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Sample records for severely reduced osseous

  1. Progressive osseous heteroplasia

    African Journals Online (AJOL)

    Progressive osseous heteroplasia is a rare genetic disorder characterized by cu- taneous ossification during infancy and progressive ossification of subcutane- ous and deep connective tissue including muscle and fascia during childhood. It is at the severe end of a spectrum of Guanine Nucleotide-binding protein,.

  2. Osseous osteoarthritic-like changes and joint mobility of the temporomandibular joints and upper cervical spine

    DEFF Research Database (Denmark)

    Sonnesen, Liselotte; Petersson, Arne; Wiese, Mie

    2017-01-01

    OBJECTIVES: To compare 1) temporomandibular joint (TMJ) mobility between patients with and without reduced upper cervical spine (UCS) mobility and with and without TMJ osseous osteoarthritic-like changes, and 2) UCS osseous changes between patients with and without TMJ osseous osteoarthritic...

  3. Effective use of strontium-89 in osseous metastases

    International Nuclear Information System (INIS)

    Kuroda, Isao

    2012-01-01

    Bone is one of the organs to which cancer metastasizes most frequently. However, it is not a vital organ, therefore, survival after the occurrence of osseous metastasis is relatively favorable. Improvements of medical treatment bring prolonged survival to patients with osseous metastases. But this makes us to recognize the importance of quality of life (QOL) due to several factors, including pain. It is important for oncologists to know how to deal with such painful osseous metastases, as pain relief may enable patients to live their remaining lives to the fullest. Strontium-89 (89Sr) has been used worldwide as in Japan, while being reported to have positive effects on pain relief and QOL improvement in patients with osseous metastases. This review paper is aimed to present not only the history, roles, and medical characters of 89Sr, but also new aspects, such as how to use bone turnover markers, which location of osseous metastases is suitable for effective use of 89Sr. (author)

  4. EXTRA-OSSEOUS EWING SARCOMA

    NARCIS (Netherlands)

    van den Berg, Hendrik; Heinen, Richard C.; van der Pal, Heleen J.; Merks, Johannes H. M.

    2009-01-01

    Background: Clinical data and data on outcome of extra-osseous Ewing tumors are scarce. Procedure: After a search for Ewing tumors in the database of a single institution over a period of 20 years, 16 out of 192 cases were found to have extra-osseous primary tumors. Results: Ages at initial

  5. Mutlifocal osseous posttransplantation lymphoproliferative disorder: case report

    Energy Technology Data Exchange (ETDEWEB)

    Lo, Ryan [University of Chicago, Department of Radiology, Chicago, IL (United States); Michalicek, Zachary [Northshore University Healthsystems, Department of Pathology, Evanston, IL (United States); Lazarus, Martin [Northshore University Healthsystems, Department of Radiology, Evanston, IL (United States)

    2015-02-14

    Posttransplant lymphoproliferative disorder (PTLD) is a known complication of organ transplantation, but musculoskeletal involvement of PTLD remains very rare. We present a case of recurrent PTLD of the bone in a heart transplant patient that was misdiagnosed as gout for several years. There are only a few cases of osseous PTLD in the literature, and we hope to better characterize its imaging findings on multiple imaging modalities. (orig.)

  6. Osseous scintigraphy and auxiliary graft

    International Nuclear Information System (INIS)

    Khelifa, F.; Siles, S.; Puech, B.

    1992-01-01

    The scintigraphy could be a good way to survey the osseous graft: three cases are studied in which were recognized the presence of a graft, surinfection, graft lysis, pseudo-arthrosis, algodystrophy. 8 refs., 5 figs

  7. "Osseous tumors of the hand "

    Directory of Open Access Journals (Sweden)

    "Farzan M

    2002-08-01

    Full Text Available The majority of osseous tumors of the hand are benign. The surgeon who evaluates and treats osseous tumors of the hand has to be familiar with limb anatomy, tumor biology, various presentations of the tumors and the range of treatment possibilities and their limitations. Lesions in the hand more often present earlier in their course than those at other sites, just because they are more likely to superficial and easily noticed. A review of all cases of osseous tumors of the hand, seen by a hand surgeon over the last 10 years, at Imam Khomeini hospital was performed. Among 55 cases with osseous tumors of hand, 48 primary benign bone tumors, 3 primary malignant bone tumors, and 4 metastatic bone tumors were found. Enchondroma was the most common benign bone tumor followed by osteoid osteoma, osteoblastoma, aneurismal bone cyst, giant cell tumor, epidermoid cyst, and osteochondroma. There were two chondrosarcoma and one Ewing’s sarcoma as primary malignant bone tumors. Metastasis to the hand from colon, esophagus, and breast were also found. There were also two cases with Brown tumor secondary to hyperparathyroidism, we conclude that a variety of osseous tumors could occur in the hand, and usually they are benign. Although malignant neoplasms in the hand that arise from tissues other than the skin are very rare, the hand may be the site of distant breast, lung, kidney, esophagus, or colon adenocarcinoma metastases, most of which have a predilection for the distal phalanges.

  8. Melatonin reduces the severity of experimental amoebiasis

    Directory of Open Access Journals (Sweden)

    Honório-França Adenilda C

    2011-04-01

    Full Text Available Abstract Background Melatonin has immunomodulatory effects but very little is known about its influence in protozoan infections, such as Entamoeba histolytica, which causes amoebiasis, a disease with significant morbidity and mortality. In this study, we evaluated the effects of exogenous melatonin interference in experimental amoebiasis and on interactions between human blood cells and E. histolytica trophozoites. Methods The effect of melatonin was investigated in models of experimental amoebiasis in hamsters and rats by evaluating the area of necrosis induced by E. histolytica. The activity of melatonin on the interactions between leukocytes and amoebae was determined by examining leukophagocytosis. For in vitro tests, polymorphonuclear and mononuclear human blood leucocytes were incubated with E. histolytica trophozoites. Results The areas of amoebic necrosis were significantly reduced in animals treated with melatonin. Melatonin treatment increased leukophagocytosis but was associated with a greater number of dead amoebae. Conclusions These results suggest that melatonin may play a beneficial role in the control of amoebic lesions, raising the possibility that this drug may be used as an adjuvant in anti-amoebic therapy.

  9. Vascularized osseous graft for scaphoid

    International Nuclear Information System (INIS)

    Mendez Daza, Carlos Hernan; Mathoulin, Cristophe

    2004-01-01

    The most commonly used technique for treatment of pseudo-arthrosis of the scaphoid is osteo-synthesis with Kirschnet wires and cortical sponge grafts. Results reported by different teams using this procedure show no more than 90% osseous consolidation, especially in cases where vascularisation of the proximal fragment of the scaphoid is compromised. Here we present a series of ten cases of pseudo-arthrosis of the scaphoid, treated using a new surgical technique involving a vascularized osseous graft of the distal radius. Using this procedure we obtained 100% consolidation, with no complications either during the procedure or immediately post-operatively. Patients returned to work in week 15 on average. In 4 cases we observed discomfort in the area of the scar, which was successfully treated using local cortisone injection. The results obtained are very similar to those seen in the literature on the different techniques for vascularized osseous grafts for pseudo-arthrosis of the scaphoid

  10. Fibro-osseous lesions of the face and jaws.

    Science.gov (United States)

    MacDonald-Jankowski, D S

    2004-01-01

    Maxillofacial fibro-osseous lesions (FOL) consists of lesions that differ, with the exception of fibrous dysplasia, to those found in the rest of the skeleton. FOLs of the face and jaws are cemento-osseous [corrected] dysplasia, fibrous dysplasia and cemento-ossifying fibroma. Radiology is central to their diagnosis because the pathology for all FOLs is similar, although they range widely in behaviour, from dysplasia, hamartoma to benign neoplasia with occasional recurrence. Furthermore, once diagnosed the management of each is different. For cemento-ossifying dysplasia, this may mean doing nothing, simply because no treatment is generally appropriate. Almost all cemento-osseous [corrected] fibromas should be treated surgically, whereas cases of fibrous dysplasia are treated according to their clinical presentation, ranging from review and follow-up to surgery necessary to save the patient's sight or reduce deformity. The most important and frequent features of the FOLs differential diagnosis is discussed with assistance of a flow-chart.

  11. Osseous Dysplasia Accompanied by a Complex Odontoma in the Mandible

    Directory of Open Access Journals (Sweden)

    N Jafari

    2017-05-01

    Full Text Available Introduction: Cement osseous dysplasia is the most common lesion of the family fibrous dysplasia which normal bone is replaced with fibrous tissue and several mineralized material. These lesions may be seen in association with various lesions. Companionship of this lesion with odontoma has been reported rarely. Case report: A 44-year-old female in one year ago has admitted to Shahid Sadoughi Faculty of Dentistry Yazd for treatment of mandibular left third molar. In panoramic radiography in the mandibular left first molar region, a mixed lesion of radiolucent-radiopaque with a corticated borderwas seen. Small swelling was observed in this area. Microscopically, the diagnosis of osseous dysplasia with odontoma for the lesion was confirmed. Conclusion: The reason of companionship of cement osseous lesions whit other lesions is not completely clear and it requires further evaluation.

  12. Primary multifocal osseous Hodgkin's lymphoma

    Directory of Open Access Journals (Sweden)

    Kohler Janice

    2008-03-01

    Full Text Available Abstract Background Hodgkin's disease (HD most commonly presents with progressive painless enlargement of peripheral lymph nodes, especially around the cervical region. A few children have systemic symptoms and weight loss. At the time of diagnosis, osseous involvement is uncommon Case presentation A case is described of Primary Multifocal Osseous Hodgkin's Lymphoma in a seven-year-old boy. He presented with a painful swelling in the sternum, and further investigations revealed deposits in his L1 vertebra, the left sacro-iliac joint and the right acetabulum. Conclusion The clinical, radiological and histological features of this disease can mimic other medical conditions, including Tuberculosis, making the diagnosis difficult and often leading to delays in treatment. This is a very rare condition and we believe this to be the youngest reported case in the literature.

  13. Progressive osseous heteroplasia (POH): an Egyptian patient | El ...

    African Journals Online (AJOL)

    Progressive osseous heteroplasia is a rare genetic disorder characterized by cutaneous ossification during infancy and progressive ossification of subcutaneous and deep connective tissue including muscle and fascia during childhood. It is at the severe end of a spectrum of Guanine Nucleotide-binding protein, ...

  14. Progressive osseous heteroplasia

    African Journals Online (AJOL)

    ous and deep connective tissue including muscle and fascia during childhood. It is at the severe end of a spectrum of Guanine ... and extensive bone formation in deep muscle and fascia. Dermal lesions co- alesce rapidly to form ... web-like calcification surrounding all the upper and lower limbs and sparing only the soft ...

  15. Do insect outbreaks reduce the severity of subsequent forest fires?

    Science.gov (United States)

    Meigs, Garrett W.; Zald, Harold S. J.; Campbell, John L.; Keeton, William S.; Kennedy, Robert E.

    2016-04-01

    Understanding the causes and consequences of rapid environmental change is an essential scientific frontier, particularly given the threat of climate- and land use-induced changes in disturbance regimes. In western North America, recent widespread insect outbreaks and wildfires have sparked acute concerns about potential insect-fire interactions. Although previous research shows that insect activity typically does not increase wildfire likelihood, key uncertainties remain regarding insect effects on wildfire severity (i.e., ecological impact). Recent assessments indicate that outbreak severity and burn severity are not strongly associated, but these studies have been limited to specific insect or fire events. Here, we present a regional census of large wildfire severity following outbreaks of two prevalent bark beetle and defoliator species, mountain pine beetle (Dendroctonus ponderosae) and western spruce budworm (Choristoneura freemani), across the US Pacific Northwest. We first quantify insect effects on burn severity with spatial modeling at the fire event scale and then evaluate how these effects vary across the full population of insect-fire events (n = 81 spanning 1987-2011). In contrast to common assumptions of positive feedbacks, we find that insects generally reduce the severity of subsequent wildfires. Specific effects vary with insect type and timing, but both insects decrease the abundance of live vegetation susceptible to wildfire at multiple time lags. By dampening subsequent burn severity, native insects could buffer rather than exacerbate fire regime changes expected due to land use and climate change. In light of these findings, we recommend a precautionary approach when designing and implementing forest management policies intended to reduce wildfire hazard and increase resilience to global change.

  16. Biodanza Reduces Acute Pain Severity in Women with Fibromyalgia.

    Science.gov (United States)

    Segura-Jiménez, Víctor; Gatto-Cardia, Claudia M; Martins-Pereira, Clélia M; Delgado-Fernández, Manuel; Aparicio, Virginia A; Carbonell-Baeza, Ana

    2017-10-01

    Biodanza is a useful therapy for the fibromyalgia management; however, there is no evidence of its effectiveness on acute pain. The objectives of the present study were: to determine the changes of a 3-month Biodanza program on acute pain severity (before vs. after session) and cumulative pain severity in women with fibromyalgia; and to check the associations of acute pain severity reduction with presession pain severity, body fat percentage, and satisfaction with the session. This was a 3-month low-moderate intensity (rate of perceived exertion around 12, based on a 6-20 point scale) Biodanza intervention study (1 session/week). Twenty-seven women with fibromyalgia (54.2 ± 6.2 years) participated. Pain severity was assessed before and after each single session with a visual analog scale. There were immediate changes in all sessions (p = .001-.028), except in the first, second, and fourth sessions. An overall 16% decrease of acute pain severity before and after each session was noted (mean presession pain vs. postsession pain, 5.8 ± 2.1 vs. 4.9 ± 2.4; respectively). There was an independent association of pain severity reduction (presession-postsession) with presession pain severity (unstandardized coefficient B = .21 ± .05; standardized coefficient β = .25; p pain severity (p pain severity (p = .007; 95% CI = .02, .12) along the 3-month intervention. No significant cumulative effect in presession pain severity was identified (p > .05). In conclusion, Biodanza is an alternative therapy that reduced acute pain severity in women with fibromyalgia. The intervention also yielded cumulative pain severity reduction, which were higher in those women with fibromyalgia presenting higher presession pain severity and lower body fat percentage. The satisfaction with the session was also a key factor positively associated with pain reduction. Copyright © 2017 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights

  17. [Aseptic loosening of total ankle replacement : Two-stage revision with bone augmentation of osseous defects and secondary prosthesis implantation].

    Science.gov (United States)

    Barg, A; Wiewiorski, M; Valderrabano, V

    2017-06-01

    To remove loosened ankle prosthesis components, perform osseous defect augmentation, and reimplant definitive prosthesis components to preserve ankle range of motion. Aseptic loosening of the tibial and/or talar ankle prosthesis components with substantial bone defect. General surgical/anesthesiological risks, infections, critical soft tissue conditions, nonmanageable hindfoot instability, neurovascular impairment of the lower extremity, neuroarthropathy, substantial nonreconstructable osseous defects with or without cysts on the tibial and/or talar side, noncompliance, primary total ankle replacement (TAR) using intramedullary fixation (stem fixation), severely reduced bone quality, insulin-dependent diabetes mellitus, smoking, unrealistic patients' expectations, high activity in sports. Exposure of the ankle joint using the previous incision. Mobilization and removal of loosened prosthesis components. Debridement of bone stock. Assessment and measurement of osseous defects. Harvesting of iliac crest autograft. Screw fixation of iliac crest autograft. Placement of polyethylene inlay as a spacer. Wound closure in layers at the ankle and the iliac crest. Implantation of definitive prosthesis components. A soft wound dressing. Thromboprophylaxis recommended. Mobilization on postoperative day 1 using a stabilizing walking boot/cast for 6 weeks (sole contact but no weight bearing). Clinical and radiographic follow-up 3 months postoperatively including computed tomography to assess osseous consolidation. After the second surgery, patient mobilization on postoperative day 1 with 15 kg partial weight bearing using a stabilizing walking boot/cast for 6 weeks. Following clinical and radiographic follow-up at 6 weeks, full weight bearing is initiated gradually. From January 2007 to December 2012, a two-stage revision TAR was performed in 5 patients (46.8 and 71.4 years). The time between the initial TAR and revision was 2.4-11.5 years. No intra

  18. External foam layers to football helmets reduce head impact severity.

    Science.gov (United States)

    Nakatsuka, Austin S; Yamamoto, Loren G

    2014-08-01

    Current American football helmet design has a rigid exterior with a padded interior. Softening the hard external layer of the helmet may reduce the impact potential of the helmet, providing extra head protection and reducing its use as an offensive device. The objective of this study is to measure the impact reduction potential provided by external foam. We obtained a football helmet with built-in accelerometer-based sensors, placed it on a boxing mannequin and struck it with a weighted swinging pendulum helmet to mimic the forces sustained during a helmet-to-helmet strike. We then applied layers of 1.3 cm thick polyolefin foam to the exterior surface of the helmets and repeated the process. All impact severity measures were significantly reduced with the application of the external foam. These results support the hypothesis that adding a soft exterior layer reduces the force of impact which may be applicable to the football field. Redesigning football helmets could reduce the injury potential of the sport.

  19. Auricular electroacupuncture reduces frequency and severity of Raynaud attacks.

    Science.gov (United States)

    Schlager, Oliver; Gschwandtner, Michael E; Mlekusch, Irene; Herberg, Karin; Frohner, Tanja; Schillinger, Martin; Koppensteiner, Renate; Mlekusch, Wolfgang

    2011-02-01

    Acupuncture has been shown to influence skin perfusion and the subjective cold perception threshold. Therefore, we hypothesized that auricular electroacupuncture (EA) might reduce symptoms in primary Raynaud's phenomenon (PRP). Twenty-six patients with PRP received 6 cycles of auricular EA. After 3, 6 and 24 weeks attack frequency and severity were reevaluated using standardized questionnaires and a visual analogue scale (VAS). Skin temperature was assessed by infrared thermography and laser Doppler perfusion imaging was used to determine skin perfusion. Compared to baseline we found a significant reduction of attack frequency after 3 (p = 0.001) and 6 weeks (p < 0.001) of auricular EA. This improvement sustained following cessation of EA, after 24 weeks (p < 0.001). Furthermore, attack associated pain was reduced after 3 (p = 0.003), 6 (p = 0.003) and 24 weeks (p = 0.001) of treatment, while skin temperature and skin perfusion did not change significantly throughout the study period. Auricular EA reduces symptoms by means of frequency and severity of attacks in PRP but has no influence on skin perfusion and skin temperature.

  20. Schizophrenia illness severity is associated with reduced loss aversion.

    Science.gov (United States)

    Currie, James; Buruju, Dheeraj; Perrin, Jennifer S; Reid, Ian C; Steele, J Douglas; Feltovich, Nick

    2017-06-01

    Loss aversion, whereby losses weigh more heavily than equal-sized gains, has been demonstrated in many decision-making settings. Previous research has suggested reduced loss aversion in schizophrenia, but with little evidence of a link between loss aversion and schizophrenia illness severity. In this study, 20 individuals with schizophrenia and 16 control participants, matched by age and sex, played two versions of the Iterated Prisoners' Dilemma, one version with only positive payoffs and another version in which negative payoffs were possible, with the second version being derived from the first by subtracting a constant value from all payoffs. The control group demonstrated significantly lower cooperation rates under negative payoffs, compared with the version with only positive payoffs, indicative of loss aversion. The patient group on average showed no loss aversion response. Moreover, the extent of loss aversion in patients was found to be negatively correlated with schizophrenia illness severity, with less ill patients showing loss aversion more similar to controls. Results were found to be robust to the inclusion of potential confounding factors as covariates within rigorous probit regression analyses. Reduced loss aversion is a feature of schizophrenia and related to illness severity. Copyright © 2017. Published by Elsevier B.V.

  1. Reducing uncertainty - responses for electricity utilities to severe solar storms

    Science.gov (United States)

    Gaunt, Charles Trevor

    2014-01-01

    Until recently, electricity utilities in mid- and low-latitude regions believed that solar storms had no (or only insignificant) effect on their power systems. Then it was noticed that the onset of damage in several large transformers, leading to their failure, correlated very closely with the Halloween storm of 2003. Since then engineers have started to appreciate that a very severe storm could have serious consequences outside the high-latitude regions. There are many uncertainties in predicting the effects of solar storms on electrical systems. The severity and time of arrival of a storm are difficult to model; so are the geomagnetically induced currents (GICs) expected to flow in the power networks. Published information about the responses of different types of transformers to GICs is contradictory. Measurements of the abnormal power flows in networks during solar storms generally do not take into account the effects of the current distortion and unbalance, potentially giving misleading signals to the operators. The normal requirement for optimum system management, while allowing for the possibility of faults caused by lightning, birds and other causes, limits the capacity of system operators to respond to the threats of GICs, which are not assessed easily by the N - 1 reliability criterion. A utility's response to the threat of damage by GICs depends on the expected frequency and magnitude of solar storms. Approaches to formulating a response are located in a system model incorporating space physics, network analysis, transformer engineering, network reliability and decision support and the benefits are identified. Approaches adopted in high-latitude regions might not be appropriate where fewer storms are expected to reach damaging levels. The risks of an extreme storm cannot be ignored, and understanding the response mechanisms suitable for low-latitude regions has the capacity to inform and reduce the uncertainty for power systems planners and operators

  2. Primary multifocal osseous lymphoma in a child

    Energy Technology Data Exchange (ETDEWEB)

    Sato, Takashi S.P. [University of Iowa, Carver College of Medicine, Iowa City, IA (United States); Ferguson, Polly J. [University of Iowa, Department of Pediatrics, Iowa City, IA (United States); Khanna, Geetika [Washington University, Mallinckrodt Institute of Radiology, St Louis, MO (United States)

    2008-12-15

    We report a case of primary multifocal osseous lymphoma in a 6-year-old girl presenting with multifocal osteolytic lesions without systemic symptoms or identifiable non-osseous primary tumor. The differential diagnoses for such a presentation include histiocytosis X, chronic recurrent multifocal osteomyelitis, acute lymphoblastic leukemia, metastatic disease, and primary bone lymphoma. Although non-Hodgkin lymphoma is common in the pediatric population, its presentation as a primary bone tumor, especially with multifocal disease, is extremely rare and is frequently misdiagnosed. We hope that awareness of this entity will help radiologists achieve timely diagnosis and intervention. (orig.)

  3. Primary multifocal osseous lymphoma in a child

    International Nuclear Information System (INIS)

    Sato, Takashi S.P.; Ferguson, Polly J.; Khanna, Geetika

    2008-01-01

    We report a case of primary multifocal osseous lymphoma in a 6-year-old girl presenting with multifocal osteolytic lesions without systemic symptoms or identifiable non-osseous primary tumor. The differential diagnoses for such a presentation include histiocytosis X, chronic recurrent multifocal osteomyelitis, acute lymphoblastic leukemia, metastatic disease, and primary bone lymphoma. Although non-Hodgkin lymphoma is common in the pediatric population, its presentation as a primary bone tumor, especially with multifocal disease, is extremely rare and is frequently misdiagnosed. We hope that awareness of this entity will help radiologists achieve timely diagnosis and intervention. (orig.)

  4. The histological study of osseous regeneration following ...

    African Journals Online (AJOL)

    Background: While various biomaterials are used for bone regeneration, the relative comparative efficiency of them has not been thoroughly investigated. Purpose: This study evaluated histopathological events during osseous healing after implantation of following bone grafts: Demineralized freeze‑dried cortical bone ...

  5. Epibulbar osseous choristoma: A case report

    Directory of Open Access Journals (Sweden)

    Keegan A. Harkins

    2017-04-01

    Conclusions and importance: We describe diagnosis and successful surgical management of osseous choristoma the rarest subtype of ocular choristoma. With only 65 cases reported since mid-19th century, the condition remains poorly described. This report provides additional information on diagnosis and treatment of this rare condition.

  6. Primary multiple osseous leiomyosarcomas of the spine ...

    African Journals Online (AJOL)

    Primary osseous leiomyosarcoma of the spine is a very unusual condition, with only few cases being reported in the literature.In fact, this type of tumors arises from the smooth muscle cells and occurs usually in the uterus and the gastrointestinal tracts. If the spine should be involved, it occurs generally as a metastatic ...

  7. Focal Cemento-osseous Dysplasia: Report of an Unusual Case

    Directory of Open Access Journals (Sweden)

    Amita Aditya

    2013-01-01

    Full Text Available Fibro-osseous lesions of the jaws pose diagnostic and therapeutic difficulties due to their clinical, radiological and histological variability. Cemento-ossifying fibroma is a rare, benign fibro-osseous lesion that arises from the periodontal ligament. Cemento- osseous dysplasia is another variant of fibro-osseous lesion which commonly involves mandible of females. We report a case of an unusual presentation of cemento-osseous dysplasia in a 13-year-old female which posed a diagnostic dilemma clinically and histopathologically, due to its close resemblance to cemento-ossifying fibroma.

  8. Ulinastatin Reduces T Cell Apoptosis in Rats with Severe Acute ...

    African Journals Online (AJOL)

    T cell apoptosis was determined by Annexin-V/PI double-staining. Oxidative stress was evaluated by examining changes in the levels of reactive oxygen species (ROS). Total superoxide ... Key words: Ulinastatin, T cell, Apoptosis, Severe acute pancreatitis, Mitochondrion. Tropical ..... finally affect its structure and function.

  9. Reduced Hsp70 and Glutamine in Pediatric Severe Malaria Anemia

    DEFF Research Database (Denmark)

    Kempaiah, Prakasha; Dokladny, Karol; Karim, Zachary

    2016-01-01

    Severe malarial anemia [SMA, hemoglobin (Hb) <5.0 g/dL] is a leading cause of global morbidity and mortality among children residing in Plasmodium falciparum transmission regions. Exploration of molecular pathways through global gene expression profiling revealed that SMA was characterized by dec...

  10. Treatment and education reduce the severity of schistosomiasis periportal fibrosis

    Directory of Open Access Journals (Sweden)

    Paula Carolina Valenca Silva

    2013-07-01

    Full Text Available Introduction This study evaluates the factors associated with the development of severe periportal fibrosis in patients with Schistosoma mansoni. Methods A cross-sectional study was conducted from April to December 2012 involving 178 patients infected with S. mansoni who were treated in the Hospital das Clínicas of Pernambuco, Brazil. Information regarding risk factors was obtained using a questionnaire. Based on the patients' epidemiological history, clinical examination, and upper abdomen ultrasound evaluation, patients were divided into 2 groups: 137 with evidence of severe periportal fibrosis and 41 patients without fibrosis or with mild or moderate periportal fibrosis. Univariate and multivariate analyses were conducted using EpiInfo software version 3.5.5. Results Illiterate individuals (30.1% and patients who had more frequent contact with contaminated water in towns in the Zona da Mata of Pernambuco (33.2% were at greater risk for severe periportal fibrosis. Based on multivariate analysis, it was determined that an education level of up to 11 years of study and specific prior treatment for schistosomiasis were preventive factors for severe periportal fibrosis. Conclusions The prevailing sites of the severe forms of periportal fibrosis are still within the Zona da Mata of Pernambuco, although there has been an expansion to urban areas and the state coast. Specific treatment and an increased level of education were identified as protective factors, indicating the need for implementing social, sanitary, and health education interventions aimed at schistosomiasis to combat the risk factors for this major public health problem.

  11. Florid osseous dysplasia of the jaws

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Su Beom; Koh, Kwang Joon [Dept. of Oral Radiology, College of Dentistry, Chonbuk National University, Chonju (Korea, Republic of)

    1995-02-15

    Few cases of florid osseous dysplasia has been described as a condition that characteristically affects the jaws. It usually manifests as multiple radiopaque masses distributed throughout the jaws. Confusion exists about the relationship of florid osseous dysplasia, gigantiform cementoma, chronic sclerosing osteomyelitis, sclerosing osteitis or multiple enostosis. Authors experienced a case of florid osseous dysplasia of the jaws in 52-year-old female on the basis of clinical, radiographic and histopathologic findings. The characteristic features are as follows: 1. In clinical examination, there was no clinical sign and symptoms except extrated area. And there was no facial asymmetry. 2. Radiograms show round or lobular dense radiopaque masses surrounded by radiolucent bands in lower molar teeth area bilaterally. And slight increased radiopacities in maxillary molar teeth area bilaterllay. There was no expansion or thinning of buccal and lingual cortical bones. There is no displacement or resorption of involved teeth. In right side of mandible, mandibular canal is displaced inferiorly due to mass. 3. Photomicrograms show densely mineralized sclerotic acellular masses with empty lacunae. Pattern is suggestive of cementum, although it could be considered sclerotic bone. In the periphery, lesion consisting of moderately cellular fibrous tissue in calcified products are deposited.

  12. Nylon flocked swab severely reduces Hexagon Obti sensibility.

    Science.gov (United States)

    Frippiat, Christophe; De Roy, Gilbert; Fontaine, Louis-Marie; Dognaux, Sophie; Noel, Fabrice; Heudt, Laeticia; Lepot, Laurent

    2015-02-01

    Hexagon Obti immunological blood test and flocked swab are widely used in forensic laboratories. Nevertheless, up to now, no compatibility tests have been published between sampling with the ethylene oxide treated flocked swab and the Hexagon Obti blood detection strip. In this study, we investigated this compatibility. Our work shows that sampling with ethylene oxide treated flocked swab reduces by a factor of at least 100 the detection threshold of blood using the Hexagon Obti immunological test. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  13. Prolonged hypothyroidism severely reduces ovarian follicular reserve in adult rats.

    Science.gov (United States)

    Meng, Li; Rijntjes, Eddy; Swarts, Hans J M; Keijer, Jaap; Teerds, Katja J

    2017-03-16

    There is substantial evidence both in humans and in animals that a prolonged reduction in plasma thyroid hormone concentration leads to reproductive problems, including disturbed folliculogenesis, impaired ovulation and fertilization rates, miscarriage and pregnancy complications. The objective of the present study is to examine the consequences of chronic hypothyroidism, induced in adulthood, for the size of the ovarian follicle pool. In order to investigate this, adult female rats were provided either a control or an iodide deficient diet in combination with perchlorate supplementation to inhibit iodide uptake by the thyroid. Sixteen weeks later animals were sacrificed. Blood was collected for hormone analyses and ovaries were evaluated histologically. At the time of sacrifice, plasma thyroid-stimulating hormone concentrations were 20- to 40-fold increased, thyroxine concentrations were negligible while tri-iothyronin concentrations were decreased by 40% in the hypothyroid group, confirming that the animals were hypothyroid. Primordial, primary and preantral follicle numbers were significantly lower in the hypothyroid ovaries compared to the euthyroid controls, while a downward trend in antral follicle and corpora lutea numbers was observed. Surprisingly the percentage of atretic follicles was not significantly different between the two groups, suggesting that the reduced preantral and antral follicle numbers were presumably not the consequence of increased degeneration of these follicle types in the hypothyroid group. Plasma anti-Müllerian hormone (AMH) levels showed a significant correlation with the growing follicle population represented by the total ovarian number of primary, preantral and antral follicles, suggesting that also under hypothyroid conditions AMH can serve as a surrogate marker to assess the growing ovarian follicle population. The induction of a chronic hypothyroid condition in adult female rats negatively affects the ovarian follicular

  14. Osseous Metaplasia in mitral valve in an elderly case

    Directory of Open Access Journals (Sweden)

    Sezen Koçarslan

    2013-09-01

    Full Text Available Metaplasia is a reversible replacement of one cell typewith another mature differentiated cell type. Osseousmetaplasia refers to the formation of mature bone elementsin extraskeletal tissues. It can occur anywhere inbody. It is encountered very rarely. This rare finding hasbeen reported in some tissues and neoplasia of variousorgans. Osseous metaplasia in cardiac valves appearsinfrequently in literature. The exact pathophysiologicmechanisms of osseous metaplasia and the origin ofbone cells in ossified valves are unknown. However, thismetaplasia process has been reported to be closely relatedwith calcification .In our study we aimed to presenta case in which we diagnosed as osseous metaplasia inmitral valve.Key words: Mitral Valve, Elderly, Calcification, OsseousMetaplasia.

  15. Subchondral synovial cysts (intra-osseous ganglion)

    International Nuclear Information System (INIS)

    Graf, L.; Freyschmidt, J.

    1988-01-01

    Twelve cases of subchondral synovial cysts (intra-osseous ganglion) have been seen and their clinical features, radiological findings and differential diagnosis are described. The lesion is a benign cystic tumour-like mass in the subchondral portion of a synovial joint. Our findings in respect of age, sex and localisation are compared with those of other authors. The aetiology and pathogenesis of the lesion is not completely understood. There is an increased incidence in middle life and joints with high dynamic and static stress are favoured, particularly in the lower extremities. Chronic stress or microtrauma, causing damage to the involved joint, therefore appears to be a plausible explanation. (orig.) [de

  16. Evaluation of osseous integration of PVD-silver-coated hip prostheses in a canine model.

    Science.gov (United States)

    Hauschild, Gregor; Hardes, Jendrik; Gosheger, Georg; Stoeppeler, Sandra; Ahrens, Helmut; Blaske, Franziska; Wehe, Christoph; Karst, Uwe; Höll, Steffen

    2015-01-01

    Infection associated with biomaterials used for orthopedic prostheses remains a serious complication in orthopedics, especially tumor surgery. Silver-coating of orthopedic (mega)prostheses proved its efficiency in reducing infections but has been limited to surface areas exposed to soft tissues due to concerns of silver inhibiting osseous integration of cementless stems. To close this gap in the bactericidal capacity of silver-coated orthopedic prostheses extension of the silver-coating on surface areas intended for osseous integration seems to be inevitable. Our study reports about a PVD- (physical-vapor-deposition-) silver-coated cementless stem in a canine model for the first time and showed osseous integration of a silver-coated titanium surface in vivo. Radiological, histological, and biomechanical analysis revealed a stable osseous integration of four of nine stems implanted. Silver trace elemental concentrations in serum did not exceed 1.82 parts per billion (ppb) and can be considered as nontoxic. Changes in liver and kidney functions associated with the silver-coating could be excluded by blood chemistry analysis. This was in accordance with very limited metal displacement from coated surfaces observed by laser ablation inductively coupled plasma-mass spectrometry (LA-ICP-MS) 12 months after implantation. In conclusion our results represent a step towards complete bactericidal silver-coating of orthopedic prostheses.

  17. Fibro-osseous lesions of the face and jaws

    International Nuclear Information System (INIS)

    MacDonald-Jankowski, D.S.

    2004-01-01

    Maxillofacial fibro-osseous lesions (FOL) consists of lesions that differ, with the exception of fibrous dysplasia, to those found in the rest of the skeleton. FOLs of the face and jaws are cemento-ossifying dysplasia, fibrous dysplasia and cemento-ossifying fibroma. Radiology is central to their diagnosis because the pathology for all FOLs is similar, although they range widely in behaviour, from dysplasia, hamartoma to benign neoplasia with occasional recurrence. Furthermore, once diagnosed the management of each is different. For cemento-ossifying dysplasia, this may mean doing nothing, simply because no treatment is generally appropriate. Almost all cemento-ossifying fibromas should be treated surgically, whereas cases of fibrous dysplasia are treated according to their clinical presentation, ranging from review and follow-up to surgery necessary to save the patient's sight or reduce deformity. The most important and frequent features of the FOLs differential diagnosis is discussed with assistance of a flow-chart

  18. Fibro-osseous lesions of the face and jaws

    Energy Technology Data Exchange (ETDEWEB)

    MacDonald-Jankowski, D.S

    2004-01-01

    Maxillofacial fibro-osseous lesions (FOL) consists of lesions that differ, with the exception of fibrous dysplasia, to those found in the rest of the skeleton. FOLs of the face and jaws are cemento-ossifying dysplasia, fibrous dysplasia and cemento-ossifying fibroma. Radiology is central to their diagnosis because the pathology for all FOLs is similar, although they range widely in behaviour, from dysplasia, hamartoma to benign neoplasia with occasional recurrence. Furthermore, once diagnosed the management of each is different. For cemento-ossifying dysplasia, this may mean doing nothing, simply because no treatment is generally appropriate. Almost all cemento-ossifying fibromas should be treated surgically, whereas cases of fibrous dysplasia are treated according to their clinical presentation, ranging from review and follow-up to surgery necessary to save the patient's sight or reduce deformity. The most important and frequent features of the FOLs differential diagnosis is discussed with assistance of a flow-chart.

  19. Palliative treatment of osseous metastases; Traitement palliatif des metastases osseuses

    Energy Technology Data Exchange (ETDEWEB)

    Resche, I.; Bodere, F.; Rousseau, C.; Chatal, J.F. [Centre Regional de Lutte Contre le Cancer Rene-Gauducheau, Service de Medecine Nucleaire, 44 - Nantes (France)

    2001-11-01

    Currently, two radiopharmaceuticals are available in France to treat painful bone metastases Metastron for prostate cancers and Quadramet whatever is the primitive tumour. Efficacy is high since 70% of response is observed with 30% of complete response, allowing diminution and even withdrawal of antalgic medication. Toxicity is purely hematologic and is predictable in time, moderate and always transient. The interest is to use internal radiotherapy very early in the course of disease, as soon as there is one painful osseous site (and several metastatic localizations on bone scan), to treat pain, to prevent pain on other sites, and to delay recourse to other forms of therapy (such as morphinic with their side effects) and thus to ensure adequate quality of life for as long as possible. (author)

  20. Progressive osseous heteroplasia: diagnosis, treatment, and prognosis

    Directory of Open Access Journals (Sweden)

    Pignolo RJ

    2015-01-01

    Full Text Available Robert J Pignolo,1–3 Girish Ramaswamy,2,3 John T Fong,2,3 Eileen M Shore,2–4 Frederick S Kaplan1–3 1Department of Medicine, 2Department of Orthopaedic Surgery, 3The Center for Research in FOP and Related Disorders, 4Department of Genetics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA Abstract: Progressive osseous heteroplasia (POH is an ultrarare genetic condition of progressive ectopic ossification. Most cases of POH are caused by heterozygous inactivating mutations of GNAS, the gene encoding the alpha subunit of the G-stimulatory protein of adenylyl cyclase. POH is part of a spectrum of related genetic disorders, including Albright hereditary osteodystrophy, pseudohypoparathyroidism, and primary osteoma cutis, that share common features of superficial ossification and association with inactivating mutations of GNAS. The genetics, diagnostic criteria, supporting clinical features, current management, and prognosis of POH are reviewed here, and emerging therapeutic strategies are discussed. Keywords: progressive osseous heteroplasia, GNAS, heterotopic ossification

  1. Endometrial Osseous Metaplasia: Case Report with Literature Review

    African Journals Online (AJOL)

    Endometrial osseous metaplasia is a rare entity[1] and Nearly. 80 cases have been reported in the world literature including, nine from India[2] and it is the presence of mature or immature bone in the endometrium.[1] Osseous metaplasia of the endometrium has also been incorrectly named as endometrial ossification ...

  2. Fibro-osseous lesions of the jaws in Ibadan, Nigeria.

    Science.gov (United States)

    Lasisi, Taye Jemilat; Adisa, Akinyele Olumuyiwa; Olusanya, Adeola Adenike

    2014-03-01

    Fibro-osseous lesion is a broad term for a diverse group of jaw disorders characterized by the replacement of normal bone by a benign fibrous connective tissue matrix. The present study reviewed the clinico-pathologic characteristics of all biopsied cases of fibro-osseous lesions at our hospital from 1990 to 2011, which we hope will serve as a reference database regionally. A retrospective clinicopathological review of all histologically diagnosed cases of jaw fibro-osseous lesions seen at our Hospital between January 1990 and December 2011. A total of one hundred and twenty one fibro-osseous lesions of jaws were histological diagnosed in the 22-year period. The lesions documented included ossifying fibroma (62%), fibrous dysplasia (37.2%) and florid cemento-osseous dysplasia (0.8%). Fibro-osseous lesions of jaws were more in females (61.2%) than males (38.8%), giving a male to female ratio of 1:1.6. Fibro-osseous lesions of jaw are a diverse group and since it may not be possible to adequately separate them histologically, the development of a more rigorous clinical algorithm as indicated in this study is essential in reaching a final diagnosis especially in resource-limited settings.

  3. Incidence of carpal boss and osseous coalition: an anatomic study.

    Science.gov (United States)

    Alemohammad, Amir M; Nakamura, Koji; El-Sheneway, Maged; Viegas, Steven F

    2009-01-01

    To determine the incidence of a clinically evident carpal boss (bony prominence on the dorsal aspect of the second and/or third carpometacarpal joint) and by means of dissection to determine the incidence of osseous coalitions and any abnormality or absence of associated ligament anatomy in the second through fifth carpometacarpal joints in a cadaver population. The area of the second through fifth carpometacarpal joints was dissected in 202 cadaver wrists. Thirty-nine of the wrists had a bony prominence and partial osseous coalition between 2 or more of the capitate, trapezoid, second metacarpal, and third metacarpal bones. When an osseous coalition was present it was incomplete, located at the dorsal aspect of the joint, and there was an absence of the normal dorsal ligaments at that joint. Ten of the 87 pairs of wrists were found to have bilateral carpal bosses with partial dorsal osseous coalition. The most common location of the osseous partial coalition was between the second metacarpal and the trapezoid. There were no osseous coalitions or absence of the normal dorsal ligaments at the fourth and/or fifth carpometacarpal joints. This study showed that there was a high percentage of partial osseous coalitions with an associated prominence of the skeletal anatomy in the general cadaver population. The etiology of the carpal boss remains unclear.

  4. Benign osseous metaplasia of the breast: Case report

    Directory of Open Access Journals (Sweden)

    Hassan Alyami

    Full Text Available Introduction: Benign Osseous metaplasia of the breast is rare, with only a few cases reported in the literature. Here we present a case of benign osseous metaplasia of the breast presenting as a breast lump. Case presentation: 38-year-old previously well woman presented with a one-year history of bilateral breast pain and a left-sided breast lump. Ultrasound and mammography suggested calcified fibroadenoma. An ultrasound-guided true cut biopsy revealed fibrous tissue containing foci of adenosis in the presence of a myoepithelial cell layer. Excision biopsy was performed, and histopathological examination showed bone matrix deposition occupying most of the nodule with peripheral hyalinized tissue but no evidence of malignancy. A diagnosis of benign osseous metaplasia of the breast was made, and the patient recovered well without recurrence after lump excision. Discussion: Only a few cases of osseous metaplasia are reported in the literature. Most reported cases are malignant, such as in fibrosarcoma, malignant mesenchymoma, osteoid sarcoma, osteogenic sarcoma, and osteochondrosarcoma.Very few cases of osseous sarcoma are reported in benign lesions such as fibroadenoma, pleomorphic adenoma, benign mesenchymoma, phyllodes tumor, and amyloid tumor of the breast. Joshi et al. first reported a case of benign osseous metaplasia of the breast presenting as breast lump in an HIV-positive patient [18]. We, therefore, consider this case to be the second case report of benign osseous metaplasia of the breast presenting as a breast lump, but the patient had no chronic illness. Conclusion: A breast lump can be the first presentation of benign osseous metaplasia. Keywords: Benign osseous metaplasia, Breast lump, Case report

  5. Calf Compartment Syndrome associated with the Use of an Intra-osseous Line in an Adult Patient: A Case Report

    Directory of Open Access Journals (Sweden)

    Malhotra R

    2016-11-01

    Full Text Available We present a case of a lower limb compartment syndrome associated with the use of an intra-osseous line inserted into the proximal tibia in an adult patient. An unconscious 59-year old male with multiple injuries presented to our Emergency Department after a road traffic accident. Bilateral proximal tibial intra osseous-lines were inserted due to poor venous access. After resuscitation his left leg was noted to be tense and swollen with absent pulses. Acute compartment syndrome was diagnosed both clinically and with compartment pressure measurement. Two incision fasciotomy on his left lower leg was performed. Intra osseous-lines in the proximal tibia are increasingly used in adult patients in the pre-hospital setting by paramedics and emergency physicians. Their use, along with the possible complications of these devices, such as the development of compartment syndrome or osteomyelitis leading to amputation, is well reported in the paediatric literature. To the best of our knowledge, there have not been any previous reports of complications in the adult patient. We present a case of lower leg compartment syndrome developing from the use of an intra-osseous line in the proximal tibia in an adult patient. With the increasing use of intra-osseous lines in adult patients, clinicians should be aware of the possibility of developing compartment syndrome which may lead to disability or amputation in severe cases.

  6. Productive osseous changes about the wrist in rheumatoid arthritis

    International Nuclear Information System (INIS)

    Cantor, R.M.; Braunstein, E.M.

    1987-01-01

    Radiographs of 225 consecutive patients with adult-form rheumatoid arthritis were examined for evidence of productive osseous changes about the wrist. The prevalence of new bone on the ulnar styloid was 10%. This form of new bone is probably due to overlying chronic tenosynovitis. A collar of new bone around the ulnar head is a result of degenerative change in the distal radioulnar joint. In general, productive osseous changes in theumatoid arthritis may represent inflammatory periosteal bone formation, osteophytosis, or contact remodeling. We found no evidence of an association between diffuse idiopathic skeletal hyperostosis and extensive productive osseous changes in patients with rheumatoid arthritis. (orig.)

  7. Productive osseous changes about the wrist in rheumatoid arthritis

    Energy Technology Data Exchange (ETDEWEB)

    Cantor, R.M.; Braunstein, E.M.

    1987-07-01

    Radiographs of 225 consecutive patients with adult-form rheumatoid arthritis were examined for evidence of productive osseous changes about the wrist. The prevalence of new bone on the ulnar styloid was 10%. This form of new bone is probably due to overlying chronic tenosynovitis. A collar of new bone around the ulnar head is a result of degenerative change in the distal radioulnar joint. In general, productive osseous changes in theumatoid arthritis may represent inflammatory periosteal bone formation, osteophytosis, or contact remodeling. We found no evidence of an association between diffuse idiopathic skeletal hyperostosis and extensive productive osseous changes in patients with rheumatoid arthritis.

  8. Focal cemento-osseous dysplasia masquerading as a residual cyst

    Directory of Open Access Journals (Sweden)

    Rajat Bhandari

    2012-01-01

    Full Text Available Focal cemento-osseous dysplasia (FCOD is a benign fibroosseous condition that can be seen in dentulous and edentulous patients. It is an asymptomatic lesion and needs no treatment; however, follow-up is essential due to the possibility that it can progress to a condition called florid cemento-osseous dysplasia. We report a case of FCOD of mandible in a 25-year-old female. Clinically, the lesion resembled periapical pathosis of odontogenic origin. An attempt has been made to discuss the clinical and histopathologic features along with differential diagnosis of cemento-osseous dysplasia.

  9. Dynamic osseous scintigraphy in the knee hyper-pressure syndromes

    International Nuclear Information System (INIS)

    Laurin, J.; Jau, P.; Ferro, L.; Fouque, M.

    1997-01-01

    This retrospective study of 49 patients, carrying an internal mono-compartmental algic syndrome of the knee, determines the place of the dynamical osseous scintigraphy in three times: in comparison with the pan-goniometry (for 42 of them), in the diagnosis of the hyper-pressure syndrome and in the evaluation of its severity. The vascularization is augmented in 10 patients and the sanguinary pool in 14. Forty eight internal compartments exhibit a tracer hyper-fixation at late times. These anomalies have been classified according to their tibial or condylar localization and intensity, than compared with the pan-goniometric values of the deviation, which in case of a varus, entail an over-pressure risk. These comparisons show a good correlation between the hyper-fixation in the sub-chondral band of the internal tibial plateau and a syndrome of hyper-pressure by deviation in varus, whether this hyper-fixation was moderated and isolated or severe or associated to a condylar image; the intensity of the fixation indicates the severity. The tibial fixation intensity is always superior to that of the rest of compartment, what is essential for the differential diagnosis in case of a simple, without hyper-pressure, arthritis, or other pathology. From this exploration stem 8 osteotomies and 1 prosthesis

  10. Nuclear instrumentation in Cuba and for osseous densitometry

    International Nuclear Information System (INIS)

    Marrero, M.; Lopez, B.; Bolanos, L.; Fernandez, J.L.; Cabal, A.; Medina, D.; Laria, J.; Alonso, D.

    1997-01-01

    The present job describes the technical characteristics and operation of two clinical equipment designed in Cuba, for the determination in vivo of the osseous mineral content in forearm, based on the of gamma absorption technique of a single photon. The development of these equipment and the measurements done with one of them are the first intents carried out in the country to diagnose osseous illnesses by means of this method. (author) [es

  11. Gadolinium-DOTA enhanced MRI of painful osseous crises in children with sickle cell anemia

    International Nuclear Information System (INIS)

    Bonnerot, V.; Sebag, G.; Montalembert, M. de; Wioland, M.; Glorion, C.; Girot, R.; Lallemand, D.

    1994-01-01

    In order to evaluate the role of gadolinium-DOTA enhanced MRI in the management of painful osseous crises in children with sickle cell anemia (SCA), nine children with SCA underwent MRI, bone scans and ultrasonographic studies during 11 osseous crises. Imaging findings were compared with the final diagnosis: three acute osteomyelitis (AO) and 16 acute infarcts (AI). MRI could not differentiate AO from AI. The appearance of severe AI was very misleading and was similar to the usual appearance of AO, including soft tissue changes, periosteal reaction and patterns of enhancement. Gadolinium-DOTA enhanced MRI was useful for determining the anatomic site and extent of AO or AI and for distinguishing between necrotic material, fluid collection and vascularized inflammatory tissue. It can also help to guide the aspiration of intraosseous, subperiosteal and soft tissue fluid collections. (orig.)

  12. Palliative radiotherapy for symptomatic osseous metastases

    International Nuclear Information System (INIS)

    Shigematsu, Naoyuki; Ito, Hisao; Toya, Kazuhito; Ko, Weijey; Kutsuki, Shouji; Tsukamoto, Nobuhiro; Kubo, Atsushi; Dokiya, Takushi; Yorozu, Atsunori.

    1995-01-01

    Bone matastases are one of the most common and serious conditions requiring radiotherapy, but there is still a considerable lack of agreement on optimal radiation schedule. We analyzed patients with symptomatic osseous matastases from lung (72 patients) and breast (63 patients) carcinoma treated by palliative radiotherapy between 1983 and 1992. In this series, the incidences of symptomatic bone metastases appearing within 2 years after the first diagnosis of the primary lesion were 96% and 36% for lung and breast carcinomas, respectively. Thirty percent of bone metastases from breast carcinoma were diagnosed more than 5 years after the first diagnosis. Thus careful follow-up must be carried out for a prolonged period. Pain relief was achieved at almost the same rate for bone metastases from lung and breast carcinomas (81% and 85%, respectively), an the rapid onset of pain relief (15 Gy or less) was obtained in about half the patients for both diseases. The rapid onset of pain relief and the lack of association between the onset of pain relief and primary tumor argued against the conventional theory that tumor shrinkage is a component of the initial response. In contrast to the fact that almost all lung carcinoma patients had very poor prognoses, one third of the breast carcinoma patients were alive more than 2 years after palliative radiotherapy. Thust, the late effects of radiation, such as radiation myelopathy, must be always considered especially in breast carcinoma patients even when it is 'just' palliative radiotherapy for bone metastases. (author)

  13. Tricho-Dento-Osseous Syndrome: Diagnosis and Dental Management

    Directory of Open Access Journals (Sweden)

    Ola B. Al-Batayneh

    2012-01-01

    Full Text Available Tricho-dento-osseous (TDO syndrome is a rare, autosomal dominant disorder principally characterised by curly hair at infancy, severe enamel hypomineralization and hypoplasia and taurodontism of teeth, sclerotic bone, and other defects. Diagnostic criteria are based on the generalized enamel defects, severe taurodontism especially of the mandibular first permanent molars, an autosomal dominant mode of inheritance, and at least one of the other features (i.e., nail defects, bone sclerosis, and curly, kinky or wavy hair present at a young age that may straighten out later. Confusion with amelogenesis imperfecta is common; however, taurodontism is not a constant feature of any of the types of amelogenesis imperfecta. Management of TDO requires a team approach, proper documentation, and a long-term treatment and follow-up plan. The aim of treatment is to prevent problems such as sensitivity, caries, dental abscesses, and loss of occlusal vertical dimension through attrition of hypoplastic tooth structure. Another aim is to restore function of the dentition and enhance the esthetics and self-esteem of the patient. This paper proposes treatment approaches that include preventive, restorative, endodontic, prosthetic, and surgical options to management. In addition, it sheds light on the difficulties faced during dental treatment of such cases.

  14. Chemical Differentiation of Osseous, Dental, and Non-skeletal Materials in Forensic Anthropology using Elemental Analysis.

    Science.gov (United States)

    Zimmerman, Heather A; Meizel-Lambert, Cayli J; Schultz, John J; Sigman, Michael E

    2015-03-01

    Forensic anthropologists are generally able to identify skeletal materials (bone and tooth) using gross anatomical features; however, highly fragmented or taphonomically altered materials may be problematic to identify. Several chemical analysis techniques have been shown to be reliable laboratory methods that can be used to determine if questionable fragments are osseous, dental, or non-skeletal in nature. The purpose of this review is to provide a detailed background of chemical analysis techniques focusing on elemental compositions that have been assessed for use in differentiating osseous, dental, and non-skeletal materials. More recently, chemical analysis studies have also focused on using the elemental composition of osseous/dental materials to evaluate species and provide individual discrimination, but have generally been successful only in small, closed groups, limiting their use forensically. Despite significant advances incorporating a variety of instruments, including handheld devices, further research is necessary to address issues in standardization, error rates, and sample size/diversity. Copyright © 2014 Forensic Science Society. Published by Elsevier Ireland Ltd. All rights reserved.

  15. Radionuclide imaging of non osseous infection

    International Nuclear Information System (INIS)

    Palestro, C.J.; New York, Yeshiva Univ., NY; Torres, M.A.

    1999-01-01

    Nuclear medicine is an important tool in the diagnostic evaluation of patients with a variety of non osseous infections. In the immunocompetent population labeled leukocyte imaging is the radionuclide procedure of choice, with Gallium imaging reserved for those situations in which the leukocyte study is non diagnostic or cannot be performed. Fever of unknown origin is caused by infection in less than one-third of cases, and therefore the number of positive leukocyte studies will be relatively low. The negative leukocyte study is also useful as it has been demonstrated that a negative study excludes, with a high degree of certainty, focal infection as the cause of an FUO. In the cardiovascular system, labeled leukocyte scintigraphy is very useful for diagnosing mycotic aneurysms and infected prosthetic vascular grafts. The specificity of the study is somewhat more variable. In the central nervous system, labeled leukocyte imaging can provide important information about the etiology of contrast enhancing brain lesions identified on computed tomography. In the immunocompromised population, typified by the AIDS patient, Gallium scintigraphy is the radionuclide procedure of choice for diagnosing opportunistic diseases. In the thorax, a normal Gallium scan, in the setting of a negative chest X-ray, virtually excludes pulmonary disease. In the abdomen, Gallium is also useful for detecting nodal disease, but is not reliable for detecting large bowel disease. Labeled leukocyte imaging should be performed when colitis is a concern. Both 18 FDG PET and 201 T1 SPECT imaging of the brain are useful for distinguishing between central nervous system lymphoma and toxoplasmosis in the HIV (+) patient. On both studies, lymphoma manifests as a focus of increased tracer uptake, whereas toxoplasmosis shows little or no uptake of either tracer

  16. Radionuclide imaging of non osseous infection

    Energy Technology Data Exchange (ETDEWEB)

    Palestro, C.J. (Long Island Jewish Medical Center, New York, NY, (United States). Dept. Nuclear Medicine New York, Yeshiva Univ., NY (United States). Albert Einstein College of Medicine); Torres, M.A. (Long Island Jewish Medical Center, New York, NY, (United States). Dept. Nuclear Medicine)

    1999-03-01

    Nuclear medicine is an important tool in the diagnostic evaluation of patients with a variety of non osseous infections. In the immunocompetent population labeled leukocyte imaging is the radionuclide procedure of choice, with Gallium imaging reserved for those situations in which the leukocyte study is non diagnostic or cannot be performed. Fever of unknown origin is caused by infection in less than one-third of cases, and therefore the number of positive leukocyte studies will be relatively low. The negative leukocyte study is also useful as it has been demonstrated that a negative study excludes, with a high degree of certainty, focal infection as the cause of an FUO. In the cardiovascular system, labeled leukocyte scintigraphy is very useful for diagnosing mycotic aneurysms and infected prosthetic vascular grafts. The specificity of the study is somewhat more variable. In the central nervous system, labeled leukocyte imaging can provide important information about the etiology of contrast enhancing brain lesions identified on computed tomography. In the immunocompromised population, typified by the AIDS patient, Gallium scintigraphy is the radionuclide procedure of choice for diagnosing opportunistic diseases. In the thorax, a normal Gallium scan, in the setting of a negative chest X-ray, virtually excludes pulmonary disease. In the abdomen, Gallium is also useful for detecting nodal disease, but is not reliable for detecting large bowel disease. Labeled leukocyte imaging should be performed when colitis is a concern. Both [sup 18]FDG PET and [sup 201]T1 SPECT imaging of the brain are useful for distinguishing between central nervous system lymphoma and toxoplasmosis in the HIV (+) patient. On both studies, lymphoma manifests as a focus of increased tracer uptake, whereas toxoplasmosis shows little or no uptake of either tracer.

  17. Implantable Prosthesis of Osseous Conduction (BAHA: Case Report

    Directory of Open Access Journals (Sweden)

    Stumpf, Claudia Mittelmann

    2011-04-01

    Full Text Available Introduction: The implantable prosthesis of osseous conduction (BAHA is deemed to be an excellent option in the auditory rehabilitation of patients with conductive and mixed hearing loss, unilaterally or bilaterally, and unilateral sensorineural hearing loss. It has been a good advantage over the conservative bone conduction apparatus and those of individual sound-amplifier apparatus (ISAA, when their usage becomes unfeasible because of chronic otitis externa, which has a hard clinic control. Objective: To introduce the first BAHA case performed in Brazil, as duly authorized by ANVISA (National Agency for Sanitary Surveillance, to rehabilitate the mixed hearing loss with occurrences of chronic otitis externa. Method: 50-year-old female patient with right-ear moderate and left-ear severe hearing loss, bilateral tinnitus derived from otosclerosis, was submitted to 04 surgeries of stapedotomy and unable to use ISAA as a result of otorrhea and bilateral otalgia. The medical and audiological evaluation indicated the benefit of using BAHA. Having surgery been performed and BAHA implemented, the patient showed a significant improvement in audiometric thresholds, speech perception and distinction, as well as she declared to be extremely satisfied with the esthetic factor. Final commentaries: BAHA surgical process is safe, simple and swift, thus providing excellent audiological results and a higher degree of satisfaction to patients.

  18. Multiple Osseous Loose Bodies Associated with Lumbar Isthmic Spondylolisthesis.

    Science.gov (United States)

    Takeshima, Yasuhiro; Hanakita, Junya; Takahashi, Toshiyuki; Nakase, Hiroyuki

    2016-11-01

    Multiple osseous loose bodies in the lumbar spine have never been reported. We describe a rare surgical case of multiple osseous loose bodies associated with lumbar isthmic spondylolisthesis. A 74-year-old man who experienced left foot numbness and bilateral gluteal pain was diagnosed with lumbar spondylolisthesis 7 years previously and managed conservatively. He reported recurrence of the left foot numbness 6 months previously, at which time aggressive (rather than conservative) therapy became a consideration. Radiographs of the lumbar spine revealed L5 isthmic spondylolisthesis with dynamic instability at L5/S1. Magnetic resonance imaging of the lumbar spine revealed multiple mass lesions dorsally located in the lumbar canal. Computed tomography myelography demonstrated multiple osseous materials near the isthmic portion at the L5 level where compression of the dural sac by the lesions induced lumbar canal stenosis. The patient underwent posterior decompression surgery that enabled total removal of the osseous lesions. Intraoperative findings revealed osseous lesions located in the fibrocartilage material and no connection of the lytic portion at the L5 level or ligamentum flavum. Postoperative course of the patient was uneventful as his neurological symptoms improved. We described the first instance of multiple loose bodies in the spinal canal with lumbar canal stenosis. It is presumed that long standing minor trauma due to dynamic instability with a trend of hyperossification induced secondary synovial osteochondromatosis forming multiple loose bodies. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Osseous and Nonosseous Bone Scan Findings in Liver Transplant Candidates with end-stage Chronic Liver Disease

    Directory of Open Access Journals (Sweden)

    Seval Erhamamcı

    2013-08-01

    Full Text Available Objective: End-stage chronic liver disease (CLD adversely affects the function of multiple organ systems including the skeletal system. The aim of this study was to assess osseous and nonosseous bone scintigraphy (BS findings in liver transplant (LT candidates with end-stage CLD. Methods: We retrospectively evaluated BS findings in 50 consecutive patients with end-stage CLD who were undergoing preoperative assessment for LT from January 2006 to December 2011. All the patients were analyzed with respect to clinical and laboratory parameters, and BS findings. Scintigrams were visually assessed for the presence of osseous and nonosseous abnormalities. Osseous abnormalities were classified as those indicating bone metabolism changes or metastatic bone disease. Typical scintigraphic findings denoting to changes in bone metabolism were the presence of decreased osseous uptake, increased periarticular uptake, asymmetrical or unusual uptake patterns. Nonosseous findings were classified according to the degree of soft-tissue uptake as mild and severe. Results: The group consisted of 46 adult and 4 adolescent patients. All adolescent patients had normal skeletal accumulation with growth plate uptake and one had mildly increased renal cortical activity. A total of 46 adult patients had one or more of the following osseous findings: generalized decrease in osseous uptake (n=4, 8.7%; bilateral decrease in lower extremity uptake (n=26, 56.5%; symmetrically increased periarticular uptake (n=26, 56.5%; bilateral cortical/periosteal increased uptake in the lower extremity indicating hepatic hypertrophic osteoarthropathy (HOA (n=8, 17.4%; bilateral increased sacroiliac activity (n=16, 34.8%; sacral activity (n=10, 21.7%, coccygeal activity (n=2, 4.3%, focally increased uptake suggestive of metastases (n=5, 10.9%. Three rib metastases appeared to be linear. Nonosseous findings observed in adult patients were mild diffuse liver uptake (n=4, 8.7% and bilateral

  20. Reduced frequency of embolic signals in severe carotid stenosis with poststenotic flow velocity reduction.

    Science.gov (United States)

    Goertler, Michael; Blaser, Till; Guhr, Susanne; Lotze, Heike; Heisinger, Jane; Kropf, Siegfried; Wallesch, Claus-Werner

    2005-01-01

    We aimed to investigate the effect of poststenotic low blood flow in patients with recently symptomatic severe carotid stenosis on arterio-arterial embolism. Analyses based on a series of 206 consecutive patients (155 men and 51 women, mean age 65.3 years) with a nondisabling ischemic event in the anterior circulation or =30% local diameter reduction). All patients underwent Doppler/duplex sonography, which included measurement of poststenotic flow velocity as an indicator for poststenotic blood flow as well as a 1-hour transcranial Doppler monitoring for the detection of embolic signals. Thirty-seven of two hundred and six patients had very severe stenosis which was associated with reduced poststenotic flow velocity ( or =90% local diameter reduction if poststenotic flow velocity was not reduced. Reduced poststenotic flow velocity in patients with very severe stenosis was associated with a significantly lower frequency of embolic signals compared to patients with the same degree of stenosis but no velocity reduction (adjusted odds ratio 0.15, 95% confidence interval 0.025-0.897, p = 0.038, adjustment for antiplatelet medication and time since ischemia). Low poststenotic flow velocity behind very severe internal carotid stenosis reduces the otherwise high frequency of embolic signals in recently symptomatic patients corroborating the hypothesis that reduced blood flow across carotid stenosis causes reduced embolism. Copyright 2005 S. Karger AG, Basel.

  1. The Impact of Osseous Malalignment and Realignment Procedures in Knee Ligament Surgery: A Systematic Review of the Clinical Evidence

    Science.gov (United States)

    Tischer, Thomas; Paul, Jochen; Pape, Dietrich; Hirschmann, Michael T.; Imhoff, Andreas B.; Hinterwimmer, Stefan; Feucht, Matthias J.

    2017-01-01

    anterior tibial translation after slope-decreasing high tibial osteotomy in ACL-deficient knees. Correcting varus malalignment in PCL/PLC/LCL instability also showed increased stability and better outcomes. Conclusion: In cases of complex knee instability, the 3-dimensional osseous alignment of the knee should be considered (eg, mechanical weightbearing line and tibial slope). In cases of failed ACL reconstruction, the tibial slope should be considered, and slope-reducing osteotomies are often helpful in the patient revised multiple times. In cases of chronic PCL and/or PLC instability, osseous correction of the varus alignment may reduce the failure rate and is often the first step in treatment. Changes in the mechanical axis should be considered in all cases of instability accompanied by early unicompartmental osteoarthritis. PMID:28451605

  2. Florid cemento-osseous dysplasia: A series of case reports

    Directory of Open Access Journals (Sweden)

    Preeti Arwind Jha

    2017-01-01

    Full Text Available Florid cemento-osseous dysplasia (FCOD is a fibro-osseous lesion that affects jaw bones of middle-aged women affecting two or more quadrants of the jaw. The disease is known to be periodontal ligament in origin which is asymptomatic, characterized by multiple, confluent, and nonexpansile radio-opacities, often with circumferential radiolucency. This case report describes two cases diagnosed with FCOD on the basis of radiographic findings which includes intraoral periapical radiograph, orthopantomograph as well as cone-beam computed tomography images.

  3. Radiography of osseous lesions of the bovine locomotor system

    International Nuclear Information System (INIS)

    Blond, L.; Beauregard, G.; Mulon, P.Y.

    2006-01-01

    Radiography is the ancillary test of choice for lameness in cattle. Osseous lesions due to osteoporosis, osteitis or osteomyelitis and sequestrae can be visualised. Radiography is the only ancillary examination that provides a thorough investigation of the lesion affecting a bovine presented with a non-weight bearing suspected fracture and limb inflammation associated with soft tissue crepitation. Radiography is the only method to ensure that the fracture is not open. It facilitates follow-up of healing of osseous lesions. The period of time required for immobilisation can be adjusted depending on the type of lesions [it

  4. [INVESTIGATION OF THE LEVEL OF MINERAL DENSITY OF SKELETAL OSSEOUS TISSUE IN PATIENTS WITH PERIODONTAL TISSUE DISEASES].

    Science.gov (United States)

    Hodovana, O I

    2015-01-01

    Results of investigation of mineral density condition of skeletal osseous tissue in patients with inflammatory and dystrophic-inflammatory diseases of periodontal tissues with ultrasound densitometry method have been presented. Various changes of osseous tissue of skeletal bones have been detected: osteopenia, osteoporosis and osteosclerosis, which correlated with the severity of pathological process in periodontium. Analysis of the obtained results has been carried out depending on patients' sex as well as form and severity degree of the course of periodontal diseases. It has been established that the peak of detected impairments of mineral density in the skeleton is due to osteopenia, the degree of severity of which deteriorates with the severity of pathological process in periodontal tissues, especially in women.

  5. Endometrial osseous metaplasia: case report with literature review ...

    African Journals Online (AJOL)

    Endometrial osseous metaplasia is a rare pathological condition with mature bone in the endometrium and can be a cause for menorrhagia and infertility as bone in the endometrium acts like intrauterine contraceptive device. We report one such case with brief review of literature in a 28‑year‑old woman presenting with ...

  6. Osseous choristoma of the tongue: two case reports.

    Science.gov (United States)

    Adhikari, Bhoj Raj; Sato, Jun; Morikawa, Tetsuro; Obara-Itoh, June; Utsunomiya, Masafumi; Harada, Fumiya; Chujo, Takatoshi; Takai, Rie; Yoshida, Koki; Nishimura, Michiko; Shakya, Mamata; Nagayasu, Hiroki; Abiko, Yoshihiro

    2016-03-17

    Osseous choristoma is a very rare, benign lesion in the maxillofacial region. It appears as a benign mass of normally matured bony tissue covered by the normal epithelium of the tongue. It is usually seen in front of the foramen cecum of the tongue. Surgical excision is the treatment of choice with an excellent prognosis and there have been very few cases of recurrence. Here we present two cases of osseous choristoma on the dorsum of the tongue. Case 1 was a 15-year-old Japanese girl who presented with a painless but gradually growing swelling on the dorsum of her tongue approximately 1 year before her admission. Case 2 was a 21-year-old Japanese woman with a complaint of pain in the lower left, posterior side of her mouth. Histological findings showed that both lesions were composed of well-organized, mature, compact bone beneath the oral mucosal membrane. Subsequent to simple surgical excision, no recurrence of the lesions was observed after the follow-up period. Previous literatures have proposed both malformation and trauma hypotheses as the etiopathologies of osseous choristoma. However, the histopathological findings of the two cases in the present study do not support the trauma hypothesis. Although osseous choristoma is clinically a benign condition, the underlying histopathological processes are important. The outcome of aberrant formation of calcified tissue in the vicinity of vital structures such as nerves and blood vessels may be of clinical significance.

  7. FLORID CEMENTO-OSSEOUS DYSPLASIA: A REPORT OF TWO ...

    African Journals Online (AJOL)

    known to originate from periodontal ligament tissues and involve essentially the same pathological process.1. They are usually classified depending on their topography and radiographic appearances, into three main groups: periapical, focal and florid cemental dysplasias.1. Florid cemento-osseous dysplasia was first ...

  8. Primary inter-osseous adenoid cystic carcenoma of the mandible ...

    African Journals Online (AJOL)

    Password, Remember me, or Register. DOWNLOAD FULL TEXT Open Access DOWNLOAD FULL TEXT Subscription or Fee Access. Primary inter-osseous adenoid cystic carcenoma of the mandible. KJ Koech, ML Chindia, AK Njiru. Abstract. No Abstract. African Journal of Oral Health Sciences Vol. 5 (1) 2007: pp. 11-13 ...

  9. Effect of varying the vertical dimension of connectors of cantilever cross-arch fixed dental prostheses in patients with severely reduced osseous support: a three-dimensional finite element analysis.

    Science.gov (United States)

    Manda, Marianthi; Galanis, Christos; Georgiopoulos, Vasilis; Provatidis, Christofer; Koidis, Petros

    2010-02-01

    Inadequate dimensioning of the connectors in a cantilever cross-arch fixed dental prosthesis (FDP) in perioprosthetic patients jeopardizes the prognosis of the restoration. The purpose of this study was to investigate the effect of increasing the vertical dimension (VD) on the maximum stress developed within the connectors during the static loading of a cross-arch FDP extended as a 1- and 2-unit cantilever. Six digital models were developed, derived from a 3-dimensional (3-D) initial model. In the initial model, the teeth were prepared for metal ceramic restorations and splinted with a cross-arch FDP, extended as a 1- or 2-unit cantilever. The VDs of the connectors proximal to the retaining abutment were 3, 4, or 5 mm. A 3-D finite element analysis (FEA) was performed. The VD increase, from 3 to 4 mm and from 3 to 5 mm, of the connector distal to the retaining abutment, for each FDP, presented a maximum stress value decrease of approximately 25% and 48%, respectively. The similar VD increase of the connector mesial to the retaining abutment, for each FDP, resulted in relatively smaller stress changes. For the 2-unit cantilever restoration, the stress decreases were approximately 9% and 15%, respectively, whereas in the 1-unit cantilever restoration, the decrease was about 10% for the 4-mm connector. Further increase of the VD to 5 mm did not relieve the peak stress. The highest stress value was measured on the 3-mm connector distal to the retaining abutment in the 2-unit cantilever restoration. Despite the VD increase, the connectors proximal to the retaining abutment still developed the highest stress values of all the connectors for every model. The connector with the highest risk of failure is the 3-mm connector distal to the retaining abutment of the 2-unit cantilever restoration. Increasing the vertical dimension is beneficial for the connector distal to the retaining abutment, while the resultant stress changes are not substantial for the connectors mesial to the retaining abutment. (J Prosthet Dent 2010;103:91-100).

  10. Osseous metastases of chordoma: imaging and clinical findings

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Connie; Torriani, Martin; Bredella, Miriam [Massachusetts General Hospital, Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Boston, MA (United States); Chebib, Ivan [Massachusetts General Hospital, Department of Pathology, Boston, MA (United States)

    2017-03-15

    To describe the imaging and clinical characteristics of chordoma osseous metastases (COM). Our study was IRB approved and HIPAA compliant. A retrospective search of our pathology database for pathology-proven COM yielded 15 patients who had undergone MRI, CT, bone scan, and/or FDG-PET/CT. The imaging and clinical features of the COMs were recorded. A control group of age and gender matched chordoma patients without osseous metastasis was evaluated. The COM mean maximal dimension was 6.4 ± 4.0 cm. The majority (60%) of patients had one lesion. Extra-osseous soft tissue component was present in 85% and was larger than intra-osseous component in 76%. On MRI the lesions were heterogeneous but predominantly T2 hyperintense with hypointense septae, and with variable enhancement. On CT the lesions were typically destructive or permeative; calcifications were rare. The extent of the soft tissue component was isodense to muscle on CT and therefore better evaluated on MRI. COM was in a body part contiguous to the site of the primary tumor. Compared to the controls, COM patients were more likely to have local recurrence (P = 0.0009) and positive resection margins (P = 0.002). At 1 year, 33% of COM patients were deceased and 13% had progressive metastases. COM are associated with large extra-osseous soft tissue components, which are better visualized by MRI. They are often located in a body part contiguous to the site of the primary tumor, portend poor prognosis, and are associated with positive resection margins and local recurrence. (orig.)

  11. Florid cemento-osseous dysplasia: review of an uncommon fibro-osseous lesion of the jaw with important clinical implications.

    Science.gov (United States)

    Fenerty, Sarah; Shaw, Wei; Verma, Rahul; Syed, Ali B; Kuklani, Riya; Yang, Jie; Ali, Sayed

    2017-05-01

    Florid cemento-osseous dysplasia (FCOD) is a rare, benign, multifocal fibro-osseous dysplastic process affecting tooth-bearing areas of the jaw, characterized by replacement of normal trabecular bone with osseous tissue and dense acellular cementum in a fibrous stroma. It is one clinicopathologic variant in a spectrum of related non-neoplastic fibro-osseous lesions known as cemento-osseous dysplasias (CODs), thought to arise from elements of the periodontal ligament. Diagnosis primarily relies upon radiographic and clinical findings; unnecessary biopsy should be avoided, as inoculation with oral pathogens may precipitate chronic infection in these hypovascular lesions. Appropriate management of uncomplicated FCOD consists of periodic radiographic follow-up. Accordingly, it is important that both radiologists and clinicians performing endodontic interventions possess familiarity with this entity in order to prevent misdiagnosis and inappropriate intervention, which may result in a protracted clinical course. Lesions are usually asymptomatic in the absence of infection, typically discovered on routine dental radiographs or imaging performed for unrelated indications. Radiographically, the condition typically manifests as widespread non-expansile intraosseous masses of varying internal lucency and sclerosis that surround the root apices of vital teeth or edentulous areas in the posterior jaw. While all CODs share similar microscopic features, FCOD is distinguished by its multifocal distribution, involving two or more quadrants of the maxilla and mandible, often in a bilateral symmetric fashion. The vast majority of cases are sporadic, though few exhibit an autosomal dominant familial inheritance pattern. In this pictorial review, we discuss the radiologic characteristics of this entity, pertinent clinical and histologic features, differential diagnoses, and management options.

  12. The combined benefits of motorcycle antilock braking systems (ABS) in preventing crashes and reducing crash severity.

    Science.gov (United States)

    Rizzi, Matteo; Kullgren, Anders; Tingvall, Claes

    2016-01-01

    Several studies have reported the benefits of motorcycle antilock braking systems (ABS) in reducing injury crashes, due to improved stability and braking performance. Both aspects may prevent crashes but may also reduce the crash severity when a collision occurs. However, it is still unknown to what extent the reductions in injury crashes with ABS may be due to a combination of these mechanisms. Swedish hospital and police reports (2003-2012) were used. The risk for permanent medical impairment (RPMI) was calculated, showing the risk of at least 1 or 10% permanent medical impairment. In total, 165 crashes involving ABS-equipped motorcycles were compared with 500 crashes with similar motorcycles without ABS. The analysis was performed in 3 steps. First, the reduction in emergency care visits with ABS was calculated using an induced exposure approach. Secondly, the injury mitigating effects of ABS were investigated. The mean RPMI 1+ and RPMI 10+ were analyzed for different crash types. The distributions of impairing injuries (PMI 1+) and severely impairing injuries (PMI 10+) were also analyzed. In the third step, the total reduction of PMI 1+ and PMI 10+ injured motorcyclists was calculated by combining the reductions found in the previous steps. An additional analysis of combined braking systems (CBS) together with ABS was also performed. The results showed that emergency care visits were reduced by 47% with ABS. In the second step, it was found that the mean RPMI 1+ and RPMI 10+ with ABS were 15 and 37% lower, respectively. Finally, the third step showed that the total reductions in terms of crash avoidance and mitigation of PMI 1+ and PMI 10+ injured motorcyclists with ABS were 67 and 55%, respectively. However, PMI 1+ and PMI 10+ leg injuries were not reduced by ABS to the same extent. Indications were found suggesting that the benefits of ABS together with CBS may be greater than ABS alone. This article indicated that motorcycle ABS reduced impairing injuries

  13. Antioxidant inhibits HMGB1 expression and reduces pancreas injury in rats with severe acute pancreatitis.

    Science.gov (United States)

    Zhang, Zhong Wei; Zhang, Qi Yu; Zhou, Meng Tao; Liu, Na Xin; Chen, Tong Ke; Zhu, Ye Fan; Wu, Liang

    2010-09-01

    Pathogenesis of severe acute pancreatitis is still unclear, which leads to a lack of proper treatment in severe acute pancreatitis therapeutic strategy. To investigate the effect of treatment with antioxidant pyrrolidine dithiocarbamate on pancreas injury in rats with severe acute pancreatitis and its possible mechanism. A total of 144 male Sprague-Dawley rats were randomly allocated into a sham operation group (n=48), a severe acute pancreatitis group (n=48), and a pyrrolidine dithiocarbamate-treated group (n=48). All the rats were killed at 1, 3, 6, 12, 24, and 48 h after operation. The pancreas histopathologies were observed and serum amylase levels were tested. Meanwhile, the nuclear factor-kappaB activation, tumor necrosis factor-alpha levels and high-mobility group box protein-1 expression levels in pancreatic tissue were studied. Animals receiving pyrrolidine dithiocarbamate had significantly improved pancreas histopathology and lower serum amylase levels (pacute pancreatitis group, pancreas tumor necrosis factor-alpha levels reached a peak at 6 h after operation and afterwards rapidly declined to normal levels. However, high-mobility group box protein-1 levels in pancreatic tissue increased remarkably at the 12th hour, reached a peak at 24 h, and maintained up to 48 h post-severe acute pancreatitis. Compared to the severe acute pancreatitis group, the pancreas nuclear factor-kappaB activity, tumor necrosis factor-alpha, high-mobility group box protein-1 levels in the pyrrolidine dithiocarbamate-treated group all remarkably decreased (pacute pancreatitis. Pyrrolidine dithiocarbamate might inhibit the activation of nuclear factor-kappaB to blockade tumor necrosis factor-alpha, thereby indirectly suppressing the high-mobility group box protein-1 and reducing pancreatic tissue damage in rats with severe acute pancreatitis.

  14. Osseous metaplasia in gliosarcoma: an unusual histologic finding. Case report

    Directory of Open Access Journals (Sweden)

    Eduardo Cambruzzi

    2014-04-01

    Full Text Available Gliosarcoma (GS is a malignant neoplasm of the central nervous system that has coexisting glial and mesenchymal components. GSs are rarely related to osseous metaplasia. The authors report a case of GS in a male patient presenting apathy and catatonia. Computed tomography/magnetic resonance imaging showed an expansive process affecting the left frontal lobe. At microscopy, a malignant glioma constituted by highly atypical glial cells intermingled with spindle-shaped cells was identified. The lesion showed areas of necrosis with pseudopalisading formation, focus of osseous metaplasia, and positive immunoexpression of S100, CD99 and vimentin in both elements. Only the sarcomatous component exhibited negative immunoexpression of glial fibrillary acidic protein (GFAP. The diagnosis of GS was then established.

  15. Sodium Thiosulfate Prevents Chondrocyte Mineralization and Reduces the Severity of Murine Osteoarthritis.

    Directory of Open Access Journals (Sweden)

    Sonia Nasi

    Full Text Available Calcium-containing crystals participate in the pathogenesis of OA. Sodium thiosulfate (STS has been shown to be an effective treatment in calcification disorders such as calciphylaxis and vascular calcification. This study investigated the effects and mechanisms of action of STS in a murine model of OA and in chondrocyte calcification.Hydroxyapatite (HA crystals-stimulated murine chondrocytes and macrophages were treated with STS. Mineralization and cellular production of IL-6, MCP-1 and reactive oxygen species (ROS were assayed. STS's effects on genes involved in calcification, inflammation and cartilage matrix degradation were studied by RT-PCR. STS was administered in the menisectomy model of murine OA, and the effect on periarticular calcific deposits and cartilage degeneration was investigated by micro-CT-scan and histology.In vitro, STS prevented in a dose-dependent manner calcium crystal deposition in chondrocytes and inhibited Annexin V gene expression. In addition, there was a reduction in crystal-induced IL-6 and MCP-1 production. STS also had an antioxidant effect, diminished HA-induced ROS generation and abrogated HA-induced catabolic responses in chondrocytes. In vivo, administration of STS reduced the histological severity of OA, by limiting the size of new periarticular calcific deposits and reducing the severity of cartilage damage.STS reduces the severity of periarticular calcification and cartilage damage in an animal model of OA via its effects on chondrocyte mineralization and its attenuation of crystal-induced inflammation as well as catabolic enzymes and ROS generation. Our study suggests that STS may be a disease-modifying drug in crystal-associated OA.

  16. Treatment with the Antipsychotic Agent, Risperidone, Reduces Disease Severity in Experimental Autoimmune Encephalomyelitis

    Science.gov (United States)

    Stone, Sarrabeth; Zareie, Pirooz; Kharkrang, Marie; Fong, Dahna; Connor, Bronwen; La Flamme, Anne Camille

    2014-01-01

    Recent studies have demonstrated that atypical antipsychotic agents, which are known to antagonize dopamine D2 and serotonin 5-HT2a receptors, have immunomodulatory properties. Given the potential of these drugs to modulate the immune system both peripherally and within the central nervous system, we investigated the ability of the atypical anti-psychotic agent, risperidone, to modify disease in the animal model of multiple sclerosis (MS)4, experimental autoimune encephalomyelitis (EAE). We found that chronic oral administration of risperidone dose-dependently reduced the severity of disease and decreased both the size and number of spinal cord lesions. Furthermore, risperidone treatment substantially reduced antigen-specific interleukin (IL)-17a, IL-2, and IL-4 but not interferon (IFN)-γ production by splenocytes at peak disease and using an in vitro model, we show that treatment of macrophages with risperidone alters their ability to bias naïve T cells. Another atypical antipsychotic agent, clozapine, showed a similar ability to modify macrophages in vitro and to reduce disease in the EAE model but this effect was not due to antagonism of the type 1 or type 2 dopamine receptors alone. Finally, we found that while risperidone treatment had little effect on the in vivo activation of splenic macrophages during EAE, it significantly reduced the activation of microglia and macrophages in the central nervous system. Together these studies indicate that atypical antipsychotic agents like risperidone are effective immunomodulatory agents with the potential to treat immune-mediated diseases such as MS. PMID:25116424

  17. Reducing asthma attacks in patients with severe asthma: The role of bronchial thermoplasty.

    Science.gov (United States)

    Dunn, Ryan; Wechsler, Michael E

    2015-01-01

    Asthma remains one of the most common diseases worldwide and results in significant societal health care costs and in morbidity and mortality to those afflicted. Despite currently available medications, 5-10% of patients with asthma have severe disease with debilitating symptoms and/or life-threatening exacerbations. Bronchial thermoplasty is a device-based therapy with proven efficacy in this subgroup of patients. Thus far, bronchial thermoplasty has been shown to reduce exacerbations and to improve important measures of asthma control. The purpose of this article is to review the pathophysiology of severe asthma, including the role of airway smooth muscle cells and the procedural aspects of bronchial thermoplasty, and to review the evidence behind this important therapy.

  18. Imaging of Benign Tumors of the Osseous Spine

    OpenAIRE

    Riahi, Hend; Mechri, Meriem; Barsaoui, Maher; Bouaziz, Mouna; Vanhoenacker, Filip; Ladeb, Mohamed

    2018-01-01

    Abstract: The purpose of this paper is to present an overview of the imaging features of the most prevalent benign bone tumors involving the spine. Benign tumors of the osseous spine account approximately for 1% of all primary skeletal tumors. Many lesions exhibit characteristic radiologic features. In addition to age and location of the lesion, radiographs are an essential step in the initial detection and characterization but are limited to complex anatomy and superposition. CT and MR imagi...

  19. Common fibro-osseous lesions of the paranasal sinuses.

    Science.gov (United States)

    Eller, Robert; Sillers, Michael

    2006-06-01

    Within in the broad spectrum of disease that can affect the paranasal sinuses is a class of benign bony abnormalities known collectively as fibro-osseous lesions. Fibrous dysplasia, ossifying fibroma, and osteoma are three distinct entities that lie along a continuum from the least to the most bony content. They have similar appearance and makeup; however, their clinical implications vary. This article focuses primarily on sinonasal osteomas, with less emphasis on fibrous dysplasia and ossifying fibroma.

  20. Prostatic adenocarcinoma with osseous metastases in a dog

    International Nuclear Information System (INIS)

    Lee-Parritz, D.E.; Lamb, C.R.

    1988-01-01

    Bone scintigraphy was used to diagnose osseous metastasis of prostatic adenocarcinoma in a 10-year-old dog with neck pain and ataxia and a large, sensitive prostate gland. Although radiography revealed a normal spine, prostatic fluid cytologic and ultrasonographic findings were compatible with prostatitis or neoplasia. Scintigraphic hot spots were seen in the axial skeleton, ribs, pelvis, humerus, and femur and corresponded to sites of metastatic prostatic adenocarcinoma

  1. Osseous Kaposi sarcoma in an HIV-positive patient

    Energy Technology Data Exchange (ETDEWEB)

    Thanos, Loukas; Mylona, Sofia; Kalioras, Vasilios; Pomoni, Maria; Batakis, Nikolaos [Radiology Department, ' ' Korgialeneio-Benakeio' ' , Red Cross Hospital of Athens, 1 Athanasaki Street, 11526, Athens (Greece)

    2004-04-01

    A case of osseous Kaposi sarcoma in a 35-year-old man is described. The patient (HIV-positive for 8 years) suffered from cutaneous Kaposi sarcoma and presented with right-sided chest pain. He underwent a chest CT scan that revealed three osteolytic lesions involving rib and vertebra with large soft tissue masses, without cutaneous lesions at these sites. CT-guided core needle biopsy led to a histological diagnosis of Kaposi sarcoma. (orig.)

  2. Premedication with fast-acting oxycodone hydrochloride hydrate effectively reduced oxaliplatin-induced severe vascular pain.

    Science.gov (United States)

    Nagao, Sayaka; Furihata, Makoto; Fukagawa, Kazushi; Furihata, Tadashi; Matsuhashi, Yuki; Wada, Tomonori

    2017-07-01

    Oxaliplatin is a platinum-based chemotherapeutic agent that holds a prominent position in the treatment of colorectal and gastric cancers. However, severe oxaliplatin-related vascular pain can be problematic for patients. Here we describe seven patients who experienced severe vascular pain caused by oxaliplatin administration. All seven patients were treated with capecitabine and oxaliplatin or capecitabine plus oxaliplatin with bevacizumab as an adjuvant or a treatment for recurrent colorectal cancer, respectively. Patients experienced intolerable vascular pain during oxaliplatin administration, which continued for several days. Moreover, vascular pain also induced insomnia and appetite loss in all patients. We recommended implantation of a central venous (CV) port to the patients; however, all patients declined this treatment. In addition, various known countermeasures were taken, but were ineffective. Therefore, patients were orally administered oxycodone hydrochloride hydrate (Oxinorm ® ) 45 min prior to oxaliplatin administration. This pretreatment successfully reduced vascular pain and improved subsequent chemotherapy. Oxinorm ® is a fast-acting opioid that can be an effective and practical option for severe vascular pain induced by oxaliplatin. The present report is the first description that emphasizes the usefulness of Oxinorm ® to overcome the vascular pain induced by administration of oxaliplatin via a peripheral vein. Copyright © 2017 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  3. Ischemic preconditioning reduces the severity of ischemia-reperfusion injury of peripheral nerve in rats

    Directory of Open Access Journals (Sweden)

    Kurutas Ergul

    2006-09-01

    Full Text Available Abstract Background and aim Allow for protection of briefly ischemic tissues against the harmful effects of subsequent prolonged ischemia is a phenomennon called as Ischemic Preconditioning (IP. IP has not been studied in ischemia-reperfusion (I/R model of peripheral nerve before. We aimed to study the effects of acute IP on I/R injury of peripheral nerve in rats. Method 70 adult male rats were randomly divided into 5 groups in part 1 experimentation and 3 groups in part 2 experimentation. A rat model of severe nerve ischemia which was produced by tying iliac arteries and all idenfiable anastomotic vessels with a silk suture (6-0 was used to study the effects of I/R and IP on nerve biochemistry. The suture technique used was a slip-knot technique for rapid release at time of reperfusion in the study. Cytoplasmic vacuolar degeneration was also histopathologically evaluated by light microscopic examination in sciatic nerves of rats at 7th day in part 2 study. Results 3 hours of Reperfusion resulted in an increase in nerve malondialdehyde levels when compared with ischemia and non-ischemia groups (p 0.05. There was also a significant decrease in vacoular degeneration of sciatic nerves in IP group than I/R group (p Conclusion IP reduces the severity of I/R injury in peripheral nerve as shown by reduced tissue MDA levels at 3 th hour of reperfusion and axonal vacoulization at 7 th postischemic day.

  4. Methods to reduce intraocular pressure on secondary glaucoma after severe eye burns

    Directory of Open Access Journals (Sweden)

    A. V. Solovieva

    2014-07-01

    Full Text Available Purpose: Show the results of treatment of secondary glaucoma after severe eye burns.Methods: We observed 70 patients (108 eyes with severe burns the eyes and their consequences, secondary glaucoma was observed in 40 patients (58 eyes. All patients with secondary glaucoma received traditional antihypertensive therapy, with its failure to resort to antiglaucomatous surgery. Cataract extraction performed in 24 cases, 16 of them in combination with other surgery: the reconstruction of the anterior chamber, penetrating keratoplasty, sinustrabeculectomy, diode laser cyclocoagulation. Diode laser cy- clocoagulation performed 42 times in 8 of them in combination with other antiglaucomatous surgery: cataract surgery, reconstruction of the anterior chamber. Sinustrabeculectomy in patients with secondary glaucoma was performed in 7 cases, 4 of them with collagen implant drainage. Ahmed glaucoma drainage implant performed in 5 cases.Results: In 23 out of 58 (39.6% of long-term compensation glaucoma IOP was achieved antihypertensive therapy without sur- gery. After cataract extraction resistant compensated IOP was achieved in 10 cases, a temporary (1 to 42 months — in 11 cases, IOP is not reduced in 2 cases. After completing diode laser cyclocoagulation stable normalization of IOP occurred in 16 cases, the temporary (from 1 month to 2 years — in 20 cases, 4 cases of IOP reduction was not achieved. As a result sinustrabeculectomy in 4 cases IOP decreased, in one case the hypotensive effect is not there. After implantation Ahmed glaucoma valve in 2 cases was achieved stable normalization of IOP, in the 2 cases — the temporary; in 1 case developed endophthalmitis, and the device was removed.Conclusion: the immediate effect of antiglaucomatous treatment was 96.6%, but the high incidence of IOP decompensation (73.7% suggesting the need for continuous follow-up patients after severe eye burn injury, and a readiness to use other methods to reduce IOP.

  5. An elective psychiatric course to reduce pharmacy students' social distance toward people with severe mental illness.

    Science.gov (United States)

    Dipaula, Bethany A; Qian, Jingjing; Mehdizadegan, Niki; Simoni-Wastila, Linda

    2011-05-10

    To determine whether an elective course on mental health could reduce pharmacy students' social distance toward people with severe mental illness. Course activities included assigned readings, class discussions, student presentations, review of video and other media for examples of social distance, presentations by patients with mental illness, and visits to hospitalized patients in a variety of psychiatric settings. The Social Distance Scale (SDS) was administered at the beginning and end of the semester to students enrolled in the elective and to a comparator group of students not enrolled in the course. Pharmacy students who did not complete the elective had significantly higher SDS scores than students who completed the elective (18.7 vs. 15.6, p Students enrolled in the course had lower precourse SDS scores, were more likely than their peers to have a personal association with mental illness, and had a decrease in precourse to postcourse scores. A course designed to reduce stigma towards the mentally ill can reduce pharmacy students' social distance.

  6. Reduced third-trimester levels of soluble human leukocyte antigen G protein in severe preeclampsia.

    Science.gov (United States)

    Hackmon, Rinat; Koifman, Arie; Hyodo, Hironobu; Hyobo, Hirohito; Glickman, Hagit; Sheiner, Eyal; Geraghty, Daniel E

    2007-09-01

    Recently, lower maternal plasma human leukocyte antigen (HLA)-G protein levels in preeclampsia (PE) in the first and second trimester was reported. Thus, we sought to evaluate the levels of HLA-G protein in patients with severe PE during the third trimester. In this prospective case control study, amniotic fluid and maternal and cord blood samples were aspirated from 50 pregnant women during the third trimester. The study group included 26 pregnant women diagnosed with severe PE and 24 women without PE serving as controls. A soluble HLA-G-specific enzyme-linked immunosorbent assay was used to measure protein levels. Statistical analysis included the Student t test and simple regression analysis. Maternal serum HLA-G levels in PE pregnancies were found to be significantly lower as compared with normal pregnancies (10.97 +/- 6.55 vs 36.05 +/- 34.53 microg/mL; P = .003). A reduced level of maternal HLA-G protein was associated with severe PE during the third trimester. This finding may suggest an essential role for HLA-G in normal and preeclamptic pregnancies.

  7. Treatment with the antipsychotic agent, risperidone, reduces disease severity in experimental autoimmune encephalomyelitis.

    Directory of Open Access Journals (Sweden)

    David O'Sullivan

    Full Text Available Recent studies have demonstrated that atypical antipsychotic agents, which are known to antagonize dopamine D2 and serotonin 5-HT2a receptors, have immunomodulatory properties. Given the potential of these drugs to modulate the immune system both peripherally and within the central nervous system, we investigated the ability of the atypical anti-psychotic agent, risperidone, to modify disease in the animal model of multiple sclerosis (MS4, experimental autoimune encephalomyelitis (EAE. We found that chronic oral administration of risperidone dose-dependently reduced the severity of disease and decreased both the size and number of spinal cord lesions. Furthermore, risperidone treatment substantially reduced antigen-specific interleukin (IL-17a, IL-2, and IL-4 but not interferon (IFN-γ production by splenocytes at peak disease and using an in vitro model, we show that treatment of macrophages with risperidone alters their ability to bias naïve T cells. Another atypical antipsychotic agent, clozapine, showed a similar ability to modify macrophages in vitro and to reduce disease in the EAE model but this effect was not due to antagonism of the type 1 or type 2 dopamine receptors alone. Finally, we found that while risperidone treatment had little effect on the in vivo activation of splenic macrophages during EAE, it significantly reduced the activation of microglia and macrophages in the central nervous system. Together these studies indicate that atypical antipsychotic agents like risperidone are effective immunomodulatory agents with the potential to treat immune-mediated diseases such as MS.

  8. Anterolateral ligament abnormalities in patients with acute anterior cruciate ligament rupture are associated with lateral meniscal and osseous injuries

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    Dyck, Pieter van; Smet, Eline de; Gielen, Jan L.; Parizel, Paul M. [Antwerp University Hospital and University of Antwerp, Department of Radiology, Antwerp (Belgium); Clockaerts, Stefan [University College Hospitals, Department of Orthopaedics, London (United Kingdom); Vanhoenacker, Filip M. [Antwerp University Hospital and University of Antwerp, Department of Radiology, Antwerp (Belgium); Ghent University Hospital and University of Ghent, Department of Radiology, Ghent (Belgium); AZ St-Maarten, Department of Radiology, Antwerp (Belgium); Lambrecht, Valerie [Ghent University Hospital and University of Ghent, Department of Radiology, Ghent (Belgium); Wouters, Kristien [Antwerp University Hospital and University of Antwerp, Department of Biostatistics, Antwerp (Belgium)

    2016-10-15

    To determine the frequency of anterolateral ligament (ALL) injury in patients with acute anterior cruciate ligament (ACL) rupture and to analyse its associated injury patterns. Ninety patients with acute ACL rupture for which MRI was obtained within 8 weeks after the initial trauma were retrospectively identified. Two radiologists assessed the status of the ALL on MRI by consensus. The presence or absence of an ALL abnormality was compared with the existence of medial and lateral meniscal tears diagnosed during arthroscopy. Associated collateral ligament and osseous injuries were documented with MRI. Forty-one of 90 knees (46 %) demonstrated ALL abnormalities on MRI. Of 49 knees with intact ALL, 15 (31 %) had a torn lateral meniscus as compared to 25 torn lateral menisci in 41 knees (61 %) with abnormal ALL (p = 0.008). Collateral ligament (p ≤ 0.05) and osseous injuries (p = 0.0037) were more frequent and severe in ALL-injured as compared with ALL-intact knees. ALL injuries are fairly common in patients with acute ACL rupture and are statistically significantly associated with lateral meniscal, collateral ligament and osseous injuries. (orig.)

  9. Agricultural measures to reduce radiation doses to man caused by severe nuclear accidents

    International Nuclear Information System (INIS)

    Dorp, F. van; Eleveld, R.; Frissel, M.J.

    1981-01-01

    Agricultural land and products may become contaminated after a severe nuclear accident. If radiation doses to man caused by the ingestion of contaminated agricultural products from such areas will be unacceptably high, measures to reduce this radiation dose will have to be taken. Radiation doses to man can be estimated by using models which describe quantitatively the transfer of radionuclides through the biosphere. The following processes and pathways are described in this study: accidental releases into atmospheric environments and subsequent nearby deposition; contamination of crops by direct deposition and the subsequent short term pathway (e.g. grass-cow-milk-man); contamination of soil and the subsequent long term pathway (e.g. soil-crop-man, soil-grass-cattle-milk/meat-man). Depending on the degree of contamination and on the estimated radiation doses to man, various measures are advised. (Auth.)

  10. A new reliability allocation weight for reducing the occurrence of severe failure effects

    International Nuclear Information System (INIS)

    Kim, Kyungmee O.; Yang, Yoonjung; Zuo, Ming J.

    2013-01-01

    A reliability allocation weight is used during the early design stage of a system to apportion the system reliability requirement to its individual subsystems. Since some failures have serious effects on public safety, cost and environmental issues especially in a mission critical system, the failure effect must be considered as one of the important factors in determining the allocation weight. Previously, the risk priority number or the criticality number was used to consider the failure effect in the allocation weight. In this paper, we identify the limitations of the previous approach and propose a new allocation weight based on the subsystem failure severity and its relative frequency. An example is given to illustrate that the proposed method is more effective than the previous method for reducing the occurrence of the unacceptable failure effects in a newly designed system

  11. Plant responses to increasing CO2 reduce estimates of climate impacts on drought severity

    Science.gov (United States)

    Swann, Abigail L. S.; Hoffman, Forrest M.; Koven, Charles D.; Randerson, James T.

    2016-09-01

    Rising atmospheric CO2 will make Earth warmer, and many studies have inferred that this warming will cause droughts to become more widespread and severe. However, rising atmospheric CO2 also modifies stomatal conductance and plant water use, processes that are often are overlooked in impact analysis. We find that plant physiological responses to CO2 reduce predictions of future drought stress, and that this reduction is captured by using plant-centric rather than atmosphere-centric metrics from Earth system models (ESMs). The atmosphere-centric Palmer Drought Severity Index predicts future increases in drought stress for more than 70% of global land area. This area drops to 37% with the use of precipitation minus evapotranspiration (P-E), a measure that represents the water flux available to downstream ecosystems and humans. The two metrics yield consistent estimates of increasing stress in regions where precipitation decreases are more robust (southern North America, northeastern South America, and southern Europe). The metrics produce diverging estimates elsewhere, with P-E predicting decreasing stress across temperate Asia and central Africa. The differing sensitivity of drought metrics to radiative and physiological aspects of increasing CO2 partly explains the divergent estimates of future drought reported in recent studies. Further, use of ESM output in offline models may double-count plant feedbacks on relative humidity and other surface variables, leading to overestimates of future stress. The use of drought metrics that account for the response of plant transpiration to changing CO2, including direct use of P-E and soil moisture from ESMs, is needed to reduce uncertainties in future assessment.

  12. Green banana reduces clinical severity of childhood shigellosis: a double-blind, randomized, controlled clinical trial.

    Science.gov (United States)

    Rabbani, Golam H; Ahmed, Shamsir; Hossain, Iqbal; Islam, Rafiqul; Marni, Farzana; Akhtar, Mastura; Majid, Nashiha

    2009-05-01

    Mature green banana (GB) fruit is rich in amylase-resistant starch that stimulates colonic production of short-chain fatty acids (referred to as fatty acid) and is useful in treating diarrheal diseases. We studied therapeutic effects of GB in childhood shigellosis by determining colonic fatty acid production in a double-blind, randomized, controlled, clinical trial. Seventy-three children aged 6 to 60 months with severe bloody dysentery caused by Shigella infection were either given a rice-based diet (54 kcal/dL), with cooked GB (250 g/L) (n = 34) or without GB (n = 39) for 5 days; all given ciprofloxacin (15 mg/kg, q12 hours). Stool volume, frequency, excretion of blood/mucus, and relevant clinical and laboratory indices were determined. On day 5 (post-treatment), 59% children in GB group had no mucus compared with 36% in controls, fecal blood was completely cleared from 96% in GB group compared with 60% without GB (P < 0.05). GB treatment significantly reduced (P < 0.01) numbers of stools/day compared with controls (70% vs. 50%, P < 0.05). GB-specific reductions of mean fecal volumes (mL/kg) ranged from 25% to 40%; (P < 0.05) during the 5-day observations. Clinical success rates were 85% in GB group compared with 67% in controls (P < 0.05). GB significantly (P < 0.01) reduced fecal myeloperoxidase activity and increased fecal fatty acid concentrations (P < 0.01). GB diet improves clinical severity in childhood shigellosis and could be a simple and useful adjunct for dietary management of this illness.

  13. Plant responses to increasing CO2 reduce estimates of climate impacts on drought severity.

    Science.gov (United States)

    Swann, Abigail L S; Hoffman, Forrest M; Koven, Charles D; Randerson, James T

    2016-09-06

    Rising atmospheric CO2 will make Earth warmer, and many studies have inferred that this warming will cause droughts to become more widespread and severe. However, rising atmospheric CO2 also modifies stomatal conductance and plant water use, processes that are often are overlooked in impact analysis. We find that plant physiological responses to CO2 reduce predictions of future drought stress, and that this reduction is captured by using plant-centric rather than atmosphere-centric metrics from Earth system models (ESMs). The atmosphere-centric Palmer Drought Severity Index predicts future increases in drought stress for more than 70% of global land area. This area drops to 37% with the use of precipitation minus evapotranspiration (P-E), a measure that represents the water flux available to downstream ecosystems and humans. The two metrics yield consistent estimates of increasing stress in regions where precipitation decreases are more robust (southern North America, northeastern South America, and southern Europe). The metrics produce diverging estimates elsewhere, with P-E predicting decreasing stress across temperate Asia and central Africa. The differing sensitivity of drought metrics to radiative and physiological aspects of increasing CO2 partly explains the divergent estimates of future drought reported in recent studies. Further, use of ESM output in offline models may double-count plant feedbacks on relative humidity and other surface variables, leading to overestimates of future stress. The use of drought metrics that account for the response of plant transpiration to changing CO2, including direct use of P-E and soil moisture from ESMs, is needed to reduce uncertainties in future assessment.

  14. Cannabidiol administration reduces sublesional cancellous bone loss in rats with severe spinal cord injury.

    Science.gov (United States)

    Li, Dehao; Lin, Zilin; Meng, Qingyi; Wang, Kun; Wu, Jiajia; Yan, Hongda

    2017-08-15

    Patients with spinal cord injury (SCI) undergo severe loss of bone mineral below the level of lesion, and data on available treatment options after SCI is scarce. The aim of this work was to investigate the therapeutic effect of cannabidiol (CBD), a non-psychoactive cannabis, on sublesional bone loss in a rat model of SCI. The adult male rats were exposed to surgical transection of the cord and treated with CBD for consecutive 14 days. It was found that CBD treatment elevated the serum levels of osteocalcin, reduced the serum levels of collagen type I cross-linked C-telopeptide, and enhanced bone mineral density of tibiae and femurs. Treatment of SCI rats with CBD enhanced bone volume, trabecular thickness, and trabecular number, and reduced trabecular separation in proximal tibiae, and increased ultimate compressive load, stiffness, and energy to max force of femoral diaphysis. Treatment of SCI rats with CBD upregulated mRNA expression of alkaline phosphatase and osteoprotegerin and downregulated mRNA expression of receptor activator of NF-κB ligand and tartrate-resistant acid phosphatase in femurs. Furthermore, treatment of SCI rats with CBD enhanced mRNA expression of wnt3a, Lrp5 and ctnnb1 in femurs. In conclusion, CBD administration attenuated SCI-induced sublesional cancellous bone loss. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Reduced Myelination and Increased Glia Reactivity Resulting from Severe Neonatal Hyperbilirubinemia.

    Science.gov (United States)

    Barateiro, Andreia; Chen, Shujuan; Yueh, Mei-Fei; Fernandes, Adelaide; Domingues, Helena Sofia; Relvas, João; Barbier, Olivier; Nguyen, Nghia; Tukey, Robert H; Brites, Dora

    2016-01-01

    Bilirubin-induced neurologic dysfunction (BIND) and kernicterus has been used to describe moderate to severe neurologic dysfunction observed in children exposed to excessive levels of total serum bilirubin (TSB) during the neonatal period. Here we use a new mouse model that targets deletion of the Ugt1 locus and the Ugt1a1 gene in liver to promote hyperbilirubinemia-induced seizures and central nervous system toxicity. The accumulation of TSB in these mice leads to diffuse yellow coloration of brain tissue and a marked cerebellar hypoplasia that we characterize as kernicterus. Histologic studies of brain tissue demonstrate that the onset of severe neonatal hyperbilirubinemia, characterized by seizures, leads to alterations in myelination and glia reactivity. Kernicterus presents as axonopathy with myelination deficits at different brain regions, including pons, medulla oblongata, and cerebellum. The excessive accumulation of TSB in the early neonatal period (5 days after birth) promotes activation of the myelin basic protein (Mbp) gene with an accelerated loss of MBP that correlates with a lack of myelin sheath formation. These changes were accompanied by increased astroglial and microglial reactivity, possibly as a response to myelination injury. Interestingly, cerebellum was the area most affected, with greater myelination impairment and glia burden, and showing a marked loss of Purkinje cells and reduced arborization of the remaining ones. Thus, kernicterus in this model displays not only axonal damage but also myelination deficits and glial activation in different brain regions that are usually related to the neurologic sequelae observed after severe hyperbilirubinemia. Copyright © 2015 by The American Society for Pharmacology and Experimental Therapeutics.

  16. Technique of ICP monitored stepwise intracranial decompression effectively reduces postoperative complications of severe bifrontal contusion

    Directory of Open Access Journals (Sweden)

    Guan eSun

    2016-04-01

    Full Text Available Background Bifrontal contusion is a common clinical brain injury. In the early stage, it is often mild, but it progresses rapidly and frequently worsens suddenly. This condition can become life threatening and therefore requires surgery. Conventional decompression craniectomy is the commonly used treatment method. In this study, the effect of ICP monitored stepwise intracranial decompression surgery on the prognosis of patients with acute severe bifrontal contusion was investigated. Method A total of 136 patients with severe bifrontal contusion combined with deteriorated intracranial hypertension admitted from March 2001 to March 2014 in our hospital were selected and randomly divided into two groups, i.e., a conventional decompression group and an intracranial pressure (ICP monitored stepwise intracranial decompression group (68 patients each, to conduct a retrospective study. The incidence rates of acute intraoperative encephalocele, delayed hematomas, and postoperative cerebral infarctions and the Glasgow outcome scores (GOSs 6 months after the surgery were compared between the two groups.Results (1 The incidence rates of acute encephalocele and contralateral delayed epidural hematoma in the stepwise decompression surgery group were significantly lower than those in the conventional decompression group; the differences were statistically significant (P < 0.05; (2 6 months after the surgery, the incidence of vegetative state and mortality in the stepwise decompression group were significantly lower than those in the conventional decompression group (P < 0.05; the rate of favorable prognosis in the stepwise decompression group was also significantly higher than that in the conventional decompression group (P < 0.05.Conclusions The ICP monitored stepwise intracranial decompression technique reduced the perioperative complications of traumatic brain injury through the gradual release of intracranial pressure and was beneficial to the prognosis of

  17. Reducing uncertainty – responses for electricity utilities to severe solar storms

    Directory of Open Access Journals (Sweden)

    Gaunt Charles Trevor

    2014-01-01

    Full Text Available Until recently, electricity utilities in mid- and low-latitude regions believed that solar storms had no (or only insignificant effect on their power systems. Then it was noticed that the onset of damage in several large transformers, leading to their failure, correlated very closely with the Halloween storm of 2003. Since then engineers have started to appreciate that a very severe storm could have serious consequences outside the high-latitude regions. There are many uncertainties in predicting the effects of solar storms on electrical systems. The severity and time of arrival of a storm are difficult to model; so are the geomagnetically induced currents (GICs expected to flow in the power networks. Published information about the responses of different types of transformers to GICs is contradictory. Measurements of the abnormal power flows in networks during solar storms generally do not take into account the effects of the current distortion and unbalance, potentially giving misleading signals to the operators. The normal requirement for optimum system management, while allowing for the possibility of faults caused by lightning, birds and other causes, limits the capacity of system operators to respond to the threats of GICs, which are not assessed easily by the N − 1 reliability criterion. A utility’s response to the threat of damage by GICs depends on the expected frequency and magnitude of solar storms. Approaches to formulating a response are located in a system model incorporating space physics, network analysis, transformer engineering, network reliability and decision support and the benefits are identified. Approaches adopted in high-latitude regions might not be appropriate where fewer storms are expected to reach damaging levels. The risks of an extreme storm cannot be ignored, and understanding the response mechanisms suitable for low-latitude regions has the capacity to inform and reduce the uncertainty for power systems

  18. Inpatient Addiction Consultation for Hospitalized Patients Increases Post-Discharge Abstinence and Reduces Addiction Severity.

    Science.gov (United States)

    Wakeman, Sarah E; Metlay, Joshua P; Chang, Yuchiao; Herman, Grace E; Rigotti, Nancy A

    2017-08-01

    severity, the differences remained statistically significant. In a non-randomized cohort of medical inpatients, addiction consultation reduced addiction severity for alcohol and drug use and increased the number of days of abstinence in the first month after hospital discharge.

  19. Florid cemento-osseous dysplasia (FCOD: case report

    Directory of Open Access Journals (Sweden)

    Tai-Min Lin

    2010-12-01

    Full Text Available Florid cemento-osseous dysplasia (FCOD is a type of fibro-osseous lesion and represents a reactive process in which normal bone is replaced by poorly cellularized cementum-like materials and cellular fibrous connective tissues. It is strictly localized to the tooth-bearing or edentulous areas, often occurring bilaterally with symmetric involvements. In this case report, a mixed radiolucent and radiopaque lesion at the periapical area of the right mandibular second molar of a 46-year-old female patient was misdiagnosed as chronic apical periodontitis initially by clinical manifestation and radiographic finding on a periapical radiograph. The tooth #47 was a distal abutment tooth of a three-unit bridge from teeth #45–#47. No decay of teeth #45 and #47 was found when the bridge was removed. Electric pulp test revealed that the tooth #47 was a vital-pulp tooth. Panoramic radiography showed a similar mixed radiolucent and radiopaque lesion at the edentulous area of tooth #37. The symmetric distribution of the two lesions with no alveolar bone expansion and the positive vitality test of the involved tooth supported the diagnosis of FCOD for this case. No endodontic treatment or surgical biopsy was performed. The patient was instructed to undergo regular clinical and radiographic follow-up to monitor the change of the lesion. We suggest that when a radiolucent or mixed lesion occurs at the periapical area of a vital-pulp tooth, panoramic radiography may help differentiate an inflammatory periapical lesion from a lesion of cemento-osseous dysplasia (COD.

  20. Benign Fibro-Osseous Lesions of the Jaws.

    Science.gov (United States)

    Abramovitch, Kenneth; Rice, Dwight D

    2016-01-01

    Fibro-osseous lesions are grouped together because histologically they show similar cellular and mineralization patterns. Despite the histologic ubiquity, their behaviors vary significantly. Because of the histologic similarity and the broad range of morbidity among them, it is important to be able to differentiate between them in the preliminary diagnostic process. The radiographic presentations along with the location of the bony changes are often extremely critical diagnostic features to help render a differential or working diagnosis in lieu of an automatic biopsy procedure. Therefore the unique and specific radiographic presentations may be one of the main criteria for preliminary diagnosis. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Osseous-Cartilaginous Spreader Graft and Nasal Framework Reconstruction.

    Science.gov (United States)

    Ors, Safvet

    2017-10-01

    Revision rhinoplasties and saddle nose deformities usually require grafting for reconstruction. Between January 1, 2000, and January 1, 2017, autologous rib grafts were used in 127 secondary and tertiary rhinoplasty patients [(57/127 females) and (70/127 males)]. Osseous-cartilaginous rib grafts (OCRGs) were divided into three parts (i.e., 1/3 upper peripheral, 1/3 central, and 1/3 lower peripheral). The harvested OCRGs were also shaped as vertical strips using a number 11 scalpel blade. These OCRGs were shaped to form the L-strut cartilaginous graft (LSCGs), osseous-cartilaginous spreader grafts (OCSGs), osseous-cartilaginous onlay grafts, nasal valve grafts (NVGs), and lower lateral cartilaginous grafts (LLCGs). The upper peripheral portion of the rib was usually used as an onlay graft for dorsal reshaping. The shape of this part was minimally convex after being cut from the main graft, and the convex shape was very appropriate for use as an onlay graft. The middle portion of the graft that consisted of the osseous and cartilaginous structure was used for the OCSGs. The middle portion of the graft that contained only cartilage was used for the LSCGs, NVGs, and LLCGs. OCRGs were used for the dorsal, alar, septal, upper lateral, and columellar struts for all patients. OCSGs were used for all of the septal grafts to provide further stability. In the nasal valve failure patients, the rib cartilage was fixed onto the lower lateral and upper lateral cartilage and was sutured using polyglactin to improve nasal valve function. One edge of the graft was sutured over the septum, and the other edge was positioned against the maxillary crest to allow for air flow at the nasal valve. After an OCSG was sutured to the septum, a flat and smooth dorsum was shaped before the dorsal onlay graft was placed and fixed. The bone fragments of the grafts that consisted of spreader and onlay grafts were tied to the radix nasi bone without any space. After 6 months of follow-up, a

  2. Osseous pseudo-myelomatose compromise, in leukemia chronic lymphoid

    International Nuclear Information System (INIS)

    Martinez Betancur, Octavio; Lopez de Goenaga, Maria Ines

    2000-01-01

    It was described a case of chronic lymphocytic leukemia in a 75 year old man, with pseudomyelomatosis osteolytic lesions in the skull, excluding other potential causes of osteolytic lesions in the clinical context of malignant lymphoproliferative neoplasm. The real frequency of osseous compromise in chronic lymphocytic leukemia is 10%. Lesions are defined as generalized osteoporosis and osteolysis with lacunar aspect, similar to myeloma lesions. Because histopathology in lymphoproliferative neoplasms may be similar, it might be difficult to diagnose chronic lymphocytic leukemia certainly, if the clinical manifestations are not considered. Differential diagnosis with other lymphoproliferative neoplasm is based basically in absolute lymphocytosis greater than 10 X 109/L, with lymphocytes with mature appearance

  3. Diagnostic accuracy at several reduced radiation dose levels for CT imaging in the diagnosis of appendicitis

    Science.gov (United States)

    Zhang, Di; Khatonabadi, Maryam; Kim, Hyun; Jude, Matilda; Zaragoza, Edward; Lee, Margaret; Patel, Maitraya; Poon, Cheryce; Douek, Michael; Andrews-Tang, Denise; Doepke, Laura; McNitt-Gray, Shawn; Cagnon, Chris; DeMarco, John; McNitt-Gray, Michael

    2012-03-01

    Purpose: While several studies have investigated the tradeoffs between radiation dose and image quality (noise) in CT imaging, the purpose of this study was to take this analysis a step further by investigating the tradeoffs between patient radiation dose (including organ dose) and diagnostic accuracy in diagnosis of appendicitis using CT. Methods: This study was IRB approved and utilized data from 20 patients who underwent clinical CT exams for indications of appendicitis. Medical record review established true diagnosis of appendicitis, with 10 positives and 10 negatives. A validated software tool used raw projection data from each scan to create simulated images at lower dose levels (70%, 50%, 30%, 20% of original). An observer study was performed with 6 radiologists reviewing each case at each dose level in random order over several sessions. Readers assessed image quality and provided confidence in their diagnosis of appendicitis, each on a 5 point scale. Liver doses at each case and each dose level were estimated using Monte Carlo simulation based methods. Results: Overall diagnostic accuracy varies across dose levels: 92%, 93%, 91%, 90% and 90% across the 100%, 70%, 50%, 30% and 20% dose levels respectively. And it is 93%, 95%, 88%, 90% and 90% across the 13.5-22mGy, 9.6-13.5mGy, 6.4-9.6mGy, 4-6.4mGy, and 2-4mGy liver dose ranges respectively. Only 4 out of 600 observations were rated "unacceptable" for image quality. Conclusion: The results from this pilot study indicate that the diagnostic accuracy does not change dramatically even at significantly reduced radiation dose.

  4. Equine laminitis model: cryotherapy reduces the severity of lesions evaluated seven days after induction with oligofructose.

    Science.gov (United States)

    Van Eps, A W; Pollitt, C C

    2009-11-01

    A previous preliminary study demonstrated the potential of distal limb cryotherapy (DLC) for preventing laminitis. Clinically, DLC must be effective for periods longer than 48 h and the preventive effect must extend beyond its discontinuation. To evaluate the effect of DLC, applied during the developmental phase of induced laminitis, on the severity of clinical laminitis and lamellar histopathology 7 days after dosing. Eighteen normal Standardbred horses were divided into 3 groups of 6. Continuous cryotherapy was applied for 72 h to the distal limbs of the first group. The second and third groups were administered laminitis inducing doses of oligofructose and 72 h of cryotherapy applied (immediately after dosing) to the second group. After clinical assessment all horses were subjected to euthanasia 7 days after dosing and hoof lamellar tissues were harvested and analysed. In the laminitis induced horses clinical lameness and laminitis histopathology was significantly reduced in horses that underwent 72 h of DLC compared with untreated controls. Cryotherapy alone produced no significant lameness or other ill effect. Continuous, medium- to long-term (72 h) cryotherapy applied to the distal limbs of horses safely and effectively ameliorates the clinical signs and pathology of acute laminitis. Pre-emptive distal limb cryotherapy is a practical method of ameliorating laminitis in ill horses at risk of developing the disease.

  5. Reduced functional connectivity of fronto-parietal sustained attention networks in severe childhood abuse.

    Directory of Open Access Journals (Sweden)

    Heledd Hart

    Full Text Available Childhood maltreatment is associated with attention deficits. We examined the effect of childhood abuse and abuse-by-gene (5-HTTLPR, MAOA, FKBP5 interaction on functional brain connectivity during sustained attention in medication/drug-free adolescents. Functional connectivity was compared, using generalised psychophysiological interaction (gPPI analysis of functional magnetic resonance imaging (fMRI data, between 21 age-and gender-matched adolescents exposed to severe childhood abuse and 27 healthy controls, while they performed a parametrically modulated vigilance task requiring target detection with a progressively increasing load of sustained attention. Behaviourally, participants exposed to childhood abuse had increased omission errors compared to healthy controls. During the most challenging attention condition abused participants relative to controls exhibited reduced connectivity, with a left-hemispheric bias, in typical fronto-parietal attention networks, including dorsolateral, rostromedial and inferior prefrontal and inferior parietal regions. Abuse-related connectivity abnormalities were exacerbated in individuals homozygous for the risky C-allele of the single nucleotide polymorphism rs3800373 of the FK506 Binding Protein 5 (FKBP5 gene. Findings suggest that childhood abuse is associated with decreased functional connectivity in fronto-parietal attention networks and that the FKBP5 genotype moderates neurobiological vulnerability to abuse. These findings represent a first step towards the delineation of abuse-related neurofunctional connectivity abnormalities, which hopefully will facilitate the development of specific treatment strategies for victims of childhood maltreatment.

  6. Targeted rehabilitation reduces visual dependency and improves balance in severe traumatic brain injury: a case study.

    Science.gov (United States)

    Kaski, Diego; Buttell, Joseph; Greenwood, Richard

    2018-04-01

    To further understand the mechanisms underlying gait impairment following traumatic brain injury. A 58-year-old man presented with marked unsteadiness and motion sensitivity following a severe traumatic brain injury. He underwent a 6-week inpatient rehabilitation program focused on re-weighting and subsequently re-integrating ascending interoceptive information, by gradual reduction of maladaptive visual fixation techniques. We report clinical neurological outcomes and measures of functional outcome, as well as an objective assessment of visual dependency (the rod and disk test) at baseline and after the rehabilitation. Clinically, the patient had gait unsteadiness exacerbated by visual motion. A significant reduction in visual dependency occurred with tailored multi-disciplinary rehabilitation via gradual removal of visual fixation strategies that the patient had developed to maintain balance (t-test; p visual dependency in the generation of maladaptive gait strategies following brain injury. Our data suggest assessing and treating visual dependency to be an important component of gait rehabilitation after traumatic brain injury. Implications for rehabilitation Whilst gait disturbance in TBI is multifactorial, abnormal visual dependency may be important but under-recognised component of the disorder. Visual dependency can be easily and objectively assessed by the bedside in patients using a dynamic rod and disc test. Tailored rehabilitation with gradual reduction of maladaptive visual fixation can reduce visual dependency and contribute to improved gait and balance following TBI.

  7. Intravenous artesunate reduces parasite clearance time, duration of intensive care, and hospital treatment in patients with severe malaria in Europe

    DEFF Research Database (Denmark)

    Kurth, Florian; Develoux, Michel; Mechain, Matthieu

    2015-01-01

    Intravenous artesunate improves survival in severe malaria, but clinical trial data from nonendemic countries are scarce. The TropNet severe malaria database was analyzed to compare outcomes of artesunate vs quinine treatment. Artesunate reduced parasite clearance time and duration of intensive...... care unit and hospital treatment in European patients with imported severe malaria....

  8. Temporalis myo-osseous flap: an experimental study

    International Nuclear Information System (INIS)

    Antonyshyn, O.; Colcleugh, R.G.; Hurst, L.N.; Anderson, C.

    1986-01-01

    The present paper investigates the anatomy and vascularization of the temporalis myo-osseous flap. This is a calvarial bone flap that employs temporalis muscle and its distal pericranial extension as a pedicle. In six human cadavers the flap was raised as an island on the anterior deep temporal artery after transecting the zygomatic arch and coronoid process. Maximal mobilization was thus obtained, allowing rotation of the flap into the mouth for intraoral reconstruction. The arc of rotation and potential surgical applications were noted. A comparative study of the temporalis myo-osseous flap and free calvarial bone graft was then conducted in a rabbit model. Vascularization of the calvarial bone flap was confirmed by technetium scintigraphy performed on the first postoperative day. The uptake of fluorochrome labels immediately after transfer verified the adequacy of the periosteal circulation in maintaining viability and new osteoid formation throughout the full thickness of calvarial bone. The transplantation of free calvarial bone grafts was followed by necrosis of most cellular elements. This was demonstrated by an absence of fluorochrome uptake up to 19 days postoperatively and a predominance of empty lacunae and nonviable marrow

  9. Diagnosis of dorsal inter osseous pseudotumours by magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Peh, W.C.G.; Wong, L.L.S. [The University of Hong Kong, Queen Mary Hospital, (Hong Kong). Hand Surgery Division, Department of Diagnotic Radiology; Ip, W.Y. [The University of Hong Kong, Queen Mary Hospital, (Hong Kong). Hand Surgery Division, Department of Orthopaedic Surgery

    1999-08-01

    Two middle-aged-patients each presenting with a progressively enlarging mass in the first dorsal web space of their hands are reported. Magnetic resonance imaging (MRI) demonstrated the cause to be a hypertrophic first dorsal inter osseous muscle, with normal T1, T2 and post-gadopentetate dimeglumine signal characteristics. The ability of MRI to diagnose anatomical variants of hand muscles is important in the clinical management of patients with these pseudotumours. The usefulness of magnetic resonance imaging (MRI) in evaluation of soft tissue tumours of the musculoskeletal system is now widely accepted. Its ability to maximize contrast between tumour and adjacent normal tissue in a multiplanar manner makes it the imaging modality of choice in pre-operative staging of soft tissue masses. In the hand and wrist, where benign tumours predominate, MRI may provide a specific diagnosis. We describe two cases in which MRI demonstrated the cause of a hand pseudotumour to be due to hypertrophy of the first dorsal inter osseous muscle. Copyright (1999) Blackwell Science Pty Ltd 20 refs., 3 figs.

  10. Chloroquine treatment enhances regulatory T cells and reduces the severity of experimental autoimmune encephalomyelitis.

    Directory of Open Access Journals (Sweden)

    Rodolfo Thomé

    Full Text Available BACKGROUND: The modulation of inflammatory processes is a necessary step, mostly orchestrated by regulatory T (Treg cells and suppressive Dendritic Cells (DCs, to prevent the development of deleterious responses and autoimmune diseases. Therapies that focused on adoptive transfer of Treg cells or their expansion in vivo achieved great success in controlling inflammation in several experimental models. Chloroquine (CQ, an anti-malarial drug, was shown to reduce inflammation, although the mechanisms are still obscure. In this context, we aimed to access whether chloroquine treatment alters the frequency of Treg cells and DCs in normal mice. In addition, the effects of the prophylactic and therapeutic treatment with CQ on Experimental Autoimmune Encephalomyelitis (EAE, an experimental model for human Multiple Sclerosis, was investigated as well. METHODOLOGY/PRINCIPAL FINDINGS: EAE was induced in C57BL/6 mice by immunization with myelin oligodendrocyte glycoprotein (MOG35-55 peptide. C57BL/6 mice were intraperitoneally treated with chloroquine. Results show that the CQ treatment provoked an increase in Treg cells frequency as well as a decrease in DCs. We next evaluated whether prophylactic CQ administration is capable of reducing the clinical and histopathological signs of EAE. Our results demonstrated that CQ-treated mice developed mild EAE compared to controls that was associated with lower infiltration of inflammatory cells in the central nervous system CNS and increased frequency of Treg cells. Also, proliferation of MOG35-55-reactive T cells was significantly inhibited by chloroquine treatment. Similar results were observed when chloroquine was administrated after disease onset. CONCLUSION: We show for the first time that CQ treatment promotes the expansion of Treg cells, corroborating previous reports indicating that chloroquine has immunomodulatory properties. Our results also show that CQ treatment suppress the inflammation in the CNS of

  11. Can Angiotensin-Converting Enzyme Inhibitors Reduce the Incidence, Severity, and Duration of Radiation Proctitis?

    International Nuclear Information System (INIS)

    Alashkham, Abduelmenem; Paterson, Catherine; Rauchhaus, Petra; Nabi, Ghulam

    2016-01-01

    Purpose: To determine whether participants taking angiotensin-converting enzyme inhibitors (ACEIs) and treated with radical radiation therapy with neoadjuvant/adjuvant hormone therapy have less incidence, severity, and duration of radiation proctitis. Methods and Materials: A propensity score analysis of 817 patients who underwent radical radiation therapy with neoadjuvant or adjuvant hormone therapy as primary line management in a cohort study during 2009 to 2013 was conducted. Patients were stratified as follows: group 1, hypertensive patients taking ACEIs (as a study group); group 2, nonhypertensive patients not taking ACEIs; and group 3, hypertensive patients not taking ACEIs (both as control groups). The incidence, severity, and duration of proctitis were the main outcome. χ 2 tests, Mann-Whitney U tests, analysis of variance, risk ratio (RR), confidence interval (CI), Kaplan-Meier plots, and log-rank tests were used. Results: The mean age of the participants was 68.91 years, with a follow-up time of 3.38 years. Based on disease and age-matched comparison, there was a statistically significant difference of proctitis grading between the 3 groups: χ 2 (8, n=308) = 72.52, P<.001. The Mann-Whitney U test indicated that grades of proctitis were significantly lower in hypertensive patients taking ACEIs than in nonhypertensive patients not taking ACEIs and hypertensive patients not taking ACEIs (P<.001). The risk ratio (RR) of proctitis in hypertensive patients taking ACEIs was significantly lower than in hypertensive patients not taking ACEIs (RR 0.40, 95% CI 0.30-0.53, P<.001) and in nonhypertensive patients not taking ACEIs (RR 0.58, 95% CI 0.44-0.77, P<.001). Time to event analysis revealed that hypertensive patients taking ACEIs were significantly different from the control groups (P<.0001). Furthermore, hypertensive patients taking ACEIs had significantly faster resolution of proctitis (P<.0001). Conclusion: Patients who were taking ACEIs were

  12. Can Angiotensin-Converting Enzyme Inhibitors Reduce the Incidence, Severity, and Duration of Radiation Proctitis?

    Energy Technology Data Exchange (ETDEWEB)

    Alashkham, Abduelmenem, E-mail: alashkham@yahoo.com [Academic Section of Urology, Division of Cancer Research, School of Medicine, University of Dundee, Scotland (United Kingdom); Paterson, Catherine [Academic Section of Urology, Division of Cancer Research, School of Medicine, University of Dundee, Scotland (United Kingdom); Rauchhaus, Petra [Tayside Clinical Trials Unit, School of Medicine, University of Dundee, Scotland (United Kingdom); Nabi, Ghulam [Academic Section of Urology, Division of Cancer Research, School of Medicine, University of Dundee, Scotland (United Kingdom)

    2016-01-01

    Purpose: To determine whether participants taking angiotensin-converting enzyme inhibitors (ACEIs) and treated with radical radiation therapy with neoadjuvant/adjuvant hormone therapy have less incidence, severity, and duration of radiation proctitis. Methods and Materials: A propensity score analysis of 817 patients who underwent radical radiation therapy with neoadjuvant or adjuvant hormone therapy as primary line management in a cohort study during 2009 to 2013 was conducted. Patients were stratified as follows: group 1, hypertensive patients taking ACEIs (as a study group); group 2, nonhypertensive patients not taking ACEIs; and group 3, hypertensive patients not taking ACEIs (both as control groups). The incidence, severity, and duration of proctitis were the main outcome. χ{sup 2} tests, Mann-Whitney U tests, analysis of variance, risk ratio (RR), confidence interval (CI), Kaplan-Meier plots, and log-rank tests were used. Results: The mean age of the participants was 68.91 years, with a follow-up time of 3.38 years. Based on disease and age-matched comparison, there was a statistically significant difference of proctitis grading between the 3 groups: χ{sup 2} (8, n=308) = 72.52, P<.001. The Mann-Whitney U test indicated that grades of proctitis were significantly lower in hypertensive patients taking ACEIs than in nonhypertensive patients not taking ACEIs and hypertensive patients not taking ACEIs (P<.001). The risk ratio (RR) of proctitis in hypertensive patients taking ACEIs was significantly lower than in hypertensive patients not taking ACEIs (RR 0.40, 95% CI 0.30-0.53, P<.001) and in nonhypertensive patients not taking ACEIs (RR 0.58, 95% CI 0.44-0.77, P<.001). Time to event analysis revealed that hypertensive patients taking ACEIs were significantly different from the control groups (P<.0001). Furthermore, hypertensive patients taking ACEIs had significantly faster resolution of proctitis (P<.0001). Conclusion: Patients who were taking ACEIs were

  13. Cemento-osseous dysplasia of the jaws in 54 Japanese patients: a radiographic study.

    Science.gov (United States)

    Kawai, T; Hiranuma, H; Kishino, M; Jikko, A; Sakuda, M

    1999-01-01

    The aim of this study was to describe the radiographic patterns of cemento-osseous dysplasia. Fifty-four patients affected with benign fibro-osseous jaw lesions that showed periapical radiopacities and/or radiolucencies in a focal or a multiplex form were studied. The clinical, radiographic, and histopathologic features of the patients with cemento-osseous dysplasia were retrospectively studied. Radiographic features of the cemento-osseous dysplasia lesions were classified according to the appearance of calcified bodies. Radiographic visibility of periodontal ligament spaces of related teeth was assessed. Forty-nine (91 %) of the 54 patients were women. The mean age of the total group was 50.8 years, and that of the male group was 64.6 years. The cemento-osseous dysplasia lesions could be classified into 6 types radiographically. Eighteen patients had at least 2 or more types of cemento-osseous dysplasia lesions. Of 147 related teeth, 142 had periodontal ligament spaces clearly visible. Six of 9 patients who had a total of 25 teeth with active hypercementosis showed concomitant occurrence of other types of cemento-osseous dysplasia lesions. Biopsy specimens showed various amounts of bonelike and cementumlike tissues. It is likely that cemento-osseous dysplasia consists of 3 variations of a single entity, all with the same unknown cause. In one variation, the entity originates from the periodontium; in another, it is of medullary bone origin; and in the third it results from the simultaneous involvement of both tissues.

  14. FDG-PET for imaging of non-osseous infection and inflammation.

    NARCIS (Netherlands)

    Vos, F.J.; Bleeker-Rovers, C.P.; Corstens, F.H.M.; Kullberg, B.J.; Oyen, W.J.G.

    2006-01-01

    FDG-PET is emerging as a promising imaging technique in non-osseous infectious and inflammatory diseases, as an increasing number of reports are appearing in literature. In general, sensitivity of FDG-PET in diagnosing non-osseous infections compares favorably to other diagnostic modalities. Lower

  15. Cemento-osseous dysplasia-like lesion and complex odontoma associated with an impacted third molar.

    Science.gov (United States)

    Prodromidis, Georgios I; Tosios, Konstantinos I; Koutlas, Ioannis G

    2011-12-01

    We present a case of a 36-year-old female with a benign fibro-osseous lesion consistent with cemento-osseous dysplasia (COD) that was located coronally to the crown of an impacted mandibular third molar tooth and was associated with a complex odontoma. The pathogenesis of this unusual association is discussed and the odontogenic origin of COD is suggested.

  16. Osseous Metaplasia in a Free-living Snake (Patagonian Green Racer; Philodryas patagoniensis) in Brazil, 2012.

    Science.gov (United States)

    Nogueira, Carlos H O; Jerdy, Hassan L; Silveira, Leonardo S

    2016-04-28

    We describe an osseous metaplasia in a wild Patagonian green racer (Philodryas patagoniensis). The 5.5×1.5-cm lesion of irregular contour on the right dorsolateral surface proximal to the snake's cloaca was raised, hard, ulcerated centrally, and radiopaque and interfered with mobility. Microscopy revealed osseous metaplasia on skin and muscle.

  17. Low Tidal Volume Reduces Lung Inflammation Induced by Liquid Ventilation in Piglets With Severe Lung Injury.

    Science.gov (United States)

    Jiang, Lijun; Feng, Huizhen; Chen, Xiaofan; Liang, Kaifeng; Ni, Chengyao

    2017-05-01

    Total liquid ventilation (TLV) is an alternative treatment for severe lung injury. High tidal volume is usually required for TLV to maintain adequate CO 2 clearance. However, high tidal volume may cause alveolar barotrauma. We aim to investigate the effect of low tidal volume on pulmonary inflammation in piglets with lung injury and under TLV. After the establishment of acute lung injury model by infusing lipopolysaccharide, 12 piglets were randomly divided into two groups, TLV with high tidal volume (25 mL/kg) or with low tidal volume (6 mL/kg) for 240 min, respectively. Extracorporeal CO 2 removal was applied in low tidal volume group to improve CO 2 clearance and in high tidal volume group as sham control. Gas exchange and hemodynamic status were monitored every 30 min during TLV. At the end of the study, pulmonary mRNA expression and plasmatic concentration of interleukin-6 (IL-6) and interleukin-8 (IL-8) were measured by collecting lung tissue and blood samples from piglets. Arterial blood pressure, PaO 2 , and PaCO 2 showed no remarkable difference between groups during the observation period. Compared with high tidal volume strategy, low tidal volume resulted in 76% reduction of minute volume and over 80% reduction in peak inspiratory pressure during TLV. In addition, low tidal volume significantly diminished pulmonary mRNA expression and plasmatic level of IL-6 and IL-8. We conclude that during TLV, low tidal volume reduces lung inflammation in piglets with acute lung injury without compromising gas exchange. © 2016 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  18. Intravenous Artesunate Reduces Parasite Clearance Time, Duration of Intensive Care, and Hospital Treatment in Patients With Severe Malaria in Europe: The TropNet Severe Malaria Study.

    Science.gov (United States)

    Kurth, Florian; Develoux, Michel; Mechain, Matthieu; Clerinx, Jan; Antinori, Spinello; Gjørup, Ida E; Gascon, Joaquím; Mørch, Kristine; Nicastri, Emanuele; Ramharter, Michael; Bartoloni, Alessandro; Visser, Leo; Rolling, Thierry; Zanger, Philipp; Calleri, Guido; Salas-Coronas, Joaquín; Nielsen, Henrik; Just-Nübling, Gudrun; Neumayr, Andreas; Hachfeld, Anna; Schmid, Matthias L; Antonini, Pietro; Pongratz, Peter; Kern, Peter; Saraiva da Cunha, José; Soriano-Arandes, Antoni; Schunk, Mirjam; Suttorp, Norbert; Hatz, Christoph; Zoller, Thomas

    2015-11-01

    Intravenous artesunate improves survival in severe malaria, but clinical trial data from nonendemic countries are scarce. The TropNet severe malaria database was analyzed to compare outcomes of artesunate vs quinine treatment. Artesunate reduced parasite clearance time and duration of intensive care unit and hospital treatment in European patients with imported severe malaria. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  19. Pattern and process of prescribed fires influence effectiveness at reducing wildfire severity in dry coniferous forests

    Science.gov (United States)

    Arkle, Robert S.; Pilliod, David S.; Welty, Justin L.

    2012-01-01

    We examined the effects of three early season (spring) prescribed fires on burn severity patterns of summer wildfires that occurred 1–3 years post-treatment in a mixed conifer forest in central Idaho. Wildfire and prescribed fire burn severities were estimated as the difference in normalized burn ratio (dNBR) using Landsat imagery. We used GIS derived vegetation, topography, and treatment variables to generate models predicting the wildfire burn severity of 1286–5500 30-m pixels within and around treated areas. We found that wildfire severity was significantly lower in treated areas than in untreated areas and significantly lower than the potential wildfire severity of the treated areas had treatments not been implemented. At the pixel level, wildfire severity was best predicted by an interaction between prescribed fire severity, topographic moisture, heat load, and pre-fire vegetation volume. Prescribed fire severity and vegetation volume were the most influential predictors. Prescribed fire severity, and its influence on wildfire severity, was highest in relatively warm and dry locations, which were able to burn under spring conditions. In contrast, wildfire severity peaked in cooler, more mesic locations that dried later in the summer and supported greater vegetation volume. We found considerable evidence that prescribed fires have landscape-level influences within treatment boundaries; most notable was an interaction between distance from the prescribed fire perimeter and distance from treated patch edges, which explained up to 66% of the variation in wildfire severity. Early season prescribed fires may not directly target the locations most at risk of high severity wildfire, but proximity of these areas to treated patches and the discontinuity of fuels following treatment may influence wildfire severity and explain how even low severity treatments can be effective management tools in fire-prone landscapes.

  20. Los implantes MG-OSSEOUS: Estudio multicéntrico retrospectivo MG-OSSEOUS implants: A multicentric retrospective study

    Directory of Open Access Journals (Sweden)

    E. Serrano Caturla

    2006-12-01

    Full Text Available Objetivo. Aportar unos datos estadísticamente fiables sobre la supervivencia e incidencias asociadas a los implantes y prótesis del modelo MG-OSSEOUS (Mozo-Grau, S.L., Valladolid, España y demostrar que su eficacia es comparable a todas las marcas comerciales. Material y método. Estudio multicéntrico retrospectivo coordinado por la empresa Scientific Management in O&SS (Barcelona, España. Se colocaron 1001 implantes en 247 pacientes y se diseñaron 328 prótesis, entre los años 2004 y 2005, con un seguimiento de 2 años. Todos los implantes cargados. Se analizan y pormenorizan todos los implantes, por diámetros, longitudes, posiciones, fases quirúrgicas, cargas, tipos y modelos de prótesis y técnicas complementarias aplicadas, tanto sincrónica como anacrónicamente. Resultados. Tras la homogeneización de las muestras, se objetiva una supervivencia del 97,8% a los 2 años, detallando los fracasos según las características de cada caso clínico. No se reporta ningún fracaso de la prótesis. Discusión. Protocolizamos una serie de criterios e indicaciones a la hora de colocar los implantes MG-OSSEOUS según los casos clínicos. Comparamos nuestros resultados con la bibliografía, tanto pretérita como actual, coincidiendo con la manera de actuar a lo largo de la historia de la implantología. Finalmente, extrapolamos los resultados que consideramos comparables a los publicados por el grupo Branemark. Conclusión. La calidad del implante MG-OSSEOUS combinada con protocolos implantológicos científicamente contrastados, muestra un 2,2% de fracaso a los 2 años de seguimiento, con un porcentaje de éxito del 100% tanto en la recolocación del implante como en la fase protésica.Objective. We present some statistically contrasted results regarding the survival and incidences of MG-OSSEOUS implants and prosthetic components (Mozo-Grau, S.L., Valladolid, Spain, and we prove that they have the same efficacy when compared with other

  1. Measures to reduce maintenance therapy with oral corticosteroid in adults with severe asthma

    DEFF Research Database (Denmark)

    Nguyen, Vivi Q; Ulrik, Charlotte S

    2016-01-01

    ), masitinib (78% reduction in OCS dose), mepolizumab (50%83% reduction in OCS dose), and omalizumab (30%64% of enrolled patients achieved a reduction in OCS dose, and one study reported a dose reduction of 45%). CONCLUSIONS: In adults with severe asthma, several corticosteroid-sparing interventions were shown...

  2. The role of reduced red cell deformability in the pathogenesis of severe falciparum malaria and its restoration by blood transfusion

    NARCIS (Netherlands)

    Dondorp, A. M.; Nyanoti, M.; Kager, P. A.; Mithwani, S.; Vreeken, J.; Marsh, K.

    2002-01-01

    As reduced red cell deformability (RCD) can contribute to derangement of the microcirculation, a central feature in the pathogenesis of severe malaria, RCD was measured with a laser diffraction technique in 232 consecutive patients with falciparum. malaria on the Kenyan coast, of whom 99 had severe

  3. High-resolution computed tomography of the osseous temporomandibular joint

    International Nuclear Information System (INIS)

    Larheim, T.A.; Kolbenstvedt, A.; Rikshospitalet, Oslo

    1984-01-01

    A standardized CT procedure for examination of the temporomandibular joint (TMJ) with axial and coronal scanning as well as reformatted coronal and sagittal sections, was performed on 32 adults. These included subjects with normal TMJ and patients suffering from muscular dysfunction/disc displacement, arthrosis or rheumatoid arthritis. Some normal CT appearances simulating disease were presented. Axial CT scanning appeared to be the most useful method for demonstrating osseous abnormalities of the TMJ. The diagnostic information was occasionally supplemented by the coronal scanning, which may be difficult to perform on patients with neck stiffness. Reformatted coronal or sagittal sections mostly confirmed TMJ abnormality and supplemented the findings at axial scans in about one third of the patients. (orig.)

  4. Fibrinogen-coated albumin microcapsules reduce bleeding in severely thrombocytopenic rabbits

    NARCIS (Netherlands)

    Levi, M. [=Marcel M.; Friederich, P. W.; Middleton, S.; de Groot, P. G.; Wu, Y. P.; Harris, R.; Biemond, B. J.; Heijnen, H. F.; Levin, J.; ten Cate, J. W.

    1999-01-01

    Severe thrombocytopenia frequently occurs in patients receiving chemotherapy and in patients with autoimmune disorders. Thrombocytopenia is associated with bleeding, which may be serious and life threatening. Current treatment strategies for thrombocytopenia may require transfusion of allogeneic

  5. Characterisation of osseous bodies of the distal phalanx of foals

    International Nuclear Information System (INIS)

    Kaneps, A.J.; O'Brien, T.R.; Redden, R.F.; Stover, S.M.; Pool, R.R.

    1993-01-01

    The distal phalanx and metacarpal physis of both forelimbs of 32 Thoroughbred foals 3-32 weeks of age were radiographed to identify those limbs with osseous bodies at a palmar process (PP) of the distal phalanx. Osseous bodies (ossicles) were identified radiographically in 19% of the foals. Sixteen of the 32 foals were selected for microradiographic and histological evaluation: 6 foals with radiographic evidence of ossicles and 10 foals without. Fourteen ossicles of the PP were observed radiographically. Ossicles were either a triangular bone fragment at the palmar aspect of the distal angle of the PP, or an oblong bone fragment separated from P3 by a radiolucent line extending 1-3 cm from the incisure of the PP to the solar margin. One foal had radiographic evidence of bilateral distal metacarpal physitis. Seventeen of 35 PPs examined microradiographically were considered normal, in that the dorsal and solar cortices were thin with trabecular bone orientated parallel to the cortical surfaces, and there was a depression in the dorsal cortical surface (i.e. parietal sulcus). Abnormal microradiographic findings in the other 18 PPs included a fracture line extending from the dorsal cortical surfaces and trabecular bridging of the fracture gap. The fracture line was often continuous with the parietal sulcus. Microradiographic evidence of a fracture was found in 75% of foals evaluated. Normal histological findings in 16 PPs included thin dorsal and solar cortices with trabeculae orientated parallel to the cortical surfaces, parallel-fibred dense connective tissue attachments of the deep digital flexor tendon to the solar cortical surfaces, and a neurovascular bundle associated with the parietal sulcus

  6. The 5-year prevalence of maxillofacial fibro-osseous lesions in Uganda.

    Science.gov (United States)

    Muwazi, L M; Kamulegeya, A

    2015-01-01

    Fibro-osseous lesions of the jaws are a diagnostic challenge for the pathologist because histologically, they are not easily distinguishable. African data on the prevalence of these lesions are scarce. We present a 5-year report of benign fibro-osseous lesions at Mulago Hospital, Uganda, showing the frequency and distribution of these lesions. Confirmed fibro-osseous lesions reports at the pathology department (2007-2012) were retrieved. Patients' clinical data including age, gender, anatomic location, and diagnosis were recorded. Descriptive statistics and simple proportion tests were carried out. We retrieved 155 confirmed benign fibro-osseous lesions over this period, 65% were females, 34% males, and the gender of one case was not specified. Fibrous dysplasia was the most prevalent lesion (n = 87, 56.1%) followed by ossifying fibroma (n = 50, 32.9%) and osseous dysplasia (n = 17, 10.9%). We neither found craniofacial nor polyostotic fibrous dysplasia. Fibrous dysplasia and ossifying fibroma peaked in the second decade at 40.2% and 40.0%, respectively. Florid osseous dysplasia was commonest in the fifth decade. In this study, all the florid osseous dysplasia were seen among females. We need to carry out prospective studies to establish as to why and what kind of women get afflicted by this lesion. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Osseous differentiation in cystosarcoma phyllodes - diagnosed by fine needle aspiration cytology

    Directory of Open Access Journals (Sweden)

    Krishnamurthy Jayashree

    2010-01-01

    Full Text Available Osseous differentiation within a phyllodes tumor is extremely rare. Cytological and histological findings of a case of malignant phyllodes tumor with osseous differentiation are presented. A 45-year-old female had a malignant phyllodes tumor with osseous stroma diagnosed by fine needle aspiration cytology. The cytological findings were representative of the histological features. The diagnosis of these tumors preoperatively is important in planning the most appropriate treatment. It is also important to follow up these patients postoperatively for long periods for recurrence and metastasis.

  8. Proliferative, reparative, and reactive benign bone lesions that may be confused diagnostically with true osseous neoplasms.

    LENUS (Irish Health Repository)

    Wick, Mark R

    2014-01-01

    Diagnostic problems attending intraosseous and parosteal pseudoneoplastic lesions can be radiographic, or histological, or both. Proliferations in this category may contain cellular fibro-osseous or chondro-osseous tissues that are difficult to separate microscopically from those seen in various true neoplasms of the bones. This review considers the clinicopathologic features of fibrous dysplasia, benign fibro-osseous lesions of the jawbones, osteofibrous dysplasia, metaphyseal fibrous defect, giant-cell reparative granuloma, "brown tumor" of hyperparathyroidism, synovial chondrometaplasia, aneurysmal bone cyst, tumefactive chronic osteomyelitis, proliferative Paget disease, and polyvinylpyrrolidone storage disease of bone.

  9. Reducing condition number by appropriate current decomposition on a multiplet of several wires

    CSIR Research Space (South Africa)

    Lysko, AA

    2011-07-01

    Full Text Available This paper discusses a numerical investigation in connection with the dependency of the condition number of the impedance matrix on the decomposition of current on a junction with several attached wires (multiplet). It is shown that the condition...

  10. Using Food Redistribution to Reduce Packing in Children with Severe Food Refusal

    Science.gov (United States)

    Gulotta, Charles S.; Piazza, Cathleen C.; Patel, Meeta R.; Layer, Stacy A.

    2005-01-01

    Positive- and negative-reinforcement-based procedures typically have targeted acceptance for children with severe food refusal; however, these procedures do not always result in successful swallowing. Once acceptance is achieved, some children expel the food repeatedly or pack (hold or pocket) it in their mouths for extended periods of time. This…

  11. Effect of several structural features in coal on its tendency to reduce

    Energy Technology Data Exchange (ETDEWEB)

    Grigor' eva, E.A.; Bakirova, E.V.; Lesnikova, E.B.; Larina, N.K.; Zharova, M.N.; Dzhalyabova, L.V.

    1981-07-01

    Relationship between the tendency of coal to be reduced and the nature and quantity of the ether and organo-mineral bonds in the structure of coals is studied. The purpose of the study was to determine the intensity of the reaction during coal hydrogenation. Sodium borhydrate was used as a reducing agent because of its selective action on carbonyl groups and because of the possibility of describing the nature of hydrolyzed bonds in coal which form carbonyl groups. By hydrolysis of hard and brown coals and subsequent selective reduction, the effect of various carbonyl groups and organo-mineral bonds formed as a result of the destruction of ether groupings and carbon to carbon cross linkages were demonstrated. (17 refs.) (In Russian)

  12. Bone marrow-derived progenitors are greatly reduced in patients with severe COPD and low-BMI.

    Science.gov (United States)

    Huertas, Alice; Testa, Ugo; Riccioni, Roberta; Petrucci, Eleonora; Riti, Viviana; Savi, Daniela; Serra, Pietro; Bonsignore, Maria Rosaria; Palange, Paolo

    2010-01-31

    Chronic obstructive pulmonary disease (COPD) patients have reduced circulating hemopoietic progenitors. We hypothesized that severity of COPD parallels the decrease in progenitors and that the reduction in body mass index (BMI) could be associated with more severe bone marrow dysfunction. We studied 39 patients with moderate to very severe COPD (18 with low-BMI and 21 with normal-BMI) and 12 controls. Disease severity was associated to a greater reduction in circulating progenitors. Proangiogenetic and inflammatory markers correlated with disease severity parameters. Compared to normal-BMI patients, low-BMI patients showed: greater reduction in circulating progenitors; higher VEGF-A, VEGF-C, HGF, Ang-2, TNF-alpha, IL-6 and MCP-1 levels. Furthermore, among patients with similar pulmonary impairment, those who displayed low-BMI had a more markedly reduced number of CD34(+) cells and late endothelial progenitors. We show that the reduction in hematopoietic and endothelial progenitor cells correlates with COPD severity. Our findings also indicate that, in severe low-BMI COPD patients, bone marrow function seems to be further impaired and may lead to reduced reparative capacity. Copyright 2009 Elsevier B.V. All rights reserved.

  13. The efficacy of kaolin clay in reducing the duration and severity of `heat' diarrhea in foals

    OpenAIRE

    PIESZKA, MAGDALENA; LUSZCZYNSKI, JAROSLAW; HEDRZAK, MAGDALENA; GONCHAROVA, KATERINA; PIERZYNOWSKI, STEFAN G.

    2016-01-01

    'Heat' diarrhea in foals is an onerous but not life-threatening ailment, which indicates that it may be of osmotic origin. This was confirmed by a successful attempt, presented in this paper, to alleviate the severity and duration of foal heat diarrhea with the use of a typical absorbent, kaolin clay, as a feed additive, usually applied in feed production as an anticaking agent. Based on the present results, it can be concluded that treatment of foals maintained on different stud fa...

  14. Estrogen treatment following severe burn injury reduces brain inflammation and apoptotic signaling

    Directory of Open Access Journals (Sweden)

    Idris Ahamed H

    2009-10-01

    Full Text Available Abstract Background Patients with severe burn injury experience a rapid elevation in multiple circulating pro-inflammatory cytokines, with the levels correlating with both injury severity and outcome. Accumulations of these cytokines in animal models have been observed in remote organs, however data are lacking regarding early brain cytokine levels following burn injury, and the effects of estradiol on these levels. Using an experimental animal model, we studied the acute effects of a full-thickness third degree burn on brain levels of TNF-α, IL-1β, and IL-6 and the protective effects of acute estrogen treatment on these levels. Additionally, the acute administration of estrogen on regulation of inflammatory and apoptotic events in the brain following severe burn injury were studied through measuring the levels of phospho-ERK, phospho-Akt, active caspase-3, and PARP cleavage in the placebo and estrogen treated groups. Methods In this study, 149 adult Sprague-Dawley male rats received 3rd degree 40% total body surface area (TBSA burns. Fifteen minutes following burn injury, the animals received a subcutaneous injection of either placebo (n = 72 or 17 beta-estradiol (n = 72. Brains were harvested at 0.5, 1, 2, 4, 6, 8, 12, 18, and 24 hours after injury from the control (n = 5, placebo (n = 8/time point, and estrogen treated animals (n = 8/time point. The brain cytokine levels were measured using the ELISA method. In addition, we assessed the levels of phosphorylated-ERK, phosphorylated-Akt, active caspase-3, and the levels of cleaved PARP at the 24 hour time-point using Western blot analysis. Results In burned rats, 17 beta-estradiol significantly decreased the levels of brain tissue TNF-α (~25%, IL-1β (~60%, and IL-6 (~90% when compared to the placebo group. In addition, we determined that in the estrogen-treated rats there was an increase in the levels of phospho-ERK (p p p p Conclusion Following severe burn injury, estrogens decrease both

  15. Reduced infant birthweight consequent upon maternal exposure to severe life events

    DEFF Research Database (Denmark)

    Khashan, Ali; McNamee, R.; Pedersen, Marianne Giørtz

    2008-01-01

    OBJECTIVE: To investigate the association between maternal exposure to severe life events and fetal growth (birthweight and small for gestational age). Stress has been associated with adverse pregnancy outcome. METHODS: Mothers of 1.38 million singleton live births in Denmark between January 1...... conception or during pregnancy have babies with significantly lower birthweight. If this association is causal, the potential mechanisms of stress-related effects on birthweight include changes in lifestyle due to the exposure and stress-related dysregulation of the hypothalamic-pituitary-adrenal axis during...

  16. Reduced plasma taurine level in Parkinson's disease: association with motor severity and levodopa treatment.

    Science.gov (United States)

    Zhang, Li; Yuan, Yongsheng; Tong, Qing; Jiang, Siming; Xu, Qinrong; Ding, Jian; Zhang, Lian; Zhang, Rui; Zhang, Kezhong

    2016-01-01

    This study aimed to evaluate the level of taurine in plasma, and its association with the severity of motor and non-motor symptoms (NMS) and chronic levodopa treatment in Parkinson's disease (PD). Plasma taurine level was measured in treated PD (tPD), untreated PD (ntPD) and control groups. Motor symptoms and NMS were assessed using the Unified Parkinson's Disease Rating Scale, the short form of the McGill Pain Questionnaire, the Hamilton Depression Scale, the Scale for Outcomes in Parkinson's disease for Autonomic Symptoms and the Pittsburgh Sleep Quality Index. Longtime exposure to levodopa was indicated by its approximate cumulative dosage. The plasma taurine levels of PD patients were decreased when compared with controls and negatively associated with motor severity but not NMS. Moreover, tPD patients exhibited lower levels of plasma taurine than ntPD patients. Interestingly, plasma taurine levels negatively correlated with cumulative levodopa dosage in tPD. After controlling for potential confounders, the association between taurine and levodopa remained significant. Our study supports that taurine may play important roles in the pathophysiology of PD and the disturbances caused by chronic levodopa administration.

  17. Osseous scintigraphy and auxiliary graft. Scintigraphie osseuse et greffe d'appoint

    Energy Technology Data Exchange (ETDEWEB)

    Khelifa, F.; Siles, S. (Hopital de la Timone, 13 - Marseille (France)); Puech, B.

    1992-12-01

    The scintigraphy could be a good way to survey the osseous graft: three cases are studied in which were recognized the presence of a graft, surinfection, graft lysis, pseudo-arthrosis, algodystrophy. 8 refs., 5 figs.

  18. Validation of X-ray fluorescence spectrometry for determining osseous or dental origin of unknown material.

    Science.gov (United States)

    Christensen, Angi M; Smith, Michael A; Thomas, Richard M

    2012-01-01

    Forensic anthropological examinations typically involve the analysis of human skeletal remains, but in cases where samples are very small and/or physically compromised, it may first be necessary to determine whether the material is even osseous or dental in origin. X-ray fluorescence spectrometry (XRF) is a technique that reveals the elemental composition of materials and is hypothesized to have utility in such cases. XRF analysis was conducted on a variety of tissues and materials in unaltered and altered (damaged) states. With few exceptions, osseous and dental tissues in unaltered and altered conditions contained characteristic levels of calcium and phosphorus, while other materials did not. Materials could be accurately identified as osseous or dental in origin based on the calcium and phosphorus levels identified by XRF, and we therefore conclude that XRF analysis is a valid and effective means of determining osseous or dental origin of unknown material. © 2011 American Academy of Forensic Sciences.

  19. CDP-choline reduces severity of intestinal injury in a neonatal rat model of necrotizing enterocolitis.

    Science.gov (United States)

    Cetinkaya, Merih; Cansev, Mehmet; Cekmez, Ferhat; Tayman, Cuneyt; Canpolat, Fuat Emre; Kafa, Ilker M; Uysal, Sema; Tunc, Turan; Sarici, S Umit

    2013-07-01

    Cytidine 5'-diphosphocholine (CDP-choline) is an endogenous intermediate in the biosynthesis of phosphatidylcholine, a contributor to the mucosal defense of the intestine. The aim of this study was to evaluate the possible cytoprotective effect of CDP-choline treatment on intestinal cell damage, membrane phospholipid content, inflammation, and apoptosis in a neonatal rat model of necrotizing enterocolitis (NEC). We divided a total of 30 newborn pups into three groups: control, NEC, and NEC + CDP-choline. We induced NEC by enteral formula feeding, exposure to hypoxia-hyperoxia, and cold stress. We administered CDP-choline intraperitoneally at 300 mg/kg/d for 3 d starting from the first day of life. We evaluated apoptosis macroscopically and histopathologically in combination with proinflammatory cytokines in the gut samples. Moreover, we determined membrane phospholipid levels as well as activities of xanthine oxidase, superoxide dismutase, glutathione peroxidase, and myeloperoxidase enzymes and the malondialdehyde content of intestinal tissue. Mean clinical sickness score, macroscopic gut assessment score, and intestinal injury score were significantly improved, whereas mean apoptosis score and caspase-3 levels were significantly reduced in pups in the NEC + CDP-choline group compared with the NEC group. Tissue proinflammatory cytokine (interleukin-1β, interleukin-6, and tumor necrosis factor-α) levels as well as tissue malondialdehyde content and myeloperoxidase activities were reduced, whereas glutathione peroxidase and superoxide dismutase activities were preserved in the NEC + CDP-choline group. In addition, NEC damage reduced intestinal tissue membrane phospholipids, whereas CDP-choline significantly enhanced total phospholipid and phosphatidylcholine levels. Long-term follow-up in additional experiments revealed increased body weight, decreased clinical sickness scores, and enhanced survival in CDP-choline-receiving versus saline-receiving pups with NEC

  20. Effect of ionizing radiation on reducing the several inhibitors in codling moth Cydia pomonella (L.) medium

    International Nuclear Information System (INIS)

    Mohamad, F. A.

    2008-01-01

    The medium for Codling moth, Cydia pomonella (L) was sterilized using ionizing radiation (0, 5, 15 and 25 KGy) or heat (cooking for 40 minutes.). inhibitors were also added either on the top of the diet or by mixing it with the diet. The results showed that all Codling moth larvae in the ionizing radiation sterilized diet died before reaching the 4th larval instar. Results of using both radiation and cooking for sterilizing the diet gave variable results; those treated with 15 KGy gave significantly more moths with higher weight and more fecundity. The results also showed that increasing the amount of microbial inhibitors in diet negatively affected the number of produced moth and their biological characteristics. Consequently irradiation could be a mean for reducing the amount of chemical inhibitors added to the diet. (author)

  1. Molecular hydrogen ameliorates several characteristics of preeclampsia in the Reduced Uterine Perfusion Pressure (RUPP) rat model.

    Science.gov (United States)

    Ushida, Takafumi; Kotani, Tomomi; Tsuda, Hiroyuki; Imai, Kenji; Nakano, Tomoko; Hirako, Shima; Ito, Yumiko; Li, Hua; Mano, Yukio; Wang, Jingwen; Miki, Rika; Yamamoto, Eiko; Iwase, Akira; Bando, Yasuko K; Hirayama, Masaaki; Ohno, Kinji; Toyokuni, Shinya; Kikkawa, Fumitaka

    2016-12-01

    Oxidative stress plays an important role in the pathogenesis of preeclampsia. Recently, molecular hydrogen (H 2 ) has been shown to have therapeutic potential in various oxidative stress-related diseases. The aim of this study is to investigate the effect of H 2 on preeclampsia. We used the reduced utero-placental perfusion pressure (RUPP) rat model, which has been widely used as a model of preeclampsia. H 2 water (HW) was administered orally ad libitum in RUPP rats from gestational day (GD) 12-19, starting 2 days before RUPP procedure. On GD19, mean arterial pressure (MAP) was measured, and samples were collected. Maternal administration of HW significantly decreased MAP, and increased fetal and placental weight in RUPP rats. The increased levels of soluble fms-like tyrosine kinase-1 (sFlt-1) and diacron reactive oxygen metabolites as a biomarker of reactive oxygen species in maternal blood were decreased by HW administration. However, vascular endothelial growth factor level in maternal blood was increased by HW administration. Proteinuria, and histological findings in kidney were improved by HW administration. In addition, the effects of H 2 on placental villi were examined by using a trophoblast cell line (BeWo) and villous explants from the placental tissue of women with or without preeclampsia. H 2 significantly attenuated hydrogen peroxide-induced sFlt-1 expression, but could not reduce the expression induced by hypoxia in BeWo cells. H 2 significantly attenuated sFlt-1 expression in villous explants from women with preeclampsia, but not affected them from normotensive pregnancy. The prophylactic administration of H 2 attenuated placental ischemia-induced hypertension, angiogenic imbalance, and oxidative stress. These results support the theory that H 2 has a potential benefit in the prevention of preeclampsia. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Chest physiotherapy using passive expiratory techniques does not reduce bronchiolitis severity: a randomised controlled trial.

    Science.gov (United States)

    Rochat, Isabelle; Leis, Patricia; Bouchardy, Marie; Oberli, Christine; Sourial, Hendrika; Friedli-Burri, Margrit; Perneger, Thomas; Barazzone Argiroffo, Constance

    2012-03-01

    Chest physiotherapy (CP) using passive expiratory manoeuvres is widely used in Western Europe for the treatment of bronchiolitis, despite lacking evidence for its efficacy. We undertook an open randomised trial to evaluate the effectiveness of CP in infants hospitalised for bronchiolitis by comparing the time to clinical stability, the daily improvement of a severity score and the occurrence of complications between patients with and without CP. Children bronchiolitis in a tertiary hospital during two consecutive respiratory syncytial virus seasons were randomised to group 1 with CP (prolonged slow expiratory technique, slow accelerated expiratory flow, rarely induced cough) or group 2 without CP. All children received standard care (rhinopharyngeal suctioning, minimal handling, oxygen for saturation ≥92%, fractionated meals). Ninety-nine eligible children (mean age, 3.9 months), 50 in group 1 and 49 in group 2, with similar baseline variables and clinical severity at admission. Time to clinical stability, assessed as primary outcome, was similar for both groups (2.9 ± 2.1 vs. 3.2 ± 2.8 days, P = 0.45). The rate of improvement of a clinical and respiratory score, defined as secondary outcome, only showed a slightly faster improvement of the respiratory score in the intervention group when including stethoacoustic properties (P = 0.044). Complications were rare but occurred more frequently, although not significantly (P = 0.21), in the control arm. In conclusion, this study shows the absence of effectiveness of CP using passive expiratory techniques in infants hospitalised for bronchiolitis. It seems justified to recommend against the routine use of CP in these patients.

  3. Comparison of intraoperative time measurements between osseous reconstructions with free fibula flaps applying computer-aided designed/computer-aided manufactured and conventional techniques.

    Science.gov (United States)

    Rustemeyer, Jan; Sari-Rieger, Aynur; Melenberg, Alex; Busch, Alexander

    2015-09-01

    We aimed to determine whether computer-aided designed/computer-aided manufactured (CAD/CAM) techniques could save intraoperative time compared with the conventional technique, by comparing flap harvesting and ischemia times, and subsequently impact flap survival. Twenty patients underwent concurrent osteocutaneous fibula flaps, either with (n = 10) or without (n = 10) the CAD/CAM technique. Demographic data, clinical history, complications, number of osseous segments, and times for virtual planning, flap harvesting, flap ischemia, tourniquet inflation, and total reconstruction were recorded. There was no significant difference between CAD/CAM and conventional techniques with respect to age, number of osseous segments, complication rates, and tourniquet inflation time. Flap harvesting times were significantly shorter in the conventional group (112.1 vs. 142.2 min, p technique, including reduced ischemia time of osteocutaneous fibula flaps, there is no impact on total reconstruction time or flap survival.

  4. A Case of Odontogenic Myxoma with Unusual Histological Features Mimicking a Fibro-Osseous Process

    Science.gov (United States)

    Basile, John R.

    2010-01-01

    Odontogenic myxoma is a rare benign but locally aggressive odontogenic tumor. This report describes a case of odontogenic myxoma producing diffusely dispersed calcified products in a pattern reminiscent of a fibro-osseous lesion of the jaw. Differential diagnoses for myxoid lesions of the jaws also are discussed. This paper highlights how an odontogenic myxoma can produce a large amount of calcified products to mimic a fibro-osseous process. PMID:20607463

  5. Clinicopathologic Study of Intra- Osseous Lesions of the Jaws in Southern Iranian Population

    OpenAIRE

    Jaafari-Ashkavandi, Zohreh; Akbari, Behrooz

    2017-01-01

    Statement of the Problem: It is necessary for surgeons and practitioners to know about relative incidence and clinicopathologic features of lesions for accurate diagnosis and approach of pathologic lesions. Data are limited about overall incidence of intra-osseous lesions of the jaws in Iranian patients. Purpose: This study evaluated the clinicopathologic features of intra- osseous lesions of the jaws in an Iranian population, in a 22-year period. Materials and Method: In this cross- sectiona...

  6. CBCT findings of periapical cemento-osseous dysplasia: A case report

    International Nuclear Information System (INIS)

    Eskandarloo, Amir; Yousefi, Faezeh

    2013-01-01

    Periapical cemento-osseous dysplasia (PCOD) is a subtype of cemento-osseous dysplasia that usually occurs in middle-aged black women. This report described a case of a 45-year-old Iranian woman who was diagnosed with PCOD on the basis of cone beam computed tomographic (CBCT) findings. CBCT enabled detailed visualization of the bone changes. This report described the special radiographic characteristics of PCOD, including discontinuity of the lingual cortex on the CBCT sectional and three-dimensional images.

  7. CBCT findings of periapical cemento-osseous dysplasia: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Eskandarloo, Amir; Yousefi, Faezeh [Dept. of Oral and Maxillofacial Radiology, Faculty of Dentistry, Hamadan University of Medical Science, Hamadan(Korea, Republic of)

    2013-09-15

    Periapical cemento-osseous dysplasia (PCOD) is a subtype of cemento-osseous dysplasia that usually occurs in middle-aged black women. This report described a case of a 45-year-old Iranian woman who was diagnosed with PCOD on the basis of cone beam computed tomographic (CBCT) findings. CBCT enabled detailed visualization of the bone changes. This report described the special radiographic characteristics of PCOD, including discontinuity of the lingual cortex on the CBCT sectional and three-dimensional images.

  8. The efficacy of salvage logging in reducing subsequent fire severity in conifer-dominated forests of Minnesota, USA

    Science.gov (United States)

    Fraver, S.; Jain, T.; Bradford, J.B.; D'Amato, A.W.; Kastendick, D.; Palik, B.; Shinneman, D.; Stanovick, J.

    2011-01-01

    Although primarily used to mitigate economic losses following disturbance, salvage logging has also been justified on the basis of reducing fire risk and fire severity; however, its ability to achieve these secondary objectives remains unclear. The patchiness resulting from a sequence of recent disturbances-blowdown, salvage logging, and ildfire- provided an excellent opportunity to assess the impacts of blowdown and salvage logging on wildfire severity. We used two fire-severity assessments (tree-crown and forest-floor characteristics) to compare post-wildfire conditions among three treatment combinations (Blowdown-Salvage-Fire, Blowdown-Fire, and Fire only). Our results suggest that salvage logging reduced the intensity (heat released) of the subsequent fire. However, its effect on severity (impact to the system) differed between the tree crowns and forest floor: tree-crown indices suggest that salvage logging decreased fire severity (albeit with modest statistical support), while forest-floor indices suggest that salvage logging increased fire severity. We attribute the latter finding to the greater exposure of mineral soil caused by logging operations; once exposed, soils are more likely to register the damaging effects of fire, even if fire intensity is not extreme. These results highlight the important distinction between fire intensity and severity when formulating post-disturbance management prescriptions. ?? 2011 by the Ecological Society of America.

  9. Stretching before sleep reduces the frequency and severity of nocturnal leg cramps in older adults : a randomised trial

    NARCIS (Netherlands)

    Hallegraeff, Joannes M.; van der Schans, Cees P.; de Ruiter, Renee; de Greef, Mathieu H. G.

    Question: In adults who experience nocturnal leg cramps, does stretching of the calf and hamstring muscles each day just before sleep reduce the frequency and severity of the cramps? Design: A randomised trial with concealed allocation and intention-to-treat analysis. Participants: Eighty adults

  10. Stretching before sleep reduces the frequency and severity of nocturnal leg cramps in older adults: a randomised trial

    NARCIS (Netherlands)

    dr. M.H. de Greef; Dr. C.P. van der Schans; R. de Ruiter; J.M. Hallegraeff

    2012-01-01

    QUESTION: In adults who experience nocturnal leg cramps, does stretching of the calf and hamstring muscles each day just before sleep reduce the frequency and severity of the cramps? DESIGN: A randomised trial with concealed allocation and intention-to-treat analysis. PARTICIPANTS: Eighty adults

  11. Partial calcanectomy and Ilizarov external fixation may reduce amputation need in severe diabetic calcaneal ulcers.

    Science.gov (United States)

    Akkurt, Mehmet Orçun; Demirkale, Ismail; Öznur, Ali

    2017-01-01

    Objective : The treatment of diabetic hindfoot ulcers is a challenging problem. In addition to serial surgical debridements, hyperbaric oxygen therapy and local wound care play important roles in the surgeon's armamentarium, for both superficial infection and gangrene of the soft tissue, often complicated by osteomyelitis of the calcaneus. The purpose of this study was to evaluate the results of an aggressive approach from diagnosis to treatment of calcaneal osteomyelitis in foot-threatening diabetic calcaneal ulcers. Methods : The study included 23 patients with diabetic hindfoot ulcers who were treated with radical excision of the necrotic tissue and application of circular external fixation. The treatment protocol was a combination of magnetic resonance imaging (MRI)-guided debridement of the necrotic tissues and application of an Ilizarov external fixator in plantarflexion to decrease the soft-tissue defect. Primary outcome measures were total cure of infection and obvious healing of the osteomyelitis at 12 weeks determined by MRI, and clinical cure through objective assessment of the appearance of the wound. Results : The wounds healed in 18 of the 23 patients (78%), partial recovery occurred and subsequent flap operation was performed in three patients (13%), and below-the-knee amputation was performed in two patients (9%). Conclusions : This surgical protocol is effective in ameliorating diabetic hindfoot ulcers with concomitant calcaneal osteomyelitis, and satisfactorily reduces the need for amputation.

  12. A Novel Chemically Modified Curcumin Reduces Severity of Experimental Periodontal Disease in Rats: Initial Observations

    Directory of Open Access Journals (Sweden)

    Muna S. Elburki

    2014-01-01

    Full Text Available Tetracycline-based matrix metalloproteinase- (MMP- inhibitors are currently approved for two inflammatory diseases, periodontitis and rosacea. The current study addresses the therapeutic potential of a novel pleiotropic MMP-inhibitor not based on an antibiotic. To induce experimental periodontitis, endotoxin (LPS was repeatedly injected into the gingiva of rats on one side of the maxilla; the contralateral (control side received saline injections. Two groups of rats were treated by daily oral intubation with a chemically modified curcumin, CMC 2.24, for two weeks; the control groups received vehicle alone. After sacrifice, gingiva, blood, and maxilla were collected, the jaws were defleshed, and periodontal (alveolar bone loss was quantified morphometrically and by μ-CT scan. The gingivae were pooled per experimental group, extracted, and analyzed for MMPs (gelatin zymography; western blot and for cytokines (e.g., IL-1β; ELISA; serum and plasma samples were analyzed for cytokines and MMP-8. The LPS-induced pathologically excessive bone loss was reduced to normal levels based on either morphometric (P=0.003 or μ-CT (P=0.008 analysis. A similar response was seen for MMPs and cytokines in the gingiva and blood. This initial study, on a novel triketonic zinc-binding CMC, indicates potential efficacy on inflammatory mediators and alveolar bone loss in experimental periodontitis and warrants future therapeutic and pharmacokinetic investigations.

  13. A new sternum elevator reduces severe complications during minimally invasive repair of the pectus excavatum.

    Science.gov (United States)

    Takagi, Satoshi; Oyama, Takuto; Tomokazu, Nishihira; Kinoshita, Koji; Makino, Taro; Ohjimi, Hiroyuki

    2012-06-01

    Although the Nuss procedure for pectus excavatum is widely employed, a variety of complications have been reported with relatively high frequency; those that involve cardiac and pericardial injuries can be life threatening. To reduce such dangers, we present here a newly developed sternal elevator. The elevator is horseshoe shaped. Its elevator side has the same curvature as a Nuss introducer, so that interference between devices is minimal and no extra skin incision is needed for the elevator insertion. The elevator holds the sternum forward and enlarges the retrosternal space for safer passage of thoracoscopically guided introducer. The authors have used the elevator for 61 pectus excavatum cases between March 2004 and December 2009 without any major complications. The entire process of substernal tunneling was endoscopically observed, which eliminated any blunt and blind dissection, even in a significantly depressed funnel chest case. With the device, the sternum was effectively elevated again for the placement of the second plate in 30 cases. Our newly developed sternum elevator makes the Nuss procedure safer and more affordable without introducing any extra scarring.

  14. Ten-week lifestyle changing program reduces several indicators for metabolic syndrome in overweight adults

    Directory of Open Access Journals (Sweden)

    Mecca Marita S

    2012-01-01

    Full Text Available Abstract We aim to investigate the effectiveness of a 10-week lifestyle intervention focusing on physical activity and high fiber intake for reducing indicators for metabolic syndrome in overweight-obese individuals. A prospective study of 50 overweight (OW adults (22 in the general educational group - G1; 28 in the high fiber nutrition group - G2 was performed. Both groups were offered dietary counseling and supervised exercise. Clinical, anthropometric, dietary and plasma biochemical tests were performed at baseline - time 0 (T0 and after 10 weeks - time 1 (T1. Both groups improved their dietary quality, but only G2 presented higher intake of fruit and vegetables (servings/day, higher plasma β-carotene levels and a 24% reduction of MetS incidence. Additionally G2 showed greater reductions in body fat (4%, and waist circumference (7%, obesity class III (2% and obesity class II (14% rate. Lifestyle intervention, including a high dietary fiber intake, improved healthy eating index and decreased body fat composition and plasma lipid concentrations leading to MetS incidence reduction.

  15. MINERALIZATION DISORDER OF OSSEOUS TISSUE AMONG THE CHILDREN, SUFFERING FROM INFLAMMATORY BOWEL DISEASES

    Directory of Open Access Journals (Sweden)

    E.A. Yablokova

    2006-01-01

    Full Text Available The growth rate of inflammatory bowel diseases among children actualizes early detection of this pathology form and its aftera effects, including secondary osteoporosis. The research purpose is to study the characteristics of osseous tissue mineralization, disorder of physical growth and sexual maturity of children, suffering from inflammatory bowel diseases. The researchers have examined 116 children, including 33 children, suffering from inflammatory bowel diseases; 26 children, suffering from persistent colitis; 29 children, suffering from gasatroduodenitis; and 28 children with no GI tract pathologies. The study deals with estimate of level of mineral osseous tissue density, biochemical rates of osseous metabolism, as well as physical growth and sexual maturity. reduction of mineral osseous tissue density was found among 48,5% of children, suffering from inflammatory bowel diseases, 23% of children, suffering from persistent colitis, 31% of children, suffering from chronic gastritis and 18% of almost healthy children, at the same time, it was more apparent among children, suffering from inflammatory bowel diseases. The lowest rates of mineral osseous tissue density were among girls. Calcium phosphoric metabolism did not change apart from calcium creatinine coefficient, if osteopenia was observed. Thus, reduction of mineral osseous tissue density is often observed among children, suffering from inflammatory bowel diseases, especially among adolescent girls. Therefore, it conditions the necessity to include densimetry into the conventional examination plan for children, suffering from inflammatory bowel diseases. Authors also find it advisable to monitor physical growth and sexual maturity of children.Key words: children, inflammatory bowel diseases, osteoporosis.

  16. Better fear conditioning is associated with reduced symptom severity in autism spectrum disorders.

    Science.gov (United States)

    South, Mikle; Larson, Michael J; White, Sarah E; Dana, Julianne; Crowley, Michael J

    2011-12-01

    Evidence from behavioral and neuroimaging studies suggest that atypical amygdala function plays a critical role in the development of autism spectrum disorders (ASD). The handful of psychophysiological studies examining amygdala function in ASD using classical fear conditioning paradigms have yielded discordant results. We recorded skin conductance response (SCR) during a simple discrimination conditioning task in 30 children and adolescents (ages 8-18) diagnosed with high-functioning ASD and 30 age- and IQ-matched, typically developing controls. SCR response in the ASD group was uniquely and positively associated with social anxiety; and negatively correlated with autism symptom severity, in particular with social functioning. Fear conditioning studies have tremendous potential to aid understanding regarding the amygdale's role in the varied symptom profile of ASD. Our data demonstrate that such studies require careful attention to task-specific factors, including task complexity; and also to contributions of dimensional, within-group factors that contribute to ASD heterogeneity. Copyright © 2011, International Society for Autism Research, Wiley-Liss, Inc.

  17. Memantine shows promise in reducing gambling severity and cognitive inflexibility in pathological gambling: a pilot study.

    Science.gov (United States)

    Grant, Jon E; Chamberlain, Samuel R; Odlaug, Brian L; Potenza, Marc N; Kim, Suck Won

    2010-12-01

    Although pathological gambling (PG) is relatively common, pharmacotherapy research for PG is limited. Memantine, an N-methyl D-aspartate receptor antagonist, appears to reduce glutamate excitability and improve impulsive decision making, suggesting it may help individuals with PG. This study sought to examine the safety and efficacy of Memantine in PG. Twenty-nine subjects (18 females) with DSM-IV PG were enrolled in a 10-week open-label treatment study of memantine (dose ranging from 10 to 30 mg/day). Subjects were enrolled from January 2009 until April 2010. Change from baseline to study endpoint on the Yale Brown Obsessive Compulsive Scale Modified for Pathological Gambling (PG-YBOCS) was the primary outcome measure. Subjects underwent pre- and post-treatment cognitive assessments using the stop-signal task (assessing response impulsivity) and the intra-dimensional/extra-dimensional (ID/ED) set shift task (assessing cognitive flexibility). Twenty-eight of the 29 subjects (96.6%) completed the 10-week study. PG-YBOCS scores decreased from a mean of 21.8 ± 4.3 at baseline to 8.9 ± 7.1 at study endpoint (p gambling per week and money spent gambling both decreased significantly (p medication was well-tolerated. Memantine treatment was associated with diminished gambling and improved cognitive flexibility. These findings suggest that pharmacological manipulation of the glutamate system may target both gambling and cognitive deficits in PG. Placebo-controlled, double-blind studies are warranted in order to confirm these preliminary findings in a controlled design.

  18. Evaluation of metallic osseous implants with nuclear medicine

    Energy Technology Data Exchange (ETDEWEB)

    Wellman, H.N.; Schauwecker, D.S.; Capello, W.N.

    1988-04-01

    Nuclear medicine has proven to have a valuable role in the evaluation of osseous metallic implants, particularly with joint prostheses, but can assist with evaluation of other appliances as well. The nuclear arthrogram has become an invaluable adjunct to simultaneously performed radiographic contrast arthrography. This application has been best evaluated in what is one of the most common of orthopedic prosthesis problems, namely, loosening of total hip prostheses. Experience indicates that both sensitivity and specificity of loosening of the femoral component can be increased to over 90% through combined use of nuclear with radiographic contrast arthrography. Furthermore the combination of routine skeletal scintimaging with the nuclear arthrogram adds a significant dimension to precise localizing of the nuclear arthrographics agent In-111 chloride. Nuclear medicine also plays an important role in further evaluating the presence of infection associated with metallic implants with In-111 WBC preparations being superior to Ga-67 as the radiopharmaceutical tracer. Infection has been detected with a sensitivity of 73% and a specificity of 93% in our series using combined In-111 WBC and simultaneous skeletal imaging with conventional Tc-99m MDP. Acute infections are more readily identifiable than chronic in association with prostheses. 29 references.

  19. Maternal early warning systems-Towards reducing preventable maternal mortality and severe maternal morbidity through improved clinical surveillance and responsiveness.

    Science.gov (United States)

    Zuckerwise, Lisa C; Lipkind, Heather S

    2017-04-01

    Despite increasing awareness of obstetric safety initiatives, maternal mortality and severe maternal morbidity in the United States have continued to increase over the past 20 years. Since results from large-scale surveillance programs suggest that up to 50% of maternal deaths may be preventable, new efforts are focused on developing and testing early warning systems for the obstetric population. Early warning systems are a set of specific clinical signs or symptoms that trigger the awareness of risk and an urgent patient evaluation, with the goal of reducing severe morbidity and mortality through timely diagnosis and treatment. Early warning systems have proven effective at predicting and reducing mortality and severe morbidity in medical, surgical, and critical care patient populations; however, there has been limited research on how to adapt these tools for use in the obstetric population, where physiologic changes of pregnancy render them inadequate. In this article, we review the available obstetric early warning systems and present evidence for their use in reducing maternal mortality and severe maternal morbidity. We also discuss considerations and strategies for implementation and acceptance of these early warning systems for clinical use in obstetrics. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Long-term osseous sequelae after acute trauma of the knee joint evaluated by MRI

    International Nuclear Information System (INIS)

    Roemer, F.W.; Bohndorf, K.

    2002-01-01

    To evaluate the frequency and location and to determine the long-term MR changes in patients with edema-like bone marrow abnormalities after acute knee trauma.Design and patients. A cohort of 176 consecutive patients in a 29 month period with acute injury of the knee joint was examined with MRI. Forty-nine patients with bone marrow edema-like signal alteration on the initial MR examination were re-evaluated with MRI after a minimum of 2 years (mean 44 months). Signal alterations and contour abnormalities on the initial and follow-up MR examinations were classified. The volume of the edema was also measured.Results. There was a prevalence of post-traumatic edema-like signal changes of 72% in 176 patients. In the follow-up group (n=49) the initial MR examination showed 80 areas of signal change with a mean volume of 15.5 cm 3 (range 0.25-175 cm 3 ). Thirty-five (44%) were signal changes without other bony or cartilaginous injuries, 19 (24%) were subchondral impaction fractures and 26 (33%) were osteochondral or chondral fractures. Sixty-nine percent of the lesions were located in the lateral, and 29% in the medial joint compartment. Three percent were patellar lesions. In seven of the 49 patients (14%) eight signal changes were seen on the follow-up MR examination. Six lesions were located in the same anatomic area as on the initial MR examination, and two new lesions had developed. The volume of the bone marrow edema was smaller in all persisting lesions (mean volume 2.26 cm 3 , range 0.3-4.8 cm 3 ). Deterioration of the subchondral impaction, chondral/osteochondral fracture or lesions resembling osteonecrosis were not found in any patient.Conclusions. The majority of acute post-traumatic marrow signal changes are found in the lateral compartment and do not show additional osseous or chondral alterations. After a minimum of 2 years acute post-traumatic bone marrow edema-like signal alterations vanish in the majority of patients. Even more severe articular surface

  1. Once-daily fluticasone furoate (FF)/vilanterol reduces risk of severe exacerbations in asthma versus FF alone.

    Science.gov (United States)

    Bateman, Eric D; O'Byrne, Paul M; Busse, William W; Lötvall, Jan; Bleecker, Eugene R; Andersen, Leslie; Jacques, Loretta; Frith, Lucy; Lim, Jessica; Woodcock, Ashley

    2014-04-01

    Combination therapy with an inhaled corticosteroid (ICS) and long-acting β2 agonist (LABA) is recommended for patients with asthma symptomatic on ICS alone. However, there is ongoing debate regarding the risk-benefit ratio of using LABA in asthma. To evaluate the effect of the addition of a novel LABA, vilanterol (VI), to a once-daily ICS, fluticasone furoate (FF), on the risk of severe asthma exacerbations in patients with uncontrolled asthma. This randomised double-blind comparative study of variable duration (≥ 24-78 weeks) was designed to finish after 330 events (each patient's first on-treatment severe asthma exacerbation). 2019 patients with asthma aged ≥ 12 years with ≥ 1 recorded exacerbation within 1 year were randomised and received FF/VI 100/25 μg or FF 100 μg, administered once daily in the evening. The primary endpoint was time to first severe exacerbation; secondary endpoints were rate of severe asthma exacerbations per patient per year and change in trough evening forced expiratory volume in 1 s (FEV1) from baseline. Compared with FF, FF/VI delayed the time to first severe exacerbation (HR 0.795, 95% CI 0.642 to 0.985) and reduced the annualised rate of severe exacerbations (rate reduction 25%, 95% CI 5% to 40%). Significantly greater improvements in trough FEV1 (pFF/VI than with FF at weeks 12, 36, 52 and at endpoint. Both treatments were well tolerated with similar rates of treatment-related adverse events and on-treatment serious adverse events. Once-daily FF/VI reduced the risk of severe asthma exacerbations and improved lung function compared with FF alone, with good tolerability and safety profile in adolescents and adults with asthma currently receiving ICS. NCT01086384.

  2. Low-Dose Oral Immunotherapy Using Low-Egg-Allergen Cookies for Severe Egg-Allergic Children Reduces Allergy Severity and Affects Allergen-Specific Antibodies in Serum.

    Science.gov (United States)

    Maeta, Akihiro; Matsushima, Marin; Muraki, Nozomi; Asano, Mariko; Takaoka, Yuri; Kameda, Makoto; Takahashi, Kyoko

    2018-01-01

    We evaluated the safety and efficacy of low-egg-allergen cookies (LAC) as low-dose oral immunotherapy (OIT) in children with severe egg allergy. We also examined the relationship between mild desensitization by low-dose OIT and serum biomarkers of allergy. We enrolled 13 children with egg allergy who could not receive OIT with hard-boiled egg white (EW). For 11 participants, OIT was carried out using LAC for 3-4 months. Open food challenges with hard-boiled EW and blood samplings were performed before and after OIT. Participants were divided into 2 groups: high effect (H-E) and no/low effect (N/L-E). Serum levels of total IgE and egg yolk-, EW-, and ovomucoid (OM)-specific IgE, ovalbumin (OVA)- and OM-specific IgG4, IgA1, and IgA2, and the percentage of CD 203c+ were measured. Allergic severity was reduced in 7 patients, who were assigned to the H-E group. Moreover, no study participants were taken off the intake of LAC during OIT. In the H-E group, OVA-specific IgA2 levels after OIT were significantly higher than before OIT. The ratios of OM-specific IgG4/OM-specific IgE and OM-specific IgA2/OM-specific IgE in the H-E group after OIT were significantly higher than before OIT. Our findings suggest that low-dose OIT using LAC is an effective and safe treatment for patients with severe egg allergy. © 2018 S. Karger AG, Basel.

  3. Evaluation of Strength in the ``Toronto'' Osseous-Prosthesis System

    Science.gov (United States)

    Giacomo, R.; Cicciã¹, M.; Dini, R.; Franceschini, G.; Maiorana, C.

    2010-06-01

    Several surgical techniques like are today available in order to recovery large bone defects of the jaw. Aim of the surgeon is to obtain a good tridimensional volume to place dental implant and to recovery the patient’s aesthetics and function. Several prosthetic solution were considered for prosthetic rehabilitation. However after a bone graft surgery Toronto screwed prosthesis on dental implants, following Branemark intuitions, was considered the better prosthetic rehabilitation solution. According to Wölff, the dental implants osteointegration is related to the strengths directed to mandibular bone. Our investigation’s aim is to underline through FEM analysis the stress over the prosthetic elements and over bone surface in order to help the surgeon choice about the dental implant positioning, and at the same time reducing the bone trauma on the patients.

  4. The vertebral trabecular model revisited: magnetic field distribution in the vicinity of osseous disconnections

    Science.gov (United States)

    Kraiger, Markus; Schnizer, Bernhard; Stollberger, Rudolf

    2016-12-01

    In the current paper a vertebral bone model is introduced that can be used for studying trabecular thinning and the formation of trabecular disconnections. Magnetostatic simulations are applied in MR-osteodensitometry to deduce the quality of trabecular bone from experimentally obtained susceptibility effects. The course of trabecular bone loss, which results in distinct interruptions and consequently severe mechanical impairment, is not assessable in the majority of such applied models. In the novel approach introduced here, analytical solutions of prolate ellipsoids were used to compute the disturbed magnetic fields within the proposed 3D model. The performed simulations focused on two variants of the vertebral model: an intact model and a pathological model accounting for microdamage. For both variants, magnetic resonance spectra were simulated for different bone volume fractions. Subsequently, resonance signals were obtained from the Fourier transform of the distribution with respect to time. The resonance time courses were analyzed through common signal models to estimate the relaxation time {{T}\\prime}2 of the corresponding free induction decay. Detailed computations revealed the significant contribution of the microdamage to the susceptibility effect. Further, when comparing the line broadening effect between the intact and disrupted models a contradictory outcome was found. The damaged osseous network for the lower bone fraction resulted in faster decay of the transverse magnetization. In conclusion, a significant contribution of trabecular disconnections to the susceptibility effect has been shown by the presented model. Future dedicated MRI experiments can explore the use of this effect to assess the integrity of cancellous bone.

  5. Lipoxin Inhibits Fungal Uptake by Macrophages and Reduces the Severity of Acute Pulmonary Infection Caused by Paracoccidioides brasiliensis

    Directory of Open Access Journals (Sweden)

    Laura R. R. Ribeiro

    2015-01-01

    Full Text Available Cysteinyl leukotrienes (CysLTs and lipoxins (LXs are lipid mediators that control inflammation, with the former inducing and the latter inhibiting this process. Because the role played by these mediators in paracoccidioidomycosis was not investigated, we aimed to characterize the role of CysLT in the pulmonary infection developed by resistant (A/J and susceptible (B10.A mice. 48 h after infection, elevated levels of pulmonary LTC4 and LXA4 were produced by both mouse strains, but higher levels were found in the lungs of susceptible mice. Blocking the CysLTs receptor by MTL reduced fungal loads in B10.A, but not in A/J mice. In susceptible mice, MLT treatment led to reduced influx of PMN leukocytes, increased recruitment of monocytes, predominant synthesis of anti-inflammatory cytokines, and augmented expression of 5- and 15-lipoxygenase mRNA, suggesting a prevalent LXA4 activity. In agreement, MTL-treated macrophages showed reduced fungal burdens associated with decreased ingestion of fungal cells. Furthermore, the addition of exogenous LX reduced, and the specific blockade of the LX receptor increased the fungal loads of B10.A macrophages. This study showed for the first time that inhibition of CysLTs signaling results in less severe pulmonary paracoccidioidomycosis that occurs in parallel with elevated LX activity and reduced infection of macrophages.

  6. Clinicopathologic Study of Intra- Osseous Lesions of the Jaws in Southern Iranian Population.

    Science.gov (United States)

    Jaafari-Ashkavandi, Zohreh; Akbari, Behrooz

    2017-12-01

    It is necessary for surgeons and practitioners to know about relative incidence and clinicopathologic features of lesions for accurate diagnosis and approach of pathologic lesions. Data are limited about overall incidence of intra-osseous lesions of the jaws in Iranian patients. This study evaluated the clinicopathologic features of intra- osseous lesions of the jaws in an Iranian population, in a 22-year period. In this cross- sectional retrospective analytical study, 4500 specimens in a 22- year period were reviewed. Baseline data of all patients with intra- osseous lesions including type and location of lesions as well as patients' age and gender, were collected and analyzed by SPSS software using descriptive analysis and Chi-square test. There were 1121 (25%) intra-osseous lesion. Odontogenic cysts and benign non- odontogenic bone lesions were the most common categories, respectively. The mean age of the patients was 30.1±16, the total male to female ratio was 1.1:1, and the most prevalent location of lesions was posterior of mandible. The results showed baseline information of intra-osseous lesions that were essentially similar to other populations; however, there were a few geographical differences. Further comprehensive studies in other parts of country are required to make a more reliable source of reference for clinicians and surgeons for evaluating and managing their patients more properly.

  7. Rare clinical experiences for surgical treatment of melanoma with osseous metastases in Taiwan

    Directory of Open Access Journals (Sweden)

    Yang Rong-Sen

    2007-07-01

    Full Text Available Abstract Background Malignant melanoma occurs infrequently in Taiwan. Once it has progressed into osseous metastases, the prognosis is poor. There are no reported clinical experiences of surgical management in this area. Methods To improve our understanding of the rare clinical experiences, we retrospectively investigated clinical characteristics, radiological findings, treatment modalities, survival outcomes and prognoses of 11 Taiwanese patients with osseous metastasis of melanoma treated surgically at two national medical centers, National Taiwan University Hospital and National Cheng Kung University Hospital from January 1983 to December 2006. Results Six patients suffered from acral-lentiginous melanoma. Nine patients sustained multiple osseous metastases and most lesions were osteolytic. Nine patients also had sustained metastases to other organs including liver, lungs, lymph nodes, brain and spleen. Second malignancies including lung cancer, thyroid papillary carcinoma, renal cell carcinoma and cervical cancer co-existed in four patients. The interval from the initial diagnosis of melanoma to the clinical detection of osseous metastases varied from 0–37.8 months (mean 9.75 months. Metastatic melanoma was invariably fatal; the mean survival time from bone metastases to death was 5.67 months. Conclusion Due to the high morbidity and poor survival of Taiwanese patients with osseous metastases of melanoma, surgical treatment should be directed towards pain relief and the prevention of skeletal debilitation in order to maintain their quality of life.

  8. Autosomal dominant mesomandibular fibro-osseous dysplasia: a self-resolving inherited fibro-osseous lesion of the jaws.

    Science.gov (United States)

    Koutlas, Ioannis G; Forsman, Cynthia L; Kyrkanides, Stephanos; Oetting, William S; Petryk, Anna

    2012-01-01

    A hereditary congenital condition characterized by a fibro-osseous lesion sharing some features with fibrous dysplasia and affecting the middle aspect of the mandible is presented. The condition was initially described as congenital monostotic fibrous dysplasia in two siblings, a male and a female. However, there is sufficient evidence that the disorder is autosomal dominant since it has been encountered in two of four children, both males, of the female propositus and one child, a boy, of the male propositus. All patients presented at birth or right after birth with enlargement of the middle part of the mandible. Radiographs from affected individuals have shown mesomandibular enlargement with irregular trabeculation akin of "ground-glass" appearance. Histologically, samples from all patients revealed woven bone proliferation in a cellular fibroblastic stroma. Interestingly, the originally described siblings, now in their 30s, have no evidence of jaw lesions either radiographically or clinically, thus indicating that the condition is self-limiting or self-resolving. An autosomal dominant mode of inheritance with apparent male predilection is favored. The molecular basis of this condition is currently unknown. However, the location of the lesions in the middle aspect of the mandible suggests dysregulation of Bone Morphogenetic Protein (BMP) signaling since BMPs regulate mandibular morphogenesis in utero, particularly in the medial region as well as postnatal bone remodeling. Immunohistochemical evaluation for a BMP-binding protein Twisted Gastrulation (TWSG1) revealed mosaic pattern of staining, with some cells, including osteoclasts, strongly stained and others exhibiting faint or no staining, thus supporting active regulation of BMP signaling within the lesion. Future investigations will determine if dysregulation of BMP signaling plays a causative role or rather reflects secondary activation of repair mechanisms and/or bone remodeling.

  9. Autosomal dominant mesomandibular fibro-osseous dysplasia: a self-resolving inherited fibro-osseous lesion of the jaws

    Directory of Open Access Journals (Sweden)

    Ioannis eKoutlas

    2012-12-01

    Full Text Available A hereditary congenital condition characterized by a fibro-osseous lesion sharing some features with fibrous dysplasia and affecting the middle aspect of the mandible is presented. The condition was initially described as congenital monostotic fibrous dysplasia in two siblings, a male and a female. However, there is sufficient evidence that the disorder is autosomal dominant since it has been encountered in two of four children, both males, of the female propositus and one child, a boy, of the male propositus. All patients presented at birth or right after birth with enlargement of the middle part of the mandible. Radiographs from affected individuals have shown mesomandibular enlargement with irregular trabeculation akin of ground-glass appearance. Histologically, samples from all patients revealed woven bone proliferation in a cellular fibroblastic stroma. Interestingly, the originally described siblings, now in their 30s, have no evidence of jaw lesions either radiographically or clinically, thus indicating that the condition is self-limiting or self-resolving. An autosomal dominant mode of inheritance with apparent male predilection is favored. The molecular basis of this condition is currently unknown. However, the location of the lesions in the middle aspect of the mandible suggests dysregulation of Bone Morphogenetic Protein signaling since BMPs regulate mandibular morphogenesis in utero, particularly in the medial region as well as postnatal bone remodeling. Immunohistochemical evaluation for a BMP-binding protein Twisted Gastrulation revealed mosaic pattern of staining, with some cells, including osteoclasts, strongly stained and others exhibiting faint or no staining, thus supporting active regulation of BMP signaling within the lesion. Future investigations will determine if dysregulation of BMP signaling plays a causative role or rather reflects secondary activation of repair mechanisms and/or bone remodeling.

  10. Symptomatic Diverticular Disease in Patients With Severely Reduced Kidney Function: Higher Rates of Complications and Transfusion Requirement

    Science.gov (United States)

    Dirweesh, Ahmed; Amodu, Afolarin; Khan, Muhammad; Zijoo, Ritika; Ambreen, Bushra; Ibrahim, Mohammad; Ijaz, Muhammad; Nawwar, Abdelhameed; Genena, Kareem; Tahir, Muhammad; Kumar, Naresh; Debari, Vincent A.; Wallach, Sara

    2017-01-01

    Background The prevalence of diverticulosis is increasing with 5-10% of patients developing diverticulitis and 5-15% developing symptomatic bleeding. Diverticulitis can result in abscess, perforation, fistula, or obstruction. Bleeding has combined morbidity and mortality rates of 10-20%. The purpose of this study was to compare diverticulitis-related complications and transfusion requirements for diverticular bleeding in patients with normal to moderately reduced kidney function (glomerular filtration rate (GFR) ≥ 30 mL/min/1.73 m2) and patients with severe renal impairment (GFR diverticular bleeding treated at our hospital from January 1, 2011 to July 31, 2016. Patients were evaluated for baseline characteristics, GFR, baseline hemoglobin, medications, comorbidities, length of stay (LOS), presence of perforations or abscesses and the need for transfusion. Results Of the 291 patients included, males were 167 (58%). Perforations and abscesses complicating diverticulitis developed in 31/136 (23%) of patients with GFR ≥ 30 mL/min/1.73 m2, and in 13/26 (50%) of patients with GFR diverticular bleeding occurred in 11/78 (14%) of patients with GFR ≥ 30 mL/min/1.73 m2 and in 22/51 (43%) of patients with GFR diverticular bleeding and LOS in patients with severely reduced kidney function compared to patients with normal-moderately reduced renal function. PMID:28270872

  11. Nuclear factor κB inhibition reduces lung vascular lumen obliteration in severe pulmonary hypertension in rats.

    Science.gov (United States)

    Farkas, Daniela; Alhussaini, Aysar A; Kraskauskas, Donatas; Kraskauskiene, Vita; Cool, Carlyne D; Nicolls, Mark R; Natarajan, Ramesh; Farkas, Laszlo

    2014-09-01

    NF-κB and IL-6, a NF-κB downstream mediator, play a central role in the inflammatory response of tissues. We aimed to determine the role of the classical NF-κB pathway in severe pulmonary arterial hypertension (PAH) induced by SU5416 and chronic hypoxia (SuHx) in rats. Tissue samples from patients with idiopathic PAH (iPAH) and control subjects were investigated. SuHx rats were treated from Days 1 to 3, 1 to 21, and 29 to 42 with the NF-κB inhibitor pyrrolidine dithiocarbamate (PDTC) and/or from Days 1 to 21 with anti-IL-6 antibody. Nuclear staining for NF-κB, an indicator of the activation of the classical NF-κB pathway, was detected in pulmonary arterial lesions of patients with iPAH and SuHx rats. NF-κB inhibition with PDTC prevented and reduced pulmonary arterial obliteration without reducing muscularization. However, the elevated lung levels of IL-6 were not reduced in PDTC-treated SuHx animals. PDTC treatment prevented or reduced apoptosis of pulmonary artery wall cells and pulmonary arterial obliteration. IL-6 inhibition had only a partial effect on apoptosis and obliteration. Pulmonary arterial media wall thickness was not affected by any of these treatments. Preventive and therapeutic PDTC treatment promoted immune regulation by increasing the number of perivascular CD4(+) T cells, in particular regulatory T cells (early treatment), and by reducing the number of perivascular CD8(+) T lymphocytes and CD45RA(+) B lymphocytes. Therapeutic PDTC treatment further preserved right ventricular function in SuHx animals. Inhibition of NF-κB may represent a therapeutic option for pulmonary arterial obliteration via reduced vessel wall cell apoptosis and improved regulation of the immune system.

  12. Therapy with omalizumab for patients with severe allergic asthma improves asthma control and reduces overall healthcare costs.

    LENUS (Irish Health Repository)

    Costello, R W

    2012-02-01

    BACKGROUND: Patients with asthma who have persistent symptoms despite treatment with inhaled steroids and long-acting beta agonists are considered to have severe asthma. Omalizumab is a monoclonal antibody directed against IgE, which is used as an add-on treatment for patients who have severe persistent allergic asthma. AIMS: The aim of this study was to assess the clinical benefit and healthcare utilisation of patients who responded to omalizumab therapy and to establish an overall cost implication. METHODS: This was an observational retrospective cohort study designed to investigate the effect of omalizumab on exacerbations of asthma before and after 6 months of treatment in Irish patients. RESULTS: Centres who had treated patients with severe allergic asthma for the 6 months prior and post omalizumab treatment were audited with a standardised assessment tool. Sixty-three (32 male) patients were studied. In the 6 months prior to omalizumab 41 of 63 (66%) had been hospitalised, and this fell to 15 of 63 (24%), p < 0.0001 in the 6 months after treatment was started. Hospital admissions reduced from 2.4 +\\/- 0.41 to 0.8 +\\/- 0.37 and the mean number of bed days occupied was reduced from 16.6 +\\/- 2.94 to 5.3 +\\/- 2.57 days, p < 0.001. The number of oral corticosteroid doses used fell from 3.1 +\\/- 0.27 to 1.2 +\\/- 0.17, p < 0.001. The overall cost saving per omalizumab responder patients for 6 months was 834. CONCLUSIONS: Six months therapy with omalizumab reduced the number of bed days, the number of hospitalisations and the use of oral corticosteroids compared to the 6 months prior to commencement. Despite the cost of the additional therapy there were overall savings in health costs.

  13. The number of degrees of freedom for statistical distribution of s wave reduced neutron width for several nuclei

    International Nuclear Information System (INIS)

    Zhixiang, Z.

    1983-01-01

    The least squares fit has been performed using chi-squared distribution function for all available evaluated data for s-wave reduced neutron width of several nuclei. The number of degrees of freedom and average value have been obtained. The missing levels of weak s-wave resonances and extra p-wave levels have been taken into account, if any. For 75 As and 103 Rh, s-wave population has been separated by Bayes' theorem before making fit. The results thus obtained are consistent with Porter-Thomas distribution, i.e., chi-squared distribution with γ=1, as one would expect. It has not been found in this work that the number of degrees of freedom for the distribution of s-wave reduced neutron width might be greater than one as reported by H.C.Sharma et al. (1976) at the international conference on interactions of neutrons with nuclei. (Auth.)

  14. Iron supplementation reduces the frequency and severity of breath-holding attacks in non-anaemic children

    Directory of Open Access Journals (Sweden)

    Anthony Zehetner

    2011-11-01

    Full Text Available Iron supplementation reduces the frequency and severity of breath-holding attacks (BHAs, particularly in children with iron deficiency. The issue of iron supplementation is less clear for Westernized children with BHAs who present to an outpatient community clinic and are not iron-deficient. This is the first reported case series of iron-replete children with frequent and disabling breath-holding attacks who have responded to a course of oral iron supplementation. This intervention is safe, improves quality of life for both child and carer, and is significantly cost-effective in terms of health resource utilization.

  15. Maternal Serum Resistin Is Reduced in First Trimester Preeclampsia Pregnancies and Is a Marker of Clinical Severity

    DEFF Research Database (Denmark)

    Christiansen, Michael; Hedley, Paula L; Placing, Sophie

    2015-01-01

    OBJECTIVE: To examine whether resistin levels in first trimester maternal serum are associated with insulin resistance or preeclampsia (PE). METHODS: A case-control study of maternal serum resistin concentration conducted using 285 normal pregnancies and 123 PE pregnancies matched for gestational...... age, parity and maternal age. Samples were taken in gestational weeks 10(+0)-13(+6). RESULTS: There was a negative correlation between resistin and clinical severity of PE, but no correlation with IS, TNF-α, body mass index, birth weight and pregnancy length. CONCLUSIONS: Resistin is reduced in first...

  16. Return on investment from fuel treatments to reduce severe wildfire and erosion in a watershed investment program in Colorado.

    Science.gov (United States)

    Jones, Kelly W; Cannon, Jeffery B; Saavedra, Freddy A; Kampf, Stephanie K; Addington, Robert N; Cheng, Antony S; MacDonald, Lee H; Wilson, Codie; Wolk, Brett

    2017-08-01

    A small but growing number of watershed investment programs in the western United States focus on wildfire risk reduction to municipal water supplies. This paper used return on investment (ROI) analysis to quantify how the amounts and placement of fuel treatment interventions would reduce sediment loading to the Strontia Springs Reservoir in the Upper South Platte River watershed southwest of Denver, Colorado following an extreme fire event. We simulated various extents of fuel mitigation activities under two placement strategies: (a) a strategic treatment prioritization map and (b) accessibility. Potential fire behavior was modeled under each extent and scenario to determine the impact on fire severity, and this was used to estimate expected change in post-fire erosion due to treatments. We found a positive ROI after large storm events when fire mitigation treatments were placed in priority areas with diminishing marginal returns after treating >50-80% of the forested area. While our ROI results should not be used prescriptively they do show that, conditional on severe fire occurrence and precipitation, investments in the Upper South Platte could feasibly lead to positive financial returns based on the reduced costs of dredging sediment from the reservoir. While our analysis showed positive ROI focusing only on post-fire erosion mitigation, it is important to consider multiple benefits in future ROI calculations and increase monitoring and evaluation of these benefits of wildfire fuel reduction investments for different site conditions and climates. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Solitary Intra-Osseous Myofibroma of the Jaw: A Case Report and Review of Literature.

    Science.gov (United States)

    Dhupar, Anita; Carvalho, Karla; Sawant, Poonam; Spadigam, Anita; Syed, Shaheen

    2017-10-24

    Myofibroma is a rare benign spindle cell neoplasm in children that usually affects both soft tissue and bone in the head and neck region. Approximately one third of these cases are seen within jaw bones as solitary lesions. Solitary intra-osseous myofibroma of the jaw bone shares its clinical, radiographic and histological features with other spindle cell tumors. The rarity of this lesion can make diagnosis difficult for clinicians and pathologists. We report a case of a solitary intra-osseous myofibroma in the mandible of a nine-year-old child.

  18. [Osseous bridge after physeal-injury to the distal tibia with spontaneous resolution].

    Science.gov (United States)

    Trnka, J; Sýkora, L; Bibza, J

    2008-12-01

    The risk of osseous bridge development after certain types of physeal injury is well established. Once formed, the bridge continues to grow and results in a progressive deformity. The authors present an unusual case of a five-year-old girl who had a Salter-Harris Type-IV fracture of the distal tibial epiphyseal plate, with subsequent osseous bridge formation and deformity development. The bridge resolved spontaneously in 16 months, and joint mechanical axis alignment was gradually restored with normal growth of the distal tibia. Key words: physis, paediatric fractures, bony bridge, growth arrest.

  19. Radiological features of a fibro-osseous pseudotumor in the digit: A case report

    International Nuclear Information System (INIS)

    Kwak, Min Jae; Kim, Sun Ki; Lee, Sang Uk; Jun, Sun Young; Lee, An Hi

    2015-01-01

    A fibro-osseous pseudotumor is a rare ossifying soft tissue lesion, which is thought to be a reactive rather than a neoplastic lesion, developing due to repeated trauma. The lesion mostly occurs in the subcutaneous tissue of the proximal phalanx of the digit and predominantly affects young adults, with a slight predominance in females. The clinicopathological features can mimic those of malignant soft tissue lesions, and diagnosis can be difficult. Less is known about the radiological appearance of the lesion, including magnetic resonance imaging (MRI) features, than about histological signs. Here, we report radiological findings, including MRI features, of a fibro-osseous pseudotumor of the digit in a young female

  20. Probiotic supplementation reduces the duration and incidence of infections but not severity in elite rugby union players.

    Science.gov (United States)

    Haywood, Brylee A; Black, Katherine E; Baker, Dane; McGarvey, James; Healey, Phil; Brown, Rachel C

    2014-07-01

    The attenuation of the number and severity of infections is of importance to athletes. Probiotics use has increased over recent years with beneficial effects believed to include improvements in immune function. Research has focused on their effectiveness for reducing the number, duration and severity of infections amongst endurance athletes. At present no research has been undertaken with team sport athletes. This randomised controlled trial aimed to determine the effectiveness of probiotics on the number, duration and severity of infections amongst elite union rugby players. Randomised control trial with two arms; placebo and probiotic. Thirty elite rugby union players were allocated in random order to receive a probiotics supplement or a placebo for four weeks each. Supplements were consumed on a daily basis. There was a four week washout period between treatments. Participants completed a daily diary to identify and rate the severity of any infectious symptoms. During the probiotic treatment 14/30 participants never experienced a single upper respiratory tract illness (URTI) or gastrointestinal (GI) episode, compared to 6/30 on the placebo supplementation (p=0.033). The mean±standard deviation for the number of days of illness tended to be higher for the placebo, (5.8±6.6 days) than probiotic (3.4±4.6 days), (p=0.054). There was no significant difference in the severity of the symptoms between the two treatment groups (p=0.110). These positive effects of probiotic supplements provide evidence for the beneficial effects of daily supplementation with these probiotic strains in highly trained rugby union players. Copyright © 2013 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  1. Low renal but high extrarenal phenotype variability in Schimke immuno-osseous dysplasia.

    Directory of Open Access Journals (Sweden)

    Beata S Lipska-Ziętkiewicz

    Full Text Available Schimke immuno-osseous dysplasia (SIOD is a rare multisystem disorder with early mortality and steroid-resistant nephrotic syndrome (SRNS progressing to end-stage kidney disease. We hypothesized that next-generation gene panel sequencing may unsurface oligosymptomatic cases of SIOD with potentially milder disease courses. We analyzed the renal and extrarenal phenotypic spectrum and genotype-phenotype associations in 34 patients from 28 families, the largest SMARCAL1-associated nephropathy cohort to date. In 11 patients the diagnosis was made unsuspectedly through SRNS gene panel testing. Renal disease first manifested at median age 4.5 yrs, with focal segmental glmerulosclerosis or minimal change nephropathy on biopsy and rapid progression to end-stage kidney disease (ESKD at median age 8.7 yrs. Whereas patients diagnosed by phenotype more frequently developed severe extrarenal complications (cerebral ischemic events, septicemia and were more likely to die before age 10 years than patients identified by SRNS-gene panel screening (88 vs. 40%, the subgroups did not differ with respect to age at proteinuria onset and progression to ESKD. Also, 10 of 11 children diagnosed unsuspectedly by Next Generation Sequencing were small at diagnosis and all showed progressive growth failure. Severe phenotypes were usually associated with biallelic truncating mutations and milder phenotypes with biallelic missense mutations. However, no genotype-phenotype correlation was observed for the renal disease course. In conclusion, while short stature is a reliable clue to SIOD in children with SRNS, other systemic features are highly variable. Our findings support routine SMARCAL1 testing also in non-syndromic SRNS.

  2. Reduced intensity conditioning, combined transplantation of haploidentical hematopoietic stem cells and mesenchymal stem cells in patients with severe aplastic anemia.

    Directory of Open Access Journals (Sweden)

    Xiao-Hong Li

    Full Text Available We examined if transplantation of combined haploidentical hematopoietic stem cells (HSC and mesenchymal stem cells (MSC affected graft failure and graft-versus-host disease (GVHD in patients with severe aplastic anemia (SAA. Patients with SAA-I (N = 17 received haploidentical HSCT plus MSC infusion. Stem cell grafts used a combination of granulocyte colony-stimulating factor (G-CSF-primed bone marrow and G-CSF-mobilized peripheral blood stem cells of haploidentical donors and the culture-expanded third-party donor-derived umbilical cord MSCs (UC-MSCs, respectively. Reduced intensity conditioning consisted of fludarabine (30 mg/m2·d+cyclosphamide (500 mg/m2·d+anti-human thymocyte IgG. Transplant recipients also received cyclosporin A, mycophenolatemofetil, and CD25 monoclonal antibody. A total of 16 patients achieved hematopoietic reconstitution. The median mononuclear cell and CD34 count was 9.3×10(8/kg and 4.5×10(6/kg. Median time to ANC was >0.5×10(9/L and PLT count >20×10(9/L were 12 and 14 days, respectively. Grade III-IV acute GVHD was seen in 23.5% of the cases, while moderate and severe chronic GVHD were seen in 14.2% of the cases. The 3-month and 6-month survival rates for all patients were 88.2% and 76.5%, respectively; mean survival time was 56.5 months. Combined transplantation of haploidentical HSCs and MSCs on SAA without an HLA-identical sibling donor was safe, effectively reduced the incidence of severe GVHD, and improved patient survival.

  3. Diagnosis and management of benign fibro-osseous lesions of the jaws: a current review for the dental clinician.

    Science.gov (United States)

    Mainville, G N; Turgeon, D P; Kauzman, A

    2017-05-01

    Benign fibro-osseous lesions of the maxillofacial skeleton constitute a heterogeneous group of disorders that includes developmental, reactive (dysplastic) and neoplastic lesions. Although their classification has been reviewed multiple times in the past, the most common benign fibro-osseous lesions are fibrous dysplasia, osseous dysplasia and ossifying fibroma. For the dental clinician, the challenges involve diagnosis and treatment (or lack thereof). A careful correlation of all clinical, radiologic and microscopic features is essential to establish a proper diagnosis and a clear treatment plan. This article aimed to review the clinical, radiologic and histopathologic characteristics of benign fibro-osseous lesions of the jaws, with emphasis on their differential diagnoses. With a deeper understanding of benign fibro-osseous lesions, clinicians will be better prepared to manage these lesions in their practice. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  4. Therapy with omalizumab for patients with severe allergic asthma improves asthma control and reduces overall healthcare costs.

    LENUS (Irish Health Repository)

    Costello, R W

    2011-05-11

    BACKGROUND: Patients with asthma who have persistent symptoms despite treatment with inhaled steroids and long-acting beta agonists are considered to have severe asthma. Omalizumab is a monoclonal antibody directed against IgE, which is used as an add-on treatment for patients who have severe persistent allergic asthma. AIMS: The aim of this study was to assess the clinical benefit and healthcare utilisation of patients who responded to omalizumab therapy and to establish an overall cost implication. METHODS: This was an observational retrospective cohort study designed to investigate the effect of omalizumab on exacerbations of asthma before and after 6 months of treatment in Irish patients. RESULTS: Centres who had treated patients with severe allergic asthma for the 6 months prior and post omalizumab treatment were audited with a standardised assessment tool. Sixty-three (32 male) patients were studied. In the 6 months prior to omalizumab 41 of 63 (66%) had been hospitalised, and this fell to 15 of 63 (24%), p < 0.0001 in the 6 months after treatment was started. Hospital admissions reduced from 2.4 ± 0.41 to 0.8 ± 0.37 and the mean number of bed days occupied was reduced from 16.6 ± 2.94 to 5.3 ± 2.57 days, p < 0.001. The number of oral corticosteroid doses used fell from 3.1 ± 0.27 to 1.2 ± 0.17, p < 0.001. The overall cost saving per omalizumab responder patients for 6 months was 834. CONCLUSIONS: Six months therapy with omalizumab reduced the number of bed days, the number of hospitalisations and the use of oral corticosteroids compared to the 6 months prior to commencement. Despite the cost of the additional therapy there were overall savings in health costs.

  5. Pruning high-value Douglas-fir can reduce dwarf mistletoe severity and increase longevity in central Oregon

    Science.gov (United States)

    Maffei, Helen M; Filip, Gregory M; Gruelke, Nancy E; Oblinger, Brent W; Margolis, Ellis; Chadwick, Kristen L

    2016-01-01

    little effect on resources available for tree growth and maintenance. In the severely pruned trees, tree-ring width was reduced for several years post-pruning, but then compensated with larger ring width in later years. Both NDVI and LCR increment were significantly higher for the pruned trees than the control trees, while the development of severe infections and/or dead tops was significantly (5X and 3X) higher for the controls. If possible, multiple indicators of tree vitality should be evaluated. Pruning can be worthwhile even if all the mistletoe is not removed, because mistletoe intensification is delayed. The impact of removing the brooms seems to be minimal, and post-pruning crowns had greater NDVI values.

  6. Saccharomyces boulardii and bismuth subsalicylate as low-cost interventions to reduce the duration and severity of cholera.

    Science.gov (United States)

    Sheele, Johnathan; Cartowski, Jessica; Dart, Angela; Poddar, Arjun; Gupta, Shikha; Stashko, Eric; Ravi, Bhaskara S; Nelson, Crawford; Gupta, Ajay

    2015-09-01

    We conducted a randomised single-blinded clinical trial of 100 cholera patients in Port-au-Prince, Haiti to determine if the probiotic Saccharomyces cerevisiae var. boulardii and the anti-diarrhoeal drug bismuth subsalicylate (BS) were able to reduce the duration and severity of cholera. Subjects received either: S. boulardii 250 mg, S. boulardii 250 mg capsule plus BS 524 mg tablet, BS 524 mg, or two placebo capsules every 6 hours alongside standard treatment for cholera. The length of hospitalisation plus the number and volume of emesis, stool and urine were recorded every 6 hours until the study subject was discharged (n = 83), left against medical advice (n = 11), or requested removal from the study (n = 6). There were no reported deaths or adverse study-related events. There were no statistically significant differences between the study arms and the outcomes of interest.

  7. Treatment of severe cholera: a review of strategies to reduce stool output and volumes of rehydration fluid.

    Science.gov (United States)

    Butler, Thomas

    2017-05-01

    Severe cholera is a life-threatening illness of hypovolemic shock and metabolic acidosis due to rapid and profuse diarrheal fluid loss. Emergency life-saving therapy is i.v. saline, optionally supplemented with potassium and alkali to correct the fluid deficit, potassium losses and acidosis. After this initial rehydration, for the next 2 days ongoing stool losses are replaced with oral rehydration solution (ORS), which contains sodium chloride, potassium and alkali together with glucose or rice powder as a source of glucose to serve as a carrier for sodium. In actual field trials, antibiotics are given to reduce fluid requirements, but large volumes averaging about 7 liters of i.v. fluid followed by about 14 liters of ORS have been given to adult patients. Disturbing trends during therapy have included overhydration, hyponatremia and polyuria. It is suggested that stool output and fluid requirements could be reduced, if borne out in future research, by avoiding overhydration by restricting ORS intake to match stool output and promoting intestinal reabsorption of luminal fluid by early introduction of glucose without salts into the intestine, more gradual correction of dehydration, giving mineralocorticoid and vasopressin, and infusing glucose or short-chain fatty acids into the proximal colon. © The Author 2017. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  8. Peptidylarginine deiminase type 4 deficiency reduced arthritis severity in a glucose-6-phosphate isomerase-induced arthritis model.

    Science.gov (United States)

    Seri, Yu; Shoda, Hirofumi; Suzuki, Akari; Matsumoto, Isao; Sumida, Takayuki; Fujio, Keishi; Yamamoto, Kazuhiko

    2015-08-21

    Peptidyl arginine deiminase 4 (PAD4) is an enzyme that is involved in protein citrullination, and is a target for anti-citrullinated peptide antibodies (ACPAs) in rheumatoid arthritis (RA). Genetic polymorphisms in the PADI4 gene encoding PAD4 are associated with RA susceptibility. We herein analyzed the roles of PADI4 in inflammatory arthritis using a glucose-6-phosphate isomerase (GPI)-induced arthritis (GIA) model in Padi4 knockout (KO) mice. Arthritis severity, serum anti-GPI antibody titers, and IL-6 concentrations were significantly reduced in Padi4 KO mice. The frequency of Th17 cells was decreased in GPI-immunized Padi4 KO mice, whereas WT and Padi4-deficient naïve CD4(+) T cells displayed the same efficiencies for Th17 cell differentiation in vitro. In addition, the numbers of myeloid lineage cells were reduced with the increased expression of pro-apoptotic genes in GPI-immunized Padi4 KO mice. Furthermore, the survival of Padi4-deficient neutrophils was impaired in vitro. Our results suggest that PADI4 exacerbates arthritis with diverse immunological modifications.

  9. Intrajejunal Infusion of Levodopa-Carbidopa Gel Can Continuously Reduce the Severity of Dropped Head in Parkinson’s Disease

    Directory of Open Access Journals (Sweden)

    Hiroshi Kataoka

    2017-10-01

    Full Text Available Dropped head can occur in patients with Parkinson’s disease and make their quality of life unpleasant because they cannot obtain a frontal view. The pathophysiologic involvement of dopamine agonist or central or peripheral mechanisms has been proposed. Levodopa therapy with the withdrawal of dopamine agonists was sometimes effective, but the effect in most patients did not persist for the entire day. We describe a patient with Parkinson’s disease whose dropped head responded throughout the day to the continuous intrajejunal infusion of levodopa-carbidopa intestinal gel (LCIG. During off-periods before treatment with LCIG, severe akinesia and freezing of gait were evident, and she could not continuously obtain a frontal view because of the dropped head. About 20 min after the intrajejunal infusion of LCIG, these features remarkably improved, and she could obtain a frontal view. The angle of dropped head was improved from 39.39 to 14.04°. This case suggests that infusion of LCIG can reduce the severity of dropped head for a longer period than oral levodopa.

  10. Complications of the use of trans-osseous wire osteosynthesis in the ...

    African Journals Online (AJOL)

    healing phase of the fractures with good treatment outcomes.10-12 Consequently, because the indications ..... healing.7-9 The inter-maxillary fixation provided the true stabilization of the fractures, while the trans-osseous ... sensation in the lower lip, cheek and tongue due to injury to inferior alveolar and lingual nerve.26, 27.

  11. Benign fibro-osseous lesions of the jaw bones in Jamaica: analysis of 32 cases.

    Science.gov (United States)

    Ogunsalu, C O; Lewis, A; Doonquah, L

    2001-05-01

    It is intended to analyse all the cases of benign fibro-osseous lesions seen at the two major public hospitals in Jamaica over a 15-year period and to compare our result with what has been previously documented by other authors. No such analysis has been carried out in Jamaica or elsewhere in the English-speaking Caribbean. The case files of patients histologically diagnosed to have a fibro-osseous lesion at both the Kingston Public Hospital and the Cornwall Regional Hospital in Jamaica from 1980 to 1995 were retrieved and information about these lesions was documented. The WHO classification for benign fibro-osseous lesions was used. A total of 32 cases of benign fibro-osseous lesions were recorded over the 15-year period. Of these, 15 were histologically reported as fibrous dysplasia, 10 as ossifying fibroma, three as gigantiform cementoma, one each as periapical cemental dysplasia and cementoblastoma, and two cases of recurrent fibrous dysplasia. With the exception of gigantiform cementoma the age at presentation for these lesions is not consistent and this can be particularly noted for ossifying fibroma and fibrous dysplasia, both of which occurred between the age of 10 and 68 years. These lesions are more common in females, furthermore it is suggested that the inconsistent age at presentation for some of these lesions may be peculiar to Jamaica, and may be due to delay in reporting a lesion by the patient, as routine dental examination is not a common practice.

  12. Benign fibro-osseous lesions of the jaws in children. A 12-year retrospective study.

    Science.gov (United States)

    Kolomvos, Nikolaos; Theologie-Lygidakis, Nadia; Christopoulos, Panagiotis; Iatrou, Ioannis

    2013-10-01

    Fibro-osseous lesions, a diverse group of bone disorders including developmental, reactive or dysplastic diseases and neoplasms, share overlapping clinical, radiographic and histopathologic features and demonstrate a wide range of biological behaviour. To evaluate the characteristics, treatment and outcome of benign fibro-osseous lesions of the jaws in children. All patients with fibro-osseous lesions of the jaws treated at the department of Oral and Maxillofacial Surgery of the «A & P Kyriakou» Children's Hospital of Athens from 2000 to 2011 were included in this study. Data were retrieved from patients' files and their present situation was registered. Sixteen males and 10 females (mean age 8.5 years) were treated. Fibrous dysplasia was most often encountered (26.9%), and the mandible was the most frequent location (76.9%). All cases were surgically treated and histopathologically confirmed. Marginal ostectomy was performed in 7 cases, partial ostectomy in 4, enucleation and curettage in 10 and trimming-remodelling in 5 cases. Mean follow-up was of 5.5 years with no recurrence, except in one case of fibrous dysplasia. Fibro-osseous lesions, although sharing similar microscopic features, exhibit a variety of clinical behaviour rendering their treatment highly individualized. Copyright © 2012 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  13. Florid cemento-osseous dysplasia: report of two cases and review of the literature

    International Nuclear Information System (INIS)

    Melo, Alessandro Severo Alves de; Torres, Erika Esteves Araujo; Keppke, Ana Luiza Leitao; Vianna, Alberto Domingues; Mello, Walter de Assis; Marchiori, Edson

    1998-01-01

    The present paper describes two cases of floride cemento-osseous dysplasia in black women. The radiographs showed sclerotic lesion in the mandible, in both cases, and in the maxilla, in one case. After resection of the lesions the evolutions were favorable. The authors show radiologic characteristics and review the literature. (author)

  14. Florid cemento-osseous dysplasia: a report of two cases seen at The ...

    African Journals Online (AJOL)

    Florid cemento-osseous dysplasia (FCOD) is commonly seen in black women, but few cases have been reported in sub-Saharan Africa. This article presents two cases of FCOD seen at the University College Hospital Ibadan. Two women aged 70 and 60 years were initially diagnosed as chronic osteomyelitis but both were ...

  15. Transcranial radiograph and magnetic resonance imaging in the evaluation of osseous changes of the temporomandibular joint

    International Nuclear Information System (INIS)

    Cho, Soo Beom; Koh, Kwang Joon

    2002-01-01

    To evaluate the diagnostic accuracy of transcranial radiographs and magnetic resonance imaging (MRI) of the temporomandibular joint (TMJ) in the assessment of osseous changes of the condylar head and articular eminence. Osseous changes of the TMJ were evaluated in forty-three patients. Osseous changes of the condylar head and articular eminence were observed in 41 joints and 64 joints, respectively on transcranial radiographs, and 48 joints and 59 joints, respectively on MRI. The flattening, sclerosis, erosion, and osteophyte formation of the condylar heads were observed in 36.6%, 43.9%, 12.2%, and 7.3%, respectively on transcranial radiographs compared with 35.4%, 20.8%, 37.5%, and 6.3%, respectively on MRI. While, the flattening, sclerosis, and erosion of the articular eminences were observed in 26.6%, 67.2%, and 6.2%, respectively on transcranial radiographs compared with 32.2%, 59.3%, and 8.5%, respectively on MRI. There were no statistical differences between transcranial radiographs and MRI scans in the detection of osseous changes of the TMJ. However, MRI scans were superior to the transcranial radiographs in the detection of erosion of the condylar head (p<0.01).

  16. Early detection of type 2 diabetes mellitus and screening for retinopathy are associated with reduced prevalence and severity of retinopathy.

    Science.gov (United States)

    Olafsdottir, Eydis; Andersson, Dan K G; Dedorsson, Inger; Svärdsudd, Kurt; Jansson, Stefan P O; Stefánsson, Einar

    2016-05-01

    To explore whether the prevalence and severity of retinopathy differ in diabetes cohorts diagnosed through screening as compared with conventional health care. A total of 257 diabetes patients, 151 detected through screening and 106 through conventional clinical care, were included. Retinopathy was evaluated by fundus photography. The modified Airlie House adaptation of the Early Treatment Retinopathy Study protocol was used to grade the photographs. Averages of clinically collected fasting blood glucose (FBG), blood pressure and body mass index values were compiled from diabetes diagnosis until the eye examination. Blood chemistry, smoking habits and peripheral neuropathy were assessed at the time of the eye examination. Among the screening-detected patients, 22% had retinopathy as compared to 51% among those clinically detected (p retinopathy were more likely to have increased average FBG (OR 1.42, 95% CI 1.19-1.70 per mmol/l) and peripheral neuropathy (OR 2.75, 95% CI 1.40-5.43), but less likely to have screening-detected diabetes (OR 0.31, 95% CI 0.17-0.57). Similar results were found using increasing severity grade of retinopathy as outcome. The cumulative retinopathy prevalence for the screening-detected diabetes cohort as compared with the clinically diagnosed cohort was significantly lower from 10 years' follow-up and onwards (p = 0.0002). Among patients with screening-detected diabetes, the prevalence of retinopathy and increasing severity of retinopathy were significantly lower than among those who had their diabetes diagnosed through conventional care, even when other risk factors for retinopathy such as duration, hyperglycaemia and blood pressure were considered. Early detection of diabetes reduces prediagnostic time spent with hyperglycaemia. In combination with early and regular screening for retinopathy, more effective prevention against retinopathy can be provided. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons

  17. Glucagon-like peptide-1 analogue, liraglutide, delays onset and reduces severity of experimental autoimmune encephalitis in Lewis rats

    Directory of Open Access Journals (Sweden)

    Brian DellaValle

    2016-11-01

    Full Text Available AbstractIntroduction: Recent findings indicate that metabolic disturbances are involved in multiple sclerosis (MS pathology and influence the susceptibility to treatment, directing attention towards anti-diabetic drugs such as metformin and pioglitazone. Liraglutide, a drug of the glucagon-like peptide-1 (GLP-1 family, is also anti-diabetic and weight-reducing and is moreover, directly neuroprotective and anti-inflammatory in a broad spectrum of experimental models of brain disease. In this study we investigate the potential for this FDA-approved drug, liraglutide, as a treatment for MS by utilizing the experimental model, experimental autoimmune encephalitis (EAE.Methods: EAE was induced in 30 female Lewis rats that subsequently received twice-daily liraglutide (200 µg/kg s.c. or saline. Healthy controls were included (saline, n=6, liraglutide, n=7. Clinical score and weight were assessed daily by blinded observers. Animals were killed at peak disease severity (day 11 or if exceeding humane endpoint (clinical score ≥4. Protein levels of manganese superoxide dismutase (MnSOD, amyloid precursor protein (APP, and glial fibrillary acidic protein (GFAP were determined.Results: Liraglutide treatment delayed disease onset (group clinical score significantly >0 by two days and markedly reduced disease severity (median clinical score 2 vs. 5; p=0.0003. Fourteen of 15 (93% of vehicle-treated rats reached the humane endpoint (clinical score ≥4 by day 11 compared to 5 of 15 (33% of liraglutide-treated rats (p=0.0004. Liraglutide substantially increased the mitochondrial antioxidant MnSOD (p<0.01 and reduced the neurodegenerative marker APP (p=0.036 in the brain. GFAP levels were not significantly changed with drug treatment (p=0.09Conclusion: We demonstrate, for the first time, that liraglutide treatment delays onset of EAE in Lewis rats and is associated with improved protective capacity against oxidative stress. These data suggest GLP-1 receptor

  18. Giant cell tumors of the tendon sheath may present radiologically as intrinsic osseous lesions

    Energy Technology Data Exchange (ETDEWEB)

    Schepper, A.M. de; Bloem, J.L. [Leiden University Medical Center, Department of Radiology, Albinusdreef 2, P.O. Box 9600, RC Leiden (Netherlands); Hogendoorn, P.C.W. [Leiden University Medical Center, Department of Pathology, Albinusdreef 2, P.O. Box 9600, RC Leiden (Netherlands)

    2007-02-15

    The purpose of this study was to explain radiographic features of giant cell tumors of the tendon sheath (GCTTS), in particular, osseous extension, by correlating imaging findings with histology in order to increase the accuracy of radiological diagnosis. In a series of 200 consecutive osseous (pseudo) tumors of the hand, on radiography, six patients presented with an intrinsic osseous lesion caused by a histologically confirmed neighboring GCTTS. Available radiographs, computed tomography (CT), and contrast-enhanced magnetic resonance (MR) images were correlated with histology. Radiography showed osseous lesions consisting of well-defined cortical defects in four (one of whom also demonstrated cortical scalloping) and a slightly expansile, well-defined osteolytic lesion in two patients. MR obtained in four patients showed the extraosseous tumor invading/eroding bone and causing cortical scalloping (three and one patients, respectively). Extension depicted on MR was confirmed on the two available resection specimens. All lesions were polylobular (cauliflower or mushroom like) and neighbored tendon sheaths. Dense collagen and hemosiderin-loaded macrophages explained the high CT attenuation and the low MR signal intensity on T2-weighted images that was observed in all four MR and in all two CT scans. The high density of proliferative capillaries explained the marked enhancement observed in all four patients with gadolinium (Gd)-chelate-enhanced MR imaging. GCTTS is a soft tissue (pseudo) tumor that may invade bone and as a consequence mimick an intrinsic osseous lesion on radiographs. In such cases, specific MR and CT features that can be explained by histological findings can be used to suggest the correct diagnosis. (orig.)

  19. Calcium phosphate barrier for augmentation of bone in noncontained periodontal osseous defects: a novel approach.

    Science.gov (United States)

    Chopra, Aditi; Sivaraman, Karthik; Awataramaney, Tarun K

    2014-11-01

    The aim of this technique is to augment bone in non-contained osseous deformities using a unique self-sustaining calcium phosphate barrier. Bone has the inherent ability to regenerate completely if it is provided with a fracture space or an undisturbed enclosed scaffold. A secluded environment is essential as it provides a secured, sterile and stable wound system that regenerates lost bone by a process of osteopromotion. Reconstructive techniques using bone grafts and barrier membranes utilize this principle for augmentation of deficient bony sites by providing a closed environment that promotes clot stability, graft retention, and facilitates correct cell repopulation. However, in noncontained bone defects like one walled infrabony periodontal defect or sites with horizontal bone loss, regeneration of bone still remains an unrealistic situation since osseous topography at such sites does not favor membrane stability or bone grafts retention. This case report presents a promising technique to augment bone in areas with horizontal loss. Augmentation of bone in the interdental area with horizontal bone loss was accomplished by building a contained defect using a unique self sustaining calcium phosphate cement formulation. The calcium phosphate barrier stimulates the lost cortical plates and promotes graft retention and clot stability. At 6 months, there was a significant bone fill and trabecular formation in the interdental area and reduction in tooth mobility. This promising technique could prove to be a good alternative to the conventional approaches for treating osseous deformities. Calcium phosphate is a promising barrier graft for repair of noncontained periodontal osseous defect. This technique cues both the clinicians and manufacturers to develop moldable tissue engineered constructs for osseous repair.

  20. Therapy with proton-pump inhibitors for gastroesophageal reflux disease does not reduce the risk for severe exacerbations in COPD.

    Science.gov (United States)

    Baumeler, Luzia; Papakonstantinou, Eleni; Milenkovic, Branislava; Lacoma, Alicia; Louis, Renaud; Aerts, Joachim G; Welte, Tobias; Kostikas, Konstantinos; Blasi, Francesco; Boersma, Wim; Torres, Antoni; Rohde, Gernot G U; Boeck, Lucas; Rakic, Janko; Scherr, Andreas; Tamm, Michael; Stolz, Daiana

    2016-07-01

    Gastroesophageal reflux disease (GERD) symptoms are associated with a higher risk of chronic obstructive pulmonary disease (COPD) exacerbation. We hypothesize that treatment with proton pump inhibitors reduces the risk of exacerbation in patients with stable COPD. A total of 638 patients with stable COPD for ≥6 weeks, ≥10 pack-years of smoking and Global Initiative for Chronic Obstructive Lung Disease II-IV seeking care in tertiary hospitals in eight European countries in the Predicting Outcome using Systemic Markers in Severe Exacerbations-COPD cohort was prospectively evaluated by us. Comorbidities including associated medical treatment were assessed at baseline, at exacerbation and at biannual visits. Median observation time was 24 months. The primary study outcomes were exacerbation and/or death. A total of 85 (13.3%) of COPD patients were on anti-GERD therapy. These patients had higher annual and higher severe exacerbation rates (P = 0.009 and P = 0.002), decreased quality of life (SF-36: activity score P = 0.004, St. George's Respiratory Questionnaire: physical functioning P = 0.013 and social functioning P = 0.007), higher body mass airflow obstruction, dyspnea and exercise capacity index (P = 0.033) and Modified Medical Research Council scores (P = 0.002), shorter 6-min walking distance (P = 0.0004) and a higher adjusted Charlson score (P GERD therapy was associated with a shorter time to severe exacerbation (HR 2.05 95% CI 1.37-3.08). Using three multivariable Cox-regression models, this association was independent of the following: (i) adjusted Charlson score and FEV1% predicted (HR 1.91 95% CI 1.26-2.90); (ii) adjusted Charlson score, body mass, airflow obstruction, dyspnea and exercise capacity index and Modified Medical Research Council (HR 1.62 95% CI 1.04-2.54); and (iii) adjusted Charlson score, FEV1% predicted and nine classes of medication for comorbidities (HR 1.63 95% CI 1.04-2.53). These findings

  1. Human mesenchymal stem cells reduce the severity of acute lung injury in a sheep model of bacterial pneumonia.

    Science.gov (United States)

    Asmussen, Sven; Ito, Hiroshi; Traber, Daniel L; Lee, Jae W; Cox, Robert A; Hawkins, Hal K; McAuley, Daniel F; McKenna, David H; Traber, Lillian D; Zhuo, Hanjing; Wilson, Jennifer; Herndon, David N; Prough, Donald S; Liu, Kathleen D; Matthay, Michael A; Enkhbaatar, Perenlei

    2014-09-01

    Human bone marrow-derived mesenchymal stem (stromal) cells (hMSCs) improve survival in mouse models of acute respiratory distress syndrome (ARDS) and reduce pulmonary oedema in a perfused human lung preparation injured with Escherichia coli bacteria. We hypothesised that clinical grade hMSCs would reduce the severity of acute lung injury (ALI) and would be safe in a sheep model of ARDS. Adult sheep (30-40 kg) were surgically prepared. After 5 days of recovery, ALI was induced with cotton smoke insufflation, followed by instillation of live Pseudomonas aeruginosa (2.5×10(11) CFU) into both lungs under isoflurane anaesthesia. Following the injury, sheep were ventilated, resuscitated with lactated Ringer's solution and studied for 24 h. The sheep were randomly allocated to receive one of the following treatments intravenously over 1 h in one of the following groups: (1) control, PlasmaLyte A, n=8; (2) lower dose hMSCs, 5×10(6) hMSCs/kg, n=7; and (3) higher-dose hMSCs, 10×10(6) hMSCs/kg, n=4. By 24 h, the PaO2/FiO2 ratio was significantly improved in both hMSC treatment groups compared with the control group (control group: PaO2/FiO2 of 97±15 mm Hg; lower dose: 288±55 mm Hg (p=0.003); higher dose: 327±2 mm Hg (p=0.003)). The median lung water content was lower in the higher-dose hMSC-treated group compared with the control group (higher dose: 5.0 g wet/g dry [IQR 4.9-5.8] vs control: 6.7 g wet/g dry [IQR 6.4-7.5] (p=0.01)). The hMSCs had no adverse effects. Human MSCs were well tolerated and improved oxygenation and decreased pulmonary oedema in a sheep model of severe ARDS. NCT01775774 for Phase 1. NCT02097641 for Phase 2. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  2. Development of quantitative analysis method for stereotactic brain image. Assessment of reduced accumulation in extent and severity using anatomical segmentation

    International Nuclear Information System (INIS)

    Mizumura, Sunao; Kumita, Shin-ichiro; Cho, Keiichi; Ishihara, Makiko; Nakajo, Hidenobu; Toba, Masahiro; Kumazaki, Tatsuo

    2003-01-01

    Through visual assessment by three-dimensional (3D) brain image analysis methods using stereotactic brain coordinates system, such as three-dimensional stereotactic surface projections and statistical parametric mapping, it is difficult to quantitatively assess anatomical information and the range of extent of an abnormal region. In this study, we devised a method to quantitatively assess local abnormal findings by segmenting a brain map according to anatomical structure. Through quantitative local abnormality assessment using this method, we studied the characteristics of distribution of reduced blood flow in cases with dementia of the Alzheimer type (DAT). Using twenty-five cases with DAT (mean age, 68.9 years old), all of whom were diagnosed as probable Alzheimer's disease based on National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA), we collected I-123 iodoamphetamine SPECT data. A 3D brain map using the 3D-stereotactic surface projections (SSP) program was compared with the data of 20 cases in the control group, who age-matched the subject cases. To study local abnormalities on the 3D images, we divided the whole brain into 24 segments based on anatomical classification. We assessed the extent of an abnormal region in each segment (rate of the coordinates with a Z-value that exceeds the threshold value, in all coordinates within a segment), and severity (average Z-value of the coordinates with a Z-value that exceeds the threshold value). This method clarified orientation and expansion of reduced accumulation, through classifying stereotactic brain coordinates according to the anatomical structure. This method was considered useful for quantitatively grasping distribution abnormalities in the brain and changes in abnormality distribution. (author)

  3. [Ridge preservation with synthetic nanocrystalline hydroxyapatite reduces the severity of gingival invaginations-a prospective clinical study].

    Science.gov (United States)

    Reichert, Christoph; Wenghoefer, Matthias; Kutschera, Eric; Götz, Werner; Jäger, Andreas

    2014-01-01

    Gingival invaginations develop after tooth extraction and subsequent orthodontic space closure. Aetiological factors and long-term effects of gingival invaginations on oral health are nearly unknown. In addition, preventive or therapeutic strategies are rare. This prospective clinical study employing the split mouth technique was performed to investigate the effect of extraction socket augmentation with a synthetic nanocrystalline hydroxyapatite (NanoBone(®) Artoss, Rostock, Germany) on the incidence and degree of gingival invaginations. A total of 10 orthodontic patients with need for symmetric premolar extractions offering a total of 28 extractions were included in this trial. The study plan provided one extraction site to be augmented with synthetic nanocrystalline hydroxyapatite (NanoBone(®)), the other served as control. After primary wound healing, space closure was performed under defined biomechanical conditions. After space closure was accomplished, occurrence and degree of gingival invaginations as well as probing depths of the adjacent teeth mesial and distal to the extractions were determined and dental radiographs were taken. The degree of gingival invaginations and probing depths mesial and distal of the extraction were significantly reduced on NanoBone(®) augmented extraction sites. In addition, 70% of the radiographs revealed translucent and hyperdense areas on the intervention side after space closure. Apical root resorption was found in 2 patients on both the NanoBone(®) side and the control side. Ridge preservation with NanoBone(®) appeared to reduce the severity of gingival invaginations. Further investigation on long-term effects is mandatory to eliminate the appearance of adverse effects.

  4. Can martial arts techniques reduce fall severity? An in vivo study of femoral loading configurations in sideways falls.

    Science.gov (United States)

    van der Zijden, A M; Groen, B E; Tanck, E; Nienhuis, B; Verdonschot, N; Weerdesteyn, V

    2012-06-01

    Sideways falls onto the hip are a major cause of femoral fractures in the elderly. Martial arts (MA) fall techniques decrease hip impact forces in sideways falls. The femoral fracture risk, however, also depends on the femoral loading configuration (direction and point of application of the force). The purpose of this study was to determine the effect of fall techniques, landing surface and fall height on the impact force and the loading configuration in sideways falls. Twelve experienced judokas performed sideways MA and Block ('natural') falls on a force plate, both with and without a judo mat on top. Kinematic and force data were analysed to determine the hip impact force and the loading configuration. In falls from a kneeling position, the MA technique reduced the impact force by 27%, but did not change the loading configuration. The use of the mat did not change the loading configuration. Falling from a standing changed the force direction. In all conditions, the point of application was distal and posterior to the greater trochanter, but it was less distal and more posterior in falls from standing than from kneeling position. The present decrease in hip impact force with an unchanged loading configuration indicates the potential protective effect of the MA technique on the femoral fracture risk. The change in loading configuration with an increased fall height warrant further studies to examine the effect of MA techniques on fall severity under more natural fall circumstances. Copyright © 2012 Elsevier Ltd. All rights reserved.

  5. Conservative interventions for treating exercise-related musculotendinous, ligamentous and osseous groin pain.

    Science.gov (United States)

    Almeida, Matheus O; Silva, Brenda N G; Andriolo, Régis B; Atallah, Alvaro N; Peccin, Maria S

    2013-06-06

    Musculoskeletal, ligamentous and osseous groin injuries are common in athletes and may result in a delay of several months to resume sports. Even then, this may not be at the former level of sport activity. The treatment of exercise-related groin pain is mainly conservative (non-surgical), using interventions such as exercises, electrotherapy, manual therapy and steroid injections. To assess the effects (benefits and harms) of conservative interventions for treating exercise-related musculotendinous, ligamentous and osseous groin pain. We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (December 2011); the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 4); MEDLINE (1948 to November week 3 2011); EMBASE (1980 to Week 49 2011); CINAHL (1982 to December 2011); LILACS (1982 to December 2011); PEDro (1929 to December 2011), SPORTDiscus (1985 to December 2011), OTseeker (to December 2011), reference lists of papers and conference proceedings (2000 to 2011). Randomized controlled trials and quasi-randomized controlled trials evaluating conservative interventions for treating exercise-related musculotendinous, ligamentous and osseous groin pain were included. Studies comparing conservative with surgical treatments were excluded. Two review authors independently extracted data and conducted risk of bias assessments. There was no pooling of data. Two studies, involving a total of 122 participants who had experienced adductor-related groin pain for at least two months, were included in this review. All but one of the participants were male athletes aged between 18 and 50 years old. Both studies were assessed as 'high risk of bias' for at least one source of bias domain. The 'successful treatment' outcome reported in both studies was based primarily on pain measures.One study, based on an intention-to-treat analysis, found a significant difference favouring exercise therapy (strengthening with an

  6. Zinc adjunct therapy reduces case fatality in severe childhood pneumonia: a randomized double blind placebo-controlled trial

    Directory of Open Access Journals (Sweden)

    Srinivasan Maheswari G

    2012-02-01

    Full Text Available Abstract Background Pneumonia is a leading cause of children's deaths in developing countries and hinders achievement of the fourth Millennium Development Goal. This goal aims to reduce the under-five mortality rate, by two thirds, between 1990 and 2015. Few studies have examined the impact of zinc adjunct therapy on the outcome of childhood pneumonia. We determined the effect of zinc as adjunct therapy on time to normalization of respiratory rate, temperature and oxygen saturation. We also studied the effect of zinc adjunct therapy on case fatality of severe childhood pneumonia (as a secondary outcome in Mulago Hospital, Uganda. Methods In this double blind, randomized, placebo-controlled clinical trial, 352 children aged 6 to 59 months, with severe pneumonia were randomized to zinc (20 mg for children ≥12 months, and 10 mg for those Results Time to normalization of the respiratory rate, temperature and oxygen saturation was not significantly different between the two arms. Case fatality was 7/176 (4.0% in the zinc group and 21/176 (11.9% in the placebo group: Relative Risk 0.33 (95% CI 0.15 to 0.76. Relative Risk Reduction was 0.67 (95% CI 0.24 to 0.85, while the number needed to treat was 13. Among HIV infected children, case fatality was higher in the placebo (7/27 than in the zinc (0/28 group; RR 0.1 (95% CI 0.0, 1.0. Among 127 HIV uninfected children receiving the placebo, case fatality was 7/127 (5.5%; versus 5/129 (3.9% among HIV uninfected group receiving zinc: RR 0.7 (95% CI 0.2, 2.2. The excess risk of death attributable to the placebo arm (Absolute Risk Reduction or ARR was 8/100 (95% CI: 2/100, 14/100 children. This excess risk was substantially greater among HIV positive children than in HIV negative children (ARR: 26 (95% CI: 9, 42 per 100 versus 2 (95% CI: -4, 7 per 100; P-value for homogeneity of risk differences = 0.006. Conclusion Zinc adjunct therapy for severe pneumonia had no significant effect on time to normalization of

  7. Effectiveness of an Educational Intervention on Reducing Misconceptions Among Ethnic Minorities With Complicated Mild to Severe Traumatic Brain Injury

    Science.gov (United States)

    Pappadis, Monique R.; Sander, Angelle M.; Łukaszewska, Beata; Struchen, Margaret A.; Leung, Patrick; Smith, Dennis W.

    2018-01-01

    Objective To evaluate the effectiveness of an educational intervention designed to reduce traumatic brain injury (TBI)–related misconceptions among blacks and Latinos with complicated mild to severe TBI. Design Randomized controlled trial with masked 1-month follow-up. Setting Community. Participants Persons (N = 52) with complicated mild to severe TBI (mean best day 1 Glasgow Coma Scale score, 11.27±3.89) were randomly recruited from 141 eligible participants (mean age, 37.71±13.88y; age range, 19–66y; mean months postinjury, 24.69±11.50); 25 participants (48.1%) of participants were black and 27 (51.9%) were Hispanic/Latino. Of the Hispanic/Latino participants, 18 (66.7%) were non-U.S. born and 12 (44.4%) spoke Spanish as their primary language. Twenty-seven individuals were randomized to the educational intervention group and 25 were randomized to the wait-list control group. Interventions Single-session educational intervention with written materials provided in English or Spanish. Main Outcome Measures Forty-item Common Misconceptions about Traumatic Brain Injury Questionnaire administered at baseline and 1-month follow-up. Results After controlling for ethnic and language differences, a significant between-group main effect (P = .010) and a significant time-group interaction for the Common Misconceptions about Traumatic Brain Injury Questionnaire were noted (Wilks Λ = .89; F1,46 = 6.00; P = .02). The intervention group showed a decrease in TBI misconception percentages, whereas the wait-list control group maintained similar percentages. At 1-month follow-up, the wait-list control group reported more misconceptions than did the intervention group (P = .019). Conclusions An educational intervention developed to address the recovery process, common symptoms, and ways to handle the symptoms provides promise as a tool to decrease TBI misconceptions among persons from ethnically and educationally diverse backgrounds. The effects of therapist characteristics

  8. Effectiveness of an Educational Intervention on Reducing Misconceptions Among Ethnic Minorities With Complicated Mild to Severe Traumatic Brain Injury.

    Science.gov (United States)

    Pappadis, Monique R; Sander, Angelle M; Łukaszewska, Beata; Struchen, Margaret A; Leung, Patrick; Smith, Dennis W

    2017-04-01

    To evaluate the effectiveness of an educational intervention designed to reduce traumatic brain injury (TBI)-related misconceptions among blacks and Latinos with complicated mild to severe TBI. Randomized controlled trial with masked 1-month follow-up. Community. Persons (N=52) with complicated mild to severe TBI (mean best day 1 Glasgow Coma Scale score, 11.27±3.89) were randomly recruited from 141 eligible participants (mean age, 37.71±13.88y; age range, 19-66y; mean months postinjury, 24.69±11.50); 25 participants (48.1%) of participants were black and 27 (51.9%) were Hispanic/Latino. Of the Hispanic/Latino participants, 18 (66.7%) were non-U.S. born and 12 (44.4%) spoke Spanish as their primary language. Twenty-seven individuals were randomized to the educational intervention group and 25 were randomized to the wait-list control group. Single-session educational intervention with written materials provided in English or Spanish. Forty-item Common Misconceptions about Traumatic Brain Injury Questionnaire administered at baseline and 1-month follow-up. After controlling for ethnic and language differences, a significant between-group main effect (P=.010) and a significant time-group interaction for the Common Misconceptions about Traumatic Brain Injury Questionnaire were noted (Wilks Λ=.89; F 1,46 =6.00; P=.02). The intervention group showed a decrease in TBI misconception percentages, whereas the wait-list control group maintained similar percentages. At 1-month follow-up, the wait-list control group reported more misconceptions than did the intervention group (P=.019). An educational intervention developed to address the recovery process, common symptoms, and ways to handle the symptoms provides promise as a tool to decrease TBI misconceptions among persons from ethnically and educationally diverse backgrounds. The effects of therapist characteristics and the client-therapist relation on outcomes should be further explored. Copyright © 2016 American

  9. Yoghurt containing galacto-oligosaccharides, prunes and linseed reduces the severity of mild constipation in elderly subjects.

    Science.gov (United States)

    Sairanen, U; Piirainen, L; Nevala, R; Korpela, R

    2007-12-01

    Constipation is a common problem in the elderly. Dietary fibre is recommended for its treatment. The aim was to examine whether yoghurt containing galacto-oligosaccharides (GOS), prunes and linseed relieve constipation in elderly subjects. A randomized, double-blinded, cross-over study. Free-living subjects. A group of 43 elderly subjects with self-reported constipation (mean age 76 years, range 61-92 years, 32 females, 11 males). The study consisted of a 2-week baseline period and 2, 3-week dietary interventions, with a 2-week wash-out period between the interventions. During the interventions, the subjects ingested, in random order, 260 g/day of either control yoghurt or test yoghurt containing GOS (12 g/day), prunes (12 g/day) and linseed (6 g/day). The use of laxatives was controlled and only allowed after 2 days without defecation. Defecation frequency was 5.7 times/week during the baseline period. During the test yoghurt period, defecation frequency was higher (8.0 vs 7.1 times/week, P=0.011), defecation was easier (on the scale 0-3, 1.3 vs 1.5, P=0.010), and there was a tendency towards softer stools (on the scale 0-3, 2.1 vs 2.2, P=0.059) compared with the control yoghurt period. The subjects felt that the test yoghurt relieved constipation more effectively than the control yoghurt (P=0.005). The sum of gastrointestinal symptoms did not differ between the interventions. The use of laxatives remained constant throughout the study. Daily intake of yoghurt containing GOS, prunes and linseed reduced the severity of constipation in elderly subjects with mild constipation. Valio Ltd, R&D.

  10. Impact-driven, pulmonary emboli of osseous fat in exercise-induced bronchospasm.

    Science.gov (United States)

    Simkin, Peter A; Snitily, Brian K

    2015-11-01

    Exercise induced bronchospasm (EIB) affects approximately 10% of normal individuals with higher prevalence rates among children, obese adults, and competitive athletes. Although hyperpnea with dry air is the best known cause, the problem is multifactorial with atopy, asthma and chlorine all playing established roles. To date, no clear mechanism has connected musculoskeletal loading with the ensuing pulmonary compromise. This paper reviews evidence that impact-driven pulses in subchondral bone pressure may push osseous fat cells into the local venous sinusoids. The resultant showers of microemboli must then travel to the lung where lysis of membrane phospholipids leads to leukotriene formation with resultant inflammation and bronchial hypersensitivity. Concurrently, the same emboli deliver triglyceride fuels for further physical activity. Thus, pulmonary microemboli derived from osseous fat may resolve the seeming paradox of athletic excellence in persons afflicted with exercise-induced bronchospasm. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  11. Magnetic resonance imaging of the elbow. Part I: Normal anatomy, imaging technique, and osseous abnormalities

    Energy Technology Data Exchange (ETDEWEB)

    Kijowski, Richard; Tuite, Michael; Sanford, Matthew [University of Wisconsin Hospital, Department of Radiology, Madison, Wisconsin (United States)

    2004-12-01

    Part I of this comprehensive review on magnetic resonance imaging of the elbow discusses normal elbow anatomy and the technical factors involved in obtaining high-quality magnetic resonance images of the elbow. Part I also discusses the role of magnetic resonance imaging in evaluating patients with osseous abnormalities of the elbow. With proper patient positioning and imaging technique, magnetic resonance imaging can yield high-quality multiplanar images which are useful in evaluating the osseous structures of the elbow. Magnetic resonance imaging can detect early osteochondritis dissecans of the capitellum and can be used to evaluate the size, location, stability, and viability of the osteochondritis dissecans fragment. Magnetic resonance imaging can detect early stress injury to the proximal ulna in athletes. Magnetic resonance imaging can detect radiographically occult fractures of the elbow in both children and adults. Magnetic resonance imaging is also useful in children to further evaluate elbow fractures which are detected on plain-film radiographs. (orig.)

  12. Florid osseous dysplasia in a middle-aged Turkish woman: A case report

    International Nuclear Information System (INIS)

    Onder, Buket; Kursun, Sebnem; Oztas, Bengi; Erdem, Erdal

    2013-01-01

    Florid osseous dysplasia (FOD) is an uncommon, benign, cemento-osseous lesion of the jaws. The etiology of FOD is still unknown. It is often asymptomatic and may be identified on routine dental radiographs. The classic radiographic appearance of FOD is amorphous, lobulated, mixed radiolucent/radiopaque masses of cotton-wool appearance with a sclerotic border in the jaws. In our case the lesion was found incidentally on routine periapical radiographs taken for restored teeth and edentulous areas. For further and detailed examination, a panoramic radiograph and cone-beam computed tomograph (CBCT) were taken. The panoramic radiograph and CBCT revealed maxillary bilateral and symmetrical, non-expansile, well-defined, round, radiopaque masses in contact with the root of the maxillary right second molar and left first molar teeth. Our aim in presenting this case report was to highlight the importance of imaging in diagnosis of FOD.

  13. Aspects of osseous, peritoneal and renal handling of bisphosphonate during peritoneal dialysis: a methodological study

    DEFF Research Database (Denmark)

    Joffe, P; Henriksen, Jens Henrik Sahl

    1996-01-01

    The accumulation of methylene bisphosphonate (MBP) in increased bone turnover is an index of the total skeletal turnover. Accordingly, a model has been described where uptake of the osseous tracer can be estimated, regardless of renal function. In the present study, the model was adapted to conti......The accumulation of methylene bisphosphonate (MBP) in increased bone turnover is an index of the total skeletal turnover. Accordingly, a model has been described where uptake of the osseous tracer can be estimated, regardless of renal function. In the present study, the model was adapted.......5 and 2.8 ml min-1 (not significant), respectively. The bone bisphosphonate clearance (BBC) at steady state was 26.0 ml min-1, a value which was significantly higher than that at infinity (16.5 ml min-1, p

  14. Florid osseous dysplasia in a middle-aged Turkish woman: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Onder, Buket; Kursun, Sebnem; Oztas, Bengi [Faculty of Dentistry, Ankara University, Ankara (Turkmenistan); Erdem, Erdal [Dept. of Oral Pathology, Faculty of Dentistry, Gazi University, Ankara (Turkmenistan)

    2013-09-15

    Florid osseous dysplasia (FOD) is an uncommon, benign, cemento-osseous lesion of the jaws. The etiology of FOD is still unknown. It is often asymptomatic and may be identified on routine dental radiographs. The classic radiographic appearance of FOD is amorphous, lobulated, mixed radiolucent/radiopaque masses of cotton-wool appearance with a sclerotic border in the jaws. In our case the lesion was found incidentally on routine periapical radiographs taken for restored teeth and edentulous areas. For further and detailed examination, a panoramic radiograph and cone-beam computed tomograph (CBCT) were taken. The panoramic radiograph and CBCT revealed maxillary bilateral and symmetrical, non-expansile, well-defined, round, radiopaque masses in contact with the root of the maxillary right second molar and left first molar teeth. Our aim in presenting this case report was to highlight the importance of imaging in diagnosis of FOD.

  15. A Multidisciplinary Approach to the Management of Atypical Osseous Epithelioid Hemangioendothelioma

    Directory of Open Access Journals (Sweden)

    J. K. Ma

    2014-01-01

    Full Text Available Hemangioendothelioma is a rare vascular tumor of intermediate malignant potential. Though epithelioid hemangioendothelioma (EH is commonly found in soft tissues, it has been known to be present in skeletal tissues. The authors present a case of a 50-year-old woman diagnosed with EH of the iliac bone and acetabulum, who experienced pathological fracture at presentation. This report describes a multidisciplinary approach to the management that includes initial incisional biopsy, curettage, and bone grafting, followed by Intensity Modulated Radiation Therapy. The patient finally underwent hemipelvic resection with allograft reconstruction after recurrence. Histopathological study revealed osseous EH of low mitotic activity that stained positively for CD31, CD34, vimentin, and Factor VIII. Herein, the authors discuss the imaging characteristics, histopathological aspects, cytogenetic findings, and the radiobiological behavior of osseous EH. After an aggressive multidisciplinary intervention, the patient is able to achieve local control with no evidence of distal metastatic disease.

  16. Quantitative contrast-enhanced CT attenuation evaluation of osseous metastases following chemotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Connie Y.; Simeone, F.J.; Torriani, Martin; Bredella, Miriam A. [Massachusetts General Hospital, Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Boston, MA (United States)

    2017-10-15

    Osseous metastases often undergo an osteoblastic healing response following chemotherapy. The purpose of our study was to demonstrate the quantitative CT changes in attenuation of osseous metastases before and after chemotherapy. Our study was IRB approved and HIPAA compliant. Our cohort consisted of 86 consecutive cancer patients with contrast-enhanced CTs before and 14 ± 2 (12-25) months after initiation of chemotherapy (60 ± 11 years, 36 males, 50 females). The average and maximum metastasis attenuations were measured in Hounsfield units (HU) by two readers. Treatment effects were assessed using paired t-tests and Fisher exact tests. Intraclass correlation coefficients (ICCs) were calculated. Patient records were reviewed to determine the patient's clinical status (worse, unchanged, or improved) at the time of follow-up CT. The distribution of lesion types was as follows: lytic (30/86, 35%), blastic (43/86, 50%), and mixed lytic-blastic (13/86, 15%). There was a significant increase in average and maximum CT attenuation of metastases following chemotherapy for all patients, which remained statistically significant when stratified by lesion type, clinical status (worsening or improving/stable), cancer type (breast, lung), and radiation therapy (P < 0.05). In a subgroup of patients whose osseous metastases decreased in average attenuation (14/86, 16%), more patients had a worse clinical status (11/14, 79%) (P = 0.02). ICC was almost perfect for average attenuation and substantial for maximum attenuation. Quantitative assessment of osseous metastatic disease using CT attenuation measurements demonstrated a statistically significant increase in attenuation more than 12 months after initiation of chemotherapy. (orig.)

  17. Technical Developments: Zero Echo Time Imaging of the Shoulder: Enhanced Osseous Detail by Using MR Imaging.

    Science.gov (United States)

    Breighner, Ryan E; Endo, Yoshimi; Konin, Gabrielle P; Gulotta, Lawrence V; Koff, Matthew F; Potter, Hollis G

    2018-03-01

    Purpose To determine the intermodality agreement of morphologic grading and clinically relevant quantitative measurements between computed tomography (CT) and zero echo time (ZTE) magnetic resonance (MR) imaging of the shoulder. The primary objective was to demonstrate the clinical applicability of ZTE in osseous shoulder imaging. Materials and Methods Thirty-four patients undergoing standard-of-care (SOC) MR imaging with concomitant CT were enrolled in this institutional review board-approved study. ZTE images were acquired after SOC MR imaging. Glenoid morphology (version, vault depth, erosion), injury or disease (osteoarthritis, Bankart and Hill-Sachs lesions, subchondral cysts), and evidence of prior surgery were graded or measured. κ Values, intraclass correlation coefficients (ICCs), and Bland-Altman limits of agreement were used to establish agreement. Qualitative comparison of osseous findings was performed between ZTE and SOC MR imaging. Results Binary classification and nominal/ordinal grades showed substantial or better agreement between raters and modalities (κ or ICC > 0.6). Continuous measurements exhibited strong correlation between raters and modalities, although not universally. Bankart ICCs were not significant, owing to low prevalence. ZTE exhibited greater conspicuity of enthesopathic cysts and marrow edema. In 21 of 34 cases, ZTE imaging of osseous features exceeded SOC MR imaging. Conclusion ZTE MR imaging provides "CT-like" contrast for bone. The results of this study demonstrate strong intermodality agreement between measurements and grades from CT and ZTE images in a cohort of patients undergoing imaging with both modalities. A majority of ZTE image sets provided superior visualization of osseous features when compared with SOC MR image sets. This superiority coupled with strong quantitative agreement with CT suggests that ZTE may be used clinically in lieu of CT in some cases. © RSNA, 2017 Online supplemental material is available for

  18. Recombinant Factor VIIa Reduces Bleeding after Blunt Liver Injury in a Pig Model of Dilutional Coagulopathy under Severe Hypothermia.

    Directory of Open Access Journals (Sweden)

    Henri M H Spronk

    Full Text Available Recombinant factor VIIa (rFVIIa is registered for use in haemophilia with inhibitors and other rare bleeding disorders, but has also been used in various other clinical conditions to terminate life-threatening bleeding. Underlying conditions (e.g. coagulopathy and dosing may affect treatment efficacy. The objective of the present study was to evaluate the impact of increasing doses of rFVIIa on blood loss and coagulation assays in haemodiluted and hypothermic pigs undergoing blunt liver injury.A grade III blunt liver injury was induced in 28 pigs after 70% haemodilution and cooling to 32.6-33.4°C. Ten minutes after trauma, animals randomly received placebo or 90, 180 or 360 μg/kg rFVIIa. Global coagulation parameters, thromboelastometry (TEM and plasma thrombin generation (TG were determined at different time points during the observation period of 120 minutes.Total blood loss was significantly lower following 90 μg/kg rFVIIa (1206 [1138-1470] mL relative to placebo (2677 [2337-3068] mL; p<0.05, with no increased effect with higher dose levels of rFVIIa. Following trauma and haemodilution, coagulation was impaired relative to baseline in both TEM and TG analysis. At 60 and 120 minutes after trauma, TEM variables improved in the rFVIIa-treated animals compared with the placebo group. Similarly, rFVIIa improved coagulation kinetics in TG. As was observed with blood loss, no significant effect between different rFVIIa dose levels was found in TEM or TG. Macro- and microscopic post-mortem examination did not reveal any signs of thromboembolic events.Early administration of 90 μg/kg rFVIIa reduced blood loss in pigs undergoing blunt liver injury even after severe haemodilution and hypothermia, with no further effect of higher dose levels. Coagulation assays showed impaired coagulation in coagulopathic animals, with a dose-independent improvement in animals treated with rFVIIa.

  19. Periodontal regeneration: management of periodontal osseous defects by the periodontist-dental hygienist team.

    Science.gov (United States)

    Schallhorn, Rachel A; McClain, Pamela K

    2014-06-01

    Periodontal health can be restored through assessment, diagnosis, treatment and management of periodontal osseous defects by the periodontist-dental hygienist team. Treatment of periodontitis has evolved over time, with regenerative periodontal therapy at the forefront in cutting-edge periodontal care. While the techniques and materials available today are allowing therapists to push the limits of periodontal regeneration and achieve success in increasingly more difficult cases, the principles of successful regeneration remain the same. Case selection, identification and resolution of etiologic and contributing factors, proper surgical technique, follow-up and patient education are keys to obtaining a successful outcome. The impact of the dental hygienist in assessment and maintenance is highlighted. Literature review of the key research studies evaluating the etiology and contributing factors in the development osseous defects, osseous defect and tooth-related characteristics, and principles of successful regenerative therapy. The authors draw upon their experience with patient care and clinical research to synthesize the evidence relevant to today's dental hygienist. Periodontal regeneration is a well-supported and predictable therapy that can be utilized to restore periodontal support and health. The dental hygienist is key in assessing and caring for the periodontal health of patients over time. Identifying who may benefit from regenerative periodontal therapy is an essential skill for today's practicing dental hygienist. Copyright © 2014 Elsevier Inc. All rights reserved.

  20. Endoscopic resection of fibro-osseous lesions of the paranasal sinuses.

    Science.gov (United States)

    Brodish, B N; Morgan, C E; Sillers, M J

    1999-01-01

    Fibro-osseous tumors, including osteomas, ossifying fibromas, and fibrous dysplasia, are not uncommon benign lesions arising in the paranasal sinuses. Conventional wisdom advocates resection when these lesions are symptomatic, or when they exhibit rapid growth. Traditionally, resection has been performed via a variety of open approaches. With the advent of sinonasal endoscopy in the mid 1980s, and subsequent advances in technology and surgical techniques, endoscopic management of some of these lesions is now feasible. To date, a search of the literature reveals only three case reports of osteomas resected with endoscopic guidance. We present a series of 10 symptomatic fibro-osseous lesions (nine osteomas and one fibrous dysplasia) occurring in nine patients in which endoscopic techniques were used. Seven ethmoid and frontal recess osteomas were resected transnasally and one sphenoid sinus fibrous dysplasia was resected using a transseptal transsphenoidal approach with the assistance of direct endoscopic visualization. There were two anticipated CSF leaks that were recognized and repaired at the time of surgery. There were no other complications and no tumor recurrence. All patients noted improvement in preoperative symptoms. We discuss patient selection, operative techniques and strategies, and the advantages and disadvantages of the endoscopic approach in the management of paranasal sinus fibro-osseous lesions.

  1. Neolithisation of technology: innovation and tradition in the Starčevo culture osseous industry

    Directory of Open Access Journals (Sweden)

    Selena Vitezović

    2016-12-01

    Full Text Available The earliest Neolithic cultures in Southeast Europe brought significant changes in many aspects of everyday life, in subsistence, settlement patterns, architecture, and also ritual aspects. Technological changes are also very important – the introduction of completely new technologies, such as clay working, or new techniques in existing industries, e.g., lithic, osseous, etc. The osseous industry is especially informative for questions on innovations and traditions, since it was well developed in both the Mesolithic and Neolithic periods. In Starčevo culture, certain Mesolithic traditions may be observed, such as techniques for antler manufacture; however, numerous innovations are also visible, particularly techno-types of Near Eastern origin such as spatula-spoons, the most characteristic bone techno-type of the Early Neolithic in South-east Europe, as well as diverse decorative items. Furthermore, new raw materials (bones from domestic animals are introduced, and new techniques for manufacture and new tools. It is also interesting to observe that, although osseous materials remain the dominant raw material for personal ornaments, they are no longer used for artistic expression.

  2. Clinico-radiological study of fibro-osseous lesions of the jaw

    International Nuclear Information System (INIS)

    Nah, Kyung Sik; Park, Tae Won

    1982-01-01

    Since the fibro-osseous lesion is not a specific diagnostic term, the author studied clinically and radiologically 44 cases which had been diagnosed as fibro-osseous lesion in SNUDH (1972-1981.12). The obtained results were as follows. 1. Clinico-radiologically, the cases of fibro-osseous lesions were divided into two groups. 2. The first group was fibrous dysplasia(21 cases). 3. The second group was tumors of periodontal ligament origin, including ossifying fibroma, cementifying fibroma and cemento-ossifying fibroma (23 cases). 4. In most cases the chief complaint was painless swelling of the jaw and the mean age of the fibrous dysplasia (24.6 yrs) was a little younger than that of the periodontal ligament origin lesions (29.2 yrs). 5. In fibrous dysplasia, maxilla was often involved and showed ground-glass of smoke pattern radiologically. 6. The tumors of periodontal ligament origin occurred more in female, mandible and radiologically showed varying amounts of radiopaque foci in well-circumscribed osteolytic lesion.

  3. Utility of Tc-99m MDP bone SPECT in evaluation of osseous involvement in craniofacial malignancies.

    Science.gov (United States)

    Saeed, Shabana; Haq, Saif Ul; Sohaib, Muhammad; Nawaz Khan, Ali

    2017-11-01

    To assess the role of technetium-99m methoxy diphosphonate (Tc-99m MDP) single photon emission tomography (SPECT) imaging for the detection of osseous invasion in craniofacial malignancies. The study was performed in 45 subjects using Tc-99m MDP (740 MBq). Out of 45 subjects, 30 were patients had different craniofacial malignancies, and 15 subjects who did not have any malignancy served as controls. Planar imaging was performed. Anterior, lateral and oblique lateral views of the skull were obtained. SPECT imaging was done taking 64 views of the skull in a 360 ° circular path, each 40 s with 128 × 128 matrices. Scans were visually interpreted using a score of 0, 1, and 2, representing a lesion as definitely absent, doubtful, and definitely present, respectively. Planar scans were compared with the SPECT images. Bone SPECT detected more lesions as compared to planar bone scan and plain radiographs. SPECT was found to be superior to planar imaging and radiographs in the detection and efficient demonstration of the extent of osseous invasion of craniofacial cancer. Sensitivity was 100% for SPECT and 83.33% for planar bone scan. SPECT imaging of the skull is a very beneficial complementary form of investigation in patients with craniofacial malignancies for the assessment of osseous invasion, particularly in tumors likely to invade the skull base. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  4. [Influence of canthaxanthin on D-galactose induced osseous changes of rat].

    Science.gov (United States)

    Pei, Ling-peng; Hui, Bo-di; Dong, Fu-hui

    2008-08-01

    To study the influence of canthaxanthin on D-galactose induced osseous changes of rat. Forty-five six-week-old Wistar male rats were randomly divided into model group, canthaxanthin group and young control group. In addition, 15 sixteen-month-old Wistar male rats were used as old control group. Model group and canthaxanthin group were given injections of D-galactose for 5 months (20 mg/kg/once per-day) to cause aging of rat. Then routine osseous parameters were tested and compared among the 4 groups. Compared with young control group, the BMD, parameters of structural mechanics and biomechanics, bone calcium, manganese, magnesium and the content of hydroxyproline in the model group decreased significantly (P bone phosphorus, the activity of bone and serum ALP increased significantly (P < 0.01). Those changes of the model group were the same as the old control group,but the changes in the canthaxanthin group significantly differed with the model group (P < 0.01). The high does of D-galactose intake can cause aging and osteoporosis at the same time in rat, but canthaxanthin can prevent and inhibit D-galactose induced osseous changes.

  5. A Radiographic study of Fibro-osseous lesions of the jaw bones

    International Nuclear Information System (INIS)

    Kwon, Kyung Yun; Choi, Karp Shik

    1998-01-01

    The purpose of the study was to obtain information on the clinical and radiographic features of the fibro-osseous lesions in the jaws. For this study, the author examined and analysed the clinical records and radiographs of 71 cases of 68 patients in fibrous dysplasia diagnosed by clinical and radiographic or histopathological examinations. The obtained results were as followings : 1. Fibrous dysplasia occurred most frequently in the 2nd decade (30.0%), ossifying fibroma in the 3rd-4th decades, periapical cemental dysplasia in the 4th decade, and all of three lesions showed slight predilection in females. In most cases, chief complaints were painless facial swelling in fibous dysplasia and ossifying fibroma, and periapical cemental dyplasia was found accidentally in radiographs. 2. Fibrous dysplasia was occurred more frequently in maxilla, ossifying fibroma in mandible and both lesions in premolar-molar area. Periapical cemental dysplasia was larger than that of ossifyng fibroma, and the shape of ossifying fibroma was more round and elliptical than fibrous dysplasia whose was fusiform. 3. Fibrous dysplasia was shown homogeneous radiopaque shadow of 57.6% and ossifying fibtoma and periapical cemental dysplasia were shown mixed appearance of radiolucency and radiopacity shadows at 74.2%, 60.0%, respectively. 4. Fibrous dysplasia was entirely shown poorly defined at 87.7%, but ossifying fibroma and periapical cemental dysplasia were shown well outlined at 60.0%, 70.0%, respectively. 5. Cortical thinning and expansion were observed in fibrous dysplasia and ossifying fibroma, and severe in ossifying fibroma than fibrous dysplasia, and those signs were not seen in periapical cemental dysplasia. Loss of lamina dura was dominant in fibrous dysplasia and root resorption was dominant in ossifying fibroma. Displacement of mandibular canal and the degree of the increase of vertical dimension were alike in both lesions. Displacement of maxillary sinus or nasal cavity, thinning

  6. A Radiographic study of Fibro-osseous lesions of the jaw bones

    Energy Technology Data Exchange (ETDEWEB)

    Kwon, Kyung Yun; Choi, Karp Shik [Dept. of Dental Radiology, College of Dentistry, Kyungpook National University, Daegu(Korea, Republic of)

    1998-02-15

    The purpose of the study was to obtain information on the clinical and radiographic features of the fibro-osseous lesions in the jaws. For this study, the author examined and analysed the clinical records and radiographs of 71 cases of 68 patients in fibrous dysplasia diagnosed by clinical and radiographic or histopathological examinations. The obtained results were as followings : 1. Fibrous dysplasia occurred most frequently in the 2nd decade (30.0%), ossifying fibroma in the 3rd-4th decades, periapical cemental dysplasia in the 4th decade, and all of three lesions showed slight predilection in females. In most cases, chief complaints were painless facial swelling in fibous dysplasia and ossifying fibroma, and periapical cemental dyplasia was found accidentally in radiographs. 2. Fibrous dysplasia was occurred more frequently in maxilla, ossifying fibroma in mandible and both lesions in premolar-molar area. Periapical cemental dysplasia was larger than that of ossifyng fibroma, and the shape of ossifying fibroma was more round and elliptical than fibrous dysplasia whose was fusiform. 3. Fibrous dysplasia was shown homogeneous radiopaque shadow of 57.6% and ossifying fibtoma and periapical cemental dysplasia were shown mixed appearance of radiolucency and radiopacity shadows at 74.2%, 60.0%, respectively. 4. Fibrous dysplasia was entirely shown poorly defined at 87.7%, but ossifying fibroma and periapical cemental dysplasia were shown well outlined at 60.0%, 70.0%, respectively. 5. Cortical thinning and expansion were observed in fibrous dysplasia and ossifying fibroma, and severe in ossifying fibroma than fibrous dysplasia, and those signs were not seen in periapical cemental dysplasia. Loss of lamina dura was dominant in fibrous dysplasia and root resorption was dominant in ossifying fibroma. Displacement of mandibular canal and the degree of the increase of vertical dimension were alike in both lesions. Displacement of maxillary sinus or nasal cavity, thinning

  7. Cinacalcet reduces plasma intact parathyroid hormone, serum phosphate and calcium levels in patients with secondary hyperparathyroidism irrespective of its severity.

    LENUS (Irish Health Repository)

    2011-09-01

    To evaluate the relationship between the severity of secondary hyperparathyroidism (SHPT) - defined in terms of baseline plasma intact parathyroid hormone (iPTH) level - and the magnitude of response to cinacalcet.

  8. Impact of reducing sodium void worth on the severe accident response of metallic-fueled sodium-cooled reactors

    International Nuclear Information System (INIS)

    Wigeland, R.A.; Turski, R.B.; Pizzica, P.A.

    1994-01-01

    Analyses have performed on the severe accident response of four 90 MWth reactor cores, all designed using the metallic fuel of the Integrated Fast Reactor (IFR) concept. The four core designs have different sodium void worth, in the range of -3$ to 5$. The purpose of the investigation is to determine the improvement in safety, as measured by the severe accident consequences, that can be achieved from a reduction in the sodium void worth for reactor cores designed using the IFR concept

  9. Similar mandibular osseous lesions in Tyrannosaurus rex and man.

    Science.gov (United States)

    Neiburger, E J

    2005-01-01

    This report identifies several cases of similar-appearing multiple lesions in the mandibles of both humans and the dinosaur Tyrannosaurus rex (T. rex). A diagnosis and potential etiologies are discussed. The appearance of these lesions in prehistoric fossils suggests that this pathology is an ancient affliction which predates humans and our mammalian ancestors. Lytic lesions of the oral structures have occurred in man and higher animals throughout time. The causes range from congenital anomalies, trauma, and infections to benign and metastatic neoplasms. Not only mammals suffer from these conditions; reptiles and birds experience similar diseases.

  10. Relative shortening and functional tethering of spinal cord in adolescent scoliosis - Result of asynchronous neuro-osseous growth, summary of an electronic focus group debate of the IBSE.

    Science.gov (United States)

    Chu, Winnie Cw; Lam, Wynnie Mw; Ng, Bobby Kw; Tze-Ping, Lam; Lee, Kwong-Man; Guo, Xia; Cheng, Jack Cy; Burwell, R Geoffrey; Dangerfield, Peter H; Jaspan, Tim

    2008-06-27

    There is no generally accepted scientific theory for the causes of adolescent idiopathic scoliosis (AIS). As part of its mission to widen understanding of scoliosis etiology, the International Federated Body on Scoliosis Etiology (IBSE) introduced the electronic focus group (EFG) as a means of increasing debate on knowledge of important topics. This has been designated as an on-line Delphi discussion. The Statement for this debate was written by Dr WCW Chu and colleagues who examine the spinal cord to vertebral growth interaction during adolescence in scoliosis. Using the multi-planar reconstruction technique of magnetic resonance imaging they investigated the relative length of spinal cord to vertebral column including ratios in 28 girls with AIS (mainly thoracic or double major curves) and 14 age-matched normal girls. Also evaluated were cerebellar tonsillar position, somatosensory evoked potentials (SSEPs), and clinical neurological examination. In severe AIS compared with normal controls, the vertebral column is significantly longer without detectable spinal cord lengthening. They speculate that anterior spinal column overgrowth relative to a normal length spinal cord exerts a stretching tethering force between the two ends, cranially and caudally leading to the initiation and progression of thoracic AIS. They support and develop the Roth-Porter concept of uncoupled neuro-osseous growth in the pathogenesis of AIS which now they prefer to term 'asynchronous neuro-osseous growth'. Morphological evidence about the curve apex suggests that the spinal cord is also affected, and a 'double pathology' is suggested. AIS is viewed as a disorder with a wide spectrum and a common neuroanatomical abnormality namely, a spinal cord of normal length but short relative to an abnormally lengthened anterior vertebral column. Neuroanatomical changes and/or abnormal neural function may be expressed only in severe cases. This asynchronous neuro-osseous growth concept is regarded as

  11. Nebulized C1-Esterase Inhibitor does not Reduce Pulmonary Complement Activation in Rats with Severe Streptococcus Pneumoniae Pneumonia

    NARCIS (Netherlands)

    de Beer, Friso; Lagrand, Wim; Glas, Gerie J.; Beurskens, Charlotte J. P.; van Mierlo, Gerard; Wouters, Diana; Zeerleder, Sacha; Roelofs, Joris J. T. H.; Juffermans, Nicole P.; Horn, Janneke; Schultz, Marcus J.

    2016-01-01

    Complement activation plays an important role in the pathogenesis of pneumonia. We hypothesized that inhibition of the complement system in the lungs by repeated treatment with nebulized plasma-derived human C1-esterase inhibitor reduces pulmonary complement activation and subsequently attenuates

  12. Osseous Metastase of Occult Paraganglioma: A Diagnostic Medical Error

    Directory of Open Access Journals (Sweden)

    Ghasemi TA

    2013-10-01

    Full Text Available Introduction: Diagnostic errors have a natural complexity. Medical diagnoses make up a large proportion of all medical errors and cause much suffering and harm. Compared to other types of error, diagnostic errors receive little attention-a major factor in continuity of unacceptable rates of diagnostic error. Case: A 55-year-old woman presented to the emergency department (ED complaining of bone pain which has been started a month ago and increased gradually in the upper right thigh. Following the emergency evaluation she was sent home with pain medication. On the second visit, a femur neck fracture was seen in the x-ray. She underwent hemiarthroplasty and was discharged. Over several weeks she was reevaluated by many Physicians, because of her worsening pain .In the third visit after the surgery, her x-ray showed bone destruction and following bone biopsy, malignant paraganglioma was diagnosed. Discussion and solution: In all cases in which patient comes to us with skeletal pain, getting a comprehensive history and a full physical examination are prior to lab tests and x-rays. Bone metastasis which can develop severe pain and pathological fractures, is common in patients with malignant paraganglioma. Effective steps for diagnostic error prevention are: Considering the diagnostic error in the normal range of quality assurance surveillance and review, identifying the elements leading to diagnostic errors and getting feedback on the diagnoses Physicians make, in order to improve their skills. Conclusion: It is an every health system priority to identify, analyze, and prevent diagnostic errors in order to improve patient safety

  13. Electroconvulsive therapy substantially reduces symptom severity and social disability associated with multiple chemical sensitivity: a case report

    DEFF Research Database (Denmark)

    Elberling, Jesper; Gulmann, Nils; Rasmussen, Alice

    2010-01-01

    Multiple chemical sensitivity (MCS) is a chronic nonallergic, multisymptom disorder triggered by common environmental chemicals in concentrations considered nontoxic for most individuals. The condition may lead to loss of occupation and social isolation, and no effective treatment has been report....... Electroconvulsive therapy (ECT) is a safe and effective treatment of severe depression and medical conditions such as chronic pain disorders....

  14. Increased bladder wall thickness is associated with severe symptoms and reduced bladder capacity in patients with bladder pain syndrome

    Directory of Open Access Journals (Sweden)

    Shu-Yu Wu

    2016-12-01

    Conclusion: There are obvious differences in bladder CT scans of patients with symptoms of bladder pain due to different etiology. Increased BWT was associated with increased pain scores and decreased bladder capacity in patients with KC and IC. BWT on a CT scan might be considered a marker for the severity of bladder inflammation.

  15. Electroconvulsive therapy substantially reduces symptom severity and social disability associated with multiple chemical sensitivity: a case report.

    Science.gov (United States)

    Elberling, Jesper; Gulmann, Nils; Rasmussen, Alice

    2010-09-01

    Multiple chemical sensitivity (MCS) is a chronic nonallergic, multisymptom disorder triggered by common environmental chemicals in concentrations considered nontoxic for most individuals. The condition may lead to loss of occupation and social isolation, and no effective treatment has been reported. Electroconvulsive therapy (ECT) is a safe and effective treatment of severe depression and medical conditions such as chronic pain disorders. We report a case of a 45-year-old man with a 5-year history of MCS who had to quit his job to live a solitary life without his wife and children because of the condition. The patient had no history of psychiatric illness and no signs of clinical depression at treatment start. Over a 3-week period, he underwent a course of 8 ECTs, giving a remarkable effect on symptom severity and social functional level. After a partial symptom relapse, maintenance treatment was started with 1 ECT every second week. No memory impairment or other complications of ECT were reported at the 4-month follow-up. In this case, a substantial, positive effect on symptom severity and social disability related to MCS was obtained by an initial ECT course and maintenance treatment. Electroconvulsive therapy should be considered an option in severe and socially disabling MCS, but more studies are needed to evaluate if ECT can be recommended as a treatment in MCS.

  16. Osseous Flap of Galea and Periosteum Filled With Mesenchymal Stem Cells, Platelet-Rich Plasma, Bone Dust, and Hyaluronic Acid.

    Science.gov (United States)

    Brock, Ryane Schmidt; Viterbo, Fausto; Deffune, Elenice; Domingues, Maria Aparecida Custodio; Mamprim, Maria Jaqueline; Paschoalinotte, Eloisa Elena

    2017-10-01

    Reconstructive surgery to craniofacial deformities caused by tumor ressections, traumas or congenital malformation are frequent in medicine practice. It aims to provide the patients with better quality of life and functional improvement of speech, breathing, chewing, and swallowing. Many are the techniques described in the literature to recover bone defects. This study evaluated a vascularized galeal and periosteum flap in rabbits, which could possibly substitute the bone graft in reconstructive surgery, especially for facial defects. It involved rabbits, divided into 12 groups, submitted to a surgical procedure to construct the galea and periosteum cranial flap filled with fragments of cranial bone, platelet-rich plasma, mesenchimal stem cells, and hyaluronic acid. The evaluation methods included image examinations and histological analysis.The results demonstrated bone formation with the use of platelet-rich plasma, mesenchimal stem cells, and bone fragments. The use of several enrichment materials of osseous cellular stimulation improved the quality and bone tissue organization. The more enrichment factor used, the better the tissue quality result was.Much research should be done to improve the methods and to analyze if results in human have the same bone formation as it happened in rabbits.

  17. Osseous reaction to implantation of two endodontic cements: Mineral trioxide aggregate (MTA) and calcium enriched mixture (CEM)

    Science.gov (United States)

    Rahimi, Saeed; Shahi, Shahriar; Kazemi, Ali; Asgary, Saeed; Eghbal, Mohammad J.; Mesgariabbasi, Mehran; Mohajeri, Daryoush

    2012-01-01

    Aim: The aim of the present in vivo study was to determine bone tissue reaction to calcium enriched mixture (CEM) and mineral trioxide aggregate (MTA) using a rat femur model. Study Design: Sixty-three rats were selected and randomly divided into three groups of 21 each [experimental groups (n=15), control (n=6)]. Implantation cavities were prepared in each femoral bone and randomly filled with the biomaterials only in the experimental groups. The animals in three groups were sacrificed 1, 4, and 8 weeks postoperatively. Histologic evaluations comprising inflammation severity and new bone formation were blindly made on H&E-stained decalcified 6-µm sections. Results: At 1, 4, and 8 weeks after implantation number of inflammatory cells had decreased in the CEM, MTA and control groups, respectively, with no statistically significant differences. Conversely, new bone formation had increased in all the experimental and control groups, without statistically significant differences. Conclusion: The results suggest that biocompatibility of MTA, as gold standard, and CEM cement as a new endodontic biomaterial are comparable Key words:Endodontics, MTA,CEM, osseous reaction. PMID:22549692

  18. Low-dose budesonide treatment reduces severe asthma-related events in patients with infrequent asthma symptoms at baseline

    DEFF Research Database (Denmark)

    Reddel, H. K.; Busse, W. W.; Pedersen, Søren

    2015-01-01

    .0 for Groups 0-1, >1-2, respectively. The rate of severe exacerbations identified by oral/systemic corticosteroid courses was lower for budesonide compared with placebo in all 3 symptom frequency groups (Figure). Patients treated with budesonide experienced significantly greater improvements in symptoms...... and significantly more symptom-free days compared with patients receiving placebo in all symptom frequency groups. CONCLUSIONS: Long-term, once-daily, low-dose budesonide treatment decreases the risk of SAREs and improves asthma symptoms in patients with mild, recent-onset asthma. These beneficial effects were seen...

  19. An alternative management approach to paranasal sinus fibro-osseous lesions.

    Science.gov (United States)

    Ooi, Eng H; Glicksman, Jordan T; Vescan, Allan D; Witterick, Ian J

    2011-01-01

    Fibro-osseous lesions of the paranasal sinuses are an uncommon heterogeneous group of lesions with variable clinical presentation. It is unclear whether these lesions directly cause symptoms or secondarily obstruct the sinuses with resultant rhinosinusitis. We have used an expectant management approach in selected patients that includes observation with serial scans or endoscopic sinus surgery (ESS) to improve the outflow tract of the affected sinus without resection of the lesion. The purpose of this work is to review our experience with management of paranasal sinus fibro-osseous lesions. Retrospective chart review from 1997 to 2009. A total of 44 patients were identified in this study. There were 19 (43%) osteoma and 25 (57%) fibrous dysplasia cases. The presenting symptoms were mainly sinonasal with headaches (36%), pain/pressure (19%), and nasal obstruction (17%). Two patients (4.5%) presented with proptosis and diplopia. Five (11%) patients had associated nasal polyps. The diagnosis was an incidental finding in seventeen (38%) cases. Twenty-two (50%) patients were managed conservatively with serial computed tomography (CT) scans to monitor for interval growth over a mean interval of 41.8 months (range, 13-130 months). There were 2 patients in the observation group with CT scan evidence of interval growth with an increase in size of 1 mm and 9 mm over 130 and 36 months, respectively. Twelve symptomatic patients (27%) underwent ESS without resection of the lesion, with symptomatic improvement in 11 patients (92%). Four patients (9%) underwent endoscopic biopsy to attain histological diagnosis. Six (13%) patients in this study had resection of their lesion with 5 of the patients having symptomatic improvement following resection. In patients with fibro-osseous lesions, we support an expectant management approach of asymptomatic patients with observation and serial imaging, treating selected symptomatic patients with ESS and resection of the lesion in patients

  20. Angle analysis of Haglund syndrome and its relationship with osseous variations and Achilles tendon calcification.

    Science.gov (United States)

    Lu, Cheng-Chang; Cheng, Yu-Min; Fu, Yin-Chih; Tien, Yin-Chun; Chen, Shen-Kai; Huang, Peng-Ju

    2007-02-01

    Haglund syndrome is a cause of posterior heel pain. The prominent posterosuperior projection into the retrocalcaneal bursa is thought to be a major etiology. Many methods have been proposed to measure the posterosuperior projection of the tuberosity into this bursa. The Fowler angle and the parallel pitch lines are the most frequently used. However, the relation between symptomatic Haglund syndrome and the measuring methods, especially the Fowler angle and parallel pitch lines, is not clear. The purposes of this paper were to study the predictive value of the most frequently used measurement methods to evaluate bursal impingement and to determine if other osseous variations and Achilles tendon calcification are associated with the development of Haglund syndrome. From October, 1996, to March, 2003, we evaluated 37 heels in 31 patients with symptomatic Haglund syndrome, and 40 heels in 27 individuals without posterior heel pain. On a lateral view radiograph, the Fowler angle, and the parallel pitch lines were measured, in addition to Achilles tendon calcification and the osseous variations, such as a posterior calcaneal step spur or plantar osseous projection. The average Fowler angles in the control group and study group were 62.31 +/- 7.79 degrees and 60.14 +/- 7.01 degrees, respectively. There was no statistically significant difference (p = 0.490). The positive parallel pitch lines in the symptomatic group were 56.8% and in the control group 42.5%. There was no statistically significant difference (p = 0.474) between the groups. No statistically significant differences were noted between the groups concerning the Fowler angle and parallel pitch lines. The posterior calcaneal step spur and Achilles tendon calcification were statistically significant between these two groups. The Fowler angle and parallel pitch lines were of little predictive value for the Haglund syndrome.

  1. [Narrative enhancement and cognitive therapy: A group intervention to reduce self-stigma in people with severe mental illness].

    Science.gov (United States)

    Roe, David; Yamin, Amit

    2017-09-01

    Research around the world has consistently shown that people with serious mental illness (SMI) are often subject to stronglyheld stigmatizing attitudes held by others in society (e.g., dangerousness, incompetence, inability to work). As a result, people with SMI often experience "internalized stigma" or "self-stigma" which reflects the process by which stigmatizing attitudes are internalized, leading to the loss of previously held or hoped for identities (e.g., self as student, self as worker, self as parent, etc.) and the adoption of identities based on stigmatizing views (e.g., self as dangerous, self as incompetent). In order to reduce the common devastating phenomenon of self-stigma, Narrative Enhancement and Cognitive Therapy (NECT) is a structured, groupbased treatment aimed to reduce self-stigma. It combines psychoeducation to help replace stigmatizing views about mental illness with empirical fndings, cognitive restructuring geared toward teaching skills to challenge negative beliefs about the self, and elements of narratology focused on enhancing one's ability to narrate one's life story. Since its development, nearly a decade ago, it has been implemented in fve different countries and fve languages and studied in three countries with results supporting its positive impact on decreasing self-stigma and improving other positive outcomes. In this paper we briefly review literature on stigma and self-stigma within the context of SMI, the need for treatment focused on decreasing self-stigma, the theoretical rational for the NECT, the format of the intervention and the existing published research.

  2. Modified Da-Cheng-Qi Decoction reduces intra-abdominal hypertension in severe acute pancreatitis: a pilot study.

    Science.gov (United States)

    Wan, Mei-Hua; Li, Juan; Huang, Wei; Mukherjee, Rajarshi; Gong, Han-Lin; Xia, Qing; Zhu, Lin; Cheng, Gui-Lan; Tang, Wen-Fu

    2012-06-01

    Intra-abdominal hypertension (IAH) is a recognized prognostic marker for severity of severe acute pancreatitis (SAP) and has a strong impact on the clinical course of SAP. Previous studies indicate that a Da-Cheng-Qi Decoction (DCQD) is beneficial in the treatment of SAP. The purpose of this study was to evaluate the effect of modified DCQD on IAH in patients with SAP. Between January 2008 and December 2008, 42 patients from the West China Hospital were randomized into either the DCQD or control group (n = 21 in each group). Mortality, intra-abdominal pressure (IAP), Acute Physiology and Chronic Health Evaluation II (APACHE II) score, C-reactive protein (CRP), oxygenation index, Balthazar CT score, rate of renal failure, decompression rate, intensive care unit (ICU) transfer rate, and length of hospital stay (LOS) were compared between the two groups. Compared to the control group, the modified DCQD treatment significantly decreased IAP (P < 0.05) and APACHE II (P < 0.05) scores on days 4 - 8, CRP on day 8 (P < 0.01), renal failure rate (P < 0.05), and LOS (P < 0.05). The oxygenation index was significantly improved in the DCQD group compared with the control group (P < 0.05). No significant differences in the Balthazar CT score, shock rate, ICU transfer rate, or mortality occurred between the two groups. The modified DCQD can effectively relieve IAH and decrease LOS for patients with SAP. Larger clinical trials are needed to confirm these findings.

  3. Primary osseous Burkitt lymphoma with nodal and intracardiac metastases in a child

    Directory of Open Access Journals (Sweden)

    Lina Cadavid, MD

    2017-03-01

    Full Text Available Burkitt lymphoma (BL is the most frequent non-Hodgkin lymphoma in pediatric patients, accounting for approximately 34% of the cases of lymphoma in children. This subtype of non-Hodgkin lymphoma was first described in 1958 as a monoclonal proliferation of B cell lymphocytes. Cardiac involvement of BL in association with osseous compromise and lymphadenopathy is rare and poorly documented. We report a case of femur primary BL in an 8-year-old boy with metastatic cardiac involvement, retroperitoneal and iliofemoral lymphadenopathy, and hepatosplenomegaly. We highlight the diagnostic challenge in a patient with clinical nonspecific findings and systemic disease.

  4. Acquired Ichthyosis Triggered by an Osseous Hemangiopericytoma: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Aikaterini Patsatsi

    2014-01-01

    Full Text Available Ichthyoses are a heterogeneous group of cutaneous keratinization disorders that can be congenital or acquired. Apart from neoplastic disorders, the acquired form of ichthyosis (AI has been associated with a variety of diseases including infections, autoimmune/inflammatory and endocrine/metabolic diseases as well as nutritional conditions, medications and others. However, malignancy accounts for half of the reported cases, most commonly including lymphoproliferative disorders. We present a case of AI as a paraneoplastic skin manifestation of a primary, osseous hemangiopericytoma (HP accompanied by multiple liver metastases. We also review the literature and discuss the necessity of investigating underlying diseases, especially malignancy, when adult-onset ichthyosis arises.

  5. Clinical, radiographic, and histological findings of florid cemento-osseous dysplasia: a case report

    International Nuclear Information System (INIS)

    Kim, Jeong Hee; Song, Byeong Chul; Kimn, Sun Ho; Park, Yang Soon

    2011-01-01

    Cemento-osseous dysplasias are a group of disorders known to originate from periodontal ligament tissue and involve, essentially, the same pathological process. They are usually classified into three main groups: periapical, florid, and focal cemental dysplasias depending on their extent and radiographic appearances. Radiographically, florid cementoosseous dysplasia (FCOD) appears as dense, lobulated masses, often symmetrically located in various regions of the jaws. The best management for the asymptomatic FCOD patient consists of regular recall examinations with prophylaxis. The management of the symptomatic patient is more difficult. A case of FCOD occurring in a 52-year-old edentulous Korean female is reported which is rare with regard to race and sex.

  6. Clinical, radiographic, and histological findings of florid cemento-osseous dysplasia: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jeong Hee; Song, Byeong Chul; Kimn, Sun Ho; Park, Yang Soon [Seoul Veterans Hospital, Seoul (Korea, Republic of)

    2011-09-15

    Cemento-osseous dysplasias are a group of disorders known to originate from periodontal ligament tissue and involve, essentially, the same pathological process. They are usually classified into three main groups: periapical, florid, and focal cemental dysplasias depending on their extent and radiographic appearances. Radiographically, florid cementoosseous dysplasia (FCOD) appears as dense, lobulated masses, often symmetrically located in various regions of the jaws. The best management for the asymptomatic FCOD patient consists of regular recall examinations with prophylaxis. The management of the symptomatic patient is more difficult. A case of FCOD occurring in a 52-year-old edentulous Korean female is reported which is rare with regard to race and sex.

  7. [Construction and improvement of animal models with different positional osseous metastasis of prostate cancer in vivo].

    Science.gov (United States)

    Bi, Y X; Xiao, M H; Zhang, N N; Li, X Y; Mao, X P; Zhang, K; Zhang, Z R; Zhao, L Y

    2017-08-18

    To provide an important tool for the study of diagnose and treatment of prostate cancer (PCa) osseous metastasis and change of bone stress force on prostate cancer (PCa) osseous metastasis and a platform, which is more congruous to clinical process, for prevention and cure of neoplastic bone metastases, and to carry out the construction and improvement of animal models of PCa with different positional osseous metastasis in vivo. Different gradient concentrations of RM-1 cells were inoculated into the cavity of left femoral bone or lumbar vertebra of mice (C57BL/6) respectively. The change of mouse activity, tumor formation, tumor size and survival time were observed respectively. And the femur tissue and spinal tissue were obtained from the mice after death. The gray value of iconography were measured by imageological examination of femur tissue, and the final histopathological examination were taken to determine the tumor type in both femur and spinal tissue. The tumor growth could be touched at the puncture site in all the mice after inoculated for 7 days. There were no obvious differences in the time of tumorigenesis, the rate of tumor growth and tumor size among the mice in the same group (P>0.05). As the result, the construction femoral bone and lumbar vertebra metastatic models of PCa had been confirmed by iconography and pathology detection. At the same time, the survival time of the mice inoculated with low concentrations of PCa cells was obviously longer than that of high concentrations of PCa cells ( at least 2 weeks longer). The animal models with different positional osseous metastasis (limbs and axial skeleton) of PCa using the same PCa cells (RM-1) had been first constructed successfully in our study. At the same time, a high success rate of construction of PCa animal model with bone metastasis was obtained by femoral bone marrow cavity injection of PCa cells. The rate of tumor growth was rapid, animal survival time was appropriate, and the PCa animal

  8. Multi Vesicular Osseous Hydatid Disease of the Mandible- A Case Report

    Directory of Open Access Journals (Sweden)

    M Nematollahi

    2010-02-01

    Full Text Available "nHydatid disease is a common and major public health issue caused by parasite Echinococcus granulosus. The highest prevalence of the parasite can be found in different parts of world like Africa, Australia, and South America. This infection can occurs in almost any part of the body. Here we present clinical, radiological, histological features and treatment of a multi ve­sicular osseous hydatid disease of the mandible in an Afghan 5 year old boy with a firm swelling in the right side of mandible.

  9. A case of progressive osseous heteroplasia: a first case in Japan

    Energy Technology Data Exchange (ETDEWEB)

    Kumagai, Kenji; Egashira, Masayuki; Tomita, Masato; Suzuki, Masahiko; Shindo, Hiroyuki [Nagasaki University, Department of Orthopedic Surgery, Nagasaki City (Japan); Motomura, Katsuaki [Nagasaki University, Department of Pediatrics, Nagasaki (Japan); Uetani, Masataka [Nagasaki University, Department of Radiology, Nagasaki (Japan)

    2008-06-15

    Progressive osseous heteroplasia (POH) is a rare, hereditary, disorder (number 166350 in Mendelian Inheritance in Man), which was first identified in 1994 and is characterized by dermal ossification beginning in infancy as a result of increasing and extensive bone formation in deep muscle and fascia. We describe a boy with typical clinical, radiographic, and genetic features of POH. A nonsense mutation in exon 7 of the GNASl gene was identified in genomic DNA from the patient. No such case has been reported in East Asia or Japan before this patient. (orig.)

  10. Deletion of UCP2 in iNOS deficient mice reduces the severity of the disease during experimental autoimmune encephalomyelitis.

    Directory of Open Access Journals (Sweden)

    Caroline Aheng

    Full Text Available Uncoupling protein 2 is a member of the mitochondrial anion carrier family that is widely expressed in neurons and the immune cells of humans. Deletion of Ucp2 gene in mice pre-activates the immune system leading to higher resistance toward infection and to an increased susceptibility to develop chronic inflammatory diseases as previously exemplified with the Experimental Autoimmune Encephalomyelitis (EAE, a mouse model for multiple sclerosis. Given that oxidative stress is enhanced in Ucp2-/- mice and that nitric oxide (NO also plays a critical function in redox balance and in chronic inflammation, we generated mice deficient for both Ucp2 and iNos genes and submitted them to EAE. Mice lacking iNos gene exhibited the highest clinical score (3.4+/-0.5 p<0.05. Surprisingly, mice deficient for both genes developed milder disease with reduced immune cell infiltration, cytokines and ROS production as compared to iNos-/- mice.

  11. Reduced erythrocyte susceptibility and increased host clearance of young parasites slows Plasmodium growth in a murine model of severe malaria

    Science.gov (United States)

    Khoury, David S.; Cromer, Deborah; Best, Shannon E.; James, Kylie R.; Sebina, Ismail; Haque, Ashraful; Davenport, Miles P.

    2015-05-01

    The best correlate of malaria severity in human Plasmodium falciparum (Pf) infection is the total parasite load. Pf-infected humans could control parasite loads by two mechanisms, either decreasing parasite multiplication, or increasing parasite clearance. However, few studies have directly measured these two mechanisms in vivo. Here, we have directly quantified host clearance of parasites during Plasmodium infection in mice. We transferred labelled red blood cells (RBCs) from Plasmodium infected donors into uninfected and infected recipients, and tracked the fate of donor parasites by frequent blood sampling. We then applied age-based mathematical models to characterise parasite clearance in the recipient mice. Our analyses revealed an increased clearance of parasites in infected animals, particularly parasites of a younger developmental stage. However, the major decrease in parasite multiplication in infected mice was not mediated by increased clearance alone, but was accompanied by a significant reduction in the susceptibility of RBCs to parasitisation.

  12. The role of temporary biventricular pacing in the cardiac surgical patient with severely reduced left ventricular systolic function.

    Science.gov (United States)

    Evonich, Rudolph F; Stephens, John C; Merhi, William; Dukkipati, Srinivas; Tepe, Nicholas; Shannon, Francis; Altshuler, Jeffrey; Sakwa, Marc; Bassett, Joseph; Hanson, Eric; Boura, Judy; O'Neill, William W; Haines, David E

    2008-10-01

    The objective was to evaluate the effects of atrial synchronous biventricular pacing in postoperative patients with severe cardiomyopathy. Atrial synchronous biventricular pacing epicardial leads were placed during cardiac surgery in patients with an ejection fraction of 30% or less. Patients were randomized to usual care pacing, the mode determined by the surgeon (excluding atrial synchronous biventricular pacing) with a preference for no pacing or atrial pacing (atrial inhibited pacing); atrial synchronous right ventricular pacing; or atrial synchronous biventricular pacing. Pacing was continued until cessation of hemodynamic support. At 12 hours postoperatively, patients were randomly tested in each mode (atrial inhibited, atrial synchronous right ventricular, and atrial synchronous biventricular pacing), and thermodilution outputs were measured. Forty subjects were randomized. Groups were similar in age (66 +/- 11 years), gender (85% were male), ejection fraction (23% +/- 6%), QRS duration (111 +/- 30 ms), and surgical indication. There was no difference in stroke index or cardiac index at 12 hours, duration of inotropic or intra-aortic balloon pump support, intensive care unit, or hospital length of stay. On comparative crossover testing, stroke volume was similar with atrial inhibited pacing and atrial synchronous biventricular pacing (59.3 +/- 13.4 vs 57 +/- 12.1, respectively, P = not significant); however, atrial synchronous right ventricular pacing was inferior (56 +/- 12.9, P or= 5%), whereas 41% had a 5% or greater decrease in stroke volume. Pacing mode affects stroke volume in patients with severe cardiomyopathy. Atrial synchronous biventricular pacing was helpful in a minority, but in 41% it compromised stroke volume.

  13. Automatic Prompting and Positive Attention to Reduce Tongue Protrusion and Head Tilting by Two Adults with Severe to Profound Intellectual Disabilities

    Science.gov (United States)

    Lancioni, Giulio E.; Singh, Nirbhay N.; O'Reilly, Mark F.; Sigafoos, Jeff; Didden, Robert; Pichierri, Sabrina

    2010-01-01

    This study assessed a simple behavioral strategy for reducing stereotypic tongue protrusion and forward head tilting displayed by a woman and a man with severe to profound intellectual disabilities. The strategy involved (a) auditory prompting (i.e., verbal encouragements to keep the tongue in the mouth or the head upright) delivered automatically…

  14. Sequential application of non-pharmacological interventions reduces the severity of labour pain, delays use of pharmacological analgesia, and improves some obstetric outcomes: a randomised trial

    Directory of Open Access Journals (Sweden)

    Rubneide Barreto Silva Gallo

    2018-01-01

    Trial registration: NCT01389128. [Gallo RBS, Santana LS, Marcolin AC, Duarte G, Quintana SM (2018 Sequential application of non-pharmacological interventions reduces the severity of labour pain, delays use of pharmacological analgesia, and improves some obstetric outcomes: a randomised trial. Journal of Physiotherapy 64: 33–40

  15. Caloric Vestibular Stimulation Reduces Pain and Somatoparaphrenia in a Severe Chronic Central Post-Stroke Pain Patient: A Case Study.

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    Grazia Fernanda Spitoni

    Full Text Available Central post-stroke pain is a neuropathic syndrome characterized by intolerable contralesional pain and, in rare cases, somatic delusions. To date, there is limited evidence for the effective treatments of this disease. Here we used caloric vestibular stimulation to reduce pain and somatoparaphrenia in a 57-year-old woman suffering from central post-stroke pain. Resting-state functional magnetic resonance imaging was used to assess the neurological effects of this treatment. Following vestibular stimulation we observed impressive improvements in motor skills, pain, and somatic delusions. In the functional connectivity study before the vestibular stimulation, we observed differences in the patient's left thalamus functional connectivity, with respect to the thalamus connectivity of a control group (N = 20, in the bilateral cingulate cortex and left insula. After the caloric stimulation, the left thalamus functional connectivity with these regions, which are known to be involved in the cortical response to pain, disappeared as in the control group. The beneficial use of vestibular stimulation in the reduction of pain and somatic delusion in a CPSP patient is now documented by behavioral and imaging data. This evidence can be applied to theoretical models of pain and body delusions.

  16. Effectiveness of a discharge education program in reducing the severity of postpartum depression: a randomized controlled evaluation study.

    Science.gov (United States)

    Ho, Shiao-Ming; Heh, Shu-Shya; Jevitt, Cecilia M; Huang, Lian-Hua; Fu, Yu-Ying; Wang, Li-Lin

    2009-10-01

    The effectiveness of a hospital discharge education program including information on postnatal depression was evaluated to reduce psychological morbidity after childbirth. A randomized controlled trial (RCT) was conducted in a regional hospital in Taipei. Two hundred first-time mothers agreed to take part and were randomly allocated to an intervention group (n=100) or control group (n=100). The intervention group received discharge education on postnatal depression provided by postpartum ward nurses. The control group received general postpartum education. The main outcome measure was the Edinburgh Postnatal Depression Scale (EPDS) administered by postal questionnaire at six weeks and three months after delivery. Women who received discharge education intervention on postnatal depression were less likely to have high depression scores when compared to the control group at three months postpartum. A discharge educational intervention including postnatal depression information given to women during the postpartum stay benefits psychological well-being. A postpartum discharge education program including information on postnatal depression should be integrated into postpartum discharge care in general practice. 2009 Elsevier Ireland Ltd.

  17. Benign fibro-osseous lesions of the jaws: a study of 127 Chinese patients and review of the literature.

    Science.gov (United States)

    Alsharif, Mohd Jamal; Sun, Zhi-Jun; Chen, Xin-Ming; Wang, Shi-Ping; Zhao, Yi-Fang

    2009-04-01

    The aim of this study is to analyze all the cases of benign fibro-osseous lesions treated at School and Hospital of Stomatology, Wuhan University, to compare the results obtained in this study with those previously documented by other authors. The 127 cases diagnosed as a fibro-osseous lesion were retrieved, and information about these lesions was documented. In all, 127 cases of benign fibro-osseous lesions were surgically treated. Of these, 55 were cemento-ossifying fibroma, 43 ossifying fibroma, and 29 fibrous dysplasia. Cemento-ossifying fibromas mostly occur in men of the second decades, mostly in the mandible. Ossifying fibromas had almost equal sex predilection and age distribution peaked in the second decades, mostly in the mandible. Fibrous dysplasia also had equal sex predilection, and age distribution peaked in the second and third decades, with equal occurrence in both jaws. The tumors needed to have a regular follow-up after the surgery.

  18. tDCS combined with optokinetic drift reduces egocentric neglect in severely impaired post-acute patients.

    Science.gov (United States)

    Turgut, Nergiz; Miranda, Marcela; Kastrup, Andreas; Eling, Paul; Hildebrandt, Helmut

    2018-06-01

    Visuospatial neglect is a disabling syndrome resulting in impaired activities of daily living and in longer durations of inpatient rehabilitation. Effective interventions to remediate neglect are still needed. The combination of tDCS and an optokinetic task might qualify as a treatment method. A total of 32 post-acute patients with left (n = 20) or right-sided neglect were allotted to an intervention or a control group (both groups n = 16). The intervention group received eight sessions of 1.5-2.0 mA parietal transcranial direct current stimulation (tDCS) during the performance of an optokinetic task distributed over two weeks. Additionally they received standard therapy for five hours per day. The control group received only the standard therapy. Patients were examined twice before (with 3-4 days between examinations) and twice after treatment (5-6 days between examinations). Compared to the control group and controlling for spontaneous remission, the intervention group improved on spontaneous body orientation and the Clock Drawing Test. Intragroup comparisons showed broad improvements on egocentric but not on allocentric symptoms only for the intervention group. A short additional application of tDCS during an optokinetic task led to improvements of severe neglect compared to a standard neurological early rehabilitation treatment. Improvements seem to concern primarily egocentric rather than allocentric neglect.

  19. Study of contamination by 100 μCi of Sr 90 in the rat: clinical, hematological and osseous effects (appearance of osteosarcomas)

    International Nuclear Information System (INIS)

    Graf, B.; Lafuma, J.; Parmentier, C.; Parmentier, N.

    1968-01-01

    Clinical, hematological and osseous effects following an intramuscular injection of 100 μCi 90 Sr were studied in the rat. In spite of the magnitude of the injection and the resulting damage, the elimination of strontium could compare with what occurs after an injection at tracer doses. Comparing with the controls at the outcoming time, clinical monitoring mainly brought out a loss of body weight. Fairly early (20. - 30. day) there occurred severe hematological damage, especially on lymphocyte line, which subsided spontaneously. As foreseen, the anatomo-pathological survey of the early period showed bone and medullar lesions in the areas of enchondral ossification. In the late period, bone sarcomas occurred in nine animals out of ten. The outstanding histological type was osteogenic osteosarcomas; besides, two animals experienced bilateral tumors. (authors) [fr

  20. A rat pancreatic ribonuclease fused to a late cotton pollen promoter severely reduces pollen viability in tobacco plants

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    R.B. Bernd-Souza

    2000-06-01

    Full Text Available The effects of an animal RNase fused to the late cotton pollen-specific promoter G9 in a plant system were investigated. Expression of the chimeric genes G9-uidA and G9-RNase in tobacco plants showed that the 1.2-kb promoter fragment of the G9 gene was sufficient to maintain tissue and temporal specificity in a heterologous system. GUS (beta-glucuronidase expression was detected only in pollen from anther stage 6 through anthesis, with maximal GUS activity in pollen from stage 10 anthers. Investigating the effects of the rat RNase on pollen viability at stage 10, we found that pollen viability was reduced from 79 to 8% and from 89 to 40%, in pollen germination and fluoresceine diacetate assays, respectively, in one G9-RNase transgenic line, suggesting a lethal effect of the RNase gene. This indicates that the rat RNase produces deleterious effects in this plant system and may be useful for engineering male sterility.Foram investigados os efeitos da expressão de uma ribonuclease de origem animal em um sistema vegetal, ligando-se esta ao promotor do gene pólen-específico G9 de algodão. Examinou-se a expressão dos genes quiméricos G9-uidA e G9-RNase em plantas de tabaco e determinou-se que o fragmento de 1.2 kb do promotor do gene G9 foi suficiente para manter a especificidade temporal e espacial da expressão, em sistema heterólogo. A expressão do gene GUS foi detectada somente em pólen, do estágio 6 do desenvolvimento da antera até a antese, com atividade máxima em pólen de anteras no estágio 10. Estudos neste estágio com linhagens transgênicas contendo G9-RNase mostraram que um clone transgênico apresentava reduções na viabilidade do pólen de 79 para 8% e de 89 para 40% nos testes de germinação e coloração com diacetato de fluoresceína, respectivamente, sugerindo letalidade na expressão do gene de RNase. Estes resultados indicam que a RNase animal apresenta um efeito deletério em planta e oferece possibilidade de uso

  1. Treatment of an intrabony osseous lesion associated with a palatoradicular groove

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    A Suchetha

    2012-01-01

    Full Text Available Various root developmental anomalies like palatoradicular groove (PRG have been associated with worsening of periodontal condition. The aim of the present case report is to describe the regenerative surgical treatment of periodontal and osseous lesion associated with the subgingival extension of PRG. A 23-year-old female patient reported with pain in upper incisor teeth region. On clinical and radiological examination, a deep endosseous defect was found distal to maxillary right lateral incisor that was etiologically associated with the presence of a PRG. Treatment procedures consisted of: Regenerative periodontal therapy using Guided tissue regeneration (GTR and hydroxyapatite (HA bone graft and 2 flattening of the radicular portion of the palatal groove. The clinical examination at 1 year revealed shallow residual probing depth (3 mm and no increase in gingival recession. The radiographic examination showed reduction in the radiolucency suggesting bone fill. A PRG may serve as a pathway for the development of a periodontal osseous defect. The combination of GTR and HA may be clinically and radiographically efficacious in the treatment of such a defect.

  2. A Clinicopathologic Analysis of 207 Cases of Benign Fibro-Osseous Lesions of the Jaws.

    Science.gov (United States)

    Phattarataratip, Ekarat; Pholjaroen, Chanajit; Tiranon, Prawwalee

    2014-06-01

    Benign fibro-osseous lesion (BFOL) is a distinct group of jaw entities composed of fibrocellular tissue and mineralized materials. In this study, we examined the epidemiological, clinical, and pathological features of patients with BFOL. Records and microslides of 207 BFOLs submitted to pathology service were retrospectively reviewed. Overall, fibrous dysplasia (FD) was the most prevalent (36.7%), followed by ossifying fibroma (OF; 32.4%), osseous dysplasia (OD; 24.6%), and juvenile ossifying fibroma (JOF; 6.3%). Female predilection was noted. FD and JOF were common in maxilla, whereas most OF and OD affected the mandible. Most patients with FD and OF presented with painless swelling, while patients with OD were symptomless. The majority of FD specimens showed woven bone, while a mixture of woven bone and cementum-like materials was often noted in OF and OD. Our data show variations in the clinicopathologic features of BFOLs. A thorough examination of all aspects of BFOL patients is imperative for accurate diagnosis. © The Author(s) 2013.

  3. Asynchronous neuro-osseous growth in adolescent idiopathic scoliosis - MRI-based research

    International Nuclear Information System (INIS)

    Chu, Winnie C.W.; Rasalkar, Darshana D.; Cheng, Jack C.Y.

    2011-01-01

    Adolescent idiopathic scoliosis (AIS) is a common worldwide problem and has been treated for many decades; however, there still remain uncertain areas about this disorder. Its involvement and impact on different parts of the human body remain underestimated due to lack of technology in imaging for objective assessment in the past. The advances in imaging technique and image analysis technology have provided a novel approach for the understanding of the phenotypic presentation of neuro-osseous changes in AIS patients as compared with normal controls. This review is the summary of morphological assessment of the skeletal and nervous systems in girls with AIS based on MRI. Girls with AIS are found to have morphological differences in multiple areas including the vertebral column, spinal cord, skull and brain when compared with age- and sex-matched normal controls. Taken together, the abnormalities in the skeletal system and nervous system of AIS are likely to be inter-related and reflect a systemic process of asynchronous neuro-osseous growth. The current knowledge about the anatomical changes in AIS has important implications with respect to the understanding of fundamental pathomechanical processes involved in the evolution of the scoliotic deformity. (orig.)

  4. The prevalence, clinical and radiographic characteristics of cemento-osseous dysplasia in Korea

    International Nuclear Information System (INIS)

    Cho, Bong Hae; Jung, Yun Hoa; Nah, Kyung Soo

    2007-01-01

    This study was intended to estimate the prevalence of cemento-osseous dysplasia (COD) in the Korean population and to assess the clinical and radiographic characteristics of this condition. Panoramic radiographs from 10,646 patients (4.982 males and 5.664 females, age range from 6 to 91 years) were reviewed for evidence of COD. Their demographics, clinical characteristics, and radiographic features were retrospectively assessed. Of 10,646 panoramic radiographs, 33 radiographs (0.31%) exhibited evidence of COD. The prevalence of COD increased to over 1% in women over 40-years old. Of these 33 patients, 16 had florid cemento-osseous dysplasia (FCOD) and 17 had focal COD. Due tp the multiplicity of FOCD, a total of 63 COD lesions were assessed. These lesions were most common in the mandibular molar area. Most of the COD lesion examined (61.9%) were less than 10 mm and the majority (82.5%) showed radiopacity. COD has a predilection for the mandibular molar area of middle-aged and older women

  5. Retreatment and surgical repair of the apical third perforation and osseous defect using mineral trioxide aggregate

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    A Savitha

    2013-01-01

    Full Text Available One of the causes of non-healing periapical pathosis in endodontically treated tooth is root perforation. This can occur pathologically by resorption and caries, iatrogenically during endodontic therapy (zip, strip, furcal perforations. Root perforation results in bacterial contamination, periradicular tissue injury, inflammation, and bone resorption. The purpose of this case report is to describe endodontic retreatment and surgical management of a longstanding periapical lesion on maxillary lateral incisor, associated with perforation and osseous defects using mineral trioxide aggregate (MTA. Although the majority of bone support and root dentin was damaged, an attempt was made to repair the defect and restore the tooth. After the surgical intervention and root canal treatment, the perforation was subsequently sealed with MTA. Later, the root was reinforced with composites and the tooth was restored with direct veneer. Conclusion: Four-and-a-half year (54 months recall examination showed no evidence of periodontal breakdown, no symptoms of further deterioration, and complete healing of periradicular lesions when examined by radiography. This case report presents a treatment strategy that could improve the healing process and beneficial outcomes for patients with perforation and osseous defect.

  6. The prevalence, clinical and radiographic characteristics of cemento-osseous dysplasia in Korea

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Bong Hae; Jung, Yun Hoa; Nah, Kyung Soo [Pusan National Univ. College of Dentistry, Pusan (Korea, Republic of)

    2007-12-15

    This study was intended to estimate the prevalence of cemento-osseous dysplasia (COD) in the Korean population and to assess the clinical and radiographic characteristics of this condition. Panoramic radiographs from 10,646 patients (4.982 males and 5.664 females, age range from 6 to 91 years) were reviewed for evidence of COD. Their demographics, clinical characteristics, and radiographic features were retrospectively assessed. Of 10,646 panoramic radiographs, 33 radiographs (0.31%) exhibited evidence of COD. The prevalence of COD increased to over 1% in women over 40-years old. Of these 33 patients, 16 had florid cemento-osseous dysplasia (FCOD) and 17 had focal COD. Due tp the multiplicity of FOCD, a total of 63 COD lesions were assessed. These lesions were most common in the mandibular molar area. Most of the COD lesion examined (61.9%) were less than 10 mm and the majority (82.5%) showed radiopacity. COD has a predilection for the mandibular molar area of middle-aged and older women.

  7. Osseous Tumours of the Hand: A Review of 99 Cases in 20 Years

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    Mahmoud Farzan

    2013-12-01

    Full Text Available   Background: Tumors involving the hand skeleton are rare. However, a basic knowledge of hand tumors is necessary for every clinician. This is due to the importance of distinguishing typical benign tumors from life or limb threatening malignant ones. Methods: This study is a review of 99 cases of osseous hand tumors presented to the department of orthopedic surgery, Imam Khomeini Hospital in Tehran, Iran, from December 1990 to February 2011. Results: Ninety-one cases were benign osseous tumors of the hand and eight tumors were malignant which four of them were considered as primary and four considered as metastatic type. The most common benign tumors were enchondroma and osteoid osteoma. Other benign tumors were epidermoid bone cyst, giant cell tumor of the bone, aneurysmal bone cyst, osteoblastoma, and osteochondroma. Primary malignant tumors were extremely rare and we have reported two chondrosarcomas, one osteosarcoma and one Ewing’s sarcoma involving the hand skeleton. Conclusion: This study indicates that the history, physical examination, laboratory and radiographic data as well as clinicians’ knowledge of specific hand tumors are required for the best management strategy. New techniques could lead to earlier diagnosis, prevent complications and indentify the most effective type of treatment.

  8. Osseous Tumours of the Hand: A Review of 99 Cases in 20 Years

    Directory of Open Access Journals (Sweden)

    Mahmoud Farzan

    2013-12-01

    Full Text Available Background: Tumors involving the hand skeleton are rare. However, a basic knowledge of hand tumors is necessary for every clinician. This is due to the importance of distinguishing typical benign tumors from life or limb threatening malignant ones. Methods: This study is a review of 99 cases of osseous hand tumors presented to the department of orthopedic surgery, Imam Khomeini Hospital in Tehran, Iran, from December 1990 to February 2011. Results: Ninety-one cases were benign osseous tumors of the hand and eight tumors were malignant which four of them were considered as primary and four considered as metastatic type. The most common benign tumors were enchondroma and osteoid osteoma. Other benign tumors were epidermoid bone cyst, giant cell tumor of the bone, aneurysmal bone cyst, osteoblastoma, and osteochondroma. Primary malignant tumors were extremely rare and we have reported two chondrosarcomas, one osteosarcoma and one Ewing’s sarcoma involving the hand skeleton. Conclusion: This study indicates that the history, physical examination, laboratory and radiographic data as well as clinicians’ knowledge of specific hand tumors are required for the best management strategy. New techniques could lead to earlier diagnosis, prevent complications and indentify the most effective type of treatment.

  9. Fixation of intracapsular femoral neck fractures: Effect of trans-osseous capsular decompression

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    Elsayed Ibraheem Elsayed Massoud

    2010-06-01

    Full Text Available Objectives: Intracapsular femoral neck fractures have been found as associated with hemarthrosis. The fluid in the intact capsule elevates the intracapsular pressure to a level could tamponades the vascular supply of the femoralhead. Therefore, capsular decompression seems necessaryto salvage the femoral head circulation. Negative impact of the capsular incision also has been reported. Therefore, we hypothesize that creation of a trans-osseousportal can decompress the capsule as well as not threaten the capsular related blood vessels.Materials and methods: In present study, 27 patients with intracapsular femoral neck fractures were included. Coinciding with closed reduction and internal fixation we made a trans-osseous portal for capsular decompression. Patients were followed-up prospectively for a mean periodof 43.1 months.Results: All fractures united. However, one patient 17 years-old who was nursed preoperatively in skin traction developed osteonecrosis of the femoral head.Conclusion: Our results supported that the trans-osseous capsular decompression has evacuated the intracapsular haematoma and has not threatened the capsular integrity. Preoperative traction of the injured limb particularly in the young patient may play a role in development of osteonecrosisof the femoral head.

  10. Asynchronous neuro-osseous growth in adolescent idiopathic scoliosis - MRI-based research

    Energy Technology Data Exchange (ETDEWEB)

    Chu, Winnie C.W.; Rasalkar, Darshana D. [The Chinese University of Hong Kong, Department of Diagnostic Radiology and Organ Imaging, Hong Kong, SAR (China); Cheng, Jack C.Y. [The Chinese University of Hong Kong, Department of Orthopaedics and Traumatology, Hong Kong, SAR (China)

    2011-09-15

    Adolescent idiopathic scoliosis (AIS) is a common worldwide problem and has been treated for many decades; however, there still remain uncertain areas about this disorder. Its involvement and impact on different parts of the human body remain underestimated due to lack of technology in imaging for objective assessment in the past. The advances in imaging technique and image analysis technology have provided a novel approach for the understanding of the phenotypic presentation of neuro-osseous changes in AIS patients as compared with normal controls. This review is the summary of morphological assessment of the skeletal and nervous systems in girls with AIS based on MRI. Girls with AIS are found to have morphological differences in multiple areas including the vertebral column, spinal cord, skull and brain when compared with age- and sex-matched normal controls. Taken together, the abnormalities in the skeletal system and nervous system of AIS are likely to be inter-related and reflect a systemic process of asynchronous neuro-osseous growth. The current knowledge about the anatomical changes in AIS has important implications with respect to the understanding of fundamental pathomechanical processes involved in the evolution of the scoliotic deformity. (orig.)

  11. A biomechanical analysis of the soft tissue and osseous constraints of the hip joint.

    Science.gov (United States)

    Smith, Matthew V; Costic, Ryan S; Allaire, Robert; Schilling, Peter L; Sekiya, Jon K

    2014-04-01

    The goal of this study was to determine the role of soft tissue and osseous constraints in hip biomechanics using a unique robotic testing apparatus. Four fresh-frozen human cadaveric hemi-pelvises without degenerative changes or dysplasia were stripped of all soft tissue except the ligamentous capsule and the intra-articular structures. All hips were tested using a robotic manipulator/universal force-moment sensor testing system to measure and compare end-range of motion (ROM) and kinematic translations in "capsule vented" (a small hole in the capsule) and "capsule separated" (capsular ligaments separated from each other) states. Then, the "capsule vented" state was compared to the condition in which the capsule and labrum were removed to calculate bone and soft tissue forces with 40 N of load applied in six different directions along three axes. There were no significant differences in end-ROM or kinematic translations between the "capsule vented" and "capsule separated" states. Bone forces significantly increased with loads applied in the anterior, posterior and superior directions. Soft tissue forces increased significantly with loads applied in the medial, lateral and inferior directions. The individual hip capsular ligaments act independently of each other to resist end-ROM. Both osseous and soft tissue constraints are important to hip biomechanics depending upon the direction of applied force. The clinical relevance is that surgical management for hip disorders should preserve the soft tissue constraints in the hip when possible to maintain normal hip biomechanics.

  12. Reduced referral and case fatality rates for severe symptomatic hyperlactataemia in a South African public sector antiretroviral programme: a retrospective observational study

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    Stead Dave

    2010-05-01

    Full Text Available Abstract Background Interventions to promote prevention and earlier diagnosis of severe symptomatic hyperlactataemia (SHL were implemented in the Western Cape provincial antiretroviral programme (South Africa from 2004. Interventions included clinician education, point-of-care lactate meters, switch from stavudine to zidovudine in high risk patients and stavudine dose reduction. This study assessed trends in referral rate, severity at presentation and case fatality rate for severe SHL. Methods Retrospective study of severe SHL cases diagnosed at a referral facility from 1 January 2003 to 31 December 2008. Severe SHL was defined as patients with compatible symptoms and serum lactate ≥ 5 mmol/l attributable to antiretroviral therapy (ART. Cumulative ART exposure at referring ART clinics was used to calculate referral rates. Results There were 254 severe SHL cases. The referral rate (per thousand patient years [py] ART exposure peaked in 2005 (20.4/1000py, but fell to 1.3/1000py by 2008 (incidence rate ratio [IRR] = 0.07, 95%CI 0.04-0.11. In 2003, 66.7% of cases presented with a standard bicarbonate (SHCO3 level Conclusions These trends suggest the interventions were associated with reduced referral, less severe metabolic acidosis at presentation and improved survival.

  13. Restored nitric oxide bioavailability reduces the severity of acute-to-chronic transition in a mouse model of aristolochic acid nephropathy.

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    Inès Jadot

    Full Text Available Aristolochic Acid (AA nephropathy (AAN is a progressive tubulointerstitial nephritis characterized by an early phase of acute kidney injury (AKI leading to chronic kidney disease (CKD. The reduced nitric oxide (NO bioavailability reported in AAN might contribute to renal function impairment and progression of the disease. We previously demonstrated that L-arginine (L-Arg supplementation is protective in AA-induced AKI. Since the severity of AKI may be considered a strong predictor of progression to CKD, the present study aims to assess the potential benefit of L-Arg supplementation during the transition from the acute phase to the chronic phase of AAN. C57BL/6J male mice were randomly subjected to daily i.p. injections of vehicle or AA for 4 days. To determine whether renal AA-induced injuries were linked to reduced NO production, L-Arg was added to drinking water from 7 days before starting i.p. injections, until the end of the protocol. Mice were euthanized 5, 10 and 20 days after vehicle or AA administration. AA-treated mice displayed marked renal injury and reduced NO bioavailability, while histopathological features of AAN were reproduced, including interstitial cell infiltration and tubulointerstitial fibrosis. L-Arg treatment restored renal NO bioavailability and reduced the severity of AA-induced injury, inflammation and fibrosis. We concluded that reduced renal NO bioavailability contributes to the processes underlying AAN. Furthermore, L-Arg shows nephroprotective effects by decreasing the severity of acute-to-chronic transition in experimental AAN and might represent a potential therapeutic tool in the future.

  14. An empirical study on the effect of speech therapy with cognitive behavior therapy on reducing the severity of stuttering and anxiety

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    Pegah Ansari

    2013-12-01

    Full Text Available The purpose of this research is to investigate the impact of speech therapy with Cognitive Behavior Therapy (CBT on reducing the severity of stuttering & anxiety for adults who stutter in the city of Isfahan, Iran. The study used a semi-experimental design with pre-test/post-test control groups and it was conducted among 24 clients. The sample was selected through available sampling method among the clients suffering from stuttering and attended public speech therapy clinics of Isfahan. The measurement instruments were Stuttering Severity Instrument (SSI4 and Beck's Anxiety Inventory (BAI. After doing the pretest, clients were placed into one experimental group of speech therapy with CBT and one control group. Speech therapy for this research included ten 45-minutes sessions accomplished for each individual subject and CBT included ten 90-minutes group sessions. After finishing the therapy sessions, the posttest was executed on both groups. For statistical analysis of data, Analysis of Covariance was carried out. The research findings indicated that speech therapy with CBT reduced the severity of Stuttering and Anxiety. Speech therapy with CBT is effective in reducing Stuttering & Anxiety.

  15. Reduced availability of serotonin transporters in obsessive-compulsive disorder correlates with symptom severity - a [11C]DASB PET study

    International Nuclear Information System (INIS)

    Reimold, M.; Smolka, M.N.; Zimmer, A.

    2007-01-01

    Reduced availability of brainstem serotonin transporters (5-HTT) has been observed in vivo in obsessive-compulsive disorder (OCD). However, results vary and may be influenced by competition with endogenous serotonin. Using positron emission tomography (PET) and [ 11 C]DASB, a specific 5-HTT ligand that showed no competition with serotonin for 5-HTT binding in vitro, we tested the hypothesis that 5-HTT availability is reduced in OCD patients and correlated with OCD severity. 5-HTT availability in the thalamus and the midbrain was measured in nine drug-free OCD patients and compared with 19 healthy controls, matched for the individual combination of 5-HTT genotype, gender and smoking status. OCD severity was assessed with the Yale-Brown obsessive compulsive scale (Y-BOCS). 5-HTT availability was significantly reduced in the thalamus and midbrain of OCD patients. Age and 5-HTT in the thalamus explained 83 % of OCD severity in patients that were drug-free for at least 1 year. This PET study confirms a central role of the serotonergic system, particularly the thalamus in the pathogenesis of obsessive compulsive disorder. (author)

  16. Reassessing the Aurignacian of Slovenia: techno-economic behaviour and direct dating of osseous projectile points.

    Science.gov (United States)

    Moreau, Luc; Odar, Boštjan; Higham, Tom; Horvat, Aleksander; Pirkmajer, Darja; Turk, Peter

    2015-01-01

    The Palaeolithic of southern Central Europe has a long history of archaeological research. Particularly, the presence of numerous osseous projectile points in many early Upper Palaeolithic (EUP) assemblages in this region has attracted the attention of the international research community. However, the scarcity of properly identified and well-dated Aurignacian contexts represents an obstacle for investigation of the nature and timing of the Middle to Upper Palaeolithic transition. In this context, the question of whether Neandertals made Aurignacian osseous projectile points, either on their own or as a consequence of cultural interaction with anatomically modern humans (AMH), still remains an open issue. Here we reassess the EUP record of Slovenia by evaluating the Aurignacian character of the assemblages from Potočka zijalka, Mokriška jama and Divje babe I in the light of their suggested roots in the local Mousterian. We provide a comprehensive description of the lithic industry from Potočka zijalka, which represents one of the rare EUP assemblages of southern Central Europe with a representative number of lithic artefacts to be analysed from the perspective of lithic technology and raw material economy. Our re-analysis of the Slovenian assemblages is backed by a series of 11 new ultrafiltered collagen 14C dates obtained directly on associated osseous projectile points from the studied assemblages. The Aurignacian of Potočka zijalka underlines the remarkable consistency of the Early Aurignacian with low typo-technological variability across Europe, resulting from a marked dependence on transported toolkits and raw material conservation. The new radiocarbon determinations for the Aurignacian of Slovenia appear to post-date the 34-32 ka BP (thousands of years before present) threshold for the last Neandertals in the region. Although not falsified, the hypothesis of Aurignacian bone tools in southern Central Europe as a product of late Neandertals is not

  17. Management of Terminal Osseous Overgrowth of the Humerus With Simple Resection and Osteocartilaginous Grafts.

    Science.gov (United States)

    Fedorak, Graham T; Cuomo, Anna V; Watts, Hugh G; Scaduto, Anthony A

    Osseous overgrowth is a common complication in children after humeral transcortical amputation. Capping tibial overgrowth with the proximal fibula has been shown to be the most effective treatment. However, best treatment practices are not clear for the humerus. We compared patients treated surgically for humeral osseous overgrowth with simple resection or autologous osteocartilaginous graft to determine if this treatment were as effective in the humerus as it has been in the tibia. A retrospective review of humeral amputees from 1987 to 2011 at a pediatric hospital was performed. Patients with 2 years follow-up who underwent surgical treatment for established humeral overgrowth were included. Patients initially managed with simple resection were compared with those managed with autologous osteocartilaginous grafts. Descriptive statistics were calculated for demographic and outcome variables. T tests and χ tests were used to compare differences between groups. Eighteen humeri in 16 patients met inclusion criteria. Mean age at surgery was 8.3 (2.6 to 13.6) years and mean follow-up was 6.3 (1.5 to 10.4) years. Thirteen humeri underwent simple resection, with recurrent overgrowth in 9, and revision surgery in 8 at a mean 2.6 years. Five humeri were primarily managed with autologous osteocartilaginous grafts. Two developed non-overgrowth-related complications at 1 and 42 months. Including revision procedures after simple resection, 10 humeri were managed with autologous osteocartilaginous grafts. Thirty percent (3/10) required revision surgery; however, there were no cases of recurrent overgrowth. χ comparison showed lower rates of complications (P=0.004) and reoperation (P=0.012) with capping as compared with simple resection. Autologous osteocartilaginous capping of the humerus has a significantly lower rate of complications and reoperation compared with simple resection. However, the capping procedure has the potential for other complications related to difficulty

  18. Air, bone and soft tissue excitation of the cochlea in the presence of severe impediments to ossicle and window mobility.

    Science.gov (United States)

    Perez, Ronen; Adelman, Cahtia; Chordekar, Shai; Ishai, Reuven; Sohmer, Haim

    2015-04-01

    Clinical conditions have been described in which one of the two cochlear windows is immobile (otosclerosis) or absent (round window atresia), but nevertheless bone conduction (BC) thresholds are relatively unaffected. To clarify this apparent paradox, experimental manipulations which would severely impede several of the classical osseous mechanisms of BC were induced in fat sand rats, including discontinuity or immobilization of the ossicular chain, coupled with window fixation. Effects of these manipulations were assessed by recording auditory nerve brainstem evoked response (ABR) thresholds to stimulation by air conduction (AC), by osseous BC and by non-osseous BC (also called soft tissue conduction-STC) in which the BC bone vibrator is applied to skin sites. Following the immobilization, discontinuity and window fixation, auditory stimulation was also delivered to cerebro-spinal fluid (CSF) and to saline applied to the middle ear cavity. While the manipulations (immobilization, discontinuity, window fixation) led to an elevation of AC thresholds, nevertheless, there was no change in osseous and non-osseous BC thresholds. On the other hand, ABR could be elicited in response to fluid pressure stimulation to CSF and middle ear saline, even in the presence of the severe restriction of ossicular chain and window mobility. The results of these experiments in which osseous and non-osseous BC thresholds remained unchanged in the presence of severe restriction of the classical middle ear mechanisms and in the absence of an efficient release window, while ABR could be recorded in response to fluid pressure auditory stimulation to fluid sites, indicate that it is possible that the inner ear may be activated at low sound intensities by fast fluid pressure stimulation. At higher sound intensities, a slower passive basilar membrane traveling wave may serve to excite the inner ear.

  19. Effect of Bisphosphonate Pretreatment on Fresh Osteochondral Allografts: Analysis of In Vitro Graft Structure and In Vivo Osseous Incorporation.

    Science.gov (United States)

    Moore, Drew D; Baker, Kevin C; Baker, Erin A; Fleischer, Mackenzie M; Newton, Michael D; Barreras, Nicholas; Vaupel, Zachary M; Fortin, Paul T

    2018-03-23

    Fresh allograft transplantation of osteochondral defects restores functional articular cartilage and subchondral bone; however, rapid loss of chondrocyte viability during storage and osteoclast-mediated bone resorption at the graft-host interface after transplantation negatively impact outcomes. The authors present a pilot study evaluating the in vitro and in vivo impact of augmenting storage media with bisphosphonates. Forty cylindrical osteochondral cores were harvested from femoral condyles of human cadaveric specimens and immersed in either standard storage media or storage media supplemented with nitrogenated or non-nitrogenated bisphosphonates. Maintenance of graft structure and chondrocyte viability were assessed at 3 time points. A miniature swine trochlear defect model was used to evaluate the influence of bisphosphonate-augmented storage media on in vivo incorporation of fresh osteochondral tissue, which was quantified via μCT and decalcified histology. In the in vitro study, Safranin-O/Fast Green staining showed that both low- and high-dose nitrogenated-treated grafts retained chondrocyte viability and cartilage matrix for up to 43 days of storage. Allografts stored in nitrogenated-augmented storage media showed both μCT and histologic evidence of enhanced in vivo bony and cartilaginous incorporation in the miniature swine trochlear defect model. Several preclinical studies have shown the potential for enhanced storage of fresh osteochondral allografts via additions of relatively common drugs and biomolecules. This study showed that supplementing standard storage media with nitrogenated bisphosphonates may improve maintenance of chondrocyte viability and graft structure during cold storage as well as enhance in vivo osseous and cartilaginous incorporation of the graft. [Orthopedics: 201x; xx(x):xx-xx.]. Copyright 2018, SLACK Incorporated.

  20. Reducing Severity of Late Blight (Phytophthora infestans and Improving Potato (Solanum tuberosum L. Tuber Yield with Pre-Harvest Application of Calcium Nutrients

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    Yewubnesh Wendimu Seifu

    2017-10-01

    Full Text Available The efficiency of pre-harvest application of calcium chloride alone, calcium nitrate alone, and combined application of calcium chloride and calcium nitrate (1:1 was evaluated in reducing the severity of P. infestans and improving potato tuber yield. Pot experiment was conducted in randomized complete block design with four replications. The treatments consisted of combination of two potato varieties (Shenkola and Gera and three types of calcium nutrients (calcium chloride alone, calcium nitrate alone, and calcium chloride mixed with calcium nitrate, each at three levels (5, 10, and 15 g per liter per plant and the control treatment (0 g of calcium nutrients. In comparison to the control treatment, the application of calcium nutrients significantly decreased the severity of late blight disease and improved potato tuber yield. The effect of calcium nutrients on the severity of late blight disease and potato tuber yield differed among the two potato varieties. The maximum severity reduction (60% was noticed in the Gera potato variety with the application of calcium chloride mixed with calcium nitrate (1:1, supplied at 15 g per plant. However, the highest average tuber yield was obtained with the application of calcium nitrate at 15 g per plant, and average tuber yield was increased by 77% in both potato varieties. Hence, foliar application of either calcium nitrate alone or calcium nitrate mixed with calcium chloride was found to be more efficient than the application of calcium chloride alone. This result suggests that the nitrate ion present in the calcium nitrate may make a difference in terms of reducing the severity of late blight disease and improving potato tuber yield. The lowered severity of late blight disease and the increased tuber yield in potato plants sprayed with calcium nutrients may be because of the higher accumulation of calcium in the plant tissue.

  1. Cone Beam Computed Tomography (CBCT Features of a Rare Fibro-Osseous Lesion: A Case Report

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    Mahrokh Imanimoghaddam

    2013-03-01

    Full Text Available Cone beam computed tomography is a useful technique for imaging the craniofacial lesions. It produces more realistic images that facilitate interpretation. Juvenile ossifying fibroma (JOF is a rare and benign fibro-osseous neoplasm that arises within the craniofacial bones, especially in the maxilla. Mandibular lesions can be seen in 10% of the cases.In both jaws, it has a predilection for the premolar and molar regions (it is mostly seen in premolar and molar regions. Radiographically, it can be present as a radiolucent, mixed or radiopaque lesion. Radiodensity varies from purely radiolucent masses to mixed densities with prominent radiopacity as the lesion matures.This case report highlights a JOF with large foci of odontome-like radiopacities in a 6-year-old boy's mandibular anterior region. The location of the lesion in the anterior mandible and comparatively rapid formation of large odontome-like radiopaque foci at this early agehas made it a rare entity.

  2. Follicular thyroid carcinoma characterized by abundant stromal components with chondroid and osseous metaplasia in a dog.

    Science.gov (United States)

    Kobayashi, Ryosuke; Yamada, Naoaki; Kitamori, Takashi; Kitamori, Fumiyo; Sato, Kazunari; Doi, Takuya; Wako, Yumi; Sato, Junko; Tsuchitani, Minoru

    2014-08-01

    A dog developed a cervical mass, and computed tomography verified a mass surrounding the trachea with some pulmonary masses. Histopathologically, the cervical mass was composed of malignant neoplastic cells showing follicular appearance which reacted positive for thyroglobulin on immunohistochemistry. A characteristic feature of the tumor was abundant and metaplastic stromal components. Anastomosed collagenous tissues connecting to capsule of the tumor were abundant in the stroma. In parts of the collagenous tissues, mature cartilages and bones were continuously formed. There was no cellular atypia or invasion in the components. We diagnosed this case as follicular thyroid carcinoma with metaplastic stroma. This is the first case report that characterizes stromal components with chondroid and osseous metaplasia in a canine thyroid carcinoma.

  3. Computer-assisted design and computer-assisted modeling technique optimization and advantages over traditional methods of osseous flap reconstruction.

    Science.gov (United States)

    Matros, Evan; Albornoz, Claudia R; Rensberger, Michael; Weimer, Katherine; Garfein, Evan S

    2014-06-01

    There is increased clinical use of computer-assisted design (CAD) and computer-assisted modeling (CAM) for osseous flap reconstruction, particularly in the head and neck region. Limited information exists about methods to optimize the application of this new technology and for cases in which it may be advantageous over existing methods of osseous flap shaping. A consecutive series of osseous reconstructions planned with CAD/CAM over the past 5 years was analyzed. Conceptual considerations and refinements in the CAD/CAM process were evaluated. A total of 48 reconstructions were performed using CAD/CAM. The majority of cases were performed for head and neck tumor reconstruction or related complications whereas the remainder (4%) were performed for penetrating trauma. Defect location was the mandible (85%), maxilla (12.5%), and pelvis (2%). Reconstruction was performed immediately in 73% of the cases and delayed in 27% of the cases. The mean number of osseous flap bone segments used in reconstruction was 2.41. Areas of optimization include the following: mandible cutting guide placement, osteotomy creation, alternative planning, and saw blade optimization. Identified benefits of CAD/CAM over current techniques include the following: delayed timing, anterior mandible defects, specimen distortion, osteotomy creation in three dimensions, osteotomy junction overlap, plate adaptation, and maxillary reconstruction. Experience with CAD/CAM for osseous reconstruction has identified tools for technique optimization and cases where this technology may prove beneficial over existing methods. Knowledge of these facts may contribute to improved use and main-stream adoption of CAD/CAM virtual surgical planning by reconstructive surgeons. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  4. Fractal analyses of osseous healing using Tuned Aperture Computed Tomography images

    Energy Technology Data Exchange (ETDEWEB)

    Nair, M.K.; Nair, U.P. [Dept. of Oral and Maxillofacial Radiology, Univ. of Pittsburgh, PA (United States); Seyedain, A. [Dept. of Periodontics, Univ. of Pittsburgh, PA (United States); Webber, R.L. [Dept. of Dentistry, Wake Forest University School of Medicine, Winston-Salem (United States); Piesco, N.P.; Agarwal, S.; Mooney, M.P. [Dept. of Oral Biology, School of Dental Medicine, Univ. of Pittsburgh, PA (Ukraine); Groendahl, H.G. [Dept. of Oral and Maxillofacial Radiology, Goteborg Univ. (Sweden)

    2001-08-01

    The aim of this study was to evaluate osseous healing in mandibular defects using fractal analyses on conventional radiographs and tuned aperture computed tomography (TACT; OrthoTACT, Instrumentarium Imaging, Helsinki, Finland) images. Eighty test sites on the inferior margins of rabbit mandibles were subject to lesion induction and treated with one of the following: no treatment (controls); osteoblasts only; polymer matrix only; or osteoblast-polymer matrix (OPM) combination. Images were acquired using conventional radiography and TACT, including unprocessed TACT (TACT-U) and iteratively restored TACT (TACT-IR). Healing was followed up over time and images acquired at 3, 6, 9, and 12 weeks post-surgery. Fractal dimension (FD) was computed within regions of interest in the defects using the TACT workbench. Results were analyzed for effects produced by imaging modality, treatment modality, time after surgery and lesion location. Histomorphometric data were available to assess ground truth. Significant differences (p<0.0001) were noted based on imaging modality with TACT-IR recording the highest mean fractal dimension (MFD), followed by TACT-U and conventional images, in that order. Sites treated with OPM recorded the highest MFDs among all treatment modalities (p<0.0001). The highest MFD based on time was recorded at 3 weeks and differed significantly with 12 weeks (p<0.035). Correlation of FD with results of histomorphometric data was high (r=0.79; p<0.001). The FD computed on TACT-IR showed the highest correlation with histomorphometric data, thus establishing the fact TACT is a more efficient and accurate imaging modality for quantification of osseous changes within healing bony defects. (orig.)

  5. Aspects of gorgonopsian paleobiology and evolution: insights from the basicranium, occiput, osseous labyrinth, vasculature, and neuroanatomy

    Directory of Open Access Journals (Sweden)

    Ricardo Araújo

    2017-04-01

    Full Text Available Synapsida, the clade including therapsids and thus also mammals, is one of the two major branches of amniotes. Organismal design, with modularity as a concept, offers insights into the evolution of therapsids, a group that experienced profound anatomical transformations throughout the past 270 Ma, eventually leading to the evolution of the mammalian bauplan. However, the anatomy of some therapsid groups remains obscure. Gorgonopsian braincase anatomy is poorly known and many anatomical aspects of the brain, cranial nerves, vasculature, and osseous labyrinth, remain unclear. We analyzed two gorgonopsian specimens, GPIT/RE/7124 and GPIT/RE/7119, using propagation phase contrast synchrotron micro-computed tomography. The lack of fusion between many basicranial and occipital bones in GPIT/RE/7124, which is an immature specimen, allowed us to reconstruct its anatomy and ontogenetic sequence, in comparison with the mature GPIT/RE/7119, in great detail. We explored the braincase and rendered various skull cavities. Notably, we found that there is a separate ossification between what was previously referred to as the “parasphenoid” and the basioccipital. We reinterpreted this element as a posterior ossification of the basisphenoid: the basipostsphenoid. Moreover, we show that the previously called “parasphenoid” is in fact the co-ossification of the dermal parasphenoid and the endochondral basipresphenoid. In line with previous descriptions, the anatomy of the osseous labyrinth is rendered in detail, revealing a unique discoid morphology of the horizontal semicircular canal, rather than toroidal, probably due to architectural constraints of the ossification of the opisthotic and supraoccipital. In addition, the orientation of the horizontal semicircular canal suggests that gorgonopsians had an anteriorly tilted alert head posture. The morphology of the brain endocast is in accordance with the more reptilian endocast shape of other non

  6. Mindfulness Meditation and Cognitive Behavioral Therapy Intervention Reduces Pain Severity and Sensitivity in Opioid-Treated Chronic Low Back Pain: Pilot Findings from a Randomized Controlled Trial.

    Science.gov (United States)

    Zgierska, Aleksandra E; Burzinski, Cindy A; Cox, Jennifer; Kloke, John; Stegner, Aaron; Cook, Dane B; Singles, Janice; Mirgain, Shilagh; Coe, Christopher L; Bačkonja, Miroslav

    2016-10-01

    To assess benefits of mindfulness meditation and cognitive behavioral therapy (CBT)-based intervention for opioid-treated chronic low back pain (CLBP). 26-week parallel-arm pilot randomized controlled trial (Intervention and Usual Care versus Usual Care alone). Outpatient. Adults with CLBP, prescribed ≥30 mg/day of morphine-equivalent dose (MED) for at least 3 months. The intervention comprised eight weekly group sessions (meditation and CLBP-specific CBT components) and 30 minutes/day, 6 days/week of at-home practice. Outcome measures were collected at baseline, 8, and 26 weeks: primary-pain severity (Brief Pain Inventory) and function/disability (Oswestry Disability Index); secondary-pain acceptance, opioid dose, pain sensitivity to thermal stimuli, and serum pain-sensitive biomarkers (Interferon-γ; Tumor Necrosis Factor-α; Interleukins 1ß and 6; C-reactive Protein). Thirty-five (21 experimental, 14 control) participants were enrolled and completed the study. They were 51.8 ± 9.7 years old, 80% female, with severe CLBP-related disability (66.7 ± 11.4), moderate pain severity (5.8 ± 1.4), and taking 148.3 ± 129.2 mg/day of MED. Results of the intention-to-treat analysis showed that, compared with controls, the meditation-CBT group reduced pain severity ratings during the study (P = 0.045), with between-group difference in score change reaching 1 point at 26 weeks (95% Confidence Interval: 0.2,1.9; Cohen's d = 0.86), and decreased pain sensitivity to thermal stimuli (P meditation practice and the magnitude of intervention benefits. Meditation-CBT intervention reduced pain severity and sensitivity to experimental thermal pain stimuli in patients with opioid-treated CLBP. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Reducing occurrence and severity of pneumonia due to pandemic H1N1 2009 by early oseltamivir administration: a retrospective study in Mexico.

    Directory of Open Access Journals (Sweden)

    Anjarath Lorena Higuera Iglesias

    Full Text Available BACKGROUND: Anti-viral treatment has been used to treat severe or progressive illness due to pandemic H1N1 2009. A main cause of severe illness in pandemic H1N1 2009 is viral pneumonia; however, it is unclear how effective antiviral treatment is against pneumonia when administered >48 hours after symptom onset. Therefore, we aimed to determine how time from symptom onset to antiviral administration affected the effectiveness of antiviral treatment against pneumonia due to pandemic (H1N1 2009. METHODS/PRINCIPAL FINDINGS: A retrospective medical chart review of 442 patients was conducted in a hospital in Mexico. Subjects had tested positive for pandemic H1N1 2009 virus by real-time reverse-transcriptase-polymerase-chain-reaction and were administered oseltamivir. Median time from symptom onset to oseltamivir administration was 5.0 days (range, 0-43. 442 subjects, 71 (16.1% had severe pneumonia which required mechanical ventilation, 191 (43.2% had mild to moderate pneumonia, and 180 (40% did not have pneumonia. Subjects were divided into four groups based on time to oseltamivir administration: ≤2, 3-7, 8-14, and >14 days. Severity of respiratory features was associated with time to treatment, and multivariate analysis indicated that time to oseltamivir administration was associated with severity of respiratory features. A proportional odds model indicated that 50% probability for occurrence of pneumonia of any severity and that of severe pneumonia in patients who would develop pneumonia reached at approximately 3.4 and 21 days, respectively, after symptom onset. Patients with a shorter time to oseltamivir administration were discharged earlier from the hospital. CONCLUSIONS: Earlier initiation of oseltamivir administration after symptom onset significantly reduced occurrence and severity of pneumonia and shortened hospitalization due to pandemic H1N1 2009. Even when administered >48 hours after symptom onset, oseltamivir showed considerable

  8. Prophylactic Treatment with Adlay Bran Extract Reduces the Risk of Severe Acute Radiation Dermatitis: A Prospective, Randomized, Double-Blind Study

    Directory of Open Access Journals (Sweden)

    Chih-Jen Huang

    2015-01-01

    Full Text Available Acute radiation dermatitis is a frequent adverse effect in patients with breast cancer undergoing radiotherapy, but there are only a small number of studies providing evidence-based interventions for this clinical condition. Adlay is a cereal crop that has been previously shown to have anti-inflammatory and antioxidant properties. In this study, we seek to evaluate the effectiveness of oral prophylactic treatment with adlay bran extract in reducing the risk of severe acute radiation dermatitis. A total of 110 patients with breast cancer undergoing radiotherapy were analyzed. Using a prospective, randomized, double-blind design, 73 patients received oral treatment with adlay bran extract and 37 patients received olive oil (placebo. Treatment was started at the beginning of radiation therapy and continued until the termination of radiation treatment. Our results showed that the occurrence of severe acute radiation dermatitis (RTOG grade 2 or higher was significantly lower in patients treated with oral adlay bran extract compared to placebo (45.2% versus 75.7%, adjusted odds ratio 0.24. No serious adverse effects from adlay bran treatment were noted. In conclusion, prophylactic oral treatment with adlay bran extract reduces the risk of severe acute radiation dermatitis and may have potential use in patients with breast cancer undergoing radiotherapy.

  9. Game-based combined cognitive and neurofeedback training using Focus Pocus reduces symptom severity in children with diagnosed AD/HD and subclinical AD/HD.

    Science.gov (United States)

    Johnstone, Stuart J; Roodenrys, Steven J; Johnson, Kirsten; Bonfield, Rebecca; Bennett, Susan J

    2017-06-01

    Previous studies report reductions in symptom severity after combined working memory (WM) and inhibitory control (IC) training in children with AD/HD. Based on theoretical accounts of the role of arousal/attention modulation problems in AD/HD, the current study examined the efficacy of combined WM, IC, and neurofeedback training in children with AD/HD and subclinical AD/HD. Using a randomized waitlist control design, 85 children were randomly allocated to a training or waitlist condition and completed pre- and post-training assessments of overt behavior, trained and untrained cognitive task performance, and resting and task-related EEG activity. The training group completed twenty-five sessions of training using Focus Pocus software at home over a 7 to 8-week period. Trainees improved at the trained tasks, while enjoyment and engagement declined across sessions. After training, AD/HD symptom severity was reduced in the AD/HD and subclinical groups according to parents, and in the former group only according to blinded teachers and significant-others. There were minor improvements in two of six near-transfer tasks, and evidence of far-transfer of training effects in four of five far-transfer tasks. Frontal region changes indicated normalization of atypical EEG features with reduced delta and increased alpha activity. It is concluded that technology developments provide an interesting a vehicle for delivering interventions and that, while further research is needed, combined WM, IC, and neurofeedback training can reduce AD/HD symptom severity in children with AD/HD and may also be beneficial to children with subclinical AD/HD. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Chitin-supplemented foliar application of chitinolytic Bacillus cereus reduces severity of Botrytis gray mold disease in chickpea under controlled conditions.

    Science.gov (United States)

    Kishore, G K; Pande, S

    2007-01-01

    To identify and evaluate chitinolytic bacteria for control of Botrytis gray mold (BGM), a devastating disease in chickpea. Two antifungal bacterial isolates, chitinolytic Bacillus cereus CRS 7 and nonchitinolytic Pseudomonas fluorescens CRS 31, from the rhizosphere of chickpea, were applied as a prophylactic foliar spray and evaluated for control of BGM. In a controlled environment, the two isolates reduced the severity of BGM on the susceptible cv. JG 62 to 6.0 and 5.6, respectively, compared with 9.0 in the control, measured on a 1-9 rating scale. Supplementation of the foliar application of CRS 7 with 0.5% and 1.0% colloidal chitin reduced BGM severity to 4.4 and 4.1 respectively, while chitin-supplemented application of CRS 31 was similar to CRS 31 applied alone. Partially purified 47-kDa chitinase from the cell-free culture filtrate of CRS 7 at 20 and 40 mug protein ml(-1) (enzyme activity 3.1 units ml(-1)) inhibited the germination and lysed the conidia of Botrytis cinerea, and as a prophylactic foliar spray reduced BGM severity to 5.4 and 4.8, respectively. Chitin supplementation improved the biocontrol of the foliar disease BGM by chitinolytic bacterium. Disease control with partially purified chitinase of CRS 7 supported the major role of chitinolysis in improved control of BGM. Enhanced control of BGM by chitin-supplemented application of CRS 7 is of significant in view of the frequent inconsistency in biocontrol of foliar diseases. This study supports further attempts on chitinolysis-based biocontrol methods for foliar disease biocontrol.

  11. Effect of ski geometry on aggressive ski behaviour and visual aesthetics: equipment designed to reduce risk of severe traumatic knee injuries in alpine giant slalom ski racing.

    Science.gov (United States)

    Kröll, Josef; Spörri, Jörg; Gilgien, Matthias; Schwameder, Hermann; Müller, Erich

    2016-01-01

    Aggressive ski-snow interaction is characterised by direct force transmission and difficulty of getting the ski off its edge once the ski is carving. This behaviour has been suggested to be a main contributor to severe knee injuries in giant slalom (GS). The aim of the current study was to provide a foundation for new equipment specifications in GS by considering two perspectives: Reducing the ski's aggressiveness for injury prevention and maintaining the external attractiveness of a ski racer's technique for spectators. Three GS ski prototypes were defined based on theoretical considerations and were compared to a reference ski (Pref). Compared to Pref, all prototypes were constructed with reduced profile width and increased ski length. The construction radius (sidecut radius) of Pref was ≥ 27 m and was increased for the prototypes: 30 m (P30), 35 m (P35), and 40 m (P40). Seven World Cup level athletes performed GS runs on each of the three prototypes and Pref. Kinetic variables related to the ski-snow interaction were assessed to quantify the ski's aggressiveness. Additionally, 13 athletes evaluated their subjective perception of aggressiveness. 15 sports students rated several videotaped runs to assess external attractiveness. Kinetic variables quantifying the ski's aggressiveness showed decreased values for P35 and P40 compared to Pref and P30. Greater sidecut radius reduced subjectively perceived aggressiveness. External attractiveness was reduced for P40 only. This investigation revealed the following evaluation of the prototypes concerning injury prevention and external attractiveness: P30: no preventative gain, no loss in attractiveness; P35: substantial preventative gain, no significant loss in attractiveness; P40: highest preventative gain, significant loss in attractiveness. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  12. Prevention of severe contractures might replace multilevel surgery in cerebral palsy: results of a population-based health care programme and new techniques to reduce spasticity.

    Science.gov (United States)

    Hägglund, Gunnar; Andersson, Sofia; Düppe, Henrik; Lauge-Pedersen, Henrik; Pedertsen, Henrik Lauge; Nordmark, Eva; Westbom, Lena

    2005-07-01

    During the 1990s three new techniques to reduce spasticity and dystonia in children with cerebral palsy (CP) were introduced in southern Sweden: selective dorsal rhizotomy, continuous intrathecal baclofen infusion and botulinum toxin treatment. In 1994 a CP register and a health care programme, aimed to prevent hip dislocation and severe contractures, were initiated in the area. The total population of children with CP born 1990-1991, 1992-1993 and 1994-1995 was evaluated and compared at 8 years of age. In non-ambulant children the passive range of motion in hip, knee and ankle improved significantly from the first to the later age groups. Ambulant children had similar range of motion in the three age groups, with almost no severe contractures. The proportion of children treated with orthopaedic surgery for contracture or skeletal torsion deformity decreased from 40 to 15% (P = 0.0019). One-fifth of the children with spastic diplegia had been treated with selective dorsal rhizotomy. One-third of the children born 1994-1995 had been treated with botulinum toxin before 8 years of age. With early treatment of spasticity, early non-operative treatment of contracture and prevention of hip dislocation, the need for orthopaedic surgery for contracture or torsion deformity is reduced, and the need for multilevel procedures seems to be eliminated.

  13. Randomized clinical trial: Nucleos(t)ide analogues improved survival of CHB-related HCC patients via reducing severity and progression of malignancy

    Science.gov (United States)

    Chen, Liwen; Cao, Zhujun; Bao, Rebecca; Zhou, Huijuan; Tang, Weiliang; Lu, Jie; Lin, Lanyi; Xie, Qing; Bao, Shisan; Wang, Hui

    2016-01-01

    Background The influence of nucleos(t)ide analogues (NAs) to treat Chronic hepatitis B (CHB) related hepatocellular carcinoma (HCC) remains to be explored. Aim To investigate if NAs reduce the severity and progression of CHB-related HCC. Results Among 532 patients, there were 118 or 414 CHB-related HCC with or without NAs therapy, respectively. BCLC scores, serum level of ALT/AST and HBV DNA were compared. During follow-up, the survival period of CHB-related HCC patients with sustained NAs is significantly longer than that with NAs post-HCC and NAs naïve (p HCC include BCLC scores (hazard ratio, 1.84 [95% confidence interval, 1.57−2.15], p HCC or NAs naïve (1.33 [1.07−1.65], p HCC patients with/without NAs were investigated. Overall survival of CHB-related HCC patients, NAs naïve (n = 156), NAs received post-HCC (n = 258) and NAs sustained (n = 118) were determined. Conclusions NAs reduced severity of CHB-related HCC patients. Sustained NAs is an important factor associated with the extended survival of CHB-related HCC patients. PMID:27329718

  14. Antroquinonol differentially modulates T cell activity and reduces interleukin-18 production, but enhances Nrf2 activation, in murine accelerated severe lupus nephritis.

    Science.gov (United States)

    Tsai, Pei-Yi; Ka, Shuk-Man; Chang, Jia-Ming; Lai, Jenn-Haung; Dai, Ming-Shen; Jheng, Huei-Lin; Kuo, Mao-Tien; Chen, Peini; Chen, Ann

    2012-01-01

    Accelerated severe lupus nephritis (ASLN), with an acute onset of severe clinical manifestations and histopathologic renal lesions, may represent transformation of mild LN to a severe form of glomerulonephritis. Abnormal activation of T and B cells and/or oxidative stress may play a major role in the pathogenesis of ASLN. This study tested the hypothesis that antroquinonol, a purified compound and major effective component of Antrodia camphorata with antiinflammatory and antioxidant activities, might prevent the transformation of mild LN into higher-grade (severe) nephritis in a murine lupus model. Experimental ASLN was induced in (NZB×NZW)F1 mice by twice weekly intraperitoneal injections of Salmonella-type lipopolysaccharide (LPS). Starting 2 days after the first dose of LPS, mice were treated daily with antroquinonol, administered by gavage, for different durations up to 5 weeks. Antroquinonol administration significantly ameliorated the proteinuria, hematuria, impairment of renal function, and development of severe renal lesions, especially cellular crescent formation, neutrophil infiltration, fibrinoid necrosis, and T cell proliferation in the glomerulus, as well as periglomerular interstitial inflammation. Mechanistic analyses revealed that antroquinonol 1) inhibited T cell activation/proliferation, but enhanced Treg cell suppression and reduced renal production of interleukin-18 (IL-18); 2) inhibited production of reactive oxygen species and nitric oxide, but increased activation of Nrf2 in the kidney; and 3) suppressed renal inflammation via blocking of NF-κB activation. Antroquinonol may have therapeutic potential for the early treatment of ASLN via its differential regulation of T cell function and lowering of IL-18 production, but also via the promotion of Nrf2 activation. Copyright © 2012 by the American College of Rheumatology.

  15. Malaria prevention reduces in-hospital mortality among severely ill tuberculosis patients: a three-step intervention in Bissau, Guinea-Bissau

    Directory of Open Access Journals (Sweden)

    Vieira Fina

    2011-03-01

    Full Text Available Abstract Background Malaria and Tuberculosis (TB are important causes of morbidity and mortality in Africa. Malaria prevention reduces mortality among HIV patients, pregnant women and children, but its role in TB patients is not clear. In the TB National Reference Center in Guinea-Bissau, admitted patients are in severe clinical conditions and mortality during the rainy season is high. We performed a three-step malaria prevention program to reduce mortality in TB patients during the rainy season. Methods Since 2005 Permethrin treated bed nets were given to every patient. Since 2006 environmental prevention with permethrin derivates was performed both indoor and outdoor during the rainy season. In 2007 cotrimoxazole prophylaxis was added during the rainy season. Care was without charge; health education on malaria prevention was performed weekly. Primary outcomes were death, discharge, drop-out. Results 427, 346, 549 patients were admitted in 2005, 2006, 2007, respectively. Mortality dropped from 26.46% in 2005 to 18.76% in 2007 (p-value 0.003, due to the significant reduction in rainy season mortality (death/discharge ratio: 0.79, 0.55 and 0.26 in 2005, 2006 and 2007 respectively; p-value 0.001 while dry season mortality remained constant (0.39, 0.37 and 0.32; p-value 0.647. Costs of malaria prevention were limited: 2€/person. No drop-outs were observed. Health education attendance was 96-99%. Conclusions Malaria prevention in African tertiary care hospitals seems feasible with limited costs. Vector control, personal protection and cotrimoxazole prophylaxis seem to reduce mortality in severely ill TB patients. Prospective randomized trials are needed to confirm our findings in similar settings. Trial registration number Current Controlled Trials: ISRCTN83944306

  16. A Cell Culture–Derived Influenza Vaccine Provides Consistent Protection Against Infection and Reduces the Duration and Severity of Disease in Infected Individuals

    Science.gov (United States)

    Ehrlich, Hartmut J.; Singer, Julia; Berezuk, Gregory; Fritsch, Sandor; Aichinger, Gerald; Hart, Mary Kate; El-Amin, Wael; Portsmouth, Daniel; Kistner, Otfried

    2012-01-01

    Background. Current knowledge of the consistency of protection induced by seasonal influenza vaccines over the duration of a full influenza season is limited, and little is known about the clinical course of disease in individuals who become infected despite vaccination. Methods. Data from a randomized double-blind placebo-controlled clinical trial undertaken in healthy young adults in the 2008–2009 influenza season were used to investigate the weekly cumulative efficacy of a Vero cell culture–derived influenza vaccine. In addition, the duration and severity of disease in vaccine and placebo recipients with cell culture–confirmed influenza infection were compared. Results. Vaccine efficacy against matching strains was consistently high (73%–82%) throughout the study, including the entire period of the influenza season during which influenza activity was above the epidemic threshold. Vaccine efficacy was also consistent (68%–83%) when calculated for all strains, irrespective of antigenic match. Vaccination also ameliorated disease symptoms when infection was not prevented. Bivariate analysis of duration and severity showed a significant amelioration of myalgia (P = .003), headache (P = .025), and fatigue (P = .013) in infected vaccinated subjects compared with placebo. Cough (P = .143) and oropharyngeal pain (P = .083) were also reduced in infected vaccinated subjects. Conclusions. A Vero cell culture–derived influenza vaccine provides consistently high levels of protection against cell culture–confirmed infection by seasonal influenza virus and significantly reduces the duration and severity of disease in those individuals in which infection is not prevented. Clinical Trials Registration. ClinicalTrials.gov NCT00566345. PMID:22267715

  17. Reduced Systemic Levels of IL-10 Are Associated with the Severity of Obstructive Sleep Apnea and Insulin Resistance in Morbidly Obese Humans

    Directory of Open Access Journals (Sweden)

    Sonia Leon-Cabrera

    2015-01-01

    Full Text Available Obstructive sleep apnea (OSA has been related to elevation of inflammatory cytokines and development of insulin resistance in morbidly obese (MO subjects. However, it is still unclear whether the systemic concentration of anti-inflammatory mediators is also affected in MO subjects directly related to the severity of OSA and level of insulin resistance. Normal weight and MO subjects were subjected to overnight polysomnography in order to establish the severity of OSA, according to the apnea-hypopnea index (AHI. Blood samples were obtained for estimation of total cholesterol and triglycerides, insulin, glucose, insulin resistance, tumor necrosis factor alpha (TNF-α, interleukin 12 (IL12, and interleukin 10 (IL-10. Serum levels of IL-10 were significantly lower in MO subjects with OSA than in MO and control individuals without OSA. Besides being inversely associated with serum TNF-α and IL-12, decreased IL-10 levels were significantly related to increased AHI, hyperinsulinemia, and insulin resistance. Serum IL-10 is significantly reduced in morbidly obese subjects with severe OSA while also showing a clear relationship with a state of hyperinsulinemia and insulin resistance probably regardless of obesity in the present sample. It may be of potential clinical interest to identify the stimulatory mechanisms of IL-10 in obese individuals with OSA.

  18. Dynamic osseous scintigraphy in the knee hyper-pressure syndromes; Scintigraphie osseuse dynamique dans les syndrome d`hyperpression du genou

    Energy Technology Data Exchange (ETDEWEB)

    Laurin, J.; Jau, P.; Ferro, L.; Fouque, M. [Clinique Clairval, 317 Bd du Redon, 13009 Marseille (France)

    1997-12-31

    This retrospective study of 49 patients, carrying an internal mono-compartmental algic syndrome of the knee, determines the place of the dynamical osseous scintigraphy in three times: in comparison with the pan-goniometry (for 42 of them), in the diagnosis of the hyper-pressure syndrome and in the evaluation of its severity. The vascularization is augmented in 10 patients and the sanguinary pool in 14. Forty eight internal compartments exhibit a tracer hyper-fixation at late times. These anomalies have been classified according to their tibial or condylar localization and intensity, than compared with the pan-goniometric values of the deviation, which in case of a varus, entail an over-pressure risk. These comparisons show a good correlation between the hyper-fixation in the sub-chondral band of the internal tibial plateau and a syndrome of hyper-pressure by deviation in varus, whether this hyper-fixation was moderated and isolated or severe or associated to a condylar image; the intensity of the fixation indicates the severity. The tibial fixation intensity is always superior to that of the rest of compartment, what is essential for the differential diagnosis in case of a simple, without hyper-pressure, arthritis, or other pathology. From this exploration stem 8 osteotomies and 1 prosthesis

  19. The effect of platelet-rich plasma on osseous healing in dogs undergoing high tibial osteotomy.

    Directory of Open Access Journals (Sweden)

    Samuel P Franklin

    Full Text Available The purpose of this study was to investigate whether platelet-rich plasma (PRP enhances osseous healing in conjunction with a high tibial osteotomy in dogs.Randomized controlled trial.Sixty-four client-owned pet dogs with naturally occurring rupture of the anterior cruciate ligament and that were to be treated with a high tibial osteotomy (tibial plateau leveling osteotomy were randomized into the treatment or control group. Dogs in the treatment group received autologous platelet-rich plasma activated with calcium chloride and bovine thrombin to produce a well-formed PRP gel that was placed into the osteotomy at the time of surgery. Dogs in the control group received saline lavage of the osteotomy. All dogs had the osteotomy stabilized with identical titanium alloy implants and all aspects of the surgical procedure and post-operative care were identical among dogs of the two groups. Bone healing was assessed at exactly 28, 49, and 70 days after surgery with radiography and ultrasonography and with MRI at day 28. The effect of PRP on bone healing was assessed using a repeated measures analysis of covariance with radiographic and ultrasonographic data and using a t-test with the MRI data.Sixty dogs completed the study. There were no significant differences in age, weight, or gender distribution between the treatment and control groups. Twenty-seven dogs were treated with PRP and 33 were in the control group. The average platelet concentration of the PRP was 1.37x106 platelets/μL (±489x103 with a leukocyte concentration of 5.45x103/μL (±3.5x103. All dogs demonstrated progressive healing over time and achieved clinically successful outcomes. Time since surgery and patient age were significant predictors of radiographic healing and time since surgery was a significant predictor of ultrasonographic assessment of healing. There was no significant effect of PRP treatment as assessed radiographically, ultrasonographically, or with MRI.The PRP used

  20. Effect of systemic administration of nicotine on healing in osseous defects. An experimental study in rabbits. Part II

    DEFF Research Database (Denmark)

    Balatsouka, Dimitra; Gotfredsen, Klaus; Sørensen, Lars

    2006-01-01

    OBJECTIVES: The aim of the present study was to analyze the effect of systemic administration of nicotine on bone healing in osseous defects in the tibia of rabbits. MATERIAL AND METHODS: Sixteen female rabbits received nicotine (n=8; test group) or saline (n=8; control group) via subcutaneously...... 4 weeks and in the left leg after 6 weeks of nicotine/placebo exposure. Thus, 2- and 4-week healing groups were created for the bone defects. After 8 weeks, the animals were killed. Tissue blocks including the bone defects were prepared for histological analysis. RESULTS: The animals in the test...... group lost weight, while the control group gained weight during the experiment. The prostaglandin E(2) levels in plasma increased significantly following nicotine exposure in the test group. No significant differences in the percentage of vessels and bone density in the osseous defects were found...

  1. Fabrication of Plga/Hap and Plga/Phb/Hap Fibrous Nanocomposite Materials for Osseous Tissue Regeneration

    Directory of Open Access Journals (Sweden)

    Krucińska Izabella

    2014-06-01

    Full Text Available The study presents the manufacturing of nanofibrous structures as osteoconductive, osteoinductive materials for osseous tissue regeneration. The fibrous structures were obtained by electrospinning of poly(l-lactide-coglicolide (PLGA with addition of hydroxyapatite (HAp and of a blend of PLGA with polyhydroxybutyrate with HAp added. The polymers used in the experiment were synthesised by an innovative method with a zirconium catalyst. First, the optimal electrospinning process parameters were selected. For the characterisation of the obtained osseous tissue reconstruction materials, the physical, macroscopic, functional, mechanical and thermal properties as well as crystallinity index were studied. The study of the radiation sterilisation influence on average molar mass, thermal and mechanical properties was made in order to analyse the degradation effect.

  2. Carpal boss in chronic wrist pain and its association with partial osseous coalition and osteoarthritis - A case report with focus on MRI findings

    OpenAIRE

    Poh, Feng

    2015-01-01

    The carpal boss is a bony prominence at the dorsal aspect of the 2 nd and/or 3 rd carpometacarpal joint, which has been linked to various etiologies, including trauma, os styloideum, osteophyte formation, and partial osseous coalition. It may result in symptoms through secondary degeneration, ganglion formation, bursitis, or extensor tendon abnormalities by altered biomechanics of wrist motion. We present a case of symptomatic carpal boss with the finding of a partial osseous coalition at the...

  3. Effectiveness of a Mobile Outreach and Crisis Services unit in reducing psychiatric symptoms in a population of homeless persons with severe mental illness.

    Science.gov (United States)

    Morris, D W; Warnock, J K

    2001-08-01

    The purpose of this study was to use a time-lag design to evaluate the effectiveness of a Mobile Outreach and Crisis Services unit in remitting psychiatric symptomatology, improving global functioning, and decreasing homelessness in a population of homeless, severely mentally ill residing in a mid-sized urban center. Using a time-lag study design, two groups of subjects--25 individuals before receiving services (control group) and 25 individuals after receiving services (experimental group)--were contrasted across outcome measures. The results indicate that a MOCS unit utilizing a Program for Assertive Community Treatment mode was effective in significantly decreasing psychiatric symptomatology, reducing homelessness, and increasing global functioning. If carefully implemented and interpreted, a time-lag design may be a means of providing valuable feedback and information in a timely manner.

  4. A short 2 week dose titration regimen reduces the severity of flu-like symptoms with initial interferon gamma-1b treatment.

    Science.gov (United States)

    Devane, John G; Martin, Mary L; Matson, Mark A

    2014-06-01

    during week 1 treatment, indicating an early peak in FLS severity during the No Titration treatment and subsequent development of tolerance. In contrast, titration results in near baseline severity scores throughout the treatment period. Similar trends were seen for 4 and 12 hour FLS severity scores. Of the individual FLS, difference in fever severity was most marked. Safety profiles for both regimens were consistent with the approved prescribing information for interferon gamma-1b. Study limitations included the use of healthy subjects rather than disease subjects, the lack of a validated assessment tool for evaluating FLS and the relatively high discontinuation rate. A short 2 week, dose-titration regimen reduces FLS severity following interferon gamma-1b treatment initiation in normal subjects.

  5. The reduced folate carrier (RFC) is cytotoxic to cells under conditions of severe folate deprivation. RFC as a double edged sword in folate homeostasis.

    Science.gov (United States)

    Ifergan, Ilan; Jansen, Gerrit; Assaraf, Yehuda G

    2008-07-25

    The reduced folate carrier (RFC), a bidirectional anion transporter, is the major uptake route of reduced folates essential for a spectrum of biochemical reactions and thus cellular proliferation. However, here we show that ectopic overexpression of the RFC, but not of folate receptor alpha, a high affinity unidirectional folate uptake route serving here as a negative control, resulted in an approximately 15-fold decline in cellular viability in medium lacking folates but not in folate-containing medium. Moreover to explore possible mechanisms of adaptation to folate deficiency in various cell lines that express the endogenous RFC, we first determined the gene expression status of the following genes: (a) RFC, (b) ATP-driven folate exporters (i.e. MRP1, MRP5, and breast cancer resistance protein), and (c) folylpoly-gamma-glutamate synthetase and gamma-glutamate hydrolase (GGH), enzymes catalyzing folate polyglutamylation and hydrolysis, respectively. Upon 3-7 days of folate deprivation, semiquantitative reverse transcription-PCR analysis revealed a specific approximately 2.5-fold decrease in RFC mRNA levels in both breast cancer and T-cell leukemia cell lines that was accompanied by a consistent fall in methotrexate influx, serving here as an RFC transport activity assay. Likewise a 2.4-fold decrease in GGH mRNA levels and approximately 19% decreased GGH activity was documented for folate-deprived breast cancer cells. These results along with those of a novel mathematical biomodeling devised here suggest that upon severe short term (i.e. up to 7 days) folate deprivation RFC transport activity becomes detrimental as RFC, but not ATP-driven folate exporters, efficiently extrudes folate monoglutamates out of cells. Hence down-regulation of RFC and GGH may serve as a novel adaptive response to severe folate deficiency.

  6. Post-severe nuclear accident chemical water and surface clean-up methods for LWRs to reduce the amounts of highly contaminated waste water

    International Nuclear Information System (INIS)

    Tietze, Sabrina; Foreman, Mark R.St.

    2014-01-01

    In the event of a nuclear accident which occasions severe damages to the fuel, in many reactor designs the water will become highly contaminated with a wide range of both short and long lived radioisotopes. Organic contaminants formed by the pyrolysis and radiolysis of organic materials (cables, paint films) will complicate the water chemistry further. In addition the radiolysis of the air, release of metal chlorides from cables and the use of sea water for cooling as a final resort will increase the ionic strength of the water and complicate the management of the water both during and after an accident. The high ionic strength may prevent the usability of conventional ion exchange resins such as sulfonated polystyrenes. A series of methods designed to be useable in extremis to reduce the release of radioactivity to groundwater, rivers or the sea are presented and discussed. Also a method for the decontamination of painted surfaces to reduce the radiation exposure of decontamination workers, within the plant is presented. Some of the proposed methods are also applicable for environmental clean-up, waste water storage and fuel handling facilities. (author)

  7. Patients with tattoo reactions have reduced quality of life and suffer from itch: Dermatology Life Quality Index and Itch Severity Score measurements.

    Science.gov (United States)

    Hutton Carlsen, K; Serup, J

    2015-02-01

    Tattoos are a trend with increasing side-effects. The burden of local reaction with swelling, itching and discomfort may impel sufferers to consult medical assistance. To assess tattoo reactions and their influence on quality of life and itching by utilizing the Dermatology Life Quality Index (DLQI) scoring system and Itch Severity Scale (ISS). Patients attending the 'Tattoo Clinic' at Bispebjerg University Hospital, Denmark with tattoo problems spanning more than 3 months were invited. Forty patients participated during September-November 2012. Patients attending their routine consultations completed the ISS and DLQI questionnaires. Patients with tattoo reactions experienced reduced quality of life, DLQI score 7.4 and were burdened by itch, ISS score 7.2. Both DLQI and ISS results attained the level of discomfort of known skin diseases such as psoriasis, pruritus and eczema albeit the typical tattooed affected areas are smaller. Sufferers of tattoo reactions have reduced quality of life and are often burdened by itching attaining the level of other cumbersome afflictions recognized as dermatological diseases associated with itch. Tattoo reactions warrant diagnosis and treatment with same professional intent shared with other skin diseases. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. The efficacy of capacitive radio-frequency diathermy in reducing buttock and posterior thigh cellulite measured through the cellulite severity scale.

    Science.gov (United States)

    De La Casa Almeida, Maria; Suarez Serrano, Carmen; Medrano Sánchez, Ester Maria; Diaz Mohedo, Esther; Chamorro Moriana, Gema; Rebollo Salas, Manuel

    2014-10-01

    Cellulite, despite its high prevalence in women, has been subjected to very little research, while the majority has been carried out using unvalidated evaluation tools. To determine the efficacy of capacitive radio-frequency diathermy (CRFD) in reducing buttock and posterior thigh cellulite and to verify its relationship with the reduction of body weight. Design: Experimental clinical study consists of two parallel groups. Totally 54 lower limbs of 27 women (26.41 ± 6.16 years) were considered with each patient's two limbs being assigned one to each group via simple random distribution. First group received local application of CRFD (30 min) and the second received the same treatment followed by a supplementary whole-segment application of CRFD (20 min). Each limb received 20 sessions, twice a week. Cellulite Severity Scale dimensions score, weight and Body Mass Index (BMI) were taken for the evaluation of the study. A significance of p less than 0.01 was observed for all the variables in both groups, thereby demonstrating the effectiveness of both the treatments; no significant differences were observed between groups (p > 0.05). Monopolar static application of CRFD is effective in reducing buttock and posterior thigh cellulite. It appears that there is not necessarily any relationship between weight loss, decreased BMI and reduction in cellulite.

  9. Accuracy of Bone Sounding in Assessing Facial Osseous-Gingival Tissue Relationship in Maxillary Anterior Teeth.

    Science.gov (United States)

    Kan, Joseph Yk; Kim, Yoon Jeong; Rungcharassaeng, Kitichai; Kois, John C

    The aim of this study was to evaluate the accuracy of bone sounding (BS) in assessing the facial osseous-gingival tissue relationship (FOGTR) of failing maxillary anterior teeth. Dental records of patients who received immediate implant placement (IIP) at the maxillary anterior area were screened. Mid-FOGTR prior to extraction (BS), and immediately after flapless extraction (direct bone level [DBL] measurement) were analyzed. A total of 160 patients with 190 maxillary anterior teeth were included. The mean FOGTR obtained from BS and DBL were 3.19 ± 0.71 mm and 3.47 ± 1.29 mm, respectively (P = .004). The two measurements were identical 83.2% of the time, within 1-mm discrepancy 4.7% of the time, and > ± 1 mm discrepancy 12.1% of the time. When discrepancy was observed, BS underestimated DBL 14.2% of the time and overestimated 2.6% of the time. Though statistically significant, the correlation was weak (Pearson correlation coefficient r = .238, P = .0018). BS is an acceptably accurate and minimally invasive diagnostic tool for measuring FOGTR. However, while the mean difference between BS and DBL measurement is small (0.28 mm), the large range of difference can be alarming. Therefore, clinicians should always prepare alternative treatment options for IIP prior to extraction.

  10. Non osseous intra-spinal tumors in children and adolescents: spinal column deformity (in french)

    International Nuclear Information System (INIS)

    Ghanem, I.; Zeller, R.; Dubousset, J.

    1997-01-01

    Purpose of the study. The delay in diagnosis of spinal tumors is not rare. The chief complaint may include pain, walking disability and spinal or limb deformities. The purpose of our study is to analyze the spinal deformities associated with non osseous intra-spinal tumors, to assess the complications of treatment, and to set out a preventive protocol. Methods. The incidence and pattern of spinal deformity was assessed before tumor treatment and ultimately after laminectomy or osteoplastic laminotomy (or lamino-plasty). Results. Among the 9 cases with preexisting spinal deformity, the curve magnitude increased after laminectomy in 4. A kyphotic, kyphoscoliotic or scoliotic deformity developed in 18 cases after surgery for tumor resection. Among these 18 patients, only one had bad an adequate osteoplastic laminotomy. The treatment of spinal deformities was surgical in 12 cases, and done by either posterior or anterior and posterior combined arthrodesis. Discussion. Spinal deformity may be the main complaint of a patient who has intraspinal tumor. Prevention of post-laminectomy spinal deformity is mandatory, and could be done by osteoplastic laminotomy and the use of a brace during a minimum period of 4 to 6 months after surgery. Conclusion. Diagnosis of intraspinal tumors in children and adolescents should be done early, and lamino-arthrectomy should be replaced by osteoplastic laminotomy. (authors)

  11. Power-Assisted Particulate Bone Grafting Effectively Prevents Osseous Defects After Cranial Vault Reconstruction.

    Science.gov (United States)

    Gandolfi, Brad M; Hirji, Sameer A; Sobol, Danielle L; Allori, Alexander C; Marcus, Jeffrey R

    2018-02-12

    Cranial vault reconstruction (CVR) is the gold standard in the operative treatment of craniosynostosis. Full thickness osseous defects (FTOD) of the calvaria have been observed in 5% to 15% patients after CVR, with higher rates cited in the fronto-orbital advancement (FOA) subset. Particulate bone graft (PBG) harvested manually has been shown to decrease FTOD after FOA from 24% to 5.5%. The authors used a modified technique using a powered craniotome, with the hypothesis that the technique would also improve outcomes. A retrospective review was performed of patients who underwent CVR for craniosynostosis between 2004 and 2014. Patient demographics, diagnosis, age, operative details, and postoperative care were reviewed in detail. Categorical, nonparametric variables were compared by Fisher exact tests. A total of 135 patients met inclusion criteria. The most common diagnoses were metopic (n = 41), sagittal (n = 33), and unilateral coronal craniosynostosis (n = 31); 65% (n = 88) underwent FOA, 29% (n = 39) underwent single-stage total vault reconstruction, and 6% (n = 8) had a posterior vault reconstruction. CVR was performed without PBG in 95 patients and with PBG in 40 patients. Without PBG, FTOD were discovered on clinical examination in 18% of patients (n=17): 11 presented with subcentimeter defects, while 6 had larger defects requiring revision cranioplasty (6% operative revision rate). Among those receiving PBG, 1 patient presented a subcentimeter FTOD (2.5% FTOD incidence and 0% operative revision rate). Particulate bone graft harvested with a powered device decreases the rate of FTOD and reoperation rate after CVR for craniosynostosis.

  12. Compromised Osseous Healing of Dental Extraction Sites in Zoledronic Acid-Treated Dogs

    Science.gov (United States)

    Allen, Matthew R.; Kubek, Daniel J.; Burr, David B.; Ruggiero, Salvatore L.; Chu, Tien-Min Gabriel

    2010-01-01

    PURPOSE The goal of this study was to document how treatment with a bisphosphonate affects the bone tissue following dental extraction. METHODS Skeletally mature female beagle dogs were either untreated controls (CON) or treated with intravenous zoledronic acid (ZOL). Following the extraction of the 4th premolars, healing was allowed for 4 or 8 weeks. Properties of the extraction site were assessed using micro-computed tomography (micro-CT) and dynamic histomorphometry. RESULTS The initial infilling of the extraction socket with bone was not affected by ZOL but subsequent removal of this bone was significantly suppressed compared to CON. After 8-weeks of healing, the alveolar cortical bone adjacent to the extraction socket had a remodeling rate of ~50%/year in CON animals while ZOL-treated animals had a rate of < 1%/year. One ZOL-treated animal developed exposed bone post-extraction which eventually led to the formation of a sequestrum. Assessment of the sequestrum with micro-CT and histology showed that it had features consistent with those reported in humans with osteonecrosis of the jaw. CONCLUSIONS These results, showing significantly compromised post-extraction osseous healing as well as presence of exposed bone and development of a sequestrum in one ZOL animal, provide a building block toward understanding the pathophysiology of osteonecrosis of the jaw. PMID:20458574

  13. Maxillofacial osseous reconstruction using the angular branch of the thoracodorsal vessels.

    LENUS (Irish Health Repository)

    Dolderer, Jürgen H

    2010-09-01

    Mandibular and maxillary resections can produce complex three-dimensional defects requiring skeletal, soft tissue, and epithelial reconstruction. The subscapular vascular axis offers a source of skin, bone, and muscle on a single pedicle for microvascular flap transfer. We reviewed four cases where the subscapular vascular pedicle was used as a source of tissue for complex facial reconstructions in maxillofacial defects. Reconstruction of these complex defects was performed with a latissimus dorsi muscle or myocutaneous flap in combination with the lateral border of the scapula, harvested on the angular branch of the thoracodorsal vessels. There were three cases of maxillectomy and one case of partial mandibulectomy for malignant tumors. In each case, the angular branch of the thoracodorsal artery supplied 6 to 8 cm of the lateral border of the scapula and a latissimus dorsi myocutaneous flap was used for soft tissue reconstruction. Follow-up ranged from 9 months to 3 years and in all cases there was successful bony union. Shoulder movement was normal. This series encourages the further use of subscapular axis flaps as flexible sources of combined myocutaneous and osseous flaps on a single vascular pedicle in cases of complex maxillofacial reconstruction.

  14. Mandibular Actinomyces osteomyelitis complicating florid cemento-osseous dysplasia: case report

    Directory of Open Access Journals (Sweden)

    Edwards Sean P

    2011-07-01

    Full Text Available Abstract Background Apart from neoplastic processes, chronic disfiguring and destructive diseases of the mandible are uncommon. Case Presentation We report, perhaps for the first time, the simultaneous occurrence of two such conditions in one patient, in a case that emphasizes the importance of bone biopsy in establishing the correct diagnosis. Florid cemento-osseous dysplasia (FCOD is a chronic, disfiguring condition of the maxillofacial region. This relatively benign disease is primarily observed in middle-aged women of African ancestry. Cervicofacial actinomycosis is an uncommon and progressive infection caused by bacilli of the Actinomyces genus that typically involves intraoral soft tissues but may also involve bone. The accurate diagnosis of actinomycosis is critical for successful treatment. A diagnosis of osteomyelitis caused by Actinomyces bacteria was diagnosed by bone biopsy in a 53 year-old African-American woman with a longstanding history of FCOD after she presented with a new draining ulcer overlying the mandible. Conclusions Clinicians should be aware of the possibility of actinomycosis arising in the setting of FCOD, and the importance of bone biopsy and cultures in arriving at a definitive and timely diagnosis.

  15. Cost utility analysis of reduced intensity hematopoietic stem cell transplantation in adolescence and young adult with severe thalassemia compared to hypertransfusion and iron chelation program.

    Science.gov (United States)

    Sruamsiri, Rosarin; Chaiyakunapruk, Nathorn; Pakakasama, Samart; Sirireung, Somtawin; Sripaiboonkij, Nintita; Bunworasate, Udomsak; Hongeng, Suradej

    2013-02-05

    Hematopoieticic stem cell transplantation is the only therapeutic option that can cure thalassemia disease. Reduced intensity hematopoietic stem cell transplantation (RI-HSCT) has demonstrated a high cure rate with minimal complications compared to other options. Because RI-HSCT is very costly, economic justification for its value is needed. This study aimed to estimate the cost-utility of RI-HSCT compared with blood transfusions combined with iron chelating therapy (BT-ICT) for adolescent and young adult with severe thalassemia in Thailand. A Markov model was used to estimate the relevant costs and health outcomes over the patients' lifetimes using a societal perspective. All future costs and outcomes were discounted at a rate of 3% per annum. The efficacy of RI-HSCT was based a clinical trial including a total of 18 thalassemia patients. Utility values were derived directly from all patients using EQ-5D and SF-6D. Primary outcomes of interest were lifetime costs, quality adjusted life-years (QALYs) gained, and the incremental cost-effectiveness ratio (ICER) in US ($) per QALY gained. One-way and probabilistic sensitivity analyses (PSA) were conducted to investigate the effect of parameter uncertainty. In base case analysis, the RI-HSCT group had a better clinical outcomes and higher lifetime costs. The incremental cost per QALY gained was US $3,236 per QALY. The acceptability curve showed that the probability of RI-HSCT being cost-effective was 71% at the willingness to pay of 1 time of Thai Gross domestic product per capita (GDP per capita), approximately US $4,210 per QALY gained. The most sensitive parameter was utility of severe thalassemia patients without cardiac complication patients. At a societal willingness to pay of 1 GDP per capita, RI-HSCT was a cost-effective treatment for adolescent and young adult with severe thalassemia in Thailand compared to BT-ICT.

  16. A walking program for people with severe knee osteoarthritis did not reduce pain but may have benefits for cardiovascular health: a phase II randomised controlled trial.

    Science.gov (United States)

    Wallis, J A; Webster, K E; Levinger, P; Singh, P J; Fong, C; Taylor, N F

    2017-12-01

    The primary aim was to evaluate the effect of a dosed walking program on knee pain for patients with severe knee osteoarthritis (OA). Secondary aims evaluated the effects on cardiovascular health, function and quality of life. Participants with severe knee OA and increased cardiovascular risk were randomly assigned to a 12-week walking program of 70 min/week of at least moderate intensity, or to usual care. The primary outcome was knee pain (0-10). Secondary outcomes were of cardiovascular risk including physical activity, blood pressure, blood lipid and glucose levels, body mass index and waist circumference; WOMAC Index scores; physical function; and quality of life. Forty-six participants (23 each group) were recruited. Sixteen participants (70%) adhered to the walking program. Intention to treat analysis showed no between-group difference in knee pain. The walking group had increased odds of achieving a healthy systolic blood pressure (OR = 5.7, 95% CI 1.2-26.9), and a faster walking speed (Mean Difference (MD) = 0.12 m/s, 95% CI 0.02-0.23). Per protocol analysis based on participant adherence showed the walking group had more daily steps (MD = 1345 steps, 95% CI 365-2325); more time walking (MD = 18 min/day, 95% CI 5-31); reduced waist circumference (MD = -5.3 cm, 95% CI -10.5 to -0.03); and increased knee stiffness (MD = 0.9 units, 95% CI 0.07-1.8). Patients with severe knee OA prescribed a 12-week walking program of 70 min/week may have had cardiovascular benefits without decreasing knee pain. Australian New Zealand Clinical Trials Registry ACTRN12615000015549. Copyright © 2016 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  17. Improved ethanol yield and reduced minimum ethanol selling price (MESP by modifying low severity dilute acid pretreatment with deacetylation and mechanical refining: 2 Techno-economic analysis

    Directory of Open Access Journals (Sweden)

    Tao Ling

    2012-09-01

    Full Text Available Abstract Background Our companion paper discussed the yield benefits achieved by integrating deacetylation, mechanical refining, and washing with low acid and low temperature pretreatment. To evaluate the impact of the modified process on the economic feasibility, a techno-economic analysis (TEA was performed based on the experimental data presented in the companion paper. Results The cost benefits of dilute acid pretreatment technology combined with the process alternatives of deacetylation, mechanical refining, and pretreated solids washing were evaluated using cost benefit analysis within a conceptual modeling framework. Control cases were pretreated at much lower acid loadings and temperatures than used those in the NREL 2011 design case, resulting in much lower annual ethanol production. Therefore, the minimum ethanol selling prices (MESP of the control cases were $0.41-$0.77 higher than the $2.15/gallon MESP of the design case. This increment is highly dependent on the carbohydrate content in the corn stover. However, if pretreatment was employed with either deacetylation or mechanical refining, the MESPs were reduced by $0.23-$0.30/gallon. Combing both steps could lower the MESP further by $0.44 ~ $0.54. Washing of the pretreated solids could also greatly improve the final ethanol yields. However, the large capital cost of the solid–liquid separation unit negatively influences the process economics. Finally, sensitivity analysis was performed to study the effect of the cost of the pretreatment reactor and the energy input for mechanical refining. A 50% cost reduction in the pretreatment reactor cost reduced the MESP of the entire conversion process by $0.11-$0.14/gallon, while a 10-fold increase in energy input for mechanical refining will increase the MESP by $0.07/gallon. Conclusion Deacetylation and mechanical refining process options combined with low acid, low severity pretreatments show improvements in ethanol yields and

  18. Effectiveness of a Respiratory Day Hospital Program to Reduce Admissions for Exacerbation in Patients with Severe COPD: A Prospective, Multicenter Study.

    Science.gov (United States)

    Huertas, Daniel; Montón, Concepción; Marín, Alicia; Solanes, Ingrid; López-Sánchez, Marta; Pomares, Xavier; Muñoz-Esquerre, Mariana; Dorca, Jordi; Santos, Salud

    2017-06-01

    The respiratory Day Hospital (DH) is a care facility currently operating at various healthcare institutions. It monitors patients with severe chronic obstructive pulmonary disease (COPD) presenting repeated exacerbations with at least two hospital admissions per year. The main aim of the study was to evaluate the effectiveness of the DH program for controlling admissions for COPD exacerbations in this cohort of patients, and to identify clinical factors associated with hospitalizations and mortality. An observational prospective multicenter study was carried out at three hospitals. The sample comprised 150 consecutive patients (median age 70 [65-76] years, FEV 1 33 [26-43]%, 97% males), included at the DH program. Over a one-year period, variables assessing effectiveness and use of healthcare resources were recorded. Factors associated with hospitalizations and mortality were identified. Patients made a median of 4[2-5] emergency visits due to COPD exacerbations with a median of 1[0-2] hospitalization(s)/year. Most of exacerbations (77%) were evaluated at the DH, but there were fewer hospitalizations from the DH than from the emergency department (21% vs. 81%, p < 0.001). In all, 29% of the patients had at least two admissions; these were the patients with the most severe disease. Age, readmission at 30-days and the presence of respiratory failure were the predictors of mortality. In conclusion, the DH program is an effective model for reducing hospitalizations in this cohort of patients. In all, 29% of the patients required two hospital admissions or more; these patients had more advanced disease and poorer prognosis, and would be most likely to benefit from additional care support.

  19. Relative shortening and functional tethering of spinal cord in adolescent scoliosis – Result of asynchronous neuro-osseous growth, summary of an electronic focus group debate of the IBSE

    Directory of Open Access Journals (Sweden)

    Burwell R Geoffrey

    2008-06-01

    Full Text Available Abstract There is no generally accepted scientific theory for the causes of adolescent idiopathic scoliosis (AIS. As part of its mission to widen understanding of scoliosis etiology, the International Federated Body on Scoliosis Etiology (IBSE introduced the electronic focus group (EFG as a means of increasing debate on knowledge of important topics. This has been designated as an on-line Delphi discussion. The Statement for this debate was written by Dr WCW Chu and colleagues who examine the spinal cord to vertebral growth interaction during adolescence in scoliosis. Using the multi-planar reconstruction technique of magnetic resonance imaging they investigated the relative length of spinal cord to vertebral column including ratios in 28 girls with AIS (mainly thoracic or double major curves and 14 age-matched normal girls. Also evaluated were cerebellar tonsillar position, somatosensory evoked potentials (SSEPs, and clinical neurological examination. In severe AIS compared with normal controls, the vertebral column is significantly longer without detectable spinal cord lengthening. They speculate that anterior spinal column overgrowth relative to a normal length spinal cord exerts a stretching tethering force between the two ends, cranially and caudally leading to the initiation and progression of thoracic AIS. They support and develop the Roth-Porter concept of uncoupled neuro-osseous growth in the pathogenesis of AIS which now they prefer to term 'asynchronous neuro-osseous growth'. Morphological evidence about the curve apex suggests that the spinal cord is also affected, and a 'double pathology' is suggested. AIS is viewed as a disorder with a wide spectrum and a common neuroanatomical abnormality namely, a spinal cord of normal length but short relative to an abnormally lengthened anterior vertebral column. Neuroanatomical changes and/or abnormal neural function may be expressed only in severe cases. This asynchronous neuro-osseous growth

  20. Self-reported food-related gastrointestinal symptoms in IBS are common and associated with more severe symptoms and reduced quality of life.

    Science.gov (United States)

    Böhn, Lena; Störsrud, Stine; Törnblom, Hans; Bengtsson, Ulf; Simrén, Magnus

    2013-05-01

    Despite the fact that food and diet are central issues, that concern patients with irritable bowel syndrome (IBS), the current understanding about the association between the intake of certain foods/food groups and the gastrointestinal (GI) symptom pattern, psychological symptoms, and quality of life is poor. The aim of this study was to determine which food groups and specific food items IBS patients report causing GI symptoms, and to investigate the association with GI and psychological symptoms and quality of life. We included 197 IBS patients (mean age 35 (18-72) years; 142 female subjects) who completed a food questionnaire in which they specified symptoms from 56 different food items or food groups relevant to food intolerance/allergy. The patients also completed questionnaires to assess depression and general anxiety (Hospital Anxiety and Depression), GI-specific anxiety (Visceral Sensitivity Index), IBS symptoms (IBS-Severity Scoring System), somatic symptoms (Patient Health Questionnaire-15), and quality of life (Irritable Bowel Syndrome Quality of Life Questionnaire). In all, 84% of the studied population reported symptoms related to at least one of the food items surveyed. Symptoms related to intake of food items with incompletely absorbed carbohydrates were noted in 138 (70%) patients; the most common were dairy products (49%), beans/lentils (36%), apple (28%), flour (24%), and plum (23%). Of these, 58% experienced GI symptoms from foods rich in biogenic amines, such as wine/beer (31%), salami (22%), and cheese (20%). Histamine-releasing foods, such as milk (43%), wine/beer (31%), and pork (21%), were also considered causes of symptoms in IBS patients. GI symptoms were also frequently reported after intake of fried and fatty foods (52%). With increasing IBS symptom severity, patients reported more food items responsible for their GI symptoms (P=0.004), and this was also found in patients with more severe somatic symptoms (Psleep (r=-0.25; P=0

  1. Implant Survival between Endo-osseous Dental Implants in Immediate Loading, Delayed Loading, and Basal Immediate Loading Dental Implants a 3-Year Follow-up

    Science.gov (United States)

    Garg, Ritesh; Mishra, Neha; Alexander, Mohan; Gupta, Sunil Kumar

    2017-01-01

    Introduction: With introduction of the term “ossteointegration of dental implant” by Branemark, advancement in implantology from 1957 to 2017 has come a long way with modification in implant type and in loading time. This study aims to evaluate the survival of endo-osseous immediate loading (IL) implant and basal IL implants in atrophic jaws with objective to compare implant survival in atrophic jaws for full mouth rehabilitation between endo-osseous IL versus endo-osseous delayed loading (DL) versus basal IL during 3-year follow-up. Materials and Methods: Fifty-two (34 endo-osseous and 18 basal) implants were placed in 4 patients requiring full mouth rehabilitation in atrophic jaws. Case 1: Endo-osseous DL implants in upper and lower arch, Case 2: Endo-osseous IL implants in upper and lower arch, Case 3: Basal IL implant in upper and lower arch, and Case 4: Endo-osseous DL in upper arch and basal IL implant in the lower arch. Intraoperative evaluation was done on the basis of pain (visual analog scale [VAS]), operative time, and initial primary implant stability. Postoperative evaluation was done on pain (VAS), infection, radiographically successful implant (orthopantomogram), and patient satisfaction (Grade 0–10). Results: All cases showed satisfactory results but more amount of intra- and post-operative pain was felt with immediate basal implants. Conclusion: We believe that clinicians should comply with patient requests, and for this reason, we agree with some authors to use minimally invasive techniques and to avoid when possible esthetic or functional problems associated with the use of removable prosthesis after teeth extractions. PMID:29264292

  2. Implant Survival between Endo-osseous Dental Implants in Immediate Loading, Delayed Loading, and Basal Immediate Loading Dental Implants a 3-Year Follow-up.

    Science.gov (United States)

    Garg, Ritesh; Mishra, Neha; Alexander, Mohan; Gupta, Sunil Kumar

    2017-01-01

    With introduction of the term "ossteointegration of dental implant" by Branemark, advancement in implantology from 1957 to 2017 has come a long way with modification in implant type and in loading time. This study aims to evaluate the survival of endo-osseous immediate loading (IL) implant and basal IL implants in atrophic jaws with objective to compare implant survival in atrophic jaws for full mouth rehabilitation between endo-osseous IL versus endo-osseous delayed loading (DL) versus basal IL during 3-year follow-up. Fifty-two (34 endo-osseous and 18 basal) implants were placed in 4 patients requiring full mouth rehabilitation in atrophic jaws. Case 1: Endo-osseous DL implants in upper and lower arch, Case 2: Endo-osseous IL implants in upper and lower arch, Case 3: Basal IL implant in upper and lower arch, and Case 4: Endo-osseous DL in upper arch and basal IL implant in the lower arch. Intraoperative evaluation was done on the basis of pain (visual analog scale [VAS]), operative time, and initial primary implant stability. Postoperative evaluation was done on pain (VAS), infection, radiographically successful implant (orthopantomogram), and patient satisfaction (Grade 0-10). All cases showed satisfactory results but more amount of intra- and post-operative pain was felt with immediate basal implants. We believe that clinicians should comply with patient requests, and for this reason, we agree with some authors to use minimally invasive techniques and to avoid when possible esthetic or functional problems associated with the use of removable prosthesis after teeth extractions.

  3. A comparison of intranasal corticosteroid, leukotriene receptor antagonist, and topical antihistamine in reducing symptoms of perennial allergic rhinitis as assessed through the Rhinitis Severity Score.

    Science.gov (United States)

    Sardana, Niti; Santos, Carah; Lehman, Erik; Craig, Timothy

    2010-01-01

    Rhinitis symptom complex consists of rhinorrhea, congestion, itchy mucosa, itchy eyes, and sneezing. Available medications vary in their benefit for each of these symptoms. It was the purpose of this article to compare symptom reduction with three different classes of medications. Montelukast, azelastine, and budesonide were compared to determine the effect on individual, as well as total, symptom scores using the Rhinitis Severity Score (RSS). All three medications were compared with placebo and showed efficacy in prior studies using Balaam's crossover design. The inclusion and exclusion criteria and all procedures were identical for all three studies. In analyzing the data from the RSS questionnaire, we used the procedure PROC MIXED in SAS specific for Balaam's crossover design (SAS Institute, Inc., Cary, NC). Although all three medications were effective compared with placebo, montelukast had the greatest effect of the three medications on reduction of ocular itching and throat and palate itching. Azelastine's effect was greater than budesonide and montelukast for reduction of rhinorrhea. Systemic medication, montelukast, as expected, provided better relief for symptoms distant from the nasal cavity, and the antihistamine, azelastine, reduced rhinorrhea, more than either montelukast or budesonide.

  4. Assessing Patient-Reported Outcomes Following Orthognathic Surgery and Osseous Genioplasty.

    Science.gov (United States)

    Schwitzer, Jonathan A; Albino, Frank P; Mathis, Ryan K; Scott, Amie M; Gamble, Laurie; Baker, Stephen B

    2015-11-01

    Primary outcomes for orthognathic surgery and genioplasty patients include satisfaction with appearance, improved motor function, and enhanced quality of life. The goal of this study was to assess outcomes among patients undergoing these procedures, and to highlight the potential use of FACE-Q instrument for use in patients with dentofacial deformities. A total of 56 patients presenting for orthognathic surgery and/or osseous genioplasty completed the FACE-Q during preoperative and/or at postoperative visits. FACE-Q scores increased following surgery in satisfaction with facial appearance overall (+24.5, P jawline (+40.7, P < 0.01), and in all satisfaction with chin items (profile, prominence, shape, and overall). Patients also demonstrated increased social confidence (+8.9, P = 0.29). There was no improvement in psychologic well-being (-0.8, P = 0.92). All 3 surgical groups of patients experienced gains in satisfaction with appearance following surgery. Patients who underwent orthognathic surgery either alone or in combination with genioplasty demonstrated statistically significant improvements in satisfaction with facial appearance overall (P < 0.01 for both groups), whereas patients who underwent genioplasty alone did not (P = 0.13). In addition, patients who underwent orthognathic surgery combined with genioplasty demonstrated greater improvement in satisfaction with chin than patients who underwent genioplasty alone. In conclusion, patients who underwent orthognathic surgery and/or genioplasty demonstrated improvement in appearance and social confidence. The use of this model supports the successful outcomes possible for patients undergoing these procedures.

  5. Antibody-Mediated Osseous Regeneration for Bone Tissue Engineering in Canine Segmental Defects

    Directory of Open Access Journals (Sweden)

    A. Khojasteh

    2018-01-01

    Full Text Available Among many applications of therapeutic monoclonal antibodies (mAbs, a unique approach for regenerative medicine has entailed antibody-mediated osseous regeneration (AMOR. In an effort to identify a clinically relevant model of craniofacial defect, the present study investigated the efficacy of mAb specific for bone morphogenetic protein- (BMP- 2 to repair canine segmental mandibular continuity defect model. Accordingly, a 15 mm unilateral segmental defect was created in mandible and fixated with a titanium plate. Anorganic bovine bone mineral with 10% collagen (ABBM-C was functionalized with 25 μg/mL of either chimeric anti-BMP-2 mAb or isotype-matched mAb (negative control. Recombinant human (rh BMP-2 served as positive control. Morphometric analyses were performed on computed tomography (CT and histologic images. Bone densities within healed defect sites at 12 weeks after surgery were 1360.81 ± 10.52 Hounsfield Unit (HU, 1044.27 ± 141.16 HU, and 839.45 ± 179.41 HU, in sites with implanted anti-BMP-2 mAb, rhBMP-2, and isotype mAb groups, respectively. Osteoid bone formation in anti-BMP-2 mAb (42.99% ± 8.67 and rhBMP-2 (48.97% ± 2.96 groups was not significantly different but was higher (p<0.05 than in sites with isotype control mAb (26.8% ± 5.35. In view of the long-term objective of translational application of AMOR in humans, the results of the present study demonstrated the feasibility of AMOR in a large clinically relevant animal model.

  6. Evaluation of Strength in the “Toronto” Osseous-Prosthesis System

    Directory of Open Access Journals (Sweden)

    Maiorana C.

    2010-06-01

    Full Text Available Several surgical techniques like are today available in order to recovery large bone defects of the jaw. Aim of the surgeon is to obtain a good tridimensional volume to place dental implant and to recovery the patient’s aesthetics and function. Several prosthetic solution were considered for prosthetic rehabilitation. However after a bone graft surgery Toronto screwed prosthesis on dental implants, following Branemark intuitions, was considered the better prosthetic rehabilitation solution. According to Wölff, the dental implants osteointegration is related to the strengths directed to mandibular bone. Our investigation’s aim is to underline through FEM analysis the stress over the prosthetic elements and over bone surface in order to help the surgeon choice about the dental implant positioning, and at the same time reducing the bone trauma on the patients.

  7. WE-AB-207B-08: Exploring and Refining the QUANTEC Guideline to Reduce Severe Hyposalivation Following IMRT for Head and Neck Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Thor, M; Oh, J; Deasy, J [Department of Medical Physics, Memorial Sloan Kettering Cancer Center, Nyc, NY (United States); Owosho, A; Rosenburg, H; Yom, S; Huryn, J; Estilo, C [Department of Surgery, Memorial Sloan Kettering Cancer Center, Nyc, NY (United States); Riaz, N; Tsai, J; Lee, N [Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, NYC, NY (United States)

    2016-06-15

    Purpose: The aim of this study was to investigate the usefulness of the QUANTEC guideline to prevent xerostomia after intensity-modulated radiotherapy (IMRT) for head and neck cancer (HNC) with respect to follow-up time. In addition, we explored alternative guidelines to further reduce xerostomia. Methods: The QUANTEC guideline suggests a mean dose to the contralateral (Dmeancontra) parotid<20 Gy, or Dmeancontra and Dmean to the ipsilateral parotid (Dmeanipsi)<25 Gy. Stimulated whole mouth saliva flow measurements (WMSFM) were conducted at a median of 11 (3–24) months for 63 patients treated with IMRT for HNC to a median dose of 70 Gy in 2006–2015. Severe hyposalivation/xerostomia was defined as WMSFM ≤25% post- relative to pre-RT. Patients were stratified into a <6m (xerostomia: 27% (n=15)), and a 6–24m (xerostomia: 19% (n=10)) follow-up group. Dose-response modeling was performed using logistic regression including Dmeancontra, or Dmeancontra and Dmeanipsi. The area under the receiver-operating characteristics curve (AUC) was used to assess discriminative ability, and the agreement between the estimated and observed rate of xerostomia was given by Spearman’s rank correlation coefficient (Rs), and related p-values. Results: Of the non-xerostomia patients, 65% (<6m) and 56% (6–24m) fulfilled Dmeancontra<20 Gy. The estimated and observed rate of xerostomia agreed at <6m (AUC=0.78; Rs=0.46; p=0.001), and was 28% at Dmeancontra=20 Gy. A smaller number of non-xerostomia patients fulfilled the two-gland guideline (33% (<6m) and 26% (6–24m)), but the AUC was higher than using Dmeancontra only (<6m: AUC=0.90; Rs=0.63; p<0.0001; 6–24m: AUC=0.84; Rs=0.25; p=0.08), and the following amendment of the two-gland guideline was suggested: (0.17*Dmeancontra+0.11*Dmeanipsi-8.13)<-1.60 (<6m), and (0.05*Dmeancontra+0.02*Dmeanipsi-3.10)<-1.60 (6–24m). Conclusion: The QUANTEC guideline is effective to prevent xerostomia <6m post-RT, but its usefulness is reduced at

  8. WE-AB-207B-08: Exploring and Refining the QUANTEC Guideline to Reduce Severe Hyposalivation Following IMRT for Head and Neck Cancer

    International Nuclear Information System (INIS)

    Thor, M; Oh, J; Deasy, J; Owosho, A; Rosenburg, H; Yom, S; Huryn, J; Estilo, C; Riaz, N; Tsai, J; Lee, N

    2016-01-01

    Purpose: The aim of this study was to investigate the usefulness of the QUANTEC guideline to prevent xerostomia after intensity-modulated radiotherapy (IMRT) for head and neck cancer (HNC) with respect to follow-up time. In addition, we explored alternative guidelines to further reduce xerostomia. Methods: The QUANTEC guideline suggests a mean dose to the contralateral (Dmeancontra) parotid<20 Gy, or Dmeancontra and Dmean to the ipsilateral parotid (Dmeanipsi)<25 Gy. Stimulated whole mouth saliva flow measurements (WMSFM) were conducted at a median of 11 (3–24) months for 63 patients treated with IMRT for HNC to a median dose of 70 Gy in 2006–2015. Severe hyposalivation/xerostomia was defined as WMSFM ≤25% post- relative to pre-RT. Patients were stratified into a <6m (xerostomia: 27% (n=15)), and a 6–24m (xerostomia: 19% (n=10)) follow-up group. Dose-response modeling was performed using logistic regression including Dmeancontra, or Dmeancontra and Dmeanipsi. The area under the receiver-operating characteristics curve (AUC) was used to assess discriminative ability, and the agreement between the estimated and observed rate of xerostomia was given by Spearman’s rank correlation coefficient (Rs), and related p-values. Results: Of the non-xerostomia patients, 65% (<6m) and 56% (6–24m) fulfilled Dmeancontra<20 Gy. The estimated and observed rate of xerostomia agreed at <6m (AUC=0.78; Rs=0.46; p=0.001), and was 28% at Dmeancontra=20 Gy. A smaller number of non-xerostomia patients fulfilled the two-gland guideline (33% (<6m) and 26% (6–24m)), but the AUC was higher than using Dmeancontra only (<6m: AUC=0.90; Rs=0.63; p<0.0001; 6–24m: AUC=0.84; Rs=0.25; p=0.08), and the following amendment of the two-gland guideline was suggested: (0.17*Dmeancontra+0.11*Dmeanipsi-8.13)<-1.60 (<6m), and (0.05*Dmeancontra+0.02*Dmeanipsi-3.10)<-1.60 (6–24m). Conclusion: The QUANTEC guideline is effective to prevent xerostomia <6m post-RT, but its usefulness is reduced at

  9. Improved ethanol yield and reduced Minimum Ethanol Selling Price (MESP by modifying low severity dilute acid pretreatment with deacetylation and mechanical refining: 1 Experimental

    Directory of Open Access Journals (Sweden)

    Chen Xiaowen

    2012-08-01

    Full Text Available Abstract Background Historically, acid pretreatment technology for the production of bio-ethanol from corn stover has required severe conditions to overcome biomass recalcitrance. However, the high usage of acid and steam at severe pretreatment conditions hinders the economic feasibility of the ethanol production from biomass. In addition, the amount of acetate and furfural produced during harsh pretreatment is in the range that strongly inhibits cell growth and impedes ethanol fermentation. The current work addresses these issues through pretreatment with lower acid concentrations and temperatures incorporated with deacetylation and mechanical refining. Results The results showed that deacetylation with 0.1 M NaOH before acid pretreatment improved the monomeric xylose yield in pretreatment by up to 20% while keeping the furfural yield under 2%. Deacetylation also improved the glucose yield by 10% and the xylose yield by 20% during low solids enzymatic hydrolysis. Mechanical refining using a PFI mill further improved sugar yields during both low- and high-solids enzymatic hydrolysis. Mechanical refining also allowed enzyme loadings to be reduced while maintaining high yields. Deacetylation and mechanical refining are shown to assist in achieving 90% cellulose yield in high-solids (20% enzymatic hydrolysis. When fermentations were performed under pH control to evaluate the effect of deacetylation and mechanical refining on the ethanol yields, glucose and xylose utilizations over 90% and ethanol yields over 90% were achieved. Overall ethanol yields were calculated based on experimental results for the base case and modified cases. One modified case that integrated deacetylation, mechanical refining, and washing was estimated to produce 88 gallons of ethanol per ton of biomass. Conclusion The current work developed a novel bio-ethanol process that features pretreatment with lower acid concentrations and temperatures incorporated with deacetylation

  10. The stability of osseous metastases of the spine in lung cancer – a retrospective analysis of 338 cases

    International Nuclear Information System (INIS)

    Rief, Harald; Bischof, Marc; Bruckner, Thomas; Welzel, Thomas; Askoxylakis, Vasileios; Rieken, Stefan; Lindel, Katja; Combs, Stephanie; Debus, Jürgen

    2013-01-01

    The objective of this retrospective analysis is to systematically assess osseous lesions on the basis of a validated scoring system in terms of stability and fractures prior to and following radiotherapy in 338 lung cancer patients with bone metastases in the vertebral column. The stability of 338 patients with 981 osteolytic metastases in the thoracic and lumbar spine was evaluated retrospectively on the basis of the Taneichi-Score between January 2000 and January 2012. 64% (215 patients) were classified stable prior to radiotherapy. Of the stable osseous metastases, none were rated unstable in the further course (p < 0.001, McNemar test). Of the 123 patients in whom the metastases were classified unstable prior to radiotherapy, 21 patients (17%) were classified stable after three months, and 30 patients (24%) stable after six months. A pathological fracture was diagnosed in 62 patients (18%) prior to radiotherapy. Regarding cases of osteolytic metastases of the vertebral bodies in which no fractures could be detected prior to the start of therapy, fractures occurred in 2% of all patients (n = 7) within six months following radiotherapy. Our analysis demonstrated that pathological fractures following radiotherapy occur in the very minority of vertebral lesions for patients with a favorable outcome. The use of a systematic radiological scoring system to classify osteolytic metastases of the vertebral column has shown to be feasible in daily routine. Prospective clinical trials are warranted in order to analyse, to what extent patients with osseous metastases can be mobilized by physiotherapy for strengthening the paravertebral muscles before radiotherapy effects can be measured by means of radiological recalcification

  11. Dose escalation study with rhenium-188 hydroxyethylidene diphosphonate in prostate cancer patients with osseous metastases

    Energy Technology Data Exchange (ETDEWEB)

    Palmedo, H.; Guhlke, S.; Bender, H.; Sartor, J.; Risse, J.; Gruenwald, F.; Biersack, H.-J. [Dept. of Nuclear Medicine, Univ. of Bonn (Germany); Schoeneich, G. [Dept. of Urology, Univ. of Bonn (Germany); Knapp, F.F. Jr. [Nuclear Medicine Group, Oak Ridge National Laboratory, (ORNL), Oak Ridge, TN (United States)

    2000-02-01

    The aim of this study was to determine the maximum tolerated dose of rhenium-188 hydroxyethylidene diphosphonate (HEDP) in prostate cancer patients with osseous metastases who are suffering from bone pain. Twenty-two patients received a single injection of escalating doses of carrier-added {sup 188}Re-HEDP [1.3 GBq (35 mCi), 2.6 GBq (70 mCi), 3.3 GBq (90 mCi) and 4.4 GBq (120 mCi)]. Blood counts and biochemical parameters were measured weekly over a period of 8 weeks. Haematological toxicity (WHO grading) of grade 3 or 4 was considered unacceptable. Clinical follow-up studies including methods of pain documentation (medication, pain diary) were performed for 6 months after treatment. In the 1.3-GBq group, no haematological toxicity was observed. First haematotoxic results were noted in those patients with a dose of 2.6 GBq {sup 188}Re-HEDP. In the 3.3-GBq group, one patient showed a reversible thrombopenia of grade 1, one a reversible thrombopenia of grade 2 and three a reversible leukopenia of grade 1. In the 4.4-GBq group, thrombopenia of grades 3 and 4 was observed in one and two patients (baseline thrombocyte count <200 x 10{sup 9}/l), respectively, and leukopenia of grade 3 was documented in one patient. The overall nadir of thrombopenia was at week 4. The individual, maximum percentage decrease in thrombocytes in the 1.3-, 2.6-, 3.3- and 4.4-GBq groups was 17%, 40%, 60% and 86%, respectively. In two patients, a transient increase in serum creatinine was observed (max. 1.6 mg/dl). Pain palliation was reported by 64% of patients, with a mean duration of 7.5 weeks. The response rate seemed to increase with higher doses, reaching 75% in the 4.4-GBq group. It is concluded that in prostate cancer patients, the maximum tolerated dose of {sup 188}Re-HEDP is 3.3 GBq if the baseline thrombocyte count is below 200 x 10{sup 9}/l. In patients with thrombocyte counts significantly above 200 x 10{sup 9}/l, a dose of 4.4 GBq might be tolerable. Thrombo- and leukopenia are

  12. Carpal boss in chronic wrist pain and its association with partial osseous coalition and osteoarthritis - A case report with focus on MRI findings

    Directory of Open Access Journals (Sweden)

    Feng Poh

    2015-01-01

    Full Text Available The carpal boss is a bony prominence at the dorsal aspect of the 2 nd and/or 3 rd carpometacarpal joint, which has been linked to various etiologies, including trauma, os styloideum, osteophyte formation, and partial osseous coalition. It may result in symptoms through secondary degeneration, ganglion formation, bursitis, or extensor tendon abnormalities by altered biomechanics of wrist motion. We present a case of symptomatic carpal boss with the finding of a partial osseous coalition at the 2 nd carpometacarpal (metacarpal-trapezoid joint and highlight the magnetic resonance imaging (MRI findings of carpal boss impingement and secondary osteoarthritis. To the best of our knowledge, there is no report in the literature describing the imaging findings of partial osseous coalition and degenerative osteoarthritis in relation to carpal boss.

  13. Carpal boss in chronic wrist pain and its association with partial osseous coalition and osteoarthritis - A case report with focus on MRI findings.

    Science.gov (United States)

    Poh, Feng

    2015-01-01

    The carpal boss is a bony prominence at the dorsal aspect of the 2(nd) and/or 3(rd) carpometacarpal joint, which has been linked to various etiologies, including trauma, os styloideum, osteophyte formation, and partial osseous coalition. It may result in symptoms through secondary degeneration, ganglion formation, bursitis, or extensor tendon abnormalities by altered biomechanics of wrist motion. We present a case of symptomatic carpal boss with the finding of a partial osseous coalition at the 2(nd) carpometacarpal (metacarpal-trapezoid) joint and highlight the magnetic resonance imaging (MRI) findings of carpal boss impingement and secondary osteoarthritis. To the best of our knowledge, there is no report in the literature describing the imaging findings of partial osseous coalition and degenerative osteoarthritis in relation to carpal boss.

  14. Osseous healing after sagittal splitting ramus osteotomy in mandibular prognathism. Three-dimensional CT measurement

    Energy Technology Data Exchange (ETDEWEB)

    Nemoto, Toshiyuki; Akizuki, Hiromichi; Michi, Ken-ichi [Showa Univ., Tokyo (Japan). School of Dentistry

    2001-07-01

    The purpose of the present study was to clarify the relationship between the cleavage and fixation of bone fragments and the osseous healing after sagittal splitting ramus osteotomy. Subjects consisted of 12 patients with mandibular prognathism, on which we performed sagittal splitting ramus osteotomy on both sides. Thus, we performed this osteotomy on 24 rami. These rami were studied immediately after, and 1 year after, surgery by Three-dimensional CT. With regard to the morphology of the anterior and posterior borders of the mandibular ramus, the majority (70.8%) showed the smooth type (smooth type: proximal and distal bone fragments are not discernible, and there is a smooth transition between them) in the lower plane. In the upper plane, the smooth type was less frequent (39.6%), and the stairway type (stairway type: either the proximal bone fragment or the distal bone fragment is protruded, thus showing a stairway form) was more frequent (43.8%). The concave type (concave type: there is a gap, i.e. an opened bone fragment, between two bone fragments, thus showing a concave form) was more frequently observed at the anterior border than at the posterior border, in both planes. With regard to the relationship between the morphology of the posterior border of the mandibular ramus and the cleavage of proximal and distal fragments, the stairway type was more frequent if both fragments were completely split through the posterior border, but the smooth type was more frequent if the cleavage spared the posterior border. With regard to the relationship between the morphology of the anterior and posterior borders of the mandibular ramus and the distance between proximal and distal bone fragments, the distance was greatest in the concave type, followed by the stairway type and the smooth type, in this order. The concave type was observed in cases in which the mean distance was more than 6.1 mm. As for the relationship between the posterior protrusion of the distal bone

  15. Exercise training with weight loss and either a high- or low-glycemic index diet reduces metabolic syndrome severity in older adults

    DEFF Research Database (Denmark)

    Malin, Steven K; Niemi, Nicole; Solomon, Thomas

    2012-01-01

    The efficacy of combining carbohydrate quality with exercise on metabolic syndrome risk is unclear. Thus, we determined the effects of exercise training with a low (LoGIx)- or high (HiGIx)-glycemic index diet on the severity of the metabolic syndrome (Z-score).......The efficacy of combining carbohydrate quality with exercise on metabolic syndrome risk is unclear. Thus, we determined the effects of exercise training with a low (LoGIx)- or high (HiGIx)-glycemic index diet on the severity of the metabolic syndrome (Z-score)....

  16. Intra-individual comparison of Tc-99m-MDP bone scan and the PSMA-ligand Tc-99m-MIP-1427 in patients with osseous metastasized prostate cancer.

    Science.gov (United States)

    Rathke, Hendrik; Afshar-Oromieh, Ali; Giesel, Frederik L; Kremer, Christophe; Flechsig, Paul; Haufe, Sabine; Mier, Walter; Holland-Letz, Tim; de Bucourt, Maximilian; Armor, Thomas; Babich, John; Haberkorn, Uwe; Kratochwil, Clemens

    2018-01-25

    To evaluate the detection rate of bone metastases obtained with the PSMA targeting tracer 99m Tc-MIP-1427 as opposed to the conventional bone scan with 99m Tc-MDP in a collective of advanced stage patients with known osseous metastasized prostate cancer. Methods: 21 Patients with known metastatic disease were staged with both, conventional bone scan and PSMA-ligand scintigraphy, within a time-frame of MDP. Lesions were scored: typical tumor, equivocal (benign/malignant), or normal within a standard reporting schema divided into defined anatomical regions. Blind and consensus reads were performed with sequential un-blinding: first planar scans, then SPECT/CT, then best valuable comparator including MRI, PET/CT and follow-up exams. Results: 11 patients had PSMA-positive visceral metastases which were predictably not diagnosed with conventional bone scan. However, SPECT/CT was required to distinguish between soft tissue uptake and overlapping bone. 4 patients had extensive MDP negative bone marrow lesions. 7 patients had superscan character in bone scan; in contrast, extent of red marrow involvement was more evident by PSMA-scan. Only 3 patients had completely equal results in the bone-scan and PSMA-scan. Also more suspicious lesions were detected in 16 patients using PSMA-scan in comparison to bone-scan. In two patients (about 10 %) a PSMA-negative tumor phenotype was present. Conclusion: PSMA-scanning presented a clearly advantage versus bone-scans by reducing the number of equivocal findings, in most patients. SPECT/CT is pivotal to differentiate between benign (e.g. degenerative changes), bone metastases and extra-osseous tumor lesions. Copyright © 2018 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

  17. Exercise training with weight loss and either a high- or low-glycemic index diet reduces metabolic syndrome severity in older adults

    DEFF Research Database (Denmark)

    Malin, Steven K; Niemi, Nicole; Solomon, Thomas

    2012-01-01

    The efficacy of combining carbohydrate quality with exercise on metabolic syndrome risk is unclear. Thus, we determined the effects of exercise training with a low (LoGIx)- or high (HiGIx)-glycemic index diet on the severity of the metabolic syndrome (Z-score)....

  18. The Implementation of a Video-Enhanced Aikido-Based School Violence Prevention Training Program To Reduce Disruptive and Assaultive Behaviors among Severely Emotionally Disturbed Adolescents.

    Science.gov (United States)

    Edelman, Andrew J.

    The martial art of Aikido was used as an intervention with 15 middle and high school students with severe emotional disturbances in an alternative educational setting. Students with an extensive history of violently disruptive and assaultive behaviors were trained for 12 weeks in this nonviolent Japanese martial art in order to achieve the…

  19. Comparison of procedures for immediate reconstruction of large osseous defects resulting from removal of a single tooth to prepare for insertion of an endosseous implant after healing

    NARCIS (Netherlands)

    Raghoebar, G. M.; Slater, J. J. H.; den Hartog, L.; Meijer, H. J. A.; Vissink, A.

    This study evaluated the treatment outcome of immediate reconstruction of 45 large osseous defects resulting from removal of a single tooth with a 1:2 mixture of Bio-Oss(R) and autologous tuberosity bone, and three different procedures for soft tissue closing (Bio-Gide(R) membrane, connective tissue

  20. A Cell-Based Self-Assembly Approach for the Production of Human Osseous Tissues from Adipose-Derived Stromal/Stem Cells.

    Science.gov (United States)

    Galbraith, Todd; Clafshenkel, William P; Kawecki, Fabien; Blanckaert, Camille; Labbé, Benoit; Fortin, Michel; Auger, François A; Fradette, Julie

    2017-02-01

    Achieving optimal bone defect repair is a clinical challenge driving intensive research in the field of bone tissue engineering. Many strategies focus on seeding graft materials with progenitor cells prior to in vivo implantation. Given the benefits of closely mimicking tissue structure and function with natural materials, the authors hypothesize that under specific culture conditions, human adipose-derived stem/stromal cells (hASCs) can solely be used to engineer human reconstructed osseous tissues (hROTs) by undergoing osteoblastic differentiation with concomitant extracellular matrix production and mineralization. Therefore, the authors are developing a self-assembly methodology allowing the production of such osseous tissues. Three-dimensional (3D) tissues reconstructed from osteogenically-induced cell sheets contain abundant collagen type I and are 2.7-fold less contractile compared to non-osteogenically induced tissues. In particular, hROT differentiation and mineralization is reflected by a greater amount of homogenously distributed alkaline phosphatase, as well as higher calcium-containing hydroxyapatite (P tissues. Taken together, these findings show that hASC-driven tissue engineering leads to hROTs that demonstrate structural and functional characteristics similar to native osseous tissue. These highly biomimetic human osseous tissues will advantageously serve as a platform for molecular studies as well as for future therapeutic in vivo translation. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  1. The combined use of enamel matrix proteins and a tetracycline-coated expanded polytetrafluoroethylene barrier membrane in the treatment of intra-osseous defects

    NARCIS (Netherlands)

    Sipos, PM; Loos, BG; Abbas, F; Timmerman, MF; van der Velden, U

    Objectives: The purpose of this split-mouth study was to evaluate the clinical response of enamel matrix proteins (EMPs, Emdogain Gel((R))) in intra-osseous defects with or without a combined application of a tetracycline-coated expanded polytetrafluoroethylene barrier membrane (e-PTFE,

  2. The combined use of enamel matrix proteins and a tetracyclinecoated expanded polytetrafluoroethylene barrier membrane in the treatment of intra-osseous defects

    NARCIS (Netherlands)

    Sipos, P.M.; Loos, B.G.; Abbas, F.; Timmerman, M.F.; Velden, U. van der

    2005-01-01

    Objectives: The purpose of this split-mouth study was to evaluate the clinical response of enamel matrix proteins (EMPs, Emdogain Gel) in intra-osseous defects with or without a combined application of a tetracycline-coated expanded polytetrafluoroethylene barrier membrane (e-PTFE, Gore-Tex).

  3. Diet and exercise reduce low-grade inflammation and macrophage infiltration in adipose tissue but not in skeletal muscle in severely obese subjects

    DEFF Research Database (Denmark)

    Bruun, Jens M; Helge, Jørn W; Richelsen, Bjørn

    2006-01-01

    RNA expression of adiponectin (P macrophage-specific markers (CD14, CD68), IL-6, IL-8, and tumor necrosis factor-alpha (P macrophage infiltration in AT, only IL-6 mRNA was decreased (P markers were......Obesity is associated with low-grade inflammation, insulin resistance, type 2 diabetes, and cardiovascular disease. This study investigated the effect of a 15-wk lifestyle intervention (hypocaloric diet and daily exercise) on inflammatory markers in plasma, adipose tissue (AT), and skeletal muscle...... found in SM. The intervention had no effect on adiponectin receptor 1 and 2 mRNA in AT or SM. Thus hypocaloric diet and increased physical activity improved insulin sensitivity and reduced low-grade inflammation. Markers of inflammation were particularly reduced in AT, whereas SM does not contribute...

  4. Residual beta-Cell Function 3-6 Years After Onset of Type 1 Diabetes Reduces Risk of Severe Hypoglycemia in Children and Adolescents

    DEFF Research Database (Denmark)

    Sorensen, J. S.; Johannesen, J.; Pociot, F.

    2013-01-01

    OBJECTIVETo determine the prevalence of residual -cell function (RBF) in children after 3-6 years of type 1 diabetes, and to examine the association between RBF and incidence of severe hypoglycemia, glycemic control, and insulin requirements.RESEARCH DESIGN AND METHODSA total of 342 children (173...... boys) 4.8-18.9 years of age with type 1 diabetes for 3-6 years were included. RBF was assessed by testing meal-stimulated C-peptide concentrations. Information regarding severe hypoglycemia within the past year, current HbA(1c), and daily insulin requirements was retrieved from the medical records....../mol]; P 0.2 nmol/L (mean +/- SE: 1.07 +/- 0.02 vs. 0.93 +/- 0.07 units/kg/day; P diabetes. Children with RBF...

  5. Buprenorphine Transdermal System Improves Sleep Quality and Reduces Sleep Disturbance in Patients with Moderate-to-Severe Chronic Low Back Pain: Results from Two Randomized Controlled Trials.

    Science.gov (United States)

    Yarlas, Aaron; Miller, Kate; Wen, Warren; Lynch, Shau Yu; Ripa, Steven R; Pergolizzi, Joseph V; Raffa, Robert B

    2016-03-01

    To evaluate the impact of buprenorphine (Butrans®) transdermal System (BTDS) treatment on sleep outcomes for patients with moderate-to-severe chronic low back pain (CLBP). Two enriched-enrollment, randomized-withdrawal, double-blind, controlled trials examined BTDS treatment for patients with moderate-to-severe CLBP. Trial I evaluated BTDS 10 and 20 mcg/hour against a placebo control among opioid-naïve patients. Trial II compared BTDS 20 mcg/hour against a lower-dose control (BTDS 5 mcg/hour) among opioid-experienced patients. The patient-reported Medical Outcomes Study Sleep Scale (MOS-SS) assessed overall sleep quality (Sleep Problems Index [SPI]), Disturbance, and other sleep outcomes. In each trial, MOS-SS scores were compared between target treatment and control arms during the 12-week double-blind phase. Correspondence of changes in sleep outcomes and pain severity and the degree to which pain reduction mediates treatment impact on sleep outcomes were examined. Medical Outcomes Study Sleep Scale scores were collected from 541 (Trial I) and 441 (Trial II) patients prior to randomization and from 369 (Trial I) and 274 (Trial II) patients at week 12. Patients receiving target treatment showed statistically significantly more improvement in SPI and Disturbance scores at 12 weeks than their respective controls (Ps opioid-naïve and opioid-experienced patients with moderate-to-severe CLBP. Benefits of BTDS for these sleep outcomes emerged within 4 weeks and were maintained over the entire 12-week treatment period. © 2015 Optum. Pain Practice published by Wiley Periodicals, Inc. on behalf of World Institute of Pain.

  6. Case of Acute Graft Failure during Suspected Humoral Rejection with Preserved Ejection Fraction, but Severely Reduced Longitudinal Deformation Detected by 2D-Speckle Tracking

    DEFF Research Database (Denmark)

    Clemmensen, Tor Skibsted; Eiskjær, Hans; Kofoed-Nielsen, Pernille B

    2014-01-01

    This case displays limited utility of left ventricular ejection fraction to detect acute graft failure due to microvascular vasculopathy and suspected humoral rejection. Despite severe and progressive graft failure, clinically and by right heart catheterizations, left ventricular ejection fraction...... remained unchanged, indicating need of more reliable noninvasive methods for graft function surveillance. Global longitudinal strain relates to clinical heart failure, filling pressure, and cardiac index during suspected humoral rejection and microvascular dysfunction in this HTX patient. We suggest...

  7. Cone Beam Computed Tomography(CBCT Features Of A Rare Fibro-Osseous Lesion: A Case Report

    Directory of Open Access Journals (Sweden)

    Mahrokh Imanimoghaddam

    2013-03-01

    Full Text Available Cone beam computed tomography is a useful technique for imaging the craniofacial lesions. It produces more realistic images that facilitate interpretation. Juvenile ossifying fibroma (JOF is a rare and benign fibro-osseous neoplasm that arises within the craniofacial bones, especially in the maxilla. Mandibular lesions can be seen in 10% of the cases.In both jaws, it has a predilection for the premolar and molar regions (it is mostly seen in premolar and molar regions. Radiographically, it can be present as a radiolucent, mixed or radiopaque lesion. Radiodensity varies from purely radiolucent masses to mixed densities with prominent radiopacity as the lesion matures. This case report highlights a JOF with large foci of odontome-like radiopacities in a 6-year-old boy's mandibular anterior region. The location of the lesion in the anterior mandible and comparatively rapid formation of large odontome-like radiopaque foci at this early agehas made it a rare entity.

  8. Microcephaly, ectodermal dysplasia, multiple skeletal anomalies and distinctive facial appearance: delineation of cerebro-dermato-osseous-dysplasia.

    Science.gov (United States)

    Castori, Marco; Pascolini, Giulia; Parisi, Valentina; Sana, Maria Elena; Novelli, Antonio; Nürnberg, Peter; Iascone, Maria; Grammatico, Paola

    2015-04-01

    In 1980, a novel multiple malformation syndrome has been described in a 17-year-old woman with micro- and turricephaly, intellectual disability, distinctive facial appearance, congenital atrichia, and multiple skeletal anomalies mainly affecting the limbs. Four further sporadic patients and a couple of affected sibs are also reported with a broad clinical variability. Here, we describe a 4-year-old girl strikingly resembling the original report. Phenotype comparison identified a recurrent pattern of multisystem features involving the central nervous system, and skin and bones in five sporadic patients (including ours), while the two sibs and a further sporadic case show significant phenotypic divergence. Marked clinical variability within the same entity versus syndrome splitting is discussed and the term "cerebro-dermato-osseous dysplasia" is introduced to define this condition. © 2015 Wiley Periodicals, Inc.

  9. A case of osseous scintigraphy showing focuses of multifocal tuberculosis; Un cas de scintigraphie osseuse montrant des foyers de tuberculose multifocale

    Energy Technology Data Exchange (ETDEWEB)

    Faurous-Vanaud, R. [Services de Medecine Nucleaire, Clinique Clementville, Montpellier (France); Faurous, P. [CRLC, Montpellier (France); Kalfa, G.; Collet, H. [Services de Medecine Nucleaire, Clinique Clementville, Montpellier (France); Couty, H.; Artus, J.C. [CRLC, Montpellier (France)

    1997-12-31

    Incidence of tuberculosis in developed countries presents in the last years a spectacular boost. However, the osteo-articular system is afflicted by tuberculosis only in a few percent of cases and the multifocal character represents less than 5% of osseous tuberculosis. It is presented here a case of multifocal osseous tuberculosis only to stress its rarity. A woman 28 years old from Djibouti presents since 8 months an asthenia and dorsal pains long thought as psychalgia. The examination has shown a major vertebral stiffness and limitation of right haunch. The radiographs showed a scoliosis centered on D8 with modifications. The biologic data are VS = 90, CRP = 124 and the hemogram is normal. The intradermal reaction (10 U of tuberculin) is phlyctenular. The TDM indicates lytic vertebral extension on D7 - D8, the osseous scintigraphy with MDP - 99 mTc indicates no anomaly in the vascular arrival time; a few minutes after injection: dorsal and upper and of right femur hyperactivity; 2 h after injection: hyper-fixation of D7 to D9 and of the upper end of right femur. The IRM indicates para-vertebral abscess of D7 to D9 with epidural abscess; abscess in the upper part of the loge of right adductors with osseous affliction of the femur`s upper end; a bacillary infectious process was a priori evoked. The patient was then placed under quadruple antibiotic-therapy anti-tuberculous care. In case of anomalous multifocal osseous scintigraphy the tuberculous affliction is part of the differential diagnosis, particularly in the immigrant populations or in HIV+ persons

  10. Loss of Dok-1 and Dok-2 in mice causes severe experimental colitis accompanied by reduced expression of IL-17A and IL-22

    International Nuclear Information System (INIS)

    Waseda, Masazumi; Arimura, Sumimasa; Shimura, Eri; Nakae, Susumu; Yamanashi, Yuji

    2016-01-01

    Appropriate immune responses and mucosal barrier functions are required for the maintenance of intestinal homeostasis. Defects in this defense system may lead to inflammatory disorders such as inflammatory bowel disease. Downstream of tyrosine kinases 1 (Dok-1) and its closest homolog, Dok-2, are preferentially expressed in immune cells, and play essential roles in the negative regulation of multiple signaling pathways in both innate and adaptive immunity. However, the function of these proteins in intestinal homeostasis remained unclear. Here we show that Dok-1/-2 double knockout (DKO) mice were highly susceptible to dextran sodium sulfate (DSS)-induced colitis compared with Dok-1 or Dok-2 single KO and wild type (WT) mice. Furthermore, DSS-treated Dok-1/-2 DKO mice exhibited increased colonic tissue damage accompanied by reduced proliferation of the epithelial cells relative to WT controls, suggesting that Dok-1/-2 DKO mice have defects in the repair of intestinal epithelial lesions. In addition, the levels of the Th17 cytokines IL-17A and IL-22, which have protective roles in DSS-induced colitis, were reduced in DSS-treated Dok-1/-2 DKO mice compared with WT mice. Taken together, our results demonstrate that Dok-1 and Dok-2 negatively regulate intestinal inflammation, apparently through the induction of IL-17A and IL-22 expression. - Highlights: • Dok-1 and Dok-2 play a cooperative role in protection against DSS-induced colitis. • Dok-1/-2 double KO (DKO) mice show extensive ulceration of the colon after DSS treatment. • Proliferation of colonic epithelium is inhibited in DSS-treated Dok-1/-2 DKO mice. • Expression of IL-17A and IL-22 is reduced in the colon of DSS-treated Dok-1/-2 DKO mice.

  11. Loss of Dok-1 and Dok-2 in mice causes severe experimental colitis accompanied by reduced expression of IL-17A and IL-22

    Energy Technology Data Exchange (ETDEWEB)

    Waseda, Masazumi; Arimura, Sumimasa [Division of Genetics, Department of Cancer Biology, The Institute of Medical Science, The University of Tokyo, Shirokanedai, Minato-ku, Tokyo, 108-8639 (Japan); Shimura, Eri [Laboratory of Systems Biology, Center for Experimental Medicine and Systems Biology, The Institute of Medical Science, The University of Tokyo, Shirokanedai, Minato-ku, Tokyo, 108-8639 (Japan); Nakae, Susumu [Laboratory of Systems Biology, Center for Experimental Medicine and Systems Biology, The Institute of Medical Science, The University of Tokyo, Shirokanedai, Minato-ku, Tokyo, 108-8639 (Japan); Precursory Research for Embryonic Science and Technology (PRESTO), Japan Science and Technology Agency, Saitama, 332-0012 (Japan); Yamanashi, Yuji, E-mail: yyamanas@ims.u-tokyo.ac.jp [Division of Genetics, Department of Cancer Biology, The Institute of Medical Science, The University of Tokyo, Shirokanedai, Minato-ku, Tokyo, 108-8639 (Japan)

    2016-09-09

    Appropriate immune responses and mucosal barrier functions are required for the maintenance of intestinal homeostasis. Defects in this defense system may lead to inflammatory disorders such as inflammatory bowel disease. Downstream of tyrosine kinases 1 (Dok-1) and its closest homolog, Dok-2, are preferentially expressed in immune cells, and play essential roles in the negative regulation of multiple signaling pathways in both innate and adaptive immunity. However, the function of these proteins in intestinal homeostasis remained unclear. Here we show that Dok-1/-2 double knockout (DKO) mice were highly susceptible to dextran sodium sulfate (DSS)-induced colitis compared with Dok-1 or Dok-2 single KO and wild type (WT) mice. Furthermore, DSS-treated Dok-1/-2 DKO mice exhibited increased colonic tissue damage accompanied by reduced proliferation of the epithelial cells relative to WT controls, suggesting that Dok-1/-2 DKO mice have defects in the repair of intestinal epithelial lesions. In addition, the levels of the Th17 cytokines IL-17A and IL-22, which have protective roles in DSS-induced colitis, were reduced in DSS-treated Dok-1/-2 DKO mice compared with WT mice. Taken together, our results demonstrate that Dok-1 and Dok-2 negatively regulate intestinal inflammation, apparently through the induction of IL-17A and IL-22 expression. - Highlights: • Dok-1 and Dok-2 play a cooperative role in protection against DSS-induced colitis. • Dok-1/-2 double KO (DKO) mice show extensive ulceration of the colon after DSS treatment. • Proliferation of colonic epithelium is inhibited in DSS-treated Dok-1/-2 DKO mice. • Expression of IL-17A and IL-22 is reduced in the colon of DSS-treated Dok-1/-2 DKO mice.

  12. Efficacy of a Micro-Prompting Technology in Reducing Support Needed by People With Severe Acquired Brain Injury in Activities of Daily Living: A Randomized Control Trial.

    Science.gov (United States)

    OʼNeill, Brian; Best, Catherine; OʼNeill, Lauren; Ramos, Sara D S; Gillespie, Alex

    2017-11-29

    To evaluate the effectiveness of an automated interactive prompting technology in supporting the morning routine of persons with acquired brain injury. The morning routine included maintaining personal hygiene and dressing. An inpatient neurorehabilitation hospital. Persons with acquired brain injury who required prompting when following their morning routine (n = 24), but were not limited by physical disability or dysphasia, took part in the study. Participants (67% with traumatic brain injury) had impairment on indices of memory and executive function. A randomized control trial evaluated the effect of an automated interactive micro-prompting device on the number of prompts by trained staff required for successful completion of the morning routine. Study-specific checklists assessed sequence performance, errors, and verbal prompts required over baseline, rehabilitation as usual, intervention, and return to baseline conditions. The intervention significantly reduced the support required to complete the task compared with usual rehabilitation. Micro-prompting technology is an effective assistive technology for cognition, which reduces support needs in people with significant cognitive impairments.

  13. Evaluation of an interaction-skills training for reducing the burden of family caregivers of patients with severe mental illness: a pre-posttest design.

    Science.gov (United States)

    Gharavi, Yasmin; Stringer, Barbara; Hoogendoorn, Adriaan; Boogaarts, Jan; Van Raaij, Bas; Van Meijel, Berno

    2018-03-27

    Family members who care for patients with severe mental illness experience emotional distress and report a higher incidence of mental illness than those in the general population. They report feeling inadequately prepared to provide the necessary practical and emotional support for these patients. The MAT training, an Interaction-Skills Training program (IST) for caregivers, was developed to meet those needs. This study used a single-arm pretest-posttest design to examine the impact of the training on caregivers' sense of competence (self-efficacy) and burden. One hundred family caregivers recruited from three mental health institutions participated in the training. Burden was assessed using the Involvement Evaluation Questionnaire, and self-efficacy using the Self-Efficacy Questionnaire. Analysis of variance with repeated measures was used to investigate whether participation in the training changed the level of family caregivers' burden and self-efficacy. Pearson's correlation was used to examine the relationships between self-efficacy and burden. Our results indicate that, after the training, self-efficacy increased significantly over time (p training. After following the IST program, family caregivers of patients with severe mental illness experienced a greater sense of competence and a significant decrease in burden. The training was greatly appreciated and satisfied caregivers' need to acquire the skills required in complex caregiving situations. This study was retrospectively registered (14/01/2018) in the ISRCTN registry with study ID ISRCTN44495131 .

  14. High-molecular-weight adiponectin is selectively reduced in women with polycystic ovary syndrome independent of body mass index and severity of insulin resistance.

    LENUS (Irish Health Repository)

    O'Connor, A

    2010-03-01

    Context: High-molecular-weight (HMW) adiponectin contributes to insulin resistance (IR), which is closely associated with the pathophysiology of polycystic ovary syndrome (PCOS). Abnormalities in adipocyte function have been identified in PCOS and potentially contribute to lower adiponectin concentrations. Objective: Our objective was to determine which variables in plasma and adipose tissue influence HMW adiponectin in a well characterized cohort of women with PCOS. Design: This was a cross-sectional study. Settings and Participants: A teaching hospital. Women with PCOS (n = 98) and body mass index (BMI)-matched controls (n = 103) (including 68 age-, BMI-, and IR-matched pairs). Interventions: A standard 75-g oral glucose tolerance test was performed for each participant. Subcutaneous adipose tissue samples were taken by needle biopsy for a subset of PCOS women (n = 9) and controls (n = 8). Main Outcome Measures: Serum levels of HMW adiponectin and their relation to indices of insulin sensitivity, body composition, and circulating androgens as well as adipose tissue expression levels of ADIPOQ, TNFalpha, PPARgamma, and AR were assessed. Results: HMW adiponectin was significantly lower in women with PCOS compared with both BMI- and BMI- and IR-matched controls (P = 0.009 and P = 0.027, respectively). Although BMI and IR were the main predictors of HMW adiponectin, an interaction between waist to hip ratio and plasma testosterone contributed to its variance (P = 0.026). Adipose tissue gene expression analysis demonstrated that AR and TNFalpha (P = 0.008 and P = 0.035, respectively) but not ADIPOQ mRNA levels were increased in PCOS compared with controls. Conclusions: HMW adiponectin is selectively reduced in women with PCOS, independent of BMI and IR. Gene expression analysis suggests that posttranscriptional\\/translational modification contributes to reduced HMW adiponectin in PCOS.

  15. AI-2 quorum-sensing inhibitors affect the starvation response and reduce virulence in several Vibrio species, most likely by interfering with LuxPQ.

    Science.gov (United States)

    Brackman, Gilles; Celen, Shari; Baruah, Kartik; Bossier, Peter; Van Calenbergh, Serge; Nelis, Hans J; Coenye, Tom

    2009-12-01

    The increase of disease outbreaks caused by Vibrio species in aquatic organisms as well as in humans, together with the emergence of antibiotic resistance in Vibrio species, has led to a growing interest in alternative disease control measures. Quorum sensing (QS) is a mechanism for regulating microbial gene expression in a cell density-dependent way. While there is good evidence for the involvement of auto-inducer 2 (AI-2)-based interspecies QS in the control of virulence in multiple Vibrio species, only few inhibitors of this system are known. From the screening of a small panel of nucleoside analogues for their ability to disturb AI-2-based QS, an adenosine derivative with a p-methoxyphenylpropionamide moiety at C-3' emerged as a promising hit. Its mechanism of inhibition was elucidated by measuring the effect on bioluminescence in a series of Vibrio harveyi AI-2 QS mutants. Our results indicate that this compound, as well as a truncated analogue lacking the adenine base, block AI-2-based QS without interfering with bacterial growth. The active compounds affected neither the bioluminescence system as such nor the production of AI-2, but most likely interfered with the signal transduction pathway at the level of LuxPQ in V. harveyi. The most active nucleoside analogue (designated LMC-21) was found to reduce the Vibrio species starvation response, to affect biofilm formation in Vibrio anguillarum, Vibrio vulnificus and Vibrio cholerae, to reduce pigment and protease production in V. anguillarum, and to protect gnotobiotic Artemia from V. harveyi-induced mortality.

  16. Empirically Reduced Dosages of Tinzaparin in Patients with Moderate-to-Severe Renal Insufficiency Lead to Inadequate Anti-Xa Levels.

    Science.gov (United States)

    Olie, Renske H; Meertens, Nathalie E L; Henskens, Yvonne M C; Ten Cate, Hugo

    2017-01-01

    Due to the higher molecular weight of tinzaparin, the low molecular weight heparin (LMWH) is less dependent on renal excretion than other LMWH preparations. However, several international guidelines recommend the same preemptive dosage reduction for all therapeutic dose LMWHs prescribed in renal insufficient patients, to ensure that there is no accumulation of anticoagulant activity and increased risk of bleeding. This study is aimed at assessing whether a preemptive dosage reduction of tinzaparin in all renal insufficient patients (comprising 25% reduction in patients with Modification of Diet in Renal Disease - estimated glomerular filtration rate (MDRD-eGFR) 30-60 mL/min/1.73 m2 and 50% reduction in patients with MDRD-eGFR renal insufficiency (MDRD-eGFR 0.85 IU/mL for therapeutic indications. Unadjusted dosages led to a median anti-Xa activity of 0.74 IU/mL (IQR 0.56-0.92). The preemptive dosage reduction was significantly associated with anti-Xa activity below therapeutic range (p = 0.007). No difference in anti-Xa activity was observed between patients with moderate (0.71 IU/mL, IQR 0.61-0.95) versus severe (0.65 IU/mL, IQR 0.41-1.06) renal insufficiency in whom an unadjusted dose had been administered (p = 0.77). None of the anti-Xa levels were above the upper margin of the presumed therapeutic range of 2.0 IU/mL. In renal insufficient patients, the preemptive dosage reduction of tinzaparin leads to inadequate anti-Xa levels. © 2017 S. Karger AG, Basel.

  17. Improved survival and reduced phenotypic severity following AAV9/MECP2 gene transfer to neonatal and juvenile male Mecp2 knockout mice.

    Science.gov (United States)

    Gadalla, Kamal K E; Bailey, Mark E S; Spike, Rosemary C; Ross, Paul D; Woodard, Kenton T; Kalburgi, Sahana Nagabhushan; Bachaboina, Lavanya; Deng, Jie V; West, Anne E; Samulski, R Jude; Gray, Steven J; Cobb, Stuart R

    2013-01-01

    Typical Rett syndrome (RTT) is a pediatric disorder caused by loss-of-function mutations in the methyl-CpG binding protein 2 (MECP2) gene. The demonstrated reversibility of RTT-like phenotypes in mice suggests that MECP2 gene replacement is a potential therapeutic option in patients. We report improvements in survival and phenotypic severity in Mecp2-null male mice after neonatal intracranial delivery of a single-stranded (ss) AAV9/chicken β-actin (CBA)-MECP2 vector. Median survival was 16.6 weeks for MECP2-treated versus 9.3 weeks for green fluorescent protein (GFP)-treated mice. ssAAV9/CBA-MECP2-treated mice also showed significant improvement in the phenotype severity score, in locomotor function, and in exploratory activity, as well as a normalization of neuronal nuclear volume in transduced cells. Wild-type (WT) mice receiving neonatal injections of the same ssAAV9/CBA-MECP2 vector did not show any significant deficits, suggesting a tolerance for modest MeCP2 overexpression. To test a MECP2 gene replacement approach in a manner more relevant for human translation, a self-complementary (sc) adeno-associated virus (AAV) vector designed to drive MeCP2 expression from a fragment of the Mecp2 promoter was injected intravenously (IV) into juvenile (4-5 weeks old) Mecp2-null mice. While the brain transduction efficiency in juvenile mice was low (~2-4% of neurons), modest improvements in survival were still observed. These results support the concept of MECP2 gene therapy for RTT.

  18. MAGnesium-oral supplementation to reduce PAin in patients with severe PERipheral arterial occlusive disease: the MAG-PAPER randomised clinical trial protocol.

    Science.gov (United States)

    Venturini, Monica Aida; Zappa, Sergio; Minelli, Cosetta; Bonardelli, Stefano; Lamberti, Laura; Bisighini, Luca; Zangrandi, Marta; Turin, Maddalena; Rizzo, Francesco; Rizzolo, Andrea; Latronico, Nicola

    2015-12-16

    Magnesium exerts analgaesic effects in several animal pain models, as well as in patients affected by acute postoperative pain and neuropathic chronic pain. There is no evidence that magnesium can modulate pain in patients with peripheral arterial occlusive disease (PAOD). We describe the protocol of a single-centre randomised double-blind clinical trial aimed at assessing the efficacy of oral magnesium supplementation in controlling severe pain in patients with advanced PAOD. Adult patients affected by PAOD at stages III and IV of Lèriche-Fontaine classification, who are opioid-naïve, and who have been admitted to our Acute Pain Service for intractable pain, will be eligible. Patients will be randomised to the control group, treated with standard therapy (oxycodone and pregabalin) plus placebo for 2 weeks, or to the experimental group (standard therapy plus magnesium oxide). Patients will be evaluated on days 0, 2, 4, 6, 8, 12 and 14; the following information will being collected: daily oxycodone dose; average and maximum pain (Numerical Rating Scale); pain relief (Pain Relief Scale); characteristics of the pain (Neuropathic Pain Scale); impact of pain on the patient's daily activities (Brief Pain Inventory). The primary outcome will be oxycodone dosage needed to achieve satisfactory analgaesia on day 14. Secondary outcomes will be pain relief on day 2, time needed to achieve satisfactory analgaesia and time needed to achieve a pain reduction of 50%. A sample size calculation was performed for the primary outcome, which estimated a required sample size of 150 patients (75 per group). Ethical approval of the study protocol has been obtained from Comitato Etico Provinciale di Brescia, Brescia, Italy. Trial results will be disseminated through scientific journal manuscripts and scientific conference presentations. NCT02455726. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  19. CD3Z hypermethylation is associated with severe clinical manifestations in systemic lupus erythematosus and reduces CD3ζ-chain expression in T cells.

    Science.gov (United States)

    Hong, Kyeong-Man; Kim, Hyun-Kyoung; Park, Seong-Yeol; Poojan, Shiv; Kim, Mi-Kyung; Sung, Joohon; Tsao, Betty P; Grossman, Jennifer M; Rullo, Ornella J; Woo, Jennifer M P; McCurdy, Deborah K; Rider, Lisa G; Miller, Frederick W; Song, Yeong-Wook

    2017-03-01

    The importance of hypomethylation in SLE is well recognized; however, the significance of hypermethylation has not been well characterized. We screened hypermethylated marks in SLE and investigated their possible implications. DNA methylation marks were screened in SLE whole-blood DNA by microarray, and two marks ( CD3Z and VHL hypermethylations) were confirmed by a methylation single-base extension method in two independent ethnic cohorts consisting of 207 SLE patients and 151 controls. The correlation with clinical manifestations and the genetic influence on those epigenetic marks were analysed. Two epigenetic marks, CD3Z and VHL hypermethylation, were significantly correlated with SLE: CD3Z hypermethylation (odds ratio = 7.76; P = 1.71 × 10 -13 ) and VHL hypermethylation (odds ratio = 3.77; P = 3.20 × 10 -8 ), and the increased CD3Z methylation was correlated with downregulation of the CD3ζ-chain in SLE T cells. In addition, less genetic influence on CD3Z methylation relative to VHL methylation was found in analyses of longitudinal and twin samples. Furthermore, a higher CD3Z methylation level was significantly correlated with a higher SLE disease activity index and more severe clinical manifestations, such as proteinuria, haemolytic anaemia and thrombocytopenia, whereas VHL hypermethylation was not. CD3Z hypermethylation is an SLE risk factor that can be modified by environmental factors and is associated with more severe SLE clinical manifestations, which are related to deranged T cell function by downregulating the CD3ζ-chain. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  20. Acetylsalicylic Acid Reduces the Severity of Dextran Sodium Sulfate-Induced Colitis and Increases the Formation of Anti-Inflammatory Lipid Mediators

    Science.gov (United States)

    Köhnke, Thomas; Bilal, Süleyman; Zhou, Xiangzhi; Rothe, Michael; Baumgart, Daniel C.; Weylandt, Karsten H.

    2013-01-01

    The role of non-steroidal anti-inflammatory drugs in inflammatory bowel disease is controversial, as they have been implicated in disease aggravation. Different from other cyclooxygenase inhibitors, acetylsalicylic acid (ASA) enhances the formation of anti-inflammatory and proresolution lipoxins derived from arachidonic acid as well as resolvins from omega-3 polyunsaturated fatty acids such as docosahexaenoic acid (DHA). In this study, we examined the effect of ASA on murine dextran sodium sulfate colitis. A mouse magnetic resonance imaging (MRI) protocol and post mortem assessment were used to assess disease severity, and lipid metabolites were measured using liquid chromatography-coupled tandem mass spectrometry. Decreased colitis activity was demonstrated by phenotype and MRI assessment in mice treated with ASA, and confirmed in postmortem analysis. Analysis of lipid mediators showed sustained formation of lipoxin A4 and an increase of DHA-derived 17-hydroxydocosahexaenoic acid (17-HDHA) after treatment with ASA. Furthermore, in vitro experiments in RAW264.7 murine macrophages demonstrated significantly increased phagocytosis activity after incubation with 17-HDHA, supporting its proresolution effect. These results show a protective effect of ASA in a murine colitis model and could give a rationale for a careful reassessment of ASA therapy in patients with inflammatory bowel disease and particularly ulcerative colitis, possibly combined with DHA supplementation. PMID:24083240

  1. TNF-alpha inhibition could reduce biomarkers of endothelial dysfunction in patients with moderate to severe psoriasis: A 52-week echo-Doppler based quasi-experimental study.

    Science.gov (United States)

    Molina-Leyva, Alejandro; Garrido-Pareja, Fermín; Ruiz-Carrascosa, José Carlos; Ruiz-Villaverde, Ricardo

    2017-10-28

    Psoriasis is associated to endothelial dysfunction, which causes impaired vascular functioning. TNF-α blockers have shown the ability to improve vascular functioning in psoriasis. The nailfold vessel resistance index (NVRI) assesses microvascular functioning at nailfold. The objectives of the study is to assess the effect of the TNF-α inhibition with adalimumab on NVRI. Quasi-experimental study. Fifteen patients with moderate-severe psoriasis received adalimumab 40mg sc according to label information. Participants were assessed at baseline and at 12, 24 and 52 weeks after study intervention. A reduction of -0.09±0.02 (P<.01) in NVRI and a -11.2±2,41ng/ml (P<.001) in E-selectin was observed at week 52. Adalimumab could produce a progressive and sustained reduction of vessel resistance at nailfold and E-selectin in patients with psoriasis. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  2. Effect of ski geometry and standing height on kinetic energy: equipment designed to reduce risk of severe traumatic injuries in alpine downhill ski racing.

    Science.gov (United States)

    Gilgien, Matthias; Spörri, Jörg; Kröll, Josef; Müller, Erich

    2016-01-01

    Injuries in downhill (DH) are often related to high speed and, therefore, to high energy and forces which are involved in injury situations. Yet to date, no study has investigated the effect of ski geometry and standing height on kinetic energy (EKIN) in DH. This knowledge would be essential to define appropriate equipment rules that have the potential to protect the athletes' health. During a field experiment on an official World Cup DH course, 2 recently retired world class skiers skied on 5 different pairs of skis varying in width, length and standing height. Course characteristics, terrain and the skiers' centre of mass position were captured by a differential Global Navigational Satellite System-based methodology. EKIN, speed, ski-snow friction force (FF), ground reaction force (FGRF) and ski-snow friction coefficient (CoeffF) were calculated and analysed in dependency of the used skis. In the steep terrain, longer skis with reduced width and standing height significantly decreased average EKIN by ∼ 3%. Locally, even larger reductions of EKIN were observed (up to 7%). These local decreases in EKIN were mainly explainable by higher FF. Moreover, CoeffF differences seem of greater importance for explaining local FF differences than the differences in FGRF. Knowing that increased speed and EKIN likely lead to increased forces in fall/crash situations, the observed equipment-induced reduction in EKIN can be considered a reasonable measure to improve athlete safety, even though the achieved preventative gains are rather small and limited to steep terrain. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  3. Sidecut radius and the mechanics of turning-equipment designed to reduce risk of severe traumatic knee injuries in alpine giant slalom ski racing.

    Science.gov (United States)

    Spörri, Jörg; Kröll, Josef; Gilgien, Matthias; Müller, Erich

    2016-01-01

    There is limited empirical knowledge about the effect of ski geometry, particularly in the context of injury prevention in alpine ski racing. We investigated the effect of sidecut radius on biomechanical variables related to the mechanics of turning. During a field experiment, six European Cup level athletes skied on three different pairs of giant slalom (GS) skis varying in sidecut radii (30 m, 35 m and 40 m). Using a video-based three-dimensional (3D) kinematic system, a 22-point body segment model of the athletes was reconstructed in 3D, and the variables ground reaction force, centre of mass (COM) speed, COM turn radius, ski turn radius, edge angle, fore/aft position and skid angle were calculated. While steering out of the fall line after gate passage, ground reaction force significantly differed between the 30 m and 40 m skis and between the 35 m and 40 m skis. These differences were mainly explainable by larger COM turn radii when skiing on the 40 m ski. During the same turn phase, significant differences in ski turn radius also were found, but there were no differences in edge angle, fore/aft position and skid angle. The sidecut-induced reduction in ground reaction force and the sidecut-induced increase in centre of mass and ski turn radius observed in this study provides indirect evidence of reduced self-steering of the ski. Self-steering plays a central role in the mechanism of anterior cruciate ligament rupture in alpine ski racing. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  4. Sidecut radius and the mechanics of turning—equipment designed to reduce risk of severe traumatic knee injuries in alpine giant slalom ski racing

    Science.gov (United States)

    Spörri, Jörg; Kröll, Josef; Gilgien, Matthias; Müller, Erich

    2016-01-01

    Background There is limited empirical knowledge about the effect of ski geometry, particularly in the context of injury prevention in alpine ski racing. We investigated the effect of sidecut radius on biomechanical variables related to the mechanics of turning. Methods During a field experiment, six European Cup level athletes skied on three different pairs of giant slalom (GS) skis varying in sidecut radii (30 m, 35 m and 40 m). Using a video-based three-dimensional (3D) kinematic system, a 22-point body segment model of the athletes was reconstructed in 3D, and the variables ground reaction force, centre of mass (COM) speed, COM turn radius, ski turn radius, edge angle, fore/aft position and skid angle were calculated. Results While steering out of the fall line after gate passage, ground reaction force significantly differed between the 30 m and 40 m skis and between the 35 m and 40 m skis. These differences were mainly explainable by larger COM turn radii when skiing on the 40 m ski. During the same turn phase, significant differences in ski turn radius also were found, but there were no differences in edge angle, fore/aft position and skid angle. Summary The sidecut-induced reduction in ground reaction force and the sidecut-induced increase in centre of mass and ski turn radius observed in this study provides indirect evidence of reduced self-steering of the ski. Self-steering plays a central role in the mechanism of anterior cruciate ligament rupture in alpine ski racing. PMID:26702014

  5. Host-induced silencing of essential genes in Puccinia triticina through transgenic expression of RNAi sequences reduces severity of leaf rust infection in wheat.

    Science.gov (United States)

    Panwar, Vinay; Jordan, Mark; McCallum, Brent; Bakkeren, Guus

    2018-05-01

    Leaf rust, caused by the pathogenic fungus Puccinia triticina (Pt), is one of the most serious biotic threats to sustainable wheat production worldwide. This obligate biotrophic pathogen is prevalent worldwide and is known for rapid adaptive evolution to overcome resistant wheat varieties. Novel disease control approaches are therefore required to minimize the yield losses caused by Pt. Having shown previously the potential of host-delivered RNA interference (HD-RNAi) in functional screening of Pt genes involved in pathogenesis, we here evaluated the use of this technology in transgenic wheat plants as a method to achieve protection against wheat leaf rust (WLR) infection. Stable expression of hairpin RNAi constructs with sequence homology to Pt MAP-kinase (PtMAPK1) or a cyclophilin (PtCYC1) encoding gene in susceptible wheat plants showed efficient silencing of the corresponding genes in the interacting fungus resulting in disease resistance throughout the T 2 generation. Inhibition of Pt proliferation in transgenic lines by in planta-induced RNAi was associated with significant reduction in target fungal transcript abundance and reduced fungal biomass accumulation in highly resistant plants. Disease protection was correlated with the presence of siRNA molecules specific to targeted fungal genes in the transgenic lines harbouring the complementary HD-RNAi construct. This work demonstrates that generating transgenic wheat plants expressing RNAi-inducing transgenes to silence essential genes in rust fungi can provide effective disease resistance, thus opening an alternative way for developing rust-resistant crops. © 2017 Her Majesty the Queen in Right of Canada. Plant Biotechnology Journal published by Society for Experimental Biology and The Association of Applied Biologists and John Wiley & Sons Ltd.

  6. Sidecut radius and kinetic energy: equipment designed to reduce risk of severe traumatic knee injuries in alpine giant slalom ski racing.

    Science.gov (United States)

    Kröll, Josef; Spörri, Jörg; Gilgien, Matthias; Schwameder, Hermann; Müller, Erich

    2016-01-01

    Kinetic energy (Ekin) increases with speed by the power of 2 and is considered a major risk factor for injuries in alpine ski racing. There is no empirical knowledge about the effect of ski geometry on Ekin. Consequently, the aim of this study was to investigate the influence of sidecut radius on the progress of Ekin while skiing through a multigate section in giant slalom (GS). 5 European-Cup level athletes skied on three different pairs of GS skis varying in sidecut radii (30, 35 and 40 m). Each athlete's position over time within a six gate section (including flat and steep terrain) was captured by the use of a differential Global Navigational Satellite System. Ekin, speed, time and path length were analysed for each pair of skis used. When using skis with greater sidecut radius, average Ekin was significantly lower over the entire six gate section, but not locally at every turn cycle. Particular decreases of Ekin were observed for both turns on the flat terrain, as well as for the turn at the terrain transition and the first turn on the steep terrain. The observed decreases in Ekin were found to be primarily explainable by increases in turn time. With respect to typical sport mechanisms that cause severe knee injuries, using skis with greater sidecut radius potentially provides additional injury preventative gain, particularly in specific areas within a run. However, this injury preventative gain during falls in GS should not be overestimated. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  7. The Effectiveness of Early Educational Interventions in the Emergency Department to Reduce Incidence or Severity of Postconcussion Syndrome Following a Concussion: A Systematic Review.

    Science.gov (United States)

    Eliyahu, Leeor; Kirkland, Scott; Campbell, Sandy; Rowe, Brian H

    2016-05-01

    Concussions or mild traumatic brain injury are a major public health concern accounting for 85% of all brain injuries. Postconcussion syndrome (PCS) has been found to affect between 15 and 25% of patients with concussion 1 year after the initial injury. The goal of this review is to assess the effectiveness of early educational information or interventions provided in the emergency department on the onset and/or severity of PCS. A comprehensive literature search strategy involving seven electronic databases was developed. A grey literature search of Google Scholar, recent conference proceedings in emergency medicine, bibliographies of included studies, and clinical trial registries was also performed. The citation list was reviewed independently by two reviewers; no restrictions on publication status or language of publication were applied. The Cochrane risk-of-bias tool and the Newcastle-Ottawa scale were used to assess quality. From 1,325 citations retrieved, four RCTs and one controlled clinical trial met inclusion criteria. Interventions identified in these studies included: educational information sheets, with or without telephone or in-person follow-up, and one study on bed rest. While rarely requested, one study offered referrals and additional treatment, if needed. None of the studies were deemed to be high quality. Heterogeneity among outcome reporting, follow-up dates and interventions used precluded a pooled analysis. Overall, only two of the five included studies involving adult patients receiving early educational interventions reported a significant improvement in PCS symptoms. No reduction in PCS symptoms was found in the study on bed rest interventions. Limited evidence exists regarding the effectiveness of early educational interventions following concussion. Standardization of the interventions, outcome measures, and follow-up periods would make quantitative comparisons more valid. Moreover, higher-quality research in the field of early

  8. Reduced persistence of the macrolide antibiotics erythromycin, clarithromycin and azithromycin in agricultural soil following several years of exposure in the field

    Energy Technology Data Exchange (ETDEWEB)

    Topp, Edward, E-mail: ed.topp@agr.gc.ca; Renaud, Justin; Sumarah, Mark; Sabourin, Lyne

    2016-08-15

    The macrolide antibiotics erythromycin, clarithromycin and azithromycin are very important in human and animal medicine, and can be entrained onto agricultural ground through application of sewage sludge or manures. In the present study, a series of replicated field plots were left untreated or received up to five annual spring applications of a mixture of three drugs to achieve a nominal concentration for each of 10 or 0.1 mg kg{sup −1} soil; the latter an environmentally relevant concentration. Soil samples were incubated in the laboratory, and supplemented with antibiotics to establish the dissipation kinetics of erythromycin and clarithromycin using radioisotope methods, and azithromycin using HPLC-MS/MS. All three drugs were dissipated significantly more rapidly in soils with a history of field exposure to 10 mg kg{sup −1} macrolides, and erythromycin and clarithromycin were also degraded more rapidly in field soil exposed to 0.1 mg kg{sup −1} macrolides. Rapid mineralization of {sup 14}C-labelled erythromycin and clarithromycin are consistent with biodegradation. Analysis of field soils revealed no carryover of parent compound from year to year. Azithromycin transformation products were detected consistent with removal of the desosamine and cladinose moieties. Overall, these results have revealed that following several years of exposure to macrolide antibiotics these are amenable to accelerated degradation. The potential accelerated degradation of these drugs in soils amended with manure and sewage sludge should be investigated as this phenomenon would attenuate environmental exposure and selection pressure for clinically relevant resistance. - Highlights: • The impact of field exposure on persistence of macrolide antibiotics was evaluated. • Soil samples were incubated in the laboratory with macrolides. • Field exposure resulted in more rapid dissipation of all macrolides. • Radiolabelled erythromycin and clarithromycin were rapidly mineralized

  9. Lactobacillus reuteri strains reduce incidence and severity of experimental necrotizing enterocolitis via modulation of TLR4 and NF-κB signaling in the intestine.

    Science.gov (United States)

    Liu, Yuying; Fatheree, Nicole Y; Mangalat, Nisha; Rhoads, Jon Marc

    2012-03-15

    Necrotizing enterocolitis (NEC) is the leading gastrointestinal cause of mortality and morbidity in the premature infant. Premature infants have a delay in intestinal colonization by commensal bacteria and colonization with potentially pathogenic organisms. Lactobacillus reuteri is a probiotic that inhibits enteric infections, modulates the immune system, and may be beneficial to prevent NEC. In previous studies, L. reuteri strains DSM 17938 and ATCC PTA 4659 differentially modulated inflammation in vitro; however, the strains had equivalent anti-inflammatory responses in LPS feeding-induced ileitis in neonatal rats in vivo. The impact of these two strains in the prevention of NEC has not been previously investigated. NEC was induced in newborn rats by orogastric formula feeding and exposure to hypoxia. L. reuteri was added to the formula to prevent NEC. NEC score, Toll-like receptor (TLR)-signaling genes, phospho-IκB activity, and cytokine levels in the intestine were examined. Both strains significantly increased survival rate and decreased the incidence and severity of NEC, with optimal effects from DSM 17938. In response to probiotic, mRNA expression of IL-6, TNF-α, TLR4, and NF-κB was significantly downregulated, while mRNA levels of anti-inflammatory cytokine IL-10 were significantly upregulated. In parallel, L. reuteri treatment led to decrease intestinal protein levels of TLR4 and cytokine levels of TNF-α and IL-1β in newborn rats with NEC. Both strains significantly inhibited not only intestinal LPS-induced phospho-IκB activity in an ex vivo study but also decreased the levels of phospho-IκB in the intestines of NEC rat model. Cow milk formula feeding produced a similar but milder proinflammatory profile in the intestine that was also ameliorated by 17938. Our studies demonstrate that each of the two L. reuteri strains has potential therapeutic value in our NEC model and in enteritis associated with cow milk feeding. These results support the

  10. Vertebral degenerative disc disease severity evaluation using random forest classification

    Science.gov (United States)

    Munoz, Hector E.; Yao, Jianhua; Burns, Joseph E.; Pham, Yasuyuki; Stieger, James; Summers, Ronald M.

    2014-03-01

    Degenerative disc disease (DDD) develops in the spine as vertebral discs degenerate and osseous excrescences or outgrowths naturally form to restabilize unstable segments of the spine. These osseous excrescences, or osteophytes, may progress or stabilize in size as the spine reaches a new equilibrium point. We have previously created a CAD system that detects DDD. This paper presents a new system to determine the severity of DDD of individual vertebral levels. This will be useful to monitor the progress of developing DDD, as rapid growth may indicate that there is a greater stabilization problem that should be addressed. The existing DDD CAD system extracts the spine from CT images and segments the cortical shell of individual levels with a dual-surface model. The cortical shell is unwrapped, and is analyzed to detect the hyperdense regions of DDD. Three radiologists scored the severity of DDD of each disc space of 46 CT scans. Radiologists' scores and features generated from CAD detections were used to train a random forest classifier. The classifier then assessed the severity of DDD at each vertebral disc level. The agreement between the computer severity score and the average radiologist's score had a quadratic weighted Cohen's kappa of 0.64.

  11. Algorithm for Severe Hallux Valgus Associated With Metatarsus Adductus.

    Science.gov (United States)

    Sharma, Jyoti; Aydogan, Umur

    2015-12-01

    Radiographic angles, such as the intermetatarsal angle, hallux valgus angle, and distal metatarsal articular angle, are commonly used to help guide operative planning for soft tissue and osseous treatment options for hallux valgus. Hallux valgus treatment in the setting of associated metatarsus adductus is less common and not well described. The presence of metatarsus adductus reduces the gap between the first and second metatarsals. Consequently, it complicates the measurement of the first-second intermetatarsal angle and can limit the area available for transposition of the first metatarsal head. A compensatory pronation is also created, which must be compensated for. We present 4 cases of patients that had hallux valgus with severe metatarsus adductus treated operatively, as well as a treatment algorithm. For concomitant correction of both the metatarsus adductus and the hallux valgus, a thorough surgical treatment algorithm was implemented to address the hallux, lesser toe deformities, and pes planus deformity. Postoperatively, the patients were kept non-weight bearing for 6 weeks, followed by gradual weight bearing in a protective boot. Physical therapy was instituted at the start of weight bearing to encourage a return to activities of daily living. At follow-up, patients reported significant relief of their pain symptoms with a narrower and improved appearance of the foot. No recurrence was noted. One patient used a medial arch support but was otherwise symptom free. Radiographic measurements improved on postoperative radiographs. For the treatment of hallux valgus with metatarsus adductus, the second and third metatarsals may need to be addressed for the first metatarsal to be laterally transposed adequately. Overall, this comprehensive approach addresses the hindfoot, midfoot, and forefoot for patients with hallux valgus associated with metatarsus adductus, with successful results. © The Author(s) 2015.

  12. Peripheral osteoma, compound odontoma, focal cemento-osseous dysplasia, and cemento-ossifying fibroma in the same hemimandible: CBCT findings of an unusual case

    Directory of Open Access Journals (Sweden)

    Andrea Borghesi, MD

    2017-12-01

    Full Text Available Peripheral osteoma is the most common subtype of osteoma that arises most frequently in the craniofacial bones. It may occur at any age with a male-to-female ratio of 2:1. Peripheral osteoma may affect the mandible, particularly the ramus and the condyle. Compound odontoma is a subtype of odontoma that occurs in young subjects without gender predilection. It affects the maxilla more frequently than the mandible. Focal cemento-osseous dysplasia and cemento-ossifying fibroma are 2 benign fibro-osseous lesions with a female predominance that occur most commonly in the posterior region of the mandible. We report the first case involving the simultaneous occurrence of these 4 benign lesions in the same hemimandible diagnosed by CBCT.

  13. Osseous changes and condyle position in TMJ tomograms: impact of RDC/TMD clinical diagnoses on agreement between expected and actual findings.

    Science.gov (United States)

    Wiese, Mie; Wenzel, Ann; Hintze, Hanne; Petersson, Arne; Knutsson, Kerstin; Bakke, Merete; List, Thomas; Svensson, Peter

    2008-08-01

    The objective of this study was to evaluate the impact of clinical TMJ diagnosis, gender, and age on the agreement between expected and actual radiographic findings. A total of 204 patients with TMJ symptoms were examined using the Research Diagnostic Criteria (RDC/TMD). Expected radiographic findings were recorded. TMJ tomograms in closed and open mouth position were assessed for osseous changes and condyle position. Expected and actual findings were compared. Logistic regression analyses were performed with agreement on radiographic findings as the dependent variable and with clinical RDC/TMD diagnoses, gender and age as the independent variables. The number of radiographic findings was mostly underestimated. A clinical diagnosis of osteoarthritis and age increased the chance of overestimating osseous changes. Disc displacement and age decreased the chance of agreement on certain condyle positions. Tomography often revealed unexpected findings. It was not possible to select particular patient groups who would benefit more or less from a radiographic examination.

  14. Osseous response on linear and cyclic RGD-peptides immobilized on titanium surfaces in vitro and in vivo.

    Science.gov (United States)

    Heller, M; Kumar, V V; Pabst, A; Brieger, J; Al-Nawas, B; Kämmerer, P W

    2018-02-01

    Biomimetic surface modifications of titanium (Ti) implants using the Arg-Gly-Asp-sequence (RGD) are promising to accelerate bone healing in cases of medical implants. Therefore, we compared the impact of linear and cyclic RGD (l- and c-RGD) covalently coupled onto Ti surfaces on the osseous response in vitro and in vivo. In vitro, osteoblasts' behavior on different surfaces (unmodified, amino-silanized [APTES], l- and c-RGD) was analysed regarding adhesion (fluorescence microscopy), proliferation (resazurin stain) and differentiation (reverse transcription polymerase chain reaction on alkaline phosphatase and osteocalcin). In vivo, osteosynthesis screws (unmodified n = 8, l-RGD n = 8, c-RGD n = 8) were inserted into the proximal tibiae of 12 rabbits and evaluated for bone growth parameters (bone implant contact [%] and vertical bone apposition [VBA;%]) at 3 and 6 weeks. In vitro, c- as well as l-RGD surfaces stimulated osteoblasts' adherence, proliferation and differentiation in a similar manner, with only subtle evidence of superiority of the c-RGD modifications. In vivo, c-RGD-modifications led to a significantly increased VBA after 3 and 6 weeks. Thus, coating with c-RGD appears to play an important role influencing osteoblasts' behaviour in vitro but especially in vivo. These findings can be applied prospectively to implantable biomaterials with hypothetically improved survival and success rates. © 2017 Wiley Periodicals Inc. J Biomed Mater Res Part A: 106A: 419-427, 2018. © 2017 Wiley Periodicals, Inc.

  15. Surgical treatment of residual osgood-schlatter disease in young adults: role of the mobile osseous fragment.

    Science.gov (United States)

    Nierenberg, Gabriel; Falah, Mazen; Keren, Yaniv; Eidelman, Mark

    2011-03-11

    Osgood-Schlatter disease is a well-known condition in late childhood characterized by pain over the tibial tubercle. This condition usually resolves spontaneously at skeletal maturity. Few patients develop pain over the tibial tubercle. Radiological examination demonstrates a round regular ossification over the tubercle. Treatment is usually symptomatic, but occasionally surgical treatment is necessary, usually due to the development of a painful ossicle. This article reports our experience with refractory Osgood-Schlatter disease in 22 patients. Most patients were operated under local anesthesia. A midline longitudinal skin incision was used, followed by subperiosteal dissection of the osseous fragment. The knee was put in soft dressing. Patients were encouraged to resume daily activity immediately postoperatively. No wound complications were noted. All patients returned to their previous level of physical activity within 12 weeks postoperatively. All but 1 were free of pain on kneeling or direct pressure over the knee joint. Based on our experience, we devised a treatment algorithm. We believe that the key factors for successful surgical treatment are clear visualization of separation on lateral knee radiographic view and a clinical mobility positive test (firm grasping of the prominent part of the tubercle and its sliding movement). Our results are uniformly good; the only failure related to mistaken inclusion criteria where the lateral radiograph did not show a distinctly separated fragment. Copyright 2011, SLACK Incorporated.

  16. Comparative study of the osseous healing process following three different techniques of bone augmentation in the mandible: an experimental study.

    Science.gov (United States)

    Benlidayi, M E; Gaggl, A; Buerger, H; Kahraman, O E; Sencar, L; Brandtner, C; Kurkcu, M; Polat, S; Borumandi, F

    2014-11-01

    The aim of this study was to evaluate the osseointegration of three different bone grafting techniques. Forty-eight mature New Zealand rabbits were divided randomly into three groups of 16 each. Horizontal augmentation was performed on the corpus of the mandible using three different techniques: free bone graft (FBG), free periosteal bone graft (PBG), pedicled bone flap (BF). The animals were sacrificed at postoperative weeks 1, 3, or 8. Specimens were decalcified for histological examination, and histomorphometric measurements were performed. The histological evaluation demonstrated bony fusion between the grafts and the augmented mandibular bone after 8 weeks in all groups. At week 8, the bone volume was significantly greater in the BF group than in the FBG (PPBG (P=0.001) groups, and also the trabecular thickness was significantly greater than in the FBG (P=0.015) and PBG (P=0.015) groups. Trabecular separation was significantly lower in the BF group than in the FBG group at week 8 (P=0.015). BF demonstrated greater osseous healing capacity compared to FBG and PBG. The preserved vascularization in BF improves the bone quality in mandibular bone augmentations. Copyright © 2014 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  17. Are the osseous and tendinous-cartilaginous tibial tuberosity-trochlear groove distances the same on CT and MRI?

    Energy Technology Data Exchange (ETDEWEB)

    Bremer Hinckel, Betina; Gomes Gobbi, Riccardo; Pecora, Jose Ricardo; Camanho, Gilberto Luis; Demange, Marco Kawamura [Institute of Orthopaedics and Traumatology of the Clinical Hospital of the Medical School of the University of Sao Paulo, Department of Orthopaedics, Sao Paulo (Brazil); Noda Kihara Filho, Eduardo; Bordalo Rodrigues, Marcelo [Institute of Orthopaedics and Traumatology of the Clinical Hospital of the Medical School of the University of Sao Paulo, Department of Musculoskeletal Radiology, Sao Paulo (Brazil)

    2015-08-15

    To verify whether the tibial tuberosity-trochlear groove distance (TT-TG) and the tendinous-cartilaginous TT-TG (the distance between the patellar tendon and trochlear groove: PT-TG) are identical using computed tomography (CT) and magnetic resonance imaging (MRI) techniques. The TT-TG and PT-TG distances were measured on the same knee samples by three observers (two measurements per observer) using CT and MRI scans collected retrospectively. The reproducibility of the measurements was assessed using the interclass correlation coefficient (ICC). The means and standard deviations of four measurements were calculated for each patient. A paired t-test was used to assess differences between measurements. Fifty knee samples (32 with patellar instability and 18 with other conditions) were evaluated. The inter- and intraobserver reliability was excellent for all four measurements (>0.8). On average, the TT-TG distance on MRI was 3.1-3.6 mm smaller than that on CT, and the PT-TG distance on MRI was 1.0-3.4 mm larger than the TT-TG distance on MRI. The osseous TT-TG and tendinous-cartilaginous PT-TG distances determined by CT and MRI were not identical. (orig.)

  18. Contribution of Implanted, Genetically Modified Muscle Progenitor Cells Expressing BMP-2 to New Bone Formation in a Rat Osseous Defect.

    Science.gov (United States)

    De La Vega, Rodolfo E; De Padilla, Consuelo Lopez; Trujillo, Miguel; Quirk, Nicholas; Porter, Ryan M; Evans, Christopher H; Ferreira, Elisabeth

    2018-01-03

    Because muscle contains osteoprogenitor cells and has a propensity to form bone, we have explored its utility in healing large osseous defects. Healing is achieved by the insertion of muscle fragments transduced with adenovirus encoding BMP-2 (Ad.BMP-2). However, it is not known whether the genetically modified muscle contributes osteoprogenitor cells to healing defects or merely serves as a local source of BMP-2. This question is part of the larger debate on the fate of progenitor cells introduced into sites of tissue damage to promote regeneration. To address this issue, we harvested fragments of muscle from rats constitutively expressing GFP, transduced them with Ad.BMP-2, and implanted them into femoral defects in wild-type rats under various conditions. GFP + cells persisted within defects for the entire 8 weeks of the experiments. In the absence of bone formation, these cells presented as fibroblasts. When bone was formed, GFP + cells were present as osteoblasts and osteocytes and also among the lining cells of new blood vessels. The genetically modified muscle thus contributed progenitor cells as well as BMP-2 to the healing defect, a property of great significance in light of the extensive damage to soft tissue and consequent loss of endogenous progenitors in problematic fractures. Copyright © 2017 The American Society of Gene and Cell Therapy. Published by Elsevier Inc. All rights reserved.

  19. Increased Wnt and Notch signaling: a clue to the renal disease in Schimke immuno-osseous dysplasia?

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    Marie Morimoto

    2016-11-01

    Full Text Available Abstract Background Schimke immuno-osseous dysplasia (SIOD is a multisystemic disorder caused by biallelic mutations in the SWI/SNF-related matrix-associated actin-dependent regulator of chromatin, subfamily A-like 1 (SMARCAL1 gene. Changes in gene expression underlie the arteriosclerosis and T-cell immunodeficiency of SIOD; therefore, we hypothesized that SMARCAL1 deficiency causes the focal segmental glomerulosclerosis (FSGS of SIOD by altering renal gene expression. We tested this hypothesis by gene expression analysis of an SIOD patient kidney and verified these findings through immunofluorescent analysis in additional SIOD patients and a genetic interaction analysis in Drosophila. Results We found increased expression of components and targets of the Wnt and Notch signaling pathways in the SIOD patient kidney, increased levels of unphosphorylated β-catenin and Notch1 intracellular domain in the glomeruli of most SIOD patient kidneys, and genetic interaction between the Drosophila SMARCAL1 homologue Marcal1 and genes of the Wnt and Notch signaling pathways. Conclusions We conclude that increased Wnt and Notch activity result from SMARCAL1 deficiency and, as established causes of FSGS, contribute to the renal disease of most SIOD patients. This further clarifies the pathogenesis of SIOD and will hopefully direct potential therapeutic approaches for SIOD patients.

  20. Intraosseous Lipoma of the Proximal Radius with Extra Osseous Extension leading to Posterior Interosseous Nerve Compression: HRUS Diagnosis.

    Science.gov (United States)

    Narayan, S; Ahluwalia, V Verma; Saharan, P Singh; Gupta, A Kumar

    2016-01-01

    Benign musculoskeletal lipomatous lesions are common in both soft tissue and bone. Imaging features of benign lipomatous lesions are often pathognomonic. Ultrasound (US) has been used to examine both soft tissue and bone tumors, allowing targeted CT or MRI examination of the region of interest. A 46-year-old female presented with a four year history of palpable mass lesion just below the lateral aspect of right elbow with clinical evidence of posterior interosseous nerve compression. X-ray showed the presence of a radiolucency mass in relation to radius. HRUS demonstrated a hyperechoic mass in soft tissue with a focal irregularity in bony cortex of radius. The mass lesion compressed the posterior interosseous nerve. Although CT and MRI diagnose them accurately, but ultrasound characteristics are also conclusive for extra osseous component. This case highlights the importance of HRUS for evaluation of musculoskeletal tumors and any secondary changes in a readily available cost effective dynamic modality and thus guide for treatment planning accordingly.

  1. The Relationship between Osseous Changes of the Temporomandibular Joint and RDC/TMD Groups in CBCT Images

    Directory of Open Access Journals (Sweden)

    Mahrokh Imanimoghaddam

    2014-09-01

    Full Text Available Abstract Introduction: Temporomandibular joint disorders (TMD are the most common disorders of the jaw, and despite their clinical importance, they are not completely understood. This study was aimed to evaluate the changes of temporomandibular joint (TMJ on cone beam computed tomography (CBCT images in disc displacement vs. osteoarthritis of the TMJ. Methods: In this study, 45 patients, including 37 women and 8 men (13-89 years of age, were examined. The patients were selected based on RDC/TMD criteria and group I disorders were excluded from the study. Accordingly, group II consisted of 43 joints with jaw clicking or displaced discs, and group III comprised 46 joints with crepitus. CBCT images in sagittal, coronal, and axial sections were examined to assess osseous changes in terms of flattening, sclerosis, erosion, resorption, and osteophyte formation. Data were analyzed using statistical tests including the chi-square, Mann-Whitney, and Kolmogorov-Smirnov tests with the confidence interval of 95%. Results: Mann-Whitney test for the comparison of mean age between groups II and III was not statistically significant (p value=0.06. A significant differences was found between two (RDC/TMD groups according to the prevalence of condylar erosion, resorption, and osteophyte (p

  2. Effectiveness of Eye Movement Desensitization and Reprocessing(EMDR to Reduce the Severity of Symptoms of Post-Traumatic Stress Disorder and Stuttering With Psychological Origin(Case Study in Child with Four Years Old

    Directory of Open Access Journals (Sweden)

    Azam Hashemian Moghadam

    2017-02-01

    Full Text Available Abstract Background: The present research aimed to measure the effectiveness of Eye Movement Desensitization and Reprocessing (EMDR on reducing the severity of symptoms of post-traumatic Stress Disorder (PTSD and Stuttering in a four-year-old child post-traumatic stress disorder in children is one of the disorders relating to trauma and stressful factors, also, stutterring or word fluency disorder is a nerve growth disorder. Materials and Methods: This research design was conducted as a case study with a multiple baseline design. Participant in this research was a four-year- old child with Diagnostic Posttraumatic Stress Disorder and Psychogenic Stuttering. He had been placed under the intervention with EMDR at Shahid Birjand Counseling Center. The instruments used for this research included demographic researcher-made questionnaire, the third edition of stuttering severity test, the scale of parents’ report of post-traumatic Symptoms and child’s report of posttraumatic Symptoms. Data analysis was done through graphic and descriptive analysis. The data was collected as base line and during the treatment as well as after the treatment and follow-up (in terms of 3 and 24 months. Results: Means percentage improvement (MPI to reducing the severity of post-traumatic symptoms was achieved as %74.66 and it was %56.06 for reduction of the severity of stuttering and they continued to maintain in the follow-up period. Conclusion: Results showed that EMDR method had affected on reduction of the severity of post-traumatic stress disorder symptoms and stuttering intensity.

  3. Roentgenographic aspects on non-Hodgkin's lymphomas presenting with osseous lesions

    International Nuclear Information System (INIS)

    Spagnoli, I.; Gattoni, F.; Viganotti, G.

    1982-01-01

    Radiographs of 992 patients with previously untreated non-Hodgkin's lymphoma were reviewed, and bone involvement was found in 61. Ten patients had primary lymphoma of bone and 51 patients had concomitant lymph node and/or visceral involvement or several affected bones. Roentgenographic analysis of all the bone lesions showed that osteolysis predominated, but without specific diagnostic features, and that cortical destruction and soft tissue involvement carry an adverse prognosis. Routine skeletal X-ray survey in the initial staging of non-Hodgkin's lymphomas is essential. (orig.)

  4. Risk Factors at Birth for Permanent Obstetric Brachial Plexus Injury and Associated Osseous Deformities

    Science.gov (United States)

    Nath, Rahul K.; Kumar, Nirupama; Avila, Meera B.; Nath, Devin K.; Melcher, Sonya E.; Eichhorn, Mitchell G.; Somasundaram, Chandra

    2012-01-01

    Purpose. To examine the most prevalent risk factors found in patients with permanent obstetric brachial plexus injury (OBPI) to identify better predictors of injury. Methods. A population-based study was performed on 241 OBPI patients who underwent surgical treatment at the Texas Nerve and Paralysis Institute. Results. Shoulder dystocia (97%) was the most prevalent risk factor. We found that 80% of the patients in this study were not macrosomic, and 43% weighed less than 4000 g at birth. The rate of instrument use was 41% , which is 4-fold higher than the 10% predicted for all vaginal deliveries in the United States. Posterior subluxation and glenoid version measurements in children with no finger movement at birth indicated a less severe shoulder deformity in comparison with those with finger movement. Conclusions. The average birth weight in this study was indistinguishable from the average birth weight reported for all brachial plexus injuries. Higher birth weight does not, therefore, affect the prognosis of brachial plexus injury. We found forceps/vacuum delivery to be an independent risk factor for OBPI, regardless of birth weight. Permanently injured patients with finger movement at birth develop more severe bony deformities of the shoulder than patients without finger movement. PMID:22518326

  5. Tin-117m(4+)-DTPA for palliation of pain from osseous metastases: A pilot study

    International Nuclear Information System (INIS)

    Atkins, H.L.; Mausner, L.F.; Srivastava, S.C.

    1995-01-01

    The physical and biological attributes of 117m Sn(4+)-DTPA indicate that it should be an effective agent for palliative therapy of painful bony metastatic disease. The aim of this study was to evaluate whether or not this agent could effectively reduce pain while sparing the hemopoietic marrow from adverse effects. Fifteen patients (10 males and 5 females) with painful bony metastases from various primary cancers were included in the study. Seven patients received 1.22 to 3.11 MBq/kg of 117m Sn intravenously (Group 1) and eight patients received 4.85 to 5.77 MBq/kg (Group 2). All but one were treated as outpatients and followed for a minimum of 2 mo. In the first group, pain relief was nonassessable in four patients because of death or additional treatment of soft-tissue disease by another modality. One patient had no relief of pain, one had complete relief of pain and one had transient relief of pain. No myelotoxicity was observed. For Group 2, three patients achieved complete relief of pain, two good relief, two partial relief and one began to experience pain relief when he suffered a pathological fracture 2 mo most-treatment. None of these patients had myelotoxicity. Tin-117m(4+)-DTPA can reduce pain from metastatic disease to bone without inducing adverse reactions related to bone marrow. Further studies are needed to assess tolerance levels for the bone marrow and to evaluate response rates and duration of effect. 6 refs., 4 figs., 4 tabs

  6. Scintigraphic index in anomalies of osseous consolidation; Indice cintilografico nas anomalias de consolidacao

    Energy Technology Data Exchange (ETDEWEB)

    Barros, J.W. de; Marinho, E.O. [Faculdade de Medicina do Triangulo Mineiro, Uberaba, MG (Brazil); Barbieri, C.H. [Sao Paulo Univ., Ribeirao Preto, SP (Brazil). Faculdade de Medicina

    1995-01-01

    Twenty-two dogs radio healing after experimental osteotomy were submitted to scintiscan evaluation. The methylene-diphosphonate-technetium (MDP{sup -99m} Tc) scintiscan was done at 3 and 6 months for dogs three-month bone healing, three-month delayed healing and six-month healing and three-month delayed healing and six-month hypertrophic nonunion. The activity index was found dividing the mean osteotomy site counts by the mean contralateral intact bone counts. The activity index was directly proportional to osteogenesis during the several bone-healing steps and its abnormalities. A good correlation was also noted between the experimental bone defect size and the healing process. The Kruskal-Wallis test was done for the statistical analysis. The activity index gradually increased from normal healing to delayed healing, to hypertrophic non-union. (author). 10 refs, 2 figs, 3 tabs.

  7. Anterolateral ligament abnormalities are associated with peripheral ligament and osseous injuries in acute ruptures of the anterior cruciate ligament.

    Science.gov (United States)

    Helito, Camilo Partezani; Helito, Paulo Victor Partezani; Leão, Renata Vidal; Demange, Marco Kawamura; Bordalo-Rodrigues, Marcelo

    2017-04-01

    Few studies have used MRI to identify the ALL. As it was shown that it is not possible to precisely characterize this ligament in all examination, it is important to identify concomitant lesions that can help in diagnosing ALL abnormalities. It is important to characterise this injury due to its association with anterolateral knee instability. Thus, the present study was performed to determine the frequency of ALL injuries in patients with acute ACL rupture and to analyse its associated knee lesions. Patients with acute ACL injuries were evaluated by MRI. Among this population, the ALL was classified as non-visualised, injured or normal. The possible abnormalities of the meniscus, collateral ligaments, popliteus tendon, posterior cruciate ligament, Iliotibial band (ITB), anterolateral capsule and osseus injuries were evaluated. The association of an ALL injury with these other knee structures as well as sex and age was calculated. Among the 228 knees evaluated, the ALL could not be entirely identified in 61 (26.7%). Of the remaining 167, 66 (39.5%) presented an ALL abnormality and only four (6.1%) were Segond fractures. ALL abnormalities were associated with lesions of the lateral collateral ligament, medial collateral ligament, popliteus tendon, ITB, anterolateral capsule and osseous contusions of the femoral condyle and tibial plateau. No correlation was found with medial meniscus, lateral meniscus and posterior cruciate ligament injuries. There was no association between ALL injuries and gender, and older patients were more likely to present an ALL injury. ALL injuries are present in approximately 40% of ACL injuries, and a minority of these are Segond fractures. These injuries are associated with peripheral ligament injuries, anterolateral structures lesions and bone contusions, but there is no association with meniscal injuries. Surgeons must be aware of these associations to consider an ALL lesion even if it is not completely clear in imaging evaluation

  8. Contribution of osseous and muscular stabilizing effects with the Latarjet procedure for anterior instability without glenoid bone loss.

    Science.gov (United States)

    Dines, Joshua S; Dodson, Christopher C; McGarry, Michelle H; Oh, Joo Han; Altchek, David W; Lee, Thay Q

    2013-12-01

    The Latarjet procedure is used to treat anterior shoulder instability. Authors contend that the main concept of the operation is using the conjoined tendon as a sling to lower the subscapularis, reinforcing the anteroinferior capsule. The effects of the "sling," as well as stability and range of motion (ROM), after the Latarjet procedure have not been documented. In this study, we test the Latarjet procedure, attempting to account for the effect of the conjoined tendon. We also use the model to characterize the kinematic effects and stabilizing mechanism of the Latarjet procedure. Six cadaveric shoulders were tested in the intact state, after anterior capsulotomy, and after the Latarjet procedure. An apparatus was designed that allowed for loading of the conjoined tendon. ROM and translation were quantified. After conclusion of testing in the Latarjet group, the conjoined tendon was released and specimens were retested to determine stability attributable to the sling effect versus the osseous effect alone. We found no statistically significant differences with regard to ROM after the Latarjet procedure. The Latarjet procedure did significantly decrease anteroinferior translation. However, when the conjoined tendon was unloaded, there was a significantly decreased resistance to anterior translation. After conjoined tendon release, there was no effect on inferior translation. This study confirmed that the Latarjet procedure successfully decreases anteroinferior translation while maintaining ROM. It did not support the belief that inferior stability is provided by the sling effect. The model developed can serve as the basis for future testing. basic science study, biomechanics. Copyright © 2013 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  9. Treatment of oligodontia with endo-osseous fixtures: experience in eight consecutive patients at the end of dental growth.

    Science.gov (United States)

    Becelli, Roberto; Morello, Roberto; Renzi, Giancarlo; Dominici, Chiara

    2007-11-01

    Clinical manifestations of oligodontia consist in agenesia of multiple teeth eventually with deciduous retained teeth, atrophy of alveolar ridge, aberrations of teeth dimension, and shape, with consequent aesthetic and functional defects. The first choice treatment is based on a team collaboration of maxillo-facial surgeon, orthodontist, and prosthodontist, and is conditioned by various clinical parameters as number and site of lacking teeth, age and dental development of patients, eventual alveolar ridge atrophy. Treatment planning should be individualized for each patient. In our experience, based on 8 consecutive patients at the end of dental growth affected by oligodontia, endo-osseous fixtures positioning was carried out in consideration of long-lasting stability and optimal aesthetical characteristics. In 5 patients rehabilitative preprosthetic surgical procedures were performed, consisting in 2 sinus lift with immediate positioning of 3 fixtures in both cases, 4 heterologous bone graft in postextractive sites with retained ankylotic deciduous teeth and 1 positioning of reabsorbable biomembrane. A temporary removable denture was positioned immediately after surgery in order to obtain a prompt aesthetical and psychosocial restore. Osseointegration ratio as observed at 8.5 years follow-up was analyzed according to surgical variables and differences in prosthetic rehabilitation (fixtures supporting single crown versus multiple crowns). Successful osteointegration was observed at 8.5 years mean follow-up in 58 fixtures, corresponding to a 96.6% ratio. Failure of integration was encountered in fixtures immediately positioned in postextractive sites having a mild grade of bone atrophy, supporting single crown. A rate of success of 100% was observed in cases of immediate or delayed positioning in postextractive or traditional sites.Fixtures positioning in patients affected by isolated oligodontia, without malformative syndromes, and at the end of dental development

  10. Computer-based planning of optimal donor sites for autologous osseous grafts

    Science.gov (United States)

    Krol, Zdzislaw; Chlebiej, Michal; Zerfass, Peter; Zeilhofer, Hans-Florian U.; Sader, Robert; Mikolajczak, Pawel; Keeve, Erwin

    2002-05-01

    Bone graft surgery is often necessary for reconstruction of craniofacial defects after trauma, tumor, infection or congenital malformation. In this operative technique the removed or missing bone segment is filled with a bone graft. The mainstay of the craniofacial reconstruction rests with the replacement of the defected bone by autogeneous bone grafts. To achieve sufficient incorporation of the autograft into the host bone, precise planning and simulation of the surgical intervention is required. The major problem is to determine as accurately as possible the donor site where the graft should be dissected from and to define the shape of the desired transplant. A computer-aided method for semi-automatic selection of optimal donor sites for autografts in craniofacial reconstructive surgery has been developed. The non-automatic step of graft design and constraint setting is followed by a fully automatic procedure to find the best fitting position. In extension to preceding work, a new optimization approach based on the Levenberg-Marquardt method has been implemented and embedded into our computer-based surgical planning system. This new technique enables, once the pre-processing step has been performed, selection of the optimal donor site in time less than one minute. The method has been applied during surgery planning step in more than 20 cases. The postoperative observations have shown that functional results, such as speech and chewing ability as well as restoration of bony continuity were clearly better compared to conventionally planned operations. Moreover, in most cases the duration of the surgical interventions has been distinctly reduced.

  11. Magnetic resonance-guided focused ultrasound surgery for treatment of painful osseous metastases

    Science.gov (United States)

    Hurwitz, Mark; Machtinger, Ronit; Fennessy, Fiona

    2011-03-01

    Magnetic resonance guided focused ultrasound surgery (MRgFUS) is an emerging technology that can non-invasively heat and ablate targeted tissue utilizing ultrasound energy. Use of MR imaging for treatment guidance provides several key advantages over more widely used ultrasound guidance for focused ultrasound ablation. MR allows for precise targeting, detailed beam path visualization, real time non-invasive temperature measurement, and treatment feedback to ensure therapeutic goals are achieved. In the realm of oncology, management of painful bone metastases is a common and daunting clinical problem. The Insightec ExAblate System has been shown in phase I/II trials for treatment of bone metastases to have an excellent safety profile and high rates of pain response. An international multi-center phase III trial for patients with painful bone metastases or multiple myeloma who are not candidates for radiation therapy is currently open. Patients are randomized 3:1 to MRgFUS or sham treatment with crossover to study treatment allowed for sham failures. The primary study endpoint is assessment of pain control over 3 months following treatment. In addition safety, quality of life, cost effectiveness analysis, and patient perceived clinical benefit are also being assessed. Details of the MRgFUS system, technical and clinical therapeutic parameters, use of real time non-invasive MR thermometry, and examples of patient treatments with use of MRgFUS to treat bone metastases will be discussed. New directions in use of MRgFUS including an update on development of a new mobile applicator and integration of MRgFUS in multimodality oncologic care will also be presented.

  12. [Diagnostic value of MRI versus 99Tcm-MDP bone scan in osseous metastasis of prostate cancer: a meta-analysis].

    Science.gov (United States)

    Shen, Guohua; Zhou, Luyi; Jia, Zhiyun; Zhang, Wenjie; Wang, Qiao; Deng, Houfu

    2014-08-01

    This paper is aimed to assess the diagnostic value of MRI versus 99 Tcm-methylene diphosphonate (99 Tcm- MDP) bone scan (BS) for osseous metastases in patients with prostate cancer. The computer-based retrieval was conducted on PubMed, EMBASE, EBSCO, Web of Knowledge, the Cochrane Library and Ovid data bases to search for trials about diagnosing osseous metastases of prostate cancer with MRI and 99Tc"m-MDP BS. Selected with time acceptance and time exclusion criteria, the data quality were evaluated with QUADAS quality assessment tool and collected. We used the Meta-Disc software to conduct meta-analysis, and then calculated the pooled sensitivity, specificity and diagnostic odds ratio (DOR), drew the summary receiving operating characteristic (SROC) curve, and measured the area under curve (AUC) and Q value. Then five studies were included, involving 353 patients. The pooled sensitivity of MRI and BS was 0. 95 (95% CI 0. 90~0. 98) and 0. 67 (95% CI 0. 58~0. 75), respectively. The pooled specificity was 0. 97 (95% CI 0. 94~0. 99) and 0. 88 (95% CI 0. 83~0. 91), respectively. The pooled DOR was 402.99 (95% CI 119. 05 ~1364. 15) and 23. 85 (95% CI 1. 32~431. 48), respectively. The AUC was 0. 990 1 and 0. 624 1, respectively. The Q was 0. 958 7 and 0. 593 8. It can well be concluded that MRI is more effective than 99 Tcm-MDP BS in the diagnosis of osseous metastases in patients with prostate cancer.

  13. FDG PET/CT Findings of Nodular Sclerosis-Subtype Classic Hodgkin Lymphoma Presented as Mediastinal Nodal Lesions at Onset But as Predominant Osseous Disease at Relapse.

    Science.gov (United States)

    Zheng, Kun; Zhuang, Hongming

    2017-06-01

    Nodular sclerosis-subtype classic Hodgkin lymphoma in general manifests as bulky mediastinal lymphadenopathy but very rarely involves bones. We report FDG PET/CT findings of a 19-year-old man with pathology-proven, nodular sclerosis-type classic Hodgkin lymphoma. His initial FDG PET/CT scan at the diagnosis showed only hypermetabolic lymphadenopathy in the mediastinum. However, the FDG PET/CT acquired when the disease recurred 20 months later showed predominant osseous disease without additional nodal lesions outside the mediastinum.

  14. Osseous vitality in single photon emission computed tomography/computed tomography (SPECT/CT) after balloon tibioplasty of the tibial plateau: a case series.

    Science.gov (United States)

    Jentzsch, Thorsten; Fritz, Yannick; Veit-Haibach, Patrick; Schmitt, Jürgen; Sprengel, Kai; Werner, Clément M L

    2015-11-17

    The minimally invasive, balloon-assisted reduction and cement-augmented internal fixation of the tibial plateau is an innovative surgical procedure for tibial plateau fractures. The close proximity of balloons and cement to the knee joint poses a potential risk for osteonecrosis; especially in the case of thin bone lamellae. However, there are no studies about the vitality of the cement-surrounding tissue after these tibioplasties. Therefore, our goal was to assess the osseous vitality after cement-augmented balloon tibioplasty using single photon emission computed tomography/computed tomography (SPECT/CT) in a series of patients. This case series evaluated available consecutive patients, whose tibial plateau fractures were treated with balloon-assisted, cement-augmented tibioplasty and received a SPECT/CT. Primary outcome variables were osseous vitality on SPECT/CTs according to the semiquantitative tracer activity analysis. The mean uptake of eight tibial regions of interest was referenced to the mean uptake count on the same region of the contralateral leg to obtain a count ratio. Osteonecrosis was defined as a photopenic area or cold defect. Secondary variables included clinical and radiological follow-up data. Statistics were carried out in a descriptive pattern. Ten patients with a mean age of 59 years and a mean follow up of 18 months were included. Calcium phosphate (CaP) substitute bone cement was used in 60% and polymethyl methacrylate mixed with hydroxyapatite (PMMA/HA) bone cement in 40%. Normal to high SPECT/CT activity without photopenic areas were observed in all patients and the mean tracer activity ratio was four, indicating vital bone in all patients. There were no postoperative infections and only one 57 year old patient with hemineglect and CaP cement showed failed osseous consolidation. The mean Tegner and Lysholm as well as the Lysholm scores were three and 80, respectively. This novel study about cement-augmented balloon tibioplasties showed

  15. β -carotene effect the induction of the sister chromatid exchanges (ICH) by gamma radiation in mouse radiosensibilized osseous marrow cells In vivo

    International Nuclear Information System (INIS)

    Morales R, P.; Cruz V, V.L.

    1997-01-01

    The effect of β- carotene over the ICH radioinduction in radiosensibilized with BrdU osseous marrow cells of mouse was determined In vivo. The treatment with 50 μg β carotene per se induces a significant increment in the ICH frequency and the pre or post-treatment with the same dose causes an additive effect in the ICH frequency produced by 0.62 Gy of gamma radiation. This implies that β- carotene does not have radioprotective activity, under conditions which was developed this experiment. (Author)

  16. Multicentre randomised controlled trial to investigate the usefulness of continuous pneumatic regulation of tracheal cuff pressure for reducing ventilator-associated pneumonia in mechanically ventilated severe trauma patients: the AGATE study protocol.

    Science.gov (United States)

    Marjanovic, Nicolas; Frasca, Denis; Asehnoune, Karim; Paugam, Catherine; Lasocki, Sigismond; Ichai, Carole; Lefrant, Jean-Yves; Leone, Marc; Dahyot-Fizelier, Claire; Pottecher, Julien; Falcon, Dominique; Veber, Benoit; Constantin, Jean-Michel; Seguin, Sabrina; Guénézan, Jérémy; Mimoz, Olivier

    2017-08-07

    Severe trauma represents the leading cause of mortality worldwide. While 80% of deaths occur within the first 24 hours after trauma, 20% occur later and are mainly due to healthcare-associated infections, including ventilator-associated pneumonia (VAP). Preventing underinflation of the tracheal cuff is recommended to reduce microaspiration, which plays a major role in the pathogenesis of VAP. Automatic devices facilitate the regulation of tracheal cuff pressure, and their implementation has the potential to reduce VAP. The objective of this work is to determine whether continuous regulation of tracheal cuff pressure using a pneumatic device reduces the incidence of VAP compared with intermittent control in severe trauma patients. This multicentre randomised controlled and open-label trial will include patients suffering from severe trauma who are admitted within the first 24 hours, who require invasive mechanical ventilation to longer than 48 hours. Their tracheal cuff pressure will be monitored either once every 8 hours (control group) or continuously using a pneumatic device (intervention group). The primary end point is the proportion of patients that develop VAP in the intensive care unit (ICU) at day 28. The secondary end points include the proportion of patients that develop VAP in the ICU, early (≤7 days) or late (>7 days) VAP, time until the first VAP diagnosis, the number of ventilator-free days and antibiotic-free days, the length of stay in the ICU, the proportion of patients with ventilator-associated events and that die during their ICU stay. This protocol has been approved by the ethics committee of Poitiers University Hospital, and will be carried out according to the principles of the Declaration of Helsinki and the Good Clinical Practice guidelines. The results of this study will be disseminated through presentation at scientific conferences and publication in peer-reviewed journals. Clinical Trials NCT02534974. © Article author(s) (or

  17. Estudio multicéntrico prospectivo con implantes MG-OSSEOUS a los 2 años de seguimiento Multicentric prospective study of MG-OSSEOUS implants at 2 year follow-up

    Directory of Open Access Journals (Sweden)

    E. Serrano

    2009-10-01

    Full Text Available Introducción. La implantología es uno de los procedimientos terapéuticos más realizados en nuestros días. El objetivo del presente estudio es presentar los resultados de los los implantes MG-OSSEOUS (Mozo-Grau, S.L., Valladolid, España a los 2 años de seguimiento. Material y método. La empresa Scientific Management in O&SS (Barcelona, España, diseñó unos cuestionarios exhaustivos que rellenaron, por cada caso, cada uno de los profesionales del estudio. La compilación y el tratamiento estadístico de los datos obtenidos fue extremadamente pormenorizada. Se aplicaron estudios de subpoblaciones desde la población N de implantes totales colocados y, mediante la aplicación de ANOVA, se valoraron parámetros concretos en dichas subpoblaciones para determinar y concluir la influencia de los mismos sobre el fracaso de los implantes. Resultados. Se colocaron 1475 implantes en 480 pacientes entre Junio de 2005 y Mayo de 2006, con una supervivencia del 98,2% con un seguimiento de 2 años de promedio con las prótesis cargadas. Se detallan los implantes por posiciones, diámetros y longitudes y se analizan los resultados en las subpoblaciones de implantes postexodoncia, implantes de carga inmediata e implantes asociados a injertos. Discusión. Se focaliza, realizando un amplio repaso de la bibliografía actual, en el alto fracaso obtenido en nuestro estudio de los implantes de diámetro ancho (4,25 mm postexodoncia y en la versatilidad del empleo de los implantes de diámetro estrecho (3,4 mm en cualquier posición oral para cualquier tipo de carga. Conclusiones. Este estudio es la completa antítesis de la filosofía, en el que se interpreta de una sola manera, científica y reproducible, una serie de resultados en el campo de la implantología oral, nuestra realidad. Seguiremos este estudio para alargar el tiempo observacional, como mínimo, a 5 años.Introduction. Implantology is the most common therapeutic procedure nowadays. Professor P

  18. Sever's Disease

    Science.gov (United States)

    ... into mature bone. Sever's disease is similar to Osgood-Schlatter disease, a condition that affects the bones in ... Bones, Muscles, and Joints Common Childhood Orthopedic Conditions Osgood-Schlatter Disease Problems With Legs and Feet Cool Cast ...

  19. A modified device for intraoral radiography to assess the distal osseous defects of mandibular second molar after impacted third molar surgery

    Energy Technology Data Exchange (ETDEWEB)

    Ana, Faria Inocencio; Mercedes, Gallas Torreira [Faculty of Medicine and Dentistry, Santiago de Compostela University, Santiago (Spain)

    2011-09-15

    This article is to describe a modified device for intraoral radiography which was developed to obtain reproducible radiographic images for assessment of distal osseous defects of the mandibular second molar (2 Mm) after impacted third molar (3 Mm) surgery. A commercial available alignment system for posterior region was modified by adding a reference gauge pin (millimetric) and threading a hollow acrylic cylinder at the ring of the radiographic positioner to attach the X-ray collimator. The design included customized resin acrylic stent for the occlusal surface of the 2Mm in maximum intercuspal position, individualizing the biteblock positioner. Periapical radiographs were taken before and after surgical extraction of 3 Mm, employing the radiographic technique of parallelism described by Kugelberg (1986) with this modified film holder and inserting the gauge pin on the deepest bone probing depth point. This technique permitted to obtain standardized periapical radiographs with a moderate to high resolution, repeatability, and accuracy. There was no difference between the measurements on the pre- and post-operative radiographs. This technique allowed better maintenance of the same geometric position compared with conventional one. The insertion of the gauge pin provided the same reference point and localized the deepest osseous defect on the two-dimensional radiographs. This technique allowed better reproducibility in posterior radiographic records (distal surface of 2 Mm) and more accurate measurements of radiographic bone level by the use of a millimetric pin.

  20. A modified device for intraoral radiography to assess the distal osseous defects of mandibular second molar after impacted third molar surgery

    International Nuclear Information System (INIS)

    Ana, Faria Inocencio; Mercedes, Gallas Torreira

    2011-01-01

    This article is to describe a modified device for intraoral radiography which was developed to obtain reproducible radiographic images for assessment of distal osseous defects of the mandibular second molar (2 Mm) after impacted third molar (3 Mm) surgery. A commercial available alignment system for posterior region was modified by adding a reference gauge pin (millimetric) and threading a hollow acrylic cylinder at the ring of the radiographic positioner to attach the X-ray collimator. The design included customized resin acrylic stent for the occlusal surface of the 2Mm in maximum intercuspal position, individualizing the biteblock positioner. Periapical radiographs were taken before and after surgical extraction of 3 Mm, employing the radiographic technique of parallelism described by Kugelberg (1986) with this modified film holder and inserting the gauge pin on the deepest bone probing depth point. This technique permitted to obtain standardized periapical radiographs with a moderate to high resolution, repeatability, and accuracy. There was no difference between the measurements on the pre- and post-operative radiographs. This technique allowed better maintenance of the same geometric position compared with conventional one. The insertion of the gauge pin provided the same reference point and localized the deepest osseous defect on the two-dimensional radiographs. This technique allowed better reproducibility in posterior radiographic records (distal surface of 2 Mm) and more accurate measurements of radiographic bone level by the use of a millimetric pin.

  1. Temporomandibular joint reconstruction with a 2-part chrome-cobalt prosthesis, chondro-osseous graft, and silastic: clinical and experimental studies.

    Science.gov (United States)

    Kummoona, Raja

    2009-11-01

    Seventy-six patients including 27 females and 49 males, with ages ranging between 4 and 35 years (mean, 19.5 y), all experienced loss of weight, stiff temporomandibular joints and inability to chew food, and facial deformities. These patients were treated in the Maxillofacial Unit, Surgical Specialties Hospital, Medical City, Baghdad, Iraq, using 4 different techniques according to the requirement of each case and the facilities available. These patients were divided into 4 groups: the first group consists of 16 children (21.06%) treated with a chondro-osseous graft; the second group, 10 children (13.16%) treated with a 2-part chrome-cobalt prosthesis; the third group, 32 children (42.11%) treated with a Sialastic rubber silicone implant (Koken Co, Tokyo, Japan); and the fourth group, 18 children (23.69%) treated with interposition arthroplasty with a temporalis muscle flap. The follow-up period of the cases ranged between 3 and 15 years. Experimental studies were done on using rabbits to assess the viability of the chondro-osseous graft and on monkeys to demonstrate the biological acceptability of the 2-part chrome-cobalt prosthesis. The aim of this clinical and experimental study was to show our experience in managing difficult tasks that craniofacial or maxillofacial surgeons may face and to share these experiences with other colleagues all over the world.

  2. Severity investigation

    NARCIS (Netherlands)

    Rooij, M.R. de; Godart, B.

    2013-01-01

    From the confirmation inspection and its subsequent test results the presence of AAR has either been confirmed or eliminated. Assuming the first outcome, the next step is to investigate the severity of the situation, see Figure 23. One should keep in mind that it is possible that some evidence of

  3. A comparative clinico-radiographic study of guided tissue regeneration with bioresorbable membrane and a composite synthetic bone graft for the treatment of periodontal osseous defects

    Directory of Open Access Journals (Sweden)

    Sumedha Srivastava

    2015-01-01

    Full Text Available Aim: The aim was to evaluate the bonefill in periodontal osseous defects with the help of guided tissue regeneration, bioresorbable membrane (PerioCol + bone graft (Grabio Glascera in combination and with bonegraft (Grabio Glascera alone. Materials and Methods: The study involved total 30 sites in systemically healthy 19 patients. The parameters for evaluation includes plaque index sulcus bleeding index with one or more periodontal osseous defects having (i probing depth (PD of ≥ 5 mm (ii clinical attachment loss (CAL of ≥ 5 mm and (iii ≥3 mm of radiographic periodontal osseous defect (iv bonefill (v crestal bone loss (vi defect resolution. The study involved the three wall and two wall defects which should be either located interproximally or involving the furcation area. The statistical analysis was done using Statistical Package for Social Sciences, the Wilcoxon signed rank statistic W + for Mann-Whitney U-test. Results: The net gain in PD and CAL after 6 months for Group I ([PerioCol] + [Grabio Glascera] and Group II (Grabio Glascera was 3.94 ± 1.81 mm, 3.57 ± 2.21 mm and 3.94 ± 1.81, 3.57 ± 2.21 mm, respectively. The results of the study for Group I and Group II with regards to mean net bonefill, was 3.25 ± 2.32 (58% mm and 5.14 ± 3.84 (40.26 ± 19.14% mm, crestal bone loss − 0.25 ± 0.68 mm and − 0.79 ± 1.19 mm. Defect resolution 3.50 ± 2.34 mm and 5.93 ± 4.01 mm, respectively. Conclusion: On comparing both the groups together after 6 months of therapy, the results were equally effective for combination of graft and membrane versus bone graft alone since no statistical significant difference was seen between above parameters for both the groups. Thus, both the treatment modalities are comparable and equally effective.

  4. Point-of-care C-reactive protein testing to reduce inappropriate use of antibiotics for non-severe acute respiratory infections in Vietnamese primary health care: a randomised controlled trial.

    Science.gov (United States)

    Do, Nga T T; Ta, Ngan T D; Tran, Ninh T H; Than, Hung M; Vu, Bich T N; Hoang, Long B; van Doorn, H Rogier; Vu, Dung T V; Cals, Jochen W L; Chandna, Arjun; Lubell, Yoel; Nadjm, Behzad; Thwaites, Guy; Wolbers, Marcel; Nguyen, Kinh V; Wertheim, Heiman F L

    2016-09-01

    Inappropriate antibiotic use for acute respiratory tract infections is common in primary health care, but distinguishing serious from self-limiting infections is difficult, particularly in low-resource settings. We assessed whether C-reactive protein point-of-care testing can safely reduce antibiotic use in patients with non-severe acute respiratory tract infections in Vietnam. We did a multicentre open-label randomised controlled trial in ten primary health-care centres in northern Vietnam. Patients aged 1-65 years with at least one focal and one systemic symptom of acute respiratory tract infection were assigned 1:1 to receive either C-reactive protein point-of-care testing or routine care, following which antibiotic prescribing decisions were made. Patients with severe acute respiratory tract infection were excluded. Enrolled patients were reassessed on day 3, 4, or 5, and on day 14 a structured telephone interview was done blind to the intervention. Randomised assignments were concealed from prescribers and patients but not masked as the test result was used to assist treatment decisions. The primary outcome was antibiotic use within 14 days of follow-up. All analyses were prespecified in the protocol and the statistical analysis plan. All analyses were done on the intention-to-treat population and the analysis of the primary endpoint was repeated in the per-protocol population. This trial is registered under number NCT01918579. Between March 17, 2014, and July 3, 2015, 2037 patients (1028 children and 1009 adults) were enrolled and randomised. One adult patient withdrew immediately after randomisation. 1017 patients were assigned to receive C-reactive protein point-of-care testing, and 1019 patients were assigned to receive routine care. 115 patients in the C-reactive protein point-of-care group and 72 patients in the routine care group were excluded in the intention-to-treat analysis due to missing primary endpoint. The number of patients who used antibiotics

  5. Improving mood with psychoanalytic and cognitive therapies (IMPACT: a pragmatic effectiveness superiority trial to investigate whether specialised psychological treatment reduces the risk for relapse in adolescents with moderate to severe unipolar depression: study protocol for a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Suckling John

    2011-07-01

    Full Text Available Abstract Background Up to 70% of adolescents with moderate to severe unipolar major depression respond to psychological treatment plus Fluoxetine (20-50 mg with symptom reduction and improved social function reported by 24 weeks after beginning treatment. Around 20% of non responders appear treatment resistant and 30% of responders relapse within 2 years. The specific efficacy of different psychological therapies and the moderators and mediators that influence risk for relapse are unclear. The cost-effectiveness and safety of psychological treatments remain poorly evaluated. Methods/Design Improving Mood with Psychoanalytic and Cognitive Therapies, the IMPACT Study, will determine whether Cognitive Behavioural Therapy or Short Term Psychoanalytic Therapy is superior in reducing relapse compared with Specialist Clinical Care. The study is a multicentre pragmatic effectiveness superiority randomised clinical trial: Cognitive Behavioural Therapy consists of 20 sessions over 30 weeks, Short Term Psychoanalytic Psychotherapy 30 sessions over 30 weeks and Specialist Clinical Care 12 sessions over 20 weeks. We will recruit 540 patients with 180 randomised to each arm. Patients will be reassessed at 6, 12, 36, 52 and 86 weeks. Methodological aspects of the study are systematic recruitment, explicit inclusion criteria, reliability checks of assessments with control for rater shift, research assessors independent of treatment team and blind to randomization, analysis by intention to treat, data management using remote data entry, measures of quality assurance, advanced statistical analysis, manualised treatment protocols, checks of adherence and competence of therapists and assessment of cost-effectiveness. We will also determine whether time to recovery and/or relapse are moderated by variations in brain structure and function and selected genetic and hormone biomarkers taken at entry. Discussion The objective of this clinical trial is to determine

  6. Effectiveness and cost-effectiveness of a minimal psychological intervention to reduce non-severe depression in chronically ill elderly patients: the design of a randomised controlled trial [ISRCTN92331982

    Directory of Open Access Journals (Sweden)

    Diederiks JPM

    2006-06-01

    Full Text Available Abstract Background Depression is a prevalent disorder in chronically ill elderly persons. It may decrease quality of life, and increase functional disability, medical costs, and healthcare utilisation. Because patients may slip into a downward spiral, early recognition and treatment of depression is important. Depression can be treated with antidepressants or psychological interventions; the latter can also be applied by trained paraprofessionals. In this paper, we describe the design of the DELTA study (Depression in Elderly with Long-Term Afflictions. The first objective of the DELTA study is to evaluate the effectiveness and cost-effectiveness of a minimal psychological intervention (MPI to reduce depression in chronically ill elderly patients. The second objective is to evaluate whether a potential effect of the MPI may differ between types of chronic illnesses. The tailor-made intervention is administered by nurses, who are trained in the principles of cognitive behavioural therapy and self-management. Methods/Design DELTA is a two-armed randomised controlled trial, comparing MPI to usual care. A total number of 180 patients with diabetes mellitus type II (DM and 180 patients with chronic obstructive pulmonary disease (COPD, who in addition suffer from non-severe depression, will be included in the study. In our study, non-severe depression is defined as having minor depression, mild major depression or moderate major depression. The primary outcome measure is depression using the Beck Depression Inventory. Secondary outcome measures include quality of life, daily functioning, self-efficacy, autonomy, and participation. In the economic evaluation, cost-effectiveness and cost-utility ratios will be calculated. Furthermore, a process evaluation will be carried out. Analyses will include both univariate and multivariate techniques and according to the intention to treat principle. The economic evaluation will be done from a societal

  7. Periodontal regenerative management of residual tunnel osseous defect results from the enucleation of lateral periodontal cyst in anterior maxilla: A rare case report

    Directory of Open Access Journals (Sweden)

    Sanjeev Kumar Salaria

    2016-01-01

    Full Text Available The lateral periodontal cyst (LPC is a nonkeratinized, noninflammatory developmental cyst occurring adjacent or lateral to tooth root. It is a relatively uncommon lesion found in the maxillary incisors and found mostly in adults during 5th to 7th decades. In this case, 45-year-old male patient reported with occasional mild discomfort between left maxillary central and lateral incisor region since 1 year. Interproximally, a well-defined round radiolucent area with corticated borders was determined radiographically between vital tooth #21 and #22. Preliminary diagnosis of LPC was established based on clinical and radiographical findings. Following enucleation of the lesion, an anticipated residual tunnel osseous defect was observed, which was managed successfully utilizing bone graft and guided tissue regeneration-assisted technique. Cystic tissue removed was examined histologically; hematoxylin- and eosin-stained sections showed features suggestive of LPC. Complete healing of tunnel defect was achieved at 1 year follow-up.

  8. Periodontal regenerative management of residual tunnel osseous defect results from the enucleation of lateral periodontal cyst in anterior maxilla: A rare case report.

    Science.gov (United States)

    Salaria, Sanjeev Kumar; Gulati, Minkle; Ahuja, Samir; Goyal, Sandeep

    2016-01-01

    The lateral periodontal cyst (LPC) is a nonkeratinized, noninflammatory developmental cyst occurring adjacent or lateral to tooth root. It is a relatively uncommon lesion found in the maxillary incisors and found mostly in adults during 5 th to 7 th decades. In this case, 45-year-old male patient reported with occasional mild discomfort between left maxillary central and lateral incisor region since 1 year. Interproximally, a well-defined round radiolucent area with corticated borders was determined radiographically between vital tooth #21 and #22. Preliminary diagnosis of LPC was established based on clinical and radiographical findings. Following enucleation of the lesion, an anticipated residual tunnel osseous defect was observed, which was managed successfully utilizing bone graft and guided tissue regeneration-assisted technique. Cystic tissue removed was examined histologically; hematoxylin- and eosin-stained sections showed features suggestive of LPC. Complete healing of tunnel defect was achieved at 1 year follow-up.

  9. Multielemental analysis of osseous remains by x-ray fluorescence to determine types of diets from the Cultura Lima (II B.C. - VIII A.C)

    International Nuclear Information System (INIS)

    Montalvo B, A.

    1997-01-01

    The multielemental analysis of 29 human bone samples and sediments from the Lima Culture (III c. BC to IX c. AC) were analyzed by x-ray fluorescence technique with Cd-109 excitation source Si(Li) detector, Canberra associated electronic and PCA-II nucleus multichannel card, in order to determine to determine the diet type of these antique inhabitant. The elements found in bone rests were Ca, Sr, Zn, Mn, Fe, Ni, Cu, Rb, Zn and Pb, and As in one of the clavicles. In sediment samples we obtained a major quantity of elements. According to the Sr an Zn obtained values in osseous rest and the developed regression model, we can conclude that the ancient inhabitants of Lima Culture had an omnivorous feeding with a carnivore tendency due to its geographic location. (author). 35 refs., 9 figs., 10 tabs., 6 ills

  10. Osteocartilaginous transfer of the proximal part of the fibula for osseous overgrowth in children with congenital or acquired tibial amputation: surgical technique and results.

    Science.gov (United States)

    Fedorak, Graham T; Watts, Hugh G; Cuomo, Anna V; Ballesteros, Julian P; Grant, Heather J; Bowen, Richard E; Scaduto, Anthony A

    2015-04-01

    Osseous overgrowth is a common problem in children after tibial transcortical amputation. We present the results of forty-seven children (fifty tibiae) treated for tibial osseous overgrowth with an autologous osteocartilaginous cap from the proximal part of the ipsilateral fibula. We reviewed the records of all patients who underwent amputation at a single pediatric hospital from 1990 to 2011. All patients who had been followed for a minimum of two years after undergoing osteocartilaginous capping with the proximal part of the ipsilateral fibula to treat established tibial overgrowth were included. Patients with acquired and congenital amputations were compared. Fifty tibiae in forty-seven patients met our inclusion criteria. There were thirty-one acquired and nineteen congenital amputations. The mean age at surgery was 7.6 years (range, 2.1 to 15.6 years), and the mean duration of follow-up was 7.2 years (range, 2.2 to 15.4 years). Five tibiae (10%) in four patients had recurrence of the overgrowth at a mean of 5.4 years (range, 2.8 to 7.6 years) after the osteocartilaginous transfer. There was no significant difference in the results between children with an acquired amputation and those with a congenital amputation. At a mean of 7.2 years after autologous osteocartilaginous capping with the proximal part of the fibula, 90% of the limbs had not had recurrent overgrowth. This is a safe and effective treatment of long-bone overgrowth following either congenital or acquired amputation in children. Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.

  11. Predictive implications of bone turnover markers after palliative treatment with 186Re-HEDP in hormone-refractory prostate cancer patients with painful osseous metastases

    International Nuclear Information System (INIS)

    Zafeirakis, Athanasios; Papatheodorou, Georgios; Arhontakis, Athanasios; Gouliamos, Athanasios; Vlahos, Lambros; Limouris, Georgios S.

    2010-01-01

    To prospectively evaluate the predictive value of various bone formation and resorption markers in patients with bone metastases from prostate cancer after palliative treatment with 186 Re-1,1-hydroxyethylidene diphosphonate ( 186 Re-HEDP). Included in the study were 36 men with prostate cancer, suffering from painful osseous metastases and treated with 186 Re-HEDP. None had received any treatment that would have interfered with bone metabolism before 186 Re-HEDP treatment or throughout the follow-up period. For each patient, pretreatment and posttreatment serum levels of osteocalcin (OC), bone alkaline phosphatase (BALP), aminoterminal (PINP) and carboxyterminal (PICP) propeptides of type I collagen, amino-terminal (NTx) and carboxyterminal (CTx) telopeptides of type I collagen and their combinations were compared with the level and duration of pain response to radionuclide treatment. Pain response was correlated only with pretreatment ΝΤx/PINP, PICP/PINP and NTx/CTx ratios and posttreatment decrease in baseline NTx and PICP values (p=0.0025-0.035). According to multivariate and ROC analyses, the best marker-derived predictors of better and longer duration of response to 186 Re-HEDP treatment were a posttreatment decrease in NTx of ≥20% (RR=3.44, p=0.0005) and a pretreatment NTx/PINP ratio of ≥1.2 (RR=3.04, p=0.036) NTx, a potent collagenous marker of bone resorption, along with the novel NTx/PINP ratio provide useful cut-off values for identifying a group of patients suffering from painful osseous metastases from hormone-refractory prostatic carcinoma who do not respond to palliative treatment with 186 Re-HEDP. This information could help avoid an inefficient and expensive radionuclide treatment. Also, in the cohort of patients who will eventually undergo such treatment, the medium-term posttreatment changes in NTx offer valuable predictive information regarding long-term palliative response. (orig.)

  12. Vertebral artery variations and osseous anomaly at the C1-2 level diagnosed by 3D CT angiography in normal subjects

    Energy Technology Data Exchange (ETDEWEB)

    Wakao, Norimitsu; Kamiya, Mitsuhiro [Aichi Medical University, Department of Spine Center, Aichi (Japan); Aichi Medical University, Department of Orthopedic Surgery, Nagakute, Aichi (Japan); Takeuchi, Mikinobu; Hirasawa, Atsuhiko; Kawanami, Katsuhisa; Takayasu, Masakazu [Aichi Medical University, Department of Spine Center, Aichi (Japan); Nishimura, Manabu [Aichi Medical University, Department of Radiology, Nagakute, Aichi (Japan); Riew, K.D. [Washington University, Department of Orthopedic Surgery, St. Louis, MO (United States); Imagama, Shiro [Nagoya University, Department of Orthopedic Surgery, Nagoya, Aichi (Japan); Sato, Keiji [Aichi Medical University, Department of Orthopedic Surgery, Nagakute, Aichi (Japan)

    2014-10-15

    The craniovertebral junction is anatomically complicated. Representative vertebral artery (VA) variations include the persistent first intersegmental artery (FIA), fenestration of the VA above and below C1 (FEN), posterior inferior cerebellar artery (PICA) from C1/2, and high-riding VA (HRVA). The ponticulus posticus (PP) is a well-known osseous anomaly at C1. Although those anomalies are frequent in patients with cervical deformity, the prevalence of these in subjects with normal cervical spines is still unknown. The aim of this study is to investigate the variations and prevalence of vascular and osseous anomalies based on three-dimensional computed tomographic (3D CT) angiography in patients without any cervical diseases, such as rheumatoid arthritis, Klippel-Feil syndrome, or Down syndrome. Eligible subjects were patients who underwent 3D CT angiography by the Department of Otorhinolaryngology and Internal Medicine from January 2009 to October 2013 in our institution. The authors defined a HRVA as a C2 pedicle with a maximum diameter of 4 mm or less. Among 480 subjects with a mean age of 63.1 years, 387 patients were eligible. One hundred and eighteen subjects were female, and 269 were male. HRVA was observed in 10.1 % of patients (39 out of 387 cases), FIA in 1.8 % (7 cases), FEN in 1.3 % (5 cases), and PICA in 1.3 % (5 cases). PP was observed in 6.2 % of patients (24 cases). According to past reports, many VA anomalies could be attributed to congenital or acquired conditions (e.g., rheumatoid arthritis). However, VA anomalies appear to exist even in patients without any such cervical diseases. (orig.)

  13. Equine hospital data as a source for study of prevalence and heritability of osteochondrosis and palmar/plantar osseous fragments of Swedish Warmblood horses.

    Science.gov (United States)

    Jönsson, L; Dalin, G; Egenvall, A; Näsholm, A; Roepstorff, L; Philipsson, J

    2011-11-01

    Disturbances in skeletal development, primarily osteochondrosis (OC) and palmar/plantar osseous fragments (POF), have been commonly reported as problems in young horses. However, there are few reports of such findings for epidemiological analyses or breeding purposes. To evaluate equine hospital data as a possible source of information for genetic evaluations by estimating prevalence and heritability of OC in the stifle, hock and fetlock joints and of POF in the fetlock. Data on Swedish Warmblood (SWB) horses were obtained from a large equine hospital in south Sweden. Prevalences were based on radiographic examinations of 879 screened horses, mainly evaluated as part of a prepurchase examination and 3639 horses with a reported history of orthopaedic problems. For the heritability study the 2 data sources were pooled and 3199 examined horses with pedigree information were considered for the linear animal model analyses. The overall prevalence of OC was 13% (stifle 9%, hock 6% and dorsal osseous fragments in fetlock [DOF] 10%) and POF 10%. The overall heritability of OC was 0.05 on the visible binomial scale. The corresponding heritabilities for OC in the stifle were 0.03, hock 0.08, DOF 0.10 and POF 0.13. These values correspond to heritabilities of 0.09-0.38 on the underlying quantitative scale. Obtained prevalences and heritabilities were in accordance with other studies, supporting the hypothesis that data regularly obtained from equine hospitals may be a valuable source in studies of inherited disorders such as OC and POF. There is a need for more standardised documentation of diagnoses and consistent recording of identity of examined horses using passports or breed databases. Compilation of results from major clinics is desired in order to cover most progenies of stallions used in a region or nation. © 2010 EVJ Ltd.

  14. Effects of the facial osseous defect morphology on gingival dynamics after immediate tooth replacement and guided bone regeneration: 1-year results.

    Science.gov (United States)

    Kan, Joseph Y K; Rungcharassaeng, Kitichai; Sclar, Anthony; Lozada, Jaime L

    2007-07-01

    This article describes different scenarios of facial osseous defects when the osseous-gingival relationship exceeds 3 mm and evaluates the effects of the morphology of the compromised facial bone on gingival dynamics after immediate tooth replacement and guided bone regeneration. The implant success rate and peri-implant bone change were also reported. Twenty-three patients treated consecutively with the mean age of 39.5 years (range, 25 to 63 years) underwent immediate tooth replacement and guided bone regeneration in sockets with facial bony defects exceeding 3 mm. Facial bony defects were categorized into V-, U-, and Ultra-U (UU)-shaped. The patients were evaluated clinically and radiographically at 1-year after implant placement. At 1-year, the implant success rate was 100% (23/23). No marginal bone change of greater than 1 mm was observed. Greater than 1.5 mm of facial gingival recessions were noted in 8.3% (1/12) of V-shaped, 42.8% (3/7) of U-shaped, and 100% (4/4) of UU-shaped defects. U- and UU-shaped defects showed significantly higher frequency and magnitude of facial gingival recession (>1.5 mm) when compared with V-shaped defects 1-year after immediate tooth replacement and guided bone regeneration. It is important to identify the type of facial bony defect during diagnosis and treatment planning, so that appropriate treatment can be prescribed. The combination of delayed implant placement after staged reconstruction of unfavorable U- and UU-shaped labial extraction socket defects should be considered in areas of high esthetic concern.

  15. Pharmacotherapy of severe asthma

    Science.gov (United States)

    Firszt, Rafael; Kraft, Monica

    2013-01-01

    Severe asthma is a complex and heterogeneous phenotype where management can be challenging. While many patients with severe asthma respond to high-dose inhaled corticosteroids in combination with a long-acting β-agonist, there remains a significant subset of patients that require oral corticosteroids to control symptoms. Alternative therapies are needed to help reduce the need for continuous oral corticosteroids; however, there are currently very few effective options. Several new alternatives to oral corticosteroids have been evaluated in severe asthma as add-on to conventional therapy. These include macrolide antibiotics, omalizumab, tumor necrosis factor-α inhibitors, cytokine receptor antagonists, and bronchial thermoplasty. The challenge with these entities is determining the appropriate phenotype of severe asthma where effectiveness is demonstrated, given the significant heterogeneity of the disease. Therefore, there is a crucial need to better understand the mechanisms and pathophysiology of severe asthma so more effective immunomodulators and biologic therapies can emerge. PMID:20462794

  16. Public health impacts of the severe haze in Equatorial Asia in September-October 2015: demonstration of a new framework for informing fire management strategies to reduce downwind smoke exposure

    Science.gov (United States)

    Koplitz, Shannon N.; Mickley, Loretta J.; Marlier, Miriam E.; Buonocore, Jonathan J.; Kim, Patrick S.; Liu, Tianjia; Sulprizio, Melissa P.; DeFries, Ruth S.; Jacob, Daniel J.; Schwartz, Joel; Pongsiri, Montira; Myers, Samuel S.

    2016-09-01

    In September-October 2015, El Niño and positive Indian Ocean Dipole conditions set the stage for massive fires in Sumatra and Kalimantan (Indonesian Borneo), leading to persistently hazardous levels of smoke pollution across much of Equatorial Asia. Here we quantify the emission sources and health impacts of this haze episode and compare the sources and impacts to an event of similar magnitude occurring under similar meteorological conditions in September-October 2006. Using the adjoint of the GEOS-Chem chemical transport model, we first calculate the influence of potential fire emissions across the domain on smoke concentrations in three receptor areas downwind—Indonesia, Malaysia, and Singapore—during the 2006 event. This step maps the sensitivity of each receptor to fire emissions in each grid cell upwind. We then combine these sensitivities with 2006 and 2015 fire emission inventories from the Global Fire Assimilation System (GFAS) to estimate the resulting population-weighted smoke exposure. This method, which assumes similar smoke transport pathways in 2006 and 2015, allows near real-time assessment of smoke pollution exposure, and therefore the consequent morbidity and premature mortality, due to severe haze. Our approach also provides rapid assessment of the relative contribution of fire emissions generated in a specific province to smoke-related health impacts in the receptor areas. We estimate that haze in 2015 resulted in 100 300 excess deaths across Indonesia, Malaysia and Singapore, more than double those of the 2006 event, with much of the increase due to fires in Indonesia’s South Sumatra Province. The model framework we introduce in this study can rapidly identify those areas where land use management to reduce and/or avoid fires would yield the greatest benefit to human health, both nationally and regionally.

  17. Cogumelo "shiitake" (Lentinula edodes reduz o crescimento de fitopatógenos e a severidade de manchas foliares em sorgo “shiitake” (Lentinula edodes mushroom reduces growth of plant pathogens and leaf spot severity in sorghum

    Directory of Open Access Journals (Sweden)

    Everaldo Piccinin

    2010-03-01

    parts, cap and stem, reduced the mycelium growth and the spore germination of the plant pathogens, while the antifungal activity of L. edodes´s mycelium growth filtrate was less pronounced. The shiitake preparations did not induce phytoalexin accumulation in sorghum mesocotyls. Aqueous extracts from fruiting bodies and lentinan partially reduced disease severity caused by E. turcicum in the cv. Brandes and by C. sublineolum in the cv. Tx-398-B, when applied 48 hours before plant inoculation. Therefore, L. edodes exhibits potential as a biological control agent or as a model for the synthesis of fungicidal compounds.

  18. MR imaging of overuse injuries in the skeletally immature gymnast: spectrum of soft-tissue and osseous lesions in the hand and wrist

    International Nuclear Information System (INIS)

    Dwek, Jerry R.; Cardoso, Fabiano; Chung, Christine B.

    2009-01-01

    In the pediatric gymnast, stress-related physeal injuries have been well described with characteristic imaging findings. However, a spectrum of overuse injuries, some rarely reported in the literature, can be encountered in the gymnast's hand and wrist. To demonstrate the MR appearance of a spectrum of overuse injuries in the skeletally immature wrist and hand of pediatric gymnasts. A total of 125 MR exams of the hand and wrist in skeletally immature children were performed at our institution during a 2-year period. Clinical histories were reviewed for gymnastics participation. MR studies of that subpopulation were reviewed and abnormalities tabulated. Of the MR studies reviewed, ten gymnasts were identified, all girls age 12-16 years (mean age 14.2 years) who presented with wrist or hand pain. Three of these children had bilateral MR exams. Abnormalities included chronic physeal injuries in three children. Two girls exhibited focal lunate osteochondral defects. Triangular fibrocartilage tears were present in three girls, one of whom had a scapholunate ligament tear. Two girls manifested metacarpal head flattening and necrosis. A variety of soft-tissue and osseous lesions can be encountered in the skeletally immature gymnast. Familiarity with these stress-related injuries is important for accurate diagnosis. (orig.)

  19. Biological Properties of Low-Toxicity PLGA and PLGA/PHB Fibrous Nanocomposite Implants for Osseous Tissue Regeneration. Part I: Evaluation of Potential Biotoxicity

    Directory of Open Access Journals (Sweden)

    Izabella Krucińska

    2017-11-01

    Full Text Available In response to the demand for new implant materials characterized by high biocompatibility and bioresorption, two prototypes of fibrous nanocomposite implants for osseous tissue regeneration made of a newly developed blend of poly(l-lactide-co-glycolide (PLGA and syntheticpoly([R,S]-3-hydroxybutyrate, PLGA/PHB, have been developed and fabricated. Afibre-forming copolymer of glycolide and l-lactide (PLGA was obtained by a unique method of synthesis carried out in blocksusing Zr(AcAc4 as an initiator. The prototypes of the implants are composed of three layers of PLGA or PLGA/PHB, nonwoven fabrics with a pore structure designed to provide the best conditions for the cell proliferation. The bioactivity of the proposed implants has been imparted by introducing a hydroxyapatite material and IGF1, a growth factor. The developed prototypes of implants have been subjected to a set of in vitro and in vivobiocompatibility tests: in vitro cytotoxic effect, in vitro genotoxicity and systemic toxicity. Rabbitsshowed no signs of negative reactionafter implantation of the experimental implant prototypes.

  20. Effect of Alendronate with β - TCP Bone Substitute in Surgical Therapy of Periodontal Intra-Osseous Defects: A Randomized Controlled Clinical Trial.

    Science.gov (United States)

    Naineni, Rohini; Ravi, Vishali; Subbaraya, Dwijendra Kocherlakota; Prasanna, Jammula Surya; Panthula, Veerendranath Reddy; Koduganti, Rekha Rani

    2016-08-01

    Alendronate (ALN), an aminobisphosphonate, inhibits osteoclastic bone resorption and also stimulates osteogenesis. Beta-Tricalcium Phosphate (β-TCP) is an osteoconductive graft material which provides a scaffold for bone formation and also a widely used drug delivery vehicle for growth factors and antibiotics. Drug delivery vehicles, like β-TCP, improve the potency of the drugs by specific local site delivery of the drug, optimal release characteristics and easy handling. The aim of the this study was to evaluate the bone formation potential of 400μg ALN delivered in β-TCP in the treatment of periodontal intra-osseous defects. Thirty patients with periodontal defects were randomly assigned to 400μg ALN + β-TCP + Saline (test) group and β-TCP + Saline (active-control) group. Clinical parameters like Clinical Attachment Level (CAL) gain, Probing Depth (PD) reduction, post-operative Gingival Recession (GR) were assessed from the baseline, 3 months and 6 months recordings. Radiographic parameters like Linear Bone Growth (LBG), Percentage Bone Fill (%BF), and change in alveolar crest height (ACH) were assessed from baseline and 6 months radiographs. Mean measurements in the ALN test group for CAL gain (3.4 ± 0.74 mm), PD reduction (4.33 ± 0.82 mm), LBG (2.88 ± 0.88 mm), and %BF (51.98 ± 15.84%) were significantly greater with a p-value TCP bone graft material was effective in improving soft tissue parameters, inhibiting alveolar crestal resorption and enhancing bone formation, compared to β-TCP alone.

  1. Histologic Evaluation of Osseous Regeneration Following Combination Therapy With Platelet-Rich Plasma and Bio-Oss in a Rat Calvarial Critical-Size Defect Model.

    Science.gov (United States)

    DeNicolo, Philip J; Guyton, M Kelly; Cuenin, Michael F; Hokett, Steven D; Sharawy, Mohamed; Borke, James; McPherson, James C

    2015-10-01

    Platelet-rich plasma (PRP) is an autogenous source of growth factors shown to facilitate human bone growth. Bio-Oss, an osteoconductive xenograft, is used clinically to regenerate periodontal defects, restore dental alveolar ridges, and facilitate sinus-lift procedures. The purpose of this study was to analyze whether a combination of PRP and Bio-Oss would enhance bone regeneration better than either material alone. PRP and/or Bio-Oss were administered in an 8-mm critical-size defect (CSD) rat calvarial model of bone defect between 2 polytetrafluoroethylene membranes to prevent soft tissue incursion. Eight weeks after the induction of the CSD, histologic sections were stained with hematoxylin and eosin stain and analyzed via light microscopy. Qualitative analyses revealed new bone regeneration in all 4 groups. The Bio-Oss and PRP plus Bio-Oss groups demonstrated greater areas of closure in the defects than the control or PRP-only groups because of the space-maintaining ability of Bio-Oss. The groups grafted with Bio-Oss showed close contact with new bone growth throughout the defects, suggesting a stronger graft. The use of PRP alone or in combination with Bio-Oss, however, did not appear to enhance osseous regeneration at 8 weeks. Areas grafted with Bio-Oss demonstrated greater space-maintaining capacity than controls, and PRP was an effective vehicle for placement of the Bio-Oss. However, at 8 weeks this study was unable to demonstrate a significant advantage of using PRP plus Bio-Oss over using Bio-Oss alone.

  2. Probiotics and Severe Acute Pancreatitis

    OpenAIRE

    Raffaele Pezzilli; Lorenzo Fantini

    2006-01-01

    Severe acute pancreatitis is frequently associated with necrosis of the gland, and the principal late complication is infection of the necrosis. The gut barrier plays an important role in severe acute pancreatitis; in fact, gut barrier integrity prevents bacteria translocation resulting from an atrophic and leaky gut, and reduces the systemic inflammatory syndrome of the pancreatitis from gut atrophy. The maintenance of gut barrier integrity is one of the goals in the treatment of severe acut...

  3. The role of computed tomography in evaluation of subchondral osseous lesions in seven horses with chronic synovitis

    International Nuclear Information System (INIS)

    Hanson, J.A.; Seeherman, H.J.; Kirker-Head, C.A.; O'Callaghan, M.W.

    1996-01-01

    Seven horses with severe, persistent lameness of sudden onset were evaluated with scintigraphy and/or computed tomography. The lameness was localised to the front fetlock joint in 2 horses and to the tibiotarsal joint in 5 horses. Five of the horses had a history of intra-articular injections of the involved joint prior to presentation. All horses had effusion of the affected joint and were positive to flexion tests. Intraarticular anaesthesia eliminated or improved the lameness in 4 cases and a nerve conduction block proximal to the affected joint improved the lameness in another. Cytology examination of fluid from affected joints identified normal joint fluid (one horse) or elevations in nucleated cell counts of 0.9 x 10(9)/l-36.8 x 10(9)/l and total protein 20-42 g/l (6 horses). The joint fluid of 2 of these horses cultured positive for bacteria. Initial radiographs were either normal (4 cases) or the changes seen were not sufficient to explain the degree of lameness. In the 6 cases where scintigraphy was performed, intense focal isotope uptake was found in the suspected region, which corresponded to the proximal portion of the first phalanx (2 cases), distal tibia (2 cases), or talus (3 cases). Computed tomography (CT) was performed because occult fracture or osteomyelitis was suspected; and knowledge of the precise anatomical location of the lesion was considered necessary to assess the need for surgery and to plan the surgical approach. Hypodense focal lesions with hyperdense haloes were found in the subchondral bone deep to the sagittal groove of the first phalanx (P1) (2 cases) in the cochlea of the distal tibia (2 cases), and in the intertrochlear portion of the talus (3 cases). Communication between the lesion and the joint space was demonstrated by CT in 5 cases. Post mortem examination of one case revealed synovitis and a chronic bone abscess (Brodie's abscess) communicating with the joint space

  4. Management of severe accidents

    International Nuclear Information System (INIS)

    Jankowski, M.W.

    1987-01-01

    The definition and the multidimensionality aspects of accident management have been reviewed. The suggested elements in the development of a programme for severe accident management have been identified and discussed. The strategies concentrate on the two tiered approaches. Operative management utilizes the plant's equipment and operators capabilities. The recovery managment concevtrates on preserving the containment, or delaying its failure, inhibiting the release, and on strategies once there has been a release. The inspiration for this paper was an excellent overview report on perspectives on managing severe accidents in commercial nuclear power plants and extending plant operating procedures into the severe accident regime; and by the most recent publication of the International Nuclear Safety Advisory Group (INSAG) considering the question of risk reduction and source term reduction through accident prevention, management and mitigation. The latter document concludes that 'active development of accident management measures by plant personnel can lead to very large reductions in source terms and risk', and goes further in considering and formulating the key issue: 'The most fruitful path to follow in reducing risk even further is through the planning of accident management.' (author)

  5. Management of severe accidents

    International Nuclear Information System (INIS)

    Jankowski, M.W.

    1988-01-01

    The definition and the multidimensionality aspects of accident management have been reviewed. The suggested elements in the development of a programme for severe accident management have been identified and discussed. The strategies concentrate on the two tiered approaches. Operative management utilizes the plant's equipment and operators capabilities. The recovery management concentrates on preserving the containment, or delaying its failure, inhibiting the release, and on strategies once there has been a release. The inspiration for this paper was an excellent overview report on perspectives on managing severe accidents in commercial nuclear power plants and extending plant operating procedures into the severe accident regime; and by the most recent publication of the International Nuclear Safety Advisory Group (INSAG) considering the question of risk reduction and source term reduction through accident prevention, management and mitigation. The latter document concludes that active development of accident management measures by plant personnel can lead to very large reductions in source terms and risk, and goes further in considering and formulating the key issue: The most fruitful path to follow in reducing risk even further is through the planning of accident management

  6. Ulinastatin Reduces T Cell Apoptosis in Rats with Severe Acute ...

    African Journals Online (AJOL)

    T cell apoptosis was determined by Annexin-V/PI double-staining. Oxidative stress was evaluated by examining changes in the levels of reactive oxygen species (ROS). Total superoxide dismutase (SOD) in serum was tested by hydroxylamine colorimetric assay, and malondialdehyde levels were examined by thiobarbituric ...

  7. Does Hearing Several Speakers Reduce Foreign Word Learning?

    Science.gov (United States)

    Ludington, Jason Darryl

    2016-01-01

    Learning spoken word forms is a vital part of second language learning, and CALL lends itself well to this training. Not enough is known, however, about how auditory variation across speech tokens may affect receptive word learning. To find out, 144 Thai university students with no knowledge of the Patani Malay language learned 24 foreign words in…

  8. Scoparia dulcis reduces the severity of Trypanosoma bruceiinduced ...

    African Journals Online (AJOL)

    We investigated the effect of oral administration of the herb, Scoparia dulcis, on Trypanosoma bruceiinduced changes in plasma lipid profile in rabbits over a period of twenty eight days. Results obtained show that infection with T. brucei resulted in significant increases in plasma total cholesterol, trriacylglycerol, and low ...

  9. Osseous involvement in AIDS patients

    International Nuclear Information System (INIS)

    Marchiori, Edson; Pereira, Abercio Arantes

    1995-01-01

    The radiological findings of eight patients with the acquired immunodeficiency syndrome (AIDS) who developed bone lesions were analyzed in conjunction with twelve similar published cases. Our series included three patients with lymphoma, two with bacillary angiomatosis, two with tuberculosis and one with staphylococcal osteomyelitis. All the lesions were lithic regardless of the etiology. Both in our cases and in those previously published bone repair was only seen in cases of bacillary angiomatosis treated with erythromycin. No pathognomonic findings were observed. However, the association of skin and bone lesions in immuno deficient patients should always bring the consideration of bacillary angiomatosis in the differential diagnosis. This is particularly relevant since this a condition amenable to treatment once correctly identified. The radiological findings in the lymphoma and tuberculosis patients have not been described previously. (author). 9 refs., 7 figs., 3 tabs

  10. Severe service sealing solutions

    International Nuclear Information System (INIS)

    Metcalfe, R.; Wensel, R.

    1994-09-01

    Successful sealing usually requires much more than initial leak-tightness. Friction and wear must also be acceptable, requiring a good understanding of tribology at the sealing interface. This paper describes various sealing solutions for severe service conditions. The CAN2A and CAN8 rotary face seals use tungsten carbide against carbon-graphite to achieve low leakage and long lifetime in nuclear main coolant pumps. The smaller CAN6 seal successfully uses tungsten carbide against silicon carbide in reactor water cleanup pump service. Where friction in CANDU fuelling machine rams must be essentially zero, a hydrostatic seal using two silicon carbide faces is the solution. In the NRU reactor moderator pumps, where pressure is much lower, eccentric seals that prevent boiling at the seal faces are giving excellent service. All these rotary face seals rely on supplementary elastomer seals between their parts. An integrated engineering approach to high performance sealing with O-rings is described. This is epitomized in critical Space Shuttle applications, but is increasingly being applied in CANDU plants. It includes gland design, selection and qualification of material, quality assurance, detection of defects and the effects of lubrication, surface finish, squeeze, stretch and volume constraints. In conclusion, for the severe service applications described, customized solutions have more than paid for themselves by higher reliability, lower maintenance requirements and reduced outage time. (author)

  11. Complete Remodeling After Conservative Treatment of a Severely Angulated Odontoid Fracture in a Patient With Osteogenesis Imperfecta: A Case Report.

    Science.gov (United States)

    Colo, Dino; Schlösser, Tom P C; Oostenbroek, Hubert J; Castelein, René M

    2015-09-15

    Case report. This is the first case report describing successful healing and remodeling of a traumatic odontoid fracture that was dislocated and severely angulated in a patient with osteogenesis imperfecta who was treated conservatively. Osteogenesis imperfecta (OI) is a rare genetic disorder resulting in a low bone mass and bone fragility, predisposing these patients to fractures that often occur at a young age. Although any bone in the body may be involved, odontoid fractures are uncommon in this population. Because of a very high fusion rate, conservative management is accepted as a safe and efficient treatment of fractures of the odontoid in children. Several authors, however, recommend surgical treatment of patients who have failure of conservative treatment and have severe angulation or displacement of the odontoid. A 5-year-old female, diagnosed with OI type I, presented with neck pain without any neurological deficits after falling out of a rocking chair backward, with her head landing first on the ground. Computed tomography confirmed a type III odontoid fracture without dislocation and she was initially treated with a rigid cervical orthosis. At 1 and 2 months of follow-up, progressive severe angulation of the odontoid was observed but conservative treatment was maintained as the space available for the spinal cord was sufficient and also considering the patient's history of OI. Eight months postinjury, she had no clinical symptoms and there was osseous healing of the fracture with remodeling of the odontoid to normal morphology. Even in patients with OI, severely angulated odontoid fractures might have the capacity for osseous healing and complete remodeling under conservative treatment. 5.

  12. Radiographic evaluation of periodontal osseous defects: in vitro study = Avaliação radiográfica dos defeitos ósseos periodontais: estudo "in vitro"

    Directory of Open Access Journals (Sweden)

    Gomes Filho, Issac Suzart et al.

    2006-01-01

    correlated literature few investigations exist on the specificity of the osseous defects radiographic image, highlighting the necessity of additional studies on the theme. Objective: To describe the radiographic aspects of periodontal bone defects, produced artificially in dry mandibles, and to emphasize the anatomic determinants that contribute to the formation of the different types of defects. Method: Eight periodontal bone defects types were produced in fourteen dry mandibles. Standardized digital photographs and conventional radiographs were obtained from each region, before and after the simulation of the referred defects. Soon afterwards, the radiographs were placed in a light box and evaluated by three examiners. Results: The bone defects showed distinct radiographics characteristics, allowing its identification, except for the one-, two-, three-walls infrabony defects. The radicular septum bone defect was the most difficult to be evaluated while the horizontal and vertical defects were the most easily interpreted. Final considerations: The interpretation of periodontal bone defects radiographics images is dependent to the resorption type is being evaluated. The description of the bone defect could be facilitated to those types that have the morphology with less overlap of the bone and dental structures.

  13. Reducing Resistance

    DEFF Research Database (Denmark)

    Lindell, Johanna

    care may influence decisions on antibiotic use. Based on video-and audio recordings of physician-patient consultations it is investigated how treatment recommendations are presented, can be changed, are forecast and explained, and finally, how they seemingly meet resistance and how this resistance......Antibiotic resistance is a growing public health problem both nationally and internationally, and efficient strategies are needed to reduce unnecessary use. This dissertation presents four research studies, which examine how communication between general practitioners and patients in Danish primary...... is responded to.The first study in the dissertation suggests that treatment recommendations on antibiotics are often done in a way that encourages patient acceptance. In extension of this, the second study of the dissertation examines a case, where acceptance of such a recommendation is changed into a shared...

  14. Reducing sedentarism

    DEFF Research Database (Denmark)

    Brown, Wendy; Andersen, Lars Bo; Sigmund, Anderssen

    being a health risk will be briefly considered. Second, a review of the evidence on the health effects of sitting will be presented. This will include results from observational cohort studies on the relationships between sitting and diabetes, cardiovascular diseases, cancers, depression, obesity...... include sitting during leisure time, at work, and during commuting. Sedentary behaviors such as TV viewing, using a computer or driving a car typically demands low levels of energy expenditure. Youth and adults spend most of their waking time sitting or doing light activities, and most of them do little......, type 2 diabetes, musculoskeletal diseases, and psychological disorders. In addition, low level of energy expenditure is one of the key determinants of the current epidemic of overweight and obesity in Europe. In order to both reduce sitting time and to increase the level of physical activity...

  15. Study of contamination by 100 {mu}Ci of Sr 90 in the rat: clinical, hematological and osseous effects (appearance of osteosarcomas); Etude d'une contamination par 100 {mu}Ci de Sr 90 chez le rat: consequences cliniques, hematologiques et osseuses (apparition d'osteosarcomes)

    Energy Technology Data Exchange (ETDEWEB)

    Graf, B.; Lafuma, J.; Parmentier, C.; Parmentier, N. [Commissariat a l' Energie Atomique, Fontenay-aux-Roses (France). Centre d' Etudes Nucleaires

    1968-07-01

    Clinical, hematological and osseous effects following an intramuscular injection of 100 {mu}Ci 90 Sr were studied in the rat. In spite of the magnitude of the injection and the resulting damage, the elimination of strontium could compare with what occurs after an injection at tracer doses. Comparing with the controls at the outcoming time, clinical monitoring mainly brought out a loss of body weight. Fairly early (20. - 30. day) there occurred severe hematological damage, especially on lymphocyte line, which subsided spontaneously. As foreseen, the anatomo-pathological survey of the early period showed bone and medullar lesions in the areas of enchondral ossification. In the late period, bone sarcomas occurred in nine animals out of ten. The outstanding histological type was osteogenic osteosarcomas; besides, two animals experienced bilateral tumors. (authors) [French] Les auteurs etudient les consequences cliniques, hematologiques et osseuses d'une contamination par 100 microcuries de Sr 90 injectes par voie intramusculaire chez le rat. Malgre l'importance de la contamination et les lesions consequentes, l'elimination du Sr 90 est comparable a celle que l'on observe apres injection de doses traceuses. La surveillance clinique ne met essentiellement en evidence, a la periode terminale, qu'une diminution du poids par rapport aux temoins. Les lesions hematologiques sont importantes, predominant sur la lignee lymphocytaire. Elles sont relativement precoces (20e - 30e jours) et regressent spontanement. La surveillance anatomo-pathologique de la periode precoce a montre, comme il etait previsible, des lesions osseuses et medullaires dans les zones d'ossification enchondrale. A la periode tardive, la survenue de sarcomes osseux a ete observee chez neuf animaux sur dix. Le type histologique predominant est l'osteosarcome osteogenique et il faut signaler egalement les tumeurs bilaterales observees chez deux animaux. (auteurs)

  16. [Severe rhabdomyolysis secondary to severe hypernatraemic dehydration].

    Science.gov (United States)

    Mastro-Martínez, Ignacio; Montes-Arjona, Ana María; Escudero-Lirio, Margarita; Hernández-García, Bárbara; Fernández-Cantalejo Padial, José

    2015-01-01

    Rhabdomyolysis is a rare paediatric condition. The case is presented of a patient in whom this developed secondary to severe hypernatraemic dehydration following acute diarrhoea. Infant 11 months of age who presented with vomiting, fever, diarrhoea and anuria for 15 hours. Parents reported adequate preparation of artificial formula and oral rehydration solution. He was admitted with malaise, severe dehydration signs and symptoms, cyanosis, and low reactivity. The laboratory tests highlighted severe metabolic acidosis, hypernatraemia and pre-renal kidney failure (Sodium [Na] plasma 181 mEq/L, urine density> 1030). He was managed in Intensive Care Unit with gradual clinical and renal function improvement. On the third day, slight axial hypotonia and elevated cell lysis enzymes (creatine phosphokinase 75,076 IU/L) were observed, interpreted as rhabdomyolysis. He was treated with intravenous rehydration up to 1.5 times the basal requirements, and he showed a good clinical and biochemical response, being discharged 12 days after admission without motor sequelae. Severe hypernatraemia is described as a rare cause of rhabdomyolysis and renal failure. In critically ill patients, it is important to have a high index of suspicion for rhabdomyolysis and performing serial determinations of creatine phosphokinase for early detection and treatment. Copyright © 2015 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Reducing costs by reducing size

    International Nuclear Information System (INIS)

    Hayns, M.R.; Shepherd, J.

    1991-01-01

    The present paper discusses briefly the many factors, including capital cost, which have to be taken into account in determining whether a series of power stations based on a small nuclear plant can be competitive with a series based on traditional large unit sizes giving the guaranteed level of supply. The 320 MWe UK/US Safe Integral Reactor is described as a good example of how the factors discussed can be beneficially incorporated into a design using proven technology. Finally it goes on to illustrate how the overall costs of a generating system can indeed by reduced by use of the 320 MWe Safe Integral Reactor rather than conventional units of around 1200 MWe. (author). 9 figs

  18. A Modified Translaminar Osseous Channel-Assisted Percutaneous Endoscopic Lumbar Discectomy for Highly Migrated and Sequestrated Disc Herniations of the Upper Lumbar: Clinical Outcomes, Surgical Indications, and Technical Considerations

    Directory of Open Access Journals (Sweden)

    Zhijun Xin

    2017-01-01

    Full Text Available Objective is to describe a safe and effective percutaneous endoscopic approach for removal of highly migrated and sequestrated disc herniations of the upper lumbar spine and to report the results, surgical indications, and technical considerations of the new technique. Eleven patients who had highly migrated and sequestrated disc herniations in the upper lumbar were included in this study. A retrospective study was performed for all patients after translaminar osseous channel-assisted PELD was performed. Radiologic findings were investigated, and pre-and postoperative visual analog scale (VAS assessments for back and leg pain and Oswestry disability index (ODI evaluations were performed. Surgical outcomes were evaluated under modified MacNab criteria. All of the patients were followed for more than 1 year. The preoperative and postoperative radiologic findings revealed that the decompression of the herniated nucleus pulposus (HNP was complete. After surgery, the mean VAS scores for back and leg pain immediately improved from 8.64 (range, 7–10 and 8.00 (range, 6–10 to 2.91 (range, 2–4 and 2.27 (range, 1–3, respectively. The mean preoperative ODI was 65.58 (range, 52.2–86, which decreased to 7.51 (range, 1.8–18 at the 12-month postoperative follow-up. The MacNab scores at the final follow-up included nine excellent, one good, and one fair. The modified translaminar osseous channel-assisted PELD could be a safe and effective option for the treatment of highly migrated and sequestrated disc herniations of the upper lumbar.

  19. The treatment of severe malaria.

    Science.gov (United States)

    Dondorp, Arjen M; Day, Nick P J

    2007-07-01

    In the SEAQUAMAT trial, parenteral artesunate was shown to be associated with a considerably lower mortality than quinine, and is now the recommended treatment for severe malaria in low-transmission areas and in the second and third trimesters of pregnancy. A trial is underway to establish its role in African children. The development of artesunate suppositories may provide the means to treat patients with severe disease in remote rural settings, potentially buying the time needed to reach a health care facility. The increasing availability of basic intensive care facilities in developing countries also has the potential to further reduce mortality.

  20. Palmer Drought Severity Index

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — PDSI from the Dai dataset. The Palmer Drought Severity Index (PDSI) is devised by Palmer (1965) to represent the severity of dry and wet spells over the U.S. based...

  1. Severe Asthma in Children.

    Science.gov (United States)

    Chipps, Bradley E; Parikh, Neil G; Maharaj, Sheena K

    2017-04-01

    The aim of this study is to characterize, diagnose, evaluate, and treat severe childhood asthma. Understanding the occurrence of the physiologic and clinical presentations of childhood severe asthma, the treatment and response may be predicted by biomarkers, but the patient's response is highly variable. The onset of severe asthma occurs early and is primarily predicted by severity of viral infection and coexistence of the atopic state.

  2. Bronchial thermoplasty for severe asthma.

    Science.gov (United States)

    Thomson, Neil C; Bicknell, Stephen; Chaudhuri, Rekha

    2012-06-01

    Bronchial thermoplasty, which involves the delivery of radio frequency energy to the airways to reduce airway smooth muscle mass, has been recently introduced for the treatment of severe asthma. This review summarizes the preclinical development, efficacy and adverse effects of bronchial thermoplasty. In addition, the potential mechanisms of action and place in management of severe asthma are discussed. The efficacy and adverse profile of bronchial thermoplasty has been assessed in three randomized controlled trials, the first two of which showed clinical benefits of bronchial thermoplasty compared with usual care in patients with moderate or severe asthma. The third trial reports the results of a comparison with sham bronchial thermoplasty in 288 adults with severe asthma. Bronchial thermoplasty improved asthma quality of life questionnaire scores compared with sham bronchial thermoplasty; in the posttreatment period, there were fewer severe exacerbations and emergency department visits. Bronchial thermoplasty causes short-term increases in asthma-related morbidity. Follow-up data to date support the long-term safety of the procedure. Bronchial thermoplasty has a role in the management of patients with severe asthma who have uncontrolled symptoms despite current therapies. Future studies need to identify factors that predict a beneficial clinical response.

  3. Severe accident phenomena

    International Nuclear Information System (INIS)

    Jokiniemi, J.; Kilpi, K.; Lindholm, I.; Maekynen, J.; Pekkarinen, E.; Sairanen, R.; Silde, A.

    1995-02-01

    Severe accidents are nuclear reactor accidents in which the reactor core is substantially damaged. The report describes severe reactor accident phenomena and their significance for the safety of nuclear power plants. A comprehensive set of phenomena ranging from accident initiation to containment behaviour and containment integrity questions are covered. The report is based on expertise gained in the severe accident assessment projects conducted at the Technical Research Centre of Finland (VTT). (49 refs., 32 figs., 12 tabs.)

  4. Management of severe preeclampsia.

    Science.gov (United States)

    Brichant, G; Dewandre, P Y; Foidart, J M; Brichant, J F

    2010-01-01

    Features of severe preeclampsia include severe proteinuric hypertension and symptoms of central nervous system dysfunction, hepatocellular injury, thrombocytopenia, oliguria, pulmonary oedema, cerebrovascular accident and severe intrauterine growth restriction. Women with severe preeclampsia must be hospitalized to confirm the diagnosis, to assess the severity of the disease, to monitor the progression of the disease and to try to stabilize the disease. Severe preeclampsia may be managed expectantly, in selected cases. The objective of expectant management in these patients is to improve neonatal outcome. Expectant management is based on antihypertensive treatment and prevention of end organ dysfunction. Antihypertensive treatment improves maternal outcome but has the potential to be deleterious for the foetus. Plasma volume expansion has been suggested for severe preeclampsia but trials failed to show any benefit. Magnesium sulfate is the anticonvulsivant of choice to treat or prevent eclampsia when indicated. Antenatal corticosteroids are recommended in severely preeclamptic women with 26-34 weeks gestation. Timing of delivery is based upon gestational age, severity of preeclampsia, maternal and foetal risks.

  5. De-severing distance

    DEFF Research Database (Denmark)

    Jensen, Hanne Louise; de Neergaard, Maja

    2016-01-01

    De-severing Distance This paper draws on the growing body of mobility literature that shows how mobility can be viewed as meaningful everyday practices (Freudendal –Pedersen 2007, Cresswell 2006) this paper examines how Heidegger’s term de-severing can help us understand the everyday coping with ...

  6. Allergy in severe asthma

    NARCIS (Netherlands)

    Del Giacco, Stefano R.; Bakirtas, A.; Bel, E.; Custovic, A.; Diamant, Z.; Hamelmann, E.; Heffler, E.; Kalayci, O.; Saglani, S.; Sergejeva, S.; Seys, S.; Simpson, A.; Bjermer, Leif

    It is well recognized that atopic sensitization is an important risk factor for asthma, both in adults and in children. However, the role of allergy in severe asthma is still under debate. The term 'Severe Asthma' encompasses a highly heterogeneous group of patients who require treatment on steps

  7. Severe childhood malnutrition

    DEFF Research Database (Denmark)

    Bhutta, Zulfiqar A; Berkley, James A; Bandsma, Robert H J

    2017-01-01

    The main forms of childhood malnutrition occur predominantly in children middle-income countries and include stunting, wasting and kwashiorkor, of which severe wasting and kwashiorkor are commonly referred to as severe acute malnutrition. Here, we use...... nutritional status and suboptimal nutritional intake in infancy and early childhood. Children with severe malnutrition have an increased risk of serious illness and death, primarily from acute infectious diseases. International growth standards are used for the diagnosis of severe malnutrition and provide...... and metabolic functions in children with malnutrition is challenging, and children remain at high risk of relapse and death. Further research is urgently needed to improve our understanding of the pathophysiology of severe malnutrition, especially the mechanisms causing kwashiorkor, and to develop new...

  8. Currency flaw severity. [Banknotes

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, C.; Burnett, M.; Goodman, C.; Sherrod, R.; Schmoyer, R.; Harrison, C.; Uppuluri, R.

    1986-01-01

    A survey of currency flaw severity was carried out using 300 banknotes and 37 judges. Each judge assigned each note to one of five flaw severity categories. These categories correspond to severity grades of 1 to 5 with 1 equivalent to ''always accepted'' and 5 ''never accepted.'' An average flaw severity grade for each note was obtained by taking the mean of the severity grades assigned to that note by the 37 judges. Thus, each note has a single numerical real-number flaw grade between 1 and 5. Mathematical modeling of the currency flaw survey results is continuing with some very promising initial results. Our present model handles common excess ink and missing ink flaw types quite well. We plan to extend the model to ink level, mash, setoff and blanket impression flaw types.

  9. Avaliação da densitometria óssea de tecido ósseo neoformado após distração osteogênica mandibular Evaluation of the neoformed osseous densitry after mandibular osteogenic distraction

    Directory of Open Access Journals (Sweden)

    Maria Tereza Moura de Oliveira

    2006-02-01

    Full Text Available OBJETIVO: avaliar radiograficamente a qualidade óssea no local da distração osteogênica. METODOLOGIA: vinte ratos foram divididos em 2 grupos: Distração Osteogênica (DO e Controle (C. Os animais do grupo DO foram submetidos à osteotomia da mandíbula, fixação de um aparelho distrator e aplicação de força de distração osteogênica. Os animais do grupo C serviram como controle para a avaliação do tecido ósseo produzido pela técnica da distração osteogênica. As mandíbulas desses animais foram segmentadas transversalmente, tiveram seus segmentos separados em 2,5mm de forma aguda no ato cirúrgico e fixados nessa posição. Nos 2 grupos, os animais foram sacrificados com 2 e 6 semanas após o término da DO (5 animais em cada período. As mandíbulas foram radiografadas simultaneamente, sobre o mesmo filme radiográfico. As imagens obtidas foram digitalizadas e submetidas à análise de densitometria óssea. RESULTADOS E CONCLUSÕES: os grupos DO e C não apresentaram diferenças estatísticas na neoformação óssea nos períodos analisados. As mandíbulas dos dois grupos apresentaram consolidação incompleta na segunda semana e consolidação completa 6 semanas após a distração osteogênica e estabilização. As diferenças encontradas entre esses dois períodos foram significativas apenas para o grupo DO.AIM: radiograph evaluation of osteogeneous distraction sites. METHODS: twenty rats were divided in 2 groups: Osteogeneous Distraction (OD and Control (C. The animals of the OD group were subjected to mandibular osteotomy, fixation of a distractor device and application of osteogenic distraction force. Rats of the C groups were used as control on the evaluation of the osseous tissue formed from the osteogeneous distraction technique. These animals mandible (C group were transversely segmented, the segments were acurately separeted one from other in 2,5mm and then fixed in position. The animals of both groups were

  10. Severe accident insights report

    International Nuclear Information System (INIS)

    Pratt, W.T.

    1988-04-01

    This report describes the conditions and events that nuclear power plant personnel may encounter during the latter stages of a severe core damage accident and what the consequences might be of actions they may take during these latter stages. The report also describes what can be expected of the performance of the key barriers to fission product release (primarily containment systems), what decisions the operating staff may face during the course of a severe accident, and what could result from these decisions based on our current state of knowledge of severe accident phenomena. 9 refs

  11. Severe malaria in Europe

    DEFF Research Database (Denmark)

    Kurth, Florian; Develoux, Michel; Mechain, Matthieu

    2017-01-01

    BACKGROUND: Malaria remains one of the most serious infections for travellers to tropical countries. Due to the lack of harmonized guidelines a large variety of treatment regimens is used in Europe to treat severe malaria. METHODS: The European Network for Tropical Medicine and Travel Health (Trop......Net) conducted an 8-year, multicentre, observational study to analyse epidemiology, treatment practices and outcomes of severe malaria in its member sites across Europe. Physicians at participating TropNet centres were asked to report pseudonymized retrospective data from all patients treated at their centre...... for microscopically confirmed severe Plasmodium falciparum malaria according to the 2006 WHO criteria. RESULTS: From 2006 to 2014 a total of 185 patients with severe malaria treated in 12 European countries were included. Three patients died, resulting in a 28-day survival rate of 98.4%. The majority of infections...

  12. Allergy in severe asthma.

    Science.gov (United States)

    Del Giacco, S R; Bakirtas, A; Bel, E; Custovic, A; Diamant, Z; Hamelmann, E; Heffler, E; Kalayci, Ö; Saglani, S; Sergejeva, S; Seys, S; Simpson, A; Bjermer, L

    2017-02-01

    It is well recognized that atopic sensitization is an important risk factor for asthma, both in adults and in children. However, the role of allergy in severe asthma is still under debate. The term 'Severe Asthma' encompasses a highly heterogeneous group of patients who require treatment on steps 4-5 of GINA guidelines to prevent their asthma from becoming 'uncontrolled', or whose disease remains 'uncontrolled' despite this therapy. Epidemiological studies on emergency room visits and hospital admissions for asthma suggest the important role of allergy in asthma exacerbations. In addition, allergic asthma in childhood is often associated with severe asthma in adulthood. A strong association exists between asthma exacerbations and respiratory viral infections, and interaction between viruses and allergy further increases the risk of asthma exacerbations. Furthermore, fungal allergy has been shown to play an important role in severe asthma. Other contributing factors include smoking, pollution and work-related exposures. The 'Allergy and Asthma Severity' EAACI Task Force examined the current evidence and produced this position document on the role of allergy in severe asthma. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Severe hypothyroidism masquerading as renal impairment

    DEFF Research Database (Denmark)

    Bistrup, C; Jensen, Dorte Møller; Kvetny, J

    1996-01-01

    A case of severe hypothyroidism in a 51-year old male is presented. The patient was especially complaining of weakness, stiffness and moderate pain in the proximal muscle groups together with rhinorrhea and nasal stenosis. Because of severely elevated S-creatine-kinase combined with reduced...

  14. Severe childhood malnutrition.

    Science.gov (United States)

    Bhutta, Zulfiqar A; Berkley, James A; Bandsma, Robert H J; Kerac, Marko; Trehan, Indi; Briend, André

    2017-09-21

    The main forms of childhood malnutrition occur predominantly in children malnutrition. Here, we use the term 'severe malnutrition' to describe these conditions to better reflect the contributions of chronic poverty, poor living conditions with pervasive deficits in sanitation and hygiene, a high prevalence of infectious diseases and environmental insults, food insecurity, poor maternal and fetal nutritional status and suboptimal nutritional intake in infancy and early childhood. Children with severe malnutrition have an increased risk of serious illness and death, primarily from acute infectious diseases. International growth standards are used for the diagnosis of severe malnutrition and provide therapeutic end points. The early detection of severe wasting and kwashiorkor and outpatient therapy for these conditions using ready-to-use therapeutic foods form the cornerstone of modern therapy, and only a small percentage of children require inpatient care. However, the normalization of physiological and metabolic functions in children with malnutrition is challenging, and children remain at high risk of relapse and death. Further research is urgently needed to improve our understanding of the pathophysiology of severe malnutrition, especially the mechanisms causing kwashiorkor, and to develop new interventions for prevention and treatment.

  15. [Severe childhood atopic dermatitis].

    Science.gov (United States)

    Mahfoudh, Anis; Zaraa, Inès; Amara, Thouraya; Zribi, Hela; El Euch, Dalenda; Mokni, Mourad; Ben Osman, Amel

    2014-04-01

    Atopic dermatitis (AD) is a chronic relapsing eczematous skin disease. It represents one of the symptoms of atopic diathesis. DA affects usually infants and children. aim : The aim of our study is to draw up the epidemiological, clinical features, treatment and outcome of severe childhood AD through a hospital series. methods: A retrospective study of 24 cases of severe childhood AD hospitalized in the Dermatology Department of La Rabta hospital of Tunis was conducted during a 28 year-period (1981 - 2009). results: The hospital incidence of severe childhood AD was 0,085‰. Patient's mean age at the beginning was 14 months. The sex ratio H/F was 1.66. Cutaneous manifestations occurred preferentially in face (75%). Generalized eczema was observed in 37.5% of cases. Pruritus and xerosis were constant. The mean duration of hospitalization was 11 days. Topical corticosteroids was the most effective method of treating severe DA, associated with antiseptic solutions emollient and antihistaminic drugs. Infectious complications were noted in 50% of cases. Ocular complications were observed in 16.7% of cases. Recurrences were reported in 9 cases. Conclusion :AD is an inflammatory, chronically relapsing, and pruritic skin disorder developing in a xerotic skin. Severe AD in childhood is rare in Tunisia. It requires a good understanding of therapeutic modalities by the patient and his family. It is a cause of important morbidity and it may have a bad impact on quality of life.

  16. Epidemiology of severe sepsis

    Science.gov (United States)

    Mayr, Florian B; Yende, Sachin; Angus, Derek C

    2014-01-01

    Severe sepsis is a leading cause of death in the United States and the most common cause of death among critically ill patients in non-coronary intensive care units (ICU). Respiratory tract infections, particularly pneumonia, are the most common site of infection, and associated with the highest mortality. The type of organism causing severe sepsis is an important determinant of outcome, and gram-positive organisms as a cause of sepsis have increased in frequency over time and are now more common than gram-negative infections. Recent studies suggest that acute infections worsen pre-existing chronic diseases or result in new chronic diseases, leading to poor long-term outcomes in acute illness survivors. People of older age, male gender, black race, and preexisting chronic health conditions are particularly prone to develop severe sepsis; hence prevention strategies should be targeted at these vulnerable populations in future studies. PMID:24335434

  17. Severe Combined Immunodeficiency Disorders.

    Science.gov (United States)

    Chinn, Ivan K; Shearer, William T

    2015-11-01

    Severe combined immunodeficiency disorders represent pediatric emergencies due to absence of adaptive immune responses to infections. The conditions result from either intrinsic defects in T-cell development (ie, severe combined immunodeficiency disease [SCID]) or congenital athymia (eg, complete DiGeorge anomaly). Hematopoietic stem cell transplant provides the only clinically approved cure for SCID, although gene therapy research trials are showing significant promise. For greatest survival, patients should undergo transplant before 3.5 months of age and before the onset of infections. Newborn screening programs have yielded successful early identification and treatment of infants with SCID and congenital athymia in the United States. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Severe malaria in Europe

    DEFF Research Database (Denmark)

    Kurth, Florian; Develoux, Michel; Mechain, Matthieu

    2017-01-01

    BACKGROUND: Malaria remains one of the most serious infections for travellers to tropical countries. Due to the lack of harmonized guidelines a large variety of treatment regimens is used in Europe to treat severe malaria. METHODS: The European Network for Tropical Medicine and Travel Health (Trop......Net) conducted an 8-year, multicentre, observational study to analyse epidemiology, treatment practices and outcomes of severe malaria in its member sites across Europe. Physicians at participating TropNet centres were asked to report pseudonymized retrospective data from all patients treated at their centre...

  19. Comparação entre a hidroxiapatita porosa de coral e o enxerto ósseo autógeno em coelhos Comparison between coralline porus hidroxyapatite and osseous xenograft in rabbits

    Directory of Open Access Journals (Sweden)

    Arthur Silveira de Figueiredo

    1997-06-01

    Full Text Available O objetivo da pesquisa é a utilização da hidroxiapatita porosa de coral, como um xenoenxerto ósseo. Utilizou-se onze coelhos da raça Nova Zelândia, nos quais fez-se defeito padrão nas metáfises femorais distais. Nesses locais praticou-se o implante de hidroxiapatita porosa de coral ou enxerto ósseo autógeno. Fez-se estudo clínico, macroscópico, exames radiológicos e histológicos em intervalos de duas, quatro e doze semanas. Os resultados comparativos foram similares enter dois tipos de implantes. Concluiu-se que a hidroxiapatita porosa de coral é um substituto adequado para enxertos ósseos autógenos em coelhos.The purpose is to utilize coralline porous hydroxyapatite as osseous xenograft. It was utilized eleven New Zeland rabbits, wich it made pattern defect in the distal femoral mataphise. In this place was used coralline porous hidroxyapatite or autogenous graft. It was made clinical, macroscopic, radiologic and histologic study, with interval of two, four and twelve weeks. The comparatives results was similaries between the two implants types. It was concluded taht coralline porous hidroxyapatite is appropriate replacement for osseos autogenous grafts in rabbits.

  20. Severe storms forecast systems

    Science.gov (United States)

    Kaplan, M.; Zack, J.

    1980-01-01

    Two research tasks are described: (1) the improvement and enhancement of an existing mesoscale numerical simulation system, and (2) numerical diagnostic studies associated with an individual case of severe storm development (April 10, 1979 in the Red River Valley of Texas and Oklahoma).

  1. The Severe Cardiorenal Syndrome

    NARCIS (Netherlands)

    Bongartz, L.G.

    2011-01-01

    In this thesis we investigated the interactions between heart and kidneys in disease in a longitudinal and integrative fashion. We developed two different rat models of the Severe Cardiorenal Syndrome and studied the effects of different interventions on progression of cardiorenal failure and on

  2. Dengue and Severe Dengue

    Science.gov (United States)

    ... both human health and the global and national economies. Before 1970, only 9 countries had experienced severe dengue epidemics. The disease is now endemic in more than 100 countries in the WHO regions of Africa, the Americas, the Eastern Mediterranean, South-East Asia ...

  3. Asthma heterogeneity and severity

    OpenAIRE

    Carr, Tara F.; Bleecker, Eugene

    2016-01-01

    Asthma is a common, chronic inflammatory airways disease characterized by a clinical syndrome of bronchial hyperresponsiveness, inflammation, and reversible airflow obstruction. Individuals with asthma can vary widely in clinical presentation, severity, and pathobiology. The incident factors, pathogenesis, prognosis, and treatment of asthma remain incompletely understood. Utilizing measurable characteristics of asthmatic patients, including demographic, physiologic, and biologic markers, can ...

  4. Imitators of severe preeclampsia.

    Science.gov (United States)

    Sibai, Baha M

    2007-04-01

    There are several obstetric, medical, and surgical disorders that share many of the clinical and laboratory findings of patients with severe preeclampsia-hemolysis, elevated liver enzymes, and low platelets syndrome. Imitators of severe preeclampsia-hemolysis, elevated liver enzymes, and low platelets syndrome are life-threatening emergencies that can develop during pregnancy or in the postpartum period. These conditions are associated with high maternal mortality, and survivors may face long-term sequelae. Perinatal mortality and morbidity also remain high in many of these conditions. The pathophysiologic abnormalities in many of these disorders include thrombotic microangiopathy, thrombocytopenia, and hemolytic anemia. Some of these disorders include acute fatty liver of pregnancy, thrombotic thrombocytopenic purpura, hemolytic uremic syndrome, and acute exacerbation of systemic lupus erythematosus. Because of the rarity of these conditions during pregnancy and postpartum, the available literature includes only case reports and case series describing these syndromes. Consequently, there are no systematic reviews or randomized trials on these subjects. Differential diagnosis may be difficult due to the overlap of several clinical and laboratory findings of these syndromes. It is important that the clinician make the accurate diagnosis when possible because the management and complications from these syndromes may be different. For example, severe preeclampsia and acute fatty liver of pregnancy are treated by delivery, whereas it is possible to continue pregnancy in those with thrombotic thrombocytopenic purpura-hemolytic uremic syndrome and exacerbation of systemic lupus erythematosus. This review focuses on diagnosis, management, and counseling of women who develop these syndromes based on results of recent studies.

  5. CANDU safety under severe accidents

    International Nuclear Information System (INIS)

    Snell, V.G.; Howieson, J.Q.; Alikhan, S.; Frescura, G.M.; King, F.; Rogers, J.T.; Tamm, H.

    1996-01-01

    The characteristics of the CANDU reactor relevant to severe accidents are set first by the inherent properties of the design, and second by the Canadian safety/licensing approach. The pressure-tube concept allows the separate, low-pressure, heavy-water moderator to act as a backup heat sink even if there is no water in the fuel channels. Should this also fail, the calandria shell itself can contain the debris, with heat being transferred to the water-filled shield tank around the core. Should the severe core damage sequence progress further, the shield tank and the concrete reactor vault significantly delay the challenge to containment. Furthermore, should core melt lead to containment overpressure, the containment behaviour is such that leaks through the concrete containment wall reduce the possibility of catastrophic structural failure. The Canadian licensing philosophy requires that each accident, together with failure of each safety system in turn, be assessed (and specified dose limits met) as part of the design and licensing basis. In response, designers have provided CANDUs with two independent dedicated shutdown systems, and the likelihood of Anticipated Transients Without Scram is negligible. Probabilistic safety assessment studies have been performed on operating CANDU plants, and on the 4 x 880 MW(e) Darlington station now under construction; furthermore a scoping risk assessment has been done for a CANDU 600 plant. They indicate that the summed severe core damage frequency is of the order of 5 x 10 -6 /year. 95 refs, 3 tabs

  6. Antigen Loading (e.g., Glutamic Acid Decarboxylase 65 of Tolerogenic DCs (tolDCs Reduces Their Capacity to Prevent Diabetes in the Non-Obese Diabetes (NOD-Severe Combined Immunodeficiency Model of Adoptive Cotransfer of Diabetes As Well As in NOD Mice

    Directory of Open Access Journals (Sweden)

    David P. Funda

    2018-02-01

    Full Text Available Tolerogenic DCs (tolDCs are being researched as a promising intervention strategy also in autoimmune diseases including type 1 diabetes (T1D. T1D is a T-cell-mediated, organ-specific disease with several well-defined and rather specific autoantigens, i.e., proinsulin, insulin, glutamic acid decarboxylase 65 (GAD65, that have been used in animal as well as human intervention trials in attempts to achieve a more efficient, specific immunotherapy. In this study, we have tested tolerogenic DCs for their effectiveness to prevent adoptive transfer of diabetes by diabetogenic splenocytes into non-obese diabetes (NOD-severe combined immunodeficiency (NOD-SCID recipients. While i.p. application of tolDCs prepared from bone marrow of prediabetic NOD mice by vitamin D2 and dexamethasone significantly reduced diabetes transfer into the NOD-SCID females, this effect was completely abolished when tolDCs were loaded with the mouse recombinant GAD65, but also with a control protein—ovalbumin (OVA. The effect was not dependent on the presence of serum in the tolDC culture. Similar results were observed in NOD mice. Removal of possible bystander antigen-presenting cells within the diabetogenic splenocytes by negative magnetic sorting of T cells did not alter this surprising effect. Tolerogenic DCs loaded with an immunodominant mouse GAD65 peptide also displayed diminished diabetes-preventive effect. Tolerogenic DCs were characterized by surface maturation markers (CD40, CD80, CD86, MHC II and the lipopolysaccharide stability test. Data from alloreactive T cell proliferation and cytokine induction assays (IFN-γ did not reveal the differences observed in the diabetes incidence. Migration of tolDCs, tolDCs-GAD65 and tolDCs-OVA to spleen, mesenteric- and pancreatic lymph nodes displayed similar, mucosal pattern with highest accumulation in pancreatic lymph nodes present up to 9 days after the i.p. application. These data document that mechanisms by which tol

  7. Management of severe hypospadias

    Directory of Open Access Journals (Sweden)

    Massimo Catti

    2008-01-01

    Full Text Available Many classifications of hypospadias have been published, mainly based on the position of the ectopic meatus, which is an insufficient criterion to define the severity of this malformation. What really marks the proximal landmark of this malformation is the level of division of the corpus spongiosum, which is always proximal to the ectopic meatus. In this article, we will focus on the most severe forms of hypospadias which include those with a proximal division of corpus spongiosum (below the midshaft, important chordee and a poor development of the ventral radius, reflecting a marked hypovirilization of the genital tubercle, and cripple hypospadias resulting from several previous failed surgical procedures. The principle of hypospadias surgery will be reviewed together with the outcome of the current surgical techniques. Furthermore, common complications will be outlined. There is no minor or major hypospadias and all forms require a solid experience of the surgeon, as minor looking hypospadias may turn out to be far more complex to repair than they appear once the ventral radius of the penis has been dissected.

  8. Epidemiology of severe trauma.

    Science.gov (United States)

    Alberdi, F; García, I; Atutxa, L; Zabarte, M

    2014-12-01

    Major injury is the sixth leading cause of death worldwide. Among those under 35 years of age, it is the leading cause of death and disability. Traffic accidents alone are the main cause, fundamentally in low- and middle-income countries. Patients over 65 years of age are an increasingly affected group. For similar levels of injury, these patients have twice the mortality rate of young individuals, due to the existence of important comorbidities and associated treatments, and are more likely to die of medical complications late during hospital admission. No worldwide, standardized definitions exist for documenting, reporting and comparing data on severely injured trauma patients. The most common trauma scores are the Abbreviated Injury Scale (AIS), the Injury Severity Score (ISS) and the Trauma and Injury severity Score (TRISS). Documenting the burden of injury also requires evaluation of the impact of post-trauma impairments, disabilities and handicaps. Trauma epidemiology helps define health service and research priorities, contributes to identify disadvantaged groups, and also facilitates the elaboration of comparable measures for outcome predictions. Copyright © 2014 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  9. Preparedness for severe malaria.

    Science.gov (United States)

    Heggheim, Åsmund; Blomberg, Bjørn; Mørch, Kristine

    2015-03-24

    About 60 patients with malaria are admitted to Norwegian hospitals every year. The prescription figures for malaria medication may suggest that Norwegians are increasingly exposed to malaria infection. All Norwegian hospitals with a department of internal medicine were sent an electronic questionnaire for reporting the available methods for diagnosing and treating malaria. There was a 100% response (48/48). Microscopy for malaria diagnosis was available at 92% (44/48) and a rapid test for detecting malaria antigen at 67% (32/48), while 6% (3/48) had no malaria detection test available. Artesunate and quinine for intravenous treatment were both available at 6% (3/48), only artesunate at 27% (13/48) and only quinine at 27% (13/48) of the hospitals. Drugs for intravenous treatment of severe malaria were not available at 40% (19/48) of the hospitals. More than a third of Norwegian hospitals lack preparedness for treating severe malaria, and some hospitals lack diagnostic procedures. Severe malaria is a condition that may rapidly become life-threatening and is treated with artesunate or quinine intravenously. All Norwegian hospitals should have procedures for emergency treatment of the disease.

  10. Several real variables

    CERN Document Server

    Kantorovitz, Shmuel

    2016-01-01

    This undergraduate textbook is based on lectures given by the author on the differential and integral calculus of functions of several real variables. The book has a modern approach and includes topics such as: •The p-norms on vector space and their equivalence •The Weierstrass and Stone-Weierstrass approximation theorems •The differential as a linear functional; Jacobians, Hessians, and Taylor's theorem in several variables •The Implicit Function Theorem for a system of equations, proved via Banach’s Fixed Point Theorem •Applications to Ordinary Differential Equations •Line integrals and an introduction to surface integrals This book features numerous examples, detailed proofs, as well as exercises at the end of sections. Many of the exercises have detailed solutions, making the book suitable for self-study. Several Real Variables will be useful for undergraduate students in mathematics who have completed first courses in linear algebra and analysis of one real variable.

  11. Several crimes solved

    CERN Document Server

    Relations with the Host States Service

    2007-01-01

    A member of a contractor's personnel suspected of having committed several thefts in and around Building 180 has recently been questioned by the French police. He was immediately tried by the court in Bourg-en-Bresse and sentenced to six months in prison, with a requirement to serve at least three months. His arrest was facilitated, among other things, by a video recording, fast and detailed statements to the CERN Fire Brigade and close collaboration between the members of the personnel concerned, the Reception and Access Control Service and the police. Several laptops and other items of electronic equipment were seized during a search of the culprit's home. A stolen digital camera has yet to be returned to its owner as he has not reported the theft to the CERN Fire Brigade and the police. The person concerned is therefore requested to go to the Gendarmerie in Saint-Genis-Pouilly with the necessary proof of ownership. In addition, the French authorities have informed CERN that the presumed authors of the a...

  12. One reason, several logics

    Directory of Open Access Journals (Sweden)

    Evandro Agazzi

    2011-06-01

    Full Text Available Humans have used arguments for defending or refuting statements long before the creation of logic as a specialized discipline. This can be interpreted as the fact that an intuitive notion of "logical consequence" or a psychic disposition to articulate reasoning according to this pattern is present in common sense, and logic simply aims at describing and codifying the features of this spontaneous capacity of human reason. It is well known, however, that several arguments easily accepted by common sense are actually "logical fallacies", and this indicates that logic is not just a descriptive, but also a prescriptive or normative enterprise, in which the notion of logical consequence is defined in a precise way and then certain rules are established in order to maintain the discourse in keeping with this notion. Yet in the justification of the correctness and adequacy of these rules commonsense reasoning must necessarily be used, and in such a way its foundational role is recognized. Moreover, it remains also true that several branches and forms of logic have been elaborated precisely in order to reflect the structural features of correct argument used in different fields of human reasoning and yet insufficiently mirrored by the most familiar logical formalisms.

  13. Artemether for severe malaria.

    Science.gov (United States)

    Esu, Ekpereonne; Effa, Emmanuel E; Opie, Oko N; Uwaoma, Amirahobu; Meremikwu, Martin M

    2014-09-11

    In 2011 the World Health Organization (WHO) recommended parenteral artesunate in preference to quinine as first-line treatment for people with severe malaria. Prior to this recommendation, many countries, particularly in Africa, had begun to use artemether, an alternative artemisinin derivative. This review evaluates intramuscular artemether compared with both quinine and artesunate. To assess the efficacy and safety of intramuscular artemether versus any other parenteral medication in treating severe malaria in adults and children. We searched the Cochrane Infectious Diseases Group Specialized Register, CENTRAL (The Cochrane Library), MEDLINE, EMBASE and LILACS, ISI Web of Science, conference proceedings and reference lists of articles. We also searched the WHO clinical trial registry platform, ClinicalTrials.gov and the metaRegister of Controlled Trials (mRCT) for ongoing trials up to 9 April 2014. Randomized controlled trials (RCTs) comparing intramuscular artemether with intravenous or intramuscular antimalarial for treating severe malaria. The primary outcome was all-cause death.Two authors independently assessed trial eligibility, risk of bias and extracted data. We summarized dichotomous outcomes using risk ratios (RR) and continuous outcomes using mean differences (MD), and presented both measures with 95% confidence intervals (CI). Where appropriate, we combined data in meta-analyses and assessed the quality of the evidence using the GRADE approach. We included 18 RCTs, enrolling 2662 adults and children with severe malaria, carried out in Africa (11) and in Asia (7). Artemether versus quinine For children in Africa, there is probably little or no difference in the risk of death between intramuscular artemether and quinine (RR 0.96, 95% CI 0.76 to 1.20; 12 trials, 1447 participants, moderate quality evidence). Coma recovery may be about five hours shorter with artemether (MD -5.45, 95% CI -7.90 to -3.00; six trials, 358 participants, low quality evidence

  14. Measurement by phase severance

    International Nuclear Information System (INIS)

    Noyes, H.P.

    1987-03-01

    It is claimed that the measurement process is more accurately described by ''quasi-local phase severance'' than by ''wave function collapse''. The approach starts from the observation that the usual route to quantum mechanics starting from the Hamilton-Jacobi equations throws away half the degrees of freedom, namely, the classical initial state parameters. To overcome this difficulty, the full set of Hamilton-Jacobi equations is interpreted as operator equations acting on a state vector. The measurement theory presented is based on the conventional S-matrix boundary condition of N/sub A/ free particles in the distant past and N/sub B/ free particles in the distant future and taking the usual free particle wave functions, multiplied by phase factors

  15. LEAD SEVERING CONTRIVANCE

    Science.gov (United States)

    Widmaier, W.

    1958-04-01

    A means for breaking an electrical circuit within an electronic tube during the process of manufacture is described. Frequently such circuits must be employed for gettering or vapor coating purposes, however, since an external pair of corector pins having no use after manufacture, is undesirable, this invention permits the use of existing leads to form a temporary circuit during manufacture, and severing it thereafter. One portion of the temporary circuit, made from a springy material such as tungsten, is spot welded to a fusable member. To cut the circuit an external radiant heat source melts the fusable member, allowing the tensed tungsten spring to contract and break the circuit. This inexpensive arrangement is particularly useful when the tube has a great many external leads crowded into the tube base.

  16. Several Mediological Principles

    Directory of Open Access Journals (Sweden)

    Alexandra Crăciun

    2011-01-01

    Full Text Available The article presents several new perspectives on the contemporary civilization provided by means of a new discipline entitled “Mediology”. This new science that the French professor Regis Debray proposes presents the characteristics of the contemporary society in relation to models of some previous stages. This article proposes a critical perspective on the model proposed by Regis Debray as compared to other sources envisaging the analysis of the evolution of the cultural models in time, such as, for instance, the perspective proposed by Giambattista Vico on the evolution of the linguistic and cultural codes. The aim of the article is that of providing an integrated perspective, allowing a better understanding of the changes underlying the informational society.

  17. Severe Measles Infection

    Science.gov (United States)

    Rafat, Cédric; Klouche, Kada; Ricard, Jean-Damien; Messika, Jonathan; Roch, Antoine; Machado, Sonia; Sonneville, Romain; Guisset, Olivier; Pujol, Wilfried; Guérin, Claude; Teboul, Jean-Louis; Mrozek, Natacha; Darmon, Michaël; Chemouni, Frank; Schmidt, Matthieu; Mercier, Emmanuelle; Dreyfuss, Didier

    2013-01-01

    Abstract France has recently witnessed a nationwide outbreak of measles. Data on severe forms of measles in adults are lacking. We sought to describe the epidemiologic, clinical, treatment, and prognostic aspects of the disease in adult patients who required admission to an intensive care unit (ICU). We performed a retrospective analysis of a cohort of 36 adults admitted to a total of 64 ICUs throughout France for complications of measles from January 1, 2009, to December 31, 2011. All cases of measles were confirmed by serologic testing and/or reverse transcription polymerase chain reaction. The cohort consisted of 21 male and 15 female patients, with a median age of 29.2 years (25th–75th interquartile range [IQR], 27.2–34.2 yr) and a median Simplified Acute Physiology Score (SAPS II) of 13 (IQR, 9–18). Among the 26 patients whose measles vaccination status was documented, none had received 2 injections. One patient had developed measles during childhood. Underlying comorbid conditions included chronic respiratory disease in 9 patients, immunosuppression in 7 patients, and obesity in 3 patients, while measles affected 5 pregnant women. Respiratory complications induced by measles infection led to ICU admission in 32 cases, and measles-related neurologic complications led to ICU admission in 2 cases. Two patients were admitted due to concurrent respiratory and neurologic complications. Bacterial superinfection of measles-related airway infection was suspected in 28 patients and was documented in 8. Four cases of community-acquired pneumonia, 6 cases of ventilator-associated pneumonia, 1 case of tracheobronchitis, and 2 cases of sinusitis were microbiologically substantiated. Of 11 patients who required mechanical ventilation, 9 developed acute respiratory distress syndrome (ARDS). Among the patients with ARDS, extraalveolar air leak complications occurred in 4 cases. Five patients died, all of whom were severely immunocompromised. On follow-up, 1 patient had

  18. Nutrition in Severe Dementia

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    Glaucia Akiko Kamikado Pivi

    2012-01-01

    Full Text Available An increasing proportion of older adults with Alzheimer's disease or other dementias are now surviving to more advanced stages of the illness. Advanced dementia is associated with feeding problems, including difficulty in swallowing and respiratory diseases. Patients become incompetent to make decisions. As a result, complex situations may arise in which physicians and families decide whether artificial nutrition and hydration (ANH is likely to be beneficial for the patient. The objective of this paper is to present methods for evaluating the nutritional status of patients with severe dementia as well as measures for the treatment of nutritional disorders, the use of vitamin and mineral supplementation, and indications for ANH and pharmacological therapy.

  19. Metabolic-mineral study in patients with renal calcium lithiasis, severe lithogenic activity and loss of bone mineral density.

    Science.gov (United States)

    Arrabal-Polo, Miguel Angel; Arrabal-Martin, Miguel; Arias-Santiago, Salvador; Garrido-Gomez, Juan; De Haro-Muñoz, Tomas De; Zuluaga-Gomez, Armando

    2012-12-01

    This study assessed the presence of osteoporosis/osteopenia in patients with severe lithogenic activity and compared their metabolisms with those in patients without lithiasis or with mild lithogenic activity. From a sample of 182 patients, those with osteopenia/osteoporosis at the hip and lumbar spine were studied separately in a two-pronged study. 66 patients with bone mineral densities (BMDs) lithiasis (n = 15); group A2 with lithiasis and mild lithogenic activity (n = 22); and group A3 with lithiasis and severe lithogenic activity (n = 29). Similarly, 86 patients with BMDs lithiasis (n = 15); group B2 with lithiasis and mild lithogenic activity (n = 29); and group B3 with lithiasis and severe lithogenic activity (n = 42). Patients from group A3 exhibited significantly higher levels of bone remodelling markers as compared to groups A1 and A2. Urinalysis also revealed higher excretion of calcium in 24-hour assessments in this group. Patients from group B3 differed from groups B1 and B2 mainly in bone remodelling markers and 24-hour urinary calcium excretion, which were significantly elevated in patients from group B3. Patients with calcium lithiasis and severe lithogenic activity in addition to osteopenia/osteoporosis present with higher levels of hypercalciuria and negative osseous balance, which possibly perpetuate and favour lithiasic activity.

  20. Muscle pedicle bone grafting using the anterior one-third of the gluteus medius attached to the greater trochanter for treatment of Association Research Circulation Osseous stage II osteonecrosis of the femoral head.

    Science.gov (United States)

    Cho, Kyu-Jin; Park, Kyung-Soon; Yoon, Taek-Rim

    2018-02-24

    The aim of this study was to evaluate the effectiveness of our technique on further collapse of the femoral head in Association Research Circulation Osseous (ARCO) stage II, patient's functional improvements, and analyze the survival rate of the affected hip. Between June 2007 and March 2015, 24 hips diagnosed with osteonecrosis of the femoral head (ONFH) were treated with our muscle pedicle bone grafting (MPBG) technique using anterior one-third of gluteus medius attached to the greater trochanter. The group was consisted of 15 men and eight women, mean age of 36 years at the time of surgery. Mean follow-up was 6.2 years. Four hips showed regeneration, 11 hips showed no progression, and nine hips showed slight extent of the lesion. But during the follow-up, three hips underwent total hip arthroplasty at the mean follow-up of 5.8 years after the surgery. The survival rate at the last follow-up was approximately 87.5%. Excluding the three failed cases, the mean total Harris hip score was improved from 57.2 to 82.3 points (p < 0.05). We had no case of complications such as limping, numbness, wound infection, heterotopic ossification, nor intra- and post-operative fracture. We showed 87.5% of survival rate by average of 6.2-year follow-up, maximum of 10.1 years. And compared to other reports, our technique showed relatively good results. In the short term, our modified MPBG technique seems to be effective in ARCO stage II ONFH. We, therefore, suggest this technique as one of the promising treatments of choices for patients with ARCO stage II ONFH.

  1. Bariatric surgery for severe obesity.

    Science.gov (United States)

    Sugerman, H J

    2001-07-01

    Severe obesity is associated with multiple comorbidities and is refractory to dietary management with or without behavioral or drug therapies. There are a number of surgical procedures for the treatment of morbid obesity, including purely gastric restrictive, a combination of malabsorption and gastric restriction or primary malabsorption. The purely gastric restrictive procedures, including vertical banded gastroplasty and laparoscopic adjustable silicone gastric banding, do not provide adequate weight loss. African-American patients do especially poorly after the banding procedure with the loss of only 11% of excess weight in one study. Gastric bypass (GBP) is associated with the loss of 66% of excess weight at 1 to 2 years after surgery, 60% at 5 years and 50% at 10 years. For unknown reasons, African-American patients lose significantly less weight than Caucasians after GBP. There is a risk of micronutrient deficiencies after GBP, including iron deficiency anemia in menstruating women, vitamin B12, and calcium deficiencies. Prophylactic supplementation of these nutrients is necessary. Recurrent vomiting after bariatric surgery may be associated with a severe polyneuropathy and must be aggressively treated with endoscopic dilatation before this complication is allowed to develop. The malabsorptive procedures include the partial biliopancreatic bypass (BPD) and BPD with duodenal switch (BPD/DS). The BPD appears to cause severe protein-calorie malnutrition in American patients; the BPD/DS may be associated with less malnutrition. Weight loss failure after GBP does not respond to tightening a dilated gastrojejunal stoma or reducing the size of the gastric pouch. These patients may require conversion to a malabsorptive distal GBP, similar to the BPD. However, because of the risk of severe protein-calorie malnutrition and calcium deficiency BPD should be reserved for patients with severe obesity comorbidity. The risk of death following bariatric surgery is between 1

  2. Emerging therapies for severe asthma

    Science.gov (United States)

    2011-01-01

    Many patients with asthma have poorly controlled symptoms, and particularly for those with severe disease, there is a clear need for improved treatments. Two recent therapies licensed for use in asthma are omalizumab, a humanized monoclonal antibody that binds circulating IgE antibody, and bronchial thermoplasty, which involves the delivery of radio frequency energy to the airways to reduce airway smooth muscle mass. In addition, there are new therapies under development for asthma that have good potential to reach the clinic in the next five years. These include biological agents targeting pro-inflammatory cytokines such as interleukin-5 and interleukin-13, inhaled ultra long-acting β2-agonists and once daily inhaled corticosteroids. In addition, drugs that block components of the arachidonic acid pathway that targets neutrophilic asthma and CRTH2 receptor antagonists that inhibit the proinflammatory actions of prostaglandin D2 may become available. We review the recent progress made in developing viable therapies for severe asthma and briefly discuss the idea that development of novel therapies for asthma is likely to increasingly involve the assessment of genotypic and/or phenotypic factors. PMID:21896202

  3. Emerging therapies for severe asthma

    Directory of Open Access Journals (Sweden)

    Spears Mark

    2011-09-01

    Full Text Available Abstract Many patients with asthma have poorly controlled symptoms, and particularly for those with severe disease, there is a clear need for improved treatments. Two recent therapies licensed for use in asthma are omalizumab, a humanized monoclonal antibody that binds circulating IgE antibody, and bronchial thermoplasty, which involves the delivery of radio frequency energy to the airways to reduce airway smooth muscle mass. In addition, there are new therapies under development for asthma that have good potential to reach the clinic in the next five years. These include biological agents targeting pro-inflammatory cytokines such as interleukin-5 and interleukin-13, inhaled ultra long-acting β2-agonists and once daily inhaled corticosteroids. In addition, drugs that block components of the arachidonic acid pathway that targets neutrophilic asthma and CRTH2 receptor antagonists that inhibit the proinflammatory actions of prostaglandin D2 may become available. We review the recent progress made in developing viable therapies for severe asthma and briefly discuss the idea that development of novel therapies for asthma is likely to increasingly involve the assessment of genotypic and/or phenotypic factors.

  4. Treatment of severe acute pancreatitis

    Directory of Open Access Journals (Sweden)

    Praznik Ivan

    2014-01-01

    Full Text Available Acute pancreatitis is an acute inflammatory process of the pancreas with variable involvement of other regional tissues or other organ systems. The severe form of the disease occurs in 10-20% of cases, and usually requires prolonged hospitalization due to a frequent local and systemic complications. Additionally, considerable mortality despite diagnostic and therapeutic advances, makes this disease a serious health problem nowadays. The aim of this study was to conduct a review of randomized controlled trials to determine differences in the efficiency between standard methods of treatment for severe acute pancreatitis and new treatment ways in terms of decreased mortality. Search of the 'Medline' database of original scientific papers and systematic review articles was made, using a combination of the following keywords: acute pancreatitis, treatment, mortality. In total 914 papers were found, published in the last 13 years; 14 of 64 randomized controlled clinical trials met the selection criteria and were eligible for inclusion. From a total of 16 papers, the conservative treatment was related to 11, which includes some of the new treatment methods, while the effects of new methods of treatment have been the subject of research in the four studies. Combined endoscopic and surgical treatment was applied in only one study. The largest sample of 290 patients was included in the study with platelet activation factor antagonist, while the smallest sample of 22 patients was used in the study that compared total parenteral with enteral nutrition. Continuous regional arterial infusion of protease inhibitors in combination with antibiotics, intravenous supplementation of alanyl-glutamine dipeptide and the early, high-volume continuous veno-venous hemofiltration showed the best results in the treatment of patients with severe acute pancreatitis. Also, the use of low molecular weight heparin and enteral nutrition significantly reduced mortality.

  5. Reduced False Memory after Sleep

    Science.gov (United States)

    Fenn, Kimberly M.; Gallo, David A.; Margoliash, Daniel; Roediger, Henry L., III; Nusbaum, Howard C.

    2009-01-01

    Several studies have shown that sleep contributes to the successful maintenance of previously encoded information. This research has focused exclusively on memory for studied events, as opposed to false memories. Here we report three experiments showing that sleep reduces false memories in the Deese-Roediger-McDermott (DRM) memory illusion. False…

  6. Relations between soil hydraulic properties and burn severity

    NARCIS (Netherlands)

    Moody, J.A.; Ebel, B.A.; Stoof, C.R.; Nyman, P.; Martin, D.A.; McKinley, R.

    2016-01-01

    Wildfire can affect soil hydraulic properties, often resulting in reduced infiltration. The magnitude of change in infiltration varies depending on the burn severity. Quantitative approaches to link burn severity with changes in infiltration are lacking. This study uses controlled laboratory

  7. Are osseous artefacts a window to perishable material culture? Implications of an unusually complex bone tool from the Late Pleistocene of East Timor.

    Science.gov (United States)

    O'Connor, S; Robertson, G; Aplin, K P

    2014-02-01

    We report the discovery of an unusually complex and regionally unique bone artefact in a Late Pleistocene archaeological assemblage (c. 35 ka [thousands of years ago]) from the site of Matja Kuru 2 on the island of Timor, in Wallacea. The artefact is interpreted as the broken butt of a formerly hafted projectile point, and it preserves evidence of a complex hafting mechanism including insertion into a shaped or split shaft, a complex pattern of binding including lateral stabilization of the cordage within a bilateral series of notches, and the application of mastic at several stages in the hafting process. The artefact provides the earliest direct evidence for the use of this combination of hafting technologies in the wider region of Southeast Asia, Wallacea, Melanesia and Australasia, and is morphologically unparallelled in deposits of any age. By contrast, it bears a close morphological resemblance to certain bone artefacts from the Middle Stone Age of Africa and South Asia. Examination of ethnographic projectile technology from the region of Melanesia and Australasia shows that all of the technological elements observed in the Matja Kuru 2 artefact were in use historically in the region, including the unusual feature of bilateral notching to stabilize a hafted point. This artefact challenges the notion that complex bone-working and hafting technologies were a relatively late innovation in this part of the world. Moreover, its regional uniqueness encourages us to abandon the perception of bone artefacts as a discrete class of material culture, and to adopt a new interpretative framework in which they are treated as manifestations of a more general class of artefacts that more typically were produced on perishable raw materials including wood. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

  8. Towards a Flood Severity Index

    Science.gov (United States)

    Kettner, A.; Chong, A.; Prades, L.; Brakenridge, G. R.; Muir, S.; Amparore, A.; Slayback, D. A.; Poungprom, R.

    2017-12-01

    -economic data, such as population density, infrastructure, urbanization or equivalent information, is required for humanitarian actors to respond properly. In the end, expanded monitoring of floods, improved mitigation measures, but also effective communication of the severity of an event has the potential to reduce loss of life in future flood events.

  9. Severe limb ischemia syndrome.

    Science.gov (United States)

    Suchý, T

    1991-01-01

    In the course of the study of the syndrome of severe limb ischemia (SLI) in a representative clinical material of 300 patients and a number of experimental studies, we arrived to the proposal of this optimal methodical procedure for acute vascular closures of traumatic and non-traumatic origin in the limbs: a) In every injury and sudden pain with a change of the function of the limb, it is necessary to think of the SLI syndrome and to search targetedly for it. b) In injuries connected with bleeding our first-rate task is the control of this bleeding. For a temporary arrest of the bleeding it is necessary to prefer more physiological methods sparing collateral circulation to the still most used tourniquet. For this purpose a new device for temporary hemostasis called Hemostop has proved itself, designed by the author and attested both experimentally and clinically, protected as a Czechoslovak patent. From surgical measures have acquitted themselves from this viewpoint the insertion of vascular clamp, ligature of the vessel or its temporary cannulation. c) To set the diagnosis of SLI, it usually suffices a careful anamnesis and clinical examination, advantageous is the investigation by ultrasound. The angiography because of time consumption should be used only in indicated cases. d) The time factor--"race against the time"--has to be always borne on our mind. It is necessary to achieve the recovery of blood circulation in the limb up to 6 or at the latest up to 10 hours from the onset of injury or closure. e) For shortening of the period of tissue hypoxia it is of advantage to use the temporary cannulation of injured vessels. This should be used always, whenever because of any reasons, it is not possible to execute the final reconstructive operation up to 10 hours since the injury, e. g. in polytraumatism, transport difficulties and the like. f) In isolated vascular injuries without bleeding (about 45%) and in all non-traumatic SLI the patients must be efficiently

  10. Diagnosis of leg osseous infection in diabetics: place of scintigraphy of the polynuclear hydrocarbons labelled by HMPAO-{sup 99m}Tc (HMPAO-LS); Diagnostic de l`infection osseuse du pied chez le diabetique: place de la scintigraphie aux polynucleaires marques a l`HMPAO-Tc 99m (HMPAO-LS)

    Energy Technology Data Exchange (ETDEWEB)

    Devillers, A.; Moisan, A.; Hennion, F.; Poirier, J.Y.; Bourguet, P. [CRLCC Eugene Marquis, Medecine Nucleaire, CHRU Endocrinologie, Rennes (France)

    1997-12-31

    In case of leg infection in diabetics it is difficult to differentiate between a chronic osteopathy, an infection of the soft tissues and an osteomyelitis (OM). We considered of interest to evaluate by a HMPAO-LS prospective study the diagnosis of osteitis in diabetic legs. Twenty seven diabetic (DID type 1 = 11, DNID type 2 = 16) patients (19 M and 8 F, average age 64 years), clinically suspected wit