Datasets:

bigbio

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biomrc

like 2

900

901

902

[ XXXX in @entity166 ].

multiple_choice

BACKGROUND: @entity166 can @entity732 . Which therapy is indicated? RESULTS: A 33-year-old @entity1 suddenly became blind in his left eye as the result of a @entity732 ( @entity732 ). This occurred during high-dosage treatment for @entity166 that had been diagnosed 3 weeks earlier. The echocardiogram showed distinct @entity47 and an abscess on the aortic valve. The @entity732 together with the ultrasound findings was considered an absolute indication for surgery of the aortic valve. During this emergency operation, a 2 cm @entity733 was found between the mitral and aortic valves. After removal of the abscess, together with the infected valve, a prosthetic valve was inserted. Following the operation, the @entity1 made an uneventful recovery. The antibiotic treatment was continued for several months. The left eye remained sightless. No recurrence of @entity166 occurred during the follow-up of 2 1/4 years. A branch retinal @entity432 occurred in the right eye of a 35-year-old @entity1 who had suffered from chronic @entity166 for several months. Insufficiency of more than one valve had been diagnosed on several occasions. The @entity1 , a @entity734 , had refused surgical treatment on each occasion. After 3 months, the @entity735 owing to @entity732 . Following high-dosage treatment with antibiotics, the @entity166 was healed. The right eye remained blind. One year later the @entity1 died. CONCLUSION: Retinal @entity432 of embolic origin in a @entity1 with @entity166 is an indication for immediate medical and/or surgical treatment. This is of particular importance if there is ultrasound evidence of an @entity340 .

903

904

905

Ultrasonographic monitoring of implant thickness after augmentation rhinoplasty with expanded XXXX .

multiple_choice

BACKGROUND: Expanded @entity736 (ePTFE), or Gore-Tex (W.L. Gore _ Associates, Flagstaff, AZ), is widely used in augmentation rhinoplasty, and the histological changes that it undergoes in the @entity1 body have been studied for decades. However, changes in the thickness of ePTFE after its use in augmentation rhinoplasty with a noninvasive object method are not well understood. METHODS: We report the results of 19 @entity1 (10 male and 9 female @entity1 ) who had undergone an uncomplicated augmentation rhinoplasty with Gore-Tex. Ultrasonography was used to evaluate changes in the thickness of @entity737 and to detect inflammatory reactions around the implants 9-67 months after surgery. RESULTS: @entity737 were clearly distinguishable from the surrounding tissue with ultrasonography. The postoperative thickness of the implant was decreased by 29%. There was no significant correlation between the degree of change in implant thickness and the length of time after surgery. However, the amount of thickness reduction was associated with the implant's initial thickness at the time of the surgery (R = 0.448; p = 0.001). In addition, four @entity1 (21%) showed @entity82 or @entity738 formation around the implant that was detectable via ultrasonography. CONCLUSION: @entity737 lost thickness after nasal dorsal augmentation in proportion to their initial thickness, and ultrasonography was useful for evaluating changes in Gore-Tex thickness.

906

907

908

Shortcomings in public and private insurance coverage of XXXX self-management education and support.

multiple_choice

The objective of this study is to present preliminary data to characterize public and private insurance coverage for @entity6 self-management education (DSM Education) and @entity6 self-management support (DSM Support). Representatives from Medicaid and 2 private insurance providers in 10 states provided coverage information for their insurance plans. Two states (the most populous state from the East and @entity739 ) were sampled purposively and 8 additional states from 4 geographic regions (northeast, southeast, northwest, southwest) were sampled at random. Representatives from each private insurer described both a premium and basic coverage plan. Thus, 10 Medicaid programs and 40 private insurance plans were represented. Information about Medicare coverage was accessed from publicly available documents. Restricted by physician certification of @entity1 eligibility, Medicare coverage included 10 hours of DSM Education plus 3 hours of medical nutrition therapy (MNT) within a continuous 12-month period, and 4 hours of follow-up (2 hours DSM Education and 2 hours MNT) for each subsequent year. Only 22 of 40 sampled private insurance and 5 of 10 Medicaid plans covered DSM Education, which ranged from 7 to 20 hours of education per year. Medicaid and private plans often limited the amount of DSM Education or required @entity1 to obtain a physician certification of eligibility. Other than on-demand access features, coverage of DSM Support was minimal. Public and private insurance coverage of DSM Education was neither widespread nor uniform, while coverage of DSM Support was scarce.

909

910

911

Conservative management of XXXX without dialysis: a systematic review.

multiple_choice

PURPOSE: To summarize evidence on conservative, nondialytic management of @entity454 regarding 1) prognosis and 2) symptom burden and quality of life (QOL). METHODS: Medline, Cinahl, and Cochrane were searched for records indexed prior to March 1, 2011. Bibliographies of articles and abstracts from recent meetings were reviewed. Authors and nephrologists were contacted to identify additional studies. Articles were reviewed by two authors and selected if they described stage 5 @entity740 ( @entity740 ) @entity1 managed without dialysis, including one or more of the following outcomes: prognosis, symptoms, or QOL. Levels of evidence ratings were assigned using the SORT (Strength of Recommendation Taxonomy) system. Data was abstracted independently by two authors for descriptive analysis. RESULTS: Thirteen studies were included. In studies of prognosis, conservative management resulted in median survival of at least six months (range 6.3 to 23.4 months). Findings are mixed as to whether dialysis prolongs survival in the elderly versus conservative, nondialytic management. Any survival benefit from dialysis decreases with comorbidities, especially @entity741 . @entity1 managed conservatively report a high symptom burden, underscoring the need for concurrent palliative care. Additional head-to-head studies are needed to compare the symptoms of age-matched dialysis @entity1 , but preliminary studies suggest that QOL is similar. CONCLUSIONS: Conservative management is an important alternative to discuss when counseling @entity1 and families about dialysis. Unlike withdrawal of dialysis in which imminent @entity204 is expected, @entity1 who decline dialysis initiation can live for months to years with appropriate supportive care.

912

913

914

Transovarial Transmission of @entity743 XXXX by @entity278 and Hyalomma marginatum.

multiple_choice

BACKGROUND: @entity278 and Hyalomma marginatum are the most common species in @entity742 herds in Northeast of Iran. There is preliminary evidence that these species may be the vectors of @entity743 @entity744 in Iran. We carried out two experiments in Mashhad area, Khorasan Razavi Province to determine whether @entity744 could be transovarially transmitted by @entity278 and H. marginatum. METHODS: In experiment 1, adults of laboratory reared H. marginatum and @entity278 were infected with @entity744 isolated from naturally infected @entity742 in Mashhad area by feeding the ticks on the @entity742 inoculated intravenously by infected blood samples. The inoculated @entity742 showed clinical signs with parasitaemia while the adult ticks were engorging on them. The engorged females were collected and kept at 28 C and 85% relative humidity in incubator. Then, larval, nymphal and adult stages derived from engorged females were used to infest the clean @entity742 . In experiment 2, two splenectomized @entity742 were infested only with the same adult ticks of two species. RESULTS: Examination of smears and PCR of blood samples to detect of @entity744 in infested @entity742 in two experiments were negative. CONCLUSION: It seems that @entity278 and H. marginatum can not transovarially transmit @entity744 in @entity742 .

915

916

917

Transovarial Transmission of @entity743 @entity744 by XXXX and Hyalomma marginatum.

multiple_choice

BACKGROUND: @entity278 and Hyalomma marginatum are the most common species in @entity742 herds in Northeast of Iran. There is preliminary evidence that these species may be the vectors of @entity743 @entity744 in Iran. We carried out two experiments in Mashhad area, Khorasan Razavi Province to determine whether @entity744 could be transovarially transmitted by @entity278 and H. marginatum. METHODS: In experiment 1, adults of laboratory reared H. marginatum and @entity278 were infected with @entity744 isolated from naturally infected @entity742 in Mashhad area by feeding the ticks on the @entity742 inoculated intravenously by infected blood samples. The inoculated @entity742 showed clinical signs with parasitaemia while the adult ticks were engorging on them. The engorged females were collected and kept at 28 C and 85% relative humidity in incubator. Then, larval, nymphal and adult stages derived from engorged females were used to infest the clean @entity742 . In experiment 2, two splenectomized @entity742 were infested only with the same adult ticks of two species. RESULTS: Examination of smears and PCR of blood samples to detect of @entity744 in infested @entity742 in two experiments were negative. CONCLUSION: It seems that @entity278 and H. marginatum can not transovarially transmit @entity744 in @entity742 .

918

919

920

Transovarial Transmission of XXXX @entity744 by @entity278 and Hyalomma marginatum.

multiple_choice

BACKGROUND: @entity278 and Hyalomma marginatum are the most common species in @entity742 herds in Northeast of Iran. There is preliminary evidence that these species may be the vectors of @entity743 @entity744 in Iran. We carried out two experiments in Mashhad area, Khorasan Razavi Province to determine whether @entity744 could be transovarially transmitted by @entity278 and H. marginatum. METHODS: In experiment 1, adults of laboratory reared H. marginatum and @entity278 were infected with @entity744 isolated from naturally infected @entity742 in Mashhad area by feeding the ticks on the @entity742 inoculated intravenously by infected blood samples. The inoculated @entity742 showed clinical signs with parasitaemia while the adult ticks were engorging on them. The engorged females were collected and kept at 28 C and 85% relative humidity in incubator. Then, larval, nymphal and adult stages derived from engorged females were used to infest the clean @entity742 . In experiment 2, two splenectomized @entity742 were infested only with the same adult ticks of two species. RESULTS: Examination of smears and PCR of blood samples to detect of @entity744 in infested @entity742 in two experiments were negative. CONCLUSION: It seems that @entity278 and H. marginatum can not transovarially transmit @entity744 in @entity742 .

921

922

923

Depletion of @entity745 affects XXXX motoneurons terminal synapsis and @entity146 .

multiple_choice

Pathological modifications in the highly conserved and ubiquitously expressed heterogeneous ribonucleoprotein @entity745 were recently associated to @entity179 including @entity746 ( @entity746 ), a @entity74 that affects predominantly motoneurons [Neumann, M. et al. (2006) Ubiquitinated @entity745 in @entity747 and @entity746 . Science 314, 130-133, Sreedharan, J. et al. (2008) @entity745 mutations in familial and sporadic @entity746 . Science 319, 1668-1672, Kabashi, E. et al. (2008) TARDBP mutations in individuals with sporadic and familial @entity746 . Nat. Genet. 40, 572-574]. However, the function of @entity745 in vivo is unknown and a possible direct role in neurodegeneration remains speculative. Here, we report that flies lacking @entity238 @entity745 appeared externally normal but presented @entity146 , reduced life span and anatomical defects at the neuromuscular junctions. These phenotypes were rescued by expression of the @entity1 protein in a restricted group of neurons including motoneurons. Our results demonstrate the role of this protein in vivo and suggest an alternative explanation to @entity746 pathogenesis that may be more due to the lack of @entity745 function than to the @entity137 of the aggregates.

924

925

926

Depletion of XXXX affects @entity238 motoneurons terminal synapsis and @entity146 .

multiple_choice

Pathological modifications in the highly conserved and ubiquitously expressed heterogeneous ribonucleoprotein @entity745 were recently associated to @entity179 including @entity746 ( @entity746 ), a @entity74 that affects predominantly motoneurons [Neumann, M. et al. (2006) Ubiquitinated @entity745 in @entity747 and @entity746 . Science 314, 130-133, Sreedharan, J. et al. (2008) @entity745 mutations in familial and sporadic @entity746 . Science 319, 1668-1672, Kabashi, E. et al. (2008) TARDBP mutations in individuals with sporadic and familial @entity746 . Nat. Genet. 40, 572-574]. However, the function of @entity745 in vivo is unknown and a possible direct role in neurodegeneration remains speculative. Here, we report that flies lacking @entity238 @entity745 appeared externally normal but presented @entity146 , reduced life span and anatomical defects at the neuromuscular junctions. These phenotypes were rescued by expression of the @entity1 protein in a restricted group of neurons including motoneurons. Our results demonstrate the role of this protein in vivo and suggest an alternative explanation to @entity746 pathogenesis that may be more due to the lack of @entity745 function than to the @entity137 of the aggregates.

927

928

929

Depletion of @entity745 affects @entity238 motoneurons terminal synapsis and XXXX .

multiple_choice

Pathological modifications in the highly conserved and ubiquitously expressed heterogeneous ribonucleoprotein @entity745 were recently associated to @entity179 including @entity746 ( @entity746 ), a @entity74 that affects predominantly motoneurons [Neumann, M. et al. (2006) Ubiquitinated @entity745 in @entity747 and @entity746 . Science 314, 130-133, Sreedharan, J. et al. (2008) @entity745 mutations in familial and sporadic @entity746 . Science 319, 1668-1672, Kabashi, E. et al. (2008) TARDBP mutations in individuals with sporadic and familial @entity746 . Nat. Genet. 40, 572-574]. However, the function of @entity745 in vivo is unknown and a possible direct role in neurodegeneration remains speculative. Here, we report that flies lacking @entity238 @entity745 appeared externally normal but presented @entity146 , reduced life span and anatomical defects at the neuromuscular junctions. These phenotypes were rescued by expression of the @entity1 protein in a restricted group of neurons including motoneurons. Our results demonstrate the role of this protein in vivo and suggest an alternative explanation to @entity746 pathogenesis that may be more due to the lack of @entity745 function than to the @entity137 of the aggregates.

930

931

932

Assessment of prescription pattern in XXXX therapy at Shamli hospitals.

multiple_choice

This drug utilization or prescription-monitoring study was conducted to evaluate the drug-prescribing trend of anti- @entity748 drugs in various hospitals (health care centre) of Shamli, (Prabuddha Nagar, Uttar Pradesh, India). The study was conducted in three famous hospitals of Shamli on three hundred thirty (330) @entity1 , using a developed prescription auditing Performa. Data was recorded from the co-operating @entity1 , attending the outpatient department using a chance random sample method for six months by interviewing and information was filled in the performa. The collected data was studied statistically for determining the most prominently prescribed medication for the treatment. The collected information suggested that b-agonist were the most frequently prescribed anti- @entity748 drugs followed by @entity288 , @entity749 , anti-histaminics and leukotriene antagonist. Also the performed prescription analysis revealed that there is significant difference in the prescriptions for multiple drug therapy (90%) as compared to single drug therapy (10%). Also even after the commercial development of @entity358 , oral dosage form like tablets (54.93%) were preferred over inhalation (31.69%). Thus, it can be concluded that the present prescribing pattern of antiasthmatics in Shamli does not completely meet standard guidelines for the @entity565 treatment. Hence there is a need of awareness amongst the physicians of Shamli so that they can follow the guidelines while treating @entity565 . Also the @entity1 must be encouraged to use newly developed inhalational drug delivery systems for improving the treatment.

933

934

935

Reversal of SSRI-associated XXXX by discontinuation of therapy.

multiple_choice

OBJECTIVE: To report 6 cases of selective @entity750 reuptake inhibitor (SSRI)-associated @entity751 . CASE SUMMARIES: In all 6 cases, the @entity1 reported loss of motivation while being treated with an SSRI. Loss of motivation was of new onset and temporally associated with the use of the SSRI. A trial of discontinuation of the SSRI was performed in all 6 @entity1 and 2 were started on @entity752 while cross-tapering from the SSRI. During the treatment trials, @entity308 and apathy were monitored in all @entity1 . Each case was assessed using the Apathy Evaluation Scale, Clinician version (AES-C), and by evaluating how the @entity1 responded to discontinuation of the SSRI. DISCUSSION: Scores on the AES-C improved significantly in all 6 cases after the SSRI was discontinued. Improvement was also seen in the motivation, novelty, and persistence subdomain scores of the AES-C. A pretreatment AES-C score was available only in the first case. Based on the Naranjo probability scale, there was a probable cause of @entity751 with SSRI therapy in the first case and a possible association in the rest of the cases. CONCLUSIONS: In some @entity1 SSRIs may cause an @entity751 that can be reversed through discontinuation of the agent. When evaluating @entity1 being treated with an SSRI, clinicians should have a high degree of suspicion and specifically inquire for this iatrogenic form of @entity751 .

936

937

938

Laparoscopic versus open colectomy for XXXX in an older population: a cohort study.

multiple_choice

BACKGROUND: Laparoscopic colectomy for @entity694 has been compared with open colectomy in randomized controlled trials, but these studies may not be generalizable because of strict enrollment and exclusion criteria which may explicitly or inadvertently exclude older individuals due to associated comorbidities. Previous studies of older @entity1 undergoing laparoscopic colectomy have generally focused on short-term outcomes. The goals of this cohort study were to identify predictors of laparoscopic colectomy in an older population in the United States and to compare short-term and long-term outcomes. METHODS: @entity1 aged 65 years or older with incident @entity14 diagnosed 1996-2002 who underwent colectomy within 6 months of @entity5 diagnosis were identified from the linked Surveillance, Epidemiology, and End Results-Medicare database. Laparoscopic and open colectomy @entity1 were compared with respect to length of stay, blood transfusion requirements, intensive care unit monitoring, complications, 30-day mortality, and long-term survival. We adjusted for potential selection bias in surgical approach with propensity score matching. RESULTS: Laparoscopic colectomy cases were associated with @entity5 ; areas with higher population density, income, and education level; areas in the western United States; and National @entity5 Institute-designated @entity5 centers. Laparoscopic colectomy cases had shorter length of stay and less intensive care unit monitoring. Although laparoscopic colectomy @entity1 (n = 424) had fewer complications (21.5% versus 26.3%), lower 30-day mortality (3.3% versus 5.8%), and longer median survival (6.6 versus 4.8 years) compared with open colectomy @entity1 (n = 27,012), after propensity score matching these differences disappeared. CONCLUSIONS: In this older population, laparoscopic colectomy practice patterns were associated with factors which likely correlate with tertiary referral centers. Although short-term and long-term survival are comparable, laparoscopic colectomy offers shorter hospitalizations and less intensive care.

939

940

941

Liver resection for liver XXXX from nondigestive endocrine @entity5 : extrahepatic disease burden defines outcome.

multiple_choice

BACKGROUND: For @entity1 with hepatic nondigestive endocrine @entity3 (HNEM), the role of liver resection is not well-defined. METHODS: We reviewed outcomes for @entity1 who underwent liver resection for HNEM at 2 centers to identify predictors of survival. RESULTS: From 1991 to 2010, 51 @entity1 underwent liver resection for HNEM. @entity5 types were adrenal gland (n = 26), thyroid (n = 11), testicular germ cell (n = 9), and ovarian granulosa cell (n = 5). 28 @entity1 (55%) had synchronous or early (diagnosed within 12 months after @entity5 resection) liver @entity3 . At liver resection, 26 @entity1 (51%) had extrahepatic @entity3 , and 7 (14%) had >= 2 sites of extrahepatic @entity3 . 32 @entity1 (63%) had major liver resection and 19 (37%) had a simultaneous extrahepatic procedure. 90-day postoperative morbidity and mortality rates were 27% and 2%, respectively. After median follow-up of 20 months (range, 1-144), the 5-year overall and recurrence-free survival rates were 58% and 37%, respectively. Survival was not affected by @entity5 type. In multivariate analysis, >= 2 sites of extrahepatic @entity3 (hazard ratio [HR] = 4.80; 95% confidence interval [CI] = 1.18-19.50; P = .028) and interval of <=12 months between @entity5 resection and diagnosis of liver @entity3 (HR = 5.33; 95% CI = 1.11-25.71; P = .037) were associated with worse overall survival after liver resection. CONCLUSION: For selected @entity1 , liver resection for HNEM is associated with long-term survival. The number of extrahepatic sites of @entity3 and the timing of appearance of liver @entity3 should be considered in @entity1 selection.

942

943

944

Liver resection for liver @entity3 from nondigestive endocrine XXXX : extrahepatic disease burden defines outcome.

multiple_choice

BACKGROUND: For @entity1 with hepatic nondigestive endocrine @entity3 (HNEM), the role of liver resection is not well-defined. METHODS: We reviewed outcomes for @entity1 who underwent liver resection for HNEM at 2 centers to identify predictors of survival. RESULTS: From 1991 to 2010, 51 @entity1 underwent liver resection for HNEM. @entity5 types were adrenal gland (n = 26), thyroid (n = 11), testicular germ cell (n = 9), and ovarian granulosa cell (n = 5). 28 @entity1 (55%) had synchronous or early (diagnosed within 12 months after @entity5 resection) liver @entity3 . At liver resection, 26 @entity1 (51%) had extrahepatic @entity3 , and 7 (14%) had >= 2 sites of extrahepatic @entity3 . 32 @entity1 (63%) had major liver resection and 19 (37%) had a simultaneous extrahepatic procedure. 90-day postoperative morbidity and mortality rates were 27% and 2%, respectively. After median follow-up of 20 months (range, 1-144), the 5-year overall and recurrence-free survival rates were 58% and 37%, respectively. Survival was not affected by @entity5 type. In multivariate analysis, >= 2 sites of extrahepatic @entity3 (hazard ratio [HR] = 4.80; 95% confidence interval [CI] = 1.18-19.50; P = .028) and interval of <=12 months between @entity5 resection and diagnosis of liver @entity3 (HR = 5.33; 95% CI = 1.11-25.71; P = .037) were associated with worse overall survival after liver resection. CONCLUSION: For selected @entity1 , liver resection for HNEM is associated with long-term survival. The number of extrahepatic sites of @entity3 and the timing of appearance of liver @entity3 should be considered in @entity1 selection.

945

946

947

Changes in blood pressure and systemic vascular resistance do not predict microvascular structure during treatment of mild essential XXXX .

multiple_choice

BACKGROUND: Essential @entity101 is characterized by small artery remodeling and increased systemic vascular resistance (SVR). We hypothesized that changes in SVR index (SVRI) were associated with measures of small artery structure as reflected by minimum coronary and forearm vascular resistance (C-Rmin and F-Rmin, respectively). Also, we investigated how F-Rmin is related to C-Rmin, coronary flow reserve (CFR), left ventricular mass index (LVMI) and blood pressure (BP). METHOD: Sixty-six never-treated @entity1 with uncomplicated mild essential @entity101 had the following measured at baseline: 24-h blood BP, LVMI, CFR and C-Rmin (echocardiography), F-Rmin (forearm plethysmography) and SVRI determined by a gas re-breathing method. After 6 months of antihypertensive therapy administered by the general practitioner, the @entity1 returned for follow-up measurements. RESULTS: Changes in SVRI did not correlate to changes in F-Rmin (r=0.001, P=0.98) or C-Rmin (r=0.13, P=0.39) but did correlate to changes in CFR (r=0.30, P=0.04). Further analysis was performed by assigning the @entity1 into two groups according to the median of drop in F-Rmin. When adjusted in a multivariate model, changes in F-Rmin (-8.1 3.2%) were significantly associated with changes in C-Rmin (-9.3 4.9%) and LVMI (-6.9 1.7%) (P<0.01), but not to either 24-h BP, SVRI or CFR. CONCLUSION: The results show that changes in neither BP nor SVRI reflected changes in minimum vascular resistance. However, changes in the forearm and coronary microcirculation occurred in parallel. Moreover, we demonstrated that neither BP nor SVRI reduction can predict changes in microvascular structure in @entity101 . Thus, direct measurements of microvascular structure are needed to determine whether improvement is obtained.

948

949

950

Common mutations of XXXX @entity1 in Taiwan: characteristics and implications of migrations from southeast China.

multiple_choice

@entity753 ( @entity753 ) is an @entity74 caused by mutations in @entity754 ( @entity754 ), @entity755 ( @entity755 ), and @entity756 ( @entity756 ) genes. This study investigated @entity753 @entity1 carrying common mutations in Taiwan and compared them to @entity753 southeastern Asians. Causal @entity753 mutations were identified by exon-by-exon sequencing with/without multiplex ligation-dependent probe amplification among 208 Taiwanese with clinically diagnosed @entity753 . Haplotype analyses among probands and family members were undertaken using TaqMan Assays. Totally, @entity754 mutations were found in 118 probands, consisting of 61 different loci, and @entity755 @entity757 mutations in 12 probands. Three mutations ( @entity758 , @entity759 , and @entity760 ) were novel. @entity754 @entity761 (13.1%), @entity762 (10.8%), and @entity755 @entity757 (9.2%) were common mutations with no differences in phenotypes. @entity754 @entity762 associated with one haplotype (CAAGCCCCATGG/(dTA)n-112nt); @entity754 @entity761 with two. @entity755 @entity757 associated with the same @entity754 binding-domain pattern in Taiwanese and southeastern Asians. We concluded that @entity754 @entity761 , @entity762 and @entity755 @entity757 are common mutations, with combined frequency of approximately 33%. The presence of different haplotypes associated with @entity753 common mutations in Taiwan indicates multiple historical migrations, probable multiple recurrent origins from southern China, and haplotype homologies reflect the presence of common ancestors in southern China.

951

952

953

Common mutations of @entity753 XXXX in Taiwan: characteristics and implications of migrations from southeast China.

multiple_choice

@entity753 ( @entity753 ) is an @entity74 caused by mutations in @entity754 ( @entity754 ), @entity755 ( @entity755 ), and @entity756 ( @entity756 ) genes. This study investigated @entity753 @entity1 carrying common mutations in Taiwan and compared them to @entity753 southeastern Asians. Causal @entity753 mutations were identified by exon-by-exon sequencing with/without multiplex ligation-dependent probe amplification among 208 Taiwanese with clinically diagnosed @entity753 . Haplotype analyses among probands and family members were undertaken using TaqMan Assays. Totally, @entity754 mutations were found in 118 probands, consisting of 61 different loci, and @entity755 @entity757 mutations in 12 probands. Three mutations ( @entity758 , @entity759 , and @entity760 ) were novel. @entity754 @entity761 (13.1%), @entity762 (10.8%), and @entity755 @entity757 (9.2%) were common mutations with no differences in phenotypes. @entity754 @entity762 associated with one haplotype (CAAGCCCCATGG/(dTA)n-112nt); @entity754 @entity761 with two. @entity755 @entity757 associated with the same @entity754 binding-domain pattern in Taiwanese and southeastern Asians. We concluded that @entity754 @entity761 , @entity762 and @entity755 @entity757 are common mutations, with combined frequency of approximately 33%. The presence of different haplotypes associated with @entity753 common mutations in Taiwan indicates multiple historical migrations, probable multiple recurrent origins from southern China, and haplotype homologies reflect the presence of common ancestors in southern China.

954

955

956

Comparing efficacy of plaque removal using professionally applied manual and power toothbrushes in 4- to 7-year-old XXXX .

multiple_choice

PURPOSE: The purpose of this study was to evaluate in 4- to 7-year-olds the efficacy of plaque removal of 2 toothbrushes: (1) the Philips Sonicare for Kids (SFK) power toothbrush with 2 amplitude settings (A and B); and (2) the Oral-B Stages 3 toothbrush ( @entity763 ). METHODS: Sixty-eight @entity1 participated in a single-masked, randomized, split-mouth study. Only subjects with a Quigley Hein plaque index (modified by Turesky et al.; TQHI) of more than 1.8 were enrolled. Subjects were randomized to SFK A (low amplitude, 7 ), SFK B (high amplitude, 9 ), or @entity763 by quadrant and brushed by a dental hygienist. TQHI was scored at 1- and 2-minute intervals by quadrant by a masked examiner. Multivariate analysis of variances for a split-mouth design was applied, and P-values were adjusted using Dunnett-Hsu modification. RESULTS: Mean baseline TQHI(+SD) scores were 2.89+0.06, 2.96+0.07, and 2.89+0.05 for @entity763 , respectively. Adjusted mean postbrushing overall percent reductions for @entity763 were 41%, 42%, and 29% at 1 minute and 67%, 65% and 49% at 2 minutes, respectively. Differences between both SFK and @entity763 were statistically significant. CONCLUSIONS: The Philips SFK removed significantly more plaque than the Oral-B Stages 3 toothbrush at 1- and 2-minute intervals with professional brushing assistance in 4- to 7-year-old subjects.

957

958

959

Comparative evaluation of barium meal follow-through and barium enteroclysis before capsule endoscopy in obscure XXXX .

multiple_choice

BACKGROUND/AIMS: Small bowel radiological investigations have lower diagnostic yield in comparison to capsule endoscopy (CE) and are inaccurate in predicting capsule impaction. Most studies have used barium meal follow-through (BAMFT) and more sensitive barium enteroclysis (BE) is infrequently used. This study was done to retrospectively compare results of performing BAMFT or BE before CE in @entity1 with obscure @entity360 . METHODOLOGY: Sixtyfive @entity1 with obscure @entity360 underwent barium examination (BE or BAMFT depending upon @entity1 's preference) and CE was performed if barium examination was normal. The demographic data, barium examination results and CE findings were retrospectively collected. RESULTS: Sixteen @entity1 underwent BAMFT and 49 @entity1 underwent BE prior to CE. BAMFT was normal in all 16 @entity1 whereas CE was normal in only 1/16 @entity1 . Seven of 49 (14.2%) @entity1 had stricture or mass on BE. In these 7 @entity1 CE was not performed. In contrast to BAMFT, 22/41 (53.6%) @entity1 with normal BE had normal CE findings also. The capsule got stuck in one @entity1 with NSAID induced @entity66 who had normal BE and required surgical removal. CONCLUSIONS: BE should be preferred over BAMFT as the radiological imaging technique for evaluation of small bowel before CE in @entity1 with obscure @entity360 as it may detect unexpected strictures and intraluminal masses. However, radiological findings either on BAMFT or BE cannot predict passage of capsule endoscope through small bowel.

960

961

962

Single-institution, multidisciplinary experience with surgical resection of primary XXXX .

multiple_choice

INTRODUCTION: Primary @entity764 are rare @entity361 and their mainstay of therapy is wide surgical resection. We report our single-institution, multidisciplinary experience with full-thickness resection for primary @entity764 . METHODS: A retrospective review of our prospectively maintained databases revealed that 51 @entity1 were referred for primary @entity764 from 1990 to 2009. RESULTS: All @entity1 required resections that included rib and/or sternum. Twenty-nine @entity1 (57%) had extended resections beyond the chest wall. Forty-two @entity1 (82%) required prosthetic reconstruction and 17 @entity1 (33%) had muscle flap coverage. Overall, 51% (26/51) of @entity1 received neoadjuvant therapy. Seventy-three percent (11/15) of high-grade soft tissue @entity242 , 77% (10/13) of high-risk @entity242 , and 67% (4/6) of @entity765 were treated with induction therapy. Negative margins were obtained in 46 @entity1 (90%). There were no perioperative mortalities. Eight @entity1 (16%) experienced complications. Local recurrence and @entity3 was detected in 14 and 23%. Five-year overall and disease-free survivals were 66% and 47%, respectively. Favorable prognostic variables for survival included age <=50 years, @entity5 volume <=200 cm, @entity765 , @entity5 , @entity511 , and low-grade soft tissue @entity242 . CONCLUSIONS: We report our multidisciplinary experience with primary @entity764 that included induction therapy in the majority of high-risk soft tissue and @entity242 and @entity765 . Despite aggressive preoperative treatments, acceptable surgical results with low morbidity and mortality can be achieved. Neoadjuvant systemic therapy may reduce local and distant recurrence and improve overall survival.

963

964

965

Long working hours and XXXX risk among Australian and New Zealand nurses and midwives: a cross-sectional study.

multiple_choice

BACKGROUND: The relationship between long working hours and harmful @entity167 consumption reported in the literature is equivocal. OBJECTIVE: This study aimed to investigate this relationship in a methodologically rigorous fashion. DESIGN AND @entity1 : A cross-sectional analysis of a large cohort study of Australian and New Zealand nurses and midwives was undertaken. METHODS: Psychometrically robust standardised assessments of @entity167 consumption and problems and other key variables were elicited using an electronic survey. Crude and adjusted logistic regression models using complete case and multistage multiple imputed data were employed. RESULTS: The study included 4419 @entity1 , 3552 from Australia and 867 from New Zealand. Long working hours were common, with 33.2% working 40-49 h/week and 7.5% working >= 50 h/week. Overall, 13.9% engaged in harmful daily drinking. Significant associations between long working hours and harmful daily @entity167 consumption was seen in crude and adjusted complete case and imputed logistic regression models. In the adjusted model with imputed data, the odds of harmful daily drinking increased by 1.17 (95% confidence interval: 1.01, 1.36) between <40 h/week and 40-49 h/week groups, and between 40-49 h/week and >= 50 h/week groups. CONCLUSIONS: Many nurses and midwives engaging in harmful daily drinking and work long hours. Since the late 1970s, the average hours worked by full-time employees in Australia has increased. Unless these long working hours can be curbed, workforce policies and programmes aimed at prevention, supportive and empathetic intervention, and recovery need to be instigated; both to protect @entity1 and the nurses and midwives themselves.

966

967

968

A prospective follow-up study of the association of radiation exposure with fatal and non-fatal XXXX among atomic bomb survivors in Hiroshima and Nagasaki (1980-2003).

multiple_choice

OBJECTIVE: Use of medical radiotherapy has increased markedly in recent decades. Whether the consequence includes an increased risk of @entity65 remains to be determined. The purpose of this study was to examine the association between radiation exposure and the incidence of @entity64 among Japanese atomic bomb survivors. DESIGN: A prospective follow-up study. SETTING AND @entity1 : Radiation exposure from the atomic bombing was assessed in 9515 subjects (34.8% @entity1 ) with 24-year follow-up from 1980. Subjects were free of prevalent @entity64 when follow-up began. OUTCOME MEASURES: @entity64 events and the underlying cause of death were reviewed to confirm the first-ever @entity64 . Subtypes (ischaemic and @entity548 events) were categorised based on established criteria according to the definitions of typical/ @entity64 . RESULTS: Overall mean radiation dose ( SD) in units of gray (Gy) was 0.38 0.58 (range: 0-3.5). During the study period, 235 @entity548 and 607 ischaemic events were identified. For @entity1 , after adjusting for age and concomitant risk factors, the risk of @entity548 rose consistently from 11.6 to 29.1 per 10 000 @entity1 -years as doses increased from <0.05 to >= 2 Gy (p=0.009). Incidence also rose within the dose range <1 Gy (p=0.004) with no dose threshold. In @entity1 , the risk of @entity548 rose with increasing radiation exposure but not until doses reached a threshold of 1.3 Gy (95% CI 0.5 to 2.3). Among @entity1 , for doses <1.3 Gy, differences in @entity64 risk were modest (13.5 per 10 000 @entity1 -years), while it increased to 20.3 per 10 000 @entity1 -years for doses that ranged from 1.3 to <2.2 Gy and to 48.6 per 10 000 @entity1 -years for doses that were higher (p=0.002). In both sexes, dose was unrelated to @entity64 . CONCLUSION: While the risk of @entity548 increases with rising radiation exposure for both sexes, effects in @entity1 are less apparent until doses exceed a threshold at 1.3 Gy.

969

970

971

MicroRNA profiling in XXXX liver after partial hepatectomy.

multiple_choice

Liver is uniquely capable to repair itself after injury. Multiple molecular and biochemical processes initiated after partial hepatectomy, lead to proliferation of all cells within the liver. MicroRNAs (miRNAs) are a class of highly abundant non-coding RNA molecules that cause post-transcriptional gene repression and are involved in several biological processes including cell cycle regulation and differentiation. In this study, we examined the expression levels of miRNAs in liver tissue received from control @entity19 (L0) and compared them with the corresponding levels in liver tissue 12 h after @entity409 induced by 2/3 partial hepatectomy (L12). MiRNA expression was investigated using microRNA profiling. Further qPCR analysis was used for validation of the differentially expressed miRNAs at an early stage of @entity409 , induced by 2/3 partial hepatectomy. TargetScan and Gene Ontology (GO) analyses were performed in order to identify the possible miRNA target genes and their ontology, respectively. A subset of miRNAs was found to be differentially expressed during @entity409 . @entity766 and @entity767 * showed the higher levels of up-regulation in liver tissue from the hepatectomized @entity19 at the end of the experiment (L12) compared to the sham operated @entity19 (L0). @entity766 up-regulation was further confirmed by qPCR. In situ hybridization (ISH) revealed that @entity766 exhibited the higher levels of expression at 12 h post hepatectomy. On the contrary, @entity768 *, @entity769 , @entity770 , @entity770 , @entity771 , mmu-miR-582-3p and mmu-miR-290-5p exhibited <0.5 down-regulation in liver tissue after partial hepatectomy in L12 vs. L0 @entity19 . The results from microarray and qPCR analyses were in good agreement. In conclusion, our results provide important information regarding the differentially expressed miRNAs in @entity19 liver tissue before and after partial hepatectomy. The early up-regulation of @entity766 during the process of @entity409 suggests a regulatory role in @entity409 in vivo.

972

973

974

The association between @entity701 dynamics and the course of XXXX .

multiple_choice

CONTEXT: One of @entity510 complication is @entity16 ( @entity16 ). It is postulated that @entity701 dynamics might be associated with the severity of this complication. AIMS: The goal of the study is to investigate whether the peak of morning serum @entity701 levels are associated with the severity of its complication during the course of the disease. SETTINGS AND DESIGN: This is a prospective cohort study conducted from January 2009 to June 2011, at our institution. MATERIALS AND METHODS: The study follows a consecutive cohort of @entity1 for 14 days after the @entity510 . Serum cortisols, @entity701 binding globulin, adenocorticotrophic hormone (ACTH) were measured pre operatively and then on post operative days (POD) 2, 4, 7, and 10. Blood was drawn to coincide with peak @entity701 levels between 08.00-09.00 hours. Neurological examinations were conducted at least twice daily and @entity1 outcome were graded according to modified Ranklin Scale. @entity16 was defined by a decrease in the Glasgow @entity772 Scale of two or more points compared to the status on @entity773 . STATISTICAL ANALYSIS: All the results were analyzed using statistical software, Statistical Package for Social Sciences (SPSS v61; SPSS, Inc., Chicago, IL). Logistic regression analysis was used to compare the relationship between the variables. RESULTS: Thirty six consecutive @entity1 are collected, but only 28 @entity1 (12 M and 16 F) were eligible for the cohort analysis. Average @entity1 age is 50.75 years old (50.75 12.27), and more than 50% (15/28) arrived with World Federation of Neurologic Surgeons grade 3 or better. Elevated total @entity701 levels of more than 24 mg/dl on day 2, 4, and 10 were associated with @entity16 , and the most significant being on day 4 (P=0.011). These @entity1 also had a higher grade on the modified Ranklin scale of disability. CONCLUSIONS: This study shows that the elevated levels of morning total @entity701 in the serum are associated with the onset of @entity16 during the disease course, and it's also associated with bad outcomes.

975

976

977

The association between XXXX dynamics and the course of @entity510 .

multiple_choice

CONTEXT: One of @entity510 complication is @entity16 ( @entity16 ). It is postulated that @entity701 dynamics might be associated with the severity of this complication. AIMS: The goal of the study is to investigate whether the peak of morning serum @entity701 levels are associated with the severity of its complication during the course of the disease. SETTINGS AND DESIGN: This is a prospective cohort study conducted from January 2009 to June 2011, at our institution. MATERIALS AND METHODS: The study follows a consecutive cohort of @entity1 for 14 days after the @entity510 . Serum cortisols, @entity701 binding globulin, adenocorticotrophic hormone (ACTH) were measured pre operatively and then on post operative days (POD) 2, 4, 7, and 10. Blood was drawn to coincide with peak @entity701 levels between 08.00-09.00 hours. Neurological examinations were conducted at least twice daily and @entity1 outcome were graded according to modified Ranklin Scale. @entity16 was defined by a decrease in the Glasgow @entity772 Scale of two or more points compared to the status on @entity773 . STATISTICAL ANALYSIS: All the results were analyzed using statistical software, Statistical Package for Social Sciences (SPSS v61; SPSS, Inc., Chicago, IL). Logistic regression analysis was used to compare the relationship between the variables. RESULTS: Thirty six consecutive @entity1 are collected, but only 28 @entity1 (12 M and 16 F) were eligible for the cohort analysis. Average @entity1 age is 50.75 years old (50.75 12.27), and more than 50% (15/28) arrived with World Federation of Neurologic Surgeons grade 3 or better. Elevated total @entity701 levels of more than 24 mg/dl on day 2, 4, and 10 were associated with @entity16 , and the most significant being on day 4 (P=0.011). These @entity1 also had a higher grade on the modified Ranklin scale of disability. CONCLUSIONS: This study shows that the elevated levels of morning total @entity701 in the serum are associated with the onset of @entity16 during the disease course, and it's also associated with bad outcomes.

978

979

980

XXXX response to repeated psychosocial stress.

multiple_choice

Psychosocial stress plays a major role in the etiology and the course of @entity146 that often show an altered activation of the @entity774 . The Trier Social Stress Test (TSST) reliably activates the @entity774 and reflects real life stress exposure. However, habituation may confound the results of clinical trials that apply TSST. The present study investigates the @entity701 response after repeated psychosocial stress induction with short-term and long-term intervals between repeated testing sessions. Forty-one healthy subjects were exposed to the TSST four times with an interval of 24 h between the first and the second testing session (t1 and t2). The 3rd and the 4th testing session (t3 and t4) were also separated by a 24-hour interval whereas there were 10 weeks between t2 and t3. A significant decrease in the salivary @entity701 responses was noticed from testing session t1 to t2 as well as from testing session t3 to t4. By contrast, there were no differences in the @entity774 reactivity between testing session t2 and t3. Our results demonstrated the habituation of the @entity774 to a standardized psychosocial stress test when testing was repeated after 24 h. By contrast, a renewed challenge with a ten-week-interval in-between activated the @entity774 in a similar manner as before. It is suggested that studies designed to investigate the @entity774 activity under repeated psychosocial stress conditions should apply the TSST three times in order to separate habituation from intervention effects.

981

982

983

Ameliorated ConA-induced XXXX in the absence of PKC-theta.

multiple_choice

Severe @entity99 that occurs when immune cells mistakenly attack an individual's own liver cells leads to @entity775 . In @entity19 , acute @entity99 can be induced by concanavalin A (ConA) treatment, which causes rapid activation of @entity776 -positive natural killer (NK) T cells. These activated NKT cells produce large amounts of cytokines, which induce strong @entity32 that damages liver tissues. Here we show that PKC- (-/-) @entity19 were resistant to ConA-induced @entity99 due to essential function of PKC- in NKT cell development and activation. A dosage of ConA (25 mg/kg) that was lethal to @entity164 ( @entity164 ) @entity19 failed to induce @entity204 resulting from @entity99 in PKC- (-/-) @entity19 . Correspondingly, ConA-induced production of cytokines such as IFNy, @entity777 , and @entity637 , which mediate the @entity32 responsible for @entity99 , were significantly lower in PKC- (-/-) @entity19 . Peripheral NKT cells had developmental defects at early stages in the thymus in PKC- (-/-) @entity19 , and as a result their frequency and number were greatly reduced. Furthermore, PKC- (-/-) bone marrow adoptively transferred to @entity164 @entity19 displayed similar defects in NKT cell development, suggesting an intrinsic requirement for PKC- in NKT cell development. In addition, upon stimulation with NKT cell-specific lipid ligand, peripheral PKC- (-/-) NKT cells produced lower levels of inflammatory cytokines than that of @entity164 NKT cells, suggesting that activation of NKT cells also requires PKC- . Our results suggest PKC- is an essential molecule required for activation of NKT cell to induce @entity99 , and thus, is a potential drug target for prevention of @entity775 .

984

985

986

Virus identification in unknown tropical XXXX cases using deep sequencing.

multiple_choice

@entity778 is an emerging infectious agent that infects an estimated 50-100 million @entity1 annually worldwide, yet current diagnostic practices cannot detect an etiologic pathogen in 40% of @entity779 -like illnesses. Metagenomic approaches to pathogen detection, such as viral microarrays and deep sequencing, are promising tools to address emerging and non-diagnosable disease challenges. In this study, we used the Virochip microarray and deep sequencing to characterize the spectrum of viruses present in @entity1 sera from 123 Nicaraguan @entity1 presenting with @entity779 -like symptoms but testing negative for @entity779 virus. We utilized a barcoding strategy to simultaneously deep sequence multiple serum specimens, generating on average over 1 million reads per sample. We then implemented a stepwise bioinformatic filtering pipeline to remove the majority of @entity1 and low-quality sequences to improve the speed and accuracy of subsequent unbiased database searches. By deep sequencing, we were able to detect virus sequence in 37% (45/123) of previously negative cases. These included 13 cases with @entity780 sequences. Other samples contained sequences with similarity to sequences from viruses in the Herpesviridae, Flaviviridae, Circoviridae, Anelloviridae, Asfarviridae, and Parvoviridae families. In some cases, the putative viral sequences were virtually identical to known viruses, and in others they diverged, suggesting that they may derive from novel viruses. These results demonstrate the utility of unbiased metagenomic approaches in the detection of known and divergent viruses in the study of tropical @entity221 .

987

988

989

An atlas of histone deacetylase expression in XXXX : fluorescence methodology for comparative semi-quantitative analysis.

multiple_choice

The histone deacetylase inhibitors, suberoylanilide @entity781 ( @entity782 , Zolinza ) and depsipeptide ( @entity783 , Istodax ) have been approved by the US Food and Drug Administration for the treatment of refractory cutaneous @entity784 . Numerous histone deacetylase inhibitors are currently undergoing clinical trials, predominantly in combination with other @entity5 modalities, for the treatment of various haematological and solid @entity5 . Most of the traditional compounds are known as broad-spectrum or pan-histone deacetylase inhibitors, possessing activity against a number of the 11 metal-dependent enzymes. One of the main questions in the field is whether class- or isoform-specific compounds would offer a therapeutic benefit compared to broad-spectrum inhibitors. Therefore, analysis of the relative expression of the different histone deacetylase enzymes in @entity5 cells and tissues is important to determine whether there are specific targets. We used a panel of antibodies directed against the 11 known @entity1 histone deacetylases to determine expression levels in MCF7 @entity0 cells and in tissue representative of @entity513 and @entity513 in situ. Firstly, we utilized a semi-quantitative method based on immunofluorescence staining to examine expression of the different histone deacetylases in MCF7 cells. Our findings indicate high expression levels of HDAC1, 3 and 6 in accordance with findings from others using RT-PCR and immunoblotting. Following validation of our approach we examined the expression of the different isoforms in representative control and @entity0 tissue. In general, our findings indicate higher expression of class I histone deacetylases compared to class II enzymes in @entity0 tissue. Analysis of individual @entity5 cells in the same tissue indicated marked heterogeneity in the expression of most class I enzymes indicating potential complications with the use of class- or isoform-specific compounds. Overall, our approach can be utilized to rapidly compare, in an unbiased semi-quantitative manner, the differential levels of expression of histone deacetylase enzymes in cells and tissues using widely available imaging software. It is anticipated that such analysis will become increasingly important as class- or isoform-specific histone deacetylase inhibitors become more readily available.

990

991

992

Are high doses of XXXX necessary for treatment of @entity401 in @entity785 ?

multiple_choice

INTRODUCTION: @entity401 ( @entity401 ) as part of @entity785 ( @entity785 ) is a leading cause of morbidity and mortality. OBJECTIVES: To evaluate the use of intravenous pulse @entity786 combined with low and high doses of @entity229 in the treatment of @entity401 in @entity785 is equally effective. METHOD: An experimental, exploratory and randomized single-blind clinical trial was conducted at Hermanos Ameijeiras Clinical Surgical Hospital from September 2006 to December 2009, including 23 @entity1 with @entity785 and @entity401 . Two treatment schedules were evaluated and randomly assigned. Group A was composed of 13 @entity1 with a monthly dose of @entity786 (ev) for 6 months and a twice-monthly dose for the remaining 6 months, @entity229 (1 mg kg day) 4 weeks and then the dose was lowered to 5mg every 2 weeks up to 10mg. Group B: 10 @entity1 with @entity786 (ev), oral @entity229 10mg daily. RESULTS: There are significant differences at onset of CVF and the honeycomb pattern between both groups, where the high dose group was at a disadvantage. At the end of treatment the low dose group achieved improvement of radiologic lesions and the Warrick index, unlike the high dose group. The remaining variables experienced improvement in both groups without marked inequality. Similarly, slight adverse reactions were present in both groups. Two @entity1 dropped out of the study. CONCLUSIONS: A combination of low dose @entity230 with @entity786 is effective in @entity401 treatment especially in active disease, and results did not showe differences regarding the high dose group but the sample size and the evolutionary severity of high dose @entity1 oblige other studies to verify this data.

993

994

995

Are high doses of @entity229 necessary for treatment of @entity401 in XXXX ?

multiple_choice

INTRODUCTION: @entity401 ( @entity401 ) as part of @entity785 ( @entity785 ) is a leading cause of morbidity and mortality. OBJECTIVES: To evaluate the use of intravenous pulse @entity786 combined with low and high doses of @entity229 in the treatment of @entity401 in @entity785 is equally effective. METHOD: An experimental, exploratory and randomized single-blind clinical trial was conducted at Hermanos Ameijeiras Clinical Surgical Hospital from September 2006 to December 2009, including 23 @entity1 with @entity785 and @entity401 . Two treatment schedules were evaluated and randomly assigned. Group A was composed of 13 @entity1 with a monthly dose of @entity786 (ev) for 6 months and a twice-monthly dose for the remaining 6 months, @entity229 (1 mg kg day) 4 weeks and then the dose was lowered to 5mg every 2 weeks up to 10mg. Group B: 10 @entity1 with @entity786 (ev), oral @entity229 10mg daily. RESULTS: There are significant differences at onset of CVF and the honeycomb pattern between both groups, where the high dose group was at a disadvantage. At the end of treatment the low dose group achieved improvement of radiologic lesions and the Warrick index, unlike the high dose group. The remaining variables experienced improvement in both groups without marked inequality. Similarly, slight adverse reactions were present in both groups. Two @entity1 dropped out of the study. CONCLUSIONS: A combination of low dose @entity230 with @entity786 is effective in @entity401 treatment especially in active disease, and results did not showe differences regarding the high dose group but the sample size and the evolutionary severity of high dose @entity1 oblige other studies to verify this data.

996

997

998

Are high doses of @entity229 necessary for treatment of XXXX in @entity785 ?

multiple_choice

INTRODUCTION: @entity401 ( @entity401 ) as part of @entity785 ( @entity785 ) is a leading cause of morbidity and mortality. OBJECTIVES: To evaluate the use of intravenous pulse @entity786 combined with low and high doses of @entity229 in the treatment of @entity401 in @entity785 is equally effective. METHOD: An experimental, exploratory and randomized single-blind clinical trial was conducted at Hermanos Ameijeiras Clinical Surgical Hospital from September 2006 to December 2009, including 23 @entity1 with @entity785 and @entity401 . Two treatment schedules were evaluated and randomly assigned. Group A was composed of 13 @entity1 with a monthly dose of @entity786 (ev) for 6 months and a twice-monthly dose for the remaining 6 months, @entity229 (1 mg kg day) 4 weeks and then the dose was lowered to 5mg every 2 weeks up to 10mg. Group B: 10 @entity1 with @entity786 (ev), oral @entity229 10mg daily. RESULTS: There are significant differences at onset of CVF and the honeycomb pattern between both groups, where the high dose group was at a disadvantage. At the end of treatment the low dose group achieved improvement of radiologic lesions and the Warrick index, unlike the high dose group. The remaining variables experienced improvement in both groups without marked inequality. Similarly, slight adverse reactions were present in both groups. Two @entity1 dropped out of the study. CONCLUSIONS: A combination of low dose @entity230 with @entity786 is effective in @entity401 treatment especially in active disease, and results did not showe differences regarding the high dose group but the sample size and the evolutionary severity of high dose @entity1 oblige other studies to verify this data.

999

1000

1001

Targeted cyst wall puncture and aspiration during EUS-FNA increases the diagnostic yield of premalignant and malignant XXXX .

multiple_choice

BACKGROUND: Characterization of @entity45 by using EUS-FNA includes chemical and cytologic analysis. OBJECTIVE: To evaluate whether material obtained from FNA of the cyst wall increases diagnostic yield. DESIGN: Prospective series. SETTING: Tertiary referral center. @entity1 : Consecutive @entity1 with @entity45 referred for EUS-FNA between March 2010 and March 2011. INTERVENTION: FNA was performed with aspiration of cyst fluid for @entity787 ( @entity787 ) and cytology, followed by cyst wall puncture (CWP). CWP is defined as puncturing the far wall of the cyst and moving the needle back and forth through the wall to sample the wall epithelium. MAIN OUTCOME MEASUREMENTS: The diagnostic yield for mucinous cystic @entity788 by @entity787 and cytology obtained from cyst fluid compared with cytology obtained from CWP. @entity787 >= 192 ng/mL was considered mucinous. RESULTS: A total of 69 @entity45 from 66 @entity1 were included. Adequate amounts of fluid were aspirated for @entity787 , amylase, and cytology in 60 cysts (81%). Cellular material adequate for cytologic assessment from CWP was obtained in 56 cysts (81%). Ten (30%) of 33 cysts with @entity787 <192 ng/mL and negative results of cyst fluid cytology had a mucinous diagnosis from CWP; 6 of 9 (67%) cysts with an insufficient amount of fluid for @entity787 analysis and cyst fluid cytology had a mucinous diagnosis from CWP. Furthermore, 4 malignant cysts were independently diagnosed by CWP cytology. The incremental diagnostic yield of CWP for mucinous or malignant cysts was therefore 29% (20 of 69 cysts, P = .0001). An episode of @entity788 (1.45%) occurred. LIMITATION: Lack of surgical criterion standard. CONCLUSIONS: CWP during EUS-FNA is a safe and effective technique for improving the diagnostic yield for premalignant and malignant @entity45 .

1002

1003

1004

Key to successful XXXX repair--an experience of @entity790 surgeries and outcome at gynaecological surgical camp-2005.

multiple_choice

BACKGROUND: @entity789 is not life threatening medical problem, but the @entity1 face demoralization, social boycott and even divorce and separation. The aetiology of the condition has been changed over the years and in developed countries obstetrical @entity292 are rare and they are usually result of gynaecological surgeries or radiotherapy. @entity790 surgery doesn't require special or advance technology but needs experienced urogynaecologist with trained team and post operative care which can restore health, hope _ sense of dignity to @entity1 . METHODS: This prospective study was carried out to analyze the success rate in @entity1 attending the referral hospital and sent from free gynaecological surgery camps held at interior of Sindh, and included preoperative evaluation for route of surgery, operative techniques and postoperative care. Total 70 @entity1 were admitted from the @entity1 attending the camp. Out of these, 29 @entity1 had @entity790 . Surgical repair of the @entity292 was done through vaginal route on 27 @entity1 while 2 required abdominal approach. RESULTS: Out of 29 surgical repairs performed, 27 proved successful. CONCLUSION: Difficult and complicated fistulae need experienced surgeon. Establishment of separate @entity292 surgery unit along with appropriate care and expertise accounts for the desired results.

1005

1006

1007

Key to successful @entity789 repair--an experience of XXXX surgeries and outcome at gynaecological surgical camp-2005.

multiple_choice

BACKGROUND: @entity789 is not life threatening medical problem, but the @entity1 face demoralization, social boycott and even divorce and separation. The aetiology of the condition has been changed over the years and in developed countries obstetrical @entity292 are rare and they are usually result of gynaecological surgeries or radiotherapy. @entity790 surgery doesn't require special or advance technology but needs experienced urogynaecologist with trained team and post operative care which can restore health, hope _ sense of dignity to @entity1 . METHODS: This prospective study was carried out to analyze the success rate in @entity1 attending the referral hospital and sent from free gynaecological surgery camps held at interior of Sindh, and included preoperative evaluation for route of surgery, operative techniques and postoperative care. Total 70 @entity1 were admitted from the @entity1 attending the camp. Out of these, 29 @entity1 had @entity790 . Surgical repair of the @entity292 was done through vaginal route on 27 @entity1 while 2 required abdominal approach. RESULTS: Out of 29 surgical repairs performed, 27 proved successful. CONCLUSION: Difficult and complicated fistulae need experienced surgeon. Establishment of separate @entity292 surgery unit along with appropriate care and expertise accounts for the desired results.

1008

1009

1010

Relationship between Younger Age, Autoimmunity, Cardiometabolic Risk, Oxidative Stress, HAART, and @entity385 in Africans with @entity645 / XXXX .

multiple_choice

Background and Purpose. It now appears clear that both @entity645 / @entity791 and antiretroviral therapy (HAART) use are associated with higher risk of @entity65 such as @entity64 . In this study, we evaluated the prevalence, the risk factors, and the cardiometabolic comorbidities of @entity64 in @entity645 / @entity791 Central African @entity1 . Methods. This hospital-based cross-sectional study collected clinical, laboratory, and imaging data of black Central African heterosexual, intravenous drug nonuser, and @entity645 / @entity791 @entity1 . Results. There were 54 @entity1 and 62 @entity1 , with a female to male ratio of 1.2 : 1. All were defined by @entity49 and oxidative stress. @entity64 was reported in 1 @entity1 , @entity385 in 17 @entity1 , and all @entity64 subtypes in 18 @entity1 (15%). Younger age <45 years (P = .003), @entity792 defined by IDF criteria (P < .0001) were associated with @entity385 . Conclusions. Clustering of several cardiometabolic factors, @entity792 , oxidative stress, and lifestyle changes may explain accelerated @entity731 and high risk of @entity64 in these young black Africans with @entity645 / @entity791 . Prevention and intervention programs are needed.

1011

1012

1013

Relationship between Younger Age, Autoimmunity, Cardiometabolic Risk, Oxidative Stress, HAART, and @entity385 in Africans with XXXX / @entity791 .

multiple_choice

Background and Purpose. It now appears clear that both @entity645 / @entity791 and antiretroviral therapy (HAART) use are associated with higher risk of @entity65 such as @entity64 . In this study, we evaluated the prevalence, the risk factors, and the cardiometabolic comorbidities of @entity64 in @entity645 / @entity791 Central African @entity1 . Methods. This hospital-based cross-sectional study collected clinical, laboratory, and imaging data of black Central African heterosexual, intravenous drug nonuser, and @entity645 / @entity791 @entity1 . Results. There were 54 @entity1 and 62 @entity1 , with a female to male ratio of 1.2 : 1. All were defined by @entity49 and oxidative stress. @entity64 was reported in 1 @entity1 , @entity385 in 17 @entity1 , and all @entity64 subtypes in 18 @entity1 (15%). Younger age <45 years (P = .003), @entity792 defined by IDF criteria (P < .0001) were associated with @entity385 . Conclusions. Clustering of several cardiometabolic factors, @entity792 , oxidative stress, and lifestyle changes may explain accelerated @entity731 and high risk of @entity64 in these young black Africans with @entity645 / @entity791 . Prevention and intervention programs are needed.

1014

1015

1016

Relationship between Younger Age, Autoimmunity, Cardiometabolic Risk, Oxidative Stress, HAART, and XXXX in Africans with @entity645 / @entity791 .

multiple_choice

Background and Purpose. It now appears clear that both @entity645 / @entity791 and antiretroviral therapy (HAART) use are associated with higher risk of @entity65 such as @entity64 . In this study, we evaluated the prevalence, the risk factors, and the cardiometabolic comorbidities of @entity64 in @entity645 / @entity791 Central African @entity1 . Methods. This hospital-based cross-sectional study collected clinical, laboratory, and imaging data of black Central African heterosexual, intravenous drug nonuser, and @entity645 / @entity791 @entity1 . Results. There were 54 @entity1 and 62 @entity1 , with a female to male ratio of 1.2 : 1. All were defined by @entity49 and oxidative stress. @entity64 was reported in 1 @entity1 , @entity385 in 17 @entity1 , and all @entity64 subtypes in 18 @entity1 (15%). Younger age <45 years (P = .003), @entity792 defined by IDF criteria (P < .0001) were associated with @entity385 . Conclusions. Clustering of several cardiometabolic factors, @entity792 , oxidative stress, and lifestyle changes may explain accelerated @entity731 and high risk of @entity64 in these young black Africans with @entity645 / @entity791 . Prevention and intervention programs are needed.

1017

1018

1019

Antibiotic resistance pattern of uropathogenic XXXX in South West Nigeria.

multiple_choice

BACKGROUND: Various studies have indicated @entity526 to be the most prevalent pathogen isolated in urine specimens. OBJECTIVES: This study was therefore conducted to find out whether the same holds in this environment. The study will also determine the resistance pattern of uropathogenic @entity526 isolates to available antibiotics. METHODS: Two hundred consecutive urine samples collected from @entity1 with clinical diagnosis of @entity293 ( @entity293 ) and which have significant @entity793 were included in this study. These were analysed using standard bacteriological techniques. @entity526 isolated from the urine specimens were subjected to antibiotic susceptibility testing because many cases of resistance to commonly available antibiotics here have been encountered in the course of management of @entity1 with @entity293 . RESULTS: Klebsiella species (40%) were found to be the most prevalent uropathogen in this environment, followed by @entity526 (25%), @entity794 (25%), @entity795 (4%), @entity796 (2.5%), and @entity797 (3.5%). Resistance of E. coli to antibiotics commonly used in our environment for @entity293 , namely, @entity115 / @entity798 , @entity799 and @entity115 were 100% each. Resistance rates to other antibiotics such as @entity800 , @entity801 , @entity802 and @entity803 were 70%, 92%, 96% and 88% respectively. CONCLUSION: The high antibiotic resistance rates recorded in this study therefore calls for urgent review of existing and implementation of effective antibiotic policy in this community.

1020

1021

1022

Wild-Type XXXX is Intrinsically Dual-Tropic.

multiple_choice

Measles is a highly contagious disease that causes temporary and severe immunosuppression in @entity1 . Signaling lymphocyte activation molecule ( @entity804 ) expressed on cells of the immune system functions as a receptor for @entity805 ). In addition to @entity804 , vaccine strains of MV also use a ubiquitously expressed complement regulatory protein, @entity806 , as a receptor, whereas wild-type (wt) MV strains do not use this receptor. However, recent studies have indicated that @entity804 is not the sole receptor for wt MV strains. These strains have an intrinsic ability to enter both immune and epithelial cells using distinct receptor binding sites in their hemagglutinin (H) protein. Recently, a clear answer was obtained through the identification of an epithelial MV receptor, @entity807 , expressed at adherens junctions, thereby greatly improving our knowledge of MV receptors. It is now clear that MV specifically targets two cell types, immune cells and epithelial cells, using @entity804 and @entity807 , respectively. MV loses the ability to use either @entity804 or @entity807 when it possesses specific mutations in the H protein. However, @entity807 -blind MV still infects @entity804 -positive immune cells efficiently ( @entity804 -tropic), and conversely, @entity804 -blind MV infects @entity807 -positive epithelial cells efficiently ( @entity807 -tropic). In this regard, MV is intrinsically dual-tropic to immune cells and epithelial cells. Although many aspects and molecular mechanisms underlying immunosuppressive effects and a highly contagious nature of MV still remain to be elucidated, analyses of physiological functions of these two receptors would provide deep insights into MV pathogenesis.

1023

1024

1025

Effectiveness of brief interventions to reduce XXXX intake in primary health care populations: a meta-analysis.

multiple_choice

BACKGROUND: Earlier meta-analyses have not made a distinction between very brief (5- to 20-min) interventions and extended (several visits) brief interventions. METHODS: Literature searches identified seven publications, comprising 14 data sets, meeting the inclusion criteria: sampling from primary care populations, random allocation to intervention and to control groups, and follow-up time 6-12 months. RESULTS: For very brief interventions, the change in @entity167 consumption was not significant among @entity1 nor among @entity1 . For extended brief interventions, the pooled effect estimate of change in @entity167 intake was -51 g of @entity167 per week (95% confidence interval -74, -29) among @entity1 . Among @entity1 the estimate was of similar magnitude, but significant lack of statistical homogeneity implied that the summary estimate was not meaningful. Significant statistical heterogeneity was observed when data on very brief interventions among @entity1 and @entity1 were pooled. That was the case also for gamma-glutamyltransferase activity. CONCLUSIONS: Extended brief interventions were effective among @entity1 . Other brief interventions seem to be effective sometimes, but not always, and the average effect cannot be reliably estimated. The reasons for the lack of uniform effectiveness should be explored.

1026

1027

1028

Giant invasive XXXX : its clinical features and surgical management.

multiple_choice

BACKGROUND: Giant invasive @entity808 (GISS) is defined as a lesion that extends over > 2 vertebral levels, erodes vertebral bodies, and extends posteriorly and laterally into the myofascial planes. Because of its rarity, few reports have been issued. OBJECTIVE: To analyze the clinical features and outcomes of GISS and to discuss surgical strategies. METHODS: We analyzed the medical records, pathological findings, and radiographic studies of @entity1 with GISS. RESULTS: Fourteen @entity1 with GISS were surgically treated between 2002 and 2007. Five lesions were in the sacral region, 4 in the lumbosacral, 2 in the thoracolumbar, and 1 each in the cervical, cervicothoracic, and thoracic regions. Gross total resection was performed in 11 of the 14 @entity1 . Satisfactory decompression was performed in all @entity1 for neural compression. Postoperatively, all @entity1 showed relief of preoperative @entity158 and @entity809 . The growth potential with the Ki-67 index was > 2% in 6 @entity1 , and 4 of them experienced @entity5 regrowth or recurrence. All @entity1 were followed up for at least 24 months. Final follow-up magnetic resonance images showed asymptomatic small @entity5 recurrence on the sacrum in 2 @entity1 . Two @entity1 required spinal stabilization. No instability was found on follow-up. CONCLUSION: Total resection is the treatment of choice for @entity1 with GISS and provides functional improvements, low permanent morbidity, and a low rate of recurrence. Total resection of the intraspinal portion and regular follow-up with consideration of the Ki-67 index is recommended when total resection is not achieved.

1029

1030

1031

Isolated XXXX : novel diagnostic and prognostic criteria with experience of a tertiary care center.

multiple_choice

BACKGROUND: Isolated @entity8 is a life-threatening infection and difficult to diagnose ante mortem due to varied presentations. Most reports in the literature are case reports. We are presenting our experience of 10 @entity1 . MATERIALS AND METHODS: Retrospective data of 10 consecutive @entity1 with primary @entity8 , including 2 post-transplant @entity1 , in our tertiary care center was analyzed. Epidemiological characteristics, predisposing conditions, clinical presentation, diagnostic findings and treatment outcomes were recorded. Characteristic radiological findings were recorded. @entity66 was managed by supportive treatment or percutaneous @entity66 with unilateral or bilateral nephrectomy. Renal involvement was confirmed in all @entity1 by histopathology. RESULTS: The mean age of presentation was 35 years. Five @entity1 who had bilateral renal involvement presented with oliguric @entity810 , @entity811 and @entity490 . Three had @entity8 and presented with @entity812 and @entity221 . The two post-transplant @entity1 presented with @entity221 and @entity813 . Even after aggressive treatment 5 @entity1 died, accounting for a mortality rate of 50%. CONCLUSION: Isolated @entity8 can be diagnosed with typical radiological findings, combined with clinical, laboratory and histopathological features. This study describes the newer ante mortem radiological diagnostic criteria and prognostic predictors of the disease.

1032

1033

1034

A comparison of qualitative and quantitative fecal immunochemical tests in the Korean national XXXX screening program.

multiple_choice

OBJECTIVE: The National Cancer Screening Program (NCSP) has since 2004 provided annual @entity14 screening using the fecal immunochemical test (FIT) for individuals aged 50 years or older. The aim of this study was to examine the positivity and detection rates of the FIT and to compare the detection rates of the qualitative and quantitative FITs in @entity1 in the 2009 NCSP. METHODS: We analyzed positivity and detection rates according to FIT type (qualitative and quantitative). We used a multinomial logistic regression to analyze the odds ratio of "benign" or "suspicious @entity5 and @entity5 " compared to "normal," adjusted for gender, age, health insurance type, region of residence, hospital type, and FIT type. RESULTS: Of the 1,181,904 @entity1 , 72.8% received a qualitative and 27.2% a quantitative FIT. The positivity rates were 8.1% for the qualitative and 2.5% for the quantitative FIT. The detection rate was 5.2% for the qualitative and 14.4% for the quantitative FIT. The odds ratio of a "suspicious @entity5 and @entity5 " versus a "normal" result was 2.73 (95% CI = 2.22-3.35) for the quantitative compared to qualitative FIT, after adjustment. CONCLUSIONS: The positivity rate of the qualitative FIT was around three times higher than that of the quantitative FIT. However, the odds ratio for detection of "suspicious @entity5 and @entity5 " versus "normal" of the quantitative FIT was about three times higher than that of the qualitative FIT. These findings suggest that quality control may be important, particularly for the qualitative FIT.

1035

1036

1037

Unrestricted consumption of fruits and vegetables in XXXX : no major impact on metabolic control.

multiple_choice

BACKGROUND/OBJECTIVES: The treatment of @entity814 ( @entity814 ) requires consistent restriction of protein intake from natural sources. Therefore, protein from all foods has to be accounted for, even the small amounts in fruits and vegetables. We studied whether free consumption of fruits and vegetables containing less than 75 mg @entity815 (phe) per 100 g affects metabolic control in @entity1 with @entity814 . SUBJECTS/METHODS: Fourteen @entity1 (2-10 years) were included in a cross-over study, with a two-week period of conventional treatment (accounting for protein from fruits and vegetables) and a two-week period with free fruit and vegetable consumption. The instruction to follow liberal fruit and vegetable consumption in the first or second study period was randomized. Detailed daily dietary records were obtained throughout the study. @entity815 and nutrient content was calculated. Dried-blood phe concentration was monitored daily. RESULTS: Although total phe intake increased by an average of 58 mg per day (P=0.037) during the 2 weeks of free fruit and vegetable consumption, dried-blood phe concentrations were unchanged. Total intake of fruits and vegetables did not increase, but @entity1 instead used the higher phe tolerance to consume more of other foods, which were calculated and accounted for. CONCLUSION: Free consumption of fruits and vegetables does not impair metabolic control in @entity814 @entity1 over a 2-week period.

1038

1039

1040

A histopathological diagnostic marker for @entity1 spinal XXXX : expression of glial fibrillary acidic protein- .

multiple_choice

Although histopathological diagnosis of spinal @entity602 is important for postoperative treatment planning and prognosis, there is a lack of reliable immunohistochemical markers. The purpose of our study was to assess the expression pattern of @entity538 - in spinal @entity602 in @entity1 @entity1 and to evaluate the utility of @entity538 - as an immunohistochemical diagnostic marker. A total of 22 @entity1 with spinal cord @entity5 were included in this study. @entity1 were classified according to the WHO designation of @entity1 @entity5 ; three @entity1 had grade 1 @entity816 , 14 had grade 2, and five had Grade 3. Normal control spinal cord tissues were obtained at autopsy from the cervical spinal cords of ten @entity1 with no history of cervical @entity130 or @entity16 . We evaluated @entity817 , @entity818 , @entity538 , and @entity538 - immunoreactivity in control tissues and @entity816 . In normal control tissues, @entity538 immunoreactivity was detected in astrocytes whereas @entity538 - immunoreactivity was observed in very few astrocytes adjacent to the subpial layer of the spinal cord. @entity538 - immunoreactivity was significantly correlated with @entity602 grade in @entity816 compared to that in normal control tissues. The optical density of @entity538 - increased significantly with @entity816 grade (correlation coefficient, R (2) = 0.680). Also, @entity817 and @entity818 immunoreactivity were detected in @entity816 . We suggest that @entity538 - may be an additional, reliable histopathological diagnostic marker for spinal @entity602 .

1041

1042

1043

A histopathological diagnostic marker for XXXX spinal @entity816 : expression of glial fibrillary acidic protein- .

multiple_choice

Although histopathological diagnosis of spinal @entity602 is important for postoperative treatment planning and prognosis, there is a lack of reliable immunohistochemical markers. The purpose of our study was to assess the expression pattern of @entity538 - in spinal @entity602 in @entity1 @entity1 and to evaluate the utility of @entity538 - as an immunohistochemical diagnostic marker. A total of 22 @entity1 with spinal cord @entity5 were included in this study. @entity1 were classified according to the WHO designation of @entity1 @entity5 ; three @entity1 had grade 1 @entity816 , 14 had grade 2, and five had Grade 3. Normal control spinal cord tissues were obtained at autopsy from the cervical spinal cords of ten @entity1 with no history of cervical @entity130 or @entity16 . We evaluated @entity817 , @entity818 , @entity538 , and @entity538 - immunoreactivity in control tissues and @entity816 . In normal control tissues, @entity538 immunoreactivity was detected in astrocytes whereas @entity538 - immunoreactivity was observed in very few astrocytes adjacent to the subpial layer of the spinal cord. @entity538 - immunoreactivity was significantly correlated with @entity602 grade in @entity816 compared to that in normal control tissues. The optical density of @entity538 - increased significantly with @entity816 grade (correlation coefficient, R (2) = 0.680). Also, @entity817 and @entity818 immunoreactivity were detected in @entity816 . We suggest that @entity538 - may be an additional, reliable histopathological diagnostic marker for spinal @entity602 .

1044

1045

1046

Can lumbopelvic fixation salvage unstable complex XXXX ?

multiple_choice

BACKGROUND: Traditional screw or plate fixation options can be used to fix the majority of @entity174 . However, these techniques are unreliable with dysmorphic upper sacral segments, @entity174 , osseous compression of neural elements, and previously failed fixation. Lumbopelvic fixation can potentially address these injuries but is a technically demanding procedure requiring spinal and pelvic fixation and it is unclear whether it reliably corrects the @entity85 . QUESTIONS/PURPOSES: We therefore assessed reduction quality and @entity819 , @entity158 related to prominent hardware, subjective dysfunction measured by the Short Musculoskeletal Function Assessment (SMFA), and complications. METHODS: We retrospectively reviewed 15 @entity1 with unstable @entity174 treated with lumbopelvic fixation between 2002 and 2010. @entity1 had radiographic monitoring regarding reduction quality and @entity819 and clinical followup using the SMFA. The minimum followup was 12 months (mean, 23 months; range, 12-41 months). RESULTS: Posterior reduction quality was 11 of 15 with less than 5 mm persistent displacement and four of 15 with 5 to 10 mm displacement. @entity819 was observed in one @entity1 as a result of a technical error. Prominent hardware resulted in greater @entity158 . Despite daily activity and bother subscores improving over time, we found long-term dysfunction in the SMFA. Eleven of the 15 @entity1 were able to return to previous work or activities. CONCLUSION: Complex posterior pelvic @entity130 of the sacrum not amenable to traditional fixation options can be salvaged with adherence to the technical details of lumbopelvic fixation. Hardware prominence and @entity158 are markedly reduced with screw head recession. Long-term impairment is noted in @entity1 with complex pelvic @entity130 requiring lumbopelvic fixation compared with normative data. LEVEL OF EVIDENCE: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

1047

1048

1049

Masked volume wise Principal Component Analysis of small @entity5 in dynamic XXXX Positron Emission Tomography.

multiple_choice

BACKGROUND: In previous clinical Positron Emission Tomography (PET) studies novel approaches for application of Principal Component Analysis (PCA) on dynamic PET images such as Masked Volume Wise PCA (MVW-PCA) have been introduced. MVW-PCA was shown to be a feasible multivariate analysis technique, which, without modeling assumptions, could extract and separate organs and tissues with different @entity146 into different principal components (MVW-PCs) and improve the image quality. METHODS: In this study, MVW-PCA was applied to 14 dynamic @entity820 -PET (MTO-PET) examinations of 7 @entity1 with small @entity5 . MTO-PET was performed before and 3 days after starting per oral @entity821 treatment. The whole dataset, reconstructed by filtered back projection (FBP) 0-45 minutes after the tracer injection, was used to study the tracer pharmacokinetics. RESULTS: Early, intermediate and late pharmacokinetic phases could be isolated in this manner. The MVW-PC1 images correlated well to the conventionally summed image data (15-45 minutes) but the image noise in the former was considerably lower. PET measurements performed by defining "hot spot" regions of interest (ROIs) comprising 4 contiguous pixels with the highest radioactivity concentration showed a trend towards higher SUVs when the ROIs were outlined in the MVW-PC1 component than in the summed images. Time activity curves derived from "50% cut-off" ROIs based on an isocontour function whereby the pixels with SUVs between 50 to 100% of the highest radioactivity concentration were delineated, showed a significant decrease of the SUVs in normal adrenal glands and in @entity822 after @entity821 treatment. CONCLUSION: In addition to the clear decrease in image noise and the improved contrast between different structures with MVW-PCA, the results indicate that the definition of ROIs may be more accurate and precise in MVW-PC1 images than in conventional summed images. This might improve the precision of PET measurements, for instance in therapy monitoring as well as for delineation of the @entity5 in radiation therapy planning.

1050

1051

1052

Masked volume wise Principal Component Analysis of small XXXX in dynamic @entity820 Positron Emission Tomography.

multiple_choice

BACKGROUND: In previous clinical Positron Emission Tomography (PET) studies novel approaches for application of Principal Component Analysis (PCA) on dynamic PET images such as Masked Volume Wise PCA (MVW-PCA) have been introduced. MVW-PCA was shown to be a feasible multivariate analysis technique, which, without modeling assumptions, could extract and separate organs and tissues with different @entity146 into different principal components (MVW-PCs) and improve the image quality. METHODS: In this study, MVW-PCA was applied to 14 dynamic @entity820 -PET (MTO-PET) examinations of 7 @entity1 with small @entity5 . MTO-PET was performed before and 3 days after starting per oral @entity821 treatment. The whole dataset, reconstructed by filtered back projection (FBP) 0-45 minutes after the tracer injection, was used to study the tracer pharmacokinetics. RESULTS: Early, intermediate and late pharmacokinetic phases could be isolated in this manner. The MVW-PC1 images correlated well to the conventionally summed image data (15-45 minutes) but the image noise in the former was considerably lower. PET measurements performed by defining "hot spot" regions of interest (ROIs) comprising 4 contiguous pixels with the highest radioactivity concentration showed a trend towards higher SUVs when the ROIs were outlined in the MVW-PC1 component than in the summed images. Time activity curves derived from "50% cut-off" ROIs based on an isocontour function whereby the pixels with SUVs between 50 to 100% of the highest radioactivity concentration were delineated, showed a significant decrease of the SUVs in normal adrenal glands and in @entity822 after @entity821 treatment. CONCLUSION: In addition to the clear decrease in image noise and the improved contrast between different structures with MVW-PCA, the results indicate that the definition of ROIs may be more accurate and precise in MVW-PC1 images than in conventional summed images. This might improve the precision of PET measurements, for instance in therapy monitoring as well as for delineation of the @entity5 in radiation therapy planning.

1053

1054

1055

The double jeopardy of blunt XXXX .

multiple_choice

OBJECTIVES: To examine the specific injuries, need for operative intervention, and clinical outcomes of @entity1 with blunt @entity823 . DESIGN: @entity130 registry and medical record review. SETTING: Level I @entity130 center in Los Angeles, California. @entity1 : All @entity1 with thoracoabdominal injuries from January 1996 to December 2010. MAIN OUTCOME MEASURES: Injuries, incidence and type of operative intervention, clinical outcomes, and risk factors for mortality. RESULTS: Blunt @entity130 occurred in 1661 @entity1 . Overall, 474 (28.5%) required laparotomy, 31 (1.9%) required thoracotomy (excluding resuscitative thoracotomy), and 1146 (69.0%) required no thoracic or abdominal operation. Overall incidence of intraabdominal solid organ injury was 59.7% and hollow viscus injury, 6.0%. Blunt cardiac @entity130 occurred in 6.3%; major @entity764 , in 4.6%; and diaphragmatic @entity130 , in 6.0%. The majority of solid organ injuries were managed nonoperatively (liver, 83.9%; spleen, 68.3%; and kidney, 91.2%). Excluding @entity1 with severe @entity542 , mortality ranged from 4.5% with nonoperative management to 18.1% and 66.7% in those requiring laparotomy and dual cavitary exploration, respectively. Age 55 years or older, Injury Severity Score of 25 or more, Glasgow @entity772 Scale score of 8 or less, initial @entity551 , massive transfusion, and liver, cardiac, or abdominal vascular @entity130 were all independent risk factors for mortality. CONCLUSIONS: Most @entity1 with blunt @entity823 are managed nonoperatively. The need for non-resuscitative thoracotomy or combined thoracoabdominal operation is rare. The abdomen contains the overwhelming majority of injuries requiring operative intervention and should be the initial cavity of exploration in the @entity1 requiring emergent surgery without directive radiologic data.

1056

1057

1058

Acute inhalation study of XXXX for derivation of acute exposure guideline levels.

multiple_choice

An acute, whole-body inhalation study for @entity824 in @entity35 was designed to support derivation of AEGL values, with emphasis on establishing NOAELs for irreversible effects of different exposure concentrations and durations. Groups of 10 @entity35 were exposed for 1 hour (0, 50, 200, or 400 ppm), 4 hours (0, 20, 50, or 100 ppm), or 8 hours (0, 10, 20, or 50 ppm). Clinical evaluations were performed during exposure and in an open field within 22-71 minutes after termination of exposure. Clinical pathology, gross necropsy, and histopathology (nasal tissues, larynx, @entity825 , lungs/bronchi, liver, and kidneys) were evaluated 14 days after exposure. Mortality was limited to 1 male exposed for 8 hours to 50 ppm. Clinical findings of gasping, rales, increased respiration noted at higher exposure levels were rapidly reversed. No treatment-related findings were observed in the liver and kidneys, or in the lungs of surviving animals. Histopathology in the nasal cavity was noted at all exposure levels following 1, 4, or 8 hours of exposure. Mild @entity32 was found at the lowest exposure levels (50-ppm/1-hour, 20-ppm/4-hour, and 10-ppm/8-hour). These effects were considered reversible and were not associated with related clinical signs. Severe, irreversible nasal olfactory epithelial lesions were present in 50 ppm/8-hour males. The NOELs for irreversible effects were 400-ppm/1-hour, 100-ppm/4-hour, and 20-ppm/8-hour. The incidence of severe findings was positively dependent on both concentration and the exposure duration. In contrast, the incidence of mild reversible findings did not appear to be dependent on duration.

1059

1060

1061

[Pseudo- XXXX with hyperimmunoglobulinemia D: a never-ending story with probable prenatal onset].

multiple_choice

Diagnosis of inflammatory non-infectious diseases with a neonatal onset is often retrospective. It may lead to @entity146 and iatrogenic procedures. @entity1 : A 6-year-old @entity1 was suffering, since birth, from recurrent febrile attacks including rashes, @entity344 and inflammatory joint involvement. This syndrome, partially improved with @entity230 , could have been of antenatal onset. Since the age of 4 years, the @entity1 is considered as having @entity826 ( @entity826 ). DISCUSSION: @entity826 must be distinguished from @entity827 . @entity1 suffer from recurrent @entity221 concomitant to inflammatory joint involvement, abdominal distress, @entity272 , swollen lymph nodes and @entity828 (especially seen in @entity1 ). All @entity1 have high serum IgD (> 100 UI/mL) and IgA levels. Nevertheless, a high IgD level is not specific. Our case could also be part of the @entity829 (chronic, infantile, neurological, cutaneous and articular) syndrome, which includes similar early manifestations associated with a constant neurological and frequent ophthalmological involvement and epiphyseal changes; to date, these last three manifestations are not present in our @entity1 . CONCLUSION: @entity826 and @entity829 are not known to be modified by any effective therapeutic agent. When presenting at birth, these inflammatory diseases must be considered as entities with a rarely described potential severity.

1062

1063

1064

A trans-specific polymorphism in @entity830 is maintained by long-standing balancing selection and may confer susceptibility to XXXX .

multiple_choice

The @entity1 @entity830 gene encodes an antiviral protein. The longest splicing isoform of @entity830 contains a C-terminal PARP-like domain, which has evolved under positive selection in primates. We analyzed the evolutionary history of this same domain in @entity1 and in @entity831 . We identified two variants that segregate in both @entity1 and @entity831 ; one of them ( @entity832 ) does not occur at a hypermutable site and accounts for a nonsynonymous substitution ( @entity833 ). The probability that the two trans-specific polymorphisms have occurred independently in the two lineages was estimated to be low (P = 0.0054), suggesting that at least one of them has arisen before speciation and has been maintained by selection. Population genetic analyses in @entity1 indicated that the region surrounding the shared variants displays strong evidences of long-standing balancing selection. Selection signatures were also observed in a @entity831 population sample. Inspection of 1000 Genomes data confirmed these findings but indicated that search for selection signatures using low-coverage whole-genome data may need masking of repetitive sequences. A case-control study of more than 1,000 individuals from mainland Italy indicated that the @entity833 SNP is significantly associated with susceptibility to @entity15 ( @entity15 ) (odds ratio [OR] = 1.47, 95% confidence intervals [CI]: 1.08-1.99, P = 0.011). This finding was confirmed in a larger sample of 4,416 Sardinians cases/controls (OR = 1.18, 95% CI: 1.037-1.344, P = 0.011), but not in a population from Belgium. We provide one of the first instances of @entity1 / @entity831 trans-specific coding variant located outside the major histocompatibility complex region. The selective pressure is likely to be virus driven; in modern populations, this variant associates with susceptibility to @entity15 , possibly via the interaction with environmental factors.

1065

1066

1067

A trans-specific polymorphism in XXXX is maintained by long-standing balancing selection and may confer susceptibility to @entity15 .

multiple_choice

The @entity1 @entity830 gene encodes an antiviral protein. The longest splicing isoform of @entity830 contains a C-terminal PARP-like domain, which has evolved under positive selection in primates. We analyzed the evolutionary history of this same domain in @entity1 and in @entity831 . We identified two variants that segregate in both @entity1 and @entity831 ; one of them ( @entity832 ) does not occur at a hypermutable site and accounts for a nonsynonymous substitution ( @entity833 ). The probability that the two trans-specific polymorphisms have occurred independently in the two lineages was estimated to be low (P = 0.0054), suggesting that at least one of them has arisen before speciation and has been maintained by selection. Population genetic analyses in @entity1 indicated that the region surrounding the shared variants displays strong evidences of long-standing balancing selection. Selection signatures were also observed in a @entity831 population sample. Inspection of 1000 Genomes data confirmed these findings but indicated that search for selection signatures using low-coverage whole-genome data may need masking of repetitive sequences. A case-control study of more than 1,000 individuals from mainland Italy indicated that the @entity833 SNP is significantly associated with susceptibility to @entity15 ( @entity15 ) (odds ratio [OR] = 1.47, 95% confidence intervals [CI]: 1.08-1.99, P = 0.011). This finding was confirmed in a larger sample of 4,416 Sardinians cases/controls (OR = 1.18, 95% CI: 1.037-1.344, P = 0.011), but not in a population from Belgium. We provide one of the first instances of @entity1 / @entity831 trans-specific coding variant located outside the major histocompatibility complex region. The selective pressure is likely to be virus driven; in modern populations, this variant associates with susceptibility to @entity15 , possibly via the interaction with environmental factors.

1068

1069

1070

Conservative management of minor XXXX after open elective colorectal surgery.

multiple_choice

INTRODUCTION: The utility of prophylactic drainage in colorectal surgery is controversial. The aim of the present article is to study the role of drainage tubes on the management of minor anastomotic dehiscences. @entity1 AND METHODS: We retrospectively review clinical reports of 18 consecutive @entity1 with anastomotic dehiscence after open elective colorectal surgery. The mean age was 63 years and the male - female ratio was 5:1. Nine (50%) @entity1 underwent re-operation for @entity298 (group A) while the remaining nine (50%) were managed conservatively (group B). The parameters evaluated in both groups were: time of the anastomotic breakdown, clinical findings, amount of fluid drained the day of the dehiscence, diagnostic means used, length of stay and mortality. RESULTS: @entity834 were observed medially after 3, 6 days from surgery in group A and after 5.6 days in group B. The most frequent clinical manifestations were: fecal material through the tubes (88.9%), pelvic @entity158 (88.9%) and fever (77.8%). @entity1 in group A had a median faecal fluid flow of 235cc the day of the dehiscence and 130cc those in group B. Imaging was employed only in three cases in group A and in all cases in group B. The length of hospital stay was longer in @entity1 treated surgically: 37 days versus 29 in those treated conservatively. CONCLUSIONS: Minor @entity834 generally occur later than greater ones, they have a milder clinical presentation and can be managed conservatively with the use of drain tubes.

1071

1072

1073

[Six-month follow-up study of drug treatment for XXXX : comparison study of four drugs].

multiple_choice

OBJECTIVES: @entity835 is one of the most common forms of addiction worldwide. A variety of reasons for use exist, however, there are only a few tested treatments with frequent relapses. In this study, we examined the efficacy of four pharmacotherapy agents for the treatment of @entity835 : @entity836 , @entity752 , @entity837 and @entity838 . MATERIALS AND METHODS: A total of 59 @entity1 were randomly assigned into four groups. Each group received one of the pharmacological agents for 120 days. Four types of questionnaires were employed: The Hamilton Rating Scale for Depression--21 items, the Hamilton Rating Scale for @entity148 , the Global Assessment of Functioning and a Visual Analogue Scale for perceived need of the drug. In addition, random urine tests were performed to detect @entity839 [ @entity839 ). RESULTS: @entity836 proved to be the most efficacious of the four agents, with only four dropouts. Other agents proved less efficacious with six, seven and eights dropouts for @entity752 , @entity838 and @entity837 , respectively. In addition, @entity836 was most efficacious in reducing @entity148 and @entity308 rates, and increasing functioning and perceived need for drug use. CONCLUSION: Out of four pharmacological agents, @entity836 proved to be most efficacious in treating @entity835 and related disorders. Further studies are needed to confirm our results.

1074

1075

1076

Correlation of morphology, electrophysiology and chemistry of neurons in the myenteric plexus of the XXXX distal colon.

multiple_choice

Intracellular recordings were made from myenteric neurons of the @entity840 distal colon to determine their electrical behaviour in response to intracellular current injection and stimulation of synaptic inputs. The recording microelectrode contained the intracellular marker biocytin, which was injected into impaled neurons so that electrophysiology, shape and immunohistochemistry could be correlated. Myenteric neurons in the distal colon were divided into four morphological groups based on their shapes and projections. One group (29 of the 78 that were characterized electrophysiologically, morphologically and immunohistochemically) was the multiaxonal Dogiel type II neurons, the majority (25/29) of which were calbindin immunoreactive. Each of these neurons had an inflection on the falling phase of the action potential that, in 24/29 neurons, was followed by a late @entity841 ( @entity841 ). Slow excitatory postsynaptic potentials were recorded in 20 of 29 Dogiel type II neurons in response to high frequency internodal strand stimulation and two neurons responded with slow inhibitory postsynaptic potentials. Low amplitude fast excitatory postsynaptic potentials occurred in 3 of 29 Dogiel type II neurons. Neurons of the other three groups were all uniaxonal: neurons with Dogiel type I morphology, filamentous ascending interneurons and small filamentous neurons with local projections to the longitudinal or circular muscle or to the tertiary plexus. Dogiel type I neurons were often immunoreactive for @entity842 synthase or calretinin, as were some small filamentous neurons, while all filamentous ascending interneurons tested were calretinin immunoreactive. All uniaxonal neurons exhibited prominent fast excitatory postsynaptic potentials and did not have a late @entity841 following a single action potential, that is, all uniaxonal neurons displayed S type electrophysiological characteristics. However, in 6/19 Dogiel type I neurons and 2/8 filamentous ascending interneurons, a prolonged hyperpolarizing potential ensued when more than one action potential was evoked. Slow depolarizing postsynaptic potentials were observed in 20/29 Dogiel type I neurons, 6/8 filamentous ascending interneurons and 8/12 small filamentous neurons. Six of 29 Dogiel type I neurons displayed slow inhibitory postsynaptic potentials, as did 2/8 filamentous ascending interneurons and 4/12 small filamentous neurons. These results indicate that myenteric neurons in the distal colon of the @entity840 are electrophysiologically similar to myenteric neurons in the ileum, duodenum and proximal colon. Also, the correlation of AH electrophysiological characteristics with Dogiel type II morphology and S electrophysiological characteristics with uniaxonal morphology is preserved in this region. However, filamentous ascending interneurons have not been encountered in other regions of the gastrointestinal tract and there are differences between the synaptic properties of neurons in this region compared to other regions studied, including the presence of slow depolarizing postsynaptic potentials that appear to involve conductance increases and frequent slow inhibitory postsynaptic potentials.

1077

1078

1079

Peritoneal expansion by artificially produced XXXX during perfusion chemotherapy.

multiple_choice

HYPOTHESIS: In cases of @entity298 , @entity298 ( @entity298 ) accomplishes homogeneous distribution of the drug and heat to the entire peritoneal cavity and exposure of the visceral and parietal surfaces to the perfusate. A new closed technique for expansion that produces artificial @entity843 is safer for medical personnel because of less heat and @entity393 and more efficacious in its hemodynamic effect on the @entity1 . DESIGN: Prospective study. SETTING: University hospital. @entity1 : Twenty-one @entity1 with @entity298 . INTERVENTIONS: We performed 23 @entity298 ( @entity298 ) procedures with peritoneal cavity expansion to an intra-abdominal pressure up to 26 mm Hg, using artificially produced @entity843 with 4 to 9 L normal saline solution. MAIN OUTCOME MEASURES: Intraoperative and @entity260 and hemodynamic changes during @entity298 . RESULTS: No intraoperative complications were recorded. The artificially produced @entity843 did not cause significant hemodynamic changes. During the immediate postoperative period, 1 @entity1 died of @entity548 and leakage of a @entity14 , resulting in a mortality rate of 4% in our series. Minor complications were seen in 14 @entity1 . The complications were not attributable to the expansion technique. CONCLUSIONS: Our proposed modification of closed-circuit @entity298 appears to be well tolerated and safe in @entity1 with a high @entity5 load, as well as for the theater personnel. It remains to be investigated whether the theoretical advantages of the proposed technique will also lead to better long-term results.

1080

1081

1082

Non- XXXX -interrupted fatty acids from marine invertebrates: Occurrence, characterization and biological properties.

multiple_choice

Marine organisms, in particular invertebrates, have proved to be a major source of unique @entity844 (FA) structures originating from unusual biosynthetic pathways. Among them, non- @entity845 -interrupted (NMI) FA occur in various molluscs in the wide ranges of concentrations (up to 20%), such as the most often encountered 20:2 @entity846 ,11, 20:2 @entity846 ,13, 22:2 @entity847 ,13 or 22:2 Delta7,15. Such NMI FA have also been reported from algae, echinoderms, sponges, tropical rays, and many other invertebrates. The most intriguing marine invertebrates seem to be sponges that commonly contain very long-chain Delta5,9 FA. A third double bond can occur in the NMI FA as reported in some marine organisms, such as 20:3 Delta7,13,16 or 30:3 @entity846 ,9,23. Lipids of invertebrates from deep-sea hydrothermal and cold-seep vents gave rise to an intense research activity including reports on unprecedented NMI polyunsaturated FA. The bivalve molluscs are able to synthesize de novo the NMI FA but their precise biological interest is presently not well-known, although structural and functional roles in biological membranes have been suggested, in particular a higher resistance to oxidative processes and microbial lipases. Biosynthetic pathways of @entity846 ,9 FA in sponges were demonstrated up to C(26) FA structures and include particular elongation and desaturation steps. Recently, intense research effort has been conducted to investigate the biomedical potential of these unusual FA. Thus, @entity846 ,9 FA displayed interesting antiplasmodial activity. The most promising FA topoisomerase I inhibitors to date seem to be the long-chain Delta5,9 FA. This inhibitory activity is probably partially responsible for the @entity137 displayed by some of the @entity846 ,9 FA towards @entity5 cell lines.

1083

1084

1085

Palliative balloon valvoplasty of the pulmonary valve in XXXX .

multiple_choice

Balloon dilation of the pulmonary valve was performed in 54 @entity1 with @entity215 with severe @entity848 , high haematocrit and severe @entity849 . Clinical, echocardiographic, angiographic, and haemodynamic data were analyzed before and after the procedure. After @entity384 , the systemic @entity26 saturation increased from a mean value of 66% to 85%. The mean value of the haematocrit before dilation was 55 + 13, and decreased to 47 after dilation (p < 0.002) in 2 months follow-up. Balloon dilation increased the size of the pulmonary valvar orifice from a mean value of 9 + 5 mm to 11.5 + 2 mm (p < 0.005). The mean Z score of the pulmonary valves, which was -3 + 1.3 before dilation, increased to -1.1 + 1.1 immediately after the procedure (p < 0.05). The size of the right and left pulmonary arteries increased after dilation from 9 mm to 10 mm, and from 8.7 + 2.4 mm to 9.8 + 2.3 mm, respectively (p < 0.05). The comparable mean Z scores increased from -2.8 + 1.9 SD to -1.8 + 1.4 SD, and from -2.4 + 1.9 SD to -1.5 + 1.6 SD for the right and left branches, respectively (p < 0.05). In @entity1 with @entity850 at the bifurcation of the pulmonary trunk and @entity509 of the left artery, successful dilation of the pulmonary valve lead to an increase of flow and improvement in size of the hypoplastic segment. In conclusion, @entity384 of the pulmonary valve in @entity215 resulted in increase of the Z score for the pulmonary valve and improved antegrade pulmonary blood flow, inducing growth of the pulmonary arteries and ameliorating the anatomic and physiologic preoperative condition.

1086

1087

1088

High-throughput micro-computed tomography imaging as a method to evaluate @entity35 and @entity95 fetal @entity853 for developmental XXXX studies.

multiple_choice

INTRODUCTION: Fetal skeletal assessments are routinely conducted as a part of preclinical safety studies to support the development of novel therapeutic agents. @entity622 staining with visual inspection of fetal skeletons is the gold standard in evaluating skeletons for the presence of @entity851 . X-ray based micro-computed tomography (micro-CT) imaging has been used to evaluate small skeletal structures, both in vivo and ex vivo. Recent technological advances have reduced micro-CT image acquisition time making this technology practical for routine fetal skeletal evaluations. Herein we report on the use of micro-CT imaging as a method to perform high-throughput assessment of fetal skeletons. METHODS: Micro-CT imaging of @entity35 and @entity95 fetal skeletons was conducted under a variety of conditions, including, in vivo, contrast-enhanced in vivo, and ex vivo. To increase throughput, micro-CT imaging was employed using custom designed @entity852 foam fetal holders to image entire litters of ex vivo fetuses. After micro-CT imaging, fetuses were routinely stained with @entity622 red to compare micro-CT imaging results with traditional alizarin red staining. RESULTS: Fetal skeletons could be visualized using in vivo micro-CT imaging; however, due to crowding, specific identification of individual fetuses was deemed not practical. Administration of a routine contrast agent to pregnant females highlighted maternal vascular structures including the placenta, but unfortunately, did not cross the placenta and did not highlight any fetal soft tissue structures. Ex vivo fetal imaging provided the best image quality of fetal skeletons and allowed for specific fetal identification. The fetal holders allowed for micro-CT imaging of approximately 400 @entity35 fetuses or approximately 140 @entity95 fetuses per hour. Micro-CT image skeletal findings and alizarin red findings were comparable. The very few discrepancies between the two methods involved the smallest skeletal elements with minimal ossification. DISCUSSION: In conclusion, micro-CT ex vivo imaging can provide a reliable high-throughput method to assess fetal @entity853 for developmental @entity137 studies.

1089

1090

1091

High-throughput micro-computed tomography imaging as a method to evaluate @entity35 and XXXX fetal @entity853 for developmental @entity137 studies.

multiple_choice

INTRODUCTION: Fetal skeletal assessments are routinely conducted as a part of preclinical safety studies to support the development of novel therapeutic agents. @entity622 staining with visual inspection of fetal skeletons is the gold standard in evaluating skeletons for the presence of @entity851 . X-ray based micro-computed tomography (micro-CT) imaging has been used to evaluate small skeletal structures, both in vivo and ex vivo. Recent technological advances have reduced micro-CT image acquisition time making this technology practical for routine fetal skeletal evaluations. Herein we report on the use of micro-CT imaging as a method to perform high-throughput assessment of fetal skeletons. METHODS: Micro-CT imaging of @entity35 and @entity95 fetal skeletons was conducted under a variety of conditions, including, in vivo, contrast-enhanced in vivo, and ex vivo. To increase throughput, micro-CT imaging was employed using custom designed @entity852 foam fetal holders to image entire litters of ex vivo fetuses. After micro-CT imaging, fetuses were routinely stained with @entity622 red to compare micro-CT imaging results with traditional alizarin red staining. RESULTS: Fetal skeletons could be visualized using in vivo micro-CT imaging; however, due to crowding, specific identification of individual fetuses was deemed not practical. Administration of a routine contrast agent to pregnant females highlighted maternal vascular structures including the placenta, but unfortunately, did not cross the placenta and did not highlight any fetal soft tissue structures. Ex vivo fetal imaging provided the best image quality of fetal skeletons and allowed for specific fetal identification. The fetal holders allowed for micro-CT imaging of approximately 400 @entity35 fetuses or approximately 140 @entity95 fetuses per hour. Micro-CT image skeletal findings and alizarin red findings were comparable. The very few discrepancies between the two methods involved the smallest skeletal elements with minimal ossification. DISCUSSION: In conclusion, micro-CT ex vivo imaging can provide a reliable high-throughput method to assess fetal @entity853 for developmental @entity137 studies.

1092

1093

1094

High-throughput micro-computed tomography imaging as a method to evaluate @entity35 and @entity95 fetal XXXX for developmental @entity137 studies.

multiple_choice

INTRODUCTION: Fetal skeletal assessments are routinely conducted as a part of preclinical safety studies to support the development of novel therapeutic agents. @entity622 staining with visual inspection of fetal skeletons is the gold standard in evaluating skeletons for the presence of @entity851 . X-ray based micro-computed tomography (micro-CT) imaging has been used to evaluate small skeletal structures, both in vivo and ex vivo. Recent technological advances have reduced micro-CT image acquisition time making this technology practical for routine fetal skeletal evaluations. Herein we report on the use of micro-CT imaging as a method to perform high-throughput assessment of fetal skeletons. METHODS: Micro-CT imaging of @entity35 and @entity95 fetal skeletons was conducted under a variety of conditions, including, in vivo, contrast-enhanced in vivo, and ex vivo. To increase throughput, micro-CT imaging was employed using custom designed @entity852 foam fetal holders to image entire litters of ex vivo fetuses. After micro-CT imaging, fetuses were routinely stained with @entity622 red to compare micro-CT imaging results with traditional alizarin red staining. RESULTS: Fetal skeletons could be visualized using in vivo micro-CT imaging; however, due to crowding, specific identification of individual fetuses was deemed not practical. Administration of a routine contrast agent to pregnant females highlighted maternal vascular structures including the placenta, but unfortunately, did not cross the placenta and did not highlight any fetal soft tissue structures. Ex vivo fetal imaging provided the best image quality of fetal skeletons and allowed for specific fetal identification. The fetal holders allowed for micro-CT imaging of approximately 400 @entity35 fetuses or approximately 140 @entity95 fetuses per hour. Micro-CT image skeletal findings and alizarin red findings were comparable. The very few discrepancies between the two methods involved the smallest skeletal elements with minimal ossification. DISCUSSION: In conclusion, micro-CT ex vivo imaging can provide a reliable high-throughput method to assess fetal @entity853 for developmental @entity137 studies.

1095

1096

1097

High-throughput micro-computed tomography imaging as a method to evaluate XXXX and @entity95 fetal @entity853 for developmental @entity137 studies.

multiple_choice

INTRODUCTION: Fetal skeletal assessments are routinely conducted as a part of preclinical safety studies to support the development of novel therapeutic agents. @entity622 staining with visual inspection of fetal skeletons is the gold standard in evaluating skeletons for the presence of @entity851 . X-ray based micro-computed tomography (micro-CT) imaging has been used to evaluate small skeletal structures, both in vivo and ex vivo. Recent technological advances have reduced micro-CT image acquisition time making this technology practical for routine fetal skeletal evaluations. Herein we report on the use of micro-CT imaging as a method to perform high-throughput assessment of fetal skeletons. METHODS: Micro-CT imaging of @entity35 and @entity95 fetal skeletons was conducted under a variety of conditions, including, in vivo, contrast-enhanced in vivo, and ex vivo. To increase throughput, micro-CT imaging was employed using custom designed @entity852 foam fetal holders to image entire litters of ex vivo fetuses. After micro-CT imaging, fetuses were routinely stained with @entity622 red to compare micro-CT imaging results with traditional alizarin red staining. RESULTS: Fetal skeletons could be visualized using in vivo micro-CT imaging; however, due to crowding, specific identification of individual fetuses was deemed not practical. Administration of a routine contrast agent to pregnant females highlighted maternal vascular structures including the placenta, but unfortunately, did not cross the placenta and did not highlight any fetal soft tissue structures. Ex vivo fetal imaging provided the best image quality of fetal skeletons and allowed for specific fetal identification. The fetal holders allowed for micro-CT imaging of approximately 400 @entity35 fetuses or approximately 140 @entity95 fetuses per hour. Micro-CT image skeletal findings and alizarin red findings were comparable. The very few discrepancies between the two methods involved the smallest skeletal elements with minimal ossification. DISCUSSION: In conclusion, micro-CT ex vivo imaging can provide a reliable high-throughput method to assess fetal @entity853 for developmental @entity137 studies.

1098

1099

1100

Clinical correlates and prognostic significance of electrocardiographic abnormalities in @entity661 (Takotsubo/stress-induced XXXX ).

multiple_choice

BACKGROUND: @entity661 ( @entity661 ) is a unique transient @entity296 that mimics an acute @entity583 . The relative frequency of ST-segment elevation on the 12-lead electrocardiogram (ECG) and its prognostic significance is unknown. The aims of this study were to evaluate the frequency and the clinical correlates of ST- and T-wave abnormalities on the admission ECG in @entity1 with @entity661 . METHODS: @entity1 were retrospectively identified from the cardiac catheterization database--those who underwent coronary and left ventricular angiography and fulfilled the Mayo criteria for @entity661 during the period January 1988 to November 2006. They were divided into 3 groups according to the presence of (1) ST-segment elevation (>1 mm in 2 contiguous lead) or new @entity714 , (2) T-wave inversion (>3 mm in 3 contiguous leads) but no ST shift, and (3) nonspecific @entity854 or normal ECG at the time of admission. Clinical and echocardiographic findings were compared between groups. RESULTS: Among the 105 @entity1 , 36 (34.2%), 32 (30.4%), and 37 (35.2%) @entity1 were in the three respective groups. There were no differences in the clinical characteristics, ejection fraction, and outcomes between the 3 groups. Over a median follow-up of 2.5 years, there was no difference in the 5-year recurrence rate of @entity661 between the 3 groups (13%, 5%, 17% @entity1 , respectively, P = .25). The 5-year mortality was similar in the 3 groups (24%, 7.3%, 10.8%, P = .58). CONCLUSIONS: ST-segment elevation is absent in two thirds of @entity1 with @entity661 . Thus, the @entity296 may mimic either ST-elevation or non-ST-elevation @entity583 . The ECG abnormalities at presentation do not correlate with the magnitude of @entity67 or outcomes.

1101

1102

1103

Clinical correlates and prognostic significance of electrocardiographic abnormalities in XXXX (Takotsubo/stress-induced @entity296 ).

multiple_choice

BACKGROUND: @entity661 ( @entity661 ) is a unique transient @entity296 that mimics an acute @entity583 . The relative frequency of ST-segment elevation on the 12-lead electrocardiogram (ECG) and its prognostic significance is unknown. The aims of this study were to evaluate the frequency and the clinical correlates of ST- and T-wave abnormalities on the admission ECG in @entity1 with @entity661 . METHODS: @entity1 were retrospectively identified from the cardiac catheterization database--those who underwent coronary and left ventricular angiography and fulfilled the Mayo criteria for @entity661 during the period January 1988 to November 2006. They were divided into 3 groups according to the presence of (1) ST-segment elevation (>1 mm in 2 contiguous lead) or new @entity714 , (2) T-wave inversion (>3 mm in 3 contiguous leads) but no ST shift, and (3) nonspecific @entity854 or normal ECG at the time of admission. Clinical and echocardiographic findings were compared between groups. RESULTS: Among the 105 @entity1 , 36 (34.2%), 32 (30.4%), and 37 (35.2%) @entity1 were in the three respective groups. There were no differences in the clinical characteristics, ejection fraction, and outcomes between the 3 groups. Over a median follow-up of 2.5 years, there was no difference in the 5-year recurrence rate of @entity661 between the 3 groups (13%, 5%, 17% @entity1 , respectively, P = .25). The 5-year mortality was similar in the 3 groups (24%, 7.3%, 10.8%, P = .58). CONCLUSIONS: ST-segment elevation is absent in two thirds of @entity1 with @entity661 . Thus, the @entity296 may mimic either ST-elevation or non-ST-elevation @entity583 . The ECG abnormalities at presentation do not correlate with the magnitude of @entity67 or outcomes.

1104

1105

1106

P2Y receptor-mediated XXXX signalling in cultured rat aortic smooth muscle cells.

multiple_choice

1. @entity855 , @entity856 , @entity857 and @entity857 -beta-S elicited @entity141 -signals in cultured aortic smooth muscle cells although @entity857 , @entity858 and @entity857 -beta-S gave approximately 40% of the maximal response seen with @entity855 and @entity856 . @entity859 , @entity860 or @entity861 had no effect. These responses were attributed to @entity862 and @entity863 receptors, which we assumed could be selectively activated by @entity856 and @entity857 -beta-S respectively. 2. The response to @entity856 was reduced (approximately 50%) by pertussis toxin, whilst this toxin had no effect upon the response to @entity857 -beta-S. This suggests @entity862 receptors simultaneously couple to pertussis toxin-sensitive and -resistant G proteins whilst @entity863 receptors couple to only the toxin-resistant proteins. 3. Repeated stimulation with @entity856 or @entity857 -beta-S caused desensitization which was potentiated by @entity864 ( @entity865 ) and attenuated by @entity866 . 4. @entity865 completely abolished sensitivity to @entity857 -beta-S but the response to @entity856 had a @entity865 -resistant component. In pertussis toxin-treated cells, however, @entity865 could completely abolish sensitivity to @entity856 and so the @entity865 -resistant part of this response seems to be mediated by pertussis toxin-sensitive G proteins. 5. Loss of sensitivity to @entity856 did not occur when pertussis toxin-treated cells were repeatedly stimulated with this @entity377 , suggesting that pertussis toxin-sensitive G proteins mediate this effect. The toxin did not, however affect desensitization to @entity857 -beta-S.

1107

1108

1109

Determinants of tuberculin reactivity among XXXX : Interpretation of positivity following BCG vaccination.

multiple_choice

OBJECTIVE: To determine the extent to which a history of Bacille Calmette-Guerin (BCG) vaccination influences the likelihood of positive @entity272 ( @entity272 ) results. DESIGN: Cross-sectional survey using a hospital-based @entity378 surveillance program. SETTING: Health Sciences Centre, a tertiary care hospital in Winnipeg, Manitoba. METHODS: The 476 @entity283 ( @entity283 ) who had @entity272 as part of the surveillance program between 1993 and 1997 constituted the study population. The two-step test was done in 91% of the @entity1 who did not have a positive initial test, defined as 10 mm or greater of induration. Data were gathered through chart review supplemented by a short questionnaire administered to the @entity283 . MAIN RESULTS: One hundred and thirty-eight @entity283 (29%) had a positive @entity272 . In a stepwise, multiple logistic model controlling for age, sex, job title, work area, age of receiving BCG, time since BCG and duration of employment, only a history of BCG vaccination (odds ratio [OR] 22; 95% CI 12 to 41) and birth outside of Canada (OR 2.6; 95% CI 1.4 to 5.8) were significantly associated with a positive @entity272 . When the definition of a positive @entity272 was modified by increments of 1 mm, from 10 mm up to 20 mm of induration in BCG recipients, BCG was associated with positive reactions with indurations up to 19 mm but not 20 mm or greater. The OR declined with each increment. Of the 84 @entity283 who were documented to have at least 20 years between BCG vaccination and testing, 41 (49%) had positive reactions. CONCLUSIONS: BCG vaccination can produce lasting tuberculin reactivity, and indurations of 19 mm or less may be due to the effects of the vaccine.

1110

1111

1112

XXXX in the computed tomography era: A 10-year experience from Auckland, New Zealand.

multiple_choice

Notes were reviewed for 68 @entity1 with @entity867 diagnosed at Auckland Hospital, Auckland, New Zealand between 1978 and 1988. Mean age was 30 years (range one week to 74 years). There were 48 @entity1 and 40% were Maori or Pacific Island Polynesians. Seventy-two per cent of @entity1 had @entity10 , 54% had @entity221 and 72% had lateralizing neurological signs. Thirty-one per cent of abscesses were associated with @entity281 (otic, sinus, dental). Forty-four per cent were in the frontal lobe. Two abscesses were sterile; 197 bacterial isolates were cultured from the remainder. Fifty-four per cent contained obligate anaerobes, which were the only isolates in 22%. Streptococcus anginosus was the single most common isolate present in 22% of the abscesses. @entity115 plus @entity868 provided cover for approximately 95% of the total isolates on the basis of sensitivity testing. Treatment was with surgery and antibiotics in all but three @entity1 , who were cured with antibiotics alone. Sixty per cent had a definitive regimen of @entity114 (or @entity869 / @entity115 ) and/or @entity868 , always intravenous initially but subsequently often orally. Median duration of antibiotic treatment was 57 days (range 28 to 206). Seventy-five per cent had initial aspiration, 9% open drainage and 7% were excised initially. Seventy-one per cent had a good functional outcome. Mortality was 8.8%. Factors associated with a poor outcome were @entity130 as a cause, and delays after admission of more than seven days to diagnosis and/or operation.

1113

1114

1115

XXXX protects lung function from hyperoxic damage.

multiple_choice

@entity205 ( @entity870 ), an inhibitor of protein phosphatase 2B (calcineurin), has been shown to play a role in exocytosis and neutrophil mobility. @entity871 (>95% @entity26 for 72 h) causes @entity651 and reduces lung compliance. This model is indicative of deficiencies in surfactant and elicits a vigorous immune response leading to further damage. We examined the effects of CsA on surfactant-secreting lung alveolar type II cells. CsA enhances @entity855 -stimulated increases in whole cell capacitance in the presence of 2 mM extracellular @entity141 . This measurement corresponds with increases in exocytosis. Because of its effect on the immune system and exocytosis from type II cells, CsA was examined for its protective effects against @entity871 -induced @entity358 in @entity19 . We found that CsA (50 mg. kg-1. day-1) attenuated @entity871 -induced reductions in lung compliance when administered before or during 72 h of >95% @entity26 (P < 0.05). CsA (10 mg. kg-1. day-1) also had a protective effect against @entity871 -induced changes in neutrophil infiltration, capillary congestion, @entity4 , and hyaline membrane formation. Wet lung weight-to-dry lung weight ratios did not show any significant changes after @entity871 or @entity871 plus CsA (P < 0. 05). CsA may be useful to treat @entity1 undergoing prolonged high- @entity26 therapy and possibly other @entity651 .

1116

1117

1118

Role of XXXX phosphorylation in the reassembly of @entity874 and other tight junction proteins.

multiple_choice

After the simulation of @entity519 by @entity855 depletion of MDCK cell monolayers with metabolic inhibitors, the tight junction (TJ) is known to become structurally perturbed, leading to loss of the permeability barrier. Peripheral TJ proteins such as @entity872 ( @entity872 ), @entity873 , and cingulin become extremely insoluble and associate into large macromolecular complexes (T. Tsukamoto and S. K. Nigam. J. Biol. Chem. 272: 16133-16139, 1997). For up to 3 h, this process is reversible by @entity855 repletion. We now show that the reassembly process depends on @entity669 phosphorylation. Recovery of transepithelial electrical resistance in @entity855 -replete monolayers was markedly inhibited by the @entity669 kinase inhibitor, @entity670 . Indirect immunofluorescence revealed a decrease in staining of @entity874 , a membrane component of the TJ, in the region of the TJ after @entity855 depletion, which reversed after @entity855 repletion; this reversal process was inhibited by @entity670 . Examination of the Triton X-100 solubilities of @entity874 and several nonmembrane TJ proteins revealed a shift of @entity874 and nonmembrane TJ proteins into an insoluble pool following @entity855 depletion. These changes reversed after @entity855 repletion, and the movement of insoluble @entity874 , @entity872 , and @entity873 back into the soluble pool was again via a @entity670 -sensitive mechanism. Rate-zonal centrifugation analyses of detergent-soluble TJ proteins showed a reversible increase in higher density fractions following @entity855 depletion-repletion, although this change was not affected by @entity670 . In 32P-labeled cells, dephosphorylation of all studied TJ proteins was observed during @entity855 depletion, followed by rephosphorylation during @entity855 repletion; rephosphorylation of @entity874 was inhibited by @entity670 . Furthermore, during the @entity855 repletion phase, @entity669 phosphorylation of Triton X-100-insoluble @entity874 , which is localized at the junction, as well as @entity873 , p130/ZO-3 (though not @entity872 ), and other proteins was evident; this @entity669 phosphorylation was completely inhibited by @entity670 . This indicates that @entity669 kinase activity is necessary for TJ reassembly during @entity855 repletion and suggests an important role for the @entity669 phosphorylation of @entity874 , @entity873 , p130/ZO-3, and possibly other proteins in the processes involved in TJ (re)formation.

1119

1120

1121

Role of @entity669 phosphorylation in the reassembly of XXXX and other tight junction proteins.

multiple_choice

After the simulation of @entity519 by @entity855 depletion of MDCK cell monolayers with metabolic inhibitors, the tight junction (TJ) is known to become structurally perturbed, leading to loss of the permeability barrier. Peripheral TJ proteins such as @entity872 ( @entity872 ), @entity873 , and cingulin become extremely insoluble and associate into large macromolecular complexes (T. Tsukamoto and S. K. Nigam. J. Biol. Chem. 272: 16133-16139, 1997). For up to 3 h, this process is reversible by @entity855 repletion. We now show that the reassembly process depends on @entity669 phosphorylation. Recovery of transepithelial electrical resistance in @entity855 -replete monolayers was markedly inhibited by the @entity669 kinase inhibitor, @entity670 . Indirect immunofluorescence revealed a decrease in staining of @entity874 , a membrane component of the TJ, in the region of the TJ after @entity855 depletion, which reversed after @entity855 repletion; this reversal process was inhibited by @entity670 . Examination of the Triton X-100 solubilities of @entity874 and several nonmembrane TJ proteins revealed a shift of @entity874 and nonmembrane TJ proteins into an insoluble pool following @entity855 depletion. These changes reversed after @entity855 repletion, and the movement of insoluble @entity874 , @entity872 , and @entity873 back into the soluble pool was again via a @entity670 -sensitive mechanism. Rate-zonal centrifugation analyses of detergent-soluble TJ proteins showed a reversible increase in higher density fractions following @entity855 depletion-repletion, although this change was not affected by @entity670 . In 32P-labeled cells, dephosphorylation of all studied TJ proteins was observed during @entity855 depletion, followed by rephosphorylation during @entity855 repletion; rephosphorylation of @entity874 was inhibited by @entity670 . Furthermore, during the @entity855 repletion phase, @entity669 phosphorylation of Triton X-100-insoluble @entity874 , which is localized at the junction, as well as @entity873 , p130/ZO-3 (though not @entity872 ), and other proteins was evident; this @entity669 phosphorylation was completely inhibited by @entity670 . This indicates that @entity669 kinase activity is necessary for TJ reassembly during @entity855 repletion and suggests an important role for the @entity669 phosphorylation of @entity874 , @entity873 , p130/ZO-3, and possibly other proteins in the processes involved in TJ (re)formation.

1122

1123

1124

Intercellular centrosome number is correlated with the copy number of chromosomes in XXXX .

multiple_choice

Centrosome amplification, which may accelerate @entity5 progression through chromosomal instability, is frequently observed in @entity1 @entity5 . The intercellular relation between the number of centrosomes and chromosomes, however, is poorly understood. Therefore, the relationship between centrosomes and chromosomal copy number in the same cells was investigated in @entity150 . Centrosomes were evaluated by immunohistochemistry, using anti-gamma-tubulin antibody in eight @entity150 cell lines. Fluorescence in situ hybridization with centromeric probes for chromosomes 7, 9, and 17 was then performed on the same cells stained with gamma-tubulin. The number of centrosomes was directly proportional to the number of chromosomes in cells with centrosome amplification, while a large intercellular variation in chromosomal copy number was detected in cells with normal numbers of centrosomes. @entity5 cells with centrosome amplification of even centrosome numbers had significantly more even numbers of chromosomes. In @entity5 cells with four centrosomes, even numbers of chromosomes were detected more frequently (87.5%). These @entity150 cell lines showed @entity875 and @entity876 overexpression. These data indicate the occurrence of centrosome amplification with the possible mechanism of cytokinesis failure, resulting in a doubling of the number of centrosomes and chromosomes.

1125

1126

1127

XXXX in @entity879 .

multiple_choice

OBJECTIVE: @entity877 , an antagonistic ligand of the endothelial @entity878 receptor, has been identified as a gatekeeper of endothelial activation. We examined whether the release of @entity877 correlates with surrogates of organ dysfunction and outcome in @entity1 with @entity879 . DESIGN: Retrospective clinical and immunohistological study. SETTING: Intensive care unit of a university hospital. @entity1 : Thirty-seven @entity1 with @entity879 and 20 healthy control subjects. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: @entity877 levels were measured in sera from 37 @entity1 with @entity879 on admission and from 20 healthy control subjects. Median age of @entity1 with @entity879 was 34 yrs, 29 were female, and 21 developed @entity75 grade 3 or greater. Nine @entity1 survived to day 28 without transplantation, five died without transplantation, and 23 received a transplant. Median (interquartile range) @entity877 serum concentrations steadily increased across the following groups: healthy control subjects (1.4 [0.9-1.7] ng/mL), @entity1 with transplant-free recovery (10.0 [4.7-12.1] ng/mL), and @entity1 who reached the composite end point of @entity204 or emergency liver transplantation (16.8 [11.3-39.5] ng/mL). @entity877 release correlated strongly with surrogate markers of organ dysfunction and disease severity measures ( @entity880 , platelet count, Sequential Organ Failure Assessment score, and Simplified Acute Physiology Score III). @entity877 levels were higher in @entity1 with @entity810 and @entity1 on mechanical ventilation. Furthermore, @entity877 levels were closely associated with @entity648 -Lactate-Etiology score but not with other liver-specific markers. Unadjusted and adjusted Cox's proportional hazards analyses identified @entity877 as a predictor of the composite end point of @entity204 or transplantation. Finally, immunohistological studies showed that @entity877 protein was upregulated in @entity879 explants compared with matched liver biopsies obtained at baseline. CONCLUSIONS: Collectively, our data show that circulating @entity877 , which potentially originates from the injured liver, correlates with several features of @entity881 and independently predicts outcome. @entity878 agonists may have potential as an endothelium-targeted therapy to ameliorate @entity881 and improve outcome in @entity879 .

1128

1129

1130

@entity877 in XXXX .

multiple_choice

OBJECTIVE: @entity877 , an antagonistic ligand of the endothelial @entity878 receptor, has been identified as a gatekeeper of endothelial activation. We examined whether the release of @entity877 correlates with surrogates of organ dysfunction and outcome in @entity1 with @entity879 . DESIGN: Retrospective clinical and immunohistological study. SETTING: Intensive care unit of a university hospital. @entity1 : Thirty-seven @entity1 with @entity879 and 20 healthy control subjects. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: @entity877 levels were measured in sera from 37 @entity1 with @entity879 on admission and from 20 healthy control subjects. Median age of @entity1 with @entity879 was 34 yrs, 29 were female, and 21 developed @entity75 grade 3 or greater. Nine @entity1 survived to day 28 without transplantation, five died without transplantation, and 23 received a transplant. Median (interquartile range) @entity877 serum concentrations steadily increased across the following groups: healthy control subjects (1.4 [0.9-1.7] ng/mL), @entity1 with transplant-free recovery (10.0 [4.7-12.1] ng/mL), and @entity1 who reached the composite end point of @entity204 or emergency liver transplantation (16.8 [11.3-39.5] ng/mL). @entity877 release correlated strongly with surrogate markers of organ dysfunction and disease severity measures ( @entity880 , platelet count, Sequential Organ Failure Assessment score, and Simplified Acute Physiology Score III). @entity877 levels were higher in @entity1 with @entity810 and @entity1 on mechanical ventilation. Furthermore, @entity877 levels were closely associated with @entity648 -Lactate-Etiology score but not with other liver-specific markers. Unadjusted and adjusted Cox's proportional hazards analyses identified @entity877 as a predictor of the composite end point of @entity204 or transplantation. Finally, immunohistological studies showed that @entity877 protein was upregulated in @entity879 explants compared with matched liver biopsies obtained at baseline. CONCLUSIONS: Collectively, our data show that circulating @entity877 , which potentially originates from the injured liver, correlates with several features of @entity881 and independently predicts outcome. @entity878 agonists may have potential as an endothelium-targeted therapy to ameliorate @entity881 and improve outcome in @entity879 .

1131

1132

1133

Platelet depletion and severity of XXXX .

multiple_choice

OBJECTIVE: To evaluate the importance of @entity882 in @entity883 using an animal model. DESIGN: A model of @entity1 @entity884 was established in @entity35 ( @entity691 catheters across the aortic valve and administration of @entity885 , 5 10(7) colony forming units [cfu] intravenous). @entity882 at four levels was produced by antiplatelet serum. Secondary methods of producing @entity882 were also evaluated. At sacrifice (96 h after platelet depletion and 72 h after infection), @entity47 were removed, weighed, diluted, plated and counted. Potential mechanisms of the dose-response relationship between vegetation density and platelet count were evaluated. SETTING: Controlled research laboratory experiments. POPULATION STUDIED: Animal models of @entity883 . MAIN RESULTS: The bacterial density of the @entity886 significantly increased as the platelet count decreased (P=0.0007). In severely @entity882 animals (two-dose antiplatelet serum), data suggest @entity887 . Platelet depletion, which was minimal with chemical methods, was produced most effectively by antithrombocyte serum. Platelet surfaces in @entity884 were found to express elevated CD62p proteins (72.7% @entity884 , 34.7% control). Platelet protein fractions were evaluated in vitro by both streptocidal (P=0.19) and phagocytosis-stimulating assays. Platelet presence in mature @entity886 averaged only about 2%. CONCLUSIONS: In platelet depletion experiments using a @entity35 model, a dose-response relationship of peripheral circulating platelet depletion to aortic valve vegetation density was found. The mechanism relating @entity882 to @entity884 severity remains unresolved.

1134

1135

1136

Congruence of reproductive concerns among adolescents with XXXX and parents: pilot testing an adapted instrument.

multiple_choice

OBJECTIVE: To identify whether a health-related quality of life (HRQoL) instrument intended to capture reproductive concerns is sensitive and appropriate for adolescent @entity1 with @entity5 . METHODS: Pilot testing was completed by administering a 10-item instrument designed to identify reproductive concerns of female adolescent @entity1 with @entity5 aged 12-18. Parents were also asked to predict their daughters' responses. Fourteen @entity1 and parents participated. The main outcome measures were language, relevance, accuracy, sensitivity, and missing content regarding the HRQoL instrument. Two pediatric hospitals and 1 local support group for @entity1 and survivors served as the setting for this study. RESULTS: The majority of parents provided inaccurate predictions of their daughters' responses regarding their reproductive concerns. Overall, parents underestimated their daughters' concerns because the majority of adolescents reported a strong desire for future parenthood whereas parents expected their daughters to be satisfied with survivorship. CONCLUSIONS: Adolescent @entity1 with @entity5 have strong reproductive concerns; however, this may not be captured on current HRQoL instruments and may be further neglected due to parents' unawareness. Discussions should be encouraged with adolescent @entity1 before beginning treatment regarding their concerns and values about parenting in the future and cannot rely on parent-proxy reports.

1137

1138

1139

Borderline XXXX of the ovary: clinical course and prognostic factors.

multiple_choice

BACKGROUND: The prognosis in borderline @entity5 of the ovary (BOT) is generally favorable. However, some @entity1 experience recurrence, and mortalities occur. There is a need to better characterize prognostic factors to be considered for individualized treatment planning. @entity1 AND METHODS: The data of 158 consecutive @entity1 who underwent surgery for BOT at a tertiary referral center for gynecologic oncology between 1997 and 2008 were retrospectively analyzed. RESULTS: Most @entity1 had early stage disease, and advanced stages FIGO II/III only occurred in 23.4%. Serous histology was most frequent (68%), followed by mucinous histology (22%). All @entity1 received surgery as initial treatment with no adjuvant systemic therapy. 37 @entity1 (40.7% of the @entity1 under the age of 50) had @entity249 ( @entity249 ). @entity66 occurred in 18 (11.4%) @entity1 , and 4 (2.5%) @entity1 died. Independent risk factors for recurrence were FIGO stages > I (hazard ratio (HR) 37.1; 95% confidence interval (CI) 4.5-155.5), @entity5 rupture (HR 12.4; 95% CI 1.5-61.5), incomplete @entity5 (HR 5.9; 95% CI 1.6-21.3), and @entity249 in @entity1 < 50 years (HR 8.0; 95% CI 2.0-31.6). CONCLUSION: Intraoperative @entity5 rupture, incomplete @entity5 , and @entity249 - all influenced by the surgeon - may impose a substantial recurrence risk. Therefore, careful counseling and balancing of risk and benefit are mandatory before therapy is applied, especially if @entity249 is planned.

1140

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Prenatal XXXX exposure and @entity146 at 3 and 5 years of age.

multiple_choice

OBJECTIVE: We evaluated @entity146 in @entity1 who were prenatally exposed to @entity888 (MA) at ages 3 and 5 years. METHODS: The @entity1 Development, Environment, and Lifestyle study, a prospective, longitudinal study of prenatal MA exposure and @entity1 outcome, enrolled subjects postpartum in Los Angeles, California; Honolulu, Hawaii; Des Moines, Iowa; and Tulsa, Oklahoma. Prenatal exposure was determined by maternal self-report and/or meconium results. Exposed and comparison groups were matched on race, birth weight, public health insurance, and education. Mothers in the comparison group denied use and had a negative meconium screen for @entity889 . Prenatal exposures to @entity286 , @entity167 , or @entity835 occurred in both groups. At ages 3 and 5 years, 330 @entity1 (166 exposed and 164 comparison) were assessed for @entity146 by using the caregiver report on the @entity1 Behavior Checklist. General linear mixed models were used to determine the effects of prenatal MA exposure, including heavy exposure (>= 3 days per week), age, and the interaction of exposure and age on @entity146 with adjustment for other drugs of abuse and environmental risk factors. RESULTS: MA exposure was associated with increased emotional reactivity and anxious/ @entity308 problems at both ages and externalizing and @entity71 problems by age 5 years. Heavy exposure was related to attention problems and withdrawn behavior at both ages. There were no effects of MA on the internalizing or total @entity146 scales. CONCLUSIONS: This first report of @entity146 in @entity1 as young as 3 years associated with MA exposure identifies an important public health problem. Continued follow-up can inform the development of preventive intervention programs.

1143

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1145

Prenatal @entity888 exposure and XXXX at 3 and 5 years of age.

multiple_choice

OBJECTIVE: We evaluated @entity146 in @entity1 who were prenatally exposed to @entity888 (MA) at ages 3 and 5 years. METHODS: The @entity1 Development, Environment, and Lifestyle study, a prospective, longitudinal study of prenatal MA exposure and @entity1 outcome, enrolled subjects postpartum in Los Angeles, California; Honolulu, Hawaii; Des Moines, Iowa; and Tulsa, Oklahoma. Prenatal exposure was determined by maternal self-report and/or meconium results. Exposed and comparison groups were matched on race, birth weight, public health insurance, and education. Mothers in the comparison group denied use and had a negative meconium screen for @entity889 . Prenatal exposures to @entity286 , @entity167 , or @entity835 occurred in both groups. At ages 3 and 5 years, 330 @entity1 (166 exposed and 164 comparison) were assessed for @entity146 by using the caregiver report on the @entity1 Behavior Checklist. General linear mixed models were used to determine the effects of prenatal MA exposure, including heavy exposure (>= 3 days per week), age, and the interaction of exposure and age on @entity146 with adjustment for other drugs of abuse and environmental risk factors. RESULTS: MA exposure was associated with increased emotional reactivity and anxious/ @entity308 problems at both ages and externalizing and @entity71 problems by age 5 years. Heavy exposure was related to attention problems and withdrawn behavior at both ages. There were no effects of MA on the internalizing or total @entity146 scales. CONCLUSIONS: This first report of @entity146 in @entity1 as young as 3 years associated with MA exposure identifies an important public health problem. Continued follow-up can inform the development of preventive intervention programs.

1146

1147

1148

Anterior thoracic foraminotomy through mini-thoracotomy for the treatment of XXXX .

multiple_choice

STUDY DESIGN: A retrospective review of a case series. OBJECTIVES: @entity890 remain a surgical challenge and historically have been associated with significant complications. While neurological outcomes have improved with the abandonment of decompressive laminectomy, the attempt to minimize surgical complications and associated morbidities continues through less-invasive approaches. With the current study, we describe a surgical technique to treat @entity890 while minimizing approach-related morbidity. METHODS: Demographic and radiographic data; clinical outcome and perioperative complications were retrospectively analysed for @entity1 with single-level @entity890 who underwent mini-thoracotomy and selective microsurgical anterior spinal cord decompression without instrumented fusion. RESULTS: Between 2007 and 2012, 7 consecutive @entity1 with @entity890 were treated (average age of 53 years; range 45-66 years). The average canal encroachment was 73.2 % (range 40-92 %) with 5 grossly calcified discs of which 3 had transdural components. All @entity1 had gradual myelopathic progression. The average Nurick grade was 3.5 (range 2-5). All @entity1 were successfully treated with anterior microsurgical decompression without instrumentation. Uninstrumented fusion with rib graft was performed only in one @entity1 with advanced degenerative changes. Average time of surgery was 337.8 min (range 220-450 min). The average length of hospital stay was 7.4 days (range 6-11 days). The average neurological status at follow-up (average 23.5 months; range 9-36 months) using the modified Nurick grading scale was 1.28. No @entity891 or loss of spinal alignment developed. There were no neurological complications. One @entity1 developed an acute @entity10 and @entity892 , 10 days after surgery, following sneezing associated with a post-operative thoracic cerebrospinal fluid leakage requiring revision. Two @entity1 suffered an approach-related complication in form of @entity9 ; one was persistent. CONCLUSIONS: Anterior decompression using a mini-transthoracic approach provides sufficient exposure for microsurgical decompression of @entity890 without disrupting the stability of the spine. Microsurgical decompression without instrumentation does not appear to lead to @entity891 or @entity893 .

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Functional MRI finding by proprioceptive input in @entity1 with XXXX .

multiple_choice

Little is known about the recovery mechanism of somatosensory function in @entity548 . We investigated the recovery mechanism of somatosensory function, using functional MRI (fMRI) findings by proprioceptive input in chronic @entity1 with @entity548 . Eleven consecutive chronic @entity1 with @entity548 who showed severe proprioceptive dysfunction were recruited. The subscale for kinesthetic sensation of the Nottingham Sensory Assessment (NSA) was used for determination of proprioceptive function. fMRI was performed during passive movements of the metacarpophalangeal joint. From fMRI, the @entity894 ( @entity894 ) was calculated for assessment of the relative activity in the ipsilateral versus the contralateral primary sensori-motor cortex ( @entity895 ). The average @entity894 for affected and unaffected hand stimulation was 0.89 and 0.90, respectively, and there was no significant difference between LIs (p> 0.05). In addition, @entity894 of the affected hand stimulation was positively related to NSA scores (r=0.790, p< 0.05). Our results for @entity894 suggest that the cortical activation pattern of @entity895 was similar in the affected and unaffected hemispheres. Therefore, it appears that the proprioceptive function of the affected hand likely recovered by the normally existing medial lemniscus and its thalamocortical pathway in our @entity1 .

1152

1153

1154

Functional MRI finding by proprioceptive input in XXXX with @entity548 .

multiple_choice

Little is known about the recovery mechanism of somatosensory function in @entity548 . We investigated the recovery mechanism of somatosensory function, using functional MRI (fMRI) findings by proprioceptive input in chronic @entity1 with @entity548 . Eleven consecutive chronic @entity1 with @entity548 who showed severe proprioceptive dysfunction were recruited. The subscale for kinesthetic sensation of the Nottingham Sensory Assessment (NSA) was used for determination of proprioceptive function. fMRI was performed during passive movements of the metacarpophalangeal joint. From fMRI, the @entity894 ( @entity894 ) was calculated for assessment of the relative activity in the ipsilateral versus the contralateral primary sensori-motor cortex ( @entity895 ). The average @entity894 for affected and unaffected hand stimulation was 0.89 and 0.90, respectively, and there was no significant difference between LIs (p> 0.05). In addition, @entity894 of the affected hand stimulation was positively related to NSA scores (r=0.790, p< 0.05). Our results for @entity894 suggest that the cortical activation pattern of @entity895 was similar in the affected and unaffected hemispheres. Therefore, it appears that the proprioceptive function of the affected hand likely recovered by the normally existing medial lemniscus and its thalamocortical pathway in our @entity1 .

1155

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XXXX as @entity5 cell energy metabolism and chemopotentiator of @entity902 drugs.

multiple_choice

@entity5 cells depend on aerobic glycolysis for @entity855 ( @entity855 ) production, making energy metabolism an interesting therapeutic target. @entity896 (BP) has been shown by others to inhibit hexokinase and eradicate @entity19 hepatocarcinomas. We report that similar to the glycolysis inhibitor @entity897 (DG), BP rapidly decreased cellular @entity855 within hours, but unlike DG, BP concomitantly induced mitochondrial depolarization without affecting levels of reducing equivalents. Over 24h, and at equitoxic doses, DG reduced @entity413 consumption more than did BP. The observed BP-induced loss of @entity855 is therefore largely due to mitochondrial effects. Cell death induced over 24h by BP, but not DG, was blocked by @entity898 , indicating involvement of reactive @entity26 species. BP-induced @entity137 was independent of @entity899 . When combined with @entity900 or @entity901 , BP led to massive cell death. The anti-proliferative effects of low-dose @entity902 were strikingly potentiated also in resistant @entity899 -deficient cells. Together with the reported lack of @entity137 , this indicates the potential of BP as a clinical chemopotentiating agent.

1158

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1160

@entity896 as XXXX cell energy metabolism and chemopotentiator of @entity902 drugs.

multiple_choice

@entity5 cells depend on aerobic glycolysis for @entity855 ( @entity855 ) production, making energy metabolism an interesting therapeutic target. @entity896 (BP) has been shown by others to inhibit hexokinase and eradicate @entity19 hepatocarcinomas. We report that similar to the glycolysis inhibitor @entity897 (DG), BP rapidly decreased cellular @entity855 within hours, but unlike DG, BP concomitantly induced mitochondrial depolarization without affecting levels of reducing equivalents. Over 24h, and at equitoxic doses, DG reduced @entity413 consumption more than did BP. The observed BP-induced loss of @entity855 is therefore largely due to mitochondrial effects. Cell death induced over 24h by BP, but not DG, was blocked by @entity898 , indicating involvement of reactive @entity26 species. BP-induced @entity137 was independent of @entity899 . When combined with @entity900 or @entity901 , BP led to massive cell death. The anti-proliferative effects of low-dose @entity902 were strikingly potentiated also in resistant @entity899 -deficient cells. Together with the reported lack of @entity137 , this indicates the potential of BP as a clinical chemopotentiating agent.

1161

1162

1163

@entity896 as @entity5 cell energy metabolism and chemopotentiator of XXXX drugs.

multiple_choice

@entity5 cells depend on aerobic glycolysis for @entity855 ( @entity855 ) production, making energy metabolism an interesting therapeutic target. @entity896 (BP) has been shown by others to inhibit hexokinase and eradicate @entity19 hepatocarcinomas. We report that similar to the glycolysis inhibitor @entity897 (DG), BP rapidly decreased cellular @entity855 within hours, but unlike DG, BP concomitantly induced mitochondrial depolarization without affecting levels of reducing equivalents. Over 24h, and at equitoxic doses, DG reduced @entity413 consumption more than did BP. The observed BP-induced loss of @entity855 is therefore largely due to mitochondrial effects. Cell death induced over 24h by BP, but not DG, was blocked by @entity898 , indicating involvement of reactive @entity26 species. BP-induced @entity137 was independent of @entity899 . When combined with @entity900 or @entity901 , BP led to massive cell death. The anti-proliferative effects of low-dose @entity902 were strikingly potentiated also in resistant @entity899 -deficient cells. Together with the reported lack of @entity137 , this indicates the potential of BP as a clinical chemopotentiating agent.

1164

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1166

In vitro and in vivo reproduction toxicology of 12 monoaminergic reuptake inhibitors: possible mechanisms of infrequent XXXX .

multiple_choice

The @entity35 Whole Embryo Culture (WEC) has been used to predict the potential teratogenicity of 12 selective/mixed monoaminergic reuptake inhibitors (MRUI). WEC results were compared with in vivo animal and @entity1 epidemiological teratogenicity data. In vitro, @entity903 and the positive control @entity904 were the only compounds identified as a clear teratogen, but developmental morphological indicators suggestive of a teratogenic potential were observed for most other MRUIs, including @entity905 , @entity837 and @entity906 . No clear evidence of teratogenic potential was observed for three compounds, however, all compounds assessed showed a dose-dependent general embryotoxicity. In vivo testing of nine MRUIs for teratogenicity was limited by maternal @entity137 (e.g. @entity448 ) without showing overt embryotoxicity (e.g. implantation loss). Next to complete absence, the cardiovascular (CV) anomalies observed (mostly) in @entity95 ranged from a low incidence (e.g. above historical background of 0.35%) to a clear incidence (mean 4.1%). It is suggested that observed specific malformations in vitro (e.g. branchial bars deformed, displaced or additional otic system), not noted in any (historical) controls, may be early ontogenetic indicators for infrequent @entity854 observed in vivo. Despite the low incidence of anomalies in vitro or in vivo, they may yet be clinically relevant as in the case of @entity903 . Possible mechanisms are discussed, e.g. perturbed neural crest cell migration.

1167

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Serum @entity908 phosphokinase is helpful in distinguishing generalized @entity410 from XXXX and @entity907 .

multiple_choice

OBJECTIVE: Distinguishing @entity302 generalized @entity410 (GTCS) from either @entity410 ( @entity410 ) or @entity907 ( @entity907 ) is important. In this study, we investigated the use of postictal serum @entity908 phosphokinase (CPK) concentrations in distinguishing between these events. METHODS: @entity1 admitted to the Neurology Ward at Namazi Hospital in Shiraz, Iran, with an attack of transient @entity909 and @entity910 witnessed by a neurologist were studied. We categorized the @entity1 into three groups: 20 @entity1 with GTCS, 22 with @entity907 , and 20 with @entity410 . A group of 20 normal healthy individuals were included in the study as the control group. Serum CPK concentration was measured 12-15 h after the attack in all @entity1 and at one time in the control group. A P value less than 5% was considered significant. RESULTS: There were no significant differences between the four groups with respect to age and sex. Mean CPK concentrations statistically significantly differed between the four groups, with higher levels in @entity1 with GTCS (P=0.0001). Serum CPK concentration had a sensitivity of 75% and specificity of 86% for the diagnosis of GTCS. CPK concentration was above 160 mg/dl in 75% of @entity1 with GTCS, 15% of @entity1 with @entity410 , 13.6% of @entity1 with @entity907 , and 15% of the control group (P=0.0001). The @entity410 , @entity907 , and control groups did not statistically significantly differ with respect to CPK concentrations. CONCLUSION: In @entity1 with a @entity909 and @entity910 , serum CPK concentration is a useful, practical, and relatively accurate parameter to assist in the differentiation of @entity302 from either @entity907 or @entity410 .

1170

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1172

Serum @entity908 phosphokinase is helpful in distinguishing generalized XXXX from @entity410 and @entity907 .

multiple_choice

OBJECTIVE: Distinguishing @entity302 generalized @entity410 (GTCS) from either @entity410 ( @entity410 ) or @entity907 ( @entity907 ) is important. In this study, we investigated the use of postictal serum @entity908 phosphokinase (CPK) concentrations in distinguishing between these events. METHODS: @entity1 admitted to the Neurology Ward at Namazi Hospital in Shiraz, Iran, with an attack of transient @entity909 and @entity910 witnessed by a neurologist were studied. We categorized the @entity1 into three groups: 20 @entity1 with GTCS, 22 with @entity907 , and 20 with @entity410 . A group of 20 normal healthy individuals were included in the study as the control group. Serum CPK concentration was measured 12-15 h after the attack in all @entity1 and at one time in the control group. A P value less than 5% was considered significant. RESULTS: There were no significant differences between the four groups with respect to age and sex. Mean CPK concentrations statistically significantly differed between the four groups, with higher levels in @entity1 with GTCS (P=0.0001). Serum CPK concentration had a sensitivity of 75% and specificity of 86% for the diagnosis of GTCS. CPK concentration was above 160 mg/dl in 75% of @entity1 with GTCS, 15% of @entity1 with @entity410 , 13.6% of @entity1 with @entity907 , and 15% of the control group (P=0.0001). The @entity410 , @entity907 , and control groups did not statistically significantly differ with respect to CPK concentrations. CONCLUSION: In @entity1 with a @entity909 and @entity910 , serum CPK concentration is a useful, practical, and relatively accurate parameter to assist in the differentiation of @entity302 from either @entity907 or @entity410 .

1173

1174

1175

Serum XXXX phosphokinase is helpful in distinguishing generalized @entity410 from @entity410 and @entity907 .

multiple_choice

OBJECTIVE: Distinguishing @entity302 generalized @entity410 (GTCS) from either @entity410 ( @entity410 ) or @entity907 ( @entity907 ) is important. In this study, we investigated the use of postictal serum @entity908 phosphokinase (CPK) concentrations in distinguishing between these events. METHODS: @entity1 admitted to the Neurology Ward at Namazi Hospital in Shiraz, Iran, with an attack of transient @entity909 and @entity910 witnessed by a neurologist were studied. We categorized the @entity1 into three groups: 20 @entity1 with GTCS, 22 with @entity907 , and 20 with @entity410 . A group of 20 normal healthy individuals were included in the study as the control group. Serum CPK concentration was measured 12-15 h after the attack in all @entity1 and at one time in the control group. A P value less than 5% was considered significant. RESULTS: There were no significant differences between the four groups with respect to age and sex. Mean CPK concentrations statistically significantly differed between the four groups, with higher levels in @entity1 with GTCS (P=0.0001). Serum CPK concentration had a sensitivity of 75% and specificity of 86% for the diagnosis of GTCS. CPK concentration was above 160 mg/dl in 75% of @entity1 with GTCS, 15% of @entity1 with @entity410 , 13.6% of @entity1 with @entity907 , and 15% of the control group (P=0.0001). The @entity410 , @entity907 , and control groups did not statistically significantly differ with respect to CPK concentrations. CONCLUSION: In @entity1 with a @entity909 and @entity910 , serum CPK concentration is a useful, practical, and relatively accurate parameter to assist in the differentiation of @entity302 from either @entity907 or @entity410 .

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1178

Serum @entity908 phosphokinase is helpful in distinguishing generalized @entity410 from @entity410 and XXXX .

multiple_choice

OBJECTIVE: Distinguishing @entity302 generalized @entity410 (GTCS) from either @entity410 ( @entity410 ) or @entity907 ( @entity907 ) is important. In this study, we investigated the use of postictal serum @entity908 phosphokinase (CPK) concentrations in distinguishing between these events. METHODS: @entity1 admitted to the Neurology Ward at Namazi Hospital in Shiraz, Iran, with an attack of transient @entity909 and @entity910 witnessed by a neurologist were studied. We categorized the @entity1 into three groups: 20 @entity1 with GTCS, 22 with @entity907 , and 20 with @entity410 . A group of 20 normal healthy individuals were included in the study as the control group. Serum CPK concentration was measured 12-15 h after the attack in all @entity1 and at one time in the control group. A P value less than 5% was considered significant. RESULTS: There were no significant differences between the four groups with respect to age and sex. Mean CPK concentrations statistically significantly differed between the four groups, with higher levels in @entity1 with GTCS (P=0.0001). Serum CPK concentration had a sensitivity of 75% and specificity of 86% for the diagnosis of GTCS. CPK concentration was above 160 mg/dl in 75% of @entity1 with GTCS, 15% of @entity1 with @entity410 , 13.6% of @entity1 with @entity907 , and 15% of the control group (P=0.0001). The @entity410 , @entity907 , and control groups did not statistically significantly differ with respect to CPK concentrations. CONCLUSION: In @entity1 with a @entity909 and @entity910 , serum CPK concentration is a useful, practical, and relatively accurate parameter to assist in the differentiation of @entity302 from either @entity907 or @entity410 .

1179

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1181

Gastrointestinal function in intensive care XXXX : terminology, definitions and management. Recommendations of the ESICM Working Group on Abdominal Problems.

multiple_choice

PURPOSE: Acute @entity344 and failure have been increasingly recognized in critically ill @entity1 . The variety of definitions proposed in the past has led to @entity911 and difficulty in comparing one study to another. An international working group convened to standardize the definitions for @entity810 and @entity344 and to review the therapeutic options. METHODS: The Working Group on Abdominal Problems (WGAP) of the European Society of Intensive Care Medicine (ESICM) developed the definitions for @entity344 in intensive care @entity1 on the basis of the available evidence and current understanding of the pathophysiology. RESULTS: Definitions for acute @entity344 (AGI) with its four grades of severity, as well as for feeding intolerance syndrome and @entity344 (e.g. @entity391 , @entity294 , @entity912 , high gastric residual volumes) are proposed. AGI is a malfunctioning of the GI tract in intensive care @entity1 due to their acute illness. AGI grade I = increased risk of developing @entity344 or failure (a self-limiting condition); AGI grade II = @entity344 (a condition that requires interventions); AGI grade III = @entity344 (GI function cannot be restored with interventions); AGI grade IV = dramatically manifesting @entity344 (a condition that is immediately life-threatening). Current evidence and expert opinions regarding treatment of @entity344 are provided. CONCLUSIONS: State-of-the-art definitions for @entity344 with gradation as well as management recommendations are proposed on the basis of current medical evidence and expert opinion. The WGAP recommends using these definitions for clinical and research purposes.

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Co-morbid @entity913 in XXXX .

multiple_choice

BACKGROUND: The co-morbid occurrence of @entity148 and @entity161 has recently begun to be investigated. @entity148 may be especially important to diagnose and manage among @entity1 with @entity161 . AIM: To investigate the prevalence and correlates of @entity913 in @entity1 with @entity161 . METHOD: Diagnosis of @entity161 and @entity914 as well as co-morbid @entity148 was established according to DSM-IV and the Structured Clinical Interview for Diagnosis ( @entity915 -P Hebrew version). Severity of @entity716 and @entity148 was assessed with the Positive and Negative Symptom Scale (PANSS) and the Liebowitz Social Anxiety Scale (LSAS). RESULTS: The cohort studied included 117 @entity1 with @entity161 . Thirteen @entity1 were diagnosed as suffering from co-morbid @entity913 (11%). There was a tendency for @entity1 with co-morbid @entity913 to have higher severity PANSS total score. There was a significant correlation between the score of the LSAS ;fear' and PANSS positive subscales. Avoidance scores were higher among @entity1 with negative signs. CONCLUSION: Co-morbidity of @entity161 and @entity148 is not rare among @entity1 with @entity161 . Treatment implications need be further investigated.

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Co-morbid XXXX in @entity161 .

multiple_choice

BACKGROUND: The co-morbid occurrence of @entity148 and @entity161 has recently begun to be investigated. @entity148 may be especially important to diagnose and manage among @entity1 with @entity161 . AIM: To investigate the prevalence and correlates of @entity913 in @entity1 with @entity161 . METHOD: Diagnosis of @entity161 and @entity914 as well as co-morbid @entity148 was established according to DSM-IV and the Structured Clinical Interview for Diagnosis ( @entity915 -P Hebrew version). Severity of @entity716 and @entity148 was assessed with the Positive and Negative Symptom Scale (PANSS) and the Liebowitz Social Anxiety Scale (LSAS). RESULTS: The cohort studied included 117 @entity1 with @entity161 . Thirteen @entity1 were diagnosed as suffering from co-morbid @entity913 (11%). There was a tendency for @entity1 with co-morbid @entity913 to have higher severity PANSS total score. There was a significant correlation between the score of the LSAS ;fear' and PANSS positive subscales. Avoidance scores were higher among @entity1 with negative signs. CONCLUSION: Co-morbidity of @entity161 and @entity148 is not rare among @entity1 with @entity161 . Treatment implications need be further investigated.

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Antihypertensive response to thiazide diuretic or angiotensin receptor blocker in elderly @entity101 is not influenced by pretreatment plasma XXXX activity.

multiple_choice

PURPOSE: @entity916 profiling has been proposed as a method to guide antihypertensive drug selection. This prespecified post-hoc analysis examined the influence of baseline plasma @entity916 activity (PRA) on blood pressure (BP) responses. METHODS: A 16-week, randomized, double-blind, prompted-titration trial evaluated initial @entity917 (V)/ @entity918 ( @entity918 ) combination therapy versus initial @entity918 or V monotherapy in individuals aged >= 70 years with systolic @entity101 . Sitting PRA was measured at baseline, Week 4, and Week 16. Subjects were stratified into 2 groups for analysis: low @entity916 (baseline PRA < 0.65 ng/mL/h) or normal-high @entity916 (baseline PRA >= 0.65 ng/mL/h). RESULTS: PRA data were available in 322/384 subjects: 178 had low PRA and 144 had normal-high PRA. At Week 4, V/ @entity918 was more effective than @entity918 or V at reducing mean sitting systolic BP (MSSBP), independent of baseline PRA, with reductions of -16.9, -12.6, and -9.5 mmHg, respectively, in low- @entity916 subjects and -19.4, -11.5, and -8.6 mmHg in normal-high @entity916 subjects. Baseline PRA was similar in responders (subjects not uptitrated at Week 4) and nonresponders (subjects uptitrated at Week 4). In responders, the reactive rise in PRA at Week 4 was related to change in MSSBP, with the greatest increases in PRA observed in the V/ @entity918 group. Higher baseline PRA was associated with a greater reactive rise in PRA. CONCLUSIONS: Baseline PRA is not a useful guide to the BP responses of initial combination V/ @entity918 in elderly individuals with systolic @entity101 .

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Antihypertensive response to thiazide diuretic or angiotensin receptor blocker in elderly XXXX is not influenced by pretreatment plasma @entity916 activity.

multiple_choice

PURPOSE: @entity916 profiling has been proposed as a method to guide antihypertensive drug selection. This prespecified post-hoc analysis examined the influence of baseline plasma @entity916 activity (PRA) on blood pressure (BP) responses. METHODS: A 16-week, randomized, double-blind, prompted-titration trial evaluated initial @entity917 (V)/ @entity918 ( @entity918 ) combination therapy versus initial @entity918 or V monotherapy in individuals aged >= 70 years with systolic @entity101 . Sitting PRA was measured at baseline, Week 4, and Week 16. Subjects were stratified into 2 groups for analysis: low @entity916 (baseline PRA < 0.65 ng/mL/h) or normal-high @entity916 (baseline PRA >= 0.65 ng/mL/h). RESULTS: PRA data were available in 322/384 subjects: 178 had low PRA and 144 had normal-high PRA. At Week 4, V/ @entity918 was more effective than @entity918 or V at reducing mean sitting systolic BP (MSSBP), independent of baseline PRA, with reductions of -16.9, -12.6, and -9.5 mmHg, respectively, in low- @entity916 subjects and -19.4, -11.5, and -8.6 mmHg in normal-high @entity916 subjects. Baseline PRA was similar in responders (subjects not uptitrated at Week 4) and nonresponders (subjects uptitrated at Week 4). In responders, the reactive rise in PRA at Week 4 was related to change in MSSBP, with the greatest increases in PRA observed in the V/ @entity918 group. Higher baseline PRA was associated with a greater reactive rise in PRA. CONCLUSIONS: Baseline PRA is not a useful guide to the BP responses of initial combination V/ @entity918 in elderly individuals with systolic @entity101 .

1194

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Characterization of a novel air-liquid interface biofilm of XXXX .

multiple_choice

Pseudomonads are able to form a variety of biofilms that colonize the air-liquid (A-L) interface of static liquid microcosms, and differ in matrix composition, strength, resilience and degrees of attachment to the microcosm walls. From @entity919 , mutants have evolved during prolonged adaptation-evolution experiments which produce robust biofilms of the physically cohesive class at the A-L interface, and which have been well characterized. In this study we describe a novel A-L interface biofilm produced by @entity919 that is categorized as a viscous mass (VM)-class biofilm. Several metals were found to induce this biofilm in static King's B microcosms, including @entity920 , @entity68 , lead and @entity921 , and we have used @entity68 to allow further examination of this structure. @entity68 was demonstrated to induce @entity919 to express cellulose, which provided the matrix of the biofilm, a weak structure that was readily destroyed by physical disturbance. This was confirmed in situ by a low (0.023-0.047 g) maximum deformation mass and relatively poor attachment as measured by crystal violet staining. Biofilm strength increased with increasing @entity68 concentration, in contrast to attachment levels, which decreased with increasing @entity68 . Furthermore, @entity68 added to mature biofilms significantly increased strength, suggesting that @entity68 also promotes interactions between cellulose fibres that increase matrix interconnectivity. Whilst weak attachment is important in maintaining the biofilm at the A-L interface, surface-interaction effects involving cellulose, which reduced surface tension by approximately 3.8 mN m(-1), may also contribute towards this localization. The fragility and viscoelastic nature of the biofilm were confirmed by controlled-stress amplitude sweep tests to characterize critical rheological parameters, which included a shear modulus of 0.75 Pa, a zero shear viscosity of 0.24 Pa s(-1) and a flow point of 0.028 Pa. Growth and morphological data thus far support a non-specific metal-associated physiological, rather than mutational, origin for production of the @entity919 VM biofilm, which is an example of the versatility of bacteria to inhabit optimal niches within their environment.

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A model of therapist competencies for the empirically supported interpersonal psychotherapy for XXXX .

multiple_choice

In order to treat @entity308 , a number of empirically supported treatments (ESTs) have been developed from both the cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT-A) frameworks. Research has shown that in order for these treatments to be implemented in @entity922 ( @entity922 ), effective therapist training must be generated and provided. However, before such training can be developed, a good understanding of the therapist competencies needed to implement these ESTs is required. Sburlati et al. (Clin @entity1 Fam Psychol Rev 14:89-109, 2011) developed a model of therapist competencies for implementing CBT using the well-established Delphi technique. Given that IPT-A differs considerably to CBT, the current study aims to develop a model of therapist competencies for the implementation of IPT-A using a similar procedure as that applied in Sburlati et al. (Clin @entity1 Fam Psychol Rev 14:89-109, 2011). This method involved: (1) identifying and reviewing an empirically supported IPT-A approach, (2) extracting therapist competencies required for the implementation of IPT-A, (3) consulting with a panel of IPT-A experts to generate an overall model of therapist competencies, and (4) validating the overall model with the IPT-A manual author. The resultant model offers an empirically derived set of competencies necessary for effectively treating @entity308 using IPT-A and has wide implications for the development of therapist training, competence assessment measures, and evidence-based practice guidelines. This model, therefore, provides an empirical framework for the development of dissemination and implementation programs aimed at ensuring that adolescents with @entity308 receive effective care in @entity922 settings. Key similarities and differences between CBT and IPT-A, and the therapist competencies required for implementing these treatments, are also highlighted throughout this article.