NAVAL ENGINEERS JOURNAL, Issue 1 2001
P. J. Hartman Ph.D
ABSTRACT Software is becoming increasingly critical to the Fleet as more and more commercial off-the-shelf (COTS) programs are being introduced in operating systems and applications. Program managers need to specify, contract, and manage the development and integration of software for warfare systems, condition based monitoring, propulsion control, parts requisitions, and shipboard administration. The intention here is to describe the state-of-the-art in Software Reliability Engineering (SRE) and defect prediction for commercial and military programs. The information presented here is based on data from the commercial software industry and shipboard program development. The strengths and weaknesses of four failure models are compared using these cases. The Logarithmic Poisson Execution Time (LPET) model best fits the data and satisfied the fundamental principles of reliability theory. The paper presents the procedures for defining software failures, tracking defects, and making spreadsheet predictions of the defects still remaining in the software after it has been deployed. Rules-of-thumb for the number of defects in commercial software and the relative expense required to fix these errors are provided for perspective. [source]

The Potential Benefits of Remaining in School on the Long,Term Mental Health Functioning of Physically and Sexually Abused Children: Beyond the Academic Domain

AMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 1 2006
Simon Williams PhD
Community,based population survey data were used to explore whether remaining in school, independent of achievement status, was associated with lower rates of psychopathology in adulthood among participants self,reporting exposure to child physical and/or sexual abuse. Remaining in school, independent of one's achievement status, was significantly associated with a lower probability of experiencing externalizing but not internalizing disorders. Theoretical and educational implications of these results are discussed. [source]

Application for regenerative medicine of epithelial cell culture-vistas of cultured epithelium

CONGENITAL ANOMALIES, Issue 3 2006
Hajime Inoue
ABSTRACT This review describes culture techniques for the epithelial system as well as trends in the clinical application of cultured keratinocytes in our department and the possibility of applying the techniques to other organs. Cultured epithelium and cultured dermis in particular have considerably preceded regeneration of other organs in the field of regenerative medicine. Since 1988 we have grafted cultured keratinocytes by the Rheinwald-Green modified method in at least 500 patients with large skin defects. As a result of the establishment of a culture technique for individual patients, it is now possible to prepare enough regenerated epithelium to cover the body surface area of as many as 10 adult patients in approximately three weeks after collecting 1 cm2 of skin, and then remaining cultured keratinocytes can be cryo-preserved for two-stage dermatoplasty at another site. This procedure makes it possible to avoid frequent skin collection from the same patient and thereby improves patients' quality of life and activities of daily living. On the other hand, to solve the problem of regenerated epithelium shrinking and problems with graft efficiency on dermis defect lesion, we have developed a proteinase-resistant regenerated dermis by mixing a certain protein with a fibrin scaffold. Recently we also took the initiative in grafting hybrid-type regenerated trachea in an animal experiment by using the epithelial and dermal cell culture technique, and some results of the graft were obtained. [source]

Habitat Loss and Extinction in the Hotspots of Biodiversity

CONSERVATION BIOLOGY, Issue 4 2002
Thomas M. Brooks
None of these hotspots have more than one-third of their pristine habitat remaining. Historically, they covered 12% of the land's surface, but today their intact habitat covers only 1.4% of the land. As a result of this habitat loss, we expect many of the hotspot endemics to have either become extinct or,because much of the habitat loss is recent,to be threatened with extinction. We used World Conservation Union [ IUCN ] Red Lists to test this expectation. Overall, between one-half and two-thirds of all threatened plants and 57% of all threatened terrestrial vertebrates are hotspot endemics. For birds and mammals, in general, predictions of extinction in the hotspots based on habitat loss match numbers of species independently judged extinct or threatened. In two classes of hotspots the match is not as close. On oceanic islands, habitat loss underestimates extinction because introduced species have driven extinctions beyond those caused by habitat loss on these islands. In large hotspots, conversely, habitat loss overestimates extinction, suggesting scale dependence (this effect is also apparent for plants). For reptiles, amphibians, and plants, many fewer hotspot endemics are considered threatened or extinct than we would expect based on habitat loss. This mismatch is small in temperate hotspots, however, suggesting that many threatened endemic species in the poorly known tropical hotspots have yet to be included on the IUCN Red Lists. We then asked in which hotspots the consequences of further habitat loss (either absolute or given current rates of deforestation) would be most serious. Our results suggest that the Eastern Arc and Coastal Forests of Tanzania-Kenya, Philippines, and Polynesia-Micronesia can least afford to lose more habitat and that, if current deforestation rates continue, the Caribbean, Tropical Andes, Philippines, Mesoamerica, Sundaland, Indo-Burma, Madagascar, and Chocó,Darién,Western Ecuador will lose the most species in the near future. Without urgent conservation intervention, we face mass extinctions in the hotspots. Resumen: Casi la mitad del total de plantas vasculares del mundo y un tercio de los vertebrados terrestres son endémicos en 25 "áreas críticas" para la biodiversidad, cada una de las cuales tiene por lo menos 1500 especies de plantas endémicas. En ninguno de estos sitios permanece más de un tercio de su hábitat prístino. Históricamente, cubrían 12% de la superficie terrestre, pero en la actualidad su hábitat intacto cubre solo 1.4% del terreno. Como resultado de esta pérdida de hábitat esperamos que muchas de las especies endémicas a estos sitios estén extintas o , porque la pérdida de hábitat es reciente , se encuentren amenazadas de extinción. Utilizamos Listas Rojas de UICN para comprobar esta predicción. En general, entre la mitad y dos tercios de las plantas amenazadas y el 57% de los vertebrados terrestres amenazados son endémicos de áreas críticas para la biodiversidad. Para aves y mamíferos en general, las predicciones de extinción en las áreas críticas para la biodiversidad, basadas en la pérdida de hábitat, coinciden con el número de especies consideradas extintas o amenazadas independientemente. En dos clases de áreas críticas para la biodiversidad la coincidencia no es muy grande. En islas oceánicas, la pérdida de hábitat subestima la extinción porque las especies introducidas han causado más extinciones que las producidas por la reducción del hábitat. Por lo contrario, la pérdida de hábitat sobrestima la extinción en áreas críticas para la biodiversidad extensas, lo que sugiere una dependencia de escala (este efecto también es aparente para plantas). Para reptiles, anfibios y plantas mucho menos especies endémicas son consideradas amenazadas o extintas por pérdida de hábitat. Sin embargo, esta discordancia es pequeña en áreas críticas para la biodiversidad en zonas templadas templadas, lo que sugiere que muchas especies endémicas amenazadas en las poco conocidas áreas críticas para la biodiversidad en zonas tropicales aun están por incluirse en las Listas Rojas. Posteriormente nos preguntamos en que áreas críticas para la biodiversidad serían más serias las consecuencias de una mayor pérdida de hábitat (absoluta o con las tasas actuales de deforestación). Nuestros resultados sugieren que el Arco Oriental y los Bosques Costeros de Tanzania/Kenia, Filipinas, Polinesia/Micronesia no pueden soportar mayores pérdidas y que, si continúan las tasas de deforestación actuales, el Caribe, Andes Tropicales, Filipinas, Mesoamérica, Sundaland, Indo-Burma, Madagascar y Chocó/Darién/Ecuador Occidental perderán más especies en el futuro. Sin acciones urgentes de conservación, habrá extinciones masivas en las áreas críticas para la biodiversidad. [source]

The coumarin herniarin as a sensitizer in German chamomile [Chamomilla recutita (L.) Rauschert, Compositae]

CONTACT DERMATITIS, Issue 6 2010
Evy Paulsen
Background: Although German chamomile (Chamomilla recutita) is considered a weak sensitizer, recent studies have shown several possible non-sesquiterpene lactone allergens in tea (infusions) from the plant. Objective: The aim of this study was to report the results of patch testing with herniarin (7-methoxycoumarin), which is one of the possible coumarin allergens in chamomile. Patients/materials/methods: Between 1991 and 2009, selected patients with known or suspected Compositae contact allergy were patch tested with herniarin 1% petrolatum. Results: Among 36 patients tested, there was one positive and three doubtful positive reactions to herniarin. All 4 patients had a relevant contact allergy to German chamomile, whereas the majority of the remaining 32 patients had chamomile allergy of unknown relevance. Conclusions: The clinical results suggest that herniarin indeed is one of the non-sesquiterpene lactone sensitizers in German chamomile and that sensitization may occur through, for example, external use of chamomile tea or use of chamomile-containing topical herbal remedies. [source]

Cross-reactivity among p -amino group compounds in sulfonamide fixed drug eruption: diagnostic value of patch testing

CONTACT DERMATITIS, Issue 2 2004
P. Tornero
We studied 28 patients with fixed drug eruption (FDE) caused by sulfonamide antibiotics to investigate cross-reactivity between sulfonamide derivatives and p -amino compounds and to explore the usefulness of patch testing, as an alternative to controlled oral challenge testing (COCT), in diagnosis within this clinical area. COCT with sulfamethoxazole (SMX), sulfadiazine (SDZ), sulfamethizole (SMZ), furosemide (FU), procaine (PRO) and glipizide (GPZ) was performed. Patch testing (PT) with SMX and SDZ was carried out. In all patients, the diagnosis of FDE was confirmed by positive COCT and allergy to trimethoprim ruled out by COCT. 42.8 and 31.8% of the SMX-induced FDE patients reacted to SMZ and SDZ, respectively. All patients (n = 28) tolerated FU, PRO and GPZ. COCT performed with the 3 sulfonamide antibiotics in 12 patients was positive in 2 subjects with the 3 drugs, in 2 patients only with SMX and SMZ and in the remaining 8, SMX was the only causative drug. PT was positive in 5 of 25 patients positive on COCT. The probability of obtaining a positive PT was higher among patients who had a residual lesion than that among those who lacked this. Cross-reactivity between different sulfonamide antibiotics is thus variable, being most likely between SMX and SMZ. We have found no cross-reactivity between sulfonamide antibiotics and other sulfonamide derivatives or p -amino drugs in FDE. PT is a useful tool in the diagnosis of FDE, especially if there are residual lesions, because it avoided the need for COCT in 20% of patients. [source]

FS13.2 Intervention on work-related skin problems among gut cleaners

CONTACT DERMATITIS, Issue 3 2004
Mari-Ann Flyvholm
Work-related skin problems are frequent in the food processing industry. A randomised intervention study with a one-year follow up was carried out among gut cleaners in order to prevent work-related skin problems due to wet work. The effects of the intervention were primarily measured by telephone interviews using questionnaires based on a standardized questionnaire for work-related skin diseases and exposure (NOSQ-2002).* The intervention activities included an evidence-based prevention program and an evidence-based method for implementation. Six of the 18 participating departments were randomly assigned to the intervention group and the remaining 12 departments to the comparison group. A total of 644 employees responded in the baseline interview and 622 in the follow-up interview carried out a year later. The participation rates were 87,5% and 71,6% respectively. Among the 495 participants answering in both interviews the frequency of eczema on hands or forearms within the past 3 months was reduced significantly by more than 25% in the intervention departments. A minor increase was observed in the comparison departments. This study has shown that even in jobs without the possibility to reduce high exposure to wet work work-related skin problems can be reduced by proper preventive measures. *) Susitaival P, Flyvholm M-A, Meding B, Kanerva L, Lindberg M, Svensson Å, Ólafsson JH. Contact Dermatitis 2003;49:70,76. [source]

Plasma cell tumours: cytomorphological features in a series of 12 cases diagnosed on fine needle aspiration cytology

CYTOPATHOLOGY, Issue 3 2010
U. Handa
U. Handa, S. Chhabra and H. Mohan Plasma cell tumours: cytomorphological features in a series of 12 cases diagnosed on fine needle aspiration cytology Objective:, Plasma cell tumours represent autonomous proliferation of plasma cells and can manifest as multiple myeloma, monoclonal gammopathy of undetermined significance, variants of plasma cell myeloma or plasmacytoma. Methods:, We report 12 cases of plasma cell tumours, which were initially diagnosed as plasmacytoma on fine needle aspiration cytology (FNAC). The patients were further subjected to bone marrow examination, serum electrophoresis, urine examination for Bence,Jones proteins, and x-ray examination of the skeleton. Results:, The cytological smears from all cases were cellular and showed numerous plasma cells in varying degrees of maturity. Subsequent to investigations, five cases were labelled as multiple myeloma with secondary extramedullary plasmacytoma, three as solitary bone plasmacytoma and two as primary extramedullary plasmacytoma. In the remaining two cases, bone marrow and urine examination findings were not available, so a conclusive diagnosis of multiple myeloma or solitary plasmacytoma could not be made. Conclusion:, The study highlights the role of FNAC in the diagnosis of plasma cell tumours. Subsequent work-up and follow-up of these patients is important to rule out the presence of multiple myeloma. [source]

P-26 CONVENTIONAL V THIN LAYER TECHNIQUES: A COMPARATIVE STUDY OF BRONCHIAL SPECIMENS USING CONVENTIONAL AND TWO LBC METHODS, THINPREP AND SUREPATH

CYTOPATHOLOGY, Issue 2006
J. L. Conachan
The current, conventional method used is quick, easy and reasonably cheap but the nature of bronchial specimens themselves creates the need for a better preparation technique. Bronchial specimens often present with many obscuring features, such as blood and mucus, which can affect definitive diagnosis. In the study, the bronchial specimens underwent routine conventional preparation and that remaining was used to prepare an LBC slide. Both LBC methods were separately evaluated alongside the conventional method where, of the 44 specimens used, half were prepared using the conventional and ThinPrep and half with the conventional and SurePath. Evaluation forms were completed by pathologists who assessed all preparations. The results showed both LBC methods produced superior preparations that were better fixed, more cellular and had improved nuclear detail. They also removed a high percentage of background debris, were more diagnostically accurate and reduced the inadequate rate by a third. The conventional slides prepared from the same specimen as the SurePath had a lower average than those prepared with the ThinPrep. This indicated that the specimens used to evaluate the SurePath method were in fact inferior to those used for ThinPrep, with the SurePath slides showing only a slight improvement in overall quality. Despite LBC preparations reducing pathologist screening and reporting time, both methods are more labour intensive and less cost effective. The majority of laboratories are not in the financial situation to trial new methods that require extra training and more staff hours, and as such this study has highlighted an important question ,Do the benefits of better quality preparation and diagnostic accuracy offset an increase in time and cost'. [source]

Change in supporting tissue following loss of a permanent maxillary incisor in children

DENTAL TRAUMATOLOGY, Issue 6 2007
Helen D. Rodd
Abstract,,, Alveolar bone resorption is an inevitable consequence of tooth loss and may be detrimental to long-term dental aesthetics and function. The aim of the present study was to quantify the degree of tissue resorption following the loss of a permanent incisor in a young population. The study group comprised 11 boys and five girls who all required the extraction of a permanent maxillary central incisor due to trauma-related sequelae. Mean age at tooth loss was 10.8 years. Upper alginate impressions were taken at regular intervals following tooth loss and were cast in yellow dental stone. Study models were sectioned longitudinally through the mid-point of both the maxillary incisor socket and the contra-lateral incisor to provide a thin plaster section. Digital photographs were acquired of the edentulous (A1) and dentate (A2) surfaces of this section and image analysis software was employed to quantify the surface area of both A1 and A2. At 3 months postextraction, mean A1 was 15.7% less than mean A2. By 6 months mean A1 had further reduced and was 25.3% less than that of the corresponding dentate alveolus. However, at subsequent time intervals following tooth extraction (>6 months), tissue loss appeared to stabilise with an overall reduction in tissue area remaining at 22%. This reduction in supporting tissue area was found to be highly statistically significant (P = 0.002, anova). Furthermore, girls appeared to have an overall greater degree of tissue loss than boys (P = 0.015). Further research is indicated to explore factors influencing the degree of tissue loss following incisor extraction and the benefit of therapeutic interventions in limiting this resorption. [source]

Nail Biopsy: Assessment of Indications and Outcome

DERMATOLOGIC SURGERY, Issue 2 2005
Chander Grover MD, MNAMS
Background For years, nail biopsy has been shunned as a difficult and scarring procedure, which is seldom required in day-to-day practice. Only a few studies with a limited number of patients have been carried out to assess its utility in dermatology. Methods We studied 270 patients with nail disorders (both infectious and noninfectious). In 205 cases, the clinical diagnosis could be confirmed with the help of routine diagnostic aids, in the form of potassium hydroxide preparation, fungal culture, and biopsy of associated skin lesions. In the remaining 65 cases, various types of nail biopsies were carried out after ruling out contraindications to nail surgery. Results Overall, the histopathologic changes were found to be diagnostic in 63% of cases. Findings were more characteristic in infectious disorders of the nail unit. The diagnostic yield varied with the type of biopsy procedure. Side effects in the form of scarring and nail dystrophy were seen in 29.2% of the patients. Discussion Nail biopsy is useful, especially in cases with isolated nail involvement, an absence of skin lesions, and disorders such as twenty-nail dystrophy. It should be advocated in cases in which the routine diagnostic procedures fail to yield results. Proper selection of cases, choice of biopsy technique, and attention to the surgical procedure help in minimizing the side effects associated with the procedure. Conclusion Nail biopsy was found to be a simple, safe, and useful procedure, especially in cases in which the clinical diagnosis is otherwise obscure. CHANDER GROVER, MD, DNB, MNAMS, SONI NANDA, MD, B. S. N. REDDY, MD, MNAMS, AND KRISHNAMOORTHY UMA CHATURVEDI, MD, HAVE INDICATED NO SIGNIFICANT INTEREST WITH COMMERCIAL SUPPPORTERS. [source]

How many well vs. unwell days can you expect over 10 years, once you become depressed?

ACTA PSYCHIATRICA SCANDINAVICA, Issue 4 2009
T. A. Furukawa
Objective:, Prognostic studies of major depression have mainly focused on episode remission and relapse, and only a limited number of studies have examined long-term course of depressive symptomatology at threshold and subthreshold levels. Method:, The Group for Longitudinal Affective Disorders Study has conducted prospective serial assessments of a cohort of heretofore untreated major depressive episodes for 10 years under naturalistic conditions. Results:, Of the 94 patients in the cohort, the follow-up rate was 70% of the 11 280 person-months. Around 77% of the follow-up months were spent in euthymia, 16% in subthreshold depression and 7% in major depression. Duration of the index episode before reaching recovery was the only significant predictor of the ensuing well time. Conclusion:, On average, patients with major depression starting treatment today may expect to spend three quarters of the next decade in euthymia but the remaining one quarter in subthrehold or threshold depression. [source]

Identification of novel genes expressed during mouse tooth development by microarray gene expression analysis

DEVELOPMENTAL DYNAMICS, Issue 8 2007
Trevor J. Pemberton
Abstract To identify genes heretofore undiscovered as critical players in the biogenesis of teeth, we have used microarray gene expression analysis of the developing mouse molar tooth (DMT) between postnatal day (P) 1 and P10 to identify genes differentially expressed when compared with 16 control tissues. Of the top 100 genes exhibiting increased expression in the DMT, 29 were found to have been previously associated with tooth development. Differential expression of the remaining 71 genes not previously associated with tooth development was confirmed by quantitative reverse transcription-polymerase chain reaction analysis. Further analysis of seven of the latter genes by mRNA in situ hybridization found that five were specific to the developing tooth in the craniofacial region (Rspo4, Papln, Amtn, Gja1, Maf). Of the remaining two, one was found to be more widely expressed (Sp7) and the other was found to be specific to the nasal serous gland, which is close to, but distinct from, the developing tooth (Vrm). Developmental Dynamics 236:2245,2257, 2007. © 2007 Wiley-Liss, Inc. [source]

Participation of children with cerebral palsy is influenced by where they live

DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 5 2004
Donna Hammal MSc
The study aimed to determine whether degree of participation of children with cerebral palsy (CP) is influenced by where they live, as predicted by the social model of disability. Ninety-two per cent children with CP resident in Northern England and born 1991-1996 were entered into the study. Participation was measured by the Lifestyle Assessment Score and its six component domain scores. Regression analysis was used to investigate variations in participation. There were 443 children (265 male, 178 female; mean age 4 years 8 months [SD1 year 1 month] at time of assessment) in the study. In the regression analysis the following factors remained significant with regard to level of participation: type of CP (167 with hemiplegia, and of those remaining 240 with bilateral spasticity); intellectual impairment (105 with IQ<50,113 with IQ 50 to 70, and 225 with IQ>70); presence of seizures (115 with active epilepsy); walking disability (114 unable to walk, 81 restricted and needing aids, 186 restricted but unaided, 62 unrestricted); communication problems (61 no formal communication, 51 use alternative formal methods, 126 some delay or difficulty, 205 no communication problems). After adjustment for these factors, there were significant variations with regard to level of participation in the Lifestyle Assessment Score by district of residence. The magnitude of these variations in Lifestyle Assessment Score between districts is similar to that accounted for by severe intellectual impairment. Similar models were obtained for four of the six domain scores. For one of these four, restriction of social interaction, the significant variation between districts was minimally influenced by the underlying type of CP, walking ability, or presence of seizures. Higher levels of participation among children with CP are associated with residence in certain districts. This is not attributable to variations in case-mix or functional capacity of the children. Participation of children with disability is partly a product of their environment. [source]

Functional MRI of visual cortex in sedated 18 month-old infants with or without periventricular leukomalacia

DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 7 2001
L T L Sie MD
Functional MRI (fMRI) of the visual cortex was evaluated in 42 sedated 18-month-old infants (mean corrected age; 31 males, 11 females) with or without periventricular leukomalacia (PVL). Data from 14 infants could not be evaluated because of movement artefacts. Ten of the remaining 28 infants showed no significant fMRI response upon visual stimulation. In 18 infants, a significant signal change upon stimulation was found in the visual cortex: in 17 a signal decrease and in one a signal increase. Functional changes were located mainly in the anterior part of the visual cortex. Seven of the 28 infants had normal MRI and 21 showed variable occipital PVL. An fMRI response was equally frequent in infants without PVL (4 of 7 infants) and with PVL (14 of 21 infants). In conclusion, fMRI was shown to be feasible in sedated infants. No correlation was found between functional activation and the presence or absence of occipital PVL. Type of fMRI response (signal decrease) and localization (anterior part of the visual cortex) are different from those seen in adults, probably reflecting a combination of sedation effects and immaturity of the visual system. At present, fMRI is a highly promising research tool; its clinical relevance still has to be established. [source]

Symptomatic candidiasis: Using self sampled vaginal smears to establish the presence of Candida, lactobacilli, and Gardnerella vaginalis

DIAGNOSTIC CYTOPATHOLOGY, Issue 10 2007
M. K. Engberts M.D.
Abstract In a prospective cohort study, 10 symptomatic women with recurrent vulvovaginal candidiasis were taught how to prepare vaginal smears of their own vaginal fluids on days 7, 14, 21, and 28. The 40 smears were stained with the PAS-method and examined by three different cytopathologists for presence of Candida. Thereafter, the smears were restained with Giemsa-stain to determine presence of lactobacilli, Gardnerella vaginalis ("clue cells") and neutrophils. All three cytopathologists unequivocally established Candida blastospores and (pseudo)hyphae in 27 out of the 40 PAS-stained vaginal smears, whereas in the remaining 13 smears Candida was not found. All 10 patients had Candida in their smears during the second half of their menstrual cycle. Self sampled smears prove to be reliable for establishing the presence of Candida in symptomatic patients with candidiasis. Candida is associated with a lactobacillus -predominated vaginal flora, but with the absence of Gardnerella vaginalis. Further studies may be directed towards the interaction between the various members of the vaginal flora. This study should open molecular methodology for determining the possible interactions of lactobacilli and Candida. Diagn. Cytopathol. 2007;35:635,639. © 2007 Wiley-Liss, Inc. [source]

ASC-US and high-risk HPV testing: Performance in daily clinical practice

DIAGNOSTIC CYTOPATHOLOGY, Issue 11 2006
Suzanne M. Selvaggi M.D.Article first published online: 13 OCT 200
Abstract Data are beginning to accrue on high-risk HPV DNA testing in patients with ASC-US on cervical cytology. We report on our experience at the University of Wisconsin Hospital and Clinics. From February 2002 through December 31, 2005 (3 yr, 11 mo), the cytopathology laboratory processed 49,599 Pap Tests, of which 1,792 (3.6%) were diagnosed as ASC-US. Six hundred and seventy two (37.5%) of these cases were processed for high-risk HPV genotypes using the Digene Hybrid® Capture II method. Of these cases, 266 (39.6%) were positive for high-risk HPV genotypes, 11 (1.6%) were equivocal, and 395 (58.8%) were negative. Biopsy follow-up was available for 127 (47.7%) of the 266 cases, of which 66 (52%) were negative, 46 (36.2%) showed CIN I, 9 (7.1%) were CIN II, and 6 (4.7%) were CIN III. Of the remaining 139 (52.3%) cases, 86 (62%) had follow-up Pap Tests, of which 57 (66.3%) were negative, 15 (17.4%) were ASC-US, 12 (15%) were low-grade squamous intraepithelial lesions, and 2 (2.3%) were high-grade squamous intraepithelial lesions; 53 (38.1%) were lost to follow-up. In combination, 90 (42.25%) of the 213 cases with follow-up showed atypia or above after a diagnosis of ASC-US; of which 58 (64%) were low-grade lesions and 17 (19%) were high-grade lesions. Our laboratory's reported high-risk HPV positivity is comparable to recent reports in the literature on its use in daily clinical practice. In addition, cervical abnormalities were found in a significant proportion of the cases. Diagn. Cytopathol. 2006;34: 731,733. © 2006 Wiley-Liss, Inc. [source]

The significance of the diagnosis of atypia in breast fine-needle aspiration

DIAGNOSTIC CYTOPATHOLOGY, Issue 5 2004
Jennifer C. Lim M.D.
Abstract The diagnosis of atypia in breast fine-needle aspiration (FNA) continues to be an area of debate in cytology practice. The aim of this study was to assess the clinical significance of this term and to evaluate potential morphological criteria, which would determine the patient's outcome. A computer-based search was carried out to retrieve breast FNAs performed between 1990 and 2000 that were diagnosed as atypical. Cases followed by surgical resection were reexamined for the presence of morphological features potentially differentiating benign and malignant lesions. Out of 1,568 breast FNAs, there were 64 cases (4%) with a diagnosis of atypia. Thirty-eight cases had surgical follow-up material that revealed malignancy in 14 cases (37%) and benign lesions in 24 cases (63%). The benign diagnostic categories included fibrocystic change (12/24), fibroadenoma (3/24), tubular adenoma (2/24), and nonspecific findings (7/24). The malignant diagnoses included ductal carcinoma (9/14), lobular carcinoma (3/14), ductal carcinoma in situ (DCIS; 1/14), and tubular carcinoma (1/14). The evaluation of cytological criteria used to differentiate benign from malignant lesions (i.e., cellularity, loss of cohesion, myoepithelial cells, nuclear enlargement, nuclear overlap, prominent nucleoli) revealed significant overlap between benign and malignant cases, particularly in cases of fibroadenoma, tubular adenoma, and proliferative breast disease. The surgical follow-up of four hypocellular cases revealed lobular carcinoma in two cases and ductal carcinoma in the remaining two cases. Our study confirmed that the diagnosis of atypia is clinically significant because it is associated with a high probability of malignancy. No morphological criterion is able to reliably differentiate benign and malignant lesions in cases diagnosed with atypia. Diagnosis of atypia is particularly significant in hypocellular cases. We recommended that breast FNAs with a diagnosis of atypia be evaluated further histologically. Diagn. Cytopathol. 2004;31:285,288. © 2004 Wiley-Liss, Inc. [source]

Cytology of primary central nervous system neoplasms in cerebrospinal fluid specimens

DIAGNOSTIC CYTOPATHOLOGY, Issue 4 2002
David C. Chhieng M.D.
Abstract Although two-thirds of tumors occurring in the central nervous system (CNS) are primary neoplasms, only 10% of positive cerebrospinal fluid (CSF) specimens are from primary CNS tumors. In this study, we reviewed the cytologic findings of 21 positive CSF specimens from primary CNS tumors. A computer search identified 21 cases of positive CSF specimens from patients with primary CNS tumors from the archives. Follow-up included review of medical charts and histologic correlation. The specimens were from 20 patients (9 females and 11 males). Their ages ranged from 6,83 yr, old with a mean of 30 yr. The cases included 9 medulloblastomas, 7 gliomas (3 glioblastoma multiformes, 2 anaplastic astrocytomas, and 2 ependymomas), 2 germinomas, 2 non-Hodgkin's large B-cell lymphomas, and 1 ganglioneurocytoma. Two cases were classified as suspicious and the remaining as positive for malignancy. Immunocytochemistry was employed in 3 cases to support the cytologic diagnosis. These cases included one large-cell lymphoma (leukocyte-common antigen-positive), one germinoma (placental alkaline phosphatase-positive), and the ganglioneurocytoma (neuron-specific enolase- and synaptophysin-positive). There were no false-positive cases. Our results suggest that positive CSF cytology in patients with a primary CNS tumor is a reliable indicator of malignancy and reflects leptomeningeal involvement. The use of immunocytochemistry is helpful in confirming the cytologic impression in some cases. Diagn. Cytopathol. 2002;26:209,212. © 2002 Wiley-Liss, Inc. [source]

Psammoma bodies in cervicovaginal smears: Incidence and significance

DIAGNOSTIC CYTOPATHOLOGY, Issue 2 2002
Vinita Parkash M.D.
Abstract Psammoma bodies (PB) are seen in a wide variety of gynecologic conditions. However, only a few reports address the incidence or significance of PB in cervicovaginal smears (CVS). Twenty patients with PBs in CVS were identified over a 5-yr period during which time 82,840 CVS were screened. Nine cases were associated with malignancy: six uterine serous/clear cell carcinoma, two serous ovarian carcinoma, and one fallopian tube carcinoma. The remaining 11 were benign: one had an ovarian cystadenofibroma and one had PB associated with benign endometrium and endosalpingiosis. In the remaining nine cases, PB were not found on additional studies, although four gave a history of oral contraception and one each had chronic endometritis and IUD in place. The presence of atypical glandular cells diagnostic of carcinoma was the only single feature that predicted carcinoma (7/7). A combination of clinicopathologic features were helpful predictors of malignancy: postmenopausal bleeding (8/9 cases), age over 45 (9/9 cases), and abnormal clinical examination (5/9 cases). Conversely, benignancy was associated with postmenopausal bleeding in 1/11 cases, age over 45 in 3/11 cases and abnormal clinical examination in 2/11 cases. The incidence of PB in our series consecutively screened smears is 8 per 82,840 smears (0.009%). Unlike prior reports, we found that the presence of PB on CVS is not as ominous a finding as previously indicated, as only 12.5% (1/8) of patients with PB on their CVS harbor carcinoma. PB in a CVS in a young patient merits a thorough examination, but not surgical exploration in the absence of additional clinical findings or atypical cells on the CVS. Older patients (>45 yr) have a higher incidence of malignancy, even in the absence of clinical findings or atypical cells on CVS, and may warrant a surgical exploration. Diagn. Cytopathol. 2002;26:81,86; DOI 10.1002/dc.10058 © 2002 Wiley-Liss, Inc. [source]

NO EVIDENCE FOR PATIENT-TO-PATIENT TRANSMISSION OF HEPATITIS C VIRUS DURING UPPER GASTROINTESTINAL ENDOSCOPY: MOLECULAR STUDIES ON THREE ACUTE HEPATITIS C PATIENTS

DIGESTIVE ENDOSCOPY, Issue 3 2009
Takayuki Toda
Background:, The risk of patient-to-patient transmission of hepatitis C virus (HCV) during endoscopy remains controversial. Using molecular approaches, we examined the possibility of patient-to-patient transmission of HCV in three patients who developed acute hepatitis C 1,6 months after examination by upper gastrointestinal endoscopy (UGIE) in a hospital endoscopy unit in Japan. Methods:, For the source of HCV infection, we used frozen sera obtained from potential candidates who underwent UGIE earlier than three index patients on the same days in the same unit. HCV genotype was determined by multiplex polymerase chain reaction (PCR) with genotype-specific primers. The 1087-nucleotide (nt) sequence of the NS5B region of the HCV genome was compared between index patients and their HCV-viremic candidates. Results:, The three index patients were exclusively infected with HCV of genotype 1b. Among a total of 60 candidate patients who underwent UGIE earlier than the index patients, 14 were positive for anti-HCV, of whom 12 had detectable HCV-RNA (1b, n = 9; 2a, n = 1; 2b, n = 2) on sera collected during each UGIE. Shared identity within the 1087-nt NS5B sequence was less than 95.0% between index patients and HCV/1b-infected candidates (n = 3, 1 and 5, respectively). None of the remaining 46 candidates who were negative for anti-HCV at UGIE examination tested positive for HCV-RNA, nor seroconverted to anti-HCV on their sera, which most likely excludes the possibility of HCV viremia despite the anti-HCV-negative serology at UGIE examination. Conclusion:, The present study suggests that patient-to-patient transmission of HCV during UGIE is infrequent. [source]

Resection surgery with neoadjuvant chemoradiotherapy improves outcomes of patients with T4 esophageal carcinoma

DISEASES OF THE ESOPHAGUS, Issue 2 2003
T. Noguchi
SUMMARY The prognosis of patients with T4 esophageal carcinoma is poor, and thus an effective treatment needs to be established. The present study assessed the effect of chemoradiotherapy (CRT), postoperative morbidity and mortality, and survival time in 41 patients with T4 esophageal carcinoma. Of these, 24 received CRT followed by surgery (group A) and the remaining 17 were treated with CRT alone (group B). Postoperative complications in group A were compared with 251 patients (group C) who underwent surgery without CRT during the same period. Postoperative complications were more frequent in group A than group C (29.2%vs 8.4%, P < 0.05). The overall median survival of group A was statistically longer than that of group B (13.8 months and 3.3 months respectively, P < 0.001). Complete histologic response (grade 3) was documented in 4 group A patients (16.7%). The overall median survival of grade 3 patients was statistically longer than the rest of group A (38.9 months vs 8.8 months, P < 0.05). The data confirm that chemoradiotherapy creates tumor regression in some patients and allows resection surgery in T4 esophageal carcinoma. Moreover, surgery with CRT confers a survival advantage in T4 esophageal carcinoma. [source]

A latitudinal gradient of beta diversity for exotic vascular plant species in North America

DIVERSITY AND DISTRIBUTIONS, Issue 3 2008
Hong Qian
ABSTRACT Determining relationships between the ranges of introduced species and geographical and environmental factors is an important step in understanding the mechanisms and processes of the spread of introduced species. In this study, I examined the beta diversity and latitude relationship for all naturalized exotic species of vascular plants in North America at a continental scale. Beta diversity was calculated as the absolute value of the slope of the relationship between the natural logarithm of the Simpson index of similarity (lnS) and spatial distance between pairs of state-level exotic floras within four latitudinal zones examined. Relative contributions of spatial distance and environmental difference to species turnover between exotic floras were examined. I found that beta diversity decreased monotonically from low to high latitudes: beta diversity for the southernmost zone was shallower than that for the northernmost zone by a factor of 2.6. Regression models of lnS in relation to spatial distance and environmental (climatic and topographical) difference for each latitudinal zone demonstrated that the explanatory power of these variables diminishes monotonically with latitude: the explained variance in lnS is 70.4%, 62.1%, 53.9%, and 33.9%, respectively, for the four latitudinal zones from south to north. For the southernmost zone, 58.3% of the variance in lnS is explained by climate variables and topography, and spatial distance explains only 2.3% of the variance. In contrast, for the northernmost zone, more than half the amount (22.5%) of the explained variance in lnS is attributable to spatial distance, and the remaining (18.9%) of the explained variance is attributable to climate variables and topography. [source]

Potential impacts of climate change on Sub-Saharan African plant priority area selection

DIVERSITY AND DISTRIBUTIONS, Issue 6 2006
Colin J. McClean
ABSTRACT The Global Strategy for Plant Conservation (GSPC) aims to protect 50% of the most important areas for plant diversity by 2010. This study selects sets of 1-degree grid cells for 37 sub-Saharan African countries on the basis of a large database of plant species distributions. We use two reserve selection algorithms that attempt to satisfy two of the criteria set by the GSPC. The grid cells selected as important plant cells (IPCs) are compared between algorithms and in terms of country and continental rankings between cells. The conservation value of the selected grid cells are then considered in relation to their future species complement given the predicted climate change in three future periods (2025, 2055, and 2085). This analysis uses predicted climate suitability for individual species from a previous modelling exercise. We find that a country-by-country conservation approach is suitable for capturing most, but not all, continentally IPCs. The complementarity-based reserve selection algorithms suggest conservation of a similar set of grid cells, suggesting that areas of high plant diversity and rarity may be well protected by a single pattern of conservation activity. Although climatic conditions are predicted to deteriorate for many species under predicted climate change, the cells selected by the algorithms are less affected by climate change predictions than non-selected cells. For the plant species that maintain areas of climatic suitability in the future, the selected set will include cells with climate that is highly suitable for the species in the future. The selected cells are also predicted to conserve a large proportion of the species richness remaining across the continent under climate change, despite the network of cells being less optimal in terms of future predicted distributions. Limitations to the modelling are discussed in relation to the policy implications for those implementing the GSPC. [source]

The distribution and prevalence of sponges in relation to environmental gradients within a temperate sea lough: vertical cliff surfaces

DIVERSITY AND DISTRIBUTIONS, Issue 6 2000
James J. Bell
Abstract. The prevalence and distribution of sponges was surveyed on vertical cliff surfaces at Lough Hyne Marine Nature Reserve, Co. Cork, Ireland. The number of sponge species was recorded at 6-metre depth intervals at four sites within Lough Hyne, and at one site on the adjacent Atlantic coastline to examine differences in abundance and zonation patterns. Sites ranged from an exposed turbulent regime to sheltered, sedimented environments. Individual species showed different distributions and prevalence between sites and with increasing depth. Greatest differences were observed between the most- and least-disturbed sites. Distinct sponge zonation patterns were evident at all sites sampled. Twenty-five species were considered dominant at all five sites with the remaining 48 species considered rare. Only four of the 25 most-dominant species occurred at the site experiencing the most turbulent flow conditions, whereas 12 species were found at the site of unidirectional fast flow. At sites of moderate to slight water movement and high sedimentation, between 18 and 24 of the most dominant species were present. Encrusting forms constituted high proportions of sponge communities at all five sites sampled (although consisting of different species). At sites of turbulent and unidirectional fast flow massive forms also dominated whereas at the least turbulent sites, where sedimentation was high, arborescent sponges were abundant. Few species showed exclusive distribution to a single depth and site, but there was some degree of correlation between species distributions and abiotic factors such as sedimentation rate and flow regimes. Sponge distributions and densities are discussed with respect to the suitability of species' morphologies to particular environments, intra-specific and inter-specific competition and physiological adaptations that enable them to survive in different habitats. [source]

A systematic review of the effectiveness of brief interventions with substance using adolescents by type of drug

DRUG AND ALCOHOL REVIEW, Issue 3 2003
Dr ROBERT J. TAIT
Abstract The aim of this paper is to evaluate the effectiveness of brief interventions (BI) with adolescents (mean age < 20) in reducing alcohol, tobacco or other drug (ATOD) use by means of a systematic review of BI for adolescent substance use in the English language literature up to 2002. We identified 11 studies involving 3734 adolescents. Follow-up ranged from 6 weeks to 24 months. Motivational interviewing was the predominant approach, underpinning eight studies: the remaining three provided personalized health information. Seven papers reported outcomes for alcohol interventions and four involved other substances (including one with separate alcohol outcomes). The overall effect size was d= 0.126 with borderline homogeneity (Q = 14.9, df = 9, p = 0.09). The effect size from the eight alcohol interventions (n = 1075) was classified as significant but "small" (d = 0.275). The remaining non-alcohol studies were considered separately as interventions involving tobacco or multiple substance use. The two interventions with tobacco involved a substantial sample (n = 2626) but had a very small effect (d = 0.037), while the two interventions addressing multiple substances involved few participants (n = 110) but had a medium , large effect (d = 0.78). Across a diverse range of settings (dental clinic, schools, universities, substance treatment centres) and, therefore, probably diverse clients, BI conferred benefits to adolescent substance users. BI had a small effect on alcohol consumption and related measures. The data for tobacco interventions suggested a very small reduction, particularly with general community interventions. The effect of BI with multiple substances appears substantial but the small sample cautions against expansive generalization. [source]

Proteomic analysis of liver cancer cells treated with 5-Aza-2,-deoxycytidine (AZA),

DRUG DEVELOPMENT RESEARCH, Issue 1 2009
Shujun Bai
Abstract 5-Aza-2,-deoxycytidine (AZA) is a potent inhibitor of DNA methylation that exhibits anti-tumor activity in a variety of tumor cells via reactivation of tumor suppressor genes. However, few studies have been done on the biological and clinical significance of AZA in human hepatocellular carcinoma. To identify potential genes that may be aberrantly methylated and confer growth advantage to neoplastic cells and to better understand the molecular mechanism(s) underlying AZA anti-tumor activity, a proteomics approach was used to annotate global gene expression changes of HepG2 cell line pre- and post-treatment with AZA. A total of 56 differentially expressed proteins were identified by 2D gel analysis, 48 of which were up-regulated while the remaining 8 were down regulated. Among the identified proteins, eight of these showed marked changed proteins, including seven up-regulated proteins: glutathione S-transferase P, protein DJ-1, peroxiredoxin-2, UMP-CMP kinase, cytochrome c-type heme lyase, enhancer of rudimentary homolog, profilin-1, and one down-regulated protein, heat-shock protein ,,1. The possible implication of these proteins in hepatocarcinogenesis is discussed. We tested two up-regulated proteins, glutathione S-transferase P and peroxiredoxin-2, using RT-PCR and their expression was consistent with the results obtained in the protein level. Both of these genes were methylated when methylation-specific PCR was used against their promoter regions. Following treatment with AZA, the gene promoter regions were found to be unmethylated, concomitant with overexpression of the proteins compared to HepG2 cells without treatment. These data provide useful information in evaluating the therapeutic potential of AZA for the treatment of HCC. Drug Dev Res 69, 2009. © 2009 Wiley-Liss, Inc. [source]

Case studies of damage to 19-storey irregular steel moment-frame buildings under near-source ground motion

EARTHQUAKE ENGINEERING AND STRUCTURAL DYNAMICS, Issue 7 2007
Swaminathan Krishnan
Abstract This paper describes the three-dimensional nonlinear analysis of six 19-storey steel moment-frame buildings, designed per the 1997 Uniform Building Code, under strong ground motion records from near-source earthquakes with magnitudes in the range of 6.7,7.3. Three of these buildings possess a reentrant corner irregularity, while the remaining three possess a torsional plan irregularity. The records create drift demands of the order of 0.05 and plastic rotation demands of the order of 4,5% of a radian in the buildings with reentrant corners. These values point to performance at or near ,Collapse Prevention'. Twisting in the torsionally sensitive buildings causes the plastic rotations on the moment frame on one face of the building (4,5% of a radian) to be as high as twice of that on the opposite face (2,3% of a radian). The asymmetric yield pattern implies a lower redundancy in the lateral force-resisting system as the failure of the heavily loaded frame could result in a total loss of resistance to torsion. Copyright © 2006 John Wiley & Sons, Ltd. [source]

"Hands-Free" Continuous Transthoracic Monitoring of Pericardiocentesis Using a Novel Ultrasound Transducer

ECHOCARDIOGRAPHY, Issue 6 2003
F.R.C.P., P.A.N. Chandraratna
Background: Pericardiocentesis can be monitored with a hand-held transducer. The purpose of this study was to assess the feasibility of monitoring pericardiocentesis using a novel ultrasound transducer, which can be attached to the chest wall, developed in our laboratory (CONTISON). Methods: We studied nine patients with large pericardial effusions. The 2.5-MHz transducer is spherical in its distal part and mounted in an external housing to permit steering in 360 degrees. The external housing is attached to the chest wall using an adhesive patch. The CONTISON transducer was placed at the cardiac apex and an apical four-chamber view obtained. Pericardiocentesis was performed from the subcostal position. The pericardial effusion was continuously imaged. Mitral inflow velocity signals were recorded before and after pericardiocentesis. When fluid was first obtained, 50 mL of fluid were discarded after which 5 mL of agitated saline was injected through the needle. Results: In the first patient the pericardiocentesis needle was seen in the left ventricular cavity. Saline injection produced a contrast effect in the left ventricle. The needle was gradually withdrawn until contrast was seen in the pericardial sac. A total of 1100 mL was removed without further complications. The second patient had clear fluid followed by blood stained aspirate. The echocardiogram revealed gradual appearance of granular echoes within the pericardial sac, suggestive of intrapericardial clot that was subsequently surgically evacuated. In the remaining seven patients, agitated saline produced a contrast effect in the pericardial sac indicative of proper needle position. Mitral flow velocity paradoxus was noted in five patients, and it resolved after pericardiocentesis in four patients. No adjustment of the transducer was required. Conclusion: The CONTISON transducer permitted continuous monitoring of pericardiocentesis. This technique could potentially facilitate pericardiocentesis. (ECHOCARDIOGRAPHY, Volume 20, August 2003) [source]

Long-distance dispersal of seeds in the fire-tolerant shrub Banksia attenuata

ECOGRAPHY, Issue 4 2009
Tianhua He
Long-distance dispersal (LDD) of seeds enables alleles, individuals and species of plants to (re)colonize suitable but remote habitats. Banksia attenuata is a long-lived resprouting shrub restricted to dune crests in fire-prone sclerophyll shrublands of the Eneabba sandplain, southwestern Australia. Highly polymorphic microsatellite DNA genetic markers and population assignment tests were employed to identify LDD immigrants among 788 individuals from 27 stands of B. attenuata comprising a metapopulation. Of the 487 (61.8% of the total) individuals unambiguously assigned to a unique source population, 27 (5.5%) were identified as immigrants by assignment to a known population other than that from which they were sampled, while the remaining 460 were assigned to the population from which they were sampled. The distance between source and sink populations for these immigrants ranged from 0.2 to 2.6,km, averaging 1.4,km, and broadly trending in the direction of seasonal winds. These results suggest that B. attenuata has similar long-distance seed dispersal properties as its co-occurring shorter-lived and fire-sensitive congener, B. hookeriana, despite fewer, larger and less mobile seeds. The frequency and distance of LDD for seeds observed in both species (5.5,6.8%) helps explain the persistence of populations on these geographically isolated dunes, where they are subject to local extinction from recurrent fire and severe summer drought, and will remain important under predicted climate change conditions. Analysis also revealed that species richness of the functional group to which B. attenuata belongs was positively correlated with the number of immigrants identified per dune, and such correlation was likely driven by environmental properties of the dunes, particularly water availability. [source]