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Distribution within Medical Sciences

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  • Selected Abstracts

    Abnormal fetal aortic velocity waveform and postnatal growth

    ACTA PAEDIATRICA, Issue 11 2000
    D Ley
    Postnatal growth from birth up to 7 y of age was evaluated in 151 children with varying degrees of intrauterine growth retardation who were previously examined in their intrauterine life with Doppler velocimetry of the thoracic descending aorta. The children with abnormal fetal aortic blood flow class (BFC), of which 39/46 (85%) had a birthweight 2 SD below the mean of the population, were lean at birth and had a high rate of catch-up growth in weight and length during the first 3 and 6 mo, respectively. After the initial phases of rapid catch-up in weight and length, mean values of SD scores for weight and height remained relatively unchanged up until 2 y of age, thereafter increasing gradually up to 7 y of age, leaving 4/46 (8%) and 4/46 (8%) below ,2 SD for weight and height, respectively. The pattern of changes in length/height and weight over time did not differ between those infants with abnormal BFC and those with normal BFC. The abnormal fetal aortic waveform was not related to rate of early catch-up growth or to height or weight at 7 y of age after adjustment for deviation in growth at birth. The magnitude of deficit in weight and length at birth was more predictive of subsequent growth. [source]

    The birth process initiates an acute phase reaction in the fetus-newborn infant

    ACTA PAEDIATRICA, Issue 9 2000
    G Marchini
    Our goal was to investigate whether the normal birth process stimulated an acute phase response in healthy infants with physiological changes in the circulating levels of acute phase cytokines and acute phase proteins. We also monitored body temperature, body weight and behavioural state in order to investigate if clinical signs of acute phase reaction were present. We made cross-sectional measurements of interleukin-1,, interleukin-6, C-reactive protein, serum amyloid A, procalcitonin, prealbumin, body weight, body temperature and the duration of the sleeping period during the first four postnatal days. We found an increase in interleukin-6 (p < 0.001) during the first day, followed by an increase in C-reactive protein, serum amyloid A and procalcitonin on the second postnatal day (p < 0.01). The level of prealbumin fell after birth and reached its lowest value at 3 d of age (p < 0,001). Interleukin-l p remained unchanged. The duration of the sleeping period was longer during the first day (p < 0.01). There was an increase in body temperature during the first day (p < 0.01). Maximal weight loss was during the first 2 d. Conclusions: The normal birth process and extra-uterine adaptation stimulates an acute phase reaction in the newborn infant with a release of interleukin-6 and acute phase proteins and a depression of prealbumin. This reaction, as the body's first line inflammatory defence system, probably affects the infant's behaviour, nutritional state as well as the regulation of body temperature. [source]

    Attenuated endothelin-1 mRNA expression with endothelin-1 receptor blockade during hypoxaemia and reoxygenation in newborn piglets

    ACTA PAEDIATRICA, Issue 6 2000
    S Medbø
    We investigated the cause of decreased plasma endothelin-1 (ET-1) during hypoxaemia and reoxygenation in newborn piglets subjected to simultaneous blocking of the ET-1 receptors. Changes in plasma ET-1 and prepro-ET-1 mRNA expression in the main pulmonary artery and the left lower lobe in the lung were studied in 1-2-d-old piglets. Ten minutes prior to hypoxaemia, the hypoxaemia group (n = 10) was given saline, two groups (both n = 9) were given 1 and 5 mg/kg i.v. SB 217242 (an ET-1 receptor antagonist). Two groups served as normoxic controls, with and without SB 217242 5 mg/kg i.v. Hypoxaemia was induced by ventilating with 8% O2 until base excess was 20mmol/l or mean arterial blood pressure was < 20mmHg. Reoxygenation was performed for 2h with room air. During hypoxaemia, plasma ET-1 decreased in the hypoxaemia group, remained unchanged in the 1-mg group and increased in the 5-mg group. At the end of reoxygenation, plasma ET-1 was above baseline in the 1-mg and 5-mg groups. In the pulmonary artery, the hypoxaemia group showed 2- to 5-fold higher prepro-ET-1 mRNA expression compared to all the other groups (p < 0.05). There were trends for higher prepro-ET-1 mRNA expression in pulmonary tissue in the hypoxaemia group compared to the two receptor-blocking groups (p < 0.07). Conclusions: We conclude that hypoxaemia and reoxygenation increase prepro-ET-1 mRNA expression in the pulmonary artery in newborn piglets. These observations suggest that the half-life of ET-1 is decreased during hypoxaemia and reoxygenation in newborn piglets. [source]

    NMR nomenclature: Nuclear spin properties and conventions for chemical shifts (IUPAC recommendations 2001),

    Robin K. Harris
    Abstract A unified scale is recommended for reporting the NMR chemical shifts of all nuclei relative to the 1H resonance of tetramethylsilane. The unified scale is designed to provide a precise ratio, ,, of the resonance frequency of a given nuclide to that of the primary reference, the 1H resonance of tetramethylsilane (TMS) in dilute solution (volume fraction, , < 1%) in chloroform. Referencing procedures are discussed, including matters of practical application of the unified scale. Special attention is paid to recommended reference samples and values of , for secondary references on the unified scale are listed, many of which are the results of new measurements. Some earlier recommendations relating to the reporting of chemical shifts are endorsed. The chemical shift, ,, is redefined to avoid previous ambiguities but to leave practical usage unchanged. Relations between the unified scale and recently published recommendations for referencing in aqueous solutions (for specific use in biochemical work) are discussed, as well as the special effects of working in the solid state with magic-angle spinning. In all, nine new recommendations relating to chemical shifts are made. Standardized nuclear spin data are also presented in tabular form for the stable (and some unstable) isotopes of all elements with non-zero quantum numbers. The information given includes quantum numbers, isotopic abundances, magnetic moments, magnetogyric ratios and receptivities, together with quadrupole moments and linewidth factors (where appropriate). © 2001 IUPAC. Concepts Magn Reson 14:326,346, 2002 [source]

    Pamidronate treatment of bone fibrous dysplasia in nine children with McCune-Albright syndrome

    ACTA PAEDIATRICA, Issue 2 2000
    R Lala
    McCune-Albright syndrome is a rare genetic disorder consisting of skin and bone dysplasia and peripheral endocrinopathies. Little data have been collected regarding bisphosphonate treatment of bone fibrous dysplasia in paediatric patients with this syndrome. The aim of our study was to investigate the therapeutic efficacy of pamidronate in these patients. Nine patients with moderate to severe forms of bone fibrous dysplasia were treated with pamidronate intravenously (0.5-1 mg/ kg/daily for 2-3 d) at 0.5-1-y intervals. Patients were treated over a time period of 0.5-3.5 y. During treatment no spontaneous fracture occurred. Bone pain and gait abnormality due to pain disappeared after 2-3 therapeutic cycles. Cranial asymmetry and limb length discrepancy remained unchanged. Elevated serum alkaline phosphatase and urine hydroxyproline values were reduced by the treatment, demonstrating drug activity at the lesional level. The effectiveness of pamidronate was also seen at the non-lesional level through an increase in bone density. Radiographic and scintigraphic evidence of lesion healing was not attained. Pamidronate treatment can ameliorate the course of bone fibrous dysplasia in children and adolescents with McCune-Albright syndrome. [source]

    Cardiovascular function in the heat-stressed human

    ACTA PHYSIOLOGICA, Issue 4 2010
    C. G. Crandall
    Abstract Heat stress, whether passive (i.e. exposure to elevated environmental temperatures) or via exercise, results in pronounced cardiovascular adjustments that are necessary for adequate temperature regulation as well as perfusion of the exercising muscle, heart and brain. The available data suggest that generally during passive heat stress baroreflex control of heart rate and sympathetic nerve activity are unchanged, while baroreflex control of systemic vascular resistance may be impaired perhaps due to attenuated vasoconstrictor responsiveness of the cutaneous circulation. Heat stress improves left ventricular systolic function, evidenced by increased cardiac contractility, thereby maintaining stroke volume despite large reductions in ventricular filling pressures. Heat stress-induced reductions in cerebral perfusion likely contribute to the recognized effect of this thermal condition in reducing orthostatic tolerance, although the mechanism(s) by which this occurs is not completely understood. The combination of intense whole-body exercise and environmental heat stress or dehydration-induced hyperthermia results in significant cardiovascular strain prior to exhaustion, which is characterized by reductions in cardiac output, stroke volume, arterial pressure and blood flow to the brain, skin and exercising muscle. These alterations in cardiovascular function and regulation late in heat stress/dehydration exercise might involve the interplay of both local and central reflexes, the contribution of which is presently unresolved. [source]

    Acute Adaptation to Volume Unloading of the Functional Single Ventricle in Children Undergoing Bidirectional Glenn Anastomosis

    Catherine Ikemba MD
    ABSTRACT Objective., Volume unloading of the functional single ventricle after a bidirectional Glenn anastomosis (BDG) prior to 1 year of age leads to improved global ventricular function as measured by the myocardial performance index (MPI), a Doppler-derived measurement of combined systolic and diastolic ventricular function. Systolic function remains unchanged after BDG according to previous studies; however, acute changes in global and diastolic function have not been previously investigated in this cohort. Our objective was to assess the short-term effects of the BDG on global ventricular function in patients with a functional single ventricle. Design., Echocardiograms to obtain MPI, isovolumic contraction time, and isovolumic relaxation time were performed at four time periods: in the operating room, in the operating room prior to BDG, shortly after separation from cardiopulmonary bypass, less than 24 hours postoperatively, and either prior to hospital discharge or at the first clinic follow-up visit. Results., Twenty-six patients were enrolled. There was significant ventricular dysfunction noted shortly after separation from cardiopulmonary bypass, median MPI 0.63 (0.39,0.81), that persisted in the short term postoperatively median MPI 0.50 (0.40,0.63). Isovolumic contraction time did not change, however, isovolumic relaxation time was significantly prolonged following BDG. Conclusion., In the postoperative patient after BDG, systolic function is preserved; however, there is evidence of diastolic and global ventricular dysfunction, at least in the short term. [source]

    Tumour necrosis factor-like weak inducer of apoptosis (TWEAK) and its receptor Fn14 during cardiac remodelling in rats

    ACTA PHYSIOLOGICA, Issue 1 2010
    E. Mustonen
    Abstract Aim:, Accumulating evidence supports the concept that proinflammatory cytokines play an essential role in the failing heart. We examined the concomitant tumour necrosis factor-like weak inducer of apoptosis (TWEAK)/Fn14 expression in myocytes in vitro as well as in vivo in cardiac remodelling. Methods:, We assessed TWEAK and its receptor Fn14 expression in response to angiotensin (Ang) II, myocardial infarction (MI) as well as to local adenovirus-mediated p38 gene transfer in vivo. The effect of various hypertrophic factors and mechanical stretch was studied in neonatal rat ventricular myocyte cell culture. Results:, Ang II increased Fn14 levels from 6 h to 2 weeks, the greatest increase in mRNA levels being observed at 6 h (6.3-fold, P < 0.001) and protein levels at 12 h (4.9-fold, P < 0.01). TWEAK mRNA and protein levels remained almost unchanged during Ang II infusion. Likewise, a rapid and sustained elevation of Fn14 mRNA and protein levels in the left ventricle was observed after experimental MI. Moreover, local p38 gene transfer increased Fn14 mRNA and protein but not TWEAK levels. Fn14 immunoreactive cells were mainly proliferating non-myocytes in the inflammation area while TWEAK immunoreactivity localized to cardiomyocytes and endothelial cells of the coronary arteries. Hypertrophic agonists and lipopolysaccharide increased Fn14 but not TWEAK gene expression in neonatal rat myocytes, while mechanical stretch upregulated Fn14 and downregulated TWEAK gene expression. Conclusions:, In conclusion, the cardiac TWEAK/Fn14 pathway is modified in response to myocardial injury, inflammation and pressure overload. Furthermore, our findings underscore the importance of Fn14 as a mediator of TWEAK/Fn14 signalling in the heart and a potential target for therapeutic interventions. [source]

    Protein kinase C mRNA and protein expressions in hypobaric hypoxia-induced cardiac hypertrophy in rats

    ACTA PHYSIOLOGICA, Issue 4 2010
    M. Uenoyama
    Abstract Aim:, Protein kinase C (PKC), cloned as a serine/threonine kinase, plays key roles in diverse intracellular signalling processes and in cardiovascular remodelling during pressure overload or volume overload. We looked for correlations between changes in PKC isoforms (levels and/or subcellular distributions) and cardiac remodelling during experimental hypobaric hypoxic environment (HHE)-induced pulmonary hypertension. Methods:, To study the PKC system in the heart during HHE, 148 male Wistar rats were housed for up to 21 days in a chamber at the equivalent of 5500 m altitude level (10% O2). Results:, At 14 or more days of exposure to HHE, pulmonary arterial pressure (PAP) was significantly increased. In the right ventricle (RV): (1) the expression of PKC-, protein in the cytosolic and membrane fractions was increased at 3,14 days and at 5,7 days of exposure respectively; (ii) the cytosolic expression of PKC-, protein was increased at 1,5, 14 and 21 days of exposure; (3) the membrane expressions of the proteins were decreased at 14,21 (PKC-,II), 14,21 (PKC-,), and 0.5,5 and 21 (PKC-,) days of exposure; (4) the expression of the active form of PKC-, protein on the plasma membrane was increased at 3 days of exposure (based on semiquantitative analysis of the immunohistochemistry). In the left ventricle, the expressions of the PKC mRNAs, and of their cytosolic and membrane proteins, were almost unchanged. The above changes in PKC-,, which were strongly evident in the RV, occurred alongside the increase in PAP. Conclusion:, PKC-, may help to modulate the right ventricular hypertrophy caused by pulmonary hypertension in HHE. [source]

    Stroke volume decreases during mild dynamic and static exercise in supine humans

    ACTA PHYSIOLOGICA, Issue 2 2009
    M. Elstad
    Abstract Aim:, The contributions of cardiac output (CO) and total peripheral resistance to changes in arterial blood pressure are debated and differ between dynamic and static exercise. We studied the role stroke volume (SV) has in mild supine exercise. Methods:, We investigated 10 healthy, supine volunteers by continuous measurement of heart rate (HR), mean arterial blood pressure, SV (ultrasound Doppler) and femoral beat volume (ultrasound Doppler) during both dynamic mild leg exercise and static forearm exercise. This made it possible to study CO, femoral flow (FF) and both total and femoral peripheral resistance beat-by-beat. Results:, During a countdown period immediately prior to exercise, HR and mean arterial pressure increased, while SV decreased. During mild supine exercise, SV decreased by 5,8%, and most of this was explained by increased mean arterial pressure. Dynamic leg exercise doubled femoral beat volume, while static hand grip decreased femoral beat volume by 18%. FF is tightly regulated according to metabolic demand during both dynamic leg exercise and static forearm exercise. Conclusion:, Our three major findings are, firstly, that SV decreases during both dynamic and static mild supine exercise due to an increase in mean arterial pressure. Secondly, femoral beat volume decreases during static hand grip, but FF is unchanged due to the increase in HR. Finally, anticipatory responses to exercise are apparent prior to both dynamic and static exercise. SV changes contribute to CO changes and should be included in studies of central haemodynamics during exercise. [source]

    In situ study of growth and dissolution kinetics of ammonium oxalate monohydrate single crystals from aqueous solutions containing cationic impurities

    K. Sangwal
    Abstract The results of an in situ investigation of the effect of four different bi- and trivalent cations (Fe(III), Cu(II), Mn(II) and Cr(III)) on the displacement velocity of individual growth steps on the (110) face of ammonium oxalate monohydrate crystals as a function of supersaturation are described and discussed. It was observed that: (1) at a particular temperature of pure solutions and solutions containing impurities, the velocity v of movement of the [110] growth steps is always greater than that of the [111] steps, (2) fluctuations in the velocity of individual growth steps occur in all solutions containing similar concentrations of different impurities, (3) the value of kinetic coefficient , for growth steps decreases with an increase in the concentration ci of Cu(II) impurity, but that for dissolution steps does not depend on ci; moreover, the value of kinetic coefficient , for growth steps is higher than that of dissolution steps, and (4) in the presence of Mn(II) and Cr(III) impurities, the kinetic coefficient , for dissolution steps is several times greater than that for growth steps. The results are explained from the standpoint of Kubota-Mullin model of adsorption of impurities at kinks in the steps and the stability of dominating complexes present in solutions. Analysis of the results revealed that: (1) the effectiveness of different impurities in inhibiting growth increases in the order: Fe(III), Cu(II), Mn(II), and Cr(III), and this behavior is directly connected with the stability and chemical constitution of dominating complexes in saturated solutions, (2) fluctuations in the velocity of growth steps is associated with the effectiveness of an impurity for adsorption; the stronger the adsorption of an impurity, the higher is the fluctuation in step velocity v, and (3) depending on the nature of the impurity, the kinetic coefficient for the dissolution steps can remain unchanged or can be higher than that of the growth steps. (© 2007 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [source]

    Effect of angiotensin II and endothelin-1 receptor blockade on the haemodynamic and hormonal changes after acute blood loss and after retransfusion in conscious dogs

    ACTA PHYSIOLOGICA, Issue 4 2004
    R. C. E. Francis
    Abstract Aim:, This study investigates angiotensin II and endothelin-1 mediated mechanisms involved in the haemodynamic, hormonal, and renal response towards acute hypotensive haemorrhage. Methods:, Conscious dogs were pre-treated with angiotensin II type 1 (AT1) and/or endothelin-A (ETA) receptor blockers or not. Protocol 1: After a 60-min baseline period, 25% of the dog's blood was rapidly withdrawn. The blood was retransfused 60 min later and data recorded for another hour. Protocol 2: Likewise, but preceded by AT1 blockade with i.v. Losartan. Protocol 3: Likewise, but preceded by ETA blockade with i.v. ABT-627. Protocol 4: Likewise, but with combined AT1plus ETAblockade. Results:, In controls, haemorrhage decreased mean arterial pressure (MAP) by approximately 25%, cardiac output by approximately 40%, and urine volume by approximately 60%, increased angiotensin II (3.1-fold), endothelin-1 (1.13-fold), vasopressin (116-fold), and adrenaline concentrations (3.2-fold). Glomerular filtration rate and noradrenaline concentrations remained unchanged. During AT1 blockade, the MAP decrease was exaggerated (,40%) and glomerular filtration rate fell. During ETA blockade, noradrenaline increased after haemorrhage instead of adrenaline, and the MAP recovery after retransfusion was blunted. The decrease in cardiac output was similar in all protocols. Conclusions:, Angiotensin II is more important than endothelin-1 for the short-term regulation of MAP and glomerular filtration rate after haemorrhage, whereas endothelin-1 seems necessary for complete MAP recovery after retransfusion. After haemorrhage, endothelin-1 seems to facilitate adrenaline release and to blunt noradrenaline release. Haemorrhage-induced compensatory mechanisms maintain blood flow more effectively than blood pressure, as the decrease in cardiac output , but not MAP , was similar in all protocols. [source]


    CYTOPATHOLOGY, Issue 2006
    K. Denton
    The terminology used for reporting cervical samples in the UK is the BSCC classification, which has evolved over many years. In 2002 the BSCC held a consensus conference to review the BSCC classification, with the intention of providing clearer results for women, improving concordance with other terminologies and facilitating consistency with new scientific developments and technologies. The consensus conference was well attended and robust. In the intervening years there have also been other further advances on morphometry, data on outcomes, data from EQA and other sources. Liquid Based cytology (LBC) has been implemented by the NHS CSP. All of these developments have impacted on the proposed classification, which will be presented in full. The term ,dyskaryosis' will be retained and several of the current reporting categories will be relatively unchanged, though additional information on LBC will be provided. The major proposed changes are: (1) A move to a single category of ,High Grade Dyskaryosis' to replace the existing categories of moderate and severe dyskaryosis. (2) Sub-division of Borderline change into three categories. Borderline change in glandular cells Borderline change ?high grade Borderline change, NOS (3) The current grades of Mild Dyskaryosis and Borderline change with Koilocytosis to be merged. Details of these proposals, together with illustrations and the evidence base for change will be presented. [source]

    Ca2+ -dependent in vitro contractility of a precipitate isolated from an extract of the heliozoon Actinophrys sol

    CYTOSKELETON, Issue 2 2006
    Mikihiko Arikawa
    Abstract Contraction of axopodia in actinophrid heliozoons (protozoa) is induced by a unique contractile structure, the "contractile tubules structure (CTS)". We have previously shown that a cell homogenate of the heliozoon Actinophrys sol yields a precipitate on addition of Ca2+ that is mainly composed of filamentous structures morphologically identical to the CTS. In this study, to further characterize the nature of the CTS in vitro, biochemical and physiological properties of the precipitate were examined. SDS-PAGE analysis showed that the Ca2+ -induced precipitate was composed of many proteins, and that no proteins in the precipitate showed any detectable changes in electrophoretic mobility on addition of Ca2+. Addition of extraneous proteins such as bovine serum albumin to the cell homogenate resulted in cosedimentation of the proteins with the Ca2+ -induced precipitate, suggesting that the CTS has a high affinity for other proteins that are not related to precipitate formation. Appearance and disappearance of the precipitate were repeatedly induced by alternating addition of Ca2+ and EGTA, and its protein composition remained unchanged even after repeated cycles. When adhered to a glass surface, the precipitate showed Ca2+ -dependent contractility with a threshold of 10,100 nM, and this contractility was not inhibited by colchicine or cytochalasin B. The precipitate repeatedly contracted and relaxed with successive addition and removal of Ca2+, indicating that the contraction was controlled by Ca2+ alone with no need for any other energy supply. From our characterization of the precipitate, we concluded that its Ca2+ -dependent formation and contraction are associated with the unique contractile organelle, the "contractile tubules structure". Cell Motil. Cytoskeleton 2006. © 2005 Wiley-Liss, Inc. [source]

    Changes in capillary luminal diameter in rat soleus muscle after hind-limb suspension

    ACTA PHYSIOLOGICA, Issue 4 2000
    This study examined the time course change of the capillary luminal diameter and the number of capillaries in the rat soleus muscle during hind-limb suspension. Male Wistar rats were divided into 1 and 3 weeks of hind-limb suspension (HS) groups (HS-1 and HS-3). The HS groups were compared with age-matched control groups. All morphometric parameters with respect to capillary and muscle fibre cross-sectional area were determined in perfusion-fixed soleus muscles. After 1 and 3 weeks of hind-limb suspension, the mean muscle fibre cross-sectional area was significantly decreased in HS-1 (,32.0%) and HS-3 (,59.3%) compared with age-matched control groups. Despite a lower capillary-to-fibre ratio (HS-1, ,19.3%; HS-3, ,21.2%), the capillary density was unchanged in HS-1 and significantly increased in HS-3 compared with age-matched control groups. The mean capillary luminal diameter was significantly smaller in HS-1 (,19.9%) and HS-3 (,21.9%) than in the age-matched control groups. The capillary-to-fibre perimeter ratio which indicates the capillary surface area available for gas exchange between blood and tissue did not significantly differ between control groups and HS groups. In conclusion, the morphometrical adaptations in rat soleus with the suspension involved changes in both the capillary luminal diameter and number of capillaries, and the change in capillary surface area was proportional to the degree of muscle atrophy in HS groups. [source]

    Risk evaluation and type of treatment of multiple dental trauma episodes to permanent teeth

    U. Glendor
    Abstract , Studies have shown that some children and adolescents are effected only once with a dental trauma, while others seem to be accident-prone and suffer from multiple dental trauma episodes (MDTE). Studies have also shown that dental traumas mostly affect upper permanent and medial incisors. Less is known about treatment consequences related to teeth with repeated dental trauma episodes. The aim was therefore to evaluate the risk of MDTE to permanent teeth among children and adolescents by age and gender and to compare types of dental treatment modalities used for patients with one episode and those with MDTE and with single and repeated traumatized teeth. The study was based on a random sample of 83 Danish 6,18-year-old children and adolescents born in 1970 who suffered from dental trauma episodes. All patients were followed during a 12-year period (1976,1988). Forty-one of the patients were registered with MDTE with a range of 2,7 episodes and a mean of 2.9 episodes/patient (SD=1.1). The mean age at single and MDTE was 11.4 years (SD=3.6) and 8.6 years (SD=2.1), respectively. No significant differences were found between age at first episode and the number of MDTE per patient. The number of patients with MDTE was significantly higher among those who suffered their first trauma episode in the age interval 6,10 years than in the age interval 11,18 years (P<0.001). A survival analysis showed that the risk of sustaining another trauma episode increased by 14.9,30.3% when the first trauma occurred before the age of 11, compared to 0,7.4% after the age of 10. The risk of sustaining multiple injuries was 8.4 times higher when the first trauma episode occurred at 9 years of age, compared with those occurring at age 12. The survival analysis also showed that for every new trauma episode, the interval between them became closer. Forty-five per cent of the MDTE affected teeth had already sustained an injury. With an increased number of trauma episodes per patient followed an increase in the number of follow-ups, filling therapy, information and prosthetics, whereas the rates of endodontics, surgery, and consultations were unchanged or even decreased. [source]

    Retinal Evaluation After 810 nm Dioderm Laser Removal of Eyelashes

    Randal T. H. Pham MD
    background. When operating hair removal lasers on the face or in the periorbital region, even with an ocular shield in place, patients often report seeing "flashing lights" each time the laser is fired. This phenomenon suggests stimulation of retinal photoreceptors and raises laser safety issues. objective. To perform retinal electrophysiologic studies to evaluate the safety of hair removal lasers in the periorbital region. methods. Five patients with severe trichiasis secondary to trachoma were studied. The 810 nm Dioderm laser (Cynosure, Inc., Chelmsford, MA) was used to treat the eyelash follicles on the lower eyelid of each patient. Cox III metal eye shields (Oculo-Plastik, Inc., Montreal, Canada) were placed behind the eyelids of both eyes during the laser procedure. Prior to irradiation, a comprehensive ophthalmic evaluation including pupillary and slit-lamp examination, funduscopy, and full-field electroretinograms (ERGs) was performed. A comprehensive ophthalmic evaluation including ERG testing was repeated 30 minutes and 3,6 months after completion of treatment. An independent blinded assessor evaluated the ERG studies. Subjective reports of laser light sensation, pain, and discomfort during and after the laser procedure were also assessed. results. There was no detectable change in slit-lamp, pupillary, or funduscopic evaluations after periorbital laser irradiation. Similarly the pre- and posttreatment ERGs were unchanged. Three patients reported seeing flashing lights during the procedure. conclusion. We found no ERG evidence of retinal damage after laser hair removal in the periorbital region, with Cox III-type ocular shields over the eyes, even when patients subjectively reported "flashing lights" during laser irradiation. [source]

    Misclassification and the use of register-based indicators for depression

    K. Thielen
    Objective:, To study the degree to which depression indicators based on register data on hospital and antidepressant treatment suffer from differential misclassification with respect to gender, age and social group. Method:, Data on 7378 persons were obtained by linking a cross-sectional survey of Danish adults aged 40 and 50 years with population-based registers. Misclassification was analysed by comparing survey data to register data on major depression using the method proposed by Rothman and Greenland. Results:, Differential misclassification was found. Adjustment for misclassification reduced women's odds ratios from 2.18 to 1.00 for hospital treatment and from 1.70 to 1.10 for antidepressants. For the lower social group, the corresponding odds ratios increased from 1.18 to 3.52, and from 1.35 to 2.32 respectively, whereas odds ratios with respect to age remained almost unchanged. Conclusion:, Differential misclassification should be considered when register-based information about hospital and antidepressant treatment are used as depression indicators. [source]

    Nesprins, but not sun proteins, switch isoforms at the nuclear envelope during muscle development

    K. Natalie Randles
    Abstract Nesprins are a family of nuclear transmembrane proteins anchored via Sun proteins to the nuclear membrane. Analysis of nesprins during human muscle development revealed an increase in nesprin-1-giant during early myogenesis in vitro. During the transition from immature to mature muscle fibres in vivo, nesprin-2 partly replaced nesprin-1 at the nuclear envelope and short nesprin isoforms became dominant. Sun1 and Sun2 proteins remained unchanged during this fibre maturation. In emerin-negative skin fibroblasts, nesprin-2-giant was relocated from the nuclear envelope to the cytoplasm, not to the endoplasmic reticulum, while nesprin-1 remained at the nuclear envelope. In emerin-negative keratinocytes lacking nesprin-1, nesprin-2 remained at the nuclear envelope. HeLa cell nuclear envelopes lacked nesprin-1, which was the dominant form in myoblasts, while a novel 130-kD nesprin-2 isoform dominated Ntera-2 cells. The results suggest the possibility of isoform-specific and tissue-specific roles for nesprins in nuclear positioning. Developmental Dynamics 239:998,1009, 2010. © 2010 Wiley-Liss, Inc. [source]

    Prospective comparison of course of disability in antipsychotic-treated and untreated schizophrenia patients

    J. Thirthalli
    Objective:, To compare the course of disability in schizophrenia patients receiving antipsychotics and those remaining untreated in a rural community. Method:, Of 215 schizophrenia patients identified in a rural south Indian community, 58% were not receiving antipsychotics. Trained raters assessed the disability in 190 of these at baseline and after 1 year. The course of disability in those who remained untreated was compared with that in those who received antipsychotics. Results:, Mean disability scores remained virtually unchanged in those who remained untreated, but showed a significant decline (indicating decrement in disability) in those who continued to receive antipsychotics and in those in whom antipsychotic treatment was initiated (P < 0.001; group × occasion effect). The proportion of patients classified as ,disabled' declined significantly in the treated group (P < 0.01), but remained the same in the untreated group. Conclusion:, Disability in untreated schizophrenia patients remains unchanged over time. Treatment with antipsychotics in the community results in a considerable reduction in disability. [source]

    Analysis of pancreatic endocrine development in GDF11-deficient mice

    Darwin S. Dichmann
    Abstract Here, we examine the role of GDF11 in pancreatic development. Using in situ hybridization and reverse transcriptase-polymerase chain reaction analyses, we show that Gdf11 transcripts are expressed in embryonic pancreas epithelium before the secondary transition but decrease rapidly afterward. To determine the function of GDF11 during pancreas development, we analyzed Gdf11,/, mouse embryos. In such embryos, pancreas size is twofold reduced at embryonic day (E) 18 compared with wild-type littermates. Quantification of the different tissue compartments shows a specific hypoplasia of the exocrine compartment, while the endocrine and ductal compartments are unaffected. Notably, NGN3+ endocrine precursor cells are increased fourfold at E18, although the amount of endocrine cells in the pancreas of these animals is unchanged compared with wild-type littermates. Similarly, the maturation of endocrine cells as well as the ratio between ,- and ,-cells appears normal. Developmental Dynamics 235:3016,3025, 2006. © 2006 Wiley-Liss, Inc. [source]

    Long-term follow-up of children with obstetric brachial plexus palsy I: functional aspects

    Christina Strömbeck MD
    The aims of this study were to describe the development of sequelae in obstetric brachial plexus palsy (OBPP) and to identify possible differences in functional outcome from 5 years of age to follow-up, 2 to 15 years later. A cohort of 70 participants (35 males, 35 females; age range 7-20y, mean 13y 6mo [SD 4y 3mo], median 13y) with OBPP of varying degrees of severity were monitored. Differences in status between 5 years of age and follow-up were studied. Active joint motion in the shoulder and hand function, especially grip strength, generally remained unchanged or improved, whereas a slight but significant deterioration occurred in elbow function. Shoulder surgery resulted in considerable improvement of shoulder function. Participants with nerve reconstruction had a similar profile of change as the non-operated group. It was concluded that ongoing follow-up of children with OBPP, beyond the preschool years, is required due to decreases in elbow function, a commonly occurring restriction in external rotation of the shoulder, together with individual variations in long-term outcomes. In a related article (part II: neurophysiological aspects) long-term neurophysiological and sensory aspects of OBPP are reported. [source]

    Long-term outcome of children with cortical visual impairment

    Carey A Matsuba MDCM MHSc FRCP(C)
    Cortical visual impairment (CVI) is now the most common cause of visual impairment in children. Little is known about the long-term visual outcome. This study evaluates the outcome of children with congenital CVI. Using medical records, 423 children (225 males, 198 females) were identified with congenital CVI. Of these children, 259 had follow-up visual acuity assessments. The children's gestational age varied with 32 weeks or less representing 15.9%; 33 to 36 weeks representing 10.7%; 37 to 42 weeks representing 61.2%; and 43 weeks or greater representing 0.9% (11.3% of patients'gestational age was unrecorded). Clinical data were extracted and information regarding outcome was gathered. The majority of children showed improvement in their visual acuity levels after 2 or more years of follow-up. For the 194 children initially assessed before 3 years of age, 97 had improved, 75 were unchanged, 18 had deteriorated, and 4 had sub-optimal assessments. For the 74 children initially assessed at 3 or more years of age, 23 had improved, 44 remained unchanged, 3 had deteriorated, and 4 had sub-optimal testing. Children with better visual acuity levels at follow-up were more likely to have favourable cognitive outcomes (non-mental retardation)* in 12.2% versus 2.8% (p<0.01). Similarly, favourable motor outcomes (independent ambulation) were present in 20.1% for those with better visual acuities versus 7.9% for those with poorer visual acuities (p<0.01). Our study demonstrates that the majority of children with CVI underwent improvement in visual acuity. Additional disabilities were common, but those children with better visual acuity outcomes faired better. Given the frequency of comorbid conditions, appropriate diagnostic assessment services are needed. [source]

    Ring chromosome 20 syndrome with intractable epilepsy

    Asude Alpman MD
    Ring chromosome 20 (r[20]) syndrome is characterized by mild to moderate learning disability*, behavioural disorders, epilepsy, and various dysmorphic features. Although still considered rare, r(20) syndrome is being increasingly diagnosed. More than 30 cases have been described in the literature since 1976. Here we report an additional case of a 14-year-old male with r(20). He had moderate to severe learning disability and epileptic seizures manifesting at about 18 months of age. During the 13 years' follow-up period he showed intractable epileptic seizures, behavioural disorders, and mild dysmorphological features including microcephaly, strabismus, micrognathia, down-slanting eyelids, and ear abnormalities. Frequent episodes of atypical absence or non-convulsive status associated with electroencephalogram changes were seen in follow-up. He was treated with several classical and new antiepileptic drugs, including intravenous immunoglobulin, corticotropin, and vagal nerve stimulation, with unsuccessful control of seizures. Finally, surgical treatment (corpus callosotomy) was performed at the age of 13 years; severity of tonic seizures was diminished, but frequency was unchanged. Although his behavioural problems, e.g. hyperactivity, were mild in early childhood they became more severe when he was 11 years old. Aggressiveness, compulsiveness with self-injury, and panic attacks developed at the age of 13 years, and were more pronounced after callosotomy. This case report provides the first description of deterioration in psychological situation in patients with r(20) intractable epilepsy. The patient was diagnosed with r(20) syndrome after 13 years of clinical follow-up. Karyotype analysis should, therefore, be performed in every patient with intractable epilepsy of unknown aetiology. [source]

    Maternal fever at birth and non-verbal intelligence at age 9 years in preterm infants

    Olaf Dammann MD MS
    To test the hypothesis that characteristics of perinatal infection are associated with long-term cognitive limitations among preterm infants, we analyzed data from 294 infants (142 females, 152 males) ,1500g birthweight and <37 completed weeks of gestation who were examined at age 9 years. We identified 47 children (20 females, 27 males) who had a non-verbal Kaufman Assessment Battery for Children (K-ABC) scale standard value below 70, i.e. more than 2 SDs below the age-adjusted mean. The 247 children (122 females, 125 males) with a score ,70 served as control participants. Maternal nationality and education, and low gestational age were significantly associated with a K-ABC non-verbal standard value <70. Both neonatal brain damage (intraventricular hemorrhage) and long-term sequelae (cerebral palsy [CP], diagnosed at age 6 years) were significantly associated with a below-normal non-verbal K-ABC score. Maternal fever at birth was present in five cases (11%) and eight controls (3%; odds ratio 3.6, 95% confidence interval 1.1 to 11.4). Clinical chorioamnionitis and preterm labor and/or premature rupture of membranes (as opposed to toxemia and other initiators of preterm delivery) were also more common among cases than control participants. When adjusting for potential confounders such as gestational age, maternal education and nationality, and CP, the risk estimate for maternal fever remained unchanged (3.8, 0.97 to 14.6). We conclude that perinatal infection might indeed contribute to an increased risk for long-term cognitive deficits in preterm infants. [source]

    Differential expression of TrkB isoforms switches climbing fiber-Purkinje cell synaptogenesis to selective synapse elimination

    Rachel M. Sherrard
    Abstract Correct neural function depends on precisely organized connectivity, which is refined from broader projections through synaptic/collateral elimination. In the rat, olivocerebellar topography is refined by regression of multiple climbing fiber (CF) innervation of Purkinje cells (PC) during the first two postnatal weeks. The molecules that initiate this regression are not fully understood. We assessed the role of cerebellar neurotrophins by examining tropomycin receptor kinase (Trk) receptor expression in the inferior olive and cerebellum between postnatal days (P)3-7, when CF-PC innervation changes from synapse formation to selective synapse elimination, and in a denervation-reinnervation model when synaptogenesis is delayed. Trks A, B, and C are expressed in olivary neurons; although TrkA was not transported to the cerebellum and TrkC was unchanged during innervation and reinnervation, suggesting that neither receptor is involved in CF-PC synaptogenesis. In contrast, both total and truncated TrkB (TrkB.T) increased in the olive and cerebellum from P4, whereas full-length and activated phosphorylated TrkB (phospho-TrkB) decreased from P4-5. This reveals less TrkB signaling at the onset of CF regression. This expression pattern was reproduced during CF-PC reinnervation: in the denervated hemicerebellum phospho-TrkB decreased as CF terminals degenerated, then increased in parallel with the delayed neosynaptogenesis as new CFs reinnervated the denervated hemicerebellum. In the absence of this signaling, CF reinnervation did not develop. Our data reveal that olivocerebellar TrkB activity parallels CF-PC synaptic formation and stabilization and is required for neosynaptogenesis. Furthermore, TrkB.T expression rises to reduce TrkB signaling and permit synapse elimination. © 2009 Wiley Periodicals, Inc. Develop Neurobiol 2009 [source]

    Proneural gene ash1 promotes amacrine cell production in the chick retina

    Weiming Mao
    Abstract The diverse types of neurons and Müller glia in the vertebrate retina are believed to arise from common progenitor cells. To better understand how neural diversity is achieved during retinal neurogenesis, we examined the function of ash1, a proneural bHLH gene expressed in progenitor cells throughout retinal neurogenesis. Published studies using retinal explant culture derived from knockout mice concluded that ash1 is required for the production of late-born neurons, including bipolar cells. In this study, gain-of-function experiments were carried out in ovo in embryonic chick retina. In the developing chick retina, expression of ash1 temporally overlapped with, but spatially differed from, the expression of ngn2, also a proneural gene expressed in progenitor cells throughout retinal neurogenesis. Retrovirus-driven overexpression of ash1 in the developing chick retina decreased the progenitor population (BrdU+ or expressing ngn2), expanded the amacrine population (AP2,+ or Pax6+), and reduced bipolar (chx10 mRNA+) and Müller glial (vimentin+) populations. Photoreceptor deficiency occurred after the completion of neurogenesis. The number of ganglion cells, which are born first during retinal neurogenesis, remained unchanged. Similar overexpression of ngn2 did not produce discernible changes in retinal neurogenesis, nor in ash1 expression. These results suggest that ash1 promotes the production of amacrine cells and thus may participate in a regulatory network governing neural diversity in the chick retina. © 2008 Wiley Periodicals, Inc. Develop Neurobiol, 2009 [source]

    Effect of chronic denervation and denervation-reinnervation on cytoplasmic creatine kinase transcript accumulation

    Charles H. Washabaugh
    Abstract The extensor digitorum longus (EDL) and soleus muscles of adult mice were chronically denervated or denervated and allowed to reinnervate. Muscles were evaluated 1, 5, 14, 21, and 52 days after sciaticectomy. In terms of weight loss, myofiber atrophy, degeneration, and fibrosis, the soleus muscle was more affected than the EDL by chronic denervation. Fifty-two days after chronic denervation, the number of molecules of MCK/ng total RNA in both muscles (determined with competitive PCR) decreased, with the soleus muscle being more affected. At that stage, BCK mRNA levels in the denervated soleus were unchanged, but they were increased (>50%) in the EDL. Reinnervation restored MCK transcript accumulation in the EDL, whereas, in the soleus MCK, transcripts exceeded control values by 57%, approaching levels in the reinnervated EDL. Despite restoration of MCK mRNA levels, the number of molecules of BCK mRNA/ng total RNA was four- to fivefold higher in reinnervated versus control muscles, suggesting that the genes encoding the CK mRNAs are not coordinately regulated in adult muscle. The role of denervation induced, fiber type changes in regulating CK mRNA accumulation has been evaluated. Electron microscopic analyses have established that fibrosis is not a factor that determines BCK mRNA levels in the chronically denervated or denervated-reinnervated muscles. CK isozyme analyses support the hypothesis that a greater proportion of BCK mRNA found in 52 day chronically denervated and denervated-reinnervated muscles is produced in myofibers vs. nonmuscle cells than in control muscles. © 2001 John Wiley & Sons, Inc. J Neurobiol 47: 194,206, 2001 [source]

    The eyes have it: visual pop-out in infants and adults

    Scott A. Adler
    Visual search studies with adults have shown that stimuli that contain a unique perceptual feature pop out from dissimilar distractors and are unaffected by the number of distractors. Studies with very young infants have suggested that they too might exhibit pop-out. However, infant studies have used paradigms in which pop-out is measured in seconds or minutes, whereas in adults pop-out occurs in milliseconds. In addition, with the previous infant paradigms the effects from higher cognitive processes such as memory cannot be separated from pop-out and selective attention. Consequently, whether infants exhibit the phenomenon of pop-out and have selective attention mechanisms as found in adults is not clear. This study was an initial attempt to design a paradigm that would provide a comparable measure between infants and adults, thereby allowing a more accurate determination of the developmental course of pop-out and selective attention mechanisms. To this end, we measured 3-month-olds' and adults' saccade latencies to visual arrays that contained either a + among Ls (target-present) or all Ls (target-absent) with set sizes of 1, 3, 5 or 8 items. In Experiment 1, infants' saccade latencies remained unchanged in the target-present conditions as set size increased, whereas their saccade latencies increased linearly in the target-absent conditions as set size increased. In Experiment 2, adults' saccade latencies in the target-present and target-absent conditions showed the same pattern as the infants. The only difference between the infants and adults was that the infants' saccade latencies were slower in every condition. These results indicate that infants do exhibit pop-out on a millisecond scale, that it is unaffected by the number of distractors, and likely have similar functioning selective attention mechanisms. Moreover, the results indicate that eye movement latencies are a more comparable and accurate measure for assessing the phenomenon of pop-out and underlying attentional mechanisms in infants. [source]

    Adding biphasic insulin aspart 30 once or twice daily is more efficacious than optimizing oral antidiabetic treatment in patients with type 2 diabetes

    W. M. W. Bebakar
    Aim:, To evaluate the efficacy and safety of adding biphasic insulin aspart 30 (BIAsp30; NovoMix® 30) to existing oral antidiabetic agents (OADs) vs. optimizing OADs in a subgroup of Western Pacific patients with type 2 diabetes inadequately controlled on oral monotherapy or oral combination therapy. Methods:, This 26-week, multi-centre, open-labelled, randomized, two-arm parallel trial consisted of a 2-week screening period, followed by 24 weeks of treatment. Subjects randomized to BIAsp30 treatment (n = 129) received BIAsp30 once daily (o.d.) at dinnertime between Week 2 and Week 14, and those not reaching treatment targets were switched to twice daily (b.i.d.) BIAsp30 at Week 14 (n = 50). Subjects randomized to the OAD-only arm (n = 63) continued with their previous OAD treatment and, in an attempt to reach treatment goals, the dose was optimized (but OAD unchanged) in accordance to local treatment practice and labelling. Results:, Significantly greater reductions in HbA1c over Weeks 0,13 with BIAsp30 (o.d.) vs. OAD-only treatment (1.16 vs. 0.58%; p < 0.001), and over Weeks 0,26, with BIAsp30 (o.d.) and BIAsp30 (b.i.d.) treatments vs. OAD-only treatment (1.24 vs. 1.34 vs. 0.67%; p < 0.01). Hypoglycaemic episodes were reported in 54% of the patients in BIAsp30 (o.d. and b.i.d. pooled) and 30% of the patients in OAD-only group. All episodes were minor or symptomatic, except for one in each treatment group, which was major. Conclusions:, Initiating BIAsp30 treatment is a safe and more effective way to improve glycaemic control in Western Pacific patients with type 2 diabetes inadequately controlled with oral monotherapy or oral combination therapy compared with optimizing oral combination therapy alone. In patients not reaching treatment target on BIAsp30 (o.d.), treatment with BIAsp30 (b.i.d.) should be considered. [source]