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A phase II study of @entity1134 in metastatic XXXX .

multiple_choice

BACKGROUND: The Notch signalling pathway is activated in a variety of @entity5 and has been implicated in @entity14 . One of the first steps in the Notch pathway activation is mediated by y-secretase, a proteolytic enzyme which produces an activated intracellular Notch (ICN). @entity1134 is a selective inhibitor of y-secretase. We tested the activity of @entity1134 in @entity1 with metastatic, refractory @entity14 . @entity1 AND METHODS: @entity1 with metastatic @entity14 who had received at least two prior lines of systemic chemotherapy were enrolled on the study. @entity1 were treated with @entity1134 at its recommended phase II dose of 20mg daily, 3 days on and 4 days off continuously. Cycle length was 28 days. Imaging was performed every two cycles. Archival tissue specimens were stained immunohistochemically for components of the notch pathway: @entity125 , ICN and the downstream target @entity1135 . RESULTS: Thirty-seven @entity1 were enrolled of whom 33 were evaluable for @entity137 and response. Immunohistochemical analysis of archival tissues demonstrated positive staining for the notch receptor as well as intracellular notch and the downstream gene @entity1135 in the majority of @entity1 . Nevertheless, no objective radiographic responses were observed in this group and only six @entity1 had stable disease as their best response. Median PFS was 1.8 months and median overall survival (OS) was 6.0 months. CONCLUSION: In this study of @entity1134 in @entity1 with refractory metastatic @entity14 , no radiographic responses were seen and time to progression was short, which suggests that @entity1134 at the study dose and schedule has minimal single agent activity in this malignancy.

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A phase II study of XXXX in metastatic @entity14 .

multiple_choice

BACKGROUND: The Notch signalling pathway is activated in a variety of @entity5 and has been implicated in @entity14 . One of the first steps in the Notch pathway activation is mediated by y-secretase, a proteolytic enzyme which produces an activated intracellular Notch (ICN). @entity1134 is a selective inhibitor of y-secretase. We tested the activity of @entity1134 in @entity1 with metastatic, refractory @entity14 . @entity1 AND METHODS: @entity1 with metastatic @entity14 who had received at least two prior lines of systemic chemotherapy were enrolled on the study. @entity1 were treated with @entity1134 at its recommended phase II dose of 20mg daily, 3 days on and 4 days off continuously. Cycle length was 28 days. Imaging was performed every two cycles. Archival tissue specimens were stained immunohistochemically for components of the notch pathway: @entity125 , ICN and the downstream target @entity1135 . RESULTS: Thirty-seven @entity1 were enrolled of whom 33 were evaluable for @entity137 and response. Immunohistochemical analysis of archival tissues demonstrated positive staining for the notch receptor as well as intracellular notch and the downstream gene @entity1135 in the majority of @entity1 . Nevertheless, no objective radiographic responses were observed in this group and only six @entity1 had stable disease as their best response. Median PFS was 1.8 months and median overall survival (OS) was 6.0 months. CONCLUSION: In this study of @entity1134 in @entity1 with refractory metastatic @entity14 , no radiographic responses were seen and time to progression was short, which suggests that @entity1134 at the study dose and schedule has minimal single agent activity in this malignancy.

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Ultrasound effect on level of stress proteins and arthritic histology in experimental XXXX .

multiple_choice

OBJECTIVE: To investigate the effect of ultrasound on the levels of stress protein in experimental @entity625 and their relation to the therapeutic effects on arthritic cartilage repair. METHODS: Thirty-six @entity35 with similar degree of early @entity625 were divided at random into two groups. In group s, 18 @entity35 received sonication; in group c, 18 control @entity35 received sham sonication. The severity of induced @entity625 was evaluated from bone scan with @entity1136 . The presence and changes of stress protein were identified from immunostain of SP72 antibody from frozen sections of arthritic cartilage and from electrophoresis of proteins extracted from chondrocytes of arthritic cartilage. The severity index, density of immunostained chondrocytes, and histopathologic changes at various periods were also studied in each group. RESULTS: The density of stress protein was increased markedly in treated @entity35 after sonication and it was closely related to the repair of arthritic cartilage. Once the pathohistology of arthritic cartilage improved, stress protein declined significantly in the follow-up period. CONCLUSION: Therapeutic ultrasound can enhance stress protein production in arthritic chondrocytes. The extragenic production of stress protein was well correlated with the therapeutic effect of ultrasound to preserve chondrocytes and bring about the repair of arthritic cartilage.

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Optimal body fat percentage cut-offs for XXXX in Chinese adults.

multiple_choice

Obesity results in an increased risk of @entity209 ( @entity209 ) and @entity164 2 @entity6 (T2DM). Body fat percentage (BF%) is a common index of body composition. The aim of the present study was to determine the optimal BF% cut-offs for @entity28 to predict @entity209 and T2DM in Chinese adults. The baseline study group comprised 3916 Chinese adults (age 30-70 years of age); 2033 subjects without @entity209 or T2DM were followed up for a maximum of 5.5 years. The BF% was estimated using bioelectrical impedance analysis. Optimal BF% cut-offs were analysed by receiver operating characteristic (ROC) curves. Binary logistic regression analysis was performed to measure the association between @entity28 at baseline defined by BF% and newly developed @entity209 and T2DM. Mean BF% levels were lower in @entity1 than in @entity1 (23.9 6.1% vs 33.5 7.1%, respectively; P < 0.01). For @entity1 , the optimal BF% cut-offs for the prediction of @entity209 and T2DM were 25.45% and 26.65%, respectively; for @entity1 , the corresponding values were 34.95% and 36.55%. Subjects with high BF% (>= 25% in @entity1 ; >= 35% in @entity1 ) had higher risks of incident @entity209 or T2DM than those with low BF% (< 25% in @entity1 ; < 35% in @entity1 ). The relative risks were 3.43 (95% confidence intervals (CI) 2.59-4.54) and 2.92 (95% CI 1.85-4.60), respectively. The optimal BF% cut-offs for @entity28 for the prediction of @entity209 and T2DM in Chinese @entity1 and @entity1 were around 25% and 35%, respectively.

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Neoadjuvant chemotherapy in XXXX may not improve rates of breast conservation.

multiple_choice

BACKGROUND: @entity1 with @entity1137 ( @entity1137 ) experience a lower pathological complete response rate to neoadjuvant chemotherapy than @entity1 with @entity513 . This study was intended to evaluate the impact of neoadjuvant chemotherapy in @entity1137 on breast-conserving surgery (BCS) rates. METHODS: Two-hundred eighty-four consecutive @entity1 with pure @entity1137 treated between May 1998 and September 2006 were reviewed. Surgical procedures and long-term outcomes were compared between @entity1 receiving neoadjuvant chemotherapy and those receiving surgery first. RESULTS: Neoadjuvant chemotherapy was administered to 84 @entity1 ; 200 @entity1 underwent surgery first. The mean @entity5 size in the neoadjuvant group (4.9 cm) was significantly larger than in @entity1 who underwent surgery first (2.5 cm, p < 0.0001). In the neoadjuvant group, clinical complete response was seen in 10% and partial response in 59%. Overall BCS rates were 17% in the neoadjuvant group compared with 43% in the surgery-first group (p < 0.0001). When controlled for initial @entity5 size, there was no difference (all p > 0.05) between the groups in terms of (1) the proportion of @entity1 who underwent an initial attempt at BCS, (2) rate of failure of BCS or (3) the proportion of @entity1 undergoing BCS as their final procedure. With a mean follow-up of 47 months, local recurrence (LR) rates were similar between the two groups (1.2% versus 0.5%, p = 0.5). CONCLUSION: The use of neoadjuvant chemotherapy does not increase the rates of breast conservation in @entity1 with pure @entity1137 .

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XXXX -treated peripheral blood mononuclear cells (PBMCs) prolong allograft survival in composite tissue allotransplantation.

multiple_choice

BACKGROUND: Composite tissue allotransplantation (CTA) was introduced as a potential treatment for complex reconstructive procedures and has become a clinical reality. Hand and face transplantation, the most widely recognized forms of CTA, have intensified immunological research in this emerging field of transplantation. @entity1138 ( @entity1139 ) is an alkylating agent that suppresses allogeneic T-cell responses. @entity1139 -treated dendritic cells/PBMCs have been shown to induce donor-specific tolerance in solid organ allograft transplantations. METHODS: Fully mismatched @entity35 were used as hind limb donors [Lewis (RT1(1))] and recipients [Brown-Norway (RT1(n))]. Fifty-five allogeneic hind limb transplantations were accomplished in six groups. Group A (n = 10) received donor-derived @entity1139 -treated PBMCs on transplantation day. Group B (n = 10) @entity35 received no immunosuppression, group C (n = 10) received @entity1140 and prednisolon, group D consisted in isograft transplantation without immunosuppression, group E (n = 10) received non-treated PBMCs, and group F (n = 5) received PBS without any donor-derived cells. Rejection was assessed clinically and histologically. RESULTS: In group A, the survival times of the allografts were prolonged to an average of 8.0 d. Rejection was significantly delayed compared with the averages of the corresponding control groups B, E, and F (5.5, 5.9, and 5.8 d). No rejection was seen in control groups C and D. CONCLUSION: These results demonstrate that @entity1139 -treated donor PBMCs significantly prolong allograft survival when administered systemically on the day of transplantation. However, the immunomodulatory effect is relatively modest with further research being required to clarify dose-effect relations, cell characteristics, and an optimized mechanism and timing for cell application.

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Appropriateness of colonoscopy in Europe (EPAGE II). XXXX and known @entity29 .

multiple_choice

BACKGROUND AND STUDY AIMS: To summarize the published literature on assessment of appropriateness of colonoscopy for investigation of chronic @entity294 , management of @entity1 with known @entity29 ( @entity29 ), and for @entity14 ( @entity14 ) surveillance in such @entity1 , and to report report appropriateness criteria developed by an expert panel, the 2008 European Panel on the Appropriateness of Gastrointestinal Endoscopy, EPAGE II. METHODS: A systematic search of guidelines, systematic reviews, and primary studies regarding the evaluation of chronic @entity294 , the management of @entity29 , and @entity14 surveillance in @entity29 was performed. The RAND/UCLA Appropriateness Method was applied to develop appropriateness criteria for colonoscopy for these conditions. RESULTS: According to the literature, colonoscopic evaluation may be justified for @entity1 aged > 50 years with recent-onset chronic @entity294 or with alarm symptoms. Surveillance colonoscopy for @entity14 should be offered to all @entity1 with extensive @entity31 or @entity30 of 8 years' duration, and to all @entity1 with less extensive disease of 15 years' duration. Intervals for surveillance colonoscopy depend on duration of evolution, initial diagnosis, and histological findings. The EPAGE II criteria also confirmed the appropriateness of diagnostic colonoscopy for @entity294 of > 4 weeks' duration. They also suggest that, in addition to assessing extent of @entity29 by colonoscopy, further colonoscopic examination is appropriate in the face of persistent or worsening symptoms. Surveillance colonoscopy in @entity29 @entity1 was generally appropriate after a lapse of 2 years. In the presence of @entity1141 at previous colonoscopy, it was not only appropriate but necessary. CONCLUSIONS: Despite or perhaps because of the limitations of the available published studies, the panel-based EPAGE II (http://www.epage.ch) criteria can help guide appropriate colonoscopy use in the absence of strong evidence from the literature.

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Appropriateness of colonoscopy in Europe (EPAGE II). @entity294 and known XXXX .

multiple_choice

BACKGROUND AND STUDY AIMS: To summarize the published literature on assessment of appropriateness of colonoscopy for investigation of chronic @entity294 , management of @entity1 with known @entity29 ( @entity29 ), and for @entity14 ( @entity14 ) surveillance in such @entity1 , and to report report appropriateness criteria developed by an expert panel, the 2008 European Panel on the Appropriateness of Gastrointestinal Endoscopy, EPAGE II. METHODS: A systematic search of guidelines, systematic reviews, and primary studies regarding the evaluation of chronic @entity294 , the management of @entity29 , and @entity14 surveillance in @entity29 was performed. The RAND/UCLA Appropriateness Method was applied to develop appropriateness criteria for colonoscopy for these conditions. RESULTS: According to the literature, colonoscopic evaluation may be justified for @entity1 aged > 50 years with recent-onset chronic @entity294 or with alarm symptoms. Surveillance colonoscopy for @entity14 should be offered to all @entity1 with extensive @entity31 or @entity30 of 8 years' duration, and to all @entity1 with less extensive disease of 15 years' duration. Intervals for surveillance colonoscopy depend on duration of evolution, initial diagnosis, and histological findings. The EPAGE II criteria also confirmed the appropriateness of diagnostic colonoscopy for @entity294 of > 4 weeks' duration. They also suggest that, in addition to assessing extent of @entity29 by colonoscopy, further colonoscopic examination is appropriate in the face of persistent or worsening symptoms. Surveillance colonoscopy in @entity29 @entity1 was generally appropriate after a lapse of 2 years. In the presence of @entity1141 at previous colonoscopy, it was not only appropriate but necessary. CONCLUSIONS: Despite or perhaps because of the limitations of the available published studies, the panel-based EPAGE II (http://www.epage.ch) criteria can help guide appropriate colonoscopy use in the absence of strong evidence from the literature.

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Appropriateness of colonoscopy in Europe (EPAGE II). @entity29 : pain, XXXX and bloating.

multiple_choice

BACKGROUND AND STUDY AIMS: To summarize the published literature on assessment of appropriateness of colonoscopy for the investigation of functional bowel symptoms, and report appropriateness criteria developed by an expert panel, the 2008 European Panel on the Appropriateness of Gastrointestinal Endoscopy, EPAGE II. METHODS: A systematic search of guidelines, systematic reviews and primary studies regarding the evaluation and management of functional bowel symptoms was performed. The RAND/UCLA Appropriateness Method was applied to develop appropriateness criteria for colonoscopy for these conditions. RESULTS: Much of the evidence for use of colonoscopy in evaluation of chronic @entity490 , and/or @entity1142 and/or abdominal bloating is modest. Major limitations include small numbers of @entity1 and lack of adequate characterization of these @entity1 . Large community-based follow-up studies are needed to enable better definition of the natural history of @entity1 with @entity29 . Guidelines stress that alarm features ("red flags"), such as @entity548 , @entity417 , @entity353 , nocturnal symptoms, family history of @entity694 , age of onset > 50 years, and recent onset of symptoms should all lead to careful evaluation before a diagnosis of @entity29 is made. EPAGE II assessed these symptoms by means of 12 clinical scenarios, rating colonoscopy as appropriate, uncertain and inappropriate in 42 % (5/12), 25 % (3/12), and 33 % (4/12) of these, respectively. CONCLUSIONS: Evidence to support the use of colonoscopy in the evaluation of @entity1 with @entity29 and no alarm features is lacking. These @entity1 have no increased risk of @entity694 and thus advice on screening for this is not different from that for the general population. EPAGE II criteria, available online (http://www.epage.ch), consider colonoscopy appropriate in @entity1 of > 50 years with @entity132 , but not in @entity1 with isolated chronic @entity490 .

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Appropriateness of colonoscopy in Europe (EPAGE II). XXXX : pain, @entity1142 and bloating.

multiple_choice

BACKGROUND AND STUDY AIMS: To summarize the published literature on assessment of appropriateness of colonoscopy for the investigation of functional bowel symptoms, and report appropriateness criteria developed by an expert panel, the 2008 European Panel on the Appropriateness of Gastrointestinal Endoscopy, EPAGE II. METHODS: A systematic search of guidelines, systematic reviews and primary studies regarding the evaluation and management of functional bowel symptoms was performed. The RAND/UCLA Appropriateness Method was applied to develop appropriateness criteria for colonoscopy for these conditions. RESULTS: Much of the evidence for use of colonoscopy in evaluation of chronic @entity490 , and/or @entity1142 and/or abdominal bloating is modest. Major limitations include small numbers of @entity1 and lack of adequate characterization of these @entity1 . Large community-based follow-up studies are needed to enable better definition of the natural history of @entity1 with @entity29 . Guidelines stress that alarm features ("red flags"), such as @entity548 , @entity417 , @entity353 , nocturnal symptoms, family history of @entity694 , age of onset > 50 years, and recent onset of symptoms should all lead to careful evaluation before a diagnosis of @entity29 is made. EPAGE II assessed these symptoms by means of 12 clinical scenarios, rating colonoscopy as appropriate, uncertain and inappropriate in 42 % (5/12), 25 % (3/12), and 33 % (4/12) of these, respectively. CONCLUSIONS: Evidence to support the use of colonoscopy in the evaluation of @entity1 with @entity29 and no alarm features is lacking. These @entity1 have no increased risk of @entity694 and thus advice on screening for this is not different from that for the general population. EPAGE II criteria, available online (http://www.epage.ch), consider colonoscopy appropriate in @entity1 of > 50 years with @entity132 , but not in @entity1 with isolated chronic @entity490 .

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Malignancy-associated chylothorax: a 20-year study of 18 XXXX from a single institution.

multiple_choice

Malignancy-associated chylothorax is a rare manifestation with uncertain characteristics and clinical significance. We segregated 18 @entity1 into @entity706 (n= 11) and solid @entity5 (n= 7) groups to analyse the characteristics, treatment response and prognostic value of @entity5 -associated chylothorax. Diagnosis of chylothorax was confirmed by a @entity412 concentration of >110 mg/dL or by the presence of chylomicrons in the @entity1143 . Concentrations of @entity413 , protein and @entity880 dehydrogenase did not differ significantly between the @entity706 and solid @entity5 groups. Although not statistically significant (P= 0.25), 90.9% @entity706 @entity1 and 57.1% solid @entity5 @entity1 had exudates. The cytology diagnostic rate in the @entity706 and solid @entity5 groups was 20.0% and 33.3% respectively (P > 0.99). After chemotherapy, six @entity706 @entity1 achieved complete remission, with simultaneous chylothorax disappearance. The overall survival rate at 12 and 24 months in the @entity706 group was 54.5% and 36.4% respectively, while that in the solid @entity5 group was 35.7% and 0% respectively. @entity706 was the chief cause of chylothorax in our cohort. @entity706 treatment, lacking supplementary interventions, is essential for treating chylothorax in @entity706 @entity1 . Chylothorax indicates extremely limited life expectancy for solid @entity5 @entity1 .

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Optimizing screening of XXXX in @entity1 undergoing bariatric surgery.

multiple_choice

BACKGROUND: Obstructive sleep @entity386 is common in @entity1 waiting for bariatric surgery (BS). International consensuses have recommended assessment of @entity27 in the preoperative evaluation to avoid perioperative complications. Polysomnography is the standard diagnostic method but is expensive and time-consuming. The aim of our study was to detect those @entity1 who merit treatment before BS using a simple predictor model. The study was conducted at 3 university hospitals (Hospital de Bellvitge, Hospital de la Santa Creu i Sant Pau, Hospital Clinic de Barcelona). METHODS: A prospective cross-sectional study was conducted of 136 consecutive bariatric subjects. The outcome variable was @entity27 , defined as an @entity386 -hypoapnea index of >= 30 events/hr by polysomnography. The predictors evaluated were anthropometric and clinical in the first model, with an @entity26 desaturation index of >= 3% added to the second model. Predictive models were constructed using multivariate logistic regression analysis. The best model was selected according to the area under the receiver operating characteristic curve. RESULTS: The first model identified 4 independent factors: age, waist circumference, systolic blood pressure, and witnessed @entity386 episodes, with a sensitivity of 78%, specificity of 68%, and area under the receiver operating characteristic curve of .83 (95% confidence interval .76-.90, P < .001). The second model identified 2 independent factors (witness @entity386 episodes, @entity26 desaturation index of >= 3%), with a sensitivity of 91%, specificity of 85%, and area under the receiver operating characteristic curve of .94 (95% confidence interval .89-.98, P < .001). The 2-step model predictive values were sensitivity of 90%, specificity of 91%, and accuracy of 90% (95% confidence interval 84-94%). After applying the first model and then the second, 45% of subjects would have been ruled out (15% and 30%, respectively) and 55% would require additional sleep management before BS. CONCLUSION: The proposed model could be useful for improving the management of complex @entity1 before BS and optimizing limited polysomnography resources.

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Optimizing screening of @entity27 in XXXX undergoing bariatric surgery.

multiple_choice

BACKGROUND: Obstructive sleep @entity386 is common in @entity1 waiting for bariatric surgery (BS). International consensuses have recommended assessment of @entity27 in the preoperative evaluation to avoid perioperative complications. Polysomnography is the standard diagnostic method but is expensive and time-consuming. The aim of our study was to detect those @entity1 who merit treatment before BS using a simple predictor model. The study was conducted at 3 university hospitals (Hospital de Bellvitge, Hospital de la Santa Creu i Sant Pau, Hospital Clinic de Barcelona). METHODS: A prospective cross-sectional study was conducted of 136 consecutive bariatric subjects. The outcome variable was @entity27 , defined as an @entity386 -hypoapnea index of >= 30 events/hr by polysomnography. The predictors evaluated were anthropometric and clinical in the first model, with an @entity26 desaturation index of >= 3% added to the second model. Predictive models were constructed using multivariate logistic regression analysis. The best model was selected according to the area under the receiver operating characteristic curve. RESULTS: The first model identified 4 independent factors: age, waist circumference, systolic blood pressure, and witnessed @entity386 episodes, with a sensitivity of 78%, specificity of 68%, and area under the receiver operating characteristic curve of .83 (95% confidence interval .76-.90, P < .001). The second model identified 2 independent factors (witness @entity386 episodes, @entity26 desaturation index of >= 3%), with a sensitivity of 91%, specificity of 85%, and area under the receiver operating characteristic curve of .94 (95% confidence interval .89-.98, P < .001). The 2-step model predictive values were sensitivity of 90%, specificity of 91%, and accuracy of 90% (95% confidence interval 84-94%). After applying the first model and then the second, 45% of subjects would have been ruled out (15% and 30%, respectively) and 55% would require additional sleep management before BS. CONCLUSION: The proposed model could be useful for improving the management of complex @entity1 before BS and optimizing limited polysomnography resources.

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Physical activity, @entity1144 and the risk of XXXX : a Korean national sample study.

multiple_choice

OBJECTIVES: To examine the interaction between physical activity and @entity1144 in relation to the Framingham Risk Score (FRS) for predicting the 10-year risk of @entity301 ( @entity301 ) using a representative sample of Korean adults. STUDY DESIGN: Cross-sectional study. METHODS: Drawing from the 2007 Korean National Health and Nutrition Examination Survey (NHANES IV-1), data from 2112 adults aged 30-74 years were analysed. The risk of @entity301 was calculated according to the FRS, and odds ratios (ORs) were analysed for the at-risk group (probability > 10%) with multivariate logistic regression. RESULTS: Compared with physically active @entity1 with a normal waist circumference (WC), inactive @entity1 with a large WC had an OR for @entity301 risk of 2.91 [95% confidence interval (CI) 1.63-5.22]. Compared with active @entity1 with a normal WC, inactive @entity1 with a large WC had an OR of 6.37 (95% CI 3.44-11.80). Among @entity1 with a normal WC, inactive @entity1 were at increased risk of @entity301 compared with active @entity1 (OR 2.16, 95% CI 1.19-3.93). Among active individuals, both @entity1 and @entity1 with large WCs were at increased risk of @entity301 compared with those with normal WCs. CONCLUSIONS: @entity1144 was associated with risk of @entity301 regardless of the level of physical activity. The 10-year risk of @entity301 associated with physical inactivity and @entity1144 was much stronger in Korean @entity1 than in Korean @entity1 . While the importance of @entity28 control and physical activity is clear, future interventions should incorporate more targeted @entity1144 prevention and control efforts, especially for @entity1 .

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Physical activity, XXXX and the risk of @entity301 : a Korean national sample study.

multiple_choice

OBJECTIVES: To examine the interaction between physical activity and @entity1144 in relation to the Framingham Risk Score (FRS) for predicting the 10-year risk of @entity301 ( @entity301 ) using a representative sample of Korean adults. STUDY DESIGN: Cross-sectional study. METHODS: Drawing from the 2007 Korean National Health and Nutrition Examination Survey (NHANES IV-1), data from 2112 adults aged 30-74 years were analysed. The risk of @entity301 was calculated according to the FRS, and odds ratios (ORs) were analysed for the at-risk group (probability > 10%) with multivariate logistic regression. RESULTS: Compared with physically active @entity1 with a normal waist circumference (WC), inactive @entity1 with a large WC had an OR for @entity301 risk of 2.91 [95% confidence interval (CI) 1.63-5.22]. Compared with active @entity1 with a normal WC, inactive @entity1 with a large WC had an OR of 6.37 (95% CI 3.44-11.80). Among @entity1 with a normal WC, inactive @entity1 were at increased risk of @entity301 compared with active @entity1 (OR 2.16, 95% CI 1.19-3.93). Among active individuals, both @entity1 and @entity1 with large WCs were at increased risk of @entity301 compared with those with normal WCs. CONCLUSIONS: @entity1144 was associated with risk of @entity301 regardless of the level of physical activity. The 10-year risk of @entity301 associated with physical inactivity and @entity1144 was much stronger in Korean @entity1 than in Korean @entity1 . While the importance of @entity28 control and physical activity is clear, future interventions should incorporate more targeted @entity1144 prevention and control efforts, especially for @entity1 .

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PPI therapy is equally effective in well-defined @entity354 and in XXXX : a meta-analysis.

multiple_choice

BACKGROUND: Symptomatic response to proton pump inhibitor (PPI) therapy in @entity1 with @entity354 ( @entity354 ) is often reported as lower than in @entity1 with @entity354 ( @entity354 ). However, the definition of @entity354 differs across clinical trials. This meta-analysis aims to estimate the rate of symptom relief in response to PPI in @entity354 @entity1 . METHODS: MEDLINE (1966-2010), Cochrane Comprehensive Trial Register (1997-2010) and EMBASE (1985-2010) databases were searched and manual searches from studies' references were performed. Randomized clinical trials were selected that included @entity1 with heartburn, and analyzed the effect of short-term PPI treatment. The primary outcome of selected studies was defined as complete or partial heartburn relief. Two reviewers independently extracted data and assessed study quality of selected articles. Random effects models and meta-regression were used to combine and analyze results. KEY RESULTS: The pooled estimate of complete relief of heartburn after 4 weeks of PPI therapy in @entity1 with @entity354 was 0.72 (95% CI 0.69-0.74) (32 studies), vs 0.50 (0.43-0.57) (eight studies) in empirically treated @entity1 , 0.49 (0.44-0.55) (12 studies) in @entity1 defined as non-erosive by negative endoscopy, and 0.73 (0.69-0.77) (two studies) in @entity1 defined as non-erosive by both negative endoscopy and a positive pH-test. CONCLUSIONS _ INFERENCES: In well-defined @entity354 @entity1 , the estimated complete symptom response rate after PPI therapy is comparable to the response rate in @entity1 with @entity354 . The previously reported low response rate in studies with @entity1 classified as @entity354 is likely the result of inclusion of @entity1 with @entity344 that do not have @entity354 .

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PPI therapy is equally effective in well-defined XXXX and in @entity354 : a meta-analysis.

multiple_choice

BACKGROUND: Symptomatic response to proton pump inhibitor (PPI) therapy in @entity1 with @entity354 ( @entity354 ) is often reported as lower than in @entity1 with @entity354 ( @entity354 ). However, the definition of @entity354 differs across clinical trials. This meta-analysis aims to estimate the rate of symptom relief in response to PPI in @entity354 @entity1 . METHODS: MEDLINE (1966-2010), Cochrane Comprehensive Trial Register (1997-2010) and EMBASE (1985-2010) databases were searched and manual searches from studies' references were performed. Randomized clinical trials were selected that included @entity1 with heartburn, and analyzed the effect of short-term PPI treatment. The primary outcome of selected studies was defined as complete or partial heartburn relief. Two reviewers independently extracted data and assessed study quality of selected articles. Random effects models and meta-regression were used to combine and analyze results. KEY RESULTS: The pooled estimate of complete relief of heartburn after 4 weeks of PPI therapy in @entity1 with @entity354 was 0.72 (95% CI 0.69-0.74) (32 studies), vs 0.50 (0.43-0.57) (eight studies) in empirically treated @entity1 , 0.49 (0.44-0.55) (12 studies) in @entity1 defined as non-erosive by negative endoscopy, and 0.73 (0.69-0.77) (two studies) in @entity1 defined as non-erosive by both negative endoscopy and a positive pH-test. CONCLUSIONS _ INFERENCES: In well-defined @entity354 @entity1 , the estimated complete symptom response rate after PPI therapy is comparable to the response rate in @entity1 with @entity354 . The previously reported low response rate in studies with @entity1 classified as @entity354 is likely the result of inclusion of @entity1 with @entity344 that do not have @entity354 .

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The modified Fontan procedure and prolonged XXXX .

multiple_choice

The modified Fontan procedure may be complicated by prolonged @entity456 . Predisposing factors are not fully understood. This study examines perioperative variables associated with prolonged effusions. We examined the Fontan procedure in 41 @entity1 . Mean age was 45 months (range, 9 to 113 months). Mean weight was 14.7 kg (range, 6.9 to 30.4 kg). Diagnoses included @entity1145 in 29 per cent, @entity1146 in 12 per cent, and @entity1147 right ventricle in 12 per cent. Fontan revisions were excluded. The extracardiac Fontan was performed in 22 @entity1 (54%) and the lateral tunnel (LT) in 18 (44%). Fenestration was performed in 56 per cent. Ten @entity1 (24%) had prolonged @entity1143 . Mean chest tube output (24.2 vs 14.1 mL/kg/d, P < 0.01), days with chest tubes (10.2 vs 5.8 days, P < 0.01), and length of stay (20.8 vs 8.13 days, P < 0.01) were significantly greater in those with effusions. Preoperative mean pulmonary artery pressure was higher in @entity1 with prolonged effusions (12.7 vs 9.90 mmHg, P = 0.001). No other factors were identified as risk factors. @entity1143 (greater than 14 days) are common after the modified Fontan procedure. A higher preoperative mean pulmonary artery pressure may be predictive of these effusions. Fenestration, type of Fontan reconstruction, and size of extracardiac conduit did not predispose to postoperative effusions.

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[Continuous skeletal traction in multifragmentary XXXX of radius and ulna combined with cast].

multiple_choice

INTRODUCTION: @entity174 of the distal third of the radius are frequently encountered in emergency services. Until recently considered as benign, however, they represent a group of numerous therapeutic problems, as debated in anatomical, radiological and clinical studies. OBJECTIVE: To emphasize the importance of recovering the radial distance and the articular congruence in @entity174 of radius treated with a cast. HYPOTHESIS: To demonstrate that ligamentotaxis obtained with the application of the Cole-Obletz technique is a good method for treatment of distal radius @entity174 that have a component of impaction, extra or @entity75 , a combination of both. MATERIAL AND METHODS: A retrospective study was realized on 10 @entity1 with @entity174 of the distal radius, between February 2005 and February 2006, including adult @entity1 of both genders. All @entity1 received the Cole-Obletz method and were evaluated by antero-posterior and lateral wrist simple X-rays. According to Frykman classification, we compaired results in the immediate post-reduction X-rays with the results obtained at one month of treatment. Three different radiographic measures were evaluated: radius distance, inclination and volar tilt of the radius. RESULTS: We evaluated a group of 10 @entity1 (80% female), with mean age of 52 years-old (24-79). Thirty percent of the @entity1 (30%) presented a type @entity797 @entity174 , fourty percent a @entity174 , and one @entity1 for types V, IV, and II @entity174 , respectively. Articular congruence was achieved in the 80% of @entity1 until full consolidation, in 10% of the @entity1 only a 50% of radius distance was completed. In a @entity1 anatomic reduction was lost on day eight. DISCUSSION: Treatment of complex distal radius @entity174 with plates and screws for maintaining anatomic reduction are not applicable in our socioeconomic context. This study was aimed to prove that the Cole-Obletz method permits to maintain adequate reduction, it is reproducible, and is achievable at low costs.

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Vascular events in XXXX .

multiple_choice

BACKGROUND AND AIMS: In @entity2 , many factors have prognostic significance, including @entity1148 , which is frequently observed. Associations between vascular events, which are the outcomes of @entity1109 , and mortality and morbidity has been evaluated in many studies. The aim of the present study was to evaluate the relationship between @entity1148 and vascular events. MATERIALS AND METHODS: In total, 281 @entity1 , who were histopathologically diagnosed with @entity2 between March 2007 and August 2009, were evaluated retrospectively. Data analysis was performed using the Statistical Package for the Social Sciences (SPSS) software (ver. 11.5 for Windows). Analysis of the distribution of constant variance for normality was assessed using the Shapiro-Wilk test. Nominal variables were evaluated using Pearson's chi-squared or Fisher's exact chi-squared tests. Significant correlations between continuous variables were investigated using Spearman's correlation test. RESULTS: Of the 281 @entity1 , 234 (83.3%) were males and 47 (16.7%) were females, with a median age of 60.6 (31-83 years). Histopathologically, 40 (14.2%) were diagnosed with @entity151 and 241 (85.8%) with @entity1149 . In total, 17 (6.04%) vascular events were identified: 11 (64.7%) @entity1150 , three (17.6%) @entity1151 , one (5.9%) cerebral arterial @entity715 , and one (5.9%) vena cava superior @entity715 . @entity1148 was not determined during @entity715 , but during subsequent visits. CONCLUSIONS: @entity1148 is frequently observed in @entity1 with @entity2 . Further prospective studies are required to evaluate the need for prophylactic anticoagulants in these @entity1 . The association between vascular events and survival, the next step of the present study, will be evaluated prospectively.

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Modified Collis-Nissen procedure for long gap pure XXXX .

multiple_choice

BACKGROUND/PURPOSE: Esophageal reconstruction in long gap @entity1152 ( @entity1152 ) is technically challenging, and several procedures have been described. The purpose of this study is to review our experience with the modified Collis-Nissen procedure in the repair of long gap pure @entity1152 . METHODS: Six @entity1 with pure @entity1152 were treated at our institution from 1985 to 2008. @entity1 ' demographics, surgical technique, timing of repair, early and late complications, and long-term functional outcomes were retrospectively reviewed. RESULTS: Five primary cases and 1 redo case were included. The mean gap length was 5.3 vertebral bodies (range, 4-6). Modified Collis-Nissen procedure was performed at a mean age of 11.6 months (range, 9-14 months) in primary cases. There was 1 @entity834 in the redo case, which healed spontaneously. Two @entity1 had anastomotic strictures requiring balloon dilatations. @entity1 were weaned from tube feeding at a mean duration of 4 months (range, 1-6 months) postoperatively. All @entity1 have normal oral intake at the last follow-up visit. Two adult @entity1 had normal growth and development and no digestive symptoms. Endoscopic examination and pH monitoring showed no signs of significant @entity354 . CONCLUSIONS: Modified Collis-Nissen procedure is a good option to consider in @entity1 with long gap pure @entity1152 and is associated with an acceptable complication rate and promising short- and long-term results.

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Lower side effects of XXXX than @entity903 in the treatment of major @entity308 among Han Chinese in Taiwan.

multiple_choice

@entity1153 is a dual-action antidepressant which inhibits both @entity750 and @entity1063 reuptake. To our knowledge, it has limited affinity for most @entity1154 neurotransmitter receptors. With limited pharmacokinetic interaction with the cytochrome 450 system, @entity1153 may have a low risk in drug interaction. The present study compares @entity1153 with @entity903 , a selective @entity750 reuptake inhibitor (SSRI) and which has been used clinically for years to evaluate the efficacy, @entity1 tolerance, and side effects in the treatment of @entity308 . The study took place in two medical centers located in Northern and Southern Taiwan. Six-three @entity1 who met the Diagnostic and Statistical Manual of @entity146 4th edition (DSM-IV) criteria for a major @entity308 and a total Hamilton Depression Rating Scale (HAM-D) score > or = 16 on the 17 item scale, were recruited. @entity1 first received either 100 mg/day of @entity1153 (33 @entity1 ) or 20 mg/day of @entity903 (30 @entity1 ), and were then assessed with HAM-D and clinical global impression scale (CGI) for severity of the illness and global improvement, at the beginning and the end of the first, second, fourth, and eighth weeks of the drug treatment. Thirty-eight @entity1 with major @entity308 completed the study. No statistically significant differences were observed between the two groups in the reduction of HAM-D and CGI scores. However, side effects such as @entity10 and @entity400 in the first week, @entity1155 and difficulty in concentration in the fourth week, and @entity1155 in the eighth week of treatment were significantly lower in the @entity1153 group, as compared to that of the @entity903 group. We concluded that @entity1153 and @entity903 had similar clinical effectiveness during the eight-week treatment of major @entity308 . Further investigation is needed to examine the clinical suitability of this drug for @entity1 with @entity409 and for elderly @entity1 suffering from @entity308 .

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Lower side effects of @entity1153 than @entity903 in the treatment of major XXXX among Han Chinese in Taiwan.

multiple_choice

@entity1153 is a dual-action antidepressant which inhibits both @entity750 and @entity1063 reuptake. To our knowledge, it has limited affinity for most @entity1154 neurotransmitter receptors. With limited pharmacokinetic interaction with the cytochrome 450 system, @entity1153 may have a low risk in drug interaction. The present study compares @entity1153 with @entity903 , a selective @entity750 reuptake inhibitor (SSRI) and which has been used clinically for years to evaluate the efficacy, @entity1 tolerance, and side effects in the treatment of @entity308 . The study took place in two medical centers located in Northern and Southern Taiwan. Six-three @entity1 who met the Diagnostic and Statistical Manual of @entity146 4th edition (DSM-IV) criteria for a major @entity308 and a total Hamilton Depression Rating Scale (HAM-D) score > or = 16 on the 17 item scale, were recruited. @entity1 first received either 100 mg/day of @entity1153 (33 @entity1 ) or 20 mg/day of @entity903 (30 @entity1 ), and were then assessed with HAM-D and clinical global impression scale (CGI) for severity of the illness and global improvement, at the beginning and the end of the first, second, fourth, and eighth weeks of the drug treatment. Thirty-eight @entity1 with major @entity308 completed the study. No statistically significant differences were observed between the two groups in the reduction of HAM-D and CGI scores. However, side effects such as @entity10 and @entity400 in the first week, @entity1155 and difficulty in concentration in the fourth week, and @entity1155 in the eighth week of treatment were significantly lower in the @entity1153 group, as compared to that of the @entity903 group. We concluded that @entity1153 and @entity903 had similar clinical effectiveness during the eight-week treatment of major @entity308 . Further investigation is needed to examine the clinical suitability of this drug for @entity1 with @entity409 and for elderly @entity1 suffering from @entity308 .

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Lower side effects of @entity1153 than XXXX in the treatment of major @entity308 among Han Chinese in Taiwan.

multiple_choice

@entity1153 is a dual-action antidepressant which inhibits both @entity750 and @entity1063 reuptake. To our knowledge, it has limited affinity for most @entity1154 neurotransmitter receptors. With limited pharmacokinetic interaction with the cytochrome 450 system, @entity1153 may have a low risk in drug interaction. The present study compares @entity1153 with @entity903 , a selective @entity750 reuptake inhibitor (SSRI) and which has been used clinically for years to evaluate the efficacy, @entity1 tolerance, and side effects in the treatment of @entity308 . The study took place in two medical centers located in Northern and Southern Taiwan. Six-three @entity1 who met the Diagnostic and Statistical Manual of @entity146 4th edition (DSM-IV) criteria for a major @entity308 and a total Hamilton Depression Rating Scale (HAM-D) score > or = 16 on the 17 item scale, were recruited. @entity1 first received either 100 mg/day of @entity1153 (33 @entity1 ) or 20 mg/day of @entity903 (30 @entity1 ), and were then assessed with HAM-D and clinical global impression scale (CGI) for severity of the illness and global improvement, at the beginning and the end of the first, second, fourth, and eighth weeks of the drug treatment. Thirty-eight @entity1 with major @entity308 completed the study. No statistically significant differences were observed between the two groups in the reduction of HAM-D and CGI scores. However, side effects such as @entity10 and @entity400 in the first week, @entity1155 and difficulty in concentration in the fourth week, and @entity1155 in the eighth week of treatment were significantly lower in the @entity1153 group, as compared to that of the @entity903 group. We concluded that @entity1153 and @entity903 had similar clinical effectiveness during the eight-week treatment of major @entity308 . Further investigation is needed to examine the clinical suitability of this drug for @entity1 with @entity409 and for elderly @entity1 suffering from @entity308 .

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Aflunov( ): a prepandemic XXXX vaccine.

multiple_choice

Influenza viruses are adept in @entity1 populations. Indeed, they have the capacity to evade the immune system through mechanisms of mutations (antigenic drift) and major variations in surface protein expression (antigenic shift). When a major change occurs, the risk of a @entity1 pandemic arises. Three @entity683 pandemics occurred during the 20th century, the most serious being the Spanish @entity683 . The last pandemic of the past century occurred in 1968, and the responsible virus infected an estimated 1-3 million @entity1 throughout the world. The first pandemic of the present century occurred in 2009 and was sustained by a H1N1 strain (A/California/07/09). In 1997, a novel avian @entity683 virus, H5N1, first infected @entity1 in China. Since its emergence, the H5N1 virus has spread from Asia to Europe and Africa, resulting in the infection of millions of poultry and wild birds. So far, 522 @entity1 cases and 322 @entity204 have been reported by the WHO. Many studies have therefore been performed to obtain efficacious and safe H5N1 vaccines. One of these is Aflunov( ). Aflunov is a prepandemic monovalent A/H5N1 @entity683 vaccine adjuvanted with @entity1156 produced by Novartis Vaccines and Diagnostics. In nonclinical studies conducted in @entity95 , Aflunov proved to be well-tolerated, did not cause maternal or embryo-fetal @entity137 , was not teratogenic, and had no effects on postnatal development. In clinical studies, Aflunov proved safe and well-tolerated in @entity1 , @entity1 , adolescents, adults and the elderly. In the same subjects, the vaccine elicited robust immunogenicity against both homologous (A/Vietnam/1194/2004 clade 1) and heterologous viral strains (for instance, A/Indonesia/05/2005 or A/ @entity233 /15/2006) and induced immunologic memory. Thus, in 2010, the CHMP issued a positive opinion on Aflunov and in January 2011 Aflunov was given marketing authorization. This vaccine could be very useful in the event of adaptation of the H5N1 virus to @entity1 , which could cause a new pandemic.

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Gender differences in associations between @entity130 history and adjustment among XXXX @entity1 .

multiple_choice

This study examines the relationship between a @entity130 history and emotional functioning in response to a @entity1118 . We broadened the traditional study of @entity130 in @entity1118 from @entity458 to include a variety of traumatic events and experiences that occurred not only during childhood, but during adulthood as well. Seventy-three (51% female, 60% lower back) @entity1118 @entity1 were administered the @entity130 History Questionnaire (Green, B.L., @entity130 History Questionnaire. In B.H. Stamm (Eds.), Measurement of Stress, @entity130 and Adaptation, Sidran, Lutherville, MD, 1996, pp. 366-369), the Multidimensional @entity158 Inventory (Kerns, R.D., Turk, D.C. and Rudy, T.E., The West Haven-Yale Multidimensional @entity158 Inventory (WHYMPI), @entity158 , 23 (1985) 345-356), The Beck Depression Inventory (Beck, A.T., Ward, C.H., Mendelson, M., Mock, J. and Erbaugh, J., An inventory for measuring @entity308 , Arch. Gen Psychiatry, 4 (1961) 561-571), and the @entity158 Scale (McCracken, L.M., Zayfert, C., Gross, R.T. The @entity158 Scale: development and validation of a scale to measure fear of @entity158 , @entity158 , 50 (1992) 67-73) prior to starting a multidisciplinary @entity158 program. We hypothesized that high levels of @entity147 and @entity148 would differentiate @entity1 with a substantial history of @entity130 from those without, while levels of @entity158 severity and disability would not. A MANOVA revealed a significant @entity130 Group (low vs. high) by Gender interaction for the dependent variables, which included both @entity147 and @entity158 severity and disability. Univariate tests showed that the interaction was significant only for @entity147 variables and not for @entity158 severity and disability. Further, the multivariate effect of @entity130 Group and the univariate effects for @entity147 variables were significant only among @entity1 . Results indicate that a substantial history of @entity130 may detrimentally impact a @entity1118 @entity1 's ability to manage their @entity158 effectively, particularly among @entity1 .

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Gender differences in associations between XXXX history and adjustment among @entity1118 @entity1 .

multiple_choice

This study examines the relationship between a @entity130 history and emotional functioning in response to a @entity1118 . We broadened the traditional study of @entity130 in @entity1118 from @entity458 to include a variety of traumatic events and experiences that occurred not only during childhood, but during adulthood as well. Seventy-three (51% female, 60% lower back) @entity1118 @entity1 were administered the @entity130 History Questionnaire (Green, B.L., @entity130 History Questionnaire. In B.H. Stamm (Eds.), Measurement of Stress, @entity130 and Adaptation, Sidran, Lutherville, MD, 1996, pp. 366-369), the Multidimensional @entity158 Inventory (Kerns, R.D., Turk, D.C. and Rudy, T.E., The West Haven-Yale Multidimensional @entity158 Inventory (WHYMPI), @entity158 , 23 (1985) 345-356), The Beck Depression Inventory (Beck, A.T., Ward, C.H., Mendelson, M., Mock, J. and Erbaugh, J., An inventory for measuring @entity308 , Arch. Gen Psychiatry, 4 (1961) 561-571), and the @entity158 Scale (McCracken, L.M., Zayfert, C., Gross, R.T. The @entity158 Scale: development and validation of a scale to measure fear of @entity158 , @entity158 , 50 (1992) 67-73) prior to starting a multidisciplinary @entity158 program. We hypothesized that high levels of @entity147 and @entity148 would differentiate @entity1 with a substantial history of @entity130 from those without, while levels of @entity158 severity and disability would not. A MANOVA revealed a significant @entity130 Group (low vs. high) by Gender interaction for the dependent variables, which included both @entity147 and @entity158 severity and disability. Univariate tests showed that the interaction was significant only for @entity147 variables and not for @entity158 severity and disability. Further, the multivariate effect of @entity130 Group and the univariate effects for @entity147 variables were significant only among @entity1 . Results indicate that a substantial history of @entity130 may detrimentally impact a @entity1118 @entity1 's ability to manage their @entity158 effectively, particularly among @entity1 .

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Gender differences in associations between @entity130 history and adjustment among @entity1118 XXXX .

multiple_choice

This study examines the relationship between a @entity130 history and emotional functioning in response to a @entity1118 . We broadened the traditional study of @entity130 in @entity1118 from @entity458 to include a variety of traumatic events and experiences that occurred not only during childhood, but during adulthood as well. Seventy-three (51% female, 60% lower back) @entity1118 @entity1 were administered the @entity130 History Questionnaire (Green, B.L., @entity130 History Questionnaire. In B.H. Stamm (Eds.), Measurement of Stress, @entity130 and Adaptation, Sidran, Lutherville, MD, 1996, pp. 366-369), the Multidimensional @entity158 Inventory (Kerns, R.D., Turk, D.C. and Rudy, T.E., The West Haven-Yale Multidimensional @entity158 Inventory (WHYMPI), @entity158 , 23 (1985) 345-356), The Beck Depression Inventory (Beck, A.T., Ward, C.H., Mendelson, M., Mock, J. and Erbaugh, J., An inventory for measuring @entity308 , Arch. Gen Psychiatry, 4 (1961) 561-571), and the @entity158 Scale (McCracken, L.M., Zayfert, C., Gross, R.T. The @entity158 Scale: development and validation of a scale to measure fear of @entity158 , @entity158 , 50 (1992) 67-73) prior to starting a multidisciplinary @entity158 program. We hypothesized that high levels of @entity147 and @entity148 would differentiate @entity1 with a substantial history of @entity130 from those without, while levels of @entity158 severity and disability would not. A MANOVA revealed a significant @entity130 Group (low vs. high) by Gender interaction for the dependent variables, which included both @entity147 and @entity158 severity and disability. Univariate tests showed that the interaction was significant only for @entity147 variables and not for @entity158 severity and disability. Further, the multivariate effect of @entity130 Group and the univariate effects for @entity147 variables were significant only among @entity1 . Results indicate that a substantial history of @entity130 may detrimentally impact a @entity1118 @entity1 's ability to manage their @entity158 effectively, particularly among @entity1 .

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Technical description of a regional lymphadenectomy in radical surgery for XXXX .

multiple_choice

BACKGROUND: The guidelines for resection of @entity1086 include a regional lymphadenectomy; yet it is uncommonly performed in practice and inadequately described in the literature. The present study describes the technique of a regional lymphadenectomy for @entity1086 , as practiced by the author. METHODS/TECHNIQUE: After confirming resectability, the duodenum is kocherized. The dissection starts from the posterior aspects of the duodenum and head of the pancreas and extends superiorly to the retroportal area. This is followed by dissection of the common hepatic artery and its branches, the bile duct and the anterior aspect of the portal vein until the hepatic hilum. Resection of the gallbladder with an appropriate liver resection completes the surgery. RESULTS: This technique was used for a regional lymphadenectomy in 27 @entity1 , of which 14 underwent radical cholecystectomy upfront, and 13 had revisional surgery for incidentally detected @entity1086 . The median number of lymph nodes dissected on histopathology was 8 (range 3 to 18). Eleven @entity1 had metastatic lymph nodes on histopathological examination. There was no post-operative mortality. Two @entity1 had a @entity1157 which resolved with conservative management. CONCLUSION: A systematic approach towards a regional lymphadenectomy ensures a consistent nodal harvest in @entity1 undergoing radical resection for @entity1086 .

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Aliskiren for the treatment of essential XXXX under real-life practice conditions: design and baseline data of the prospective 3A registry.

multiple_choice

BACKGROUND: The renin-angiotensin system (RAS) is a key target for blood pressure control and for cardiovascular and renal protection. Aliskiren is the first-in-class direct oral inhibitor of renin that controls the rate-limiting step in the RAS cascade. So far little is known about the use and efficacy of aliskiren in the treatment of essential @entity101 under clinical practice conditions. METHODS: The 3A registry was an open, prospective cohort study (observational registry) of 14,988 @entity1 in 899 offices throughout Germany. Consecutive @entity1 were eligible for inclusion if their physician had decided to modify their antihypertensive therapy. This included treatment with aliskiren or an angiotensin converting enzyme inhibitor (ACE-I)/angiotensin receptor blocker (ARB) or agents not blocking the RAS, alone or on top of an existing drug regimen. RESULTS: Mean age of @entity1 was 65 years, their mean body mass index was 28.2 kg/m(2) 53.5% were @entity1 , 36% working, 90% in statutory health insurance and 26% in any disease management programme. @entity1 in the aliskiren and the RAS groups compared with the non-RAS group were older, more often @entity1 , had a longer history of @entity101 , and had a higher prevalence of comorbidities ( @entity6 , @entity712 , @entity299 , @entity8 ). Mean systolic, but not diastolic blood pressure was substantially higher in the aliskiren group (158/91 mmHg vs. 154/89 mmHg in ACE-I/ARB vs. 152/89 mmHg in non-RAS). Mean number of antihypertensive drugs was higher in the aliskiren group compared with the other groups (3.0 drugs vs. 2.5 in ACE-I/ARB vs. 1.6 in non-RAS; p < 0.0001). CONCLUSIONS: In this large cohort of outpatients with @entity101 , aliskiren was used mainly in @entity1 with more severe stages of @entity101 and those with @entity66 such as @entity6 and @entity8 . The 3A registry will provide important information about the use and efficacy of aliskiren in a real-life setting.

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[Treatment of XXXX foot in the hemiplegic adult by retrograde fixation of the peroneus brevis tendon onto the anterior tibialis tendon].

multiple_choice

PURPOSE OF THE STUDY: The purpose of the present study was to assess the Bardot procedure in the treatment of @entity85 of the foot in @entity1158 . This procedure associates the fixation of the peroneus brevis distal tendon onto the tibialis anterior, heel-cord lengthening, and tenotomies of the flexores digitorum. MATERIAL AND METHODS: Fifty-six @entity1 underwent this procedure between 1989 and 1996. The indication for surgery was @entity85 in adult @entity1158 . Preoperatively all the @entity1 had an instability and 80.5 per cent of them had to wear an ankle and foot orthesis. Postoperatively forty-one @entity1 with a mean follow up of 3.5 years (range: one to 9 years), were available for examination including 24 females and 17 males with a mean age of 46 years at time of surgery (range: 27 to 76). RESULTS: All the @entity1 were objectively improved. Seven of them had a discreet residual @entity85 , but none felt unstable. They all were able to walk barefooted, only one @entity1 still required an adapted shoe. The gait and the quality of live were subjectively improved for 92.7 per cent of the @entity1 . None of the @entity1 has been worsened. DISCUSSION: When @entity508 disturbs significantly quality of live, tendon re-balancement of the hemiplegic foot should be proposed. The fixation of the distal tendon of the peroneus brevis onto the tibialis anterior is effectively performed only if this latter is efficient in the swing phase of gait. If there is no fixed @entity1159 , neurosurgery or chemotherapy are preferable. In case of irreducible @entity85 arthrodesis could be indicated. CONCLUSION: Tendon re-balancement in hemiplegic foot using a peroneus tendon fixation onto the tibialis anterior should be carried out after examination by a team of specialists (surgeon, neurosurgeon, rehabilitation team). In such conditions it offers constantly an improvement to the @entity1 .

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[Guidelines for specialized nutritional and metabolic support in the critically ill- @entity1 . Update. Consensus of the Spanish Society of Intensive Care Medicine and Coronary Units-Spanish Society of Parenteral and Enteral Nutrition (SEMICYUC-SENPE): severe acute XXXX ].

multiple_choice

@entity656 ( @entity656 ) causes @entity149 leading to high catabolic, hypermetabolic and hyperdynamic stress states with marked morbidity and mortality. In the last decade, nutritional support has become a key element in the treatment of @entity656 . Thus, specialized nutrition is indicated from admission, with enteral nutrition being preferred to parenteral nutrition. Enteral nutrition should be initiated early using infusion through the jejunum beyond the ligament of Treitz to minimize pancreatic stress. There are no specific studies that establish the type of diet to be used but experts recommend the use of polymeric diets. Parenteral nutrition, without a specific formula, is indicated in @entity1 with @entity656 who are intolerant to enteral nutrition or when the clinical signs of @entity788 are exacerbated or aggravated by enteral nutrition. Even so, a minimal level of enteral infusion should be maintained to preserve the trophic effect of the intestinal mucosa. In the last few years, several studies of the administration of immunomodulatory diets in @entity1 with @entity656 have been carried out to demonstrate their effects on the course of the disease. However, there are few clear recommendations on the prognostic benefits of pharmaconutrient enriched diets in these @entity1 . There is substantial scientific evidence suggesting that the only clear indication for pharmaconutrition in @entity1 with @entity656 is parenteral @entity1160 administration, which is recommended by all clinical guidelines with distinct grades of evidence.

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[Guidelines for specialized nutritional and metabolic support in the critically ill- XXXX . Update. Consensus of the Spanish Society of Intensive Care Medicine and Coronary Units-Spanish Society of Parenteral and Enteral Nutrition (SEMICYUC-SENPE): severe acute @entity788 ].

multiple_choice

@entity656 ( @entity656 ) causes @entity149 leading to high catabolic, hypermetabolic and hyperdynamic stress states with marked morbidity and mortality. In the last decade, nutritional support has become a key element in the treatment of @entity656 . Thus, specialized nutrition is indicated from admission, with enteral nutrition being preferred to parenteral nutrition. Enteral nutrition should be initiated early using infusion through the jejunum beyond the ligament of Treitz to minimize pancreatic stress. There are no specific studies that establish the type of diet to be used but experts recommend the use of polymeric diets. Parenteral nutrition, without a specific formula, is indicated in @entity1 with @entity656 who are intolerant to enteral nutrition or when the clinical signs of @entity788 are exacerbated or aggravated by enteral nutrition. Even so, a minimal level of enteral infusion should be maintained to preserve the trophic effect of the intestinal mucosa. In the last few years, several studies of the administration of immunomodulatory diets in @entity1 with @entity656 have been carried out to demonstrate their effects on the course of the disease. However, there are few clear recommendations on the prognostic benefits of pharmaconutrient enriched diets in these @entity1 . There is substantial scientific evidence suggesting that the only clear indication for pharmaconutrition in @entity1 with @entity656 is parenteral @entity1160 administration, which is recommended by all clinical guidelines with distinct grades of evidence.

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1601

A national survey of the availability of intensity-modulated XXXX and stereotactic radiosurgery in Canada.

multiple_choice

BACKGROUND: The timely and appropriate adoption of new @entity1161 ( @entity1161 ) technologies is a challenge both in terms of providing of optimal @entity1 care and managing health care resources. Relatively little is known regarding the rate at which new @entity1161 technologies are adopted in different jurisdictions, and the barriers to implementation of these technologies. METHODS: Surveys were sent to all radiation oncology department heads in Canada regarding the availability of @entity1161 equipment from 2006 to 2010. Data were collected concerning the availability and use of Intensity Modulated Radiation Therapy (IMRT) and stereotactic radiosurgery (SRS), and the obstacles to implementation of these technologies. RESULTS: IMRT was available in 37% of responding centers in 2006, increasing to 87% in 2010. In 2010, 72% of centers reported that IMRT was available for all @entity1 who might benefit, and 37% indicated that they used IMRT for "virtually all" head and neck @entity1 . SRS availability increased from 26% in 2006 to 42.5% in 2010. Eighty-two percent of centers reported that @entity1 had access to SRS either directly or by referral. The main barriers for IMRT implementation included the need to train or hire treatment planning staff, whereas barriers to SRS implementation mostly included the need to purchase and/or upgrade existing planning software and equipment. CONCLUSIONS: The survey showed a growing adoption of IMRT and SRS in Canada, although the latter was available in less than half of responding centers. Barriers to implementation differed for IMRT compared to SRS. Enhancing @entity1 resources is an important consideration in the implementation of new @entity1161 technologies, due to the multidisciplinary nature of the planning and treatment process.

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[Prevention of sudden death in XXXX ].

multiple_choice

@entity1162 (LQTS) is associated to an increased risk of @entity943 , @entity1163 and @entity1164 ( @entity1164 ). Four disease genes have been identified and different mutations described in each gene. This locus heterogenicity appears to have important functional and prognostic implications. Sympathetic imbalance has been invoked to explain an arrhythmogenic substrate. Prolonged repolarization is associated to increased dispersion of repolarization enhancing the propensity to develop early afterdepolarizations that may initiate polymorphic @entity1165 ( @entity1166 ). @entity1163 or @entity1167 usually occur in young @entity1 during exercise, possibly in association with relative @entity1168 . The annual incidence of recurrent @entity1163 and @entity1164 is 5% and 1%, respectively. Diagnostic criteria include clinical and electrocardiographic variables, family history of early @entity1164 and propensity for recurrent @entity1163 . Careful assessment of clinical manifestations and ECG characteristics of family members is justified. Female gender, QTc interval > 500 ms, history of @entity1163 or @entity1167 are independent risk factors that predict arrhythmic events. Pharmacological agents known to be able to cause @entity1162 or beta-adrenergic stimulation must be avoided. Clinical management of asymptomatic @entity1 with the LQTS is still controversial. Initial treatment of choice for the large majority of @entity1 is administration of @entity1169 . This treatment is effective in 75-80% of cases. Other therapeutic options include left cervicothoracic sympathectomy, pacemakers, and the implantable cardioverter defibrillator. Risk stratification and efficacy of the subsequent treatment has significantly changed the clinical outcome of @entity1 with LQTS. Recent molecular biology studies and data analysis from the International LQTS Registry may contribute to the definition of the best strategy for the future.

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Rapid sequence intubation for pediatric emergency XXXX : higher frequency of failed attempts and adverse effects found by video review.

multiple_choice

STUDY OBJECTIVE: Using video review, we seek to determine the frequencies of first-attempt success and adverse effects during @entity1170 ( @entity1170 ) in a large, tertiary care, pediatric @entity341 ( @entity341 ). METHODS: We conducted a retrospective study of @entity1 undergoing @entity1170 in the @entity341 of a pediatric institution. Data were collected from preexisting video and written records of care provided. The primary outcome was successful tracheal intubation on the first attempt at laryngoscopy. The secondary outcome was the occurrence of any adverse effect during @entity1170 , including episodes of physiologic deterioration. We collected time data from the @entity1170 process by using video review. We explored the association between physician type and first-attempt success. RESULTS: We obtained complete records for 114 of 123 (93%) @entity1 who underwent @entity1170 in the @entity341 during 12 months. Median age was 2.4 years, and 89 (78%) were medical resuscitations. Of the 114 subjects, 59 (52%) were tracheally intubated on the first attempt. Seventy subjects (61%) had 1 or more adverse effects during @entity1170 ; 38 (33%) experienced oxyhemoglobin desaturation and 2 required cardiopulmonary resuscitation after physiologic deterioration. Fewer adverse effects were documented in the written records than were observed on video review. The median time from induction through final endotracheal tube placement was 3 minutes. After adjusting for @entity1 characteristics and illness severity, attending-level providers were 10 times more likely to be successful on the first attempt than all trainees combined. CONCLUSION: Video review of @entity1170 revealed that first-attempt failure and adverse effects were much more common than previously reported for @entity1 in an @entity341 .

1608

1609

1610

[ XXXX : vacuum therapy as the treatment of choice].

multiple_choice

BACKGROUND: @entity281 occur after @entity1171 in @entity1 with @entity455 , the @entity281 needs to be cured quickly and safely to protect implants, bone, and tendons. Vacuum therapy (TNP) provides a perfect treatment plan that keeps the inpatient time low whilst ensuring high @entity1 comfort. METHODS AND @entity1 : Four angiopathic @entity1 with deep wound @entity281 after ankle osteosynthesis were treated. At admission, loss of stability and spread of the @entity281 were the immediate risks. To prevent this, we treated the @entity1 with vacuum therapy after initial debridement until skin cover was achieved. RESULTS: In all cases stability was secured and after 2 dressing changes, the swabs were sterile. The inpatient time was 13 days; overall vacuum therapy time was 59 days. @entity1 satisfaction was high. DISCUSSION: Vacuum therapy is a perfect strategy after surgical debridement and before secondary mesh grafting. It protects the stability of the bone and open-lying delicate structures in @entity1 with @entity281 and offers an easy, safe, and successful treatment path with a short inpatient time.

1611

1612

1613

Impact of vena cava filters on in-hospital case fatality rate from XXXX .

multiple_choice

BACKGROUND: The effects of vena cava filters on case fatality rate are not clear, although they are used increasingly in @entity1 with @entity1151 . The purpose of this investigation is to determine categories of @entity1 with @entity1151 in whom vena cava filters reduce in-hospital case fatality rate. METHODS: In-hospital all-cause case fatality rate according to the use of vena cava filters was determined in @entity1 with @entity1151 discharged from short-stay hospitals throughout the United States using data from the Nationwide Inpatient Sample. RESULTS: In-hospital case fatality rate was marginally lower in stable @entity1 who received a vena cava filter: 21,420 of 297,700 (7.2%) versus 135,240 of 1,712,800 (7.9%) (P<.0001). Filters did not improve in-hospital case fatality rate if @entity1150 was diagnosed in stable @entity1 . A few stable @entity1 (1.4%) received thrombolytic therapy. Such @entity1 who received a vena cava filter had a lower case fatality rate than those who did not: 550 of 8550 (6.4%) versus 2950 of 19,050 (15%) (P<.0001). Unstable @entity1 who received thrombolytic therapy had a lower in-hospital case fatality rate with vena cava filters than those who did not: 505 of 6630 (7.6%) versus 2600 of 14,760 (18%) (P<.0001). Unstable @entity1 who did not receive thrombolytic therapy also had a lower in-hospital case fatality rate with a vena cava filter: 4260 of 12,850 (33%) versus 19,560 of 38,000 (51%) (P<.0001). CONCLUSION: At present, it seems prudent to consider a vena cava filter in @entity1 with @entity1151 who are receiving thrombolytic therapy and in unstable @entity1 who may not be candidates for thrombolytic therapy. Future prospective study is warranted to better define in which @entity1 a filter is appropriate.

1614

1615

1616

Drainage of the tracheal blind pouch created by XXXX .

multiple_choice

@entity1172 is a simple and reliable operation for the treatment of @entity1 with repetitive and intractable @entity1173 ; however, it is apprehended that pooling in the tracheal blind pouch may cause @entity260 . In the present study, we examined drainage of the blind pouch created by @entity1172 . Fourteen @entity1 aged 3-63 years with repetitive @entity1174 underwent @entity1172 by the modified Lindeman procedure. A barium swallow was performed 10-30 days after surgery. X-rays of the lateral view of the neck were taken at 6 and 24 h after the swallow, and then every 24 h until the contrast medium cleared. The contrast medium in the blind pouch cleared within 24 h in nine @entity1 . In the remaining five, the clearance time was < or =48 and < or =72 h in two @entity1 each, and 96 h in one @entity1 . The clearance time in @entity1 aged under 20 years was < or =24 h, while middle-aged to elderly @entity1 showed prolonged clearance time. No late complications of the blind pouch, such as infections, were observed. The potential risk of complications caused by pooling in the tracheal blind pouch in @entity1172 is prevented presumably due to the slow but continuous turnover of pooling material. This result supports the validity and usefulness of @entity1172 for the treatment of intractable @entity1173 .

1617

1618

1619

A delay in pubertal onset affects the covariation of body weight, XXXX , and bone size.

multiple_choice

The skeletal system functions as a locomotive organ and a mineral reservoir and combinations of genetic and environmental factors affect the skeletal system. Although delayed @entity1175 is associated with compromised bone mass, suppression of @entity172 should be beneficial to cortical strength. The purpose was to employ path analysis to study bone strength and delayed @entity1175 . Forty-five female @entity35 were randomly assigned to a control group (n = 15) and an experimental group (n = 30) that received injections of gonadotropin releasing hormone antagonist (GnRH-a). Causal models were constructed by specifying directed paths between bone traits. The first model tested the hypothesis that the functional relationships between bone traits and body weight were altered by a delay in pubertal onset. GnRH-a injections during @entity1175 altered the covariation between body weight and bone size. The second model was constructed to test the hypothesis that variability in stiffness was causally related to variability in body weight. The model also tested the relationship between the periosteal and endocortical surfaces and their relationship to stiffness. There was no change in the relationship between the surfaces in the @entity1176 -a group. The third model determined the effect of @entity53 on both total area and relative cortical area in both groups. The relationship between periosteal surface and serum @entity53 levels was only significant during @entity172 suppression. These data suggest that increases in body weight during or prior to @entity1175 may not be protective of bone strength.

1620

1621

1622

[Reconstructive surgery of the efferent urinary tract in pelvic exenteration of gynecological XXXX ].

multiple_choice

In locally advanced or recurrent @entity5 of the female genital tract anterior or total exenteration may be mandatory in case of @entity5 invasion into the lower urinary tract or if a second course of radiation therapy is not feasible. The management of resection and reconstruction of the affected lower urinary tract has to be well integrated into the gynecological therapeutic concept. In 11/32 @entity1 the reconstruction of the partially resected lower urinary tract was feasible with preservation of a functionally intact urinary bladder. Urinary diversion following pelvic exenteration was achieved in 13/17 @entity1 with a continent urinary reservoir and in 4/17 @entity1 with an ileal conduit. Operative reinterventions were needed only in @entity1 with continent urinary diversion in 5 cases. All these @entity1 had a past history of primary radiation therapy of their gynecological @entity5 . In the remaining other 11 @entity1 with a history of primary radiation therapy no complications occurred. 9 of 32 @entity1 survived the operative procedure 40.8 (25-57) month with no evidence of recurrent @entity5 . Continent urinary diversion represents an excellent therapeutic option for replacement of function lost due to exenterative pelvic surgery. Stringent selection of @entity1 is mandatory to consider the presented therapeutic concept a reasonable tool in the management of the described clinical situations.

1623

1624

1625

Is contrast exposure safe among the highest risk XXXX @entity1 ?

multiple_choice

BACKGROUND: Despite improvements in the diagnosis and management of @entity810 ( @entity810 ), posttraumatic @entity8 continues to be associated with increased morbidity and mortality. Intravenous (IV) contrast is known to induce @entity810 in high-risk groups including the elderly and critically ill. We sought to determine whether IV contrast exposure among high-risk @entity130 @entity1 resulted in @entity8 as defined by the Acute @entity8 . METHODS: We performed a 3-year retrospective analysis of all @entity1 admitted to our Level I @entity130 center surgical intensive care unit for >48 hours. @entity1 with preexisting chronic @entity8 were excluded. We performed univariate and bivariate analyses to identify risk factors for @entity810 . Multivariable logistic regression analysis identified independent predictors for @entity810 . Subgroup analysis was undertaken among high-risk groups to include elderly @entity1 (aged >= 65 years) with admission @entity551 (systolic blood pressure <90 mm Hg) and an Injury Severity Score (ISS) >= 25. RESULTS: Of the 6,317 @entity1 , 571 (9.0%) @entity1 met the inclusion criteria; 170 (29.8%) @entity1 developed @entity810 . Age >= 65 years (odds ratio [OR] 2.26, 95% confidence interval [CI] = 1.06-4.80, p <0.034) and ISS >= 25 (OR 1.86, 95% CI = 1.12-3.07, p <0.015) were determined to be independent predictors of @entity810 . IV contrast was not identified to be a predictor of @entity810 . Upon subgroup analysis, IV contrast exposure was not a predictor of @entity810 among the elderly, @entity551 , or severely injured @entity1 (ISS >= 25). CONCLUSION: A complete @entity130 workup including studies requiring IV contrast exposure should be considered safe even among high-risk @entity130 @entity1 .

1626

1627

1628

Is contrast exposure safe among the highest risk @entity130 XXXX ?

multiple_choice

BACKGROUND: Despite improvements in the diagnosis and management of @entity810 ( @entity810 ), posttraumatic @entity8 continues to be associated with increased morbidity and mortality. Intravenous (IV) contrast is known to induce @entity810 in high-risk groups including the elderly and critically ill. We sought to determine whether IV contrast exposure among high-risk @entity130 @entity1 resulted in @entity8 as defined by the Acute @entity8 . METHODS: We performed a 3-year retrospective analysis of all @entity1 admitted to our Level I @entity130 center surgical intensive care unit for >48 hours. @entity1 with preexisting chronic @entity8 were excluded. We performed univariate and bivariate analyses to identify risk factors for @entity810 . Multivariable logistic regression analysis identified independent predictors for @entity810 . Subgroup analysis was undertaken among high-risk groups to include elderly @entity1 (aged >= 65 years) with admission @entity551 (systolic blood pressure <90 mm Hg) and an Injury Severity Score (ISS) >= 25. RESULTS: Of the 6,317 @entity1 , 571 (9.0%) @entity1 met the inclusion criteria; 170 (29.8%) @entity1 developed @entity810 . Age >= 65 years (odds ratio [OR] 2.26, 95% confidence interval [CI] = 1.06-4.80, p <0.034) and ISS >= 25 (OR 1.86, 95% CI = 1.12-3.07, p <0.015) were determined to be independent predictors of @entity810 . IV contrast was not identified to be a predictor of @entity810 . Upon subgroup analysis, IV contrast exposure was not a predictor of @entity810 among the elderly, @entity551 , or severely injured @entity1 (ISS >= 25). CONCLUSION: A complete @entity130 workup including studies requiring IV contrast exposure should be considered safe even among high-risk @entity130 @entity1 .

1629

1630

1631

The influence of stimulus temperature rise rate, adapting temperature, and stimulus duration on suprathreshold responses evoked by noxious heat in the glabrous skin of the limb. Comparison of neuronal discharge in the XXXX spinal dorsal horn with @entity1 sensations.

multiple_choice

The influence of stimulus temperature rise rate (2.5 degrees C/s, 5.0 degrees C/s, and 10.0 degrees C/s), adapting (baseline) temperature (25 degrees C, 30 degrees C, and 35 degrees C), and duration of peak stimulus temperature (1.0 s, 2.5 s, 5.0 s, and 10.0 s) on responses evoked by noxious heat stimuli of suprathreshold intensity was studied in wide dynamic range (WDR) neurons of the @entity35 spinal dorsal horn. The spinal neuronal responses were compared with @entity1 psychophysical data obtained using the same stimuli. Noxious heat stimuli with a peak temperature of 54 degrees C were applied with a contact thermostimulator to the glabrous skin of the hindfoot in @entity35 or to the palmar skin in @entity1 . With the highest ramp rate and the highest adapting temperature, the sensory and spinal neuronal response latencies were decreased more than expected on the basis of the change in physical parameters of the stimulus. The magnitudes of sensory and spinal neuronal response were independent of the stimulus ramp rate, whereas @entity158 magnitude estimates and spinal neuronal impulse counts evoked by the same peak stimulus temperature were increased with an increase in the adapting stimulus temperature. The onset latencies of @entity158 reactions and spinal neuronal responses were independent of the peak stimulus duration, whereas the latency of the maximum discharge in spinal neurons increased with prolongation of the peak stimulus. The sensory magnitude estimate of @entity158 and the neuronal impulse count were increased with increase in stimulus duration. Following spinalization, the spinal neuronal responses were stronger and the stimulus duration-dependent increase in the impulse count developed faster. Moreover, the peak frequency of spinal neuronal response increased significantly with prolongation of the heat stimuli after spinalization, but not in animals with an intact spinal cord. The results indicate that stimulus rise rate, stimulus duration, and the adapting temperature are important factors in determining the sensory and spinal neuronal responses to high-intensity heat stimuli. The changes in the total impulse counts evoked by varying supraliminal heat stimuli in spinal dorsal horn WDR neurons corresponded well with the changes in @entity158 magnitude estimates in @entity1 . Also, the changes in spinal neuronal response onset latencies were accompanied by corresponding changes in onset latencies of @entity1 @entity158 reactions but not with @entity158 magnitude estimates. The effect of spinalization indicated that descending pathways control not only the response magnitude in the spinal dorsal horn WDR neurons but also the temporal characteristics of the spinal neuronal response.

1632

1633

1634

The influence of stimulus temperature rise rate, adapting temperature, and stimulus duration on suprathreshold responses evoked by noxious heat in the glabrous skin of the limb. Comparison of neuronal discharge in the @entity35 spinal dorsal horn with XXXX sensations.

multiple_choice

The influence of stimulus temperature rise rate (2.5 degrees C/s, 5.0 degrees C/s, and 10.0 degrees C/s), adapting (baseline) temperature (25 degrees C, 30 degrees C, and 35 degrees C), and duration of peak stimulus temperature (1.0 s, 2.5 s, 5.0 s, and 10.0 s) on responses evoked by noxious heat stimuli of suprathreshold intensity was studied in wide dynamic range (WDR) neurons of the @entity35 spinal dorsal horn. The spinal neuronal responses were compared with @entity1 psychophysical data obtained using the same stimuli. Noxious heat stimuli with a peak temperature of 54 degrees C were applied with a contact thermostimulator to the glabrous skin of the hindfoot in @entity35 or to the palmar skin in @entity1 . With the highest ramp rate and the highest adapting temperature, the sensory and spinal neuronal response latencies were decreased more than expected on the basis of the change in physical parameters of the stimulus. The magnitudes of sensory and spinal neuronal response were independent of the stimulus ramp rate, whereas @entity158 magnitude estimates and spinal neuronal impulse counts evoked by the same peak stimulus temperature were increased with an increase in the adapting stimulus temperature. The onset latencies of @entity158 reactions and spinal neuronal responses were independent of the peak stimulus duration, whereas the latency of the maximum discharge in spinal neurons increased with prolongation of the peak stimulus. The sensory magnitude estimate of @entity158 and the neuronal impulse count were increased with increase in stimulus duration. Following spinalization, the spinal neuronal responses were stronger and the stimulus duration-dependent increase in the impulse count developed faster. Moreover, the peak frequency of spinal neuronal response increased significantly with prolongation of the heat stimuli after spinalization, but not in animals with an intact spinal cord. The results indicate that stimulus rise rate, stimulus duration, and the adapting temperature are important factors in determining the sensory and spinal neuronal responses to high-intensity heat stimuli. The changes in the total impulse counts evoked by varying supraliminal heat stimuli in spinal dorsal horn WDR neurons corresponded well with the changes in @entity158 magnitude estimates in @entity1 . Also, the changes in spinal neuronal response onset latencies were accompanied by corresponding changes in onset latencies of @entity1 @entity158 reactions but not with @entity158 magnitude estimates. The effect of spinalization indicated that descending pathways control not only the response magnitude in the spinal dorsal horn WDR neurons but also the temporal characteristics of the spinal neuronal response.

1635

1636

1637

Early risk stratification of unstable angina/non-Q @entity583 : biochemical markers of XXXX .

multiple_choice

@entity1186 is an important determinant of prognosis in @entity1 with @entity1187 ( @entity1187 ). However, the identification of @entity1 at high-risk for progression of @entity1186 is difficult partly because we currently lack clinically meaningful laboratory methods for its detection. The most promising approaches involve the measurement in plasma of markers of fibrin formation and degradation. Thrombin activity, as reflected by plasma or urine concentrations of fibrinopeptide A, is increased in @entity1 with @entity1187 and is associated with adverse outcome. However, the use of fibrinopeptide A as a marker of fibrin formation is limited by the very short half-life of the compound, by artifact due to sample acquisition, and by extremely long turnaround times. To overcome these limitations, measurement of soluble fibrin has been proposed. We have recently explored the prognostic value of a new fibrin-specific ELISA assay for soluble fibrin in @entity1 with @entity1187 and found that @entity1 with the highest levels had a 2-fold increased risk of early and late @entity299 . Increases in plasma concentrations of cross-linked fibrin degradation products (XL-FDPs), which reflect increased fibrin turn-over, are a marker of risk for complications of @entity583 . However, until recently, assays for XL-FDPs lacked specificity, because they did not distinguish between fibrin and fibrinogen degradation products. Recently, fibrin-specific ELISAs have been described and a rapid whole blood assay for D-dimer has been developed. We recently validated the prognostic value of this whole blood agglutination assay in @entity1 with @entity1187 . These results suggest that: (1) The detection of significant activation of the coagulation and/or fibrinolytic system may be important for rapid risk stratification of @entity1 with @entity1187 ; (2) @entity1 with biochemical evidence of ongoing @entity1186 may particularly benefit from aggressive antithrombotic strategies; (3) sequential measurement of these markers may be useful to guide antithrombotic treatment during the unstable phase of @entity453 .

1638

1639

1640

Early risk stratification of unstable angina/non-Q XXXX : biochemical markers of @entity1186 .

multiple_choice

@entity1186 is an important determinant of prognosis in @entity1 with @entity1187 ( @entity1187 ). However, the identification of @entity1 at high-risk for progression of @entity1186 is difficult partly because we currently lack clinically meaningful laboratory methods for its detection. The most promising approaches involve the measurement in plasma of markers of fibrin formation and degradation. Thrombin activity, as reflected by plasma or urine concentrations of fibrinopeptide A, is increased in @entity1 with @entity1187 and is associated with adverse outcome. However, the use of fibrinopeptide A as a marker of fibrin formation is limited by the very short half-life of the compound, by artifact due to sample acquisition, and by extremely long turnaround times. To overcome these limitations, measurement of soluble fibrin has been proposed. We have recently explored the prognostic value of a new fibrin-specific ELISA assay for soluble fibrin in @entity1 with @entity1187 and found that @entity1 with the highest levels had a 2-fold increased risk of early and late @entity299 . Increases in plasma concentrations of cross-linked fibrin degradation products (XL-FDPs), which reflect increased fibrin turn-over, are a marker of risk for complications of @entity583 . However, until recently, assays for XL-FDPs lacked specificity, because they did not distinguish between fibrin and fibrinogen degradation products. Recently, fibrin-specific ELISAs have been described and a rapid whole blood assay for D-dimer has been developed. We recently validated the prognostic value of this whole blood agglutination assay in @entity1 with @entity1187 . These results suggest that: (1) The detection of significant activation of the coagulation and/or fibrinolytic system may be important for rapid risk stratification of @entity1 with @entity1187 ; (2) @entity1 with biochemical evidence of ongoing @entity1186 may particularly benefit from aggressive antithrombotic strategies; (3) sequential measurement of these markers may be useful to guide antithrombotic treatment during the unstable phase of @entity453 .

1641

1642

1643

Effect of time of 7E3 administration on rt-PA-induced reperfusion: study in a @entity235 model of XXXX -based occlusion-reperfusion.

multiple_choice

Chimeric version of the murine monoclonal antibody, 7E3 has been proposed for the early restoration of coronary artery patency during thrombolytic therapy. We determined the optimal time for administration of 7E3 during recombinant tissue plasminogen activator (rt-PA)-induced thrombolysis using a @entity235 model of @entity1186 . After 30 min of @entity715 , microspheres were injected to assess regional myocardial blood flow, followed by a 90-min rt-PA infusion. @entity235 were randomized to three groups wherein 7E3 (0.8 mg kg(-1), i.v.) was administered either 5 min before rt-PA (Group I), at the first evidence of thrombolysis (Group II), or after the completion of rt-PA infusion (Group III). Hemodynamic parameters were monitored for 6 h after which @entity1188 size was estimated. Time to occlusion/reperfusion was similar in all groups. In the rt-PA alone group, 78% arteries reoccluded after 60 min of reperfusion. The incidence of reocclusion was lower in Groups II (25%, P = 0.04) and III (0%. P < 0.01). All arteries (100%) were patent at the end of the protocol in Group III vs 50% remaining patent in Group I (P = 0.01). Arterial patency was maintained longer in Group III (301 min, n = 10), compared with Groups I (124 min, n = 5) and II (124 min, n = 6). Arterial flow was greater in Group III (82%) compared with Groups I (27%) and II (35%) (P < 0.01). Regional myocardial blood flow and @entity1188 size were similar in all groups. The data indicate that the time of administration of 7E3 in conjunction with rt-PA-induced thrombolysis influences patency status. The experimental results suggest that in the absence of @entity117 and heparin, optimal thrombolysis is obtained when 7E3 is administered after the completion of rt-PA infusion regimen.

1644

1645

1646

Effect of time of 7E3 administration on rt-PA-induced reperfusion: study in a XXXX model of @entity715 -based occlusion-reperfusion.

multiple_choice

Chimeric version of the murine monoclonal antibody, 7E3 has been proposed for the early restoration of coronary artery patency during thrombolytic therapy. We determined the optimal time for administration of 7E3 during recombinant tissue plasminogen activator (rt-PA)-induced thrombolysis using a @entity235 model of @entity1186 . After 30 min of @entity715 , microspheres were injected to assess regional myocardial blood flow, followed by a 90-min rt-PA infusion. @entity235 were randomized to three groups wherein 7E3 (0.8 mg kg(-1), i.v.) was administered either 5 min before rt-PA (Group I), at the first evidence of thrombolysis (Group II), or after the completion of rt-PA infusion (Group III). Hemodynamic parameters were monitored for 6 h after which @entity1188 size was estimated. Time to occlusion/reperfusion was similar in all groups. In the rt-PA alone group, 78% arteries reoccluded after 60 min of reperfusion. The incidence of reocclusion was lower in Groups II (25%, P = 0.04) and III (0%. P < 0.01). All arteries (100%) were patent at the end of the protocol in Group III vs 50% remaining patent in Group I (P = 0.01). Arterial patency was maintained longer in Group III (301 min, n = 10), compared with Groups I (124 min, n = 5) and II (124 min, n = 6). Arterial flow was greater in Group III (82%) compared with Groups I (27%) and II (35%) (P < 0.01). Regional myocardial blood flow and @entity1188 size were similar in all groups. The data indicate that the time of administration of 7E3 in conjunction with rt-PA-induced thrombolysis influences patency status. The experimental results suggest that in the absence of @entity117 and heparin, optimal thrombolysis is obtained when 7E3 is administered after the completion of rt-PA infusion regimen.

1647

1648

1649

XXXX stones produced by Madin-Darby @entity235 kidney (MDCK) cells inoculated in @entity19 .

multiple_choice

The @entity235 renal distal tubular cell line Madin-Darby @entity235 kidney (MDCK) forms @entity78 microliths during a long-term culture in vitro. We identified osteopontin ( @entity1189 ) and @entity1190 ( @entity1191 ) from a urinary stone matrix. We recently also detected the expression of @entity1189 and @entity1191 in MDCK cells. The relationship between the mechanism of the stone formation and these stone matrix proteins is not yet known. Here, MDCK cells were cultured and inoculated in the subcutis of @entity19 . After 4, 8 and 12 weeks, the inoculated tissues were resected, fixed and immunostained with polyclonal anti-human @entity1189 and polyclonal anti-human @entity1191 antibodies. Some serial specimens were stained with von Kossa's procedure. MDCK cells formed some follicular formations in the subcutis of @entity19 at least at 12 weeks after transplantation. At 8 weeks after the inoculation, we detected small @entity78 stones with MDCK cells trapped in the follicles. The cells forming the stones also expressed both @entity1189 and @entity1191 . The @entity1191 expression sites coincided with the stone formation sites. We confirmed that MDCK cells inoculated in @entity19 had stone-forming potential, and we speculate that @entity1189 and @entity1191 play important roles in stone formation by MDCK cells.

1650

1651

1652

@entity78 stones produced by Madin-Darby XXXX kidney (MDCK) cells inoculated in @entity19 .

multiple_choice

The @entity235 renal distal tubular cell line Madin-Darby @entity235 kidney (MDCK) forms @entity78 microliths during a long-term culture in vitro. We identified osteopontin ( @entity1189 ) and @entity1190 ( @entity1191 ) from a urinary stone matrix. We recently also detected the expression of @entity1189 and @entity1191 in MDCK cells. The relationship between the mechanism of the stone formation and these stone matrix proteins is not yet known. Here, MDCK cells were cultured and inoculated in the subcutis of @entity19 . After 4, 8 and 12 weeks, the inoculated tissues were resected, fixed and immunostained with polyclonal anti-human @entity1189 and polyclonal anti-human @entity1191 antibodies. Some serial specimens were stained with von Kossa's procedure. MDCK cells formed some follicular formations in the subcutis of @entity19 at least at 12 weeks after transplantation. At 8 weeks after the inoculation, we detected small @entity78 stones with MDCK cells trapped in the follicles. The cells forming the stones also expressed both @entity1189 and @entity1191 . The @entity1191 expression sites coincided with the stone formation sites. We confirmed that MDCK cells inoculated in @entity19 had stone-forming potential, and we speculate that @entity1189 and @entity1191 play important roles in stone formation by MDCK cells.

1653

1654

1655

@entity78 stones produced by Madin-Darby @entity235 kidney (MDCK) cells inoculated in XXXX .

multiple_choice

The @entity235 renal distal tubular cell line Madin-Darby @entity235 kidney (MDCK) forms @entity78 microliths during a long-term culture in vitro. We identified osteopontin ( @entity1189 ) and @entity1190 ( @entity1191 ) from a urinary stone matrix. We recently also detected the expression of @entity1189 and @entity1191 in MDCK cells. The relationship between the mechanism of the stone formation and these stone matrix proteins is not yet known. Here, MDCK cells were cultured and inoculated in the subcutis of @entity19 . After 4, 8 and 12 weeks, the inoculated tissues were resected, fixed and immunostained with polyclonal anti-human @entity1189 and polyclonal anti-human @entity1191 antibodies. Some serial specimens were stained with von Kossa's procedure. MDCK cells formed some follicular formations in the subcutis of @entity19 at least at 12 weeks after transplantation. At 8 weeks after the inoculation, we detected small @entity78 stones with MDCK cells trapped in the follicles. The cells forming the stones also expressed both @entity1189 and @entity1191 . The @entity1191 expression sites coincided with the stone formation sites. We confirmed that MDCK cells inoculated in @entity19 had stone-forming potential, and we speculate that @entity1189 and @entity1191 play important roles in stone formation by MDCK cells.

1656

1657

1658

[In vitro transduction of XXXX osteoblast cell populations with retroviral vectors].

multiple_choice

OBJECTIVES: The involvement of cytokines in @entity32 of @entity1 tissue is well established. @entity1192 ( @entity1192 ) is a major agent in the pathophysiology of periarticular bone resorption in @entity309 and in @entity170 . Because the use of recombinant cytokines and growth factors is limited due to their short half lives, techniques are needed to get a permanent release of these therapeutic proteins. The rational of this study was to show that retroviral transduction of @entity1 osteoblastic cells is possible in vitro using the marker gene LacZ and the potentially therapeutic gene encoding for @entity1 @entity1193 ( @entity1193 ). Different transduction techniques were combined to improve the rate of transduction in vitro. METHODS: Osteoblastic cells were isolated from @entity1 spongious bone and cultured in vitro. The @entity1194 (LacZ) gene and the cDNA of @entity1193 were introduced into the isolated cells by retrovirus mediated gene transfer. LacZ activity was determined by Xgal staining, @entity1193 was measured quantitatively by ELISA. RESULTS: The transfer of retroviral @entity1193 led to @entity1193 expression of 8614 to 10,089 pg @entity1193 /50,000 cells/48 h. By combining different techniques to improve transduction, the X-gal staining established a rate of transduction of 60%. CONCLUSION: Our results demonstrate that retroviral transduction of @entity1 osteobalstic cells is possible in vitro, and leads to high levels of the synthesized transgene product. The rate of retroviral transduction can be accelerated in vitro.

1659

1660

1661

Cyclical ischaemic preconditioning modulates the adaptive immune response in XXXX limb ischaemia-reperfusion injury.

multiple_choice

BACKGROUND: Reperfusion injury (RI) has significant local and systemic consequences. Ischaemic preconditioning (IPC) modulates RI and the innate immune response. This study examined whether IPC attenuates RI-mediated changes in lymphocyte populations and function following elective surgery. METHODS: Twenty-five @entity1 sustaining 1 h of tourniquet ischaemia during cruciate ligament reconstruction were randomized before surgery to three 5-min ischaemia cycles separated by 5 min of reperfusion, or to a control group. Systemic levels of interleukin (IL) 4 and interferon (IFN) gamma, and surface expression of @entity1195 ro/ra, @entity1196 and @entity1197 were measured. T cells were examined systemically and in stimulated serum co-culture to determine @entity404 / @entity405 and @entity1198 /Th2 shifts through intracellular cytokine production. RESULTS: @entity404 CD45ro cell numbers increased after RI without IPC, whereas @entity405 cells expressing @entity1195 ro and @entity1197 increased with IPC. Preconditioned serum in co-culture attenuated increases in @entity404 and decreases in @entity405 numbers, a process prevented by inhibition of antigen activation. Following RI, systemic @entity1199 levels were significantly lower after IPC, whereas co-culture with post-RI serum increased proinflammatory intracellular cytokine production. CONCLUSION: IPC modulated T cell responses in limb RI through reduced activation and proinflammatory cytokine production by @entity404 cells, while preventing @entity404 / @entity405 derangement. IPC prevented lymphocyte-directed @entity1200 .

1662

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1664

Postoperative functional rehabilitation after repair of XXXX : a comparison of two different protocols.

multiple_choice

PURPOSE: Early functional rehabilitation after surgical tendon repair facilitates the healing process and leads to improved joint function. There is a paucity of studies commenting on rehabilitation after surgical repair of @entity397 , and most surgeons prefer a prolonged period of immobilization and protected weight bearing. The purpose of the present study is to compare the clinical outcome after a more functional and after a rather restrictive postoperative rehabilitation protocol. METHODS: All consecutive @entity1 were included who had a surgical repair of a primary unilateral @entity397 in one of the two participating hospitals and a minimum follow-up of 24 months. @entity1 of site A were only allowed limited flexion and weight bearing while @entity1 from site B were allowed early functional rehabilitation with full weight bearing. Clinical outcome was measured with the subjective IKDC form. Fisher's exact test and Mann-Whitney U test were used for statistical analysis. RESULTS: Sixty-six @entity1 were included in the study. Twenty-eight @entity1 (Group A) were treated with restrictive and 38 @entity1 (Group B) with early functional postoperative rehabilitation. The two groups did not differ in terms of demographic characteristics. Clinical follow-up was available for 95% of @entity1 after an average of 4.5 years. No clinical difference was identified with the use of IKDC form. @entity1 of group A returned to work an average of 10 days later than @entity1 from group B, but this difference was not significant. Two re-ruptures were observed in each group. There was no significant difference in terms of complication quality or quantity. CONCLUSION: Early functional postoperative mobilization with full weight bearing after primary repair of a @entity397 is safe and will not lead to inferior clinical outcome or an increased complication rate. LEVEL OF EVIDENCE: Therapeutic, III.

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Dermal extracellular matrix in XXXX .

multiple_choice

Thirty-eight biopsies of cutaneous lesions from @entity1201 @entity1 [borderline tuberculoid (BT) 14, @entity1202 ( @entity1202 ) 18, @entity1203 (LL) 6] were processed for staining of some extracellular matrix (ECM) components (collagen, proteoglycans, elastic fibers and fibronectin). Specific histological staining and the indirect immunofluorescence method with antibodies to collagen and fibronectin were utilized. The ECM of the normal dermis was strikingly modified in the inflammatory infiltrate. By Gomori's reticulin and anti-fibronectin immunostaining, replacement of the dense interlaced collagen fibers with a reticular mesh was observed in the infiltrate. The immunoreactivity obtained with anti-type I and anti-type III collagens showed positive fibrils and a lumpy pattern in the @entity75 with a higher amount in the @entity75 . The lack of clear-cut boundaries between the normal dermis and the inflammatory infiltrate in the @entity1203 ( @entity1202 , LL) lesions was correlated with the blurred limits of the clinical lesions of this pole of the @entity1201 spectrum. Absence of elastic fibers in the infiltrate was a constant finding, and fuchsin-positive microfibrils were found in some infiltrates. The clear zone of @entity75 was devoid of oxytalan fibers. Elaunin fiber rings around sweat gland acini were present even when the @entity1201 infiltrate was seen enveloping them. The original ECM is replaced by a newly assembled one, which is suited for the dynamic nature of the inflammatory process. The trophic effects of the ECM upon the cutaneous epithelial structures are modified so that @entity194 and late degeneration ensues. These ECM modifications contribute, therefore, to the biological alterations of the skin functions in @entity1201 .

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XXXX arising in an ileal duplication: report of a case.

multiple_choice

This report presents the extremely rare case of an adult @entity1 who presented with @entity298 caused by the perforation of an ileal duplication, associated with a @entity674 ( @entity674 ) arising within the duplication. A 70-year-old female was admitted to the hospital with lower @entity490 . Abdominal computed tomography showed free air in the peritoneal cavity. An emergency laparotomy was performed, presuming @entity298 caused by a perforation of the gastrointestinal tract. The surgical findings showed that the @entity298 was caused by the perforation of an ileal duplication, 90 cm proximal to the ileocecal valve, with an extrinsic @entity5 protruding from the duplication. A segmental resection of the ileum-including the @entity5 and ileal duplication-was performed. Histopathology showed that the @entity5 was composed of spindle-shaped and epithelioid cells. The @entity5 was immunohistochemically positive for KIT, with a deletion mutation spanning the intron 10-exon 11 boundary. Accordingly, a diagnosis was made of a @entity674 arising within a duplication of the ileum. Duplications of the alimentary tract are encountered only occasionally in adults. Although quite rare, malignant change should therefore be considered as a possible complication when a solid portion is observed within a duplication of the alimentary tract.

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General joint frailty model for recurrent event data with a dependent terminal event: Application to XXXX data.

multiple_choice

Many biomedical studies focus on delaying disease relapses and on prolonging survival. Usual methods only consider one event, often the first recurrence or @entity204 . However, ignoring the other recurrences may lead to biased results. The whole history of the disease should be considered for each @entity1 . In addition, some diseases involve recurrences that can increase the risk of @entity204 . In this case, the @entity204 time may be dependent on the recurrent event history. We propose a joint frailty model to analyze recurrences and @entity204 simultaneously. Two gamma-distributed frailties take into account both the inter-recurrences dependence and the dependence between the recurrences and the survival times. We estimate separate parameters for disease recurrent event times and survival times in the joint frailty model to distinguish treatment effects and prognostic factors on these two types of events. We show how maximum penalized likelihood estimation can be applied to semiparametric estimation of the continuous hazard functions in the proposed joint frailty model with right censoring. We also propose parametrical approach. We evaluate the model by simulation studies and illustrate through a study of @entity1 with @entity706 .

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@entity286 and XXXX use and @entity5 in Puerto Rico.

multiple_choice

OBJECTIVES: To determine risk for @entity5 in Puerto Rico associated with use of @entity167 and @entity286 . METHODS: In Puerto Rico, @entity167 and @entity286 use were compared among @entity5 and pharynx (n = 342), @entity5 of major and minor salivary glands (n = 25) and 521 population-based controls. RESULTS: @entity167 (usual use, Ptrend < 0.0001 for @entity1 and Ptrend = 0.02 for @entity1 ) and @entity286 (usual use, Ptrend < 0.0001, for both @entity1 and @entity1 ) were strong independent risk factors for @entity5 in Puerto Rico, with a multiplicative effect from combined exposures. Risks did not vary systematically by use of filter vs. nonfilter cigarettes. Risks with use of other forms of smoked @entity286 were about sevenfold among both @entity1 and @entity1 . Risks decreased only gradually after cessation of @entity286 and @entity167 use. @entity286 use, but not @entity167 , was linked to @entity5 of the salivary glands. The burden of @entity5 due to @entity167 and @entity286 use in Puerto Rico (76% for @entity1 , 52% for @entity1 ) agreed closely with earlier estimates for the mainland US population, while about 72% of @entity5 ( @entity1 and @entity1 , combined) was due to @entity286 use. CONCLUSIONS: Excess risks for @entity5 in Puerto Rico are largely explained by patterns of @entity167 and @entity286 use. Smoking filter vs. nonfilter cigarettes does not alter risk, while cessation of @entity167 and @entity286 use appears to reduce risk only gradually.

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@entity286 and @entity167 use and XXXX in Puerto Rico.

multiple_choice

OBJECTIVES: To determine risk for @entity5 in Puerto Rico associated with use of @entity167 and @entity286 . METHODS: In Puerto Rico, @entity167 and @entity286 use were compared among @entity5 and pharynx (n = 342), @entity5 of major and minor salivary glands (n = 25) and 521 population-based controls. RESULTS: @entity167 (usual use, Ptrend < 0.0001 for @entity1 and Ptrend = 0.02 for @entity1 ) and @entity286 (usual use, Ptrend < 0.0001, for both @entity1 and @entity1 ) were strong independent risk factors for @entity5 in Puerto Rico, with a multiplicative effect from combined exposures. Risks did not vary systematically by use of filter vs. nonfilter cigarettes. Risks with use of other forms of smoked @entity286 were about sevenfold among both @entity1 and @entity1 . Risks decreased only gradually after cessation of @entity286 and @entity167 use. @entity286 use, but not @entity167 , was linked to @entity5 of the salivary glands. The burden of @entity5 due to @entity167 and @entity286 use in Puerto Rico (76% for @entity1 , 52% for @entity1 ) agreed closely with earlier estimates for the mainland US population, while about 72% of @entity5 ( @entity1 and @entity1 , combined) was due to @entity286 use. CONCLUSIONS: Excess risks for @entity5 in Puerto Rico are largely explained by patterns of @entity167 and @entity286 use. Smoking filter vs. nonfilter cigarettes does not alter risk, while cessation of @entity167 and @entity286 use appears to reduce risk only gradually.

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XXXX and @entity167 use and @entity5 in Puerto Rico.

multiple_choice

OBJECTIVES: To determine risk for @entity5 in Puerto Rico associated with use of @entity167 and @entity286 . METHODS: In Puerto Rico, @entity167 and @entity286 use were compared among @entity5 and pharynx (n = 342), @entity5 of major and minor salivary glands (n = 25) and 521 population-based controls. RESULTS: @entity167 (usual use, Ptrend < 0.0001 for @entity1 and Ptrend = 0.02 for @entity1 ) and @entity286 (usual use, Ptrend < 0.0001, for both @entity1 and @entity1 ) were strong independent risk factors for @entity5 in Puerto Rico, with a multiplicative effect from combined exposures. Risks did not vary systematically by use of filter vs. nonfilter cigarettes. Risks with use of other forms of smoked @entity286 were about sevenfold among both @entity1 and @entity1 . Risks decreased only gradually after cessation of @entity286 and @entity167 use. @entity286 use, but not @entity167 , was linked to @entity5 of the salivary glands. The burden of @entity5 due to @entity167 and @entity286 use in Puerto Rico (76% for @entity1 , 52% for @entity1 ) agreed closely with earlier estimates for the mainland US population, while about 72% of @entity5 ( @entity1 and @entity1 , combined) was due to @entity286 use. CONCLUSIONS: Excess risks for @entity5 in Puerto Rico are largely explained by patterns of @entity167 and @entity286 use. Smoking filter vs. nonfilter cigarettes does not alter risk, while cessation of @entity167 and @entity286 use appears to reduce risk only gradually.

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Childbearing at older age and XXXX risk (Sweden).

multiple_choice

OBJECTIVES: Several studies have found an inverse association between older age at last birth and @entity1204 risk. A nested case-control study was undertaken to examine the influence of this and other aspects of reproductive patterns on the risk of developing @entity1204 . METHODS: Among @entity1 born in 1925 and later, 4,839 eligible @entity1 were identified in the Swedish @entity5 Register. For each case, five individually age-matched controls were randomly selected from a population-based Fertility Register. Relative risks were estimated from odds ratios obtained from conditional logistic regression analyses. RESULTS: Compared to uniparous @entity1 , childless @entity1 were at a higher risk of @entity1204 (odds ratio [OR] = 1.38, 95% confidence interval [CI] = 1.25-1.52). This association was stronger in younger (< 50 years) than in older (50+ years) @entity1 . At all ages of first birth, a delivery was associated with a reduced risk of @entity1204 that slowly diminished with time. Among parous @entity1 , the risk decreased by almost 20% for each additional live birth (OR = 0.81, CI = 0.78-0.84). In an analysis limited to @entity1 with two or more births that compared the independent effects of age at first and at last birth, only older age at last birth was associated with a lowered risk of @entity1204 . The risk decreased at a rate of about 15% per five-year delay of last birth. CONCLUSIONS: @entity1204 is often referred to as the prototype hormonally-determined disease in @entity1 . However, our findings give further support to the hypothesis that a birth may not only affect risk through hormonal influences, but possibly also through mechanical shedding of cells that have undergone malignant transformation.

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[Concurrent chemoradiotherapy followed by consolidation chemotherapy and sequential chemoradiotherapy for XXXX : comparison in 93 @entity1 ].

multiple_choice

OBJECTIVE: To compare the efficacy and @entity137 of concurrent chemoradiotherapy followed by consolidation chemotherapy (CCRT-CT) and sequential chemoradiotherapy (SCRT) in the treatment of @entity5 . METHODS: From February, 2007 to June, 2010, 93 @entity1 with unresectable @entity5 were treated with SCRT or CCRT-CT. SCRT group (50 cases) received radiotherapy after 2-6 cycles of chemotherapy (median 2 cycles) followed by 0-4 cycles (median 2 cycles) of chemotherapy. CCRT-CT group (43 cases) received 2 cycles of chemotherapy every 3 weeks with concurrent radiotherapy followed by 2-4 cycles (median 2 cycles) of chemotherapy with the same drugs. The chemotherapy consisted of @entity900 plus @entity136 , @entity1205 or @entity1206 . Radiotherapy was administered using two-dimensional conformal irradiation (36-40 Gy/18-20f) followed by three-dimensional conformal boost to 56-70 Gy/28-35f (median DT64Gy) or using three-dimensional conformal irradiation 50-74 Gy/25-37f (median DT62Gy). RESULTS: The response rates were 76.7% and 54.0% in CCRT-CT and SCRT group, respectively (P<0.05). The median progression-free time in the two groups was 16.0 and 10.0 months, with the overall survival time of 18.0 and 12.5 months, respectively. The 1-, 2- and 3-year overall survival rates were 83.7%, 48.8% and 20.9% in CCRT-CT group and 52.0%, 20.0%, and 2.0% in SCRT group, respectively (P<0.05). CCRT-CT group showed a significantly lower rate of distant @entity3 than SCRT group (P<0.05), but the local recurrence rate was similar between the two groups. The main side effects included @entity1207 , @entity1208 , @entity1209 and @entity417 / @entity1210 / @entity882 . CCRT-CT group had a significantly higher rate of III-IV grade @entity1209 and @entity417 / @entity1210 / @entity882 than SCRT group. CONCLUSION: Compared to SCRT, CCRT-CT can improve the response rate, progression free survival and overall survival and decrease the rate of distant @entity3 , but is associated with a higher @entity137 .

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[Concurrent chemoradiotherapy followed by consolidation chemotherapy and sequential chemoradiotherapy for @entity5 : comparison in 93 XXXX ].

multiple_choice

OBJECTIVE: To compare the efficacy and @entity137 of concurrent chemoradiotherapy followed by consolidation chemotherapy (CCRT-CT) and sequential chemoradiotherapy (SCRT) in the treatment of @entity5 . METHODS: From February, 2007 to June, 2010, 93 @entity1 with unresectable @entity5 were treated with SCRT or CCRT-CT. SCRT group (50 cases) received radiotherapy after 2-6 cycles of chemotherapy (median 2 cycles) followed by 0-4 cycles (median 2 cycles) of chemotherapy. CCRT-CT group (43 cases) received 2 cycles of chemotherapy every 3 weeks with concurrent radiotherapy followed by 2-4 cycles (median 2 cycles) of chemotherapy with the same drugs. The chemotherapy consisted of @entity900 plus @entity136 , @entity1205 or @entity1206 . Radiotherapy was administered using two-dimensional conformal irradiation (36-40 Gy/18-20f) followed by three-dimensional conformal boost to 56-70 Gy/28-35f (median DT64Gy) or using three-dimensional conformal irradiation 50-74 Gy/25-37f (median DT62Gy). RESULTS: The response rates were 76.7% and 54.0% in CCRT-CT and SCRT group, respectively (P<0.05). The median progression-free time in the two groups was 16.0 and 10.0 months, with the overall survival time of 18.0 and 12.5 months, respectively. The 1-, 2- and 3-year overall survival rates were 83.7%, 48.8% and 20.9% in CCRT-CT group and 52.0%, 20.0%, and 2.0% in SCRT group, respectively (P<0.05). CCRT-CT group showed a significantly lower rate of distant @entity3 than SCRT group (P<0.05), but the local recurrence rate was similar between the two groups. The main side effects included @entity1207 , @entity1208 , @entity1209 and @entity417 / @entity1210 / @entity882 . CCRT-CT group had a significantly higher rate of III-IV grade @entity1209 and @entity417 / @entity1210 / @entity882 than SCRT group. CONCLUSION: Compared to SCRT, CCRT-CT can improve the response rate, progression free survival and overall survival and decrease the rate of distant @entity3 , but is associated with a higher @entity137 .

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Balloon-assisted transarterial embolization of intracranial dural arteriovenous XXXX .

multiple_choice

OBJECT: The authors report their preliminary experience using a balloon-assisted technique (BAT) in the transarterial embolization of intracranial dural arteriovenous @entity292 (DAVFs). METHODS: The authors reviewed the prospectively collected data obtained in 7 consecutive @entity1 with DAVFs in whom embolization was achieved using transarterially injected Onyx with either the venous or arterial BAT. Procedures were performed at the Division of Interventional Neuroradiology at the University of California at Los Angeles Medical Center between September 2005 and January 2008. RESULTS: Three @entity1 presented with @entity1211 and 4 did not. Three @entity1 underwent transarterial Onyx-based embolization combined with transvenous balloon protection; the balloon was inflated in the transverse sinus in 2 of these @entity1 and in the superior sagittal sinus in the third. One of them underwent an additional transarterial Onyx embolization with arterial BAT, whereas 4 other @entity1 were treated with arterial BAT alone. The occipital artery was temporarily occluded with the balloon in 4 of these cases, whereas in the fifth, the authors used temporary balloon occlusion of the middle meningeal artery. Angiograms obtained immediately after embolization demonstrated complete or near-complete obliteration of the @entity292 in 6 @entity1 and partial occlusion in 1 @entity1 . There were no immediate or postprocedural complications. Two @entity1 who presented with @entity932 never suffered a second @entity548 , and all other @entity1 experienced either complete resolution or significant improvement of their symptoms. CONCLUSIONS: The BAT provides a new complementary method in the transarterial embolization of DAVFs that are not amenable to transvenous embolization. The venous BAT protects the patency of critical venous pathways, whereas the arterial BAT provides better control of the Onyx-based embolization.

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Improved screening for silent @entity955 after XXXX .

multiple_choice

OBJECTIVES: To what extent silent paroxysmal @entity955 ( @entity955 ) is present in @entity64 @entity1 has not been established. We hypothesized that brief intermittent long-term electrocardiogram (ECG) recordings at regular time intervals are more effective than short-term continuous ECG monitoring in detecting silent @entity955 episodes. METHODS AND RESULTS: Consecutive @entity1 who had suffered an ischaemic @entity64 ( @entity64 ) and were without known @entity955 underwent a 24 h continuous ECG recording and performed 10 s rhythm registrations using a hand-held ECG recorder twice daily for 30 days and when @entity943 symptoms occured. Two hundred and forty-nine @entity64 @entity1 were included. Mean National Institute of Health @entity64 Scale (NIHSS) score was 0.9 (0-10). In total, 17 @entity1 were diagnosed with @entity955 . One hundred and eight @entity955 episodes were diagnosed in 15 @entity1 using intermittent recording, out of which 22% where unscheduled symptom triggered episodes. In three @entity1 @entity955 was diagnosed with both methods and in two @entity1 @entity955 was detected exclusively with 24 h Holter monitoring. A significant difference in favour of the hand-held ECG was shown between the two methods (P = 0.013). The total prevalence of @entity955 was 6.8% and increased to 11.8% in @entity1 >= 75 years. No @entity955 was found in @entity1 <65 years. CONCLUSIONS: Prolonged brief intermittent @entity943 screening substantially improves the detection of silent paroxysmal @entity955 in @entity1 with a recent @entity64 , and thus facilitates the detection of @entity1 who should receive oral anticoagulant treatment.

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Improved screening for silent XXXX after @entity64 .

multiple_choice

OBJECTIVES: To what extent silent paroxysmal @entity955 ( @entity955 ) is present in @entity64 @entity1 has not been established. We hypothesized that brief intermittent long-term electrocardiogram (ECG) recordings at regular time intervals are more effective than short-term continuous ECG monitoring in detecting silent @entity955 episodes. METHODS AND RESULTS: Consecutive @entity1 who had suffered an ischaemic @entity64 ( @entity64 ) and were without known @entity955 underwent a 24 h continuous ECG recording and performed 10 s rhythm registrations using a hand-held ECG recorder twice daily for 30 days and when @entity943 symptoms occured. Two hundred and forty-nine @entity64 @entity1 were included. Mean National Institute of Health @entity64 Scale (NIHSS) score was 0.9 (0-10). In total, 17 @entity1 were diagnosed with @entity955 . One hundred and eight @entity955 episodes were diagnosed in 15 @entity1 using intermittent recording, out of which 22% where unscheduled symptom triggered episodes. In three @entity1 @entity955 was diagnosed with both methods and in two @entity1 @entity955 was detected exclusively with 24 h Holter monitoring. A significant difference in favour of the hand-held ECG was shown between the two methods (P = 0.013). The total prevalence of @entity955 was 6.8% and increased to 11.8% in @entity1 >= 75 years. No @entity955 was found in @entity1 <65 years. CONCLUSIONS: Prolonged brief intermittent @entity943 screening substantially improves the detection of silent paroxysmal @entity955 in @entity1 with a recent @entity64 , and thus facilitates the detection of @entity1 who should receive oral anticoagulant treatment.

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Uterine cells are recruited to the infarcted heart and improve cardiac outcomes in female XXXX .

multiple_choice

We evaluated the hypothesis that uterine cells home to the heart after injury and improve cardiac outcomes. Premenopausal @entity1 have fewer @entity65 than age-matched @entity1 , but the mechanisms responsible for this protection have not been conclusively identified. Hysterectomy was performed in young female @entity35 (leaving the ovaries intact), and 7 days later the left coronary artery was ligated to produce a @entity583 ( @entity583 ). Cardiac function at 28 days post- @entity583 was measured using echocardiography. Fractional shortening was best in non-hysterectomized (non-Hx) females and lower in both Hx females and males. Uteri were then removed from GFP @entity35 and heterotopically transplanted into non-GFP recipients to investigate homing of uterine cells to the @entity1188 . Seven days later, the uterine transplant recipients underwent coronary ligation. GFP(+) cells were found in the recipient hearts 7 days after @entity583 and persisted for 6 months. Confocal analysis showed that homed uterine cells were located around blood vessels, suggesting their involvement in neovascularization. We then evaluated uterine cell transplantation by intravenously injecting GFP(+) uterine cells into Hx females immediately after @entity583 . These GFP(+) cells were found to home to the injured myocardium, stimulate angiogenesis, improve cardiac function, and increase survival. This study demonstrates that uterine cells can home to the injured myocardium, enhance tissue repair, and prevent @entity299 . Uterine cells may play a role in the prevention of @entity65 in females.

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Cost effectiveness of antimicrobial catheters in the XXXX : addressing uncertainty in the decision.

multiple_choice

INTRODUCTION: Some types of antimicrobial-coated central venous catheters (A-CVC) have been shown to be cost effective in preventing @entity1212 ( @entity1212 ). However, not all types have been evaluated, and there are concerns over the quality and usefulness of these earlier studies. There is uncertainty amongst clinicians over which, if any, A-CVCs to use. We re-evaluated the cost effectiveness of all commercially available A-CVCs for prevention of @entity1212 in adult @entity1213 ( @entity1213 ) @entity1 . METHODS: We used a Markov decision model to compare the cost effectiveness of A-CVCs relative to uncoated catheters. Four catheter types were evaluated: @entity1214 and @entity1215 (MR)-coated catheters, @entity575 , @entity902 and @entity505 (SPC)-impregnated catheters, and two @entity1216 and @entity1217 -coated catheters; one coated on the external surface (CH/SSD (ext)) and the other coated on both surfaces (CH/SSD (int/ext)). The incremental cost per quality-adjusted life year gained and the expected net monetary benefits were estimated for each. Uncertainty arising from data estimates, data quality and heterogeneity was explored in sensitivity analyses. RESULTS: The baseline analysis, with no consideration of uncertainty, indicated all four types of A-CVC were cost-saving relative to uncoated catheters. MR-coated catheters prevented 15 infections per 1,000 catheters and generated the greatest health benefits, 1.6 quality-adjusted life years, and cost savings (AUD 130,289). After considering uncertainty in the current evidence, the MR-coated catheters returned the highest incremental monetary net benefits of AUD 948 per catheter; however there was a 62% probability of error in this conclusion. Although the MR-coated catheters had the highest monetary net benefits across multiple scenarios, the decision was always associated with high uncertainty. CONCLUSIONS: Current evidence suggests that the cost effectiveness of using A-CVCs within the @entity1213 is highly uncertain. Policies to prevent @entity1212 amongst @entity1213 @entity1 should consider the cost effectiveness of competing interventions in the light of this uncertainty. Decision makers would do well to consider the current gaps in knowledge and the complexity of producing good quality evidence in this area.

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[Influence of salmon calcitonin on changes in thyroid hormone concentration and on XXXX secretion. II].

multiple_choice

The aim of this investigation was determination of salmon calcitonin (SC) administration influence on hypothalamus-pituitary-thyroid axis. The investigation was carried out on a group of 26 @entity1 . The group was divided in two different ways: into @entity1 younger and older than 65 years, and into @entity1 and @entity1 . Investigation protocol consists of 4 days. On the 1st day @entity1 received 100U of SC, on the 2nd day--100U of SC and 0.4 mg @entity1218 , on the 3rd day--0.4 mg @entity1218 , on the 4th day--0.9% solution of @entity1219 and 5% solution of @entity1 albumin. @entity1220 serum concentrations were determined by RIA method. Infusion of SC caused @entity1220 serum concentration increase in all groups. This effect is qualitatively similar but quantitatively different in investigated groups. Administration of SC with @entity1218 causes significantly smaller growth of @entity1220 concentration than observed after infusion of @entity1218 alone. The mechanism of SC influence on pituitary may be similar to the one of @entity1218 .

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Early visual information processing and the Defence Mechanism Test in XXXX .

multiple_choice

OBJECTIVE: The aim of this study was to determine whether impairment in visual information processing measured by backward masking was related to high threshold values in the Defence Mechanism Test (DMT) in @entity1 with @entity161 . METHOD: A total of 20 @entity1 with @entity161 according to DSM-IV, most of whom were out- @entity1 , were studied with backward masking and a modified version of the DMT (DMTm). RESULTS: Nine of the @entity1 showed an @entity73 . There was a relationship between @entity73 and the DMTm with either no or a late C-phase (correct perception in DMTm) in the first series, and a late perception of the peripheral @entity1 in the second series. There was no relationship for the other 14 threshold values. The @entity1 did not have high threshold values in the DMTm as was expected. CONCLUSION: In this sample consisting mainly of out- @entity1 , there were few relationships between @entity73 and high threshold values in DMTm. Their visual information processing was not as disturbed as expected. Most previous studies on both backward masking and the DMT in @entity1 with @entity161 have been conducted among in- @entity1 , who could be expected to be more disturbed than the out- @entity1 in the present study. The results of studies on in- @entity1 with @entity161 must not be generalized to include out- @entity1 , and vice versa.

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Health-related quality of life in pediatric XXXX survivors: a multifactorial assessment including parental factors.

multiple_choice

AIM: We aimed to evaluate the health-related quality of life (HRQOL) and the effect of associated factors such as @entity5 type, treatment strategies, sex, age, and parental factors like education and psychopathology in pediatric @entity5 survivors and make a comparison with healthy @entity1 . @entity1 AND METHODS: "Pediatric Quality of Life Inventory (PedsQL) 4.0 TM, Generic Core Scale" for @entity1 and parents, and "Brief Symptom Inventory" for parents were used. Three hundred and two survivors without major @entity51 and 272 healthy controls of 8 to 18 years of age were enrolled to study. RESULTS: Comparison of scores according to @entity1 self-report between survivor and control groups revealed lower points in physical and school subscale of survivor group (P<0.01 and P<0.001, respectively). Female survivors had reported significantly worse HRQOL in physical and emotional subscales of PedsQL than male survivors (P<0.001). Female survivors of >= 16 years of age had reported worse scores in school subscale than females of younger age groups and male survivors of same age group. Parents of control group reported better results in school subscales (P<0.001) and social functioning subscales (P<0.05) than parents of survivor group. Brief Symptom Inventory score had significant effect on @entity1 self-report and parent proxy-report of physical functioning (P<0.001), emotional functioning (P<0.001), social functioning (P<0.001), and school subscales (P<0.001) of PedsQL. Significantly better scores of physical functioning subscale in the survivors whose parents are university graduate than the survivors whose parents are primary school graduate were detected (P<0.001). The survivors with @entity1221 had reported lower scores in the social, emotional, physical, and school functioning subscales of PedsQL than @entity1 with non-Hodgkin and @entity978 (P<0.001). @entity1 self-report school subscale scores were lower in survivors treated with radiotherapy in combination or as sole therapy than survivors in whom radiotherapy was not given (P<0.001). CONCLUSIONS: Our study has provided evidence about less-studied determinants of HRQOL like parental factors such as psychopathology or educational level in childhood @entity5 survivors. Future research can build on this evidence to obtain additional factors other than well-known medical and treatment-related factors.

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Serial computed tomography and lung function testing in pulmonary XXXX .

multiple_choice

Little is known about longitudinal lung function variation in @entity1 with pulmonary @entity1222 ( @entity1222 ). The contribution of serial lung computed tomography (CT) to managing these @entity1 has not been evaluated. This long-term retrospective study included 49 @entity1 who were serially evaluated by lung CT and pulmonary function tests. The lung function variation was categorised as improvement or deterioration. The extent of the CT lesions was correlated with lung function. Lung function deteriorated in 60% of the @entity1 . Forced expiratory volume in 1 s (FEV(1)) and diffusing capacity of the lung for @entity1223 (D(L,CO)) were the parameters that most frequently deteriorated. A subgroup of @entity1 experienced a dramatic decline in FEV(1) within 2 yrs of diagnosis. @entity1224 was the major functional pattern observed. In a multivariate analysis, % predicted FEV(1)at diagnosis was the only factor associated with the incidence of @entity1224 . The increase in cystic lesions on the lung CTs was associated with @entity73 but did not anticipate the decline in FEV(1) or D(L,CO). Serial lung function tests are essential for following @entity1 with @entity1222 , who frequently develop @entity1224 . A lung CT at diagnosis is informative, but routine sequential CTs seem less useful. A prospective study is needed to characterise those @entity1 with early progressive disease.

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beta subunit reshuffling modifies N- and P/Q-type XXXX channel subunit compositions in lethargic @entity19 brain.

multiple_choice

Neuronal voltage-dependent @entity141 channels are heteromultimers of @entity1225 , and alpha2delta subunits, and any one of five alpha1 subunits ( @entity1226 -E) may associate with one of four beta subunits (beta1-4). The specific @entity1225 combination assembled determines single-channel properties, while variation in the proportion of each combination contributes to the functional diversity of neurons. The @entity19 mutant lethargic (lh) exhibits severe @entity16 due to a mutation that deletes the alpha1 subunit interaction domain of the @entity1227 subunit. Since beta subunits regulate critical alpha1 subunit properties in heterologous expression systems, loss of @entity1227 in lethargic could dramatically alter channel localization and behavior unless beta1-3 subunits can be used as substitutes in vivo. Here we demonstrate increased steady-state associations of @entity1226 and @entity1225 with the remaining beta1-3 subunits, without significant changes in beta1-3 mRNA abundance. The immunolocalization of @entity1226 and @entity1225 protein in lethargic brain is indistinguishable from wild-type by light microscopy. Furthermore, the measurement of large-amplitude P-type currents in dissociated lethargic Purkinje neurons indicates that these @entity1226 -containing channels retain regulation by beta subunits. We conclude that several properties of @entity1226 and @entity1225 proteins are not uniquely regulated by @entity1227 in vivo and may be rescued by beta1-3 subunit reshuffling. The complex neurological manifestation of the lethargic mutation therefore emerges from loss of @entity1227 coupled with the widespread pairing of surrogate beta subunits with multiple @entity141 channel subtypes. The existence of beta subunit reshuffling demonstrates that molecular plasticity of @entity141 channel assembly, a normal feature of early brain development, is retained in the mature brain.

1722

1723

1724

beta subunit reshuffling modifies N- and P/Q-type @entity141 channel subunit compositions in lethargic XXXX brain.

multiple_choice

Neuronal voltage-dependent @entity141 channels are heteromultimers of @entity1225 , and alpha2delta subunits, and any one of five alpha1 subunits ( @entity1226 -E) may associate with one of four beta subunits (beta1-4). The specific @entity1225 combination assembled determines single-channel properties, while variation in the proportion of each combination contributes to the functional diversity of neurons. The @entity19 mutant lethargic (lh) exhibits severe @entity16 due to a mutation that deletes the alpha1 subunit interaction domain of the @entity1227 subunit. Since beta subunits regulate critical alpha1 subunit properties in heterologous expression systems, loss of @entity1227 in lethargic could dramatically alter channel localization and behavior unless beta1-3 subunits can be used as substitutes in vivo. Here we demonstrate increased steady-state associations of @entity1226 and @entity1225 with the remaining beta1-3 subunits, without significant changes in beta1-3 mRNA abundance. The immunolocalization of @entity1226 and @entity1225 protein in lethargic brain is indistinguishable from wild-type by light microscopy. Furthermore, the measurement of large-amplitude P-type currents in dissociated lethargic Purkinje neurons indicates that these @entity1226 -containing channels retain regulation by beta subunits. We conclude that several properties of @entity1226 and @entity1225 proteins are not uniquely regulated by @entity1227 in vivo and may be rescued by beta1-3 subunit reshuffling. The complex neurological manifestation of the lethargic mutation therefore emerges from loss of @entity1227 coupled with the widespread pairing of surrogate beta subunits with multiple @entity141 channel subtypes. The existence of beta subunit reshuffling demonstrates that molecular plasticity of @entity141 channel assembly, a normal feature of early brain development, is retained in the mature brain.

1725

1726

1727

Treatment of XXXX with catheter-directed thrombolysis and stent placement, complicated by heparin-induced @entity882 .

multiple_choice

@entity1228 is an uncommon process in which the right common iliac artery compresses the left common iliac vein, resulting in left iliofemoral deep vein @entity715 and severe leg @entity4 . We report the case of a 41-year-old female who presented with severe @entity4 present for 1 day. One week earlier she had experienced acute @entity662 . Duplex ultrasound revealed a left iliofemoral deep vein @entity715 . A computed tomography (CT) scan performed for @entity490 revealed @entity715 of the entire left common and external iliac veins. A ventilation-perfusion scan diagnosed a @entity1151 . The @entity1 was treated with systemic intravenous heparin and catheter-directed thrombolysis of the iliofemoral deep vein @entity715 . Complete thrombolysis and iliofemoral vein patency was achieved over 5 days. A persistent @entity850 in the left common iliac vein consistent with @entity1228 was alleviated with percutaneous balloon angioplasty and placement of a Wallstent. Heparin therapy was terminated at the time of stenting because of suspected heparin-induced @entity882 . The @entity1 was started on a continuous infusion of 10% dextran 40, and @entity1229 therapy was initiated. Heparin-induced antibodies were confirmed by a C-14 @entity750 release assay. The endovascular reconstruction remains patent 4 months later. Heparin-induced @entity882 complicating endovascular reconstruction of the iliofemoral venous system in a @entity1 with @entity1228 is an uncommon occurrence. This case and a review of the literature are discussed.

1728

1729

1730

Treatment of @entity1228 with catheter-directed thrombolysis and stent placement, complicated by heparin-induced XXXX .

multiple_choice

@entity1228 is an uncommon process in which the right common iliac artery compresses the left common iliac vein, resulting in left iliofemoral deep vein @entity715 and severe leg @entity4 . We report the case of a 41-year-old female who presented with severe @entity4 present for 1 day. One week earlier she had experienced acute @entity662 . Duplex ultrasound revealed a left iliofemoral deep vein @entity715 . A computed tomography (CT) scan performed for @entity490 revealed @entity715 of the entire left common and external iliac veins. A ventilation-perfusion scan diagnosed a @entity1151 . The @entity1 was treated with systemic intravenous heparin and catheter-directed thrombolysis of the iliofemoral deep vein @entity715 . Complete thrombolysis and iliofemoral vein patency was achieved over 5 days. A persistent @entity850 in the left common iliac vein consistent with @entity1228 was alleviated with percutaneous balloon angioplasty and placement of a Wallstent. Heparin therapy was terminated at the time of stenting because of suspected heparin-induced @entity882 . The @entity1 was started on a continuous infusion of 10% dextran 40, and @entity1229 therapy was initiated. Heparin-induced antibodies were confirmed by a C-14 @entity750 release assay. The endovascular reconstruction remains patent 4 months later. Heparin-induced @entity882 complicating endovascular reconstruction of the iliofemoral venous system in a @entity1 with @entity1228 is an uncommon occurrence. This case and a review of the literature are discussed.

1731

1732

1733

Systematic review of multidisciplinary rehabilitation in @entity1 with XXXX .

multiple_choice

BACKGROUND: @entity1230 is a cause of significant disability in adults of working age. Despite the implementation of @entity130 systems for improved coordination and organization of care, rehabilitation services are not yet routinely considered integral to @entity130 care processes. METHODS: MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine, Physiotherapy Evidence Database, Latin American and Caribbean Literature on Health Sciences and Cochrane Library databases were searched up to May 2011 for randomized clinical trials, as well as observational studies, reporting outcomes of injured @entity1 following multidisciplinary rehabilitation that addressed functional restoration and societal reintegration based on the International Classification of Functioning, Disability and Health. RESULTS: No randomized and/or controlled clinical trials were identified. Fifteen observational studies involving 2386 @entity1 with @entity130 were included. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach assessed methodological quality as 'poor' in all studies, with selection and observer bias. Although @entity1 with low functional scores showed improvement after rehabilitation, they were unable to resume their pretrauma level of activity. Their functional ability was significantly associated with motor independence on admission and early acute rehabilitation, which contributed to a shorter hospital stay. Injury location, age, co-morbidity and education predicted long-term functional consequences. @entity130 care systems were associated with reduced mortality. The gaps in evidence include: rehabilitation settings, components, intensity, duration and types of therapy, and long-term outcomes for survivors of @entity1230 . CONCLUSION: Rehabilitation is an expensive resource and the evidence to support its justification is needed urgently. The issues in study design and research methodology in rehabilitation are challenging. Opportunities to prioritize @entity130 rehabilitation, disability management and social reintegration of @entity1230 survivors are discussed.

1734

1735

1736

Systematic review of multidisciplinary rehabilitation in XXXX with @entity1230 .

multiple_choice

BACKGROUND: @entity1230 is a cause of significant disability in adults of working age. Despite the implementation of @entity130 systems for improved coordination and organization of care, rehabilitation services are not yet routinely considered integral to @entity130 care processes. METHODS: MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine, Physiotherapy Evidence Database, Latin American and Caribbean Literature on Health Sciences and Cochrane Library databases were searched up to May 2011 for randomized clinical trials, as well as observational studies, reporting outcomes of injured @entity1 following multidisciplinary rehabilitation that addressed functional restoration and societal reintegration based on the International Classification of Functioning, Disability and Health. RESULTS: No randomized and/or controlled clinical trials were identified. Fifteen observational studies involving 2386 @entity1 with @entity130 were included. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach assessed methodological quality as 'poor' in all studies, with selection and observer bias. Although @entity1 with low functional scores showed improvement after rehabilitation, they were unable to resume their pretrauma level of activity. Their functional ability was significantly associated with motor independence on admission and early acute rehabilitation, which contributed to a shorter hospital stay. Injury location, age, co-morbidity and education predicted long-term functional consequences. @entity130 care systems were associated with reduced mortality. The gaps in evidence include: rehabilitation settings, components, intensity, duration and types of therapy, and long-term outcomes for survivors of @entity1230 . CONCLUSION: Rehabilitation is an expensive resource and the evidence to support its justification is needed urgently. The issues in study design and research methodology in rehabilitation are challenging. Opportunities to prioritize @entity130 rehabilitation, disability management and social reintegration of @entity1230 survivors are discussed.

1737

1738

1739

Matrix metalloproteinase-9, -10, and -12, @entity1231 and @entity899 expression in @entity19 liver during XXXX -induced oxidative stress and @entity130 .

multiple_choice

Treatment during early @entity5 development has greater success because tissue growth remains largely confined to its original locus. At later stages, malignant cells migrate from their original location, invade surrounding normal areas, and can disseminate widely throughout the body. Remodeling of the extracellular matrix (ECM) serves as a key facilitator of this dissemination. Proteolytic enzymes including plasmin and matrix metalloproteinases (MMPs) play an integral role in degrading the surrounding ECM proteins and clearing a path for @entity5 cell migration. Specific MMPs are highly expressed late during @entity3 . It is not understood whether early changes in MMPs influence apoptotic and @entity39 cell death, processes known to govern the early stages of @entity105 . Similarly, the interaction between @entity1231 and @entity899 is tightly controlled by a complex array of post-translational modifications, which in turn dictates the stability and activity of both @entity899 and @entity1231 . The present studies examine the hypothesis that model hepatotoxin @entity1232 ( @entity1233 ), which is also a model carcinogen, will induce the MMP family of proteins after administration in hepatotoxic doses. Doses of 25, 50, and 100 mg/kg @entity1233 were administered i.p. to male C3H @entity19 . Changes in parameters associated with apoptotic and @entity39 cell death, DNA damage, cell proliferation, and extracellular proteinases were examined in liver at 24 h. Serum ALT activity, oxidative stress [ @entity1234 ], and caspase-activated DNAse mediated DNA laddering increased in a dose-dependent manner, as did the level of @entity1231 protein. @entity1235 ( @entity1235 , stromelysin-2, @entity1236 ), and @entity899 protein levels increased following 25 mg/kg @entity1233 , but were successively decreased after higher @entity1233 doses. The results of this study demonstrate changes in @entity1231 and MMPs during @entity1233 -induced @entity99 and provide a plausible linkage between @entity1233 -induced oxidative stress-mediated @entity130 and its likely involvement in setting the stage for initiating subsequent metastatic disease at later circumstances.

1740

1741

1742

Matrix metalloproteinase-9, -10, and -12, @entity1231 and @entity899 expression in XXXX liver during @entity1232 -induced oxidative stress and @entity130 .

multiple_choice

Treatment during early @entity5 development has greater success because tissue growth remains largely confined to its original locus. At later stages, malignant cells migrate from their original location, invade surrounding normal areas, and can disseminate widely throughout the body. Remodeling of the extracellular matrix (ECM) serves as a key facilitator of this dissemination. Proteolytic enzymes including plasmin and matrix metalloproteinases (MMPs) play an integral role in degrading the surrounding ECM proteins and clearing a path for @entity5 cell migration. Specific MMPs are highly expressed late during @entity3 . It is not understood whether early changes in MMPs influence apoptotic and @entity39 cell death, processes known to govern the early stages of @entity105 . Similarly, the interaction between @entity1231 and @entity899 is tightly controlled by a complex array of post-translational modifications, which in turn dictates the stability and activity of both @entity899 and @entity1231 . The present studies examine the hypothesis that model hepatotoxin @entity1232 ( @entity1233 ), which is also a model carcinogen, will induce the MMP family of proteins after administration in hepatotoxic doses. Doses of 25, 50, and 100 mg/kg @entity1233 were administered i.p. to male C3H @entity19 . Changes in parameters associated with apoptotic and @entity39 cell death, DNA damage, cell proliferation, and extracellular proteinases were examined in liver at 24 h. Serum ALT activity, oxidative stress [ @entity1234 ], and caspase-activated DNAse mediated DNA laddering increased in a dose-dependent manner, as did the level of @entity1231 protein. @entity1235 ( @entity1235 , stromelysin-2, @entity1236 ), and @entity899 protein levels increased following 25 mg/kg @entity1233 , but were successively decreased after higher @entity1233 doses. The results of this study demonstrate changes in @entity1231 and MMPs during @entity1233 -induced @entity99 and provide a plausible linkage between @entity1233 -induced oxidative stress-mediated @entity130 and its likely involvement in setting the stage for initiating subsequent metastatic disease at later circumstances.

1743

1744

1745

Matrix metalloproteinase-9, -10, and -12, @entity1231 and @entity899 expression in @entity19 liver during @entity1232 -induced oxidative stress and XXXX .

multiple_choice

Treatment during early @entity5 development has greater success because tissue growth remains largely confined to its original locus. At later stages, malignant cells migrate from their original location, invade surrounding normal areas, and can disseminate widely throughout the body. Remodeling of the extracellular matrix (ECM) serves as a key facilitator of this dissemination. Proteolytic enzymes including plasmin and matrix metalloproteinases (MMPs) play an integral role in degrading the surrounding ECM proteins and clearing a path for @entity5 cell migration. Specific MMPs are highly expressed late during @entity3 . It is not understood whether early changes in MMPs influence apoptotic and @entity39 cell death, processes known to govern the early stages of @entity105 . Similarly, the interaction between @entity1231 and @entity899 is tightly controlled by a complex array of post-translational modifications, which in turn dictates the stability and activity of both @entity899 and @entity1231 . The present studies examine the hypothesis that model hepatotoxin @entity1232 ( @entity1233 ), which is also a model carcinogen, will induce the MMP family of proteins after administration in hepatotoxic doses. Doses of 25, 50, and 100 mg/kg @entity1233 were administered i.p. to male C3H @entity19 . Changes in parameters associated with apoptotic and @entity39 cell death, DNA damage, cell proliferation, and extracellular proteinases were examined in liver at 24 h. Serum ALT activity, oxidative stress [ @entity1234 ], and caspase-activated DNAse mediated DNA laddering increased in a dose-dependent manner, as did the level of @entity1231 protein. @entity1235 ( @entity1235 , stromelysin-2, @entity1236 ), and @entity899 protein levels increased following 25 mg/kg @entity1233 , but were successively decreased after higher @entity1233 doses. The results of this study demonstrate changes in @entity1231 and MMPs during @entity1233 -induced @entity99 and provide a plausible linkage between @entity1233 -induced oxidative stress-mediated @entity130 and its likely involvement in setting the stage for initiating subsequent metastatic disease at later circumstances.

1746

1747

1748

Matrix metalloproteinase-9, -10, and -12, XXXX and @entity899 expression in @entity19 liver during @entity1232 -induced oxidative stress and @entity130 .

multiple_choice

Treatment during early @entity5 development has greater success because tissue growth remains largely confined to its original locus. At later stages, malignant cells migrate from their original location, invade surrounding normal areas, and can disseminate widely throughout the body. Remodeling of the extracellular matrix (ECM) serves as a key facilitator of this dissemination. Proteolytic enzymes including plasmin and matrix metalloproteinases (MMPs) play an integral role in degrading the surrounding ECM proteins and clearing a path for @entity5 cell migration. Specific MMPs are highly expressed late during @entity3 . It is not understood whether early changes in MMPs influence apoptotic and @entity39 cell death, processes known to govern the early stages of @entity105 . Similarly, the interaction between @entity1231 and @entity899 is tightly controlled by a complex array of post-translational modifications, which in turn dictates the stability and activity of both @entity899 and @entity1231 . The present studies examine the hypothesis that model hepatotoxin @entity1232 ( @entity1233 ), which is also a model carcinogen, will induce the MMP family of proteins after administration in hepatotoxic doses. Doses of 25, 50, and 100 mg/kg @entity1233 were administered i.p. to male C3H @entity19 . Changes in parameters associated with apoptotic and @entity39 cell death, DNA damage, cell proliferation, and extracellular proteinases were examined in liver at 24 h. Serum ALT activity, oxidative stress [ @entity1234 ], and caspase-activated DNAse mediated DNA laddering increased in a dose-dependent manner, as did the level of @entity1231 protein. @entity1235 ( @entity1235 , stromelysin-2, @entity1236 ), and @entity899 protein levels increased following 25 mg/kg @entity1233 , but were successively decreased after higher @entity1233 doses. The results of this study demonstrate changes in @entity1231 and MMPs during @entity1233 -induced @entity99 and provide a plausible linkage between @entity1233 -induced oxidative stress-mediated @entity130 and its likely involvement in setting the stage for initiating subsequent metastatic disease at later circumstances.

1749

1750

1751

Matrix metalloproteinase-9, -10, and -12, @entity1231 and XXXX expression in @entity19 liver during @entity1232 -induced oxidative stress and @entity130 .

multiple_choice

Treatment during early @entity5 development has greater success because tissue growth remains largely confined to its original locus. At later stages, malignant cells migrate from their original location, invade surrounding normal areas, and can disseminate widely throughout the body. Remodeling of the extracellular matrix (ECM) serves as a key facilitator of this dissemination. Proteolytic enzymes including plasmin and matrix metalloproteinases (MMPs) play an integral role in degrading the surrounding ECM proteins and clearing a path for @entity5 cell migration. Specific MMPs are highly expressed late during @entity3 . It is not understood whether early changes in MMPs influence apoptotic and @entity39 cell death, processes known to govern the early stages of @entity105 . Similarly, the interaction between @entity1231 and @entity899 is tightly controlled by a complex array of post-translational modifications, which in turn dictates the stability and activity of both @entity899 and @entity1231 . The present studies examine the hypothesis that model hepatotoxin @entity1232 ( @entity1233 ), which is also a model carcinogen, will induce the MMP family of proteins after administration in hepatotoxic doses. Doses of 25, 50, and 100 mg/kg @entity1233 were administered i.p. to male C3H @entity19 . Changes in parameters associated with apoptotic and @entity39 cell death, DNA damage, cell proliferation, and extracellular proteinases were examined in liver at 24 h. Serum ALT activity, oxidative stress [ @entity1234 ], and caspase-activated DNAse mediated DNA laddering increased in a dose-dependent manner, as did the level of @entity1231 protein. @entity1235 ( @entity1235 , stromelysin-2, @entity1236 ), and @entity899 protein levels increased following 25 mg/kg @entity1233 , but were successively decreased after higher @entity1233 doses. The results of this study demonstrate changes in @entity1231 and MMPs during @entity1233 -induced @entity99 and provide a plausible linkage between @entity1233 -induced oxidative stress-mediated @entity130 and its likely involvement in setting the stage for initiating subsequent metastatic disease at later circumstances.

1752

1753

1754

Resurfacing potential of heterologous chondrocytes suspended in fibrin glue in large full-thickness defects of femoral articular cartilage: an experimental study in the XXXX .

multiple_choice

A large full-thickness articular-cartilage defect was created in the medial femoral condyle of 32 adult @entity1237 . The defects were xenografted with isolated @entity95 chondrocytes suspended in fibrin glue. Sham operated @entity1237 , where only a standardized defect was created, were used as controls. Results of cartilage repair were assessed after 3, 8, 13, 26 and 52 weeks. The repair tissue was evaluated macroscopically, histologically and biochemically. Results indicated that xenografted @entity95 chondrocytes survived the transplantation and maintained their potential to produce matrix in fibrin glue, particularly if they were located in a non-weight-bearing area. In terms of an immunological reaction to xenografted chondrocytes, only mild signs of @entity603 were observed in both groups and rejection of transplanted cells did not occur. From 3 weeks gradually progressive resolvement of the fibrin glue was observed with subsequent replacement by fibrous tissue. Initially xenografted defects histologically showed better tendency for cartilage regeneration, however, 52 weeks after surgery no significant differences could be detected in the repair tissue of both groups macroscopically, histologically and on biochemical scoring. The amount of collagen type II in the newly synthesized matrix was 75% 1 year after surgery. This study shows that isolated heterologous chondrocytes can be used for transplantation in articular cartilage defects, however, fibrin glue does not offer enough biomechanical support to the cells to maintain its function as a three-dimensional scaffold.

1755

1756

1757

Neuronal nicotinic @entity934 receptors are modulated by XXXX .

multiple_choice

It is known that @entity219 modulates nicotinic @entity934 receptors (nAChRs). Here, we studied the effects of @entity219 on neuronal alpha4beta4 nAChRs, expressed in @entity1238 oocytes and activated by @entity1239 . Membrane ion currents elicited by @entity1239 (10 nM to 100 microM) were enhanced by @entity219 (100 microM). Maximal @entity219 potentiation of the @entity1239 -activated current (2530%) occurred at 50 nM @entity1239 , and potentiation gradually decreased as the @entity1239 concentration increased. The EC(50) and IC(50) for the @entity1239 -activated current were 639 nM and 14.7 microM @entity1239 , respectively. Both parameters decreased in the presence of @entity219 to 160 nM and 4.6 microM, respectively, probably due to an increase of sensitivity of nAChRs for @entity1239 . We used different concentrations and durations of exposure to @entity1239 , due to desensitization of nAChRs directly depends on both these factors. With 500 nM @entity1239 and 20 min washing periods between @entity1239 applications, @entity219 potentiation remained constant, 901% for 2 min and 813% for 20 min of @entity1239 exposure. With continuous application of @entity1239 , @entity219 potentiation decreased as the time of @entity1239 exposure increased, 721% for 2 min and 254% for 48 min of @entity1239 exposure. Our results indicate that @entity219 -potentiating effects on alpha4beta4 nAChRs strongly depend on both concentration and time of exposure to @entity1239 , suggesting that @entity219 potentiation depends on the degree of desensitization.

1758

1759

1760

Neuronal nicotinic XXXX receptors are modulated by @entity219 .

multiple_choice

It is known that @entity219 modulates nicotinic @entity934 receptors (nAChRs). Here, we studied the effects of @entity219 on neuronal alpha4beta4 nAChRs, expressed in @entity1238 oocytes and activated by @entity1239 . Membrane ion currents elicited by @entity1239 (10 nM to 100 microM) were enhanced by @entity219 (100 microM). Maximal @entity219 potentiation of the @entity1239 -activated current (2530%) occurred at 50 nM @entity1239 , and potentiation gradually decreased as the @entity1239 concentration increased. The EC(50) and IC(50) for the @entity1239 -activated current were 639 nM and 14.7 microM @entity1239 , respectively. Both parameters decreased in the presence of @entity219 to 160 nM and 4.6 microM, respectively, probably due to an increase of sensitivity of nAChRs for @entity1239 . We used different concentrations and durations of exposure to @entity1239 , due to desensitization of nAChRs directly depends on both these factors. With 500 nM @entity1239 and 20 min washing periods between @entity1239 applications, @entity219 potentiation remained constant, 901% for 2 min and 813% for 20 min of @entity1239 exposure. With continuous application of @entity1239 , @entity219 potentiation decreased as the time of @entity1239 exposure increased, 721% for 2 min and 254% for 48 min of @entity1239 exposure. Our results indicate that @entity219 -potentiating effects on alpha4beta4 nAChRs strongly depend on both concentration and time of exposure to @entity1239 , suggesting that @entity219 potentiation depends on the degree of desensitization.

1761

1762

1763

@entity731 , vascular XXXX and therapeutic strategies.

multiple_choice

With the arrival of the era of global population @entity1240 , we strive for healthy @entity1240 and a healthy senior life rather than simple prolongation of the physical age. For the past 50 years, @entity65 ( @entity65 ) have been the most common cause of @entity204 among the elderly @entity1 globally. In China, there has been an exponential increase in the incidence of @entity299 and @entity64 in the elderly population. @entity731 is the pathological change in the @entity453 , @entity64 , and @entity1095 . Despite the significant benefit demonstrated, control of classic risk factors alone, such as lifestyle change or drug therapy, was shown to have limitations in reducing the incidence of @entity65 . @entity455 has been shown to be an important independent predictor of @entity65 events. Interventions targeting vascular @entity1240 have emerged as a new paradigm in conjunction with control of risk factors for the prevention of @entity65 . @entity455 and @entity731 are two distinct pathological changes and difficult to distinguish clinically. Recent research with Chinese medicine (CM) has shown encouraging observations, linking the clinical benefit of delaying vascular @entity1240 and treating @entity731 . These results demonstrate great potential of CM in the prevention and treatment of @entity65 .

1764

1765

1766

XXXX , vascular @entity1240 and therapeutic strategies.

multiple_choice

With the arrival of the era of global population @entity1240 , we strive for healthy @entity1240 and a healthy senior life rather than simple prolongation of the physical age. For the past 50 years, @entity65 ( @entity65 ) have been the most common cause of @entity204 among the elderly @entity1 globally. In China, there has been an exponential increase in the incidence of @entity299 and @entity64 in the elderly population. @entity731 is the pathological change in the @entity453 , @entity64 , and @entity1095 . Despite the significant benefit demonstrated, control of classic risk factors alone, such as lifestyle change or drug therapy, was shown to have limitations in reducing the incidence of @entity65 . @entity455 has been shown to be an important independent predictor of @entity65 events. Interventions targeting vascular @entity1240 have emerged as a new paradigm in conjunction with control of risk factors for the prevention of @entity65 . @entity455 and @entity731 are two distinct pathological changes and difficult to distinguish clinically. Recent research with Chinese medicine (CM) has shown encouraging observations, linking the clinical benefit of delaying vascular @entity1240 and treating @entity731 . These results demonstrate great potential of CM in the prevention and treatment of @entity65 .

1767

1768

1769

A comparison of injections of botulinum toxin and topical XXXX ointment for the treatment of chronic anal fissure.

multiple_choice

BACKGROUND AND METHODS: Lateral internal sphincterotomy, the most common treatment for chronic anal fissure, may cause permanent @entity130 , which can lead to @entity1241 . We compared two nonsurgical treatments that avert the risk of @entity1241 . We randomly assigned 50 adults with symptomatic chronic posterior anal fissures to receive treatment with either a total of 20 U of botulinum toxin injected into the internal anal sphincter on each side of the anterior midline or 0.2 percent @entity1242 ointment applied twice daily for six weeks. RESULTS: After two months, the fissures were healed in 24 of the 25 @entity1 (96 percent) in the botulinum-toxin group and in 15 of the 25 (60 percent) in the @entity1242 group (P=0.005). No @entity1 in either group had @entity1241 . At some time during treatment, five @entity1 in the @entity1242 group had transient, moderate-to-severe @entity10 that were related to treatment. None of the @entity1 in the botulinum-toxin group reported adverse effects. Ten @entity1 who did not have a response to the assigned treatment - 1 in the botulinum-toxin group and 9 in the @entity1242 group - crossed over to the other treatment; the fissures subsequently healed in all 10 @entity1 . There were no relapses during an average of about 15 months of follow-up. CONCLUSIONS: Although treatment with either topical @entity1242 or botulinum toxin is effective as an alternative to surgery for @entity1 with chronic anal fissure, botulinum toxin is the more effective nonsurgical treatment.

1770

1771

1772

[Challenges in nutrition-based treatment for weight control in adolescents suffering from XXXX ].

multiple_choice

The rate of overweight @entity1 amongst @entity161 sufferers is higher than it is in the general population and this is true even prior to starting drug treatment. It is well known that anti- @entity716 medications increase the severity of weight control problems. It seems that @entity1017 is even more significant in adolescents than in adults. The mechanisms in those medications which cause @entity1017 are not well understood. Hormones like @entity1243 , Ghrelin and others are being investigated in relation to this issue. Various interventions, like @entity353 medications, were investigated in adults suffering from @entity161 but not in adolescents. Other @entity353 interventions, for example behavior therapy, were also investigated in adults, both as preventive measures and as treatment for already present excessive weight. Even caloric limitation was attempted in closed adult wards. The majority of studies show that there is only a small loss of weight and the @entity1 maintain their high Body Mass Index (BMI). Among adolescents suffering from @entity161 it was found that @entity1017 results mostly from increase in caloric intake. The easy availability of processed foods and their relatively low cost, result in the positive caloric balance. During adolescence there is increased sensitivity to outer appearance, however, those youngsters have great difficulty following professionals' advice for a balanced diet. This is particularly hard for those adolescents who are treated with antipsychotics and suffer from increased appetite. In a comparative study of various @entity353 treatments for @entity1 it was found that the most efficient one is group @entity353 clinics intended strictly for parents. The efficacy of such group @entity353 clinics for parents of @entity161 suffering adolescents should also be investigated.

1773

1774

1775

Prospective analysis of CT of the sinuses in acute XXXX .

multiple_choice

OBJECTIVE: Asthma and @entity1244 are both inflammatory diseases of the respiratory epithelium, but to our knowledge no prospective analyses of CT of the sinuses in @entity1 with acute @entity565 have been performed. The purpose of this study was to investigate the type and extent of abnormalities found on CT of the sinuses in @entity1 with acute @entity565 . SUBJECTS AND METHODS: Sixty-five @entity1 with acute @entity565 and 62 age-, race-, and sex-matched control subjects were enrolled in the emergency department. Limited coronal sinus CT was performed and scans were interpreted by a radiologist who was unaware of the @entity1 's clinical condition. Scans were analyzed for the presence of mucosal thickening in the sinuses, ostiomeatal complexes, and nasal cavities. Scans were also assigned a CT score for total mucosal thickening. A CT score of 12 or more points indicated @entity66 . RESULTS: Mucosal thickening in the nasal passages (p < .001), ostiomeatal complexes (p < .05), and ethmoidal (p < .05) and sphenoidal sinuses (p < .05) was associated with acute @entity565 , but maxillary mucosal thickening was not (p = .44). CT scores differed significantly between @entity748 @entity1 (7.7 +/- 0.8 points) and control subjects (4.1 +/- 0.4 points) (p < .001). Nineteen of the 65 @entity748 @entity1 had @entity66 compared with two of the 62 control subjects (p < .001). Thirteen @entity748 @entity1 with @entity66 underwent follow-up CT 5 months later, and 11 of the 13 @entity1 showed improvement in CT score without having undergone specific therapy for @entity1244 . CONCLUSION: Mucosal thickening in the nasal passages and sphenoidal, ethmoidal, and frontal sinuses is more common in @entity1 with acute @entity565 than in control subjects. However, maxillary sinus mucosal thickening is no more common in @entity748 @entity1 than in control subjects.

1776

1777

1778

Temporal and regional regulation of alpha1, beta2 and beta3, but not alpha2, alpha4, alpha5, alpha6, beta1 or @entity1247 @entity1246 (A) receptor subunit messenger RNAs following one-week oral XXXX administration.

multiple_choice

The effect of prolonged @entity1245 administration on @entity1246 (A) receptor subunit (alpha1-6, beta1-3, @entity1247 ) messenger RNAs was investigated in the @entity35 hippocampus and cortex, among other brain areas. @entity35 were orally administered @entity1248 for one week, a protocol which results in @entity1245 anticonvulsant tolerance in vivo, and in the hippocampus in vitro, in the absence of behavioral signs of withdrawal. Autoradiographs of brain sections, hybridized with [35S]oligoprobes in situ, were examined immediately (day 0) or two days after drug treatment, when @entity35 were tolerant, or seven days after treatment, when tolerance had reversed, and were compared to sections from pair-handled, vehicle-treated controls. Alpha1 subunit messenger RNA level was significantly decreased in @entity1249 pyramidal cells and dentate granule cells at day 0, an effect which persisted only in @entity1249 neurons. Decreased "alpha1-specific" @entity575 grain density over a subclass of interneurons at the pyramidal cell border suggested concomitant regulation of interneuron @entity1246 (A) receptors. A reduction in beta3 subunit messenger RNA levels was more widespread among hippocampal cell groups ( @entity1249 , @entity1250 , @entity1251 and dentate gyrus), immediately and two days after treatment, and was also detected in the frontal and parieto-occipital cortices. Changes in beta2 subunit messenger RNA levels in @entity1249 , @entity1251 and dentate gyrus cells two days after ending @entity1248 treatment suggested a concomitant up-regulation of beta2 messenger RNA. There was a trend toward an increased level of alpha5, beta3 and @entity1247 subunit messenger RNAs in @entity1249 , @entity1251 and dentate gyrus cells, which was significant for the beta3 and @entity1247 subunit messenger RNAs in the frontal cortex seven days after ending @entity1248 treatment. There were no @entity1248 treatment-induced changes in any other @entity1246 (A) receptor subunit messenger RNAs. The messenger RNA levels of three (alpha1, beta2 and beta3) of nine @entity1246 (A) receptor subunits were discretely regulated as a function of time after ending one-week @entity1248 treatment related to the presence of anticonvulsant tolerance, but not dependence. The findings suggested that a localized switch in the subunit composition of @entity1246 (A) receptor subtypes involving these specific subunits may represent a minimal requirement for the changes in @entity1246 (A) receptor-mediated function recorded previously at hippocampal @entity1249 GABAergic synapses, associated with @entity1245 anticonvulsant tolerance.

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Temporal and regional regulation of alpha1, beta2 and beta3, but not alpha2, alpha4, alpha5, alpha6, beta1 or @entity1247 XXXX (A) receptor subunit messenger RNAs following one-week oral @entity1248 administration.

multiple_choice

The effect of prolonged @entity1245 administration on @entity1246 (A) receptor subunit (alpha1-6, beta1-3, @entity1247 ) messenger RNAs was investigated in the @entity35 hippocampus and cortex, among other brain areas. @entity35 were orally administered @entity1248 for one week, a protocol which results in @entity1245 anticonvulsant tolerance in vivo, and in the hippocampus in vitro, in the absence of behavioral signs of withdrawal. Autoradiographs of brain sections, hybridized with [35S]oligoprobes in situ, were examined immediately (day 0) or two days after drug treatment, when @entity35 were tolerant, or seven days after treatment, when tolerance had reversed, and were compared to sections from pair-handled, vehicle-treated controls. Alpha1 subunit messenger RNA level was significantly decreased in @entity1249 pyramidal cells and dentate granule cells at day 0, an effect which persisted only in @entity1249 neurons. Decreased "alpha1-specific" @entity575 grain density over a subclass of interneurons at the pyramidal cell border suggested concomitant regulation of interneuron @entity1246 (A) receptors. A reduction in beta3 subunit messenger RNA levels was more widespread among hippocampal cell groups ( @entity1249 , @entity1250 , @entity1251 and dentate gyrus), immediately and two days after treatment, and was also detected in the frontal and parieto-occipital cortices. Changes in beta2 subunit messenger RNA levels in @entity1249 , @entity1251 and dentate gyrus cells two days after ending @entity1248 treatment suggested a concomitant up-regulation of beta2 messenger RNA. There was a trend toward an increased level of alpha5, beta3 and @entity1247 subunit messenger RNAs in @entity1249 , @entity1251 and dentate gyrus cells, which was significant for the beta3 and @entity1247 subunit messenger RNAs in the frontal cortex seven days after ending @entity1248 treatment. There were no @entity1248 treatment-induced changes in any other @entity1246 (A) receptor subunit messenger RNAs. The messenger RNA levels of three (alpha1, beta2 and beta3) of nine @entity1246 (A) receptor subunits were discretely regulated as a function of time after ending one-week @entity1248 treatment related to the presence of anticonvulsant tolerance, but not dependence. The findings suggested that a localized switch in the subunit composition of @entity1246 (A) receptor subtypes involving these specific subunits may represent a minimal requirement for the changes in @entity1246 (A) receptor-mediated function recorded previously at hippocampal @entity1249 GABAergic synapses, associated with @entity1245 anticonvulsant tolerance.

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Temporal and regional regulation of alpha1, beta2 and beta3, but not alpha2, alpha4, alpha5, alpha6, beta1 or XXXX @entity1246 (A) receptor subunit messenger RNAs following one-week oral @entity1248 administration.

multiple_choice

The effect of prolonged @entity1245 administration on @entity1246 (A) receptor subunit (alpha1-6, beta1-3, @entity1247 ) messenger RNAs was investigated in the @entity35 hippocampus and cortex, among other brain areas. @entity35 were orally administered @entity1248 for one week, a protocol which results in @entity1245 anticonvulsant tolerance in vivo, and in the hippocampus in vitro, in the absence of behavioral signs of withdrawal. Autoradiographs of brain sections, hybridized with [35S]oligoprobes in situ, were examined immediately (day 0) or two days after drug treatment, when @entity35 were tolerant, or seven days after treatment, when tolerance had reversed, and were compared to sections from pair-handled, vehicle-treated controls. Alpha1 subunit messenger RNA level was significantly decreased in @entity1249 pyramidal cells and dentate granule cells at day 0, an effect which persisted only in @entity1249 neurons. Decreased "alpha1-specific" @entity575 grain density over a subclass of interneurons at the pyramidal cell border suggested concomitant regulation of interneuron @entity1246 (A) receptors. A reduction in beta3 subunit messenger RNA levels was more widespread among hippocampal cell groups ( @entity1249 , @entity1250 , @entity1251 and dentate gyrus), immediately and two days after treatment, and was also detected in the frontal and parieto-occipital cortices. Changes in beta2 subunit messenger RNA levels in @entity1249 , @entity1251 and dentate gyrus cells two days after ending @entity1248 treatment suggested a concomitant up-regulation of beta2 messenger RNA. There was a trend toward an increased level of alpha5, beta3 and @entity1247 subunit messenger RNAs in @entity1249 , @entity1251 and dentate gyrus cells, which was significant for the beta3 and @entity1247 subunit messenger RNAs in the frontal cortex seven days after ending @entity1248 treatment. There were no @entity1248 treatment-induced changes in any other @entity1246 (A) receptor subunit messenger RNAs. The messenger RNA levels of three (alpha1, beta2 and beta3) of nine @entity1246 (A) receptor subunits were discretely regulated as a function of time after ending one-week @entity1248 treatment related to the presence of anticonvulsant tolerance, but not dependence. The findings suggested that a localized switch in the subunit composition of @entity1246 (A) receptor subtypes involving these specific subunits may represent a minimal requirement for the changes in @entity1246 (A) receptor-mediated function recorded previously at hippocampal @entity1249 GABAergic synapses, associated with @entity1245 anticonvulsant tolerance.

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@entity1253 as novel biomarkers in paediatric XXXX .

multiple_choice

OBJECTIVES: @entity1 with @entity1252 are at risk for @entity731 and @entity209 . Cytokines produced by adipocytes, @entity1253 , are important in @entity413 /lipid metabolism and the development of @entity731 . The objectives of this study were to evaluate leptin, @entity1254 and ghrelin concentrations in paediatric @entity1252 (pSLE) and to correlate these concentrations with measures of disease activity, serum lipid concentrations, measures of insulin resistance and serum @entity1255 concentrations. METHODS: Two hundred and eight samples from 105 @entity1 with pSLE and 77 samples from 77 healthy paediatric controls were evaluated by ELISA to measure leptin, adiopnectin and ghrelin. Students' t-test was used for analysis. Concentrations of @entity1253 were correlated with disease activity, serum lipids, insulin resistance and @entity1255 . RESULTS: Overall 35 @entity1252 @entity1 (34%) had an abnormally elevated leptin level. The only significant correlation of leptin concentrations was with @entity1255 concentrations but not disease activity, @entity229 dose, lipids or insulin resistance. There was no difference in the mean @entity1254 concentrations between the control and @entity1 groups and none of the @entity1 samples were below the normal lower limit while seven were elevated. There was a significant correlation of @entity1254 concentrations with @entity229 dose, lipid concentrations and insulin resistance but not with disease activity or @entity1255 . Elevated ghrelin concentrations were found in 20% of the pSLE @entity1 . The only correlation of ghrelin concentrations was with @entity1255 . CONCLUSIONS: @entity1253 are novel biomarkers in pSLE. They may represent cardiovascular risk and are not just surrogate markers for disease activity, therapy or serum lipids. Their correlation with @entity731 needs to be explored.

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XXXX as novel biomarkers in paediatric @entity1252 .

multiple_choice

OBJECTIVES: @entity1 with @entity1252 are at risk for @entity731 and @entity209 . Cytokines produced by adipocytes, @entity1253 , are important in @entity413 /lipid metabolism and the development of @entity731 . The objectives of this study were to evaluate leptin, @entity1254 and ghrelin concentrations in paediatric @entity1252 (pSLE) and to correlate these concentrations with measures of disease activity, serum lipid concentrations, measures of insulin resistance and serum @entity1255 concentrations. METHODS: Two hundred and eight samples from 105 @entity1 with pSLE and 77 samples from 77 healthy paediatric controls were evaluated by ELISA to measure leptin, adiopnectin and ghrelin. Students' t-test was used for analysis. Concentrations of @entity1253 were correlated with disease activity, serum lipids, insulin resistance and @entity1255 . RESULTS: Overall 35 @entity1252 @entity1 (34%) had an abnormally elevated leptin level. The only significant correlation of leptin concentrations was with @entity1255 concentrations but not disease activity, @entity229 dose, lipids or insulin resistance. There was no difference in the mean @entity1254 concentrations between the control and @entity1 groups and none of the @entity1 samples were below the normal lower limit while seven were elevated. There was a significant correlation of @entity1254 concentrations with @entity229 dose, lipid concentrations and insulin resistance but not with disease activity or @entity1255 . Elevated ghrelin concentrations were found in 20% of the pSLE @entity1 . The only correlation of ghrelin concentrations was with @entity1255 . CONCLUSIONS: @entity1253 are novel biomarkers in pSLE. They may represent cardiovascular risk and are not just surrogate markers for disease activity, therapy or serum lipids. Their correlation with @entity731 needs to be explored.

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XXXX cold shock domain proteins: relationships to floral and silique development.

multiple_choice

Cold shock domain proteins (CSPs) are highly conserved from bacteria to higher plants and animals. Bacterial cold shock proteins function as RNA chaperones by destabilizing RNA secondary structures and promoting translation as an adaptative mechanism to low temperature stress. In animals, cold shock domain proteins exhibit broad functions related to growth and development. In order to understand better the function of CSPs in planta, detailed analyses were performed for @entity958 CSPs (AtCSPs) on the transcript and protein levels using an extensive series of tissue harvested throughout developmental stages within the entire life cycle of @entity958 . On both the transcript and protein levels, AtCSPs were enriched in shoot apical meristems and siliques. Although all AtCSPs exhibited similar expression patterns, @entity1256 was the most abundantly expressed gene. In situ hybridization analyses were also used to confirm that @entity1256 and @entity1257 transcripts accumulate in developing embryos and shoot apices. AtCSPs transcripts were also induced during a controlled floral induction study. In vivo ChIP analysis confirmed that an embryo expressed MADS box transcription factor, @entity1258 , interacts within two AtCSP promoter regions and alters the respective patterns of AtCSP transcription. Comparative analysis of AtCSP gene expression between Landsberg and Columbia ecotypes confirmed a 1000-fold reduction of @entity1257 gene expression in the Landsberg background. Analysis of the @entity1257 genomic locus identified multiple polymorphisms in putative regulatory cis-elements between the two ecotypes. Collectively, these data support the hypothesis that AtCSPs are involved in the transition to flowering and silique development in @entity958 .

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Short, full-dose adjuvant chemotherapy in high-risk adult soft tissue @entity242 : a randomized clinical trial from the XXXX Group and the Spanish @entity242 Group.

multiple_choice

PURPOSE: A previous randomized clinical trial by the @entity242 Group (ISG) had shown a survival benefit of adjuvant chemotherapy (CT) in high-risk extremity soft @entity242 (STS). However, the dose-intensity of the last two cycles was suboptimal. We then undertook a multicentric international phase III study to compare three and five cycles of the same CT. @entity1 AND METHODS: @entity1 were randomly assigned either to receive three cycles of preoperative CT with @entity1259 120 mg/m(2) and @entity1260 9 g/m(2) and @entity1261 (arm A) or to receive the same three cycles of preoperative CT followed by two further cycles of postoperative CT (arm B). Noninferiority of the primary end point, overall survival (OS), was assessed by the CI of the hazard ratio (HR; arm A/arm B) obtained from the Cox model. RESULTS: Between January 2002 and April 2007, 328 @entity1 were recruited (164 @entity1 in each arm). At a median follow-up of 63 months (interquartile range, 49 to 77 months), 100 @entity204 were recorded, 49 in arm A and 51 in arm B. Five-year OS probability was 0.70 for the entire group of @entity1 (0.68 in arm A and 0.71 in arm B). The HR of arm A versus arm B was 1.00 (90% CI, 0.72 to 1.39). CONCLUSION: In this population of @entity1 with high-risk localized STS, three cycles of full-dose preoperative CT were not inferior to five cycles. The outcome compares favorably with the expected survival of @entity1 with high-risk STS and was superimposable on the CT arm of the previous ISG trial.

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Short, full-dose adjuvant chemotherapy in high-risk adult soft tissue @entity242 : a randomized clinical trial from the @entity242 Group and the Spanish XXXX Group.

multiple_choice

PURPOSE: A previous randomized clinical trial by the @entity242 Group (ISG) had shown a survival benefit of adjuvant chemotherapy (CT) in high-risk extremity soft @entity242 (STS). However, the dose-intensity of the last two cycles was suboptimal. We then undertook a multicentric international phase III study to compare three and five cycles of the same CT. @entity1 AND METHODS: @entity1 were randomly assigned either to receive three cycles of preoperative CT with @entity1259 120 mg/m(2) and @entity1260 9 g/m(2) and @entity1261 (arm A) or to receive the same three cycles of preoperative CT followed by two further cycles of postoperative CT (arm B). Noninferiority of the primary end point, overall survival (OS), was assessed by the CI of the hazard ratio (HR; arm A/arm B) obtained from the Cox model. RESULTS: Between January 2002 and April 2007, 328 @entity1 were recruited (164 @entity1 in each arm). At a median follow-up of 63 months (interquartile range, 49 to 77 months), 100 @entity204 were recorded, 49 in arm A and 51 in arm B. Five-year OS probability was 0.70 for the entire group of @entity1 (0.68 in arm A and 0.71 in arm B). The HR of arm A versus arm B was 1.00 (90% CI, 0.72 to 1.39). CONCLUSION: In this population of @entity1 with high-risk localized STS, three cycles of full-dose preoperative CT were not inferior to five cycles. The outcome compares favorably with the expected survival of @entity1 with high-risk STS and was superimposable on the CT arm of the previous ISG trial.