bluuebunny/crossref_metadata_2025 huggingface dataset:
Moisture Effect on the Interlaminar Resistance of Woven Fabric Thermoplastic Composite
Authors: Zenasni Ramdane , Saadi Bachir Ait
Published: October 2006

In the present study, the effect of moisture on the interlaminar fracture toughness of two woven fabric composite materials has been investigated. The composites used are made of a woven fabric 8H Satin glass fiber and 8H Satin carbon fiber. The matrix is a polyetherimide (PEI). The composites are used in aeronautical and aerospace applications. The interlaminar fracture behavior is analyzed using the mode I, double cantilever beam (DCB) test, and the mode II, end notched flexure (ENF), in order to determine the energy required for the initiation and growth of an artificial crack. The composites are subjected to a relative humidity (95%) and a constant temperature (70° C) in a climatic chamber for 30, 60, 120, and 180 days. The delamination energies are calculated using the corrected beam, Berry theories, and the experimental calibration method at the characteristic points. The result shows that the decrease in the fracture behavior is more important in the material CD342 8H Satin weave. The fracture mechanism was also analyzed by means of scanning electron microscopy.
Injection Molding of Postconsumer Wood–Plastic Composites I: Morphology
Authors: Gosselin R. , Rodrigue D. , Riedl B.
Published: October 2006

In this study, fiber-reinforced microcellular foams are produced via injection molding and studied as a function of mold temperature as well as wood, blowing agent, and coupling agent concentrations. Birch wood fibers are added to a post-consumer recycled HDPE/PP matrix (85: 15 ratio) in proportions ranging from 0 to 40 wt% and then foamed. Maleic-anhydride-polypropylene copolymer (MAPP) is also used as a coupling agent in proportions ranging from 0 to 10 wt% of wood content. In this first part, the morphological analysis of composite foams is presented including cell roundness, cell size, skin thickness, void fraction, and fiber aspect ratio.
Recycling of PP-based Sandwich Panels with Continuous Fiber Composite Skins
Authors: Corvaglia Paolo , Passaro Alessandra , Manni Orazio , Barone Luigi , Maffezzoli Alfonso
Published: October 2006

ABSTRACT: In this article, a procedure for recycling of polypropylene (PP)-based sandwich panels is presented. PP/glass laminates as the skins and PP foam as the core material are used. The waste panel is converted into short-fiber composite material. The panel is first ground by a mill and homogenized in a mixer or an extruder, then the pellets are re-ground and injection molded. The influence of mixer parameters and fiber content on the mechanical and physical properties of the recycled material is experimentally investigated. The orientation and length of the glass fibers are measured using an optical microscope; SEM analysis is used to characterize the morphology of injection-molded samples.
Interstitial pulmonary disorders in indium-processing workers
Authors: Chonan T. , Taguchi O. , Omae K.
Published: October 2006

The production of indium-tin oxide has increased, owing to the increased manufacture of liquid-crystal panels. It has been reported that interstitial pneumonia occurred in two indium-processing workers; therefore, the present study aimed to evaluate whether interstitial pulmonary disorders were prevalent among indium workers.

The study was carried out in 108 male workers in the indium plant where the two interstitial pneumonia patients mentioned above were employed, and included high-resolution computed tomography (HRCT) of the lungs, pulmonary function tests and analysis of serum sialylated carbohydrate antigen KL-6 and the serum indium concentration.

Significant interstitial changes were observed in 23 indium workers on HRCT and serum KL-6 was abnormally high (>500 U·mL-1) in 40 workers. Workers with serum indium concentrations in the highest quartile had significantly longer exposure periods, greater HRCT changes, lower diffusing capacity of the lung for carbon monoxide and higher KL-6 levels compared with those in the lowest quartile. The serum indium concentration was positively correlated with the KL-6 level and with the degree of HRCT changes.

In conclusion, the results of the present study indicated that serum KL-6 and high-resolution computed tomography abnormalities were prevalent among indium workers and that these abnormalities increased with the indium burden, suggesting that inhaled indium could be a potential cause of occupational lung disease.
8-Isoprostane as a marker of oxidative stress in nonsymptomatic cigarette smokers and COPD
Authors: Kinnula V. L. , Ilumets H. , Myllärniemi M. , Sovijärvi A. , Rytilä P.
Published: October 2006

8-Isoprostane is a potentialin vivomarker for oxidant burden, but its usefulness in induced sputum of smokers and chronic obstructive pulmonary disease (COPD) has not been investigated.

The current study investigated 58 subjects comprising 11 never-smokers, 11 ex-smokers, 13 healthy current smokers and 23 COPD with stage 0–III disease (according to the Global Initiative for Chronic Obstructive Lung Disease criteria). 8-Isoprostane was determined from induced sputum by enzyme immunoassay.

Sputum 8-isoprostane levels were similar in the never-smokers and ex-smokers, but were elevated in the healthy smokers compared with nonsmokers, and in those with stage I–III COPD. Sputum 8-isoprostane levels could not differentiate nonsymptomatic smokers from those with Stage 0 COPD. There was a correlation between sputum 8-isoprostane level and lung function parameters (forced expiratory volume in one second/forced vital capacity and sputum neutrophils.

In conclusion, sputum 8-isoprostane levels correlate with the severity of chronic obstructive pulmonary disease. However, they do not appear to differentiate healthy smokers from those who are at risk of developing chronic obstructive pulmonary disease (Global Initiative for Chronic Obstructive Lung Disease stage 0).
Impact of CPAP on asthmatic patients with obstructive sleep apnoea
Authors: Lafond C. , Sériès F. , Lemière C.
Published: October 2006

The impact of continuous positive airway pressure (CPAP) treatment on the airway responsiveness of asthmatic subjects with obstructive sleep apnoea (OSA) has scarcely been studied.

A prospective study was performed comparing the changes in airway responsiveness and quality of life in stable asthmatic OSA patients, before and 6 weeks after their nocturnal CPAP treatment.

A total of 20 subjects (11 males and nine females) participated in the study. With the nocturnal CPAP treatment, the apnoea/hypopnoea index dropped from 48.1±23.6·h-1to 2.6±2.5·h-1. There were no significant changes in airway responsiveness after CPAP treatment (provocative concentration causing a 20% fall in forced expiratory volume in one second (FEV1; PC202.5 mg·mL-1(1.4–4.5)) compared with baseline (PC202.2 mg·mL-1(1.3–3.5)). There was no significant change in FEV1either. However, the asthma quality of life of the subjects improved from 5.0±1.2 at baseline to 5.8±0.9 at the end of the study.

In conclusion, nocturnal continuous positive airway pressure treatment did not alter airway responsiveness or forced expiratory volume in one second in subjects with stable mild-to-moderate asthma and newly diagnosed obstructive sleep apnoea. However, nocturnal continuous positive airway pressure treatment did improve asthma quality of life.
A step test to assess exercise-related oxygen desaturation in interstitial lung disease
Authors: Dal Corso S. , Duarte S. R. , Neder J. A. , Malaguti C. , de Fuccio M. B. , de Castro Pereira C. A. , Nery L. E.
Published: October 2006

A 6-min step test (6MST) may constitute a practical method for routinely assessing effort tolerance and exercise-related oxyhaemoglobin desaturation (ERD) in the primary care of patients with interstitial lung disease.

In total, 31 patients (19 males) with idiopathic pulmonary fibrosis (n = 25) and chronic hypersensitivity pneumonia were submitted, on different days, to two 6MSTs. Physiological responses were compared with those found on maximal and submaximal cycle ergometer tests at the same oxygen uptake (V′O2). Chronic breathlessness was also determined, as measured by the baseline dyspnoea index (BDI).

Responses to 6MST were highly reproducible: 1.3±2.0 steps·min-1, ±5 beats·min-1(cardiac frequency), ±50 mL·min-1(V′O2), ±7 L·min-1(minute ventilation) and ±2% (arterial oxygen saturation measured by pulse oximetry (Sp,O2)). The number of steps climbed in 6 min was correlated to peakV′O2and the BDI. There were significant associations among the tests in relation to presence (change inSp,O2between rest and exercise ≥4%) and severity (Sp,O2<88%) of ERD. Four patients, however, presented ERD only in response to 6MST. Resting diffusing capacity of the lung for carbon monoxide and alveolar–arterial oxygen tension difference were the independent predictors of the number of steps climbed.

A single-stage, self-paced 6-min step test provided reliable and reproducible estimates of exercise capacity and exercise-related oxyhaemoglobin desaturation in interstitial lung disease patients.
Statin use is associated with reduced mortality in COPD
Authors: Søyseth V. , Brekke P. H. , Smith P. , Omland T.
Published: October 2006

Patients with chronic obstructive pulmonary disease (COPD) have an increased risk of ischaemic heart disease (IHD). Statins reduce mortality and morbidity in IHD. It has been hypothesised that statin treatment is associated with reduced long-term mortality in patients with COPD.

Using a retrospective cohort design, 854 consecutive patients (mean age 70.8 yrs; 51.5% female) with a diagnosis of COPD exacerbation were included in the study at discharge from a Norwegian teaching hospital.

Median follow-up was 1.9 yrs, during which 333 patients died. The crude mortality rate per 1,000 person-yrs was 110 in patients treated with statins, and 191 in patients not treated with statins. After adjustment for sex, age, smoking, pulmonary function and comorbidities, the hazard ratio (HR) for statin usersversusstatin nonusers was 0.57 (95% confidence interval 0.38–0.87). When subdividing statin users and statin nonusers into groups according to concomitant treatment with inhaled corticosteroids (ICS) the following HRs were found: 0.75 (0.58–0.98) for ICS only; 0.69 (0.36–1.3) for statins only; and 0.39 (0.22–0.67) for the combined treatment with statin and ICS compared with no such treatment.

Treatment with statins was associated with improved survival after chronic obstructive pulmonary disease exacerbation, while inhaled corticosteroids appeared to increase the survival benefit associated with statin use.
The correlation between asthma control and health status: the GOAL study
Authors: Bateman E. D. , Bousquet J. , Keech M. L. , Busse W. W. , Clark T. J. H. , Pedersen S. E.
Published: October 2006

The present study examined the association between guideline-derived asthma control and health-related quality of life, assessed using the Asthma Quality of Life Questionnaire (AQLQ), in patients with uncontrolled asthma whose treatment was directed towards achieving the highest possible level of control.

The present randomised, double-blind, parallel-group study compared the efficacy of fluticasone propionate (FP) and salmeterol/fluticasone propionate combination (SFC) in achieving two composite, guideline-derived measures of control: total control (TC) and well-controlled (WC) asthma. Not achieving these levels was classed as not well-controlled (NWC). Doses were augmented until patients achieved TC or reached the maximum dose. This dose was maintained for the remainder of the study. AQLQ was assessed at baseline and at each clinic visit.

AQLQ scores improved throughout the study, reaching near-maximal levels in patients achieving TC and WC, and 52-week mean scores in the three control groups were statistically significantly different. Clinically meaningful improvements (mean change from baseline) were: TC group (SFC 1.9, FP 1.8), WC (SFC 1.5, FP 1.5) and NWC (SFC 1.0, FP 0.9).

In conclusion, the treatment aimed at controlling asthma improves the health-related quality of life to levels approaching normal. The difference in Asthma Quality of Life Questionnaire scores between total control and well-controlled confirms that patients distinguish even between these high levels of control.
Rubinstein-Taybi Syndrome: spectrum of CREBBP mutations in Italian patients
Authors: Bentivegna Angela , Milani Donatella , Gervasini Cristina , Castronovo Paola , Mottadelli Federica , Manzini Stefano , Colapietro Patrizia , Giordano Lucio , Atzeri Francesca , Divizia Maria T , Uzielli Maria L Giovannucci , Neri Giovanni , Bedeschi Maria F , Faravelli Francesca , Selicorni Angelo , Larizza Lidia
Published: October 2006

Background

Rubinstein-Taybi Syndrome (RSTS, MIM 180849) is a rare congenital disorder characterized by mental and growth retardation, broad and duplicated distal phalanges of thumbs and halluces, facial dysmorphisms and increased risk of tumors. RSTS is caused by chromosomal rearrangements and point mutations in one copy of the CREB-binding protein gene (CREBBPorCBP) in 16p13.3. To date mutations inCREBBPhave been reported in 56.6% of RSTS patients and an average figure of 10% has ascribed to deletions.

Methods

Our study is based on the mutation analysis ofCREBBPin 31 Italian RSTS patients using segregation analysis of intragenic microsatellites, BAC FISH and direct sequencing of PCR and RT-PCR fragments.

Results

We identified a total of five deletions, two of the entire gene and three, all in a mosaic condition, involving either the 5' or the 3' region. By direct sequencing a total of 14 de novo mutations were identified: 10 truncating (5 frameshift and 5 nonsense), one splice site, and three novel missense mutations. Two of the latter affect the HAT domain, while one maps within the conserved nuclear receptor binding of (aa 1–170) and will probably destroy a Nuclear Localization Signal. Identification of the p.Asn1978Ser in the healthy mother of a patient also carrying a de novo frameshift mutation, questions the pathogenetic significance of the missense change reported as recurrent mutation. Thirteen additional polymorphisms, three as of yet unreported, were also detected.

Conclusion

A high detection rate (61.3%) of mutations is confirmed by this Italian study which also attests one of the highest microdeletion rate (16%) documented so far.
Hand1 regulates cardiomyocyte proliferation versus differentiation in the developing heart
Authors: Risebro Catherine A. , Smart Nicola , Dupays Laurent , Breckenridge Ross , Mohun Timothy J. , Riley Paul R.
Published: October 2006

The precise origins of myocardial progenitors and their subsequent contribution to the developing heart has been an area of considerable activity within the field of cardiovascular biology. How these progenitors are regulated and what signals are responsible for their development are, however,much less well understood. Clearly, not only is there a need to identify factors that regulate the transition from proliferation of cardioblasts to differentiation of cardiac muscle, but it is also necessary to identify factors that maintain an adequate pool of undifferentiated myocyte precursors as a prerequisite to preventing organ hypoplasia and congenital heart disease. Here, we report how upregulation of the basic helix-loop-helix (bHLH)transcription factor Hand1, restricted exclusively to Hand1-expressing cells, brings about a significant extension of the heart tube and extraneous looping caused by the elevated proliferation of cardioblasts in the distal outflow tract. This activity is independent of the further recruitment of extracardiac cells from the secondary heart field and permissive for the continued differentiation of adjacent myocardium. Culture studies using embryonic stem (ES) cell-derived cardiomyocytes revealed that,in a Hand1-null background, there is significantly elevated cardiomyocyte differentiation, with an apparent default mesoderm pathway to a cardiomyocyte fate. However, Hand1 gain of function maintains proliferating precursors resulting in delayed and significantly reduced cardiomyocyte differentiation that is mediated by the prevention of cell-cycle exit, by G1 progression and by increased cell division. Thus, this work identifies Hand1 as a crucial cardiac regulatory protein that controls the balance between proliferation and differentiation in the developing heart, and fills a significant gap in our understanding of how the myocardium of the embryonic heart is established.
How much does heterosexual commercial sex contribute to India's HIV epidemic?
Authors: Gisselquist David , Correa Mariette
Published: October 2006

Through a search, we identified five models of India's HIV epidemic, all of which articulate the hypothesis that heterosexual commercial sex drives India's HIV epidemic. All five models assume more female sex workers (FSWs) than have been mapped (counted), and more than can be inferred from men's sexual behaviour. With best and highest plausible evidence-based estimates (15–20% of 300,000–700,000 FSWs are HIV-positive; FSWs have 570 client contacts per year; clients use condoms with 60–75% of FSW contacts; and the rate of HIV transmission from FSWs to clients is 0.0011–0.002 per unprotected contact), FSWs and clients account for 2–15% of HIV-infected adults, far less than model-based estimates of 44–68%. Overestimating the contribution of commercial sex to India's HIV epidemic misleads prevention programmes to ignore other risks, and promotes the stigmatizing assumption that HIV infection is a sign of immoral behaviour.
A passage to India's HIV epidemics: sending out an SOS
Authors: Potterat John J
Published: October 2006

The official view is that India's epidemics are driven, directly and indirectly, by heterosexual prostitution. Review of available evidence by researchers in India undermines this weakly supported orthodoxy and suggests that correcting weaknesses in its AIDS surveillance system can lead to a more reliable picture of HIV propagation and hence to evidence-based interventions. Contenders for leading roles in HIV transmission are under-suspected and unmeasured skin-puncturing exposures.
Cholesteatoma and chronic otitis media following middle ear intubation
Authors: Buckingham Richard A.
Published: October 2006

As in any surgical procedure, complications can occur following middle ear intubation for secretory otitis media or atelectasis. Serial Kodachrome studies of the middle ear demonstrate the types of lesions that occur and the methods used to correct them. Chronic otitis media in the form of chronic granulomas or perforations are relatively simple problems that are easily corrected. Cholesteatomas can arise from intubation either by formation of atelectatic pockets following extrusion of the tube or from ingrowth of the surface epithelium of the tympanic membrane onto the medial surface of the tympanic membrane. These lesions often require surgical correction.

Middle ear intubation should not be done indiscriminately, and prolonged follow‐up of patients is mandatory for the early detection of complications.
Homograft septal cartilage for attic support in intact canal wall tympanomastoidectomy and tympanoplasty
Authors: Pappas James J. , Bailey H. A. Ted , Mcgrew Robert N. , Graham Sharon S.
Published: October 2006

The postoperative formation of attic retraction pockets following tympanoplasty, with or without mastoidectomy, has often been a significant cause of recurrent disease accompanied by decreased hearing levels. Nasal septal cartilage is recommended as a successful homograft material for attic support. The basis and indications for its use are discussed. Preparation and storage of the homograft materials and surgical technique are described. Long‐term results are reported, including a special group in which the status of the homograft material was assessed during revision surgery. Minimal complications have been encountered.

Conclusions support the overall advantages of this technique utilizing homograft septal cartilage as an effective means of posterosuperior canal wall support, an aid in preventing retraction pocket formation.
Evaluation and management of coagulation disorders in elective surgical patients
Authors: Fuller Alen Munson
Published: October 2006

This is a review of coagulation disorders in elective surgical patients. The study represents both a personal experience in unusual bleeding and clotting disturbances and, in addition, a 15‐year review of unique problems evaluated by the Coagulation Department of a local general hospital. Of this group of cases, 17 were selected to illustrate the purpose of this report. Potential “bleeders” due to coagulation defects may be missed preoperatively both by history and by commonly accepted screening tests. The incidence of this situation is fortunately rare, but unfortunately this dulls the likelihood of early diagnosis with the initiation of specific treatment measures. The limitations of preoperative screening tests were apparent and should not be considered a fail‐safe detector of coagulation disorders. Qualitative and quantitative factor assays are the cornerstone for accurate diagnosis and a guide for specific replacement therapy. Although most surgeons will never have an in‐depth knowledge of hematology, the importance of having some fundamental awareness is apparent. This study encourages surgeons not to take the hemostatic mechanism for granted, and to see the need for understanding hematologic diagnosis and treatment.
Migraine prophylaxis: A new approach
Authors: Ryan Robert E. , Ryan Robert E.
Published: October 2006

From previous research with migraine patients we know that there are abnormalities of platelet aggregation and adhesiveness. These abnormalities suggest that possibly platelet antagonists might prevent migraine attacks.

Dipyridamole and aspirin are both platelet antagonists and are the two drugs used in this double blind study.

The patients were randomly assigned to 4 treatment groups; 1. Dipyridamole, 2. Aspirin, 3. Dipyridamole plus Aspirin, and 4. Placebo. There were 40 patients in each group (160 total). These patients had either classical or common migraine, were male or female, and the age group was 21–65. No pregnant females were used. All patients had at least 3 migraine attacks per month prior to entry into the study.

The patients received the study medication for 8 weeks following a 4 week washout period during which no prophylactic medication for migrain was used.

The results show that the group of patients taking the combination of dipyridamole and aspirin had the greater decrease in both headache frequency and headache index. The dipyridamole group and the aspirin group had better results than the placebo group.

The improvement in the 3 groups receiving the actual test medication had better results in the second month, than they did in the first month. This leads one to the conclusion that perhaps if the protocol for this study called for 3 months testing rather than 2, the results would be even better.

Platelets are the smallest element found in the blood. In normal blood there are usually between 200, 000 to 400,000. This number is dependent upon a negative feedback mchanism which is modulated by thrompopoietin. The platelets are removed from the blood stream by the spleen and the liver after they have passed their normal life span, which is usually found to be from 8 to 10 days.

Platelets contain granules. There are two types of granules, one is the amine storage granule, often called the platelet dense bodies. These granules contain ADP (adenosine dephosphate) ATP, SHT, mucopolysacarides, adrenalin, and calcium. The other type of granule is the alpha granule which contains lysomal enzymes and possibly fibrinogen.
Gross and microscopic anatomy of the eighth cranial nerve in relationship to the solitary schwannoma
Authors: Neely J. Gail
Published: October 2006

Surgical advances over the past two decades, allowing the discovery of smaller solitary schwannomas of the VIIIth cranial nerve and their extirpation with preservation of the VIIth cranial nerve, have lead to attempts to resect the tumor without completely resecting its nerve of origin. This paper reports the macroscopic and microscopic observations of 22 solitary schwannomas of the VIIIth cranial nerve as they relate to the nerve of origin.

Nine tumors were removed, en bloc with the VIIIth nerve, tranversely subscrially sectioned and studied by light microscopy. Four of the en bloc cases and 13 additional cases were studied by biopsying the VIIIth nerve branches, lateral, and the VIIIth nerve trunk medial to the tumor. The results suggest that the VIIIth nerve is involved throughout the extent of the tumor and, in some cases, beyond the tumor limits with intraneural invasion by tumor cells. There is an immediate dispersion of VIIIth nerve fibers to extremely small aggregates dispersed peripherally about the tumor surface. These fiber aggregates are not surgically dissectable from the tumor because of the difficulty in identifying the fibers and because of tumor infiltration of normal appearing nerves.

The pure tone threshold average of 500–2,000 Hz. tends to correlate more closely with the number of cochlear fibers present, lateral to the tumor, than do other auditory tests. The percent of unilateral vestibular weakness does not correlate with the number of fibers present in the superior vestibular nerve.

In summary, these histologic data suggest that complete tumor resection from VIIIth nerve fibers may be beyond our present technological capabilities. They further suggest severe limits to accurate identification of candidates for this conservation surgery.
Local convexity, adapted experiments and the wave equation: Lecam's randomization criterion and related results
Authors: Weisshaupt Heinz
Published: October 2006

We provide
generalizations of LeCam's randomization criterion and present related results
which we call black-box criteria. We investigate the general functional
analytic structure behind randomization criteria and black-box criteria. We
show by a general categorical argument that randomization criteria and
corresponding black-box criteria are equivalent. By abstraction to locally
convex spaces we eliminate the lattice structure usually involved. The
applications of our general functional analytic results range from the
comparison of adapted statistical experiments to the wave equation.
Black, white and shades of grey: SUNCT or short-lasting chronic paroxysmal hemicrania?
Authors: Fragoso Yára Dadalti
Published: October 2006

AIM OF THE STUDY: To report a case of unilateral headache with two possibilities of diagnosis. METHOD: Case report. RESULTS: Patient with unilateral, intense, stabbing periocular headache with conjuntival injection and tearing. Although the duration of attacks was typical of SUNCT, there was complete remission of the pain with indomethacin, suggesting that this was a case of chronic paroxysmal hemicrania with unusually short attack duration. CONCLUSION: Therapeutic trials of indomethacin on younger patients presenting clinical diagnosis of SUNCT could be tried on a more regular basis.
Visual and automatic cyclic alternating pattern (CAP) scoring
Authors: Rosa Agostinho , Alves Gabriela Rodrigues , Brito Magneide , Lopes Maria Cecília , Tufik Sérgio
Published: October 2006

The classification of short duration events in the EEG during sleep, as the A stage of the cyclic alternating pattern (CAP) is a tedious and error prone task. The number of events under normal conditions is large (several hundreds), and it is necessary to mark the limits of the events with precision, otherwise the time sensitive classification of the CAP phases (A and B) and specially the scoring of different types of A phases will be compromised. The objective of this study is to verify the feasibility of visual CAP scoring with only one channel of EEG, the evaluation of the inter-scorer agreement in a variety of recordings, and the comparison of the visual scorings with a known automatic scoring system. Sixteen hours of one channel (C4-A1 or C3-A2) of NREM sleep were extracted from eight whole night recordings in European Data Format and presented to the different scorers. The average inter-scorer agreement for all scorers is above 70%, the pair wise inter-scorer agreement found was between 69% up to 77.5%. These values are similar to what has been reported in different type studies. The automatic scoring system has similar performance of the visual scorings. The study also has shown that it is possible to classify the CAP using only one channel of EEG.
Reibergrama para la evaluación de la síntesis intratecal de C3c
Authors: Dorta-Contreras Alberto Juan , Noris-García Elena , Padilla-Docal Bárbara , Rodríguez-Rey Alexis , Bu-Coifiu-Fanego Raisa , Magraner-Tarrau María Esther , Martí-Brenes Mauricio
Published: October 2006

INTRODUCCIÓN: El diagrama de las razones de Reiber o reibergrama cobra cada día mayores usos para la caracterización de la síntesis intratecal de proteínas. El reibergrama fue definido para las clases mayores de inmunoglobulinas pero luego ha sido utilizado para evaluar otras proteínas basado en la teoría de la difusión molecular/velocidad de flujo del líquido cefalorraquídeo (LCR). MÉTODO: El C3c, producto de la degradación del factor del complemento C3 y con una masa molecular de 145 KDa, se acerca a las características moleculares de la IgG para las leyes de la difusión de Fick. Se asume las constantes de la IgG en la fórmula de Reiber para evaluar la síntesis intratecal de C3c así como su correspondiente reibergrama. Se estudiaron 27 pacientes y 27 controles a los que se les dosificó albúmina y C3c en suero y LCR por inmunodifusión radial. RESULTADOS: Con el reibergrama propuesto para el C3c se evaluaron estos pacientes. Se comprueba la validez de este reibergrama para distintas condiciones de barrera con o sin síntesis intratecal de C3c. CONCLUSION: El reibergrama y su fórmula correspondiente propuesto para la C3c puede ser usado para la evaluación de la síntesis intratecal de C3c.
Basilar impression associated with impacted cisterna magna, spastic paraparesis and distress of balance: case report
Authors: Gonçalves da Silva José Alberto , Holanda Maurus Marques de Almeida , Leiros Maria do Desterro , Melo Luiz Ricardo Santiago , Araújo Antônio Fernandes de , Almeida Everardo Bandeira de
Published: October 2006

We report on a 48 years-old man with basilar impression without syringohydromyelia, in which the cisterna magna was impacted by the cerebellar tonsils. Six months after posterior fossa decompression there was the disappearance of nuchal rigidity, vertigo, spastic paraparesis and improvement of balance. Nevertheless hyperreflexia and diminished pallesthesia of the lower limbs persisted.
Intracranial arterial aneurysms in childhood: case report
Authors: Pinto Fernando Campos Gomes , Valiengo Leandro , Santos Pedro Paulo Mariani Lima , Matushita Hamilton , Plese José Píndaro Pereira
Published: October 2006

A case of an intracranial arterial aneurysm at internal carotid bifurcation in a 10-year-old girl is described with the special features of cerebral aneurysm which occur in children, comparing with the adults. We alert for the necessity of carefully operative technique in order to avoid damage and intraoperative rupture of the aneurysm due to the very thin vessel wall that this population can develop. Our recommendation is early surgery in these patients.
Confiabilidade de escalas de comprometimento neurológico em pacientes com acidente vascular cerebral
Authors: Caneda Marco Aurélio Gralha de , Fernandes Jefferson Gomes , Almeida Andrea Garcia de , Mugnol Fabiana Eloisa
Published: October 2006

Escalas de comprometimento neurológico são utilizadas na avaliação de novos tratamentos, no acompanhamento da evolução clínica e em decisões terapêuticas. Estudamos a confiabilidade de três escalas: a Escala de Rankin (ER), o Índice de Barthel (IB) e a National Institute of Health Stroke Scale (NIHSS) versadas em português, em 51 indivíduos com acidente vascular cerebral, estimando a concordância entre resultados de diferentes examinadores. Utilizamos os coeficientes de concordância Kappa e Coeficiente de Correlação Intraclasse. A ER teve coeficientes moderados, substanciais ou excelentes. No IB estes foram substanciais ou excelentes nos totais e nos itens, assim como quando foi estratificado em agrupamentos prognósticos e funcionais. A NIHSS apresentou coeficientes excelentes nos totais, substanciais nos itens e moderados e excelentes nas estratificações em grupos de pontos e de itens afins. Estes resultados indicam que as versões em português da ER, o IB e a NIHSS apresentam adequada confiabilidade.
Autonomic seizures and autonomic status epilepticus in early onset benign childhood occipital epilepsy (Panayiotopoulos syndrome)
Authors: Tedrus Gloria Maria Almeida Souza , Fonseca Lineu Corrêa
Published: October 2006

To study clinical and EEG features of children with ictal vomiting and no underlying brain lesions (Panayiotopoulos syndrome). The subjects were 36 children aged 2-13 years. The onset of seizures occurred between 1 and 5 years of age. Fourteen children (38.8%) had a single seizure. Fourteen children (38.8%) had autonomic status epilepticus. Impairment of consciousness was reported in 30 (83.3%) children, eye deviation in 10 (27.7%) other autonomic symptoms and head deviation in 9, generalization in 8, visual symptoms in one child, and, speech arrest or hemifacial motor symptoms in 8 cases. The EEG showed occipital spikes or spike-wave complexes in 27 (75.0%) children, blocked by opening of the eyes in 8 (22.2%) cases. Nine patients (25%) also had rolandic spikes and 3 had extraoccipital spikes. Six (16.6%) patients had normal EEG. No clinical differences were observed between patients having occipital or extraoccipital spikes. In children only with autonomic seizures, the spikes are predominantly occipital but blockage by opening of the eyes is a less frequent feature. In some children there is an overlapping of different focal childhood idiopathic syndromes.
Structural brain abnormalities in early-onset schizophrenia
Authors: Ferrari Maria Cristina Lombardo , Kimura Luci , Nita Luciana M. , Elkis Hélio
Published: October 2006

BACKGROUND: Few studies investigated brain abnormalities in early onset schizophrenia. OBJECTIVE: To assess computed tomography (CT) abnormalities in patients with childhood or adolescence onset schizophrenia. Method: CT scans of patients with childhood (6 to 11 years old) (N=6) or adolescence (12-17 years old) (N=9) schizophrenia were compared to normal controls. Patients were diagnosed based on the DSM-III-R criteria. Ventricular enlargement was measured by the Ventricle to Brain Ratio (VBR) and Cortical Atrophy (pre-frontal prominence) was measured by the Pre-Frontal Atrophy Index (PFAI). RESULTS: There was a significant difference in VBR, but not in PFAI, between subjects and controls [8.26±2.79, and 5.71±3.26 (p=0.029)], and [2.72±1.77, and 3.21±1.53 (p=0.424)], respectively. There were no differences of VBR and PFAI between children and adolescents with schizophrenia. CONCLUSION: Compared to controls, patients with child or adolescent onset schizophrenia exhibit more pronounced ventricular enlargement. There were no differences regarding prefrontal atrophy.
Carpal tunnel syndrome and manual milking: nerve conduction studies in 43 cases
Authors: Kouyoumdjian João Aris , Araújo Rogério Gayer Machado de
Published: October 2006

From 1989 to 2004, 3125 consecutive patients had electrodiagnosis of carpal tunnel syndrome (CTS); from these 43 cases (1.38%) were associated to manual milking; mean age was 44.9 years and 88.4% were male. The mean time in the milking profession was 247 months; the mean daily milking time was 146 minutes; symptoms referred at electrodiagnostic consultation had lasted on average 34 months, 83% were bilateral. The median sensory nerve conduction study was abnormal in 75.6% to the right and 66.7% to the left hand. The median nerve motor distal latency (MDL) was abnormal in 92.1% to the right and in 80.0% to the left hand. There were no differences between right and left for all electrophysiological parameters. In CTS related to manual milking most cases were men, with the MDL more affected than the sensory distal latencies and the electrophysiological abnormalities were found to be symmetric. Manual milking could be a natural model for occupational CTS. In contrast to idiopathic CTS, there was a greater involvement of motor fascicles; this finding is remarkable for CTS.
Failed back surgery syndrome: casuistic and etiology
Authors: Rodrigues Flávio Freinkel , Dozza Diego Cassol , Oliveira Claudio Russio de , Castro Ricardo Gomes de
Published: October 2006

OBJECTIVE: To report our data of cases of failed back surgery syndrome (FBSS) and surgical and nonsurgical etiologies. METHOD: The medical charts of 121 patients submitted to laminectomy, hemilaminectomy combined with discectomy and/or foraminotomy between January 1997 and October 2004 in the Instituto of Neurologia Deolindo Couto were reviewed. The inclusion criterion was does not improve or the symptoms return after the surgery and with a minimum of three medical consultations with adequate investigation for the diagnosis. The patients had been divided in three main pre-surgical diagnosis: herniated disc, lumbar stenosis and the association of these. RESULTS: From the 121 patients submitted to spine surgical intervention, 47 (38.8%) had presented criteria for the FBSS. Among the 26 patients who had presented operative diagnosis of lumbar stenosis, 8 (30.7%) had presented FBSS; of the 83 with disc herniation, 31 (37.3%) had the syndrome; and the 12 patients with lumbar stenosis associated with disc herniation, 7 (58.3%) had failure of the back surgery. CONCLUSION: The failure of back surgery remains a challenge for the surgeons. There is an incessant search for the causes and the action mechanisms of this syndrome and the best method of treatment.
C1 lateral mass screws for posterior segmental stabilization of the upper cervical spine and a new method of three-point rigid fixation of the C1-C2 complex
Authors: Vilela Marcelo D. , Jermani Charles , Braga Bruno P.
Published: October 2006

OBJECTIVE: To describe our experience with C1 lateral mass screws as part of a construct for C1-2 stabilization and report an alternate method of C1-C2 complex three-point fixation. METHOD: All patients that had at least one screw placed in the lateral mass of C1 as part of a construct for stabilization of the C1-C2 complex entered this study. In selected patients who had a higher chance of nonunion an alternate construct was used: transarticular C1-C2 screws combined with C1 lateral mass screws. RESULTS: Twenty-one C1 lateral mass screws were placed in 11 patients. In three patients the alternate construct was used. All patients had a demonstrable solid and stable fusion on follow-up. CONCLUSION: C1 lateral mass screws are safe and provide immediate stability. The use of C1-C2 transarticular screws combined with C1 lateral mass screws is a feasible and also an excellent alternative for a three-point fixation of the C1-C2 complex.
Transcription analysis of TIMP-1 and NM23-h1 genes in glioma cell invasion
Authors: Nasser José Augusto , Falavigna Asdrúbal , Ferraz Fernando , Duigou Gregory , Bruce Jeffrey
Published: October 2006

PURPOSE: To evaluate using transcription analysis the presence and importance of two genes: NM23-H1 and TIMP-1 on control of tumor cell invasion in diffuse astrocytomas (WHO II) and glioblastoma multiforme (WHO IV). METHOD: Northern blot analysis of NM23-H1 and TIMP-1 was performed. Eight diffuse astrocytomas and 19 glioblastomas (WHO IV) were analyzed to determine if TIMP-1 and NM23-H1 were candidates to inhibition of tumor cell invasion quantitated RNA levels. The samples were collected directly from operating room. Total cellular RNA was extracted from frozen tissue samples using guanidinium-isothiocyanate and cesium chloride gradients. Total RNA (10 mg per sample) from tumor tissue were size fractionated through 1% agarose-formaldehyde gel and transferred to nylon filters and then hybridized to 32P-labeled DNA probes and placed for autoradiography. Levels of specific RNAs were determined by computer-assisted laser densitometry. Blot filters were sequentially hybridized to nm23 and TIMP-1 probes in addition to GAPDH, as a control. Statistical analyses were carried out according to t-test for equality of means. RESULTS: NM23-H1 were detected in each sample, however it did not correlate with malignancy and invasiveness. On the other side TIMP-1 gene expression showed a clear correlation between low expression and invasiveness. CONCLUSION: The data suggest that TIMP-1 is an inhibitor of high grade gliomas invasion. NM23-H1 was present in the entire gliomas sample, but it did not vary in diffuse astrocytomas and glioblastomas.
Classificação das fraturas tóraco-lombares baseada em investigação por imagem: avaliação de 33 casos
Authors: Rios Gleyson M. , Martins Roberto S. , Zanon-Colange Nelci , Santos Marco T.S. dos , Souza Rafael W. de , Moraes Osmar J.S.
Published: October 2006

As fraturas das regiões torácica e lombar da coluna vertebral constituem amplo espectro de diferentes tipos de lesões resultantes de mecanismos fisiopatológicos distintos. A fim de se reduzir as controvérsias existentes a respeito da conduta destas lesões é necessária a utilização de uma classificação que permita a sua correta caracterização. Neste estudo avaliamos retrospectivamente 33 pacientes portadores de fraturas tóraco-lombares com o objetivo de categorizar e avaliar os fatores relacionados a esta patologia. O mecanismo de trauma mais freqüente foi queda de altura, presente em 24 casos. Na maioria dos pacientes (57,6%) as fraturas localizaram-se na transição tóraco-lombar (T12-L1) e o quadro neurológico mais freqüente foi o déficit sensitivo-motor completo abaixo da lesão, em 45,45% dos casos. A apresentação neurológica foi mais grave nos pacientes com lesões torácicas em relação às lesões lombares (teste de Fischer, p=0,039). Uma correlação positiva foi observada entre a severidade do quadro neurológico e a gravidade da lesão segundo a classificação de Magerl (r de Pearson=0,85, p<0,001). Concluímos que as fraturas tóraco-lombares são lesões graves considerando a apresentação neurológica inicial e que é necessária a utilização de uma classificação ampla e adequada como a utilizada no presente estudo.
Craniectomia descompressiva para tratamento da hipertensão intracraniana traumática em crianças e adolescentes: análise de sete casos
Authors: Faleiro Rodrigo Moreira , Faleiro Luiz Carlos Mendes , Oliveira Marcelo Magaldi , Silva Tiago , Caetano Elisa Costa , Gomide Isabela , Pita Cristina Carneiro , Lopes Gustavo , Gusmão Sebastião
Published: October 2006

INTRODUÇÃO: A craniectomia descompressiva (CD) é técnica utilizada para tratamento da hipertensão intracraniana (HIC) pós-traumática. Sua indicação ainda não está bem definida na população pediátrica. OBJETIVO: Relatar a utilização desta técnica em sete casos pediátricos. MÉTODO: Estudo retrospectivo de sete pacientes (2 a 17 anos) que receberam CD unilateral para tratamento de HIC. Todos tiveram monitorização pós-operatória da pressão intracraniana (PIC) e a CD foi classificada em ultra-precoce (<6h), precoce (6-12h) e tardia (>24h) de acordo com o seu tempo de realização após o trauma. O seguimento mínimo foi seis meses. RESULTADOS: Os pacientes foram seguidos por tomografia e quadro clínico, sendo classificados de acordo com a Escala de Outcome de Glasgow (GOS). Três pacientes faleceram (GOS1), um estava em estado vegetativo (GOS2), dois com déficit neurológico moderado (GOS3 e 4) e um com reabilitação funcional completa (GOS5) à época da alta hospitalar. Após período mínimo de seis meses, o paciente que estava em estado vegetativo e um dos que tinha déficit neurológico moderado melhoraram. Perdeu-se seguimento do paciente com alta em GOS4. Como complicação, ocorreram coleção subdural (2), hidrocefalia (1) e infecção superficial (1). Dos quatro que sobreviveram, dois receberam cranioplastia autóloga e os outros dois, heteróloga. CONCLUSÃO: A CD é método eficaz para redução da PIC, mas não é isenta de complicações. Sua aplicação ainda não está bem definida na população pediátrica, carecendo de estudos multicêntricos.
Avaliação plasmática de igf-1 no prolactinoma
Authors: Zylberberg Daniela , Naliato Erika C.O. , Sarmet Alair , Sato Eduardo , Costa Fernando S.R. , Violante Alice H.D.
Published: October 2006

Prolactinomas são os tumores hipofisários mais comuns, podendo co-secretar GH (hormônio do crescimento). IGF-1 (fator de crescimento insulina-símile-1) é o principal responsável pelas ações do GH e parâmetro diagnóstico de acromegalia. Objetivando determinar por uma dosagem de IGF-1, na avaliação inicial de pacientes com prolactinoma, ocorrência de tumores mistos [GH e prolactina (PRL)], estudamos 7 homens e 27 mulheres, entre 19 e 72 anos, confrontando-os aos resultados de GH basal e durante teste oral de tolerância à glicose, quando GH basal >0,4 ng/mL ou níveis de IGF-1 alterados. A proporção de pacientes com GH >0,4 ng/mL e IGF-1 elevada foi alta; mas, após administração de 75g de glicose por via oral, nenhum paciente foi diagnosticado como acromegálico. Sugerimos, porém que a dosagem de IGF-1 seja realizada pelo risco de co-secreção de GH nos prolactinomas. Atenção especial para pacientes que apresentem significativa diminuição dos níveis de PRL, sem correspondente regressão do tamanho do adenoma.
Co-evolução entre raças fisiológicas de colletotrichum lindemuthianum e feijoeiro
Authors: Chiorato Alisson Fernando , Carbonell Sergio Augusto Morais , Moura Rafaeli Ramos de , Ito Margarida Fumiko , Colombo Carlos Augusto
Published: October 2006

O agente causal da antracnose (Colletotrichum lindemuthianum) em feijoeiro comum é classificado, assim como seu hospedeiro, em Andino e Mesoamericano, sendo a resposta à infecção dependente da origem genética de um e de outro. Desta forma, o objetivo do presente trabalho foi avaliar 220 acessos do Banco de Germoplasma de feijoeiro (Phaseolus vulgaris) do Instituto Agronômico, IAC, quanto à infecção por três raças fisiológicas do patógeno (31, 65 e 89), caracterizando uma possível co-evolução entre a origem do acesso e do patógeno. No estudo, foram utilizados 120 acessos de origem mesoamericana, 57 andinos e 43 cultivares geneticamente melhoradas. Além dos dados relacionados à infecção, foram avaliados 23 descritores morfo-agronômicos com finalidade de melhor caracterizar os acessos em relação aos seus respectivos centros de origem. As análises estatísticas foram baseadas em componentes principais a fim de exibir graficamente a variabilidade em função da origem do patógeno e dos acessos. Dentre os acessos mesoamericanos, 50% foram suscetíveis às três raças, enquanto nos andinos apenas 33% foram suscetíveis. Entre as cultivares geneticamente melhoradas, 79% foram resistentes a pelo menos uma das raças, provavelmente devido a seleções para resistência ao C. lindemuthianum. Nos gráficos da análise de componentes principais, a maioria dos acessos resistentes foi agrupada na região de dispersão dos acessos andinos. Os resultados permitiram estabelecer uma associação entre a origem do feijoeiro e do patógeno da antracnose, ajudando assim no conhecimento biológico da reação dos acessos ao C. lindemuthianum e orientando a escolha de genitores para realização de cruzamentos visando à resistência a essa doença.