Thirty-four patients with prostatic carcinoma were studied with quantitative bone scintigraphy and whole-body counting (WBC) 1 and 24 h after injection of [sup 99m]Tc-MDP before as well as two weeks and two months after orchiectomy. Thirteen of the patients had normal bone scintigrams and WBR at the three different investigations; 21 had skeletalmetastases. The latter showed throughout the study higher local gamma camera count rates as well as WBR values than the patiens with normal scintigrams. In these patients a ''flare phenomenon'', with an increase in count rate two weeks after orchiectomy followed by a decrease two months post-operatively, was seen with quantitative bone scintigraphy but not with WBC. However, WBC may be a valuable method indicating the total extent of skeletalmetastases in the body, while quantitative bone scintigraphy is more accurate in the ...
Thirty-four patients with prostatic carcinoma were studied with quantitative bone scintigraphy and whole-body counting (WBC) 1 and 24 h after injection of "9"9"mTc-MDP before as well as two weeks and two months after orchiectomy. Thirteen of the patients had normal bone scintigrams and WBR at the three different investigations; 21 had skeletalmetastases. The latter showed throughout the study higher local gamma camera count rates as well as WBR values than the patiens with normal scintigrams. In these patients a ''flare phenomenon'', with an increase in count rate two weeks after orchiectomy followed by a decrease two months post-operatively, was seen with quantitative bone scintigraphy but not with WBC. However, WBC may be a valuable method indicating the total extent of skeletalmetastases in the body, while quantitative bone scintigraphy is more accurate in the interpretation of individual ...
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 carcinoma. It is suggested that screening for liver ...
The case is presented of a 64-year-old man who complained on admission of discomfort in the right shoulder at the time of excision of a large section of the axillary skin which contained extra-mammary Paget disease. Shortly thereafter, radiological studies of the humerus and scapula showed obvious malignant disease which proved to be metastatic upon biopsy of the humerus and pathological studies of the excised area of extra-mammary Paget disease in the axillary skin. The patient died twelve months after the diagnosis was established with widespread metastatic disease. The literature on the subject was reviewed and it was demonstrated that metastases to the skeleton from lesions of the skin are relatively rare. This case is exceptional because of the rapid fatal course and the extent of metastatic disease originating in extra-mammary Paget disease of the axillary skin.
Bone metastases at the thoracic and lumbar segment of the spine are usually presented with painful sensation and medullar compression. The treatment is based on the clinical and neurological conditions of the patient and the degree of tumor invasion. In the present study, 32 patients with spinal metastasis of thoracic and lumbar segment were prospectively analyzed. These patients were treated by decompression and internal stabilization followed by radiotherapy or irradiation with external immobilization. The election of the groups was in accordance with the tumor radiotherapy sensitivity, clinical conditions, spinal stability, medullar or nerve compression and patient's decision. The Frankel scale and pain visual test were applied at the moment of diagnosis and after 1 and 6 months. The surgical group had better results with preserving the ambulation longer and significant reduction of ...
Dynamic quantitative bone scintigraphy was performed on 31 men with prostatic carcinoma before orchiectomy as well as 2 weeks, 2 and 6 months postoperatively. After injection of technetium methylene diphosphonate Tc 99m ("9"9"mTc-MDP) the count rate was recorded as serial images over the lower thoracic and all the lumbar vertebrae from 1 to 240 min post-injection. Thirteen men had normal bone scintigrams with no changes in "9"9"mTc-MDP content at the four different investigation times. Eighteen men had skeletalmetastases. Throughout the study half of the abnormal vertebrae in these patients showed an abnormal count rate after only 6 min post-injection. After 1 h it was possible in almost all abnormal vertebrae to predict abnormal bone uptake. In response to therapy a 'flare phenomenon' with an increase in count rate was seen 2 weeks after orchiectomy followed by a decrease 2 months postoperatively in most of the abnormal vertebrae. The count ...
While bone metastases producing photon deficient defects on bone scintigraphy have previously been reported, this finding has not been emphasized for hepatocellular carcinoma (HCC). Furthermore, ''filling-in'' of such photon deficient defects with 67Ga at skeletal sites of metastatic HCC has not been described. In this case report, the combination of a photon deficient defect on bone scintigraphy and avid accumulation of 67Ga in this same area was of value in confirming the diagnosis of metastatic HCC.
We encountered a case of Ewing's sarcoma. The patient was a 19 year-old girl, who visited a local physician because of pain in the left scapular region, and was referred to us. Roentgenograms of her left scapula revealed an irregular moth-eaten shadow which was suspected to be a malignant bone tumor. The histological diagnosis of Ewing's sarcoma was comfirmed by needle biopsy. The initial stage of treatment consisted of radiation therapy (6000 rads) and chemotherapy (VAC and ADR). At the end of the initial stage, the symptoms were improved, the size of the local lesion was reduced on the roentgenogram and there was no evidence of distant metastases. (author).
Purpose: To evaluate a simple method for quantification of focal activity in bone scintigraphy (BS). Material and methods: The gamma camera was calibrated using a phantom. Quantitative bone scintigraphy (QBS) was performed on 11 men recently diagnosed with prostate cancer (PCa), for whom routine BS showed involvement of the skeleton. Following endocrine therapy for 4 to 8 months, a second QBS was performed. Changes in QBS values were then compared to changes in serum levels of prostate-specific antigen (PSA). Results: PSA response indicating regression of PCa was accompanied by a decrease in the QBS value in 8 of the 11 patients. The overall mean error of the QBS values was 15%. conclusion: QBS according to this method is a relatively simple procedure that might contribute to objective evaluation of therapeutic effects in skeletalmetastases, although its validity must be tested in a larger clinical material.
Purpose: To evaluate a simple method for quantification of focal activity in bone scintigraphy (BS). Material and methods: The gamma camera was calibrated using a phantom. Quantitative bone scintigraphy (QBS) was performed on 11 men recently diagnosed with prostate cancer (PCa), for whom routine BS showed involvement of the skeleton. Following endocrine therapy for 4 to 8 months, a second QBS was performed. Changes in QBS values were then compared to changes in serum levels of prostate-specific antigen (PSA). Results: PSA response indicating regression of PCa was accompanied by a decrease in the QBS value in 8 of the 11 patients. The overall mean error of the QBS values was 15%. conclusion: QBS according to this method is a relatively simple procedure that might contribute to objective evaluation of therapeutic effects in skeletalmetastases, although its validity must be tested in a larger clinical material
The authors assess the role of Computed Topography in the diagnosis and management of multiple myeloma (MM) and investigate if Computed Tomography findings can influence the clinical approach, prognosis and treatment. 273 multiple myeloma patients submitted to Computed Tomography June 1994, to December, 1996. The patients were 143 men and 130 women (mean age: 65 years): 143 were stage I, 38 stage II and 92 stage III according to Durie and Salomon's clinical classification. All patients were submitted to blood tests, spinal radiography and Computed Tomography, the latter with serial 5-mm scans on several vertebral bodies. Computed Tomography despicted vertebral arch and process involvement in 3 cases with the vertebral pedicle sign. Moreover, Computed Tomography proved superior to radiography in showing the spread of myelomatous masses into the soft tissues in a case with solitary permeative lesion in the left public bone, which facilitated subsequent biopsy. As for extraosseous ...
Quantitative bone scintigraphy was performed at 4 and 24 h after injection of {sup 99m}Tc-MDP. The lower thoracic and all the lumbar vertebrae were recorded in 37 patients with prostatic carcinoma before orchiectomy as well as two weeks, two and six months postoperatively. Fourteen patients had normal bone scintigrams. By means of the measured variation in the count rate between normal vertebrae, the criterion for a vertebra to be considered as abnormal was determined using the 4 h-uptake values. For patients with normal scintigrams the count rate at 24 h was below the 4 h level and the mean 24 h/4 h ratio was determined to be 0.85 {+-} 0.09 (1 SD). Normal vertebrae in patients with skeletalmetastases had only slightly lower count rate values at 24 h than at 4 h. Abnormal vertebrae showed a higher count rate at 24 h, especially two weeks postoperatively, while a tendency towards lower values than at 4 h was seen after 6 months. If the 24 h/4 h ...
Quantitative bone scintigraphy was performed at 4 and 24 h after injection of "9"9"mTc-MDP. The lower thoracic and all the lumbar vertebrae were recorded in 37 patients with prostatic carcinoma before orchiectomy as well as two weeks, two and six months postoperatively. Fourteen patients had normal bone scintigrams. By means of the measured variation in the count rate between normal vertebrae, the criterion for a vertebra to be considered as abnormal was determined using the 4 h-uptake values. For patients with normal scintigrams the count rate at 24 h was below the 4 h level and the mean 24 h/4 h ratio was determined to be 0.85 #+-# 0.09 (1 SD). Normal vertebrae in patients with skeletalmetastases had only slightly lower count rate values at 24 h than at 4 h. Abnormal vertebrae showed a higher count rate at 24 h, especially two weeks postoperatively, while a tendency towards lower values than at 4 h was seen after 6 months. If the 24 h/4 h ...
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 ...
Studies on the determinants of pain-related support are needed to enhance couples-based treatments for pain. The purpose of this study was to determine the extent to which pain catastrophizing...Full Text Available
The present case report documents the hitherto unusual application of camouflage orthodontics in one of our patients. Our female patient had previously been treated orthodontically alio loco and had also undergone bimaxillary orthognathic surgery. She presented with TMJ complaints, with associated pains. Despite a dental Class I and centrally seated condyles, her discs had prolapsed anteriorly without reduction and she had developed a massive degenerative-inflammatory TMJ disease. Skeletally, she was a Class II case despite previous orthognathic surgery. In addition, there was also an initial suspicion of rheumatic involvement that could not be confirmed. We distalized the entire lower dental arch without bicuspid extraction. Then we advanced the mandible with the Mandibular Anterior Repositioning Appliance (MARA).We discuss exactly how the modified camouflage therapy was structured and how the individual treatment steps took place. ...
Ewing's sarcoma classically presents as a hot spot on bone scan as a result of increased vascularity of the tumor and new bone formation. Purpose We report and analyze an uncommon pattern of a 'cold' lesion in Ewing's sarcoma on bone scan and its pathophysiologic significance. Case report A 15-year-old boy complaining of thigh pain. CT scan evoked Ewing's sarcoma or osteitis. MRI evoked chronic osteitis. Scintigraphy showed a fairly intense and heterogeneous uptake on the femoral lesion and no abnormal uptake elsewhere. Biopsy showed none pathologic pattern. Three months later, a second biopsy concluded to Ewing's sarcoma. Bone scan showed a larger lesion with peripheral intense uptake centered by enlarged 'cold' area in the left femoral diaphysis and no evident bone metastasis. The patient underwent chemotherapy and surgery. Three months later, bone scan showed extensive skeletal metastasis. Conclusion Ewing's sarcoma appears usually as an ...
Bone metastases of an Ewing's sarcoma were detected by magnetic resonance imaging (MRI), when bone scan, CT and plain films were still normal. This is due to the ability of MRI to detect intramedullary metastases before involvement of the cortex. (Auth.).
Radionuclide bone metastases therapy is a major achievement of nuclear medicine. Development of less radiotoxic and more effective radiopharmaceuticals is therefore a challenge for radiopharmacists and industry. This paper reviews the application of rhenium-188 HEDP as a reactor- or generator-produced nuclide for bone metastases therapy. (author)
Although previous research suggests that preamputation pain is a risk factor for pain after amputation, little is known about the association between acute postsurgical pain and chronic amputation-related pain. The current prospective study examined the associations of preamputation pain and acute postamputation pain with chronic amputation-related pain. The sample consisted of patients with lower limb amputation (N = 57) who provided both preamputation and postamputation data during a 2-year study period. Preamputation pain intensity and duration were assessed before amputation; acute phantom limb pain (PLP) and residual limb pain (RLP) intensity were assessed on postsurgical days 4 and 5. Acute PLP intensity was the only significant independent predictor of chronic PLP ...
IntroductionShoulder pain covers a wide range of problems and affects up to 20% of the population. It is not a specific diagnosis. Shoulder pain can be caused by problems with the...Full Text Available
BACKGROUND:In adults, it is well known that high levels of pain catastrophizing are related to increased pain and disability as well as to heightened anxiety and depression. However,...Full Text Available
BACKGROUND:Despite increasing attention to the epidemiology of pain, relatively little is known about the association between pain and health in children. In particular, no studies...Full Text Available
Stabbing paroxysmal pain due to neurological disease can often be controlled by anticonvulsants, whereas steady burning pain is often responsive to tricyclic antidepressants, and to neuroleptics. Overuse...Full Text Available
Despite the existence of effective analgesic drugs, many cancer patients live and die with ineffective pain control. The control of cancer pain is largely achievable with the appropriate use of available...Full Text Available
BackgroundAdequate pain assessment is critical for evaluating the efficacy of analgesic treatment in clinical practice and during the development of new therapies. Yet the currently...Full Text Available
Little is known about how sociodemographic factors relate to children’s chronic pain. This paper describes the pain, health, and sociodemographic characteristics of a cohort of children...Full Text Available
Pain and pain-related interference with physical function have not been thoroughly studied in individuals who have undergone knee-disarticulation amputations. The principal aim of this study...Full Text Available
Opioids have been regarded for millennia as among the most effective drugs for the treatment of pain. Their use in the management of acute severe pain and chronic pain related to advanced medical...Full Text Available
The aim of the study was to determine whether children with chronic benign pain are in contact with their general practitioner (GP) more frequently than those without chronic benign pain. A random sample...Full Text Available
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 ...
Quantitative bone scintigraphy was performed in patients with prostatic carcinoma before orchiectomy as well as two weeks, two and six months after operation. The count rate was recorded as serial gamma camera images over the lower thoracic and all lumbar vertebrae from 1 to 240 min and at 24 h after injection of "9"9"Tc"m-MDP. In almost all abnormal vertebrae an increased count rate was observed within one hour after injection. Most of the vertebrae which were considered normal at 4 h after injection, but had an increased 24h/4h ratio developed into abnormal vertebrae later in the study. The patients with normal bone scintigrams showed no change in "9"9Tc"m-MDP uptake during the study. The reproducibility of quantitative bone scintigraphy was found to be #+-# 7% (1 SD). In response to therapy, most of the patients with abnormal bone scintigrams showed an increase in count rate two weeks after operation followed by a decrease to the pre-operative level after two months and a further ...
AIMS: To examine the frequency of intraocular metastases in patients who had died of cancer, in an eye bank and necropsy population sample. METHODS: The first group included 302 cancer cases received...Full Text Available
Construction is one of the important industries employing a large number of people on its workforce. A wide range of activities are involved in it. Due to the advent of industrialization and recent developments, this industry is taking a pivotal role for construction of buildings, roads, bridges, and so forth. The workers engaged in this industry are victims of different occupational disorders and psychosocial stresses. In India, they belong to the organized and unorganized sectors. However, data in respect to occupational health and psychosocial stress are scanty in our country. It is true that a sizable number of the workforce is from the unorganized sectors - the working hours are more than the stipulated hours of work - the work place is not proper - the working conditions are non-congenial in most of the cases and involve risk factors. Their wages are also not adequate, making it difficult for them to run their families. The hazards include handling of different materials required ...
This is a retrospective analysis of bone scans in 72 patients with Ewing's sarcoma. Sites of primary disease were found to be evenly distributed among the axial skeleton and the proximal and distal extremities. Primary disease sites in the axial skeleton were more frequently associated with metastases. Fifty-three of these patients had their first scans done at presentation; among them, 25 were found to have metastases. Unsuspected metastases were picked up in 28 of all the patients. Metastases at presentation were seen to be associated with a poorer prognosis.
Pain is necessary for survival but chronic pain is disabling and causes significant health and economic problems. This study provides an understanding of the future for spinal cord stimulation. Stimulation by means of chronically implanted electrodes, was carried out in 200 patients with pain of varied benign organic etiology. In 177 of them, pain was confined to the failed back syndrome. Most patients were referred by a Pain Management Service. 226 epidural implants were used: 80 unipolar, 59 Resume, 12 bipolar, and 75 quadripolar. Patients were followed for periods of 6 months to 12 years, with a mean follow-up of 44 months. 84 patients (42%) were able to control their pain by stimulation alone, 22 patients (11%) needed occasional analgesic supplements along with their stimulation program. Pain secondary to failed back syndrome, multiple ...
The University of North Carolina Comprehensive Pain Center, which has been in existence since 1972, is a pain evaluation, treatment and research program based upon individual diagnosis, comprehensive...Full Text Available
Chronic pain patients who show aberrant drug-related behavior often are discontinued from treatment when they are noncompliant with their use of opioids for pain. The purpose of this study was...Full Text Available
While research has shown that patients’ beliefs about their pain are related to pain adjustment and treatment outcomes, little is known about the beliefs of their significant others....Full Text Available
Pain caused by chronic pancreatitis is medically intractable and resistant to conventional interventional or surgical treatment. We report a case of spinal cord stimulation (SCS) for intractable pain...Full Text Available
Sex differences in pain are frequently reported in the literature. However, less is known about possible sex differences in the experience of pain secondary to a disability. The current study...Full Text Available
In all mammals, tissue inflammation leads to pain and behavioral sensitization to thermal and mechanical stimuli called hyperalgesia. We studied pain mechanisms in the African naked mole-rat, an unusual...Full Text Available
BACKGROUND:Canadian chronic pain prevalence estimates range from 11% to 66%, are affected by sampling and measurement bias, and largely represent urban settings.OBJECTIVES:To...Full Text Available
Chronic neurogenous pain is often an extremely difficult condition to manage. In the orofacial region, trauma from injury or dental procedures may lead to the development of severe neuralgic pains and...Full Text Available
BACKGROUND:Reports indicate that characteristics of older adults with chronic pain may be different than those of younger persons.OBJECTIVE:To study...Full Text Available
ObjectiveTo examine the longitudinal relationship between depressive symptoms at study entry (T1) on pain intensity (PI) and functional disability over a 1-year period...Full Text Available
Even clinicians who keep up with the research literature on pain mechanisms may find themselves uncertain when trying to bring these new theories down to practical application for a patient with pain....Full Text Available
Idiopathic or functional abdominal pain (FAP) is common in school-age children and typically reflects a functional gastrointestinal disorder (FGID). FGIDs in adults have been distinguished by...Full Text Available
Objective:To assess the efficacy of facet joint infiltrations for pain relief in 44 selected patients with chronic nonradicular low back pain (LBP).Materials...Full Text Available
Psychological illness influences the experience and expression of pain and disability. We tested three null hypotheses: (1) patients with nonspecific pain (medically unexplained and idiopathic) and...Full Text Available
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
ObjectiveThe purpose of this study is to identify the factors affecting the failure of trials (<50% pain reduction in pain for trial period) to improve success rate of spinal...Full Text Available
Five methods of personality assessment are evaluated to provide guidance for the psychological treatment of patients with chronic back pain. Patient pain drawings, pentothal pain studies, stress score...Full Text Available
Assessment of the results of laminectomy for lumbar disc lesions is unsatisfactory, but it seems that some degree of recurrent pain is virtually inevitable. The clinical features and incidence of the...Full Text Available
BackgroundLow back pain (LBP) is the most prevalent musculoskeletal condition and one the most common causes of disability in the developed nations. Anecdotally, there is a general...Full Text Available
BackgroundNonsteroidal anti-inflammatory drugs are commonly used to treat postoperative and chronic pain. Animal studies suggest these drugs act in part by blocking...Full Text Available
The treatment of chronic pain conditions continue to present a challenge to the medical field. Physical therapy treatment needs to approach the management of chronic pain differently than the approach used to resolve acute pain. Patients with chronic pain often have many factors that have perpetuated the pain condition. These factors, as well as pain itself, influence their ability to reactivate and perform functional daily activities. Physical therapists can begin to address some of the factors, including fear and deconditioning, by building confidence and body awareness in a self-care model including a slow graduated reactivation program. There is evidence that patients with chronic pain conditions have altered motor control that may be influencing reoccurrences and possible flares of pa...
Interest and research into the mechanisms and treatment of neuropathic pain have increased during recent years, but current treatment is still far from satisfactory (Dworkin...Full Text Available
BackgroundStump and phantom pains are debilitating sequelae of amputations that are often resistant to treatment. The efficacy of pharmacologic therapies, including...Full Text Available
The family physician dealing with gynecologic pelvic pain (acute or chronic) enters at the beginning of the problem as diagnostician, refers the patient to a specialist in the interim, and resumes...Full Text Available
Cryoanalgesia, the local application of extreme cold to nerves to produce analgesia, has been used to treat patients with intractable perineal pain. The cryoprobe was inserted percutaneously through...Full Text Available
ObjectiveTo describe the prevalence, intensity, and functional impact of the following types of pain associated with upper-limb loss: phantom limb, residual limb,...Full Text Available
Skeletal muscle uses calcium as a second messenger to respond and adapt to environmental stimuli. Elevations in intracellular calcium levels activate calcineurin, a serine/threonine phosphatase, resulting...Full Text Available
The effect of A1-adenosine receptor antagonism via 8-cyclopentyl-1,3-dipropyl-xanthine (CPDPX) on the stimulation of skeletal muscle glucose uptake by...Full Text Available
IntroductionIrradiation of normal, non-malignant bone during cancer therapy can lead to atrophy and increased risk of fracture at several skeletal sites, particularly...Full Text Available
Forty-six patients with end-stage renal failure were subjected to iliac crest biopsy before the initiation of a dialysis programme and regardless of the presence of skeletal symptoms....Full Text Available
Insulin resistance in skeletal muscle is a key phenotype associated with type 2 diabetes (T2D) for which the molecular mediators remain unclear. We therefore conducted an expression analysis of human...Full Text Available
This study investigated the impact of lifelong sedentariness on skeletal muscle mass and mitochondrial function. Thirty C57BL/6 strain mice (2 months) were randomly divided into three groups (young-Y;...Full Text Available
Epifluorescence images of Ca2+ transients elicited by electrical stimulation of single skeletal muscle fibers were studied with fast imaging techniques that take advantage of the large fluorescence...Full Text Available
1. The effects of 1 mg/ml whole Naja nivea (Cape cobra) venom, and of three different toxins isolated from it, on spinal reflex excitability and cardiac and skeletal muscle activity...Full Text Available
Oculo-skeletal dysplasia segregates in two canine breeds, the Labrador retriever and samoyed, in which the causative loci have been termed drd1 and drd2, respectively....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
Feb 11, 1997 ... Dr. Baldwin's research focuses on understanding the mechanisms of skeletal and cardiac muscle adaptations to hormonal and activity ...
Two cDNA libraries corresponding to polyA+ RNA from human adult skeletal muscle have been constructed by cloning in the PstI site of pBR322. Skeletal alpha actin cDNA clones have been isolated and characterized....Full Text Available
The aim of the study was to determine whether children with chronic benign pain are in contact with their general practitioner (GP) more frequently than those without chronic benign pain. A random sample of children and adolescents aged between 0 and 18 years of age was drawn from the records of ten general practices. According to their responses to a pain questionnaire, subjects were assigned to the chronic benign pain group (n = 95) if they had pain of more than three months' duration, or to the control group (n = 105) if they had pain of less than three months' duration or no pain at all. All the subjects had an average GP consultation rate of 2.6 contacts per year. No significant age and sex differences were found. Chronic benign pain in childhood and adolescence is not related to increased use of healthcare ...
Sex differences in pain are frequently reported in the literature. However, less is known about possible sex differences in the experience of pain secondary to a disability. The current study explored these issues in persons with limb loss (n = 335, 72% men) who were recruited as part of a postal survey. Participants provided ratings of phantom limb pain (PLP), residual limb pain (RLP), and general pain intensity. Participants also completed measures of pain-related interference, catastrophizing, coping, and beliefs. Results indicated that a greater proportion of males than females (86% vs 77%, respectively) reported the presence of PLP; however, this difference was no longer prominent when cause of limb loss was controlled. No sex differences were found in the presence of RLP, or in avera...
The language used by chronic benign pain patients to characterize their pain complaint was analyzed to determine the best predictor of psychiatric disturbance. Using the 78 adjectives provided by the McGill Pain Questionnaire, the number of affective descriptors used was the best predictor of psychiatric disturbance. Addition of sensory descriptors either to augment the total number of descriptors used (magnitude) or as a pattern of sensory greater than affective or sensory less than affective failed to increase predictive strength. PMID:6877847
In response to an earlier published paper by Fordyce, some assumptions underlying the behavior management paradigm of chronic pain are critically discussed. While operant treatment has proved successful, the conclusion that operant factors play an important role in the development and maintenance of chronic benign pain is debated. Some empirical studies, regularly used to demonstrate this role, are re-evaluated. An alternative theory is proposed for chronic pain behavior, in which the role of a lower tolerance to proprioceptive stimuli, which may include more than just pain stimuli, is emphasized. PMID:3313200
Over the years, nurses, doctors and scientists have sought ways of assessing the impact of pain on patients. While many of the instruments devised have been extremely useful in identifying the nature and intensity of pain, defining the effect it has on people's lives and perceptions has proved much more problematic. Based on the work she carried out with patients suffering from chronic benign pain, Karen Rose explores one aspect of these effects--the feeling of isolation. By using a four-step anthropological approach to identify the impact of pain, she argues, nurses can arrive at a realistic and accurate assessment of how patients are coping. PMID:7947167
The waterjet technique enables precise tissue dissection without thermal damage and with preservation of vessels in general surgery. In neurosurgery, these qualities could help to avoid damage of intact brain parenchyma in tumour resections. The present study reports our first results with this technique in brain metastases. Ten patients with intracranial metastases underwent surgery with the aid of the waterjet. Resection was performed in combination with conventional neurosurgical methods. The follow-up consisted of neurological examination and MRI studies. Intraoperatively, the device was easy to handle. No complications due to the device were observed. Vessels were preserved at pressures below 20 bars. Six of the tumours consisted of soft tissue which was poorly demarcated from the surrounding brain. In these tumours, the waterjet was very helpful. It enabled tumour debulking by aspiration and - more important - precise separation of tumour ...
In eight patients with Ewing's sarcoma bone scans were performed using "9"9"mTc-MDP. This procedure rendered possible the diagnosis of clinically or radiologically silent metastases. (orig.).
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
"Pillar pain" is a relatively frequent complication after surgical release of the median nerve at the wrist. Its etiology still remains unknown although several studies highlight a neurogenic inflammation as a possible cause. Pillar pain treatment usually includes rest, bracing and physiotherapy, although a significant number of patients still complain of painful symptoms two or even three years after surgery. The aim of this study was to investigate the efficacy of low-energy, flux density-focused extracorporeal shock wave therapy (ESWT) in the treatment of pillar pain. We treated 40 consecutive patients with ESWT who had pillar pain for at least six months after carpal tunnel release surgery, and to our knowledge, this is the first study that describes the use of ESWT for treating this c...
Background and aims. The multiplicity of vaccine injections during childhood leads to iterative painful and stressful experiences which may lead in turn to anticipated pain and then possibly to a true needle phobia. We aimed at evaluating a multifactorial strategy of pain management combining pharmacological and non-pharmacological approaches during vaccination, as compared to usual care, in 4- to 12-year-old children. Methods. In all, 239 children were enroled by 25 family practitioners in an open-label study. After a pseudo-randomization, usual pain management (n = 132) was compared to a multifactorial strategy (n = 107) associating preliminary application of an anesthesic patch, preferential use of specified vaccines, child education by the parents and the doctor, parental accompaniment...
The adverse effects of aging of other organs (ovaries at menopause) on the skeleton are well known, but ironically little is known of skeletal aging itself. Evidence indicates that age-related...Full Text Available
Patients rely on their primary care physician to manage multiple, often chronic medical conditions that require prescription medications. Balancing the risk to benefit of treatments can be challenging...Full Text Available
Phospholemman (PLM), a member of the FXYD family of regulators of ion transport, is a major sarcolemmal substrate for protein kinases A and C in cardiac and skeletal muscle. In the heart, PLM...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
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).
We report the isolation of adherent, clonogenic, fibroblast-like cells with osteogenic and adipogenic potential from the blood of four mammalian species. These cells phenotypically resemble but are...Full Text Available
Purpose: To evaluate the role of stereotactic radiosurgery (SRS) and whole-brain radiotherapy (WBRT) for the treatment of brain metastases in patients with renal cell cancer (RCC). Patients and methods: 88 patients were treated with either SRS (n = 51) or SRS + WBRT (n = 17) for one to three lesions, or with WBRT (n = 20) for more than three brain metastases. Overall survival (OS), intracerebral control (IC) and local control (LC) were retrospectively analyzed. Six potential prognostic factors were assessed: age, gender, number of brain metastases, extracerebral metastases, recursive partitioning analysis (RPA) class, and interval from tumor diagnosis to irradiation. Results: The median times for OS, IC, and LC from the time of diagnosis were 11, 9, and 10 months. The median OS times for SRS, SRS + WBRT, and WBRT were 12, 16, and 2 months. Addition of WBRT to the SRS improved IC (p = 0.032) but not OS ...
In this retrospective study, 28 cases of Ewing's sarcoma are reviewed for the onset of metastasis. Bone scans demonstrated bone metastasis in three out of 28 patients at presentation. Of the 22 patients free of metastases at presentation, ten subsequently developed bone metastases. In six of these patients, the bone scan was the earliest demonstrator of metastatic disease. Bone scans are recommended at presentation and periodically during follow-up.
Interferon-γ (IFN-γ) has been shown to enhance anti-tumor immunity and inhibit the formation of bone-resorbing osteoclasts. We evaluated the role of IFN-γ in bone metastases,...Full Text Available
Chondrosarcomas are the most frequently occurring primary malignant chest wall tumors. Furthermore, the lungs serve as the most frequent sites for metastases. Pulmonary metastases from sarcomas usually...Full Text Available
To assess whether ring enhancements of liver metastases on Mn-DPDP enhanced, early MR images were well visualized on delayed images, as compared with those of hepatocellular carcinomas (HCC), and to investigate the detection accuracy and conspicuity of each tumor. Twenty patients with liver metastases and 15 with HCC were studied by Mn-DPDP enhanced, T1-weighted MR images. Peripheral ring enhancement and conspicuity were investigated. Differences in detection accuracy and frequency of ring enhancement in liver metastases and HCC were assessed. In liver metastases (n= 69), 44 cases (63.8%) without ring enhancement and 25 (36.2%) with were noted on early images. Sixteen cases (23.2%) without ring enhancement, 38 (55.1%) with ring enhancement similar to the early images, and 15 (21.7%) with prominent ring enhancement were noted on delayed images. In HCC (n=37), 36 cases (97.3%) without ring enhancement and ...
Presented here is a case of a young woman, with an undiagnosed osteoid osteoma of the spine, which presented with painful scoliosis in adolescence and was treated by bracing until her accession to adulthood....Full Text Available
ObjectivesUse of prescription opioids for chronic pain is increasing, as is abuse of these medications, though the nature of the link between these trends is unclear....Full Text Available
BackgroundAnterior knee pain (AKP) is a common musculoskeletal complaint. It has been suggested that one factor that may contribute to the presence of AKP is a delay in the recruitment...Full Text Available
BackgroundThe objective of this study was to develop and validate a daily electronic Endometriosis Pain and Bleeding Diary (EPBD) for assessing treatment-related changes in endometriosis...Full Text Available
Shoulder pain is a common orthopedic condition seen by physical therapists, with many potential contributing factors and proposed treatments. Although manual physical therapy interventions for the cervicothoracic...Full Text Available
A retrospective study is presented of 83 athletes with tendo Achillis pain (TAP) treated conservatively over a 12-year period from 1976 to 1988. Local steroid injections did not contribute to an earlier...Full Text Available
BackgroundPatients’ general tendency to adhere to health care provider-recommended treatments is associated with a number of health outcomes, but whether it influences pain...Full Text Available
This article reports on an exploratory study of hospice social workers’ assessment and collaborative practices related to pain management; especially caregiver concerns about patient...Full Text Available
Sex-related influences on pain and analgesia have become a topic of tremendous scientific and clinical interest, especially in the last 10 to 15 years. Members of our research group published...Full Text Available
The development of central neuropathic pain varies among patients with spinal cord injury (SCI). The factors contributing to the development and perpetuation of segmental pain (at-level allodynia)...Full Text Available
BackgroundSeverely disabling chronic pain in the adult population is strongly associated with a range of negative health consequences for individuals and high health care costs,...Full Text Available
Previous studies in several different trigeminal nerve injury/inflammation models indicated that the hyperexcitability of primary afferent neurons contributes to the pain pathway underlying mechanical...Full Text Available
The objective of this study was to evaluate the effect of pregabalin in painful cervical or lumbosacral radiculopathy treated in Primary Care settings under routine clinical practice. An observational,...Full Text Available
Racial and ethnic disparities in healthcare persist in the U.S. Although pain is one of the most prevalent and disabling symptoms of disease, only a few studies have assessed disparities in...Full Text Available
BackgroundControversy exists about how to effectively measure patient reported outcomes in IBS clinical trials. Pain numeric rating scales (NRS) are widely used in...Full Text Available
The frozen shoulder is a common cause of shoulder pain and disability. Most patients slowly improve over 12 to 24 months. Some have prolonged loss of movement, pain, and associated disability. Treatments...Full Text Available
Lumbar epidural anesthesia is useful in a variety of chronic benign pain syndromes, including lumbar radiculopathy, low back pain syndrome, spinal stenosis, and vertebral compression fractures. Given...Full Text Available
Objectives. To assess the feasibility of treating musculoskeletal pain in the lower back and/or lower extremities in persons with Parkinson's disease (PD) with cranial electrotherapy...Full Text Available
Inclusion of family members in the assessment of patients with chronic pain can improve outcomes. Family functioning can be assessed in four basic areas: boundaries, power, communication, and intimacy....Full Text Available
BackgroundNeuropathic pain (NP) is partially mediated by neuroinflammatory mechanisms, and also modulates local neurogenic inflammation. Dietary lipids, in particular the total amount...Full Text Available
Patients with adhesive capsulitis were clinically evaluated to establish whether pain elicited by pressure on the coracoid area may be considered a pathognomonic sign of this condition. The study group...Full Text Available
... Search Help? Coping with Test Pain, Discomfort, and Anxiety Introduction | Be Prepared | Know Your Tests | Relax | Conclusion ... though they may feel some embarrassment, discomfort, or anxiety at the outset. If undergoing medical tests makes ...
BackgroundThe purpose of our study was to evaluate the clinical value of hybrid SPECT/CT for the assessment of patients with painful total knee arthroplasty (TKA).MethodsTwenty-three...Full Text Available
BackgroundUntil now only limited research has been done on the prevalence of chronic pain in primary care. The aim of this investigation was to study the health care utilisation...Full Text Available
ObjectivePersons with chronic or recurrent pain frequently visit the emergency department (ED), yet little research examines this experience. We conducted this national survey to...Full Text Available
Approximately 20% to 30% of patients who undergo coronary arteriography for the evaluation of chest pain are found to have normal coronary arteries. These patients have a survival rate comparable to...Full Text Available
BackgroundChronic non-specific musculoskeletal pain (CNSMSP) may develop in childhood and adolescence, leading to disability and reduced quality of life that continues into adulthood....Full Text Available
Functional imaging has revolutionized the neurosciences. In the pain field it has dramatically altered our understanding of how the brain undergoes significant functional, anatomical and chemical changes...Full Text Available
Behavioural assessment methods have been used to signal the need for intervention and to evaluate treatment effectiveness. Direct observation and rating scales have been used to assess pain and distress...Full Text Available
The aim of this study was to investigate whether astroglia in the medullary dorsal horn (trigeminal spinal subnucleus caudalis; Vc) may be involved in orofacial neuropathic pain following trigeminal...Full Text Available
ContextWhile opioids are increasingly used for chronic non-cancer pain (CNCP), we know little about opioid dosing patterns among individuals with CNCP in usual care...Full Text Available
In the last 40 years, significant advances have been made in the understanding of the neurophysiologic processes involved in the experience of trauma and pain. This knowledge, together with the rapid growth and understanding in the behavioral health sciences, has expanded to include a much better appreciation of how these fields are converging and contribute to a process called neuroplasticity. These basic mechanisms common to all patients have important implications for clinical outcome and for improving clinical practice. This article is written for clinicians who manage patients with sacroiliac joint dysfunction, a specific type of nonspecific low back pain.
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 ...
BackgroundAδ and C fibers are the major pain-conducting nerve fibers, activate only partly the same brain areas, and are differently involved in pain syndromes....Full Text Available
The utilization of health care services in children and adolescents with chronic benign pain was studied in a Dutch population sample of 254 chronic pain sufferers aged 0-18 years. Children and adolescents who had reported chronic pain (continuous or recurrent pain >3 months) in our previous prevalence study were asked to keep a 3-week diary on their pain and to fill out questionnaires on background factors, health care use and the impact of pain. Parent ratings were used for children aged 0-11 years, self-report was used in adolescents (12-18 years). In a 3-month period, in 53.4% of the cases medication was used for pain, and general practitioners and specialists were consulted for pain in 31.1% and 13.9% of subjects, respectively. Physiotherapists, psychologists and alternative health providers were visited by 11.5, ...
Multiple myeloma is a highly radiosensitive skeletal malignancy, but bone-seeking radionuclides have not yet found their place in disease management. We previously reported that the proteasome inhibitor...Full Text Available
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.
We investigated the distribution and expression of mutant mtDNAs carrying the A-to-G mutation at position 8344 in the tRNA(Lys) gene in the skeletal muscle of four patients with myoclonus epilepsy and...Full Text Available
The bioenergetic capacity of skeletal muscle in a 17-year-old patient with a severe defect in complex III of the electron transport chain has been examined by 31P NMR measurements of the molar ratio...Full Text Available
Study Design Best evidence synthesis. Objective To undertake a best evidence synthesis of the published evidence on the burden and determinants of neck pain and its associated disorders in the general population. Summary of Background Data The evidence on burden and determinants of neck has not previously been summarized. Methods The Bone and Joint Decade 2000?2010 Task Force on Neck Pain and Its Associated Disorders performed a systematic search and critical review of literature published between 1980 and 2006 to assemble the best evidence on neck pain. Studies meeting criteria for scientific validity were included in a best evidence synthesis. Results We identified 469 studies on burden and determinants of neck pain, and judged 249 to be scientifically admissible; 101 articles related to...
Psychological distress and postamputation pain were investigated in a sample of 582 males with long-term limb amputations (mean time since amputation 639.3 months, standard deviation 166.1; range 240-784 months). Prevalence of significant depressive symptoms (Hospital Anxiety and Depression Scale [HADS]-D score?8) was 32.0%, and 34.0% of respondents met the screening criterion for clinical anxiety (HADS-A score?8). Nearly one quarter (24.6%) of respondents reported significant post-traumatic psychological stress symptoms (Impact of Event Scale scores?35). In total, 87.8% experienced either phantom or residual limb pain. Affective distress scores differed according to the respondents' type of pain experience. Respondents who experienced residual limb pain reported significantly hig...
The subjective experience of one's environment is constructed by interactions among sensory, cognitive, and affective processes. For centuries, meditation has been thought to influence such processes by enabling a nonevaluative representation of sensory events. To better understand how meditation influences the sensory experience, we used arterial spin labeling functional magnetic resonance imaging to assess the neural mechanisms by which mindfulness meditation influences pain in healthy human participants. After 4 d of mindfulness meditation training, meditating in the presence of noxious stimulation significantly reduced pain unpleasantness by 57% and pain intensity ratings by 40% when compared to rest. A two-factor repeated-measures ANOVA was used to identify interactions between meditation and pain-related brain activation. Meditation reduced pain-related activation of the ...
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 (DBC) 48% and 37%, respectively. Only ten of 46 patients (22%) with initial SRS ...
Forty-four patients with small cell carcinoma of the bronchus underwent CT and MR studies of the brain to detect cerebral metastases. All patients were studied with contrast-enhanced CT scans, short (T1-weighted) and long (T2-weighted), spin-echo (SE) and FLASH 90 grades sequences were also obtained. A quantitative comparison of the results was carried out to assess the sensitivity of the different techniques in the detection of brain metastases according to lesion diameter. Metastases were identified in 19/44 patients (43%). All techniques detected the lesions >2 cm; of the metastases <2 cm, 63/124 (51%) were detected only by GdDTPA SE-T1 and FLASH sequences and 11 more (9%) only by Gd-DTPA SE-T1 scans. All the lesions identified oh enhanced CT scans or on T2-weighted images were easily detected by Gd-DTPA scans. CT sensitivity was higher than that of pre-contrast SE-T1 and FLASH studies and only ...
A large proportion of patients may develop chronic pain following cancer treatments such as surgery, radiotherapy, or chemotherapy. These patients can experience significant levels of physical and psychological morbidity. Our aim was to investigate a cognitive-behavioral pain management program (PMP) for cancer patients with chronic treatment-related pain. Thirteen patients (1 man, 12 women; mean age 52 yrs) completed the study, 9 of whom had a history of breast cancer and had received extensive medical treatment, including surgery. A combination of physical and psychological techniques were adapted from previous work in chronic benign pain and implemented by two therapists. Interventions included education, relaxation, exercise training, and goal setting. A variety of outcomes were examined to assess general fitness, psychological distress, coping success, activities of daily living, and ...
Miriplatin, a cisplatin derivative with a high affinity for iodized oil, is a novel chemotherapeutic agent designed for use in the transarterial treatment of hepatocellular carcinoma. This case report...Full Text Available
BackgroundEwing sarcoma (ES) is the second most common bone tumor in children, and survival of those with metastatic ES has not improved. Previous studies have shown...Full Text Available
Cervical cancer is known to metastasize primarily by the lymphatic system. Dissemination through lymphatic vessels represents an early step in regional tumor progression, and the presence of lymphatic...Full Text Available
Experimental metastases in the brain of mice are infiltrated by microglia, and parabiosis experiments of green fluorescent protein (GFP+) and GFP- mice revealed that these microglia...Full Text Available
BackgroundThe tumor microenvironment has been described as a critical milieu determining tumor growth and metastases. A pivotal role of metastasis-inducing S100A4 in the development...Full Text Available
BackgroundSome breast cancer patients receiving anti-angiogenic treatment show increased metastases, possibly as a result of induced hypoxia. The effect of hypoxia on tumor cell...Full Text Available
Bone metastasis of primary colorectal cancer is uncommon. When it occurs, it is usually a late manifestation of disease and is indicative of poor prognosis. We describe a patient with multiple metachronous...Full Text Available
BackgroundNon-small cell lung cancer (NSCLC) is the foremost cause of cancer-related death in Western countries, which is due partly to the propensity of NSCLC cells to metastasize....Full Text Available
Metastases to the cerebellopontine angles (CPAs) are rare. Typically, the clinical course is one of rapid onset and progression of crarial nerve deficits. The clinical presentation and course of carcinoma...Full Text Available
Sarcomas usually metastasize to lugs. The following case report describes an unusual metastasis of Ewing's sarcoma to extradural parietal region bilaterally. The primary was found at lower end of ulna. (author)
The yellow Iranian scorpion Odontobuthus doriae can cause fatal envenoming, but its mechanism of action is unclear. One of the reported manifestations of envenoming is moderate to severe involuntary tremor of skeletal muscle. In order to understand better the mechanism of action of this venom on skeletal muscle function, we examined the effects of the venom in vitro on chick biventer cervicis (CBC) and mouse hemidiaphragm (MHD) nerve muscle preparations. O. doriae venom (0.3-10mg/ml) initially increased and then decreased twitch height. The venom also caused contracture in both preparations. In mouse triangularis sterni preparations, used for all intracellular recording techniques, the venom enhanced the release of acetylcholine and induced repetitive firing of nerve action potentials and ...
Trastuzumab increases survival amongst women with human epidermal growth factor receptor (HER)-2 receptor positive metastatic breast cancer, but maternal and fetal risks are associated with advanced disease and its treatment in pregnancy. We present a case of a primigravid with HER-2 positive metastatic breast cancer who received trastuzumab throughout pregnancy. She presented with cerebral metastases, requiring surgical decompression and resection. Reversible oligohydramnios developed during pregnancy. Fetal safety data on trastuzumab in pregnancy is limited, but case reports suggest a recurring pattern of (mostly reversible) oligohydramnios.
Background and purpose: To assess the effectiveness of radiotherapy in preventing tumour seeding after chest drain or pleural biopsy in patients with malignant mesothelioma and to determine, if tract metastases appear, whether they are tender or troublesome to patients. Patients and methods: Patients with a histological diagnosis of pleural mesothelioma and an invasive procedure within the preceding 21 days were stratified by age, performance status and treatment centre. Randomisation was performed between immediate drain site radiotherapy 21 Gy in three fractions (XRT arm) or best supportive care (BSC) with follow-up to 12 months. Patients were asked to complete questionnaires on treatment toxicity and on symptoms from any tract metastases detected. Results: Sixty-one patients were recruited from two centres between 1998 and 2004; 56 men, 5 women, median age 70. 31 were allocated to drain site radiotherapy. Seven patients developed tract ...
Postamputation pain (PAP) affects over 60% of major limb amputees. One of the main challenges in treating PAP is the difficulty involved in identifying pain mechanism(s), which pertains to both residual limb pain (RLP) and phantom limb pain (PLP). In this study, sympathetic blocks were performed on 17 major limb amputees refractory to treatment, including 2 placebo-controlled blocks done for bilateral amputations. One hour postinjection, mean RLP scores at rest declined from 5.2 (SD 2.8) to 2.8 (SD 2.6) (P = .0002), and PLP decreased from 5.3 (SD 3.1) to 2.3 (SD 2.1) (P = .0009). By 1 week, mean pain scores for RLP and PLP were 4.3 (SD 2.9) and 4.2 (SD 3.0), respectively. Overall, 8 of 16 (50%) patients experienced ?50% reduction in RLP 1-hour postinjection, with the beneficial effects ...
The utilization of nuclear medicine bone scanning examinations early in the diagnostic process allows physicians to render prompt and correct treatment in urgent or difficult athletic cases. Bone scanning should be performed for athletic injuries whenever (1) x-rays are normal but bone or joint pain persists; (2) x-rays are positive but it cannot be determined if the findings are acute or chronic; (3) soft-tissue injuries present and x-rays are not useful; and (4) bone pain or joint impairment present without a history of trauma.89 references.
Objective: The aim of this study was to obtain an overview of the methodological quality of studies on the measurement properties of neck pain and disability questionnaires and to describe how well various aspects of the design and statistical analyses of studies on measurement properties are performed. Methods: A systematic review was performed of published studies on the measurement properties of neck pain and disability questionnaires. Two reviewers independently rated the quality of the studies using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. This checklist was developed in an international Delphi consensus study. Results: A total of 47 articles were included on the measurement properties of 8 different questionnaires. The meth...
Chronic benign pain is commonly associated with chronic fatigue and depression. Depression and chronic fatigue syndrome are also associated with each other and often include pain. Psychologic factors are prominent in these conditions, and they may share neurobiologic factors as well. Management requires separately addressing each component of patients' distress and usually includes physical rehabilitation, education, administration of nonhabituating medications and often counseling. Depression may be a favorable prognostic sign, as it suggests a treatable condition and provides incentive for recovery. PMID:1876618
Back pain from osteoporosis is commonly related to compression fractures. The patient with vertebral compression fractures additionally suffers from an ongoing risk of recurrent fractures and postural abnormalities that can result in impaired respiratory function, leading to increased risk of morbidity. Weakened back muscles, especially the back extensor group, are felt to contribute significantly to this risk. The combination of pharmacologic and nonpharmacologic interventions, through physical activity, exercise, and modalities, are potential interventions that could be used to help reduce the pain of osteoporotic compression fractures as well as potentially reducing recurrent fracture rates.
A new method of administration of an opioid was recently registered: fentanyl transdermal (brand name: Durogesic), intended particularly for the indication range 'pain in cancer'. Fentanyl is lipid-soluble so that deposition in the skin takes place and the biological half-life is approximately 20 hours after removal of the plaster. It is safe to start on a basis of an equianalgesic conversion of 100:1 in relation to oral morphine, although this may entail some risk of fentanyl under dosage. The dose adjustment time is 12-24 hours before a constant fentanyl level is reached; therefore, after attaching the first sticking plaster, the original morphine dose should be continued for another 12 hours. In addition, the patient may, if necessary, be given supplementary morphine preferably as a short-acting drug. There seems to be no clear indication for transdermal fentanyl either in neuropathic pain or in chronic benign pain. ...
Dengue, a major public health problem throughout subtropical and tropical regions, is an acute infectious disease characterized by biphasic fever, headache, pain in various parts of the body, prostration,...Full Text Available
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...
ObjectiveNeuralgic amyotrophy (NA) is a distinct clinical syndrome that is characterized by the acute onset of shoulder and arm pain, weakness, and sensory loss. The purpose of this...Full Text Available
The physical demands of performing on musical instruments can cause pain, sensory loss, and lack of coordination. Five cases illustrate common problems. Knowledge of the interaction between the technique...Full Text Available
Cutaneous scarring can cause patients symptoms ranging from the psychological to physical pain. Although the process of normal scarring is well described the ultimate cause of pathological scarring...Full Text Available
Opinion statementCritical limb ischemia (CLI), defined as chronic ischemic rest pain, ulcers, or gangrene attributable to objectively proven arterial occlusive disease, is the most advanced...Full Text Available
The antinociceptive effects of honokiol and magnolol, two major bioactive constituents of the bark of Magnolia officinalis, were investigated on animal paw licking responses and thermal...Full Text Available
Somite boundary formation is crucial for segmentation of vertebrate somites and vertebrae and skeletal muscle morphogenesis. Previously, we developed a Tol2 transposon-mediated...Full Text Available
Recessive inactivating mutations in human matrix metalloproteinase 2 (MMP2, gelatinase A) are associated with syndromes that include abnormal facial appearance, short stature, and severe bone...Full Text Available
The choice of treatment in adult skeletal Class III occlusions often poses a particularly tricky problem for the orthodontist. Faced with the option of either orthodontic camouflage or orthognathic surgery, the clinician's clinical experience is of paramount importance, especially in borderline cases. The aim of our study was to uncover a guide model enabling the practitioner to distinguish between skeletal Class III cases which can be suitably treated with orthodontics and those requiring orthognathic surgery. The lateral headfilms of 47 adult patients exhibiting skeletal Class III occlusions were analyzed. The orthodontic group comprised 22 patients and the surgical group 25. Twenty-seven linear, proportional and angular measurements were scrutinized. Stepwise discriminant analysis was used to identify the dentoskeletal and esthetic variables which most distinguished the two groups. The Holdaway angle was chosen to ...
Changes in glucose 1,6-bisphosphate and regulators of glucose-1,6-bisphosphate synthase and phosphatase during isometric contraction have been determined. Biopsies were obtained from the quadriceps...Full Text Available
Skeletal muscle and adipose tissue development often has a reciprocal relationship in vivo, particularly in myodystrophic states. We have investigated whether determined myoblasts with no inherent adipogenic...Full Text Available
1. The amino acid sequences around the thiol groups of glyceraldehyde 3-phosphate dehydrogenase from badger and monkey skeletal muscle were compared with the sequences around the thiol groups in the...Full Text Available
SummaryThe structure and function of myosin crossbridges in asynchronous insect flight muscle (IFM) have been elucidated in situ using multiple approaches. These...Full Text Available
Skeletal radiotracer (sup(99m)Tc-HEDP) uptake was quantitated with and without the aid of a computer in 30 chronic dialysis patients with histologic evidence of renal osteodystrophy. Before scintigraphy, elevated soft-tissue activity due to the absence of renal radiotracer excretion was reduced by hemodialysis. The results were compared with those of a normal group and with the results of the biochemical and the bone morphometric studies of these patients. In all patients the radiotracer uptake was elevated, often markedly. In several patients with minimal histologic bone disease, however, soft-tissue activity could not be normalized by hemodialysis although its influence on the quantitative data could be further reduced (but not excluded) by computer evaluation of skeletal radiotracer uptake. Since the latter technique clearly distinguished the majority of the patients from the normals, it appears that computerized quantitative ...
Calpains are Ca2+-dependent proteinases that mediate protein turnover in crustacean skeletal muscles. We used an antibody directed against lobster muscle-specific calpain (Ha-CalpM)...Full Text Available
BackgroundAs the resident stem cells of skeletal muscle, satellite cells are activated by extracellular cues associated with local damage. Once activated, satellite cells will re-enter...Full Text Available
There are many factors that can influence glucose uptake by contracting skeletal muscle during exercise and although one may be intramuscular glycogen content, this relationship is at present not fully...Full Text Available
Muscular dystrophies (MDs) comprise a group of degenerative muscle disorders characterized by progressive muscle wasting and often premature death. The primary defect common to most MDs involves disruption...Full Text Available
Searching for the structural requirements improving the potency and the stereoselectivity of Na+ channel blockers as antimyotonic agents, new...Full Text Available
Skeletal formation is an essential and intricately regulated part of vertebrate development. Humans and mice deficient in Growth and Differentiation Factor 6 (Gdf6) have numerous...Full Text Available
Natural accumulations of skeletal material (death assemblages) have the potential to provide historical data on species diversity and population structure for regions lacking decades of wildlife monitoring,...Full Text Available
This book provides differential diagnostic possibilities of specific scan abnormalities in one volume for easy reference. This book is organized by organ systems and covers the central nervous system, the endocrine, skeletal, pulmonary, gastrointestinal, genitourinary, and cardiovascular systems. The gamuts are designed to teach differential diagnosis and to assist in the actual interpretation of patient slides.
Fibroblast growth factor (FGF) signaling is involved in skeletal development of the vertebrate. Gain-of-function mutations of FGF receptors (FGFR) cause craniosynostosis, premature fusion of the skull,...Full Text Available
Silent information regulators are potent NAD+-dependent protein deacetylases, which have been shown to regulate gene silencing, muscle differentiation and DNA damage repair. Here,...Full Text Available
Japanese medaka (Oryzias latipes) embryos exposed to ethanol have developed craniofacial, cardiovascular and skeletal defects which can be compared with the phenotypic features...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
The repair process of damaged tissue involves the coordinated activities of several cell types in response to local and systemic signals. Following acute tissue injury, infiltrating inflammatory cells...Full Text Available
The purpose of this study was to investigate the sources of ATP in the 1A arteriole, and to investigate age-related changes in ATP overflow. Arterioles (1A) from the red portion of the gastrocnemius...Full Text Available
The purpose of this paper is to describe a technique of forced surgical rotation of the mandible used in skeletal Class II patients with deep bite and prominent chin. Posterior occlusal composite onlays combined with preoperative orthodontic treatment without anterior intrusion increase the posterior rotational component of the surgical mandibular advancement, when removed during operation. This manoeuvre allows for the surgical closure of the posterior open bite, while anteriorly the deep bite is opened. This technique avoids bimaxillary rotation surgery with dorsal impaction in mild to moderate cases. In any case, a chin setback osteotomy with compromised aesthetics can be avoided.
The method, use and results of computer-aided diagnosis of bone tumours and tumour-like skeletal abnormalities in childhood are described. One hundred and twentyone histologically verified cases were analysed and subjected to computer-aided diagnosis. Statistical methods were used, resulting in an accuracy of 96.7% and 91.7% respectively. In order to obtain additional confirmation of the diagnosis, a so-called growth rate was calculated by the computer. This proved to be a reliable criterion for evaluating the biological behaviour of tumours, irrespective of the histological diagnosis. The reasons for misdiagnosis were discussed. Attention is drawn to the importance of an accurate analysis of the radiographs and its input into the computer.
We report here the imaging findings of a rare case of a lethal form of Gorham disease in a young female patient. Multimodality imaging findings over 13 year-follow-up demonstrated progressive wide spread skeletal and soft tissue abnormalities with permeative osteolysis, pathological fractures and severe skeletal deformities. Unusual extensive osseous and soft tissue pneumatosis was illustrated on cross-sectional studies. The progressive nature of this form of Gorham disease and the subsequent complications eventually culminated in patient's death. (orig.)
We report here the imaging findings of a rare case of a lethal form of Gorham disease in a young female patient. Multimodality imaging findings over 13 year-follow-up demonstrated progressive wide spread skeletal and soft tissue abnormalities with permeative osteolysis, pathological fractures and severe skeletal deformities. Unusual extensive osseous and soft tissue pneumatosis was illustrated on cross-sectional studies. The progressive nature of this form of Gorham disease and the subsequent complications eventually culminated in patient's death. (orig.)
BackgroundGeneralized anxiety disorder (GAD) is the most frequent anxiety disorder in primary care patients. It is known that painful physical symptoms (PPS) are associated with...Full Text Available
1. Ro 15-8081 (Hoffmann-La Roche, Basle, Switzerland) is a novel mixed 5-HT/noradrenaline uptake inhibitor producing potent antinociceptive effects in animal pain models. 2. In healthy man, two models...Full Text Available
Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) remains an enigmatic medical condition. Creation of the (NIH) Chronic Prostatitis Collaborative Research Network (CPCRN) funded by...Full Text Available
Background: In the German CESS-studies, Ewing's sarcoma patients with pulmonary metastases at diagnosis were considered as candidates for additional bilateral lung irradiation. We have retrospectively analyzed the impact of radiotherapy on survival. Material and methods: Out of 42 patients presenting with pulmonary metastases of Ewing's sarcoma between 1981 and June 1992, 30 were evaluable. One patient died of progressive disease prior to lung irradiation. The other patients had a complete radiographic remission either after chemotherapy (n=25) or chemotherapy plus resection of lung metastases (n=4). 22 patients received bilateral lung irradiation with doses of 12 to 21 Gy (once daily 1.5 Gy or twice daily 1.25 Gy), six had no further treatment and one had bone marrow transplantation for consolidation. Results: Ten patients are in complete remission, nine of them had received lung irradiation and one had a complete ...
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 eligibility required that patients had undergone surgical resection ...
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 eligibility required that patients had undergone surgical resection ...
The accuracy is investigated of both lymphangiography and CT in detecting lymph nodes metastases in 59 patients evaluated preoperatively and subsequently submitted to surgery with selective/systemic pelvic and paraaortic lymphadenectomy. CT accuracy was also investigated in 46 patients with a clinically suspected relapse of ovarian cancer (verified by means of clinical and/or CT follow-up in 36 patients, by laparotomy in 7, by fine-needle biopsy in 1 and by necroscopy in the last 2). In the first group (previously untreated patients) the overall results in the pelvis were, respectively, for lymphangiography and CT: 94.9% vs 89.8% accuracy, 86.6% vs 60% sensitivity, 97.7% vs 100% specificity, and 92.8% vs 100%, 95.5% vs 88% positive and negative predictive values. In the paraaortic region the results were: 89.1% vs 86.5% accuracy, 73.3% vs 66.6% sensitivity, 100% specificity for both techniques, 100% positive predictive value, and 84.6% vs 81.5% negative predictive ...
Morphine sulfate (MS Contin), a proven analgesic in the treatment of cancer pain and chronic benign pain, seems to be a good analgesic for the treatment of burn pain. MS Contin is morphine sulfate incorporated in a wax cellulose matrix delivery system. This wax cellulose delivery system gives MS Contin its duration of action. Ten patients were enrolled in an open-labeled, nonrandomized study. The study was designed to examine the analgesic efficacy of MS Contin in the burn population. Each patient remained in the study for 6 days. The efficacy of the analgesic regimen was subjectively measured by the visual pain scale. The MS Contin group was retrospectively compared with a group of patients who were given continuous intravenous infusions of morphine. The two groups were matched according to age, burn size, surgical procedures, and hospital stay. The analgesic qualities of MS Contin were comparable to ...
Purpose. To evaluate injection-associated pain, safety, and efficacy with the isotonic contrast medium iodixanol (Visipaque 270 mg I/ml) compared with iopromide (Ultravist 300 mg I/ml) in femoral arteriography. Methods. A multicenter, double-blind, randomized, parallel-group clinical investigation was carried out in 54 hospitals in Europe. Of the patients evaluated, 1225 received iodixanol and 1227 iopromide in conventional and/or digital subtraction angiography. Results. The iodixanol group reported statistically significantly less injection-associated pain (0.9%) than the iopromide group (9.5%) (p<0.001). Further, 4.1% in the iodixanol group experienced pain and/or severe heat sensation vs 19.8% in the iopromide group (p<0.001). In the iodixanol group, 1.8% of the patients experienced contrast-related adverse events vs 2.4% in the iopromide group (p=NS). Overall diagnostic information was optimal for 94.1% in the ...
Studies of the effectiveness of operant, relaxation, cognitive, and multimodal behavioural approaches to the treatment of chronic benign pain other than headache were evaluated. In general, the quality of the studies was poor, and most investigations lacked appropriate and adequate control conditions, outcome measures, and/or follow-ups. While outcome reports for all four behavioural treatments have been mainly positive, few data were found which conclusively demonstrate that any of the approaches are effective or that they are the treatment of choice. The data do, however, imply that behavioural approaches may help patients lead more normal and productive lives. Specifically, the literature suggests that: (1) the operant method leads to increased activity levels and decreased pain and drug intake, (2) the relaxation approach results in decreased EMG levels and some pain reductions, (3) the cognitive techniques are ...
BackgroundMetastases to the stomach from an extra-gastric neoplasm are an unusual event, identified in less than 2% of cancer patients at autopsy. The stomach may be involved by hematogenous spread from a distant primary (most commonly breast, melanoma or lung), or by contiguous spread from an adjacent malignancy, such as the pancreas, esophagus and gallbladder. These latter sites may also involve the stomach via lymphatic or haematogenous spread. We present three cases of secondary gastric malignancy.Methods/ResultsThe first is a 19-year-old male who received a diagnosis of testicular choriocarcinoma in September 2004. Metastatic malignancy was demonstrated in the stomach after partial gastrectomy was performed to control gastric hemorrhage.The second is a 75-year-old male, generally well, who was diagnosed with adenocarcinoma of the lung in September 2005. Poorly differentiated adenocarcinoma of the lung was demonstrated in a subsequent biopsy of "gastric ...
Twenty-seven histologically confirmed cases of localised Ewing's sarcoma were treated by two different regimes. Radiotherapy alone was used in 13 cases and a combination of chemotherapy and radiotherapy in 14. Single agent chemotherapy (cyclophosphamide) was given sequentially in nine patients and cyclophosphamide and actinomycin-D in five. There is a significant difference in the response to these different regimes. Only 69.2% of patients treated by radiotherapy alone were disease-free, for a median period of 10.4 months and metastases were noticed in 53.8% of cases. The disease-free survival in patients treated by combination therapy (radiotherapy and chemotherapy) was 18.4 months and metastases were seen in only 42.9%. However, no metastases were seen in patients who received cyclophosphamide and actinomycin-D, during a period of 14 months and only one patient showed residual disease. It is concluded that the addition of ...
A model of weightlessness in which the hindlimbs of rats are elevated by their tails at a 40 degrees angle to unload the hindlimbs while maintaining normal weight bearing on the forelimbs has been used to simulate certain conditions of space flight. When we used this model in growing rats, we found that growth in bone weight ceased by 1 week in the hindlimbs and lumbar vertebrae, whereas growth in bone weight in the forelimbs and cervical vertebrae remained unaffected. Within 2 weeks, however, the accretion of bone weight in the hindlimbs and lumbar vertebrae returned to normal despite continued skeletal unloading. Since bone weight in the growing rat is primarily determined by bone formation (bone resorption is modest), we investigated the effects of selective skeletal unloading on bone formation during 2 weeks of hindlimb elevation using radioisotope incorporation (with /sup 45/Ca and (/sup 3/H)proline) and histomorphometry (with tetracycline ...
A 46-year-old man was referred to us after he presented to his local physician complaining of difficulty eating. Upper gastrointestinal endoscopy revealed a tumor at the esophagogastric junction (EGJ), and moderately differentiated adenocarcinoma was diagnosed from the biopsy findings. Computed tomography (CT) showed apparent enlargement of the pretracheal lymph nodes, the lymph nodes around the bilateral recurrent laryngeal nerves, and the lower thoracic paraesophageal lymph nodes, confirming metastasis. Since the disease was far advanced esophagogastric cancer with marked lymph node metastases throughout the mediastinum, curative resection would have been unlikely. Thus, he was commenced on systemic chemotherapy with cisplatin (90 mg/body, day 8) + S-1 (120 mg/body/day, given for 3 weeks...
Objective To report the clinical response to image-guided percutaneous cryotherapy (IPC) for the palliative management of localized metastases in patients with gynecologic malignancies. Methods Institutional review board approval and patient consent were obtained. Gynecologic oncology patients were identified from our institution's cryotherapy database from August 2003 to August 2007. Cryotherapy was performed with 2.4?mm diameter probes (Endocare, Irvine, CA) with ultrasound or computerized tomography (CT) guidance under conscious sedation and local anesthesia. Follow-up was conducted by imaging studies and clinical encounters, using Response Evaluation Criteria in Solid Tumors (RECIST criteria). Results Twenty-eight ablation sessions were performed for 41 metastatic foci in 15 patients w...
Aim of the work was to describe computerised tomography (CT) findings of calcified renal metastases focusing on differential diagnosis problems. Abdominal CT scans of 8000 patients with tumor, performed from 1984 to 1998, have been retrospectively reviewed. [Italian] Scopo del lavoro e' quello di descrivere gli aspetti con tomografia computerizzata delle metastasi renali calcificate enfatizzando le problematiche diagnostico differenziali. Sono state valutate retrospettivamente le indagini TC addominali di 8000 pazienti affetti da tumore nel periodo 1984-1998, analizzando le lesioni calcificate riscontrate.
Knee osteoarthritis (OA) is a common degenerative joint disorder and a major cause of pain and disability. The hypothesis tested in this study was that the passion fruit peel extract (PFP), a flavonoid-rich dietary supplement, would reduce symptoms due to knee OA. Thirty-three OA patients were enrolled in a randomized, double-blind, placebo-controlled trial with parallel-group design. Patients received either placebo or PFP pills (150 mg, daily) in a double-blinded fashion for 2 months. The OA clinical symptoms were evaluated monthly with Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index. In the PFP group, there was a significant improvement in total WOMAC score and WOMAC subscale score of physical function after 30 days and pain after 60 days. At 60 days, reductions o...
The aim of this review is to evaluate the role of inflammatory spine disease in patients with chronic back pain. The contribution of imaging modalities for the diagnostic evaluation of back pain is discussed. A systematic literature search based on the classification of seronegative spondyloarthropathies and rheumatoid arthritis was performed. The results of this search and the experiences in a large collective of rheumatological patients are analyzed. The prevalence of rheumatoid arthritis (1-2%) is comparable to that of spondyloarthropathies (1.9%). The etiology of these entities is not fully elucidated. Magnetic resonance imaging is increasingly used for early detection and surveillance of therapy with TNF-#alpha# antagonists. Bone marrow edema, which is only detectable with MRI, represents an early sign of inflammation. Therapy with TNF-#alpha# antagonists is based on clinical and laboratory criteria, and signs of inflammation in MRI. MRI ...
Skeletal radiotracer (sup(99m)Tc-HEDP) uptake was quantitated with and without the aid of a computer in 30 chronic dialysis patients with histologic evidence of renal osteodystrophy. Before scintigraphy, elevated soft-tissue activity due to the absence of renal radiotracer excretion was reduced by hemodialysis. The results were compared with those of a normal group and with the results of the biochemical and the bone morphometric studies of these patients. In all patients the radiotracer uptake was elevated, often markedly. In several patients with minimal histologic bone disease, however, soft-tissue activity could not be normalized by hemodialysis although its influence on the quantitative data could be further reduced (but not excluded) by computer evaluation of skeletal radiotracer uptake. Since the latter technique clearly distinguished the majority of the patients from the normals, it appears that computerized quantitative ...
Summary Despite the great interest of red porgy as a new species for Mediterranean aquaculture, its commercial production is constrained by the high incidence of skeletal deformities occurring in this species under culture conditions. Several studies have been conducted to better understand the origin of these anomalies in this species, using different system intensiveness, rotifers enrichment products or rotifers docosahexaenoic acid content. The first study showed that culture intensification increased the number of fish with an extra vertebrae, what was probably related to the different nutritional quality of live preys employed in each treatment, since water temperature, salinity and genetic background were identical for the different batches of fish studied. Total incidence of skeleta...
Ewing's sarcoma and Triton's tumor are two uncommon bone tumors of the skull that have nonspecific clinical and imaging features. However, imaging methods are important in the detection of the lesions during the diagnostic investigation in order to evaluate the extent of the bone lesions, involvement of the soft tissues and brain, and to determine the presence of local recurrence and metastases. The confirmatory diagnosis relies on histological studies and immunohistochemistry. The authors report two cases of patients with these tumors and present the radiological findings. (author)
A solid pseudopapillary tumor is an uncommon tumor of the pancreas that rarely metastasizes to other organs and usually shows good prognosis. An extrapancreatic tumor arising from a solid pseudopapillary tumor is very rare. We report a case of an atypical extrapancreatic solid pseudopapillary tumor that arose from the great omentum and disseminated to the peritoneum, and discuss the radiologic findings, including the CT, US, and MRI.
A solid pseudopapillary tumor is an uncommon tumor of the pancreas that rarely metastasizes to other organs and usually shows good prognosis. An extrapancreatic tumor arising from a solid pseudopapillary tumor is very rare. We report a case of an atypical extrapancreatic solid pseudopapillary tumor that arose from the great omentum and disseminated to the peritoneum, and discuss the radiologic findings, including the CT, US, and MRI
Purpose: To evaluate the outcomes of patients with Ewing's sarcoma family of tumors (ESFT) treated with modern radiotherapy techniques with MRI along with optimal chemotherapy. Methods and Materials: The records of all 60 patients with ESFT who received radiation to the primary site between 1990 and 2004 were reviewed. All patients received chemotherapy, including vincristine, doxorubicin, cyclophosphamide, ifosfamide, and etoposide. Radiation was used as the sole modality for local control in 31 patients and was given either before (n = 3) or after surgical resection (n = 26) in the remainder. All patients had MRI and CT scan-based treatment planning, and 43% received intensity-modulated radiation therapy. Radiation doses ranged from 30 Gy to 60 Gy (median, 51 Gy), and 35% received hyperfractionated radiotherapy. Results: Median age was 16 years (range, 2-40 years). Because of selection bias for radiotherapy, the majority of primary tumors were centrally located (72%): spine (n = 18), ...
The NSABP B-32 trial is examining whether patients with initially negative sentinel lymph nodes (SLNs) who have occult metastases detected on deeper levels and cytokeratin immunohistochemistry...Full Text Available
This study was a retrospective evaluation of the efficacy of stereotactic radiosurgery (SRS) in patients with >4 metastases to the brain. Materials and Methods: Between January 2004 and December 2006, 68 patients with ?4 multiple brain metastases were included and reviewed retrospectively. Twenty-nine patients received SRS and 39 patients received whole brain radiotherapy (WBRT). Patients with small cell lung cancers and melanomas were excluded. The primary lesions were non-small cell lung cancer (69.0%) and breast cancer (13.8%) in the SRS group and non-small cell lung cancer (64.1%), breast cancer (15.4%), colorectal cancer (12.8%), esophageal cancer (5.1%) in the WBRT group. SRS involved gamma-knife radiosurgery and delivered 10?20 Gy (median, 16 Gy) in a single fraction with a 50% marginal dose. WBRT was delivered daily in 3 Gy fractions, for a total of 30 Gy. After completion of treatment, a follow-up brain MRI or a contrast-enhanced ...
The authors present an unusual case of a patient with orbital metastases from renal carcinoma involving the extra ocular muscles bilaterally. The importance of computed tomography for the differential diagnosis with other orbital lesions is emphasized. (author)
Osteoporotic vertebral fractures often lead to pain and disability. They can be successfully treated, and possibly prevented, by injecting cement into the vertebral body, a procedure known as vertebroplasty....Full Text Available
Femur fractures typically affect elderly patients with multiple co-morbidities. Pain control can be difficult, requiring intensive nursing and physician care as elderly patients may manifest cardiovascular...Full Text Available
Frozen shoulder (adhesive capsulitis) is a common, painful and disabling condition which is typically slow to resolve. Patients with this condition will be seen in every musculoskeletal practitioner’s...Full Text Available
In recent years RNA interference (RNAi) has rapidly become the most widely used tool for gene knockdown due to its high specificity and potency. RNAi is an evolutionarily conserved mechanism...Full Text Available
According to the International Headache Society, idiopathic stabbing headache (ISH), an indomethacin-responsive headache syndrome, is a paroxysmal disorder of short duration manifested as head pain...Full Text Available
Cryoanalgesia (the use of cold to provide anesthesia or analgesia) is the oldest anesthetic and analgesic still in current clinical use. Its intraoperative use in providing postoperative analgesia for...Full Text Available
We describe a case of sacral perineural cyst presenting with complaints of low back pain with neurological claudication. The patient was treated by laminectomy and excision of the cyst. Tarlov cysts...Full Text Available
When attempting to feed on their hosts, ticks face the problem of host hemostasis (the vertebrate mechanisms that prevent blood loss), inflammation (that can produce itching or pain and thus...Full Text Available
BackgroundAdhesive capsulitis is a common, painful, and disabling condition that has been managed with corticosteroid injections for over 50 years. There is debate over the use of...Full Text Available
BackgroundDistraction osteogenesis is the standard treatment for the management of lower limb length discrepancy of more than 3 cm and bone loss secondary to congenital anomalies,...Full Text Available
ObjectivesThe updated Rome III criteria for pediatric functional gastrointestinal disorders (FGIDs) include new FGID categories and changes to the Rome II criteria...Full Text Available
This paper discusses the clinical application and main objective of testicular imaging. The authors present cases that represent a spectrum of the abnormalities which might be detected by testicular imaging, with special attention given to testicular torsion and the acute diseases which may mimic it clinically. Accuracy of the test is noted.
... Previous Topic Pain Next Topic Scars and wounds Prostheses Prostheses (pross-THEE-sees) are man-made substitutes ... covered by medical insurance (this includes wigs). Breast prostheses: Contact your local chapter of the American Cancer ...
Indomethacin, a potent nonsteroidal anti-inflammatory drug, has been used in the treatment of various kinds of pains, inflammation and arthritis. However, oral administration of indomethacin produces...Full Text Available
Osteoid osteoma of the spine is a relatively rare bone-forming tumor. Pain that is worse at night and relieved by aspirin and muscle contracture are the most characteristic symptoms of spinal osteoid...Full Text Available
Antagonists for kainate receptors (KARs), a family of glutamate-gated ion channels, are efficacious in a number of animal models of neuropathologies, including epilepsy, migraine pain, and anxiety....Full Text Available
The inflammatory process has direct effects on normal and abnormal wound healing. Hypertrophic scar formation is an aberrant form of wound healing and is an indication of an exaggerated function of...Full Text Available
A 63-year-old man was admitted to our hospital with a complaint of right lateroabdominal pain. He was diagnosed with metastatic colon cancer, and then developed multiple brain embolic infarctions 7...Full Text Available
Posterior spinal ligament pathology is becoming increasingly recognized as a significant cause of low back pain. Despite the growing clinical importance of interspinous ligament degeneration in low...Full Text Available
Pericardial fat necrosis is an infrequent cause of acute chest pain and this can mimic acute myocardial infarction and acute pericarditis. We describe here a patient with the magnetic resonance imaging...Full Text Available
BackgroundThe analgesic effect of perioperative low doses intravenous lidocaine has been demonstrated after abdominal surgery. This study aimed to evaluate whether...Full Text Available
The somatic sensory system responds to stimuli of distinct modalities, including touch, pain, itch, and temperature sensitivity. In the past century, great progress has been made in understanding the...Full Text Available
BackgroundWe have recently reported successful treatment of patients with chronic pain syndromes using human pooled intravenous immunoglobulin (IVIG) in a prospective, open-label...Full Text Available
Local anesthetics are able to induce pain relief by binding to the sodium channels of excitable membranes, blocking the influx of sodium ions and the propagation of the nervous impulse. Ropivacaine...Full Text Available
The indications, contra-indications and technique of caudal epidural injections in the treatment of low back pain and sciatica are described. Of 201 patients treated by epidural injection, about 56%...Full Text Available
The first case of human sparganosis in Canada is reported in a 23-year-old woman who emigrated from Greece in 1969. Examination of a ribbon-like worm removed from a painful swelling in the neighbourhood...Full Text Available
The purpose of this investigation was to determine the association between gender and the prevalence and incidence of patellofemoral pain syndrome (PFPS). One thousand five hundred and twenty-five participants from the United States Naval Academy (USNA) were followed for up to 2.5 years for the development of PFPS. Physicians and certified athletic trainers documented the cases of PFPS. PFPS was defined as retropatellar pain during at least two of the following activities: ascending/descending stairs, hopping/jogging, prolonged sitting, kneeling, and squatting, negative findings on examination of knee ligament, menisci, bursa, and synovial plica, and pain on palpation of either the patellar facets or femoral condyles. Poisson and logistic regressions were performed to determine the association between gender and the incidence and prevalence of PFPS, respectively. The incidence rate for PFPS was 22/1000 person-years. Females ...
Background & objectives:Acanthamoeba keratitis (AK) is a painful and vision-threatening ocular infection. The differentiation of Acanthamoeba...Full Text Available
BackgroundLeukotrienes (LTs) belong to the large family of lipid mediators implicated in various inflammatory conditions such as asthma and rheumatoid arthritis. Four distinct types...Full Text Available
This case describes a 10-year-old girl who developed a Ewing's sarcoma in her proximal fibula. The radiologic features mimicked those of a unicameral bone cyst. The presence of pain and the atypical location led to a prompt biopsy and the correct diagnosis. The mechanism of this unusual radiographic presentation is discussed. (orig.)
Examination of a painful hip is fairly concise and reliable at detecting the presence of a hip joint problem. Hip joint disorders often go undetected, leading to the development of secondary disorders....Full Text Available
Low back pain is common during pregnancy. However, the prevalence of symtomatic lumbar disc herniation is rare, and cauda equina syndrome due to disc herniation during pregnancy is even rarer. We report...Full Text Available
BackgroundChronic rotator cuff pathology (CRCP) is a common shoulder condition causing pain and disability. Physiotherapy is often the first line of management for CRCP yet there...Full Text Available
Multiple disease-specific systematic reviews on the effectiveness of physical therapy intervention for shoulder dysfunction have been inconclusive. To date, there have been two systematic reviews that...Full Text Available
IntroductionChest pain with ST-segment elevation is a rare clinical problem during dobutamine stress testing. Although beta-agonists treatment prior to dobutamine stress testing...Full Text Available
Biliary obstructions are rarely caused by a foreign body and have received sparse attention. We present an unusual case with pruritis and abdominal pain caused by impacted full length surgical gauze...Full Text Available
A 23-year-old woman presented to our hospital with nonspecific pain in the abdomen. She underwent radiological investigations, which revealed a solid and cystic mass in the tail end of the pancreas....Full Text Available
BackgroundBlood sampling through heel lancing is the most common invasive painful procedure performed on newborn infants.Case PresentationWe report...Full Text Available
BackgroundAcute low back pain is a very common symptom and reason for many medical consultations. In some unusual circumstances it could be linked to a rare aetiology.Case...Full Text Available
Seventy seven patients with soft tissue shoulder lesions including adhesive capsulitis and disorders of the rotator cuff and acromioclavicular joint were admitted to a trial comparing two different...Full Text Available
The overarching goal of medical training is to nurture the growth of knowledgeable, caring and insightful clinicians guided by the ideals of medical professionalism. Recent definitions of professional...Full Text Available
Snapping or grating scapula is a condition of the shoulder girdle in which the patient complains of pain and an audible snapping sound which may be associated with pain. We evaluated the diagnostic value of the computed tomography (CT) scans using the clinical diagnosis of a grating scapula as the gold standard. This retrospective study reports the sensitivity, specificity, likelihood ratio and receiver operator characteristic curve for the CT scans and the k value as a measure of the interobserver agreement. None of the parameters validated the examination. We therefore concluded that CT scans are inappropriate for differentiation between a grating scapula and a normally functioning shoulder except in cases where bony abnormalities are present. (orig.)
Lumbar epidural anesthesia is useful in a variety of chronic benign pain syndromes, including lumbar radiculopathy, low back pain syndrome, spinal stenosis, and vertebral compression fractures. Given the increased number of epidural nerve blocks being performed, some have reported unexplained complications of a transient or permanent nature and with varying degrees of severity. However, no case has been reported of a broken epidural needle tip retained in the lumbar facet joint area. This represents the first reported case presentation of foraminal stenosis developing in a patient after a retained epidural needle tip. PMID:21286465
AimsRosiglitazone and fenofibrate, specific agonists of the peroxisome proliferator activated receptors-γ (PPARγ) and -α (PPARα),...Full Text Available
Subjects maintained an isometric contraction of the quadriceps femoris muscle at two-thirds maximal voluntary contraction (m.v.c.) force for 5 s (5.0 +/- 0.3 s; mean +/- S.E. of mean; n = 6) or until...Full Text Available
The Wnt signaling pathway is a robust regulator of skeletal homeostasis. Gain-of-function mutations promote high bone mass, whereas loss of Lrp5 or Lrp6 co-receptors decrease bone mass. Similarly, mutations...Full Text Available
OBJECTIVE: To present recent evidence on the use of ovarian hormone therapy (OHT) for osteoporosis and outline safe and effective regimens. OPTIONS: Estrogen alone, estrogen and progestins, progestins...Full Text Available
Parathyroid hormone (PTH) is used clinically in osteoporotic patients to increase bone mass by enhancing bone formation. PTH therapy is not uniformly effective at all skeletal sites and “lifestyle”...Full Text Available
Little is known about how diet and energy metabolism interact in determination of lifespan under ad libitum feeding. From 12 weeks of age until death, male and female wild-type (WT) and transgenic (TG)...Full Text Available
Activities of glycogen synthase (GS) and GS phosphatase were determined on human muscle biopsies before and after isometric contraction at 2/3 maximal voluntary force. Total GS activity did not change...Full Text Available
Investigations of radionuclide metabolism and effects in various mammalian species revealed important similarities between animals and humans and between some animal species. These include skeletal deposition of radium and radiostrontium in bone volume; deposition on bone surfaces of plutonium and other actinides; liver deposition of actinides; induction of skeletal or liver malignancies by these radionuclides; induction of tooth and jaw abnormalities; mammary cancer induction by radium in humans and in the beagle; depression of circulating cells in blood; and induction of bone fractures. There are also inter-species differences that may not have been noted if multiple species (including humans) had not been studied. Some of these are more rapid excretion of radium in humans compared with most other mammals; induction by radium of eye melanomas in animals but not humans; rapid loss of deposited plutonium from liver in many species of mice and ...
Using QCT, we made a longitudinal, population-based assessment of rates of bone loss over life at the distal radius, distal tibia, and lumbar spine. Cortical bone loss began in perimenopause in women...Full Text Available
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 ...
In the Department of Radiology of Catholic University S. Cuore in Rome, a review was made of 342 CT examinations with a view towards optimizing the therapeutic planning in patients affected by bone metastases. All patients were submitted to radiological positioning and then to CT evaluation in order to assess the volume to be treated. In 224 cases it was not necessary to perform wide CT examination (3-5 standard tomograms being enough, 2 of which at the superior and inferior margins of the planned field). In the second group of 118 patients it was necessary to perform CT (serial axial scans) - increasing by 1-1.5 cm - up to the superior and inferior margins of the lesion. The existence of 2 types of lesions was confirmed: those involving mainly bony structures and those infiltrating the soft tissues. CT evaluation allowed the definition of the target volume to the real extension of the lesion in 14% of the whole of cases, while in the group of 118 cases studied ...
The Zollinger-Ellison syndrome (ZES) is taken as an example of the diagnostic and therapeutic strategy in gastro-entero-pancreatic endocrine tumours, given the standard characteristics of this procedure, whatever the nature of the primitive tumour. Management of ZES includes: anatomical localization of gastrinoma and of possible metastases, in 60 % of cases this step conditioning therapeutic indications and chances of cure; search of a type 1-multiple endocrine neoplasia (MEN A), in 25 % of cases; therapeutic indications: ablative surgery with curative intent in case of gastrinoma and of resectable liver metastases, palliative treatment otherwise: anti-secretory drugs, somatostatin analogues, chemotherapy and interferon {alpha}; long-term follow-up of patients with resected tumour. At each step, somatostatin receptor scintigraphy with indium 111-pentetreotide does play a pivotal role. (author). 110 refs.
Differentiating a benign from a malignant lesion by information such as density data, or signal intensities or echo gradients, is not possible with CT, nor MRI, nor ultrasonography. Only some lesions show characteristic signs. Inflammations cannot be difscriminated from malignant tumors. CTs of small tumors in particular are so poor in contrast that it is much more difficult to detect tumors or discriminate them from other lesions, as compared to MR images or ultrasonographs. CT does not detect surface tumors, but is more sensitive than MRI or US in detecting discrete cortical bone lesions. The same applies to small calcified tumors. MRI however is most sensitive in detecting tumor volumes in the yellow marrow, and is the best modality for evaluation of extraossal extension of tumors. CT yields better results than MRI if applied for simultaneous screening of lymph node metastases in the lower neck. MRI frequently is spoilt by movement artefacts. High-resolution, ...
Between 1973 and 1978 combined radiotherapy and chemotherapy were given to 22 patients with histologically proven Ewing's sarcoma. The combined chemotherapy consisted of cyclophosphamide, vincristin, adriamycin, as well as dacarbazine in some cases. The neoplasm was a localized one at the beginning of treatment in 14 of the 22. These patients received high-voltage rediotherapy to the primary focus at a focal dose between 42 and 55 Gray (4200-5500 rad), followed by chemotherapy. After 6-8 treatment cycles, adriamycin was replaced by methotrexate. Nine of the 14 patients survived without recurrence for 12 to over 59 months. Eight patients had extensive metastases at the beginning of treatment: they at first received only chemotherapy, followed by radiotherapy or operation, as indicated. Full clinical remission was achieved in five of them: in three this remission has now lasted for more than 18, 40 and 44 months, respectively. These results indicate that (1) ...
Combined treatment of 131 patients aged 3-16 with local form of Ewing's sarcoma is carried out. Survival rate per year was studied in patients without diagnosed metastases depending on chemiotherapy method. It is stated that improved results of treatment of children with Ewing's sarcoma may be achieved by combining radiotherapy with long-term systemic polychemotherapy. The most efficient and expedient method of radiotherapy of long bone sarcoma in children is dialy three-field irradiation with 2 Gy at SFD to the tumor 60 Gy, and adjacent tissues - 40 Gy.
Purpose: To evaluate the effect of low-dose radiation therapy and surgery on local control in patients with Ewing's Sarcoma. Materials and Methods: Between 1979 and 1995 24 patients (ages 4-47) with Ewing's sarcoma were treated with combined modality therapy that included multi agent chemotherapy, surgical resection, and radiation therapy. Twelve patients had metastatic disease at the time of presentation (pleura = 3, lung = 5, bone 4). Tumor location was central in 16 and peripheral in 8. Multi agent chemotherapy consisted of vincristine/actinomycin D/cyclophosphamide/doxorubicin in 19. The same agents with the addition of ifosfamide and etoposide were given in 5. The extent of resection was considered to be radical in 14 and of the 16 patients who received preoperative chemotherapy, 5 were found to have a pathologic complete response. All patients with lung metastases at diagnosis received whole-lung irradiation to 1400 cGy in 10 fractions. Radiation therapy to ...
Radiotherapeutic results of the Ewing sarcoma of the long tubular bones in 140 pediatric patients aged 3-16 are analyzed with the respect to different methods of irradiation. Three-field irradiation, the fields being located at 120 deg to one another with daily irradiation of all three fields at a focal dose of 2 Gy, was found superior in treatment of primary neoplasm. It is stressed that the disease termination mainly depends on the efficiency of primary neoplasm treatment, as the neoplasm reccurence generally is followed by metastases. Radiation load is calculated for maximal irradiation area of soft tissues in children.
The value of CT in respect of preoperative determination of tumour status and of tumour classification was studied using 127 histologically identified ovarial tumours as basis in a blind study via mutual image classification by the two participating institutes. The medium accuracy of diagnosis was 82%, but the results were found to be greatly dependent on tumour histology. Quotas of more than 90% were obtained in case of functional cysts, cystomas, cystadeno-carcinomas and dermoids, whereas classification was less successful with the other types of tumours such as germ cell tumours, tumours of the sexually differentiated stroma, metastases and tubo-ovarial abscesses.
Surgical resection is the only curative treatment strategy for intrahepatic cholangiocarcinoma (CC). Therefore, accurate staging is essential for appropriate management of patients with CC. We assessed the usefulness of 2-["1"8F]fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET) in the staging of CC. We undertook a retrospective review of FDG PET images in 21 patients (10 female, 11 male; mean age 57 years) diagnosed with CC. Ten patients had hilar CC and 11, peripheral CC. Patients underwent abdominal magnetic resonance imaging (MRI) (n=20) and computed tomography (CT) (n=12) for the evaluation of primary tumours, and chest radiography and whole-body bone scintigraphy for work-up of distant metastases. For semi-quantitative analysis, the maximum voxel standardised uptake value (SUV_m_a_x) was obtained from the primary tumour. All peripheral CCs showed intensely increased FDG uptake, and some demonstrated ring-shaped uptake corresponding to ...
To evaluate repeated hepatic intraarterial chemotherapy (HIC) as a palliative treatment option for unresectable cholangiocarcinoma and liver metastases of various origins that were progressive under systemic chemotherapy. Between 2002 and 2006, 55 patients were treated in 4-week intervals (mean five sessions). Combined gemcitabine/mitomycin was administered intraarterially within 1 h. Tumor response was evaluated after the third session according to RECIST. Treated tumor entities were colorectal carcinoma (CRC) (n = 12), breast cancer (BC) (n = 12), cholangiocarcinoma (CCC) (n = 10), pancreatic (n = 4), ovarian (n = 3), gastric, cervical, papillary (each n = 2), prostate, esophageal carcinoma, leiomyosarcoma (each n = 1), cancer of unknown primacy (CUP) (n = 5). All patients tolerated the treatment well without any major side effects or complications. In total, there were 1 complete response (CR), 19 partial responses (PR), 19 stable (SD) and 16 progressive ...
The authors compared unenhanced and contrast-enhanced fast MRI and Computerized Tomography in the detection of liver metastases. Eleven patients with single or multiple hepatic lesions (42 in all) were submitted to V and magnetic resonance studies; T1- and T2- weighted TSE, T2-weighted TSE with fat suppression, unenhanced breath-hold TFE and early or delayed enhanced breath-hold TFE images were acquired with a 1.5 T superconductive magnet (Philips NT). The quantitative analysis of all magnetic resonance images was performed for contrast/noise ratio (CNR) and number of detected lesions; magnetic resonance and Computerized Tomography images were also compared qualitatively for lesion conspicuity, anatomical structure identification and artifacts. The results were compared with Student's test. Early enhanced breath-hold TFE was statistically superior to T1-weighted TSE (p = .0009), T2-weighted TSE (p = .01) and Computerized Tomography ( p = .0004) for lesion ...
We aimed to investigate the effects of local anesthetics soaked in Merocel nasal packs on hemorrhage and pain after septoplasty. The methodology includes a prospective double-blind study that was conducted in patients undergoing septoplasty because of nasal septal deviation. The study included 143 patients. The patients were divided into four groups. Each group received 1% lidocaine?+?0.000625% adrenalin, 0.375% ropivacaine, 0.25% bupivacaine as study groups or 0.9% sodium chloride as a control group in their Merocel packs postoperatively. The local anesthetics or sodium chloride were reapplied at the eighth postoperative hour. Each patient was given a questionnaire where verbal analog score and amount of postoperative hemorrhage was noted. The statistical analysis was performed using two ...
Background: Ecchymosis, oedema, haematoma and pain after SMAS-based facelift surgery are all the direct result of the physical trauma of surgery and subsequent inflammatory response. Hilotherapy is a novel form of cryotherapy that purports to minimise these events through single-use face masks circulating cooled, sterile water. This study was performed to assess the validity of Hilotherapy in this population of patients. Methods: Over 14 weeks fifty consecutive patients were randomised to post-operative facial cooling with Hilotherapy or management with standard dressings alone, while fifteen subsequent, consecutive patients were randomised to cooling of one side of the face but not the other. Assessment of ecchymosis, oedema, haematoma and pain was performed independently by clinical staf...
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 ...
Abstract Introduction: Transduodenal ampullectomy (TDA) can be performed for benign and premalignant tumors of the ampulla of Vater (AOV) as an alternative to pancreaticoduodenectomy. However, the laparoscopic approach has rarely been attempted. In this report 2 cases of benign ampullary tumor that were treated by totally laparoscopic TDA. Patients and Methods: Case 1 was of a 75-year-old female who was admitted with left knee pain and underwent arthroscopic debridement. On postoperative day 6, she showed elevated levels of alkaline phosphatase, aspirate aminotransferase, alanine transaminase, and gamma-glutamyl transpeptidase, without any other laboratory test abnormality. She had no complaint of abdominal pain, and physical examinations were unremarkable. Computed tomography (CT), magnet...
Background: This study was conducted to examine the effects of prophylactic misoprostol prior to intrauterine device (IUD) placement in nulliparous women. Study Design: Nulliparous, reproductive-aged women desiring an IUD for contraception were randomized to receive 400 mcg of buccal misoprostol or placebo 90 min prior to IUD insertion. Subjects completed a series of 100-mm visual analogue scales (VAS, anchors: 0=none, 100 mm=worst imaginable) to measure their perceived pain at several times points (anticipated pain, leg positioning, speculum placement, tenaculum placement, IUD insertion, equipment removal and 5 min postinsertion). Secondary outcomes included provider ''ease of placement'' (100-mm VAS, anchors: 0=easy, 100 mm=extremely difficult), side effects and retention of the IUD afte...
SummaryBackground Persistent Lyme Disease Symptoms (PLDS) have included fatigue, headaches, poor concentration and memory, lightheadedness, joint pain, and mood disturbances. Evidence-based guidelines committees disagree over the severity of PLDS. The 2004 International Lyme and Associated Diseases Society (ILADS) concluded that PLDS are severe. The 2006 Infectious Disease Society of America (IDSA) guidelines committee concluded that PLDS are nothing more than the "aches and pains of daily living" and an ad hoc International Lyme group concluded that PLDS are "symptoms common in persons who have never had Lyme disease." Hypothesis Clinical trials validate the severity of persistent Lyme disease symptoms. Evaluation of the Hypothesis There are 22 standardized instruments used to measure the...
The interscalenic block technique is widely used for ambulatory shoulder surgery despite a substantial number of failures and adverse effects. We prospectively evaluated satisfaction in 40 consecutive patients who underwent open Bankart repair under a single general anesthesic performed in an ambulatory care unit. The mean age of the patients was 23 years. There were 29 men and 11 women. Patients were evaluated postoperatively with a visual analog scale of pain (in the recovery room, at the time of discharge, and the day after and 1 week after surgery) via a home assessment questionnaire that included the following: effectiveness of oral pain medication, ability to perform activities of daily life, and overall satisfaction. One patient failed to be discharged because of a feeling of faintn...
Pyogenic sacroiliitis is a rare entity in children. Diagnosis is often delayed because of its variable clinical presentation, low suspicion by the examining physician, and rare findings on radiographs. Delayed diagnosis, however, results in complications such as iliopsoas abscess. We report the case of a 12-year-old girl hospitalized with a 21-day history of fever, pain in the left iliac fossa, and flexion contracture of the hip. On examination, she had fever (38.9 ^oC), psoitis, localized tenderness at the left sacroiliac joint, and pain elicited by lateral compression of the pelvis. The abdominal examination was normal. The erythrocyte sedimentation rate was 130mm in the first hour, C-reactive protein was 186mg/l, and the white blood cell count was 18,400/mm^3, with 79% neutrophils. Urin...
Compact bone makes up approximately 80% of the human skeletal mass. This study examines the effect of estrogen deficiency on compact bone turnover and associated geometrical structural adaptation over a 31-month period in a large animal model. Twenty-seven skeletally mature sheep were divided into control (n = 16) and ovariectomy group (OVX, n = 11). Animals were administered five different fluorochrome dyes to label intracortical bone turnover, and sacrificed at 31 months. Compact bone samples were analyzed for cortical geometry, intracortical turnover at five time points, resorption cavities, porosity, and compressive strength. Intracortical bone turnover was significantly increased in OVX, which demonstrated seasonal variation. Cross-sectional area in OVX was significantly greater than control and was associated with an increased section modulus. Intracortical porosity was significantly increased in OVX, however, there was no significant ...
This report of progress and future objectives timetable is based on an included schematic of goals and objectives and the project abstract which is included as Appendix 1. Five matters are summarized in the order of (1) novel methods of calcified bone confocal microscopy and reconstruction image analysis of decalcified beagle and human cortical bone serial sections, (2) macroscopic cross-correlation of beagle and human cortical and cancellous bone fractions with CT analysis, (3) guidance to the most radiobiologically important skeletal regions of interest with the just completed {sup 90}Sr bone tumor map from life time beagle studies, (4) deposition patterns of radioactive agents that participate in apatite crystal nucleation processes in bone and leave radiation-excited electrons trapped in bone mineral, and (5) the budget period timetable. The discovery that beta particles from {sup 166}Ho (T{sub {1/2}} =26 hr, {beta}{sub max} = 1.8 MeV) phosphonic acid bone ...
The need for noninvasive sensitive techniques for the diagnosis and follow-up of metabolic bone disease in dialysis patients has stimulated the author's interest in the efficacy of more detailed quantitative bone scintigraphy. Using hemodialysis to reduce elevated soft-tissue activity at scintigraphy, an attempt was made to assess the diagnostic sensitivity of quantitative bone scintigraphy as compared to qualitative bone scintigraphic, biochemical, radiographic and bone histologic studies. The second aim of these studies was to determine if one of the two major components of renal osteodystrophy is a major determinant for skeletal radiotracer uptake. The clinical observations on the efficacy and possible specificity of quantitative bone scintigraphy in the diagnosis and follow-up during treatment of renal osteodystrophy are presented briefly in this chapter. Thus, the use of scintigraphy for the routine detection and follow-up of renal osteodystrophy in dialysis ...
In this article, we describe an approach to model the electromechanical behavior of the skeletal muscle based on the Huxley formulation. We propose a model that complies with a well established macroscopic behavior of striated muscles where force-length, force-velocity, and Mirsky-Parmley properties are taken into account. These properties are introduced at the microscopic scale and related to a tentative explanation of the phenomena. The method used integrates behavior ranging from the microscopic to the macroscopic scale, and allows the computation of the dynamics of the output force and stiffness controlled by EMG or stimulation parameters. The model can thus be used to simulate and carry out research to develop control strategies using electrical stimulation in the context of rehabilitation. Finally, through animal experiments, we estimated model parameters using a Sigma Point Kalman Filtering technique and dedicated experimental protocols in isometric ...
Rats from an inbred Sprague-Dawley strain were fed semisynthetic diets with a low (0.3 energy percent (en %)), normal (3 en %) or high (10 en %) content of essential fatty acids (EFA) for at least three generations. Twenty-nine- to 33-day-old male rats were given a single intragastric dose of (1-14C)linoleic acid in olive oil, and the respiratory CO2, urine and feces were collected for 46 hours (expt 1) or 20 hours (expt 2). The 14C activity in respiratory CO2, feces, urine and the carcass was determined in both experiments. In experiment 2 it was also measured in samples of the brown fat, liver, adrenals, white fat, skeletal muscles and brain. In both experiments the rats fed the low EFA diet retained significantly more 14C activity than the rats fed the normal or high EFA diets. In all groups the concentration of label was highest in the brown fat and the adrenals, but the above differences among the groups with respect to 14C retention were mainly observed in ...
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 ...
Inhibition efficiency of some water-soluble hydrazones for C-steel corrosion in hydrochloric acid has been tested by weight loss, polarisation measurements and open circuit technique. The inhibition effect was attributed to the adsorption of the additives on the C-steel surface as supported by adsorption measurements at Pt electrode using cyclic voltammetry. Electrochemical measurements indicated that all the additives behave as cathodic-type inhibitors. The data obtained fit well to both the Temkin adsorption isotherm and the kinetic-thermodynamic model. The inhibition behaviour and its order were explained with the help of the proposed skeletal representation.
The parathyroid endocrine glands, usually four in number and about the size of a split pea, lie on either side of the posterior aspect of the thyroid gland. Occasionally one or more of these structures are found in an aberrant position in the neck or even in the superior mediastinum. The parathyroid secretion, parathormone, regulates the level of serum calcium within sharply defined limits. Lack of parathormone, with lowering of the serum calcium, results in hyper-irritability of skeletal muscle, the clinical condition known as tetany. This is encountered following inadvertent removal or bruising of the parathyroid glands at thyroidectomy. PMID:21488463
The oral administration of 2,3-dihydroxybenzoic acid (DHB) to rats injected intravenously 1 hr previously with "2"3"9Pu citrate caused an increase in urinary excretion of Pu about 8 times that of animals treated with 0.9% NaCl (controls). Liver retention of Pu was decreased from 18% at 2 days in the control animals to 11% in DHB-treated rats. The skeletal retention was similarly reduced from 56% in the control group to 40% in the DHB-treated animals.
BackgroundHamstring injuries are the most common injury in Australian Rules football. It was the aims to investigate whether a sports chiropractic manual therapy intervention protocol...Full Text Available
AbstractIn a previous study using male rats, a correlation was found between the development of “at-level” allodynia in T6-7 dermatomes following severe T8 spinal contusion...Full Text Available
During their life, intervertebral discs undergo degenerative changes which need not necessarily become lesions. Conventional X-rays do not provide information on the condition of the intervertebral discs, so MRT or CT are recommended as primary techniques as they are non-invasive. Invasive methods like myelography and especially discography should not be used unless a case is highly problematic. In infants with pains in the back, MRT should be carried out as early as possible as there is nearly always an organic cause. (orig.)
... 03/08/2011 Professor named Chair at Epworth Hospital Professor Nilmini Wickramasinghe from the College of Business at RMIT University has been named Epworth Chair, Health Information Management , by Epworth HealthCare. 26/07/2011 Study investigates drug-free relief for tension headaches As Australia marks its first National Pain Week ...
An 8-year-old child presented with severe chest pain and respiratory distress after he accidentally bit an automobile tyre tube which burst into his mouth. The chest radiograph revealed left-sided pneumothorax....Full Text Available
BackgroundPostherpetic neuralgia (PHN) is a painful and difficult to treat complication of acute herpes zoster. Current treatment options provide only partial relief and are often...Full Text Available
Primary peritoneal malignant mixed mullerian tumors are very rare. We report the case of a patient presenting with pain in the right upper quadrant of the abdomen and in whom the physical examination demonstrated a peritoneal mass. Computed tomography (CT) confirmed the presence of a mass, with invasion of adjacent organs.
Clinical studies have proved the effectiveness of local ablading methods in pations with non-resectable liver metastases of a colorectal carcinoma. RF ablation and LITT are a potentially curative therapy option and an alternative to systemic chemotherapy; the latter is carried out primarily for reducing tumour size with the goal of secondary resectability. The number of R0-sesectable metastases can be enhanced by a combined therapy of surgery and local ablading methods, e.g. by preoperative, intraoperative or postoperative ablasion of further non-resectable tumours during surgery. Systemic chemotherapy combined with surgery as an adjuvant method is not recommended unless in cases of non-abladable tumour recidivation. Currently, systemic chemotherapy is used as a neo-adjuvant therapy for tumour size reduction with the goal of secondary resectability or, in case of inoperability, local ablation. (orig.) [German] Abladierende Verfahren. Klinische ...
To investigate the role of intravenously administered, radioiodinated peanut lectin ("1"3"1I-PNA) in the non-invasive detection of cancer, the pharmacokinetics and scintigraphic distribution of this novel tumor-seeking compound were studied in 8 patients with metastatic cancer of the colon, breast or lung. Scintigraphic localization of "1"3"1I-PNA was apparent at certain anatomical sites of known metastases in 2 patients and in a further 2 patients an adjacent malignant pleural effusion was visualized. The rapid clearance of radioactivity from the whole body and plasma with marked renal concentration and rapid urinary excretion of significant amounts of intact "1"3"1I-PNA (mol.wt. 107,000,pI 5.95) implied that this molecule was excreted selectively by the renal tubules. PNA or other lectins may find a role in the scintigraphic detection of selected types of cancer. (author).
Aim To better define the indications for adrenalectomy for adrenal metastasis we have analysed factors predicting survival in our institutional series. Methods A consecutive series of 30 patients undergoing adrenalectomy for metastasis (1996-2007), excluding patients with simultaneous ipsilateral renal cell carcinoma (RCC), was studied. Metastases were regarded as synchronous (6 mo), depending on the interval after primary surgery. Survival was calculated from time of adrenalectomy and factors influencing survival were identified. Results The tumour diagnoses were RCC n = 9, malignant melanoma n = 5, non-small-cell lung cancer n = 5, colorectal carcinoma n = 4, foregut carcinoid n = 2, adrenocortical carcinoma, breast cancer, hepatocellular carcinoma, urothelial c...
Lung cancer staging according to the TNM system is based on morphological assessment of the primary cancer, lymph nodes and metastases. All aspects of this important oncological classification are measurable with MRI. Pulmonary nodules can be detected at the clinically relevant size of 4-5 mm in diameter. The extent of mediastinal, hilar and supraclavicular lymph node affection can be assessed at the same time. The predominant metastatic spread to the adrenal glands and spine can be detected in coronal orientation during dedicated MRI of the lungs. Search focused whole body MRI completes the staging. Various additional MR imaging techniques provide further functional and clinically relevant information during a single examination. In the oncological context the most important techniques are imaging of perfusion and tumor motion. Functional MRI of the lungs complements the pure staging and improves surgical approaches and radiotherapy planning. (orig.)
Abstract Metastases to the thyroid gland diagnosed by means of fine needle cytology or by excision have been reported in the literature. To our knowledge, metastatic neoplasms to the parathyroid gland have never been described up to now. In this article, we introduce a rare case of metastatic breast carcinoma to a parathyroid adenoma in a 56-year-old woman, which clinically simulated a left thyroid nodule. The patient had a history of left breast carcinoma; the recent discovery of a palpable mass in the left thyroid area had elicited fine needle cytology sampling for its diagnostic evaluation. The obtained cytopathological sample was cellular but limited to a single Diff-Quik-stained smear; hence, no ancillary studies could be entertained. A cytopathological diagnosis of positive for malig...
A successful boron neutron capture treatment (BNCT) of a patient with multiple liver metastases has been first given in Italy, by placing the removed organ into the thermal neutron column of the Triga research reactor of the University of Pavia. In Finland, FiR 1 Triga reactor with an epithermal neutron beam well suited for BNCT has been extensively used to irradiate patients with brain tumors such as glioblastoma and recently also head and neck tumors. In this work we have studied by MCNP Monte Carlo simulations, whether it would be beneficial to treat an isolated liver with epithermal neutrons instead of thermal ones. The results show, that the epithermal field penetrates deeper into the liver and creates a build-up distribution of the boron dose. Our results strongly encourage further studying of irradiation arrangement of an isolated liver with epithermal neutron fields.
BackgroundPeritoneal metastasis occurs in up to 30% of patients with gastric cancer. The aim of this experimental study is to develop and validate a novel ex vivo model of the human peritoneum to better identify factors involved in the development of peritoneal metastasis in order to improve its management and prognosis. MethodsPeritoneal discs harvested from hernia sacs obtained at inguinal hernia surgery were suspended in media using Teflon rings. Viability of the tissue was investigated using MTS assay, light and scanning electron microscopy (LM and SEM) over 72 h. To assess validity of the model, phenotypic changes in tumor cells were investigated. Changes in matrix metalloproteinases (MMP)-2 and -9 activities in HGC and AGS gastric adenocarcinoma cells after co-culture were investigat...
The purpose of the present study was to compare the effectiveness of MRI, CT and radioimmunoscintigraphy in the staging and detection of bladder cancers in 28 patients. We distinguish two groups: Group I included the tumour stages CIS-T_3_A and the second group the deep infiltrative tumours T_3_B-T_4. MRI was slightly superior to CT in respect of tumour staging (75% correct results as compared to 63%). No understaging occurred with MRI, whereas in 22% of the cases the stage of the tumour was underestimated using CT diagnostics. Overstaging occurred in 25% of the MRI and 15% of the CT-diagnostics, respectively. RIS cannot distinguish the tumour groups, and hence this method is useful only for the detection of the primary tumour and metastases. In 77% of cases the tumour was detected and in 15% the tumour could be safely excluded. (orig.).
In order to understand the role of EGF in the development of human mammary epithelial tissue, we analysed the binding of /sup 125/I-EGF to sections of breast cancer biopsies. A mean specific /sup 125/I-EGF binding of 8.9 fmol per mg protein was estimated in thin sections of 17 breast cancer biopsies. Microautoradiographic analysis of /sup 125/I-EGF binding to the tissue sections was applied to demonstrate that EGF was bound predominantly to mammary epithelial cells. The binding was clearly correlated to the number of mitoses of mammary epithelial cells in the same samples. The highest EGF binding and proliferation rates were found in biopsies from breast cancer with axillary lymph-node metastases.
The philosophy pervading the treatment approach to Ewing's sarcoma was to have therapy encompass all foci of disease, including sites of occult or potential involvement in addition to obvious clinical manifestations. The experience with integrated methods of treatment in 66 consecutive patients at the National Cancer Institute is reviewed. A median survival of 18 months (44 percent 2 year survival rate) for patients with recognizable metastases on admission bears impressive witness to the value of adjuvant therapy in Ewing's sarcoma. Even more encouraging, an uncorrected 5 year survival rate of 53 percent (42 percent continuously free of disease) for patients given ''pyrophylactic'', adjuvant therapy indicates the potential for permanent control of disease in a significant fraction of cases with clinically localized primary tumors. (U.S.).
Twenty one examinations of chest FCR were performed in 15 malignancies with pulmonary metastases. The rate for demonstrating, less than 5, from 5 to 15, and more than 15 mm pulmonary nodules using with FCR was retrospectively evaluated on the basis of the lesions detected with CT. The demonstrating rate for pulmonary nodules less than 5 mm in diameter was only 8 % ; for 5 - 15 mm nodules, about 87 %. However, several 5 - 15 mm nodules were not demonstrated due to overlap of the pulmonary vessels and bony structures. All nodules more than 15 mm were demonstrable. Chest FCR may demonstrate more pulmonary nodules than conventional radiography. However, the further studies should be required for the improvement of detectability of them with FCR. (author).
Two lines of mouse tumor cells were shown to be capable of aggregating mouse and rabbit platelets in vitro. This process required higher Mg/sup 2 +/ concentrations than were needed by other commonly used platelet-aggregating agents. Platelet-aggregating activity was also found in tumor cell membrane fragments. This membrane-bound platelet-aggregating material contained protein, lipid, and carbohydrate moieties. The presence of all three appeared to be essential for stimulating platelet aggregation. Destruction of any component abolished its activity. Platelet aggregation induced by tumor cell membrane fragments was associated with a secretory release reaction. In this process, growth-promoting activity for tumor cells was also released from platelets. These results underline the importance of platelets in establishing tumor metastases.
In this study, wood samples were exposed to light irradiations (direct sunlight, xenon lamp, mercury vapour lamp) and thermal treatments were carried out in dry- and in humid conditions at 90degreeC. One part of the samples was covered by an aluminium plate during light irradiation. The samples under the aluminium plate also suffered considerable chemical changes, monitored by infrared technique and colour measurement. The sunlight produced greater colour change under the aluminium plate than the artificial light sources. During light irradiation, the carbonyl band having two maximum at 1700 and 1746cm-1 increased and the peak of the aromatic skeletal vibration arising from lignin (1510cm-1) decreased together with the guaiacyl vibrations at 1275cm-1. There was absorption decrease at 1174c...
Hsp20, referred to as HspB6, is constitutively expressed in various tissues. Specifically, HspB6 is most highly expressed in different types of muscle including vascular, airway, colonic, bladder, and uterine smooth muscle; cardiac muscle; and skeletal muscle. It can be phosphorylated at Ser-16 by both cAMP- and cGMP-dependent protein kinases (PKA/PKG). Recently, Hsp20 and its phosphorylation have been implicated in multiple physiological and pathophysiological processes including smooth muscle relaxation, platelet aggregation, exercise training, myocardial infarction, atherosclerosis, insulin resistance and Alzheimer's disease. In the heart, key advances have been made in elucidating the significance of Hsp20 in contractile function and cardioprotection over the last decade. This mini-rev...
Throughout much of the 1980s, deforestation in Brazil eliminated more than 15,000 square kilometers (9000 square miles) of forest per year. Data gathered by several satellites in the Landsat series of spacecraft shows enormous tracts of forest disappearing in Rondonia, Brazil from 1975 through 2001. The human phenomenon of deforestation starts, especially in the dense tropical forests of Brazil, when systematic cutting of a road opens new territory to potential deforestation by penetrating into new areas. Clearing of vegetation along the sides of those roads then tends to fan out to create a pattern akin to a fish skeleton. As new paths appear in the woods, more areas become vulnerable. Finally, the spaces between the skeletal bones fall to defoliation.
Premnalatifolin A (1), a unique icetexane diterpene dimer was isolated from the stem-bark of Indian medicinal plant, Premna latifolia. Its structure and relative stereochemistry were elucidated on the basis of detailed spectroscopic analysis, including HRESIMS and 2D NMR (COSY, HSQC, HMBC, and NOESY) spectra. The compound has dimeric carbon skeleton composed of two icetexane skeletal diterpenes linked via ether bond. Further, premnalatifolin A (1) was also evaluated for its cytotoxicity against cancer cell lines (HT-29, A-431, MCF-7, Hep-G2, PC-3, A-549, B-16 F10, and ACHN), which displayed potent activity against HT-29 and MCF-7 cell lines with the IC50 values of 12.15 and 1.11mg/mL, respectively.
Isolation of functional and intact mitochondria from solid tissue is crucial for studies that focus on the elucidation of normal mitochondrial physiology and/or mitochondrial dysfunction in conditions such as aging, diabetes, and cancer. There is growing recognition of the importance of mitochondria both as targets for drug development and as off-target mediators of drug side effects. Unfortunately, mitochondrial isolation from tissue is generally carried out using homogenizer-based methods that require extensive operator experience to obtain reproducible high-quality preparations. These methods limit dissemination, impede scale-up, and contribute to difficulties in reproducing experimental results over time and across laboratories. Here we describe semiautomated methods to disrupt tissue ...
Abstract The heterotetrameric K++-channel KCNQ1/KCNE1 is expressed in heart, skeletal muscle, liver and several epithelia including the renal proximal tubule. In the heart, it contributes to the repolarization of cardiomyocytes. The repolarization is impaired in ischemia. Ischemia stimulates the AMP-activated protein kinase (AMPK), a serine/threonine kinase, sensing energy depletion and stimulating several cellular mechanisms to enhance energy production and to limit energy utilization. AMPK has previously been shown to downregulate the epithelial Na++ channel ENaC, an effect mediated by the ubiquitin ligase Nedd4-2. The present study explored whether AMPK regulates KCNQ1/KCNE1. To this end, cRNA encoding KCNQ1/KCNE1 was injected into Xenopus oocytes with and without additional injection o...
Myotonic dystrophy type 1 (DM1) is characterized by both a premature appearance of age-related phenotypes and multiple organ involvement, which affects skeletal and smooth muscle as well as the eye, heart, central nervous system, and endocrine system. Although erectile dysfunction (ED) is a frequent complaint in patients with DM1, it has not been investigated in great depth. Hypogonadism, which is reported to be one of the physical causes of ED in the general population, frequently occurs in DM1. We planned this case?control study to evaluate the relationship between hypogonadism, as defined by the sexual hormone profile (FSH, LH, testosterone (T) and prolactin) and ED, as assessed by means of an internationally validated self-administered questionnaire (IIEF). DM1 patients had significant...
Mechanomyography (MMG) is the muscle surface oscillations that are generated by the dimensional change of the contracting muscle fibers. Because MMG reflects the number of recruited motor units and their firing rates, just as electromyography (EMG) is influenced by these two factors, it can be used to estimate the force exerted by skeletal muscles. The aim of this study was to demonstrate the feasibility of MMG for estimating the elbow flexion force at the wrist under an isometric contraction by using an artificial neural network in comparison with EMG. We performed experiments with five subjects, and the force at the wrist and the MMG from the contributing muscles were recorded. It was found that MMG could be utilized to accurately estimate the isometric elbow flexion force based on the v...
The early diagnosis of such disorders is of major importance because, in most cases, severe consequences can only be averted by early treatment. The value of magnetic resonance imaging (MRI) in many orthopaedic and traumatological conditions is generally accepted. The value of MRI in this particular field is illustrated by typical case reports on common clinical problems [Deutsch] Der Fruehdiagnose von Erkrankungen des Kindes- und Jugendalters kommt grosse Bedeutung zu, da oftmals nur durch eine daraus resultierende Fruehbehandlung schwerwiegende Folgen vermieden werden koennen. Die Kernspintomographie (Magnetresonanztomographie=MRT) ist in zahlreichen orthopaedischen-traumatologischen Fragestellungen bereits etabliert. An ausgewaehlten Fallbeispielen haeufiger klinischer Problemstellungen soll in der vorliegenden Arbeit der Stellenwert der MRT dargestellt werden. (orig.)
Calcaneus quantitative ultrasound (QUS) assessment is a safe and reliable method for evaluating skeletal status. Until now, considerable data have been accumulated on the distribution of QUS in Caucasian populations, whereas such data are still insufficient in Asian populations, especially in Chinese mainland. The present study aimed to obtain the distribution characteristic of calcaneus QUS in healthy Chinese women, and to further investigate the distribution of low bone mass by QUS stiffness index (SI). This study included 2,498 healthy Chinese females aged 10-87 yr. The QUS exhibited a characteristic mild rise and then fall pattern with increasing age. Age, body height, and weight were significant influencing factors on SI, especially age and weight. The prevalence of osteoporosis detec...
The role of radiation therapy in local tumor control and decreased incidence of pulmonary metastasis is reported in 271 patients who were entered into the Intergroup Ewing's Sarcoma Study with more than one year follow-up and on whom all radiotherapy records were reviewed. The majority of the patients were irradiated to the primary tumor with doses of 4500 to 6500 rad in five to six weeks in combination with systemic administration of three drugs (vincristine, actinomycin-D and cyclophosphamide) or four drugs (vincristine, actinomycin-D, cyclophosphamide and adriamycin). One of the groups of patients was treated with three drugs and bilateral pulmonary irradiation (1500 rad, uncorrected dose, in two weeks). Preliminary analysis shows an overall local primary tumor control of 89%. Patients with lesions in the pelvis had a local failure rate of 17% (9 of 52) and in the humerus 23% (7 of 31). Factors affecting local recurrences are analyzed in detail. Distant ...
Stereotactic radiosurgery (SRS) precisely delivers high-dose radiation to a small target (usually less than 3-4 cm in diameter), in a single session with steep dose-fall, employing various radiation methods. SRS provides good tumor control for small brain metastases from various primary cancers, with minimal untoward effects on surrounding normal brain. This excellent tumor control prevents neurological death and maintains good activity of daily life. Although surgery with whole-brain radiation therapy (WBRT) remains an important option for patients with a solitary brain metastasis, SRS with or without WBRT should be considered in patients with a limited number of small tumors and a good prognosis. Many reports, as well as both retrospective and prospective reviews, have shown WBRT before or after SRS to improve local control and reduce new distant lesion emergence. However, upfront WBRT does not improve survival. There are two major delivery techniques, Gamma ...
This paper is a progress report on the role of radiation therapy (RT) in local tumor control and the decreased incidence of pulmonary metastasis in 251 patients entered in the Intergroup Ewing's Sarcoma Study. All were followed for more that 1 year, and their RT records were reviewed. Doses to the primary tumor in the range of 4,500--6,500 rad were administered over approximately 5 to 6 weeks in combination with 4 drugs, i.e., vincristine (VCR), dactinomycin (DAC), cyclophosphamide (CY), and adriamycin, or only the first 3. One group of patients received the 3 drugs and bilateral pulmonary irradiation (approximately 1,500 rad in 2 wk). Preliminary analysis showed a local primary tumor control of approximately 90%. Patients with lesions in the pelvis and humerus had local failure rates of 13% (7 of 54) and 21.4% (6 of 28), respectively. The treatment groups differed significantly in the incidence of pulmonary metastasis. Patients treated with the 4 drugs (regimen 1) had a 14% incidence, ...
Purpose To investigate the sensitivity and accuracy of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for restaging the mediastinum after induction chemotherapy in patients with non-small-cell lung cancer (NSCLC). Patients and Methods One hundred twenty-four consecutive patients with tissue-proven stage IIIA-N2 disease who were treated with induction chemotherapy and who had undergone mediastinal restaging by EBUS-TBNA were reviewed. On the basis of computed tomography, 58 patients were classified as having stable disease and 66 were judged to have had a partial response. All patients subsequently underwent thoracotomy with attempted curative resection and a lymph node dissection regardless of EBUS-TBNA findings. Results Persistent nodal metastases were detected by using EBUS-TBNA in 89 patients (72%). Of the 35 patients in whom no metastases were assessed by EBUS-TBNA, 28 were found to have residual stage IIIA-N2 ...
Anti-carcinoembryonic antigen monclonal antibody (MAb) CEA 102 was produced by immunization with purified CEA and the specific accumulation of radiolabeled CEA 102 in colorectal cancers was investigated by autoradiography of sugical specimens using Fuji Computed Radiography (FCR). Five patients with colorectal cancer were injected intravenously with {sup 131}I-labeled intact CEA 102 or its F(ab'){sub 2}. Primary tumor and liver metastases were successfully detected by external scanning with a gamma camera in 4 cases. Autoradiographic study of the surgical specimens using FCR showed predominant localization of {sup 131}I-labeled CEA 102 in primary tumors and liver metastases in all cases. Even a small liver metastasis (0.5 cm) was clearly visualized in the autoradiogram by FCR. The pixel distribution curves of the density of the respective tissues in the autoradiograms by FCR showed the heterogeneity of the distribution of administreted ...
Anti-carcinoembryonic antigen monclonal antibody (MAb) CEA 102 was produced by immunization with purified CEA and the specific accumulation of radiolabeled CEA 102 in colorectal cancers was investigated by autoradiography of sugical specimens using Fuji Computed Radiography (FCR). Five patients with colorectal cancer were injected intravenously with "1"3"1I-labeled intact CEA 102 or its F(ab')_2. Primary tumor and liver metastases were successfully detected by external scanning with a gamma camera in 4 cases. Autoradiographic study of the surgical specimens using FCR showed predominant localization of "1"3"1I-labeled CEA 102 in primary tumors and liver metastases in all cases. Even a small liver metastasis (0.5 cm) was clearly visualized in the autoradiogram by FCR. The pixel distribution curves of the density of the respective tissues in the autoradiograms by FCR showed the heterogeneity of the distribution of administreted radiolabeled MAb in ...
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 pulmonary metastases received bilateral pulmonary RT. Local recurrence rate was analyzed according to treatment groups and was 16.8%. Total 15 yr survival was 33% and 8 yr ...
Nerve growth factor (NGF), a survival factor for neurons enforces pain by sensitizing nociceptors. Also in the pancreas, NGF was associated with pain and it can stimulate the proliferation of pancreatic cancer cells. Hepatic stellate cells (HSC) respond to NGF with apoptosis. Transforming growth factor (TGF)-b, one of the strongest pro-fibrogenic activators of pancreatic stellate cells (PSC) induced NGF and its two receptors in an immortalized human cell line (ihPSC) and primary rat PSC (prPSC) as determined by RT-PCR, western blot, and immunofluorescence. In contrast to HSC, PSC expressed both NGF receptors, although p75NTR expression was weak in prPSC. In contrast to ihPSC TGF-b activated both Smad signaling cascades in prPSC. NGF secretion was diminished by the activin-like kinase (ALK)...
The E and P industry has high levels of uncertainty and risk, which oil companies attempt to quantify before embarking on each individual E and P project. However, the actual return on investment often falls well short of the hurdle rate. This discrepancy has been attributed to systemic limitations in decision analysis processes and workflow, which result in repeated underestimation of risk and overestimation of the predicted production of the project. Well designed decision analysis processes in association with clearly defined, multi-scenario analyses of significant technical uncertainties are required. However, simulation of these uncertainties is not realistic given the performance and infrastructure limitations of conventional technology (Begg et al., 2001; Floris and Peersmann, 2000). During the past five years, more than 20 companies have attempted to map the requirements of new technology that is needed to improve uncertainty assessment and decision analysis. ...
Uterus didelphys with obstructed hemivagina and ipsilateral renal agenesis is a rare entity, sometimes referred to as Herlyn-Werner-Wunderlich syndrome (HWW). It usually presents after menarche with progressive pelvic pain, sometimes with regular menses, and a palpable mass due to hemihaematocolpos. The diagnosis is generally made only if the suspicion of this genitourinary syndrome is raised. To highlight the imaging diagnostic clues in this rare condition. We report on 11 adolescents with this condition. Sonography mostly allowed the correct diagnosis by showing uterovaginal duplication, haematocolpos or haematometrocolpos, and the absence of the ipsilateral kidney. MRI provided more detailed information regarding uterine morphology, the continuity with each vaginal channel (obstructed and nonobstructed), and the bloody nature of the contents. Early and accurate diagnosis of this syndrome is important so that adequate and prompt surgical therapy (excision of the ...
Over 300 cases of femoral neck fractures following radiotherapy for intrapelvic malignant tumor have been reported in various countries since Baensch reported this disease in 1927. In Japan, 40 cases or so have been reported, and cases of bilateral femoral neck fractures have not reached to ten cases. The authors experienced a case of 75 year-old female who received radiotherapy for cancer of the uterus, and suffered from right femoral neck fracture 3 months after and left femoral neck fracture one year and half after. As clinical symptoms, she had not previous history of trauma in bilateral femurs, but she complained of a pain in a hip joint and of gait disturbance. The pain in left femoral neck continued for about one month before fracture was recognized with roentgenogram. As histopathological findings, increase of fat marrow, decrease of bone trabeculae, and its marked degeneration were recognized. Proliferation of some blood vessels was ...
The aortovenous fistulas are rare, most of them are aortocaval fistula. The non-caval communication of the fistula is sparse. Herein we report a 47-year-old female diagnosed as traumatic aorto-superior mesenteric vein (Ao-SMV) fistula. The abdominal pain, fullness, and frank bruit on abdominal auscultation suggested the diagnosis of an intra-abdominal arteriovenous fistula. The diagnosis of Ao-SMV was further confirmed by the computed tomography (CT) and aortography. The fistula was successfully treated with transcatheter coil embolization. This is the first case of Ao-SMV fistula. It provides an alternative option of treatment other than conventional surgery. PMID:19327940
DescriptionLameness, commonly referred to as the leg health, in the modern broiler chicken is an emotive issue and the debate surrounding this subject is not helped by the lack of agreement as to how leg health should be assessed. A commonly used tool for scoring leg health is the Bristol Gait Score, a technique used in the recently reported Defra project AW0230 (`Leg Health and Welfare in Commercial Broiler Production`). The authors of the final report for AW0230 noted that for the chickens gait scored [continued...
Fifty patients scheduled to undergo IVF received a standard anesthetic of fentanyl and propofol for induction, followed by propofol infusion, with Bispectral index values and modified Ramsey sedation scores recorded at 5-minute intervals for the duration of anesthesia care. Moderate sedation was found only transiently during the first 5-10 minutes of the oocyte retrieval, but thereafter the level of sedation increased, with deep sedation and general anesthesia measured in all patients as determined by both the Bispectral index scores and lack of response to painful stimulation.
Visceral hypersensitivity is currently considered a key pathophysiological mechanism involved in pain perception in large subgroups of patients with functional gastrointestinal disorders, including irritable bowel syndrome (IBS). In IBS, visceral hypersensitivity has been described in 20%?90% of patients. The contribution of the central nervous system and psychological factors to visceral hypersensitivity in patients with IBS may be significant, although still debated. Peripheral factors have gained increasing attention following the recognition that infectious enteritis may trigger the development of persistent IBS symptoms, and the identification of mucosal immune, neural, endocrine, microbiological, and intestinal permeability abnormalities. Growing evidence suggests that these factors ...
Spinal cord stimulation (SCS) is frequently used for relief of chronic benign pain resistant to conservative therapies. Clinical practice suggests, at least in patients with failed back surgery syndrome (FBSS), the possibility that SCS significantly improves motor performances. We present here the case of a 41-years-old female patient with FBSS, who showed a clear improvement in muscle strength after SCS, persisting at 6-months follow-up. We speculate that the electrical stimulation of posterior columns could potentiate the caudal, segmental spinal reflexes resulting in a facilitation of motoneurons activation. PMID:16175150
A 60-year-old male was bitten by a venomous snake (Vipera ammodytes) and gradually developed signs of an allergic reaction including generalized itching, generalized rash, and chest discomfort. This was followed by severe retrosternal pain with electrocardiographic evidence of an inferior myocardial ischemia progressing to acute myocardial infarction. Cardiac enzymes and troponin, serum tryptase, and histamine were elevated. Coronary arteriography showed normal coronary arteries. This is a characteristic type I variant of Kounis syndrome, which is the concurrence of acute coronary syndromes with conditions associated with mast cell activation including allergic or hypersensitivity reactions as well as anaphylactic or anaphylactoid reactions. This is the first report to show that viper bite...
Periureteral or subtrigonal injection of dextranomer/hyaluronic acid (Dx/HA) copolymer (Deflux, Q-Med, Uppsala, Sweden) is an increasingly common endoscopic treatment for vesicoureteral reflux. We report a confusing radiographic finding of bilateral calcified Dx/HA injections initially thought to represent bilateral distal ureteral stones in a boy who presented with intermittent periumbilical pain. Urologists, radiologists, and emergency room physicians should be aware of the potential for calcification of ureteral implants of Dx/HA, and of the potentially confusing radiographic images that may result. (orig.)
Aim: To evaluate the role of computed tomography (CT) in needle placement for ganglion impar blocks, and to determine the efficacy of CT-guided ganglion impar blocks in the management of coccydynia. Materials and methods: The results of ganglion impar blockade in eight patients with coccydynia secondary to trauma or unknown cause were reviewed. The diagnosis of coccydynia was based on clinical history, location of pain, and response to previous diagnostic and therapeutic procedures. The eight patients were treated with CT-guided ganglion impar blocks to manage their coccyx pain after conservative procedures, including oral medication and cushions, failed to provide relief. All patients were subjected to ganglion impar blocks under a thin-section CT-guided technique for needle placement, using a mixture of bupivacaine and triamcinolone. The patients were followed-up for a period of 6-months. Results: Eight patients were treated in this study ...
Botulinum neurotoxin is produced by the bacterium, Clostridium botulinum. The neurotoxin inhibits acetylcholine at the neuromuscular junction, thus interfering with overall muscular contraction. Botulinum neurotoxin is commonly used for the following medical conditions: cervical dystonia, upper limb spasticity, blepharospasm, strabismus, and hyperhydrosis. However, the use of botulinum neurotoxin was recently approved for the prophylaxis of headaches in adults with chronic migraines. The proposed mechanism of botulinum neurotoxin is no longer solely limited to the inhibition of acetylcholine. There are new mechanisms emerging that involve inhibition of proinflammatory agents and neuropeptides involved in chronic pain. Consequently, there is a disruption of the overall sensory feedback loop...
Computerized tomography-guided neurolytic splanchnic nerve block is a technique for relieving abdominal cancer pain; the goal is the alcoholic neurolytic interruption of the sensitive structures in retroperitoneal space. Computerized tomography yields accurate anatomical detailing and the course for needle placement and alcohol spread. January, 1993, to July, 1996, twenty-one bilateral splanchnic nerve blocks were performed through the posterior access. Forty-eight hours after alcoholism. 14 patients (66%) had complete pain regression; 52% of the patients needed no analgesics for 6 to 54 days and only 9 patients (42%) needed another low opioid therapy. Complications included hypotension and diarrhea in all cases. One had a cardiac arrest and diet 8 days after the procedure. There were no other complications. The whole procedure usually lasted 60 min (range: 45 to 90 min). Splanchnic nerve neurolysis is a useful treatment in the patients with ...
Aim: To determine whether experience improves the consistency of visual search behaviour in fracture identification in plain radiographs, and the effect of specialization. Material and methods: Twenty-five observers consisting of consultant radiologists, consultant orthopaedic surgeons, orthopaedic specialist registrars, orthopaedic senior house officers, and accident and emergency senior house officers examined 33 skeletal radiographs (shoulder, hand, and knee). Eye movement data were collected using a Tobii 1750 eye tracker with levels of diagnostic confidence collected simultaneously. Kullback-Leibler (KL) divergence and Gaussian mixture model fitting of fixation distance-to-fracture were used to calculate the consistency and the relationship between discovery and reflective visual search phases among different observer groups. Results: Total time spent studying the radiograph was not significantly different between the groups. However, the expert groups had a ...
In this paper, the analysis of carbonate depositional systems, using high resolution sequence stratigraphy, studies the ratio between change in accommodation space and skeletal carbonate production. This approach establishes the concurrent change in nature of facies belts (expansion, retraction and type) and fossil communities, within the detailed time frame in accommodation. Carbonate production is generally considered to be a fairly simple function of environmental conditions such as climate and water depth. However, data from several case studies also show a covariance between change in stratigraphic architecture of carbonate systems (the seaward or landward stepping stacking patterns of stratigraphic units) and charge in facies. Case studies include Carboniferous algal mound development in the Paradox Basin (USA), Devonian stromatoporoid reef development in Alberta (Canada), and Cenomanian rudistid shoal development in Oman. The hypotheses are tested on cases ...
This paper deals with an analysis of a single specimen of Tentaculites crotalinus SALTER emend. CIGUEL et al. (1984) that present a possible partial preservation of the shell. It comes from an outcrop of the Grossa Formation (Devonian) near Jaguariaiva, State of Parana. The skeletal microstructure of the Tentaculitoidea shell rather poorly Known. Thus, the phylogenetic relationships of these invertebrates still uncertain. Tentaculitids are very common fossils in Devonian Ponta Grossa Formation (Parana Basin) but so far Known only from external and internal moulds. The objective of this study is to demonstrate wheter the layer found in between the internal and external mould is or not a case shell preservation. The chemical composition of this layer and of the external mould was analysed by X rays. X rays difratometry was applied only to the matrix (at the external mould). The structure of the supposed shell remain was studied by binocular stereomicroscope and ...
The effect of 10 wk endurance swim training on 3-O-methylglucose (3-MG) uptake (at 40 mM 3-MG) in skeletal muscle was studied in the perfused rat hindquarter. Training resulted in an increase of approximately 33% for maximum insulin-stimulated 3-MG transport in fast-twitch red fibers and an increase of approximately 33% for contraction-stimulated transport in slow-twitch red fibers compared with nonexercised sedentary muscle. A fully additive effect of insulin and contractions was observed both in trained and untrained muscle. Compared with transport in control rats subjected to an almost exhaustive single exercise session the day before experiment both maximum insulin- and contraction-stimulated transport rates were increased in all muscle types in trained rats. Accordingly, the increased glucose transport capacity in trained muscle was not due to a residual effect of the last training session. Half-times for reversal of contraction-induced glucose transport were ...
A single exposure energy subtraction technique with a metal filter and an imaging plate for the Fuji Computed Radiography (FCR) system was developed for dual-energy subtraction radiography (DES) of the chest. By the use of this technique, 206 patients with suspected lung cancer were scanned in the clinical settings. The subtracted images in 200 patients, excluding six with poor image quality, were examined. Soft-tissue images (bone cancelled images) were useful in visualizing abnormality of the airway and nodules lying under the ribs; and bone images (soft-tissue cancelled images) in detecting rib metastases and the presence or absence of calcification in nodules. Additional information was acquired in 21 % (42/200). A single exposure is capable of neglecting motion artifacts. In addition, this technique may be of value in DES, which is considered to be one of the routine examinations, in view of low exposure doses. The need of conventional roentgenograph, in ...
A single exposure energy subtraction technique with a metal filter and an imaging plate for the Fuji Computed Radiography (FCR) system was developed for dual-energy subtraction radiography (DES) of the chest. By the use of this technique, 206 patients with suspected lung cancer were scanned in the clinical settings. The subtracted images in 200 patients, excluding six with poor image quality, were examined. Soft-tissue images (bone cancelled images) were useful in visualizing abnormality of the airway and nodules lying under the ribs; and bone images (soft-tissue cancelled images) in detecting rib metastases and the presence or absence of calcification in nodules. Additional information was acquired in 21 % (42/200). A single exposure is capable of neglecting motion artifacts. In addition, this technique may be of value in DES, which is considered to be one of the routine examinations, in view of low exposure doses. The need of conventional roentgenograph, in ...
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 colorectal metastases in the lung shows early promise as a ...
Purpose: To determine the diagnostic value of high resolution MR imaging with a circularly polarised (c.p.) body phased-array coil for the staging of pelvic lymph nodes in cervical carcinoma. Material and methods: 42 patients with histologically proven carcinoma of the cervix were studied on a 1.5 T scanner by using a c.p. body phased-array coil. The imaging protocol included T_2-weighted turbo-spin-echo (TSE) and T_1-weighted spin-echo sequences pre and post IV application of Gd-DTPA; slice thickness was 5-7 mm and pixel size 0.53 mm"2. Lymph nodes with a diameter of #>=#8 mm were considered to have metastatic involvement. MR imaging results were compared with histopathologic findings. Results: MR imaging showed enlarged lymph nodes (#>=# 8 mm) in 16 of 18 patients with histologic proof of lymph node metastases (sensitivity 89%). In 22 of 24 cases MR findings were true negative (specificity 92%). Diagnostic accuracy was 91%. Conclusion: High-resolution MR ...
The present study was undertaken in 27 children with localized Ewing's sarcoma treated at our hospital. In 9 cases the lesion was central and in 18 peripheral. Treatment consisted of: 1) Chemotherapy with 6 drugs (vincristine, cyclophosphamide, methotrexate, bleomycin, dactinomycin and doxorubicin) for one year in all patients; 2) Radiotherapy in 24 patients at a dose of 30-40 Gy in the entire bone with a booster dose of 10-15 Gy in the lesion. In 7 patients debulking surgery was performed followed by irradiation. Two cases with tumor in expendable bones and one with extensive destructive lesion in the tibia underwent radical surgery. One patient suffered local recurrence (femur) and 6 developed distant metastases. The remaining 20 (74%) patients were alive and tumor-free after follow-up periods of 17-80 months. Among the 12 patients with extremity lesions who were alive, 7 (58%) had minimal or mild treatment sequelae, 2 moderate, and 3 severe sequelae but no ...
SommarioScopo Valutare limpatto clinico negli anni dellecografia intraoperatoria (IOUS) nella identificazione delle metastasi epatiche rispetto alle altre metodiche di imaging. Materiali e metodi risultati delle ecografie intraoperatorie effettuate per lidentificazione delle metastasi epatiche in un periodo compreso tra gli anni 2000 e 2006 sono stati retrospettivamente revisionati e comparati con le metodiche di imaging preoperatorio: Ecografia (US), Tomografia Computerizzata (TC) e/o Risonanza Magnetica (RM). Tutti i casi sono stati patologicamente provati. Sono stati calcolati per anno i casi discordanti in termini di presenza/assenza di lesione focale epatica. Il confronto statistico e stato effettuato con il test di McNemar. Un valore del p<0,05 e stato considerato statisticamente sig...
Most radiologists accept that modest doses of irradiation (4500-5000 rad/4 1/2-5 weeks) can control subclinical regional lymph node metastases from squamous cell carcinomas of the head and neck and adenocarcinomas of the breast. There have been few reports concerning elective irradiation of the ilioinguinal region. Between October 1964 and March 1980, 91 patients whose primary cancers placed the ilioinguinal lymph nodes at risk received elective irradiation at the University of Florida. Included are patients with cancers of the vulva, penis, urethra, anus and lower anal canal, and cervix or vaginal cancers that involved the distal one-third of the vagina. In 81 patients, both inguinal areas were clinically negative; in 10 patients, one inguinal area was positive and the other negative by clinical examination. The single significant complication was a bilateral femoral neck fracture. The inguinal areas of four patients developed mild to moderate fibrosis. One ...
Forty resected cases of intrahepatic cholangiocarcinoma were classified into four types according to the gross appearance; type I: mass forming type (n=8), type II: mass forming with periductal infiltrating type (n=20), type III: periductal infiltrating type (n=9) and type IV: intraductal growth type (n=3). Diagnostic features of these four types were studied. Peripheral enhancement was a common angiographic feature and tumor stains were recognized in 88%, 20%, 0%, 33%, respectively. Angiography and dynamic computed tomography (D-CT) were useful in differential diagnosis with hepatocellular carcinoma. Accuracy rate in diagnosis of portal vein involvement by angiography and D-CT was 82% and 91%, respectively. MRI was more useful in tumor detection than D-CT in cases with attenuation difference, in 55% of type II and in 75% of type III. Increase of arterial involvement, biliary tract involvement and portal vein involvement, incidence of lymph nodes metastases became ...
Computed tomography (CT) of the thorax shows early promise of important diagnostic advances. We believe that CT often provides information superior to that provided by standard roentgenographic techniques, is capable of significantly influencing patient management, and in selected instances, offers unique information not available by other methods. Computed tomography permits the imaging of mediastinal structures not possible with conventional roentgenographic methods and can diagnose with certainty benign mediastinal conditions such as pericardial cysts and focal or diffuse accumulations of fat. It is ideal for detecting pleural abnormalities and for displaying underlying parenchymal disease in patients with complex pleuroparenchymal shadows on conventional films. Pulmonary metastases unseen on the plain chest film can be detected with greater sensitivity than by any other method. Future applications of CT include the staging of mediastinal lymph nodes in ...
Computed tomography (CT) of the thorax shows early promise of important diagnostic advances. We believe that CT often provides information superior to that provided by standard roentgenographic techniques, is capable of significantly influencing patient management, and in selected instances, offers unique information not available by other methods. Computed tomography permits the imaging of mediastinal structures not possible with conventional roentgenographic methods and can diagnose with certainty benign mediastinal conditions such as pericardial cysts and focal or diffuse accumulations of fat. It is ideal for detecting pleural abnormalities and for displaying underlying parenchymal disease in patients with complex pleuroparenchymal shadows on conventional films. Pulmonary metastases unseen on the plain chest film can be detected with greater sensitivity than by any other method. Future applications of CT include the staging of mediastinal lymph nodes in ...
To evaluate the diagnostic accuracy of Fuji computed radiography (FCR) in the detection of interstitial pulmonary infiltrates, FCR life-size images at a pixel size of 0.1 mm were compared with conventional radiographs taken on the same day. Seventeen radiologists assessed the radiographs and FCR images of 56 cases, including 39 cases of various interstitial lung diseases such as interstitial pneumonia, pulmonary abnormalities associated with collagen disease, sarcoidosis, multiple pulmonary metastases, diffuse panbronchiolitis and pulmonary emphysema, and 17 normal controls. All of the pulmonary abnormalities were confirmed by high resolution CT. Observer performance tests were carried out using receiver operating characteristic analysis. In 21 cases of increased pulmonary density revealed by high resolution CT, FCR was significantly superior to conventional radiographs in the detection of reticular or linear shadows. In 11 cases of subtle interstitial ...
To evaluate the diagnostic accuracy of Fuji computed radiography (FCR) in the detection of interstitial pulmonary infiltrates, FCR life-size images at a pixel size of 0.1 mm were compared with conventional radiographs taken on the same day. Seventeen radiologists assessed the radiographs and FCR images of 56 cases, including 39 cases of various interstitial lung diseases such as interstitial pneumonia, pulmonary abnormalities associated with collagen disease, sarcoidosis, multiple pulmonary metastases, diffuse panbronchiolitis and pulmonary emphysema, and 17 normal controls. All of the pulmonary abnormalities were confirmed by high resolution CT. Observer performance tests were carried out using receiver operating characteristic analysis. In 21 cases of increased pulmonary density revealed by high resolution CT, FCR was significantly superior to conventional radiographs in the detection of reticular or linear shadows. In 11 cases of subtle interstitial ...
Pulmonary tumors in children are rare. Nevertheless, there are besides malign primary neoplasms and metastases also some benign tumors that the radiologist should know. The identification of some tumors is difficult, since some of them may mimic pulmonary inflammation. The first diagnostic tool is chest radiography. After that, a CT with contrastmedium should be performed, if possible a multislice-CT (MSCT). Identification of mediastinal structures is best with MRI. (orig.) [German] Tumoren der Lunge sind im Kindesalter selten. Trotzdem finden sich neben den malignen primaeren und sekundaeren Raumforderungen auch im Kindesalter immer wieder benigne Tumoren, die der Radiologe kennen sollte. Eine eindeutige Identifizierung kann schwierig sein, da z. B. entzuendliche Infiltrate vorgetaeuscht werden koennen. Die primaere Untersuchungsmethode ist das konventionelle Thoraxroentgen. Die weitere Diagnostik muss mit der Computertomographie, nach Moeglichkeit mit einem ...
Background. A change in practice at our institution resulted in increased use of anesthesia for CT scan of the chest in children who required sedation. Objective. To determine whether there is a difference in the frequency or severity of pulmonary atelectasis on CT scan in children sedated by anesthesiologists compared with children sedated by radiologists using intravenous pentobarbital. Materials and methods. Retrospective blinded review of 60 CT scans of the chest performed in 41 children. Forty-one studies in children sedated by radiologists (median age 29 months) were compared with 19 studies in children sedated by anesthesiologists (median age 25 months). Results. Atelectasis sufficient to obscure pulmonary metastases was shown in 5 of 41 (12 %) radiology sedations and 13 of 19 (68 %) anesthesiology sedations (P < 0.01). Higher grades of atelectasis were recorded in children under anesthesia (P < 0.01). Conclusion. Atelectasis is more frequent and more ...
To compare the accuracy in the detection and staging of various malignant tumors with high resolution whole-body MRI using parallel imaging with whole-body dual-modality PET-CT. Preliminary results of an interim analysis from a prospective, blinded study are presented, in which 20 patients (mean age 59 years, range 27-77 years) with different oncological diseases underwent whole-body dual modality FDG-PET-CT screening for tumor search or staging in case of confirmed or suspected metastatic disease. All patients also underwent whole-body MRI imaging with the use of parallel imaging (iPAT). High-resolution coronal T1w- and STIR-sequences of 5 body levels with 512 x 512 matrix, axial fast T2w imaging of lung and abdomen (HASTE), contrast-enhanced dynamic and static T1w-sequences of liver, brain, abdomen, and pelvis were performed. Using a 32-channel whole-body MRI scanner (Magnetom Avanto, Siemens Medical Solutions) with a total field of view of 205 cm and free table movement, all ...
The aim of this review is to evaluate the role of inflammatory spine disease in patients with chronic back pain. The contribution of imaging modalities for the diagnostic evaluation of back pain is discussed. A systematic literature search based on the classification of seronegative spondyloarthropathies and rheumatoid arthritis was performed. The results of this search and the experiences in a large collective of rheumatological patients are analyzed. The prevalence of rheumatoid arthritis (1-2%) is comparable to that of spondyloarthropathies (1.9%). The etiology of these entities is not fully elucidated. Magnetic resonance imaging is increasingly used for early detection and surveillance of therapy with TNF-{alpha} antagonists. Bone marrow edema, which is only detectable with MRI, represents an early sign of inflammation. Therapy with TNF-{alpha} antagonists is based on clinical and laboratory criteria, and signs of inflammation in MRI. MRI ...
The immune system modulates many key biological processes in humans. However, the exact role of the immune system in particle-associated periprosthetic osteolysis is controversial. Human tissue retrieval studies, in vivo and in vitro experiments suggest that the immune response to polymer particles is non-specific and macrophage-mediated. Lymphocytes may modulate this response. However direct lymphocyte activation by polymer particle-protein complexes seems unlikely. However, metallic byproducts may complex with serum proteins and lead to a Type IV, lymphocyte-mediated immune reaction. In predisposed individuals, this reaction may rarely lead to persistent painful joint effusions, necessitating debridement and excision of the bearing surfaces of the prosthesis. In these patients, retrieved...
Objective To investigate the impact on life quality of women with traumatic and non-traumatic origin fibromyalgia syndrome [FMS]. Method Women affected with FMS were selected and divided into two groups: those with traumatic origin FMS [Group 1] and those with non-traumatic origin FMS [Group 2]. A standard question form was used for the research, as well as the fibromyalgia impact questionnaire [FIQ] for evaluation of life quality. Results Seventy-two patients, 34 for Group 1 and 38 for Group 2 were analyzed. The main triggering symptoms were divorce [23.5 percent of cases] and death in the family [23.5 percent of cases]. In addition to diffuse pain, the main symptoms presented were poor sleep quality, weariness, and paresthesia, with no difference between the groups; migraine had a greate...
Summary Background Pemphigus vulgaris and pemphigus foliaceus are rare, potentially life-threatening, autoimmune disorders characterized by antibodies to epidermal adhesion molecules. Clinical characteristics are painful chronic erosions of mucous membranes and of the skin. There are only few published studies on the impact of the disease on the health status (HS) of patients with these conditions. Objectives To assess the impact of disease on the HS of patients with pemphigus. Methods Fifty-eight patients enrolled at the Bullous Skin Diseases Unit of IDI-IRCCS in the period January-June 2006 were assessed for their HS using the Medical Outcomes Study 36-item short form health survey (SF-36) questionnaire and for anxiety and depression using the Institute for Personality and Ability Testin...
Two cases of tetracycline ulcers of the oesophagus are reported and compared with thirteen other cases from the literature. In most cases, the patients had taken their capsules with little or no fluid just before going to bed. Some hours later they developed retrosternal pain that was intensified by swallowing. Endoscopy showed sharply demarcated greyish-white areas of mucosal damage which represented layers of stratified squamous cells, separated by oedema, and a dense neutrophilic infiltration of the lamina propria and the muscularis mucosa. Roentgenology was unsuitable to detect the lesions. They healed without complications within one to six weeks. Prolonged retention of the capsules in the oesophagus is thought to cause the mucosal damage. Patients on oral tetracycline or doxycycline treatment should therefore be instructed to take their capsules with a meal or with copious water and not just before going to bed.
The prevalence of hepatic cysts is 0.1% to 0.5% based on autopsy studies, and 2.5% based on US examinations. Percutaneous therapies are a new alternative to surgery. They include simple percutaneous aspiration, catheter drainage alone, and catheter drainage with sclerotherapy. We present an 11-year-old boy admitted to hospital because of abdominal pain. A diagnosis of simple hepatic cyst was made, which was treated with aspiration and tetracycline hydrochloride solution (5%) injection into the cystic cavity. Complete regression was seen on US and MRI examination at 3 months, with total collapse and deflation of the cyst. The cyst regressed totally, leaving a hyperechoic linear scar on US examination at 1 year. On the basis of the clinical and imaging results obtained, percutaneous sclerotherapy of hepatic cysts can be recommended as the treatment of choice and as a valid alternative to laparoscopy in children. (orig.)
Paraquat is a nonselective contact herbicide of great toxicological importance, being associated with high mortality rates, mainly due to respiratory failure. We report the case of a 22-year-old male admitted to the emergency room with a sore throat, dysphagia, hemoptysis, and retrosternal pain after the ingestion of 50 mL of a paraquat solution, four days prior to admission. Chest CT scans revealed pulmonary opacities, pneumomediastinum, pneumothorax, and subcutaneous emphysema. The patient was submitted to two cycles of immunosuppressive therapy with cyclophosphamide, methylprednisolone, and dexamethasone. The pulmonary gas exchange parameters gradually improved, and the patient was discharged four weeks later. The clinical and tomographic follow-up evaluations performed at four months after discharge showed that there had been further clinical improvement. We also present a brief review of the literature, as well as a discussion of the therapeutic algorithm for ...
Paraquat is a nonselective contact herbicide of great toxicological importance, being associated with high mortality rates, mainly due to respiratory failure. We report the case of a 22-year-old male admitted to the emergency room with a sore throat, dysphagia, hemoptysis, and retrosternal pain after the ingestion of 50 mL of a paraquat solution, four days prior to admission. Chest CT scans revealed pulmonary opacities, pneumomediastinum, pneumothorax, and subcutaneous emphysema. The patient was submitted to two cycles of immunosuppressive therapy with cyclophosphamide, methylprednisolone, and dexamethasone. The pulmonary gas exchange parameters gradually improved, and the patient was discharged four weeks later. The clinical and tomographic follow-up evaluations performed at four months after discharge showed that there had been further clinical improvement. We also present a brief review of the literature, as well as a discussion of the therapeutic algorithm for ...
Deep brain stimulation (DBS) has been used for relieving chronic pain in patients that have been through other existing options. The septum has been one of the targets for such treatment. The purpose of this study was to determine the inhibitory effect of electrical stimulation in the medial septum diagonal band of broca (MSDB) on neuronal activity in the spinal cord of rats anesthetized with sodium pentobarbital. While unilaterally stimulating the MSDB, wide dynamic range neurons in the lumbar region of the spinal cord were recorded in response to graded mechanical stimulation of the hind paws (brush, pressure, and pinch). Stimulation was at 1, 5, 10, and 20V, at 100Hz, and 0.1ms duration. Significant bilateral reduction was observed in response to pressure (ipsilaterally: 0.90+/-0.05, 0....
Purpose. To examine the impact of residual limb osteomyelitis (RLO) on the rehabilitation of lower limb amputees. Method. Retrospective review of the casenotes of patients with RLO. Information sought included details of amputation, clinical features of investigations for and management of RLO and its effect on rehabilitation. Results. There were seven transfemoral and three transtibial amputees. Indications for amputation were vascular disease in nine cases, trauma in one. In each case, delayed wound healing or residual limb pain prompted radiological, hematological and microbiological investigations. Average time between amputation and diagnosis was 187 days. One patient died before treatment commenced. Two transtibial amputees were treated with intravenous antibiotics while rehabilitati...
Abstract Introduction. Spinal cord stimulation (SCS) is an effective procedure for the treatment of neuropathic extremity pain, with success rates approaching 70%. However, mechanical failures, including breakage and migration, can significantly limit the long-term effectiveness of SCS. A systematic analysis of surgical techniques was undertaken by a consensus group, coupled with extensive in vivo and in vitro biomechanical testing of system components. Methods. A computer model based on morphometric data was used to predict movement in a standard SCS system between an anchored lead and pulse generator placed in various locations. These displacements were then used to determine a realistic range of forces exerted on components of the SCS system. Laboratory fixtures were constructed to subj...
Abstract Recently, a study of patients with rheumatoid arthritis who developed herpes zoster while taking a tumor necrosis factor (TNF)- inhibitor reported a decreased incidence of postherpetic neuralgia. The objective of this study was to investigate whether patients on TNF- inhibitors who developed herpes zoster have a lower incidence of subsequent development of postherpetic neuralgia. A retrospective review of herpes zoster patients on TNF- inhibitors (infliximab, etanercept, or adalimumab) was conducted in 12 dermatology clinics. Medical records of such patients were reviewed thoroughly to confirm herpes zoster and TNF- inhibitors and any subsequent development of postherpetic neuralgia (pain score -3 out of 10 after 90 days of shingles onset) was noted. A total of 206 cases were revi...
Glomangioma have many synonyms including: glomus tumors, tumors of neuromyoarterial glomi, angioneuromas, angioneuromyomas, neuromyoarterial glomi, painful subcutaneous tubercles, Popoff tumors or subcotaneous glomal tumors. They are common in humans, rare in nonhuman primates and to the best of our knowledge, have only been reported in irradiated rhesus. The neoplasms originate in arterial-venous shunts known as neuromyoarterial glomi which are commonly found beneath fingernails and fingertips, but have been reported in many locations both superficial and deep. The neoplasm can be confused with hemangiopericytomas, hemangiomas, paragangliomas, and leiomyomas, and must be definitely diagnosed ultrastructurally. A glomangioma at the 6-7 thoracic intervertebral space caused compression of the spinal cord with posterior paralysis in an irradiated 20-year-old female rhesus monkey (Macaca mulatta).
Abstract Introduction.- Sling erosion/extrusion is a complication after suburethral sling insertion for female stress urinary incontinence that occurs in approximately 6% of patients. Symptoms may include vaginal discharge, infections, postcoital bleeding, and alterations of the sexual function. Little is known about the effect of sling erosion on the sexual function of the male partner. Aim.- The aim of this study was to determine male sexual function in partners of women who had undergone sling insertion for stress urinary incontinence and who developed sling erosion postoperatively. Main Outcome Measures.- Main outcome measures were the Brief Male Sexual Function Inventory (BMSFI) and visual analog scale (VAS) scores. Methods.- Male partners of patients who presented with sling erosion ...
Background: Measurements from pressure biofeedback units (PBUs) can be used to evaluate the activity of the transversus abdominis (TrA) muscle indirectly. These measurements can classify patients or monitor the progress of treatment programmes for people with low back pain. Objective: To systematically review studies on the measurement properties of PBUs for the assessment of TrA activity. Data sources: Eligible studies were identified through searches of PUBMED, CINAHL and BIREME (1990 to 2009). In addition, hand searches of journals and citation tracking were performed. Study selection: Full-text studies involving any type of clinimetric tests of PBU measurement for the assessment of TrA activity were selected. Data extraction: Two independent reviewers selected the studies, extracted th...
A rare case of primary splenic cyst is shown in a young woman who had a left subcostal abdominal pain. Abdominal echography and CT scan revealed a cyst of the anterior aspect of the spleen. A sorologic test for hidatic disease was negative. On the basis of a presumed diagnostic of nonparasitic cyst, the patient was referred to a laparoscopic decapsulation with excision of the cysts wall not covered by splenic tissue. The patient was discharged 24 hours later. Histological report revealed epidermoid cyst. The laparoscopic approach has being recently considered an effective and less invasive alternative in the treatment of splenic diseases. We demonstrated that it should be considered for the treatment of splenic cysts present in a superficial location, with the advantage of organ preservation. (author)
Chronic mesenteric arterial ischemia is an uncommon condition associated a high morbidity and mortality. It is most Commonly caused by atherosclerotic occlusive disease. Patients may suffer epigastric or periumbilical postprandial pain ten to thirty minutes after eating. A case of chronic mesenteric artery stenosis, the diagnosis was performance with colonoscopy and biopsy. We present a case report of a patient with chronic mesenteric ischemia. Mesenteric arteriography was performed and documented estenosis of the mesenteric superior artery. Then percutaneous arteriography with angioplasty and implant of stent was performed. The patients became completely asymptomatic and normal colon mucous is observed in control colonoscopy. The purpose of this report is to present the case endoscopy, clinic and radiological features and to describe the percutaneous angioplasty and implant of stent. We believe that angioplasty treatment offers and improvement in this pathology ...
Perceptions of sensation and pain in healthy people are believed to be the net result of sensory input and descending modulation from brainstem and cortical regions depending on emotional and cognitive factors. Here, the influence of attention on neural activity in the spinal cord during thermal sensory stimulation of the hand was investigated with functional magnetic resonance imaging by systematically varying the participants' attention focus across and within repeated studies. Attention states included (1) attention to the stimulus by rating the sensation and (2) attention away from the stimulus by performing various mental tasks of watching a movie and identifying characters, detecting the direction of coherently moving dots within a randomly moving visual field and answering mentally-...
This study evaluated the clinical efficacy of treatment with oral risedronate (17.5?mg once daily) for 8?weeks in 11 Japanese patients with Paget?s disease of bone (PDB). Risedronate suppressed the excessive bone turnover associated with PDB and improved several biochemical markers, including serum alkaline phosphatase (ALP), serum bone-specific ALP (BALP), urinary deoxypyridinoline (DPD), and urinary cross-linked N-telopeptide of type 1 collagen (NTX). These markers began to decrease within about 2?weeks after the initiation of treatment in most patients, and the response persisted for up to 40?weeks after the cessation of treatment. Risedronate reduced pain by week 24 in most patients. According to quantitative bone scintigraphy, the lesion with the highest radioisotope (RI) uptake showe...
The objective of this study was to examine the effect of a nonsteroidal anti-inflammatory drug (NSAID) plaster for knee osteoarthritis among Japanese patients. An open-labeled, randomized, controlled, multiclinic trial was performed involving outpatient clinic groups. Two comparative groups?plaster NSAIDs and oral NSAIDs?were randomly allocated. The drugs used were limited to the current top three in both groups in Japan. Treatments were assessed after four?weeks and compared with the baseline scores. Outcomes were evaluated by two psychometric measures: Japanese knee osteoarthritis measure, and pain with the visual analogue scale. The total number of patients included in the final evaluation was 165 (87 for the plaster group and 78 for the oral group). Between these two groups there were ...
During sporting events, injured athletes often return to competition after icing because of the reduction in pain. Although some controversy exists, several studies suggest that cryotherapy causes a decrease in muscle activity, which may lead to a higher risk of injury upon return to play. The purpose of this study was to investigate the effect of a 20-min knee joint cryotherapy application on the electromyographic activity of leg muscles during a single-leg drop jump in twenty healthy subjects, randomly assigned to an experimental and a control group. After the pre-tests, a crushed-ice bag was applied to the knee joint of the experimental group subjects for 20min, while the control group subjects rested for 20min. All subjects were retested immediately after this period and retested again...
There are no specific diagnostic tests or a gold standard method for measuring disease activity and outcome in spondyloarthropathies (SpA). Many different methods have been developed to assess the signs and symptoms in SpA. The aim of this study was to evaluate the value of scintigraphy, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and Bath Ankilosing Spondylitis Disease Activity Index (BASDAI) in the evaluation of disease activity in early axial SpA diagnosed with magnetic resonance imaging (MRI). Thirty early MRI-positive axial SpA patients (23 males, 7 females) with a median age of 35 (18?55) years and a median duration of inflammatory low back pain of 24 (8?60) months were included in the study. In the patients with sacroiliitis, the sensitivity, specificity, and pos...
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.)
Computed Tomography (CT) of the spine was performed on 17 patients with myeloma in order to assess the role of the technique in recognizing and evaluating the extent of the lesions. Myelomatous lesions followed two patterns at CT: first of all, multiple focal lesions, whose density is either solid, liquid, or fatty; second, an extensive pattern involving the spongiosa of the vertebra, including the posterior arch. CT detected more lesions than conventional radiology; furthermore, the extent of the lesions was much better demonstrated by CT. CT should thus be performed: a) in case of pain and/or neurological findings in negative radiological examinations; b) to evaluate the extent of myelomatous lesions (mainly in the spine); c) in solitary myeloma CT may be performed on different bone segments with clinical symptomatology but normal X-ray findings.
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
AbstractBackground Few published data are available on the benefits of aspirin use in patients with unstable angina (UA). Hypothesis Aspirin use carries a mortality benefit in a population-based cohort of patients presenting with UA. Methods All residents of Olmsted County, Minnesota presenting to local emergency departments with acute chest pain from January 1985 through December 1992 having symptoms consistent with UA were identified through medical records. A total of 1628 patients were identified with UA and were stratified by aspirin use in-hospital and at discharge. Cardiovascular mortality and nonfatal myocardial infarction and stroke were assessed over a median of 7.5 years follow-up and all-cause mortality data over a median of 16.7 years. The mean age of patients with UA was 65 y...
Amphiphysin is a protein concentrated in neuronal synapses and peripherally associated with neurotransmitter vesicles. It is expressed in many neurons of the central and peripheral nervous systems, in the adrenal medulla, in the anterior and posterior pituitary, in cell lines of the endocrine pancreas, and in spermatocytes. Its subcellular localization and tissue distribution indicate a potential involvement in mechanisms of regulated exocytosis. A role in the dynamic organization of the membrane-associated cytoskeleton is suggested by structural homology to the products of two yeast genes, RVS161 and RVS167, whose mutation results in an abnormal actin distribution, disturbs budding morphology, and impairs cell entry into stationary phase. Limited stretches of sequence similarity, including an SH3 domain, are also shared with other actin-binding proteins. Amphiphysin is the dominant autoantigen in paraneoplastic Stiff-Man syndrome, a neurological autoimmune disorder characterized by ...
A recently-developed BMT method combines a ''Perfusion Method'' (PM) for collecting bone marrow cells (BMCs) with the Intra-Bone Marrow (IBM) injection of BMCs (IBM-BMT). As distinct from the conventional aspiration method (AM), the PM allows rapid (within 1 h) collection of BMCs without T cell contamination (T cells < 10%). Therefore, no GvHD occurs. Moreover, the burden on donors, such as back pain, bleeding and infection, can be reduced. Full chimerism can be achieved even with only mild conditioning regimens if IBM-BMT is carried out, since IBM-BMT replaces not only the recipient's hemopoietic stem cells (HSCs) but also mesenchymal stem cells (MSCs) with donor-derived HSCs and MSCs. Using this method, we show that most currently intractable diseases are HSC or MSC disorders, and that t...
Secondary ischemic necrosis of femoral head due to loss of blood supply following to femoral neck fracture is well known. The regional distribution of bone-seeking radiopharmaceuricals in the skeleton can depend on a number of factors, but bone blood flow is a major physiological determinant of regional skeletal uptake of Tc-99m polyphosphate and bone imaging may thus be used for the evaluation of vascularity of the femoral head. The authors made a comparative study of scintigraphic findings and operative findings of 28 cases of femoral neck fracture treated at Kyung Hee University Hospital from April 1980 to May 1984. The results were as follows: 1. In 16 cases of proven avascular necorsis of femoral head, scintigraphy showed absent or decreased activity in 14 cases (87.5%), while radiography showed increased density in 10 cases (62.5%). 2. In 12 cases of proven vital femoral head, scintigraphy showed increased activity in 9 cases (75%) and radiography showed ...
We examined the subcellular localization of ryanodine receptors (RyR) in the cardiac muscle of carp using biochemical, immunohistochemical, and electron microscopic methods and compared it with those of rats and guinea pigs. To achieve this goal, an anti-RyR antibody was newly raised against a synthetic peptide corresponding to an amino acid sequence that was conserved among all sequenced RyRs. Western blot analysis using this antibody detected a single RyR band following the SDS-PAGE of sarcoplasmic reticulum (SR) membranes from carp atrium and ventricle as well as from mammalian hearts and skeletal muscles. The carp heart band had slightly greater mobility than those of mammalian hearts. Although immunohistochemical staining showed evident striations corresponding to the Z lines in longitudinal sections of mammalian hearts, clusters of punctate staining, in contrast, were distributed ubiquitously throughout carp atrium and ventricle. Electron microscopic images ...
Sprengel deformity is a congential malformation with usually unilateral elevation and medial rotation of the scapula. An omovertebral bone is generally present. Associated skeletal malformations are frequently present. Though functional impairment is mild, the cosmetic and psycho-social impairment can be considerable. The prognosis of early surgical therapy is good. The presented case also justifies surgical correction in the older child. (orig.) [German] Die Sprengel-Deformitaet ist eine angeborene Fehlbildung mit meist einseitiger Elevation und Medialrotation der Skapula. Meist ist ein Os omovertebrale vorhanden. Assoziierte skelettale Fehlbildungen sind haeufig. Obgleich funktionell wenig einschraenkend, ist die kosmetische und psycho-soziale Beeintraechtigung oft erheblich. Die Prognose der fruehen operativen Therapie ist gut. Der vorliegende Fall ermutigt zur operativen Therapie auch im hoeheren Kindesalter. (orig.)
1,2,3-Trisilacyclopenta-1,4-diene 2, featuring three skeletal Si atoms in the five-membered ring, was synthesized by the thermolysis of the 1,2,3-trisilabicyclo[1.1.0]butane derivative 1 at 130 degrees C in the presence of hex-3-yne. Possessing the properties of nonconjugated cyclopentadiene, 2 readily underwent reduction with KC(8), which was followed by treatment with LiBr to form the lithium salt of 1,2,3-trisilacyclopentadienide 3(-)*[Li(+)(thf)], from which the ketone-coordinated derivative 3(-)*[Li(+)(O=C(t)Bu(2))] was prepared. Both 3(-)*[Li(+)(L)] (L = thf, O=C(t)Bu(2)) are classified as novel 6pi-electron aromatic systems based on their characteristic X-ray crystal and NMR spectral data. Addition of 12-crown-4 to 3(-)*[Li(+)(thf)] resulted in the unexpected formation of 4(-)*[Li(+)(12-crown-4)(2)], featuring the unprecedented cyclic disilenide ion 4(-). PMID:19378994
Changes in radiostrontium clearance (SrC) and bone formation (tetracycline labeling) were observed in the femurs of skeletally mature dogs following the various operative steps involved in bone screw fixation. Drilling, but not periosteal stripping, produced a small but statistically significant increase in SrC and endosteal bone formation in the distal third of the bone. Strontium clearance values equivalent to those produced by drilling alone were recorded after screw fixation at low or high torque (5 versus 20 inch pounds), as well as by the insertion of loosely fitting stainless steel implants. Bone formation (equals the percentage tetracycline-labeled trabecular bone surfaces) was increased by 30% when SrC values exceeded 3.5 ml/100 g bone/min, and the relationship was linear when SrC values ranged between 1.0 and 7.0 ml/100 g bone/min. The changes in SrC and bone formation one-week after bone screw application are primarily those associated with a response to ...
A scintimetric study using Tc-99m MDP was made of 54 patients with delayed union, nonunion, or late segmental collapse of the femoral head, 4-92 months after femoral neck fracture. In radiographically verified collapse, the radionuclide uptake ratio between the femoral head on the fractured and on the intact side (HHR) was significantly higher than in fractures resulting in delayed union or nonunion. On the basis of scintimetric and radiographic findings, the patients with healing disturbances could be divided into three groups, characterized by the following features: (1) Satisfactory post-reduction position of the fracture without subsequent redisplacement and a high HHR, which as a rule turned out to be delayed union; (2) The same radiographic pattern but with a lower HHR, which in most cases resulted in nonunion; (3) Inadequate reduction or early redisplacement of the fracture with a high HHR, which resulted in nonunion. The fractional precision in discriminating between different ...
Quantitative bone scintigraphy was performed in 24 patients with prostatic carcinoma before orchiectomy and up to one to four years after operation. The gamma camera count rate was recorded over the lower thoracic and all lumbar vertebrae 4 h after injection of [sup 99m]Tc-MDP. Twelve patients has normal bone scintigrams throughout the study. They showed from two years after operation a slight increase in count rate values compared with the preoperative values, probability due to hormonal changes after orchiectomy and to age-related alterations in skeletal metabolism. Twelve patients had abnormal bone scintigrams. They showed as a response to treatment the flare phenomenon with an increase in count rate over the abnormal vertebrae when measured two weeks after operation followed by a decrease after two months. The lowest count rate values were obtained between six months and one year after operation. Thereafter the count rate seemed to remain on the same level. An ...
Quantitative bone scintigraphy was performed in 24 patients with prostatic carcinoma before orchiectomy and up to one to four years after operation. The gamma camera count rate was recorded over the lower thoracic and all lumbar vertebrae 4 h after injection of "9"9"mTc-MDP. Twelve patients has normal bone scintigrams throughout the study. They showed from two years after operation a slight increase in count rate values compared with the preoperative values, probability due to hormonal changes after orchiectomy and to age-related alterations in skeletal metabolism. Twelve patients had abnormal bone scintigrams. They showed as a response to treatment the flare phenomenon with an increase in count rate over the abnormal vertebrae when measured two weeks after operation followed by a decrease after two months. The lowest count rate values were obtained between six months and one year after operation. Thereafter the count rate seemed to remain on the same level. An ...
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 TSA correlated significantly with the changes in the biochemical and histological parameters of hyperparathyroidism, but not ...
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 the TSA correlated significantly with the changes in the biochemical and histological parameters of hyperparathyroidism, but ...
A multifunctional protein kinase, purified from rat liver as ATP-citrate lyase kinase, has been identified as a glycogen synthase kinase. This kinase catalyzed incorporation of up to 1.5 mol of and)2numberSPO4/mol of synthase subunit associated with a decrease in the glycogen synthase activity ratio from 0.85 to a value of 0.15. Approximately 65-70% of the TUPO4 was incorporated into site 3 and 30-35% into site 2 as determined by reverse phase high performance liquid chromatography. This multifunctional kinase was distinguished from glycogen synthase kinase-3 on the basis of nucleotide and protein substrate specificities. Since the phosphate contents in glycogen synthase of sites 3 and 2 are altered in diabetes and by insulin administration, the possible involvement of the multifunctional kinase was explored. Glycogen synthase purified from diabetic rabbits was phosphorylated in vitro by this multifunctional kinase at only 10% of the rate compared to synthase purified from control ...
Abstract Elongate plasmodia with myxosporean spores belonging to the genus Unicapsula, Davis, 1924 were found in the skeletal muscle of the striped seabream, Lithognathus mormyrus (L.), a candidate for the mediterranean aquaculture. The only species of Unicapsula described from the Mediterranean is Unicapsula pflugfelderi Schubert et al. 1975, which occurs in the picarel, Spicara smaris (L.). For morphological and molecular comparison of U. pflugfelderi from S. smaris with Unicapsula sp. from L. mormyrus measurements of plasmodia and spores, ultrastructural details and 18S and 28S rDNA sequences were analysed. Whereas plasmodia were 2-3 times larger in S. smaris than in L. mormyrus (length 2.47-0.81 mm; width 0.22-0.09 mm; P = 0.000), spore morphology showed minor differences and both 18S ...
Ewing's sarcoma is a highly malignant neoplasm of the bone whose origin is still uncertain. A strong relationship exists between Ewing's sarcoma and tumors of neural origin (Ewing family of tumors). Ewing's sarcoma must be distinguished from other round-cell tumors like lymphoma and neuroblastoma and also must be differentiated from osteogenic sarcomas. On plain radiographs, Ewing's sarcoma appears as a lytic or mixed lytic-sclerotic, rarely as predominantly sclerotic lesion with margins Lodwick grade III. It is located primarily in the diaphyseal and metadiaphyseal regions of the long bones of the lower extremities. A large soft tissue tumor is usually present. Magnetic resonance imaging is the imaging modality of choice to evaluate the extent of the primary lesion, to monitor the response to neoadjuvant chemotherapy and to follow up non-resected Ewing's sarcomas. Bone scintigraphy is necessary to detect skeletal metastasis, and "2"0"1thallium scanning has been ...
The chicken extracellular matrix glycoprotein ES/130 is necessary for epithelial-mesenchymal transformation in the developing hear and is also expressed in noncardiac chicken tissues such as limb and notochord. We have identified hES, the human homology of chicken ES/130. Fluorescence in situ hybridization analysis (FISH) localizes hES to human chromosome 20p11.2-p12. FISH analyses of individuals with 20p12 deletions and affected by Alagille syndrome exclude hES as a candidate gene for this disorder. Reverse transcriptase-polymerase chain reaction studies reveal that hES is expressed in both fetal and adult human tissues and that hES expression in the left ventricle is increased in the failing adult heart. Further studies will evaluate how hES mutations may relate to congenital human cardiac and skeletal anomalies as well as cardiac remodeling in the adult. 16 refs., 2 figs.
Correct ortopedic therapy for traumas of the cervical rachis requires perfect knowledge of the spatial balance of the fracture focus. The authors belive Computed Tomography (CT) to be the most suitable, and often indispensable, method for this purpose. Twenty-four patients were examined for traumatic pathology of the cervical rachis. In 7 cases with clinically minor traumas, the negative outcome of the traditional traumas, the negative outcome of the traditional exam was considered reliable and sufficient for therapeutic purposes. The extant 17 patients were examined also by means of CT, either to better dermine the characteristics of skeletal lesions already ascertained with traditional techniques or to asses the presence of clinically-suspected osteo-articular lesions, even with negative conventional X-rays. For 9 of these patients orthopedic treatment was considered sufficient, whereas 8 patients underwent surgery and were subsequently examined with CT, which ...
These summary descriptive data of ethnically similar cohorts of indigenous and migrant Japanese males have shown similarities or slight differences in characteristics wholly or largely genetically determined, such as blood groups, stature, and skeletal size. Differences have been noted in characteristics largely environmental or behavioral, such as diet and cigarette smoking habit, as well as in characteristics determined by a varying mixture of genetic and environmental influences, such as weight, blood pressure, glucose tolerance, and serum lipid and uric acid levels. Detailed analyses of the distributions of laboratory variables, of dietary data obtained by different methods, and of correlations among laboratory, dietary, physical, and demographic variables are currently in progress. Also part of the study plan are determinations of disease prevalence from evaluation of examination, laboratory, and electrocardiographic findings, of disease incidence from repeat ...
Exercise training associated with robust conditioning can be useful for the study of molecular mechanisms underlying exercise-induced cardiac hypertrophy. A swimming apparatus is described to control training regimens in terms of duration, load, and frequency of exercise. Mice were submitted to 60- vs 90-min session/day, once vs twice a day, with 2 or 4% of the weight of the mouse or no workload attached to the tail, for 4 vs 6 weeks of exercise training. Blood pressure was unchanged in all groups while resting heart rate decreased in the trained groups (8-18%). Skeletal muscle citrate synthase activity, measured spectrophotometrically, increased (45-58%) only as a result of duration and frequency-controlled exercise training, indicating that endurance conditioning was obtained. In groups which received duration and endurance conditioning, cardiac weight (14-25%) and myocyte dimension (13-20%) increased. The best conditioning protocol to promote physiological ...
The heavy chains of Acanthamoeba myosins, IA, IB and II, turkey gizzard myosin, and rabbit skeletal muscle myosin subfragment-1 were specifically labeled by radioactive ATP, ADP, and UTP, each of which is a substrate or product of myosin ATPase activity, when irradiated with uv light at 0"0C. With UTP, as much as 0.45 mol/mol of Acanthamoeba myosin IA heavy chain and 1 mol/mol of turkey gizzard myosin heavy chain was incorporated. Evidence that the ligands were associated with the catalytic site included the observations that reaction occurred only with nucleotides that are substrates or products of the ATPase activity; that the reaction was blocked by pyrophosphate which is an inhibitor of the ATPase activity; that ATP was bound as ADP; and that label was probably restricted to a single peptide following limited subtilisin proteolysis of labeled Acanthamoeba myosin IA heavy chain and extensive cleavage with CNBr and trypsin of labeled turkey gizzard myosin heavy ...
AIM: To define the value of digital radiography with a clinical flat panel detector system for evaluation of wrist fractures in comparison with state of the art storage phosphor radiography. MATERIAL AND METHODS: Hard copy images of 26 fractured wrist specimens were acquired with the same exposure dose on a state of the art storage phosphor radiography system and a clinical flat panel detector. Image features like cortical bone surface, trabecular bone, soft tissues and fracture delineation were independently analysed by 4 observers using a standardised protocol. Image quality ratings were evaluated with an analysis of variance (ANOVA). RESULTS: Flat panel detector radiographs were rated superior with respect to cortical and trabecular bone representation as well as fracture evaluation, while storage phosphor radiographs produced better soft tissue detail. CONCLUSION: In some of the observed image quality aspects, the performance of caesium iodide/amorphous silicon flat panel detector ...
AIM: To define the value of digital radiography with a clinical flat panel detector system for evaluation of wrist fractures in comparison with state of the art storage phosphor radiography. MATERIAL AND METHODS: Hard copy images of 26 fractured wrist specimens were acquired with the same exposure dose on a state of the art storage phosphor radiography system and a clinical flat panel detector. Image features like cortical bone surface, trabecular bone, soft tissues and fracture delineation were independently analysed by 4 observers using a standardised protocol. Image quality ratings were evaluated with an analysis of variance (ANOVA). RESULTS: Flat panel detector radiographs were rated superior with respect to cortical and trabecular bone representation as well as fracture evaluation, while storage phosphor radiographs produced better soft tissue detail. CONCLUSION: In some of the observed image quality aspects, the performance of caesium iodide/amorphous silicon flat panel detector ...
In 576 patients quantitative scintigraphy of the sacroiliac joints and the spinal cord with "9"9"mTc-pyrophosphate was performed. 328 were patients with proven ankylosing spondylitis according to the New York criteria. 120 were patients with a clinically and roentgenologically suspected ankylosing spondylitis and 128 persons formed a healthy control group. The count rate in small regions of interest (ROI) in the sacroiliac joints, the spinal cord and the os sacrum were compared on the basis of indexes. The scintigraphic data of patients with ankylosing spondylitis were compared with the healthy control group and with the radiographic findings and radiologic staging of the disease. In a longitudinal follow-up study during 1 to 6 years these investigations were continued together with clinical and roentgenological checks. Quantitative bone scintigraphy provides characteristic indexes for ankylosing spondylitis, indicating the increased mineral metabolism of the sacroiliac joints and the ...
To assess the efficacy and resulting complications of tetracycline sclerotherapy in renal, hepatic, ovarian, and perivesical cysts. We retrospectively reviewed 23 cases of benign cysts (16 renal, 4 hepatic, 2 ovarian, and 1 perivesical) in 22 patients in whom the condition was diagnosed or confirmed by either ultrasound, CT, or cytology, and who underwent percutaneous tetracycline sclerotherapy. Using a 21-gauge Chiba needle, the target cyst was punctured under ultrasound guidance. Prior to the injection of 1500 mg of tetracycline diluted in 5 ml of normal saline, almost all the cystic content was aspirated, and at the end of the procedure the tetracycline was left in the cyst. During a period of between 3 and 22 months, 18 of the 23 cases were followed up. In six of the 18 cases followed up, the cysts either decreased in size by 10%, or collapsed completely. In seven cases a collapse of over 50% was noted, and in the remaining five the cyst recurred. In one of these, complete collapse ...
Ewing's sarcoma is the most common malignant bone tumour occurring in children and adolescents and exists in two different clinico pathological entities: osseous Ewing's sarcoma (OES) and extraosseous Ewing's sarcoma (EES). Five cases of primary epidural EES are described, which presented with non-specific symptoms leading to a long diagnostic delay. The median age at diagnosis was 22 years (range 13-36 years). The median diagnostic delay was 3 months. All patients had one or more neurological deficits. All underwent surgical exploration with a laminectomy and partial resection followed by adjuvant radiotherapy to a dose of 46-50 Gy and chemotherapy with VAC (vincristine, adriamycin and cyclophosphamide) alternating with ICE (ifosphamide, cisplatin and etoposide) for at least six cycles. The mean follow-up period is 21.2 months (range 11-32 months). Four of the five patients achieved a complete remission and are disease free at the time of writing this report. Two patients have a ...
Differentiating a benign from a malignant lesion by information such as density data, or signal intensities or echo gradients, is not possible with CT, nor MRI, nor ultrasonography. Only some lesions show characteristic signs. Inflammations cannot be difscriminated from malignant tumors. CTs of small tumors in particular are so poor in contrast that it is much more difficult to detect tumors or discriminate them from other lesions, as compared to MR images or ultrasonographs. CT does not detect surface tumors, but is more sensitive than MRI or US in detecting discrete cortical bone lesions. The same applies to small calcified tumors. MRI however is most sensitive in detecting tumor volumes in the yellow marrow, and is the best modality for evaluation of extraossal extension of tumors. CT yields better results than MRI if applied for simultaneous screening of lymph node metastases in the lower neck. MRI frequently is spoilt by movement artefacts. High-resolution, ...
Purpose: The purpose of this study was to evaluate the efficacy and toxicity of replication-competent adenovirus-mediated double suicide gene therapy in an adjuvant setting with external beam radiation therapy (EBRT) in an experimental prostate cancer model in preparation for a Phase I clinical study in humans. Methods: For efficacy studies, i.m. DU145 and intraprostatic LNCaP C4-2 tumors were established in immune-deficient mice. Tumors were injected with the lytic, replication-competent Ad5-CD/TKrep adenovirus containing a cytosine deaminase (CD)/herpes simplex virus thymidine kinase (HSV-1 TK) fusion gene. Two days later, mice were administered 1 week of 5-fluorocytosine + ganciclovir (GCV) prodrug therapy and fractionated doses of EBRT (trimodal therapy). Tumor control rate of trimodal therapy was compared to that of EBRT alone. For toxicology studies, immune-competent male mice received a single intraprostatic injection (10"1"0 vp) of the replication-competent Ad5-CD/TKrep ...
The staging of patients with multiple myeloma demands sensitive imaging methods for the assessment of the skeletal system. MRI allows for direct visualization of the bone marrow which exhibits five different infiltration patterns in multiple myeloma: 1. normal appearance of the bone marrow, 2. focal involvement, 3. homogeneous diffuse infiltration, 4. combined diffuse and focal infiltration, 5. ''salt and pepper'' pattern with inhomogeneous bone marrow signals due to multiple fat islands. The combination of T1w-SE and STIR sequences is best suited for detecting all infiltration patterns and for the differential diagnoses e. g. hemangiomas. With parallel imaging in MRI, acquisition times can be markedly reduced and whole-body screening of the bone marrow can be achieved within 30 min. MRI is superior to radiography for the detection of focal as well as diffuse infiltration. Multidetector computed tomography and especially 16- and ...
The purpose of this study was to use high-resolution magnetic resonance (MR) imaging combined with image analysis to investigate the three-dimensional (3D) trabecular structure, anisotropy, and connectivity of human vertebral, femoral, and calcaneal specimens. The goal was to determine whether: (a) MR-derived measures depict known skeletal-site-specific differences in architecture and orientation of trabeculae; (b) 3D architectural parameters combined with bone mineral density (BMD) improve the prediction of the elastic modulus using a fabric tensor formulation; (c) MR-derived 3D architectural parameters combined with BMD improve the prediction of strength using a multiple regression model, and whether these results corresponded to the results obtained using higher resolution depictions of trabecular architecture. A total of 94 specimens (12 x 12 x 12 mm cubes) consisting of trabecular bone only were obtained, of which there were 7 from the calcaneus, 15 from ...
Full text: Production: This radio iodine produced by three methods: 1) Wet method: The irradiated tellurium is dissolved in an oxidizing mixture which also converts iodine in to iodide. This is a chemical method and iodine that it produced with this method has low purity and efficiency. 2). Dry Method: The irradiated tellurium is dissolved in furnace (750 deg. C) with sublimation method and iodine absorbed in sodium solution . In this case we have more than 99.5 % purity and 80 % efficiency. We are using this type in Iran. 3) Fission fragment method: In this case the iodine separated from fission fragment directly and we have high purity (career free) and specific activity of iodine. Application: Iodine is a versatile tracer element. It is used to determine thyroid cancer metastases, and size, shape and activity of the thyroid gland. Critical organ of iodine is thyroid gland. One of the common diagnostic procedures for determining thyroid function therefore, is to ...
Purpose: For planning the therapeutic strategies and estimating the prognosis in esophageal cancer, N-staging is very important. To date, MRI still is of minor importance as imaging modality of the mediastinum despite promising developments in the past, like ECG-gating or 'averaging' sequences, e.g. LOTA (Long-term averaging), which facilitate mediastinal and thoracic MR-imaging. In a prospective approach, the value of MRI based N-staging was examined with respect to LOTA-sequences. Material and Methods: Within from weeks prior to esophagectomy, standardized MRI of the esophagus was performed in 15 patients (10 squamous-cell-carcinomas and 5 adenocarcinomas) using a 1.5 T whole body scanner. Imaging quality was classified based on depiction of aortic wall or tracheal wall layers. Criteria for malignant infiltration were a diameter of more than 15 mm or a round appearance of a lymph node together with GD-DTPA enhancement. All data were blinded and separately read by two radiologists. ...
Purpose: To identify results and prognostic factors on long-term survival and local control following treatment of localized Ewing's sarcoma. Patients and Methods: Between 1979 and 2004, a total of 60 children and young adults with Ewing's sarcoma were treated. Patients with distant metastases at presentation (n = 6) and recurrent cases (n = 2) were excluded from this analysis. Patients were exclusively treated within ongoing national and international protocols CESS-81, CESS-86, EICESS-92, EURO-EWING-99. All patients received local irradiation with a total dose of 45-60 Gy; in addition, 41 (79%) of the patients had local surgical procedures, 27 (52%) of them with clear margins. Results: Overall survival rates at 5 and 10 years were 56% and 45%, respectively. Patients #<=# 14 years at diagnosis had overall survival rates of 66% and 61% at 5 and 10 years compared to older patients with corresponding survival rates of 47% and 31%, respectively (p = 0.05). Patients ...
Twenty-four high-risk Ewing's sarcoma patients were treated on an intensive combined modality protocol including low-dose fractionated total body irradiaiton (TBI) and autologous bone marrow infusion (ABMI). Twenty patients (83%) achieved a complete clinical response to the primary and/or metastatic sites following induction therapy. The median disease-free interval was 18 months, and nine patients remain disease-free with a follow-up of 22 to 72 months. Local failure as a manifestation of initial relapse occurred in only three patients (15%), each having synchronous distant failure. Eight patients failed initially with only distant metastases, usually within 1-2 years following a complete clinical response. Two patterns of granulocyte recovery following consolidative therapy (including TBI and ABMI) were recognized. The time to platelet recovery was different for the groups with early and late granulocyte recovery. Patients with late recovery did not tolerate ...
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 metastases developed after primary treatment in 27 patients after a median of 14 months. The median ...
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 and stage IV lesions, respectively. Most of the patients received external irradiation and intraoral electron beam therapy. ...
Objective: To discuss the clinical application value of dual energy subtraction (DES) in direct digital radiography of chest. Methods: 83 cases of chest digital radiography(DR) using double-energy subtraction (DES) were randomly selected, and three posterior-anterior (PA) chest films (standard image, bone image and soft tissue image) were obtained in each case, which is so called 'bone and soft tissue separated' technology. Results: With the aid of double energy subtraction (DES), the bony chest was subtracted, the sensitivity and specificity of pulmonary calcification were improved, and sensitivity of pulmonary nodes was also improved, enhancing the distinction between pulmonary benign or malignant lesions, enlightening the diagnosis of chest cage lesions, and showing a clear superiority in the detection of pulmonary nodes comparing to common chest films. The double energy subtraction (DES) films showed a higher diagnostic accuracy in the detection of bony cage and central airway ...
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 a recurrence rate of as high as 20%. We conclude that asymptomatic gallstone patients should only be followed up by ultrasound ...
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 quantitative bone scintigraphy should not be employed to monitor changes in joint ...
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 scintigraphy should not be employed to monitor changes in joint inflammation in ...
A population of male civil servants in Rome, Italy, was investigated to determine the prevalence of symptomatic and asymptomatic gallstone disease. Field activities started in December, 1982 and were concluded in July, 1984. Diagnosis was made using real-time ultrasonography. Participation in the study was 71.5%. Prevalence of gallstone disease was 8.2% and increased with age from 2.3% in the 20- to 25-year-old age group to 14.4% in the 60- to 69-year-old age group, based on both presence of gallstones and history of cholecystectomy. About one-third of the subjects with gallstone disease had previously been submitted to cholecystectomy. Only 7.7% of the subjects with presence of gallstones complained of at least one episode of biliary pain in the preceding 5 years. Frequency of "minor" dyspeptic symptoms was not different between men with and those without gallstones. PMID:3391519
The solid-pseudopapillary tumor (SPT) of the pancreas is a rare type of exocrine pancreatic neoplasm. SPT predominantly affects young women and female children, and is usually discovered incidentally. This tumor is generally benign with a low incidence of malignancy. A 13-year-old girl was admitted to the hospital with a few weeks' history of mild abdominal pain and jaundice. On physical examination, there was no palpable mass. The laboratory tests showed increased SR, CRP, high bilirubin, amylase and lipase serum levels. Ultrasound imaging revealed a solid lesion in the region of the pancreatic head. On MRI, precise tumor localization in the head of the pancreas with pancreatic duct dilatation and compression of the common bile duct were visualized. Pancreaticoduodenectomy and cholecystectomy was performed with good clinical outcome. Microscopic and immunohistochemical studies indicated that tumor cells were typical of SPT without any signs of malignancy. After ...
The visual outcomes of Acanthamoeba keratitis, a rare cause of corneal infection, can be devastating. This paper reports two contact lens wearers with severe pain and photophobia who presented to the emergency room. Biomicroscopy revealed radial keratoneuritis in both individuals. Tissue culture on a nonnutrient agar plate with Escherichia coli overlay resulted in a heavy growth of Acanthamoeba. The inpatient treatment included 0.02% polyhexamethylene biguanide, chlorhexidine, neomycin/polymyxin B/bacitracin (Neosporin), and oral fluconazole, which successfully controlled the corneal infection and improvement in the best corrected visual acuity in both patients. Infection did not recur during the 12-month follow-up period. Acanthamoeba keratitis can present as radial keratoneuritis, mimicking other common corneal infections resulting in diagnostic and treatment delays. Early diagnosis and prudent treatment of Acanthamoeba keratitis are the keys to restoring vision ...
This is a report of 21 patients presenting with epigastric pain, bilious vomiting, upper gastrointestinal bleeding, iron-deficiency anemia, and weight loss, who had undergone Billroth II gastrectomy from 3 to 35 yr earlier. Eighteen of 21 patients were found to have significant enterogastric reflux indices varying from 60% to 95% demonstrated by /sup 99m/Tc HIDA scintigraphy. Thirteen patients had diversion antireflux surgery in the form of a Roux-en-Y procedure, and 1 patient had a Henley loop jejunal interposition. Postoperative /sup 99m/Tc HIDA scintigraphic studies showed the enterogastric reflux indices to have decreased significantly to a range of 2%-26% (p less than 0.00001). There was marked improvement of symptoms, including correction of anemia and weight gain in those patients who had been anemic or who had sustained earlier weight loss. The enterogastric reflux indices of 10 asymptomatic control patients after Billroth II gastrectomy ranged from 4% to ...
A population of female civil servants in Rome, Italy, was investigated to determine the prevalence of symptomatic and asymptomatic gallstone disease and to define the associated factors. Field activities started in February 1981 and concluded in April 1982. Diagnosis was assessed by real time ultrasonography. Prevalence of gallstone disease increased with age from 2.5% in the 20- to 29-year-old age group to 25.0% in the 60- to 64-year-old age group, based on both presence of gallstones and history of cholecystectomy. Only one third of the women with gallstones had complained of at least one episode of biliary pain in the last five years. Frequency of "minor" dyspeptic symptoms was not different between women with and those without gallstones. In a multiple logistic function analysis, a positive association was found between age, body mass index, parity, and prevalence of gallstone disease. No association was demonstrated between the presence of gallstones or ...
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 infection of the prosthesis ...
The mortality in undrained abdominal abscesses is high with a mortality rate ranging between 45 and 100%. The outcome in abdominal abscesses, however, has improved due to advances in image guided percutaneous interventional techniques. The main indications for the catheter drainage include treatment or palliation of sepsis associated with an infected fluid collection, and alleviation of the symptoms that may be caused by fluid collections by virtue of their size, like pancreatic pseudocele or lymphocele. The single liver abscesses may be drained with ultrasound guidance only, whereas the multiple abscesses usually require computed tomography (CT) guidance and placement of multiple catheters. The pancreatic abscesses are generally drained routinely and urgently. Non-infected pancreatic pseudocysts may be simply observed unless they are symptomatic or cause problems such as pain or obstruction of the biliary or the gastrointestinal tract. Percutaneous routes that ...
Forty cases of Ewing's sarcoma of various sites had attended the Department of Radiotherapy at the Wanless Hospital and the Miraj Medical Centre, attached to the Government Medical College, Miraj, Maharashtra, from January, 1970 through December, 1979. There were 28 male patients and 12 female patients in the series with a male to female ratio of 2.3:1. The youngest patient in the series was a female of 6 years of age with the tumour in the scapula and the oldest patient was a 32-year-old male with a lesion in the metacarpal bone. Sixty per cent of the cases were seen in the second decade. The average age of the patients was 13.5 years. The bones of the lower extremities were most commonly involved with the highest number (35 per cent) of the cases occurring in the femur. Involvement of the bones of the right side of the body was almost equal to that of the left side. Swelling over the site of the lesion and pain over the swelling were the most common complaints ...
Percutaneous coronary revascularisation [PCR] improves angina and health related quality of life [HRQOL] compared to standard medical therapy. It is unknown whether PCR has the same benefits for patients with a history of CABG. Over a period of 5?years, we assessed HRQOL of patients undergoing PCR using Part 1 of the Nottingham Health Profile [NHP] at baseline 3, 12 and 24?months. We compared HRQOL after PCR in 255 patients with CABG to 2680 without. There were more males [81.1% v 69.6% p?=?0.002] and older patients [mean age 60.1?years v. 58.0 p?=?0.03] in CABG group. Perceived HRQOL improved at 24?months for pain, energy and emotional reaction but the improvement was less in the CABG group. However, mean NHP scores at 24?months for those with CABG had returned to baseline levels for slee...
Introduction: There are many problems in the radiological diagnosis of aseptic loosening in total hip arthroplasty. Computed tomography (CT) and magnetic resonance tomography (MRT) are not usable for metallic implants (stainless steel, cobalt alloy, titanium alloy). Material and Methods: From April 1993 to December 1993 15 CFRP non-cemented hip prostheses have been implanted. In a prospective clinical study plane radiographs, CT and MRT have been analysed. Results: Three stems were revised (1 femoral fracture, 1 severe thigh pain, 1 aseptic loosening). CFRP are not visible in plane radiographs. There was a complete (two-third of the cases) or nearly complete (one-third of the cases) small sclerotic interface between the prosthesis and the bone, these were apparent in CT and MRT in stable implant cases and did not have any clinical correlations. Discussion: The small sclerotic interface is quite different in comparison to so called 'Reactive lines'. In one case of ...
Gallstone is a common disease with a 10% prevalence in the United States and Western Europe. However, it is only symptomatic in 20-30% of patients, with biliary pain "colic" being the most common symptom. Complications of asymptomatic gallstone disease are generally rare, with an incidence of <1 %/yr. The most common complications of gallstone disease are acute cholecystitis, acute pancreatitis, ascending cholangitis, and gangrenous gallbladder. Less frequent complications include Mirizzi syndrome, cholecystocholedochal fistula, and gallstone ileus. Mirizzi syndrome and cholecystocholedochal fistula are two manifestations of the same process that starts with impaction of a gallstone in the gallbladder neck that results in obstruction of the bile duct, causing jaundice. The gallstone may erode into the bile duct, causing cholecystocholedochal fistula. Gallstone ileus refers to small bowel obstruction resulting from the impaction of one or more gallstones after ...
Adenosine triphosphate (ATP) is an alternative to dipyridamole or adenosine in thallium-201 myocardial scintigraphy. However, the optimal dose of ATP has not been determined. A Doppler guide wire study showed the coronary flow velocity at a dose of 0.15 mg/kg of ATP was equal or higher than that at 0.14 mg/kg of adenosine or 0.56 mg/kg of dipyridamole. ATP was given intravenously to 67 patients with coronary artery disease at 0.15 mg/kg/min for 6 min. Thallium-201 was injected at 3 min, followed by immediate and delayed (3 hrs) tomographic imaging. There was no serious side effect during examination, although chest pain (26%), dyspnea (17%), and flushing (33%) were common. The sensitivity and specificity to detect coronary artery disease were 98 and 100%, respectively. The sensitivity to detect left anterior descending artery, left circumflex artery, and right coronary artery lesions was 94, 59 and 77%, respectively. ATP loading thallium-201 scintigraphy provides ...
The clinical courses of heterotopic ossification (HO) as a consequence of trauma and central nervous system insults have many similarities as well as dissimilarities. Detection is commonly noted at two months. The incidence of clinically significant HO is 10%-20%. Approximately 10% of the HO is massive and causes severe restriction in joint motion or ankylosis. The most common sign and symptom are decreased range of motion and pain. The locations are the proximal limbs and joints. Sites of HO about a joint may vary according to the etiology of the HO. Roentgenographic evolution of HO occurs during a six-month period in the majority of patients. Treatment modalities include diphosphonates, indomethacin, radiation, range of motion exercises, and surgical excision. Surgical timing differs according to etiology: traumatic HO may be resected at six months; spinal cord injury HO is excised at one year; and traumatic brain injury HO is removed at 1.5 years. A small number ...
The clinical courses of heterotopic ossification (HO) as a consequence of trauma and central nervous system insults have many similarities as well as dissimilarities. Detection is commonly noted at two months. The incidence of clinically significant HO is 10%-20%. Approximately 10% of the HO is massive and causes severe restriction in joint motion or ankylosis. The most common sign and symptom are decreased range of motion and pain. The locations are the proximal limbs and joints. Sites of HO about a joint may vary according to the etiology of the HO. Roentgenographic evolution of HO occurs during a six-month period in the majority of patients. Treatment modalities include diphosphonates, indomethacin, radiation, range of motion exercises, and surgical excision. Surgical timing differs according to etiology: traumatic HO may be resected at six months; spinal cord injury HO is excised at one year; and traumatic brain injury HO is removed at 1.5 years. A small number ...
/sup 203/Pb(NO/sub 3/)/sub 2/ was administered i.v. to pregnant C57BL mice at different stages, from day 8 to day 18 of gestation. The whole animals or excised uteri were subjected to autoradiography or were autopsied for scintillation counting of excised organs. Lead appeared in embryonic and fetal tissues at all stages of gestation. Early (approx. day 8-11) lead was restricted mainly to the embryonic blood, suggesting that free lead was essentially not transferred to the embryo but may have been incorporated in the embryonic hemoglobin when the erythrocytes were formed in the yolk sac placenta (an extraembryonic membrane). From day 12 and later, an uptake was seen in the liver and the cartilaginous skeleton, and from day 14, a strong accumulation was found in calcified bone. This means that the overall fetal concentration increases successively with gestational age of the conceptus. The uptake in fetal liver may be related to the erythropoiesis taking place in the liver in later ...
"2"0"3Pb(NO_3)_2 was administered i.v. to pregnant C57BL mice at different stages, from day 8 to day 18 of gestation. The whole animals or excised uteri were subjected to autoradiography or were autopsied for scintillation counting of excised organs. Lead appeared in embryonic and fetal tissues at all stages of gestation. Early (approx. day 8-11) lead was restricted mainly to the embryonic blood, suggesting that free lead was essentially not transferred to the embryo but may have been incorporated in the embryonic hemoglobin when the erythrocytes were formed in the yolk sac placenta (an extraembryonic membrane). From day 12 and later, an uptake was seen in the liver and the cartilaginous skeleton, and from day 14, a strong accumulation was found in calcified bone. This means that the overall fetal concentration increases successively with gestational age of the conceptus. The uptake in fetal liver may be related to the erythropoiesis taking place in the liver in later gestation. While ...
A computationally efficient dynamic adaptive chemistry (DAC) scheme is described that permits on-the-fly mechanism reduction during reactive flow calculations. The scheme reduces a globally valid full mechanism to a locally, instantaneously applicable smaller mechanism. Previously we demonstrated its applicability to homogeneous charge compression ignition (HCCI) problems with n-heptane [L. Liang, J.G. Stevens, J.T. Farrell, Proc. Combust. Inst. 32 (2009) 527-534]. In this work we demonstrate the broader utility of the DAC scheme through the simulation of HCCI and shock tube ignition delay times (IDT) for three gasoline surrogates, including two- and three-component blends of primary reference fuels (PRF) and toluene reference fuels (TRF). Both a detailed 1099-species mechanism and a skeletal 150-species mechanism are investigated as the full mechanism to explore the impact of fuel complexity on the DAC scheme. For all conditions studied, pressure and key species ...
Beagle dogs were given single, whole-body "6"0Co gamma-radiation exposures at one of three prenatal (8, 28, or 55 days postcoitus) or three postnatal (2, 70, or 365 days postpartum) ages to evaluate the relative radiosensitivity of various stages of brain development. A total of 387 dogs received mean doses ranging from 0.16 to 3.83 Gy, and 120 dogs were sham-irradiated. Groups of dogs were sacrificed at preselected times from 70 days to 11 years of age. Brain weight decreased significantly with increasing dose in dogs irradiated at 28 or 55 days postcoitus or at 2 days postpartum. Irradiations at 28 days postcoitus were dramatically more effective in causing a reduction in brain weight than those at 55 days postcoitus or 2 days postpartum. Among dogs given 1.0 Gy or more and followed for up to 4 years, there was a radiation effect evident at all three sensitive exposure ages. Among dogs given lower doses and followed for up to 11 years, there was a significant decrease in brain weight ...
A portion of the active site of rabbit skeletal myosin near the ribose ring of ATP can be labeled by the photoaffinity analogue 3{prime}(2{prime})-O-(4-benzoylbenzoyl)adenosine triphosphate (Bz{sub 2}ATP). The specificity of the photolabeling was assured by first trapping ({sup 14}C)Bz{sub 2}ATP at the active site by use of thiol cross-linking agents. Five radioactive peptides were isolated by high-performance liquid chromatography after extensive trypsin and subtilisin digestion of photolabeled myosin subfragment 1. Four of these peptides were sequenced by Edman techniques, and all originated from a region with the sequence Gly-Glu-Ile-Thr-Val-Pro-Ser-Ile-Asp-Asp-Gln, which corresponds to rabbit myosin heavy chain residues 312-328. The fifth labeled peptide had an amino acid composition appropriate for residues 312-328. Amino acid composition, radiochemical analysis, and sequence data indicate that Ser-324 is the major amino acid residue photolabeled by Bz{sub ...
DBA/2J (DBA) mice are susceptible to audiogenic seizures (ASs) in an age-dependent manner. Anion transport as measured by radioiodide uptake was determined in thyroid gland, salivary gland, skeletal muscle, cerebral cortex, cerebellum, brainstem, and CSF from these mice at various ages. Anion transport was also determined in C57BL/6J(C57) mice, an AS-resistant strain. In thyroid, DBA mice had an enhanced ability to concentrate iodide at 21 days of age when they have maximal AS susceptibility, as compared with the same-aged C57 mice. This difference in thyroid function was less marked at 40 days of age, when DBA mice are less AS susceptible, and was absent at 110 days of age, when DBA mice are AS resistant. In brain, differences in iodide uptake were also noted between these two strains of mice at 21 days of age. DBA mice had an increased concentration of iodide in CSF, an indication that they have a defect in the transport of iodide out of the CSF across the ...
It has been five years since the last in-depth American College of Nuclear Physicians/Society of Nuclear Medicine Symposium on the subject of single photon emission computed tomography (SPECT) was held. Because this subject was nominated as the single most desired topic we have selected SPECT imaging as the basis for this year's program. The objectives of this symposium are to survey the progress of SPECT clinical applications that have taken place over the last five years and to provide practical and timely guidelines to users of SPECT so that this exciting imaging modality can be fully integrated into the evaluation of pathologic processes. The first half was devoted to a consideration of technical factors important in SPECT acquisition and the second half was devoted to those organ systems about which sufficient clinical SPECT imaging data are available. With respect to the technical aspect of the program we have selected the key areas which demand awareness and attention in order ...
To predict the response of blood lead to airborne and dietary lead requires knowledge of the rate of uptake of lead into the body from lung and gut, its subsequent partitioning between compartments, the stay time in those compartments, and its redistribution or excretion. Tracer studies with volunteers have shown no differences in systemic distribution of inorganic lead between tissues whether it is taken by inhalation, ingestion or injection. Lead is rapidly transferred from plasma to red cells, and there is slower movement thence into liver and other soft tissues, to bone, and to excreta. Work at Harwell and elsewhere with /sup 203/Pb has shown that the initial rapid distribution leaves rather over half the assimilated lead attached to red cells. The result is remarkably consistent, and applies also to dogs and baboons. The renal clearance (Vu) (ratio of U to CB, or daily urinary output expressed as mass of blood having the same lead content), and also the endogenous fecal clearance ...
The distribution of i.v. administered lead (/sup 203/Pb-acetate; 50 nmol/kg b.w.) was studied by means of autoradiography and impulse counting in pregnant C57BL mice (day 18) treated orally with dithiocarbamates. Diethyldithiocarbamate (DEDTC), disulfuram or thiram (2 X 1) mmol/kg b.w.) or vehicle (gelatine) alone, was given by gavage 2 h before and immediately after the injection of lead. All three dithiocarbamates, especially thiram, changed the distribution pattern of lead. Thiram and DEDTC had the greatest effect at 4 h after lead administration, disulfiram at 24 h. In the mother, most notably the brain concentration increased (70-fold for thiram at 4 h) while that of erythrocytes and skeleton decreased (50- and 4-fold, respectively). The total fetal concentration unexpectedly showed only a moderate increase (proportional 2-fold for thiram), which may be due partly to the low maternal plasma lead concentration. The partition within the fetal tissues was, however, changed by the ...
The distribution of i.v. administered lead ("2"0"3Pb-acetate; 50 nmol/kg b.w.) was studied by means of autoradiography and impulse counting in pregnant C57BL mice (day 18) treated orally with dithiocarbamates. Diethyldithiocarbamate (DEDTC), disulfuram or thiram (2 X 1) mmol/kg b.w.) or vehicle (gelatine) alone, was given by gavage 2 h before and immediately after the injection of lead. All three dithiocarbamates, especially thiram, changed the distribution pattern of lead. Thiram and DEDTC had the greatest effect at 4 h after lead administration, disulfiram at 24 h. In the mother, most notably the brain concentration increased (70-fold for thiram at 4 h) while that of erythrocytes and skeleton decreased (50- and 4-fold, respectively). The total fetal concentration unexpectedly showed only a moderate increase (proportional 2-fold for thiram), which may be due partly to the low maternal plasma lead concentration. The partition within the fetal tissues was, however, changed by the ...
The Fredericksberg of South Florida may have a great oil potential that has been overlooked as a primary target in past decades. Previous exploration in the area has targeted the Lower Cretaceous oil-producing Sunniland Formation lower in the stratigraphic section. The Fredericksberg Dollar Bay Formation has hydrocarbon shows in many wells occurring in limestone biohermal deposits as well as in an upper dolomitic section. The Dollar Bay Formation is part of the Big Cypress Group of the Comanchean Series of the Lower Cretaceous. The Lower Cretaceous lithology is composed of evaporitic-carbonate cycles consisting of anhydrites, dolomites, and limestones. There are also present some calcareous shales, mudstones, salt, lignitic material, and carbonaceous material, especially in the anhydrite and limestone intervals. The limestones are usually micritic, chalky, calcarenitic, sometimes argillaceous, containing skeletal particles of gastropods, pelecypods, ostracods, ...
Purpose: The purpose of this research was to identify the extent and scope of changes to radiography practice. Method: Questionnaires were sent to radiology managers at acute National Health Service (NHS) hospitals in 2000 as a follow-up to an initial survey conducted in 1998. Information was sought on region, teaching/non-teaching status, the nature of extended role tasks undertaken and the year in which these tasks were first undertaken. Results: Some 172 questionnaires were returned from a total of 253 dispatched (68%). In 161 hospitals radiographers administered intravenous injections and performed barium enemas in 119 hospitals, while a red-dot system was in operation in 141 hospitals. Reporting by radiographers had increased since 1998. Replies indicated that, at 124 hospitals, radiographers were reporting in ultrasound. Skeletal reporting was the second most-frequently-reported activity, with 63 hospitals indicating that radiographers reported in this ...
Abstract High-mobility group box 1 (HMGB1), a damage-associated molecular pattern (DAMP) molecules, favors tissue regeneration via recruitment and activation of leukocytes and stem cells. Here we demonstrate, in a model of acute sterile muscle injury, that regeneration is accompanied by active reactive oxygen species (ROS) production counterbalanced and overcome by the generation of antioxidant moieties. Mitochondria are initially responsible for ROS formation. However, they undergo rapid disruption with almost complete disappearance. Twenty-four hours after injury, we observed a strong induction of MURF1 and atrogin-1 ubiquitin ligases, key signals in activation of the proteasome system and induction of muscle atrophy. At later time points, ROS generation is maintained by nonmitochondrial sources. The antioxidant response occurs in both regenerating fibers and leukocytes that express high levels of free thiols and antioxidant enzymes, such as superoxide dismutase 1 (SOD1) and ...
The enhancements described of high-performance CT systems of latest design have again confirmed the importance of CT systems for acute and selective diagnostic imaging. Higher availability, shorter exposure times, and better applicability and handling for examination of poly-traumata patients or patients of intensive care departments are some of the advantages achieved with CT systems which demonstrate CT system efficiency in addition to MRI, which for specific examinations will remain the modality of first choice for diagnostic evaluation. The Tomoscan Av-E presented here was able to answer all relevant diagnostic questions appearing in routine diagnostics and scientific work. For patients, examinations using the spiral CT technique also offers significant advantages. (orig./CB) [Deutsch] Durch die dargestellten Verbesserungen bei Hochleistungs-CT-Systemen neuester Bauart wurde die Bedeutung der CT fuer die akute und selektive Diagnostik erneut bestaetigt. Bessere Verfuegbarkeit, ...
Throughout much of the 1980s, deforestation in Brazil eliminated more than 15,000 square kilometers (9000 square miles) per year. That pace has only increased through the 90s and into the 21st century. Brazil is also home to more than a quarter of Earths tropical forests. Considering that the band of lush green that circles the globe through many equatorial nations is fundamental to the overall health of the whole planets environment, careful monitoring of forest health in the tropics is essential. Tropical forests act as major carbon sinks, places where ambient carbon dioxide in the atmosphere can be absorbed by growing things and sequestered for years. Definitive evidence shows that excess carbon dioxide can contribute to the greenhouse effect and speed global warming. Similarly, tropical forests also act as a primary producer of oxygen. In the respiration process that absorbs gaseous carbon dioxide, trees and other plants give off oxygen. It is for these and a host of other reasons ...
Duchenne and Becker muscular dystrophies are caused by defects of dystrophin, which forms a part of the membrane cytoskeleton of specialized cells such as muscle. It has been previously shown that the dystrophin-associated protein A1 (59-kDa DAP) is actually a heterogeneous group of phosphorylated proteins consisting of an acidic ({alpha}-A1) and a distinct basic ({beta}-A1) component. Partial peptide sequence of the A1 complex purified from rabbit muscle permitted the design of oligonucleotide probes that were used to isolate a cDNA for one human isoform of A1. This cDNA encodes a basic A1 isoform that is distinct from the recently described syntrophins in Torpedo and mouse and is expressed in many tissues with at least five distinct mRNA species of 5.9, 4.8, 4.3, 3.1, and 1.5 kb. A comparison of the human cDNA sequence with the GenBank expressed sequence tag (EST) data base has identified a relative from human skeletal muscle, EST25263, which is probably a human ...
Thalassaemic patients are in need of frequent assessment of bone age because of growth failure and pubertal disorders. To compare the ''rapid'' Greulich and Pyle (G and P) method with the third edition of the Tanner and Whitehouse (TW3) method for determining skeletal maturity and predicting final height in thalassaemic patients. A total of 191 radiographs from 58 patients (28 male, 30 female) were retrospectively evaluated by two investigators, one for each method. In 47 radiographs from 15 patients having attained their adult height, predicted final height was calculated according to each method. The mean bone ages determined by both the G and P and TW3 methods were lower than mean chronological age, although the differences were not statistically significant (10.04 {+-} 3.69 years and 9.98 {+-} 3.39 years vs. 10.78 {+-} 3.96 years, respectively). Both methods had a tendency to over-estimate final height. Overall, the TW3 ...
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 detected in three independent families. ...
A cross sectional study on the mineral density of the 3rd lumbar vertebral trabecular bone was carried out in 123 children less than 15 years old, comprising 44 controls, and 79 patients affected with conditions which are at risk for developing metabolic derangement of skeletal bone (34 patients taking antiepileptic drugs (AED), 29 undergoing glucocorticoid (GC) therapy and 16 bedridden patients), by using quantitative computed tomography (QCT) with a CaCO{sub 3} phantom. Serum Ca and alkaline-phosphatase (Alp) levels were measured at the time of QCT examinations in all. The results obtained were as follows: The QCT values in the control children showed neither age dependency nor a sexual difference before puberty. The QCT values in each group showed significant difference with one another; the control group>the AED group>the GC group>the bedridden group (p<0.05{approx}0.005). The serum Ca levels in each pathology group were significantly lower than ...
A study was made investigate a relationship existing in the dentoskeletal framework and the soft tissue profile around the face, and compared the sexual differences between boys and girls having the normal occlusion in the mixed dentition. The lateral cephalograms were composed of 67 boys aged 10.3 years and 68 girls aged 10.4 years, respectively. By means of the lateral cephalograms, both the hard-and soft tissue structures were simultaneously analyzed, measured and evaluated by introducing the several reference items: S-N plane, palatal plane, mandibular plane, N-A line and A-P line for the dentoskeletal structures and N'-P' line for the soft tissue, and the 21 measuring points for the both structures. The significant findings were as follows: 1. In general the boys showed the larger nasal component dimension than did the girls, but the length and height of nose(N'-Prn and NA-Prn) showed the significant sexual difference among those when evaluated statistically. 2. The lip-thickness ...
A study was performed to investigate the size of pharyngeal cavity and sexual differences between Korean adult mal e and female by introducing linear analysis of the lateral cephalogram. The radiograms were composed of 46 adult male aged 24.64 and 52 adult female aged 22.74 respectively. In order to study and measure the pharyngeal area, the following skeletal landmarks were selected: S,N,A,Ptm, B,H,H', M ,S-N, FH and CV, and the angle CV-FH was measured to provide a factor for correction of error resulting from improper he ad positioning of subjects, especially in the relative positions of A and H, while radiography. All points to be measured were projected at right angles to the Frankfort plane. For the purpose of measuring the anteroposterior dimensions of pharyngeal cavity the distances were measured in A-Ptm, A-S, S-Ptm and CV-H, and vertical measurements were made in SN-A, SN-PNS, SN-H' and M-H. The obtained results were as follows: 1. The pharyngeal cavity ...
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 cut-off value for response on CT based on the response evaluation criteria in solid tumors criteria. Response on PET-CT was assessed using ...
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 after 22.4 Gy and 44.8 Gy, total dose and treatment time as for ...
Lung cancer staging according to the TNM system is based on morphological assessment of the primary cancer, lymph nodes and metastases. All aspects of this important oncological classification are measurable with MRI. Pulmonary nodules can be detected at the clinically relevant size of 4-5 mm in diameter. The extent of mediastinal, hilar and supraclavicular lymph node affection can be assessed at the same time. The predominant metastatic spread to the adrenal glands and spine can be detected in coronal orientation during dedicated MRI of the lungs. Search focused whole body MRI completes the staging. Various additional MR imaging techniques provide further functional and clinically relevant information during a single examination. In the oncological context the most important techniques are imaging of perfusion and tumor motion. Functional MRI of the lungs complements the pure staging and improves surgical approaches and radiotherapy planning. (orig.) [German] Das ...
Thirty-seven patients with primary nonresectable intrahepatic cholangiocarcinoma (57% with prior treatment and/or metastasis) were prospectively treated with external radiation, chemotherapy, and "1"3"1I labelled anti-CEA. Therapy began in all trials with whole liver irradiation (21.0 Gy, 3.0 Gy/Fx, 4 days/week, 10 MV photons) with alternate treatment day chemotherapy (Adriamycin, 15 mg + 5-FU, 500 mg). One month after external beam therapy, chemotherapy was given (Adriamycin, 15 mg + 5-FU, 500 mg) followed the next day by the first administration of "1"3"1I anti-CEA. The treatment schedule used was 20 mCi day 0; 10 mCi day 5 as an outpatient. This schedule was derived from tumor dose estimates which indicated that 20 mCi (8-10 mCi/mg IgG) was sufficient to achieve tumor saturation with a tumor effective half-life of 3 to 5 days, depending upon the species of animal from which the antibody was obtained. The median tumor dose for the 20 mCi + 10 mCi regimen was 6.2 Gy. Antibody therapy ...
Energy from biomass is a CO{sub 2} neutral, sustainable form of energy. Anaerobic digestion is an established technology for converting biomass to biogas, which contains around 60% methane, besides CO{sub 2} and various contaminants. Most types of biomass contain material that cannot be digested; in woody biomass, this portion is particularly high. Therefore, conventional anaerobic digestion is not suited for the production of biogas from woody biomass. While wood is already being converted to energy by conventional thermal methods (gasification with subsequent methanation), dung, manure, and sewage sludge represent types of biomass whose energy potential remains largely untapped (present energetic use of manure in Switzerland: 0.4%). Conventional gas phase processes suffer from a low efficiency due to the high water content of the feed (enthalpy of vaporization). An alternative technology is the hydrothermal gasification: the water contained within the biomass serves as reaction ...
Purpose: Cardiomyopathy is one of the major complications of {beta} thalassaemia major as a result of transfusion iron overload. The aim of our study is to evaluate with MR if there is any difference of iron deposition signal intensity (SI) or distribution between non-cardiopatic and cardiopatic thalassaemic patients in order to establish if there is a relationship between cardiopathy and iron deposition. Materials and methods: We studied 20 patients affected by {beta} thalassaemia major, of whom 10 cardiopatic and 10 non-cardiopatic, and 10 healthy volunteers as control group. Serum ferritin and left ventricular ejection fraction were calculated in thalassaemic patients. All patients were examinated using a 1.5 MR unit with ECG-gated GE cine-MR T2*-weighted, SE T1-weighted and GE T2*-weighted sequences. In all cases, using an adequate ROI, the myocardial and skeletal muscle signal intensity (SI), the myocardial/skeletal muscle signal intensity ...
The objective was to characterize imaging findings of benign notochordal cell tumors (BNCTs). Clinical and imaging data for 9 benign notochordal cell tumors in 7 patients were reviewed retrospectively. Conventional radiographs (n = 9), bone scintigrams (n = 2), computed tomographic images (n = 7), and magnetic resonance images (n = 8) were reviewed. Eight of the 9 lesions were stained with hematoxylin-eosin and microscopically examined. There were 3 male and 4 female patients with an age range of 22 to 55 years (average age, 44 years). Two patients had two lesions at different sites. The lesions involved the cervical spine in 4 patients, the lumbar spine in 2, the sacrum in 2, and the coccyx in 1. The most common symptom was mild pain. The lesions of 2 patients were found incidentally during imaging studies for unrelated conditions. Five patients underwent surgical procedures. One patient died of surgical complications. All other patients have been well without ...