ALCOHOLISM, Issue 2010
Koji Fujita
Background:, The pathogenesis of nonalcoholic steatohepatitis (NASH) is still unclear. Recently, the 2-hit hypothesis was proposed, in which nitric oxide production, representing oxidative stress, was proposed as a very important candidate for the second hit. Methods:, The total study period was 10 weeks. A total of 20 rats were randomly divided into 2 groups. Group 1 was administered the Choline-Deficient, l-Amino Acid-Defined diet to produce a NASH model, and Group 2 as control received the Choline-Sufficient, l-Amino Acid-defined diet. The blood and tissue concentrations of nitrate + nitrite were measured using the Griess reagent and the expression levels of inducible nitric oxide synthase (iNOS) proteins and mRNA was determined by Western blotting. Results:, In regard to nitric oxide (NO) and NO metabolites, there were significant differences in the blood (especially portal venous blood) as well as tissue (liver and visceral fat) concentrations between the 2 animal groups; the amounts of NO metabolites in the tissues were much higher in the NASH models. The level of nitrotyrosine was much markedly higher in the NASH models than in the controls. In regard to the tissue expression of iNOS a significant difference between the 2 groups was found in the visceral fat, especially in the mesenterium. Conclusions:, Based on these results, we hypothesize that the iNOS expression and NO levels in the visceral fat increase, with increased diffusion of NO and its metabolites into the liver, resulting in increased nitrotyrosine formation in the liver; this, in turn, induces inflammation, apoptosis, and fibrosis in the liver, which are one of the characteristic features of NASH. [source]

GASTRIC SCHWANNOMA WITH ADJACENT EXTERNAL PROGRESSION HARBORED ABERRANT NF2 GENE

DIGESTIVE ENDOSCOPY, Issue 3 2009
Naotaka Ogasawara
Gastric schwannomas are rare benign mesenchymal tumors. We describe a schwannoma of gastric origin with adjacent external progression. Sections showed a spindle cell tumor arranged in interlaced bundles and fascicles that was S-100 and CD34 positive but c-KIT protein negative. Histology and immunohistochemistry revealed the typical appearance of a gastric schwannoma. Genetic evaluation revealed that the tumor harbored a point mutation in exon 6 of the tumor suppressor neurofibromatosis 2 (NF2) gene, which resulted in an amino acid substitution of NF2 protein, and no mutation in exon 4b of the NF1 gene. In conclusion, we identified a rare mutation of the NF2 gene in gastric schwannoma. A diagnosis can only be definitive when based on histological and immunohistochemical findings. Digestive tract schwannomas are rare mesenchymal tumors that are differentiated from gastrointestinal stromal tumors by the absence of KIT protein. Follow up suggested that complete resection is an effective long-term treatment strategy. [source]

MALIGNANT PROGRESSION OF ANAL INTRA-EPITHELIAL NEOPLASIA

ANZ JOURNAL OF SURGERY, Issue 8 2006
Angus J. M. Watson
Background: Anal intra-epithelial neoplasia (AIN) is believed to be a precursor to squamous cell carcinoma of the anus. The risk of developing anal cancer in patients with AIN, although known to occur, has been thought to be relatively low. This study reviews our experience with AIN, reviewing the incidence and risk factors for development of invasive malignancy and the outcome of present management strategies. Methods: This study examined a cohort of 72 patients identified from a prospective database with AIN from a single institution between January 1996 and December 2004. A single pathologist examined all pathological specimens. Results: There were 72 patients (52 women) and the median age was 49 years (range, 18,81 years). We identified progression of AIN to invasive malignancy in eight patients despite undergoing surveillance. Regression following treatment or biopsy was seen in 25 patients. Four patients required stomas for incontinence following treatment. Conclusion: This study has shown a high rate of progression to invasive malignancy (11%) with AIN despite surveillance. The patients at risk of developing squamous cell carcinoma were the immunocompromised and those with genital intra-epithelial field change. Treatment of AIN has significant complications and despite treatment, invasive cancers do occur. Decisions made for treatment of AIN can affect treatment choices if invasive malignancy develops. [source]

DOES THE INTRARENAL REACTIVE OXYGEN SPECIES/ANGIOTENSINOGEN/RENIN,ANGIOTENSIN SYSTEM AXIS PLAY AN IMPORTANT ROLE IN THE PROGRESSION OF CHRONIC KIDNEY DISEASE?

CLINICAL AND EXPERIMENTAL PHARMACOLOGY AND PHYSIOLOGY, Issue 8 2009
Yoshio Konishi
No abstract is available for this article. [source]

Refractory Progression of Coronary Aneurysms, a Case of Delayed Onset Kawasaki Disease as Depicted by Cardiac Computed Tomography Angiography

CONGENITAL HEART DISEASE, Issue 3 2010
FACP, Shah Azmoon MD
ABSTRACT Background., Kawasaki disease (KD) is an immune-mediated vasculitis of unknown etiology with self-limited clinical course that was first described in 1967 by Dr. Tomisaku Kawasaki. It is a disease of early childhood and rare past late adulthood but one that can have detrimental consequences when there is a delay in diagnosis and treatment. Cardiovascular complications causing increased morbidity and mortality may include coronary artery aneurysms, myocardial infarction, heart failure, arrhythmias, and peripheral artery occlusion. Case Presentation., Here, we present an atypical case of delayed onset KD in a young teenager. DS had visited three different emergency departments during the course of 2 weeks for unrelenting fevers. Despite multiple treatment protocols including immunoglobulin, steroids, and tumor necrosis factor-alpha antagonists, he continued to have progression of cardiovascular complications. While echocardiographic findings were suspicious for cardiac complications, a cardiac computed tomography (CT) angiography was able to clearly distinguish giant coronary aneurysms. Conclusion., Without prompt therapy, fever and manifestations of acute inflammation can last for several weeks to months with increased risk toward complications. The incidence of coronary artery aneurysms has been noted to be 25% in untreated patients with a mortality rate of up to 2%. Using low-dose protocols along with high spatial and temporal resolution of cardiac CT angiography may provide a useful and complimentary imaging modality in accurate diagnosis and follow-up of patients with KD. [source]

Rapid Progression of a Basal Cell Carcinoma After Photodynamic Therapy

DERMATOLOGIC SURGERY, Issue 8 2010
JULIE K. KAREN MD
The authors have indicated no significant interest with commercial supporters. [source]

A Rare Case of Rapid Progression from Incurved Nail to Pincer Nail

DERMATOLOGIC SURGERY, Issue 9 2009
MASAAKI KOSAKA MD
No abstract is available for this article. [source]

Progression to clinically diagnosed and treated diabetes from impaired glucose tolerance and impaired fasting glycaemia

DIABETIC MEDICINE, Issue 12 2003
Q. Qiao
Abstract Aims To evaluate the risk of diabetes in subjects with impaired fasting glycemia (IFG) as compared with impaired glucose tolerance (IGT) and normal glucose tolerance. Methods Men (1223) and women (1370) aged 45,64 years and free of diabetes at baseline were followed-up for 10 years, with 26 737 person years accumulated. The incident diabetic cases were identified through the national Drug Register and the Hospital Discharge Register. Results During the 10 years of follow-up, 53 (4.3%) men and 47 (3.4%) women developed diabetes. IFG alone defined 22 (15.5/1000 person years) diabetic cases, which was higher than for subjects with normal fasting glucose. Subjects with isolated IGT identified an additional 34 cases (155% more) which could not be defined by IFG alone. The area under the ROC curve was larger for 2-h glucose (0.77, 95% CI 0.72,0.82) than for fasting glucose (0.65, 0.58,0.71). The multivariate adjusted Cox hazard ratio was higher for isolated IGT (3.9, 95% CI 2.4,6.2) than for isolated IFG (2.3, 0.9,5.7) as compared with subjects with neither IFG nor IGT. Conclusion Both IFG and IGT are risk predictors for diabetes, but IGT defines a much larger target population for prevention. [source]

Elongation Index as a New Index Determining the Severity of Left Ventricular Systolic Dysfunction and Mitral Regurgitation in Patients with Congestive Heart Failure

ECHOCARDIOGRAPHY, Issue 7 2005
Mehmet Yokusoglu M.D.
The shape of the left ventricle is an important echocardiographic feature of left ventricular dysfunction. Progression of the mitral regurgitation and consequent left ventricular remodeling is unpredictable in heart failure. Elongation index is an index of left ventricular sphericity. The surface area of the elongated ventricle is larger than that of a spherical one. The objective of this study was to assess the relation between elongation index and the degree of mitral regurgitation along with noninvasive indices of left ventricular function. Thirty-two patients (21 male, 11 female, mean age: 57 ± 6 yrs) with congestive heart failure and mitral regurgitation were included. Patients were stratified into three groups according to vena contracta width as having mild (n = 11), moderate (n = 11) and severe mitral regurgitation (n = 10). The elongation index (EI) was considered as equal to {[(left ventricular internal area-measured) , (theoretical area of the sphere with measured left ventricular volume)]/(theoretical area of the sphere with measured left ventricular volume)}. Ejection fractions by the modified Simpson rule, dP/dt and sphericity index (SI) were also recorded. The relationship between (EI), ejection fraction, dP/dt and SI reached modest statistical significance (p < 0.05). When the EI and SI were compared, the correlation was also significant (p < 0.01). The areas under the receiver operator curve of EI and SI for discriminating dP/dt < 1000 mm Hg/s were 0.833 and 0.733, respectively. In conclusion, the elongation, which defines the shape of the left ventricle, might be related to the systolic function of the left ventricle and the degree of the mitral regurgitation. Further studies are needed to demonstrate its use in other clinical entities. [source]

Progression through early drinking milestones in an adolescent treatment sample

ADDICTION, Issue 3 2010
Kristina M. Jackson
ABSTRACT Aims Research using nationally representative and community samples demonstrates a robust association between early onset of drinking and increased likelihood of numerous adverse outcomes. However, little is known about the subsequent drinking that occurs early in the drinking career. The present study dissects the transition from any alcohol use to treatment entry by taking a fine-grained approach to examining the attainment and progression of drinking events in a sample of adolescents in substance use treatment. Design/Setting Data were taken from the Drug Abuse Treatment Outcome Study for Adolescents (DATOS-A), a multi-site, community-based study of adolescents entering treatment. Participants Respondents included 3331 youth aged 12,18 years (mean = 15.75) admitted to treatment in 1993,95 (74% male, 52% white, 24% African American, 20% Hispanic). Measurements Age of attainment was obtained for five drinking-related milestones, including first drink of alcohol, first time drunk, first monthly drinking, first drank five or more drinks/day on a weekly basis and first drank five or more drinks/day on a daily basis. Findings Most milestones were attained at a very early age, and average progression through adjacent drinking events was relatively swift, Movement through early drinking milestones was accelerated in girls and white youth. Youth who reported their first drink at an early age (age 10 or younger) showed slower progression, suggesting the existence of distinct processes underlying early use and drinking transitions within an individual. Conclusions This study provides data relevant to understanding drinking progression/natural history in a large clinical sample, especially for differences by gender and ethnicity. The findings have implications for the identification of intermediate stages that might benefit from selected intervention programs. [source]

Progression of oral snuff use among Finnish 13,16-year-old students and its relation to smoking behaviour

ADDICTION, Issue 4 2006
Ari Haukkala
ABSTRACT Aims To examine the progression of oral moist snuff use among adolescents and its relation to smoking behaviour and nicotine addiction. Design and setting A 3-year smoking prevention study in 27 schools of Helsinki, Finland, starting with the seventh grade to the ninth grade., Participants and measurements Pupils (n = 2816) completed questionnaires four times, which included information on smoking behaviour, snuff experiments, nicotine addiction (Fagerström Tolerance Questionnaire) and other activities. Findings The prevalence of snuff experimentation rose among boys from 7% in the seventh grade to 43% 3 years later in the ninth grade, and among girls from 2% to 13% for the corresponding period. Among boys, smoking predicted later snuff use in all assessments and snuff experimentation predicted later weekly smoking. The impact of snuff experimentation upon later smoking experimentation was smaller than vice versa. Among boys active in sports, smoking was less common but snuff use was more common. Combined use was common; by the end of the follow-up only 10% of weekly smokers had not tried oral snuff. Nicotine dependence scores increased linearly with snuff use among weekly smokers., Conclusions Despite the European Union sales ban on oral snuff products since 1995, in Finland snuff use is common among boys. Although combined use of snuff and cigarettes is associated with higher levels of nicotine dependence among adolescent boys, the direction of causality is not known. Unlike cigarette smoking, oral snuff use was tried among boys who spent their free time with sports-related activities. [source]

Audiogenic kindling in Wistar and WAG/Rij rats: Kindling-prone and kindling-resistant subpopulations

EPILEPSIA, Issue 10 2008
Lyudmila V. Vinogradova
Summary Purpose:, Audiogenic kindling (AK) is a model of naturally occurring epileptogenesis triggered by repeated sound stimulation of rats genetically prone to audiogenic seizures. It is accepted that limbic seizure networks underlie progressive changes in behavioral seizure pattern during AK. The present study investigated AK progression in rats susceptible and unsusceptible to absence seizures. Methods:, Progression of AK as indicated by an appearance and intensification of limbic clonus was examined in Wistar Albino Glaxo/Rijswijk (WAG/Rij) rats with genetic absence epilepsy and in Wistar rats. Results:, Subpopulations of kindling-prone and kindling-resistant rats were found in both Wistar and WAG/Rij strains. Despite identical seizure responses to the first sound stimulation, AK progression dramatically differed between the two subpopulations. AK-prone rats exhibited rapid kindling development up to maximal stage-5 severity. In AK-resistant rats, limbic clonus did not appear after 30 stimulations or if it appeared, it did not progress beyond stage 2. The proportions of AK-prone and AK-resistant animals within Wistar and WAG/Rij strains were similar. Comparison of Wistar and WAG/Rij rats within the kindling-prone and kindling-resistant groups did not reveal a significant strain effect on AK progression. However, within the WAG/Rij strain, a significantly higher incidence of absence seizures was found in AK-resistant rats compared to AK-prone rats. Conclusions:, The present study demonstrates that sensitivity to sound-induced epileptogenesis differs dramatically within Wistar and WAG/Rij strains, whereas genetic susceptibility to absence seizures does not change AK progression significantly. It is supposed that an increased incidence of nonconvulsive seizures and resistance to kindling result from a common seizure modulating mechanism. [source]

Breakpoints in immunoregulation required for Th1 cells to induce diabetes

EUROPEAN JOURNAL OF IMMUNOLOGY, Issue 9 2006
Margaret Neighbors
Abstract We describe a novel TCR-transgenic mouse line, TCR7, where MHC class,II-restricted, CD4+ T cells are specific for the subdominant H-2b epitope (HEL74,88) of hen egg lysozyme (HEL), and displayed an increased frequency in the thymus and in peripheral lymphoid compartments over that seen in non-transgenic littermate controls. CD4+ T cells responded vigorously to HEL or HEL74,88 epitope presented on APC and could develop into Th1 or Th2 cells under appropriate conditions. Adoptive transfer of TCR7 Ly5.1 T cells into Ly5.2 rat insulin promoter (RIP)-HEL transgenic recipient hosts did not lead to expansion of these cells or result in islet infiltration, although these TCR7 cells could expand upon transfer into mice expressing high levels of HEL in the serum. Islet cell infiltration only occurred when the TCR7 cells had been polarized to either a Th1 or Th2 phenotype prior to transfer, which led to insulitis. Progression from insulitis to autoimmune diabetes only occurred in these recipients when Th1 but not Th2 TCR7 cells were transferred and CTLA-4 signaling was simultaneously blocked. These findings show that regulatory pathways such as CTLA-4 can hold in check already differentiated autoreactive effector Th1 cells, to inhibit the transition from tolerance to autoimmune diabetes. See accompanying commentary at http://dx.doi.org/10.1002/eji.200636591 [source]

Progression of dysautonomia in multiple system atrophy: a prospective study of self-perceived impairment

EUROPEAN JOURNAL OF NEUROLOGY, Issue 1 2007
M. Köllensperger
To assess severity and progression of self-perceived dysautonomia and their impact on health-related quality of life (Hr-QoL) in multiple system atrophy (MSA), twenty-seven patients were recruited by the European MSA Study Group (EMSA-SG). At baseline, all patients completed the Composite Autonomic Symptom Scale (COMPASS) and the 36 item Short Form Health Survey (SF-36), and they were assessed using the 3-point global disease severity scale (SS-3) and the Unified MSA Rating Scale (UMSARS). After 6 months follow-up, the self completed COMPASS Change Scale (CCS), the SF-36, SS-3, and UMSARS were obtained. MSA patients showed marked self-perceived dysautonomia at baseline visit and pronounced worsening of dysautonomia severity on the CCS at follow-up. Severity and progression of dysautonomia did not correlate with age, disease duration, motor impairment and overall disease severity at baseline. There were no significant differences between genders and motor subtypes. Baseline COMPASS scores were, however, inversely correlated with SF-36 scores. Progression of self-perceived dysautonomia did not correlate with global disease progression. Hr-QoL scores were stable during follow-up. This is the first study to investigate self-perceived dysautonomia severity in MSA and its evolution over time. Our data suggest that dysautonomia should be recognized as a key target for therapeutic intervention in MSA. [source]

Oral status of 35 subjects with eating disorders , A 1-year study

EUROPEAN JOURNAL OF ORAL SCIENCES, Issue 4 2000
Rolf Öhrn
The aim was to record changes over time in the oral status of subjects with diagnosed eating disorders. The outpatient psychiatrist had referred to the hospital dental clinic 35 women (19,47 yr, median 27 yr) with eating disorders, diagnosed according to DSM III-R criteria. At the baseline examination, dental, medical and dietary histories were taken, and intra-oral clinical and radiographic examinations were supplemented by intra-oral photographs, study casts and salivary analysis. The subjects were re-examined 1 yr later. Together, the investigators assessed progression of tooth wear blindly by comparing coded study casts from the baseline and 12-month examinations. Progression of erosive tooth wear was recorded in almost half of the subjects. Several subjects had low unstimulated salivary flow rates (<0.1 ml/min) and very high counts of mutans streptococci and lactobacilli, both at baseline and 1 yr later. The flow rates for paraffin-stimulated saliva at baseline were significantly lower for subjects with progression of erosive tooth wear than for those without. Because of the increased susceptibility to both caries and erosion, patients with eating disorders should be encouraged to have regular dental check-ups. Test of salivary flow may serve as an indicator of patients' risk of progression of erosive tooth wear. [source]

Disease Progression in Hemodynamically Stable Patients Presenting to the Emergency Department With Sepsis

ACADEMIC EMERGENCY MEDICINE, Issue 4 2010
Seth W. Glickman MD
Abstract Background:, Aggressive diagnosis and treatment of patients presenting to the emergency department (ED) with septic shock has been shown to reduce mortality. To enhance the ability to intervene in patients with lesser illness severity, a better understanding of the natural history of the early progression from simple infection to more severe illness is needed. Objectives:, The objectives were to 1) describe the clinical presentation of ED sepsis, including types of infection and causative microorganisms, and 2) determine the incidence, patient characteristics, and mortality associated with early progression to septic shock among ED patients with infection. Methods:, This was a multicenter study of adult ED patients with sepsis but no evidence of shock. Multivariable logistic regression was used to identify patient factors for early progression to shock and its association with 30-day mortality. Results:, Of 472 patients not in shock at ED presentation (systolic blood pressure > 90 mm Hg and lactate < 4 mmol/L), 84 (17.8%) progressed to shock within 72 hours. Independent factors associated with early progression to shock included older age, female sex, hyperthermia, anemia, comorbid lung disease, and vascular access device infection. Early progression to shock (vs. no progression) was associated with higher 30-day mortality (13.1% vs. 3.1%, odds ratio [OR] = 4.72, 95% confidence interval [CI] = 2.01 to 11.1; p , 0.001). Among 379 patients with uncomplicated sepsis (i.e., no evidence of shock or any end-organ dysfunction), 86 (22.7%) progressed to severe sepsis or shock within 72 hours of hospital admission. Conclusions:, A significant portion of ED patients with less severe sepsis progress to severe sepsis or shock within 72 hours. Additional diagnostic approaches are needed to risk stratify and more effectively treat ED patients with sepsis. ACADEMIC EMERGENCY MEDICINE 2010; 17:383,390 © 2010 by the Society for Academic Emergency Medicine [source]

Modifiable Risk Factors for Migraine Progression (or for Chronic Daily Headaches),Clinical Lessons

HEADACHE, Issue 2006
Marcelo E. Bigal MD
Herein we summarize clinical issues gleaned from a full peer-reviewed article on modifiable risk factors for migraine. Since migraine is progressive in some but not in most individuals, identifying patients at risk for progression is crucial. Key interventions include: (1) Decrease headache frequency with behavioral and pharmacologic interventions; (2) Monitor the body mass index and encourage maintenance of normal weight; (3) Avoid medication overuse; (4) Avoid caffeine overuse; (5) Investigate and treat sleep problems and snoring; (6) Screen and treat depression and other psychiatric comorbidities. These recommendations have not been demonstrated to improve outcomes in longitudinal studies. [source]

Progression of Tolosa-Hunt Syndrome to a Cavernous Dural Arteriovenous Fistula: A Case Report

HEADACHE, Issue 2 2003
Hidenori Sugano MD
First page of article [source]

Microenvironmental influences on human B-cell development

IMMUNOLOGICAL REVIEWS, Issue 1 2000
F. E. Bertrand
Summary: Mammalian B-cell development can be viewed as a developmental performance with several acts. The acts are represented by checkpoints centered around commitment to the B-lineage and functional Ig gene rearrangement , culminating in expression of the pre-B-cell receptor (pre-BCR) and the BCR. Progression of cells through these checkpoints is profoundly influenced by the fetal liver and adult bone marrow (BM) stromal cell microenvironments. Our laboratory has developed a model of human B-cell development that utilizes freshly isolated/non-transformed human BM stromal cells as an in vitro microenvironment. Human CD34+ hematopoietic stem cells plated in this human BM stromal cell microenvironment commit to the B lineage and progress through the pre-BCR and BCR checkpoints. This human BM stromal cell microenvironment also provides survival signals that prevent apoptosis in human B-lineage cells. Human B-lineage cells exhibit differential expression of Notch receptors and human BM stromal cells express the Notch ligand Jagged-1. These results suggest a potential role for Notch in regulating B-lineage commitment and/or progression through the pre-BCR and BCR checkpoints. [source]

Micromechanical analysis of failure propagation in frictional granular materials

INTERNATIONAL JOURNAL FOR NUMERICAL AND ANALYTICAL METHODS IN GEOMECHANICS, Issue 15 2009
Antoinette Tordesillas
Abstract The extent to which the evolution of instabilities and failure across multiple length scales can be reproduced with the aid of a bifurcation analysis is examined. We adopt an elastoplastic micropolar constitutive model, recently developed for dense cohesionless granular materials within the framework of thermomicromechanics. The internal variables and their evolution laws are conceived from a direct consideration of the dissipative mechanism of force chain buckling. The resulting constitutive law is cast entirely in terms of the particle scale properties. It thus presents a unique opportunity to test the potential of micromechanical continuum formulations to reproduce key stages in the deformation history: the development of material instabilities and failure following an initially homogeneous deformation. Progression of failure, initiating from frictional sliding and rolling at contacts, followed by the buckling of force chains, through to macroscopic strain softening and shear banding, is reproduced. Bifurcation point, marking the onset of shear banding, occurred shortly after the peak stress ratio. A wide range of material parameters was examined to show the effect of particle scale properties on the progression of failure. Model predictions on the thickness and angle of inclination of the shear band and the structural evolution inside the band, namely the latitudinal distribution of particle rotations and the angular distributions of contacts and the normal contact forces, are consistent with observations from numerical simulations and experiments. Copyright © 2009 John Wiley & Sons, Ltd. [source]

Monitoring Delamination Progression in Thermal Barrier Coatings by Mid-Infrared Reflectance Imaging

INTERNATIONAL JOURNAL OF APPLIED CERAMIC TECHNOLOGY, Issue 2 2006
Jeffrey I. Eldridge
Mid-infrared (MIR) reflectance imaging is shown to be a reliable diagnostic tool for monitoring delamination progression in thermal barrier coatings (TBCs). MIR reflectance imaging utilizes the maximum transparency of TBCs in the 3,6 ,m wavelength region to probe below-surface delamination crack propagation that is typically hidden from visible wavelength inspection. The image contrast that identifies delamination progression arises from the increased reflectance produced by a large component of total internal reflection at the TBC/buried-crack interface. Imaging was performed at a wavelength of 4 ,m to take advantage of the relatively high transmittance of plasma-sprayed 8 wt% yttria-stabilized zirconia (8YSZ) TBCs along with a desirable relative insensitivity to potentially interfering absorptions by atmospheric constituents at that wavelength. A key advantage of MIR reflectance imaging over competing techniques is that it is sensitive to delamination progression even at very early stages before delamination cracks start linking together; therefore, TBC health assessment can be achieved throughout the life of the TBC well before TBC failure is imminent. Examples are presented to demonstrate monitoring delamination progression by MIR reflectance imaging in 8YSZ TBC-coated specimens subjected to furnace cycling to 1163°C. The experimental results were in good agreement with reflectance values predicted by a four-flux Kulbelka,Munk approximation applied to the extreme cases of a completely adherent and a completely detached TBC. Practical considerations, including potential interfering effects from surface contamination, sintering, and erosion are discussed. [source]

The Influence of Gender, Ethnicity, and Individual Differences on Perceptions of Career Progression in Public Accounting

INTERNATIONAL JOURNAL OF AUDITING, Issue 1 2001
D. Jordan Lowe
Prior research examining gender and diversity issues has generally lacked supporting theory and experimental investigation. This study provides theory-based experimental evidence regarding the effects of gender, ethnicity, and other individual differences on performance evaluations of audit seniors. We utilized organizational socialization theory in examining the accounting profession's view of diversity issues. The process model of performance evaluation provided guidance in the selection of ratee, rater, and contextual characteristics as factors to analyze. An experiment was conducted with 95 audit seniors from one of the Big 5 public accounting firms. Results indicate that gender and ethnic heritage are important factors in the career prospects of audit seniors. The demeanor of an auditor was also important as an interactive factor and influences judgments differently depending on the gender or ethnic origin of the auditor evaluated. These results suggest that diversity is a very complex issue. Examining single factors without considering the interactions of a variety of factors may lead to incorrect conclusions. [source]

Weight restoration in a patient with anorexia nervosa on dialysis

INTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 4 2005
D. Blake Woodside MD
Abstract Objective We report a case of weight restoration in a patient with anorexia nervosa, end-stage renal disease (ESRD) requiring dialysis, and cardiac insufficiency. Method The technical challenges and ethical issues involved in her clinical management are reviewed. Renal insufficiency is a common complication of more severe anorexia nervosa. Results Progression to renal failure, when it occurs, is most typically a terminal event. There are currently no published guidelines for monitoring the weight gain of patients undergoing dialysis. Conclusion We present a case of a patient who progressed from renal insufficiency to renal failure while in treatment for anorexia nervosa, and who was ultimately successfully weight restored while on renal dialysis. © 2005 by Wiley Periodicals, Inc. [source]

Progression of prostate cancer to neuroendocrine cell tumor

INTERNATIONAL JOURNAL OF UROLOGY, Issue 8 2001
Masashi Tanaka
Abstract Background: The progression to endocrine therapy-resistant prostate cancer is partly due to clonal change to neuroendocrine cell tumor. To elucidate this pathologic process, the clinical courses of four cases of neuroendocrine cell tumor that were found at autopsy are reported. Methods: Between 1995 and 1999, autopsies were performed for 20 cases of prostate cancer. Lesions predominantly composed of a neuroendocrine cell tumor (small cell carcinoma) were found in four men. The clinical courses of these cases were compared to 16 other non-neuroendocrine cell tumors (adenocarcinomas). Results: The outstanding features of the neuroendocrine cell tumors were: (i) survival was brief after relapse, although the duration of control by employing endocrine therapy varied; (ii) the prostate-specific antigen level did not increase after relapse; and (iii) the sites of metastasis were similar to those of common adenocarcinomas. Conclusion: The progression to a neuroendocrine cell tumor indicated a poor prognosis and slight (if any) changes in the serum prostate-specific antigen level. This tumor might not appear to respond to any therapeutic attempt. [source]

Intravenous dexamethasone-cyclophosphamide pulse therapy in comparison with oral methylprednisolone-azathioprine therapy in patients with pemphigus: Results of a multicenter prospectively randomized study

JOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT, Issue 3 2005
Intravenöse Dexamethason-Cyclophosphamid-Pulstherapie im Vergleich zu einer oralen Methylprednisolon-Azathioprin-Therapie bei Patienten mit Pemphigus-Erkrankungen: Ergebnisse einer multizentrischen, prospektiven, randomisierten Studie
Azathioprin; Cyclophosphamid; Pemphigus; Pulstherapie Summary Background: Pemphigus is a potentially life-threatening autoimmune blistering skin disease usually treated with high-dose corticosteroids in combination with immunosuppressive drugs. In a multicenter, prospectively randomized study we compared efficacy and side effects of a dexamethasone-cyclophosphamide (D/C) pulse therapy with a methylprednisolone-azathioprine (M/A) therapy in 22,patients with newly diagnosed pemphigus vulgaris and pemphigus foliaceus. Patients and methods: The 11,patients of the M/A group were treated with daily doses of methylprednisolone (initially 2,mg/kg body weight) and azathioprine (2,,,2,5,mg/kg body weight) which were subsequently tapered. D/C pulse therapy in 11,patients consisted of intravenous administration of 100,mg dexamethasone/d on 3 consecutive days along with cyclophosphamide (500,mg) on day one. Pulses were initially repeated every 2,,,4 weeks and then at increasing intervals. In between the pulses, oral cyclophosphamide (50,mg) was given daily for 6,months. Results: Within 24,months after treatment initiation, 5/11,patients of the D/C group had a remission (complete remissions after discontinuation of therapy in 3,patients) and 6/11,patients had a progression. In the M/A group, there were remissions in 9/11,patients (complete remissions after discontinuation of therapy in 3,patients) and progression in 1/11,patients. There were more relapses in M/A therapy after remission than in D/C therapy. Side effects were more common in the M/A group. These differences were not significant (p > 0,05). Conclusion: Because of the high number of progressions in patients treated with D/C therapy, we can not confirm the encouraging results of earlier reports about pulse D/C therapy. Nevertheless D/C therapy seemed to be better tolerated and, in case of primary efficacy, was associated with fewer recurrences than M/A therapy. Zusammenfassung Hintergrund: Pemphiguserkrankungen sind potentiell lebensbedrohliche blasenbildende Autoimmunerkrankungen, die üblicherweise mit hochdosierten Kortikosteroiden in Kombination mit Immunsuppressiva behandelt werden. In einer multizentrischen, prospektiven, randomisierten Studie verglichen wir die Wirksamkeit und Nebenwirkungen einer Dexamethason-Cyclophosphamid (D/C)-Pulstherapie mit einer Methylprednisolon-Azathioprin (M/A)-Therapie bei 22,Patienten mit neu diagnostiziertem Pemphigus vulgaris und Pemphigus foliaceus. Patienten und Methoden: 11,Patienten der M/A-Gruppe wurden kontinuierlich oral mit Methylprednisolon (initial 2,mg/kg Körpergewicht/Tag) und Azathioprin (2,,,2,5,mg/kg Körpergewicht/Tag) behandelt; die Dosen wurden schrittweise reduziert. Die Therapie bei den 11,Patienten der D/C-Gruppe erfolgte durch intravenöse Gabe von 100,mg Dexamethason/Tag an 3 aufeinander folgenden Tagen und 500,mg Cyclophosphamid am ersten Tag. Die Pulstherapie wurde zunächst alle 2,,,4 Wochen, dann in längeren Abständen wiederholt. Im Intervall wurden 50,mg Cyclophosphamid/Tag oral für 6,Monate verabreicht. Ergebnisse: Innerhalb von 24,Monaten nach Therapiebeginn kam es bei 5 von 11,Patienten der D/C-Gruppe zu einer Remission (komplette Remission nach Absetzen der Therapie bei 3,Patienten); bei 6 der 11,Patienten verlief die Erkrankung progredient. In der M/A-Gruppe kam es bei 9 von 11,Patienten zu einer Remission (komplette Remission nach Absetzen der Therapie bei 3,Patienten) und bei einem Patienten zu einer Progression. In der M/A-Gruppe traten häufiger Rezidive nach Remission auf als in der D/C-Gruppe. Therapienebenwirkungen kamen in der M/A-Gruppe häufiger vor. Diese Unterschiede waren nicht signifikant (p > 0,05). Schlußfolgerungen: Aufgrund der hohen Anzahl von Progressionen bei Patienten der D/C-Gruppe können wir die positiven Ergebnisse früherer Berichte über die D/C-Pulstherapie nicht bestätigen. Dennoch scheint die D/C-Therapie, beim einzelnen Patienten einmal erfolgreich, seltener zu Rezidiven zu führen und möglicherweise auch besser verträglich zu sein als die M/A-Therapie. [source]

Predictors of Progression and Regression in Exercise Adoption in Young Women,

JOURNAL OF APPLIED SOCIAL PSYCHOLOGY, Issue 4 2003
Les C. Higgins
An integrative model of readiness to exercise (Marcus, Eaton, Rossi, & Harlow, 1994) was tested. Measures of stage of exercise adoption and of the 2 motivation variables from the model plus 3 others were obtained at baseline and 6 months later from 238 young adult females. Logistic regression analysis was used to assess the effects of both state (baseline) and change measures of the variables on progressive and regressive movement among the stages of change. Progression was predicted by change in self-efficacy (p= .018), change in perceived behavioral control (p= .007), and a baseline measure of desire to exercise (.041). Regression was predicted by change in self-efficacy (p= .04). These findings provide only partial support for the integrative model. [source]

Role of D1 and E Cyclins in Cell Cycle Progression of Human Fibroblasts Adhering to Cementum Attachment Protein,

JOURNAL OF BONE AND MINERAL RESEARCH, Issue 6 2001
Takayoshi Yokokoji
Abstract Cementum attachment protein (CAP) is a collagenous protein present in the matrix of tooth cementum that mediates preferential attachment of some mesenchymal cell types, and CAP binding capacity is related to mineralizing tissue-forming capacity in culture. We have examined if adhesion to surfaces containing CAP as the only attachment protein permits human fibroblasts to escape G1 arrest and synthesize DNA, and if adhesion to CAP modulates the levels of cyclins D1 and E. Human gingival fibroblasts (HGFs) were serum-starved, trypsinized, and added to plates coated with CAP or bovine serum albumin (BSA). Cells were then exposed to either 10% fetal bovine serum (FBS) or to cementum-derived growth factor (CGF), an insulin-like growth factor I (IGF-I)-like molecule sequestered in tooth cementum, plus epidermal growth factor (EGF). DNA synthesis was measured as [3H]thymidine uptake, and cyclin D1 and E levels were determined by Western analysis. Cyclin E-dependent kinase (Cdk) activity was assessed in terms of H1 kinase activity in immunoprecipitates of cyclin E. Cells adhering to CAP synthesized DNA, whereas on BSA they remained unattached and did not synthesize DNA. Protein levels of cyclin D1 were higher in cells adhering to CAP in the absence and presence of growth factors. Cyclin E levels were not affected by adhesion alone, but they increased in the presence of growth factors. Cyclin E-associated kinase activity was higher in cells adherent on CAP, and it increased further in the presence of growth factors. Our results indicate that adhesion to CAP increases cyclin D1 levels and cyclin E-associated Cdk activity, and that these increases contribute to cell cycle progression. We previously observed that the signaling reactions induced during adhesion are characteristic of the CAP; together these observations indicate that specific matrix components present in the local environment can contribute to recruitment and differentiation of specific cell types for normal homeostasis and wound healing. [source]

Slowed Progression or Elimination of Atherosclerosis by Low-Frequency Electrical Impulses

JOURNAL OF CARDIAC SURGERY, Issue 1 2003
Ph.D., Valeri Chekanov M.D.
In this investigation we demonstrated the slow progression or elimination of atherosclerosis by low-frequency EI in case of moderate atherosclerosis (after eight weeks of HCD). Methods: Series I rabbits (control group) were fed HCD for eight weeks. Series II rabbits were fed HCD for eight weeks and were then switched to normal diet for eight weeks (no EI). Series III rabbits were fed HCD for eight weeks and then switched to a normal diet with simultaneous EI (applied near the abdominal aorta) for eight weeks (3 V, 30 single impulses per minute, 24 hours/day). After euthanization, the level of atherosclerosis, percentage of surface area involved in the atherosclerosis process, and an atherosclerosis score were calculated in the aortic arch, thoracic and abdominal aorta. Results: Statistically significant differences were seen in the level of atherosclerosis in the abdominal aorta between series III animals (0.4 ± 0.2) and the other two groups: 1.5 ± 0.4 in series I (HCD only), 1.2 ± 0.3 in series II (HCD then normal diet). Gross examination of the surface also revealed statistically significant differences (p < 0.05) in the percentage of atherosclerosis between the control series I (30.1 ± 4.1%) and series II (21.3 ± 3.6%), compared with series III (5.5 ± 5.4%). In addition, the atherosclerosis score was also significantly different: 45.8 ± 3.9 in series I, 25.2 ± 6.9 in series II, and 2.2 ± 2.0 in series III (p < 0.05). Conclusion: Our study showed that, when applied near the abdominal aorta, low-frequency electrical impulses decrease atherosclerotic deposition in the abdominal aorta. (J Card Surg 2003; 18:47-58) [source]

Pathophysiology and Disease Progression of Atrial Fibrillation: Importance of Achieving and Maintaining Sinus Rhythm

JOURNAL OF CARDIOVASCULAR ELECTROPHYSIOLOGY, Issue 8 2008
F.A.C.C., MARC COHEN M.D.
Atrial fibrillation (AF) is a progressive disease in which arrhythmia-induced remodeling facilitates evolution from paroxysmal AF to persistent and permanent AF. Changes in electrical, structural, and contractile properties of cardiac tissue that are thought to underlie AF maintenance and progression are reviewed. Also examined is the negative impact of AF on clinical outcomes, as well as the potential benefits of restoration and maintenance of sinus rhythm. Because of the limited efficacy and adverse effects of current antiarrhythmics, new antiarrhythmic drugs need to be developed that provide safer and more effective rhythm control in AF. [source]

Angiotensin Receptor Blocker Use May Decrease the Incidence and Progression of Alzheimer's Disease and Dementia in Older Men but the Strength of the Evidence Is Questionable

JOURNAL OF CLINICAL HYPERTENSION, Issue 6 2010
Michael J. Bloch MD
First page of article [source]