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Validation of a model to develop a symptom index for benign prostatic hyperplasia in dogs.
Benign prostatic hyperplasia (BPH) is a spontaneous and age-related condition in humans and intact male dogs. A symptom index for BPH in men was created by the American Urological Association. In this study, it has been developed and statistically validated as a model to assign an objective score to canine BPH severity based on clinical signs observed and/or subjectively reported to the veterinarian by dog owners. The medical records of the Animal Reproduction Unit of University of Bologna (Italy) were used to select dogs with a clinical diagnosis of BPH. A data set was built up, and the animals were included in the statistical analysis as dependent variables. A score of 1-3 was assigned to the disease severity of each case based on signs annotated, graded using a scale ranging from 1 to 4. Signs of BHP were entered as predictors while disease severity as dependent variable to generate the predictive model. The model was finally used to re-classify each case of the data set, and the percentage of corrected predictions calculated. Overall, 373 subjects were entered in the model. Between them, 243, 107 and 23 animals have been represented based on medical records with a BPH severity score of 1, 2 and 3, respectively. The model correctly predicted the response variable in 97.3% of the cases. In this study, a BPH symptom index was created for the first time in dogs, which may be useful to standardize BPH severity with an objective score and to evaluate the necessity, the kind and the effectiveness of treatment. PMID:23279506
Zambelli, D; Cunto, M; Gentilini, F
Non-Invasive Evaluation of Bladder Outlet Obstruction in Men Suspected of Benign Prostatic Hyperplasia: Usefulness of the D Index
Objective To compare a new index of voiding dysfunction (D) based purely on free uroflow vs. Abrams-Griffiths (A-G) number obtained from intubated flow, for classification of bladder outlet obstruction in men. Patients and Methods Urodynamic tracings of 60 non-neurological patients (30 before transurethral resection of the prostate and of 30 men suspected of benign prostatic hyperplasia included in a medical therapy trial) were retrospectively analyzed. The Valentini-Besson-Nelson model was used to evaluate the value of the D index. A-G was obtained from intubated flows. Obstruction was defined as D > 32.5 cm H2O (translation of A-G criterion). Results D showed 82.05% sensitivity with 66.66% specificity; the positive predictive value was 82.05% and the negative predictive value 66.66% for the whole population, 83.3 vs. 80.9% sensitivity with 58.3 vs. 77.7% specificity for pre- transurethral resection of the prostate vs. medical therapy group. Conclusion D index which can be obtained from a free uroflow appears as a valuable alternative to invasive urodynamic investigations when the diagnosis of bladder outlet obstruction needs to be more solidly established before a treatment decision or in men suspected of benign prostatic hyperplasia who elect for watchful waiting.
Valentini, Francoise A.; Nelson, Pierre P.; Zimmern, Philippe E.
Psychological impact on parents of children with congenital adrenal hyperplasia: a study from Sri Lanka.
Abstract Introduction: Congenital adrenal hyperplasia (CAH) is a group of autosomal recessively inherited disorders with significant morbidity. The long-term implications result in immense psychological stress to the parents. This study assessing the psychological impact on the parents is a first in Sri Lanka and one of the few worldwide. Objective: Document the presence of depressive symptoms in parents of children with CAH. Design: Study participants were 37 parents of children diagnosed with CAH who were attending an endocrinology clinic of the largest children's hospital in Sri Lanka. Centre for Epidemiological Studies-Depression scale (CES-D), a psychometrically sound scale for assessing depressive symptomatology, was used. Results: The study classified 59% of the parents as being affected, and the psychological impact on them did not reduce with time. Conclusion: Parents of children with CAH demonstrated symptoms of depression that did not abate with the passage of time. PMID:24468601
de Silva, K S H; de Zoysa, Piyanjali; Dilanka, W M S; Dissanayake, B S
Mis-sizing of stent promotes intimal hyperplasia: impact of endothelial shear and intramural stress.
Stent can cause flow disturbances on the endothelium and compliance mismatch and increased stress on the vessel wall. These effects can cause low wall shear stress (WSS), high wall shear stress gradient (WSSG), oscillatory shear index (OSI), and circumferential wall stress (CWS), which may promote neointimal hyperplasia (IH). The hypothesis is that stent-induced abnormal fluid and solid mechanics contribute to IH. To vary the range of WSS, WSSG, OSI, and CWS, we intentionally mismatched the size of stents to that of the vessel lumen. Stents were implanted in coronary arteries of 10 swine. Intravascular ultrasound (IVUS) was used to size the coronary arteries and stents. After 4 wk of stent implantation, IVUS was performed again to determine the extent of IH. In conjunction, computational models of actual stents, the artery, and non-Newtonian blood were created in a computer simulation to yield the distribution of WSS, WSSG, OSI, and CWS in the stented vessel wall. An inverse relation (R(2) = 0.59, P < 0.005) between WSS and IH was found based on a linear regression analysis. Linear relations between WSSG, OSI, and IH were observed (R(2) = 0.48 and 0.50, respectively, P < 0.005). A linear relation (R(2) = 0.58, P < 0.005) between CWS and IH was also found. More statistically significant linear relations between the ratio of CWS to WSS (CWS/WSS), the products CWS � WSSG and CWS � OSI, and IH were observed (R(2) = 0.67, 0.54, and 0.56, respectively, P < 0.005), suggesting that both fluid and solid mechanics influence the extent of IH. Stents create endothelial flow disturbances and intramural wall stress concentrations, which correlate with the extent of IH formation, and these effects were exaggerated with mismatch of stent/vessel size. These findings reveal the importance of reliable vessel and stent sizing to improve the mechanics on the vessel wall and minimize IH. PMID:21926337
Chen, Henry Y; Sinha, Anjan K; Choy, Jenny S; Zheng, Hai; Sturek, Michael; Bigelow, Brian; Bhatt, Deepak L; Kassab, Ghassan S
Mis-sizing of stent promotes intimal hyperplasia: impact of endothelial shear and intramural stress
Stent can cause flow disturbances on the endothelium and compliance mismatch and increased stress on the vessel wall. These effects can cause low wall shear stress (WSS), high wall shear stress gradient (WSSG), oscillatory shear index (OSI), and circumferential wall stress (CWS), which may promote neointimal hyperplasia (IH). The hypothesis is that stent-induced abnormal fluid and solid mechanics contribute to IH. To vary the range of WSS, WSSG, OSI, and CWS, we intentionally mismatched the size of stents to that of the vessel lumen. Stents were implanted in coronary arteries of 10 swine. Intravascular ultrasound (IVUS) was used to size the coronary arteries and stents. After 4 wk of stent implantation, IVUS was performed again to determine the extent of IH. In conjunction, computational models of actual stents, the artery, and non-Newtonian blood were created in a computer simulation to yield the distribution of WSS, WSSG, OSI, and CWS in the stented vessel wall. An inverse relation (R2 = 0.59, P < 0.005) between WSS and IH was found based on a linear regression analysis. Linear relations between WSSG, OSI, and IH were observed (R2 = 0.48 and 0.50, respectively, P < 0.005). A linear relation (R2 = 0.58, P < 0.005) between CWS and IH was also found. More statistically significant linear relations between the ratio of CWS to WSS (CWS/WSS), the products CWS � WSSG and CWS � OSI, and IH were observed (R2 = 0.67, 0.54, and 0.56, respectively, P < 0.005), suggesting that both fluid and solid mechanics influence the extent of IH. Stents create endothelial flow disturbances and intramural wall stress concentrations, which correlate with the extent of IH formation, and these effects were exaggerated with mismatch of stent/vessel size. These findings reveal the importance of reliable vessel and stent sizing to improve the mechanics on the vessel wall and minimize IH.
Chen, Henry Y.; Sinha, Anjan K.; Choy, Jenny S.; Zheng, Hai; Sturek, Michael; Bigelow, Brian; Bhatt, Deepak L.
Impact of Image Noise on Gamma Index Calculation
NASA Astrophysics Data System (ADS)
Purpose: The Gamma Index defines an asymmetric metric between the evaluated image and the reference image. It provides a quantitative comparison that can be used to indicate sample-wised pass/fail on the agreement of the two images. The Gamma passing/failing rate has become an important clinical evaluation tool. However, the presence of noise in the evaluated and/or reference images may change the Gamma Index, hence the passing/failing rate, and further, clinical decisions. In this work, we systematically studied the impact of the image noise on the Gamma Index calculation. Methods: We used both analytic formulation and numerical calculations in our study. The numerical calculations included simulations and clinical images. Three different noise scenarios were studied in simulations: noise in reference images only, in evaluated images only, and in both. Both white and spatially correlated noises of various magnitudes were simulated. For clinical images of various noise levels, the Gamma Index of measurement against calculation, calculation against measurement, and measurement against measurement, were evaluated. Results: Numerical calculations for both the simulation and clinical data agreed with the analytic formulations, and the clinical data agreed with the simulations. For the Gamma Index of measurement against calculation, its distribution has an increased mean and an increased standard deviation as the noise increases. On the contrary, for the Gamma index of calculation against measurement, its distribution has a decreased mean and stabilized standard deviation as the noise increases. White noise has greater impact on the Gamma Index than spatially correlated noise. Conclusions: The noise has significant impact on the Gamma Index calculation and the impact is asymmetric. The Gamma Index should be reported along with the noise levels in both reference and evaluated images. Reporting of the Gamma Index with switched roles of the images as reference and evaluated images or some composite metrics would be a good practice.
Chen, M.; Mo, X.; Parnell, D.; Olivera, G.; Galmarini, D.; Lu, W.
Impact of Benign Prostatic Hyperplasia Pharmacological Treatment on Transrectal Prostate Biopsy Adverse Effects
Background. Benign prostatic hyperplasia (BPH) pharmacological treatment may promote a decrease in prostate vascularization and bladder neck relaxation with theoretical improvement in prostate biopsy morbidity, though never explored in the literature. Methods. Among 242 consecutive unselected patients who underwent prostate biopsy, after excluding those with history of prostate biopsy/surgery or using medications not for BPH, we studied 190 patients. On the 15th day after procedure patients were questioned about symptoms lasting over a week and classified according to pharmacological BPH treatment. Results. Thirty-three patients (17%) were using alpha-blocker exclusively, five (3%) 5-alpha-reductase inhibitor exclusively, twelve (6%) patients used both medications, and 140 (74%) patients used none. There was no difference in regard to age among groups (P = 0.5). Postbiopsy adverse effects occurred as follows: hematuria 96 (50%), hematospermia 53 (28%), hematochezia 22 (12%), urethrorrhagia 19 (10%), fever 5 (3%), and pain 20 (10%). There was a significant negative correlation between postbiopsy hematuria and BPH pharmacological treatment with stronger correlation for combined use of 5-alpha-reductase inhibitor and alpha-blocker over 6 months (P = 0.0027). Conclusion. BPH pharmacological treatment, mainly combined for at least 6 months seems to protect against prostate biopsy adverse effects. Future studies are necessary to confirm our novel results.
Falcone, Ciro Eduardo; Amstalden Neto, Arnaldo; Moretti, Tomas Bernardo Costa; Magna, Luis Alberto; Denardi, Fernandes; Reis, Leonardo Oliveira
[Impact of moss soil crust on vegetation indexes interpretation].
Vegetation indexes were the most common and the most important parameters to characterizing large-scale terrestrial ecosystems. It is vital to get precise vegetation indexes for running land surface process models and computation of NPP change, moisture and heat fluxes over surface. Biological soil crusts (BSC) are widely distributed in arid and semi-arid, polar and sub-polar regions. The spectral characteristics of dry and wet BSCs were quite different, which could produce much higher vegetation indexes value for the wet BSC than for the dry BSC as reported. But no research was reported about whether the BSC would impact on regional vegetation indexes and how much dry and wet BSC had impact on regional vegetation indexes. In the present paper, the most common vegetation index NDVI were used to analyze how the moss soil crusts (MSC) dry and wet changes affect regional NDVI values. It was showed that 100% coverage of the wet MSC have a much higher NDVI value (0.657) than the dry MSC NDVI value (0.320), with increased 0.337. Dry and wet MSC NDVI value reached significant difference between the levels of 0.000. In the study area, MSC, which had the average coverage of 12.25%, would have a great contribution to the composition of vegetation index. Linear mixed model was employed to analyze how the NDVI would change in regional scale as wet MSC become dry MSC inversion. The impact of wet moss crust than the dry moss crust in the study area can make the regional NDVI increasing by 0.04 (14.3%). Due to the MSC existence and rainfall variation in arid and semi-arid zones, it was bound to result in NDVI change instability in a short time in the region. For the wet MSC's spectral reflectance curve is similar to those of the higher plants, misinterpretation of the vegetation dynamics could be more severe due to the "maximum value composite" (MVC) technique used to compose the global vegetation maps in the study of vegetation dynamics. The researches would be useful for detecting and mapping MSC from remote sensing imagery. It also is to the advantage to employing vegetation index wisely. PMID:21595239
Fang, Shi-bo; Zhang, Xin-shi
Endometrial hyperplasia covers a group of abnormalities encompassing pre-malignant lesions of the endometrium. It is classified according to cellular and structural appearances, and is recognized as an oestrogen-dependent condition. Pre-disposing factors include therapies resulting in exogenous oestrogenic stimulation, and conditions causing excessive oestrogen production.The risk of progression to cancer in untreated cases is uncertain as a result of a tendency
Robert Hammond; Jane Johnson
Impact of Treatment With Statins on Prostate-Specific Antigen and Prostate Volume in Patients With Benign Prostatic Hyperplasia
Purpose We investigated the impact on prostate-specific antigen (PSA) and prostate volume (PV) of statin medication for 1 year in patients with benign prostatic hyperplasia (BPH). Materials and Methods We retrospectively investigated 791 patients in whom BPH was diagnosed. For analysis, the patients were divided into four groups according to their medications: group A, ?-blocker; group B, ?-blocker+statin; group C, ?-blocker+dutasteride; group D, ?-blockers+statin+dutasteride. To investigate changes in serum PSA, PV, and total cholesterol, we analyzed the data at the time of initial treatment and after 1 year of medication. Results After 1 year, group A showed a 1.3% increase in PSA and a 1.0% increase in PV. Group B showed a 4.3% decrease in PSA and a 1.8% decrease in PV. The difference in PV reduction between groups A and B was statistically significant (p<0.001). Group C showed a 49.1% reduction in PSA and a 22.9% reduction in PV. Group D showed a 51.6% reduction in PSA and a 24.5% reduction in PV. The difference in PV reduction between groups C and D was not statistically significant (p=0.762). By use of a multivariate logistic regression model, we found that the probability of PV reduction after 1 year was more than 14.8 times in statin users than in statin nonusers (95% confidence interval, 5.8% to 37.6%; p<0.001). Conclusions Statin administration reduced PSA and PV in BPH patients. This finding may imply the improvement of lower urinary tract symptoms and prevention of cardiovascular disease and chemoprevention of prostate cancer with statin treatment.
Lee, Sang Hun; Park, Tae Ju; Bae, Min Ho; Choi, Sung Ho; Cho, Young Sam; Joo, Kwan Joong; Kwon, Chil Hun
Impact of maternal body mass index on neonatal outcome
Introduction Maternal body mass index has an impact on maternal and fetal pregnancy outcome. An increased maternal BMI is known to be associated with admission of the newborn to a neonatal care unit. The reasons and impact of this admission on fetal outcome, however, are unknown so far. Objective The aim of our study was to investigate the impact of maternal BMI on maternal and fetal pregnancy outcome with special focus on the children admitted to a neonatal care unit. Methods A cohort of 2049 non-diabetic mothers giving birth in the Charite university hospital was prospectively studied. The impact of maternal BMI on maternal and fetal outcome parameters was tested using multivariate regression analysis. Outcome of children admitted to a neonatal ward (n = 505) was analysed. Results Increased maternal BMI was associated with an increased risk for hypertensive complications, peripheral edema, caesarean section, fetal macrosomia and admission of the newborn to a neonatal care unit, whereas decreased BMI was associated with preterm birth and lower birthweight. In the neonatal ward children from obese mothers are characterized by hypoglycaemia. They need less oxygen, and exhibit a shorter stay on the neonatal ward compared to children from normal weight mothers, whereas children from underweight mothers are characterized by lower umbilical blood pH and increased incidence of death corresponding to increased prevalence of preterm birth. Conclusion Pregnancy outcome is worst in babies from mothers with low body mass index as compared to healthy weight mothers with respect to increased incidence of preterm birth, lower birth weight and increased neonate mortality on the neonatal ward. We demonstrate that the increased risk for neonatal admission in children from obese mothers does not necessarily indicate severe fetal impairment.
A correlation between Schmidt hammer rebound numbers with impact strength index, slake durability index and P-wave velocity
The main objective of this study was to establish statistical relationship between Schmidt hammer rebound numbers with impact strength index (ISI), slake durability index (SDI) and P-wave velocity. These are important properties to characterize a rock mass and are being widely used in geological and geotechnical engineering. Due to its importance, Schmidt hammer rebound number is considered as one of
P. K. Sharma; Manoj Khandelwal; T. N. Singh
Evaluating Journal Quality: Is the H-Index a Better Measure than Impact Factors?
ERIC Educational Resources Information Center
Objectives: This study evaluates the utility of a new measure--the h-index--that may provide a more valid approach to evaluating journal quality in the social work profession. Method: H-index values are compared with Thomson ISI 5-year impact factors and expert opinion. Results: As hypothesized, the h-index correlates highly with ISI 5-year impact�
Hodge, David R.; Lacasse, Jeffrey R.
Impact of dark energy perturbations on the growth index
NASA Astrophysics Data System (ADS)
We show that in clustering dark energy models the growth index of linear matter perturbations, ?, can be much lower than in ?CDM or smooth quintessence models and presents a strong variation with redshift. We find that the impact of dark energy perturbations on ? is enhanced if the dark energy equation of state has a large and rapid decay at low redshift. We study four different models with these features and show that we may have 0.33(z)<0.48 at 0
Batista, Ronaldo C.
A Neurodegenerative Vascular Burden Index and the Impact on Cognition
A wide range of vascular burden factors has been identified to impact vascular function and structure as indicated by carotid intima�media thickness (IMT). On the basis of their impact on IMT, vascular factors may be selected and clustered in a vascular burden index (VBI). Since many vascular factors increase the risk of Alzheimer�s disease (AD), a multifactorial neurodegenerative VBI may be related to early pathological processes in AD and cognitive decline in its preclinical stages. We investigated an elderly cohort at risk for neurodegeneration (TREND study, n?=?1102) for the multifactorial influence of vascular burden factors on IMT measured by ultrasound. To create a VBI for this cohort, vascular factors and their definitions (considering medical history, medication, and/or blood marker data) were selected based on their statistical effects on IMT in multiple regressions including age and sex. The impact of the VBI on cognitive performance was assessed using the Trail-Making Test (TMT) and the consortium to establish a registry for Alzheimer�s disease (CERAD) neuropsychological battery. IMT was significantly predicted by age (standardized ??=?0.26), sex (0.09; males?>?females) and the factors included in the VBI: obesity (0.18), hypertension (0.14), smoking (0.08), diabetes (0.07), and atherosclerosis (0.05), whereas other cardiovascular diseases or hypercholesterolemia were not significant. Individuals with 2 or more VBI factors compared to individuals without had an odds ratio of 3.17 regarding overly increased IMT ( ??1.0?mm). The VBI showed an impact on executive control [log(TMT B?A), p?=?0.047] and a trend toward decreased global cognitive function (CERAD total score, p?=?0.057) independent of age, sex, and education. A VBI established on the basis of IMT may help to identify individuals with overly increased vascular burden linked to decreased cognitive function indicating neurodegenerative processes. The longitudinal study of this risk cohort will reveal the value of the VBI as prodromal marker for cognitive decline and AD.
Heinzel, Sebastian; Liepelt-Scarfone, Inga; Roeben, Benjamin; Nasi-Kordhishti, Isabella; Suenkel, Ulrike; Wurster, Isabel; Brockmann, Kathrin; Fritsche, Andreas; Niebler, Raphael; Metzger, Florian G.; Eschweiler, Gerhard W.; Fallgatter, Andreas J.; Maetzler, Walter; Berg, Daniela
A correlation between Schmidt hammer rebound numbers with impact strength index, slake durability index and P-wave velocity
The main objective of this study was to establish statistical relationship between Schmidt hammer rebound numbers with impact\\u000a strength index (ISI), slake durability index (SDI) and P-wave velocity. These are important properties to characterize a rock\\u000a mass and are being widely used in geological and geotechnical engineering. Due to its importance, Schmidt hammer rebound number\\u000a is considered as one of
P. K. Sharma; Manoj Khandelwal; T. N. Singh
The impact of processing delay on the exposure index value
NASA Astrophysics Data System (ADS)
Digital radiography poses the risk of unnoticed increases in patient dose. Manufacturers responded to this by offering an exposure index (EI) value to clinicians. Use of the EI value in clinical practice is encouraged by the American College of Radiology and American Association of Physicists in Medicine. This study assesses the impact of processing delay on the EI value. An anthropormorphic phantom was used to simulate three radiographic examinations; skull, pelvis and chest. For each examination, the phantom was placed in the optimal position and exposures were chosen in accordance with international guidelines. A Carestream (previously Kodak) computed radiography system was used. The imaging plate was exposed, and processing was delayed in various increments from 30 seconds to 24 hours, representing common delays in clinical practice. The EI value was recorded for each exposure. The EI value decreased considerably with increasing processing delay. The EI value decreased by 100 within 25 minutes delay for the chest, and 20 minutes for the skull and pelvis. Within 1 hour, the EI value had fallen by 180, 160 and 100 for the chest, skull and pelvis respectively. After 24 hours, the value had decreased by 370, 350 and 340 for the chest, skull and pelvis respectively, representing to the clinician more then a halving of exposure to the detector in Carestream systems. The assessment of images using EI values should be approached with caution in clinical practice when delays in processing occur. The use of EI values as a feedback mechanism is questioned.
Butler, M. L.; Brennan, P. C.; Last, J.; Rainford, L.
Congenital Adrenal Hyperplasia
... is congenital adrenal hyperplasia? Congenital adrenal hyperplasia, or CAH, is a disorder that affects the adrenal glands. ... and cortisol and aldosterone. A person who has CAH doesn't make enough of the hormones cortisol ...
Potential monitoring of crop production using a satellite-based Climate-Variability Impact Index
The capabilities of the MODerate resolution Imaging Spectroradiometer (MODIS) present some exciting possibilities for improved and timely monitoring of crop production. A quantitative index is introduced in this paper to study the relationship between remotely sensed leaf area index (LAI) and crop production. The Climate-Variability Impact Index (CVII), defined as the monthly contribution to anomalies in annual growth, quantifies the
Ping Zhang; Bruce Anderson; Bin Tan; Dong Huang; Ranga Myneni
Monitoring of Crop Production Using a new Satellite-Based Climate-Variability Impact Index
The capabilities of the MODerate resolution Imaging Spectroradiometer (MODIS) present some exciting possibilities for improved and timely monitoring of crop production. A quantitative index is introduced in this paper to study the relationship between remotely-sensed leaf area index (LAI) and crop production. The Climate-Variability Impact Index (CVII), defined as the monthly contribution to anomalies in annual growth, quantifies the percentage
P. Zhang; B. Anderson; B. Tan; D. Huang; R. Myneni
The Impact of Body Mass Index on Heterotopic Ossification
Purpose: To analyze the impact of different body mass index (BMI) as a surrogate marker for heterotopic ossification (HO) in patients who underwent surgical repair (SR) for displaced acetabular fractures (DAF) followed by radiation therapy (RT). Methods and Materials: This is a single-institution retrospective study of 395 patients. All patients underwent SR for DAF followed by RT {+-} indomethacin. All patients received postoperative RT, 7 Gy, within 72 h. The patients were separated into four groups based on their BMI: <18.5, 18.5-24.9, 25-29.9, and >30. The end point of this study was to evaluate the efficacy of RT {+-} indomethacin in preventing HO in patients with different BMI. Results: Analysis of BMI showed an increasing incidence of HO with increasing BMI: <18.5, (0%) 0/6 patients; 18.5-24.9 (6%), 6 of 105 patients developed HO; 25-29.9 (19%), 22 of 117; >30 (31%), 51 of 167. Chi-square and multivariate logistic regression analysis showed that the correlation between odds of HO and BMI is significant, p < 0.0001. As the BMI increased, the risk of HO and Brooker Classes 3, 4 HO increased. The risk of developing HO is 1.0 Multiplication-Sign (10%) more likely among those with higher BMI compared with those with lower BMI. For a one-unit increase in BMI the log odds of HO increases by 1.0, 95% CI (1.06-1.14). Chi-square test shows no significant difference among all other factors and HO (e.g., indomethacin, race, gender). Conclusions: Despite similar surgical treatment and prophylactic measures (RT {+-} indomethacin), the risk of HO appears to significantly increase in patients with higher BMI after DAF. Higher single-fraction doses or multiple fractions and/or combination therapy with nonsteroidal inflammatory drugs may be of greater benefit to these patients.
Mourad, Waleed Fouad, E-mail: email@example.com [Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS (United States); Department of Radiation Oncology, Beth Israel Medical Center, New York, NY (Israel); Department of Radiation Oncology, Albert Einstein College of Medicine of Yeshiva University, Bronx, NY (United States); Packianathan, Satya [Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS (United States); Shourbaji, Rania A. [Department of Epidemiology and Biostatistics, Jackson State University, Jackson, MS (United States); Zhang Zhen; Graves, Mathew [Department of Orthopedic Surgery, University of Mississippi Medical Center, Jackson, MS (United States); Khan, Majid A. [Department of Radiology, University of Mississippi Medical Center, Jackson, MS (United States); Baird, Michael C. [Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS (United States); Russell, George [Department of Orthopedic Surgery, University of Mississippi Medical Center, Jackson, MS (United States); Vijayakumar, Srinivasan [Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS (United States)
The DCI index: Discounted cumulated impact-based research evaluation
Abstract Research evaluation is increasingly popular and important among,research funding bodies and science policy makers. Various indicators have been proposed,to evaluate the standing of individual scientists, institutions, journals, or countries. A simple and popular one among the indicators is the h-index, the Hirsch index (Hirsch 2005), which is an indicator for lifetime achievement,of a scholar. Several other indicators have been
Kalervo J�rvelin; Olle Persson
The impact of transurethral procedures for benign prostate hyperplasia on male sexual function: a meta-analysis.
The effect of transurethral procedures for benign prostate hyperplasia (BPH) on male sexual function is still controversial, and we conducted this meta-analysis to compare the effects of different transurethral surgical procedures for the treatment of symptomatic BPH on male erectile function (EF) and ejaculatory function (EJF). Databases, including MEDLINE, EMBASE, and the Cochrane Controlled Trial Register, were searched to identify randomized controlled trials (RCT) that compared watchful waiting, transurethral electrovaporization (TUEVP) or holmium laser treatment (HLT) with transurethral resection of the prostate (TURP). Trials were included if they were RCTs, contained fully available data, compared with conventional TURP for BPH, and referred to male EF and EJF. A total of 12 RCTs involving a total of 1889 subjects were selected for analysis, including 2 trials comparing TURP and watchful waiting, 6 comparing TURP with TUEVP, and 4 comparing TURP with HLT. TURP was associated with a higher occurrence of retrograde ejaculation compared with watchful waiting but not to TUEVP (P = .95) or HLT (P = .37) and associated with a lower incidence of male erectile dysfunction compared with TUEVP (P = .04) but not HLT. According to the analysis, TURP lead to a higher prevalence of retrograde ejaculation compared with watchful waiting but had less of an effect on EF than TUEVP. TURP did not have a significantly different effect on EF or EJF compared with HLT. PMID:21868751
Zong, Huan-Tao; Peng, Xiao-Xia; Yang, Chen-Chen; Zhang, Yong
A Statistical Assessment of Two Measures of Citation: The Impact Factor and the Immediacy Index.
ERIC Educational Resources Information Center
Results of an investigation designed to determine whether the impact factor or the immediacy index--two derivative measures of citation analysis--provide useful insights into qualitative relationships among scientific journals indicate that neither measure is significant. (MBR)
Tomer, Christinger
Benign prostate hyperplasia (BPH) - resources
Resources - benign prostatic hyperplasia (BPH); Prostate enlargement resources; BPH resources ... following organizations provide information on benign prostatic hyperplasia ( prostate enlargement ): National Kidney and Urologic Diseases Information Clearinghouse - ...
Evidence of Methodologic Bias in the Derivation of the Science Citation Index Impact Factor
See related article and editorial.Study objective: The �impact factor� published in Science Citation Index (SCI) is widely used in the scientific community to measure the relative importance of a medical journal. In contrast to all other indicators of academic growth in emergency medicine, impact factors for emergency medicine journals have remained low and unchanged since the inception of the specialty.
E. John Gallagher; Douglas P Barnaby
Clinical impact of body mass index on bactibilia and bacteremia
Background The aim of this study was to evaluate the association between obesity and infected bile or bacteremia in patients with acute calculous cholecystitis. Methods Authors analyzed the medical records of 139 patients who had undergone cholecystectomy for the treatment of acute calculous cholecystitis from January 2007 to June 2013 in a single teaching hospital. Association of body mass index (BMI) with bactibilia and bacteremia was assessed using univariate and multivariate analysis. Clinical findings and biliary infection related data were recorded for the following variables: gender, age, alcohol and smoking history, the results of blood and bile cultures, cholesterolosis, diabetes, hypertension, and duration of the hospital stay. Results The microbial culture rate of bactibilia and bacteremia were 50.4% and 21.6%, respectively. In the univariate analysis, bacteremia was associated with bactibilia (OR: 4.33, p?=?0.002). In the multivariate analysis for the risk factors of bactibilia, BMI and bacteremia were related with bactibilia (OR: 0.59, 95% CI: 0.42-0.84, p?=?0.003) (OR: 3.32, 95% CI: 1.22-9, p?=?0.02). In the multivariate analysis for the risk factors of bacteremia, BMI, bactibilia and age were related with bacteremia (OR: 0.76, 95% CI: 0.59-0.99, p?=?0.04) (OR: 3.46, 95% CI: 1.27-9.45, p?=?0.02) (OR: 1.05, 95% CI: 1.01-1.09, p?=?0.02). Conclusion In this retrospective study, BMI was inversely correlated with bacteremia or bactibilia, which means obese or overweight patients are less likely to be associated with bacteremia or bactibilia in patients with acute calculous cholecystitis.
Contribution of Endothelial Injury and Inflammation in Early Phase to Vein Graft Failure: The Causal Factors Impact on the Development of Intimal Hyperplasia in Murine Models
Objectives Autologous veins are preferred conduits in by-pass surgery. However, long-term results are hampered by limited patency due to intimal hyperplasia. Although mechanisms involved in development of intimal hyperplasia have been established, the role of inflammatory processes is still unclear. Here, we studied leukocyte recruitment and intimal hyperplasia in inferior vena cava grafts transferred to abdominal aorta in mice. Methods and Results Several microscopic techniques were used to study endothelium denudation and regeneration and leukocyte recruitment on endothelium. Scanning electron microscopy demonstrated denudation of vein graft endothelium 7 days post-transfer and complete endothelial regeneration by 28 days. Examination of vein grafts transferred to mice transgenic for green fluorescent protein under Tie2 promoter in endothelial cells showed regeneration of graft endothelium from the adjacent aorta. Intravital microscopy revealed recruitment of leukocytes in vein grafts at 7 days in wild type mice, which had tapered off by 28 days. At 28 and 63 days there was significant development of intimal hyperplasia. In contrast; no injury, leukocyte recruitment nor intimal hyperplasia occurred in arterial grafts. Leukocyte recruitment was reduced in vein grafts in mice deficient in E- and P-selectin. In parallel, intimal hyperplasia was reduced in vein grafts in mice deficient in E- and P-selectin and in wild type mice receiving P-selectin/E-selectin function-blocking antibodies. Conclusion The results show that early phase endothelial injury and inflammation are crucial processes in intimal hyperplasia in murine vein grafts. The data implicate endothelial selectins as targets for intervention of vein graft disease.
Tseng, Chi-Nan; Karlof, Eva; Chang, Ya-Ting; Lengquist, Mariette; Rotzius, Pierre; Berggren, Per-Olof; Hedin, Ulf; Eriksson, Einar E.
Intravascular Papillary Endothelial Hyperplasia.
National Technical Information Service (NTIS)
Papillary endothelial hyperplasia is a peculiar benign intravascular process that bears a remarkable resemblance to a hemangiosarcoma. In 44 cases of this lesion studied from the files of the Armed Forces Institute of Pathology, the process manifested as ...
K. P. Clearkin F. M. Enzinger
The impact of global warming on the Southern Oscillation Index
NASA Astrophysics Data System (ADS)
The Southern Oscillation Index (SOI)�a measure of air pressure difference across the Pacific Ocean, from Tahiti in the south-east to Darwin in the west�is one of the world's most important climatic indices. The SOI is used to track and predict changes in both the El Ni�o-Southern Oscillation phenomenon, and the Walker Circulation (WC). During El Ni�o, for example, the WC weakens and the SOI tends to be negative. Climatic variations linked to changes in the WC have a profound influence on climate, ecosystems, agriculture, and societies in many parts of the world. Previous research has shown that (1) the WC and the SOI weakened in recent decades and that (2) the WC in climate models tends to weaken in response to elevated atmospheric greenhouse gas concentrations. Here we examine changes in the SOI and air pressure across the Pacific in the observations and in numerous WCRP/CMIP3 climate model integrations for both the 20th and 21st centuries. The difference in mean-sea level air pressure (MSLP) between the eastern and western equatorial Pacific tends to weaken during the 21st century, consistent with previous research. Here we show that this primarily arises because of an increase in MSLP in the west Pacific and not a decline in the east. We also show, in stark contrast to expectations, that the SOI actually tends to increase during the 21st century, not decrease. Under global warming MSLP tends to increase at both Darwin and Tahiti, but tends to rise more at Tahiti than at Darwin. Tahiti lies in an extensive region where MSLP tends to rise in response to global warming. So while the SOI is an excellent indicator of interannual variability in both the equatorial MSLP gradient and the WC, it is a highly misleading indicator of long-term equatorial changes linked to global warming. Our results also indicate that the observed decline in the SOI in recent decades has been driven by natural, internally generated variability. The externally forced signal in the June-December SOI during 2010 is estimated to be approximately 5% of the standard deviation of variability in the SOI during the 20th century. This figure is projected to increase to 40% by the end of the 21st century under the A2 SRES scenario. The 2010 global warming signal is already a major contributor to interdecadal variability in the SOI, equal to 45% of the standard deviation of 30-year running averages of the SOI. This figure is projected to increase to nearly 340% by the end of the 21st century. Implications that these discoveries have for understanding recent climatic change and for seasonal prediction are discussed.
Power, Scott B.; Kociuba, Greg
Fire Weather Index : from high resolution climatology to Climate change impact study
Fire meteo indices provide efficient guidance tools for the prevention, early warning and surveillance of forest fires. These indices are only based on meteorological input data. Fire meteorological danger is estimated by M�t�o-France at national level through the use of Fire Weather Index. This study deals with the impact of climate change on fire danger in France. It has been
E. Cloppet; M. Regimbeau
Combined true thymic hyperplasia and lymphoid hyperplasia in Graves' disease.
True thymic hyperplasia (enlarged gland composed of histologically unremarkable cortical and medullary parenchyma) and lymphoid hyperplasia (medullary lymphoid follicles in the clinical setting of autoimmunity) usually develop as independent pathologic processes. We reviewed the clinical features and gross and microscopic pathology of 2 hyperthyroid patients with features of both thymic hyperplasia and lymphoid hyperplasia. The diagnosis of thymic hyperplasia was supported by thymic weights greater than two standard deviations above the mean weight for age and histologic evidence of expanded cortical and medullary parenchyma. The diagnosis of lymphoid hyperplasia was supported by the increased number and size of medullary lymphoid follicles and the association with Graves' disease. This unusual combination results from two separate pathogenic mechanisms operating simultaneously in hyperthyroid patients. Elevated thyroid hormones directly stimulate the proliferation of thymic epithelium, producing thymic hyperplasia. The immune abnormalities underlying Graves' disease can also result in lymphoid hyperplasia of the thymus. PMID:2235767
Judd, R; Bueso-Ramos, C
Impact of Reward and Punishment Motivation on Behavior Monitoring as Indexed by the Error Related Negativity
The Error Related Negativity (ERN) is thought to index a neural behavior monitoring system with its source in anterior cingulate cortex (ACC). While ACC is involved in a wide variety of cognitive and emotional tasks, there is debate as to what aspects of ACC function are indexed by the ERN. In one model the ERN indexes purely cognitive function, responding to mismatch between intended and executed actions. Another model posits that the ERN is more emotionally driven, elicited when an action is inconsistent with motivational goals. If the ERN indexes mismatch between intended and executed action, then it should be insensitive to motivational valence, e.g. reward or punishment; in contrast if the ERN indexes the evaluation of responses relative to goals, then it might respond differentially under different motivational valence. This study used a flanker task motivated by potential reward and potential punishment on different trials and also examined the N2 and P3 to the imperative stimulus, the response Pe, and the FRN and P3 to the outcome feedback to assess the impact of motivation valence on other stages of information processing in this choice reaction time task. Participants were slower on punishment motivated trials and both the N2 and ERN were larger on punishment-motivated trials, indicating that loss aversion has an impact on multiple stages of information processing including behavior monitoring.
Potts, Geoffrey F.
Saw Palmetto for Benign Prostatic Hyperplasia
In this double-blind trial, we randomly assigned 225 men over the age of 49 years who had moderate-to-severe symptoms of benign prostatic hyperplasia to one year of treatment with saw palmetto extract (160 mg twice a day) or placebo. The pri- mary outcome measures were changes in the scores on the American Urological Association Symptom Index (AUASI) and the maximal
Stephen Bent; Christopher Kane; Katsuto Shinohara; John Neuhaus; Esther S. Hudes; Harley Goldberg; Andrew L. Avins
Budget impact analysis of a new prostate cancer risk index for prostate cancer detection.
The objective of this study was to evaluate the budget impact of a new prostate cancer risk index for detecting prostate cancer. The index is calculated as the combination of serum prostate-specific antigen (PSA), free PSA and a precursor form p2PSA. We constructed two budget impact models using PSA cutoff values of ?2?ng?ml(-1) (model #1) and ?4?ng?ml(-1) (model #2) for recommending a prostate biopsy in a hypothetical health plan with 100?000 male members aged 50-75 years old. The budgetary impact on the 1-year expected total costs for prostate cancer detection was calculated. Adding the index to the current PSA prostate cancer testing strategies including the total PSA and percent free PSA, the number of detected cancer cases decreased by 20 and 5, in models #1 and #2, respectively. The savings on expected 1-year cost for prostate cancer detection were $356?647 (or $0.30 per-member-per-month (PMPM)) in model #1 and $94?219 ($0.08 PMPM) in model #2. The index produced higher cost savings in the model #1 with PSA cutoff ?2?ng?ml(-1) than the model #2 with cutoff ?4?ng?ml(-1) with a small short-term reduction in the number of positive tests. PMID:21537346
Nichol, M B; Wu, J; An, J J; Huang, J; Denham, D; Frencher, S; Jacobsen, S J
Optimal management of endometrial hyperplasia
The optimal management of endometrial hyperplasia is the subject of considerable debate. In this chapter the development of our current classification of endometrial hyperplasias is outlined in some detail in order to give an understanding of the complexity of the problem of determining the malignant potential of the hyperplasia which is the central issue in determining optimal treatment. While hysterectomy
Donald E. Marsden; Neville F. Hacker
Enhancing the h index for the objective assessment of healthcare researcher performance and impact
Objective To investigate whether the h index (a bibliometric tool which is increasingly used to assess and appraise an individual's research performance) could be improved to better measure the academic performance and citation profile for individual healthcare researchers. Design Cohort study. Setting Faculty of Medicine, Imperial College London, UK. Participants Publication lists from 1 January 2000 until 31 December 2009 for 501 academic healthcare researchers from the Faculty of Medicine. Main outcome measures The h index for each researcher was calculated over a nine-year period. The citation count for each researcher was differentiated into high (h2 upper), core (h2 centre) and low (h2 lower) visibility areas. Segmented regression model (sRM) was used to statistically estimate number of high visibility publications (sRM value). Validity of the h index and other proposed adjuncts were analysed against academic rank and conventional bibliometric indicators. Results Construct validity was demonstrated for h index, h2 upper, h2 centre, h2 lower and sRM value (all P < 0.05). Convergent validity of the h index and sRM value was shown by significant correlations with total number of publications (r = 0.89 and 0.86 respectively, P < 0.05) and total number of citations (r = 0.96 and 0.65, respectively, P < 0.05). Significant differences in h index and sRM value existed between non-physician and physician researchers (P < 0.05). Conclusions This study supports the construct validity of the h index as a measure of healthcare researcher academic rank. It also identifies the assessment value of our developed indices of h2 upper, h2 centre, h2 lower and sRM. These can be applied in combination with the h index to provide additional objective evidence to appraise the performance and impact of an academic healthcare researcher.
Patel, Vanash M; Ashrafian, Hutan; Bornmann, Lutz; Mutz, Rudiger; Makanjuola, Jonathan; Skapinakis, Petros; Darzi, Ara; Athanasiou, Thanos
Atypical ductal hyperplasia: interobserver and intraobserver variability.
Interobserver reproducibility in the diagnosis of benign intraductal proliferative lesions has been poor. The aims of the study were to investigate the inter- and intraobserver variability and the impact of the addition of an immunostain for high- and low-molecular weight keratins on the variability. Nine pathologists reviewed 81 cases of breast proliferative lesions in three stages and assigned each of the lesions to one of the following three diagnoses: usual ductal hyperplasia, atypical ductal hyperplasia and ductal carcinoma in situ. Hematoxylin and eosin slides and corresponding slides stained with ADH-5 cocktail (cytokeratins (CK) 5, 14. 7, 18 and p63) by immunohistochemistry were evaluated. Concordance was evaluated at each stage of the study. The interobserver agreement among the nine pathologists for diagnosing the 81 proliferative breast lesions was fair (?-value=0.34). The intraobserver ?-value ranged from 0.56 to 0.88 (moderate to strong). Complete agreement among nine pathologists was achieved in only nine (11%) cases, at least eight agreed in 20 (25%) cases and seven or more agreed in 38 (47%) cases. Following immunohistochemical stain, a significant improvement in the interobserver concordance (overall ?-value=0.50) was observed (P=0.015). There was a significant reduction in the total number of atypical ductal hyperplasia diagnosis made by nine pathologists after the use of ADH-5 immunostain. Atypical ductal hyperplasia still remains a diagnostic dilemma with wide variation in both inter- and intraobserver reproducibility among pathologists. The addition of an immunohistochemical stain led to a significant improvement in the concordance rate. More importantly, there was an 8% decrease in the number of lesions classified as atypical ductal hyperplasia in favor of usual hyperplasia; in clinical practice, this could lead to a decrease in the number of surgeries carried out for intraductal proliferative lesions. PMID:21532546
Jain, Rohit K; Mehta, Rutika; Dimitrov, Rosen; Larsson, Lisbeth G; Musto, Paul M; Hodges, Kurt B; Ulbright, Thomas M; Hattab, Eyas M; Agaram, Narasimhan; Idrees, Muhammad T; Badve, Sunil
Monitoring Crop Yield in USA Using a Satellite-Based Climate-Variability Impact Index
NASA Technical Reports Server (NTRS)
A quantitative index is applied to monitor crop growth and predict agricultural yield in continental USA. The Climate-Variability Impact Index (CVII), defined as the monthly contribution to overall anomalies in growth during a given year, is derived from 1-km MODIS Leaf Area Index. The growing-season integrated CVII can provide an estimate of the fractional change in overall growth during a given year. In turn these estimates can provide fine-scale and aggregated information on yield for various crops. Trained from historical records of crop production, a statistical model is used to produce crop yield during the growing season based upon the strong positive relationship between crop yield and the CVII. By examining the model prediction as a function of time, it is possible to determine when the in-season predictive capability plateaus and which months provide the greatest predictive capacity.
Zhang, Ping; Anderson, Bruce; Tan, Bin; Barlow, Mathew; Myneni, Ranga
Congenital adrenal hyperplasia
... or inappropriately). Congenital adrenal hyperplasia can affect both boys and girls. About 1 in 10,000 to 18,000 ... penis but normal testes Well-developed muscles Both boys and girls will be tall as children but much shorter ...
Impact on enzyme activity as a new quality index of wastewater.
The aim of this study was to define a new indicator for the quality of wastewaters that are released into the environment. A quality index is proposed for wastewater samples in terms of the inertness of wastewater samples toward enzyme activity. This involves taking advantage of the sensitivity of enzymes to pollutants that may be present in the waste samples. The effect of wastewater samples on the rate of a number of different enzyme-catalyzed reactions was measured, and the results for all the selected enzymes were analyzed in an integrated fashion (multi-enzymatic sensor). This approach enabled us to define an overall quality index, the "Impact on Enzyme Function" (IEF-index), which is composed of three indicators: i) the Synoptic parameter, related to the average effect of the waste sample on each component of the enzymatic sensor; ii) the Peak parameter, related to the maximum effect observed among all the effects exerted by the sample on the sensor components; and, iii) the Interference parameter, related to the number of sensor components that are affected less than a fixed threshold value. A number of water based samples including public potable tap water, fluids from urban sewage systems, wastewater disposal from leather, paper and dye industries were analyzed and the IEF-index was then determined. Although the IEF-index cannot discriminate between different types of wastewater samples, it could be a useful parameter in monitoring the improvement of the quality of a specific sample. However, by analyzing an adequate number of waste samples of the same type, even from different local contexts, the profile of the impact of each component of the multi-enzymatic sensor could be typical for specific types of waste. The IEF-index is proposed as a supplementary qualification score for wastewaters, in addition to the certification of the waste's conformity to legal requirements. PMID:23353880
Balestri, Francesco; Moschini, Roberta; Cappiello, Mario; Del-Corso, Antonella; Mura, Umberto
Standard precipitation index to track drought and assess impact of rainfall on watertables in irrigation areas
The Standard Precipitation Index (SPI) is employed to track drought and assess the impact of rainfall on shallow groundwater\\u000a levels in three selected irrigation areas of the Murray-Darling Basin in Australia. The continuous SPI method can provide\\u000a better means of quantifying rainfall variability and correlating it with changes of shallow watertable levels since it is\\u000a based on continuous statistical functions
S. Khan; H. F. Gabriel; T. Rana
Biotic indexes reveal the impact of harbour enlargement on benthic fauna
Environmental effects of enlargement works in Puerto Calero (Lanzarote, Canary Islands) were analysed in the sediments using abiotic variables (total hydrocarbons, polyaromatic hydrocarbons, organic matter and granulometry) and three biotic indexes (AMBI, M-AMBI and BENTIX). A before�after\\/control�impact (BACI) design was developed with four sampling campaigns, before (November 2004), during (March and July 2005) and after (July 2006) works. Inner stations
R. Riera; �. Monterroso; M. Rodr�guez; E. Ramos
Hypothetical influence of non-indexed Spanish medical journals on the impact factor of the Journal Citation Reports-indexed journals
The purpose of this study is to analyze the hypothetical changes in the 2002 impact factor (IF) of the biomedical journals\\u000a included in the Science Citation Index-Journal Citation Reports (SCI-JCR) by also taking into account cites coming from 83 non-indexed Spanish journals on different medical specialties.\\u000a A further goal of the study is to identify the subject categories of the
Rafael Aleixandre-benavent; Juan Carlos Valderrama Zuri�n; Alberto Miguel-dasit; Adolfo Alonso Arroyo; Miguel Castellano G�mez
A screening level index for assessing the impacts of veterinary medicines on dung flies.
Veterinary parasiticides are administered to livestock to control a wide range of parasites. Following excretion, these substances may persist in the environment and impact nontarget organisms. This paper describes a simple screening-based index for predicting the effects of veterinary parasiticides on dung flies using data on parasiticide toxicity, animal husbandry, and parasiticide use. The utility of the index has been assessed, at the farm scale for a number of dipteran species, using data from a survey of farms in England and insect ecology and ecotoxicological data. The results indicate that a large proportion (35%) of parasiticide treatments in England will have no impact on dung fly populations. In terms of individual parasiticides, the macrocyclic lactone doramectin was predicted to have the highest impact on English dipteran populations with a maximum reduction in the population of horn flies on one farm of 28%. Ivermectin pour-on had the next highest impact (6.8%), followed by eprinomectin (6.4%), and ivermectin injection (4.1%). Due to a lack of data, it was not possible to assess the effects of the benzimidazole parasiticides (oxfendazole and fenbendazole), morantel and permethrin. The approach is simple, nondata-intensive and has the potential to be a valuable tool for use in environmental risk assessment or management of new and existing veterinary parasiticides. PMID:17438826
Boxall, Alistair B A; Sherratt, Tom N; Pudner, Victoria; Pope, Louise J
Laparoscopic surgery for endometrial cancer: increasing body mass index does not impact postoperative complications
Objective To determine the effect of body mass index on postoperative complications and the performance of lymph node dissection in women undergoing laparoscopy or laparotomy for endometrial cancer. Methods Retrospective chart review of all patients undergoing surgery for endometrial cancer between 8/2004 and 12/2008. Complications graded and analyzed using Common Toxicity Criteria for Adverse Events ver. 4.03 classification. Results 168 women underwent surgery: laparoscopy n=65, laparotomy n=103. Overall median body mass index 36.2 (range, 18.1 to 72.7) with similar distributions for age, body mass index and performance of lymph node dissection between groups. Following laparoscopy vs. laparotomy the percent rate of overall complications 53.8:73.8 (p=0.01), grade ?3 complications 9.2:34.0 (p<0.01), ?3 wound complications 3.1:22.3 (p<0.01) and ?3 wound infection 3.1:20.4 (p=0.01) were significantly lower after laparoscopy. In a logistic model there was no effect of body mass index (?36 and<36) on complications after laparoscopy in contrast to laparotomy. Para-aortic lymph node dissection was performed by laparoscopy 19/65 (29%): by laparotomy 34/103 (33%) p=0.61 and pelvic lymph node dissection by laparoscopy 21/65 (32.3%): by laparotomy 46/103 (44.7%) p=0.11. Logistic regression analysis revealed that for patients undergoing laparoscopy for stage I disease there was an inverse relationship between the performance of both para-aortic lymph node dissection and pelvic lymph node dissection and increasing body mass index (p=0.03 and p<0.01 respectively) in contrast to the laparotomy group where there was a trend only (p=0.09 and 0.05). Conclusion For patients undergoing laparoscopy, increasing body mass index did not impact postoperative complications but did influence the decision to perform lymph node dissection.
Arumugam, Cibi; Gordinier, Mary E.; Metzinger, Daniel S.; Pan, Jianmin; Rai, Shesh N.
A giant prostatic hyperplasia (GPH) weighing more than 700 g is a rare entity. It is believed that only eight such cases have been previously reported in the medical literature. This case report concerns a patient with a GPH weighing 740 g which was successfully removed by suprapubic prostatectomy. To our knowledge, this is the fourth largest benign prostatic enlargement ever reported in the literature.
Maliakal, Joseph; Mousa, Emad E.; Menon, Varna
Treating congenital adrenal hyperplasia.
Genettreating congenital adrenal hyperplasia.ic alterations associated with rare endocrine diseases disrupt the body's normal chemical communication system. Faulty genes can affect any part of the hormone pathway by altering the way the body recognises a hormone, or how a hormone acts on a target organ. One example is congenital adrenal hyperplasia. CAH results from an inherited alteration in a gene that blocks an essential enzyme (usually 21-hydroxylase) in the adrenal hormone pathway. Synthesis of cortisol (the "stress" hormone) and aldosterone, which regulates the blood pressure through sodium, potassium and fluid balance, is impaired or absent. The adrenal glands enlarge as they work harder to correct the imbalance, resulting in the overproduction of androgens (male hormones); the more severe the enzyme block, the greater the male hormone production. In 95% of people with CAH, it is due to an alteration in the 21-hydroxylase gene, which is recessively inherited (Perrin et al, 2000). One in 55 people is a carrier for CAH (Baumgartner-Parzer et al, 2005). PMID:24568018
Stewart, Sue
Endometrial Carcinoma Associated with Hyperplasia
The aim of this study was to clarify the relationship of endometrial hyperplasia to endometrial carcinoma. From 1979 through 1990, 115 cases of stage I�IV endometrial carcinomas treated initially by hysterectomy were reviewed histologically. Forty-two of 115 (36.5%) patients had hyperplasia in the endometrium adjacent to the carcinoma. Women with both endometrial carcinoma and hyperplasia were significantly younger than those
Tsunehisa Kaku; Naoki Tsukamoto; Tooru Hachisuga; Nobuhiro Tsuruchi; Kunihiro Sakai; Toshio Hirakawa; Satoshi Amada; Toshiaki Saito; Toshiharu Kamura; Hitoo Nakano
The informational impact of electronic trading systems on the FTSE 100 stock index and its futures contracts
This article examines the partial adjustment factors of Financial Times Stock Exchange (FTSE) 100 stock index and stock index futures. Using high frequency data from 15 January 1997 to 17 March 2000, it aims to assess the informational impact of the electronic trading systems implemented at the London Stock Exchange and London International Financial Futures Exchange (LIFFE). The results suggest
Helder M. C. V. Sebasti�o
Development of spatial water resources vulnerability index considering climate change impacts.
This study developed a new framework to quantify spatial vulnerability for sustainable water resources management. Four hydrologic vulnerability indices--potential flood damage (PFDC), potential drought damage (PDDC), potential water quality deterioration (PWQDC), and watershed evaluation index (WEIC)--were modified to quantify flood damage, drought damage, water quality deterioration, and overall watershed risk considering the impact of climate change, respectively. The concept of sustainability in the Driver-Pressure-State-Impact-Response (DPSIR) framework was applied in selecting all appropriate indicators (criteria) of climate change impacts. In the examination of climate change, future meteorological data was obtained using CGCM3 (Canadian Global Coupled Model) and SDSM (Statistical Downscaling Model), and future stream run-off and water quality were simulated using HSPF (Hydrological Simulation Program - Fortran). The four modified indices were then calculated using TOPSIS, a multi-attribute method of decision analysis. As a result, the ranking obtained can be changed in consideration of climate change impacts. This study represents a new attempt to quantify hydrologic vulnerability in a manner that takes into account both climate change impacts and the concept of sustainability. PMID:21940039
Jun, Kyung Soo; Chung, Eun-Sung; Sung, Jin-Young; Lee, Kil Seong
Minimum impact and immediacy of citations to physics open archives of arXiv.org: Science Citation Index based reports
The present work has calculated the minimum Open Archive Impact Factors and Open Archive Immediacy Index for the Physics Classes of arXiv.org as calculated for traditional journals in Journal Citation Reports of Institute of Scientific Information using Science Citation Index without the citation by the classes itself. The calculated Impact Factors reveal that High-Energy Physics classes of arXiv.org ('hep-th', 'hep-lat',
E. R. Prakasan; Anil Sagar; V. L. Kalyane; Anil Kumar; Stevan Harnad
The fallacy of using NII in analyzing aircraft operations. [Noise Impact Index
NASA Technical Reports Server (NTRS)
Three measures of noise annoyance (Noise Impact Index, Level-Weighted Population, and Annoyed Population Number) are compared, regarding their utility in assessing noise reduction schemes for aircraft operations. While NII is intended to measure the average annoyance per person in a community, it is found that the method of averaging can lead to erroneous conclusions, particularly if the population does not have uniform spatial distribution. Level-Weighted Population and Annoyed Population Number are shown to be better indicators of noise annoyance when rating different strategies for noise reduction in a given community.
Melton, R. G.; Jacobson, I. D.
Assessment of the Impacts of Rice Cropping through a Soil Quality Index
NASA Astrophysics Data System (ADS)
In Entre R�os (Argentina), rice cultivation is carried out mainly in Vertisols. Several factors, such as the use of sodium bicarbonate waters for irrigation, the excessive tillage required, and the lack of proper planning for land use, mainly regarding the crop sequence, cause serious impacts on the soil and have an effect on sustainable agriculture. Thus, the development of methodologies to detect these impacts has become a priority. The aim of this study was to standardize soil quality indicators (SQI) and integrate them into an index to evaluate the impacts of the rice production system on soil, at the farm scale. The study was conducted in farms of the traditional rice cultivation area of Entre R�os province, Argentina. We evaluated a minimum data set consisting of six indicators: structural stability and percolation, total organic matter content (TOM), exchangeable sodium content (ESC), electrical conductivity of saturation extract (ECe) and reaction of the soil (pH). From a database from 75 production lots, we determined the reference values, i.e. limits to ensure the maintenance of long-term productivity and the allowable thresholds for each indicator. The indicators were standardized and integrated into a soil quality index. Five ranges of soil quality were established: very low, low, moderate, high and very high, depending on the values assigned to each SQI. This index allowed differentiating the impact of different crop sequences and showed that the increased participation of rice crop in the rotation resulted in a deterioration of the soil structure due to the decrease in the TOM and to the cumulative increase in ESC caused by the sodium bicarbonate water used for irrigation. Soil management strategies should aim to increase TOM values and to reduce the input of sodium to the exchange complex. A rotation with 50% to 60% of pasture and 40 to 50% of agriculture with a participation of rice lower than 20 to 25% would allow the sustainability of the production system. The use of the so called SQI, i.e. soil quality index, for rice crop production will allow generating early warning of degradation and thus adopting recovery measures.
Sione, S. M.; Wilson, M. G.; Paz Gonz�lez, A.
Impact of the Ki67 proliferation index on response to peptide receptor radionuclide therapy
Purpose��The role of the Ki-67 tumour proliferation index (PI) in predicting the efficacy of peptide receptor radionuclide therapy\\u000a (PRRT) in gastroenteropancreatic tumours (GEP-NET) remains undetermined. This single-centre analysis focused on the potential\\u000a therapeutic impact of this immunohistochemical parameter.\\u000a \\u000a \\u000a \\u000a \\u000a Methods��A total of 81 consecutive GEP-NET patients treated with 177Lu-DOTA-octreotate (mean activity of 7.9�GBq per cycle, usually four treatment cycles at standard
Samer Ezziddin; Martin Opitz; Mared Attassi; Kim Biermann; Amir Sabet; Stefan Guhlke; Holger Brockmann; Winfried Willinek; Eva Wardelmann; Hans-J�rgen Biersack; Hojjat Ahmadzadehfar
A new index for the prediction of the indentation of composites under low velocity impact loads
NASA Astrophysics Data System (ADS)
The effectiveness of a new empirical model for the prediction of the indentation depth resulting in a glass fibre laminates subjected to a low velocity impact, was verified. CFRP indentation data, drawn from a database, were considered to validate the new model. The advantage of the new model is that the effect of the tup diameter is explicitly accounted for. Furthermore, a single material constant has to be experimentally determined and it can be assumed as an index for the indentation sensitivity. The constant was found similar for GFRP and CFRP laminates denoting independence of constraint conditions, laminate type or laminae orientation and stacking sequence.
Lopresto, V.; Caprino, G.; Leone, C.
A statistical assessment of the impact of land uses on surface water quality indexes.
The release of wastewater from various land uses is threatening the quality of surface water. Different land uses pose varying degrees of danger to water resources. The hazardous extent of each activity depends on the amount and characteristics of the wastewater. The concept of the contamination potential index (CPI) of an activity is introduced and applied here. The index depends on the quantity of wastewater from a single source and on various chemicals in the waste whose concentrations are above allowable standards. The CPI concept and the land use impact assessment are applied to the surface water conditions in Nakhon Nayok Province in the central region of Thailand. The land uses considered in this study are residential area, industrial zone, in-season and off-season rice farming, and swine and poultry livestock. Multiple linear regression analysis determines the impact of the CPIs of these land uses on certain water quality characteristics, i.e., total dissolved solids, electrical conductivity, phosphate, and chloride concentrations, using CPIs and previous water quality measurements. The models are further verified according to the current CPIs and measured concentrations. The results of the backward and forward modeling show that the land uses that affect water quality are off-season rice farming, raising poultry, and residential activity. They demonstrate that total dissolved solids and conductivity are reasonable parameters to apply in the land use assessment. PMID:22406854
Seeboonruang, Uma
Nonclassic Congenital Adrenal Hyperplasia
Nonclassic congenital adrenal hyperplasia (NCAH) due to P450c21 (21-hydroxylase deficiency) is a common autosomal recessive disorder. This disorder is due to mutations in the CYP21A2 gene which is located at chromosome 6p21. The clinical features predominantly reflect androgen excess rather than adrenal insufficiency leading to an ascertainment bias favoring diagnosis in females. Treatment goals include normal linear growth velocity and �on-time� puberty in affected children. For adolescent and adult women, treatment goals include regularization of menses, prevention of progression of hirsutism, and fertility. This paper will review key aspects regarding pathophysiology, diagnosis, and treatment of NCAH.
Witchel, Selma Feldman; Azziz, Ricardo
Hyperplasia and carcinoma in secretory endometrium: a diagnostic challenge.
The diagnosis of endometrial hyperplasia or carcinoma in a background of secretory endometrium can be difficult. We attempt to establish the diagnostic criteria to be used in such cases. We examined 80 cases of endometrial hyperplasia, carcinoma, and other conditions with glandular crowding arising in secretory endometrium, analyzed their morphologic features, assessed the volume percentage stroma in each case and performed Ki67 immunostaining on 27 cases. Thirteen cases each of secretory and gestational endometrium served as controls. The mean age of the patients was 45 yr. The non-neoplastic diseases included simple hyperplasia without atypia (56%), endometrial polyps (12.5%), and chronic endometritis with glandular crowding (3%). The proportion of cases with complex hyperplasia without atypia was 10%. Neoplastic diseases included atypical complex hyperplasia (12.5%) and endometrioid carcinoma (6%). The secretory changes were usually less advanced in the hyperplastic glands than in the background endometrium. The morphologic features that best distinguished hyperplasia or carcinoma from secretory endometrium included glandular crowding that stood out from the background; architectural disorder (the long axes of the glands pointing in different directions or parallel to the endometrial surface); dilated, irregularly shaped glands, including budding or branching glands and staghorn-shaped glands; stroma of a polyp; cribriform or confluent glands in cases of carcinoma; nuclear atypia in cases of atypical hyperplasia and carcinoma; and crowded nonsecretory glands. The volume percentage stroma of neoplastic lesions was less than that of non-neoplastic ones (34% vs. 61%, P=0.000001) and that of secretory endometrium (34% vs. 68%, P=0.000038). Non-neoplastic lesions did not have significantly more crowded glands than secretory endometrium (61% vs. 68%, P=0.11). Gestational endometrium had more crowded glands than non-neoplastic lesions (39% vs. 61%, P=0.000004), an approximately equal volume percentage stroma with complex hyperplasia without atypia (39% vs. 43%, P=0.51), and less crowded glands than neoplastic lesions (39% vs. 34%, P=0.03). The Ki67 index of the neoplastic lesions was higher than that of the controls, including secretory and gestational endometria (positive nuclei per 100 epithelial cells, 44.8 vs. 4.6, P=0.0004), of the non-neoplastic lesions (44.8 vs. 5.4, P=0.002) and of complex hyperplasia without atypia (44.8 vs. 9.3, P=0.007). Hyperplasia and carcinoma in secretory endometrium can be diagnosed on the basis of increased glandular crowding, architectural irregularity, nuclear atypia, and increased Ki67 index. PMID:24487463
Truskinovsky, Alexander M; Lifschitz-Mercer, Beatriz; Czernobilsky, Bernard
Monitoring of Crop Production Using a new Satellite-Based Climate-Variability Impact Index
NASA Astrophysics Data System (ADS)
The capabilities of the MODerate resolution Imaging Spectroradiometer (MODIS) present some exciting possibilities for improved and timely monitoring of crop production. A quantitative index is introduced in this paper to study the relationship between remotely-sensed leaf area index (LAI) and crop production. The Climate-Variability Impact Index (CVII), defined as the monthly contribution to anomalies in annual growth, quantifies the percentage of the climatological production either gained or lost due to climatic variability during a given month. By examining the integrated CVII over the growing season, this LAI-based index can provide both fine-scale and aggregated information on vegetation productivity for various crop types. Once the relationship between the CVII and crop production is developed based on the historical record, a trained statistical model can be applied to produce homogeneous production forecasts (in which the model is trained and tested for a particular region), as well as heterogeneous forecasts (in which the model is trained in a particular region and applied to a different region). Both the homogeneous and the heterogeneous model predictions are consistent with USDA/FAO estimates at regional scales. Finally, by determining the estimated production as a function of the growing-season months the CVII can provide significant in-season predictions for end-of-year production. Overall, the high temporal and spatial resolution of the satellite LAI products makes the CVII a useful tool in near-real time crop monitoring and production estimation. Case-studies from recent droughts in Niger and the U.S. Midwest Corn Belt will be presented.
Zhang, P.; Anderson, B.; Tan, B.; Huang, D.; Myneni, R.
A methodological issue concerning the use of Social Sciences Citation Index Journal Citation Reports impact factor data for journal ranking
Following a brief introduction of citation-based journal rankings as potential serials management tools, the most frequently used citation measure- impact factor - is explained. This paper then demonstrates a methodological bias inherent in averaging Social Sciences Citation Index Journal Citation Reports (SSCI JCR) impact factor data from two or more consecutive years. A possible method for correcting the bias, termed
Endometrial Hyperplasia in Young Women.
National Technical Information Service (NTIS)
Findings in a long-term follow-up study of 97 young women with endometrial hyperplasia are presented. In 24 patients (25%), the endometrial hyperplasia was associated with sclerocystic ovaries consistent with the so-called Stein-Leventhal syndrome. Fertil...
D. L. Chamlian H. B. Taylor
Acid Mine Drainage Index (AMDI): a benthic invertebrate biotic index for assessing coal mining impacts in New Zealand streams
Acid mine drainage (AMD) is a widespread phenomenon globally. Drainage into streams from coal mines often contains a cocktail of acidic waters high in dissolved metals, and consequently stream invertebrate communities may be severely impacted. Traditionally, the intensity of impacts has been assessed by combinations of water chemistry and benthic invertebrate metrics; however, a metric specifically designed for assessing mining
DP Gray; JS Harding
Relative impacts of vegetation coverage and leaf area index on climate change in a greener north
NASA Astrophysics Data System (ADS)
To identify relative impacts of vegetation coverage and leaf area index (LAI) on climate in a greener north, a set of climate model sensitivity experiments was conducted in which vegetation coverage and/or LAI were increased over the land poleward of 60�N. The simulation results indicate that an increase in vegetation coverage makes a significant contribution to surface warming, while increasing LAI does not. The increased vegetation coverage reduces both background (snow-free) and snow-covered surface albedos and results in a maximum surface warming (>2�C) during spring and early summer. The increase in vegetation coverage also alters the partitioning between soil evaporation and vegetation evapotranspiration, and consequently reduces soil moisture loss from surface soil. Increased LAI leads to an enhancement of both convective and large scale components of precipitation, while the increase in vegetation coverage primarily increases the ratio of convective to large-scale precipitation.
Zhang, Jing; Walsh, John E.
A damage index of indentation sensitivity in low velocity impact conditions
NASA Astrophysics Data System (ADS)
The empirical model recently found [1] for the prediction of the indentation depth was verified for composite laminates different in matrix and fibre subjected to low velocity impact loads. The data obtained in [1] on common glass and carbon fibre laminates made by common epoxy matrix, were here compared to the results obtained on laminates made by glass fibre immersed in phenolic matrix and novel basalt fibre in epoxy resin. The model takes into explicitly account the tup diameter and presents the advantage that only a single material constant to be experimentally determined is necessary for the prediction. The comparison showed that the value of the constant is different for the different material systems analysed so that it can be assumed as an index for the indentation sensitivity.
Lopresto, V.; Caprino, G.; Leone, C.; Langella, A.
A Malay version of the Child Oral Impacts on Daily Performances (Child-OIDP) index: assessing validity and reliability
Background: The study aimed to develop and test a Malay version of the Child-OIDP index, evaluate its psychometric properties and report on the prevalence of oral impacts on eight daily performances in a sample of 11-12 year old Malaysian schoolchildren. Methods: The Child-OIDP index was translated from English into Malay. The Malay version was tested for reliability and validity on
Z. Y. M. Yusof; N. Jaafar
Impact of metabolic syndrome on global left ventricular function: As evaluated by the myocardial performance index
Background Metabolic syndrome is associated with the development of diabetes mellitus and cardiovascular disease. The impact of metabolic syndrome on the progression of atherosclerosis has been well documented. This study was designed to evaluate the impact of metabolic syndrome on global left ventricular function by using left ventricular myocardial performance index (LVMPI). Methods The diagnosis of metabolic syndrome was made as per the criteria of the International Diabetes Federation. Echocardiography was performed with a Philips IE33 machine using a 1�5�MHz transthoracic probe. LVMPI was calculated by adding isovolumic contraction time with isovolumic relaxation time and dividing it by ejection time. Results The mean LVMPI value in metabolic syndrome was 0.64���0.09, while that in controls was 0.48���0.06 (p�<�0.001). Metabolic syndrome was seen to have more significant influence on LVMPI. Conclusions Metabolic syndrome is a strong predictor of sub-clinical myocardial dysfunction in subjects free of clinically apparent heart disease.
Sreenivasa Kumar, M.L.; Rajasekhar, D.; Vanajakshamma, V.; Latheef, K.
Fire Weather Index : from high resolution climatology to Climate change impact study
NASA Astrophysics Data System (ADS)
Fire meteo indices provide efficient guidance tools for the prevention, early warning and surveillance of forest fires. These indices are only based on meteorological input data. Fire meteorological danger is estimated by M�t�o-France at national level through the use of Fire Weather Index. This study deals with the impact of climate change on fire danger in France. It has been motivated by the numerous forest fires during the 2003 drought and it aims at finding whether such events will be more frequent in the future. The first step of this project was to produce a high resolution FWI climatology. Safran model has been used to derive a 50-year hydrometeorological reanalysis, running from 1958 to 2008, on a 8 km regular grid. This reanalysis has been used in order to assess a long-term trend (a statistically significant increase in FWI for France). Then climate change potential impact on forest fire risk has been studied with climate change scenarios (ARPEGE V4 model with 3 emissions scenarios : A1B, A2 and B1) with special focus on downscaling and correction methods. Quantile-quantile normalization approach has been applied in order to calculate daily FWI from 2030 to 2100. Observed climatology (1958-2008 reanalysis on a 8km grid) has been compared to model climatology. Correction method has been applied for each statistical threshold. This method allowed us to produce downscaled FWI data and to study climate change impact at 8 km resolution. Trends are very clear for FWI and in terms of total number of daily FWI above a threshold. We can expect a huge increase in forest fire risk by 2060. All the French territory could face an average fire risk currently observed on Mediterranean area only. According to A2 and A1B scenarios, the year 2003 could become in France the standard in terms of fire risk by 2060.
Cloppet, E.; Regimbeau, M.
Prostate: Benign Prostatic Hyperplasia (BPH)
... prostatic hyperplasia (BPH)? As a man ages, his prostate gland commonly becomes enlarged. This condition is known ... especially at night. This condition develops as the prostate enlarges and presses against the urethra, causing it ...
[Pseudotumoral hyperplasia of Brunner's glands].
Hyperplasia of Br�nner's glands is a dysembryoplastic or hyperplasic lesion with an elective location of the proximal duodenum. Symptoms are often non-specific but severe manifestations can occur (haemorrhage, duodenal obstruction). Two cases of hyperplasia of Br�nner's glands were reported due to their particularly large size and a misguiding clinical appearance. Difficulties in diagnosis due to this rare benign entity were discussed. PMID:8143953
Maurel, J; Diallo, G; Ongot, M C; Verwaerde, J C; Mandard, J C; Segol, P; Gignoux, M
Reliability of a Novel CBCT-Based 3D Classification System for Maxillary Canine Impactions in Orthodontics: The KPG Index
The aim of this study was to evaluate both intra- and interoperator reliability of a radiological three-dimensional classification system (KPG index) for the assessment of degree of difficulty for orthodontic treatment of maxillary canine impactions. Cone beam computed tomography (CBCT) scans of fifty impacted canines, obtained using three different scanners (NewTom, Kodak, and Planmeca), were classified using the KPG index by three independent orthodontists. Measurements were repeated one month later. Based on these two sessions, several recommendations on KPG Index scoring were elaborated. After a joint calibration session, these recommendations were explained to nine orthodontists and the two measurement sessions were repeated. There was a moderate intrarater agreement in the precalibration measurement sessions. After the calibration session, both intra- and interrater agreement were almost perfect. Indexes assessed with Kodak Dental Imaging 3D module software showed a better reliability in z-axis values, whereas indexes assessed with Planmeca Romexis software showed a better reliability in x- and y-axis values. No differences were found between the CBCT scanners used. Taken together, these findings indicate that the application of the instructions elaborated during this study improved KPG index reliability, which was nevertheless variously influenced by the use of different software for images evaluation.
Visconti, Luca; Martin, Conchita
Reliability of a novel CBCT-based 3D classification system for maxillary canine impactions in orthodontics: the KPG index.
The aim of this study was to evaluate both intra- and interoperator reliability of a radiological three-dimensional classification system (KPG index) for the assessment of degree of difficulty for orthodontic treatment of maxillary canine impactions. Cone beam computed tomography (CBCT) scans of fifty impacted canines, obtained using three different scanners (NewTom, Kodak, and Planmeca), were classified using the KPG index by three independent orthodontists. Measurements were repeated one month later. Based on these two sessions, several recommendations on KPG Index scoring were elaborated. After a joint calibration session, these recommendations were explained to nine orthodontists and the two measurement sessions were repeated. There was a moderate intrarater agreement in the precalibration measurement sessions. After the calibration session, both intra- and interrater agreement were almost perfect. Indexes assessed with Kodak Dental Imaging 3D module software showed a better reliability in z-axis values, whereas indexes assessed with Planmeca Romexis software showed a better reliability in x- and y-axis values. No differences were found between the CBCT scanners used. Taken together, these findings indicate that the application of the instructions elaborated during this study improved KPG index reliability, which was nevertheless variously influenced by the use of different software for images evaluation. PMID:24235889
Dalessandri, Domenico; Migliorati, Marco; Rubiano, Rachele; Visconti, Luca; Contardo, Luca; Di Lenarda, Roberto; Martin, Conchita
The impact of exposure misclassification on associations between prepregnancy body mass index and adverse pregnancy outcomes
Prepregnancy body mass index (BMI) is a widely used marker of maternal nutritional status that relies on maternal self-report of prepregnancy weight and height. Pregravid BMI has been associated with adverse health outcomes for the mother and infant, but the impact of BMI misclassification on measures of effect has not been quantified. The authors applied published probabilistic bias analysis methods to quantify the impact of exposure misclassification bias on well-established associations between self-reported prepregnancy BMI category and five pregnancy outcomes (small- and large-for gestational age birth (SGA; LGA), spontaneous preterm birth (sPTB), gestational diabetes (GDM), and preeclampsia) derived from a hospital-based delivery database in Pittsburgh, PA (2003-2005; n=18 362). The bias analysis method recreates the data that would have been observed had BMI been correctly classified, assuming given classification parameters. The point estimates derived from the bias analysis account for random error as well as systematic error caused by exposure misclassification bias and additional uncertainty contributed by classification errors. In conventional multivariable logistic regression models, underweight women were at increased risk of SGA and sPTB, and reduced risk of LGA, while overweight, obese, and severely obese women had elevated risks of LGA, GDM, and preeclampsia compared with normal-weight women. After applying the probabilistic bias analysis method, adjusted point estimates were attenuated, indicating the conventional estimates were biased away from the null. However, the majority of relations remained readily apparent. This analysis suggests that in this population, associations between self-reported prepregnancy BMI and pregnancy outcomes are slightly overestimated.
Bodnar, Lisa M.; Siega-Riz, Anna Maria; Simhan, Hyagriv N.; Diesel, Jill C.; Abrams, Barbara
The impact of change in pregnancy body mass index on cesarean delivery.
Abstract Objective: To examine the impact of pregnancy changes in body mass index (BMI) on the incidence of cesarean delivery. Methods: This is a retrospective cohort study using linked birth certificate and discharge diagnosis data from the year 2007. Adjusted odds ratios (aOR) were calculated for the outcome of cesarean delivery, as a function of a categorical change in pregnancy BMI (kg/m(2)): BMI loss (BMI change<-0.5), no change (-0.5 to 0.5), minimal (0.6 to 5), moderate (5.1 to 10) and excessive (>10). The impact of pregnancy change in BMI was determined for the entire cohort and then stratified by prepregnancy BMI category. Results: The study population consisted of 436?414 women with singleton gestations. When compared to women with no net change in BMI, women with excessive BMI changes collectively had a 80% increased incidence of cesarean delivery (aOR?=?1.78). By prepregnancy obesity class, the aOR for cesarean delivery in women with excessive BMI change were: normal weight (aOR?=?2.25), overweight (aOR?=?2.39), obese class I (aOR?=?2.23), obese class II (aOR?=?2.56) and obese class III (aOR?=?2.08). Conclusions: The odds of cesarean delivery were uniformly increased in all prepregnancy BMI categories as net BMI change increased. These data illustrate that all women, not just the overweight and obese, are at significantly increased risk of cesarean delivery with excessive BMI change during pregnancy. PMID:24047475
Swank, Morgan L; Caughey, Aaron B; Farinelli, Christine K; Main, Elliott K; Melsop, Kathryn A; Gilbert, William M; Chung, Judith H
The impact of the prenatal ultrasonography on birth of babies with Korean pediatric surgical index diseases
Purpose The purpose of this study is to examine the impact of prenatal ultrasonography (US) on the birth of babies with diseases listed on the Korean pediatric surgery index diseases (IDs). Methods Depending the ease of diagnosis using prenatal US, [diagnostic facility if prenatal US] IDs were divided into easily diagnosed (ED), not easily diagnosed (NED) and detected with difficulty (DD) groups. Five-year data were obtained for the total live birth number (TBN) from the Korean Statistical Information Service, and the actual birth number of IDs (ABNID) from the Korean Health Insurance Review and Assessment Service. The certified incidences of IDs (I) were obtained from a prestigious textbook of pediatric surgery. The estimated abortion rate (AR) of fetus in each group was obtained using the following formula: AR (%) = [1 - (ABNID)/(TBN � I)] � 100. Results The AR with all IDs was 38 to 77%. The AR was 78 to 93% for ED group, 38 to 66% for NED group and 0% for DD group. Conclusion In spite of high survival rates after treatment, the AR of each group depends on the ease of diagnosis using prenatal US in Korea. A recommendatory policy for the fetus with IDs should be urgently established after general consensus within the related medical societies.
Shin, Jae Ho
Impact of early postnatal weight gain and feeding patterns on body mass index in adolescence.
Postnatal weight gain may predispose to the development of obesity during childhood. The aims of this study were to study the impact of weight gain during specific periods of the first year of life and of feeding patterns on the body mass index (BMI) of adolescents. Growth records during the first 24 months of life of 88 obese and 214 non-obese 12 year-old Arab children were evaluated. Birth weight and length were similar for obese and non-obese adolescents, while the rate of breastfeeding was significantly lower in the obese group (p < 0.01). Obese adolescents demonstrated a small yet significant accelerated weight gain at 4 (p = 0.002) and 12 (p = 0.01) months of age. Weight gain during the first 2 months of life and feeding pattern were independent predictors of BMI at the age of 12 years. Thus, early postnatal weight gain is associated with obesity in adolescence, while breastfeeding seems to have a protective effect. PMID:18404968
Shehadeh, Naim; Weitzer-Kish, Hila; Shamir, Raanan; Shihab, Shihab; Weiss, Ram
Impact of Body Mass Index on Outcomes After Conformal Radiotherapy in Patients With Prostate Cancer
Purpose: Several retrospective analyses have suggested that obese men with prostate cancer treated with external beam radiotherapy (EBRT) have outcomes inferior to those of normal-weight men. However, a recently presented analysis for the first time challenged this association between body mass index (BMI) and treatment failure. It is therefore important to provide further data on this issue. Methods and Materials: This was a retrospective analysis of 564 men treated with risk-adapted conformal EBRT at a single institution. Low-risk patients received EBRT alone, and the other patients received EBRT plus endocrine treatment. In addition, high-risk patients were treated to higher EBRT doses (74 Gy). A rectal balloon catheter for internal immobilization, which can be identified on portal images, was used in 261 patients (46%). Thus, localization did not rely on bony landmarks alone in these cases. Results: The median BMI was 26, and 15% of patients had BMI {>=}30. Neither univariate nor multivariate analyses detected any significant impact of BMI on biochemical relapse, prostate cancer-specific survival, or overall survival. The 5-year biochemical relapse rate was 21% and prostate cancerspecific survival 96%. Conclusions: The present analysis of a large cohort of consecutively treated patients suggests that efforts to reduce prostate movement and geographic miss might result in comparable outcomes in obese and normal-weight patients.
Geinitz, Hans, E-mail: firstname.lastname@example.com [Department of Radiation Oncology, Klinikum rechts der Isar der Technischen Universitaet Muenchen, Munich (Germany); Thamm, Reinhard; Mueller, Tobias; Jess, Kerstin [Department of Radiation Oncology, Klinikum rechts der Isar der Technischen Universitaet Muenchen, Munich (Germany); Zimmermann, Frank B. [Department of Radiation Oncology, Universitaetsspital Basel, Basel (Switzerland); Molls, Michael [Department of Radiation Oncology, Klinikum rechts der Isar der Technischen Universitaet Muenchen, Munich (Germany); Nieder, Carsten [Department of Oncology and Palliative Medicine, Nordland Hospital, Bodo (Norway); Faculty of Medicine, University of Tromso, Tromso (Norway)
Intimal hyperplasia: slow but deadly.
Intimal hyperplasia is the leading cause of long-term failure in coronary artery bypass vein grafting, coronary artery stenting, angioplasty, arteriovenous fistula for dialysis, and allograft transplantation. Intimal hyperplasia is a product of vascular smooth muscle cell proliferation, migration through the internal elastic lamina, and deposition of extracellular matrix proteins driven by growth factors in the vasculature. This vascular pathology results in a progressive diminution of the vessel lumen and serves as a site for thrombosis and atherosclerotic lesions. A key cell type in the initiation of intimal hyperplasia is the vascular endothelial cell, which appears to have down-stream effects on the vascular smooth muscle proliferation and migration. Currently, the only means available for prevention of intimal hyperplasia is through inhibition of mammalian target of rapamycin (mTOR) with the immunosuppressant rapamycin. mTOR integrates up-stream signals from growth factors such as IL-2 and senses the cellular nutrient and energy levels and redox status. This presentation will discuss the potential means of preserving the vascular endothelial cell and, thereby, reducing the development of intimal hyperplasia in our open-heart surgical patients. PMID:22751382
Mills, B; Robb, T; Larson, D F
Pharmacotherapy for benign prostatic hyperplasia.
Benign prostatic hyperplasia is a benign neoplasm of the prostate seen in men of advancing age. Microscopic evidence of the disorder is seen in about 70% of men by 70 years of age, whereas symptoms requiring some form of surgical intervention occur in 30% of men during their lifetime. Although the exact cause of benign prostatic hyperplasia is not clear, it is well recognized that high levels of intraprostatic androgens are required for the maintenance of prostatic growth. In recent years, extensive surveys of patients undergoing transurethral resection of the prostate reveal an 18% incidence of morbidity that has essentially not changed in the past 30 years. This procedure is also the second highest reimbursed surgical therapy under Medicare. These findings have resulted in an intensive search for alternative therapies for prostatic hyperplasia. An alternative that has now been well defined is the use of alpha-adrenergic blockers to relax the prostatic urethra. This is based on findings that a major component of benign prostatic hyperplasia symptoms is spasm of the prostatic urethra and bladder neck, which is mediated by the alpha-adrenergic nerves. A second approach is to block androgens involved in maintaining prostate growth. Several such drugs are now available for clinical use, and we discuss their side effects and use. We also include the newer recommendations on evaluating benign prostatic hyperplasia that are cost-effective yet comprehensive. Images
Narayan, P; Indudhara, R
Climate Change Impact on Forest Cover using Warmth Index and Minimum Temperature in Korea
NASA Astrophysics Data System (ADS)
The objective of study was to predict the changes in regional forest distribution using the Warmth Index (WI) and minimum temperature index (MTI) in Korea. Previously, there were several trials to explain the forest cover changes in Korea using global-scale models, such as MC1 (MAPSS-CENTURY) and CEVSA (Carbon Exchange between Vegetation, Soil, and Atmosphere). However, these global vegetation models are not pertinent to simulate the climate change impact on relatively small Korean ecosystem. Therefore, the zonal distribution of WI and MTI was applied to interpret the spatial patterns of forest vegetation. Firstly, the climate data of past years (1971-2000) was prepared by Korea Meteorological Administration (KMA), and ECHO-G model provided future climate data under A1B scenario. Then, the optimal habitat rages of tree species were plotted by spatial distribution patterns of WI and MTI. In terms of cold tolerance for tree species, minimum monthly mean temperature of January (the coldest month) was converted to MTI, which related to intercellular freezing. MTI distribution of Korea in past years was ranged from -84.85 to 14. Overall MTI will be inclined in future period (2021-2050) and period (2071-2100), ranged from -80.91 to 19.45 and from 34.36 to -58.73, respectively. Also, WI was calculated by summing up of monthly mean temperature above 5 degrees Celsius. WI distribution of Korea in past years (1971-2000) was ranged from 72 to 132.9 degrees Celsius month. Overall WI will be increased in future period (2021-2050) and period (2071-2100), ranged from 81 to 147.9 degrees Celsius month and from 98 to 174.1 degrees Celsius month, respectively. As results of simulations, there were certain changes in vegetation distribution by climate change. The optimal habitat range of evergreen needleleaf species will be decreased and the range of deciduous and evergreen broadleaf species will be increased in the future; 1) especially, the optimal range of Pinus densiflora will shrink in the future, and 2) in southern part of Korea, the integration of WI and MTI tends to be laid over the optimal range for evergreen broadleaf species, such as Camellia japonica and Cyclobalanopsis glauca. The zonal distribution of integrated WI and MTI can explain more specifically than previous studies using only WI or MTI and global scale models.
Choi, S.; Lee, W.; Yoo, S.; Park, S.
Prostate Enlargement: Benign Prostatic Hyperplasia (BPH)
... Topics and Titles : Prostate Enlargement: Benign Prostatic Hyperplasia Prostate Enlargement: Benign Prostatic Hyperplasia On this page: The ... Needed? Hope through Research Additional Reading Glossary The Prostate Gland The prostate is a walnut-sized gland ...
Impact of body mass index and albumin on morbidity and mortality after cardiac surgery
Objective: Extremely thin and overly obese patients may not tolerate cardiac surgery as well as other patients. A retrospective study was conducted to determine whether the extremes of body mass index (weight\\/height2 [kg\\/m2]) and\\/or cachexia increased the morbidity and mortality associated with cardiac operations. Methods: Body mass index was used to objectively measure �thinness� (body mass index 30); preoperative serum
Daniel T. Engelman; David H. Adams; John G. Byrne; Sary F. Aranki; John J. Collins; Gregory S. Couper; Elizabeth N. Allred; Lawrence H. Cohn; Robert J. Rizzo
Developmental Trajectories of Body Mass Index Among Japanese Children and Impact of Maternal Factors during Pregnancy
Background The aims of this study were to 1) determine the distinct patterns of body mass index (BMI) trajectories in Japanese children, and 2) elucidate the maternal factors during pregnancy, which contribute to the determination of those patterns. Methodology/Principal Findings All of the children (1,644 individuals) born in Koshu City, Japan, between 1991 and 1998 were followed in a longitudinal study exploring the subjects� BMI. The BMI was calculated 11 times for each child between birth and 12 years of age. Exploratory latent class growth analyses were conducted to identify trajectory patterns of the BMI z-scores. The distribution of BMI trajectories were best characterized by a five-group model for boys and a six-group model for girls. The groups were named �stable thin,� �stable average,� �stable high average,� �progressive overweight,� and �progressive obesity� in both sexes; girls were allocated to an additional group called �progressive average.� Multinomial logistic regression found that maternal weight, smoking, and skipping breakfast during pregnancy were associated with children included in the progressive obesity pattern rather than the stable average pattern. These associations were stronger for boys than for girls. Conclusions/Significance Multiple developmental patterns in Japanese boys and girls were identified, some of which have not been identified in Western countries. Maternal BMI and some unfavorable behaviors during early pregnancy may impact a child�s pattern of body mass development. Further studies to explain the gender and regional differences that were identified are warranted, as these may be important for early life prevention of weight-associated health problems.
Haga, Chiyori; Kondo, Naoki; Suzuki, Kohta; Sato, Miri; Ando, Daisuke; Yokomichi, Hiroshi; Tanaka, Taichiro; Yamagata, Zentaro
A Malay version of the Child Oral Impacts on Daily Performances (Child-OIDP) index: assessing validity and reliability
Background The study aimed to develop and test a Malay version of the Child-OIDP index, evaluate its psychometric properties and report on the prevalence of oral impacts on eight daily performances in a sample of 11�12?year old Malaysian schoolchildren. Methods The Child-OIDP index was translated from English into Malay. The Malay version was tested for reliability and validity on a non-random sample of 132, 11�12?year old schoolchildren from two urban schools in Kuala Lumpur. Psychometric analysis of the Malay Child-OIDP involved face, content, criterion and construct validity tests as well as internal and test-retest reliability. Non-parametric statistical methods were used to assess relationships between Child-OIDP scores and other subjective outcome measures. Results The standardised Cronbach�s alpha was 0.80 and the weighted Kappa was 0.84 (intraclass correlation?=?0.79). The index showed significant associations with different subjective measures viz. perceived satisfaction with mouth, perceived needs for dental treatment, perceived oral health status and toothache experience in the previous 3?months (p?0.05). Two-thirds (66.7%) of the sample had oral impacts affecting one or more performances in the past 3?months. The three most frequently affected performances were cleaning teeth (36.4%), eating foods (34.8%) and maintaining emotional stability (26.5%). In terms of severity of impact, the ability to relax was most severely affected by their oral conditions, followed by ability to socialise and doing schoolwork. Almost three-quarters (74.2%) of schoolchildren with oral impacts had up to three performances affected by their oral conditions. Conclusion This study indicated that the Malay Child-OIDP index is a valid and reliable instrument to measure the oral impacts of daily performances in 11�12?year old urban schoolchildren in Malaysia.
Thymic hyperplasia in Graves' disease.
Graves' disease is an autoimmune thyroid condition characterized by the production of autoantibodies against the thyrotropin receptor. It is known to be associated with autoimmune conditions such as myasthenia gravis, Addison's disease, type 1 diabetes mellitus, and vitiligo. We present a case of rare autoimmune association of Graves' disease with thymic hyperplasia which regressed after treatment with antithyroid drugs. Exact pathophysiology of thymic hyperplasia in Graves' is not well understood; it is likely to be the result of rather than the cause of Graves' disease. PMID:23869315
Kotwal, Narendra; Singh, Yashpal; Menon, Anil; Behera, Vineet
Thymic hyperplasia in Graves' disease
Graves� disease is an autoimmune thyroid condition characterized by the production of autoantibodies against the thyrotropin receptor. It is known to be associated with autoimmune conditions such as myasthenia gravis, Addison's disease, type 1 diabetes mellitus, and vitiligo. We present a case of rare autoimmune association of Graves� disease with thymic hyperplasia which regressed after treatment with antithyroid drugs. Exact pathophysiology of thymic hyperplasia in Graves� is not well understood; it is likely to be the result of rather than the cause of Graves� disease.
Kotwal, Narendra; Singh, Yashpal; Menon, Anil; Behera, Vineet
Focal epithelial hyperplasia: Case report.
The purpose of the present article is to present a 15 year-old patient with focal epithelial hyperplasia and to review the references on the subject-related etiological, pathological, diagnostic and treatment aspects. Focal epithelial hyperplasia is a rare human papilloma virus (HPV) related to oral lesion with very low frequency within our population. Surgical treatment with a biopsy was performed, acanthosis and parakeratosis are consistent histopathological features, since the patient had no history of sexual contact and HIV infection, the virus was probably acquired from environmental sources. PMID:22071419
Puriene, Alina; Rimkevicius, Arunas; Gaigalas, Mindaugas
The pi-index: a new indicator for assessing scientific impact
There are several simple and sophisticated scientometric indicators generally applied in the literature (e.g. total number of publications and citations, citations per journal paper, relative citedness indexes, Hirsch index, etc.), which may characterize the publications of scientists both qualitatively and quantitatively. The calculation methods generally use data referring to the total set of papers studied. Scientific progress, how - ever,
Peter Vinkler
Outcome of congenital adrenal hyperplasia.
In congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency, affected girls are born with ambiguous genitalia due to increased secretion of androgens in utero by the defective adrenal gland. Even though it is generally accepted that there are differences between male and female brain development, determining factors have been difficult to identify. Girls with CAH have frequently been studied to evaluate the impact of prenatal androgen exposure on psychological, psychosocial, and psychosexual development, and impairments in various areas have been identified. However, there is no comprehensive study available regarding the outcome of this chronic disorder in adult life. We studied the quality of life in women with CAH, with particular emphasis on how they cope with genital malformations, genital operations, and chronic disease as well as lifelong medication. The patients filled out questionnaires covering their physical state, psychological well-being, social relationships, and functional capacity, as well as questionnaires on psychosexual identification and psychosocial integration. The results were evaluated using a computerized statistical program for social studies. Out of a total of 94 patients above 18 years of age, 45 agreed to participate and were compared to 46 healthy, age-matched controls. Age at diagnosis was 2. 31 +/- 1.55 years and 38% suffered from the simple-virilizing, 45% from the salt-wasting, and 17.0% from the late-onset form of CAH. About one-third of patients had Prader stage 3 or 4 genital virilization. While the overall quality of life did not differ significantly, CAH patients were more often single (47.8% vs. 66.7%) and fewer of them had children (22.2% vs. 38.6%) compared to controls. Significant impairments were found in regard to body image and attitudes toward sexuality, but there was no increased homosexual preference. The women were successful in adjusting to illness and receiving social support. It is speculated that improved psychosocial adaptation is part of a coping mechanism that helps to maintain a high level of well-being despite impairment. Coping mechanisms should be identified and strengthened in order to help patients cope with their chronic illness. PMID:9238119
Kuhnle, U; Bullinger, M
Assessment of different doses of N applied to a melon crop in the quality of groundwater: environmental impact indexes.
NASA Astrophysics Data System (ADS)
Provided that the intensive use of N in agricultural systems has negatively impacted environmental quality, because a higher fertilization requirements of the crop to make the nitrate leached into the aquifer contaminating, as well as increasing their presence on the ground resulting in a time of intercropping nitrates washing with the arrival of rains. It's necessary to know the N management to reduce the pollution risks and may lead the higher production with the fewer economic cost, environmental and health. The aim of this study was to asses how different doses of nitrogen applied to a melon crop affected the quality of groundwater. The doses of N applied ranged between 11 and 393 kg ha-1. Several indexes, based in N leaching consequence of the agricultural practice, were calculated and provided an essential tool for knowing the risks of groundwater pollution with the practices used. Drinking water impact, irrigation water management impact and environmental impact indexes were obtained during four years in a vulnerable area of the centre of Spain. Acknowledgements: This project has been supported by INIA-RTA04-111
Castellanos, M. T.; Cartagena, M. C.; Ribas, F.; Cabello, M. J.; Arce, A.; Tarquis, A. M.
Silodosin versus naftopidil for the treatment of benign prostatic hyperplasia: a multicenter randomized trial.
This was a multicenter randomized trial to investigate the clinical efficacy and the impact on sexual function of alpha-1A selective silodosin and alpha-1D selective naftopidil for treatment of benign prostatic hyperplasia. A total of 97 patients with lower urinary tract symptoms/benign prostatic hyperplasia who had an International Prostate Symptom Score of 8 or more were randomly assigned to receive silodosin (8?mg/day, n?=?53) or naftopidil (75?mg/day, n?=?44). Before and 4, 8 and 12?weeks after treatment, International Prostate Symptom Score and its quality of life score were used to assess lower urinary tract symptoms. Also, International Index of Erectile Function-5, and an original questionnaire were used to evaluate erectile function and ejaculation for sexually active patients, respectively. The silodosin group showed advantages in terms of voiding symptoms and quality of life of International Prostate Symptom Score when compared with the naftopidil group. Both silodosin and naftopidil showed no significant effect on International Index of Erectile Function-5. A total of 23 sexually active patients in the silodosin group experienced more ejaculatory impairment than 21 patients in the naftopidil group, with a decrease of ejaculation volume (87% vs 40%, P?=?0.003), prolonged time to ejaculation (56% vs 33%, P?=?0.027) and decrease of orgasm (50% vs 39%, P?=?0.027). These results suggest that alpha-1A selective blockers are more effective for voiding symptoms, whereas alpha-1D selective blockers offer a minor degree of ejaculatory dysfunction. PMID:23731168
Yamaguchi, Kenya; Aoki, Yutaka; Yoshikawa, Tetsuo; Hachiya, Takahiko; Saito, Tadanori; Takahashi, Satoru
[Evalution of benign prostatic hyperplasia].
Benign prostatic hyperplasia is a disorder of aging men and according to reasons for consultation its incidence is continually increasing in parallel with the constant increase in life expectancy. Recommendations about its management have been made by numerous national and international, scientific authorities and those responsible for public health. However, despite a rationale based on regularly published data, there are many disparities between them and they are only partially followed up in routine practice. The purpose of a working group during the "2nd Interfaces in Urology" was to make a new assessment on this disorder with regard to the most recent data and existing recommendations, in order to offer clinicians a clearer attitude for the prescription of the initial evaluation of benign prostatic hyperplasia. PMID:16425735
Desgrandchamps, Fran�ois
Impact of Increased Body Mass Index on Laparoscopic Surgery for Rectal Cancer
Background: Laparoscopy was initially considered to be a risky procedure for rectal cancer patients, especially patients with an increased body weight. The literature is scarce regarding the effects of obesity on laparoscopic rectal surgery. The aim of the current study was to analyze the effect of an increased body mass index (BMI) on outcome of laparoscopic surgery for rectal cancer.
Tayfun Karahasanoglu; Ismail Hamzaoglu; Bilgi Baca; Erman Aytac; Ebru Kirbiyik
Various treatment options for benign prostatic hyperplasia: A current update
In benign prostatic hyperplasia (BPH) there will be a sudden impact on overall quality of life of patient. This disease occurs normally at the age of 40 or above and also is associated with sexual dysfunction. Thus, there is a need of update on current medications of this disease. The presented review provides information on medications available for BPH. Phytotherapies with some improvements in BPH are also included. Relevant articles were identified through a search of the English-language literature indexed on MEDLINE, PUBMED, Sciencedirect and the proceedings of scientific meetings. The search terms were BPH, medications for BPH, drugs for BPH, combination therapies for BPH, Phytotherapies for BPH, Ayurveda and BPH, BPH treatments in Ayurveda. Medications including watchful waitings, Alpha one adrenoreceptor blockers, 5-alpha reductase inhibitors, combination therapies including tamsulosin-dutasteride, doxazosin-finasteride, terazosin-finasteride, tolterodine-tamsulosin and rofecoxib-finasteride were found. Herbal remedies such as Cernilton, Saxifraga stolonifera, Zi-Shen Pill (ZSP), Orbignya speciosa, Phellodendron amurense, Ganoderma lucidum, Serenoa Repens, pumpkin extract and Lepidium meyenii (Red Maca) have some improvements on BPH are included. Other than these discussions on Ayurvedic medications, TURP and minimally invasive therapies (MITs) are also included. Recent advancements in terms of newly synthesized molecules are also discussed. Specific alpha one adrenoreceptor blockers such as tamsulosin and alfuzosin will remain preferred choice of urologists for symptom relief. Medications with combination therapies are still needs more investigation to establish as preference in initial stage for fast symptom relief reduced prostate growth and obviously reduce need for BPH-related surgery. Due to lack of proper evidence Phytotherapies are not gaining much advantage. MITs and TURP are expensive and are rarely supported by healthcare systems.
Shrivastava, Alankar; Gupta, Vipin B.
On indexing in the Web of Science and predicting journal impact factor
We discuss what document types account for the calculation of the journal impact factor (JIF) as published in the Journal Citation Reports (JCR). Based on a brief review of articles discussing how to predict JIFs and taking data differences between the Web of Science (WoS) and the JCR into account, we make our own predictions. Using data by cited-reference searching for Thomson Scientific�s WoS, we predict 2007 impact factors (IFs) for several journals, such as Nature, Science, Learned Publishing and some Library and Information Sciences journals. Based on our colleagues� experiences we expect our predictions to be lower bounds for the official journal impact factors. We explain why it is useful to derive one�s own journal impact factor.
Wu, Xiu-fang; Fu, Qiang; Rousseau, Ronald
Employee Valuation of Pension Claims and the Impact of Indexing Initiatives
There is discussion in both Canada and the United States of the government's requiring private pension plans to provide contractual cost-of-living protection. This paper employs both an auction and an implicit contract model to identify the compensating wage differentials required of possible indexing initiatives. The contract model, motivated by the prevalence (especially in Canada) of ad hoc cost-of-living adjustments to
James E. Pesando
Gene Expression in Low Glycemic Index Diet - Impact on Metabolic Control
Background: Correcting postprandial hyperglycemia forms an important part of the prevention and management of type 2 diabetes. Methods: A low-glycemic-index liquid formula designated as Inslow was prepared by replacing dextrin in the standard balanced formula (SBF) with 55.7% palatinose. Long-term administration of Inslow prevented fatty liver and improved insulin resistance in rats. Expressions of mRNA of factors involved in glucose
E. Takeda; H. Arai; K. Muto; K. Matsuo; M. Sakuma; M. Fukaya; H. Yamanaka-Okumura; H. Yamamoto; Y. Taketani
The impact of body build on the relationship between body mass index and percent body fat
OBJECTIVE: The objective of the study was to test the hypothesis that differences in the relationship between percent body fat (%BF) and body mass index (BMI) between populations can be explained (in part) by differences in body build.DESIGN: Cross-sectional, comparative study.SUBJECTS: 120 age, gender and BMI matched Singapore Chinese, Beijing Chinese and Dutch (Wageningen) Caucasians.MEASUREMENTS: From body weight and body
P. Deurenberg; M Deurenberg Yap; J. Wang; F. P. Lin; G. Schmidt
Medical treatment of benign prostatic hyperplasia
Pharmaceutical preparations are commonly used for benign prostate hyperplasia. This article reviews the current understanding of the natural history of the condition and the literature regarding medical treatment.
Connolly, Stephen S; Fitzpatrick, John M
BPH: Minimally Invasive Management (Benign Prostatic Hyperplasia/Enlarged Prostate)
... sit amet, consectetur adipiscing elit. BPH: Minimally Invasive Management (Benign Prostatic Hyperplasia/Enlarged Prostate) Throughout a man's ... BPH: Diagnosis (Benign Prostatic Hyperplasia/Enlarged Prostate) BPH: Management (Benign Prostatic Hyperplasia/Enlarged Prostate) BPH: Medical Management ( ...
Tackling climate change impacts in the context of sustainability: the livelihood index as an integrative framework
NASA Astrophysics Data System (ADS)
Climate change will have consequences for human livelihoods, deriving from multiple direct and indirect impacts. Knowledge on sectoral impacts is increasing, e.g. the water the sector, however this knowledge remains fragmented and an integrative framework to assess the consequences of sectoral climate impacts on human livelihoods is missing. Further, adaptation needs to adapt to the expected climate impacts should be linked to goals of sustainable development. We introduce a modelling framework to quantify relevant livelihood dimensions, based on an extensive, interdisciplinary literature review. The applied fuzzy methodology allows translating the concept of livelihoods into a measurable framework, while retaining relationships and processes along the chain of aggregation. The framework includes a range of aspects including natural, infrastructural as well as societal resources. A quantification of these requirements can provide insights to several important issues in human-environmental systems. On the one hand it allows linking and integrating sectoral climate impacts, enabling cross-sectoral comparison. On the other hand, it paves the way towards addressing issues of sustainability, by focussing on the fulfilment of needs, which is a core component of the sustainability concept. On the basis of several climate change scenarios, we exemplify our approach by calculating the consequences of changes in water availability for human livelihoods over the course of the century. We present results from a global assessment at country-level, as well as more detailed insight from several country case studies at sub-national resolution.
Lissner, Tabea K.; Reusser, Dominik E.; Kropp, J�rgen P.
The criteria weight determination of factors impacting the melt flow index of degradable plastics using Lambda-Max method
NASA Astrophysics Data System (ADS)
Three common methods of determining criteria weights using the Analytic Hierarchy Process (AHP) are extent analysis, logarithmic least square method (LLSM) and Lambda-Max. Lambda-Max criteria weights determination method uses pair wise comparison of criteria considered. Studies have shown that Lambda-Max is a preferred criteria weight determination method since it involves lesser computation with consistent results of precise criteria weights generated. In this paper the criteria weights of four factors impacting the Melt Flow Index of degradable plastics are calculated using Lambda-Max method. The input factors (criteria) are the percentages by mass of polyethylene, oil palm biomass, palm olein and starch used in the formulation of degradable plastics. The criteria weights are calculated using Lambda-Max based on input given by four experts. The finding indicates the feasibility of using Lambda-Max method in criteria weight determination for determining the impact of four factors in the formulation of degradable plastics as reflected by the consistency control index value calculated.
Dom, Rosma Mohd; Saadon, Nurul Adzlyana; Mohamad, Daud
The use of benthic macroinvertebrates to monitor water quality and ecological integrity is not as well established for wetlands as it is for rivers, streams and lakes where this form of biomonitoring is now a formalized procedure. he impact to wetlands from urbanization (as measu...
Impact factor, H index, peer comparisons, and Retrovirology: is it time to individualize citation metrics?
There is a natural tendency to judge a gift by the attractiveness of its wrapping. In some respect, this reflects current mores of measuring the gravitas of a scientific paper based on the journal cover in which the work appears. Most journals have an impact factor (IF) which some proudly display on their face page. Although historically journal IF has
Kuan-Teh Jeang
Relations of relative scientometric impact indicators. The relative publication strategy index
Relations of three relative scientometric indicators (Relative Citation Rate, RCR, Relative Subfield Citedness, RW, and Relative Publication Strategy, RPS) are studied. RW can be calculated by the percentage share of citations divided by that of publications. The findings indicate that publishing\\u000a in journals with relatively high impact factor is a necessary but not sufficient condition for attaining a high RW
P. Vinkler
The CINMa index: assessing the potential impact of GM crop management across a heterogeneous landscape.
While significant progress has been made on the modification of crops for the benefit of producers, the same cannot be said in regards to eliciting the potential impact that these crops may have on the wider landscape and the diversity of life therein. Management impacts can create difficulties when making policy, regulation and licensing decisions in those countries where agriculture has a significant social and ecological position in the landscape. To begin to gauge the potential impacts of the management of a selection of GM crops on an agricultural landscape, four key biodiversity stressors (Chemicals, Introgression, Nutrients and Management: CINMa) were identified and a grading system developed using published data. Upon application to five selected GM crops in a case study area, CINMa identifies areas in the wider landscape where biodiversity is likely to be negatively or positively impacted, as well as agricultural zones which may benefit from the land use change associated with the management of GM crops and their associated post market environmental monitoring. PMID:21975254
Collier, Marcus J; Mullins, Ewen
Oral verrucous hyperplasia: a case report.
Oral verrucous hyperplasia is a whitish or pinkinsh elevated pre malignant lesion which occurs rarely. Its is also considered to be an early form of verrucous carcinoma. We have reported a case of verrucous hyperplasia which was diagnosed and treated with buccal fat pad as graft. PMID:25018612
Navaneetham, Anuradha; Dayanand Saraswathi, M C; Santosh, B S
Morphologic hysteroscopic criteria suggestive of endometrial hyperplasia
Objectives: To evaluate the morphologic hysteroscopic criteria leading to a diagnosis of endometrial hyperplasia and compare their accuracy with that of histology. Methods: A total of 95 hysteroscopic examinations were evaluated. Of these, 37 had a histologic diagnosis of normal endometrium and the remaining 58 of simple or complex endometrial hyperplasia. We compared the morphologic hysteroscopic criteria for the two
L. H Uno; O Sugimoto; F. M Carvalho; V. R Bagnoli; A. M Fonseca; J. A Pinotti
Revealing the impact of radiation-induced refractive index changes in polymer gel dosimeters
NASA Astrophysics Data System (ADS)
This study examines effects of radiation-induced refractive index (RI) changes in polymer gel dosimeters. A prototype fan-beam optical computed tomography scanner was used to image a normoxic polymer gel dosimeter that was irradiated with two simple irradiation patterns-one single beam, one cross beam. A combed fan-beam was used for rayline tracing. Scans revealed that notable rayline errors occur when a steep, side-to-side dose gradient (i.e. RI gradient) is encountered. When the gradient occurs in the plane of the detector system, distinctive streaks in images are observed. When the gradient occurs perpendicular to the plane of the detector system, much more severe image errors are observed.
Campbell, W. G.; Jirasek, A.; Wells, D.
Global spatial indexing of the human impact on Al, Cu, Fe, and Zn mobilization.
With increasing consumption of material by human activity, the extent of human influence relative to nature in the mobilization of metals and other elements on Earth continues to grow. Recognizing people as modern geomorphic agents, I produced global data layers at 1 degreesx1 degrees of human-mediated mass flows (coal combustion, biomass burning, and mining) and nature-mediated mass flows (net primary productivity, sea salt aerosol emission, and denudation to the oceans) for the industrial metals of aluminum, iron, copper, and zinc for the year 2000. The major mobilization processes are denudation (natural) and mining (anthropic), though net primary productivity for Zn and Cu and coal combustion for Al are nearly as significant. All flows are subsequently combined into an index representing human versus nature flow dominance. As the first maps of mobilization flows of metals widely used by modern technology, they reveal that approximately 1-5% (depending upon the metal) of Earth's land surface now has metal flow dominated by human activity. PMID:20666554
Rauch, Jason N
Quantifying the impact of climate change on drought regimes using the Standardised Precipitation Index
NASA Astrophysics Data System (ADS)
The study presents a methodology to characterise short- or long-term drought events, designed to aid understanding of how climate change may affect future risk. An indicator of drought magnitude, combining parameters of duration, spatial extent and intensity, is presented based on the Standardised Precipitation Index (SPI). The SPI is applied to observed (1955-2003) and projected (2003-2050) precipitation data from the Community Integrated Assessment System (CIAS). Potential consequences of climate change on drought regimes in Australia, Brazil, China, Ethiopia, India, Spain, Portugal and the USA are quantified. Uncertainty is assessed by emulating a range of global circulation models to project climate change. Further uncertainty is addressed through the use of a high-emission scenario and a low-stabilisation scenario representing a stringent mitigation policy. Climate change was shown to have a larger effect on the duration and magnitude of long-term droughts, and Australia, Brazil, Spain, Portugal and the USA were highlighted as being particularly vulnerable to multi-year drought events, with the potential for drought magnitude to exceed historical experience. The study highlights the characteristics of drought which may be more sensitive under climate change. For example, on average, short-term droughts in the USA do not become more intense but are projected to increase in duration. Importantly, the stringent mitigation scenario had limited effect on drought regimes in the first half of the twenty-first century, showing that adaptation to drought risk will be vital in these regions.
Jenkins, Katie; Warren, Rachel
Basal Cell Hyperplasia in the Peripheral Zone of the Prostate
Basal cell hyperplasia in the prostate is often viewed as a transition zone proliferation, related to usual, nodular glandular, and stromal hyperplasia. Basal cell hyperplasia in the prostatic peripheral zone, the most common site for development of prostatic intraepithelial neoplasia and carcinoma, has not been previously characterized. We characterized the incidence and histomorphological attributes of basal cell hyperplasia in a
Phataraporn Thorson; Paul E. Swanson; Robin T. Vollmer; Peter A. Humphrey
Cutaneous vascular proliferations. Part II. Hyperplasias and benign neoplasms
This second part of our review about vascular proliferations summarizes the clinicopathologic features of the cutaneous vascular hyperplasias and benign neoplasms. Hyperplasias comprise a heterogeneous group of vascular proliferations that eventually show a tendency to regression. Angiolymphoid hyperplasia with eosinophilia is included within the group of hyperplasias because of its historical denomination and its reactive nature, probably as a consequence
Luis Requena; Omar P. Sangueza
Spontaneously Improving Occipitocondylar Hyperplasia: A Case Report
This case report presents a pediatric patient with the extremely rare craniovertebral junction anomaly of occipitocondylar hyperplasia. This 4-year old boy presented with macrocephaly and mild to moderate pontomedullary compression from the unilateral occipitocondylar hyperplasia. Based on the asymptomatic clinical presentation, it was decided to follow the patient with serial magnetic resonance images without surgical intervention. Upon further imaging the occipitocondylar hyperplasia spontaneously resolved. This case report offers watchful waiting as an alternative treatment approach to surgical intervention as was reported in the literature previously. Possible pathophysiologic mechanisms are also briefly explored.
Nagy, Laszlo; Ray, Coby
Energy absorption during impact on the proximal femur is affected by body mass index and flooring surface.
Impact mechanics theory suggests that peak loads should decrease with increase in system energy absorption. In light of the reduced hip fracture risk for persons with high body mass index (BMI) and for falls on soft surfaces, the purpose of this study was to characterize the effects of participant BMI, gender, and flooring surface on system energy absorption during lateral falls on the hip with human volunteers. Twenty university-aged participants completed the study with five men and five women in both low BMI (<22.5kg/m(2)) and high BMI (>27.5kg/m(2)) groups. Participants underwent lateral pelvis release experiments from a height of 5cm onto two common floors and four safety floors mounted on a force plate. A motion-capture system measured pelvic deflection. The energy absorbed during the initial compressive phase of impact was calculated as the area under the force-deflection curve. System energy absorption was (on average) 3-fold greater for high compared to low BMI participants, but no effects of gender were observed. Even after normalizing for body mass, high BMI participants absorbed 1.8-fold more energy per unit mass. Additionally, three of four safety floors demonstrated significantly increased energy absorption compared to a baseline resilient-rolled-sheeting system (% increases ranging from 20.7 to 28.3). Peak system deflection was larger for high BMI persons and for impacts on several safety floors. This study indicates that energy absorption may be a common mechanism underlying the reduced risk of hip fracture for persons with high BMI and for those who fall on soft surfaces. PMID:24837217
Bhan, Shivam; Levine, Iris C; Laing, Andrew C
Genetic Markers Associated with Benign Prostatic Hyperplasia.
National Technical Information Service (NTIS)
The present invention regards expression profiles of one or more nucleic acids indicative of the presence of, susceptibility to, and/or predicting response to therapy of benign prostatic hyperplasia (BPH) in an individual. The present invention identifies...
D. M. Spencer E. Canto J. Levitt K. M. Slawin M. Ittmann
[Pharmacologic treatment of benign prostatic hyperplasia].
Medical treatment for benign prostatic hyperplasia is reviewed by the author. Experiences with herbal extracts have been known for more than 2 decades. Treating benign prostatic hyperplasia with these extracts are recommended in initial phase. Effectiveness of these drugs are approved by some placebo controlled double blind studies. However effectiveness of these are not as good as medical drugs'. It is well known that they have no side effects and are cheaper than medicines. Prostate volume is decreased and mechanical component of dysuria is improved by treating for long time (months, years) with 5 alfa reductase finasterid which contain hormone. This drug is indicated when volume of the prostate is over 40 g. Dynamical component of benign prostatic hyperplasia is treated with a receptor blockers which act on the bladder neck. These medicines effect earlier and are recommended for all benign prostatic hyperplasia patients independently of prostate volume. These might have some side effect like hypotension. PMID:14596018
Romics, Imre
Throid Hyperplasia at Autopsy in Mulago Hospital.
National Technical Information Service (NTIS)
Thyroid hyperplasia was found in 89 per cent of unselected autopsy cases at Mulago Hospital. This reflects a low intake of dietary iodine. The number of tribes involved indicates that this is a widespread problem in Uganda. (Author)
D. H. Connor R. H. Follis
Endometrial Stromal Hyperplasia: An Underrecognized Condition
Hyperplasia of the endometrial stroma is a poorly recognized lesion, lacking widespread recognition with most, if not all, such cases sequestrated in the literature as endometrial stromal nodules or low-grade endometrial stromal sarcomas. In this paper, we describe three examples of �endometrial stromal hyperplasia� which have a remarkable morphological similarity with the normally proliferating endometrial stroma and the endometrial stromal neoplasms, but which also possess subtle, but sufficient, differences to justify their taxonomic separation.
Koutsougeras, Gerasimos; Giatromanolaki, Alexandra
The Impact of Age, Sex, Body Mass Index and Menstrual Cycle Phase on Gastric Myoelectrical Activity Characteristics in a Healthy Croatian Population
The aim of the study was to determine the impact of demographic and anthropometric parameters on the gastric myoelectrical activity characteristics in a healthy Croatian population. The influence of age, sex, body mass index (BMI) and menstrual cycle phase on the gastric myoelectrical activity characteristics was assessed. The study included 120 healthy subjects of both sexes (60 male and 60
Nikolina Tolj; Dragan Schwarz; Ante Bili; Dragan Jur
First data on an Index of Biotic Integrity (IBI) based on fish assemblages for the assessment of the impact of deforestation in a tropical West African river system
African tropical rainforests, and especially their freshwater biodiversity, are seriously threatened by ongoing industrial deforestation. Sound ecological management is needed to ensure the sustainability of these resources. For this purpose, an index of biotic integrity (IBI), based on fish assemblage characteristics, is developed in this paper. It is used to quantify the impact of industrial deforestation on freshwater biodiversity. Data
Andr� Kamdem Toham; Guy G. Teugels
Genomic Grade Index (GGI): Feasibility in Routine Practice and Impact on Treatment Decisions in Early Breast Cancer
Purpose Genomic Grade Index (GGI) is a 97-gene signature that improves histologic grade (HG) classification in invasive breast carcinoma. In this prospective study we sought to evaluate the feasibility of performing GGI in routine clinical practice and its impact on treatment recommendations. Methods Patients with pT1pT2 or operable pT3, N0-3 invasive breast carcinoma were recruited from 8 centers in Belgium. Fresh surgical samples were sent at room temperature in the MapQuant Dx� PathKit for centralized genomic analysis. Genomic profiles were determined using Affymetrix U133 Plus 2.0 and GGI calculated using the MapQuant Dx� protocol, which defines tumors as low or high Genomic Grade (GG-1 and GG-3 respectively). Results 180 pts were recruited and 155 were eligible. The MapQuant test was performed in 142 cases and GGI was obtained in 78% of cases (n=111). Reasons for failures were 15 samples with <30% of invasive tumor cells (11%), 15 with insufficient RNA quality (10%), and 1 failed hybridization (<1%). For tumors with an available representative sample (? 30% inv. tumor cells) (n=127), the success rate was 87.5%. GGI reclassified 69% of the 54 HG2 tumors as GG-1 (54%) or GG-3 (46%). Changes in treatment recommendations occurred mainly in the subset of HG2 tumors reclassified into GG-3, with increased use of chemotherapy in this subset. Conclusion The use of GGI is feasible in routine clinical practice and impacts treatment decisions in early-stage breast cancer. Trial Registration ClinicalTrials.gov NCT01916837, http://clinicaltrials.gov/ct2/show/NCT01916837
Metzger-Filho, Otto; Catteau, Aurelie; Michiels, Stefan; Buyse, Marc; Ignatiadis, Michail; Saini, Kamal S.; de Azambuja, Evandro; Fasolo, Virginie; Naji, Sihem; Canon, Jean Luc; Delree, Paul; Coibion, Michel; Cusumano, Pino; Jossa, Veronique; Kains, Jean Pierre; Larsimont, Denis; Richard, Vincent; Faverly, Daniel; Cornez, Nathalie; Vuylsteke, Peter; Vanderschueren, Brigitte; Peyro-Saint-Paul, Helene; Piccart, Martine; Sotiriou, Christos
Neointimal hyperplasia persists at six months after sirolimus-eluting stent implantation in diabetic porcine
BACKGROUND: Observational clinical studies have shown that patients with diabetes have less favorable results after percutaneous coronary intervention compared with the non-diabetic counterparts, but its mechanism remains unclear. The aim of this study was to examine the changes of neointimal hyperplasia after sirolimus-eluting stent (SES) implantation in a diabetic porcine model, and to evaluate the impact of aortic inflammation on
Qi Zhang; Lin Lu; LiJin Pu; RuiYan Zhang; Jie Shen; ZhengBing Zhu; Jian Hu; ZhenKun Yang; QiuJin Chen; WeiFeng Shen
Delayed uterine fluid clearance and reduced uterine perfusion in bitches with endometrial hyperplasia and clinical management with postmating antibiotic.
In many species a transient uterine inflammatory response follows mating and is proposed to remove excess spermatozoa, bacteria, and other contaminants from the uterus. Similar events have been documented in the bitch involving increased uterine contractions, polymorphonuclear neutrophil influx and uterine artery vasodilation. Some healthy bitches with endometrial hyperplasia have increased numbers of uterine luminal polymorphonuclear neutrophils after mating and reduced fertility; it is purported that this represents a presumed postmating endometritis. This study used B-mode and Doppler ultrasonography at the time of mating to measure uterine contractions, clearance of ejaculated fluid, and uterine artery velocity in normal bitches and those with endometrial hyperplasia. Mating resulted in an increase in the number of uterine contractions, although fewer mating-induced contractions were noted in bitches with endometrial hyperplasia. Interestingly, uterine fluid cleared significantly more slowly after mating from the bitches with endometrial hyperplasia than the normal bitches (P = 0.01). In a further study, Doppler ultrasonography showed that in normal bitches there was a significant increase in uterine artery blood velocity (P = 0.04) and a decrease in the resistance index after mating (P = 0.04), indicating vasodilation. In bitches with endometrial hyperplasia the baseline resistance index was significantly higher than normal bitches (P = 0.05), and furthermore, although there was a significant decrease in resistance index after mating, in the bitches with endometrial hyperplasia this was of a smaller magnitude that in normal bitches. These findings indicate lower baseline uterine perfusion, and a blunted vasodilation response to mating in bitches with endometrial hyperplasia. Short-duration postmating administration of systemic antibiotic increased pregnancy rates in bitches with endometrial hyperplasia (P < 0.01). Litter sizes in bitches with endometrial hyperplasia were lower than those of normal bitches both before and after treatment with postmating antibiotic (P = 0.04 and < 0.01, respectively). Mating-induced endometritis in bitches with endometrial hyperplasia appears to affect fertility by reducing the uterine vasodilatory response to mating and delaying clearance of uterine fluid as a result of decreased uterine contractions but the effect can be ameliorated in part by the postmating administration of antibiotic. PMID:22980089
England, G C W; Moxon, R; Freeman, S L
Long-term outcome of genital reconstruction of Middle Eastern women with congenital adrenal hyperplasia
Objectives: There is a paucity of data on the long-term outcome of genital reconstruction of female children with congenital adrenal hyperplasia (CAH) as they become adult women. We report on the surgical outcome general condition and marriage status. Materials and Methods: We reviewed the medical records of women 20 years or older with CAH who had genital reconstruction. We interviewed married patients utilizing the female sexual function index (FSFI-6) questionnaire and compared them to age-matched controls. Results: We identified 43 women with CAH with a median age of 24.2 � 3.9 years and a median follow-up of 23.4 � 4.6 years. Salt wasting and the severity of virilization affected most patients, parents were commonly cousins, children were reared as boys for a protracted period and surgical reconstruction was usually complex. Only five women had married. Compared with single women, married women had significantly more frequent normal menses, emergency hospital admissions and number of repeated reconstructive surgery. There was no significant difference in FSFI score between patients and controls. Four women conceived and three gave birth to one healthy child. There was no significant difference in the number of children between patients and controls. Conclusions: CAH has a significant impact on adult women in our region. Most of the patients remain single. Few women get married and these are able to lead a nearly normal sexual life and give birth to healthy children.
Seyam, Raouf M.; Bissada, Nabil K.; Abdul-Aaly, Mohamed; Sakati, Nadia A.; Al Taweel, Waleed; Alkhudair, Waleed K.
A Case of Cushing's Syndrome Presenting as Endometrial Hyperplasia
We describe here the case of a 39-year-old woman with a cortisol-producing adrenal adenoma and she presented with endometrial hyperplasia and hypertension without the specific characteristics of Cushing's syndrome. The patient had consulted a gynecologist for menometrorrhagia 2 years prior to her referral and she was diagnosed with endometrial hyperplasia and hypertension. Her blood pressure and the endometrial lesion were refractory despite taking multiple antihypertensives and repetitive dilation and curettage and progestin treatment. On admission, the clinical examination revealed mild central obesity (a body mass index of 22.9 kg/m2, a waist circumference of 85 cm and a hip circumference of 94cm), but there was no hirsutism and myopathy. She showed impaired glucose tolerance on an oral glucose tolerance test. The biochemical hypercortisolemia together with the prolactin and androgen levels were evaluated to explore the cause of her anovulation. Adrenal Cushing's syndrome was confirmed on the basis of the elevated urinary free cortisol (454 �g/24h, normal range: 20-70) with a suppressed ACTH level (2.0 pg/mL, normal range: 6.0-76.0) and the loss of circadian cortisol secretion. A CT scan revealed a 3.1 cm, hyperechoic, well-marginated mass in the left adrenal gland. Ten months post-adrenalectomy, the patient had unintentionally lost 9 kg of body weight, had regained a regular menstrual cycle and had normal thickness of her endometrium.
Lee, Sang Min; Jung, Tae Sik; Jung, Jung Hwa; Kang, Mi Yeon; Kim, Sun Joo; Chung, Soon Il
Impact of body mass index and weight fluctuation on lymphedema risk in patients treated for breast cancer.
Identifying risk factors for lymphedema in patients treated for breast cancer has become increasingly important, given the current lack of standardization surrounding diagnosis and treatment. Reports on the association of body mass index (BMI) and weight change with lymphedema risk are conflicting. We sought to examine the impact of pre-operative BMI and post-treatment weight change on the incidence of lymphedema. From 2005 to 2011, 787 newly diagnosed breast cancer patients underwent prospective arm volume measurements with a Perometer pre- and post-operatively. BMI was calculated from same-day weight and height measurements. Lymphedema was defined as a relative volume change (RVC) of ? 10 %. Univariate and multivariate Cox proportional hazards models were used to evaluate the association between lymphedema risk and pre-operative BMI, weight change, and other demographic and treatment factors. By multivariate analysis, a pre-operative BMI ? 30 was significantly associated with an increased risk of lymphedema compared to a pre-operative BMI <25 and 25- <30 (p = 0.001 and p = 0.012, respectively). Patients with a pre-operative BMI 25- <30 were not at an increased risk of lymphedema compared to patients with a pre-operative BMI <25 (p = 0.409). Furthermore, a cumulative absolute weight fluctuation of 10 pounds gained/lost per month post-operatively significantly increased risk of lymphedema (HR: 1.97, p = < 0.0001). In conclusion, pre-operative BMI of ? 30 is an independent risk factor for lymphedema, whereas a BMI of 25- <30 is not. Large post-operative weight fluctuations also increase risk of lymphedema. Patients with a pre-operative BMI ? 30 and those who experience large weight fluctuations during and after treatment for breast cancer should be considered at higher-risk for lymphedema. Close monitoring or early intervention to ensure optimal treatment of the condition may be appropriate for these patients. PMID:24122390
Jammallo, Lauren S; Miller, Cynthia L; Singer, Marybeth; Horick, Nora K; Skolny, Melissa N; Specht, Michelle C; O'Toole, Jean; Taghian, Alphonse G
The Impact of Body Mass Index on Short- and Long-Term Outcomes in Patients Undergoing Coronary Artery Graft Bypass
Objective This study was designed to investigate the impact of body mass index (BMI) on short- and long-term outcomes after initial revascularization with coronary artery bypass graft (CABG) surgery. Methods 4916 Chinese who consecutively underwent isolated, primary CABG at the Cardiovascular Institute of Fuwai Hospital from January 1, 1999 to December 31, 2005 were included in this study. They were classified based on BMI as follows: underweight: <18.5 kg/m2, normal weight: 18.5 to 23.9 kg/m2, overweight: 24 to 27.9 kg/m2, obesity: 28 to 32 kg/m2, and severe obesity: >32 kg/m2. Short (in-hospital) and long-term (5-years) major post-operative complications and mortalities were compared among various BMI groups after initial revascularization. Results Multiple regression analysis of five years follow-up of clinical end points indicated that various BMI groups were not associated with significant differences in 5 years mortality and MACCE, however, old age, smoking, hypertension, myocardial infarction and heart failure were the risk factor for the mortality. Conclusions In this large-scale study with long term follow-up after primary CABG in an exclusively ethnic Chinese population, we found that different BMI groups were not significantly associated with 5-years mortality and MACCE, however, old age, smoking, hypertension, myocardial infarction and heart failure were the risk factors of post-operative mortality, and old age, hypertension and heart failure increased the rate of MACCE.
Xu, Fei; Zheng, Zhe; Chen, Ming; Li, Lei; Wu, Chaoqun; Wang, Qian; Hu, Shengshou
Intrathyroidal parathyroid hyperplasia in tertiary hyperparathyroidism.
We report herein a case of intrathyroidal parathyroid hyperplasia in a patient with tertiary hyperparathyroidism. The patient was recommended for parathyroidectomy due to sustained hypercalcemia after kidney transplantation. Preoperative radiologic evaluations showed a benign-looking thyroid mass and three enlarged parathyroid glands. Intraoperative intact parathyroid hormone (iPTH) level and frozen biopsy results indicated a missed parathyroid gland after immediate subtotal parathyroidectomy. Then, a secondary partial resection of thyroid including the thyroid nodule was performed. An excised intrathyroid nodule was diagnosed to be parathyroid hyperplasia by frozen biopsy, and intraoperative iPTH level abruptly decreased. A benign-looking thyroidal mass in patients with secondary or tertiary hyperparathyroidism should be carefully evaluated considering the possibility of an intrathyroidal parathyroid hyperplasia. PMID:24964443
Kim, Byung Seup; Ryu, Han Suk; Kang, Kyung Ho; Park, Sung Jun
[Serenoa repens in benign prostatic hyperplasia].
Serenoa repens is one of many herbal products used to treat benign prostatic hyperplasia. The treatment has been studied extensively, but the methodological quality has often been poor. Metaanalysis of early studies indicate that the treatment may have favourable effects on patients with benign prostatic hyperplasia, but more recent investigations of better methodological quality have questioned these results. The available documentation does not support use of products containing serenoa repens for these patients. Serenoa repens is associated with mild adverse effects comparable to that of placebo. PMID:18511974
Log, Tomas
Classic congenital adrenal hyperplasia: A delayed presentation
Congenital adrenal hyperplasia (CAH) is a rare congenital disorder, which in cases of female genotype may result in virilization. Specific enzyme deficiencies in adrenocorticoid hormones biosynthetic pathway lead to excess androgen production causing virilization. Classic type presents early in infant life as salt losing or simple virilizing type, whereas non classic form presents late at puberty or in adult life. Depending on the type of classic CAH, type of adrenocorticoid deficiency, extent of virilization & genotype, surgical corrective procedures, glucocorticoid & mineralocorticoid replacement therapy are the mainstay of management. We present here a case of classic congenital adrenal hyperplasia of simple virilizing type, which presented later in childhood.
Aziz Siddiqui, Saima; Soomro, Nargis; Ganatra, Ashraf
Dietary genistein stimulates mammary hyperplasia in gilts.
The possible role of the phytoestrogen genistein on prepubertal development of mammary glands, hormonal status and bone resorption was investigated in gilts. Forty-five gilts were fed a control diet containing soya (CTLS, n = 15), a control diet without soya (CTL0, n = 15) or the CTLS diet supplemented with 2.3 g of genistein daily (GEN, n = 15) from 90 days of age until slaughter (day 183 � 1). Both basal diets were isonitrogenous and isocaloric. Jugular blood samples were obtained on days 89 and 176 to determine concentrations of isoflavone metabolites (on day 176 only), prolactin, estradiol, progesterone, insulin-like growth factor 1 (IGF1), and N-telopeptide of type I collagen (NTx; on day 176 only). At slaughter, mammary glands were excised, parenchymal and extraparenchymal tissues were dissected, and composition of parenchymal tissue (protein, fat, dry matter (DM), DNA) was determined. Histochemical analyses of mammary parenchyma were performed. Dietary genistein increased parenchymal protein (P < 0.05) while decreasing DM (P < 0.05) and tending to lower fat content compared with the CTLS, but not the CTL0, diet. There was more parenchymal DNA (1.26 v. 0.92 mg/g, P < 0.05) in GEN than CTLS gilts, likely reflecting an increase in the quantity of mammary epithelial cells. Circulating concentrations of genistein were increased in GEN gilts (P < 0.001) but concentrations of hormones or NTx (indicator of bone collagen resorption) were not affected by GEN (P > 0.1). Percentage of estradiol receptor alpha (ER?)-positive epithelial cells was lower (P < 0.05) in GEN than CTLS gilts, whereas 5-bromo-2'-deoxyuridine labeling index was unaltered (P > 0.1). Transcript levels for ER?, ER?, IGF1, epidermal growth factor (EGF), epidermal growth factor receptor and transforming growth factor alpha were not altered by treatments. Supplementation of the diet with genistein during the growing phase in gilts, therefore, led to hyperplasia of mammary parenchymal tissue after puberty; yet, even though circulating genistein was increased, this was not accompanied by changes in mammary expression of selected genes or circulating hormone levels. PMID:22443950
Farmer, C; Palin, M F; Gilani, G S; Weiler, H; Vignola, M; Choudhary, R K; Capuco, A V
Problems in the Differential Diagnosis of Endometrial Hyperplasia and Carcinoma
The differential diagnosis of endometrial hyperplasia and well-differentiated endometrioid adenocarcinoma is complicated not only by the resemblance of these lesions to each other, but also by their tendency to be overdiagnosed (particularly hyperplasia) on the background of polyps, endometritis, artifacts, and even normally cycling endometrium. Atypical hyperplasia may also be overdiagnosed when epithelial metaplastic changes occur in simple or complex
Steven G. Silverberg
The Value of Curettage in Diagnosis of Endometrial Hyperplasia
Objectives. The aim of this study was to assess the value of diagnosis of endometrial hyperplasia by curettage and to determine the results of proliferating cell nuclear antigen (PCNA) immunostaining in differentiating endometrial carcinoma from endometrial hyperplasia.Methods. According to Kurman's criteria, we treated 150 patients with endometrial hyperplasia detected by curettage and compared retrospectively the diagnosis by curettage with that
Xing Xie; Wei-Guo Lu; Da-Feng Ye; Huai-Zeng Chen; Yun-Feng Fu
Adult Consequences of Congenital Adrenal Hyperplasia
Background: Congenital adrenal hyperplasia (CAH) caused by 21-hydroxylase deficiency accounts for 95% of all CAH cases and is one the most common inborn metabolic disorders. While consensus and guidelines on therapeutic management in infancy and childhood are available, data regarding the treatment of adults with CAH are scarce. This review highlights the issues that need to be addressed when caring
Wiebke Arlt; Nils Krone
Orally administered nicotine induces urothelial hyperplasia in rats and mice.
Tobacco smoking is a major risk factor for multiple human cancers including urinary bladder carcinoma. Tobacco smoke is a complex mixture containing chemicals that are known carcinogens in humans and/or animals. Aromatic amines a major class of DNA-reactive carcinogens in cigarette smoke, are not present at sufficiently high levels to fully explain the incidence of bladder cancer in cigarette smokers. Other agents in tobacco smoke could be excreted in urine and enhance the carcinogenic process by increasing urothelial cell proliferation. Nicotine is one such major component, as it has been shown to induce cell proliferation in multiple cell types in vitro. However, in vivo evidence specifically for the urothelium is lacking. We previously showed that cigarette smoke induces increased urothelial cell proliferation in mice. In the present study, urothelial proliferative and cytotoxic effects were examined after nicotine treatment in mice and rats. Nicotine hydrogen tartrate was administered in drinking water to rats (52 ppm nicotine) and mice (514 ppm nicotine) for 4 weeks and urothelial changes were evaluated. Histopathologically, 7/10 rats and 4/10 mice showed simple hyperplasia following nicotine treatment compared to none in the controls. Rats had an increased mean BrdU labeling index compared to controls, although it was not statistically significantly elevated in either species. Scanning electron microscopic visualization of the urothelium did not reveal significant cytotoxicity. These findings suggest that oral nicotine administration induced urothelial hyperplasia (increased cell proliferation), possibly due to a mitogenic effect of nicotine and/or its metabolites. PMID:24269753
Dodmane, Puttappa R; Arnold, Lora L; Pennington, Karen L; Cohen, Samuel M
The impact of farm management on species-specific leaf area index (LAI): Farm-scale data and predictive models
Leaf area index (LAI; the single-sided leaf area per unit area of ground) is a measure of plant standing crop in terrestrial ecosystems and is a key parameter in meteorological, climate and hydrological models. While the LAI of individual species can be measured by destructive harvesting and LAI of whole landscapes can be estimated by remote sensing, estimates of species-specific
Michael J. O. Pocock; Darren M. Evans; Jane Memmott
Human land uses may have major impacts on ecosystems, affecting biodiversity, habitat, air and water quality. The human use index (also known as U-index) is the percentage of human land use in an area, including agriculture, urban and suburban development, and mining. Low values ...
Human land uses may have major impacts on ecosystems, affecting biodiversity, habitat, air and water quality. The human use index (also known as U-index) is the percentage of human land use in an area, including agriculture, urban and suburban development, and mining. Low values ...
Multiple myeloma presenting as gingival hyperplasia
Multiple myeloma is a malignant neoplasm that is characterized by a monoclonal proliferation of plasma cells. Oral and maxillofacial manifestations as an initial sign or symptom of multiple myeloma are rare. A 58-year-old male patient presented with generalized gingival enlargement for last 6 months. Based on clinical presentation, a diagnosis of gingival hyperplasia was made. After Phase I therapy, excisional biopsy was taken in anterior mandibular region and excised tissue was sent for histopathological examination. The histopathology report revealed a lining of stratified squamous epithelium with foci of ulceration. The subepithelial zone showed infiltration by sheets of mainly binucleate and multinucleate plasma cells, few cells being less differentiated. Rounded cytoplasmic inclusion bodies were identified in many of these cells. After a series of clinical investigations, a case of �multiple myeloma� was diagnosed. Patient presenting with generalized gingival hyperplasia should be worked up for systemic disease like multiple myeloma.
Jain, Sanjeev; Kaur, Harjit; Kansal, Gaurav; Gupta, Parul
Multiple myeloma presenting as gingival hyperplasia.
Multiple myeloma is a malignant neoplasm that is characterized by a monoclonal proliferation of plasma cells. Oral and maxillofacial manifestations as an initial sign or symptom of multiple myeloma are rare. A 58-year-old male patient presented with generalized gingival enlargement for last 6 months. Based on clinical presentation, a diagnosis of gingival hyperplasia was made. After Phase I therapy, excisional biopsy was taken in anterior mandibular region and excised tissue was sent for histopathological examination. The histopathology report revealed a lining of stratified squamous epithelium with foci of ulceration. The subepithelial zone showed infiltration by sheets of mainly binucleate and multinucleate plasma cells, few cells being less differentiated. Rounded cytoplasmic inclusion bodies were identified in many of these cells. After a series of clinical investigations, a case of "multiple myeloma" was diagnosed. Patient presenting with generalized gingival hyperplasia should be worked up for systemic disease like multiple myeloma. PMID:24049344
Jain, Sanjeev; Kaur, Harjit; Kansal, Gaurav; Gupta, Parul
Congenital adrenal hyperplasia with cholestatic jaundice.
Congenital Adrenal Hyperplasia describes a group of autosomal recessive disorders characterized by a decrease in Cortisol production. 11 beta hydroxylase deficiencies is the second most common form. However, its presentation with cholestatic jaundice is extremely rare. We present a case of a 29-day-old infant who came to us with unusual dark complexion, persistent jaundice, and electrolyte imbalance. On investigation he was diagnosed as a case of congenital adrenal hyperplasia. Treatment with hydrocortisone and fludrocortisone cleared his jaundice and complexion with subsequent improvement in electrolytes. The aim of this report is to illustrate an unusual presentation of CAH with Cholestatic jaundice. This is the first case to be reported from Pakistan. The case outlines the difficult workup that was encountered in the diagnosis and management of the patient. PMID:24605732
Ali, Nisreen Feroz; Zafar, Farhana; Bangash, Areeb Sohail; Malik, Abdul; Mohammedi, Karimunnisa
Angiolymphoid Hyperplasia with Eosinophilia with Follicular Mucinosis
Follicular mucinosis occurring along with angiolymphoid hyperplasia with eosinophils (ALHE) has been described in a 49-year-old male. The patient presented with pruritic hyperpigmented papules and nodules on the vertex and right parietal scalp. There was no any other complaint. Histopathological examination from one of the papule showed prominent blood vessels in the dermis lined by plump histiocytoid endothelial cells that were surrounded by a dense lymphoid infiltrate with numerous eosinophils; these findings are typical of angiolymphoid hyperplasia with eosinophilia. Features of follicular mucinosis were observed in the same section with 3 hyperplastic follicular infundibula containing pools of mucin in the infundibular epithelium. The concurrent occurrence of these 2 distinct histopathological patterns in the same biopsy specimen has been reported rarely.
Gutte, Rameshwar; Doshi, Bhavana; Khopkar, Uday
Fertility in patients with congenital adrenal hyperplasia.
Congenital adrenal hyperplasia (CAH) is the most frequently encountered genetic steroid disorder affecting fertility. Steroid hormones play a crucial role in sexual development and reproductive function; patients with either 21- hydroxylase or 11?-hydroxylase deficiency thus face immense challenges to their fertility. Given the relevance of CAH in reproductive medicine as well as the diagnostic challenges posed by the phenotypic overlap with polycystic ovary syndrome, we review the reproductive pahophysiology of both classic and nonclassic CAH and present contemporary treatment options. PMID:24355046
Reichman, David E; White, Perrin C; New, Maria I; Rosenwaks, Zev
Inflammatory hyperplasia: From diagnosis to treatment.
Gingival enlargement, the currently accepted terminology for an increase in the size of the gingiva, is a common feature of gingival disease. Local and systemic factors influence the gingival conditions of the patient. These factors results in a spectrum of diseases that can be developmental, reactive and inflammatory to neoplastic. In this article, the history, etiology, clinical and histopathological features, treatment strategies and preventive protocol of inflammatory hyperplasia are discussed. PMID:24744554
Shukla, Pradeep; Dahiya, Varun; Kataria, Prerna; Sabharwal, Shreya
Inflammatory hyperplasia: From diagnosis to treatment
Gingival enlargement, the currently accepted terminology for an increase in the size of the gingiva, is a common feature of gingival disease. Local and systemic factors influence the gingival conditions of the patient. These factors results in a spectrum of diseases that can be developmental, reactive and inflammatory to neoplastic. In this article, the history, etiology, clinical and histopathological features, treatment strategies and preventive protocol of inflammatory hyperplasia are discussed.
Shukla, Pradeep; Dahiya, Varun; Kataria, Prerna; Sabharwal, Shreya
Feminizing genital reconstruction in congenital adrenal hyperplasia
The past several decades have seen multiple advances in the surgical reconstruction for girls born with Disorders of Sexual Differentiation. This surgery can be technically very demanding, and must be individualized for each patient, as the degree of virilization and level of confluence of the vagina and urogenital sinus will dictate the surgical approach. In this manuscript we present our approach and experience in the surgical options for girls born with Congenital Adrenal Hyperplasia, with special attention regarding clitoroplasty, urogenital mobilization, and vaginoplasty.
Leslie, Jeffrey A.; Cain, Mark Patrick; Rink, Richard Carlos
The effects of PPAR? agonist rosiglitazone on neointimal hyperplasia in rabbit carotid anastomosis model
Background Neointimal hyperplasia involving smooth muscle cell (SMC) proliferation, migration and extracellular matrix (ECM) degradation is an important component of atherosclerosis. It develops as a response to vascular injury after balloon angioplasty and vascular graft placement. Matrix metalloproteinases (MMPs) induce SMC proliferation, migration and contribute to intimal hyperplasia by degrading ECM. PPAR? agonists inhibit SMC proliferation, migration and lesion formation. In this study, we aimed to investigate the effects of PPAR? agonist rosiglitazone on neointimal hyperplasia and gelatinase (MMP-2 and MMP-9) expressions in rabbit carotid anastomosis model. Methods New Zealand white rabbits (n?=?13, 2.7�3.2?kg) were divided into placebo and treatment groups. Right carotid artery (CA) was transected and both ends were anastomosed. Treatment group (n?=?6) received rosiglitazone (3?mg/kg/day/p.o.) and placebo group (n?=?7) received PBS (phosphate buffered saline, 2.5?ml/kg/day/p.o.) for 4?weeks postoperatively. After the sacrification, right and left CAs were isolated. Morphometric analyses and immunohistochemical examinations for gelatinases were performed. Results Intimal area (0.055?�?0.005 control vs 0.291?�?0.020??m2 anastomosed, p?0,05) and index (0.117?�?0.002 control vs 0.574?�?0.013 anastomosed, p?0,01) significantly increased in anastomosed arteries compared to control arteries from placebo group. However, in rosiglitazone-treated group, intimal area (0.291?�?0.020 PBS vs 0.143?�?0.027 rosiglitazone, p?0,05) and index (0.574?�?0.013 PBS vs 0.263?�?0.0078 rosiglitazone, p?0,01) significantly decreased. Furthermore, gelatinase immunopositivity was found to have significantly increased in anastomosed arteries from placebo group and decreased with rosiglitazone treatment. Conclusions These results suggest that rosiglitazone may prevent neointimal hyperplasia, which is the most important factor involved in late graft failure, by inhibiting gelatinase enzyme expression.
Development and validation of a tool for identifying women with low bone mineral density and low-impact fractures: the S�o Paulo Osteoporosis Risk Index (SAPORI)
Summary��The performance of the S�o Paulo Osteoporosis Risk Index (SAPORI) was tested in 1,915 women from the original cohort, S�o\\u000a Paulo Osteoporosis Study (SAPOS) (N?=?4332). This new tool was able to identify women with low bone density (spine and hip) and low-impact fracture, with an\\u000a area under the receiving operator curve (ROC) of 0.831, 0.724, and 0.689, respectively.\\u000a \\u000a \\u000a \\u000a \\u000a Introduction��A number
M. M. Pinheiro; E. T. Reis Neto; F. S. Machado; F. Omura; J. Szejnfeld; V. L. Szejnfeld
Impact of index change saturation on the growth behavior of higher-order type I ultrafast induced fiber Bragg gratings
Ultrafast infrared induced fiber Bragg gratings in a hydrogen-loaded SMF-28 fiber are shown to exhibit complex and, what we believe to be, novel spectral evolutions. It is believed that the induced grating peak profile in the fiber is nonsinusoidal as a result of the nonlinear absorption required to modify the material. Rouard's method is used to show that the observed spectral evolution is a consequence of the saturation of the nonsinusoidal index change profile.
Smelser, Christopher W.; Mihailov, Stephen J.; Grobnic, Dan [Communications Research Centre Canada, 3701 Carling Ave., P.O. Box 11490, Station H, Ottawa, Ontario K2H 8S2 (Canada)
Impact of protein standardization of milk powder with lactose or permeate on whey protein nitrogen index and heat classification
Whey protein nitrogen index (WPNI) is a well-known method of classifying nonfat dry milk powder (NFDM) based on its heat treatment.\\u000a This classification scheme provides one criterion for the selection of NFDM for food applications. However, the effects of\\u000a variation in NFDM composition on WPNI are not well documented. The objective of this study was to determine the effects of
Vandna Sikand; Phillip S. Tong; John Walker
18F-FDG-Avid Brunner Gland Hyperplasia.
Brunner gland hyperplasia, a rare duodenal tumor, usually presents with benign features. A 68-year-old man with a history of anemia presented with a polypoid duodenal mass that was detected by CT and esophagogastroduodenoscopy. This mass showed high F-FDG avidity on PET/CT and was histopathologically confirmed as Brunner gland hyperplasia. We suggest that Brunner gland hyperplasia should be considered in the differential diagnosis of F-FDG-avid duodenal tumors. PMID:24686216
Park, Seol Hoon; Park, Kwang-Min; Kim, Jae Seung
ERIC Educational Resources Information Center
Focuses on access to digital image collections by means of manual and automatic indexing. Contains six sections: (1) Studies of Image Systems and their Use; (2) Approaches to Indexing Images; (3) Image Attributes; (4) Concept-Based Indexing; (5) Content-Based Indexing; and (6) Browsing in Image Retrieval. Contains 105 references. (AEF)
Rasmussen, Edie M.
Impact of Intellectual Capital on Organisational Performance: An Empirical Study of Companies in the Hang Seng Index (Part 1)
ERIC Educational Resources Information Center
Purpose: The purpose of this paper, which is written in two parts, is to investigate empirically if intellectual capital (IC) has an impact on the financial aspects of organisational performance as well as attempting to identify the IC components that may be the drivers for the leading financial indicators of listed companies. The study sought�
Chan, Kin Hang
Impact of Intellectual Capital on Organisational Performance: An Empirical Study of Companies in the Hang Seng Index (Part 2)
ERIC Educational Resources Information Center
Purpose: The purpose of this paper, which is written in two parts, is to investigate empirically if intellectual capital (IC) has an impact on the financial aspects of organisational performance as well as attempting to identify the IC components that may be the drivers for the leading financial indicators of listed companies. The study sought�
Chan, Kin Hang
Evaluating the anthropogenic impact on karst environments: Karst Disturbance Index applied to West-Central Florida and Southeast Italy
Due to its high fragility, that derives from the intrinsic geological and hydrogeological characteristics, karst is extremely vulnerable to degradation and pollution. Although the carrying capacity of these natural environments is low, a variety of human activities is implemented on karst settings generating impacts at the surface and subsurface. The human-induced effects in karst can be assessed by applying a
L. A. North; M. Parise; P. E. van Beynen
Impact of consumption of vegetable, fruit, grain, and high glycemic index foods on aggressive prostate cancer risk.
Prostate cancer is a common but complex disease, and distinguishing modifiable risk factors such as diet for more aggressive disease is extremely important. Previous work has detected intriguing associations between vegetable, fruit, and grains and more aggressive prostate cancer, although these remain somewhat unclear. Here we further investigate such potential relationships with a case-control study of 982 men (470 more aggressive prostate cancer cases and 512 control subjects). Comparing the highest to lowest quartiles of intake, we found that increasing intakes of leafy vegetables were inversely associated with risk of aggressive prostate cancer [adjusted odds ratio (OR) = 0.66, 95% CI: 0.46, 0.96; P trend = 0.02], as was higher consumption of high carotenoid vegetables (OR = 0.71, 95% CI: 0.48, 1.04; P trend = 0.04). Conversely, increased consumption of high glycemic index foods were positively associated with risk of aggressive disease (OR = 1.64, 95% CI: 1.05, 2.57; P trend = 0.02). These results were driven by a number of specific foods within the food groups. Our findings support the hypothesis that diets high in vegetables and low in high glycemic index foods decrease risk of aggressive prostate cancer. PMID:21774611
Hardin, Jill; Cheng, Iona; Witte, John S
Impact of consumption of vegetable, fruit, grain, and high glycemic index foods on aggressive prostate cancer risk
Prostate cancer is a common but complex disease, and distinguishing modifiable risk factors such as diet for more aggressive disease is extremely important. Previous work has detected intriguing associations between vegetable, fruit, and grains and more aggressive prostate cancer, although these remain somewhat unclear. Here we further investigate such potential relationships with a case-control study of 982 men (470 more aggressive prostate cancer cases and 512 control subjects). Comparing the highest to lowest quartiles of intake, we found that increasing intakes of leafy vegetables were inversely associated with risk of aggressive prostate cancer (adjusted odds ratio (OR) =0.66, 95% CI: 0.46, 0.96, P-trend=0.02), as was higher consumption of high carotenoid vegetables (OR=0.71, 95% CI: 0.48, 1.04; P-trend=0.04). Conversely, increased consumption of high glycemic index foods were positively associated with risk of aggressive disease (OR=1.64, 95% CI: 1.05, 2.57; P-trend=0.02). These results were driven by a number of specific foods within the food groups. Our findings support the hypothesis that diets high in vegetables and low in high glycemic index foods decrease risk of aggressive prostate cancer.
Hardin, Jill; Cheng, Iona; Witte, John S.
Temperature-induced index gratings and their impact on mode instabilities in high-power fiber laser systems.
Mode-interference along an active fiber in high-power operation gives rise to a longitudinally oscillating temperature profile which, in turn, is converted into a strong index grating via the thermo-optic effect. In the case of mode beating between the fundamental mode and a radially anti-symmetric mode such a grating exhibits two periodic features: a main one which is radially symmetric and has half the period of the modal beating, and a second one that closely follows the mode interference pattern and has its same period. In the case of modal beating between two radially symmetric modes the thermally induced grating only has radially symmetric features and exhibits the same period of the mode interference. The relevance of such gratings in the context of the recently observed mode instabilities of high-power fiber laser systems is discussed. PMID:22274367
Jauregui, Cesar; Eidam, Tino; Otto, Hans-J�rgen; Stutzki, Fabian; Jansen, Florian; Limpert, Jens; T�nnermann, Andreas
Angiofollicular lymph node hyperplasia with amyloidosis.
Two cases of angiofollicular lymph node hyperplasia are described, one of the solitary plasma cell type the other of the multicentric hyaline vascular type. Both cases illustrate the wide ranging clinical and pathological findings associated with this condition but both also have unusual features. The solitary plasma cell lesion had an exceptional 32 year clinical history and was associated with systemic amyloidosis of AL type. The multicentric hyaline vascular case was associated with coexistent multiple myeloma and amyloid deposition also of AL type. These cases are presented with a review of the relevant literature. Images Figure 1 Figure 2
West, K. P.; Morgan, D. R.; Lauder, I.
Molecular genetics of congenital adrenal hyperplasia.
More than 95% of cases of congenital adrenal hyperplasia are attributable to steroid 21-hydroxylase (21-OH) deficiency. In normal individuals, there are usually two 21-OH genes on each chromosome 6, a functional 21-OH gene-CYP21B-and a closely related 21-OH pseudogene-CYP21A-which is defective in expression. Recent advances have shown that the pathologic mutations that contribute to 21-OH deficiency arise as a consequence of unequal crossover and gene conversion-like mechanisms that involve sequence interaction between the normally functional 21-OH gene and its pseudogene. PMID:18411093
Strachan, T
[Focal nodular hyperplasia of the liver].
Among the benign liver tumours particularly the focal nodular hyperplasia (FNH) increased its importance. Within 10 years we could observe 28 patients with the lesion. Macroscopically the nodular changes show extremely characteristic findings. The histological picture reminds us of cirrhosis, the prevailing presence in women and the clinical recognition mostly at reproductive age let us think of a hormonal action in development and growth of the lesion. The same concerns the use of hormonal contraceptive drugs. Differential-diagnostically particularly malignant processes are to be demarcated. Though the danger of a haemorrhage with formation of a haemoperitoneum is insignificant, in the individual case a surgical approach should be taken into consideration. PMID:2545053
M�lleken, K
Clinical and Imaging Findings of True Hemifacial Hyperplasia
Congenital hemifacial hyperplasia is a rare developmental disorder of unknown etiology, characterized by a marked unilateral facial asymmetry. It involves the hard (bones and teeth) and soft tissues of the face. We report an interesting case of true hemifacial hyperplasia in a 25-year-old male highlighting the clinical and computed tomography imaging findings.
Bhuta, Bansari A.; Desai, Rajiv S.; Bansal, Shivani P.; Chemburkar, Vipul V.; Dev, Prashant V.
Rebound thymic hyperplasia five years after chemotherapy for Wilms' tumor
Rebound thymic hyperplasia following chemotherapy is well documented, usually occurring within the first year. A delayed presentation makes distinction from an anterior mediastinal mass problematic in view of the increased risk of a second primary malignancy in pediatric cancer survivors. An unusual case of rebound thymic hyperplasia is described, presenting five years after completion of chemotherapy for Wilms' tumors.
J. Chertoff; R. A. Barth; J. D. Dickerman
Prenatal Diagnosis and Treatment of Congenital Adrenal Hyperplasia
Congenital adrenal hyperplasia is a group of inherited disorders caused by an enzyme deficiency in steroid biosynthesis. The most common form of congenital adrenal hyperplasia is 21-hydroxylase deficiency, which in its severe form can cause genital ambiguity in females. Steroid 21-hydroxylase deficiency can be diagnosed in utero through molecular genetic analysis of fetal DNA. Prenatal treatment successfully reduces genital ambiguity,
Saroj Nimkarn; Maria I. New
Impact of norepinephrine on the relationship between pleth variability index and pulse pressure variations in ICU adult patients
Introduction Pleth Variability Index (PVI) is an automated and continuous calculation of respiratory variations in the perfusion index. PVI correlates well with respiratory variations in pulse pressure (?PP) and is able to predict fluid responsiveness in the operating room. ICU patients may receive vasopressive drugs, which modify vascular tone and could affect PVI assessment. We hypothesized that the correlation between PVI and ?PP and the ability of PVI to identify patients with ?PP > 13% is dependent on norepinephrine (NE) use. Methods 67 consecutive mechanically ventilated patients in the ICU were prospectively included. Three were excluded. The administration and dosage of NE, heart rate, mean arterial pressure, PVI and ?PP were measured simultaneously. Results In all patients, the correlation between PVI and ?PP was weak (r2 = 0.21; p = 0.001). 23 patients exhibited a ?PP > 13%. A PVI > 11% was able to identify patients with a ?PP > 13% with a sensitivity of 70% (95% confidence interval: 47%-87%) and a specificity of 71% (95% confidence interval: 54%-84%). The area under the curve was 0.80 � 0.06. 35 patients (53%) received norepinephrine (NE(+)). In NE(+) patients, PVI and ?PP were not correlated (r2 = 0.04, p > 0.05) and a PVI > 10% was able to identify patients with a ?PP > 13% with a sensitivity of 58% (95% confidence interval: 28%-85%) and a specificity of 61% (95% confidence interval:39%-80%). The area under the ROC (receiver operating characteristics) curve was 0.69 � 0.01. In contrast, NE(-) patients exhibited a correlation between PVI and ?PP (r2 = 0.52; p < 0.001) and a PVI > 10% was able to identify patients with a ?PP > 13% with a sensitivity of 100% (95% confidence interval: 71%-100%) and a specificity of 72% (95% confidence interval: 49%-90%). The area under the ROC curve was 0.93 � 0.06 for NE(-) patients and was significantly higher than the area under the ROC curve for NE(+) patients (p = 0.02). Conclusions Our results suggest that in mechanically ventilated adult patients, NE alters the correlation between PVI and ?PP and the ability of PVI to predict ?PP > 13% in ICU patients.
Automatic indexing has been a critical technology as more full-text data becomes available online. The paper discusses issues for automatic indexing of different types of full-text and also presents a survey of much of the current research into new techniques for automatic indexing.
Harman, D.
The pathogenesis of benign prostatic hyperplasia.
Development of prostatic hyperplasia is an almost universal feature of the aging man and dog, and in both species the process develops only in males with intact testes. As the result of studies of plasma hormone levels as a function of age, measurements of the concentration of androgen and of androgen receptor proteins within the prostate, and studies of the effects of the administration of various hormones on growth of the prostate in the castrated dog, it is possible to provide a working hypothesis as to the pathogenesis. Dihydrotestosterone accumulation within the gland serves as the hormonal mediator for the hyperplasia in both species; the accumulation probably occurs in part because of decreased catabolism of the molecule and in part because of enhanced intracellular binding of the molecule. The process is accelerated by estrogen, which enhances the level of the androgen receptor in the gland; increase in the androgen receptor allows for androgen-mediated growth even in the face of declining androgen production in advanced age. On theoretic grounds the therapeutic implications of this model are exciting; several potential medical treatments may be feasible that do not involve a chemical castration. PMID:6155068
Wilson, J D
Laparoscopic Partial Hepatectomy of Focal Nodular Hyperplasia
Focal nodular hyperplasia is a benign liver lesion incidentally discovered with increasing frequency because of the proliferation of imaging studies. Radiographic characterization can diagnose this pathologic lesion and nonoperative therapy is the standard of care. However, surgical resection may be required for diagnostic reasons or symptomatic patients. Depending on the anatomic location of the lesion, biopsy and/or resection can be performed laparoscopically. We herein report the case of a 26-year-old Japanese woman with a hepatic tumor who required a medical examination. Her medical history was negative for alcohol abuse, oral contraceptive administration and trauma. Clinical examination showed no significant symptoms. Ultrasonography, computed tomography and magnetic resonance imaging showed a mass located in the left lateral segment of the liver with a diameter of about 40 mm. It was difficult to diagnose the tumor definitively from these imaging studies, so we performed laparoscopic partial hepatectomy with successive firing of endoscopic staplers. The histopathological diagnosis was focal nodular hyperplasia. Surgical procedures and postoperative course were uneventful and the patient was discharged from the hospital on postoperative day 5.
Sakata, Mayu; Syoji, Tsuyoshi; Nishiyama, Raisuke; Taniguchi, Masami; Yamazaki, Masanori; Higashi, Yukihiro; Suzuki, Kunihito; Kawamura, Takahumi; Yonekawa, Hajime; Maruo, Hirotoshi
Drug-induced nodular regenerative hyperplasia.
Drug-induced nodular regenerative hyperplasia is an uncommon injury with unique pathophysiology, clinical, and diagnostic considerations. This injury is characteristically asymptomatic in its early phases with only mild elevations in transaminases (< 3� upper limit of normal [ULN]). The latency period is typically more than 6 months. Once clinically apparent, it is marked by complications of portal hypertension, including hypersplenism, ascites, and variceal bleeding, with little or no hepatic dysfunction. Hence, it is an important cause of noncirrhotic portal hypertension. The most commonly associated drugs include thiopurines, chemotherapeutic agents, and antiretroviral agents. Diagnosis is aided by the recognition of noncirrhotic portal hypertension, a detailed history of prior drug exposure, and exclusion of the other causes of nodular regenerative hyperplasia. Clinical history, abdominal imaging, and hepatic hemodynamic studies provide important diagnostic clues, but histologic examination remains the diagnostic gold standard. Therapeutic intervention is aimed at earliest discontinuation of the offending agent and of portal hypertension complications. The natural history varies widely, and portal hypertension can progresses despite drug discontinuation. PMID:24879987
Ghabril, Marwan; Vuppalanchi, Raj
Management of Congenital Adrenal Hyperplasia in Childhood
Purpose of review Congenital adrenal hyperplasia (CAH) can present management challenges to the pediatric clinician. Glucocorticoid replacement remains the cornerstone of treatment; however, there are new formulations and delivery mechanisms being studied. Clinicians continue to discuss the optimal treatment of patients from the prenatal stage, through infancy to adulthood. As well, the role of genetics in the clinical care of patients with CAH, and screening for complications, remain topics of discussion. This review will highlight advances made in the past year, as they pertain to the management of pediatric patients with CAH. Recent findings This article covers recent studies pertaining to optimal medication regimens, including prenatal dexamethasone treatment; medication delivery; monitoring of hormonal control; and the role of genotyping and genetics in the management of children with CAH. Summary Much remains to be learned about the optimal management of children with CAH, including fludrocortisone replacement in simple-virilizing patients, frequency of and specific monitoring strategies (e.g., electrolytes, bone age, etc.), catecholamine status, stress-dosing in non-classical adrenal hyperplasia, and early screening for complications or metabolic sequelae. Further randomized, prospective studies are needed to address these issues.
Kim, Mimi S.; Ryabets-Lienhard, Anna; Geffner, Mitchell E.
The Impact of In Utero Exposure to Diabetes on Childhood Body Mass Index Growth Trajectories: The EPOCH Study
Objective To examine associations between exposure to maternal diabetes in utero and body mass index (BMI) growth trajectories from birth through 13 years of age among a diverse cohort of youth. Study design Mixed linear effects models were constructed to assess differences in BMI and BMI growth velocity from birth through 13 years of age for 95 subjects exposed to diabetes in utero and 409 unexposed subjects enrolled in a retrospective cohort study. Results The overall BMI growth trajectory (adjusted for sex and race/ethnicity) was not significantly different for exposed and unexposed subjects from birth through 26 months of age (p=0.48). However, the overall growth trajectory from 27 months of age through 13 years differed by exposure status (p=0.008), adjusted for sex and race/ethnicity. The difference was primarily due to a significantly higher BMI growth velocity among exposed youth between 10�13 years, increasing by 4.56 kg/m2 compared to 3.51 kg/m2 in the unexposed (p=0.005). Control for demographic variables, socioeconomic factors and maternal pre-pregnancy BMI did not alter the observed associations. Conclusions Exposure to maternal diabetes in utero accelerates BMI growth in late childhood thus increasing long-term obesity risk.
Crume, Tessa L.; Ogden, Lorraine; Daniels, Stephen; Hamman, Richard F.; Norris, Jill M.; Dabelea, Dana
Impact of Pretreatment Body Mass Index on Patients With Head-and-Neck Cancer Treated With Radiation
Purpose: To investigate the association of pretreatment body mass index (preT BMI) with outcomes of head-and-neck cancer in patients treated with radiotherapy (RT). Methods and Materials: All 1,562 patients diagnosed with head-and-neck cancer and treated with curative-intent RT to a dose of 60 Gy or higher were retrospectively studied. Body weight was measured both at entry and at the end of RT. Cancer-specific survival (CSS), overall survival (OS), locoregional control (LRC), and distant metastasis (DM) were analyzed by preT BMI (<25 kg/m{sup 2} vs. {>=}25 kg/m{sup 2}). The median follow-up was 8.6 years. Results: Patients with lower preT BMI were statistically significantly associated with poorer CSS and OS than those with higher preT BMI. There was no significant difference between preT BMI groups in terms of LRC and DM. Body weight loss (BWL) during radiation did not influence survival outcomes. However, in the group with higher preT BMI, CSS, OS, and DM-free survival of patients with less BWL during radiation were statistically longer when compared with greater BWL. Conclusion: This study demonstrates that higher preT BMI positively influenced survival outcomes for patients with head-and-neck cancer. Patients with higher preT BMI who were able to maintain their weight during radiation had significantly better survival than patients with greater BWL.
Pai, Ping-Ching [Department of Radiation Oncology, Chang Gung Memorial Hospital and University at Lin-Kou, Taoyuan, Taiwan (China); Chuang, Chi-Cheng [Department of Neurosurgery, Chang Gung Memorial Hospital and University at Lin-Kou, Taoyuan, Taiwan (China); Tseng, Chen-Kan [Department of Radiation Oncology, Chang Gung Memorial Hospital and University at Lin-Kou, Taoyuan, Taiwan (China); Tsang, Ngan-Ming, E-mail: firstname.lastname@example.com [Department of Radiation Oncology, Chang Gung Memorial Hospital and University at Lin-Kou, Taoyuan, Taiwan (China); School of Traditional Chinese Medicine, Taoyuan, Taiwan (China); Chang, Kai-Ping [Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital and University at Lin-Kou, Taoyuan, Taiwan (China); Yen, Tzu-Chen [Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital and University at Lin-Kou, Taoyuan, Taiwan (China); Liao, Chun-Ta [Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital and University at Lin-Kou, Taoyuan, Taiwan (China); Hong, Ji-Hong; Chang, Joseph Tung-Chieh [Department of Radiation Oncology, Chang Gung Memorial Hospital and University at Lin-Kou, Taoyuan, Taiwan (China)
A review of the use of tadalafil in the treatment of benign prostatic hyperplasia in men with and without erectile dysfunction
Epidemiological data link erectile dysfunction (ED) and benign prostatic hyperplasia (BPH)-associated lower urinary tract symptoms (LUTS), two highly prevalent conditions in aging men, assuming common pathophysiological pathways. Tadalafil 5 mg once daily has been approved for the treatment of men with LUTS with or without comorbid ED. The aim of this review is to provide an overview of current knowledge on the epidemiological and pathophysiological links between ED and LUTS and to focus on tadalafil as a new treatment option in men with BPH-associated LUTS. A Medline search was completed using the Medical Subject Headings (MESH� keywords) �prostatic hyperplasia� and �phosphodiesterase inhibitors�. This search revealed 125 relevant references (entire Medline database up to 11 March 2014). The efficacy of tadalafil 5 mg once daily for the treatment of LUTS has been reported by several well-designed studies. Tadalafil improves significantly the total International Prostate Symptom Score (IPSS), the voiding and storage subscores, the IPSS Quality of Life (QoL) and the BPH Impact Index (BII). Its efficacy is irrelevant to the erectile function status of the patients. However, in the majority of these studies tadalafil is not associated with improvement in maximum urine flow or post-void residual volume (PVR). Its safety profile is well established and no new or unexpected adverse events other than those reported in ED studies have been recorded. Tadalafil is today a new treatment alternative to other established drugs for LUTS such as the ?-adrenergic antagonists or 5?-reductase inhibitors. However, it is not just an alternative, since sexual adverse events associated with these drugs are avoided and tadalafil is the only drug that can treat both ED and LUTS at the same time.
Effect of combination treatment on patient-related outcome measures in benign prostatic hyperplasia: clinical utility of dutasteride and tamsulosin
Background: Benign prostatic hyperplasia, the fourth most commonly diagnosed medical condition in the elderly, is a major underlying cause of lower urinary tract symptoms in men. Medical therapy is usually the first therapeutic option. Combination therapy is increasingly used for better symptom relief and outcome. Methods: We searched the literature using the MEDLINE database for the efficacy of combination therapy in men with benign prostatic hyperplasia in terms of symptom improvement and impact on quality of life. Results: Combination therapy with dutasteride and tamsulosin not only provides better symptom improvement and improved urinary flow rate, but is also associated with a more favorable impact on quality of life and patient satisfaction with treatment than monotherapy. Combination therapy also reduces the risk of events related to disease progression, such as acute urinary retention and benign prostatic hyperplasia-related surgery. Conclusion: Combination therapy with dutasteride and tamsulosin is highly efficacious as medical therapy for benign prostatic hyperplasia in patients with moderate-to-severe lower urinary tract symptoms.
Djavan, Bob; Dianat, Seyed Saeid; Kazzazi, Amir
Tomotherapy treatment plan quality assurance: The impact of applied criteria on passing rate in gamma index method
Purpose: Pretreatment patient plan verification with gamma index (GI) metric analysis is standard procedure for intensity modulated radiation therapy (IMRT) treatment. The aim of this paper is to evaluate the variability of the local and global gamma index obtained during standard pretreatment quality assurance (QA) measurements for plans performed with Tomotherapy unit. The QA measurements were performed with a 3D diode array, using variable passing criteria: 3%/3 mm, 2%/2 mm, 1%/1 mm, each with both local and global normalization.Methods: The authors analyzed the pretreatment QA results for 73 verifications; 37 were prostate cancer plans, 16 were head and neck plans, and 20 were other clinical sites. All plans were treated using the Tomotherapy Hi-Art System. Pretreatment QA plans were performed with the commercially available 3D diode array ArcCHECK�. This device has 1386 diodes arranged in a helical geometry spaced 1 cm apart. The dose measurements were acquired on the ArcCHECK� and then compared with the calculated dose using the standard gamma analysis method. The gamma passing rate (%GP), defined as the percentage of points satisfying the condition GI < 1, was calculated for different criteria (3%/3 mm, 2%/2 mm, 1%/1 mm) and for both global and local normalization. In the case of local normalization method, the authors set three dose difference threshold (DDT) values of 2, 3, and 5 cGy. Dose difference threshold is defined as the minimum absolute dose error considered in the analysis when using local normalization. Low-dose thresholds (TH) of 5% and 10% were also applied and analyzed.Results: Performing a paired-t-test, the authors determined that the gamma passing rate is independent of the threshold values for all of the adopted criteria (5%TH vs 10%TH, p > 0.1). Our findings showed that mean %GPs for local (or global) normalization for the entire study group were 93% (98%), 84% (92%), and 66% (61%) for 3%/3 mm, 2%/2 mm, and 1%/1 mm criteria, respectively. DDT was equal to 2 cGy for the local normalization analysis cases. The authors observed great variability in the resulting %GP. With 3%/3 mm gamma criteria, the overall passing rate with local normalization was 4.6% less on the average than with global one, as expected. The wide difference between %GP calculated with global or local approach is also confirmed by an unpaired t-test statistical analysis.Conclusions: The variability of %GP obtained confirmed the necessity to establish defined agreement criteria that could be universal and comparable between institutions. In particular, while the gamma passing rate does not depend on the choice of threshold, the choice of DDT strongly influences the gamma passing rate for local calculations. The difference between global and local %GP was statistically significant for prostate and other treatment sites when DDT was changed from 2 to 3 cGy.
Bresciani, Sara; Di Dia, Amalia; Maggio, Angelo; Cutaia, Claudia; Miranti, Anna; Infusino, Erminia; Stasi, Michele [Medical Physics Division, Institute for Cancer Research and Treatment (IRCCS), 10060 Candiolo (Italy)] [Medical Physics Division, Institute for Cancer Research and Treatment (IRCCS), 10060 Candiolo (Italy)
Application of ERICA index to evaluation of soil ecosystem health according to sustainability threshold for chemical impact.
The aim of the improved ERICA model for risk assessment (Boriani et al., 2010) is to give an instrument able to measure the effect of xenobiotics introduced into the environment. This will be of great help for "green" processes and sustainable industries and may help to advertise their products as safe for the environment following impact assessment. In this work we have added new indicators and scoring systems to be used in particular with attention for the soil compartment. Even though it is partly starting to be considered by some legislations, there is still an open debate to assess if a compound added to a certain scenario will increase risk for human beings and the environment. The prolonged environmental occurrence introduces uncertainty regarding the presence and properties of degradation products and cumulative effects from multiple substances present in the environment. Tools capable of efficiently coping with this issue may prove useful for stakeholders. For instance, industries able to show that their substances present good characteristics also related to fate and transport properties may document the added value of environmental friendly products. Furthermore, the use of these tools may lead to awareness by industries of minimizing the environmental impact of the whole production chain. In the present study we show how the instrument ERICA may work by addressing multiple sources of exposure. An improved version of ERICA and in particular its parameter EF (fate and transport of chemical compounds into the environment) is described in this paper and is applied to a scenario of two veterinarian pharmaceutical compounds: Sulfadiazine (SDZ) and Toltrazuril and their metabolites present in the environment. Results show that the new EF parameter is able to prioritize the chemical compounds better than the previous version with respect to their ability to degrade or not into the environment. PMID:23186630
Boriani, Elena; Benfenati, Emilio; Baderna, Diego; Thomsen, Marianne
Pseudoangiomatous stromal hyperplasia tumor: a clinical, radiologic and pathologic study of 26 cases
Pseudoangiomatous stromal hyperplasia tumors are rare. In this retrospective study, we evaluated the clinical, radiologic, and pathologic features of pseudoangiomatous stromal hyperplasia tumors and compared histologic findings of pseudoangiomatous stromal hyperplasia tumors with clinical outcome. We identified 26 patients (mean age, 47 years) with pseudoangiomatous stromal hyperplasia tumors who had been diagnosed at our institution. Sixteen patients (62%) were premenopausal,
Marco Ferreira; Constance T Albarracin; Erika Resetkova
Congenital adrenal hyperplasia: Treatment and outcomes
Congenital adrenal hyperplasia (CAH) describes a group of autosomal recessive disorders where there is impairment of cortisol biosynthesis. CAH due to 21-hydroxylase deficiency accounts for 95% of cases and shows a wide range of clinical severity. Glucocorticoid and mineralocorticoid replacement therapies are the mainstays of treatment of CAH. The optimal treatment for adults with CAH continues to be a challenge. Important long-term health issues for adults with CAH affect both men and women. These issues may either be due to the disease or to steroid treatment and may affect final height, fertility, cardiometabolic risk, bone metabolism, neuro-cognitive development and the quality-of-life. Patients with CAH should be regularly followed-up from childhood to adulthood by multidisciplinary teams who have knowledge of CAH. Optimal replacement therapy, close clinical and laboratory monitoring, early life-style interventions, early and regular fertility assessment and continuous psychological management are needed to improve outcome.
Kamoun, Mahdi; Feki, Mouna Mnif; Sfar, Mohamed Habib; Abid, Mohamed
Optimizing the management of benign prostatic hyperplasia
One of the challenges facing primary care physicians and specialists as the population ages is the management of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH). While as many as 18% of men in their 40s report bother from an enlarged prostate, that figure rises dramatically, whereby 50% of men in their 50s and 90% of men in their 90s will complain of bothersome symptoms related to an enlarged prostate. Studies have shown that BPH is a progressive disease, which if left untreated can result in worsening of symptoms, acute urinary retention and renal failure. Until about 20 years ago the only management option available to urologists was surgery. In the early 1990s medical therapy emerged as the predominant treatment for BPH. Therapy may be tailored to target symptoms and progression of disease.
Elterman, Dean S.; Kaplan, Steven A.
Microwave Treatment of Prostate Cancer and Hyperplasia
NASA Technical Reports Server (NTRS)
Microwave ablation in the form of microwave energy applied to a heart muscle by a coaxial catheter inserted in a vein in the groin area can be used to heat and kill diseased heart cells. A microwave catheter has been developed to provide deep myocardial ablation to treat ventricular tachycardia by restoring appropriate electrical activity within the heart and eliminating irregular heartbeats. The resulting microwave catheter design, which is now being developed for commercial use in treating ventricular tachycardia, can be modified to treat prostate cancer and benign prostatic hyperplasia (BPH). Inasmuch as the occurrence of BPH is increasing currently 350,000 operations per year are performed in the United States alone to treat this condition this microwave catheter has significant commercial potential.
Arndt, G. Dickey; Ngo, Phong; Carl, J. R.; Raffoul, George
Molecular genetics of congenital adrenal hyperplasia.
Congenital adrenal hyperplasia results from a deficiency in any of the five enzymes necessary to synthesize cortisol from cholesterol: cholesterol desmolase (P450scc), 3 beta-hydroxysteroid dehydrogenase (3 beta-HSD), 17-hydroxylase (P450c17), 21-hydroxylase (P450c21) and 11-hydroxylase (P450c11). P450scc and P450c11 are structurally-related mitochondrial cytochrome P450 enzymes, whereas P450c17 and P450c21 are microsomal enzymes. The P450scc gene, CYP11A, is located on chromosome 15, and the P450c17 gene, CYP17, is on chromosome 10. The P450c21 gene, CYP21B, and a pseudogene, CYP21A, are located in the HLA major histocompatibility complex on chromosome 6p, while the P450c11 gene, CYP11B, is on chromosome 8q along with a second related gene of unknown function. Thus, despite common regulation by ACTH, there is no clustering of the genes for steroidogenic enzymes. CYP11A and CYP11B have an identical intron-exon organization, and CYP17 and CYP21B have similar gene structures, but the two pairs of genes encoding mitochondrial and microsomal P450 enzymes resemble each other poorly. More than 90% of cases of congenital adrenal hyperplasia result from 21-hydroxylase deficiency, and most of the remainder are caused by 11-hydroxylase deficiency. About one-quarter of 21-hydroxylase deficiency alleles are associated with a deletion of all or part of CYP21B. Most of the remaining mutant alleles result from transfers of deleterious mutations from the CYP21A pseudogene to CYP21B, a process termed gene conversion. These mechanisms provide an explanation for the relatively high frequency of 21-hydroxylase deficiency. The clinical severity of various forms of 21-hydroxylase deficiency may be roughly correlated with particular mutations. PMID:3077248
White, P C; New, M I
Oral contraceptives and focal nodular hyperplasia of the liver.
A variety of benign liver tumors associated with the use of oral contraceptives has been described. However, there is controversy regarding the possible relation of focal nodular hyperplasia of the liver to oral contraceptive therapy. Over a ten-year period at the Soroka Medical Center, two young women were found to have hepatic tumors diagnosed as focal nodular hyperplasia. In both cases the hepatic nodules were an incidental finding at laparotomy and were thought to be metastatic tumors. The clinical and pathological findings in both cases are reported. The features of focal nodular hyperplasia and its possible relation to oral contraceptive use is discussed. PMID:3223780
Hagay, Z J; Leiberman, R J; Katz, M; Witznitzer, A
A Case of Lipoid Congenital Adrenal Hyperplasia Presenting with Cholestasis
Background Lipoid congenital adrenal hyperplasia, is the rarest and usually the most severe form of adrenal steroidogenic defect,which may presents as infantile cholestasis. Case Presentation Here we present a 45 days old infant who came to our attention with cholestasis and severe intractable vomiting and electrolyte disturbances. Evaluation resulted in diagnosis of congenital adrenal hyperplasia. Hydrocortisone and flodrocortisone improved the symptoms including jaundice and vomiting. Hyponatremia and hyperkalemia also resolved with above mentioned treatment. Conclusion Congenital adrenal hyperplasia as one of the causes of neonatal cholestasis should be kept in mind, whenever there are also electrolytes abnormalities.
Khodadad, Ahmad; Modaresi, Vajiheh; Kiani, Mohammad-Ali; Rabani, Ali; Pakseresht, Bahar
Unravelling the molecular basis of micronodular adrenal hyperplasia
Purpose of review This review discusses the molecular basis of micronodular adrenal hyperplasia (MAH). It focuses on the role of genetic defects in cAMP signaling related molecules, namely PRKAR1A, GNAS, PDE11A and PDE8B in the predisposition for tumor formation. It also discusses the involvement of cAMP signaling and related pathways, and their impact on the adrenocortical phenotype formation. Recent findings Molecular defects in the phosphodiesterases (PDE) family are the most recently discovered genetic defects predisposing to various adrenocortical tumor formation. In contrast to GNAS and PRKAR1A, defects in PDE genes are associated more frequently with incomplete penetrance. Summary Recent findings indicate the importance of cAMP signaling for normal adrenocortical functioning and the sensitivity of the adrenal gland to subtle alterations in cAMP levels. Identifying low-penetrance mutations in more than one PDEs in patients with MAH is suggestive for a complementary role of the different PDEs in the adrenal gland, and possible involvement of other members of this gene family in adrenocortical signaling
Horvath, Anelia; Stratakis, Constantine
The impacts of first line highly active antiretroviral therapy on serum selenium, cd4 count and body mass index: a cross sectional and short prospective study
Introduction The relationship that exists between body weights, serum selenium and immunological markers of HIV/AIDS continue to provoke more researches in the recent times. The objectives of this study were to examine baseline body mass index, CD4 count and serum selenium and to prospectively assess the impacts of HAART on same parameters 48 weeks post HAART among HIV patients. Methods A cohort comprising 140 newly diagnosed HIV positive were prospectively studied. Anthropometric measurements, serum selenium and CD4 count were assessed at diagnosis and 48 weeks post HAART. Results The mean age for patients was 35�8.8 years; 68% was female. Patients� mean weight was 56.79�10.22kg, BMI; 21.59�3.53, serum selenium; 0.55 � 0.45�mol/L and CD4 count; 288.36 � 232.23 at the baseline. At diagnosis, 47 (33.6%) were in stage 1, 49 (35.0%) in stage 2, 26 (18.6%) and 18 (12.9%) were in stage 3 and 4 respectively. Similarly, most patients had normal body mass index, 94 (67.14%), 26 (18.57%) were underweight, (12.86%) were overweight and two (1.43%) were obese at diagnosis. At 48 weeks post HAART, the mean weight, BMI, serum selenium and CD4 count were significantly increased. Conclusion HAART repleted CD4 count and serum selenium, Post HAART overweight was associated with lesser CD4 count reconstitution and selenium repletion. A renew call for weight monitoring in HAART era.
Akinboro, Adeolu Oladayo; Onayemi, Olaniyi; Ayodele, Olugbenga Edward; Mejiuni, Ayodele David; Atiba, Adeniran Samuel
BPH: Medical Management (Benign Prostatic Hyperplasia /Enlarged Prostate)
... dolor sit amet, consectetur adipiscing elit. BPH: Medical Management (Benign Prostatic Hyperplasia /Enlarged Prostate) Throughout a man's ... can I get more information? BPH: Diagnosis BPH: Management BPH: Minimally Invasive Management BPH: Surgical Management Benign ...
What Are the Treatments for Congenital Adrenal Hyperplasia (CAH)?
... What are the treatments for congenital adrenal hyperplasia (CAH)? Skip sharing on social media links Share this: Page Content Treatments for CAH include medication and surgery as well as psychological ...
MX-INDUCED URINARY BLADDER EPITHELIAL HYPERPLASIA IN EKER RATS Epidemiological studies have shown a positive association between chronic exposure to chlorinated drinking water and human cancer, particularly of the urinary bladder. MX (3- chloro-4-(dichloromethyl)-5-hydrox...
Clinical associations of hepatic stellate cell (HSC) hyperplasia.
Hepatic stellate cell (HSC) hyperplasia has been principally attributed to hypervitaminosis A. There are sporadic reports of HSC hyperplasia in other conditions such as chronic biliary disease and hepatitis C, but clinical associations of this entity have not been studied in detail. We aimed to investigate the clinical associations of HSC hyperplasia aside from hypervitaminosis A. We identified 34 patients whose liver histology showed HSC hyperplasia. We reviewed the liver samples; additional histologic findings in addition to HSC hyperplasia were consolidated into a histologic diagnosis. We collected clinical, laboratory, and radiologic data; the histologic diagnosis was combined with this data to reach an "overall diagnosis." Four patients had hypervitaminosis A (all native livers). In native livers (n?=?24), HSC hyperplasia also occurred in association with drug-induced hepatitis [n?=?6, niacin was the most common inducing agent (n?=?3)], reactive hepatitis (n?=?4), chronic hepatitis C (n?=?4), autoimmune hepatitis (n?=?3), steatohepatitis (n?=?1), chronic biliary disease (n?=?1), and portal venopathy (n?=?1). In liver allografts (n?=?10), HSC hyperplasia was seen in protocol biopsies without other significant abnormalities (n?=?5), chronic biliary disease (n?=?4), and acute cellular rejection (n?=?1). All patients used medications (total of 99) and 82�% were on multiple medications. HSC hyperplasia is an uncommon and relatively nonspecific finding that most commonly occurs in multimedicated patients, often in the absence of hypervitaminosis A. Associated conditions include drug toxicity (such as niacin), post-liver transplant setting, reactive hepatitis (due to systemic illness or inflammatory disorders of the gastrointestinal tract), and chronic liver disease. PMID:24809674
Mounajjed, Taofic; Graham, Rondell P; Sanderson, Schuyler O; Smyrk, Thomas C
[Two cases of thymic hyperplasia with Basedow's disease].
Two cases of thymic hyperplasia with Basedow's disease were reported. One case was a 23-year-old female. The CT examination disclosed a mediastinal mass, which was reduced in size after an anti-thyroid drug and subtotal thyroidectomy normalized the thyroid function. The other case was a 29-year-old male with thyrotoxic myopathy. The CT examination disclosed a mediastinal mass, which suggested thymoma. A total thymectomy was performed and the mass was pathologically diagnosed as thymic hyperplasia. PMID:1703252
Nomori, H
Finasteride Reduces the Risk of Incident Clinical Benign Prostatic Hyperplasia
Background Despite the high prevalence of clinical benign prostatic hyperplasia (BPH) among older men, there remains a notable absence of studies focused on BPH prevention. Objective To determine if finasteride prevents incident clinical BPH in healthy older men. Design, setting, and participants Data for this study are from the Prostate Cancer Prevention Trial. After excluding those with a history of BPH diagnosis or treatment, or an International Prostate Symptom Score (IPSS) ?8 at study entry, 9253 men were available for analysis. Outcome measurements and statistical analysis The primary outcome was incident clinical BPH, defined as the initiation of medical treatment, surgery, or sustained, clinically significant urinary symptoms (IPSS >14). Finasteride efficacy was estimated using Cox proportional regression models to generate hazards ratios (HRs). Results and limitations Mean length of follow-up was 5.3 yr. The rate of clinical BPH was 19 per 1000 person-years in the placebo arm and 11 per 1000 person-years in the finasteride arm (p < 0.001). In a covariate-adjusted model, finasteride reduced the risk of incident clinical BPH by 40% (HR: 0.60; 95% confidence interval, 0.51�0.69; p < 0.001). The effect of finasteride on incident clinical BPH was attenuated in men with a body mass index ?30 kg/m2 (pinteraction = 0.04) but otherwise did not differ significantly by physical activity, age, race, current diabetes, or current smoking. The post hoc nature of the analysis is a potential study limitation. Conclusions Finasteride substantially reduces the risk of incident clinical BPH in healthy older men. These results should be considered in formulating recommendations for the use of finasteride to prevent prostate diseases in asymptomatic older men.
Parsons, J. Kellogg; Schenk, Jeannette M.; Arnold, Kathryn B.; Messer, Karen; Till, Cathee; Thompson, Ian M.; Kristal, Alan R.
Endometrial carcinoma risk among women diagnosed with endometrial hyperplasia: the 34-year experience in a large health plan
Classifying endometrial hyperplasia (EH) according to the severity of glandular crowding (simple hyperplasia (SH) vs complex hyperplasia (CH)) and nuclear atypia (simple atypical hyperplasia (SAH) vs complex atypical hyperplasia (CAH)) should predict subsequent endometrial carcinoma risk, but data on progression are lacking. Our nested case�control study of EH progression included 138 cases, who were diagnosed with EH and then with
J V Lacey; O B Ioffe; B M Ronnett; B B Rush; D A Richesson; N Chatterjee; B Langholz; A G Glass; M E Sherman
Analysis of arterial intimal hyperplasia: review and hypothesis
Background Despite a prodigious investment of funds, we cannot treat or prevent arteriosclerosis and restenosis, particularly its major pathology, arterial intimal hyperplasia. A cornerstone question lies behind all approaches to the disease: what causes the pathology? Hypothesis I argue that the question itself is misplaced because it implies that intimal hyperplasia is a novel pathological phenomenon caused by new mechanisms. A simple inquiry into arterial morphology shows the opposite is true. The normal multi-layer cellular organization of the tunica intima is identical to that of diseased hyperplasia; it is the standard arterial system design in all placentals at least as large as rabbits, including humans. Formed initially as one-layer endothelium lining, this phenotype can either be maintained or differentiate into a normal multi-layer cellular lining, so striking in its resemblance to diseased hyperplasia that we have to name it "benign intimal hyperplasia". However, normal or "benign" intimal hyperplasia, although microscopically identical to pathology, is a controllable phenotype that rarely compromises blood supply. It is remarkable that each human heart has coronary arteries in which a single-layer endothelium differentiates early in life to form a multi-layer intimal hyperplasia and then continues to self-renew in a controlled manner throughout life, relatively rarely compromising the blood supply to the heart, causing complications requiring intervention only in a small fraction of the population, while all humans are carriers of benign hyperplasia. Unfortunately, this fundamental fact has not been widely appreciated in arteriosclerosis research and medical education, which continue to operate on the assumption that the normal arterial intima is always an "ideal" single-layer endothelium. As a result, the disease is perceived and studied as a new pathological event caused by new mechanisms. The discovery that normal coronary arteries are morphologically indistinguishable from deadly coronary arteriosclerosis continues to elicit surprise. Conclusion Two questions should inform the priorities of our research: (1) what controls switch the single cell-layer intimal phenotype into normal hyperplasia? (2) how is normal (benign) hyperplasia maintained? We would be hard-pressed to gain practical insights without scrutinizing our premises.
Benign Prostatic Hyperplasia: from Bench to Clinic
Benign prostatic hyperplasia (BPH) is a prevalent disease, especially in old men, and often results in lower urinary tract symptoms (LUTS). This chronic disease has important care implications and financial risks to the health care system. LUTS are caused not only by mechanical prostatic obstruction but also by the dynamic component of obstruction. The exact etiology of BPH and its consequences, benign prostatic enlargement and benign prostatic obstruction, are not identified. Various theories concerning the causes of benign prostate enlargement and LUTS, such as metabolic syndrome, inflammation, growth factors, androgen receptor, epithelial-stromal interaction, and lifestyle, are discussed. Incomplete overlap of prostatic enlargement with symptoms and obstruction encourages focus on symptoms rather than prostate enlargement and the shifting from surgery to medicine as the treatment of BPH. Several alpha antagonists, including alfuzosin, doxazosin, tamsulosin, and terazosin, have shown excellent efficacy without severe adverse effects. In addition, new alpha antagonists, silodosin and naftopidil, and phosphodiesterase 5 inhibitors are emerging as BPH treatments. In surgical treatment, laser surgery such as photoselective vaporization of the prostate and holmium laser prostatectomy have been introduced to reduce complications and are used as alternatives to transurethral resection of the prostate (TURP) and open prostatectomy. The status of TURP as the gold standard treatment of BPH is still evolving. We review several preclinical and clinical studies about the etiology of BPH and treatment options.
Cho, Hee Ju
Congenital adrenal hyperplasia: an update in children
Purpose of review Congenital adrenal hyperplasia (CAH) in children, the majority of which is due to 21-hydroxylase deficiency, represents a group of disorders in which there is impaired cortisol synthesis and abnormalities in adrenal hormonal profiles. There continues to be debate regarding the optimal management of and treatment for these children. This review will highlight the most recent advances in neonatal screening for CAH, as well as the timeliest recommendations for the treatment and management of 21-hydroxylase deficiency, both the classic and non-classic forms of the disorder. Recent findings Substantive advancements have been made with regards to neonatal screening for CAH, allowing for earlier diagnosis while minimizing the morbidity and mortality associated with delayed detection. While the achievement of normal growth and development remains the ultimate goal of treatment, recent studies have provided further insight into the management and refinement of therapy in these children. Summary The optimal management and treatment for children with CAH is still unclear. While there have been recent advances in the diagnosis and treatment of this group of disorders, there is still much to learn in order to optimize therapy for these individuals.
Trapp, Christine M.; Speiser, Phyllis W.; Oberfield, Sharon E.
Impact of supervision of methadone consumption on deaths related to methadone overdose (1993-2008): analyses using OD4 index in England and Scotland
Objective To evaluate the impact of introduction of supervision of methadone dosing on deaths related to overdose of methadone in Scotland and England between 1993 and 2008 while controlling for increased prescribing of methadone. Design Analysis of annual trends in deaths related to overdose of methadone in relation to defined daily doses of methadone prescribed. Setting Scotland and England. Population Deaths in which methadone was coded as the only drug involved or as one of the drugs implicated. Main outcome measure Annual OD4-methadone index (number of deaths with methadone implicated per million defined daily doses of methadone prescribed in that year). Results OD4-methadone declined substantially over the four epochs of four years between 1993 and 2008. It decreased significantly (P<0.05) in 10 of 12 epoch changes: in Scotland from 19.3 (95% confidence interval 15 to 24) to 4.1 (2.8 to 5.4) and finally to 3.0 (2.4 to 3.5) for methadone only deaths (and from 58 to 29 to 14 for deaths with any mention of methadone); in England from 27.1 (25 to 29) to 24.8 (23 to 27) and finally to 5.8 (5.3 to 6.3) for methadone only deaths (and from 46 to 42 to 12 for deaths with any mention of methadone). The decreases in OD4-methadone were closely related to the introduction of supervised dosing of methadone in both countries, first in Scotland (1995-2000) and later in England (1999-2005). These declines occurred over periods of substantial increases in prescribing of methadone (18-fold increase in defined daily doses per million population annually in Scotland and sevenfold increase in England). Conclusions Introduction of supervised methadone dosing was followed by substantial declines in deaths related to overdose of methadone in both Scotland and England. OD4-methadone index analyses, controlled for substantial increases in methadone prescribing in both countries, identified at least a fourfold reduction in deaths due to methadone related overdose per defined daily dose (OD4-methadone) over this period.
Impact of baseline and nadir neutrophil index in non-small cell lung cancer and ovarian cancer patients: Assessment of chemotherapy for resolution of unfavourable neutrophilia
Background Chronic inflammation has been recognized to foster tumour development. Whether chemotherapy can be used to neutralize chronic inflammation is unclear. Methods We evaluated baseline and nadir neutrophils in 111 patients (pts.) with non-small cell lung cancer (NSCLC) and 118 pts. with ovarian cancer (OC) treated with chemotherapy administered with dose-individualization to achieve nadir neutropenia of 1.5. We used predefined baseline neutrophil cut-offs 4.5 � 109/L (NSCLC) and 3.9 � 109/L (OC). Results Absence of chemotherapy-induced nadir neutropenia (CTCAE grade 0, neutrophils???LLN) was seen in 23% of OC and 25% of NSCLC pts. Absence of nadir neutropenia was associated with decreased overall survival (OS) compared with presence (>grade 0) of neutropenia (9 vs. 14�months, P?=?0.004 for NSCLC and 23 vs. 56�months; P?=?0.01 for OC). Obtaining grade 3/4 neutropenia did not improve survival compared with grade 1/2 neutropenia. In multivariate analyses, baseline neutrophils ?4.5 � 109/L (HR: 2.0; 95% CI: 1.11-3.44;P = 0.02) and absence of nadir neutropenia (HR: 1.6; 95% CI: 1.02-2.65;P = 0.04) for NSCLC and absence of nadir neutropenia (HR: 1.7; 95% CI: 1.04;2.93;P = 0.04) for OC were independently associated with short OS. Three prognostic neutrophil index (NI) groups were defined. Favourable NI: low baseline neutrophils and presence of nadir neutropenia (>grade 0), Intermediate NI: elevated baseline neutrophils and presence of nadir neutropenia (>grade 0), and Poor NI: elevated baseline neutrophils and absence of nadir neutropenia (grade 0). For NSCLC patients, the median OS was 18.0, 13.4, and 8.8�months for favourable, intermediate and poor NI, respectively (fav vs. poor P?=?0.002; fav vs. intermed P?=?0.04; and intermed vs. poor P?=?0.03). For OC patients, median OS was 69, 52 and 23�months for favourable, intermediate and poor NI, respectively (fav vs. poor P?=?0.03; fav vs. intermed P?=?0.3; and intermed vs. poor P?=?0.02). Interestingly, survival rates in the intermediate NI groups indicated that individualised dose of chemotherapy to induce neutropenia may partly overcome the negative impact of elevated baseline neutrophils. Conclusions A neutrophil index comprising elevated baseline neutrophils and absence of neutropenia identified a high risk group of NSCLC and ovarian cancer patients with only modest effect of chemotherapy. New treatment options for this subset of patients are required.
Photoselective Vaporization for the Treatment of Benign Prostatic Hyperplasia
Background As an alternative to transurethral resection of the prostate (TURP), photoselective vaporization of the prostate (PVP) provides a bloodless, relatively painless relief of lower urinary tract symptoms for men with benign prostatic hyperplasia. Following a review of the evidence in 2006, the Ontario Health Technology Advisory Committee recommended that a study be conducted to evaluate PVP in Ontario. Objectives To compare the clinical effectiveness, safety, cost-effectiveness, and budget impact of PVP compared to conventional TURP for the treatment of benign prostatic hyperplasia in Ontario. Methods A prospective, nonrandomized trial was conducted in 3 Ontario centres. Consenting subjects were assessed at baseline and 1, 3, and 6 months following surgery. Outcome measures included International Prostate Symptom Score (IPSS), peak urinary flow rate (Qmax), post-void residual (PVR) volume, prostate-specific antigen (PSA), health-related quality of life (HRQOL) using the EuroQol 5 Domain questionnaire, and the Sexual Health Inventory for Men (SHIM) score. Adverse events, resource utilization, and productivity losses were also assessed. Cost-effectiveness and budget impact analyses were completed using data from the study. Results Between February 2008 and August 2010, 164 subjects were enrolled in the study (n = 140 for PVP and n = 24 for TURP). Treatment outcomes were similar between the 2 groups at 6 months, with the IPSS decreasing similarly over time (P = 0.718). For other treatment outcomes (Qmax, PSA, HRQOL, SHIM) both treatments provided similar benefit over time; only changes in PVR volume favoured PVP (P = 0.018). The majority of PVP patients were managed on an outpatient basis, with only 7.1% requiring admission (all TURP subjects were inpatients). At 6 months, PVP was less costly than TURP ($3,891 versus $4,863; P = 0.001), with similar quality-adjusted life-years (0.448 versus 0.441; P = 0.658). PVP remained the most cost-effective treatment across all decision-making thresholds, with the technology costing less and providing similar clinical outcomes. Extrapolating the results to a provincial level indicated (based on an estimated case volume of 12,335 TURPs) that there is an opportunity to reallocate just over $14 million (Cdn), primarily related to the reduced need for hospital admission. Limitations This study was nonrandomized, and the results should be interpreted with some caution, despite generally similar baseline characteristics between the 2 groups. Recruiting individuals to the TURP arm was a challenge, resulting in a size imbalance between treatment arms. Conclusions Based on this analysis, PVP appears to be a cost-effective alternative to TURP, providing similar clinical benefit at a lower cost to the health system. Plain Language Summary For men with lower urinary tract symptoms due to an enlarged prostate, a laser treatment called photoselective vaporization of the prostate (or PVP) is just as effective as surgery. PVP does not require an overnight stay in the hospital for most men, and it costs almost $1,000 less. This report describes the results of a study that collected information about treatment outcomes, quality of life, and health care use related to PVP and surgery in Ontario.
Bowen, James M.; Whelan, J. Paul; Hopkins, Robert B.; Burke, Natasha; Woods, Edward A.; McIsaac, Gary P.; O'Reilly, Daria J.; Xie, Feng; Sehatzadeh, Shayan; Levin, Leslie; Mathew, Suja P.; Patterson, Lisa L.; Goeree, Ron; Tarride, Jean-Eric
Impact of radio frequency source power-induced ion energy on a refractive index of SiN film deposited by a pulsed-PECVD at room temperature
Using a pulsed-plasma enhanced chemical vapor deposition system, silicon nitride films were deposited at room temperature. A refractive index was examined in the range of bias power and duty ratio, 200�800W and 40�90%, respectively. Ion energy diagnostics was related to the refractive index. The refractive index decreased with decreasing the duty ratio at all powers but 800W. For all the
Suyeon Kim; Byungwhan Kim
NASA Technical Reports Server (NTRS)
Impact, emergency escape and crash survival protection are studied. Accleration, the G system of units, data interpretation, and human tolerance limits are summarized, along with physiological and biochemical response to impact. Biomechanical factors of impact are also cited.
Snyder, R. G.
Laparoscopic Adrenalectomy for Nonfamilial Adrenal Medullary Hyperplasia
Background and Objectives: Sporadic adrenomedullary hyperplasia (AMH) is characterized by a medical history of hypertension, excessive catecholamine excretion, and histomorphometric evidence of increased adrenomedullary tissue relative to the cortex in the absence of multiple endocrine neoplasia. The aim of this study was to perform a retrospective analysis of patients after laparoscopic adrenalectomy for AMH, an early form of sporadic adrenal medulla�related endocrine hypertension, as well as to update our understanding of the clinical features and management of this clinicomorphologic entity. Methods: We performed a retrospective review of the medical records of patients operated on between 2007 and 2011 at Reina Sofia University General Hospital, Murcia, Spain, with a diagnosis of AMH. Patient characteristics, diagnostic studies, surgical procedures, and histologic findings were analyzed. Results: Seven hypertensive patients with intermittent adrenergic crises were found to have AMH (3 men and 4 women; mean age, 44 years). Catecholamine levels were increased. Radiologic studies included 1 or more of the following: magnetic resonance imaging, computed tomography, positron emission tomography imaging with fluorodeoxyglucose, dihydroxyphenylalanine�positron emission tomography�computed tomography, Octreoscan (Mallinckrodt Pharmaceuticals, St. Louis, MO, USA) and 123I-metaiodobenzylguanidine scintigraphy. Laparoscopic adrenalectomy was performed in all cases. One patient underwent bilateral adrenalectomy because of persistent symptomatology after unilateral adrenalectomy. Surgery was associated with normalization of catecholamine hypersecretion and complete disappearance of symptoms, as well as the reduction or abstention of antihypertensive therapy. Conclusions: Sporadic AMH is a clinicomorphologic entity that may mimic pheochromocytoma clinically. Recent advances in diagnostic and surgical methods have changed the management and outcome of this unusual disease. Laparoscopic adrenalectomy may be recommended as the gold standard in the treatment of this entity. Definitive diagnosis is provided by histologic study.
Candel Arenas, Maria Fe; Gonzalez Valverde, Francisco Miguel; Terol Garaulet, Emilio; Maestre Maderuelo, Maria; Meoro Aviles, Amparo; Pastor Quirante, Francisco; Albarracin Marin Blazquez, Antonio
[Problems of so-called atypical hyperplasia of the prostate].
In search of a precancerous morphological correlate for the carcinoma of the prostate gland becoming more and more frequent with growing age the prostate glands of 450 males from the current autopsy material were investigated by means of large sections according to the so-called serial section technique. The appearance of cellular atypias was discovered for the time being in the various form of hyperplasia of the prostate gland and their corresponding correlations to the latent carcinoma of the prostate gland. In all hyperplasias examined cellular atypias of different degrees of severity and a good correlation to the carcinoma were found, so that they can be regarded as precancerous in the narrower sense. The notion of the "atypical hyperplasia" should not be used, since in it too many different hyperplastic lesions are comprised. On the other hand, in every form of hyperplasia the presence of corresponding cellular atypias should be mentioned. The evidence of a hyperplasia with moderate and severe cellular atypias in the biopsy and TUR-material requires a careful treatment of the residual material by the pathologist and a search for carcinoma by the urologist. In no case it is the cause for an invasive diagnostics or surgical consequences. PMID:2444040
Mehlhorn, J
NSDL National Science Digital Library
This site is the index of a book used in a geochemistry course taught by W. M. White at Cornell University. There are 15 chapters and a table of contents available. All of the chapters are large PDF files and take some time to download. Figures and exercises accompany the text.
White, William M.; Department Of Earth And Atmospheric Sciences, Cornell U.
A hybrid fuzzy-ontology based intelligent system to determine level of severity and treatment recommendation for Benign Prostatic Hyperplasia.
This paper deals with application of fuzzy intelligent systems in diagnosing severity level and recommending appropriate therapies for patients having Benign Prostatic Hyperplasia. Such an intelligent system can have remarkable impacts on correct diagnosis of the disease and reducing risk of mortality. This system captures various factors from the patients using two modules. The first module determines severity level of the Benign Prostatic Hyperplasia and the second module, which is a decision making unit, obtains output of the first module accompanied by some external knowledge and makes an appropriate treatment decision based on its ontology model and a fuzzy type-1 system. In order to validate efficiency and accuracy of the developed system, a case study is conducted by 44 participants. Then the results are compared with the recommendations of a panel of experts on the experimental data. Then precision and accuracy of the results were investigated based on a statistical analysis. PMID:24184111
Torshizi, Abolfazl Doostparast; Zarandi, Mohammad Hossein Fazel; Torshizi, Ghazaleh Doostparast; Eghbali, Kamyar
NSDL National Science Digital Library
Two excellent bibliographic resources for population studies are the "Population Index" from the Office of Population Research at Princeton University, and "Population Organizations: Finder's Guide" from the Center for Demography and Ecology at the University of Wisconsin-Madison. "Population Index" is a quarterly publication that has been available since 1935. It "covers all fields of interest to demographers, including fertility, mortality, population size and growth, migration, nuptiality and the family, research methodology, projections and predictions, historical demography, and demographic and economic interrelations. Input is derived from original publications including monographs, journal articles, other serial publications, working papers, doctoral dissertations, machine-readable data files, and relevant acquisitions lists and bibliographies." About 3,500 citations are produced annually. Full text for the Index is available at the "Population Index" Web site for 1986-present (Vol. 52-present). Indexes can be searched by author, subject matter, geographical region, or publication year. There is now an experimental free text search capability for the 1994-present issues. "Population Organizations: Finder's Guide" is a no frills "practical tool for population professionals who need a single source for the quick location of organizations that publish and distribute or post population or family planning documents." It contains hundreds of citations, providing organization addresses, phone and FAX numbers, and Internet addresses when available. The Guide is updated every six months and is maintained by Ruth Sandor, Director of the Library of the Center for Demography and Ecology. Office of Population Research, Princeton University: http://opr.princeton.edu/ "Population Organizations: Finder's Guide": gopher://cde2.ssc.wisc.edu:70/00/addazlis gopher to: cde2.ssc.wisc.edu select: Population Organizations: Finder's Guide Center for Demography and Ecology, University of Wisconsin-Madison: http://www.ssc.wisc.edu/cde/
Pathophysiology and management of endometrial hyperplasia and carcinoma.
Endometrial cancer is currently the commonest pelvic malignancy affecting American women, most of whom share the same pathophysiologic basis, that is, unopposed estrogenic stimulation. The initial result of hyperestrogenism is the development of endometrial hyperplasia, which is reversible in most cases by appropriate hormonal therapy. Persistent stimulation eventually leads to atypical hyperplasia with nuclear atypia and invasive carcinoma. Because there is no cost-effective screening method for the detection of endometrial hyperplasia and carcinoma, it is essential to survey the high-risk population with appropriate diagnostic techniques. After diagnosis, therapy should be individualized based on pathologic findings (cell type and histologic grade) and extent of disease (International Federation of Gynaecologists and Obstetricians stage, depth of myometrial invasion, and pelvic and para-aortic lymph node status). Recent studies suggest that sex hormone receptors and nuclear DNA ploidy patterns provide useful prognostic information independent of histologic grade. Images
Fu, Y. S.; Gambone, J. C.; Berek, J. S.
A case report of large thymic hyperplasia associated with hyperthyroidism.
A 32-year-old female case of large thymic hyperplasia with hyperthyroidism is reported. A computed tomography (CT) examination disclosed a large mediastinal mass (16 x 11 cm) with a heterogeneous internal structure containing both soft tissue density areas and fat density areas. The mass was histologically diagnosed as thymic lymphoid hyperplasia. The thymic mass enlarged during hyperthyroidism and then regressed markedly after treatment with antithyroid drugs. After the thymic mass decreased by about one third of its maximum volume, the mass stopped regressing and has remained the same size for more than 6 years. A CT scan showed a decrease in the soft tissue density area and predominance of the fat density area. The potential response to antithyroid therapy must be considered before recommending resection of thymic tumors diagnosed as hyperthyroidism-related thymic hyperplasia. PMID:20081752
Takami, Koji; Omiya, Hideyasu; Higashiyama, Masahiko; Maeda, Jun; Okami, Jiro; Oda, Kazuyuki; Tsujinaka, Toshimasa; Kodama, Ken
Sclerosing Lobular Hyperplasia- Correlation between Cytomorphological and Histological Findings
Sclerosing lobular hyperplasia of the mammary gland is an uncommmon benign lesion which is mainly seen in adolescents and young women. The breast lobules are enlarged due to ductal and acinar proliferations but they have normal architecture. There is extensive fibrosis of the intralobular stroma, and to a lesser degree, of the interlobular parenchyma. Patients generally complain of a palpable, painless/slightly tender and well-defined lump in breast. Fine-needle aspiration cytology of sclerosing lobular hyperplasia is non diagnostic with features similar to fibroadneoma except for the absence of stromal fragments. In order to reach a definitive diagnosis, a histopathologic evaluation is needed. However, a distinction between the two benign entities is of no clinical significance.We are describing a case of sclerosing lobular hyperplasia that occurred in the left breast of a 26-year-old lady.
Lamichaney, Rachna; Sherpa, Mingma; Pradhan, Diwakar
Sclerosing Lobular Hyperplasia- Correlation between Cytomorphological and Histological Findings.
Sclerosing lobular hyperplasia of the mammary gland is an uncommmon benign lesion which is mainly seen in adolescents and young women. The breast lobules are enlarged due to ductal and acinar proliferations but they have normal architecture. There is extensive fibrosis of the intralobular stroma, and to a lesser degree, of the interlobular parenchyma. Patients generally complain of a palpable, painless/slightly tender and well-defined lump in breast. Fine-needle aspiration cytology of sclerosing lobular hyperplasia is non diagnostic with features similar to fibroadneoma except for the absence of stromal fragments. In order to reach a definitive diagnosis, a histopathologic evaluation is needed. However, a distinction between the two benign entities is of no clinical significance.We are describing a case of sclerosing lobular hyperplasia that occurred in the left breast of a 26-year-old lady. PMID:24783103
Lamichaney, Rachna; Sherpa, Mingma; Pradhan, Diwakar
Angiolymphoid hyperplasia with eosinophilia associated with tetanus toxoid vaccination.
Three cases of angiolymphoid hyperplasia with eosinophilia are reported at the site of tetanus toxoid vaccination. All presented as nodules on the upper arm, a known adverse effect of the vaccine following superficial inoculation. Histologically the nodules showed numerous small and medium sized vessels, some lined by hyperplastic endothelial cells with perivascular lymphocytic cuffing and an inflammatory infiltrate of plasma cells, eosinophils and scattered mast cells. Lymphoid follicles replete with germinal centres were identified in the dermis and subcutaneous tissue. Immunostaining revealed a polytypic lymphoplasmacytic infiltrate and a curious IgE reticulated pattern within the germinal centres, a feature described in both Kimura's disease and angiolymphoid hyperplasia. The present study suggests that atopic reaction to tetanus toxoid may be an aetiological factor in some cases of angiolymphoid hyperplasia. PMID:2376400
Akosa, A B; Ali, M H; Khoo, C T; Evans, D M
Construct validation of the USA-Spanish version of the SF36 health survey in a Cuban-American population with benign prostatic hyperplasia
This study examined the USA-Spanish version of the SF-36 health survey (validated in Mexican- Americans) and tested its construct validity in Cuban-Americans with benign prostatic hyperplasia (BPH). The study evaluated the SF-36 and American Urological Association (AUA) Symptom Index scores of 264 individuals with BPH. Individuals were assigned to one of the following groups: non-Hispanics who received the English version,
R. Arocho; C. A. McMillan; P. Sutton-Wallace
[Thymus hyperplasia in a patient with antiphospholipid syndrome].
Thymus is an important central lymphoid organ that plays a pivotal role in the generation of peripheral T-lymphocytes. Thymoma and thymus hyperplasia have been associated with various autoimmune disorders, mainly myasthenia gravis. There is no established relationship between thymus pathology and antiphospholipid syndrome; however, there are some reported cases of antiphospholipid syndrome associated with myasthenia gravis or following thymectomy. We present the case of a patient with antiphospholipid syndrome and thymic lymphoid follicular hyperplasia. We discuss the association between both entities and suggest a diagnostic approach of a patient with a radiological disorder of the thymus and antiphospholipid syndrome. PMID:19569281
Carragoso, Adelino; Faria, Bernardo; Silva, Jos� Roberto; Capelo, Joana; Vidinha, Joana; Santos, Carla Ferreira; Gaspar, Orlando
The use of sestamibi imaging in parathyroid hyperplasia.
The authors describe a 42-year-old man with parathyroid hyperplasia secondary to chronic renal failure. Parathyroidectomy was indicated because of persistent hypercalcemia and an increasing parathyroid hormone level despite medical management. A parathyroid sestamibi scan was performed immediately before operation and a gamma-detecting probe was used during operation. Six parathyroid glands weighing nearly 21 g were present. Without the use of the gamma-detecting probe during operation, one of the glands would have been missed. The efficacy of sestamibi scanning with parathyroid hyperplasia is discussed. PMID:12607864
Fernandez, Kristen L; Turer, Paul; Spiegler, Ethan J; Singer, John A
Thymic Hyperplasia after Lung Transplantation Imitating Posttransplant Lymphoproliferative Disorder
Thymic hyperplasia is usually associated with the treatment of malignant tumours and is sometimes linked with endocrine diseases. For the first time, we report a case of thymic hyperplasia in a patient 2 years after bilateral lung transplantation. Contrast-enhanced chest CT scan was highly suspicious for a posttransplant lymphoma or thymoma. Therefore, the patient received total thymectomy. Excised specimens were sent to the Department of Pathology. Unexpectedly, the histological examination revealed hyperplastic thymic tissue without evidence for a posttransplant lymphoproliferative disorder or malignancy.
Steger, Christina Maria; Semsroth, Severin; Hager, Thomas; Rieker, Ralf; Muller, Ludwig
[Intimal hyperplasia within a vascular anastomosis].
Intimal hyperplasia (IH) appears to rank high amongst plausible causes of reconstructed arteries restenosis. It always occurs in the area of a surgical intervention on a vessel in response to a mechanical lesion. IH is the cause of thrombosis in 15 to 50% of cases following vascular reconstruction during the first year after the operation (with the exception of early thromboses, which are probably caused by an improperly performed interventional technique). Of a wide variety of clinical situations leading to development of IH in the vascular wall, for the purposes of the present review, we singled out the problem concerning the onset and development of this tissue reaction in intervascular anastomoses, which is currently one of the most important issues. Analysing the publications on the problem concerned showed that amongst significantfactors influencing the development of IH in the anastomosis, the investigators single out different parameters of the anastomoses, configuration (either an end-to-end or an end-to-side anastomosis, the use of special inserts and patches within the latter), as well as the use of autologous or synthetic conduits, blanket suture or interrupted suture, peculiarities of local haemodynamics (linear blood flow rate, distribution of parietal fraction forces, zones of stagnation and flow separation), etc. To a certain degree, the published data are rather controversial. There remain many problems, which are either unaddressed as yet, or insufficiently studied, if at all. For instance, while establishing an anastomosis between a bypass graft and an artery, surgeons often resort to endarterectomy. It is not known whether or not this technique would influence the IH pattern in the anastomosis concerned. Neither is it clear whether the high velocity flow exerts a direct damaging action upon the endothelium, whether it promotes the development of IH in the area of the lesion, and if affirmative, then what the mechanisms of this effect really are. Not studied is the role of various types of synthetic fibres and synthetic grafts (except PTFE), various kinds of suture material in the development of IH in the zone of a vascular anastomosis concerned. This of course is far from being a complete list of the challenges requiring further investigation. PMID:19791568
Kur'ianov, P S; Razuvaev, A S; Vavilov, V N
Intravascular papillary endothelial hyperplasia: histomorphological and immunohistochemical features
Background Intravascular papillary endothelial hyperplasia (IPEH) is a benign intravascular process with features mimicking other benign and malignant vascular proliferations. IPEH lesions predominate in the head-neck region and the extremities. The characteristic histomorphological feature of IPEH is a papillary structure covered with hyperplastic endothelial cells within the vascular lumen. It is critical that this clinically benign lesion should not be mistaken for well-differentiated vascular tumors. In addition to the characteristic histological features, other useful diagnostic features included the intra-luminal location of the lesion, an intimate association with the organizing thrombus, the absence of necrosis, cellular pleomorphism, and mitotic activity. In addition, immunohistochemistry may indicate the vascular origin and proliferative index. In this study, we evaluated histomorphological and immunohistochemical findings (CD31, CD34, FVIII, type IV collagen, SMA, MSA, CD105, and Ki-67 staining) of ten IPEH cases. Methods Ten IPEH cases were re-examined for a panel of histomorphological and immunohistochemical features. CD31, CD34, FVIII, Type IV collagen, SMA and MSA antibodies utilized for immunohistochemical analysis. The histomorphological and immunohistochemical findings were evaluated by two independent pathologists using light microscopy. Results All ten cases involved intraluminal lesions with characteristic features of IPEH. All ten cases (100%) were stained positive for CD31 and CD34. The degree of staining with FVIII, type IV collagen, SMA, and MSA was variable. Conclusion In this series of specimens, CD31 and CD34 were the most sensitive markers indicating the vascular origin of the lesion. Staining for the other vascular markers (FVIII, type IV collagen, SMA and MSA) was variable. Different maturation degrees of lesions may account for the variation in immunohistochemical staining. Few previous investigations evaluated a wide range of antigen panels in IPEH sections. In our opinion, the evaluation of immune markers in a larger sample set will reveal new features in the maturity and developmental pathogenesis of vascular lesions and angiogenesis. IPEH is a benign lesion, which must be differentiated from malignant tumors such as angiosarcoma and Kaposi�s sarcoma. Improved definition of IPEH lesions using immunohistochemical markers may enhance the ability to differentiate between various vascular lesions. Virtual slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1381849312101856.
Dihydrotestosterone and the Concept of 5?�Reductase Inhibition in Human Benign Prostatic Hyperplasia
Objective:The development of the human benign prostatic hyperplasia clearly requires a combination of testicular androgens and aging. Although the role of androgens as the causative factor for human benign prostatic hyperplasia is debated, they undoubtedly have at least a permissive role. The principal prostatic androgen is dihydrotestosterone (DHT). Although not elevated in human benign prostatic hyperplasia, DHT levels in the
G. Bartsch; R. S. Rittmaster; H. Klocker
Pretreatment with intraluminal rapamycin nanoparticle perfusion inhibits neointimal hyperplasia in a rabbit vein graft model
Purpose Poly lactic-co-glycolic acid nanoparticles (PLGA-NP) are widely used as a biodegradable biomaterial in medicine. Rapamycin-eluting stents have been used for prevention of restenosis during surgery. This study investigated the effect of pretreatment with intraluminal perfusion of carbopol-encapsulated rapamycin-loaded PLGA nanoparticles (RAP-PLGA-NP) on neointimal hyperplasia in a rabbit vein graft model. Methods A segment of common carotid artery was replaced with a segment of external jugular vein in 60 rabbits which were then separated into four treatment groups, ie, Group 1, in which vein grafts were pretreated with intraluminal RAP-PLGA-NP perfusion, Group 2 in which vein grafts underwent equivalent empty vehicle (PLGA-NP) perfusion, Group 3, in which vein grafts received no treatment, and Group 4, which served as a sham operation group receiving normal vein contrast. On postoperative day 28, the grafts and normal veins were harvested for histologic examination, flow cytometry analysis, and high-performance liquid chromatography measurement. Results Compared with Group 1, the intima of the grafts were thickened, the ratio of intimal area to vessel area increased, and the collagen volume index of the vein grafts increased significantly in Groups 2 and 3. The cell proliferation index in Group 1 (21.11 � 3.15%) was much lower than that in Group 2 (30.35 � 2.69%) and in Group 3 (33.86 � 8.72%). By high-performance liquid chromatography measurement, retention of rapamycin was detected in Group 1 (11.2 � 0.37 ?g/10 mg) 28 days after single drug perfusion. Conclusion Pretreatment with intraluminal RAP-PLGA-NP perfusion may inhibit neointimal hyperplasia in vein grafts by penetrating into local tissue and limiting cell proliferation.
Liu, Kai; Cao, Guangqing; Zhang, Xiquan; Liu, Ruifang; Zou, Weiwei; Wu, Shuming
Impact of body mass index on incident hypertension and diabetes in Chinese Asians, American Whites, and American Blacks: the People's Republic of China Study and the Atherosclerosis Risk in Communities Study.
Researchers have hypothesized that the impact of body mass index on chronic disease may be greater in Asians than in Whites; however, most studies are cross-sectional and have no White comparison group. The authors compared the associations with body mass index in Chinese Asians (n = 5,980), American Whites (n = 10,776), and American Blacks (n = 3,582) using prospective data from the People's Republic of China Study (1983-1994) and the Atherosclerosis Risk in Communities Study (1987-1998). Slopes of risk differences over body mass index levels were compared among the three ethnic groups in adjusted analyses. The authors found larger associations with body mass index in Chinese Asians compared with American Whites and Blacks for hypertension (p < 0.05). The increase in the incidence of hypertension associated with a one-unit increase in body mass index over approximately 8 years of follow-up was 2.5, 1.7, and 1.8 percentage points for Chinese Asians, American Whites, and American Blacks, respectively. For diabetes, the estimates were 1.7, 1.1, and 1.6 percentage points for the same groups- higher in Chinese Asians than in American Whites (p < 0.05) but similar between Chinese Asians and American Blacks. Given the ethnic differences in associations, the results support advocacy of public health and medical actions toward obesity prevention and treatment in China. PMID:18375949
Stevens, June; Truesdale, Kimberly P; Katz, Eva G; Cai, Jianwen
Serenoa Repens, lycopene and selenium: a triple therapeutic approach to manage benign prostatic hyperplasia.
Benign prostatic hyperplasia (BPH) is a major health concern that is likely to have an increasing impact in line with the gradual aging of the population. BPH is characterized by smooth muscle and epithelial proliferation primarily within the prostatic transition zone that can cause a variety of problems for patients, the most frequent are the lower urinary tract symptoms. BPH is thought to involve in disruption of dihydrotestosterone (DHT)-supported homeostasis between cell proliferation and cell death, and, as a result, proliferative processes predominate and apoptotic processes are inhibited. Phytotherapeutic supplements, mainly based on Saw Palmetto-derived Serenoa Repens (SeR), are numerous and used frequently. Serenoa Repens reduces inflammation and decreases in vivo the androgenic support to prostatic cell growth. Furthermore, SeR stimulates the apoptotic machinery; however, data supporting efficacy is limited, making treatment recommendations difficult. Besides SeR, selenium (Se), an essential trace element mainly functioning through selenoproteins and able to promote an optimal antioxidant/oxidant balance, and lycopene (Ly), a dietary carotenoid synthesized by plants, fruits, and microorganisms with a strong antioxidant activity, has been shown to exert beneficial effects in prostate disease. SeR is frequently associated with Ly and Se, in order to increase its therapeutic activity in benign prostatic hyperplasia (BPH). It has been shown that the Ly-Se-SeR association has a greater and enhanced antiinflammatory activity that might be of particular interest in the treatment of BPH. The Ly-Se-SeR association is also more effective than SeR alone in reducing prostate weight and hyperplasia, in augmenting the pro-apoptotic Bax and caspase-9 and blunting the anti-apoptotic Bcl-2 mRNA. In addition, Ly-Se-SeR more efficiently suppresses the EGF and Vascular Endothelial Growth Factor (VEGF) expressions in hyperplastic prostates. Therefore, SeR particularly when combined with Se and Ly may have a greater potential for the management of benign prostate hyperplasia. PMID:23432584
Minutoli, L; Bitto, A; Squadrito, F; Marini, H; Irrera, N; Morgia, G; Passantino, A; Altavilla, D
Exendin-4, a glucagon-like peptide-1 receptor agonist, attenuates neointimal hyperplasia after vascular injury.
Exendin-4 is a glucagon-like peptide-1 receptor agonist that has been used as a drug for treatment of type 2 diabetes. To investigate the effect of exendin-4 on the cardiovascular system, we investigated the impact of exendin-4 on neointimal hyperplasia of the femoral artery after vascular injury. We performed wire-mediated endovascular injury in C57BL/6 mice, followed by administration of exendin-4 24 nmol/kg/day via infusion pump. Four weeks after the injury, exendin-4 treatment significantly attenuated neointimal hyperplasia of the injured artery, although it did not affect glucose metabolism and lipid profile in wild-type mice. Immunofluorescence study revealed abundant expression of GLP-1 receptor on ?-smooth muscle actin-positive cells in the injured vessel. Cell proliferation assay using rat aortic smooth muscle cells showed that exendin-4 reduced PDGF-BB induced smooth muscle cell proliferation through the cAMP/PKA pathway. Exendin-4 also inhibited TNF? production by peritoneal macrophages in response to inflammatory stimulus. Our findings indicate that a GLP-1 receptor agonist attenuated neointimal formation after vascular injury. GLP-1 receptor agonists or drugs that raise endogenous GLP-1 level might be effective in the treatment of vascular diseases. PMID:23220706
Hirata, Yoichiro; Kurobe, Hirotsugu; Nishio, Chika; Tanaka, Kimie; Fukuda, Daiju; Uematsu, Etsuko; Nishimoto, Sachiko; Soeki, Takeshi; Harada, Nagakatsu; Sakaue, Hiroshi; Kitagawa, Tetsuya; Shimabukuro, Michio; Nakaya, Yutaka; Sata, Masataka
Thymic hyperplasia in a patient with Grave's disease.
Hyperplastic changes of the thymus may be found in patients with Graves' disease. However, this rarely presents as an anterior mediastinal mass, particularly among adults. In this report, we describe a 46-year old woman with Graves' disease and thymic hyperplasia. PMID:22321290
Hamzaoui, Amira A; Klii, Rim R; Salem, Randa R; Kochtali, Ines I; Golli, Mondher M; Mahjoub, Silvia S
Mistaken gender identity in non-classical congenital adrenal hyperplasia
Gender identity is the sense of belonging that one feels for a particular sex psychologically and socially, independent of one's biological sex. There is much less systematic data on gender identity in females with congenital adrenal hyperplasia (CAH). We report a case of non-classical CAH presenting as a case of gender identity disorder.
Kukreti, Prerna; Kandpal, Manish; Jiloha, R. C.
Therapeutic options in the treatment of benign prostatic hyperplasia
Current theraputic options for the treatment of symptomatic benign prostatic hyperplasia (BPH) are reviewed. Therapeutic options for mild lower urinary tract symptoms (LUTS), as defined by the American Urological Association, are generally treated medically. Moderate to severe LUTS can be treated medically or with surgical therapy. Current medical and surgical treatments for LUTS secondary to BPH are reviewed and evolving treatments are explored.
Sandhu, Jaspreet S
Mistaken gender identity in non-classical congenital adrenal hyperplasia.
Gender identity is the sense of belonging that one feels for a particular sex psychologically and socially, independent of one's biological sex. There is much less systematic data on gender identity in females with congenital adrenal hyperplasia (CAH). We report a case of non-classical CAH presenting as a case of gender identity disorder. PMID:24891708
Kukreti, Prerna; Kandpal, Manish; Jiloha, R C
Surgical management of mandibular condylar hyperplasia type 1
This study compared outcomes of two surgical methods for patients diagnosed with active condylar hyperplasia type 1. Group 1 (n = 12) was treated with orthognathic surgery only, while group 2 (n = 42) was treated with high condylectomies, articular disc repositioning, and orthognathic surgery. There was no statistically significant difference between the two groups for maximum incisal opening, lateral
Larry M. Wolford; Carlos A. Morales-Ryan; Patricia Garc�a-Morales; Daniel Perez
Angiolymphoid hyperplasia with eosinophilia presenting as an axillary artery aneurysm
A man in his late 20s presented with a painless swelling in his left axilla accompanied with nocturnal sweating. On examination, there was a well circumscribed, pulsatile lump within the axilla. Subsequent imaging revealed an axillary artery aneurysm with thrombus within. Subsequent surgical repair was undertaken. Subsequent histological examination of the vessel revealed features characteristic of angiolymphoid hyperplasia with eosinophilia.
Kukreja, Neil; Koslowski, Matthias; Insall, Robert
Thymic hyperplasia in a patient with Grave's disease
Hyperplastic changes of the thymus may be found in patients with Graves' disease. However, this rarely presents as an anterior mediastinal mass, particularly among adults. In this report, we describe a 46-year old woman with Graves' disease and thymic hyperplasia.
Thymic hyperplasia. A clue to the diagnosis of hyperthyroidism.
The association of simultaneous abnormalities of the thyroid and thymus is well documented, particularly in the case of Graves' disease. We present a case of a natural death following thyroid storm in which marked thymic hyperplasia was present. This finding can be helpful in determining the cause of death. PMID:2220714
Fyfe, B; Dominguez, F; Poppiti, R J
Not so benign endometrial hyperplasia: Endometrial cancer after endometrial ablation
The masking or development of endometrial cancer after endometrial ablation is a concern often alluded to in discussions of complications of endometrial ablation. It is necessary to look for a common factor when this complication occurs. Six cases published in peer-reviewed literature were collected to establish a link between the development of endometrial cancer and endometrial ablation. Preexisting endometrial hyperplasia
Richard J. Gimpelson
Monoclonal origin of vulvar intraepithelial neoplasia and some vulvar hyperplasias.
Squamous neoplasms of the female genital tract, including vulvar intraepithelial neoplasia, presumably are derived from a single cell. This study addressed this hypothesis and determined the clonal status of other squamous epithelial alterations associated with vulvar carcinoma, including hyperplasia and lichen sclerosis. X chromosome inactivation patterns of 22 epithelial lesions and matched normal epithelium were determined using a polymerase chain reaction (PCR)-based assay targeting the X-linked human androgen receptor gene (HUMARA). Clonality was inferred by comparing matched lesional and control tissues as follows: 1) monoclonal, if intensity of either PCR product was skewed relative to normal reference epithelium (control), 2) polyclonal, if both lesional and control were unskewed, and 3) unknown, if both lesion and control tissues were skewed toward the same allele. Two cases were excluded because of noninformative homozygous HUMARA alleles. Of 8 vulvar intraepithelial neoplasias analyzed, 7 were scored monoclonal and 1 polyclonal. Of 12 hyperplasias, 6 were monoclonal, including one with lichen sclerosis, 2 were polyclonal, and in 4, the clonal status could not be determined. The PCR-based clonal assay supports a monoclonal derivation for vulvar intraepithelial neoplasia and, in some cases, vulvar hyperplasia, and lichen sclerosis. The finding of monoclonal hyperplasia and lichen sclerosis suggests that clonal expansion may evolve before the development of morphological atypia in these epithelia. Images Figure 1 Figure 2
Tate, J. E.; Mutter, G. L.; Boynton, K. A.; Crum, C. P.
Atypical ductal hyperplasia: interobserver and intraobserver variability
Interobserver reproducibility in the diagnosis of benign intraductal proliferative lesions has been poor. The aims of the study were to investigate the inter- and intraobserver variability and the impact of the addition of an immunostain for high- and low-molecular weight keratins on the variability. Nine pathologists reviewed 81 cases of breast proliferative lesions in three stages and assigned each of
Rohit K Jain; Rutika Mehta; Rosen Dimitrov; Lisbeth G Larsson; Paul M Musto; Kurt B Hodges; Thomas M Ulbright; Eyas M Hattab; Narasimhan Agaram; Muhammad T Idrees; Sunil Badve
Men's Theories About Benign Prostatic Hyperplasia and Prostate Cancer Following a Benign Prostatic Hyperplasia Decision Aid
Objective To use qualitative methods to explore audiotape evidence of unanticipated confusion between benign prostatic hyperplasia (BPH) and prostate cancer in using a videotape BPH treatment decision aid (DA). Design Qualitative analysis of semi-structured interviews and surveys originally collected to study men's interpretation of a DA. Setting and Participants Community sample of college and noncollege educated African American and white men (age?50; n=188). Measures Transcript analysis identified themes in men's comments about BPH and cancer. Surveys measured BPH general and prostate cancer-specific knowledge, literacy (Short Test of Functional Health Literacy in Adults), BPH symptoms, and demographics. Results In transcript analysis, 18/188 men spontaneously talked about BPH and cancer as being related to each other, despite explicit statements to the contrary in the video. Survey data suggest that up to 126/188 men (67%) persisted in misconceptions even after viewing the DA video. Three themes were identified in the transcripts: (1) BPH and cancer are equated, (2) BPH surgery is for the purpose of removing cancer, and (3) BPH leads to cancer. Conclusions Overall knowledge increases with DA use may mask incorrect theories of disease process. Further research should identify decision support designs and clinical counseling strategies to address persistence of beliefs contrary to new information presented in evidence-based DAs.
Holmes-Rovner, Margaret; Price, Chrystal; Rovner, David R; Kelly-Blake, Karen; Lillie, Janet; Wills, Celia; Bonham, Vence L
Ki-67 index as an ancillary tool in the differential diagnosis of proliferative endometrial lesions with secretory change.
"Secretory change" can accompany a variety of proliferative endometrial lesions, ranging from hyperplasia to carcinoma. It is characterized by subnuclear or supranuclear vacuolization, mimicking early secretory endometrium (SEM). As an additional diagnostic challenge, mitotic activity and cytologic atypia are often low in hyperplastic lesions with secretory change. As mitotic activity in lesions with secretory change is decreased, the mitotic index may not be useful to distinguish SEM with glandular crowding from hyperplasia with secretory change. We therefore hypothesized that Ki-67 immunohistochemistry, an alternative marker of proliferative activity, might be useful in this setting. Forty-four endometrial lesions with secretory change and 30 controls were stained for Ki-67. Three "hot spot" areas per case were photographed and 200 to 300 cells were manually counted to obtain the ratio of Ki-67-positive cells versus total cells. A second pathologist performed an independent review of the same preselected fields and estimates without preselection. There was an incremental increase in the Ki-67 index from 2.6% in SEM to 17% in nonatypical hyperplasia, 36% in atypical hyperplasia, and 60% in endometrial carcinoma. The Ki-67 index for SEM was significantly (P<0.01) lower than hyperplastic lesions and carcinoma with secretory change. Similar, statistically significant results were obtained by independent estimates of Ki-67 immunopositivity. In the setting of secretory morphology, the Ki-67 index was highly sensitive and specific (>90%) for the differential diagnosis of SEM with crowding versus nonatypical hyperplasia, atypical hyperplasia, and endometrial carcinoma. In summary, the Ki-67-labeling index is a useful technique to distinguish SEM with crowding, an exaggerated physiological condition, from cancer precursors. PMID:24487464
Gurda, Grzegorz T; Baras, Alexander S; Kurman, Robert J
Serenoa repens for benign prostatic hyperplasia
Background Benign prostatic hyperplasia (BPH), a nonmalignant enlargement of the prostate, can lead to obstructive and irritative lower urinary tract symptoms (LUTS). The pharmacologic use of plants and herbs (phytotherapy) for the treatment of LUTS associated with BPH is common. The extract of the berry of the American saw palmetto, or dwarf palm plant, Serenoa repens (also known by its botanical name of Sabal serrulatum), is one of several phytotherapeutic agents available for the treatment of BPH. Objectives This systematic review aimed to assess the effects of Serenoa repens in the treatment of LUTS consistent with BPH. Search strategy Trials were searched in computerized general and specialized databases (MEDLINE, EMBASE, and The Cochrane Library), by checking bibliographies, and by handsearching the relevant literature. Selection criteria Trials were eligible if they (1) randomized men with symptomatic BPH to receive preparations of Serenoa repens (alone or in combination) for at least four weeks in comparison with placebo or other interventions, and (2) included clinical outcomes such as urologic symptom scales, symptoms, and urodynamic measurements. Eligibility was assessed by at least two independent observers. Data collection and analysis Information on patients, interventions, and outcomes was extracted by at least two independent reviewers using a standard form. The main outcome measure for comparing the effectiveness of Serenoa repens with placebo or other interventions was the change in urologic symptom-scale scores. Secondary outcomes included changes in nocturia and urodynamic measures. The main outcome measure for side effects or adverse events was the number of men reporting side effects. Main results In this update 9 new trials involving 2053 additional men (a 64.8% increase) have been included. For the main comparison - Serenoa repens versus placebo - 3 trials were added with 419 subjects and 3 endpoints (IPSS, peak urine flow, prostate size). Overall, 5222 subjects from 30 randomized trials lasting from 4 to 60 weeks were assessed. Twenty-six trials were double blinded and treatment allocation concealment was adequate in eighteen studies. Serenoa repens was not superior to placebo in improving IPSS urinary symptom scores, (WMD (weighted mean difference) ?0.77 points, 95% CI ?2.88 to 1.34, P > 0.05; 2 trials), finasteride (MD (mean difference) 0.40 points, 95% CI ?0.57 to 1.37, P > 0.05; 1 trial), or tamsulosin (WMD ?0.52 points, 95% CI ?1.91 to 0.88, P > 0.05; 2 trials). For nocturia, Serenoa repens was significantly better than placebo (WMD ?0.78 nocturnal visits, 95% CI ?1.34 to ?0.22, P < 0.05; 9 trials), but with the caveat of significant heterogeneity (I2 = 66%). A sensitivity analysis, utilizing higher quality, larger trials (? 40 subjects), demonstrated no significant difference (WMD ?0.31 nocturnal visits, 95% CI ?0.70 to 0.08, P > 0.05; 5 trials) (I2 = 11%). Serenoa repens was not superior to finasteride (MD ?0.05 nocturnal visits, 95% CI ?0.49 to 0.39, P > 0.05; 1 trial), or to tamsulosin (per cent improvement) (RR) (risk ratio) 0.91, 95% CI 0.66 to 1.27, P > 0.05; 1 trial). Comparing peak urine flow, Serenoa repens was not superior to placebo at trial endpoint (WMD 1.02 mL/s, 95% CI ?0.14 to 2.19, P > 0.05; 10 trials), or by comparing mean change (WMD 0.31 mL/s, 95% CI ?0.56 to 1.17, P > 0.05; 2 trials). Comparing prostate size at endpoint, there was no significant difference between Serenoa repens and placebo (MD ?1.05 cc, 95% CI ?8.84 to 6.75, P > 0.05; 2 trials), or by comparing mean change (MD ?1.22 cc, 95% CI ?3.91 to 1.47, P > 0.05; 1 trial). Authors� conclusions Serenoa repens was not more effective than placebo for treatment of urinary symptoms consistent with BPH.
Tacklind, James; MacDonald, Roderick; Rutks, Indy; Wilt, Timothy J
Epidemiology and etiology of benign prostatic hyperplasia and bladder outlet obstruction
Benign prostatic hyperplasia (BPH) is a histological diagnosis associated with unregulated proliferation of connective tissue, smooth muscle and glandular epithelium. BPH may compress the urethra and result in anatomic bladder outlet obstruction (BOO); BOO may present as lower urinary tract symptoms (LUTS), infections, retention and other adverse events. BPH and BOO have a significant impact on the health of older men and health-care costs. As the world population ages, the incidence and prevalence of BPH and LUTS have increased rapidly. Although non-modifiable risk factors � including age, genetics and geography � play significant roles in the etiology of BPH and BOO, recent data have revealed modifiable risk factors that present new opportunities for treatment and prevention, including sex steroid hormones, the metabolic syndrome and cardiovascular disease, obesity, diabetes, diet, physical activity and inflammation. We review the natural history, definitions and key risk factors of BPH and BOO in epidemiological studies.
Patel, Nishant D.; Parsons, J. Kellogg
Qianliening capsule inhibits benign prostatic hyperplasia angiogenesis via the HIF-1? signaling pathway
Angiogenesis plays an important role in the progression and development of benign prostatic hyperplasia (BPH), and has become a promising target for BPH treatment. The hypoxia-inducible factor-1? (HIF-1?) signaling pathway promotes the process of angiogenesis, contributing to the growth and progression of a number of hyperplasia diseases, including BPH. Qianliening capsule (QC) is a traditional Chinese formula that has been used clinically in China to treat BPH for a number of years. Recently, QC was demonstrated to inhibit prostatic cell growth and induce apoptosis in vivo and in vitro via regulating the epidermal growth factor/signal transducer and activator of transcription 3 signaling pathway and mitochondrion-dependent apoptosis pathway. However, the mechanisms underlying the anti-BPH effect remain largely unknown. To further elucidate the mechanism of QC activity in BPH treatment, a rat BPH model established by injecting testosterone following castration was established and the effect of QC on prostatic tissue angiogenesis was evaluated, as well as the underlying molecular mechanisms. QC was shown to reduce the prostatic index in BPH rats, but without affecting the body weight, demonstrating that QC is effective in the treatment of BPH and without apparent toxicity. In addition, QC treatment significantly reduced the intraprostatic microvessel density, indicating antiangiogenesis activity in vivo. In addition, treatment with QC inhibited the expression of HIF-1? in BPH rats, as well as the expression of vascular endothelial growth factor and basic fibroblast growth factor. Therefore, for the first time, the present study hypothesized that QC inhibits angiogenesis in prostatic tissue of BPH rats via the inhibition of the HIF-1? signaling pathway, which may be one of the mechanisms in which QC treats BPH.
[Nodular pseudoangiomatous stromal hyperplasia of the breast in two adolescents].
Nodular pseudoangiomatous stromal hyperplasia is a very rare benign breast lesion found in 0.4% of biopsies. It usually presents as a fast-growing palpable lesion in women between 30 and 40 years of age and is exceptionally rare in adolescents. Histological examination reveals a proliferation of stromal cells from connective tissue forming anastomosed empty pseudovascular spaces lined with myofibroblasts. We present the cases of two adolescents (13 and 18 years old) with fast-growing palpable breast nodules. Both underwent breast ultrasonography and core biopsy. The ultrasonographic findings of nodular pseudoangiomatous stromal hyperplasia were indistinguishable from those reported for juvenile fibroadenoma and for phyllodes tumor. Thus, histological study was required for the definitive diagnosis. Treatment depends on the size of the nodule. In our two patients, the lesion was surgically excised through tumorectomy and mastectomy. PMID:21737108
Gallardo Mu�oz, I; Raya Povedano, J L; Santos Romero, A L
[Do we need congenital adrenal hyperplasia screening for premature infants?].
Congenital adrenal hyperplasia neonatal screening has been introduced in France since 1995. A recent survey has questioned its relevance in premature infants because of a high number of false positives and a low positive predictive value of 17-hydroxyprogesterone dosage. A workgroup at the French screening association (Association fran�aise de d�pistage et de pr�vention des handicaps de l'enfant) collected all the epidemiological, clinical and biological data of premature children presenting with adrenal hyperplasia from the national cohort. Their results were compared with those of healthy premature children. All the data showed that the screening in children born before 32 weeks of gestational age is irrelevant, but that it is efficient after this term. A pilot study has been implemented in population to evaluate the opportunity to discontinue this screening in extreme preterm neonates. PMID:24361036
Huet, F; Godefroy, A; Cheillan, D; Somma, C; Roussey, M
Response to treatment of congenital adrenal hyperplasia in infancy.
Nine infants with congenital adrenal hyperplasia were started on replacement doses of hydrocortisone (20.6-32.6 mg/m2/day) without receiving a high dose for an initial period first. Plasma adrenal steroid concentrations fell to acceptable levels by 3 months of age. Adequate biochemical control was maintained and satisfactory growth achieved even though the mean dose of hydrocortisone had been reduced to 15 mg/m2/day by the age of 3 years. Inadvertent overtreatment and growth suppression in infants with congenital adrenal hyperplasia may be avoided by using replacement doses from the start, and by permitting the relative dose of hydrocortisone to fall as the body surface area increases during the first year of life.
Young, M C; Hughes, I A
Prenatal treatment of congenital adrenal hyperplasia: risks outweigh benefits.
Prenatal treatment of congenital adrenal hyperplasia by administering dexamethasone to a woman presumed to be carrying an at-risk fetus has been described as safe and effective in several reports. A review of data from animal experimentation and human trials indicates that first-trimester dexamethasone decreases birthweight; affects renal, pancreatic beta cell, and brain development; increases anxiety; and predisposes to adult hypertension and hyperglycemia. In human studies, first-trimester dexamethasone is associated with orofacial clefts, decreased birthweight, poorer verbal working memory, and poorer self-perception of scholastic and social competence. Numerous medical societies have cautioned that prenatal treatment of congenital adrenal hyperplasia with dexamethasone should only be done in prospective clinical research settings with institutional review board approval, and therefore is not appropriate for routine community practice. PMID:23123167
Miller, Walter L; Witchel, Selma Feldman
Thyrotoxic myopathy mimicking myasthenic syndrome associated with thymic hyperplasia.
A 41-year-old man with progressive limb weakness manifested fluctuating muscle weakness as seen in myasthenia gravis (MG). Laboratory investigations revealed hyperthyroidism without the complication of MG. Electrophysiological studies demonstrated abnormal features of neuromuscular transmissions resembling those of the Lambert-Eaton myasthenic syndrome rather than those of MG. A CT scan showed a mediastinal mass that suggested thymic hyperplasia which often complicates MG or hyperthyroidism. Medical treatment of hyperthyroidism resulted in resolution of MG-like symptoms and regression of thymic hyperplasia on CT concomitant with normalization of thyroid function. This case highlights the fact that careful investigations are needed to differentiate MG-like symptoms from genuine MG in cases of hyperthyroidism with thymic lesions. PMID:18310980
Tsuda, Emiko; Imai, Tomihiro; Matsumura, Akihiro; Hisahara, Shin; Nonaka, Michio; Shiraishi, Hirokazu; Motomura, Masakatsu; Shimohama, Shun
[Laser tonsillectomy in tonsillar hyperplasia of early childhood].
Tonsillotomy, the partial resection of hyperplastic tonsils, is generally rejected in Germany as a treatment option for obstructions of the isthmus faucium in early childhood. We think this approach merits consideration. The favorable results obtained with tonsillotomy in the University Hospital Benjamin Franklin (n = 637), a private clinic, and an ENT practice with surgical facilities (n = 189) showed that there is no justification for adhering to literature reports of severe late complications with scarred tonsillar crypts and peritonsillar abscesses. No patient has developed any of these complications thus far. Following tonsillotomy, preoperative complaints (snoring, respiratory obstruction, dysphagia, and failure to grow) decreased considerably. Thus, tonsillotomy proved to be a suitable modality for treating tonsillar hyperplasia in early childhood. The prerequisite for long-term success is strict limitation of this intervention to the diagnosis of tonsillar hyperplasia. PMID:12089813
Helling, K; Abrams, J; Bertram, W K; Hohner, S; Scherer, H
Literature Survey of Airborne Vehicles Impacting with Water and Soil: Head Injury Criteria and Severity Index Development of Computer Program KRASH.
National Technical Information Service (NTIS)
This report describes a two part study to identify KRASH code requirements for analyses of: Structure/terrain interaction; Head/structure Interaction. The literature survey of water and soil impact methodology is presented. The reports are reviewed with r...
G. Wittlin M. A. Gamon
Impact of river channel shifts on tetraether lipids in the Rh�ne prodelta (NW Mediterranean): Implication for the BIT index as an indicator of paleoflood events
NASA Astrophysics Data System (ADS)
In this study, we tested the applicability of the BIT (Branched and Isoprenoid Tetraether) index as a proxy of paleoflood events in the river-dominated continental margin of the Gulf of Lions (NW Mediterranean). We compared the concentrations and distributions of branched glycerol dialkyl glycerol tetraethers (brGDGTs) and crenarchaol of suspended particulate matter (SPM) collected in the downstream of the Rh�ne River as well as a core-top and a ~8-m long piston core RHS-KS57 taken in the Rh�ne prodelta. The piston core covers the last 400 years with four distinct intervals recording the river influence under natural and man-induced shifts of Rh�ne distributaries: Bras de Fer, Grand Rh�ne, Pegoulier, and Roustan. Our results indicate that there are mixed sources of brGDGTs and crenarchaeol in the Rh�ne prodelta, which complicates the use of the BIT index as an indicator of continental OC inputs and thus as a paleoflood proxy. However, the sedimentary BIT record obtained from the period, when the continental material was delivered by the Rh�ne River more directly to the core site (Roustan phase; 1892 to Present-day), strongly mimics the historical paleoflood record. This shows the potential of the BIT index as a paleoflood proxy, as long as the delivery route of the continental material by the rivers to the core sites remained constant over the time. Our study also highlights that shifts in the course of the distributaries and river channels should be taken into account for the use of the BIT index as a paleoflood proxy.
Kim, Jung-Hyun; Buscail, Roselyne; Fanget, Anne Sophie; Eyrolle-Boyer, Fr�d�rique; Bassetti, Maria-Angela; Dorhout, Denise; Baas, Marianne; Bern�, Serge; Sinninghe Damst�, Jaap S.
Lower urinary tract symptoms, benign prostatic hyperplasia, and obesity
Obesity has emerged as a global public health challenge. During the past 20 years, there has been a dramatic increase in obesity\\u000a in the United States. In 2007, only one state had a prevalence of obesity less than 20%. In this growing epidemic of national\\u000a concern is an emerging relationship between lower urinary tract symptoms (LUTS), benign prostatic hyperplasia (BPH),
Anne K. Mongiu; Kevin T. McVary
Efficacy of high condylectomy for management of condylar hyperplasia
The purpose of this study was to compare the treatment outcome and long-term stability of 2 groups of young adult patients diagnosed with active condylar hyperplasia and treated with 2 different surgical methods. Thirty-seven patients (19 females and 18 males) met the criteria for inclusion in the study. Group 1 (n = 12; average age at surgery, 17.5 years) was
Larry M. Wolford; Pushkar Mehra; Oscar Reiche-Fischel; Carlos A. Morales-Ryan; Patricia Garc??a-Morales
Primary papillary hyperplasia of the gallbladder mimicking gallbladder cancer.
Abstract Primary papillary hyperplasia of the gallbladder (PPHG) is a rare entity. PPHG is a benign diffuse mucosal projection without any background chronic inflammation-related disease of the gallbladder or bile ducts. Reported cases of PPHG are limited in that its characteristics are not well defined. We herein report a case of PPHG mimicking gallbladder cancer in radiologic investigations and present a review of the literature. Also coincident erythroderma is discussed. PMID:24833147
Baba, Hiroyuki; Wakabayashi, Mai; Oba, Atsushi; Tsubomoto, Takashi; Nakamura, Hiroshi; Sanada, Takahiro; Kuwabara, Hiroshi; Nakajima, Kazumi; Goseki, Narihide
Epithelioid Hemangioma (Angiolymphoid Hyperplasia with Eosinophilia) in Zosteriform Distribution
Epithelioid hemangioma (EH) or angiolymphoid hyperplasia with eosinophilia (ALHE) is an uncommon benign disease. We report an unusual case of EH (ALHE) that arose on the lower back in a zosteriform array. The presence of the characteristic histological appearance of plump endothelial cells with hobnail-like protrusions led to the diagnosis of EH (ALHE). Histological examination of the lesion also revealed the existence of arteriovenous shunts, the possible factor contributing to the pathogenesis of EH (ALHE).
Kurihara, Yuichi; Inoue, Hiroyoshi; Kiryu, Hiromaro; Furue, Masutaka
The role of combination medical therapy in benign prostatic hyperplasia
To review key trials of monotherapy and combination therapy of ?1-adrenergic receptor antagonists (?1-ARAs), 5?-reductase inhibitors (5?RIs) and anti-muscarinic agents in the treatment of lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). To assess the safety and efficacy of combination therapies for LUTS associated with BPH, a search of the MEDLINE and Cochrane databases (1976�2008) was conducted
K A Greco; K T McVary
Overview of interventional treatment options for benign prostatic hyperplasia
Transurethral resection of the prostate (TURP) remains the gold standard surgical intervention for men with benign prostatic hyperplasia (BPH). However, there are other, newer technologies that have also demonstrated safety and efficacy at least equivalent to that of TURP (e.g., Holmium laser, photoselective vaporization of the prostate). These minimally invasive techniques may be particularly useful for selected patient populations (e.g., those on anticoagulant therapy).
Elhilali, Mostafa M.
Giant Prostatic Hyperplasia: Fourth largest prostate reported in medical literature.
A giant prostatic hyperplasia (GPH) weighing more than 700 g is a rare entity. It is believed that only eight such cases have been previously reported in the medical literature. This case report concerns a patient with a GPH weighing 740 g which was successfully removed by suprapubic prostatectomy. To our knowledge, this is the fourth largest benign prostatic enlargement ever reported in the literature. PMID:24790752
Maliakal, Joseph; Mousa, Emad E; Menon, Varna
[Thymic hyperplasia in a patient with Graves' disease].
Benign thymic hyperplasia (TH) is a known feature of hyperthyroidism. In most cases, thymic enlargement is minimal; however, this syndrome may occasionally appear as an appreciable anterior mediastinal mass. Recognition of the benign nature of TH and its regression following treatment of the hyperthyroidism is important to prevent unnecessary surgical procedures. We present a case of TH associated with hyperthyroidism due to Graves' disease. PMID:19627717
Garc�a, Elena; Garc�a-Hierro, V�ctor; Pilar Alvarez, Mar�a; de la Maza, Laura; Santos, Estefan�a; Pi, Javier; Castillo, Luis; Ruiz, Enrique
bcl-2 Expression in Endometrial Hyperplasia and Carcinoma
The bcl-2 gene codes for a protein which functions to inhibit apoptotic cell death. bcl-2 overexpression was originally described in follicular lymphoma, but more recently bcl-2 expression has been observed in a variety of other human neoplasms. In this study we used immunohistochemistry to examine bcl-2 protein expression in endometrial hyperplasia and carcinoma. bcl-2 protein was observed in 4\\/4 cases
Theodore H. Niemann; Tracey L. Trgovac; Violeta R. Mcgaughy; Luis Vaccarello
[Surgical management of congenital adrenal hyperplasia in young girls].
Congenital adrenal hyperplasia (CAH) is the commonest cause of virilization in genetically female children. Although no consensus has been reached concerning the indications, surgical management of these patients has improved considerably over the last twenty years. The authors describe the main genitoplasty techniques currently used and report their results, although they are difficult to interpret in view of the small number of published series. PMID:15000319
Mure, Pierre-Yves; Gelas, Thomas; Ripepi, Mirella; Hoch, Mikael; Mouriquand, Pierre
Energy Delivery Systems for Treatment of Benign Prostatic Hyperplasia
Executive Summary Objective The Ontario Health Technology Advisory Committee asked the Medical Advisory Secretariat (MAS) to conduct a health technology assessment on energy delivery systems for the treatment of benign prostatic hyperplasia (BPH). Clinical Need: Target Population and Condition BPH is a noncancerous enlargement of the prostate gland and the most common benign tumour in aging men. (1) It is the most common cause of lower urinary tract symptoms (LUTS) and bladder outlet obstruction (BOO) and is an important cause of diminished quality of life among aging men. (2) The primary goal in the management of BPH for most patients is a subjective improvement in urinary symptoms and quality of life. Until the 1930s, open prostatectomy, though invasive, was the most effective form of surgical treatment for BPH. Today, the benchmark surgical treatment for BPH is transurethral resection of the prostate (TURP), which produces significant changes of all subjective and objective outcome parameters. Complications after TURP include hemorrhage during or after the procedure, which often necessitates blood transfusion; transurethral resection (TUR) syndrome; urinary incontinence; bladder neck stricture; and sexual dysfunction. A retrospective review of 4,031 TURP procedures performed by one surgeon between 1979 and 2003 showed that the incidence of complications was 2.4% for blood transfusion, 0.3% for TUR syndrome, 1.5% for hemostatic procedures, 2.8% for bladder neck contracture, and 1% for urinary stricture. However, the incidence of blood transfusion and TUR syndrome decreased as the surgeon�s skills improved. During the 1990s, a variety of endoscopic techniques using a range of energy sources have been developed as alternative treatments for BPH. These techniques include the use of light amplification by stimulated emission of radiation (laser), radiofrequency, microwave, and ultrasound, to heat prostate tissue and cause coagulation or vaporization. In addition, new electrosurgical techniques that use higher amounts of energy to cut, coagulate, and vaporize prostatic tissue have entered the market as competitors to TURP. The driving force behind these new treatment modalities is the potential of producing good hemostasis, thereby reducing catheterization time and length of hospital stay. Some have the potential to be used in an office environment and performed under local anesthesia. Therefore, these new procedures have the potential to rival TURP if their effectiveness is proven over the long term. The Technology Being Reviewed The following energy-based techniques were considered for assessment: transurethral electrovaporization of the prostate (TUVP) transurethral electrovapor resection of the prostate (TUVRP) transurethral electrovaporization of the prostate using bipolar energy (plasmakinetic vaporization of the prostate [PKVP]) visual laser ablation of the prostate (VLAP) transurethral ultrasound guided laser incision prostatectomy (TULIP) contact laser vaporization of the prostate (CLV) interstitial laser coagulation (ILC) holmium laser resection of the prostate (HoLRP) holmium laser enucleation of the prostate (HoLEP) holmium laser ablation of the prostate (HoLAP) potassium titanyl phosphate (KTP) laser transurethral microwave thermotherapy (TUMT) transurethral needle ablation (TUNA) Review Strategy A search of electronic databases (OVID MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations, EMBASE, The Cochrane Library, and the International Agency for Health Technology Assessment [INAHTA] database) was undertaken to identify evidence published from January 1, 2000 to June 21, 2006. The search was limited to English-language articles and human studies. The literature search identified 284 citations, of which 38 randomized controlled trials (RCTs) met the inclusion criteria. Since the application of high-power (80 W) KTP laser (photoselective vaporization of the prostate [PVP]) has been supported in the United States and has resulted in a rapid diffusion of this technology in the absence of any RCTs, th
SPDEF regulates goblet cell hyperplasia in the airway epithelium
Goblet cell hyperplasia and mucous hypersecretion contribute to the pathogenesis of chronic pulmonary diseases including cystic fibrosis, asthma, and chronic obstructive pulmonary disease. In the present work, mouse SAM pointed domain-containing ETS transcription factor (SPDEF) mRNA and protein were detected in subsets of epithelial cells lining the trachea, bronchi, and tracheal glands. SPDEF interacted with the C-terminal domain of thyroid transcription factor 1, activating transcription of genes expressed selectively in airway epithelial cells, including Sftpa, Scgb1a1, Foxj1, and Sox17. Expression of Spdef in the respiratory epithelium of adult transgenic mice caused goblet cell hyperplasia, inducing both acidic and neutral mucins in vivo, and stainined for both acidic and neutral mucins in vivo. SPDEF expression was increased at sites of goblet cell hyperplasia caused by IL-13 and dust mite allergen in a process that was dependent upon STAT-6. SPDEF was induced following intratracheal allergen exposure and after Th2 cytokine stimulation and was sufficient to cause goblet cell differentiation of Clara cells in vivo.
Park, Kwon-Sik; Korfhagen, Thomas R.; Bruno, Michael D.; Kitzmiller, Joseph A.; Wan, Huajing; Wert, Susan E.; Khurana Hershey, Gurjit K.; Chen, Gang; Whitsett, Jeffrey A.
Recombinant Plasminogen Activator Inhibitor-1 Inhibits Intimal Hyperplasia
Objective Plasminogen activator inhibitor-1 (PAI-1) over-expression is implicated in vascular disease. However, the effects of a primary increase in PAI-1 expression on arterial remodeling are poorly defined. We tested the hypothesis that recombinant PAI-1 inhibits intimal hyperplasia after vascular injury. Methods and Results Rats underwent carotid artery injury and received intraperitoneal injections of saline or mutant forms of PAI-1 for 14 days, including an active, stable mutant (PAI-1-14-1b), a mutant lacking anti-PA activity (PAI-1-R), or a mutant defective in vitronectin (VN) binding (PAI-1-K). All forms of PAI-1 significantly inhibited neointima formation, while elastase-cleaved PAI-1, which lacks both anti-PA and VN-binding functions, did not. Similar effects were observed in a murine model. However, the anti-proliferative effect of PAI-1-R was lost in Vn?/? mice, suggesting that PAI-1 can inhibit intimal hyperplasia in vivo by a VN-dependent pathway not involving direct inhibition of proteases. In vitro, recombinant PAI-1 inhibited wild-type vascular smooth muscle cell (VSMC) proliferation, promoted apoptosis, and inhibited migration. These effects were lost in VN-deficient VSMC. Conclusion Recombinant PAI-1 inhibits intimal hyperplasia by inhibiting proteases and binding VN. VN is a key determinant of the anti-proliferative effect of PAI-1 over-expression. PAI-1-R has therapeutic potential to inhibit vascular restenosis without promoting thrombosis.
Wu, Jianbo; Peng, Lin; McMahon, Grainne A.; Lawrence, Daniel A.; Fay, William P.
Relationship of hyperplasia to cancer in 3-methylcholanthrene-induced mammary tumorogenesis.
Light microscopic study of the evolution of 3-methylcholanthrene-induced mammary tumors in Wistar-Furth rats revealed a seriation of changes proceeding from early hyperplasia (8 days) to advanced hyperplasia (57 days) and cancer (78 days). Ultrastructurally, cellular changes in advanced hyperplasia and cancer were indistinguishable, being characterized by nuclear chromatin clumping, prominent nucleoli, cytoplasmic polyribosomal aggregates and pseudopodal extensions, and prominent Golgi structures. These features, as well as the lack of limiting lamina basalia, allowed for their distinction from the cells of early hyperplasia. Further, only nodules of both advantanced hyperplasia and cancer were transplantable in syngeneic recipients. Chromosomal aberrations were qualitatively similar in cells obtained from all lesions but were progressively more frequent. Although these findings do not allow for the discrimination of advanced hyperplasia and cancer, they indicate their close pathogenetic relationship as well as the very early occurrence of chromosomal alterations in the development of mammary cancer in this model system. PMID:1142740
Fisher, E R; Shoemaker, R H; Sabnis, A
Angioarchitecture and blood circulation in focal nodular hyperplasia of the liver
Backtround\\/Aims: We sought to clarify important unresolved points regarding angioarchitecture and blood circulation in focal nodular hyperplasia.Methods: Twenty-nine surgically resected focal nodular hyperplasia lesions were examined histologically, immuhistochemically, and radiologically. In three autopsy cases, red- and blue-colored gelatin was injected into the hepatic artery and the portal vein, respectively, to demonstrate the vasculature in focal nodular hyperplasia.Results: Histologically, no orientation
Yoshihiko Fukukura; Osamu Nakashima; Akiko Kusaba; Masayoshi Kage; Masamichi Kojiro
Facial asymmetry with enlarged frontal sinus and hyperplasia of the cranial, nasal, and mandible bones.
The conditions of facial asymmetry are caused by congenital or acquired diseases, and several unclassifiable syndromes with unknown etiologies exist. In this report, a case of facial asymmetry with enlarged frontal sinus and hyperplasia of the frontal cranial bone and nasal bone is presented.Although the etiology of the facial malformation was clear, it was thought that the cause of the enlarged frontal sinus was related to the unidentified bony hyperplasia and facial asymmetry related to hemimandibular hyperplasia. PMID:24978687
Taguchi, Rie; Yamashita, Masanobu; Kawakami, Shigehiko
Teaching Physiology with Citation Index
ERIC Educational Resources Information Center
Explains use of the Citation Index in writing term papers by assigning an older publication as a starting point in a literature search. By reading the original research report and following its subsequent use by other researchers, the student discovers the impact of the original research. (CS)
Klemm, W. R.
Novel nanocomposite stent coating releasing resveratrol and quercetin reduces neointimal hyperplasia and promotes re-endothelialization.
Late-term thrombosis associated with drug-eluting stents may be due to the non-selective actions of antimitogenic drugs on endothelial cells, leading to delayed vascular healing after stenting angioplasty. Currently, there is a need for stent-based therapies that can both attenuate neointimal hyperplasia and promote re-endothelialization. The aim of this study was to compare the effects of a resveratrol (R)- and quercetin (Q)-eluting stent with that of a bare metal stent (BMS) on neointimal hyperplasia and re-endothelialization in a rat model of arterial angioplasty and stenting. Miniature stents (2.5�1.25mm) were sprayed with nanocomposite coatings containing two concentrations of R:Q (50:25?g/cm(2) (RQ1) or 150:75?g/cm(2) (RQ2)). The stents were deployed into the common carotid artery of rats and their impact on vascular remodeling was compared to that of BMS. Luminal stenosis in arteries stented with RQ2-eluting stents was reduced by 64.6% (p<0.05) compared to arteries stented with BMS. Accompanying this effect was a 59.8% reduction in macrophage infiltration (p<0.05). There were no differences found between RQ1 and BMS. Finally, the RQ2-coated stent accelerated re-endothelialization by 50% compared with BMS (p<0.05). Thus, compared with BMS, local delivery of R and Q from a stent platform significantly reduced in-stent stenosis, while promoting re-endothelialization. These data suggest that R and Q may be favorable candidates for novel stent coatings, potentially reducing the risk of late thrombosis associated with drug-eluting stents. PMID:22269665
Kleinedler, James J; Foley, John D; Orchard, Elysse A; Dugas, Tammy R
Building and Evaluation of the Rural Ecological Environment Index System
The rural ecological environment system is complexity, multi-attribute and multilayer tissue system, so its impact factors include natural, economic and social factor. The paper builds three lays rural ecological environment index system with analytic hierarchy process and presents standard value of the index evaluation, and calculates index weight with principal component analysis, and gives indexes computing method, and designs five
Cao Lian-hai; Hao Shi-long; Chen Nan-xiang
The use of the dynamic respiration index to predict the potential MSW-leachate impacts after short term mechanical biological treatment.
The aim of this work was to evaluate the effects of short full scale MBT process (28 d) getting a biological stability of DRI < 1000 mg O(2) kg VS(-1) h(-1), on the impact of leachate produced in simulated landfill. As consequence of that, waste was processed by full scale MBT and both untreated and treated waste were successively incubated in simulated landfills for 1 year. Leachates were collected at different incubation times and characterized. Results obtained indicated that MBT allowed waste-organic matter (OM) reduction favoring, also, optimal condition for successive OM degradation in the simulated landfill. Final results indicated a total reduction of leachate impact for the treated waste (DRI of 978 mg O(2)kg VS(-1) h(-1)) with respect to the untreated waste of: -54%, -69%, -77%, -70%, -81% and -16% for NTK, NH(3), TOC, COD, BOD(5) and total heavy metal contents, respectively. PMID:23201514
Salati, Silvia; Scaglia, Barbara; Di Gregorio, Alessandra; Carrera, Alberto; Adani, Fabrizio
[The impact of load density differences on land subsidence based on build-up index and PS-InSAR technology].
The excessive mining for underground water is the main reason inducing the land subsidence in Beijing, while, increasing of load brought by the urban construction aggravate the local land subsidence in a certain degree. As an international metropolis, the problems of land subsidence that caused by urban construction are becoming increasingly highlights, so revealing the relationship between regional load increase and the response of land subsidence also becomes one of the key problems in the land subsidence research field. In order to analyze the relationship between the load changes in construction and the land subsidence quantitatively, the present study selected the TM remote sensing image covering Beijing plain and used Erdas Modeler tool to invert the index based on building site (IBI), acquired the spatial and temporal change information in research area further; Based on results monitored by PS-InSAR (permanent scatterer interferometry) and IBI index method, and combined with the GIS spatial analysis method in the view of pixels in different scales, this paper analyzes the correlation between typical area load change and land subsidence, The conclusions show that there is a positive correlation between the density of load and the homogeneity of subsidence, especially in area which has a high sedimentation rate. Owing to such characteristics as the complexity and hysteretic nature of soil and geological structure, it is not obvious that the land subsidence caused by the increase of load in a short period. But with the increasing of local land load made by high density buildings and additional settlement of each monomer building superposed with each other, regional land subsidence is still a question that cannot be ignored and needs long-term systematic research and discussion. PMID:24159875
Chen, Bei-Bei; Gong, Hui-Li; Li, Xiao-Juan; Lei, Kun-Chao; Lin, Zhu; Wang, Yan-Bing
Indexing Consistency and Quality.
ERIC Educational Resources Information Center
A measure of indexing consistency is developed based on the concept of 'fuzzy sets'. It assigns a higher consistency value if indexers agree on the more important terms than if they agree on less important terms. Measures of the quality of an indexer's work and exhaustivity of indexing are also proposed. Experimental data on indexing consistency�
Zunde, Pranas; Dexter, Margaret E.
Pituitary hyperplasia: a complication of the pseudomalabsorption of thyroxine
Objective �The pseudomalabsorption of thyroxine� has been used to describe patients with hypothyroidism who fail to comply with their treatment. We describe a unique case of a 32-year-old with hypothyroidism who developed pituitary hyperplasia and hyperprolactinemia secondary to the pseudomalabsorption of thyroxine. Investigations and treatment After baseline thyroid-function tests were performed, the patient was administered levothyroxine 0.5 mg under the supervision of a registered nurse. Thyroid function testing was repeated at 30, 60, 120, and 180 minutes. Arrangements were made for further daily supervised loading of levothyroxine 0.1 mg. Results With the administration of 0.5 mg levothyroxine, free thyroxine levels increased by 120 minutes, and with daily supervised dosing of 0.1 mg there was normalization of the thyroid hormone levels and a reduction of thyroid-stimulating hormone levels. Maintenance of thyroid-stimulating hormone < 15 mU/L for 2 weeks led to a reduction in prolactin levels and regression in the size of the pituitary on magnetic resonance imaging. Conclusion If left untreated, these patients face significant morbidity and are at risk of developing pituitary hyperplasia, complications from an increase in pituitary size, hyperprolactinemia, and potentially myxedema coma. Recognizing pituitary hyperplasia and hyperprolactinemia as a complication from the pseudomalabsorption of levothyroxine may prevent the potential of a misdiagnosis of a prolactinoma leading to unnecessary investigations and inappropriate treatment. Patient awareness of this serious complication and the rapid, demonstrable resolution with adequate thyroid hormone replacement may provide motivation to comply with supervised dosing of levothyroxine. It has also been suggested that supervised treatment enables the individual to maintain their patient status, which may be in part the motivation behind this disorder.
Doyle, Mary-Anne; Lochnan, Heather A
The coexistence of atypical intraductal hyperplasias with breast carcinoma.
We present a study made during 4 years (1992-1996), which pursued the underlining of the atypical intraductal hiperplasias (A.I.D.H.) lesions, met isolated or in the association with mamar carcinoma. Our study included a 188 number of the breast tumors, among: in the 23 cases we established the existence of the modification by the A.I.D.H, type at the fibrocystics disease associated or not with the other benign diseases of the breast (fibroadenosis, intraductal papiloma) and in the 63 cases there were the modification by the AIDH associated with in situ or invasiv carcinoma. Epithelial hyperplasia is frequently associated with the fibrocystic changes, being included in the category of fibrocystic or proliferating modifications. The synonymous terms used for the epithelial hyperplasia are the hiperplazia ductala, or the epitelioza, or the papilomatosis The last two are suggested by the proliferation possibility (papillary or linear) of the epithelial or the mio-epithelial cells. Regardless of the microscopic aspect of the lesion, that should be acknowledged and treated as it is, due to the increased risk of the development of a carcinoma later on, and also due to the ratio of association between the modification and the mammary carcinoma. The risk of occurrence of subsequent carcinoma is augmented in the presence of the epithelial atipii and also increases in the presence of a mammary carcinoma at the relatives of the first rank (1.3). In this context, the importance of the differential diagnosis between the simple intraductal hyperplasia and the atypical one, the difficulty of differentiation from intraductal carcinoma in some cases, and finally the association with an increased risk of subsequent occurrence of carcinoma, constitute into sufficient arguments to consider this topic separately. PMID:15678845
Bogdan, F; G�rni??, L; Florescu, M; Simionescu, C; Cr?i?oiu, S; Com?nescu, V
The Functional Role of Reactive Stroma in Benign Prostatic Hyperplasia
The human prostate gland is one of the only internal organs that continue to enlarge throughout adulthood. The specific mechanisms that regulate this growth, as well as the pathological changes leading to the phenotype observed in the disease benign prostatic hyperplasia (BPH), are essentially unknown. Recent studies and their associated findings have made clear that many complex alterations occur, involving persistent and chronic inflammation, circulating hormonal level deregulation, and aberrant wound repair processes. BPH has been etiologically characterized as a progressive, albeit discontinuous, hyperplasia of both the glandular epithelial and stromal cell compartments coordinately yielding an expansion of the prostate gland and clinical symptoms. Interestingly, the inflammatory and repair responses observed in BPH are also key components of general wound repair in post-natal tissues. These responses include altered expression of chemokines, cytokines, matrix remodeling factors, chronic inflammatory processes, altered immune surveillance and recognition, as well as the formation of a prototypical �reactive� stroma which is similar to that observed across various fibroplasias and malignancies of a variety of tissue sites. Stromal tissue, both embryonic mesenchyme, and adult reactive stroma myofibroblasts, has been shown to exert potent and functional regulatory control over epithelial proliferation and differentiation as well as immunoresponsive modulation. Thus, the functional biology of a reactive stroma, within the context of an adult disease typified by epithelial and stromal aberrant hyperplasia, is critical to understand within the context of prostate disease and beyond. The mechanisms that regulate reactive stroma biology in BPH represent targets of opportunity for new therapeutic approaches that may extend to other tissue contexts. Accordingly, this review seeks to address the dissection of important factors, signaling pathways, genes, and other regulatory components that mediate the interplay between epithelium and stromal responses in BPH.
Schauer, Isaiah G.; Rowley, David R.
Epithelioid hemangioma of the orbit or angiolymphoid hyperplasia with eosinophilia.
A patient was referred to the department for an incidentally discovered right orbital mass on MRI. After surgical excision, histopathologic examination led to the diagnosis of epithelioid hemangioma, a tumor rarely located in the orbit, whose main histopathologic feature is an exuberant proliferation of small vascular channels lined by enlarged endothelial cells. The clinical characteristics and histopathology of epithelioid hemangioma allow differentiation with Kimura disease, angiosarcoma, intravascular papillary endothelial hyperplasia, and other vascular tumors that share the common feature of an abnormal proliferation of endothelial cells. Although epithelioid hemangioma is extremely rare, it should be considered in the differential diagnosis of orbital tumors. PMID:24026000
S�nchez-Orgaz, Margarita; Insausti-Garc�a, Alfredo; Gregorio, Laura Y�benes; Duralde, Alvaro Arbizu; Romero-Mart�n, Ricardo
Habitat Suitability Index Models: Veery
Habitat preferences and species characteristics of the veery (Catharus fuscesens) are described in this publication. It is one of a series of Habitat Suitability Index (HSI) models and was developed through an analysis of available scientific data on the habitat requirements of the veery. Habitat use information is presented in a review of the literature, followed by the development of an HSI model. The model is presented in three formats: graphic; word; and mathematical. Suitability index graphs quantify the species-habitat relationship. These data are synthesized into a model designed to provide information for use in impact assessment and habitat management.
Sousa, Patrick J.
Prenatal diagnosis and treatment of congenital adrenal hyperplasia owing to 21-hydroxylase deficiency
Classical forms of congenital adrenal hyperplasia are caused by a severe deficiency of 21-hydroxylase, an enzyme involved in steroid biosynthesis, which triggers excessive androgen production before birth. Affected females experience virilization both physically and psychologically. Prenatal diagnosis and treatment of congenital adrenal hyperplasia has been implemented for more than 20 years. In utero gene-specific diagnosis is now feasible for fetal
Saroj Nimkarn; Maria I New
Endometrial curettage in abnormal uterine bleeding and efficacy of progestins for control in cases of hyperplasia.
Background: Abnormal uterine bleeding (AUB) is the most important symptom of endometrial hyperplasia and endometrial curettage (EC) is the gold standard diagnostic procedure. We present the results of patients who underwent EC for AUB and the efficacy of progestin administration in those with endometrial hyperplasia. Materials and Methods: A total of 415 female patients who presented to Duzce Public Hospital in 2011-2012 for AUB and who underwent EC were included. We determined the reasons for AUB, and females with hyperplasia were treated with 10 mg/day medroxyprogesterone acetate for 14 days/month or 160 mg/day megestrol acetate continuously for 3 months. We evaluated the efficacy of progestins for periods of three and/or six cycles by repeating EC. A statistical analysis of specific endometrial causes according to age of presentation was conducted using the chi-square test. Results: Among the 415 females (average age, 53.5 years) followed for 6 months, 186 had physiological changes (44.8%), 89 had simple hyperplasia (21.44%), 1 had atypical hyperplasia (0.2%), 6 had (1.44%) complex hyperplasia, 3 had (0.72%) atypical complex hyperplasia, and 5 had adenocarcinoma (1.2%). Regression rates were 72.7-100%, and the optimum results were observed after 6 months of hormonal therapy. Conclusions: The main cause of AUB was physiological change. Progestin therapy resulted in significant regression even in females with atypical hyperplasia. PMID:24870785
Mesci-Haftaci, Simender; Ankarali, Handan; Yavuzcan, Ali; Caglar, Mete
Finasteride in the treatment of clinical benign prostatic hyperplasia: A systematic review of randomised trials
BACKGROUND: Benign prostatic hyperplasia affects older men. This systematic review determined efficacy and adverse effects of finasteride. REVIEW METHODS: PubMed, the Cochrane Library, reference lists of reports, and reviews were searched for randomised, double-blind trials of finasteride in benign prostatic hyperplasia. Outcomes included symptom score, urinary flow rate, prostate volume, discontinuation, and adverse effects. Relative risk and NNT or NNH
Jayne E Edwards; R Andrew Moore
Effects of azithromycin on cyclosporine-induced gingival hyperplasia in renal transplant patients
BackgroundGingival hyperplasia is a well-known complication of cyclosporine therapy, affecting 21% to 35% of renal transplant patients. Metronidazole, clarithromycin, and azithromycin, all azalid antimicrobial agents derived from the macrolide antibiotic erythromycin, have been used for treatment. Marked improvements in gingival hyperplasia have been recorded in particular with azithromycin. The aim of the present study was to investigate histopathological features of
B. Tokg�z; H. I. Sar?; O. Y?ld?z; S. Aslan; M. Sipahio?lu; T. Okten; O. Oymak; C. Uta?
High Expression of Neutral Endopeptidase in Idiopathic Diffuse Hyperplasia of Pulmonary Neuroendocrine Cells
Idiopathic diffuse hyperplasia of pulmonary neuroendocrine cells (IDHPNC) is a clinicopathological entity characterized by a diffuse hyperplasia of neuroendocrine cells involving distal bronchi and bronchioles. The pathogenesis of this syndrome remains unknown. The hyperplastic neuroendo- crine (NE) cells contain multiple neuropeptides, including the bombesinlike peptides (BLP), which are likely important in the pathogenesis of the disorder by stimulating proliferation of
Gynecomastia-Like Hyperplasia of Axillary Ectopic Breast Tissue in a Young Female
Gynecomastia-like hyperplasia of orthotopic female breast tissue is a rare entity. We present the singularly unique case of a 22-year-old female who presented with a small axillary mass subsequently discovered to be a discrete deposit of ectopic breast tissue with gynecomastia-like hyperplasia. This case highlights the etiology, variable presentation, and evaluation of ectopic breast tissue.
Shatzel, Joseph; Khoury, Thaer; Milligan, Janine; Skitzki, Joseph J.
Fine needle aspiration cytology diagnosis of malignant lymphoma and reactive lymphoid hyperplasia
AIMS: To assess the diagnostic accuracy of lymph node fine needle aspiration (FNA) cytology to distinguish reactive lymphoid hyperplasia from malignant lymphoma, and to evaluate the contribution of ancillary techniques applied to cytological material. METHODS: Two hundred and seventy seven consecutive lymph node FNA specimens reported to be consistent with reactive lymphoid hyperplasia (n = 213) or suggestive\\/diagnostic of malignant
C. J. Stewart; J. A. Duncan; M. Farquharson; J. Richmond
Usual and atypical ductal hyperplasia�members of the same family?
Among the intraductal lesions, usual ductal hyperplasia, atypical ductal hyperplasia and ductal carcinoma in situ play a pivotal role for two reasons. (1) Within the currently accepted model of human breast cancer evolution, these lesions are still viewed as successive steps in a linear progression model, ultimately leading to invasive breast carcinoma. (2) Some of these lesions may pose considerable
W Boecker; H Buerger
Atypical ductal hyperplasia and ductal carcinoma in situ of the breast associated with perineural invasion
Perineural invasion is a histologic feature usually diagnostic of invasion in malignancies. In the breast, however, it has been associated with benign lesions such as sclerosing adenosis (SA), complex sclerosing lesion\\/radial scar (CSL\\/RS), and ductal carcinoma in situ (DCIS). This article describes perineural invasion associated with atypical ductal hyperplasia (ADH), florid hyperplasia without atypia (FH), and DCIS. All cases with
Helenice Gobbi; Roy A Jensen; Jean F Simpson; Sandra J Olson; David L Page
Tanshinone inhibits intimal hyperplasia in the ligated carotid artery in mice
Vascular smooth muscle cell (VSMC) proliferation is considered to play a central role in the development of intimal hyperplasia with pathological artery healing. Danshen, the Salvia miltiorrhiza Bge., has long been regarded as an effective traditional Chinese medicine for cardiovascular diseases. In this paper, the effects of tanshinone (TA), the lipid-soluble pharmacological constituents of danshen, on the intima hyperplasia and
Jun-rong Du; Xin Li; Rong Zhang; Zhong-ming Qian
Apoptosis May Be an Early Event of Progestin Therapy for Endometrial Hyperplasia
Objective. The aim of this study was to investigate the role of apoptosis during progestin therapy for the treatment of endometrial hyperplasia.Methods. Pre- and posttreatment paraffin-embedded endometrial tissue samples from 19 women with endometrial hyperplasia were examined for changes in glandular cellularity and apoptotic activity related to the administration of progestins. Twelve patients were successfully treated with progestin therapy and
Charlie A. Amezcua; Jean J. Lu; Juan C. Felix; Frank Z. Stanczyk; Wenxin Zheng
Aromatase inhibitor anastrozole for treating endometrial hyperplasia in obese postmenopausal women
This is a preliminary study investigating the efficacy of aromatase inhibitor anastrozole in treating endometrial hyperplasia in obese postmenopausal women. We administered anastrozole for 12 months to 11 obese postmenopausal women with high operative risk, in order to treat endometrial hyperplasia (four simple, five complex and two atypical). Endometrial thickness in all cases and histology too in the two cases
Theodoros Agorastos; Violeta Vaitsi; Konstantinos Pantazis; Efstathios Efstathiadis; Dimitrios Vavilis; John N. Bontis
Use of computerized morphometric analyses of endometrial hyperplasias in the prediction of coexistent cancer
OBJECTIVE: Our purpose was to determine whether computerized morphometric analysis is predictive of coexistent cancer in uteri that show endometrial hyperplasia in curettings or biopsy specimens. STUDY DESIGN: Forty-five patients with endometrial hyperplasia and 10 patients with well-differentiated cancers diagnosed from curettings or biopsy specimens and treated by hysterectomy at Thomas Jefferson University Hospital between 1989 and 1993 were identified
Charles J. Dunton; Jan P. A. Baak; Juan P. Palazzo; Paul J. van Diest; Mary McHugh; Eric A. Widra
Maspin expression, subcellular localization and clinicopathological correlation in endometrial hyperplasia and endometrial adenocarcinoma.
Maspin expression in endometrial hyperplasia and endometrial endometrioid adenocarcinomas was assessed and its correlation with p53 and Ki67 expressions and clinical outcome, as well as its potential to distinguish typical from atypical endometrial hyperplasia, were assessed in this study. Histological sections from 114 cases of endometrial endometrioid adenocarcinoma, 75 cases of endometrial hyperplasia (typical and atypical), and 23 normal endometrial tissue samples were examined. The most representative hematoxylin-eosin slides were selected and 2-3 micron-thick sections were cut for immunohistochemical staining with maspin, p53, and Ki67 antibodies. While there was no maspin expression in normal endometrial cells, it was present in 14.5% of the patients with endometrial hyperplasia without atypia. Staining for maspin was positive in atypical hyperplasia and endometrial adenocarcinoma in, respectively, 45% and 49.1% of the cases studied. No statistically significant correlations were found between maspin and Ki-67 antibodies or p53 expression. Our findings showed that maspin expression, which generally correlates with a less aggressive behavior, is significantly higher in atypical hyperplasia and in endometrial endometrioid adenocarcinoma. Maspin positivity in endometrial hyperplasia could be used to identify pseudo-atypical hyperplasia and could be considered a potentially useful prognostic parameter in those cases in which adenocarcinomas are well differentiated. PMID:24346847
Blandamura, Stella; Alessandrini, Lara; Saccardi, Carlo; Giacomelli, Luciano; Fabris, Alberta; Borghero, Angela; Litta, Pietro
Effect of an integral suspension of Lepidium latifolium on prostate hyperplasia in rats.
This paper studies the effect of an integral suspension of Lepidium latifolium on experimental induced prostate hyperplasia, in rats. Oral treatment with 0.86 mg kg(-1) day(-1) for 6 months, significantly reduced prostate size and volume in castrated rats where the hyperplasia were induced by steroid treatment. PMID:15030923
Mart�nez Caballero, S; Carricajo Fern�ndez, C; P�rez-Fern�ndez, R
Effect of an integral suspension of Lepidium latifolium on prostate hyperplasia in rats
This paper studies the effect of an integral suspension of Lepidium latifolium on experimental induced prostate hyperplasia, in rats. Oral treatment with 0.86 mg kg?1 day?1 for 6 months, significantly reduced prostate size and volume in castrated rats where the hyperplasia were induced by steroid treatment.
S. Mart??nez Caballero; C. Carricajo Fern�ndez; R. P�rez-Fern�ndez
Use of PR2000, a Herbal Formulation in the Medical Management of Benign Prostatic Hyperplasia
Benign prostatic hyperplasia (BPH) is one of the most common processes affecting elderly men. This study was undertaken to evaluate the efficacy of PR-2000, an herbal preparation in the treatment of patients with benign prostatic hyperplasia. The trial included 68 patients who were diagnosed with BPH and graded accordingly using the American Urological Association (AUA) symptom score, uroflowmetric study and
C. U. Shah; Mahender Nayak; Kala Suhas Kulkarni
Florid basal cell hyperplasia of the prostate: a histological, ultrastructural, and immunohistochemical analysis
Basal cell proliferation is a common finding in a benign hyperplastic prostate gland. Occasionally, basal cell hyperplasia is so florid that it can be mistaken for prostatic adenocarcinoma. We characterized histological, ultrastructural, and immunohistochemical features of florid basal cell hyperplasia from transurethral resections (n = 11) and prostatectomy specimens (n = 4). Fifteen cases of prostatic adenocarcinoma were used as
Ximing J Yang; Maria S Tretiakova; Elizabeth Sengupta; Can Gong; Zhong Jiang
The Association between Early Life and Adult Body Mass Index and Physical Activity with Risk of non-Hodgkin Lymphoma: Impact of Gender
Purpose To evaluate the association of body mass index (BMI) and physical activity (PA) during adulthood and at age 18 with risk of non-Hodgkin lymphoma (NHL). Methods We enrolled 950 newly diagnosed NHL patients and 1146 frequency-matched clinic-based controls. Height, weight, and PA (recent adult and at age 18) were self-reported. Odds ratios (OR), 95% confidence intervals (CI), and tests for trend were estimated using unconditional logistic regression adjusted for age, gender, and residence. Results BMI at age 18 was associated with an increased NHL risk (OR=1.38 for highest vs. lowest quartile, p-trend=0.0012), which on stratified analysis was specific to females (OR=1.90, p-trend=0.00025). There was no association of adult BMI with NHL risk. Higher physical activity in adulthood (OR=1.03, p-trend=0.85) or at age 18 (OR=0.88, 95%CI: 0.72�1.07) was not associated with risk, but there was an inverse association for adult physical activity that was specific to females (OR=0.71, p-trend=0.039). Only BMI at age 18 remained significantly associated with NHL risk when modeled together with adult or age 18 physical activity. There was little evidence for heterogeneity in these results for the common NHL subtypes. Conclusions Early adult BMI may be of greatest relevance to NHL risk, particularly in females.
Kelly, Jennifer L.; Fredericksen, Zachary S.; Liebow, Mark; Shanafelt, Tait D.; Thompson, Carrie A.; Call, Timothy G.; Habermann, Thomas M.; Macon, William R.; Wang, Alice H.; Slager, Susan L.; Cerhan, James R.
Perinatal exposure to the xenoestrogen bisphenol-A induces mammary intraductal hyperplasias in adult CD-1 mice
Humans are routinely exposed to bisphenol-A (BPA), an estrogenic compound that leaches from consumer products. Given the sensitivity of the developing organism to hormones, exposure of fetuses and infants is a concern. Here, CD-1 mice were exposed to environmentally relevant doses of BPA during gestation and the lactational period (gestational day 8 through postnatal day 16). At 3, 9 and 12�15 months of age, mammary glands from exposed offspring were examined for structural changes. BPA-exposed females demonstrated altered mammary phenotypes including the appearance of alveolar buds. Additionally, intraductal hyperplasias were observed exclusively in BPA�exposed females. These lesions had the appearance of �beaded� ducts, with epithelial cells present inside the ductal lumen and increased proliferation indexes compared to normal ducts. Similar structures have also been observed following exposure to other estrogens. These results are further evidence that perinatal BPA exposure can alter the morphology of the rodent mammary gland in adulthood.
Vandenberg, Laura N.; Maffini, Maricel V.; Schaeberle, Cheryl M.; Ucci, Angelo A.; Sonnenschein, Carlos; Rubin, Beverly S.; Soto, Ana M.
[Specifics of hormonal and energy balance in patients with hyperplasia and endometrial neoplasia with metabolic syndrome in the background].
We conducted a comparative investigation of the hormonal status (LH, FSH, estradiol, progesterone, testosterone, prolactin, SHBG), energy status (leptin, ghrelin, insulin), and carbohydrate and lipid metabolism in patients with endometrial hyperplasia and neoplasia (168 patients) with or without metabolic syndrome in the background. Patients with metabolic syndrome had a high frequency of elevated estrogen (72%), testosterone (65%), insulin (81%), leptin (68%). There was a marked increase in the basal level of luteinizing hormone, prolactin, index, LH/FSH, but decrease in FSH and progesterone. There were significant changes in carbohydrate and lipid metabolism. The possible mechanisms for the contribution of the investigated factors to the development of the pathological processes in the endometrium are presented. PMID:23814828
Chernyshova, A L; Kolomiets, L A; Bochkar�va, N V; Kondakova, I V
Impact of heat stress on conception rate of dairy cows in the moderate climate considering different temperature-humidity index thresholds, periods relative to breeding, and heat load indices.
The objectives of this retrospective study were to investigate the relationship between temperature-humidity index (THI) and conception rate (CR) of lactating dairy cows, to estimate a threshold for this relationship, and to identify periods of exposure to heat stress relative to breeding in an area of moderate climate. In addition, we compared three different heat load indices related to CR: mean THI, maximum THI, and number of hours above the mean THI threshold. The THI threshold for the influence of heat stress on CR was 73. It was statistically chosen based on the observed relationship between the mean THI at the day of breeding and the resulting CR. Negative effects of heat stress, however, were already apparent at lower levels of THI, and 1 hour of mean THI of 73 or more decreased the CR significantly. The CR of lactating dairy cows was negatively affected by heat stress both before and after the day of breeding. The greatest negative impact of heat stress on CR was observed 21 to 1 day before breeding. When the mean THI was 73 or more in this period, CR decreased from 31% to 12%. Compared with the average maximum THI and the total number of hours above a threshold of more than or 9 hours, the mean THI was the most sensitive heat load index relating to CR. These results indicate that the CR of dairy cows raised in the moderate climates is highly affected by heat stress. PMID:24612695
Sch�ller, L K; Burfeind, O; Heuwieser, W
Sexual dysfunction and lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH).
Sexuality is an essential aspect of a couple's relationship and has a significant impact on life satisfaction. Benign prostatic hyperplasia (BPH) is a condition that commonly affects older men and is often associated with lower urinary tract symptoms (LUTS) and sexual dysfunction. Men with moderate-to-severe LUTS are at increased risk for sexual dysfunction, including moderate-to-severe erectile dysfunction (ED), ejaculatory dysfunction (EjD), and hypoactive desire (HD). The results of several recent large-scale studies have shown a consistent and strong relationship between LUTS and both ED and EjD. It appears that the pathophysiological mechanisms of LUTS and the related prostatic enlargement of BPH as well as certain treatments for this condition may have an impact on both the erection and ejaculation components of the sexual response. Validated questionnaires that assess sexual function provide clinicians with valuable information to help guide treatment selection decisions. Effective medical therapies for LUTS associated with BPH include alpha(1)-adrenergic receptor antagonists (i.e., alfuzosin, doxazosin, tamsulosin, and terazosin) and 5alpha-reductase inhibitors (i.e., finasteride and dutasteride). The side effects of these medications, including sexual dysfunction, are important distinguishing features. The successful management of patients with LUTS associated with BPH should include assessments of sexual function and monitoring of medication-related sexual side effects. For men with LUTS and sexual dysfunction, an appropriate integrated management approach, based on each patient's symptoms and outcome objectives, is warranted. PMID:15925080
Rosen, Raymond C; Giuliano, Francois; Carson, Culley C
p53 nuclear accumulation and ER? expression in ductal hyperplasia of breast in a cohort of 215 Chinese women
INTRODUCTION: Women with ductal hyperplasia including usual ductal hyperplasia (UDH) and atypical ductal hyperplasia (ADH) have an increased risk of developing invasive ductal carcinoma (IDC) of breast. The importance of several molecular markers in breast cancer has been of considerable interest during recent years such as p53 and estrogen receptor alpha (ER?). However, p53 nuclear accumulation and ER? expression have
Xiao-yun Mao; Chui-feng Fan; Hua-chuan Zheng; Jing Wei; Fan Yao; Feng Jin
Impact of Cardiovascular Risk Factors on Progression of Arteriosclerosis in Younger Patients: Evaluation by Carotid Duplex Ultrasonography and Cardio-Ankle Vascular Index(CAVI).
Aim: To evaluate progression of arteriosclerosis using cardio-ankle vascular index(CAVI) and carotid duplex ultrasonography(DUS) in young and adolescent patients considered to be at risk of cardiovascular disease. Methods: We evaluated the progression of arteriosclerosis using CAVI and carotid DUS in 240 young and adolescent patients. Dyslipidemia(DL), hypertension(HT), and diabetes mellitus(DM) were major cardiovascular risk factors. Patients were divided to 4 groups according to number of risk factors. Results: In terms of risk factors, CAVI and CAVI difference(CAVI-D) were elevated only in the HT group(p=0.0290, p=0.0243 vs. no risk respectively). CAVI-D was positively associated with diastolic blood pressure(DBP). Mean IMT was positively associated with LDL-C or systolic blood pressure, and negatively with HDL-C. Plaque score was associated with LDL-C or DBP. In patients with the 3 risk factors, CAVI, CAVI-D and mean intima-media thickness(IMT) were significantly higher than in those without risk(p=0.0009, p=0.0042 and p=0.0151 respectively), and CAVI and CAVID were higher than in those with 1 risk(p=0.0204 and p=0.0231). Carotid plaque develops from around 30 years of age in Japan. Despite numbers of risk factors, there were no differences in CAVI, CAVI-D, mean IMT or plaque score between smoker and non-smoker groups. Conclusion: In conclusion, an increase in the number of risk factors also results in progression of arteriosclerosis in young and adolescent patients. HT was the most important risk factor for arteriosclerosis in these patients. PMID:24521982
Suzuki, Jun; Kurosu, Takumi; Kon, Tokuo; Tomaru, Takanobu
Offshore wind farms as productive sites or ecological traps for gadoid fishes?--impact on growth, condition index and diet composition.
With the construction of wind farms all across the North Sea, numerous artificial reefs are created. These windmill artificial reefs (WARs) harbour high abundances of fish species which can be attracted from�elsewhere or can be the result of extra production induced by these wind farms. To resolve the attraction-production debate in suddenly altered ecosystems (cf. wind farms), the possible consequences of attraction should be assessed; thereby bearing in mind that ecological traps may arise. In this paper we investigated whether the wind farms in the Belgian part of the North Sea act as ecological traps for pouting and Atlantic cod. Length-at-age, condition and diet composition of fish present at the windmill artificial reefs was compared to local and regional sandy areas. Fish data from the period 2009-2012 were evaluated. Mainly I- and II-group Atlantic cod were present around the WARs; while the 0- and I-group dominated for pouting. For Atlantic cod, no differences in length were observed between sites, indicating that fitness was comparable at the WARs and in sandy areas. No significant differences in condition index were observed for pouting. At the WARs, they were slightly larger and stomach fullness was enhanced compared to the surrounding sandy areas. Also diet differed considerably among the sites. The outcome of the proxies indicate that fitness of pouting was slightly enhanced compared to the surrounding sandy areas. No evidence was obtained supporting the hypothesis that the WARs act as an ecological trap for Atlantic cod and pouting. PMID:23800713
Reubens, Jan T; Vandendriessche, Sofie; Zenner, Annemie N; Degraer, Steven; Vincx, Magda
The Long and Short Term Impact of Elevated Body Mass Index on Risk of New Atrial Fibrillation in the Women's Health Study
Objectives To characterize the relationship between changes in body mass index (BMI) and incident atrial fibrillation (AF) in a large cohort of women. Background Obesity and AF are increasing public health problems. The importance of dynamic obesity-associated AF risk is uncertain, and mediators are not well characterized. Methods Cases of AF were confirmed by medical record review in 34,309 participants in the Women�s Health Study. Baseline and updated measures of BMI were obtained from periodic questionnaires. Results Over 12.9 +/? 1.9 years of follow-up, 834 AF events were confirmed. BMI was linearly associated with AF risk, with a 4.7% (95% CI 3.4, 6.1, p<0.0001) increase in risk with each kg/m2. Adjustment for inflammatory markers minimally attenuated this risk. When updated measures of BMI were utilized to estimate dynamic risk, overweight (HR 1.22 95%CI 1.02, 1.45, p=0.03) and obesity (HR 1.65 95%CI 1.36, 2.00, p<0.0001) were associated with adjusted short term elevations in AF risk. Participants becoming obese during the first 60 months had a 41% adjusted increase in risk of developing AF (p=0.02) compared to those maintaining BMI <30 kg/m2. The prevalence of overweight and obesity increased over time. The adjusted proportion of incident AF attributable to short term elevations in BMI was substantial (18.3%). Conclusions In this population of apparently healthy women, BMI was associated with short and long term elevations in AF risk, accounting for a large proportion of incident AF independent of traditional risk factors. A strategy of weight control may reduce the increasing incidence of AF.
Tedrow, Usha B; Conen, David; Ridker, Paul M; Cook, Nancy R; Koplan, Bruce A; Manson, JoAnn E; Buring, Julie E; Albert, Christine M
Downstream anastomotic hyperplasia. A mechanism of failure in Dacron arterial grafts.
The precise location and progression of anastomotic hyperplasia and its possible relationship to flow disturbances was investigated in femoro-femoral Dacron grafts in 28 dogs. In 13 grafts, the outflow from the end-to-side downstream anastomosis was bidirectional (BDO), and in 15 it was unidirectional (UDO) (distally). Grafts were electively removed at intervals of two to 196 days or at the time of thrombosis. Each anastomosis and adjacent artery was perfusion-fixed and sectioned sagittally. The mean sagittal section was projected onto a digitized pad, and the total area of hyperplasia internal to the arterial internal elastic lamina and within the adjacent graft was integrated by computer. The location of the hyperplasia was compared with previously established sites of flow separation and stagnation. The observation was made that hyperplasia is significantly greater at the downstream, as compared with the upstream, anastomosis in both groups (BDO = p less than 0.001 and UDO = p less than 0.001) (analysis of variance for independent groups). Furthermore, this downstream hyperplasia was progressive with time (BDO p less than 0.01) (UDO p less than 0.01); Spearman Rank Correlation. There was no significant increase in the extent of downstream hyperplasia where flow separation was known to be greater (BDO). Five grafts failed (three BDO, two UDO), as a result of complete occlusion of the downstream anastomosis by fibrous hyperplasia. Transmission electron microscopy showed the hyperplasia to consist of collagen-producing smooth muscle cells. Anastomotic hyperplasia is significantly greater at the downstream anastomosis, is progressive with time, and is the primary cause of failure of Dacron arterial grafts in this model. Quantitative analysis of downstream anastomotic hyperplasia may be a valuable measure of the biocompatibility of Dacron grafts. Images Fig. 2. Fig. 3. Fig. 5. Fig. 6. Fig. 7. Fig. 8.
LoGerfo, F W; Quist, W C; Nowak, M D; Crawshaw, H M; Haudenschild, C C
Impact of Waist Circumference and Body Mass Index on Risk of Cardiometabolic Disorder and Cardiovascular Disease in Chinese Adults: A National Diabetes and Metabolic Disorders Survey
Background We updated the prevalence of obesity and evaluated the clinical utility of separate and combined waist circumference (WC) or body mass index (BMI) category increments in identifying cardiometabolic disorder (CMD) and cardiovascular disease (CVD) risk in Chinese adults. Methods and Findings 46,024 participants aged ?20 years, a nationally representative sample surveyed in 2007�2008, were included in this analysis. Taking the cutoffs recommended by the Chinese Joint Committee for Developing Chinese Guidelines (JCDCG) and the Working Group on Obesity in China (WGOC) into account, the participants were divided into four WC and four BMI groups in 0.5-SD increments around the mean, and 16 cross-tabulated combination groups of WC and BMI. 27.1%, 31.4%, and 12.2% of Chinese adults are centrally obese, overweight, or obese according to JCDCG and WGOC criteria. After adjustment for confounders, after a 1-SD increment, WC is associated with a 1.7-fold or 2.2-fold greater risk of having DM or DM plus dyslipidemia than BMI, while BMI was associated with a 2.3-fold or 1.7-fold higher hypertension or hypertension plus dyslipidemia risk than WC. The combination of WC and BMI categories had stronger association with CMD risk, i.e., the adjusted ORs (95% CI) of having DM, hypertension, and dyslipidemia for the combined and separate highest WC and BMI categories were 2.19 (1.96�2.44) vs 1.88 (1.67�2.12) and 1.12 (0.99�1.26); 5.70 (5.24�6.19) vs 1.51 (1.39�1.65) and 1.69 (1.57�1.82); and 3.73 (3.42�4.07) vs 2.16 (1.98�2.35) and 1.33 (1.25�1.40), respectively. The combination of WC and BMI categories was more likely to identify individuals with lower WC and lower BMI at CVD risk, even after the effects of CMD were controlled (all P<0.05). Conclusion Central obesity, overweight, and obesity are epidemic in Chinese adults. The combination of WC and BMI measures is superior to the separate indices in identifying CMD and CVD risk.
Hou, Xuhong; Lu, Juming; Weng, Jianping; Ji, Linong; Shan, Zhongyan; Liu, Jie; Tian, Haoming; Ji, Qiuhe; Zhu, Dalong; Ge, Jiapu; Lin, Lixiang; Chen, Li; Guo, Xiaohui; Zhao, Zhigang; Li, Qiang; Zhou, Zhiguang; Shan, Guangliang; Yang, Zhaojun; Yang, Wenying; Jia, Weiping
Indexing Consistency and Quality.
ERIC Educational Resources Information Center
Proposed is a measure of indexing consistency based on the concept of "fuzzy sets." By this procedure a higher consistency value is assigned if indexers agree on the more important terms than if they agree on less important terms. Measures of the quality of an indexer's work and exhaustivity of indexing are also proposed. Experimental data on�
Zunde, Pranas; Dexter, Margaret E.
A restriction site indexing method for selectively amplifying any fragment generated by a Class II restriction enzyme includes adaptors specific to fragment ends containing adaptor indexing sequences complementary to fragment indexing sequences near the termini of fragments generated by Class II enzyme cleavage. A method for combinatorial indexing facilitates amplification of restriction fragments whose sequence is not known.
Guilfoyle, Richard A. (Madison, WI) [Madison, WI; Guo, Zhen (Bellevue, WA) [Bellevue, WA
A restriction site indexing method for selectively amplifying any fragment generated by a Class II restriction enzyme includes adaptors specific to fragment ends containing adaptor indexing sequences complementary to fragment indexing sequences near the termini of fragments generated by Class II enzyme cleavage. A method for combinatorial indexing facilitates amplification of restriction fragments whose sequence is not known.
Guilfoyle, Richard A. (Madison, WI) [Madison, WI; Guo, Zhen (Bellevue, WA) [Bellevue, WA
Differential impact of body mass index on absolute and percent breast density: implications regarding their use as breast cancer risk biomarkers.
Percent breast density (PBD), a commonly used biomarker of breast cancer risk (BCR), is confounded by the influence of non-dense breast tissue on its measurement and factors, such as BMI, which have an impact on non-dense tissue. Consequently, BMI, a potent BCR factor, is, paradoxically, negatively correlated with PBD. We propose that absolute breast density (ABD) is a more accurate biomarker of BCR. We used a volumetric method to compare the correlation between PBD and ABD with baseline demographics and dietary and physical activity variables in a group of 169 postmenopausal women enrolled in a clinical trial prior to any intervention. As expected, a strong negative correlation between PBD and BMI was observed (Rho�=�-0.5, p�<�5e(-12)). In contrast, we observed a strong, previously not well established, positive correlation of BMI with ABD (Rho�=�0.41, p�<�2.5e(-8)), which supports the use of ABD as a more accurate indicator of BCR. Correction of PBD by BMI did not frequently provide the same information as ABD. In addition, because of the strong influence of BMI on ABD, many correlations between dietary variables and ABD did not emerge, until adjustment was made for BMI. ABD corrected by BMI should be the gold standard BD measurement. These findings identify the optimal measurement of BD when testing the influence of an intervention on BD as a biomarker of BCR. PMID:24951269
Schetter, Susann E; Hartman, Terryl J; Liao, Jason; Richie, John P; Prokopczyk, Bogdan; DuBrock, Cindy; Signori, Carina; Hamilton, Christopher; Demers, Laurence M; El-Bayoumy, Karam; Manni, Andrea
Prevention of Bronchial Hyperplasia by EGFR Pathway Inhibitors in an Organotypic Culture Model
Lung cancer is the leading cause of cancer-related mortality worldwide. Early detection or prevention strategies are urgently needed to increase survival. Hyperplasia is the first morphologic change that occurs in the bronchial epithelium during lung cancer development, followed by squamous metaplasia, dysplasia, carcinoma in situ, and invasive tumor. The current study was designed to determine the molecular mechanisms that control bronchial epithelium hyperplasia. Using primary normal human tracheobronchial epithelial (NHTBE) cells cultured using the 3-dimensional organotypic method, we found that the epidermal growth factor receptor (EGFR) ligands EGF, transforming growth factor-alpha, and amphiregulin induced hyperplasia, as determined by cell proliferation and multilayered epithelium formation. We also found that EGF induced increased cyclin D1 expression, which plays a critical role in bronchial hyperplasia; this overexpression was mediated by activating the mitogen-activated protein kinase pathway but not the phosphoinositide 3-kinase/Akt signaling pathway. Erlotinib, an EGFR tyrosine kinase inhibitor, and U0126, a MEK inhibitor, completely inhibited EGF-induced hyperplasia. Furthermore, a promoter analysis revealed that the activator protein-1 transcription factor regulates EGF-induced cyclin D1 overexpression. Activator protein-1 depletion using siRNA targeting its c-Jun component completely abrogated EGF-induced cyclin D1 expression. In conclusion, we demonstrated that bronchial hyperplasia can be modeled in vitro using primary NHTBE cells maintained in a 3-dimensional (3-D) organotypic culture. EGFR and MEK inhibitors completely blocked EGF-induced bronchial hyperplasia, suggesting that they have a chemopreventive role.
Lee, Jangsoon; Ryu, Seung-Hee; Kang, Shin Myung; Chung, Wen-Cheng; Gold, Kathryn Ann; Kim, Edward S.; Hittelman, Walter N.; Hong, Waun Ki; Koo, Ja Seok
A Primary Care Physician's Perspective on Benign Prostatic Hyperplasia
Primary care clinicians are generally the first point of contact for men who suffer troublesome symptoms of benign prostatic hyperplasia. Although a subset of these patients will ultimately require referral to a urologist for an invasive procedure to provide symptom control, the majority can be appropriately managed in the ambulatory setting. Most symptomatic men respond favorably to ?-blockers, which provide prompt improvement in symptoms such as nocturia. Although ?-blockers may control troublesome lower urinary tract symptoms, there is no suggestion that they forestall the need for surgery or reduce the likelihood of development of acute urinary retention. Therefore, clinicians need to become familiar with use of 5-?-reductase inhibitors, as this is the only class of pharmacotherapy that has been shown to have a diseasemodifying effect.
Kuritzky, Louis
Spontaneous regression of focal nodular hyperplasia: a pathological report
Focal nodular hyperplasia (FNH) is a benign tumour of the liver, occurring in 0.6�3% of the general population. Most lesions are diagnosed incidentally. With the increasing use and improvement of diagnostic imaging, FNH is being observed more often. It has been shown, using radiological approaches, that most FNH remain stable, or even regress, over a long follow-up period. In addition, it is extremely rare that FNH were discovered in elderly. However, to our knowledge, there is no pathological report illustrating the regression of FNH. We report here a case showing the pathological changes occurring during the regression phase of FNH, with dense fibrous tissue mixed with arteries replacing hepatocytes nodules.
Laumonier, H; Leblanc, F; Balabaud, C; Bioulac-Sage, P
Spontaneous regression of focal nodular hyperplasia: a pathological report.
Focal nodular hyperplasia (FNH) is a benign tumour of the liver, occurring in 0.6-3% of the general population. Most lesions are diagnosed incidentally. With the increasing use and improvement of diagnostic imaging, FNH is being observed more often. It has been shown, using radiological approaches, that most FNH remain stable, or even regress, over a long follow-up period. In addition, it is extremely rare that FNH were discovered in elderly. However, to our knowledge, there is no pathological report illustrating the regression of FNH. We report here a case showing the pathological changes occurring during the regression phase of FNH, with dense fibrous tissue mixed with arteries replacing hepatocytes nodules. PMID:22778370
Laumonier, H; Leblanc, F; Balabaud, C; Bioulac-Sage, P
Subpontic osseous hyperplasia: Three case reports and literature review
Subpontic osseous hyperplasia (SOH) is an ectopic growth of bone occurring on the edentulous ridge beneath a fixed partial denture. The aim of this article is to present three patients with SOH with long-term follow-up and to make a current overview of the literature. Presented maxillary SOH is the second case in the dental literature. Intraorally the lesions were bone-hard and painless swellings in the subpontic space. Radiographically, the maxillary case was a nodular bone growth having similar radiodensity and trabeculation to the adjacent bone with a thin radiopaque border. Mandibular cases were bony growths, which were more radiopaque than the adjacent alveolar ridge. Follow-up radiographs revealed regression in two of the cases. Clinicians should take care not to cause the possible etiologies of SOH such as functional stresses and chronic irritation by the prosthetic treatments and be aware of SOH does not usually require treatment or a biopsy.
Aydin, Ulkem; Yildirim, Derya; Bozdemir, Esin
Diagnosis and management of classical congenital adrenal hyperplasia.
Congenital adrenal hyperplasia (CAH) is among the most common genetic disorders. Deficiency of adrenal steroid 21-hydroxylase deficiency due to mutations in the CYP21A2 gene accounts for about 95% cases of CAH. This disorder manifests with androgen excess with or without salt wasting. It also is a potentially life threatening disorder; neonatal screening with 17-hydroxyprogesterone measurement can diagnose the condition in asymptomatic children. Carefully monitored therapy with glucocorticoid and mineralocorticoid supplementation will ensure optimal growth and development for children with CAH. Genital surgery may be required for girls with CAH. Continued care is required for individuals with CAH as adults to prevent long-term adverse consequences of the disease, including infertility, metabolic syndrome and osteoporosis. PMID:23624029
Marumudi, Eunice; Khadgawat, Rajesh; Surana, Vineet; Shabir, Iram; Joseph, Angela; Ammini, Ariachery C
Diagnosis and management of hepatic focal nodular hyperplasia
Focal nodular hyperplasia (FNH) is the second most common benign tumor of the liver, after hemangioma. It is generally found incidentally and is most common in reproductive-aged women, but it also affects males and can be diagnosed at any age. Patients are rarely symptomatic, but FNH sometimes causes epigastric or right upper quadrant pain. The main clinical task is to differentiate it from other hypervascular hepatic lesions such as hepatic adenoma, hepatocellular carcinoma, or hypervascular metastases, but invasive diagnostic procedures can generally be avoided with the appropriate use of imaging techniques. Magnetic resonance (MR) imaging is more sensitive and specific than conventional ultrasonography (US) or computed tomography (CT), but Doppler US and contrast-enhanced US (CEUS) can greatly improve the accuracy in the diagnosis of FNH. Once a correct diagnosis has been made, in most cases there is no indication for surgery, and treatment includes conservative clinical follow-up in asymptomatic patients.
Venturi, A.; Piscaglia, F.; Vidili, G.; Flori, S.; Righini, R.; Golfieri, R.; Bolondi, L.
Bartholin's Gland Bilateral Nodular Hyperplasia: A Case Report Study
Introduction: Tumors which originate from the Bartholin�s glands (BGs) are very rare. Many solid masses that arise from the BGs are carcinoma, though these benign solid lesions are rare. Case Presentation: To the best of the reporter�s knowledge, about 35 cases have been reported in the English literature so far, most of which accompanied with signs or symptoms of Bartholin�s duct cyst. In this paper we report a 43-year-old woman with bilateral solid masses in the BGs, incidentally detected during anterior-posterior colpoperineoplasty. The masses were then excised. Discussion: The histopathological examination showed increased number of acini with preserved duct-acinar connection, consistent with nodular hyperplasia. The patient had used oral contraceptive pill for four years.
Akbarzadeh Jahromi, Mojgan; Sari Aslani, Fatemeh; Samsami Dehghani, Alamtaj; Mahmoodi, Elham
[5-alpha-reductase inhibitors in benign prostatic hyperplasia].
Sixteen patients presenting benign prostate gland hyperplasia undergo conservative treatment with Finasterid over the period 1992 through 1995. Prior to treatment, in all patients the subjective complaints are assayed on the basis of the IPSS rating system for severity of complaints. Uroflowmetry along with evaluating the quantity of residual urine using an isotope method, and echographic determination of the prostate gland volume, are performed. During the six- to nine-month follow-up study, an increase in maximal urinary output by 3.2 ml/sec, as well as reduction of the prostate gland volume by 24.5 per cent are documented in 78 per cent of the patients against the background of alleviated subjective complaints in 69 per cent. PMID:9379618
Panchev, P; Ne?kov, K
Silodosin in the treatment of benign prostatic hyperplasia
Benign prostatic hyperplasia (BPH)-associated lower urinary tract symptoms (LUTS) are highly prevalent in older men. Medical therapy is the first-line treatment for LUTS due to BPH. Alpha-adrenergic receptor blockers remain one of the mainstays in the treatment of male LUTS and clinical BPH. They exhibit early onset of efficacy with regard to both symptoms and flow rate improvement, and this is clearly demonstrated in placebo-controlled trials with extensions out to five years. These agents have been shown to prevent symptomatic progression of the disease. The aim of this article is to offer a critical review of the current literature on silodosin, formerly known as KMD-3213, a novel alpha-blocker with unprecedented selectivity for ?1A-adrenergic receptors, as compared with both ?1B- and ?1D -adrenoceptors, exceeding the selectivity of all currently used ?1-blockers, and with clinically promising effects.
Rossi, Maxime; Roumeguere, Thierry
Brunner's gland hyperplasia at the ampulla of Vater.
Brunner's gland hyperplasia (BGH) is a diagnostic challenge where in the pathophysiology and natural history remain poorly understood. This Case Report describes BGH arising at the ampulla of Vater, causing abdominal pain and vomiting in a 46-year-old man. Owing to the inconclusive nature of imaging studies and suspicious intraoperative findings, a Whipple resection was performed without any complications. Histological analysis showed that the obstructing lesion was BGH, with no evidence of malignancy. This is only the second such case of its kind at the ampulla of Vater to be reported. In addition, we present the previously unreported endoscopic ultrasound findings. The subsequent literature review focuses on the pathophysiology, clinical presentation, diagnosis and management of BGH. PMID:16534163
Janes, S E J; Zaitoun, A M; Catton, J A; Aithal, G P; Beckingham, I J
Thymic hyperplasia in a patient with Graves' disease.
Hyperplastic changes of the thymus may be found in patients with Graves' disease. However, this rarely presents as an anterior mediastinal mass, particularly among adults. In this report, we describe a 32-year old woman with Graves' disease and hyperthyroidism. During medical evaluation and treatment for her hyperthyroidism, a large anterior mediastinal mass was incidentally discovered. A cytological study of the lesion via computed tomogram-guided fine needle biopsy could not make a definitive diagnosis and suggested the possibility of a thymoma, which led to a surgical exploration. However, the final pathological diagnosis of the surgically removed tissue was thymic hyperplasia. The relationship between Graves' disease and thymic changes is discussed. PMID:11355328
Hsu, L H; Chen, J C; Tsai, G J; Tsou, M H; Hsu, W H
Luteinized cystic ovarian hyperplasia associated with placentomegaly due to chorangiomatosis.
Luteinized cystic ovarian hyperplasia (LCOH) is a rare benign condition characterized by bilateral ovarian enlargement during pregnancy secondary to high maternal human chorionic gonadotropin serum levels referred to occur under several conditions. We report the case of a 29-year-old obese woman with LCOH incidentally discovered during cesarean section of a single pregnancy at 35 weeks of gestation for fetal intrauterine demise. The fetus showed external ambiguous genitalia, imperforate anus, bilateral dysplastic kidneys, and hydrometrocolpos secondary to atresia of the vagina. The placental weight was 1,450g (normal for gestational age: 415g). The placenta showed diffuse chorangiomatosis (CM) characterized by multifocal stem villi enlargement containing increased number of small vessels with alpha-smooth muscle actin positive cells in the walls in a dense reticulin fibers-rich stroma. The combination of LCOH and placentomegaly due to CM appears to be unique. PMID:16175750
Saltzman, Mario; Drut, M�nica; Drut, Ricardo
Mandible condylar hyperplasia: a review of diagnosis and treatment protocol
Condylar hyperplasia (CH) is a bone disease characterized by the increased development of one mandibular condyle. It regularly presents as an active growth with facial asymmetry generally without pain. Statistically it affects more women in adolescence, although it does not discriminate by age or gender. Its best-known consequence is asymmetric facial deformity (AFD), which combined with alteration of the dental occlusion with unilateral crossbite or open bite. It is not known when CH begins and how long it lasts; diagnostic examinations are described and are efficient in some research about diagnosis. Protocol treatment is not well studie and depends on the criteria described in this paper. The aim of this research is to provide up-to-date information about the diagnosis of this disease and to analyze the treatment protocol, visualizing the CH and AFD presented.
Olate, Sergio; Netto, Henrique Duque; Rodriguez-Chessa, Jaime; Alister, Juan Pablo; de Albergaria-Barbosa, Jose; de Moraes, Marcio
Nerve hyperplasia: a unique feature of ketamine cystitis
Background There is an emerging association between ketamine abuse and the development of urological symptoms including dysuria, frequency and urgency, which have a neurological component. In addition, extreme cases are associated with severe unresolving bladder pain in conjunction with a thickened, contracted bladder and an ulcerated/absent urothelium. Here we report on unusual neuropathological features seen by immunohistology in ketamine cystitis. Results In all cases, the lamina propria was replete with fine neurofilament protein (NFP+) nerve fibres and in most patients (20/21), there was prominent peripheral nerve fascicle hyperplasia that showed particular resemblance to Morton�s neuroma. The nerve fascicles, which were positive for NFP, S100 and the p75 low-affinity nerve growth factor receptor (NGFR), were generally associated with a well-developed and in places, prominent, epithelial membrane antigen+/NGFR+ perineurium. This peripheral nerve fascicle hyperplasia is likely to account for the extreme pain experienced by ketamine cystitis patients. Urothelial damage was a notable feature of all ketamine cystitis specimens and where urothelium remained, increased NGFR expression was observed, with expansion from a basal-restricted normal pattern of expression into the suprabasal urothelium. Conclusions The histological findings were distinguishing features of ketamine cystitis and were not present in other painful bladder conditions. Ketamine cystitis afflicts predominantly young patients, with unknown long-term consequences, and requires a strategy to control severe bladder pain in order to remove a dependency on the causative agent. Our study indicates that the development of pain in ketamine cystitis is mediated through a specific neurogenic mechanism that may also implicate the urothelium.
Serenoa repens extract in the treatment of benign prostatic hyperplasia.
We are experiencing a revival of interest in phytotherapeutic agents, both in Europe and North America, especially as a consequence of patients' dissatisfaction with the adverse effects of the medical alternatives. One of the most frequently prescribed and studied such agents is Serenoa repens extract, derived from the berry of the dwarf palm tree. We aimed to review the most important published data regarding this type of treatment for benign prostatic hyperplasia. A review of the existing articles regarding the use of Serenoa repens extracts for benign prostatic hyperplasia was performed. The articles were analysed with regard to their relevance, scientific value and the size of the evaluated series. Multiple mechanisms of action have been attributed to this extract, including antiandrogenic action, an anti-inflammatory/anti-oedematous effect, prolactin signal modulation, and an antiproliferative effect exerted through the inhibition of growth factors. Regarding efficacy, European Association of Urology guidelines state that Serenoa repens extracts significantly reduce nocturia in comparison with placebo. However, the guideline committee is unable to make specific recommendations about phytotherapy of male lower urinary tract symptoms owing to the heterogeneity of the products and the methodological problems associated with meta-analyses. Most of the published trials regarding Serenoa repens phytotherapy demonstrate a significant improvement of urinary status and a favourable safety profile. Also, some authors have credited it with giving a significant improvement in erectile function and decreasing complications following transurethral resection of the prostate, especially bleeding. The results of phytotherapy with Serenoa repens extracts are very promising. More high-quality, randomized, placebo-controlled studies are required in order to demonstrate without doubt the true therapeutic value of these products. Particular attention must be focused on differentiating between registered preparations, which are regulated as drugs, and those considered to be food supplements. PMID:21969849
Geavlete, Petrisor; Multescu, Razvan; Geavlete, Bogdan
Serenoa repens extract in the treatment of benign prostatic hyperplasia
We are experiencing a revival of interest in phytotherapeutic agents, both in Europe and North America, especially as a consequence of patients� dissatisfaction with the adverse effects of the medical alternatives. One of the most frequently prescribed and studied such agents is Serenoa repens extract, derived from the berry of the dwarf palm tree. We aimed to review the most important published data regarding this type of treatment for benign prostatic hyperplasia. A review of the existing articles regarding the use of Serenoa repens extracts for benign prostatic hyperplasia was performed. The articles were analysed with regard to their relevance, scientific value and the size of the evaluated series. Multiple mechanisms of action have been attributed to this extract, including antiandrogenic action, an anti-inflammatory/anti-oedematous effect, prolactin signal modulation, and an antiproliferative effect exerted through the inhibition of growth factors. Regarding efficacy, European Association of Urology guidelines state that Serenoa repens extracts significantly reduce nocturia in comparison with placebo. However, the guideline committee is unable to make specific recommendations about phytotherapy of male lower urinary tract symptoms owing to the heterogeneity of the products and the methodological problems associated with meta-analyses. Most of the published trials regarding Serenoa repens phytotherapy demonstrate a significant improvement of urinary status and a favourable safety profile. Also, some authors have credited it with giving a significant improvement in erectile function and decreasing complications following transurethral resection of the prostate, especially bleeding. The results of phytotherapy with Serenoa repens extracts are very promising. More high-quality, randomized, placebo-controlled studies are required in order to demonstrate without doubt the true therapeutic value of these products. Particular attention must be focused on differentiating between registered preparations, which are regulated as drugs, and those considered to be food supplements.
Geavlete, Petrisor; Multescu, Razvan; Geavlete, Bogdan
Effect of Boerhaavia diffusa in experimental prostatic hyperplasia in rats
Objective: Present investigation was undertaken to study the effectiveness of hydroalcoholic extract of roots of Boerhaavia diffusa in experimental benign prostatic hyperplasia (BPH) in rats using various animal models. Materials and Methods: BPH in rats was induced by subcutaneous injection of testosterone (5 mg/kg) daily for 28 days. Rats were divided in to five groups (six rats each). A negative control group received arachis oil (1 ml/kg s.c.) and four groups were injected testosterone. These four groups were further divided into reference group (finasteride 1 mg/kg), model group (testosterone), study group A (B. diffusa 100 mg/kg), and study group B (B. diffusa 250 mg/kg). On the 29th day, rats were sacrificed and body weight, prostate weight, bladder weight, and serum testosterone level were measured and histological studies were carried out. Further in vitro analysis of B. diffusa extract on contractility of isolated rat vas deferens and prostate gland, produced by exogenously administered agonists were carried out. All results were expressed as mean � SEM. 0 Data were analyzed by one-way analysis of variance followed by Tukey's test. Results: B. diffusa (100 mg/kg) treatment for 28 days resulted in significant inhibition of prostate growth (P < 0.05). Drug extract did not have significant change on serum testosterone level. Histopathological analysis of prostate gland supported above results. Results of in vitro experiment suggest that extracts had attenuated the contractile responses of isolated vas deferens and prostate gland to exogenously applied agonists. Conclusion: The results suggested that treatment with B. diffusa may improve symptoms of disease and inhibit the increased prostate size. In vitro study implies that herbal extracts has the machinery to produce beneficial effect on prostatic smooth muscle, which would relieve the urinary symptoms of disease. B. diffusa could be a potential source of new treatment of prostatic hyperplasia.
Vyas, Bhavin A.; Desai, Niket Y.; Patel, Paras K.; Joshi, Shrikant V.; Shah, Dinesh R.
Testicular Adrenal Rest Tumors in a Patient with Congenital Adrenal Hyperplasia
Congenital adrenal hyperplasia refers to a group of autosomal recessive disorders caused by a deficiency of an enzyme involved in the synthesis of glucocorticoids. The enzyme deficiency generally leads to a deficiency of cortisol and/or aldosterone production within the adrenal cortex. The lack of glucocorticoids generally leads to elevated levels of plasma corticotropin (ACTH), which often results in adrenal hyperplasia. Testicular adrenal rest tumors may develop in males with congenital adrenal hyperplasia due to overstimulation of aberrant adrenal cells within the testes. Recognition of this disease entity is essential when evaluating young males with testicular masses.
Olpin, Jeffrey Dee; Witt, Benjamin
[Expression of epidermal growth factor receptor and plasmatic level of melatonin in simple and complex endometrial hyperplasia].
The goal of our research was to find the prognostic significance of the epidermal growth factor receptor (EGFR) in the hyperplastic endometrium. Immunohistochemical study of morphological material (endometrial scrap) was conducted in order to reveal the EGFR expression (in 35 patients). The study of consistence of melatonin (universal antiproliferative and anticancerogenic hormone) in patients' blood serum was performed as well (using ELISA method). The numeric data of investigation were processed statistically using the SPSS-12 program and IBM SPSS Statistics, 20. According to received results, the more complicated the type of endometrial hyperplasia is, the stronger EGFR expression is and the more melatonin consistence is reduced in blood plasma. However, sometimes much lower level of melatonin not only in case of complex hyperplasia (with atypia), but also in case of simple hyperplasia (without atypia) was observed. In addition, melatonin consistence is in norm not only in case of simple hyperplasia, but also in case of complex hyperplasia. Also, unimportant reduction of melatonin level is seen in plasma in case of both types of endometrial hyperplasia (without atypia): if, for example, in simple hyperplasia, this slight reduction of melatonin level in plasma is seen in condition of sharp EGFR expression, the same amount reduction of plasmatic melatonin in complex hyperplasia is seen in condition of weak EGFR expression. To sum up: in case of simple endometrial hyperplasia without atypia, reduction of plasma melatonin level should be a bad prognostic indicator and this condition can be followed by transformation of hyperplasia into atypical form; the normal plasmatic level of melatonin in complex endometrial hyperplasia without atypia (in condition of weak EGFR expression) should be a good prognostic indicator; unimportant reduction of plasma melatonin level and in addition, EGFR sharp expression in simple hyperplasia, is probably the sign, that hyperplasia can change and become complex; however, the same indicators of plasma melatonin level (on the background of weak EGFR expression) in complex hyperplasia (without atypia) should not indicate the poor prognosis. PMID:24214601
Dznelashvili, N O; Kasradze, D G; Tavartkiladze, A G; Mariamidze, A G; Dzhinchveladze, D N
Relationships between Participants' International Prostate Symptom Score and BPH Impact Index Changes and Global Ratings of Change in a Trial of Phytotherapy for Men with Lower Urinary Tract Symptoms
Purpose To relate changes in AUA Symptom Index (AUASI) scores with bother measures and global ratings of change among men with lower urinary tract symptoms enrolled in a trial of saw palmetto. Materials and Methods To be eligible, men were ?45 years old, had ajpeak uroflow ?4 ml/sec, and an AUASI score ? 8 and ? 24. Participants self-administered the AUASI, IPSS quality of life item (IPSS QoL), BPH Impact Index (BII) and two global change questions at baseline and 24, 48, and 72 weeks. Results Among 357 participants, global ratings of �a little better� were associated with mean decreases in AUASI scores from 2.8 to 4.1 points, across three time points. The analogous range for mean decreases in BII scores was 1.0 to 1.7 points, and for the IPSS QoL item 0.5 to 0.8 points. At 72 weeks, for the first global change question, each change measure could discriminate between participants rating themselves at least a little better versus unchanged or worse 70-72% of the time. A multivariable model increased discrimination to 77%. For the second global change question, each change measure correctly discriminated ratings of at least a little better versus unchanged or worse 69-74% of the time, and a multivariable model increased discrimination to 79%. Conclusions Changes in AUASI scores could discriminate between participants rating themselves at least a little better versus unchanged or worse. Our findings support the practice of powering studies to detect group mean differences in AUASI scores of at least 3 points.
Barry, Michael J.; Cantor, Alan; Roehrborn, Claus G.
Insulin sensitivity index, acute insulin response, and glucose effectiveness in a population-based sample of 380 young healthy Caucasians. Analysis of the impact of gender, body fat, physical fitness, and life-style factors.
BACKGROUND: Insulin sensitivity and insulin secretion are traits that are both genetically and environmentally determined. AIM: The aim of this study was to describe the distribution of the insulin sensitivity index (Si), the acute insulin response, and glucose effectiveness (Sg) in young healthy Caucasians and to estimate the relative impact of anthropometric and environmental determinants on these variables. METHODS: The material included 380 unrelated Caucasian subjects (18-32 yr) with measurement of Si, Sg and insulin secretion during a combined intravenous glucose (0.3 grams/kg body weight) and tolbutamide (3 mg/kg body weight) tolerance test. RESULTS: The distributions of Si and acute insulin response were skewed to the right, whereas the distribution of Sg was Gaussian distributed. Sg was 15% higher in women compared with men (P < 0.001). Waist circumference, body mass index, maximal aerobic capacity, and women's use of oral contraceptives were the most important determinants of Si. Approximately one-third of the variation of Si could be explained by these factors. Compared with individuals in the upper four-fifths of the distribution of Si, subjects with Si in the lowest fifth had higher waist circumference, higher blood pressure, lower VO2max, and lower glucose tolerance and fasting dyslipidemia and dysfibrinolysis. Only 10% of the variation in acute insulin response could be explained by measured determinants. CONCLUSION: Estimates of body fat, maximal aerobic capacity, and women's use of oral contraceptives explain about one-third of the variation in Si in a population-based sample of young healthy Caucasians.
Clausen, J O; Borch-Johnsen, K; Ibsen, H; Bergman, R N; Hougaard, P; Winther, K; Pedersen, O
NASA Technical Reports Server (NTRS)
The CENDI Indexing Workshop held at NASA Headquarters, Two Independence Square, 300 E Street, Washington, DC, on September 21-22, 1994 focused on the following topics: machine aided indexing, indexing quality, an indexing pilot project, the MedIndEx Prototype, Department of Energy/Office of Scientific and Technical Information indexing activities, high-tech coding structures, category indexing schemes, and the Government Information Locator Service. This publication consists mostly of viewgraphs related to the above noted topics. In an appendix is a description of the Government Information Locator Service.
NASA Astrophysics Data System (ADS)
AGU has just completed a major revision of its Index Terms. The last major revision of the Index Terms was conducted in 1995. AGU Index Terms are used for classification of both AGU publications and meetings programs. The new Index Terms will be available for use by the AGU community on 17 December (http://www.agu.org/pubs/indexterms).A 15-person working group, representing various disciplinary groups across the AGU, was established by, and reports to, the Publications Committee. The Index Committee members consulted with their constituencies and considered term-by-term usage of the old Index Term list in creating the new list.
Kodama, Kenneth P.
The accompanying table compares refinery construction and operating wages monthly for the years 1992 and 1993. The Nelson-Farrar refinery construction cost indexes are inflation indexes, while the operating indexes incorporate a productivity which shows improvement with experience and the increasing size of operations. The refinery construction wage indexes in the table show a steady advance over the 2-year period. Common labor indexes moved up faster than skilled indexes. Refinery operating wages showed a steady increase, while productivities averaged higher near the end of the period. Net results is that labor costs remained steady for the period.
Farrar, G.L.
Impact of a nurse-directed, coordinated school health program to enhance physical activity behaviors and reduce body mass index among minority children: A parallel-group, randomized control trial
Background Underserved children, particularly girls and those in urban communities, do not meet the recommended physical activity guidelines (>60 min of daily physical activity), and this behavior can lead to obesity. The school years are known to be a critical period in the life course for shaping attitudes and behaviors. Children look to schools for much of their access to physical activity. Thus, through the provision of appropriate physical activity programs, schools have the power to influence apt physical activity choices, especially for underserved children where disparities in obesity-related outcomes exist. Objectives To evaluate the impact of a nurse directed, coordinated, culturally sensitive, school-based, family-centered lifestyle program on activity behaviors and body mass index. Design, settings and participants: This was a parallel group, randomized controlled trial utilizing a community-based participatory research approach, through a partnership with a University and 5 community schools. Participants included 251 children ages 8�12 from elementary schools in urban, low-income neighborhoods in Los Angeles, USA. Methods The intervention included Kids N Fitness�, a 6-week program which met weekly to provide 45 min of structured physical activity and a 45 min nutrition education class for parents and children. Intervention sites also participated in school-wide wellness activities, including health and counseling services, staff professional development in health promotion, parental education newsletters, and wellness policies for the provision of healthy foods at the school. The Child and Adolescent Trial for Cardiovascular Health School Physical Activity and Nutrition Student Questionnaire measured physical activity behavior, including: daily physical activity, participation in team sports, attending physical education class, and TV viewing/computer game playing. Anthropometric measures included height, weight, body mass index, resting blood pressure, and waist circumference. Measures were collected at baseline, completion of the intervention phase (4 months), and 12 months post-intervention. Results Significant results for students in the intervention, included for boys decreases in TV viewing; and girls increases in daily physical activity, physical education class attendance, and decreases in body mass index z-scores from baseline to the 12 month follow-up. Conclusions Our study shows the value of utilizing nurses to implement a culturally sensitive, coordinated, intervention to decrease disparities in activity and TV viewing among underserved girls and boys.
Wright, Kynna; Giger, Joyce Newman; Norris, Keth; Suro, Zulma
FOXA1 deletion in luminal epithelium causes prostatic hyperplasia and alteration of differentiated phenotype.
The forkhead box (Fox) superfamily of transcription factors has essential roles in organogenesis and tissue differentiation. Foxa1 and Foxa2 are expressed during prostate budding and ductal morphogenesis, whereas Foxa1 expression is retained in adult prostate epithelium. Previous characterization of prostatic tissue rescued from embryonic Foxa1 knockout mice revealed Foxa1 to be essential for ductal morphogenesis and epithelial maturation. However, it is unknown whether Foxa1 is required to maintain the differentiated status in adult prostate epithelium. Here, we employed the PBCre4 transgenic system and determined the impact of prostate-specific Foxa1 deletion in adult murine epithelium. PBCre4/Foxa1(loxp/loxp) mouse prostates showed progressive florid hyperplasia with extensive cribriform patterning, with the anterior prostate being most affected. Immunohistochemistry studies show mosaic Foxa1 KO consistent with PBCre4 activity, with Foxa1 KO epithelial cells specifically exhibiting altered cell morphology, increased proliferation, and elevated expression of basal cell markers. Castration studies showed that, while PBCre4/Foxa1(loxp/loxp) prostates did not exhibit altered sensitivity in response to hormone ablation compared with control prostates, the number of Foxa1-positive cells in mosaic Foxa1 KO prostates was significantly reduced compared with Foxa1-negative cells following castration. Unexpectedly, gene expression profile analyses revealed that Foxa1 deletion caused abnormal expression of seminal vesicle-associated genes in KO prostates. In summary, these results indicate Foxa1 expression is required for the maintenance of prostatic cellular differentiation. PMID:24840332
DeGraff, David J; Grabowska, Magdalena M; Case, Tom C; Yu, Xiuping; Herrick, Mary K; Hayward, William J; Strand, Douglas W; Cates, Justin M; Hayward, Simon W; Gao, Nan; Walter, Michael A; Buttyan, Ralph; Yi, Yajun; Kaestner, Klaus H; Matusik, Robert J
Medications and surgical interventions for benign prostatic hyperplasia are potential confounders of prostate-specific antigen.
Prostate-specific antigen (PSA) is the most widely used marker for prostate cancer (CaP) screening and monitoring benign prostatic hyperplasia (BPH) progression. However, lack of an established abnormal threshold and the presence of other benign processes confound the interpretation of PSA levels. Many factors besides inflammation, trauma, and instrumentation can influence PSA levels; specifically, BPH and its associated medical and surgical therapies frequently complicate the interpretation of this serum blood test. For example, the commonly used 5 alpha reductase inhibitor (5ARI) medications directly affect PSA levels by decreasing prostate volume. The amount of time and potentially even the 5ARI formulary a patient is administered has been implicated to directly impact the degree of reduction in PSA (a proxy for prostate volume). In addition, each of the currently available surgical procedures for BPH appears to remove varying amounts of prostatic adenoma. This directly confounds CaP screening because each procedure is associated with a relatively specific postoperative nadir PSA level, and PSA kinetics are not well described in the literature. Taken together, it is important for clinicians to comprehend that BPH and its associated medical and surgical interventions should directly influence their interpretation of PSA and PSA velocity when screening for CaP or following BPH progression. PMID:20467844
Modi, Parth; Helfand, Brian T; McVary, Kevin T
Distinct roles of E2F proteins in vascular smooth muscle cell proliferation and intimal hyperplasia
Intimal hyperplasia (IH) and restenosis limit the long-term utility of bypass surgery and angioplasty due to pathological proliferation and migration of vascular smooth muscle cells (VSMCs) into the intima of treated vessels. Consequently, much attention has been focused on developing inhibitory agents that reduce this pathogenic process. The E2F transcription factors are key cell cycle regulators that play important roles in modulating cell proliferation and cell fate. Nonselective E2F inhibitors have thus been extensively evaluated for this purpose. Surprisingly, these E2F inhibitors have failed to reduce IH. These findings prompted us to evaluate the roles of different E2Fs during IH to determine how selective targeting of E2F isoforms impacts VSMC proliferation. Importantly, we show that E2F3 promotes proliferation of VSMCs leading to increased IH, whereas E2F4 inhibits this pathological response. Furthermore, we use RNA probes to show that selective inhibition of E2F3, not global inhibition of E2F activity, significantly reduces VSMC proliferation and limits IH in murine bypass grafts.
Giangrande, Paloma H.; Zhang, JianXin; Tanner, Alice; Eckhart, Andrea D.; Rempel, Rachel E.; Andrechek, Eran R.; Layzer, Juliana M.; Keys, Janelle R.; Hagen, Per-Otto; Nevins, Joseph R.; Koch, Walter J.; Sullenger, Bruce A.
Protective effects of seahorse extracts in a rat castration and testosterone-induced benign prostatic hyperplasia model and mouse oligospermatism model.
This study investigated the effects of seahorse (Hippocampus spp.) extracts in a rat model of benign prostatic hyperplasia (BPH) and mouse model of oligospermatism. Compared to the sham operated group, castration and testosterone induced BPH, indicated by increased penile erection latency; decreased penis nitric oxide synthase (NOS) activity; reduced serum acid phosphatase (ACP) activity; increased prostate index; and epithelial thickening, increased glandular perimeter, increased proliferating cell nuclear antigen (PCNA) index and upregulation of basic fibroblast growth factor (bFGF) in the prostate. Seahorse extracts significantly ameliorated the histopathological changes associated with BPH, reduced the latency of penile erection and increased penile NOS activity. Administration of seahorse extracts also reversed epididymal sperm viability and motility in mice treated with cyclophosphamide (CP). Seahorse extracts have potential as a candidate marine drug for treating BPH without inducing the side effects of erectile dysfunction (ED) or oligospermatism associated with the BPH drug finasteride. PMID:24607683
Xu, Dong-Hui; Wang, Li-Hong; Mei, Xue-Ting; Li, Bing-Ji; Lv, Jun-Li; Xu, Shi-Bo
ERIC Educational Resources Information Center
Describes the characteristics of System Development Corporation's (SDC) online index to its database, "Database Index," and presents the results of various test searches to demonstrate the limitations and benefits of the new online file. (JD)
Antony, Arthur
National Technical Information Service (NTIS)
Problems of indexing and index use lie at the heart of information use. They determine maximum possible use of information use. They determine maximum possible use of information systems and sources, affect communication with users, influence the use of r...
C. Beal
Prostate Tissue Composition and Response to Finasteride in Men With Symptomatic Benign Prostatic Hyperplasia
PurposeWe sought to quantify prostate tissue changes induced by finasteride and to identify a predictor of finasteride response in men with symptomatic benign prostatic hyperplasia (BPH) via a randomized, placebo controlled, double-blind clinical trial.
Leonard S. Marks; Alan W. Partin; Glenn J. Gormley; Frederick J. Dorey; Erlinda D. Shery; Joel B. Garris; Eric N. P. Subong; Elizabeth Stoner; Jean B. deKernion
Long-term effect of megestrol acetate in the treatment of endometrial hyperplasia.
Fifty-two postmenopausal women who were poor surgical risks and had histologically proved adenomatous hyperplasia, atypical hyperplasia, or adenocarcinoma in situ of the endometrium were treated with megestrol acetate, 40 mg per day, continuously for 9 to 104 months (mean, 42 months). More than 90% of these women had complete remissions of the hyperplasia. Three women with carcinoma in situ were followed up for 57, 65, and 104 months, without recurrence of the disease. Four women required hysterectomy; none had invasive adenocarcinoma. No adverse side effects of the drug were observed. Thus, we conclude that the continuous use of megestrol acetate is an effective, safe, alternative form of therapy for endometrial hyperplasia in postmenopausal women. PMID:6859142
Gal, D; Edman, C D; Vellios, F; Forney, J P
Immunohistochemical characterization of cellular proliferation in small intestinal hyperplasia of rats with hepatic Strobilocercus fasciolaris infection.
Rats infected with the larvae of Taenia taeniaeformis harbour the intermediate stage of the parasite Strobilocercus fasciolaris within the liver. Affected animals also develop gastric and intestinal hyperplasia. The pathogenesis of the gastric hyperplasia has been extensively investigated, but few studies have addressed the nature of the intestinal changes. This study characterizes the proliferation of small intestinal epithelial cells by immunohistochemical labelling for proliferating cell nuclear antigen (PCNA) and bromodeoxyuridine (BrdU) uptake. At 6 weeks post-infection (wpi) there was an increase in villous length but crypt depth was normal. At 9 wpi there was evidence of epithelial hyperplasia, increased villous length and crypt depth, and expansion of zones of epithelial proliferation. Immunohistochemical labelling indicated that an increase in the number of proliferating cells produced a greater number of progeny cells. Intestinal hyperplasia during experimental infection with T. taeniaeformis larvae is likely to be related to the associated gastropathy, although the mechanisms underlying both changes remain undefined. PMID:18539293
Lagapa, J T; Oku, Y; Kamiya, M
Benign Prostatic Hyperplasia (BPH), or Enlarged Prostate: Questions to Discuss with Your Doctor
... contact us Benign Prostatic Hyperplasia (BPH), or Enlarged Prostate Questions to Discuss With Your Doctor: Over the ... infections? Have you ever had surgery on your prostate, bladder, or kidneys? Do you have gastrointestinal problems ...
High condylectomy procedure: a valuable resource for surgical management of the mandibular condylar hyperplasia.
Condylar hyperplasia is an overdevelopment of the condyle, which may manifest unilaterally or bilaterally. This pathological condition can lead to facial asymmetry, malocclusion, and dysfunction of the temporomandibular joint. The etiology and pathogenesis of condylar hyperplasia remain uncertain, but it has been suggested that its etiology may be associated with hormonal factors, trauma, and hereditary hypervascularity, affecting both genders. The diagnosis is made by clinical examination, and radiological imaging, and additionally, bone scintigraphy, is a fundamental resource for determining whether the affected condyle shows active growth. Patients with active condylar hyperplasia management have better results when they are subjected to the high condylectomy procedure. The authors report a case in a 20-year-old female subject with unilateral active condylar hyperplasia who was treated by high condylectomy. The patient has been followed up for 4 years without signs of recurrence and with good functional stability of the occlusion. PMID:23851829
Pereira-Santos, Darklilson; De Melo, Willian Morais; Souza, Francisley Avila; de Moura, Walter Leal; Cravinhos, Julio C�sar de Paulo
Long-term 6-year experience with finasteride in patients with benign prostatic hyperplasia
ObjectivesTo summarize the 6-year clinical trial data with finasteride. Benign prostatic hyperplasia is a chronic and progressive disease and therefore assessment of long-term safety and efficacy is important.
Franklin C Lowe; John D McConnell; Perry B Hudson; Nicholas A Romas; Rex Boake; Michael Lieber; Mostafa Elhilali; Jack Geller; Juliane Imperto-McGinely; Gerald L Andriole; Reginald C Bruskewitz; Patrick C Walsh; Georg Bartsch; John N Nacey; Sukrut Shah; Frances Pappas; Amy Ko; Thomas Cook; Elizabeth Stoner; Joanne Waldstreicher
Experience of Long-Term Afala Treatment in Benign Prostatic Hyperplasia
The use of ultralow doses of antibodies to prostate-specific antigen (afala) for long-term treatment of benign prostatic hyperplasia\\u000a in patients with moderate symptoms rapidly and effectively reduces irritative and obstructive symptoms, significantly decreases\\u000a residual urine volume, and increases the rate of urination. Afala therapy is indicated for patients with stage I-II benign\\u000a prostatic hyperplasia of moderately pronounced symptoms.
A. V. Gudkov
Parathyroid hyperplasia in uremic rats precedes down-regulation of the calcium receptor
Parathyroid hyperplasia in uremic rats precedes down-regulation of the calcium receptor.BackgroundRecent evidence points to a relationship between the down-regulation of the calcium-sensing receptor (CaR) and parathyroid cell hyperplasia that is associated with chronic renal failure. It is not known, however, if down-regulation of the CaR precedes, and perhaps initiates, parathyroid cell proliferation, or if a decrease in the expression of
Cynthia S. Ritter; Jane L. Finch; Eduardo A. Slatopolsky; Alex J. Brown
Neuroendocrine Cell Hyperplasia of Infancy: Diagnosis With High-Resolution CT
OBJECTIVE Neuroendocrine cell hyperplasia of infancy is a form of childhood interstitial lung disease originally reported as persistent tachypnea of infancy. Reports of small series of cases and anecdotal experience have suggested that this disorder may have a consistent CT pattern. The purpose of this study was to review the CT findings in children with neuroendocrine cell hyperplasia of infancy to determine the findings at high-resolution CT, the diagnostic accuracy of CT compared with biopsy, and interrater reliability. MATERIALS AND METHODS Images from 23 CT examinations of children with biopsy-proven neuroendocrine cell hyperplasia of infancy and six CT examinations of children with other childhood interstitial lung diseases were reviewed by two pediatric radiologists with special expertise in thoracic imaging. Identifying digital data were removed, and images were reviewed without clinical data. A CT assessment form was completed for each patient. RESULTS Ground-glass opacification was the most common finding in patients with neuroendocrine cell hyperplasia of infancy. The right middle lobe and lingula were most commonly involved. Air trapping with a mosaic pattern was the second most common finding. Interrater reliability was very good with a kappa value of 0.93. The sensitivity and specificity of CT in the diagnosis of neuroendocrine cell hyperplasia of infancy were at least 78% and 100%. CONCLUSION Neuroendocrine cell hyperplasia of infancy can have a characteristic appearance on high-resolution CT scans, the imaging findings being useful in differentiating neuroendocrine cell hyperplasia of infancy from other types of childhood interstitial lung disease. The appearance aids radiologists in suggesting a specific diagnosis but does not exclude this diagnosis; in 17�22% of cases, the readers in this study did not suggest the diagnosis of neuroendocrine cell hyperplasia of infancy when it was present.
Brody, Alan S.; Guillerman, R. Paul; Hay, Thomas C.; Wagner, Brandie D.; Young, Lisa R.; Deutsch, Gail H.; Fan, Leland L.; Deterding, Robin R.
Mucocele-like tumor and columnar cell hyperplasia of the breast occurring in a morphologic continuum
INTRODUCTION: Mucocele-like tumor was originally described in 1986 as a benign breast proliferation consisting of multiple dilated cysts lined by cytologically bland, flat to cuboidal cells. Subsequent reports described the coexistence of, including the morphologic inter-transitions between, mucocele-like tumor and a variety of other breast proliferations, including intraductal carcinoma, invasive carcinoma, atypical ductal hyperplasia, and hyperplasia of the usual type.
Oluwole Fadare; M Rajan Mariappan
Expression of proliferation and apoptosis-related proteins in usual ductal hyperplasia of the breast
Expression of proliferation- and apoptosis-related proteins was studied by immunohistochemistry in 130 usual ductal hyperplasias of the breast, of which 39 cases (30%) had adjacent invasive cancer. Overexpression of cyclin D1 and Ki-67 was found in 6% and 29% of the cases, respectively. Only two mild ductal hyperplasias were Her-2\\/neu positive. Overexpression of p21 and reduced expression of p27, both
Ellen C. M Mommers; Paul J Van Diest; Angelique M Leonhart; Chris J. L. M Meijer; Jan P. A Baak
Fast-Growing Pseudoangiomatous Stromal Hyperplasia of the Breast: Report of a Case
Pseudoangiomatous stromal hyperplasia (PASH) is a rare type of benign mesenchymal proliferative disease of the breast. Histologically,\\u000a it is composed of a proliferation of spindle cells with inter-anastomosing vascular-like arrangement in the interlobular or\\u000a interductal stroma. Clinically, pseudoangiomatous stromal hyperplasia is usually found in premenopausal women as a discrete,\\u000a painless mass, which is firm and movable. We report a case
Kweon Yoo; Ok Hee Woo; Hwan Seok Yong; Aeree Kim; Woo Sang Ryu; Bum Hwan Koo; Eun-Young Kang
Predictive diagnosis of endometrial hyperplasia and personalized therapeutic strategy in women of fertile age
Introduction Endometrial hyperplasia has a high risk for malignant transformation and relapses; existing mini-invasive treatments may lead to irrevocable endometrium destruction. The aims were to analyze receptor systems in endometrial hyperplasia, to evaluate the capabilities of ultrasonography, sonoelastography for diagnosis and treatment control, and to develop treatment algorithm. Materials and methods We included 313 women (20�45�years), assessed into the following: group 1 (n?=?112) with glandular cystic hyperplasia, group 2 (n?=?98) endometrial polyps, and group 3 (n?=?103) atypical hyperplasia; and 82 controls who have undergone hysteroscopy before in vitro fertilization in tubal origin infertility were also included. Patients underwent clinical examination, transvaginal ultrasound, immunohistochemical study, and hormonal therapy/hysteroresectoscopy. Results In patients with glandular hyperplasia, we registered increase of endometrium estrogen receptors (75.6% in the epithelium and 30.9% in the stroma; in controls, 43.3% and 29.6%, respectively); in polyps, there was a significant estrogen receptor increase in the stroma (48.2% vs 29.6% in controls), and in atypical hyperplasia, progesterone receptors significantly increased in the stroma. Ki-67 increased (40% to 50%) in the epithelium without changes in the stroma. Ultrasound has a sensitivity of 96% and a specificity of 85% for early detection of endometrial pathology and prediction outcome of intervention, and sonoelastography has a sensitivity of 91% and a specificity of 83% for polyp diagnosis. Personalized treatment was effective in 88.8%, relapse was diagnosed in 11.2% after 6�months, and conservative treatment of atypical hyperplasia was effective in 45%: in 25.8%, ablative hysteroresectoscopy was performed, while in 22.6% with comorbidities, hystero/oophorectomies were performed. Conclusions The evaluation of receptor status with ultrasound data in patients with endometrial hyperplasia allows for a clear definition of the treatment policy, avoidance of relapse, treatment optimization, and observation of such patients.
Cinacalcet HCl attenuates parathyroid hyperplasia in a rat model of secondary hyperparathyroidism
Cinacalcet HCl attenuates parathyroid hyperplasia in a rat model of secondary hyperparathyroidism.BackgroundSecondary hyperparathyroidism (HPT) in chronic kidney disease (CKD) is a physiologic response to kidney failure characterized by elevated serum parathyroid hormone (PTH) levels and parathyroid gland enlargement. Calcimimetic agents acting through allosteric modification of the calcium-sensing receptor (CaR) can attenuate parathyroid hyperplasia in rats with secondary HPT. The present
Hyperplasia of the thymic gland in a patient with Graves' disease.
A tumor-like lesion in the anterior mediastinum was recognized in a 21-year-old female patient with Graves' disease. A CT examination and MRI suggested a thymoma. A subtotal thyroidectomy and a total thymectomy were therefore performed simultaneously. A pathological study of the thymic mass showed thymic hyperplasia. These findings suggest that an enlarged anterior mediastinal mass in a Graves' disease could thus sometimes turn out to be thymic hyperplasia and not a thymoma. PMID:11173355
Inoue, K; Sugio, K; Inoue, T; Ishida, T; Sugimachi, K
Increased Expression of LH\\/hCG Receptors in Endometrial Hyperplasia and Carcinoma in Anovulatory Women
Endometrial hyperplasias and carcinomas are well documented to occur in anovulatory women with or without polycystic ovarian syndrome (PCO), which is characterized by hypersecretion of luteinizing hormone (LH). Although overexpression of LH\\/human chorionic gonadotropin (hCG) receptors has been demonstrated in endometrial carcinomas, whether LH\\/hCG receptors are also expressed in the endometrial hyperplasias is not known. In this study, the expression
Ikuo Konishi; Masafumi Koshiyama; Masaki Mandai; Hideki Kuroda; Shinichi Yamamoto; Kanako Nanbu; Takayuki Komatsu; Katsuko Matsushita; Ch. V. Rao; Takahide Mori
Differentiating cutaneous squamous cell carcinoma and pseudoepitheliomatous hyperplasia by multiplex qRT-PCR.
Squamous cell carcinoma is the second most common cutaneous malignancy. The diagnosis can occasionally be difficult as there are many lesions that are mimics, clinically and on pathologic examination. One of the most challenging lesions to differentiate from squamous cell carcinoma is pseudoepitheliomatous hyperplasia, a reactive proliferation of the epidermis that can be encountered secondary to a variety of inflammatory and neoplastic conditions. Utilizing the data set from our previously performed DNA microarray studies on formalin-fixed and paraffin-embedded tissue, we found that the genes C15orf48 and KRT9 had a distinct and robust gene expression pattern in distinguishing squamous cell carcinoma from pseudoepitheliomatous hyperplasia. C15orf48 had higher expression than KRT9 in squamous cell carcinoma, but lower expression than KRT9 in pseudoepitheliomatous hyperplasia. We developed and blindly validated a multiplex TaqMan PCR assay that utilizes these two highly discriminatory genes, which can be performed on material extracted from formalin-fixed and paraffin-embedded tissue. The TaqMan assay was able to differentiate squamous cell carcinoma from pseudoepitheliomatous hyperplasia in 54 of 58 cases (93%). Squamous cell carcinoma was accurately identified in 27 of 28 cases (96%); pseudoepitheliomatous hyperplasia in 27 of 30 cases (90%). This multiplex TaqMan PCR assay may be used as a helpful ancillary molecular diagnostic test to accurately distinguish squamous cell carcinoma from pseudoepitheliomatous hyperplasia in challenging cases. PMID:23702732
Su, Albert; Ra, Seong; Li, Xinmin; Zhou, Jian; Binder, Scott
Prostatic artery embolization in the treatment of benign prostatic hyperplasia: short and medium follow-up.
To evaluate the short and mid-term results of prostatic artery embolization in patients with benign prostatic embolization. Retrospective study between March 2009 and June 2011 with 103 patients (mean age 66.8 years, 50-85) that met our inclusion criteria with symptomatic benign prostatic hyperplasia. The clinical outcome was evaluated by the International Prostate Symptom Score (IPSS), quality of life (QoL), International Index of Erectile Function, prostate volume (PV), prostate-specific antigen (PSA), peak urinary flow (Q(max)), and post-void residual volume (PVR) measurements at 3 and 6 months, 1 year, 18 months, and 2 years after PAE and comparison with baseline values was made. Technical and clinical successes, as well as poor clinical outcome definitions, were previously defined. In this review, we evaluate the short and mid-term clinical outcomes and morbidity of patients treated only with non-spherical polyvinyl alcohol. Six months after the procedure, the PV decreased about 23%, IPSS changed to a mean value of 11.95 (almost 50% reduction), the QoL improved slightly more than 2 points, the Q(max) changed to a mean value of 12.63 mL/s, the PVR underwent a change of almost half of the baseline value, and the PSA decreased about 2.3 ng/mL. In the mid-term follow-up and comparing to the baseline values, we still assisted to a reduction in PV, IPSS, QoL, PVR, and PSA, and an increase in Q(max). Prostatic Artery Embolization is a safe procedure with low morbidity that shows good short- and mid-term clinical outcome in our institution. PMID:23244726
Rio Tinto, Hugo; Martins Pisco, Jo�o; Bilhim, Tiago; Duarte, Marisa; Fernandes, L�cia; Pereira, Jos�; Campos Pinheiro, L
Ramelteon combined with an alpha1-blocker might decreases nocturia in men with benign prostatic hyperplasia.
BACKGROUND: Nocturia is defined as waking one or more times during the night due to the urge to void. Recently, the effectiveness of several sedatives and analgesics for nocturia has been reported. We herein investigated the effects of ramelteon, an antioxidant and sleep inducer, on nocturia unresponsive to alpha1-blocker monotherapy in males with lower urinary tract symptoms (LUTS) as a pilot study. METHODS: Subjects were 19 patients who had LUTS suggestive of benign prostate hyperplasia, received alpha1-blockers (tamsulosin, silodosin, or naftopidil), and continued to have two or more episodes of nocturia per night before starting ramelteon. Ramelteon at 8 mg once daily for one month was added to the alpha1-blocker. A self-administered questionnaire including the International Prostate Symptom Score (IPSS), quality of life (QoL) index, Overactive Bladder Symptom Score (OABSS), and Nocturia Quality-of-Life Questionnaire (N-QOL) were assessed before and one month after starting ramelteon. RESULTS: The mean score on IPSS question 7 (nocturia) decreased significantly from 2.88 before starting ramelteon to 2.41 one month after starting the medication (P = 0.03). The mean total OABSS decreased significantly from 6.31 to 5.38 (P = 0.03), and the mean for OABSS question 2 (nighttime frequency of nocturia) also significantly decreased from 2.63 to 2.13 (P = 0.01). The mean total N-QOL score did not change significantly. Two patients had dizziness; the remaining patients had no adverse drug-related events. CONCLUSIONS: Ramelteon in combination with an alpha1-blocker might be a treatment option for reducing nocturia in men with BPH. PMID:23758651
Kawahara, Takashi; Morita, Satoshi; Ito, Hiroki; Terao, Hideyuki; Sakata, Ryoko; Ishiguro, Hitoshi; Tanaka, Katsuyuki; Miyamoto, Hiroshi; Matsuzaki, Junichi; Kubota, Yoshinobu; Uemura, Hiroji
Late clinical presentation of congenital adrenal hyperplasia in older children: findings from national paediatric surveillance
Objectives To describe the clinical presentation and sequelae, including salt-wasting crises of newly-diagnosed congenital adrenal hyperplasia (CAH) in children aged over 1?year in a contemporary population without screening. To appraise the potential benefit of newborn screening for late-presenting CAH. Design Active national surveillance undertaken in Great Britain prospectively from 2007�2009 through the British Paediatric Surveillance Unit. Setting England, Wales and Scotland. Patients Children first presenting aged 1�15?years with clinical features of CAH and elevated 17-hydroxyprogesterone. Results Fifty-eight children (26 [45%] boys) aged 1�15?years were reported; 50 (86%) had 21-hydroxylase deficiency. Diagnosis was precipitated by secondary sexual characteristics (n=38 [66%]; median age 5.8 [IQR] 4.8, 7.6) years, genital virilisation (8 girls; 3.2 [IQR 1.3, 7.3] years) or an affected sibling (n=8; 10.0 [IQR 7.4, 13.3] years). At least 33 (57%) children had advanced bone age and 13 (30%) were obese (body mass index ?95th centile). No child had experienced a salt-wasting crisis. Conclusions In Great Britain, 30 children aged 1�15?years present annually for the first time with CAH. Older children frequently manifest prematurely advanced epiphyseal and pubertal maturation and genital virilisation, which are often irreversible and likely to have long-lasting consequences for adult health and wellbeing. Almost one-third of affected children are obese before commencing steroid therapy. Newborn screening offers the potential to avoid serious clinical manifestations in older children with unrecognised CAH; however, it may also detect some children who would otherwise remain asymptomatic and for whom the benefit from treatment is uncertain.
Knowles, Rachel L; Khalid, Javaria M; Oerton, Juliet M; Hindmarsh, Peter C; Kelnar, Christopher J; Dezateux, Carol
Increased Risk of Benign Prostate Hyperplasia in Sleep Apnea Patients: A Nationwide Population-Based Study
Background Sleep apnea (SA) is a common sleep disorder characterized by chronic intermittent hypoxia (IH). Chronic IH induces systemic inflammatory processes, which can cause tissue damage and contribute to prostatic enlargement. The purpose of this study was to evaluate the association between benign prostate hyperplasia (BPH) and SA in a Taiwanese population. Methods The study population was identified from Taiwan�s National Health Insurance Research Database (NHIRD) and contained 202 SA patients and 1010 control patients. The study cohort consisted of men aged ?30 years who were newly diagnosed with SA between January 1997 and December 2005. Each patient was monitored for 5 years from the index date for the development of BPH. A Cox regression analysis was used to calculate the hazard ratios (HRs) for BPH in the SA and control patients. Results During the 5-year follow-up, 18 SA patients (8.9%) and 32 non-SA control patients (3.2%) developed BPH. The adjusted HR for BPH was 2.35-fold higher in the patients with SA than in the control patients (95% confidence interval (CI) 1.28�4.29, P<.01). We further divided the SA patients into 4 age groups. After adjusting for potential confounding factors, the highest adjusted HR for BPH in the SA patients compared with the control patients was 5.59 (95% CI?=?2.19�14.31, P<.001) in the patients aged between 51 and 65 years. Conclusion Our study results indicate that patients with SA are associated with increased longitudinal risk of BPH development, and that the effects of SA on BPH development are age-dependent.
Chou, Wei-Po; Liu, Mu-En; Lai, Chiou-Lian; Liu, Ching-Kuan; Ku, Yan-Chiou; Tsai, Shih-Jen; Chou, Yii-Her; Chang, Wei-Pin
Ramelteon combined with an ?1-blocker decreases nocturia in men with benign prostatic hyperplasia
Background Nocturia is defined as waking one or more times during the night due to the urge to void. Recently, the effectiveness of several sedatives and analgesics for nocturia has been reported. We herein investigated the effects of ramelteon, an antioxidant and sleep inducer, on nocturia unresponsive to ?1-blocker monotherapy in males with lower urinary tract symptoms (LUTS) as a pilot study. Methods Subjects were 19 patients who had LUTS suggestive of benign prostate hyperplasia, received ?1-blockers (tamsulosin, silodosin, or naftopidil), and continued to have two or more episodes of nocturia per night before starting ramelteon. Ramelteon at 8�mg once daily for one month was added to the ?1-blocker. A self-administered questionnaire including the International Prostate Symptom Score (IPSS), quality of life (QoL) index, Overactive Bladder Symptom Score (OABSS), and Nocturia Quality-of-Life Questionnaire (N-QOL) were assessed before and one month after starting ramelteon. Results The mean score on IPSS question 7 (nocturia) decreased significantly from 2.88 before starting ramelteon to 2.41 one month after starting the medication (P?=?0.03). The mean total OABSS decreased significantly from 6.31 to 5.38 (P?=?0.03), and the mean for OABSS question 2 (nighttime frequency of nocturia) also significantly decreased from 2.63 to 2.13 (P?=?0.01). The mean total N-QOL score did not change significantly. Two patients had dizziness; the remaining patients had no adverse drug-related events. Conclusions Ramelteon in combination with an ?1-blocker could be a treatment option for reducing nocturia in men with BPH.
Management of benign prostatic hyperplasia: role of phosphodiesterase-5 inhibitors.
Several studies have highlighted a strong association between benign prostatic hyperplasia/lower urinary tract symptoms (BPH/LUTS) and erectile dysfunction (ED), particularly in elderly men. Many epidemiological trials, such as in vitro and in vivo studies, have reported the emerging role of metabolic syndrome, including abdominal obesity, impaired glucose metabolism, hypertriglyceridemia, low high-density lipoprotein cholesterol, and hypertension, in the development and progression of urinary and sexual symptoms. Moreover, many authors have focused their studies on the identification of all the shared pathogenetic mechanisms of LUTS/BPH and ED, including alteration of cyclic guanosine monophosphate and RhoA-ROCK pathways or vascular and neurogenic dysfunction. All these are potential targets for proposed phosphodiesterase type 5 inhibitors (PDE5-Is). Therefore, several trials have recently been designed to evaluate the role of PDE5-Is alone or in combination with conventional treatment for BPH, such as ?-adrenergic blockers, in men affected by LUTS/BPH, with or without ED. Different PDE5-Is are in clinical use worldwide and currently six of them are licensed for the oral treatment of ED. All these compounds differ in pharmacokinetic factors, with influence on drug action, and subsequently in the overall safety and efficacy profile. PMID:24811735
Gacci, M; Carini, M; Salvi, M; Sebastianelli, A; Vignozzi, L; Corona, G; Maggi, M; McVary, K T; Kaplan, S A; Oelke, M; Serni, S
Role of laser therapy in benign prostate hyperplasia (BPH)
NASA Astrophysics Data System (ADS)
Benign prostatic hyperplasia (BPH) is a common disease in males older than 50 years of age. 75-80% of this population is considered to have some degree of BPH causing clinical symptoms and requiring urological treatment. Transurethral resection of the prostate (TUR-P) is currently the standard surgical treatment modality for BPH. In an attempt to minimize the need for hospitalization and the associated perioperative and postoperative morbidity, alternatives have been sought. Various types of laser techniques such as interstitial laser coagulation and side-firing technology have been proposed. Numerous studies have shown that laser procedures safely and effectively reduce the volume of the prostate. Intra- and postoperative bleeding are nearly unknown complications for laser procedures, whereas this is the most relevant complication for the TUR-P. Due to significant tissue edema after laser treatment, patients commonly show delayed time to void adequately and, therefore, catheter drainage is often necessary for 3 to 21 days. Retrograde ejaculation is reported to occur less (0- 10%) compared to TUR-P (greater than 60%). Urinary tract infections are very common after interstitial laser coagulation. Although not many long-term clinical data are available, various studies have shown that BPH patients improve in symptom score, flow rate and post-void residual up to 3 years after laser treatment. This paper presents a concise review of efficacy, advantages and disadvantages of the most frequently used laser techniques as well as the long-term clinical data compared to TUR-P.
de Riese, Werner T.; Sharpe, Brent A.; Aronoff, David B.; Mittemeyer, Bernhard T.
Approach to the patient: the adult with congenital adrenal hyperplasia.
The most common form of congenital adrenal hyperplasia is steroid 21-hydroxylase deficiency (21OHD). When the nonclassical (mild) form is included, 21OHD is the most common genetic disease in human beings. With the advent of pharmaceutical preparation of glucocorticoids starting in the 1960s and newborn screening starting in the 1990s, the majority of children with 21OHD are reaching adulthood, which has yielded a cohort of patients with, in essence, a new disease. Only recently have some data emerged from cohorts of adults with 21OHD, and in some centers, experience with the management of these patients is growing. These patients suffer from poor health, infertility, characteristic tumors in the adrenal glands and gonads, and consequences of chronic glucocorticoid therapy. Their care is fragmented and inconsistent, and many stop taking their medications out of frustration. Internal medicine residents and endocrinology fellows receive little training in their care, which further discourages their seeking medical attention. Adults with 21OHD have a different physiology from patients with Addison's disease or other androgen excess states, and their needs are different than those of young children with 21OHD. Consequently, their care requires unorthodox treatment and monitoring strategies foreign to most endocrine practitioners. Our goal for this article is to review their physiology, complications, and needs in order to develop rational and effective treatment and monitoring strategies. PMID:23837188
Auchus, Richard J; Arlt, Wiebke
A Case of Congenital Adrenal Hyperplasia Mimicking Cushing's Syndrome
Congenital adrenal hyperplasia (CAH) is characterized by decreased adrenal hormone production due to enzymatic defects and subsequent rise of adrenocorticotrophic hormone that stimulates the adrenal cortex to become hyperplastic, and sometimes tumorous. As the pathophysiology is basically a defect in the biosynthesis of cortisol, one may not consider CAH in patients with hypercortisolism. We report a case of a 41-yr-old man with a 4 cm-sized left adrenal tumorous lesion mimicking Cushing's syndrome who was diagnosed with CAH. He had central obesity and acanthosis nigricans involving the axillae together with elevated 24-hr urine cortisol level, supporting the diagnosis of Cushing's syndrome. However, the 24-hr urine cortisol was suppressed by 95% with the low dose dexamethasone suppression test. CAH was suspected based on the history of precocious puberty, short stature and a profound suppression of cortisol production by dexamethasone. CAH was confirmed by a remarkably increased level of serum 17-hydroxyprogesterone level. Gene mutation analysis revealed a compound heterozygote mutation of CYP21A2 (I173N and R357W).
Kim, Hye Jeong; Kang, Mira; Kim, Jae Hyeon; Kim, Sun Wook; Chung, Jae Hoon; Min, Yong-Ki; Lee, Moon-Kyu; Kim, Kwang-Won
Neonatal screening for congenital adrenal hyperplasia in Japan.
A nationwide screening test for congenital adrenal hyperplasia (CAH) was first initiated in Japan in 1989, over 20 years ago, and it is now 30 years since a pilot study was initiated in Sapporo in 1982. The incidence of 21-hydroxylase deficiency in Japan is about 1/18,000 persons, which is similar to that in other countries. The effectiveness of early detection and treatment of CAH in Japan has been demonstrated by cost-benefit analyses. However, the false-positive rate of CAH screening in preterm infants remains high compared to screening tests for term infants. To improve the positive predictive value, we have employed 21-hydroxylase gene (CYP21A2) analysis on dried blood spots and high performance liquid chromatography (HPLC) to measure 17-hydroxyprogesterone, and currently use tandem mass spectrometry (LC-MS/MS) as a screening technique. We suggest that LC-MS/MS should be used in the future to improve the accuracy of CAH screening in Japan. PMID:23330248
Tajima, Toshihiro; Fujikura, Kaori; Fukushi, Masaru; Hotsubo, Tomoyuki; Mitsuhashi, Yu
A case of congenital adrenal hyperplasia mimicking Cushing's syndrome.
Congenital adrenal hyperplasia (CAH) is characterized by decreased adrenal hormone production due to enzymatic defects and subsequent rise of adrenocorticotrophic hormone that stimulates the adrenal cortex to become hyperplastic, and sometimes tumorous. As the pathophysiology is basically a defect in the biosynthesis of cortisol, one may not consider CAH in patients with hypercortisolism. We report a case of a 41-yr-old man with a 4 cm-sized left adrenal tumorous lesion mimicking Cushing's syndrome who was diagnosed with CAH. He had central obesity and acanthosis nigricans involving the axillae together with elevated 24-hr urine cortisol level, supporting the diagnosis of Cushing's syndrome. However, the 24-hr urine cortisol was suppressed by 95% with the low dose dexamethasone suppression test. CAH was suspected based on the history of precocious puberty, short stature and a profound suppression of cortisol production by dexamethasone. CAH was confirmed by a remarkably increased level of serum 17-hydroxyprogesterone level. Gene mutation analysis revealed a compound heterozygote mutation of CYP21A2 (I173N and R357W). PMID:23166432
Kim, Hye Jeong; Kang, Mira; Kim, Jae Hyeon; Kim, Sun Wook; Chung, Jae Hoon; Min, Yong-Ki; Lee, Moon-Kyu; Kim, Kwang-Won; Lee, Myung-Shik
Focal nodular hyperplasia: what are the indications for resection?
Focal nodular hyperplasia (FNH) is a benign condition of the liver that is often discovered incidentally on radiological investigation. FNH has no malignant potential, is rarely symptomatic and surgical intervention is almost never required. However, eight patients with a diagnosis of FNH associated with upper abdominal pain or rapid growth were referred for surgery. All patients had been extensively investigated for other causes of pain and had been observed for between 1 and 7 years prior to surgical referral. The FNH lesions were between 1 cm and 8 cm in diameter. One FNH lesion 7.5 cm in diameter lay in segment VII/VIII and was related to the right and middle hepatic veins. All patients were resected with immediate and lasting control of their symptoms. Based on this experience FNH should be managed in a manner similar to haemangiomas with most lesions being safe to observe. However, it should be recognized that symptomatic FNH does occur, as well as FNH behaving in an unusual fashion such as rapid growth. Both of these findings are indications for resection.
Chun Hsee, Li; McCall, John L.
Water-induced thermotherapy for benign prostatic hyperplasia.
Water-induced thermotherapy (WIT), administered by the Thermoflex System, represents a novel minimally invasive technique for the treatment of benign prostatic hyperplasia (BPH). The Thermoflex System consists of an extracorporeal heat source and a proprietary closed-loop catheter system. Water, heated to 60 degrees C, is continuously circulated through the catheter to a treatment balloon, which conducts thermal energy to targeted prostatic tissue. The combination of heat and compression reduces the heat sink effect of the circulating blood, thus enhancing the thermal energy transfer to the compressed tissue. WIT treatment is performed using only topical urethral anesthetic, in a single 45-minute session. The 2-year follow-up data from a European multicenter study consisting of 125 patients showed an improvement in peak urine flow of 87.4% (from baseline 8.7 +/- 1.9 to 16.3 +/- 9.1 mL/s) and in the International Prostate Symptom Score (IPSS) of -54.2% (from baseline 24 +/- 5 to 11 +/- 5). Patient tolerance of WIT was rated as "excellent" or "good" in 91.8% of the procedures. WIT is efficacious, simple, and inexpensive, has few side effects, and does not need special probes to monitor prostate or rectum temperature; thus, it can be used in hospitals, outpatient clinics, and doctors' offices. PMID:11108569
Cioanta, I; Muschter, R
Multiple focal nodular hyperplasias induced by oxaliplatin-based chemotherapy.
Focal nodular hyperplasia (FNH) is a benign condition that affects normal liver with low prevalence. Recently, the extensive use of oxaliplatin to treat patients with colorectal cancer has been reported to be associated with the development of different liver injuries, as well as focal liver lesions. The present work describes two patients with multiple bilateral focal liver lesions misdiagnosed as colorectal liver metastases, and treated with liver resection. The first patient had up to 15 small bilateral focal liver lesions, with magnetic resonance imaging consistent with colorectal liver metastases (CLM), and fluorodeoxyglucose (FDG)-positron emission tomography (PET) negative. The second patient had up to 5 small focal liver lesions, with computed tomography consistent with CLM, and FDG-PET negative. They had parenchyma sparing liver surgery, with uneventful postoperative course. At the histology the diagnosis was multiple FNHs. The risks of oxaliplatin-based chemotherapy regimens in development of liver injuries, such as FNH, should not be further denied. The value of the modern multidisciplinary management of patients with colorectal cancer relies also on the precise estimation of the risk/benefit for each patient. PMID:23805360
Donadon, Matteo; Di Tommaso, Luca; Roncalli, Massimo; Torzilli, Guido
[Transvesical radiofrequency needle ablation on prostatic benign hyperplasia].
Transurethral needle ablation (TUNA) of the prostate is an effective method of thermal treatment of patients with benign prostatic hyperplasia (BPH). Suprapubic transvesical access was used in order to extend indications for interstitial application of radiofrequency energy. Transvesical needle ablation (TVNA) was performed in 89 patients with BPH under conditions of chronic ischuria or in the presence of a suprapubic cystostoma. A cystoscope with an attachment for fixation and insertion of a needle electrode into prostatic tissue is inserted into the bladder through a newly created or adapted suprapubic access. The position of the needle is monitored by transurethral sonography. The ablation protocol is virtually the same as transurethral. Spontaneous urination normalized in 63 (70.8%) patients within 12 months. I-PSS, Qol, Qmax, RU, and PQmax improved. The prostate volume decreased by 1-.5%. TVNA is more effective than TUNA as a less invasive method which allows interventions under local anesthesia; there are virtually no contraindications to the use of TVNA and in many patients it can be performed in an outpatient setting. PMID:11186320
Arustamov, D L; Mukhtarov, Sh T; Arustamov, L D
[Contemporary diagnosis and therapy in women with congenital adrenal hyperplasia].
Congenital adrenal hyperplasia (CAH) is an autosomal recessive defect in steroidogenesis, mostly affecting 21-hydroxylase enzyme deficiency. The other seldom cortisol synthesis abnormalities include deficiencies of: 11beta-hydroxylase, 3beta-hydroxysteroid dehydrogenase, 17beta-hydroxylase, 17,20-lase and 11 beta-hydroxysteroid dwehydrogenase type 1. There are three main types, depending on the clinical level of 21-hydroxylase deficiency: (1) classical form--salt-wasting CAH (2) the classical form non- salt-wasting (3) non-classical form. CAH incidence is estimated at 1/14 000-1/10 000, of which about 70% is the classic salt-wasting form. The clinical picture varies considerably depending on the form. In the classic salt-wasting CAH may develop into the a shock. In classic CAH without loss of salt dominates virilization in girls and precocious puberty in boys. A non-classical forms usually presents as hyperandrogenisation and fertility. CAH treatment is mainly based on the use of glucocorticoid therapy, and if necessary supplemented mineralocorticoids. There is also potential to consider prenatal treatment (female fetuses diagnosed as CAH) with the use of dexamethason. However this kind of treatment is related to some medical and ethical controversies. PMID:24575652
Maciejewska-Jeske, Marzena; Meczekalski, B?azej
A classification system for conditions causing condylar hyperplasia.
A classification system was developed to place patients with condylar hyperplasia (CH) into categories based on histology, clinical and imaging characteristics, effects on the jaws and facial structures, and rate of occurrence. Four major categories were defined. CH type 1 is an accelerated and prolonged growth aberration of the "normal" mandibular condylar growth mechanism, causing a predominantly horizontal growth vector, resulting in prognathism that can occur bilaterally (CH type 1A) or unilaterally (CH type 1B). CH type 2 refers to enlargement of the mandibular condyle caused by an osteochondroma, resulting in predominantly unilateral vertical overgrowth and elongation of the mandible and face. One of the forms has predominantly a vertical growth vector and condylar enlargement, but without exophytic tumor extensions (type 2A), whereas the other primary form grows vertically but develops horizontal exophytic tumor growth off of the condyle (CH type 2B). CH type 3 includes other rare, benign tumors and CH type 4 includes malignant conditions that originate in the mandibular condyle causing enlargement. The order of classification is based on occurrence rates and type of pathology, where CH type 1A is the most commonly occurring form and CH type 4 is the rarest. This classification system for CH pathology should help the clinician understand the nature of the pathology, progression if untreated, recommended ages for surgical intervention to minimize adverse effects on subsequent facial growth and development in younger patients, and the surgical protocols to comprehensively and predictably treat these conditions. PMID:24388179
Wolford, Larry M; Movahed, Reza; Perez, Daniel E
Treatment and health outcomes in adults with congenital adrenal hyperplasia.
Congenital adrenal hyperplasia (CAH) is a genetic disorder caused by defective steroidogenesis that results in glucocorticoid deficiency; the most common underlying mutation is in the gene that encodes 21-hydroxylase. Life-saving glucocorticoid treatment was introduced in the 1950s, and the number of adult patients is now growing; however, no consensus has been reached on the management of CAH beyond childhood. Adult patients are prescribed a variety of glucocorticoids, including hydrocortisone, prednisone, prednisolone, dexamethasone and combinations of these drugs taken in either a circadian or reverse circadian regimen. Despite these personalized treatments, biochemical control of CAH is only achieved in approximately one-third of patients. Some patients have a poor health status, with an increased incidence of obesity and osteoporosis, and impaired fertility and quality of life. The majority of poor health outcomes seem to relate to inadequate treatment rather than the genotype of the patient. Patients receiving high doses of glucocorticoids and the more potent synthetic long-acting glucocorticoids are at an increased risk of obesity, insulin resistance and a reduced quality of life. Further research is required to optimize the treatment of adult patients with CAH and improve health outcomes. PMID:24342885
Han, Thang S; Walker, Brian R; Arlt, Wiebke; Ross, Richard J
Congenital adrenal hyperplasia: issues in diagnosis and treatment in children.
Congenital adrenal hyperplasia (CAH) is a common disorder of impaired adrenal cortisol biosynthesis with associated androgen excess. The clinical presentation of 21-hydroxylase deficiency, the commonest cause of CAH, forms a spectrum and can be divided into classic and non-classic types. The former consists of life threatening salt wasting and non-life threatening simple virilizing phenotypes. Patients with the non-classic form are asymptomatic or have mild features of androgen excess. Most developed countries have newborn screening facilities for CAH. In the absence of newborn screening, the diagnosis of CAH may be missed or delayed. This can result in neonatal mortality in salt wasting forms and incorrect sex of rearing in females with simple virilizing form. The diagnosis is reached by demonstrating high serum 17-hydroxyprogesterone (17OHP) levels. Preterm birth and neonatal illness can cause physiological elevation of 17OHP, thus complicating the diagnosis of CAH in the newborn period. Prenatal diagnosis and treatment with dexamethasone to prevent virilization of affected female fetuses is another area of controversy. The management of CAH is complicated by the need to use supraphysiologic doses of glucocorticoids to suppress adrenal androgen synthesis. In this review, the authors address pertinent issues related to the diagnosis and management of CAH in children. PMID:24254335
Sharma, Rajni; Seth, Anju
Taenia taeniaeformis: colonic hyperplasia in heavily infected rats.
Only one study previously mentioned the involvement of colon during Taenia taeniaeformis larvae infection in rats with inconsistent occurrence of lesions. Present study aimed to determine the consistency of histopathologic changes in colonic epithelia, and the proliferation of mucosal cells through BrdU and PCNA immunohistochemistry. Results demonstrated that crypt hyperplasia of the colon was found in all infected rats, although variable in degree even in a single tissue section. Cystic cavities were frequently seen in severely hyperplastic mucosa. Proliferative zone lengths were significantly increased and PCNA positive cells were observed throughout the colonic crypt lengths at 9 but not at 6 weeks post infection. Cell proliferation involving the major types of cells in the epithelial colon was also increased in infected rats at 9 weeks post infection, with labeling indices significantly greater than the control rats throughout the BrdU time course labeling. Findings suggested that massive increases in epithelial cells and depth of colonic crypts were due to a remarkable increase in cell proliferation. The study concluded that enteropathy in the colon during T. taeniaeformis infection could be consistently observed in heavily infected rats. PMID:18793638
Lagapa, Jose Trinipil; Oku, Yuzaburo; Kamiya, Masao
Benign prostatic hyperplasia and male lower urinary tract symptoms (LUTS)
Introduction Lower urinary tract symptoms related to benign prostatic hyperplasia (BPH) and bladder outlet obstruction may affect up to 30% of men in their early 70s. Symptoms can improve without treatment, but the usual course is a slow progression of symptoms, with acute urinary retention occurring in 1% to 2% of men with BPH per year. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of medical, herbal, and surgical treatments? We searched: Medline, Embase, The Cochrane Library, and other important databases up to July 2009 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 63 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: 5 alpha-reductase inhibitors, alpha-blockers, beta-sitosterol plant extract, Pygeum africanum, rye grass pollen extract, saw palmetto plant extracts, transurethral electrovaporisation, transurethral Holmium laser enucleation of the prostate, transurethral microwave thermotherapy, transurethral needle ablation, and transurethral resection (including transurethral resection versus transurethral incision, and transurethral resection versus visual laser ablation/laser vaporisation).
Benign prostatic hyperplasia: An overview of existing treatment
Benign prostatic hyperplasia (BPH) is the most common condition in aging men, associated with lower urinary tract symptoms (LUTS). A better understanding of the prostate physiology, function, and pathogenesis has led to the development of promising agents, useful in the management of LUTS in men. The specific approach used to treat BPH depends upon number of factors like age, prostrate size, weight, prostate-specific antigen level, and severity of the symptoms. 5?-reductase inhibitors decrease the production of dihydrotestosterone within the prostate, which results in decreased prostate volume, increased peak urinary flow rate, improvement of symptoms, decreased risk of acute urinary retention, and need for surgical intervention. ?1-adrenergic receptor (?1-AR) antagonists decrease LUTS and increase urinary flow rates in men with symptomatic BPH, but do not reduce the long-term risk of urinary retention or need for surgical intervention. Clinical efficacy of either 5?-reductase inhibitor or ?1-AR antagonist has been further improved by using combination therapy; however, long-term outcomes are still awaited. Many more potential new therapies are under development that may improve the treatment of BPH. This article gives a brief account of rationale and efficacy of different treatment options presently available in the management of BPH.
Dhingra, Neelima; Bhagwat, Deepak
Inflammation in benign prostatic hyperplasia: a 282 patients' immunohistochemical analysis
Introduction and objectives Prostatic inflammation could be a key component in prostate enlargement and benign prostatic hyperplasia (BPH) progression. Our aim was to characterize inflammatory cells infiltrate within BPH tissue and to correlate inflammation and clinical data. Material and methods Inflammation was profiled on three clinical outcome tissue microarrays (TMAs), including 282 patients treated by surgery for a complicated and/or symptomatic BPH. Inflammation score was defined by combining six cytological parameters and 5 markers on immunohistochemistry (IHC). Cytological parameters were lymphocytes, macrophages and polynuclears leukocytes infiltrates, and three glandular aspect modifications: glandular atrophy, glandular destruction and tissue fibrosis. IHC markers were CD3, CD4 and CD8 decorating T-lymphocytes, CD20 decorating B-lymphocytes, and CD163 decorating macrophages. Results The majority of patients had inflammatory cells infiltrating BPH tissues: 81% had T-lymphocytes markers (CD3), 52% had B-lymphocytes markers (CD20) and 82% had macrophages markers (CD163). IPSS score (21 vs 12; p=0,02) and prostate volume (77cc vs 62cc; p=0.002) were significantly higher in patients with high grade prostatic inflammation. Conclusion We characterized inflammatory cells infiltrate in a large cohort of surgically treated BPH specimens. The role of inflammation in BPH development was highlighted by the strong correlation between histological inflammation, IPSS and prostate volume. Prostate enlargement due to chronic inflammatory process may progressively conduce to BPH progression. Therefore, inflammation is a therapeutic target for BPH.
Robert, Gregoire; Descazeaud, Aurelien; Nicolaiew, Nathalie; Terry, Stephane; Sirab, Nanor; Vacherot, Francis; Maille, Pascale; Allory, Yves; De La Taille, Alexandre
[Dutasteride: main results in the treatment of benign prostatic hyperplasia].
Benign prostatic hyperplasia (BPH) is a progressive disease characterized by an increase in prostatic volume. The resulting urinary irritative and/or obstructive symptoms, when present, often reduce the patient's quality of life. Prostatic dihydrotestosterone, the androgen produced following transformation of testosterone by the enzyme 5-alpha-reductase, is responsible for these changes. Among various products used for drug therapy, 5-alpha-reductase inhibitors play a specific role in the long-term management of BPH. Between the two currently available products, dutasteride is the only dual 5-alpha-reductase inhibitor (types 1 and 2). The efficacy of dutasteride was tested in several scientific studies and the cumulative results of three controlled, double-blind pivotal studies, showed at 2-year a clear improvement in all parameters modified during this disorder. A significant decrease in the severity and frequency of the urinary symptoms, in prostate volume, the risk of urine retention, the necessity to resort to surgery and an increase in peak urinary flow were observed with dutasteride. These results were confirmed in the 4-year-open label extension of these pivot studies both for tolerability of the product and the maintenance of its efficacy over time. PMID:15651494
Le-Coent, R
Proliferation, Apoptosis, and Survivin Expression in Keratinocytic Neoplasms and Hyperplasias
The dysregulation of apoptosis occurs in many cutaneous disease states. Several apoptosis inhibitors have been shown elevated in neoplasms and in some inflammatory conditions, but their relation to proliferative and apoptotic states has not been defined. We examined the expression of the apoptosis inhibitor survivin in a panel of keratinocytic neoplasms and hyperproliferative skin lesions using both immunohistochemistry and a newly developed in situ hybridization technique. Proliferation and apoptotic indices were also assessed by immunohistochemical staining for proliferating cell nuclear antigen and TUNEL, respectively. We found the highest rate of proliferation in verrucae and psoriasis followed by actinic keratosis, squamous and basal cell carcinoma, lichen simplex chronicus, and seborrheic keratosis; all were significantly (P < 0.05) higher than normal skin. Apoptotic rate was increased in squamous (P = 0.05) and basal cell carcinoma (P = 0.03), but not significantly different from normal skin in the other lesions tested. Survivin expression was seen in most neoplasms and hyperproliferative lesions, but not normal skin. Survivin expression was often restricted to the upper third of the epidermis in psoriasis and lichen simplex chronicus, whereas all the other lesions stained diffusely. Survivin expression appears to be a consistent feature of keratinocytic neoplasms and hyperproliferative lesions and may contribute to the formation of epidermal hyperplasia seen in all of these disease states.
Bowen, Anneli R.; Hanks, Adrianne N.; Murphy, Kelley J.; Florell, Scott R.; Grossman, Douglas
Therapeutic strategies to combat neointimal hyperplasia in vascular grafts
Neointimal hyperplasia (NIH) in bypass conduits such as veins and prosthetic grafts is an important clinical entity that limits the long-term success of vascular interventions. Although the development of NIH in the conduits shares many of the same features of NIH that develops in native arteries after injury, vascular grafts are exposed to unique circumstances that predispose them to NIH, including surgical trauma related to vein handling, hemodynamic changes creating areas of low flow, and differences in biocompatibility between the conduit and the host environment. Multiple different approaches, including novel surgical techniques and targeted gene therapies, have been developed to target and prevent the causes of NIH. Recently, the PREVENT trials, the first molecular biology trials in vascular surgery aimed at preventing NIH, have failed to produce improved clinical outcomes, highlighting the incomplete knowledge of the pathways leading to NIH in vascular grafts. In this review, we aim to summarize the pathophysiologic pathways that underlie the formation of NIH in both vein and synthetic grafts and discuss current and potential mechanical and molecular approaches under investigation that may limit NIH in vascular grafts.
Collins, Michael J; Li, Xin; Lv, Wei; Yang, Chenzi; Protack, Clinton D; Muto, Akihito; Jadlowiec, Caroline C; Shu, Chang; Dardik, Alan
Approach to the Patient: The Adult With Congenital Adrenal Hyperplasia
The most common form of congenital adrenal hyperplasia is steroid 21-hydroxylase deficiency (21OHD). When the nonclassical (mild) form is included, 21OHD is the most common genetic disease in human beings. With the advent of pharmaceutical preparation of glucocorticoids starting in the 1960s and newborn screening starting in the 1990s, the majority of children with 21OHD are reaching adulthood, which has yielded a cohort of patients with, in essence, a new disease. Only recently have some data emerged from cohorts of adults with 21OHD, and in some centers, experience with the management of these patients is growing. These patients suffer from poor health, infertility, characteristic tumors in the adrenal glands and gonads, and consequences of chronic glucocorticoid therapy. Their care is fragmented and inconsistent, and many stop taking their medications out of frustration. Internal medicine residents and endocrinology fellows receive little training in their care, which further discourages their seeking medical attention. Adults with 21OHD have a different physiology from patients with Addison's disease or other androgen excess states, and their needs are different than those of young children with 21OHD. Consequently, their care requires unorthodox treatment and monitoring strategies foreign to most endocrine practitioners. Our goal for this article is to review their physiology, complications, and needs in order to develop rational and effective treatment and monitoring strategies.
Arlt, Wiebke
Micro and bulk analysis of prostate tissues classified as hyperplasia
NASA Astrophysics Data System (ADS)
BPH (Benign Prostatic Hyperplasia) is the most common benign neoplasm (non cancerous enlargement of the prostate gland), whose prevalence increases with age. The gland, when increased in size, exerts pressure on the urethra, causing obstruction to urine flow. The latter may result in severe urinary tract and kidney conditions. In this work prostate samples from patients diagnosed with BPH were analyzed using synchrotron radiation. Micro-analysis of the hyperplastic samples was carried out on the L-beam line at HASYLAB, DESY (Germany), while bulk analysis on selected samples was performed at the DRX2 beamline at LNF, Frascati (Italy). Microanalysis with a mono-energetic beam 15 ?m in diameter confirmed that concentrations of certain elements, such as S, Mn, Cu, Fe and Zn, are good indicators of pathological disorders in prostate tissue that may be considered effective tracers of developing compliant. The concentrations of Mn, Cu, Fe and Zn are higher in hyperplastic tissues, as compared to normal ones, while for sulphur the opposite is observed. Additionally, Fe and S K-edge XANES (X-ray Absorption Near Edge Structure) spectroscopy experiments were carried out in order to determine the chemical speciation of these elements in our samples.
Kwiatek, W. M.; Bana?, A.; Bana?, K.; Cinque, G.; Dyduch, G.; Falkenberg, G.; Kisiel, A.; Marcelli, A.; Podg�rczyk, M.
Multifocal epithelial hyperplasia: A potentially precancerous disease? (Review).
Multifocal epithelial hyperplasia (MEH), also known as Heck's disease, manifests as a papulonodular lesion in the oral mucosa and has been associated with the human papillomavirus, a virus related to various precancerous diseases in the oral cavity. It has a predisposition for the female gender and for children. Although the majority of reported cases have been among American Indians and Eskimos, it has been described in multiple ethnic groups in various geographical locations. The objective of this review was to report on the clinical characteristics and epidemiology of MEH and its possible correlation with oral cancer. It is based on a search of articles in international journals published prior to April 2011, using the PubMed database and selecting articles related to the epidemiology and clinical characteristics of MEH. The review revealed a higher number of cases in individuals of American Indian origin and a predilection of the disease for the female gender and for patients between the 1st and 2nd decades of life. The most frequent lesion site was the lower lip. The disease has been associated with socio-economic and genetic factors, among others. No cases of malignant transformation have been reported. PMID:22740890
Bascones-Mart�nez, A; Cok, S; Bascones-Ilund�in, C; Arias-Herrera, S; Gomez-Font, R; Bascones-Ilund�in, J
Genetic Analysis of Prostatic Atypical Adenomatous Hyperplasia (Adenosis)
Atypical adenomatous hyperplasia (AAH) of the prostate, a small glandular proliferation, is a putative precursor lesion to prostate cancer, in particular to the subset of well-differentiated carcinomas that arise in the transition zone, the same region where AAH lesions most often occur. Several morphological characteristics of AAH suggest a relationship to cancer; however, no definitive evidence has been reported. In this study, we analyzed DNA from 25 microdissected AAH lesions for allelic imbalance as compared to matched normal DNA, using one marker each from chromosome arms 1q, 6q, 7q, 10q, 13q, 16q, 17p, 17q, and 18q, and 19 markers from chromosome 8p. We observed 12% allelic imbalance, with loss only within chromosome 8p11�12. These results suggest that genetic alterations in transition zone AAH lesions may be infrequent. This genotypic profile of AAH will allow for comparisons with well-differentiated carcinomas in the transition zone of the prostate.
Doll, Jennifer A.; Zhu, Xiaopei; Furman, Jaime; Kaleem, Zahid; Torres, Carlos; Humphrey, Peter A.; Donis-Keller, Helen
Coronary restenosis: evaluation of a restenosis injury index in a swine model.
To investigate the mechanisms of restenosis and detect useful interventions to prevent it, reliable quantitative measurements must be evaluated. Coronary arteries of domestic and minipigs (n = 18) were mechanically injured by balloon overstretching and killed at different intervals (2 to 25 weeks) after quantitative angiographic analysis. Morphometric measurements evaluated intimal hyperplasia at 0.59 +/- 0.42 mm without relation to artery size or balloon/artery ratio. Intimal hyperplasia, expressed as the ratio of neointimal area to total wall area (A), is directly related to the injury, assessed by the ratio of internal elastic lamina (IEL) fracture length to IEL circumference (B), r = 0.84, p = 0.002. Restenosis injury index, defined as A/B, provides a useful tool for the quantitative assessment of future angioplasty-related restenosis interventions. PMID:8249790
Bonan, R; Paiement, P; Scortichini, D; Cloutier, M J; Leung, T K
Effects of 100 and 300 Units of Onabotulinum Toxin A on Lower Urinary Tract Symptoms of Benign Prostatic Hyperplasia: A Phase II Randomized Clinical Trial
Purpose We conducted a 2-stage, multicenter, double-blind, randomized phase II clinical trial of 100 and 300 unit doses of onabotulinum toxin A to treat the lower urinary tract symptoms of benign prostatic hyperplasia. Materials and Methods Men 50 years old or older with clinically diagnosed benign prostatic hyperplasia, American Urological Association symptom index 8 or greater, maximum urinary flow rate less than 15 ml per second, voided volume 125 ml or greater, and post-void residual 350 ml or less were randomized to prostatic transrectal injection of 100 or 300 units of onabotulinum toxin A. The primary outcome was at least 30% improvement from baseline to 3 months in American Urological Association symptom index and/or maximum urinary flow rate and safety. The men were followed for 12 months. Results A total of 134 men were randomized and treated (68 with 100 units, 66 with 300 units), with 131 assessed at 3 months and 108 assessed at 12 months. Each dose met the 3-month primary outcome criteria. In the 100 unit arm the mean baseline American Urological Association symptom index of 18.8 decreased by 7.1 and 6.9 at 3 and 12 months, respectively. In the 300 unit arm the baseline of 19.5 decreased by 8.9 and 7.1, respectively. In the 100 unit arm the mean baseline maximum urinary flow rate of 10.0 ml per second increased by 2.5 and 2.2, respectively, and in the 300 unit arm the baseline of 9.6 increased by 2.6 and 2.3, respectively. Conclusions The intraprostatic injection of 100 or 300 units of onabotulinum toxin A passed predetermined criteria for treatment efficacy and safety, and a randomized trial with either dose is warranted. The 100 unit dose may be preferable due to similar efficacy with reduced costs and adverse effects.
Crawford, E. David; Hirst, Kathryn; Kusek, John W.; Donnell, Robert F.; Kaplan, Steven A.; McVary, Kevin T.; Mynderse, Lance A.; Roehrborn, Claus G.; Smith, Christopher P.; Bruskewitz, Reginald
40 CFR 1508.7 - Cumulative impact.
Code of Federal Regulations, 2010 CFR
... 2010-07-01 2010-07-01 false Cumulative impact. 1508.7 Section 1508.7 Protection...QUALITY TERMINOLOGY AND INDEX § 1508.7 Cumulative impact. Cumulative impact is the impact on the environment which...
40 CFR 1508.7 - Cumulative impact.
Code of Federal Regulations, 2010 CFR
... 2009-07-01 2009-07-01 false Cumulative impact. 1508.7 Section 1508.7 Protection...QUALITY TERMINOLOGY AND INDEX § 1508.7 Cumulative impact. Cumulative impact is the impact on the environment which...
40 CFR 1508.7 - Cumulative impact.
Code of Federal Regulations, 2013 CFR
... 2013-07-01 2013-07-01 false Cumulative impact. 1508.7 Section 1508.7 Protection...QUALITY TERMINOLOGY AND INDEX § 1508.7 Cumulative impact. Cumulative impact is the impact on the environment which...
Indian Deep-sea Environment Experiment (INDEX)
Indian Deep-sea Environment Experiment (INDEX) is a multi-disciplinary study to establish baseline conditions and evaluate the possible impact of deep-seabed mining in Central Indian Basin. A disturbance was simulated to study the effects of sediment re-suspension and re-settlement in the benthic areas. Monitoring the process of restoration and recolonisation of benthic environment and development of predictive models for environmental impact
Rahul Sharma
Importance of prostate volume and urinary flow rate in prediction of bladder outlet obstruction in men with symptomatic benign prostatic hyperplasia
Objectives To predict bladder outlet obstruction with parameters of non-invasive investigations for patients with symptomatic benign prostatic hyperplasia. Patients and methods A sample of 122 men with moderate to severe lower urinary tract symptoms suggestive of benign prostatic hyperplasia was selected. Transrectal prostate ultrasound, free flow measurement, and transabdominal ultrasound for residual urine were carried out together with digital rectal examination for all patients. All patients underwent urodynamic pressure/flow test. Two groups of obstructed (91 patient) and equivocal/unobstructed (31 patient) were analyzed. Probabilistic model based on logistic regression was developed for prediction of obstruction. Results Various parameters were compared in obstructed and non-obstructed/equivocal groups, highlighting important parameters for obstruction. Correlation analysis indicates higher obstruction dependence on average and peak flow rates and lower dependence on total prostate and transition zone volumes, transition zone index. Binary logistic regression model suggests that average flow rate combined with total prostate volume is the best predictor of obstruction (83% of correct predictions; PPV = 92%; NPV = 52%) in the analyzed sample. The analyzed model suggests that peak flow rate could also be almost equally important parameter instead of average flow rate. Conclusions The study suggests that average/peak flow rate combined with total prostate volume can be used for prediction of obstruction. The developed probabilistic model helps to determine patients who need invasive urodynamic testing for decision on surgical treatment.
Milonas, Daimantas; Jievaltas, Mindaugas; Matjosaitis, Aivaras Jonas; Kincius, Marius; Grybas, Aivaras; Kopustinskas, Vytis
Influence of ischemia before vein grafting on early hyperplasia of the graft and the dynamic changes of the intima after grafting
Background To investigate both the influence of ischemia before grafting on early hyperplasia of the vein grafts, and the dynamic changes of the intima after grafting in a rabbit model of vein graft disease. Methods We performed paired vein graft experiments under different ischemic conditions (15 vs. 60 min; 15 vs. 90 min) in the neck of the rabbits and compared the differences between the grafts. Clopidogrel, an anti-platelet agent, was administered before and after surgery. Twenty-eight days after the grafting procedure, the veins were evaluated microscopically. The dynamic changes of the intima after grafting were evaluated by scanning electron microscopy over time. Results The vein grafts subjected to 60- or 90-min ischemia exhibited no differences compared to those subjected to 15-min ischemia in terms of the mean thickness of the intimal, medial, and adventitial layers of the graft. Similarly, there was no difference in the Ki-67 labeling index (proliferation marker) between the vein grafts. Vein grafts with 15-min ischemia lost endothelial cells (ECs) but healed by 3 days post graft, whereas vein grafts with 90-min ischemia suffered serious EC loss, which was restored with new ECs during days 2 to 14 post graft. Conclusions Ninety-minute ischemia before vein grafting can cause serious EC loss, but does not increase early intimal hyperplasia when clopidogrel is administered. Protecting the vein from ischemia and reperfusion injury preserves ECs.
The role of combination medical therapy in benign prostatic hyperplasia.
To review key trials of monotherapy and combination therapy of alpha(1)-adrenergic receptor antagonists (alpha(1)-ARAs), 5alpha-reductase inhibitors (5alphaRIs) and anti-muscarinic agents in the treatment of lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). To assess the safety and efficacy of combination therapies for LUTS associated with BPH, a search of the MEDLINE and Cochrane databases (1976-2008) was conducted for relevant trials and reviews using the terms benign prostatic hyperplasia, lower urinary tract symptoms, alpha(1)-adrenergic receptor antagonists, 5alpha-reductase inhibitors, anti-muscarinics, anticholinergics, combination therapy, alfuzosin, doxazosin, tamsulosin, terazosin, dutasteride, finasteride, tolterodine, flavoxate, propiverine, oxybutynin, erectile dysfunction, sildenafil, vardenafil and tadalafil. Data from the Medical Therapy of Prostatic Symptoms (MTOPS) study indicated a role for long-term use of alpha(1)-ARAs and 5alphaRIs in combination. In the MTOPS study, combination therapy with the alpha(1)-ARA doxazosin and the 5alphaRI finasteride was significantly more effective than either component alone in reducing symptoms (P=0.006 vs doxazosin monotherapy; P<0.001 vs finasteride monotherapy) and in lowering the rate of clinical progression (P<0.001 vs either monotherapy). These findings were confirmed by the 2-year preliminary results of the Combination of Avodart and Tamsulosin study. In this study, combination therapy of the alpha(1)-ARA tamsulosin and the 5alphaRI dutasteride resulted in a significantly greater decrease in International Prostate Symptom Score (IPSS) when compared with either monotherapy. Several recent trials have studied the efficacy of combining alpha(1)-ARAs and anti-muscarinic agents in the treatment of BPH. These studies have found this combination to result in statistically significant benefits in quality of life scores, patient satisfaction, urinary frequency, storage symptoms and IPSS scores. Studies have not shown an increased risk of urinary retention associated with the use of anti-muscarinics in a highly select cohort of men with BPH. The available data suggest that combination therapy can be beneficial in the treatment of BPH and associated LUTS. The greatest efficacy for the alpha(1)-ARA and 5alphaRI combination was shown in patients with larger prostate size and more severe symptoms. The combination of alpha(1)-ARAs and 5alphaRIs appears to prevent disease progression in these patients. The combination of alpha(1)-ARAs with anti-muscarinic agents is useful for relieving symptoms of bladder outlet obstruction and detrusor overactivity. Theoretic concerns regarding the risk of acute urinary retention have been refuted in several recent clinical trials; however, it must be noted that the patients in these trials were a highly select cohort of men. Men with overactive bladder and BPH who are not receiving adequate alleviation of symptoms from the first-line alpha(1)-ARAs may benefit from the addition of an anti-muscarinic agent. PMID:19002123
Greco, K A; McVary, K T
Web search engines use indexes to eciently retrieve pages containing specified query terms, as well as pages linking to specified pages. The problem of compressed indexes that permit such fast retrieval has a long history. We consider the problem: assuming that the terms in (or links to) a page are generated from a probability distribution, how well com- pactly can
Flavio Chierichetti; Ravi Kumar; Prabhakar Raghavan
Spatial information processing has been a focus of research in the past decade. In spatial databases, data are associated with spatial coordinates and extents, and are retrieved based on spatial proximity. A formidable number of spatial indexes have been proposed to facilitate spatial data retrieval. In this paper, we examine various spatial indexes proposed in the literature and present a
Beng Chin Ooi; Ron Sacks-Davis Jiawei
Objects can be recognized on the basis of their color alone by color indexing, a technique developed by Swain-Ballard (1991) which involves matching color-space histograms. Color indexing fails, however, when the incident illumination varies either spatially or spectrally. Although this limitation might be overcome by preprocessing with a color constancy algorithm, we instead propose histogramming color ratios. Since the ratios
Brian V. Funt; Graham D. Finlayson
NSDL National Science Digital Library
The Institute for Genomic Resources (TIGR) placed online the Tomato Gene Index (version 1.2) in 1999. The index is searchable by nucleotide or protein sequence, identifier (TC, ET, EST, GB), tissue, or gene product name. Note that this resource is available free of charge "only to researchers at non-profit institutions using it for non-commercial purposes."
Negative index lens aberrations
We examine the Seidel aberrations of thin spherical lenses composed of media with refractive index not restricted to be positive. We find that consideration of this expanded parameter space allows for the reduction or elimination of more aberrations than is possible with only positive index media. In particular, we find that spherical lenses possessing real aplanatic focal points are possible
David Schurig
NSDL National Science Digital Library
According to the Consumer Price Index for March 2000, the Consumer Price Index for All Urban Consumers (CPI-U) rose 0.8 percent in March. This is a 3.7 percent increase since March 1999. After seasonal adjustments, the CPI-U rose 0.7 percent, after a 0.5 percent increase in February 2000.
NASA Technical Reports Server (NTRS)
The Universal Index System (UIS) is an index management system that uses a uniform interface to solve the heterogeneity problem among database management systems. UIS provides an easy-to-use common interface to access all underlying data, but also allows different underlying database management systems, storage representations, and access methods.
Kelley, Steve; Roussopoulos, Nick; Sellis, Timos; Wallace, Sarah
A retroreflector is formed of a graded index lens with a reflective coating at one end. The lens has a length of an odd multiple of a quarter period thereof. Hexagonally shaped graded index lenses may be closely packed in an array to form a retroreflecting surface.
Layne, Clyde B. (Livermore, CA)
A retroreflector is formed of a graded index lens and a reflective coating at one end. The lens has a length of an odd multiple of a quarter period thereof. Hexagonally shaped graded index lenses may be closely packed in an array to form a retroreflecting surface.
Layne, C.B.
Targeting Androgen Receptor to Suppress Macrophage-induced EMT and Benign Prostatic Hyperplasia (BPH) Development
Early studies suggested macrophages might play roles in inflammation-associated benign prostatic hyperplasia (BPH) development, yet the underlying mechanisms remain unclear. Here we first showed that CD68+ macrophages were identified in both epithelium and the stromal area of human BPH tissues. We then established an in vitro co-culture model with prostate epithelial and macrophage cell lines to study the potential impacts of infiltrating macrophages in the BPH development and found that co-culturing prostate epithelial cells with macrophages promoted migration of macrophages. In a three-dimensional culture system, the sphere diameter of BPH-1 prostate cells was significantly increased during coculture with THP-1 macrophage cells. Mechanism dissection suggested that expression levels of epithelial-mesenchymal transition (EMT) markers, such as N-cadherin, Snail, and TGF-?2, were increased, and administration of anti-TGF-?2 neutralizing antibody during co-culture suppressed the EMT and THP-1-mediated growth of BPH-1 cells, suggesting THP-1 might go through EMT to influence the BPH development and progression. Importantly, we found that modulation of androgen receptor (AR) in BPH-1 and mPrE cells significantly increased THP-1 and RAW264.7 cell migration, respectively, and enhanced expression levels of EMT markers, suggesting that AR in prostate epithelial cells might play a role in promoting macrophage-mediated EMT in prostate epithelial cells. Silencing AR function via an AR degradation enhancer, ASC-J9, decreased the macrophage migration to BPH-1 cells and suppressed EMT marker expression. Together, these results provide the first evidence to demonstrate that prostate epithelial AR function is important for macrophage-mediated EMT and proliferation of prostate epithelial cells, which represents a previously unrecognized role of AR in the cross-talk between macrophages and prostate epithelial cells. These results may provide new insights for a new therapeutic approach to battle BPH via targeting AR and AR-mediated inflammatory signaling pathways.
Lu, Tianjing; Lin, Wen-Jye; Izumi, Kouji; Wang, Xiaohai; Xu, Defeng; Fang, Lei-Ya; Li, Lei; Jiang, Qi
Benign prostate hyperplasia: evaluation of treatment response with DCE MRI.
Benign prostate hyperplasia (BPH) is a major disease and its non-surgical therapy a major area of interest. The purpose of this study was to establish perfusion parameters in beagles with BPH using dynamic contrast-enhanced (DCE) MRI and to investigate changes due to the effects of finasteride treatment. Twelve male beagles (mean age 4.4 +/- 0.9,years) were divided into a control and treatment group that received a daily dose of 1 mg/kg finasteride. DCE MRI was carried out in a clinical scanner using a 3D spoiled gradient echo sequence prior to and during treatment. 0.2 mmol/kg contrast agent (gadoteridol) was administered with an injection rate of 0.2 ml/s followed by a 15 ml flush of saline. Contrast enhancement was evaluated by pharmacokinetic mapping of a two-compartment model with colour overlay images in addition to regional ROI analysis. Quantitative parameters were defined by the amplitude of contrast enhancement A, the exchange rate k(ep) and the time to maximum signal enhancement. Dynamic contrast-enhanced MRI investigations of the prostate revealed two distinct zones, an inner, periurethral zone and an outer, parenchymal zone. The periurethral zone is highly vascularized, whereas the parenchymal zone is moderately vascularized when compared to other parenchymal organs. During treatment, in the parenchymal zone the intensity of enhancement (amplitude A) and the time to maximum signal enhancement increased, while the exchange rate k(ep) decreased. Dynamic contrast-enhanced MRI of BPH reveals distinct differences between individual zones within the prostate. Moreover, changes during successful treatment suggest increased blood volume per volume of tissue and decreased vessel leakiness. PMID:15221660
Heverhagen, J T; von Tengg-Kobligk, H; Baudendistel, K T; Jia, G; Polzer, H; Henry, H; Levine, A L; Rosol, T J; Knopp, M V
[The imaging diagnosis of hepatic focal nodular hyperplasia].
Focal nodular hyperplasia (FNH) is a rare benign hepatocellular tumor occurring in noncirrhotic patients, mostly females, 20-50 years of age. It is usually asymptomatic. The authors took the lead from 5 cases of FNH studied over last year to analyze the different patterns exhibited by the condition on the various imaging techniques currently available. At scintigraphy with 99mTc DISIDA or with TcSC, FNH can be hyper, normal, or hypocaptating. On US scans, the lesion is often homogeneous and isoechoic, but it can also be hyper/hypoechoic. With Doppler US, high-flow signals can be observed. On unenhanced CT scans the lesion is solid, well-demarcated, isodense or slightly hyperdense; sometimes it shows a central hypodense area corresponding to fibrovascular scar. On postcontrast scans it appears hyper/isodense. At dynamic CT the lesion density, which is high during the arterial phase, decreases quickly in the parenchymal and the venous phases and reaches equal/inferior values to surrounding liver parenchyma. On liver angio-CT it is sometimes possible to visualize the bile ducts in the central scar. At angiography, FNH is hypervascular and homogeneous. On MR scans, in T1-weighted SE sequences, the condition is isointense or slightly hypointense, whereas on T2-weighted pulse sequences it is slightly hyperintense; the central scar is hypointense on T1, and hyperintense on T2, weighted scans. As we have no pathognomonic patterns but only orientative ones, a reliable differential diagnosis with hepatocellular adenoma (HA) and fibrolamellar hepatocellular carcinoma (FL-HCC) must be based on biopsy or cytology or, even better, histology. The differential diagnosis is nevertheless necessary because, while FNH does not usually require a surgical approach but only a radiological follow-up, both HA (due to possible bleeding and degeneration) and FL-HCC require surgery. PMID:1664964
Bazzocchi, M; Macorig, D; Cecconi, P; Gozzi, G
Characterisation of inflammatory cells in benign prostatic hyperplasia.
Inflammation is a common finding in benign prostatic hyperplasia (BPH) and may be classified as acute, chronic active or chronic inactive prostatitis. The aim of the present study was to localise the different types of inflammatory cells in prostatic lesions to determine the sequence of events in the cellular reaction. We have carried out immunohistological characterisation of the inflammatory cells, using CD45RO and CD3 antibodies to detect T-lymphocytes, CD20 antibodies to detect B-lymphocytes, CD68 to detect macrophages, kappa and lambda immunoglobulin light chains, and antibodies against prostate specific antigen (PSA) and prostate specific acid phosphatase (PSAP). Macrophages accumulated in the lumen and glandular epithelial layers of damaged prostatic glands and were found in the periglandular cuff of inflammatory cells in acute and chronic active prostatitis. Lymphocytes also accumulated in large numbers in the glandular epithelial layers and around the glands, indicating an association with macrophages. B-lymphocytes were scanty, if at all present, in acute and chronic active prostatitis, but were prominent within well-organised follicle centres in chronic active prostatitis. Cells positive for light chains were few and scattered in prostatic tissue. PSA and PSAP activity was lost in recently damaged prostatic glandular epithelium and reappeared only in regenerating secretory epithelium, indicating leakage as a result of damage. We suggest that the initial response to prostatic injury is cellular, and probably related to leakage into the periglandular tissues of PSA, PSAP and other antigenic molecules normally present in prostatic secretion. Macrophages respond, followed by recruitment of T-lymphocytes which participate in the inflammatory response and accumulate around the damaged glands. B-cell activity appears to be a late event. PMID:9842422
Anim, J T; Udo, C; John, B
Monitoring congenital adrenal hyperplasia using blood spot 17-hydroxyprogesterone assay.
Blood spots taken by finger prick collected on filter paper cards can provide an option to venous blood extraction in monitoring 17-OHP levels in children with Congenital Adrenal Hyperplasia (CAH). This study was done to evaluate the usefulness of blood spot 17-OHP in monitoring disease control in pre-pubertal children with CAH, to correlate it with simultaneously extracted venous 17-OHP levels, and to compare blood spot levels of children with CAH with that of normal non-virilized children. Nine pre-pubertal children with CAH (1 male; 8 females) were enrolled in the study. Age, sex, growth velocity, height age and bone age were determined. Simultaneous venous and blood spot specimens were taken between 0800 and 0900 hours. Nine pre-pubertal, age- and sex-matched normal non-virilized children served as controls. COAT-A-COUNT was used to measure venous 17-OHP levels, and AutoDELFIA Neonatal 17alpha-OH-progesterone was employed for blood spot specimens. Mean age of patients with CAH was 42.78 months (SD= 21.45214). Four had simple virilizing form and five were salt-losers. Venous 17-OHP levels ranged from 7.5 to 800nmol/l. Blood spot 17-OHP levels ranged from < or =0.5000nmol/l to 355.5nmol/l. There was a strong positive correlation between the venous and blood spot determination, with a correlation coefficient gamma= 0.947 (p < 0.001). All of the children in the control group had a blood spot 17-OHP level < or =0.5000nmol/l. Taking blood spot 17-hydroxyprogesterone levels is a simple, acceptable, convenient, and less costly alternative to venous 17-OHP determination in monitoring treatment response of children with CAH. The decision to make treatment modification, however, should be made on random blood spot 17-OHP interpretation in conjunction with clinical history and evaluation of growth parameters. PMID:15906729
Santos, Caridad M; Abad, Lorna R; Cua, Sioksan C; Domingo, Carmelita F
Contact laser vaporization techniques for benign prostatic hyperplasia.
Contact laser applications for the relief of bladder outlet obstruction caused by an enlarged prostate are different from the noncontact Nd:YAG laser methods. The noncontact techniques rely on coagulation necrosis or high power-density vaporization. The pure contact Nd:YAG laser allows cutting, coagulation, and vaporization of tissue with minimal penetration beyond the contact surface. In the contact laser prostatectomy technique, the laser probe directly touches and vaporizes the prostatic tissue. This results in immediate removal of the obstructing tissue, in a manner similar to the standard electrosurgical transurethral resection (TURP), and offers the patient the potential for decreased catheter time and a more rapid resolution of symptoms. Our initial experience suggests that the contact technique (contact laser ablation of the prostate or CLAP) may be better suited for the smaller prostate gland (i.e., less than 20-30 g). For prostates larger than 30 g, a newly described procedure known as coagulation and hemostatic resection of the prostate (CHRP) can be used. This method combines initial noncontact coagulation of the prostate with vaporization of a channel. The goal of CHRP is to allow more rapid removal of the catheter with a continued improvement in urine flow secondary to the coagulation effects. The contact laser is specifically designed to vaporize tissue such as the prostate and allows immediate observation of a TUR defect. Improvements in the delivery system and in the size of the contact laser probes have made CLAP a useful modality for the treatment of symptomatic benign prostatic hyperplasia. PMID:7543321
Gomella, L G; Lotfi, M A; Rivas, D A; Chancellor, M B
Karyometry in atypical endometrial hyperplasia: A Gynecologic Oncology Group study
Objectives Treatment for atypical endometrial hyperplasia (AEH) is based on pathologic diagnosis. About 40% of AEH is found to be carcinoma at surgery. This study's objective is to derive an objective characterization of nuclei from cases diagnosed as AEH or superficially invasive endometrial cancer (SIEC). Methods Cases from GOG study 167A were classified by a central pathology committee as AEH (n=39) or SIEC (n=39). High resolution digitized images of cell nuclei were recorded. Features of the nuclear chromatin pattern were computed. Classification rules were derived by discriminant analysis. Results Nuclei from cases of AEH and SIEC occupy the same range on a progression curve for endometrial lesions. Cases of AEH and SIEC both comprise nuclei of two phenotypes: hyperplastic characteristics and premalignant/neoplastic characteristics. The principal difference between AEH and SIEC is percentage of premalignant/neoplastic nuclei. When this percentage approaches 50-60% superficial invasion is likely. SIEC may develop already from lesions at the low end of the progression curve. Conclusions AEH comprises cases which may constitute a low risk group involving <40% of AEH cases. These cases hold a percentage of <20% of nuclei of a preneoplastic phenotype. AEH cases from the central and high end of progression have >40 % of nuclei of preneoplastic phenotype. Nuclei of the preneoplastic phenotype in AEH lesions are almost indistinguishable from nuclei in SIEC, where this percentage exceeds 60%. The percentage of nuclei of the preneoplastic phenotype in AEH lesions might serve as criterion for assessment of risk for the development of invasive disease.
Bartels, Peter H; Garcia, Francisco AR; Trimble, Cornelia L; Kauderer, James; Curtin, John; Lim, Peter C; Hess, Lisa M; Silverberg, Steven; Zaino, Richard J; Yozwiak, Michael; Bartels, Hubert G; Alberts, David S
Laser Treatment of Benign Prostatic Hyperplasia: Dosimetric and Thermodynamic Considerations
NASA Astrophysics Data System (ADS)
Benign prostatic hyperplasia (BPH) is the most commonly occurring neoplastic disease in the aging human male. Currently, surgical treatment of BPH is the primary therapeutic method. However, due to surgical complications, less invasive methods of treatment are desirable. In recent years, thermal coagulation of the hyperplastic prostate by a laser has received a considerable amount of attention. Nevertheless, the optimum laser irradiation parameters that lead to a successful and safe treatment of BPH have not been determined. This dissertation studies the physics of laser coagulation of prostate from both basic science and practical perspectives. Optical properties of prostatic tissue are determined over a spectrum of wavelengths. Knowledge of these properties allows for selection of appropriate laser wavelengths and provides a basis for performing dose equivalency studies among various types of lasers. Furthermore, knowledge of optical properties are needed for development of computer simulation models that predict the extent of thermal injury during laser irradiation of prostate. A computer model of transurethral heating of prostate that can be used to guide the clinical studies in determining an optimum dosimetry is then presented. Studies of the effects of non-laser heating devices, optical properties, blood perfusion, surface irrigation, and beam geometry are performed to examine the extent of heat propagation within the prostate. An in vitro model for transurethral laser irradiation of prostate is also presented to examine the effects of an 810 nm diode laser, thermal boundary conditions, and energy deposition rate during Nd:YAG laser irradiation. Results of these studies suggest that in the presence of laminar irrigation, the convective boundary condition is dominated by thermal diffusion as opposed to the bulk motion of the irrigation fluid. Distinct phases of thermal events are also identified during the laser irradiation. The in vivo studies of transurethral laser irradiation of prostate in canine models are also performed to search for an optimum dosimetry that will result in a maximum zone of coagulation necrosis.
Anvari, Bahman
Nonclassic Lipoid Congenital Adrenal Hyperplasia Masquerading as Familial Glucocorticoid Deficiency
Context: Familial glucocorticoid deficiency (FGD) is an autosomal recessive disorder resulting from resistance to the action of ACTH on the adrenal cortex. Affected individuals are deficient in cortisol and, if untreated, are likely to succumb to hypoglycemia and/or overwhelming infection. Mutations of the ACTH receptor (MC2R) and the melanocortin 2 receptor accessory protein (MRAP), FGD types 1 and 2 respectively, account for approximately 45% of cases. Objective: A locus on chromosome 8 has previously been linked to the disease in three families, but no underlying gene defect has to date been identified. Design: The study design comprised single-nucleotide polymorphism genotyping and mutation detection. Setting: The study was conducted at secondary and tertiary referral centers. Patients: Eighty probands from families referred for investigation of the genetic cause of FGD participated in the study. Interventions: There were no interventions. Results: Analysis by single-nucleotide polymorphism array of the genotype of one individual with FGD previously linked to chromosome 8 revealed a large region of homozygosity encompassing the steroidogenic acute regulatory protein gene, STAR. We identified homozygous STAR mutations in this patient and his affected siblings. Screening of our total FGD patient cohort revealed homozygous STAR mutations in a further nine individuals from four other families. Conclusions: Mutations in STAR usually cause lipoid congenital adrenal hyperplasia, a disorder characterized by both gonadal and adrenal steroid deficiency. Our results demonstrate that certain mutations in STAR (R192C and the previously reported R188C) can present with a phenotype indistinguishable from that seen in FGD.
Metherell, Louise A.; Naville, Danielle; Halaby, George; Begeot, Martine; Huebner, Angela; Nurnberg, Gudrun; Nurnberg, Peter; Green, Jane; Tomlinson, Jeremy W.; Krone, Nils P.; Lin, Lin; Racine, Michael; Berney, Dan M.; Achermann, John C.; Arlt, Wiebke; Clark, Adrian J. L.
[A molecular method of diagnosis of congenital adrenal hyperplasia].
Congenital adrenal hyperplasia (CAH) is caused mainly by deficiency of the 21-hydroxylase enzyme. The disease may appear in the classical salt-losing, simple virilizing forms or as a mild, nonclassical form. 21-hydroxylase is encoded by the CYP21B gene on the short arm of chromosome 6, in the midst of the human leukocyte antigen (HLA) complex, between HLA Class I and Class II regions. We describe a method for identifying mutations in the CYP21B gene. It is based on amplification of the gene using the polymerase chain reaction and identification of mutations with sequence-specific oligo-probes. The mutations identified were: V281 and P30L responsible for nonclassical CAH, and 12 splice, Q318X, I172N, cluster E6, and a deletion including 8bP in the third exon (8bP del) responsible for the classical form of CAH. We also analyzed 2 families affected with the classical form of CAH which demonstrate possible complications in genotyping. Typing for HLA haplotypes can be helpful in certain cases, as demonstrated in 1 of the families presented. In this case it was necessary to distinguish between 2 possible genotypes: 1 with the mutations in tandem on 1 chromosome and the other with the mutated genes on both chromosomes. HLA haplotyping enabled the assignment of the mutations to the relevant chromosomes and thus allowed correct genetic counseling. The other family demonstrated the importance of CYP21B genotyping in individuals with the nonclassical form of CAH. This form may consist of 1 mild and 1 severe mutation, representing a serious potential for transmitting the classical form of CAH. PMID:11341187
Israel, S; Brautbar, C
Clinical and imaging features of focal nodular hyperplasia in children.
OBJECTIVE. The purpose of this article is to review the clinical and imaging features of focal nodular hyperplasia (FNH) developed in children. MATERIALS AND METHODS. At a single institution, pediatric patients who underwent imaging studies and who had pathologically proven FNH were studied. Clinical characteristics, including presenting symptoms and signs and the presence of underlying disease, were reviewed from the medical records. Imaging features of FNHs, including the number, size, ultrasound echogenicity and vascularity, CT attenuation, MRI signal intensity and enhancement pattern, and the presence of a central scar, were evaluated. RESULTS. Twenty-five patients (11 boys and 14 girls; median age, 8.6 years) were found to have a solitary (n = 23) or multiple (n = 2) FNH lesions with a mean size of 4.9 cm (range, 1-10 cm). Multiple lesions were associated with small size of the lesions and history of malignancy treated by chemotherapy. Most patients were asymptomatic (n = 22). Biliary atresia was the most common underlying disease (n = 5). On ultrasound, FNHs most commonly appeared to be isoechoic and hypervascular. On dynamic CT and MRI, strong enhancement on the arterial phase and becoming isoattenuated or of isointense signal intensity on the portal or delayed phase was common. A central scar was usually noted in large lesions in about half the cases. CONCLUSION. Pediatric FNH is uncommon and usually is found incidentally in otherwise healthy children. However, it may occur in children who have underlying diseases, including biliary atresia. In addition, it can be encountered during surveillance of childhood cancer survivors with less common imaging features, including lack of a central scar and multiplicity. PMID:24758647
Cha, Dong Ik; Yoo, So-Young; Kim, Ji Hye; Jeon, Tae Yeon; Eo, Hong
Gastric Tuft Cells Express DCLK1, and Increase in Hyperplasia
Epithelial tuft cells are named for their characteristic microtubule bundle located at the cell apex where it is exposed to the luminal environment. As such, tuft cells are found in multiple organs, including the gastrointestinal (GI) tract where the apical �tuft� is hypothesized to detect and transmit environmental signals. Thus, the goal of our study was to characterize gastric tuft cells during GI tract development, then subsequently in the normal and metaplastic adult stomach. GI tracts from mouse embryos, newborn and post-natal mice were analyzed. Tuft cells were identified by immunohistochemistry using acetylated-?-tubulin (acTub) antibody to detect the microtubule bundle. Additional tuft cell markers, e.g., doublecortin-like kinase 1 (DCLK1), were used to co-localize with acTub. Tuft cells were quantified in human gastric tissue arrays and in mouse stomachs with or without inflammation. In the developing intestine, tuft cells in both the crypts and villi expressed all markers by E18.5. In the stomach, acTub co-localized with DCLK1 and other established tuft cell markers by E18.5 in the antrum but not until postnatal day 7 in the corpus, with the highest density of tuft cells clustered at the forestomach ridge. Tuft cell numbers increased in hyperplastic human and mouse stomachs. In the adult GI tract, the tuft cell marker acTub co-expressed with DCKL1 and chemosensory markers, e.g., TRPM5. In summary, tuft cells appear in the gastric antrum and intestine at E18.5, but their maximal numbers in the corpus are not achieved until after weaning. Tuft cell numbers increase with inflammation, hyperplasia and metaplasia.
Saqui-Salces, Milena; Keeley, Theresa M.; Grosse, Ann S.; Qiao, Xiaotan T.; El-Zaatari, Mohamad; Gumucio, Deborah L.; Samuelson, Linda C.; Merchant, Juanita L.
Modulating vascular intimal hyperplasia using HSV-1 mutant requires activated MEK.
Outcomes of cardiovascular procedures, such as angioplasty and stent or bypass grafting are limited by failure, predominantly caused by pathological smooth muscle cell (SMC) proliferation, known as intimal hyperplasia. Local delivery of a genetically engineered herpes simplex virus (HSV) is known to block vascular SMC proliferation while allowing for re-endothelialization. However, the mechanism this mutant virus uses to prevent SMC hyperplasia is unknown. The Ras signaling cascade is activated in SMCs undergoing hyperplasia leading to phosphorylation of the mitogen-activated protein kinase (MAPK). In this study we tested the hypothesis that MAPK kinase (MEK) activity is the molecular basis by which SMCs are susceptible to mutant HSV. We show that genetically engineered herpes simplex-1 viruses (HSV-1) can target proliferating SMCs. We demonstrate that the molecular basis of this HSV-1 anti-proliferative effect is MEK activation in SMCs. We demonstrate efficacy and practicality of the MEK-dependent HSV-1 for the treatment of intimal hyperplasia in a clinically relevant in vivo model. Important to this strategy is the ability to modulate the effects by controlling viral dose. These results propel genetically engineered HSV-1 therapy towards clinical evaluation in treatment of intimal hyperplasia. PMID:22418062
Skelly, C L; He, Q; Spiguel, L; McCormick, S; Weichselbaum, R
Adenomatoid hyperplasia of the minor salivary glands on the buccal mucosa: A rare case report
INTRODUCTION Adenomatoid hyperplasia of the minor salivary glands is a hyperplastic oral lesion which may be seen on minor salivary gland bearing areas on all oral mucosa, especially on soft and hard palate. This study reports a rare case of buccal adenomatoid hyperplasia of the minor salivary glands and discusses the clinical significance. PRESENTATION OF CASE 48 year old male patient presented with a complaint of a swelling on his left cheek. Clinical examination revealed a bluish mass on the buccal mucosa. A provisional diagnosis of salivary gland neoplasm was made and the lesion was excised under local anesthesia. The histological diagnosis was adenomatoid hyperplasia of the minor salivary glands. DISCUSSION Buccal localization of the adenomatoid hyperplasia of the minor salivary glands is quite uncommon in the literature. There are two cases in the English literature for our knowledge. In the clinical examination, the nodular and protuberated appearance of the lesion resembles buccal minor salivary gland tumors and vascular lesions. Histological analysis is fundamental to achieve correct diagnosis. CONCLUSION The differential diagnosis of buccal nodular, exophytic and colored mucosal lesions should include adenomatoid hyperplasia of the minor salivary glands.
Dereci, Omur; Cimen, Emre
Long segmental hyperplasia of interstitial cells of Cajal with giant diverticulum formation
Sporadic gastrointestinal stromal tumors (GISTs) usually form a well-circumscribed mass. In contrast, diffuse interstitial cell of Cajal (ICC) hyperplasia along the Auerbach plexus without a discrete mass may occur in patients with germline mutations in the NF1, c-KIT or PDGFRA genes. However, sporadic, diffuse ICC hyperplasia without c-KIT or PDGFRA mutations has not been reported. We describe herein one such case, forming a giant diverticulum. A 63-year-old woman with no features of Neurofibromatosis 1 (NF1) presented with increasing abdominal pain for more than 30 years. A large, diverticulum-like mass in the ileum was resected. Microscopically, a diffuse proliferation of bland spindle cells was seen extending for 12 cm, replacing the muscularis propria and lined by intact mucosa. The spindle cells were CD117+/CD34+/DOG1+/SMA+/Desmin-/S100-. Mutation analyses did not reveal any mutations in c-KIT or PDGFRA. The lesion had two silent mutations in the NF1 gene. It is rare of the diffuse form of sporadic ICC hyperplasia showing diffuse longitudinal microscopic growth completely replacing the muscularis propria, mimicking diffuse ICC hyperplasia in hereditary GIST syndromes, but without solid components and no c-KIT or PDGFRA gene mutations. This peculiar form of sporadic ICC hyperplasia may be related to intestinal dysmotility in this ileal segment and giant diverticulum formation.
Xue, Liyan; Qiu, Tian; Song, Ying; Shan, Ling; Liu, Xiuyun; Guo, Lei; Ying, Jianming; Zou, Shuangmei; Shi, Susheng; Polydorides, Alexandros D; Zhao, Xinming; Lu, Ning; Lin, Dongmei
Platelet-activating factor induces goblet cell hyperplasia and mucin gene expression in airways.
In patients dying from asthma, extensive mucous plugging occurs in the airways, associated with goblet cell hyperplasia. In this study, we examined the hypothesis that platelet-activating factor (PAF) induces goblet cell hyperplasia and mucin gene exp