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IM
Terms modified by IM Selected AbstractsReed-Sternberg cells in atypical primary EBV infectionACTA PAEDIATRICA, Issue 2 2001M Bitsori The presence of Epstein-Barr virus (EBV) in the Hodgkin's/Reed-Sternberg (HRS) cells of a significant proportion of cases of Hodgkin's lymphoma (HL) is a matter of consideration when a case of presumptive HL has to be differentiated from infectious mononucleosis (IM). A 15-y-old boy was admitted with a presumptive diagnosis of extranodal HL, based on the biopsy of a painless ulcer on the right mandibular alveolar crest. Histologic examination of the lesion was consistent with mixed cellularity HL. The patient additionally presented with hepatosplenomegaly and regional lymphadenopathy. Serology for EBV was indicative of acute infection. Histological examination of regional lymphoid tissue was consistent with immunologic activation due to primary EBV infection. The patient was left untreated, under close observation. All clinical findings resolved within 3 mo and EBV viral capsid antigen (VCA) IgM antibodies converted to negative after 6 mo. A 3-y follow-up period was uneventful. [source] Vacuolar H+ -ATPase expression is increased in acid-secreting intercalated cells in kidneys of rats with hypercalcaemia-induced alkalosisACTA PHYSIOLOGICA, Issue 4 2007W. Wang Abstract Aims:, Hypercalcaemia is known to be associated with systemic metabolic alkalosis, although the underlying mechanism is uncertain. Therefore, we aimed to examine whether hypercalcaemia was associated with changes in the expression of acid,base transporters in the kidney. Methods:, Rats were infused with human parathyroid hormone (PTH, 15 ,g kg,1 day,1), or vehicle for 48 h using osmotic minipumps. Results:, The rats treated with PTH developed hypercalcaemia and exhibited metabolic alkalosis (arterial HCO: 31.1 ± 0.8 vs. 28.1 ± 0.8 mmol L,1 in controls, P < 0.05, n = 6), whereas the urine pH of 6.85 ± 0.1 was significantly decreased compared with the pH of 7.38 ± 0.1 in controls (P < 0.05, n = 12). The observed alkalosis was associated with a significantly increased expression of the B1-subunit of the H+ -ATPase in kidney inner medulla (IM, 233 ± 45% of the control level). In contrast, electroneutral Na+ -HCO cotransporter NBCn1 and Cl,/HCO anion exchanger AE2 expression was markedly reduced in the inner stripe of the outer medulla (to 26 ± 9% and 65 ± 6%, respectively). These findings were verified by immunohistochemistry. Conclusions:, (1) hypercalcaemia-induced metabolic alkalosis was associated with increased urinary excretion of H+; (2) the increased H+ -ATPase expression in IM may partly explain the enhanced urinary acidification, which is speculated to prevent stone formation because of hypercalciuria and (3) the decreased expression of outer medullary AE2 suggests a compensatory reduction of the transepithelial bicarbonate transport. [source] Respiratory muscle performance with stretch-shortening cycle manoeuvres: maximal inspiratory pressure,flow curvesACTA PHYSIOLOGICA, Issue 3 2005G. E. Tzelepis Abstract Aim:, To test the hypothesis that the maximal inspiratory muscle (IM) performance, as assessed by the maximal IM pressure,flow relationship, is enhanced with the stretch-shortening cycle (SSC). Methods:, Maximal inspiratory flow,pressure curves were measured in 12 healthy volunteers (35 ± 6 years) during maximal single efforts through a range of graded resistors (4-, 6-, and 8-mm diameter orifices), against an occluded airway, and with a minimal load (wide-open resistor). Maximal inspiratory efforts were initiated at a volume near residual lung volume (RV). The subjects exhaled to RV using slow (S) or fast (F) manoeuvres. With the S manoeuvre, they exhaled slowly to RV and held the breath at RV for about 4 s prior to maximal inspiration. With the F manoeuvre, they exhaled rapidly to RV and immediately inhaled maximally without a post-expiratory hold; a strategy designed to enhance inspiratory pressure via the SSC. Results:, The maximal inspiratory pressure,flow relationship was linear with the S and F manoeuvres (r2 = 0.88 for S and r2 = 0.88 for F manoeuvre, P < 0.0005 in all subjects). With the F manoeuvre, the pressure,flow relationship shifted to the right in a parallel fashion and the calculated maximal power increased by approximately 10% (P < 0.05) over that calculated with the S manoeuvre. Conclusion:, The maximal inspiratory pressure,flow capacity can be enhanced with SSC manoeuvres in a manner analogous to increases in the force,velocity relationship with SSC reported for skeletal muscles. [source] Helicobacter Pylori and Precancerous Gastric LesionsDIGESTIVE ENDOSCOPY, Issue 3 2000Pham Quang Cu Background: To determine the relationship between Helicobacter pylori (H. pylori) infection and the precancerous gastric lesions: atrophic gastritis (AG) and intestinal metaplasia (IM) and dysplasia. Methods: A total of 347 dyspeptic patients, including 141 H. pylori -positive patients and 206 H. pylori -negative patients, were studied alongside age- and sex-matched controls. The patients underwent gastroscopy and endoscopic biopsy for detection of H. pylori, and histological examinations. Helicobacter pylori was detected by a urease test (CLO; Delta West; Bentley, Australia), by histology (H&E stain, Giemsa) and by serology (BioSig; BioMeditech, NJ, USA). Atrophic gastritis, IM and dysplasia were detected by histological examination (Giemsa, H&E stain). Results: There is a higher rate of atrophic gastritis in H. pylori -positive than in H. pylori -negative patients (46 vs 13.5%, odds ratio (OR) = 5.4; P < 0.01). Gastritis in H. pylori -positive patients also has a higher rate of activity than in H. pylori -negative patients. The rate of IM is higher in H. pylori -positive patients than in H. pylori -negative patients (35 vs 11%; OR = 4.3; P < 0.01). Metaplasia is more often diffuse in H. pylori -positive than in H. pylori -negative patients. Dysplasia is more common in H. pylori -positive than in H. pylori -negative patients (12 and 3.8%; OR = 3.3; P < 0.01). Conclusions: This study supports the suggestion of a relationship between H. pylori infection and precancerous gastric lesions. Wherever H. pylori is present, the precancerous lesions are more common and more severe. [source] Novel agents to override imatinib resistance mechanismsDRUG DEVELOPMENT RESEARCH, Issue 7 2008Asumi Yokota Abstract Chronic myelogenous leukemia (CML) is a disorder of hematopoietic stem cells that results from the Philadelphia chromosome (Ph) created through translocation of human chromosomes 9 and 22. The resulting Bcr-Abl fusion protein has constitutively high tyrosine kinase activity that causes transformation of hematopoietic stem cells. Imatinib mesylate (IM) was developed as a specific Bcr-Abl kinase inhibitor and is efficacious in treating Ph-chromosome-positive (Ph+) leukemias such as CML and Ph+ acute lymphoblastic leukemia (ALL). Within a few years of its introduction to the clinic, IM has dramatically altered the first-line therapy for CML. Although most newly diagnosed CML patients in the chronic phase (CP) achieved durable responses when treated with IM, resistance to IM has become a major problem in patients with advanced-stage disease. The most important mechanism of IM resistance are point mutations within the Abl kinase domain; therefore, there is an urgent need for novel agents that can inhibit mutated Bcr-Abl. In this review, we describe novel Bcr-Abl tyrosine kinase inhibitors, the so-called "Super Gleevec" inhibitors. Drug Dev Res 69:398,406, 2008. © 2008 Wiley-Liss, Inc. [source] Seismic collapse risk of precast industrial buildings with strong connectionsEARTHQUAKE ENGINEERING AND STRUCTURAL DYNAMICS, Issue 8 2010Miha Kramar Abstract A systematic seismic risk study has been performed on some typical precast industrial buildings that consists of assemblages of cantilever columns with high shear-span ratios connected to an essentially rigid roof system with strong pinned connections. These buildings were designed according to the requirements of Eurocode 8. The numerical models and procedures were modified in order to address the particular characteristics of the analyzed system. They were also verified by pseudo-dynamic and cyclic tests of full-scale large buildings. The intensity measure (IM)-based solution strategy described in the PEER methodology was used to estimate the seismic collapse risk in terms of peak ground acceleration capacity and the probability of exceeding the global collapse limit state. The effect of the uncertainty in the model parameters on the dispersion of collapse capacity was investigated in depth. Reasonable seismic safety (as proposed by the Joint Committee on Structural Safety) was demonstrated for all the regular single-storey precast industrial buildings addressed in this study. However, if the flexural strength required by EC8 was exactly matched, and the additional strength, which results from minimum longitudinal reinforcement, was disregarded as well as large dispersion in records was considered, the seismic risk might in some cases exceed the acceptable limits. Copyright © 2009 John Wiley & Sons, Ltd. [source] Prediction of spatially distributed seismic demands in specific structures: Structural response to loss estimationEARTHQUAKE ENGINEERING AND STRUCTURAL DYNAMICS, Issue 6 2010Brendon A. Bradley Abstract A companion paper has investigated the effects of intensity measure (IM) selection in the prediction of spatially distributed response in a multi-degree-of-freedom structure. This paper extends from structural response prediction to performance assessment metrics such as probability of structural collapse; probability of exceeding a specified level of demand or direct repair cost; and the distribution of direct repair loss for a given level of ground motion. In addition, a method is proposed to account for the effect of varying seismological properties of ground motions on seismic demand that does not require different ground motion records to be used for each intensity level. Results illustrate that the conventional IM, spectral displacement at the first mode, Sde(T1), produces higher risk estimates than alternative velocity-based IM's, namely spectrum intensity, SI, and peak ground velocity, PGV, because of its high uncertainty in ground motion prediction and poor efficiency in predicting peak acceleration demands. Copyright © 2009 John Wiley & Sons, Ltd. [source] Prediction of spatially distributed seismic demands in specific structures: Ground motion and structural responseEARTHQUAKE ENGINEERING AND STRUCTURAL DYNAMICS, Issue 5 2010Brendon A. Bradley Abstract The efficacy of various ground motion intensity measures (IMs) in the prediction of spatially distributed seismic demands (engineering demand parameters, (EDPs)) within a structure is investigated. This has direct implications to building-specific seismic loss estimation, where the seismic demand on different components is dependent on the location of the component in the structure. Several common IMs are investigated in terms of their ability to predict the spatially distributed demands in a 10-storey office building, which is measured in terms of maximum interstorey drift ratios and maximum floor accelerations. It is found that the ability of an IM to efficiently predict a specific EDP depends on the similarity between the frequency range of the ground motion that controls the IM and that of the EDP. An IMs predictability has a direct effect on the median response demands for ground motions scaled to a specified probability of exceedance from a ground motion hazard curve. All of the IMs investigated were found to be insufficient with respect to at least one of magnitude, source-to-site distance, or epsilon when predicting all peak interstorey drifts and peak floor accelerations in a 10-storey reinforced concrete frame structure. Careful ground motion selection and/or seismic demand modification is therefore required to predict such a spatially distributed demands without significant bias. Copyright © 2009 John Wiley & Sons, Ltd. [source] Structural performance assessment under near-source pulse-like ground motions using advanced ground motion intensity measuresEARTHQUAKE ENGINEERING AND STRUCTURAL DYNAMICS, Issue 7 2008Polsak Tothong Abstract This paper demonstrates the effectiveness of utilizing advanced ground motion intensity measures (IMs) to evaluate the seismic performance of a structure subject to near-source ground motions. Ordinary records are, in addition, utilized to demonstrate the robustness of the advanced IM with respect to record selection and scaling. To perform nonlinear dynamic analyses (NDAs), ground motions need to be selected; as a result, choosing records that are not representative of the site hazard can alter the seismic performance of structures. The median collapse capacity (in terms of IM), for example, can be systematically dictated by including a few aggressive or benign pulse-like records into the record set used for analyses. In this paper, the elastic-based IM such as the pseudo-spectral acceleration (Sa) or a vector of Sa and epsilon has been demonstrated to be deficient to assess the structural responses subject to pulse-like motions. Using advanced IMs can be, however, more accurate in terms of probabilistic response prediction. Scaling earthquake records using advanced IMs (e.g. inelastic spectral displacement, Sdi, and IM1I&2E; the latter is for the significant higher-mode contribution structures) subject to ordinary and/or pulse-like records is efficient, sufficient, and robust relative to record selection and scaling. As a result, detailed record selection is not necessary, and records with virtually any magnitude, distance, epsilon and pulse period can be selected for NDAs. Copyright © 2008 John Wiley & Sons, Ltd. [source] Seismic demand sensitivity of reinforced concrete shear-wall building using FOSM methodEARTHQUAKE ENGINEERING AND STRUCTURAL DYNAMICS, Issue 14 2005Tae-Hyung Lee Abstract The uncertainty in the seismic demand of a structure (referred to as the engineering demand parameter, EDP) needs to be properly characterized in performance-based earthquake engineering. Uncertainties in the ground motion and in structural properties are responsible for EDP uncertainty. In this study, sensitivity of EDPs to major uncertain variables is investigated using the first-order second-moment method for a case study building. This method is shown to be simple and efficient for estimating the sensitivity of seismic demand. The EDP uncertainty induced by each uncertain variable is used to determine which variables are most significant. Results show that the uncertainties in ground motion are more significant for global EDPs, namely peak roof acceleration and displacement, and maximum inter-storey drift ratio, than those in structural properties. Uncertainty in the intensity measure (IM) of ground motion is the dominant variable for uncertainties in local EDPs such as the curvature demand at critical cross-sections. Conditional sensitivity of global and local EDPs given IM is also estimated. It is observed that the combined effect of uncertainties in structural properties is more significant than uncertainty in ground motion profile at lower IM levels, while the opposite is true at higher IM levels. Copyright © 2005 John Wiley & Sons, Ltd. [source] Developing efficient scalar and vector intensity measures for IDA capacity estimation by incorporating elastic spectral shape information,EARTHQUAKE ENGINEERING AND STRUCTURAL DYNAMICS, Issue 13 2005Dimitrios Vamvatsikos Abstract Scalar and vector intensity measures are developed for the efficient estimation of limit-state capacities through incremental dynamic analysis (IDA) by exploiting the elastic spectral shape of individual records. IDA is a powerful analysis method that involves subjecting a structural model to several ground motion records, each scaled to multiple levels of intensity (measured by the intensity measure or IM), thus producing curves of structural response parameterized by the IM on top of which limit-states can be defined and corresponding capacities can be calculated. When traditional IMs are used, such as the peak ground acceleration or the first-mode spectral acceleration, the IM-values of the capacities can display large record-to-record variability, forcing the use of many records to achieve reliable results. By using single optimal spectral values as well as vectors and scalar combinations of them on three multistorey buildings significant dispersion reductions are realized. Furthermore, IDA is extended to vector IMs, resulting in intricate fractile IDA surfaces. The results reveal the most influential spectral regions/periods for each limit-state and building, illustrating the evolution of such periods as the seismic intensity and the structural response increase towards global collapse. The ordinates of the elastic spectrum and the spectral shape of each individual record are found to significantly influence the seismic performance and they are shown to provide promising candidates for highly efficient IMs. Copyright © 2005 John Wiley & Sons, Ltd. [source] A vector-valued ground motion intensity measure consisting of spectral acceleration and epsilonEARTHQUAKE ENGINEERING AND STRUCTURAL DYNAMICS, Issue 10 2005Jack W. Baker Abstract The ,strength' of an earthquake ground motion is often quantified by an Intensity Measure (IM), such as peak ground acceleration or spectral acceleration at a given period. This IM is used to predict the response of a structure. In this paper an intensity measure consisting of two parameters, spectral acceleration and epsilon, is considered. The IM is termed a vector-valued IM, as opposed to the single parameter, or scalar, IMs that are traditionally used. Epsilon (defined as a measure of the difference between the spectral acceleration of a record and the mean of a ground motion prediction equation at the given period) is found to have significant ability to predict structural response. It is shown that epsilon is an indicator of spectral shape, explaining why it is related to structural response. By incorporating this vector-valued IM with a vector-valued ground motion hazard, we can predict the mean annual frequency of exceeding a given value of maximum interstory drift ratio, or other such response measure. It is shown that neglecting the effect of epsilon when computing this drift hazard curve leads to conservative estimates of the response of the structure. These observations should perhaps affect record selection in the future. Copyright © 2005 John Wiley & Sons, Ltd. [source] Diagnosis Clusters for Emergency MedicineACADEMIC EMERGENCY MEDICINE, Issue 12 2003Debbie A. Travers RN Objectives: Aggregated emergency department (ED) data are useful for research, ED operations, and public health surveillance. Diagnosis data are widely available as The International Classification of Diseases, version, 9, Clinical Modification (ICD-9-CM) codes; however, there are over 24,000 ICD-9-CM code-descriptor pairs. Standardized groupings (clusters) of ICD-9-CM codes have been developed by other disciplines, including family medicine (FM), internal medicine (IM), inpatient care (Agency for Healthcare Research and Quality [AHRQ]), and vital statistics (NCHS). The purpose of this study was to evaluate the coverage of four existing ICD-9-CM cluster systems for emergency medicine. Methods: In this descriptive study, four cluster systems were used to group ICD-9-CM final diagnosis data from a southeastern university tertiary referral center. Included were diagnoses for all ED visits in July 2000 and January 2001. In the comparative analysis, the authors determined the coverage in the four cluster systems, defined as the proportion of final diagnosis codes that were placed into clusters and the frequencies of diagnosis codes in each cluster. Results: The final sample included 7,543 visits with 19,530 diagnoses. Coverage of the ICD-9-CM codes in the ED sample was: AHRQ, 99%; NCHS, 88%; FM, 71%; IM, 68%. Seventy-six percent of the AHRQ clusters were small, defined as grouping <1% of the diagnosis codes in the sample. Conclusions: The AHRQ system provided the best coverage of ED ICD-9-CM codes. However, most of the clusters were small and not significantly different from the raw data. [source] Molecular Genetic Study on Angelman Syndrome Patients without a Chromosomal DeletionEPILEPSIA, Issue 2000Shinji Saitoh Purpose: Angelman syndrome (AS) is a ncurobehavioral disorder characterized by severe mental retardation, easily cvoked laughter, ataxic gait, and epilepsy. Epilepsy associated with AS is characterized by early childhood onset gencralized seizures with profound EEG abnormalities. Therefore, AS is a good human model for genetic epilepsy syndromes. Approximately 70% of AS cases are caused by maternal deletions of chromosomc 15q I I-qI3; whereas, 30% are not associated with a chromosomal dcletion. Thcse non-deletion AS patients are caused by paternal uniparental disomy (UPD), imprinting mutation (IM), or loss-or-function mutations of the UBE3A gene, cach of which predisposes different recurrence risk. To elucidate molecular etiology of non-dclction AS patients, we investigated 34 AS patients without a chromosomal deletion. Methods: Thirty sporadic AS patients, and 4 familial AS patients (2 families of 2 sibs) were enrolled to the study. The diagnosis of AS was based on Williams' criteria (Williams et al., Am J Med Genet 1995, 56: 237). Genomic DNA was extracted from peripheral blood by a standard procedure. DNA mcthylation tcst at SNRPN locus and genotyping using 7 highly informative PCR-based polymorphisms within 15q I I - q I3 were carried out to identify UPD and IM. When both UPD and IM were ruled out, the patients were classified :LS non-UPD, non-IM. For thcsc non-UPD, non-1M paticnts, UBE3A mutations were screened by PCR-SSCP analysis using 10 sets ofprimcrs covering all coding exons. Results: Among 30 sporadic patients, I UPD and 3 IM patients were identified, and the remaining 26 patients were classified as non-UPD, non-IM. Among 4 familial patients, 2 sibs from I family were detected as IM, whcrcas 2 sibs from another family were classified as non-UPD, non-IM. No UBE3A mutations were identified within 26 sporadic and 2 familial non-UPD, non-IM patients. Conclusion: Threc molecular classes were identified for noindeletion AS patients. Therefore, the underlying genetic mechanism was dcmonstratcd to be complex for AS patients without a chromosomal deletion. Combination of the DNA methylation test and PCR-based polymorphisms was sufficient to detect UPD and IM patients. Because recurrence risk is low for UPD and high lor IM, systematic molecular investigation including the DNA methylation test and PCR-based polymorphisms should bc donc for non-delction AS paticnts for genetic counscling purpose. A majority of non-deletion patients were classified as noii-UPD, non-1M. Although, approximate 30% of non-UPD, nonIM patients arc rcportcd to have UBE3A mutations, no such mutations were identified in our study. An underlying molecular mechanism was not rcvealcd for this group of patients, and therefore, assessment of recurrence risk was difficult. Further investigation is necessary for noii-UPD, non-1M paticnts. [source] Eating disorders in females with type 1 diabetes: an update of a meta-analysisEUROPEAN EATING DISORDERS REVIEW, Issue 4 2002Søren Nielsen Abstract Objective: Firstly to provide a quantitative summary of existing studies on the occurrence of eating disorders (ED) in females with type 1 diabetes (IDDM), with the focus on retinopathy and insulin misuse for the different eating disorders. Secondly to disseminate knowledge about useful statistical tools. Research Design and Methods: Data were extracted from the relevant case,control and follow-up studies. Odds ratios (OR) and risk differences (RD) were the main effect sizes analysed. Analyses were based on ,exact' methods as many studies are sparse. Data and findings are presented in sufficient detail for re-analysis. Results: An hypothesis of an increase in Anorexia Nervosa (AN) in IDDM is not supported by existing evidence. Bulimia Nervosa is increased (OR,=,2.9 (95%CI: 1.03 to 8.4); pOR,=,0.04) in IDDM. Both ED-NOS and subthreshold ED is increased (OR ,2; pOR,<,0.001) in females with IDDM. Co-existing ED in IDDM increases the overall common OR for retinopathy to 4.8 (95%CI: 3.0 to 7.8); pOR,<,0.00001, and the overall mean RD is 33% (95%CI: 25% to 42%); pRD,<,0.001. Insulin misuse (IM) is increased when ED co-exists with IDDM: OR 12.6 (95%CI: 7.8 to 21.1); pOR,<,0.00001, and mean RD is 40% (95%CI: 29% to 50%); pRD,<,0.001. Conclusions: ED-NOS and subthreshold ED seem to be the quantitatively most important EDs in type 1 diabetic females. Mismanagement of diabetes in the form of IM is frequent in eating disordered IDDM probands. Early occurrence of retinopathy and other complications is an increased risk in concurrent cases, as is premature death. The implications of Binge Eating Disorder (BED) and overweight needs to be elucidated for both type 1 and type 2 diabetes. Copyright © 2002 John Wiley & Sons, Ltd and Eating Disorders Association. [source] Allogeneic haematopoietic cell transplantation for chronic myelogenous leukaemia in the era of imatinib: a retrospective multicentre studyEUROPEAN JOURNAL OF HAEMATOLOGY, Issue 1 2006Martin Bornhäuser Abstract:,Objective:,To analyse the results of allogeneic haematopoietic cell transplantation (HCT) in patients with advanced stages of Philadelphia chromosome-positive chronic myelogenous leukaemia (CML) who had previously been treated with imatinib mesylate (IM). Methods:,We analysed the outcome of 61 patients with CML who had received allogeneic HCT from sibling (n = 18) or unrelated (n = 43) donors after having been treated with IM. Forty-one patients had received IM because of accelerated or blast phase CML. Conditioning therapy contained standard doses of busulfan (n = 25) or total-body irradiation (n = 20) in conjunction with cyclophosphamide in the majority of cases. Sixteen patients received dose-reduced conditioning with fludarabine-based regimens. Results:,The incidence of grades II,IV and III,IV graft-versus-host disease was 66% and 38% respectively. The probability of overall survival (OS), disease-free survival (DFS) and relapse at 18 months for the whole patient cohort were 37%, 33% and 24% respectively. The probability of non-relapse mortality (NRM) at 100 d and 12 months was 30% and 46% respectively. Univariate analysis showed that fludarabine-based conditioning therapy, age ,40 yr and >12 months interval between diagnosis and transplantation were associated with a significantly lower OS and DFS and a higher NRM. Conclusion:,These data suggest that although pretreatment with IM is not an independent negative prognostic factor, it cannot improve the dismal prognosis of CML patients at high risk for transplant-related mortality. [source] Assessment of peripheral blood lymphocyte subsets in idiopathic myelofibrosisEUROPEAN JOURNAL OF HAEMATOLOGY, Issue 2 2000Francisco Cervantes Abstract: The objective of this study was to contribute to a better characterization of the immunological profile of idiopathic myelofibrosis (IM) at presentation by analysing the blood lymphocyte subsets and their possible correlations with other disease features. Absolute blood lymphocytes and lymphocyte subsets were assessed in 31 IM patients, compared with those from 34 healthy individuals, and correlated with the patients' main clinical, hematological and bone marrow histologic features. The mean lymphocyte count of the IM patients was 1.1 (SD 0.6)×109/L, versus 1.6 (SD 0.49)×109/L in controls (p=0.0006), with 24 of the 31 patients (77.4%) showing lymphocytopenia (<1.5×109/L). IM patients had significantly lower counts of CD3, CD4, CD8, and CD3,/CD56+ cells, and significantly higher CD3+/CD56+ lymphocyte counts. Although no significant differences were found between patients and controls with regard to CD19+/CD5+ cell counts, increased CD5+ B-cell lymphocytes were observed in three IM patients. In one of the latter patients, Ig gene rearrangement analysis of the heavy chain gene demonstrated such a subpopulation to be clonal, but the patient did not develop features of chronic lymphoid leukemia during a 5-yr follow-up. No correlation was found between the patients' blood lymphocyte counts and other disease features. We conclude that most IM patients have absolute lymphopenia, decreased T cells and increased cytotoxic T cells at diagnosis, and 10% of them show an increased CD5+ B-cell subpopulation. [source] Influence of silica gel in production of diacylglycerol via enzymatic glycerolysis of palm oleinEUROPEAN JOURNAL OF LIPID SCIENCE AND TECHNOLOGY, Issue 6 2009Chiou Moi Yeoh Abstract Enzymatic glycerolysis was explored in this paper for the production of diacylglycerol (DAG) oils from palm olein. Three commercial enzymes, Lipozyme TL,IM, Lipozyme RM,IM and Novozym 435 were used for their ability to synthesize DAG in a solvent-free system. Novozym 435 was found to be the more effective enzyme, resulting in a high DAG production even in the absence of an adsorbent such as silica gel. The yields of DAG were between 43 and 50,wt-%. Lipozyme TL,IM and RM,IM, being supported on hydrophilic materials, require an adsorbent to allow slow release of glycerol for reaction with the enzyme and oil. In the absence of silica, no reaction was observed. The success of the reaction is therefore very dependent on the amount of silica used. The yields of DAG using Lipozyme TL,IM and RM,IM were 52 and 45,wt-%, respectively. In addition, the degree of reduction in tocopherols and tocotrienols appeared correlated with the efficacy of the glycerolysis reaction. Changes in the slip melting points and solid fat contents of the products are indicative of the reaction occurring. [source] Structured lipids from rice bran oil and stearic acid using immobilized lipase from Rhizomucor mieheiEUROPEAN JOURNAL OF LIPID SCIENCE AND TECHNOLOGY, Issue 1 2008Rajni Chopra Abstract The major objective of the present study was to prepare structured lipids rich in stearic acid from rice bran oil (RBO) using immobilized lipase (IM,60) from Rhizomucor miehei. The effects of incubation time and temperature, substrate molar ratio, and enzyme load on incorporation of stearic acid were studied. Acidolysis reactions were performed in hexane. Pancreatic lipase-catalyzed sn -2 positional analysis and tocopherol analyses were performed before and after enzymatic modification. The kinetics of the reaction was studied and maximum incorporation of stearic acid was observed at 6,h, at 37,°C, when the triacylglycerol and stearic acid molar ratio was maintained at 1,:,6 and the enzyme concentration was 10% of total substrates weight. Stearic acid in RBO after acidolysis was increased from 2.28 to 48.5%, with a simultaneous decrease in palmitic, oleic and linoleic acids. HPLC analysis of tocopherols and tocotrienols was carried out and their content in modified RBO was not significantly affected compared to that of native RBO. The oryzanol content of the modified RBO was reduced from 1.02 to 0.68%. Melting and crystallizing characteristics of the modified fat were studied using differential scanning calorimetry. The total solid fat content at 25,°C increased from 26.12 to 34.8% with an increase in stearic acid incorporation into RBO from 38 to 48%, but it was comparatively less than for cocoa butter and vanaspati. However, the modified RBO completely melted at 37,°C and was useful as plastic fat for various culinary purposes, bakery and confectionary applications. The results of the present study indicated that structured lipids prepared from RBO rich in stearic acid retained their beneficial nutraceuticals; in addition, they do not contain any trans fatty acids. [source] Quality of life in 1000 patients with early relapsing,remitting multiple sclerosisEUROPEAN JOURNAL OF NEUROLOGY, Issue 6 2009N. Putzki Background and purpose:, To examine the quality of life (QoL) in a large cohort of untreated patients with relapsing,remitting multiple sclerosis (RRMS) and to investigate the impact of intramuscular (IM) interferon beta-1a (IFNß-1a) treatment. Methods:, Prospective, observational, open-label, multicentre study conducted in Germany. Untreated patients with RRMS who initiated treatment with IM IFNß-1a were included and followed for 12 months. QoL was measured using the EQ-5D questionnaire. Clinical response was assessed by relapse rate and disability (Expanded Disability Status Scale; EDSS). Results:, A total of 1157 patients were included [mean age 37.6 years, median disease duration 13 months, mean relapse rate 1.7 (95%CI: 1.58,1.73), median EDSS score 2.0]. Relapse rate was reduced to 0.6 at 12 months (95%CI: 0.51,0.69, P < 0.0001). EDSS did not change significantly. At baseline, QoL was considerably lower in MS patients compared with the general German population, but was improved after treatment initiation [utilities of EQ-5D: 0.77 (95%CI: 0.75,0.78) vs. 0.75 (95%CI: 0.74,0.76) at baseline, 95%CI for difference: 0.01,0.03, P = 0.0046]. Higher disease activity and inability to work were negative predictors of QoL. 14.7% of patients were incapable of working for MS-related reasons. Conclusions:, Quality of life is considerably impaired in early stages of MS. Treatment initiation with IM IFNß attenuates MS disease activity and improves QoL. Inability to work early during the disease is a major challenge for the social security systems. [source] Fatigue life expenditure assessment and countermeasure for turbine blades due to harmonic excitations of slip energy recovery drivesEUROPEAN TRANSACTIONS ON ELECTRICAL POWER, Issue 8 2009Jong-Ian Tsai Abstract The long-term effect of noncharacteristic harmonic currents arising from a slip energy recovery drive (SERD) on the fatigue life expenditure in turbine-generator blades is presented in this paper. Since the SERD converter can be rated at a fraction of a motor due to its static converter cascade with the wound-rotor and with high efficiency characteristics, still the feedwater pumps (FPs) in a few power plants are driven by such an induction motor (IM) drive. However, because the frequencies of the three main harmonic terms of the recovery currents are subsynchronous and offer a probability distribution due to the adjustable speed operation, a systematic fatigue estimation approach was devised by the author to investigate the long-term impact for the low-pressure (LP) turbine blades. From the simulation results, it was found that such a long-term harmonic excitation becomes a cause of turbine blade failure for single generator connected to the SERD system, even though the amplitude of these harmonic currents is normal. By the effect analysis of uncertainty, the countermeasure for the turbine integrity was then found. Copyright © 2008 John Wiley & Sons, Ltd. [source] MULTILOCUS ANALYSES OF ADMIXTURE AND INTROGRESSION AMONG HYBRIDIZING HELICONIUS BUTTERFLIESEVOLUTION, Issue 6 2006Marcus R. Kronforst Abstract Introgressive hybridization is an important evolutionary process and new analytical methods provide substantial power to detect and quantify it. In this study we use variation in the frequency of 657 AFLP fragments and DNA sequence variation from 15 genes to measure the extent of admixture and the direction of interspecific gene flow among three Heliconius butterfly species that diverged recently as a result of natural selection for Müllerian mimicry, and which continue to hybridize. Bayesian clustering based on AFLP genotypes correctly delineated the three species and identified four H. cydno, three H. pachinus, and three H. melpomene individuals that were of mixed ancestry. Gene genealogies revealed substantial shared DNA sequence variation among all three species and coalescent simulations based on the Isolation with Migration (IM) model pointed to interspecific gene flow as its cause. The IM simulations further indicated that interspecific gene flow was significantly asymmetrical, with greater gene flow from H. pachinus into H. cydno (2Nm 5 4.326) than the reverse (2Nm 5 0.502), and unidirectional gene flow from H. cydno and H. pachinus into H. melpomene (2Nm 5 0.294 and 0.252, respectively). These asymmetries are in the directions expected based on the genetics of wing patterning and the probability that hybrids of various phenotypes will survive and reproduce in different mimetic environments. This empirical demonstration of extensive interspecific gene flow is in contrast to a previous study which found little evidence of gene flow between another pair of hybridizing Heliconius species, H. himera and H. erato, and it highlights the critical role of natural selection in maintaining species diversity. Furthermore, these results lend support to the hypotheses that phenotypic diversification in the genus Heliconius has been fueled by introgressive hybridization and that reinforcement has driven the evolution of assortative mate preferences. [source] Comparison of Routes of Flumazenil Administration to Reverse Midazolam-induced Respiratory Depression in a Canine ModelACADEMIC EMERGENCY MEDICINE, Issue 5 2000Melanie S. Heniff MD ABSTRACT Objective: To determine whether flumazenil, a drug used to reverse benzodiazepine-induced respiratory depression and approved only for IV use, is effective by alternative routes. Methods: A randomized, controlled, nonblinded, crossover canine trial was performed to evaluate reversal of midazolam-induced respiratory depression by flumazenil when administered by alternative routes. Mongrel dogs were sedated with thiopental 19 mg/kg IV, then tracheally intubated. With the dogs spontaneously breathing, tidal volume, end-tidal CO2, and O2 saturation were observed until a stable baseline was achieved. Incremental doses of midazolam were administered until respiratory depression (30% decline in tidal volume, 10% decrease in O2 saturation, and 15% increase in end-tidal CO2) occurred. Flumazenil was administered by a randomly selected route [0.2 mg followed 1 minute later by 0.3 mg IV, sublingual (SL) or intramuscular (IM); or 1 mg followed 1 minute later by 1.5 mg per rectum (PR)]. Time to return to baseline respiratory functions was recorded ("time to reversal"). Each of 10 dogs was studied using all 4 routes of flumazenil administration with a washout period of at least 7 days. An additional dog served as a control (no flumazenil). Results: The control time to reversal was 1,620 seconds. The IV route was significantly faster (mean 120 ± 24.5 sec) than the other 3 routes (p < 0.005). The SL route was the second fastest (mean 262 ± 94.5 sec), the IM route was the third fastest (mean 310 ± 133.7 sec), and the PR route was the slowest (mean 342 ± 84.4 sec). The SL, IM, and PR routes did not differ significantly from one another. Conclusions: Flumazenil administered by all 4 routes reversed midazolam-induced respiratory depression in a dog model. For the selected dosages used, the IV route was significantly faster than all 3 other routes, and SL was the second fastest. [source] Evaluation of gastric toxicity of indomethacin acid, salt form and complexed forms with hydroxypropyl-,-cyclodextrin on Wistar rats: histopathologic analysisFUNDAMENTAL & CLINICAL PHARMACOLOGY, Issue 6 2009A.C. Ribeiro-Rama Abstract Indomethacin (IM) is a non-steroidal anti-inflammatory drug which inhibits prostaglandin biosynthesis. It is practically insoluble in water and has the capacity to induce gastric injury. Hydroxypropyl-,-cyclodextrin (HP-,-CD) is an alkylated derivative of ,-CD with the capacity to form inclusion complexes with suitable molecules. IM is considered to form partial inclusion complexes with HP-,-CD by enclosure of the p -chlorobenzoic part of the molecule in the cyclodextrin channel, reducing the adverse effects. The aim of this paper is to evaluate the gastric damage induced by the IM inclusion complex prepared by freeze-drying and spray-drying. A total of 135 Wistar rats weighing 224.4 ± 62.5 g were put into 10 groups. They were allowed free access to water but were maintained fasted for 18 h before the first administration until the end of the experiment. IM acid-form, IM trihydrated-sodium-salt and IM-HP-,-CD spray and freeze-dried, at normal and toxic doses, were administered through gastric cannula once/day for 3 days. Seventy-two hours after the first administration, the animals were sacrificed and the stomachs collected and prepared for morphological study by using the haematoxylin-eosin technique. Lesion indexes (rated 0/4) were developed and the type of injury was scored according to the severity of damage and the incidence of microscopic evidence of harm. Microscopic assessment demonstrated levels of injury with index one on 10,25%. The type of complexation method had different incidence but the same degree. The results show that IM inclusion complexation protects against gastric injury, reducing the incidence and the maximum degree of severity from 4 to 1, with a better performance of the spray-dried complex. [source] Biopsy Strategies for Endoscopic Surveillance of Pre-malignant Gastric LesionsHELICOBACTER, Issue 4 2010Annemarie C. De Vries Abstract Background:, Endoscopic surveillance of pre-malignant gastric lesions may add to gastric cancer prevention. However, the appropriate biopsy regimen for optimal detection of the most advanced lesions remains to be determined. Therefore, we evaluated the yield of endoscopic surveillance by standardized and targeted biopsy protocols. Materials and Methods:, In a prospective, multi-center study, patients with intestinal metaplasia (IM) or dysplasia (DYS) underwent a surveillance gastroscopy. Both targeted biopsies from macroscopic lesions and 12 non-targeted biopsies according to a standardized protocol (antrum, angulus, corpus, cardia) were obtained. Appropriate biopsy locations and the yield of targeted versus non-targeted biopsies were evaluated. Results:, In total, 112 patients with IM (n = 101), or low-grade (n = 5) and high-grade DYS (n = 6) were included. Diagnosis at surveillance endoscopy was atrophic gastritis (AG) in one, IM in 77, low-grade DYS in two, high-grade DYS in three, and gastric cancer in one patient. The angulus (40%), antrum (35%) and lesser curvature of the corpus (33%) showed the highest prevalence of pre-malignant conditions. Non-targeted biopsies from the lesser curvature had a significantly higher yield as compared to the greater curvature of the corpus in diagnosing AG and IM (p = .05 and p = .03). Patients with extensive intragastric IM, which was also present at the cardia were at high risk of a concurrent diagnosis of dysplasia or gastric cancer. High-grade DYS was detected in targeted biopsies only. Conclusions:, At surveillance endoscopies, both targeted and non-targeted biopsies are required for an appropriate diagnosis of (pre-)malignant gastric lesions. Non-targeted biopsies should be obtained in particular from the antrum, angulus and lesser curvature of the corpus. [source] Validation of Diagnostic Tests for Helicobacter pylori with Regard to Grade of Atrophic Gastritis and/or Intestinal MetaplasiaHELICOBACTER, Issue 6 2009Cheol Min Shin Abstract Background and Aims:, To evaluate the validity of the biopsy-based tests (histology, culture, and urease test) and serology in detecting current Helicobacter pylori infection against a background of atrophic gastritis (AG) or intestinal metaplasia (IM). Methods:,Helicobacter pylori infection was diagnosed in 651 subjects, using the predefined gold standard for H. pylori tests. The sensitivity, specificity, and positive and negative predictive values of culture, CLOtest, histology (Giemsa stain), and serology were calculated with regard to the histological grade of AG and IM. The level of serum pepsinogen (PG) I and II was also measured as a marker for the presence of AG. Results:, In the study population (n = 651), sensitivity and specificity, respectively, were as follows: culture, 56.2 and 100%; histology, 93.0 and 94.0%; CLOtest, 80.4 and 96.7%; serology, 96.0 and 67.5%. If the analysis is limited to those without AG or IM (n = 158) or to those younger than 40 years (n = 69), all tests, except for culture, had a sensitivity and specificity >90%. The sensitivity of CLOtest and the specificity of serology markedly decreased with progression of AG and IM, and serology was less specific in the presence of AG, as determined by a PG I/II ratio ,4.1 (specificity, 83.7% vs 40.7% in PG I/II >4.1 and ,4.1, respectively). Conclusions:, Any one of biopsy-based tests or serology was found to be excellent for identifying current H. pylori infection among individuals without AG or IM and/or younger patients (<40 years). However, a combination of at least two tests is necessary in the clinical setting of AG or IM. [source] Serum Levels of Leptin As Marker For Patients At High Risk of Gastric CancerHELICOBACTER, Issue 6 2009Lisette G. Capelle Abstract Background:, Serological screening for gastric cancer (GC) may reduce mortality. However, optimal serum markers for advanced gastric precursor lesions are lacking. Aim:, To evaluate in a case,control study whether serum leptin levels correlate with intestinal metaplasia (IM) and can serve as a tool to identify patients at high risk for GC. Materials and Methods:, Cases were patients with a previous diagnosis of IM or dysplasia, controls were patients without such a diagnosis. All patients underwent endoscopy. Fasting serum was collected for the measurement of leptin, pepsinogens I/II, gastrin, and Helicobacter pylori. Receiver operating characteristic (ROC) curves and their area under the curve (AUC) were provided to compare serum leptin levels with other serological markers. Results:, One hundred nineteen cases and 98 controls were included. In cases, the median leptin levels were 116.6 pg/mL versus 81.9 pg/mL in controls (p = .01). After adjustment for age, sex and BMI, leptin levels remained higher in cases than in controls (p < .005). In multivariate analysis, male sex (p = .002), age (<0.001), low pepsinogen levels (p = .004) and high leptin levels (p = .04) were independent markers for the presence of IM. In addition, a ROC curve including age, sex and pepsinogen I levels had an AUC of 0.79 (95% CI (0.73,0.85)). Adding serum leptin levels increased the AUC to 0.81 (95% CI (0.75,0.86)). Conclusions:, High leptin levels are associated with an increased risk of IM. Moreover, serum leptin levels are a significant independent marker for the presence of IM. However, in combination with the serological test for pepsinogen I the additional value of serum leptin levels is rather limited. [source] Therapeutic targets in chronic myeloid leukaemiaHEMATOLOGICAL ONCOLOGY, Issue 2 2007Nicholas B. Heaney Abstract Chronic myeloid leukaemia (CML) is a clonal disorder of the haemopoietic stem cell arising as a consequence of the formation of the bcr-abl oncogene. The particular molecular basis of this condition has enabled the development of therapies that selectively target diseased cells. The success of the rationally designed first-line therapy imatinib mesylate (IM) is tempered by the problems of disease persistence and resistance. Novel strategies have been identified to take forward therapy in CML and these will be discussed in this review. This work is generated from a review of published literature and contains particular insight into the work performed by our group in this field. Copyright © 2007 John Wiley & Sons, Ltd. [source] A randomized study of adefovir dipivoxil in place of HBIG in combination with lamivudine as post,liver transplantation hepatitis B prophylaxis,HEPATOLOGY, Issue 5 2008Peter W. Angus Prior to effective prophylaxis, liver transplantation for hepatitis B virus (HBV)-related disease was frequently complicated by recurrence, which could be severe and rapidly progressive. Combination hepatitis B immunoglobulin (HBIG) and lamivudine prophylaxis reduces this rate of recurrence to <5% at 5 years; however, HBIG administration is costly and inconvenient. We conducted a multicenter randomized study of adefovir dipivoxil substitution for low-dose intramuscular (IM) HBIG in patients without HBV recurrence at least 12 months posttransplantation for HBV-related disease. Thirty-four patients were randomized, 16 to adefovir (1 patient withdrew consent at 3 months and is not considered in the results) and 18 to continue HBIG. All continued lamivudine. Groups were well matched by age, sex, and time since transplantation (median, 4.5 years), and background virological risk for HBV recurrence (30% of patients in the adefovir group, 24% in the HBIG group having detectable HBV DNA at transplantation). All patients were alive at study completion without recurrence. One patient in the adefovir group became hepatitis B surface antigen,positive at 5 months but was persistently HBV DNA undetectable via polymerase chain reaction (sensitivity 14 IU/mL) over the following 20 months. Median creatinine was not significantly changed over the course of the study in either group. One patient in the adefovir group with a background of diabetic and hypertensive nephropathy (baseline creatinine 150 ,mol/L) developed increased creatinine leading to dose reduction and ultimately cessation of adefovir at 15 months. Yearly cost of combination adefovir/lamivudine prophylaxis was $8,290 versus $13,718 IM HBIG/lamivudine. Conclusion: Compared with combination HBIG plus lamivudine prophylaxis, combination adefovir plus lamivudine provides equivalent protection against recurrent HBV infection but with better tolerability and less cost. (HEPATOLOGY 2008.) [source] PHOTOGRAPHS, SYMBOLIC IMAGES, AND THE HOLOCAUST: ON THE (IM)POSSIBILITY OF DEPICTING HISTORICAL TRUTHHISTORY AND THEORY, Issue 2 2009JUDITH KEILBACH ABSTRACT Photography has often been scrutinized regarding its relationship to reality or historical truth. This includes not only the indexicality of photography, but also the question of how structures and processes that comprise history and historical events can be depicted. In this context, the Holocaust provides a particular challenge to photography. As has been discussed in numerous publications, this historic event marks the "limits of representation." Nevertheless there are many photographs "showing" the Holocaust that have been produced in different contexts that bespeak the photographers' gaze and the circumstances of the photographs' production. Some of the pictures have become very well known due to their frequent reproduction, even though they often do not show the annihilation itself, but situations different from that; their interpretation as Holocaust pictures results rather from a metonymic deferral. When these pictures are frequently reproduced they are transformed into symbolic images, that is, images that can be removed from their specific context, and in this way they come to signify abstract concepts such as "evil." Despite being removed from their specific context these images can, as this essay argues, refer to historical truth. First, I explore the arguments of some key theorists of photography (Benjamin, Kracauer, Sontag, Barthes) to investigate the relationship between photography and reality in general, looking at their different concepts of reality, history, and historical truth, as well as the question of the meaning of images. Second, I describe the individual circumstances in which some famous Holocaust pictures were taken in order to analyze, by means of three examples, the question what makes these specific pictures so particularly suitable to becoming symbolic images and why they may,despite their abstract meaning,be able to depict historical truth. [source] | |||||||||||||||||||||||||||||||||||||||||||