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2098800

2098801

2098802

Prosthetic carotid bypass grafts for XXXX : a prospective study of 198 consecutive cases.

multiple_choice

OBJECTIVES: Carotid endarterectomy (CEA) is the standard treatment for @entity731 involving the carotid bifurcation. However, CEA can be challenging under some conditions. The goal of this study was to determine the outcome and durability of prosthetic carotid bypass grafting ( @entity5241 ) with @entity736 ( @entity736 ) grafts as an alternative to CEA. METHODS: This is a prospective series of 198 consecutive @entity1 with @entity5241 , representing 12.4% of 1595 @entity1 with a carotid reconstruction procedure performed in our department between September 1986 and December 2006. Qualifying event was @entity64 in 67 @entity1 (34%) and @entity4905 ( @entity4905 ) in 45 (23%), and 86 @entity1 (43%) were asymptomatic. Primary indications for @entity5241 were extensive @entity731 (n=71; 36%), @entity543 associated with kinking (n=49; 25%), recurrent @entity850 (n=47; 23%), @entity850 after radiation therapy (n=18; 9%) and technical failure of CEA (n=13; 7%), with excessive arterial wall thinning and perforation after endarterectomy (n=10) or intimal flap on completion digital angiography (n=3). RESULTS: The combined @entity64 and @entity204 rate at 30 days were 0.5% (one @entity64 ). Median follow-up was 9.5 years (interquartile range (IQR): 6.2-18.3 years). At 10 years, primary patency was 97.9+/-3.4%. Six @entity3215 (3.0%) became occluded during follow-up; one @entity1 had a restenosis greater than 50% and 18 @entity1 (9.1%) had a restenosis of less than 50%. Five @entity1 had an @entity64 (one @entity64 , one at 103 days with a patent @entity5241 and three related to occlusion of the @entity5241 at 4, 13 and 15 years after the procedure). At 10 years, cumulative @entity64 -free survival was 98.4+/-3.2%, and cumulative survival was 78.8+/-7.0%. CONCLUSIONS: @entity5241 is a safe surgical alternative and is durable, with a low incidence of graft restenosis, when CEA seems hazardous.

2098803

2098804

2098805

Gender differences in the clinical diagnosis of XXXX --a hospital-based study from Central India.

multiple_choice

OBJECTIVE: @entity1600 can be difficult to diagnose clinically, and as it is thought to be more common in females, we describe here the clinical characteristics of cervical @entity1600 in @entity1 and @entity1 and compare this with cytology to assess their diagnostic value. METHODS: Two hundred and nineteen @entity1 with @entity1600 , aged 14 years or more, who presented with a neck mass to the Department of Pathology, Ujjain Hospital, Ujjain, India were included in the study. The presenting clinical symptoms and signs were compared between @entity1 and @entity1 and with the cytology of fine needle aspirates from the lymph nodes. RESULTS: Seventy-five percent of the @entity1 were aged between 14 and 35 years, with a male to female ratio of 1:2.1. One or more constitutional symptoms were present in 56.6% of @entity1 on presentation. There were more @entity1 with clinical symptoms than @entity1 . Fever was the most common manifestation in both gender groups. Fever for more than 30 days, cough, weight loss, and night sweats were significantly more common in @entity1 . On cytology, @entity39 were found to be associated with constitutional symptoms. CONCLUSIONS: Constitutional symptoms were more frequently reported by @entity1 than by @entity1 and showed a correlation with @entity39 on cytology.

2098806

2098807

2098808

Medical ethics in the 1990s. Emphasis on XXXX -and-dying issues will continue but social concerns will command increased attention.

multiple_choice

During the 1990s medical ethics will undergo changes. Individual clinical issues, especially those related to @entity204 and dying, will continue to create conflict and preoccupy hospital staffs. But professional ethicists will focus on social concerns more frequently than they have in the past. Following are some of the most crucial ethical issues and directions they are likely to take in this decade: Clinical practice and the law will move toward less demanding standards of proof regarding the withdrawal of treatment from @entity1 who are no longer competent. Public policy will set more lenient standards for judging whether a @entity1 would refuse artificial nutrition and hydration if he or she were able. Unless sensible @entity1 strengthen the distinction between active and passive euthanasia, more physicians and legislatures will move toward physician-assisted suicide. Those proposing a higher-brain definition of @entity204 , as opposed to whole-brain definitions, will gain ground with the general public, but not with legislators. New transplantation technologies will increase medical options but create more problems with paying for the procedures. As techniques are perfected, ethical questions will focus more on financing than on the source of transplantable material. @entity791 treatment priorities will clash with other medical demands (e.g., treatment for @entity0 ), and concerns about protecting both providers and @entity1 from contracting @entity791 will move policy toward routine testing. Progress in public argument will be made on the abortion issue. Members of ethics committees will have to be trained to address financing issues. Some medical schools and residency programs will add courses on the concept of character and on character development to their ethics programs.(ABSTRACT TRUNCATED AT 250 WORDS)

2098809

2098810

2098811

Renal artery stenting for XXXX : interventional approach and initial clinical results.

multiple_choice

BACKGROUND: Significant @entity2791 is being increasingly diagnosed and interventional cardiologists are taking on the unfamiliar role of deploying renal stents. We describe our technique for renal artery stenting using techniques and equipment similar to that used in coronary stenting and present early results. METHODS: Thirty-two @entity1 with significant @entity2791 (diameter @entity850 60-95%) and difficult to control @entity101 or @entity8 were referred for renal stenting. Renal @entity12306 scans were performed before intervention. All the procedures were attempted from the femoral artery approach using guides, low profile wires and balloon catheters similar to those used for coronary work. The lowest profile renal or coronary stents were deployed using a monorail technique. RESULTS: @entity731 was the cause of the @entity2791 in 31 @entity1 . Stents were successfully deployed in 30 of these @entity1 (97%). One @entity1 required a second procedure from the brachial artery approach. An additional @entity1 with @entity4267 underwent angioplasty only. @entity850 was reduced from a mean of 79 to 1%. Translesional mean pressure gradients were reduced from 22 to 1mmHg. There were no major procedural or in-hospital complications. Anti- @entity101 drugs were reduced from a mean of 3 prior to stenting to 0.7 at discharge. Renal @entity12306 scans were a poor predictor of severity of @entity850 . Renal @entity12306 scans suggested functionally significant @entity2791 in only 48% of @entity1 but the clinical responses suggested that this was an underestimate. CONCLUSIONS: Stenting of renal arteries using coronary like techniques and equipment results in a high rate of procedural success and good early clinical outcomes.

2098812

2098813

2098814

Cranial neural crest emergence and migration in the Mexican XXXX ( @entity7547 ).

multiple_choice

The timing and pattern of cranial neural crest cell emergence and migration in the Mexican @entity7547 , @entity7547 , are assessed using @entity4653 ( @entity4653 ). Cranial neural crest cells emerge and begin to migrate at the time of neural fold closure and soon form three distinct streams. The most anterior (mandibular) stream emerges first, at the level of the mesencephalon. Cells in this stream migrate rostroventrally around the optic vesicle. The second (hyoid) and third (branchial) streams emerge in close succession at the level of the rhombencephalon and extend ventrolaterally. Cells forming the hyoid stream migrate rostral to the otic vesicle, whereas the branchial stream divides into two parallel streams, which migrate caudal to the otic vesicle. At later stages (stage 26 onwards) the cranial neural crest cells disperse into the adjacent mesoderm and can no longer be followed by dissection and @entity4653 . The pattern of cranial neural crest emergence and migration, and division into migratory streams is similar to that in other amphibians and in the @entity36214 ( @entity36214 ). Emergence of crest cells from the neural tube, relative to the time of neural tube closure, occurs relatively late in comparison to anurans, but much earlier than in the @entity36214 . These results establish a morphological foundation for studies in progress on the further development and fate of cranial neural crest cells in the Mexican @entity7547 , as well as for studies of the role of cranial neural crest in cranial patterning.

2098815

2098816

2098817

Cranial neural crest emergence and migration in the Mexican @entity7547 ( XXXX ).

multiple_choice

The timing and pattern of cranial neural crest cell emergence and migration in the Mexican @entity7547 , @entity7547 , are assessed using @entity4653 ( @entity4653 ). Cranial neural crest cells emerge and begin to migrate at the time of neural fold closure and soon form three distinct streams. The most anterior (mandibular) stream emerges first, at the level of the mesencephalon. Cells in this stream migrate rostroventrally around the optic vesicle. The second (hyoid) and third (branchial) streams emerge in close succession at the level of the rhombencephalon and extend ventrolaterally. Cells forming the hyoid stream migrate rostral to the otic vesicle, whereas the branchial stream divides into two parallel streams, which migrate caudal to the otic vesicle. At later stages (stage 26 onwards) the cranial neural crest cells disperse into the adjacent mesoderm and can no longer be followed by dissection and @entity4653 . The pattern of cranial neural crest emergence and migration, and division into migratory streams is similar to that in other amphibians and in the @entity36214 ( @entity36214 ). Emergence of crest cells from the neural tube, relative to the time of neural tube closure, occurs relatively late in comparison to anurans, but much earlier than in the @entity36214 . These results establish a morphological foundation for studies in progress on the further development and fate of cranial neural crest cells in the Mexican @entity7547 , as well as for studies of the role of cranial neural crest in cranial patterning.

2098818

2098819

2098820

Is the mode of occurrence of XXXX correlated to bladder function and spontaneous resolution?

multiple_choice

PURPOSE: To investigate whether mode of occurrence of @entity3025 ( @entity3025 ), during micturition (M), during filling without increase in pressure (passive, P) or in response to an @entity2472 ( @entity2472 ), can be explained by differences in bladder function. Also, to study if the mode of occurrence of @entity3025 can predict spontaneous resolution. MATERIALS AND METHODS: There were 93 @entity1 (68 @entity1 and 25 @entity1 ) with @entity3025 (grade III-V) included. Videocystometry was performed at median ages 5, 22 and 32 months registering grade and mode of reflux and bladder function characteristics. RESULTS: Mode of occurrence of reflux changed with age. During infancy P, @entity2472 and M reflux comprised almost equal parts. At follow up, P reflux had @entity2472 and M reflux had decreased. This was partly due to a significantly higher probability of spontaneous resolution for M than P reflux, at 40 months (42 vs 18%). P and M reflux were significantly correlated to bladder function characteristics. P reflux was seen in @entity1 with high bladder capacity and occurred early in filling. Other predictors were higher age within the respective group and female sex. M reflux was correlated to lack of residual urine, low bladder capacity and absence of overactivity. Other indicators were male sex and low-grade reflux. CONCLUSIONS: P and M reflux correlate to different bladder patterns: P with high bladder capacity and M with low bladder capacity and without signs of @entity1494 . M seems to be benign with a higher resolution rate.

2098821

2098822

2098823

Clinical, histologic, and immunohistochemical analyses of feline XXXX in situ.

multiple_choice

@entity2517 ( @entity2517 ) and @entity2735 ( @entity2735 ) are two distinct forms of in @entity957 in felines. They usually occur on different locations and present with specific clinical and histologic features. However, in some cases, these diseases cannot be distinguished either clinically or histopathologically. The aim of the present study was to determine the accuracy of diagnosis based on clinical or histologic criteria alone, and whether immunohistochemistry for papillomavirus or @entity876 can improve the accuracy of diagnosis. A series of in @entity957 cases (n = 45) were selected according to their location and initial histologic classification and subsequently classified as @entity2517 (n = 22) or @entity2735 (n = 23) according to the clinical criteria and were reevaluated histologically by 2 dermatopathologists. All @entity2735 cases and most of the @entity2517 cases (n = 15) were confirmed histologically. In 7 cases clinically classified as @entity2517 , this diagnosis was not unanimously confirmed histologically because of the presence of overlapping features. @entity876 immunoreactivity was observed in 11/14 (79%) confirmed @entity2517 cases and in 4/22 (18%) @entity2735 cases, while papillomavirus antigen was not detected in any confirmed @entity2517 case but was detected in 11/23 (48%) @entity2735 cases. It was concluded that @entity2735 can usually be reliably diagnosed histologically. The histologic diagnosis of lesions clinically suggestive of @entity2517 might sometimes be difficult. Results of immunohistochemistry for @entity876 and papillomavirus antigen were supportive for a role of sun exposure and papillomavirus in the pathogenesis of @entity2517 and @entity2735 , respectively.

2098824

2098825

2098826

[Balloon inflating and cement filling for treatment of XXXX of the femoral head: a three-dimensional infinite-element study].

multiple_choice

OBJECTIVE: To evaluate the biomechanical changes of balloon inflating and cement filling in @entity2530 of the femoral head using finite-element analysis. METHODS: The procedure of percutaneous balloon inflating and cement filling was simulated in fresh specimen of @entity1 femoral head. CT scan and three-dimensional reconstruction were used to establish the three-dimensional model of the femoral head. The physiological load was analyzed using three-dimensional finite element model to simulate the load and calculate stress on the hip during walking. Finite element analysis was performed on the @entity2530 and bone cement filling model to measure the Von-Mises force at the top, neck and weight-bearing area of the femoral head. Another 8 fresh specimens of @entity2738 of @entity1 were obtained to stimulate balloon inflating and bone cement filling procedures, and the displacement of the femoral head under different loads was recorded before and after the procedures. RESULTS: After bone cement filling in the @entity39 area, the load reduced significantly in the weight-bearing area of the femoral head, and the load distribution became more uniform at the femoral neck and the top of the head. The anti-deformation ability of the @entity39 femoral head increased after bone cement filling. The infinite-element analysis and specimen biomedical test showed similar results. CONCLUSION: @entity661 and bone cement filling in the @entity39 area can change the biomechanics mechanism of the femoral head and neck, improve the supporting capacity under load, and prevent the progression of @entity135 .

2098827

2098828

2098829

Role of IgG anti-beta-lactoglobulin antibody in the diagnosis of XXXX 's @entity1267 in India.

multiple_choice

OBJECTIVE: Little is known about @entity291 's @entity1267 (CMPI) in India. This study was aimed at finding CMPI cases and determining the role of IgG anti-beta-lactoglobulin antibody in the diagnosis of this condition in India. METHODS: From June 2004 to December 2005, 30 @entity1 with presumptive diagnosis of CMPI, based on endoscopic rectal or duodenal biopsy showing excess eosinophils and response to milk withdrawal, were enrolled and studied prospectively. Definite diagnosis was made in 20 @entity1 on the basis of positive milk challenge. IgG anti-beta-lactoglobulin antibodies were tested in @entity1 with CMPI before and after stopping milk and after milk challenge. Antibody levels were also studied in 27 age-matched disease controls and 50 healthy adults. RESULTS: The median age of 20 @entity1 (16 @entity1 ) with CMPI was 16.5 (6-36) months. Of them, 18 presented with @entity294 (12 bloody) and 2 had @entity548 . The presumptive diagnosis was most often (85%) based on colonic or rectal biopsy findings. Rectal biopsy was diagnostic in all 20 cases irrespective of the mode of presentation compared with duodenal biopsy which was diagnostic in 3 cases (p< 0.0001). There was no difference in antibody levels between cases and controls; the antibody level decreased significantly after milk withdrawal (p< 0.005), but did not rise significantly after milk re-challenge. CONCLUSIONS: CMPI is a common cause of chronic @entity294 in @entity1 in northern India. Sigmoidoscopy and rectal biopsy help in establishing the diagnosis in most cases. IgG anti-lactoglobulin antibody test is not useful in diagnosing CMPI in the Indian setting.

2098830

2098831

2098832

Role of IgG anti-beta-lactoglobulin antibody in the diagnosis of @entity291 's XXXX in India.

multiple_choice

OBJECTIVE: Little is known about @entity291 's @entity1267 (CMPI) in India. This study was aimed at finding CMPI cases and determining the role of IgG anti-beta-lactoglobulin antibody in the diagnosis of this condition in India. METHODS: From June 2004 to December 2005, 30 @entity1 with presumptive diagnosis of CMPI, based on endoscopic rectal or duodenal biopsy showing excess eosinophils and response to milk withdrawal, were enrolled and studied prospectively. Definite diagnosis was made in 20 @entity1 on the basis of positive milk challenge. IgG anti-beta-lactoglobulin antibodies were tested in @entity1 with CMPI before and after stopping milk and after milk challenge. Antibody levels were also studied in 27 age-matched disease controls and 50 healthy adults. RESULTS: The median age of 20 @entity1 (16 @entity1 ) with CMPI was 16.5 (6-36) months. Of them, 18 presented with @entity294 (12 bloody) and 2 had @entity548 . The presumptive diagnosis was most often (85%) based on colonic or rectal biopsy findings. Rectal biopsy was diagnostic in all 20 cases irrespective of the mode of presentation compared with duodenal biopsy which was diagnostic in 3 cases (p< 0.0001). There was no difference in antibody levels between cases and controls; the antibody level decreased significantly after milk withdrawal (p< 0.005), but did not rise significantly after milk re-challenge. CONCLUSIONS: CMPI is a common cause of chronic @entity294 in @entity1 in northern India. Sigmoidoscopy and rectal biopsy help in establishing the diagnosis in most cases. IgG anti-lactoglobulin antibody test is not useful in diagnosing CMPI in the Indian setting.

2098833

2098834

2098835

Family characteristics and long-term effects of childhood XXXX .

multiple_choice

OBJECTIVES. This study investigated the role of family variables in the development of @entity458 in childhood @entity458 (CSA) survivors, contributing to the debate between the 'abuse related' perspective, which assumes a direct causal link between abuse and later problems, and the ' @entity409 ' perspective, which assumes that these problems are caused by the dysfunctional nature of families in which abuse occurs. The two questions of central concern were: (1) whether maladaptive family dynamics and CSA were each associated with later adjustment; and (2) whether these associations acted independently of one another. DESIGN. A retrospective cohort study comparing sexually abused and non-abused @entity1 matched one-to-one on demographic variables. METHODS. The 64 clinical @entity1 were recruited by sending questionnaires to clients on a psychological therapy waiting list, and 44 students were recruited from questionnaires made available at University Health Centres. @entity1 completed measures of psychological and sexual adjustment, family functioning, and construing. Multiple linear regression models investigated overall and independent associations between abuse, family circumstances, and adjustment in adulthood. RESULTS. There was only weak evidence for the influence of CSA, independently of family environment, on later psychological distress and sexual adjustment, but strong evidence for the influence of aspects of family environment, independent of abuse, on later psychological distress, sexual adjustment, self-esteem, body image, and sexual attitude. CONCLUSIONS. The findings provide support for the ' @entity409 ' perspective on the long-term effects of CSA.

2098836

2098837

2098838

Randomised trial of an inhaled XXXX agonist, inhaled @entity228 and their combination in the treatment of @entity565 .

multiple_choice

BACKGROUND: Although many @entity748 @entity1 are treated with a combination of @entity2263 agonist and @entity228 inhalers, the clinical effects of combining the drugs are unknown. Studies on the early @entity748 response to allergen suggest that @entity2263 agonists may reduce the benefit of inhaled corticosteroids. A study of the effects of combining the drugs on @entity565 control was undertaken. METHODS: Sixty one subjects with mild to moderate @entity565 were randomised to a double blind crossover comparison of inhaled @entity4184 (200-400 microg twice daily), @entity4183 (500-1000 microg four times daily), combined treatment, and placebo. Each treatment was given for six weeks following a four week washout period. Ipratropium was used for symptom relief. Treatments were ranked from worst (1) to best (4) based on need for oral @entity134 , mean morning peak flow, @entity302 , @entity13265 use, and @entity565 symptoms. Lung function and @entity2488 were measured before and after each treatment. RESULTS: Evaluable data for all four treatments were obtained from 47 subjects. The mean rank of each treatment was: placebo = 2.05; @entity4183 = 2.13; @entity4184 = 2.48; combined treatment = 3.34. Combined treatment was ranked significantly better than any other treatment (p<0.01). Mean (95% CI) morning and evening peak flows were 14 (5 to 23) and 24 (15 to 34) l/min higher, respectively, during combined treatment than during @entity4184 , and 27 (17 to 37) and 15 (7 to 23) l/min higher than during @entity4183 . @entity1109 tended to be least frequent during combined treatment but were not significantly different from @entity4184 alone. There was no significant difference between combined treatment and @entity4184 alone for lung function and @entity2488 . CONCLUSIONS: In this group of mild to moderate @entity748 subjects the combination of @entity2263 agonist and @entity228 gave better @entity565 control than either treatment alone. There was no evidence that regular @entity2263 agonist treatment impaired the beneficial effect of inhaled @entity228 .

2098839

2098840

2098841

Randomised trial of an inhaled @entity2263 agonist, inhaled XXXX and their combination in the treatment of @entity565 .

multiple_choice

BACKGROUND: Although many @entity748 @entity1 are treated with a combination of @entity2263 agonist and @entity228 inhalers, the clinical effects of combining the drugs are unknown. Studies on the early @entity748 response to allergen suggest that @entity2263 agonists may reduce the benefit of inhaled corticosteroids. A study of the effects of combining the drugs on @entity565 control was undertaken. METHODS: Sixty one subjects with mild to moderate @entity565 were randomised to a double blind crossover comparison of inhaled @entity4184 (200-400 microg twice daily), @entity4183 (500-1000 microg four times daily), combined treatment, and placebo. Each treatment was given for six weeks following a four week washout period. Ipratropium was used for symptom relief. Treatments were ranked from worst (1) to best (4) based on need for oral @entity134 , mean morning peak flow, @entity302 , @entity13265 use, and @entity565 symptoms. Lung function and @entity2488 were measured before and after each treatment. RESULTS: Evaluable data for all four treatments were obtained from 47 subjects. The mean rank of each treatment was: placebo = 2.05; @entity4183 = 2.13; @entity4184 = 2.48; combined treatment = 3.34. Combined treatment was ranked significantly better than any other treatment (p<0.01). Mean (95% CI) morning and evening peak flows were 14 (5 to 23) and 24 (15 to 34) l/min higher, respectively, during combined treatment than during @entity4184 , and 27 (17 to 37) and 15 (7 to 23) l/min higher than during @entity4183 . @entity1109 tended to be least frequent during combined treatment but were not significantly different from @entity4184 alone. There was no significant difference between combined treatment and @entity4184 alone for lung function and @entity2488 . CONCLUSIONS: In this group of mild to moderate @entity748 subjects the combination of @entity2263 agonist and @entity228 gave better @entity565 control than either treatment alone. There was no evidence that regular @entity2263 agonist treatment impaired the beneficial effect of inhaled @entity228 .

2098842

2098843

2098844

Randomised trial of an inhaled @entity2263 agonist, inhaled @entity228 and their combination in the treatment of XXXX .

multiple_choice

BACKGROUND: Although many @entity748 @entity1 are treated with a combination of @entity2263 agonist and @entity228 inhalers, the clinical effects of combining the drugs are unknown. Studies on the early @entity748 response to allergen suggest that @entity2263 agonists may reduce the benefit of inhaled corticosteroids. A study of the effects of combining the drugs on @entity565 control was undertaken. METHODS: Sixty one subjects with mild to moderate @entity565 were randomised to a double blind crossover comparison of inhaled @entity4184 (200-400 microg twice daily), @entity4183 (500-1000 microg four times daily), combined treatment, and placebo. Each treatment was given for six weeks following a four week washout period. Ipratropium was used for symptom relief. Treatments were ranked from worst (1) to best (4) based on need for oral @entity134 , mean morning peak flow, @entity302 , @entity13265 use, and @entity565 symptoms. Lung function and @entity2488 were measured before and after each treatment. RESULTS: Evaluable data for all four treatments were obtained from 47 subjects. The mean rank of each treatment was: placebo = 2.05; @entity4183 = 2.13; @entity4184 = 2.48; combined treatment = 3.34. Combined treatment was ranked significantly better than any other treatment (p<0.01). Mean (95% CI) morning and evening peak flows were 14 (5 to 23) and 24 (15 to 34) l/min higher, respectively, during combined treatment than during @entity4184 , and 27 (17 to 37) and 15 (7 to 23) l/min higher than during @entity4183 . @entity1109 tended to be least frequent during combined treatment but were not significantly different from @entity4184 alone. There was no significant difference between combined treatment and @entity4184 alone for lung function and @entity2488 . CONCLUSIONS: In this group of mild to moderate @entity748 subjects the combination of @entity2263 agonist and @entity228 gave better @entity565 control than either treatment alone. There was no evidence that regular @entity2263 agonist treatment impaired the beneficial effect of inhaled @entity228 .

2098845

2098846

2098847

Incidence of defibrillator XXXX due to pulmonary erosion.

multiple_choice

BACKGROUND: Intrathoracic defibrillator patches were used prior to effective transvenous defibrillation systems. Spontaneous erosion through the visceral pleural has been documented but the incidence has not been previously reported. METHODS: All @entity1 who underwent insertion of @entity1479 patches at Westmead Hospital were identified from Hospital and device company databases. Medical records were reviewed and further follow-up performed through local doctors and the National Registry of Deaths where appropriate. RESULTS: One hundred and four @entity1 underwent insertion of @entity1479 intrathoracic patches between 1987 and 2000. The patches were positioned adjacent to the pericardium in the @entity1143 . Eight @entity1 died within three months of surgery and two @entity1 developed early @entity281 . Of the other 94 @entity1 , 40 were alive at the time of last review such that there had been 562 @entity1 years of survival with four @entity1 developing spontaneous @entity281 . The incidence was 0.7% per @entity1 year. The diagnosis was delayed in all four @entity1 . All underwent removal of the @entity1479 system with one perioperative @entity204 . CONCLUSIONS: There is a small but significant risk of late spontaneous @entity1479 @entity281 . The condition is life-threatening and the diagnosis is usually delayed.

2098848

2098849

2098850

Preference for place of XXXX in Germany.

multiple_choice

BACKGROUND: Dying in the preferred place is considered a key requirement for a " @entity204 ." The aims of our study were to explore preferred places of @entity204 of deceased @entity1 and their bereaved relatives in Rhineland-Palatinate (Germany). We further wanted to assess the congruence between preferred and actual place of @entity204 . METHODS: The cross-sectional study was based on a random sample of 5000 inhabitants of Rhineland-Palatinate (Germany) who died between May 25 and August 24, 2008. Relatives of these deceased @entity1 were interviewed by a written survey. RESULTS: After removing duplicates, 4967 questionnaires were sent out, 3832 delivered, and 1378 completed, yielding a response rate of 36.0%. Regarding the deceased, 93.8% wanted to die at home, 0.7% in a hospital, 2.8% in palliative care, 2.4% in a nursing home, and 0.3% elsewhere. The figures for the relatives were 80.7%, 4.3%, 7.5%, 7.1%, and 0.5%, respectively. Of the deceased 58.9% and of the relatives 59.1% had their wish fulfilled. Logistic regression analysis revealed that living in a rural municipality (adjusted odds ratio [aOR]: 1.88; 95% confidence interval [CI]: 1.02-3.43), rural town (aOR: 2.30; 95% CI: 1.17-4.49) or small town (aOR: 1.95; 95% CI: 1.04-3.68), having a nonworking relative (aOR: 1.79; 95% CI: 1.16-2.76), and living together with a relative (aOR: 2.28; 95% CI:1.57-3.32) increases the probability to die in the preferred place. DISCUSSION: Because the availability of a relative was the most important factor to die in the preferred place, relatives of dying @entity1 should be supported in providing informal care. The introduction of palliative home care teams should allow more @entity1 to die in their preferred place by easing the burden of informal carers.

2098851

2098852

2098853

Time to treatment as an important factor for the response to XXXX in @entity4932 .

multiple_choice

OBJECTIVE: @entity1499 ( @entity1500 ) is the most commonly used disease-modifying antirheumatic drug in @entity4932 ( @entity4932 ). Currently, individual response to @entity1500 cannot be reliably predicted. Identification of clinical and genetic factors that influence the response to @entity1500 could be helpful in realizing the optimal treatment for individual @entity1 . METHODS: A cohort of 128 @entity4932 @entity1 treated with @entity1500 were studied retrospectively. Eleven clinical parameters and genotypes of 6 single @entity377 polymorphisms in 5 genes related to the mechanism of action of @entity1500 were compared between @entity1500 responders and nonresponders using a multivariate regression analysis. RESULTS: The time from diagnosis to start of @entity1500 treatment, physician's global assessment at baseline, and the starting dose were significantly associated with the response to @entity1500 at 6 months after initiation. @entity1 with a shorter time from diagnosis to start of @entity1500 and a higher disease activity according to the physician but with a lower @entity1500 dose showed an increased response. The effect of the starting dose on @entity1500 response seemed to be mainly due to the influence of the systemic @entity4932 subtype. The time from diagnosis to start of @entity1500 treatment and physician's global assessment at baseline were highly correlated. Therefore, the precise effect size of each independent variable could not be determined. CONCLUSION: In @entity1 with @entity4932 , the time from diagnosis to start of @entity1500 appears to be an important factor for @entity1500 response. Our results suggest that an earlier start of @entity1500 treatment will lead to an increased response.

2098854

2098855

2098856

Time to treatment as an important factor for the response to @entity1499 in XXXX .

multiple_choice

OBJECTIVE: @entity1499 ( @entity1500 ) is the most commonly used disease-modifying antirheumatic drug in @entity4932 ( @entity4932 ). Currently, individual response to @entity1500 cannot be reliably predicted. Identification of clinical and genetic factors that influence the response to @entity1500 could be helpful in realizing the optimal treatment for individual @entity1 . METHODS: A cohort of 128 @entity4932 @entity1 treated with @entity1500 were studied retrospectively. Eleven clinical parameters and genotypes of 6 single @entity377 polymorphisms in 5 genes related to the mechanism of action of @entity1500 were compared between @entity1500 responders and nonresponders using a multivariate regression analysis. RESULTS: The time from diagnosis to start of @entity1500 treatment, physician's global assessment at baseline, and the starting dose were significantly associated with the response to @entity1500 at 6 months after initiation. @entity1 with a shorter time from diagnosis to start of @entity1500 and a higher disease activity according to the physician but with a lower @entity1500 dose showed an increased response. The effect of the starting dose on @entity1500 response seemed to be mainly due to the influence of the systemic @entity4932 subtype. The time from diagnosis to start of @entity1500 treatment and physician's global assessment at baseline were highly correlated. Therefore, the precise effect size of each independent variable could not be determined. CONCLUSION: In @entity1 with @entity4932 , the time from diagnosis to start of @entity1500 appears to be an important factor for @entity1500 response. Our results suggest that an earlier start of @entity1500 treatment will lead to an increased response.

2098857

2098858

2098859

Recurrence analysis in 66 cases with grade I and grade II XXXX in the extremities.

multiple_choice

OBJECTIVE: We analyzed @entity511 in long bones to assess whether @entity511 should both be grouped as low grade @entity5 ( @entity85 Society Stage I or Stage II), and to explore rational surgical treatment for @entity511 . METHODS: We retrospectively reviewed 66 @entity1 from January 1996 to December 2007 with Grade I and II @entity511 of the extremities without @entity3 at the Department of Orthopaedics of Shanghai Sixth @entity1 's Hospital. Thirty-eight @entity1 had undergone intralesional or marginal resection, and 28 @entity1 had undergone wide marginal or radical excision based on imaging findings. The mean age of the @entity1 was 43 years (range, 5-85) and the minimum follow-up was 31 months (mean, 48; range, 5-141). We analyzed grade diagnosis, therapeutic options, and local recurrence rate of the two grades of @entity511 . RESULTS: Of all @entity1 , 22 experienced local recurrence, making the local recurrence rate 33.3%. A statistically significant difference in outcome between @entity1 with Grade I and Grade II @entity5 undergoing intralesional resection was identified. No significant difference according to surgical method was found between the two groups in total. CONCLUSION: Grade II @entity511 should be grouped as high stage @entity5 (Stage II) and grade I @entity511 assigned to the low stage @entity5 group (Stage I). Our experience suggests the surgical method should be related to radiographic margin status and oncologic classification. Wide resection should be considered for Grade II, while intralesional resection is suitable for Grade I.

2098860

2098861

2098862

Bilateral decompression via unilateral fenestration using mobile microendoscopic discectomy technique for XXXX .

multiple_choice

OBJECTIVE: To evaluate the feasibility and clinical efficacy of bilateral decompression via unilateral fenestration (BDUF) with mobile microendoscopic discectomy (MMED) for @entity2649 . METHODS: From June 2007 to June 2009, 32 @entity1 were treated by the technique of BDUF with MMED for @entity2649 in our hospital. All @entity1 complained of bilateral sciatic @entity9 and @entity613 that was dominant in one limb. CT scan and MRI revealed disc @entity850 of the spinal canal. @entity1 with bilateral severe @entity850 and multilevel @entity850 were excluded. RESULTS: The procedure was technically successful in all @entity1 , bilateral decompression and spinal canal enlargement being achieved by unilateral fenestration. The mean operative time was 70 min (range, 50-100 min), with a mean @entity190 of 150 ml (range, 50-350 ml). No significant complication was noted; dural tears were encountered in only two @entity1 without obvious side effects. The @entity1 were followed up for 3 to 24 months (mean, 12 months) and the clinical results were excellent in 21 cases and good in 11 cases according to the MacNab scale. CONCLUSION: The procedure of BDUF can be performed in conjunction with the MMED technique for @entity2649 with good clinical results; however, severe @entity850 may be not suitable for this technique.

2098863

2098864

2098865

Posterior screw-plate system for treating old XXXX of the odontoid process.

multiple_choice

OBJECTIVE: To assess the efficacy of a screw-plate system for the treatment of old @entity174 of the odontoid process. METHODS: Twenty-six @entity1 with old @entity174 of the odontoid process were treated by a posterior screw-plate system. There were 17 @entity1 and 9 @entity1 ranging in age from 17 to 58 years (mean, 32.8 years). According to the Anderson-D'Alonzo classification, 19 @entity1 were classified as type II, and 7 as type III. According to the Frankel classification, there were 3 @entity1 of grade C, 21 of grade D and 2 of grade E. RESULTS: All operations were successfully performed. The operation time was 75-120 min (mean, 90 min) and the intraoperative @entity190 50-200 ml (mean, 125 ml). There were no postoperative complications. All @entity1 were followed up for 24-36 months. At the final follow-up, one @entity1 had improved from grade C to grade D, two from grade C to grade E, and 15 from grade D to grade E. The other cases had remained stable. There was no breakage of nails or failure of internal fixation during follow-up. Stable bone union was observed in all cases, the average healing time being 7.8 months. CONCLUSION: Posterior screw-plate system is a safe and effective method for treating old @entity174 of the odontoid process.

2098866

2098867

2098868

Multiple tiny XXXX throughout entire esophageal tract.

multiple_choice

A 45-year-old @entity1 complaining of abdominal fullness was referred for endoscopic examination. She was a non-smoker and non-drinker. An endoscopic examination revealed the presence of more than 100 tiny, rounded, elevated, yellowish lesions <0.5 mm in diameter scattered throughout the upper and lower esophagus. Based on the endoscopic examination results, her stomach manifested symptoms of mildly superficial @entity3621 . Histopathologic examination of the esophagus biopsy specimen revealed that some of the lobules of the cells displayed typical sebaceous differentiation covered by a squamous epithelium. No evidence of inflammatory reaction, hair follicles, or @entity5 was found. The @entity1 's blood and serum findings were unremarkable. Our final diagnosis was multiple tiny @entity39473 in the esophagus. This is an interesting and rare case of esophageal sebaceous glands distributed throughout the entire esophagus. Because there were no esophageal symptoms or/and eating problems, the @entity1 did not require endoscopic surgery or other treatment. Follow-up examinations were recommended at intervals between 6 months and 1 year. At the 2-year follow-up, an endoscopic examination revealed no change in the size or the number of the tiny ectopic esophageal sebaceous glands.

2098869

2098870

2098871

Conservative management of XXXX in a developing country.

multiple_choice

BACKGROUND: @entity1511 is a significant health burden in the Third world. @entity378 and its complications are on the increase because of the @entity645 / @entity791 challenge. The aim of this study was to review the @entity1 managed for @entity1511 at the University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria. METHODS: This was a retrospective study of @entity1 seen at the University of Port Harcourt Teaching Hospital between January 1999 and December 2002 with @entity378 of the spine. @entity1 case notes were reviewed after collating out-and-in- @entity1 records. Analysis was done using multiway frequency tables. RESULTS: There were 16 males and 18 females, with a ratio of 1:1.1. Their ages ranged from 3.3 to 82 years with an average of 31.1. Peak ages of occurrence were the 3rd and 4th decades. Eighteen @entity1 (52.9%) presented within the first 6 months of symptoms. The most frequent presenting symptoms were @entity615 , @entity353 , difficulty with walking, low grade fever, and night sweats. The most frequent signs were gibbus and lower limb @entity912 . The most common association was pulmonary tuberculous (32.4%). The thoracic spine was mostly affected, followed by the lumbar spine. Wedge collapse of the vertebrae was the common radiological finding. Twenty two @entity1 had multilevel affection. Twenty @entity1 (71%) had a lymphocyte differential of more than 45%, 87% had erythrocyte sedimentation rate of over 20 mm/hr. Westergren, and Mantoux test was positive in 55 percent of the @entity1 . Twelve @entity1 had outpatient treatment and 22 had in- @entity1 treatment. Duration of hospital stay ranged from 7 to 157 days with an average of 62.6 days. All the @entity1 had standard combination antituberculosis therapy. No @entity1 had surgery for @entity1511 . Outcome of treatment was good (68.2%). Follow up was poor with a high default rate. There were 3 mortalities (8.8%). CONCLUSION: @entity245 partly due to lack of experience makes a high index of suspicion necessary to make a diagnosis. Outcome utilizing conservative methods of treatment is good.

2098872

2098873

2098874

XXXX : a clinical experience at the University College Hospital Ibadan.

multiple_choice

BACKGROUND: Infection within the retropharyngeal space could progress on to an @entity733 formation resulting into @entity37397 ( @entity37397 ), which can either be acute or chronic. @entity37397 can be a life-threatening emergency, with potential for airway compromise and other @entity532 . This review is aimed at highlighting our experience with @entity1 with a diagnosis of @entity37397 . METHODS: Retrospective review of thirty @entity1 with a confirmed diagnosis of @entity37397 , who were admitted and managed within an eleven-year period (1993 to 2003) in the Otolaryngology department of the University College Hospital Ibadan. RESULTS: There were fifteen males and females each with M:F ratio of 1:1, consisting of twenty-five @entity1 and five adults and their median age was 21 months and twenty three (77%) were younger than 5 years. It was observed that while the adult @entity1 presented early for specialist treatment, the paediatric @entity1 presented late. The major complaints were @entity221 (87%), @entity649 or stridor (57%), cough (53%), @entity4048 /swelling (43%), and refusal of feeds (30%). Other minor complaints were @entity158 , @entity1282 , @entity448 , and @entity353 . The commonest associated symptoms seen especially among the younger age group were nasal discharge, nasal blockage, tooth-ache, snoring and limitation of neck movement. CONCLUSION: The treatment of retropharyngeal space infections in @entity1 and adults should include accurate clinical diagnosis, empirical usage of broad-spectrum antibiotics, and timely surgical drainage.

2098875

2098876

2098877

Implications of XXXX method in body contouring outcomes.

multiple_choice

BACKGROUND: @entity1 frequently present for body contouring after massive @entity353 resulting from bariatric procedures or diet and exercise. The authors investigated whether body contouring complications vary by @entity353 method. METHODS: Four hundred forty-nine @entity1 (511 cases) were entered into a prospective registry. Diet and exercise @entity1 were matched to bariatric @entity1 based on identical procedures performed. Conditional logistic regression was used to test for differences between groups. One-to-one matching was then performed by nearest neighbor matching to the most similar @entity1 who underwent bariatric procedures based on sex, age, and body mass index. The t test was used to compare matched @entity1 . RESULTS: Twenty-nine @entity1 (6.5 percent) lost weight exclusively through diet and exercise. They had significantly higher preoperative hematocrit (p = 0.02) and hemoglobin (p = 0.05), and tended to have multiple procedures performed at the same time, higher absolute complication rates, and significantly higher infection rates (p = 0.03). When matched to 191 bariatric @entity1 based on procedures performed, diet and exercise @entity1 had a higher complication rate that did not reach significance (odds ratio, 1.5; p = 0.28). One-to-one matching resulted in 34 procedure-matched pairs with nonsignificant trends toward better nutrition and more complications in diet and exercise @entity1 . CONCLUSIONS: Infection rates were higher in @entity1 who had body contouring after massive @entity353 from diet and exercise versus bariatric procedures. When matched, despite lower nutrition markers, @entity1 treated with bariatric procedures had outcomes similar to those of diet and exercise @entity1 . We did not find evidence for an association between @entity353 method and risk in the body contouring @entity1 .

2098878

2098879

2098880

[A case of XXXX successfully treated by total pneumonectomy].

multiple_choice

A 39 year-old Japanese @entity1 who had been treated for @entity5641 developed a @entity5 in the left lung and was admitted to our hospital. Although evidence of @entity3254 was not proved medically, he had been treated successfully with antituberculous drugs for 9 months. Two months after completion of antituberculous therapy, his X-ray showed a @entity5 shadow close to his left hilum. A computed tomography (CT) scan showed a @entity2 with a diameter of 3.3cm, atelectasis in an ajacent field, and no effusion. Tumor markers targeted for @entity2 remained within normal range. Bronchofiberscopy demonstrated a polypoid @entity5 from left upper lobe bronchus. The pathological examination of CT guided percutaneous biopsy (CTGB) specimen revealed undifferentiated @entity5 . A pulmonary angiogram disclosed @entity3885 . He underwent total pneumonectomy of the left lung, and the final pathological diagnosis of @entity358 was made. He received neither chemotherapy nor radiotherapy. He is well and disease free 3 years after resection. Surgical resection may improve the prognosis of this malignancy.

2098881

2098882

2098883

Validation of forehead venous pressure as a measure of respiratory effort for the diagnosis of XXXX .

multiple_choice

OBJECTIVES: The aim of the study was to validate the measurement of Forehead Venous Pressure derived from a single site on the forehead as an alternative to esophageal manometry and respiratory effort bands in the differential diagnosis of @entity387 . METHODS: Fourteen subjects underwent a laboratory polysomnography concurrently with ARES Unicorder at Walter Reed Army Medical Center. Two-hundred respiratory events were selected by a scorer boarded in sleep medicine and classified into six event categories used in the differential diagnosis of @entity25 @entity1353 . Four sets of events were prepared, each containing airflow and one of four measures of respiratory effort (i.e., esophageal manometer, chest and abdomen bands, and forehead venous pressure). A second board-certified scorer scored each set of events twice while blinded to the type of the effort signal. RESULTS: The inter-rater Kappa scores across all event types indicated all four effort signals provided moderate agreement (kappa = 0.43-0.47). When comparing the intra-rater Kappa scores, the chest belt was superior (kappa = 0.88) to the esophageal manometry, FVP and abdomen belt (kappa = 0.78-0.82). The Kappa scores for the intra-rater comparison with the esophageal serving as the gold standard, FVP abdomen and chest all showed near perfect agreement (kappa = 0.81-0.86). The esophageal manometer and FVP provided slightly better inter-rater agreement in the detection of both obstructive @entity387 and @entity386 as compared to the chest and abdomen belts. There was a 20-30% drop in inter-rater reliability in the detection of flow-limitation and ventilation-change events compared to obstructive events, and all effort signals showed poor inter-rater agreement for central and mixed events. CONCLUSIONS: The results of the study suggest that the FVP can serve as an alternative to respiratory bands in the differential diagnosis of @entity25 @entity1353 , and in the recognition of @entity1 appropriate for bilevel continuous positive airway pressure devices.

2098884

2098885

2098886

Association between baseline plasma @entity1243 levels and subsequent development of XXXX in Japanese Americans.

multiple_choice

OBJECTIVE: Plasma @entity1243 levels correlate strongly with increased total adipose tissue, a known risk factor for type 2 @entity6 , yet the role of @entity1243 in the etiology of @entity6 remains unclear. We sought to determine whether @entity1243 is a risk factor for development of @entity6 in Japanese Americans. RESEARCH DESIGN AND METHODS: We compared baseline @entity1243 levels in 370 nondiabetic Japanese Americans who remained nondiabetic for 5-6 years of follow-up with those of 40 nondiabetic Japanese Americans who developed @entity6 during follow-up. All @entity1 had computed tomography measurements of baseline subcutaneous chest, abdomen, thigh, and intra-abdominal fat, with total fat defined as the sum of all these measurements. RESULTS: The mean age was 51.7 +/- 11.7 years for @entity1 and 51.9 +/- 12.0 years for @entity1 . The 23 @entity1 who developed @entity6 had significantly higher @entity1243 levels than the 212 @entity1 who remained nondiabetic (P < 0.01). Among @entity1 , baseline @entity1243 levels predicted @entity6 risk independent of baseline total fat, @entity2690 , @entity2690 resistance, @entity413 , or age in separate multiple logistic regression models (relative risk adjusted for baseline total fat = 1.80 per SD increase [2.7 ng/ml], 95% CI 1.02-3.17). This association was particularly strong among @entity1 in the top decile for intra-abdominal fat. In contrast, the 17 @entity1 who developed @entity6 had @entity1243 levels similar to those of the 158 @entity1 who remained nondiabetic (P = 0.31). CONCLUSIONS: Among Japanese Americans, increased baseline @entity1243 levels are associated with increased risk of developing @entity6 in @entity1 but not in @entity1 .

2098887

2098888

2098889

Association between baseline plasma XXXX levels and subsequent development of @entity6 in Japanese Americans.

multiple_choice

OBJECTIVE: Plasma @entity1243 levels correlate strongly with increased total adipose tissue, a known risk factor for type 2 @entity6 , yet the role of @entity1243 in the etiology of @entity6 remains unclear. We sought to determine whether @entity1243 is a risk factor for development of @entity6 in Japanese Americans. RESEARCH DESIGN AND METHODS: We compared baseline @entity1243 levels in 370 nondiabetic Japanese Americans who remained nondiabetic for 5-6 years of follow-up with those of 40 nondiabetic Japanese Americans who developed @entity6 during follow-up. All @entity1 had computed tomography measurements of baseline subcutaneous chest, abdomen, thigh, and intra-abdominal fat, with total fat defined as the sum of all these measurements. RESULTS: The mean age was 51.7 +/- 11.7 years for @entity1 and 51.9 +/- 12.0 years for @entity1 . The 23 @entity1 who developed @entity6 had significantly higher @entity1243 levels than the 212 @entity1 who remained nondiabetic (P < 0.01). Among @entity1 , baseline @entity1243 levels predicted @entity6 risk independent of baseline total fat, @entity2690 , @entity2690 resistance, @entity413 , or age in separate multiple logistic regression models (relative risk adjusted for baseline total fat = 1.80 per SD increase [2.7 ng/ml], 95% CI 1.02-3.17). This association was particularly strong among @entity1 in the top decile for intra-abdominal fat. In contrast, the 17 @entity1 who developed @entity6 had @entity1243 levels similar to those of the 158 @entity1 who remained nondiabetic (P = 0.31). CONCLUSIONS: Among Japanese Americans, increased baseline @entity1243 levels are associated with increased risk of developing @entity6 in @entity1 but not in @entity1 .

2098890

2098891

2098892

Epidemiology of XXXX Interventions and Complications (EDIC). Design, implementation, and preliminary results of a long-term follow-up of the @entity6 Control and Complications Trial cohort.

multiple_choice

OBJECTIVE: The @entity6 Control and Complications Trial (DCCT) demonstrated the powerful impact of glycemic control on the early manifestations of microvascular complications. Contemporary prospective data on the evolution of macrovascular and late microvascular complications of type 1 @entity6 are limited. The Epidemiology of @entity6 Interventions and Complications (EDIC) study is a multicenter, longitudinal, observational study designed to use the well-characterized DCCT cohort of > 1,400 @entity1 to determine the long-term effects of prior separation of glycemic levels on micro- and macrovascular outcomes. RESEARCH DESIGN AND METHODS: Using a standardized annual history and physical examination, 28 EDIC clinical centers that were DCCT clinics will follow the EDIC cohort for 10 years. Annual evaluation also includes resting electrocardiogram. Doppler ultrasound measurements of ankle/arm blood pressure, and screening for @entity8 . At regular intervals, a timed 4-h urine is collected, lipid profiles are obtained, and stereoscopic fundus photographs are taken. In addition, dual B-mode Doppler ultrasound scans of the common and internal carotid arteries will be performed at years 1 and 6 and at study end. RESULTS: Written informed consent was obtained from 96% of the DCCT subjects. The @entity1 , compared with nonparticipants, tended to have better glycemic control at the completion of the DCCT and were more likely to have their @entity6 care provided by DCCT personnel. The EDIC baseline measurement stratified by sex delineates multiple @entity65 risk factor differences such as age (older in @entity1 ), waist-to-hip ratio (higher in @entity1 ). HDL @entity165 (lower in @entity1 ), @entity101 (more prevalent in @entity1 ), and maximum intimal-medial thickness of common and internal carotid arteries (thicker in @entity1 ). Of the original conventional treatment group, 69% have changed to continuous subcutaneous insulin infusion or multiple daily injections. Although the mean HbA1c difference between the intensive and conventional treatment groups narrowed at EDIC years 1 and 2, @entity4051 c remained significantly lower in the intensive group. Of all expected clinic visits, 95% were completed, and the quality of EDIC data is very similar to that observed in the DCCT. CONCLUSIONS: Although obvious problems exist in extended follow-up studies of completed clinical trials, these are balanced by the value of continued systematic observation of the DCCT cohort. In contrast to other epidemiologic studies, EDIC will provide 1) definitive data on type 1 as distinct from type 2 @entity6 ; 2) reliance on prospective rather than on cross-sectional analysis; 3) long-term follow-up in a large population; 4) consistent use of objective, reliable measures of outcomes and glycemia; and 5) observation of @entity1 from before the onset of complications.

2098893

2098894

2098895

Epidemiology of @entity6 Interventions and Complications (EDIC). Design, implementation, and preliminary results of a long-term follow-up of the XXXX Control and Complications Trial cohort.

multiple_choice

OBJECTIVE: The @entity6 Control and Complications Trial (DCCT) demonstrated the powerful impact of glycemic control on the early manifestations of microvascular complications. Contemporary prospective data on the evolution of macrovascular and late microvascular complications of type 1 @entity6 are limited. The Epidemiology of @entity6 Interventions and Complications (EDIC) study is a multicenter, longitudinal, observational study designed to use the well-characterized DCCT cohort of > 1,400 @entity1 to determine the long-term effects of prior separation of glycemic levels on micro- and macrovascular outcomes. RESEARCH DESIGN AND METHODS: Using a standardized annual history and physical examination, 28 EDIC clinical centers that were DCCT clinics will follow the EDIC cohort for 10 years. Annual evaluation also includes resting electrocardiogram. Doppler ultrasound measurements of ankle/arm blood pressure, and screening for @entity8 . At regular intervals, a timed 4-h urine is collected, lipid profiles are obtained, and stereoscopic fundus photographs are taken. In addition, dual B-mode Doppler ultrasound scans of the common and internal carotid arteries will be performed at years 1 and 6 and at study end. RESULTS: Written informed consent was obtained from 96% of the DCCT subjects. The @entity1 , compared with nonparticipants, tended to have better glycemic control at the completion of the DCCT and were more likely to have their @entity6 care provided by DCCT personnel. The EDIC baseline measurement stratified by sex delineates multiple @entity65 risk factor differences such as age (older in @entity1 ), waist-to-hip ratio (higher in @entity1 ). HDL @entity165 (lower in @entity1 ), @entity101 (more prevalent in @entity1 ), and maximum intimal-medial thickness of common and internal carotid arteries (thicker in @entity1 ). Of the original conventional treatment group, 69% have changed to continuous subcutaneous insulin infusion or multiple daily injections. Although the mean HbA1c difference between the intensive and conventional treatment groups narrowed at EDIC years 1 and 2, @entity4051 c remained significantly lower in the intensive group. Of all expected clinic visits, 95% were completed, and the quality of EDIC data is very similar to that observed in the DCCT. CONCLUSIONS: Although obvious problems exist in extended follow-up studies of completed clinical trials, these are balanced by the value of continued systematic observation of the DCCT cohort. In contrast to other epidemiologic studies, EDIC will provide 1) definitive data on type 1 as distinct from type 2 @entity6 ; 2) reliance on prospective rather than on cross-sectional analysis; 3) long-term follow-up in a large population; 4) consistent use of objective, reliable measures of outcomes and glycemia; and 5) observation of @entity1 from before the onset of complications.

2098896

2098897

2098898

Starvation-induced expression of autophagy-related genes in XXXX .

multiple_choice

BACKGROUND INFORMATION: Autophagy is a catabolic process for degradation of cytoplasmic components in the vacuolar apparatus. A genome-wide survey recently showed evolutionary conservation among autophagy genes in @entity375 , mammals and plants. To elucidate the molecular and subcellular machinery responsible for the sequestration and subsequent digestion of intracellular material in plants, we utilized a combination of morphological and molecular methods (confocal laser-scanning microscopy, transmission electron microscopy and real-time PCR respectively). RESULTS: Autophagy in @entity958 suspension-cultured cells was induced by @entity505 starvation, which triggered an immediate arrest of cell growth together with a rapid degradation of cellular proteins. We followed the onset of these responses and, in this report, provide a clear functional classification for the highly polymorphic autophagosomes by which the cell sequesters and degrades a portion of its own cytoplasm. Quantification of autophagy-related structures shows that cells respond to the stress signal by a rapid and massive, but transient burst of autophagic activity, which adapts to the stress signal. We also monitored the real-time expressions of @entity68017 , AtATG4a, AtATG4b, @entity68018 and @entity59398 -AtATG8i genes, which are orthologues of @entity375 genes involved in the @entity46874 ubiquitination-like conjugation pathway and are linked to autophagosome formation. We show that these autophagy-related genes are transiently up-regulated in a co-ordinated manner at the onset of starvation. CONCLUSIONS: @entity969 starvation induces autophagy and up-regulates orthologues of the @entity375 @entity46874 conjugation pathway genes in @entity958 cultured cells. The @entity68017 , AtATG4a, AtATG4b, @entity68018 and @entity59398 -AtATG8i genes are expressed in successive waves that parallel the biochemical and cytological remodelling that takes place. These genes thus serve as early markers for autophagy in plants.

2098899

2098900

2098901

Short burst XXXX therapy after activities of daily living in the home in @entity1030 .

multiple_choice

BACKGROUND: Short burst @entity26 therapy (SBOT) is widely prescribed in the UK with little evidence of benefit. A study was performed to examine whether SBOT benefits @entity1 when undertaking normal activities at home among those who already use it. METHODS: Twenty-two @entity1 with @entity1030 ( @entity1030 ) were included in the study. All regularly used SBOT at home and claimed that it helps them. Each @entity1 chose two daily living activities for which they used SBOT for relief of @entity1353 . @entity1 were then randomised to use either an air or @entity26 gas cylinder. At least 15 min later the same activity was performed using the other gas cylinder. The same process was then repeated for the second chosen activity. The main endpoints were subjective and objective times to recovery, analysed for each activity separately or taking the average over the two activities. A paired statistical analysis was performed. RESULTS: All @entity1 used SBOT with nasal prongs after exercise. Using the average recovery time over two activities for each @entity1 , the mean objective recovery time was 38 s lower (95% CI -81 to +5) using @entity26 and the mean subjective recovery time was 34 s lower (95% CI -69 to +2). Five @entity1 were correctly able to distinguish @entity26 from air after both activities and there was a suggestion that their recovery times were shorter than those who did not correctly identify the gases (91 s vs 20 s using objective recovery times, and 80 s vs 22 s using subjective recovery times), although this was a subgroup analysis based on only five @entity1 with non-significant results. CONCLUSIONS: There is some evidence that SBOT shortens recovery time after activities of daily living in a selected group of @entity1 with @entity1030 , but the effect is small. There appears to be a subgroup of @entity1 who may benefit to a much greater degree.

2098902

2098903

2098904

Short burst @entity26 therapy after activities of daily living in the home in XXXX .

multiple_choice

BACKGROUND: Short burst @entity26 therapy (SBOT) is widely prescribed in the UK with little evidence of benefit. A study was performed to examine whether SBOT benefits @entity1 when undertaking normal activities at home among those who already use it. METHODS: Twenty-two @entity1 with @entity1030 ( @entity1030 ) were included in the study. All regularly used SBOT at home and claimed that it helps them. Each @entity1 chose two daily living activities for which they used SBOT for relief of @entity1353 . @entity1 were then randomised to use either an air or @entity26 gas cylinder. At least 15 min later the same activity was performed using the other gas cylinder. The same process was then repeated for the second chosen activity. The main endpoints were subjective and objective times to recovery, analysed for each activity separately or taking the average over the two activities. A paired statistical analysis was performed. RESULTS: All @entity1 used SBOT with nasal prongs after exercise. Using the average recovery time over two activities for each @entity1 , the mean objective recovery time was 38 s lower (95% CI -81 to +5) using @entity26 and the mean subjective recovery time was 34 s lower (95% CI -69 to +2). Five @entity1 were correctly able to distinguish @entity26 from air after both activities and there was a suggestion that their recovery times were shorter than those who did not correctly identify the gases (91 s vs 20 s using objective recovery times, and 80 s vs 22 s using subjective recovery times), although this was a subgroup analysis based on only five @entity1 with non-significant results. CONCLUSIONS: There is some evidence that SBOT shortens recovery time after activities of daily living in a selected group of @entity1 with @entity1030 , but the effect is small. There appears to be a subgroup of @entity1 who may benefit to a much greater degree.

2098905

2098906

2098907

Quadriceps strength and the risk of cartilage loss and symptom progression in XXXX .

multiple_choice

OBJECTIVE: To determine the effect of quadriceps strength in individuals with @entity626 ( @entity571 ) on loss of cartilage at the tibiofemoral and patellofemoral joints (assessed by magnetic resonance imaging [MRI]) and on knee @entity158 and function. METHODS: We studied 265 subjects (154 @entity1 and 111 @entity1 , mean+/-SD age 67+/-9 years) who met the American College of Rheumatology criteria for symptomatic knee @entity571 and who were participating in a prospective, 30-month natural history study of knee @entity571 . Quadriceps strength was measured at baseline, isokinetically, during concentric knee extension. MRI of the knee at baseline and at 15 and 30 months was used to assess cartilage loss at the tibiofemoral and patellofemoral joints, with medial and lateral compartments assessed separately. At baseline and at followup visits, knee @entity158 was assessed using a visual analog scale, and physical function was assessed using the Western Ontario and McMaster Universities @entity571 Index. RESULTS: There was no association between quadriceps strength and cartilage loss at the tibiofemoral joint. Results were similar in malaligned knees. However, greater quadriceps strength was protective against cartilage loss at the lateral compartment of the patellofemoral joint (for highest versus lowest tertile of strength, odds ratio 0.4 [95% confidence interval 0.2, 0.9]). Those with greater quadriceps strength had less knee @entity158 and better physical function over followup (P<0.001). CONCLUSION: Greater quadriceps strength had no influence on cartilage loss at the tibiofemoral joint, including in malaligned knees. We report for the first time that greater quadriceps strength protected against cartilage loss at the lateral compartment of the patellofemoral joint, a finding that requires confirmation. Subjects with greater quadriceps strength also had less knee @entity158 and better physical function over followup.

2098908

2098909

2098910

The effect of internal DC shocks on the XXXX frequency.

multiple_choice

The objective of this study, was to investigate the effect of internal DC shocks on the @entity955 frequency (AFF). AFF has previously been shown to predict the success and energy requirements in @entity1 undergoing internal cardioversion (IC) of @entity955 ( @entity955 ). However the possibility that unsuccessful shocks during IC may influence the AFF has not been before studied. Thirty eight @entity1 with @entity955 , suggested for DC cardioversion at the Royal Victoria Hospital in Belfast, were included in our study. Two catheters were positioned in the right atrial appendage (RAA) and the coronary sinus (CS), to deliver a biphasic shock waveform, synchronized with the R wave of the electrocardiogram (ECG) signal. A voltage step-up protocol (50-300 V) was used for @entity1 cardioversion. The ECG was analyzed for a mean of 52,8+/-10.1 seconds (corresponding to segments before and after nonsuccessful shocks). Atrial fibrillatory activity was extracted by means of bandpass filtering and ventricular activity (QRST) cancellation. QRST complexes were cancelled using a recursive least squared (RLS) adaptive filter. FFT was applied to the residual atrial fibrillatory signal. AFF was estimated from the dominant frequency within the 3-12 Hz band of the power spectrum. R-R intervals during the segments were also analyzed. A total of 26 @entity1 were successfully cardioverted, employing 167 shocks (141 nonsuccessful). AFF, computed with 10 s of signal, showed significant reduction (mean 0.3052 +/- 1.1055 Hz, P=0.028) comparing segments immediately before and after shocks, and AFF significantly increases (mean 0.2582 +/- 0.609 Hz, P=0.007) between segments immediately after shocks and those 35 s after. AFF showed distinct behavior according to the energy level of the shocks. In conclusion, intracardiac electric shocks could cause transitory changes in the AFF of @entity1 with @entity955 .

2098911

2098912

2098913

Aryepiglottoplasty for XXXX : the Alder Hey experience.

multiple_choice

@entity12203 is the most common cause of stridor in @entity1 . Severely affected @entity1 are at risk of feeding difficulties, apnoeic episodes and @entity3618 secondary to @entity1224 . The aim of this study was to assess the outcome of aryepiglottoplasty. This is a simple surgical procedure that relieves the obstruction by dividing the aryepiglottic folds. Thirty @entity1 had an aryepiglottoplasty at the Royal Liverpool @entity1 's Hospital between January 1995 and June 2001. The case notes of all 30 @entity1 were reviewed for age, sex, age at operation, indications, operative technique, complications and long-term outcomes. Complete resolution of stridor was obtained in 83 per cent of @entity1 , with an improvement in a further 7 per cent. Post-operative complications included lower @entity1729 (13 per cent) and @entity391 (7 per cent). In conclusion, simple endoscopic aryepiglottoplasty remains an effective way of treating @entity1224 in @entity1 . Its high resolution and low complication rate make it a safe, first choice procedure for treatment of moderate to severe @entity12203 .

2098914

2098915

2098916

Comparison of epidural @entity1342 0.2% and @entity1342 0.2% in combination with @entity681 0.75 microg XXXX for postcaesarean analgesia.

multiple_choice

Analgesic techniques after c-section must be effective producing early mobilisation to enable mothers to care effort their babies. In this study, the comparison of @entity1342 0.2% alone, with @entity1342 0.2%+ @entity681 0.75 microg @entity19264 for @entity1 controlled epidural analgesia (PCEA) was aimed. Fifty @entity1 (ASA-I) were enrolled in the study. All @entity1 had combined spinal-epidural anaesthesia. Infusion of analgesic solutions was started when sensory level decreased by two dermatome levels. The @entity1 randomly assigned, into two groups (n=25). In Group-I, @entity1342 0.2% and @entity681 0.75 microg @entity19264 , in Group-II, @entity1342 0.2% alone were applied (bolus 1.25 mL, lockout 30 min, with 2.5 mL h-1 background infusion). @entity158 (Visual Analog Scale), motor blockage (Bromage scale) and sedation (Four point scale) were evaluated during 24 hours after Caesarean, using the scales of visual analogue, bromage, and four-point, respectively. Haemodynamic and respiratory parameters, side effects, total drug consumption and additional analgesic need, were recorded. Statistical analysis included student-t, chi-square, and Mann Whitney U tests. There was no difference in demographic data, sedation scores, haemodynamic and respiratory parameters, between the groups. Motor block and @entity158 scores were significantly higher in Group-II than in Group-I at 2 and 4. h. Total drug consumption was 65.24+/-4.20 mL for Group-I and 81.1+/-6.44 mL for Group-II, (P<0.05). Four @entity1 in Group-I and 21 @entity1 in Group-II received additional analgesic. @entity111 was observed more frequently in Group-I. The addition of @entity681 0.75 microg @entity19264 to @entity1342 0.2% for PCEA after Caesarean led to more effective analgesia and less motor weakness when compared to @entity1342 0.2% alone, especially during early postoperative period.

2098917

2098918

2098919

Comparison of epidural XXXX 0.2% and @entity1342 0.2% in combination with @entity681 0.75 microg @entity19264 for postcaesarean analgesia.

multiple_choice

Analgesic techniques after c-section must be effective producing early mobilisation to enable mothers to care effort their babies. In this study, the comparison of @entity1342 0.2% alone, with @entity1342 0.2%+ @entity681 0.75 microg @entity19264 for @entity1 controlled epidural analgesia (PCEA) was aimed. Fifty @entity1 (ASA-I) were enrolled in the study. All @entity1 had combined spinal-epidural anaesthesia. Infusion of analgesic solutions was started when sensory level decreased by two dermatome levels. The @entity1 randomly assigned, into two groups (n=25). In Group-I, @entity1342 0.2% and @entity681 0.75 microg @entity19264 , in Group-II, @entity1342 0.2% alone were applied (bolus 1.25 mL, lockout 30 min, with 2.5 mL h-1 background infusion). @entity158 (Visual Analog Scale), motor blockage (Bromage scale) and sedation (Four point scale) were evaluated during 24 hours after Caesarean, using the scales of visual analogue, bromage, and four-point, respectively. Haemodynamic and respiratory parameters, side effects, total drug consumption and additional analgesic need, were recorded. Statistical analysis included student-t, chi-square, and Mann Whitney U tests. There was no difference in demographic data, sedation scores, haemodynamic and respiratory parameters, between the groups. Motor block and @entity158 scores were significantly higher in Group-II than in Group-I at 2 and 4. h. Total drug consumption was 65.24+/-4.20 mL for Group-I and 81.1+/-6.44 mL for Group-II, (P<0.05). Four @entity1 in Group-I and 21 @entity1 in Group-II received additional analgesic. @entity111 was observed more frequently in Group-I. The addition of @entity681 0.75 microg @entity19264 to @entity1342 0.2% for PCEA after Caesarean led to more effective analgesia and less motor weakness when compared to @entity1342 0.2% alone, especially during early postoperative period.

2098920

2098921

2098922

Comparison of epidural @entity1342 0.2% and XXXX 0.2% in combination with @entity681 0.75 microg @entity19264 for postcaesarean analgesia.

multiple_choice

Analgesic techniques after c-section must be effective producing early mobilisation to enable mothers to care effort their babies. In this study, the comparison of @entity1342 0.2% alone, with @entity1342 0.2%+ @entity681 0.75 microg @entity19264 for @entity1 controlled epidural analgesia (PCEA) was aimed. Fifty @entity1 (ASA-I) were enrolled in the study. All @entity1 had combined spinal-epidural anaesthesia. Infusion of analgesic solutions was started when sensory level decreased by two dermatome levels. The @entity1 randomly assigned, into two groups (n=25). In Group-I, @entity1342 0.2% and @entity681 0.75 microg @entity19264 , in Group-II, @entity1342 0.2% alone were applied (bolus 1.25 mL, lockout 30 min, with 2.5 mL h-1 background infusion). @entity158 (Visual Analog Scale), motor blockage (Bromage scale) and sedation (Four point scale) were evaluated during 24 hours after Caesarean, using the scales of visual analogue, bromage, and four-point, respectively. Haemodynamic and respiratory parameters, side effects, total drug consumption and additional analgesic need, were recorded. Statistical analysis included student-t, chi-square, and Mann Whitney U tests. There was no difference in demographic data, sedation scores, haemodynamic and respiratory parameters, between the groups. Motor block and @entity158 scores were significantly higher in Group-II than in Group-I at 2 and 4. h. Total drug consumption was 65.24+/-4.20 mL for Group-I and 81.1+/-6.44 mL for Group-II, (P<0.05). Four @entity1 in Group-I and 21 @entity1 in Group-II received additional analgesic. @entity111 was observed more frequently in Group-I. The addition of @entity681 0.75 microg @entity19264 to @entity1342 0.2% for PCEA after Caesarean led to more effective analgesia and less motor weakness when compared to @entity1342 0.2% alone, especially during early postoperative period.

2098923

2098924

2098925

Comparison of epidural @entity1342 0.2% and @entity1342 0.2% in combination with XXXX 0.75 microg @entity19264 for postcaesarean analgesia.

multiple_choice

Analgesic techniques after c-section must be effective producing early mobilisation to enable mothers to care effort their babies. In this study, the comparison of @entity1342 0.2% alone, with @entity1342 0.2%+ @entity681 0.75 microg @entity19264 for @entity1 controlled epidural analgesia (PCEA) was aimed. Fifty @entity1 (ASA-I) were enrolled in the study. All @entity1 had combined spinal-epidural anaesthesia. Infusion of analgesic solutions was started when sensory level decreased by two dermatome levels. The @entity1 randomly assigned, into two groups (n=25). In Group-I, @entity1342 0.2% and @entity681 0.75 microg @entity19264 , in Group-II, @entity1342 0.2% alone were applied (bolus 1.25 mL, lockout 30 min, with 2.5 mL h-1 background infusion). @entity158 (Visual Analog Scale), motor blockage (Bromage scale) and sedation (Four point scale) were evaluated during 24 hours after Caesarean, using the scales of visual analogue, bromage, and four-point, respectively. Haemodynamic and respiratory parameters, side effects, total drug consumption and additional analgesic need, were recorded. Statistical analysis included student-t, chi-square, and Mann Whitney U tests. There was no difference in demographic data, sedation scores, haemodynamic and respiratory parameters, between the groups. Motor block and @entity158 scores were significantly higher in Group-II than in Group-I at 2 and 4. h. Total drug consumption was 65.24+/-4.20 mL for Group-I and 81.1+/-6.44 mL for Group-II, (P<0.05). Four @entity1 in Group-I and 21 @entity1 in Group-II received additional analgesic. @entity111 was observed more frequently in Group-I. The addition of @entity681 0.75 microg @entity19264 to @entity1342 0.2% for PCEA after Caesarean led to more effective analgesia and less motor weakness when compared to @entity1342 0.2% alone, especially during early postoperative period.

2098926

2098927

2098928

Evaluation of the use of prophylactic cranial irradiation in XXXX .

multiple_choice

BACKGROUND: Prophylactic cranial irradiation has been used in @entity1 with @entity151 to reduce the incidence of @entity75 after primary therapy. The purpose of this study was to evaluate the effects of prophylactic cranial irradiation (PCI) on overall survival and cause-specific survival. METHODS: A total of 7995 @entity1 with @entity5 diagnosed between 1988 and 1997 were retrospectively identified from centers participating in the National @entity5 Institute's Surveillance, Epidemiology, and End Results (SEER) Program. Of them, 670 were identified as having received PCI as a component of their first course of therapy. Overall survival and cause-specific survival were estimated by the Kaplan-Meier method, comparing @entity1 treated with or without prophylactic whole-brain radiotherapy. The Cox proportional hazards model was used in the multivariate analysis to evaluate potential prognostic factors. RESULTS: The median follow-up time was 13 months (range, 1 month to 180 months). Overall survival at 2 years, 5 years, and 10 years was 23%, 11%, and 6%, respectively, in @entity1 who did not receive PCI. In @entity1 who received PCI, the 2-year, 5-year, and 10-year overall survival rates were 42%, 19%, and 9%, respectively (P =or <.001). The cause-specific survival rate at 2 years, 5 years, and 10 years was 28%, 15%, 11%, respectively, in @entity1 who did not receive PCI and 45%, 24%, 17%, respectively, in @entity1 who did receive PCI (P =or <.001). On multivariate analysis of cause-specific and overall survival, age at diagnosis, sex, grade, extent of @entity66 , size of disease, extent of lymph node involvement, and PCI were found to be significant (P = or<.001). The hazards ratios for disease-specific and all cause mortality were 1.13 and 1.11, respectively, for those not receiving PCI. CONCLUSIONS: Significantly improved overall and cause-specific survival was observed in @entity1 treated with prophylactic cranial irradiation on unadjusted and adjusted analyses. This study concurs with the previously published European experience. Prophylactic cranial irradiation should be considered for @entity1 with @entity5 .

2098929

2098930

2098931

@entity10855 resistance and XXXX activity induced by plasma and purified monospecific human IgG anti-beta2-glycoprotein-I antibodies.

multiple_choice

INTRODUCTION: We investigated the @entity10855 ( @entity10855 ) phenotype and the @entity4555 ( @entity4555 ), activity induced by anti-beta2-glycoprotein-I (anti- @entity9500 ) antibodies. PATIENTS AND METHODS: We studied plasma and sera samples from 29 @entity1 with persistently positive anti- @entity9500 : 22 with @entity715 (12 with primary @entity12009 , 10 with @entity12009 secondary to @entity1252 ) and seven without @entity715 (all with @entity1252 ); 25 healthy subjects were studied as controls. We detected anticardiolipin antibodies (ACA); IgG (and its subclasses) and IgM anti- @entity9500 , on irradiated and non-irradiated plates by ELISA. @entity10855 was assessed by the activated partial thromboplastin time (APTT)-based assay and by the modified test. The FV Leiden mutation was studied by PCR. @entity4555 determination included screening and confirmatory dRVVT. Serum anti-2 @entity14243 were affinity purified on sepharose columns and their isotype, subclass, and reactivity against various antigens were studied by ELISA. RESULTS: We found that titers of IgG anti- @entity9500 on irradiated plates were higher than on non-irradiated plates (p = 0.002), IgG2 was the predominant subclass. Fifteen @entity1 (13 with @entity715 ) had @entity4555 and 15 (also 13 with @entity715 ) induced the @entity10855 phenotype. Eleven (all with @entity715 ) had both. Two @entity1 were heterozygous for the Leiden mutation. Two purified antibodies, monospecific for @entity9500 , induced an in vitro @entity10855 phenotype and @entity4555 activity. CONCLUSIONS: Our results seem to indicate that the inhibition of the APC anticoagulant function by IgG2 anti- @entity9500 with @entity4555 activity may be one of the responsible mechanisms of @entity49 in @entity1 with @entity12009 .

2098932

2098933

2098934

XXXX resistance and @entity4555 activity induced by plasma and purified monospecific human IgG anti-beta2-glycoprotein-I antibodies.

multiple_choice

INTRODUCTION: We investigated the @entity10855 ( @entity10855 ) phenotype and the @entity4555 ( @entity4555 ), activity induced by anti-beta2-glycoprotein-I (anti- @entity9500 ) antibodies. PATIENTS AND METHODS: We studied plasma and sera samples from 29 @entity1 with persistently positive anti- @entity9500 : 22 with @entity715 (12 with primary @entity12009 , 10 with @entity12009 secondary to @entity1252 ) and seven without @entity715 (all with @entity1252 ); 25 healthy subjects were studied as controls. We detected anticardiolipin antibodies (ACA); IgG (and its subclasses) and IgM anti- @entity9500 , on irradiated and non-irradiated plates by ELISA. @entity10855 was assessed by the activated partial thromboplastin time (APTT)-based assay and by the modified test. The FV Leiden mutation was studied by PCR. @entity4555 determination included screening and confirmatory dRVVT. Serum anti-2 @entity14243 were affinity purified on sepharose columns and their isotype, subclass, and reactivity against various antigens were studied by ELISA. RESULTS: We found that titers of IgG anti- @entity9500 on irradiated plates were higher than on non-irradiated plates (p = 0.002), IgG2 was the predominant subclass. Fifteen @entity1 (13 with @entity715 ) had @entity4555 and 15 (also 13 with @entity715 ) induced the @entity10855 phenotype. Eleven (all with @entity715 ) had both. Two @entity1 were heterozygous for the Leiden mutation. Two purified antibodies, monospecific for @entity9500 , induced an in vitro @entity10855 phenotype and @entity4555 activity. CONCLUSIONS: Our results seem to indicate that the inhibition of the APC anticoagulant function by IgG2 anti- @entity9500 with @entity4555 activity may be one of the responsible mechanisms of @entity49 in @entity1 with @entity12009 .

2098935

2098936

2098937

Increased small intestinal permeability in XXXX : rather genetic than environmental and a risk factor for @entity66 ?

multiple_choice

BACKGROUND: A disturbed epithelial barrier could play a pivotal role in @entity31 ( @entity31 ). We performed a family-based study analyzing in vivo gastrointestinal permeability in @entity1 with @entity31 , their healthy relatives, spouses, and controls. METHODS: In total, 89 @entity1 with @entity31 in remission, 35 first-degree relatives ( @entity31 -R), 24 nonrelated spouses ( @entity31 -NR), and 99 healthy controls (HC) were studied. Permeability was assessed by a sugar-drink test using @entity969 (gastroduodenal permeability), @entity11884 / @entity2656 (intestinal permeability), and sucralose (colonic permeability). Data were correlated with clinical characteristics including medical treatment. RESULTS: Increased intestinal permeability was detected significantly more often in @entity31 @entity1 in remission (25/89, 28.1%) compared with HC (6/99, 6.1%; P < 0.001). Similar results were obtained in @entity31 -R (7/35, 20.0%; P = 0.01 compared with HC) regardless of sharing the same household with the @entity1 or not. No difference was found between @entity31 -NR (3/24, 12.5%) and HC. Notably, in @entity31 @entity1 increased intestinal permeability was found in 12/28 @entity1 (42.9%) with pancolitis, 7/30 (23.3%) @entity1 with @entity1960 , and in 2/19 (10.5%) @entity1 with @entity4272 (P = 0.04). Gastroduodenal and colonic permeability were similar in all groups. Among @entity1 on @entity500 , increased intestinal permeability was only seen in 1/18 (5.6%) @entity1 . In contrast, in 24/70 (34.3%) @entity1 without @entity500 , an increased intestinal permeability was found (P = 0.005). CONCLUSIONS: An increased intestinal but not colonic permeability was found in @entity31 @entity1 in clinical remission that could mark a new risk factor for @entity66 location. Similar findings in healthy relatives but not spouses suggest that this barrier defect is genetically determined.

2098938

2098939

2098940

Increased small intestinal permeability in @entity31 : rather genetic than environmental and a risk factor for XXXX ?

multiple_choice

BACKGROUND: A disturbed epithelial barrier could play a pivotal role in @entity31 ( @entity31 ). We performed a family-based study analyzing in vivo gastrointestinal permeability in @entity1 with @entity31 , their healthy relatives, spouses, and controls. METHODS: In total, 89 @entity1 with @entity31 in remission, 35 first-degree relatives ( @entity31 -R), 24 nonrelated spouses ( @entity31 -NR), and 99 healthy controls (HC) were studied. Permeability was assessed by a sugar-drink test using @entity969 (gastroduodenal permeability), @entity11884 / @entity2656 (intestinal permeability), and sucralose (colonic permeability). Data were correlated with clinical characteristics including medical treatment. RESULTS: Increased intestinal permeability was detected significantly more often in @entity31 @entity1 in remission (25/89, 28.1%) compared with HC (6/99, 6.1%; P < 0.001). Similar results were obtained in @entity31 -R (7/35, 20.0%; P = 0.01 compared with HC) regardless of sharing the same household with the @entity1 or not. No difference was found between @entity31 -NR (3/24, 12.5%) and HC. Notably, in @entity31 @entity1 increased intestinal permeability was found in 12/28 @entity1 (42.9%) with pancolitis, 7/30 (23.3%) @entity1 with @entity1960 , and in 2/19 (10.5%) @entity1 with @entity4272 (P = 0.04). Gastroduodenal and colonic permeability were similar in all groups. Among @entity1 on @entity500 , increased intestinal permeability was only seen in 1/18 (5.6%) @entity1 . In contrast, in 24/70 (34.3%) @entity1 without @entity500 , an increased intestinal permeability was found (P = 0.005). CONCLUSIONS: An increased intestinal but not colonic permeability was found in @entity31 @entity1 in clinical remission that could mark a new risk factor for @entity66 location. Similar findings in healthy relatives but not spouses suggest that this barrier defect is genetically determined.

2098941

2098942

2098943

Effectiveness of physiotherapy for adults with XXXX : a systematic review.

multiple_choice

OBJECTIVE: To systematically review the literature investigating the effectiveness of physiotherapy in adults with @entity76 and to document treatment strategies currently employed in the physiotherapy management of this @entity1 population. DATA SOURCES: Eight electronic databases were searched to source English-language studies published up to December 2007. Secondary searching of reference lists was also undertaken. REVIEW METHODS: Studies were included if they used a quantitative research design to investigate the effect of physiotherapy on adults with diagnosed @entity76 . Three reviewers were involved in study selection. Eligible studies were assessed for methodological quality. Data pertaining to the @entity1 , interventions received, outcomes measured, and the effectiveness of the intervention were systematically extracted and synthesised in a narrative format. RESULTS: Nine studies were included in the review. The majority of the studies (n = 7) were case studies or case series. The median quality score was 8/16 (range 4-10). The studies were heterogeneous in terms of @entity1 characteristics, interventions received and outcomes measured. All studies reported positive effects of physiotherapy over a range of outcomes measured, in particular balance, gait and function. CONCLUSION: There is some evidence that supports the effectiveness of physiotherapy in adults with @entity76 . However, these results need to be interpreted with caution due to the low volume, quality and clinical applicability of this evidence. There is a need for further high-quality research in this area.

2098944

2098945

2098946

[An epidemiological study for XXXX pedestrian traffic injuries that occurred in school-zone].

multiple_choice

OBJECTIVES: Pedestrian traffic injuries have been an important cause of childhood mortality and morbidity for decades. The aim of this study was to describe the epidemiological characteristics of @entity1 pedestrian traffic injuries that occurred during 2000 in one metropolitan city and its school-zones, and to determine the factors associated with those accidents. METHODS: A cross-sectional study was performed in 2001. Police records were used to identify the cases of @entity130 . @entity1 aged between 6 and 15 years, injured during road walking, were included in this study. A direct survey of the environmental factors within the school-zones in study area (n=116) was also performed. Self-administered questionnaires, via mail and telephone surveys, were used to assess the safety education programmes. The schools were divided into two groups according to the occurrence of pedestrian traffic injuries in their school-zone. RESULTS: @entity130 (n=597) were found to account for 3.2% of all traffic injuries in the subject area. The epidemiological characteristics were not significantly different between genders. There were some significant risk factors within the environmental factors, such as local road (OR: 2.3, 95% CI=1.05-5.35), heavy traffic volume (OR: 2.2, 95% CI=1.00-5.04), poor visibility of speed-limit signs (OR: 2.8, 95% CI=1.25-6.42), no separation of pedestrian routes from cars (OR: 2.6, 95% CI=1.02-6.75) and barriers on the pedestrian routes (OR: 2.2, 95% CI=1.01-5.08). Only one factor, that of education in a safety-park (OR: 0.3, 95% CI=0.09-0.96), was significantly associated in the traffic and pedestrian safety education factors. CONCLUSION: Significant associations with @entity130 risk were identified in some of the modifiable environmental factors than in the educational factors.

2098947

2098948

2098949

Changing trends in state XXXX hospital use from 2002 to 2005.

multiple_choice

OBJECTIVE: National surveys have shown @entity810 in the number of residents in state @entity146 hospitals since the 1950s and in the number of admissions since the 1970s. However, data from 2002 and 2005 indicate a reversal of these long-term trends. The objective of this study was to present the new data and to advocate for research on the factors contributing to these changes. METHODS: This study is based on state-level data submitted annually to the Center for Mental Health Services. The 11 states showing increases in admissions and residents between 2002 and 2005 were surveyed by telephone about the factors leading to the changes. RESULTS: Between 2002 and 2005, the number of admissions nationwide increased 21.1%, and the number of residents increased by 1.0%. State mental health agency staff attributed the increases principally to one factor-the increase in the number of forensic admissions and residents. Staff also identified increases in the number of admissions with @entity161 (increased 23.2%) and @entity1316 (increased 16.3%) as a second factor, plus declines in the availability of housing and community-based care providers. CONCLUSIONS: The reversal of long-term trends may signal threats to the goal of community-based mental health care. Research is urgently needed to examine the factors associated with these increases. Potential factors to be investigated include the increase in the number of forensic admissions and the antecedents of this phenomenon, increases in the number of admissions with @entity161 , the changing capacity of general hospital inpatient @entity146 services in the community, and changes in the demographic makeup of American society, reflected in an aging population and increased racial-ethnic diversity.

2098950

2098951

2098952

The role of pre-operative B mode ultrasound in the evaluation of the axillary lymph node @entity3 in the initial staging of XXXX .

multiple_choice

The lymph node status of a @entity0 is one of the main prognostic criterias. This status is very important to determine the therapeutic approach. Physical examination alone is not sufficient to assess axillary @entity3 . Mammographic examination can give us an idea about @entity0 and axillary involvement. Ultrasonographic evaluation can improve the sensitivity of clinical and mammographic examination in assessing axillary lymph node status. 42 @entity1 operated on for @entity0 between January 2000-January 2003 were included in this prospective study. In the study, we used axillary B mode ultrasound to evaluate the axillary lymph nodes. There are several sonographic features to categorize them. Axillary B mode ultrasound was performed to evaluate the axillary lymph nodes for metastatic involvement. In the evaluation of lymph nodes, the sonographic criteria were centric echogenity, thickening of cortex, length/width ratio (L/W) and the diameter of lymph nodes. Hyperechogenic hilus was accepted as a benign finding. The thickening of the cortex less than 50% of the thickening of the centric echogenic hilus was also accepted as a benign finding. L/W ratio below 2 and parameters above 2 cm were accepted as malignant findings. 168 lymph nodes in 42 @entity1 were evaluated pre-operatively with axillary B mode ultrasound. As a result, these lymph nodes were defined as benign in 19 @entity1 (45.2%) and malignant in 23 @entity1 (54.8%). Axillary lymph node status was found as benign in 18 @entity1 (42.9%) and malignant in 24 @entity1 (57.1%) pathologically . Comparative results of ultrasound and axillary lymph node status can be seen on Table III. As a result, the sensitivity of axillary B mode ultrasound to show the @entity3 was found as 79.1%, specificity was 77.7%, positive predictive value 82.6% and negative predictive value 73.6%. We think some better results may be obtained in the future and these developments may affect the surgeon's decisions concerning axillary dissection for @entity0 operations.

2098953

2098954

2098955

The role of pre-operative B mode ultrasound in the evaluation of the axillary lymph node XXXX in the initial staging of @entity0 .

multiple_choice

The lymph node status of a @entity0 is one of the main prognostic criterias. This status is very important to determine the therapeutic approach. Physical examination alone is not sufficient to assess axillary @entity3 . Mammographic examination can give us an idea about @entity0 and axillary involvement. Ultrasonographic evaluation can improve the sensitivity of clinical and mammographic examination in assessing axillary lymph node status. 42 @entity1 operated on for @entity0 between January 2000-January 2003 were included in this prospective study. In the study, we used axillary B mode ultrasound to evaluate the axillary lymph nodes. There are several sonographic features to categorize them. Axillary B mode ultrasound was performed to evaluate the axillary lymph nodes for metastatic involvement. In the evaluation of lymph nodes, the sonographic criteria were centric echogenity, thickening of cortex, length/width ratio (L/W) and the diameter of lymph nodes. Hyperechogenic hilus was accepted as a benign finding. The thickening of the cortex less than 50% of the thickening of the centric echogenic hilus was also accepted as a benign finding. L/W ratio below 2 and parameters above 2 cm were accepted as malignant findings. 168 lymph nodes in 42 @entity1 were evaluated pre-operatively with axillary B mode ultrasound. As a result, these lymph nodes were defined as benign in 19 @entity1 (45.2%) and malignant in 23 @entity1 (54.8%). Axillary lymph node status was found as benign in 18 @entity1 (42.9%) and malignant in 24 @entity1 (57.1%) pathologically . Comparative results of ultrasound and axillary lymph node status can be seen on Table III. As a result, the sensitivity of axillary B mode ultrasound to show the @entity3 was found as 79.1%, specificity was 77.7%, positive predictive value 82.6% and negative predictive value 73.6%. We think some better results may be obtained in the future and these developments may affect the surgeon's decisions concerning axillary dissection for @entity0 operations.

2098956

2098957

2098958

Smoking restrictions and treatment for smoking: policies and procedures in XXXX inpatient units in Australia.

multiple_choice

OBJECTIVE: @entity286 smoking is the leading preventable cause of @entity204 and disease in Australia. Even though smoking prevalence in the general population has been reduced (20% smoke), prevalence rates remain high among @entity146 inpatients (70%-90%). This study aimed to identify smoking policies and procedures in public @entity146 inpatient units in New South Wales, Australia; the provision of "smoking care" in such units (for example, quit-smoking advice or @entity1239 replacement therapy); and policies and procedures associated with the assessment of smoking status and provision of smoking care. METHODS: A cross-sectional survey was mailed to all public @entity146 inpatient units in New South Wales for completion by nurse unit managers. RESULTS: Of the 131 units, 123 units completed and returned surveys (94%). Over one-third (36%) of respondents reported instances in which inpatients began smoking during their admission. A similar proportion (39%) reported that staff provided cigarettes to @entity1 who smoked when @entity1 ' supply was expended. Fifty percent of respondents reported that all @entity1 were assessed for smoking status; however, 70% reported that @entity1239 dependence was not assessed. Units on which staff adhered to smoking restrictions were three times as likely to assess @entity1 ' smoking status as units where staff never adhered to restrictions (odds ratio=3.05, p=.01). CONCLUSIONS: Inadequate establishment of nonsmoking environments and of smoking restriction enforcement as well as inconsistencies in the provision of smoking care were evident. The findings suggest that failure of @entity146 services to provide smoking care is systemic and not related to particular types of services (for example acute versus nonacute or regional versus metropolitan).

2098959

2098960

2098961

[Association of XXXX polymorphism (-308 A/G) with high activity of @entity309 and therapy response to Etanercept].

multiple_choice

INTRODUCTION: Genetic markers are significant predictive factors in the assessment of therapeutic response of @entity309 ( @entity309 ) to biological medication. OBJECTIVE: The aim of the study was to determinate the association of @entity310 @entity15646 polymorphism with a high @entity309 activity and its predictive value in therapeutic response after 12 months of treatment with Etanercept. METHODS: The study enrolled 132 @entity1 with @entity309 treated with @entity1499 ( @entity1500 ) and 58 control subjects. The -308 TNF polymorphism was examined using the polymerase chain reaction - restriction fragment length polymorphism (PCR-RFLP). The @entity1 were divided into two groups: group A with A/A and A/G genotype and group G with G/G genotype. After 12 months, beside @entity1500 , Etanercept was introduced in 36 @entity1 . We compared clinical activity among the groups at the beginning and after one year of therapy by using DAS28 SE (Disease activity score with sedimentation). RESULTS: There was no significant difference found in the distribution of G and A allele in the @entity309 group compared to the control group. A significantly higher disease activity was noticed in A compared to the G group (DAS28 SE: 6.31 to 5.81; p < 0.05). The @entity1 with A allele kept the majority of the disease activity even after a year of study (DAS28 SE: 5.25 to 3.89). After a year of @entity1500 and Etanercept therapy, a significantly larger proportion of @entity1 in the G group displayed a good clinical response to treatment compared to the A group (81.5% to 25%; p < 0.05). The average change of DAS28 SE in G group was 2.24, while in the A group DAS 28 reduction was significantly lower (1.17; p = 0.005). CONCLUSION: There was no significant difference in the frequency of A in the @entity1 with @entity309 compared to healthy subjects. The presence of A allele is associated with more serious clinical presentation of the disease and lower therapeutic response to Etanercept.

2098962

2098963

2098964

[Association of @entity310 polymorphism (-308 A/G) with high activity of XXXX and therapy response to Etanercept].

multiple_choice

INTRODUCTION: Genetic markers are significant predictive factors in the assessment of therapeutic response of @entity309 ( @entity309 ) to biological medication. OBJECTIVE: The aim of the study was to determinate the association of @entity310 @entity15646 polymorphism with a high @entity309 activity and its predictive value in therapeutic response after 12 months of treatment with Etanercept. METHODS: The study enrolled 132 @entity1 with @entity309 treated with @entity1499 ( @entity1500 ) and 58 control subjects. The -308 TNF polymorphism was examined using the polymerase chain reaction - restriction fragment length polymorphism (PCR-RFLP). The @entity1 were divided into two groups: group A with A/A and A/G genotype and group G with G/G genotype. After 12 months, beside @entity1500 , Etanercept was introduced in 36 @entity1 . We compared clinical activity among the groups at the beginning and after one year of therapy by using DAS28 SE (Disease activity score with sedimentation). RESULTS: There was no significant difference found in the distribution of G and A allele in the @entity309 group compared to the control group. A significantly higher disease activity was noticed in A compared to the G group (DAS28 SE: 6.31 to 5.81; p < 0.05). The @entity1 with A allele kept the majority of the disease activity even after a year of study (DAS28 SE: 5.25 to 3.89). After a year of @entity1500 and Etanercept therapy, a significantly larger proportion of @entity1 in the G group displayed a good clinical response to treatment compared to the A group (81.5% to 25%; p < 0.05). The average change of DAS28 SE in G group was 2.24, while in the A group DAS 28 reduction was significantly lower (1.17; p = 0.005). CONCLUSION: There was no significant difference in the frequency of A in the @entity1 with @entity309 compared to healthy subjects. The presence of A allele is associated with more serious clinical presentation of the disease and lower therapeutic response to Etanercept.

2098965

2098966

2098967

@entity302 in a @entity1 with XXXX .

multiple_choice

INTRODUCTION: @entity21693 ( @entity21693 ) is a rare @entity2526 characterized by @entity2652 , multiple @entity154 , delayed psychomotor development and pharmaco-resistant @entity302 . CASE OUTLINE: We present a 5-year-old @entity1 with severe delay in growth and development, @entity4242 , mild @entity2652 and @entity302 . The pregnancy was complicated by @entity1592 . Generalized @entity2421 was observed at birth. First @entity410 started at age of 9 months as unilateral @entity159 ( @entity159 ), sometimes with bilateral generalization. @entity410 were often triggered by fever and were resistant to antiepileptic treatment. Introduction of @entity2812 and @entity1092 therapy led to complete @entity410 control at the age of 33 months. Electroencephalographic (EEG) finding was typical at the beginning. After transitory improvement between age four and five years, epileptiform EEG activity appeared again at the age of five years, without observed clinical @entity410 . Magnetic resonance imaging showed diffuse @entity1010 and delay in @entity17 . Using Multiplex ligation-dependent probe amplification (MLPA) method, we disclosed heterozygote microdeletation of the distal part of the short arm of chromosome 4 (4p16). CONCLUSION: We present a clinical course of @entity302 in a @entity1 with @entity21693 . The diagnosis was verified by modern molecular technique. This is the first molecular characterization of a @entity1 with @entity21693 performed in our country.

2098968

2098969

2098970

XXXX in a @entity1 with @entity21693 .

multiple_choice

INTRODUCTION: @entity21693 ( @entity21693 ) is a rare @entity2526 characterized by @entity2652 , multiple @entity154 , delayed psychomotor development and pharmaco-resistant @entity302 . CASE OUTLINE: We present a 5-year-old @entity1 with severe delay in growth and development, @entity4242 , mild @entity2652 and @entity302 . The pregnancy was complicated by @entity1592 . Generalized @entity2421 was observed at birth. First @entity410 started at age of 9 months as unilateral @entity159 ( @entity159 ), sometimes with bilateral generalization. @entity410 were often triggered by fever and were resistant to antiepileptic treatment. Introduction of @entity2812 and @entity1092 therapy led to complete @entity410 control at the age of 33 months. Electroencephalographic (EEG) finding was typical at the beginning. After transitory improvement between age four and five years, epileptiform EEG activity appeared again at the age of five years, without observed clinical @entity410 . Magnetic resonance imaging showed diffuse @entity1010 and delay in @entity17 . Using Multiplex ligation-dependent probe amplification (MLPA) method, we disclosed heterozygote microdeletation of the distal part of the short arm of chromosome 4 (4p16). CONCLUSION: We present a clinical course of @entity302 in a @entity1 with @entity21693 . The diagnosis was verified by modern molecular technique. This is the first molecular characterization of a @entity1 with @entity21693 performed in our country.

2098971

2098972

2098973

@entity302 in a XXXX with @entity21693 .

multiple_choice

INTRODUCTION: @entity21693 ( @entity21693 ) is a rare @entity2526 characterized by @entity2652 , multiple @entity154 , delayed psychomotor development and pharmaco-resistant @entity302 . CASE OUTLINE: We present a 5-year-old @entity1 with severe delay in growth and development, @entity4242 , mild @entity2652 and @entity302 . The pregnancy was complicated by @entity1592 . Generalized @entity2421 was observed at birth. First @entity410 started at age of 9 months as unilateral @entity159 ( @entity159 ), sometimes with bilateral generalization. @entity410 were often triggered by fever and were resistant to antiepileptic treatment. Introduction of @entity2812 and @entity1092 therapy led to complete @entity410 control at the age of 33 months. Electroencephalographic (EEG) finding was typical at the beginning. After transitory improvement between age four and five years, epileptiform EEG activity appeared again at the age of five years, without observed clinical @entity410 . Magnetic resonance imaging showed diffuse @entity1010 and delay in @entity17 . Using Multiplex ligation-dependent probe amplification (MLPA) method, we disclosed heterozygote microdeletation of the distal part of the short arm of chromosome 4 (4p16). CONCLUSION: We present a clinical course of @entity302 in a @entity1 with @entity21693 . The diagnosis was verified by modern molecular technique. This is the first molecular characterization of a @entity1 with @entity21693 performed in our country.

2098974

2098975

2098976

Acute pure motor @entity1688 : is it dengue XXXX ?

multiple_choice

BACKGROUND AND AIM: In view of paucity of comprehensive evaluation about @entity281 producing @entity1688 , we report the clinical, laboratory and neurophysiological studies in these @entity1 . SUBJECTS AND METHODS: Seven out of 16 @entity1 with @entity281 presented with @entity1688 and they were subjected to a detailed clinical history and examination. Diagnosis of dengue was based on characteristic clinical and positive serum IgM ELISA. Blood counts, serum chemistry, CSF analysis and nerve conduction and electromyographic (EMG) studies were performed in all. Outcome was defined at the end of 1 month into complete, partial and poor on the basis of activities of daily living RESULTS: The age of the @entity1 ranged between 9 and 42 years and 2 were females. Fever was present in all and @entity925 in 5 @entity1 . Weakness developed within 3-5 days of illness, which was severe in 4 and moderate in 3 @entity1 . @entity2421 and @entity427 were present in 5 @entity1 . Nerve conduction and EMG studies were normal in all except one whose EMG was @entity121 . Serum @entity9153 and SGPT were raised in all and serum @entity648 in 3 @entity1 . All the @entity1 had @entity1003 and 6 had @entity882 . Muscle biopsy in 1 @entity1 was suggestive of @entity5442 . Six @entity1 improved completely and one had poor recovery who needed ventilatory support. CONCLUSION: @entity778 may result in acute pure motor @entity1688 due to @entity5442 . In an endemic area it should be considered in the differential diagnosis of @entity912 .

2098977

2098978

2098979

Acute pure motor XXXX : is it dengue @entity5442 ?

multiple_choice

BACKGROUND AND AIM: In view of paucity of comprehensive evaluation about @entity281 producing @entity1688 , we report the clinical, laboratory and neurophysiological studies in these @entity1 . SUBJECTS AND METHODS: Seven out of 16 @entity1 with @entity281 presented with @entity1688 and they were subjected to a detailed clinical history and examination. Diagnosis of dengue was based on characteristic clinical and positive serum IgM ELISA. Blood counts, serum chemistry, CSF analysis and nerve conduction and electromyographic (EMG) studies were performed in all. Outcome was defined at the end of 1 month into complete, partial and poor on the basis of activities of daily living RESULTS: The age of the @entity1 ranged between 9 and 42 years and 2 were females. Fever was present in all and @entity925 in 5 @entity1 . Weakness developed within 3-5 days of illness, which was severe in 4 and moderate in 3 @entity1 . @entity2421 and @entity427 were present in 5 @entity1 . Nerve conduction and EMG studies were normal in all except one whose EMG was @entity121 . Serum @entity9153 and SGPT were raised in all and serum @entity648 in 3 @entity1 . All the @entity1 had @entity1003 and 6 had @entity882 . Muscle biopsy in 1 @entity1 was suggestive of @entity5442 . Six @entity1 improved completely and one had poor recovery who needed ventilatory support. CONCLUSION: @entity778 may result in acute pure motor @entity1688 due to @entity5442 . In an endemic area it should be considered in the differential diagnosis of @entity912 .

2098980

2098981

2098982

Postoperative hypofractionated radiotherapy in XXXX .

multiple_choice

PURPOSE: To evaluate the safety and efficacy of hypofractionated radiotherapy (HRT) in @entity463 ( @entity463 ) @entity1 in terms of overall and progression-free survival. @entity1 AND METHODS: Adult @entity1 with @entity463 were prospectively treated with HRT after total, subtotal or partial @entity5 excision. HRT was applied 3 days a week with a @entity5 dose of 3.33 Gy per fraction. At the first phase of treatment 12 fractions and at the second phase 3 fractions with smaller fields were delivered. The total dose was 50 Gy/15 fractions/5 weeks. The results were compared with a historical control group of @entity463 @entity1 treated with conventional RT. RESULTS: 20 @entity1 with @entity463 were treated between 1997-2000 at our department. The @entity5 was multifocal in one (5%) case. The types of operations used were total @entity5 excision 10(50%) cases, subtotal excision 5 (25%) cases and partial excision 5 (25%) cases. For the historical control group the corresponding operations were 19 (56%), 6 (18%) and 9 (26%). In the study group one-year survival was 50% and median survival 12 months. Mean overall survival was 13.5 (11.3 months for the historical control group, p=0.16) and progression-free survival 6.8 months (5.6 for the historical control group, p=0.36). Treatment was well tolerated. Acute @entity137 was minimal and only one HRT @entity1 had late @entity137 ( @entity39 ). CONCLUSION: The mean overall survival with HRT was better but statistically non significant compared with the historical control group. Our study supports that HRT can be used instead of conventional and hyperfractionated radiotherapy and studies of HRT with higher doses may be meaningful.

2098983

2098984

2098985

[Euthanasia and XXXX ].

multiple_choice

Euthanasia is clinical practice in several countries world-wide. @entity5 @entity1 ' attitude in this field was focused through a review of case reports and questionnaire-based studies on Medline (1992-97). A total of nine publications including 459 @entity5 @entity1 from USA, Canada and Holland were found. The majority of @entity1 had poor performance status and @entity1442 . At least one third reported themselves positive to euthanasia. @entity1 below 50 years of age, having superior performance status and not considering themselves religious, more frequently supported euthanasia. Psychological factors seem to be more significant than physical factors for support of euthanasia. Loss of control, being a burden on one's family and loss of dignity are the psychological factors most frequently reported. A "help to live" approach aimed at avoiding @entity1 requests for help to die will mean that health care workers must allocate more of their time to these @entity1 . Overcrowded hospitals with several @entity1 in corridors and lack of nursing-homebeds do not make this situation easier to handle.

2098986

2098987

2098988

Role of type Ialpha @entity1076 5-kinase in insulin secretion, @entity413 metabolism, and membrane potential in XXXX beta-cells.

multiple_choice

Insulin secretion from beta-cells is regulated by a complex signaling network. Our earlier study has reported that @entity5180 participates in @entity413 - and @entity268 -induced insulin secretion probably via maintaining a functional actin structure for recruitment of insulin granules. Type Ialpha @entity1076 5-kinase ( @entity55027 ) is a downstream effector of @entity5180 and a critical enzyme for synthesis of @entity1078 ( @entity1078 ). By using an RNA interference technique, @entity55027 in @entity4009 beta-cells could be specifically knocked down by 70-75%. @entity55027 knockdown disrupted filamentous actin structure and caused changes in cell morphology. In addition, @entity1078 content in the plasma membrane was reduced and the @entity413 effect on PIP(2) was abolished but without affecting @entity413 -induced formation of @entity671 . At basal conditions (2.8 mM @entity413 ), @entity55027 knockdown doubled insulin secretion, elevated @entity413 metabolic rate, depolarized resting membrane potential, and raised cytoplasmic free @entity141 levels ([ @entity141 ](i)). The total insulin release at high @entity413 was increased upon @entity55027 knockdown. However, the percent increment of insulin secretion by high @entity413 and @entity1928 over the basal release was significantly reduced, an effect more apparent on the late phase of insulin secretion. Metabolism and [ @entity141 ](i) rises at high @entity413 were also attenuated in cells after @entity55027 knockdown. In contrast, @entity55027 knockdown had no effect on cell growth and viability. Taken together, our data suggest that @entity55027 may play an important role in both the proximal and distal steps of signaling cascade for insulin secretion in beta-cells.

2098989

2098990

2098991

Role of type Ialpha XXXX 5-kinase in insulin secretion, @entity413 metabolism, and membrane potential in @entity4009 beta-cells.

multiple_choice

Insulin secretion from beta-cells is regulated by a complex signaling network. Our earlier study has reported that @entity5180 participates in @entity413 - and @entity268 -induced insulin secretion probably via maintaining a functional actin structure for recruitment of insulin granules. Type Ialpha @entity1076 5-kinase ( @entity55027 ) is a downstream effector of @entity5180 and a critical enzyme for synthesis of @entity1078 ( @entity1078 ). By using an RNA interference technique, @entity55027 in @entity4009 beta-cells could be specifically knocked down by 70-75%. @entity55027 knockdown disrupted filamentous actin structure and caused changes in cell morphology. In addition, @entity1078 content in the plasma membrane was reduced and the @entity413 effect on PIP(2) was abolished but without affecting @entity413 -induced formation of @entity671 . At basal conditions (2.8 mM @entity413 ), @entity55027 knockdown doubled insulin secretion, elevated @entity413 metabolic rate, depolarized resting membrane potential, and raised cytoplasmic free @entity141 levels ([ @entity141 ](i)). The total insulin release at high @entity413 was increased upon @entity55027 knockdown. However, the percent increment of insulin secretion by high @entity413 and @entity1928 over the basal release was significantly reduced, an effect more apparent on the late phase of insulin secretion. Metabolism and [ @entity141 ](i) rises at high @entity413 were also attenuated in cells after @entity55027 knockdown. In contrast, @entity55027 knockdown had no effect on cell growth and viability. Taken together, our data suggest that @entity55027 may play an important role in both the proximal and distal steps of signaling cascade for insulin secretion in beta-cells.

2098992

2098993

2098994

Role of type Ialpha @entity1076 5-kinase in insulin secretion, XXXX metabolism, and membrane potential in @entity4009 beta-cells.

multiple_choice

Insulin secretion from beta-cells is regulated by a complex signaling network. Our earlier study has reported that @entity5180 participates in @entity413 - and @entity268 -induced insulin secretion probably via maintaining a functional actin structure for recruitment of insulin granules. Type Ialpha @entity1076 5-kinase ( @entity55027 ) is a downstream effector of @entity5180 and a critical enzyme for synthesis of @entity1078 ( @entity1078 ). By using an RNA interference technique, @entity55027 in @entity4009 beta-cells could be specifically knocked down by 70-75%. @entity55027 knockdown disrupted filamentous actin structure and caused changes in cell morphology. In addition, @entity1078 content in the plasma membrane was reduced and the @entity413 effect on PIP(2) was abolished but without affecting @entity413 -induced formation of @entity671 . At basal conditions (2.8 mM @entity413 ), @entity55027 knockdown doubled insulin secretion, elevated @entity413 metabolic rate, depolarized resting membrane potential, and raised cytoplasmic free @entity141 levels ([ @entity141 ](i)). The total insulin release at high @entity413 was increased upon @entity55027 knockdown. However, the percent increment of insulin secretion by high @entity413 and @entity1928 over the basal release was significantly reduced, an effect more apparent on the late phase of insulin secretion. Metabolism and [ @entity141 ](i) rises at high @entity413 were also attenuated in cells after @entity55027 knockdown. In contrast, @entity55027 knockdown had no effect on cell growth and viability. Taken together, our data suggest that @entity55027 may play an important role in both the proximal and distal steps of signaling cascade for insulin secretion in beta-cells.

2098995

2098996

2098997

Intensive care units, communication between nurses and physicians, and XXXX ' outcomes.

multiple_choice

BACKGROUND: Various factors in hospitals can adversely affect @entity1 ' outcomes, including faulty communication between nurses and physicians. Whether specific communication elements (timeliness, accuracy, @entity1538 , understanding) can influence adverse outcomes is unknown. OBJECTIVES: To determine the relationships between @entity1 ' outcomes and (1) nurses' perceptions of elements of communication between nurses and physicians and (2) characteristics of the practice environment. METHODS: A cross-sectional survey design was used. Information on @entity2489 , @entity281 associated with a central catheter, and pressure @entity1066 was collected from 25 intensive care units in southeastern Michigan. Simultaneously, 462 nurses in those units (response rate, 53.3%) were anonymously surveyed. The Conditions for Work Effectiveness Questionnaire-II and the Practice Environment Scale of the Nursing Work Index were used to measure characteristics of the practice environment. The Intensive Care Unit Nurse-Physician Questionnaire was used to measure communication between nurses and physicians. Statistical tests included correlation and multiple regression. Analyses were conducted at the unit level. RESULTS: Unit response rates varied from 6% to 100%. Together, variability in understanding communication and capacity utilization were predictive of 27% of the variance in @entity2489 . Timeliness of communication was inversely related to pressure @entity1066 (r= -0.38; P=.06), and workplace empowerment and scores on the Acute Physiology and Chronic Health Evaluation III were positive predictors of @entity2489 (R(2)=0.36; P=.005). CONCLUSIONS: Not all elements of communication were related to the selected adverse outcomes. The connection between characteristics of the practice environment at the unit level and adverse outcomes remains elusive.

2098998

2098999

2099000

[The @entity1205 radiosensitization experience for the treatment of unresectable XXXX ].

multiple_choice

BACKGROUND: @entity1205 is an increasingly important drug for the treatment of @entity418 . The @entity1205 radiosensitization has been established in @entity5 cell lines. The therapeutic response and @entity137 of a weekly @entity1205 in combination with radiotherapy for unresectable @entity418 were examined. METHODS: Ten @entity1 with locally advanced or metastatic @entity1544 were recruited in the following protocol. The median age was 65.7 years. @entity1 received radiation in 2 Gy single daily fractions to a total dose of 60 Gy. @entity1205 (10 mg/m2) was administered weekly for 6 consecutive weeks. RESULTS: One @entity1 could not be evaluated. The overall response rate was 77% with 11% CR and 66% PRs. Mild grade 2 leukocytes @entity137 was observed in 2/10 @entity1 , which enforced the treatment absence for 7-14 days. Grade 2 @entity3136 was noted in one @entity1 . No severe grade 3 adverse effects were observed. CONCLUSION: It is concluded that low dose @entity1205 with radiotherapy is feasible and, a high response rate can be expected. @entity137 is modest, and this protocol may be useful for the outpatients or neoadjuvant chemotherapy.

2099001

2099002

2099003

[The XXXX radiosensitization experience for the treatment of unresectable @entity418 ].

multiple_choice

BACKGROUND: @entity1205 is an increasingly important drug for the treatment of @entity418 . The @entity1205 radiosensitization has been established in @entity5 cell lines. The therapeutic response and @entity137 of a weekly @entity1205 in combination with radiotherapy for unresectable @entity418 were examined. METHODS: Ten @entity1 with locally advanced or metastatic @entity1544 were recruited in the following protocol. The median age was 65.7 years. @entity1 received radiation in 2 Gy single daily fractions to a total dose of 60 Gy. @entity1205 (10 mg/m2) was administered weekly for 6 consecutive weeks. RESULTS: One @entity1 could not be evaluated. The overall response rate was 77% with 11% CR and 66% PRs. Mild grade 2 leukocytes @entity137 was observed in 2/10 @entity1 , which enforced the treatment absence for 7-14 days. Grade 2 @entity3136 was noted in one @entity1 . No severe grade 3 adverse effects were observed. CONCLUSION: It is concluded that low dose @entity1205 with radiotherapy is feasible and, a high response rate can be expected. @entity137 is modest, and this protocol may be useful for the outpatients or neoadjuvant chemotherapy.

2099004

2099005

2099006

Observation: application and advantages of BMK in osteoporosis by monitoring the dose of antiresorptive drugs with XXXX .

multiple_choice

One of the potential applications of BMK is the dynamic measure of bone metabolism. The present study aimed to observe the dynamic response of @entity1 ' bone toward the antiresorptive drugs by using BMK in the prospective procedure. The subjects were 309 Thai @entity1 . They were divided by age into 3 groups: A) 56 @entity1 at 50-60 years old, B) 116 @entity1 at 61-70 years old and C) 137 @entity1 at over 71 years old. They had the blood BMK tests based on these conditions: 1) prior to the prescription of antiresorptive drugs, 2) every month for following up the administration of the drugs until the proper doses were obtained, 3) every 3 month after the proper doses were obtained. The @entity1 were observed on the 5-category criteria resulting in as follows: Category 1: No previous history of antiresorptive drugs adminitration and the @entity17283 level was lower than normal. The antiresorptive drugs were not required during this 2-year observation. There were 7 cases aged 50-60, 13 cases aged 61-70 and 16 cases aged 71 up. Category 2: No previous history of antiresorptive drugs administration but the @entity17283 was higher than normal. Then the antiresorptive drugs were prescribed and the @entity17283 later became lower than normal. Thereafter, the antiresorptive drugs were not required any more through this 2-year study. There were 5 cases aged 50-60, 22 cases aged 61-70 and 22 cases aged 71 up. Category 3: No previous history of antiresorptive drugs administration but the @entity17283 was higher than normal. The antiresorptive drugs were prescribed until the @entity17283 became normal or lower than normal, but the values were not stable. So the drugs were prescribed intermittently. There were 10 cases aged 50-60, 28 cases aged 61-70 and 18 cases aged 71 up. Category 4: Having the previous history of antiresorptive drugs administration for more than 1 year, and the @entity17283 was lower than normal. The @entity1 did not take any antiresorptive drugs during this 2-year study. There were 15 cases aged 50-60, 37 cases aged 61-70 and 55 cases aged 71 up. Category 5: Having the previous history of antiresorptive drugs administration for more than 1 year and the @entity17283 was lower than normal. Later, the values became higher and the antiresorptive drugs were continued intermittently during the 2-year study. There were 19 cases aged 50-60, 16 cases aged 61-70 and 25 cases aged 71 up. In conclusion, the change of bone turn over rate after the antiresorptive therapy for individual @entity1 is very independent and varied. The up and down changes depend on many factors such as environments, genes, etc. Besides, the time of drugs response evaluated by BMK needed to be assigned within 1 month. The @entity1 ' BMK is suggested to be observed regularly. The observation is the justifying key not only to determine the suitable amount of antiresorptive drugs as well as the effective time response on the individual @entity1 but also to help reduce @entity1 ' medical cost.

2099007

2099008

2099009

XXXX of the left main bronchus: results of treatment with balloons and metallic stents.

multiple_choice

PURPOSE: To assess the results of treatment with @entity384 and metallic Z stents in @entity1 with @entity378 of the left main bronchus. MATERIALS AND METHODS: Nineteen @entity1 with @entity378 of the left main bronchus were treated with balloon (n = 15) and self-expanding metallic Z stents (n = 4). Respiratory status and pulmonary function tests were followed up for 2-90 months. RESULTS: In the balloon group, improvements in @entity1353 occurred in 73% (11 of 15 @entity1 ) immediately, 73% after 1 month, 73% after 6 months, 64% after 1 year, 64% after 3 years, and 42% after 6 years (Kaplan-Meier method). Improvement of pulmonary function (FEV1 or FVC) was achieved in 62% (eight of 13) after 1 year. In the stent group, immediate improvements of @entity1353 or pulmonary function occurred in all @entity1 . However, @entity174 of the stents occurred in two @entity1 , at 4 and 18 months, respectively. Occlusion of the lumen of the stent by granulation tissue occurred in another at 18 months. CONCLUSION: Balloon dilation can be an effective method for the treatment of @entity378 of the main bronchus. Metallic Z stents should be used cautiously because of their problems of mechanical durability and overgrowth of granulation tissue.

2099010

2099011

2099012

[Injuries among XXXX treated at emergency medical centers and in hospitals 1990-97].

multiple_choice

The Norwegian National Injury Sample Registry is a prospective case register of @entity130 occurring in the defined population of four cities. All @entity130 treated in hospitals and emergency wards are recorded in the registry. We used data from this registry to provide an epidemiologic overview of the incidence of @entity130 among @entity1 aged 0-14 in Norway. The study population consisted of approximately 61,500 @entity1 annually or approximately 492,000 @entity1 -years over the 1990-97 period. A total of 57,000 @entity130 were registered, or 116 @entity130 per 1,000 @entity1 -years. Approximately 2% of the @entity130 were classified as severe. 36% of all @entity130 occurred at home, 13% during sport activities and 13% were caused by accidents at school. Incidence was higher among @entity1 than @entity1 in all age groups. During their first 15 years of life, @entity1 sustained on average 2.0 @entity130 and @entity1 1.5 @entity130 . Data from the Norwegian National Sample Injury Registry may provide useful information for prevention of and research on @entity130 among @entity1 .

2099013

2099014

2099015

The location of the primary entry tear in acute type B XXXX affects early outcome.

multiple_choice

OBJECTIVES: The goal of the retrospective study was to relate the site of the primary entry tear in acute type B aortic dissections to the presence or development of complications. METHODS: A consecutive series of 52 @entity1 referred with acute type B @entity1580 was analysed with regard to the location of the primary entry tear ( @entity1653 or concavity of the distal aortic arch) using the referral CT scans at the time of diagnosis. These findings were related to the clinical outcome as well as to the need for intervention. RESULTS: Twenty-five @entity1 (48%) had the primary entry tear located at the @entity1653 of the distal aortic arch, whereas 27 @entity1 (52%) had the primary entry tear located at the concavity of the distal aortic arch. Twenty per cent of @entity1 with the primary entry tear at the @entity1653 presented with or developed complications, whereas 89% had or developed complications with the primary entry tear at the concavity (P < 0.001). Furthermore, in @entity1 with complicated type B @entity1580 , the distance of the primary entry tear to the left subclavian artery was significantly shorter as in uncomplicated @entity1 (8 vs. 21 mm; P = 0.002). In Cox regression analysis, a primary entry tear at the concavity of the distal aortic arch was identified as an independent predictor of the presence or the development of complicated type B @entity1580 . CONCLUSIONS: A primary entry tear at the concavity of the aortic arch as well as a short distance between the primary entry tear and the left subclavian artery are frequently associated with the presence or the development of complicated acute type B @entity1580 . These findings shall help us to further differentiate acute type B aortic dissections in addition to the common categorization in complicated and uncomplicated. These findings may therefore also have an impact on primary treatment.

2099016

2099017

2099018

[An unusual picture of XXXX and morbid obesity].

multiple_choice

HISTORY AND CLINICAL FINDINGS: Marked hyperinsulinism was demonstrated in the course of an oral @entity413 tolerance test (oGTT) in a 63-year-old @entity1 with severe @entity28 (height 1.59 m, body weight 123 kg, body-mass index 46.4 kg/m2). The @entity6 metabolic state, first diagnosed 12 years ago, had been replaced by a low plasma @entity413 level: she often had attacks of ravenous hunger. A reducing diet of 800 kcal had not been tolerated. She had not had any @entity1163 . She had continually gained weight since puberty, but her weight had remained relatively constant for the past 5 years during which she had been treated with @entity1955 for a @entity1893 (stage II). INVESTIGATIONS: In the course of an oGTT (75 g @entity413 ) the basal insulin concentration (146 pmol/l) had risen to 1663 pmol/l at 30 min. The basal @entity2690 level was 50 times normal (66 pmol/l vs. 1.418 pmol/l), while the initial plasma @entity413 level had fallen from 4.3 mmol/l to 3.8 mmol/l. Spiral computed tomography of the pancreas showed a 3 x 2.5 cm mass in the region of the tail of the pancreas. TREATMENT AND COURSE: At laparoscopy a 4 cm @entity5 was palpated in the region of the pancreatic tail. Left resection of the pancreas was performed. Histopathological examination of the surgical specimen confirmed an @entity9608 . A repeat of oGTT 6 months postoperatively demonstrated a markedly diminished insulin level compared with the preoperative results, as well as a @entity6 metabolic state. CONCLUSION: In case of dramatic improvement of @entity6 in an @entity28 @entity1 without drug treatment or weight reduction an insulin-producing @entity5 should be considered in the differential diagnosis. There may be no typical hypoglycaemic symptoms because of insulin resistance associated with the @entity28 .

2099019

2099020

2099021

Molecularly-targeted therapies for XXXX .

multiple_choice

Targeting cell-signalling pathways that confer survival advantage to @entity5 cells has become a major focus of investigation for the treatment of various @entity5 . @entity1149 ( @entity1149 ), a disease with wide molecular heterogeneity, has become a main testing ground for the evaluation of various targeted agents. Inhibition of the epidermal growth factor pathway with @entity3866 results in improved survival and symptom control for @entity1 with advanced @entity1149 who progressed following one or two prior chemotherapy regimens. @entity4562 , the first @entity470 ( @entity470 ) inhibitor to be approved by the FDA, failed to demonstrate survival advantage over placebo in a large Phase III trial for @entity1 with advanced @entity1149 . The results of this study have raised several important clinical and biological issues that may be relevant for the development of other targeted agents. Recent identification of mutations in the @entity855 -binding pocket of the @entity470 is the first step towards proper @entity1 selection for therapy with an @entity470 @entity669 kinase inhibitor. In addition, predictive potential has also been seen with @entity470 gene amplification. It is unclear whether monoclonal antibodies against the @entity470 may be active independent of the @entity470 mutation, as the site of action is different from @entity669 kinase inhibitors. A recent randomised clinical trial that combined the antiangiogenic agent bevacizumab with chemotherapy has demonstrated survival advantage over chemotherapy alone for certain subsets of @entity1 with advanced @entity1149 . The exciting results of this study represent an important advance in the treatment of @entity1 with advanced @entity1149 .

2099022

2099023

2099024

Symptomatic thrower's XXXX . Arthroscopic evaluation and treatment.

multiple_choice

A long-term follow-up was performed on 22 @entity1 treated for a @entity5040 and symptomatic posterior shoulder @entity158 during either the late cocking, acceleration, or follow-through phases of throwing. Arthroscopic evaluation of these @entity1 revealed undersurface tearing of the rotator cuff in all but one. Fifteen @entity1 also had tearing of the posterior labrum. Anterior labral fraying was noted in four @entity1 . Treatment consisted of debridement of the rotator cuff and labral tears. The @entity5040 was removed arthroscopically in 11 @entity1 . Eighteen of 22 throwers treated were available for long-term follow-up at a mean of 6.3 years (range, 1 to 12). Only 10 of 18 (55%) throwers evaluated had returned to their premorbid level of throwing. All 10 were asymptomatic and had maintained a high level of performance for a mean of 3.6 years (range, 1 to 8). At the time of latest follow-up, five players were still participating at the major league level and five had retired. One @entity1 had recurrence of the @entity11343 8 years after surgery. Among our @entity1 a trend existed toward a poorer result and failure of return to activity with a posterior osteophyte greater than 100 mm2. A posterior glenoid @entity11343 , when identified in the symptomatic shoulder of the throwing athlete, can be considered a definite marker of internal impingement.

2099025

2099026

2099027

XXXX : observations on a series of 73 cases.

multiple_choice

The posterior fossa is an uncommon site for @entity4282 . Clinical progress is silent and slow, but the deterioration is sudden and quick to become fatal if not promptly treated. Early recognition is therefore extremely important. The recommended treatment for posterior fossa @entity4282 is surgical evacuation soon after the diagnosis, since the posterior fossa contains vital structures. However, conservative management under close clinical and radiological supervision can be applied in @entity1 without mass effect. In our study, a review of 73 cases with posterior fossa @entity4282 among a total number of 737 @entity1 with @entity4282 is presented, and a new neuroradiological classification is proposed in order to determine the appropriate type of treatment. In this series, 14 @entity1 were treated conservatively, while 59 required surgery. The conservatively treated 9 pediatric and 5 adult @entity1 , and 51 of the 59 surgically treated cases, in other words a total of 65 of the 73 @entity1 , showed excellent recovery; 4 @entity1 treated surgically had a moderate disability, and 4 @entity1 died (overall mortality 5.4%). The critical factors influencing outcome were the neuroradiological class, the level of consciousness just before the operation, and the other systemic and/or intracranial traumatic lesions. In this study, the critical observation was that the neuroradiological findings were earlier, more reliable and predictive than the clinical findings. Therefore, based upon the obliteration of perimesencephalic cisterns and/or displacement of the fourth ventricle, a new neuroradiological classification was designed for decision-making in management.

2099028

2099029

2099030

Role of AT-1 receptor in regulation of vascular @entity657 , @entity568 , PAI-1, MAP kinase, and matrix expressions in XXXX .

multiple_choice

BACKGROUND: @entity209 has emerged as the major cause of @entity731 . The associated @entity731 is accompanied by and, in part, due to @entity32 . In an attempt to explore the molecular sources of @entity32 and possible involvement of renin-angiotensin system, we studied @entity28 Zucker @entity35 , which exhibit all features of @entity209 . METHODS: Seven-week-old male @entity28 Zucker @entity35 were randomized to @entity9886 -treated (100 mg/L drinking @entity2507 ) and untreated groups. Lean Zucker @entity35 served as controls. After four months, aortas were obtained and processed for various determinations by reverse transcription-polymerase chain reaction (RT-PCR) and Western blot and immunohistochemical analysis for collagen type IV. RESULTS: Compared to the lean controls, @entity28 Zucker @entity35 showed significant increases in collagen staining, as well as expressions of collagen, fibronectin, plasminogen activator inhibitor-1, and two major proinflammatory mediators (i.e., @entity568 and @entity657 ). This was associated with significant increases in @entity12220 and @entity2508 mitogen activated protein kinase activities, as well as marked up-regulation of @entity11154 ( @entity11154 ) mRNA expression. These abnormalities were prevented by administration of the @entity11154 blocker (ARB). CONCLUSION: The untreated @entity28 Zucker @entity35 exhibit increased matrix protein accumulation in the aorta and marked up-regulations of proinflammatory and profibrotic pathways. These abnormalities are associated with up-regulation of @entity11154 and are prevented by @entity11154 blockade pointing to the potential role of @entity11154 activation.

2099031

2099032

2099033

Role of AT-1 receptor in regulation of vascular XXXX , @entity568 , PAI-1, MAP kinase, and matrix expressions in @entity28 .

multiple_choice

BACKGROUND: @entity209 has emerged as the major cause of @entity731 . The associated @entity731 is accompanied by and, in part, due to @entity32 . In an attempt to explore the molecular sources of @entity32 and possible involvement of renin-angiotensin system, we studied @entity28 Zucker @entity35 , which exhibit all features of @entity209 . METHODS: Seven-week-old male @entity28 Zucker @entity35 were randomized to @entity9886 -treated (100 mg/L drinking @entity2507 ) and untreated groups. Lean Zucker @entity35 served as controls. After four months, aortas were obtained and processed for various determinations by reverse transcription-polymerase chain reaction (RT-PCR) and Western blot and immunohistochemical analysis for collagen type IV. RESULTS: Compared to the lean controls, @entity28 Zucker @entity35 showed significant increases in collagen staining, as well as expressions of collagen, fibronectin, plasminogen activator inhibitor-1, and two major proinflammatory mediators (i.e., @entity568 and @entity657 ). This was associated with significant increases in @entity12220 and @entity2508 mitogen activated protein kinase activities, as well as marked up-regulation of @entity11154 ( @entity11154 ) mRNA expression. These abnormalities were prevented by administration of the @entity11154 blocker (ARB). CONCLUSION: The untreated @entity28 Zucker @entity35 exhibit increased matrix protein accumulation in the aorta and marked up-regulations of proinflammatory and profibrotic pathways. These abnormalities are associated with up-regulation of @entity11154 and are prevented by @entity11154 blockade pointing to the potential role of @entity11154 activation.

2099034

2099035

2099036

Role of AT-1 receptor in regulation of vascular @entity657 , XXXX , PAI-1, MAP kinase, and matrix expressions in @entity28 .

multiple_choice

BACKGROUND: @entity209 has emerged as the major cause of @entity731 . The associated @entity731 is accompanied by and, in part, due to @entity32 . In an attempt to explore the molecular sources of @entity32 and possible involvement of renin-angiotensin system, we studied @entity28 Zucker @entity35 , which exhibit all features of @entity209 . METHODS: Seven-week-old male @entity28 Zucker @entity35 were randomized to @entity9886 -treated (100 mg/L drinking @entity2507 ) and untreated groups. Lean Zucker @entity35 served as controls. After four months, aortas were obtained and processed for various determinations by reverse transcription-polymerase chain reaction (RT-PCR) and Western blot and immunohistochemical analysis for collagen type IV. RESULTS: Compared to the lean controls, @entity28 Zucker @entity35 showed significant increases in collagen staining, as well as expressions of collagen, fibronectin, plasminogen activator inhibitor-1, and two major proinflammatory mediators (i.e., @entity568 and @entity657 ). This was associated with significant increases in @entity12220 and @entity2508 mitogen activated protein kinase activities, as well as marked up-regulation of @entity11154 ( @entity11154 ) mRNA expression. These abnormalities were prevented by administration of the @entity11154 blocker (ARB). CONCLUSION: The untreated @entity28 Zucker @entity35 exhibit increased matrix protein accumulation in the aorta and marked up-regulations of proinflammatory and profibrotic pathways. These abnormalities are associated with up-regulation of @entity11154 and are prevented by @entity11154 blockade pointing to the potential role of @entity11154 activation.

2099037

2099038

2099039

Serum XXXX in elderly @entity1 : associations with sex hormones, @entity2690 , and adipose tissue volumes.

multiple_choice

OBJECTIVE: There are few data for associations of serum @entity1243 with body fat, fat distribution, sex hormones, or fasting @entity2690 in elderly adults. We hypothesized that the sex difference in serum @entity1243 concentrations would disappear after adjustment for subcutaneous, but not visceral body fat. Serum @entity1243 would not be associated with sex hormone concentrations or serum fasting @entity2690 after adjusting for body fat and fat distribution. RESEARCH METHODS AND PROCEDURES: @entity1386 ( @entity1386 ) and @entity1386 ( @entity1386 ) volumes were measured using magnetic resonance imaging in a cross-sectional sample of 56 nondiabetic, elderly @entity1 and @entity1 aged 64 years to 94 years. Serum @entity1243 , sex hormones ( @entity251 and @entity1815 ), sex hormone-binding globulin, and fasting @entity2690 were also measured. Nine @entity1 were taking hormone replacement, and five @entity1 were clinically hypogonadal. RESULTS: @entity1243 was significantly associated with both @entity1386 and @entity1386 in each sex. Adjustment for @entity1386 reduced the sex difference in @entity1243 by 56%, but adjustment for @entity1386 increased the difference by 25%. @entity1243 was not associated with serum @entity1815 or hormone replacement therapy in the @entity1 , but had a significant, negative association with @entity251 in the @entity1 that was independent of @entity1386 , but not @entity1386 . @entity1243 was significantly associated with fasting @entity2690 in both sexes independent of age, sex hormones, sex hormone-binding globulin, @entity1386 and @entity1386 . DISCUSSION: Sex difference in serum @entity1243 is partly explained by different amounts of @entity1386 . Studies including both @entity1 and @entity1 should adjust for @entity1386 rather than total body fat that includes @entity1386 . The sex difference in serum @entity1243 is not due to @entity172 , but may be partly explained by @entity251 . @entity251 is negatively associated with @entity1243 in @entity1 , but the association is confounded with @entity1386 . @entity1243 is associated with fasting @entity2690 in nondiabetic elderly @entity1 and @entity1 independent of body fat, fat distribution, or sex hormones.

2099040

2099041

2099042

Serum @entity1243 in elderly @entity1 : associations with sex hormones, XXXX , and adipose tissue volumes.

multiple_choice

OBJECTIVE: There are few data for associations of serum @entity1243 with body fat, fat distribution, sex hormones, or fasting @entity2690 in elderly adults. We hypothesized that the sex difference in serum @entity1243 concentrations would disappear after adjustment for subcutaneous, but not visceral body fat. Serum @entity1243 would not be associated with sex hormone concentrations or serum fasting @entity2690 after adjusting for body fat and fat distribution. RESEARCH METHODS AND PROCEDURES: @entity1386 ( @entity1386 ) and @entity1386 ( @entity1386 ) volumes were measured using magnetic resonance imaging in a cross-sectional sample of 56 nondiabetic, elderly @entity1 and @entity1 aged 64 years to 94 years. Serum @entity1243 , sex hormones ( @entity251 and @entity1815 ), sex hormone-binding globulin, and fasting @entity2690 were also measured. Nine @entity1 were taking hormone replacement, and five @entity1 were clinically hypogonadal. RESULTS: @entity1243 was significantly associated with both @entity1386 and @entity1386 in each sex. Adjustment for @entity1386 reduced the sex difference in @entity1243 by 56%, but adjustment for @entity1386 increased the difference by 25%. @entity1243 was not associated with serum @entity1815 or hormone replacement therapy in the @entity1 , but had a significant, negative association with @entity251 in the @entity1 that was independent of @entity1386 , but not @entity1386 . @entity1243 was significantly associated with fasting @entity2690 in both sexes independent of age, sex hormones, sex hormone-binding globulin, @entity1386 and @entity1386 . DISCUSSION: Sex difference in serum @entity1243 is partly explained by different amounts of @entity1386 . Studies including both @entity1 and @entity1 should adjust for @entity1386 rather than total body fat that includes @entity1386 . The sex difference in serum @entity1243 is not due to @entity172 , but may be partly explained by @entity251 . @entity251 is negatively associated with @entity1243 in @entity1 , but the association is confounded with @entity1386 . @entity1243 is associated with fasting @entity2690 in nondiabetic elderly @entity1 and @entity1 independent of body fat, fat distribution, or sex hormones.

2099043

2099044

2099045

Serum @entity1243 in elderly XXXX : associations with sex hormones, @entity2690 , and adipose tissue volumes.

multiple_choice

OBJECTIVE: There are few data for associations of serum @entity1243 with body fat, fat distribution, sex hormones, or fasting @entity2690 in elderly adults. We hypothesized that the sex difference in serum @entity1243 concentrations would disappear after adjustment for subcutaneous, but not visceral body fat. Serum @entity1243 would not be associated with sex hormone concentrations or serum fasting @entity2690 after adjusting for body fat and fat distribution. RESEARCH METHODS AND PROCEDURES: @entity1386 ( @entity1386 ) and @entity1386 ( @entity1386 ) volumes were measured using magnetic resonance imaging in a cross-sectional sample of 56 nondiabetic, elderly @entity1 and @entity1 aged 64 years to 94 years. Serum @entity1243 , sex hormones ( @entity251 and @entity1815 ), sex hormone-binding globulin, and fasting @entity2690 were also measured. Nine @entity1 were taking hormone replacement, and five @entity1 were clinically hypogonadal. RESULTS: @entity1243 was significantly associated with both @entity1386 and @entity1386 in each sex. Adjustment for @entity1386 reduced the sex difference in @entity1243 by 56%, but adjustment for @entity1386 increased the difference by 25%. @entity1243 was not associated with serum @entity1815 or hormone replacement therapy in the @entity1 , but had a significant, negative association with @entity251 in the @entity1 that was independent of @entity1386 , but not @entity1386 . @entity1243 was significantly associated with fasting @entity2690 in both sexes independent of age, sex hormones, sex hormone-binding globulin, @entity1386 and @entity1386 . DISCUSSION: Sex difference in serum @entity1243 is partly explained by different amounts of @entity1386 . Studies including both @entity1 and @entity1 should adjust for @entity1386 rather than total body fat that includes @entity1386 . The sex difference in serum @entity1243 is not due to @entity172 , but may be partly explained by @entity251 . @entity251 is negatively associated with @entity1243 in @entity1 , but the association is confounded with @entity1386 . @entity1243 is associated with fasting @entity2690 in nondiabetic elderly @entity1 and @entity1 independent of body fat, fat distribution, or sex hormones.

2099046

2099047

2099048

[Pathologic proximal XXXX in @entity1 in an @entity2001 ].

multiple_choice

PURPOSE OF THE STUDY: Proximal @entity3330 in @entity1 are rare, @entity174 being extremely rare. Despite many meanings these @entity174 are still "unsolved" there are some definite rules for treatment of true @entity130 . @entity174 are outstanding with their extremely rare incidence. The aim of the study is to overview a large clinical material, find out the incidence of this pathologic @entity174 , the extent and shape of the @entity2001 ( @entity2001 ), specific therapeutic approach, technical problems of eventual osteosynthesis, number of reoperations and sequels. MATERIAL: Altogether 49 @entity1 with 50 accidental and @entity174 of proximal part of the femur treated in the Regional Pediatric @entity130 Centre of the Department of Pediatric and @entity130 Surgery, 3rd Faculty of Medicine, Charles University, Prague. METHODS: Retrospective and prospective study of @entity1 (0 to 15 years of age) treated with proximal femoral accidental and @entity174 during the 20 year period (from August 1984 to November 2004). Classification of @entity174 according to Delbet and Colonna. Diagnosis of @entity2001 with plain X-rays, eventually CT scans. RESULTS: During the 20 years period (August 1984 to November 2004) 49 @entity1 with 50 proximal @entity3330 were treated in the Department. Four @entity1 sustained a pathologic @entity174 through an @entity2001 . Two of these latter @entity1 were treated by an open reduction and osteosynthesis with the use of the proximal femoral AO-ASIF angled-plate and two @entity1 nonoperatively using skeletal traction because of impossibility of insertion of the osteosynthetic material without a damage of the growth plate. Subsequent operations of the @entity2001 were necessary in these two @entity1 . All four @entity1 recovered well without sequels. DISCUSSION: @entity174 in @entity2001 are usually treated nonoperatively and the cyst itself is treated after @entity174 healing. Proximal femoral impairment is the exception from this rule because of weigh bearing necessity. However, there may be problems with insertion of the implant when the cyst is very near to capital physis and traction treatment is then the method of choice with a delay of operative treatment of the cyst. CONCLUSIONS: Pathologic proximal @entity3330 in @entity2001 are extremely rare and need individual approach. Some of them should be operated on the others primarily treated by traction with secondary operation of the cyst. Complications can be frequent.

2099049

2099050

2099051

[Pathologic proximal @entity3330 in @entity1 in an XXXX ].

multiple_choice

PURPOSE OF THE STUDY: Proximal @entity3330 in @entity1 are rare, @entity174 being extremely rare. Despite many meanings these @entity174 are still "unsolved" there are some definite rules for treatment of true @entity130 . @entity174 are outstanding with their extremely rare incidence. The aim of the study is to overview a large clinical material, find out the incidence of this pathologic @entity174 , the extent and shape of the @entity2001 ( @entity2001 ), specific therapeutic approach, technical problems of eventual osteosynthesis, number of reoperations and sequels. MATERIAL: Altogether 49 @entity1 with 50 accidental and @entity174 of proximal part of the femur treated in the Regional Pediatric @entity130 Centre of the Department of Pediatric and @entity130 Surgery, 3rd Faculty of Medicine, Charles University, Prague. METHODS: Retrospective and prospective study of @entity1 (0 to 15 years of age) treated with proximal femoral accidental and @entity174 during the 20 year period (from August 1984 to November 2004). Classification of @entity174 according to Delbet and Colonna. Diagnosis of @entity2001 with plain X-rays, eventually CT scans. RESULTS: During the 20 years period (August 1984 to November 2004) 49 @entity1 with 50 proximal @entity3330 were treated in the Department. Four @entity1 sustained a pathologic @entity174 through an @entity2001 . Two of these latter @entity1 were treated by an open reduction and osteosynthesis with the use of the proximal femoral AO-ASIF angled-plate and two @entity1 nonoperatively using skeletal traction because of impossibility of insertion of the osteosynthetic material without a damage of the growth plate. Subsequent operations of the @entity2001 were necessary in these two @entity1 . All four @entity1 recovered well without sequels. DISCUSSION: @entity174 in @entity2001 are usually treated nonoperatively and the cyst itself is treated after @entity174 healing. Proximal femoral impairment is the exception from this rule because of weigh bearing necessity. However, there may be problems with insertion of the implant when the cyst is very near to capital physis and traction treatment is then the method of choice with a delay of operative treatment of the cyst. CONCLUSIONS: Pathologic proximal @entity3330 in @entity2001 are extremely rare and need individual approach. Some of them should be operated on the others primarily treated by traction with secondary operation of the cyst. Complications can be frequent.

2099052

2099053

2099054

[Pathologic proximal @entity3330 in XXXX in an @entity2001 ].

multiple_choice

PURPOSE OF THE STUDY: Proximal @entity3330 in @entity1 are rare, @entity174 being extremely rare. Despite many meanings these @entity174 are still "unsolved" there are some definite rules for treatment of true @entity130 . @entity174 are outstanding with their extremely rare incidence. The aim of the study is to overview a large clinical material, find out the incidence of this pathologic @entity174 , the extent and shape of the @entity2001 ( @entity2001 ), specific therapeutic approach, technical problems of eventual osteosynthesis, number of reoperations and sequels. MATERIAL: Altogether 49 @entity1 with 50 accidental and @entity174 of proximal part of the femur treated in the Regional Pediatric @entity130 Centre of the Department of Pediatric and @entity130 Surgery, 3rd Faculty of Medicine, Charles University, Prague. METHODS: Retrospective and prospective study of @entity1 (0 to 15 years of age) treated with proximal femoral accidental and @entity174 during the 20 year period (from August 1984 to November 2004). Classification of @entity174 according to Delbet and Colonna. Diagnosis of @entity2001 with plain X-rays, eventually CT scans. RESULTS: During the 20 years period (August 1984 to November 2004) 49 @entity1 with 50 proximal @entity3330 were treated in the Department. Four @entity1 sustained a pathologic @entity174 through an @entity2001 . Two of these latter @entity1 were treated by an open reduction and osteosynthesis with the use of the proximal femoral AO-ASIF angled-plate and two @entity1 nonoperatively using skeletal traction because of impossibility of insertion of the osteosynthetic material without a damage of the growth plate. Subsequent operations of the @entity2001 were necessary in these two @entity1 . All four @entity1 recovered well without sequels. DISCUSSION: @entity174 in @entity2001 are usually treated nonoperatively and the cyst itself is treated after @entity174 healing. Proximal femoral impairment is the exception from this rule because of weigh bearing necessity. However, there may be problems with insertion of the implant when the cyst is very near to capital physis and traction treatment is then the method of choice with a delay of operative treatment of the cyst. CONCLUSIONS: Pathologic proximal @entity3330 in @entity2001 are extremely rare and need individual approach. Some of them should be operated on the others primarily treated by traction with secondary operation of the cyst. Complications can be frequent.

2099055

2099056

2099057

Walking speed on parquetry and carpet after XXXX : effect of surface and retest reliability.

multiple_choice

OBJECTIVE: At the transition stage from rehabilitation to home this study aimed to (1) investigate the effect of floor surface (carpet and parquetry) on walking speed; (2) investigate whether there was a difference between these surfaces as @entity64 @entity1 voluntarily increased from comfortable to fast pace; (3) investigate whether walking speed on parquetry was a predictor of walking speed on carpet at the two paces; (4) investigate whether walking speed at a comfortable pace was a predictor of walking speed at a fast pace on the two surfaces; and (5) quantify systematic and random error in repeated measurements for fast-paced walking trials. DESIGN: Subjects walked 10 metres at comfortable and fast paces on carpet and parquetry on two consecutive days. SETTING: Inpatient rehabilitation centre. SUBJECTS: Twenty-four @entity64 @entity1 . MAIN OUTCOME MEASURE: Walking speed. RESULTS: Two-way analysis of variance confirmed that @entity1 walked more slowly on carpet than parquetry (F(1,23) = 5.3, p <0.05) at both paces; the interaction effect was not significant (p >0.05). Walking speed on parquetry was a strong predictor of walking speed on carpet at a comfortable (r = 0.92), and fast pace (r = 0.97). Walking speed at comfortable pace was a moderately strong predictor of walking speed at fast pace on parquetry (r = 0.84), and on carpet (r = 0.88). Random error in repeated measurements was higher when walking fast on carpet (7.21 m/min) and parquetry (8.32 m/min) than when walking at a comfortable pace on carpet (4.63 m/min) and parquetry (3.48 m/min). Systematic error was negligible (p <0.05). CONCLUSION: Carpet surface was more challenging than parquetry surface, as evidenced by the systematic decrease in walking speed. This may have been due to lack of familiarity. Relative to the wide range of scores in the group, @entity64 @entity1 showed consistency of walking speed across both surfaces. Likewise, @entity64 @entity1 retained their relative position in the group as they changed from a comfortable to a fast walking pace. The difference in random error between comfortable and fast-paced trials highlights the need to quantify error in the repeated measurement situation according to specific test conditions.

2099058

2099059

2099060

Programme of stepping down from twice daily @entity7080 inhibitor therapy for symptomatic XXXX associated with a formulary change at a VA medical center.

multiple_choice

BACKGROUND: In July 2001, our Veterans' Affairs hospital changed its formulary @entity7080 inhibitor (PPI) from @entity10042 to @entity7619 . All @entity1 previously receiving @entity10042 30 mg twice daily were switched to @entity7619 20 mg once daily. AIM: To determine if @entity1 with @entity354 ( @entity354 ), who were previously managed on @entity10042 30 mg twice daily, could be maintained on @entity7619 20 mg once daily. @entity1 AND METHODS: Four hundred and thirty-five @entity1 had received @entity10042 30 mg twice daily for at least 12 months before the formulary change. Medical records were reviewed for 12 months before and after the formulary change. RESULTS: There were 432 @entity1 and three @entity1 with a mean age of 66.7 years (range: 38-91). Two hundred and twelve @entity1 were excluded. Of the remaining 223, 111 (50%) were maintained successfully on @entity7619 20 mg once daily. Twenty-three (10%) stayed off all acid suppression during follow-up. The number of @entity922 did not significantly change during the follow-up. Fifty-six percent who had @entity2681 failed a dose taper compared with 31% of those with endoscopy-negative @entity354 (P<0.025). CONCLUSIONS: Most @entity1 receiving twice daily PPI therapy for @entity354 could be maintained on once daily PPI or no acid suppression for 12 months of follow-up. Dose reduction was more successful in those without @entity2681 .

2099061

2099062

2099063

Programme of stepping down from twice daily XXXX inhibitor therapy for symptomatic @entity354 associated with a formulary change at a VA medical center.

multiple_choice

BACKGROUND: In July 2001, our Veterans' Affairs hospital changed its formulary @entity7080 inhibitor (PPI) from @entity10042 to @entity7619 . All @entity1 previously receiving @entity10042 30 mg twice daily were switched to @entity7619 20 mg once daily. AIM: To determine if @entity1 with @entity354 ( @entity354 ), who were previously managed on @entity10042 30 mg twice daily, could be maintained on @entity7619 20 mg once daily. @entity1 AND METHODS: Four hundred and thirty-five @entity1 had received @entity10042 30 mg twice daily for at least 12 months before the formulary change. Medical records were reviewed for 12 months before and after the formulary change. RESULTS: There were 432 @entity1 and three @entity1 with a mean age of 66.7 years (range: 38-91). Two hundred and twelve @entity1 were excluded. Of the remaining 223, 111 (50%) were maintained successfully on @entity7619 20 mg once daily. Twenty-three (10%) stayed off all acid suppression during follow-up. The number of @entity922 did not significantly change during the follow-up. Fifty-six percent who had @entity2681 failed a dose taper compared with 31% of those with endoscopy-negative @entity354 (P<0.025). CONCLUSIONS: Most @entity1 receiving twice daily PPI therapy for @entity354 could be maintained on once daily PPI or no acid suppression for 12 months of follow-up. Dose reduction was more successful in those without @entity2681 .

2099064

2099065

2099066

XXXX treatment of problematic scars.

multiple_choice

BACKGROUND: Keloids and @entity2805 can be uncomfortable, disfiguring, and aesthetically undesirable. Anecdotal reports suggest that low-dose intralesional @entity1487 can be used to treat these undesirable scars. METHODS: Using a prospective case series protocol, both @entity12347 and @entity2805 @entity1 were included. Keloid @entity1 underwent excision followed by a series of treatments with intralesional @entity1487 into the healing scar to prevent recurrence (n = 32). The @entity2805 @entity1 were treated with the same series of injections without scar excision to both control symptoms and improve scar appearance (n = 21). The primary outcome measures were scar volume and a symptom questionnaire. @entity1 were followed for 1 year after completing the injection treatments. RESULTS: In the @entity12347 group, the recurrence rate was 19 percent at 1-year follow-up for this group of @entity1 who had failed previous corticosteroid injection therapy. In the @entity2805 group, 14 percent did not respond to the series of injections. In this group, there was a median volume decrease of 50 percent maintained for 1 year after injection therapy was terminated. CONCLUSIONS: Intralesional @entity1487 is a safe and effective means of controlling problem scars in terms of both recurrence and symptom control. Benefits were maintained for at least 1 year after completion of therapy. Intralesional @entity1487 should be considered another option for @entity1 suffering from problematic scars.

2099067

2099068

2099069

Relationship between peak expiratory flow rate and shoulders posture in healthy individuals and moderate to severe asthmatic XXXX .

multiple_choice

INTRODUCTION: @entity565 respiratory muscles causing changes in posture. OBJECTIVES: To evaluate shoulder position in asthmatics and its correlation to the peak expiratory flow rate (PEFR). METHODS: A cross-sectional study involving 19 asthmatics (study group) and 20 healthy volunteers (control group). Assessment of PEFR was used to determine @entity1224 . Shoulder position was quantified as the ratio between the front and back measurements, in centimeters, of the distance between the two outermost points of each scapula. @entity6865 ( @entity6865 ) ratio data from both groups were compared and correlated to PEFR. RESULTS: The asthmatics presented lower PEFR (279 +/- 64 L/min) and @entity6865 (0.88: range 0.83-0.9) than did control subjects (555 +/- 100 L/min and 0.97: range 0.95-1, respectively) (p < 0.001). There was a correlation between PEFR and @entity6865 (asthmatics r = 0.8; controls r = 0.5). CONCLUSION: Determining @entity6865 ratios allowed us to identify those postural alterations that correlated with pulmonary function in asthmatics and in healthy individuals. Further investigation is needed before @entity6865 can be used as a tool for clinical evaluation of @entity565 @entity1 .

2099070

2099071

2099072

Community-based interventions to improve breast and cervical XXXX screening: results of the Forsyth County @entity5 Screening (FoCaS) Project.

multiple_choice

The FoCaS (Forsyth County @entity5 Screening) Project was one of six projects funded by the National @entity5 Institute "Public Health Approaches to Breast and @entity5 " initiative. The goal of this project was to improve the use of breast and cervical @entity5 screening among low-income, predominately African-American, @entity1 age 40 and older. Strategies implemented in the intervention city included public health clinic in-reach strategies (chart reminders, exam room prompts, in-service meetings, and @entity1 -directed literature) and community outreach strategies (educational sessions, literature distribution, community events, media, and church programs). Baseline and follow-up data from independent cross-sectional samples in both the intervention and comparison cities were used to evaluate the effects of the intervention program. A total of 248 @entity1 were surveyed at baseline, and 302 @entity1 were surveyed 3 years later at follow-up. The proportion of @entity1 reporting regular use of mammography increased (31 to 56%; P < 0.001) in the intervention city. In the comparison city, a nonsignificant (ns) increase in mammography utilization was observed (33 to 40%; P = ns). Pap smear screening rates also improved in the intervention city (73 to 87%; P = 0.003) but declined in the comparison city (67 to 60%; P = ns). These relationships hold in multivariate models. The results suggest that a multifaceted intervention can improve screening rates in low-income populations. These results have important implications for community-based research and efforts in underserved populations.

2099073

2099074

2099075

Community-based interventions to improve breast and cervical @entity5 screening: results of the Forsyth County XXXX Screening (FoCaS) Project.

multiple_choice

The FoCaS (Forsyth County @entity5 Screening) Project was one of six projects funded by the National @entity5 Institute "Public Health Approaches to Breast and @entity5 " initiative. The goal of this project was to improve the use of breast and cervical @entity5 screening among low-income, predominately African-American, @entity1 age 40 and older. Strategies implemented in the intervention city included public health clinic in-reach strategies (chart reminders, exam room prompts, in-service meetings, and @entity1 -directed literature) and community outreach strategies (educational sessions, literature distribution, community events, media, and church programs). Baseline and follow-up data from independent cross-sectional samples in both the intervention and comparison cities were used to evaluate the effects of the intervention program. A total of 248 @entity1 were surveyed at baseline, and 302 @entity1 were surveyed 3 years later at follow-up. The proportion of @entity1 reporting regular use of mammography increased (31 to 56%; P < 0.001) in the intervention city. In the comparison city, a nonsignificant (ns) increase in mammography utilization was observed (33 to 40%; P = ns). Pap smear screening rates also improved in the intervention city (73 to 87%; P = 0.003) but declined in the comparison city (67 to 60%; P = ns). These relationships hold in multivariate models. The results suggest that a multifaceted intervention can improve screening rates in low-income populations. These results have important implications for community-based research and efforts in underserved populations.

2099076

2099077

2099078

Laparoscopic oophoropexy prior to radiation for pediatric XXXX and subsequent ovarian function.

multiple_choice

BACKGROUND: @entity2670 has been reported to occur in female @entity5 survivors who had received spinal radiation as @entity1 . We aimed to determine whether laparoscopic unilateral oophoropexy prior to radiotherapy effectively preserves ovarian function. METHODS: In a retrospective analysis, the study group comprised @entity1 , aged 18 and younger, who received spinal irradiation for a @entity1313 . @entity2670 , the primary endpoint, was defined as an elevated follicle-stimulating hormone level or persistent @entity2588 . RESULTS: After applying exclusion criteria, 15 @entity1 comprised the group that had undergone laparoscopic oophoropexy, and 11 @entity1 comprised the comparison group that did not have oophoropexy. Mean age at diagnosis, length of follow-up, proportion of high-risk @entity5 and doses and duration of chemotherapy and radiation were not different between the two groups. Two of 15 @entity1 (13%, 95% CI 0.2-40%) with oophoropexy had @entity2670 compared with five of 11 (45%, 95% CI 17-77%) in the comparison group (P = 0.09). CONCLUSIONS: Oophoropexy may protect against radiation-induced @entity2670 in @entity1 receiving spinal radiation. A high risk of @entity2670 was seen in @entity1 who did not undergo oophoropexy. In @entity1 who underwent oophoropexy, a lower rate of @entity2670 was seen.

2099079

2099080

2099081

XXXX binding of @entity35 cerebral proteins is reduced in experimental @entity1375 .

multiple_choice

To determine the effect of thyroid hormones (TH) on cerebral tissue @entity1234 ( @entity1865 ) content and accumulation of @entity1865 -bound proteins, @entity1378 @entity35 and @entity1375 @entity35 were compared to euthyroid controls. @entity1378 was induced by daily injection of @entity6143 (15 ug (100 g)-1) intraperitoneally daily for 10 days. @entity1375 was induced with 0.025% @entity3937 in the drinking water for 4 weeks. Immunoblot analysis of cerebral and plasma proteins was carried out using a specific anti- @entity1865 -protein antiserum. @entity1865 was measured as @entity4466 reactive substance. @entity1375 was associated with significant reduction in @entity1865 -proteins of plasma (59.3+/-9.5% vs. 99.8+/-23.0% of control p<0.05) and cerebral tissue (17.6+/-19.9% vs. 100.2+/-29.0% of control p<0.001). @entity1378 did not significantly alter @entity1865 -protein distribution. These changes did not correlate with cerebral tissue or plasma @entity1865 concentration. It is concluded that @entity1375 in @entity35 is associated with significant decrease in @entity1865 -bound proteins. This may have some clinical and biological implications.

2099082

2099083

2099084

@entity1234 binding of @entity35 cerebral proteins is reduced in experimental XXXX .

multiple_choice

To determine the effect of thyroid hormones (TH) on cerebral tissue @entity1234 ( @entity1865 ) content and accumulation of @entity1865 -bound proteins, @entity1378 @entity35 and @entity1375 @entity35 were compared to euthyroid controls. @entity1378 was induced by daily injection of @entity6143 (15 ug (100 g)-1) intraperitoneally daily for 10 days. @entity1375 was induced with 0.025% @entity3937 in the drinking water for 4 weeks. Immunoblot analysis of cerebral and plasma proteins was carried out using a specific anti- @entity1865 -protein antiserum. @entity1865 was measured as @entity4466 reactive substance. @entity1375 was associated with significant reduction in @entity1865 -proteins of plasma (59.3+/-9.5% vs. 99.8+/-23.0% of control p<0.05) and cerebral tissue (17.6+/-19.9% vs. 100.2+/-29.0% of control p<0.001). @entity1378 did not significantly alter @entity1865 -protein distribution. These changes did not correlate with cerebral tissue or plasma @entity1865 concentration. It is concluded that @entity1375 in @entity35 is associated with significant decrease in @entity1865 -bound proteins. This may have some clinical and biological implications.

2099085

2099086

2099087

@entity1234 binding of XXXX cerebral proteins is reduced in experimental @entity1375 .

multiple_choice

To determine the effect of thyroid hormones (TH) on cerebral tissue @entity1234 ( @entity1865 ) content and accumulation of @entity1865 -bound proteins, @entity1378 @entity35 and @entity1375 @entity35 were compared to euthyroid controls. @entity1378 was induced by daily injection of @entity6143 (15 ug (100 g)-1) intraperitoneally daily for 10 days. @entity1375 was induced with 0.025% @entity3937 in the drinking water for 4 weeks. Immunoblot analysis of cerebral and plasma proteins was carried out using a specific anti- @entity1865 -protein antiserum. @entity1865 was measured as @entity4466 reactive substance. @entity1375 was associated with significant reduction in @entity1865 -proteins of plasma (59.3+/-9.5% vs. 99.8+/-23.0% of control p<0.05) and cerebral tissue (17.6+/-19.9% vs. 100.2+/-29.0% of control p<0.001). @entity1378 did not significantly alter @entity1865 -protein distribution. These changes did not correlate with cerebral tissue or plasma @entity1865 concentration. It is concluded that @entity1375 in @entity35 is associated with significant decrease in @entity1865 -bound proteins. This may have some clinical and biological implications.

2099088

2099089

2099090

@entity76 produces selective XXXX .

multiple_choice

The cerebellum is often active in imaging studies of @entity2414 , consistent with a putative role in articulatory rehearsal. While @entity1 with @entity76 occasionally exhibit a mild impairment on standard neuropsychological tests of working memory, these tests are not diagnostic for exploring these processes in detail. The current study was designed to determine whether damage to the cerebellum is associated with @entity73 tasks, and if so, under what circumstances. Moreover, we assessed the hypothesis that these impairments are related to impaired rehearsal mechanisms. @entity1 with damage to the cerebellum (n = 15) exhibited a selective @entity2414 : spatial forward and backward spans were normal, but forward and backward verbal spans were lower than controls. While the differences were significant, digit spans were relatively preserved, especially in comparison to the dramatic reductions typically observed in classic 'short-term memory' @entity1 with perisylvian @entity75 . The @entity1 tended to be more impaired on a verbal version compared to a spatial version of a working memory task with a long delay and this impairment was correlated with overall symptom and @entity4653 severity. These results are consistent with a contribution of the cerebellum to rehearsal and suggest that inclusion of a delay before recall is especially detrimental in individuals with @entity76 . However, when we examined markers of rehearsal (i.e. word-length and articulatory suppression effects) in an immediate serial recall task, we found that qualitative aspects of the @entity1 ' rehearsal strategies were unaffected. We propose that the cerebellum may contribute to @entity2414 during the initial phonological encoding and/or by strengthening memory traces rather than by fundamentally subserving covert articulatory rehearsal.

2099091

2099092

2099093

XXXX produces selective @entity2414 .

multiple_choice

The cerebellum is often active in imaging studies of @entity2414 , consistent with a putative role in articulatory rehearsal. While @entity1 with @entity76 occasionally exhibit a mild impairment on standard neuropsychological tests of working memory, these tests are not diagnostic for exploring these processes in detail. The current study was designed to determine whether damage to the cerebellum is associated with @entity73 tasks, and if so, under what circumstances. Moreover, we assessed the hypothesis that these impairments are related to impaired rehearsal mechanisms. @entity1 with damage to the cerebellum (n = 15) exhibited a selective @entity2414 : spatial forward and backward spans were normal, but forward and backward verbal spans were lower than controls. While the differences were significant, digit spans were relatively preserved, especially in comparison to the dramatic reductions typically observed in classic 'short-term memory' @entity1 with perisylvian @entity75 . The @entity1 tended to be more impaired on a verbal version compared to a spatial version of a working memory task with a long delay and this impairment was correlated with overall symptom and @entity4653 severity. These results are consistent with a contribution of the cerebellum to rehearsal and suggest that inclusion of a delay before recall is especially detrimental in individuals with @entity76 . However, when we examined markers of rehearsal (i.e. word-length and articulatory suppression effects) in an immediate serial recall task, we found that qualitative aspects of the @entity1 ' rehearsal strategies were unaffected. We propose that the cerebellum may contribute to @entity2414 during the initial phonological encoding and/or by strengthening memory traces rather than by fundamentally subserving covert articulatory rehearsal.

2099094

2099095

2099096

Transient @entity143 receptor-mediated hypoperfusion following umbilical cord occlusion in preterm fetal XXXX .

multiple_choice

Exposure to severe @entity519 leads to delayed @entity1897 . There is evidence in the very immature brain that transient abnormal glutaminergic receptor activity can occur during this phase of recovery. We therefore examined the role of @entity1024 ( @entity143 ) receptor activity in mediating secondary hypoperfusion in preterm fetal @entity742 at 70% of gestation. Fetuses received either sham @entity1763 or @entity1763 and were studied for 12 h recovery. The specific, non-competitive @entity143 receptor antagonist @entity3390 (2 mg kg-1 bolus plus 0.07 mg kg h-1i.v.) or saline (vehicle) was infused from 15 min after @entity1763 until 4 h. In the @entity1763 -vehicle group abnormal epileptiform EEG transients were observed during the first 4 h of reperfusion, the peak of which corresponded approximately to the nadir in peripheral and @entity1779 . @entity3390 significantly suppressed this activity (2.7+/-1.3 versus 11.2+/-2.7 counts min-1 at peak frequency, P<0.05) and markedly delayed and attenuated the rise in vascular resistance in both peripheral and cerebral vascular beds observed after @entity1763 , effectively preventing the initial deep period of hypoperfusion in carotid blood flow and femoral blood flow (P<0.01). However, while continued infusion did attenuate subsequent transient @entity591 , it did not prevent the development of a secondary phase of persistent but less profound hypoperfusion. In conclusion, the present studies suggest that in the immature brain the initial phase of delayed @entity1897 following exposure to severe @entity519 is mediated by @entity143 receptor activity. The timing of this effect in the cerebral circulation corresponds closely to abnormal EEG activity, suggesting a pathological glutaminergic activation that we speculate is related to evolving @entity1545 .

2099097

2099098

2099099

Transient XXXX receptor-mediated hypoperfusion following umbilical cord occlusion in preterm fetal @entity742 .

multiple_choice

Exposure to severe @entity519 leads to delayed @entity1897 . There is evidence in the very immature brain that transient abnormal glutaminergic receptor activity can occur during this phase of recovery. We therefore examined the role of @entity1024 ( @entity143 ) receptor activity in mediating secondary hypoperfusion in preterm fetal @entity742 at 70% of gestation. Fetuses received either sham @entity1763 or @entity1763 and were studied for 12 h recovery. The specific, non-competitive @entity143 receptor antagonist @entity3390 (2 mg kg-1 bolus plus 0.07 mg kg h-1i.v.) or saline (vehicle) was infused from 15 min after @entity1763 until 4 h. In the @entity1763 -vehicle group abnormal epileptiform EEG transients were observed during the first 4 h of reperfusion, the peak of which corresponded approximately to the nadir in peripheral and @entity1779 . @entity3390 significantly suppressed this activity (2.7+/-1.3 versus 11.2+/-2.7 counts min-1 at peak frequency, P<0.05) and markedly delayed and attenuated the rise in vascular resistance in both peripheral and cerebral vascular beds observed after @entity1763 , effectively preventing the initial deep period of hypoperfusion in carotid blood flow and femoral blood flow (P<0.01). However, while continued infusion did attenuate subsequent transient @entity591 , it did not prevent the development of a secondary phase of persistent but less profound hypoperfusion. In conclusion, the present studies suggest that in the immature brain the initial phase of delayed @entity1897 following exposure to severe @entity519 is mediated by @entity143 receptor activity. The timing of this effect in the cerebral circulation corresponds closely to abnormal EEG activity, suggesting a pathological glutaminergic activation that we speculate is related to evolving @entity1545 .