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Selected AbstractsDoes ageing influence deep brain stimulation outcomes in Parkinson's disease?MOVEMENT DISORDERS, Issue 10 2007Fabienne Ory-Magne MD Abstract We sought to define the influence of ageing in clinical, cognitive, and quality-of-life outcomes after subthalamic nucleus deep brain stimulation (STN-DBS) in Parkinson's disease (PD). We performed motor assessment (UPDRS), mood tests, cognitive, and quality of life evaluation (PDQ-39) on PD patients before surgery, and 12 and 24 months after, and we recorded adverse events. The variations of these parameters after surgery were correlated with age using regression statistical tests. Cerebral bleeding risk was evaluated by a nonparametric test. We enrolled 45 patients (mean age 60 ± 9 years, range 40,73). No significant correlation was found between age and motor scores and PDQ-39 improvements at 12 months. At 24 months, there was a significant negative correlation between age and the improvement of three dimensions of PDQ 39 (mobility, activities of daily life, and cognition). Cognitive impairment showed no correlation, but apathy and depression were positively correlated with age. Significant statistical difference was observed between cerebral bleeding and age. STN-DBS is an effective treatment for elderly patients with advanced PD. A longer follow-up duration and a larger population seem necessary to better assess the quality of life perception in elderly patients and to determinate the real risk of hemorrage. © 2007 Movement Disorder Society [source] Impact of traumatic experiences and violent acts upon response to treatment of a sample of Colombian women with eating disordersINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 4 2005Maritza Rodríguez MD Abstract Objective The current article compared the impact of exposure to sexual trauma and other types of physical threats against the patient or the patient's family on response to treatment, relapse, and dropout rates in 160 Colombian women between 12 and 49 years of age with eating disorders. Method A comparison was made to 70 cases with unsatisfactory response to treatment and 90 controls with a better response to treatment goals. Results Forty-five percent had a history of sexual abuse, other violent traumas, or both. Significant statistical differences were observed between both groups in exposure variables. The highest probability of poor outcome was observed in patients with sexual abuse and exposure to other violent acts (odds ratio [OR] = 6.37, 95% confidence interval [CI] = 2.1,19.07). The risk of dropout or relapse was, respectively, 10 and 3 times greater among those exposed. Discussion Violent social conditions should be noted as another form of trauma with potential impact on outcome in Colombian women with eating disorders. © 2005 by Wiley Periodicals, Inc. [source] Ceramic-On-Metal for Total Hip Replacement: Mixing and Matching Can Lead to High WearARTIFICIAL ORGANS, Issue 4 2010Saverio Affatato Abstract Ceramic-on-ceramic and metal-on-metal bearing surfaces are often employed for total hip replacement because of their resistance to wear. However, they have some limits: brittleness is a major concern for ceramic, and ion release is a drawback for metal. To reduce the effect of these limitations, a hybrid coupling of ceramic-on-metal has been proposed. The theoretical advantage of this new coupling might lead orthopedic surgeons to use it indiscriminately. We asked whether the wear rate of this innovative solution was comparable with that of ceramic-on-ceramic, which is considered to be the gold standard for wear resistance. In a hip simulator study, we tested the wear pattern of a hybrid ceramic-on-metal coupling supplied by the same distributor; in particular, three different configurations were tested for 5 million cycles: 36-mm ceramic-on-ceramic, 32-mm and 36-mm ceramic-on-metal. These combinations were gravimetrically and geometrically evaluated. After 5 million cycles, the volumetric loss for the metal acetabular cups (, 36-mm) was 20-fold greater than that of the ceramic cups of the same size (, 36-mm); a volumetric loss of 4.35 mm3 and 0.26 mm3 was observed, respectively, for ceramic-on-metal and ceramic-on-ceramic combinations. Significant statistical differences were observed between all 36-mm different combinations (P < 0.0001). The increased diameter of the 36-mm ceramic-on-metal configuration resulted in a lower volumetric loss compared with that of the 32-mm ceramic-on-metal configuration. Our findings showed an increase in wear for the proposed hybrid specimens with respect to that of the ceramic-on-ceramic ones. This confirms that even in the case of ceramic-on-metal bearings, mixing and matching could not prove effective wear behavior, not even comparable with that of the ceramic-on-ceramic gold standard. [source] Hepatocellular carcinoma with main portal vein tumor thrombusCANCER, Issue 6 2009Treatment with 3-dimensional conformal radiotherapy after portal vein stenting, transarterial chemoembolization Abstract BACKGROUND: Hepatocellular carcinoma (HCC) with main portal vein tumor thrombus (MPVTT) is often associated with poor prognosis. We retrospectively assessed the effectiveness of percutaneous transhepatic portal vein stenting and transarterial chemoembolization (PTPVS-TACE) combined with or without 3-dimensional conformal radiotherapy (3-DCRT) for HCC with MPVTT. METHODS: Forty-five patients with HCC complicated by MPVTT were treated with PTPVS-TACE. Among them, 16 patients (group A) received 3-DCRT with 30-60Gy as daily 2Gy fractions. The remaining 29 patients (group B) received no radiotherapy. The tumor responses, complications, stent patency rates, and cumulative survival rates were evaluated, and the Kaplan-Meier method and log-rank test were used for survival analysis. RESULTS: No severe complications were associated with PTPVS-TACE and 3-DCRT. The objective response rate (CR and PR) was 35.6%. The 60-, 180-, and 360-day cumulative stent patency rates were 93.3%, 62.2%, and 34.6% in group A, and 58.6%, 21.7%, and 10.8% in group B, respectively, showing significant difference between the 2 groups (P < .01). The mean patency time was 475.20 ± 136.97 and 199.58 ± 61.40 days, respectively. The 60-, 180-, and 360-day cumulative survival rates were 93.8%, 81.3%, and 32.5%, respectively, for group A, 86.2%, 13.8%, and 6.9%, respectively, for group B. Significant statistical differences were detected between the 2 groups (P < .01). CONCLUSIONS: These findings suggest that sequential therapy by PTPVS-TACE-3-DCRT is possibly an effective treatment modality for HCC complicated by main portal vein tumor thrombus. Cancer 2009. © 2009 American Cancer Society. [source] ATD perimetry in glaucoma and ocular hypertensive patients.ACTA OPHTHALMOLOGICA, Issue 2007A preliminar study Purpose: The new ATD perimetry assesses contrast sentivity thresholds for the three afferent sensory pathways of the visual system. Our aim is to compare contrast sensitivity to stimuli with different spatio-temporal frequencies in glaucomatous (G) and ocular hypertensive (OHT) subjects. Methods: Twenty three G and OHT subjects were selected from the ophthalmic clinic, all subjects signed an informed consent. Inclusion criteria were diagnosis of G or OHT, normal Farnsworth-Munsell color test, ametropia less than 6 D, visual acuity over 20/30, absence of previous ocular surgery and experience in perimetry. Twenty locations and the fovea were evaluated in a 60º x 40º fovea-centered field. Eight gabor stimuli were used: 0.5cpd-12Hz, 0.5cpd-24Hz, 4cpd-2Hz and 4cpd 12Hz, modulated along the achromatic (A) direction, 0.5cpd-12Hz and 4cpd-2Hz along the red/green (T) and blue/yellow (D) directions. Statistical analysis included ANOVA and Schéffé tests. Results: Mean thresholds for G and OHT were respectively, 0.4872 ± 0.5323 and 0.1077 ± 0.1922, for A 0.5cpd-12Hz; 0.7296 ± 0.5925 and 0.2280 ± 0.2246 for stimulus A 0.5cpd-24Hz; 1.4444 ± 0.5244 and 1,2671 ± 0.6138 for A 4cpd-2Hz; and 0.7751 ± 0.1937 and 0.6851 ± 0.2379 for D 0.5cpd-12Hz. Significant statistical differences (p<0.05) were found between G and OHT groups only with these stimuli. Conclusions: These preliminary results show that certain stimuli may differentiate between G and OHT subjects. A larger population sample, including glaucoma suspects, is currently under study. [source] Did a Foreign Language in the Elementary Schools (FLES) Program in a Kansas School District Affect Students' Academic Achievement in English?FOREIGN LANGUAGE ANNALS, Issue 3 2005Bernard G. Schuster Abstract: What happens to English academic achievement when valued class time is devoted to a foreign language in the elementary schools (FLES) program? Is there a reduction in achievement as suggested by a time-on-task hypothesis, or is there some form of compensation, as suggested by additive bilingualism? The school district in this study started a FLES program with Grade 2 students in five schools in 1995,96, and the students continued FLES through Grades 3, 4, and 5. Students in the other eight district schools received no FLES. The FLES and no-FLES students were compared based on the Grade 6 Iowa Test of Basic Skills (ITBS), using Grade 2 ITBS Survey Battery to control for initial variation in test scores. No significant statistical difference was found. [source] Endothelial cell growth on silicon modified hydrogenated amorphous carbon thin filmsJOURNAL OF BIOMEDICAL MATERIALS RESEARCH, Issue 1 2008A. A. Ogwu Abstract The biological response of human microvascular endothelial cells (HMEC-1) seeded on Si-DLC films and on control surfaces was evaluated in terms of initial cell enhancement, growth, and cytotoxicity. The microstructure of the films was characterised by Raman spectroscopy and X-ray photoelectron spectroscopy. The effect of changes in microstructure, surface energy, surface electronic state, and electronic conduction, on the biological response of the films to endothelial cells was investigated. Endothelial cell adhesion and growth was found to be affected by changes in the microstructure of the films induced by silicon doping and thermal annealing. We observed a significant statistical difference in endothelial cell count between the as-deposited DLC and Si-DLC films using the one sample t -test at a p -value of 0.05. We also found a statistically significant difference between the adhesion of HMEC films on DLC and Si-DLC films at various annealing temperatures using the one-way ANOVA F statistic test at p < 0.05 and the post-hoc Tukey test. One sample t -test at p < 0.05 of MTT-assay results showed the endothelial cells to be viable when seeded on DLC/Si-DLC films. We suspect that the increased adhesion of endothelial cells induced by increasing the amount of silicon in the Si-DLC films is associated with the development of a suitable surface energy due to silicon addition, which neither favored cell denaturing nor preferential water spreading before cellular attachment on the film surface. The presence of an external positively charged dipole on the Si-DLC films confirmed by our Kelvin probe measurements is also expected to enhance the adhesion of endothelial cells that are well known to carry a negative charge. The Si-DLC films investigated hold potential promise as coatings for haemocompatible artificial implants. © 2007 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2008 [source] Chagas' disease: IgG isotypes against cytoplasmic (CRA) and flagellar (FRA) recombinant repetitive antigens of Trypanosoma cruzi in chronic Chagasic patientsJOURNAL OF CLINICAL LABORATORY ANALYSIS, Issue 5 2007A.F.A. Verçosa Abstract The wide range of clinical Chagas' disease manifestations, of which heart involvement is the most significant, because of its characteristics, frequency and consequences, and lack of treatment and cure, justify research in this area. Specific immunoglobulin G (IgG) antibody subclasses have been associated with human Chagas' disease. Thus, in this study, the profile of IgG subclasses against cytoplasmic (CRA) and flagellar (FRA) recombinant repetitive T. cruzi,specific antigens was correlated with cardiac (CARD, n=33), cardiodigestive (CD, n=7), and indeterminate (IND, n=20) forms of Chagas' disease by indirect enzyme-linked immunosorbent assay (ELISA). IgG subclasses were detected in almost all Chagas patients studied. Nevertheless, only specific IgG2 isotype FRA was found with a significant statistical difference in CARD patients when compared to IND patients. This result suggests the potential use of this isotype for prognostic purposes, for monitoring the progression of chronic Chagas' disease, and for predicting the risk of CARD damage. This is important information, as it could help physicians to evaluate and manage the treatment of their patients. However, a follow-up study is necessary to confirm our result. J. Clin. Lab. Anal. 21:271,276, 2007. © 2007 Wiley-Liss, Inc. [source] IL-2 gene C/T polymorphism is associated with prostate cancerJOURNAL OF CLINICAL LABORATORY ANALYSIS, Issue 6 2006Hsi-Chin Wu Abstract Cytokines are reported to be associated with the formation of prostate cancer. Our aim was to investigate whether C/T polymorphisms of the interleukin-2 (IL-2) gene and IL-2 receptor beta (IL-2RB) gene are associated with prostate cancer. We compared the frequency of the polymorphisms of the IL-2 gene and the IL-2RB gene between 96 patients with prostate cancer and 105 healthy male volunteers from the same area (age >60 years). They were followed for at least 5 years. There was a significant difference in distribution of the genotype of the IL-2 gene polymorphism between the prostate cancer group and the control group (P = 0.017). The distribution of the TT homozygote of the IL-2 gene was significantly higher in the cancer group (32.3%) than in the control group (16.2%). However, no significant statistical difference was found between the polymorphism of the IL-2 gene and prostate cancer in survival analysis during a 5-year follow up period (log rank test; P = 0.19). There was no significant difference in the distribution of the genotype of the IL-2RB gene polymorphism between controls and cancer patients (P = 0.388). This study suggests that the IL-2 gene may be associated with susceptibility to prostate cancer in the Taiwan population. J. Clin. Lab. Anal. 20:245,249, 2006. © 2006 Wiley-Liss, Inc. [source] Effects of simultaneous kidney-pancreaticoduodenal transplantation on diabetes-induced renal insufficiency in ratsMICROSURGERY, Issue 4 2001Jin Han Yoon M.D., Ph.D. An investigation of the functional and histological changes was done after en-bloc kidney-pancreaticoduodenal transplantation (kpdt) in the diabetes-induced, renal insufficient Lewis rats. For donor preparation, an end-to-side portocaval shunt was performed, and the aortic, vena caval segments, and ureter-bladder patch were obtained. They were anastomosed microsurgically to recipient's aorta, vena cava, and bladder in end-to-side fashion. Of 15 diabetes-induced kpdt rats, 14 survived. Two of the 14 surviving rats showed ischemic necrosis. The remaining 12 transplants showed well-preserved glomeruli and Langerhans islets for 5 months postoperatively. Biochemical data comparing diabetic and sham-operated rats (six rats each), six diabetic controls, and 12 kpdt rats showed no significant statistical difference at said observation period. The diabetes-induced kpdt rats showed improvement of following biochemical data: within 1 week postoperatively, the glucose level fell from 300 to 115 mg/dL; BUN level from >20 to <20 mg/dL; the creatinine level from 1.5 to <1.2 mg/dL. The insulin level returned to normal, 1.1 ng/mL, in 2 weeks. The results demonstrate that the kpdt model is an effective and successful operative technique in diabetic rats and may provide effective therapeutic methods for diabetes-induced renal insufficiency. © 2001 Wiley-Liss, Inc. MICROSURGERY 21:173,178 2001 [source] The braun thermoscan thermometer: validation of normal ranges in a paediatric practicePEDIATRIC ANESTHESIA, Issue 9 2002C.A. Streets Introduction Pyrexia is a common cause of operative cancellation in paediatric practice, and so the accurate determination of temperature is of paramount importance. Recently the Braun ThermoScan infrared aural thermometer has been introduced to Derriford Hospital as a safe and non-invasive technique for measuring temperature. Initially the published upper limits of normal for this technique appeared to be higher than expected. Initial experiences with the thermometer in Derriford Hospital produced high temperature readings in children who were otherwise clinically well. The aim of this study was to compare the manufacturer's published normal ranges with those obtained from a general paediatric population. Methods Ethics Committee approval was obtained. The study was conducted between July and November 2001. Patients less than 16 years of age, and admitted to either the Day Surgical Unit or the general paediatric wards for elective surgery were included. Each child had its temperature measured on admission using the Braun ThermoScan aural thermometer. The ages and temperatures were recorded, and the values compared with the manufacturer's normal ranges using standard error of the means. Results Preliminary data are reported from 248 children: 1,2 years (n = 30), 3,10 years (n = 159), and 11,15 years (n = 59). The table demonstrates that there is no significant statistical difference between the manufacturer's ranges and those of the Derriford Hospital paediatric elective surgical population. Discussion The Braun ThermoScan infrared aural thermometer is considered to be a safe, hygienic, and convenient technique for measuring temperature. Despite initial misgivings that a temperature approaching 38°C could not be considered normal, this study has confirmed that the manufacturer's published normal ranges are indeed compatible with those obtained from a district general hospital paediatric population. Conclusion This study validates the manufacturer's published normal range for the Braun ThermoScan thermometer. This therefore leaves a clinical dilemma , does a child with a temperature of 37.9°C have a pyrexia or not? [source] Group-specific component (GC) in curiaú and pacoval, two african-derived brazilian populationsAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 6 2001Silviene Fabiana De Oliveira The group-specific component (GC) system is of interest in anthropological genetic studies because the distribution of its subtypes distinguishes among major ethnic groups. The GC system was analyzed in Curiaú and Pacoval, two remnant Quilombo populations (African-derived populations) from the Brazilian Amazon. There was no significant statistical difference in allelic frequencies between the two populations or between them and three other African-derived Brazilian populations (Mimbó, Sítio Velho, and Gaucinha in Northeastern Brazil). These populations share similarities among themselves and with African populations (high frequencies of GC*1F and lower frequencies of GC*1S), which may reflect the influence of a high level of African contribution to their formation, but there is a clear difference between them and Europeans and South American Indians. It is suggested that the GC system is a useful marker for studying relationships between single populations and major ethnic groups, but does not discriminate between populations which share the same parental stock. Am. J. Hum. Biol. 13:718,720, 2001. © 2001 Wiley-Liss, Inc. [source] Prevalence of Helicobacter pylori in Patients with Nasal Polyps: A Preliminary ReportTHE LARYNGOSCOPE, Issue 11 2004Can Koc MD Abstract Objectives: The aim of the study is to determine the presence of H. pylori in nasal polyps by both immunohistochemical staining with H. pylori antibody of biopsy specimens and enzyme-linked immunoadsorbent assay (ELISA) of sera. Study Design: A prospective, controlled, clinical trial. Methods: We enrolled 30 patients with nasal polyps and 20 controls with middle concha bullosa undergoing endoscopic sinus surgery (ESS). Blood samples of both the study and control groups were evaluated for anti- H. pylori specific immunoglobulin (Ig)G antibodies by ELISA. In addition, biopsy specimens of the removed polyps and the mucosal part of middle conchas were examined by the immunohistochemical analysis with H. pylori antibody. Results: In the blood samples, specific IgG antibodies to H. pylori were found in 26 (86.7%) of 30 polyp patients and 17 (85%) of 20 controls. In 6 (20%) of the 30 patients, H. pylori was identified in the nasal polyp tissue, but it was not detected in the mucosal part of the middle concha specimens. No significant statistical difference was observed for H. pylori antibodies by ELISA among the patients with nasal polyps and the control group (Fisher's exact test, P = .59). However, there was a statistical difference between the polyp biopsy specimens and the control biopsy specimens by immunohistochemical staining (Fisher's exact test, P = .037). Conclusions: This study indicates that H. pylori was found in increased prevalence in the nasal polyps. However, further controlled epidemiologic studies would be necessary to confirm our results and clarify the potential underlying pathogenetic mechanisms. [source] Novel Imaging Analysis System to Measure the Spatial Dimension of Engineered Tissue ConstructARTIFICIAL ORGANS, Issue 2 2010Kyoung-Hwan Choi Abstract The measurement of the spatial dimensions of tissue-engineered constructs is very important for their clinical applications. In this study, a novel method to measure the volume of tissue-engineered constructs was developed using iterative mathematical computations. The method measures and analyzes three-dimensional (3D) parameters of a construct to estimate its actual volume using a sequence of software-based mathematical algorithms. The mathematical algorithm is composed of two stages: the shape extraction and the determination of volume. The shape extraction utilized 3D images of a construct: length, width, and thickness, captured by a high-quality camera with charge coupled device. The surface of the 3D images was then divided into fine sections. The area of each section was measured and combined to obtain the total surface area. The 3D volume of the target construct was then mathematically obtained using its total surface area and thickness. The accuracy of the measurement method was verified by comparing the results with those obtained from the hydrostatic weighing method (Korea Research Institute of Standards and Science [KRISS], Korea). The mean difference in volume between two methods was 0.0313 ± 0.0003% (n = 5, P = 0.523) with no significant statistical difference. In conclusion, our image-based spatial measurement system is a reliable and easy method to obtain an accurate 3D volume of a tissue-engineered construct. [source] Is head and neck melanoma a distinct entity?BRITISH JOURNAL OF DERMATOLOGY, Issue 4 2006A clinical registry-based comparative study in 5702 patients with melanoma Summary Background, The head and neck region is more heavily exposed to ultraviolet (UV) radiation than any other body site. Therefore, cutaneous malignant melanoma (CMM) of the head and neck area is proposed to have notable differences from melanoma at other body sites regarding clinicopathological features and survival of patients. Objectives, The present retrospective study based on clinical registry data aims to compare clinical features and prognostic factors of head and neck melanoma (HNM) vs. melanoma at other anatomical regions (MOR) in order to detect differences which may be associated to the mode of sun exposure. Methods, The clinical records and histopathological findings of 844 patients with clinical stage I and II invasive HNM were compared with the data of 4858 patients with MOR. Survival analysis was performed using the Kaplan,Meier estimate, and the multivariate Cox proportional hazard model was used to evaluate independent prognostic factors. Results, Melanoma density was clearly higher for HNM than for MOR: this was particularly true for the face, where it was elevated by a factor of 2·6. There was a higher male/female ratio in patients with HNM and they were significantly older than patients with MOR (P < 0·0001). Breslow tumour thickness did not differ between HNM and MOR. However, CMMs at the scalp were significantly thicker and to a higher degree ulcerated. Concerning clinicopathological CMM subtypes, there was an increased proportion of lentigo maligna melanoma among HNM and of nodular melanoma in the scalp and neck regions. Excision margins were narrower and the rate of complete primary excision was lower in HNM than in MOR. Overall, there was no significant statistical difference in cumulative 10-year survival rates according to Kaplan,Meier estimates among patients with HNM (84·6%) and MOR (87·8%). Tumour thickness turned out to be the variable with the highest prognostic impact followed by ulceration in both HNM and MOR. Conclusions, In relation to the skin surface significantly more CMMs were found in the head and neck area than in other anatomical regions. This might indicate, but does not prove, that UV exposure promotes the development of CMM. Although HNM showed specific clinicopathological features, prognosis remained unaffected. Thus HNM seems not to be a distinct subtype of CMM. [source] Metabolic differences between male and female adolescents with non-alcoholic fatty liver disease, as detected by ultrasoundACTA PAEDIATRICA, Issue 8 2010MTB Fernandes Abstract Background:, Age, developmental stage and gender are risk factors for paediatric non-alcoholic fatty liver disease (NAFLD). Aims:, The aim of this study was to identify differences in clinical or laboratory variables between sexes in adolescents with NAFLD. Methodology:, Ninety obese adolescents including 36 males and 54 females were evaluated. Inclusion criteria for this study were a Body Mass Index above the 95th percentile, as set forth by the National Center for Health Statistics, and an age of 10,19 years. A clinical and laboratory evaluation was conducted for all adolescents. Results:, The variables that were found to be predictive of NAFLD in adolescence were visceral fat, Aminotransferase, Gamma-Glutamyl Transferase, triglyderides, cholesterol and LDL-cholesterol. We also observed that cholesterol and LDL-cholesterol variables were influenced by gender, i.e. there was a significant statistical difference in the values of these variables between male and female adolescents. With regard to cholesterol serum concentrations, the risk was 6.99 times greater for females, compared with 1.2 times for males; and for LDL-cholesterol serum concentrations the risk was 8.15 times greater for females, compared with and 1.26 times for males. Conclusion:, Female adolescents with NAFLD showed a significantly different metabolic behaviour than males. [source] The course and branching pattern of pudendal nerve in fetusCLINICAL ANATOMY, Issue 7 2008Necdet Kocabiyik Abstract The pudendal nerve is a considerably large branch of the sacral plexus. There are many articles in the literature concerning the pudendal nerve in adults, but as far as we know, there is none on the branching pattern and variations in pudendal nerve anatomy in fetus. This study investigates the pudendal nerve trunking with respect to the piriformis muscle in 25 formalin-fixed fetuses (50 sides of pelves, 15 females, 10 males), ranging from 20 to 37 weeks of gestation. We investigate pudendal nerve trunking in four types: Type I-a is defined as single-trunk with the inferior rectal nerve branching proximal to the dorsal nerve of penis/clitoris (38%), Type I-b is also single-trunk with the dorsal nerve of penis/clitoris branching proximal to the inferior rectal nerve (24%), Type II is double-trunk with medial trunk as an inferior rectal nerve (34%), and Type III is triple-trunk (4%). We measured the average diameter of the main trunk of pudendal nerve in Type I-a and I-b groups to be 0.98 ± 0.33 mm. We also measured the average length of the pudendal nerve trunks before the dorsal nerve of penis/clitoris branch to be 7.35 ± 3.50 mm. There was no significant statistical difference in the average length, diameter, number of trunks, and pudendal nerve variations between male and female and also right and left sides of the pelves. This first and detailed fetal study of pudendal nerve trunking with respect to the piriformis muscle would be useful for educational anatomy dissections and anatomical landmark definitions for relevant clinical procedures. Clin. Anat. 21:691,695, 2008. © 2008 Wiley-Liss, Inc. [source] Does Playing Blindfold Chess Reduce the Quality of Game: Comments on Chabris and Hearst (2003)COGNITIVE SCIENCE - A MULTIDISCIPLINARY JOURNAL, Issue 1 2010Veljko Jeremic Abstract Blindfold chess is a special type of chess game where both the board and pieces are not visible to its players. This paper aims to determine whether the quality of the game played blindfolded is lower than when played under normal conditions. The best chess program was used to analyze games played by the world's top Grandmasters under both conditions. We have analyzed the Monaco 1993,1998 data set introduced by Chabris and Hearst (2003). The results showed that although a larger number of mistakes occurred while playing blindfolded, no significant statistical difference between the rapid and blindfold games has been found. Nevertheless, by applying the same methodology to the Monaco 2002,2007 data set a substantial difference between the blindfold and the rapid chess game was noticed. In this paper, we have addressed the possible improvement of the chess game quality and the advances in chess programs that may be responsible for detecting more blunders. [source] Significance of white blood cell count and its subtypes in patients with acute coronary syndromeEUROPEAN JOURNAL OF CLINICAL INVESTIGATION, Issue 5 2009G. Huang Abstract Background, Inflammation plays a role in the pathogenesis of coronary atherosclerosis. Materials and methods, Six hundred twenty-three patients with acute coronary syndrome (ACS) referred for coronary angiography for the first time in our hospital were enrolled in this study. White blood cell and its subtypes were measured on admission. The study population was divided into three groups based on total white blood cell count and followed up. Clinical end points were major adverse cardiac events (MACEs), including cardiogenic death, stroke, heart failure, non-fatal myocardial infarction, rehospitalization for angina pectoris. Results, The median age was 68 years (range 31,92) and 64·2% of the patients were men. The median white blood cell count was 6·48 × 109 L,1 (range 2·34,27·10 × 109 L,1). The median follow-up duration was 21 months (range 1,116) and MACEs occurred in 167 patients. The multivariable Cox proportional hazards regression model revealed that neutrophil count [Relative risk = 1·098, 95% Confidence interval (CI): 1·010,1·193, P = 0·029) was a risk factor for MACEs. The logistic regression model revealed that lymphocyte count [Odds ratio (OR) = 1·075, 95% CI: 1·012,1·142, P = 0·018] and monocyte count (OR = 8·578, 95% CI: 2·687,27·381, P < 0·001) were predictive of stenosis , 75%; Neutrophil proportion (OR = 1·060, 95% CI: 1·007,1·115, P = 0·026), monocyte count (OR = 12·370, 95% CI: 1·298,118·761, P = 0·029) were predictive of the presence of multivessel disease. Kaplan,Meier analysis of short-term and long-term cumulative survival showed no significant statistical differences among three groups. Conclusions, Neutrophil count adds prognostic information to MACEs in ACS. Monocyte count and lymphocyte count are predictive of severity of coronary atherosclerosis. [source] Morphometric Controls and Basin Response in The Cascade MountainsGEOGRAFISKA ANNALER SERIES A: PHYSICAL GEOGRAPHY, Issue 3 2001Fes De Scally Morphometric variables associated with 36 debris torrent, 78 snow avalanche, 45 composite debris torrent and snow avalanche and 14 streamflow basins in the Cascade Mountains of southwestern British Columbia, Canada are examined. The results show significant statistical differences in top and bottom elevations, relief, channel length and gradient, basin area, fan gradient and area, and basin ruggedness between snow avalanche basins and the two basin types affected by debris torrents, reflecting the very different nature of these processes. Only top and bottom elevations and fan area differ significantly between debris torrent and debris torrent-snow avalanche basins, implying that the latter are probably debris torrent basins in origin. As many as six morphometric variables are significantly different between streamflow basins and the other basin types, allowing the former to be differentiated despite their small, steep character. Discriminant analysis indicates that bottom elevation and channel or path gradient are the best variables for classifying the four basin types by process. Generally strong correlations exist between basin area on the one hand and relief, channel length and channel gradient on the other in debris torrent, debris torrent-snow avalanche, and streamflow basins. Fan gradient and area are, however, weakly or modestly correlated with basin area or ruggedness. No such morphometric relations are present in snow avalanche basins. The results of this study also indicate that in debris torrent-prone basins the fan gradient and Melton's R have identifiable lower thresholds while basin area has an upper threshold, but use of these thresholds for identification of debris torrent hazard is complicated by overlapping thresholds for streamflow basins. [source] Who Cares About Disabled Victims of Crime?JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES, Issue 3 2007Barriers, Facilitators for Redress Abstract, The author identified and discusses barriers and facilitators for public action after the occurrence of abuse against an adult with an intellectual disability (ID). Data were collected via a postal survey sent to guardians in one Swedish region with questions about suspected abuse against their wards (n = 978), of whom 392 had an ID (the remaining were affected by dementia or had another physical or mental disability). The rate of abuse was 4.8% (n = 19) among those wards with an ID. A range of abuses were reported, but there were no significant statistical differences attributed by sex of the wards. Facilitating examples for redress in the statutory framework were identified, but it was observed that implementation of redress was often flawed. Three alternative public actions were discussed: (1) victims' refusal to contact the public sector; (2) internal handling by the social services; and (3) reporting to police (but case closed). Findings showed that there were difficulties in understanding that passive respect for integrity and autonomy is not in line with the public ethos that demands actively caring for dependent wards, that offences in residential settings were sometimes handled internally and not reported in accord with the statutory framework, and that the ability of the criminal justice system to compensate for communicative disabilities seemed deficient. [source] Electrophysiologicai Characteristics of the Atrium in Sinus Node Dysfunction With and Without Postpacing Atrial FihriliationPACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 3 2000ANTONIO DE SISTI DE SISTI, A., ET AL.: Electrophysiologicai Characteristics of the Atrium in Sinus Node Dysfunction With and Without Postpacing Atrial Fibrillation . In patients with sinus node dysfunction (SND) with or without associated paroxysmal atrial fibrillation (AF), the effectiveness of atrial pacing in reducing the incidence of AF is not definitive. In addition, despite several studies involving large populations of implanted patients, little attention has been paid to the electrophysioiogicai (EP) atrial substrate and the effect of permanent atrial pacing. The aim of this study is to correlate EP data and the risk of AF after DDD device implantation. We reviewed FP data of 38 consecutive patients with SND. mean age 70 ± 8 years, who were investigated free of antiarrhythmic treatment, for the evaluation of the atrial substrate. We also considered as control group 25 subjects, mean age 63 ± 14 years, referred to our EP laboratory for unexplained syncope or various atrioventricular disturbances. Following pharmacological washout and at a drive cycle length of 600 ms. effective and functional refractory periods (ERP, FRP), Sl-Al and S2-A2 latency, Al and A2 conduction duration, and latent vulnerability index (EHP/A2) were measured. AF induction was tested with up to three extrastimuli at paced cycle lengths of 600 and 400 ms in 20 patients. Induction of sustained AF (> 30 seconds) was considered as the endpoint. P wave duration on the surface ECG in lead II/Vl was also measured. DDD pacing mode was chosen in all patients with the minimal atrial rate programmed between 60 and 75 beats/min (mean 64 ± 4 beats/min). After implantation, the patients were followed-up for 29 ± 17 months and clinically documented occurrence of AF was determined. When comparing patients with SND and subjects of the control group, we did not find any significant statistical differences in terms of ERP (237 ± 33 vs 250 ± 29 ms), FRP (276 ± 30 vs 280 ± 32 ms) and Sl-Al (39 ± 16 vs 33 ± 11 ms) and S2-A2 latency (69 ± 24 vs 63 ± 25 ms). In contrast, we observed significant differences regarding Al (55 ± 19 vs 39 ± 13 ms; P < 0.001), A2 (95 ± 34 vs 57 ± 18 ms; P < 0.001) and P wave duration (104 ± 18 vs 94 ± 15 ms; P < 0.05), and ERP/A2 (2.8 ± 1.2 vs 4.8 ± 1.6; P < 0.001). When comparing patients with (n = 11) or without (n =27) postpacing AF occurrence, we did not find any difference with reference to ERP, FRP. Sl-Al, S2-A2, Al duration, or follow-up duration. In patients with postpacing AF occurrence, A2 was longer (116 ± 41 vs 87 ± 27 ms; P < 0.01), FRP/A2 lower (2.1 ± 0.4 vs 3.1 ± 1.4; P < 0.05), P wave more prolonged (116 ± 22 vs 99 ± 14 ms; P < 0.01), and preexisting AF history predominant (6/11 vs 5/27 patients; P < 0.05). No difference was observed between patients with (n = 8) and without (n = 12) AF induction during the EP study. In patients with SND, the atrial refractoriness appears normal and the most important abnormality concerns conduction slowing disturbances. Persistence of AF despite pacing stresses the importance of mechanisms responsible for AF not entirely brady-dependent. In this setting, more prolonged atrial conduction disturbances, responsible for a low vulnerability index, and a preexisting history of AF enable us to identify a high risk patient group for AF in the follow-up. sinus node dysfunction, atrial fibrillation, electrophysiologicai study, atrial pacing [source] Asymmetric Periflexural Exanthem of Childhood: Microbiologic Case-Control StudyPEDIATRIC DERMATOLOGY, Issue 3 2000D. Coustou M.D. To do so, we designed a prospective case-control study using throat, stool, blood, and skin samples, and enlisted 37 children with APEC and 37 age-matched controls without eruption seen consecutively from February 1995 to April 1996 from a mixed referral center and community-based population. No interventions were done. Used as the main outcome measure was the differences in the two groups for microbiologic investigations. No significant statistical differences between cases and controls for virus and bacteria investigated were found. No microorganism was identified as a possible etiologic agent in any of the APEC patients. APEC is not a nonspecific cutaneous eruptive pattern to several common microbiologic agents. More sophisticated molecular approaches are needed to address its etiology. [source] ORIGINAL RESEARCH,MEN'S SEXUAL HEALTH: Sexual Function in Male Patients Undergoing Treatment for Renal Failure: A Prospective ViewTHE JOURNAL OF SEXUAL MEDICINE, Issue 12 2009Anmar Nassir MD, FRCS(C) ABSTRACT Introduction., Chronic renal failure in males causes wide-ranging disturbances including sexual dysfunction. The percentage and progression of sexual dysfunction in patients entering a dialysis program require further evaluation. Aim., Our aim was to determine the ongoing effect of standard renal failure treatment on sexual function. Methods., The sexual function was assessed prospectively, upon initiation of dialysis and every 10,12 months while on dialysis or after kidney transplantation. Participants were adult males with sexual partners. Main Outcome Measure., The semiquantitative standard International Index of Erectile Function questionnaire was used initially as a baseline and compared with all subsequent follow-up measures. Results., Fifty-two patients fulfilled the eligibility criteria and completed the questionnaire. Of the 52 subjects, 25 were on hemodialysis and 27 were on peritoneal dialysis. Only 17.3% of participants were potent upon entry into the study. Of the rest, 71% was classified as suffering from severe erectile dysfunction (ED). Sexual desire appeared less affected when compared with other domains. Of the study participants, 67% expressed an interest in treatment for ED, but only 12% had ever received any such therapy. Follow-up ranged from 10 months to 48 months. After excluding kidney-transplanted patients, ED scores on entry and at four subsequent reassessments were almost identical and showed no significant statistical differences. Patients showed significant improvement in ED score after kidney transplantation, with scores remaining high for 20,36 months of follow-up, compared with pre-transplantation. Conclusions., This prospective study suggests that dialysis does not benefit sexual function, although a benefit was seen in a subset of men undergoing renal transplantation. We conclude that sexual function in men beginning dialysis should be assessed, and treatment for ED should be offered if appropriate. Nassir A. Sexual function in male patients undergoing treatment for renal failure: A prospective view. J Sex Med 2009;6:3407,3414. [source] ORIGINAL RESEARCH,ED PHARMACOTHERAPY: Can an Educational Program Optimize PDE5i Therapy?THE JOURNAL OF SEXUAL MEDICINE, Issue 5 2007A Study of Canadian Primary Care Practices ABSTRACT Introduction., The importance of patient instructions, designed to optimize therapy with phosphodiesterase type 5 inhibitors for the treatment of erectile dysfunction (ED), has recently been demonstrated. Aim., To evaluate the impact of an educational program for new sildenafil users against usual ED management in Canadian primary care practices. Methods., This multicenter, 6-month cluster randomized prospective study was conducted across Canada in general practitioners' offices where sites were randomized to receive a treatment optimization program (TOP) tool at visit 1 (TOP sites) or not to receive the TOP tool (non-TOP sites) while continuing with usual practice. Study participants were men seeking medical attention for ED and who were sildenafil naïve. The TOP tool consisted of a tear-off sheet, a brochure, and a video. Study drug was not provided to the patients. Sildenafil samples and prescriptions were dispensed as per usual care practices. Main Outcome Measures., The Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) questionnaire was used to determine treatment satisfaction at visit 2 (month 3) and visit 3 (month 6). Patient and physician satisfaction with the TOP tool was assessed using self-reported questionnaires. Results., The intent-to-treat (ITT) population consisted of 2,573 patients from 231 primary care sites. At visits 2 and 3, treatment satisfaction with sildenafil was high with almost 9 patients out of 10 satisfied with treatment. No significant statistical differences were observed in the EDITS scores between the TOP and the non-TOP groups at visits 2 and 3. More than 80% of the participants were satisfied or very satisfied with the video and the brochure. More than 8 out of 10 participating physicians (84%) would use the TOP tool in their current practice if available. Conclusions., TOP is a valuable and time-efficient ED management tool providing benefits to newly diagnosed ED patients and to their physicians. Brock G, Carrier S, Casey R, Tarride J-E, Elliott S, Dugré H, Rousseau C, D'Angelo P, and Defoy I. Can an educational program optimize PDE5i Therapy? A study of Canadian primary care practices. J Sex Med 2007;4:1404,1413. [source] |