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Selected AbstractsDrawing for Illustration and Annotation in 3DCOMPUTER GRAPHICS FORUM, Issue 3 2001David Bourguignon We present a system for sketching in 3D, which strives to preserve the degree of expression, imagination, and simplicity of use achieved by 2D drawing. Our system directly uses user-drawn strokes to infer the sketches representing the same scene from different viewpoints, rather than attempting to reconstruct a 3D model. This is achieved by interpreting strokes as indications of a local surface silhouette or contour. Strokes thus deform and disappear progressively as we move away from the original viewpoint. They may be occluded by objects indicated by other strokes, or, in contrast, be drawn above such objects. The user draws on a plane which can be positioned explicitly or relative to other objects or strokes in the sketch. Our system is interactive, since we use fast algorithms and graphics hardware for rendering. We present applications to education, design, architecture and fashion, where 3D sketches can be used alone or as an annotation of an existing 3D model. [source] Underdosing of Midazolam in Emergency Endotracheal IntubationACADEMIC EMERGENCY MEDICINE, Issue 4 2003Mark J. Sagarin MD Objectives: To determine whether midazolam, when used as an induction agent for emergency department (ED) rapid-sequence intubation (RSI), is used in adequate and recommended induction doses (0.1 to 0.3 mg/kg), and to compare the accuracy of the dosing of midazolam for ED RSI with the accuracy of dosing of other agents. Methods: The authors conducted a systematic query of a prospectively collected database of ED intubations using the National Emergency Airway Registry data, gathered in 11 participating EDs over a 16-month period. A data form completed at the time of emergency department intubation (EDI) enabled analysis of patients' ages, weights, and indications for EDI, as well as the techniques and drugs used to facilitate EDI. Data were analyzed to determine whether midazolam is used in recommended doses during RSI. Patients intubated with midazolam alone were compared with patients who received other induction agents for RSI. Results: Of 1,288 patients entered in the study, 1,023 (79%) underwent RSI. Of the 888 RSI patients with an age recorded, midazolam was used as the sole induction agent in 140 (16%). The mean (±SD) dosages of midazolam used in RSI were 2.6 (±1.7) mg in children (age , 18) and 3.7 (±2.5) mg in adults (age ,19); the mean (±SD) dosages by weight were 0.08 (±0.04) mg/kg in children and 0.05 (±0.03) mg/kg in adults. More than half (56%) of the children, and nearly all (92%) of the adults, received dosages lower than the minimum recommended dosage (0.1 mg/kg). Of patients who received barbiturates, only 21% of children and 21% of adults received a dose lower than the minimum recommended. When combined with another induction agent, midazolam was dosed similarly to when it was used alone: mean adult doses were 3.1 (±1.2) mg and 0.04 (±0.02) mg/kg. Conclusions: Underdosing of midazolam during ED RSI is frequent, and appears to be related to incorrect dosage selection, rather than to a deliberate intention to reduce the dose used. [source] The optimization of protein secondary structure determination with infrared and circular dichroism spectraFEBS JOURNAL, Issue 14 2004Keith A. Oberg We have used the circular dichroism and infrared spectra of a specially designed 50 protein database [Oberg, K.A., Ruysschaert, J.M. & Goormaghtigh, E. (2003) Protein Sci. 12, 2015,2031] in order to optimize the accuracy of spectroscopic protein secondary structure determination using multivariate statistical analysis methods. The results demonstrate that when the proteins are carefully selected for the diversity in their structure, no smaller subset of the database contains the necessary information to describe the entire set. One conclusion of the paper is therefore that large protein databases, observing stringent selection criteria, are necessary for the prediction of unknown proteins. A second important conclusion is that only the comparison of analyses run on circular dichroism and infrared spectra independently is able to identify failed solutions in the absence of known structure. Interestingly, it was also found in the course of this study that the amide II band has high information content and could be used alone for secondary structure prediction in place of amide I. [source] The near-surface information gap for time and depth imagingGEOPHYSICAL PROSPECTING, Issue 6 2004A. Vesnaver ABSTRACT The shallowest few hundred metres of the earth cannot be adequately imaged by conventional seismic when tuned for deeper targets. Adding independent measurements (such as uphole or shallow refraction surveys) reduces this information gap, but in some arid areas (such as Saudi Arabia) the near-surface complexities are not well resolved, even in this way. The joint tomographic inversion of different wave types can contribute to reducing these ambiguities further, by complementing the different penetration ranges and propagation directions of reflected, refracted and diving waves. Here, we demonstrate the weakness of diving waves when used alone, and the value of complementing them by available reflected and refracted arrivals. [source] Effect of Autogenic Training on Drug Consumption in Patients With Primary Headache: An 8-Month Follow-up StudyHEADACHE, Issue 3 2003Terezia Zsombok MD Objective.,To examine the effects of Schultz-type autogenic training on headache-related drug consumption and headache frequency in patients with migraine, tension-type, or mixed (migraine plus tension-type) headache over an 8-month period. Background.,Behavioral treatments often are used alone or adjunctively for different types of headache. There are, however, only a few studies that have compared the efficacy and durability of the same treatment in different types of primary headache, and the effects of treatment on headache-related drug consumption rarely have been assessed even in these studies. Methods.,Twenty-five women with primary headache (11 with mixed headache, 8 with migraine, and 6 with tension-type headache) were evaluated via an open-label, self-controlled, 8-month, follow-up study design. After an initial 4 months of observation, patients began learning Schultz-type autogenic training as modified for patients with headache. They practiced autogenic training on a regular basis for 4 months. Based on data from headache diaries and daily medication records, headache frequencies and the amounts of analgesics, "migraine-specific" drugs (ergots and triptans), and anxiolytics taken by the patients were compared in the three subgroups over the 8-month period. Results.,From the first month of implementation of autogenic training, headache frequencies were significantly reduced in patients with tension-type and mixed headache. Significant reduction in frequency was achieved in patients with migraine only from the third month of autogenic training. Decreases in headache frequencies were accompanied by decreases in consumption of migraine drugs and analgesics resulting in significant correlations among these parameters. Reduction in consumption of anxiolytic drugs was more rapid and robust in patients with tension-type headache compared to patients with migraine, and this outcome failed to show any correlation with change in headache frequency. Conclusion.,Schultz-type autogenic training is an effective therapeutic approach that may lead to a reduction in both headache frequency and the use of headache medication. [source] Inhibition of hepatitis C virus infection by anti-claudin-1 antibodies is mediated by neutralization of E2,CD81,Claudin-1 associations,HEPATOLOGY, Issue 4 2010Sophie E. Krieger The tight junction protein claudin-1 (CLDN1) has been shown to be essential for hepatitis C virus (HCV) entry,the first step of viral infection. Due to the lack of neutralizing anti-CLDN1 antibodies, the role of CLDN1 in the viral entry process is poorly understood. In this study, we produced antibodies directed against the human CLDN1 extracellular loops by genetic immunization and used these antibodies to investigate the mechanistic role of CLDN1 for HCV entry in an infectious HCV cell culture system and human hepatocytes. Antibodies specific for cell surface,expressed CLDN1 specifically inhibit HCV infection in a dose-dependent manner. Antibodies specific for CLDN1, scavenger receptor B1, and CD81 show an additive neutralizing capacity compared with either agent used alone. Kinetic studies with anti-CLDN1 and anti-CD81 antibodies demonstrate that HCV interactions with both entry factors occur at a similar time in the internalization process. Anti-CLDN1 antibodies inhibit the binding of envelope glycoprotein E2 to HCV permissive cell lines in the absence of detectable CLDN1-E2 interaction. Using fluorescent-labeled entry factors and fluorescence resonance energy transfer methodology, we demonstrate that anti-CLDN1 antibodies inhibit CD81-CLDN1 association. In contrast, CLDN1-CLDN1 and CD81-CD81 associations were not modulated. Taken together, our results demonstrate that antibodies targeting CLDN1 neutralize HCV infectivity by reducing E2 association with the cell surface and disrupting CD81-CLDN1 interactions. Conclusion: These results further define the function of CLDN1 in the HCV entry process and highlight new antiviral strategies targeting E2-CD81-CLDN1 interactions. (HEPATOLOGY 2010.) [source] Current techniques of liver transectionHPB, Issue 3 2007RONNIE T.P. POON The operative mortality rate of liver resection has decreased from 10% to 20% before the 1980s to <5% in most specialized hepatobiliary centers nowadays. The most important factor for better outcome is reduced blood loss due to improvement in surgical techniques. Liver transection is the most challenging part of liver resection, associated with a risk of massive hemorrhage. Understanding the segmental anatomy of the liver and delineation of the proper transection plane using intraoperative ultrasound are prerequisites to safe liver transection. Clamp crushing and ultrasonic dissection are the two most widely used transection techniques. In recent years, new instruments using different types of energy for coagulation or sealing of vessels have been developed for liver transection. These include radiofrequency devices, Harmonic Scalpel, Ligasure and TissueLink dissecting sealer. Whether these new instruments, used alone or in combination with clamp crushing or ultrasonic dissection, improve the safety of liver transection has not been clearly demonstrated. The use of the vascular stapler for transection of major intrahepatic vascular trunks is also gaining popularity. These new instruments are particularly useful in liver transection during laparoscopic liver resection. Adjunctive measures such as intermittent Pringle maneuver and low central venous pressure anesthesia are also useful measures to reduce the risk of hemorrhage. This article reviews the safety and efficacy of different techniques of liver transection, with particular attention to evidence from randomized controlled trials available in the literature. [source] A Decision-Making Framework for Sediment ContaminationINTEGRATED ENVIRONMENTAL ASSESSMENT AND MANAGEMENT, Issue 3 2005Peter M. Chapman Abstract A decision-making framework for determining whether or not contaminated sediments are polluted is described. This framework is intended to be sufficiently prescriptive to standardize the decision-making process but without using "cook book" assessments. It emphasizes 4 guidance "rules": (1) sediment chemistry data are only to be used alone for remediation decisions when the costs of further investigation outweigh the costs of remediation and there is agreement among all stakeholders to act; (2) remediation decisions are based primarily on biology; (3) lines of evidence (LOE), such as laboratory toxicity tests and models that contradict the results of properly conducted field surveys, are assumed incorrect; and (4) if the impacts of a remedial alternative will cause more environmental harm than good, then it should not be implemented. Sediments with contaminant concentrations below sediment quality guidelines (SQGs) that predict toxicity to less than 5% of sediment-dwelling infauna and that contain no quantifiable concentrations of substances capable of biomagnifying are excluded from further consideration, as are sediments that do not meet these criteria but have contaminant concentrations equal to or below reference concentrations. Biomagnification potential is initially addressed by conservative (worst case) modeling based on benthos and sediments and, subsequently, by additional food chain data and more realistic assumptions. Toxicity (acute and chronic) and alterations to resident communities are addressed by, respectively, laboratory studies and field observations. The integrative decision point for sediments is a weight of evidence (WOE) matrix combining up to 4 main LOE: chemistry, toxicity, community alteration, and biomagnification potential. Of 16 possible WOE scenarios, 6 result in definite decisions, and 10 require additional assessment. Typically, this framework will be applied to surficial sediments. The possibility that deeper sediments may be uncovered as a result of natural or other processes must also be investigated and may require similar assessment. [source] Safety and efficacy of the combination of trastuzumab with docetaxel for HER2-positive women with advanced breast cancer.INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 6 2004A review of the existing clinical trials, results of the expanded access programme in the UK Summary Trastuzumab is a humanised monoclonal antibody against the extracellular domain of HER2 (human epidermal growth factor receptor-2) that is overexpressed in about 25% of human breast cancers. It has shown clinical benefit in HER2-positive breast cancer cases when used alone or in combination with chemotherapy. Trastuzumab increases the response rate to chemotherapy and prolongs survival when used in combination with taxanes. In this article, we review the clinical trials where trastuzumab has been administered together with docetaxel, and we present the results of the trastuzumab expanded access programme (EAP) in the UK. Combination of trastuzumab with docetaxel results in similar response rates and time-to-progression with the trastuzumab/paclitaxel combinations. The toxicity of the combination and the risk of heart failure are low. The clinical data for the docetaxel/trastuzumab combination indicate a favourable profile from both the efficacy and the safety point of view and confirm the feasibility and safety of trastuzumab administration both as monotherapy and in combination with docetaxel. [source] Evaluation of methods to control Phytonemus pallidus and Anthonomus rubi in organic strawberry productionJOURNAL OF APPLIED ENTOMOLOGY, Issue 8 2007R. Berglund Abstract:, Use of the predatory mite Neoseiulus cucumeris (Oudemans) (Acari, Phytoseiidae) and a fleece cover in combination with pyrethrum application showed potential for control of two important pests in organic production of strawberry (Fragaria × ananassa Duch.), although there were some unexpected interactions between pyrethrum and the release of N. cucumeris that need to be investigated further. Two cultivars, Honeoye and Cavendish, were treated with pyrethrum with or without fleece to control strawberry blossom weevils [Anthonomus rubi Herbst. (Col., Curculionidae)] and N. cucumeris was released to control strawberry mites [Phytonemus pallidus (Banks) (Acari, Tarsonemidae)]. Number of strawberry mites, number of flower buds damaged by the weevil, incidence of grey mould and powdery mildew, and fruit yield were measured in two consecutive fruiting seasons. In Honeoye, the fleece in combination with pyrethrum decreased the proportion of damaged buds by 11,23% and increased yield by 49,91 g per plant. When pyrethrum was used alone it did not influence the number of damaged buds or yield. This indicates that the combined treatment was more effective because of the fleece. In Cavendish, the fleece and pyrethrum treatments were not found to be effective. Almost no P. pallidus was found in Honeoye and the results were not analysable. In plots with Cavendish where N. cucumeris had been released, there were approximately 50% fewer P. pallidus from the end of August onwards in 2003. However, this response did not significantly influence the succeeding year's yield. The number of fruits infected with fungi was very low and no effects were observed for any of the treatments. [source] Control of Aspergillus section Flavi growth and aflatoxin accumulation by plant essential oilsJOURNAL OF APPLIED MICROBIOLOGY, Issue 1 2008R. Bluma Abstract Aims:, The antifungal effect of Pimpinella anisum (anise), Pëumus boldus (boldus), Mentha piperita (peppermint), Origanum vulgare (oregano) and Minthosthachys verticillata (peperina) essential oils against Aspergillus section Flavi (two isolates of Aspergillus parasiticus and two isolates of Aspergillus flavus) was evaluated in maize meal extract agar at 0·982 and 0·955 water activities, at 25°C. Methods and Results:, The percentage of germination, germ-tube elongation rate, growth rate and aflatoxin B1 (AFB1) accumulation at different essential oils concentrations were evaluated. Anise and boldus essential oils were the most inhibitory at 500 mg kg,1 to all growth parameters of the fungus. These essential oils inhibited the percentage of germination, germ-tube elongation rate and fungal growth. AFB1 accumulation was completely inhibited by anise, boldus and oregano essential oils. Peperina and peppermint essential oils inhibited AFB1 production by 85,90% in all concentrations assayed. Conclusions:, Anise and boldus essential oils could be considered as effective fungitoxicans for Aspergillus section flavi. Significance and Impact of the Study:, Our results suggest that these phytochemical compounds could be used alone or in conjunction with other substances to control the presence of aflatoxigenic fungi in stored maize. [source] Survival of spores of Rhizopus stolonifer, Aspergillus niger, Botrytis cinerea and Alternaria alternata after exposure to ethanol solutions at various temperaturesJOURNAL OF APPLIED MICROBIOLOGY, Issue 6 2004F. Mlikota Gabler Abstract Aims:, To quantify and model the toxicity of brief exposures of spores of Rhizopus stolonifer, Aspergillus niger, Botrytis cinerea and Alternaria alternata to heated, aqueous ethanol solutions. These fungi are common postharvest decay pathogens of fresh grapes and other produce. Sanitation of produce reduces postharvest losses caused by these and other pathogens. Methods and Results:, Spores of the fungi were exposed to solutions containing up to 30% (v/v) ethanol at 25,50°C for 30 s, then their survival was determined by germination on semisolid media. Logistical, second-order surface-response models were prepared for each fungus. Subinhibitory ethanol concentrations at ambient temperatures became inhibitory when heated at temperatures much lower than those that cause thermal destruction of the spores by water alone. At 40°C, the estimated ethanol concentrations that inhibited the germination of 50% (LD50) of the spores of B. cinerea, A. alternata, A. niger and R. stolonifer were 9·7, 13·5, 19·6 and 20·6%, respectively. Conclusions:, Ethanol and heat combinations were synergistic. Control of spores of these fungi could be accomplished with much lower temperatures and ethanol concentrations when combined compared with either used alone. Botrytis cinerea and A. alternata were less resistant to the combination than A. niger or R. stolonifer. [source] Surgical treatment of peri-implantitis using a bone substitute with or without a resorbable membrane: a prospective cohort studyJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 7 2007Ann-Marie Roos-Jansåker Abstract Objectives: The aim of this prospective cohort study was to compare two regenerative surgical treatment modalities for peri-implantitis. Material and Methods: Thirty-six patients having a minimum of one osseointegrated implant, with a progressive loss of bone amounting to 3 threads (1.8 mm) following the first year of healing, combined with bleeding and/or pus on probing, were involved in this study. The patients were assigned to two different treatment strategies. After surgical exposure of the defect, granulomatous tissue was removed and the infected implant surface was treated using 3% hydrogen peroxide. The bone defects were filled with a bone substitute (Algipore®). In 17 patients (Group 1), a resorbable membrane (Osseoquest®) was placed over the grafted defect before suturing. In 19 patients (Group 2), the graft was used alone. Results: One-year follow-up demonstrated clinical and radiographic improvements. Probing depths were reduced by 2.9 mm in Group 1 and by 3.4 mm in Group 2. Defect fill amounted to 1.5 and 1.4 mm, respectively. There was no significant difference between the groups. Conclusion: It is possible to treat peri-implant defects with a bone substitute, with or without a resorbable membrane. [source] Effect of toothpaste on the plaque inhibitory properties of a cetylpyridinium chloride mouth rinseJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 3 2003S. Sheen Abstract Background and aims: Cetylpyridinium chloride (CPC) mouth rinses have moderate plaque inhibitory activity when used alone but rarely have shown adjunctive benefits to tooth brushing with toothpaste. Several explanations for this apparent anomaly can be proferred, including loss of antiseptic activity due to interactions with toothpaste ingredients. The aim of this study was to measure the effect of toothpaste on the plaque inhibitory properties of a CPC mouth rinse using paired rinses of CPC, toothpaste slurry (TP) and water (W). Methods: The study was a single blind, randomised, seven-treatment, cross over design balanced for residual effects, involving 21 healthy, dentate subjects. The paired rinses were: W-CPC, CPC-W, TP-CPC, CPC-TP, W-TP, TP-W and W-W. Rinsing with solutions or slurries was done for 60 s twice per day. On day 1, subjects were rendered plaque free, suspended tooth cleaning and commenced the allocated rinse regimen. On day 5, plaque was scored by index. A 2½ day wash out of normal oral hygiene was allowed between each regimen. Results: The order from lowest to highest plaque scores was as follows: W-CPC = CPC-W < CPC-TP < TP-CPC , W-TP < TP-W < W-W. Several differences in pairs of treatments were statistically significant, the most relevant of which were significantly less plaque with W-CPC compared to TP-CPC, TP-W and W-TP, and significantly more plaque with W-W compared to all other regimens except TP-W. Conclusions: Toothpaste, whilst possessing some plaque inhibitory activity, when used immediately before a CPC mouth rinse adversely affected the plaque inhibitory action of this antiseptic. This in part may explain the reported lack of adjunctive benefits of CPC rinses to normal oral hygiene practices and supports the suggestion, made for chlorhexidine rinses, that their use should follow toothpaste by at least 60 min. Zusammenfassung Die Wirkung von Zahnpasta auf die plaquehemmenden Eigenschaften einer Mundspüllösung mit Cetylpyridinium-Chlorid Grundlagen und Ziel: Cetylpyridinium-Chlorid (CPC) Mundspüllösung haben, wenn sie alleine verwendet werden, eine moderate plaquehemmende Aktivität. Es wurde jedoch selten gezeigt, dass sie zusätzlich zum Zähneputzen Vorteile haben. Mehrere Erklärungen für diese offensichtliche Anomalie können angeboten werden, einschließlich des Verlusts der antiseptischen Aktivität wegen einer Interaktion mit Inhaltstoffen der Zahnpasta. Ziel dieser Studie war es, die Wirkung der Zahnpasta auf die plaquehemmenden Eigenschaften einer CPC-Mundspüllösung zumessen. Es wurde CPC zusammen mit Zahnpasta-Lösung (TP) oder zusammen mit Wasser (W) verwendet. Methoden: Die randomisierte, einfach-blinde-Studie hatte ein 7-Behandlungs- Crossover-Design und war ausgeglichen hinsichtlich der Resteffekte. Einundzwanzig gesunde und bezahnte Personen wurden aufgenommen. Die paarweisen Spülungen waren: W-CPC, CPC-W, TP-CPC, CPC-TP, W-TP, TP-W und W-W. Die Spülungen wurden zweimal pro Tag für 60 Sekunden durchgeführt. An Tag-1 wurde bei der Teilnehmern Plaquefreiheit hergestellt, sie enthielten sich der Mundhygiene und begannen die zugewiesenen Spülungen. An Tag-5 wurde die Plaque mittels Index beurteilt. Zwischen den Spülmaßnahmen war eine 2,5-tägige Auswaschperiode mit normaler Mundhygiene erlaubt. Ergebnisse: Die Reihenfolge vom niedrigsten zum höchsten Plaquewert war W-CPC = CPC-W < CPC-TP < TP-CPC = W-TP < TP-W < W-W. Mehrere Unterschiede zwischen den Behandlungspaaren waren statistisch signifikant. Der Relevanteste davon war signifikant weniger Plaque mit W-CPC verglichen zu TP-CPC, TP-W und W-TP sowie signifikant mehr Plaque mit W-W verglichen mit allen anderen Spülungen außer TP-W. Schlussfolgerungen: Zahnpasta beeinflusst, obwohl sie eine gewisse plaquehemmende Aktivität hat, wenn sie unmittelbar vor der CPC-Mundspülung verwendet wird, die plaquehemmende Wirkung dieser antiseptischen Lösung. Dies könnte zum Teil die berichteten nicht vorhandenen Vorteile, wenn die CPC-Mundspülung zusätzlich zur normalen Mundhygiene durchgeführt wird, erklären. Es unterstützt die Annahme, dass Chlorhexidin-Spülungen der Zahnpastaanwendung wenigstens 60 Minuten später folgen sollten. Résumé L'effet d'un dentifrice sur les propriétés inhibitrices de la plaque dentaire d'un bain de bouche au chlorure de cétylpyridinium Les bains de bouche au chlorure de cétylpyridinium (CPC) ont de faibles activités inhibitrices de la plaque dentaire lorsqu'ils sont utilisés seuls, mais quelquefois révèlent un bénéfice supplémentaire lorsqu'ils sont associés au brossage et à une pâte dentifrice. Différentes explications de cette apparente anomalie peuvent être avancées incluant la perte de l'activité de l'antiseptique dûe aux interactions avec les ingrédients contenus dans le dentifrice. Le but de cette étude a été de mesurer l'effet d'un dentifrice sur les propriétés inhibitrices de la plaque dentaire d'un bain de bouche CPC en utilisant des bain de bouche au CPC, un mélange aqueux d'un dentifrice (TP) et de l'eau (W). Cette étude avait un modèle croisé de sept traitements, randomisé en simple aveugle, balancé pour les effets résiduels comprenant 21 sujets dentés sains. Les paires de rinçage étaient : W-CPC, CPC-W, TP-CPC, CPC-TP, W-TP, TP-W et W-W. Le rinçage avec les solutions ou le mélange aqueux a été effectué durant 60s deux fois par jour. Au jour 1, les sujets se retrouvaient sans plaque dentaire, arrêtaient tout nettoyage dentaire et commençaient le régime préconisé. Au jour 5, la plaque dentaire a été mesurée par indice. Deux jours et demi d'intervalle avec hygiène buccale normale était utilisés entre chaque régime. L'ordre des indices de plaque du plus bas vers le plus haut étaient W-CPC = CPC-W < CPC-TP Maxillary Sinus Elevation Surgery: An OverviewJOURNAL OF ESTHETIC AND RESTORATIVE DENTISTRY, Issue 5 2003ELIAZ KAUFMAN DDS ABSTRACT Maxillary sinus elevation surgery was developed to increase the height of bone available for implant placement in the posterior maxilla. The efficacy and predictability of this procedure have been determined in numerous studies. The basic approach to the sinus (Caldwell-Luc operation) involves an osteotomy performed on the lateral maxillary wall, elevation of the sinus membrane, and placement of bone graft material. The graft materials can be categorized into four groups: autogenous bone, allografts (harvested from human cadavers), alloplasts (synthetic materials), and xenografts (grafts from a nonhuman species). These graft materials can be used alone or in combination with each other. Implant placement can occur at the same surgical procedure (immediate placement) or following a healing period of 6 to 9 months (delayed placement). A more conservative approach to the sinus, the osteotome technique, has been described as well. CLINICAL SIGNIFICANCE This article provides an overview of the surgical technique, with emphasis on anatomic considerations, preoperative patient evaluation (clinical and radiographic), indications and contraindications to the procedure, and possible risks and complications. [source] Field performance and seasonal changes in the efficacy against Helicoverpa armigera (Hübner) of transgenic cotton expressing the insecticidal protein vip3AAGRICULTURAL AND FOREST ENTOMOLOGY, Issue 2 2007Danny J. Llewellyn Abstract 1,Three years of field experiments in Eastern Australia were carried out on transgenic cotton (Gossypium hirsutum L.) event Cot102 expressing the insecticidal protein gene vip3A from Bacillus thuringiensis to evaluate performance against Helicoverpa armigera Hübner. Efficacy, defined as the capacity of plant tissues to induce larval mortality, was determined with a well-validated leaf bioassay fortnightly through the growth cycle of the cotton in each season. 2,Cot102 plants proved highly efficacious against H. armigera, particularly early in the season, although their efficacy declined as the season progressed, in a manner similar to, but not as dramatic as, that observed with commercial Cry1Ac expressing cotton (Bollgard or Ingard cotton). 3,Field surveys indicated that very few larvae survived beyond first instar on intact growing plants. 4,In one season efficacy declined for a period of approximately 20 days after a cool wet period, suggesting that this may have had a detrimental effect on the expression or efficacy of the gene, but this will need to be verified in further replicated trials. 5,Quantitative enzyme-linked immunosorbent assays indicated that there was no dramatic reduction in production of the vip3A protein during growth and maturation of the crop, suggesting that other host plant factors were affecting the efficacy of the insecticidal protein in the insect gut. 6,These data indicate that Cot102 cotton would provide a useful alternative to Bollgard cotton but, given the similar lytic mode of action of vip3A proteins in the insect midgut, there may be similar inherent vulnerabilities to resistance evolution for these proteins if used alone. Pyramiding of the vip3A trait with a second insecticidal gene would appear to be a high priority for achieving sustainable deployment against H. armigera or similar susceptible species. [source] Reduction of fibrosis in a rat model of non-alcoholic steatohepatitis cirrhosis by human HGF gene transfection using electroporationJOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 8pt2 2008Shigeru Kiyama Abstract Background and Aim:, To study the histological changes caused by transfection of the hepatocyte growth factor (HGF) gene using electroporation (EP) in a non-alcoholic steatohepatitis (NASH) cirrhotic liver model. Methods:, NASH cirrhotic livers were prepared by administering a choline-deficient diet to 5-week-old male Wister rats for 12 weeks. Three groups of rats were used: rats in the G(+) group were transfected with the GFP gene using EP, rats in the H(+) group were transfected with the HGF gene using EP, and rats in the H(,) group were only injected with the HGF gene. Rats were sacrificed 2 days after gene transfection, and the Azan positive rate (APR) and Sudan positive rate (SPR) were calculated to evaluate fibrosis and fatty changes. Results:, The APR of the NASH cirrhotic livers was significantly higher than that in the normal livers. The APR did not decrease in the G(+) group and the H(,) group, but decreased significantly in the nonelectroporated as well as electroporated areas of the H(+) group. For SPR, there were no significant differences between the G(+), H(,), and H(+) groups. Conclusion:, The improvement of fibrosis was not significant when a direct injection of the HGF gene was used alone, but it was enhanced by the concomitant use of EP. However, no efficacy was observed in fat components. These findings suggest that transfection of the HGF gene by EP may lead to an improvement of irreversible cirrhotic livers to reversible fatty livers. [source] Dynamics of lamivudine-resistant hepatitis B virus during adefovir monotherapy versus lamivudine plus adefovir combination therapyJOURNAL OF MEDICAL VIROLOGY, Issue 7 2008Samreen Ijaz Abstract Adefovir dipivoxil has been used alone or together with lamivudine to suppress lamivudine-resistant hepatitis B virus (HBV). However, the dynamics of HBV populations under different selection pressures and their impact on treatment outcome are poorly understood. Pyrosequencing® was applied to quantify longitudinally the evolution of wild type and lamivudine/ adefovir-resistant HBV. Eight patients, with lamivudine-resistant HBV, were randomized to receive adefovir monotherapy or adefovir/lamivudine combination therapy for a median of 79 and 71 weeks, respectively. Pyrosequencing® proved highly sensitive with a lower limit of quantitation of minor HBV populations of 2% irrespective of viraemia levels. Adefovir/lamivudine treatment resulted in greater viraemia reduction than adefovir monotherapy. During combination therapy, lamivudine-resistant HBV populations (codons 180 and 204) remained dominant (>90%) and no adefovir-resistance developed. During adefovir monotherapy, reversion to wild-type HBV was detected in two patients with one patient accumulating rapidly adefovir-resistant HBV along with increased viraemia. In conclusion, the dynamics of drug-resistant HBV strains vary under different selection pressures which have a significant impact on the success of rescue therapy, as well as for the selection of new mutations. The use of techniques such as Pyrosequencing provides an evidence-based approach for successful management of drug-resistant HBV. J. Med. Virol. 80: 1160,1170, 2008. © 2008 Wiley-Liss, Inc. [source] Synergistic dopaminergic neurotoxicity of manganese and lipopolysaccharide: differential involvement of microglia and astrogliaJOURNAL OF NEUROCHEMISTRY, Issue 2 2010Ping Zhang Abstract Overexposure to manganese is known to cause damage to basal ganglial neurons and the development of movement abnormalities. Activation of microglia and astrocytes has increasingly been associated with the pathogenesis of a variety of neurological disorders. We have recently shown that microglial activation facilitates manganese chloride (MnCl2, 10,300 ,M)-induced preferential degeneration of dopamine (DA) neurons. In this study, we report that combinations of MnCl2 (1,30 ,M) and endotoxin lipopolysaccharide (LPS, 0.5,2 ng/mL), at minimally effective concentrations when used alone, induced synergistic and preferential damage to DA neurons in rat primary neuron-glia cultures. Mechanistically, MnCl2 significantly potentiated LPS-induced release of tumor necrosis factor-alpha and interleukin-1 beta in microglia, but not in astroglia. MnCl2 and LPS were more effective in inducing the formation of reactive oxygen species and nitric oxide in microglia than in astroglia. Furthermore, MnCl2 and LPS-induced free radical generation, cytokine release, and DA neurotoxicity was significantly attenuated by pre-treatment with potential anti-inflammatory agents minocycline and naloxone. These results demonstrate that the combination of manganese overexposure and neuroinflammation is preferentially deleterious to DA neurons. Moreover, these findings not only shed light on the understanding of manganese neurotoxicity but may also bear relevance to the potentially multifactorial etiology of Parkinson's disease. [source] Comparative study of four candidate strategies to detect cervical cancer in different health care settingsJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 4 2007Meherbano M. Kamal Abstract Aim:, Considering the differing but potentially supplementary properties of visual inspection of the cervix with acetic acid (VIA) and the cytological examination (CYTO) of cervical smears for the screening of cervical cancers, we examined the performance of these two tests and their combinations for the screening of cervical cancer in different health care settings. Methods:, In this cross-sectional diagnostic test performance evaluation study of 4235 female subjects in the reproductive age group, we assessed the screening performance of four strategies: VIA alone, CYTO alone, VIA and CYTO combined in a parallel fashion, and VIA and CYTO combined in tandem. Subjects were recruited from three settings: Hospital, Urban Community and Rural Community. Colposcopy was used as the reference standard. Screening performance was assessed using sensitivity, specificity, post-test probabilities and likelihood ratios (LR), diagnostic odds, area under receiver operating characteristic curve and LR ,2. Results:, Both VIA and CYTO when used alone had a low sensitivity but high specificity, especially in the Rural Community setting. A combination of the results of VIA and CYTO improved the diagnostic accuracy but the strategy using a parallel combination of VIA and CYTO was the most accurate. In general, all screening strategies using VIA and CYTO showed a modest screening performance. Conclusions:, In the settings of varying levels of health care and low resources, caution is needed for a generalized use of VIA for cervical cancer screening. Further evaluation of the cost-effective ways of combining VIA and CYTO is needed in these circumstances. [source] Antiproliferative, cytotoxic and antitumour activity of coumarins isolated from Calophyllum brasilienseJOURNAL OF PHARMACY AND PHARMACOLOGY: AN INTERNATI ONAL JOURNAL OF PHARMACEUTICAL SCIENCE, Issue 5 2007César Ruiz-Marcial Among the eight Calophyllum species found on the American continent, Calophyllum brasiliense is the most widely distributed. Chemical analysis of this species has shown the presence of xanthones with cancer chemopreventive properties and antifungal activity. Recently, three new coumarins with antineoplastic properties have been found. In this study, we have evaluated the biological effects of the antiproliferative activity of coumarins isolated from C. brasiliense on the survival, cell cycle and apoptosis of cells in-vitro and their antitumour effects in mice. The cytological study showed that coumarins from C. brasiliense reduce the survival of BMK cells (baby mouse kidney cells) by inducing apoptosis and, to a lesser degree, necrosis. The cell cycle was arrested in S-phase and the division of BMK cells was inhibited. Coumarins had caused a reduction of experimental tumours in 83% of animals by the end of the treatment. Therefore, coumarins have the potential to be used alone or in combination with other antineoplastic drugs, and they might increase the effectiveness of other treatments for cancer. [source] Liquid-crystalline thermosets by the curing of dimeric liquid-crystalline epoxyimine monomers with 2,4-toluene diisocyanateJOURNAL OF POLYMER SCIENCE (IN TWO SECTIONS), Issue 16 2003David Ribera Abstract We studied the curing processes of several series of dimeric liquid-crystalline epoxyimine monomers with 2,4-toluene diisocyanate (TDI) alone or with added catalytic proportions of 4-(N,N -dimethylamino)pyridine. We obtained isotropic materials or liquid-crystalline thermosets with different degrees of order, which depended on the structures of the monomers. To fix ordered networks, we had to do the curing in two steps when TDI was used alone as the curing agent. However, when a tertiary amine was added in catalytic proportions, the ordered networks were fixed in just one step. In this way, we were able to fix both nematic and smectic mesophases. The significance of the polarization of the mesogen for obtaining liquid-crystalline thermosets was demonstrated. © 2003 Wiley Periodicals, Inc. J Polym Sci Part A: Polym Chem 41: 2521,2530, 2003 [source] Meta-analysis: isosorbide-mononitrate alone or with either beta-blockers or endoscopic therapy for the management of oesophageal varicesALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 7 2010L. L. Gluud Aliment Pharmacol Ther 2010; 32: 859,871 Summary Background, The evidence concerning the use of isosorbide-mononitrate (IsMn) for oesophageal varices is equivocal. Aim, To assess the effects of IsMn for patients with oesophageal varices and no previous bleeding (primary prevention) or previous variceal bleeding (secondary prevention). Methods, Systematic review with meta-analyses of randomized trials on IsMn alone or with beta-blockers or endoscopic therapy for oesophageal varices. Electronic and manual searches were combined. Randomized trials on primary and secondary prevention were included. The primary outcome measure was mortality. Intention-to-treat random effects meta-analyses were performed. The robustness of the results was assessed in trial sequential analyses. Results, Ten randomized trials on primary and 17 on secondary prevention were included. Evidence of bias was identified. No apparent effect of IsMn on mortality compared with placebo or beta-blockers or IsMn plus beta-blockers vs. beta-blockers was identified. Compared with endoscopic therapy, IsMn plus beta-blockers had no apparent effect on bleeding, but did seem to reduce mortality in secondary prevention (RR 0.73, 95% CI 0.59,0.89), but not in primary prevention. The effect of IsMn plus beta-blockers on mortality in secondary prevention was not confirmed in trial sequential analysis. Conclusions, Isosorbide-mononitrate used alone or in combination with beta blockers does not seem to offer any reduction in bleeding in the primary or secondary prevention of oesophageal varices. Compared with endoscopic therapy, there may be a survival advantage in using IsMn and beta-blockers, but additional large multicentre trials are needed to verify this finding. [source] Prospective, open-label, comparative study of clindamycin 1%/benzoyl peroxide 5% gel with adapalene 0.1% gel in Asian acne patients: efficacy and tolerabilityJOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY & VENEREOLOGY, Issue 3 2009H-C Ko Abstract Background, Used as individual agents, topical antibiotics and benzoyl peroxide are known to be effective in treatment of acne. Clindamycin phosphate 1% with benzoyl peroxide 5% (CDP/BPO) is a new combination gel, made by rationale, in that combination drug is more effective than either ingredients used alone. Adapalene 0.1% (ADA) is the third-generation retinoid, shown to be as effective as other topical retinoid with well tolerability. Objectives, To compare the efficacy and tolerability in combination of CDP/BPO in comparison with ADA in Asian patients with mild to moderate acne vulgaris. Methods, Total of 69 patients, including 31 patients for CDP/BPO group and 38 for ADA group, with mild to moderate acne vulgaris were enrolled for a 12-week prospective, randomized, open-label comparative study of topical agents. Efficacy was assessed by lesion counts, acne grading system, and global improvement. Adverse events were also evaluated in scale of 0 (none) to 3 (severe). Results, Both CDP/BPO and ADA were effective in reducing lesion counts and acne severity scale and showed significant global improvement. However, CDP/BPO offered greater efficacy against inflammatory lesions than ADA. Both drugs were well tolerated with minimal adverse drug reactions. Conclusion, Combination formulation of CDP/BPO and ADA were shown to be both effective in decreasing total, inflammatory, and non-inflammatory lesion counts along with well tolerability in Asian patients with mild to moderate acne vulgaris. Conflicts of interest None declared [source] Acoustic identification of insectivorous bats (order Chiroptera) of Yucatan, MexicoJOURNAL OF ZOOLOGY, Issue 1 2002J. Rydell Abstract The echolocation calls of insectivorous bats of the northern Yucatan Peninsula, Mexico, with the exception of the phyllostomids and molossids, are presented. The aim is to provide a catalogue of bat sounds that can be used for acoustic inventories of insectivorous bats using the Pettersson heterodyne and time-expansion bat detectors. The acoustic method can be used alone or in combination with inventories based on mist-netting, a method more suitable for the low-intensity echolocators (mainly the phyllostomids), which are difficult to monitor acoustically. The insectivorous species of the Yucatan are generally easy to identify by their echolocation calls, particularly when combined with visual observations of foraging bats at dusk. [source] The use of coal fly ash in sodic soil reclamationLAND DEGRADATION AND DEVELOPMENT, Issue 3 2003D. Kumar Abstract An experiment was conducted for two years in northwest India to explore the feasibility of using coal fly ash for reclamation of waterlogged sodic soils and its resultant effects on plant growth in padi,wheat rotation. The initial pH, electrical conductivity, exchangeable sodium percentage and sodium adsorption ratio of the experimental soil were 9.07, 3.87,dS,m,1, 26.0 and 4.77 (me l),1/2, respectively. The fly ash obtained from electrostatic precipitators of thermal power plant had a pH of 5.89 and electrical conductivity of 0.88,dS,m,1. The treatments comprised of fly ash levels of 0.0, 1.5, 3.0, 4.5, 6.0 and 7.5 per cent, used alone as well as in combination with 100, 80, 60, 40, 20 and 10 per cent gypsum requirement of the soil, respectively. There was a slight reduction in soil pH while electrical conductivity of the soil decreased significantly with fly ash as measured after padi and wheat crops. The sodium adsorption ratio of the soil decreased with increasing fly ash levels, while gypsum treatments considerably added to its favourable effects. Fly ash application increased the available elemental status of N, K, Ca, Mg, S, Fe, Mn, B, Mo, Al, Pb, Ni, Co, but decreased Na, P and Zn in the soil. An application of fly ash to the soil also increased the concentrations of above elements except Na, P and Zn in the seeds and straw of padi and wheat crops. The available as well as elemental concentrations in the plants was maximum in the 0 per cent fly ash,+,100 per cent gypsum requirement treatment except Na and heavy elements like Ni, Co, Cr. The treatment effects were greater in the fly ash,+,gypsum requirement combinations as compared to fly ash alone. Saturated hydraulic conductivity and soil water retention generally improved with the addition of fly ash while bulk density decreased. Application of fly ash up to 4.5 per cent level increased the straw and grain yield of padi and wheat crops significantly in both years. The results indicated that for reclaiming sodic soils of the southwest Punjab, gypsum could possibly be substituted up to 40 per cent of the gypsum requirement with 3.0 per cent acidic fly ash. Copyright © 2003 John Wiley & Sons, Ltd. [source] Clinical evaluation of a single-wavelength fractional laser and a novel multi-wavelength fractional laser in the treatment of photodamaged skin,LASERS IN SURGERY AND MEDICINE, Issue 6 2009Laurel Naversen Geraghty BA Abstract Background and Objectives Nonablative fractional lasers are well recognized for rejuvenating photoaged skin. We previously reported favorable outcomes with short follow-up after the use of 1,440-nm Nd:YAG laser energy used alone or in combination with a 1,320-nm laser to effect rejuvenation and wrinkle reduction. We now report longer follow-up data. Study Design/Materials and Methods Nineteen Caucasian subjects (average age 47±8.4; range 33,62) exhibiting mild-to-moderate photoaging of the face and neck were treated four times (average interval 18.1± 4.1 days; range 11,37 days) with the 1,440-nm Nd:YAG fractional laser (average fluence 3.7±0.3,J/cm2) or the 1,320/1,440-nm multiplex Nd:YAG fractional laser (1,320-nm average fluence 8.4±0.4,J/cm2; 1,440-nm average fluence 2.3±0.2,J/cm2). Outcomes were assessed by subjects and the treating physician using a quartile scale to evaluate skin tightening, surface texture, rhytids, dyschromia, erythema, and global appearance after 1, 3, and 6 months. Retroauricular punch biopsies from three patients were used to evaluate wound healing. Three patients withdrew from the study prior to evaluation, one missed the 1-month evaluation, and one missed the 6-month evaluation. Results Assessment by subjects and the treating physician revealed clinical improvement for all outcomes after 1, 3, and 6 months. The differences between the treatment groups were not statistically significant. Subjects demonstrated the greatest average 6-month improvements in surface texture and global skin appearance. Subjects treated with the multiplex laser reported more skin tightening than the group treated only with the 1,440-nm laser. Histological evaluation revealed wound healing within 10 days and significant neocollagenesis at 3 months. No adverse events were reported in any subject. Conclusion The 1,440-nm Nd:YAG and 1,320/1,440-nm multiplex Nd:YAG lasers safely and effectively produced improved surface texture, rhytids, dyschromia, erythema, global skin appearance, and skin tightening. Histopathologic findings correlated with clinical observations. Lasers Surg. Med. 41:408,426, 2009. © 2009 Wiley-Liss, Inc. [source] Adaptive evolutionary conservation: towards a unified concept for defining conservation unitsMOLECULAR ECOLOGY, Issue 12 2001Dylan J. Fraser Abstract Recent years have seen a debate over various methods that could objectively prioritize conservation value below the species level. Most prominent among these has been the evolutionarily significant unit (ESU). We reviewed ESU concepts with the aim of proposing a more unified concept that would reconcile opposing views. Like species concepts, conflicting ESU concepts are all essentially aiming to define the same thing: segments of species whose divergence can be measured or evaluated by putting differential emphasis on the role of evolutionary forces at varied temporal scales. Thus, differences between ESU concepts lie more in the criteria used to define the ESUs themselves rather than in their fundamental essence. We provide a context-based framework for delineating ESUs which circumvents much of this situation. Rather than embroil in a befuddled debate over an optimal criterion, the key to a solution is accepting that differing criteria will work more dynamically than others and can be used alone or in combination depending on the situation. These assertions constitute the impetus behind adaptive evolutionary conservation. [source] Phenotypic and genotypic characterization of reference strains of the genus AspergillusMYCOSES, Issue 3-4 2001P.-M. Rath Aspergillus; Genotypisierung; Biotypisierung; SDS-PAGE; RAPD Summary. Twenty-five culture collection strains from four Aspergillus species (A. fumigatus n = 8, A. flavus n = 8, A. niger n= 4, A. nidulans n = 5) were characterized by four methods: (i) determination of patterns in an assimilation assay; (ii) protein pattern of whole mycelial cell lysates in the sodium dodecyl sulphate (SDS)-polyacrylamide gel electrophoresis (PAGE); (iii) reactivity of a pool serum obtained from cystic fibrosis patients with mycelial lysates in the immunoblot; and (iv) random amplification of polymorphic DNA (RAPD) with eight primers having arbitrary or repetitive sequences. In the assimilation assay the A. fumigatus strains showed identical patterns in contrast to the strains of the species A. flavus, A. niger, and A. nidulans, which each showed four patterns. In the SDS-PAGE no differences in the band patterns in the A. fumigatus strains were found, in contrast to the A. flavus (three patterns), A. nidulans (five patterns) and A. niger strains (two patterns). The immunoblot patterns were characteristic for each species with bands at 62 and 17/18 kDa in the A. fumigatus strains, at 51 and 18 kDa in the A. flavus strains, at 51 kDa in the A. niger strains, and at 51, 40 and 17/18 kDa in the A. nidulans strains allowing, however, no intraspecies typing. In the RAPD assay four out of eight primers gave interpretable patterns with 3,20 bands. None of the primers showed sufficient discriminatory power when used alone. However, when combining the results of two of the primers (5,-GTA TTG CCC T-3, and 5,-GAT AGA TAG ATA GAT A-3,) all strains except two A. fumigatus strains could be clearly separated from each other. It is concluded that the the RAPD assay showed the most discriminatory power in all Aspergillus species investigated. In contrast to the phenotypically similar A. fumigatus strains, the strains of the species A. flavus, A. nidulans and A. niger differed in their phenotypic characteristics. The presented data of strains from international culture collections may serve as basis for interlaboratory standardization of typing methods. Zusammenfassung. Fünfundzwanzig Aspergillus -Stämme aus internationalen Stammsammlungen (A. fumigatus n = 8, A. flavus n = 8, A. niger n = 4, A. nidulans n = 5) wurden mit vier Methoden charakterisiert: (1) Reaktionsmuster in einem Assimilationstest (2) Proteinmuster von Ganzzell-Lysaten in der SDS-PAGE (3) Reaktionsmuster eines Poolserums von Patienten mit Mukoviszidose mit Zellextrakten im Immunoblot und (4) random amplification of polymorphic DNA (RAPD) mit acht Primern zufälliger oder repetitiver Sequenz. Im Assimilationstest zeigten die A. fumigatus -Stämme identische Muster, während die Stämme der Spezies A.flavus, A. niger und A. nidulans je vier Reaktionsmuster aufwiesen. In der SDS-PAGE wiesen die A. fumigatus -Stämme identische Muster auf, während die A. flavus -Stämme drei, die A. niger -Stämme zwei, und die A. nidulans -Stämme fünf verschiedene Muster zeigten. Im Immunoblot waren die Muster für jede Spezies charakteristisch mit Banden bei 62 kDa und 17/18 kDa bei A. fumigatus, bei 51 kDa und 18 kDa bei A. flavus, bei 51 kDa bei A. niger und bei 51, 40 und 17/18 kDa bei A. nidulans. Eine Intraspezies-Typisierung gelang jedoch nicht. In der RAPD ergaben vier der acht Primer interpretierbare Muster mit 3 bis 20 Banden. Keiner der Primer alleine zeigte eine ausreichende Diskriminationskapazität. Wurden die Resultate von zwei Primern (5,-GTA TTG CCC T-3, and 5,-GAT AGA TAG ATA GAT A-3,) kombiniert, konnten mit Ausnahme von zwei A. fumigatus -Stämmen alle Isolate voneinander abgegrenzt werden. Die Ergebnisse zeigen, daß die RAPD die größte Diskriminationskapazität aufweist. Im Gegensatz zu den phänotypisch ähnlichen A. fumigatus -Stämmen unterschieden sich die Stämme der Spezies A. flavus, A. nidulans und A. niger voneinander. Die gezeigten Daten von Stämmen internationaler Stammsammlungen können als Grundlage für die Standardisierung von Typisierungsmethoden dienen. [source] Development of a decision support system for diagnosis and grading of brain tumours using in vivo magnetic resonance single voxel spectraNMR IN BIOMEDICINE, Issue 4 2006Anne R. Tate Abstract A computer-based decision support system to assist radiologists in diagnosing and grading brain tumours has been developed by the multi-centre INTERPRET project. Spectra from a database of 1H single-voxel spectra of different types of brain tumours, acquired in vivo from 334 patients at four different centres, are clustered according to their pathology, using automated pattern recognition techniques and the results are presented as a two-dimensional scatterplot using an intuitive graphical user interface (GUI). Formal quality control procedures were performed to standardize the performance of the instruments and check each spectrum, and teams of expert neuroradiologists, neurosurgeons, neurologists and neuropathologists clinically validated each case. The prototype decision support system (DSS) successfully classified 89% of the cases in an independent test set of 91 cases of the most frequent tumour types (meningiomas, low-grade gliomas and high-grade malignant tumours,glioblastomas and metastases). It also helps to resolve diagnostic difficulty in borderline cases. When the prototype was tested by radiologists and other clinicians it was favourably received. Results of the preliminary clinical analysis of the added value of using the DSS for brain tumour diagnosis with MRS showed a small but significant improvement over MRI used alone. In the comparison of individual pathologies, PNETs were significantly better diagnosed with the DSS than with MRI alone. Copyright © 2006 John Wiley & Sons, Ltd. [source]
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