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Applicability of robot-assisted laparoscopic radical prostatectomy in renal allograft recipients.
To evaluate the general applicability of robotic-assisted laparoscopic radical prostatectomy (RALP) in renal transplant recipients and potential surgical modifications due to the position of the transplanted kidney in the iliac fossa, as RALP has proven to be an effective and safe treatment option for prostate cancer (PCa) removal. A 71-year-old patient who had undergone renal transplantation was diagnosed with biopsy-proven localized Gleason 7a PCa. The prostate-specific antigen value was 12.4 ng/mL. RALP was performed by a transperitoneal approach using six ports. By partial mobilization of the bladder, the working space for the radical prostatectomy was created, while leaving the renal transplant and ureter untouched. Lymph node dissection was performed only on the contralateral side of the transplanted kidney. The procedure concluded after 220 minutes and the estimated blood loss was 300 mL. The perioperative clinical course was uneventful. The kidney function remained normal with a creatinine value of 1.2 mg/dL. A complete extirpation of the prostate with negative surgical margins was achieved. After catheter removal, the patient was completely continent. RALP in renal transplant recipients is feasible and can be achieved with favorable oncological and functional outcome. No modifications to the standard RALP technique are required in these patients, except from a partial dissection of the bladder from the abdominal wall and a one-sided lymph node dissection. | {
"pile_set_name": "PubMed Abstracts"
} |
Dronedarone for atrial fibrillation therapy.
Dronedarone is a new benzofuran derivative that has been developed as an antiarrhythmic agent on the basis of the amiodarone molecular structure with the intent of maintaining the same pharmacological effects while reducing thyroid and pulmonary toxicity. The drug is a multichannel blocker with antiadrenergic properties: it reduces heart rate and prolongs the action potential duration. Dronedarone is primarily metabolized by cytochrome P450; its half-life is much shorter than that of amiodarone because of a lower lipophilicity. As a consequence, only 7 days are needed to reach steady-state plasma levels. It has been tested in clinical trials both for rate and rhythm control and, even if its antiarrhythmic efficacy seems to be somehow lower than that of amiodarone, dronedarone is less often discontinued due to adverse reactions or organic toxicity. For these reasons, dronedarone can be very useful in long-term treatment of atrial fibrillation, by reducing hospitalizations and mortality. | {
"pile_set_name": "PubMed Abstracts"
} |
A comparative study of transformation functions for nonrigid image registration.
Transformation functions play a major role in nonrigid image registration. In this paper, the characteristics of thin-plate spline (TPS), multiquadric (MQ), piecewise linear (PL), and weighted mean (WM) transformations are explored and their performances in nonrigid image registration are compared. TPS and MQ are found to be most suitable when the set of control-point correspondences is not large (fewer than a thousand) and variation in spacing between the control points is not large. When spacing between the control points varies greatly, PL is found to produce a more accurate registration than TPS and MQ. When a very large set of control points is given and the control points contain positional inaccuracies, WM is preferred over TPS, MQ, and PL because it uses an averaging process that smoothes the noise and does not require the solution of a very large system of equations. Use of transformation functions in the detection of incorrect correspondences is also discussed. | {
"pile_set_name": "PubMed Abstracts"
} |
Practice variation in the management of intrapartum fetal distress in The Netherlands and the Western world.
Solid evidence on the effect of intrauterine resuscitation on neonatal outcome is limited, and superiority of one intervention over the others is not clear. We therefore surveyed the clinical practice variation in fetal monitoring and the management of fetal distress during labor, in Dutch labor wards. In addition, we have compared recommendations from international guidelines. We conducted a survey among all 86 Dutch hospitals, using a questionnaire on fetal monitoring and management of fetal distress. In addition, we requested international guidelines of 28 Western countries to study international recommendations regarding labor management. The response rate of the national survey was 100%. Labor wards of all hospitals use CTG for fetal monitoring, 98% use additional fetal scalp blood sampling, and 23% use ST-analysis. When fetal distress is suspected, oxytocin is discontinued and tocolytic drugs are applied in all hospitals. Nearly all hospitals (98%) use maternal reposition for fetal resuscitation, 33% use amnioinfusion, and 58% provide maternal hyperoxygenation. Management is mainly based on the Dutch national guideline (58%) or on local guidelines (26%). Eight international guidelines on fetal monitoring were obtained for analysis. Fetal scalp blood sampling facilities are recommended in all the obtained guidelines. Use of ST-analysis is recommended in three guidelines and advised against in three guidelines. Five guidelines also advised on intrauterine resuscitation: discontinuation of oxytocin and use of tocolytic drugs was advised in all guidelines, amnioinfusion was recommended in two guidelines and advised against in two guidelines, whereas maternal hyperoxygenation was recommended in two guidelines and advised against in one guideline. Nationwide clinical practice, and recommendations from international guidelines agree on the use of fetal scalp blood sampling in addition to cardiotocography during labor. The opinion on the use of ST-analysis differs per clinic and per guideline. Discontinuation of oxytocin, administration of tocolytic drugs and maternal repositioning are rather uniform, on national and international level. However, there is a large variation in the use of amnioinfusion and maternal hyperoxygenation, which may be explained by the contradictory recommendations of the different guidelines. | {
"pile_set_name": "PubMed Abstracts"
} |
Microbiological assay for azithromycin in pharmaceutical formulations.
The validation of a microbiological assay, applying the cylinder-plate method, for the determination of the antibiotic azithromycin is described. Using a strain of Micrococcus luteus ATCC 9341 as the test organism, azithromycin at concentrations ranging from 0.1 to 0.4 microgml(-1) could be measured in capsules and suspensions. A prospective validation of the method showed that it was linear (r=0.998), precise (RSD=1.40-capsules; RSD=1.19-powder for suspension and RSD=1.73-oral suspension) and accurate (it measured the added quantities). We conclude that the microbiological assay is satisfactory for quantitation of in vitro antibacterial activity of azithromycin. | {
"pile_set_name": "PubMed Abstracts"
} |
Lipid composition of the membrane released after an in vitro acrosome reaction of epididymal boar sperm.
Prior to fertilization, mammalian sperm must undergo the acrosome reaction, which involves modifications of the plasma and outer acrosomal membranes followed by vesiculation and release of the membranes. The membrane fraction that was released from caudal boar sperm undergoing an in vitro acrosome-like reaction was isolated and characterized with respect to density, marker enzymes and lipid composition. This membrane had a lower phospholipid/protein ratio (mg/mg) than the sperm plasma membrane, whereas both membranes had similar molar sterol/phospholipid ratios. The major phospholipid was sphingomyelin, followed by phosphatidylethanolamine and phosphatidylcholine, whereas in the plasma membrane the order was reversed; the two major phosphoglycerides contained alkylacyl and alkenylacyl species in addition to the diacyl species. The released membrane also contained lower amounts of cholesterol sulfate and unsaturated fatty acids than the plasma membranes. These results, in combination with our studies on the changes of the sperm membranes during maturation and acrosome reaction, will allow a better understanding of the mechanism of the sperm acrosome reaction. | {
"pile_set_name": "PubMed Abstracts"
} |
Measuring observer performance in chest radiology: some experiences.
All decisions made under conditions of uncertainty have error rates. All meaningful decisions are made under conditions of uncertainty. Can this uncertainty be measured? Can variations in how different observers deal with this uncertainty be ascertained? The ability to measure observer performance in diagnostic imaging was one of the issues that initiated the field of medical decision analysis. This article exemplifies an approach and is worth discussing as a preamble to presenting our long-term project of measuring variations in observer performance. The paper focuses on the interpretation of chest x-ray images, although the principles and findings described can be applied to nearly every radiologic modality and interpretation task. | {
"pile_set_name": "PubMed Abstracts"
} |
[Extradural hematoma: comparative radiological study between comatose and non-comatose patients].
A series of 129 patients harbouring extradural hematomas was analysed considering the neurological state immediately before operation as the most consistent variable. Seventy eight patients were considered to be comatose (Group I) and 51 were noncomatose. Among the comatose group, 30 were investigated with computerized tomography (23.3% mortality, 50% good results), 31 were submitted to angiography (48.3% mortality, 38.7% good results), and 17 were operated based on the neurological examination and skull radiography (47% mortality, 35.2% good results). The presence or absence of skull fracture and the density of hematoma did not change the final outcome. Associated intracranial lesions increased the mortality and lowered the good results in both groups. Frontal hematomas (10 cases) in the comatose group were associated with high mortality (52.6%) due to bad neurological state (Glasgow 3-5) and to isolated or multiple intracranial associated lesions (6 patients). | {
"pile_set_name": "PubMed Abstracts"
} |
Distinct role of bilobalide and ginkgolide A in the modulation of rat CYP2B1 and CYP3A23 gene expression by Ginkgo biloba extract in cultured hepatocytes.
In the present study, primary cultures of rat hepatocytes were treated for 48 h with one of several extracts of Ginkgo biloba (10, 100, or 1000 microg/ml). Maximal increase in CYP2B1 and CYP3A23 mRNA levels was obtained at 100 microg/ml. This concentration of G. biloba extract also increased CYP3A2 and CYP3A18 mRNA expression in addition to CYP2B-mediated 7-benzyloxyresorufin O-dealkylation (BROD) and CYP3A-mediated testosterone 6beta-hydroxylation. In other experiments, cultured hepatocytes were treated for 48 h with bilobalide, ginkgolide A, ginkgolide B, ginkgolide C, ginkgolide J, kaempferol, quercetin, isorhamnetin, or a flavonol diglycoside at a concentration that represented the level present in a 100 microg/ml concentration of an extract. Only bilobalide (2.8 microg/ml) increased CYP2B1 mRNA expression, and the -fold increase (7.9 +/- 0.5; mean +/- S.E.M.) was similar to that (8.3 +/- 1.7) by the extract. By comparison, only ginkgolide A (1.1 microg/ml) increased CYP3A23 mRNA expression, but the extent (2.6 +/- 0.5-fold) was less than the 5.3 +/- 1.7-fold increase by the extract. A greater concentration (5 microg/ml) of ginkgolide A was required to elevate CYP3A2 and CYP3A18 mRNA expression. Over the range of 1 to 5 microg/ml, bilobalide increased CYP2B1 mRNA and BROD, but not CYP3A23 mRNA or testosterone 6beta-hydroxylation, whereas ginkgolide A increased CYP3A23 mRNA and testosterone 6beta-hydroxylation, but not CYP2B1 mRNA or BROD. Overall, our novel results indicate a distinct role of bilobalide and ginkgolide A in the modulation of CYP2B1 and CYP3A23 gene expression and enzyme activities by G. biloba extract in primary cultures of rat hepatocytes. | {
"pile_set_name": "PubMed Abstracts"
} |
Mapping prodromal psychosis: a critical review of neuroimaging studies.
The onset of schizophrenia is usually preceded by a prodromal phase characterized by functional decline and subtle prodromal symptoms, which include attenuated psychotic phenomena, cognitive deterioration and a decline in socio-occupational function. Preventive interventions during this phase are of great interest because of the impressive clinical benefits. However, available psychopathological criteria employed to define a high risk state for psychosis have low validity and specificity. Consequently there is an urgent need of reliable neurocognitive markers linked to the pathophysiological mechanisms that underlie schizophrenia. Neuroimaging techniques have rapidly developed into a powerful tool in psychiatry as they provide an unprecedented opportunity for the investigation of brain structure and function. This review shows that neuroimaging studies of the prodromal phases of psychosis have the potentials to identify core structural and functional markers of an impending risk to psychosis and to clarify the dynamic changes underlying transition to psychosis and to address significant correlations between brain structure or function and prodromal psychopathology. Additionally, neurochemical methods can address the key role played by neurotransmitters such as dopamine and glutamate during the psychosis onset. To conclude, multimodal neuroimaging may ultimately clarify the neurobiology of the prodromal phases by the integration of functional, structural and neurochemical findings. | {
"pile_set_name": "PubMed Abstracts"
} |
Libidinal cathexis and emotional growth in the analytical treatment of psychosomatic patients.
The paper deals with a form of analytical therapy in psychosomatics, which was developed and applied for many years in a model research ward. The therapeutic arrangement, or setting, was designed to make provision for all 3 elements of a person's make-up - his environment, his mind and his body. At the heart of the model is the therapeutic team, which offers the patient empathatic 'holding' and encourages his emotional growth. The members of the team have learned to offer themselves to the patient as a unit with a common inner attitude towards him. This means that they must first have worked out a unified approach, a hermeneutic structure, with which to understand him. Against the background of a special genetic conception of a mother's function for her child, the ward was turned into a setting that confronts the patient, in psychodramatized form, with a specific form of 'physical ambience'. In coming to grips with the team's physical, sensual presence, the patient is stimulated into developing a transference relationship to the empathizing, maternal father-figure, the 'père maternel'. In this way he can break loose from his clinging dependency on an 'omnipotent object', his dyadic partner, and, through internalizing the therapist both in his female and his male aspects, create a libidinal object in his inner world. | {
"pile_set_name": "PubMed Abstracts"
} |
Evaluation of artificial neural networks in the classification of primary oesophageal dysmotility.
Artificial neural networks (ANNs) can rapidly analyse large data sets and exploit complex mathematical relationships between variables. We investigated the feasibility of utilizing ANNs in the recognition and objective classification of primary oesophageal motor disorders, based on stationary oesophageal manometry recordings. One hundred swallow sequences, including 80 that were representative of various oesophageal motor disorders and 20 of normal motility, were identified from 54 patients (34 F; median age 59 years). Two different ANN techniques were trained to recognize normal and abnormal swallow sequences using mathematical features of pressure wave patterns both with (ANN(+)) and without (ANN(-)) the inclusion of standard manometric criteria. The ANNs were cross-validated and their performances were compared to the diagnoses obtained by standard visual evaluation of the manometric data. Interestingly, ANN(-), rather than ANN(+), programs gave the best overall performance, correctly classifying >80% of swallow sequences (achalasia 100%, nutcracker oesophagus 100%, ineffective oesophageal motility 80%, diffuse oesophageal spasm 60%, normal motility 80%). The standard deviation of the distal oesophageal pressure and propagated pressure wave activity were the most influential variables in the ANN(-) and ANN(+) programs, respectively. ANNs represent a potentially important tool that can be used to improve the classification and diagnosis of primary oesophageal motility disorders. | {
"pile_set_name": "PubMed Abstracts"
} |
Altered expression of integrins in RSV-transformed chick epiphyseal chondrocytes.
Chondrocytes have been shown to express both in vivo and in vitro a number of integrins of the beta1-, beta3- and beta5-subfamilies (Biorheology 37 (2000) 109). Normal and v-Src-transformed chick epiphyseal chondrocytes (CEC) display different adhesion properties. While normal CEC with time in culture tends to increase their adhesion to the substrate by organizing focal adhesions and actin stress fibers, v-Src-transformed chondrocytes display a refractile morphology and disorganization of actin cytoskeleton. We wondered whether the reduced adhesion and spreading of v-Src-transformed chondrocytes could be ascribed to changes in integrin expression and/or function. Integrin expression by normal CEC is studied and compared to v-Src-transformed chick chondrocytes, using monoclonal and polyclonal antibodies to integrins alpha- and beta-chains. We show the presence of alpha1-, alpha3-, alphav-, alpha6-, beta1- and beta3-chains on CEC, with very low levels of alpha2- and alpha5-chains. Alphav chain associates with multiple beta subunits in normal and transformed chondrocytes. With the exception of alpha1- and alpha2-chains, the levels of the integrin chains analyzed are higher in transformed chondrocytes as compared with normal chondrocytes. In spite of the increased levels of integrin expression, transformed chondrocytes exhibit loss of focal adhesion and actin stress fibers and low adhesion activity on several extracellular matrix constituents. These observations raise the possibility that, in addition to its effects on global pattern of integrin expression, v-Src can influence integrin function in chondrocytes. | {
"pile_set_name": "PubMed Abstracts"
} |
Immunohistochemical comparison of markers for wound healing on plastic-embedded and frozen mucosal tissue.
Immunohistologic investigations of wound healing in human oral mucosa require specific cell biological markers as well as consecutive small biopsies. Small specimens are ideally embedded in plastic (methylmethacrylate, MMA) resin due to their miniature size. This limits the use of antibodies for these markers. In this immunohistochemical study, the distribution of wound healing markers, e.g. cytokeratin (CK), laminin, collagen IV, vimentin, vinculin and fibronectin, were compared between semithin sections of plastic-embedded tissue and frozen sections of mucosal tissue in order to assess their use for future investigations. The antibodies against laminin, collagen IV and CK 1/2/10/11, 5/6, 13, 14, 17, 19 gave comparable staining patterns on cryostat sections of attached mucosa and on semithin sections of MMA-embedded attached mucosa. In the epithelial cell layers, the following distribution of CK immunostaining was observed: The basal cell layer was positive for CK 5/6, CK 14 and CK 19; the intermediate cell layer for CK 13, CK 17 and CK 1/2/10/11, and the superficial cell layer for CK 13 and CK 1/2/10/11. For most of these antibodies, enzyme digestion with 0.1% trypsin was adequate for demasking the antigens, except for anti-CK 14, anti-CK 17 and anti-laminin; predigestion with 0.4% pepsin in 0.01 N HCl gave similar staining results. The antibodies against vimentin, vinculin, fibronectin and CK 4 showed no affinity or a reciprocal reaction on the semithin sections. Therefore, the antibodies against CK 1/2/10/11; 5/6; 13; 14; 17, and 19, as well as the basement proteins laminin and collagen IV are deemed markers suitable on semithin sections of plastic-embedded attached oral mucosa. | {
"pile_set_name": "PubMed Abstracts"
} |
Additivity of retinal and pursuit velocity in the perceptions of depth and rigidity from object-produced motion parallax.
Two psychophysical experiments were conducted to investigate the mechanism that generates stable depth structure from retinal motion combined with extraretinal signals from pursuit eye movements. Stimuli consisted of random dots that moved horizontally in one direction (ie stimuli had common motion on the retina), but at different speeds between adjacent rows. The stimuli were presented with different speeds of pursuit eye movements whose direction was opposite to that of the common retinal motion. Experiment 1 showed that the rows moving faster on the retina appeared closer when viewed without eye movements; however, they appeared farther when pursuit speed exceeded the speed of common retinal motion. The 'transition' speed of the pursuit eye movement was slightly, but consistently, larger than the speed of common retinal motion. Experiment 2 showed that parallax thresholds for perceiving relative motion between adjacent rows were minimum at the transition speed found in experiment 1. These results suggest that the visual system calculates head-centric velocity, by adding retinal velocity and pursuit velocity, to obtain a stable depth structure. | {
"pile_set_name": "PubMed Abstracts"
} |
Induction of monocyte tissue factor expression by homocysteine: a possible mechanism for thrombosis.
Moderately elevated plasma homocysteine levels are an important independent risk factor for arterial and venous thrombosis and for atherosclerosis. Some investigators have proposed that homocysteine's effects result from oxidant injury to the vascular endothelium or from an alteration in endothelial function. However, homocysteine may have other cellular targets. We now report that homocysteine, at physiologically relevant concentrations, induces the expression of tissue factor by monocytes. In response to homocysteine, monocytes express procoagulant activity in a dose-dependent and a time-dependent manner. This activity is attributable to tissue factor because it was dependent on factor VII and blocked by anti-tissue factor antibodies. Tissue factor mRNA levels were also increased in monocytes after homocysteine treatment. The effect was found to be specific because analogues of homocysteine (homocystine and homocysteine thiolactone) did not mimic homocysteine's activity, nor did other thiol compounds (cysteine, 2-mercaptoethanol, dithiothreitol). On the other hand, methionine, the metabolic precursor of homocysteine, was active though less potent than homocysteine. Catalase and superoxide dismutase (scavengers of H(2)O(2) and O(2)(-) Radicals, respectively) were unable to block the expression of tissue factor induced by homocysteine, as was a 5-fold excess of the reducing agent 2-mercaptoethanol. We conclude that the induction of tissue factor expression by circulating monocytes is a plausible mechanism by which homocysteine may induce thrombosis and that a nonspecific redox process is not involved. | {
"pile_set_name": "PubMed Abstracts"
} |
Calcium-permeable channels in rat hepatoma cells are activated by extracellular nucleotides.
Extracellular ATP is known to cause uptake of Ca2+ by rat liver cells. The specific pathway permitting influx of Ca2+ has not yet been identified. In the present investigations, we studied the properties of ATP-evoked 45Ca2+ uptake in rat hepatoma cell monolayers and then used patch-clamp electrophysiology to identify the channel that may account for this uptake. The results suggest that ATP-stimulated 45Ca2+ uptake occurs as a result of P2-purinergic receptor interaction because uptake was inhibited by Reactive Blue (100 microM), a blocker of this type of receptor. Furthermore, the ability of other adenine nucleotides to stimulate 45Ca2+ uptake was related to the selectivity sequence for binding to the P2-purinergic receptor. ATP-stimulated 45Ca2+ uptake occurs primarily through a conductance pore since it was inhibited by 70% upon dissipation of the membrane potential using the K+ ionophore valinomycin. The calcium channel blockers nifedipine and verapamil failed to inhibit 45Ca2+ uptake, but gadolinium (GdCl3) was an effective blocker. In cell-attached patch-clamp experiments, a single type of channel was activated with ATP (100 microM) addition to the bath in 18 of 32 trials. The current-voltage relationship of the ATP-activated channel is identical to that of the stretch-activated channel previously characterized in this laboratory as a calcium-permeable cation-nonselective channel [Am. J. Physiol. 258 (Cell Physiol. 27): C421-C428, 1990]. There are several lines of evidence which suggest that this cation-nonselective channel may account for ATP-stimulated 45Ca2+ uptake.(ABSTRACT TRUNCATED AT 250 WORDS) | {
"pile_set_name": "PubMed Abstracts"
} |
Our approach to pediatric dermatologic laser surgery.
Many pediatric dermatological conditions may be successfully treated with laser surgery. The clinical approach to various pediatric dermatological conditions utilizing laser treatment options is discussed. Clinical uses of various modalities such as pulsed dye laser, KTP laser, Nd-YAG laser, Q-switched ruby laser, erbium-YAG laser, diode laser, non-coherent blue light sources, and fractional resurfacing are presented with successful parameters, developed over 22 years, utilized on a daily basis in a laser surgery clinic. Laser surgery can make a significant improvement in many pediatric skin lesions, thanks to the unique properties of pediatric skin and a vast array of laser technologies. | {
"pile_set_name": "PubMed Abstracts"
} |
Studies on the (pro) insulin biosynthesis of islets of Langerhans of sand rats (Psammomys obesus).
By feeding a regular laboratory chow, sand rats (Psammomys obesus) from our breeding colony gained different body weights, though they received approximately the same quantity of calories. Sand rats, reaching a body weight above 160 g (group B) showed significantly increased blood glucose values in contrast to the animals with a body weight under 160 g (group A). Isolated pancreatic islets of these two groups of sand rats were incubated with [3H]-leucine to study the incorporation of this amino acid into proinsulin and insulin. The incorporation into proteins of pancreatic islets of sand rats of group B was stimulated by 0.45 mg and 3.0 mg/ml glucose. In group A there was no further stimulation from 0.45 mg to 3.0 mg/ml glucose. Insulin secretion could be stimulated by glucose in both groups, but the stimulation was stronger in group B than in group A. | {
"pile_set_name": "PubMed Abstracts"
} |
Video-assisted thoracoscopic surgery.
Video-assisted thoracoscopic surgery is finding an ever-increasing role in the diagnosis and treatment of a wide range of thoracic disorders that previously required sternotomy or open thoracotomy. The potential advantages of video-assisted thoracoscopic surgery include less postoperative pain, fewer operative complications, shortened hospital stay and reduced costs. The following review examines the surgical and anesthetic considerations of video-assisted thoracoscopic surgery, with an emphasis on recently published articles. | {
"pile_set_name": "PubMed Abstracts"
} |
Minimally invasive therapies for prostatitis.
A plethora of reports describe a number of promising new minimally invasive treatment modalities available to patients with chronic prostatitis. This article reviews these studies, with most evaluating treatments using heat or intraprostatic injection. The results are difficult to compare because of the inconsistencies in study design, modalities of treatment, and outcome measures. Standard criteria for assessing symptom severity in chronic prostatitis recently have been developed and prospective clinical trials are underway to evaluate minimally invasive therapies for this debilitating condition. Until definitive data from these trials are available, minimally invasive therapies most likely will continue to be empirical and not a standard of care. | {
"pile_set_name": "PubMed Abstracts"
} |
Febrile seizures: A revisit to an old problem.
Febrile seizures are a common clinical problem occurring in about 3% of children. They recur in about 30% to 40% of patients, particularly in those whose initial seizure occurs before one year of age. There is very little risk of epilepsy, neurological deficit or mental retardation to justify long term phenobarbitone therapy. Intermittent prophylactic therapy with oral or rectal diazepam at time of subsequent fever, has been found to be useful. Emphasis should be placed on parental counselling and education. | {
"pile_set_name": "PubMed Abstracts"
} |
Staff detection with stable paths.
The preservation of musical works produced in the past requires their digitalization and transformation into a machine-readable format. The processing of handwritten musical scores by computers remains far from ideal. One of the fundamental stages to carry out this task is the staff line detection. We investigate a general-purpose, knowledge-free method for the automatic detection of music staff lines based on a stable path approach. Lines affected by curvature, discontinuities, and inclination are robustly detected. Experimental results show that the proposed technique consistently outperforms well-established algorithms. | {
"pile_set_name": "PubMed Abstracts"
} |
[Mitochondrial DNA genetic differentiation of the muksun Coregonus muksun (Pallas) and related Siberian species of Coregonus (Coredonidae, Salmoniformes)].
Restriction enzyme analysis of the mitochondrial DNA (mtDNA) fragment encoding subunit 1 of the NADH dehydrogenase complex (ND-1) amplified via polymerase chain reaction (PCR) has been used to obtain data on genetic differentiation of muksun Coregonus muksun (Pallas) populations. Population polymorphism with respect to the restriction sites of 18 endonucleases has been described. It has been demonstrated that the muksun is genetically related to the pidschian C. pidschian (Gmelin), its sympatric species in Siberian waters. Analysis of the median network of mtDNA haplotypes has shown that haplotypes of muksun from various Siberian basins form a common group with haplotypes of pidschian of the Arctic Ocean basin, some frequent haplotypes been found in both forms. This raises the question as to the validity of the muksun as a species. Differences within this group of haplotypes are much smaller than those typical of species of the genus Coregonus. The possibility of a hybrid origin of the muksun from a pidschian-like ancestor and species of the cisco-peled (C. sardinella-C. peled) complex is discussed. | {
"pile_set_name": "PubMed Abstracts"
} |
Major complications after radio-frequency thermal ablation of hepatic tumors: spectrum of imaging findings.
Although radio-frequency (RF) ablation has been accepted as a promising and safe technique for treatment of unresectable hepatic tumors, investigation of its complications has been limited. According to the multicenter (1,139 patients in 11 institutions) survey data of the Korean Study Group of Radiofrequency Ablation, a spectrum of complications occurred after RF ablation of hepatic tumors. The prevalence of major complications was 2.43%. The most common complications were hepatic abscess (0.66%), peritoneal hemorrhage (0.46%), biloma (0.20%), ground pad burn (0.20%), pneumothorax (0.20%), and vasovagal reflex (0.13%). Other complications were biliary stricture, diaphragmatic injury, gastric ulcer, hemothorax, hepatic failure, hepatic infarction, renal infarction, sepsis, and transient ischemic attack. One procedure-related death (0.09%) occurred (due to peritoneal hemorrhage). Three important strategies for decreasing the rate of complications are prevention, early detection, and proper management. A physician who performs RF ablation of hepatic malignancies should be aware of the broad spectrum of major complications so that these strategies can be used. | {
"pile_set_name": "PubMed Abstracts"
} |
Childhood personality foreshadows adult personality and life outcomes two decades later.
In a normative sample of 205 children ages 8-12, tracked into adulthood, we examined the predictive links between four childhood personality traits--Mastery Motivation, Academic Conscientiousness, Surgency, and Agreeableness--and adult personality and adaptation 20 years later. Personality demonstrated modest to moderate continuity over those two decades and showed significant predictive validity for success in adult life, including academic attainment, work competence, rule-abiding versus antisocial conduct, and romantic and friend relationships. Results indicated that personality shows coherent patterns over time in terms of both stability and linkages to adaptive behavior. Explicating the processes underlying such patterns is the next frontier for a truly developmental science of personality. | {
"pile_set_name": "PubMed Abstracts"
} |
Visual impairment and amblyopia in Malaysian pre-school children - The SEGPAEDS study.
Little is known regarding the extent of visual impairment amongst pre-school children in Malaysia. To determine the prevalence of visual impairment and amblyopia in Malaysian preschool children. A cross-sectional, population-based study was conducted on children aged four to six years from 51 participating kindergartens in the district of Segamat, Johor, Malaysia from 20 March 2016 to 6 April 2016. All subjects had initial eye screening consisting of LogMar visual acuity, orthoptics examination and Spot vision screener assessment. Subjects who failed the initial eye screening were invited for a formal eye assessment consisting of cycloplegic refraction and a comprehensive ocular examination. Definitions of visual impairment and amblyopia were based on the Multi-Ethnic Pediatric Eye Disease Study criteria. A total of 1287 children were recruited. Mean subject age was 5.03 (SD:0.77) and males represented 52.3% of subjects. Subjects by ethnicity were Malay (54.8%), Chinese (27.7%), Indian (15.6%) and Orang Asli (1.9%). Formal eye assessment was required for 221 subjects and 88.8% required ophthalmic intervention. Refractive error, representing 95.4% of diagnosed ocular disorders, comprised of astigmatism (84%), myopia (9%) and hypermetropia (6.9%). With-the-rule astigmatism was present in 93.4% of the subjects with astigmatism. Visual impairment was present in 12.5% of our subjects, with 61% having bilateral visual impairment. Of the subjects with visual impairment, 59.1% had moderate visual impairment. The prevalence of amblyopia was 7.53%, and 66% of the amblyopic subjects had bilateral amblyopia. Our study highlights an urgent need for initiation of preschool vision screening in Malaysia. | {
"pile_set_name": "PubMed Abstracts"
} |
Mechanism of tachyphylaxis associated with neurogenic plasma extravasation in the rat trachea.
Electrical stimulation of the vagus nerve of rats is known to produce plasma extravasation in the trachea, presumably by releasing substance P or other tachykinins from sensory nerves. We sought to determine whether the tachyphylaxis that develops after prolonged vagal stimulation results from an inability of sensory nerves to release tachykinins or from an inability of tracheal blood vessels to respond to tachykinins. To induce tachyphylaxis, we electrically stimulated the right vagus nerve of Long-Evans rats for 5 min (5 V, 1 ms, 20 Hz). Then, 10 min later, we gave intravenous injections of capsaicin (0.3 mumol/kg), histamine (18 mumols/kg), or substance P (2.2 nmol/kg), which produce equivalent amounts of plasma extravasation as assessed by the extravasation of Evans blue dye. We found that vagal stimulation reduced the amount of dye extravasation produced by capsaicin but not the amount produced by either histamine or substance P. We also found that pretreating neonatal rats with capsaicin, which destroys tachykinin-containing sensory nerves, reduced the amount of dye extravasation produced by capsaicin but not the amount produced by either histamine or substance P. This finding suggests that capsaicin produces plasma extravasation in the trachea by releasing tachykinins from sensory nerves, whereas histamine and substance P do so by acting directly on tracheal blood vessels. Taken together, our results indicate that prolonged vagal stimulation reduces the ability of sensory nerves to release tachykinins but that tracheal blood vessels remain fully responsive to both histamine and substance P. | {
"pile_set_name": "PubMed Abstracts"
} |
Striatal volume deficits in children with ADHD who present a poor response to methylphenidate.
Methylphenidate (MPH) is the first choice of medical treatment for attention-deficit/hyperactivity disorder (ADHD). Its mechanism of action is to inhibit the reuptake of dopamine and noradrenaline mainly in the region of the striatum. It has been estimated that 10-30 % of patients with ADHD do not respond adequately to MPH. The aim of this study was to evaluate whether striatal differences exist between good and poor responders to MPH. The sample included 27 treatment-naïve children with ADHD between the ages of 6 and 14. MPH administration started 1 day after the MRI acquisition. After a month, psychiatrists established the good or poor response to treatment according to clinical criteria. MRI images were analyzed using a technique based on regions of interest applied specifically to the caudate and accumbens nuclei. Sixteen patients showed good response to MPH and 11 a poor one. Regions of interest analysis showed that good responders had a higher concentration of gray matter in the head of both caudate nuclei and the right nucleus accumbens. Furthermore, a significant correlation was found between caudate and accumbens nuclei volume and the Conners' Parent Rating Scale and Continuous Performance Test improvement. These results support the hypothesis of the involvement of the caudate and accumbens nuclei in MPH response and in ADHD pathophysiology. | {
"pile_set_name": "PubMed Abstracts"
} |
Oxidative modification of low density lipoproteins by human polymorphonuclear leukocytes.
Oxidatively modified low density lipoproteins are thought to play an important role in the generation of macrophage-derived foam cells in early atherosclerotic lesions. Cultured endothelial cells, monocytes, macrophages and smooth muscle cells can modify low density lipoproteins, either by a free radical mechanism or by the action of lipoxygenases. Previous studies demonstrated that activated human polymorphonuclear leukocytes can oxidize low density lipoprotein lipids. Stimulation of the cells with phorbol 12-myristate 13-acetate resulted in an increase both in superoxide anion production and in low density lipoprotein oxidation. The present results show that the oxidative modification of low density lipoproteins by human polymorphonuclear leukocytes can be inhibited by superoxide dismutase but not by the lipoxygenase inhibitor, (5,8,11,14)-eicosatetraynoic acid. The low density lipoproteins oxidized by polymorphonuclear leukocytes were recognized by the scavenger receptor of macrophages (P 388 cell line). It is proposed that the superoxide anion is an important factor in the oxidative modification of low density lipoproteins induced by polymorphonuclear leukocytes, and that under conditions of increased oxidative metabolism in vivo, polymorphonuclear leukocytes can contribute to foam cell formation by a scavenger receptor-dependent process at lesion sites. | {
"pile_set_name": "PubMed Abstracts"
} |
Negative slope conductance at large depolarizations in cat spinal motoneurons.
The current-voltage relation of cat spinal motoneurons obtained by somatic voltage clamp exhibits a region of negative slope conductance at large depolarizations in addition to the previously reported N-shaped region at small depolarizations. The N shape at large depolarizations is caused by one outward current component which grows larger and then smaller with depolarization. | {
"pile_set_name": "PubMed Abstracts"
} |
Direct bis-arylation of cyclobutanecarboxamide via double C-H activation: an auxiliary-aided diastereoselective Pd-catalyzed access to trisubstituted cyclobutane scaffolds having three contiguous stereocenters and an all-cis stereochemistry.
An auxiliary-aided Pd-catalyzed highly diastereoselective double C-H activation and direct bis-arylation of methylene C(sp(3))-H bonds of cyclobutanecarboxamides and the syntheses of several novel trisubstituted cyclobutanecarboxamide scaffolds having an all-cis stereochemistry are reported. Extensive screening of various auxiliaries and reaction conditions was performed to firmly establish the optimized reaction conditions required for effecting the mono- or double C-H arylation of cyclobutanecarboxamides. The auxiliary-attached cyclobutanecarboxamides 15a, 15g, and 15h, prepared from the auxiliaries such as, 8-aminoquinoline, 2-(methylthio)aniline, and N',N'-dimethylethane-1,2-diamine were found to undergo an efficient direct bis-arylation. The Pd-catalyzed arylation reaction of N-(quinolin-8-yl)cyclobutanecarboxamide 15a with one equivalent or more of aryl iodides, afforded the corresponding bis-arylated cyclobutanecarboxamides 16a-y. Nevertheless, the Pd-catalyzed arylation of 15a with just 0.5 equiv of the aryl iodides 13a, 13b, 13e, and 13m, selectively gave the corresponding monoarylated cyclobutanecarboxamides 17a-17d. The Pd-catalyzed arylation of 15g or 15h with one equivalent or more of aryl iodides afforded the bis-arylated cyclobutanecarboxamides 19a-19c and 21a-21m, respectively. However, the Pd-catalyzed arylations of compounds 15g or 15h with just 0.5 equiv of aryl iodides were ineffective. The stereochemistry of compounds obtained in this work was unambiguously assigned from the X-ray structures of representative products. | {
"pile_set_name": "PubMed Abstracts"
} |
Nutrition in the spotlight: metabolic effects of environmental light.
Use of artificial light resulted in relative independence from the natural light-dark (LD) cycle, allowing human subjects to shift the timing of food intake and work to convenient times. However, the increase in artificial light exposure parallels the increase in obesity prevalence. Light is the dominant Zeitgeber for the central circadian clock, which resides within the hypothalamic suprachiasmatic nucleus, and coordinates daily rhythm in feeding behaviour and metabolism. Eating during inappropriate light conditions may result in metabolic disease via changes in the biological clock. In this review, we describe the physiological role of light in the circadian timing system and explore the interaction between the circadian timing system and metabolism. Furthermore, we discuss the acute and chronic effects of artificial light exposure on food intake and energy metabolism in animals and human subjects. We propose that living in synchrony with the natural daily LD cycle promotes metabolic health and increased exposure to artificial light at inappropriate times of day has adverse effects on metabolism, feeding behaviour and body weight regulation. Reducing the negative side effects of the extensive use of artificial light in human subjects might be useful in the prevention of metabolic disease. | {
"pile_set_name": "PubMed Abstracts"
} |
In vivo cellular imaging of lymphocyte trafficking by MRI: a tumor model approach to cell-based anticancer therapy.
The aim of this study was to demonstrate the feasibility of in vivo cell tracking to monitor anticancer cell therapy by means of a high-resolution noninvasive MRI method. Ovalbumin-specific splenocytes (OT-1) labeled with anionic gamma-Fe2O3 superparamagnetic iron oxide (SPIO) nanoparticles were adoptively transferred into C57BL/6 mice with growing ovalbumin-expressing tumors. OT-1 cells were tracked in vivo by 7 T MRI 24, 48, and 72 hr after they were injected. The results showed significant negative enhancement of the spleen at 24 hr, and of the tumor at 48 and 72 hr, after labeled cell injection. This suggests that the lymphocytes initially homed toward the spleen and were then recruited by the tumor. The presence of labeled cells was confirmed in ex vivo by 9.4 T microimaging of tumors and magnetic sorting of spleen cells. These results confirm that MR tracking of lymphocytes is feasible in vivo. This high-resolution imaging method could be used to improve the monitoring of immune cell therapy. | {
"pile_set_name": "PubMed Abstracts"
} |
[Spirometry: quality in the respiratory medicine clinics of a public health care area].
Spirometry can be considered a routine way to evaluate patients with respiratory complaints, both inside and outside the hospital setting. To assess the quality of spirometry in a public health care area with respect to two factors: the technicians' performance and the calibration of spirometers. Four health care clinics were studied. Four technicians participated and the four spirometers were tested at different volumes (calibration syringes 1L and 3L) and different flows (explosive decompression). Eight patients with COPD participated in the study of inter-technician variability. Agreement among the technicians was very high: 0.98-0.99 for FEV1 and 0.91-0.98 for FVC. The mean results obtained by the technicians were: FEV1 = 2.15 0.03, range 2.20-2.14; FVC = 3.25 0.05, range 3.30-3.21 (ns). Volumetric readings from the spirometers were correct for the 1I calibration syringe, but 2 out of 4 spirometers lost linearity with the 3I calibration syringe. One spirometer gave readings out of range for all flow levels, and 2 out of 4 spirometers were out of range at low flows. 1. Results obtained by different technicians were not significantly different and there was high agreement among them, confirming that performance of spirometry was good. 2. The spirometers showed poor linearity at low flows. | {
"pile_set_name": "PubMed Abstracts"
} |
HIV/AIDS epidemic in the State of Amazonas: characteristics and trends from 2001 to 2012.
A scoping review was conducted to describe the epidemiological characteristics of the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) epidemic in the State of Amazonas, Brazil, from 2001 to 2012, and temporary patterns were estimated from surveillance data. The results suggest that in its third decade, the Amazon HIV/AIDS epidemic is far from being stabilized and displays rising AIDS incidence and mortality rates and late diagnoses. The data suggest that AIDS cases are hitting mostly young adults and have recently shifted toward men, both homosexual and heterosexual. AIDS cases among the indigenous people have remained stable and low. However, the epidemic has disseminated to the interior of the state, which adds difficulties to its control, given the geographical isolation, logistical barriers, and culturally and ethnically diverse population. Antiretroviral (ARV) therapy has been decentralized, but peripheral ARV services are still insufficient and too distant from people who need them. Recently, the expansion of point-of-care (POC) rapid HIV testing has been contributing to overcoming logistical barriers. Other new POC devices, such as the PIMA CD4 analyzer, will bring the laboratory to the patient. AIDS uniquely coexists with other tropical infections, sharing their epidemiological profiles. The increased demand for HIV/AIDS care services can only be satisfied through increased decentralization to peripheral health units, which can also naturally integrate care with other tropical infections and can promote a shift from vertical to integrated programming. Future challenges involve building surveillance data on HIV case notification and covering the spectrum of engagement in care, including adherence to treatment and follow-up loss. | {
"pile_set_name": "PubMed Abstracts"
} |
A new technique to mark the donor and host corneas in keratoplasty.
A new technique is described to easily and accurately mark the donor and the host cornea in keratoplasty using simple, readily available instruments and utilizing a simple mathematical equation. This technique will allow for even distribution of the donor tissue in the recipient bed. | {
"pile_set_name": "PubMed Abstracts"
} |
Recovery of endo-polygalacturonase using polyethylene glycol-salt aqueous two-phase extraction with polymer recycling.
The partitioning behaviour of endo-polygalacturonase (endo-PG) and total protein from a clarified Kluyveromyces marxianus fermentation broth in polyethylene glycol (PEG)-ammonium sulfate and PEG-potassium phosphate (pH=7) aqueous two-phase systems was experimentally investigated. Both the enzyme and total protein partitioned in the bottom phase for these two kinds of systems. The enzyme partitioning coefficient can be lower than 0.01 in PEG8000-(NH4)2SO4 ATPS with a large phase volume ratio and a moderate tie-line length, which implies the possibility of concentration operation using aqueous two phase partitioning. An ion-exchange separation of high purification efficiency was applied to analyze the clarified and dialyzed fermentation broth. A total purification factor of only 2.3 was obtained, which indicated the high enzyme protein content in the total protein of the fermentation broth. Consequently, the main purpose for separating endo-PG is concentration rather than purification. A separation scheme using an aqueous two-phase extraction process with polymer recycling and a dialysis was proposed to recover endo-PG from the fermentation supernatant of K. marxianus for commercial purpose. A high enzyme recovery up to 95% and a concentration factor of 5 to 8 with a purification factor of about 1.25 were obtained using the single aqueous two-phase extraction process. More than 95% polymer recycled will not affect the enzyme recovery and purification factor. Dialysis was used mainly to remove salts in the bottom phase. The dialysis step has no enzyme loss and can further remove small bulk proteins. The total purification factor for the scheme is about 1.7. | {
"pile_set_name": "PubMed Abstracts"
} |
Surgeon Age in Relation to Prognosis After Esophageal Cancer Resection.
It was hypothesized that patient survival improves with increasing surgeon age up to an age where it then decreases. Experience, physical and psychological abilities required for esophagectomy may change with increasing surgeon age. This population-based cohort study included all patients having undergone esophagectomy for esophageal cancer in Sweden in 1987 to 2010, with follow-up until 2016. Risk-adjusted cumulative sum (RA-CUSUM) analysis was performed to estimate the relation between surgeon age and 90-day mortality, all-cause, and disease-specific 5-year mortality. Change-points in surgeon age identified by the RA-CUSUM were then analyzed in relation to mortality using multivariable Cox regression, providing hazard ratios (HRs) with 95% confidence intervals (CIs), adjusted for age, sex, comorbidity, tumor stage, tumor histology, neoadjuvant therapy, surgeon volume, and calendar year. Among 139 surgeons performing 1761 esophagectomies, RA-CUSUM analysis of 90-day mortality showed change-points at 43 years (downward deflection) and at 56 years (upward deflection). Both all-cause and disease-specific 5-year mortality had corresponding change-points at 52 years and 56 years. Compared with surgeon age 52 to 55 years, surgeon age ≤51 years was associated with increased 90-day mortality (HR = 1.71, 95% CI 1.01-2.90) and 5-year all-cause mortality (HR = 1.21, 95% CI 1.02-1.43), and surgeon age ≥56 years showed increased 90-day mortality (HR = 2.38, 95% CI 1.38-4.13), 5-year all-cause mortality (HR = 1.29, 95% CI 1.08-1.55), and disease-specific 5-year mortality (HR = 1.18, 95% CI 1.01-1.42). Surgeon age ≤51 and ≥56 years may increase short- and long-term mortality after esophagectomy for cancer. | {
"pile_set_name": "PubMed Abstracts"
} |
r-1,t-2,3,c-4-Tetrahydroxy-1,2,3,4-tetrahydrophenanthrene in human urine: a potential biomarker for assessing polycyclic aromatic hydrocarbon metabolic activation.
Individual differences in the metabolic activation and detoxification of carcinogenic polycyclic aromatic hydrocarbons (PAHs) may influence cancer risk. This has been investigated in many studies using genotyping approaches, but the results to date have been inconsistent. We propose that carcinogen metabolite phenotyping would be a more reliable way to determine the role of host metabolism in PAH-related cancer. Many PAHs are metabolically activated by formation of bay-region diol epoxides. Phenanthrene, generally considered to be noncarcinogenic, is the simplest PAH with a bay region and is metabolized to diol epoxides by the same enzymes and with the same stereochemistry as the prototypic carcinogenic PAH, benzo[a]pyrene. The major end product of this metabolic activation pathway is r-1,t-2,3,c-4-tetrahydroxy-1,2,3,4-tetrahydrophenanthrene (trans, anti-PheT). We have developed a method for the analysis of trans, anti-PheT in human urine. r-1,t-2,4,c-3-tetrahydroxy-1,2,3,4-tetrahydrophenanthrene (trans, syn-PheT) was used as internal standard. After hydrolysis by beta-glucuronidase and sulfatase, solid phase extraction, and high-performance liquid chromatography collection, the sample was silylated and analyzed by gas chromatography-negative ion chemical ionization-mass spectrometry-selected ion monitoring at m/z 372. The resulting chromatograms were remarkably clean and trans, anti-PheT was readily detected in all human urine samples. Levels of trans, anti-PheT were 791 +/- 363 pmol/mg creatinine (n = 20) in psoriasis patients treated with a PAH-containing ointment, 25.7 +/- 16.8 pmol/mg creatinine (n = 32) in coke oven workers exposed to PAH, 4.58 +/- 2.95 pmol/mg creatinine (n = 31) in smokers, and 1.51 +/- 1.15 pmol/mg creatinine (n = 30) in nonsmokers. Levels of trans, anti-PheT correlated with levels of 1-hydroxypyrene in the urine of coke oven workers, smokers, and nonsmokers. Thus, trans, anti-PheT appears to be an excellent biomarker of PAH uptake. Levels of trans, anti-PheT were 8,000-19,000 times higher than those of the corresponding metabolite of benzo[a]pyrene. The results of this study demonstrate that trans, anti-PheT can be detected in human urine. We propose that measurement of this metabolite of phenanthrene may be important as part of a carcinogen metabolite-phenotyping approach to determine individual response to PAH exposure. | {
"pile_set_name": "PubMed Abstracts"
} |
Breast awareness and screening.
Breast cancer is the most commonly diagnosed cancer in the UK. Breast awareness and screening, along with better treatment, can significantly improve outcomes, and more women than ever are now surviving the disease. This article discusses breast awareness and screening, symptoms and risk factors for breast cancer, and how nurses can raise breast awareness and screening uptake. | {
"pile_set_name": "PubMed Abstracts"
} |
Comparison and characterization of biosorption by Weissella viridescens MYU 205 of periodic group 12 metal ions.
Because heavy metals cause various health hazards, we studied biosorption by Weissella viridescens MYU 205. MYU 205 showed high biosorption for Cd (II) and Hg (II) and was low for Zn (II). The Hg (II) biosorption rate was high at about 80%. Different biosorptions were shown for each metal after successive incubation. About 20% of the Zn (II) biosorption was observed after 3 h. Cd (II) biosorption increased in a time-dependent manner until 3 h, then gradually decreased. Hg (II) was immediately sorbed at 79.6 ± 4.7% and decreased at 3 h to 52.9 ± 2.6%, and then gradually increased to 77.8 ± 3.6%. Using heat-killed cells, the rate of biosorption of Zn (II) and Cd (II) decreased whereas Hg (II) tended to increase. The metal resistance was high, that is Zn (II) > Cd (II) > Hg (II); while the affinity was opposite where MYU 205 showed high affinity to Hg (II) and low affinity to Zn (II). Our data shows lactic acid bacteria may be powerful heavy metal sorbents for detoxification. | {
"pile_set_name": "PubMed Abstracts"
} |
[Psychiatric education and cultural components during medical training: Latin American perspectives].
Medical education has incorporated psychiatric or mental health components more consistently during the last decades thanks to various factors such as: advances in neurobiological research; the increasing prevalence of mental disorders in global health; the increasingly close relationship between mental health and public health; comorbidities with medical conditions and the impact of sociocultural phenomena in clinical manifestations, diagnosis, treatment, prognosis and prevention. Based on acquisition of core competencies and ethical principles of universal acceptance, the teaching process examined in this article proposes an education based on the provision of clinical experiences integrated throughout the collection of adequate information, the development of diagnostic capabilities, and exposure to a wide variety of forms of academic assessment of students and residents in training. The cultural components of psychiatric education receive special mention; we provide examples of their systematic integration with the acquisition of general skills. The teaching tools include theoretical and applied activities and supervision. Particular attention is paid to how the principles of modern psychiatric medical education, including cultural aspects and practice of holistic health care objectives, can and should be in effect in Latin American countries. | {
"pile_set_name": "PubMed Abstracts"
} |
The C-terminal domain of canstatin suppresses in vivo tumor growth associated with proliferation of endothelial cells.
Angiogenesis is crucial for the growth and metastasis of solid tumors with sizes larger than a few cubic millimeter Canstatin, the non-collagenous 1 (NC1) domain of alpha2 chain of type IV collagen, was previously shown to inhibit proliferation of endothelial cells in vitro and suppress in vivo tumor growth. Our previous studies showed that canstatin-N, the N-terminal 1-89 amino acid fragment of canstatin, inhibited the neovascularization in vivo, potently induced apoptosis of endothelial cells in vitro, and suppressed in vivo tumor growth in BALB/c mice. In the present study, we demonstrated that canstatin-C, the C-terminal 157-227 amino acid fragment of canstatin, also specifically inhibited in vitro the proliferation of human umbilical vein endothelial cells and induced apoptosis, but the apoptosis-inducing activity, while close to that of the full-length canstatin, was much lower than that of canstatin-N. Canstatin-C also suppressed in vivo tumor growth in BALB/c mice at a dosage of 10mg/kg/day. These results suggest that canstatin-C is an anti-angiogenic domain of canstatin mainly associated with the specific inhibition of proliferation of endothelial cells, whereas canstatin-N with the potential apoptosis-inducing activity on endothelial cells. | {
"pile_set_name": "PubMed Abstracts"
} |
Identification and functional expression of a carrier-mediated riboflavin transport system on rabbit corneal epithelium.
To investigate the functional expression of a carrier-mediated transport mechanism for riboflavin (vitamin B2) across cultured rabbit primary corneal epithelial cells (rPCECs) and intact rabbit cornea. The secondary objective was to understand the physiological significance behind the presence of such a transport system for riboflavin on the apical side of the corneal epithelium. rPCECs and freshly excised rabbit corneas were selected as in vitro and ex vivo models, respectively. Transport and uptake characteristics of [3H]riboflavin were determined at various time points, concentrations, temperatures, and pH. Substrate specificity, energy, and ion dependence studies were carried out to characterize the translocation mechanism. Rabbit tear analysis was done with liquid chromatography/tandem mass spectrometry (LC-MS/MS) to understand the physiological relevance of this transporter. The uptake process in rPCECs was found to be concentration dependent and saturable at higher concentrations. The process was also independent of pH, Na+, and Cl- but dependent on energy and temperature. Unlabeled riboflavin and its structural analogues caused significant inhibition, whereas unrelated vitamins did not interfere with the process. Transport of [3H]riboflavin across rabbit cornea was also saturable at higher concentration and energy dependent but Na+ independent. Substrate specificity studies across intact rabbit cornea produced results similar to the uptake studies in cultured rPCECs. LC-MS/MS analysis of rabbit tears showed the presence of riboflavin. Results suggest the presence of a specialized, high-affinity transport mechanism for riboflavin that is expressed on the apical side of rabbit corneal epithelium and may in turn be responsible for influx of riboflavin from tears to cornea. | {
"pile_set_name": "PubMed Abstracts"
} |
Three-month efficacy and safety of once-daily diltiazem in chronic stable angina pectoris.
The 3-month efficacy and safety of a once-daily controlled formulation of diltiazem (180 to 360 mg/day) were assessed in a study of 54 patients with angina pectoris. This multicenter study was a nonrandomized, placebo run-in, open-label, 3-month trial followed by a 1-week, double-blind, randomized period during which most patients (89%) received placebo. There were only minimal changes in the time to termination (mean change +/- SEM -5.8 +/- 9.6 seconds), time to onset of angina (10.5 +/- 12.2 seconds), and the time to 1 mm ST-segment depression (2.9 +/- 12.5 seconds) from the end of the titration phase to the end of the open-label study. There were, however, statistically significant differences between the end of the 3-month treatment phase and the end of the 1-week randomized placebo phase for those 3 efficacy parameters (-37.3 +/- 11.2, -58.6 +/- 13.6, and -45.6 +/- 16.4 seconds, respectively). Diltiazem significantly decreased the frequency of anginal attacks and nitroglycerin use at the end of the 3-month treatment phase compared with results at the end of the randomized double-blind placebo phase. No new or unusual adverse events were reported during treatment. The present results suggest that there is no loss of efficacy of once-a-day diltiazem when administered for a long period to patients with chronic stable angina pectoris. | {
"pile_set_name": "PubMed Abstracts"
} |
Comparing irinotecan with best supportive care and infusional 5-fluorouracil: a critical evaluation of the results of two randomized phase III trials.
Two randomized phase III trials have been conducted in colorectal cancer patients with nonbulky metastatic disease who have failed first-line therapy with 5-fluorouracil (5-FU). In one trial, the use of 350 mg/m2 irinotecan was shown to significantly prolong survival relative to best supportive care. Patients receiving irinotecan also experienced higher quality of life than the controls. In the second trial, the same regimen of irinotecan resulted in a significantly longer median survival than the comparator regimen consisting of best estimated infusional 5-FU. Quality of life was similar across treatments. These two trials were large, well-conducted, and used appropriate methodology for patient selection, measurement of outcome, and statistical analysis. The results of these trials have implications for everyday clinical practice. When appropriate, irinotecan should be offered to patients who have failed 5-FU. Irinotecan should be the reference arm for future studies of investigational second-line drugs; the potential of irinotecan (alone or in combination) in the first-line and adjuvant treatment of colorectal cancer now needs to be evaluated. | {
"pile_set_name": "PubMed Abstracts"
} |
A double-blind, placebo-controlled study of aripiprazole adjunctive to antidepressant therapy among depressed outpatients with inadequate response to prior antidepressant therapy (ADAPT-A Study).
We assessed the efficacy of low-dose aripiprazole added to antidepressant therapy (ADT) in major depressive disorder (MDD) patients with inadequate response to prior ADT. As per the sequential parallel comparison design, 225 MDD subjects were randomized to adjunctive treatment with aripiprazole 2 mg/day or placebo across two 30-day phases, with a 2:3:3 randomization ratio to drug/drug (aripiprazole 2 mg/day in phase 1; 5 mg/day in phase 2), placebo/placebo (placebo in both phases), and placebo/drug (placebo in phase 1; aripiprazole 2 mg/day in phase 2). Eligible subjects were patients whose MDD was independently deemed 'valid' with SAFER criteria. Subjects had been receiving ADT for ≥8 weeks, and had inadequate response to ≥1 and <4 adequate ADTs in the current episode, as defined by the Antidepressant Treatment Response Questionnaire. The pooled, weighted response difference between aripiprazole 2 mg/day and placebo in the two phases was 5.6% (p = 0.18; NS). The aripiprazole 2 mg/day-placebo difference on the Montgomery-Asberg Depression Rating Scale pooled across the two phases was -1.51 (p = 0.065; NS). Other secondary endpoint analyses showed nonsignificant pooled differences favoring aripiprazole over placebo. Of the 225 randomized subjects in phase 1, 2 dropped out in both arms, while in phase 2, of 138 phase 1 placebo nonresponders, 9 dropped out on aripiprazole and 5 on placebo. There were only minimal differences in adverse event rates between treatments, except for constipation, weight gain, and dry mouth, more common on aripiprazole. This study provides clear support for the tolerability of low-dose aripiprazole as an ADT-augmenting agent, with marginal efficacy. | {
"pile_set_name": "PubMed Abstracts"
} |
An assay to detect glycoproteins that contain mannose 6-phosphate.
We have developed a broadly applicable solid phase assay for quantitative and qualitative analysis of phosphorylated lysosomal enzymes and other glycoproteins that contain mannose 6-phosphate (Man6-P) residues. Samples are immobilized on membranes and proteins that contain Man6-P are detected using an iodinated, soluble form of the cation-independent Man6-P receptor. The assay is highly specific, sensitive, and linear over 3 orders of magnitude. The technique has two general applications. First, it can be used in a dot blot format to analyze large numbers of samples for total levels of Man6-P glycoproteins. Second, it can be used in a western blot format to identify Man6-P glycoproteins that have been fractionated by polyacrylamide gel electrophoresis. Specific applications of this novel assay include structural characterization of glycoproteins, diagnosis of mucolipidosis II and III, and screening of pharmaceuticals for lysosomotropic activity. Other potential applications are discussed. | {
"pile_set_name": "PubMed Abstracts"
} |
Adrenal gland involvement in synchronizing the preovulatory release of LH in rats.
In this study we have demonstrated that acute adrenalectomy (1000 hr proestrus) has no effect on the release of LH on proestrous afternoon. However, chronic adrenalectomy results in the loss of some factor responsible for synchronizing the preovulatory LH surge. Since this investigator has shown previously (15) that progesterone can influence the timing of LH release in ovariectomized and ovariectomized-adrenalectomized animals, it is most likely that adrenal progesterone is involved in synchronizing this event. | {
"pile_set_name": "PubMed Abstracts"
} |
Titration of AAV-2 particles via a novel capsid ELISA: packaging of genomes can limit production of recombinant AAV-2.
We demonstrate the rapid and reliable quantification of physical AAV-2 (adeno-associated virus type 2) particles via a novel ELISA based on a monoclonal antibody which selectively recognizes assembled AAV-2 capsids. Titration of a variety of recombinant AAV-2 (rAAV) preparations revealed that at least 80+percent of all particles were empty, compared with a maximum of 50percent in wild-type AAV-2 stocks, indicating that the recombinant genomes were less efficiently encapsidated. This finding was confirmed upon titration of CsCl gradient fractions from recombinant and wild-type AAV-2 stocks. ELISA-based measurement of capsid numbers revealed a large number of physical particles with low densities corresponding to empty capsids in the recombinant, but not in the wild-type AAV-2 preparations. Moreover, additional expression of VP proteins during rAAV production was found to result in an excessive capsid formation, whilst yielding only minor increases in DNA-containing or transducing rAAV particles. We conclude that encapsidation of viral genomes rather than capsid assembly can be limiting for rAAV production, provided that a critical level of VP expression is maintained. The feasibility of quantifying AAV-2 capsid numbers via the ELISA allows determination of physical to DNA-containing or infectious particle ratios. These are important parameters which should help to optimize and standardize the production and application of recombinant AAV-2. | {
"pile_set_name": "PubMed Abstracts"
} |
Immune rejection of a large sarcoma following cyclophosphamide and IL-12 treatment requires both NK and NK T cells and is associated with the induction of a novel NK T cell population.
Combined immunotherapy with cyclophosphamide (Cy) and IL-12, but not IL-12 alone, stimulates eradication of a large established solid tumor (20 mm), MCA207, a methylcholanthrene-induced murine sarcoma. In these studies we demonstrate that NK1.1(+) cells and CD1d-dependent NK T cells each play important yet distinct roles in regression of a large tumor in response to Cy and IL-12, and we define a novel NK T cell subset, selectively increased by this treatment. Mice depleted of NK1.1(+) cells demonstrated more rapid initial tumor growth and prolonged tumor regression following treatment, but tumors were eventually eradicated. In contrast, initial tumor regression following therapy was unimpaired in CD1d(-/-) mice, which are deficient in most NK T cells, but tumors recurred. No tumor regression occurred following Cy and IL-12 therapy in CD1d(-/-) mice that were depleted of NK1.1(+) cells. We found that Cy and IL-12 induced the selective increase in liver and spleen lymphocytes of a unique NK T subpopulation (DX5(+)NK1.1(-)CD3(+)). These cells were not induced by treatment in CD1d(-/-) mice. Our studies demonstrate a contribution of both NK and NK T cells to the Cy- and IL-12-stimulated anti-tumor response. We describe the selective induction of a distinct NK T cell subset by Cy and IL-12 therapy, not seen following IL-12 therapy alone, which we suggest may contribute to the successful anti-tumor response induced by this immunotherapeutic regimen. | {
"pile_set_name": "PubMed Abstracts"
} |
Analysis of chlormethiazole, ethchlorvynol and trichloroethanol in biological fluids by gas-liquid chromatography as an aid to the diagnosis of acute poisoning.
A simple method has been developed whereby chlormethiazole, ethchlorvynol and trichloroethanol can be simultaneously detected and measured in biological fluids. The procedure is based upon the rapid extraction of a small (50-microliter) sample volume with an equal volume of chloroform containing an internal standard, followed by the gas-liquid chromatographic analysis of this extract. Specimens of blood plasma or serum, urine and gastric contents can be used, and no interference from either endogenous or exogenous sources has been observed. The method is suitable for the measurement of the plasma concentrations of these compounds attained after overdosage. | {
"pile_set_name": "PubMed Abstracts"
} |
Inner ear proteomics: a fad or hear to stay.
Proteomics, the large-scale analysis of the structure and function of proteins, as well as of protein-protein interactions, has evolved into a major component of 'systems analysis'. This requires the integration of information from different sources and at multiple levels, and involves two distinct parameters, (1) high-throughput protein separation, identification, and characterization, and (2) the extension of the obtained analytical data for the determination of the physiological function. The inner ear poses exceptional challenges to the study of proteomics because of its minute size, poor accessibility, association with complex fluid spaces, and diversity of cell types. Various approaches to the study of proteomics of the inner ear are presented, and success stories, noteworthy failures and what lies ahead, will be discussed. | {
"pile_set_name": "PubMed Abstracts"
} |
Patterns of care for patients with primary differentiated carcinoma of the thyroid gland treated in Germany during 1996. U.S. and German Thyroid Cancer Group.
To determine current patterns of care and disease characteristics for patients with thyroid carcinoma, a Patient Care Evaluation Study was initiated in 1996 in the U.S. and Germany. This project addresses ongoing concerns with respect to the diagnostic evaluation and treatment of patients diagnosed with thyroid carcinoma and raises questions concerning how physicians are interpreting current standards and acting on the basis of these recommendations. Patients with primary thyroid carcinoma were entered into a prospective multicenter observational study with free choice of treatment (no control group) between January 1, 1996 and December 31, 1996 in Germany. This resulted in a total of 2537 cases under observation and analysis; 1685 patients had papillary carcinoma (66.4%), 691 had follicular carcinoma (27.2%), 70 had medullary carcinoma (2.8%), and 91 had anaplastic carcinoma (3.6%). The 2376 patients with carcinoma of either papillary or follicular histology were included in the current analysis. The major symptoms reported for patients with papillary and follicular thyroid carcinoma was neck mass (reported in 76% and 79%, respectively) followed by dysphagia (reported in 25% and 27%, respectively), stridor (reported in 9% and 14%, respectively), and neck pain (reported in 7% and 8%, respectively). Greater than 50% of the patients with papillary thyroid carcinoma were reported to have American Joint Committee on Cancer/International Union Against Cancer Stage I disease. Between 37-39% of the follicular carcinoma patients had Stage I and Stage II disease. Only slight differences in the diagnostic approach to patients with papillary or follicular carcinoma were noted. The majority of patients underwent an ultrasound of the thyroid region (78.1%), which was suggestive of carcinoma in only 39% of the cases. A thyroid scan was performed on 76.6% of patients, and the results were suggestive of carcinoma in 44.8% of the individuals. In contrast, fine-needle aspiration biopsy of the thyroid is highly recommended in the current Clinical Practice Guidelines (CPG) but results were obtained in only 27.4% of the patients. Total thyroidectomy without lymph node dissection was the most commonly used surgical procedure in the treatment of patients with papillary and follicular thyroid carcinoma. Only approximately 2% of patients at low risk in the group with Stage I disease were treated with a lobectomy. In 80% of the patients with Stage I papillary thyroid carcinoma and approximately 90% of those patients diagnosed with Stage II, III, and IV disease treating physicians chose to utilize radioiodine as adjuvant treatment after disease-directed surgery. External beam radiation was added to the treatment regimen for many patients diagnosed with Stage III and IV disease (30% in patients with papillary thyroid carcinoma and 33% in patients with follicular thyroid carcinoma). To the authors' knowledge no single effective diagnostic test for thyroid carcinoma currently is available and in the majority of cases a combination of ultrasound, thyroid scan, or fine-needle aspiration biopsy together with the clinical findings (e.g., thyroid mass) led to a diagnosis of carcinoma. The authors suspect that the high prevalence of concomitant pathologic findings such as goiter, even in the healthy population in Germany, reduces the accuracy of all diagnostic test methods and may account for the frequent use of imaging techniques. The majority of patients underwent a total or near-total thyroidectomy. Total thyroidectomy with radical lymph node dissection was used very frequently in those patients with papillary thyroid carcinoma (22%). German physicians tend to surgically treat early stage thyroid carcinoma somewhat more radically than recommended in the CPG. With respect to other treatment options employed as part of the first course of treatment, radioiodine appears to play the most important role. [See commentary o | {
"pile_set_name": "PubMed Abstracts"
} |
Effect of alumina-blasting pressure on adhesion of CAD/CAM resin block to dentin.
The aim of this study was to evaluate how alumina-blasting pressure affects the bond strength of CAD/CAM resin blocks (CRBs) to bovine dentin using two different types of resin cements. CRB slices were divided into three groups by alumina-blasting pressure, namely, untreated and 0.1 MPa and 0.2 MPa, and further divided into three subgroups by combination of CRBs surface treatment and types of cement: Scotchbond Universal and RelyX ultimate (RXB), Scotchbond Universal and RelyX unicem2 (U2B), ceramic primer and RelyX unicem2 (U2C). The CRB slices were then cemented to bovine dentin, microtensile bond strength test was performed and evaluated. Regardless of the alumina-blasting pressure, RXB group have the highest µTBS and bond strength tends to increase with increasing alumina-blasting pressure. Alumina-blasting to CRB surface by at an appropriate pressure and use of conventional resin cement were required to obtain strong adhesion with the tooth structure. | {
"pile_set_name": "PubMed Abstracts"
} |
Evaluation of student nurses' perception of preparedness for oral medication administration in clinical practice: a collaborative study.
Attainment of oral medication administration skills and competency for student nurses is challenging and medication errors are common. The ability of nurses to master a clinical skill is dependent upon educational instruction and practice. The aim of this study was to evaluate nursing students' perception of preparedness for oral medication administration in two practice environments and determine possible relationship between student demographics and their perceived preparedness for oral medication administration. This was a cross sectional, exploratory study. Eighty-eight second year students from a baccalaureate nursing course from two metropolitan Australian tertiary institutions participated. Student nurses' perception of preparedness for oral medication administration was measured via a self-administered, adapted, and validated questionnaire. The overall mean Total Preparedness Score was 86.2 (range 71-102). There was no significant difference for perceived total preparedness to administer oral medications between the two facilities. Whilst there was no significant relationship established between student demographics and their perceived preparedness to administer oral medications, four single questions related to clinical practice were shown to be significant. Low fidelity simulated teaching environments that incorporate time management and post medication situations, may improve student nurses' perceived preparedness for oral medication administration. | {
"pile_set_name": "PubMed Abstracts"
} |
Phase II pilot study of combined chemohormonal therapy with doxorubicin and estramustine in metastatic prostate cancer.
Twenty-nine patients with progressive hormone-refractory metastatic adenocarcinoma of the prostate were treated with daily estramustine phosphate at 10 mg/kg, and I.V. doxorubicin 50 mg/m2 every 3 weeks. Twenty-six patients were evaluable. Four of seven patients with nonosseous measurable disease had partial responses lasting 3 to 10 months. Eleven of 19 patients with osseous metastases had stable disease or improvement on bone scan, 6 of these for 7 months or longer. Median time to progression was 20 weeks, and the median survival was 43 weeks. | {
"pile_set_name": "PubMed Abstracts"
} |
Neuroprotective effect of phosphocreatine on oxidative stress and mitochondrial dysfunction induced apoptosis in vitro and in vivo: Involvement of dual PI3K/Akt and Nrf2/HO-1 pathways.
Methylglyoxal (MGO), an active metabolite of glucose, is observed in high levels in the tissues and blood of diabetic patients. Phosphocreatine (PCr), a high-energy phosphate compound, exhibits a range of pharmacological actions but little is well known of its neuroprotective action. The aim of the present study was to investigate the neuroprotective effects and the possible mechanisms of PCr. Diabetes is closely associated with neurodegenerative diseases, leading not only to the peripheral nervous system (PNS) and but also to central nervous system (CNS) damage. Therefore, we established two rat models of diabetes in vivo induced by MGO and streptozocin (STZ) respectively, while utilized differentiated PC-12 cells in vitro. Treatment of PC-12 cells with PCr markedly attenuated MGO-induced change of viability, apoptosis, accompanied by decreased levels of caspase-3, casapse-9 and Bcl-2/Bax protein ratio. Determination of cellular respiratory function was performed with intact PC-12 cells and homogenized hippocampal neuron tissue of rat. Reactive oxygen species (ROS) generation was assessed by membrane permeable fluorescent probe DCFH-DA. The expressions of Akt, Nrf2 and HO-1 were examined by Western blot. PCr pretreatment significantly reduced oxidative stress-induced high LDH, MDA level, and ROS production of PC-12 cells. PCr pretreatment also significantly decreased mitochondrial dysfunction in vitro and in vivo. In addition, PCr pretreatment increased the expression of p-Akt, Nrf2 and HO-1, and reduced the apoptosis. Moreover, the expression of Cleaved caspase3 was partially increased and the p-Akt, Nrf2 and HO-1 was partially reduced by a PI3K inhibitor (LY294002). While, compared with LY294002 groups, pre-treatment with PCr at the concentrations of 20 mM significantly reduced the expression of Cleaved caspase3 and increased the expression of p-Akt, Nrf2 and HO-1. Molecular docking assay showed that PCr possessed powerful affinity towards to Akt with lower binding energy. In conclusion, the neuroprotective effects of PCr in vitro and in vivo rely on normalizing mitochondrial function and reducing oxidative stress via Akt mediated Nrf2/HO-1 pathway, suggesting that PCr may be a novel therapeutic candidate for the treatment of diabetes-associated neurodegenerative diseases. | {
"pile_set_name": "PubMed Abstracts"
} |
[Giant cell arteritis revealed by scalp necrosis].
Scalp necrosis is an uncommon manifestation of giant cell arteritis (GCA). In this paper, we report our experience with a 78-year old woman in whom extensive scalp necrosis developed as a complication of GCA. A left frontal defect (7 X 4 cm) involving full-thickness scalp was observed. The necrosis extended deeply, involving the epicranium and the outer table of the skull. The therapeutic approach included corticotherapy, anticoagulation and wound care. Severe wound infection (osteitis, subgaleal abscess) occurred, requiring prolonged antibiotherapy. Second intention healing was obtained using a conservative approach. During the healing process, areas of neovascularization developed beneath the exposed part of the outer table and the necrotic bone underwent resorption. | {
"pile_set_name": "PubMed Abstracts"
} |
Beneficial effects of better control of secondary hyperparathyroidism with paricalcitol in chronic dialysis patients.
Treatment of secondary hyperparathyroidism (SHPT) with calcitriol is often limited by the occurrence of hypercalcemia, hyperphosphatemia and risk of vascular calcifications. Paricalcitol, a vitamin D analogue with lower calcemic and phosphatemic effects, is successfully utilized in dialysis patients, although some uncertainty remains about the optimal dosage. Amelioration of survival in hemodialysis patients has been correlated to the use of calcitriol and, even better, paricalcitol. We evaluated 1-year treatment with paricalcitol in 12 chronic hemodialysis patients with moderate-severe SHPT previously treated with intravenous calcitriol. Starting dose of paricalcitol was calculated according to the severity of the disease by the formula: intact parathyroid hormone (iPTH)/80, and successive titration performed according to the NKF-DOQI guidelines. Paricalcitol caused a rapid decrease in serum levels of iPTH with a consistent percentage of values falling below 150 pg/mL in the first months of treatment. Although the occurrence of hypercalcemia was not significantly different between treatment with calcitriol and paricalcitol, a slight but significant increase in mean calcium levels was observed during paricalcitol treatment. A significant amelioration of erythropoiesis and acid-base balance was observed during paricalcitol treatment. Paricalcitol efficiently suppresses PTH secretion in dialysis patients with SHPT, with a moderate calcemic, but not a phosphatemic, effect. The dose of paricalcitol calculated as iPTH/80 may cause acute lowering of bone turnover. The improvement of anemia control and the amelioration of acid-base balance are 2 important additive effects of the better control of SHPT that may improve survival of hemodialysis patients. | {
"pile_set_name": "PubMed Abstracts"
} |
Cellular changes of Reissner's membrane in Meniere's disease: human temporal bone study.
To study the cellular characteristics of Reissner's membrane (RM) in temporal bones (TBs) from patients with endolymphatic hydrops with symptoms of Meniere's disease (EH/+MD) and TBs with endolymphatic hydrops without symptoms of Meniere's disease (EH/-MD) in an effort to understand the role of endolymphatic hydrops in MD symptoms. Comparative study of human TB histopathology. Epithelial and mesothelial cellularity of RM from control TBs, TBs from patients with EH/+MD, and TBs from patients with EH/-MD were compared. The cellularity of epithelial and mesothelial cell nuclei (defined as number of cells/100 microm width of RM) were counted along the width of RM. The width of RM was measured from the vestibular crest of the spiral ligament to the limbus spiralis. The cellular densities of epithelial cells in the basal and middle turns of RM were significantly higher in the EH/+MD and EH/-MD groups compared with "controls." There was no difference in epithelial cellularity between EH/+MD and EH/-MD. There was a decrease in the number of mesothelial cells of RM in the basal turn in EH/+MD and EH/-MD groups (statistically significant only in EH/+MD group) when compared with controls. The number of mesothelial cells of RM in the middle turn in EH/+MD and EH/-MD groups were significantly decreased compared with normals. Similar findings in cellularity of RM in temporal bones with EH/+MD and EH/-MD suggest that pathophysiologic mechanisms other than hydrops may be responsible for symptoms in Meniere's disease. | {
"pile_set_name": "PubMed Abstracts"
} |
A survey of the prevalence of Escherichia coli O157 in raw meats, raw cow's milk and raw-milk cheeses in south-east Scotland.
2429 samples of foodstuffs were examined for the presence of verocytotoxigenic Escherichia coli O157 (VTEC O157) by means of immunomagnetic separation (IMS) over a 2-year period commencing April 1997. Specimens comprised 1190 raw meats, 500 raw milks and 739 raw-milk cheeses. The meat and cheese samples were purchased from retail premises in south-east Scotland; raw milk samples were obtained directly from farms. In addition, total E. coli counts were performed on milk and cheese samples, and the pH of cheese specimens measured. The water activity (Aw) was also measured for a representative sample of each cheese type, and for all of the samples with high levels of E. coli. VTEC O157 was isolated from two samples of beef burger, both manufactured on the premises of the same butchers shop. Control studies with artificially inoculated foodstuffs demonstrated a sensitivity of detection of < 5 organisms 25 g(-1). These findings, which contrast with the results of similar studies elsewhere in the UK, suggest that other sources of infection may be important in explaining the high rates of infection with this organism in south-east Scotland. | {
"pile_set_name": "PubMed Abstracts"
} |
Flow and Diameter Changes of Forearm Arteries During Temporary Unilateral Reciprocal Occlusion: A Prospective Observational Study.
Transradial and transulnar artery approaches are commonly used for percutaneous interventions, with considerably low risk of developing hand ischemia, for reasons that have not been fully understood. The aim of this study was to evaluate the changes in the diameter, peak systolic flow velocity (PSV), and volume flow (VF) of the radial (RA) and ulnar artery (UA) during unilateral reciprocal temporary occlusion. A total of 204 extremity arteries of 102 consecutive patients were evaluated using Doppler ultrasonography. At the level of the wrist, RA and UA were consecutively compressed for 60 seconds. The diameter, PSV, and VF parameters of both arteries were evaluated during unilateral reciprocal compression. Compared with the baseline values, the median (interquartile range) increases in diameter, PSV, and VF were 0.2 (0.1-0.3) mm, 6.8 (1.7-17.5) cm/s, and 1.9 (0.8-10) ml/min, respectively, for RA, and 0.1 (0.1-0.3) mm, 9.4 (2.6-18.0) cm/s, and 10.0 (0.0-20.0) ml/min, respectively, for UA during reciprocal compression (p < 0.001 for all). Reciprocal compression significantly increased the diameter, PSV, and VF of both arteries during reciprocal compression. © 2016 Wiley Periodicals, Inc. J Clin Ultrasound 45:197-203, 2017. | {
"pile_set_name": "PubMed Abstracts"
} |
[Detection of human papilloma virus infection in men].
Globally, human papillomavirus (HPV) is the most frequent sexually transmitted infection (STI) and it affects men and women equally. In men, HPV has been mainly associated with skin lesions like ano-genital warts and intraepithelial neoplasia of penis and anus in recent years. HPV prevalence in men varies extremely due to kind of sample and detection techniques. The most widely used samples to study HPV in men are: penile shaft, glans, prepuce, coronal sulcus, urine and semen, and its detection is usually performed with techniques like reverse line blot (RLB) and hybrid capture (HC). Given that the highest infection rates are in Africa and Latin America, the aim of this review is to describe the pathogenesis of HPV and its main detection techniques in men. | {
"pile_set_name": "PubMed Abstracts"
} |
The effect of heterotopic bone formation on prosthetic loosening after total hip replacement.
Seven hundred thirty-two total hip replacements performed from 1970 to 1980 were evaluated for the degree of heterotopic bone formation postoperatively and its effect on long-term mechanical loosening. There were 231 Charnley total hip replacements, of which 152 had no heterotopic bone formation, 58 had Grade 1 formation, and 21 had Grade 2 or 3 formation. Among the 123 Mueller total hip replacements, 98 had no heterotopic bone formation, 19 had Grade 1 formation, and 6 had Grade 2 or 3 formation. For the 378 T-28 total hip replacements, there were 305 with no heterotopic bone formation, 59 with Grade 1 formation, and 14 with Grade 2 or 3 formation. Survival analyses using the definition of failure as loosening, fracture, or revision of the acetabulum or femoral components were constructed. There was no correlation between mechanical loosening, fracture, or revision of the total hip replacement and any degree of heterotopic bone formation. | {
"pile_set_name": "PubMed Abstracts"
} |
Simulating heavy metal concentrations in an aquatic environment using artificial intelligence models and physicochemical indexes.
Although heavy metal monitoring campaigns are established worldwide, it is still difficult to model heavy metals in aquatic environments with limited monitoring data. In this study, surface water physicochemical indexes and heavy metal concentrations were measured in a drinking water source in the Taihu Lake region, China. Afterwards, indexes including water temperature, pH, suspended matter, turbidity, and total nitrogen, nitrate nitrogen, ammonia nitrogen, total phosphorous, orthophosphate and permanganate index were used to simulate dissolved, particulate and total heavy metal concentrations using artificial neural network (ANN) and support vector machine (SVM) models. Sensitivity analysis showed that simulated heavy metal concentrations were most sensitive to pH. Thereafter, quick simulation models based on five sensitive parameters (pH, suspended matter, water temperature, total phosphorus and permanganate index) allowed for quick simulations of heavy metal concentrations were built. Both ANN and SVM quick simulation models simulated particulate heavy metal concentrations well with most Nash-Sutcliffe efficiency coefficients >0.8. Models performed worse when simulating dissolved and total heavy metal concentrations. Results demonstrate that artificial intelligence models like ANN and SVM are alternative ways to simulate heavy metal concentrations with limited monitoring data. Furthermore, sensitivity analysis may help to identify key factors affecting heavy metal behavior, and to improve environmental monitoring campaigns and management strategies. | {
"pile_set_name": "PubMed Abstracts"
} |
Bilayer tablets based on poly (epsilon-caprolactone) and polymethylmethacrilates as controlled-release systems for ruminants.
Rumen-stable devices ensure a protection of active ingredients against chemical degradation and bacterial fermentation processes that occur in the rumen. These systems should also provide postruminal bioavailability and controlled release of the active ingredient. The objective of this study was the preparation of bilayer tablets as rumen-stable delivery systems, designed for the oral administration of active ingredients (folic acid) to ruminants. The tablets are composed of two layers: layer A ("high-density layer") constituted by poly (epsilon-caprolactone) mixed with iron powder and characterized by sufficient density to avoid rumination; layer B ("release layer"), containing folic acid (25 mg), poly (epsilon-caprolactone) or polymethylmethacrylates (Eudragit RS and RL) designed to be rumen-stable and to target a controlled release of folic acid in the intestinal tract. In vitro rumen-protection tests were performed in buffer systems at pH 5.5 and pH 2.0, simulating a ruminal and abomasal environment, to verify the stability of bilayer tablets at these conditions. In vitro release tests were carried out in phosphate buffer at pH 7.4, to study the release behavior of the dosage forms in the intestinal environment. A preliminary in vivo test was carried out with radiographic images made after administration of the tablets to sheep, to evaluate their capacity to be retained in the reticulum-rumen. The amount of iron powder used provides a density of about 2.3 g/cm3 to the whole tablet. The tablets having layer B constituted by poly (epsilon-caprolactone) or Eudragit RS do not disintegrate in buffer media at pH 5.5 and pH 2.0, and they are characterized by a sustained release at pH 7.4. Radiological preliminary tests show that these prepared bilayer tablets are able to be retained in the reticulum-rumen tract of the sheep. | {
"pile_set_name": "PubMed Abstracts"
} |
Quantitative duplex and color Doppler ultrasound in the follow-up of beta-irradiated (106Ru/106Rh) choroidal melanomas. A prospective study.
The tumor response to radiotherapy depends highly on the local oxygen concentration, which is governed by the tumor's microcirculatory network. The aim of this prospective study was to quantitate the neovascular blood flow in human choroidal melanomas prior to 106Ru/106Rh irradiation and during a 1-year follow-up period. Pulsatile blood flow was elicited by means of duplex and color Doppler ultrasound in 54 of a total of 55 untreated melanomas with a mean peak systolic frequency of 1.0 kHz (range 0.3-2.7 kHz). The neovascular blood flow decreased significantly 4 and 6 months after beta-irradiation. No intrinsic tumor vascularity was detected 8 and 12 months after treatment. In 3 patients, a rising peak systolic frequency occurred following radiotherapy in advance of recurrent tumor growth. Results indicate that the noninvasive quantitation of neovascular blood flow in irradiated choroidal melanomas by pulsed Doppler ultrasound offers a new diagnostic modality for assessing tumor recurrence. | {
"pile_set_name": "PubMed Abstracts"
} |
Spontaneous Yersiniosis due to Yersinia pseudotuberculosis serotype 7 in a squirrel monkey.
A captive male Bolivian squirrel monkey (Saimiri boliviensis) of less than 1 year of age died following diarrhea and debilitation on the day of death. At necropsy, necrotizing enteritis accompanied with enlarged Peyer's patches, solitary lymphatic follicles and mesenteric lymph nodes, and multiple yellowish-white nodules in the spleen and liver were found. Histopathologically, these lesions were necrotizing inflammation containing Gram-negative bacilli. Yersinia pseudotuberculosis serotype 7 was isolated from the spleen and liver. The virF gene, which is an essential virulent plasimid (pYV) in pathogenic Y. pseudotuberculosis isolates, and the ypmA gene, which is a superantigenic toxin, were detected in the isolates. This is the first report of a fatal case of Yersinia pseudotuberculosis 7 infection in the world. | {
"pile_set_name": "PubMed Abstracts"
} |
The origin of angiosperms: New and old problems.
Recent palaeobotanical discoveries assisted by the thorough morphological analysis of 'living fossils'-archaic extant plants-have brought to light many unexpected features of the early angiosperms and their immediate precursors, while studies in palaeoecology have provided a basis for deciphering the chronology of evolutionary events and their environmental forcing. Our previous ideas of what is primitive and what angiosperm ancestors looked like are presently under revision. We now have a clearer picture of how macroevolution proceeds and how a large taxon could come into being. | {
"pile_set_name": "PubMed Abstracts"
} |
Tumor markers in parotid gland carcinomas: immunohistochemical investigations.
Substances with "marker" characteristics for tumors were studied in parotid gland neoplasms. The substances included intermediate-sized filaments, oncofetal and proliferation antigens, metalloproteins, antigens related to the blood group system, and enzymes and other cellular products. The immunoperoxidase technique was applied on the following kind of tissues: normal parotid glands, Morbus Sjögren, cystadenolymphomas, pleomorphic adenomas, adenocarcinomas, adenoid cystic carcinomas, salivary duct carcinomas, mucoepidermoid tumors, squamous cell carcinomas, and anaplastic carcinomas. The intermediate-sized filaments of the prekeratin type were demonstrated in the ducts and myoepithelial cells of the normal parotid glands, and in the epithelial tumors, which all were vimentin negative. Carcinoembryonic antigen was found in squamous cell carcinomas and glandular differentiated tumors, whereas lactoferrin was detected only in a part of glandular tumors. Amylase was seen in acinic cell tumors. | {
"pile_set_name": "PubMed Abstracts"
} |
Performance and biofilm characteristics of biotrickling filters for ethylbenzene removal in the presence of saponins.
Saponins were applied to enhance ethylbenzene removal in biotrickling filters (BTFs), and comparison experiments were carried out to evaluate the effects of saponins on ethylbenzene removal and biofilm characteristics at various saponin concentrations. Results showed that the optimum concentration of saponins was 40 mg/L and a maximum removal efficiency (RE) of ethylbenzene reached 84.3%. When the inlet ethylbenzene concentration increased, ranging from 750 to 2300 mg/m3, the RE decreased from 92.1 to 60.8% and from 69.4 to 44.2% for BTF1 and BTF2 in which saponin was and was not added, respectively. The corresponding RE declined from 91.1 to 40.8% and from 71.5 to 35.8% with a decreased empty bed residence time ranging from 45 to 7.5 s. Additionally, significant differences existed between both BTFs not only in the contents of polysaccharide and proteins but also in the surface charge of biofilms, and the ratio of protein to polysaccharide increased with the increase of saponin concentration, which indicated the presumable effect of saponins on liquid-biofilm transfer rates of ethylbenzene. Mechanisms for the enhanced removal of hydrophobic volatile organic compounds at the presence of surfactants were also discussed. | {
"pile_set_name": "PubMed Abstracts"
} |
Use of active site-directed inhibitors to study in situ degradation of glycoproteins by the perfused rat liver.
Use was made of the asialoglycoprotein receptor system in a perfused rat liver in order to study lysosomal degradation and subsequent metabolism of radioactive derivatives of asialo-ovine submaxillary mucin and asialo-alpha 1-acid glycoprotein. A trace of N-acetyl-D-[6-3H]galactosamine-labeled asialo-ovine submaxillary (4 micrograms) was completely taken up by the tissue in less than 20 min. After 3 h 24% of the radioactivity from the mucin reappeared on newly synthesized serum glycoproteins that were secreted into the perfusate. [6-3H] Galactose asialo-alpha 1-acid glycoprotein was also rapidly cleared by the liver; however, after 3 h greater than 60% of the radioactivity derived from this sugar labeled glycoprotein was secreted back into the perfusate as [3H]glucose. Rat livers perfused with 0.15 mM beta-D-galactopyranosylmethyl-p-nitrophenyltriazene lost 90% of their beta-D-galactosidase activity within 1 h while other representative glycosidases showed no change as followed by hydrolysis of p-nitrophenylglycosides. Livers pretreated with this triazene compound metabolized [3H]GalNAc asialo-ovine submaxillary mucin normally but were unable to process [3H]Gal asialo-alpha 1-acid glycoprotein as evidenced by a complete inhibition of [3H]glucose release following addition of the latter substrate. Metabolism of N-acetyl[14C]glucosamine asialo-alpha 1-acid glycoprotein was similarly inhibited by 70%. 125I-labeled asialo-alpha 1-acid glycoprotein catabolism was not affected by the chemically induced beta-D-galactosidase deficiency. Subcellular fractionation of inhibitor-treated livers accumulating radioactive carbohydrate showed the majority of the label was associated with a fraction enriched in lysosomes. Analysis of the trapped radioactivity by high resolution Bio-Gel P-4 chromatography revealed nearly intact oligosaccharides minus only the reducing N-acetylglucosamine of the chitobiose core. Direct comparison of these sugar chains with those isolated from human and canine GM1 gangliosidosis liver by silicic acid thin layer chromatography showed those isolated from rat liver to be identical to the major subset of oligosaccharides found in the human disease. In similar experiments in which the galactosyl triazene was replaced by swainsonine, an alpha-D-mannosidase inhibitor, catabolism of [14C]GlcNAc asialo-alpha 1-acid glycoprotein resulted in the accumulation of a single oligosaccharide of the structure. Man3[14C]GlcNAc1. These results demonstrate an endo-N-acetyl-beta-D-glucosaminidase is active in rat liver lysosomes. | {
"pile_set_name": "PubMed Abstracts"
} |
Effects of phosphodiesterase inhibitors on oesophageal neuromuscular functions.
The cyclic nucleotides adenosine 3',5'-cyclic monophosphate (cAMP) and guanosine 3',5'-cyclic monophosphate (cGMP) mediate the inhibitory effects of vasoactive intestinal polypeptide and nitric oxide on oesophageal smooth muscle. Phosphodiesterases (PDE) terminate their actions. We hypothesized that PDE inhibitors alter nerve-induced responses of oesophageal and lower oesophageal sphincter (LES) smooth muscle. An electrical field known to activate intrinsic oesophageal nerves was used to stimulate transverse muscle strips from the opossum oesophagus. This produced a contractile off-response from circular oesophageal muscle and a biphasic relaxation of the LES - an initial rapid relaxation (R1) and a slower sustained relaxation (R2). The effects on LES and oesophageal muscle of zaprinast (type V), zardaverine (type III/IV) and theophylline (non-specific) PDE inhibitors were explored. All three PDE inhibitors decreased LES tone and attenuated the off-response. Zaprinast and theophylline increased the latency of the off-response. Zaprinast prolonged R1, and slowed its recovery. It also increased the percentage relaxation of the second R2. Zardaverine increased the percentage relaxation of R2. Theophylline slowed the recovery of R2. PDEs play a role in maintaining LES tone and its recovery after LES relaxation. They may also modulate oesophageal motor activity. | {
"pile_set_name": "PubMed Abstracts"
} |
Sleep apnoea syndrome and early stage cirrhosis: a pilot study.
Hepatic encephalopathy in patients with end-stage liver cirrhosis is associated with alterations in sleep patterns. Cirrhosis may also affect pulmonary function and it might be involved in the development of obstructive sleep apnoea syndrome (OSAS) in patients with ascites. We carried out a study to evaluate the presence of OSAS in cirrhotic patients without evidence of ascites (early stage cirrhosis). We investigated 20 patients with Child A or B cirrhosis (19 and one, respectively) and 10 non-cirrhotic patients with chronic viral hepatitis (disease control group). All subjects were interviewed and underwent a thorough physical examination, a full polysomnographic study and a pulmonary function testing by spirometry. Serum samples were also obtained in order to determine the liver function tests. The presence of OSAS and inverted sleep patterns was similar in cirrhotic patients and disease controls. However, significant correlations were revealed between age and hypopnoeas per hour of sleep; age and the Apneas/Hypopneas Index (AHI); age and FEV1/FVC; gamma-glutamyl transpeptidase and FEV1/FVC; and total bilirubin and total sleep time. Early stage cirrhosis is not associated with sleep disorders and OSAS. However, total bilirubin levels might be a useful laboratory marker for early assessment of disturbance in sleep patterns and therefore of subclinical hepatic encephalopathy in Child A cirrhosis. | {
"pile_set_name": "PubMed Abstracts"
} |
Coexistence of novel amylin-binding sites with calcitonin receptors in human breast carcinoma MCF-7 cells.
Amylin, calcitonin (CT) and calcitonin gene-related peptide (CGRP) share limited structural homology including amino-terminal ring structures linked by a disulfide bridge and amidated carboxy-termini. Here, we have compared [125I]Bolton-Hunter-[Lys1] rat amylin ([125I]amylin) binding and the stimulation of cyclic AMP accumulation by human (h) amylin, hCT and hCGRP-I in the human breast carcinoma cell lines MCF-7 and T47D, which predominantly express hCT1a and hCT1b receptor isoforms (hCTR1a, hCTR1b) at a similar total number of hCT-binding sites. In MCF-7 cells, half-maximal inhibition (IC50) of [125I]amylin binding by human amylin was observed at 3.6 +/- 0.8 nM (n = 6). hCT and hCGRP-I displaced [125I]amylin binding with 22 and 66 times higher IC50. [125I]hCT binding was inhibited by hCT with an IC50 of 8.1 +/- 1.9 nM (n = 5), and human amylin and hCGRP-I were over 100 times less potent. In T47D cells, on the other hand, specific binding of [125I]amylin was not observed, but hCT inhibited [125I]hCT binding with an IC50 of 3.2 +/- 0.4 nM (n = 3), and human amylin and hCGRP-I had over 200 times higher IC50. In MCF-7 cells, half-maximal stimulation (EC50) of cyclic AMP accumulation by human amylin, hCT and hCGRP-I occurred at 1.4 +/- 0.2, 1.7 +/- 0.4 and 6.3 +/- 1.3 nM respectively. In T47D cells, the EC50 of hCT was 0.32 +/- 0.02 nM (n = 3), and 30- and 1900-fold higher with human amylin and hCGRP-I. In conclusion, the expression of hCTR1a and hCTR1b and [125I]hCT binding were indistinguishable in MCF-7 and T47D cells. Yet, [125I]amylin binding was only recognized in MCF-7 cells, consistent with a distinct amylin receptor. | {
"pile_set_name": "PubMed Abstracts"
} |
The total quasi-steady-state approximation for fully competitive enzyme reactions.
The validity of the Michaelis-Menten-Briggs-Haldane approximation for single enzyme reactions has recently been improved by the formalism of the total quasi-steady-state approximation. This approach is here extended to fully competitive systems, and a criterion for its validity is provided. We show that it extends the Michaelis-Menten-Briggs-Haldane approximation for such systems for a wide range of parameters very convincingly, and investigate special cases. It is demonstrated that our method is at least roughly valid in the case of identical affinities. The results presented should be useful for numerical simulations of many in vivo reactions. | {
"pile_set_name": "PubMed Abstracts"
} |
[Traumatic spinal cord injury in children; early and late effects].
Spinal cord injuries (SCIs) have physical, emotional, psychological and economic consequences for patients. Although SCIs in children are rare, they have to cope with the consequences for the rest of their lives. In this article, three children who presented at our emergency department are discussed. These children had suffered SCIs from different etiologies. Most SCIs are caused by trauma and more males than females suffer SCIs. The younger children are, the more likely they will sustain cervical SCIs, which can be attributed to several distinct anatomical differences in the juvenile spine. Depending on the level of the spine injured, multiple secondary problems can occur. In this article, we paint a picture of the complex and multidisciplinary treatment and rehabilitation of young SCI patients and emphasise the need for treatment to take place in a specialised (children's) rehabilitation unit. | {
"pile_set_name": "PubMed Abstracts"
} |
High frequency of genetic diversity of Plasmodium vivax field isolates in Myanmar.
Malaria is one of the most serious problems threatening human health in Myanmar. Although the morbidity and mortality rates due to malaria have been gradually declining, Myanmar still contributes to a large proportion of malarial death in the South-East Asia region. However, little is known about the nature and extent of genetic diversity of the malarial parasites circulating in Myanmar. In this study, we investigated the overall infection status of Plasmodium and the population diversity of Plasmodium vivax by analyzing three genetic markers, circumsporozoite protein (CSP), merozoite surface protein-1 (MSP-1), and merozoite surface protein-3 (MSP-3alpha), of P. vivax field isolates collected from infected individuals. In 349 blood samples collected from the individuals who exhibited clinical symptoms associated with malaria, 63.0% showed a positive result for malaria (220/349). P. vivax was detected in 58.2% (128/220) and Plasmodium falciparum was detected in 29.1% (64/220). Mixed infections with both parasites were detected in 12.7% (28/220). The 116 blood samples in which single infection of P. vivax was confirmed were selected and subjected to further genetic analysis. Genotyping of the CSP gene of P. vivax showed that VK210 type (98.3%, 114/116) is predominant in Myanmar, but a significant level of mixed infections of VK210 and VK247 types (24.1%, 28/116) was also identified. Sequence analyses of MSP-1 and MSP-3alpha genes revealed a large number of distinguishable alleles: 12 for MSP-1 and 25 for MSP-3alpha. These results collectively suggest that the P. vivax population in Myanmar is highly diverse and multiple clonal infections are prevalent in the country. | {
"pile_set_name": "PubMed Abstracts"
} |
[Basal interhemispheric approach for distal anterior cerebral aneurysms].
To investigate retrospectively the usefulness of basal interhemispheric approach for neck clipping of aneurysms located on genu or infracallosal portion of anterior cerebral artery. Seventeen aneurysms in 17 patietns treated by clipping with basal inter-hemispheric approach in our department for past 8 years were reviewed. Of them, 12 were ruptured aneurysm and 5 were unruptured one. The distance between frontal base and most frontally located bridging vein and the shortest distance from cranium to aneurysm were measured from angiograms of lateral view, and the point on cranium of the shortest distance was identified in each cases. Bridging vein damage suffered during surgical approach and the duration of brain retractor use were examined from operative videotapes. The clinical outcome was rated at discharge by Modified Rankin Scale. The distance between frontal base and most frontally located bridging vein was ranged as 15-69 mm (mean, 32 mm). The shortest distance between cranium and aneurysm in each case was ranged as 25-48 mm (mean, 33 mm), and the point on cranium of the shortest distance was these within 20 mm from frontal base in 11 cases. Any damage or cut of bridging vein were not seen in all cases. The duration of brain retractor for unilateral frontal lobe and for bifrontal lobe in recent 14 cases was ranged 0-46 minutes 41 seconds (mean, 8 minutes 55 seconds) and 0-16minutes (mean, 2minutes 24 seconds), respectively. No brain damage caused by operative procedure was detected on postoperative CT scan. All five patients of unruptured one and 8 patients of ruptured one were rated as 0 by Modified Rankin scale, 2 patients of ruptured one as 3 and 5, and 2 patients of ruptured one died. The basal interhemispheric approach for neck clipping of aneurysm located on genu or infracallosal portion of anterior cerebral artery would provide wide view of aneurysm and its surrounding structures with minimum retraction of frontal lobe, short distance to the aneurysm, and low risk of bridging vein damage. | {
"pile_set_name": "PubMed Abstracts"
} |
Alternatives for optimal hormone replacement therapy.
To satisfy the needs of women with a wide variety of different medical histories and preferences, a wide choice of various forms of hormone replacement therapy (HRT) is desirable. The potential long-term benefits of HRT, in terms of osteoporosis, cardiovascular disease and dementia, require good compliance, which in turn requires an HRT formulation that is highly acceptable. An absence of weight gain and lack of androgenic effects are of great importance, as are predictable bleeding and positive effects on postmenopausal symptoms and quality of life. HRT should be tailored to each woman's needs by the choice of appropriate estrogens and particularly a progestogen with a suitable pharmacological profile. An ideal progestogen should be targeted at preventing endometrial hyperplasia without opposing the effects of estrogen on the vessels. Several new progestogens have been synthesized in recent years. Dienogest, the progestogenic component of a new hormone replacement therapy with estradiol valerate, has many desirable features, including antiandrogenic properties; in this respect, it is unique amongst progestogens derived from testosterone. Tailored HRT should treat symptoms, minimize risk factors, meet personal preferences and lifestyle needs, and not be contraindicated for concomitant diseases. During the next decade, optimal HRT must match a number of trends, including an aging population, and is likely to be influenced by the outcome of major trials such as the Women's Health Initiative trial whose negative results will impact the prescriptions, the advent of new compounds--particularly the selective estrogen receptor modulators and progestogen receptor modulators--and the introduction of new methods of delivery, including vaginal rings and medicated intrauterine systems. | {
"pile_set_name": "PubMed Abstracts"
} |
Return to Babel.
End of life and beginning of life are surprisingly similar. What can we learn about the value and nature of our lives from dementia and aging? | {
"pile_set_name": "PubMed Abstracts"
} |
Practice nursing: an evaluation of a training practice initiative.
Globally, health care is moving towards a primary care approach. In the UK initiatives for nurses wishing to gain experience in primary and community care may be crucial with the advent of Primary Care Groups (PCGs) and Primary Care Trusts (PCTs). This paper outlines an initiative in practice nursing, developed as a pilot study by a Health Authority. The training practice initiative was aimed at nurses returning to practice and offered them an experiential and supportive career pathway into primary care. The evaluation (carried out over 1 year), highlighted that those primarily involved in the initiative--the trainees, educators and general practitioners--felt it had been successful, especially in relation to professional development issues. The funding bodies for the initiative, who previously had concerns over the recruitment and retention of practice nurses, were also optimistic that the support networks which developed as a result of the initiative had raised morale. The paper suggests several educational, organizational and professional issues which arose from the evaluation exercise. Further, it suggests how this initiative, in an extended form, could provide an effective basis for the training and development of nursing staff in PCGs/PCTs. | {
"pile_set_name": "PubMed Abstracts"
} |
Diagnostic construct validity of MMPI-2 Restructured Form (MMPI-2-RF) scale scores.
In the current investigation, the authors examined the diagnostic construct validity of the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) in a patient sample. All participants were diagnosed via the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I/P). The data set used in this study was composed of 544 patients--67 with bipolar disorder, 407 with major depressive disorder, and 70 with schizophrenia. Multivariate analyses revealed a pattern of mean scale differences among patient groups that was mostly consistent with the prominent features of each diagnostic group; logistic regression analyses identified a number of scales that were strong, unique predictors in the differentiation between pairs of diagnostic groups. The higher order scales (H-O)--the Emotional/Internalizing Dysfunction (EID) and Thought Dysfunction (THD) scales were most useful in differentiating between patient groups. For differentiating bipolar disorder patients from the other diagnostic groups, the Activation (ACT) Specific Problem scale was most useful. Although not all hypothesized scale differences emerged; overall, the pattern of results provides support for the diagnostic construct validity of the MMPI-2-RF scales. | {
"pile_set_name": "PubMed Abstracts"
} |
Impact of a brief intervention on the burnout levels of pediatric residents.
To estimate burnout prevalence among pediatric residents and to evaluate the impact of a brief intervention aimed at controlling burnout. A randomized controlled trial was conducted on 74 pediatric residents. The Maslach Burnout Inventory was administered to all subjects, and demographic information was gathered (age, gender, children, cohabitants, and residency year). The experimental group (n = 37) participated in self-care workshops over the course of 2 months, and the control group (n = 37) did not receive any intervention. After the intervention, the Maslach Burnout Inventory was administered again to all participants. All potential predictors of burnout were included in a logistic regression model. The efficacy of the intervention was evaluated by the chi-square test. P values < 0.05 were considered significant. The burnout prevalence among pediatric residents was 66%. After controlling for age, gender, children, and cohabitants, the prevalence of burnout was significantly higher among third-year residents (odds ratio = 11.8; 95% confidence interval 2.3-59.3; p = 0.003). There were no significant differences regarding burnout prevalence in the experimental group between the baseline and post-intervention periods (p = 0.8) or between the two groups after intervention (p = 0.8). The only difference observed was an improvement regarding "depersonalization" in the experimental group (p = 0.031). The burnout prevalence among pediatric residents was 66% and was higher among third-year residents. A brief intervention was not effective in reducing burnout prevalence, despite the achievement of an improvement in "depersonalization." | {
"pile_set_name": "PubMed Abstracts"
} |
Nuclear receptors: nomenclature, ligands, mechanisms of their effects on gene expression.
Nuclear receptors are DNA binding transcription factors possessing conservative domain organization. Their activity is regulated by lipophilic ligands, phosphorylation, and by interactions with other proteins. This review highlights the nomenclature of 1999 for human nuclear receptors and the ligand structure and domain organization of these receptors. The review also summarizes recent data on the structure of hormone response elements of specific genes, the structure-functional organization of receptor co-regulators (coactivators and corepressors). They mediate their effects on transcription via two main mechanisms: chromatin remodeling and the effect on the main transcriptional factors. Some attention is focused on specific features of signal transduction at negative hormone-response elements, regulation of receptor activity via phosphorylation, mechanisms of receptor cycle termination, and on physiological and biochemical properties of certain groups of receptors and processes that they regulate. | {
"pile_set_name": "PubMed Abstracts"
} |
Effective use of e-grading in the dental simulation clinic.
The purpose of this article is to describe the development and implementation of a grading software system, accessible from any platform, that engages today's generation of students and replaces paper grading. Set up at one U.S. dental school in an all-access, anytime (24/7) web-based program accessed through tablets, the software allows for a comparison between students' self-grading and instructor grading. This comparison facilitates student-faculty interaction, promoting discussion and student learning. The software can also be used for practical examination grading in which blinded grading between instructors is possible. The data gathered can produce descriptive reports students can draw upon to encourage self-learning and guided learning, propelling students to a better understanding of critical principles as they progress through multiple psychomotor skill sets. Other reports generated by the software allow for instructor calibration, exporting of grades directly into the university grading report system, and visual analysis of trends within each class. In a post-course survey, students (56 percent response rate) and faculty (79 percent response rate) agreed that the electronic grading was more efficient and allowed more time for faculty-student interaction than the previous grading system, thus creating an environment more conducive to learning. Overall, the software has improved students' perception of enhanced kinetic skills, while facilitating administration of preclinical projects and practical examinations. | {
"pile_set_name": "PubMed Abstracts"
} |
Immunohistochemical study on the distribution of nitrotyrosine and neuronal nitric oxide synthase in aged rat cerebellum.
In the present study, we examined age-related changes in 3-nitrotyrosine (NT) and neuronal nitric oxide synthase (nNOS) in rat cerebellum using immunohistochemistry. No immunoreactivity for NT was found in any layers of adult cerebellar cortex. In aged cerebellar cortex, the most prominent labeling of NT was found in the Purkinje cell layers and molecular layers. In aged cerebellar nuclei, NT immunoreactivity was observed in the surrounding neuropil. In aged rat cerebellum, nNOS immunoreactivity was significantly decreased in the molecular layer, while it was slightly increased in the granular layer. Image analysis showed no significant age-related changes in nNOS immunoreactivity in the cerebellar nuclei. In summary, this report has demonstrated that NT increases with age in the cerebellum, and suggests that NO production by the neuronal form of NOS may not be the rate limiting step in NT formation in the aged brain. Further work is needed to examine the mechanisms underlying the increased immunoreactivity for NT, and the functional implications of this increase. | {
"pile_set_name": "PubMed Abstracts"
} |
High-resolution computed tomography sampling for detection of asbestos-related lung disease.
We determined whether a limited number of high-resolution computed tomography (HRCT) scans will effectively screen for interstitial lung disease (ILD) in a population of individuals exposed to asbestos. We retrospectively reviewed the computed tomography studies of 49 patients exposed to asbestos. HRCT in the supine and prone positions had been performed at specifically preselected levels. Two teams of thoracic radiologists evaluated, on separate occasions: (1) all images, (2) prone images only, and (3) a single prone image through the lung bases for the presence of diffuse ILD. A relatively high level of accuracy was obtained with a single prone scan. However, improvement to 95% or better was found when additional prone images were used. A screening study for ILD, in this case patients exposed to asbestos, may be performed by preselected prone HRCT images only. The ease and decreased time of performing the procedure make screening relatively large patient groups for ILD more feasible. | {
"pile_set_name": "PubMed Abstracts"
} |
Calibrated near-forward volume scattering function obtained from the LISST particle sizer.
The physical nature of particles, such as size, shape, and composition govern their angular light scattering, which is described by the volume scattering function (VSF). Despite the fact that the VSF is one of the most important inherent optical properties, it has rarely been measured in aquatic environments since no commercial instrument exists to measure the full VSF in the field. The commonly used LISST (Laser In Situ Scattering and Transmissometry) particle sizer (Sequoia Scientific, http://www.sequoiasci.com) measures near-forward angular scattering of a laser source (lambda= 670 nm) at 32 logarithmically-spaced photodetectors arranged between 0.08 and 15 degrees and inverts the data to obtain particle size distribution (PSD). In order to calibrate the LISST to provide the near-forward VSF of unknown particle suspensions, we analyzed the scattering of light by polystyrene bead suspensions of known size distributions and composition, and empirically compared it with the results of Mie theory. This (1) allowed us to obtain a set of instrument specific scaling factors needed to retrieve the magnitude of the VSF and (2) provided validation that the shape of the VSF was appropriately obtained. | {
"pile_set_name": "PubMed Abstracts"
} |
Prolyl isomerase Pin1 acts as a switch to control the degree of substrate ubiquitylation.
Pin1, a conserved eukaryotic peptidyl-prolyl cis/trans isomerase, has important roles in cellular regulation. Because of its activity to switch the conformation of peptidyl-proline bonds in polypeptide chains, Pin1 operates as a binary switch, often in fate-determining pathways. Pin1 activity is usually controlled by substrate phosphorylation, but how Pin1 switches protein fates has been unclear. Here we show that Pin1 controls the degree of substrate ubiquitylation and thereby protein functions. We found that yeast Pin1 (Ess1) is essential for viability because it controls the NF-kappaB-related Spt23 transcription factor involved in unsaturated fatty-acid synthesis. High Pin1 activity results in low ubiquitylation of Spt23, which triggers Spt23 precursor processing and hence transcription factor activation. By contrast, decreased Pin1 activity leads to robust Spt23 polyubiquitylation and subsequent proteasomal degradation. Inhibition of Pin1 in mammalian cells changes the ubiquitylation status of the tumour suppressor protein p53 from oligoubiquitylation, which is known to trigger nuclear export, to polyubiquitylation, which causes nuclear p53 degradation. This suggests that the Pin1 activity is often translated into a fate-determining ubiquitylation switch, and that Pin1 may affect the degree of substrate ubiquitylation in other pathways as well. | {
"pile_set_name": "PubMed Abstracts"
} |
SOS Chromotest methodology for fundamental genetic research.
The present mini-review summarizes data in selected fields of basic genetics which were exclusively obtained in agreement with the principles of SOS Chromotest methodology and with Escherichia coli PQ37 sfiA::lacZ as a tester strain. | {
"pile_set_name": "PubMed Abstracts"
} |
Review of Clinical Applications of Fluorodeoxyglucose-PET/Computed Tomography in Pediatric Patients with Lymphoma.
[(18)F]fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) imaging is routinely used in the initial diagnosis and response assessment during and immediately after therapy, as well as in the follow-up surveillance. FDG PET/CT outperforms diagnostic CT and other conventional imaging modalities in the evaluation of pediatric patients with lymphoma, with higher sensitivity and specificity, leading to more accurate staging/restaging and modifications of therapeutic strategies. Resolution of FDG-avid lesions in the early post-therapy phase often indicates good response to treatment and better prognosis. FDG PET/CT also outperforms bone marrow biopsy in detecting bone marrow infiltration of lymphoma. | {
"pile_set_name": "PubMed Abstracts"
} |
Prediction of Objectively Measured Physical Activity and Self-Reported Disability Following Lumbar Fusion Surgery.
To investigate the predictive value of preoperative fear-avoidance factors (self-efficacy for exercise, pain catastrophizing, kinesiophobia, and depression), walking capacity, and traditional predictor variables for predicting postoperative changes in physical activity level and disability 6 months after lumbar fusion surgery in patients with chronic low back pain (LBP). We prospectively enrolled 118 patients scheduled for lumbar fusion surgery for motion-elicited chronic LBP with degenerative changes in 1-3 segments of the lumbar spine. Associations between the predictors and the dependent variables were investigated with multiple linear regression analysis. Dependent variables were physical activity level as objectively measured with a triaxial accelerometer and disability as measured with the Oswestry Disability Index. Preoperative physical activity level (β = -0.349; P < 0.001) and self-efficacy for exercise (β = 0.176; P = 0.021) were significant predictors of the postoperative change in physical activity. Preoperative disability (β = -0.790; P < 0.001), self-efficacy for exercise (β = 0.152; P = 0.024), and pain catastrophizing (β = 0.383; P = 0.033) were significant predictors for the change in the Oswestry Disability Index. Patients with low levels of preoperative physical activity were more likely to increase their level of physical activity after lumbar fusion surgery, especially when their self-efficacy for exercise was high. However, most of these patients still had low levels of physical activity after surgery, and they may therefore need extra support in increasing their postoperative physical activity levels. | {
"pile_set_name": "PubMed Abstracts"
} |
Nonradiative Plasmon Decay and Hot Carrier Dynamics: Effects of Phonons, Surfaces, and Geometry.
The behavior of metals across a broad frequency range from microwave to ultraviolet frequencies is of interest in plasmonics, nanophotonics, and metamaterials. Depending on the frequency, losses of collective excitations in metals can be predominantly classical resistive effects or Landau damping. In this context, we present first-principles calculations that capture all of the significant microscopic mechanisms underlying surface plasmon decay and predict the initial excited carrier distributions so generated. Specifically, we include ab initio predictions of phonon-assisted optical excitations in metals, which are critical to bridging the frequency range between resistive losses at low frequencies and direct interband transitions at high frequencies. In the commonly used plasmonic materials, gold, silver, copper, and aluminum, we find that resistive losses compete with phonon-assisted carrier generation below the interband threshold, but hot carrier generation via direct transitions dominates above threshold. Finally, we predict energy-dependent lifetimes and mean free paths of hot carriers, accounting for electron-electron and electron-phonon scattering, to provide insight toward transport of plasmonically generated carriers at the nanoscale. | {
"pile_set_name": "PubMed Abstracts"
} |
Clinical score for the outcome of external cephalic version: a two-phase prospective study.
To design a score based on clinical parameters to predict the outcome of external cephalic versions (ECVs) at term. A two-phase study was conducted (analysis/design and prospective validation) regarding 1000 versions performed between March 2002 and November 2010. The variables considered in the score were selected based on the results of multiple logistic regression models and multiple correspondence analyses published by our group. The predictive capacity was estimated through the area under the ROC curve. The success rates for ECV in phases 1 and 2 were 52.2 and 51.2%, respectively, making the overall success rate 51.7%. The score was designed with the variables parity, placental location, breech variety and amount of amniotic fluid giving a value for each one. A clinical recommendation, based on the result of the score, was the estimated success rate with the 95% confidence interval. The predictive capacity of the score for the outcome of ECV at term was 70.1% (95% CI 66.9-73.4). A score composed of four easily measurable variables enabled us to predict the outcome of ECV at term. | {
"pile_set_name": "PubMed Abstracts"
} |
Risk factors affecting outcome of unrelated cord blood transplantation for children with familial haemophagocytic lymphohistiocytosis.
Allogeneic haematopoietic stem cell transplantation is still the only available curative option for Familial Haemophagocytic Lymphohistiocytosis (FHLH). Most studies report outcomes after bone marrow or peripheral blood stem cell transplantation. We analysed the outcomes of 118 children with FHLH undergoing single-unit umbilical cord blood transplantation performed from 1996 to 2014. Myeloablative conditioning regimen was given to 90% of the patients, and was mostly busulfan-based (n = 81, 76%), including anti-thymocyte globulin or alemtuzumab (n = 102, 86%). The cumulative incidence of Day 60 neutrophil engraftment was 85%; and that of non-relapse mortality and acute graft-versus-host disease (GvHD) was 21% and 33% at 100 days, respectively. The 6-year cumulative incidence of chronic GvHD was 17% and the 6-year probability of overall survival was 55%. In multivariate analysis, children receiving a graft with a total nucleated cell dose greater than 9·9 × 107 /kg had a better overall survival (hazard ratio [HR]: 0·49, 95% CI: 0·27-0·88, P = 0·02). Degree of human leucocyte antigen (HLA) matching was associated with improved disease-free survival (5/6 vs. 6/6 HR: 2·11, 95% confidence interval [CI]: 1·01-4·4, P = 0·05 and ≤4/6 vs. 6/6, HR: 2·82, CI: 1·27-6·23, P = 0·01). Umbilical cord blood transplantation with a high cell dose and good HLA match is a suitable alternative option to haematopoietic stem cell transplantation in children with FHLH who lack a HLA-matched donor. | {
"pile_set_name": "PubMed Abstracts"
} |
Impact of High-Fidelity Simulation and Pharmacist-Specific Didactic Lectures in Addition to ACLS Provider Certification on Pharmacy Resident ACLS Performance.
This pilot study explored the use of multidisciplinary high-fidelity simulation and additional pharmacist-focused training methods in training postgraduate year 1 (PGY1) pharmacy residents to provide Advanced Cardiovascular Life Support (ACLS) care. Pharmacy resident confidence and comfort level were assessed after completing these training requirements. The ACLS training requirements for pharmacy residents were revised to include didactic instruction on ACLS pharmacology and rhythm recognition and participation in multidisciplinary high-fidelity simulation ACLS experiences in addition to ACLS provider certification. Surveys were administered to participating residents to assess the impact of this additional education on resident confidence and comfort level in cardiopulmonary arrest situations. The new ACLS didactic and simulation training requirements resulted in increased resident confidence and comfort level in all assessed functions. Residents felt more confident in all areas except providing recommendations for dosing and administration of medications and rhythm recognition after completing the simulation scenarios than with ACLS certification training and the didactic components alone. All residents felt the addition of lectures and simulation experiences better prepared them to function as a pharmacist in the ACLS team. Additional ACLS training requirements for pharmacy residents increased overall awareness of pharmacist roles and responsibilities and greatly improved resident confidence and comfort level in performing most essential pharmacist functions during ACLS situations. | {
"pile_set_name": "PubMed Abstracts"
} |
[Bilateral obstructive diseases of the upper urinary tract in children].
The authors examined 371 children aged 4 days to 15 years with obstructive diseases of the urinary tract. In 51 out of them there was bilateral hydronephrosis and 54 had bilateral obstructive megaureter. A new uretero-pelvic anastomosis was made in 47 children with bilateral hydronephrosis, in 31 out of them it was created successively. Resection of the pelvis was performed in 5 cases. Principles of the stepwise operative treatment are described as well as indications to a plasty without drainage in hydronephrosis. Operations were performed on 46 patients (92 ureters) with obstructive megaureter, 8 patients were treated conservatively. The conservative treatment is thought by the authors to be expedient in patients with compensated disturbance of urodynamics of the upper urinary tracts in obstructive megaureter and the every year rentgen-urodynamic control. Ureterocystoneostomy is indicated only in a progressing course of the disease. | {
"pile_set_name": "PubMed Abstracts"
} |
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