Home  About us  Contact
 

U Test (u + test)

Distribution by Scientific Domains
Medical Sciences88%
Life Sciences5%
2 Other Domains7%
Distribution within Medical Sciences
Neurology12%
Transplantation5%
15 Other Subdomains71%

Kinds of U Test

  • mann-whitney u test
    		•
  • whitney u test
    		•

    Selected Abstracts

    Follicular variant of papillary carcinoma: Cytologic findings on FNAB samples,experience with 16 cases

    DIAGNOSTIC CYTOPATHOLOGY, Issue 2 2001
    Franco Fulciniti M.D.
    Abstract Between January 1, 1992 and December 31, 1997, a cytopathological diagnosis of follicular variant of papillary thyroid carcinoma (FVPC) was made on a series of 16 out of 18 patients with palpable nodules who underwent fine-needle aspiration biopsy (FNAB) in our Department. The results of aspiration biopsy were followed by histopathological examination of the surgically excised tissues. There were three false-negative aspirations (16.6%), of which two were probably bound to fine-needle sampling and one due to a mixture of benign and malignant cells which had originally gone unrecognized. The accuracy of the cytopathologic diagnosis in this variant was 88.8%. An analysis of the diagnostic cytopathological criteria was performed, which demonstrated the importance of both architectural features (monolayered and branching sheets, microacinar structures, and their combinations) and nuclear features (presence of nuclear grooves). Background -bound features were mainly represented by dense, nonfilamentous colloid. The cytopathologic findings in FVPC were compared to those found in a series of 10 usual papillary carcinomas (UPC) and 10 follicular neoplasms (FN). These latter had originally been diagnosed by FNAB and were subsequently classified histologically as follicular adenoma (n = 6), follicular carcinoma (n = 3), or adenomatoid colloid nodule (n = 1). Statistical evaluation was performed on the cytopathological findings in the three classes of lesions (FVPC, UPC, and FN) as to their presence and relative frequency or absence by using a nonparametric one-way ANOVA (Kruskall-Wallis) and, where necessary, a Mann-Whitney U test. Papillary cellular fragments and multinucleated giant cells (P < 0.005), nonfilamentous dense colloid, squamoid cells, and syncytia were significantly more represented in UPC than in FVPC (P < 0.05), while histiocytes were significantly more frequent in FVPC (P < 0.005). Other nuclear and/or background features were significant only in the distinction between papillary carcinomas as a group and FN. The cytological differential diagnosis of the FVPC is briefly discussed with relevance to the possible pitfalls caused by its peculiar cyto- and histomorphology. Diagn. Cytopathol. 2001;25:86,93. © 2001 Wiley-Liss, Inc. [source]

    An increased proportion of inflammatory cells express tumor necrosis factor alpha in idiopathic achalasia of the esophagus

    DISEASES OF THE ESOPHAGUS, Issue 5 2009
    A. Kilic
    SUMMARY Achalasia is a motility disorder characterized by the absence of coordinated peristalsis and incomplete relaxation of the lower esophageal sphincter. The etiology remains unclear although dense inflammatory infiltrates within the myenteric plexus have been described. The nature of these infiltrating cells is unknown. The aim of this study was to evaluate the expression of proinflammatory cytokines , namely, tumor necrosis factor alpha and interleukin-2 , in the distal esophageal muscle in patients with achalasia. Lower esophageal sphincter muscle from eight patients undergoing myotomy or esophagectomy for achalasia of the esophagus were obtained at the time of surgery. Control specimens consisted of similar muscle taken from eight patients undergoing operation for cancer or Barrett's esophagus. The expression of tumor necrosis factor alpha and interleukin-2 were assessed by immunohistochemistry. The total number of inflammatory cells within the myenteric plexus were counted in five high power fields. The percentage of infiltrating cells expressing tumor necrosis factor alpha or interleukin-2 was calculated. Clinical data including demographics, preoperative lower esophageal sphincter pressure, duration of symptoms, and dysphagia score (1 = no dysphagia to 5 = dysphagia to saliva) were obtained through electronic medical records. Statistical comparisons between the groups were made using the unpaired t -test, Fisher's exact test, or Mann,Whitney U test, with a two-tailed P -value less than 0.05 being considered significant. The total number of inflammatory cells was found to be similar between the groups. A significantly higher proportion of inflammatory cells expressed tumor necrosis factor alpha in achalasia as compared with controls (22 vs. 11%; P= 0.02). A similar percentage of infiltrating cells expressed interleukin-2 (40 vs. 41%; P= 0.87). Age, gender, preoperative lower esophageal sphincter pressure, or dysphagia score were not correlated to expression of these cytokines. There was, however, a significant inverse correlation between duration of symptoms and the proportion of inflammatory cells expressing tumor necrosis factor alpha in achalasia (P= 0.007). In conclusion, a higher proportion of infiltrating inflammatory cells expressed tumor necrosis factor alpha in achalasia. Furthermore, this proportion appears to be highest early in the disease process. Further studies are required to more clearly delineate the role of tumor necrosis factor alpha in the pathogenesis of this idiopathic disease. [source]

    Ethinyl Estradiol, Not Progestogens, Reduces Lamotrigine Serum Concentrations

    EPILEPSIA, Issue 9 2005
    Arne Reimers
    Summary:,Purpose: To study the interaction between lamotrigine (LTG) and hormonal contraception. Methods: LTG serum concentrations of female patients using either no hormonal contraception (n = 18), an ethinyl estradiol (EE)-containing (n = 11), or a progestogen (PG)-only,containing compound (n = 16) were analyzed. Patients were recruited prospectively, and blood samples were drawn during drug fasting and at steady-state conditions. Comedication with enzyme inducers, valproate, topiramate, or sertraline was not allowed. Some patients changed groups and thus served as their own controls. Samples were analyzed by a gas chromatography/ mass spectroscopy method. The Mann,Whitney U test was used for statistical comparison of the groups. Results: The LTG serum concentration-to-dose ratio (CDR), expressed as (mg/L)/(mg/d) was significantly lower in women using EE than in the control group (mean ± SD, 0.010 ± 0.004 vs. 0.017 ± 0.006; p = 0.003). The CDR in women using PG was 0.02 ± 0.007, which was not statistically different from controls. No difference was found in CDR between women using either oral, topical, or parenteral PG. Five women switched from the control to the EE group and experienced a considerable reduction in CDR. An increase of the CDR toward control level was seen in the two women who changed from EE to PG. Conclusions: It is the EE component of oral contraceptives that interacts with LTG. The PG-only compounds did not alter LTG serum concentrations in this study. These findings should be considered when counselling women with epilepsy in the childbearing ages. [source]

    Consistent Localization of Interictal Epileptiform Activity on EEGs of Patients with Tuberous Sclerosis Complex

    EPILEPSIA, Issue 3 2005
    Floor E. Jansen
    Summary:,Purpose: We addressed consistent localization of focal interictal epileptiform activity on EEGs of patients with tuberous sclerosis complex (TSC) and epilepsy. Methods: Twenty-one patients with TSC with a 10-year history of epilepsy and interictal epileptiform activity in three or more EEG recordings were included. None of the patients had undergone epilepsy surgery. Local maxima of interictal epileptiform activity were measured from 76 EEG traces and 33 EEG reports. Information about the patients' clinical course was extracted from their medical records. Magnetic resonance imaging (MRI) and neuropsychological examinations were performed. Statistical analysis was performed with the Mann,Whitney U test. Results: In eight patients, interictal epileptiform activity was consistently detected in one or two regions (group 1), and in 13 patients, epileptiform activity was detected in three or more regions (group 2). The number of foci increased throughout the disease course in both groups. Age at seizure onset and IQ were significantly higher in group 1. Complex partial seizures occurred more often in the patients of group 1. In 19 of the 21 patients, the most consistent epileptiform activity was localized in the frontotemporal region. Conclusions: Ninety percent of patients with TSC showed at least one region of consistent interictal epileptiform activity. Patients with one or two regions of epileptiform activity were older at seizure onset, often experienced complex partial seizures, and had mild or no mental deficits. These patients may be candidates for epilepsy surgery. [source]

    IL-10 promoter haplotype influence on interferon treatment response in multiple sclerosis

    EUROPEAN JOURNAL OF NEUROLOGY, Issue 3 2005
    S. Wergeland
    The level of interleukin-10 (IL-10) expression is related to polymorphisms -1082 (G/A), -819 (T/C) and -592 (A/C) in the promoter region of the IL-10 gene, which constitute three haplotypes, GCC, ATA, and ACC. The ATA (a non-GCC) haplotype, which is associated with low IL-10 expression, has been shown to improve interferon (IFN) treatment response in hepatitis C. We analysed the distribution of IL-10 promoter haplotype combinations to determine whether they could influence initial IFN treatment response in 63 patients with relapsing-remitting multiple sclerosis (MS). The patients were grouped into non-GCC or GCC haplotypes, and the clinical and magnetic resonance imaging (MRI) disease activity was compared in the two groups. During the first 6 months of treatment, MS patients with non-GCC haplotypes experienced fewer new MRI T1-contrast enhancing lesions [0.77 ± 0.36 (SEM)] than patients with the GCC haplotype (2.45 ± 0.57) (P = 0.05, Mann-Whitney U test). No differences were detected on clinical disease activity. The results suggest an influence of IL-10 promoter polymorphisms on IFN treatment response in MS. [source]

    Regional sympathetic denervation affects the relation between canine local myocardial blood flow and oxygen consumption

    EXPERIMENTAL PHYSIOLOGY, Issue 3 2007
    David J. C. Alders
    Myocardial blood flow and oxygen consumption are heterogeneously distributed. Perfusion and myocardial oxygen consumption are closely correlated in the normal heart. It is unknown how this metabolism,perfusion relation is influenced by sympathetic denervation. We investigated this question in seven chloralose-anaesthetized dogs, 3,4 weeks after regional sympathetic denervation of the left circumflex coronary artery area of supply of the left ventricle. Measurements were made of local myocardial blood flow (MBF, in ml min,1 (g dry wt),1), measured with microspheres, and myocardial oxygen consumption (, in ,mol min,1 (g dry wt),1) in the same location, calculated from the 13C spectrum of tissue extracts after intracoronary infusion of 3,13C-lactate. Since both innervated and denervated regions are subject to the same arterial pressure, lower blood flow indicates higher resistance. Mean MBF was 5.56 ml min,1 (g dry wt),1 (heterogeneity of 3.47 ml min,1 (g dry wt),1) innervated, 7.48 ml min,1 (g dry wt),1 (heterogeneity of 3.62 ml min,1 (g dry wt),1) denervated (n.s.). Significant linear relations were found between MBF and of individual samples within the innervated and denervated regions. The slopes of these relations were not significantly different, but the adjusted mean was significantly higher in the denervated regions (+1.92 ml min,1 (g dry wt),1, an increase of 38% of the mean MBF at the pooled mean , P= 0.028, ANCOVA). The ratio (in ml ,mol,1) was significantly higher, being 0.296 ± 0.167 ml ,mol,1 in the denervated region compared with the innervated region, 0.216 ± 0.126 ml ,mol,1, P= 0.0182, Mann,Whitney U test. These results indicate that sympathetic tone under chloralose anaesthesia imposes a moderate vasoconstrictive effect in the myocardium that is not detected by comparison of the mean blood flow or resistance. [source]

    A study of the effect of a resistive heat moisture exchanger (trachinaze) on pulmonary function and blood gas tensions in patients who have undergone a laryngectomy: A randomized control trial of 50 patients studied over a 6-month period

    HEAD & NECK: JOURNAL FOR THE SCIENCES & SPECIALTIES OF THE HEAD AND NECK, Issue 5 2003
    Andrew Simpson Jones MD
    Abstract Background. Previous work from this department has shown that resistive tracheostomy filters increase the partial pressure of oxygen in capillary blood and also provide a significant amount of heat/moisture exchange. Until now it has not been shown whether there is any long-term beneficial effect and in particular whether raised tissue oxygenation is maintained using a practical filter device. Methods. We carried out a 6-month randomized control trial including 50 laryngectomees. Twenty-five patients were treated with the Liverpool Heat Moisture Exchange device incorporating an airway resistor (Trachinaze). Another 25 patients were treated with a placebo device. Relevant subjective and objective data were collected before and at the end of the study. The objective measurements were capillary oxygen tension (which parallels blood arterial tension), carbon dioxide tension, FEV1, FVC, and PIF. Patients were reviewed at intervals throughout the study. Data were analyzed using the Mann,Whitney U test and the paired t test to test the difference between the active device and placebo at 6 months. Results. Subjective lower airway parameters, including cough, number of chest infections, mucus production, and shortness of breath at rest, were significantly improved in the active group compared with the placebo group. The objective parameters FEV1, FVC, and PIF were not significantly different. Capillary oxygen tension, however, was highly significantly raised in the active group at 6 months. Conclusions. Trachinaze is highly superior to placebo at improving subjective pulmonary parameters, including shortness of breath. It is also superior in its ability to maintain an increased peripheral tissue oxygen tension over a 6-month period. © 2003 Wiley Periodicals, Inc. Head Neck 25: 000,000, 2003 [source]

    Radicular peroxide penetration from carbamide peroxide gels during intracoronal bleaching

    INTERNATIONAL ENDODONTIC JOURNAL, Issue 7 2008
    O. Gökay
    Abstract Aim, To evaluate and compare radicular peroxide diffusion from different concentrations of carbamide peroxide bleaching gels. Methodology, Fifty maxillary premolar teeth were separated into five groups (n = 10). Standardized endodontic access cavities were prepared in the occlusal surfaces, and the root canals were prepared using a step back technique and filled using the lateral compaction technique. The gutta-percha filling was removed 4 mm short of the cemento-enamel junction (CEJ) and a 2-mm-thick glass,ionomer cement base was placed. Outer root surfaces were sealed with wax and nail polish, leaving the coronal third of the tooth and the CEJ exposed. All teeth were immersed in a plastic tube containing 2 mL of distilled water, and the experimental groups were treated with a bleaching agent of either 10%, 17% or 37% carbamide peroxide (CP) or a mixture of 30% hydrogen peroxide (HP) and sodium perborate (SP) placed into the coronal pulp chamber of teeth and left for 24 h. Peroxide penetration was measured using the ferrothiocyanate method. Statistical analysis of data was conducted by using the Kruskal,Wallis Analysis of Variance and Mann,Whitney U test. Results, Higher peroxide penetration occurred with the 30% HP-SP mixture than with the CP bleaching gels, and the 37% CP group also promoted greater peroxide penetration than the other CP groups (P < 0.05). There was no statistically significant difference between 10% and 17% CP groups (P > 0.05). Conclusion, Peroxide penetration of CP gels was significantly lower than that of a HP-SP mixture. [source]

    Saliva concentrations of RANKL and osteoprotegerin in smoker versus non-smoker chronic periodontitis patients

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 10 2008
    Nurcan Buduneli
    Abstract Objectives: To compare the salivary receptor activator of NF- ,B ligand (RANKL) and osteoprotegerin (OPG) concentrations in smokers versus non-smokers with chronic periodontitis. Material and Methods: Whole saliva samples were obtained from 67 untreated chronic periodontitis patients, of whom 34 were smokers, and from 44 maintenance patients, of whom 22 were smokers. Full-mouth clinical periodontal measurements were recorded. Saliva cotinine, sRANKL and OPG concentrations were determined by ELISA. Statistical analysis was performed using the Mann,Whitney U test, Bonferroni's correction for multiple comparisons and Spearman's correlations. Results: Untreated smokers exhibited significantly higher values of clinical periodontal recordings than untreated non-smokers (all p<0.05). Salivary cotinine level correlated with clinical attachment level (p=0.023). Smoker versus non-smoker maintenance groups showed no significant differences in clinical parameters. There were significant differences in sRANKL and OPG concentrations between untreated and maintenance groups (all p<0.01). Salivary OPG concentration was significantly lower (all p<0.01) and the sRANKL/OPG ratio was higher (all p<0.01) in smokers than in non-smokers. OPG concentration correlated positively with probing depth, clinical attachment level and bleeding on probing (all p<0.005) and negatively with pack-year, and cotinine level (p<0.05). Conclusion: Salivary RANKL and OPG concentrations are suggested to be affected by smoking as not only the untreated but also the treated smokers exhibited higher RANKL and lower OPG concentrations than non-smokers. [source]

    TLR2 Arg753Gly, TLR4 Asp299Gly and Thr399Ile gene polymorphisms are not associated with chronic periodontitis in a Turkish population

    JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 7 2007
    Afig Berdeli
    Abstract Aim: Toll-like receptor (TLR) gene polymorphisms could affect the host's ability to respond to microbial pathogens. In this case,control study, the association of TLR2 and TLR4 gene polymorphisms with chronic periodontitis (CP) was investigated. Materials and Methods: Genomic DNA was obtained from the peripheral blood of 83 patients with CP and 106 periodontally healthy subjects. The TLR2 Arg753Gly, Arg677Trp and TLR4 Asp299Gly, Thr399Ile gene polymorphisms were genotyped by the polymerase chain reaction-restriction fragment length polymorphism method. The data were analysed by a ,2 test, logistic regression analysis and the Mann,Whitney U test. Results: The 753Gln allele was found in 6.1% of the CP patients as compared with 6.6% in the control group (p>0.05). The frequency of the 299Gly and 399Ile allele was 2.4% and 1.8% in CP patients. For the healthy subjects, the frequency was 2.8% for the 299Gly and 2.5% for the 399Ile allele (p>0.05). None of the CP patients or healthy subjects showed homozygosity for the TLR2 and TLR4 alleles. Percentage of sites with bleeding on probing and plaque were significantly higher in 299Gly-positive patients compared with 299Gly-negative patients (p<0.05). Conclusion: These results showed that the TLR2 and TLR4 gene polymorphisms studied are not associated with susceptibility to CP in Turkish patients. [source]

    The role of Doppler sonography in predicting severity of acute pancreatitis

    JOURNAL OF CLINICAL ULTRASOUND, Issue 3 2008
    Naile Bolca Topal MD
    Abstract Purpose To investigate the role of Doppler sonography (DUS) examination of major abdominal arteries in predicting severity of acute pancreatitis (AP). Methods Twenty-nine patients diagnosed with AP and 14 controls were blindly and prospectively evaluated with Doppler sonography. Disease severity was defined clinically according to acute physiology and chronic health evaluation (APACHE II) score and was classified as severe for APACHE II score ,8. DUS examination included the measurement of peak systolic velocity (PSV), end diastolic velocity (EDV), pulsatility index (PI), and resistance index (RI) of the celiac artery (CA) and superior mesenteric artery (SMA). Statistical analysis included Mann-Whitney U test, Student t test, and receiver operating characteristic curve analysis. Results Twelve patients had severe AP and 17 had mild AP. PSV, EDV, and PI of the CA and RI of the SMA were higher in the severe AP group than in the mild AP and control groups (p < 0.001 and p < 0.0001, respectively). The sensitivity and specificity were 100% and 94%, respectively, for a 87 cm/second CA PSV cutoff value, 75% and 100%, respectively, for a 22 cm/second CA EDV cutoff value, 92% and 82%, respectively, for a 1.29 CA PI cutoff value, and 100% and 100%, respectively, for a 0.86 SMA RI cutoff value. Conclusion DUS can be useful in predicting the severity of AP in the early period of admission phase of the disease. © 2007 Wiley Periodicals, Inc. J Clin Ultrasound, 2008 [source]

    Testing Features of Graphical DIF: Application of a Regression Correction to Three Nonparametric Statistical Tests

    JOURNAL OF EDUCATIONAL MEASUREMENT, Issue 4 2006
    Daniel M. Bolt
    Inspection of differential item functioning (DIF) in translated test items can be informed by graphical comparisons of item response functions (IRFs) across translated forms. Due to the many forms of DIF that can emerge in such analyses, it is important to develop statistical tests that can confirm various characteristics of DIF when present. Traditional nonparametric tests of DIF (Mantel-Haenszel, SIBTEST) are not designed to test for the presence of nonuniform or local DIF, while common probability difference (P-DIF) tests (e.g., SIBTEST) do not optimize power in testing for uniform DIF, and thus may be less useful in the context of graphical DIF analyses. In this article, modifications of three alternative nonparametric statistical tests for DIF, Fisher's ,2test, Cochran's Z test, and Goodman's U test (Marascuilo & Slaughter, 1981), are investigated for these purposes. A simulation study demonstrates the effectiveness of a regression correction procedure in improving the statistical performance of the tests when using an internal test score as the matching criterion. Simulation power and real data analyses demonstrate the unique information provided by these alternative methods compared to SIBTEST and Mantel-Haenszel in confirming various forms of DIF in translated tests. [source]

    Short-term efficacy of physical therapy compared to splint therapy in treatment of arthrogenous TMD

    JOURNAL OF ORAL REHABILITATION, Issue 11 2007
    F. ISMAIL
    Summary, A prospective randomized study was carried out to evaluate the efficacy of physical therapy in addition to splint therapy on treatment outcome in patients with temporomandibular disorders (TMD) with respect to objective and subjective parameters. Twenty-six patients suffering from an arthrogenic TMD and exhibiting a painfully restricted jaw opening were randomized in two groups. Thirteen patients were treated solely with Michigan splint (group I), 13 patients received supplementary physical therapy (group II). Before treatment a clinical examination and electronic recording of jaw movements were performed and subjective pain level was evaluated by visual analogue scales. After 3 months of therapy maintenance of improvement was evaluated. Within treatment groups comparison of data before and after treatment was analysed using Wilcoxon test. Groups were compared by Mann,Withney- U test. A P -value < 0.05 was considered significant. Compared with the baseline, in both groups mandibular movement capacity increased significantly after treatment, whereas subjective pain decreased significantly (P < 0.05). Active jaw opening increased from 28.6 ± 5.8 to 35.9 ± 4.8 mm in group I and from 30.1 ± 5.4 to 40.8 ± 4.1 mm in group II. After therapy the difference of active jaw opening between groups was significant (P < 0.05). Physical therapy also gave a supplementary improvement of protrusive mandibular movement capacity during electronic registration and subjective pain level. For none of these parameters this difference between groups was significant. Physical therapy seems to have a positive effect on treatment outcome of patients with TMD. [source]

    Vascular endothelial growth factor 121 and 165 in the subacromial bursa are involved in shoulder joint contracture in type II diabetics with rotator cuff disease

    JOURNAL OF ORTHOPAEDIC RESEARCH, Issue 6 2003
    Akiyoshi Handa
    Vascular endothelial growth factor (VEGF) is a glycoprotein that plays an important role in neovascularization and increases vascular permeability. We reported that VEGF is involved in motion pain of patients with rotator cuff disease by causing synovial proliferation in the subacromial bursa (SAB). The present study investigates whether VEGF is also involved in the development of shoulder contracture in diabetics with rotator cuff disease. We examined 67 patients with rotator cuff disease, including 36 with complete cuff tears, 20 with incomplete tears, and 11 without apparent tears (subacromial bursitis). The patients were into groups according to the presence or absence of diabetes (14 type II diabetics and 53 non-diabetics). Specimens of the synovium of the SAB were obtained from all patients during surgery. Expression of the VEGF gene in the synovium of the subacromial bursa was evaluated by using the reverse transcriptase polymerase chain reaction. The VEGF protein was localized by immunohistochemistry, and the number of vessels was evaluated based on CD34 immunoreactivity. The results showed that VEGF mRNA was expressed in significantly more diabetics (100%, 14/14) than in non-diabetics (70%, 37/53) (P = 0.0159, Fisher's test). Investigation of VEGF isoform expression revealed VEGF121 in all 14 diabetics and in 37 of the 53 non-diabetics, VEGF 165 in 12 of the 14 diabetics and in 21 of the 53 non-diabetics, and VEGF 189 in 1 of the 14 diabetics and in 2 of the 53 non-diabetics. No VEGF206 was expressed in either group. VEGF protein was localized in both vascular endothelial cells and synovial lining cells. The mean number of VEGF-positive vessels and the vessel area were also significantly greater in the diabetics (p < 0.015, Mann-Whitney U test). Synovial proliferation and shoulder joint contracture were more common in the diabetics (P = 0.0329 and P = 0.073, respectively; Fisher's test). The mean preoperative range of shoulder motion significantly differed in terms of elevation between two groups: 103.8° in diabetics and 124.9° in no diabetics (p = 0.0039 Mann,Whitney U test). In contrast, external rotation did not significantly differ: 44° in diabetics and 49° in non-diabetics (p ° 0.4957, Mann,Whitney U test). These results suggest that VEGF121 and VEGF165 expression in the SAB is responsible for the development of shoulder joint contracture, especially in elevation, among type II diabetic patients with rotator cuff disease. © 2003 Orthopaedic Research Society. Published by Elsevier Science Ltd. All rights reserved. [source]

    Increased Acid Sphingomyelinase Activity in Peripheral Blood Cells of Acutely Intoxicated Patients With Alcohol Dependence

    ALCOHOLISM, Issue 1 2010
    Martin Reichel
    Background:, Acid sphingomyelinase (ASM; EC 3.1.4.12) hydrolyses membrane sphingomyelin into the bioactive lipid ceramide and is thus involved in different cellular processes such as differentiation, immunity, or cell death. Activation of ASM has been reported in particular in conjunction with the cellular stress response to several external stimuli, and increased ASM activity was observed in a variety of human diseases. Ethanol-induced activation of ASM has been observed in different cell culture systems, thus raising the question about the effect of alcohol intoxication in human subjects on ASM activity in vivo. Methods:, We determined ASM activity in peripheral blood mononucleated cells of 27 patients suffering from alcohol dependence. Patients were classified according to their blood alcohol concentration at admission, and ASM activity was determined repeatedly from all patients during alcohol withdrawal. Results:, Acutely intoxicated patients displayed significantly higher ASM activity than patients in early abstinence (Mann,Whitney U test: Z = , 2.6, p = 0.009). ASM activity declined in acutely intoxicated patients to normal values with the transition from the intoxicated state to early abstinence (Wilcoxon test: Z = ,2.7, p = 0.007). At the end of withdrawal, ASM activity was significantly increased again compared to the early phase of abstinence in both patient groups (Wilcoxon test: Z = ,2.691, p = 0.007 and Z = ,2.275, p = 0.023, respectively). Conclusions:, Alcohol-induced activation of ASM occurs in human subjects and might be responsible for deleterious effects of ethanol intoxication. Chronic alcohol abuse may induce deregulation of sphingomyelin metabolism in general, and this impairment may cause side effects during withdrawal from alcohol. [source]

    Cigarette smoking is associated with an increased incidence of vascular complications after liver transplantation

    LIVER TRANSPLANTATION, Issue 7 2002
    Surakit Pungpapong
    Hepatic artery thrombosis (HAT) and other vascular complications are significant causes of morbidity after liver transplantation. Although cigarette smoking increases the risk of vascular complications after renal transplantation, its impact after liver transplantation remains unknown. Between May 1995 and April 2001, 288 liver transplantations were performed in 263 patients. Vascular complications developed in 39 patients (13.5%) (arterial complications, 28 patients [9.7%]; venous complications, 11 patients [3.8%]). Patient demographics, comorbid illnesses, and risk factors were analyzed using the Mann-Whitney U test, Chi-squared test, and Fisher's exact test. In patients with a history of cigarette smoking, incidence of vascular complications was higher than in those without history of cigarette smoking (17.8% v 8%, P = .02). Having quit cigarette smoking 2 years before liver transplantation reduced the incidence of vascular complications by 58.6% (24.4% v 11.8%, P = .04). The incidence of arterial complications was also higher in patients with a history of cigarette smoking compared with those without such history (13.5% v 4.8%, P = .015). Cigarette smoking cessation for 2 years also reduced the risk of arterial complications by 77.6% (21.8% v 5.9%, P =.005). However, the incidence of venous complications was not associated with cigarette smoking. Furthermore, there was no significant association between development of vascular complications and all other characteristics studied. Cigarette smoking is associated with a higher risk for developing vascular complications, especially arterial complications after liver transplantation. Cigarette smoking cessation at least 2 years before liver transplantation can significantly reduce the risk for vascular complications. Cigarette smoking cessation should be an essential requirement for liver transplantation candidates to decrease the morbidity arising from vascular complication after liver transplantation. [source]

    Shock Coordinated with High Power of Morphology Electrogram Improves Defibrillation Success in Patients with Implantable Cardioverter Defibrillators

    PACING AND CLINICAL ELECTROPHYSIOLOGY, Issue 9 2002
    ALEXANDER BERKOWITSCH
    BERKOWITSCH, A., et al.: Shock Coordinated with High Power of Morphology Electrogram Improves Defibrillation Success in Patients with Implantable Cardioverter Defibrillators. Animal studies have suggested that the success of defibrillation may depend on the properties of VF waveform obtained from the morphology electrogram (ME) at the time of the shock. The reliable identification of depolarization events in the fibrillatory signal can be achieved using adaptive estimation of the instantaneous signal power (P). The aim of this study was to investigate if a high P of the ME (PME) was related to ventricular DFT and if the upslope in ME can be associated with the depolarization event. A total of 575 VF (mean duration 10 s) episodes recorded and stored during ICD implantation in 77 patients with ventricular arrhythmias were used for analysis. The DFT was defined using a double step-down test. The values of PME immediately before pulse delivery (Pshock) and shock outcomes were registered. The differences between Pshock of successful and failed defibrillation were tested with the Mann-Whitney U test. The relationship between individual medians of Pshock (Pmed) and DFT was analyzed using the Kruskall-Wallis H-test. The coincidence between identified depolarization and upslope in ME was tested using the chi-square test. A P value of 0.05 was set for an error probability. The Pshock in case of failed defibrillation was significantly lower than Pshock in successful cases by the pulses of any strength (P < 0.001). The test revealed a significant inverse correlation between Pmed and DFT with P < 0.001. The depolarization corresponded to the upslope of ME in 85% of cases. This study demonstrated that a high value of instantaneous power of ME indicates the optimal time for shock delivery. The implementation of this algorithm in ICDs may improve the defibrillation efficacy. [source]

    Prognostic value of bone marrow angiogenesis in multiple myeloma: Use of light microscopy as well as computerized image analyzer in the assessment of microvessel density and total vascular area in multiple myeloma and its correlation with various clinical, histological, and laboratory parameters

    AMERICAN JOURNAL OF HEMATOLOGY, Issue 9 2006
    Sahibinder Singh Bhatti
    Abstract We studied the prognostic value of parameters of angiogenesis on bone marrow biopsies in newly diagnosed multiple myeloma (MM) patients. Angiogenesis parameters studied were the microvessel count done manually on light microscopy (MVD-A), microvessel count done by using computerized image analyzer (MVD-B), and total vascular area (TVA) measured by computerized image analyzer. One hundred ten newly diagnosed cases of MM treated at Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, were analyzed with respect to clinical features, laboratory findings, histological features, angiogenesis parameters, and responses to the treatment on follow-up. Twenty age- and sex-matched controls were studied for comparing with angiogenesis of the test cases. Bone marrow microvessels were examined using immunohistochemical staining for CD34. MVD-A (range 4.9,85.2; mean 28.2; SD 19.4), MVD-B (range 2.0,26.9; mean 11.7; SD 5.9), and TVA measured in percentage (range 0.1,17.1; mean 2.4; SD 2.5) were measured for test cases (n = 110). Grading of angiogenesis parameters of the test cases were done; such that angiogenesis parameters of controls (taken as baseline) were grade I. There was a statistically highly significant correlation between (MVD-A vs MVD-B, pcc = 0.92; MVD-A vs TVA, pcc = 0.78; MVD-B vs TVA, pcc = 0.76). The myeloma cases had significantly higher angiogenesis parameters when compared with controls (Kruskall-Wallis test, P < 0.001). "Complete responders" (n = 38/110) had significant lower angiogenesis (Mann-Whitney U test, P < 0.001) than "nonresponders" (n = 72/110). On treatment follow-up "rapid disease progressors" had the highest levels of angiogenesis (mean rank for MVD-A = 84.7, MVD-B = 82.1, and TVA = 81.1). On multivariate (logistic regression) analysis, factors found to have independent prognostic significance in complete responders (adjusted odd ratio (95% CI, P value)] were: (a) MVD-B grade I [0.134 (0.10,0.16, P < 0.001)], (b) clinical substage A [0.163 (0.12,0.19, P = 0.008)], (c) Bartl's histological stage II & I [0.262 (0.2,0.32, P = 0.021)], (d) MVD-A grade I [0.28 (0.22,0.36, P = 0.03)], (e) ,2 microglobulin levels less than 3,400 ng/dl [0.31 (0.23,0.42, P = 0.04)]. Kaplan-Meier survival analysis for myeloma-related death (n = 16) shows a mean survival time (in months) of 24.75; SE = 3; 95% CI = 21,28. We conclude that MVD (particularly MVD-B) is a very good predictor for the complete response in patients of MM and should be done routinely on bone marrow biopsies. Am. J. Hematol., 2006. © 2006 Wiley-Liss, Inc. [source]

    Criminal Behavior in Antisocial Substance Abusers between Five and Fifteen Years Follow-Up

    THE AMERICAN JOURNAL ON ADDICTIONS, Issue 1 2007
    Mats Fridell PhD
    Antisocial personality disorder (ASPD) is one of the most common co-occurring disorders in substance abusers, characterized among other things by a high propensity for criminal actions. A cohort of 125 substance abusers were followed in a longitudinal design. Patients were diagnosed with ASPD at an index treatment episode, interviewed at five-year follow-up, and followed-up through the Swedish criminal justice register by 2005 for the years 1995,2003. ASPD and non-ASPD subjects were compared using Mann Whitney U test for ordinal variables (number of offenses and months in prison) and chi-square tests for categorical variables. A total of 107 were alive by 1995, when the period of observation began. ASPD diagnosed at baseline was related to criminal offenses and incarceration during the follow-up from 5 to 15 years. For most categories, ASPD diagnosis was associated with higher frequency of offense. An ASPD diagnosis based on SCID-II interview made at five-year follow-up was related to the number of offenses but unrelated to incarceration. In a sample of drug abusers, ASPD was associated with high levels of criminal behavior, even years after the diagnosis was given. A diagnosis based on clinical observation during treatment was at least as predictive of criminal behavior as a diagnosis based on a SCID-II interview. [source]

    Long-interval T2-weighted subtraction magnetic resonance imaging: A powerful new outcome measure in multiple sclerosis trials

    ANNALS OF NEUROLOGY, Issue 5 2010
    Bastiaan Moraal MD
    Objective To compare long-interval T2-weighted subtraction (T2w-Sub) imaging with monthly gadolinium-enhanced T1-weighted (Gd-T1w) imaging for (1) detection of active lesions, (2) assessment of treatment efficacy, and (3) statistical power, in a multiple sclerosis (MS), phase 2, clinical trial setting. Methods Magnetic resonance imaging (MRI) data over 9 months from 120 patients (61 treatment, 59 placebo) from the oral temsirolimus trial were used. T2w-Sub images were scored for active lesions, independent of the original reading of the monthly Gd-T1w images. Treatment efficacy was evaluated using the nonparametric Mann-Whitney U test, and parametric negative binomial (NB)-regression and power calculations were conducted. Results Datasets from 116 patients (58 treatment, 58 placebo) were evaluated. The mean number of T2w-Sub lesions in the treatment group was 3.0 (±4.6) versus 5.9 (±8.8) for placebo; the mean cumulative number of new Gd-T1w lesions in the treatment group was 5.5(±9.1) versus 9.1(±17.2) for placebo. T2w-Sub imaging showed increased power to assess treatment efficacy compared with Gd-T1w imaging, when evaluated by Mann-Whitney U test (p = 0.017 vs p = 0.177), or NB-regression without (p = 0.011 vs p = 0.092) or with baseline adjustment (p < 0.001 vs p = 0.002). Depending on the magnitude of the simulated treatment effect, sample size calculations showed reductions of 22 to 34% in the number of patients (translating into reductions of 81,83% in the number of MRI scans) needed to detect a significant treatment effect in favor of T2w-Sub imaging. Interpretation Compared with monthly Gd-T1w imaging, long-interval T2w-Sub MRI exhibited increased power to assess treatment efficacy, and could greatly increase the cost-effectiveness of phase 2 MS trials by limiting the number of patients, contrast injections, and MRI scans needed. ANN NEUROL 2010;67:667,675 [source]

    Lesional and nonlesional skin from patients with untreated juvenile dermatomyositis displays increased numbers of mast cells and mature plasmacytoid dendritic cells

    ARTHRITIS & RHEUMATISM, Issue 9 2010
    Sheela Shrestha
    Objective To investigate the distribution of mast cells and dendritic cell (DC) subsets in paired muscle and skin (lesional/nonlesional) from untreated children with juvenile dermatomyositis (DM). Methods Muscle and skin biopsy samples (4 skin biopsy samples with active rash) from 7 patients with probable/definite juvenile DM were compared with muscle and skin samples from 10 healthy pediatric controls. Mast cell distribution and number were assessed by toluidine blue staining and analyzed by Student's t -test. Immunohistochemical analysis was performed to identify mature DCs, myeloid DCs (MDCs), and plasmacytoid DCs (PDCs) by using antibodies against DC-LAMP, blood dendritic cell antigen 1 (BDCA-1), and BDCA-2, respectively. Myxovirus resistance protein A (MxA) staining indicated active type I interferon (IFN) signaling; positive staining was scored semiquantitatively and analyzed using the Mann-Whitney U test. Results Both inflamed and nonlesional skin from patients with juvenile DM contained more mast cells than did skin from pediatric controls (P = 0.029), and comparable numbers of mast cells were present in lesional and nonlesional skin. Interestingly, mast cell numbers were greater in skin than in paired muscle tissue from patients with juvenile DM (P = 0.014) and were not increased in muscle from patients with juvenile DM compared with control muscle. Both muscle and skin from patients with juvenile DM showed more mature PDCs and MxA staining than did their corresponding control tissues (P < 0.05). In both muscle and skin from patients with juvenile DM and in pediatric control muscle, there were fewer MDCs than PDCs, and the distributions of MDCs and PDCs were similar in pediatric control skin samples. Conclusion The identification of mast cells in skin (irrespective of rash) from patients with juvenile DM, but not in paired muscle tissue, suggests that they have a specific role in juvenile DM skin pathophysiology. In skin from patients with juvenile DM, increased numbers of PDCs and increased expression of type I IFN,induced protein suggest a selective influence on T cell differentiation and subsequent effector function. [source]

    Mann-Whitney U test and Kruskal-Wallis test should be used for comparisons of differences in medians, not means: Comment on the article by van der Helm-van Mil et al

    ARTHRITIS & RHEUMATISM, Issue 5 2009
    Bin Zhang ScD
    No abstract is available for this article. [source]

    Power and Sample Size Estimation for the Wilcoxon Rank Sum Test with Application to Comparisons of C Statistics from Alternative Prediction Models

    BIOMETRICS, Issue 1 2009
    B. Rosner
    Summary The Wilcoxon Mann-Whitney (WMW) U test is commonly used in nonparametric two-group comparisons when the normality of the underlying distribution is questionable. There has been some previous work on estimating power based on this procedure (Lehmann, 1998, Nonparametrics). In this article, we present an approach for estimating type II error, which is applicable to any continuous distribution, and also extend the approach to handle grouped continuous data allowing for ties. We apply these results to obtaining standard errors of the area under the receiver operating characteristic curve (AUROC) for risk-prediction rules under H1 and for comparing AUROC between competing risk prediction rules applied to the same data set. These results are based on SAS -callable functions to evaluate the bivariate normal integral and are thus easily implemented with standard software. [source]

    Safety and efficacy of using the LigaSure vessel sealing system for securing the pedicles in vaginal hysterectomy: randomised controlled trial

    BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 3 2005
    M.A. Hefni
    Objective To assess the safety and efficacy of using the LigaSure vessel sealing system for securing the pedicles during vaginal hysterectomy in comparison with the conventional method of securing the pedicles by suture ligation. Design Randomised controlled trial. Setting Gynaecology Department, Benenden Hospital, Kent. Population One hundred and sixteen women undergoing vaginal hysterectomy were prospectively randomised to either LigaSure (Group I) or suture ligation (Group II) for securing the pedicles. Methods Data of patients were collected prospectively. Statistical analysis was performed using the Mann,Whitney U test, ,2 and Fisher's exact test as appropriate. Main outcome measures Operating time, operative blood loss and peri-operative complications. Results The operating time was significantly shorter in the LigaSure group compared with the control group (P < 0.04). There was no statistical significant difference between the two groups in operative blood loss (P= 0.433), but peri-operative haemorrhagic complications were less frequent in the LigaSure group (0%vs 6.8%, P= 0.057). Four patients in the control group required either conversion to laparotomy because of bleeding, return to theatre for immediate post-operative haemorrhage or readmission for vault haematoma, whereas none in the LigaSure group had bleeding from unsecured pedicles. Conclusion The LigaSure vessel sealing system is a safe alternative for securing pedicles in vaginal hysterectomy when compared with conventional suture ligation. Larger studies are required to determine its place in gynaecological surgery. [source]

    Pregnancy outcome in severe placental abruption

    BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 7 2003
    Salma Imran Kayani
    Objective To determine the relationship between decision to delivery interval and perinatal outcome in severe placental abruption. Design A case,control study. Setting Large inner city teaching hospital. Methods Retrospective case note review of pregnancies terminated following severe placental aburption and fetal bradycardia. One year paediatric follow up by case note review or postal questionnaire. The differences in outcome (death or cerebral palsy) were examined using non-parametric and univariate analysis for the following time periods , times from onset of symptoms to delivery, onset of symptoms to admission, admission to delivery, onset bradycardia to delivery and decision to delivery interval. Main outcome measures Prenatal death or survival with cerebral palsy. Results Thirty-three women with singleton pregnancies over 28 weeks of gestation, admitted with clinically overt placental abruption, where delivery was effected for fetal bradycardia. Eleven of the pregnancies had a poor outcome (cases), eight infants died and three surviving infants have cerebral palsy. Twenty-two pregnancies had a good outcome (controls): survival with no developmental delay. No statistically significant relationship was found between maternal age, parity, gestation, or birthweight and a poor outcome. A statistically significant relationship between time from decision to delivery was identified (P= 0.02, Mann,Whitney U test). The results of a univariate logistic regression for this variable suggest that the odds ratio of a poor outcome for delivery at 20 minutes compared with 30 minutes is 0.44 (95% CI 0.22,0.86). Fifty-five percent of infants were delivered within 20 minutes of the decision to deliver. Serious maternal morbidity was rare. Conclusion In this small study of severe placental abruption complicated by fetal bradycardia, a decision to delivery interval of 20 minutes or less was associated with substantially reduced neonatal morbidity and mortality. [source]

    High incidence of obstetric interventions after successful external cephalic version

    BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 6 2002
    Louis Yik-Si Chan
    Objective To investigate the delivery outcome after successful external cephalic version (ECV). Design Case,control study. Setting University teaching hospital. Population The study group consisted of 279 consecutive singleton deliveries at term over a six-year period, all of which had had successful ECV performed. The control group included 28,447 singleton term deliveries during the same six-year period. Methods Between group differences were compared with the Mann,Whitney U test or Student's t test where appropriate. Odds ratio and 95% confidence interval (CI) were calculated for categorical variables. Main outcome measures Incidence of and indications for obstetric interventions. Results The risk of instrumental delivery and emergency caesarean section was higher in the ECV group (14.3%vs 12.8%; OR 1.4; 95% CI 1.0,2.0, and 23.3%vs 9.4%; OR 3.1; 95% CI 2.3,4.1, respectively). The higher caesarean rate was due to an increase in all major indications, namely, suspected fetal distress, failure to progress in labour and failed induction. The higher incidence of instrumental delivery was mainly due to an increase in prolonged second stage. The odds ratio for operative delivery remained significant after controlling for potential confounding variables. There were also significantly greater frequencies of labour induction (24.0%vs 13.4%; OR 2.0; 95% CI 1.5,2.7) and use of epidural analgesia (20.4%vs 12.4%; OR 1.8; 95% CI 1.4,2.4) by women in the ECV group. The higher induction rate is mainly due to induction for post term, abnormal cardiotocography (CTG) and antepartum haemorrhage (APH) of unknown origin. Conclusion The incidence of operative delivery and other obstetric interventions are higher in pregnancies after successful ECV. Women undergoing ECV should be informed about this higher risk of interventions. [source]

    Transcranial Doppler ultrasonography-directed intravenous glycoprotein IIb/IIIa receptor antagonist therapy to control transient cerebral microemboli before and after carotid endarterectomy,

    BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 6 2008
    D. van Dellen
    Background: Patients with a transient focal neurological deficit, critical carotid stenosis and/or microemboli detected by transcranial Doppler ultrasonography (TCD) have a significant risk of stroke. The effect of tirofiban, a selective glycoprotein IIb/IIIa inhibitor, was assessed in patients with microembolic signals on TCD after transient ischaemic attacks or carotid endarterectomy (CEA). Methods: Thirty-three patients with microemboli on TCD (13 symptomatic preoperative, 19 postoperative, one both) were treated with tirofiban between 2002 and 2007. All patients had carotid stenosis greater than 70 per cent. TCD monitoring was used during and after tirofiban therapy. Results: The median (range) rate of microemboli decreased from 22 (4,260) per h before surgery and 81 (44,216) per h after surgery to 0 (0,9) per h in both groups (P < 0·001, Mann,Whitney U test). This occurred rapidly (preoperative median 30 min; postoperative median 45 min) and was well tolerated in all patients, with no serious adverse effects. Conclusion: Cerebral microemboli were controlled by tirofiban both before and after CEA. Further study is required to compare the relative efficacy of tirofiban and dextran. Copyright © 2008 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source]

    Association between hyperhomocysteinaemia and abdominal aortic aneurysm

    BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 4 2001
    S. Caldwell
    Background: Hyperhomocysteinaemia is associated with occlusive vascular disease. In vitro evidence has demonstrated the induction of a serine elastase by homocysteine in vascular smooth muscle. Anecdotal evidence from case reports and post-mortem studies has suggested an association with abdominal aortic aneurysm (AAA). The aim was to determine the prevalence of hyperhomocysteinaemia in patients with AAA. Methods: Some 120 subjects (60 controls and 60 patients with AAA) were studied prospectively. Epidemiological, clinical and haematological data were collected. Patients were defined as having AAA if ultrasonographic measurement of the aorta was greater than 4·5 cm. Those with evidence of occlusive peripheral vascular disease or an ankle: brachial pressure index lower than 0·8 were excluded. Homocysteine was measured with a commercial high-pressure liquid chromatography analyser. The reference range from age-matched controls was 8·9,14·3 µmol l,1. Results: The median(s.d.) value of homocysteine for patients was significantly higher than that for the control group: 13·1(7·88) versus 10·9(5·07) µmol l,1 (P = 0·03, Mann,Whitney U test). Hyperhomocysteinaemia (homocysteine concentration greater than 14·3 µu;mol l,1) was present in 48 per cent of patients with AAA, compared with 24 per cent of the control population (P < 0·01, ,2 test). There were no significant differences between groups with regard to age, folate levels, vitamin B12 concentration or renal function. Conclusion: These results strongly suggest an association between hyperhomocysteinaemia and AAA. If studies currently ongoing demonstrate a causal relationship between hyperhomocysteinaemia and vascular disease progression, it raises the possibility of treating small aneurysms with vitamin supplementation to slow their growth. © 2001 British Journal of Surgery Society Ltd [source]

    Reduction of vascular smooth muscle cell proliferation by immunomodulation

    BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 4 2001
    Y. C. Chan
    Background: Immunological factors may play an important role in mediating the progression of atherosclerosis and myointimal hyperplasia, with heat shock proteins being implicated as possible autoantigens. The authors have shown previously that immunomodulation can reduce vascular smooth muscle cell (vSMC) proliferation following balloon injury to rat carotid arteries. The aim of the present study was to examine the effects of immunomodulatory agents on the proliferation of rat aortic vSMCs remote from the area of balloon injury. The agents used were SRL172 (heat-killed Mycobacterium vaccae) and heat shock protein 65 kDa (HSP65) in Freund's incomplete adjuvant. Both these agents are known to influence T-cell responses. Methods: Male Sprague,Dawley rats were used. All immunizations were given subcutaneously. Four groups were studied (ten animals in each group): group 1 animals were immunized with normal saline, group 2 received SRL172, group 3 SRL172 and HSP65,Freund's, and group 4 HSP65,Freund's. Three immunizations were performed as well as carotid balloon injury. Three animals died, leaving 37 for analysis. Some 5 weeks later the animals were killed and the aorta was harvested. Standard explant techniques were applied to grow aortic vSMCs until confluency, passaged three times, quiesced, and fetal calf serum (FCS) of varying concentrations (0·4,10 per cent) was then added, incubated for another 48 h and cell counts carried out. Results: The proliferation rate of aortic vSMCs in the control group was significantly greater than that in the other study groups (Fig.). While all the treatment groups had significantly less proliferation compared with the control group (*P < 0·05, ,P < 0·01, Mann,Whitney U test), no statistically significant differences existed between any of the study groups. Conclusion: Immunomodulation may result in a reduction of vSMC proliferation. Although the precise mechanisms involved are unclear, these results are in concordance with previous findings that T-cell immunomodulation decreases the development of myointimal hyperplasia after injury, and suggest that a fundamental phenotypic shift has been produced by these immunizations. [source]

    End-tidal Carbon Dioxide Measurements in Children with Acute Asthma

    ACADEMIC EMERGENCY MEDICINE, Issue 12 2007
    Bridgette D. Guthrie MD
    Objectives A noninvasive method to assess ventilation may aid in management of children with acute asthma. The purpose of this study was to evaluate the association between end-tidal carbon dioxide (EtCO2) values and disease severity among children with acute asthma. Methods This was a prospective, blinded, observational study of children 3,17 years old treated for acute asthma in a pediatric emergency department (ED). EtCO2 measurements were taken before the initiation of therapy and after each nebulization treatment (maximum of three). Peak expiratory flow rate (PEFR), Pediatric Asthma Severity Score (PASS), oxygen saturation, and disposition were recorded. Treating physicians, unaware of the EtCO2 results, made all treatment decisions, including disposition. Results One hundred children were enrolled. The mean initial EtCO2 value was 35 mm Hg (95% confidence interval = 34.3 to 36.1 mm Hg). The mean disposition EtCO2 value was 33.3 mm Hg (95% confidence interval = 32.6 to 34.4 mm Hg). PEFR measures were completed on 43 patients and PASS recorded on 100 patients. There was an overall trend toward lower EtCO2 values during treatment (p < 0.01). Sixteen patients were admitted. Initial EtCO2 values were lower among children admitted to the hospital (35.6 mm Hg vs. 32.9 mm Hg; Mann-Whitney U test; p < 0.02). EtCO2 values at disposition did not differ between groups based on PEFR, PASS, or hospital admission. Conclusions Noninvasive bedside measurement of EtCO2 values among children with acute asthma is feasible. EtCO2 values did not distinguish children with mild disease from those with more severe disease. Further data are needed to clarify the association between EtCO2 values and other indicators of disease severity, particularly in children with more severe disease. [source]