bluuebunny/crossref_metadata_2025 huggingface dataset:
Aspectos eletrencefalográficos em crianças com mucopolissacaridose
Authors: Albuquerque Rafaella Montana Lago , Liberalesso Paulo Breno Noronha , Santos Mara Lucia Schmitz Ferreira , Klagenberg Karlin Fabianne , Jurkiewicz Ari Leon , Zeigelboim Bianca Simone
Published: April 2011

INTRODUÇÃO: Mucopolissacaridose é uma doença hereditária rara, de transmissão autossômica recessiva, causada por deficiência enzimática. Entre as manifestações clínicas mais frequentes estão as hérnias inguinais e umbilicais, hirsutismo, alterações nasais e labiais, opacidade corneana, limitações articulares, hepatoesplenomegalia, disostose, retardo do crescimento e atraso cognitivo. O objetivo do estudo foi analisar os principais aspectos eletrencefalográficos de pacientes com mucopolissacaridose. MÉTODOS: Estudo clínico retrospectivo. RESULTADOS: Foram incluídos 16 pacientes com idade média de 10,3 anos, sendo 11 (68,8%) do sexo masculino. Quatro pacientes (25%) foram classificados como MPS tipo I, sete (43,8%) como MPS tipo II, um (6,3%) como MPS tipo III, um (6,3%) como MPS tipo IV e três (18,6%) como MPS tipo VI. Quatro (25%) pacientes apresentavam diagnóstico de epilepsia. Quanto ao EEG, a atividade de base foi normal em seis (40%) casos, descargas generalizadas em um (6,7%) e descargas focais ou multifocais em dois casos (13,3%). CONCLUSÃO: Embora crises epilépticas não estejam entre os aspectos mais frequentes da doença, o EEG deve ser realizado rotineiramente durante a investigação neurológica desses pacientes. Há evidente predomínio de alterações eletrencefalográficas inespecíficas, embora paroxismos epileptogênicos possam ser encontrados em crianças com mucopolissacaridose com ou sem epilepsia.
Uma descrição newtoniana do movimento de um pêndulo esférico
Authors: Barbosa Valmar Carneiro , Moraes Pedro Cláudio Guaranho de
Published: April 2011

O sistema físico conhecido como pêndulo esférico é normalmente tomado como um exemplo das aplicações da mecânica analítica. Isto priva as pessoas que não tiveram contato com esta abordagem da mecânica clássica do entendimento completo de como este sistema se comporta. Assim, neste trabalho, usamos a mecânica newtoniana para apresentar um estudo do movimento de um pêndulo esférico. Para fazer isto, obtemos as equações de movimento, determinamos as quantidades que são conservadas durante a evolução temporal deste sistema, analisamos a sua energia potencial efetiva e discutimos os diferentes movimentos que este sistema pode ter. Apresentamos vários resultados numéricos e fazemos uma comparação qualitativa com dados experimentais
Obrigações empresariais no Novo Código Civil
Authors: Sica Ligia Paula Pires Pinto
Published: April 2011

Tendo em vista a promulgação do novo código civil brasileiro, que reúne dispositivos que revogam o antigo código civil de 1916 e a maioria dos capítulos do código comercial de 1850, unificando-os, é importante que se frise que remanesce a diferenciação entre as matérias de direito civil e comercial, de acordo com suas lógicas peculiares. Sendo assim e tendo o novo código introduzido diversas normas de caráter geral, este trabalho pretende discutir o papel do juiz e da jurisprudência na aplicação dessas normas de maneira casuística, dando-lhes tratamentos distintos de acordo com os fatos apresentados em juízo, de forma a manter a autonomia das áreas do direito mencionadas e garantir aos agentes econômicos o grau de segurança e previsibilidade necessário às suas atuações no mercado.
Convenção de pagamento em moeda estrangeira no Brasil
Authors: Siqueira Marcelo Sampaio
Published: April 2011

Este trabalho pretende tratar da nulidade de estipulações contratuais em moeda estrangeira no Brasil, ainda que realizada a conversão em moeda corrente nacional quando do efetivo pagamento. Em função disso, o trabalho analisa o artigo 318 do novo código civil brasileiro e a normatização especial sobre o tema.
Setenta anos depois: direitos autorais em Noel Rosa
Authors: Arbix Daniel do Amaral
Published: April 2011

Um regime ótimo de direitos autorais, ao tomar fundamento no estímulo ao desenvolvimento de novos bens intelectuais, depende de limites bem traçados. Este artigo procura aferir a funcionalidade desses direitos no que diz respeito a composições musicais, de sorte a avaliar, nesse campo específico, a maleabilidade da proteção aos direitos autorais e sua adequação à criação de novas obras. Para tanto, remete-se à experiência criativa de e sobre noel rosa, expoente do samba brasileiro. A marcada assunção de riscos por autores de obras derivadas, a formalização irregular das relações jurídicas entre titulares de direitos autorais e a profissionalização de determinados autores são constatadas como respostas diretas aos incentivos legais pertinentes. A incerteza decorrente dessas respostas expõe a dessintonia entre alguns dos objetivos das normas analisadas e seus efeitos práticos.
Juizados Especiais: entre a legalidade e a legitimidade - análise prospectiva dos juizados especiais da comarca de Niterói, 1997-2005
Authors: Mello Marcelo Pereira de , Meirelles Delton R. Soares
Published: April 2011

A chamada judicialização das questões sociais e políticas tem provocado debates acerca do acesso à justiça e da legitimidade das decisões judiciais. Nesse contexto, resultante dos debates que precederam a constituição de 1988, os Juizados Especiais foram pensados como um modelo institucional alternativo ao judiciário estatal, formalista, burocrático e centralizado. Segundo o espírito das discussões então prevalentes entre os constituintes e a previsão constitucional fixada na época, os juizados especiais deveriam se dedicar à apreciação e ao julgamento de conflitos e crimes com pequeno potencial ofensivo, abrindo a sua composição para a participação de juízes leigos. Nesta pesquisa, nós analisaremos os litígios julgados nos Juizados Especiais de Niterói, estado do Rio de Janeiro, com os seguintes objetivos: a) contextualizar o problema da legitimidade das decisões dos Juizados Especiais, enfocando a oposição entre o modelo da legitimidade judicial estatal, burocrática e legalista e o modelo democrático de participação cidadã; b) estabelecer comparações entre a cultura jurídica brasileira e os padrões contemporâneos de legitimidade do judiciário; c) verificar a efetividade das decisões dos Juizados Especiais.
International financial crisis and bank statization in Germany
Authors: Albuquerque Roberto Chacon de
Published: April 2011

Facing an international financial crisis that could lead its own financial system to the brink of collapse, the German government needed to show political will in order to save financial institutions in risky situations. This article analyzes the legal strategies used to rescue the financial system, including the statization of banking institutions as an ultima ratio. Prior to the bank statization established by the Rescue Takeover Act, the Financial Market Stabilization Act foresaw an increase in the capital of financial institutions by means of state control without statization. This last act, nonetheless, has not been considered enough to avoid the collapse of a banking institution that is relevant for the whole financial system such as Hypo Real Estate (HRE).
Processos proliferativos gengivais não neoplásicos em paciente sob tratamento ortodôntico
Authors: Pedron Irineu Gregnanin , Utumi Estevam Rubens , Tancredi Ângelo Rafael Calábria , Perez Flávio Eduardo Guillin , Marcucci Gilberto
Published: April 2011

INTRODUÇÃO: a aparatologia ortodôntica dificulta a higiene bucal e pode contribuir para a formação de lesões gengivais, como os processos proliferativos gengivais não neoplásicos. Essas lesões, dependendo de alguns fatores - como o tempo de evolução, constituintes histopatológicos e condições bucais -, podem ser reversíveis, em alguns casos, por meio da orientação sobre higiene bucal e da terapia periodontal básica. Entretanto, na maioria das vezes há necessidade de tratamento cirúrgico. OBJETIVO: o propósito deste trabalho é relatar o caso de uma paciente portadora de aparatologia ortodôntica fixa que apresentou duas lesões gengivais distintas, diagnosticadas como granuloma piogênico e hiperplasia gengival inflamatória. Foram discutidas as características clínicas e histopatológicas, incidência e frequência, modalidades terapêuticas e prevenção de ambas as lesões, demonstrando a importância do encaminhamento do material colhido ao exame histopatológico, dada a possibilidade de diversas hipóteses diagnósticas. Em ambas as lesões foi realizada a exérese cirúrgica. RESULTADOS: a lesão na arcada superior, diagnosticada como granuloma piogênico, apresentou recorrência, sendo necessária terapia periodontal básicae repetiçãodoprocedimento cirúrgico. Alesão na arcada inferior foi diagnosticada como hiperplasia gengival, sendo removida cirurgicamente e acompanhada clinicamente, com prescrição de orientação da higiene bucal ao paciente
Expressão de TGFβ1 mRNA nas fases iniciais de expansão da sutura palatina mediana
Authors: Kobayashi Emilia Teruko , Shibata Yasuaki , Veltrini Vanessa Cristina , Suguino Rosely , Machado Fabricio Monteiro de Castro , Provenzano Maria Gisette Arias , Ferronato Tatiane , Kato Yuzo
Published: April 2011

INTRODUÇÃO: a expansão da maxila induz a formação de novo osso na sutura palatina mediana por um processo de proliferação e diferenciação celular. A força de expansão pode estimular, nas células progenitoras, a produção de citocinas com atividade osteoindutiva, tais como o transforming growth factor β1(TGFβ1). OBJETIVOS: o principal objetivo deste estudo foi determinar a função dessa citocina nos estágios iniciais de expansão da sutura palatina mediana. MÉTODOS: um aparelho ortodôntico foi instalado entre os molares superiores direito e esquerdo de ratos com 4 semanas de idade. A força de expansão inicial foi de 50g. Os grupos controle e experimental foram sacrificados nos dias 0, 2 e 5. Cortes bucais de 6µm foram obtidos e sujeitos à técnica de hibridização in-situ. RESULTADOS: dois dias após a aplicação de força, as células osteocondroprogenitoras, distribuídas no lado interno do tecido cartilaginoso, exibiram altos níveis de transcrição de transforming growth factor β1. No dia 5, o nível de transcrição de TGFβ1 foi observado nos osteócitos e nas células osteoblásticas, na superfície do novo osso. A atividade osteoblástica foi confirmada por meio de um estudo imunohistoquímico utilizando-se Osteocalcina-Pro (OC-Pro). CONCLUSÕES: os dados sugerem que a expansão da sutura palatina induz a diferenciação de células osteocondroprogenitoras em osteoblastos, estimuladas pela produção de citocinas
Análise da expansão rápida da maxila por meio da tomografia computadorizada Cone-Beam
Authors: Ribeiro Gerson Luiz Ulema , Locks Arno , Pereira Juliana , Brunetto Maurício
Published: April 2011

Diante do diagnóstico de uma arcada maxilar esqueleticamente atrésica, o tratamento de escolha geralmente é a expansão ortopédica da maxila, envolvendo a separação da sutura palatina mediana. A avaliação dessa sutura era basicamente realizada por meio da radiografia oclusal superior, limitando sua análise em norma frontal. Da mesma forma, quantificar essa atresia radiograficamente nas telerradiografias cefalométricas sempre foi um obstáculo para o clínico, devido à grande sobreposição das estruturas faciais. O advento da tomografia computadorizada na Odontologia tem transformado a forma de diagnóstico devido à alta precisão na avaliação das dimensões das estruturas faciais, possibilitando quantificar de maneira fiel o comportamento das hemimaxilas, a inclinação dentária, a formação óssea na sutura nos três planos do espaço, assim como a reabsorção óssea alveolar e demais consequências da expansão palatina
Má oclusão Classe III de Angle, subdivisão direita, tratada sem exodontias e com controle de crescimento
Authors: Fernandes Sérgio Henrique Casarim
Published: April 2011

A Classe III de Angle é uma má oclusão caracterizada por discrepâncias anteroposteriores dentárias e faciais, normalmente acompanhadas por alterações esqueléticas, com componente genético associado. O diagnóstico precoce e correto e o tratamento adequado são de suma importância para promover o controle do crescimento e evitar recidivas. Este artigo relata o tratamento, executado em duas fases, de uma paciente do sexo feminino de 12 anos de idade, apresentando uma má oclusão de Classe III de Angle, subdivisão direita, com mordida cruzada anterior em máxima intercuspidação habitual (MIH) e topo em relação cêntrica (RC), apresentando, ainda, falta de espaço na maxila, que foi tratada sem exodontias e com controle de crescimento. Esse caso foi apresentado à Diretoria do Board Brasileiro de Ortodontia e Ortopedia Facial (BBO), representando a categoria 1, ou seja, uma má oclusão Classe III de Angle, tratada sem exodontias e com controle de crescimento, como parte dos requisitos para a obtenção do título de Diplomado pelo BBO
Avaliação dos fatores determinantes da estética do perfil facial
Authors: Reis Sílvia Augusta Braga , Abrão Jorge , Claro Cristiane Aparecida de Assis , Capelozza Filho Leopoldino
Published: April 2011

OBJETIVO: avaliar a influência da idade, do sexo, da relação oclusal sagital, do Padrão Facial e de 8 medidas do perfil facial sobre a estética do perfil. MÉTODOS: foram utilizadas tabelas de contingência, o Teste Qui-quadrado e o coeficiente de Cramér para avaliar a possível associação entre a nota dada por 32 avaliadores (14 ortodontistas, 12 leigos e 6 artistas) para a estética do perfil de 100 brasileiros - adultos, leucodermas, portadores de selamento labial passivo - e a idade, o sexo, a relação oclusal sagital, o Padrão Facial e as variáveis da análise facial numérica do perfil. RESULTADOS: não foi observada associação entre a idade, o sexo e a relação oclusal sagital e a estética do perfil facial. A associação foi observada entre a nota recebida para a estética do perfil e o Padrão Facial, o ângulo de convexidade facial e o ângulo do terço inferior da face. CONCLUSÃO: o Padrão Facial, definido na avaliação do perfil pela convexidade do perfil facial, e a projeção anterior do mento foram, entre os fatores avaliados, os determinantes para a estética do perfil facial.
Induction of Polyphenol Oxidase Activity in Dormant Wild Oat (Avena fatua) Seeds and Caryopses: A Defense Response to Seed Decay Fungi
Authors: Fuerst E. Patrick , Anderson James V. , Kennedy Ann C. , Gallagher Robert S.
Published: April 2011

Persistence of the soil seed bank requires both dormancy and resistance to seed decay organisms. However, there is little or no information evaluating biochemical responses of dormant weed seeds to pathogens. Wild oat caryopses were incubated with four pathogenic fungal isolates to evaluate the response of the pathogen defense enzyme, polyphenol oxidase (PPO). Caryopsis PPO activity was induced by threeFusariumspp. isolates previously obtained from whole seeds incubated in the field whereas caryopsis PPO activity was decreased by aPythiumisolate.Fusarium avenaceumisolateF.a.1 caused the greatest PPO induction and was studied in more detail. When whole wild oat seeds were incubated onF.a.1, PPO activity was induced in seeds, hulls (lemma and palea), and caryopses. Incubation of whole seeds onF.a.1 gradually induced caryopsis PPO activity over an 8-d period, whereas incubation of caryopses onF.a.1 over a 4-d period caused a greater and more rapid induction of PPO activity. Very little PPO activity could be leached from untreated caryopses, but nearly all of the induced PPO activity inF.a.1-treated caryopses was readily leached when incubated in buffer. In Western blots, both untreated andF.a.1-treated leachates contained a ∼57-kilodalton (kD) protein, putatively the mature and relatively inactive form of PPO. However, lower molecular weight antigenic proteins between ∼52 and ∼25 kD were strongly induced inF.a.1-treated caryopses, with this induction being correlated with the increase in PPO activity. We hypothesize that dormant weed seeds possess biochemical defenses against pathogens and, more specifically, that proteolysis in the presence of fungal pathogens may release an activated form of PPO from the surface of wild oat caryopses and hulls.
Glucosinolate and Isothiocyanate Production from Brassicaceae Cover Crops in a Plasticulture Production System
Authors: Bangarwa Sanjeev K. , Norsworthy Jason K. , Mattice John D. , Gbur Edward E.
Published: April 2011

Brassicaceae cover crops are gaining attention as potential biofumigants for soil pest suppression because of their ability to release biologically active isothiocyanates (ITCs) and other compounds from hydrolysis of glucosinolates (GSLs). However, biofumigation potential of a Brassicaceae is related to its GSL and ITC profile and GSL to ITC conversion efficiency. Field and laboratory experiments were conducted to evaluate the biofumigation potential of seven Brassicaceae cover crops for weed control in plasticulture tomato and bell pepper. GSL concentration and composition varied among cover crops and between roots and shoots of each cover crop. Similar GSLs were produced in both years by roots or shoots of each cover crop, but GSL concentrations were variable between years. Total GSLs contributed to the soil by incorporation of Brassicaceae cover crop tissues were estimated between 47 to 452 nmol g−1soil. Highest ITC concentration was detected in soil at 3 h after cover crop incorporation, and concentration decreased at later timings. GSL to ITC conversion efficiency ranged from 1 to 39%, with variation among cover crops and between years. No injury was observed in tomato and bell pepper transplanted 1 wk after cover crop incorporation, indicating the tolerance of tomato and pepper to ITCs released by the cover crops. Early-season yellow nutsedge control from Brassicaceae cover crops was ≤ 53% at 2 wk after transplanting and declined to ≤ 18% later in the season. This research demonstrates that Brassicaceae cover crops have marginal potential for early-season weed control and cannot be used as a weed control practice in commercial tomato and bell pepper production.
Multi-criteria contractor selection – a practical application of analytic hierarchy process
Authors: Oladapo A. A.
Published: April 2011

The analytic hierarchy process (AHP) has been proposed by several authors as a method of contractor selection that eliminates the shortcomings of the ‘lowest bidder’ approach commonly used in the construction industry. Most authors only demonstrate the conceptual model for using AHP in contractor selection with hypothetical data. The objective of this study was to take the process a step further by using real-life project data. The study also sought to compare the ranking of contractors with the ‘lowest bidder’ method and AHP. The study concluded that the ranking of the contractors by AHP differed from their ‘lowest bidder’ ranking for most of the contractors (about 68%). This suggests that the extra effort required using AHP compared to using the ‘lowest bidder’ method is justified. However, the reliability of these results is limited by the fact that they are based on a single case only.
Insurance, Consumer Choice, and the Equilibrium Price and Quality of Hospital Care
Authors: Katz Michael L
Published: April 2011

I analyze price and quality competition in a model that captures important institutional features of U.S. hospital markets. I first consider duopoly hospitals serving a population of patients who are covered by insurance that their employers purchase from duopoly health plans. I show that second-best quality levels can be sustained as equilibrium outcomes under both indemnity insurance and managed care even when patients are fully insured. I also demonstrate that a monopoly hospital system can yield efficient quality levels and that prices may be lower under monopoly than duopoly even when there are no technical efficiencies associated with monopoly. The latter result arises when employers and health insurance plans view the hospitals as complements even though any given consumer views them as substitutes.
Application of ion-association titration for the assay of bupropion hydrochloride in pharmaceuticals
Authors: Abdulrahman Sameer , Basavaiah Kanakapura
Published: April 2011

Two simple and rapid titrimetric methods are described for the determination
of bupropion hydrochloride (BUPH) in pharmaceuticals. The proposed methods
are based on the solvent extraction-titration of BUPH with two
ion-association reagents, i.e. sodium lauryl sulphate (SLS) and
tetraphenylborate (TPB). In method A, SLS was used as titrant and the
titration was carried out in the presence of dilute sulphuric acid and
chloroform using dimethyl yellow as indicator whereas in method B, the
titrant was TPB and the titration was done in borate-phosphate buffer of pH
6.0 and 1,2-dichloroethane with tetrabromophenolphthalein ethyl ester (TBPE)
as indicator. In the two-phase titrations, the proposed procedures give sharp
end points as the color of the organic phase changes from yellow to pink in
method A and from red-violet to yellow in method B. The methods are
applicable over the ranges of 1.0-20.0 and 3.0-10.0 mg of BUPH for method A
and method B, respectively. The accuracy and precision of the methods are
good. The methods were applied successfully to the determination of BUPH in
tablets and the results were in agreement with the label claim and those of
the comparison method.
The Upgrade of Hereditary Cancer Surveillance Schedule by Valka District Population Screening Data
Authors: Vanags Andrejs , Strumfa Ilze , Gardovskis Andris , Melbarde-Gorkusa Inga , Abolins Arnis , Trofimovics Genadijs , Gardovskis Janis
Published: April 2011

The Upgrade of Hereditary Cancer Surveillance Schedule by Valka District Population Screening Data

Introduction. The concept of hereditary cancer is one of the most important achievements in modern oncology. It has major scientific implications as well as high practical value in surveillance, prevention and adjustment of treatment for hereditary and familial malignancies. Identification of the persons-at-risk allows recommending a follow-up schedule for timely diagnostics of the corresponding cancers. Aim of the Study is to evaluate the need for hereditary cancer surveillance program in Latvia and to adjust the surveillance schedule by population screening data. Materials and methods. The study was performed as population screening in the Valka district, evaluating the family cancer history of 18642 respondents. Hereditary cancers were diagnosed by internationally accepted clinical criteria. Descriptive statistical analysis was carried out by CIA software. Results. There were 885 persons, fulfilling the clinical diagnostic criteria of hereditary and familial cancer syndromes. The full spectrum of hereditary malignancies was identified thus indirectly characterising the familial background of oncological diseases in the local population. The cancer burden among blood relatives was high for all syndromes, exceeding 8.6%. The mean age of cancer diagnostics was significantly different among the syndromes, ranging 38.0-72.0 years. Conclusions. The presence of familial background in all most frequent cancer locations and the high cancer burden in the affected kindreds justify the need for familial cancer surveillance. The data about the age of cancer manifestation can be used to adjust the follow-up schedule for most syndromes. Specific recommendations are elaborated and described in the article.
Apolipoprotein A1 and Transferrin as Biomarkers in Ovarian Cancer Diagnostics
Authors: Macuks Ronalds , Baidekalna Ieva , Gritcina Julia , Avdejeva Arina , Donina Simona
Published: April 2011

Apolipoprotein A1 and Transferrin as Biomarkers in Ovarian Cancer Diagnostics

Introduction. Advanced technologies such as matrix assisted laser desorption/ionization and surface enhanced laser desorption/ionization mass spectrometry has introduced promising insights into ovarian cancer detection. Several highly sensitive and specific protein peaks have been identified that discriminates ovarian cancer patients from patients with benign ovarian tumors and controls. Aim of the Study. Objective of this study is to evaluate diagnostic accuracy each individual marker and combined serum biomarker assay consisting of apolipoprotein A1, transferrin and Ca125. Materials and methods. A case-control study consisted of 99 women - 37 patients with ovarian cancer, 31 patients with benign ovarian diseases, and 31 age-matched healthy controls. Apolipoprotein A1 and transferrin was measured in sera using immunological turbidimetric assay. Tumor marker CA125 was analyzed by standard enzyme-labeled chemiluminescent immunometric assay. To compare the difference between variables in the study groups, ANOVA test was performed and for correlation Pearson's correlation analysis applied. Sensitivity and specificity of the diagnostic tests was calculated using statistical program Vassarstat. Results. Serum apolipoprotein A1 and transferrin were down regulated, controversially to Ca125, which was up regulated among ovarian cancer patients. Negative correlation between transferrin and Ca 125 (p<0.00), apolipoprotein A1 and Ca 125 (p<0.00) and positive correlation between transferrin and apolipoprotein A1 (p<0.00) was observed. For single biomarker test highest diagnostic sensitivity and specificity for Ca125 was observed. Addition of apolipoprotein A1 or transferrin to serum level of Ca125 with the condition, that both have to overlap the threshold (Ca125 > 21U/ml and apolipoprotein A1 ≤ 139.1 mg/dl or transferrin ≤ 2.3 g/l), yielded test specificity of 96.7%. Addition of apolipoprotein A1 to Ca125 improved test sensitivity up to 94.5% maintaining high sensitivity at the same time 91.1%, respectively, when discriminating controls from ovarian cancer patients. Biomarker test consisting of apolipoprotein A1, transferrin and Ca125 had high specificity at unacceptable sensitivity. Conclusions. Combined biomarker tests discovered using advanced technologies can aid more accurate ovarian cancer detection. Use of apolipoprotein A1 in combination with Ca125 at distinct thresholds can improve ovarian cancer detection.
Predicting Fetal Prognosis by Assessing Fetal and Maternal Blood Flow Patterns in Pregnancies with Fetal Growth Restriction
Authors: Vedmedovska Natalija , Rezeberga Dace , Teibe Uldis , Donders Gilbert
Published: April 2011

Predicting Fetal Prognosis by Assessing Fetal and Maternal Blood Flow Patterns in Pregnancies with Fetal Growth Restriction

Introduction. Fetal growth restriction (FGR) is associated with prematurity and a number of complications, as well as long-term impact on metabolic or cardiac function in adults. Aim of the Study. To study the prognostic value of staging maternal and fetal Doppler blood flow velocities in women with FGR; and evaluate prenatal characteristics as possible risk factors for severe vascular abnormalities. Materials and methods. 70 singleton pregnancies complicated by FGR were included in prospective follow-up study. Blood flow velocities in the uterine (UtA), umbilical (AU), middle cerebral (ACM) arteries and ductus venosus (DV) were measured. FGR neonates grouped as follows: I) normal blood velocity waveforms; II) abnormal UtA velocimetry and/or presence of early diastolic "notch"; III) abnormal AU without signs of "brain sparing"; IV) abnormal AU and ACM pulsatility index (PI) and V) AU absent or reversed end diastolic flow and an abnormal DV. Prenatal risk factors and perinatal outcome were assessed in relation to these Doppler blood flow patterns and compared with Fisher exact and Pearson c2 test. Results. There was a strong correlation between the severity of grouping and birth weight (p<0.001), gestational age at delivery (p<0.001), low amniotic fluid index (p<0.001), low Apgar scores (p=0.01) and neonatal transfer rate to NICU or hospital (p=0.02). Groups IV and V fetuses had the highest perinatal mortality (p=0.01). Women having genital infections (RTI) had significantly worse Doppler flow profile than non-smoking women at term without RTI (p=0.02). Conclusions. Severity of blood flow redistribution correlates with fetal morbidity and mortality. Less severe vascular changes, such as abnormal AU flow without centralization, and even increased uterine artery PI alone are linked to reduced birth weight, higher likelihood of preterm birth and increased risk of morbidity. Genital infections contribute significantly to hemodynamic changes related to the FGR. Screening and preventing of STI as well as optimizing the time of delivery may improve the overall outcome of compromised fetuses.
The Evaluation of Early Results after Total Hip Replacement in Dysplastic Hip Patients
Authors: Zebolds Silvestris , Jumtins Andris
Published: April 2011

The Evaluation of Early Results after Total Hip Replacement in Dysplastic Hip Patients

Introduction. Dysplasia of hip joint leads to osteoarthritis. Suffer relatively young population in ages between 20 and 40. Due to severe changes of anatomy total hip replacement (THR) in dysplastic hip patients is a challenge for orthopaedic surgeons. Radical anatomical and biomechanical reconstruction may lead to high complication rate. The planning of the rotation center of hip joint is a key of success in the treatment of dysplastic osteoarthritis patients. Aim of the Study. The aim of the study was to evaluate the early results for dysplastic osteoarthritis patients (DOA), who underwent THR in Riga State Hospital of Traumatology and Orthopaedics in 2008-2009. Materials and methods. 63 THR were performed in 59 patients (50 women, 9 men). In all cases cementless acetabular components of endoprosthesis were used. Functional evaluation was made due to method of grading functional value of hip - Merle d'Aubigne and Postel. Hip dysplasia was divided in 4 groups due to classification after Crowe. Special digital orthopaedic programmes (AGFA, IMPAX) were used for preoperative planning and radiographic postoperative analysis. Results. Regarding to method of grading functional value of hip - Merle d'Aubigne and Postel we found out a significant improvement in range of movements, mobility and pain relief. Due to Crowe classification there were 19 patients with Crowe type I dysplasia, 29 with Crowe type II and 15 with Crowe type III. 43 acetabular cups were placed in the primary socket and 20 in the secondary socket. Radiographic analysis showed significant changes in location of rotation center of hip and offset after THR in dysplastic hip patients. Conclusions. Significant functional improvement was achieved after THR in DOA patients and the radiographic analysis showed significant decrease of horizontal location of RC and increase of offset after THR in DOA patients.
Immunohistochemical Study of Choledochal Cyst Wall
Authors: Ozolina Linda , Pilmane Mara , Engelis Arnis
Published: April 2011

Immunohistochemical Study of Choledochal Cyst Wall

Introduction. Choledochal cysts are rare congenital anomalies that appear as localized cystic or fusiform biliary tree dilatations. Choledochal cyst is a rare congenital anomaly with a reported incidence of 1 in 100,000-150,000 live births (7). Nearly 25% of choledochal cysts are diagnosed in the first year of life and 60% in the first decade, but 20% detected are after the age of 20 years (12). Aim of the Study. The pathogenesis of choledochal cysts remains still unknown. The aim of this study was to examine relative distribution of growth factors, neuropeptide-containing innervation and apoptosis in the choledochal cyst wall. Materials and methods. Histopathological study of choledochal cyst wall was conducted on four patients aging from six months till 14 years. Tissues were processed for haematoxylin - eosin staining, immunohistochemistry for PGP 9.5, NGFR, NF, VEGF, CGRP and TUNEL method. Results. In overview sections we observed granulation tissue, blood vessel sanguineness and inflammatory infiltrate. Fibromuscular coat was thickened showing thick collagen bundles and dispersed smooth myocytes. Serosa was present in one case, all the rest demonstrated adhesions with dilated blood vessels and perivascular infiltrate. PGP 9.5 - containing nerve fibers and nerve fiber bundles were mostly observed in moderate and large amounts. NGFR in large amount was seen in nerve fiber bundles and nerve fibers among smooth muscle cells in the wall of small blood vessels. NF positive structures - nerve fibers and nerve fiber bundles - were found in moderate amount, except one case were the expression was very low. CGRP was found in neuroendocrine cells, nerve fiber bundles, leukocytes, inflammatory cells and endoteliocytes. Expression varied from low to moderately high. VEGF expression in most patient material was negative. Apoptosis was observed in inflammatory cells and epiteliocytes, showing large amount of positive structures. Conclusions. The amount of PGP 9.5 and CGRP demonstrates relatively good cyst wall innervation. Marked expression of NGFR proves still existing neuronal growth stimulation despite relatively unchanged neuronal cytoskeleton. Negative expression of VEGF proves lack of ischemia. Apoptosis mainly affects inflammatory cells and epiteliocytes, while the choledochal cyst wall presumably is composed of functionaly viable tissue.
First Results of using Stem Cell Transplantation for Pediatric Patients in Case of Dilated Cardiomyopathy
Authors: Lacis Aris , Bergmane Inta , Ozolins Valts , Lubaua Inguna , Groma Valerija , Ligere Elina , Jakobsons Eriks , Erglis Andrejs
Published: April 2011

First Results of using Stem Cell Transplantation for Pediatric Patients in Case of Dilated Cardiomyopathy

Introduction. Dilated cardiomyopathy is a serious disorder of the myocardium in pediatric age. Conservative therapy is limited and lethal outcome observed in one third of patients within a year. Bone marrow derived progenitor cell transplantation is becoming a promising method of treatment in adult population and there is ground to believe there are perspectives in pediatric cardiology. Aim of the Study. We present the first results of bone marrow cell transplantation in case of dilated cardiomyopathy for six patients at age four months to seventeen years. Materials and methods. We did the six Bone marrow derived progenitor cell (BMCs) intramycardial transplantations. Five to 30 mililiters of bone marrow were aspirated from iliac bone. Seventeen to 90 million BMCs were isolated and as suspension of physiologic saline given to patients by intramyocardial punction. Every patient underwent repeated examination every two month. Results. Six months following bone marrow derived progenitor stem cell intramyocardial transplantation we observed increase of ejection fraction in 4 patients, decrease of dilatation echocardiographycally and cardiothoracic ratio (CTR) at chest x-ray; decrease of the stage of heart insufficiency clinically from class IV to I-II(NYHA). Conclusions. We see the intramyocardial administration of bone marrow cells proved to be technically feasible and safe, also the procedure does not need for expensive technical equipment. The bone marrow transplantation improves the patients clinical situation and physical measurements. Our method might be used for the stabilization of the patient to get the time for further treatment.
The Concept, Diagnostics, Surgical Prevention and Treatment of Hereditary Colorectal Cancer in Nowadays Medicine
Authors: Vanags Andrejs , Strumfa Ilze , Abolins Arnis , Gardovskis Andris , Melbarde-Gorkusa Inga , Trofimovics Genadijs , Gardovskis Janis
Published: April 2011

The Concept, Diagnostics, Surgical Prevention and Treatment of Hereditary Colorectal Cancer in Nowadays Medicine

Colorectal cancer is a frequent cause of oncological morbidity and mortality. It is the second most common cancer in Europe (13.0%) almost matching the frequency of lung cancer, the most widespread malignancy (13.2%). In European Union countries colorectal cancer is the most frequent tumour. Colorectal cancer is also the second most common cause of cancer death in Europe accounting for 11.9% of cancer-related mortality (4). In 20% of colorectal cancer patients, genetic background exists. However, the discovered genetic mutations related to high lifetime risk of colorectal cancer account only for 5-6% of colorectal cancer cases (27). The two main hereditary cancer syndromes involving the large bowel are familial adenomatous polyposis, responsible for 1% of the annual colorectal cancer burden, and hereditary non-polyposis colorectal cancer that accounts for 2-3% of colorectal cancer cases (9). Both syndromes are remarkable not only by the scientific novelty in hereditary cancer research but only for high practical significance as the knowledge about the peculiar risk of primary and metachronous colorectal cancer as well as about certain extracolonic malignancies is necessary to plan the surgical intervention correctly.
Diagnosis and Management of the Thyroid Nodules
Authors: Ozolins Arturs , Narbuts Zenons , Strumfa Ilze , Prieditis Peteris , Gardovskis Janis
Published: April 2011

Diagnosis and Management of the Thyroid Nodules

Thyroid nodules are a common clinical problem. Most of the discovered nodules are benign, however increase in thyroid cancer incidence has been reported. For management of thyroid nodules distinction between benign and malignant thyroid tumors is essential. Thyroid nodule management involves notice to: clinical features, biochemical tests, imaging studies, fine needle aspiration, thyroid scintigraphy and immunocytochemistry. In spite of different combinations of diagnostic tools used, it is still difficult to precisely determine malignant potential of thyroid nodules.
Neurogenic Thoracic Outlet Syndrome caused by Subacute Clavicle Osteomyelitis
Authors: Kapickis Martins
Published: April 2011

Neurogenic Thoracic Outlet Syndrome caused by Subacute Clavicle Osteomyelitis

A rare case of neurogenic thoracic outlet syndrome caused by subacute osteomyelitis (SOM) of clavicle is presented. It was treated by clavicle resection, I rib resection and scalenectomy followed by reconstruction of the clavicle by 6th rib vascularised bone transfer based on serratus anterior muscle as a rotational flap.
Methicillin Susceptible Panton - Valentine Leukocidin Positive S. Aureus Pneumonia in a Child with Novel Influenza H1N1 Infection
Authors: Cupane Liene , Pugacova Nina , Aleksejevs Girts , Berzina Dace , Gardovska Dace , Miklasevics Edvins
Published: April 2011

Methicillin Susceptible Panton - Valentine Leukocidin Positive S. Aureus Pneumonia in a Child with Novel Influenza H1N1 Infection

The first case in Latvia of Panton - Valentine leukocidin (PVL) positive methicillin susceptible Staphylococcus aureus (MSSA) pneumonia in an adolescent with novel influenza A H1N1 is described. A 15 year old boy was admitted to intensive care suffering from severe respiratory failure with bilateral necrotic pneumonia. The presence of influenza A H1N1 was confirmed by PCR. Invasive S. aureus was spa type t435 and Panton-Valentine leukocidin gene positive. He received therapy with ceftriaxone, oxacillin, clindamycin and oseltamivir phosphate and underwent two chest operations. He was discharged after 58 days in hospital.
Modified Senning Operation in the Treatment of Transposition of The Great Arteries
Authors: Lacis Aris , Lubaua Inguna , Smits Lauris , Ozolins Valts , Sikora Normunds , Straume Zane
Published: April 2011

Modified Senning Operation in the Treatment of Transposition of The Great Arteries

The arterial switch operation has become the procedure of choice for patients with transposition of the great arteries(TGA) in most medical centres. Although atrial switching may occasionally be employed in some centres in cases with delayed diagnosis, pulmonary hypertension and some other unusual entities. We preferred to use the atrial switch operation - modified Senning procedure for 6 years 6 months old boy with TGA, small atrial septal defect (ASD) and patent ductus arteriosus (PDA).
Laparoscopic Repair of Paraesophageal Hiatal Hernia in a Newborn
Authors: Engelis Arnis , Schaarschmidt Klaus , Petersons Aigars , Zviedre Astra , Kakar Mohit
Published: April 2011

Laparoscopic Repair of Paraesophageal Hiatal Hernia in a Newborn

A 3-month old boy was hospitalized with the suspicion of right sided pneumonia. Examination revealed hiatal or paraesophageal hernia. Ultimately, a laparoscopic operation was performed. During the operation, PEHH of the transverse colon with displaced gastro esophageal junction was discovered. Laproscopic hiatal hernia repair with modified Thal fundoplication were performed. Recovery of child 2 years after surgery was uneventful.
Delayed clinical improvement after deep brain stimulation–related subdural hematoma
Authors: Oyama Genko , Okun Michael S. , Zesiewicz Theresa A. , Tamse Tiffany , Romrell Janet , Zeilman Pamela , Foote Kelly D.
Published: April 2011

Object

The purpose of this paper is to present 4 cases that illustrate the management and outcome of subdural hematoma (SDH) following deep brain stimulation (DBS) lead implantation.

Methods

The authors identified 4 cases of SDH following DBS lead implantation from a pool of 500 consecutive lead implantations (incidence 0.08%) performed at the University of Florida. Cases were characterized by chart review, serial Unified Parkinson's Disease Rating Scale evaluations, and changes on serial postoperative imaging studies.

Results

Two of the 4 patients with DBS-related SDH were clinically symptomatic. In the other 2 cases the SDH was incidentally discovered on routine postoperative lead localization imaging studies. None of the patients required craniotomy for evacuation of the SDH in the acute phase. Three of the 4 cases were managed with bur hole drainage in the chronic phase, and one was successfully managed nonoperatively. In all 4 cases, thresholds for stimulationinduced side effects were lower during initial postoperative programming than during intraoperative macrostimulation. Expected clinical improvement from DBS was achieved without lead revision in all 4 cases, but only after a significant delay.

Conclusions

Subdural hematoma is a rare and potentially avoidable complication of DBS that does not typically mandate acute hematoma evacuation or hardware revision and does not preclude an excellent outcome from DBS therapy. The clinical picture and apparent lead position tend to improve with time, and it may be wise to delay repositioning of an ineffective DBS lead following a hemorrhage until the DBS lead and surrounding brain tissue have settled into their final position and the insulted brain has had sufficient time to recover.
Venous sacrifice in neurosurgery: new insights from venous indocyanine green videoangiography
Authors: Ferroli Paolo , Acerbi Francesco , Tringali Giovanni , Albanese Erminia , Broggi Morgan , Franzini Angelo , Broggi Giovanni
Published: April 2011

Object

The purpose of this paper is to evaluate whether venous indocyanine green (ICG) videoangiography has any potential for predicting the presence of a safe collateral circulation for veins that are at risk for intentional or unintentional damage during surgery.

Methods

The authors performed venous ICG videoangiography during 153 consecutive neurosurgical procedures. On those occasions in which a venous sacrifice occurred during surgery, whether that sacrifice was preplanned (intended) or unintended, venous ICG videoangiography was repeated so as to allow us to study the effect of venous sacrifice. A specific test to predict the presence of venous collateral circulation was also applied in 8 of these cases.

Results

Venous ICG videoangiography allowed for an intraoperative real-time flow assessment of the exposed veins with excellent image quality and resolution in all cases. The veins observed in this study were found to be extremely different with respect to flow dynamics and could be divided in 3 groups: 1) arterialized veins; 2) fast-draining veins with uniform filling and clear flow direction; and 3) slow-draining veins with nonuniform filling. Temporary clipping was found to be a simple and reversible way to test for the presence of potential anastomotic circulation.

Conclusions

Venous ICG videoangiography is able to reveal substantial variability in the venous flow dynamics. “Slow veins,” when they are tributaries of bridging veins, might hide a potential for anastomotic circulation that deserve further investigation.
Morphometry of the outlet of the foramen magnum in crania with atlantooccipital fusion
Authors: Tubbs R. Shane , Lancaster Jeffrey R. , Mortazavi Martin M. , Shoja Mohammadali M. , Chern Joshua J. , Loukas Marios , Cohen-Gadol Aaron A.
Published: April 2011

Object

Assimilation of the atlas to the occiput may result in symptoms that are often compressive in nature around the outlet of the foramen magnum. The aim of the present study was to elucidate the morphological features of the bone through this foramen.

Methods

Thirteen adult skulls with atlantooccipital fusion underwent morphometrical analysis of the outlet of the foramen magnum.

Results

All specimens but one were found to have a decreased area of the outlet of the foramen magnum. In those 12 specimens, a decrease of 15%–35% was seen. Fusions of the atlas that were based primarily along the anterior rim of the foramen magnum resulted in more obstruction of its outlet. In general, the horizontal diameters of the outlet of these foramina were more decreased from the normal range.

Conclusions

These findings demonstrate that in the majority of cases, assimilation of the atlas to the occiput results in a compromised outlet of the foramen magnum.
A Cultural History of Crocodiles in the Philippines: Towards a New Peace Pact?
Authors: van der Ploeg Jan , van Weerd Merlijn , Persoon Gerard A.
Published: April 2011

Crocodiles have an image problem in the Philippines. In mainstream Filipino society crocodiles are considered dangerous man-eaters, and compared with corrupt government officials or selfish basketball players. It is often argued that these negative public attitudes towards crocodiles make in-situ crocodile conservation impossible in the Philippines. Only by securing economic benefits for rural communities through sustainable use can crocodiles be conserved. In this paper we contest this narrow utilitarian view. In fact indigenous peoples in the northern Sierra Madre have a history of co-existence with crocodiles. In the pre-Hispanic Philippines people feared and revered crocodiles: specific rules regulated the relationship between crocodiles and people. Traditional beliefs and practices enable people to share the landscape with a potentially dangerous carnivore. This forces us to rethink conventional conservation strategies that focus narrowly on economic values.
Book Reviews
Authors: Tone John Lawrence , Brown Julia , Satya Laxman D. , Arnold David
Published: April 2011

J.R. McNeill, Mosquito Empires: Ecology and War in the Greater Caribbean, 1620-1914 (John Lawrence Tone)
Rutgerd Boelens, David Getches and Armando Guevara-Gil, Out of the Mainstream: Water Rights, Politics and Identity (Julia Brown)
Irfan Habib, Man and Environment: The Ecological History of India (Laxman D. Satya)
Stephen Mosley, The Environment in World History (David Arnold)