Miracle-dz/UniFAR-FTUs huggingface dataset:
Atlanto-occipital fusion for dislocation in children with neurologic preservation. A case report.

STUDY DESIGN A retrospective clinical review of patients with atlanto-occipital dislocations. OBJECTIVES To determine if fusion of the occiput to C1 can be accomplished without extension to the axis. SUMMARY OF BACKGROUND DATA Patients with atlanto-occipital dislocations who have preservation of spinal cord function are quite rare. The standard approach to stabilization has been fusion of the occiput to the axis (C2). This may compromise rotation unnecessarily, however. The authors investigated the success of attempting to fuse only the occiput to C1 in children. METHODS Two children with atlanto-occipital dislocation who had normal neurologic function underwent fusion from the occiput to the atlas after reduction. RESULTS Both cases showed successful fusion with no unwanted extension to lower levels. Full head rotation was preserved. CONCLUSIONS This technique restores stability without restricting rotation.
Efficient Assimilation of Lactose Carbon in Premature Infants

Summary Previous studies have shown that there is minimal fecal excretion of carbohydrate energy in premature infants with high breath H2 concentrations, implying that the colon plays an important role in salvaging lactose energy. The present study extends this work by using a stable isotope method for serial assessment of lactose carbon excretion. Thus, in nine premature infants (30–32 weeks of gestation and 11–36 days of age), we conducted 23 longitudinal studies of breath hydrogen concentration and the cumulative fecal excretion of 13C derived from a single dose of [D-1-13C]lactose. The ranges of values (X ± SD) for breath hydrogen concentration and lactose absorption were respectively 4–440 ppm/5% CO2 (92 ± 100) and 82–100% tracer dose (98.4 ± 3.9). In 21 studies, lactose carbon excretion was <2% of the dose. There was a significant correlation between postnatal age and breath hydrogen concentration (R = 0.48; p = 0.02). These studies suggest that colonic fermentation activity is adequate for efficient colonic salvage of lactose even during the second week of life.
Improvement of Renal Function in Type 2 Diabetic Nephropathy

Background. Therapeutic failure in preventing renal disease progression in type 2 diabetic nephropathy (DN) is due to a failure in the early detection of DN by microalbuminuria and the inappropriate correction of renal hemodynamic maladjustment secondary to glomerular endothelial dysfunction. Methods. Thirty patients associated with normoalbuminuric type 2 DN were subject to the following studies: tubular function by means of fractional excretion of magnesium (FE Mg), vascular function by means of determining the circulating endothelial cell, VEGF, VEGF/TGF B ratio, and intrarenal hemodynamic studies. Results. FE Mg, circulating endothelial cells, and TGF B were abnormally elevated, and VEGF/TGF B ratio was decreased in these normoalbuminuric patients. The intrarenal hemodynamic study revealed a hemodynamic maladjustment characterized by a preferential constriction at the efferent arteriole and a reduction in peritubular capillary flow. Following treatment with vasodilators, a decrease in efferent arteriolar resistance and increase in peritubular capillary flow as well as glomerular clearance were observed. Conclusion. FE Mg appears to be a more sensitive marker than microalbuminuria for the early detection of DN. Increased endothelial cell injury is reflected by enhanced circulating endothelial cell loss in conjunction with the increased TGF B and the decreased ratio between VEGF and TGF B. This is further supported by the dysfunctioning glomerular endothelium, which is characterized by hemodynamic maladjustment and a reduction in the peritubular capillary flow. A correction of such hemodynamic maladjustment by multidrug vasodilators effectively improves renal perfusion and restores renal function in type 2 DN.
Gonococcal arthritis

treatment with prazosin, or prazosin plus a beta-blocker. Pape et all report similar findings in 14 patients, of whom 13 had negative ANF tests before and after prazosin and one a positive pretreatment test, which became negative after 18 weeks on prazosin. Marshall points out that his ANF findings are unlike those of systemic lupus erythematosus and that no patient had symptoms of an autoimmune illness. This is in agreement with my experience in 85 patients now treated with prazosin for periods up to five years (total patient years 255). There have never been signs or symptoms indicating an autoimmune reaction, nor have any significant laboratory abnormalities been found.
Familial aggregation of ischemic stroke in young women: the Stroke Prevention in Young Women Study

Background and Purpose: Stroke occurs infrequently in young adults. While a familial basis for older onset stroke is well established, the extent of familial clustering in young‐onset stroke is unknown. To address this issue, we compared the frequency of stroke in relatives of stroke cases to that in relatives of controls across different ages and by stroke subtype. Methods: Through a population‐based case‐control study of stroke, we identified 487 women aged 15–49 years with ischemic stroke and 615 women without stroke matched by age and geographic region. Family history of stroke was collected for 5,749 relatives (parents and siblings) of case and control probands by standardized interview. Results: Strokes were reported in 149 relatives of case patients and 119 relatives of controls. Siblings of stroke case patients had more than four times the risk of stroke compared to siblings of controls (OR, 4.17; 95% CI, 1.9–8.8) and mothers of stroke case patients had twice the risk of stroke compared to mothers of control subjects (OR, 2.02; 95% CI, 1.4–3.0). The association between stroke in probands and family history of stroke was strongest among women aged 15–24 years (OR, 2.5; 95% CI, 0.4–15.1), and diminished with increasing proband age (OR, 1.6; 95% CI, 0.8–3.3 among women 25–34 years and OR, 1.5; 95% CI, 1.1–1.9 among women 35‐‐49 years; P<0.0001 for trend). Conclusions: We conclude that young‐onset stroke aggregates in families and that the magnitude of aggregation increases with decreasing proband age. Genet. Epidemiol. 2006. Published 2006 Wiley‐Liss, Inc.
Asymmetry detection during pathological gait using a plantar pressure sensing system

Foot pain has long been associated with various pathologies of the foot. These common clinical problems often correspond with high plantar pressure, which can lead to severe plantar injury if it is left untreated. The detection of plantar pressure abnormalities is therefore of paramount importance for the diagnosis, early intervention, treatment and prevention of plantar injury. Traditional clinical methods for the diagnosis of plantar pressure abnormalities are predominantly subjective and can be unreliable. This study aimed to utilise sensor shoe-insoles to assess the asymmetry in peak plantar pressure during gait between the left and right feet of individuals with and without known foot pathologies. Outcomes of this study demonstrate that the level of asymmetry is significantly different between the control and pathological population at the third and fourth metatarsophalangeal joints (MPJs) (P <; 0.05). The use of plantar pressure measurement and asymmetry analysis may prove to be effective in the diagnosis and assessment of treatment outcomes for the prevention of foot injury.
Diagnostic accuracy of ultrasonography in the acute assessment of common thoracic lesions after trauma.

BACKGROUND The accuracy of combined clinical examination (CE) and chest radiography (CXR) (CE + CXR) vs thoracic ultrasonography in the acute assessment of pneumothorax, hemothorax, and lung contusion in chest trauma patients is unknown. METHODS We conducted a prospective, observational cohort study involving 119 adult patients admitted to the ED with thoracic trauma. Each patient, secured onto a vacuum mattress, underwent a subsequent thoracic CT scan after first receiving CE, CXR, and thoracic ultrasonography. The diagnostic performance of each method was also evaluated in a subgroup of 35 patients with hemodynamic and/or respiratory instability. RESULTS Of the 237 lung fields included in the study, we observed 53 pneumothoraces, 35 hemothoraces, and 147 lung contusions, according to either thoracic CT scan or thoracic decompression if placed before the CT scan. The diagnostic performance of ultrasonography was higher than that of CE + CXR, as shown by their respective areas under the receiver operating characteristic curves (AUC-ROC): mean 0.75 (95% CI, 0.67-0.83) vs 0.62 (0.54-0.70) in pneumothorax cases and 0.73 (0.67-0.80) vs 0.66 (0.61-0.72) for lung contusions, respectively (all P < .05). In addition, the diagnostic performance of ultrasonography to detect pneumothorax was enhanced in the most severely injured patients: 0.86 (0.73-0.98) vs 0.70 (0.61-0.80) with CE + CXR. No difference between modalities was found for hemothorax. CONCLUSIONS Thoracic ultrasonography as a bedside diagnostic modality is a better diagnostic test than CE and CXR in comparison with CT scanning when evaluating supine chest trauma patients in the emergency setting, particularly for diagnosing pneumothoraces and lung contusions.
Body mass index for chronic hemodialysis patients: Stable hemodialysis and mortality

Abstract Body mass index (BMI) is used as a reference for weight control programs in the general population and in morbidity and mortality studies in diabetes patients. However, the implications of BMI in chronic hemodialysis patients is unclear. We studied the BMI of chronic hemodialysis patients, focusing on problems encountered during outpatient hemodialysis therapy and on 2‐year mortality. Outpatients with chronic hemodialysis (n = 258; 144 men, 114 women) were divided into four groups: (i) patients with stable hemodialysis; (ii) patients with marked hypotension requiring catecholamine infusion during hemodialysis; (iii) patients with excessive interdialysis weight gain requiring occasional additional hemodialysis; and (iv) patients with troublesome hemodialysis due to other causes. The statistical differences between the average BMI among these groups were evaluated, and were subdivided into sex, age and the duration of hemodialysis history. The 2‐year mortality rates of these patients were also studied according to their BMI. In patients under 60 years of age, those with excessive interdialysis weight gain had statistically larger BMI (23.2; n = 35) compared to patients with good hemodialysis control (20.1; n = 178), regardless of gender and hemodialysis history. The mortality rate was at a minimum at approximately 20 BMI in patients under 60 years of age. However, lower BMI was associated with a greater mortality rate in patients 60 years or over. For chronic hemodialysis patients, the BMI associated with stable hemodialysis and minimum mortality is approximately 20, in those under 60 years of age. The BMI of aged hemodialysis patients should be considered separately in morbidity and mortality studies.
Static forces variation and pressure distribution in laryngoscopy performed by straight and curved blades

A theoretical analysis of the forces acting on the laryngoscope during the lifting of the epiglottis is carried out by applying the basic principles of statics. The static model of a laryngoscope equipped with a straight and a curved blade and the forces variation, as a function of the introduction angle and of tissue reaction application point, are described. The pharyngeal tissues and epiglottis pressure distribution on the blade is obtained, with a 1mm2 resolution, by measurements performed in-vitro on a simulation mannequin, using straight and curved blades. The straight blade requires more effort than the curved one to obtain the same visualization of vocal cords, however forces exerted by using a laryngoscope with a curved blade do not vary linearly with the application point of tissue reaction. Average intensity of the tissue reaction has been found in the order of 32±11N. Pressure distribution is maximally concentrated on the tip of curved blades (0.5MPa on 5mm axial length), whereas it is more dispersed on straight blades (0.2MPa on 10mm axial length). The inclination of the handle also influences the effort of the operator: for both blades, from 0rad to 1.57rad, the lifting force shows a total variation of about 13% of the top value, the transversal forces vary less than 6% of the top value.
Transforming growth factor-beta1 as a useful serologic marker of small hepatocellular carcinoma.

BACKGROUND Although alpha-fetoprotein (AFP) is a useful serologic marker of hepatocellular carcinoma (HCC), it has been reported insufficiently sensitive in detecting small HCCs. Plasma transforming growth factor-beta1 (TGFbeta1) has been reported to be elevated in HCC patients compared with liver cirrhosis patients. It has been reported that TGFbeta1 mRNA was overexpressed in HCC, especially in patients with small HCC and well-differentiated HCC compared with patients with liver cirrhosis. The current study investigated the usefulness of TGFbeta1 compared with AFP in the diagnosis of small HCCs. METHODS Thirty-eight patients with small HCC (< or = 3 cm), 31 patients with liver cirrhosis only, and 23 normal volunteers were studied. Using plasma TGFbeta1 and serum AFP levels measured at the time of diagnosis, the sensitivities and specificities were calculated in the diagnosis of small HCCs. RESULTS Plasma TGFbeta1 and serum AFP levels were significantly higher in patients with small HCC than in those with liver cirrhosis. In diagnosing small HCCs, the cut-off values of plasma TGFbeta1 and serum AFP were 800 pg/mL and 200 ng/mL, respectively, where the specificities were over 95%. At the cut-off level of plasma TGFbeta1 and serum AFP, the sensitivities were 68% and 24%, respectively. CONCLUSIONS The current results suggest that TGFbeta1 may be a useful serologic marker in detecting HCCs earlier because it shows higher sensitivity than, with specificity as, AFP in the diagnosis of small HCCs.
Molecular cloning, characterization and brain mapping of the melanocortin 5 receptor in the goldfish

The melanocortin 5 receptor (MC5R) is activated by melanocyte‐stimulating hormones (MSHs) and has a widespread tissue distribution, while its detailed central expression pattern and brain functions are fairly unknown. We report cloning, pharmacological characterization, tissue distribution and detailed brain mapping of melanocortin 5 receptor in goldfish (gMC5R). The goldfish orthologue protein is 69% identical to human MC5R and is conserved in important functional domains. The gMC5R showed similar potency to α‐, β‐ and γ‐MSH peptides in radioligand binding as the mammalian orthologues, while MTII and HS024 were both agonists at this receptor. The gMC5R‐mRNA was found in the peripheral tissues including kidney, spleen, skin and retina, with low expression levels in the intestine, fat, muscle, gill, pituitary and ovary. In situ hybridization studies demonstrated that gMC5R transcripts are widely distributed in the goldfish brain. The gMC5R expression was found in ventral telencephalon, pre‐optic area, dorsal and ventral thalamus, infundibular hypothalamus, posterior tuberculum, tectum and tegmentum mesencephali, reticular formation, vagal and facial lobes and spinal cord. The cloning and characterization of this receptor provides an important tool to elucidate its participation in neuroendocrine and behavioural control.
Pattern of energy expenditure during simulated competition.

PURPOSE To determine how athletes spontaneously use their energetic reserves when the only instruction was to finish in minimal time, and whether experience from repeated performance changes the strategy of recreational athletes. METHODS Recreational road cyclists/speed skaters (N = 9) completed three laboratory time trials of 1500 m on a windload braked cycle. The pattern of energy use was calculated from total work and from the work attributable to aerobic metabolism, which allowed computation of anaerobic energy use. Regional level speed skaters (N = 8) also performed a single 1500-m time trial with the same protocol and measurements. RESULTS The serial trials were completed in (mean +/- SD) 133.8 +/- 6.6, 133.9 +/- 5.8, 133.8 +/- 5.5 s (P > 0.05 among trials); and in 125.7 +/- 10.9 s in the skaters (P < 0.05 vs cyclists). The [OV0312]O(2peak) during the terminal 200 m was similar within trials (3.23 +/- 0.44, 3.34 +/- 0.44, 3.30 +/- 0.51 (P > 0.05)) versus 3.91 +/- 0.68 L.min-1 in the skaters (P < 0.05 vs cyclists). In all events, the initial power output and anaerobic energy use was high and decayed to a more or less constant value ( approximately 25% of peak) over the remainder of the event. Contrary to predictions based on an assumed "all out" starting strategy, the subjects reserved some of their ability to perform anaerobic work for a terminal acceleration. The total work accomplished was not different between trials (43.53, 43.78, and 47.48 kJ in the recreational athletes, or between the cyclists and skaters (47.79 kJ). The work attributable to anaerobic sources was not different between the rides (20.67, 20.53, and 21.12 kJ in the recreational athletes). In the skaters, the work attributable to anaerobic sources was significantly larger versus the cyclists (24.67 kJ). CONCLUSION Energy expenditure during high-intensity cycling seems: 1) to be expended in a manner that allows the athlete to preserve an anaerobic energetic contribution throughout an event, 2) does not appear to have a large learning effect in already well trained cyclists, and 3) anaerobic energy expenditure may be the performance discriminating factor among groups of athletes.
The Contribution of Chemokines and Chemokine Receptors to the Rejection of Fetal Proislet Allografts

Chemokines regulate the recruitment of leukocytes to sites of inflammation and may therefore play an important role in lymphocyte trafficking between draining lymph nodes and pancreatic islet tissue allografts. The intragraft expression of α- and β-chemokine mRNA during the rejection of BALB/c proislet (fetal precursor islet tissue) allografts in CBA/H mice was assessed quantitatively and semiquantitatively by RT-PCR analyses. Allograft rejection was associated with the strongly enhanced (from day 4) and prolonged expression (up to day 10) of the α-chemokine IP-10 and enhanced intragraft mRNA expression of the β-chemokines MCP-1, MIP-1α, MIP-1β, RANTES, and eotaxin. Peak transcript expression was identified at day 4 (IP-10, MCP-1), day 5 (eotaxin), day 6 (MIP-1α, MIP-1β), and day 14 (RANTES). To examine the role of β-chemokine receptors in allograft rejection, additional allografts to CCR2–/–, CCR5–/–, and wild-type CCR+/+ mice were analyzed by histology, immunohistochemistry, and morphometry. In CCR5–/–mice, the intragraft recruitment of T cells and macrophages was slower and allograft destruction was delayed; in CCR2–/–mice, the initial entry of macrophages was retarded but graft survival was not prolonged. These findings suggest that IP-10 regulates the initial influx of T cells into proislet allografts, MCP-1/CCR2 signaling controls initial macrophage entry, and the MIP-1α, MIP-1β, and RANTES/CCR5 pathway contributes to the rejection response by subsequently amplifying the recruitment of T cell subpopulations required for graft destruction.
Synaptic limitations to contrast coding in the retina of the blowfly Calliphora

We investigate the effects of synaptic transmission on early visual processing by examining the passage of signals from photoreceptors to second order neurons (LMCS). We concentrate on the roles played by three properties of synaptic transmission: (1) the shape of the characteristic curve, relating pre- and postsynaptic signal amplitudes, (2) the dynamics of synaptic transmission and (3) the noise introduced during transmission. The characteristic curve is sigmoidal and follows a simple model of synaptic transmission (Appendix) in which transmitter release rises exponentially with presynaptic potential. According to this model a presynaptic depolarization of 1.50–1.86 mV produces an e-fold increase in postsynaptic conductance. The characteristic curve generates a sigmoidal relation between postsynaptic (LMC) response amplitude and stimulus contrast. The shape and slope of the characteristic curve is unaffected by the state of light adaptation. Retinal antagonism adjusts the characteristic curve to keep it centred on the mean level of receptor response generated by the background. Thus the photoreceptor synapses operate in the mid-region of the curve, where the slope or gain is highest and equals approximately 6. The dynamics of transmission of a signal from photoreceptor to second-order neuron approximates to the sum of two processes with exponential time courses. A momentary receptor depolarization generates a postsynaptic hyperpolarization of time constant 0.5–1.0 ms, followed by a slower and weaker depolarization. Light adaptation increases the relative amplitude of the depolarizing process and reduces its time constant from 80 ms to 1.5 ms. The hyperpolarizing process is too rapid to bandlimit receptor signals. The noise introduced during the passage of the signal from receptor to second-order neuron is measured by comparing signal: noise ratios and noise power spectra in the two cell types. Under daylight conditions from 50 to 70% of the total noise power is generated by events associated with the transmission of photoreceptor signals and the generation of LMC responses. According to the exponential model of transmitter release, the effects of synaptic noise are minimized when synaptic gain is maximized. Moreover, both retinal antagonism and the sigmoidal shape of the characteristic curve promote synaptic gain. We conclude that retinal antagonism and nonlinear synaptic amplification act in concert to protect receptor signals from contamination by synaptic noise. This action may explain the widespread occurrence of these processes in early visual processing.