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Kinds of Pre Selected AbstractsStromal cell,derived factor 1/CXCR4 signaling is critical for the recruitment of mesenchymal stem cells to the fracture site during skeletal repair in a mouse modelARTHRITIS & RHEUMATISM, Issue 3 2009Toshiyuki Kitaori Objective Stromal cell,derived factor 1 (SDF-1; CXCL12/pre,B cell growth-stimulating factor) is a dominant chemokine in bone marrow and is known to be involved in inflammatory diseases, including rheumatoid arthritis. However, its role in bone repair remains unknown. The purpose of this study was to investigate the role of SDF-1 and its receptor, CXCR4, in bone healing. Methods The expression of SDF-1 during the repair of a murine structural femoral bone graft was examined by real-time polymerase chain reaction and immunohistochemical analysis. The bone graft model was treated with anti,SDF-1 neutralizing antibody or TF14016, an antagonist for CXCR4, and evaluated by histomorphometry. The functional effect of SDF-1 on primary mesenchymal stem cells was determined by in vitro and in vivo migration assays. New bone formation in an exchanging-graft model was compared with that in the autograft models, using mice partially lacking SDF-1 (SDF-1+/,) or CXCR4 (CXCR4+/,). Results The expression of SDF1 messenger RNA was increased during the healing of live bone grafts but was not increased in dead grafts. High expression of SDF-1 protein was observed in the periosteum of the live graft. New bone formation was inhibited by the administration of anti,SDF-1 antibody or TF14016. SDF-1 increased mesenchymal stem cell chemotaxis in vitro in a dose-dependent manner. The in vivo migration study demonstrated that mesenchymal stem cells recruited by SDF-1 participate in endochondral bone repair. Bone formation was decreased in SDF-1+/, and CXCR4+/, mice and was restored by the graft bones from CXCR4+/, mice transplanted into the SDF-1+/, femur, but not vice versa. Conclusion SDF-1 is induced in the periosteum of injured bone and promotes endochondral bone repair by recruiting mesenchymal stem cells to the site of injury. [source] Global-scale patterns of nutrient resorption associated with latitude, temperature and precipitationGLOBAL ECOLOGY, Issue 1 2009Z. Y. Yuan ABSTRACT Aim Nutrient resorption from senescing leaves is an important mechanism of nutrient conservation in plants, but the patterns of nutrient resorption at the global scale are unknown. Because soil nutrients vary along climatic gradients, we hypothesize that nutrient resorption changes with latitude, temperature and precipitation. Location Global. Methods We conducted a meta-analysis on a global data set collected from published literature on nitrogen (N) and phosphorus (P) resorption of woody plants. Results For all data pooled, both N resorption efficiency (NRE) and P resorption efficiency (PRE) were significantly related to latitude, mean annual temperature (MAT) and mean annual precipitation (MAP): NRE increased with latitude but decreased with MAT and MAP. In contrast, PRE decreased with latitude but increased with MAT and MAP. When functional groups (shrub versus tree, coniferous versus broadleaf and evergreen versus deciduous) were examined individually, the patterns of NRE and PRE in relation to latitude, MAT and MAP were generally similar. Main conclusions The relationships between N and P resorption and latitude, MAT and MAP indicate the existence of geographical patterns of plant nutrient conservation strategies in relation to temperature and precipitation at the global scale, particularly for PRE, which can be an indicator for P limitation in the tropics and selective pressure shaping the evolution of plant traits. Our results suggest that, although the magnitude of plant nutrient resorption might be regulated by local factors such as substrate, spatial patterns are also controlled by temperature or precipitation. [source] Allocation of Photosynthates and Grain Growth of Two Wheat Cultivars with Different Potential Grain Growth in Response to Pre- and Post-anthesis ShadingJOURNAL OF AGRONOMY AND CROP SCIENCE, Issue 5 2003Z. Wang Abstract Grain yield in wheat is dependent on photosynthate production and allocation. Light intensity is one of the main factors affecting photosynthate production and allocation, and grain yield. This study was conducted to determine whether cultivars varying in grain number per spike and grain weight respond differently to pre-anthesis shading (PRE) and post-anthesis shading (POST), and to characterize the responses in production and allocation of photosynthate, yield and yield components, and spike traits. Both PRE and POST caused a decrease in both dry matter (DM) accumulation and allocation to grain. Cultivar Lumai 22, which has a large spike and large grains, was more sensitive to either PRE or POST. PRE reduced photosynthate production and partitioning to the spike in Lumai 22 at anthesis. In contrast, PRE had little influence on these parameters in the small-spike, small-grain cultivar Yannong 15. POST reduced the partitioning to the grain, especially in Lumai 22, for which marked reductions in biomass and grain yield were found for both the PRE and POST treatments. Changes in yield components attributable to shading varied with cultivars. The number of spikes m,2 was not affected by either PRE or POST. Lumai 22 was more seriously affected by shading than Yannong 15 in terms of grain number per spike and weight per grain. The decreases in grain number or weight per spikelet in both the PRE and POST treatments took place mainly in the upper and basal spikelets, especially in Lumai 22. We concluded that the adaptability of the small-spike, small-grain cultivar Yannong 15 to either PRE or POST was much greater than that of the large-spike, large-grain cultivar Lumai 22 in terms of many characteristics closely related to grain yield. Hence, we suggest that, in areas where low light intensity often occurs, the small-spike, small-grain cultivar would be more likely to produce high, stable grain yields. [source] Dietary arginine requirement of fingerling Indian major carp, Labeo rohita (Hamilton) based on growth, nutrient retention efficiencies, RNA/DNA ratio and body compositionJOURNAL OF APPLIED ICHTHYOLOGY, Issue 6 2009S. F. Abidi Summary To quantify the optimum dietary arginine requirement of fingerling Indian major carp, Labeo rohita (4.10 ± 0.04 cm; 0.62 ± 0.02 g), an 8-week growth trial was conducted in eighteen 70-L indoor circular aqua-coloured troughs provided with a flow-through system at 28 ± 1°C. Isonitrogenous (40 g 100 g,1 crude protein) and isocaloric (4.28 kcal g,1 gross energy) amino acid test diets containing casein and gelatin as intact protein sources with graded levels of arginine (0.5, 0.75, 1.0, 1.25, 1.50 and 1.75 g 100 g,1 dry diet) were fed to triplicate groups of fish to apparent satiation at 07:00, 12:00 and 17:30 hours. Growth performance of fish fed the above diets was evaluated on the basis of absolute weight gain (AWG), specific growth rate (SGR), feed conversion ratio (FCR), protein efficiency ratio (PER), protein retention efficiency (PRE) and energy retention efficiency (ERE). Maximum AWG (2.61), SGR (2.80), best FCR (1.35), highest PER (1.85), PRE (37%) and ERE (76%) were recorded at 1.25 g 100 g,1 dietary arginine. Maximum body protein (18.88 g 100 g,1) and RNA/DNA ratio (5.20) were also obtained in a 1.25 g 100 g,1 arginine dry diet. Except for the reduced growth performance in fish fed arginine-deficient diets, no other deficiency signs were apparent. Based on the broken-line and second-degree polynomial regression analysis of the AWG, SGR, FCR, PER, PRE and ERE data, the optimum arginine requirement for fingerling Labeo rohita was found to be in the range of 1.22,1.39 g 100 g,1 of the dry diet, corresponding to 3.05,3.47 g 100 g,1 of dietary protein. [source] A Randomized School-Based Jumping Intervention Confers Site and Maturity-Specific Benefits on Bone Structural Properties in Girls: A Hip Structural Analysis Study,JOURNAL OF BONE AND MINERAL RESEARCH, Issue 3 2002M. A. Petit Abstract We compared 7-month changes in bone structural properties in pre- and early-pubertal girls randomized to exercise intervention (10-minute, 3 times per week, jumping program) or control groups. Girls were classified as prepubertal (PRE; Tanner breast stage 1; n = 43 for intervention [I] and n = 25 for control [C]) or early-pubertal (EARLY; Tanner stages 2 and 3; n = 43 for I and n = 63 for C). Mean ± SD age was 10.0 ± 0.6 and 10.5 ± 0.6 for the PRE and EARLY groups, respectively. Proximal femur scans were analyzed using a hip structural analysis (HSA) program to assess bone mineral density (BMD), subperiosteal width, and cross-sectional area and to estimate cortical thickness, endosteal diameter, and section modulus at the femoral neck (FN), intertrochanter (IT), and femoral shaft (FS) regions. There were no differences between intervention and control groups for baseline height, weight, calcium intake, or physical activity or for change over 7 months (p > 0.05). We used analysis of covariance (ANCOVA) to examine group differences in changes of bone structure, adjusting for baseline weight, height change, Tanner breast stage, and physical activity. There were no differences in change for bone structure in the PRE girls. The more mature girls (EARLY) in the intervention group showed significantly greater gains in FN (+2.6%, p = 0.03) and IT (+1.7%, p = 0.02) BMD. Underpinning these changes were increased bone cross-sectional area and reduced endosteal expansion. Changes in subperiosteal dimensions did not differ. Structural changes improved section modulus (bending strength) at the FN (+4.0%, p = 0.04), but not at the IT region. There were no differences at the primarily cortical FS. These data provide insight into geometric changes that underpin exercise-associated gain in bone strength in early-pubertal girls. [source] Etomidate and thiopental inhibit platelet function in patients undergoing infrainguinal vascular surgeryACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 4 2001A. Gries Background: Postoperative platelet hyperaggregability following general anesthesia has been reported in patients undergoing major vascular surgery. In contrast, since anesthetic agents inhibited platelet function both in vitro and in vivo, an increased risk for postoperative bleedings due to prolonged platelet dysfunction has been discussed. Nevertheless, data describing platelet-affecting properties of induction agents such as etomidate and thiopental in patients undergoing major vascular surgery are lacking. Methods: Platelet function was determined at 0, 2, 20, and 200 ,g/ml thiopental and at 0, 0.2, 2, 20 ,g/ml etomidate in vitro in blood samples drawn from 16 patients suffering from severe occlusive arterial disease. In addition, 30 patients undergoing vascular surgery were investigated before (PRE) and after anesthesia induction (T0) either with etomidate (ETO group, n=16) or thiopental (THIO group, n=14), and 2 h after the beginning of surgery (T2). Platelet function was determined according to platelet aggregation, in vitro bleeding time, and flow cytometric measurements. Results:In vitro, P-selectin expression was inhibited by etomidate at 2 and 20 ,g/ml (,28% and ,38%, respectively) and also by thiopental at 200 ,g/ml (,27%). In patients undergoing vascular surgery, anesthesia induction in the ETO group resulted in a 31% prolongation of the in vitro bleeding time and an inhibition of ADP- and collagen-induced platelet aggregation (,30% and ,17%, respectively) and of P-selectin expression (,25%) at T0. In the THIO group, only ADP-induced platelet aggregation was affected (,16%). At T2, all parameters had reached PRE level again in both groups. Furthermore, in comparison with the THIO group, operation time was significantly prolonged and transfusion volume was significantly increased in the ETO group. In addition, platelet count and hematocrit significantly decreased at T2, whereas levels of tPA, PAI-1, fibrinogen and antithrombin III and partial thromboplastin time remained unchanged in both groups during the study period. Conclusions: In the present study, etomidate and, to a minor extent, thiopental offered significant platelet inhibitory properties. Anesthetic-induced platelet inhibition may lead to higher transfusion rates and prolonged operation times. Therefore, anesthetic-related platelet inhibitory properties should be considered when searching for the anesthetic agent of choice, especially in patients with compromised hemostasis and co-existing bleeding disorders. [source] Neuronal loss and neurofibrillary degeneration in the hippocampal cortex in late-onset sporadic Alzheimer's diseasePSYCHIATRY AND CLINICAL NEUROSCIENCES, Issue 5 2000Yuken Fukutani MD Abstract To explore more fully the relationship between neuronal death and neurofibrillary degeneration, unaffected neurons, intracellular neurofibrillary tangles (i-NFT) and extracellular NFT (e-NFT) in 22 patients with late-onset sporadic Alzheimer's disease (AD) were morphometrically evaluated in eight subdivisions of the hippocampal cortex, using the Gallyas hematoxylin-eosin stain. The subdivisions examined included CA4, CA3, CA2, CA1 (CA: cornu ammonis), prosubiculum (PRO), subiculum and presubiculum (PRE), parasubiculum (PARA) and the entorhinal cortex (ENT). The unaffected neuron density was significantly lower and both i-NFT and e-NFT densities were significantly higher in subdivisions other than CA4 and CA3 in AD patients compared with those in the aged controls. Unaffected neuron density was significantly, inversely correlated with e-NFT density and with total NFT density in all subdivisions except for PRE in AD patients. Especially in CA2, CA1, PRO and ENT, there were strong correlations between the neuron density and these NFT densities. Both unaffected neuron and e-NFT densities in CA1 and ENT were significantly correlated with the disease duration. The i/e-NFT ratio, an index of the degree and/or rate of progress of neuronal death via neurofibrillary degeneration, showed the lowest value in ENT in AD patients. The findings suggest that neuronal death via neurofibrillary degeneration starts earliest and/or most rapidly progresses in ENT. Furthermore, the i/e-NFT ratios in both ENT and CA1 were significantly correlated with the disease duration, suggesting that the neuronal death pattern in the two subdivisions parallels disease progression. [source] Prolonged strenuous exercise alters the cardiovascular response to dobutamine stimulation in male athletesTHE JOURNAL OF PHYSIOLOGY, Issue 1 2005Robert C. Welsh Prolonged strenuous exercise has been associated with transient impairment in left ventricular (LV) systolic and diastolic function that has been termed ,cardiac fatigue'. It has been postulated that cardiac ,-adrenoreceptor desensitization may play a central role; however, data are limited. Accordingly, we assessed the cardiovascular response to progressive dobutamine stimulation after prolonged strenuous exercise (2 km swim, 90 km bike, 21 km run). Nine experienced male athletes were studied: PRE (2,3 days before), POST (after) and REC (1,2 days later). The cardiovascular response to progressive continuous dobutamine stimulation (0, 5, 20, and 40 ,g kg,1 min,1) was assessed, including heart rate (HR), systolic blood pressure (SBP), LV cavity areas (two-dimensional echocardiography) and contractility (end-systolic elastance, SBP/end-systolic cavity area (ESCA)). POST there was limited evidence of myocardial necrosis (measured by troponin I), while catecholamines were elevated. HR was higher POST (mean ±s.d.; PRE, 58 ± 9; POST, 79 ± 9; REC, 57 ± 7 beats min,1; P < 0.05), while SBP was lower (PRE, 127 ± 15; POST, 116 ± 9; REC, 121 ± 12 mmHg; P < 0.05). A blunted HR, SBP and LV contractility (SBP/ESCA; PRE 29 ± 6 versus POST 20 ± 6 mmHg cm,2; P < 0.05) response to dobutamine was demonstrated POST, with values returning towards baseline in REC. Following prolonged strenuous exercise, the chronotropic and inotropic response to dobutamine stimulation is blunted. This study supports the hypothesis that beta-receptor downregulation and/or desensitization may play a major role in prolonged-strenuous-exercise-mediated cardiac fatigue. [source] Tin-Free Radical Alkoxyamine Addition and Isomerization Reactions by Using the Persistent Radical Effect: Variation of the Alkoxyamine StructureCHEMISTRY - A EUROPEAN JOURNAL, Issue 8 2005Kian Molawi Dipl.-Chem. Abstract Various C-centered radicals can efficiently be generated through thermal CO-bond homolysis of alkoxyamines. This method is used to perform environmentally benign radical cyclization and intermolecular addition reactions. These alkoxyamine isomerizations and intermolecular carboaminoxylations are mediated by the persistent radical effect (PRE). In the paper, the effect of the variation of the alkoxyamine structure,in particular steric effects in the nitroxide moiety,on the outcome of the PRE mediated radical reactions will be discussed. Fourteen different nitroxides were used in the studies. It will be shown that reaction times can be shortened about 100 times upon careful tuning of the alkoxyamine structure. Activation energies for the CO-bond homolysis of the various alkoxyamines are provided. The kinetic data are used to explain the reaction outcome of the PRE-mediated processes. [source] Changes in left ventricular ejection time and pulse transit time derived from finger photoplethysmogram and electrocardiogram during moderate haemorrhageCLINICAL PHYSIOLOGY AND FUNCTIONAL IMAGING, Issue 3 2009Paul M. Middleton Summary Objectives:, Early identification of haemorrhage is difficult when a bleeding site is not apparent. This study explored the potential use of the finger photoplethysmographic (PPG) waveform derived left ventricular ejection time (LVETp) and pulse transit time (PTT) for detecting blood loss, by using blood donation as a model of controlled mild to moderate haemorrhage. Methods:, This was a prospective, observational study carried out in a convenience sample of blood donors. LVETp, PTT and R-R interval (RRi) were computed from simultaneous measurement of the electrocardiogram (ECG) and the finger infrared photoplethysmogram obtained from 43 healthy volunteers during blood donation. The blood donation process was divided into four stages: (i) Pre-donation (PRE), (ii) first half of donation (FIRST), (iii) second half of donation (SECOND), (iv) post-donation (POST). Results and conclusions:, Shortening of LVETp from 303+/,2 to 293+/,3 ms (mean+/,SEM; P<0·01) and prolongation of PTT from 177+/,3 to 186+/,4 ms (P<0·01) were observed in 81% and 91% of subjects respectively when comparing PRE and POST. During blood donation, progressive blood loss produced falling trends in LVETp (P<0·01) and rising trends in PTT (P<0·01) in FIRST and SECOND, but a falling trend in RRi (P<0·01) was only observed in SECOND. Monitoring trends in timing variables derived from non-invasive ECG and finger PPG signals may facilitate detection of blood loss in the early phase. [source] Pulp revascularization of replanted immature dog teeth after treatment with minocycline and doxycycline assessed by laser Doppler flowmetry, radiography, and histologyDENTAL TRAUMATOLOGY, Issue 2 2004Alessandra Luisa de Souza Ritter Abstract,,, This study investigated the effect of topical antibiotic treatment on pulp revascularization in replanted teeth. Thirty-four immature teeth were selected from three young dogs. Baseline radiographs and laser Doppler flowmetry (LDF) readings were obtained. Specimens were randomly divided into four groups: Thirty-eight teeth were extracted, kept dry for 5 min, and either (Group 1) covered with minocycline mixture (G1, n = 11), (Group 2) soaked in doxycycline (G2, n = 11), or (Group 3) soaked in saline (G3-negative control, n = 6), and replanted. Teeth in Group 4 were not extracted (positive control, n = 6). Postoperative radiographs and LDF readings were obtained for 2 months after replantation. After sacrifice, the jaws were collected and processed for light microscopy. Pre- and postreplantation LDF readings and radiographs, and histologic findings were analyzed to assess revascularization. Pulp revascularization occurred in 91% (G1), 73% (G2), and 33% (G3) of the specimens. In conclusion, minocycline facilitates pulp revascularization in replanted immature teeth after replantation. [source] Low-Fluence Q-Switched Neodymium-Doped Yttrium Aluminum Garnet Laser for Melasma with Pre- or Post-Treatment Triple Combination CreamDERMATOLOGIC SURGERY, Issue 6 2010SE-YEONG JEONG MD BACKGROUND Topical triple combination (TC) treatment is considered the primary approach to melasma. Recently, collimated low-fluence 1,064-nm Q-switched neodymium-doped yttrium aluminum garnet (Nd:YAG) laser treatment has attracted attention as an alternative approach. OBJECTIVES To compare the clinical efficacy and adverse effects of low-fluence Q-switched Nd:YAG laser when performed before and after treatment with topical TC using a split-face crossover design. METHODS Thirteen patients with melasma received topical treatment with TC cream or 1,064-nm Q-switched Nd:YAG laser treatment on opposite sides of the face for 8 weeks, and then treatments were reversed for 8 weeks. Responses were evaluated using the Melasma Area and Severity Index scoring system, spectrophotometry measurements, and a subjective self-assessment method. RESULTS After 16 weeks, better results were seen in subjective assessments when laser treatment was used after 8 weeks of topical TC treatment than before usage of TC. There were no significant adverse effects with the laser treatments. CONCLUSIONS Laser treatment after topical TC cream was found to be safer and more effective than the post-treatment use of topical agents. The authors have indicated no significant interest with commercial supporters. [source] Treatment of Superficial Infantile Hemangiomas of the Eyelid Using the 595-nm Pulsed Dye LaserDERMATOLOGIC SURGERY, Issue 5 2010CHRISTOPHER M. HUNZEKER MD BACKGROUND Despite the proven effectiveness of the 595-nm pulsed dye laser (PDL) in treating superficial infantile hemangiomas, many physicians are reluctant to treat such lesions involving the eyelid. OBJECTIVE To examine the safety and efficacy of the 595-nm PDL for the treatment of superficial infantile hemangiomas of the eyelid. MATERIALS & METHODS Records were reviewed for patients with superficial infantile hemangiomas of the eyelid treated with 595-nm PDL. Pre- and post-treatment photographs were compared. Reviewers rated the degree of improvement of the hemangioma as excellent (76,100%), good (51,75%), moderate (26,50%), or poor (0,25%) and indicated whether the hemangioma was 100% clear. Side effects of scarring, atrophy, hyperpigmentation, and hypopigmentation were assessed. RESULTS Twenty-two patients met the study criteria. Eight (36.4%) demonstrated complete clearance of their hemangioma, 17 (77.3%) received an improvement rating of excellent, and five (22.7%) received a rating of good. No scarring, atrophy, or hypopigmentation was noted. Two patients (9.1%) were noted to have hyperpigmentation in the treated area. CONCLUSION Early treatment with the 595-nm PDL can safely and effectively diminish proliferative growth and hasten resolution of superficial infantile hemangiomas of the eyelid. Roy G. Geronemus, MD, is on the Medical Advisory Board for Candela Laser Corp. [source] Does Imiquimod Histologically Rejuvenate Ultraviolet Radiation,Damaged Skin?DERMATOLOGIC SURGERY, Issue 12 2007KATHLEEN SMITH MD BACKGROUND Imiquimod (IMI) 5% is believed by some to result in an improved cosmetic appearance of chronically ultraviolet radiation (UV)-damaged skin. OBJECTIVE The objective was to determine what histologic and immunohistologic changes were present in actinically damaged skin after treatment with IMI. METHODS AND MATERIALS Pre- and posttherapy biopsies of 12 patients with histories of actinic keratoses were evaluated with routine histology and immunohistochemical stains including p53, p63, proliferating cell nuclear antigen (PCNA), c-kit, and Factor XIIIa. RESULTS After IMI therapy there was less compact hyperkeratosis, a more uniform rete ridge pattern with a more ordered proliferation of the epidermis, and a decrease in sun-damaged melanocytes. The papillary dermis showed a more uniform cellularity, and there was increased cellularity within the area of solar elastosis. After therapy, staining for p53, p63, and PCNA was decreased within the epidermis; staining for c-kit was decreased but more uniform in the basal cell; and Factor XIIIa expression was increased within the papillary dermis with a more ordered pattern of staining. CONCLUSION These morphologic and immunohistochemical patterns may explain some of the improvement in overall skin appearance after IMI therapy and may be related to the spectrum of signaling pathways induced by the imidazoquinolines. [source] The Use of Phosphatidylcholine for Correction of Lower Lid Bulging Due to Prominent Fat PadsDERMATOLOGIC SURGERY, Issue 4 2001Patrícia Guedes Rittes MDArticle first published online: 20 DEC 200 Background. Patients with prominent periorbital fat pads often complain of having a persistent "tired" look and seek treatment from their dermatologist. Objective. A non-surgical treatment of fat pads. Methods. Thirty patients were treated for prominent lower eyelid fat pads with phosphatidylcholine injection. Pre- and posttreatment photographs were taken for long-term analysis. Results. A marked reduction of the lower eyelid fat pads was noted over the 2-year follow-up period. There were no recurrences. Conclusion. The injection of phosphatidylcholine (250 mg/5 ml) into the fat pads is a simple office procedure that may postpone or even substitute for lower eyelid blepharoplasty. [source] A randomized controlled trial of the impact of therapeutic horse riding on the quality of life, health, and function of children with cerebral palsyDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 2 2009E DAVIS PHD This randomized controlled trial examined whether therapeutic horse riding has a clinically significant impact on the physical function, health and quality of life (QoL) of children with cerebral palsy (CP). Ninety-nine children aged 4 to 12 years with no prior horse riding experience and various levels of impairment (Gross Motor Function Classification System Levels I,III) were randomized to intervention (10wks therapeutic programme; 26 males, 24 females; mean age 7y 8mo [SD 2y 5mo] or control (usual activities, 27 males, 22 females; mean age 8y 2mo [SD 2y 6mo]). Pre- and post-measures were completed by 72 families (35 intervention and 37 control). Children's gross motor function (Gross Motor Function Measure [GMFM]), health status (Child Health Questionnaire [CHQ]), and QoL (CP QoL-Child, KIDSCREEN) were assessed by parents and QoL was assessed by children before and after the 10-week study period. On analysis of covariance, there was no statistically significant difference in GMFM, CP QoL-Child (parent report and child self-report), and CHQ scores (except family cohesion) between the intervention and control group after the 10-week study period, but there was weak evidence of a difference for KIDSCREEN (parent report). This study suggests that therapeutic horse riding does not have a clinically significant impact on children with CP. However, a smaller effect cannot be ruled out and the absence of evidence might be explained by a lack of sensitivity of the instruments since the QoL and health measures have not yet been demonstrated to be sensitive to change for children with CP. [source] Pre-/post-otic rhombomeric interactions control the emergence of a fetal-like respiratory rhythm in the mouse embryoDEVELOPMENTAL NEUROBIOLOGY, Issue 12 2006C. Borday Abstract How regional patterning of the neural tube in vertebrate embryos may influence the emergence and the function of neural networks remains elusive. We have begun to address this issue in the embryonic mouse hindbrain by studying rhythmogenic properties of different neural tube segments. We have isolated pre- and post-otic hindbrain segments and spinal segments of the mouse neural tube, when they form at embryonic day (E) 9, and grafted them into the same positions in stage-matched chick hosts. Three days after grafting, in vitro recordings of the activity in the cranial nerves exiting the grafts indicate that a high frequency (HF) rhythm (order: 10 bursts/min) is generated in post-otic segments while more anterior pre-otic and more posterior spinal territories generate a low frequency (LF) rhythm (order: 1 burst/min). Comparison with homo-specific grafting of corresponding chick segments points to conservation in mouse and chick of the link between the patterning of activities and the axial origin of the hindbrain segment. This HF rhythm is reminiscent of the respiratory rhythm known to appear at E15 in mice. We also report on pre-/post-otic interactions. The pre-otic rhombomere 5 prevents the emergence of the HF rhythm at E12. Although the nature of the interaction with r5 remains obscure, we propose that ontogeny of fetal-like respiratory circuits relies on: (i) a selective developmental program enforcing HF rhythm generation, already set at E9 in post-otic segments, and (ii) trans-segmental interactions with pre-otic territories that may control the time when this rhythm appears. © 2006 Wiley Periodicals, Inc. J Neurobiol, 2006 [source] Laparoscopic Heller myotomy with Dor fundoplication for achalasia: long-term outcomes and effect on chest painDISEASES OF THE ESOPHAGUS, Issue 4 2010A. Sasaki SUMMARY The aim of the present study was to evaluate the long-term outcomes of laparoscopic Heller myotomy with Dor fundoplication (LHD) and its effect on chest pain. Between June 1995 and August 2009, a total of 35 patients with achalasia underwent an LHD. The symptom scores were calculated by combining the frequency and the severity. Pre- and postoperative evaluations included symptom score, radiology, manometry, and 24-hour pH manometry. Median total symptom score was significantly lower than the preoperative score (19 vs 4, P < 0.001) at a median follow-up of 94 months. Among the 35 patients, 18 (51%) had chest pain. The frequency of chest pain was similar for the pre- and postoperative scores, but the severity tended to be less. Median esophageal diameter (5.4 cm vs 3.5 cm, P < 0.001) and lower esophageal sphincter pressure (41 mmHg vs 8.9 mmHg, P < 0.001) were significantly reduced after surgery. Median age, duration of symptoms, esophageal diameter, and lower esophageal sphincter pressure were similar between patients with and without chest pain prior to surgery. No significant differences were observed between the two groups in terms of amplitude, duration, and frequency of contractions from the findings of postoperative 24-hour esophageal manometry. Chest pain resolved in three patients (17%) and improved in seven patients (39%) after surgery. LHD can durably relieve achalasic symptoms of both dysphagia and regurgitation, and it can be considered the surgical procedure of choice. However, achalasic chest pain does not always seem to be related with patient characteristics and manometric findings. [source] Laparoscopic fundoplication in mentally normal children with gastroesophageal reflux diseaseDISEASES OF THE ESOPHAGUS, Issue 2 2002K. V. Menon SUMMARY., Laparoscopic antireflux surgery has been performed in neurologically impaired and scoliotic children. We aimed to assess the effectiveness of laparoscopic fundoplication in mentally normal children with gastroesophageal reflux disease that failed to respond to medical therapy. Data were prospectively collected (symptoms, medical therapy, endoscopies' findings) on 12 children (nine boys, three girls) aged 9,15 years with gastroesophageal reflux disease. Pre- and postoperative ambulatory 24-h pH and DeMeester and Johnson scores were also recorded. Effectiveness of surgery was assessed by comparison of pre- and postoperative total acid exposure time, Visick grade, need for antireflux medication and symptom scores. In total, 11 children underwent a laparoscopic Nissen fundoplication and one underwent a Toupet procedure. Median length of stay was 2 (2,3) nights. The median preoperative pH acid exposure time (AET) was 4.7 (0.8,16.4) percent compared with postoperative AET of 0.4 (0,3) percent. Early postoperative dysphagia occurred in four out of 12 patients, requiring a total of six dilatations. Postoperative Visick scores were: grade I=7 and grade II=5. Laparoscopic fundoplication can be safely performed and is effective in children with GERD who have failed to respond to medical therapy. [source] Evaluation of a training program to improve clinicians' assessment of patient stabilityDRUG AND ALCOHOL REVIEW, Issue 4 2009ADAM R. WINSTOCK Abstract Introduction and Aims. Public clinics in New South Wales (NSW), Australia play a central role in inducting and stabilising opioid dependent clients onto treatment before transfer to a community pharmacy. Clinical assessment of stability is a vital skill in ensuring that clients are appropriately and effectively transferred. A two-hour clinical training program was delivered to staff at 31 public clinics, that aimed to improve staff confidence in assessing client stability, and skills in negotiating the transfer of clients to community pharmacies. Design and Methods. Pre- and post-training evaluation was conducted examining self-ratings of confidence and ability in the assessment of client stability, and the perceived utility of a clinical algorithm to improve assessments. Follow-up was conducted 3 to 6 months post-training assessing individual and clinic level changes in clinical practice. Results. 205 staff completed pre- and post-training questionnaires. Staff demonstrated a moderate level of self-reported baseline knowledge and skills in assessing client stability (mean = 6.5; 1 = poor; 10 = excellent) that improved when re-assessed following the training (mean = 8.0). 76 staff responded to the follow-up questionnaire. , 75% reported some level of improvement in their approach to clinical practice regarding stability assessment, and 59% reported being more effective in identifying clients appropriate for community pharmacy transfer. Of 19 public clinics, 14 reported an increased focus on stability assessment. Nine clinics reported barriers to achieving changes in clinical practice. Discussion and Conclusions. This evaluation demonstrates that it is possible to implement a targeted clinical training package to staff that translates into positive changes in clinical practice.[Winstock AR, Lea T. Evaluation of a training program to improve clinicians' assessment of patient stability. Drug Alcohol Rev 2009;28:353,359] [source] Hydrologic and geomorphic effects of temporary ice-dammed lake formation during jökulhlaupsEARTH SURFACE PROCESSES AND LANDFORMS, Issue 7 2003Matthew J. Roberts Abstract Glacial outburst ,oods (jökulhlaups) occur frequently in glaciated environments, and the resultant ,ooding causes geomorphic change and, in some instances, damage to local infrastructure. During some jökulhlaups, ,oodwater is stored temporarily in ice-marginal locations. In July 1999, a linearly rising jökulhlaup burst from Sólheimajökull, Iceland. During this remarkable event, subglacial ,oodwater pooled transiently in two relict ice-dammed lake basins, before draining suddenly back into Sólheimajökull. The signi,cance of such rapid formation and attendant drainage of temporary ice-dammed lakes during jökulhlaups has not been addressed. Consequently, this paper: (i) assesses the hydrologic and geomorphic effects of temporary ice-dammed lake formation caused by lake-basin ,retro-,lling'; and (ii) discusses the impact and signi,cance of transient retro-,lling under jökulhlaup conditions. Pre- and post-,ood ,eldwork at Sólheimajökull enabled the impact and signi,cance of lake-basin retro-,lling to be assessed. Field evidence demonstrates that the July 1999 jökulhlaup had an unusually rapid rise to peak discharge, resulting in subglacial ,oodwater being purged to ice-marginal locations. The propensity for temporary retro-,lling was controlled by rapid expulsion of ,oodwater from Sólheimajökull, coincident with locations suitable for ,oodwater storage. Floodwater inundated both ice-marginal lake basins, permitting signi,cant volumes of sediment deposition. Coarse-grained deltas prograding from the ice margin and boulders perched on scoured bedrock provide geomorphic records of sudden retro-,lling. The depositional characteristics of lake-basin deposits at Sólheimajökull are similar to jökulhlaup sediments documented in proglacial settings elsewhere; however, their depositional setting and association with ice-marginal landforms is distinctive. Findings suggest that temporary ice-dammed lake formation and drainage has the capacity to alter the shape of the ,ood hydrograph, especially if drainage of a temporary lake is superimposed on the original jökulhlaup. Deposits associated with lake-basin retro-,lling have a long-term preservation potential that could help to identify temporary ice-dammed lake formation in modern and ancient glacial environments. Copyright © 2003 John Wiley & Sons, Ltd. [source] Pre- and post-test mathematical modelling of a plan-asymmetric reinforced concrete frame building,EARTHQUAKE ENGINEERING AND STRUCTURAL DYNAMICS, Issue 11 2006Peter Fajfar Abstract Pre- and post-test analyses of the structural response of a three-storey asymmetric reinforced concrete frame building were performed, aimed at supporting test preparation and performance as well as studying mathematical modelling. The building was designed for gravity loads only. Full-scale pseudo-dynamic tests were performed in the ELSA laboratory in Ispra. In the paper the results of initial parametric studies, of the blind pre-test predictions, and of the post-test analysis are summarized. In all studies a simple mathematical model, with one-component member models with concentrated plasticity was employed. The pre-test analyses were performed using the CANNY program. After the test results became available, the mathematical model was improved using an approach based on a displacement-controlled analysis. Basically, the same mathematical model was used as in pre-test analyses, except that the values of some of the parameters were changed. The OpenSees program was employed. Fair agreement between the test and numerical results was obtained. The results prove that relatively simple mathematical models are able to adequately simulate the detailed seismic response of reinforced concrete frame structures to a known ground motion, provided that the input parameters are properly determined. Copyright © 2006 John Wiley & Sons, Ltd. [source] Competence of New Emergency Medicine Residents in the Performance of Lumbar PuncturesACADEMIC EMERGENCY MEDICINE, Issue 7 2005Richard L. Lammers MD Abstract Background: Medical students are taught some procedural skills during medical school, but there is no uniform set of procedures that all students learn before residency. Objective: To determine the level of competence in the performance of a lumbar puncture (LP) by new postgraduate year 1 (PGY1) emergency medicine (EM) residents. Methods: An observational study was conducted at three EM residencies with 42 PGY1 residents who recently graduated from 26 various medical schools. The LP procedure was divided into 26 major and 44 minor steps to create a scoring protocol. The model, procedure, and scoring protocol were validated by experienced emergency physicians. Subjects performed the procedure without interruption or feedback on an LP training model using a standard LP kit. A step was scored as "performed correctly" if two of the three evaluators concurred. Pre- and poststudy questionnaires assessed subjects' prior instruction and clinical experience with LP, self-confidence, sense of relevance, motivation, and fatigue. Results: Subjects completed an average of 14.8 (57%; 95% confidence interval [95% CI] = 53% to 61%) of the major steps (range: 4,26) and 19.1 (43%; 95% CI = 42% to 45%) of the minor steps (range: 7,28) in 14.3 minutes (range: 3,22). Sixty-nine percent failed to obtain cerebrospinal fluid from the model. Subjects' levels of confidence changed slightly on a five-point scale from 2.8 ("little-to-some") before the test to 2.5 after the test. Eighty-three percent of the subjects previously performed LPs on patients during medical school (average attempts = 2.2; range: 0,10), but only 40% of those who did so were supervised by an attending during their first attempt. Conclusions: In the cohort studied, new PGY1 EM residents had not attained competence in performing LPs from training in medical school. Most new PGY1 residents probably require training, practice, and close, direct supervision of this procedure by attending physicians until the residents demonstrate competent performance. [source] Outcome after hemispherectomy in hemiplegic adult patients with refractory epilepsy associated with early middle cerebral artery infarctsEPILEPSIA, Issue 6 2009Arthur Cukiert Summary Purpose:, To study the outcome after hemispherectomy (HP) in a homogeneous adult patient population with refractory hemispheric epilepsy. Methods:, Fourteen adult patients submitted to HP were studied. Patients had to be at least 18 years old, and have refractory epilepsy, clearly focal lateralized seizures and unilateral porencephalus consistent with early middle cerebral artery infarct on magnetic resonance imaging (MRI). All patients were submitted to functional hemispherectomy. We analyzed age of seizure onset, age by the time of surgery, gender, seizure type and frequency, interictal and ictal electroencephalography (EEG) findings, MRI and IQ scores preoperatively; seizure frequency, drug regimen, and IQ outcome were studied postoperatively. Results:, Mean follow-up was 64 months. All patients had frequent daily seizures preoperatively. All patients had unilateral simple partial motor seizures (SPS); 11 patients had secondarily generalized tonic,clonic (GTC) seizures and five patients had complex partial seizures (CPS), preoperatively. All patients had hemiplegia and hemianopsia. Twelve patients had unilateral EEG findings, and in two epileptic discharges were seen exclusively over the apparently normal hemisphere. Twelve patients were seizure-free after surgery and two patients had at least 90% improvement in seizure frequency. Pre- and postoperative mean general IQ was 84 and 88, respectively. Five of the twelve Engel I patients were receiving no drugs at last follow-up. There was no mortality or major morbidity. Conclusions:, Our results suggest that well-selected adult patients might also get good results after HP. Although good results were obtained in our adult series, the same procedure yielded a much more striking result if performed earlier in life. [source] Seizure Outcome after Resection of Supratentorial Cavernous Malformations: A Study of 168 PatientsEPILEPSIA, Issue 3 2007Christian R. Baumann Summary:,Purpose: The optimal management of cerebral cavernous malformations (CCMs) with epileptic seizures is still a matter of debate. The aim of our study was to examine seizure outcome in the largest published series of surgically treated patients with epilepsy due to a supratentorial CCM, and to define predictors for good surgical outcome. Methods: We retrospectively studied 168 consecutive patients with a single supratentorial CCM and symptomatic epilepsy in a multicenter study. Pre- and postoperative clinical examinations, age at epilepsy onset, age at operation, type of symptoms due to the CCM (seizures, headache, hemorrhage, focal deficits), type and frequency of epileptic seizures, and the localization and size of the CCM were assessed. Seizure outcome was determined in the first, second, and third postoperative years. Results: The CCM was completely resected in all patients. More than two thirds of the patients were classified as seizure free in the first 3 postoperative years. Predictors for good seizure outcome were age older than 30 years at the time of surgery, mesiotemporal CCM localization, CCM size <1.5 cm, and the absence of secondarily generalized seizures. No mortality occurred in our series, but only mild postoperative neurologic deficits in 12 (7%) patients. Conclusions: Considering the natural history of CCMs, the favorable neurologic and seizure outcome, surgical resection of CCMs should be considered in all patients with supratentorial CCMs and concomitant epilepsy, irrespective of the presence or absence of predictors for a favorable seizure outcome. [source] Ibotenate Injections into the Pre- and Parasubiculum Provide Partial Protection against Kainate-Induced Epileptic Damage in Layer III of Rat Entorhinal CortexEPILEPSIA, Issue 7 2001Tore Eid Summary: ,Purpose: A loss of neurons in layer III of the entorhinal cortex (EC) is often observed in patients with temporal lobe epilepsy and in animal models of the disorder. We hypothesized that the susceptibility of layer III of the EC to prolonged seizure activity might be mediated by excitatory afferents originating in the presubiculum. Methods: Experiments were designed to ablate the presubiculum unilaterally by focal ibotenate injections and to evaluate the effect of this deafferentation on the vulnerability of EC layer III neurons to the chemoconvulsant kainate (injected systemically 5 days later). Results: After treatment with kainate, 11 of the 15 rats preinjected with ibotenate showed clear-cut, partial neuroprotection in layer III of the EC ipsilateral to the ibotenate lesion. Serial reconstruction of the ibotenate-induced primary lesion revealed that entorhinal neurons were protected only in animals that had lesions in the pre- and parasubiculum, especially in the deep layers (IV,VI). Conclusions: The deep layers of the pre- and parasubiculum appear to control the seizure-induced damage of EC layer III. This phenomenon may be of relevance for epileptogenesis and for the pathogenesis of temporal lobe epilepsy. [source] Return to work following unilateral enucleation in 34 horses (2000,2008)EQUINE VETERINARY JOURNAL, Issue 2 2010M. E. UTTER Summary Reasons for study: The effect of unilateral enucleation on vision and potential loss of performance in horses has received little study. Objective: To evaluate the likelihood of return to prior discipline following unilateral enucleation in horses, assessing the role of age at enucleation, equine discipline, reason for enucleation, time to vision loss and eye enucleated. Hypothesis: Unilateral enucleation has no significant effect on likelihood of return to work in horses, for both right and left eyes, across age and discipline. Method: A retrospective review of medical records identified 92 horses that underwent unilateral enucleation at the University of Pennsylvania New Bolton Center from April 2000,April 2008. Case variables determined from the medical record included breed and sex of horse, age at enucleation, which eye was enucleated, reason for enucleation and onset of vision loss. Pre- and post operative occupations were determined by telephone interview with the owner or trainer of each horse. Results: Based on hospital surgery logs, 92 enucleations were performed over the 8 year period and 77 records were available for review, with follow-up information available for 34 horses. Of these, 29/34 (85%) horses returned to work in pleasure or trail riding (11/13), flat racing (7/10), hunter/jumpers (4/4), dressage (3/3), group lessons (1/1), eventing (1/1), steeplechase (1/1) and as a broodmare (1/1). Four of 5 horses (4/34, or 12% sample) that did not return to work (2 pleasure and 2 racing) were retired due to anticipated or perceived decrease in performance or behaviour change following unilateral enucleation, with the remaining horse retired from racing for lameness issues unrelated to enucleation. Twenty-two of 25 horses (88%) with acute vision loss and 7/9 horses (78%) with gradual vision loss returned to their previous discipline. Conclusions: Horses are able to return to a variety of occupations after unilateral enucleation. [source] Older patients' experiences of treatment for colorectal cancer: an analysis of functional status and service useEUROPEAN JOURNAL OF CANCER CARE, Issue 5 2004C. BAILEY msc, rgn Age and ageing are an important part of the context within which the care and treatment of people with cancer is provided. More information is needed about the effects of cancer treatment on the lives of older people following inpatient care. We conducted a 3-year study in which older people with colorectal cancer completed a detailed questionnaire on multidimensional function and service use before and after elective treatment. Here we present an analysis of changes in functional status and service use over the pre- to post-treatment period, and set out a detailed picture of older people's experiences before and after treatment. In total, 337 patients with colorectal adenocarcinoma aged 58,95 years were interviewed before treatment using the OARS Multidimensional Functional Assessment Questionnaire (OMFAQ), Rotterdam Symptom Checklist (RSCL) and a severity of morbidity score. Study end points were defined as post-treatment functional status, symptom distress, severity of morbidity and frequency of service use. Pre- and post-treatment data were compared using matched analyses. Logistic regression was used to assess associations between age and the main outcome measures, and frequency of service use after treatment was compared between age groups using the ,2 test. Overall, patients experienced both positive and negative outcomes following treatment. It was notable that patients aged ,,75 years showed improvement in only one of the principal outcome measures. Patterns of service use following treatment suggest that support at home is a key issue for patients. With the exception of nursing care, however, help at home is provided on a majority of occasions by families themselves. This raises important questions about how much preparation patients and families receive or would like before they leave hospital after treatment for cancer. A collaborative, family-centred approach to meeting people's needs is called for in the months following inpatient care. [source] Learner-control vs. program-control instructional multimedia: a comparison of two interactions when teaching principles of orthodontic appliancesEUROPEAN JOURNAL OF DENTAL EDUCATION, Issue 4 2005M. Aly Abstract Background:, Many studies have compared computer assisted learning (CAL) to more traditional learning formats and have shown CAL to be as effective as or superior to the alternative resources. However, there are only scarce attempts to show which style of CAL leads to the best learning outcomes in orthodontics. Aim:, To compare the effectiveness of a learner-control (group A) vs. program-control (group B) multimedia learning environment courseware packages regarding knowledge, understanding and transfer of content when applied to teaching principles of orthodontic appliances to undergraduate students. Methods:, Pre- and post-test assessments of undergraduate dental students (n = 30) who either studied a learner-control multimedia learning environment courseware package (n = 15) or a program-control version (n = 15) on equivalent material of the orthodontic appliances curriculum. Both groups were evaluated by means of multiple-choice questions covering knowledge, understanding and application. A one-way ANOVA was carried out in order to check for statistical difference between the two groups. The P -value was set at 0.05. Results:, There was no difference in prior knowledge between both groups at baseline. Although, both groups significantly improved their scores after having studied the course, no significant difference was found between both groups in relation to answers to questions about knowledge, understanding and application. Conclusions:, In this study, the learner-control instructional multimedia program was found to be as effective as the program-control version when teaching principles of the orthodontic appliances to undergraduate students. The focus needs to be on improving the value of CAL. Comparative evaluations of how different CAL approaches compare with or complement one another are certainly needed. [source] Validation of the Pulmonary Score: An Asthma Severity Score for ChildrenACADEMIC EMERGENCY MEDICINE, Issue 2 2002Sharon R. Smith MD Objectives: In the absence of a validated "user-friendly" method of scoring asthma severity, the authors derived the pulmonary score (PS). The purpose of this study was to begin validation trials of the PS by comparing it with the peak expiratory flow rate (PEFR). Methods: The study enrolled a convenience sample of children, aged 5-17 years, who came to the emergency department (ED) for treatment of an acute asthma exacerbation. The PEFR (best of three attempts) and the PS were measured before and after the first albuterol treatment by a physician and a nurse from a pool of 45 trained observers. The PS includes respiratory rate, wheezing, and retractions, each rated on a 0-3 scale. Decreasing PS and increasing PEFR indicate clinical improvement. Pre- and post-treatment PEFRs and PSs were compared using paired t-tests to establish construct validity. Correlation of pre- and post-treatment PSs with PEFRs was measured to establish criterion validity. Results: Forty-six subjects completed the study. Mean percent predicted PEFR improved after treatment by 20.7% (p = 0.0001), and mean PS by 1.5 for nursing-obtained scores (p < 0.0001) and 1.9 for physician-obtained scores (p < 0.0001). Pre- and post-treatment PSs were significantly correlated with PEFRs. Correlations for the nursing-obtained scores were pre-treatment r = -0.57 (p = 0.0003) and post-treatment r = -0.67 (p = 0.0001), and for the physician-obtained scores were pre-treatment r = -0.44 (p = 0.003) and post-treatment r = -0.56 (p = 0.0001). The pre-treatment interrater reliability was 0.62 and the post-treatment was 0.53. Conclusions: These data support the construct and criterion validities of the PS as a measure of asthma severity among children in the ED. The PS is a practical substitute to estimate airway obstruction in children who are too young or too sick to obtain PEFRs. [source] | |||||||||||||||||||||||||||||||||||||||||||