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Selected AbstractsImprovement of respiratory compromise through abductor reinnervation and pacing in a patient with bilateral vocal fold impairment,THE LARYNGOSCOPE, Issue 1 2010Michael Broniatowski MD Abstract Objectives/Hypothesis. To determine whether respiratory compromise from bilateral vocal fold impairment (paralysis) can be objectively alleviated by reinnervation and pacing. Methods. A patient with paramedian vocal folds and synkinesis had a tracheotomy for stridor after bilateral laryngeal nerve injury and Miller Fisher syndrome. One posterior cricoarytenoideus (PCA) received a nerve-muscle pedicle fitted with a perineural electrode for pacemaker stimulation. The airway was evaluated endoscopically and by spirometry for up to 1 year. Results. Bilateral vocal fold patency during quiet breathing was reversed to active vocal fold adduction during tracheal occlusion. Peak inspiratory flows (PIFs) were significantly higher (P < .001) after reinnervation. PIFs and glottic apertures increased further under stimulation (42 Hz, 1,4 mA, 42,400 ,sec). although the differences were not significant. Conclusions. Based on our preliminary data, PCA reinnervation and pacing offer promise for amelioration of respiratory compromise after paradoxical adduction in bilateral vocal fold impairment. Laryngoscope, 2010 [source] Human prostate cancer risk factors,,§CANCER, Issue S10 2004David G. Bostwick M.D. Abstract Prostate cancer has the highest prevalence of any nonskin cancer in the human body, with similar likelihood of neoplastic foci found within the prostates of men around the world regardless of diet, occupation, lifestyle, or other factors. Essentially all men with circulating androgens will develop microscopic prostate cancer if they live long enough. This review is a contemporary and comprehensive, literature-based analysis of the putative risk factors for human prostate cancer, and the results were presented at a multidisciplinary consensus conference held in Crystal City, Virginia, in the fall of 2002. The objectives were to evaluate known environmental factors and mechanisms of prostatic carcinogenesis and to identify existing data gaps and future research needs. The review is divided into four sections, including 1) epidemiology (endogenous factors [family history, hormones, race, aging and oxidative stress] and exogenous factors [diet, environmental agents, occupation and other factors, including lifestyle factors]); 2) animal and cell culture models for prediction of human risk (rodent models, transgenic models, mouse reconstitution models, severe combined immunodeficiency syndrome mouse models, canine models, xenograft models, and cell culture models); 3) biomarkers in prostate cancer, most of which have been tested only as predictive factors for patient outcome after treatment rather than as risk factors; and 4) genotoxic and nongenotoxic mechanisms of carcinogenesis. The authors conclude that most of the data regarding risk relies, of necessity, on epidemiologic studies, but animal and cell culture models offer promise in confirming some important findings. The current understanding of biomarkers of disease and risk factors is limited. An understanding of the risk factors for prostate cancer has practical importance for public health research and policy, genetic and nutritional education and chemoprevention, and prevention strategies. Cancer 2004. © 2004 American Cancer Society. [source] Can a Global Peace Last Even If Achieved?INTERNATIONAL STUDIES REVIEW, Issue 3 2005Huntington, the Democratic Peace Current events have surfaced new challenges in the international state system. These are alternatively characterized as state versus substate conflicts, religious conflicts or the outgrowth of the rise in fundamentalism, class struggle between the West and the Third World resulting from globalization, and the lack of democratic government in those states that breed terrorists. Whereas religious conflict is difficult to fix if true and globalization hard to stop, the democratic peace offers promise because changing the form of government is a conceivable goal. But would it help? Samuel Huntington provides an interesting, if unintended, challenge to the democratic peace in both The Third Wave and The Clash of Civilizations. If democracy is reversible under some circumstances, can it really lead to a lasting peace? If there are cultural divisions in the world, are these necessarily united by polity? If racism is real, does polity really eliminate it? Based on Huntington, the democratic peace falters. [source] Cholestatic liver disease: pathophysiology and therapeutic optionsLIVER INTERNATIONAL, Issue 2002AF. Hofmann Abstract: Cholestasis results from defective canalicular secretion of bile or obstruction to bile flow distal to the canaliculus. In early primary biliary cirrhosis, bile secretion continues, because of the secretory pressure of bile or because some ductules are not obstructed. With complete cholestasis, a bile acid deficiency occurs in the small intestinal lumen leading to lipid maldigestion and fat-soluble vitamin malabsorption. Bacterial proliferation, bacterial translocation to lymph nodes and endotoxemia may also occur leading to an acute phase reaction. Retention of bile acids in the hepatocyte leads to apoptosis. Accumulation of bile acids in the systemic circulation leads to pruritus, and may contribute to endothelial injury in the lungs and kidney. Early attempts to mimic hepatic excretory function by hemoperfusion over adsorbent columns were unsuccessful for a variety of reasons. Extracorporeal dialysis against albumin offers promise of a realistic albeit partial simulation of hepatic excretory function. [source] Re-thinking the complexities of ,culture': what might we learn from Bourdieu?NURSING INQUIRY, Issue 1 2007M. Judith Lynam In this paper we continue an ongoing dialogue that has as its goal the critical appraisal of theoretical perspectives on culture and health, in an effort to move forward scholarship on culture and health. We draw upon a programme of scholarship to explicate theoretical tensions and challenges that are manifest in the discourses on culture and health and to explore the possibilities Bourdieu's theoretical perspective offers for reconciling them. That is, we hope to demonstrate the need to move beyond descriptions ,of' culture to an understanding of cultures as dynamic, and to show ways cultural practices create contexts that have the potential to foster or impede health. In our early research, largely undertaken in Canada's multicultural context, we sought to make visible the ways in which culture shaped conceptions of health and influenced health practices of immigrant groups. In recent years this focus has expanded to include populations that reflect the cultural and social diversity of our region. From the outset we attempted to move towards a conception of culture as negotiated, unifying, transformative and dynamic. While this position continues to hold appeal we are continually reminded that, despite our leanings towards constructivism, there is salience to the notion of culture as having enduring elements. It is this tension between the view of culture as embodied and enduring and culture as constructed and dynamic that we seek to examine. We explore whether Bourdieu's theoretical perspective offers promise for reconciling these apparently competing views. Using exemplars from our research we share insights that Bourdieu's work has offered to our analyses, thereby enabling us to move towards a view of culture that holds in tension these apparently contradictory positions of culture as both essence (albeit unstable, negotiated) and constructed. [source] Building native protein conformation from NMR backbone chemical shifts using Monte Carlo fragment assemblyPROTEIN SCIENCE, Issue 8 2007Haipeng Gong Abstract We have been analyzing the extent to which protein secondary structure determines protein tertiary structure in simple protein folds. An earlier paper demonstrated that three-dimensional structure can be obtained successfully using only highly approximate backbone torsion angles for every residue. Here, the initial information is further diluted by introducing a realistic degree of experimental uncertainty into this process. In particular, we tackle the practical problem of determining three-dimensional structure solely from backbone chemical shifts, which can be measured directly by NMR and are known to be correlated with a protein's backbone torsion angles. Extending our previous algorithm to incorporate these experimentally determined data, clusters of structures compatible with the experimentally determined chemical shifts were generated by fragment assembly Monte Carlo. The cluster that corresponds to the native conformation was then identified based on four energy terms: steric clash, solvent-squeezing, hydrogen-bonding, and hydrophobic contact. Currently, the method has been applied successfully to five small proteins with simple topology. Although still under development, this approach offers promise for high-throughput NMR structure determination. [source] 3124: Algorithms and instrumentation for quantified retinal oximetry in a snapshotACTA OPHTHALMOLOGICA, Issue 2010AR HARVEY Purpose To develop an instrument and techniques for useful absolute and relative clinical oximetry of the retina. Methods A novel snapshot multispectral imaging system has been optimised for retinal oximetry. Eight monochromatic images of the retina are recorded with a field of view of 24 degrees. Algorithms calculate the absorption of light at each point along delineated blood vessels and for each of the eight wavebands. Data inversion using an analytical model for light propagation enables oximetry at along the blood vessels. Spectral inversion has been refined using ray tracing and Monte Carlo modelling of light propagation using a realistic phantom eye. Results A comparison of Monte Carlo modelling of light propagation in the phantom retina with recorded images for blood of various oxygenations indicates the influence of several unknowns, including scatter from optical surfaces within the ophthalmoscope and eye, the geometry of the blood vessels and eye, the optical constants of the ocular media and the complexity of light propagation in the retinal structure. Relative oximetry within the retina is possible with repeatability of about 1% in the phantom and 5% in a real eye but the influence of various systematic effects can introduce systematic differences between actual and calculated oxygenation that can significantly exceed these values. Conclusion Although oximetry using only a very small number of spectral bands is possible, this is prone to systematic errors that can effect both absolute and relative oximetry. The ability to record eight spectral images in a single snapshot offers promise to provide an enhanced clinically useful and validated oximetry technique. [source] | ||||||||||