminate, less painful to the patient than conventional hand injection, and characterized by less swelling and bruising, with minimal post-treatment downtime. [source] Identification of genes expressed preferentially in the developing peripheral margin of the optic cupDEVELOPMENTAL DYNAMICS, Issue 9 2009Jeffrey M. Trimarchi Abstract Specification of the peripheral optic cup by Wnt signaling is critical for formation of the ciliary body/iris. Identification of marker genes for this region during development provides a starting point for functional analyses. During transcriptional profiling of single cells from the developing eye, two cells were identified that expressed genes not found in most other single cell profiles. In situ hybridizations demonstrated that many of these genes were expressed in the peripheral optic cup in both early mouse and chicken development, and in the ciliary body/iris at subsequent developmental stages. These analyses indicate that the two cells probably originated from the developing ciliary body/iris. Changes in expression of these genes were assayed in embryonic chicken retinas when canonical Wnt signaling was ectopically activated by CA-,-catenin. Twelve ciliary body/iris genes were identified as upregulated following induction, suggesting they are excellent candidates for downstream effectors of Wnt signaling in the optic cup. Developmental Dynamics 238:2327,2339, 2009. © 2009 Wiley-Liss, Inc. [source] Avascular necrosis not Charcot'sDIABETIC MEDICINE, Issue 10 2001Y. P. Samarasinghe Abstract Background, A case of avascular necrosis (AN) of the navicular bone, in a 24-year-old woman with Type 1 diabetes with peripheral neuropathy, in the absence of any history of direct trauma is presented. The clinical and radiological features at presentation suggested an evolving Charcot arthropathy (CA), but subsequent serial X-rays clearly confirmed AN. Conclusions Swelling and foot deformity in association with long-standing diabetic peripheral neuropathy is suggestive of CA, although AN, a less common condition, may show the same clinical features. It is therefore important to undertake further confirmatory radiological investigations if there is any doubt about the diagnosis. Diabet. Med. 18, 846,848 (2001) [source] Pathological gambling: an increasing public health problemACTA PSYCHIATRICA SCANDINAVICA, Issue 4 2001Article first published online: 7 JUL 200 Gambling has always existed, but only recently has it taken on the endlessly variable and accessible forms we know today. Gambling takes place when something valuable , usually money , is staked on the outcome of an event that is entirely unpredictable. It was only two decades ago that pathological gambling was formally recognized as a mental disorder, when it was included in the DSM-III in 1980. For most people, gambling is a relaxing activity with no negative consequences. For others, however, gambling becomes excessive. Pathological gambling is a disorder that manifests itself through the irrepressible urge to wager money. This disorder ultimately dominates the gambler's life, and has a multitude of negative consequences for both the gambler and the people they interact with, i.e. friends, family members, employers. In many ways, gambling might seem a harmless activity. In fact, it is not the act of gambling itself that is harmful, but the vicious cycle that can begin when a gambler wagers money they cannot afford to lose, and then continues to gamble in order to recuperate their losses. The gambler's ,tragic flaw' of logic lies in their failure to understand that gambling is governed solely by random, chance events. Gamblers fail to recognize this and continue to gamble, attempting to control outcomes by concocting strategies to ,beat the game'. Most, if not all, gamblers try in some way to predict the outcome of a game when they are gambling. A detailed analysis of gamblers' selfverbalizations reveals that most of them behave as though the outcome of the game relied on their personal ,skills'. From the gambler's perspective, skill can influence chance , but in reality, the random nature of chance events is the only determinant of the outcome of the game. The gambler, however, either ignores or simply denies this fundamental rule (1). Experts agree that the social costs of pathological gambling are enormous. Changes in gaming legislation have led to a substantial expansion of gambling opportunities in most industrialized countries around the world, mainly in Europe, America and Australia. Figures for the United States' leisure economy in 1996 show gross gambling revenues of $47.6 billion, which was greater than the combined revenue of $40.8 billion from film box offices, recorded music, cruise ships, spectator sports and live entertainment (2). Several factors appear to be motivating this growth: the desire of governments to identify new sources of revenue without invoking new or higher taxes; tourism entrepreneurs developing new destinations for entertainment and leisure; and the rise of new technologies and forms of gambling (3). As a consequence, prevalence studies have shown increased gambling rates among adults. It is currently estimated that 1,2% of the adult population gambles excessively (4, 5). Given that the prevalence of gambling is related to the accessibility of gambling activities, and that new forms of gambling are constantly being legalized throughout most western countries, this figure is expected to rise. Consequently, physicians and mental health professionals will need to know more about the diagnosis and treatment of pathological gamblers. This disorder may be under-diagnosed because, clinically, pathological gamblers usually seek help for the problems associated with gambling such as depression, anxiety or substance abuse, rather than for the excessive gambling itself. This issue of Acta Psychiatrica Scandinavica includes the first national survey of problem gambling completed in Sweden, conducted by Volberg et al. (6). This paper is based on a large sample (N=9917) with an impressively high response rate (89%). Two instruments were used to assess gambling activities: the South Oaks Gambling Screen-Revised (SOGS-R) and an instrument derived from the DSM-IV criteria for pathological gambling. Current (1 year) and lifetime prevalence rates were collected. Results show that 0.6% of the respondents were classified as probable pathological gamblers, and 1.4% as problem gamblers. These data reveal that the prevalence of pathological gamblers in Sweden is significantly less than what has been observed in many western countries. The authors have pooled the rates of problem (1.4%) and probable pathological gamblers (0.6%), to provide a total of 2.0% for the current prevalence. This 2% should be interpreted with caution, however, as we do not have information on the long-term evolution of these subgroups of gamblers; for example, we do not know how many of each subgroup will become pathological gamblers, and how many will decrease their gambling or stop gambling altogether. Until this information is known, it would be preferable to keep in mind that only 0.6% of the Swedish population has been identified as pathological gamblers. In addition, recent studies show that the SOGS-R may be producing inflated estimates of pathological gambling (7). Thus, future research in this area might benefit from the use of an instrument based on DSM criteria for pathological gambling, rather than the SOGS-R only. Finally, the authors suggest in their discussion that the lower rate of pathological gamblers obtained in Sweden compared to many other jurisdictions may be explained by the greater availability of games based on chance rather than games based on skill or a mix of skill and luck. Before accepting this interpretation, researchers will need to demonstrate that the outcomes of all games are determined by other factor than chance and randomness. Many studies have shown that the notion of randomness is the only determinant of gambling (1). Inferring that skill is an important issue in gambling may be misleading. While these are important issues to consider, the Volberg et al. survey nevertheless provides crucial information about gambling in a Scandinavian country. Gambling will be an important issue over the next few years in Sweden, and the publication of the Volberg et al. study is a landmark for the Swedish community (scientists, industry, policy makers, etc.). This paper should stimulate interesting discussions and inspire new, much-needed scientific investigations of pathological gambling. Acta Psychiatrica Scandinavica Guido Bondolfi and Robert Ladouceur Invited Guest Editors References 1.,LadouceurR & WalkerM. The cognitive approach to understanding and treating pathological gambling. In: BellackAS, HersenM, eds. Comprehensive clinical psychology. New York: Pergamon, 1998:588 , 601. 2.,ChristiansenEM. Gambling and the American economy. In: FreyJH, ed. Gambling: socioeconomic impacts and public policy. Thousand Oaks, CA: Sage, 1998:556:36 , 52. 3.,KornDA & ShafferHJ. Gambling and the health of the public: adopting a public health perspective. J Gambling Stud2000;15:289 , 365. 4.,VolbergRA. Problem gambling in the United States. J Gambling Stud1996;12:111 , 128. 5.,BondolfiG, OsiekC, FerreroF. Prevalence estimates of pathological gambling in Switzerland. Acta Psychiatr Scand2000;101:473 , 475. 6.,VolbergRA, AbbottMW, RönnbergS, MunckIM. Prev-alence and risks of pathological gambling in Sweden. Acta Psychiatr Scand2001;104:250 , 256. 7.,LadouceurR, BouchardC, RhéaumeNet al. Is the SOGS an accurate measure of pathological gambling among children, adolescents and adults?J Gambling Stud2000;16:1 , 24. [source] Detection of tumor cells in body cavity fluids by flow cytometric and immunocytochemical analysisDIAGNOSTIC CYTOPATHOLOGY, Issue 8 2006Awtar Krishan Ph.D. Abstract Measurement of electronic volume versus DNA content of nuclei can be used to discriminate between normal and malignant cells. Epithelial membrane antigen immunocytochemistry (EMA-ICC), a helpful ancillary test in body cavity fluids, is not universally accurate for detecting malignancy in effusions. The current study was undertaken to determine if multiparametric flow cytometry (based on simultaneous analysis of light scatter, nuclear volume, DNA, and nuclear protein content) in combination with (EMA-ICC) could be used for the detection of malignant cells in peritoneal and pleural fluids. We studied 130 body cavity fluids (68 peritoneal and 62 pleural fluids) by conventional cytology and multiparametric laser flow cytometry. EMA-ICC was performed using EMA antibodies and L-SAB detection system (DakoCytomation, Carpinteria, CA). EMA-ICC had significantly higher sensitivity than conventional cytology (79% versus 59%, P = 0.016) and ploidy (79% versus 38%, P = 0.001). Cytology had significantly higher specificity than ploidy (97% versus 82%, P = 0.012). The differences in specificity between EMA-ICC and ploidy (87% versus 82%, P= 0.607) or EMA-ICC and cytology (87% versus 97%, P = 0.109) were not statistically significant. However, assuming serial testing, sensitivity increased significantly for the combinations of cytology and EMA-ICC (79.4%, P = 0.016) and cytology and ploidy (73.5%, P = 0.004) as compared to cytology alone (58.8%). Also, the combination of cytology and ploidy had a higher sensitivity than ploidy alone (73% versus 38%, P < 0.0001). However, the sensitivity associated with the three tests used in serial (85.3%) was not significantly different from the sensitivities corresponding to the combination of cytology and EMA-ICC (79%) or cytology and ploidy (73%). Multiparametric flow cytometry utilizing high resolution DNA, nuclear volume, protein measurement, and ICC, in combination with cytomorphology, may be a valuable tool for rapid identification of malignant cells in body cavity fluids. Diagn. Cytopathol. 2006;34:528,541. © 2006 Wiley-Liss, Inc. [source] Smears diagnosed as ASCUS: Interobserver variation and follow-upDIAGNOSTIC CYTOPATHOLOGY, Issue 2 2001C.F.I.A.C., Rose Marie Gatscha S.C.T. (A.S.C.P.) Abstract The purpose of this study was to apply atypical squamous cells of undetermined significance (ASCUS) criteria from the Bethesda System for Reporting Cervical/Vaginal Cytologic Diagnoses (TBS) to the rescreen of cases previously diagnosed as ASCUS, to compare initial and rescreen diagnoses, and to analyze agreement with follow-up (cytology or histology). Two cytotechnologists (S.B. and M.J.M.) and one cytopathology fellow (M.A.) rescreened 632 cervicovaginal specimens diagnosed as ASCUS between June 1, 1992,December 31, 1995. Age and LMP were provided. Rescreen diagnoses were categorized as within normal limits (WNL), ASCUS, low-grade squamous intraepithelial lesions (LSIL), high-grade squamous intraepithelial lesions (HSIL), or carcinoma (CA). Complete agreement was found in 200 specimens (32%): 31 (15%) WNL; 91 (45%) ASCUS; 77 (38.5%) SIL; and one (0.50%) CA. Follow-up revealed no abnormality in 67% of the cases reclassified as WNL, 49% of the cases reclassified as ASCUS, and 48% of the cases reclassified as squamous intraepithelial lesions (SIL). SIL was found in 29% of cases reclassified as WNL, 29% of specimens rediagnosed as ASCUS, and 34% of cases reclassified as SIL. Partial agreement was found in 391 specimens (62%). In 41 specimens (6%), rescreeners were in complete disagreement, and follow-up revealed 9/41 (22%) SIL or worse; 21/41 (51%) WNL; and 4/41 (10%) inconclusive. Applying established criteria, 14% (91/632) of cases diagnosed as ASCUS resulted in complete agreement, and 30% (190/632) resulted in partial agreement. Follow-up of cases initially diagnosed as ASCUS revealed SIL or CA in 30% of cases. ASCUS is a significant diagnosis warranting careful patient follow-up. Diagn. Cytopathol. 2001;25:138,140. © 2001 Wiley-Liss, Inc. [source] Nuclear Weapons: The Global and Popular Context of PolicyDIPLOMATIC HISTORY, Issue 2 2005Charles Chatfield Book reviewed: Lawrence S. Wittner. Toward Nuclear Abolition: A History of the World Nuclear Disarmament Movement, 1971to the Present. Stanford, CA: Stanford University Press, 2003. 491 pp. Notes, bibliography, index. $75.00 (cloth), $32.95 (paper). [source] Cognitive profiles of chinese adolescents with dyslexiaDYSLEXIA, Issue 1 2010Kevin K. H. Chung Abstract The present study sought to identify cognitive abilities that might distinguish Hong Kong Chinese adolescents with and without dyslexia and examined the cognitive profile of dyslexic adolescents in order to better understand this important problem. The performance of 27 Chinese adolescents with childhood diagnoses of dyslexia was compared with 27 adolescents of the same chronological age (CA) and 27 of matched reading level (RL) on measures of literacy and cognitive abilities: Chinese word reading, one-minute reading, reading comprehension, dictation, verbal short-term memory, rapid naming, visual-orthographic knowledge, morphological and phonological awareness. The results indicated that the dyslexic group scored lower than the CA group, but similar to the RL group, especially in the areas of rapid naming, visual-orthographic knowledge and morphological awareness, with over half having multiple deficits exhibited 2 or more cognitive areas. Furthermore, the number of cognitive deficits was associated with the degree of reading and spelling impairment. These findings suggest that adolescents with childhood diagnoses of dyslexia have persistent literacy difficulties and seem to have multiple causes for reading difficulties in Chinese. Copyright © 2009 John Wiley & Sons, Ltd. [source] Sensitivity to visual and auditory stimuli in children with developmental dyslexiaDYSLEXIA, Issue 2 2008Bernardine King Abstract This study considered the extent to which 23 children with dyslexia differed from 23 reading age (RA) and 23 chronological age (CA) matched controls in their ability to make temporal judgements about auditory and visual sequences of stimuli, and in the speed of their reactions to the onsets and offsets of visual and auditory stimuli. The children with dyslexia were slower (p,=,0.039) than the CA controls in their reactions to non-verbal auditory onsets (tones), were less able to recognize the first stimulus of a sequence of tones (p,=,0.022), and were less accurate in identifying the initial phoneme of a sequence of three (p,<,0.001). These characteristics may be manifestations of an impaired temporal processing system for rapid auditory stimuli. CA controls responded more quickly to tone onsets than to tone offsets (p,=,0.025), but the dyslexic and RA groups showed no significant difference (p,>,0.05) in their reaction times to onsets and offsets of these non-verbal auditory stimuli. Dyslexic readers showed impairment compared with CA controls in responding to the last of a sequence of three non-verbal visual stimuli (shapes), p,=,0.02. Reaction times in the visual and auditory onset and offset tasks were richly intercorrelated in the control groups, but the dyslexic group did not show as many significant correlations in reaction times between the auditory and visual domains, or between the onset and offset RTs within each modality. These results suggest that there may be a less integrated cross-modal and intra-modal temporal system in children with dyslexia than in controls. In many of the measures in this study, the performance of the dyslexic group resembled that of the RA control group but differed from CA controls, which implies a developmental delay. The possibility that such a cognitive delay may be related to an underlying neurological disorder is discussed. Copyright © 2007 John Wiley & Sons, Ltd. [source] The Pocket Echocardiograph: Validation and FeasibilityECHOCARDIOGRAPHY, Issue 7 2010Benjamin C. Culp M.D. Background: A new, miniaturized ultrasound device, the pocket echocardiograph (PE), is highly portable and can be carried inside a lab-coat pocket. Studies of this device are limited and have not examined the use by novice echocardiographers. We hypothesize that a novice echocardiographer can use PE to produce interpretable cardiac images, and that both novice and expert echocardiographers can use PE to accurately quantify ejection fraction. Methods: Unselected subjects (n = 40) in an echocardiography laboratory underwent blinded formal transthoracic echocardiography (TTE) and PE (Acuson P10, Siemens, Mountain View, CA, USA). A cardiology fellow with 2 months of echocardiography training acquired PE images. The fellow and an experienced echocardiographer interpreted the PE studies offline in a blinded fashion. To assess adequacy, studies were graded as technically adequate, limited, or inadequate. A visual estimation of ejection fraction was made. Comparisons were made to the formal reported TTE. Results: Subjects were heterogeneous, 43% male; age 64 ± 17 years, and ejection fraction 52.4%± 12.3%. All PE studies were interpretable, and the vast majority of PE and TTE images were considered technically adequate (77.5% and 85% respectively; P = 0.32). Ejection fraction showed a good correlation, bias, and limits of agreement for the fellow's interpretation (r = 0.78, ,5.9%, ±16.6%) with stronger association for the experienced echocardiographer (r = 0.88, ,0.8%, ±11.4%). Conclusion: Novice echocardiographers using the PE can produce adequate quality images. Both expert and novice echocardiographers can use PE to quantify ejection fraction over a broad range of patients. The device's low cost and portability may greatly expand the availability of bedside echocardiography for routine or urgent cardiovascular assessment. (Echocardiography 2010;27:759-764) [source] Real Time Myocardial Contrast Echocardiography During Supine Bicycle Stress and Continuous Infusion of Contrast Agent.ECHOCARDIOGRAPHY, Issue 6 2007Cutoff Values for Myocardial Contrast Replenishment Discriminating Abnormal Myocardial Perfusion Background: Myocardial contrast echocardiography (MCE) is a new imaging modality for diagnosing coronary artery disease (CAD). Objective: The aim of our study was to evaluate feasibility of qualitative myocardial contrast replenishment (RP) assessment during supine bicycle stress MCE and find out cutoff values for such analysis, which could allow accurate detection of CAD. Methods: Forty-four consecutive patients, scheduled for coronary angiography (CA) underwent supine bicycle stress two-dimensional echocardiography (2DE). During the same session, MCE was performed at peak stress and post stress. Ultrasound contrast agent (SonoVue) was administered in continuous mode using an infusion pump (BR-INF 100, Bracco Research). Seventeen-segment model of left ventricle was used in analysis. MCE was assessed off-line in terms of myocardial contrast opacification and RP. RP was evaluated on the basis of the number of cardiac cycles required to refill the segment with contrast after its prior destruction with high-power frames. Determination of cutoff values for RP assessment was performed by means of reference intervals and receiver operating characteristic analysis. Quantitative CA was carried out using CAAS system. Results: MCE could be assessed in 42 patients. CA revealed CAD in 25 patients. Calculated cutoff values for RP-analysis (peak-stress RP >3 cardiac cycles and difference between peak stress and post stress RP >0 cardiac cycles) provided sensitive (88%) and accurate (88%) detection of CAD. Sensitivity and accuracy of 2DE were 76% and 79%, respectively. Conclusions: Qualitative RP-analysis based on the number of cardiac cycles required to refill myocardium with contrast is feasible during supine bicycle stress MCE and enables accurate detection of CAD. [source] Effects of stocked trout on native fish communities in boreal foothills lakesECOLOGY OF FRESHWATER FISH, Issue 2 2010Leslie E. Nasmith Nasmith LE, Tonn WM, Paszkowski CA, Scrimgeour GJ. Effects of stocked trout on native fish communities in boreal foothills lakes. Ecology of Freshwater Fish 2010: 19: 279,289. © 2010 John Wiley & Sons A/S Abstract,,, Ecological effects of stocking nonnative trout into lakes are receiving increased attention, especially in alpine environments. We assessed effects of stocked trout on native forage fishes in the boreal foothills of Alberta (Canada) by comparing fish density, population size structure and spatial and temporal activities in stocked and unstocked lakes over 3 years (2005,2007). The numerically dominant dace (primarily Phoxinus spp.) were larger in stocked lakes, consistent with size-limited predation. Dace were also more crepuscular and concentrated on the lake-bottom in stocked lakes, compared to more daytime activity in the water column in unstocked lakes. There were, however, no demonstrable effects of trout on the abundance of forage fish. The lack of major population-level impacts of stocked trout suggests that current stocking practices, characteristics of boreal foothill lakes (e.g. thermal structure, abundant invertebrates, dense macrophytes) and/or behavioural adjustments of forage fish contribute to healthy native fish populations in our stocked lakes. [source] A Glassy Carbon Electrode Modified with Multiwalled Carbon Nanotube/Chitosan Composite as a New Sensor for Simultaneous Determination of Acetaminophen and Mefenamic Acid in Pharmaceutical Preparations and Biological SamplesELECTROANALYSIS, Issue 15 2010Ali Babaei Abstract A new chemically modified electrode is constructed based on multiwalled carbon nanotube/chitosan modified glassy carbon electrode (MWCNTs-CHT/GCE) for simultaneous determination of acetaminophen (ACT) and mefenamic acid (MEF) in aqueous buffered media. The measurements were carried out by application of differential pulse voltammetry (DPV), cyclic voltammetry (CV) and chronoamperometry (CA) methods. Application of DPV method showed that the linear relationship between oxidation peak current and concentration of ACT and MEF were 1,,M to 145,,M, and 4,,M to 200,,M, respectively. The analytical performance of this sensor has been evaluated for detection of ACT and MEF in human serum, human urine and a pharmaceutical preparation with satisfactory results. [source] Electroanalysis of Norepinephrine at Bare Gold Electrode Pure and Modified with Gold Nanoparticles and S-Functionalized Self-Assembled Layers in Aqueous SolutionELECTROANALYSIS, Issue 13 2009Teresa, uczak Abstract Gold nanoparticles (Au-NPs), cystamine (CA) and 3,3,-dithiodipropionic acid (DTDPA) modified gold bare electrodes were applied in voltammetric sensors for simultaneous detection of norepinephrine (NEP), ascorbic (AA) and uric (UA) acids. A linear relationship between norepinephrine concentration and current response was obtained in the range of 0.1,,M to 600,,M M with the detection limit ,0.091,,M for the electrodes modified at 2D template and in the range of 0.1,,M to 700,,M M with the detection limit ,0.087,,M for the electrodes modified at 3D template The results have shown that using modified electrodes it is possible to perform electrochemical analysis of norepinephrine without interference of ascorbic and uric acids, whose presence is the major limitation in norepinephrine determination at a bare gold electrode. The modified SAMs electrodes show good selectivity, sensitivity, reproducibility and high stability. [source] Square-Wave Voltammetry as a Tool for Investigation of Doxorubicin Interactions with DNA Isolated from Neuroblastoma CellsELECTROANALYSIS, Issue 3-5 2009Dalibor Huska Abstract We investigated ethidium bromide intercalation into DNA molecule as a model system to test square-wave voltammetry (SWV) as a suitable method for this purpose We found that 0.13,,g EtBr intercalates into 1,,g dsDNA in average. Further, SWV was utilized for investigation of doxorubicin-DNA interactions. Intercalated doxorubicin reduced observed dsDNA cytosine and adenine (CA) signal, but also provided new signal called DOXO at ,0.35,V. This phenomenon was observed at both single and double stranded DNA standards. We also employed adsorptive transfer stripping technique coupled with SWV for study of doxorubicin-DNA interactions. Doxorubicin intercalation into dsDNA molecule adsorbed onto working electrode was fast, because we observed considerable changes in CA and DOXO signals after 360,s. Finally, we detected doxorubicin-DNA adducts formed in doxorubicin treated neuroblastoma cells. [source] Electrochemical Detection of Cadmium and Lead Complexes with Low Molecular Weight Organic AcidsELECTROANALYSIS, Issue 3-5 2009Jaklová Dytrtová Abstract The Cd and Pb complexes with oxalic (OA) and citric acid (CA) were detected in model and soil solutions using cyclic and stripping voltammetry. A mixed complex consisting of Cd, Pb, and OA was found; its peak potential varied from ,582.0 to ,542.5,mV (vs. Ag/AgCl/KCl(3,mol L,1)). For mixed complex formation, the presence of PbOH+ species and Cd2+ in oxalic acid solution was necessary. Only the ,simple' complexes of CA with Pb and Cd were found in the model solution. The existence of all investigated metal complexes is confined to neutral pH range. The mixed complex was also found in real soil solutions. [source] "Paterniplex", a highly discriminative decaplex STR multiplex tailored for investigating special problems in paternity testingELECTROPHORESIS, Issue 21 2007Thomas Betz Abstract The goal of the study was to develop a STR multiplex ("Paterniplex") that is , as supplement to commercially available multiplex kits like the Identifiler® kit (Applied Biosystems, Foster City, CA) , suitable for solving complex paternity cases such as deficiency cases or cases with mutations. The Paterniplex comprises the nine highly polymorphic STRs D8S1132, D7S1517, D10S2325, D12S391, Se33, D17S976, Penta E, Penta D and FGA in addition to Amelogenin as sex determination marker. The loci were selected because of their high degree of polymorphism (higher than that of the widely used TH01 marker). Only one locus, FGA, is shared with the Identifiler kit to avoid sample mix up. The study further gives details on the population genetics of the loci in a German Caucasian population (allelic distribution, Hardy,Weinberg Equilibrium and forensic efficiency markers such as the Discriminating Power) and three examples for cases that could not be solved using commercially available kits alone, but using the Paterniplex in addition to a commercial kit. [source] Competitive Analysis and New Venture Performance: Understanding the Impact of Strategic Uncertainty and Venture Origin*ENTREPRENEURSHIP THEORY AND PRACTICE, Issue 1 2002Shaker A. Zahra Effective competitive analysis (CA) is important for success in today's marketplace. CA may be particularly important to new ventures that may lack experience in their industries and knowledge of their rivals. Using survey data from 228 new ventures, this study concludes that the formality, comprehensiveness, and user orientation of CA activities are positively associated with new venture performance. Strategic uncertainty and venture origin also significantly moderate the relationship between CA and new venture performance. [source] Chromosome aberrations in peripheral blood lymphocytes of high-risk HPV-infected women with HGSILENVIRONMENTAL AND MOLECULAR MUTAGENESIS, Issue 9 2008Rosa E. Álvarez-Rosero Abstract Genomic instability is one of the main characteristics of malignant tumors, including HPV-induced cervical cancer. The aim of this study was to explore the use of assessing chromosome aberrations (CA) in peripheral blood lymphocytes as a biomarker for genomic instability in high-risk HPV-infected women with high-grade squamous intraepithelial lesions (HGSIL). A total of 120 women were recruited for this study, following cytology/colposcopy evaluation and HPV DNA detection. The study groups consisted of 30 HPV(+) women with histologically confirmed cervical intraepithelial neoplasia grade 2/3 and 30 HPV(+) women with carcinoma in situ (CIS). Two control groups, including 30 women HPV(,) and 30 women HPV(+), were recruited among women who were reported as cytology negative. Lymphocyte cell cultures were established for 52 hr, and 100 complete metaphase cells were evaluated per subject for CA analysis. The results show that women with CIS had significantly higher frequencies of both aneuploidy (0.67 ± 0.20 vs. 0.14 ± 0.08, P = 0.020) and tetraploidy (0.88 ± 0.23 vs. 0.17 ± 0.08, P = 0.013) in comparison with HPV(,) controls. These findings suggest the usefulness of peripheral blood lymphocytes to detect genomic instability associated with HPV-induced HGSIL. Environ. Mol. Mutagen., 2008. © 2008 Wiley-Liss, Inc. [source] | |||||||||||||||||||||||||||||||||||||||||||||||||