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Selected AbstractsTreatment of Port-Wine Stain Birthmarks Using the 1.5-msec Pulsed Dye Laser at High Fluences in Conjunction with Cryogen Spray CoolingDERMATOLOGIC SURGERY, Issue 4 2002Kristen M. Kelly MD Background. The majority of port-wine stain (PWS) patients treated with the pulsed dye laser (PDL) do not achieve complete blanching. Safe administration of higher fluences has been proposed as a means of improving treatment efficacy. Objective. To determine the safety and efficacy of PWS treatment with the 1.5-msec PDL at high fluences in conjunction with cryogen spray cooling. Methods. Twenty PWS patients were treated with the PDL in combination with cryogen spray cooling utilizing a 7 or 10 mm spot size and fluences ranging from 6 to 15 J/cm2. Before and after treatment photographs were compared on a blinded basis. Results. No scarring or skin textural changes occurred. Blanching scores were as follows: 20% of patients achieved 75% or greater blanching after an average of 3.3 treatments, 30% achieved 50,74% blanching, 20% achieved 25,49% blanching, and 30% achieved less than 25% blanching. Conclusion. In conjunction with cryogen spray cooling, the PDL can be safely used at high fluences. At this time it is not clear that the use of higher fluences improves treatment efficacy; however, as other aspects of PWS laser treatment are optimized, safe administration of higher fluences is likely to be advantageous. [source] Provisional Prosthetic Management of Mobile Teeth in Conjunction with a Removable Partial Denture Using Orthodontic WireJOURNAL OF PROSTHODONTICS, Issue 7 2009Won-suk Oh DDS Abstract Precision attachment-retained removable partial dentures eliminate the use of visible clasps and improve the esthetic appearance of the smile; however, terminal abutment teeth may be subject to unfavorable stresses under function when misused. A provisional prosthetic management technique that incorporates an orthodontic wire to assist cross-arch support and stability of the periodontally weakened abutment teeth is described. This technique is simple, reversible, does not alter the esthetic appearance of the smile, and controls the mobility of the abutment teeth until a definitive treatment plan is established. [source] Guidelines for Collecting and Recording the Race and Ethnicity of Juveniles in Conjunction with Juvenile Delinquency Disposition Reporting to the Juvenile Court Judges' CommissionJUVENILE AND FAMILY COURT JOURNAL, Issue 2 2007PATRICIA TORBET ABSTRACT One of the most compelling reasons for accurate racial coding of juveniles involved in the juvenile justice system is to ensure that all youth are treated fairly, regardless of race or ethnicity. Pennsylvania juvenile courts and probation departments now have instructions and guidelines for collecting and recording race and ethnicity in compliance with Federal standards. These guidelines can be easily adopted by other states and jurisdictions. [source] Portal Venous Donor-Specific Transfusion in Conjunction with Sirolimus Prolongs Renal Allograft Survival in Nonhuman PrimatesAMERICAN JOURNAL OF TRANSPLANTATION, Issue 1 2009K. K. Dhanireddy Pretransplant exposure to donor antigen is known to modulate recipient alloimmunity, and frequently results in sensitization. However, donor-specific transfusion (DST) can have a protolerant effect that is dependent on route, dose and coadministered immunosuppression. Rodent studies have shown in some strain combinations that portal venous (PV) DST alone can induce tolerance, and uncontrolled clinical use of PVDST has been reported. In order to determine if pretransplant PVDST has a clinically relevant salutary effect, we studied it and the influence of concomitant immunosuppression in rhesus monkeys undergoing renal allotransplantation. Animals received PVDST with unfractionated bone marrow and/or tacrolimus or sirolimus 1 week prior to transplantation. Graft survival was assessed without any posttransplant immunosuppression. PVDST alone or in combination with tacrolimus was ineffective. However, PVDST in combination with sirolimus significantly prolonged renal allograft survival to a mean of 24 days. Preoperative sirolimus alone had no effect, and peripheral DST with sirolimus prolonged graft survival in 2/4 animals, but resulted in accelerated rejection in 2/4 animals. These data demonstrate that PVDST in combination with sirolimus delays rejection in a modest but measurable way in a rigorous model. It may thus be a preferable method for donor antigen administration. [source] Diastereo- and Enantioselective Synthesis of ,,,-Epoxyketones Using Aqueous NaOCl in Conjunction with Dihydrocinchonidine Derived Phase-Transfer Catalysis at Room Temperature.CHEMINFORM, Issue 47 2007Limitations., Scope Abstract ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 200 leading journals. To access a ChemInform Abstract, please click on HTML or PDF. [source] Extraction of Lanthanides from Aqueous Solution by Using Room-Temperature Ionic Liquid and Supercritical Carbon Dioxide in ConjunctionCHEMISTRY - A EUROPEAN JOURNAL, Issue 6 2006Soufiane Mekki Dr. Abstract For the first time, the study of a three-step extraction system of water/ionic liquid/supercritical CO2 has been performed. Extraction of trivalent lanthanum and europium from an aqueous nitric acid solution to a supercritical CO2 phase via an imidazolium-based ionic liquid phase is demonstrated, and extraction efficiencies higher than 87,% were achieved. The quantitative extraction is obtained by using different fluorinated ,-diketones with and without the addition of tri(n -butyl)phosphate. The complexation phenomenon occurring in the room-temperature ionic-liquid (RTIL) phase was evidenced by using luminescence spectroscopy. [source] Cutting Torque Measurements in Conjunction with Implant Placement in Grafted and Nongrafted Maxillas as an Objective Evaluation of Bone Density: A Possible Method for Identifying Early Implant Failures?CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 1 2004Björn Johansson DDS ABSTRACT Background: Bone grafts are frequently used to enable the placement of dental implants in atrophied jaws. The biomechanical properties of bone grafts used in one- or two-stage implant procedures (in comparison with the use of nongrafted bone) are not well known. Purpose: The purpose of this study was (1) to measure cutting torques during the placement of self-tapping dental implants in nongrafted bone and in bone grafts, either as blocks or in a milled particulate form, in patients undergoing implant treatment in an edentulous maxilla and (2) to identify implants with reduced initial stability and to correlate these findings with a clinical classification of jawbone quality. Materials and Methods: The study included 40 consecutive patients with edentulous maxillas, 27 of whom were subjected to bone grafting prior to or in conjunction with implant placement (grafting group) and 13 of whom received implants without grafting (nongrafted group). Grafted bone from the iliac crest bone was used (1) as onlay blocks, (2) as maxillary sinus inlay blocks, or (3) in particulate form in the maxillary sinus. Implants were placed after 6 to 7 months of healing, except in the maxillary sinus inlay blocks, where implants were placed simultaneously. Cutting torque values were obtained from 113 grafted implant sites and from 109 nongrafted implant sites. Results: Significantly lower cutting torque values were assessed in grafted regions than in nongrafted regions, irrespective of grafting technique. Lower values were also seen for implants placed in block grafts after 6 months when compared to other grafting techniques used. The cutting torque values revealed an inverse linear relation to the Lekholm and Zarb bone quality index. Conclusion: The cutting torque values correlated well with the Lekholm and Zarb index of bone quality. Significantly lower cutting torque values were seen in grafted bone than in nongrafted bone. [source] Shallow Bounding Volume Hierarchies for Fast SIMD Ray Tracing of Incoherent RaysCOMPUTER GRAPHICS FORUM, Issue 4 2008H. Dammertz Abstract Photorealistic image synthesis is a computationally demanding task that relies on ray tracing for the evaluation of integrals. Rendering time is dominated by tracing long paths that are very incoherent by construction. We therefore investigate the use of SIMD instructions to accelerate incoherent rays. SIMD is used in the hierarchy construction, the tree traversal and the leaf intersection. This is achieved by increasing the arity of acceleration structures, which also reduces memory requirements. We show that the resulting hierarchies can be built quickly and are smaller than acceleration structures known so far while at the same time outperforming them for incoherent rays. Our new acceleration structure speeds up ray tracing by a factor of 1.6 to 2.0 compared to a highly optimized bounding interval hierarchy implementation, and 1.3 to 1.6 compared to an efficient kd-tree. At the same time, the memory requirements are reduced by 10,50%. Additionally we show how a caching mechanism in conjunction with this memory efficient hierarchy can be used to speed up shadow rays in a global illumination algorithm without increasing the memory footprint. This optimization decreased the number of traversal steps up to 50%. [source] Numerical Treatment of Seismic Accelerograms and of Inelastic Seismic Structural Responses Using Harmonic WaveletsCOMPUTER-AIDED CIVIL AND INFRASTRUCTURE ENGINEERING, Issue 4 2007Pol D. Spanos The effectiveness of the harmonic wavelets for capturing the temporal evolution of the frequency content of strong ground motions is demonstrated. In this regard, a detailed study of important earthquake accelerograms is undertaken and smooth joint time-frequency spectra are provided for two near-field and two far-field records; inherent in this analysis is the concept of the mean instantaneous frequency. Furthermore, as a paradigm of usefulness for aseismic structural purposes, a similar analysis is conducted for the response of a 20-story steel frame benchmark building considering one of the four accelerograms scaled by appropriate factors as the excitation to simulate undamaged and severely damaged conditions for the structure. The resulting joint time-frequency representation of the response time histories captures the influence of nonlinearity on the variation of the effective natural frequencies of a structural system during the evolution of a seismic event. In this context, the potential of the harmonic wavelet transform as a detection tool for global structural damage is explored in conjunction with the concept of monitoring the mean instantaneous frequency of records of critical structural responses. [source] Scene Graph and Frame Update Algorithms for Smooth and Scalable 3D Visualization of Simulated Construction OperationsCOMPUTER-AIDED CIVIL AND INFRASTRUCTURE ENGINEERING, Issue 4 2002Vineet R. Kamat One of the prime reasons inhibiting the widespread use of discrete-event simulation in construction planning is the absence of appropriate visual communication tools. Visualizing modeled operations in 3D is arguably the best form of communicating the logic and the inner working of simulation models and can be of immense help in establishing the credibility of analyses. New software development technologies emerge at incredible rates that allow engineers and scientists to create novel, domain-specific applications. The authors capitalized on a computer graphics technology based on the concept of the scene graph to design and implement a general-purpose 3D visualization system that is simulation and CAD-software independent. This system, the Dynamic Construction Visualizer, enables realistic visualization of modeled construction operations and the resulting products and can be used in conjunction with a wide variety of simulation tools. This paper describes the scene graph architecture and the frame updating algorithms used in designing the Dynamic Construction Visualizer. [source] Seine: a dynamic geometry-based shared-space interaction framework for parallel scientific applicationsCONCURRENCY AND COMPUTATION: PRACTICE & EXPERIENCE, Issue 15 2006L. Zhang Abstract While large-scale parallel/distributed simulations are rapidly becoming critical research modalities in academia and industry, their efficient and scalable implementations continue to present many challenges. A key challenge is that the dynamic and complex communication/coordination required by these applications (dependent on the state of the phenomenon being modeled) are determined by the specific numerical formulation, the domain decomposition and/or sub-domain refinement algorithms used, etc. and are known only at runtime. This paper presents Seine, a dynamic geometry-based shared-space interaction framework for scientific applications. The framework provides the flexibility of shared-space-based models and supports extremely dynamic communication/coordination patterns, while still enabling scalable implementations. The design and prototype implementation of Seine are presented. Seine complements and can be used in conjunction with existing parallel programming systems such as MPI and OpenMP. An experimental evaluation using an adaptive multi-block oil-reservoir simulation is used to demonstrate the performance and scalability of applications using Seine. Copyright © 2006 John Wiley & Sons, Ltd. [source] Anomalous Left Anterior Descending Coronary Artery from the Pulmonary Artery, Unroofed Coronary Sinus, Patent Foramen Ovale, and a Persistent Left-sided SVC in a Single Patient: A Harmonious Quartet of DefectsCONGENITAL HEART DISEASE, Issue 2 2009Andrew J. Klein MD ABSTRACT Unroofing of the coronary sinus without complex structural heart defects is a rare congenital defect often seen in conjunction with a persistent left-sided superior vena cava. Anomalous origin of the left anterior descending artery from the pulmonary artery with normal origin of the left circumflex coronary artery is an even rarer congenital cardiac defect. We report a case of a 54-year-old woman presenting with mild dyspnea on exertion who was found on invasive and noninvasive evaluations to have a unique combination of defects,unroofed coronary sinus, persistent left-sided superior vena cava, patent foramen ovale, and anomalous origin of the left anterior descending artery from the pulmonary artery without evidence of previous coronary ischemia. [source] "I Am Not Alone": The Feasibility and Acceptability of Interactive Voice Response-Facilitated Telephone Peer Support Among Older Adults With Heart FailureCONGESTIVE HEART FAILURE, Issue 3 2007Michele Heisler MD Patient self-management is a critical determinant of heart failure (HF) outcomes, yet patients with HF are often frail and socially isolated, factors that may limit their ability to manage self-care and access clinic-based services. Mobilizing peer support among HF patients is a promising strategy to improve self-management support. In this pilot, the authors evaluated the feasibility and acceptability of an interactive voice response (IVR)-based platform to facilitate telephone peer support among older adults with HF. Participants completed a baseline survey, were offered a 3-hour training session in peer communication skills, and were paired with another patient who had HF. Participants were asked to contact their partner weekly using a toll-free IVR phone system that protected their anonymity and provided automated reminders if contacts were not made. Times and duration of participants' telephone contacts were monitored and recorded. After the 7-week intervention, participants completed surveys and brief face-to-face interviews. The authors found high levels of use and satisfaction and improvements in depressive symptoms among the 20 pilot study participants. An IVR peer-support intervention is feasible, is acceptable to patients, and may have positive effects on patients' HF social support and health outcomes, in conjunction with structured health system support, that warrant more rigorous evaluation in a randomized trial. [source] Role of ß Blockers in Congestive Heart FailureCONGESTIVE HEART FAILURE, Issue 6 2000MPhil, Nazim Uddin Azam Khan MD Prolonged activation of the adrenergic nervous system has adverse consequences on the cardiovascular system in patients with congestive heart failure. , adrenergic receptor,blocker therapy modifies these deleterious effects. , blockers have been shown to improve myocardial function and survival when used in conjunction with conventional treatment with diuretics, angiotensinconverting enzyme inhibitors, and digoxin. , blocker therapy in mild-to-moderate heart failure should not be delayed because it causes some reversal of both neurohormonal compensatory mechanisms and the deletorious myocardial remodeling process. This paper reviews the beneficial effects of , adrenergic receptor-blocker therapy on the pathophysiology, symptoms, left ventricular function, morbidity, and mortality in patients with congestive heart failure. [source] Application of the New Keystone-Species Concept to Prairie Dogs: How Well Does It Work?CONSERVATION BIOLOGY, Issue 6 2000Natasha B. Kotliar This prompted Power et al. (1996) to refine the definition: keystone species have large effects on community structure or ecosystem function (i.e., high overall importance), and this effect should be large relative to abundance (i.e., high community importance). Using prairie dogs (Cynomys spp.) as an example, I review operational and conceptual difficulties encountered in applying this definition. As applied to prairie dogs, the implicit assumption that overall importance is a linear function of abundance is invalid. In addition, community importance is sensitive to abundance levels, the definition of community, and sampling scale. These problems arise largely from the equation for community importance, as used in conjunction with removal experiments at single abundance levels. I suggest that we shift from the current emphasis on the dualism between keystone and nonkeystone species and instead examine how overall and community importance vary (1) with abundance, (2) across spatial and temporal scales, and (3) under diverse ecological conditions. In addition, I propose that a third criterion be incorporated into the definition: keystone species perform roles not performed by other species or processes. Examination of how these factors vary among populations of keystone species should help identify the factors contributing to, or limiting, keystone-level functions, thereby increasing the usefulness of the keystone-species concept in ecology and conservation. Although the quantitative framework of Power et al. falls short of being fully operational, my conceptual guidelines may improve the usefulness of the keystone-species concept. Careful attention to the factors that limit keystone function will help avoid misplaced emphasis on keystone species at the expense of other species. Resumen: Se ha sugerido que el concepto de especie pilar no sea usado más en ecología y conservación, principalmente debido a que el concepto ha sido pobremente definido. Esto instigó a Power et al. (1996) a refinar la definición: las especies pilar tienen grandes efectos en la estructura de una comunidad o la función de un ecosistema (alta importancia en lo general), y este efecto debe ser grande en relación con la abundancia (alta importancia en la comunidad). Usando los perros de pradera (Cynomys spp) como ejemplo, revisé las dificultades operativas y conceptuales encontradas durante la aplicación de esta definición. Al aplicarse a perros de pradera, la suposición implícita de que la importancia en lo general es una función lineal de la abundancia es inválida. Además, la importancia en la comunidad es sensible a los niveles de abundancia, a la definición de comunidad y a la escala de muestreo. Estos problemas surgen, en gran medida, de la ecuación para la importancia en la comunidad, al ser usada conjuntamente con experimentos de remoción a un solo nivel de abundancia. Sugiero que el énfasis actual en la dualidad sobre especies pilares/no pilares cambie para examinar cómo varía la importancia en lo general y en la comunidad; (1) con la abundancia, (2) a lo largo de escalas espaciales y temporales, y (3) bajo diversas condiciones ecológicas. Además, propongo que sea incorporado un tercer criterio en la definición: las especies pilar llevan a cabo funciones no llevadas a cabo por otras especies o procesos. El análisis de cómo varían estos factores entre poblaciones de especies pilar ayudará a identificar los factores que contribuyen, o limitan las funciones a nivel pilar, incrementando con ello la utilidad del concepto de especie pilar en ecología y conservación. Aunque el marco de trabajo cuantitativo de Power et al. no llega a ser completamente operacional, mis guías conceptuales pueden mejorar la utilidad de este concepto. Una atención especial a los factores que limitan el funcionamiento pilar ayudaría a evitar un énfasis mal ubicado en especies pilar a costa de otras especies. [source] Reconciling Financial Information at Varied Levels of Aggregation,CONTEMPORARY ACCOUNTING RESEARCH, Issue 2 2004ANIL ARYA Abstract Financial statements summarize a firm's fiscal position using only a limited number of accounts. Readers often interpret financial statements in conjunction with other information, some of which may be aggregated in a different way (or not at all). This paper exploits properties of the double-entry accounting system to provide a systematic approach to reconciling diverse financial data. The key is the ability to represent the double-entry system by network flows and, thereby, access well-recognized network optimization techniques. Two specific uses are investigated: the reconciliation of audit evidence with management-prepared financial statements, and the creation of transaction-level financial ratios. [source] The ponderous evolution of corporate environmental reporting in Ireland.CORPORATE SOCIAL RESPONSIBILITY AND ENVIRONMENTAL MANAGEMENT, Issue 2 2003Recent evidence from publicly listed companies Ireland's recent rapid economic growth has exacerbated pressure on the environment, leading to increased scrutiny of corporate environmental impacts. In order to assess whether external corporate environmental reporting (CER) has evolved in conjunction with this increased scrutiny, this paper reports on the results of a comprehensive analysis of CER practice among all Irish listed companies. The findings are interpreted using the lens of legitimacy theory. The results indicate that, apart from companies whose core activities have an easily observable environmental impact, there is little extensive CER undertaken, in terms of either its quantity or quality. Despite evidence of increasing trends in disclosure, in most instances disclosing companies remain at the very early stages in their consideration of CER. It is argued that this negligible disclosure potentially represents a minimalistic response to pressure from stakeholders whose power to threaten organizations' legitimacy is limited. Copyright © 2003 John Wiley & Sons, Ltd. and ERP Environment [source] Teaching the Fuzzy Front End of Innovation: Experimenting with Team Learning and Cross-Organizational IntegrationCREATIVITY AND INNOVATION MANAGEMENT, Issue 3 2009Miia Martinsuo How can the extremely uncertain front end of innovation , managing the fuzzy front end , be taught to graduate students? This paper describes and analyses experiments with experiential, problem-based learning focused on the front end of innovation. The focus is on the learning and cross-organizational integration of student teams; factors that have been identified as central to the success of teams involved in the front end of innovation. An experiential course, ,From an idea to a business plan in product development', was developed in conjunction with an actual company, and piloted with four student groups in 2007 and 2008. Data on this novel course were collected through participant observation, team self-assessment and questionnaires. This paper reports favourable results for the effectiveness of the course design; it discusses the impact of team size and cross-organizational team composition on team performance; and identifies the implications for teaching the front end of innovation. [source] Pharmacological issues in the management of people with mental illness and problems with alcohol and illicit drug misuseCRIMINAL BEHAVIOUR AND MENTAL HEALTH, Issue 4 2007Trudi Hilton Background,While there is plentiful information on the pharmacological management of detoxification from alcohol and on withdrawal from or maintenance of opiates for people with a principal problem of substance misuse or dependency, the pharmacological management of substance misusers presenting with a mental illness can be more complicated. Mental health and substance misuse services tend to be separate, but there is now a drive to increase effective overlap between them by equipping mental health clinicians with the skills and confidence to manage substance misuse disorders in conjunction with major mental illness. Aims,This paper aims to highlight, for a multi-professional readership, some of the prescribing options and precautions to consider when psychotropic medicines are prescribed for treatment of a mental illness in someone who may continue to use illicit substances or alcohol. It also considers interactions with the completely licit substances, nicotine and caffeine. With recent legislation prohibiting smoking in public places people are likely to reduce or stop smoking, which can have a substantial effect on the levels of medication in their blood. Copyright © 2007 John Wiley & Sons, Ltd. [source] An optimized whole blood method for flow cytometric measurement of ZAP-70 protein expression in chronic lymphocytic leukemiaCYTOMETRY, Issue 4 2006T. Vincent Shankey Abstract Background: ZAP-70 protein expression has been proposed as a marker for immunoglobulin heavy chain mutational status, which some studies have correlated with disease course in B-cell chronic lymphocytic leukemia (CLL). Studies published to date measuring levels of expression of ZAP-70 intracellular protein using flow cytometry have demonstrated poor performance, as defined by the difference in signal in known positive and negative lymphocyte populations. Methods: A recently published method (Chow S, Hedley DW, Grom P, Magari R, Jacobberger JW, Shankey TV, Cytometry A 2005;67:4,17) to measure intracellular phospho-epitopes was optimized using a design of experiments (DOE) approach to provide the best separation of ZAP-70 expression in positive T- or NK-cells as compared to negative B-cells in peripheral blood samples. A number of commercially available anti-ZAP-70 antibody-conjugates were screened using this methodology, and the antibody-conjugate showing the best performance was chosen to develop a four-color, five antibody assays to measure ZAP-70 levels in whole blood specimens. Results: Using the optimized fixation and permeabilization method, improvement in assay performance (signal-to-noise, S/N) was seen in most of the antibodies tested. The custom SBZAP conjugate gave the best S/N when used in conjunction with this optimized fixation /permeabilization method. In conjunction with carefully standardized instrument set-up protocols, we obtained both intra- and interlaboratory reproducibility in the analysis of ZAP-70 expression in whole blood samples from normal and CLL patients. Conclusions: The development of a sensitive, specific and highly reproducible ZAP-70 assay represents only the first essential step for any clinical assay. The universal implementation of a validated data analysis method and the establishment of methodology-based cutoff points for clinical outcomes must next be established before ZAP-70 protein analysis can be routinely implemented in the clinical laboratory. © 2006 International Society for Analytical Cytology [source] In vivo determination of muscle viscoelasticity in the human legACTA PHYSIOLOGICA, Issue 4 2001S. Fukashiro The purpose of this study was to examine the methodological validity of the free vibration technique for determining individual viscoelastic characteristics of the human triceps surae muscle-tendon complex (MTC) in vivo. Six subjects sat with first phalangeal joint of the forefoot on the edge of a force-plate. The special frame on the knee was loaded with weight (0,40 kg) for testing. Oscillations of the triceps surae MTC system were initiated with a hand-held hammer by tapping the weight. In order to keep the same posture, the output of the force plate was displayed on the oscilloscope and subjects were asked to maintain the beam on the oscilloscope at a particular location in relation to a reference line. The damped oscillations in conjunction with the equation of motion of a damped mass-spring model were used to calculate the viscosity of muscle (b) and the elasticity of muscle fibres and tendon (k) in each subject, considering moment arm of the ankle joint. With this arrangement, we have obtained high reproducibility in this method. The coefficient of variations (CVs) of b and k in five trials at each weight were quite small (range: 0.5,18.7% in b and 1.0,15.1% in k). There were no significant differences in viscoelastic coefficients between right and left legs. Therefore, it appears that free vibration technique, used here, is adequate in describing the viscoelastic characteristics of the triceps surae in vivo in humans. [source] Glutathione deficiency intensifies ischaemia-reperfusion induced cardiac dysfunction and oxidative stressACTA PHYSIOLOGICA, Issue 1 2001S. Leichtweis The efficacy of glutathione (GSH) in protecting ischaemia-reperfusion (I-R) induced cardiac dysfunction and myocardial oxidative stress was studied in open-chest, stunned rat heart model. Female Sprague,Dawley rats were randomly divided into three experimental groups: (1) GSH-depletion, by injection of buthionine sulphoxamine (BSO, 4 mmol kg,1, i.p.) 24 h prior to I-R, (2) BSO injection (4 mmol kg,1, i.p.) in conjunction with acivicin (AT125, 0.05 mmol kg,1, i.v.) infusion 1 h prior to I-R, and (3) control (C), receiving saline treatment. Each group was further divided into I-R, with surgical occlusion of the main left coronary artery (LCA) for 30 min followed by 20 min reperfusion, and sham. Myocardial GSH content and GSH : glutathione disulphide (GSSG) ratio were decreased by ,50% (P < 0.01) in both BSO and BSO + AT125 vs. C. Ischaemia-reperfusion suppressed GSH in both left and right ventricles of C (P < 0.01) and left ventricles of BSO and BSO + AT125 (P < 0.05). Contractility (+dP/dt and ,dP/dt) in C heart decreased 55% (P < 0.01) after I and recovered 90% after I-R, whereas ±dP/dt in BSO decreased 57% (P < 0.01) with ischaemia and recovered 76 and 84% (P < 0.05), respectively, after I-R. For BSO + AT125, ±dP/dt were 64 and 76% (P < 0.01) lower after ischaemia, and recovered only 67 and 61% (P < 0.01) after I-R. Left ventricular systolic pressure in C, BSO and BSO + AT125 reached 95 (P > 0.05) 87 and 82% (P < 0.05) of their respective sham values after I-R. Rate-pressure double product was 11% (P > 0.05) and 25% (P < 0.05) lower in BSO and BSO + AT125, compared with Saline, respectively. BSO and BSO + AT125 rats demonstrated significantly lower liver GSH and heart Mn superoxide dismutase activity than C rats after I-R. These data indicate that GSH depletion by inhibition of its synthesis and transport can exacerbate cardiac dysfunction inflicted by in vivo I-R. Part of the aetiology may involve impaired myocardial antioxidant defenses and whole-body GSH homeostasis. [source] Incidence of dental trauma associated with facial trauma in Brazil: a 1-year evaluationDENTAL TRAUMATOLOGY, Issue 1 2004Alessandro Costa Da Silva Abstract,,, Dental trauma occurs frequently in young people, and mostly occurs in conjunction with facial trauma. In the literature, there are still few reports relating dental trauma, facial trauma, and soft-tissue injuries. This research aimed to evaluate: (i) the overall incidence of dental trauma in 340 patients who presented with facial trauma over a 1-year-period, (ii) the epidemiology of these related diseases, and (iii) the most common dental trauma when a facial trauma was present. Of all facial trauma, 15.29% presented dental trauma, of which luxations and avulsions were the most frequent injuries (40.30% each), occurring mainly on weekends (38.46%) and in October (15.38%), followed by March and June (13.46% each). The sex ratio presented the proportion of 3.3:1 (M:F). Trauma occurred mainly in the second decade (44.23%). These results highlight the high incidence of dental and facial trauma, and suggest the importance of the adoption of appropriate prevention protocols and effective therapeutic methods. [source] Use of Intraoperative Botulinum Toxin in Facial ReconstructionDERMATOLOGIC SURGERY, Issue 2 2009TIMOTHY CORCORAN FLYNN MD BACKGROUND Botulinum toxin is a potent neuromodulator that temporarily relaxes muscles and can improve wound healing. OBJECTIVE This retrospective analysis assessed the use of intraoperative botulinum toxin type A or B in patients undergoing surgical reconstruction after Mohs micrographic surgery for treatment of skin cancer. The primary effect of intradermal botulinum toxin on wound healing was also studied. METHODS & MATERIALS Charts of patients who received intraoperative botulinum toxin type A (n=9) or B (n=9) in conjunction with reconstructive surgery after Mohs micrographic surgery were reviewed. Three volunteers also underwent dermal injections of botulinum toxin type A followed by erbium laser resurfacing. RESULTS Outcomes did not differ in patients treated with botulinum toxin type A and type B. Patients had excellent apposition of wound edges and smooth skin overlying soft tissue; no significant complications were noted. Healing of erbium laser ablation did not differ between botulinum toxin type A,treated skin and control skin. CONCLUSIONS Administration of botulinum toxin type A or B after reconstruction after Mohs micrographic surgery aided wound healing; botulinum toxin type A and botulinum toxin type B were equally effective. Intradermal botulinum toxin type A demonstrated no primary effect on healing of erbium laser,resurfaced skin. [source] Perioperative Management of von Willebrand Disease in Dermatologic SurgeryDERMATOLOGIC SURGERY, Issue 4 2007AIMEE L. LEONARD MD BACKGROUND Von Willebrand disease (VWD) is the most common inherited bleeding disorder, affecting an estimated 0.1% to 1% of the population. It is caused by a qualitative or quantitative defect of von Willebrand factor. Primary manifestations include intractable mucocutaneous bleeding after surgery or trauma. OBJECTIVE The objective was to review the pathophysiology and clinical features of VWD and to propose a perioperative management strategy for patients with this condition undergoing dermatologic surgery. METHODS AND MATERIALS Literature is reviewed. RESULTS The various types and clinical manifestations of this condition are reviewed, and a perioperative strategy is presented for managing patients with VWD who undergo cutaneous oncologic or cosmetic surgical procedures. CONCLUSIONS In most cases, dermatologic surgery can be safely performed in patients with VWD. The use of appropriate therapeutic prophylaxis in conjunction with a hematologist is indicated in high-risk, nonelective procedures. [source] Novel Face-Lift Suspension Suture and Inserting Instrument: Use of Large Anchors Knotted into a Suture with Attached Needle and Inserting Device Allowing for Single Entry Point Placement of Suspension Suture.DERMATOLOGIC SURGERY, Issue 3 2006Preliminary Report of 20 Cases with 6- to 12-Month Follow-Up BACKGROUND Various suspension suture techniques exist to elevate the mid-face, jowls, and neck. OBJECTIVE To assess safety and efficacy of a new suspension suture and inserting instrument with both standard and minimal incision (no-skin-excision) face-lifts. METHODS A new type of multianchor suspension suture assembled from commercially available 2-0 absorbable monofilament material, with 5 to 9 equally spaced knots through which are secured 7 to 9 mm bits of 0 thickness similar suture material, and an attached straightened needle, was used to elevate and suspend facial tissues to temporal or mastoid fascia. The suspension sutures are placed in the deep subcutaneous tissues, just above the superficial musculo aponeurotic system (SMAS), by use of a novel, blunt instrument, which does not require a second, distal exit point. The suspension suture distal end floats free. The proximal needle end is sutured to fascia. The suture was used on 20 patients. Fourteen of them underwent pure, "no-skin-excision," suspension lifts. Six had suspension suture elevation of the mid-face in conjunction with relatively conservative open lifts. Nine- to 12-month results were evaluated. RESULTS With open face-lifts, 9- to 12-month results are excellent with significant persistence of the correction initially achieved. Resulting scars remained fine line. There were no complications. With pure suspension lifts, initial results were impressive. By 6 months, correction started to fade. By 12 months 100% of initial correction for jowls, and 80 to 100% for mid-face, appeared lost. Recovery time was 2 to 4 days. There were no significant complications. CONCLUSION Large multianchor, absorbable monofilament sutures can safely and effectively enhance results of conservative lifts, with remarkable elevation of the mid-face not achievable with simple SMAS flaps. These suspension sutures can easily and safely achieve impressive, though relatively short-term results, with a minimal incision, "no-skin-excision" technique. [source] Treatment of Port-Wine Stain Birthmarks Using the 1.5-msec Pulsed Dye Laser at High Fluences in Conjunction with Cryogen Spray CoolingDERMATOLOGIC SURGERY, Issue 4 2002Kristen M. Kelly MD Background. The majority of port-wine stain (PWS) patients treated with the pulsed dye laser (PDL) do not achieve complete blanching. Safe administration of higher fluences has been proposed as a means of improving treatment efficacy. Objective. To determine the safety and efficacy of PWS treatment with the 1.5-msec PDL at high fluences in conjunction with cryogen spray cooling. Methods. Twenty PWS patients were treated with the PDL in combination with cryogen spray cooling utilizing a 7 or 10 mm spot size and fluences ranging from 6 to 15 J/cm2. Before and after treatment photographs were compared on a blinded basis. Results. No scarring or skin textural changes occurred. Blanching scores were as follows: 20% of patients achieved 75% or greater blanching after an average of 3.3 treatments, 30% achieved 50,74% blanching, 20% achieved 25,49% blanching, and 30% achieved less than 25% blanching. Conclusion. In conjunction with cryogen spray cooling, the PDL can be safely used at high fluences. At this time it is not clear that the use of higher fluences improves treatment efficacy; however, as other aspects of PWS laser treatment are optimized, safe administration of higher fluences is likely to be advantageous. [source] The Corset Platysma Repair: A Technique RevisitedDERMATOLOGIC SURGERY, Issue 3 2002Carolyn I. Jacob MD background. Platysma banding along with excess submental adipose tissue and sagging skin can lead to an aged appearance. Several methods for improving neck and submental contours exist, including neck liposuction, bilateral platysma plication, midline platysma plication with transection of distal fibers, necklift with skin excision, and botulinum toxin injection for platysma relaxation. With the current interest in minimally invasive procedures, surgeons and patients are searching for techniques that produce maximal improvement with minimal intervention. objective. To present a modified technique for maximizing neck contouring, discuss possible complications of the procedure, and describe appropriate candidates for the corset platysmaplasty. methods. We performed a retrospective analysis of 10 consecutive patients who underwent neck liposuction with concomitant corset platysmaplasty at our institution. results. All 10 patients achieved good to excellent submental and jawline contouring, determined by both physician and patient assessment, with no visible platysma banding at 6 months follow-up. No major complications were noted. conclusion. Use of corset platysmaplasty is a safe and effective method for neck rejuvenation. This variation of platysmaplasty can be used in conjunction with neck liposuction to maximize jawline and neck contour enhancement. [source] Safety and efficacy of vaccinesDERMATOLOGIC THERAPY, Issue 2 2009Brenda L. Bartlett ABSTRACT For the past two centuries, vaccines have provided a safe and effective means of preventing a number of infectious diseases. Although the safety of some vaccines has been questioned in recent years, the currently available vaccines are more than a millionfold safer than the diseases they are designed to prevent. Vaccines, however, should always be used in conjunction with other public health interventions. One important intervention is education because the general public can be led to believe that vaccines are unsafe and not needed by misinformation readily available electronically and in print. Not only are some vaccines available via injection but other vaccines are also given orally or intranasally. New vaccines are being studied for topical and intravaginal use. In addition, new systems are being developed for more efficient production of vaccines, especially for influenza. Vaccines are currently available for only a limited number of viral and bacterial diseases. In the future, it is anticipated that safe and effective vaccines will be developed against a number of other viral and bacterial infections as well as fungal and protozoan diseases. [source] Medical treatment of hirsutismDERMATOLOGIC THERAPY, Issue 5 2008Ulrike Blume-Peytavi ABSTRACT:, Hirsutism is usually the result of an underlying adrenal, ovarian, or central endocrine abnormality mainly due to polycystic ovary syndrome but may also be idiopathic or drug induced. The aim of medical treatment of hirsutism is to rectify any causal hormonal balance, slow down or stop excessive hair growth, and improve the aesthetic appearance of hirsutism, thereby positively affecting the patient's quality of life. Today, for the majority of women, a monotherapy with oral contraceptives that have antiandrogenic activity is recommended as a first-line treatment for hirsutism. Combining an oral contraceptive pill with an antiandrogen is recommended if clinical improvement of hirsutism is insufficient after 6,9 months' monotherapy. In women who present with hirsutism, hyperandrogenism, and insulin resistance, insulin sensitizers are effective for the hirsutism as well as the hyperinsulinemia, hyperandrogenism, and infertility but there is no convincing evidence that they are effective for hirsutism alone. Topical eflornithine is a medical therapy that can be a useful adjuvant for hirsutism when used in conjunction with systemic medications or with laser/photoepilation. [source] | |||||||||||||||||||||||||||||||||||||