bluuebunny/crossref_metadata_2025 huggingface dataset:
An Anatomic Source of False Venous Reflux with Continuous Wave Doppler
Authors: TONG YISHA , ROYLE JOHN
Published: June 2013

background. The limitations of continuous wave (CW) Doppler have been recognized in the assessment of venous reflux since CW Doppler is not able to distinguish reflux signals from more than one vein. In our experience, some regions with venous reflux suggested by CW Doppler were noted to have no reflux in any individual vein during duplex studies.

objective. The aim of the study was to assess the anatomic source of the venous reflux suggested by CW Doppler but not confirmed by duplex ultrasound.

methods. Five hundred and fifty‐one consecutive lower limbs with primary or recurrent varicose veins were examined with CW Doppler and subsequently by color‐coded duplex ultrasound to assess the source of venous reflux.

results. The duplex ultrasound study revealed no reflux in 44 specific regions (8%) where reflux had been indicated by CW Doppler. Two types of anatomy were noted. Two or more superficial veins joined the deep venous system via a common junction in 25 cases. A descending vein joined the deep venous system in 19 cases.

conclusion. A bidirectional Doppler signal in a region of venous junction without any incompetent veins can be misinterpreted as venous reflux. A careful examination of veins not only at the region of the junction, but also at some distance down the stem of the vein is important during CW Doppler or duplex assessment.
Use of Nitrous Oxide in Hair Transplantation Surgery
Authors: SADICK NEIL S. , MILITANA CHARLES J.
Published: June 2013

A study of 400 hair transplants carried out in 200 patients using nitrous oxide as an inducing agent before instillation oflidocaine 1%/epinephrine 100,000 parts anesthesia is presented. Clinical efficacy, side effect profile, and toxicity profile are presented. Nitrous oxide is an excellent agent used for the preanesthetic induction phase of hair transplantation surgery.
Q‐switched Ruby Laser
Authors: LOWE NICHOLAS J. , LUFTMAN DEBRA , SAWCER DAVID
Published: June 2013

The Q‐switched ruby laser is effective in the treatment of amateur tattoos and other pigmented lesions. Previous studies have shown that, though amateur tattoos usually respond well, professional tattoos show greater resistance to clearing. Our study evaluates the treatment of 20 patients with 28 professional (blue, green, black) tattoos by a Q‐switched ruby laser with a 28‐ns pulse width, and using high energy fluences up to 10 J/cm2. Responses proved to be good to excellent among these patients, who needed fewer treatments than previously reported.
Sterilization of the Handengine
Authors: SHELTON RON M. , GREKIN ROY C.
Published: June 2013

background
: The risk of interpatient infection through a dermabrasion handpiece is not known, nor is there a published standard of handpiece maintenance.

objective
: To investigate the possibility of transferring material through the handpiece and evaluate the methods used by dermatologists to disinfect and/or sterilize dermabrasion equipment.

methods
: Handengines run while immersed in fluoresceindyed alcohol were observed for fluorescence. After dermabrasion of a fluorescein‐basted pig's foot the instrument was inspected. A survey of handpiece disinfection /sterilization procedures was sent to 114 members of the American Society for Dermatologic Surgery.

results
: Although material can be transmitted to the motor/handpiece through the chuck and vice versa, contamination of the instrument did not occur in a dermabrasion simulation. 58.7% of respondents sterilize the chuck and only 38.1% sterilize the motor/handpiece.

conclusions
S: No absolute requirement to sterilize the handengine is warranted. It is prudent however to sterilize the chuck in a steam autoclave and gas sterilize the motor/handpiece to eliminate the rare possibility of cross‐contamination.
Nontufted Incisional Slit Grafting
Authors: HUGENECK JÖRG , KOKOTT REINHARD , WAGNER KARL‐HEINZ , PRAWETZ‐MOSER CLAUDIA
Published: June 2013

background. The nontufted incisional slit grafting method described here is a decisively modified technique in the field of hair transplantation.

objective. Traditional techniques of incisional slit grafting have the risk to produce a tufted look due to compression from the sides when the grafts are placed in the incision.

methods and results. Our specific method of dissection of the donor hair creates very small flat grafts that are the same shape as the recipient sites and includes trimming the epidermis and a part of the dermis. The advantage of this technique is that there is no compression on the grafts and thus it results in a diminished tufted look.

conclusion. With this technique it is possible to transplant more than 2000 grafts in one session, meaning that patients with extreme baldness and a relatively small fringe of hair can become hairy in an aesthically pleasing way due to the extremely economic redistribution of the donor hair.
Digital Photoplethysmography and Light Reflection Rheography
Authors: VERAART JOEP C. J. M. , VAN DER KLEY A. M. JOOST , NEUMANN H. A. MARTINO
Published: June 2013

background. Light reflection rheography (LRR) is appropriate for the global assessment of calf‐pump insufficiency regardless of whether it is caused by varicosity, the post‐phlebitic syndrome, or deep venous thrombosis. The instrument has been increasingly used by many phlebologists. Digital photoplethysmography (D‐PPG) is a further development of this well‐established LRR. With this D‐PPG instrument it is possible, in contrast to LRR, to calibrate the reflected light.

objective and methods. To compare the venous refilling times of both the LRR and the D‐PPG when measured at the same time on the same leg. We also evaluated the practical use of both instruments. In total we performed 152 simultaneous measurements with both instruments.

results. We found a statistically significant correlation when we compared the venous refilling time of both LRR and D‐PPG (r = .664; P < .001). The observed agreement between both instruments for detecting a disturbed venous refilling time (≤ 25 seconds) is 92%.

conclusion. Both instruments seems to correlate as has been shown in this and other studies. The D‐PPG has the advantage of being more handy. Futhermore the reflected light is calibrated, which enables to compare intra‐ and interindividual measurements.
Standardizing Chemical Peel Solution Formulations to Avoid Mishaps
Authors: BRIDENSTINE JAMES B. , DOLEZAL JAMES F.
Published: June 2013

background. Chemical peeling using trichloroacetic acid (TCA) is a populär and long utilized procedure in dermatology and cosmetic surgery.

objective. To determine the actual concentration of TCA infour disparate methods of preparation of Solutions, expressed in the Standard pharmaceutical method of weight to volume (wt/vol).

methods. Method I was wt/vol, method H was weight to weight (wt/wt), method III was grams of TCA added to 100 cc water, and method IV was the usage of saturated TCA, and calling it 100%, then making appropriate dilutions. The amounts of TCA in each Solution for methods II, III, and IV were converted, by calculation, to the wt/vol method.

results. The relative concentrations of TCA, ranked by the wt/vol pharmaceutical Standard, showed that from strongest to weakest: method IV > method II > method I > method III.

conclusions. Tremendous variations were found in the relative concentrations of TCA in these Solutions. To avoid mishaps and complications, the wt/vol method should be used.
Dermatologic Surgery of the Hand: General Principles and Avoiding Complications
Authors: ROHRER THOMAS E. , LESLIE BRUCE , GRANDE DONALD J.
Published: June 2013

Dermatologists and dermatologic surgeons are frequently presented with significant pathology of the hand. Because the hand plays such a unique and important role in man's everyday life, preservation and restoration of its form and function is critical. The hand is both powerful and extremely delicate. Before performing any procedures in this area, dermatologists and dermatologic surgeons must have a clear understanding of the cutaneous and deep anatomy of the hand and digits, as well as a thorough knowledge of the disease process being treated and the modality being used. This article reviews the intricate anatomy, the proper he‐mostasis and anesthesia, and many of the complications seen in dermatologic surgery and procedures of the hand, digits, and nails. With appropriate preoperative evaluation and precautions, many dermatologic procedures may be safely performed on the hand.

LEARNING OBJECTIVES. After studying the following article, participant should be able to:

Understand the anatomy of the hand.

Show an awareness of complications that can result from hand surgery.

Utilize principles that will permit aesthetic hand reconstruction.
Mycoplasma gallisepticum and Escherichia coli mixed infection model in broiler chickens for studying valnemulin pharmacokinetics
Authors: Xiao X. , Zhao D. H. , Yang X. , Shi W. , Deng H. , Ma J. , Zhang S. , Liu Y. H.
Published: June 2013

A Mycoplasma gallisepticum–Escherichia coli mixed infection model was developed in broiler chickens, which was applied to pharmacokinetics of valnemulin in the present experiment. The velogenic M. gallisepticum standard strain S6 was rejuvenated to establish the animal model, and the wild E. coli strain O78 was injected as supplementary inoculum to induce chronic respiratory disease in chickens. The disease model was evaluated based on its clinical signs, histopathological examination, bacteriological assay, and serum plate agglutination test. The pharmacokinetics of valnemulin in infected chickens was determined by intramuscular (i.m.) injection and oral administration (per os, p.o.) of a single dose of 10 mg/kg body weight (BW). Plasma samples were analyzed by liquid chromatography–tandem mass spectrometry. The plasma concentration–time curve of valnemulin was analyzed using the noncompartmental method. After the i.m. administration, the mean values of Cmax, Tmax, AUClast, MRT, CLβ/F, Vz/F, and t1⁄2β, were 27.94 μg/mL, 1.57 h, 171.63 μg·h/mL, 4.51 h, 0.06 L/h/kg, 0.56 L/kg, and 6.50 h, respectively. By contrast, the corresponding values after p.o. administration were 5.93 μg/mL, 7.14 h, 47.60 μg·h/mL, 9.80 h, 0.22 L/h/kg, 3.35 L/kg, and 10.60 h. The disposition of valnemulin was retarded in infected chickens after both modes of extravascular administration as compared to the healthy controls. More attention should be given to monitoring the therapeutic efficacy and adverse effects of mixed infection because of higher required plasma drug concentration and enlarged AUC with valnemulin treatment.
Civil forfeiture and Article 6 of the ECHR: due process implications for England & Wales and Ireland
Authors: King Colin
Published: June 2013

Civil forfeiture is playing an increasingly prominent role in the fight against organised crime. While this tool is attractive to law enforcement agencies, it does give rise to concerns under Art 6 of the ECHR. Such proceedings ought to attract the full range of enhanced procedural protections inherent in the criminal process. Even if the Strasbourg Court decides otherwise, there is an argument that the presumption of innocence ought to apply where civil forfeiture proceedings are instituted against a person subsequent to that person being acquitted in criminal proceedings. The Strasbourg jurisprudence, though, is permeated by confusion and inconsistency, which does not inspire confidence that the rights of the individual will be protected. The final section of this paper, then, considers whether civil forfeiture represents a proportionate response in the fight against organised crime. Ultimately, though, given lack of information on such crime, we cannot provide an answer either way – what can be said, though, is that civil forfeiture has had a significant impact on the rights of the individual.
Quantification of collagen and elastic fibers using whole‐slide images of liver biopsy specimens
Authors: Abe Tokiya , Hashiguchi Akinori , Yamazaki Ken , Ebinuma Hirotoshi , Saito Hidetsugu , Kumada Hiromitsu , Izumi Namiki , Masaki Naohiko , Sakamoto Michiie
Published: June 2013

Histological evaluation of fibrosis after a liver biopsy is crucial for evaluating the pathology of patients with chronic liver disease. Previous studies have reported quantitative analyses of fibrosis using images of collagen‐stained sections. However, analysis of these studies requires manual selection of the region of interest. In addition, the quantification of elastic fibers is not considered. The present study was conducted in order to measure both the collagen and elastic fiber area ratios using Elastica van Gieson‐stained whole‐slide images (WSIs) of liver biopsy specimens. High‐resolution WSIs provide precise color classification, enabling accurate detection of even fine collagen and elastic fibers. To minimize the influence of pre‐existing fibrous tissue, median area ratios of the collagen and elastic fibers were independently calculated from the image tiles of the WSIs. These median area ratios were highly concordant with area ratios after the pre‐existing fibrous tissues were manually trimmed from the WSI. Further, these median area ratios were correlated with liver stiffness as measured by transient elastography (collagen: r = 0.73 [P < 0.01], elastic: r = 0.53 [P < 0.01]). Our approach to quantifying liver fibrosis will serve as an effective tool to evaluate liver diseases in routine practice.
Late reaction times identify MCI
Authors: Fernaeus Sven‐Erik , Östberg Per , Wahlund Lars‐Olof
Published: June 2013

A group of 172 mild cognitive impairment (MCI) patients and 79 healthy control participants (HC) were tested on simple reaction time (SRT). There was a significant difference between MCI and HC in mean SRT. The test could be partitioned into five segments of 16 trials each, but RT's were not always available for each partition. However, scores from each segment for 166 MCI and 41 of the HC's were available. These data showed that a significant interaction between RT‐partition and diagnostic category was the main source of the difference between groups. The interaction indicated that MCI patients performed at about the same level as HC in the initial three of the five segments of the test, but were significantly impaired during the last two segments of the 80 trials. The results were interpreted as impaired sustained attention among a large part of the MCI group, and the study shows the importance of taking into account all avaliable data resulting from this type of test.
Pretense of parentage by siblings in immigration: Polesky's paradox reconsidered
Authors: Wenk Robert E. , Shao Alison
Published: June 2013

Background

Older and younger siblings occasionally attempt to impersonate parent and child to expedite immigration under US family‐based visa policies. The rate with which full siblings escape detection by current relationship tests is unknown.

Study Design and Methods

Retrospective study of full‐sibling immigrant pairs was undertaken to determine the proportion that show insufficient genetic evidence to exclude parentage. Sibship and parentage indices (SI and PI) were compared/case in unexcluded sibling cases and true parent–child cases. Alleles shared per short‐tandem‐repeat locus were compared in sibling and parent–child pairs. The proportion of successful parentage fraud by siblings was estimated from the parentage exclusion rate among immigrants and the proportion of sibships without genetic inconsistencies (GIs).

Results

When 11 to 25 independent loci were tested per two‐sibling case to verify or refute parentage, tests failed to demonstrate any GI in 9% and PI was greater than SI in seven of 10 of these cases. Another 29% of full‐sibling pairs demonstrated insufficient evidence (fewer than two GIs) to exclude parentage. Thus, 0.4% of sibling pairs could falsely claim a parent–child relationship and show no GIs. Another 1.4% could make that false claim and not present sufficient evidence to be excluded.

Conclusion

At present, with no evidence of parentage exclusion in a full‐sibling pair, the relative magnitudes of PI and SI are misleading relationship indicators because too few loci are examined and rates of sharing one and two alleles/locus vary greatly in parentage and sibling pairs. Only evidence of exclusion ascertains false parentage claims by siblings. Nevertheless, the expected rate of successful fraud is quite low.
Stability and etching of titanium oxynitride films in hydrogen microwave plasma
Authors: Do Hien , Yen Tzu-Chun , Chang Li
Published: June 2013

Epitaxial titanium oxynitride (TiNO) films deposited on MgO by pulsed laser deposition were treated in hydrogen microwave plasma. Scanning electron microscopy and x-ray photoelectron spectroscopy were used to examine the stability and etching of TiNO which strongly depended on hydrogen gas pressure. TiNO was very chemically stable and remained with good crystallinity under hydrogen pressure below 5300 Pa. With increase of pressure, it may lead to the formation of etch pits in inverse pyramid shape. The etch mechanism as well as the effects of gas pressure and etching time are also presented.
Improving the calibration of radiochromic films by the use of uncertainties in optical density and dose
Authors: Garcia Luis Isaac Ramos , Azorin José Fernando Pérez
Published: June 2013

Purpose:

To compare how the inclusion of the uncertainties in dose and optical density affects the results of the calibration of Gafchromic®EBT3 radiochromic films.

Methods:

Five methods of least square minimization were compared for calibration of radiochromic films. These differed in the way in which the uncertainties of dose and optical density are taken into account. The comparison was made by simulating the calibration fit at an increasing number of points measured in the calibration table and in the gamma analysis of ten real IMRT verifications.

Results:

According to the results of the simulations, the methods that take into account all the variability in dose and optical density are superior to those that do not use them. The improvements are reflected in lower bias of the parameters, lower variability and faster convergence when the number of the points increases in the calibration table. When these methods are employed in the gamma analysis comparison, the statistical significance of the results depends on how restrictive the parameters are that define this comparison.

Conclusions:

Methods that take into account all the variability both in dose and in optical density should be used in the calibration process.
Iranian 'Medical' Reactor Stokes Search for Alternatives
Authors: Stone Richard
Published: June 2013

A new report lays out alternatives for producing medical isotopes that avoid uranium and plutonium—an intriguing topic for negotiations over Iran's nuclear program and the ultimate fate of the IR-40 heavy water reactor slated to start operating next year.
Visual Analysis of DNA Microarray Data for Accurate Molecular Identification of Non-albicans Candida Isolates from Patients with Candidemia Episodes
Authors: De Luca Ferrari Michela , Ribeiro Resende Mariângela , Sakai Kanae , Muraosa Yasunori , Lyra Luzia , Gonoi Tohru , Mikami Yuzuru , Tominaga Kenichiro , Kamei Katsuhiko , Zaninelli Schreiber Angelica , Trabasso Plinio , Moretti Maria Luiza
Published: June 2013

The performance of a visual slide-based DNA microarray for the identification of non-
albicans Candida
spp. was evaluated. Among 167 isolates that had previously been identified by Vitek 2, the agreement between DNA microarray and sequencing results was 97.6%. This DNA microarray platform showed excellent performance.
ON CONJUGACY CLASS SIZES AND CHARACTER DEGREES OF FINITE GROUPS
Authors: QIAN GUOHUA , WANG YANMING
Published: June 2013

Let p be a fixed prime, G a finite group and P a Sylow p-subgroup of G. The main results of this paper are as follows:

(1) If gcd (p-1, |G|) = 1 and p2 does not divide |xG| for any p′-element x of prime power order, then G is a solvable p-nilpotent group and a Sylow p-subgroup of G/Op(G) is elementary abelian.

(2) Suppose that G is p-solvable. If pp-1 does not divide |xG| for any element x of prime power order, then the p-length of G is at most one.

(3) Suppose that G is p-solvable. If pp-1 does not divide χ(1) for any χ ∈ Irr (G), then both the p-length and p′-length of G are at most 2.
ANTIOXIDANT ACTIVITY OF AMINOTHIAZOL HYDROXYCOUMARIN DERIVATIVES
Authors: FARMANZADEH DAVOOD , NAJAFI MEYSAM
Published: June 2013

In this work, the antioxidant properties of the series of 10 aminothiazol hydroxyl coumarin derivatives have been investigated with DFT/B3LYP method. For these antioxidants all reaction enthalpies related to HAT, SPLET, SET-PT mechanisms were calculated in the gas phase and polar solvents. Based on calculated reaction enthalpies (BDE, IP and PA values) the derivations 2, 3 and 4 have the highest antioxidant activity among the studied compounds. Calculated results show that derivations 7, 5 and 6 have the lowest antioxidant activity. The observed theoretical trends for antioxidant activities of studied compounds were similar to trends of previous experimental studies that OH50, TAC50, IC50, CE50 values have been used as a benchmark for measuring the antioxidant properties of these compounds. These results can be useful in synthesis of novel aminothiazol hydroxycoumarin derivatives with high antioxidant activity. Calculated results show that BDE, PA and IP values of studied derivations have linear dependence with structure parameters such as R( O – H ), q( O ) and EHOMO. These observed linear dependences can be useful in synthesis of novel aminothiazol hydroxyl coumarin derivatives with high antioxidant activity. For studied compounds, results indicated that the SPLET and HAT mechanisms represent the thermodynamically preferred mechanism both, in solvent and the gas phase.
HOW TO BETTER IDENTIFY AND MEASURE R&D IN SERVICES: CONSTRAINTS IN BRAZILIAN HOSPITALS
Authors: BOHRER CARIZA TEIXEIRA , DE VARGAS EDUARDO RAUPP
Published: June 2013

This paper proposes a reflection to induce a better understanding of R&D in services, based on case studies carried out in Brazilian University Hospitals (UHs). The results show that the generation and increase of the stock of knowledge in services go beyond those reported in the material component. We also found that a diversity of actors contributed in an informal way to these dynamics. Concerning R&D funding, we noticed that service R&D is not always planned through a formal project. Then we suggested expanded R&D indicators which seems to contribute to the improvement of statistics related to R&D in services.
Combined Catalysis and Optical Screening for High Throughput Discovery of Solar Fuels Catalysts
Authors: Gregoire John M , Xiang ChengXiang , Mitrovic Slobodan , Liu XiaoNao , Marcin Marty , Cornell Earl W , Fan Jie , Jin Jian
Published: June 2013

Considerable research and development efforts are being devoted to the efficient generation of solar fuels. A solar fuels device couples a solar photoabsorber with catalysts to convert solar energy to chemical energy via reactions such as oxygen evolution (water splitting). Widespread deployment of this technology hinges upon discovery of new materials through efforts such as the high throughput screening of oxygen evolution catalysts, as discussed in this manuscript. We derive an expression for the efficiency of the oxygen evolution catalyst that combines catalytic and optical properties. Using this hybrid efficiency, we screen 5456 samples in a (Fe-Co-Ni-Ti)Ox pseudo-quaternary catalyst library using automated, high throughput electrochemistry and optical experiments. The observed compositional trends in this catalyst efficiency lead to the discovery of a new high performance composition region.
Acute inhibition of the cystic fibrosis transmembrane conductance regulator (CFTR) Cl− channel by thyroid hormones involves multiple mechanisms
Authors: Cai Zhiwei , Li Hongyu , Chen Jeng-Haur , Sheppard David N.
Published: June 2013

The chemical structures of the thyroid hormones triiodothyronine (T3) and thyroxine (T4) resemble those of small-molecules that inhibit the cystic fibrosis transmembrane conductance regulator (CFTR) Cl− channel. We therefore tested the acute effects of T3, T4 and reverse T3 (rT3) on recombinant wild-type human CFTR using the patch-clamp technique. When added directly to the intracellular solution bathing excised membrane patches, T3, T4, and rT3 (all tested at 50 μM) inhibited CFTR in several ways: they strongly reduced CFTR open probability by impeding channel opening; they moderately decreased single-channel current amplitude, and they promoted transitions to subconductance states. To investigate the mechanism of CFTR inhibition, we studied T3. T3 (50 μM) had multiple effects on CFTR gating kinetics, suggestive of both allosteric inhibition and open-channel blockade. Channel inhibition by T3 was weakly voltage dependent and stronger than the allosteric inhibitor genistein, but weaker than the open-channel blocker glibenclamide. Raising the intracellular ATP concentration abrogated T3 inhibition of CFTR gating, but not the reduction in single-channel current amplitude nor the transitions to subconductance states. The decrease in single-channel current amplitude was relieved by membrane depolarization, but not the transitions to subconductance states. We conclude that T3 has complex effects on CFTR consistent with both allosteric inhibition and open-channel blockade. Our results suggest that there are multiple allosteric mechanisms of CFTR inhibition, including interference with ATP-dependent channel gating and obstruction of conformational changes that gate the CFTR pore. CFTR inhibition by thyroid hormones has implications for the development of innovative small-molecule CFTR inhibitors.
Recent Advances in Particulate Matter and Nanoparticle Toxicology: A Review of theIn VivoandIn VitroStudies
Authors: Nemmar Abderrahim , Holme Jørn A. , Rosas Irma , Schwarze Per E. , Alfaro-Moreno Ernesto
Published: June 2013

Epidemiological and clinical studies have linked exposure to particulate matter (PM) to adverse health effects, which may be registered as increased mortality and morbidity from various cardiopulmonary diseases. Despite the evidence relating PM to health effects, the physiological, cellular, and molecular mechanisms causing such effects are still not fully characterized. Two main approaches are used to elucidate the mechanisms of toxicity. One is the use ofin vivoexperimental models, where various effects of PM on respiratory, cardiovascular, and nervous systems can be evaluated. To more closely examine the molecular and cellular mechanisms behind the different physiological effects, the use of variousin vitromodels has proven to be valuable. In the present review, we discuss the current advances on the toxicology of particulate matter and nanoparticles based on these techniques.
A Cough Deteriorating Gross Hematuria: A Clinical Sign of a Forthcoming Life-Threatening Rupture of an Intraparenchymal Aneurysm of Renal Artery (Wunderlich's Syndrome)
Authors: Anastasiou Ioannis , Katafigiotis Ioannis , Pournaras Christos , Fragkiadis Evangelos , Leotsakos Ioannis , Mitropoulos Dionysios , Constantinides Constantinos A.
Published: June 2013

Macroscopic hematuria regards the 4% to 20% of all urological visits. Renal artery aneurysms (RAAs) are detected in approximately 0.01%–1% of the general population, while intraparenchymal renal artery aneurysms (IPRAAs) are even more rarely detected in less than 10% of patients with RAAs. We present a case of a 58-year-old woman that came into the emergency room (ER) complaining of a gross hematuria during the last four days. Although in the ER room the first urine sample was clear after a cough episode, a severe gross hematuria began which led to a hemodynamically unstable patient. Finally, a radical nephrectomy was performed, and an IPRAA was the final diagnosis. A cough deteriorating hematuria could be attributed to a ruptured intraparenchymal renal artery aneurysm, which even though constitutes a rare entity, it is a life-threatening medical emergency.
Effect of Fluorometholone/Tetrahydrozoline Fixed Combination on Conjunctival Autograft Morphology after Primary Pterygium Excision
Authors: Ozgurhan Engin Bilge , Kara Necip , Bozkurt Ercument , Gencer Baran , Agca Alper , Alkin Zeynep , Demirok Ahmet
Published: June 2013

Purpose.To evaluate the effect of a fluorometholone/tetrahydrozoline fixed combination on conjunctival graft morphology after primary pterygium excision.Methods.The patients who underwent pterygium excision with conjunctival autograft transplantation were randomized into three groups based on postoperative medications as the fluorometholone/tetrahydrozoline group, fluorometholone group, and dexamethasone group. Conjunctival graft thickness was measured with anterior segment optical coherence tomography. The conjunctival graft hyperemia was evaluated using a high definition external camera.Results.The mean graft thickness was significantly lower in the fluorometholone/tetrahydrozoline group compared with fluorometholone and dexamethasone groups at 2 weeks (P=0.002andP=0.012, resp.) and at 1 month after surgery (P=0.003andP=0.013, resp.). The conjunctival hyperemia score was significantly lower in the fluorometholone/tetrahydrozoline group compared with fluorometholone and dexamethasone groups at 2 weeks (P=0.000andP=0.000, resp.) and at 1 month (P=0.039andP=0.040, resp.). The graft thickness and conjunctival hyperemia score were similar among the groups at 1 week and 3 months (P>0.05).Conclusion.The findings of the present study revealed that treatment with the fluorometholone/tetrahydrozoline fixed combination may be helpful to decrease graft edema and to achieve better cosmetic appearance at 2 weeks and 1 month after pterygium excision.
Amino-Functionalization of Multiwall Carbon Nanotubes and Its Use for Solid Phase Extraction of Mercury Ions from Fish Sample
Authors: Soleimani Majid , Ghahraman Afshar Majid , Sedghi Arman
Published: June 2013

We describe here the amino-functionalization of multiwall carbon nanotubes (MWCNTs) and also its application as an adsorbent of solid phase extraction (SPE). The amino-functionalized MWCNTs have a good capacity to retain Hg2+, but the raw and purified MWCNTs are found not to adsorb Hg2+ ions. The amino-functionalized MWCNTs are prepared with amino-functionalization of purified MWCNTs by ethylenediamine. The physicochemical properties of purified and amino-functionalized MWCNTs are characterized by Fourier transform infrared spectroscopy, thermogravimetric analysis, and the Boehm titration. The amino-functionalized MWCNTs are selected as novel sorbents for the solid phase extraction of Hg2+. The amino-functionalized MWCNT-SPE method is used for the determination of Hg2+ from complex matrix including fish and real water samples. Effective parameters on Hg2+ retention such as pH, flowrate, nature of the eluent, the ionic strength, selectivity coefficient, and retention capacity are investigated. The enrichment factor and maximum capacity of the sorbent are 100 mL and 11.58 mg/g, respectively. The linear range, limit of detection, and relative standard deviation of the proposed method are 0.003 to 0.3 μg/L, 1.25×10−3 μg/L, and 2.23%, respectively. Selectivity experiments show that the adsorbents have a stronger specific retention for Hg2+ than Fe3+, Cu2+, Pb2+, Ni2+, Mn2+, Ca2+, and Mg2+.
Coronary Arteriovenous Fistula Secondary to Percutaneous Coronary Intervention of Chronic Total Occlusion
Authors: Narasimhan Seshasayee
Published: June 2013

This is a case report of a 61-year-old female presenting with ongoing chest pain in the setting of an NSTEMI with lateral ST-T changes. On attempting to open the left circumflex (LCX), it resulted in a proximal LCX dissection. The patient remained stable with no further chest pain. She was treated with IV Eptifibatide for 48 hours and restudied in 72 hours. Repeat coronary angiography showed a marginally improved proximal dissection plane with a coronary AV fistula. She was managed conservatively and discharged with a non-invasive assessment in 8 weeks. The patient had a negative stress echocardiogram and was managed with maximal medical therapy.
Failure of Urological Implants in Spinal Cord Injury Patients due to Infection, Malfunction, and Implants Becoming Obsolete due to Medical Progress and Age-Related Changes in Human Body Making Implant Futile: Report of Three Cases
Authors: Vaidyanathan Subramanian , Soni Bakul , Singh Gurpreet , Hughes Peter , Selmi Fahed , Mansour Paul
Published: June 2013

Any new clinical data, whether positive or negative, generated about a medical device should be published because health professionals should know which devices do not work, as well as those which do. We report three spinal cord injury patients in whom urological implants failed to work. In the first, paraplegic, patient, a sacral anterior root stimulator failed to produce erection, and a drug delivery system for intracavernosal administration of vasoactive drugs was therefore implanted; however, this implant never functioned (and, furthermore, such penile drug delivery systems to produce erection had effectively become obsolete following the advent of phosphodiesterase type 5 inhibitors). Subsequently, the sacral anterior root stimulator developed a malfunction and the patient therefore learned to perform self-catheterisation. In the second patient, also paraplegic, an artificial urinary sphincter was implanted but the patient developed a postoperative sacral pressure sore. Eight months later, a suprapubic cystostomy was performed as urethral catheterisation was very difficult. The pressure sore had not healed completely even after five years. In the third case, a sacral anterior root stimulator was implanted in a tetraplegic patient in whom, after five years, a penile sheath could not be fitted because of penile retraction. This patient was therefore established on urethral catheter drainage. Later, infection withStaphylococcus aureusaround the receiver block necessitated its removal. In conclusion, spinal cord injury patients are at risk of developing pressure sores, wound infections, malfunction of implants, and the inability to use implants because of age-related changes, as well as running the risk of their implants becoming obsolete due to advances in medicine. Some surgical procedures such as dorsal rhizotomy are irreversible. Alternative treatments such as intermittent catheterisations may be less damaging than bladder stimulator in the long term.
The Social Attribution Task-Multiple Choice (SAT-MC): A Psychometric and Equivalence Study of an Alternate Form
Authors: Johannesen Jason K. , Lurie Jessica B. , Fiszdon Joanna M. , Bell Morris D.
Published: June 2013

The Social Attribution Task-Multiple Choice (SAT-MC) uses a 64-second video of geometric shapes set in motion to portray themes of social relatedness and intentions. Considered a test of “Theory of Mind,” the SAT-MC assesses implicit social attribution formation while reducing verbal and basic cognitive demands required of other common measures. We present a comparability analysis of the SAT-MC and the new SAT-MC-II, an alternate form created for repeat testing, in a university sample (n=92). Score distributions and patterns of association with external validation measures were nearly identical between the two forms, with convergent and discriminant validity supported by association with affect recognition ability and lack of association with basic visual reasoning. Internal consistency of the SAT-MC-II was superior (alpha = .81) to the SAT-MC (alpha = .56). Results support the use of SAT-MC and new SAT-MC-II as equivalent test forms. Demonstrating relatively higher association to social cognitive than basic cognitive abilities, the SAT-MC may provide enhanced sensitivity as an outcome measure of social cognitive intervention trials.
A Simple Assay to Screen Antimicrobial Compounds Potentiating the Activity of Current Antibiotics
Authors: Iqbal Junaid , Siddiqui Ruqaiyyah , Kazmi Shahana Urooj , Khan Naveed Ahmed
Published: June 2013

Antibiotic resistance continues to pose a significant problem in the management of bacterial infections, despite advances in antimicrobial chemotherapy and supportive care. Here, we suggest a simple, inexpensive, and easy-to-perform assay to screen antimicrobial compounds from natural products or synthetic chemical libraries for their potential to work in tandem with the available antibiotics against multiple drug-resistant bacteria. The aqueous extract ofJuglans regiatree bark was tested against representative multiple drug-resistant bacteria in the aforementioned assay to determine whether it potentiates the activity of selected antibiotics. The aqueous extract ofJ. regiabark was added to Mueller-Hinton agar, followed by a lawn of multiple drug-resistant bacteria,Salmonella typhior enteropathogenicE. coli. Next, filter paper discs impregnated with different classes of antibiotics were placed on the agar surface. Bacteria incubated with extract or antibiotics alone were used as controls. The results showed a significant increase (>30%) in the zone of inhibition around the aztreonam, cefuroxime, and ampicillin discs compared with bacteria incubated with the antibiotics/extract alone. In conclusion, our assay is able to detect either synergistic or additive action ofJ. regiaextract against multiple drug-resistant bacteria when tested with a range of antibiotics.
Common Witness “in Christ”: Peregrinations through Mission and Migration
Authors: Wild-Wood Emma
Published: June 2013

Abstract

The study of Mission and Migration has developed rapidly in recent years. This article aims to scope the field by examining a variety of trajectories from different disciplines and by suggesting ways in which enquiries may be furthered. It examines contemporary missiological thought, insights from the New Testament and comprehensions of diaspora, of belonging and of pilgrimage, providing diverse examples. It suggests pursuing a spirituality of radical hospitality and a methodology that widens the term of sociological enquiry. The focus of this wide-ranging collection of interlocking themes is provided by the exploration of common witness in Christ. The reflections on identity and on academic enquiry indicate why multi-ethnic witness to Christ, in a globalised era of mass migration, proves difficult to achieve. It uses the “is” provided by social science as a springboard for the “ought” of biblical and missiological vision.
Design and validation of an intelligent wheelchair towards a clinically-functional outcome
Authors: Boucher Patrice , Atrash Amin , Kelouwani Sousso , Honoré Wormser , Nguyen Hai , Villemure Julien , Routhier François , Cohen Paul , Demers Louise , Forget Robert , Pineau Joelle
Published: June 2013

Background

Many people with mobility impairments, who require the use of powered wheelchairs, have difficulty completing basic maneuvering tasks during their activities of daily living (ADL). In order to provide assistance to this population, robotic and intelligent system technologies have been used to design an intelligent powered wheelchair (IPW). This paper provides a comprehensive overview of the design and validation of the IPW.

Methods

The main contributions of this work are three-fold. First, we present a software architecture for robot navigation and control in constrained spaces. Second, we describe a decision-theoretic approach for achieving robust speech-based control of the intelligent wheelchair. Third, we present an evaluation protocol motivated by a meaningful clinical outcome, in the form of the Robotic Wheelchair Skills Test (RWST). This allows us to perform a thorough characterization of the performance and safety of the system, involving 17 test subjects (8 non-PW users, 9 regular PW users), 32 complete RWST sessions, 25 total hours of testing, and 9 kilometers of total running distance.

Results

User tests with the RWST show that the navigation architecture reduced collisions by more than 60% compared to other recent intelligent wheelchair platforms. On the tasks of the RWST, we measured an average decrease of 4% in performance score and 3% in safety score (not statistically significant), compared to the scores obtained with conventional driving model. This analysis was performed with regular users that had over 6 years of wheelchair driving experience, compared to approximately one half-hour of training with the autonomous mode.

Conclusions

The platform tested in these experiments is among the most experimentally validated robotic wheelchairs in realistic contexts. The results establish that proficient powered wheelchair users can achieve the same level of performance with the intelligent command mode, as with the conventional command mode.
Long-term outcome of patients with active ankylosing spondylitis with etanercept-sustained efficacy and safety after seven years
Authors: Baraliakos Xenofon , Haibel Hildrun , Fritz Claudia , Listing Joachim , Heldmann Frank , Braun Juergen , Sieper Joachim
Published: June 2013

Introduction

Data from clinical studies on the long-term efficacy and safety of anti-tumor necrosis factor (TNF)-α therapy in patients with ankylosing spondylitis (AS) are scarce. This is the first report on continuous treatment with the TNFα fusion protein etanercept over seven years (y).

Methods

Overall, 26 patients with active AS were initially treated with etanercept 2 × 25 mg s.c./week with no concomitant disease modifying anti-rheumatic drugs (DMARDs) or steroids. The clinical response was assessed by standardized parameters. The primary outcome was the proportion of patients in the Spondyloarthritis International Society (ASAS) partial remission at seven years. AS disease activity scores (ASDAS) for status and improvement were compared to conventional outcome measures.

Results

Overall, 21/26 patients (81%) completed two years of treatment and 16/26 patients (62%) completed seven years. In the completer analysis, 31% patients were in ASAS partial remission at seven years, while 44% patients showed an ASDAS inactive disease status. Mean Bath AS activity index (BASDAI) scores, which were elevated at baseline (6.3 ± 0.9), showed constant improvement and remained low: 3.1 ± 2.5 at two years and 2.5 ± 2.2 at seven years, while ASDAS also improved (3.9 ± 0.7 at baseline, 1.8 ± 0.9 at two years, 1.6 ± 0.8 at seven years), all P <0.001. From the 10 dropouts, only 5 patients discontinued treatment due to adverse events. Patients who completed the study had lower baseline Bath AS function index (BASFI) scores vs. patients who discontinued. No other clinical parameter at baseline could predict any long-term outcome.

Conclusions

This study confirms the clinical efficacy and safety of etanercept in patients with active AS over seven years of continuous treatment. After seven years, more than half of the initially treated patients remained on anti-TNF therapy, and one-third were in partial remission.

Trial Registration

ClinicalTrials.gov: NCT01289743
Impact of arterial load on the agreement between pulse pressure analysis and esophageal Doppler
Authors: Monge García Manuel Ignacio , Gracia Romero Manuel , Gil Cano Anselmo , Rhodes Andrew , Grounds Robert Michael , Cecconi Maurizio
Published: June 2013

Introduction

The reliability of pulse pressure analysis to estimate cardiac output is known to be affected by arterial load changes. However, the contribution of each aspect of arterial load could be substantially different. In this study, we evaluated the agreement of eight non-commercial algorithms of pulse pressure analysis for estimating cardiac output (PPCO) with esophageal Doppler cardiac output (EDCO) during acute changes of arterial load. In addition, we aimed to determine the optimal arterial load parameter that could detect a clinically significant difference between PPCO and the EDCO.

Methods

We included mechanically ventilated patients monitored with a prototype esophageal Doppler (CardioQ-Combi™, Deltex Medical, Chichester, UK) and an indwelling arterial catheter who received a fluid challenge or in whom the vasoactive medication was introduced or modified. Initial calibration of PPCO was made with the baseline value of EDCO. We evaluated several aspects of arterial load: total systemic vascular resistance (TSVR = mean arterial pressure [MAP]/EDCO * 80), net arterial compliance (C = EDCO-derived stroke volume/pulse pressure), and effective arterial elastance (Ea = 0.9 * systolic blood pressure/EDCO-derived stroke volume). We compared CO values with Bland-Altman analysis, four-quadrant plot and a modified polar plot (with least significant change analysis).

Results

A total of 16,964-paired measurements in 53 patients were performed (median 271; interquartile range: 180-415). Agreement of all PPCO algorithms with EDCO was significantly affected by changes in arterial load, although the impact was more pronounced during changes in vasopressor therapy. When looking at different parameters of arterial load, the predictive abilities of Ea and C were superior to TSVR and MAP changes to detect a PPCO-EDCO discrepancy ≥ 10% in all PPCO algorithms. An absolute Ea change > 8.9 ± 1.7% was associated with a PPCO-EDCO discrepancy ≥ 10% in most algorithms.

Conclusions

Changes in arterial load profoundly affected the agreement of PPCO and EDCO, although the contribution of each aspect of arterial load to the PPCO-EDCO discrepancies was significantly different. Changes in Ea and C mainly determined PPCO-EDCO discrepancy.
The peripheral perfusion index and transcutaneous oxygen challenge test are predictive of mortality in septic patients after resuscitation
Authors: He Huai-wu , Liu Da-wei , Long Yun , Wang Xiao-ting
Published: June 2013

Introduction

The peripheral perfusion index (PI) is a noninvasive numerical value of peripheral perfusion, and the transcutaneous oxygen challenge test (OCT) is defined as the degree of transcutaneous partial pressure of oxygen (PtcO2) response to 1.0 FiO2. The value of noninvasive monitoring peripheral perfusion to predict outcome remains to be established in septic patients after resuscitation. Moreover, the prognostic value of PI has not been investigated in septic patients.

Methods

Forty-six septic patients, who were receiving PiCCO-Plus cardiac output monitoring, were included in the study group. Twenty stable postoperative patients were studied as a control group. All the patients inspired 1.0 of FiO2 for 10 minutes during the OCT. Global hemodynamic variables, traditional metabolic variables, PI and OCT related-variables were measured simultaneously at 24 hours after PiCCO catheter insertion. We obtained the 10min-OCT ((PtcO2 after 10 minutes on inspired 1.0 oxygen) - (baseline PtcO2)), and the oxygen challenge index ((10min-OCT)/(PaO2 on inspired 1.0 oxygen - baseline PaO2)) during the OCT.

Results

The PI was significantly correlated with baseline PtcO2, 10min-OCT and oxygen challenge index (OCI) in all the patients. The control group had a higher baseline PtcO2, 10min-OCT and PI than the septic shock group. In the sepsis group, the macro hemodynamic parameters and ScvO2 showed no differences between survivors and nonsurvivors. The nonsurvivors had a significantly lower PI, 10min-OCT and OCI, and higher arterial lactate level. The PI, 10min-OCT and OCI predicted the ICU mortality with an accuracy that was similar to arterial lactate level. A PI <0.2 and a 10min-OCT <66mmHg were related to poor outcome after resuscitation.

Conclusions

The PI and OCT are predictive of mortality for septic patients after resuscitation. Further investigations are required to determine whether the correction of an impaired level of peripheral perfusion may improve the outcome of septic shock patients.