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Reevaluation
Selected AbstractsThe Role of Intracranial Electrode Reevaluation in Epilepsy Patients After Failed Initial Invasive MonitoringEPILEPSIA, Issue 5 2000Adrian M. Siegel Summary: Purpose: Intracranial electrode recording often provides localization of the site of seizure onset to allow epilepsy surgery. In patients whose invasive evaluation fails to localize seizure origin, the utility of further invasive monitoring is unknown. This study was undertaken to explore the hypothesis that a second intracranial investigation is selected patients warrants consideration and can lead to successful epilepsy surgery. Methods: A series of 110 consecutive patients with partial epilepsy who had undergone intracranial electrode evaluation (by subdural strip, subdural grid, and/or depth electrodes) between February 1992 and October 1998 was retrospectively analyzed. Of these, failed localization of seizure origin was thought to be due to sampling error in 13 patients. Nine of these 13 patients underwent a second intracranial investigation. Results: Reevaluation with intracranial electrodes resulted in satisfactory seizure-onset localization in seven of nine patients, and these seven had epilepsy surgery. Three frontal, two temporal, and one occipital resection as well as one multiple subpial transection were performed. Six patients have become seizure free, and one was not significantly improved. The mean follow-up is 2.8 years. There was no permanent morbidity. Conclusions: In selected patients in whom invasive monitoring fails to identify the site of seizure origin, reinvestigation with intracranial electrodes can achieve localization of the region of seizure onset and allow successful surgical treatment. [source] 3T versus 1.5T phased-array MRI in the presurgical work-up of patients with partial epilepsy of uncertain focusJOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 2 2009Maeike Zijlmans MD Abstract Purpose To study 3T compared to 1.5T phased array magnetic resonance imaging (MRI) in the presurgical work-up of patients with epilepsy with complex focus localization. Materials and Methods In all, 37 patients (>10 years) in preoperative work-up for epilepsy surgery were offered 3T in addition to 1.5T MRI if ambiguity existed about the epileptic focus. Scans were randomly reviewed by two observers, blinded for prior imaging, patient-identifying information, and each other's assessments, followed by a consensus meeting. The number of abnormal scans, detected lesions, and interobserver agreement were calculated and compared. The final consensus was compared to original scan reports. Results One observer identified 22 lesions in both 3 and 1.5T scans, while the second identified more lesions in 1.5T scans (28 vs. 20). 3T MRI had better interobserver agreement. 3T revealed more dysplasias, while 1.5T revealed more tissue loss and mesial temporal sclerosis (MTS). The final consensus yielded 29 lesions, whereas original reports identified only 17 lesions. Conclusion The 3T scans revealed different lesions compared to 1.5T. Patients can benefit most from 3T scans when a dysplasia is suspected. Reevaluation by another experienced neuroradiologist is advised in case of negative or equivocal MRIs. J. Magn. Reson. Imaging 2009;30:256,262. © 2009 Wiley-Liss, Inc. [source] Ensuring Clinical Education Outcomes: A Call for Reevaluation and ReformJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 12 2005COLUMN EDITOR Scott Weber EdD, FACHE, FHIMSS No abstract is available for this article. [source] Reevaluation of the Dietary Protein Requirement of Japanese Flounder Paralichthys olivaceusJOURNAL OF THE WORLD AQUACULTURE SOCIETY, Issue 2 2003Kangwoong Kim An experiment was conducted to determine the dietary protein requirement by different analysis methods and to study the effects of dietary protein levels on growth performance and body composition in Japanese flounder Paralichthys olivaceus fed white fish meal and casein-based diets for 8 wk. After a 1-wk conditioning period, one of six isocaloric diets containing 30, 36, 42, 48, 54, and 60% crude protein (CP) was fed to fish at approximately 4,5% of wet body weight on a dry matter basis to triplicate groups of 15 fish averaging 13.3 ± 0.06 g (mean ± SD). After 8 wk of the feeding trial, weight gain (WG) and feed efficiency (FE) from fish fed 48% CP diet were similar to those from fish fed 42% and 54% CP diets, and were significantly higher than those from fish fed 30, 36 and 60% CP diets (P < 0.05). Fish fed 48 and 54% CP diets had a significant higher specific growth rate (SGR) than did fish fed 30 and 36% CP diets (P 0.05). Protein efficiency ratio (PER) was inversely related to the dietary protein level. No significant differences existed in hematocrit (PCV) and survival rate among the dietary treatments. Broken-line model analysis indicated that the optimum dietary protein level could be 44.0 ± 3.0% for maximum WG in Japanese flounder. Polynomial regression analysis of the dose-response showed that maximum WG occurred at 50.2% (R2= 0.94) based on WG, and the second-order polynomial regression analysis with 95% confidence limits revealed that the range of minimum protein requirement was between 38.9% and 40.3% based on WG. Therefore, these findings suggest that the optimum dietary protein requirement for maximum growth of Japanese flounder is greater than 40%, but less than 44% CP in the fish meal and casein-based diets containing 17.0 kJ/g of energy. [source] A Reevaluation of the New York Court of Appeals: The Home, the Market, and Labor, 1885-1905LAW & SOCIAL INQUIRY, Issue 3 2002Felice Batlan Closely examining a range of New York Court of Appeals police-power cases during the period 1885 to 1905, this article demonstrates that the New York Court had a long history of accepting and continually expanding the police power. In these police-power cases, one finds the court grappling with an evolving sense of how to balance the concept of and need for a well-regulated society against the rights of an individual in an increasingly complex and interconnected world, as well as a tenacious refusal to abandon Victorian bourgeois norms regarding the dichotomy between the home and workplace. By contextualizing and historicizing New York Court of Appeals cases, the article challenges the dominant historiographical interpretations about late-nineteenth-century law. Moving away from a paradigm that labels the court conservative or liberal, formalist or realist, it argues that the court participated in creating a regulatory state while also employing a reasoning that adopted a sharp distinction between the market and the site of the domestic. [source] Intrathecal Baclofen and Catheter Tip Inflammatory Mass Lesions (Granulomas): A Reevaluation of Case Reports and Imaging Findings in Light of Experimental, Clinicopathological, and Radiological EvidencePAIN MEDICINE, Issue 4 2008T. R. Deer MD First page of article [source] Reevaluation of the Phylogenetic Relationship between Mobilid and Sessilid Peritrichs (Ciliophora, Oligohymenophorea) Based on Small Subunit rRNA Genes SequencesTHE JOURNAL OF EUKARYOTIC MICROBIOLOGY, Issue 5 2006YING-CHUN GONG ABSTRACT. Based on morphological characters, peritrich ciliates (Class Olygohymenophorea, Subclass Peritrichia) have been subdivided into the Orders Sessilida and Mobilida. Molecular phylogenetic studies on peritrichs have been restricted to members of the Order Sessilida. In order to shed more light into the evolutionary relationships within peritrichs, the complete small subunit rRNA (SSU rRNA) sequences of four mobilid species, Trichodina nobilis, Trichodina heterodentata, Trichodina reticulata, and Trichodinella myakkae were used to construct phylogenetic trees using maximum parsimony, neighbor joining, and Bayesian analyses. Whatever phylogenetic method used, the peritrichs did not constitute a monophyletic group: mobilid and sessilid species did not cluster together. Similarity in morphology but difference in molecular data led us to suggest that the oral structures of peritrichs are the result of evolutionary convergence. In addition, Trichodina reticulata, a Trichodina species with granules in the center of the adhesive disc, branched separately from its congeners, Trichodina nobilis and Trichodina heterodentata, trichodinids without such granules. This indicates that granules in the adhesive disc might be a phylogenetic character of high importance within the Family Trichodinidae. [source] Azathioprine in Liver Transplantation: A Reevaluation of Its Use and a Comparison with Mycophenolate MofetilAMERICAN JOURNAL OF TRANSPLANTATION, Issue 8 2009G. Germani Calcineurin inhibitors (CNIs) combined with steroids with or without azathioprine (AZA), have been a standard immunosuppression regimen after liver transplantation (LT). Since 2000 many centers have substituted AZA by mycophenolate mofetil (MMF). However, in LT the superiority of MMF over AZA is not clearly demonstrated. Therefore, we questioned the benefit of MMF versus AZA in LT with regard to rejection, renal dysfunction and hepatitis C virus (HCV) recurrence and survival. Using a literature search, relevant randomized controlled trials (RCT) and cohort studies were identified: two RCTs compared MMF to AZA only for acute rejection. Treated rejection was less with MMF in only one RCT (38.5% vs. 47.7%; p = 0.025), with no difference in patient and graft survival. No RCTs compared MMF and AZA in patients with CNI-related chronic renal dysfunction. Among two studies evaluating MMF, with substitution of AZA, one was stopped due to severe rejection. Recurrent HCV was less severe in 5/9 studies with AZA compared with 2/17 using MMF, six of which documented worse recurrence. Published data in LT show little, if any, clinical benefit of MMF versus AZA. RCTs should reevaluate AZA in LT. Evaluation of HCV replication and recurrence will be particularly important as AZA may have advantages over MMF. [source] Reevaluation of the interaction between HLA,DRB1 shared epitope alleles, PTPN22, and smoking in determining susceptibility to autoantibody-positive and autoantibody-negative rheumatoid arthritis in a large UK Caucasian populationARTHRITIS & RHEUMATISM, Issue 9 2009Ann W. Morgan Objective To define interactions between the HLA,DRB1 shared epitope (SE), PTPN22, and smoking in cyclic citrullinated peptide (CCP) antibody, and rheumatoid factor (RF),positive and ,negative rheumatoid arthritis (RA). Methods Data on ,5,000 RA patients and ,3,700 healthy controls recruited from 6 centers in the UK were analyzed; not all centers had both genotype data and smoking data available for study. The magnitude of association was assessed in autoantibody-positive and -negative subgroups. The effect of smoking on antibody status among cases was assessed following adjustment for year of birth and center, using Mantel-Haenszel analysis. Analyses of the combined effects of PTPN22, HLA,DRB1 SE, and smoking were performed using additive and multiplicative models of interaction within a logistic regression framework. Results The combined effects of PTPN22, HLA,DRB1 SE, and smoking were defined, with no evidence of departure from a multiplicative model. Within the case population, all 3 factors were independently associated with the generation of CCP antibodies (odds ratio [OR] 11.1, P < 0.0001), whereas only HLA,DRB1 SE and smoking were independently associated with RF production (OR 4.4, P < 0.0001). There was some evidence of increasing likelihood of antibody positivity with heavier smoking. Finally, we demonstrated that smoking was associated with the generation of both CCP and RF antibodies (OR 1.7, P = 0.0001). Conclusion PTPN22 appears to be primarily associated with anticitrulline autoimmunity, whereas HLA,DRB1 SE is independently associated with RF. This study has confirmed associations of specific gene,environment combinations with a substantially increased risk of developing RA. Further work is needed to determine how these data can be used to inform clinical practice. [source] Cytologic diagnosis of osseous lesions: A review with emphasis on the diagnosis of primary neoplasms of boneDIAGNOSTIC CYTOPATHOLOGY, Issue 4 2009Lester J. Layfield M.D. Abstract Fine-needle aspiration has been utilized as the initial diagnostic technique at a large number of body sites for over three quarters of a century. As early as the 1930s, fine-needle aspiration (FNA) was used to investigate lesions of the musculoskeletal system. In many early reports, FNA was most frequently and successfully used for the diagnosis of metastatic disease to bone. Less emphasis was placed on its utility for the investigation of primary neoplasms of bone and soft tissue. Current utilization of FNA continues to de-emphasize its application to the diagnosis of primary lesions of the musculoskeletal system. Recent advances in imaging techniques, immunohistochemistry, and molecular diagnostics along with an increasing familiarity among pathologists with the cytologic appearance of primary osseous tumors has led to reevaluation of the technique for investigation of these tumors. The diagnostic accuracy of FNA along with its relatively low cost and high degree of safety makes it a desirable technique for the investigation of primary lesions of the musculoskeletal system. This article reviews issues of diagnostic accuracy, optimal practice procedures, and benefits of the technique including cost reduction. The article will review criteria for selection of appropriate tissue targets for FNA to reduce the number of unsatisfactory specimens. Cytomorphologic features of the more common primary neoplasms of bone will be summarized along with recommendations for the utilization of immunohistochemistry and molecular diagnostics in the work-up of primary neoplasms of bone. Diagn. Cytopathol. 2009. © 2009 Wiley-Liss, Inc. [source] Fine-needle aspiration of soft tissue leiomyosarcoma: An analysis of the most common cytologic findings and the value of ancillary techniquesDIAGNOSTIC CYTOPATHOLOGY, Issue 9 2006Henryk A. Domanski M.D., Ph.D. Abstract This study aims to determine the diagnostic accuracy of fine-needle aspiration cytology (FNAC) of primary leiomyosarcoma (LMS) of soft tissue and to review diagnostic criteria and adjunctive methods, which can contribute to a confident diagnosis. We evaluated the preoperative FNAC in 89 patients with primary LMS for the following: cytomorphology and correspondence of FNA to histological features of excised tumors and clinical data. In addition, the utility of adjunctive techniques was analyzed and other spindle-cell lesions in the differential diagnoses were discussed. An unequivocal, malignant diagnosis was rendered by FNAC in 78 cases; 74 tumors were diagnosed as sarcoma, of which 31 as LMS or suspicion of LMS. In addition, three smears were labeled as malignant tumor, one as carcinoma metastasis, and three as neurilemmoma. Seven aspirates were inconclusive and one insufficient. On reevaluation, the diagnostic smears in most cases contained tumor cell fascicles with an admixture of dispersed cells or stripped nuclei. The most common cells were spindle cells with elongated, blunt-ended, segmented or fusiform nuclei, and round/polygonal cells, often with rounded or indented nuclei. In addition, 51 cases showed pleomorphic, often multinucleated cells. Osteoclasts, intranuclear vacuoles, and mitoses occurred in 14, 47, and 27 cases, respectively. Thus, most high-grade LMSs have cytologic features that allow diagnosis of sarcoma. Ancillary studies can confirm the diagnosis of LMS and help in the correct interpretation of predominant spindle-cell or epitheloid-cell smears resembling neurilemoma or carcinoma, respectively. Diagn. Cytopathol. 2006;34:597,604. © 2006 Wiley,Liss, Inc. [source] Fine-needle aspiration of neurilemoma (schwannoma).DIAGNOSTIC CYTOPATHOLOGY, Issue 6 2006A clinicocytopathologic study of 116 patients Abstract The preoperative fine-needle aspiration cytology (FNAC) diagnoses in 116 surgically excised neurilemomas were reviewed and compared with the corresponding histopathologic diagnoses made on surgical specimens and with clinical data. In addition, the utility of adjunctive techniques was analyzed and other spindle-cell lesions in the differential diagnoses were discussed. An unequivocal, benign diagnosis was rendered by FNAC in 80 cases, 67 of which were correctly labelled as neurilemoma in a review of the original cytology reports. There were 6 false-positive malignant diagnoses while 23 smears were considered insufficient and 7 inconclusive as to whether benign or malignant. On reevaluation, the diagnostic smears in most cases contained spindle cells with wavy nuclei embedded in a fibrillar, occasionally collagenous, and/or myxoid matrix and Antoni A/Antoni B tissue fragments. A moderate to abundant admixture of round to oval cells was also frequent. Nuclear palisading was seen in 41 smears with distinctive Verocay bodies in 10. Markedly pleomorphic nuclei were seen in smears from 8 ancient and 6 conventional neurilemomas, and slight to moderate nuclear pleomorphism was observed in 38 additional cases. Thus most neurilemomas have distinct cytomorphologic features that allow correct diagnosis. The major problem in FNAC of neurilemoma is to obtain sufficient material. Furthermore aspirates showing predominantly Antoni A features, nuclear pleomorphism, and/or myxoid changes can easily be confused with other types of benign or malignant soft-tissue tumors. Diagn. Cytopathol. 2006;34:403,412. © 2006 Wiley-Liss, Inc. [source] Estrogen and progesterone hormone receptor status in breast carcinoma: Comparison of immunocytochemistry and immunohistochemistryDIAGNOSTIC CYTOPATHOLOGY, Issue 3 2002Svetlana Tafjord M.D. Abstract We evaluated the correlation between histologic and cytologic specimens in the determination of estrogen receptor (ER) and progesterone receptor (PR) status in breast carcinoma and investigated the causes of clinically significant discrepancies. We analyzed 70 immunoassays for ER and 60 for PR from 71 patients with breast carcinoma. Concordance between cytology and histology was 89% for ER and 63% for PR using scores from pathology reports. Concordance between cytology and histology was 98% for ER and 91% for PR using consensus scores (obtained after reevaluation by the team of pathologists). Thirty of 130 (23%) tests had clinically relevant discrepancies, 53% of which were caused by wrong interpretation of cytologic findings, 10% by wrong interpretation of histologic findings, 17% by sampling error and 20% were not available for reevaluation. Wrong interpretation of the results for ER and PR status in cytology was a far more frequent cause of clinically relevant discrepancies than sampling errors. The use of strict criteria is recommended. Diagn. Cytopathol. 2002;26:137,141; DOI 10.1002/dc.10079 © 2002 Wiley-Liss, Inc. [source] Seismic performance and new design procedure for chevron-braced framesEARTHQUAKE ENGINEERING AND STRUCTURAL DYNAMICS, Issue 4 2006Edoardo M. Marino Abstract The paper is concerned with the seismic design of steel-braced frames in which the braces are configured in a chevron pattern. According to EuroCode 8 (EC8), the behaviour factor q, which allows for the trade-off between the strength and ductility, is set at 2.5 for chevron-braced frames, while 6.5 is assigned for most ductile steel moment-resisting frames. Strength deterioration in post-buckling regime varies with the brace's slenderness, but EC8 adopts a unique q value irrespective of the brace slenderness. The study focuses on reevaluation of the q value adequate for the seismic design of chevron-braced frames. The present EC8 method for the calculation of brace strength supplies significantly different elastic stiffnesses and actual strengths for different values of brace slenderness. A new method to estimate the strength of a chevron brace pair is proposed, in which the yield strength (for the brace in tension) and the post-buckling strength (for the brace in compression) are considered. The new method ensures an identical elastic stiffness and a similar strength regardless of the brace slenderness. The advantage of the proposed method over the conventional EC8 method is demonstrated for the capacity of the proposed method to control the maximum inter-storey drift. The q values adequate for the chevron-braced frames are examined in reference to the maximum inter-storey drifts sustained by most ductile moment-resisting frames. When the proposed method is employed for strength calculation, the q value of 3.5 is found to be reasonable. It is notable that the proposed method does not require larger cross-sections for the braces compared to the cross-sections required for the present EC8 method. Copyright © 2005 John Wiley & Sons, Ltd. [source] Interobserver and intraobserver reproducibility in focal cortical dysplasia (malformations of cortical development)EPILEPSIA, Issue 12 2009Wendy A. Chamberlain Summary Purpose:, Malformations of cortical development (MCD) (cortical dysplasias) are well-recognized causes of intractable epilepsy. Although a histologic classification system for MCD has been proposed by Palmini et al. (Neurology; 2004; 62:S2), studies to date have not assessed reproducibility. The purpose of this study was to analyze inter- and intraobserver agreement among eight experienced neuropathologists (NPs) with respect to this classification system. Methods:, Sections from 26 epilepsy resections were selected to represent the range of pathologies described by Palmini et al. Recuts of single sections from each case were sent to the NPs to classify. The slides were resent at a later date for reclassification. Kappa analysis for both inter- and intraobserver concordance was performed. Results:, Interobserver agreement was moderate (, = 0.4968). There was ,62.5% (5 of 8 NPs) agreement for 19 of 26 cases. The greatest concordance was present when making focal cortical dysplasia (FCD) types IIA/B classifications (12 of the 14 cases with ,75% consensus). Mild MCD (types I/II) and FCD types IA/B classifications were the least reproducible, and used most frequently in cases without consensus. Intraobserver concordance was moderate to very good (range , = 0.4654,0.8504). The category with the fewest classification changes made on reevaluation was FCD type IIB (4.2%), whereas that with the most changes was mild MCD (types I/II) (52.9%). Discussion:, Interobserver concordance using this approach was moderate. The classification categories with the greatest concordance were FCD type IIA/B, and the least, mild MCD and FCD types IA/B. In addition, difficulty in differentiating Mild MCD/FCD type I lesions from normal and/or gliotic tissue was noted. [source] Epilepsy as a Consequence of Cerebral Malaria in Area in Which Malaria Is Endemic in Mali, West AfricaEPILEPSIA, Issue 5 2006Edgard Brice Ngoungou Summary:,Purpose: Cerebral malaria (CM) is suspected to be a potential cause of epilepsy in tropical areas, but little information is available. The purpose of this study was to evaluate the role of CM in epilepsy among children in Mali. Methods: An exposed,nonexposed study was performed to identify children who had epilepsy after malaria in the 0- to 15-year age group. The exposure factor was CM defined according to World Health Organization (WHO) criteria, and the nonexposure factor was symptomatic malaria without the characteristics of CM (NCM). All the children underwent a screening questionnaire and were examined by a medical physician. After the screening phase, a specialist in neuropediatrics examined the children suspected to have epilepsy. EEG and computed tomography (CT) scans were performed in some of these patients. Results: In total, 101 subjects who had had CM and 222 who had had NCM were included. Fifty-four children (CM, 34; NCM, 20) were suspected to have epilepsy, and six were confirmed (CM, five; NCM, one). The incidence rate was 17.0 per 1000 person-years in the CM group and 1.8 per 1000 person-year in the NCM group; thus the relative risk (RR) was 9.4 [95% confidence interval (CI), 1.3,80.3; p = 0.02]. After adjustment on age and duration of follow-up, the RR was 14.3 (95% CI, 1.6,132.0; p = 0.01). Conclusions: The risk of sequelar epilepsy is significantly higher in the CM group compared with the NCM group. A reevaluation of this cohort should be carried out later to search for temporal epilepsy that appeared after age 10 years. [source] Usefulness of the Head-Upright Tilt Test for Distinguishing Syncope and Epilepsy in ChildrenEPILEPSIA, Issue 6 2001J. Eirís-Puñal Summary: ,Purpose: Episodic loss of consciousness in children, whether or not associated with hypertonia or short-duration clonic movements, presents a diagnostic challenge to the pediatrician and child neurologist. We provide some evidence of the usefulness of the head-upright tilt test for investigating the causes of transient loss of consciousness in children, and for distinguishing between syncope, convulsive syncope, and epilepsy. Methods: We studied nine children previously diagnosed as epileptic on the basis of compatible clinical events and epileptiform findings in routine EEGs who were treated over the long term with antiepileptic drugs, but whose clinical records suggested syncope or convulsive syncope rather than epilepsy on reevaluation. All subjects underwent head-upright tilt testing. Results: The tilt-test result was positive in all nine cases, with the patients reporting the same symptoms as in the previously considered epileptic attacks. Conclusions: Inadequate histories and misuse/overinterpretation of EEG results often lead to misdiagnosis of epilepsy in children. The head-upright tilt test is a useful and reliable diagnostic technique, allowing syncopal events to be induced and evaluated under controlled conditions. In a subset of patients, it may help to distinguish epilepsy from simple or convulsive syncope. [source] Early Recognition of Benign Partial Epilepsy in InfancyEPILEPSIA, Issue 6 2000Akihisa Okumura Summary: Purpose: The aim of this study is to determine how precisely we can recognize the outcome in infants with epilepsy beginning in the first year of life. Methods: We performed a prospective 5-year follow-up study on 63 patients who developed epilepsy in the first year of life. We first judged that patients met the criteria of "possible benign partial epilepsy in infancy (BPEI)" on enrollment in this study. At 2 years of age, we reevaluated the seizure and developmental outcome in the patients who were diagnosed as having "possible BPEI." We finally judged that patients met the criteria of "definite BPEI" at age 5 years. "Possible BPEI" was defined as epilepsy meeting all the following conditions: (a) complex partial seizures and/or secondarily generalized seizures; (b) normal psychomotor development and neurologic findings before onset; (c) normal interictal electroencephalograms; (d) normal cranial computed tomography (CT) and magnetic resonance imaging (MRI) findings; and (e) no seizures during the first 4 weeks of life. "Definite BPEI" was defined as epilepsy meeting all the following criteria in addition to those of "possible BPEI": (a) normal psychomotor development beyond age 5 years, and (b) no seizures beyond age 2 years. Results: Thirty-two of the 63 patients met the inclusion criteria completely and were included in the "possible BPEI" group. Twenty-five of the 32 patients completed the 5-year follow-up. At age 2 years, four patients were excluded from the "possible BPEI" group because of seizure recurrence and/or delayed development. By age 5 years, one had a recurrence of seizures, and another exhibited mildly delayed psychomotor development. We finally diagnosed 19 patients as having "definite BPEI.""Definite BPEI" accounted for 76% of the patients diagnosed as having "possible BPEI" at the first presentation and 90% of those who met the conditions on reevaluation at age 2 years. Conclusions: Recognition of BPEI is possible, to some extent, at the first presentation, and reevaluation at age 2 years is useful for a more precise diagnosis. [source] Evaluation of the genetic basis of phenotypic heterogeneity in north Indian patients with Thalassemia majorEUROPEAN JOURNAL OF HAEMATOLOGY, Issue 6 2010Nidhi Sharma Abstract Objectives: To assess the molecular basis of phenotypic heterogeneity in north Indian patients with thalassemia major (TM). Methods: To determine the clinical severity, 130 patients of TM were studied for the age of first presentation and frequency of blood transfusion. The type of beta mutations, Xmn,1G, polymorphism and G6PD Mediterranean mutation was characterized. Analysis of the phenotypic presentation and the genotype was performed. Results: Majority (83.8%) presented before 1 year of age (mean 8.8 months). The caste distribution showed 41.6% were Aroras and 32.3% were migrants from Pakistan. IVS1-5(G,C) was commonest (32.7%) and the common five Indian mutations comprised of 88.4% of alleles. The mean age of presentation with IVS1-5(G,C), Fr 8/9, (+G) 619-bp del and IVS1-1(G,T) homozygosity was 4.3, 6, 3.4 and 9.1 months respectively. Xmn,1G, status showed ,/, in 66.9%, +/, in 26.1% and +/+ in 6.9% patients. Xmn,1G,,/, presented before 1 year of age. The mean age of presentation with +/+ was 18.3 months. Six hemizygous boys and one heterozygous girl with G6PD Mediterranean were found (prevalence 5.3%). Eight patients could be reclassified as thalassemia intermedia on follow up. Conclusions: This study showed that majority of TM in north India present before 1 year of age and homozygous 619-bp deletion presents the earliest. The presence of Xmn-1G, polymorphism delays the presentation, is associated with the IVS 1-1 (G,T) and shows variable improvement with hydroxyurea therapy. Based on the results of genotyping, reevaluation of patients can improve the outcome in a few patients. [source] Overcoming disciplinary solitude: The archaeology and geology of native copper in Eastern North AmericaGEOARCHAEOLOGY: AN INTERNATIONAL JOURNAL, Issue 1 2007Mary Ann Levine Although native copper has attracted the scholarly attention of both geologists and archaeologists since the middle of the 19th century, it is only recently that native copper studies have benefited from interdisciplinary research. This history of disciplinary solitude can be traced to the professionalization of the two fields in the early 20th century, an era in which crossdisciplinary communication began to wane. The effects of this phenomena resulted in the development of a model of aboriginal native copper procurement by archaeologists that did not take into account the geological literature, which had long identified numerous,rather than a single,source of native copper in North America. In this article, the author discusses how this disciplinary solitude developed and how it resulted in the creation of a dominant model for native copper procurement that constrained our understanding of aboriginal lifeways for generations. The author also considers how increasing collaboration between geologists and archaeologists since the 1970s has led to the reevaluation of an old model of native copper procurement that has been uncritically accepted by most archaeologists for over a century and a half. © 2007 Wiley Periodicals, Inc. [source] Geophysical exploration of Guajará, a prehistoric earth mound in BrazilGEOARCHAEOLOGY: AN INTERNATIONAL JOURNAL, Issue 3 2003Bruce W. Bevan An interdisciplinary team studied Guajará, a prehistoric artificial mound in the Brazilian Amazon. The geophysical surveys and excavations were interactive;this interaction furnished more information than either geophysics or excavation alone could have provided. While seven different geophysical methods were applied, the magnetic survey reported here was particularly valuable. A detailed interpretation of this survey quantified the magnetic material in the mound, and this furnished an initial estimate of the number of cooking hearths in the mound. Ten test excavations were concentrated at magnetic anomalies. These excavations located cooking hearths and burial urns. A reevaluation of the magnetic survey was then done in order to refine the estimate of the number of hearths in the mound; this yielded an estimate of 2200 hearths. This allowed the population of the site to be approximated at 78,156 people. The geophysical survey and excavations also identified possible locations for subsequent broad-area excavations. © 2003 Wiley Periodicals, Inc. [source] Reevaluating the Relationship Between In-, Out-, and Net Migration for Nonmetropolitan Counties: An Update on Beale's U-Shaped CurveGEOGRAPHICAL ANALYSIS, Issue 3 2001Alexander C. Vias The relationship of gross migration to net migration is continuously undergoing reevaluation in the literature. However, one major finding by Beale (1969) that produced the famous u-shaped curve has received little attention, a surprising situation considering the significant changes that have taken place in rural America since 1969. In this paper I use gross migration data from IRS returns for 1995,1998, and differentiate the rates using a number of classification schemes developed by the USDA and the Census Bureau. The results show that rural America is a diverse place, and that migration rates vary tremendously depending on the geographic, economic, and social characteristics of the county. Furthermore, the relationship between gross and net migration varies much more than previously suggested, especially in negative net migration counties, a finding with implications for migration theory and public policy. [source] The Crisis in the Investiture Crisis NarrativeHISTORY COMPASS (ELECTRONIC), Issue 6 2009Maureen C. Miller Recent research has undermined the connection between lay investiture and the iconic event usually seen as the most dramatic expression of the investiture conflict: the encounter of Pope Gregory VII and King Henry IV of Germany at Canossa. This is just one, however, of many interpretive problems plaguing historical narratives of the investiture crisis. This essay briefly summarizes the classic interpretations that have dominated 20th-century understanding of these events and sets out the major problem raised in more recent research. Arguing that a new interpretive framework is necessary, the author suggests two paths forward: a radical reconsideration of the papacy from a truly post-confessional perspective and a reevaluation of the conflict in the context of new understandings of lordship and political change. [source] Effects of aging on early B- and T-cell developmentIMMUNOLOGICAL REVIEWS, Issue 1 2005Hyeyoung Min Summary:, Lymphocyte production in the bone marrow and the thymus is reduced during aging, but why this decline occurs has not been fully elucidated. The ability to isolate hematopoietic stem and progenitor cells using sophisticated flow cytometric strategies and to manipulate them in vitro and in vivo has provided insights into the effects of aging on primary lymphopoiesis. These analyses have showed that intrinsic changes in hematopoietic precursors that affect their proliferative potential are one factor that contributes to the age-related decline in B- and T-cell production. This and other age-related defects may be exacerbated by changes in the lymphopoietic support potential of the bone marrow and thymic microenvironments as well as by age-induced fluctuations in the production of various endocrine hormones. Particular attention with regard to the latter point has focused on changes in the production of sex steroids, growth hormone, and insulin-like growth factor-I. The present review summarizes recent studies of how age-related perturbations affect primary lymphopoiesis and highlights how the data necessitate the reevaluation of a number of existing paradigms. [source] Critical Whiteness Theories and the Evangelical "Race Problem": Extending Emerson and Smith's Divided by FaithJOURNAL FOR THE SCIENTIFIC STUDY OF RELIGION, Issue 3 2008ERIC TRANBY In their 2000 book,Divided by Faith, Michael Emerson and Christian Smith use the case of evangelical Christians to demonstrate how uncompromising individualist ideals get in the way of clear thinking and decisive action about racial inequalities in contemporary American society. We use insights developed from whiteness studies and critical race theory to sharpen and further extend this analysis. More specifically, we suggest: (1) that anti-black stereotypes may be subtler, more pervasive, and more functionally necessary than Emerson and Smith assume; and (2) that the individualistic ideals Emerson and Smith focus on are not race neutral but, instead, are part of a taken-for-granted and vigorously defended majority white culture and identity. These points are developed through a theoretical reconstruction of Emerson and Smith's argument and a reevaluation of their methodological approach and data. Finally, we present data from a recent national survey of race and religion in American life that provide preliminary quantitative support for our revisionist claims. [source] RESIDUAL PECTINESTERASE ACTIVITY IN DEHYDRATED ONION AND GARLIC PRODUCTSJOURNAL OF FOOD PROCESSING AND PRESERVATION, Issue 1 2002ELISABETH GARCIA During the dehydration of onion and garlic products, use of high temperatures is undesirable due to the potential loss of aroma and flavor characteristics. As a consequence, residual pectinesterase (PE) activity may be found in these dehydrated spices. This study reports the presence of PE activity in raw onions and in dehydrated onion and garlic products. Pectinesterase activity is higher in the raw onion stem disks, and dehydrated products made from this tissue, than in the bulbs. Dehydrated onion products induced gelation of citrus pectin solutions and tomato purees. Although some inactivation of PE in dehydrated onion water suspensions and extracts was observed after 10 min at 50C, complete inactivation required 2 min at 82C. Commercial dehydration operations may require reevaluation to eliminate residual PE activity in dehydrated onion and garlic products. [source] Stages of Change, Processes of Change, and Social Support for Exercise and Weight Gain in Postpartum WomenJOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 2 2006Colleen Keller Objectives:, To test the extent to which social support and variables included in the Transtheoretical Model were explanatory for exercise initiation and weight maintenance in postpartum women. Design:, A cross-sectional descriptive design. Setting:, Data were collected in the participant's homes. Participants:, Postpartum women who had normal pregnancies were interviewed and measured on body fat, physical activity, and psychosocial scales. Main outcome measure:, (a) Stages of exercise change measure, (b) Seven Day Recall, (c) Friend and Family Support for Exercise Scale, (d) Processes of Change Questionnaire, and (e) body fat measures including body mass index and percent body fat. Results:, Forty percent reported engaging in vigorous activity less than 1 hour daily, 55% walked less than four city blocks daily, and 52% engaged in less than 2 hours of vigorous weekend activity. Multilinear regression showed that the processes of change contributed 36% to the body mass index, and 21% of the variance in waist-thigh ratio. Of the processes of change, environmental reevaluation correlated significantly with body mass index. Conclusion:, The impact of a woman's weight on others as well as information concerning the health effects of obesity and physical activity could enhance the initiation of exercise in the postpartum woman. JOGNN, 35, 232-240; 2006. DOI: 10.1111/J.1552-6909.2006.00030.x [source] A Clinicopathological Study of Postoperatively Upgraded Early Squamous-Cell Carcinoma of the Uterine CervixJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 4 2000Dr. Manabu Yoshida Abstract Objective: To investigate the clinicopathological backgrounds and diagnostic problems of postoperatively upgraded early squamous-cell carcinomas of the uterine cervix Patients and Methods: A total of 23 patients with postoperatively upgraded early squamous-cell carcinomas who were treated at the Saitama Cancer Center during the period of January 1, 1976, through December 31, 1991, were analyzed clinicopathologically. We reexamined the Pap smears (ectocervix, endocervix), colposcopic findings, punch biopsies, and histological findings of the operative specimens. All patients were divided into one of 3 groups based on each patient's main location of the carcinoma of the cervix: Type A: ectocervical type; Type B: endocervical type; or Type C: combined (ectocervical and endocervical) type. Clinical staging of the uterine cervical carcinomas was done in accordance with the 1994 FIGO rules. Results: The numbers of patients were: Type A, 2; Type B, 10; Type C, 11. Of the 23 patients, 21 (91.3%) had lesions in the endocervical portion at least. Fifteen patients (65.2%) complained of atypical vaginal bleeding. Colposcopic findings suggesting an invasive carcinoma appeared for only 6 patients (26.1%). A cytological reevaluation revealed that the endocervical findings were much stronger than the ectocervical ones in 10 (66.7%) of 15 patients whose smears of both sites could be rechecked. Conclusions: Even if the preoperative diagnosis was early cervical carcinoma, CIS or Stage Ia1, the signs of atypical vaginal bleeding suggested that the final clinical stage would be upgraded after an operation. Furthermore, when the endocervical cytological findings were much more exaggerated than the ectocervical ones, the possibility of deeply invaded endocervical lesions should be considered. [source] Effects of alternative instrumentation strategies in adolescent idiopathic scoliosis: A biomechanical analysisJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 1 2009Martin Robitaille Abstract The recent advent of modern instrumentation systems has improved the correction of scoliosis, but complicated the surgical decision-making process, especially with the introduction of diverse spinal fixation devices, new preoperative corrective maneuvers, and the reevaluation of many rules concerning the selection of fusion levels and other guidelines for surgical correction. Our objective was to assess the biomechanical effects of different instrumentation strategies for the same scoliotic cases. Several instrumentation strategies suggested by a group of 32 experienced senior surgeons for five cases were individually simulated using a validated computer model implemented in a spine surgery simulator. The resulting geometric indices varied among the five cases (e.g., range of main thoracic Cobb angles: 5,17°, 16,29°, 25,44°, 15,34°, 16,32°; kyphosis: 22,33°, 20,54°, 33,55°, 24,49°, 29,46°; and lordosis: 10,52°, 24,38°, 26,54°, 8,28°, 34,53°). The average correction was better with pedicle screws (71%) than with hooks (51%) and hybrid constructs (67%). For the first time, to our knowledge, the effect of different instrumentation strategies was compared on the same patients, which is possible only with a surgery simulator. A large variability of instrumentation strategies existed among experienced surgeons and produced rather different results. This study questions the criteria for optimal configuration and standards to design the best surgical construct. © 2008 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 27:104,113, 2009 [source] Psychometric reevaluation of the Women in Science Scale (WiSS)JOURNAL OF RESEARCH IN SCIENCE TEACHING, Issue 10 2007Steven V. Owen The Women in Science Scale (WiSS) was first developed in 1984, and is still being used in contemporary studies, yet its psychometric properties have not been evaluated with current statistical methods. In this study, the WiSS was administered in its original 27-item form to 1,439 middle and high school students. Confirmatory factor analysis based upon the original description of the WiSS was modestly supportive of the proposed three-factor structure, but the claimed dimensions showed substantial redundancy. Therefore, we split our sample and performed exploratory factor analyses on one half. The most satisfactory solution, a two-factor model, was then applied to the crossvalidation sample with a confirmatory factor analysis. This two-factor structure was supported with a total of 14 items. Factor 1, Equality, contains eight items, and factor 2, Sexism, six items. Although our data are limited to adolescents, the WiSS, with improved psychometric properties, may be used descriptively to assess attitudes toward women in science and with additional stability and repeatability testing, may be used in evaluation research. The shortened WiSS should result in shorter administration time, fewer missing data, and increased acceptance among survey administrators in classroom settings. © 2007 Wiley Periodicals, Inc. J Res Sci Teach 44: 1461,1478, 2007 [source] | |||||||||||||||||||||||||