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Terms modified by Complete Selected AbstractsCryosurgery in the Treatment of Earlobe Keloids: Report of Seven CasesDERMATOLOGIC SURGERY, Issue 12 2005Tomas Fikrle MD Background. Keloids are benign cutaneous lesions that result from excessive collagen synthesis and deposition. Earlobe keloids in particular are seen as a complication of plastic surgery or piercing. Many different treatment modalities have been used, often with unsatisfactory results. Methods. We have made a retrospective analysis of seven young patients (ages 9 to 22 years) with earlobe keloids. Scarring followed plastic surgery in six cases and piercing in one case. All patients were treated with cryosurgery as the monotherapy. The freeze time and the number of sessions varied depending on the clinical findings, the effect of the treatment, and the patients' tolerance. Cryotherapy was started 6 to 24 months after keloid development. Results. Scar volume was reduced in all cases. Complete flattening in five patients and a pronounced reduction to a maximum of 25% of the previous thickness in one other patient were achieved. One patient discontinued the therapy because of soreness after only partial improvement. The procedure was painful for all patients; no further side effects were noticed. No recurrence was observed within 1 to 4.5 years of follow-up. Conclusion. We present an excellent effect of cryosurgery as the monotherapy for the treatment of earlobe keloid scars of young patients. TOMAS FIKRLE, MD, AND KAREL PIZINGER, MD, PHD, HAVE INDICATED NO SIGNIFICANT INTEREST WITH COMMERCIAL SUPPORTERS. [source] Outcome of severe unilateral cerebellar hypoplasiaDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 8 2010ANDREA PORETTI Aim, Complete or subtotal absence of one cerebellar hemisphere is exceptional; only single cases have been described. We aimed to assess the long-term outcome in children with severe unilateral cerebellar hypoplasia (UCH). Method, As part of a retrospective study we describe neuroimaging features, clinical findings, and cognitive outcomes of seven children with UCH (five males, two females; age at first magnetic resonance imaging [MRI]: median 1y 3mo, range 9d,8y 10mo; age at latest follow-up: median 6y 6mo, range 2y 3mo,14y 11mo). Results, One child had abnormalities on prenatal MRI at 21 weeks' gestation. The left cerebellar hemisphere was affected in five children, and the right hemisphere in two children. The vermis was involved in five children. The volume of the posterior fossa was variable. At the latest follow-up, neurological findings included truncal ataxia and muscular hypotonia in five children, limb ataxia in three patients, and head nodding in two patients. Three children had learning disability*, five had speech and language disorders, and one had a severe behavioural disorder. Interpretation, Severe UCH is a residual change after a disruptive prenatal cerebellar insult, most likely haemorrhagic. The outcome is variable, ranging from almost normal development to marked developmental impairment. Ataxia is a frequent but not a leading sign. It seems that involvement of the cerebellar vermis is often, but not consistently, associated with a poorer cognitive outcome, whereas an intact vermis is associated with normal outcome and no truncal ataxia. [source] Exploring the idiotypes of insulin antibodies as markers for remission in Type 1 diabetesDIABETIC MEDICINE, Issue 12 2004D. Devendra Abstract Aims Complete or partial remission can occur in newly diagnosed Type 1 diabetes patients. We created idiotype-specific reagents to explore the idiotypes of insulin antibodies (IA) in a patient in remission, and to compare with a patient who was not. Methods Phage display was used to create a library of phagotopes specific to insulin binding in four sera. Sera from a Type 1 diabetes subject deemed to have undergone remission were taken at diagnosis and again during remission. Sera from a non-remitter were taken at diagnosis and after 3 months on insulin. Phagotopes from the four sera were randomly selected and tested for insulin specificity in a radiobinding assay by using sera from remitters and non-remitters. Results IA-binding phagotope selected from serum during remission displaced insulin binding in all nine IA+ remitters and all 10 IA+ non-remitters. IA-binding phagotope selected from the non-remission patient (3 months after insulin therapy) displaced insulin binding in 8/9 IA+ remitters and 8/10 IA+ non-remitters. The consensus peptide sequences adduced from the phages were identical for both these phagotopes. Phagotopes derived from insulin autoantibody-positive individuals at diagnosis were unable to displace insulin binding in the IA+ sera 3 months later, whether in remission or not. Conclusions We have established the principle of using phage display in the investigation of insulin antibodies during remission in Type 1 diabetes. The immunological characteristics of IA 3 months after the introduction of insulin treatment were different from those at diagnosis of Type 1 diabetes (IAA). Using phage display technology, it was not possible to distinguish insulin antibodies according to remission status. [source] Effect of triclosan dentifrices on mouth volatile sulphur compounds and dental plaque trypsin-like activity during experimental gingivitis developmentJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 12 2002G. R. Nogueira-Filho Abstract Background: The objective of this study was to evaluate the effect of three commercial anti-plaque dentifrices containing 0.3% triclosan + 2% pvm/ma (Colgate Total®), 0.3% triclosan + 0.75% Zn (Signal Global®) and 0.3% triclosan + 5% PPi (Crest Complete®) in comparison with an experimental dentifrice (0.3% triclosan + 2% pvm/ma + 0.75% Zn + 4% PPi) and a control dentifrice without anti-plaque agents on trypsin-like activity in dental plaque (detected by the hydrolysis of [Na-Benzoyl-DL-Anginine p-Nitroanilide (BAPNA)] and volatile sulphur compounds (VSCs) in mouth air during experimental gingivitis development. Method: A 5-step double blind, crossover experimental gingivitis study was conducted on 19 volunteers during a 21-day period. The volunteers refrained from brushing an experimental quadrant of teeth. The dentifrices were applied to those teeth via toothshield three times per day; simultaneously they brushed the other teeth with the same dentifrice. After each period, VSCs in mouth air and BAPNA hydrolysis by dental plaque accumulated in the experimental quadrant were determined. Results: There was an increase (p < 0.05) in VSCs in mouth air when experimental gingivitis was induced in only one quadrant of teeth. None of the dentifrices was able to avoid the increase of VSCs during the experimental gingivitis development. The majority of the antiplaque dentifrices evaluated reduced the increase of VSC formation in comparison with the control (p < 0.05). There was no relationship between the ability of the dentifrices in reducing VSC formation and the inhibition of trypsin-like activity in dental plaque. Conclusions: Anti-plaque dentifrices reduce the increase of VSCs that occurs during the development of experimental gingivitis. [source] Unusual hepatic-portal-systemic shunting demonstrated by Doppler sonography in children with congenital hepatic vein ostial occlusionJOURNAL OF CLINICAL ULTRASOUND, Issue 4 2004Maha Barakat MD Abstract Purpose This report describes unusual changes in the hepatic vasculature in 3 children presenting with upper gastrointestinal hemorrhage. Methods The study included 3 children (ages 5,8 years) who presented with hematemesis. All had mild hepatosplenomegaly and normal liver function. Esophageal varices were demonstrated in all on upper endoscopy. Color and spectral Doppler sonography was performed to assess the hepatic vasculature, including the hepatic veins (HVs), portal vein (PV), hepatic artery (HA), and inferior vena cava (IVC). Results The HVs were all patent but with ostial occlusion at the point of their communication with the IVC. Complete flow reversal was shown inside the HVs, with blood draining into collateral vessels at the liver surface and paraumbilical vein. In one patient, the paraumbilical vein could be traced to its communication with the right external iliac vein. In all children, the direction of flow in the PV, HA, and IVC was normal. After endoscopic sclerotherapy, all children were shown to be in good general condition and to have normal liver function for a follow-up period of 15,36 months. Conclusions Ostial occlusion of the HV is a rare cause of hepatic outflow obstruction in children. Doppler sonography is a valuable, noninvasive imaging technique for evaluation of the hepatic vasculature and the accompaning shunting pathways in such cases. © 2004 Wiley Periodicals, Inc. J Clin Ultrasound 32:172,178, 2004; Published online in Wiley InterScience (www. interscience.wiley.com). DOI: 10.1002/jcu.20019 [source] RELATIONSHIPS of PHYSICAL PROPERTIES of FAT-SUBSTITUTES, COOKING METHODS and FAT LEVELS WITH QUALITY of GROUND BEEF PATTIESJOURNAL OF FOOD PROCESSING AND PRESERVATION, Issue 2 2000J. JU Ground beef patties containing 2 fat levels (5%, 10%), and 3 fat-substitutes (LeanBind, Rice* Complete 3, and Sta-Slim 171) were processed using 3 cooking methods (microwave, roasting, and pan-frying). Correlation analyses between patty quality and the physical properties of the fat-substitutes, as well as the composition of both raw and cooked patties were conducted. Regression models of patty quality parameters as functions of the physical properties of the fat-substitutes, and as the function of the patty composition were developed. This work demonstrated that the fat-substitutes can be evaluated based on regression models relating patty quality to the physical properties of the fat-substitutes. [source] The Environmental Impact of Getting the NewsJOURNAL OF INDUSTRIAL ECOLOGY, Issue 3-4 2002A Comparison of On-Line, Newspaper Information Delivery, Television Summary The environmental impact associated with reading an on-line and a printed newspaper is analyzed and compared with respective parts of a television (TV) broadcast. Two reference units were chosen for comparison to account for differences between media in presentation and consumption (reading or watching a news item) and consumption of the daily news as a whole. The environmental impact is assessed using life-cycle assessment (LCA). Key drivers of the environmental impact for both electronic delivery systems are energy consumption and power generation. Not only do the manufacturing of the products and their use have an environmental impact, but so does the use of the necessary infrastructure, that is, energy consumption of the telephone network or data transfer via Internet. Printing of on-line information also turned out to be important. In the case of the printed newspapers, energy consumption is again important, here for the manufacturing of pulp and paper. Complete printed newspapers (the form in which they are typically purchased) have a very high environmental burden relative to watching the TV news or reading on-line news, even if the propensity to extend TV viewing is taken into consideration. [source] Obstacles in large-scale epidemiological assessment of sensory impairments in a Dutch population with intellectual disabilitiesJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 8 2004H. Evenhuis Abstract Background A population-based epidemiological study on visual and hearing impairment was planned in a random sample of 2100 clients, drawn from a base population of 9012 users of Dutch residential and day-care intellectual disability (ID) services with the whole range of IDs. Stratification was applied for age 50 years and over and Down syndrome. Visual and hearing functions were assessed according to a standardized protocol, in cooperation with regular ophthalmologists and regional audiological centres. Anticipated obstacles in sample collection, random inclusion, informed consent, expertise of investigators, time and costs were eliminated by a careful preparation. However, inclusion and participation were incomplete. Method In a descriptive retrospective design, we collected data from our study files on inclusion and participation as well as reasons for non-participation, to identify unanticipated obstacles for this kind of research. Results Consent was obtained for 1660 clients, and 1598 clients participated in the data collection (76% of intended sample of 2100). Inclusion and participation rates were especially lower in community-based care organizations, resulting in unintentional skewing of the sample towards more severe levels of ID. Complete and reliable data to diagnose visual impairment were obtained for 1358/1598 (85%) and to diagnose hearing impairment for 1237/1598 participants (77%). Unanticipated obstacles had to do with the quality of coordination within care organizations, with characteristics of screening methods, and with collaboration with the regular health care system. Assessments of visual function were more easy to organize than were those of hearing. Based on our current experience, practical recommendations are given for future multicentre research, especially in community-based settings. [source] Depigmentation of the normally pigmented patches in universal vitiligo patients by cryotherapyJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 3 2000Mohammed Radmanesh Abstract Background Complete depigmentation may occur, albeit rarely, in patients with universal vitiligo. They usually have one or more pigmented patches that remain normal, most frequently over the malar area of the face and dorsal aspects of forearms. Total repigmentation may not occur in these patients, even after receiving 150 session of PUVA therapy alone or in conjunction with other medical or surgical procedures, and there is possibility of recurrence after cessation of therapy. These patients are usually more interested in depigmentation rather than trying for repigmentation. Objective Because of the relatively high sensitivity of melanocytes to cryotherapy and the possibility of isomorphic phenomenon in vitiligo patients, removal of the remaining normally pigmented patches was attempted in patients with universal vitiligo using cryotherapy. Method Five volunteer patients with universal vitiligo were chosen, all of whom wished to have their pigmented patches removed. In all five patients a small area was tested first in order to assure the patients of what the procedure involved and to show its likely result. All pigmented areas were then treated to 1,3 sessions of cryotherapy using a closed contact CO2 cryogun, with 4,6-week intervals. Results Complete and permanent depigmentation was achieved in all five patients with excellent cosmetic results and no complications or scarring. Conclusion Cryotherapy is a cost effective, non-complicating, easily available procedure which can be used for depigmentation of normally pigmented patches in patients with universal vitiligo. [source] Complete and unambiguous assignments of 1H and 13C chemical shifts of new arylamino derivatives of ortho -naphthofuranquinonesMAGNETIC RESONANCE IN CHEMISTRY, Issue 12 2008Eufrânio N. da Silva Júnior Abstract Six new nor-,-lapachones have been synthesized from reaction of 3-bromo-nor-,-lapachone with arylamines. These derivatives have potent anticancer properties against several cell lines. Here, we report complete unambiguous assignments of 1H and 13C chemical shifts of the new compounds. The assignments were made using a combination of one- and two-dimensional NMR techniques (1H, 13C, 1H1H COSY, 1H13C HSQC, and 1H13C HMBC). Copyright © 2008 John Wiley & Sons, Ltd. [source] Alcohol and lactation: A systematic reviewNUTRITION & DIETETICS, Issue 2 2006Roslyn GIGLIA Abstract The aim of the present paper is to critically review the current literature on the effect of alcohol intake during lactation on the hormonal control of lactogenesis; breast milk and infant blood alcohol concentration; and on the breastfeeding infant. The databases PubMed, CINAHL, Proquest Health and Medical Complete, ScienceDirect and ISI Web of Knowledge were searched for articles published between 1990 and 2005. We found limited research investigating the effect of alcohol intake on the infants of lactating women, with most being conducted using animal models. Results consistently show a decrease in lactational performance in both animal and human studies of alcohol intake and breastfeeding. Alcohol intake by lactating mothers in amounts recommended as ,safe' for non-lactating women may have a negative effect on infant development and behaviour. Clear guidelines for alcohol consumption are required for lactating women and health professionals to guide breastfeeding mothers to make educated choices regarding alcohol intake during this critical period of infant development. [source] Transoral atlantoaxial reduction plate internal fixation for the treatment of irreducible atlantoaxial dislocation: a 2- to 4-year follow-upORTHOPAEDIC SURGERY, Issue 2 2010Qing-shui Yin MD Objective:, To evaluate the mid-term outcomes of transoral atlantoaxial reduction plate (TARP) internal fixation for the treatment of irreducible atlantoaxial dislocation. Methods:, From April 2003 to April 2005, 31 patients with irreducible atlantoaxial dislocation were treated with TARP internal fixation. The average age was 37.9 years (range, 15,69 years). The subjective symptoms, objective signs, and neurological function of the patients were assessed. Radiography and magnetic resonance imaging (MRI) were performed and the results analyzed according to the Symon and Lavender clinical standard, Japanese Orthopaedic Association (JOA) score for spinal cord function and imaging standard for spinal cord decompression. Results:, Complete or almost complete anatomical reduction was obtained in all 31 patients. No screw-loosening or atlantoaxial redislocation was found in 29 cases. According to the Symon and Lavender clinical standard, 14 cases had recovered completely, 7 to mild, 6 to moderate, and 4 to severe type by final follow-up, compared to the preoperative classifications of 4 as moderate, 15 as severe, and 12 as extra severe type. The outcome for 26 patients was evaluated as excellent and in 5 as adequate. The average postoperative improvement in spinal cord function was 73.3% and of decompression of the cervical cord 92.6%. The only complication was loosening of screws in two cases with senile osteoporosis. One case underwent TARP revision surgery and the other posterior occipitocervical internal fixation. Both of them were eventually cured. Conclusion:, The TARP operation is a good choice for patients with irreducible atlantoaxial dislocation and has valuable clinical application. [source] Prognostic value of bone marrow angiogenesis in multiple myeloma: Use of light microscopy as well as computerized image analyzer in the assessment of microvessel density and total vascular area in multiple myeloma and its correlation with various clinical, histological, and laboratory parametersAMERICAN JOURNAL OF HEMATOLOGY, Issue 9 2006Sahibinder Singh Bhatti Abstract We studied the prognostic value of parameters of angiogenesis on bone marrow biopsies in newly diagnosed multiple myeloma (MM) patients. Angiogenesis parameters studied were the microvessel count done manually on light microscopy (MVD-A), microvessel count done by using computerized image analyzer (MVD-B), and total vascular area (TVA) measured by computerized image analyzer. One hundred ten newly diagnosed cases of MM treated at Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, were analyzed with respect to clinical features, laboratory findings, histological features, angiogenesis parameters, and responses to the treatment on follow-up. Twenty age- and sex-matched controls were studied for comparing with angiogenesis of the test cases. Bone marrow microvessels were examined using immunohistochemical staining for CD34. MVD-A (range 4.9,85.2; mean 28.2; SD 19.4), MVD-B (range 2.0,26.9; mean 11.7; SD 5.9), and TVA measured in percentage (range 0.1,17.1; mean 2.4; SD 2.5) were measured for test cases (n = 110). Grading of angiogenesis parameters of the test cases were done; such that angiogenesis parameters of controls (taken as baseline) were grade I. There was a statistically highly significant correlation between (MVD-A vs MVD-B, pcc = 0.92; MVD-A vs TVA, pcc = 0.78; MVD-B vs TVA, pcc = 0.76). The myeloma cases had significantly higher angiogenesis parameters when compared with controls (Kruskall-Wallis test, P < 0.001). "Complete responders" (n = 38/110) had significant lower angiogenesis (Mann-Whitney U test, P < 0.001) than "nonresponders" (n = 72/110). On treatment follow-up "rapid disease progressors" had the highest levels of angiogenesis (mean rank for MVD-A = 84.7, MVD-B = 82.1, and TVA = 81.1). On multivariate (logistic regression) analysis, factors found to have independent prognostic significance in complete responders (adjusted odd ratio (95% CI, P value)] were: (a) MVD-B grade I [0.134 (0.10,0.16, P < 0.001)], (b) clinical substage A [0.163 (0.12,0.19, P = 0.008)], (c) Bartl's histological stage II & I [0.262 (0.2,0.32, P = 0.021)], (d) MVD-A grade I [0.28 (0.22,0.36, P = 0.03)], (e) ,2 microglobulin levels less than 3,400 ng/dl [0.31 (0.23,0.42, P = 0.04)]. Kaplan-Meier survival analysis for myeloma-related death (n = 16) shows a mean survival time (in months) of 24.75; SE = 3; 95% CI = 21,28. We conclude that MVD (particularly MVD-B) is a very good predictor for the complete response in patients of MM and should be done routinely on bone marrow biopsies. Am. J. Hematol., 2006. © 2006 Wiley-Liss, Inc. [source] A Cre::FLP fusion protein recombines FRT or loxP sites in transgenic maize plants,PLANT BIOTECHNOLOGY JOURNAL, Issue 8 2008Vesna Djukanovic Summary The coding sequences of Cre (site-specific recombinase from bacteriophage P1) and FLP (yeast 2-µm plasmid site-specific recombinase) were fused in frame to produce a novel, dual-function, site-specific recombinase gene. Transgenic maize plants containing the Cre::FLP fusion expression vector were crossed to transgenic plants containing either the loxP or FRT excision substrate. Complete and precise excisions of chromosomal fragments flanked by the respective target sites were observed in the F1 and F2 progeny plants. The episomal DNA recombination products were frequently lost. Non-recombined FRT substrates found in the F1 plants were recovered in the F2 generation after the Cre::FLP gene segregated out. They produced the recombination products in the F3 generation when crossed back to the FLP-expressing plants. These observations may indicate that the efficiency of site-specific recombination is affected by the plant developmental stage, with site-specific recombination being more prevalent in developing embryos. The Cre::FLP fusion protein was also tested for excisions catalysed by Cre. Excisions were identified in the F1 plants and verified in the F2 plants by polymerase chain reaction and Southern blotting. Both components of the fusion protein (FLP and Cre) were functional and acted with similar efficiency. The crossing strategy proved to be suitable for the genetic engineering of maize using the FLP or Cre site-specific recombination system. [source] Reductions in basal limb blood flow and vascular conductance with human ageing: role for augmented ,-adrenergic vasoconstrictionTHE JOURNAL OF PHYSIOLOGY, Issue 3 2001Frank A. Dinenno 1Basal whole-limb blood flow and vascular conductance decrease with age in men. We determined whether these age-associated changes in limb haemodynamics are mediated by tonically augmented sympathetic ,-adrenergic vasoconstriction. 2Seven young (28 ± 2 years; mean ±s.e.m.) and eight older (64 ± 2 years) healthy, normotensive adult men were studied. Baseline femoral artery blood flow (Doppler ultrasound) and calculated vascular conductance were 29 and 31 % lower, respectively, and vascular resistance was 53 % higher in the older men (all P < 0.001). 3Local (intra-femoral artery) ,-adrenergic receptor blockade with phentolamine evoked greater increases in femoral blood flow (105 ± 11 vs. 60 ± 6 %) and vascular conductance (125 ± 13 vs. 66 ± 7 %), and reductions in vascular resistance (55 ± 2 vs. 39 ± 3 %) in the experimental limb of the older compared with the young men (all P < 0.001). As a result, ,-adrenergic receptor blockade eliminated the significance of the age-associated differences in absolute levels of femoral blood flow (500 ± 51 vs. 551 ± 35 ml min,1), vascular conductance (6.02 ± 0.73 vs. 6.33 ± 0.26 U), and vascular resistance (0.17 ± 0.03 vs. 0.16 ± 0.01 U; P= 0.4,0.8, n.s.). Femoral haemodynamics in the control limb were unaffected by phentolamine administration in the contralateral (experimental) limb. Complete ,-adrenergic receptor blockade was demonstrated by the absence of vasoconstriction in the experimental limb in response to the cold pressor test. Local propranolol was administered to control for any ,-adrenergic effects of phentolamine. Propranolol did not affect haemodynamics in the experimental or control limbs. 4Our results indicate that the age-related reductions in basal limb blood flow and vascular conductance are mediated largely by chronically elevated sympathetic ,-adrenergic vasoconstriction. This may have important physiological and pathophysiological implications for the ageing human. [source] Endoscopic Staple Diverticulostomy for Recurrent Zenker's Diverticulum,THE LARYNGOSCOPE, Issue 1 2003Richard L. Scher MD Abstract Objectives The purpose of this study was to evaluate the technical feasibility, effectiveness, and morbidity of using endoscopic staple diverticulostomy (ESD) as treatment for Zenker's diverticulum (ZD) recurring after either prior endoscopic treatment or external diverticulectomy or diverticulopexy. Study Design A retrospective review of a case series of 18 patients with recurrent ZD. Methods All patients cared for with ZD were evaluated to identify those patients with recurrent ZD. The clinical records of patients with recurrent ZD were reviewed for: demographics, prior treatment, time to recurrence, factors associated with recurrence, technical feasibility of treatment, complications, effectiveness and duration of symptom relief. Results Between March 1995 and July 2001, a total of 127 consecutive patients with ZD received care. Eighteen of these patients were treated for recurrent ZD: nine treated originally by ESD, and nine by external approach (seven by diverticulectomy and two by diverticulopexy), with three of these patients treated twice. Seventeen patients had partial or complete relief of symptoms after their initial treatment, with recurrence of symptoms noted 0 to 60 months later. Specific factors associated with recurrence of symptoms were identified in only one patient. Treatment of recurrent ZD by ESD was technically feasible in 16 of the patients. Complete or improved symptom relief has been reported by 16 of the patients after revision ESD, with follow-up from 9 to 69 months. No significant treatment complications occurred. Fifteen patients resumed clear liquid diet on the day of surgery, and one on the day after surgery. All patients were discharged from the hospital by the second postoperative day (mean = 0.6 d). Conclusions ESD is an effective, technically feasible, and safe treatment for patients with ZD recurring after prior endoscopic or external treatment, and it should be the initial treatment of choice for these patients. [source] The Political Quarterly,Complete and OnlineTHE POLITICAL QUARTERLY, Issue 3 2005Article first published online: 5 SEP 200 No abstract is available for this article. [source] Intensive and Prolonged Treatment of Focal and Segmental Glomerulosclerosis Recurrence in Adult Kidney Transplant Recipients: A Pilot StudyAMERICAN JOURNAL OF TRANSPLANTATION, Issue 5 2009G. Canaud No treatment has consistently induced long-term remission of proteinuria in adult patients with focal segmental glomerulosclerosis (FSGS) recurrence after kidney transplantation. We undertook an open-label, nonrandomized pilot trial of intensive and prolonged treatment of FSGS recurrence. Over an 18-month period, 10 adult kidney transplant recipients with FSGS recurrence received concomitantly high-dose steroids, intravenous cyclosporine for 14 days followed by oral cyclosporine therapy, and an intensive and prolonged course of plasma exchanges (PE). We compared this treatment with those of a control group of 19 patients with a FSGS recurrence transplanted between 1997 and 2005. Complete, rapid (mean 23 ± 7 days) and sustained remission was obtained in 9/10 patients (90%) as opposed to 27% in the control group. At month 3 and month 12, proteinuria was 0.16 g/day (range 0.05,0.3 g/day) and 0.19 g/day (range 0.05,1 g/day) respectively. Only one patient remained in partial remission at month 12 but he had already lost two previous grafts due to FSGS recurrence. PEs were stopped at month 9 in all patients except for the patient with a partial remission who remains PE-dependent. This small pilot study provides very encouraging results demonstrating that this treatment rapidly achieves complete and sustained remission in a high proportion of patients. [source] Comparison of Different Methods of ST Segment Resolution Analysis for Prediction of 1-Year Mortality after Primary Angioplasty for Acute Myocardial InfarctionANNALS OF NONINVASIVE ELECTROCARDIOLOGY, Issue 1 2007Jakub Przyluski M.D. Background: Resolution of ST segment elevation corresponds with myocardial tissue reperfusion and correlates with clinical outcome after ST elevation myocardial infarction. Simpler method evaluating the extent of maximal deviation persisting in a single ECG lead was an even stronger mortality predictor. Our aim was to evaluate and compare prognostic accuracy of different methods of ST segment elevation resolution analysis after primary percutaneous coronary intervention (PCI) in a real-life setting. Methods: Paired 12-lead ECGs were analyzed in 324 consecutive and unselected patients treated routinely with primary PCI in a single high-volume center. ST segment resolution was quantified and categorized into complete, partial, or none, upon the (1) sum of multilead ST elevations (sumSTE) and (2) sum of ST elevations plus reciprocal depressions (sumSTE+D); or into the low-, medium-, and high-risk groups by (3) the single-lead extent of maximal postprocedural ST deviation (maxSTE). Results: Complete, partial, and nonresolution groups by sumSTE constituted 39%, 40%, and 21% of patients, respective groups by sumSTE+D comprised 40%, 39%, and 21%. The low-, medium-, and high-risk groups constituted 43%, 32%, and 25%. One-year mortality rates for rising risk groups by sumSTE were 4.7%, 10.2%, and 14.5% (P = 0.049), for sumSTE+D 3.8%, 9.6%, and 17.6% (P = 0.004) and for maxSTE 5.1%, 6.7%, and 18.5% (P = 0.001), respectively. After adjustment for multiple covariates only maxSTE (high vs low-risk, odds ratio [OR] 3.10; 95% confidence interval [CI] 1.11,8.63; P = 0.030) and age (OR 1.07; 95% CI 1.02,1.11; P = 0.002) remained independent predictors of mortality. Conclusions: In unselected population risk stratifications based on the postprocedural ST resolution analysis correlate with 1-year mortality after primary PCI. However, only the single-lead ST deviation analysis allows an independent mortality prediction. [source] Thoracoscopic talc pleurodesis for malignant pleural effusionANZ JOURNAL OF SURGERY, Issue 1-2 2003David Love Background: Malignant pleural effusion (MPE) is a common and distressing condition at the end of life for many patients with disseminated cancer. The challenge for the surgeon lies in managing this problem in order to deliver the most effective palliation with the least impact on the limited time available to these patients. Methods: Herein is reported a retrospective review of outcomes for a consecutive series of 66 MPE (61 patients) treated over a 5-year period from 1995 to 2000. A standard operative technique involving a single-lung anaesthetic and two-port thoracoscopy was employed. Outcomes were determined by contacting the referring practitioner or the patients themselves. Principal outcome measures included time to recurrence of the effusion and survival. Results: Complete follow up was achieved for 60 MPE (55 patients; five of whom were treated for metachronous, bilateral disease). The three most common primary sites were breast, lung and mesothelial tissue. The planned procedure was not completed in two cases due to encasement of the underlying lung by tumour. Primary failure (immediate recurrence of the effusion) occurred in six cases. Delayed recurrence of the effusion occurred in a further 23 MPE resulting in complete control in 31 cases (52%) until death. Overall median survival was 220 days and the 30-day mortality was 0. Conclusions: Complete and permanent control of a malignant effusion is difficult to achieve. Management based on thoracoscopy and talc insufflation produces satisfactory results with an acceptable morbidity and no early mortality. The ability to inspect the pleural space, break down adhesions and completely drain pockets of fluid to achieve complete lung expansion probably contributes to this. [source] Complete and partial replacement of Artemia nauplii by Moina micrura during early postlarval culture of white shrimp (Litopenaeus schmitti)AQUACULTURE NUTRITION, Issue 2 2006L. MARTÍN Abstract Growth rate, soluble protein content, osmotic stress and digestive enzyme activity were studied in early Litopenaeus schmitti postlarvae under different feeding regimens, by partially or completely replacing Artemia nauplii with Moina micrura. Growth was significantly higher in the postlarvae fed with a mixture of M. micrura, Artemia nauplii and algae (0.030 mg dry weight (dw) larva,1 day,1, 17.4 ± 2.1% day,1), together with the postlarvae fed on Artemia nauplii and algae (0.027 mg dw larva,1 day,1, 18.3 ± 1.9% day,1). Complete replacement of Artemia nauplii by M. micrura produced the lowest growth rate (0.018 mg dw larva,1 day,1, 14.3 ± 1.6% day,1) and induced the highest protease and , -amylase activities and lower soluble protein contents. No significant difference among the treatments could be detected in postlarval resistance to osmotic stress. Based on the growth results, soluble protein content, enzymatic activity and osmotic stress resistance, we determined that the partial replacement of Artemia nauplii by M. micrura did not affect the growth, the soluble protein content and the nutritional state in the postlarvae of L. schmitti. To our knowledge, this is the first reported use of M.micrura as feed for early postlarvae of L. schmitti. [source] Complete and sustained remission of juvenile dermatomyositis resulting from aggressive treatmentARTHRITIS & RHEUMATISM, Issue 6 2009Susan Kim Objective To assess the time needed to achieve sustained, medication-free remission in a cohort of patients with juvenile dermatomyositis (DM) receiving a stepwise, aggressive treatment protocol. Methods Between 1994 and 2004, a cohort of 49 children with juvenile DM who were followed up at a single tertiary care children's hospital using disease activity measures according to a specific protocol received standardized therapy with steroids and methotrexate. If a patient's strength or muscle enzyme levels did not normalize with this initial therapy, additional medications were added in rapid succession to the treatment regimen. The primary outcome measure was time to complete remission. Additional outcome measures were onset of calcinosis, effect of treatment on height, and complications resulting from medications. Results Forty-nine patients were followed up for a mean ± SD of 48 ± 30 months. All but 1 patient received 2 or more medications simultaneously. Transient localized calcifications occurred in 4 patients (8%), and 2 additional patients (4%) had persistent calcinosis. Despite the aggressive therapy, complications associated with treatment were mild and were primarily attributable to steroids. No persistent effect on longitudinal growth was observed. A complete, medication-free remission was achieved in 28 patients; the median time to achievement of complete remission was 38 months (95% confidence interval 32,44 months). None of these patients experienced a disease flare that required resumption of medications during the subsequent period of observation (mean ± SD 36 ± 19.7 months). Conclusion Our findings suggest that aggressive treatment of juvenile DM aimed at achieving rapid, complete control of muscle weakness and inflammation improves outcomes and reduces disease-related complications. In more than one-half of the children whose disease was treated in this manner (28 of 49), a prolonged, medication-free remission was attained within a median of 38 months from the time of diagnosis. [source] Complete or ultraconservative removal of decayed tissue in unfilled teethAUSTRALIAN DENTAL JOURNAL, Issue 3 2009D Ricketts Background:, The treatment of deep dental decay has traditionally involved removal of all the soft demineralized dentine before a filling is placed. However, this has been challenged in three groups of studies which involve sealing soft caries into the tooth. The three main groups either remove no caries and seal the decay into the tooth, remove minimal (ultraconservative) caries at the entrance to a cavity and seal the remaining caries in, or remove caries in stages over two visits some months apart to allow the pulp time to lay down reparative dentine (the stepwise excavation technique). Objectives:, To test the null hypothesis of no difference in the incidence of damage or disease of the nerve of the tooth (pulp), progression of decay and longevity of restorations irrespective of whether the removal of decay had been minimal (ultraconservative) or complete. Search strategy:, The Cochrane Oral Health Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, PubMed and EMBASE databases were searched. The reference lists in relevant papers were checked. Selection criteria:, Randomized controlled trials and controlled clinical trials comparing minimal (ultraconservative) caries removal with complete caries removal in unrestored permanent and deciduous teeth. Data collection and analysis:, Outcome measures recorded were exposure of the nerve of the tooth (pulp) during caries removal, patient experience of symptoms of pulpal inflammation or necrosis, progression of caries under the filling, time until the filling was lost or replaced. Due to the heterogeneity of the included studies the overall estimate of effect was calculated using a random-effects model. Main results:, Four studies met the inclusion criteria; two stepwise excavation studies and two ultraconservative caries removal studies. Partial caries removal in symptomless, primary or permanent teeth reduces the risk of pulp exposure. We found no detriment to the patient in terms of pulpal symptoms in this procedure and no reported premature loss or deterioration of the restoration. Authors' conclusions:, The results of this systematic review reject the null hypothesis of no difference in the incidence of damage or disease of the nerve of the tooth (pulp) irrespective of whether the removal of decay had been minimal (ultraconservative) or complete and accepts the null hypothesis of no difference in the progression of decay and longevity of restorations. However, the number of included studies is small and differ considerably. Partial caries removal is therefore preferable to complete caries removal in the deep lesion, in order to reduce the risk of carious exposure. However, there is insufficient evidence to know whether it is necessary to re-enter and excavate further but studies that have not re-entered do not report adverse consequences. [source] Factors predictive of 5-year survival after transarterial chemoembolization for inoperable hepatocellular carcinoma,BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 3 2003C. B. O'Suilleabhain Background: Transarterial chemoembolization (TACE) is widely used for unresectable hepatocellular carcinoma (HCC), but the long-term survival benefit remains unclear. Methods: Pretreatment variables were analysed for factors predictive of actual 5-year survival from a prospective database of patients with inoperable HCC treated by TACE between 1989 and 1996. Results: Complete 5-year follow-up (median 91 months) was obtained for 320 patients who underwent a median of 4 (range 1,41) TACEs. Median tumour size was 9 (range 1,28) cm. There were 25 5-year survivors (8 per cent), including eight with tumours larger than 10 cm in diameter and three with portal vein branch involvement. On univariate analysis, female gender (P = 0·037), absence of ascites (P = 0·028), platelet count below 150 ×109 per litre (P = 0·011), albumin concentration greater than 35 g/l (P = 0·04), ,-fetoprotein level below 1000 ng/ml (P = 0·007), unilobar tumour (P = 0·027), fewer than three tumours (P = 0·015), absence of venous invasion (P = 0·011), and tumour diameter less than 8 cm (P = 0·021) were significant predictors of 5-year survival. Albumin concentration greater than 35 g/l (P = 0·011), unilobar tumour (P = 0·012) and ,-fetoprotein level below 1000 ng/ml (P = 0·014) were independent prognostic factors on multivariate analysis. Conclusion: Five-year survival is possible with TACE for inoperable HCC, even in some patients with advanced tumours. Unilobar tumours, ,-fetoprotein level below 1000 ng/ml and albumin concentration greater than 35 g/l were factors predictive of 5-year survival. Copyright © 2003 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] Beneficial effects of preoperative intravitreal bevacizumab on trabeculectomy outcomes in neovascular glaucomaACTA OPHTHALMOLOGICA, Issue 1 2010Yoshiaki Saito Abstract. Purpose:, This study aimed to investigate the effects of preoperative intravitreal bevacizumab (IVB) on outcomes in trabeculectomy for neovascular glaucoma (NVG). Methods:, Charts for 52 NVG eyes of 52 consecutive patients who received primary trabeculectomy with mitomycin C (MMC) were reviewed. Postoperative follow-up periods for all patients were , 4 months. Thirty-two consecutive eyes were treated without IVB (control group) and 20 consecutive eyes received IVB (1.25 mg) 10 ± 11 days before trabeculectomy (IVB group). The main outcome measures were postoperative intraocular pressure (IOP) and incidence of postoperative complications. Surgical success was defined as IOP< 21 mmHg with or without medication (qualified or complete success, respectively). Failure was defined as IOP exceeding these criteria, phthisis bulbi, loss of light perception or additional glaucoma surgeries. Kaplan,Meier survival analysis with the log-rank test was performed to compare surgical success rates between the two groups. Results:, Complete and qualified success rates at 6 months were 95% versus 50% and 95% versus 75% in the IVB and control groups, respectively. The IVB group achieved significantly better surgical success rates than the control group (complete success, p < 0.001; qualified success, p = 0.026). Postoperative hyphaema on day 1 or hyphaema with a duration of > 1 week occurred significantly less frequently in the IVB group than in the control group (p = 0.009, p = 0.014, respectively). The incidence of serious complications such as endophthalmitis, phthisis bulbi and a marked decrease in visual acuity did not increase in the IVB group. Conclusions:, This retrospective study showed that preoperative IVB decreased postoperative hyphaema and increased surgical success rates, and thus may be an effective adjunct to trabeculectomy in NVG. [source] Complete ,-Facial Diastereoselectivity in Diels,Alder Reactions of Dissymmetric 2,4-Cyclohexadienones.CHEMINFORM, Issue 48 2002Hui-Fang Hou Abstract For Abstract see ChemInform Abstract in Full Text. [source] Generalized self-efficacy and performance on the 20-metre shuttle run in childrenAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 2 2008John Cairney It has been argued that motivation significantly affects the measurement of aerobic capacity when using field tests with children. In this study, the impact of generalized self-efficacy on performance (Stage Completed) in the Léger shuttle run is examined in a cohort of children (N = 2,245, 9.38 ± 0.52 years old) in Grade 4 from 75 elementary schools. Children completed the Children's Self-perceptions of Adequacy in and Predilection for Physical Activity scale (CSAPPA) to establish levels of generalized self-efficacy toward physical activity, were measured for height and weight, and then completed the Léger Shuttle run to predict aerobic capacity. Regression analysis was used to study the impact of self-efficacy on test performance. After adjusting for age, gender, and BMI, two of the three CSAPPA factor subscales, higher perceived adequacy regarding physical activity (, = 0.196, P < 0.001) and greater predilection to select physical over sedentary activities (, = 0.123, P < 0.001), were independently associated with better test performance as indicated by stage completed. Together, self-efficacy accounted for 9% of the total variation in Léger shuttle run performance. A significant interaction between BMI and perceived adequacy was found (, = ,0.106, P < 0.005). Children with both high BMI scores and below average perceived adequacy had the poorest performance results. Generalized self-efficacy, as measured by the CSAPPA, is significantly related to Léger shuttle run performance. Moreover, self-efficacy influences the relationship between other known factors affecting test performance (BMI), suggesting that self-perception of ability/competence has a complex effect on test performance. These results illustrate the importance of considering psychological factors when interpreting physiologic assessments in children. Am. J. Hum. Biol., 2008. © 2007 Wiley-Liss, Inc. [source] Michelle H. Biros, MD, MS, Completes 10 Years as Editor-in-Chief of Academic Emergency MedicineACADEMIC EMERGENCY MEDICINE, Issue 12 2008James R. Miner MD No abstract is available for this article. [source] Utility Functions for Ceteris Paribus PreferencesCOMPUTATIONAL INTELLIGENCE, Issue 2 2004Michael McGeachie Ceteris paribus (all-else equal) preference statements concisely represent preferences over outcomes or goals in a way natural to human thinking. Although deduction in a logic of such statements can compare the desirability of specific conditions or goals, many decision-making methods require numerical measures of degrees of desirability. To permit ceteris paribus specifications of preferences while providing quantitative comparisons, we present an algorithm that compiles a set of qualitative ceteris paribus preferences into an ordinal utility function. Our algorithm is complete for a finite universe of binary features. Constructing the utility function can, in the worst case, take time exponential in the number of features, but common independence conditions reduce the computational burden. We present heuristics using utility independence and constraint-based search to obtain efficient utility functions. [source] A language to model animation out of behaviour-embedded graphical componentsCOMPUTER ANIMATION AND VIRTUAL WORLDS (PREV: JNL OF VISUALISATION & COMPUTER ANIMATION), Issue 3 2002Prabir K. Pal Abstract Almost all entities,animate or inanimate,that we see around us change with time. The changes are brought about by changes in the values of their attributes. By using a set of parameters to represent the variable attributes of an entity, and by suitably manipulating their values at run time, the behaviour of an entity can be broadly mimicked in animation. The majority of entities, however, are all too complex to animate directly. They are better described in terms of nested layers of smaller and simpler entities, which we call components. Each component is structurally and behaviourally complete and can be described independent of its application. In the present paper, we propose a scheme for 3D animation that broadly follows this line. The keystone of this scheme is a language, nicknamed ,V', which defines the structural and visual attributes of each component of the scene and associates a parameterized behaviour with it, if necessary, in the form of a program script. Thereafter, wherever such a component appears, it does so with a built-in behaviour, which can nevertheless be regulated by its higher-level component through its parameters. The advantage is that an entire animation can be modelled in a declarative fashion in terms of nested components with embedded behaviour. Besides, each component is easy to write, alter and reuse. The effort for development, debugging and maintenance of animation modelled in this way is much less as the concerns are almost always local. Copyright © 2002 John Wiley & Sons, Ltd. [source] | |||||||||||||||||||||||||||||||||||||||||||||||||||||||