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Early Period (early + period)
Selected AbstractsTrophy-taking and dismemberment as warfare strategies in prehistoric central CaliforniaAMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY, Issue 1 2010Valerie A. Andrushko Abstract We document evidence for trophy-taking and dismemberment with a new bioarchaeological database featuring 13,453 individuals from prehistoric central California sites. Our study reveals 76 individuals with perimortem removal of body parts consistent with trophy-taking or dismemberment; nine of these individuals display multiple types of trophy-taking and dismemberment for a total of 87 cases. Cases span almost 5,000 years, from the Early Period (3000,500 BC) to the Late Period (AD 900,1700). Collectively, these individuals share traits that distinguish them from the rest of the population: a high frequency of young adult males, an increased frequency of associated trauma, and a tendency towards multiple burials and haphazard burial positions. Eight examples of human bone artifacts were also found that appear related to trophy-taking. These characteristics suggest that trophy-taking and dismemberment were an important part of the warfare practices of central Californian tribes. Temporally, the two practices soared in the Early/Middle Transition Period (500,200 BC), which may have reflected a more complex sociopolitical system that encouraged the use of trophies for status acquisition, as well as the migration of outside groups that resulted in intensified conflict. Overall, trophy-taking and dismemberment appear to have been the product of the social geography of prehistoric central California, where culturally differentiated tribes lived in close proximity to their enemies. Am J Phys Anthropol, 2010. © 2009 Wiley-Liss, Inc. [source] Brief communication: Additional cases of maxillary canine-first premolar transposition in several prehistoric skeletal assemblages from the Santa Barbara Channel Islands of California,AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY, Issue 1 2010Sabrina B. Sholts Abstract This article identifies and discusses seven new cases of complete maxillary canine-premolar transposition in ancient populations from the Santa Barbara Channel region of California. A high frequency of this tooth transposition has been previously documented within a single prehistoric cemetery on one of the Channel Islands. A total of 966 crania representing 30 local sites and about 7,000 years of human occupation were examined, revealing an abnormally high prevalence of this transposition trait among islanders during the Early period of southern California prehistory (,5500,600 B.C.). One of the affected crania is from a cemetery more than 7,000-years-old and constitutes the earliest case of tooth transposition in humans so far reported. The results are consistent with findings by other studies that have indicated inbreeding among the early Channel Islands groups. Together with the normal transposition rates among mainland populations, the decreasing prevalence of maxillary canine-first premolar transposition among island populations across the Holocene suggests that inbreeding on the northern Channel Islands had all but ceased by the end of the first millennium B.C., most likely as a result of increased cross-channel migration and interaction. Am J Phys Anthropol 143:155,160, 2010. © 2010 Wiley-Liss, Inc. [source] Drifters and the Dancing Mad: The Public School Music Curriculum and the Fabrication of Boundaries for ParticipationCURRICULUM INQUIRY, Issue 3 2008RUTH GUSTAFSON ABSTRACT Recent reforms in the general music curriculum have, for the most part, failed to lessen the attrition rates of African Americans from public school music programs. In this article I assert that an embodied ideal of cultural nobility, exemplified by Auguste Rodin's famous statue, The Thinker, has unconsciously operated as a template for participation. As a model comportment in the Western musical tradition, The Thinker has a broader relevance insofar as other school subjects emerged from similar cultural ideals. Beginning with the early period of public music instruction up to the present, I examine the construction of racial boundaries by linking a specific body comportment hailed as worthy by the music curriculum to historically constructed notions of Whiteness. This issue has been underexplored in research in both music and general education. For that reason, this article examines overlapping systems of reasoning about music, comportment, class, religion, language, nationality, and race in professional and popular texts from the early 1800s to the present. This positions public music instruction as authored, not by pedagogical insight alone, but through changes in musical taste, social practices, strategies of governing populations, and definitions of worthy citizenship. There are three levels of analysis. The first is a personal account of the early manifestations of attrition of African Americans from school music programs. The second level of analysis brings the problem of equity into proximity with the tradition of genteel comportment that permeated the training of the good ear or listener and the fabrication of the bona fide citizen. These, I argue are congruent with the historical construction of Whiteness as a standard mark of worthiness. At the third level of analysis, I take up present-day curriculum designs. This section discusses how the language of the music curriculum continues to draw boundaries for participation through protocols that regulate musical response. Here, I argue that the exclusion of popular genres such as hip-hop should be rethought in light of the evidence that shifting historical definitions for music fabricated an overly restrictive template for comportment, recognizing the prototype of Whiteness as the sole embodiment of merit. [source] Simultaneous Kindling of the Bilateral Hippocampi: An Advanced Model for Epilepsy ResearchEPILEPSIA, Issue 8 2000Shinichi Kogure Summary: Purpose: To examine whether simultaneous kindling of bilateral hippocampi [bilateral kindling (BK)] could accelerate the achievement of seizures by the breakdown of kindling antagonism or decelerate the achievement of seizures by its enhancement. Methods: The hippocampi of 17 adult rabbits were simultaneously kindled bilaterally according to Goddard's method. Results: All animals developed stage 5 convulsions after a mean of 28 stimulations. Six animals showed spontaneous seizure discharges. Afterdischarge duration increased abruptly during the early period of kindling, but thereafter it gradually progressed. Chronological analyses of interictal discharges (HDs) demonstrated that simple as well as complex types of IIDs increased their frequencies during BK. Conclusions: Compared with unilaterally kindled animals, the BK procedure significantly increased the percentage of animals that successfully kindled (100% vs. 59%; p < 0.01), whereas it significantly decelerated the kindling progression (28 days vs. 19 days; p < 0.02). We conclude that the BK procedure represents potentiation of both excitatory and inhibitory mechanisms. Although the reason why such an antagonistic relationship between them breaks down is still unknown, the BK provides an advanced animal model to study the pathogenic mechanisms of kindling and to screen anticonvulsants. [source] Impaired formation of the inner retina in an AChE knockout mouse results in degeneration of all photoreceptorsEUROPEAN JOURNAL OF NEUROSCIENCE, Issue 11 2004Afrim H. Bytyqi Abstract Blinding diseases can be assigned predominantly to genetic defects of the photoreceptor/pigmented epithelium complex. As an alternative, we show here for an acetylcholinesterase (AChE) knockout mouse that photoreceptor degeneration follows an impaired development of the inner retina. During the first 15 postnatal days of the AChE,/, retina, three major calretinin sublaminae of the inner plexiform layer (IPL) are disturbed. Thereby, processes of amacrine and ganglion cells diffusely criss-cross throughout the IPL. In contrast, parvalbumin cells present a nonlaminar IPL pattern in the wild-type, but in the AChE,/, mouse their processes become structured within two ,novel' sublaminae. During this early period, photoreceptors become arranged regularly and at a normal rate in the AChE,/, retina. However, during the following 75 days, first their outer segments, and then the entire photoreceptor layer completely degenerate by apoptosis. Eventually, cells of the inner retina also undergo apoptosis. As butyrylcholinesterase (BChE) is present at a normal level in the AChE,/, mouse, the observed effects must be solely due to the missing AChE. These are the first in vivo findings to show a decisive role for AChE in the formation of the inner retinal network, which, when absent, ultimately results in photoreceptor degeneration. [source] Phylogenetic analysis of developmental and postnatal mouse cell lineagesEVOLUTION AND DEVELOPMENT, Issue 1 2010Stephen J. Salipante SUMMARY Fate maps depict how cells relate together through past lineage relationships, and are useful tools for studying developmental and somatic processes. However, with existing technologies, it has not been possible to generate detailed fate maps of complex organisms such as the mouse. We and others have therefore proposed a novel approach, "phylogenetic fate mapping," where patterns of somatic mutation carried by the individual cells of an animal are used to retrospectively deduce lineage relationships through phylogenetic inference. Here, we have cataloged genomic polymorphisms at 324 mutation-prone polyguanine tracts for nearly 300 cells isolated from a single mouse, and have explored the cells' lineage relationships both phylogenetically and through a network-based approach. We present a model of mouse embryogenesis, where an early period of substantial cell mixing is followed by more coherent growth of clones later. We find that cells from certain tissues have greater numbers of close relatives in other specific tissues than expected from chance, suggesting that those populations arise from a similar pool of ancestral lineages. Finally, we have investigated the dynamics of cell turnover (the frequency of cell loss and replacement) in postnatal tissues. This work offers a longitudinal study of developmental lineages, from conception to adulthood, and provides insight into basic questions of mouse embryology as well as the somatic processes that occur after birth. [source] Time course of the renal functional response to partial nephrectomy: measurements in conscious ratsEXPERIMENTAL PHYSIOLOGY, Issue 1 2007R. M. Chamberlain Previous investigations into the functional responses of the surviving nephrons following reductions in renal mass have been performed largely in anaesthetized animals and have taken little account of how the compensatory changes develop with time. The present study has assessed a method for determining glomerular filtration rate (GFR) in unrestrained, uncatheterized, conscious rats (plasma disappearance of 99mTc-diethylenetriamene pentaacetic acid (DTPA)) and has used this method to document the time course of the changes in GFR over a 32 day period following uninephrectomy or 5/6 nephrectomy. Concurrent measurements of excretion rates and of the clearance of lithium (the latter being an index of end-proximal fluid delivery) provided information on changes in overall tubular function and segmental reabsorption. After uninephrectomy, the GFR of the remaining kidney (compared with that of a single kidney of sham-operated animals) increased maximally (by ,50%) within 8 days; after 5/6 nephrectomy, the increase in the GFR of the remnant kidney was maximal (at ,300%) within 16 days. Overall excretion rates of sodium and potassium were well maintained in partially nephrectomized animals throughout the period of study, while the excretion of water increased (by ,30% after uninephrectomy and by ,120% after 5/6 nephrectomy), partly as a result of the compensatory increases in GFR but mainly as a consequence of moderate (after uninephrectomy) or marked (after 5/6 nephrectomy) reductions in fractional reabsorption. During the early period after 5/6 nephrectomy, potassium excretion sometimes exceeded the filtered load, indicating net secretion. Lithium clearance data indicated that the changes in tubular function after 5/6 nephrectomy include a reduction in fractional reabsorption in the proximal tubule, whereas after uninephrectomy any such effect on the proximal tubule is minor and transient. [source] Morphological development and nutritive value of herbage in five temperate grass species during primary growth: analysis of time dynamicsGRASS & FORAGE SCIENCE, Issue 2 2009Abstract In a 2-year field experiment, morphological development and measures of the nutritive value of herbage for livestock during primary growth in Meadow foxtail, Tall oatgrass, Cocksfoot, Perennial ryegrass and Yorkshire fog were investigated. All measured variables were affected significantly by both species and sampling date, and their interaction (P < 0·001), in the period of primary growth. Changes with time in mean stage weight for Meadow foxtail and Cocksfoot were different from the other species due to their indeterminate growth habits. Mean stage weight of Tall oatgrass and Yorkshire fog increased more rapidly than that of Perennial ryegrass with time. Changes in mean stage weight with time were described by linear, parabolic and sigmoid relationships. Crude protein (CP) concentration of herbage was higher for Cocksfoot and Meadow foxtail than for Perennial ryegrass. A parabolic relationship of CP concentration with time was typical for all the species. Concentrations of neutral-detergent fibre (NDF) and acid-detergent fibre (ADF) in herbage of the species differed most during the mid-period of primary growth. Their increases with time showed curvilinear (sigmoid and parabolic) relationships. Perennial ryegrass had lower concentrations of both NDF and ADF in herbage than the other species. Differences between the in vitro dry matter (DM) digestibility among the grasses increased in mid- and late periods of primary growth. Perennial ryegrass had higher values for in vitro DM digestibility but the difference from other species was small in the early period of primary growth and from cocksfoot in the late period of primary growth. In vitro DM digestibility showed, in most cases, a sigmoid and, in others, a linear decrease with time. Principal component analysis showed that perennial ryegrass and meadow foxtail were the most distinctive of the species in characteristics relating to morphological development and the nutritive value of herbage to livestock. [source] Global atmospheric energetics from NCEP,Reanalysis 2 and ECMWF,ERA40 ReanalysisINTERNATIONAL JOURNAL OF CLIMATOLOGY, Issue 2 2009Carlos A. F. Marques Abstract The global atmospheric energy cycle is estimated on an annual basis using Reanalysis 2 data from the National Centers for Environmental Prediction and National Center for Atmospheric Research (NCEP/NCAR), and ERA 40 Reanalyses from the European Centre for Medium-Range Weather Forecasts (ECMWF) for the period 1979,2001. A formalism to avoid belowground data on pressure levels intercepted by topography is adopted. No appreciable differences were found between the two datasets from the energetics point of view. The so-called ,, and v·grad z formulations were both used for the conversions from zonal available potential energy into zonal kinetic energy (CZ) and from eddy available potential energy into eddy kinetic energy (CE). Results with both formulations are comparable only when using the formalism preventing belowground data to enter into the computations. Atmospheric energetics are also computed using ECMWF Reanalyses for the period 1958,1978. A significant increase was found in the eddy kinetic and eddy available potential energies from the early period to the later period, likely related to the assimilation in the reanalyses of satellite data after 1979. The conversion rate, CZ, was found to change its sign throughout the years. The atmospheric energy cycle using the ECMWF Reanalyses data is compared with five previous estimates. Differences in the direction of the conversion rate, CZ, between the various estimates may be explained by the different time periods chosen for averaging. Owing to the omission of belowground data, the conversion from zonal available potential energy into eddy available potential energy (CA) was somewhat smaller in ECMWF Reanalyses than in the previous estimates. Despite those differences, an overall agreement may be found between the various estimates for the atmospheric energy cycle. Copyright © 2008 Royal Meteorological Society [source] The psychosocial spiritual experience of elderly individuals recovering from stroke: a systematic reviewINTERNATIONAL JOURNAL OF EVIDENCE BASED HEALTHCARE, Issue 2 2008Marianne Lamb RN Abstract Objectives, The objective of this review was to appraise and synthesise best available evidence on the psychosocial spiritual experience of elderly individuals recovering from stroke. Inclusion criteria, This review considered qualitative studies whose participants were adults, mean age of 65 years and older, and who had experienced a minimum of one stroke. Studies were included that described the participant's own experience of recovering from stroke. Search strategy, The search strategy sought to find both published and unpublished studies and papers, not limited to the English language. An initial limited search of MEDLINE and CINAHL was undertaken followed by an analysis of text words contained in the title and abstract, and of index terms used to describe the article. A second extensive search was then undertaken using all identified key words and index terms. Methodological quality, Each paper was assessed by two independent reviewers for methodological quality prior to inclusion in the review using the Qualitative Assessment and Review Instrument (QARI) developed by the Joanna Briggs Institute. Disagreements were resolved through consultation with a third reviewer. Data collection, Information was extracted from each paper independently by two reviewers using the data extraction tool from QARI developed by the Joanna Briggs Institute. Disagreements were resolved through consultation with a third reviewer. Data synthesis, Data synthesis aimed to portray an accurate interpretation and synthesis of concepts arising from the selected population's experience during their recovery from stroke. Results, A total of 35 studies were identified and of those 27 studies were included in the review. These qualitative studies examined the perceptions of elderly individuals who had experienced a stroke. Findings were analysed using JBI-QARI. The process of meta-synthesis using this program involved categorising findings and developing synthesised topics from the categories. Four syntheses were developed related to the perceptions and experiences of stroke survivors: sudden unexpected event, connectedness, reconstruction of life and life-altering event. Conclusion, The onset and early period following a stroke is a confusing and terrifying experience. The period of recovery involves considerable psychological and physical work for elderly individuals to reconstruct their lives. For those with a spiritual tradition, connectedness to others and spiritual connection is important during recovery. The experience of stroke is a life-altering one for most elderly individuals, involving profound changes in functioning and sense of self. [source] Analysis of chimerism during the early period after allogeneic peripheral stem cell transplantationINTERNATIONAL JOURNAL OF LABORATORY HEMATOLOGY, Issue 6 2001B. Gleissner As there are few reports on early evaluation of chimerism, we assessed fluorescence short tandem repeats (STR) by polymerase chain reaction (PCR) assays to analyse donor and recipient characteristics at early time points after peripheral stem cell transplantation (PBSCT). Peripheral blood of 13 patients was analysed in 1- to 2-day intervals starting from the day of PBSCT. Donor and recipient allelic patterns were determined by a commercially available multiplex STR assay that simultaneously evaluates four or five gene loci. Mixed chimerism appeared in all patients during days 1,9 after transplantation and preceded haematologic engraftment for 3,12 days. Even patients without myeloablative conditioning therapy (n=4) revealed donor allelic patterns within 1,5 days. Nine patients changed during the following days to a complete donor allelic pattern and had an uncomplicated post-transplant disease course. Four patients did not consistently retain complete donor chimerism; two of them relapsed within the next 3 months, one died from septicemia within 7 days, and the fourth, transplanted for aplastic anaemia, is still in complete remission. Overall, STR analysis using a simple and comparatively cheap multiplex system permits the detection of chimerism very early after transplantation and may provide relevant information that correlates with the clinical follow-up. [source] A cornerstone for adequate supply of safe bloodISBT SCIENCE SERIES: THE INTERNATIONAL JOURNAL OF INTRACELLULAR TRANSPORT, Issue 1 2006M. Y. Zhu Blood safety and timely adequate supply have significant impacts not only on healthcare service, but also the socio-economic development and political stability of a country. However, until a decade ago the importance has not been seriously taken in the country. Distinct blood programme and safety strategy were not always available. In certain regions of the country the supervision to establishments involved in blood collection, processing and transfusion was neither strict nor sufficient. During the early period of 1990, HIV was transmitted among plasma-apheresis donors in two central provinces. The relevant plasma-apheresis centres, in which plasma is collected solely as source materials for fractionation, were accused for wrongdoings including not performing HIV screening, and mixing red cells from different donors with same blood types before back infusion. [source] Development of the shields for tendon injury repair using polyvinyl alcohol , hydrogel ( PVA-H)JOURNAL OF BIOMEDICAL MATERIALS RESEARCH, Issue 4 2001Masanori Kobayashi Abstract In recent years, marked advances have been made in repair techniques for tendon injury, but the treatment of finger flexor tendon injury is still one of the most difficult and important problems in the orthopedic field. The main problem in tendon repair is adhesion between the tendon and surrounding tissue. To prevent this adhesion and achieve tendon union, we developed adhesion preventive shields for tendon repair using polyvinyl alcohol hydrogel ( PVA-H) with 90% water content, and carried out an implant experiment using the deep flexor tendon of the third toe of domestic fowl. Injured tendons shielded with PVA-H showed union at about 3 weeks after the operation without adhesion to the surrounding tissue and good function such as gliding and range of motion. Neither breakage of the PVA-H shield itself nor infection, nor degeneration in the surrounding tissue were observed. These results confirmed that the tendon itself has repair ability, and the tendon is regenerated by synovial nutrition through PVA-H. High water content PVA-H may have clinically potential and be applicable to adhesion-preventive shields for tendon repair. However, re-rupture was observed, probably due to accidental tendon injury at an early period after the operation. In some cases, tendon immobilization methods to prevent re-rupture might be necessary. © 2001 John Wiley & Sons, Inc. J Biomed Mater Res (Appl Biomater) 58: 344,351, 2001 [source] The role of Doppler sonography in predicting severity of acute pancreatitisJOURNAL OF CLINICAL ULTRASOUND, Issue 3 2008Naile Bolca Topal MD Abstract Purpose To investigate the role of Doppler sonography (DUS) examination of major abdominal arteries in predicting severity of acute pancreatitis (AP). Methods Twenty-nine patients diagnosed with AP and 14 controls were blindly and prospectively evaluated with Doppler sonography. Disease severity was defined clinically according to acute physiology and chronic health evaluation (APACHE II) score and was classified as severe for APACHE II score ,8. DUS examination included the measurement of peak systolic velocity (PSV), end diastolic velocity (EDV), pulsatility index (PI), and resistance index (RI) of the celiac artery (CA) and superior mesenteric artery (SMA). Statistical analysis included Mann-Whitney U test, Student t test, and receiver operating characteristic curve analysis. Results Twelve patients had severe AP and 17 had mild AP. PSV, EDV, and PI of the CA and RI of the SMA were higher in the severe AP group than in the mild AP and control groups (p < 0.001 and p < 0.0001, respectively). The sensitivity and specificity were 100% and 94%, respectively, for a 87 cm/second CA PSV cutoff value, 75% and 100%, respectively, for a 22 cm/second CA EDV cutoff value, 92% and 82%, respectively, for a 1.29 CA PI cutoff value, and 100% and 100%, respectively, for a 0.86 SMA RI cutoff value. Conclusion DUS can be useful in predicting the severity of AP in the early period of admission phase of the disease. © 2007 Wiley Periodicals, Inc. J Clin Ultrasound, 2008 [source] Quality Characterization of Farmed Atlantic Halibut During Ice StorageJOURNAL OF FOOD SCIENCE, Issue 2 2006Christelle Guillerm-Regost ABSTRACT: A quality index method (QIM) was developed for farmed Atlantic halibut and together with instrumental, chemical, sensory, and bacteriological analysis, quality changes of halibut stored on ice for 26 d was evaluated. Two groups of fish were fed diets that differed only in the source of lipid, where 1 diet contained only marine oil sources and the other a 50/50 mixture of marine and soybean oil. Fish were slaughtered after 1 y and then stored on ice for 26 d. The fish were sampled on day 1, day 2, and every 2nd day after that. Dietary lipid sources had no effect on freshness, (ATP) degradation (K-value), texture, color, or liquid-holding capacity. The QIM scores increased with storage time, in particular the appearance and eyes parameters. The QIM is a good freshness indicator for halibut. The K-value was strongly correlated with storage time (r= 0.99), while total bacterial counts increased after 7 to 8 d of ice storage. The texture, liquid-holding capacity, and color were significantly affected by storage time during the early period of storage, probably due to rigor stiffness and rigor resolution. The texture, liquid-holding capacity, and color did not change significantly from approximately day 8 of storage until the end of the experiment at day 26. [source] The business cycle in postwar LebanonJOURNAL OF INTERNATIONAL DEVELOPMENT, Issue 2 2008Ghassan Dibeh Abstract The postwar business cycle in Lebanon was dominated by the exchange rate based stabilization (ERBS) program implemented by the successive postwar governments. In the early period 1993,2002, a boom-bust dynamics was generated during which the economy exhibited the well-documented stylised facts of ERBS programs. The paper develops a cyclical index (ci) for Lebanon during this period and a VAR model shows that real interest rates (rr) had a significant impact on the dynamics of the business cycle during the early ERBS period. The second period 2002,2005 was marked by a recovery generated by foreign aid given to Lebanon in the Paris II international donors' conference held in November 2002. The period ended in a recession in 2005 brought about by the assassination of Lebanon's ex-prime minister Rafic Hariri. The third phase of the business cycle was caused by the Israel,Lebanon war in the summer of 2006 which led to widespread civilian and infrastructure damage and ended a brief recovery in early 2006. Throughout the period 2002,2006, foreign aid was instrumental in the resilience of the ERBS program. Copyright © 2007 John Wiley & Sons, Ltd. [source] Arterial oxygen tension increase 2,3 h after hyperbaric oxygen therapy: a prospective observational studyACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 1 2007B. Ratzenhofer-Komenda Background:, Inhalation of hyperbaric oxygen (HBO) has been reported to decrease arterial oxygen tension (PaO2) in the early period after exposure. The current investigation aimed at evaluating whether and to what extent arterial blood gases were affected in mechanically ventilated intensive care patients within 6 h after HBO treatment. Methods:, Arterial blood gases were measured in 11 ventilated subjects [nine males, two females, synchronized intermittent mandatory ventilation (SIMV) mode] undergoing HBO therapy for necrotizing soft tissue infection (seven patients), burn injury (two patients), crush injury (one patient) and major abdominal surgery (one patient). Blood gases were obtained with the patients in the supine position under continuous analgesia and sedation before the hyperbaric session (baseline), during isopression, after decompression, after each transport, and 1, 2, 3 and 6 h after exposure. Heart rates and blood pressures were recorded. Intensive care unit (ICU) ventilator settings remained unchanged. Transport and chamber ventilator settings were adjusted to baseline with maintenance of tidal volumes and positive end-expiratory pressure (PEEP) levels. The hyperbaric protocol consisted of 222.9 kPa (2.2 absolute atmospheres) and a 50-min isopression phase. The paired Wilcoxon's test was used. Results:, Major findings (median values, 25%/75% quantiles) as per cent change of baseline: PaO2 values decreased by 19.7% (7.0/31.7, P < 0.01) after 1 h and were elevated over baseline by 9.3% (1.5/13.7, P < 0.05) after 3 h. SaO2, alveolar-arterial oxygen tension difference and PaO2/FiO2 ratio behaved concomitantly. Acid-base status and carbon dioxide tension were unaffected. Conclusion:, Arterial oxygen tension declines transiently after HBO and subsequently improves over baseline in intensive care patients on volume-controlled mechanical ventilation. The effectiveness of other ventilation modes or a standardized recruitment manoeuvre has yet to be evaluated. [source] Hepatitis B immunoglobulin in combination with lamivudine for prevention of hepatitis B virus reactivation in children undergoing bone marrow transplantationPEDIATRIC TRANSPLANTATION, Issue 8 2006Betul Tavil Abstract:, There is little information in literature about the use of hepatitis B immunoglobulin (HBIg) in recipients of bone marrow transplantation (BMT). Here, we report two children who received IV HBIg (Hepatect-CP) and lamivudine treatment during BMT course for either patient or donor hepatitis B virus (HBV) viremia. A four-year-old girl underwent a fully human leukocyte antigen-matched allogeneic BMT for thalassemia major from her mother positive for hepatitis B surface antigen (HBsAg). A 12-yr-old boy with chronic myeloid leukemia, positive for HBsAg and HBV-DNA received a fully HLA-matched allogeneic BMT from his sister in the first chronic phase of the disease. HBIg was successfully used in both cases to prevent HBV reactivation of the recipients. The results of our observations are encouraging and we suggest that HBIg in combination with lamivudine may be used in such cases especially in post-transplant early period to prevent HBV reactivation. [source] Proceedings of the 20th Annual Conference of the Japanese Association for Adolescent Psychotherapy, 16 November 2002, Tokyo, JapanPSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 5 2003Article first published online: 28 AUG 200 Inpatient treatment of obsessive,compulsive disorder in a child and adolescent psychiatry ward M. USAMI National Center of Neurology and Psychiatry, Kohnodai Hospital, Chiba, Japan This is a case report of a 13-year-old-boy (2nd grade in junior high school). His father had poor communication; his mother was a very fragile woman. The boy had been overprotected by his parents, as long as he responded to their expectations. He did not have any other siblings. He played well with his friends since he was young, and did not have problems until the 1st term (from April to July) of 1st grade in junior high school. However, in September he started to have difficulties going well with his friends, and going to school. He spent most of his time in his room, and began to repeat checking and hand-washing frequently. Even at midnight, he forced his mother to touch the shutter from outside of the house for many times. He also ritually repeated to touch his mother's body, after he licked his hands, for over an hour. He became violent, when his parents tried to stop him. In April, year X, his parents visited our hospital for the first time. From then, his mother could not tolerate her son's coerciveness any longer. His father explained to the boy that ,your mother has been hospitalized', and she started to live in the next room to the boy's without making any noise. After 3 months he noticed that his mother was not hospitalized, and he got very excited. He was admitted to our hospital with his family and relatives, in October, year X. At the initial stage of hospitalization he showed distrust and doubt towards the therapist and hospital. He had little communication with other boys and did not express his feelings. Therefore, there was a period of time where he seemed to wonder whether he could trust the treatment staff or not. During his interviews with his therapist he repeated only ,I'm okay' and did not show much emotional communication. For the boy, exposing himself was equivalent to showing his vulnerability and incompleteness. Therefore, the therapist considered that he was trying to denying his feelings to avoid this. The therapist set goals for considering his own feelings positively and expressing them appropriately. Also, the therapist carried out behavioral restrictions towards him. He hardly had any emotional communication with the staff, and his peer relationship in the ward was superficial. Therefore, he gradually had difficulty spending his time at the end of December On the following day in which he and the therapist decided to return to his house for the first time, he went out of the ward a few days before without permission. From thereon it was possible for him to share feelings such as hostility and aggression, dependence and kindness with the therapist. The therapist changed his role from an invasive one to a more protective one. Then, his unsociability gradually faded. He also developed good peer relationships with other boys in the ward and began to express himself feeling appropriately. He was also able to establish appropriate relations with his parents at home, and friends of his neighborhood began to have normal peer relationships again. During childhood and adolescence, boys with obsessive,compulsive disorder are known to have features such as poor insight and often involving their mothers. We would like to present this case, through our understanding of dynamic psychiatry throughout his hospitalization, and also on the other therapies that were performed. Psychotherapy with a graduate student that discontinued after only three sessions: Was it enough for this client? N. KATSUKI Sophia University, Tokyo, Japan Introduction: Before and after the psychotherapy, SWT was administrated in this case. Comparing these two drawings, the therapist was provided with some ideas of what kind of internal change had taken place inside this client. Referring to the changes observed, we would like to review the purposes and the ways of the psychotherapy, as well as the adequacy of the limited number of the sessions (vis-a-vis result attained.) Also we will discuss later if any other effective ways could be available within the capacities of the consulting system/the clinic in the university. Case: Ms. S Age 24 years. Problems/appeal: (i) awkwardness in the relationship with the laboratory colleagues; (ii) symptoms of sweating, vomiting and quivering; and (iii) anxiety regarding continuing study and job hunting. Diagnosis: > c/o PTSD. Psychotherapeutic setting: At the therapy room in the clinic, placed at the university, 50 min-session; once a week; paralleled with the medical treatment. Process: (1) Since she was expelled from the study team in the previous year, it has become extremely difficult for her to attend the laboratory (lab) due to the aforementioned symptoms. She had a feeling of being neglected by the others. When the therapist suggested that she compose her mental confusions in the past by attending the therapy room, she seemed to be looking forward to it, although she said that she could remember only a few. (2) She reported that she overdosed on sedatives, as she could not stop irritating. She was getting tough with her family, also she slashed the mattress of her bed with a knife for many times. She complained that people neither understood nor appreciated her properly. and she said that she wanted revenge on the leader of the lab by punishing him one way or other. (3) Looking back the previous session, she said ,I had been mentally mixed up at that time, but I feel that now I can handle myself, as I stopped the medication after consulting the psychiatrist. According to what she said, when she disclosed the occurrences in the lab to her mother, she felt to be understood properly by her mother and felt so relieved. and she also reported that she had been sewing up the mattress which she slashed before, without any reason. She added, " although I don't even know what it means, I feel that this work is so meaningful to me, somehow". Finally, she told that she had already made her mind to cope with the situation by herself from now on, although it might result in a flinch from the real solution. Situations being the above, the session was closed. Swt: By the remarkable changes observed between the two drawings, the meanings of this psychotherapy and its closure to the client would be contemplated. Question of how school counselors should deal with separation attendant on students' graduation: On a case in which the separation was not worked through C. ASAHARA Sophia University, Tokyo, Japan Although time limited relationship is one of the important characteristics in school counseling, the question of separation attendant on it has not been much discussed based on specific cases. This study focuses on the question of separation through looking at a particular case, in which the separation was not worked through, and halfway relationship continued even after the student's graduation and the counselor's resignation. I was a part time school counselor at a junior high school in Tokyo. The client was a 14-year-old female student, who could not go to her classroom, and spent a few hours in a sick bay when she came to school. She was in the final grade and there was only half a year left before graduation when we first met, and we started to see each other within a very loose structure. As her personality was hyper-vigilant and defensive, it took almost 2 months before I could feel that she was nearer. Her graduation was the first occasion of separation. On that occasion, I found that there had been a discrepancy between our expectations; while I took it for granted that our relationship would end with the graduation, she expected to see me even after she graduated, and she actually came up to see me once in a while during the next year. A year later, we faced another occasion of separation, that was my resignation. Although I worried about her, all I have done for her was to hand a leaflet of a counseling office, where I work as a part time counselor. Again I could not refer to her feelings or show any concrete directions such as making a fixed arrangement. After an occasional correspondence for the next 10 months (about 2 years after her graduation), she contacted me at the counseling office asking for a constant counseling. Why could I not deal with both occasions? and how did that affect the client thereafter? There were two occasions of separation. At the time of the client's graduation, I seemed to be enmeshed in the way of separation that is peculiar to the school setting. In general in therapeutic relationship, mourning work between counselor and client is regarded as being quite important. At school, however, separation attendant on graduation is usually taken for granted and mourning work for any personal relationship tends to be neglected. Graduation ceremony is a big event but it is not about mourning over one's personal relationships but separation from school. That may be why I did not appreciate how the client counted on our relationship. At the time of my resignation I was too worried about working through a change from very loose structure which is peculiar to the school setting to a usual therapeutic structure (fees are charged, and time, place are fixed). That is why I did nothing but give her a leaflet. In this way, we never talked about her complex feelings such as sadness or loneliness, which she was supposed to experience on separation. Looking at the aforementioned process from the client's viewpoint, it can be easily imagined that she could not accept the fact of separation just because she graduated. and later, she was forced to be in double-bind situation, in which she was accepted superficially (handed a leaflet), while no concrete possibility was proposed concerning our relationship (she could never see me unless she tries to contact me.) As a result, she was left alone and at a loss whether she could count on me or not. The halfway situation or her suspense was reflected in her letter, in which she appeared to be just chatting at first sight, but between the lines there was something more implying her sufferings. Above discussion suggests that in some case, we should not neglect the mourning work even in a school setting. To whom or how it is done is the next theme we should explore and discuss in the future. For now, we should at least be conscious about the question of separation in school setting. Study of the process of psychotherapy with intervals for months M. TERASHIMA Bunkyo Gakuin University, Tokyo, Japan This is a report on the process of psychotherapy of an adolescent girl who showed manic and depressive state. At the time of a depressed state, she could not go to a college and withdrew into home, and the severe regressive situation was shown. Her therapy began at the age of 20 and she wanted to know what her problem was. The process of treatment went on for 4 years but she stopped coming to sessions for several months because of failure of the therapist. She repeated the same thing twice. After going through these intervals the client began to remember and started to talk about her childhood , suffering abusive force from her father, with vivid impressions. They once were hard for her to accept, but she began to establish the consistent figure of herself from past to present. In this case, it could be thought that the intervals of the sessions had a certain role, with which the client controlled the structure of treatment, instead of an attack against the therapist. Her object relation, which is going to control an object offensively, was reflected in these phenomena. That is, it can be said that the ambivalence about dependency , difficult to depend but desirous of the object , was expressed. Discontinuation of the sessions was the product of the compromise formation brought about the ambivalence of the client, and while continuing to receive this ambivalence in the treatment, the client started to realize discontinuance of her memories and then advanced integration of her self-image. For the young client with conflict to dependence such as her, an interval does not destroy the process of treatment but in some cases it could be considered as a therapeutic element. In the intervals the client could assimilate the matter by herself, that acquired by the sessions. Psychotherapy for a schizoid woman who presented eccentric speech and behaviour M. OGASAWARA Osaka University Graduate School of Medicine, Osaka, Japan Case presentation: A case of a 27-year-old woman at the beginning of therapy. Life history: She had been having a wish for death since she was in kindergarten and she had been feeling strong resistance to do the same as others after school attendance. She had a history of ablutomania from the age of 10,15, but the symptom disappeared naturally. and she said that she had been eliminated from groups that she tried to enter. After graduating a junior college, she changed jobs several times without getting a full-time position. Present history: Scolded by her boy friend for her coming home too late one day, she showed confusion such as excitement, self-injury or terror. She consulted a psychiatrist in a certain general hospital, but she presented there eccentric behaviours such as tense facial expression, stiffness of her whole body, or involuntary movement of limbs. and because she felt on bad terms with the psychiatrist and she had come to cause convulsion attacks in the examination room, she was introduced to our hospital. Every session of this psychotherapy was held once a week and for approximately 60 min at a time. Treatment process: She sometimes presented various eccentric attitudes, for example overturning to the floor with screaming (1), going down on her knees when entrance at the door (5), entering with a knife in her mouth and hitting the wall suddenly (7), stiffening herself just outside the door without entering the examination room (9), taking out a knife abruptly and putting it on her neck (40), exclaiming with convulsion responding to every talk from the therapist (41), or stiffening her face and biting herself in the right forearm suddenly (52). She also repeated self-injuries or convulsion attacks outside of the examination room in the early period of the therapy. Throughout the therapy she showed hypersensitivity for interpersonal relations, anxiety about dependence, terror for self-assertion, and avoidance for confrontation to her emotional problems. Two years and 6 months have passed since the beginning of this therapy. She ceased self-injury approximately 1 year and 6 months before and her sense of obscure terror has been gradually reduced to some extent. Discussion: Her non-verbal wariness and aggression to the therapist made the sessions full of tension and the therapist felt a sense of heaviness every time. In contrast, she could not express aggression verbally to the therapist, and when the therapist tried to identify her aggression she denied it. Her anxiety, that she will be thoroughly counterattacked to self-disintegration if she shows aggression to other persons, seems to be so immeasurably strong that she is compelled to deny her own aggression. Interpretations and confrontations by the therapist make her protective, and occasionally she shows stronger resistance in the shape of denial of her problems or conversion symptoms (astasia, aphonia, or involuntary movements) but she never expresses verbal aggression to the therapist. and the therapist feels much difficulty to share sympathy with her, and she expresses distrust against sympathetic approach of the therapist. However, her obvious disturbance that she expresses when she feels the therapist is not sympathetic shows her desire for sympathy. Thus, because she has both strong distrust and desire for sympathy, she is in a porcupine dilemma, which is characteristic of schizoid patients as to whether to lengthen or to shorten the distance between herself and the therapist. This attitude seems to have been derived from experience she might have had during her babyhood and childhood that she felt terror to be counterattacked and deserted when she showed irritation to her mother. In fact, existence of severe problems of the relationship between herself and her mother in her babyhood and childhood can be guessed from her statement. Although she has been repeating experiences to be excluded from other people, she shows no attitude to construct interpersonal relationship actively. On the contrary, by regarding herself to be a victim or devaluating other persons she externalizes responsibility that she herself should assume essentially. The reason must be that her disintegration anxiety is evoked if she recognizes that she herself has problems; that is, that negative things exist inside of her. Therefore, she seems to be inhibited to get depressive position and obliged to remain mainly in a paranoid,schizoid position. As for the pathological level, she seems to have borderline personality organization because of frequent use of mechanisms to externalize fantastically her inner responsibility. For her high ability to avoid confronting her emotional problems making the most of her verbal ability, every intervention of the therapist is invalidated. So, it seems very difficult for her to recognize her own problems through verbal interpretations or confrontation by the therapist, for the present. In general, it is impossible to confront self problems without containing negative emotions inside of the self, but her ability seemed to be insufficient. So, to point out her problems is considered to be very likely to result in her confusion caused by persecution anxiety. Although the therapy may attain the stage on which verbal interpretation and confrontation work better some day, the therapist is compelled to aim at promoting her ability to hold negative emotion inside of herself for the time being. For the purpose, the therapist is required to endure the situation in which she brings emotion that makes the therapist feel negative counter-transference and her process to experience that the therapeutic relation itself would not collapse by holding negative emotion. On supportive psychotherapy with a male adolescent Y. TERASHIMA Kitasato University Health Care Center, Kanagawa, Japan Adolescent cases sometimes show dramatic improvements as a consequence of psychotherapy. The author describes how psychotherapy can support an adolescent and how theraputic achievements can be made. Two and a half years of treatment sessions with a male adolescent patient are presented. The patient was a 19-year-old man, living with his family. He had 5 years of experience living abroad with his family and he was a preparatory school student when he came to a mental clinic for help. He was suffering from not being able to sleep well, from difficulties concerning keeping his attention on one thing, and from fear of going to distant places. He could barely leave his room, and imagined the consequence of overdosing or jumping out of a window. He claimed that his life was doomed because his family moved from a town that was familiar to him. At the first phase of psychotherapy that lasted for approximately 1 year, the patient seldom responded to the therapist. The patient was basically silent. He told the therapist that the town he lives in now feels cold or that he wants to become a writer. However, these comments were made without any kind of explanation and the therapist felt it very difficult to understand what the patient was trying to say. The sessions continued on a regular basis. However, the therapist felt very useless and fatigued. Problems with the patient and his family were also present at this phase of psychotherapy. He felt unpleasant at home and felt it was useless to expect anything from his parents. These feelings were naturally transferred to the therapist and were interpreted. However, interpretation seemed to make no changes in the forms of the patient's transference. The second phase of psychotherapy began suddenly. The patient kept saying that he did not know what to talk about. However, after a brief comment made by the therapist on the author of the book he was reading, the patient told the therapist that it was unexpected that the therapist knew anything of his favorite writer. After this almost first interaction between the patient and the therapist, the patient started to show dramatic changes. The patient started to bring his favorite rock CDs to sessions where they were played and the patient and the therapist both made comments on how they felt about the music. He also started asking questions concerning the therapist. It seemed that the patient finally started to want to know the therapist. He started communicating. The patient was sometimes silent but that did not last long. The therapist no longer felt so useless and emotional interaction, which never took place in the first phase, now became dominant. The third phase happened rapidly and lasted for approximately 10 months. Conversations on music, art, literature and movies were made possible and the therapist seldom felt difficulties on following the patient's line of thought. He started to go to schools and it was difficult at first but he started adjusting to the environment of his new part-time jobs. By the end of the school year, he was qualified for the entrance to a prestigious university. The patient's problems had vanished except for some sleeping difficulties, and he did not wish to continue the psychotherapy sessions. The therapist's departure from the clinic added to this and the therapy was terminated. The patient at first reminded the therapist of severe psychological disturbances but the patient showed remarkable progress. Three points can be considered to have played important roles in the therapy presented. The first and the most important is the interpretation by behavior. The patient showed strong parental transference to the therapist and this led the therapist to feel useless and to feel fatigue. Content analysis and here-and-now analysis seemed to have played only a small part in the therapy. However, the therapist tried to keep in contact with the patient, although not so elegant, but tried to show that the therapist may not be useless. This was done by maintaining the framework of the therapy and by consulting the parents when it was considered necessary. Second point is the role that the therapist intentionally took as a model or target of introjection. With the help of behavioral interpretation that showed the therapist and others that it may not be useless, the patient started to introject what seemed to be useful to his well being. It can be considered that this role took some part in the patient going out and to adjust to the new environment. Last, fortune of mach must be considered. The patient and the therapist had much in common. It was very fortunate that the therapist knew anything about the patient's favorite writer. The therapist had some experience abroad when he was young. Although it is a matter of luck that the two had things in common, it can be said that the congeniality between the patient and the therapist played an important role in the successful termination of the therapy. From the physical complaint to the verbal appeal of A's recovery process to regain her self-confidence C. ITOKAWA and S. KAZUKAWA Toyama Mental Health Center, Toyama, Japan This is one of the cases at Toyama Mental Health Center about a client here, we will henceforth refer to her simply as ,A'. A was a second grade high school student. We worked with her until her high school graduation using our center's full functions; counseling, medical examination and the course for autogenic training (AT). She started her counseling by telling us that the reason for her frequent absences from school began because of stomach pains when she was under a lot of stress for 2 years of junior high school, from 2nd grade to 3rd grade. Due to a lack of self confidence and a constant fear of the people around her, she was unable to use the transportation. She would spend a large amount of time at the school infirmary because she suffered from self-diagnosed hypochondriac symptoms such as nausea, diarrhea and a palpitation. She continued that she might not be able to have the self-confidence to sit still to consult me on her feelings in one of our sessions. A therapist advised her to take the psychiatric examination and the use of AT and she actually saw the medical doctor. In counseling (sessions), she eventually started to talk about the abuse that started just after her entering of junior high school; she approached the school nurse but was unable to tell her own parents because she did not trust them. In doing so, she lost the rest of her confidence, affecting the way she looked at herself and thought of how others did. At school she behaved cheerfully and teachers often accused her of idleness as they regarded this girl's absences along with her brightly dyed hair and heavy make-up as her negligent laziness. I, as her therapist, contacted some of the school's staff and let them know of her situation in detail. As the scolding from the teachers decreased, we recognized the improvement of her situation. In order to recover from the missed academic exposure due to her long absence, she started to study by herself. In a couple of months her physical condition improved gradually, saying ,These days I have been doing well by myself, haven't I?' and one year later, her improved mental condition enabled her to go up to Tokyo for a concert and furthermore even to enjoy a short part-time job. She continued the session and the medical examination dually (in tangent) including the consultation about disbelief to the teachers, grade promotion, relationships between friends and physical conditions. Her story concentrated on the fact that she had not grown up with sufficiently warm and compassionate treatment and she could not gain any mental refuge in neither her family nor her school, or even her friends. Her prospects for the future had changed from the short-ranged one with no difficulty to the ambitious challenge: she aimed to try for her favorite major and hoped to go out of her prefecture. But she almost had to give up her own plan because the school forced her to change her course as they recommended. (because of the school's opposition with her own choice). So without the trust of the teachers combined with her low self-esteem she almost gave up her hopes and with them her forward momentum. In this situation as the therapist, I showed her great compassion and discussed the anger towards the school authorities, while encouraging this girl by persuading her that she should have enough self-confidence by herself. Through such sessions, she was sure that if she continued studying to improve her own academic ability by herself she could recognize the true meaning of striving forward. and eventually, she received her parents' support who had seemed to be indifferent to her. At last she could pass the university's entrance exams for the school that she had yearned to attend. That girl ,A' visited our center 1 month later to show us her vivid face. I saw a bright smile on her face. It was shining so brightly. [source] Does Rurality Affect Quality of Life Following Treatment for Breast Cancer?THE JOURNAL OF RURAL HEALTH, Issue 4 2010Stephanie A. Reid-Arndt PhD Abstract Purpose: The present research examined the extent to which rural residence and social support seeking are associated with quality of life (QOL) among breast cancer patients following chemotherapy. Methods: Female breast cancer patients (n = 46) from communities of varying degrees of rurality in a Midwestern state completed psychological and QOL measures at 1-month postchemotherapy. Analyses assessed the relationships between QOL outcomes, rurality, and social support seeking. Findings: Using age and education as covariates, regression analyses were conducted to determine the extent to which QOL was related to social support seeking and rural/urban residence. Analyses revealed that social support seeking was associated with lower scores on multiple indices of QOL, and it was associated with higher self-reported symptoms of depression. Several significant associations with rural/urban residence were noted as well. Specifically, increasing rurality, as defined by USDA Rural-Urban continuum codes, was associated with lower overall QOL, lower functional well-being, and increased complaints of breast cancer specific symptoms. Conclusions: These findings highlight the relevance of continued efforts to address social support needs among women with a history of breast cancer living in rural and urban communities. They also suggest that individuals in more rural communities may be at risk for lowered QOL in the early period following cancer treatment. Future research is needed to replicate these results with larger and more diverse samples of rural and urban dwelling individuals, and to determine whether these effects may be attributed to identifiable characteristics of rural communities (eg, fewer cancer-related resources). [source] Experimental population design for estimation of dominant molecular marker effect on egg-production traitsANIMAL GENETICS, Issue 5 2003M. G. Kaiser Summary A potential limitation of the use of a dominant molecular marker system such as DNA fingerprinting (DFP) is the inability to distinguish homozygous from heterozygous allele state in an individual, and a resulting inaccuracy in estimating effects of the marker alleles. The objective of this study was to accurately estimate the effect of DFP markers on egg-production traits. A BC1 population was produced from two distinct layer lines. Four DFP bands, each originating predominantly in one of the two parental lines, were evaluated for linkage with egg-production quantitative trait loci in the BC1 population. The egg-production traits consisted of eight early period and seven late period measurements. Eight marker-trait linkages were identified out of 60 total statistical tests. By utilizing information on frequency of DFP bands in two parental lines, selecting F1 sires with DFP bands present, and backcrossing to the line lacking these bands, the population design allowed definitive identification of the DFP zygosity in the BC1 resource population hens. In this manner, accurate estimates of marker allele effects on egg-production traits were obtained from the dominant marker system of DNA fingerprinting. [source] Cost-effective method for laparoscopic choledochotomyANZ JOURNAL OF SURGERY, Issue 1-2 2005John Griniatsos Background: Recent reports have noted that postoperative complications following open or laparoscopic choledochotomy for common bile duct (CBD) exploration are mainly related to the T-tube presence, and that there has been no trend of decrease in the laparoscopic era. Laparoscopic endobiliary stent placement with primary closure of the CBD has been proposed as a safe and effective alternative to T-tube placement. Methods: Between January 1999 and January 2003, 53 consecutive patients suffering from proven choledocholithiasis underwent laparoscopic common bile exploration (LCBDE) via choledochotomy. In the early period, a T-tube was placed at the end of the procedure (group A, n = 32) while, from June 2001 onwards, laparoscopic biliary stent placement and primary CBD closure were chosen as the drainage method (group B, n = 21). Results: Six patients developed T-tube-related complications postoperatively. Univariate analysis revealed statistically significant lower morbidity rate and shorter postoperative hospital stay for the stent group. Although not statistically significant, a median saving of £780 per patient was observed in the stent group. Conclusion: Biliary endoprosthesis placement following laparoscopic choledochotomy avoids the well-known complications of a T-tube, leading to a shorter postoperative hospital stay. The method is safe and effective and it should also be considered as cost-effective compared to T-tube placement. Further studies are required in order to document cost-effectiveness of the method. [source] Lessons from the origins of eyewitness testimony research in EuropeAPPLIED COGNITIVE PSYCHOLOGY, Issue 6 2008Siegfried Ludwig Sporer After 100 years of research I look back at the beginnings of the psychology of eyewitness testimony to assess the ,progress' researchers have made. Specifically, I review the origins of (experimental) psychological research at the first three decades of the 20th century in Central Europe which quickly expanded around the world. Both eyewitness errors (e.g. due to suggestive questioning) as well as intentional distortions of the truth (lies) were thoroughly studied at that time. An eyewitness statement was considered a joint product of cognitive factors and of interrogation. It is argued that many of the central issues that are at the focus of study today had already been addressed in this early period, perhaps even with a broader scope than much contemporary writing. At the end, I propose an integrative model of the psychology of testimony that may help to organise past and future research. Ten theses that address unresolved issues and suggestions for solutions after 100 years of research are outlined. Copyright © 2008 John Wiley & Sons, Ltd. [source] Immunological Response to (1,4)-,- d -Glucan in the Lung and Spleen of Endotoxin-Stimulated Juvenile RatsBASIC AND CLINICAL PHARMACOLOGY & TOXICOLOGY, Issue 5 2009Ectis A. Velazquez Experimental groups (n = 16/group) included controls with an intraperitoneal injection of saline, endotoxaemic rats with a non-lethal dose of 10 mg/kg Escherichia coli endotoxin, and endotoxaemic rats treated with two doses of 10 mg/kg ,-DG, intraperitoneally, 2 and 4 hr after endotoxin injection. At 24 hr of treatment, rats were euthanized and lungs and spleen were removed for cytokines determination and lung injury. Endotoxaemia increased IL-1, concentration by fivefold in both organs, while creating a moderate pulmonary hypercellularity (demonstrated by about 11% increase in the alveolar-septal thickening and 11% decrease in the alveolar-interstitial space ratio). In the lung, ,-DG treatment reduced concentrations of IL-1, by 30% (p > 0.05), IL-6 by 43% (p < 0.01), IFN-, by 46% (p < 0.01) and the anti-inflammatory cytokine, IL-10, by 31% (p > 0.05) compared to endotoxaemia. In the spleen, ,-DG treatment decreased the ratio of IL-1, to IL-10 by 55% (p < 0.05), demonstrating an anti-inflammatory trend. These data suggest that ,-DG differentially modulates cytokine response in the lung and spleen and modifies the pro- and anti-inflammatory balance during an early period of endotoxaemia in juvenile rats. [source] Women's Views of Pregnancy Ultrasound: A Systematic ReviewBIRTH, Issue 4 2002Jo Garcia MSc ABSTRACT: Background: Ultrasound has become a routine part of care for pregnant women in most countries with developed health services. It is one of a range of techniques used in screening and diagnosis, but it differs from most others because of the direct access that it gives parents to images of the fetus. A review of women's views of ultrasound was commissioned as part of a larger study of the clinical and economic aspects of routine antenatal ultrasound use. Methods: Studies of women's views about antenatal screening and diagnosis were searched for on electronic databases. Studies about pregnancy ultrasound were then identified from this material. Further studies were found by contacting researchers, hand searches, and following up references. The searches were not intentionally limited by date or language. Studies that reported direct data from women about pregnancy ultrasound were then included in a structured review. Studies were not excluded on the basis of methodological quality unless they were impossible to understand. They were read by one author and tabulated. The review then addressed a series of questions in a nonquantitative way. Results: The structured review included 74 primary studies represented by 98 reports. Studies from 18 countries were included, and they employed methods ranging from qualitative interviewing to psychometric testing. The review included studies from the very early period of ultrasound use up to reports of research on contemporary practice. Ultrasound is very attractive to women and families. Women's early concerns about the safety of ultrasound were rarely reported in more recent research. Women often lack information about the purposes for which an ultrasound scan is being done and the technical limitations of the procedure. The strong appeal of diagnostic ultrasound use may contribute to the fact that pregnant women are often unprepared for adverse findings. Conclusions: Despite the highly varied study designs and contexts for the research included, this review provided useful information about women's views of pregnancy ultrasound. One key finding for clinicians was the need for all staff, women, and partners to be well informed about the specific purposes of ultrasound scans and what they can and cannot achieve. (BIRTH 29:4 December 2002) [source] Advantages of laparoscopic stented choledochorrhaphy over T-tube placementBRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 7 2004A. M. Isla Background: Postoperative complications after laparoscopic choledochotomy are mainly related to the tube. Both laparoscopic endobiliary stent placement with primary closure of the common bile duct (CBD) and primary closure of the CBD without drainage have been proposed as safe and effective alternatives to -tube placement. Methods: This was a retrospective analysis of data collected prospectively on 53 consecutive patients suffering from proven choledocholithiasis who underwent laparoscopic CBD exploration through a choledochotomy between January 1999 and January 2003. In the early period a -tube was placed at the end of the procedure (n = 32). Biliary stent placement and primary CBD closure was performed from June 2001 (n = 21). Results: There were no significant differences in epidemiological characteristics, preoperative factors or intraoperative findings between the groups. Seven patients developed complications, six in the -tube group and one in the stent group. Univariate analysis revealed a significantly lower morbidity rate and shorter postoperative hospital stay in the stent group. Conclusion: Placement of a biliary endoprosthesis after laparoscopic choledochotomy achieves biliary decompression, and avoids the complications of a tube, leading to a shorter postoperative hospital stay. The method is a safe and effective alternative method of CBD drainage after laparoscopic choledochotomy. Copyright © 2004 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source] Second Primary Cancers Following Breast Cancer in the Japanese Female PopulationCANCER SCIENCE, Issue 1 2001Hideo Tanaka To assess the risk of developing second primary cancers following breast cancer in Japanese females, we performed a retrospective cohort study of 2786 patients who were newly diagnosed with breast cancer at our hospital between 1970-1994, until the end of 1995 (average follow-up period, 8.6 years). The expected number of each second primary cancer was calculated by multiplying the number of appropriate person-years at risk by the corresponding age- and calendar period-specific cancer incidence rates for women obtained from the Osaka Cancer Registry. One hundred and seventeen patients developed a second primary cancer other than subsequent breast cancer, yielding an observed-to-expected ratio (O/E) of 1.3 [95% confidence interval (CI)=1.1-1.6]. The risk for developing a second primary cancer was significantly elevated during the first year following the diagnosis of breast cancer, and decreased with the passage of tune to unity. A significantly increased risk was noted for the development of ovarian cancer (O/E=2.4, 95% CI=1.0-4.6), thyroid cancer (O/E=3.7, 95% CI=1.5-7.6) and non-Hodgkin's lymphoma (NHL) (O/E=3.5, 95% CI=1.4-7.1) among the breast cancer patients compared with the general population. Patients who received hormonal therapy as the breast cancer treatment showed a significantly increased risk for ovarian cancer (O/E=5.5, 95% CI=1.8-12.9). Patients who received chemotherapy as the breast cancer treatment had an increased risk for NHL (O/E=5.0, 95% CI=1.6-11.6). These findings indicate that Japanese female patients with breast cancer had a 30% higher risk of developing a second primary cancer than the general population, the higher risk being manifested in the early period following the diagnosis of breast cancer. Medical surveillance of breast cancer patients for NHL, as well as for ovarian cancer and thyroid cancer, is required. [source] Nonregenerative stimulation of hepatocyte proliferation in the rat: Variable effects in relation to spontaneous liver growth; a possible link with metabolic inductionCELL PROLIFERATION, Issue 5 2000C. Nadal Three procedures were used to stimulate hepatocyte proliferation in the rat without reducing liver mass, resulting in a supplementary growth which differs from the regenerative growth observed after loss of liver mass by hepatectomy or toxic necrosis. They were: (a) the ingestion of cyproterone, a cytochrome P450 inducing drug (b) the injection of an irritant which provokes glycogenesis and synthesis of acute-phase proteins (c) the injection of albumin-bound bilirubin leading to elimination of glucuronated bilirubin in bile. This ensuing supplementary growth was studied in the rat under several conditions of hepatic proliferation: 1In normal adult rats, in which hepatocyte proliferation is very low, the effect on proliferation was either weak or undetectable. 2In suckling rats, with a rapid body and liver growth, all the stimulants provoked a synchronized wave of proliferation with a steep increase of the percentage of S-phase hepatocytes from 4.5% in controls to 15,30% in treated rats. This increase was followed by a compensatory period of low proliferation during which a treatment with a second stimulant was much less effective. 3In 2/3 hepatectomized adult rats, the proliferation induced by cyproterone was higher than the spontaneous regenerative proliferation alone and additional to it during all of the regenerative process. The proliferation induced by acute inflammation was competitive with the synchronous spontaneous proliferation during the early period of synchronized proliferation following surgery, suggesting that both are similar acute responses. Differently, during the late period of lower and unsynchronized regenerative proliferation, the proliferation provoked by acute inflammation was additional to the spontaneous one. A stimulation of proliferation by injection of the albumin-bilirubin complex was observed during the late period after 2/3 hepatectomy. The highest level of stimulation occurred when the liver growth and the hepatocyte proliferation were already high. This suggests that these stimulants are not complete mitogenic stimuli and need cofactors which are present during the spontaneous growth or, alternatively, that the effect of stimulants is opposed by an inhibitory mechanism present in the adult rat. [source] Management of isolated rectal bleeding in newborn infants: comparison of two time periodsACTA PAEDIATRICA, Issue 2 2010Ayala Maayan-Metzger Abstract Aim:, To demonstrate the differences in treatment of isolated rectal bleeding (IRB) by comparing two study time period groups and to evaluate whether decreased treatment intensity increased complications during the follow-up period. Methods:, Retrospective recording of medical charts of 307 neonates with IRB during two time periods. Results:, The rate of IRB in both period groups was similar among term and near-term infants, but significantly lower among preterm infants in the later period study group. The rate of breast milk feeding among preterm infants increased significantly in the later compared with the early group. Duration of antibiotic treatments and feeding cessation was significantly shortened in the late period study as compared with the early period. The rates of recurrent episodes of IRB among preterm infants were similar in the early and late period groups. No infant developed necrotizing enterocolitis within the episode of isolated rectal bleeding. Conclusions:, Decreased treatment duration to 1 day of nil per os and 2 days of antibiotics was not associated with increased rates of deterioration to severe clinical conditions, nor to recurrent episodes of isolated rectal bleeding. [source] Emotional reactivity in infants with congenital heart defects: findings from a large case-cohort study in NorwayACTA PAEDIATRICA, Issue 1 2010K Stene-Larsen Abstract Aim:, Advances in medical treatment in recent years have led to dramatically improved survival rates of children with severe congenital heart defects (CHD). However, very little is known about the psychological consequences for these children, particularly during and after the early period of invasive treatment. In this study, we investigated the extent to which the severity of the CHD affects the child's emotional reactivity at 6 months of age. Method:, We linked prospective data from the Norwegian Mother and Child Cohort Study, conducted by the Norwegian Institute of Public Health with a nationwide medical CHD registry and identified 212 infants with CHD in a cohort of 61 299 infants. Mothers reported on their child's emotional reactivity at age 6 months by means of a standardized questionnaire. Results:, Infants with severe to moderate CHD had 60% higher odds for severe emotional reactivity (cut-off at the 85 percentile) compared with healthy infants, after controlling for important maternal and child confounders. Conclusion:, Our study is the first to show elevated emotional reactivity in children with moderate to severe CHD, suggesting a need for special parental attention to soothe their distress. Follow-up studies will show whether this emotional reactivity is transient or an early marker of continuing emotional or behavioural problems. [source] | |||||||||||||||||||||||||||||||||||||