Distribution by Scientific Domains
Distribution within Medical Sciences

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  • Selected Abstracts

    The extensive polymorphism of KIR genes

    IMMUNOLOGY, Issue 1 2010
    Derek Middleton
    Summary The functions of human natural killer (NK) cells are controlled by diverse families of antigen receptors. Prominent among these are the killer cell immunoglobulin-like receptors (KIR), a family of genes clustered in one of the most variable regions of the human genome. Within this review we discuss the vast polymorphism of the KIR gene complex which rivals that of the human leucocyte antigen (HLA) complex. There are several aspects to this polymorphism. Initially there is presence/absence of individual KIR genes, with four of these genes, termed framework genes, being present in all individuals tested to date, except on those very occasional instances when the gene has been deleted. Within each gene, alleles are present at different frequencies. We provide details of a new website that enables convenient searching for data on KIR gene, allele and genotype frequencies in different populations and show how these frequencies vary in different worldwide populations and the high probability of individuals differing in their KIR repertoire when both gene and allele polymorphism is considered. The KIR genes present in an individual may be classified into A and/or B haplotypes, which respectively have a more inhibitory role or a more activating role on the function of the NK cell. Family studies have been used to ascertain the make-up of these haplotypes, inclusion of allele typing enabling determination of whether one or two copies of a particular gene is present. In addition to genetic diversification the KIR gene complex shows differences at the functional level with different alleles having different protein expression levels and different avidity with their HLA ligand. [source]

    A case of necrobiotic xanthogranuloma without paraproteinemia presenting as a solitary tumor on the thigh

    Sung Eun Chang MD
    A 82-year-old Korean woman had had a 6-month history of an asymptomatic, flat, hard, red to brown tumor on her right thigh. This lesion had been slowly enlarging with an advancing margin. She had noted gradually developing pain associated with necrosis and ulceration on the lesion. Examination revealed a solitary, 8 × 7.5 cm, yellow to dark red, telangiectatic tumor with multiple areas of punched out ulceration and a peripheral elevated yellowish margin on the right inner upper thigh (Fig. 1). No clinically similar lesions on the periorbital area or other sites were seen. Histologic examination revealed a massive palisading granulomatous infiltration with several layers of extensive bands of necrobiotic zone in the entire dermis and deep subcutaneous tissue (Fig. 2a). In the granulomatous infiltrate in the dermis and subcutis, many various-shaped, some bizarre, angulated, foreign-body type multinucleated giant cells, many Touton giant cells, and a few Langhans giant cells were found to be scattered (Fig. 2b). There were numerous xanthomatized histiocytes. Dense infiltration of lymphoplasma cells was seen in the periphery of the granuloma and perivascularly. Conspicuous granulomatous panniculitis composed of lymphoplasma cells, polymorphonuclear cells, foam cells, and Touton and foreign-body giant cells was also seen. However, cholesterol clefts and lymphoid follicles were not seen. Subcutaneous septae were widened by necrobiotic change and fibrosis with thrombosed large vessels. Gram, Gomeri-methenamine silver and acid-fast stains were negative. The necrobiotic areas were positive to alcian blue. Laboratory investigation revealed elevated white blood cell counts, anemia and elevated erythrocyte sedimentation rate. The following parameters were within the normal range: lipids, glucose, renal and liver function tests, serum complements, serum immunoglobulins, cryoglobulins and antinuclear antibodies. The findings of chest X-ray, skull X-ray and ectorcardiography were normal. Serum electrophoresis and serum immunoelectrophoresis revealed no abnormality. The patient was diagnosed as having necrobiotic xanthogranuloma without paraproteinemia. She was treated with oral steroid (0.5,0.6 mg/kg) and NSAIDS for 1 month with partial improvement of pain and the lesion ceased to enlarge. In the following 1 year of follow-up, with only intermittent NSAIDS, her lesion did not progress and there were no signs of systemic involvement or new skin lesions. Figure Figure 1 . (a) A solitary, red to brown plaque with multiple ulcerations and a peripheral elevated yellowish margin on the inner upper thigh Figure 2. (a) A dermal and subcutaneous massive xanthogranulomatous infiltrate with zonal necrobiosis of collagen (× 20). (b) Prominent infiltrate of xanthomatized histiocytes and giant cells with perivascular lymphoplasma cells (H&E, × 100) [source]

    The Fulfilment Theology of Jean Daniélou, Karl Rahner and Jacques Dupuis

    NEW BLACKFRIARS, Issue 1024 2008
    Adam Sparks
    Abstract Prominent in much Theology of Religions is the concept of fulfilment (the extension of the fulfilment of the Old Covenant by Christ, to the fulfilment of other religions by Christ). The three Catholic theologians who are the subject of this article , Jean Daniélou, Karl Rahner and Jacques Dupuis , rely heavily on the fulfilment concept in their understanding of the relationship between other religions and Christianity. However, each uses the concept differently. This article outlines and then compares the use of the fulfilment concept in the theology of these three prominent theologians, and in doing so develops a fulfilment typology. [source]

    Bridging Scholarship in Management: Epistemological Reflections

    John D. Aram
    If the relevance gap in management research is to be narrowed, management scholars must identify and adopt processes of inquiry that simultaneously achieve high rigour and high relevance. Research approaches that strive for relevance emphasize the particular at the expense of the general and approaches that strive for rigour emphasize the general over the particular. Inquiry that attains both rigour and relevance can be found in approaches to knowledge that involve a reasoned relationship between the particular and the general. Prominent among these are the works of Ikujiro Nonaka and John Dewey. Their epistemological foundations indicate the potential for a philosophy of science and a process of inquiry that crosses epistemological lines by synthesizing the particular and the general and by utilizing experience and theory, the implicit and the explicit, and induction and deduction. These epistemologies point to characteristics of a bridging scholarship that is problem-initiated and rests on expanded standards of validity. The present epistemological reflections are in search of new communities of knowing toward the production of relevant and rigorous management knowledge. [source]

    Establishing an ED HIV Screening Program: Lessons from the Front Lines

    Jeremy Brown MD
    In September 2006, the Centers for Disease Control and Prevention released its revised recommendations for human immunodeficiency virus (HIV) testing. Prominent among these were the recommendations that emergency departments should perform routine screening for HIV infection. This report outlines the steps needed to set up an emergency department,based HIV screening program based on these guidelines. It contains the lessons that were learned when such a program was initiated at an academic emergency department. Consideration of these steps will help streamline the establishment of the program, but there should be careful consideration of the program's costs and sustainability before embarking on the process. [source]

    The State of Child and Adolescent Psychotherapy Research

    Alan E. Kazdin
    Child and adolescent therapy has progressed considerably, as reflected in the number of controlled studies, their methodological quality, and identification of evidence-based treatments. The progress is qualified by several characteristics of the therapy research that depart from the characteristics of clinical practice. Key areas of research are being neglected and this neglect greatly limits progress and what we know about treatment. Prominent among these is the neglect of research on the mechanisms of change and the moderators of treatment outcome. This article highlights progress, characteristics, and limitations of current therapy research. In addition, a research plan is offered to advance research by: 1) understanding the mechanisms or processes through which therapeutic change occurs; 2) drawing on developmental psychopathology research to inform treatment; and 3) expanding the range of questions that guide treatment research and the range of outcome domains on which treatment conclusions are based. [source]

    Separation, domestic violence, and divorce mediation

    Desmond Ellis
    DOVE, an instrument designed to assess and manage the risk of domestic violence, was administered to a sequential, random sample of one hundred forty-seven male and female partners prior to their participation in divorce mediation. Nineteen statistically significant predictors of both pre- and post-separation violence and abuse were identified. Conjugal violence and abuse, male partner control, and mental health problems were prominent among predictors of post-separation violence and abuse. Safety plan interventions and referrals aimed at promoting women's safety during and following their participation in divorce mediation are identified in the concluding segment of the paper. [source]

    The effect of number of lengthening contractions on rat isometric force production at different frequencies of nerve stimulation

    ACTA PHYSIOLOGICA, Issue 3 2009
    M. E. T. Willems
    Abstract Aim:, To test the effect of 3, 10, 60 and 240 lengthening contractions (LC) on maximal isometric force of rat plantar flexor muscles at different stimulation frequencies. Methods:, Using a dynamometer and electrical nerve stimulation, maximally active skeletal muscles were stretched by ankle rotation to produce LC of the plantar flexor muscles in intact female rats. After the lengthening contraction protocols, maximal isometric force was measured at different frequencies of nerve activation to obtain frequency-dependent force deficits (weakness). Results:, The magnitude of the force deficit, measured 1 h after the protocols at 80 Hz, increased as a function of repetition number (three LC, 33.3 ± 1.7%; 10 LC, 37.2 ± 2.3%; 60 LC, 67.6 ± 1.5%; 240 LC, 77.7 ± 1.2%). Force deficits were also measured at each stimulation frequency tested (5:120 Hz). Using a ratio of isometric force at 20:100 Hz stimulation, the relative depression of force at low frequency was determined. The relative depression of isometric force at low frequency was most prominent during the early repetitions. Conclusion:, As low-frequency force depression appears to result primarily from excitation,contraction (E,C) coupling failure, the early LC in a series of repeated contractions probably contribute most to damage of the cellular components involved in E,C coupling. [source]

    Creating Research Questions from Strategies and Perspectives of Contemporary Art

    CURRICULUM INQUIRY, Issue 1 2001
    G. Thomas Fox
    This essay considers how strategies and perspectives from contemporary art can suggest new questions for educational research. Although arts-based research has become more prominent lately, the concern of this paper is that the arts have become used primarily as decorative features to educational research (to further illuminate, depict, and explain the ambiguities and complexities of educational practices, see Donmoyer 1997), rather than deeply moving or disorientating perspectives on education. Another stimulant for looking into contemporary art is the concern that education must focus more on the edges of what is understood, rather than on the centers (see, for example, Fox 1995). The essay uses examples to demonstrate how a number of themes from contemporary art can be interpreted to redirect our curiosity about educational practices, policies, and theories. The paper concludes that further consideration of contemporary art can move researchers to ask more varied questions, especially about the wisdom of our progressive, critical, or humanistic views of students and learning that we have built over this century. [source]

    Near-infrared dyes for six-color immunophenotyping by laser scanning cytometry

    CYTOMETRY, Issue 3 2002
    Andreas O.H. Gerstner
    Abstract Background To adequately analyze the complexity of the immune system and reduce the required sample volume for immunophenotyping in general, more measurable colors for the discrimination of leukocyte subsets are necessary. Immunophenotyping by the laser scanning cytometer (LSC), a slide-based cytometric technology, combines cell detection based on multiple colors with their subsequent visualization without the need for physical cell sorting. In the present study, the filter setting of the LSC was adapted for the measurement of the far-red emitting dye cyanine 7 (Cy7), thereby increasing the number of measurable commercially available fluorochromes. Methods The optical filters of the LSC were replaced,photomultiplier (PMT) 3/allophycocyanin (APC): 740-nm dichroic long pass, and 670-/55-nm bandpass; PMT 4/Cy7: 810-/90-nm bandpass. Peripheral blood leukocytes were stained directly by fluorochrome-labeled antibodies or by indirect staining. The tandem dyes of Cy7 (phycoerythrin [PE]-Cy7, APC-Cy7) and the fluorochromes fluorescein isothiocyanate (FITC), PE, PE-Cy5, and APC were tested alone and in different combinations. Results With the new filter combination and tandem fluorochromes, Cy7 was measurable at 488-nm (argon laser) or 633-nm (helium-neon laser) excitation. Resolution was in the range of FITC for PE-Cy7 but approximately 30% lower for APC-Cy7; spillover into the respective donor fluorochrome channel for both tandem dyes was prominent. A six-color panel for leukocyte subtyping was designed. Conclusions With this adaptation, it is possible to measure the tandem conjugates PE-Cy7 and APC-Cy7. This new setup opens the way for six-color immunophenotyping by LSC. Cytometry 48:115,123, 2002. © 2002 Wiley-Liss, Inc. [source]

    Early molecular events in the assembly of the focal adhesion-stress fiber complex during fibroblast spreading

    CYTOSKELETON, Issue 3 2004
    Baruch Zimerman
    Cell adhesion to the extracellular matrix triggers the formation of integrin-mediated contact and reorganization of the actin cytoskeleton. Examination of nascent adhesions, formed during early stages of fibroblast spreading, reveals a variety of forms of actin-associated matrix adhesions. These include: (1) small (,1 ,m), dot-like, integrin-, vinculin-, paxillin-, and phosphotyrosine-rich structures, with an F-actin core, broadly distributed over the ventral surfaces of the cells; (2) integrin-, vinculin-, and paxillin-containing "doublets" interconnected by short actin bundles; (3) arrays of actin-vinculin complexes. Such structures were formed by freshly plated cells, as well as by cells recovering from latrunculin treatment. Time-lapse video microscopy of such cells, expressing GFP-actin, indicated that long actin cables are formed by an end-to-end lining-up and apparent fusion of short actin bundles. All these structures were prominent during cell spreading, and persisted for up to 30,60 min after plating. Upon longer incubation, they were gradually replaced by stress fibers, associated with focal adhesions at the cell periphery. Direct examination of paxillin and actin reorganization in live cells revealed alignment of paxillin doublets, forming long and highly dynamic actin bundles, undergoing translocation, shortening, splitting, and convergence. The mechanisms underlying the assembly and reorganization of actin-associated focal adhesions and the involvement of mechanical forces in regulating their dynamic properties are discussed. Cell Motil. Cytoskeleton 58:143,159, 2004. © 2004 Wiley-Liss, Inc. [source]

    Risk of emotional disorder in offspring of depressed parents: gender differences in the effect of a second emotionally affected parent

    Karlien M.C. Landman-Peeters M.A.
    Abstract In offspring of depressed parents a second parent with emotional problems is likely to increase risk of emotional disorder. This effect may however differ between sons and daughters and between offspring of depressed fathers and offspring of depressed mothers. In adolescent and young-adult offspring of parents with major depressive disorder, this study examined the effects of a second affected parent, offspring gender, gender of the depressed parent and their interactions on risk of depression and anxiety disorder. We found that daughters had a higher risk of depression and anxiety than sons and that offspring of depressed mothers had a higher risk of anxiety than offspring of depressed fathers. In addition to these main effects, we found an interaction between parent and offspring gender inasmuch that sons of depressed fathers had the lowest risk of depression and anxiety relative to the other groups. A second affected parent tended to increase risk of depression and significantly increased risk of anxiety. However, this effect of a second affected parent on offspring anxiety was most prominent in daughters when the second affected parent was the father, whereas risk in sons did not increase if the father was affected as well. Our results indicate that paternal and maternal depression similarly and additively increase daughters' risk of emotional disorder, but that sons' risk only increases with maternal depression. Intergenerational transmission of emotional disorder seems strongest when the female gender is involved, either in the form of a daughter or a depressed mother. Depression and Anxiety 0:1,8, 2007. © 2007 Wiley-Liss, Inc. [source]

    Symptom features of postpartum depression: are they distinct?,

    Ira H. Bernstein Ph.D.
    Abstract The clinical features of postpartum depression and depression occurring outside of the postpartum period have rarely been compared. The 16-item Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR16) provides a means to assess core depressive symptoms. Item response theory and classical test theory analyses were conducted to examine differences between postpartum (n=95) and nonpostpartum (n=50) women using the QIDS-SR16. The two groups of females were matched on the basis of age. All met DSM-IV criteria for nonpsychotic major depressive disorder. Low energy level and restlessness/agitation were major characteristics of depression in both groups. The nonpostpartum group reported more sad mood, more suicidal ideation, and more reduced interest. In contrast, for postpartum depression sad mood was less prominent, while psychomotor symptoms (restlessness/agitation) and impaired concentration/decision-making were most prominent. These symptomatic differences between postpartum and other depressives suggest the need to include agitation/restlessness and impaired concentration/decision-making among screening questions for postpartum depression. Depression and Anxiety 0:1,7, 2006. Published 2006 Wiley-Liss, Inc. [source]

    Histometric and Histochemical Analysis of the Effect of Trichloroacetic Acid Concentration in the Chemical Reconstruction of Skin Scars Method

    BACKGROUND Atrophic scars can be induced by various causes, including severely inflamed acne, chicken pox, and trauma. Many treatment modalities are used for reconstructing and improving the appearance of scars with various treatment results. OBJECTIVE A recent report shows the clinical efficacy of the chemical reconstruction of skin scars (CROSS) method, which consists of the focal application of trichloroacetic acid (TCA) in a higher concentration. Histometric analysis of the CROSS method, however, has not yet been established. METHODS In this study, five hairless mice were used to evaluate the effect of the CROSS method and to analyze the difference between the CROSS method and simple TCA application. RESULTS Similar histologic changes were observed in the two methods, including epidermal and dermal rejuvenation with new collagen deposition. These changes, however, were more prominent in the CROSS method,treated areas, particularly when 100% TCA was used. CONCLUSION The results of this study suggest that treatment of atrophic scars using the CROSS method is more effective than simple application of TCA in activating fibroblasts in the dermis and increasing the amount of collagen. [source]

    Efficacy of the Flashlamp-Pumped Pulsed-Dye Laser in Nonsurgical Delay of Skin Flaps

    Ali Riza Erçöçen MD
    Objective. The purpose of this article was to determine the effectiveness of laser delay by use of the flashlamp-pumped pulsed-dye laser operating at a wavelength of 585 nm; to elucidate the comparable or dissimilar macroscopic, microscopic, and hemodynamic changes between laser and surgical delay methods; and to clarify the possible mechanisms underlying the delay effect of laser. Methods. A standardized caudally based random dorsal rat flap model was used in this study: Acute random skin flaps served as control subjects (group 1). Surgical delay was employed by incision of lateral longitudinal borders both without (group 2) and with (group 3) undermining, and laser delay methods were performed by laser irradiation of both lateral longitudinal borders (group 4) and the entire surface (group 5) of the proposed flap. Evaluation was done by histologic examination, India ink injection, laser Doppler perfusion imaging, and measurement of flap survival. Results. Histologically, dilation and hypertrophy of subpapillary and subdermal vessels were evident in groups 2, 3, and 4; on the other hand, degranulation of mast cells in the vicinity of occluded vessels at the 1st hour of laser delay and a striking mast cell proliferation and degranulation in association with newly formed vessels (angiogenesis) at the 14th day of laser delay were prominent in group 5. India ink injections revealed longitudinally arranged large-caliber vessels and cross-filling between the vessels of adjacent territories in groups, 2, 3, and 4, but only small-caliber vessels in group 5. Compared with the acute flaps, both surgical and laser delay significantly increased the mean flap perfusion to the maximal levels after a 14-day delay period, and all delay procedures improved flap survival; the most significant increase in surviving area was observed in group 3, whereas the less significant increase in surviving area was in group 5. Conclusion. This study demonstrates that laser delay is as effective as surgical delay and that laser delay by lasering lateral borders leads to dilation and longitudinal rearrangement of the existing vessels rather than angiogenesis, whereas laser delay by lasering the entire surface results in delay effect by inducing angiogenesis due to activation and degranulation of the mast cells. [source]

    Human primary corneal fibroblasts synthesize and deposit proteoglycans in long-term 3-D cultures

    R. Ren
    Abstract Our goal was to develop a 3-D multi-cellular construct using primary human corneal fibroblasts cultured on a disorganized collagen substrate in a scaffold-free environment and to use it to determine the regulation of proteoglycans over an extended period of time (11 weeks). Electron micrographs revealed multi-layered constructs with cells present in between alternating parallel and perpendicular arrays of fibrils. Type I collagen increased 2,4-fold. Stromal proteoglycans including lumican, syndecan4, decorin, biglycan, mimecan, and perlecan were expressed. The presence of glycosaminoglycan chains was demonstrated for a subset of the core proteins (lumican, biglycan, and decorin) using lyase digestion. Cuprolinic blue,stained cultures showed that sulfated proteoglycans were present throughout the construct and most prominent in its mid-region. The size of the Cuprolinic-positive filaments resembled those previously reported in a human corneal stroma. Under the current culture conditions, the cells mimic a development or nonfibrotic repair phenotype. Developmental Dynamics 237:2705,2715, 2008. © 2008 Wiley-Liss, Inc. [source]

    Comparative analysis of Gata3 and Gata2 expression during chicken inner ear development

    Kersti Lilleväli
    Abstract The inner ear is a complex sensory organ with hearing and balance functions. Gata3 and Gata2 are expressed in the inner ear, and to gain more insight into their roles in otic development, we made a detailed expression analysis in chicken embryos. At early stages, their expression was highly overlapping. At later stages, Gata2 expression became prominent in vestibular and cochlear nonsensory epithelia. In contrast to Gata2, Gata3 was mainly expressed in the developing sensory epithelia, reflecting the importance of this factor in the sensory,neural development of the inner ear. While the later expression patterns of both Gata3 and Gata2 were highly conserved between chicken and mouse, important differences were observed especially with Gata3 during early otic development, providing indications of divergent molecular control during placode invagination in mice and chickens. We also found indications that the regulatory hierarchy observed in mouse, where Gata3 is upstream of Gata2 and Fgf10, could be conserved in chicken. Developmental Dynamics 236:306,313, 2007. © 2006 Wiley-Liss, Inc. [source]

    Developmental analysis of activin-like kinase receptor-4 (ALK4) expression in Xenopus laevis

    Yumei Chen
    Abstract The type I transforming growth factor-beta (TGF,) receptor, activin-like kinase-4 (ALK4), is an important regulator of vertebrate development, with roles in mesoderm induction, primitive streak formation, gastrulation, dorsoanterior patterning, and left,right axis determination. To complement previous ALK4 functional studies, we have analyzed ALK4 expression in embryos of the frog, Xenopus laevis. Results obtained with reverse transcriptase-polymerase chain reaction indicate that ALK4 is present in both the animal and vegetal poles of blastula stage embryos and that expression levels are relatively constant amongst embryos examined at blastula, gastrula, neurula, and early tail bud stages. However, the tissue distribution of ALK4 mRNA, as assessed by whole-mount in situ hybridization, was found to change over this range of developmental stages. In the blastula stage embryo, ALK4 is detected in cells of the animal pole and the marginal zone. During gastrulation, ALK4 is detected in the outer ectoderm, involuting mesoderm, blastocoele roof, dorsal lip, and to a lesser extent, in the endoderm. At the onset of neurulation, ALK4 expression is prominent in the dorsoanterior region of the developing head, the paraxial mesoderm, and midline structures, including the prechordal plate and neural folds. Expression in older neurula stage embryos resolves to the developing brain, somites, notochord, and neural crest; thereafter, additional sites of ALK4 expression in tail bud stage embryos include the spinal cord, otic placode, developing eye, lateral plate mesoderm, branchial arches, and the bilateral heart fields. Together, these results not only reflect the multiple developmental roles that have been proposed for this TGF, receptor but also define spatiotemporal windows in which ALK4 may function to modulate fundamental embryological events. Developmental Dynamics 232:393,398, 2005. © 2004 Wiley-Liss, Inc. [source]

    Electrocardiogram Differentiation of Benign Early Repolarization Versus Acute Myocardial Infarction by Emergency Physicians and Cardiologists

    Samuel D. Turnipseed MD
    Abstract Objectives: ST-segment elevation (STE) related to benign early repolarization (BER), a common normal variant, can be difficult to distinguish from acute myocardial infarction (AMI). The authors compared the electrocardiogram (ECG) interpretations of these two entities by emergency physicians (EPs) and cardiologists. Methods: Twenty-five cases (13 BER, 12 AMI) of patients presenting to the emergency department with chest pain were identified. Criteria for BER required four of the following: 1) widespread STE (precordial greater than limb leads), 2) J-point elevation, 3) concavity of initial up-sloping portion of ST segment, 4) notching or irregular contour of J point, and 5) prominent, concordant T waves. Additional BER criteria were 1) stable ECG pattern, 2) negative cardiac injury markers, and 3) normal cardiac stress test or angiography. AMI criteria were 1) regional STE, 2) positive cardiac injury markers, and 3) identification of culprit coronary artery by angiography in less than eight hours of presentation. The 25 ECGs were distributed to 12 EPs and 12 cardiologists (four in academic medicine, four in community practice, and four in community academics [health maintenance organization] in each physician group). The physicians were informed of the patients' age, gender, and race, and they then interpreted the ECGs as BER or AMI. Undercalls (AMI misdiagnosed as BER) and overcalls (BER misdiagnosed as AMI) were calculated for each physician group. Results: Cardiologists correctly interpreted 90% of ECGs, and EPs correctly interpreted 81% of ECGs. The proportion of undercalls (missed AMI/total AMI) was 2.8% for cardiologists (95% confidence interval [CI] = 0.09% to 5.5%) compared with 9.7% for EPs (95% CI = 4.8% to 14.6%) (p = 0.02). The proportion of overcalls (missed BER/total BER) was 17.3% for cardiologists (95% CI = 11.4% to 23.3%) versus 27.6% for EPs (95% CI = 20.6% to 34.6%) (p = 0.03). The mean number of years in practice was 19.8 for cardiologists (95% CI = 19 to 20.5) and 11 years for EPs (95% CI = 10.5 to 12.0) (p < 0.001). Conclusions: Although correct interpretation was high in both groups, cardiologists, who had significantly more years of practice, had fewer misinterpretations than EPs in distinguishing BER from AMI electrocardiographically. [source]

    Subacute sclerosing panencephalitis: an update

    Subacute sclerosing panencephalitis (SSPE) is a chronic encephalitis occurring after infection with measles virus. The prevalence of the disease varies depending on uptake of measles vaccination, with the virus disproportionally affecting regions with low vaccination rates. The physiopathology of the disease is not fully understood; however, there is evidence that it involves factors that favour humoral over cellular immune response against the virus. As a result, the virus is able to infect the neurons and to survive in a latent form for years. The clinical manifestations occur, on average, 6 years after measles virus infection. The onset of SSPE is insidious, and psychiatric manifestations are prominent. Subsequently, myoclonic seizures usually lead to a final stage of akinetic mutism. The diagnosis is clinical, supported by periodic complexes on electroencephalography, brain imaging suggestive of demyelination, and immunological evidence of measles infection. Management of the disease includes seizure control and avoidance of secondary complications associated with the progressive disability. Trials of treatment with interferon, ribavirin, and isoprinosine using different methodologies have reported beneficial results. However, the disease shows relentless progression; only 5% of individuals with SSPE undergo spontaneous remission, with the remaining 95% dying within 5 years of diagnosis. [source]

    Influx of calcium through L-type calcium channels in early postnatal regulation of chloride transporters in the rat hippocampus

    Jennifer G. Bray
    Abstract During the early postnatal period, GABAB receptor activation facilitates L-type calcium current in rat hippocampus. One developmental process that L-type current may regulate is the change in expression of the K+Cl, co-transporter (KCC2) and N+K+2Cl, co-transporter (NKCC1), which are involved in the maturation of the GABAergic system. The present study investigated the connection between L-type current, GABAB receptors, and expression of chloride transporters during development. The facilitation of L-type current by GABAB receptors is more prominent in the second week of development, with the highest percentage of cells exhibiting facilitation in cultures isolated from 7 day old rats (37.5%). The protein levels of KCC2 and NKCC1 were investigated to determine the developmental timecourse of expression as well as expression following treatment with an L-type channel antagonist and a GABAB receptor agonist. The time course of both chloride transporters in culture mimics that seen in hippocampal tissue isolated from various ages. KCC2 levels increased drastically in the first two postnatal weeks while NKCC1 remained relatively stable, suggesting that the ratio of the chloride transporters is important in mediating the developmental change in chloride reversal potential. Treatment of cultures with the L-type antagonist nimodipine did not affect protein levels of NKCC1, but significantly decreased the upregulation of KCC2 during the first postnatal week. In addition, calcium current facilitation occurs slightly before the large increase in KCC2 expression. These results suggest that the expression of KCC2 is regulated by calcium influx through L-type channels in the early postnatal period in hippocampal neurons. © 2009 Wiley Periodicals, Inc. Develop Neurobiol 2009 [source]

    The effects of lipid-lowering drug therapy on cardiovascular responsiveness in type 2 diabetic patients

    Laurence Guy HowesArticle first published online: 18 MAR 200
    Type 2 diabetes is associated with a high prevalence of dyslipidaemia and a high incidence of cardiovascular disease. Lipid lowering therapy with HMG Co-A reductase inhibitors (statins) reduce the risk of cardiovascular events in type 2 diabetic and non-diabetic patients, effects which are believed to be partly due to improvements in vascular function. The aetiology of abnormal vascular function in type 2 diabetics is likely to be multifactorial and the pattern of vascular dysfunction in type 2 diabetes may differ from that which occurs in non-diabetic patients with dyslipidaemia. Abnormalities in endothelium derived hyperpolarising factor (EDHF) mediated vasodilation in resistance vessels may be more prominent in both type 1 and type 2 diabetes than in non-diabetic patients with endothelial dysfunction. The effects of lipid lowering therapy on vascular responsiveness may differ in type 2 diabetic patients from those found in non-diabetic patients. Statin therapy does not appear to improve responses to endothelial dependent vasodilators in type 2 diabetics, but may alter the ratio between nitric oxide (NO) and EDHF mediated responses. Fibrate therapy improves flow mediated dilation of brachial arteries in type 2 diabetic patients, but only appears to improve endothelium dependant vasodilator responses in resistance vessels when given in conjunction with co-enzyme Q. [source]

    Acetyl-CoA carboxylases 1 and 2 show distinct expression patterns in rats and humans and alterations in obesity and diabetes

    Sebastian Kreuz
    Abstract Background Acetyl-CoA carboxylases (ACC) 1 and 2 are central enzymes in lipid metabolism. To further investigate their relevance for the development of obesity and type 2 diabetes, expression of both ACC isoforms was analyzed in obese fa/fa Zucker fatty and Zucker diabetic fatty rats at different ages in comparison to Zucker lean controls. Methods ACC1 and ACC2 transcript levels were measured by quantitative real-time polymerase chain reaction in metabolically relevant tissues of Zucker fatty, Zucker diabetic fatty and Zucker lean control animals. Quantitative real-time polymerase chain reaction was also applied to measure ACC tissue distribution in human tissues. For confirmation on a protein level, quantitative mass spectrometry was used. Results Disease-related transcriptional changes of both ACC isoforms were observed in various tissues of Zucker fatty and Zucker diabetic fatty rats including liver, pancreas and muscle. Changes were most prominent in oxidative tissues of diabetic rats, where ACC2 was significantly increased and ACC1 was reduced compared with Zucker lean control animals. A comparison of the overall tissue distribution of both ACC isoforms in humans and rats surprisingly revealed strong differences. While in rats ACC1 was mainly expressed in lipogenic and ACC2 in oxidative tissues, ACC2 was predominant in oxidative and lipogenic tissues in humans. Conclusion Our data support a potential role for both ACC isoforms in the development of obesity and diabetes in rats. However, the finding of fundamental species differences in ACC1 and ACC2 tissue expression might be indicative for different functions of both isoforms in humans and rats and raises the question to which degree these models are predictive for the physiology and pathophysiology of lipid metabolism in humans. Copyright © 2009 John Wiley & Sons, Ltd. [source]

    Prospective screening for biopsy proven coeliac disease, autoimmunity and malabsorption markers in Belgian subjects with Type 1 diabetes

    DIABETIC MEDICINE, Issue 7 2005
    M. Buysschaert
    Abstract Aims To determine prospectively the prevalence of biopsy proven coeliac disease (CD) in an adult Type 1 diabetic population from Belgium with regards to associated auto-immunity and malabsorption. Methods and results Determination in 400 Type 1 diabetic patients of serum anti-endomysial and/or anti-transglutaminase auto-antibodies. All subjects with abnormal serology underwent an intestinal biopsy. Ten patients (2.5%) had positive antibodies. Diagnosis of CD was confirmed by an intestinal biopsy. Eight patients were symptom-free, although laboratory findings suggesting malabsorption were prominent in the presence of CD [microcytic anaemia, iron and folate deficiencies, low levels of 25(OH)vitamin D3, calcium and cholesterol]. Other auto-immune conditions, especially vitiligo, were found in patients with CD. Conclusions Asymptomatic coeliac disease occurs frequently in adult Type 1 diabetic patients, and is often associated with subclinical malabsorption. Screening should be part of routine evaluation, to implement life-long dietary gluten avoidance. [source]

    The mushroom bodies , prominent brain centres of arthropods and annelids with enigmatic evolutionary origin

    ACTA ZOOLOGICA, Issue 1 2010
    Rudi Loesel
    Abstract Loesel, R. and Heuer, C.M. 2010. The mushroom bodies , prominent brain centres of arthropods and annelids with enigmatic evolutionary origin. ,Acta Zoologica (Stockholm) 91: 29,34 Mushroom bodies (MBs) are the most prominent and conspicuous neuropils in the brain of arthropods, onychophorans and vagile polychaete annelids but have not been described in any other animal group with complex brain architecture. Due to a number of unique neuroanatomical characters MBs can easily be identified and distinguished from other brain centres. However, their evolutionary origin and the question whether MBs are homologous structures is still under debate. This paper will briefly summarize the available morphological data and their implications with respect to the molecular evidence on early metazoan radiation. Unraveling the origin of MBs is an example of the challenges neurophylogenists will face in the future, especially so since it will signify a major step towards reconstructing early metazoan brain evolution. [source]

    From Disaster to Sustainable Civil Society: The Kobe Experience

    DISASTERS, Issue 1 2004
    Rajib Shaw
    Nine years after the Kobe earthquake in Japan, social issues are still prominent, and the rehabilitation process is still ongoing. The earthquake caused two major changes in Japanese society: an increase in voluntary and non-government activities, and the enhancement of cooperation between local government and the residents' association. People's participation in the decision-making process was a significant achievement. To sustain the efforts generated after the earthquake, the Kobe Action Plan was formulated and tested in different disaster scenarios. The current study suggests that civil societies in urban areas are sustainable if, first, the activities related to daily services are provided by the resident's associations; and second, these are linked to economic incentives. Leadership plays a crucial role in collective decision-making. Creation of the support system is essential for long-term sustainability of civil-society activities. These observations are exemplified in the case study in Nishi Suma, one of the worst-affected areas in the Kobe city. [source]

    The dentition of Goodrichthys, a Carboniferous ctenacanthiform shark from Scotland

    ACTA ZOOLOGICA, Issue 2009
    Michal Ginter
    Abstract Study of three sets of chondrichthyan teeth from the Mississippian (Viséan) of Glencartholm, Scotland, namely the dentition of the holotype of a ctenacanthiform shark Goodrichthys eskdalensis, the dentition of a recently found, yet undescribed shark (NMS 2000.14.2), and a group of isolated teeth probably found in a nodule, tentatively suggests that all of them represent the same species. The combined characters of these teeth show that the dentition of Goodrichthys was moderately heterodont, of a cladodont design, in which larger teeth may have had three, and smaller ones only two, lateral cusps on each side of a prominent, coarsely cristated median cusp. The base is similar to that of Cladodus and Famennian representatives of Ctenacanthus, with a prominent, undivided basolabial shelf and an almost straight orolingual ridge. [source]

    Ultrastructure of spermatozoa of lizards in the genus Mabuya from Central Brazil

    ACTA ZOOLOGICA, Issue 1 2009
    S. M. De Sá Mandel
    Abstract This is the first description of spermatozoal ultrastructure of Mabuya skinks. The spermatozoa of the species studied are filiform, consisting of a head region, a midpiece and a tail. The head is characterized by the following features: a depressed acrosome anteriorly, an acrosome vesicle divided into cortex and medulla, paracrystalline subacrosomal material, a pointed tip perforatorium, a circular perforatorium base plate inside the subacrosomal cone, an epinuclear lucent zone separated from the subacrosomal cone by a membrane, a large nuclear rostrum, and round nuclear shoulders. The midpiece presents a bilateral stratified laminar structure, a distal centriole, peripheral fibres 3 and 8 grossly enlarged, columnar mitochondria with linear cristae, dense body rings and a triangular annulus. Finally, the tail is composed of a principal piece and an end piece. An axoneme and a fibrous sheath characterize the principal piece, and the end piece is formed only by an axoneme, which loses its pattern in the last portion. Comparisons with members of Teiidae revealed differences in the numbers of dense rings. A well-developed epinuclear lucent zone in Mabuya is less prominent among teiids. In the spermatozoa of Mabuya, the first ring of dense bodies is very large, uniquely resembling the condition present in snakes. [source]

    Effect of Preload on Left Ventricular Longitudinal Strain by 2D Speckle Tracking

    ECHOCARDIOGRAPHY, Issue 8 2008
    Jin-Oh Choi M.D.
    Background: Peak systolic longitudinal strain (PSLS) obtained using the 2D speckle tracking method is a novel indicator of the long-axis function of the left ventricle (LV). We used the 2D strain profile to examine the effect of preload reduction by hemodialysis (HD) on LV PSLS in patients with end-stage renal disease (ESRD). Method and results: Twenty-nine pairs of echocardiographic evaluations were obtained before and after dialysis. Global LV PSLS was ,18.4 ± 2.9%, at baseline and decreased to ,16.9 ± 3.2% after HD (P < 0.001). Segmental analysis showed that the decrease in PSLS after dialysis was most prominent in mid-LV segments (,17.1 ± 3.5% vs. ,15.4 ± 3.4%, P < 0.001). Conclusion: PSLS obtained from the 2D strain profile is a reliable parameter that may be useful for evaluating LV systolic long-axis function. However, PSLS should be applied cautiously in ESRD patients because it could be affected by dialysis. [source]

    Modified TEI Index: A Promising Parameter in Essential Hypertension?

    ECHOCARDIOGRAPHY, Issue 4 2005
    Nurgül Keser M.D.
    Purpose: Modified TEI index is pointed to be more effective in the evaluation of global cardiac functions compared to systolic and diastolic measurements alone. We planned to determine its applicability in hypertension and relation with left ventricular mass index (LVMI). Methods: We studied 48 patients with mild/moderate hypertension and normal coronary angiograms. In total 22 patients (12 men, 10 women, mean age: 55 ± 6) with normal LVMI were studied in group I, 26 patients (12 men, 14 women, mean age: 57 ± 7) with increased LVMI in group II, and 20 patients (10 men, 10 women, mean age: 53 ± 7) with normal blood pressure as a control group. Standard 2D, Doppler, and mitral annulus pulse wave tissue Doppler were used for all measurements. Modified TEI index was calculated as diastolic time interval measured from end of Am wave to origin of Em (a,) minus systolic Sm duration (b,) divided by b(a,,b,/b,). Results: Modified TEI index was significantly higher in both groups than normal group and in group II than in group I. (Control group: 0.33 ± 0.05, group I: 0.51 ± 0.17, group II: 0.68 ± 0.16, P< 0.0001). Conclusion: Modified TEI index, a marker of left ventricular systolic and diastolic functions, is impaired in hypertensives before hypertrophy develops and impairment is more prominent in hypertrophy. Therefore, (1) modified TEI index in hypertensives is a safe, feasible, and sensitive index for evaluation of global ventricular functions. (2) Evaluation of hypertensives with this index periodically may guide interventions directed toward saving systolic and diastolic functions. (3) Modified TEI index is gaining importance as a complementary parameter to standard Doppler or in cases where standard Doppler has its limitations. [source]