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Selected Treatment (selected + treatment)
Selected AbstractsIs aperistalsis with complete lower esophageal sphincter relaxation an early stage of classic achalasia?JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Issue 4 2007Jeong Hwan Kim Abstract Background:, Aperistalsis with complete lower esophageal sphinter (LES) relaxation, characterized by the complete relaxation of the LES and aperistalsis of the esophageal body on manometry, has been considered by some authors to be an early manifestation of classic achalasia, which is defined as incomplete relaxation of the LES and aperistalsis of the esophageal body. The aim of the present study was to compare the clinical features of patients with aperistalsis with complete LES relaxation, with those of patients with classic achalasia. Methods:, Eighteen patients with aperistalsis with complete LES relaxation and 53 patients with classic achalasia were analyzed with regard to clinical history, the maximal diameter of the esophageal body on barium esophagogram, LES resting pressure and the duration of LES relaxation on manometric recordings, and the selected treatment and its efficacy. Results:, The aperistalsis with complete LES relaxation group had distinctly different features compared to those of the classic achalasia group including older age, more frequent association with non-cardiac chest pain, less frequent association with dysphagia and weight loss, lower LES resting pressures, and longer duration of LES relaxation. However, the two groups were similar in terms of maximal diameter of the esophageal body, and efficacy associated with pneumatic dilation. Conclusions:, Aperistalsis with complete LES relaxation on manometry is not necessarily an early manifestation of classic achalasia. However, this condition does not preclude a diagnosis of achalasia or a good response to achalasia therapy. [source] Extracorporeal Life Support as Ultimate Strategy for Refractory Severe Cardiogenic Shock Induced by Tako-tsubo Cardiomyopathy: A New Effective Therapeutic OptionARTIFICIAL ORGANS, Issue 10 2009Massimo Bonacchi Abstract We report a possible new therapeutic strategy, using extracorporeal cardiopulmonary support (ECLS), for severe refractory cardiogenic shock (SRCS) in a patient with Tako-tsubo cardiomyopathy (TC). TC is a syndrome characterized by left ventricular wall motion abnormalities, without coronary artery disease, mimicking the diagnosis of acute coronary syndrome. This ventricular dysfunction can be reversible; however, it can progress into refractory cardiogenic shock with limited therapeutic options available. For the first time in a Tako-tsubo patient with refractory cardiogenic shock, we used ECLS treatment in order to rest the heart, sustain circulation and end-organ perfusion, and promote potential ventricular recovery. ECLS might be the selected treatment for SRCS in patients with TC, and seems to be an effective and useful ultimate therapeutic strategy for preventing death. [source] An Adaptive Two-stage Design with Treatment Selection Using the Conditional Error Function ApproachBIOMETRICAL JOURNAL, Issue 4 2006Jixian Wang Abstract As an approach to combining the phase II dose finding trial and phase III pivotal trials, we propose a two-stage adaptive design that selects the best among several treatments in the first stage and tests significance of the selected treatment in the second stage. The approach controls the type I error defined as the probability of selecting a treatment and claiming its significance when the selected treatment is indifferent from placebo, as considered in Bischoff and Miller (2005). Our approach uses the conditional error function and allows determining the conditional type I error function for the second stage based on information observed at the first stage in a similar way to that for an ordinary adaptive design without treatment selection. We examine properties such as expected sample size and stage-2 power of this design with a given type I error and a maximum stage-2 sample size under different hypothesis configurations. We also propose a method to find the optimal conditional error function of a simple parametric form to improve the performance of the design and have derived optimal designs under some hypothesis configurations. Application of this approach is illustrated by a hypothetical example. (© 2006 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim) [source] The effect of surface treatments on the fretting behavior of Ti-6Al-4V alloyJOURNAL OF BIOMEDICAL MATERIALS RESEARCH, Issue 2 2008Matteo Dalmiglio Abstract Stem modularity in total hip replacement introduces an additional taper joint between Ti-6Al-4V stem components with the potential for fretting corrosion processes. One possible way to reduce the susceptibility of the Ti-6Al-4V/Ti-6Al-4V interface to fretting is the surface modification of the Ti-6Al-4V alloy. Among the tested, industrially available surface treatments, a combination of two deep anodic spark deposition treatments followed by barrel polishing resulted in a four times lower material release with respect to untreated, machined fretting pad surfaces. The fretting release has been quantified by means of radiotracers introduced in the alloy surface by proton irradiation. In a simple sphere on flat geometry, the semispherical fretting pads were pressed against flat, dog-bone shaped Ti-6Al-4V fatigue samples cyclically loaded at 4 Hz. In this way a cyclic displacement amplitude along the surfaces of 20 ,m has been achieved. A further simplification consisted in the use of deionized water as lubricant. A comparison of the radiotracer results with an electrochemical material characterization after selected treatments by potentiostatic tests of modular stems in 0.9% NaCl at 40°C for 10 days confirmed the benefit of deep anodic spark deposition and subsequent barrel polishing for improving the fretting behavior of Ti-6Al-4V. © 2007 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 2008 [source] EFFECT OF HIGH HYDROSTATIC PRESSURE ON SPORES OF GEOBACILLUS STEAROTHERMOPHILUS SUSPENDED IN SOYMILKJOURNAL OF FOOD PROCESSING AND PRESERVATION, Issue 5 2007YOKIUSHIRDHILGILMARA ESTRADA-GIRÓN ABSTRACT The inactivation of Geobacillus stearothermophilus spores (ATCC 7953) inoculated in soymilk was investigated using high hydrostatic pressure (550, 585 and 620 MPa) in combination with temperature (70, 80 and 90C) for selected times (2 s to 15 min). Inactivation of spores occurred at all selected treatments. Less than 10 CFU/mL of G. stearothermophilus were observed after 7 min of treatment at 620 MPa and 90C. An increase in the inactivation rate constant, at the highest pressure, was observed, resulting in a decrease in D values at all temperatures. D values were calculated as 10.6, 6.2 and 3.5 min for 70, 80 and 90C, respectively after pressurization at 620 MPa. zp values decreased as temperature increased with values ranging from 142 to 238 MPa. The activation energy required for inactivation of G. stearothermophilus spores in soymilk, at the selected treatments, was in the range of 37.9,57.4 kJ/mol. [source] The Impact of Antioxidant Addition on Flavor of Cheddar and Mozzarella Whey and Cheddar Whey Protein ConcentrateJOURNAL OF FOOD SCIENCE, Issue 6 2010I.W. Liaw Abstract:, Lipid oxidation products are primary contributors to whey ingredient off-flavors. The objectives of this study were to evaluate the impact of antioxidant addition in prevention of flavor deterioration of fluid whey and spray-dried whey protein. Cheddar and Mozzarella cheeses were manufactured in triplicate. Fresh whey was collected, pasteurized, and defatted by centrifugal separation. Subsequently, 0.05% (w/w) ascorbic acid or 0.5% (w/w) whey protein hydrolysate (WPH) were added to the pasteurized whey. A control with no antioxidant addition was also evaluated. Wheys were stored at 3 °C and evaluated after 0, 2, 4, 6, and 8 d. In a subsequent experiment, selected treatments were then incorporated into liquid Cheddar whey and processed into whey protein concentrate (WPC). Whey and WPC flavors were documented by descriptive sensory analysis, and volatile components were evaluated by solid phase micro-extraction with gas chromatography mass spectrometry. Cardboard flavors increased in fluid wheys with storage. Liquid wheys with ascorbic acid or WPH had lower cardboard flavor across storage compared to control whey. Lipid oxidation products, hexanal, heptanal, octanal, and nonanal increased in liquid whey during storage, but liquid whey with added ascorbic acid or WPH had lower concentrations of these products compared to untreated controls. Mozzarella liquid whey had lower flavor intensities than Cheddar whey initially and after refrigerated storage. WPC with added ascorbic acid or WPH had lower cardboard flavor and lower concentrations of pentanal, heptanal, and nonanal compared to control WPC. These results suggest that addition of an antioxidant to liquid whey prior to further processing may be beneficial to flavor of spray-dried whey protein. Practical Application:, Lipid oxidation products are primary contributors to whey ingredient off-flavors. Flavor plays a critical and limiting role in widespread use of dried whey ingredients, and enhanced understanding of flavor and flavor formation as well as methods to control or minimize flavor formation during processing are industrially relevant. The results from this study suggest that addition of an antioxidant to liquid whey prior to further processing may be beneficial to minimize flavor of spray-dried whey protein. [source] | |||||||||||||