Total potassium was assayed in 150 normal weight and obese females (cervical carcinoma-52, endometrial carcinoma-25 and breast cancer-73) by measurements of 40K spontaneous radiation in a low-background chamber. Control group included 30 healthy and 25 obese females. Computations of body cell and extracellular mass and fat were carried out on the basis of the said measurements. Extracellular fluid volume was measured in 38 patients by X-ray fluorescence method using sodium bromide. The results pointed to a body cell mass deficit matched by increased extracellular mass due to a higher fat level in patients with breast, endometrial and cervical carcinoma. The said correlation was particularly pronounced in obesepatients. The beneficial effect of treatment was more often observed in patients with normal body weight. ...
Exercise promotes weight loss and improves insulin sensitivity. However, the molecular mechanisms mediating its beneficial effects are not fully understood. Obesitycorrelates with increased production...Full Text Available
No research has compared expressions of weight bias across different subgroups of obese individuals. This study compared attitudes toward and beliefs about obesity in women with and without binge eating disorder (BED) and examined whether these attitudes are related to psychological factors. Fifty obese women with BED were compared with an age- and body mass index (BMI)-matched group of 50 obese women without BED on a battery of established measures of anti-fat attitudes and beliefs about weight controllability and psychological factors (self-esteem, depression, and eating disorder features). The ageand BMI-matched groups did not differ with respect to beliefs about obesity or attitudes toward obese persons, or in self-esteem or depression. Correlational analyses conducted separately within each group revealed that women with BED who ...
Objective: To study the changes of serum leptin, insulin and adiponectin levels and their relationship with BMI in females with simple obesity. Methods: Serum leptin, adiponectin and insulin levels were measured with RIA in 48 pre-obese females (BMI=23-24.9 kg/m"2), 40 females with simple obesity, (BMI#>=#25 kg/m"2) and 42 female controls (BMI 18-22.9 kg/m"2). Correlations among these variables were studied. Results: Serum leptin, insulin levels were significantly higher and serum adiponectin levels were significantly lower in both the pre-obese and obese females than those in controls. Serum leptin, insulin levels were positively correlated to BMI; Serum adiponectin levels were negatively correlated to BMI. Conclusion: Within normal range of BMI, the leptin-insulin feedback mechanism provided satisfactory ...
BACKGROUNDLifestyle modifications are successfully employed to treat obese and overweight women with polycystic ovary syndrome (PCOS). The aims of the current pilot study were (i) to compare the efficacy on reproductive functions of a structured exercise training (SET) programme with a diet programme in obese PCOS patients and (ii) to study their clinical, hormonal and metabolic effects to elucidate potentially different mechanisms of action.METHODSForty obese PCOS patients with anovulatory infertility underwent a SET programme (SET group, n = 20) and a hypocaloric hyperproteic diet (diet group, n = 20). Clinical, hormonal and metabolic data were assessed at baseline, and at 12- and 24-week follow-ups. Primary endpoint was cumulative pregnancy rate.RESULTSThe two groups had similar demogra...
BackgroundHealthcare professionals can play a crucial role in optimizing the health status of patients with cardiovascular risk factors (abdominal obesity, high blood pressure, low...Full Text Available
Roux-en-Y gastric bypass surgery (RYGB) remains to be the most effective long-term treatment for obesity and its associated comorbidities, but the specific mechanisms involved remain elusive. Because RYGB patients appear to no longer be preoccupied with thoughts about food and are satisfied with much smaller meals and calorically dilute foods, brain reward mechanisms could be involved. Just as obesity can produce maladaptive alterations in reward functions, reversal of obesity by RYGB could normalize these changes or even further reset the food reward system through changes in gut hormone secretion, aversive conditioning and/or secondary effects of weight loss. Future studies with longitudinal assessments of reward behaviors and their underlying neural circuits before and after surgery wil...
Vitamin D deficiency is a well-known comorbidity of obesity that can be exacerbated after bariatric surgery and can predispose the patient for hypocalcemia. Vitamin D and calcium doses to prevent and...Full Text Available
Objectives: Evaluate the effect of diet, physical exercise, and a daily oral intake of a soy isoflavones extract (Fisiogen) contained 200mg of Glycine max, which corresponded to 80mg of isoflavone (60.8mg of genistein, 16mg of daidzein and 3.2mg of glicitein) on leptin and other adipokines plasma levels in healthy obese postmenopausal women. Methods: A multicentric randomized longitudinal prospective cohort study was conducted in a sample of 87 healthy obese postmenopausal women. Patients were randomly assigned to a 1200kcal diet and exercise group (control group) or a group of 1200kcal diet, exercise, and daily oral intake of daily oral intake of a soy isoflavones extract (Fisiogen) contained 200mg of Glycine max, which corresponded to 80mg of isoflavone (60.8mg of genistein, 16mg of daid...
In recent years, Obesity (defined as Body Mass Index > 30 kg/m2) has increased its prevalence reaching epidemic levels in countries such as The United States where it has became a national health issue. In Colombia the Obesity prevalence is figured around 14%. Treatment options for Obesity include life style modifications, pharmacologist management and surgical approach (Bariatric Surgery). This article describes a patient with previous bariatric surgery, who presents abdominal pain and melena owed to isquemic process of the alimentary limb caused by an internal hernia which is a potentially lethal condition if it is not highly suspected allowing its early diagnosis and treatment
Computed Tomography (CT) and, more recently, ultrasound (US), have proved excellent tools for quantifying adipose tissue distribution. Body fat distribution is an important factor in the treatment of obesity and its complications. In this work it is investigated the correlation between CT and US measurements in pediatric obesity. Forty obese children and adolescents aged 4.1-14.8 years were submitted to CT and US. Intra-abdominal, subcutaneous and total body fat were calculated (in cm{sup 2}), with the CT image analysis software. The rectus muscle-spine and rectus muscle-aorta distances, as indicative of visceral fat thickness, were measured on US images with(out) compression. The distance between skin fat and fat-rectus muscle interfaces was measured as subcutaneous fat thickness. US-CT findings have been compared with other morphometric variables-i.e., patient's (ideal) ...
Increased oxidative stress is a known cause of cardiac dysfunction in animals and patients with diabetes, but the sources of reactive oxygen species [e.g., superoxide anion (O2−)]...Full Text Available
Abstract Background: Obstructive sleep apnea (OSA), a highly prevalent condition, is independently associated with increased risks of developing type 2 diabetes mellitus (T2D) and metabolic syndrome. It is unclear, however, if the severity of OSA has any impact on glycemic control among patients with T2D. We therefore aimed to determine the independent association between OSA severity and glycosylated hemoglobin (HbA1c) in patients with T2D. Methods: This was an observational cross-sectional study of 52 consecutive patients attending the diabetes obesity clinic between January 2008 to February 2010 with risk factors for sleep apnea and who underwent polysomnography study. Clinical, demographic, and lifestyle data were recorded using a questionnaire. Results: Prevalence of OSA in this clini...
Background This report describes the authors? experience with a unique endoluminal, endoscopically delivered and retrieved gastroduodenojejunal bypass sleeve, including short-term weight loss and changes in comorbidities. Methods A prospective, single-center trial was designed. The patients were morbidly obese individuals who met the National Institutes of Health criteria for bariatric surgery. The device used was a unique gastroduodenojejunal bypass sleeve secured at the esophagogastric junction with endoscopic and laparoscopic techniques and designed to create an endoluminal gastroduodenojejunal bypass. At completion of the trial, the device was explanted with endoscopic retrieval. The primary end points were safety and incidence of adverse events. The secondary outcomes included the per...
Background & objectives: Fatigue is a debilitating symptom experienced by patients undergoing dialysis, but there is only limited information on its prevalence and its association with patient...Full Text Available
Objective: To study the correlation of the bone mineral density (BMD) and the body composition components of body mass index (BMI), FAT and LEAN in Chinese obesity. Methods: There were 150 cases in obesity group diagnosed by BMI, including 75 males [ median age 46 years, mean weight (89.64 #+-# 8.33) kg] and 75 females [median age 45 years, mean weight (77.23 #+-# 6.85) kg]. There were 150 persons with normal BMI in the control group, including 75 males [(median age 47 years, mean weight (62.34 #+-# 5.72) kg] and 75 females [ median age 45 years, mean weight (50.16 #+-# 5.06) kg]. The body height and weight of 300 persons in two groups were measured respectively and ,simultaneously calculated the BMI. These data and the body composition parameters measured by the dual energy X-ray absorptiometry (DEXA) in these two groups were compared and analyzed. The data obtained used two-sample t-test analysis, bi-variable ...
The prevalence of obesity among children, adolescents and adults has been dramatically increasing worldwide during the last several decades. The obesity epidemic has been recognized as one of...Full Text Available
Background:Childhood obesity is increasingly being observed with changing lifestyles of families. The magnitude of overweight ranges from 9% to 27.5% and obesity ranges...Full Text Available
To determine the mechanism of the cardiac dilatation and reduced contractility of obese Zucker Diabetic Fatty rats, myocardial triacylglycerol (TG) was assayed chemically and morphologically. TG was...Full Text Available
BackgroundThe increasing prevalence of obesity in young women is a major public health concern. Few data are available concerning the epidemiology of malnutrition especially obesity...Full Text Available
Uncoupling protein 2 (UCP2) maps to a region on distal mouse chromosome 7 that has been linked to the phenotypes of obesity and type II diabetes. We recently reported that UCP2 expression is increased...Full Text Available
Adipocyte death has been reported in both obese humans and rodents. However, its role in metabolic disorders, including insulin resistance, hepatic steatosis, and inflammation associated with obesity...Full Text Available
Obesity is characterized by the abnormal or excessive deposition of fat in the adipose tissue. Its consequences go far beyond adverse metabolic effects on health, causing an increase in oxidative stress,...Full Text Available
Communication problems have been implicated in many safety and quality issues, but tools to examine communication networks and their impact on patient outcomes are only beginning to become available....Full Text Available
Aims:To investigate the relationship between the duration of comatose state, severity of rhabdomyolysis and frequency of peripheral nerve injury (PNI) in patients following...Full Text Available
Anxiety may cause adverse outcomes through physiologic pathways in patients with cardiac disease. The purpose of this dissertation was to investigate anxiety and its correlates in persons with acute myocardial infarction (AMI) and heart failure (HF). The ...
Obesity is associated with increased susceptibility to dyslipidemia, insulin resistance, and hypertension, a combination of traits that comprise the traditional definition of the metabolic syndrome. Recent evidence suggests that obesity is also associated with the development of nonalcoholic fatty liver disease (NAFLD). Despite the high prevalence of obesity and its related conditions, their etiologies and pathophysiology remains unknown. Both genetic and environmental factors contribute to the development of obesity and NAFLD. Previous genetic analysis of high-fat, diet-induced obesity in C57BL/6J (B6) and A/J male mice using a panel of B6-ChrA/J/NaJ chromosome substitution strains (CSSs) demonstrated that 17 CSSs conferred resistance to high-fat, diet-induced obesity. One of these CSS st...
Objective Comorbidities predisposing cardiac surgical patients toward deep sternal wound infection, such as diabetes and obesity, are rising in the United States. Longitudinal analysis of risk factors, morbidity, and mortality was performed to assessed effects of these health trends on deep sternal wound infection rates. Methods In this retrospective analysis of all median sternotomies performed at a single institution from 1991 through 2006, demographic and surgical characteristics were identified from a prospective database. The cohort was separated into periods from 1992 through 2001 and 2002 through 2006 to identify longitudinal trends in risk factors for deep sternal wound infection. Univariate and matched multivariable analyses were performed. Results Overall, study population had in...
Menopause is characterized by the progressive reduction of estrogens resulting to cessation of menses. It is associated with an increase of cardiovascular risk factors such as hyperglycemia, hypertension, dyslipidemia and of abdominal and/or selective visceral fat mass deposition. Obesity, a modern day epidemic, is promoted by an obesogenic environment that interacts with the genetic background. The result is a positive energy balance materialized by the accumulation of the adipose tissue. This process is marked by great individual variation. Obesity is also associated with the presence of cardiovascular risk factors. In this review, the main pathophysiologic processes for the increase of obesity in menopause and the possible effects of pre-menopausal obesity regarding the cessation of ova...
Background: In order to reconceptualize somatoform disorders (SFDs), the psychological characteristics of SFD patients are increasingly investigated. The cognitive style of magical thinking (MT) has not been studied so far in patients with SFDs. Sampling and Methods: In a cross-sectional study, 201 allergy workup patients were interviewed using the Structured Clinical Interview for DSM-IV; they answered a set of self-report questionnaires including the Schizotypal Personality Questionnaire subscale for MT and the Patient Health Questionnaire (PHQ). The expression of MT was explored in 61 patients with SFDs compared to 140 patients without SFDs. Results: Patients with SFDs reached higher scores of MT, also when controlled for gender, depression, and anxiety. In particular, they stated more frequently that they were believers in telepathy (64 ...
Intraspinal synovial cysts were diagnosed in six patients during a 5-year period and retrospectively studied. Plain films of the lumbar spine showed degenerative changes in all patients. Lumbar myelography showed a posterior and lateral defect caused by extradural compression. Using CT without contrast enhancement established the diagnosis in five of the six patients. In four cases MRI was performed, three before and after injection of gadolinium diethyline-triamine penta-acetic acid (Gd-DTPA). Including the patient with a false-negative CT, MRI was positive in all patients. (orig.)
A destructive spondyloarthropathy is reported in four patients undergoing maintenance hemodialysis for chronic renal disease. In a separate investigation a controlled, prospective radiographic study of the cervical spine revealed this spondyloarthropathy in 4 (15%) of 26 long-term dialysis patients. A single disk level was involved in three patients, and two disc levels were involved in one patient. This spondyloarthropathy correlated with the duration of dialysis but not with the radiographic evidence of renal osteodystrophy or severity of laboratory abnormalities associated with hyperparathyroidism. Three of these four patients also had discovertebral erosions or destruction involving the lumbar spine. Cervical spine flexion views revealed evidence of ligamentous laxity or instability in three (12%) dialysis patients, all with vertebral ...
In a "nutrition transition", the consumption of foods high in fats and sweeteners is increasing throughout the developing world. The transition, implicated in the rapid rise of obesity and diet-related...Full Text Available
Serum protein and lipid concentrations as well as the serum protein binding of propranolol, diazepam and phenytoin were measured in normal weight and obese volunteers. Concentrations of alpha 1-acid...Full Text Available
The current obesity pandemic is expected to result in considerable downstream morbidity, mortality and incremental costs to health care systems around the world. The major metabolic complications of...Full Text Available
ObjectiveTo investigate the effect of maternal obesity on mode of delivery following induction of labour (IOL) for prolonged pregnancy and subsequent intrapartum and neonatal complications.DesignRetrospective...Full Text Available
Obesity and metabolic syndrome result from excess calorie intake and genetic predisposition and are mechanistically linked to type II diabetes and accelerated body aging; abnormal nutrient and insulin...Full Text Available
The influence of obesity on the metabolism of apolipoprotein B (apo B) in very low density lipoprotein (VLDL), intermediate density lipoprotein (IDL), and low density lipoprotein (LDL) was investigated...Full Text Available
Understanding the pathogenesis of obesity is now more important than ever, given the remarkable world-wide epidemic. This paper explores the potential role of core temperature in energy balance, and...Full Text Available
BackgroundAdipose tissue lipid storage and processing capacity can be a key factor for obesity-related metabolic disorders such as insulin resistance and diabetes. Lipid uptake is...Full Text Available
Acquired resistance to the action of insulin to stimulate glucose transport in skeletal muscle is associated with obesity and promotes the development of type 2 diabetes. In skeletal muscle,...Full Text Available
BackgroundObesity is one of the principal causative factors involved in the development of metabolic syndrome. AMP-activated protein kinase (AMPK) is an energy sensor that regulates...Full Text Available
Radioimmunochemical assay was used to study the hypophyseal and peripheral hormones activity in 60 patients with chronic alcoholism, stage II. A correlation has been established between the patient's age and prolactin and FSH concentrations, as well as between the duration of the recent hard drinking and the concentrations of prolactin, testosterone, FSH and interstitial cell stimulating hormone. It has been shown that the manifestation of the alcoholic abstinent syndrome depended on the prolactin concentration. The test sensitivity estimated by the prolactin level rise and the testosterone level reduction reached 92.3%. The specificity of the changes detected comprised 25%. A conclusion has been made that the disorders noted in the patients with chronic alcoholic intoxication can be used as an objective test in the alcoholism diagnosis. PMID:3936321
Contrast agent-enhanced CT scans in nine male patients with histologically proved benign lymphoepithelial lesions of the perotid gland were reviewed. All scans showed cystic-appearing masses with peripheral rim enhancement corresponding to the macroscopic appearance of the lesion. Five patients were seropositive for human immunodeficiency virus (HIV) infection or had infections seen in acquired immunodeficiency syndrome. Three patients were members of high-risk groups. Only one patient had symptoms of the SICCA syndrome. Once a rare cause of parotid gland enlargement, benign lymphoepithelial lesions have recently been seen with increasing frequency in patients with HIV infection. Although the CT appearance is not pathognomic, correlation results of aspiration cytology and with clinical history can lead to a preoperative diagnosis of a benign lymphoepithelial ...
Post amputation pain can be debilitating for patients and families. Chronic pain is a common phenomenon after lower extremity amputation, occurring in up to 80% of this population. The purpose of this...Full Text Available
BackgroundAtrial fibrillation (AF) is the most common cardiac arrhythmia with a population prevalence of about 1%. Natriuretic peptide level is elevated in patients with AF with...Full Text Available
Objectives:There is no study about correlation between vitamin D serum level and multiple sclerosis (MS) in Iran. So in this survey, we investigated the serum level of 25-hydroxy...Full Text Available
The growing epidemic of juvenile obesity has prompted pediatricians to investigate obesity-related conditions in obese teenagers. We report a clinical case of severe hepatic fibrosis in an adolescent with severe and recent obesity. Because of elevated serum aminotransferase levels, abnormal hepatic ultrasonography and insulin resistance (impaired glucose tolerance), we suspected nonalcoholic steatohepatitis (NASH). Disease activity and fibrosis were confirmed on liver biopsy. Considering the risk of progression toward cirrhosis and its complications, and the pathological liver lesions, we started long-term medical monitoring and drug therapy to control weight loss. At present, although biopsy is the only validated way to establish the diagnosis of NASH, there is no consensus on its indicat...
Male infertility, characterized by hypogonadism, decreased semen quality or ejaculatory dysfunction, accounts for approximately 20% of infertility cases. Obesity and metabolic dysfunction have been identified, among other causal factors, to contribute to male infertility. In the context of the Western world's `obesity epidemic', this article discusses three main biological mechanisms linking obesity to impaired male reproductive function: hypogonadism, testicular heat stress/hypoxia-induced apoptosis and endocrine disruption by `obesogens'. Among these, obesity-induced hypogonadism is undoubtedly the most clinically significant and is easily assessed. Rapidly expanding areas of research in this area include leptin modulation of kisspeptins and hypothalamic-pituitary-testicular hormone path...
Abstract This study examines the relationship between emotional/behavioral difficulties and obesity among US adolescents aged 12-17 using parent-reported data for 11,042 adolescents in the National Health Interview Survey. Obesity was defined as body mass index (BMI) ?sex/age-specific 95th percentile BMI cut-points from the 2000 CDC Growth Charts. Types of emotional/behavioral difficulties were identified using the Strengths and Difficulties Questionnaire. Among females, emotional/behavioral difficulties were associated with obesity among non-Hispanic (NH) white and Hispanic adolescents (both those with interviews in English and interviews in Spanish). Among males, emotional/behavioral difficulties were associated with obesity among NH white adolescents and Hispanic males with interview...
Objective: To assess dynamic MRI with Gd-DTPA enhancement for evaluating inflammatory changes in the subacromial bursa. Design and patients: We detected the signal intensity changes in dynamic MRI of the subacromial bursa, and confirmed these macroscopically by arthroscopy and histologically. The signal intensity was measured using built-in software, and the enhancement ratio (E ratio) was calculated from dynamic MR images. In addition, as a parameter of the rate of the increase in the signal intensity from 0 to 80 s, the mean increase per second in the E ratio was obtained as the coefficient of enhancement (CE). The correlation was studied of the E ratio and CE with the arthroscopic findings (redness, villous formation, thickening and adhesion), and of the E ratio and CE with the histological findings (capillary proliferation, papillary hyperplasia, fibrosis and inflammatory cell infiltration) of the subacromial bursa. Of ...
Bone radiotracer uptake in renal osteodystrophy was investigated in 35 dialysis patients by correlating the results of quantitative bone scintigraphy with those of biochemical and bone morphometric studies. There were highly significant correlations (P < 0.001) between the total skeletal activity and the biochemical (iPTH and alkaline phosphatase), and histologic parameters of hyperparathyroidism. These clinical results strongly suggest that increased bone turnover i.e. hyperparathyroidism, rather than osteomalacia is the major cause of increased skeletal uptake in renal osteodystrophy.
When total mesorectal excision (TME) is accurately performed, dysfunction, theoretically, does not occur. However, there are differences among individuals in the running patterns and the volumes of nerve fibers, and if obesity or a narrow pelvis is present, nerve identification is difficult. Currently, the rate of urinary dysfunction after rectal surgery ranges from 33% to 70%. Many factors other than nerve preservation play a role in minor incontinence. Male sexual function shows impotence rates ranging from 20% to 46%, while 20%-60% of potent patients are unable to ejaculate. In women, information on sexual function is not easily obtained, and there are more unknown aspects than in men. As urinary, sexual, and defecation dysfunction due to adjuvant radiotherapy have been reported to occur at a high frequency, the creation of a protocol that enables analysis of long-term functional outcome will be essential for future clinical trials. In the ...
MRI (Magnetic resonance imaging) has been widely used in the diagnosis of primary carpal tunnel syndrome (CTS). However, it has had limited clinical application in diagnosing persistent or recurrent CTS. We aimed to investigate the efficacy of this imaging modality in patients who had previously undergone open carpal tunnel release without relief of symptoms, and assess the correlation of MRI with intra-operative findings upon re-exploration. MRI studies were performed on 17 wrists (16 patients) presenting with recurrent/persistent symptoms and signs of CTS in whom repeat nerve conduction studies were also performed. Surgical re-exploration was undertaken on 16 wrists in which a 100% correlation was noted between MRI and intra-operative findings of an incompletely released or re-grown tran...
The purpose of this study was to assess the efficacy of MRM in providing preoperative locoregional information on patients with breast cancer. MRI was performed on 62 female breast cancer patients. A 1.5 T MR-system was used to acquire fat-suppressed T{sub 1}WI, T{sub 2}WI and dynamic-contrast-enhanced images with an SPGR pulse sequence. The extent of the cancer measured with MRM was confirmed histologically in all patients. The size obtained from MRM correlated well with the size obtained histologically, including intraductal spread of cancer (R: 0.853). As for shape, the round/oval type evident from MRM correlated more accurately (R: 0.934) than the ill-defined type associated with a linear and/or clumped enhanced area (R:0.744). The difference between the size obtained from MRM and the size obtained histologically, including IDS, was less than 15 mm in the majority of ...
L-[3-"1"8F]-#alpha#-methyltyrosine ("1"8F-FMT) is an amino-acid tracer for positron-emission tomography (PET). We have conducted a clinicopathologic study to elucidate the correlation of angiogenesis with "1"8F-FMT and 2-["1"8F]-fluoro-2-deoxy-D-glucose ("1"8F-FDG) uptake in patients with non-small cell lung cancer (NSCLC). Thirty-seven NSCLC patients were enrolled in this study, and two PET studies with "1"8F-FMT and "1"8F-FDG were performed. Uptake of PET tracers was evaluated with standardized uptake value. Vascular endothelial growth factor (VEGF), CD31, CD34, L-type amino acid transporter 1 (LAT1) and Ki-67 labeling index of the resected tumors were analyzed by immunohistochemical staining, and correlated with the clinicopathologic variables and the uptake of PET tracers. The median VEGF rate was 45% (range, 10-78%). High expression was seen in 30 patients (81%, 30/37). VEGF ...
Bone scintigraphy was performed in 16 men with newly diagnosed prostatic carcinoma before orchiectomy as well as 2 weeks and 2 months after operation. The uptake in the lower thoracic and lumbar vertebrae was registered up to 240 min after injection of /sup 99m/Tc-MDP and was then calculated for each patient and vertebra. The relative standard deviation in measured uptake due to measuring technique was estimated to be +-7%. In eight patients, who had normal bone scintigraphies before orchiectomy, there were no changes in the uptake values after operation. The remaining eight patients had widespread metastatic involvement prior to treatment, six of these patients showed a so-called 'flare phenomenon' in the abnormal vertebrae which means an initial increase in uptake after operation followed by a decreased uptake in response to therapy. One patient had a ...
Bone scintigraphy was performed in 16 men with newly diagnosed prostatic carcinoma before orchiectomy as well as 2 weeks and 2 months after operation. The uptake in the lower thoracic and lumbar vertebrae was registered up to 240 min after injection of "9"9"mTc-MDP and was then calculated for each patient and vertebra. The relative standard deviation in measured uptake due to measuring technique was estimated to be #+-#7%. In eight patients, who had normal bone scintigraphies before orchiectomy, there were no changes in the uptake values after operation. The remaining eight patients had widespread metastatic involvement prior to treatment, six of these patients showed a so-called 'flare phenomenon' in the abnormal vertebrae which means an initial increase in uptake after operation followed by a decreased uptake in response to therapy. One patient had a continuously increased uptake ...
The central nervous system (CNS), generally accepted to regulate energy homeostasis, has been implicated in the metabolic perturbations that either cause or are associated with obesity. Normally, the CNS receives hormonal, metabolic, and neuronal input to assure adequate energy levels and maintain stable energy homeostasis. Recent evidence also supports that the CNS uses these same inputs to regulate glucose homeostasis and this aspect of CNS regulation also becomes impaired in the face of dietary-induced obesity. This review focuses on the literature surrounding hypothalamic regulation of energy and glucose homeostasis and discusses how dysregulation of this system may contribute to obesity and T2DM.
Cerebral blood flow (CBF) was measured by the "1"3"3Xe inhalation method in patients with multi-infarct dementia (MID, N = 26), Alzheimer's dementia (AD, N = 19), and among age-matched, neurologically normal, healthy volunteers (N = 26). Cognitive performance was assessed in all subjects using the Cognitive Capacity Screening Examination (CCSE). Cerebral vasomotor responses were calculated from differences in values of mean hemispheric gray matter blood flow (Delta CBF) measured during inhalation of 100% oxygen (hyperoxia) compared with CBF measured while breathing room air. Significant correlations were found between CCSE performance and vasomotor responsiveness in patients with MID (P less than .01), but not in patients with AD or in neurologically normal volunteers. Loss of vasomotor responsiveness is an indicator of cerebrovascular disease with rigidity and/or loss of reactivity of cerebral vessels, ...
The relative sensitivity and combined value of myocardial technetium-99m stannous pyrophosphate imaging and determinations of serum MB creatine phosphokinase (the ''myocardial'' CPK isoenzyme) in detecting acute myocardial infarction were evaluated in 41 patients with suspected infarction and 23 patients recovering from cardiac surgery. In the patients with suspected infarction, myocardial infarction was confirmed in 25 and was consistently associated with increased serum MB CPK. Abnormal radionuclide images were obtained in 23 of 25 patients (92%)) with definite myocardial infarction and in 2 of 16 patients without confirmed infarction. Although the localization of infarction by imaging correlated well with the localization by electrocardiogram, infarct size estimated by imaging did not correlate well with estimates based on peak total ...
Bariatric surgical procedures have become important therapeutic options for treatment of morbid obesity in both adults and adolescents co-morbidities of obesity such as glucose intolerance, type 2 diabetes (T2DM), metabolic syndrome, steatohepatitis, hyperlipidemia and cardiovascular disease. These co-morbidities of obesity have significant impacts on the overall quality of life of the individual and our society at large. Roux-en-Y gastric bypass (RYGB) and the relatively newer procedures of gastric banding (GB) and vertical sleeve gastrectomy (VSG) have proven to be efficacious in achieving rapid weight loss and reversing the comorbidities of obesity. Unfortunately, bariatric procedures are not without risks including micronutrient deficiency, failure to maintain lost weight, and mortalit...
... for a stapling or division of tissue the creation of a small gastric pouch which then assists ... follow up. Laparoscopic gastric bypass entails the surgical creation of a small gastric pouch, typically about an ...
All treatments for obesity, including dietary restriction of carbohydrates, have a goal of reducing the storage of fat in adipocytes. The chief enzyme responsible for the mobilization of FFA from adipose...Full Text Available
Adipose tissue plays an essential role in energy homeostasis as a metabolic and endocrine organ. Accordingly, adipocytes are emerging as a major drug target for obesity and obesity-mediated metabolic syndrome. Dysfunction of enlarged adipocytes in obesity is involved in obesity-mediated metabolic syndrome. Adipocytokines, such as adiponectin released from small adipocytes, are able to prevent these disorders. In this study, we found that honokiol, an ingredient of Magnolia officinalis used in traditional Chinese and Japanese medicines, enhanced adipocyte differentiation in 3T3-L1 preadipocytes. Oil Red O staining showed that treatment with honokiol in the presence of insulin dose-dependently increased lipid accumulation in 3T3-L1 preadipoyctes although its activity was weak compared with r...
diet and genetic obesity metabolic defects and inflammation. To determine the role of adipocyte death in promoting adipose tissue inflammation and insulin resistance in animal...
RationaleProcedures for studying the effects of medications on satiation will assist the development of obesity medications.ObjectivesFull Text Available
A sensitive radio-assay for ferritin was developed and used to examine serum ferritin levels in 105 patients with recurrent oral ulceration (ROU), 41 patients with Behcet's syndrome (BS), 42 with other ulcerative oral lesions, 35 patients with non-ulcerative oral lesions and in 78 controls. Ferritin levels increased with age and were significantly higher in males than females. The mean ferritin concentrations in male patients with ROU, BS or with other oral ulcers were significantly reduced in comparison with controls, and in female patients were significantly reduced in those with major aphthous ulcers. The prevalence of low serum ferritin levels was about 8% in patients with ROU, 15% in BS and 9.5% in patients with other ulcerative oral lesions, compared with less than 3% in patients with non-ulcerative oral ...
Purpose: Efficacy and safety of the own single-center experience with moderately dosed radiosurgery (SRS) for limited (one to four) brain metastases were analyzed and correlated with patient- and treatment-related variables. Patients and Methods: Between 05/1998 and 10/2006, 93 patients received SRS for a total of 142 brain metastases. The median number of brain metastases treated per patient was one (range, one to four). 46 patients (49%) received initial SRS alone, 13 patients (14%) SRS with up-front whole-brain radiotherapy (WBRT), and 34 patients (37%) SRS for recurrent metastases after WBRT. Median dose was 16 Gy (range, 10-20 Gy). Results: Median overall survival (OS) was 7.5 months. The actuarial 6- and 12-month data for OS were 60% and 35%, for local brain control (LBC) 87% and 79%, and for distant brain control ...
Renal osteodystrophy is a metabolic bone disease and a common complication of end-stage chronic renal failure and maintenance dialysis treatment. In this study, we examined the correlation between quantifying bone scintigraphy and serum biochemical markers in hemodialysis patients. Bone scintigraphy with technetium-99m-hydroxy-methylene-diphosphonate ("9"9"mTc-HMDP) was performed on 28 patients on maintenance hemodialysis. Bone scintigraphy was performed using a standard protocol and was quantified by setting regions of interest (ROIs) over selected regions. The bone-to-soft-tissue ratio (B/ST ratio) at each region was calculated in all patients. The B/ST ratios were then compared with serum biochemical markers. The B/ST ratio for the skull correlated well with serum bone-specific alkaline phosphatase (BAP) (r=0.735, p<0.001), serum deoxypyridinoline (DPD) (r=0.806, p<0.001) ...
The effect of various forms of treatment of renal osteodystrophy was evaluated in 25 dialysis patients by quantitative bone scintigraphy, using 99m-Tc-HEDP. The results were compared with those of biochemical and bone morphometric studies. The total skeletal activity (TSA) decreased in 5 patients after transplantation, in 11 after parathyroidectomy and in 6 out of 9 treated conservatively, but did not normalize in any of the patients. Bone morphometric evaluation of treatment, which could be performed in 19 of the 20 patients who did not receive a transplant, demonstrated a reduction in the degree of hyperparathyroidism in 17 patients (89 percent). Osteoid excess was reduced in 13 patients (68 percent) but an evident reduction of osteomalacic osteoid, i.e. improvement of osteomalacia, occurred in only 4 patients (21 percent). Changes in the ...
The effect of various forms of treatment of renal osteodystrophy was evaluated in 25 dialysis patients by quantitative bone scintigraphy, using 99m-Tc-HEDP. The results were compared with those of biochemical and bone morphometric studies. The total skeletal activity (TSA) decreased in 5 patients after transplantation, in 11 after parathyroidectomy and in 6 out of 9 treated conservatively, but did not normalize in any of the patients. Bone morphometric evaluation of treatment, which could be performed in 19 of the 20 patients who did not receive a transplant, demonstrated a reduction in the degree of hyperparathyroidism in 17 patients (89 per cent). Osteoid excess was reduced in 13 patients (68 per cent) but an evident reduction of osteomalacic osteoid, i.e. improvement of osteomalacia, occurred in only 4 patients (21 per cent). Changes in ...
To evaluate the role and the prognostic value of bronchoalveolar lavage (BAL) in scleroderma patients with interstitial lung disease. We reviewed the records of 79 patients with systemic sclerosis (SSc) who had dyspnea and pulmonary involvement and underwent BAL study. Sixty-two patients were prospectively followed up for 12?36?months and re-evaluated by pulmonary function tests (PFTs). Seventy-nine SSc patients were enrolled (71 F and 8?M), 55 with limited and 24 with a diffuse form; mean age 55???13?years; mean disease duration 55.2???59?months. All patients were ANA positive, of these 30 were anti-topoisomerase-1 positive (anti-Topo1) and 22 were anti-centromere positive (ACA). Thirty-one patients had alveolitis (39.2%) that was neutrophilic in 12 patients, eosinophilic in 3 and mixed (...
The aims of this study were to quantify the severity and extent of subclinical interstitial lung disease as depicted on HRCT and to study the relationship between the patterns of lung disease quantified by HRCT and the functional parameters and bronchoalveolar lavage findings in patients with rheumatic diseases. The results confirm that HRCT is a sensitive tool in detecting interstitial lung disease in patients with rheumatic diseases with no signs and symptoms of pulmonary involvement. The relationship between the different HRCT patterns and bronchoalveolar lavage cell profiles can identify patients at higher risk of developing irreversible lung fibrosis. A long-term, prospective follow-up study is needed to determine whether these patients will develop over pulmonary disease.
AbstractObjective To review studies investigating the brain correlates of unawareness of cognitive and behavioural symptoms in people with dementia. Design A detailed search of the literature was conducted to include all the peer-reviewed studies published in English aimed at identifying the structural or functional brain correspondents of unawareness in dementia patients. Their results were interpreted in relation to the methodological differences in terms of type of dementia studied, the protocol adopted to measure lack of awareness, the imaging techniques employed, the experimental designs and statistical analyses performed. Results Eighteen studies undertaken to explore the functional and structural correlates of unawareness of cognitive symptoms in dementia were identified. Although t...
Background: This study investigates the psychometric properties of the Patient Health Questionnaire-2 (PHQ-2) in the general population of Hong Kong. Methods: Random sampling was used to recruit 6028 participants aged 15years or over. Among them, 203 were surveyed twice within a two-week period. Participants completed the Chinese version of the PHQ-9 (including 2 items of the PHQ-2), the Chinese Health Questionnaire, the Happiness Scale, the SF-12, and questions about diagnosis and health service utilization. Internal consistency, test-retest reliability, construct and discriminant validity of the PHQ-2 were assessed. Results: Cronbach's a was 0.76. The test-retest reliability over two weeks calculated by intraclass correlation was 0.70. Spearman correlation results showed that the PHQ-2 s...
Coronary heart disease is the leading cause of death specially among elderly. Coronary angiography is the best diagnostic method in the patients, but is unfortunately an invasive procedure with its inherent risks. Myocardial perfusion scan is a noninvasive and sensitive method for evaluation of Coronary artery disease and is suggested by many investigators in recent years. In this study, 64 patients who had a Tc99m-MIBI SPECT myocardial perfusion study at our department, underwent coronary angiography within 4 months. Correlation of the methods revealed that SPECT Tc99m -MIBI had a high sensitivity and specificity in our hand, which is comparable with international findings.
The synovial and bone uptake of tracer in the knees of patients with rheumatoid arthritis (RA) was quantified using {sup 99}Tc{sup m}-hexamethyl propylene amine oxime-labelled leucocytes and {sup 99}Tc{sup m}-methylene diphosphonate (MDP), respectively. Significant neutrophil migration and MDP uptake occurred in the knees of patients with RA irrespective of the disease duration. In all but one patient neutrophil migration was reduced after intra-articular steroid injection. The change in MDP uptake after steroid injection was variable. There was a significant correlation between the percentage reduction in neutrophil migration and pain score, while the latter correlated poorly with the change in MDP uptake. The quantification of the neutrophil component of the inflammatory process is a sensitive index for monitoring RA activity and response to pharmacological interventions, while ...
The synovial and bone uptake of tracer in the knees of patients with rheumatoid arthritis (RA) was quantified using "9"9Tc"m-hexamethyl propylene amine oxime-labelled leucocytes and "9"9Tc"m-methylene diphosphonate (MDP), respectively. Significant neutrophil migration and MDP uptake occurred in the knees of patients with RA irrespective of the disease duration. In all but one patient neutrophil migration was reduced after intra-articular steroid injection. The change in MDP uptake after steroid injection was variable. There was a significant correlation between the percentage reduction in neutrophil migration and pain score, while the latter correlated poorly with the change in MDP uptake. The quantification of the neutrophil component of the inflammatory process is a sensitive index for monitoring RA activity and response to pharmacological interventions, while quantitative bone ...
To evaluate the role of positron emission tomography-computed tomography (PET-CT) in staging and determining early treatment response to chemotherapy in children with neuroblastoma (NB) and its correlation with the final outcome. Patients and Methods: Seventeen patients of NB with mean age of 51.5 months (age range 2-132 months; 14 males, 3 females) underwent serial "1"8F-fluorodeoxyglucose (FDG) PET-CT imaging. All 17 patients were for staging before any treatment. Twelve of 17 patients underwent "1"3"1I meta-iodobezylguanidine (MIBG) scan and bone scan. MIBG uptake was seen in the primary lesion in 11/12 patients. MIBG uptake in bones was seen in 3/12 patients. All bone lesions were concordant on MIBG and bone scan. Early response to chemotherapy was evaluated after two cycles using PET-CT. A 30% reduction in longest diameter was taken as ...
Twenty-two patients, all with surgically proven primary hyperparathyroidism, were studied by TI-201 thallous chloride and Tc-99m pertechnetate subtraction imaging. Fifteen parathyroid adenomata and one hyperplastic gland between 0.33 and 14.8 g were correctly localized in 16 patients. Two adenomata and seven hyperplastic or histologically normal parathyroids between 0.1 g and 1.4 g in seven patients were not localized. One patient had a correctly localized 13.0-g adenoma with a nonlocalized 0.3 g hyperplastic parathyroid gland and there were two false positive localizations. Sensitivity was 64% (glands), and 73% (patients). There was only fair correlation with parathormone (PTH) levels, but these were elevated in all but four of the patients with correctly localized parathyroids. The authors conclude that the imaging procedure is useful but ...
Purpose: To evaluate contrast-enhanced CT scan in the diagnosis of intrahepatic cholangiocarcinoma by correlating the CT appearance with pathologic specimens. Materials and methods: Twenty-eight patients with pathologically proven intrahepatic cholangiocarcinoma were examined. Unenhanced abdominal CT study were performed in 28 patients; conventional contrast-enhanced CT in 27 patients. Enhanced CT scan including fast injection, fast scan and delayed scan at the largest section of the lesion was done in 7 patients. Contiguous 10 mm CT scans of the surgical specimens were also obtained in 8 patients. The preoperative and specimen CT scans in these 8 patients were compared with the corresponding pathological sections. A total of 103 areas of the pathological sections was compared with the CT appearances. Results: All lesions contained areas of ...
Our aim was to investigate the diagnostic reliability of multidetector-row computed tomography (MDCT) for preoperative assessment of local tumoral spread in hilar cholangiocarcinoma. Thirteen of 30 consecutive patients with hilar cholangiocarcinoma who underwent surgery, excluding 17 patients who underwent biliary drainage or preoperative portal embolization, were retrospectively evaluated. Using MDCT systems of 4 detector rows or 16 detector rows, plain and dynamic contrast-enhanced images of three phases were obtained. Extent of tumor spread and lymph node metastasis were assessed with MDCT and compared with histopathological findings. The Bismuth-Corlette classification of hilar cholangiocarcinoma with MDCT were type I, 1 patient; type IIIa, 3 patients; type IIIb, 4 patients; and type IV, 5 patients; those with histopathological findings were type I, 1 ...
Purpose: To assess the relationship between large intracranial vessel occlusive vasculopathy (vasculopathy) and radiation therapy, and to clarify the clinical efficacy of magnetic resonance (MR) imaging in the diagnosis and screening of the vasculopathy. Methods and Materials: We retrospectively evaluated the medical records and serial MR images for 32 pediatric patients, in whom radiation therapy had been given to fields including the circle of Willis and major cerebral arteries. All children had periodically undergone follow-up neurologic assessment and MR imaging examinations at Kanagawa Children's Medical Center for more than one year after radiation therapy (range 1.3-14 years). Patients who had not remained free of tumor progression up to the time of final evaluation were excluded. Results: Vasculopathy developed in 6 of 32 patients 2-13 years after radiation therapy. Three of them presented with transient ischemic ...
The purpose of the paper is to investigate whether high-resolution CT (HRCT) can detect the subjects with massive emphysematous destruction in a group of patients with severe chronic obstructive pulmonary disease (COPD) and therefor be of help in selecting the candidates to surgical lung volume reduction. Have been examined 40 former smokers with severe COPD (FEV_1#<=#40% of the predicted value, with no major improvement after inhalation of bronchodilators). The emphysema extent score was significantly correlated with the hematocrit value and Tiffeneau index (p<2) in all the 40 patients. The severity of bronchial obstruction was the same in bronchitis and dyspnoeic patients. The subject with chronic bronchitis had milder emphysema (mean extent 35% versus 47% in the dyspnoeic subjects) and a higher frequency of bronchial involvement. A decrease in FEV_1 was significantly ...
Insulitis is considered the histopathological hallmark of type I diabetes. In the non-obese diabetic (NOD) mouse, diabetes has never been observed in the absence of insulitis. The in vivo detection of insulitis could be of relevance for early prediction of diabetes. As approximately 15% of islet-infiltrating lymphocytes express interleukin 2 receptors, the authors have labelled recombinant inter-leukin 2 with "1"2"3I and used this radiopharmaceutical to detect insulitis by gamma camera imaging. The authors studied 71 prediabetic NOD and 27 normal Balb/c mice. Labelled #alpha#-lactalbumin was used as the control protein. In the first set of experiments the tissue distribution of radiolabelled interleukin 2 in isolated organs from animals sacrificed at different time points was studied. Higher radioactivity was detected in the pancreas of NOD mice injected with labelled interleukin 2, as compared to NOD mice receiving labelled #alpha#-lactalbumin. In another set of ...
Clinical and hormonal indices of androgenic activity were compared in 118 males chronically intoxicated with alcohol. The population was divided into two groups with respect to their clinical and hormonal androgenic indices: 76 patients with (Group 1), and 46 patients without (Group 2) androgenic insufficiency. Distinct signs and syndromes of alcohol addiction were shown to correlate with the extent of cross-regulation impairment within hypothalamo-hypophyseo-gonadal system. This was particularly derived from comparison of clinical picture of chronic alcohol intoxication and hormone activity in the groups. Conventional therapy failed to restore the neuroendocrine indices that was apparently due to inhibition of cross-regulation links in the hypothalamo-hypophyseo-gonadal system at several stages of alcohol addiction. PMID:3223149
Abstract Residual limb pain (RLP) and phantom limb pain (PLP) can be debilitating and can prevent functional gains following amputation. High correlations have been reported between RLP and the stump neuromas following amputation. Many treatment methods including physical therapy, medications, and interventions, have been used with limited success. Pulsed radiofrequency ablation (PRFA) has shown promise in treating neuropathic pain because of the inhibition of evoked synaptic activity. We present 4 amputees who were treated with PRFA after failing conservative management for their RLP and PLP. All 4 patients underwent PRFA and demonstrated at least 80% relief of RLP for over 6 months. One patient reported a complete resolution of phantom sensation while another patient had significantly de...
Abstract Acute lung injury (ALI) in sepsis is characterized by an increase in microvascular permeability, resulting in pulmonary edema. Several studies have suggested that angiopoietin-1 and -2 play a contributory role in the pathogenesis of ALI. Polymyxin B-immobilized fiber column hemoperfusion is effective for sepsis-induced ALI. We investigated the angiopoietin levels before and after direct hemoperfusion with polymyxin B-immobilized fiber column (PMX) therapy. Enzyme-linked immunoassay was used to measure the serum angiopoietin-1 and -2 levels in 25 patients with septic shock treated with PMX. Eleven of the 25 patients were diagnosed with ALI. There was a significant positive correlation between the angiopoietin-1 level and the PaO2/FiO2 ratio, but there was a significant inverse corr...
Purpose: To determine if involved field radiation (IF) is equivalent to standard whole bone radiation (SF) in local tumor control; to establish patterns of failure following treatment; and to determine response, event-free survival (EFS), and overall survival rates from multidisciplinary therapy in Ewing's sarcoma. Methods and Materials: Between 1983 and 1988, 184 children with Ewing's sarcoma were enrolled onto Pediatric Oncology Group 8346 (POG 8346). A total of 178 (97%) met eligibility criteria; 6 had pathology other than Ewing's sarcoma. Induction chemotherapy of cyclophosphamide/doxorubicin (adriamycin )(C/A) x 12 weeks was followed by local treatment either surgery or radiation therapy and C/A, dactinomycin, and vincristine for 50 weeks. Resection was advised for patients with small primary tumors if accomplished without functional loss. Forty patients were randomized to receive SF, whole bone radiation to 39.6 Gy plus a 16.2 Gy boost ...
The "1"3"1I-labelled monoclonal antibodies 791T/36 and 79IT/36 Fab fragments have been evaluated in the imaging of patients with colorectal cancer, with benign colorectal tumours, and with malignant tumours of other parts of the gastrointestinal tract. The results of clinical imaging have been carefully correlated with clinical findings and direct measurement of the preferential uptake of antibody by the tumours. (UK).
Identity is a part of self-consciousness, which is also expressed as ''being in the world'' which one in turn shows to others as the Self. The assessment of the Self in a population of patients with Alzheimer's disease, according to a multidimensional definition (physical, social, spiritual), showed that the social self was impaired, and the severity of impairment of the self was correlated to apathy and lack of semantic autobiographical memory. It also appears that ipseity is selectively affected by the disease.
Abstract: The clustered logrank test is a nonparametric method of significance testing for correlated survival data. Examples of its application include cluster randomized trials where groups of patients rather than individuals are randomized to either a treatment or a control intervention. We describe a SAS macro that implements the 2-sample clustered logrank test for data where the entire cluster is randomized to the same treatment group. We discuss the theory and applications behind this test as well as details of the SAS code.
Although the radioisotope liver scan has primarily been of use in the detection of the intra-hepatic space occupying lesions, there has been an increasing awareness of its use in evaluation of liver function. In this study, the degree of hepatomegaly, changes in shape and mottling radiodensity on each lobe and splenic visualization in the liver scans done with colloidal radiogold were numerically expressed as scores under the arbitrary standard in 210 patients with liver cirrhosis. The clinical value of this scoring system was studied with special regards to the correlation between the radiogold hepatic uptake half time and conventional liver function tests. Following were the results; 1) The normal scan appeared in 6.7% of 210 patients with liver cirrhosis. 2) The colloidal radiogold hepatic uptake half time was abnormally and progressively prolonged in parallel to severity of hepatocellular dysfunction. The mean hepatic ...
Acute vertebrobasilar occlusion (VBO) is associated with a high risk of stroke and death. Although local thrombolysis may achieve recanalization and improve outcome, mortality is still between 35% and 75%. However, without recanalization the chance of a good outcome is extremely poor, with mortality rates of 80-90%. Early treatment is a fundamental factor, but detailed studies of the exact time management of the diagnostic and interventional workflow are still lacking. Data on 18 patients were retrospectively evaluated. Time periods between symptom onset, admission to hospital, time of diagnosis, and beginning of intervention were correlated with postinterventional neurological status. The Glasgow Coma Scale and National Institute of Health Stroke Scale (NIHSS) were used to examine patients before and after local thrombolysis. Additionally, multivariate statistics were applied to reveal similarities between ...
Purpose: To report the detection of con-compacted ventricular myocardium (NVCM) with MRI compared to echocardiography in 8 patients. Material and methods: Non-compaction of the ventricular myocardium is a congenital disorder characterized by an altered structure of the myocardial wall resulting from an intrauterine arrest in endomyocardial embryogenesis. The morphological findings consist of a prominent meshwork of multiple myocardial trabeculations and deep intertrabecular recesses, communicating with the left ventricular cavity. 8 consecutive patients (mean age 7.3 years) with clinical and echocardiographic signs of NCVM were examined by MRI (1.5 T, Vision, Siemens) in short axis and 2- and 4-chamber views, using T_1-weighted TSE and Cine-GRE in 6 patients and true FISP sequences in 2 patients. MRI and echocardiography were evaluated for visibility, signs of NCVM and involvement of myocardial wall ...
Purpose: To analyze p53, bcl-2, c-myc, and cyclooxygenase-2 protein expression changes and examine their relationship with various antioxidant enzymes in esophageal carcinoma patients. Methods and Materials: Patients in Group 1 underwent transhiatal esophagectomy and those in Group 2 were administered chemoradiotherapy followed by surgery after 4 weeks of neoadjuvant therapy. Results: The relationship analysis among the various protein markers and antioxidant enzymes showed an inverse correlation between bcl-2 and superoxide dismutase/catalase in tumor tissues, irrespective of the treatment arm followed. An important positive association was observed between bcl-2 and reduced glutathione levels in the tumor tissue of patients receiving neoadjuvant therapy. Another apoptosis-modulating marker, c-myc, in the tumor tissue of Group 2 patients showed similar pattern levels (high and low) ...
Prognosis of 95 consecutive patients with non-small cell lung cancer with brain metastases were evaluated. Three factors, therapy for brain metastases, general performance status (PS) and distant metastases to other organs had significant impact on survival. Among these 3 factors, PS was independent from the other 2 factors. Significant correlation was present, however, between therapy and other organ metastases, and few patients with brain and other distant metastases received aggressive treatment for brain metastases. Cranial irradiation had significant impact on survival even in those patients with brain and other distant metastases. Cranial irradiation also reduced death from brain metastases in responders. Our results indicate that there are several subgroups with different prognosis in patients with non-small cell lung cancer with brain metastases, therefore the most ...
Abstract in english In order to evaluate the presence of specific IgG antibodies to Borrelia burgdorferi in patients with clinical manifestations associated with Lyme borreliosis in Cali, Colombia, 20 serum samples from patients with dermatologic signs, one cerebrospinal fluid (CSF) sample from a patient with chronic neurologic and arthritic manifestations, and twelve serum samples from individuals without clinical signs associated with Lyme borreliosis were analyzed by IgG Western blot. The (more) results were interpreted following the recommendations of the Centers for Diseases Control and Prevention (CDC) for IgG Western blots. Four samples fulfilled the CDC criteria: two serum specimens from patients with morphea (localized scleroderma), the CSF from the patient with neurologic and arthritic manifestations, and one of the controls. Interpretation of positive serology for Lyme ...
The study was designed to determine the correlation between parenchymal lesions on MRI and depression. Thirty patients with depression satisfying the following criteria were selected: (1) 60 years or over at the time of MRI scanning, (2) no evidence of cerebrovascular disorder or dementia, and (3) no evidence of neurological findings such as extremity palsy. Seventy six patients with no history of psychiatric visits to a clinic served as controls. There was no significant difference in risk factors for cerebrovascular disorders, such as hypertension, diabetes mellitus, and ischemic heart disease, between the depressive group and the control group. MRI manifestations were semiquantitatively scored according to the periventricular hyperintensity (PVH), white matter hyperintensity (WMH), and pons hyperintensity (PH). All of the PVH score, WMH score, and cerebral enlargement index correlated with age. ...
The volume of cortical activation as detected by functional magnetic resonance imaging (fMRI) in the visual cortex has previously been shown to be reduced following optic neuritis (ON). In order to understand the cause of this change, we studied the cortical activation, both the size of the activated area and the signal change following ON, and compared the results with results of neuroophthalmological testing. We studied nine patients with previous acute ON and 10 healthy persons served as controls using fMRI with visual stimulation. In addition to a reduced activated volume, patients showed a reduced blood oxygenation level dependent (BOLD) signal increase and a greater asymmetry in the visual cortex, compared with controls. The volume of visual cortical activation was significantly correlated to the result of the contrast sensitivity test. The BOLD signal increase correlated significantly to both the ...
Purpose: With intracranial tumors a flat, contrast-enhancing, probably dural structure adjacent to the tumor can occasionally be observed on gadolinium-DTPA enhanced MR images. Therefore we have attempted to evaluate a tumor infiltration of this enthancement on MRI. Material and Methods: This study included 50 patients. 19 patients had a dural thickening at the tumor base (13 meningiomas and 6 metastases), while 31 patients did not (12 meningiomas and 19 metastases). Studies included plane T_2-weighted spin echo (SE) images as well as T_1-weighted axial, coronal, or sagittal plains with and without contrast agent. Histopathological examinations, were done on the tumor base adjacent to the dura mater. Results: 7 of 12 meningiomas showed a meningeal thickening on MRI with histopathologically proven tumor infiltration as did also 5 of 6 metastases. But 3 of 12 meningiomas and 15 of 19 metastases without dural thickening at the ...
BACKGROUND: Immune suppressant medications such as thiopurines and anti-tumor necrosis factor agents are important for maintaining disease control in most patients with inflammatory bowel diseases (IBDs); however, their use has been associated with the development of malignant lymphoma. The purpose of this Dutch nationwide study was to estimate the relative risk of malignant lymphoma in IBD patients. METHODS: IBD patients who developed a lymphoma between 1997 and 2004 were identified using the Dutch National Database of PALGA. Data from confirmed cases were collected from individual hospitals, including data on Epstein-Barr virus (EBV). The age-adjusted 8-year incidence of malignant lymphoma in the Netherlands was retrieved from the Central Bureau of Statistics. RESULTS: Forty-two hospitals were visited and 285 matches evaluated in the total cohort of 17,834 IBD patients. Forty-four lymphomas were ...
It is not known whether body weight alone can adjust for the volume of liver in the calculation of the chelating dose in {beta}-thalassaemia major patients, who frequently have iron overload and hepatitis. The hypothesis is that liver volume in children and adolescents suffering from {beta}-thalassaemia major is affected by ferritin level and liver function. Thirty-five {beta}-thalassaemia major patients aged 7-18 years and 35 age- and sex-matched controls had liver volume measured by MRI. Serum alanine aminotransferase (ALT) and ferritin levels were obtained in the thalassaemia major patients. Body weight explained 65 and 86% of the change in liver volume in {beta}-thalassaemia major patients and age-matched control subjects, respectively. Liver volume/kilogram body weight was significantly higher (P<0.001) in thalassaemia major patients than in control subjects. There was a ...
A report on the long-term follow up of the first cooperative Scandinavian Sarcoma Group study in Ewing's sarcoma of bone is presented. Fifty-two previously untreated patients entered the study between 1984 and 1990. Half of the tumors were located in the extremities and one quarter in the pelvis. The combined modality treatment consisted of 5 cycles of chemotherapy - including vincristine, methotrexate, doxorubicin, cyclophosphamide, bleomycin and dactinomycin. The first two cycles were followed by local resection or amputation in 35 patients and by radiotherapy alone in 17 patients. When surgery was not performed, was incomplete or yielded poor margins radiotherapy was given at a dose of 40-60 Gy. Local tumor relapses developed in 10 patients and in all but one patient were accompanied by metastatic disease. Five patients had metastasis at diagnosis and distant ...
Total 125 patients with primary and metastatic Ewing's sarcoma were treated in various ways between 1963 to 1977. Patients were divided into 3 groups according to the treatment methods. Group 1 was nonprotocol patients with or without chemotherapy. Total 58 patients were entered. Group 1 was divided into 2 subgroups. 33 patients were treated locally without chemotherapy and 25 patients were treated with local therapy and nonprotocol chemotherapy. Group 2 was treated with local therapy and plus T-2 regimen multiagent chemotherapy. 29 patients were entered. Group 3 was treated with local therapy and T-6 regimen multiagent chemotherapy. 38 patients were entered. Local treatments for primary tumor were surgery and/or radiation therapy. Radiation dose ranged between 2,000 and 8,000 rad. Patients with ...
Previous research demonstrates that we tend to derogate individuals who are perceived to be in a social relationship with stigmatized persons. Two experiments examined whether this phenomenon also occurs for individuals seen in the presence of an obese person and whether a social relationship is necessary for stigmatization to spread. The results from both experiments revealed that a male job applicant was rated more negatively when seen with an overweight compared to a normal weight female and that just being in the mere proximity of an overweight woman was enough to trigger stigmatization toward the male applicant. Experiment 2 examined possible moderating effects of the proximity finding. Applicants seated next to heavy (vs. average weight) individuals were denigrated consistently regardless of the perceived depth of the relationship, the participant's anti-fat attitudes or gender, and whether or not positive information was presented concerning the woman. The ...
Six patients with eosinophilic granuloma were studied retrospectively in order to correlate the MRI appearances with the pathology. Ages ranged from 2 years 6 months to 11 years. The bones involved were the humerus, ulna, radius, femur, clavicle and ilium. Plain films, MRI and pathology specimens were obtained. A lytic lesion with indistinct margins, endosteal erosions and periosteal reaction was seen in all cases on plain radiographs. Bone marrow signal was decreased on T1-weighted images and increased on T2-weighted images throughout the bony lesion in all cases. T2-weighted images showed extensive soft-tissue abnormalities suggesting inflammatory changes in four cases. In two cases abnormalities were limited. Extensive changes correlated histologically with an early phase lesion. Localized minor changes were associated with a mid-phase lesion. Inflammatory soft-tissue changes could be associated with eosinophilic ...
The purpose of this study was to determine whether resistance exercise training-induced reductions in inflammation are mediated via melanocortin 3 receptor expression in obese (BMI 32.7 ± 3.7)...Full Text Available
Syndrome X is a combination or co-occurrence of several known cardiovascular risk factors (including central obesity, dyslipidemias, fatty liver disease, hyperinsulinemia, insulin resistance,...Full Text Available
BackgroundLarge population growth surveys of children and adolescents aged 6 to 18 y were undertaken in Hong Kong in 1963 and 1993. The global epidemic of obesity is a major public...Full Text Available
Adipocyte differentiation is a complex developmental process that involves the coordinated interplay of numerous transcription factors. PPARγ has emerged as a master regulator of adipogenesis...Full Text Available
Percutaneous tracheostomy is a routine procedure in intensive care units. In cases of very low position of the larynx, cervical spine deformation, morbid obesity, or neck tumor, performance of the classic...Full Text Available
Brown fat is a specialized tissue that can dissipate energy and counteract obesity through a pattern of gene expression that greatly increases mitochondrial content and uncoupled respiration. PRDM16...Full Text Available
Abnormal fat metabolism plays an important role in the pathogenesis of obesity-related type 2 diabetes mellitus. This study examined whether free fatty acid levels (FFAs), like insulin levels, oscillate...Full Text Available
Some pathological conditions with feeding pattern alterations, including obesity and Huntington disease (HD) are associated with hypothalamic dysfunction and neuronal cell death. Additionally, the hypothalamus...Full Text Available
Insulin resistance plays a central role in type 2 diabetes and obesity, which develop as a consequence of genetic and environmental factors. Dietary changes including high fat diet (HFD) feeding promotes...Full Text Available
OBJECTIVENicotinamide adenine dinucleotides (NAD+ and NADH) play a crucial role in cellular energy metabolism, and a dysregulated NAD+-to-NADH ratio is implicated...Full Text Available
Objective:We examine the extent to which body weight affects three types of perceived interpersonal mistreatment, and evaluate whether these patterns vary by race,...Full Text Available
OBJECTIVE—Identification of arterial genes and pathways altered in obesity and diabetes.RESEARCH DESIGN AND METHODS—Aortic gene expression profiles of...Full Text Available
Gestational exposure to maternal overweight (OW) influences the risk of obesity in adult life. Male offspring from OW dams gain greater body weight and fat mass and develop insulin resistance when fed...Full Text Available
Hypothalamic systems which regulate appetite may be permanently modified during early development. We have previously reported hyperphagia and increased adiposity in the adult offspring of rodents fed...Full Text Available
The mammalian circadian system consists of a central oscillator in the suprachiasmatic nucleus of the hypothalamus, which coordinates peripheral clocks in organs throughout the body. Although circadian...Full Text Available
While levels of weight bias vary among individuals, it is not clear why one person possesses stronger anti-fat attitudes than another person. This investigation examined whether individual differences commonly associated with greater anti-fat bias are also associated with a greater preference for thinness among people of varying levels of weight. Young adults (62% women; 84% Caucasian) recruited from psychology classes (N=308) rated four male and female figures with approximate BMIs of 18.5, 25, 30, and 40, on measures of dislike and personality characteristics and completed measures assessing weight controllability, attitudes toward the obese, and perceptual reliance. Greater negative attitudes, weight controllability beliefs, and perceptual reliance were positively associated with greater dislike and negative personality attributes among obese/severely obese figures, but inversely related among low normal weight figures. ...
Cellular hypertrophy is regulated by coordinated pro- and antigrowth machineries. Foxo transcription factors initiate an atrophy-related gene program to counter hypertrophic growth. This study was designed...Full Text Available
Physical activity and sedentary behavior are central components of lifetime weight control; however, our understanding of dimensions of these behaviors in childhood is limited. This study investigated...Full Text Available
Obesity is a risk factor for stroke and neurodegenerative disease. Excess body fat has been linked to impaired glucose metabolism, insulin resistance, and impulsivity and may be a precursor to decline...Full Text Available
BackgroundObesity has reached epidemic proportions in the United States. It is implicated in the development of a variety of chronic disease states and is associated with increased...Full Text Available
Social stress is prevalent in many facets of modern society. Epidemiological data suggest that stress is linked to the development of overweight, obesity and metabolic disease. Although there...Full Text Available
The prevalent surge in childhood and adolescent obesity within the past 3 decades poses a significant challenge for many pediatric clinicians who are charged with treating this condition. The...Full Text Available
OBJECTIVEPhosphoinositide 3-kinase enhancer A (PIKE-A) is a proto-oncogene that promotes tumor growth and transformation by enhancing Akt activity. However, the physiological functions...Full Text Available
BackgroundObesity is a major public health threat and policies aimed at curbing this epidemic are emerging. National calorie labeling legislation is forthcoming and requires rigorous...Full Text Available
Growing evidences indicate that proteases are implicated in adipogenesis and in the onset of obesity. We previously reported that the cysteine protease cathepsin K (ctsk) is overexpressed in the white...Full Text Available
BackgroundThe occurrence of diabetes has greatly increased in low- and middle-income countries, particularly in Asia, as has the prevalence of overweight and obesity; in European-derived...Full Text Available
BackgroundHigh intake of sugar-sweetened beverages in childhood is linked to increased risk of obesity and type II diabetes later in life. Using three nationally representative surveys...Full Text Available
BackgroundWith rates of childhood obesity increasing, physical activity (PA) promotion especially in young children has assumed greater importance. Given the limited effectiveness...Full Text Available
ObjectiveMaintaining weight loss is a major challenge in obesity treatment. Individuals often indicate that waning motivation prompts cessation of effective weight...Full Text Available
Background and RationaleAtypical antipsychotics exhibit metabolic side effects including diabetes mellitus and obesity. The adverse events are preceded by acute worsening of oral...Full Text Available
Objective: To determine whether asymptomatic bacterial vaginosis (BV) is associated with upper genital tract inflammation or bacterial colonization.Methods: Fifty nonpregnant women with intact uteri who planned to undergo gynecologic surgery and had no recent symptoms of vaginal infection were enrolled. We obtained a vaginal swab for Gram stain, endocervical swab for chlamydia and gonorrhea DNA probe testing, and Pipelle endometrial biopsy for aerobic and anaerobic cultures and histology. We correlated surgical findings and histology of available surgical specimens with the microbiologic results. The diagnosis of BV was made according to Speigel's criteria. Bacteria isolated from the uterus were classified as high virulence versus low virulence. Contingency tables were analyzed using the chi-square or Fisher Exact tests.Results: Twenty-one of 50 patients had BV on Gram stain, 3 had intermediate BV, and 3 had unreadable slides. Eleven ...
Objective: To investigate transcutaneous oximetry as parameter of the microcirculation is correlated to ankle-brachial-index as parameter of the macrocirculation after peripheral angioplasty procedures. Design: Prospective study. Materials and methods: 60 patients suffering from intermittent claudication were scheduled for angioplasty treatment. 45 patients were considered as eligible for angioplasty after angiographic evaluation, 15 patients underwent angiography only. Transcutaneous oximetry measurements were performed before the procedure, at the end of intervention, 24 h as well as 2 and 4 weeks after percutaneous transluminal angioplasty. Ankle-brachial-indices were obtained before intervention, 24 h as well as 2 and 4 weeks later. Results: Ankle-brachial-indices increased significantly at 24 h after angioplasty in patients being treated with angioplasty. Transcutaneous ...
Background Computed tomography (CT) and magnetic resonance (MR) imaging can help diagnose benign adrenal adenomas, but prior studies rely on nonoperative follow-up as proof of a lesion?s benign nature. We examined adrenalectomy tissues to determine if imaging characteristics correlate with histopathologic findings. Methods We retrieved data for 196 consecutive adrenalectomies in 192 patients from 2000 to 2008. Imaging results were considered to signify benign adrenal adenoma if one or more of the following was present: Hounsfield units 60% or relative contrast washout of >40%, or MR with chemical-shift imaging demonstrating loss of signal intensity on out-of-phase images. Results The sensitivity and specif...
The authors have performed I-123 IMP single- photon emission CT (SPECT) brain imaging on seven mildly demented patients with acquired immunodeficiency syndrome (AIDS) and on seven normal subjects. Pixel-intensity histograms have been analyzed for the fraction of pixels in the lowest quartile of the intensity range. This fraction (F) averaged 17.7% (standard deviation [SD] = 4.3) in the AIDS group and 12.6 (SD = 4.7) in the normal group (P <.05). Regression analysis of neuropsychological testing (NPT) scores vs F yielded a correlation coefficient of.71. The presence or degree of atrophy did not correlate with F or NPT scores.
Full text: Tumour ablation with radiofrequency (RF) energy is a relatively new procedure for the treatment of focal malignant disease. At our institution this is currently being used in the treatment of certain liver and lung lesions with the patients involved being enrolled in clinical trials. The poster describes the technique used at our institution for the placement of the radiofrequency ablation electrode using CT fluoroscopy. Criteria for patient selection are included. Complications from the procedure are described, as well as follow up appearances and results. Our results from the treatment of primary and secondary lesions in the liver correlate well with published literature. Treatment is still not as successful as surgical resection but there is significantly less morbidity. Where this method may be appropriate is when the patient is not a candidate for surgical resection. The treatment of ...
Diagnostic x-ray spectrometry, a method based on x-ray fluorescence analysis, was used for noninvasive determination of iron and zinc in two distinct skin areas, representing predominantly dermal and epidermal tissues, in 56 patients with beta-thalassemia major and intermedia. The mean iron levels in the skin of patients with beta-thalassemia major and intermedia were elevated by greater than 200% and greater than 50%, respectively, compared with control values. The zinc levels of both skin areas examined were within the normal range. The data indicate that the rate and number of blood transfusions, which correlated well with serum ferritin levels (r . 0.8), are not the only factors that determine the amount of iron deposition in the skin (r less than 0.6). Other sources of iron intake contribute to the total iron load in the tissues, particularly in patients who are not given multiple transfusions. The ...
Functional imaging of the pharynx used to be the domain of cineradiography, CT and ultrafast CT. The development of modern MRI techniques led to new access to functional disorders of the pharynx. The aim of this study was to implement a new MRI technique to examine oropharyngeal obstructive mechanisms in patients with obstructive sleep apnea (OSA). Sixteen patients suffering from OSA and 6 healthy volunteers were examined on a 1.5 T whole-body imager ('Vision', Siemens, Erlangen Medical Engineering, Germany) using a circular polarized head coil. Imaging was performed with 2D flash sequences in midsagittal and axial planes. Patients and volunteers were asked to breathe normally through the nose and to simulate snoring and the Mueller maneuver during magnetic resonance imaging (MRI). Prior to MRI, all patients underwent an ear, nose and throat (ENT) examination, functional fiberoptic nasopharyngoscopy and ...
To analyze and review the most common focal lesions of the external auditory canal (EAC), describing the computed tomography (CT) findings. The CT images of EAC were reviewed in a series of 167 patients. Abnormal findings were recorded in 13 cases. The CT images were correlated with otoscopic and/or intraoperative findings. There were four cases of osteoma (one located outside the EAC); all of which were treated surgically, as was the one case of exostosis. Six patients presented debris in EAC, coinciding with clinical evidence of external otitis. There were two cholesteatomas derived from EAC, one of them secondary to survery to treat osteoma. On patient was diagnosed as having a basal cell carcinoma of the ear, extending to EAC, but refused to undergo surgery. Five patients presented small triangular laminae of dense bone arising from the upper wall of the EAC which were defined ...
Summary Background Systematic screening for liver fibrosis in heavy-drinking patients is a challenge. Aims To assess Fibroscan for non-invasive diagnosis of asymptomatic liver fibrosis in alcohol abuse patients, to determine diagnostic liver stiffness cut-off values and to compare performance of Fibroscan with seven non-invasive laboratory tests. Methods One hundred and three alcoholic patients were studied. Liver fibrosis was staged by METAVIR system. Fibroscan, Fibrotest, Fibrometer, Hepascore, APRI, PGA, PGAA and hyaluronic acid tests were performed. Liver stiffness cut-offs were determined using receiver-operating characteristic (ROC) curves. Results Liver stiffness was correlated with fibrosis (r = 0.72, P < 0.014), with median at 5.7, 6.3, 8.4, 15 and 47.3 kPa for F0 (n = 8), F1 (n =...
Iron overload has been described in patients undergoing chronic hemodialysis. The present study was undertaken to evaluate a rapid, noninvasive method for determination of skin iron by the technique of diagnostic x-ray spectrometry (DXS). Thirty-five patients receiving chronic hemodialysis treatment entered the study and were compared with 25 normal controls. Since pathological skin iron deposition occurs mainly at the dermal-epidermal junction in the basal cells of the epidermis, measurements were made in the thenar eminence representing mainly epidermal tissue (FeE), and in the forearm representative mainly of dermis (FeD). The mean +/- SD FeE iron concentrations were equivalent to 14.5 +/- 8.8 and 18.2 +/- 10.2 parts per million wet weight tissue (ppm) and both were significantly higher than in normal controls in which they averaged 9.2 +/- 2.5 ppm (P less than 0.005) and 10.2 +/- 3.2 ppm (P less than 0.001), respectively. There was ...
Introduction The progressive growth of malignancies is accompanied by a decline in the immune response through mechanisms which are poorly understood. Apoptosis and induction of inflammation by tumor released cytokines as tumor escape mechanisms have been proposed to play an important role in colorectal carcinogenesis. Methods Expression of Tumor necrosis factor-alpha (TNF-?) was analyzed in colorectal cancer specimen and the cancer cell line HT-29 by immunohistochemistry and RT-PCR. TNF-? expression on protein and mRNA level were correlated with clinical characteristics and impact on survival. TNFR-1 was co-labelled with TNF-? and CD8+ cytotoxic T cells in immunofluorescence double staining experiments. Results: 94% (n?=?98/104) of the patients with CRC expressed TNF-?. High TNF-? express...
Background Experimental and clinical studies have identified a crucial role of microcirculation impairment in severe infections. We hypothesized that mottling, a sign of microcirculation alterations, was correlated to survival during septic shock. Methods We conducted a prospective observational study in a tertiary teaching hospital. All consecutive patients with septic shock were included during a 7-month period. After initial resuscitation, we recorded hemodynamic parameters and analyzed their predictive value on mortality. The mottling score (from 0 to 5), based on mottling area extension from the knees to the periphery, was very reproducible, with an excellent agreement between independent observers [kappa?=?0.87, 95% CI (0.72?0.97)]. Results Sixty patients were included. The SOFA scor...
In 15 patients (16 hip joints) we found the clinical and radiological signs of BMOS. On T1-weighted MRI images areas of low signal intensity could be observed in the head, neck and the intertrochanteric region of the femur in various extensions. These areas showed a significant increase in signal intensity on the T2-weighted images. Because pain was resistant to conservative therapy all these patients were treated by core decompression of the femoral head in a prospective study. Bone cores were evaluated histologically using undecalcified sections and quantitative microradiography. The existence of intramedullary oedema in exactly the regions exhibiting the MRI pattern of bone marrow oedema was verified histologically; however, bone and marrow changes similar to those of early avascular necrosis (AVN) were also visible. (orig.)
The primary aim was to evaluate delayed contrast-enhanced MRI in depicting perineural spread of hilar cholangiocarcinoma (CCC) and consequently to determine the capability of MRI/MRCP for staging CCC. Fifteen patients that underwent MRI/MRCP and surgical treatment were retrospectively included. Two radiologists evaluated MR images to assess delayed periductal enhancement, extent of bile duct stenosis, liver parenchymal and vascular involvement and presence of liver atrophy. An agreement between delayed enhancement of the bile duct walls and perineural neoplastic spread showed a very good correlation factor (0.93). The overall accuracy in detecting biliary neoplastic invasion was higher for delayed T1-weighted images (93.3%) than for the MRCP images (80%), and T1-delayed image increased the MR accuracy in assessing the neoplastic resectability (p < 0.05). MRI correctly predicted vascular involvement in 73% and liver involvement in 80% of the ...
Objective: Solid pseudopapillary tumor of the pancreas (SPTP tumor) is a rare pancreatic neoplasm with low malignant potential, which usually affects female patients in the second or third decades of life. It is a non-functional, slow-growing neoplasm that very often reaches considerable size before the first symptoms appear. Symptomatology is frequently related to tumor size. Surgical excision is usually curative in most cases. Infrequently the tumor can appear in male patients or in aged women, which can make the diagnosis more difficult. Some patients develop liver metastases in the follow-up that can be resected. Our purpose is to review the radiological and pathological findings of SPTP with emphasis on these infrequent cases. Subjects and methods: The medical records and radiological findings of patients who underwent surgery for SPTP between 2000 and 2005 were retrospectively reviewed. Study ...
Objective: Solid pseudopapillary tumor of the pancreas (SPTP tumor) is a rare pancreatic neoplasm with low malignant potential, which usually affects female patients in the second or third decades of life. It is a non-functional, slow-growing neoplasm that very often reaches considerable size before the first symptoms appear. Symptomatology is frequently related to tumor size. Surgical excision is usually curative in most cases. Infrequently the tumor can appear in male patients or in aged women, which can make the diagnosis more difficult. Some patients develop liver metastases in the follow-up that can be resected. Our purpose is to review the radiological and pathological findings of SPTP with emphasis on these infrequent cases. Subjects and methods: The medical records and radiological findings of patients who underwent surgery for SPTP between 2000 and 2005 were retrospectively reviewed. Study ...
Isocapnic hyperventilation with cold air (IHCA) is a reliable technique for assessing indirect bronchial hyperresponsiveness in patients with asthma. Impedance measurement of the respiratory system by the forced pseudorandom noise oscillation technique is a sensitive technique to assess changes in bronchial tone after IHCA. The aim of this study was to evaluate the effect of 6 weeks of treatment with beclomethasone dipropionate, 1,000 microg x day-1, on IHCA in asthmatic patients, measured with both forced oscillation technique and flow-volume recordings. Forty patients with mild asthma were included in this double-blind, placebo-controlled parallel-group study. Stratification on the basis of sex was performed to overcome differences in airway diameter. At entry and every 2 weeks during the treatment period, IHCA was performed and patient diaries were evaluated. Characteristic changes in forced ...
Introduction: Previous studies have published the correlation between myocardial perfusion SPECT (MP) during cold pressor test (CPT) and intracoronary acetylcholine and its usefulness as independent marker of endothelial dysfunction (ED). Objective: To analyze the incidence of positivization of MP exercise studies in the follow up of asymptomatic patients with moderate cardiovascular risk (CV) and ED detected by PF. Material and Methods: Of 301 patients of the PARADIGMA Registry (normal exercise MP SPECT and clinical probability < 20% of events at 10 years [moderate risk by Framingham index]) 55 had positive PF (+) (18.3%). Prospectively and consecutively, 15 asymptomatic patients with PF (+), and a control group (CG) of 15 patients with negative PF, with paired sex, age and coronary risk factors (CRF), that accomplished a 12 #+-# 2 months follow up, and that underwent a new ...
Purpose: To determine the value of MRI in the postoperativ evaluation of a singular ventricle compared to echocardiography and cardiac catheterization. Materials and methods: Thirty-one patients (range: 6 months to 30 years) with a functional single ventricle following palliative corrective operations. Five patients had a Blalock-Taussig-Shunt, 8 patients a Glenn-Anastomosis and 18 a cavopulmonary shunt (6 with classic Fontan-Circulation, 12 with modified cavopulmonary anastomosis). The results in terms of postoperative morphologic changes were compared to percutaneous echocardiography (31/31) and cardiac catheterization (6/31). Results: Echocardiography, which was performed on all patients, could not visualize the entire length of the tunnel, the Glenn-Anastomosis or the central pulmonary arteries in 70% of the patients due to an inadequate acoustic window. MRI was able to show the ...
The current role of magnetic resonance imaging (MRI) in different organ systems is discussed and compared to nuclear medicine and to other available clinical diagnostic modalities. The value of optimizing radiofrequency pulse sequence selection to provide additional tissue characterization is also described. The results of nuclear medicine and MRI studies in 56 patients are compared to evaluate the clinical diagnostic contribution of each imaging modality for various pathological processes. In addition, the state-of-the-art MRI systems and future development in MRI technology with its potential contribution is defined.
Purpose: To determine the value of MRI in the preoperative evaluation of chronic paranasal sinusitis and to compare the results with CT and intraoperative findings. Method/Materials: 42 patients with clinical signs of chronic paranasal sinusitis underwent MRI after CT evaluation on one day, with subsequent functional endoscopic sinus surgery on the next day. Coronary CT was obtained with 5-mm slices and table-feed in the prone position, while MRI was performed in the supine position with coronary T_2-TSE+pd and coronary and transverse HASTE, each with 5-mm slice thickness. Aquisition time in MRI was less than 8 minutes. Two radiologists reviewed the CT and MRI scans for signs of sinusitis and detection of anatomical landmarks. The results were correlated with the intraoperative findings. Results: MRI offered no artifacts of dental work and showed more often high quality pictures than CT. CT and MRI demonstrated a good ...
Magnetic resonance (MR) imaging was performed in 26 patients with Ewing's sarcoma of bone preceding and following neoadjuvant chemotherapy, to assess tumour response non-invasively prior to surgery. T1- and T2-weighted spin echo images were obtained. Changes including intra- and extramedullary signal intensities, tumour demarcation, tumour volume and the appearance of residual extramedullary tumour were compared with histophathology of the resected specimens. Reduction of tumour volume was significantly higher in good responders. Other single parameters did not correlated with histologic tumour response. However, when several MR parameters summarized in a classification system were combined, a positive correlation with histopathologic response was found. A limited decrease of tumour volume (<25 %) and/or residual soft tissue mass following chemotherapy correlated with a poor response. An ...
Bone formation and resorption have been measured in patients with idiopathic osteoporosis by histomorphometry of 7.5-mm trephine biopsies and in the whole body by 85Sr radiotracer methodology and calcium balances. The studies were synchronized and most were preceded by double in vivo tetracycline labeling. Correlations between histological and kinetic bone formation indices were better when better when based on the extent of double tetracycline labels than on measurements of osteoid by visible light microscopy. Correction of the kinetic data for long-term exchange, using 5 months' serial whole body counting of retained 85Sr, improved the fit of the kinetic to the histological data. A statistical analysis of the measurement uncertainties showed that the residual scatter in the best correlations (between exchange-corrected bone formation rates and double-labeled osteoid surface indices) could be attributed to ...
The main purpose of this work is to evaluate the role of CT in identifying other morphological signs of met static lymph node involvement from non small cell bronchogenic carcinoma. This is done to improve N staging, a critical step in this disease. In fact, since diameter is the only criterion used to distinguish normal form abnormal lymph nodes, mediastinal CT only has 80% diagnostic accuracy. 137 patients with known or suspected lung cancer were examined with Helical CT during early and late arterial phases (2 min. delay, 3 mm thickness, 5 mm inter slice gap) to depict node characteristics. Mediastinal lymph nodes, located according to the American Thoracic Society mapping, were considered normal when they were not visible or, if visible, less than 1 cm in diameter and of homogeneous density; lymph nodes over 1 cm in diameter and homogenous density were considered reactive. A lymph node was considered metastatic when, independent of size, the following signs ...
Purpose: We present an update analysis of the multiinstitutional Ewing's sarcoma study CESS 86. Methods and Materials: From January 1986 through June 1991, 177 patients with localized Ewing's sarcoma of bone, aged 25 years or less, were recruited. Chemotherapy consisted of four 9-week courses of vincristine, actinomycin D, cyclophosphamide, and adriamycin (VACA) in low-risk tumors (extremity tumors =# 100 cm"3). Local therapy was an individual decision in each patient and was either radical surgery (amputation, wide resection) or resection plus postoperative irradiation with 45 Gy or definitive radiotherapy with 60 Gy (45 Gy plus boost). Irradiated patients were randomized concerning the type of fractionation in either conventional fractionation (once daily 1.8-2.0 Gy, break of chemotherapy) or hyperfractionated split-course irradiation simultaneously with the VACA/VAIA chemotherapy (twice daily 1.6 Gy, break of 12 days ...
To evaluate the efficacy of percutaneous transluminal angioplasty (PTA) and stent insertion in central venous steno-occlusion. Between August 1992 and January 1998, 11 patients with symptomatic central venous steno-occlusion (six stenoses and five occlusions) underwent pereutaneous treatment. Eleven PTAs were performed and stents were introduced in two patients because of incomplete PTA. During follow-up, a total of eight revisions were performed in five patients with recurrence (six stenoses and two occlusions). Success and long term patency rates were evaluated. The length and degree of the lesion and degree of residual stenosis, as well as pressure gradient through the lesion and decrease of the gradient after PTA, were correlated with patency rates. Complications during the procedures and follow-up period were evaluated. The overall success rate was 89.5%;those of primary and revision intervention ...
The aim of this work was to develop several strategies and software-packages for the evaluation of in-vivo-data of the human brain, which were acquired with high-resolution 1H-MRSI at 1.5 and 3 T. Several studies involving phantoms, volunteers and patients were performed. Quality assurance studies were conducted in order to evaluate the reproducibility of the applied MR-techniques at both field strengths. A qualitative comparison-study between MRSI-data from a 1.5 T clinical MR-scanner and a 3 T research MR-scanner showed the advantages of the more advanced MRSI sequences and higher field strength (3 T). A study involving patients with primary brain tumours (gliomas) was performed in cooperation with the Department of Neurosurgery (University of Erlangen-Nuremberg). The methods developed in the course of this study, such as the integration of MRS-data into a stereotactic-system, the segmentation of metabolic maps and the ...
Eight of 100 normotensive children who had pyelonephritic scarring secondary to urinary infection and vesicoureteric reflux were found in an earlier study to have increased plasma renin activity (PRA). Because the risk of these patients becoming hypertensive is between 10% and 20% and because renin activity may play a part in the pathogenesis of the hypertension, PRA and blood pressure were studied in 98 of the original group after five years of follow up. Two patients could not be traced, and other factors that might influence blood pressure or PRA led us to exclude 13 others, 10 of whom were girls taking oral hormonal contraceptives. Increased PRA was found in 11 of the remaining 85 patients but not in five of the eight patients with increased PRA in the first study. Of eight children identified as hypertensive in the follow up study, only three had had increased PRA five years previously. In normal ...
The purpose of this study is to develop a geometrically accurate imaging protocol at 3 T magnetic resonance imaging (MRI) for stereotactic radiosurgery (SRS) treatment planning. In order to achieve this purpose, a methodology is developed to investigate the geometric accuracy and stability of 3 T MRI for SRS in phantom and patient evaluations. Forty patients were enrolled on a prospective clinical trial. After frame placement prior to SRS, each patient underwent 3 T MRI after 1.5 T MRI and CT. MR imaging protocols included a T1-weighted gradient echo sequence and a T2-weighted spin echo sequence. Phantom imaging was performed on 3 T prior to patient imaging using the same set-up and imaging protocols. Geometric accuracy in patients and phantoms yielded comparable results for external fiducial reference deviations and internal landmarks between 3 T and 1.5 T MRI (mean ?0.6 mm; ...
Involvement of the dopaminergic system has been suggested in patients suffering from attention deficit hyperactivity disorder (ADHD) since the symptoms can be successfully treated with methylphenidate, a potent blocker of the dopamine transporter (DAT). This study reports the findings on the status of the DAT in adults with ADHD before and after commencement of treatment with methylphenidate, as measured using [{sup 99m}Tc]TRODAT-1. Seventeen patients (seven males, ten females, aged 21-64 years, mean 38 years) were examined before and after the initiation of methylphenidate treatment (3 x 5 mg/day). All subjects were injected with 800 MBq [{sup 99m}Tc]TRODAT-1 and imaged 3 h p.i. Single-photon emission tomography (SPET) scans were acquired using a triple-headed gamma camera. For semi-quantitative evaluation of the DAT, transverse slices corrected for attenuation were used to calculate specific binding in the striatum, with the cerebellum used ...
A factor produced by plerocercoids of the tapeworm Spirometra mansonoides is similar to human growth hormone (hGH) in that it stimulates body growth, binds to hGH receptors, cross-reacts with anti-hGH antibodies, and has lactogenic and insulin-like activities. The purpose of this study was to determine whether plerocercoid growth factor (PGF) is similar to hGH in expressing diabetogenic activity in the genetically obese (ob/ob) mouse. To determine an effective dose for use in the obese mice, the ability of daily injections of PGF to stimulate growth of phenotypically normal mice of the same strain was assessed in a 10-day weight gain assay. Injections of PGF stimulated a dose-dependent weight gain (r = 0.83) and 25 ng eq/day of PGF stimulated a response not significantly different from that produced by 100 micrograms of bovine growth hormone/day. Diabetogenicity was assessed using fasting blood glucose and glucose tolerance tests in ...
Bariatric surgical procedures have become important therapeutic options for treatment of morbid obesity in both adults and adolescents co-morbidities of obesity such as glucose intolerance, type 2 diabetes (T2DM), metabolic syndrome, steatohepatitis, hyperlipidemia and cardiovascular disease. These co-morbidities of obesity have significant impacts on the overall quality of life of the individual and our society at large. Roux-en-Y gastric bypass (RYGB) and the relatively newer procedures of gastric banding (GB) and vertical sleeve gastrectomy (VSG) have proven to be efficacious in achieving rapid weight loss and reversing the comorbidities of obesity. Unfortunately, bariatric procedures are not without risks including micronutrient deficiency, failure to maintain lost weight, and mortality. Further, the resolution of T2DM has long been understood to precede weight loss, and this finding provides ...
Identification of factors that determine individual patient risk for recurrence and progression in superficial papillary carcinoma of the bladder is a subject of extensive research as it would be a major outcome in patient management. It has been well recognized that traditional prognostic markers as tumor grade and stage are not accurate enough in predicting biological behavior. A large number of markers have been investigated as potential prognostic factors and relatively few can help in predicting outcome. Material and Methods: Forty-nine cases undergoing complete transurethral resection for primary superficial papillary transitional cell carcinoma were subjected to clinicopathologic evaluation as well as immunohistochemical staining for p53, bcl-2, cytokeratin 20 and Ki-67. The CAS-200 image analyzer was used to estimate the Ki-67 labeling index. Results: Recurrence was observed in 19 cases (38.8%) and progression in 7 cases (14.3%) with a ...
Purpose: To determine if involved field radiation (IF) is equivalent to standard whole bone radiation (SF) in local tumor control; to establish patterns of failure following treatment; and to determine response, event free (EFS) and overall survival rates from multi-disciplinary therapy in Ewing's Sarcoma (ES). Materials and Methods: Between 1983 and 1988, 184 children with ES were enrolled onto POG 8346. 178 (97%) met eligibility criteria; 6 had non-ES pathology. Induction treatment of Cyclophosphamide/Adriamycin (C/A) x 12 weeks was followed by local treatment either surgery or radiation therapy (XRT) and C/A, Dactinomycin and Vincristine for 50 weeks. Resection was advised for patients with small primary tumors if accomplished without functional loss. 40 patients were randomized to receive SF, whole bone XRT to 39.6 Gy plus a 16.2 Gy boost (total 55.8 Gy) or IF to 55.8 Gy while 84 were assigned to IF XRT. Results: Of 179 eligible ...
The purpose of this study was to correlate histopathological with CT findings in patients suffering from hepatocellular carcinoma (HCC) eligible for orthotopic liver transplantation (OLT), with a special focus on the antitumoral effect of transarterial chemoembolization (TACE) therapy. A total of 42 consecutive patients suffering from HCC had been treated prior to OLT by means of TACE. TACE was carried out with a mixture of Lipiodol (10-20 ml) and mitomycin C (max. dosage, 10 mg). TACE was performed at 6- to 8-week intervals. Follow-up investigation included contrast-enhanced multislice CT controls and laboratory control. Liver explants were evaluated macroscopically and microscopically to determine the number and size of the tumor lesions as well as the degree of tumor necrosis. Necrosis was investigated in H and E-stained sections. The degree of necrosis was classified as follows: 0-25%, 26-50%, 51-75%, 75-99%, and ...
The results of 144 previously untreated cases of primary Ewing's sarcoma of bone are reported with a minimum follow-up of 5 years. This series was treated between 1972 and 1982 at Istituto Ortopedico Rizzoli with a combined therapy. The local control of the disease consisted of amputation (ten cases), resection followed by radiation therapy (35-45 Gy) (48 cases) and radiation therapy alone (40-60 Gy) (86 cases). Adjuvant chemotherapy, rigorously standardized, was performed according two different protocols: the first (85 cases treated in the period 1972-1978) consisted of vincristine (VCR) Adriamycin (doxorubicin) (ADM), and cyclophosphamide (EDX); the second (59 cases treated in the period 1979-1982) of VCR, ADM, EDX and dactinomycin (DACT). At a follow-up of 5 to 16 years (median, 9), 59 patients (41%) are continuously disease-free (CDF), 81 (56%) developed metastatic disease and/or local recurrence, and four (3%) had a second malignancy. Three factors seem to be ...
Purpose: To clarify the characteristics of meningioma scintigraphy with multiple brain imaging agents and to evaluate their roles in diagnosis of meningiomas. Methods: Blood flow, "9"9"mTc-ECD, "9"9"mTc-DTPA, and/or "9"9"mTc-MIBI brain imagings were performed in 21 patients with meningiomas (3 malignant, 18 benign) proved by surgery and pathology. CT/MRI examinations were also made within one month. Characteristics of meningioma images were analyzed and uptake ratios were calculated. Results: In 16 of 20 patients, increased radioactivity during the arterial phase in the blood flow image was seen. Concave round or oval defects with smooth contour in the cerebral cortex were observed in 17 of 19 patients with "9"9"mTc-ECD, depression of frontoparietal cortex was found in one case and no abnormality in the other. A homogeneous accumulation of radioactivity in area corresponding to the defect in "9"9"mTc-ECD image was found in ...
Abstract Aims: The aim of this study was to examine whether metabolic syndrome (MS) is associated with periodontitis in a representative sample of Korean adults, who were involved in the Fourth Korea National Health and Nutrition Examination Survey (KNHANES). Materials and Methods: A total of 7178 subjects over the age of 19 years who participated in KNHANES were examined. MS was defined as the definition proposed by the National Cholesterol Education Program Adult Treatment Panel III and the abdominal obesity cut-off line based on Korean Society for the Study of Obesity. The periodontal status was assessed by the Community Periodontal Index. Multivariate logistic regression analysis was carried out adjusting for the sociodemographics, oral health behaviours and status, and health behaviou...
Inhibition of adipogenesis and lipid accumulation has a very crucial role to prevent obesity. Low molecular weight (LMW) chitosan is known to inhibit fat accumulation and adipogenesis. (N,O)-sulfated chitosan is a sulfation derivative of chitosan oligomers, and its anti-obesity effect is not yet reported. In this study, it has been reported that (N,O)-sulfated chitosan significantly decreased lipid accumulation, an indicator for adipogenesis, in differentiating 3T3-L1 preadipocyte cells. Furthermore, mRNA expressions and protein levels of key adipogenic markers such as peroxisome prolifetor-activated receptor (PPAR)-@c and CCAAT-enhancer binding protein (C/EBP)-@a were considerably decreased by (N,O)-sulfated chitosan treatment. As a consequence, sulfation of LMWC remarkably increased its ...
Objectives Our purpose was to evaluate interaction of green tea consumption and abdominal obesity as related factors for lacunar infarction in Korean women. Designs A hospital-based, incident case-control study. Settings The Prevention and Managements of Stroke in Women study. Participants Cases (n=233) of first incident lacunar infarction were enrolled and matched by age to stroke-free hospital controls (n=204). Measurements The data were collected through face-to-face interviews by well trained research assistants to assess demographic, medical, lifestyle, marital status, religions status, green tea consumptions, family history of stroke, smoking status, alcohol consumption, meat and vegetable intake frequency, and past history of hypertension. Biochemical analysis, fasting blood specime...
Apelin is a peptide known as the ligand of the G-protein-coupled receptor APJ. Several active apelin forms exist such as apelin-36, apelin-17, apelin-13, and the pyroglutamated form of apelin-13. Apelin and APJ are expressed in the central nervous system, particularly in the hypothalamus and in many peripheral tissues. Apelin has been shown to be involved in the regulation of cardiovascular and fluid homeostasis, food intake, cell proliferation, and angiogenesis. In addition to be an ubiquitous peptide, apelin is also produced and secreted by adipocytes and thus considered as an adipokine. This has opened a new field of investigation establishing a link between apelin and metabolic disorders (obesity, type 2 diabetes, etc.) which is the focus of the present review. Several studies, but not...
In this article is reviewed the role of Computed Tomography (CT) in thoracic complications following ortho topic liver transplantation (OLT). In a post-OLT population of 567 patients transplanted in the Italian institutions, 100 patients (17.6%) were examined with chest CT. It was reviewed data relative to the total number of examinations, clinical and/or radiographic indications, the CT technique-i.e., conventional (with (out) intravenous, i.v., contrast material) or high-resolution (HRCT). It also reviewed the radiologic patterns and their correlation with the other clinical, bronchoscopic and/or laboratory results. Of 152 chest CT examinations, 45 (29.6%) were performed because of clinical indications, 31 (20.4%) because of a radiographic abnormality, 64 (42.1%) because of clinical and radiographic abnormality, 64 (42.1%) because of clinical and radiographic indications, while in 12 cases (7.9%) the reasons were unknown; ...
Aim: The purpose of this prospective study was to evaluate the value of immunoscintigraphy (ISG) with anti-225.28S in clinically suspected ocular melanoma. Methods: For this purpose standardized ISG was performed in 36 patients using both planar acquisition and emission computed tomography (ECT). Ocular melanoma was present in 31 patients. In 21 patients therapy was enucleation of the eye. These specimens were evaluated by histology and immunohistochemistry in 11 of 21 patients. Results: Regarding the clinical diagnosis, ISG was positive only in 15 of 31 patients with ocular melanoma, regarding histology in 11 of 21 and regarding immunohistochemistry in 5 of 6 patients with a positive immunoreaction. 5 patients showed no immunoreactivity, their ISG was negative. Conclusion: Thus a good correlation between ISG and ...
[F-18]FDG PET brain imaging is an accurate predictor of primary brain tumor grading and prognosis. The purpose of this study was to evaluate simplified [F-18]FDG PET metabolic indices as indicators of proliferative activity of brain tumor cells. Twenty-five patients with glioma were studied with [F-18]FDG PET. From the tissue radioactivity ratios, following tumor metabolic indices were calculated: 1) the tumor-to-whole brain ratio (T/WB), 2) the ratio of tumor-to-contralateral gray matter at the level of centrum semiovale (T/GM), 3) the ratio of tumor-to-contralateral white matter at the level of centrum semiovale (T/WM), 4) the tumor-to-ipsilateral cerebella ratio (T/iCB) and 5) the tumor-to-contralateral cerebellar ratio (T/cCB). A standardized threshold method was used to define ROIs in the tumor areas having representative metabolic activites. Correlations of the tumor metabolic indices with histologic grade, Ki-67 labeling index (Ki-67 ...
The aim of this study was to evaluate typical magnetic resonance imaging (MRI) findings in early rheumatic diseases manifesting at the soft tissues of the hand using a retrospective analysis. A total of 186 MRI examinations of patients with clinical suspicion of a rheumatic disease were evaluated in a consensus reading by two experienced radiologists. All imaging patterns were assessed with respect to their type and localization. Under blinded and non-blinded conditions diagnoses were correlated with final clinical diagnosis. The most frequent diagnoses were rheumatoid arthritis (RA, 45.7%) and psoriatic arthritis (PsA, 15.6%). The mean correlation between clinical and MRI diagnosis (r) was 0.75 in blinded and 0.853 in non-blinded reading (p <0.001). The following extra-articular imaging patterns were found: synovitis (59.1%), tendovaginitis (91.4%), dactylitis (14.5%), and bone marrow edema (18.3%). Only dactylitis was ...
In cases of obstructive colorectal cancer (CRC), preoperative diagnosis of the proximal lesion is often difficult when the primary lesion impedes the passage of the endoscope. The aim of this study was to evaluate the usefulness of fluorine-18-fluorodeoxyglucose positron emission tomography (FDG-PET) in such cases. A total of 52 obstructive CRC patients who underwent preoperative FDG-PET and subsequent surgical resection were retrospectively reviewed. The correlation between characteristics of the proximal lesion and FDG-PET findings was analyzed statistically. There was a significant correlation between the proximal lesion size and the maximum standardized uptake value (P=0.00016). Abnormal FDG accumulation in the proximal colon indicated the existence of proximal cancer or adenoma with a sensitivity of 50% and a specificity of 100%. There was a significant difference in the distribution of tumor size between the cases ...
The urine test strip is the most common test used to detect ketones in veterinary patients, but it can underestimate the degree of ketonuria and hence, ketonemia. Additionally, adequate urine samples for analysis may be difficult to obtain from dehydrated animals. The standard method used to detect and monitor ketonemia in human medicine is measurement of serum or whole blood beta-hydroxybutyrate (?HOB). A point-of-care (POC) analyzer has been validated for this purpose in humans. This study compared the accuracy of the POC device to an enzymatic reaction laboratory method for measurement of ?HOB in dogs. Although the POC sensor tended to overestimate ?HOB concentrations, there was good correlation (R(2) = 0.96) and good agreement between the 2 methods with a bias +/- precision of 0.0860 +/- 0.3410 mmol/L ?HOB. The POC ?HOB sensor can be useful for assessing ketonemia in dogs. PMID:21119867
Background The crucial role of cigarette smoking in the development of pneumothorax is unclear because nonsmokers can also develop primary spontaneous pneumothorax. The purpose of this study was to clarify the pathophysiologic effects of cigarette smoking and its clinical correlations in primary spontaneous pneumothorax. Methods Included were 115 specimens of lung tissue from patients with primary spontaneous pneumothorax who underwent video-assisted thoracoscopic surgery from January 2001 to December 2002. We reviewed the clinical features of 56 smokers and 59 nonsmokers with an average follow-up of 67 months. The pathologic findings of resected lung specimens were analyzed retrospectively. Results There were no statistical differences in sex, age, body height, body weight, body mass inde...
Intervertebral disc (IVD) cell apoptosis has been suggested to play an important role in promoting the degeneration process. It has been demonstrated that IVD cell apoptosis occurs through either death receptor, mitochondrial or endoplasmic reticulum (ER) pathway. Our study aimed to explore the relationship among these three pathways and grade of IVD degeneration (IVDD). IVDs were collected from patients with lumbar fracture, vertebral tumor, disc herniation or spondylolisthesis. IVDs were distinguished by MRI and histomorphological examination, cell apoptosis was detected by TUNEL staining. Biomarkers of these three apoptosis pathways were detected by RT-PCR and Western blot. Furthermore, the correlation between apoptosis pathways biomarkers and disc pathology were analyzed. Nucleus pulpo...
High-level expression of mitotic arrest defective protein 2 (MAD2), a central component of the spindle assembly checkpoint, has been observed in a variety of human malignancies. Aim of the present study was to observe the expression of MAD2 in human non-small-cell lung cancer (NSCLC) and explore its clinicopathologic significance and evaluate MAD2 expression as a prognostic marker. MAD2 transcript was found to be overexpressed in the great majority of lung cancers by semi-quantitative RT-PCR. A total of 358 NSCLCs were analyzed immunohistochemically on tissue microarrays. High-level MAD2 expression was observed in 26.3% (94 of 358 cases), and correlated with male sex (P=0.0002), tumor progression (pT status) (P=0.0009), visceral or parietal pleural invasion (P=0.0151), non-adenocarcinoma, ...
Allogeneic stem-cell transplantation (SCT) is potentially curative therapy in AML by providing both dose-intensive chemo-radiotherapy and induction of graft-versus-leukemia (GvL) effect. Historically, more emphasis was given to the intensity of conditioning. Over the last decade the pendulum turned more towards induction of GvL as the primary goal. A plethora of non-myeloablative (NMA) and reduced-intensity conditioning regimens (RIC) were introduced trying to reduce transplant-related toxicities and allow SCT in elderly and medically infirm patients. In addition, reduced-toxicity myeloablative regimens (RTC) based on fludarabine and myeloablative alkylating-agent doses were designed to allow safer administration of dose-intensive therapy. Conditioning dose-intensity is highly correlated w...
Prepulse inhibition (PPI) is a measure of sensorimotor gating, a pre-attentional inhibitory brain mechanism that filters extraneous stimuli. Prepulse inhibition is correlated with measures of cognition and executive functioning, and is considered an endophenotype of schizophrenia and other psychiatric illnesses in which patients show PPI impairments. As a first step toward identifying genes that regulate PPI, we performed a quantitative trait locus (QTL) screen of PPI phenotypes in a panel of mouse chromosome substitution strains (CSSs). We identified five CSSs with altered PPI compared with the host C57BL/6J strain: CSS-4 exhibited decreased PPI, whereas CSS-10, -11, -16 and -Y exhibited higher PPI compared with C57BL/6J. These data indicate that A/J chromosomes 4, 10, 11, 16 and Y harbor...
Abstract Gaseous microemboli (GME) remain a challenge for cardiopulmonary bypass (CPB) because there is a positive correlation between microemboli exposure during CPB and postoperative neurological injury. Thus, minimizing the number of GME delivered to pediatric patients undergoing CPB procedures would lead to better clinical outcomes. In this study, we used a simulated CPB model to evaluate the effectiveness of capturing GME and the degree of membrane pressure drop for a new membrane oxygenator, Capiox Baby FX05 (Terumo Corporation, Tokyo, Japan), which has an integrated arterial filter with open and closed purge line. We used identical components in this study as our clinical CPB circuit. Three emboli detection and classification quantifier transducers were placed at prepump, preoxygena...
Twenty-six patients with late complications following femoral neck fracture were examined with both skeletal and bone marrow radionuclide scintimetry. There was no correlation between the methods with respect to the quantitative assessment of femoral head vascularity based on different uptake ratios comparing the fractured and the intact side. Skeletal scintimetry always had good image quality and permitted reliable differentation between nonunion of the fracture and late segmental collapse, in contrast to bone marrow scintimetry which gave poor image quality. Skeletal scintimetry thus seems superior to bone marrow scintimetry for assessment and differential diagnosis of late complications following femoral neck fracture. It is emphasized that the physiological mechanisms for radionuclide uptake must be taken into account when comparing scintimetric studies using different tracers.
Twenty-six patients with late complications following femoral neck fracture were examined with both skeletal and bone marrow radionuclide scintimetry. There was no correlation between the methods with respect to the quantitative assessment of femoral head vascularity based on different uptake ratios comparing the fractured and the intact side. Skeletal scintimetry always had good image quality and permitted reliable differentation between nonunion of the fracture and late segmental collapse, in contrast to bone marrow scintimetry which gave poor image quality. Skeletal scintimetry thus seems superior to bone marrow scintimetry for assessment and differential diagnosis of late complications following femoral neck fracture. It is emphasized that the physiological mechanisms for radionuclide uptake must be taken into account when comparing scintimetric studies using different tracers. (author).
The adverse effects and diagnostic accuracy of thallium-201 myocardial SPECT after intravenous infusion of adenosine triphosphate (ATP) were studied and compared with SPECT examinations with other type of loading. The subjects of the study were 147 patients with or without coronary artery disease, who underwent some type of loading SPECT and coronary arteriography (CAG) within 30 days. Myocardial ischemia was evaluated qualitatively in SPECT and was compared with CAG for the diagnostic accuracy of coronary artery disease. The degree of myocardial uptake defect was also calculated semiquantitatively using visual scoring method and compared with coronary artery severity score. The adverse effects occurred in 46.7% of ATP loading SPECT which was more frequent that DIP loading SPECT, but all of them were transient and mild. As for the diagnostic ability the ATP loading SPECT was as effective as other type of loading in qualitative interpretation, and the perfusion ...
This study aimed to reveal that severe disturbance of attachment relationship with primary care-giver can affect functional and anatomical brain development by measuring cerebral perfusion on "9"9"mTc-ECD brain SPECT and correlative MRI. We included 18 children aged 31 to 76 months who met the diagnostic criteria of RAD as defined in DSM-IV and ICD-10 and SSP and CARS. "9"9"mTc-ECD SPECT was performed using CERASPECT. MRI was performed in all patients. SPECT data were visually assessed. 15 of 18 children had abnormal perfusion on SPECT, revealing decreased perfusion of Lt.thalamus (7/15) and Rt.thalamus (3/15), and bilateral thalami (5/15). Perfusion of basal ganglia was decreased in 8 children. Decreased perfusion of Lt. parietal area was seen in 2. Whereas, all patients had normal MR findings. Perfusion abnormalities involving thalamus, BG in most children with RAD were found in this study. These results suggest that ...
60 patients between 17 and 72 years of age were investigated. First, an enteroclysis was performed in typical manner. The applicated methylcellulosis was blended with positive oral MR contrast media (Magnevist oral, Schering). After enteroclysis, MRI of the abdomen was performed using T1- and T2-weighted breathhold sequences (Flash 2D pre- and postcontrast and TSE) in axial and coronal planes. The length of the affected bowel and the stenosis seen with enteroclysis correlated well with the visible thickening of the small bowel wall and the stenosis seen in MRI. Using MRI, additional findings could be obtained in 28 patients, such as fistulas, abscesses or a hydronephrosis, or a better assessment of the stenosis was possible with MRI, because of the avoidance of overshadowing of the affected bowel loop with MRI. A brilliant MR-tomographic imaging of the small bowel is possible under the condition, that the small bowel ...
Many otolaryngologists perform septoplasty with or without turbinate surgery and the surgical method relies largely on the surgeon's clinical judgment. This study used computed tomography (CT) of the sinuses of 20 patients to examine the correlation between a unilateral deviated nasal septum and compensatory hypertrophy of the contralateral inferior turbinate to suggest guidelines for septal and turbinate surgery. The thickness of the mucosa and conchal bone, the projection angle of the conchal bone, and the distances between the conchal bone, and lateral nasal line and median line were measured. The volume of the inferior turbinate was measured from the three-dimensional reconstruction. Each measurement was compared with those of the nasal cavity on the contralateral and of normal control subjects. The inferior turbinate on the concave side had a significantly greater volume, including the thickness of medial mucosa and the thickness and ...
BackgroundAdipokines, e.g. TNFα, IL-6 and leptin increase insulin resistance, and consequent hyperinsulinaemia influences breast cancer progression. Beside its mitogenic...Full Text Available
Non-alcoholic fatty liver disease is a serious health problem linked to obesity and type 2 diabetes. To investigate the biological outcome and therapeutic potential of hepatic fatty acid uptake inhibition,...Full Text Available
Sida rhomboidea. Roxb leaf extract (SRLE) is being used by the populace of North-East India to alleviate symptoms of diabetes and obesity. We have previously reported its hypolipidemic and anti-diabetic properties. In this study, we report the effect of SRLE on (i) in vivo modulation of genes controlling high fat diet (HFD) induced obesity and (ii) in vitro 3T3L1 pre-adipocyte differentiation and leptin release. Supplementation with SRLE significantly prevented HFD induced increment in bodyweight, plasma lipids and leptin, visceral adiposity and adipocyte hypertrophy. Also, SRLE supplementation reduced food intake, down regulated PPAR?2, SREBP1c, FAS and LEP expressions and up-regulated CPT-1 in epididymal adipose tissue compared to obese mice. In vitro adipogenesis of 3T3L1 pre-adipocytes was significantly retarded in the presence of SRLE extract. Also decreased triglyceride accumulation, leptin release and ...
The CCAAT/enhancer-binding protein β (C/EBPβ) is required for adipocyte differentiation and maturation. We have studied the role of the transcription factor, C/EBPβ,...Full Text Available
Tea catechin is one of the compounds that are closely related to obesity and insulin sensitivity. In order to determine the effect of catechin on adipocyte differentiation, we treated 3T3-L1 preadipocytes...Full Text Available
Objective: To investigate the predictive value of ADC value in grading of neuroepithelial tumors. Methods: The clinical data and images of 70 patients with neuroepithelial tumors pathologically proven were collected and analyzed retrospectively. All the patients were classified into low (WHO I or II) and high (WHO III or IV) grade groups which included 40 and 30 cases respectively according to the 2007 WHO classification of tumours of the central nervous system. All the patients underwent plain and contrast-enhanced MR scan and DWI before surgery. The minimum ADC (MinADC) value was measured postoperatively on ADC maps. The Ki-67 labeling index (Ki-67 LI) of tumor tissue was determined by immunohistochemistry. MinADC values for two groups were analyzed using student t test, while the age and Ki-67 LI for the two groups was analyzed using Mann-Whitney test (P<0.05 considered to be significant). Also the MinADC value and ...
An increased compendium of drugs useful in ocular motor system dysfunction has expanded our capacity to treat selected ocular motility disorders. Adjunctive therapeutic modes (e.g., Fresnel prisms and orthoptic exercises) can also be beneficial. PAN and see-saw nystagmus can be treated with baclofen. Downbeat nystagmus may respond to clonazepam therapy, and prisms may help if the nystagmus can be modified with convergence. Congenital nystagmus may respond minimally to drugs (e.g., baclofen), but prisms or surgical procedures, or both, are still the primary treatment modalities. Innovar may be helpful in patients with severe, incapacitating vestibular disorders, and scopolamine alone or in combination with promethazine may be beneficial in patients with milder ambulatory acute peripheral vestibular disorders. Benign positional vertigo is best treated initially with positional exercises before drug therapy is instituted. Opsoclonus and ocular ...
OBJECTIVE: To evaluate the interobserver agreement of ultrasonographic assessment of finger and toe joints in patients with rheumatoid arthritis (RA) by 2 investigators with different medical backgrounds. METHODS: Ultrasonography and clinical examination were performed on 150 small joints of 30 patients with active RA. A General Electric LOGIQ 500 ultrasound unit with a 7-13-MHz linear array transducer was used. In each patient, 5 preselected small joints (second and third metacarpophalangeal, second proximal interphalangeal, first and second metatarsophalangeal) were examined independently on the same day by 2 ultrasound investigators (an experienced musculoskeletal radiologist and a rheumatologist with limited ultrasound training). Joint effusion, synovial thickening, bone erosions, and power Doppler signal were evaluated in accordance with an introduced 4-grade semiquantitative scoring system, on which the investigators ...
We investigated the efficacy of combined FDG-PET/CT imaging for the diagnosis of small-size uveal melanomas and the feasibility of combining separate, high-resolution (HR) FDG-PET with MRI for its improved localization and detection. Patients, methods: 3 patients with small-size uveal melanomas (0.2-1.5 ml) were imaged on a combined whole-body PET/CT, a HR brain-PET, and a 1.5 T MRI. Static, contrast-enhanced FDG-PET/CT imaging was performed of head and torso with CT contrast enhancement. HR PET imaging was performed in dynamic mode 0-180 min post-injection of FDG. MRI imaging was performed using a high-resolution small-loop-coil placed over the eye in question with T2-3D-TSE and T1-3D-SE with 18 ml Gd-contrast. Patients had their eyes shaded during the scans. Lesion visibility on high-resolution FDGPET images was graded for confidence: 1: none, 2: suggestive, 3: clear. Mean tumour activity was calculated for summed image ...
The vascular status of femoral heads in the post-traumatic period of intracapsular femoral neck fracture (ICFNF) remains uncertain until the patient actually develops avascular necrosis (AVN). Several methods for predicting the viability of femoral head have been reported, that are not effective or widely used because of unreliability, potential complications, and technical difficulties. The present study involved the use of Dynamic MRI (DMRI) in assessing femoral head vascularity to predict AVN. The role of DMRI was studied prospectively in 30 patients with 31 ICFNF. Fractures were divided in to three types (Type A, B, or C) based on the femoral head vascularity shown by dynamic curve patterns on MRI evaluation. Type A was preserved vascularity, Type B was some decrease in vascularity but still viable while Type C was significantly reduced vascularity. These were followed-up for 6 months to 2 years to observe the final outcome in terms of ...
Aim: To evaluate magnetic resonance cholangiography (MRC) with high-resolution dynamic gadolinium-enhanced magnetic resonance imaging (MRI) in determining the imaging features of hilar cholangiocarcinoma that relate to tumour extent and influence resectability. Materials and methods: Twenty-six patients that underwent resection were reviewed. Tumour location and extent, lobar atrophy, the degree of portal vein and hepatic artery involvement were recorded. The findings were correlated with surgical and histopathological findings. Results: Biliary assessment was concordant in 14 and discordant in eight of 14 stented and four of 12 non-stented patients. In 63/82 veins and 43/74 arteries results were fully concordant. The mean sensitivity, specificity, positive and negative predictive values (PPV, NPV) in predicting involvement of the main portal vein (MPV) at surgery were 83.3, 100, 100, and 92.5%; of the left main branch of ...
CT is the most accurate method to detect pulmonary emphysema in vivo. They compared prospectively two different methods for emphysema quantitation in 5 normal volunteers and 20 consecutive patients with chronic obstructive pulmonary disease (COPD). All subjects were submitted to function tests and HRCT; three scans were acquired at preselected levels during inspiration. The type and extent of pulmonary emphysema were defined by two independent observers under blind conditions. Disagreements were subsequently settled by consent. All subjects were also examined with expiratory spiral CT using a density mask program, at two different cut-off levels (-850,-900 HU). Visual score and expiratory spiral density mask values (-850 HU) were significantly correlated (r = 0.86), but the visual extent of emphysema was always higher than shown by expiratory spiral CT. The emphysema extent assessed with both CT methods correlated with the ...
CT is the most accurate method to detect pulmonary emphysema in vivo. They compared prospectively two different methods for emphysema quantitation in 5 normal volunteers and 20 consecutive patients with chronic obstructive pulmonary disease (COPD). All subjects were submitted to function tests and HRCT; three scans were acquired at preselected levels during inspiration. The type and extent of pulmonary emphysema were defined by two independent observers under blind conditions. Disagreements were subsequently settled by consent. All subjects were also examined with expiratory spiral CT using a density mask program, at two different cut-off levels (-850,-900 HU). Visual score and expiratory spiral density mask values (-850 HU) were significantly correlated (r = 0.86), but the visual extent of emphysema was always higher than shown by expiratory spiral CT. The emphysema extent assessed with both CT methods correlated with the ...
Objective: To compare the histopathology of nodular fasciitis (NF) with the magnetic resonance imaging (MRI) findings in order to evaluate the basis of the MR signal characteristics. Design and patients: Ten patients with NF, nine females and 1 male, with an age ranging from 13 to 58 years (mean 26.8 years) were studied. MRI findings, available in all 10 patients, were compared with the histopathology in nine patients, and an area-to-area comparative study of the whole specimen section histopathology and MRI was performed in two patients. Results: On the basis of an excisional biopsy or resection specimen, the nine lesions were classified into myxoid (n=4), cellular (n=3) and fibrous (n=2) subtypes. Four myxoid lesions with a subcutaneous location showed a homogeneous SI comparable with muscle on T1-weighted images, high SI on T2-weighted images, and had homogeneous enhancement. One ...
There is a lot of interest in the studies that would help to understand whether there is a casual association between cancer and various types of molecular or cytogenetic damage detected in human cells. One major oncogenesis process is activation of proto-oncogenes by point mutations or chromosomal translocation. There are substantial evidence that indicates that the loss of heterozygosity of certain chromosomes is involved in human cancerogenesis. Our study aimed to elicit the possible association between cancer and DNA and cytogenetic abnormalities induced in lymphocytes of people bearing various categories of skin cancer cells. Fresh blood was collected by venipuncture from 25 individuals (including nine prior to cancer treatment). All patients were nonsmoking males, however 42.3 % of them were former smokers. Blood samples were divided into two parts and in the first part of samples cytogenetic studies were performed immediately, while from the second part ...
Coronary angiography provides anatomical information whereas thellium myocardial scintigraphy measures resistive tissue perfusion. Because of this fundamental difference. The authors question the validity of using coronary angiography as the gold standard to judge thellium myocardial scintigraphy. The authors studied 20 patients undergoing elective percutaneous coronary angioplasty who fulfilled the following criteria: (1) history of chest pain; (2) angiographically significant single vessel disease (>50% stenosis); (3) no prior myocardial infarction. All patients underwent maximal exercise thallium single photon emission computed tomography (T1-SPECT). Tl-SPECT was scored visually according to a 0 to 3 scale (0=absent uptake; 1=markedly decreased uptake; 2=minimally decreased uptake; 3=normal uptake). Translesional gradient and percent stenosis were measured before and after angioplasty. The authors found that significant linear ...
Thallium-201 myocardial imaging was performed in 80 children with coronary arterial lesions due to Kawasaki disease in order to assess the value of serial and exercise myocardial imagings. In eight of these children, abnormalities of the image were noted. Twenty children had serial thallium studies with an interval of three to 18 months, and five of these showed changes in the image including appearance of a new perfusion defect in one patient and improvement of perfusion defects in four. These changes of the myocardial image were correlated well with coronary angiographic findings obtained within a few days of the isotope studies. It was noted that the changes of the myocardial image were more frequently observed at relatively recent period recovered from Kawasaki disease. Exercise myocardial imaging using a bicycle ergometer was performed in eight children with coronary arterial lesions. In three an evidence of improvement of the myocardial ...
In clinical applications, it is very important to accurately determine the range of a proton beam in a patient. Recently, a prototype prompt-gamma scanning system, called a prompt-gamma scanner (PGS), has been constructed at Hanyang University in Korea with the collaboration of the Korean national cancer center (NCC), based on a series of Monte Carlo simulations. The PGS system is composed of a prompt-gamma collimator, a CsI(Tl) scintillation detector, a multi-channel analyzer (MCA), a precision movement system, and an integrated readout system. The prompt-gamma collimator is designed to effectively shield high-energy neutrons from the proton beam passage and subsequent capture gammas. The PGS system can be used to scan the distribution of the prompt gammas in the patient from the proton beam passage. The distribution of the prompt gammas can then be used to determine the proton beam range or the distal dose edge in the ...
Mutations in the FGD1 gene have been shown to cause Aarskog-Scott syndrome (AAS), or facio-digito-genital dysplasia (OMIM#305400), an X-linked disorder characterized by distinctive genital and skeletal developmental abnormalities with a broad spectrum of clinical phenotypes. To date, 20 distinct mutations have been reported, but little phenotypic data are available on patients with molecularly confirmed AAS. In the present study, we report on our experience of screening for mutations in the FGD1 gene in a cohort of 60 European patients with a clinically suspected diagnosis of AAS. We identified nine novel mutations in 11 patients (detection rate of 18.33%), including three missense mutations (p.R402Q; p.S558W; p.K748E), four truncating mutations (p.Y530X; p.R656X; c.806delC; c.1620delC), one in-frame deletion (c.2020_2022delGAG) and the first reported splice site mutation (c.1935+3A>C). A recurrent mutation (p.R656X) was ...
Purpose: Liposarcoma is the most common soft tissue sarcoma in adults. The purpose of the study was to correlate MR imaging features with the four ICD subclasses. Methods: 28 patients with liposarcoma were examined preoperatively on a 1.0 T MRI system, using spin echo sequences, gradient echo imaging and STIR sequences. In all patients, classification of the liposarcomas was made by histologic diagnosis (ICD-10-M-classification). Results: Well differentiated liposarcomas (9 patients) showed a number of MRI features consistent with lipoma (well defined mass high signal intensity (SI) on T{sub 1} images, low signal on T{sub 2} images, no or only little signal increase of tumour tissue after contrast material application, no necrosis). Not well differentiated liposarcomas (myxoid 14 patients, pleomorphic three patients, round cell two patients) ...
A combination of sustained release (SR) naltrexone (32mg/day) and bupropion SR (360mg/day) plus behavioral counseling was evaluated for the treatment of smoking cessation and mitigation of nicotine withdrawal and weight gain. Thirty overweight or obese nicotine-dependent subjects were enrolled in a 24-week, open-label study; 85% and 63% completed 12 and 24weeks, respectively. The target quit date was Week 4. Week 4-12 continuous abstinence rate was 48%, 78% of subjects achieved CO 10ppm, serum cotinine decreased from 185 to 48mg/L, and tobacco use decreased from 129 to 14 cigarettes/week. Similar results were seen at Week 24. Body weight was essentially unchanged (Week 12: -0.1%; Week 24: +0.4%). Except for a transient significant increase 1week after the target quit date (p<0.05), nicotin...
The liver is a primary target of growth hormone (GH). GH signals are mediated by the transcription factor signal transducer and activator of transcription 5 (STAT5). Here, we focus on recent discoveries about the role of GH-STAT5 signaling in hepatic physiology and pathophysiology. We discuss roles of the GH-STAT5 axis in body growth, lipid metabolism, and the cell cycle pertaining to hepatosteatosis, fibrosis, and hepatocellular carcinoma. Finally, we discuss recent discoveries about the role of GH-STAT5 in sex-specific gene expression and bile acid, steroid, and drug metabolism.
Regular physical activity (PA) decreases the risk of several chronic diseases including some cancers, type II diabetes, obesity, and cardiovascular disease; however, the majority of US adults are not meeting the recommended levels to experience these benefits. To address this public health concern, the underlying mechanisms for behavior change need to be understood, translated and disseminated into appropriately tailored interventions. The Transtheoretical Model (TTM) provides a framework for both the conceptualization and the measurement of behavior change, as well as facilitating promotion strategies that are individualized and easily adapted. The purpose of this manuscript is to present the constructs of the TTM as they relate to PA behavior change. We begin with a brief synopsis of rec...
Now, more than ever, there are serious health concerns for obese and overweight children. Schools are the perfect setting for children to learn, and this influence can play an important role in preventing children from becoming obese and overweight. The study concerns the behaviors of Health Promoting School (HPS) according to a broad definition of HPS in World Health Organization (WHO), or dependent on schools own health promoting policies. The purpose of study research is to examine whether promoting physical activity among the children at schools in relation to a school health policy such as Food and Nutrition Policy (FNP). This was determined through the comparisons between the FNP based schools and non policy based schools. The study undertook surveys among school food coordinators in the selected Danish primary schools through a web-based questionnaire. The questions in the survey were more focused on physical activity in internal and ...
Full text: Radiotherapy treatment planning (RTP) relies heavily on medical imaging. Until recently, the most important planning tool was the treatment simulator. The kilovoltage radiographic capabilities in a treatment simulator enabled the boundaries of treatment fields to be visualized with respect to bony anatomic landmarks. Perhaps the most important advance in treatment planning in recent years is the ability to visualize the passage of the beams with respect to a more accurate geometrical representation of the tumor and other soft tissue structures. This 'virtual simulation' uses a computer-based representation of a patient to determine the extent of the disease and the location of radiation sensitive normal tissue. Computer tomographic (CT) imaging produces a high-resolution three-dimensional representation of anatomy that can be correlated with other image sets such as magnetic resonance images (MRI) of function. Positron emission ...
Basal cell carcinoma (BCC) is the most frequent cutaneous neoplasm, with a generally favorable clinical behavior. Sometimes, indeed, it recurs after therapy and/or metastasizes. As point mutations in the coding sequence of the p53 tumor suppressor gene have been implicated in the progression of many human tumors, we studied the expression of p53 protein on this neoplasia. We tested immunohistochemically the positivity for p53 protein (NCL-p53-CM1, YLEM) on 19 cases of morphologically "non aggressive" BCC (BCC1) and on 19 "aggressive" BCC (BCC2), all with one or more relapses and 3 with distant metastases also. Results were related to clinico-pathological and follow-up data. All but one BCC2 were found positive for p53 protein. Conversely, only 2 cases of BCC1 exhibited low immunoreactivity for p53 protein, with high statistical differences between the two groups. No correlation was found between the immunoreactivity, age of patients, and site ...
Subjects were 18 cases with adenocarcinoma of 20 mm or less in diameter, which were detected and resected surgically from September, 1993 to August, 1998. On these cases, thin-Section CT (TSCT) images were compared with pathological findings. Patients were 15 men and 3 women, with mean age of 63.4-year-old. An average tumor size was 11.5 mm (5-17 mm). According to pathological classification of Noguchi, type A as in 6 cases, type B in 3, type C in 7 and type F in 2. TSCT was carried by vas voltage =150 kVp, vas current =200 mA, beam width =2 mm, WW =2000 HU, and WL =-700 HU. The ratio of CT attenuation value in cancer by TSCT correlated with the ratio of aeration rate in the pathologic specimen. The cases of 30% or less on the ratio of CT attenuation value were 100% in types A and B, and 71% in type C. These results suggested that it is necessary to devide into two type in group of type C and the ratio of CT attenuation value is important on ...
Quantitative gated SPECT (QGS) was evaluated in 7 normal volunteers and 31 patients with cardiac diseases. Adequate cut off value of a prefilter was 0.45. In phantom, the left ventricular volume value was 93.9% of determined value by 180-degree projection in L type and 98.8% by 360-degree projection in opposed type. In normal volunteers, LVEF measured by QGS program related to value by first pass method. As for functional map, regional EF and wall motion decreased at the septum side, and wall thickening at base side of heart. Good correlation was recognized (p<0.0001) between blood flow image and functional map (regional EF and wall thickening). In 20 cases of acute myocardial infarction, lesion was detected conspicuously in regional EF and wall motion. The accuracy of coronary arterial stenosis improved in functional map (regional EF 92%, wall motion 92% and wall thickening 88%). In particular, the accuracy of 3 rami lesion was 100% in ...
SummaryA laboratory-based surveillance study was conducted from January 2007 to May 2010 in San Martino Tertiary Referral Hospital in Genoa, Italy in which the molecular epidemiology of multidrug-resistant Acinetobacter baumannii was investigated in the five intensive care units (ICUs). A total of 53 A. baumannii strains were isolated from patients admitted to ICUs (69.8%) and to other epidemiologically linked hospital wards (30.2%) and were genotyped by repetitive extragenic palindromic polymerase chain reaction (REP-PCR), multilocus sequence typing (MLST) and adeB sequence typing. REP-PCR fingerprinting analysis, MLST and adeB typing results were well correlated and allowed us to classify strains causing epidemic events into three major epidemic clones: A (REP-I/ST4, adeB-STII genotype) ...
A new microdensitometry method for quantitative assessment of bone mineral content using Fuji computed radiography (FCR) was developed and the results were compared with those obtained by the conventional film-screen method. Using both methods, X-ray pictures of the 2nd metacarpal bone were taken with a reference aluminum step wedge in nine normal subjects and nine parameters representing the width and density of bone marrow and cortex were calculated in middle of the bone shaft. Interobserver reproducibility assessed for three parameters was significantly higher in the FCR method than the conventional one. The value of {Sigma}GS computed by the FCR method, that is equivalent to the net bone density of the transverse section of the shaft, showed higher correlation with the one obtained by computed tomography in comparison with the conventional method. In our FCR method, moreover, interobserver reproducibility and accuracy was improved by employing automatic ...
A new microdensitometry method for quantitative assessment of bone mineral content using Fuji computed radiography (FCR) was developed and the results were compared with those obtained by the conventional film-screen method. Using both methods, X-ray pictures of the 2nd metacarpal bone were taken with a reference aluminum step wedge in nine normal subjects and nine parameters representing the width and density of bone marrow and cortex were calculated in middle of the bone shaft. Interobserver reproducibility assessed for three parameters was significantly higher in the FCR method than the conventional one. The value of #SIGMA#GS computed by the FCR method, that is equivalent to the net bone density of the transverse section of the shaft, showed higher correlation with the one obtained by computed tomography in comparison with the conventional method. In our FCR method, moreover, interobserver reproducibility and accuracy was improved by employing automatic ...
We examined whether proton magnetic resonance spectroscopy (MRS) could provide accurate information on histological grade and cell proliferation in astrocytomas. We studied 23 patients with astrocytomas: five grade II, 10 grade III and eight with grade IV (glioblastoma multiforme). We performed proton MRS and determined the Ki-67 labeling index (LI), a tumour proliferation marker, in the same areas of the astrocytomas, and examined the statistical relationship between proton MRS and Ki-67 LI. The N-acetylaspartate (NAA)/creatine-phosphocreatine (Cr) and NAA/choline (Cho)-containing compound ratios were always significantly lower and the Cho/Cr ratios significantly higher than those for normal brain. The Cho/Cr ratio correlated positively and the NAA/Cho ratio inversely with Ki-67 LI. These findings suggest that the Cho signal in proton MRS reflects cellular proliferation. In Kaplan-Meier survival analysis, there was no significant difference ...
For diagnosis of loosening or infection after implantation of a single-side or double-side total hip endoprosthesis 59 patients being in pain were investigated by a combination of bone scan (Technetium-99m DPD) and leucocyte scan (Indium-111 labelled leucocytes). The correlation between clinical results and scintigraphic findings revealed: bone scintigraphy detects loosening of prostheses with 95% sensitivity (45/47); bone scintigraphy excludes an instable prosthesis with 89% specificity (3/27). 45% of the loosened prostheses revealed an infection (21/47): leucocyte scintigraphy could detect 17 correct positive. Three leucocyte scans of 53 prostheses without clinical signs of infection were false positive. Therefore, leucocyte scintigraphy had a sensitivity of 91% and a specificity of 94% for detecting infection. Bone scintigraphy can detect loosening of prostheses with 93% accuracy, Indium-111 labelled leucocyte scintigraphy can detect ...
Early diagnosis of hepatocellular carcinoma (hepatoma) along with surgical resection is the most appropriate therapeutic modality. For this purpose, there have been many reports concerning the diagnostic value of Lipiodol-CT scan. The authors selected 45 patients with hepatoma during the period of Feb.1986 to Jan. 1988 who received a conventional CT scan, hepatic angiography and a Lipiodol-CT scan. The results were as follows: 1. There was no statistical significant between serum AFP level and mass size, morphology and amount of necrosis. 2. Tumor necrosis was observed in a single massive and multinodular type when the tumor size exceeded 5 cm. 3. Pattern II on Lipiodol-CT, homogenous accumulation of Lipiodol except for the area of inner necrosis, was most frequently demonstrated, which means that a tumor mass with hypervascularity and increased blood flow will attract Lipiodol better. 4. Lipiodol-CT was superior to conventional CT in detecting small, daughter ...
We compared the values of the myocardial thickness and the left ventricle diameters measured with MRI and echocardiography. The ejection fraction was compared in MRI and ventriculography. 34 patients with different heart dysfunctions were examined with MRI (FISP 2D sequence). 26 of them were also studied by echocardiography and 20 by biplane cine-ventriculography. The enddiastolic thicknesses of the left ventricular postero-lateral wall and of the septum interventriculare were measured on short axis images. An ellipsoidal modell was used for volume calculation and ejection fraction. Correlation of MRI values of thickness and ejection fraction with echocardiographi and angiographi showed r>0,8. As known for 1.56 T Imagers, the myocardial thickness in MRI was underestimated compared to echocardiography (1.4 mm#+-#1.7). The ejection fraction was underevaluated compared to ventriculography (4.5%#+-#10.1). MRI (1.0 T) accurately measures ...
When postpartum cervical biopsy specimens were compared with biopsy specimens from nonpregnant women, they revealed a 12-fold decrease in mechanical strength, a 50% reduction in the concentrations of collagen and sulfated glycosaminoglycans, a 35% reduction in hyaluronic acid, an increase in collagen extractability, and a fivefold increase in collagenolytic activity. Primiparas with relatively high concentrations of collagen and hyaluronic acid had relatively long cervical dilatation times during established labor, suggesting a physiologic importance to these variables. This correlation was not found in multiparas, even though the mean values of the biochemical parameters tested were similar to those in primiparas. Second-trimester biopsy specimens taken from patients with cervical incompetence contained normal collagen concentrations, but relatively high collagen extractabilities and collagenolytic activities, exceeding normal postpartum ...
The authors describe the different types of postoperative carcinoma recurrences, as seen on CT examinations of the chest, in 38 patients who underwent different surgical procedures for bronchogenic carcinoma (12 pneumonectomies, 22 lobectomies, 2 segmentectomies, and 2 atypical resections). The recurrences were classified as follows: 1) recurrence in the bronchial stump; 2) limph node enlargement; 3) recurrence in the thoracic wall; 4) recurrence in the residual lobe; 5) pleural effusion; 6) nodule in the contralateral lung. The CT findings, Correlated with those from plain chest radiographs and clinical simptoms, indicate a higher incidence of recurrences in the hilar region, either in the bronchial stump or as node after total and subtotal resection are separately analyzed. While after pneumonectomy plain chest radiographs fail to demonstrate the recurrence in most cases, so that CT is nearly always mandatory, after subtotal resection the ...
Serum ferritin levels were measured in 72 normal subjects and in 214 cases with various diseases by an immunoradiometric assay. In normal subjects, the serum ferritin levels were 27-230 ng/ml. Elevated serum ferritins were observed in most cases with iron excess and acute hepatitis. Markedly elevated levels were found in the majority of cases with acute leukemia, malignant lymphoma, hepatoma, and pancreatic cancer. High ferritin levels were also found in other malignant diseases. However, the range overlapped broadly with that of nonmalignant diseases. The serum ferritin correlated significantly with serum iron in normals and in those with iron deficiency anemia. In most nonmalignant cases, the serum ferritin and iron levels distributed on a regression line obtained from levels in normals and those with iron deficiency anemia. However, 92% of the malignant cases showed a serum ferritin to iron ratio higher than that of normal subjects. The estimation of the serum ...
Purpose: To report the detection of con-compacted ventricular myocardium (NVCM) with MRI compared to echocardiography in 8 patients. Material and methods: Non-compaction of the ventricular myocardium is a congenital disorder characterized by an altered structure of the myocardial wall resulting from an intrauterine arrest in endomyocardial embryogenesis. The morphological findings consist of a prominent meshwork of multiple myocardial trabeculations and deep intertrabecular recesses, communicating with the left ventricular cavity. 8 consecutive patients (mean age 7.3 years) with clinical and echocardiographic signs of NCVM were examined by MRI (1.5 T, Vision, Siemens) in short axis and 2- and 4-chamber views, using T{sub 1}-weighted TSE and Cine-GRE in 6 patients and true FISP sequences in 2 patients. MRI and echocardiography were evaluated for visibility, signs of NCVM and involvement of myocardial ...
Purpose: Three-dimensional rotational angiography (3DRA) is a new technique based on a rotational angiographic acquisition able to display arterial vessels in a 3D rendering mode. The system was mainly developed for neuroradiological evaluations but preliminary extracranial experiences have also been reported. The aim of our work was to compare the results of three-dimensional angiography of the carotid arteries done with high-flow injection of contrast medium from the aortic arch with the results of selective angiography. Materials and methods: Twenty patients underwent digital angiography of the supra-aortic vessels in order to quantify a stenosis of the carotid bifurcations previously detected at Doppler Ultrasound. Examinations were performed with the Philips Integris Allura system provided with the rotational angiography (RA) tool connected to a workstation for three-dimensional reconstruction able to display vessels in a 3D fashion (Volume Rendering, Shaded ...
Dual energy X-ray absorptiometry (Hologic QDR-1000) was used to quantitatively analyze the diagnosis and prevention of osteoporosis. The peak bone mineral density (BMD) of the spine appeared in normal men in their twenties and in normal women in their thirties. There was acceleration of bone loss in the 50 to 60 year age bracket (premenopause and postmenopause) in normal women. On the contrary, the peak BMD of the femoral neck in normal men and women appeared in their twenties after which it decreased slightly with age. Comparison showed that the femoral neck BMD of normal women was lower than that of men throughout all ages. The fracture threshold, 0.756 g/cm[sup 2] for the spine, was obtained by scanning 73 females with spinal fractures, the mean BMDs for L2-L4 at the 90th percentile level were used as the fracture threshold. The fracture threshold of femoral neck fracture was the femoral proximal BMD of the 9th decile. Classification by the Public Welfare Silver Science ...
Purpose: To quantify left ventricular function derived from retrospectively ECG-gated multislice spiral CT (MSCT) data sets in comparison to MRI. Materials and Methods: In 16 patients (14 males, 2 females, mean age 56.8 #+-# 11.5 years), retrospectively ECG-gated MSCT angiography of the coronary arteries and breath-hold steady state free precession cine MRI were performed. From MSCT data-sets, 20 axial image series were reconstructed every 5% of the RR interval. Multiplanar images were reformatted in the short axis orientation from axial images. End-systolic and end-diastolic images were selected. From these images end-systolic volume (ESV), end-diastolic volume (EDV) and stroke volume (SV) as well as the ejection fraction (EF) and myocardial mass (MM) were determined using the Simpson's method and compared with MRI. Furthermore, image quality was assessed for both imaging modalities using a four point grading scale. Results: All parameters were found to have an ...
To investigate the pattern of normal white-matter maturation as demonstrated by high-field-strength MR imaging, 82 normal infants were examined using a 1.5-T unit with spin-echo T1-weighted and T2-weighted pulse sequences. The infants ranged in age from 4 days to 2 years. The scans were assessed for qualitative changes of white matter relative to gray matter and correlated with the patient's age in 14 anatomic areas of the brain. The MR images showed that changes of brain maturation occur in an orderly manner, commencing in the brain stem and progressing to the cerebellum and the cerebrum. Changes from brain myelination were seen earlier on T1-weighted images than on T2-weighted images, possibly because of T1 shortening by the components of the developing myelin sheaths. The later changes on the T2-weighted images correlated best with the development of myelination, as demonstrated by histochemical methods. T1-weighted ...
A computed tomography (CT) cut-off for differentiating neoplastic lesions (polyps/carcinoma) from normal colon in contrast-enhanced CT colonography (CTC) relating to the contrast phase and lesion size is determined. CT values of 64 colonic lesions (27 polyps <10 mm, 13 polyps {>=}10 mm, 24 carcinomas) were determined by region-of-interest (ROI) measurements in 38 patients who underwent contrast-enhanced CTC. In addition, the height (H) of the colonic lesions was measured in CT. CT values were also measured in the aorta (A), superior mesenteric vein (V) and colonic wall. The contrast phase was defined by xA + (1 - x)V using x as a weighting factor for describing the different contrast phases ranging from the pure arterial phase (x=1) over the intermediate phases (x=0.9-0.1) to the pure venous phase (x=0). The CT values of the lesions were correlated with their height (H), the different phases (xA + (1 - x)V) and the ratio [xA + (1 ...
Hyperglycemia frequently occurs with acute medical illness, especially among patients with cardiovascular disease, and has been linked to increased morbidity and mortality in critically ill patients....Full Text Available
We discuss some methods to quantitatively investigate the properties of correlation matrices. Correlation matrices play an important role in portfolio optimization and in several other quantitative descriptions of asset price dynamics in financial markets. Specifically, we discuss how to define and obtain hierarchical trees, correlation based trees and networks from a correlation matrix. The hierarchical clustering and other procedures performed on the correlation matrix to detect statistically reliable aspects of the correlation matrix are seen as filtering procedures of the correlation matrix. We also discuss a method to associate a hierarchically nested factor model to a hierarchical tree obtained from a correlation matrix. The information retained in filtering procedures and its stability with respect to statistical ...
In this work a study of simulation of the gamma graphic studies that are carried out in human esophagus in the Dept. of Nuclear Medicine of the 'Celestino Hernandez Robau Hospital of Santa Clara is presented. For the investigation tubular reactors were used and sting-response techniques with radioactive tracer of Technetium 99 metastable to a concentration of 1 mCi and several flows were applied. The distribution curves of residences times were obtained, those that respond to an equation of the type: Y = A + B exp (- exp((x-C)/D)) - ((x-C/D)+1). They were also carried out, optimizations studies of the doses of the radioactive to give to the patients from 1 mCi (that is the one used in studies) up to 0,5 mCi, and the influences on the obtained distributions of residence time were analyzed. It was confirmed the possibility to lower the doses with clear information of the signal. It was also carried out a simulation of the attenuation of the radiations that ...
The purpose of this study was to examine the day-to-day reproducibility and single measurement reliability of peak force, time to half peak force and rate of force development indices of knee extension neuromuscular performance in patients with end-stage renal failure. Eleven self-selected patients (6 men, 5 women) receiving maintenance dialysis (dialysis history 67 +/- 42.8 month) completed 3 inter-day assessment sessions. Each comprised a standardized warm-up and 3 intermittent static maximal voluntary actions of the knee extensors of the preferred limb (45 degrees knee flexion angle [0 degrees = full knee extension]) using a specially-constructed dynamometer. Repeated measures ANOVA of coefficient of variation scores revealed significant differences between indices in their reproducibility across day-to-day trials. Post-hoc comparisons of group mean scores suggested that peak force (6.6 +/- 3.0%) offers significantly greater measurement ...
A retrospective review was made of 2,659 autopsy patients obtained during the past 31 years and a half in Hiroshima Atomic Bomb Hospital. Of the patients, 1,328 (49.9%) were A-bomb survivors. Five hundred and six A-bomb survivors (38.1%) had been exposed at up to 2,000 m from the hypocenter. There was no correlation between the incidence of malignancy and the presence of exposure to A-bombing. The incidence of multiple malignancy was slightly higher in A-bomb survivors exposed at the place nearer the hypocenter. In the group of A-bomb survivors, cancer of the lung was the most common for men; and cancer of the stomach was the most common for women. The incidence of malignancy has been high in the exposed group during the early eras of examination; however, this figure has recently become high in the non-exposed group. Regarding the kinds of malignancy, there was no significant difference between the exposed and non-exposed ...
To compare the accuracy of MR imaging using an endorectal-pelvic and a pelvic phased-array coil for preoperative local staging of rectal carcinoma. To determine preoperative staging, 38 patients with rectal carcinoma underwent MR imaging. All patients were examined with both an endorectal-pelvic and a pelvic phased-array coil. All underwent surgery and staging was pathologically confirmed. Two radiologists blinded to pathologic stage analyzed perirectal invasion and perirectal node metastasis, and scored according to a four-point scale. Radiologic and pathologic findings were correlated. Receiver operating characteristic (ROC) analysis of Wilcoxon statistic (W values) was used to compare diagnostic accuracy between the two different MR methods. Interobserver variation was measured using {kappa} statistics. For perirectal invasion, T1WI endorectal-pelvic phased-array coil images (reader 1:0. 854, reader 2:0.818) showed ...
The proton beam has a unique advantage over the electron and photon beams in that it can give very high radiation dose to the tumor volume, while effectively sparing the neighboring healthy tissue and organs. For the clinical application of the proton beam, it is very important to confirm the location of the proton beam in the patient, preferentially during the treatment. It has been suggested that the range of the proton beam in the patient can be determined by measuring prompt gammas from the proton beam passage. Recently, a prototype prompt-gamma scanning system has been constructed and tested using experimental and therapeutic proton beams. The measurement results for the proton beams of 70 . 230 MeV showed that a clear correlation exists between the distribution of the prompt gammas and the proton beam range. The scanning method, however, is not suitable for the upcoming 'spot scanning' technique. The ...
INTRODUCTION. We searched for a pathophysiologically based feature of major water electrolytes, which may define water quality better than the water hardness, respecting urinary calculus formation. MATERIALS AND METHODS. Utilizing a multistage stratified sampling, 2310 patients were diagnosed in the imaging centers of the provincial capitals in Iran between 2007 and 2008. These were composed of 1755 patients who were settled residents of 24 provincial capitals. Data on the regional drinking water composition, obtained from an accredited registry, and their relationships with the region's incidence of urinary calculi were evaluated by metaregression models. The stone risk index (defined as the ratio of calcium to magnesium-bicarbonate product in drinking water) was used to assess the risk of calculus formation. RESULTS. No correlation was found between the urinary calculus incidence and the amount of calcium, bicarbonate, or ...
Purpose: Hormonal stimulation can induce background enhancement (BE) in MR mammography (MRM). This fact has been assumed to decrease the accuracy of MRM. Consequently, this report investigates: 1. The prevalence of BE in postmenopausal vs. premenopausal women in correlation to hormonal cycle phase (CP). 2. The impact of hormonal status (HS) and BE on diagnostic accuracy. Materials and Methods: Consecutive patients over 22 months with complete HS information (week of CP or postmenopausal) were included in this prospective investigation. Exclusion criteria were any hormonal therapy, hysterectomy as well as cancer proven by biopsy. The standard of reference was histopathology. All MRM scans were acquired using the same protocol (1.5 T, dynamic T 1w GRE after 0.1 mmol/kg bw Gd-DTPA i. v.). Two radiologists rated all examinations in consensus according to BI-RADS. BE was defined as: 0 = missing, 1 = moderate, 2 = distinct. Results: 224 ...
The purpose of this study is to investigate the role of femoral marrow MR imaging as predictor of outcome for hemopoietic stem cell transplantation (HSCT) in beta-thalassemia major. MR imaging of the proximal femur, including T1- and T2-weighted spin echo and short-tau inversion recovery and in-phase and out-of-phase fast field echo images, was prospectively performed in 27 thalassemia major patients being prepared for HSCT. The area of red marrow and its percentage of the proximal femur were measured, and the presence of marrow hemosiderosis was assessed. Age-adjusted multivariate logistic regression was used to determine the relationship between red marrow area percentage and marrow hemosiderosis and HSCT outcome. Red area percentage were less in patients with successful (90.25{+-}4.14%) compared to unsuccessful transplants (94.54% {+-}2.93%; p=0.01). Red marrow area percentage correlated positively with duration of ...
No prospective studies have evaluated the effects of correction of iron deficiency anemia on insulin resistance in non-diabetic premenopausal women with iron deficiency anemia. All patients were treated with oral iron preparations. Insulin resistance was calculated with the Homeostasis Model Assessment formula. All patients were dichotomized by the median for age and BMI to assess how the relationship between iron deficiency anemia and insulin resistance was affected by the age and BMI. Although the fasting glucose levels did not change meaningfully, statistically significant decreases were found in fasting insulin levels following anemia treatment both in the younger age (<40 years) (P=0.40) women and in the low BMI (27 kg/m) (P=0.22) subgroups but not in the older age (>= 40 years) and the high BMI (>-27Kg/m) subgroups. Post-treatment fasting insulin levels were positively correlated both with BMI (r=0.386, ...
Intracapsular femoral neck fractures remain unsolved fractures even after improvement in techniques of diagnosis and internal fixation. Individuals who sustain displaced femoral neck fractures are at high risk of developing avascular necrosis and non-union. Although several methods for predicting the viability of femoral head have been reported, they are not effective or widely used because of unreliability, potential complications and technical difficulties. Dynamic MRI was introduced in the recent past as a simple, non-invasive technique to predict the femoral head viability after the femoral neck fractures. In this study role of dynamic MRI was studied in 30 patients with 31 intracapsular femoral neck fractures. Fractures were divided in to three types according to dynamic curve patterns on MRI evaluation and were followed up for 6 months to 2 years to observe the final outcome. Sensitivity, Specificity and the Accuracy of dynamic MRI in predicting vascularity ...
Intracapsular femoral neck fractures remain unsolved fractures even after improvement in techniques of diagnosis and internal fixation. Individuals who sustain displaced femoral neck fractures are at high risk of developing avascular necrosis and non-union. Although several methods for predicting the viability of femoral head have been reported, they are not effective or widely used because of unreliability, potential complications and technical difficulties. Dynamic MRI was introduced in the recent past as a simple, non-invasive technique to predict the femoral head viability after the femoral neck fractures. In this study role of dynamic MRI was studied in 30 patients with 31 intracapsular femoral neck fractures. Fractures were divided in to three types according to dynamic curve patterns on MRI evaluation and were followed up for 6 months to 2 years to observe the final outcome. Sensitivity, Specificity and the Accuracy of dynamic MRI in predicting vascularity ...
Purpose: With intracranial tumors a flat, contrast-enhancing, probably dural structure adjacent to the tumor can occasionally be observed on gadolinium-DTPA enhanced MR images. Therefore we have attempted to evaluate a tumor infiltration of this enthancement on MRI. Material and Methods: This study included 50 patients. 19 patients had a dural thickening at the tumor base (13 meningiomas and 6 metastases), while 31 patients did not (12 meningiomas and 19 metastases). Studies included plane T{sub 2}-weighted spin echo (SE) images as well as T{sub 1}-weighted axial, coronal, or sagittal plains with and without contrast agent. Histopathological examinations, were done on the tumor base adjacent to the dura mater. Results: 7 of 12 meningiomas showed a meningeal thickening on MRI with histopathologically proven tumor infiltration as did also 5 of 6 metastases. But 3 of 12 meningiomas and 15 of 19 metastases without dural ...
ObjectiveTo identify patient-care practices related to an increased prevalence of hepatitis C virus (HCV) infection among chronic hemodialysis patients.Full Text Available
Carcinoma in situ in the contralateral testis was diagnosed in 27 of 500 patients (5.4%) with unilateral testicular germ cell cancer. Eight of the 27 patients received intensive chemotherapy for spread...Full Text Available
Rectus sheath hematomas are a frequent but sometimes misdiagnosed disease in patients under anticoagulative drugs, hemodialysis, or simply in the elderly. The most frequent localization is in the lower part of the abdomen: the explanation lies in the anatomy of the abdominal wall, especially in the arcuate line of the rectus sheath. Aim of this work is to explain the reason of the almost constant location correlating the anatomy with the CT features. The rectus abdominis muscle lies between the aponeuroses of the transverse and oblique muscles which form the so called rectus sheath. This arrangement is found from the costal arch to a level approximately between the umbilicus and the pubic symphisis, where the rear layer of the rectus sheath ends with a curved edge, called the arcuate or semicircular line of Douglas. Beneath this line the aponeuroses of the three muscles pass in front of the rectus which is separated from the peritoneum only by ...
ObjectiveWe sought to determine the clinical outcomes of patients undergoing surgical aortic valve replacement with hemodynamically confirmed severe pulmonary hypertension and aortic stenosis and compare them with the outcomes of patients not undergoing aortic valve replacement and patients undergoing aortic valve replacement with mild-to-moderate pulmonary hypertension. MethodsA total of 317 patients with severe aortic stenosis (aortic valve area 35 mm Hg) was present in 81 patients, of whom 35 (43.2%) underwent surgical aortic valve replacement. We compared the clinical outcomes of these 35 patients with the 46 patient...
The main purpose of this work is to evaluate the role of CT in identifying other morphological signs of met static lymph node involvement from non small cell bronchogenic carcinoma. This is done to improve N staging, a critical step in this disease. In fact, since diameter is the only criterion used to distinguish normal form abnormal lymph nodes, mediastinal CT only has 80% diagnostic accuracy. 137 patients with known or suspected lung cancer were examined with Helical CT during early and late arterial phases (2 min. delay, 3 mm thickness, 5 mm inter slice gap) to depict node characteristics. Mediastinal lymph nodes, located according to the American Thoracic Society mapping, were considered normal when they were not visible or, if visible, less than 1 cm in diameter and of homogeneous density; lymph nodes over 1 cm in diameter and homogenous density were considered reactive. A lymph node was considered metastatic when, independent of size, the following signs ...
Werner states are paradigmatic examples of quantum states and play an innovative role in quantum information theory. In investigating the correlating capability of Werner states, we find the curious phenomenon that quantum correlations, as quantified by the entanglement of formation, may exceed the total correlations, as measured by the quantum mutual information. Consequently, though the entanglement of formation is so widely used in quantifying entanglement, it cannot be interpreted as a consistent measure of quantum correlations per se if we accept the folklore that total correlations are measured (or rather upper bounded) by the quantum mutual information.
This study reports the outcome of real-time ultrasonographic screening tests of a healthy population. The study group consisted of 33 female teachers who were found to have asymptomatic gallstone disease. All cases were followed up to determine the incidence of biliary colic or complications. After a 38-month period of follow-up, seven subjects (21.2%) developed either biliary colic or complication. Study results revealed that the 38-month cumulative probability of the development of biliary colic or complication was 36%. Data shown that development of biliary colic or complications was positively associated with obesity, but no assocition was found with age, number of activities, or duration of contraceptive pill-taking. Having such a high percentage of subjects who developed biliary colic or complications within a relatively short period of time suggests that the silent gallstone is not innocent. PMID:17372404
A wide variety of phytochemicals present in our diet, including fruits, vegetables, and spices, have been shown to possess a broad range of health-beneficial properties. The cytoprotective and restorative effects of dietary phytochemicals are likely to result from the modulation of several distinct cellular signal transduction pathways. Many dietary phytochemicals that are synthesized as secondary metabolites function as toxins, that is, -phytoalexins,- and hence protect plants against insects and other damaging organisms and stresses. However, at the relatively low doses consumed by humans and other mammals, these same toxic plant-derived chemicals, as mild stressors, activate adaptive cellular response signaling, conferring stress resistance and other health benefits. This phenomenon has...
Kundur [Benincasa hispida (Thunb.) Cogn.], a member of the family Cucurbitaceae, is one of the famous crops that are grown primarily for its fruits and usually recognized with its nutritional and medicinal properties especially in Asian countries. Kundur fruit has been valued as a nutritious vegetable as it provides a good source for natural sugars, amino acids, organic acids, mineral elements and vitamins. A number of medicinal properties such as anti-diarrheal, anti-obesity, anti-ulcer, and antioxidant and diuretic have been ascribed to this fruit of high economic value. As a rich source of functionally important bioactives and therapeutics such as triterpenes, phenolics, sterols, and glycosides, the fruit has been widely used for the treatment of epilepsy, ulcer, and other nervous disor...
Keratinocyte growth factor receptor (KGFR) and fibroblast growth factor receptor (FGFR) 2c share identical amino acid sequences, except for a 46-amino acid domain in the extracellular region. Monoclonal antibodies (MAbs) specific to KGFR have not been reported nor are commercially available. In this study, we generated murine MAbs specific to KGFR in non-obese diabetic (NOD) mice using a modified Repeated Immunizations at Multiple Sites (RIMMS) technology. Stable cell lines expressing the full-length human KGFR or FGFR2c were produced to facilitate the identification of KGFR-specific MAbs. Following the initial screening of hybridoma clones with a fluorescence-based, confocal cell detection method and ELISA, KGFR-specific MAbs were selected and confirmed by flow cytometry and Western blot ...
Purpose: To assess the new method of 3-dimensional echocardiography in comparison to the 'gold standard' MRI as to its ability to calculate left ventricular volumes in patients with congenital heart disease. Materials and methods: Eighteen patients between the ages of 3.9 to 37.3 years (mean: 12.8{+-}9.7) with a geometrically abnormal left ventricle were examined using a 1.5 T scanner with a fast gradient-echo sequence (TR=14 ms, TE=2.6-2.9 ms, FOV=300-400 mm, flip angle=20 , matrix=128:256, slice thickness=5 mm, retrospective gating) in multislice-multiphase technique. Transthoracic 3D-echocardiography was performed with a 3.5 MHz transducer and a Tomtec {sup trademark} (Munich, Germany) system for 3D reconstruction. Results: Volume calculation was possible in all patients with 3D-echocardiography, but the muscle mass calculation only succeeded in 11 to 18 patients (61%) due to ...
The purpose of this work is to investigate whether any morphometric or densitometric are detectable in the kidneys of type 2 diabetic patients. 40 diabetic patients were examined and of 20 non-diabetics (the control group) were submitted to triphasic helical CT for different abdominal conditions. The type 2 diabetic patients were 23 men and 17 women, mean age 62 years, while the nondiabetic controls were 12 men and 8 women, mean age 58 years. All the CT images were analyzed using the Multiplanar Reconstruction (MPR) software. It was evaluated morphometric features, such as the presence of parenchymal or vascular calcifications, axial and coronal renal diameters, coronal renal area, and cortico medullary ratio, and densitometric and functional features, such as unenhanced renal density, cortical and medullary density in the arterial phase, parenchymal density in the nephrographic phase, and contrast elimination. It was also ...
Functional imaging of the pharynx used to be the domain of cineradiography, CT and ultrafast CT. The development of modern MRI techniques led to new access to functional disorders of the pharynx. The aim of this study was to implement a new MRI technique to examine oropharyngeal obstructive mechanisms in patients with obstructive sleep apnea (OSA). Sixteen patients suffering from OSA and 6 healthy volunteers were examined on a 1.5 T whole-body imager (`Vision`, Siemens, Erlangen Medical Engineering, Germany) using a circular polarized head coil. Imaging was performed with 2D flash sequences in midsagittal and axial planes. Patients and volunteers were asked to breathe normally through the nose and to simulate snoring and the Mueller maneuver during magnetic resonance imaging (MRI). Prior to MRI, all patients underwent an ear, nose and throat (ENT) examination, functional fiberoptic nasopharyngoscopy and ...
A correlation was developed for laminar film condensation on vertical fluted surfaces. The theoretical analysis of Panchal and Bell was used for defining important physical property groups. The experimental data of Combs et al. were used to validate the proposed correlation. The experimental database used in the present study included four flute geometries that could be approximated to cosine-type flutes and seven fluids. The resulting correlation can predict the average condensate heat transfer coefficient within {+-}20%.
Background and purpose: The low density of lung tissue causes a reduced attenuation of photons and an increased range of secondary electrons, which is inaccurately predicted by the algorithms incorporated in some commonly available treatment planning systems (TPSs). This study evaluates the differences in dose in normal lung tissue computed using a simple and a more correct algorithm. We also studied the consequences of these differences on the dose-effect relations for radiation-induced lung injury. Materials and methods: The treatment plans of 68 lung cancer patients initially produced in a TPS using a calculation model that incorporates the equivalent-pathlength (EPL) inhomogeneity-correction algorithm, were recalculated in a TPS with the convolution-superposition (CS) algorithm. The higher accuracy of the CS algorithm is well-established. Dose distributions in lung were compared using isodoses, dose-volume histograms (DVHs), the mean lung dose (MLD) and the ...
Purpose/Objective: At present, treatment verification between portal and reference images is performed based on manually-identified features by radiation oncologist, which is both time-consuming and potentially error-prone. There is a demand for the computerized verification procedure in clinical application. The purpose of this study is to develop a computerized portal verification scheme for pelvic treatment fields. Materials/Methods: The automated verification system involves image acquisition, image feature extraction, feature matching between reference and portal images and quantitative evaluation of patient setup. Electronic portal images with a matrix size of 256 x 256 and 12 bit gray levels were acquired using a liquid matrix electronic portal imaging device. Simulation images were acquired by digitizing simulation films using a TV camera into images with 256 x 256 matrix and 8 bit gray levels. Initially a Canny edge detector is applied to identify the ...
We explore the relationship between the hard X-ray photon index $\\Gamma$ and the Eddington ratio (\\xi=L_{X}(0.5-25 keV)/L_{Edd}) in six XRBs. We find that different XRBs follow different anti-correlations between $\\Gamma$ and $\\xi$ when $\\xi$ is less than a critical value, while they follow the same positive correlation when $\\xi$ is larger than the critical value. This anti-correlation and positive correlation are also found in LLAGNs and QSOs respectively, and the anti-correlation and positive correlation of different XRBs roughly converge to the same point ($\\log \\xi=-2.1, \\Gamma=1.5$), which may correspond to the accretion mode transition, since that the anti-correlation and positive correlation are consistent with the prediction of ADAFs and standard disk/corona system respectively. The traditional low/hard ...
The present paper dealt with the extension of tendon friction coefficient correlation as a function of loading end load and circumferential angle, proposed in the former paper. The extended correlation further included the effects of the number of strands contacted with sheath, tendon diameter, politicization of tendon and tendon local curvature. The validity of the correlation was confirmed by several published measured data. The structural analysis of middle cylinder part of 1/4 PCCV (Prestressed Concrete Containment Vessel) model was conducted using the present friction coefficient correlation. The results were compared with the analysis using constant friction coefficient, focused on the tendon tension force distribution. (author)
The individuality of production devices should be taken into account when statistical models are designed for parallelized devices. In the present work, a new clustering method, referred to as NC-spectral clustering, is proposed for discriminating the individuality of production devices. The key idea is to classify samples according to the differences of the correlation among measured variables, since the individuality of production devices is expressed by the correlation. In the proposed NC-spectral clustering, the nearest correlation (NC) method and spectral clustering are integrated. The NC method generates the weighted graph that expresses the correlation-based similarities between samples, and the constructed graph is partitioned by spectral clustering. A new statistical process monit...
60 patients between 17 and 72 years of age were investigated. First, an enteroclysis was performed in typical manner. The applicated methylcellulosis was blended with positive oral MR contrast media (Magnevist oral, Schering). After enteroclysis, MRI of the abdomen was performed using T1- and T2-weighted breathhold sequences (Flash 2D pre- and postcontrast and TSE) in axial and coronal planes. The length of the affected bowel and the stenosis seen with enteroclysis correlated well with the visible thickening of the small bowel wall and the stenosis seen in MRI. Using MRI, additional findings could be obtained in 28 patients, such as fistulas, abscesses or a hydronephrosis, or a better assessment of the stenosis was possible with MRI, because of the avoidance of overshadowing of the affected bowel loop with MRI. A brilliant MR-tomographic imaging of the small bowel is possible under the condition, that the small bowel ...
Materials and methods: 12 patients with 22 coronary bypass grafts underwent intraoperative flow quantification using the transit time ultrasound method. These values were compared to postoperative MR phase shift measurements. Flow measurements were performed preoperatively in 28 coronary arteries of 20 patients. For flow measurement, we used a velocity-encoded k-space segmented gradient echo sequence with a temporal resolution of 110 or 125 ms, respectively. 6-8 pase shift images could be acquired during one cardiac cycle. Results: There was a significant correlation between intraoperative and flow measurements using velocity-encoded MR imaging (r=0.76, p<0.0001, t-test). Flow volumes determined by MR imaging were systematically larger than those determined by the transit time ultrasound method. Mean flow in coronary arteries was reduced in severely stenosed vessels (>70%) compared to normal vessels. Intra- ...
Purpose: To determine the value of MRI in the preoperative evaluation of chronic paranasal sinusitis and to compare the results with CT and intraoperative findings. Method/Materials: 42 patients with clinical signs of chronic paranasal sinusitis underwent MRI after CT evaluation on one day, with subsequent functional endoscopic sinus surgery on the next day. Coronary CT was obtained with 5-mm slices and table-feed in the prone position, while MRI was performed in the supine position with coronary T{sub 2}-TSE+pd and coronary and transverse HASTE, each with 5-mm slice thickness. Aquisition time in MRI was less than 8 minutes. Two radiologists reviewed the CT and MRI scans for signs of sinusitis and detection of anatomical landmarks. The results were correlated with the intraoperative findings. Results: MRI offered no artifacts of dental work and showed more often high quality pictures than CT. CT and MRI demonstrated a good ...
Patients who fail to attend initial appointments reduce clinic efficiency. To maximize attendance by newly referred outpatients, we introduced a mandatory group orientation clinic for all new patients...Full Text Available
One hundred and fifty patients requiring maintenance haemodialysis were investigated to determine the incidence and pattern of tuberculosis. Twenty patients were found to have tuberculosis, giving an...Full Text Available
In a group of 32 patients with terminal renal failure the initial hypocalcaemia was corrected after two months' adequate maintenance haemodialysis. In seven patients hypercalcaemia occurred with a...Full Text Available
BackgroundPersonal health records (PHRs) provide patients with access to personal health information (PHI) and targeted education. The use of PHRs has the potential to improve a...Full Text Available
By analyzing the data of 459 patients who completed the Supportive Care Needs Survey (SCNS), the prevalence, medical and non-medical predictors of unmet needs were investigated. Breast cancer patients...Full Text Available
Background/Objective:Three patients with spinal cord injury (SCI) and 3 able-bodied (AB) patients were infused with naloxone during a study to examine their neuroendocrine...Full Text Available
Background:Encouragement of stroke patients to resume driving is important to promote their reintegration into the community. Limited rehabilitation has been performed in this regard,...Full Text Available
Using plasma glutathione S-transferase measurements hepatocellular integrity was assessed in groups of hyperthyroid and hypothyroid patients before and after treatment. Ten of 14 hyperthyroid patients...Full Text Available
OBJECTIVE: To evaluate prospectively the efficacy of a single fraction of high-dose radiotherapy in patients with Kaposi's sarcoma. PATIENTS: Between 1994 and 2004, 47 patients with Kaposi's sarcoma...Full Text Available
A patient’s electronic medical record contains a large amount of unstructured textual information. As patient records become increasingly dense owing to an aging population and increased occurrence...Full Text Available
BackgroundAcute kidney injury (AKI) is associated with increased short-term mortality of septic patients; however, the exact influence of AKI on long-term mortality in such patients...Full Text Available
Electronic personal health records (ePHRs) can potentially maximize access and coordination of health information and improve patient/clinician collaboration, patient self-management, and health outcomes....Full Text Available
OBJECTIVE: To assess the motor function of the left, supposedly unaffected, limbs of patients with an acute right vascular hemiplegia. METHODS: Fifteen patients with an acute vascular right hemiplegia...Full Text Available
The DNA sequences were determined for the lipoprotein lipase (LPL) gene from five unrelated Japanese patients with familial LPL deficiency. The results demonstrated that all five patients are homozygotes...Full Text Available
BackgroundDiagnostic delay in patients with tuberculosis (TB) leads to ongoing TB transmission, higher mortality rates and increased patient and government health expenditure. Qualitative...Full Text Available
Patients treated with bleomycin are at risk of developing the acute adult respiratory distress syndrome post-operatively. In a prospective study of 12 patients who had received bleomycin preoperatively...Full Text Available
BackgroundIn patients with Stage 5 Chronic Kidney Disease who require renal replacement therapy a major decision concerns modality choice. However, many patients defer the decision...Full Text Available
BackgroundCompared to healthy controls, cancer patients have a higher risk of unemployment, which has negative social and economic impacts on the patients and on society at large....Full Text Available
The performance of the Lung Imaging Fluorescence Endoscope (LIFE) system was compared with conventional bronchoscopy in 158 patients: 68 patients with invasive cancer, 42 patients with abnormal sputum...Full Text Available
In a combined clinical, radiological, and laboratory study of 77 patients throughout the leprosy spectrum, 10 patients had an enthesitis which has not been described previously as far as is known and...Full Text Available
Patients do considerable information work. Technologies that help patients manage health information so they can play active roles in their health-care, such as personal health records, provide...Full Text Available
BackgroundThe effects of intervention programs on health-related quality of life (HRQOL) of patients with hip fracture have not been well studied. We hypothesized that older patients...Full Text Available
The increased risk of thrombosis in patients with active cancer has multiple causes. Acute thrombosis of the aorta is an exceedingly rare but potentially devastating complication in patients with cancer...Full Text Available
BackgroundClassification systems may be useful to direct more aggressive treatment to cancer patients with a relatively poor prognosis. The definition of 'poor prognosis' often lacks...Full Text Available
Six patient assessment systems that have explicit decision rules for replicating team judgments on level of care patient placement were selected for analysis. The six were selected because of their...Full Text Available
S100A4, a member of the Ca(2+)-activated S100 protein family, regulates the motility and invasiveness of cancer cells. Moreover, high S100A4 expression levels correlate with poor patient survival in several cancers. Although biochemical, biophysical, and structural data indicate that S100A4 is a noncovalent dimer, it is unknown if two functional S100A4 monomers are required for the productive recognition of protein targets and the promotion of cell invasion. To address this question, we created covalently linked S100A4 dimers using a glycine rich flexible linker. The single-chain S100A4 (sc-S100A4) proteins exhibited wild-type affinities for calcium and nonmuscle myosin-IIA, retained the ability to regulate nonmuscle myosin-IIA assembly, and promoted tumor cell invasion when expressed in S100A4-deficient colon carcinoma cells. Mutation of the two calcium-binding EF-hands in one monomer, while leaving the other monomer intact, caused a ...
In a prospective study 102 patients with malignant tumors of the tongue, oropharynx, hypopharynx, and larynx were staged by means of MRI. Special attention was directed at those tumour extensions that could influence the treatment strategy. The MR findings were correlated with the results of palpation, endoscopy, ultrasound, computerised tomography and histopathological findings. MRI showed a good delineation of pT{sub 2} to pT{sub 4} tumours. However, visualisation of small tumours in the soft palate, the tonsils, the pyriform sinuses and vocal cords was difficult. In conclusion our results suggest that in addition to endoscopy MRI is a valuable tool for the examination of tumours of tongue, oropharynx, hypopharynx and larynx. (orig.) [Deutsch] In einer prospektiven Studie wurden 102 Patienten mit malignen Tumoren der Mundhoehle, des Oro- und Hypopharynx sowie des Larynx mit der Mgnetresonanztomographie (MRT) untersucht, wobei besonders Wert ...
Metal oxide semiconductor (MOS) integrated circuits, with the benefits of low power consumption, represent the state of the art technology for implantable medical devices. Three significant sources of radiation are classified as having the ability to damage or alter the behavior of implantable electronics; Secondary neutron cosmic radiation, alpha particle radiation from the device packaging and therapeutic doses(up to 70 G{gamma}) of high energy radiation used in radiation oncology. The effects of alpha particle radiation from the packaging may be eliminated by the use of polyimide or silicone rubber die coatings. The relatively low incidence of therapeutic radiation incident on an implantable device and the use of die coating leaves cosmic radiation induced secondary neutron single event upset (SEU) as the main pervasive ionising radiation threat to the reliability of implantable devices. A theoretical model which predicts the susceptibility of a RAM cell to secondary neutron cosmic ...
BackgroundXMRV (xenotropic murine leukemia virus-related virus) is the first known example of an exogenous gammaretrovirus that can infect humans. A limited number of reports suggest that XMRV is intrinsically resistant to many of the antiretroviral drugs used to treat HIV-1 infection, but is sensitive to a small subset of these inhibitors. In the present study, we used a novel marker transfer assay to directly compare the antiviral drug sensitivities of XMRV and HIV-1 under identical conditions in the same host cell type.ResultsWe extend the findings of previous studies by showing that, in addition to AZT and tenofovir, XMRV and HIV-1 are equally sensitive to AZddA (3'-azido-2',3'-dideoxyadenosine), AZddG (3'-azido-2',3'-dideoxyguanosine) and adefovir. These results indicate that specific 3'-azido or acyclic nucleoside analog inhibitors of HIV-1 reverse transcriptase (RT) also block XMRV infection with comparable efficacy in vitro. Our data confirm that XMRV is highly resistant to the ...
The usefulness of helical CT early phase images optimized by the SmartPrep method for evaluation of wall invasion by colorectal cancer was investigated. Between August 1997 and September 1998, CT was performed to evaluate the primary tumor and local extension in 10 consecutive patients with colorectal cancer confirmed by barium enema- and/or colonoscopy. Early-phase images were acquired by using SmartPrep application software. This method allows the optimal scan delay time to be obtained by continuous monitoring of increases in CT values after injection of contrast medium. Sections of the surgical specimens, close to the same plane as the CT images, and of the same slice thickness, were analyzed histopathologically. All 10 cancers, regardless of size, showed strong enhancement on the early-phase images (81.4-112 HU, mean: 95.1 HU). The strongly enhanced image areas on CT corresponded to the primary cancer areas on histopathological specimens. A low-density zone was ...
Retrospective analyses were performed to evaluate the therapeutic efficacy of intra-oral cone (IOC) radiation therapy for carcinoma of the oral tongue, especially about its faculty of local control and complications. Thirty-nine patients with squamous cell carcinoma of the oral tongue were treated with IOC radiation therapy alone or in combination with external irradiation. IOC radiation therapy was given not only for T1 and T2, but also for T3 tumors. Hypofractionation was used for IOC radiation therapy. The 2 year local control rates, including surgical salvage, for T1, T2, T3 and T4 were 100%, 73.3%, 40% and 0%, respectively. The 5 year actuarial survival rates for Stage I, II, III and IV were 100%, 65.3%, 35.4% and 0%, respectively. The incidences of radiation complications, i.e. soft tissue ulceration and osteoradionecrosis, were 42.9% and 2.9%, respectively. It is suggested that relatively high rate of soft tissue ulceration was due to hypofractionation. We ...
PURPOSE: Hepatocellular carcinoma (HCC) is a highly virulent malignancy with no effective treatment thus requiring innovative and effective targeted therapies. The oncogene Astrocyte elevated gene-1 (AEG-1) plays a seminal role in hepatocarcinogenesis and profoundly downregulates insulin-like growth factor binding protein-7 (IGFBP7). The present study focuses on analyzing potential tumor suppressor functions of IGFBP7 in HCC and the relevance of IGFBP7 downregulation in mediating AEG-1 function.EXPERIMENTAL DESIGN: IGFBP7 expression was detected by immunohistochemistry in HCC tissue microarray and real-time PCR and ELISA in human HCC cell lines. Dual Fluorescence in situ hybridization was performed to detect loss of heterozygosity at IGFBP7 locus. Stable IGFBP7-overexpressing clones were established in the background of AEG-1-overexpressing human HCC cells and were analyzed for in vitro proliferation and senescence and in vivo tumorigenesis and angiogenesis.RESULTS: IGFBP7 expression ...
ObjectiveHIV and type 2 diabetes are known risk factors for albuminuria, but no previous reports have characterized albuminuria in HIV-infected patients with diabetes.Research Design and MethodsWe performed a cross-sectional study including 73 HIV-infected adults with type 2 diabetes, 82 HIV-infected non-diabetics, and 61 diabetic control subjects without HIV. Serum creatinine >1.5 mg/dL was exclusionary. Albuminuria was defined as urinary albumin/creatinine ratio >30 mg/g.ResultsThe prevalence of albuminuria was significantly increased among HIV-infected diabetics (34% vs. 13% of HIV non-diabetic vs. 16% diabetic control, p?=?0.005). HIV status and diabetes remained significant predictors of albuminuria after adjusting for age, race, BMI, and blood pressure. Albumin/creatinine ratio correlated significantly with HIV viral load (r?=?0.28, p?=?0.0005) and HIV-infected subjects with albuminuria had significantly greater cumulative exposure ...
Accurate lung tumor tracking in real time is a keystone to image-guided radiotherapy of lung cancers. Existing lung tumor tracking approaches can be roughly grouped into three categories: (1) deriving tumor position from external surrogates; (2) tracking implanted fiducial markers fluoroscopically or electromagnetically; (3) fluoroscopically tracking lung tumor without implanted fiducial markers. The first approach suffers from insufficient accuracy, while the second may not be widely accepted due to the risk of pneumothorax. Previous studies in fluoroscopic markerless tracking are mainly based on template matching methods, which may fail when the tumor boundary is unclear in fluoroscopic images. In this paper we propose a novel markerless tumor tracking algorithm, which employs the correlation between the tumor position and surrogate anatomic features in the image. The positions of the surrogate features are not directly tracked; instead, we use principal ...
This study presents the data of an evaluation of the automated Nuclisens easyMAG and EasyQ systems versus the Roche AmpliPrep-AMPLICOR combination for testing of high-volume human immunodeficiency virus (HIV) load. This represents a follow-up of a previous study investigating the performance of the real-time Nuclisens assay using the semiautomated NucliSENS miniMAG extraction procedure. Three hundred eighteen patient samples were analyzed using both methods. The easyMAG-EasyQ HIV type 1 system has a higher sensitivity and broader dynamic range than the Cobas AmpliPrep-AMPLICOR system when the standard Roche assay is used alone, 25 to 3,000,000 IU/ml versus 400 to 750,000 HIV RNA copies/ml, respectively. There was significant correlation between the assays (0.93; P < 0.0001), with good accuracy (percent similarity mean ? = 96%), good precision (percent similarity standard deviation = 4.97%), and overall good agreement with a low percent ...
Faced with increasing indications for the use of iodine-131 labelled lipiodol in the treatment of hepatocellular carcinoma (HCC), it appears essential to develop an individualized dosimetrY so we can predict the potential effectiveness of this treatment and adjust the activity to be injected. We developed a dosimetric protocol based on imagery and dedicated to calculation of the tumoral dose during the treatment of hepatocellular carcinoma by iodine-131 labelled lipiodol. This concept was developed on a SPECT- CT gantry, and integrates corrections for the phenomena of attenuation, diffusion and dead time. The dose is calculated according to the formalism proposed by the Medical Internal Radiation Dose Committee (MIRD). This protocol was applied to a series of 41 patients in the framework of a retrospective study. The results obtained in terms of biodistribution are compatible with previously published data. The total biological response rate is 42% (n= 41) for the ...
Autoreactive cytotoxic CD8 T-cells (CTLs) play a key pathogenic role in the destruction of insulin-producing beta-cells resulting in type 1 diabetes. However, knowledge regarding their targets is limited, restricting the ability to monitor the course of the disease and immune interventions. In a multi-step discovery process to identify novel CTL epitopes in human preproinsulin (PPI), PPI was digested with purified human proteasomes, and resulting COOH-fragments aligned with algorithm-predicted HLA-binding peptides to yield nine potential HLA-A1, -A2, -A3 or -B7-restricted candidates. An UV-exchange method allowed the generation of a repertoire of multimers including low-affinity HLA-binding peptides. These were labeled with quantum dot-fluorochromes and encoded in a combinatorial fashion, allowing parallel and sensitive detection of specific, low-avidity T-cells. Significantly increased frequencies of T-cells against four novel PPI epitopes (PPI(4-13)/B7, PPI(29-38)/A2, PPI(76-84)/A3 ...
Objective: To retrospectively evaluate the results of conservative therapy using escorpal iodine-125 (model 6711, Amershan) plaque for brachytherapy of choroidal melanoma. Materials And Methods: We evaluated 49 patients with choroidal melanoma treated at 'Hospital do Cancer', Sao Paulo, Brazil, from March 2001 to January 2003. The following clinical parameters were analyzed and correlated with local control and survival rate: gender, age, lesion dimension, treatment duration, as well as doses in apex and base of the tumors. Results: The maximum diameter and height of the base of the tumors treated were 17 mm and 12 mm, respectively. Doses at those points ranged from 213 to 463 Gy (median: 347 Gy) and 51 to 250 Gy (median: 91 Gy), respectively. The actuarial rates of ocular preservation, disease free survival and ocular preservation in 2-years were 96%, 93.5% and 96.3%, respectively. A tumor height < 6 mm was the only ...
Optional multiple long-axial gated blood pool SPECT images were prepared for the purpose of stereoscopic and quantitative imaging of left ventricular wall motion (LVWM). Sixteen patients with ischemic heart disease and 8 healthy subjects were imaged in 32 views in the 360 degrees position after iv injection of 740 MBq of Tc-99m-labeled human serum albumin D. The R-R interval was divided into 16. After preparing conventional oblique images, long-axial images were prepared. Shortening rate of left ventricular wall was calculated in 5 segments of the apex and base of the left ventricle. An average shortening rate in each segment was graded with a score from a minimum of 0 to a maximum of 40% or more. In the normal group, shortening rate in each segment, except for the base of the septal region, exceeded 40%. In the group of ischemic heart disease, radial shortening was capable of visualizing the degree and extent of the whole LVWM abnormality. LVWM abnormality seen on ...
We aim to examine the spectrum of bacteria causing corneal infections and their antibiotic susceptibility patterns. This will serve as a guideline for empiric therapy of corneal infections. We conducted the study over a period of 18 months from March 2001 through December 2002 in King Abdul-Aziz University Hospital, Riyadh, Kingdom of Saudi Arabia. Corneal specimens taken from 200 patients were inoculated directly onto different types of media. The isolates were identified and then tested against the appropriate topical or systemic antibiotics. Sixty-seven (33.5%) of the total specimens were culture positive and 133 (66.5%) were culture negative. Fourteen (7%) of these showed organisms in the Gram stained smears and correlated well with the culture reports. Of the 67 positive cultures, 53 (79.1%) were Gram-positive bacteria mostly coagulase-negative Staphylococci 29 (43.3%) followed by Streptococcus pneumoniae (S. pneumoniae) 13 (19.4%). Among ...
Forty-three patients with basal and squamous cell carcinomata arising on the pinna were treated radically using a 10 MeV electron beam. The technique and dosage are described and discussed. Primary cancer control with retention of the pinna was achieved in 34 patients. Salvage pinnectomy was performed in four patients for recurrence and one patient for radiation necrosis. Two patients with large primary tumours failed to resolve and died of their disease. The advantages for the patient of the policy of primary radical electron beam therapy are discussed.
Forty-one patients were treated with epidural neurolysis using 50 % ethyl alcohol 2 ml. Thirty eight patients were suffering from cancer pain and three patients were complaining of chronic benign pain. Alcohol block was repeated 2.3 times (mean) in the same patient. Thirty patients were followed after the treatment. Forty-seven percent of the patients reported 70 % or greater pain relief and 20 % of the patients reported about 50 % pain relief. Duration of pain relief was from 9 days to 203 days with a mean duration of 54 days. Adverse effects were reported 43 % of the patients. There is no miserable adverse effect. Adverse effect reported most was pain with epidural injection of drugs after the alcohol block had been performed. PMID:8544293
BackgroundApproximately 25% of ischemic stroke patients awaken with neurological deficits. In these patients, in whom the time from symptom onset is uncertain, brain imaging is a...Full Text Available
A patient with Cushing's syndrome due to a nonresectable chromophobe adenoma underwent external irradiation of the hypothalamic-pituitary area. The signs of Cushing's syndrome ameliorated subsequently...Full Text Available
Although clinic environments are a primary location for exchanging information with clinicians, patients experience these spaces as harsh environments to access, use, exchange, and manage information....Full Text Available
The ultrastructure of conjunctival melanocytic lesions in 49 patients was evaluated to find significant differences between benign and malignant cells. The patients studied included 9 with benign epithelial...Full Text Available
Although the life expectancy of thalassemia patients has markedly improved over the last few decades, patients still suffer from many complications of this congenital disease. The presence of a high...Full Text Available
ObjectivesTo determine the content and extent, design, and relative importance of patient assessment courses in the professional pharmacy curriculum.MethodsA...Full Text Available
We describe the successful creation of a transjugular intrahepatic portosystemic shunt (TIPS) in a patient with complete situs inversus using a simple modification of the standard TIPS technique.
BackgroundProvision of consumer information and patient education are considered an essential part of chronic disease management programmes developed for patients with heart failure....Full Text Available
PurposeTo identify the extent of persistence (period of time of continuous therapy with the drug prescribed) of glaucoma patients treated with prostaglandins (latanoprost, bimatoprost,...Full Text Available
Two experiments used the McGill Pain Questionnaire (MPQ) to examine the affective dimension of pain in patients whose pain was secondary to malignancy. In experiment I, segregating groups of cancer patients on the basis of extreme scores (high versus low) on the MPQ failed to produce segregation on independent measures of affect and infirmity. This outcome contrasts with earlier work with chronic benign pain patients. Experiment II compared cancer pain patients matched with benign pain patients on intensity of pain report on the affective dimension of the MPQ. Cancer pain patients reported a reliably higher affective loading to their pain. These data suggest that cancer pain patients employ different criteria than benign pain patients in selecting affective pain descriptors. Possible explanations for this difference are ...
The Model for the Assessment of Psychosocial Problems (MAPP) can help family medicine residents effectively assess patients with psychosocial problems. Following a patient-centred clinical method, MAPP...Full Text Available
Direct radiological measurements of the mineral content of femoral bone were performed in 13 patients on maintenance dialysis. They were found to be sufficiently sensitive to be used for monitoring,...Full Text Available
A group of patients is described who developed the clinical features of foveomacular retinitis. No causative factors were isolated, and all patients strongly denied any type of sun gazing. It is possible...Full Text Available
Purpose:To report crystal formation as a complication of intravitreal ganciclovir injection.Patients and methods:A 73-year-old female patient with...Full Text Available
This exploratory research paper investigated the coping strategies of families of hospitalized psychiatric patients and identified their positive and negative coping strategies. In this paper, the coping...Full Text Available
The purpose of this study was to investigate the extent of consumer demand for patient-oriented pharmacy services. Data, collected via a self-administered questionnaire distributed to 300 households,...Full Text Available
The evaluation of hepatic histology and treatment of hepatitis C virus (HCV)/HIV-coinfected patients is rapidly changing. HCV has become an important cause of mortality in HIV-infected patients. Consequently, assessment of liver histology in all coinfected patients is particularly important. The evaluation of hepatic histology is shifting from reliance on the liver biopsy toward noninvasive modalities. Additionally, the importance of HCV-associated morbidity and mortality in HIV-infected patients has prompted increasing numbers of these patients to be HCV treatment candidates. Prospective trials in coinfected patients have reported lower sustained virologic responses compared to HCV-monoinfected patients. Consequently, the numbers of coinfected nonresponders to pegylated interferon/ribavir...
Background Increasing numbers of cancer patients are using the Internet, but little is known about their attitudes toward online health care.Full Text Available
Bone integrity and mineral status were studied with a noninvasive method in uremic patients with severe secondary hyperparathyroidism undergoing maintenance hemodialysis.
The Systems Development Group and the Pharmacy Service of the Washington D.C. VAMC are involved in automating the administrative and clinical data requirements of a satellite out-patient pharmacy....Full Text Available
Hypertension affects most hemodialysis patients and is often poorly controlled. Adequate control of blood pressure is difficult with conventional hemodialysis alone but is important to improve...Full Text Available
BackgroundAdnexal masses are not uncommon in patients with breast cancer. Breast cancer and ovarian malignancies are known to be associated. In patients with breast cancer and co-existing...Full Text Available
Multifractal detrended cross-correlation analysis (MF-DXA) has been developed to detect the long-range power-law cross-correlation of considered signals in the presence of non-stationarity. However, crossovers arising from extrinsic periodic trends make the scaling behavior difficult to analyze. We introduce a Fourier filtering method to eliminate the trend effects and systematically investigate the multifractal cross-correlation of simulated and real traffic signals. The crossover locations are found approximately corresponding to the periods of underlying trend. Traffic velocity on one road and flows on adjacent roads show strong cross-correlation. They also present weak multifractality after periodic trends are removed. The traffic velocity and flow are cross-correlated in opposite directions which is accordant to their actual evolution.
Purpose: To evaluate the significance of preoperative localization of abnormal parathyroid glands to the surgical outcome in patients with primary hyperparathyroidism. Material and Methods: Thirty-nine patients with primary hyperparathyroidism were studied preoperatively with US (39 patients), CT (30 patients) and MR imaging (18 patients). The overall diagnostic accuracy for US was 87%, CT 66% and MR 94%. In patients with a single parathyroid adenoma US was the most cost-effective localization technique with a detection rate of 96%. CT had a lower detection rate (78%) but was of particular value for fairly large ectopic adenomas in the root of the neck. MR imaging was a good confirmatory test (93%). In patients with multiple gland disease (primary hyperplasia and multiple adenomas), no single localization study alone was sufficient. ...
The role of MRT in the prebiopsy diagnosis of muscular and vascular inflammatory conditions was evaluated prospectively and an optimal method of examination was investigated. 92 patients with a suspected diagnosis of myositis (60 cases) or vasculitis (32 cases) were examined, in each case two extremities were studied using transverse T_1 and T_2 weighted SE sequences and double echo STIR sequences on a 0.5 Tesla (56 patients) or 1.5 Tesla magnet (36 patients; T5/S15 Gyroscan, Philips). The site of the biopsy depended on the MRT findings. In 41 patients the suspected diagnosis was confirmed histologically, in two patients an infective myositis was diagnosed on clinical grounds despite negative histology. MRT demonstrated muscle oedema in 86% of patients. There were negative findings after immuno-suppressive therapy (two patients), in focal ...
Therapeutic effect of p-aminobenzoic acid-N-xyloside Na (K-247) were studied. Eleven patients with a variety of solid tumors were treated with K-247 alone. K-247 was given orally 800 mg daily for 4 weeks. As for side effect of the drug, only mild gastritis was observed in a few patients. Partial response (over 25% reduction of tumor size) with a median duration of two months was observed in 3 patients. These cases were metastatic tumor of lung from the carcinoma of thyroid, metastatic tumors of lung from the carcinoma of kidney, and mediastinal tumor. In eight patients the response was classified as no change and in one patient there was progressive disease. Thus K-247 has some therapeutic activity in patients with solid tumor. Combination therapy of irradiation and administration of K-247 were also studied. In the twelve patients receiving ...
This report deals with the preliminary results of trials in the DATECA project with stage I, II and III patients with non-seminomatous germ cell tumours. Stage 1 patients were randomized between infradiaphragmatic irradiation and observation. No significant difference in recurrence rates has been observed as yet. Eighteen of 95 patients had recurrence with a median time to relapse of 3 months. Fifteen patients achieved complete remission after treatment by combination chemotherapy while 3 patients are still undergoing treatment. Stage II patients received 6 series of cis-platinum, bleomycin, and vinblastine. The patients were initially randomized to receive chemotherapy alone versus chemotherapy plus irradiation. Irradiation led to increased toxicity and decreased doses of the antineoplastic drugs. Fifty-one patients ...
This report deals with the preliminary results of trials in the DATECA project with stage I, II and III patients with non-seminomatous germ cell tumours. Stage 1 patients were randomized between infradiaphragmatic irradiation and observation. No significant difference in recurrence rates has been observed as yet. Eighteen of 95 patients had recurrence with a median time to relapse of 3 months. Fifteen patients achieved complete remission after treatment by combiantion chemotherapy while 3 patients are still undergoing treatment. Stage II patients received 6 series of cis-platinum, bleomycin, and vinblastine. The patients were initially randomized to receive chemotherapy alone versus chemotherapy plus irradiation. Irradiation led to increased toxicity and decreased doses of the antineoplastic drugs. Fifty-one patients ...
AbstractThis cohort study of 1302 persons aged ≥65 years, conducted in the Yoruba-speaking regions of Nigeria, determines the prevalence and correlates of hearing impairment (HI)...Full Text Available
The angular ..gamma gamma..-correlations for nuclei of Sr even-even isotopes with A=82, 84, 86, 88 were measured. Multipole structurs of ..gamma..-transtion series and th coefficients multipole mixing were determined.
The angular #gamma##gamma#-correlations for nuclei of Sr even-even isotopes with a=8 82, 84, 86, 88 were measured. Multipole structurs of #gamma#-transtion series and th coefficients multipole mixing were determined.
A series of 22 steady-state, rod bundle, dispersed flow film boiling experiments has been performed in the Thermal-Hydraulic Test Facility (THTF), a pressurized-water loop containing 64 full-length electrically heated rods. Test parameters in the upflow experiments cover a wide range of conditions typical of those which might be encountered during a nuclear reactor loss-of-coolant accident. Local equilibrium fluid conditions were calculated using mass and energy conservation considerations. Experimentally determined heat transfer coefficients were compared to several available film boiling heat transfer correlations: Dougall-Rohsenow, Groeneveld 5.7, Groeneveld-Delorme, Chen, Jones-Zuber, and Yoder-Rohsenow. The Groeneveld 5.7 correlation tended to predict the data better than any other correlation tested. The Dougall-Rohsenow correlation tends to overpredict the data while the Yoder-Rohsenow ...
ObjectiveLimited data is available to understand the prevalence and correlates of suicidal behavior among U.S. Latino subgroups. This paper compares the prevalence...Full Text Available
This study examines the results of bacterial culture from 159 endometrial biopsy samples from 97 commercial dairy cows and correlations between bacteriological and histological findings. Bacteria were...Full Text Available
Work continued on the correlations of catalytic activity of metals and surface structure. Work is described in the following areas: CO oxidation on a Cu/Rh(100) Bimetallic catalysts; electronic properties of bimetallic surfaces; and reflection absorption spectroscopy of bimetallic surfaces. 5 figs. (CBS)
DNA replication programs have been studied extensively in yeast and animal systems, where they have been shown to correlate with gene expression and certain epigenetic modifications. Despite the conservation...Full Text Available
A simple closed-form equation to calculate the envelope correlation between any two receiver or transmitter antennas in a multi-input multi-output (MIMO) system of an arbitrary number of elements is derived. The equation uses the scattering parameters obtained at the antenna feed point to calculate the envelope correlation coefficient. This approach has the advantage that it does not require knowledge of the antenna radiation pattern. Numerical data that include conductor and permittivity loss are shown to validate the approach. Using the scattering parameters for calculating the envelope correlation is less laborious and relatively cheaper, as compared to the radiation pattern approach.
Two mesoscopic SQUID rings which are far from each other are considered. A source of two-mode nonclassical microwaves irradiates the two rings with correlated photons. The Josephson currents are in this case quantum mechanical operators, and their expectation values with respect to the density matrix of the microwaves yield the experimentally observed currents. Classically correlated (separable) and quantum mechanically correlated (entangled) microwaves are considered, and their effect on the Josephson currents is quantified. Results for two different examples that involve microwaves in number states and coherent states are derived. It is shown that the quantum statistics of the tunnelling electron pairs through the Josephson junctions in the two rings are correlated.
Coke petrography could be useful for improving blast furnace coke properties and for solving cokemaking production problems. To do this, quantitative correlations between coke structure, coal properties and carbonization conditions, and coke properties are useful, if not essential. Some examples of correlations of this type were presented in this paper. Specifically, microstructural parameters of cokes produced in Inland Steel Company's pilot scale coke oven were correlated with the rank and blend proportions of the parent coal, with the reactivity of the coke, and with the ASTM stability of cokes prepared from single coals.
Purpose: Treatment results and the pattern of relapse were evaluated in the multimodal treatment of Ewing's sarcomas of the chest wall. Methods and Materials: In a retrospective analysis, 114 patients with non-metastatic Ewing's sarcoma of the chest wall were evaluated. They were treated in the CESS 81, CESS 86, or EICESS 92 studies between January 1981 and December 1993. The treatment consisted of polychemotherapy (VACA, VAIA, or EVAIA) and local therapy, either surgery alone (14 patients), radiotherapy alone (28 patients) or a combination of both (71 patients). The median follow-up was 46.6 months (range 5-170). A relapse analysis for all patients with local or combined relapses was performed. Results: Overall survival was 60% after 5 years, event-free survival was 50%. Thirty-seven patients had a systemic relapse (32.4%), 11 patients had ...
The purpose of this study is to evaluate the radiologic findings of the extraosseous Ewing's sarcoma. Six patients with pathologically confirmed extraosseous Ewing's sarcoma were retrospectively reviewed. Patients included two men and four women with an average age of 21.5 years (age range 9-48 years). Plain radiographs (six patients), magnetic resonance (MR) images (five patients), computed tomographic (CT) scans (three patients) and whole body scintigraphy (two patients) were reviewed and analyzed. Images were evaluated with regard to lesion location, size, margin, muscle or bone involvement and intrinsic imaging characteristics on CT and MRI. The tumors were located in the thigh (three patients), back (two patients) and upper arm (one patient). The tumors ranged in size from 2.3 cm to 7.5 cm ...
Two patients receiving maintenance dialysis therapy developed osteonecrosis, the first in the humeral head and the second in the talus. Both patients lacked known risk factors for developing osteonecrosis. A possible pathogenic role of secondary hyperparathyroidism in this disorder is suggested. Rheumatologists evaluating patients receiving maintenance dialysis with rheumatic manifestations should be aware of this potential complication. PMID:2185360
Between October 1990 and March 1991, 8 patients with cystic lesions in the region of the posterior bladder wall, the seminal vesicles and the prostate were examined by MRI. In all cases there was accurate characterisation of the lesion and of its anatomy. In 3 patients with abnormalities in the retrovesical space there was very good agreement with the operative findings. 4 patients were treated conservatively. In these patients there was good agreement with the findings on cystoscopy, CT and sonography. (orig.).
Elevated fatty acid levels have been thought to contribute to insulin resistance. Repression of the glucose transporter 4 (GLUT4) gene as well as impaired GLUT4 translocation may be a mediator for fatty acid-induced insulin resistance. This study was initiated to determine whether palmitate treatment repressed GLUT4 expression, whether glucose/fatty acid metabolism influenced palmitate-induced GLUT4 gene repression (PIGR), and whether attempts to prevent PIGR restored palmitate-induced impairment of glucose uptake (PIIGU) in C2 myotubes. Not only stimulators of fatty acid oxidation, such as bezafibrate, AICAR, and TOFA, but also TCA cycle substrates, such as pyruvate, leucine/glutamine, and ?-ketoisocaproate/monomethyl succinate, significantly prevented PIGR. In particular, supplementing with pyruvate through methyl pyruvate resulted in nearly complete prevention of PIIGU, whereas palmitate treatment reduced the intracellular pyruvate level. These results suggest that pyruvate ...
Lethal yellow (A{sup y}) is a mutation at the mouse agouti locus in chromosome 2 that causes a number of dominant pleiotropic effects, including a completely yellow coat color, obesity, an insulin-resistant type II diabetic condition, and an increased propensity to develop a variety of spontaneous and induced tumors. Additionally, homozygosity for A{sup y} results in preimplantation lethality, which terminates development by the blastocyst stage. The A{sup y} mutation is the result of a 170-kb deletion that removes all but the promoter and noncoding first exon of another gene called Raly, which lies in the same transcriptional orientation as agouti and maps 280 kb proximal to the 3{prime} end of the agouti gene. The authors present a model for the structure of the A{sub y} allele that can explain the dominant pleiotropic effects associated with this mutation, as well as the recessive lethality, which is unrelated to the agouti gene.
We study two correlated electrons in a nearest-neighbour tight-binding chain, with both on-site and nearest-neighbour interaction. Both the cases of parallel and antiparallel spin are considered. In addition to the free electron band for two electrons, there are correlated bands with positive or negative energy, depending on whether the interaction parameters are repulsive or attractive. Electrons form bound states, with amplitudes that decay exponentially with separation. Conditions for such states to be filled at low temperatures are discussed.
The long-range correlation properties in the hourly time variability of geochemical signals measured in a 70 m depth well at Triponzo (Umbria region), are investigated by the detrended fluctuation analysis (DFA). DFA is a data processing method that allows for the detection of scaling behaviors in observational time series even in the presence of non-stationarities. The procedure adopted has allowed for the unambiguous identification of possible correlations among the recorded signals and local earthquakes.
The authors report an extension of the source imaging method for analyzing three-dimensional sources from three-dimensional correlations. The technique consists of expanding the correlation data and the underlying source function in spherical harmonics and inverting the resulting system of one-dimensional integral equations. With this strategy, they can image the source function quickly, even with the extremely large data sets common in three-dimensional analyses.
The Baldwin Effect, a negative correlation between emission-line equivalent width and luminosity in active galactic nuclei, is still of interest as a diagnostic of accretion physics nearly thirty years after its discovery. This review examines recent developments in the study of correlations between line and continuum emission in AGNs, as measured both in ensembles and in individual sources.
Two sets of analytical correlations describing transitions between two-phase flow regimes are reviewed and discussed. One, the T-D set, is based on mechanistic models; the other, the Weisman set, on experimental correlations. The T-D set is preferred for horizontal flow, whereas the Weisman set seems preferrable for vertical flow. A computer code (FLOP) based on the T-D theory is described and applied to validate the theory.
Over 7000 events containing a fully reconstructed D{bar D} pair have been extracted from data recorded by the FOCUS photoproduction experiment at Fermilab. Preliminary results from a study of correlations between D and {bar D} mesons are presented. Correlations are used to study perturbative QCD predictions and investigate non-perturbative effects. We also present a preliminary result on the production of {psi}(3770).
Background Limited data is available for investigating the long-term safety and effects of intracoronary progenitor cell therapy in patients with acute myocardial infarction (AMI). Objective To assess the clinical course, NT-proBNP and MRI data as objective markers of cardiac function of the TOPCARE-AMI patients at 5-year follow-up. Design The TOPCARE-AMI trial was the first randomized study investigating the effects of intracoronary infusion of circulating (CPC) or bone marrow-derived progenitor cells (BMC) in 59 patients with successfully reperfused AMI. Results Five-year follow-up data were completed in 55 patients, 3 patients were lost to follow-up. None of the patients showed any signs of intramyocardial calcification or tumors at 5?years. One patient died during the initial hospitali...
Objective: To investigate the X-ray radiation dose patients dealt with the hepatic intervention. Methods: Thermoluminescence and tissue-equivalent anthropomorphic phantom were used to measure the X-ray radiation dose in patients dealt with the hepatic intervention in 85 patients. Results: The peak skin dose in the patients who accepted hepatic intervention was from 179.95 to 1759.00 mGy, effective dose approached 29.22 mSv (male), 29.27 mSv (female). Conclusion: Hepatic intervention is now regarded as an important therapeutic method for liver cancer. However, the patients were exposed to too much X-ray radiation during interventional procedures. Some more effective protection should be taken to decrease the X-ray radiation dose accepted by patients. (authors)
Purpose We retrospectively analyzed the results of percutaneous nephrolithotomy operations for treatment of staghorn kidney stone disease in elderly patients and compared surgical parameters and outcomes with a control group of young adult patients. Patients and method Between 2002 and 2010, 300 consecutive patients underwent percutaneous nephrolithotomy operation for treatment of staghorn kidney stone disease. Forty-five of the patients were older than 65?years and considered to be in elderly group. Thirty-seven of the patients were between the ages 18 and 36?years and considered to be the control group. Surgical parameters and outcomes were compared between groups. Results There were no significant differences between groups for stone area, operation time, difference in hemoglobin levels...
Background Trauma centers are designated to provide systematized multidisciplinary care to injured patients. Effective trauma systems reduce patient mortality by facilitating the treatment of injured patients at appropriately resourced hospitals. Several U.S. studies report reduced mortality among patients admitted directly to a level I trauma center compared with those admitted to hospitals with less resources. It has yet to be shown whether there is an outcome benefit associated with the ?level of hospital? initially treating severely injured trauma patients in Australia. This study was designed to determine whether the level of trauma center providing treatment impacts mortality and/or hospital length of stay. Methods Outcomes were evaluated for severely injured trauma patients with an ...
BACKGROUND: Controversy exists as to whether patients with thick (Breslow depth >4 mm), clinically lymph node-negative melanoma require sentinel lymph node (SLN) biopsy. The authors examined the impact of SLN biopsy on prognosis and outcome in this patient population. METHODS: A review of the authors institutional review board-approved melanoma database identified 293 patients with T4 melanoma who underwent surgical excision between 1998 and 2007. Patient demographics, histologic features, and outcome were recorded and analyzed. RESULTS: Of 227 T4 patients who had an SLN biopsy, 107 (47%) were positive. The strongest predictors of a positive SLN included angiolymphatic invasion, satellitosis, or ulceration of the primary tumor. Patients with a T4 melanoma and a negative SLN had a significa...
Background: The Internet has become a popular source of health information for patients with a variety of medical concerns; however, research examining patient interactions on the Internet has been limited. Purpose: Four questions were examined in a survey study of hysterectomy patients who visited http://www.hystersisters.com: (a) Do hysterectomy patients use the support Web site because they perceive their proximal sources of social support to be inadequate? (b) What kinds of support do patients receive from the Web site? (c) What attributes characterize the "Hystersisters" that are perceived to be most helpful? (d) How do informational sources vary depending on the nature of the patient concern? Methods: Women (N = 137) responded to questions about social support, Web site use, and perc...
Abstract Purpose: To compare the safety and efficiency of conventional monopolar, plasmakinetic and holmium laser transurethral resection of bladder tumor (CM-TURBT, PK-TURBT and HoL-TURBT) while managing primary non-muscle invasive bladder cancer. Patients and Methods: From 2005 to 2009, 173 patients with primary non-muscle invasive bladder cancer underwent endoscopic surgery. Among them, 51 patients underwent CM-TURBT, 58 patients underwent PK-TURBT, and 64 patients underwent HoL-TURBT. All patients were divided into three risk groups (low, intermediate, and high) based on the European Association of Urology guidelines and prognostic factors of recurrence. Clinical data, included preoperative, operative, and postoperative management and follow-up, were recorded. Results: Patient demograp...
Somatostatin receptor expression has been demonstrated on a number of plasma cell lines. Therefore, we questioned whether somatostatin receptor scintigraphy (SRS) can be used to demonstrate in vivo multiple myeloma (MM) activity. SRS was performed in newly diagnosed (n = 9) or relapsing (n = 18) MM patients or in patients with localized plasmacytoma (n = 2). The results were compared with radiographic findings. A positive SRS was demonstrated in 44% of the newly diagnosed patients, in 83% of the relapsed patients and in both patients with plasmacytoma. The SRS findings corresponded with radiographic abnormalities in 40% of the patients. However, in relapsed patients 60% demonstrated increased SRS uptake in areas without new radiographic abnormalities. The positive SRS corresponded with histologically proven disease activity and responded ...
Staging bone scans or skeletal surveys were obtained of 97 patients with endometrial carcinoma. Of the 77 patients with Stage I or II disease, no metastases were identified at staging. Three patients in the entire series demonstrated bony metastases; all of these metastases were detectable by radionuclide bone scan and radiographic bone survey. Eighty-nine patients were examined with radionuclide liver/spleen scanning at the time of staging. Four of the 89 initial scans were interpreted as demonstrating hepatocellular disease, and all four patients had abnormal liver function studies. Only one patient demonstrated a possible hepatic metastasis at initial diagnosis. This patient also had abnormal liver function studies. Based on these results, bone surveys and radionuclide bone scans are not indicated as screening procedures in endometrial ...
The aim of this study was to evaluate typical magnetic resonance imaging (MRI) findings in early rheumatic diseases manifesting at the soft tissues of the hand using a retrospective analysis. A total of 186 MRI examinations of patients with clinical suspicion of a rheumatic disease were evaluated in a consensus reading by two experienced radiologists. All imaging patterns were assessed with respect to their type and localization. Under blinded and non-blinded conditions diagnoses were correlated with final clinical diagnosis. The most frequent diagnoses were rheumatoid arthritis (RA, 45.7%) and psoriatic arthritis (PsA, 15.6%). The mean correlation between clinical and MRI diagnosis (r) was 0.75 in blinded and 0.853 in non-blinded reading (p <0.001). The following extra-articular imaging patterns were found: synovitis (59.1%), tendovaginitis (91.4%), dactylitis (14.5%), and bone marrow edema (18.3%). Only dactylitis ...
After some observations about the tests of the research exposed in the literature, authors illustrate the tests for 142 patients divided into 5 groups: a) patients affected with acute viral hepatitis; b) patients affected with praegressa acute viral hepatitis; c) relatives of patients with acute viral hepatitis; d) volunteers; e) patients affected with chronic uraemia under dialisis periodic treatment. After the testing control, authors, conclude with an hipotesis: a possible epidemic function of faeces, urine saliva, in the passage of the acute viral hepatitis. PMID:488577
Computerized tomography of the adrenal glands was performed in 10 patients with Cushing's syndrome using a G.E. 8800 CT/T Body Scanner. The tomographic findings of unilateral adrenal masses in 4 patients were confirmed by surgery. In the remaining 6 patients, computerized tomography did not identify any masses, and both glands were well visualized and showed normal shape. In these patients, measurement of the adrenal glands revealed both normal (n=1) and enlarged glands (n=5). The findings of adrenalectomy (n=4) or transphenoidal surgery and follow-up (n=2) established the diagnosis of adrenal phyperplasia in all patients. (Author).
In this article is reviewed the role of Computed Tomography (CT) in thoracic complications following ortho topic liver transplantation (OLT). In a post-OLT population of 567 patients transplanted in the Italian institutions, 100 patients (17.6%) were examined with chest CT. It was reviewed data relative to the total number of examinations, clinical and/or radiographic indications, the CT technique-i.e., conventional (with (out) intravenous, i.v., contrast material) or high-resolution (HRCT). It also reviewed the radiologic patterns and their correlation with the other clinical, bronchoscopic and/or laboratory results. Of 152 chest CT examinations, 45 (29.6%) were performed because of clinical indications, 31 (20.4%) because of a radiographic abnormality, 64 (42.1%) because of clinical and radiographic abnormality, 64 (42.1%) because of clinical and radiographic indications, while in 12 cases (7.9%) the reasons were unknown; ...
This paper presents two imaging methods by using cross correlation. The one method images the subsurface by cross-correlation of the observed data and partial derivative seismograms calculated for a guessed model. The other method images the interface by use of cross-correlation of the virtual sources and the back propagated wave fields calculated from the observed data. Experimental tests show that both methods image subsurface interfaces well even if the guessed model is different from the true one. These imaging methods are reverse time migration that we perform cross-correlation as an imaging condition and have an advantage, as compared to conventional waveform inversion method, that images subsurface structure without iterative perturbation of the assumed model. (author). 18 refs., 15 figs.
The purpose of this study was to examine the relationship between histomorphometric variables of cancellous bone structure and ultimate compressive strength (UCS) in the second lumbar vertebra (L2) and to determine whether structural variables in the iliac crest are predictive of the same variables and of UCS in L2. At autopsy, 7.5 mm diameter cores were removed from the iliac crest and from L2 of 29 subjects who had died suddenly without bone disease. Cancellous bone volume (BV/TV, %) was significantly lower in L2 than in iliac crest due to lower trabecular number (Tb.N, per mm) and thickness (Tb.Th, microns). There were significant correlations between iliac crest and L2 for BV/TV, Tb.N and trabecular separation (Tb.Sp, microns), but not for Tb.Th. BV/TV was negatively correlated, and Tb.Sp was positively correlated with age at both sites. Tb.Th was not significantly correlated with age in the iliac ...
This study examines the sensitivity of the travel time distribution predicted by a reference case model to (1) scale of representation of the model parameters, (2) size of the model domain, (3) correlation range of log-transmissivity, and (4) cross correlations between transmissivity and effective thickness. The basis for the reference model is the preliminary stochastic travel time model previously documented by the Basalt Waste Isolation Project. Results of this study show the following. The variability of the predicted travel times can be adequately represented when the ratio between the size of the zones used to represent the model parameters and the log-transmissivity correlation range is less than about one-fifth. The size of the model domain and the types of boundary conditions can have a strong impact on the distribution of travel times. Longer log-transmissivity correlation ranges cause larger ...
Simple correlations and corresponding nomographs are presented, which express the maximum useful heat received from salt-gradient solar ponds throughout the year or during a specified season of the year, and the corresponding optimum depth of the nonconvective zone in terms of the thickness of the upper convective zone and the temperature under which the maximum useful heat is received. The correlations are valid for the Athens (Greece) area or for regions with a similar climate, because solar radiation and ambient temperature values for Athens have been employed, obtained by a statistical process of hourly measurements over a period of about 20 years. For other climates, it is easy to develop similar correlations using the same methodology, Development of the proposed correlations is based on a method, which simulates the transient operation of the salt-gradient pond using finite-differences, and ...
With the aim of demonstrating the usefulness of computerised tomography (CT) findings in the planning of brain neurosurgery in gunshot victims, for prompt and successful treatment, 30 patients with brain gunshot wounds were examined with CT over 5 years. The mortality rate of firearm wounds of the skull base was 34% higher than that of the hemisphere; this is due to carotid hemorrhage and midbrain damage. Such traumas require emergency radiological diagnosis and neurosurgical treatment because of their severity and early irreversible complications. Complex operations and skilled surgeons may prevent disabling postoperative sequels. CT findings are indispensable and must be correctly interpreted. The radiologist and the neurosurgeon must collaborate closely and both must consider several diagnostic factors affecting surgical planning. [Italian] Scopo dello studio e' stato quello di dimostrare l'utilita' della semeiologia della tomografia ...
Objective was to present our 8 year experience in the prevention of the obturator nerve reflex during transurethral resection of bladder tumors. This study was performed in Ataturk University Hospital between 1999 and 2007. We retrospectively reviewed the records of 89 patients with inferolateral bladder tumors, who underwent transurethral resection under epidural or general anesthesia and requested obturator nerve reflex inhibition. Epidural anesthesia was administered to 57 patients, while the remaining 32 patients underwent general anesthesia via mask; and succinylcholine was administered prior to resection. Of the 57 patients received epidural anesthesia, 18 were diagnosed as inferolateral bladder tumors during endoscopy and had to undergo general anesthesia. Obturator nerve block was attempted preoperatively in 39 patients. However, a nerve identification failure, hematoma and ...
Purpose To analyze the clinical profile, management and outcome of non-hematological tumors in head and neck region in children less than 18?years of age. Patients and methods Medical records of patients (0?18?years) presenting with non-hematological tumors of head and neck region from 2000 to 2010 were reviewed. Result Out of the 78 patients identified, 50 were males with median age of 14?years (3?months to 18?years). Histologically, 58 out of the 78 patients had malignant tumors and 20 were metastatic at presentation. Common site of tumor origin was noted as thyroid (23/78), salivary glands (21/78) and nasopharynx (13/78). Out of 78 patients, 44 patients were treated by surgery, 26 patients received radiation and 13 patients received chemotherapy, while 9 patients received radio-iodine (...
Objective:? Primary hyperparathyroidism (HPT) is characterised by autonomous secretion of PTH from enlarged parathyroid glands leading, in most patients, to asymptomatic hypercalcaemia. Familial hypocalciuric hypercalcaemia (FHH) is an autosomal dominant disorder caused by inactivating mutations in the calcium sensing receptor (CaSR) gene; it is characterised by lifelong and usually asymptomatic hypercalcaemia. Establishing the correct diagnosis is important because surgery can be curative in HPT, but ineffective in FHH. There is overlap in the diagnostic criteria for the two disorders and some patients carrying inactivating mutations in the CaSR gene, which is suggestive of FHH, also have HPT with hyperplastic parathyroid glands or adenomas. Design and Patients:? CaSR gene mutations were analyzed and clinical and biochemical parameters evaluated in 139 consecutive out-patients presenting with ...
Thirty-nine previously untreated patients with squamous cell carcinoma of the tongue were treated by irradiation or a combination of irradiation and surgery, with or without chemotherapy, between January 1971 and December 1980. All of the patients had a follow-up period of at least nine years. Twenty-two patients were men and 17 were women. The average age was 50.1 years, with a range of 30 to 74 years. The absolute five-year survival rate was 82.1% and the cumulative ten-year survival rate 76.9% for these 39 patients. Cervical node metastases were clinically found on admission in 14 patients whose five-year survival rate was 64.3%, whereas it was 92.0% for 25 patients without metastasis. The absolute five-year survival rate decreased from 92.3% for patients with stage I lesions to 90.9%, 87.5% and 42.9% for those with stage II, stage III ...
Purpose: To visualise the vessel wall of the descending thoracic aorta using magnetic resonance imaging. To evaluate the diagnostic potential of tailored T{sub 1}-weighted sequences with contrast enhancement to assess systemic atherosclerotic disease. Methods: This study was performed on a clinical 1.5 Tesla scanner using a gradient strength of 30 mT/m and the phased array spine coil. A cadaver was examined to optimise a magnetic resonance imaging (MRI) protocol to evaluate atherosclerotic aortic wall disease. The acquired MR images were compared to gross specimens and histology. Subsequently seven patients who had undergone transesophageal ultrasound (TEU) with detailed assessment of the descending thoracic aorta were examined with MRI. The optimised protocol included untriggered and fat suppressed T{sub 2}-weighted turbo spin echo sequences and ECG-triggered and fat suppressed T{sub 1}-weighted spin echo sequences before and after iv administration of Gd-DTPA. ...
There is limited information on the incidence of acute kidney injury (AKI) in patients with traumatic brain injury (TBI) although AKI may contribute to morbidity and mortality. We investigated the incidence of AKI in patients with moderate and severe TBI and the association of AKI with risk factors and outcomes in these patients. We studied all TBI patients over 16 years of age admitted to the two designated trauma hospitals in the state of Victoria, Australia from 1 January to 31 December 2008. Patients were included if they had head trauma and presented with a Glasgow coma scale (GCS) <13. Prospectively collected data from the hospital trauma registries, ICUs, and pathology databases were analyzed retrospectively. Risk injury failure loss end (RIFLE) criteria were used to categorize rena...
The prospective study includes 25 patients without pathology of the femoral head for the evaluation of the normal femoral head perfusion. In addition 34 patients with femoral head necrosis underwent i.a. DSA preoperatively before pedicled pelvic bone grafting. 15 patients after pelvic bone graft operation and 7 patients with medial femoral head fracture were also examined via superselective DSA. In cases with femoral head necrosis a rarefaction or interruption of the rami nutricii proximales, or an occlusion of the medial circumflex femoral artery were observed. Patients with medial femoral neck fracture showed an interruption of the rami nutricii proximales of the femoral head. Postoperative DSA - after pedicled pelvic bone graft - revealed a regular arterial graft perfusion in 82%. (orig.).
Soluble TWEAK is a member of the TNF-alpha family of cytokines that has been shown to predict mortality in patients with heart failure. Pulmonary artery hypertension is a devastating disease, in which right ventricular function has been shown to be the major determinant of prognosis. In this hypothesis-generating study, we sought to evaluate the potential usefulness of sTWEAK in the prediction of disease severity in patients with pulmonary artery hypertension. We therefore conducted a retrospective analysis of sTWEAK serum levels in 95 stable patients with PAH. For all patients data on hemodynamic parameters, biomarkers and functional exercise tests were available. Compared to controls, patients with PAH showed significantly decreased levels of sTWEAK [median 314?pg/ml (interquartile range...
Objectives Vietnamese patients? views on healthcare are changing as surgical interventions become more commonplace, but their views on perioperative care have remained largely unstudied during this period of rapid change. This study assesses Vietnamese patients? impression of anesthesia safety and postoperative pain in relation to clinical outcomes with the aim of improving patient-centered perioperative care. Methods The study cohort consisted of 180 hospitalized patients who were followed for 24?h following abdominal surgery. The assessments of these patients on the use of anesthesia and postoperative pain were measured by means of a 5-point Likert scale survey. Perioperative events were recorded on standardized forms by medical staff. The relationship between relevant factors affecting ...
To determine the proportion of rheumatoid arthritis (RA) patients receiving preventive health care according to US Preventive Services Task Force recommendations compared with a community-based population sample, with emphasis on dyslipidemia testing, given the increased risk of cardiovascular disease (CVD) in RA patients. Patients with RA (ICD-9 code 714.0 at ?2 office visits with a rheumatologist) and a primary care physician (PCP) at the Geisinger Health System (GHS) were identified through electronic health records. The records were searched back from 3/31/08 for the length of time required to satisfy each outcome measure. Percentages were compared with population testing rates using the Pearson Chi-square test. Eight hundred and thirty-one RA patients were compared to 169,476 subjects...
In a retrospective single-centre study 170 consecutive patients were included who received a Kotz modular prosthesis after resection of bone tumours of the proximal femur to evaluate the management of prosthetic infection. Infection occurred in 12 of 166 patients available for follow-up (six males; six females; mean age, 47?years; range, ten to 75?years) after a mean of 39?months (range, one to 166?months; infection rate, 7.2%). Mean follow-up was 54?months (range, four to 200?months). One patient died of septic shock. Two patients were treated by wound revision only. Treatment of infection in the remaining patients was one-stage revision in eight and hip disarticulation in one. Infection control by one-stage revision was achieved in five of eight patients; re-infection occurred in three p...
Context. Cardiovascular medication overdoses can be difficult to treat. Various treatment modalities are currently recommended. Objective. To describe patient outcomes and adverse events of high-dose insulin therapy in consecutive overdose patients in cardiogenic shock after implementation of a high-dose insulin protocol (1-10 U/kg/h, while avoiding or tapering off vasopressors). Methods. This is an observational consecutive case series of patients identified from a registry. Data were collected by retrospective chart review of patients treated by our toxicology service with this protocol from February 2007 until March 2010. Results. Twelve patients were treated with high-dose insulin. The mean age was 36.5 years (SD 11.7). Seven patients had pre-existing vasopressor therapy, and all were ...
Abstract Introduction.- There are no studies on the sexual function of male patients with Behet's disease (BD), but it is probable that male sexual dysfunction may be seen in this chronic condition. Aim.- The aim of this study was to assess the effect of BD on male sexual function and psychiatric status, and to examine the relationship between sexual function and depression in this population. Methods.- Patients with a diagnosis of BD for at least one year were included in the study. The patients' age, educational level, and duration of disease were recorded. A healthy control group was selected with highly similar characteristics to the patient group. The sexual functions of the patient and the control groups were assessed using the International Index of Erectile Functions (IIEF), and th...
Background There is increasing recognition that lower nurse staffing levels are associated with higher morbidity and mortality among medical and surgical patients. The degree to which this applies to elderly patients with hip fractures is unclear. Questions/purposes We conducted a pilot study using administrative data as an initial step in investigating the relationship between nurse staffing levels and in-hospital mortality among elderly patients with hip fractures. Patients and Methods We retrospectively reviewed administrative data for 13,343 patients 65?years or older with a primary diagnosis of hip fracture admitted to 39 Michigan hospitals between 2003 and 2006. We used logistic regression to calculate the change in predicted probability of in-hospital death conferred by differences ...
Objective: To compare pediatric patients with periventricular leukomalacia (PVL) with normal children by using diffusion tensor MR imaging. Methods: Diffusion tensor images were obtained in 15 pediatric patients with PVL and 15 age-matched normal children. Regions of interest were drawn to measure the fractional anisotropy (FA) in bilateral posterior limb of internal capsule, bilateral optic radiation, genu of corpus callosum, and splenium of corpus callosum. The values of PVL patients and normal children were compared using non-dependent samples T-test. Results: The FA values of regions of interest prescribed were significantly lower in PVL patients than in normal children (P<0.01). Conclusion: Diffusion tensor imaging may reveal retard of myelination of fiber tracts in PVL patients. It can be a potential tool in evaluating the brain development of children. (authors)
Objective To demonstrate clinical features of a patient subgroup presenting with polycystic ovary syndrome (PCOS) without polycystic ovary morphology. Design Retrospective study. Setting Hospital-based IVF center. Patient(s) In the present study, 876 PCOS patients were selected from women who visited the Reproductive Medicine Center at Shandong Provincial Hospital, Shandong University, between September 2004 and October 2006. Women with PCOS were divided into two groups based on ultrasound image: group A, PCOS patients with classic polycystic ovary (n = 800); group B, PCOS patients without polycystic ovary morphology (n = 76). The following available data were analyzed in the large cohort of women: body height, weight, waistline, hip circumference, hirsutism scores, family history, serum s...
This study is for chemoradiotherapy of unresectable and recurrent cholangiocarcinoma (CCC). Between April 2005 and March 2007, 5 patients were evaluated for unresectable and recurrent CCC. All patients were performed percutaneous transhepatic biliary drainage (PTBD) and treated with chemoradiotherapy. The radiation method was an external beam radiotherapy (EBRT) and remote after loading system (RALS). The chemotherapy was 5-fluorouracil (FU) and gemcitabine by intravenous injection. Three patients had unresectable and 2 had recurrent CCC. As for the side effects, 4 patients had a slight neutropenia and 1 had an uncontrollable gastric bleeding. No patient had cholangitis. The mean survival time for unresectable and recurrent CCC was 13.7 months and 17 months, respectively. Our results indicated that chemoradiotherapy had been consistent with efficacy in patients ...
All patients with von Willebrand?s disease (vWD) who showed an arterial or venous thrombosis and were reported in the literature have been evaluated. 11 patients had arterial thrombosis while 19 had venous thrombosis for a total of 30 cases. 9 out the 11 cases with arterial thrombosis had myocardial infarction. Two had cerebral thrombosis. Associated risk factors for arterial thrombosis were available only for three patients who showed, respectively, smoking and dyslipidemia (2 cases) and smoking and intravenous desmopressin infusion (1 case). The majority of patients with venous thrombosis showed DVT with or without PE. Four patients presented with apparently isolated PE. In two instances thrombosis occurred in unusual sites (central retinal vein and portal vein, respectively). Several as...
Background There is some evidence that a patient?s pre-operative condition influences short-term and long-term post-operative outcomes. The aim of the present study is to compare the physiological and operative severity score for the enumeration of mortality and morbidity (POSSUM) and modified Glasgow prognostic score (mGPS) models in the prediction of post-operative outcome, both short term and long term, in patients undergoing resection of oesophago-gastric cancer. Patients and Methods Patients who underwent curative resection for oesophago-gastric cancer from January 2005 to May 2009 and who had data to score the POSSUM, P-POSSUM, O-POSSUM and mGPS models were included in the study. Observed morbidity and mortality rates were compared with predicted outcome in different risk groups. Bot...
Abstract Objective:- This study explored 12-month outcome and its associations to social adjustment-related variables in patients with first-episode non-affective psychosis in Finland and Spain. Methods:- Forty-nine Finnish and 37 Spanish patients were evaluated at admission on various characteristics of social adjustment. Outcome was measured for 68 (79%) patients by the Brief Psychiatric Rating Scale, Global Assessment Scale, and Grip on Life. Results:- One-fourth of the patients experienced psychotic symptoms at follow-up. Sixty per-cent of the patients showed good global functioning and Grip on Life. In both patient groups, poor earlier global functioning, weak social network, poor Grip on Life, and psychological dependence on family of origin were associated with poor outcome. In the ...
The aim of this retrospective study was to determine the safety and efficacy of chemoembolization (TACE) as palliative treatment for patients with unresectable intrahepatic cholangiocarcinoma (CCA) and to compare the results with those in the literature. Fifteen patients with histology-proven CCA (5 men, 10 women) had received palliative treatment with TACE over a 6-year period. The treatment protocol comprised repeated TACE at a minimum of 8-week intervals. TACE was performed with a mixture of 10 ml Lipiodol and 10 mg mitomycin C injected into the tumor-supplying vessels. Follow-up investigations after 8-10 weeks comprised contrast-enhanced multislice spiral CT and laboratory control. Statistical evaluation included survival analysis using the Kaplan-Meier method. During the investigation period 58 TACEs (3.9 #+-# 3.8; 1-15) were performed in 15 patients. Mean tumor size was 10.8 #+-# 4.6 cm (range, 2.0-18.0 cm). Unifocal ...
In this study, we investigated the effects of one- and two-staged orchiopexy on testicular volume and serum testosterone levels in cases with high, abdominally localized, bilateral nonpalpable testes. Between March 1996 and April 2001, orchiopexy was performed on 46 testes in 23 patients with bilateral nonpalpable testes. In 15 of the 23 patients, a two-stage Fowler-Stephens orchiopexy was performed, and in 8 of the 23 patients, a one-stage laparoscopic orchiopexy was performed. For one patient who lacked both testes, bilateral prosthetic testes were inserted. The patients' ages were between 20 and 23 years (average, 21 years). In the first stage of the two-stage orchiopexy, the spermatic artery was ligated laparoscopically. Six months later, open surgery orchiopexy was performed. Patients were followed for 2 to 16 months (average, 10 months) and were evaluated ...
BACKGROUND: The urgent need for patient safety education for healthcare students has been recognised by many accreditation bodies, but to date there has been sporadic attention to undergraduate/graduate medical programmes. Medical students themselves have identified quality and safety of care as an important area of instruction; as future doctors and healthcare leaders, they must be prepared to practise safe healthcare. Medical education has yet to fully embrace patient safety concepts and principles into existing medical curricula. Universities are continuing to produce graduate doctors lacking in the patient safety knowledge, skills and behaviours thought necessary to deliver safe care. A significant challenge is that patient safety is still a relatively new concept and area of study; thus, many medical educators are unfamiliar with the literature and unsure how to integrate ...
The aim of this study was to evaluate the results of postoperative radiotherapy in a case of perihilar cholagiocarcinoma by analyzing overall survival rate, patterns of failure, prognostic factors for overall survival, and toxicity. Between January 1998 and March 2008, 38 patients with perihilar cholangiocarcinoma underwent a surgical resection and adjuvant radiotherapy. The median patient age was 59 years (range, 28 to 72 years), which included 23 men and 15 women. The extent of surgery was complete resection in 9 patients, microscopically positive margins in 25 patients, and a subtotal resection in 4 patients. The tumor bed and regional lymphatics initially received 45 Gy or 50 Gy, but was subsequently boosted to a total dose of 59.4 Gy or 60 Gy in incompletely resected patients. The median radiotherapy dose was 59.4 Gy. Concurrent chemotherapy was ...
BACKGROUND: The urgent need for patient safety education for healthcare students has been recognised by many accreditation bodies, but to date there has been sporadic attention to undergraduate/graduate medical programmes. Medical students themselves have identified quality and safety of care as an important area of instruction; as future doctors and healthcare leaders, they must be prepared to practise safe healthcare. Medical education has yet to fully embrace patient safety concepts and principles into existing medical curricula. Universities are continuing to produce graduate doctors lacking in the patient safety knowledge, skills and behaviours thought necessary to deliver safe care. A significant challenge is that patient safety is still a relatively new concept and area of study; thus, many medical educators are unfamiliar with the literature and unsure how to integrate ...
The frequency of peripheral pulmonary artery stenosis in patients after surgical repair of tetralogy of Fallot (TOF) ranges from 20 to 40%. This can be either primary or secondary to the surgical intervention. The influence of resulting lung perfusion alterations on the life quality of patients is difficult to predict. The aim of this study was to compare the utility of the diagnostic procedures in this group of patients, with particular focus on lung perfusion scintigraphy. This study comprised 104 patients who underwent repair of TOF at ages from 5 months to 25 years. The patients have been followed up for from 4.2 to 25 years. On the basis of chest X-ray peripheral pulmonary artery stenosis was suspected in 11 patients, in 12 on the basis of echocardiography examination. Lung perfusion scintigraphy has been performed on 87 patients. The ...
Background and purpose: A diagnosis of malignancy and its treatment is a very stressful time for patients and their families. This study was conducted to determine the impact of more intensive written information on patients' anxiety levels. The secondary aim was to determine the impact of this information on patients' satisfaction levels. Materials and methods: This prospective randomized trial consisted of patients with a pathological diagnosis of cancer having radical radiotherapy (RT). Patients were randomized to receive the more intensive information (including written information and a telephone call from the research nurse) or not to receive the more intensive information at the time of their initial consultation with the radiation oncologist. Study questionnaires measuring anxiety (STAI form) were completed prior to their first consultation (baseline) at the time of ...
Of 1850 patients with cholelithiasis diagnosed in the past 17 years, 1116 female and 734 male, 598 patients (32.3%) presented with one or more of three major symptoms, i.e., abdominal pain, fever and jaundice, whereas the remainder (67.7%) had none of these symptoms. The proportion of the asymptomatic patients was similar in all age groups, being around 70%. Only 20 per cent of 680 asymptomatic patients, followed for 10 to 17 years (median 13.3 years), developed biliary symptoms. Older patients over 70 years of age had a higher rate of change to the symptomatic group, as compared with younger patients under 70, 29.5% vs. 19.3%, respectively. During this period, carcinoma of the gallbladder developed in one of the asymptomatic patients (0.1%). Oral dissolution therapy was successful in only 4.2 per cent of attempted cases and associated with ...
Background and objectives: While many patients with end-stage renal disease (ESRD) have impaired physical and psychologic well-being, less is known about these health domains in patients with advanced...Full Text Available
Fresh blood has many potential advantages over older blood, but there is no evidence that these properties translate into clinical benefit for intensive care patients. The observational multicenter...Full Text Available
BackgroundLittle is known about the role European patient organisations play in the process of deciding on reimbursement for medicines. Therefore we explore the...Full Text Available
Background and objectives: Patients receiving dialysis have a high burden of cardiovascular disease. Some receive coronary artery revascularization but the optimal method is controversial.Design,...Full Text Available
The prognosis for patients with newly diagnosed malignant gliomas remains poor; however there have been some recent advances in treatment that have generated optimism. Medical management usually includes...Full Text Available
Although management of warfarin is challenging for patients with chronic kidney disease (CKD), no prospective studies have compared response to warfarin among patients with minimal, moderate, and severe...Full Text Available
AIM: To investigate clinical characteristics associated with the presence of irritable bowel syndrome (IBS) symptoms in hemodialysis (HD) patients.METHODS: This was a cross-sectional study. A...Full Text Available
To study the expression of Fc receptors in human alveolar macrophages (AM), the cells were collected from 12 healthy controls and 22 patients with sarcoidosis and the activity involved in binding to...Full Text Available
IntroductionIn critically ill patients the relationship between the storage age of red blood cells (RBCs) transfused and outcomes are controversial. To determine if duration of RBC...Full Text Available
Because the results with cobalt-57-bleomycin (57Co-bleo) as a tumour-seeking agent in patients with pulmonary tumours were promising, a prospective study was carried out to test the sensitivity and...Full Text Available
The measurement of bone loss in patients undergoing maintenance dialysis over a period of two and a half years is reported. The tendency to lose bone is a likely event in renal failure, but depends...Full Text Available
Anemia commonly affects critically ill patients. The causes are multifactorial and include acute blood loss, blood loss from diagnostic testing and blunted red blood cell production. Blood transfusions...Full Text Available