Distribution by Scientific Domains
Distribution within Medical Sciences

Kinds of Unknown

  • far unknown
  • primary unknown

  • Terms modified by Unknown

  • unknown amount
  • unknown cause
  • unknown characteristic
  • unknown coefficient
  • unknown component
  • unknown composition
  • unknown compound
  • unknown disturbance
  • unknown effects
  • unknown etiology
  • unknown factor
  • unknown form
  • unknown function
  • unknown gene
  • unknown impurity
  • unknown input
  • unknown input observer
  • unknown location
  • unknown mean
  • unknown mechanism
  • unknown metabolite
  • unknown model parameter
  • unknown number
  • unknown origin
  • unknown parameter
  • unknown pathogenesis
  • unknown phase
  • unknown plant
  • unknown point
  • unknown primary
  • unknown primary site
  • unknown property
  • unknown protein
  • unknown quantity
  • unknown reason
  • unknown risk factor
  • unknown role
  • unknown sample
  • unknown sequence
  • unknown sex
  • unknown significance
  • unknown species
  • unknown structure
  • unknown transition probability
  • unknown variable

  • Selected Abstracts

    Investigation of virulence genes in clinical isolates of Yersinia enterocolitica

    Haoxuan Zheng
    Abstract In this study, we aimed to investigate the distribution of virulence genes in clinical isolates of pathogenic Yersinia enterocolitica. Two thousand six hundred stool samples were collected from 2600 patients with diarrhea, and were tested using the culture method and real-time PCR. Then, all isolates of pathogenic Y. enterocolitica cultured from the culture method were examined for virulence genes (inv, ail, ystA, ystB, ystC, yadA, virF) by PCR and for the presence of plasmid by four phenotypic tests. As a result, 160 pathogenic strains were successfully detected by the culture method, including bio/serotype 1A/unknown (4), 1B/unknown (8), 2/O:9 (39), 2/unknown (7), 3/O:3 (22), 3/unknown (6), 4/O:3 (55), 4/unknown (10) and 5/unknown (9). The positive rate of virulence genes tested in 160 isolates was inv (100%), ail (94%), ystA (93%), ystB (7.5%), ystC (5%), yadA (89%) and virF (82%) while the phenotypic test included autoagglutination (87%), binding of crystal violet (89%), calcium-dependent growth (74%) and Congo red absorption (78%), respectively. Finally, we found that not all pathogenic Y. enterocolitica necessarily carry all traditional virulence genes in both chromosomes and plasmids to cause illness. Perhaps, some of them, lacking some traditional virulence genes, contain other unknown virulence markers that interact with each other and play an important role in the diverse pathogenesis of pathogenic Y. enterocolitica. [source]

    Crystal Structure of an EMAP-II-Like Cytokine Released from a Human tRNA Synthetase

    Xiang-Lei Yang
    Aminoacyl-tRNA synthetases catalyze the first step of protein synthesis by aminoacylation of tRNAs. Remarkably, biological fragments of two human enzymes , tyrosyl-tRNA synthetase (TyrRS) and tryptophanyl-tRNA synthetase , are active cytokines produced by proteolysis or alternative splicing. One is a C-terminal fragment of TyrRS (C-TyrRS) that has potent activity for chemotaxis of leukocytes and monocytes and for stimulating production of other cytokines. Significantly, the cytokine activity of C-TyrRS is absent in the context of the full-length native protein. Unknown is the mechanism by which domain-release from the dimeric native protein activates the cytokine. Here, the crystal structure of C-TyrRS is presented at 2.2,Å resolution. This structure is similar to that of endothelial monocyte-activating protein II (EMAP-II), with critical residues of a heptapeptide element important for chemotaxis activity exposed on the first strand of a , -barrel of the monomeric unit. In contrast, the same residues of C-TyrRS are buried in an operational model for native TyrRS. Importantly, C-TyrRS is shown here to be monomeric when released from dimeric native TyrRS. Further analysis suggests that the critical residues are exposed when tRNA is bound. Thus, tRNA binding to native TyrRS may be an additional or alternative way to activate cytokine signaling. [source]

    "Unknown Risks" of non-steroid topical medications for atopic dermatitis

    Anne Marie McNeill PhD
    Introduction, Tacrolimus ointment is a nonsteroid treatment for atopic dermatitis which is both effective and has a minimal side-effect profile. However, some clinicians may be reluctant to use tacrolimus ointment due to the "unknown risks", meaning those that have not been uncovered in human studies conducted thus far. Therefore, the available animal data regarding the "unknown risks" of topical tacrolimus therapy are reviewed, and a discussion of the interpretation of this available but limited data is presented. Animal studies, Some of the fear on the part of clinicians regarding the use of topical tacrolimus may come from the results of animal studies which showed an increase in lymphoma and UV-induced skin cancer after treatment with topical tacrolimus in animal models of carcinogenesis. However, rigorous assessment of these studies suggest that it is somewhat likely that these represent a species-specific response to tacrolimus in an animal already predisposed to tumor formation, and therefore may not be relevant in assessing the possibility of an increased human health risk. Conclusions, Animal and human studies suggest that topical tacrolimus is a safe alternative to topical steroids, with the major known adverse effect being a transient burning sensation, compared with the known adverse effects of topical steroids, including long-lasting ones. Therefore, in the opinion of the authors, currently available data, including animal studies, does not suggest that "unknown risks" of topical tacrolimus need be any more concerning than the known side-effects of the topical steroids. [source]

    Managing the Unknown: A New Approach to Managing High Uncertainty and Risk in Projects by Christoph H. Loch, Arnoud DeMeyer, and Michael T. Pich

    Preston G. Smith
    No abstract is available for this article. [source]

    Monuments and Texts: Antiquarianism and the Beauty of Antiquity

    ART HISTORY, Issue 4 2002
    Maria Grazia Lolla
    Maria Grazia Lolla has published articles in English and Italian on various aspects of antiquarianism, aesthetics and eighteenth,century culture, as well as on Caribbean poetry and literature. She received her PhD from the University of Cambridge, has been awarded fellowships from the British Council and the Italian Ministry of Foreign Affairs, and has held research fellowships at the Wesleyan University Center for the Humanities and the Huntington Library. Now at work on Rivers Unknown to Song: Antiquarian Explorations of the East and West Indies, she is an adjunct professor at New York University. From the beginning of the Renaissance antiquaries had been publishing monuments at such a pace that publishing as much as collecting or studying monuments could be counted amongst the defining features of antiquarianism. However widely and routinely practised, the publication of monuments revealed substantial divisions within the world of antiquarianism. Antiquaries were faced with the choice of either textualizing monuments , turning monuments from visual or tactile objects into reading material , or attempting to reproduce their materiality , even if the monument was a text. The paper analyses Johann Joachim Winckelmann's Monumenti antichi inediti (1767) as a significant example of the former and the discussion concerning the publication of Domesday Book that took place in the rooms of the London Society of Antiquaries in 1768 as a compelling example of the latter. Juxtaposed to one another, Monumenti antichi inediti and the projected facsimile of the Domesday Book provide mutually revealing accounts of the aesthetic and intellectual complexities of eighteenth,century antiquarian practice. Where Winckelmann patently sought to rid monuments of their materiality in an effort, perhaps, to nobilitate antiquarianism , while nevertheless keeping it in a suitably ancillary position to literature , the fellows of the Society of Antiquaries chose the facsimile as the vehicle of preservation and transmission best suited to conveying their admiration of texts as material objects, indeed, as non,representational art. As necessarily (and self,consciously) imperfect attempts to reproduce original monuments, facsimiles provide both a marker of deep scepticism about the possibility of ever really knowing the past and a precious trace of past versions of the past , of what could be seen and deemed worthy of preservation, scholarly investigation and aesthetic appreciation. [source]

    Anthocyanin profile of Spanish Vitis vinifera L. red grape varieties in danger of extinction

    Abstract This paper reports on a study of the anthocyanin fraction in berry skins of ten minority red and pink grapevine varieties from Castilla-La Mancha (Spain) and two traditional varieties from this growing region, Tempranillo and Garnacha Tinta, as references. These varieties were correctly identified beforehand by analysing six microsatellite regions recommended by the GENRES 081 project; five varieties were identified with genotypes identical to those described previously, and five new genotypes not described for any variety according to the literature consulted. Grape skin extracts of each variety were analysed by HPLC-UV-Vis, and four perfectly differentiated anthocyanin profiles were obtained. In six out of ten varieties (Churriago, Unknown 1, Unknown 2, Ariño, Brujidera and Moravia Agria) the major anthocyanin was malvidin-3-glucoside (39%). Tinto Velasco contained more than 29% delphinidin-3-glucoside, Gordera Roja and Teta de Vaca Tinta more than 40% peonidin-3-glucoside, and Rojal more than 29% cyanidin-3-glucoside. Results of this work point out the existence of unusual anthocyanic profiles in several of these indigenous varieties, and highlight the necessity of studying the effects of variety on other flavonoids and their impact on wine colour. [source]

    Estimating Abundance Using Mark,Resight When Sampling Is with Replacement or the Number of Marked Individuals Is Unknown

    BIOMETRICS, Issue 1 2009
    Brett T. McClintock
    Summary Although mark,resight methods can often be a less expensive and less invasive means for estimating abundance in long-term population monitoring programs, two major limitations of the estimators are that they typically require sampling without replacement and/or the number of marked individuals available for resighting to be known exactly. These requirements can often be difficult to achieve. Here we address these limitations by introducing the Poisson log and zero-truncated Poisson log-normal mixed effects models (PNE and ZPNE, respectively). The generalized framework of the models allow the efficient use of covariates in modeling resighting rate and individual heterogeneity parameters, information-theoretic model selection and multimodel inference, and the incorporation of individually unidentified marks. Both models may be implemented using standard statistical computing software, but they have also been added to the mark,recapture freeware package Program MARK. We demonstrate the use and advantages of (Z)PNE using black-tailed prairie dog data recently collected in Colorado. We also investigate the expected relative performance of the models in simulation experiments. Compared to other available estimators, we generally found (Z)PNE to be more precise with little or no loss in confidence interval coverage. With the recent introduction of the logit-normal mixed effects model and (Z)PNE, a more flexible and efficient framework for mark,resight abundance estimation is now available for the sampling conditions most commonly encountered in these studies. [source]


    Warren Colman
    ABSTRACT This paper considers consciousness from the point of view of extreme materialism, which asserts that everything is physical and extreme idealism, which asserts that,the world is my idea'. Attempting to avoid dualism, I argue that there is no fundamental ground of being and that consciousness is a no-thing. Science can explain its mechanisms in terms of,propositional knowledge'but this is distinct from the,experiential knowledge'that refers to the domain of meaning (psychic reality). Although consciousness is omnipresent and infinite, it is surrounded by the further infinity of the Unknown. Together these comprise the totality that Jung called,the Self'. The paper concludes with some reflections on the experience of Being in,the Isness Business'. [source]

    A perspective factorization method for Euclidean reconstruction with uncalibrated cameras

    Mei Han
    Abstract Structure from motion (SFM), which is recovering camera motion and scene structure from image sequences, has various applications, such as scene modelling, robot navigation, object recognition and virtual reality. Most of previous research on SFM requires the use of intrinsically calibrated cameras. In this paper we describe a factorization-based method to recover Euclidean structure from multiple perspective views with uncalibrated cameras. The method first performs a projective reconstruction using a bilinear factorization algorithm, and then converts the projective solution to a Euclidean one by enforcing metric constraints. The process of updating a projective solution to a full metric one is referred as normalization in most factorization-based SFM methods. We present three normalization algorithms which enforce Euclidean constraints on camera calibration parameters to recover the scene structure and the camera calibration simultaneously, assuming zero skew cameras. The first two algorithms are linear, one for dealing with the case that only the focal lengths are unknown, and another for the case that the focal lengths and the constant principal point are unknown. The third algorithm is bilinear, dealing with the case that the focal lengths, the principal points and the aspect ratios are all unknown. The results of experiments are presented. Copyright © 2002 John Wiley & Sons, Ltd. [source]

    Manifold Homotopy via the Flow Complex

    Bardia Sadri
    Abstract It is known that the critical points of the distance function induced by a dense sample P of a submanifold , of ,n are distributed into two groups, one lying close to , itself, called the shallow, and the other close to medial axis of ,, called deep critical points. We prove that under (uniform) sampling assumption, the union of stable manifolds of the shallow critical points have the same homotopy type as , itself and the union of the stable manifolds of the deep critical points have the homotopy type of the complement of ,. The separation of critical points under uniform sampling entails a separation in terms of distance of critical points to the sample. This means that if a given sample is dense enough with respect to two or more submanifolds of ,n, the homotopy types of all such submanifolds together with those of their complements are captured as unions of stable manifolds of shallow versus those of deep critical points, in a filtration of the flow complex based on the distance of critical points to the sample. This results in an algorithm for homotopic manifold reconstruction when the target dimension is unknown. [source]

    Statistical optimization of octree searches

    Rener Castro
    Abstract This work emerged from the following observation: usual search procedures for octrees start from the root to retrieve the data stored at the leaves. But as the leaves are the farthest nodes to the root, why start from the root? With usual octree representations, there is no other way to access a leaf. However, hashed octrees allow direct access to any node, given its position in space and its depth in the octree. Search procedures take the position as an input, but the depth remains unknown. This work proposes to estimate the depth of an arbitrary node through a statistical optimization of the average cost of search procedures. As the highest costs of these algorithms are obtained when starting from the root, this method improves on both the memory footprint by the use of hashed octrees, and execution time through the proposed optimization. [source]

    Recurrence of kernicterus in term and near-term infants in Denmark

    ACTA PAEDIATRICA, Issue 10 2000
    F Ebbesen
    Classical acute bilirubin encephalopathy (kernicterus) in term and near-term infants had not been seen in Denmark for at least 20 y until 1994. From 1994 to 1998, however, six cases were diagnosed. Aetiology of the hyperbilirubinaemia was known in two infants; spherocytosis and galactosaemia, most likely known in two infants; possible A-O blood type immunization, and unknown in two infants. However, one of these last-mentioned infants had a gestational age of only 36 wk. The maximum plasma total bilirubin concentrations were 531,745 ,mol/L. The increase in the number of cases of kernicterus was considered to have been caused by: (i) a decreased awareness of the pathological signs, (ii) a change in the assessment of the risk of bilirubin encephalopathy, (iii) early discharge of the infants from the maternity ward, (iv) so-called breastfeeding-associated jaundice, (v) demonstration of bilirubin being an antioxidant, and (vi) difficulty in estimating the degree of jaundice in certain groups of immigrants. Accordingly, for prevention: (a) Attempt to change the healthcare workers' understanding of the risk of bilirubin encephalopathy, (b) give further instructions, both orally and in writing, to mothers before discharge from the maternity ward, (c) be more liberal in giving infant formula supplements, (d) conduct home visits by the community nurse at an earlier stage, (e) follow authorized guidelines for phototherapy and exchange transfusion, (f) lower plasma bilirubin concentration limits as an indication for phototherapy and exchange transfusion, (g) screen all term and near-term infants, and (h) measure the skin's yellow colour with a device that corrects for the skin's melanin content. Conclusions: Audit of the six cases presented indicates that measures are necessary in both the primary and secondary healthcare sectors if the risk of kernicterus is to be avoided. Screening may be considered, but in order to identify the problems it would first be reasonable to perform a larger prospective study in which audit is performed on all newborn infants, born at term and near-term, who develop a plasma bilirubin concentration above the exchange transfusion limit. [source]

    The Neutralizer: a self-configurable failure detector for minimizing distributed storage maintenance cost

    Zhi Yang
    Abstract To achieve high data availability or reliability in an efficient manner, distributed storage systems must detect whether an observed node failure is permanent or transient, and if necessary, generate replicas to restore the desired level of replication. Given the unpredictability of network dynamics, however, distinguishing permanent and transient failures is extremely difficult. Though timeout-based detectors can be used to avoid mistaking transient failures as permanent failures, it is unknown how the timeout values should be selected to achieve a better tradeoff between detection latency and accuracy. In this paper, we address this fundamental tradeoff from several perspectives. First, we explore the impact of different timeout values on maintenance cost by examining the probability of their false positives and false negatives. Second, we propose a self-configurable failure detector called the Neutralizer based on the idea of counteracting false positives with false negatives. The Neutralizer could enable the system to maintain a desired replication level on average with the least amount of bandwidth. We conduct extensive simulations using real trace data from a widely deployed peer-to-peer system and synthetic traces based on PlanetLab and Microsoft PCs, showing a significant reduction in aggregate bandwidth usage after applying the Neutralizer (especially in an environment with a low average node availability). Overall, we demonstrate that the Neutralizer closely approximates the performance of a perfect ,oracle' detector in many cases. Copyright © 2008 John Wiley & Sons, Ltd. [source]

    Etiology, pathogenesis and prevention of neural tube defects

    Rengasamy Padmanabhan
    ABSTRACT Spina bifida, anencephaly, and encephalocele are commonly grouped together and termed neural tube defects (NTD). Failure of closure of the neural tube during development results in anencephaly or spina bifida aperta but encephaloceles are possibly post-closure defects. NTD are associated with a number of other central nervous system (CNS) and non-neural malformations. Racial, geographic and seasonal variations seem to affect their incidence. Etiology of NTD is unknown. Most of the non-syndromic NTD are of multifactorial origin. Recent in vitro and in vivo studies have highlighted the molecular mechanisms of neurulation in vertebrates but the morphologic development of human neural tube is poorly understood. A multisite closure theory, extrapolated directly from mouse experiments highlighted the clinical relevance of closure mechanisms to human NTD. Animal models, such as circle tail, curly tail, loop tail, shrm and numerous knockouts provide some insight into the mechanisms of NTD. Also available in the literature are a plethora of chemically induced preclosure and a few post-closure models of NTD, which highlight the fact that CNS malformations are of hetergeneitic nature. No Mendelian pattern of inheritance has been reported. Association with single gene defects, enhanced recurrence risk among siblings, and a higher frequency in twins than in singletons indicate the presence of a strong genetic contribution to the etiology of NTD. Non-availability of families with a significant number of NTD cases makes research into genetic causation of NTD difficult. Case reports and epidemiologic studies have implicated a number of chemicals, widely differing therapeutic drugs, environmental contaminants, pollutants, infectious agents, and solvents. Maternal hyperthermia, use of valproate by epileptic women during pregnancy, deficiency and excess of certain nutrients and chronic maternal diseases (e.g. diabetes mellitus) are reported to cause a manifold increase in the incidence of NTD. A host of suspected teratogens are also available in the literature. The UK and Hungarian studies showed that periconceptional supplementation of women with folate (FA) reduces significantly both the first occurrence and recurrence of NTD in the offspring. This led to mandatory periconceptional FA supplementation in a number of countries. Encouraged by the results of clinical studies, numerous laboratory investigations focused on the genes involved in the FA, vitamin B12 and homocysteine metabolism during neural tube development. As of today no clinical or experimental study has provided unequivocal evidence for a definitive role for any of these genes in the causation of NTD suggesting that a multitude of genes, growth factors and receptors interact in controlling neural tube development by yet unknown mechanisms. Future studies must address issues of gene-gene, gene-nutrient and gene,environment interactions in the pathogenesis of NTD. [source]

    Review of animal models for autism: implication of thyroid hormone

    Miyuki Sadamatsu
    ABSTRACT,, Autism is a behaviorally defined disorder associated with characteristic impairments in social interactions and communication, as well as restricted and repetitive behaviors and interest. Its prevalence was once thought to be 2/10 000, but recently several large autism prevalence reviews revealed that the rate of occurrence was roughly 30/10 000. While it has been considered a developmental disorder, little is certain about its etiology. Neuroanatomical studies at the histological level in the brains of autistic patients provide many arguments in the etiology of autism. Results from postmortem and imaging studies have implicated many major structures of the brain including the limbic system, cerebellum, corpus callosum, basal ganglia and brainstem. There is no single biological or clinical marker for autism. While several promising candidate genes have been presented, the critical loci are yet unknown. Environmental influences such as rubella virus, valproic acid, and thalidomide exposure during pregnancy are also considered important, as concordance in monozygotic twins is less than 100% and the phenotypic expression of the disorder varies widely. It is thus hypothesized that non-genetic mechanisms contribute to the onset of autistic syndrome. In light of these ambiguities, hope is held that an animal model of autism may help elucidate matters. In this article, we overview most of the currently available animal models for autism, and propose the rat with mild and transient neonatal hypothyroidism as a novel model for autism. [source]

    Necessity to establish new risk assessment and risk communication for human fetal exposure to multiple endocrine disruptors in Japan

    Emiko Todaka
    ABSTRACT, Our recent study clearly shows that fetuses are exposed to multiple chemicals including endocrine disruptors in Japan. Although the embryo and fetus stages are the most sensitive period to chemicals in humans' life cycle, the health effects of the chemicals such as endocrine disruptors to them are largely unknown. The conventional risk assessment method cannot assess the risk to fetuses precisely. Now we need a new risk assessment, in which the target is fetuses and not the adults, in addition to the conventional risk assessment At the same time, we also need a new strategy to practically eliminate the risk for the future generations. To make the strategy effective, we suggest a new approach to reduce the risk and avoid the possible adverse health effects, using primary, secondary and tertiary preventions as they are used in public health. We also suggest a new concept of "pre-primary prevention" to reduce the risk for fetuses. Furthermore, to make this method even more practical, we suggest a new risk communication method. In this paper, we present a framework of risk avoidance of multiple chemical exposure to fetuses. [source]

    Neurulation in the human embryo revisited

    Tomoko Nakatsu
    ABSTRACT It used to be widely accepted that neural tube closure in the human initiates at the level of the future neck and proceeds both cranially and caudally like zip fastener closing. This continuous closure model was recently challenged, and observation of human embryos at the neurulation stage revealed that the closure of the human neural tube initiates at multiple sites. Multi-site closure of the neural tube has been observed in many other animal species, but the initiation sites and the process of neural tube closure are variable among species. Therefore we should be careful when extrapolating the data of normal and abnormal neurulation in laboratory animals to the human. Recent studies in mouse genetics and developmental biology have shown that neural tube defects are quite heterogeneous both etiologically and pathogenetically. Gene mutations responsible for human neural tube defects are largely unknown, but molecular studies of human cases of neural tube defects and their comparison with the mouse genome data should provide a molecular basis for human neural tube defects. [source]

    Craniorachischisis and Heterotaxia with Heart Disease in Twins: Link or Change Nature?

    Sebastiano Bianca MD
    ABSTRACT Craniorachischisis is a rare neural tube defect in which both acrania and a complete schisis of the vertebral column are present. Heterotaxy results from failure to establish normal left,right asymmetry during embryonic development and is characterized by a variable group of congenital anomalies that include complex cardiac malformations and situs inversus or situs ambiguous. We report a diamniotic twin pregnancy with two malformed fetuses affected one by craniorachischisis and the other by heterotaxya with paired right-sided viscera, asplenia, and complex congenital heart disease. The occurrence of severe congenital anomalies in both members of the twin pair implies a strong influence of genetic factors. At present, the genetic basis determining the different phenotypes observed in our twins is unknown. Our case with the simultaneous presence of both midline and laterality defects in twins supports the hypothesis that the midline plays a critical role in establishing left,right asymmetry in the body and that a mutation in a gene responsible for both heterotaxy and midline defects may be strongly supposed. [source]

    Pulmonary Hypertension in Patients after Repair of Transposition of the Great Arteries

    Ellen Chan MD
    ABSTRACT One well-documented complication of unrepaired d-transposition of the great arteries (d-TGA) is progressive pulmonary vascular disease. It is generally accepted that pulmonary vascular disease will not develop if d-TGA repair is performed early in life. Herein, we report a number of repaired d-TGA, especially in older patients with Mustard/Senning procedures, in whom pulmonary vascular disease developed years after their original repair. The etiology of this phenomenon is unknown, warranting further investigation. Our case reports highlight an overlooked, possible long-term complication following d-TGA repair. From this experience, we recommend that evidence of progressive pulmonary vascular disease may need to be regularly sought during the follow-up of patients after d-TGA repair, especially Mustard/Senning repairs, as early treatment of pulmonary hypertension may improve long-term clinical outcomes. [source]

    The effects of acute and chronic exercise on the vasculature

    ACTA PHYSIOLOGICA, Issue 4 2010
    J. J. Whyte
    Abstract Regular physical activity (endurance training, ET) has a strong positive link with cardiovascular health. The aim of this review is to draw together the current knowledge on gene expression in different cell types comprising the vessels of the circulatory system, with special emphasis on the endothelium, and how these gene products interact to influence vascular health. The effect beneficial effects of ET on the endothelium are believed to result from increased vascular shear stress during ET bouts. A number of mechanosensory mechanisms have been elucidated that may contribute to the effects of ET on vascular function, but there are questions regarding interactions among molecular pathways. For instance, increases in flow brought on by ET can reduce circulating levels of viscosity and haemostatic and inflammatory variables that may interact with increased shear stress, releasing vasoactive substances such as nitric oxide and prostacyclin, decreasing permeability to plasma lipoproteins as well as the adhesion of leucocytes. At this time the optimal rate-of-flow and rate-of-change in flow for determining whether anti-atherogenic or pro-atherogenic processes proceed remain unknown. In addition, the impact of haemodynamic variables differs with vessel size and tissue type in which arteries are located. While the hurdles to understanding the mechanism responsible for ET-induced alterations in vascular cell gene expression are significant, they in no way undermine the established benefits of regular physical activity to the cardiovascular system and to general overall health. This review summarizes current understanding of control of vascular cell gene expression by exercise and how these processes lead to improved cardiovascular health. [source]

    Protein-Losing Enteropathy after Fontan Operation

    Jack Rychik MD
    ABSTRACT Protein-losing enteropathy (PLE) is a poorly understood and enigmatic disease process affecting patients with single ventricle after Fontan operation. In those afflicted, PLE after Fontan operation results in significant morbidity and mortality. The pathophysiology of the disease is unknown; however, a proposed mechanism incorporates a combination of phenomena including: (1) altered hemodynamics, specifically low cardiac output; (2) increased mesenteric vascular resistance; (3) systemic inflammation; and (4) altered enterocyte basal membrane glycosaminoglycan make-up. A paradigm for the clinical management of PLE after Fontan operation is proposed. [source]

    Identifying Left Ventricular Dysfunction in Pulmonary Hypertension

    Navin Rajagopalan MD
    The significance of left ventricular (LV) dysfunction in patients with pulmonary hypertension (PH) is unknown. Our purpose was to quantify LV function in PH patients by measuring LV myocardial performance index (MPI) and correlating it with invasively determined hemodynamic variables. The authors prospectively measured LV MPI via transthoracic echocardiography in 50 patients with PH (53±11 years; 35 women) who also underwent right heart catheterization within 1 day of echocardiography. For comparative purposes, LV MPI was also measured in 15 healthy volunteers who served as controls. LV MPI was significantly increased in the PH group compared with controls (0.62±0.27 vs 0.36±0.08; P<.001), indicating worse LV dysfunction despite that LV ejection fraction was not significantly different between the groups (58%±4% vs 60%±3%). LV MPI demonstrated significant correlations with invasively determined mean pulmonary artery pressure (r=.50; P<.001), pulmonary vascular resistance (r=.57; P<.001), and cardiac index (r=,.64; P<.001). By receiver operating characteristic analysis, LV MPI >0.75 predicted cardiac index <2 L/min/m2 with 89% sensitivity and 78% specificity (area under the curve, 0.89). In a multivariate model, LV MPI was independently associated with cardiac index (P<.01). Patients with PH demonstrate abnormal LV function as quantified by elevated LV MPI, which correlates significantly with pulmonary vascular resistance and cardiac index. [source]

    Statin Use Is Associated With Improved Survival in Patients With Advanced Heart Failure Receiving Resynchronization Therapy

    Andrew D. Sumner MD
    It is unknown whether statin use improves survival in patients with advanced chronic heart failure (HF) receiving cardiac resynchronization therapy (CRT). The authors retrospectively assessed the effect of statin use on survival in patients with advanced chronic HF receiving CRT alone (CRT-P) or CRT with implantable cardioverter-defibrillator therapy (CRT-D) in 1520 patients with advanced chronic HF from the Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure (COMPANION) trial database. Six hundred three patients (40%) were taking statins at baseline. All-cause mortality was 18% in the statin group and 22% in the no statin group (hazard ratio [HR] 0.85; confidence interval (CI), 0.67,1.07; P=.15). In a multivariable analysis controlling for significant baseline characteristics and use of CRT-P/CRT-D, statin use was associated with a 23% relative risk reduction in mortality (HR, 0.77; CI, 0.61,0.97; P=.03). Statin use is associated with improved survival in patients with advanced chronic HF receiving CRT. No survival benefit was seen in patients receiving statins and optimal pharmacologic therapy without CRT. [source]

    Validity of a Discharge Diagnosis of Heart Failure: Implications of Misdiagnosing

    Cândida Fonseca MD
    Heart failure (HF) costs are largely due to hospitalization. The validity of a death/discharge diagnosis of HF (DDHF) is largely unknown. The authors assessed the validity of DDHF and the impact of misdiagnosing. The case notes of patients consecutively admitted to a medical department between January and June 2001 were reviewed. Cases with DDHF or cardiovascular diseases, potential precursors of HF (PPHF), were included. The diagnosis of HF (European Society of Cardiology guidelines) was classified as definite, possible, or miscoded. Of the 1038 patients admitted, 234 were enrolled: 157 with DDHF and 77 with PPHF. One hundred eighty patients had a definite diagnosis of HF. Of the 157 diagnoses coded as definite HF, 130 were correct, 21 had possible HF, and 6 were miscoded. Of the 77 patients classified as having PPHF, 38 had definite HF. The accuracy of the DDHF diagnosis was 72.2%: 21.1% were underdiagnosed and 8.3% overdiagnosed. DDHF failed to capture many HF admissions and therefore alone underestimates the prevalence, burden, and costs of the syndrome. [source]

    Potential of Marine Reserves to Cause Community-Wide Changes beyond Their Boundaries

    arrecifes rocosos templados; cambios a nivel comunitario; cascadas tróficas; estados comunitarios alternativos; exceso de pesca; reservas marinas Abstract:,Fishing and other human activities can alter the abundances, size structure, and behavior of species playing key roles in shaping marine communities (e.g., keystone predators), which may in turn cause ecosystem shifts. Despite extensive evidence that cascading trophic interactions can underlie community-wide recovery inside no-take marine reserves by protecting high-level predators, the spatial extent of these effects into adjacent fished areas is unknown. I examined the potential for community-wide changes (i.e., the transition from overgrazed coralline barrens to macroalgal beds) in temperate rocky reefs within and around a no-take marine reserve. For this purpose I assessed distribution patterns of predatory fishes, sea urchins, and barrens across the reserve boundaries. Predatory fishes were significantly more abundant within the reserve than in adjacent locations, with moderate spillover across the reserve edges. In contrast, community-wide changes of benthic assemblages were apparent well beyond the reserve boundaries, which is consistent with temporary movements of predatory fishes (e.g., foraging migration) from the reserve to surrounding areas. My results suggest that no-take marine reserves can promote community-wide changes beyond their boundaries. Resumen:,La pesca y otras actividades humanas pueden alterar la abundancia, tamaño, estructura y comportamiento de las especies que juegan papeles clave en el modelado de las comunidades marinas (e.g., depredadores clave), que a su vez pueden causar cambios en los ecosistemas. No obstante la evidencia extensiva de que las interacciones tróficas en cascada pueden subyacer en la recuperación de la comunidad dentro de reservas marinas que no permiten la pesca mediante la protección de depredadores de nivel alto, se desconoce la extensión espacial de estos efectos en áreas adyacentes. Examiné el potencial de los cambios a nivel comunidad (i.e., la transición de áreas coralinas sobre pastoreadas a lechos de microalgas) en arrecifes rocosos templados dentro y alrededor de una reserva marina sin pesca. Para este propósito, evalué los patrones de distribución de peces depredadores, erizos de mar y áreas sobre pastoreadas en los límites de la reserva. Los peces depredadores fueron significativamente más abundantes dentro de la reserva que en localidades adyacentes, con un excedente moderado en los bordes de la reserva. En contraste, los cambios a nivel de comunidad en los ensambles bénticos fueron aparentes más allá de los límites de la reserva, lo que es consistente con los movimientos temporales de los peces depredadores (e.g., migración de forrajeo) desde la reserva hacia las áreas circundantes. Mis resultados sugieren que las reservas que no permiten la pesca pueden promover cambios a nivel comunidad más allá de sus límites. [source]

    Physiological and Behavioral Differences in Magellanic Penguin Chicks in Undisturbed and Tourist-Visited Locations of a Colony

    corticoesterona; ecoturismo; perturbación humana; Spheniscus magellanicus Abstract:,Studies examining anthropogenic effects on wildlife typically focus on adults and on behavioral responses rather than the physiological consequences of human disturbances. Here we examined how Magellanic Penguin ( Spheniscus magellanicus) chicks living in either tourist-visited or undisturbed areas of a breeding colony were affected by human visitation by comparing the baseline and stress-induced levels of corticosterone during three periods of the breeding season. Newly hatched chicks in visited areas had higher corticosterone stress responses than newly hatched chicks in undisturbed areas (p =0.007), but baseline levels were similar (p =0.61). By 40,50 days of age and around fledging time, both visited and undisturbed chicks showed a robust corticosterone stress response to capture. Tourist-visited chicks did not flee when approached by humans, however, whereas undisturbed chicks fled significantly sooner (i.e., when approached no closer than 9 m; p < 0.0001). Although it is unknown whether Magellanic Penguin chicks raised in visited areas suffer negative consequences from the elevation of the corticosterone stress response at hatching, they do exhibit behavioral habituation to human contact by the time they are ready to fledge. Unlike adults living in tourist areas, however, fledging chicks in visited areas do not have a decreased stress response to capture and restraint. Our results show that the coupling of behavioral and physiological habituation in Magellanic Penguins is complex and life-history context may greatly affect the ability of wildlife to adapt to anthropogenic disturbances. Resumen:,Los estudios de los efectos antropogénicos sobre la vida silvestre se centran típicamente en adultos y en las respuestas conductuales en lugar de las consecuencias fisiológicas de las perturbaciones humanas. Aquí examinamos el efecto de la visita de humanos sobre pollos de pingüino (Spheniscus magellanicus) en áreas visitadas por turistas o no perturbadas mediante la comparación de los niveles, base e inducidos por estrés, de corticoesterona durante tres períodos de la temporada reproductiva. Los pollos recién eclosionados en áreas visitadas tuvieron mayor respuesta de la corticoesterona al estrés que los pollos recién eclosionados en áreas no perturbadas (p =0.007), pero los niveles básicos fueron similares (p =0.61). A los 40,50 días y en la etapa de volantón, los pollos visitados y no perturbados mostraron una marcada respuesta de la corticoesterona al estrés al ser capturados. Sin embargo, los pollos visitados por turistas no huyeron cuando se les acercaron humanos, mientras que los pollos no perturbados huyeron significativamente antes (i.e., acercamiento a más de 9 m; p < 0.0001). Aunque se desconoce si los pollos de pingüino criados en áreas visitadas sufren consecuencias negativas por la elevación de la corticosterona en respuesta al estrés al eclosionar, si presentan acostumbramiento conductual al contacto con humanos al momento que están listos para dejar el nido. Sin embargo, a diferencia de adultos que viven en áreas turísticas, los pollos volantones en las áreas visitadas no tienen una disminución en la respuesta al estrés cuando son capturados y sujetados. Nuestros resultados muestran la complejidad de la combinación del acostumbramiento conductual y fisiológico en Spheniscus magellanicus y que el contexto de la historia de vida puede afectar a la habilidad de la vida silvestre para adaptarse a las perturbaciones antropogénicas. [source]

    Understanding the Causes of Disease in European Freshwater Crayfish

    Aphanomyces astaci; bioseguridad; epizootia; langostinos de agua dulce; patología de langostinos; peste de langostinos Abstract:,Native European freshwater crayfish (Astacida, Decapoda) are under severe pressure from habitat alteration, the introduction of nonindigenous species, and epizootic disease. Crayfish plague, an acute disease of freshwater crayfish caused by the fungus-like agent Aphanomyces astaci, was introduced into Europe in the mid-nineteenth century and is responsible for ongoing widespread epizootic mortality in native European populations. We reviewed recent developments and current practices in the field of crayfish pathology. The severity of crayfish plague has resulted in an overemphasis on it. Diagnostic methods for detecting fungi and fungal-like agents, and sometimes culturing them, are frequently the sole techniques used to investigate disease outbreaks in European freshwater crayfish. Consequently, the causes of a significant proportion of outbreaks are undetermined. Pathogen groups well known for causing disease in other crustaceans, such as viruses and rickettsia-like organisms, are poorly understood or unknown in European freshwater crayfish. Moreover, the pathogenic significance of some long-known pathogens of European freshwater crayfish remains obscure. For effective management of this culturally significant and threatened resource, there is an urgent need for researchers, diagnosticians, and resource managers to address the issue of disease in European freshwater crayfish from a broader perspective than has been applied previously. Resumen:,Los langostinos nativos de Europa (Astacida, Decapada) están bajo severa presión por alteración del hábitat, la introducción de especies no nativas y una enfermedad epizoótica. La peste de langostinos, una enfermedad aguda de langostinos de agua dulce producida por el agente micoide Aphanomyces astaci, fue introducida a Europa a mediados del siglo diecinueve y es responsable de la actual mortalidad epizoótica de poblaciones Europeas nativas. Revisamos acontecimientos recientes y prácticas actuales en el campo de la patología de langostinos. La severidad de la peste de langostinos ha resultado en un excesivo énfasis en ella. Los métodos para diagnosticar, y algunas veces cultivar, hongos y agentes micoides frecuentemente son la única técnica empleada al investigar brotes de la enfermedad en langostinos de agua dulce en Europa. Consecuentemente, no están determinadas las causas de una proporción significativa de los brotes. Grupos patógenos, como virus y organismos similares a rickettsias, bien conocidos por producir enfermedades en otros crustáceos son poco o nada conocidos en langostinos de agua dulce de Europa. Más aún, el significado patogénico de algunos patógenos de langostinos de agua dulce de Europa largamente conocidos es oscuro. Para el manejo efectivo de este recurso culturalmente significativo y amenazado es urgente la necesidad de investigadores, diagnosticadores y gestores de recursos para atender el asunto de la enfermedad en langostinos de agua dulce europeos desde una perspectiva más amplia que la previamente aplicada. [source]

    Cerebral oxygenation decreases but does not impair performance during self-paced, strenuous exercise

    ACTA PHYSIOLOGICA, Issue 4 2010
    F. Billaut
    Abstract Aim:, The reduction in cerebral oxygenation (Cox) is associated with the cessation of exercise during constant work rate and incremental tests to exhaustion. Yet in exercises of this nature, ecological validity is limited due to work rate being either fully or partly dictated by the protocol, and it is unknown whether cerebral deoxygenation also occurs during self-paced exercise. Here, we investigated the cerebral haemodynamics during a 5-km running time trial in trained runners. Methods:, Rating of perceived exertion (RPE) and surface electromyogram (EMG) of lower limb muscles were recorded every 0.5 km. Changes in Cox (prefrontal lobe) were monitored via near-infrared spectroscopy through concentration changes in oxy- and deoxyhaemoglobin (,[O2Hb], ,[HHb]). Changes in total Hb were calculated (,[THb] = ,[O2Hb] + ,[HHb]) and used as an index of change in regional blood volume. Results:, During the trial, RPE increased from 6.6 ± 0.6 to 19.1 ± 0.7 indicating maximal exertion. Cox rose from baseline to 2.5 km (,,[O2Hb], ,,[HHb], ,,[THb]), remained constant between 2.5 and 4.5 km, and fell from 4.5 to 5 km (,,[O2Hb], ,,[HHb], ,,[THb]). Interestingly, the drop in Cox at the end of the trial coincided with a final end spurt in treadmill speed and concomitant increase in skeletal muscle recruitment (as revealed by higher lower limb EMG). Conclusion:, Results confirm the large tolerance for change in Cox during exercise at sea level, yet further indicate that, in conditions of self-selected work rate, cerebral deoxygenation remains within a range that does not hinder strenuous exercise performance. [source]

    Formaldehyde-releasers: relationship to formaldehyde contact allergy.

    CONTACT DERMATITIS, Issue 2 2009
    Contact allergy to formaldehyde, inventory of formaldehyde-releasers
    This is one of series of review articles on formaldehyde and formaldehyde-releasers (others: formaldehyde in cosmetics, in clothes and in metalworking fluids and miscellaneous). Thirty-five chemicals were identified as being formaldehyde-releasers. Although a further seven are listed in the literature as formaldehyde-releasers, data are inadequate to consider them as such beyond doubt. Several (nomenclature) mistakes and outdated information are discussed. Formaldehyde and formaldehyde allergy are reviewed: applications, exposure scenarios, legislation, patch testing problems, frequency of sensitization, relevance of positive patch test reactions, clinical pattern of allergic contact dermatitis from formaldehyde, prognosis, threshold for elicitation of allergic contact dermatitis, analytical tests to determine formaldehyde in products and frequency of exposure to formaldehyde and releasers. The frequency of contact allergy to formaldehyde is consistently higher in the USA (8,9%) than in Europe (2,3%). Patch testing with formaldehyde is problematic; the currently used 1% solution may result in both false-positive and false-negative (up to 40%) reactions. Determining the relevance of patch test reactions is often challenging. What concentration of formaldehyde is safe for sensitive patients remains unknown. Levels of 200,300 p.p.m. free formaldehyde in cosmetic products have been shown to induce dermatitis from short-term use on normal skin. [source]

    Allergic contact dermatitis from modified colophonium in wound dressings

    CONTACT DERMATITIS, Issue 1 2007
    Teresa M. Pereira
    This study concerns a 69-year-old female patient with a longstanding history of venous ulcerations on both lower legs and multiple sensitivities, who developed eczematous lesions with the hydrocolloid dressing Combiderm® (Convatec Ltd., a Bristol-Myers Squibb division, Ickenham, Middlesex, UK). Epicutaneous tests were positive to this dressing and to a modified colophonium derivative, i.e. glyceryl rosinate, however not to the unmodified colophonium from the standard series. A review of the literature showed several case reports about sensitization to similar hydrocolloids being distributed under various brand names in different countries and which contain the pentaerythritol ester of the hydrogenated rosin as the tackifying agent. Some of the patients described did, while others did not, react to colophonium but only to a modified derivative. In our patient, the reaction to glyceryl rosinate most probably represent cross-sensitivity with the modified colophonium derivative used in Combiderm®, the presence (but not the exact nature) of which was showed by the company. In patients where allergic contact dermatitis from hydrocolloid dressings is strongly suspected and colophonium tests negatively, patch testing to modified colophonium derivatives should therefore be performed. As the complete composition of wound dressings is most often unknown, we urgently advocate legal requirements for labelling of those and in fact all medically used devices. [source]