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2098200

2098201

2098202

Extracorporeal photopheresis (ECP) in the treatment of XXXX ( @entity2132 )

multiple_choice

The aim of our study was to assess the efficacy of extracorporeal photopheresis (ECP) in @entity2132 ( @entity2132 ). Eleven @entity1 with chronic cutaneous @entity2132 were studied. Four had mucosal involvement and five had @entity358 . All had failed to improve on first- and second-line therapy. Three @entity1 received ECP alone; the remainder continued to receive @entity230 and/or immunosuppressive therapy. @entity1 received ECP twice monthly for 4 months and then once monthly for 3 months. They were evaluated by serial skin scores, mucosal and skin photography, pulmonary function tests, biochemical and haematological parameters. Nine @entity1 showed objective evidence of cutaneous improvement with a mean reduction in skin score of 48% overall. In the 10th @entity1 , skin scores and oral involvement improved on twice monthly ECP but deteriorated when reduced to once monthly. The final @entity1 died from @entity177 secondary to cyclosporin @entity137 . Two out of five @entity1 with lung involvement showed a mild improvement in pulmonary function tests. Liver function tests were abnormal in five @entity1 ; they improved in one and deteriorated in three. All @entity1 receiving concomitant immunosuppressive/ @entity134 therapy were able to reduce drug dosages by trial completion. Our results indicate that ECP can benefit @entity1 with cutaneous and mucosal chronic @entity2132 who have failed on first- and second-line therapies. The effect on the systemic manifestations of @entity2132 is less consistent.

2098203

2098204

2098205

XXXX : bolus tracking with a 40-detector CT scanner to time arterial phase imaging.

multiple_choice

PURPOSE: To evaluate prospectively bolus tracking to time @entity99 ( @entity99 ) imaging of @entity157 (HCCs) with a 40-detector computed tomographic (CT) scanner. MATERIALS AND METHODS: This study received institutional review board approval; informed consent was obtained. The study included 192 @entity1 (123 @entity1 , 69 @entity1 ; mean age, 67.6 years) with known or suspected @entity157 who underwent dynamic CT, including @entity99 scanning; CT depicted 111 hypervascular HCCs in 72 @entity1 . Scanning was performed with a 40-detector CT scanner, and bolus tracking was used to time the start of @entity99 imaging. @entity1 were randomly assigned to five protocols; @entity99 scanning was started at a specified interval after trigger threshold was reached: 9 seconds (protocol A), 12 seconds (protocol B), 15 seconds (protocol C), 18 seconds (protocol D), or 21 seconds (protocol E). Trigger threshold level was set at 100 HU above aortic baseline CT number. Enhancement values in the aorta and the @entity96 contrast (TLC) were measured. Dunnett multiple comparisons were performed to compare enhancement values among the five protocols. RESULTS: Mean scanning time for the whole liver was 2.1 seconds. Mean enhancement value of the aorta in protocols A, B, C, D, and E were 284.3 HU +/- 54.7, 293.8 HU +/- 51.0, 308.7 HU +/- 55.9, 291.5 HU +/- 42.2, and 235.5 HU +/- 51.2, respectively. Aortic enhancement was significantly lower in protocol E than in protocol A (P < .01); there was no significant difference between protocols A and B, A and C, and A and D. Mean TLCs in protocols A, B, C, D, and E were 23.4 HU +/- 7.6, 35.5 HU +/- 14.0, 36.2 HU +/- 6.8, 47.2 HU +/- 19.2, and 35.1 HU +/- 15.8, respectively. A significant difference was found only between protocols A and D (P < .01). CONCLUSION: Peak TLC during the @entity99 occurred 18 seconds after triggering.

2098206

2098207

2098208

Gene structure and polymorphism of an invertebrate XXXX synthase gene.

multiple_choice

@entity842 synthases (NOSs) are ubiquitous in living organisms. However, little is known about the evolution of this large gene family. The first inducible NOS to be described from an invertebrate regulates @entity311 parasite (Plasmodium spp.) development in the mosquito Anopheles stephensi. This single copy gene shows the highest homology to the vertebrate neuronal isoforms, followed by decreasing homology to endothelial and inducible isoforms. The open reading frame of 1247 @entity1522 is encoded by 19 exons, which span approximately 33 kilobases. More than 50% of the mosquito exons, distributed around the putative @entity1446 , calmodulin, and FAD/ @entity1110 cofactor-binding domains, are conserved with those of the three @entity1 genes. Repetitive elements identified within the larger introns include a polymorphic dinucleotide repeat, two tandem repeats, and a putative miniature inverted repeat transposable element. Sequence analysis and primer extension indicate that the upstream promoter is 'TATA-less' with multiple transcription start sites within approximately 250 base pairs of the initiation @entity1853 . Transcription factor binding sites in the 5'-flanking sequence demonstrate a bipartite distribution of lipopolysaccharide- and inflammatory cytokine-responsive elements that is strikingly similar to that described for vertebrate inducible NOS gene promoters.

2098209

2098210

2098211

The possible contribution of anti-Gal to XXXX .

multiple_choice

Anti- @entity19447 is a natural antibody specific for the alpha-galactosyl epitope. Previous studies suggested that @entity2743 ( @entity2743 ) @entity1 had @entity428 compared to normal controls, but titers returned to normal after treatment. We developed an anti-Gal enzyme-linked immunosorbent assay (ELISA) using the property of anti-Gal to bind tightly to @entity19 laminin. We found no significant correlations between anti-Gal and @entity2015 ( @entity2015 ) or free @entity1955 (T(4)) in untreated @entity2743 @entity1 (n = 15) without clinical @entity6875 or euthyroid, previously treated @entity2743 @entity1 with @entity6875 . There was a significant regression between @entity2015 and free T(4) in the @entity1378 @entity1 (p < 0.01). Addition of total anti- Gal antibody to the regression showed a trend toward improved correlation (p = 0.15 for improved correlation relative to @entity2015 and free T(4) alone), suggesting it may stimulate @entity2743 thyroid tissue. However, in contrast to previous studies we found @entity1378 @entity1 (n = 20) had lower levels of anti-Gal immunoglobulin G (IgG) (18.4 +/- 4.0 vs. 41.8 +/- 8.9) than normals (n = 36 p < 0.05). Interestingly, @entity1378 @entity1 without clinical @entity6875 tended to have lower IgG anti-Gal levels than euthyroid @entity1 with @entity6875 (p = 0.1). @entity1378 significantly lowers anti-Gal, but the possible increase of anti-Gal in @entity1 with @entity6875 suggests anti-Gal may play a role in @entity6875 , or may reflect the euthryoid status of these @entity1 . This trend needs further study.

2098212

2098213

2098214

Increased risk of XXXX after pregnancy.

multiple_choice

The improvement in @entity1669 during pregnancy and the subsequent exacerbation postpartum is secondary to immune system changes necessary to a normal pregnancy. Prior studies have shown that a clinically significant number of @entity1 develop @entity2743 ( @entity2743 ) in the postpartum period. The aim of this study was to examine the risk of post pregnancy @entity2743 and define @entity1 characteristics that may impact the diagnosis and treatment strategies for this group. We performed a retrospective review of 152 consecutive @entity1 , aged 18-39 years when diagnosed with @entity2743 , to examine the relation between disease diagnosis and prior pregnancy. Differences in @entity1 characteristics and treatment outcomes of @entity1 were analyzed. New York City population data were used to estimate a relative risk for the development of postpartum @entity2743 . We found that in parous @entity1 , 45% were diagnosed with @entity2743 in the postpartum period and 55% had an onset in subsequent years. No significant differences were noted in @entity1 characteristics or treatment outcomes. We found that the risk of @entity1 developing post pregnancy @entity2743 was greatest in the older @entity1 (35-39 years), with 56% developing @entity2743 compared to 42% of nulliparous @entity1 . These data, therefore, suggest an increased risk for older @entity1 . We were able to calculate the increase in estimated relative risk for postpartum disease by using control population data. The risk maximized at 5.6 for the age group 35-39 years when compared to the control population. These data support earlier studies that showed that a clinically significant number of @entity1 develop @entity2743 after childbirth compared to nulliparous @entity1 and extends this risk for many years. The mechanism of this long-standing increased susceptibility requires further delineation.

2098215

2098216

2098217

Modelling changes in transmural propagation and susceptibility to XXXX induced by volatile anaesthetics in ventricular tissue.

multiple_choice

Volatile anaesthetics such as @entity1508 , @entity5161 and @entity2614 inhibit membrane currents contributing to the ventricular action potential. Transmural variation in the extent of current blockade induces differential effects on action potential duration (APD) in the endocardium and epicardium which may be pro-arrhythmic. Biophysical modelling techniques were used to simulate the functional impact of anaesthetic-induced blockade of membrane currents on APD and effective refractory period (ERP) in @entity35 endocardial and epicardial cell models. Additionally, the transmural conduction of excitation waves in 1-dimensional cell arrays, the tissue's vulnerability to arrhythmogenesis and dynamic behaviour of re-entrant excitation in 2-dimensional cell arrays were studied. Simulated anaesthetic exposure reduced APD and ERP in both epicardial and endocardial cell models. The reduction in APD was greater in endocardial than epicardial cells, reducing transmural APD dispersion consistent with experimental data. However, the transmural ERP dispersion was augmented. All three anaesthetics increased the width of the tissue's vulnerable window during which a premature stimulus could induce unidirectional conduction block but only @entity1508 reduced the critical size of ventricular substrates necessary to initiate and sustain re-entrant excitation. All three anaesthetics accelerated the rate of re-entrant excitation waves, but only @entity1508 prolonged the lifespan of re-entry. These data illustrate in silico, that modest changes in ion channel conductance abbreviate @entity35 ventricular APD and ERP, reduce transmural APD dispersion, but augment transmural ERP dispersion. These changes collectively enhance the propensity for @entity943 generation and provide a substrate for re-entry circuits with a longer half life than in control conditions.

2098218

2098219

2098220

Expression of eosinophil chemotactic factors in XXXX .

multiple_choice

We have occasionally experienced eosinophilic abscess of the liver in @entity1 with @entity356 , suggesting that some eosinophil mobilizing (chemotactic and proliferative) factors might be produced by @entity189 cells. The aim of this study was to determine whether or not @entity356 expresses the well-known eosinophil chemotactic factors (ECFs) and whether or not the expression is related to the histologic subtypes. Seventeen consecutive surgically removed @entity5 were collected: 7 signet ring cell type, 7 poorly differentiated @entity420 , and 3 moderately differentiated @entity420 . Hematoxylin- @entity1711 stained sections were re-evaluated for eosinophil and mast cell infiltration. The expression of @entity1199 , @entity225 and @entity2841 ( @entity2841 ) were examined by immunocytochemical stain. There was no available frozen tissue for @entity1199 and @entity225 in one case. @entity356 expressed @entity1199 in all 16 cases, @entity225 in 12 of 16 cases and @entity2841 in 10 of 17 cases. Of particular interest, 7 of 10 @entity2841 -expressing @entity189 were signet ring cell type. Even in the remaining 3 cases, most @entity2841 -positive cells were signet ring cells scattered within @entity420 . No correlation of ECF expression between either eosinophil/mast cell infiltration or peripheral blood @entity1712 was identified. In conclusion, most @entity356 express the well-known ECFs and the expression of @entity2841 is specific for signet ring @entity189 cells.

2098221

2098222

2098223

From the archives of the AFIP: XXXX and tumorlike lesions: nonosseous lesions of the extraocular orbit.

multiple_choice

The histologic spectrum of nonosseous @entity5 and tumorlike lesions of the extraocular orbit in @entity1 differs from that in adults, and the appearance of these lesions at imaging reflects their pathologic features. @entity980 is the most @entity5 in @entity1 . This @entity5 usually manifests in young @entity1 , grows quite rapidly, and is fairly vascular. @entity75 are common orbital lesions in newborns and young @entity1 . The most prevalent of these are @entity7492 , a true @entity5 , and @entity1211 , @entity600 . @entity2695 is quite vascular, has a predictable course of proliferation followed by slow involution, and is distinguished on magnetic resonance images by the finding of flow voids within the mass and at its periphery. @entity1211 in the orbit is an anomaly of venous and lymphatic development that is characterized by unenhancing, cystic lymphatic and enhancing, solid venous components. Intralesional @entity548 is common and frequently produces distinctive fluid-fluid levels within the cystic portions. Unlike @entity2695 , @entity1211 grow with the @entity1 and never involute spontaneously. Infantile @entity81 is one of the @entity81 and affects newborns and young @entity1 . The @entity5 is nodular and composed of a zonal architecture, with frequent @entity548 or @entity39 in the central portion, characteristics that confer a target appearance at imaging. These lesions usually stop growing or spontaneously regress. All of these extraocular masses typically manifest with proptosis, and imaging differentiation is desirable because the treatments and prognoses vary greatly.

2098224

2098225

2098226

Optimization of spore and antifungal lipopeptide production during the solid-state fermentation of XXXX .

multiple_choice

@entity3881 TrigoCor 1448 was grown on @entity3505 middlings in 0.5-l solid-state fermentation (SSF) bioreactors for the production of an antifungal biological control agent. Total antifungal activity was quantified using a 96-well microplate bioassay against the plant pathogen @entity4278 @entity10327 . melonis. The experimental design for process optimization consisted of a 2(6-1) fractional factorial design followed by a central composite face-centered design. Initial SSF parameters included in the optimization were aeration, fermentation length, pH buffering, peptone addition, @entity1507 addition, and incubator temperature. Central composite face-centered design parameters included incubator temperature, aeration rate, and initial moisture content (MC). Optimized fermentation conditions were determined with response surface models fitted for both spore concentration and activity of biological control product extracts. Models showed that activity measurements and spore production were most sensitive to substrate MC with highest levels of each response variable occurring at maximum moisture levels. Whereas maximum antifungal activity was seen in a limited area of the design space, spore production was fairly robust with near maximum levels occurring over a wider range of fermentation conditions. Optimization resulted in a 55% increase in inhibition and a 40% increase in spore production over nonoptimized conditions.

2098227

2098228

2098229

Analysis of @entity5549 gene ( XXXX polymorphism) in the clinical response to SSRIs in @entity308 @entity1 of European origin.

multiple_choice

INTRODUCTION AND OBJECTIVES: There is convincing evidence of interactions between serotonergic and dopaminergic systems and it seems that an increase of @entity935 concentration in the whole brain could be a limiting factor for the antidepressant like effect of antidepressants. The @entity5549 gene might be a good candidate for explaining some aspects of the pharmacological response to SSRIs. METHODS: The aim of our study was to analyse the @entity27510 functional polymorphism on @entity5549 gene and clinical response (4 weeks) and clinical remission (6/8 and 12 weeks) in two samples of @entity308 @entity1 (DSM-IV) treated with SSRIs of Italian and Spanish origin. Clinical outcome was measured using 21 items Hamilton scale, weekly in the Italian sample (along 6 weeks) and monthly in the Spanish one (along 12 weeks). RESULTS: No overall effect of genotype or genotypextime interaction was detected. However, we observed a genotypextime interaction on @entity3831 decrease for @entity837 treatment (F((4.6,317.5)) = 3.38, P = 0.007) in the Spanish sample. No clear effect was observed in the Italian sample. The three samples were pooled in order to test if carrying the Met/Met genotype confers an increased risk for non-remission at 6-8 weeks. The results showed that Met/Met carriers have an odds ratio of 2.21 (95% CI [1.20-4.12]) for non-remission (chi(2) = 7.43, df = 2, P = 0.006). The Met/Met effect was not observed in response at 4th week (for all SSRI treatments) or in remission at 12th week ( @entity837 treatment). CONCLUSIONS: @entity5549 gene could have a small and indirect effect of clinical response to SSRIs by slowing-down the antidepressant action along the follow-up, basically in @entity837 treatment.

2098230

2098231

2098232

Analysis of @entity5549 gene ( @entity27510 polymorphism) in the clinical response to SSRIs in XXXX @entity1 of European origin.

multiple_choice

INTRODUCTION AND OBJECTIVES: There is convincing evidence of interactions between serotonergic and dopaminergic systems and it seems that an increase of @entity935 concentration in the whole brain could be a limiting factor for the antidepressant like effect of antidepressants. The @entity5549 gene might be a good candidate for explaining some aspects of the pharmacological response to SSRIs. METHODS: The aim of our study was to analyse the @entity27510 functional polymorphism on @entity5549 gene and clinical response (4 weeks) and clinical remission (6/8 and 12 weeks) in two samples of @entity308 @entity1 (DSM-IV) treated with SSRIs of Italian and Spanish origin. Clinical outcome was measured using 21 items Hamilton scale, weekly in the Italian sample (along 6 weeks) and monthly in the Spanish one (along 12 weeks). RESULTS: No overall effect of genotype or genotypextime interaction was detected. However, we observed a genotypextime interaction on @entity3831 decrease for @entity837 treatment (F((4.6,317.5)) = 3.38, P = 0.007) in the Spanish sample. No clear effect was observed in the Italian sample. The three samples were pooled in order to test if carrying the Met/Met genotype confers an increased risk for non-remission at 6-8 weeks. The results showed that Met/Met carriers have an odds ratio of 2.21 (95% CI [1.20-4.12]) for non-remission (chi(2) = 7.43, df = 2, P = 0.006). The Met/Met effect was not observed in response at 4th week (for all SSRI treatments) or in remission at 12th week ( @entity837 treatment). CONCLUSIONS: @entity5549 gene could have a small and indirect effect of clinical response to SSRIs by slowing-down the antidepressant action along the follow-up, basically in @entity837 treatment.

2098233

2098234

2098235

Analysis of XXXX gene ( @entity27510 polymorphism) in the clinical response to SSRIs in @entity308 @entity1 of European origin.

multiple_choice

INTRODUCTION AND OBJECTIVES: There is convincing evidence of interactions between serotonergic and dopaminergic systems and it seems that an increase of @entity935 concentration in the whole brain could be a limiting factor for the antidepressant like effect of antidepressants. The @entity5549 gene might be a good candidate for explaining some aspects of the pharmacological response to SSRIs. METHODS: The aim of our study was to analyse the @entity27510 functional polymorphism on @entity5549 gene and clinical response (4 weeks) and clinical remission (6/8 and 12 weeks) in two samples of @entity308 @entity1 (DSM-IV) treated with SSRIs of Italian and Spanish origin. Clinical outcome was measured using 21 items Hamilton scale, weekly in the Italian sample (along 6 weeks) and monthly in the Spanish one (along 12 weeks). RESULTS: No overall effect of genotype or genotypextime interaction was detected. However, we observed a genotypextime interaction on @entity3831 decrease for @entity837 treatment (F((4.6,317.5)) = 3.38, P = 0.007) in the Spanish sample. No clear effect was observed in the Italian sample. The three samples were pooled in order to test if carrying the Met/Met genotype confers an increased risk for non-remission at 6-8 weeks. The results showed that Met/Met carriers have an odds ratio of 2.21 (95% CI [1.20-4.12]) for non-remission (chi(2) = 7.43, df = 2, P = 0.006). The Met/Met effect was not observed in response at 4th week (for all SSRI treatments) or in remission at 12th week ( @entity837 treatment). CONCLUSIONS: @entity5549 gene could have a small and indirect effect of clinical response to SSRIs by slowing-down the antidepressant action along the follow-up, basically in @entity837 treatment.

2098236

2098237

2098238

Analysis of @entity5549 gene ( @entity27510 polymorphism) in the clinical response to SSRIs in @entity308 XXXX of European origin.

multiple_choice

INTRODUCTION AND OBJECTIVES: There is convincing evidence of interactions between serotonergic and dopaminergic systems and it seems that an increase of @entity935 concentration in the whole brain could be a limiting factor for the antidepressant like effect of antidepressants. The @entity5549 gene might be a good candidate for explaining some aspects of the pharmacological response to SSRIs. METHODS: The aim of our study was to analyse the @entity27510 functional polymorphism on @entity5549 gene and clinical response (4 weeks) and clinical remission (6/8 and 12 weeks) in two samples of @entity308 @entity1 (DSM-IV) treated with SSRIs of Italian and Spanish origin. Clinical outcome was measured using 21 items Hamilton scale, weekly in the Italian sample (along 6 weeks) and monthly in the Spanish one (along 12 weeks). RESULTS: No overall effect of genotype or genotypextime interaction was detected. However, we observed a genotypextime interaction on @entity3831 decrease for @entity837 treatment (F((4.6,317.5)) = 3.38, P = 0.007) in the Spanish sample. No clear effect was observed in the Italian sample. The three samples were pooled in order to test if carrying the Met/Met genotype confers an increased risk for non-remission at 6-8 weeks. The results showed that Met/Met carriers have an odds ratio of 2.21 (95% CI [1.20-4.12]) for non-remission (chi(2) = 7.43, df = 2, P = 0.006). The Met/Met effect was not observed in response at 4th week (for all SSRI treatments) or in remission at 12th week ( @entity837 treatment). CONCLUSIONS: @entity5549 gene could have a small and indirect effect of clinical response to SSRIs by slowing-down the antidepressant action along the follow-up, basically in @entity837 treatment.

2098239

2098240

2098241

Phrenic XXXX caused by interscalene brachial plexus block: effects of digital pressure and a low volume of local anesthetic.

multiple_choice

BACKGROUND AND OBJECTIVES: Interscalene brachial plexus block (ISB) is associated with @entity616 and diaphragmatic @entity912 when high volumes (40-50 mL) of local anesthetic are injected. The goal of our study was to test if a low volume of local anesthetic administered while maintaining proximal digital pressure might more selectively block the @entity2198 . METHODS: Twenty healthy @entity1 undergoing ISB for orthopedic surgery of the upper extremity were randomly allocated to receive either 20 mL 1.5% @entity10541 while proximal digital pressure to the site of puncture was performed, or 40 mL 1.5% @entity10541 without digital pressure. Spirometry and clinical data were evaluated at baseline, 10, and 90 minutes after accomplishing the block and after the motor and sensory block resolved. Diaphragmatic excursion during deep inspiration was also evaluated 90 minutes after the block was performed, with the @entity1 in the sitting position. RESULTS: Interscalene brachial plexus block produced diaphragmatic @entity912 in all @entity1 included in the study, as demonstrated by the pulmonary function testing and the chest radiograph. No significant differences were found in any of the parameters studied. At 10 minutes, baseline functional residual capacity had diminished by 34 +/- 10% in the 40 mL group and 37 +/- 13% in the 20 mL group. Maximum cephalad sensory dermatome level was also similar in both groups, being @entity4417 or above in all @entity1 . Ipsilateral hemidiaphragmatic motion was similar in both groups (3.2 +/- 2.3 cm in the 40 mL group and 2.6 +/- 1.7 cm in the 20 mL group). However, in no case was @entity1353 manifested. CONCLUSIONS: Decreasing the volume of local anesthetic and applying proximal digital pressure to the site of injection is not effective in reducing the cervical block spread and the frequency or intensity of diaphragmatic @entity912 during interscalene ISB.

2098242

2098243

2098244

Performance and dietary preferences of XXXX grazing chicory, birdsfoot trefoil or alfalfa in north central Alberta.

multiple_choice

Little information exists on the performance of deer on alternative forage species in northern temperate environments during summer and fall, the period of inherent maximum growth in deer. In performance and choice experiments, we compared live @entity1017 (g/kg(0.75)/day), absolute [kg/ha @entity62 ( @entity62 )] and relative (% @entity62 ) herbage utilization, relative preference index (RPI) as well as plant community visitation of @entity4325 grazing alfalfa (Medicago sativa), birdsfoot trefoil (Lotus corniculatus) or chicory (Cichorium intybus) in north central Alberta, Canada. Herbage phytomass and quality was also measured on the grazed pastures. Alfalfa had higher @entity62 yields and crude protein concentrations than chicory and trefoil. Chicory had lower neutral detergent fiber concentrations than the other forages. @entity5569 concentrations were greatest in birds foot trefoil (nearly 55 g/kg @entity62 ), well above those in the other forages (<5 g/kg @entity62 ). Live @entity1017 was similar among deer feeding within the paddocks seeded to birds foot trefoil and chicory, and more than two times higher (p < 0.05) than deer feeding in paddocks seeded to alfalfa. Deer spent more grazing time (about 40%) on chicory pastures than on alfalfa and birds foot trefoil pastures. RPI values were greatest for birds foot trefoil at 2.11, intermediate for chicory at 1.40, and lowest for alfalfa at <0.60. Absolute herbage utilization remained similar (p > 0.05) among the three forage species. In contrast, relative herbage utilization was greater from birds foot trefoil (52% @entity62 ) than chicory (40% @entity62 ) or alfalfa (25% @entity62 ). These results suggest that the use of alfalfa with other alternative forages may prove beneficial to deer production, rather than using alfalfa pasture alone.

2098245

2098246

2098247

Naevus-associated XXXX : cause or chance?

multiple_choice

Controversies exist regarding the true incidence and significance of the histological association between @entity8205 and @entity320 . The current study was undertaken to determine the incidence of @entity8205 histologically associated with @entity320 , to compare the clinicopathological profiles of @entity320 associated with a @entity9397 (MN+) and @entity320 not associated with a @entity9397 (MN-), and to verify the interobserver reliability of classifying the @entity9397 remnants as congenital or acquired. We evaluated 131 @entity1 with invasive @entity320 < or = 4 mm in thickness with a Clark's level < V. Histological evidence of an associated @entity9397 was found in 27 out of 131 @entity320 cases (20.6%). MN+ were significantly more frequent among males compared with MN-(P = 0.002) and were predominantly located on the trunk (P =0.001). No significant differences between MN+ and MN- were found in the distribution of histotype, Clark's level and thickness. Among MN-, the @entity9397 component showed acquired features in 14 cases (51.8%), whereas 12 cases (44.5%) had features of small superficial congenital naevi; in one case (3.7%) a confident distinction between congenital and acquired @entity9397 could not be made. Overall, there was concordance among the three observers in the diagnosis of the type of @entity9397 remnants in 81.4% of cases (kappa = 0.78; P<0.0001). We conclude that, although the majority of cutaneous @entity320 arise de novo, in approximately 20% of cases an associated @entity9397 is found. Our observation that MN+ and MN- have different clinicopathological profiles suggests that, at least for some cases, a causal relationship between the two lesions may be present. However, when the @entity9397 is histopathologically adjacent to the @entity320 , the possibility of a collision event cannot be ruled out. Finally, we documented a significant concordance among examiners in the diagnosis of the congenital versus acquired nature of the associated @entity9397 . This suggests that the histopathological criteria generally employed to distinguish between congenital and acquired naevi have good reproducibility.

2098248

2098249

2098250

The Chiari/ XXXX complex presenting in adults with myelomeningocoele: an indication for early intervention.

multiple_choice

OBJECTIVE: To determine how adults with myelomeningocoele who develop the Chiari/ @entity1644 complex present, and to determine if surgical intervention influences outcome in these @entity1 . METHODS: A chart review of the 220 @entity1 who attend a clinic for adults with spina bifida and @entity1276 (CASBAH), and follow-up of the five cases with myelomeningocoele who had surgical intervention for associated symptomatic Chiari/ @entity1644 complex. RESULTS: Bilateral upper limb weakness and @entity5653 were the commonest presenting symptoms (four @entity1 ). @entity132 (three @entity1 ) was also common, @entity1282 (one) and @entity2055 (one) occurring less often. The median time to surgical intervention was 36 months. Two @entity1 had a shunting procedure performed in isolation, two foramen magnum decompression in addition to a shunting procedure and one a foramen magnum decompression. Surgical intervention did not completely reverse problems attributed to the Chiari/ @entity1644 complex in any of the cases. One @entity1 died post-operatively. Of the four who survived one had some improvement in function post-operatively, two remained static and one had further mild deterioration. CONCLUSION: All adults with myelomeningocoele should be questioned about changes in upper limb function for early detection of Chiari/ @entity1644 complex. Our results suggest that early intervention is needed if further deterioration is to be avoided, and to improve the chances of neurological and functional recovery.

2098251

2098252

2098253

[Endoscopic removal of XXXX through laparoscopic access of the ureter and the pelvis].

multiple_choice

PURPOSE: We studied the efficiency and the morbidity of endoscopic @entity1290 during laparoscopic @entity1901 . MATERIAL AND METHODS: Six @entity1 presenting with an @entity1901 resisting to ESWL and four @entity1 presenting with an UPJ obstruction were studied. Every @entity1 had one to five associated @entity1290 . The @entity1 were operated with transperitoneal laparoscopic ureterolithotomy or pyeloplasty. An endoscopy of the upper urinary tract was realized during the same operating time through laparoscopic access. A flexible ureteroscope (five cases) or semi-flexible ureteroscope (one case) were used after ureterolithotomy. A fibroscope (four cases) was used before pyeloplasty. The endoscope was introduced through the port of the iliac fossa and the stones were extracted with a basket grasper. The @entity1 were followed by abdominal plain film 12 weeks after surgery, by IPV six weeks after surgery and then annually with abdominal plain film and ultrasound. RESULTS: No operative complication arose. Nine of 10 @entity1 had a complete extraction of the @entity1290 (one @entity1 had an extraction only of four out of five @entity1290 ). No damage of any endoscope was observed. At a minimum follow-up of 18 months, no @entity292 nor stenosis of the ureter was diagnosed. CONCLUSION: Endoscopic @entity1290 through laparoscopic access of the upper urinary tract is effective, sure and reproducible. Such procedure requires experience in laparoscopy and endoscopy of the upper urinary tract. The evaluation of this procedure must be pursued.

2098254

2098255

2098256

Treatment of XXXX by primary coronary angioplasty or intravenous thrombolysis in the "real world": one-year results from a nationwide French survey.

multiple_choice

BACKGROUND: Recent randomized trials comparing primary coronary angioplasty and intravenous thrombolysis at the acute stage of @entity583 have shown a limited but definite advantage for primary angioplasty. The aim of this study was to document 1-year outcome in @entity1 receiving either thrombolysis or primary angioplasty for @entity583 in the "real world." METHODS AND RESULTS: We used a nationwide prospective registry of all @entity1 admitted for @entity583 in French intensive care units in November 1995. Of the 721 @entity1 who received reperfusion therapy, 152 were treated with primary angioplasty and 569 received intravenous thrombolysis. The two groups were remarkably similar with respect to all baseline descriptors, except that a higher proportion of @entity1 in the angioplasty group had a history of @entity64 (10% versus 2%, P<0.01). In-hospital outcome was not different in the 2 groups. One-year survival was 85.5% in the angioplasty group and 89. 5% in the thrombolysis group (P=0.18). Multivariate analysis showed that older age, anterior location of @entity1188 , female sex, and history of @entity712 were related to 1-year mortality. In @entity1 alive on day 5, the use of primary angioplasty and higher Killip class were additional adverse prognostic indicators. CONCLUSIONS: The results of this large registry of real-world practice indicate no survival benefit for @entity1 treated with primary angioplasty compared with those who received thrombolytic therapy.

2098257

2098258

2098259

Influence of an interventional program on resource use and cost in pediatric XXXX .

multiple_choice

OBJECTIVE: Asthma is the most common chronic condition of childhood, for which morbidity, mortality, and cost are increasing. This study was performed to determine whether @entity1 education and assignment to a primary care provider improve outcomes and cost in the management of pediatric @entity565 . STUDY DESIGN: A prospective pilot study of 61 @entity1 was conducted with a retrospective review. Data were obtained from health and pharmacy records. @entity1 AND METHODS: Sixty-one unassigned pediatric @entity565 @entity1 who were noted to be frequent users of emergency department services and who had no primary care provider were identified. This cohort received @entity565 education and was assigned a provider trained in the national @entity565 guidelines. Hospital admissions, Emergency Department and clinic visits, use of @entity2263 agonists and anti-inflammatory drugs, number of chest radiographs, and continuity of care were recorded for a mean of 58.1 months before and 11.2 months after the intervention. A cost analysis was done. RESULTS: All measured parameters showed favorable changes after intervention, with the decrease in the number of prescriptions of monthly inhaled anti-inflammatory drugs and chest radiographs ordered being statistically significant (P = 0.007 and P = 0.040, respectively). Monthly admissions, @entity341 , and clinic visits declined after intervention when evaluated after 22.8 months of follow up. Annual resource savings after intervention was estimated to be 4845.29 per @entity1 for this military hospital. CONCLUSIONS: A combined intervention consisting of provider and @entity1 education and assignment to a primary care provider was associated with improved care and economic outcomes in this group.

2098260

2098261

2098262

Unrelated donor reduced-intensity allogeneic hematopoietic stem cell transplantation for relapsed and XXXX .

multiple_choice

Myeloablative allogeneic hematopoietic cell transplantation (HCT) may cure @entity1 with relapsed or @entity978 ( @entity978 ), but is associated with a high treatment-related mortality (TRM). Reduced-intensity and nonmyeloablative (RIC/NST) conditioning regimens aim to lower TRM. We analyzed the outcomes of 143 @entity1 undergoing unrelated donor RIC/NST HCT for relapsed and refractory @entity978 between 1999 and 2004 reported to the Center for International Blood and Marrow Transplant Research (CIBMTR). @entity1 were heavily pretreated, including autologous HCT in 89%. With a median follow-up of 25 months, the probability of TRM at day 100 and 2 years was 15% (95% confidence interval [CI] 10%-21%) and 33% (95% CI 25%-41%), respectively. The probabilities of progression free survival (PFS) and overall survival (OS) were 30% and 56% at 1 year and 20% and 37% at 2 years. The presence of extranodal disease and the Karnofsky Performance Scale (KPS) <90 were significant risk factors for TRM, PFS, and OS, whereas chemosensitivity at transplantation was not. Dose intensity of the conditioning regimen (RIC versus NST) did not impact outcomes. Unrelated donor HCT with RIC/NST can salvage some @entity1 with relapsed/refractory @entity978 , but relapse remains a common reason for treatment failure. Clinical studies should be aimed at reducing the incidence of @entity2132 ( @entity2132 ) and relapse.

2098263

2098264

2098265

XXXX during pediatric extracorporeal life support: incidence and risk factors.

multiple_choice

OBJECTIVE: Identify the incidence and risk factors for development of @entity149 of pediatric extracorporeal life support (ECLS). DESIGN: Retrospective review of Extracorporeal Life Support Organization (ELSO) registry database. SETTING: Pediatric intensive care units of 115 tertiary centers internationally. @entity1 : Pediatric @entity1 , 1 month to 18 yrs of age, who had ECLS between the years 1981-2002. MEASUREMENTS AND MAIN RESULTS: Data concerning 4,942 @entity1 who underwent one run of ECLS were analyzed. Six hundred thirty-six @entity1 (12.9%) developed acute, severe CNS complications. @entity1 who required ECLS during extracorporeal cardiopulmonary resuscitation (n = 161; 3.3%) were more likely to develop CNS complications (n = 42; 26.1%) than @entity1 who did not have extracorporeal cardiopulmonary resuscitation (p < .001; odds ratio [OR], 2.48; 95% confidence interval [CI], 1.73-3.57). Stepwise logistic regression analysis of therapies @entity1 received before initiation of ECLS showed that the use of a left ventricular assist device (p = .001; OR, 3.45; 95% CI, 1.64-7.22), @entity3157 (p < .001; OR, 1.61; 95% CI, 1.26-2.05), and vasopressor/inotropic medications (p = .035; OR, 1.22; 95% CI, 1.01-1.48) were significant independent predictors of development of CNS complications. Among @entity1 who had @entity358 as an indication for ECLS, the CNS complication rate was significantly higher for those treated with venoarterial ECLS than those who had venovenous ECLS (13.5% vs. 5.7%; p < .001; OR, 0.43; 95% CI, 0.34-0.67). Multiple logistic regression analysis of the complications other than CNS complications associated with the use of ECLS showed that pH <7.20, @entity1011 concentration >3.0 mg/dL, use of inotropes, presence of myocardial stun, and requirement of cardiopulmonary resuscitation during ECLS independently predicted development of CNS complications. CONCLUSION: @entity1 who have @entity520 , a @entity3157 or inotrope/vasopressor requirement, cardiopulmonary resuscitation, or a left ventricular assist device before initiation of ECLS are at greater risk for development of CNS complications. After initiation of ECLS, @entity1 who develop @entity177 or @entity520 or undergo venoarterial ECLS should be closely monitored for development of CNS complications.

2098266

2098267

2098268

The role of postoperative colonoscopic surveillance after radical surgery for XXXX : a prospective, randomized clinical study.

multiple_choice

BACKGROUND: Although colonoscopy plays an important role in postoperative surveillance of @entity1 with @entity14 , the optimum protocol for colonoscopic surveillance has not been established. OBJECTIVE: Our purpose was to compare the efficacy of 2 different colonoscopic surveillance strategies in terms of both survival and recurrence resectability. DESIGN: Prospective, randomized, controlled trial. SETTING: A teaching hospital in Sun Yat-sen University. @entity1 : Three hundred twenty-six consecutive @entity1 undergoing radical surgery for @entity14 . INTERVENTION: In the intensive colonoscopic surveillance group (ICS group, n = 165), colonoscopy was performed at 3-month intervals for 1 year, at 6-month intervals for the next 2 years, and once a year thereafter. In the routine colonoscopic surveillance group (RCS group, n = 161), colonoscopy was performed at 6 months, 30 months, and 60 months postoperatively. MAIN OUTCOME MEASUREMENTS AND RESULTS: The 5-year survival rate was 77% in the ICS group and 73% in the RCS group (P > .05). Postoperative @entity14 was detected in 13 @entity1 (8.1%) in the ICS group and in 18 @entity1 (11.4%) in the RCS group. In the ICS group, there were more asymptomatic postoperative @entity14 (P = .04), more @entity1 had reoperation with curative intent (P = .048), and the probability of survival after postoperative @entity14 was higher (P = .03). LIMITATION: Lack of detailed characterization of metachronous @entity2513 in these @entity1 . CONCLUSIONS: Although the @entity1 in the ICS group had more curative operations for postoperative @entity14 and survived significantly longer, ICS itself did not improve overall survival.

2098269

2098270

2098271

Understanding the epidemiology and progression of XXXX .

multiple_choice

OBJECTIVES: This review examines the burden and patterns of disease in @entity1252 ( @entity1252 ) and the influence and interactions of gender, ethnicity, age, and psychosocial attributes with respect to disease progression, focusing on issues relevant to clinical practice and research. METHODS: PubMed literature search complemented by review of bibliographies listed in identified articles. RESULTS: An increased risk among reproductive age @entity1 is clearly seen in African Americans in the United States. However, in other populations, a different pattern is generally seen, with the highest age-specific incidence rates occurring in @entity1 after age 40 years. The disease is 2 to 4 times more frequent, and more severe, among nonwhite populations around the world and tends to be more severe in @entity1 and in pediatric and late-onset @entity1252 . @entity1252 @entity1 now experience a higher than 90% survival rate at 5 years. The less favorable survival experience of ethnic minorities is possibly related to socioeconomic status rather than to ethnicity per se, and adequate social support has been shown to be a protective factor, in general, in @entity1252 @entity1 . Discordance between physician and @entity1 ratings of disease activity may affect quality of care. CONCLUSIONS: Our understanding of ways to improve outcomes in @entity1252 @entity1 could benefit from @entity1 -oriented research focusing on many dimensions of disease burden. Promising research initiatives include the inclusion of community-based @entity1 in longitudinal studies, use of self-assessment tools for rating disease damage and activity, and a focus on self-perceived disease activity and treatment compliance.

2098272

2098273

2098274

Quantitative analysis of electrically evoked auditory brainstem responses in implanted @entity1 with XXXX /dyssynchrony.

multiple_choice

OBJECTIVE: Cochlear implantation is a common treatment approach for @entity1 with @entity2167 /dyssynchrony ( @entity1278 / @entity195 ) who do not benefit from hearing aids. The auditory brainstem response (ABR) is a measure of neural synchrony along the auditory pathway up through the brainstem. By definition, acoustically evoked ABR is absent in @entity1278 / @entity195 , however, ABR can be elicited by electrical stimulation through the cochlear implant (electrically evoked ABR [EABR]). Reports of EABR with @entity1278 / @entity195 to date have been primarily descriptive in nature. The objective of this study was to quantify EABR wave V measures in implanted @entity1 with and without @entity1278 / @entity195 . STUDY DESIGN: Retrospective analysis of EABR waveforms from March 2000 through February 2005. SETTING: Comprehensive Cochlear Implant Program/Tertiary Referral Center. @entity1 : Pediatric cochlear implant users of two etiologic groups: congenital @entity1278 / @entity195 (n = 5) and other congenital profound @entity1274 (n = 27). INTERVENTION: Diagnostic. MAIN OUTCOME MEASURES: Intraoperative EABR wave V threshold, suprathreshold amplitude, and latency measures were compared between groups. RESULTS: The EABR threshold and suprathreshold amplitude measures across the population were variable regardless of etiology. With some exceptions, a trend was observed for the @entity1278 / @entity195 group that included average or below-average thresholds and below-average suprathreshold response amplitudes. CONCLUSION: Cochlear implantation can provide synchronous neural responses to auditory stimulation in @entity1278 / @entity195 , as previously known. The quantification of EABR measures in this study indicates that subjects with @entity1278 / @entity195 have sufficient neural sensitivity to electrical stimulation, however, they may experience less robust neural responses at suprathreshold levels. Given the heterogeneity of potential causes of @entity1278 / @entity195 , however, caution needs to be applied when grouping this population for analyses.

2098275

2098276

2098277

Quantitative analysis of electrically evoked auditory brainstem responses in implanted XXXX with @entity2167 /dyssynchrony.

multiple_choice

OBJECTIVE: Cochlear implantation is a common treatment approach for @entity1 with @entity2167 /dyssynchrony ( @entity1278 / @entity195 ) who do not benefit from hearing aids. The auditory brainstem response (ABR) is a measure of neural synchrony along the auditory pathway up through the brainstem. By definition, acoustically evoked ABR is absent in @entity1278 / @entity195 , however, ABR can be elicited by electrical stimulation through the cochlear implant (electrically evoked ABR [EABR]). Reports of EABR with @entity1278 / @entity195 to date have been primarily descriptive in nature. The objective of this study was to quantify EABR wave V measures in implanted @entity1 with and without @entity1278 / @entity195 . STUDY DESIGN: Retrospective analysis of EABR waveforms from March 2000 through February 2005. SETTING: Comprehensive Cochlear Implant Program/Tertiary Referral Center. @entity1 : Pediatric cochlear implant users of two etiologic groups: congenital @entity1278 / @entity195 (n = 5) and other congenital profound @entity1274 (n = 27). INTERVENTION: Diagnostic. MAIN OUTCOME MEASURES: Intraoperative EABR wave V threshold, suprathreshold amplitude, and latency measures were compared between groups. RESULTS: The EABR threshold and suprathreshold amplitude measures across the population were variable regardless of etiology. With some exceptions, a trend was observed for the @entity1278 / @entity195 group that included average or below-average thresholds and below-average suprathreshold response amplitudes. CONCLUSION: Cochlear implantation can provide synchronous neural responses to auditory stimulation in @entity1278 / @entity195 , as previously known. The quantification of EABR measures in this study indicates that subjects with @entity1278 / @entity195 have sufficient neural sensitivity to electrical stimulation, however, they may experience less robust neural responses at suprathreshold levels. Given the heterogeneity of potential causes of @entity1278 / @entity195 , however, caution needs to be applied when grouping this population for analyses.

2098278

2098279

2098280

Islet cell membrane antigens activate diabetogenic XXXX + T-cells in the BB/Wor @entity35 .

multiple_choice

Type 1 @entity6 is a major histocompatibility complex (MHC) class II-associated @entity792 mediated by beta-cell-specific T-cells and characterized by circulating autoantibodies to beta-cell molecules. In the BB/Wor @entity6 -prone (DP) @entity35 , type 1 @entity6 develops spontaneously with an incidence of >90%. BB @entity6 can be adoptively transferred to naive syngeneic or MHC class II-compatible @entity35 with islet cell-activated T-cell lines derived from diabetic BB/Wor @entity35 . However, the target beta-cell autoantigen(s) in BB @entity6 has not yet been defined. BB @entity35 T-cell lines activated in vitro with @entity1358 ( @entity1358 ) and BB islet cell crude membranes (CM), but not islet cell cytosol, adoptively transfer @entity6 into young DP recipients. To determine if the target autoantigen is an integral or peripheral membrane protein, islet cell CM were treated with 0.5 mol/l @entity4338 or 0.2 mol/l @entity4339 (pH 11). Both treatments selectively extract peripheral proteins from the cell membrane without affecting the disposition of integral (transmembrane) proteins. T-cell lines activated in vitro with @entity1358 and 0.5 mol/l @entity4338 , or pH 11 (0.2 mol/l @entity4339 )-treated islet cell CM, transferred @entity6 into young DP @entity35 . Conversely, T-cell lines activated in vitro with @entity1358 and the supernatant of 0.5 mol/l @entity4338 -treated CM (containing extracted peripheral proteins), did not adoptively transfer @entity6 . After activation in vitro with islet cell membrane antigens, the @entity6 -inducing cell lines were comprised of both @entity11264 + CD8- T-cells and 10-30% B-cells. We conclude that a major @entity11264 + T-cell target autoantigen in BB @entity6 is a membrane-associated beta-cell molecule with the characteristics of an integral beta-cell membrane protein. The identification of this MHC class II-restricted beta-cell target molecule will allow the design of antigen-specific intervention protocols to prevent the onset of type 1 @entity6 in genetically susceptible individuals.

2098281

2098282

2098283

Islet cell membrane antigens activate diabetogenic @entity11264 + T-cells in the BB/Wor XXXX .

multiple_choice

Type 1 @entity6 is a major histocompatibility complex (MHC) class II-associated @entity792 mediated by beta-cell-specific T-cells and characterized by circulating autoantibodies to beta-cell molecules. In the BB/Wor @entity6 -prone (DP) @entity35 , type 1 @entity6 develops spontaneously with an incidence of >90%. BB @entity6 can be adoptively transferred to naive syngeneic or MHC class II-compatible @entity35 with islet cell-activated T-cell lines derived from diabetic BB/Wor @entity35 . However, the target beta-cell autoantigen(s) in BB @entity6 has not yet been defined. BB @entity35 T-cell lines activated in vitro with @entity1358 ( @entity1358 ) and BB islet cell crude membranes (CM), but not islet cell cytosol, adoptively transfer @entity6 into young DP recipients. To determine if the target autoantigen is an integral or peripheral membrane protein, islet cell CM were treated with 0.5 mol/l @entity4338 or 0.2 mol/l @entity4339 (pH 11). Both treatments selectively extract peripheral proteins from the cell membrane without affecting the disposition of integral (transmembrane) proteins. T-cell lines activated in vitro with @entity1358 and 0.5 mol/l @entity4338 , or pH 11 (0.2 mol/l @entity4339 )-treated islet cell CM, transferred @entity6 into young DP @entity35 . Conversely, T-cell lines activated in vitro with @entity1358 and the supernatant of 0.5 mol/l @entity4338 -treated CM (containing extracted peripheral proteins), did not adoptively transfer @entity6 . After activation in vitro with islet cell membrane antigens, the @entity6 -inducing cell lines were comprised of both @entity11264 + CD8- T-cells and 10-30% B-cells. We conclude that a major @entity11264 + T-cell target autoantigen in BB @entity6 is a membrane-associated beta-cell molecule with the characteristics of an integral beta-cell membrane protein. The identification of this MHC class II-restricted beta-cell target molecule will allow the design of antigen-specific intervention protocols to prevent the onset of type 1 @entity6 in genetically susceptible individuals.

2098284

2098285

2098286

Development and characterization of an animal model of dental XXXX .

multiple_choice

CONCLUSION: The results of this study confirm that the present @entity95 model of @entity1180 ( @entity1180 ) is reproducible and simulates @entity1 dental @entity1244 with respect to initiation, progression and @entity32 . It is applicable to further studies of @entity1244 of odontogenic origin. OBJECTIVES: To induce acute @entity1180 in @entity95 by using their own oral microflora to create a periapical @entity281 and to follow morphological, radiographic, bacteriological and histological changes to the sinus mucosa. MATERIAL AND METHODS: The experimental animals comprised 26 New Zealand White @entity95 . Maxillary premolar root canals were identified bilaterally and the continuously growing germs of the roots were severed by diathermy. The animals were randomized into 2 groups: in Group 1 (n=20) the teeth were left open for the entire study period; in Group 2 (n=6) the root canals were sealed 1 week after the initial intervention. The animals in Group 1 were sacrificed at intervals ranging from 2 h to 9 months after intervention. All animals in Group 2 were sacrificed 6 months after intervention. After macroscopic and radiographic examination, post-mortem inspection of the @entity13382 and maxillary complex and microbiological sampling, the entire nasal sinus complex with the hard palate in situ was resected and processed for serial coronal sectioning. RESULTS: In Group 1, after 3 months, the radiographic changes ranged from widening of the periodontal space to bone reaction. At sacrifice, changes in the sinus mucosa ranged from signs of @entity32 to purulent @entity1180 . Microbial growth, predominantly Gram-negative aerobes, increased over time. In Group 2, the findings were generally more pronounced. Anaerobic microorganisms were predominant. In both groups the findings were consistent with @entity1180 .

2098287

2098288

2098289

Sclerotherapy of microcystic XXXX in oral and facial regions.

multiple_choice

PURPOSE: @entity600 ( @entity600 ) are @entity455 that can cause @entity73 . Complete surgical resection is often difficult and intralesional injection of sclerosing agents has been proposed as an alternative to the surgery. The aim of this study was to review our experience with @entity7290 (bleomycin A(5)) injection alone or in combination with surgery for treatment of oral and facial @entity600 , and to observe the histologic changes after intralesional injection of @entity7290 . @entity1 AND METHODS: Seventy-nine @entity1 who received intralesional injection of @entity7290 for the treatment of oral and facial @entity600 were reviewed. There were 47 males and 32 females, at a ratio of 1 to 0.68. Age ranged from 4 months to 17 years. The sites of the lesions occurred primarily in the tongue, which was found in 37 cases, followed by cheeks in 18, involved lips in 10, parotid gland in 7, oropharynx in 5, and floor of the mouth in only 2 cases. Among them, 42 @entity1 received @entity7290 sclerotherapy solely, 14 @entity1 had sclerotherapy in combination with secondary surgery, and 23 other @entity1 had surgery with sclerotherapy. @entity1 had been followed up more than 6 months after the last treatment. The rating of the results was 4-graded: excellent, good, fair, and poor (based on clinical outcome). The histologic changes were observed under microscope in 14 resected specimens after the sclerotherapy. RESULTS: Primary anatomic locations of 79 @entity600 involved the face in 25 cases, and the oral cavity in 54. Median number of injections received per @entity1 was 4.2 (range, 3 to 8). Among the 79 @entity1 , 44 cases (55.7%) were graded as excellent, 23 cases (29.11%) as good, 10 cases (12.66%) as fair, and 2 cases (2.53%) as poor. There were fewer totally cured or near-normal appearance in the sole sclerotherapy group (42.86%) than in the surgery with the sclerotherapy group (73.91%; P< .05). In specimens resected after @entity7290 injection, histologic examination showed the destructive lymphatic vessels and obvious stromal @entity82 . CONCLUSIONS: Intralesional injection of @entity7290 was effective for over two thirds of the @entity1 with oral and facial @entity600 . Perioperative sclerotherapy may improve the treatment of these @entity600 .

2098290

2098291

2098292

Mechanical testing of XXXX cardiac tissue: some implications for MRI safety.

multiple_choice

PURPOSE: The effects of aging on tissue strength and its ability to withstand forces associated with MRI have not been investigated. This study aimed to determine the forces required to cause @entity1713 of a heart valve prosthesis in @entity1 with age-related @entity179 exposed to MRI. METHODS: Eighteen tissue samples excised during routine heart valve replacement surgery were subjected to a suture pull-out test using a tensile materials testing machine. Five preconditioning cycles were applied before commencing the final destructive test. The test was complete when the sample ruptured and the suture was pulled completely free from the tissue. Results were compared with previously calculated magnetically induced forces at 4.7 T. RESULTS: All tissue samples displayed a basic failure pattern. Mean forces required to cause initial yield and total @entity397 were 4.0 N (+/- 3.3 N) and 4.9 N (+/- 3.6 N), respectively. Significant factors determining initial yield were stenosed calcific tissue (p < .01), @entity528 (single pathology) (p < .04) and tissue stiffness (p < .01). @entity528 (p < .03) and tissue stiffness (p < .03) were also significant in determining maximum force required to cause total @entity397 . CONCLUSION: Specific age-related degenerative @entity299 stiffen and strengthen tissue resulting in significant forces being required to pull a suture through valve annulus tissue. These forces are significantly greater than magnetically induced < 4.7 T. Therefore, @entity1 with @entity340 are unlikely to be at risk of valve dehiscence during exposure to static magnetic field < or = 4.7 T.

2098293

2098294

2098295

Therapy of focal @entity11410 in @entity1 with XXXX and recombinant beta-interferon - results of a placebo-controlled multicenter study.

multiple_choice

Focal @entity11410 in childhood is a rare but life-threatening disease. Animal experiments and case reports suggest a positive effect of an additional therapy with interferon-beta on the course of the disease. Therefore, we initiated a prospective, double-blind placebo-controlled study to investigate the benefit of a combination therapy of @entity1033 ( @entity3073 ) and recombinant interferon-beta ( @entity17129 ) in juvenile focal @entity11410 . - Initial inclusion criterium was suspicion of focal @entity11410 . Diagnosis was proven by demonstration of characteristic focal lesions in cerebral imaging or virological evidence of HSV in cerebrospinal fluid. @entity1 were treated with @entity3073 plus @entity17129 or @entity3073 plus placebo. Neurological outcome was determined 21 days and 3 months after onset of the disease. - Initially 59 @entity1 were enrolled in the study. @entity198 was proven in 14 @entity1 (7 @entity3073 + @entity17129 , 7 @entity3073 + placebo). The study groups were balanced in terms of important prognostic criteria. 10 @entity1 (5 @entity3073 + @entity17129 , 5 @entity3073 + placebo) were cured or had slight defects, 4 @entity1 (2 @entity3073 + @entity17129 , 2 @entity3073 + placebo) showed moderate to severe defects. There was no significant difference in favour of the additive therapy with @entity17129 .

2098296

2098297

2098298

Therapy of focal XXXX in @entity1 with @entity1033 and recombinant beta-interferon - results of a placebo-controlled multicenter study.

multiple_choice

Focal @entity11410 in childhood is a rare but life-threatening disease. Animal experiments and case reports suggest a positive effect of an additional therapy with interferon-beta on the course of the disease. Therefore, we initiated a prospective, double-blind placebo-controlled study to investigate the benefit of a combination therapy of @entity1033 ( @entity3073 ) and recombinant interferon-beta ( @entity17129 ) in juvenile focal @entity11410 . - Initial inclusion criterium was suspicion of focal @entity11410 . Diagnosis was proven by demonstration of characteristic focal lesions in cerebral imaging or virological evidence of HSV in cerebrospinal fluid. @entity1 were treated with @entity3073 plus @entity17129 or @entity3073 plus placebo. Neurological outcome was determined 21 days and 3 months after onset of the disease. - Initially 59 @entity1 were enrolled in the study. @entity198 was proven in 14 @entity1 (7 @entity3073 + @entity17129 , 7 @entity3073 + placebo). The study groups were balanced in terms of important prognostic criteria. 10 @entity1 (5 @entity3073 + @entity17129 , 5 @entity3073 + placebo) were cured or had slight defects, 4 @entity1 (2 @entity3073 + @entity17129 , 2 @entity3073 + placebo) showed moderate to severe defects. There was no significant difference in favour of the additive therapy with @entity17129 .

2098299

2098300

2098301

Therapy of focal @entity11410 in XXXX with @entity1033 and recombinant beta-interferon - results of a placebo-controlled multicenter study.

multiple_choice

Focal @entity11410 in childhood is a rare but life-threatening disease. Animal experiments and case reports suggest a positive effect of an additional therapy with interferon-beta on the course of the disease. Therefore, we initiated a prospective, double-blind placebo-controlled study to investigate the benefit of a combination therapy of @entity1033 ( @entity3073 ) and recombinant interferon-beta ( @entity17129 ) in juvenile focal @entity11410 . - Initial inclusion criterium was suspicion of focal @entity11410 . Diagnosis was proven by demonstration of characteristic focal lesions in cerebral imaging or virological evidence of HSV in cerebrospinal fluid. @entity1 were treated with @entity3073 plus @entity17129 or @entity3073 plus placebo. Neurological outcome was determined 21 days and 3 months after onset of the disease. - Initially 59 @entity1 were enrolled in the study. @entity198 was proven in 14 @entity1 (7 @entity3073 + @entity17129 , 7 @entity3073 + placebo). The study groups were balanced in terms of important prognostic criteria. 10 @entity1 (5 @entity3073 + @entity17129 , 5 @entity3073 + placebo) were cured or had slight defects, 4 @entity1 (2 @entity3073 + @entity17129 , 2 @entity3073 + placebo) showed moderate to severe defects. There was no significant difference in favour of the additive therapy with @entity17129 .

2098302

2098303

2098304

XXXX : case report and review of the literature.

multiple_choice

@entity13836 ( @entity13836 ) are a heterogeneous group of disorders associated with @entity882 and giant platelets, and may include other clinical or laboratory findings such as @entity3686 , @entity1274 , leukocyte inclusions, and @entity231 . @entity1 with @entity13836 may have mild to moderate @entity548 symptoms or be completely asymptomatic. The most recently described @entity13836 is the @entity16611 ( @entity16611 ), which consists of @entity882 with giant platelets and leukocyte inclusions. Only three previous reports about this syndrome have been published. Herein, we report the first African-American family with @entity16611 . The propositus is a 4-week-old male born to a mother carrying the diagnosis of chronic @entity882 ( @entity882 ). His 4-year-old brother also has @entity882 . There is no history of @entity548 symptoms in any of the family members. The diagnosis was established by demonstrating @entity882 with giant platelets and leukocyte inclusions on both peripheral smear and by electron microscopy. This report illustrates the importance of obtaining a family history when evaluating @entity882 with special emphasis on a history of @entity882 , @entity8 , @entity2319 , and @entity231 . It is important to differentiate between @entity13836 and chronic @entity882 to avoid the unnecessary diagnostic studies, and, more critically, unneeded and potentially harmful therapy.

2098305

2098306

2098307

[Surgical treatment of XXXX ].

multiple_choice

BACKGROUND: The incidence of @entity694 is increasing in Norway and about 2200 new cases are now diagnosed each year. This paper presents accepted principles of the surgical treatment of the disease. MATERIAL AND METHODS: The article is based on literature retrieved from the PubMed and Cochrane databases, guidelines from other European countries and USA, and the authors' clinical experience. RESULTS AND INTERPRETATION: Some 2 / 3 of the @entity1 have no distant @entity3 and a resectable primary @entity5 , and the intention of treatment is curative. A curative resection is achieved by applying the following techniques: The lymphovascular pedicle is divided centrally, removing all the draining regional lymph nodes of the @entity5 -bearing bowel segment. The circumferential dissection is carried out in the mesocolic plane. In cases of @entity5 infiltration of this plane or infiltration of neighbouring organs, extended circumferential resection is necessary to obtain free margins. A minimum bowel resection margin of 5 cm on either side of the @entity5 is oncologically adequate, but the extent of bowel resection depends on the individual's vessel anatomy and bowel circulation. A multidisciplinary team should treat @entity1 with potentially resectable distant @entity3 . Multimodal treatment is an option and treatment should follow a certain sequence. With ileus due to obstructing @entity5 of the transverse and left colon, endoluminal stenting should be attempted as a bridge to surgery within 1 - 2 weeks. The quality of surgical treatment of @entity14 could be improved in Norway, by categorizing surgical techniques more systematically and ensuring more consistent reporting to the new Norwegian @entity14 register.

2098308

2098309

2098310

GliaSite brachytherapy boost as part of initial treatment of XXXX multiforme: a retrospective multi-institutional pilot study.

multiple_choice

PURPOSE: To report on a retrospective analysis of the cumulative experience from eight institutions using the GliaSite Radiotherapy System as a brachytherapy boost in the initial management of @entity463 multiforme. METHODS AND MATERIALS: Eight institutions provided data on 20 @entity1 with histologically proven @entity463 multiforme with a median age of 59 years (range, 39-76) and median Karnofsky performance scale of 80 (range, 50-100). After maximal surgical debulking, @entity1 were treated with GliaSite brachytherapy to a median dose of 50 Gy, followed by external beam radiotherapy to a median dose of 60 Gy (range, 46-60 Gy), for a cumulative dose escalation of 110 Gy (range, 84-130 Gy). RESULTS: The average survival for this study population was 11.4 months (range, 4-29). When the @entity1 ' survival was compared with that of historical controls according to their Radiation Therapy Oncology Group recursive partitioning analysis class, the average survival was increased by 3 months (95% confidence interval, 0.23-4.9) corresponding to a 43% increase (p = 0.033). Three @entity1 (14%) experienced Radiation Therapy Oncology Group Grade 3 @entity149 . Of the treatment failures, 50% were >2 cm from the edge of the balloon. CONCLUSION: The results of this analysis have demonstrated that dose escalation (>100 Gy) with GliaSite is well tolerated and associated with minimal @entity137 . Local control improved with the use of GliaSite brachytherapy. The putative survival advantage seen in this study needs to be interpreted with caution; nevertheless, the data provide sufficient justification to investigate the potential role of radiation dose escalation in conjunction with GliaSite in the initial treatment of @entity463 multiforme.

2098311

2098312

2098313

XXXX of the mandible causing severe facial asymmetry: a case report.

multiple_choice

@entity705 is one of the most common @entity5 of bone. Although @entity705 is rarely seen in facial region, the cases in literature are usually in the mandibular region, especially around the condyle. The treatments of these lesions include total condylectomy or local resection of the lesion. The aim of the present study is to emphasize the importance of stereolithographic models in @entity5 surgery and how it affects the treatment planning, operation time and prognosis. In this report, the @entity1 had an @entity705 in the left condylar region, pushing the condyle seriously to the anterior. The clinical findings were 8 mm deviation of midline to the right side, 23 mm mouth opening, unilateral posterior cross-bite on the right side, and 8 mm negative horizontal overjet. We acquired a 3-dimensional solid model of the @entity1 . Determination of the anatomy of the surgical area, determination of the surgical access method, and other treatment planning were all done on the stereolithographic model. Based on the model evaluation, the @entity5 was conservatively resected and the condyle left intact, leaving no sequelae. All the preoperative problems were resolved except the @entity601 .

2098314

2098315

2098316

High XXXX intake protects against age-related @entity73 .

multiple_choice

OBJECTIVE: To study the relationships between dietary macronutrient intakes and age-related changes in cognitive functions. METHODS: We investigated these associations in the prevalence survey (1992 through 1993) of the Italian Longitudinal Study on Aging (ILSA). The population-based sample of 5,632 subjects of the ILSA, age 65 to 84 years, was identified from the electoral rolls of eight Italian municipalities. In this study, standardized test batteries assessing global cognitive functions (Mini-Mental State Examination [MMSE]), selective attention (Digit Cancellation Test [DCT]), and episodic memory (Babcock Story Recall Test), and a semi-quantitative food frequency questionnaire evaluating macronutrient energy intakes, were performed on 278 nondemented elderly subjects from the randomized cohort of Casamassima, Bari (n = 704). RESULTS: There was an inverse relationship between @entity6221 ( @entity8981 ) energy intake and @entity73 (MMSE < 24). The effect of education on the odds of having a MMSE score <24 decreased exponentially with the increase of @entity8981 intakes (over 2,400 kJ; odds ratio, 0.69). Moreover, a significant inverse association was observed between @entity8981 intakes and DCT score (odds ratio, 0.99). No association was found between nutritional variables and episodic memory. CONCLUSIONS: In an elderly population of Southern Italy with a typical Mediterranean diet, high @entity8981 intakes appeared to be protective against age-related @entity73 . Prospective clinical trials are needed to evaluate the impact of specific dietary macronutrient intakes on the age-related changes of cognitive functions.

2098317

2098318

2098319

High @entity6221 intake protects against age-related XXXX .

multiple_choice

OBJECTIVE: To study the relationships between dietary macronutrient intakes and age-related changes in cognitive functions. METHODS: We investigated these associations in the prevalence survey (1992 through 1993) of the Italian Longitudinal Study on Aging (ILSA). The population-based sample of 5,632 subjects of the ILSA, age 65 to 84 years, was identified from the electoral rolls of eight Italian municipalities. In this study, standardized test batteries assessing global cognitive functions (Mini-Mental State Examination [MMSE]), selective attention (Digit Cancellation Test [DCT]), and episodic memory (Babcock Story Recall Test), and a semi-quantitative food frequency questionnaire evaluating macronutrient energy intakes, were performed on 278 nondemented elderly subjects from the randomized cohort of Casamassima, Bari (n = 704). RESULTS: There was an inverse relationship between @entity6221 ( @entity8981 ) energy intake and @entity73 (MMSE < 24). The effect of education on the odds of having a MMSE score <24 decreased exponentially with the increase of @entity8981 intakes (over 2,400 kJ; odds ratio, 0.69). Moreover, a significant inverse association was observed between @entity8981 intakes and DCT score (odds ratio, 0.99). No association was found between nutritional variables and episodic memory. CONCLUSIONS: In an elderly population of Southern Italy with a typical Mediterranean diet, high @entity8981 intakes appeared to be protective against age-related @entity73 . Prospective clinical trials are needed to evaluate the impact of specific dietary macronutrient intakes on the age-related changes of cognitive functions.

2098320

2098321

2098322

XXXX , early onset of substance use and behavioral problems in adolescence.

multiple_choice

BACKGROUND: Very few prospective studies examine the relationship between @entity25 and subsequent substance use. In this study, we examined how sleep problems at ages 3-8 predicted onset of @entity167 , cigarette, and marijuana use in adolescence. We also investigated the relationships between @entity25 and adolescent internalizing and externalizing problems. METHODS: Study @entity1 were 292 @entity1 and 94 @entity1 from a community sample of high risk families and controls in an ongoing longitudinal study. RESULTS: Controlling for parental @entity988 , sleep problems at ages 3-8 predicted onset of @entity167 , cigarette, and marijuana use among @entity1 and onset of @entity167 use among @entity1 . @entity25 were related to maternal ratings of internalizing and externalizing problems during adolescence for both @entity1 and @entity1 . Adjusting for these problems did not weaken the effects of sleep problems on onset of substance use. CONCLUSIONS: This is to our knowledge the first study that prospectively examines gender differences in the relationship between sleep problems and early onset of substance use. @entity25 predicted early onset of substance use for @entity1 but not @entity1 . If @entity25 indeed increase the probability of substance use onset, greater attention by parents to sleep problems in @entity1 and adolescents would potentially have ameliorative long-term effects. Parents are encouraged to explore different ways to help their @entity1 sleep better, including obtaining information and suggestions from their primary care physicians.

2098323

2098324

2098325

Improvement of texture and structure of reduced-fat Cheddar cheese by XXXX -producing lactococci.

multiple_choice

The objective of this study was to evaluate the effect of capsular and ropy @entity19766 (EPS)-producing strains of @entity7878 ssp. cremoris on textural and microstructural attributes during ripening of 50%-reduced-fat Cheddar cheese. Cheeses were manufactured with added capsule- or ropy-forming strains individually or in combination. For comparison, reduced-fat cheese with or without @entity24568 added at 0.2% (wt/vol) to cheese milk and full-fat cheeses were made using EPS-nonproducing starter, and all cheeses were ripened at 7 degrees C for 6 mo. @entity19766 -producing strains increased cheese moisture retention by 3.6 to 4.8% and cheese yield by 0.28 to 1.19 kg/100 kg compared with control cheese, whereas @entity24568 -containing cheese retained 1.4% higher moisture and had 0.37 kg/100 kg higher yield over the control cheese. Texture profile analyses for 0-d-old cheeses revealed that cheeses with EPS-producing strains had less firm, springy, and cohesive texture but were more brittle than control cheeses. However, these effects became less pronounced after 6 mo of ripening. Using transmission electron microscopy, fresh and aged cheeses with added EPS-producing strains showed a less compact protein matrix through which larger whey pockets were dispersed compared with control cheese. The numerical analysis of transmission electron microscopy images showed that the area in the cheese matrix occupied by protein was smaller in cheeses with added EPS-producing strains than in control cheese. On the other hand, @entity24568 had little impact on both cheese texture and microstructure; after 6 mo, cheese containing @entity24568 showed a texture profile very close to that of control reduced-fat cheese. The protein-occupied area in the cheese matrix did not appear to be significantly affected by @entity24568 addition. @entity19766 -producing strains could contribute to the modification of cheese texture and microstructure and thus modify the functional properties of reduced-fat Cheddar cheese.

2098326

2098327

2098328

[Neonatal intracerebral @entity548 as initial symptom of XXXX cerebri WHO III--neurological outcome after partial hemispherectomy].

multiple_choice

INTRODUCTION: @entity816 presenting as @entity10053 cerebri in neonates are extremely rare. Tumours in newborns are mostly of neuroectodermal origin. CASE REPORT: We report about a female newborn at term [birth weight 3 600 g (P 90), head circumference 35 cm (P 95) APGAR 9/10/10] with an intracerebral partially clotted @entity548 in the left parieto-occipital region. The @entity548 was expansive leading to axial and lateral cerebral herniation. The intracerebral @entity548 in the left occipital region was surgically removed. Macroscopically no solid @entity5 was seen, but small fragments of an @entity5 (WHO grade III) were diagnosed histologically. After surgery, no remaining @entity5 was visible in the MRI. 6 weeks later, a recurrent @entity5 (4 4 cm) was found in the area of the initial @entity548 . Further treatment was initially refused by the parents. The @entity1 was readmitted to our hospital at the age of 11 months in good clinical condition and presented with left-sided @entity1269 , right-sided @entity1805 and intermittent strabismus convergens alternans. Because of the good clinical condition further therapeutic treatment was initiated. Due to the final extension of the @entity5 into the temporal, parietal and occipital lobes, a @entity10053 cerebri WHO III was diagnosed. An extended partial hemispherectomy was done. After neurosurgery, no further @entity16 occurred. In the follow-up examination, MRI showed no relapse of the @entity5 . Chemotherapy according to the HIT SKK protocol was initiated. A relapse did not occur over a follow-up of 2 years. CONCLUSION: This is a rare case report of a @entity10053 cerebri WHO grade III, treated with partial hemispherectomy, leading to a good clinical and neurological long-term outcome.

2098329

2098330

2098331

[Neonatal intracerebral XXXX as initial symptom of @entity10053 cerebri WHO III--neurological outcome after partial hemispherectomy].

multiple_choice

INTRODUCTION: @entity816 presenting as @entity10053 cerebri in neonates are extremely rare. Tumours in newborns are mostly of neuroectodermal origin. CASE REPORT: We report about a female newborn at term [birth weight 3 600 g (P 90), head circumference 35 cm (P 95) APGAR 9/10/10] with an intracerebral partially clotted @entity548 in the left parieto-occipital region. The @entity548 was expansive leading to axial and lateral cerebral herniation. The intracerebral @entity548 in the left occipital region was surgically removed. Macroscopically no solid @entity5 was seen, but small fragments of an @entity5 (WHO grade III) were diagnosed histologically. After surgery, no remaining @entity5 was visible in the MRI. 6 weeks later, a recurrent @entity5 (4 4 cm) was found in the area of the initial @entity548 . Further treatment was initially refused by the parents. The @entity1 was readmitted to our hospital at the age of 11 months in good clinical condition and presented with left-sided @entity1269 , right-sided @entity1805 and intermittent strabismus convergens alternans. Because of the good clinical condition further therapeutic treatment was initiated. Due to the final extension of the @entity5 into the temporal, parietal and occipital lobes, a @entity10053 cerebri WHO III was diagnosed. An extended partial hemispherectomy was done. After neurosurgery, no further @entity16 occurred. In the follow-up examination, MRI showed no relapse of the @entity5 . Chemotherapy according to the HIT SKK protocol was initiated. A relapse did not occur over a follow-up of 2 years. CONCLUSION: This is a rare case report of a @entity10053 cerebri WHO grade III, treated with partial hemispherectomy, leading to a good clinical and neurological long-term outcome.

2098332

2098333

2098334

[Complications of an unrecognized XXXX ].

multiple_choice

@entity1 with an untreated @entity583 may present with serious late complications. 3 @entity1 are described. A 63-year-old @entity1 became progressively more short of breath 4 days after an acute episode of @entity662 accompanied by @entity390 and @entity9201 . It proved to be a @entity1455 following a @entity397 of a papillary muscle. A @entity1 aged 65 collapsed 5 days after an episode of @entity615 and @entity390 . This was a @entity2293 due to @entity397 of the left ventricle. A @entity1 aged 74 had transient @entity2026 and during investigations for this was seen to have anomalies on ECG. She had @entity999 and a @entity15941 with associated @entity715 . All 3 @entity1 recovered following mitral-valve replacement, repair of the @entity397 and medicinal treatment for the clot, respectively. Around one-third of @entity1 who have a @entity583 do not have @entity662 but experience @entity1353 , autonomic nervous symptoms ( @entity9201 , @entity390 , @entity391 ), extreme and inexplicable tiredness and @entity1163 . These atypical symptoms should suggest @entity583 . In order to avoid high morbidity and @entity204 from complications such as @entity943 , @entity712 , @entity397 and @entity439 formation it is important that a @entity1 who has had a @entity583 should be treated as soon as possible, preferably by reperfusion therapy.

2098335

2098336

2098337

[Total hip arthroplasty in post- XXXX . Can type and position of the acetabular component influence longevity of the prosthesis?].

multiple_choice

PURPOSE OF THE STUDY: The aim of the study was a retrospective evaluation of our @entity1 with post- @entity572 treated by cemented or non-cemented total hip arthroplasty (THA) in order to ascertain which type and position of the acetabular component was most effective. MATERIAL: In the years 1999-2002, 111 THA procedures were performed in 93 @entity1 , 76 @entity1 and 17 @entity1 , with post- @entity625 . The average age of the @entity1 at the time of implantation was 52.6 years. On the basis of pre-operative radiographic findings, the @entity1 ' conditions were evaluated using the Hartofilakidis classification into three disease categories: @entity1141 , @entity258 and high dislocation, and the @entity1 were placed in two groups. Group 1 included 78 @entity1 , and group 2 comprised 26 @entity1 . None of our @entity1 was classified as having high dislocation. Thirty-nine of these @entity1 had previously undergone surgery for @entity572 . METHODS: A total of 104 THAs were evaluated, because radiographic data was incomplete in seven cases. In addition to X-ray findings, the prosthesis type (cemented, hybrid, non-cemented), @entity532 and signs of loosening were included in the evaluation. Clinical outcomes were assessed by the Harris score. The follow-up terminating on 31st December 2005 was 67 months on the average. RESULTS: In group 1 @entity1 , the average Harris score increased from 38.6 to 80.3 points and in group 2 @entity1 from 35.5 to 84.9 points, mostly with excellent and good results. In 72.1 % of the hips, a press-fit acetabular component was implanted. In 55.8 % of the cases, the acetabular component was implanted off the anatomical center of rotation, into the high hip center, with the range from 9 to 20 mm and an average of 15 mm. The average limb lengthening was 2.5 cm, ranging from 1.0 to 3.5 cm. CONCLUSIONS: Our results show that it is more effective to use non-cemented THA for post- @entity572 . The implantation of a noncemented acetabular component into the high center provides better covering of the cup with solid bone, without the necessity of cotyloplasty or structural graft use. Also, it does not markedly affect hip function or @entity1 ' subjective feelings.

2098338

2098339

2098340

Genomics screen in transformed stem cells reveals XXXX , @entity57581 , and @entity33382 as putative anticancer drug targets.

multiple_choice

Since the sequencing of the @entity1 genome, recent efforts in @entity5 drug target discovery have focused more on the identification of novel functions of known genes and the development of more @entity5 models. In the present study, we investigated in vitro transformed @entity1 adult mesenchymal stem cells (MSC) to identify novel candidate @entity5 drug targets by analyzing the transcriptional profile of known enzymes compared with non-transformed MSC. The identified enzymes were compared with published @entity5 gene expression data sets. Surprisingly, the majority of up-regulated enzymes are already known @entity5 drug targets or act within known druggable pathways. Only three enzymes ( @entity17472 , @entity33382 , and @entity57581 ) are potentially novel targets that are up-regulated in transformed MSC and expressed in @entity189 and @entity242 . We confirmed the overexpression of @entity17472 , @entity57581 , and @entity33382 in transformed MSC, transformed fibroblasts, and @entity5 cell lines MCF7, SK-LMS1, MG63, and U2OS. In functional assays, we show that small interfering RNA knockdown of @entity17472 inhibits anchorage-independent growth but does not alter in vitro proliferation of @entity5 cell lines, normal MSC, or normal fibroblasts. Knockdown of @entity57581 impaired anchorage-dependent in vitro growth of @entity5 cell lines and impaired the in vitro growth of primary MSC but not differentiated @entity1 fibroblasts. We show that the knockdown of @entity57581 decreases cell proliferation by delaying entry into S phase of the cell cycle and is transcriptionally regulated by @entity876 . These in vitro data validate @entity57581 and @entity17472 as putative @entity5 targets and endorse this in silico approach for identifying novel candidates.

2098341

2098342

2098343

Genomics screen in transformed stem cells reveals @entity17472 , @entity57581 , and XXXX as putative anticancer drug targets.

multiple_choice

Since the sequencing of the @entity1 genome, recent efforts in @entity5 drug target discovery have focused more on the identification of novel functions of known genes and the development of more @entity5 models. In the present study, we investigated in vitro transformed @entity1 adult mesenchymal stem cells (MSC) to identify novel candidate @entity5 drug targets by analyzing the transcriptional profile of known enzymes compared with non-transformed MSC. The identified enzymes were compared with published @entity5 gene expression data sets. Surprisingly, the majority of up-regulated enzymes are already known @entity5 drug targets or act within known druggable pathways. Only three enzymes ( @entity17472 , @entity33382 , and @entity57581 ) are potentially novel targets that are up-regulated in transformed MSC and expressed in @entity189 and @entity242 . We confirmed the overexpression of @entity17472 , @entity57581 , and @entity33382 in transformed MSC, transformed fibroblasts, and @entity5 cell lines MCF7, SK-LMS1, MG63, and U2OS. In functional assays, we show that small interfering RNA knockdown of @entity17472 inhibits anchorage-independent growth but does not alter in vitro proliferation of @entity5 cell lines, normal MSC, or normal fibroblasts. Knockdown of @entity57581 impaired anchorage-dependent in vitro growth of @entity5 cell lines and impaired the in vitro growth of primary MSC but not differentiated @entity1 fibroblasts. We show that the knockdown of @entity57581 decreases cell proliferation by delaying entry into S phase of the cell cycle and is transcriptionally regulated by @entity876 . These in vitro data validate @entity57581 and @entity17472 as putative @entity5 targets and endorse this in silico approach for identifying novel candidates.

2098344

2098345

2098346

Genomics screen in transformed stem cells reveals @entity17472 , XXXX , and @entity33382 as putative anticancer drug targets.

multiple_choice

Since the sequencing of the @entity1 genome, recent efforts in @entity5 drug target discovery have focused more on the identification of novel functions of known genes and the development of more @entity5 models. In the present study, we investigated in vitro transformed @entity1 adult mesenchymal stem cells (MSC) to identify novel candidate @entity5 drug targets by analyzing the transcriptional profile of known enzymes compared with non-transformed MSC. The identified enzymes were compared with published @entity5 gene expression data sets. Surprisingly, the majority of up-regulated enzymes are already known @entity5 drug targets or act within known druggable pathways. Only three enzymes ( @entity17472 , @entity33382 , and @entity57581 ) are potentially novel targets that are up-regulated in transformed MSC and expressed in @entity189 and @entity242 . We confirmed the overexpression of @entity17472 , @entity57581 , and @entity33382 in transformed MSC, transformed fibroblasts, and @entity5 cell lines MCF7, SK-LMS1, MG63, and U2OS. In functional assays, we show that small interfering RNA knockdown of @entity17472 inhibits anchorage-independent growth but does not alter in vitro proliferation of @entity5 cell lines, normal MSC, or normal fibroblasts. Knockdown of @entity57581 impaired anchorage-dependent in vitro growth of @entity5 cell lines and impaired the in vitro growth of primary MSC but not differentiated @entity1 fibroblasts. We show that the knockdown of @entity57581 decreases cell proliferation by delaying entry into S phase of the cell cycle and is transcriptionally regulated by @entity876 . These in vitro data validate @entity57581 and @entity17472 as putative @entity5 targets and endorse this in silico approach for identifying novel candidates.

2098347

2098348

2098349

Viusid, a nutritional supplement, increases survival and reduces disease progression in XXXX -related decompensated @entity82 : a randomised and controlled trial.

multiple_choice

OBJECTIVES: Viusid is a nutritional supplement with recognised antioxidant and immunomodulatory properties which could have beneficial effects on @entity82 -related clinical outcomes such as survival, disease progression and development of @entity157 ( @entity157 ). This study evaluated the efficacy and safety of viusid in @entity1 with @entity3531 -related decompensated @entity82 . DESIGN: A randomised double-blind and placebo-controlled study was conducted in a tertiary care academic centre (National Institute of Gastroenterology, Havana, Cuba). The authors randomly assigned 100 @entity1 with @entity3531 -related decompensated @entity82 to receive viusid (three oral sachets daily, n=50) or placebo (n=50) during 96 weeks. The primary outcome of the study was overall survival at 96 weeks, and the secondary outcomes included time to disease progression, time to @entity157 diagnosis, time to worsening of the prognostic scoring systems @entity1 -Pugh and Model for End-Stage @entity409 , and time to a new occurrence or relapse for each one of the main clinical complications secondary to portal @entity101 at 96 weeks. RESULTS: Viusid led to a significant improvement in overall survival (90%) versus placebo (74%) (HR 0.27, 95% CI 0.08 to 0.92; p=0.036). A similar improvement in disease progression was seen in viusid-treated @entity1 (28%), compared with placebo-treated @entity1 (48%) (HR 0.47, 95% CI 0.22 to 0.89; p=0.044). However, the beneficial effects of viusid were wholly observed among @entity1 with @entity1 -Pugh classes B or C, but not among @entity1 with @entity1 -Pugh class A. The cumulative incidence of @entity157 was significantly reduced in @entity1 treated with viusid (2%) as compared with placebo (12%) (HR 0.15, 95% CI 0.019 to 0.90; p=0.046). Viusid was well tolerated. CONCLUSIONS: The results indicate that treatment with viusid leads to a notable improvement in overall clinical outcomes such as survival, disease progression and development of @entity157 in @entity1 with @entity3531 -related decompensated @entity82 . Trial registration number http://ClinicalTrials.gov (NCT00502086).

2098350

2098351

2098352

Viusid, a nutritional supplement, increases survival and reduces disease progression in @entity3531 -related decompensated XXXX : a randomised and controlled trial.

multiple_choice

OBJECTIVES: Viusid is a nutritional supplement with recognised antioxidant and immunomodulatory properties which could have beneficial effects on @entity82 -related clinical outcomes such as survival, disease progression and development of @entity157 ( @entity157 ). This study evaluated the efficacy and safety of viusid in @entity1 with @entity3531 -related decompensated @entity82 . DESIGN: A randomised double-blind and placebo-controlled study was conducted in a tertiary care academic centre (National Institute of Gastroenterology, Havana, Cuba). The authors randomly assigned 100 @entity1 with @entity3531 -related decompensated @entity82 to receive viusid (three oral sachets daily, n=50) or placebo (n=50) during 96 weeks. The primary outcome of the study was overall survival at 96 weeks, and the secondary outcomes included time to disease progression, time to @entity157 diagnosis, time to worsening of the prognostic scoring systems @entity1 -Pugh and Model for End-Stage @entity409 , and time to a new occurrence or relapse for each one of the main clinical complications secondary to portal @entity101 at 96 weeks. RESULTS: Viusid led to a significant improvement in overall survival (90%) versus placebo (74%) (HR 0.27, 95% CI 0.08 to 0.92; p=0.036). A similar improvement in disease progression was seen in viusid-treated @entity1 (28%), compared with placebo-treated @entity1 (48%) (HR 0.47, 95% CI 0.22 to 0.89; p=0.044). However, the beneficial effects of viusid were wholly observed among @entity1 with @entity1 -Pugh classes B or C, but not among @entity1 with @entity1 -Pugh class A. The cumulative incidence of @entity157 was significantly reduced in @entity1 treated with viusid (2%) as compared with placebo (12%) (HR 0.15, 95% CI 0.019 to 0.90; p=0.046). Viusid was well tolerated. CONCLUSIONS: The results indicate that treatment with viusid leads to a notable improvement in overall clinical outcomes such as survival, disease progression and development of @entity157 in @entity1 with @entity3531 -related decompensated @entity82 . Trial registration number http://ClinicalTrials.gov (NCT00502086).

2098353

2098354

2098355

XXXX without @entity3225 during Operations Iraqi Freedom and Enduring Freedom.

multiple_choice

OBJECTIVE: To report the long-term follow-up results of intraocular foreign body (IOFB) removal at Walter Reed Army Medical Center during Operation Iraqi Freedom and Operation Enduring Freedom from February 2003 through November 2005 and to determine the prognostic factors for visual outcome in this @entity1 population. DESIGN: Retrospective, noncomparative, interventional case series. @entity1 : Seventy-nine eyes of 70 United States military soldiers deployed in support of operations Iraqi Freedom and Enduring Freedom sustained IOFB injuries and subsequently were treated at the Walter Reed Army Medical Center with a minimum of 6 months of follow-up. INTERVENTION: The principal procedure performed was 20-gauge 3-port vitrectomy with IOFB removal through limbal or pars plana incision. MAIN OUTCOME MEASURES: Final visual acuity, rate of proliferative @entity1715 , rate of @entity3225 . RESULTS: Average @entity1 age was 27 years, with an average of 331 days of postoperative follow-up. Average IOFB size was 3.7 mm (range, 0.1-20 mm). Median time to IOFB removal was 21 days (mean, 38 days; range, 2-661 days). Mean preoperative visual acuity was 20/400 (1.36 logarithm of mean angle of resolution [logMAR] units) and mean final visual acuity was 20/120 (0.75 logMAR). Of the @entity1 , 53.4% achieved visual acuity of 20/40 or better, whereas 77.5% achieved visual acuity of better than 20/200. There were no cases of @entity3225 (0/79 eyes; 95% confidence interval, 0%-3.1%), siderosis bulbi, or @entity10352 . Among the eyes, 10.3% evolved to no light perception or had been enucleated by the 6-month follow-up visit. Poor visual outcome correlated with @entity2790 (P<0.032). Seventeen of 79 eyes (21%) experienced proliferative @entity1715 . Proliferative @entity1715 correlated with poor initial vision (hand movements or worse; P = 0.035) and @entity2790 (P<0.001). Timing of vitrectomy did not correlate with visual outcome. The most common systemic antibiotic administered was @entity800 , whereas the most common topical antibiotic administered was @entity3477 . CONCLUSIONS: Poor visual outcome and @entity260 rates are related to @entity2790 . @entity2790 with a combination of systemic and topical antibiotic coverage can result in good visual outcome without an apparent increased risk of @entity3225 or other deleterious side effects.

2098356

2098357

2098358

@entity2790 without XXXX during Operations Iraqi Freedom and Enduring Freedom.

multiple_choice

OBJECTIVE: To report the long-term follow-up results of intraocular foreign body (IOFB) removal at Walter Reed Army Medical Center during Operation Iraqi Freedom and Operation Enduring Freedom from February 2003 through November 2005 and to determine the prognostic factors for visual outcome in this @entity1 population. DESIGN: Retrospective, noncomparative, interventional case series. @entity1 : Seventy-nine eyes of 70 United States military soldiers deployed in support of operations Iraqi Freedom and Enduring Freedom sustained IOFB injuries and subsequently were treated at the Walter Reed Army Medical Center with a minimum of 6 months of follow-up. INTERVENTION: The principal procedure performed was 20-gauge 3-port vitrectomy with IOFB removal through limbal or pars plana incision. MAIN OUTCOME MEASURES: Final visual acuity, rate of proliferative @entity1715 , rate of @entity3225 . RESULTS: Average @entity1 age was 27 years, with an average of 331 days of postoperative follow-up. Average IOFB size was 3.7 mm (range, 0.1-20 mm). Median time to IOFB removal was 21 days (mean, 38 days; range, 2-661 days). Mean preoperative visual acuity was 20/400 (1.36 logarithm of mean angle of resolution [logMAR] units) and mean final visual acuity was 20/120 (0.75 logMAR). Of the @entity1 , 53.4% achieved visual acuity of 20/40 or better, whereas 77.5% achieved visual acuity of better than 20/200. There were no cases of @entity3225 (0/79 eyes; 95% confidence interval, 0%-3.1%), siderosis bulbi, or @entity10352 . Among the eyes, 10.3% evolved to no light perception or had been enucleated by the 6-month follow-up visit. Poor visual outcome correlated with @entity2790 (P<0.032). Seventeen of 79 eyes (21%) experienced proliferative @entity1715 . Proliferative @entity1715 correlated with poor initial vision (hand movements or worse; P = 0.035) and @entity2790 (P<0.001). Timing of vitrectomy did not correlate with visual outcome. The most common systemic antibiotic administered was @entity800 , whereas the most common topical antibiotic administered was @entity3477 . CONCLUSIONS: Poor visual outcome and @entity260 rates are related to @entity2790 . @entity2790 with a combination of systemic and topical antibiotic coverage can result in good visual outcome without an apparent increased risk of @entity3225 or other deleterious side effects.

2098359

2098360

2098361

Occurrence of Vibrio spp. in XXXX ( @entity13367 ) from the German Wadden Sea.

multiple_choice

The present study aimed at determining the contamination of @entity13367 grown in Germany with relevant bacterial organisms. Seasonal variations were examined. For that purpose, mussel samples were taken regularly between June 2004 and May 2005 in seven shellfish-growing areas of the German Wadden Sea. A total of 90 samples were analysed. The analysis included the compulsory microbiological parameters @entity526 and @entity5746 spp., as well as the determination of the contamination with Vibrio spp. Although the analysed mussels complied with the legislation in force, potential @entity1 pathogens were detected in a wide range of samples. Vibrio spp. was detected in 74.4% of the samples analysed in this study. Among Vibrio isolates, @entity12671 was the species most frequently detected (51.2%), followed by @entity8966 (39.5%). @entity5345 was detected in 3.5% of the samples. @entity8966 and @entity5345 were not found in samples collected at low water temperatures. The results indicate that @entity13367 from shellfish-growing areas in the German Wadden Sea regularly contain pathogens relevant to public health. They also show that @entity526 is not a reliable indicator for the contamination with Vibrio spp. To improve consumer protection, it therefore seems necessary to extend the analysis of mussels for direct @entity1 consumption by additional parameters.

2098362

2098363

2098364

Occurrence of Vibrio spp. in @entity13367 ( XXXX ) from the German Wadden Sea.

multiple_choice

The present study aimed at determining the contamination of @entity13367 grown in Germany with relevant bacterial organisms. Seasonal variations were examined. For that purpose, mussel samples were taken regularly between June 2004 and May 2005 in seven shellfish-growing areas of the German Wadden Sea. A total of 90 samples were analysed. The analysis included the compulsory microbiological parameters @entity526 and @entity5746 spp., as well as the determination of the contamination with Vibrio spp. Although the analysed mussels complied with the legislation in force, potential @entity1 pathogens were detected in a wide range of samples. Vibrio spp. was detected in 74.4% of the samples analysed in this study. Among Vibrio isolates, @entity12671 was the species most frequently detected (51.2%), followed by @entity8966 (39.5%). @entity5345 was detected in 3.5% of the samples. @entity8966 and @entity5345 were not found in samples collected at low water temperatures. The results indicate that @entity13367 from shellfish-growing areas in the German Wadden Sea regularly contain pathogens relevant to public health. They also show that @entity526 is not a reliable indicator for the contamination with Vibrio spp. To improve consumer protection, it therefore seems necessary to extend the analysis of mussels for direct @entity1 consumption by additional parameters.

2098365

2098366

2098367

Postembedding immunogold labelling reveals subcellular localization and pathway-specific enrichment of XXXX activated glutaminase in rat cerebellum.

multiple_choice

@entity1391 activated glutaminase is a key enzyme in @entity2227 synthesis. Here we have employed a quantitative and high-resolution immunogold procedure to analyse the cellular and subcellular expression of this enzyme in the cerebellar cortex. Three main issues were addressed. First, is @entity1391 activated glutaminase exclusively or predominantly a mitochondrial enzyme, as biochemical data suggest? Second, to what extent is the mitochondrial content of glutaminase dependent on cell type and transmitter identity? Third, can individual neurons maintain a subcellular segregation of mitochondria with different glutaminase content? An attempt was also made to disclose the intramitochondrial localization of glutaminase, and to correlate the content of this enzyme with that of @entity2227 and @entity1160 in the same mitochondria (by use of triple labelling). Antisera to the N- and C-termini of glutaminase revealed strong labelling of the putatively glutamatergic mossy fibre terminals. The vast majority of gold particles (approximately 96%) was associated with the mitochondria. Equally high labelling intensities were found in mitochondria of perikarya and dendrites in the pontine nuclei, a major source of mossy fibres. The level of glutaminase immunoreactivity in parallel and climbing fibres (which like the mossy fibres are thought to use @entity2227 as transmitter) was only about 20% of that in mossy fibres, and similar to that in non-glutamatergic neurons (Purkinje and Golgi cells). Glial cell mitochondria were devoid of specific glutaminase labelling and revealed a much lower @entity2227 : @entity1160 ratio than did the mitochondria of mossy fibres. As to the submitochondrial localization of glutaminase, immunogold particles were often found to be aligned with the cristae, suggesting an association of the enzyme with the inner mitochondrial membrane. However, the existence of a glutaminase pool in the mitochondrial matrix could not be excluded. The outer mitochondrial membrane was unlabelled. The present study provides quantitative evidence for a substantial heterogeneity in the mitochondrial content of glutaminase. This heterogeneity applies not only to neurons with different transmitter signatures, but also to different categories of glutamatergic pathways. In terms of the routes involved, the synthesis of transmitter @entity2227 may be less uniform than previously expected.

2098368

2098369

2098370

Effect of a micronized purified XXXX fraction on in vivo platelet functions in the @entity35 .

multiple_choice

The aim of this study was to investigate the effects of a micronized purified @entity3096 fraction (MPFF) on in vivo @entity35 platelet functions. @entity1423 and disaggregation were evaluated by a noninvasive, automated isotope monitoring system (AimsPlus). @entity4343 -labeled platelets were injected into anesthetized @entity35 and stimulated by @entity857 ( @entity857 ) (10 microg/kg, i.v.) or collagen (50 microg/kg, i.v.). Fibrinogen binding to ex vivo @entity857 -activated platelets was determined by flow cytometry. MPFF (100 mg/kg, p.o.) significantly reduced @entity857 -induced @entity1423 (p<0.05) and increased @entity1423 (p<0.05) compared with controls. Moreover, MPFF inhibited collagen-induced @entity1423 (p<0.001) and increased @entity1423 (p<0.01). In addition, fibrinogen binding to 2.5 or 5 microM @entity857 -stimulated platelets also was reduced significantly (p<0.05 and 0.01, respectively). These results show that MPFF inhibits in vivo @entity35 platelet functions.

2098371

2098372

2098373

Effect of a micronized purified @entity3096 fraction on in vivo platelet functions in the XXXX .

multiple_choice

The aim of this study was to investigate the effects of a micronized purified @entity3096 fraction (MPFF) on in vivo @entity35 platelet functions. @entity1423 and disaggregation were evaluated by a noninvasive, automated isotope monitoring system (AimsPlus). @entity4343 -labeled platelets were injected into anesthetized @entity35 and stimulated by @entity857 ( @entity857 ) (10 microg/kg, i.v.) or collagen (50 microg/kg, i.v.). Fibrinogen binding to ex vivo @entity857 -activated platelets was determined by flow cytometry. MPFF (100 mg/kg, p.o.) significantly reduced @entity857 -induced @entity1423 (p<0.05) and increased @entity1423 (p<0.05) compared with controls. Moreover, MPFF inhibited collagen-induced @entity1423 (p<0.001) and increased @entity1423 (p<0.01). In addition, fibrinogen binding to 2.5 or 5 microM @entity857 -stimulated platelets also was reduced significantly (p<0.05 and 0.01, respectively). These results show that MPFF inhibits in vivo @entity35 platelet functions.

2098374

2098375

2098376

Total laparoscopic repair of XXXX with short proximal necks.

multiple_choice

With the development of @entity439 repair, @entity1028 with short infrarenal necks (< or =10 mm, AAASN) are considered @entity439 . Minimally invasive treatment consists of hybrid procedures or fenestrated endografts. We present our experience with direct aortic repair for AAASN performed via a total laparoscopic approach. Data are expressed as median values with extremes. From February 2002 to December 2007, 32 @entity1 had total laparoscopic AAASN repair. Length of the infrarenal aortic neck was 5 mm (0-10). Median age of the 29 @entity1 and three @entity1 was 70 years (range 50-84). Nine @entity1 presented with preoperative grade 1 @entity177 (28.1%). The procedure was totally laparoscopic in 30 @entity1 (93.7%). Aortic approaches included left retrorenal (n = 24) and transperitoneal left retrocolic (n = 8) exposures. Median operative and clamping times were 270 (range 215-410) and 83 (range 36-147) min, respectively. Aortic clamping was suprarenal in 14 cases (43.7%), with suprarenal clamping time of 24 min (range 9-37). Median @entity190 was 850 mL (range 215-2,400). Thirty-day mortality was 3.1% (one @entity1 died from @entity583 ). Two @entity1 presented with severe @entity262 complications (6.4%, @entity86 with @entity548 , @entity9757 ). Seventeen @entity1 developed mild or moderate @entity262 nonlethal complications (53.1%): transient @entity177 (n = 12), grade 1 @entity63 (n = 1), surrenal insufficiency (n = 1), @entity741 (n = 1), and @entity299 (n = 2). One @entity1 was reoperated for an @entity1321 . Liquid diet was reintroduced after 1 day (range 1-13). Most @entity1 were ambulatory by day 3 (range 2-17). Median lengths of stay were 48 hr (range 12-552) in the intensive care unit and 10 days (range 4-37) in the hospital. With a median follow-up of 27 months (range 1-50), 28 @entity1 are alive, with complete recovery without graft anomalies. Three @entity1 died, from @entity9757 (n = 1) and @entity189 (n = 2), respectively, at 29, 19, and 44 months' follow-up. Two @entity1 presented stable juxta-renal aortic dilation <35 mm. Total laparoscopic juxtarenal AAA repair is feasible and worthwhile for @entity1 with AAASN. Short- and midterm results match well with those of open surgery. Total laparoscopic repair in AAASN reduces the @entity130 . Based on these encouraging early results, we elected to perform laparoscopy whenever possible in good surgical risk @entity1 with AASN.

2098377

2098378

2098379

Caregiver recall of treatment recommendations in XXXX .

multiple_choice

OBJECTIVE: Health care providers in @entity4932 ( @entity4932 ) might refer to caregivers' self-report of @entity1 's treatment-related behaviors to assist in clinical decisions. However, caregivers may believe that they are adhering to treatment even though they have a different understanding of recommendations than that intended by the medical team. We examined whether caregiver recall of @entity1 's @entity4932 treatment matched actual recommendations at baseline and 3, 6, 9, and 12 months. METHODS: A total of 235 primary caregivers were recruited from rheumatology clinics at 2 pediatric university-based teaching hospitals in Canada. Using the Parent Adherence Report Questionnaire, caregivers indicated whether their @entity1 was prescribed medications and/or exercises. Medical charts were reviewed to determine the prescribed treatment. Level of agreement between both sets of data was then examined. RESULTS: A total of 175 caregivers provided complete data. Mean age of the @entity1 was 10.2 years (68.6% @entity1 ); 44.6% were diagnosed with @entity4932 . Kappa coefficients for medication represented substantial to almost perfect agreement beyond chance, with better levels of agreement at 12 months (kappa = 0.81, 95% confidence interval [95% CI] 0.68, 0.94) than at baseline (kappa = 0.61, 95% CI 0.47, 0.76). Kappa coefficients for exercise represented slight to moderate agreement beyond chance, with better agreement at 12 months (kappa = 0.44, 95% CI 0.24, 0.63) than at baseline (kappa = 0.27, 95% CI 0.08, 0.47). CONCLUSION: Weaker agreement for the exercise regimen raises concern that caregivers may pay less attention to exercise recommendations or that these recommendations may not be easily understood.

2098380

2098381

2098382

The effect of chromosome 9p21 variants on XXXX may be modified by dietary intake: evidence from a case/control and a prospective study.

multiple_choice

BACKGROUND: One of the most robust genetic associations for @entity65 ( @entity65 ) is the Chromosome 9p21 region. However, the interaction of this locus with environmental factors has not been extensively explored. We investigated the association of 9p21 with @entity583 ( @entity583 ) in individuals of different ethnicities, and tested for an interaction with environmental factors. METHODS AND FINDINGS: We genotyped four 9p21 SNPs in 8,114 individuals from the global INTERHEART study. All four variants were associated with @entity583 , with odds ratios (ORs) of 1.18 to 1.20 (1.85 10(-8) <=p <=5.21 10(-7)). A significant interaction (p=4.0 10(-4)) was observed between @entity29765 and a factor-analysis-derived "prudent" diet pattern score, for which a major component was raw vegetables. An effect of 9p21 on @entity583 was observed in the group with a low prudent diet score (OR=1.32, p=6.82 10(-7)), but the effect was diminished in a step-wise fashion in the medium (OR=1.17, p=4.9 10(-3)) and high prudent diet scoring groups (OR=1.02, p=0.68) (p=0.014 for difference). We also analyzed data from 19,129 individuals (including 1,014 incident cases of @entity65 ) from the prospective FINRISK study, which used a closely related dietary variable. In this analysis, the 9p21 risk allele demonstrated a larger effect on @entity65 risk in the groups with diets low or average for fresh vegetables, fruits, and berries (hazard ratio [HR]=1.22, p=3.0 10(-4), and HR=1.35, p=4.1 10(-3), respectively) compared to the group with high consumption of these foods (HR=0.96, p=0.73) (p=0.0011 for difference). The combination of the least prudent diet and two copies of the risk allele was associated with a 2-fold increase in risk for @entity583 (OR=1.98, p=2.11 10(-9)) in the INTERHEART study and a 1.66-fold increase in risk for @entity65 in the FINRISK study (HR=1.66, p=0.0026). CONCLUSIONS: The risk of @entity583 and @entity65 conferred by Chromosome 9p21 SNPs appears to be modified by a prudent diet high in raw vegetables and fruits. Please see later in the article for the Editors' Summary.

2098383

2098384

2098385

Modified FOLFIRI as Second-Line Chemotherapy after Failure of Modified FOLFOX-4 in Advanced XXXX .

multiple_choice

PURPOSE: The purpose of this study was to evaluate efficacy and @entity137 of @entity2600 , @entity4181 and @entity1487 (FOLFIRI) as second-line treatment after failure of @entity901 , @entity4181 and @entity1487 (FOLFOX) for advanced @entity356 . MATERIALS AND METHODS: @entity1 who received modified FOLFOX-4 as first-line treatment and then received sequential modified FOLFIRI for disease progression were included in this study. The modified FOLFIRI regimen consisted of @entity2600 150 mg/m(2) in a 90-minute intravenous infusion on day 1, @entity4181 (LV) 20 mg/m(2) and @entity1487 ( @entity1487 ) 400 mg/m(2) as a bolus followed by 600 mg/m(2) as a 22-hour infusion on days 1 and 2 with the same dose of @entity1487 /LV of modified FOLFOX-4 every 2 weeks. RESULTS: A total of 32 @entity1 received 126 courses of FOLFIRI chemotherapy. No complete response was achieved. Three @entity1 (9.4%; 95% confidence interval [CI], 0 to 20.1%) achieved partial response, whereas 11 (34.4%; 95% CI, 17.0 to 51.8%) @entity1 showed stable disease. Disease control rate (complete response, partial responses and stable diseases) was 43.8% (95% CI, 25.6 to 61.9%) and median follow up duration was 11.3 months (range, 2.23 to 37.9 months). Median time to progression was 2 months (95% CI, 1.49 to 2.51 months), and median overall survival from the start of FOLFIRI was 5.84 months (95% CI, 4.34 to 7.34 months). @entity137 were tolerable. CONCLUSION: Modified FOLFIRI as second-line chemotherapy after failure of the modified FOLFOX-4 in advanced @entity356 was tolerable but showed a lower response rate. Further study about retrying @entity1487 /LV with @entity2600 after failure of the @entity1487 /LV combined regimen is necessary in advanced @entity356 .

2098386

2098387

2098388

The primary patency of percutaneous transluminal angioplasty in hemodialysis XXXX with vascular access failure.

multiple_choice

BACKGROUND AND OBJECTIVES: Dysfunction of @entity2548 ( @entity2548 ) and @entity2758 ( @entity2758 ) contributes significantly to morbidity and hospitalization in the dialysis population. We evaluated the primary patency of @entity2548 following percutaneous transluminal angioplasty (PTA) in haemodialysis @entity1 . SUBJECTS AND METHODS: We performed 231 interventions in 118 @entity1 with a mean age of 62.1 12.9 years. We performed 122 interventions in 53 AVG @entity1 (44.9%), and 109 interventions in 65 AVF @entity1 (55.1%). If there was @entity715 of the vascular access, urokinase was administered and/or @entity715 aspiration was performed. The stent was inserted when balloon dilatation did not expand sufficiently or elastic recoil occurred. RESULTS: For the 118 @entity1 , the median patency time was 10.45 10.29 months at 92 months of follow-up. The primary patencies for stenotic @entity2548 at 6, 12, 24, 36, 48, and 60 months were 63.4%, 41.4%, 17.0%, 9.7%, 7.3%, and 2.4%, respectively. The primary patencies for @entity2758 at 6, 12, 24, and 36 months were 36.9%, 19.5%, 10.8%, 2.1%, respectively, and were obtained by means of the Kaplan-Meier analysis (log rank=6.42, p<0.05). The median patency time was 11.0 months and 4.45 months in the non- @entity715 and @entity715 groups, respectively. The complication rate was 1.73% (4/231); two cases of @entity2849 and two cases of extravasation were detected. All therapy failures (5/231) occurred in @entity5892 and were treated surgically. CONCLUSION: @entity865 is an efficacious method for the correction of stenosis of @entity2548 for hemodialysis, thus prolonging the patency of the @entity292 .

2098389

2098390

2098391

Correlation versus causation? Pharmacovigilance of the analgesic XXXX exemplifies the need for refined spontaneous ADR reporting.

multiple_choice

Annually, @entity137 result in more than 2,000,000 hospitalizations and rank among the top 10 causes of @entity204 in the United States. Consequently, there is a need to continuously monitor and to improve the safety assessment of marketed drugs. Nonetheless, pharmacovigilance practice frequently lacks causality assessment. Here, we report the case of @entity29588 , a centrally acting non-opioid analgesic. We re-evaluated the plausibility and causality of 226 unselected, spontaneously reported hepatobiliary @entity137 according to the adapted Bradford-Hill criteria, CIOMS score and WHO-UMC scales. Thorough re-evaluation showed that only about 20% of the reported cases were probable or likely for @entity29588 treatment, suggesting an incidence of @entity29588 -related @entity99 of 1 100,000 when estimated prescription data are considered, or 0.8 in 10,000 on the basis of all 226 reported @entity137 . Neither daily or cumulative dose nor duration of treatment correlated with markers of @entity99 . In the majority of cases (151/226), an average of 3 co-medications with drugs known for their liver liability was observed that may well be causative for @entity137 , but were reported under a suspected @entity29588 ADR. Our study highlights the need to improve the quality and standards of ADR reporting. This should be done with utmost care taking into account contributing factors such as concomitant medications including over-the-counter drugs, the medical history and current health conditions, in order to avoid unjustified flagging and drug warnings that may erroneously cause uncertainty among healthcare professionals and @entity1 , and may eventually lead to unjustified safety signals of useful drugs with a reasonable risk to benefit ratio.

2098392

2098393

2098394

Plasmapheresis before thymectomy in XXXX : routine versus selective protocols.

multiple_choice

OBJECTIVE: The value of thymectomy in management of @entity1737 ( @entity1737 ) is well recognized. Plasmapheresis (PMP) before thymectomy appears to improve the postoperative outcome. As PMP has its own complications, selective use of PMP preoperatively for @entity1 at risk of post-thymectomy complications would improve the postoperative outcome, and decreases the @entity25982 -related complications. The aim of this study is to evaluate the effectiveness and safety of routine versus selective use of PMP before thymectomy. MATERIAL AND METHODS: We performed a retrospective analysis of two different protocols in two institutions comparing the routine (group I) versus selective use (group II) of prethymectomy PMP. The computerized database and the medical records of 164 @entity1 diagnosed with @entity1737 who underwent thymectomy between 1998 and 2007, were reviewed. RESULTS: In group I, 74 @entity1 were treated with PMP before thymectomy. In group II (90 @entity1 ), 35 @entity1 were identified as high-risk and were treated with PMP before thymectomy, and in 55 @entity1 , thymectomy was performed without preoperative PMP. There was significant difference in the recorded PMP-related complications between group I and group II; 25.7% (19 @entity1 ) versus 8.9% (8 @entity1 ), respectively. There was no difference between the two groups as regards the duration of postoperative mechanical ventilation, intensive care unit (ICU) stay and hospital stay. CONCLUSION: This study demonstrated that selective use of PMP before thymectomy may reduce the incidence of PMP-related complications without affecting the overall outcome.

2098395

2098396

2098397

The staging of XXXX : understanding heterogeneity in treatment efficacy.

multiple_choice

@entity1 @entity295 is an intrinsically complex disease. Populations of @entity1 enrolled into clinical trials of novel @entity295 therapies are notoriously heterogeneous with respect to the inciting cause of their disease, the co-morbid conditions that define its course, and the acute severity of their initial presentation. This heterogeneity is reflected in strikingly variable mortality risks across studies, and probably, though less clearly-established, in variable response rates to a given intervention. In an accompanying article in this issue of Critical Care, Macias and colleagues argue that the effectiveness of adjuvant @entity295 therapies is not dependent on the baseline mortality risk, since the few "positive" trials that have been published show widely divergent placebo mortality rates. But this analysis assumes that biologically distinct interventions will be equally efficacious in clinically diverse populations, and confuses severity as a population descriptor with severity as a surrogate measure of a biologic state in an individual @entity1 . In a pivotal trial of recombinant @entity1 activated protein C (rhAPC) in @entity1 with severe @entity295 , an aggregate 6% mortality decrement appeared to be the result of negligible efficacy in the least severely ill @entity1 , and considerably greater efficacy in those who were at greatest risk of dying. A larger follow-up study recruiting low risk @entity1 confirmed this impression, showing a convincing absence of benefit in @entity1 who clinicians judged to be less severely ill. If we accept Macias' argument, we are led to the conclusion that rhAPC is of limited use in the management of severe @entity295 . On the other hand, if we view severity as a crude surrogate for a particular pathologic state, we would shift our focus to better defining those populations most likely to benefit from intervention, including @entity1 who may not have met criteria for entry in the original PROWESS trial--those with disseminated @entity5642 or acute organ dysfunction from causes other than @entity295 . Staging systems that stratify heterogeneous @entity1 populations by risk and by potential to benefit from intervention have proven to be essential to the development of multimodal adjuvant treatment for @entity5 . They will be no less important in the optimal management of @entity295 .

2098398

2098399

2098400

Endoluminal procedures for bariatric XXXX : expectations among bariatric surgeons.

multiple_choice

BACKGROUND: Primary and revisional bariatric endoluminal procedures are currently being developed. Acceptable levels of risk and @entity353 for these procedures have not yet been established. The aim of this study was to evaluate the expectations and concerns among bariatric surgeons regarding these procedures. METHODS: The American Society for Metabolic and Bariatric Surgery Emerging Technologies Committee developed a questionnaire that was distributed to the membership. Risk tolerance was assessed with comparison to commonly performed endoscopic and bariatric procedures. The percentage of excess @entity353 (EWL) ranges were provided to assess the expectations for results 1 year after the procedure. RESULTS: A total of 214 responses were returned. The acceptable level of risk to achieve 10-20% EWL after primary and revisional procedures was equivalent to, or less than, that of a therapeutic endoscopic procedure for 81% and 76% of respondents, respectively. The acceptable level of risk to achieve 30-40% EWL after primary and revisional procedures was equivalent to that after laparoscopic adjustable gastric banding for 45% and 35% of respondents, respectively and equivalent to that after laparoscopic Roux-en-Y gastric bypass for 8% and 22%, respectively. In addition, 62% of respondents responded that 10-30% EWL would be acceptable for revisional procedures, and 35% responded that 10-30% EWL would be acceptable after a primary procedure. The primary concern was unproven efficacy, followed by durability, poor @entity353 , availability of equipment, and procedural risk. Finally, 58% would not be willing to recommend an endoluminal procedure until the efficacy has been established, regardless of the risk. CONCLUSION: Risk tolerance and @entity353 expectations among bariatric surgeons are different for primary and revisional endoscopic procedures. Most surgeons were unwilling to consider endoluminal procedures for their @entity1 until the efficacy has been proven.

2098401

2098402

2098403

Ipilimumab for advanced XXXX : a nursing perspective.

multiple_choice

PURPOSE/OBJECTIVES: To discuss the response patterns and side effects related to ipilimumab, a new immunotherapeutic agent under investigation in the treatment of advanced @entity320 and other @entity5 . DATA SOURCES: Published articles, abstracts, research data, and clinical experience. DATA SYNTHESIS: Ipilimumab is a fully human monoclonal antibody that inhibits the activity of @entity4386 ( @entity4386 ), a naturally immunosuppressive molecule. The most common side effects are immune mediated (e.g., inflammatory @entity294 , @entity111 ) and appear to occur as a direct result of @entity4386 inhibition and enhanced immune system activation. Side effects generally are grade I or II and resolve with standard treatments. Most grade III or IV events are managed successfully after @entity514 diagnosis and treatment with @entity288 ; @entity134 -refractory events resolve after treatment with infliximab or @entity6051 . CONCLUSIONS: The response patterns and side effects associated with ipilimumab therapy greatly differ from those common to other advanced @entity320 therapies (e.g., chemotherapy, cytokines, vaccines). IMPLICATIONS FOR NURSING: Nurses have an important role in educating @entity1 about the differences between anti- @entity4386 therapy and chemotherapy. In addition, teaching @entity1 to recognize ipilimumab's side effects and report them early can result in fast treatment to prevent symptom progression from grade I or II to III or IV. Communication between nurses and @entity1 throughout the treatment process will help @entity1 benefit maximally from the new therapeutic strategy.

2098404

2098405

2098406

Comparison of XXXX - and @entity6108 -mediated antiproliferative effects in colorectal cell lines.

multiple_choice

@entity14 remains a leading cause of @entity5 death worldwide, despite markedly improved response rates to current systemic therapies. @entity901 either alone or incorporated into @entity1487 /leucovorin regimes has resulted in increased survival rates, particularly with regards to metastatic @entity14 . The chemopreventive @entity3978 @entity6108 , which is currently in clinical trial, has been advocated for use in @entity14 either singly or in combination with chemotherapeutic drugs. In this study, the antiproliferative capacity of both compounds was compared in HCEC (normal-derived), HT29 ( @entity876 mutant @entity420 ) and HCT116 ( @entity876 wt @entity420 ) colorectal cell lines to determine whether effects were cell-type specific at pharmacologically achievable doses, and whether the combination resulted in enhanced efficacy. Both @entity901 and @entity6108 displayed marked antiproliferative capacity at therapeutic concentrations in the two @entity5 cell lines. Order of sensitivity to @entity901 was HCT116>HT29>HCEC, whereas order of sensitivity to @entity6108 was HT29>HCT116>HCEC. HCT116 cells underwent induction of G2/M arrest in response to both @entity901 (irreversible) and @entity6108 (reversible). Apoptosis was induced by both agents, and up to 16-fold induction of @entity876 protein was observed in response to the combination. Antiproliferative effects in HT29 cells were largely cell cycle independent, and were mediated by induction of apoptosis. Effects were greatly enhanced in both cell lines when agents were combined. This study provides further evidence that @entity6108 may be of use in therapeutic regimes directed against @entity14 , and suggests that in combination with @entity901 it may enhance efficacy of the latter in both @entity876 wt and @entity876 mutant @entity14 .

2098407

2098408

2098409

Comparison of @entity901 - and XXXX -mediated antiproliferative effects in colorectal cell lines.

multiple_choice

@entity14 remains a leading cause of @entity5 death worldwide, despite markedly improved response rates to current systemic therapies. @entity901 either alone or incorporated into @entity1487 /leucovorin regimes has resulted in increased survival rates, particularly with regards to metastatic @entity14 . The chemopreventive @entity3978 @entity6108 , which is currently in clinical trial, has been advocated for use in @entity14 either singly or in combination with chemotherapeutic drugs. In this study, the antiproliferative capacity of both compounds was compared in HCEC (normal-derived), HT29 ( @entity876 mutant @entity420 ) and HCT116 ( @entity876 wt @entity420 ) colorectal cell lines to determine whether effects were cell-type specific at pharmacologically achievable doses, and whether the combination resulted in enhanced efficacy. Both @entity901 and @entity6108 displayed marked antiproliferative capacity at therapeutic concentrations in the two @entity5 cell lines. Order of sensitivity to @entity901 was HCT116>HT29>HCEC, whereas order of sensitivity to @entity6108 was HT29>HCT116>HCEC. HCT116 cells underwent induction of G2/M arrest in response to both @entity901 (irreversible) and @entity6108 (reversible). Apoptosis was induced by both agents, and up to 16-fold induction of @entity876 protein was observed in response to the combination. Antiproliferative effects in HT29 cells were largely cell cycle independent, and were mediated by induction of apoptosis. Effects were greatly enhanced in both cell lines when agents were combined. This study provides further evidence that @entity6108 may be of use in therapeutic regimes directed against @entity14 , and suggests that in combination with @entity901 it may enhance efficacy of the latter in both @entity876 wt and @entity876 mutant @entity14 .

2098410

2098411

2098412

Underdiagnosis of pediatric obesity and underscreening for fatty liver disease and XXXX by pediatricians and pediatric subspecialists.

multiple_choice

OBJECTIVES: To evaluate how often general pediatricians, pediatric endocrinologists, and gastroenterologists diagnose @entity1 as overweight and how often interventions are provided, including nutritional counseling and screening for @entity1561 ( @entity1561 ) and @entity209 . STUDY DESIGN: The study was a retrospective chart review of outpatient visits at 2 academic hospitals. RESULTS: A total of 2256 @entity1 visits were analyzed, including 715 visits by overweight @entity1 . Of those 715 visits, 31% resulted in a diagnosis of overweight. Diagnosis of overweight and nutritional counseling were least likely to occur during gastroenterology visits (22% and 13%, respectively, P < .01). Screening for @entity209 was most likely to occur during endocrinology visits (34%; P < .01). Screening for @entity1561 was most likely to occur during gastroenterology visits (23%; P < .01). @entity1 age < 5 years and those with a body mass index percentile (BMI%) of 85% to 94% were least likely to receive diagnosis and intervention for overweight. CONCLUSIONS: The majority of overweight @entity1 were not diagnosed and did not receive relevant and recommended evaluations and interventions. Specific attention should be focused on providing diagnosis and interventions for overweight @entity1 , especially those age < 5 years and with a BMI% of 85% to 94%.

2098413

2098414

2098415

Serum pepsinogens and risk of XXXX in the General Population Nutrition Intervention Trial cohort.

multiple_choice

OBJECTIVE: Low serum @entity7597 ( @entity7597 ) and low @entity7597 /pepsinogen II ratio ( @entity7597 ) are markers of @entity356 . We aimed to prospectively test the association between serum @entity7597 /II ratio and risks of @entity418 , @entity418 , and @entity957 ( @entity957 ). DESIGN: Case-cohort study nested in a prospective cohort with over 15 years of follow-up. SETTING: Rural region of the @entity1 's Republic of China. SUBJECTS: @entity1 and @entity1 aged 40-69 years at study baseline. MAIN OUTCOME MEASURES: Adjusted hazard ratios and 95% confidence intervals for the association between serum @entity7597 /II ratio and @entity5 risk. RESULTS: Compared to subjects with @entity7597 /II ratio of >4, those with <or=4 had hazard ratios (HRs) (95% CIs) of 2.72 (1.77 to 4.20) and 2.12 (1.42 to 3.16) for @entity418 , respectively. Risk of both @entity5 was also increased when we used other cut points ranging from 3 to 6, or quartile models, or nonlinear continuous models. Risk of @entity957 was marginally increased in those with @entity7597 /II ratio <or=4, with HR (95% CI) of 1.56 (0.99 to 2.47), but quartile models and continuous models showed no increased risk. The nonlinear continuous models suggested that any single cut point collapsed subjects with dissimilar @entity356 risks, and that using cut points was not an efficient use of data in evaluating these associations. CONCLUSION: In this prospective study, we found similar and significantly increased risks of @entity418 in subjects with low @entity7597 /II ratio but little evidence for an association with the risk of @entity957 .

2098416

2098417

2098418

Management of XXXX .

multiple_choice

OBJECTIVE: There appears to be a high incidence of @entity29542 in New Zealand. This study was designed to evaluate the diagnosis and surgical treatment of plunging @entity29542 in @entity1 at Auckland Starship @entity1 's Hospital, New Zealand. METHODS: A prospective study of 21 pediatric @entity1 with a clinical diagnosis of plunging @entity29542 was conducted. All @entity1 underwent clinical assessment and fine needle aspiration cytology. Cytological diagnosis was considered definitive and radiological investigations were not conducted. Surgical treatment comprising intraoral excision of the ipsilateral sublingual gland and @entity9007 was performed. RESULTS: The preoperative diagnosis was unchanged after surgery and histopathological analysis in all cases. There were no recurrences at 24-month follow up. There are no long-term complications to date. CONCLUSIONS: Intraoral removal of the sublingual glands and @entity9007 is an effective and safe method for the treatment of plunging @entity29542 in the pediatric population.

2098419

2098420

2098421

@entity7604 infusion: a therapeutic option in XXXX after primary percutaneous transluminal coronary angioplasty.

multiple_choice

A 42-year-old male presented to the emergency department with acute @entity662 . The electrocardiogram revealed @entity583 . Emergency coronary angiography revealed @entity432 of the distal right coronary artery with @entity715 . @entity1 was taken up for primary percutaneous coronary angioplasty with stenting of distal right coronary artery. Six hours following the procedure, the @entity1 developed re-elevation of ST-segment in inferior leads of electrocardiogram and subsequent @entity1344 . Repeat coronary angiography revealed patent stent and @entity3361 in proximal part, which was relieved by intracoronary injection of @entity12118 . After an hour, the @entity1 re-developed symptoms of @entity662 along with @entity1168 , @entity551 and ST segment elevation. Intravenous infusion of @entity12118 did not improve the condition but produced persistent @entity551 . Infusion of @entity7604 was then started. Over time, normalisation of electrocardiogram occurred. The @entity1 was discharged in stable condition. This case suggests that @entity7604 may be effective in alleviating @entity3361 when the use of other agents fails.

2098422

2098423

2098424

XXXX infusion: a therapeutic option in @entity3361 after primary percutaneous transluminal coronary angioplasty.

multiple_choice

A 42-year-old male presented to the emergency department with acute @entity662 . The electrocardiogram revealed @entity583 . Emergency coronary angiography revealed @entity432 of the distal right coronary artery with @entity715 . @entity1 was taken up for primary percutaneous coronary angioplasty with stenting of distal right coronary artery. Six hours following the procedure, the @entity1 developed re-elevation of ST-segment in inferior leads of electrocardiogram and subsequent @entity1344 . Repeat coronary angiography revealed patent stent and @entity3361 in proximal part, which was relieved by intracoronary injection of @entity12118 . After an hour, the @entity1 re-developed symptoms of @entity662 along with @entity1168 , @entity551 and ST segment elevation. Intravenous infusion of @entity12118 did not improve the condition but produced persistent @entity551 . Infusion of @entity7604 was then started. Over time, normalisation of electrocardiogram occurred. The @entity1 was discharged in stable condition. This case suggests that @entity7604 may be effective in alleviating @entity3361 when the use of other agents fails.

2098425

2098426

2098427

[Cheilectomy and Kessel-Bonney procedure for treatment of XXXX ].

multiple_choice

OBJECTIVE: Joint-preserving procedure for initial @entity571 of the first metatarsophalangeal joint for improvement of restricted joint motion and achievement of a harmonic gait. INDICATIONS: @entity24070 stage I and II according to Regnauld's classification. CONTRAINDICATIONS: @entity24070 Regnauld stage III. General medical contraindications to surgical interventions and anesthesiological procedures. SURGICAL TECHNIQUE: Operation in regional anesthesia (foot block). Tourniquet. Longitudinal skin incision over the dorsal aspect of the first metatarsophalangeal joint. Incision of the joint capsule with protection of the @entity531 . Cheilectomy: removal of osteophytes at the metatarsal head and the base of the proximal phalanx. Resection of the dorsal third of the metatarsal head with an oscillating saw in @entity1411 of the proximal phalanx. Kessel-Bonney procedure: dissection of the proximal phalanx. Incomplete dorsal osteotomy with an oscillating saw at the metaphysis of the proximal phalanx and removal of a dorsal wedge with a base of 2-3 mm. Osteosynthesis with mini-plate or transosseous suture. POSTOPERATIVE MANAGEMENT: Postoperative elevation of the operated foot. Analgesia with nonsteroidal anti-inflammatory drugs. Postoperative shoe for 3-4 weeks. Immediate weight bearing. Mobilization of the metatarsophalangeal joint with an elastic bandage. Taping in extension and elastic forefoot dressing for 3 weeks postoperatively. Clinical and radiologic controls after 6 and 12 weeks. RESULTS: 53 operations on 45 @entity1 were performed. 39 @entity1 (86%; 28 female, eleven male, mean age 43.6 years) were followed up. After a period of 26 months (range: 10-51 months), 32 of 39 @entity1 (82%) were satisfied or very satisfied. The median preoperative range of motion was 12.3 degrees for dorsal extension and 17.1 degrees for @entity1411 . Function had increased to a dorsiflexion of 34.2 degrees and a @entity1411 of 32.8 degrees. All @entity1 returned to a normal walking ability after a mean period of 3.7 weeks. Due to delayed wound @entity446 , one revision was necessary. According to Kitaoka's Forefoot Score, the mean preoperative value of 44.3 (standard deviation [SD]: +/- 16) increased postoperatively to a mean value of 78.9 (SD: +/- 12).

2098428

2098429

2098430

Long-term follow-up and cost analysis following surgery for @entity1744 caused by intra- XXXX .

multiple_choice

BACKGROUND: This study examined the natural course of @entity1 following surgery for @entity1744 ( @entity1744 ) caused by @entity1661 . In addition, a cost analysis was performed. METHODS: A retrospective analysis was undertaken of 102 @entity1 who underwent surgery between 1987 and 1992 for @entity1321 due to @entity1661 . RESULTS: Median follow-up was 14 years. The 102 @entity1 experienced 273 episodes of @entity1321 after the index operation, of which 237 involved inpatient readmissions; 47.3 per cent of the episodes resulted in further surgery. @entity302 were more common in @entity1 with no previous abdominal surgery (P < 0.001). Some 52.0 per cent of the @entity1 had undergone only one operation for @entity1744 . A mean of 2.7 episodes per @entity1 occurred after the index operation. The cost of adhesion-related problems in this study was 1,588,594 @entity7634 or 6702 @entity7634 per inpatient episode. CONCLUSION: The readmission rate in a selected cohort of @entity1 with proven intra- @entity1661 was higher than reported previously. The annual cost of adhesion-related problems in Sweden was estimated as 39.9-59.5 million @entity7634 , and the cost of inpatient readmissions was almost equal to that for @entity356 .

2098431

2098432

2098433

Long-term follow-up and cost analysis following surgery for XXXX caused by intra- @entity1661 .

multiple_choice

BACKGROUND: This study examined the natural course of @entity1 following surgery for @entity1744 ( @entity1744 ) caused by @entity1661 . In addition, a cost analysis was performed. METHODS: A retrospective analysis was undertaken of 102 @entity1 who underwent surgery between 1987 and 1992 for @entity1321 due to @entity1661 . RESULTS: Median follow-up was 14 years. The 102 @entity1 experienced 273 episodes of @entity1321 after the index operation, of which 237 involved inpatient readmissions; 47.3 per cent of the episodes resulted in further surgery. @entity302 were more common in @entity1 with no previous abdominal surgery (P < 0.001). Some 52.0 per cent of the @entity1 had undergone only one operation for @entity1744 . A mean of 2.7 episodes per @entity1 occurred after the index operation. The cost of adhesion-related problems in this study was 1,588,594 @entity7634 or 6702 @entity7634 per inpatient episode. CONCLUSION: The readmission rate in a selected cohort of @entity1 with proven intra- @entity1661 was higher than reported previously. The annual cost of adhesion-related problems in Sweden was estimated as 39.9-59.5 million @entity7634 , and the cost of inpatient readmissions was almost equal to that for @entity356 .

2098434

2098435

2098436

Evaluation of correlation between carotid artery intima media wall thickness and XXXX in Sari, north of Iran.

multiple_choice

The purpose of this study was to investigate role of predictive value of carotid artery ultrasonography on the basis of intima-media thickness in @entity453 . Ultrasonography and quantitative coronary angiography were achieved for assessment carotid and @entity453 in 80 consecutive @entity1 (mean age 57.37 years) with @entity662 that referred for cardiac catheterization. Mean values of parameters were recognized that carotid artery @entity731 to be equally involved between left and right carotid arteries. Fifty nine (73.8%) of @entity1 had @entity453 . Degree of involvement in coronary arteries regarding the @entity6520 were 26, 30, 21, 15 and 8%. The most of @entity1 have 1-VD involvement. There is a significant association between mean IMT of carotid and CAD. The 80% of @entity1 had @entity101 (> or = 0.8 mm). None of @entity1 with normal coronary angiography have IMT most of 1.2 mm. @entity66 has a acceptable sensitivity (87%), Specifity (43%), negative predictive value (54%) and positive predictive value (81%) for presence of CAD. In @entity1 that assessment for @entity662 , @entity101 of carotid artery in ultrasonography (> or = 1.2 mm) has significantly related to presence of CAD. @entity1 with mean IMT over 1.2 mm, 87% likehood of presence of @entity3979 in our region that must be evaluated, treatment and followed. Therefor, measurement of carotid IMT seem to be a predictive parameter for presence and severity of CAD. This is a useful, noninvasive peripheral marker for assessment presence of @entity453 .

2098437

2098438

2098439

Imaging and analytical methods as applied to the evaluation of vasculature and XXXX in @entity1 @entity1313 .

multiple_choice

Tissue @entity519 results from the interaction of cellular respiration, vascular @entity26 carrying capacity, and vessel distribution. We studied the relationship between @entity5 vasculature and regions of low pO(2) using quantitative analysis of binding of the @entity13682 EF5 given to @entity1 intravenously (21 mg/kg) approximately 24 h preceding surgery. We describe new computer algorithms for determining EF5 binding as a function of radial distance from individual blood vessels and converting this value to tissue @entity4095 . Tissues from six @entity1 @entity1313 were assessed. In a @entity2698 , a WHO Grade 2 and WHO Grade 3 glial @entity1313 , all tissue pO(2) values calculated by EF5 binding were >20 mmHg (described as "physiologically oxygenated"). In these three @entity5 , EF5 binding gradients (measured as a function of distance from each observed vessel) were low, with small positive and negative values averaging close to zero. Much lower tissue @entity26 levels were found, including near some vessels, in @entity463 . Gradients of EF5 binding away from vessels were larger in @entity463 than in the low-grade @entity5 , but positive and negative values again averaged to near zero. Based on these preliminary data, we hypothesize a new paradigm for @entity5 blood flow in @entity1 @entity1313 whereby in-flowing and out-flowing blood patterns may have contrasting effects on average tissue EF5 (and by inference, @entity26 ) gradients. Our studies also imply that neither distance to the nearest blood vessel nor distance from each observed blood vessel provide reliable estimates of tissue pO(2).

2098440

2098441

2098442

Imaging and analytical methods as applied to the evaluation of vasculature and @entity519 in @entity1 XXXX .

multiple_choice

Tissue @entity519 results from the interaction of cellular respiration, vascular @entity26 carrying capacity, and vessel distribution. We studied the relationship between @entity5 vasculature and regions of low pO(2) using quantitative analysis of binding of the @entity13682 EF5 given to @entity1 intravenously (21 mg/kg) approximately 24 h preceding surgery. We describe new computer algorithms for determining EF5 binding as a function of radial distance from individual blood vessels and converting this value to tissue @entity4095 . Tissues from six @entity1 @entity1313 were assessed. In a @entity2698 , a WHO Grade 2 and WHO Grade 3 glial @entity1313 , all tissue pO(2) values calculated by EF5 binding were >20 mmHg (described as "physiologically oxygenated"). In these three @entity5 , EF5 binding gradients (measured as a function of distance from each observed vessel) were low, with small positive and negative values averaging close to zero. Much lower tissue @entity26 levels were found, including near some vessels, in @entity463 . Gradients of EF5 binding away from vessels were larger in @entity463 than in the low-grade @entity5 , but positive and negative values again averaged to near zero. Based on these preliminary data, we hypothesize a new paradigm for @entity5 blood flow in @entity1 @entity1313 whereby in-flowing and out-flowing blood patterns may have contrasting effects on average tissue EF5 (and by inference, @entity26 ) gradients. Our studies also imply that neither distance to the nearest blood vessel nor distance from each observed blood vessel provide reliable estimates of tissue pO(2).

2098443

2098444

2098445

Imaging and analytical methods as applied to the evaluation of vasculature and @entity519 in XXXX @entity1313 .

multiple_choice

Tissue @entity519 results from the interaction of cellular respiration, vascular @entity26 carrying capacity, and vessel distribution. We studied the relationship between @entity5 vasculature and regions of low pO(2) using quantitative analysis of binding of the @entity13682 EF5 given to @entity1 intravenously (21 mg/kg) approximately 24 h preceding surgery. We describe new computer algorithms for determining EF5 binding as a function of radial distance from individual blood vessels and converting this value to tissue @entity4095 . Tissues from six @entity1 @entity1313 were assessed. In a @entity2698 , a WHO Grade 2 and WHO Grade 3 glial @entity1313 , all tissue pO(2) values calculated by EF5 binding were >20 mmHg (described as "physiologically oxygenated"). In these three @entity5 , EF5 binding gradients (measured as a function of distance from each observed vessel) were low, with small positive and negative values averaging close to zero. Much lower tissue @entity26 levels were found, including near some vessels, in @entity463 . Gradients of EF5 binding away from vessels were larger in @entity463 than in the low-grade @entity5 , but positive and negative values again averaged to near zero. Based on these preliminary data, we hypothesize a new paradigm for @entity5 blood flow in @entity1 @entity1313 whereby in-flowing and out-flowing blood patterns may have contrasting effects on average tissue EF5 (and by inference, @entity26 ) gradients. Our studies also imply that neither distance to the nearest blood vessel nor distance from each observed blood vessel provide reliable estimates of tissue pO(2).

2098446

2098447

2098448

Apoptosis and XXXX expression in the livers of @entity1 with @entity1560 .

multiple_choice

OBJECTIVES: Apoptosis may play a role in the pathogenesis of alcoholic ( @entity14087 ) and @entity7936 ( @entity7936 ). In this study, we investigated the modulation of apoptosis-related liver proteins in @entity1560 . METHODS: Hepatocyte apoptosis was evaluated by the TUNEL assay in liver tissue of 12 @entity1 with @entity7936 , 12 with @entity14087 and in histologically normal controls. In addition, @entity522 processing was evaluated by immunoblot analysis. Expression of death receptors, @entity588 family members, and NF-kappaB inhibitor (IkappaB) were determined by western blot. Liver biopsies were also graded for @entity32 and @entity82 . RESULTS: Apoptotic hepatocytes were markedly increased in @entity7936 (P<0.05) and @entity14087 (P<0.001) as compared to controls. Active @entity522 was also elevated in @entity1560 (P<0.01), coinciding with upregulation of pro-apoptotic @entity589 (P<0.001). Further, production of @entity5 @entity39 factor-receptor 1 was increased up to 4-fold (P<0.05). Degradation of IkappaB increased >70% in @entity1560 (P<0.001). Notably, @entity588 was also strongly expressed (>100-fold; P<0.001). These data were significantly correlated with relative degrees of @entity32 . CONCLUSION: The results show that @entity99 in @entity7936 and @entity14087 is associated with apoptosis and NF-kappaB activation. Anti-apoptotic @entity588 is strongly expressed, probably reflecting an adaptive response to @entity28 or @entity167 -related stress.

2098449

2098450

2098451

Apoptosis and @entity588 expression in the livers of @entity1 with XXXX .

multiple_choice

OBJECTIVES: Apoptosis may play a role in the pathogenesis of alcoholic ( @entity14087 ) and @entity7936 ( @entity7936 ). In this study, we investigated the modulation of apoptosis-related liver proteins in @entity1560 . METHODS: Hepatocyte apoptosis was evaluated by the TUNEL assay in liver tissue of 12 @entity1 with @entity7936 , 12 with @entity14087 and in histologically normal controls. In addition, @entity522 processing was evaluated by immunoblot analysis. Expression of death receptors, @entity588 family members, and NF-kappaB inhibitor (IkappaB) were determined by western blot. Liver biopsies were also graded for @entity32 and @entity82 . RESULTS: Apoptotic hepatocytes were markedly increased in @entity7936 (P<0.05) and @entity14087 (P<0.001) as compared to controls. Active @entity522 was also elevated in @entity1560 (P<0.01), coinciding with upregulation of pro-apoptotic @entity589 (P<0.001). Further, production of @entity5 @entity39 factor-receptor 1 was increased up to 4-fold (P<0.05). Degradation of IkappaB increased >70% in @entity1560 (P<0.001). Notably, @entity588 was also strongly expressed (>100-fold; P<0.001). These data were significantly correlated with relative degrees of @entity32 . CONCLUSION: The results show that @entity99 in @entity7936 and @entity14087 is associated with apoptosis and NF-kappaB activation. Anti-apoptotic @entity588 is strongly expressed, probably reflecting an adaptive response to @entity28 or @entity167 -related stress.

2098452

2098453

2098454

Apoptosis and @entity588 expression in the livers of XXXX with @entity1560 .

multiple_choice

OBJECTIVES: Apoptosis may play a role in the pathogenesis of alcoholic ( @entity14087 ) and @entity7936 ( @entity7936 ). In this study, we investigated the modulation of apoptosis-related liver proteins in @entity1560 . METHODS: Hepatocyte apoptosis was evaluated by the TUNEL assay in liver tissue of 12 @entity1 with @entity7936 , 12 with @entity14087 and in histologically normal controls. In addition, @entity522 processing was evaluated by immunoblot analysis. Expression of death receptors, @entity588 family members, and NF-kappaB inhibitor (IkappaB) were determined by western blot. Liver biopsies were also graded for @entity32 and @entity82 . RESULTS: Apoptotic hepatocytes were markedly increased in @entity7936 (P<0.05) and @entity14087 (P<0.001) as compared to controls. Active @entity522 was also elevated in @entity1560 (P<0.01), coinciding with upregulation of pro-apoptotic @entity589 (P<0.001). Further, production of @entity5 @entity39 factor-receptor 1 was increased up to 4-fold (P<0.05). Degradation of IkappaB increased >70% in @entity1560 (P<0.001). Notably, @entity588 was also strongly expressed (>100-fold; P<0.001). These data were significantly correlated with relative degrees of @entity32 . CONCLUSION: The results show that @entity99 in @entity7936 and @entity14087 is associated with apoptosis and NF-kappaB activation. Anti-apoptotic @entity588 is strongly expressed, probably reflecting an adaptive response to @entity28 or @entity167 -related stress.

2098455

2098456

2098457

Correlation of ultrasound attenuation and histopathological parameters of the liver in chronic XXXX .

multiple_choice

OBJECTIVE: In @entity1 with chronic @entity409 two characteristic ultrasound patterns of bright liver, the low ( @entity6684 ) and the high (DII) attenuation types, are seen. Correlation was studied between liver attenuation and histopathological analysis of biopsy specimens of the same @entity1 . METHODS: Ultrasound attenuation of the liver was measured quantitatively using a homogeneous tissue-equivalent reference phantom. Semiquantitative scores were used for histopathological analysis of biopsy specimens. RESULTS: One hundred and twenty-two @entity1 were investigated; 40 of them showed a normal liver echopattern. The average attenuation was 0.68+/-0.03 dB/cm per MHz. Histopathological parameters were normal in most of the @entity1 , except for four cases where a minimal amount of collagen and 14 cases where a subtle amount of lipid content could be detected, in three cases accompanied by some cells indicating @entity32 . From 82 @entity1 with bright liver, 47 showed the @entity6684 type. The average attenuation was 0.80+/-0.03 dB/cm per MHz. In all of these @entity1 , significant increases of collagen content and inflammatory reaction were found. In 23 cases a negligible amount of lipid deposition could also be revealed. Thirty-five @entity1 exhibited a DII-type bright liver. The average attenuation was 1.21+/-0.06 dB/cm per MHz. A significant amount of lipid deposition was detected in all cases. In 13 @entity1 a minimal amount of collagen and in 14 @entity1 some inflammatory cells were detected. CONCLUSIONS: In livers with a normal echopattern, none or minimal pathological changes were seen. In @entity6684 -type bright liver, connective tissue dominance exists, in DII-type bright liver lipid deposition dominance. On this basis it is proved that the diagnosis of a @entity1560 can be established without biopsy, if no other indication for biopsy exists.

2098458

2098459

2098460

XXXX : six new cases from China.

multiple_choice

BACKGROUND: @entity23577 is an infrequently reported disease characterized clinically by painless swelling of the soft tissues at interphalangeal joints. Histopathologic features include increased dermal accumulation of collagen fibers. Young males are predominantly affected. There are only approximately 50 cumulative cases reported worldwide. OBJECTIVE: : This is a review of 6 new cases of @entity23577 from our center. METHODS: Characteristics of our cases are described in detail and the literature of this disease is reviewed. RESULTS: The mean disease onset age of our 6 @entity1 was 14 +/- 2.7 years; 5 of the @entity1 were male and 1 was female. Clinical presentations included chronic noninflammatory bulbous swelling of proximal interphalangeal (PIP) joints. Mean numbers of @entity2720 were 5 +/- 3; most frequently affected were PIP2, 3, and 4 symmetrically. There was 1 @entity1 with monoarticular involvement. X-ray demonstrated soft tissue swelling with no bony or @entity16 . Histopathology displayed increased dermal deposition of collagen fibers. CONCLUSIONS: @entity23577 is not well recognized by rheumatologists and should be differentiated from inflammatory @entity625 involving @entity6520 .

2098461

2098462

2098463

The association between blood XXXX value and long-term mortality.

multiple_choice

This study aims at estimating the association between different fasting blood @entity413 levels (FBG) and total mortality during a long-term follow-up. In all 2,300 subjects were health examined, out of a stratified sample of 32,185 individuals aged 18-64 years drawn from the population in Stockholm County from the years 1969-70. FBG values were divided into following groups:<3.0, 3.0-4.4, 4.5-5.5, 5.66.0, 6.1-6.6, and > 6.6 mmol/l (corresponding to fasting plasma @entity413 , FPG,<3.5, 3.5-4.9, 5.0-6.0, 6.1-6.9, 7.0-7.7 and > 7.7 mmol/l), and known @entity6 . All @entity1 were followed up in the National Cause of Death Register up to the end of 1996. Multivariate analysis was performed by Cox regression, with three models, the first age- and sex-adjusted, the second also adjusted for care need category and @entity101 , and the third with added BMI-category, with hazard ratios (HR) and 95% confidence interval (CI). Smoking habits were available for around half of the sample. Compared to the FBG showing the lowest mortality, i.e. @entity68016 .6-6.0 mmol/l, we found an age- and sex-adjusted excess risk for subjects with known @entity6 (HR 7.39, 95% CI 3.78-14.45), with FBG > 6.6 mmol/l (HR 2.30, 95% CI 1.20-4.39), and with FBG<3.0 mmol/l (HR 3.44, 95% CI 1.47-8.06). The excess risk persisted when adjusting for care need, @entity101 , BMI, and also for smoking. The cause of the increased mortality risk with low FBG values is unclear, but low FBG value seems to be a risk marker of poor health.

2098464

2098465

2098466

Early XXXX after laparoscopic gastric bypass: case series and treatment algorithm.

multiple_choice

BACKGROUND: To review our experience with early @entity3885 ( @entity3885 ) at a large academic teaching hospital and provide a management algorithm. Early @entity3885 is a known and often overlooked complication of laparoscopic Roux-en-Y gastric bypass. METHODS: From 2003 to 2007, 1097 @entity1 underwent laparoscopic Roux-en-Y gastric bypass at our institution. Data, including @entity1 demographics, co-morbidities, intraoperative data, peri- and @entity260 , and outcomes, were prospectively recorded and retrospectively reviewed. RESULTS: Early post-laparoscopic Roux-en-Y gastric bypass @entity3885 occurred in 13 @entity1 (1.2%). The average time to presentation was 15 days (range 5-27). @entity1 presented with a combination of @entity390 , @entity391 , and @entity490 ; all underwent computed tomography to confirm the diagnosis. The causes of @entity3885 included dietary noncompliance (46%), anastomotic @entity4 (23%), narrowing of the jejunojejunostomy at surgery (23%), and luminal clot (8%). Management was determined using our proposed treatment algorithm. Three @entity1 (23%) required operative intervention, with the remainder successfully treated conservatively. CONCLUSION: From our experience, we propose a treatment algorithm for standardized management of early @entity3885 , reserving reoperation for those who are acutely ill on presentation or those in whom conservative management fails. A review of our series using this algorithm has suggested that most @entity1 can be successfully treated nonoperatively; however, bariatric surgeons must maintain a low threshold for surgical re-intervention in cases in which rapid recovery is not seen.

2098467

2098468

2098469

Assessment of two 3D MDCT colonography protocols for observation of XXXX .

multiple_choice

OBJECTIVE: The objective of our study was to assess the value of two-way interpretation (i.e., from rectum to cecum and vice versa) compared with one-way interpretation (i.e., from rectum to cecum only) in terms of polyp detection and interpretation time on MDCT colonography. MATERIALS AND METHODS: Fifty consecutive @entity1 underwent both CT colonography and conventional colonoscopy. Three radiologists independently analyzed the CT colonographic examinations of each @entity1 using a primary 3D method. All examinations were analyzed using two techniques: navigation from rectum to cecum only (one-way) and navigation from rectum to cecum and vice versa (two-way). Sensitivity and positive predictive value were calculated on both a per-polyp basis and a per- @entity1 basis. Alternative free-response receiver operating characteristic (ROC) curve analysis was estimated, and image interpretation time was documented. RESULTS: One hundred fifty-five @entity1127 were depicted in 45 @entity1 by colonoscopy. The mean sensitivity of CT colonography for polyp detection with two-way (88.4%) was significantly superior to that with one-way (78.1%) (p < 0.01). The mean positive predictive value of each observer with one-way was 66.7%, whereas that with two-way was 65.8%. The mean area under the alternative free-response ROC curve (A(z) value) with two-way (0.827) was higher than that with one-way (0.816), but there was not a statistically significant difference. The average interpretation time of each observer with two-way (39 min) was statistically significantly longer than that with one-way (25 min) (p < 0.01). CONCLUSION: When using a primary 3D interpretation technique at CT colonography, complete 3D navigation from rectum to cecum and from cecum to rectum is mandatory to maximize polyp detection. The image interpretation time for two-way interpretation is statistically significantly longer than that with one-way interpretation.

2098470

2098471

2098472

16-MDCT coronary angiography versus invasive coronary angiography in acute XXXX : a blinded prospective study.

multiple_choice

OBJECTIVE: The purpose of our study was to prospectively evaluate the usefulness of CT coronary angiography versus invasive coronary angiography for the detection of clinically significant @entity453 in @entity1 hospitalized for acute @entity662 . SUBJECTS AND METHODS: Sixty-six consecutive @entity1 (52 @entity1 and 14 @entity1 ; average age, 57 +/- 11 [SD] years) who were hospitalized for acute @entity662 underwent CT coronary angiography and invasive coronary angiography within an average time interval of 4 days. ECG-gated CT coronary angiography was performed with a 16-MDCT scanner (0.42-sec rotation time, 16 x 0.75 mm detector collimation). Beta-blockers were not administered routinely, and thus the average heart rate was 71 +/- 11 beats per minute. CT coronary angiographic images were evaluated concurrently by two radiologists, who were blinded to invasive coronary angiography results, for stenoses having a diameter of 50% or more, using a 15-segment classification, including all segments 2 mm or more in diameter. The consensus interpretation was compared with results of invasive coronary angiography. RESULTS: CT coronary angiography was technically successful in 59 @entity1 (89%). After exclusion of 20 (3.1%) of 649 coronary segments, which were classified as nonevaluable by CT coronary angiography, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of CT coronary angiography for identifying significant @entity453 in the remaining 629 coronary segments were 80% (68/85), 89% (482/544), 52% (68/130), 97% (482/499), and 87% (550/629), respectively. The overall accuracy for the main vessels (left main, left anterior descending, left circumflex, and right coronary arteries) was 93%, 88%, 86%, and 86%, respectively. CONCLUSION: CT coronary angiography using a 16-MDCT scanner enables accurate noninvasive detection of significant @entity453 in @entity1 hospitalized for acute @entity662 . Furthermore, relative high sensitivity and specificity of CT coronary angiography can be achieved without pharmacologic manipulation of @entity1 heart rates.

2098473

2098474

2098475

Leukocyte-depleted blood transfusion is associated with decreased survival in resected XXXX .

multiple_choice

OBJECTIVES: Blood transfusion has been shown to have deleterious effect on @entity2 survival, but little data are available that assess whether leukocyte-depleted (LD) blood has a similar adverse effect. Our institution has been using LD red cells since 2001. We sought to determine whether LD blood has an effect on survival after resection of @entity5 . METHODS: From a prospective database, we evaluated all @entity1 with pathologic stage I @entity1149 . @entity1 receiving LD blood were compared with those receiving no transfusion. Survival was estimated using the Kaplan-Meier method and compared using the log-rank test. Multivariate analysis by Cox regression was used to identify independent risk factors affecting survival. RESULTS: From 2001 to 2009, 361 @entity1 were evaluated; 63 received LD red cell cell transfusion and 298 received no transfusion. Median follow-up was 48 months. Disease-free survival (P < .001) and overall survival (P < .001) were worse in @entity1 receiving LD blood. Stratifying for stage, disease-free survival continued to be worse with transfusion for stage IA (P = .002) and IB (P = .002). Similarly, overall survival continued to be worse with transfusion for stage IA (P < .001) and IB (P < .001). For disease-free and overall survival, univariate analysis revealed increased age, male gender, @entity417 , transfusion, and higher stage to be adverse factors, with transfusion and higher stage continuing to be significant adverse factors after multivariate analysis. CONCLUSIONS: Our data suggest that transfusion of LD blood is associated with a worse disease-free and overall survival in @entity1 with resected stage I @entity1149 .

2098476

2098477

2098478

Single-patch, 2-patch, and caval division techniques for repair of partial XXXX : does it matter?

multiple_choice

OBJECTIVE: We reviewed our experience with the single-patch, 2-patch, and caval division techniques for repair of a partial @entity358 . METHODS: From 1990 to 2009, 124 @entity1 (65 male @entity1 ; 52%) were identified. The single-patch, two-patch, and caval division technique was used in 60 (49%), 24 (19%), and 40 (32%) @entity1 , respectively. The median age was 34.5 years (range, 1-76). Of the 124 @entity1 , 99 (80%) had an @entity118 . RESULTS: There was no early mortality. Survival at 5, 10, and 15 years was 99%, 95%, and 82%, respectively. One @entity1 (3%) in the caval division group required early reoperation for @entity4264 . All @entity1 , exept for 3, had regained sinus rhythm at discharge. Late @entity4264 developed in 3 @entity1 (7.5%) in the caval division group, 3 (5%) in the single-patch group, and 1 (4%) in the 2-patch group ( = .5). Two @entity1 underwent reoperation for late @entity3885 : 1 (2%) in the single-patch group and 1 (4%) in the 2-patch group (P = .08). A permanent pacemaker was required in 3 @entity1 (3%). CONCLUSIONS: Surgical treatment of partial @entity358 is associated with excellent outcomes. The overall incidence of late superior vena caval or @entity849 is low. Although not significant, the 2-patch technique might be associated with a greater incidence of @entity1817 and late @entity849 . The late development of @entity4264 is a concern with all techniques, necessitating close follow-up.

2098479

2098480

2098481

Comparison of intraabdominal abscess formation after laparoscopic and open appendicectomies in XXXX .

multiple_choice

AIM: Although laparoscopic appendicectomy (LA) is an accepted alternative to the @entity1538 ( @entity1538 ) approach, it has been suggested that there is a higher incidence of intraabdominal abscesses (IAAs). Our aim was to determine the incidence of IAA in 3 pediatric surgical centers routinely practicing both techniques. METHODS: Data were collected retrospectively for pediatric @entity1 undergoing LA or @entity1538 over an 8-year period. Analysis included IAA formation, @entity698 complexity, radiologic/histologic investigations, grade of surgeon, and wound @entity281 . MAIN RESULTS: A total of 1267 appendicectomies were performed (514 LAs and 753 @entity29624 ). There was no difference between the incidences of @entity6207 (LA, 3.9% [19/491] vs @entity1538 , 3.9% [28/714]; P = 1.0). The incidence of IAA was increased in those with @entity532 (34/375 [9.1%] vs 13/830 [1.6%]; P <= .0001). There was an increased proportion of those with @entity532 in the LA group (182/491 [37.1%] vs 193/714 [27.0%]; P = .0002). Surgical trainees were more likely to be the primary surgeon in the @entity1538 group (79% vs 63%; P = .0001), although the incidence of IAA did not correlate with grade of surgeon. There was no significant difference in incidence of wound @entity281 between groups (LA, 4.6% [8/173] vs @entity1538 , 2.5% [18/377]; P = .93). CONCLUSION: This large retrospective study shows that the technique of appendicectomy does not appear to affect the incidence of IAAs. @entity1 with @entity532 are more likely to develop an IAA regardless of technique.

2098482

2098483

2098484

Combining infliximab with XXXX for the induction and maintenance of remission in refractory @entity30 : a controlled pilot study.

multiple_choice

OBJECTIVES: Immunosuppression of chronic active @entity30 resistant or intolerant to @entity10043 antimetabolites still remains a clinical challenge. To obtain long-lasting effects with the anti- @entity310 antibody infliximab repeated infusions are often required. @entity1499 has been shown to be a moderately effective drug in maintaining remission in @entity30 . The aim of the present pilot study was to evaluate the combination of infliximab and @entity1499 as therapy for refractory @entity30 . METHODS: Nineteen @entity1 with chronic active @entity30 resistant or intolerant to @entity500 were enrolled. @entity1 received either two infusions of infliximab (5 mg/kg) alone (n=8) or in combination with long-term @entity1499 at a dosage of 20 mg/week (n=11) over 48 weeks. RESULTS: Two out of eight @entity1 receiving infliximab monotherapy and four out of 11 @entity1 treated with infliximab and concomitant @entity1499 had discontinued study treatment by week 48, solely because of lack of efficacy. Clinical remission at week 48 was observed in five out of seven @entity1 treated with infliximab and @entity1499 , but only in two out of six @entity1 receiving infliximab monotherapy. In addition, @entity1 treated with concomitant @entity1499 achieved remission earlier (median time 2 versus 18 weeks) and needed fewer @entity230 (median @entity617 dose 0 versus 11.8 mg). Despite an increased mean number of adverse events per @entity1 in the @entity1499 group, the proportions of @entity1 experiencing any adverse events and serious adverse events were similar across treatment groups. CONCLUSIONS: The combination of infliximab with long-term @entity1499 may be a promising concept in refractory @entity30 . Our data prompt larger trials.

2098485

2098486

2098487

Combining infliximab with @entity1499 for the induction and maintenance of remission in refractory XXXX : a controlled pilot study.

multiple_choice

OBJECTIVES: Immunosuppression of chronic active @entity30 resistant or intolerant to @entity10043 antimetabolites still remains a clinical challenge. To obtain long-lasting effects with the anti- @entity310 antibody infliximab repeated infusions are often required. @entity1499 has been shown to be a moderately effective drug in maintaining remission in @entity30 . The aim of the present pilot study was to evaluate the combination of infliximab and @entity1499 as therapy for refractory @entity30 . METHODS: Nineteen @entity1 with chronic active @entity30 resistant or intolerant to @entity500 were enrolled. @entity1 received either two infusions of infliximab (5 mg/kg) alone (n=8) or in combination with long-term @entity1499 at a dosage of 20 mg/week (n=11) over 48 weeks. RESULTS: Two out of eight @entity1 receiving infliximab monotherapy and four out of 11 @entity1 treated with infliximab and concomitant @entity1499 had discontinued study treatment by week 48, solely because of lack of efficacy. Clinical remission at week 48 was observed in five out of seven @entity1 treated with infliximab and @entity1499 , but only in two out of six @entity1 receiving infliximab monotherapy. In addition, @entity1 treated with concomitant @entity1499 achieved remission earlier (median time 2 versus 18 weeks) and needed fewer @entity230 (median @entity617 dose 0 versus 11.8 mg). Despite an increased mean number of adverse events per @entity1 in the @entity1499 group, the proportions of @entity1 experiencing any adverse events and serious adverse events were similar across treatment groups. CONCLUSIONS: The combination of infliximab with long-term @entity1499 may be a promising concept in refractory @entity30 . Our data prompt larger trials.

2098488

2098489

2098490

Contemporary profile of oral manifestations of XXXX /AIDS and associated risk factors in a Southeastern US clinic.

multiple_choice

BACKGROUND: Introduction of @entity3457 ( @entity3457 ) has resulted in a significant decrease of oral manifestations (OMs). The profile and risk factors for OM in those individuals initiating @entity3457 remain understudied in the Southeast of the United States, region of increasing @entity645 prevalence. OBJECTIVE: To determine clinical, socio-demographic, and laboratory characteristics associated with the presence of OM among @entity1 initiating @entity3457 . METHODS: Retrospective review of electronically captured data from @entity1 initiating @entity3457 at a Southeastern US clinic. Prevalence was determined, and risk factors for overall OM, @entity11876 ( @entity11876 ), and all other OM were evaluated using logistic regression. RESULTS: In our sample (n = 744), majority of individuals were males (75 percent), African-American (50 percent), mean age of 39 years, 42 percent of which reported sex with @entity1 (MSM). Two hundred sixty-six had some type of OM. Compared with those without any OM, @entity1 with OM had a lower mean baseline @entity404 + T cells count ( @entity404 count) (331 260 versus 179 244 @entity404 cells/mm(3) ) and higher mean baseline @entity2858 RNA viral load (4.0 1.34 log(10) versus 4.6 1.30 log(10) ) (P < 0.01). In the logistic regression models seeking to determine factors associated with an increased risk of OM and @entity11876 , the only characteristic associated with the outcome was baseline @entity404 value. Being male, African-American, and heterosexual showed a protective role for OM other than @entity11876 . CONCLUSION: OM continues to be common despite @entity3457 . General OM and @entity11876 were closely associated with a low baseline @entity404 count. Knowledge of risk factors for OM can potentially help clinicians target oral evaluation of @entity645 -positive individuals.

2098491

2098492

2098493

Absolute reduction in lower limb lean body mass in Japanese @entity1 with XXXX .

multiple_choice

BACKGROUND: @entity626 ( @entity571 ) is a significant contributor to disability, and @entity28 is one of the most modifiable risk factors. The association between knee @entity571 and @entity28 has been reported to relate to quadriceps strength. To begin to examine this hypothesis, independent measures of quadriceps lean mass are needed. OBJECTIVE: The objective of this study was to characterize the absolute lower limb lean body mass in @entity1 with knee @entity571 . METHODS: Japanese @entity1 , aged 45 and over, who presented to a community orthopedics clinic, were categorized as 1) those with no @entity158 , presenting with @entity174 , @entity615 (n = 604); and 2) those presenting with @entity158 meeting clinical and radiographic criteria for knee @entity571 (n = 341). Segmental lower limb lean body mass (L-LBM) was measured with multifrequency bioelectrical impedance analysis and subjects were stratified by body mass index (BMI) by Western Pacific Region World Health Organization weight categories. RESULTS: Control and knee @entity571 groups were comparable with respect to age and BMI. Despite an increase in L-LBM with increasing BMI, there was a statistically significant reduction in L-LBM in knee @entity571 subjects in comparison with control subjects in matched normal weight, overweight, and @entity28 strata (11.1, 12.4, and 13.1 kg in the nonknee @entity571 compared with 10.5, 10.6, and 11.6 kg in the knee @entity571 group). CONCLUSIONS: A reduction in absolute L-LBM is observed in older Japanese @entity1 with knee @entity571 in comparison with control subjects. Longitudinal studies are warranted in which L-LBM can be prospectively evaluated in a cohort followed for incident knee @entity571 to better characterize the temporal relationship with L-LBM decline. Clinicians should consider this reduction in L-LBM in @entity1 with knee @entity571 to recommend therapy aimed at reducing risk for @entity194 and disability.

2098494

2098495

2098496

Absolute reduction in lower limb lean body mass in Japanese XXXX with @entity626 .

multiple_choice

BACKGROUND: @entity626 ( @entity571 ) is a significant contributor to disability, and @entity28 is one of the most modifiable risk factors. The association between knee @entity571 and @entity28 has been reported to relate to quadriceps strength. To begin to examine this hypothesis, independent measures of quadriceps lean mass are needed. OBJECTIVE: The objective of this study was to characterize the absolute lower limb lean body mass in @entity1 with knee @entity571 . METHODS: Japanese @entity1 , aged 45 and over, who presented to a community orthopedics clinic, were categorized as 1) those with no @entity158 , presenting with @entity174 , @entity615 (n = 604); and 2) those presenting with @entity158 meeting clinical and radiographic criteria for knee @entity571 (n = 341). Segmental lower limb lean body mass (L-LBM) was measured with multifrequency bioelectrical impedance analysis and subjects were stratified by body mass index (BMI) by Western Pacific Region World Health Organization weight categories. RESULTS: Control and knee @entity571 groups were comparable with respect to age and BMI. Despite an increase in L-LBM with increasing BMI, there was a statistically significant reduction in L-LBM in knee @entity571 subjects in comparison with control subjects in matched normal weight, overweight, and @entity28 strata (11.1, 12.4, and 13.1 kg in the nonknee @entity571 compared with 10.5, 10.6, and 11.6 kg in the knee @entity571 group). CONCLUSIONS: A reduction in absolute L-LBM is observed in older Japanese @entity1 with knee @entity571 in comparison with control subjects. Longitudinal studies are warranted in which L-LBM can be prospectively evaluated in a cohort followed for incident knee @entity571 to better characterize the temporal relationship with L-LBM decline. Clinicians should consider this reduction in L-LBM in @entity1 with knee @entity571 to recommend therapy aimed at reducing risk for @entity194 and disability.

2098497

2098498

2098499

The additional detrimental effects of cold preservation on transplantation-associated injury in kidneys from living and brain-dead donor XXXX .

multiple_choice

BACKGROUND: @entity1620 and cold preservation are major alloantigen-independent risk factors for transplantation outcome. The present study was conducted to assess the influence of these factors on transplantation-associated injury independently or in combination. METHODS: @entity1620 was induced in F344 @entity35 . Renal grafts were harvested after 6 hr and either directly transplanted in unilateral nephrectomized Lewis recipient or subjected to 24 hr of cold preservation in University of Wisconsin solution before implantation. Allografts obtained from living donor @entity35 were also subjected to cold preservation or not. DNA damage was assessed before implantation by terminal deoxynucleotide transferase-mediated @entity1977 nick-end labeling staining. Ten days after transplantation, renal histology was performed according to Banff '97 classification. The expressions of cytokines and adhesion molecules were analyzed by quantitative polymerase chain reaction. RESULTS: Cold preservation significantly increased the number of terminal deoxynucleotide transferase-mediated @entity1977 nick-end labeling positive cells in renal allografts. Ten days after transplantation, histology revealed a higher degree of @entity9538 and @entity1333 scores when the grafts were subjected to cold storage. @entity1333 was aggravated when the graft was obtained from @entity1620 ( @entity1620 ) donors. @entity1620 , but not cold preservation alone, was associated with @entity5720 . This was more frequently observed after cold preservation. Immunohistology showed an increase in MHC class II+ cells after cold preservation. The combination of @entity1620 and cold preservation revealed a higher degree of @entity6667 and @entity13358 expression. CONCLUSIONS: Our Study emphasizes that cold @entity63 time should be limited when renal allografts from brain-dead donors are transplanted.