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Distribution within Medical Sciences

Kinds of Liss

  • wiley liss

  • Selected Abstracts

    A universal metric for sequential MIMO detection,

    Christian Kuhn
    Conventionally, detection in multiple-antenna systems is based on a tree-search or a lattice-search with a metric that can be computed by recursively accumulating the corresponding metric increments for a given hypothesis. For that purpose, a multiple-antenna detector traditionally applies a preprocessing to obtain the search-metric in a suitable form. In contrast to that, we present a reformulation of the search-metric that directly allows for an appropriate evaluation of the metric on the underlying structure without the need for a computationally costly preprocessing step. Unlike the traditional approach, the new metric can also be applied when the system has fewer receive than transmit antennas. We present simulation results in which the new metric is applied for turbo detection involving the list-sequential (LISS) detector that was pioneered by Joachim Hagenauer. Copyright 2007 John Wiley & Sons, Ltd. [source]

    An effective strategy for legacy systems evolution

    Maseud Rahgozar
    Abstract A large number of organizations depend on the business-critical information systems for their daily activities that have been developed over the last two decades or more. These systems are called Legacy Information Systems (LISs). They mostly run on old software and hardware technology tools and environments. They are hard to modify, expensive to maintain and difficult to integrate with new technology tools and programs. They need to be evolved into modern environments. The LIS modernization is a long outstanding problem of the IT community. This paper presents a classification of current approaches to this problem and suggests guidelines and a methodology for an optimal solution based on many years of professional experiences of the authors in this area. Parts of this methodology have been implemented and tested in many migration projects and they have proven to be effective. This approach optimizes the time, the human resources and the global costs and reduces the risk factors and side effects of renovation projects by developing migration tools once per platform. Copyright 2003 John Wiley & Sons, Ltd. [source]

    NMR-based analysis of structure of heteroleptic triple-decker (phthalocyaninato) (porphyrinato) lanthanides in solutions

    Kirill P. Birin
    Abstract A novel approach for the structural analysis of heteroleptic triple-decker (porphyrinato)(phthalocyaninato) lanthanides(III) in solutions is developed. The developed approach consists in molecular mechanics (MM+) optimization of the geometry of the complex taking into account the lanthanide-induced shift (LIS) datasets. LISs of the resonance peaks in 1H NMR spectra of a series of symmetric complexes [An4P]Ln[(15C5)4Pc]Ln[An4P], where An4P2, is 5,10,15,20-tetrakis(4-methoxyphenyl)porphyrinato-dianion, [(15C5)4Pc]2, is 2,3,9,10,16,17,24,25-tetrakis(15-crown-5)phthalocyaninato-dianion and Ln = La, Ce, Pr, Nd, Sm, Eu, are analyzed. Analysis of LISs showed two sets of protons in the molecule with opposite signs of shift. Two-nuclei analysis of LISs testifies isostructurality of the whole series of investigated complexes in solution despite contraction of the lanthanide ions. Model-free separation of contact and dipolar contributions of LISs was performed with one-nucleus technique and did not show changes in contact and dipolar terms within the investigated series. MM+ optimization of the molecular structure allowed the interpretation of features of LIS for each particular group of protons. Parameterization of MM + -optimized model of molecule with values of structure-dependent dipolar contributions of LIS allows the development of the precise structural model of the triple-decker complex in solution. This approach allows the determination of the geometry and structure of the sandwich macrocyclic tetrapyrrolic complexes together with conformational analysis of flexible peripheral substituents in solutions. The developed method can be applied with minor modifications for the determination of structural parameters of other types of lanthanides(III) complexes with tetrapyrrolic ligands and also supramolecular systems based on them. Copyright 2010 John Wiley & Sons, Ltd. [source]

    Demographic and clinical characteristics of motor vehicle accident victims in the community general health outpatient clinic: a comparison of PTSD and non-PTSD subjects

    Marina Kupchik M.D.
    Abstract Motor vehicle accidents (MVAs) are the leading cause of posttraumatic stress disorder (PTSD) in the general population, often with enduring symptomatology. This study details epidemiological and clinical features that characterize PTSD among MVA victims living in a nonhospitalized community setting long after the MVA event, and includes exploration of premorbid and peritraumatic factors. MVA victims (n=60; 23 males, 37 females) identified from the registry of a community general health outpatient clinic during a 7-year period were administered an extensive structured battery of epidemiological, diagnostic and clinical ratings. Results indicated that 30 subjects (50%; 12 males, 18 females) had MVA-related PTSD (MVAR-PTSD). Among those with PTSD, 16 individuals exhibited PTSD in partial remission, and six, in full remission. There were no significant demographic or occupational function differences between PTSD and non-PTSD groups. The most common comorbid conditions with MVAR-PTSD were social phobia (20%), generalized anxiety disorder (7.8%) and obsessive,compulsive disorder (0.5%). Previous MVA's were not predictive of PTSD. Subjects with MVAR-PTSD scored worse on the Clinician-Administered Posttraumatic Stress Disorder Scale, Part 2 (CAPS-2), Impact of Event Scale, Hamilton Depression Rating Scale, Hamilton Anxiety Rating Scale, Impulsivity Scale, and Toronto Alexithymia Rating Scale. Study observations indicate a relatively high rate of PTSD following an MVA in a community-based sample. The relatively high rate of partially remitted MVAR-PTSD (N=16) underscores the importance of subsyndromal forms of illness. Alexithymia may be an adaptive method of coping with event stress. The development of PTSD appears not to be associated with the severity of MVA-related physical injury. Depression and Anxiety 24:244,250, 2007. 2006 Wiley,Liss, Inc. [source]

    Granular cell tumor of the neurohypophysis: Report of a case with intraoperative cytologic diagnosis

    Maria Luisa C. Policarpio-Nicolas M.D.
    Abstract Cytological techniques including touch and smear preparations are very useful diagnostic modality in the evaluation of central nervous system (CNS) lesions and, in many instances, may be effectively used as the sole modality of tissue preparation for intraoperative consultation. Cytologic preparations offer many advantages over frozen sections for CNS specimens. These include selective examination of multiple areas from small biopsy specimens, superior preservation and details of cellular morphology, fewer artifacts, faster results, and improved cost-effectiveness. We describe the cytologic diagnosis of a granular cell tumor (GCT) of the neurohypophysis in a 33-year-old male who presented with headache and blurred vision. CT scan revealed an enlarged sella with a 2.15 2.0 cm pituitary lesion. Transsphenoidal resection of the mass was performed and submitted for intraoperative consultation. Smears and touch preparations were made on a portion of the mass that showed uniform polygonal cells with round to ovoid nuclei and abundant eosinophilic granular cytoplasm. An intraoperative cytological diagnosis of "favor GCT" was rendered. The histologic sections of the remaining material confirmed the diagnosis. Although GCT of the neurohypophysis is very rare, a specific intraoperative cytological diagnosis is possible. We report the clinical, cytological, and pathological findings of a GCT affecting the neurohypophysis. Diagn. Cytopathol. 2008;36:58,63. 2007 Wiley,Liss, Inc. [source]

    Fine-needle aspiration of soft tissue leiomyosarcoma: An analysis of the most common cytologic findings and the value of ancillary techniques

    Henryk A. Domanski M.D., Ph.D.
    Abstract This study aims to determine the diagnostic accuracy of fine-needle aspiration cytology (FNAC) of primary leiomyosarcoma (LMS) of soft tissue and to review diagnostic criteria and adjunctive methods, which can contribute to a confident diagnosis. We evaluated the preoperative FNAC in 89 patients with primary LMS for the following: cytomorphology and correspondence of FNA to histological features of excised tumors and clinical data. In addition, the utility of adjunctive techniques was analyzed and other spindle-cell lesions in the differential diagnoses were discussed. An unequivocal, malignant diagnosis was rendered by FNAC in 78 cases; 74 tumors were diagnosed as sarcoma, of which 31 as LMS or suspicion of LMS. In addition, three smears were labeled as malignant tumor, one as carcinoma metastasis, and three as neurilemmoma. Seven aspirates were inconclusive and one insufficient. On reevaluation, the diagnostic smears in most cases contained tumor cell fascicles with an admixture of dispersed cells or stripped nuclei. The most common cells were spindle cells with elongated, blunt-ended, segmented or fusiform nuclei, and round/polygonal cells, often with rounded or indented nuclei. In addition, 51 cases showed pleomorphic, often multinucleated cells. Osteoclasts, intranuclear vacuoles, and mitoses occurred in 14, 47, and 27 cases, respectively. Thus, most high-grade LMSs have cytologic features that allow diagnosis of sarcoma. Ancillary studies can confirm the diagnosis of LMS and help in the correct interpretation of predominant spindle-cell or epitheloid-cell smears resembling neurilemoma or carcinoma, respectively. Diagn. Cytopathol. 2006;34:597,604. 2006 Wiley,Liss, Inc. [source]

    K-Ras and microsatellite marker analysis of fine-needle aspirates from intraductal papillary mucinous neoplasms of the pancreas,

    Karen E. Schoedel M.D.
    Abstract Preoperative diagnosis of pancreatic cystic lesions is difficult despite the combination of cytomorphology, radiographic imaging characteristics, and fluid tumor markers such as carcinoembryonic antigen. Intraductal papillary mucinous neoplasms (IPMNs) represent a subset of preinvasive pancreatic cystic neoplasms and are associated with accumulated genetic mutations, especially K-ras and tumor suppressor genes such as p53. Application of molecular techniques to cyst fluid obtained by endoscopic ultrasound guided fine-needle aspiration (EUSFNA) may contribute to preoperative assessment. Sixteen patients with pancreatic cystic lesions had cyst fluid obtained by preoperative pancreatic EUSFNA or intraoperative aspiration. All patients subsequently underwent surgical resection of the pancreas and IPMN was documented in all (6 adenomas, 6 borderline tumors, and 4 carcinomas). DNA was extracted from the cyst fluids and mutational analysis for K-ras point mutations and loss of heterozygosity (LOH) analysis using a preselected panel of genomic loci were performed. LOH was observed in 3 of 4 carcinomas as compared to 4 of 11 adenomas and borderline lesions (1 was QNS). LOH and K-ras mutations were both acquired in 2 of 4 carcinomas and in 1 of 12 adenoma/borderline lesions. Although the study is small, molecular analysis for LOH and K-ras mutations is useful in the preoperative evaluation of cystic pancreatic lesions. Increasing degree of neoplasia appears to correlate with increased genetic abnormality using a panel of selected genomic markers. Diagn. Cytopathol. 2006;34:605,608. 2006 Wiley,Liss, Inc. [source]

    Endometrial glandular and stromal breakdown, part 1: Cytomorphological appearance

    C.M.I.A.C., Keiko Shimizu C.T.
    Abstract Endometrial carcinoma is the most common invasive neoplasm of the female reproductive tract. Early detection and accurate diagnosis of these lesions and its precursor by endometrial cytology is now accepted in Japan and regarded as an effective primary method of evaluating endometrial pathology (atypical hyperplasia or carcinoma). Careful cytomorphologic evaluation of the abnormal endometrial lesions has made possible an accurate and reproducible microscopic assessment. The current study was conducted to determine the significance of endometrial cytology on disordered endometrium associated with anovulation when compared with endometrial hyperplasia. From January 1998 through April 2004, 144 cases on which histopathological diagnoses were obtained by endometrial curettage after taken direct endometrial sample by Endocyte. The materials comprise 49 cases of normal proliferative endometrium, and 63 cases of endometrial hyperplasia without atypia were prepared as control cases. The cytomorphology was examined involving so-called endometrial glandular and stromal breakdown (EGBD). EGBD cases evidenced significant numbers of stromal cells condensed and formed compact nests with hyperchromatic nuclei and little or no cytoplasm. They were often associated with fragmented clusters of endometrial glands with condensed cluster of stromal cells. Both the fragmented cluster of endometrial glands and condensed cluster of stromal cells are a characteristic cytologic feature of EGBD endometrium on the cyto-architectural diagnosis. The combination of these cellular patterns is highly specific to this abnormal pathological condition in EGBD endometrium. To improve the accuracy of the cytodiagnosis, it is important that the cytology of the EGBD endometrium should be diagnosed negative; as a result, we can achieve successful endometrial cytology with cyto-architectural criteria for the endometrial pathology. Diagn. Cytopathol. 2006;34:609,613. 2006 Wiley,Liss, Inc. [source]

    In Situ Observation of Dynamic Recrystallization in the Bulk of Zirconium Alloy (Adv. Eng.

    The cover shows the in-situ diffraction setup. A fine synchrotron beam transmits the sample situated in a (heated) load frame and scatters into Debye-Scherrer cones. Large crystallites map onto spots onto the 2D detector rather than continuous rings. In the background, the intensity distribution of one selected reflection - here beta-Zr 110 - is plotted in color scale as a function of azimuthal angle (horizontal axis) and time (vertical axis) revealing the different states during thermo-mechanical processing. More details can be found in the article by K.-D. Liss on page 637. [source]

    A critical evaluation of genomic control methods for genetic association studies

    Tony Dadd
    Abstract Population stratification is an important potential confounder of genetic case-control association studies. For replication studies, limited availability of samples may lead to imbalanced sampling from heterogeneous populations. Genomic control (GC) can be used to correct ,2 test statistics which are presumed to be inflated by a factor ,; this may be estimated by a summary ,2 value (,median or ,mean) from a set of unlinked markers. Many studies applying GC methods have used fewer than 50 unlinked markers and an important question is whether this can adequately correct for population stratification. We assess the behavior of GC methods in imbalanced case-control studies using simulation. SNPs are sampled from two subpopulations with intra-continental levels of FST (,0.005) and sampling schemata ranging from balanced to completely imbalanced between subpopulations. The sampling properties of ,median and ,mean are explored using 6,1,600 unlinked markers to estimate Type 1 error and power empirically. GC corrections based on the ,2 -distribution (GCmedian or GCmean) can be anti-conservative even when more than 100 single nucleotide polymorphisms (SNPs) are genotyped and realistic levels of population stratification exist. The GCF procedure performs well over a wider range of conditions, only becoming anti-conservative at low levels of , and with fewer than 25 SNPs genotyped. A substantial loss of power can arise when population stratification is present, but this is largely independent of the number of SNPs used. A literature survey shows that most studies applying GC have used GCmedian or GCmean, rather than GCF, which is the most appropriate GC correction method. Genet. Epidemiol. 2009. 2008 Wiley Liss, Inc. [source]

    Histamine release test and measurement of antigen‐specific IgE antibody in the diagnosis of allergic conjunctival diseases

    Eiichi Uchio
    Abstract Although systemic allergic laboratory tests for the quantification of allergen‐specific serum IgE antibody have been widely used, in these tests a high titer of serum specific IgE does not necessarily indicate evidence of allergy. We evaluated the diagnostic value of the glass microfiber‐based histamine release test (HRT) using small amounts of whole blood, in 36 cases of allergic conjunctival diseases: 17 cases of allergic conjunctivitis and 19 of atopic keratoconjunctivitis. The patients were evaluated by HRT, capsulated hydrolic carrier polymer (CAP)‐RAST, and conjunctival provocation test (CPT) against ten allergens. The positive rates for all allergens were higher in CAP‐RAST than in HRT. The mean concordance of HRT with CAP‐RAST results was 0.789. The mean concordance of HRT with CPT was 0.892 and that of CAP‐RAST with CPT was 0.693. A significantly higher concordance was observed in HRT than CAP‐RAST for Japanese cedar and mite antigen. The mean sensitivity, specificity, and efficiency of HRT were higher than those of CAP‐RAST. These results indicate that CAP‐RAST is good for the screening of allergens and that HRT has an advantage in the confirmation of clinical allergens in allergic conjunctival diseases because of its high sensitivity, specificity, efficiency, and higher concordance with CPT. J. Clin. Lab. Anal. 15:71–75, 2001. © 2001 Wiley‐Liss, Inc. [source]

    Negative interference of bilirubin and hemoglobin in the MEIA troponin I assay but not in the MEIA CK‐MB assay

    Amitava Dasgupta
    Abstract Troponin I is a sensitive and specific marker for the diagnosis of myocardial infarction. Several commercially available immunoassays measure the concentration of troponin I in serum. The microparticle enzyme immunoassay (MEIA) for troponin I (Abbott Laboratories, Abbott Park, IL) is widely used in clinical laboratories, including our hospital laboratory. We studied the effect of bilirubin and hemolysis on the MEIA for troponin I and compared our assay with a newly available chemiluminescent assay (CLIA) for troponin I (Bayer Diagnostics, Tarrytown, NY). We also measured CK‐MB concentration using the MEIA CK‐MB assay. One serum pool was prepared by combining several specimens of one patient with elevated troponin I and with a diagnosis of myocardial infarction. Other serum pools were prepared by combining sera with similar troponin I values. All serum pools showed normal bilirubin concentrations and had no hemolysis. Then we supplemented aliquots of serum pools with various concentrations of bilirubin (5.0, 10.0, 15.0, and 20.0 mg/dL). After supplementation, troponin I concentrations were measured again using the MEIA and CLIA. We observed a statistically significant decrease in troponin I concentration in the presence of bilirubin with the MEIA. For example, in serum pool 1, the troponin I concentration was 16.3 (bilirubin: 0.8 mg/dL). In the presence of 5.0, 10.0, 15.0 and 20.0 mg/dL of added bilirubin, the cardiac troponin I concentrations were 13.9, 13.4, 13.3 and 13.0 ng/ml respectively. We observed similar negative interference of bilirubin in troponin I measurement by the MEIA in other pools. The troponin I value decreased slightly (not statistically significant) in one pool and did not change in two other pools in the presence of bilirubin when we measured troponin I concentration using the CLIA. Interestingly, bilirubin did not interfere with the MEIA CK‐MB assay. Moderate hemolysis did not have any effect on the troponin I assay using either the MEIA or CLIA. However, gross hemolysis (hemoglobin > 40 mg/dL) interfered with both assays for troponin I. J. Clin. Lab. Anal. 15:76–80, 2001. © 2001 Wiley‐Liss, Inc. [source]

    Applications of neural network analyses to in vivo 1H magnetic resonance spectroscopy of Parkinson disease patients

    David Axelson PhD
    Abstract Purpose To apply neural network analyses to in vivo magnetic resonance spectra of controls and Parkinson disease (PD) patients for the purpose of classification. Materials and Methods Ninety-seven in vivo proton magnetic resonance spectra of the basal ganglia were recorded from 31 patients with (PD) and 14 age-matched healthy volunteers on a 1.5-T imager. The PD patients were grouped as follows: probable PD (N = 15), possible PD (N = 11), and atypical PD (N = 5). Total acquisition times of approximately five minutes were achieved with a TE (echo time) of 135 msec, a TR (repetition time) of 2000 msec, and 128 scan averages. Neural network (back propagation, Kohonen, probabilistic, and radial basis function) and related (generative topographic mapping) data analyses were performed. Results Conventional data analysis showed no statistically significant differences in metabolite ratios based on measuring signal intensities. The trained networks could distinguish control from PD with considerable accuracy (true positive fraction 0.971, true negative fraction 0.933). When four classes were defined, approximately 88% of the predictions were correct. The multivariate analysis indicated metabolic changes in the basal ganglia in PD. Conclusion A variety of neural network and related approaches can be successfully applied to both qualitative visualization and classification of in vivo spectra of PD patients. J. Magn. Reson. Imaging 2002;16:13,20. 2002 Wiley -Liss, Inc. [source]

    Evolution of the spermatozoon in muroid rodents

    William G. Breed
    Abstract In the rodent superfamily Muroidea, a model for the evolution of sperm form has been proposed in which it is suggested that a hook-shaped sperm head and long tail evolved from a more simple, nonhooked head and short tail in several different subfamilies. To test this model the shape of the sperm head, with particular emphasis on its apical region, and length of sperm tail were matched to a recent phylogeny based on the nucleotide sequence of several protein-coding nuclear genes from 3 families and 10 subfamilies of muroid rodents. Data from the two other myomorph superfamilies, the Dipodoidea and kangaroo rats in the Geomyoidea, were used for an outgroup comparison. In most species in all 10 muroid subfamilies, apart from in the Murinae, the sperm head has a long rostral hook largely composed of acrosomal material, although its length and cross-sectional shape vary across the various subfamilies. Nevertheless, in a few species of various lineages a very different sperm morphology occurs in which an apical hook is lacking. In the outgroups the three species of dipodid rodents have a sperm head that lacks a hook, whereas in the heteromyids an acrosome-containing apical hook is present. It is concluded that, as the hook-shaped sperm head and long sperm tail occur across the muroid subfamilies, as well as in the heteromyid rodents, it is likely to be the ancestral condition within each of the subfamilies with the various forms of nonhooked sperm heads, that are sometimes associated with short tails, being highly derived states. These findings thus argue against a repeated evolution in various muroid lineages of a complex, hook-shaped sperm head and long sperm tail from a more simple, nonhooked sperm head and short tail. An alternative proposal for the evolution of sperm form within the Muroidea is presented in the light of these data. J. Morphol. 2005 Wiley- Liss, Inc. [source]

    Management of well-differentiated thyroid carcinoma presenting within a thyroglossal duct cyst

    Snehal G. Patel MD
    Abstract Background and Objective Well-differentiated thyroid carcinoma (WDTC) is diagnosed in approximately 1.5% of thyroglossal duct cysts (TGDC). No clear consensus exists regarding further management after adequate excision of the cyst, especially the role of total thyroidectomy and postoperative radioactive iodine therapy. The current review was undertaken in an attempt to clarify these issues. Methods Demographic, clinical, tumor, treatment, pathology, and outcome data on 57 eligible patients reported in recent literature were pooled together with 5 patients treated at our institution for this analysis. Results A Sistrunk operation was performed for resection of the thyroglossal duct cyst in the majority (90%) of patients. Histologic examination of the tumor in the cyst revealed that papillary carcinoma was the most frequent (92%) histologic type. A total thyroidectomy was performed consequent to the diagnosis of thyroglossal duct cyst carcinoma in approximately half of the 62 patients. A malignant tumor was reported in 27% of the thyroidectomy specimens. Postoperative radioactive iodine therapy was administered in 16 (26%) patients. With a median follow-up of 71 months (range 1,456 months), the 5- and 10-year Kaplan,Meier overall survival was 100 and 95.6%, respectively. There were no disease-related deaths reported in any of the patients. Univariate analysis revealed that the only significant predictor of overall survival was the extent of primary surgery for the thyroglossal cyst. The addition of total thyroidectomy to Sistrunk operation did not have a significant impact on outcome (P,=,0.1). Patients treated with postoperative radioactive iodine (RAI) fared significantly worse than those that did not need RAI, which may be explained by the fact that this modality would generally be used in patients with higher risk tumors. Conclusions The Sistrunk operation is adequate for most patients with incidentally diagnosed TGDC carcinoma in the presence of a clinically and radiologically normal thyroid gland. Results of adequate excision using the Sistrunk operation are excellent and the concept of risk-groups should be used to identify patients, who would benefit from more aggressive treatment. J. Surg. Oncol. 2002;79:134,139. 2002 Wiley,Liss, Inc. [source]

    Immunohistochemical study of receptor activator of nuclear factor kappa-B ligand (RANK-L) in human osteolytic bone tumors

    Christopher R. Good BA
    Abstract Background and Objectives Osteolytic bone tumors produce intercellular signaling proteins that regulate bone remodeling by altering the rates of osteoclast and osteoblast differentiation and activity. This report examines osteolytic bone tumor expression of receptor activator of nuclear factor B-ligand (RANK-L), a cytokine that is arguably the most critical regulator of osteoclast differentiation and activation. Methods This prospective immunohistochemical study examined RANK-L expression in frozen tissues from sixteen surgical specimens of patients who underwent surgery for the treatment of osteolytic bone tumors between 1999 and 2000. Results RANK-L was positive in 13 of the 16 cases. Primary benign bone tumors, primary malignant bone tumors, and metastasis to bone were positive for RANK-L. Conclusions The cells in some, but not all, osteolytic tumors produce the cytokine RANK-L. Further study is necessary to determine in which specific tumors RANK-L is the cytokine responsible for increased osteoclastic activity, and to develop possible therapeutic use of RANK-L antagonists such as osteoprotegerin (OPG). J. Surg. Oncol. 2002;79:174,179. 2002 Wiley,Liss, Inc. [source]

    Regression of metastatic carcinoid tumors with octreotide therapy: Two case reports and a review of the literature

    Wey L. Leong MD
    Abstract Background The antiproliferative effect of the somatostatin analogue, octreotide, on metastatic carcinoid tumors is poorly understood. Partial tumor regression seen radiogaphically has been reported with the use of octreotide therapy for neuroendocrine tumors. Complete regression of carcinoid tumors is rarely reported. Results Two patients with metastatic midgut carcinoid tumors were treated with subcutaneous octreotide 300 ,g/day for symptomatic control of their carcinoid syndrome before debulking palliative surgery. During the laporatomies, both patients were found to have complete macroscopic regression of the metastastatic lesions that had been identified radiologically before surgery, including liver metastases in one patient and periportal and retrocaval lymph nodes in the other. After surgery, the patients were evaluated every 3 months, and had no detectable disease at 30 and 43 months, respectively. Thirty cases of partial tumor regression with octreotide administered with or without other treatment modalities have been reported in the literature. Most of the patients involved received other treatment modalities. Only one other case reported in the literature showed complete regression with octreotide monotherapy. Conclusions We report two cases of metastatic midgut carcinoid tumors that demonstrated a significant anti-proliferative response to octreotide monotherapy. Review of the literature failed to identify any specific prognostic factors with which the response to octreotide can be predicted. Possible mechanisms for this antiproliferative effect of octreotide on carcinoid tumors are discussed. J. Surg. Oncol. 2002;79:180,187. 2002 Wiley,Liss, Inc. [source]

    Effect of pulsing in low-level light therapy,

    Javad T. Hashmi MD
    Abstract Background and Objective Low level light (or laser) therapy (LLLT) is a rapidly growing modality used in physical therapy, chiropractic, sports medicine and increasingly in mainstream medicine. LLLT is used to increase wound healing and tissue regeneration, to relieve pain and inflammation, to prevent tissue death, to mitigate degeneration in many neurological indications. While some agreement has emerged on the best wavelengths of light and a range of acceptable dosages to be used (irradiance and fluence), there is no agreement on whether continuous wave or pulsed light is best and on what factors govern the pulse parameters to be chosen. Study Design/Materials and Methods The published peer-reviewed literature was reviewed between 1970 and 2010. Results The basic molecular and cellular mechanisms of LLLT are discussed. The type of pulsed light sources available and the parameters that govern their pulse structure are outlined. Studies that have compared continuous wave and pulsed light in both animals and patients are reviewed. Frequencies used in other pulsed modalities used in physical therapy and biomedicine are compared to those used in LLLT. Conclusion There is some evidence that pulsed light does have effects that are different from those of continuous wave light. However further work is needed to define these effects for different disease conditions and pulse structures. Lasers Surg. Med. 42:450,466, 2010. 2010 Wiley,Liss, Inc. [source]

    Visible light-induced killing of bacteria as a function of wavelength: Implication for wound healing

    Anat Lipovsky MSc
    Abstract Background and objective Visible light (400,800,nm) at high intensity was previously found to kill bacteria that are frequently found in infected wounds, while low-power white light enhances bacterial proliferation. The phototoxic effect was found to involve induction of reactive oxygen species (ROS) production by the bacteria. The aim of the present study was to identify the most effective wavelengths in the visible range for inducing a bactericidal effect. Experimental ROS production in Staphylococcus aureus and Escherichia coli as a function of wavelengths in the visible range (400,500, 500,800, 415, and 455,nm) was studied using the electron paramagnetic resonance (EPR) spin trapping technique. The phototoxicity of 415 and 455,nm light at different fluencies on the survival of S. aureus and E. coli was assessed by colony count of the bacteria following irradiation. Results ROS production following blue (400,500,nm) light illumination was found to be higher than that of red (500,800,nm). Within the blue range, light of 415,nm induced more ROS than 455,nm, which correlated with results obtained for the reduction in colony count of S. aureus and E. coli following illumination using equal intensities of these two wavelengths. At low fluencies, both 415 and 455,nm enhanced proliferation of S. aureus but reduced viability of E. coli. Conclusion Intense blue light, preferably at 415,nm, could be used for bacterial eradication. However, it should be noted that low intensity of visible light can be dangerous since it may promote proliferation of the microorganisms. Lasers Surg. Med. 42:467,472, 2010. 2010 Wiley,Liss, Inc. [source]

    Varying ratios of wavelengths in dual wavelength LED photomodulation alters gene expression profiles in human skin fibroblasts

    D.H. McDaniel MD
    Abstract Background and Objective LED photomodulation has been shown to profoundly influence cellular behavior. A variety of parameters with LED photomodulation can alter cellular response in vitro. The effects of one visible and one infrared wavelength were evaluated to determine the optimal ratio to produce a net increase in dermal collagen by altering the ratio of total energy output of each wavelength. The ratio between the two wavelengths (590 and 870,nm) was shifted in 25% increments. Study Design/Materials and Methods Human skin fibroblasts in culture were exposed to a 590/870,nm LED array with total combined energy density fixed at 4.0,mW/cm.. The ratio of 590/870,nm tested parameters were: 100/0%, 75/25%, 50/50%, 25/75%, and 0/100%. These ratios were delivered using pulsed duty cycle of exposure (250,milliseconds "on" time/100,milliseconds "off" time/100,pulses) for a total energy fluence of 0.1,J/cm.. Gene expression was examined using commercially available extra cellular matrix and adhesion molecule RT PCR Arrays (SA Biosciences, Fredrick, MD) at 24,hours post-exposure. Results Different expression profiles were noticed for each of the ratios studied. Overall, there was an average (in an 80 gene array) of 6% expression difference in up or downregulation between the arrays. The greatest increase in collagen I and decrease in collagenase (MMP-1) was observed with 75/25% ratio of 590/870,nm. The addition of increasing proportions of IR wavelengths causes alteration in gene expression profile. The ratios of the wavelengths caused variation in magnitude of expression. Conclusions Cell metabolism and gene expression can be altered by simultaneous exposure to multiple wavelengths of low energy light. Varying the ratios of specific wavelength intensity in both visible and near infrared light therapy can strongly influence resulting fibroblast gene expression patterns. Lasers Surg. Med. 42:540,545, 2010. 2010 Wiley,Liss, Inc. [source]

    Effects of low-level laser therapy on collagen expression and neutrophil infiltrate in 5-fluorouracil-induced oral mucositis in hamsters

    Nilza Nelly Fontana Lopes DDS
    Abstract Background and Objectives Several studies have suggested that low-level laser therapy (LLLT) can ameliorate oral mucositis; however, the mechanisms involved are not well understood. The aim of this study was to investigate the mechanisms of action of LLLT on chemotherapy-induced oral mucositis, as related to effects on collagen expression and inflammation. Materials and Methods A hamster cheek pouch model of oral mucositis was used with all animals receiving intraperitoneal 5-fluorouracil, followed by surface irritation. Animals were randomly allocated into three groups, and treated with an InGaAIP diode laser at a wavelength of 660,nm and output power of 35 or 100,mW laser, or no laser. Clinical severity of mucositis was assessed at four time-points by a blinded examiner. Buccal pouch tissue was harvested from a subgroup of animals in each group at four time-points. Collagen was qualitatively and quantitatively evaluated after picrosirius staining. The density of the neutrophil infiltrate was also scored. Results Peak clinical severity of mucositis was reduced in the 35,mW laser group as compared to the 100,mW and control groups. The reduced peak clinical severity of mucositis in the 35,mW laser group was accompanied by a decrease in the number of neutrophils and an increase in the proportion of mature collagen as compared to the other two groups. The total quantity of collagen was significantly higher in the control (no laser) group at the day 11 time-point, as compared to the 35,mW laser group, consistent with a more prolonged inflammatory response in the control group. Conclusion This study supports two mechanisms of action for LLLT in reducing mucositis severity. The increase in collagen organization in response to the 35,mW laser indicates that LLLT promotes wound healing. In addition, LLLT also appears to have an anti-inflammatory effect, as evidenced by the reduction in neutrophil infiltrate. Lasers Surg. Med. 42:546,552, 2010. 2010 Wiley,Liss, Inc. [source]

    Hyperthermic injury to adipocyte cells by selective heating of subcutaneous fat with a novel radiofrequency device: Feasibility studies

    Walfre Franco PhD
    Abstract Background and Objective The main objective of the present study is to demonstrate the feasibility of utilizing a novel non-invasive radiofrequency (RF) device to induce lethal thermal damage to subcutaneous adipose tissue only by establishing a controlled electric field that heats up fat preferentially. Study Design/Materials and Methods Adipocyte cells in six-well plates were subjected to hyperthermic conditions: 45, 50, 55, 60, and 65C during 1, 2, and 3,minutes. Cell viability was assessed 72,hours after exposure. Two groups of abdominoplasty patients were treated with the RF device during and days before their surgical procedure. Temperatures of cutaneous and subcutaneous tissues were measured during treatment (3,minutes) of the first group. The immediate tissue response to heating was assessed by acute histology. The delayed tissue response was assessed by histology analysis of the second group, 4, 9, 10, 17, and 24 days after treatment (22,minutes). A mathematical model was used to estimate treatment temperatures of the second group. The model uses patient-based diagnostic measurements as input and was validated with in vivo clinical temperature measurements. Results Cell viability dropped from 89% to 20% when temperature increased from 45 to 50C during 1,minute exposures. Three minutes at 45C resulted in 40% viability. In vivo, the temperature of adipose tissue at 7,12,mm depth from the surface increased to 50C while the temperature of cutaneous tissues was <30C during RF exposure. Acute and longitudinal histology evaluations show normal epidermal and dermal layers. Subcutaneous tissues were also normal acutely. Subcutaneous vascular alterations, starting at day 4, and fat necrosis, starting at day 9, were consistently observed within 4.5,19,mm depth from the skin surface. Subcutaneous tissue temperatures were estimated to be 43,45C for 15,minutes. Conclusions A controlled internal electric field perpendicular to the skin,fat interface is selective in heating up fat and, consequently, has the ability to induce lethal thermal damage to subcutaneous adipose tissues while sparing overlying and underlying tissues. In vitro adipocyte cells are heat sensitive to thermal exposures of 50 and 45C on the order of minutes, 1 and 3,minutes, respectively. In vivo, 15,minutes thermal exposures to 43,45C result in a delayed adipocyte cellular death response,in this study, 9 days. The novel RF device presented herein effectively delivers therapeutic thermal exposures to subcutaneous adipose tissues while protecting epidermal and dermal layers. Lasers Surg. Med. 42:361,370, 2010. 2010 Wiley,Liss, Inc. [source]

    Lining the mouth floor with prelaminated fascio-mucosal free flaps: Clinical experience

    MICROSURGERY, Issue 5 2002
    D.D.S., L. Chiarini M.D.
    Soft-tissue defects of the mouth floor need thin, foldable, and pliable tissues able to preserve local anatomy as well as chewing, phonation, and deglutition. The oral mucosa is made of a stratified, nonkeratinized, epithelium-secreting mucus, which lubricates the oral cavity and facilitates tongue movements. No flap exists that can reproduce the physiology of the oral mucosa better than the oral mucosa itself. Prefabrication of mucosal flaps may represent the best solution. Therefore, 10 consecutive cases of mouth floor cancer were treated with prelamination of the fascia antibrachialis with mucosal grafts obtained from the healthy cheek, and with subsequent transplantation 3 weeks later. A significant increase in mucosal graft surface was seen in all cases, with a mean size twice the original. All flaps healed uneventfully. Follow-up time ranged between 2,60 months (average, 26.6 months). Morphological and functional results were excellent. Tongue motility, speech intelligibility, and swallowing were reestablished in all treated cases. Mucosal prelamination of the forearm fascia is feasible and allows physiological reconstruction of oral cavity defects up to 6 4 cm. 2002 Wiley Liss, Inc. MICROSURGERY 22:177,186 2002 [source]

    Lower limb replantations: Indications and a new scoring system

    MICROSURGERY, Issue 5 2002
    Bruno Battiston M.D.
    The need for reconstruction of lower limb amputations is increasing, due to high-energy trauma in road accidents and work-related injuries. The indication for lower limb replantation is still controversial. Compared with upper limb replantations, indications are more select due to the frequent complications in lower limb salvage procedures, such as severe general complications or local complications such as necrosis, infections, nonunions, the need for secondary lengthening, or other reconstructive procedures. The satisfactory results given by artificial prosthesis, such as quicker recovery time and fewer secondary procedures, also contribute to the higher degree of selection for lower limb replantation candidates. Since 1993, we have replanted 14 amputations of the lower limb in 12 patients, including 2 bilateral cases. Although survival of the replanted segment was obtained in all patients, 5 cases were subsequently amputated for severe secondary complications. Of the remaining 9 cases, evaluated by means of Chen criteria, 7 had good results (3 Chen I and 4 Chen II), 1 sufficient (Chen III), and 1 poor (Chen IV). The best results were obtained in young patients. Our experience led us to examine the necessity for careful, objective patient selection. We developed a score evaluation system by modifying the international classifying method for severe limb traumas (mangled extremity severity score, or MESS system). This relatively simple system, based on the retrospective study of our cases, considers several parameters (patient's age, general conditions, level and type of lesion, time of injury, and associated lesions), giving each one a score. The total score gives the indication for replantation, predicts the functional outcome, and facilitates decision-making. 2002 Wiley Liss, Inc. MICROSURGERY 22:187,192 2002 [source]

    Novel alternatively spliced mRNA (1c) of the protein kinase A RIα subunit is implicated in haploid germ cell specific expression

    Maria K. Dahle
    Abstract By using 5′ RACE on rat testis cDNA we identified three alternatively spliced mRNAs of the RIα subunit of cAMP‐dependent protein kinase that differed in their 5′ untranslated regions. Two of these 5′‐regions showed similarity with the human RIα exons 1a and 1b, while the third (1c) constituted a novel mRNA splice variant. Northern blot analysis showed that the 1c mRNA was specifically expressed in testis and only in postmeiotic germ cells. In contrast, the RIα 1b and RIα 1a mRNAs were present both in premeiotic germ cells and somatic cells of the testis, and the expression of both RIα 1a and 1b mRNAs were stimulated by cAMP in Sertoli cells. In sperm, the RIα protein was expressed after meiosis, and targeted to various subcellular structures via anchoring proteins. The RIα 1c haploid‐specific mRNA, therefore, may be important for the regulation of RIα expression in sperm. Mol. Reprod. Dev. 59:11–16, 2001. © 2001 Wiley‐Liss, Inc. [source]

    Comparison by restriction fragment differential display RT‐PCR of gene expression pattern in bovine oocytes matured in the presence or absence of fetal calf serum

    S. Jacek Rzucidlo
    Abstract A novel restriction fragment differential display (RFDD) RT‐PCR has been used to compare patterns of mRNA expression in bovine oocytes matured in vitro in the presence (10%) or absence of fetal calf serum (FCS). Total RNA extracted from matured and denuded oocytes was processed using display Profile kit (Display System Biotech). RFDD RT‐PCR products were separated on 6% polyacrylamide gel and analyzed using a Storm 860 scanner. Selected bands representing potentially differentially expressed fragments were excised from the gel and re‐amplified. Re‐amplified fragments with size matched to the original fragment were cloned into the TA vector and sequenced. Initially, 10 and 15 differentially expressed fragments were isolated from oocytes matured in the presence and absence of FCS, respectively. Eight out of 10 and 10 out of 15 fragments were re‐amplified successfully as evidenced bysize similarity to the original fragments. Finally, the size of six inserts sequenced from each group matched the size of corresponding original as well as re‐amplified fragments. Sequence comparison search revealed similarity of some isolated fragments to 18s ribosomal RNA, bovine apolipoprotein A‐I, bovine mitochondrion DNA, human CGI‐79 mRNA, human Ab1‐interactor protein, and bovine satellite DNA. The other sequenced fragments may represent novel genes. We showed that RFDD RT‐PCR can be effectively applied to contrast gene expression pattern in bovine oocytes and that presence or absence of FCS during maturation interval affects gene expression pattern in matured bovine oocytes. Mol. Reprod. Dev. 59:90–96, 2001. © 2001 Wiley‐Liss, Inc. [source]

    Progesterone induces activation in Octopus vulgaris spermatozoa

    Elisabetta Tosti
    Abstract The purpose of the present study was to determine whether Octopus vulgaris spermatozoa are activated by progesterone stimulation. Spermatozoa were collected from the spermatophores in the Needham's sac of the male (MS) and from the spermathecae of oviducal glands of the female (FS). We used transmission (TEM) and scanning (SEM) electron microscopy to study the morphology of untreated, Ca2+ ionophore A23187 and progesterone‐treated MS spermatozoa, and untreated FS spermatozoa. We showed that ionophore and progesterone stimulation of MS spermatozoa induce breakdown of the membranes overlapping the acrosomal region, exposing the spiralized acrosome. These modifications resemble the acrosome reaction observed in other species. FS stored in the spermathecae did not show the membranes covering the acrosomal region present in the MS spermatozoa. When ionophore and progesterone treatments were performed in Ca2+‐free artificial sea water, no changes were observed, suggesting the role of external calcium in modifying membrane morphology. Lectin studies showed a different fluorescence distribution and membrane arrangement of FS‐untreated spermatozoa with respect to the MS, suggesting that spermatozoa transferred in the female genital tract after mating, are stored in a pre‐activated state. The plasma membrane of the untreated MS and FS spermatozoa was labelled with Progesterone‐BSA‐FITC, indicating the presence of plasma membrane progesterone receptor. Taken together these data suggest that progesterone induces an acrosome‐ like reaction in MS spermatozoa similar to that induced by calcium elevation. In addition progesterone may play a role in the pre‐activation of spermatozoa stored in the female tract, further supporting the hypothesized parallelism between cephalopods and vertebrates. Mol. Reprod. Dev. 59:97–105, 2001. © 2001 Wiley‐Liss, Inc. [source]

    MDM2 polymorphism increases susceptibility to childhood acute myeloid leukemia: A report from the Children's Oncology Group,

    PEDIATRIC BLOOD & CANCER, Issue 2 2010
    Christine L. Phillips MD
    Abstract Background The variant polymorphism in the gene MDM2, SNP309, leads to increased level of mdm2 protein and subsequent downregulation of p53 tumor suppressor pathway. Presence of this single nucleotide polymorphism (SNP) has been associated with earlier tumorigenesis in patients with Li,Fraumeni syndrome, as well as decreased survival in patients with CLL. In addition, cells homozygous (G/G) for SNP 309 were found to have 10-fold increase resistance to topoisomerase II inhibitors in vitro. Procedure We genotyped children (n,=,575) with de novo acute myeloid leukemia (AML) treated on three Children's Oncology Group protocols (CCG 2941/2961/AAML 03P1) for the presence of SNP309. Healthy blood donors were genotyped as control population. Results The variant G/G genotype was associated with an increased susceptibility to AML (OR 1.5; P,=,0.049). However, the presence of the variant allele at SNP309 did not modify disease response or toxicity in children treated on CCG protocols 2941/2961. Conclusions The variant SNP 309 influences susceptibility to pediatric AML, but does not impact overall response to therapy. Pediatr Blood Cancer. 2010;55:248,253. 2010 Wiley,Liss, Inc. [source]

    Placing of tunneled central venous catheters prior to induction chemotherapy in children with acute lymphoblastic leukemia,

    PEDIATRIC BLOOD & CANCER, Issue 2 2010
    Mette Mller Handrup MD
    Abstract Background Tunneled central venous catheters (CVCs) are inevitable in children with acute lymphoid leukemia (ALL). The aim of this study was to evaluate the risk of CVC-related complications in children with ALL in relation to timing of catheter placement and type of catheter. Procedure All children hospitalized from January 2000 to March 2008 with newly diagnosed ALL and with double-lumen total implantable devices (TIDs) or tunneled external catheters (TEs) were included retrospectively. We only used data related to the patient's first catheter. Results We included 98 children; 35 received a TID and the remaining 63 received a TE. A total number of 29,566 catheter days and 93 catheter-associated blood stream infections (CABSI) was identified. We found a CABSI rate of 3.1/1,000 catheter days (5.4/1,000 catheter days for TEs and 1.4/1,000 catheter days for TIDs, incidence rate ratio (IRR) 3.82 (95% CI 2.37,6.35) P,=,0.0001). No difference was found in CABSI between neither early versus later placed TIDs (IRR,=,0.99 (95% CI 0.41,2.45) P,=,0.98) nor early versus later placed TEs (IRR,=,0.81 (95% CI 0.40,1.86) P,=,0.54). We found no difference between early and later placed catheters regarding non-elective removal (RR,=,0.86 (95% CI 0.72,1.03) P,=,0.09). TEs had a higher risk of non-elective removal compared with TIDs (RR,=,3.95 (95% CI 1.88,8.29) P,<,0.001). Conclusions The study did not find that children with ALL and with early placed CVCs experienced significantly more complications compared with children with late placed catheters. This study found that children with ALL and TEs experienced more complications than children with TIDs. Pediatr Blood Cancer. 2010;55:309,313. 2010 Wiley,Liss, Inc. [source]

    Cyclic neutropenia and severe congenital neutropenia in patients with a shared ELANE mutation and paternal haplotype: Evidence for phenotype determination by modifying genes,

    PEDIATRIC BLOOD & CANCER, Issue 2 2010
    Peter E. Newburger MD
    Abstract Background Cyclic neutropenia (CN) and severe congenital neutropenia (SCN) are disorders of neutrophil production that differ markedly in disease severity. Mutations of the ELANE gene (the symbol recently replacing ELA2) are considered largely responsible for most cases of CN and SCN, but specific mutations are typically associated with one or the other. Procedure We performed ELANE genotyping on all individuals and paternal sperm in an SCN kindred with eight SCN progeny of a sperm donor and six different mothers. Results One patient with CN had the same S97L ELANE mutation as seven patients with the SCN phenotype. The mutant allele was detected in the donor's spermatozoa, representing 18% of the ELANE gene pool, but not in DNA from his lymphocytes, neutrophils, or buccal mucosa, indicating gonadal mosaicism. Conclusions The coexistence of CN and SCN phenotypes in this kindred with a shared paternal haplotype strongly suggests both a role for modifying genes in determination of congenital neutropenia disease phenotypes, and the classification of CN and SCN within a spectrum of phenotypes expressing varying degrees of the same disease process. Pediatr Blood Cancer. 2010;55:314,317. 2010 Wiley,Liss, Inc. [source]