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[ [ "two recent studies in bmc evolutionary biology on the effects of inbreeding in a seed beetle ( bilde et al . ) and in drosophila ( vermeulen et al . ) , respectively , provide additional insight into the genetic factors involved .", "differences in life span between males and females are commonly observed across many species . for example , where the heterogametic sex ( xy sex chromosomes ) is male , as in humans and drosophila , females tend to live longer than males .", "taken together , all these data suggest that the genetic differences between males and females have a significant effect upon aging and life span .", "genetic and environmental interventions that affect life span tend to have a greater effect in one sex than the other .", "for example , quantitative trait loci ( qtls ) that affect life span are often sex - specific or sex - biased in drosophila , mice and humans , and studies over the past few years show strikingly different effects of inbreeding in male versus female insects .", "quantitative genetic analyses have revealed a different genetic architecture of life span in males versus females .", "in contrast , in most bird species , where the heterogametic sex is female ( zw sex chromosomes ) , males tend to live longer than females ." ], [ "several possible and potentially overlapping genetic mechanisms have been suggested to explain differences in life span between genders , including asymmetric inheritance of sex chromosomes , differences in physiology , maternal effects , and sex - specific selective pressures .", ", the genetic differences between male and female zygotes must underlie aspects of the sex - specific effects of maternal products on life span .", "consistent with this idea , maternal effects on life span are greater in males than females for certain species such as the seed beetle .", "one possibility is that because maternal - effect gene products are being produced by a female genome , they may be more optimized for female offspring , thereby contributing to the reduced life span often observed in males .", "these deleterious recessive mutations could lead to decreased life span , affecting males more than females .", "the maternal effect may also contribute to differences in life span between males and female ." ], [ "finding mechanisms that explain the difference in life span between males and females is hindered by our lack of understanding of the basic mechanisms of aging and underlying causes of mortality .", "of course , this result does not rule out an important role for maternal products in modulating life span , but it does show that they are not the direct targets of the observed inbreeding effects .", "one possible explanation for the decrease in female life span is that inbreeding led to homozygosity of recessive alleles that are deleterious for female lifespan , providing support for the unprotected x hypothesis .", "suggest that the increase in male life span might be due to changes in energy - intensive behaviors , such as a reduction in courtship or aggression , thereby leading to longer life span .", "however , this hypothesis can not account for the increase in life span observed in males .", "have examined the effects of inbreeding on male and female life span in the species callosobruchus maculatus ." ], [ "sex - specific differences in genetic architecture could contribute to the observed differences in life span and the effects of inbreeding .", "future studies may be directed toward further study of the underlying differences in genetic architecture between males and females , in particular , testing the idea that deleterious alleles affecting life span may be more exposed to selection in males than in females due to reduced non - additive effects in males , thereby reducing inbreeding load for male - specific deleterious alleles in the population .", "sex - specific selective pressures that result in higher male reproductive fitness may contribute to sexual dimorphism of life span .", "given that additive variation responds to selection more quickly , because additive variation does not involve interactions of multiple loci , sex - specific differences in selection could underlie aspects of sexual dimorphism in life span observed in many species .", "for example , a recent study examined how evolution shapes variation in transcript abundance in male and female drosophila , and sex - specific differences in the mode of transcriptome inheritance were identified . in males ,", "for example , costly male - biased metabolism or behaviors , such as aggression or specific courtship behaviors , might be positively selected for , but could result in decreased life - span in males relative to females ." ], [ "we thank sergey nuzhdin for helpful discussions . this work was supported by grants from the department of health and human services to jt ( 1r01ag011833 ) and to ma ( 1r01gm073039 ) ." ] ]

[ [ "the present study was an attempt to assess the usefulness of serum pct as a marker of sepsis in critically ill patients , using the semi - quantitative , rapid immunochromatographic kit , in apollo hospitals , bangalore .", "sepsis can be difficult to distinguish from non - infectious conditions in critically ill or comatose patients in the early stages ; and diagnosis , treatment and outcomes greatly differ between patients with and without sepsis .", "positive bacteriological cultures , including blood cultures , may not be available before 24 to 48 hours ; interpretation of local colonization may be ambiguous ; and traditional markers of infection , such as body temperature and white blood cell ( wbc ) count , may not be specific . furthermore , there are concerns about possible blood culture negative clinical sepsis , particularly in the setting of increased prophylactic and empirical antibiotic use .", "sepsis is crucial for patient management , an effective marker specific for bacterial infection is very useful in the critical care settings .", "pct has been proposed as an indicator of the presence of infection and as a useful marker of the severity of sepsis .", "conversely , differentiating true infection from contamination after growth of common skin commensals in blood cultures , poses a diagnostic problem . since early identification of infections and" ], [ "the result was independently read by two microbiologists to minimize reading bias and interpreted as per the manufacturer 's recommendations : \n i)pct > 10 ng / ml : severe bacterial sepsis or septic shockii)pct 2 to 10 ng / ml : severe systemic inflammatory response , most likely due to sepsis unless other causes are knowniii)pct 0.5 to 2 ng / ml : a systemic infection can not be excludediv)pct < 0.5 ng / ml : local bacterial infection possible ; sepsis unlikely \n pct > 10 ng / ml : severe bacterial sepsis or septic shock pct 2 to 10 ng / ml : severe systemic inflammatory response , most likely due to sepsis unless other causes are known pct 0.5 to 2 ng / ml : a systemic infection can not be excluded pct < 0.5 ng / ml : local bacterial infection possible ; sepsis unlikely the clinical condition , signs and symptoms of sepsis , antibiotics used , blood culture and final outcome of patients were recorded for all patients .", "the study included patients from the intensive care unit ( icu ) with suspected sepsis .", "this study was carried out from july 2007 to june 2008 in the department of microbiology , apollo hospitals , bangalore .", "of sepsis cases 100 and specificity being pct positives / total no . of cases without sepsis", "( sepsis , severe sepsis , septic shock ) or no sepsis based on the accp ( american college of chest physicians ) recommendations .", "serum pct was assayed semi - quantitatively by rapid immunochromatographic technique using a commercially available test kit ( pct - q , b.r.a.h.m.s ." ], [ "sensitivity and specificity of the pct assay were analyzed using two different cut - off values for pct ( 0.5 ng / ml and 2 ng / ml ) ; sensitivity being pct positives / total no . of sepsis cases", "statistical analysis was carried out using chi - square test to evaluate the correlation between pct levels and sepsis ." ], [ "relation of serum pct levels with sepsis , number of patients ( blood cultures ; mortality )", "serum pct cut - offs of 0.5 ng / ml and 2 ng / ml were analyzed separately for their sensitivity and specificity as biomarkers for sepsis among the 21 patients with sepsis and 19 patients without sepsis .", "two patients ( post - myomectomy hypertrophic obstructive cardiomyopathy and acute myocardial infarction ) with positive blood cultures ( s. epidermidis and s. haemolyticus ) were concluded to have cardiogenic shock and not septic shock , as they responded well to inotropic support . in 1 of them , antibiotics were given additionally , considering his postoperative status ( single - vessel stenting done 3 days prior to pct testing ) . in this cohort , in a patient with a differential diagnosis of food botulism , a low pct assisted in excluding an infective aetiology , and the patient was subsequently diagnosed as having acute oculobulbar syndrome . in 8 out of the 9 fatal cases ,", "of the 18 patients with pct < 0.5 ng / ml , only 2 patients with bronchopneumonia had evidence of sepsis ." ], [ "the aim of this study was to assess the usefulness of serum pct as a marker of sepsis in critically ill patients in our hospital .", "early identification of infection and sepsis in critically ill patients is a challenge for clinicians .", "however , most studies have found superiority of pct in comparison to crp as a marker of infection and sepsis ." ], [ "the pct assay was found to be a promising biomarker of sepsis in this small exploratory study and provided valuable and early information before the culture results were available .", "pct assay might assist in avoiding unwarranted antibiotic usage in critically ill patients who present with symptoms similar to those in infective conditions .", "the semi - quantitative , rapid assay revealed moderate sensitivity ( 86% ) and high specificity ( 95% ) at a cut - off above 2 ng / ml .", "however , the assay result must be interpreted in association with the clinical findings and other laboratory parameters ." ] ]

[ [ "we used monthly reports of slide - confirmed malaria and annual census based population data from 434 counties ( municpios ) in the brazilian amazon region for 19961999 , during which no coordinated national malaria interventions occurred ( 12 ) . to study the relationship of reported malaria cases to climate , we used monthly precipitation and temperature from the cru ts 2.1 gridded climate data set for selected states ( 13 ) ( figure 1 ) . to consider how the precipitation malaria relationship depends on surface water conditions ,", "the relationships between precipitation and malaria incidence in the amazon basin are spatially varied and change signs , depending on the region .", "malaria incidence per 1,000 population ( black lines ) and mean monthly precipitation ( blue lines ) during la nia ( orange bars ) and el nio ( red bars ) events for the states of a ) amazonas , b ) mato grosso , and c ) roraima ." ], [ "our evidence suggests that precipitation drives malaria risk in the amazon basin , but the relationship varies in the uplands ( more precipitation , more / less malaria ) and is negative in areas dominated by wetlands and large rivers ( more precipitation , less malaria ) .", "our findings show the need to account for local landscape characteristics , especially the extent of wetlands and open water , in regional to global projections of the effects of climate change on malaria .", "better understanding the impact of climate and landscape on malaria will improve our ability to assess health risks .", "our results suggest that monthly precipitation along the amazon basin can have both strong positive and negative associations with malaria incidence .", "studies have proposed that flooding created new pools of water suitable for mosquito larvae as the water levels slowly receded from alluvial forests along the rio branco river in roraima and the maroni river on the frontiers of suriname and french guiana ( 6,15 ) .", "further research is needed to address the limitations of our study , including its short time frame and the crude countywide approximation of percentage wetlands as an exposure ." ] ]

[ [ "the clavicle is a rare site for bone tumours . according to the world health organisation", ", the giant cell tumor is an aggressive potentially malignant lesion which means that its evolution based on histological features is unpredictable .", "sites commonly affected by giant cell tumour are proximal tibia , distal femur and distal radius .", "the oncologic patterns of clavicle resemble that of flat bones and not other long bones . among tumors of clavicle ," ], [ "a 60 year old man presented to our department with pain and swelling over lateral end of left clavicle ( fig . 1 , fig .", "we got a plain radiograph which revealed which an expansile radiolucent lesion arising from lateral end of left clavicle ( fig .", "the excised mass was sent for histopathological examination which also confirmed it to be a giant cell tumor .", "the patient was happy with the surgical outcome and at 1 year follow up there was no evidence of recurrence or metastasis .", "since the clavicle does not necessary require reconstruction and the patient was a retired school teacher , not engaged in any physical work so surgical resection of the tumor was planned .", "4 ) . to aid in the diagnosis fine needle aspiration cytology was done which revealed a predominantly cellular lesion having sheets of plump , oval mononuclear cells with mild pleomorphism ." ], [ "the differential diagnosis of giant cell tumor of clavicle which pose a diagnostic challenge both for the surgeon and the histopathologist are primary aneurysmal bone cyst , non ossifying fibroma.eosiniphilic granuloma and tuberculous osteomyelitis .", ". primary bone tumors of the clavicle are more likely to be malignant than benign , and amongst these tumors which occur in clavicle , giant cell tumor is a rare entity .", "it was found that there are very few case reports describing giant cell tumors of clavicle , , . due to the paucity of the available literature" ], [ "the clavicle is a rare site for bone tumors and shares its oncological behavior with that of flat bones rather than long bones .", "we have reported this case to emphasize the fact any expansile lytic lesion occurring in the lateral end of clavicle should be taken seriously and the diagnosis can be easily missed both clinically and radiographically if the clinician is not aware of the wide array of differential diagnosis which range from an infectious etiology like tuberulous osteomyelitis to a neoplastic etiology like giant cell tumour .", "there seems to be a difference in opinion regarding functional outcome after claviculectomy for tumour like lesions of clavicle and our case report further highlights the fact the claviculectomy without any reconstruction seems to be a good option with no disability noted in long term ." ], [], [], [ "since it is a single case report involving a single subject and we are not reporting the first case of this type in the literature , hence no approval was taken from the relevant ethics committee but written informed consent was taken from the patient to publish his details and clinical photographs ." ], [ "a copy of the written consent is available for review by the editor - in - chief of this journal on request .", "written informed consent was obtained from the patient for publication of this case report and accompanying images ." ], [ "ak , kk and js contributed to the development of protocol and edited the manuscript ." ], [] ]

[ [ "the aetiology of the development of pathological gambling in parkinson 's disease is still unclear , however , research suggests an association with dopamine replacement therapy , specifically with dopamine agonists ( voon et al . , 2006 ;", "this review summarizes evidence in this field of research attempting to reveal the relationship between parkinson therapy and pathological gambling , discusses the reasons why some patients react on them differently than others , what the relevant risk factors are and considers how impulsivity may contribute to the development of gambling symptoms .", "pathological gambling is defined in the current classification system of the world health organization ( 1992 ) ( icd10 ) as an impulse control disorder ( icd ) which causes excessive , uncontrollable gambling despite financial losses and social problems , while the latest version of the diagnostic and statistical manual ( dsm5 ) of the american psychiatric association ( 2013 ) grouped pathological gambling together with substancerelated and addictive disorders and renamed it to gambling disorder . despite this aetiological debate , in parkinson 's patients", "it has been observed that pathological gambling occurs more frequently ( 3.46.1% ) than in the general population ( 0.252% ) , alongside with icds , such as binge eating , so called hypersexuality and compulsive shopping ( cox et al . , 2005 ; avanzi et al . , 2006 ; grosset et al . , 2006 ; voon et al . , 2006 ;", "weintraub et al . , 2006 ; gallagher et al . , 2007 ) .", "bondolfi et al . , 2008 ; weintraub et al . , 2010 ; santangelo et al . ," ], [ "( 2007 ) found that these patients are younger , earned a higher score in tests investigating noveltyseeking and impulsive behaviour , and were more likely to have a personal or family history of alcohol abuse .", "parkinson 's disease is rather similar : young age , male sex , impulsivity , noveltyseeking , smoking and alcoholism are also considered risk factors for pathological gambling in the general population ( johansson et al . , 2009 ) .", "being male and smoking in the past also seem to be risk factors ( gallagher et al .", ", 2007 ; valena et al . , 2013 ) . in this respect , pathological gambling with and without", "observing the progress of their disease , in comparison to other parkinson 's patients , those who later develop pathological gambling tend to have an earlier onset of the illness and also suffer more frequently from manic or hypomanic episodes during the onperiod of dopaminergic medication ( voon et al . , 2007 ) ." ], [ "even in the first case reports about parkinson 's patients developing pathological gambling , a clear correlation has been observed with the initiation or dose escalation of dopaminergic medication ( molina et al . , 2000 ;", "recent research also shows a strong effect of aripiprazole , prescribed for the treatment of mood disorders and schizophrenia , with stronger gamblingrelated cognition in comparison to other dopamine agonists ( grallbronnec et al . , 2016 ) .", "main results of studies on the association of pathological gambling with parkinson 's disease therapy bis , barratt impulsivity scale ; da , dopamine agonists ; icd , impulse control disorder ; igt , iowa gambling task ; ledd , ldopa equivalent daily dose ; pd , parkinson 's disease ; pg , pathological gambling ; stn dbs , subthalamic nucleus deep brain stimulation .", "further , subthalamic nucleus deep brain stimulation ( stn dbs ) has a controversial role in the development of pathological gambling in parkinson 's disease .", "seedat et al . , 2000 ) . in further studies comparing the effect of different parkinson 's therapies , dopamine agonists emerged as the medication with the strongest association with the development of pathological gambling ( voon et al . , 2006 ; weintraub et al . , 2006 , 2010 ;", "2009 ) . as impulsivity is considered as a risk factor for developing pathological gambling in parkinson patients ( voon et al . , 2007 ) , the contentious effects of stn dbs raise questions about the role of impulsivity in the development of gambling behaviour in general ( table 1 ) ." ], [ "2006 ) . to analyse the genetic susceptibility of parkinson 's patients with pathological gambling , several genes have been examined that are relevant for the function of the mesolimbic reward system . the most obvious genes to investigate are the dopamine receptor genes , which could be affected by dopaminergic medications .", "these research findings suggest that an underlying genetic susceptibility might facilitate the development of pathological gambling in parkinson 's patients .", "altogether , these results and the observed connection to dopaminergic medication described above suggest that the vulnerability of parkinson patients towards pathological gambling may be triggered by dopamine agonists .", "the fact that not all parkinson 's patients develop medicationassociated impulse control disorders or pathological gambling and that most of the patients solely developed pathological gambling under dopaminergic medication suggests an underlying genetic vulnerability mechanism ( voon et al . ,", "the homozygote genotype of a single nucleotide mutation ( p.s9 g ) of the drd3 gene has been shown to have a higher frequency in pathological gamblers with parkinson 's disease ( lee et al . , 2009 ) .", "however , the number of tandem repeats of a 48bp region in the drd4 gene is associated with pathological gambling , substance abuse and impulsivity , with discordant results of what number of repeats is relevant ( de castro et al . , 1997 ; comings et al . , 1999" ], [ "the results showed that during the economic decisionmaking task , lowfrequency oscillations synchronize in the subthalamic nucleus .", "( 2013 ) studied the function of the subthalamic nucleus by capturing local field potentials ( lfp ) in parkinson 's patients with and without pathological gambling on medication during an economic task .", "the results of this experiment underline the role of the subthalamic nucleus in decisionmaking and might also explain why symptoms of pathological gambling resolve in some parkinson patients after stn dbs surgery .", "( 2008 ) compared the blood perfusion of different brain regions in parkinson 's patients with pathological gambling with patients who only have parkinson 's disease and a control group in a spect imaging study in a resting condition .", "neuronal activity during loss and gain anticipation and loss avoidance have not been researched yet in parkinson 's patients with pathological gambling ." ], [ "( 2007 ) compared two groups of patients with parkinson 's disease with a control group , assessing their learning ability in a probabilistic prediction task and their performance in a conflictbased decision task .", "one of the groups of parkinson 's patients was treated with dopaminergic medication , the other group with stn dbs and lowdose dopaminergic therapy .", "altogether , more research is needed for clarification of the effects of stn dbs . on the other hand , the results of those studies comparing the effect of stn dbs and dopamine agonist medication support the theory that parkinson 's patients with pathological gambling show impaired learning mechanisms modulated by dopamine agonists .", "these findings question the causal relationship between high impulsivity and pathological gambling in parkinson 's patients .", "as described above , impulsive behaviour is considered to be a general risk factor for developing pathological gambling in patients with parkinson 's disease ( voon et al ." ], [ "several genetic and neurofunctional findings suggest that individual differences in dopaminergic neurotransmission in the ventral striatum and associated brain areas contribute to pathological gambling in parkinson 's disease , and indicate complex interactions between such risk factors . taken together ,", ". however , most of the studies performed in parkinson 's patients with pathological gambling are retrospective or crosssectional research , which makes the analysis of potentially causal factors more difficult .", "for example , in crosssectional studies , impulsivity seems to be an important risk factor ( voon et al . , 2007 ) ; however , these findings are not fully consistent with the results of experimental studies on the effects of dbs of the stn . prospective or longitudinal studies could broaden the perspective on the role of potential risk factors , that is , impulsivity or impaired learning . despite the obstacles in conducting such studies , the results of this research can play a crucial role in understanding the development of pathological gambling and icds not only in parkinson 's patients but also in the general population .", "altered learning processes in parkinson 's patients with pathological gambling appear to include increased baseline blood perfusion of mesolimbic brain areas , increased activation by reward and reduced activation by punishment in those brain areas , which are implicated in reinforcement learning ( schultz , 2002 ) , impulsivity ( horn et al . , 2003 ) , addiction ( kalivas & volkow , 2005 ) and pathological gambling ( romanczukseiferth et al . , 2015 )" ], [] ]

[ [ "suicide is one of the leading causes of death throughout the world ; it ranks among the top 10 causes of death for individuals of all ages and is the leading cause of death in males under 35 years old.1,2 a decrease in the concentrations of serotonin metabolites ( in particular the serotonin 5-hydroxyindoleacetic ) in patients with suicide behavior ( suicide attempt and suicide ) suggests that the serotonergic system is associated with suicide behavior.3,4 studies have consistently proposed that genes of the serotonergic system could play an important role in suicide.5,6 for example , in sh - sy5y cells , the administration of human interferon - alpha modifies the htr2c mrna editing , and this could be a mechanism of drug - induced depression or suicidal side effects in humans.7,8 it has also been proposed that the serotonin receptor 2c ( htr2c ) gene9,10 contributes to suicide behavior.11 the htr2c belongs to the family of 5-ht2 receptors , which has three members : 5-ht2a , 5-ht2b , and 5-ht2c.1 the gene that encodes the htr2c is located on the long arm of the x chromosome at position 24 ; and it contains six exons and five introns , spanning at least 230 kb.12 one of the most common variants of the htr2c is the cys23ser ( rs6318 ) , which is a functional polymorphism ( c / g at position 68 ) that results in the substitution of cysteine for serine at position 23 of the n - terminal extracellular domain.2,13,14 in the last few years , several authors have reported an association between the htr2c polymorphism and suicidal behavior.15 furthermore , in analyses performed by gender , a negative association has been observed between the htr2c polymorphism and suicidal behavior.14,16 other polymorphisms of htr2c that also have been studied in suicide behavior are rs547536 , rs2192372 , rs2428707 , and rs4272555;14 however , no association has been established in several populations . therefore , the association between the htr2c gene remains controversial , given that the available case ", "the objective of this work was to analyze the association by gender between five genetic variants of htr2c gene , rs547536 , rs2192372 , rs6318 , rs2428707 , and rs4272555 , and suicide attempt in a mexican population .", "control studies have obtained both positive and negative findings.1315,1620 in addition , to date , the relationship between the htr2c gene and suicide behavior in the mexican population has not yet been studied . as the htr2c gene is located on chromosome x ," ], [ "a total of 187 unrelated patients , of whom 110 ( 58.8% ) were females and 77 ( 41.2% ) were males who had attempted suicide , were included in this study .", "we defined suicide attempt as a self - harm behavior with at least some intent to end one s life .", "we want to emphasize that all the individuals in this study were exclusively from comalcalco and had parents and grandparents of mexican origin so as to reduce ethnic variation and stratification effects .", "all the individuals ( suicide patients and healthy subjects ) were evaluated by trained psychiatrists or clinical psychologists with a master s degree as the minimum education level . for all of them , the lifetime diagnoses were determined using the diagnostic and statistical manual of mental disorders fourth edition ( dsm - iv ) criteria following appropriate interviews ( structured clinical interview for dsm - iv [ scid ] i and ii).21 the suicide patients were classified in one of the following psychiatric diagnoses : schizophrenia spectrum disorders n=32 ( 17.1% ) , mood disorders n=59 ( 31.5% ) , stress - related disorders n=73 ( 39.0% ) , and substance - related disorders 23 ( 12.4% ) . written informed consent was obtained from all subjects after the procedures had been fully explained to them .", "we also included 223 healthy subjects as controls ( 146 females [ 65.5% ] , 77 males [ 34.5% ] ) who were recruited from the blood donor center at the same hospital .", "we selected five single - nucleotide polymorphisms ( snps ) of the htr2c gene found in the promotor and introns of the gene ( table 1 ) .", "the subjects were recruited from the outpatient service of the general hospital of comalcalco in the state of tabasco , mexico ." ], [ "all the individuals ( suicide patients and healthy subjects ) were evaluated by trained psychiatrists or clinical psychologists with a master s degree as the minimum education level . for all of them , the lifetime diagnoses were determined using the diagnostic and statistical manual of mental disorders fourth edition ( dsm - iv ) criteria following appropriate interviews ( structured clinical interview for dsm - iv [ scid ] i and ii).21 the suicide patients were classified in one of the following psychiatric diagnoses : schizophrenia spectrum disorders n=32 ( 17.1% ) , mood disorders n=59 ( 31.5% ) , stress - related disorders n=73 ( 39.0% ) , and substance - related disorders 23 ( 12.4% ) ." ], [ "the study was performed in compliance with the ethical standards of the 1964 declaration of helsinki .", "the study was approved by the local ethics and research committee of divisin acadmica multidisciplinaria de comalcalco ( damc)-universidad jurez autnoma de tabasco ( ujat ) ( ujat - damc-2012 - 02 ) .", "written informed consent was obtained from all subjects after the procedures had been fully explained to them ." ], [ "we selected five single - nucleotide polymorphisms ( snps ) of the htr2c gene found in the promotor and introns of the gene ( table 1 ) .", "genomic dna was isolated from whole blood samples using standard procedures that have been previously reported.9,22 genotyping of the htr2c variants rs547536 , rs2192372 , rs4272555 , rs6318 , and rs2428707 was performed using the taqman ( applied biosystems inc , foster city , ca , usa ) snp genotyping assay obtained from applied biosystems ." ], [ "random blind duplicates of up 30% of the samples were used as a quality control measure , and we obtained consistent results .", "finally , the haploview 4.2 ( broad institute , cambridge , ma , usa)23 was employed to calculate the linkage disequilibrium ( ld ) of the markers .", "then , and fisher s exact tests were used to compare the genotype and allele frequencies between cases and controls .", "first , the hardy weinberg equilibrium for the htr2c variants was determined using pearson s goodness of fit test . for female controls ,", "the genotype frequencies of rs6318 , rs2428707 , and rs4272555 did not deviate from hardy weinberg equilibrium ( p>0.05 ) ; however , the genotype frequencies of rs547536 and rs2192372 did deviate from hardy weinberg equilibrium ( p<0.05 ) ." ], [ "the g allele of the snp rs2428707 was associated with an increased risk of suicide attempt ( p=0.01 , odd ratio [ or ] = 3.68 , 95% confidence inrterval [ ci ] : 1.2410.90 ) , while the c allele of the snp rs4272555 was associated with a decreased risk of suicide attempt ( p=0.01 , or = 0.26 , 95% ci : 0.090.79 ) .", "the htr2c variants rs4272555 and rs2428707 were significantly associated with suicide attempt in this mexican population . in the female group ,", "we conducted a haplotype analysis of the same five markers and did not find a significant association between suicide attempt and any of the examined haplotypes ( p>0.01 , table 4 ) .", "the ld ( linkage disequilibrium ) in this mexican population was measured for all markers examined in this case control study ( rs547536 , rs2192372 , rs6318 , rs4272555 , and rs2428707 ) .", "table 3 shows the genotype and allele frequencies of the htr2c variants rs547536 , rs21923372 , rs6318 , rs2428707 , and rs4272555 in the suicide attempters and control groups ." ], [ "the g allele of the snp rs2428707 was associated with an increased risk of suicide attempt ( p=0.01 , odd ratio [ or ] = 3.68 , 95% confidence inrterval [ ci ] : 1.2410.90 ) , while the c allele of the snp rs4272555 was associated with a decreased risk of suicide attempt ( p=0.01 , or = 0.26 , 95% ci : 0.090.79 ) .", "the htr2c variants rs4272555 and rs2428707 were significantly associated with suicide attempt in this mexican population . in the female group ,", "the demographic characteristics of the cases ( mean age : 25.96 years , standard deviation [ sd ] : 9.26 range : 1456 years ) and comparison group ( mean age : 31.95 years , sd : 13.03 range : 1461 years ) in this mexican population are presented in table 2 .", "table 3 shows the genotype and allele frequencies of the htr2c variants rs547536 , rs21923372 , rs6318 , rs2428707 , and rs4272555 in the suicide attempters and control groups .", "the distributions of the htr2c variants rs547536 , rs21923372 , and rs6318 were not significantly different between the subjects with suicidal behavior and the control group ( table 3 ) .", "subsequently , for the snps that showed a significant association , we summarized the evidence and performed a meta - analysis ." ], [ "we conducted a haplotype analysis of the same five markers and did not find a significant association between suicide attempt and any of the examined haplotypes ( p>0.01 , table 4 ) .", "the ld ( linkage disequilibrium ) in this mexican population was measured for all markers examined in this case control study ( rs547536 , rs2192372 , rs6318 , rs4272555 , and rs2428707 ) ." ], [ "the aim of the present study was to assess the association between the htr2c variants rs547536 , rs2192372 , rs6318 , rs2428707 , and rs4272555 and suicide attempt in a mexican population .", "to our knowledge , this is the first association analysis between htr2c polymorphisms and suicidal behavior performed in a latin american population .", "we found that the g allele of rs2428707 was associated with an increased risk of suicidal behavior in females ; however , this is not similar to the results of previous studies.14,20 this discrepancy could be due to differences of the sample sizes used ." ], [ "our results suggest an association between the rs2428707 and rs4272555 polymorphisms of htr2c in mexican females with suicidal ideation .", "future research must examine the potential mediating effects of the htr2c gene variants to highlight the importance of the serotonin system in suicidal behavior , with special focus on the receptor gene htr2c ." ], [ "descriptive characteristics of two studies analyzing the role of the htr2c gene variant rs2428707 in suicide attempt descriptive characteristics of two studies in the meta - analysis of the htr2c gene variant rs4272555 in suicide attempt", "or and forest plot for the meta - analysis of rs2428707 . note : g allele vs a allele with heterogeneity .", "funnel plot indicating publication bias for studies included in the meta - analysis of rs4272555 .", "note : g allele vs a allele with heterogeneity . or and forest plot for the meta - analysis of rs4272555 ." ] ]

[ [ "the deposition of glucan and mannoprotein - rich cell wall material on the mother and daughter side of the primary septum later completes the trilaminar septum that can be observed under normal culture conditions . a disturbance in the assembly of the septation apparatus the cohesive functional unit that constructs the primary septum leads to the formation of highly aberrant septa [ 10 , 11 ] .", "the present study was undertaken to assess the effect of ba on morphogenesis and cell wall synthesis in yeast , using the well - established model organism saccharomyces cerevisiae as a study subject . ", "the septa formed under these conditions do not allow for the separation of cells after cytokinesis , leading to the formation of chains and clumps of misshaped cells .", "to complete abscission , the last phase of cytokinesis , the cells first separate mother and daughter cells with a chitin primary septum .", "based on the observation that ba causes such clumping and chain formation in s. cerevisiae , the present study was initiated to assess the influence of ba on the function of the septation apparatus ." ], [ "assays containing cobalt only show activities of chitin synthases 2 and 3 while cobalt / nickel assays show the activity of chitin synthase 3 .", "chitin synthesis was determined as described by choi and cabib . to measure chitin synthase 2 and 3 activities ,", "transformants showed a wild - type like distribution of chitin in calcofluor white stained preparations , demonstrating full functionality of the chs3p - ha fusion protein .", "analysis of slt2p phosphorylation and total slt2p by western blotting followed established protocols [ 19 , 20 ] . as a loading control , an antibody directed against tub4p ( goat -tubulin yk18 , santa cruz biotechnology ) was used at 1/1,000 dilution .", "for the determination of chs3p - ha , cell membranes were isolated according to orlean .", "viability staining of yeast cultures was performed by incubating cells in 0.2 mg / ml methylene blue in 50 mm kh2po4 for 5 minutes at rt . in order to visualize the distribution of chitin and glucan in the cell wall ," ], [ "the multiple posttranslational and protein targeting processes involved in chs3p and chs2p activation necessitate enzymatic determination of chitin synthase activities in addition to detection of protein amounts . ", "neither maximal nor physiological ( without addition of gtp-s ) glucan synthase activity showed an increase at high concentrations of ba .", "a measurement of glucan synthase activity in the membranes of strain yph499 showed a constant decline with increasing ba concentrations ( figure 7(b ) ) .", "phosphorylation of slt2p increases with escalating concentrations of ba , suggesting that ba induces a cell wall integrity stress response .", "instead , the cells synthesized protuberances extending far into the cytosol and large irregular septa , often at ectopic locations at the cell periphery . in order to assess ba - induced cell wall integrity signaling , the amounts and the phosphorylation status of the signaling kinase slt2p were determined by western blotting ( figure 6(a ) ) .", "staining of chitin and glucan in walls of cells grown with 0.4% ba revealed a buildup of cell wall material at bud necks , particularly in cell chains ( figure 2 ) . in order to characterize the cytokinesis defect in ba - treated cells ,", "while at 0.1% and 0.2% ba decreases chitin synthase activities , presence of 0.3% and 0.4% ba increases chitin synthesis . at 0.4% ba ," ], [ "the data presented here show that ba impairs the formation of the primary septum in s. cerevisiae a defect that can be explained by incorrect assembly of the cytoskeleton at the bud neck .", "furthermore , our data show that a ba - induced septation defect , just like other septation defects , triggers cell wall integrity signaling through the pkc1-slt2 pathway and results in increased chitin synthase 3 activity .", "the present study expands on this observation by showing that ba disturbs morphogenesis in the model yeast saccharomyces cerevisiae , particularly during cytokinesis . ", "however , since the regulation of chitin synthase 2 activity is not well understood , we dare not hazard an explanation for this phenomenon . the data presented in this study show that in s. cerevisiae ba disturbs the localization of the contractile actomyosin ring secondary to causing irregularities in the septin scaffold at the bud neck .", "the present study shows that ba activates yeast cell wall integrity signaling pathways as evidenced by ba concentration - dependent phosphorylation of slt2p ." ] ]

[ [ "although these objects are extracted either by endoscopy or laparoscopic gastrostomy , we devised an innovative technique by using pneumatic gastric insufflation and extracted the toothbrush by a tiny gastrotomy under local anesthesia .", "the pylorus , duodenal c - loop , and ileocecal valve are the three physiological narrowings in the gastrointestinal tract , and most of the swallowed indigestible foreign bodies pass through it without complications . however , foreign bodies such as a toothbrush can not pass out of the stomach , and the gastrointestinal tract should get rid of these objects as soon as possible to avoid pressure necrosis and gastrointestinal perforation ." ], [ "x - ray of the abdomen suggested the presence of a foreign body and a computed tomography ( ct ) scan was done which confirmed a toothbrush lying in the stomach [ figures 1 , 2 ] .", "x - ray of the abdomen suggesting the presence of the toothbrush in the abdomen computed tomography ( ct ) scan of the abdomen showing the presence of the toothbrush in the tomach endoscopic picture of toothbrush with biopsy forceps in situ to retrieve it from the stomach", "an upper gastrointestinal endoscopy was done which revealed the toothbrush in the stomach with its head toward the gastroduodenal junction ." ], [ "however , objects longer than 10 cm like a toothbrush can not negotiate the duodenal c - loop due to its fixed position in the retroperitoneum , and these must be removed as soon as possible to avoid pressure necrosis and gastric perforation .", "in the stomach , 80 - 90% of foreign bodies pass uneventfully through the gastrointestinal tract without complications .", "however , we devised a simple technique of minilaparotomy and gastrotomy under local anesthesia for removing such foreign bodies . in this technique ,", "however , extreme caution and experience of the endoscopist is required for such procedures . in failed cases of endoscopic removal ,", "more than 40 cases of toothbrush ingestion have been reported in the literature till date .", "the stomach is distended with the help of air insufflation through the endoscope and a small incision is made in the midepigasrium under local anesthesia and the foreign object can be removed directly under the vision of the endoscope ." ], [ "a swallowed toothbrush is a rare occurrence and it never passes through the gastrointestinal tract spontaneously .", "early removal of the toothbrush is critical for reducing morbidity and mortality . in cases where endoscopic removal fails ,", "endoscopy still remains an aid in performing surgical gastrotomy for delivering such complex foreign bodies under local anesthesia ." ] ]

[ [ ", this study was performed to compare the effect of concept mapping with traditional nursing care plan on nursing students ct in clinical pediatric course .", "in iran , it can be stated that although ct is important in clinical judgments and decisions but during the training period , have had no significant development therefore the traditional education system needs evolution and revision in order to realize training purposes in line with fostering creative and efficient students . with regard to the need for finding best way to promote nursing students ct and the limited evidence of comparing concept mapping with traditional nursing care plan in clinical setting", "concept map development is an alternative to using care plans as a method to document a plan of care based on evidenced - based practices .", "use of the nursing process is an essential element to cultivate ct and judgment skills in nursing students .", "however , some researchers have reported that the current linear nursing care plan format does not meet the educational needs of students to develop ct skills and visualize the interconnectedness of patient clinical data ." ], [ "a before - after experimental design with the control group was used to compare the effect of concept mapping and traditional linear nursing care planning on baccalaureate nursing student 's ct skills at shahrekord university of medical sciences in shahrekord , iran .", "students were randomly divided into six equal groups of 10 students ; three groups as the control group and the other three groups as an experimental group . to prevent contact between the control and experimental groups , they take the pediatric clinical course in sequential time order . during the course", "all 60 students from the nursing faculty of the shahrekord university of medical sciences , shahrekord , iran , who had enrolled in pediatric nursing clinical course , and in sixth - semester of their study in the year 2011 , were invited to participate in this study .", "an overall score of < 11 indicated a lack of ct skills , a score of 1125 indicated average ct skills , and a score above 25 indicated strong ct skills . for a given ct skill , a subscale score of 4 or less indicated weakness , whereas a subscale score of 7 or above indicated strength .", "agreement to use and evaluate concept mapping as a teaching strategy in clinical courses was obtained from the nursing department of shahrekord university of medical sciences , shahrekord , iran .", "a sample concept map demonstrated by student students in the control group received traditional clinical teaching to create linear nursing care plans on a blank sheet .", "the students were asked to read and analyze the patient profile data , formulate initial problems , prioritize nursing diagnoses and identify the relationship between nursing diagnoses , then develop and implement interventions to solve the problems , and to evaluate the effectiveness of their nursing care ." ], [ "a before - after experimental design with the control group was used to compare the effect of concept mapping and traditional linear nursing care planning on baccalaureate nursing student 's ct skills at shahrekord university of medical sciences in shahrekord , iran ." ], [ "to prevent contact between the control and experimental groups , they take the pediatric clinical course in sequential time order . during the course , students cared for patients from an assigned pediatric setting . because students were not able to have prior contact with their patients , they began developing their nursing care plans on the 1 day of their clinical experience .", "all 60 students from the nursing faculty of the shahrekord university of medical sciences , shahrekord , iran , who had enrolled in pediatric nursing clinical course , and in sixth - semester of their study in the year 2011 , were invited to participate in this study .", "students were randomly divided into six equal groups of 10 students ; three groups as the control group and the other three groups as an experimental group .", "they were asked to create a nursing care plan for a child they were caring for , which required gathering information on complete patient histories , relevant medications , treatments and medical diagnoses ." ], [ "the students were asked to read and analyze the patient profile data , formulate initial problems , prioritize nursing diagnoses and identify the relationship between nursing diagnoses , then develop and implement interventions to solve the problems , and to evaluate the effectiveness of their nursing care .", "this activity provided all students with the opportunity to think out aloud about the accuracy and completeness of the nursing diagnoses , goals , nursing interventions and relationship depicted on their concept maps .", "a sample concept map demonstrated by student students in the control group received traditional clinical teaching to create linear nursing care plans on a blank sheet .", "on the 2 day of clinical experience , clinical instructor who has the experience of concept mapping development taught the students in the experimental group how to create concept maps .", "they also had 5 days after the clinical experience to reflect on and evaluate the effectiveness of their nursing care before the concept maps were due .", "the students were informed in advance that a concept map should display each nursing diagnosis and more importantly , its relationship to the patient 's data , pathophysiology of the disease and interventions in a holistic view .", "they also had the opportunity to discuss their care plans in group discussion with guidance provided by the teacher ." ], [ "ct skills were measured using the california critical thinking skill test ( cctst ) with subscales of analysis ( 9 items ) , evaluation ( 14 items ) , inference ( 11 items ) , and two types of reasoning ( deductive reasoning and inductive reasoning included 16 and 14 items respectively ) .", "khalili and hossein zadeh reported that this scale in comparison with the other measuring tools of ct is more comprehensive .", "an overall score of < 11 indicated a lack of ct skills , a score of 1125 indicated average ct skills , and a score above 25 indicated strong ct skills . for a given ct skill , a subscale score of 4 or less indicated weakness , whereas a subscale score of 7 or above indicated strength .", "we selected this scale because it was tested for reliability and validity in iranian nursing students .", "the reliability coefficient of subscales after factor analysis in their study was in the range of 62 - 67% .", "( l4 items ) note that a kr-20 range of 0.650.75 for this type of instrument is acceptable .", "this instrument contains 34 items in multiple - choice format , 19 four - option multiple - choice items and 15 five - option multiple - choice items .", "the range of possible total scores was 034 , with each subscale having a possible score range of 012 .", "data were collected before and after the program in a clinical setting at the beginning and end of clinical education ." ], [ "participants in the experimental group were informed that they would be free to change to the traditional teaching strategy at any time without effects on their course evaluation . to ensure students in the control group were not disadvantaged , after completing the study , they were taught concept mapping during a 1-day workshop .", "agreement to use and evaluate concept mapping as a teaching strategy in clinical courses was obtained from the nursing department of shahrekord university of medical sciences , shahrekord , iran .", "information about the study was given to every participant to assure the protection of human rights by the clinical teacher ." ], [ "we used independent and paired t - tests to compare mean scores between the experimental and control groups at pre- and post - tests .", "data analysis was performed using statistical package for the social sciences ( spssinc . , chicago , il , usa ) software . in all analyses , p - 0.05" ], [ "paired t - test showed significant improvement in overall and all subscales of cctst from pretest to posttest in both groups ( p < 0.001 ) [ tables 2 and 3 ] but t - test demonstrates that improvement in students ct skills in the experimental group was significantly greater than that in the control group after the program ( p < 0.001 ) [ table 4 ] .", "student 's ct skills on the pretest comparison of overall and subscales of cctst - a in the experimental group comparison of overall and subscales of cctst - a in the control group student s ct skills on the posttest", "the statistical analysis showed that two groups did not appreciably differ in age or sex .", "there was no significant difference between the groups overall , and in all subscales before the program [ table 1 ] .", "almost all students were 21 years old except one who was 22 years old ( range : 2122 ) ." ], [ "this study was developed to examine whether concept mapping helped students develop better ct skills than the traditional method in an undergraduate pediatric clinical course . in the current study", ", it was found that either concept map or traditional linear nursing care plan could promote ct skills in nursing students from lacking to an average ct standard .", "however , similar to findings of other prior studies which observed improvements to nurses ct abilities following a concept mapping teaching strategy , the present study provided evidence to indicate that the effects of concept mapping were greater than those of traditional linear nursing care plans , with greater improvements to students overall and all subscales of ct skills as indicated by cctst scores . considering that the test of ct is based on the problem - solving process and the nursing process in the defined problem - solving stages , the use of which could improve ct skills .", "our study suggested that preparing nursing care using the concept map is more effective in promoting ct in nursing students than traditional linear nursing care plans ." ], [ "as with all studies with small samples , generalization of findings must be made cautiously . however , this study adds to the growing body of knowledge that suggests concept mapping improves students abilities to see patterns and relationships .", "although this study identified some short - term effects of the concept mapping program , its long - term effects remain unknown .", "the sample set came from only one university in iran limiting the feasibility of generalization of results to other universities and countries .", "future investigations should include multisite evaluations in a range of geographic locales with larger sample sizes ." ], [ "when presented with complex health - care situations and the need to process vast amounts of information , clinical nurses must be in ownership of ct skills in order to make appropriate professional judgments and clinical decision making .", "concept mapping , in comparison with the traditional linear nursing care plan , resulted in greater improvements in all ct skills .", "however , the 5 weeks program demonstrated only short - term effects , therefore , further longitudinal studies are suggested .", "results from the present study support the application of concept mapping as a clinical teaching strategy to promote the development of ct skills ." ], [], [] ]

[ [ "these include the \n intrinsic flexor pollicis brevis , flexor pollicis longus , lumbricalis , flexor brevis , and \n flexor longus muscles1 .", "we \n believe it is important to elucidate the contribution of femoral muscles to toe - gripping \n strength . in the present study , we investigated femoral muscle activity during toe - gripping to \n examine the role of the femoral muscles in toe - gripping strength .", "furthermore , toe - gripping \n strength can be increased by training5 , \n which can decrease the risk of falls1 . \n", "however , as both studies focused on the activity of the \n crural muscles , the activity of the femoral muscles during toe - gripping remains unclear ." ], [ "toe - gripping strength of the dominant toe and emg activity of the ipsilateral thigh were \n synchronously recorded to assess the activity of the rectus femoris and biceps femoris \n muscles .", "relationships between the % iemg of the rectus and biceps \n femoris muscles were statistically analyzed using spearman s correlation coefficient .", "the right toe was dominant \n ( defined as the toe used to kick a ball ) . to measure the maximum voluntary contraction ( mvc ) activity of the rectus femoris muscles , \n as described by kai9 ,", "after confirmation of adequate skin preparation ( skin resistance of less \n than 5 k ) , three bipolar lead electrodes ( de-2.1 , delsys , inc . , boston , usa ) were attached \n to the skin over the rectus femoris and the long head of the biceps femoris , as described by \n peroto10 . for measurement of the rectus \n", "the emg was recorded for 3 seconds while each subject exerted maximal force of knee \n extension . to measure the mvc of the biceps femoris muscle ,", "repeated mann - whitney u tests were used to compare the % iemg of the \n rectus and biceps femoris muscles .", "femoris muscle , the electrode was attached at the midpoint between the superior edge of the \n patella and the anterior superior iliac spine . for measurement of the long head of the \n biceps femoris ,", ", the subjects were instructed to sit with their trunk in the \n vertical position , hip and knee joints at 90 , and ankle joints in the neutral position ." ], [ "the % iemg of the biceps femoris was significantly higher than that of the \n rectus femoris ( p < 0.01 , table 1table 1.comparison of the % iemg values of the rectus femoris and biceps femoris muscles \n during toe - gripping actionrectus femorisbiceps femorismedian ( range : min max)median ( range : min max)%iemg4.8 * ( 1.521.1)27.2 ( 3.068.1)mann - whitney u test * : p < 0.05 ) .", "the average ( mean sd ) \n % iemg values of the rectus and biceps femoris muscles were 7.0% 6.2% and 25.6% 15.9% , \n respectively .", "the average ( mean sd ) toe - gripping strength was 20.9 3.6 kg .", "mann - whitney u test * : p < 0.05 using spearman s correlation coefficient analysis , a significant positive correlation was \n found between the % iemg of the rectus femoris and that of the biceps femoris ( r = 0.548 , p \n" ], [ "in the present study , we found that the % iemg of the biceps femoris was significantly \n higher than that of the rectus femoris .", "we found that toe - gripping action stimulates femoral muscle activity and that the % iemg of \n the biceps femoris was significantly higher than that of the rectus femoris .", "these results suggest that femoral muscles \n co - contract during toe - gripping action , and thus possibly contribute to knee joint \n stability .", "this suggests that the % iemg of the rectus \n femoris increases with increases in the % iemg of the biceps femoris ." ] ]

[ [ "hence , in the present study we addressed the question if affective evaluations of dementia patients can be manipulated using a standard evaluative conditioning paradigm .", "thus , explicit knowledge about the cs - ucs relation seems crucial in fear conditioning while evaluative conditioning can be demonstrated in the absence of contingency awareness [ 1012 ] . since there could be variables that play a different role in these forms of learning ; dementia patients might show intact evaluative conditioning despite impaired fear conditioning . indeed ,", "this effect is called ( associative ) evaluative conditioning and has been demonstrated in humans with a large variety of procedures and stimuli ( e.g. , [ 24 ] ; for a meta - analysis see ) . in dementia severely impaired explicit memory", "it was hypothesized that fear conditioning is an instance of signal learning ; it is learned that the ucs is going to appear after the presentation of the cs .", "nonetheless , patients with dementia might still be able to implicitly learn affective reactions through the process of evaluative conditioning .", "another classical paradigm that has already been used to investigate conditioning of affective reactions in this population is fear conditioning ." ], [ "the study included 15 dementia patients ( diagnosed as alzheimer 's disease ( n = 10 ) or mixed dementia ( n = 5 ) ) .", "the sam was designed to assess subjective ratings of participants ' emotional responses and minimize the influence of language and culture on ratings .", "participants were told that the aim of the experiment was to examine the relationship between mood and subjective affective evaluation . in line with this cover", "the sam valence rating scale has been successfully used in previous studies with dementia patients [ 13 , 14 ] . using the paper - pencil version of this instrument , participants rated the stimuli as to their emotional valence ( range : 19 ) . ", "the happy faces were added to increase the variance in subjective liking between pictures . \n emotional ratings .", "test stimuli were 10 pictures of neutral ( i.e. , displaying no facial expression of emotion ) unfamiliar faces ( 6 female : 3 young , 3 old ; 4 male : 2 young , 2 old ) and one picture of a happy young , female adult as well as one picture of a happy old , male adult selected from the productive aging laboratory face database . however , based on affective valence ratings of these pictures in other studies ( dann hier referenz ) , some of the included faces were also rated as positive or negative .", "subsequently , the pictures were presented to participants one after the other and rated with respect to valence using the sam rating scale ." ], [ "we conducted a separate analysis using only pictures paired with l and d pictures to further investigate the influence of the experimental manipulation .", "as expected , we found a grater rating change over time for stimuli paired with l and d pictures than stimuli paired with n pictures ( see table 2 ) .", "this interaction was due to the fact that there was no influence of the type of stimulus pair at baseline ( f(2,27 ) = 0.296 ; p > .746 ) , but a significant effect after conditioning in the direction of the experimental manipulation ( f(2,27 ) = 5.460 ; p < .010 ) .", "the repeated measures anova for valence ratings of pictures paired with l and d stimuli of dementia patients revealed a significant main effect of type of stimulus pair ( f(1,14 ) = 16.000 ; p >" ], [ "the main aim of the present study was to investigate if affective evaluations of dementia patients can specifically be influenced through a standard evaluative conditioning paradigm .", "as hypothesized , dementia patients changed their valence ratings of unfamiliar and previously neutral faces according to its pairing with either a liked or disliked face stimulus . generally , the neutral pictures that were paired with a liked stimulus were rated higher and the neutral picture that was paired with the disliked stimulus was rated lower on the valence dimension after our evaluative conditioning intervention by dementia patients .", "our result could also indicate that evaluative conditioning effects are stronger in dementia patients than in healthy elderly controls .", "the results of dementia patients are in line with findings demonstrating evaluative conditioning in healthy participants using subliminally presented stimuli [ 2729 ] .", "results of our study suggest that dementia patient ' affective evaluations of neutral stimuli can be changed through pairing with liked or disliked stimuli ." ] ]

[ [ "internal herniation of a small bowel behind the external iliac artery after lymphadenectomy is a very rare complication to this procedure and to our knowledge only reported twice in the literature . in the first paper published in 1978", "the author described how they managed their patient with laparotomy and resection of a perforated small bowel .", "para - aortic and pelvic lymphadenectomy is often performed in the treatment of ovarian or testicular cancer .", "the hernia orifice was closed by using a free peritoneal graft harvested from the under surface of the anterior abdominal wall .", "this patient had to undergo several surgical procedures to re - establish blood flow to the extremity because of trombosis of the iliac artery ." ], [ "we noticed pulsation on the iliac vessel after the small bowel reduction and we evaluated the pulsation of the dorsalis pedis artery and the posterior tibial artery during the operation .", "a 56-year - old woman underwent in 2008 prophylactic bilateral laparoscopic salpingoophrectomy because of a mutation in brca1 gene .", "the histological result revealed a serous papillary adenocarcinoma in the right ovary and on its surface . therefore a restaging operation was performed ." ], [ "due to limited peritoneum in the area of the hernia defect and the skeletonized external iliac artery , we did not do any direct suture of the orifice as this might have compromised the artery and/or the vein . due to previous omentectomy ,", "we do not routinely use verres needle in laparoscopy , we prefer to use visiport as an optical trocar or an open hasson approach that is another safe alternative to minimize the chance of bowel perforation on entrance into the abdominal cavity .", "an alternative might have been to harvest a free peritoneum graft to cover the defect as described in the two other cases .", "a challenge would have been if the bowel could not be reduced due to long standing obstruction .", "if the patient later experience any sign of recurrence and need another operation we will have to close the defect .", "a longer follow - up of the patient is needed to clearly conclude if this simple procedure has been sufficient ." ], [ "strangulated internal hernia behind the iliac vessel is a rare entity only reported twice in the literature .", "a quick recovery with no complications , short hospital stay and minimal discomfort postoperatively made our approach an acceptable surgical option for this patient .", "this is the first case in the literature where laparoscopically reduction of the internal herniated bowel underneath the iliac vessel is performed ." ], [], [], [ "a copy of the written consent is available for review by the editor - in - chief of this journal on request .", "written informed consent was obtained from the patient for publication of this case report and accompanying images ." ] ]

[ [ "herein , we report ( i ) the modified synthetic approach to 3-(1h - benzimidazol-2-yl)-1h - pyrazolo[3,4-b]pyridines ( recall chart 1 : l1 , x = h , y = h ; l2 , x = br ; y = h ; l3 , x = br ; y = ch2och3 ) ; ( ii ) the synthesis and characterization of a new family of organoruthenium(ii ) ( 11a , 12a , 13a ) and osmium(ii ) ( 11b , 12b , 13b ) complexes of the general formula [ mcl(-p - cymene)l]cl , where l = 3-(1h - benzimidazol-2-yl)-1h - pyrazolo[3,4-b]pyridines ( l1l3 ) ( chart 1 ) ; ( iii ) stabilization of the 7b tautomer of methoxymethyl - substituted l3 by metal coordination as well as ( iv ) nmr spectroscopic characterization of two tautomers 7b - l3 and 4b-l3 in a metal - free state ; and ( v ) cell cycle effects , as well as the antiproliferative and cdk inhibitory activities of both metal - free ligands and organometallic complexes .", "organometallic compounds [ m(-arene)(yz)x ] ( where m = ru , os ) exhibit promising anticancer activity and are the focus of attention for several groups .", "these compounds have shown activity toward classic ( dna ) and nonclassic ( e.g. , cdks ) targets in anticancer chemotherapy .", "many small - molecule organic compounds , which have been identified as cdk modulators , are currently in preclinical or clinical development . however , no cdk inhibitors have gained marketing approval , despite 20 years of scientific investigation ." ], [ "the cdk - inhibitory capacities of test compounds were studied by a radiochemical assay using recombinant cdk1/cyclin b and cdk2/cyclin e isolated from sf21 insect cells and histone h1 as the substrate for phosphorylation , as described by marko et al .", "crystals of 12b and 12b2ch3oh2h2o suitable for xrd study have been obtained from a solution of 12b in methanol .", "crystals of 11b4h2o suitable for xrd study have been obtained from a solution of 11b in ethanol .", "calculations are based on at least three independent experiments with triplicates for each concentration level . to study the effects on the cell cycle of exponentially growing ch1 cells by flow cytometric analysis of their relative dna content" ], [ "although the lack of generally pronounced cell cycle effects does not argue for a strong role of cdk inhibition in the mechanism of action of the investigated compounds , inhibitory potencies were studied in cell - free experiments with two recombinant cdk / cyclin complexes , by means of the histone h1 kinase assay .", "concentration - dependent effects of metal - free ligands ( l1l3 ) as well as corresponding ruthenium ( 11a13a ) and osmium complexes ( 11b13b ) , on kinase activities of recombinant cdk1/cyclin b ( top ) and cdk2/cyclin e ( bottom ) .", "in contrast to the observed cell cycle effects , but in accordance with antiproliferative activities , cdk - inhibitory potency of the metal - free ligands is consistently higher than that of the metal complexes . in particular , only l1l3 effectively inhibit cdk2/cyclin e in low concentrations ( 1 m or 10 m ) , whereas all complexes require higher concentrations to exert > 50% inhibitory effects . as in the mtt assay ,", "results reveal that all compounds are capable of inhibiting kinase activities in a concentration - dependent manner , being more effective on cdk2/cyclin e than on cdk1/cyclin b ( see figure 9 ) .", " effect curves of each ligand , compared to the corresponding ruthenium and osmium complexes , in ch1 ovarian cancer cells ( mtt assay , 96 h exposure ) : ( a ) l1 , 11a , 11b ; ( b ) l2 , 12a , 12b ; and ( c ) l3 , 13a , 13b . both the presence of substituents in the ligands and complexation result in a marked shift of antiproliferative activity . since 3-(1h - benzimidazol-2-yl)-1h - pyrazolo[3,4-b]pyridines have been reported to be potent cdk inhibitors , we expected the investigated ligands and complexes to induce cell cycle perturbations . to confirm this assumption in a sensitive cell line ,", "os1a cl1a , 83.56(18) ; and n5a os1a cl1a , 84.2(2). ligands l1l3 , as well as the corresponding ruthenium(ii ) ( 11a13a ) and osmium(ii ) ( 11b13b ) arene complexes , were studied with regard to their capacity of inhibiting cell growth in vitro in the human cancer cell lines ch1 ( ovarian carcinoma ) , sw480 ( colon carcinoma ) , and a549 ( non - small cell lung cancer ) , yielding the ic50 values listed in table 2 ." ], [ "these were used as bidentate ligands , and six novel organometallic complexes of the general formula [ mcl(-p - cymene)(l)]cl , where m = ru ( 11a , 12a , 13a ) or os ( 11b , 12b , 13b ) and l = l1l3 , have been synthesized and comprehensively characterized using spectroscopic and x - ray diffraction methods .", "the known multistep synthesis of 3-(1h - benzimidazol-2-yl)-1h - pyrazolo[3,4-b]pyridines , which we have modified , essentially afforded three organic compounds ( l1l3 ) that possess cdk - inhibiting properties .", "the known cdk - inhibitory activity of the ligands could be confirmed in cell - free experiments , in particular in cdk2/cyclin e , and their stronger effects on cdk activity parallel their higher capacity of inhibiting cancer cell growth in vitro , compared to their metal complexes .", "complexation of l1l3 with ruthenium or osmium yielded compounds with increased solubility in the biological medium , yet lowered antiproliferative activity in human cancer cell lines .", "nevertheless , the lack of pronounced effects on the cell cycle of chemosensitive ovarian cancer cells argues against a major role for inhibition of cell growth , at least in this setting .", "modulation of biological activities by substitution at the ligands can be accomplished in the metal - free molecules and their metal complexes in a similar way ." ] ]

[ [ "this paper highlights a rare entity of psjof involving the maxillary sinus and nasal cavity on the left side .", "fibro - osseous lesions of the jaws represent a diverse group of entities which include developmental ( hamartomatous ) lesions , reactive or dysplastic processes and neoplasms .", "the term juvenile psammomatoid ossifying fibroma is now used to designate the neoplasm of the craniofacial skeleton of young age with well - defined clinicopathological features ." ], [ "a 20-year - old female patient reported with a painless progressive swelling in the left cheek region and difficulty in breathing since 1 year .", "haemorrhagic areas were also seen . the constellation of clinical , radiological , and histopathological features of this lesion supported an interpretation of psammomatoid variant of jof .", "after complete removal of the mass , borders were carefully osteotomized to avoid the chances of recurrence [ figure 5 ] . the excised specimen was sent for histopathological examination [ figure 6 ] and the diagnosis of psjof was confirmed ." ], [ "jof are benign , potentially aggressive fibro - osseous lesions of the craniofacial bones . the word ", "psjof is a unique variant of jof that has a predilection for orbit and pnss accounting for about 72% followed by calvarium 11% , maxilla 10% , and mandible 7% .", "is associated with maxilla involving maxillary sinus and nasal cavity in a 20-year - old female patient ." ], [ "early detection and complete surgical excision of the lesion followed by long - term follow - up is necessary for proper clinical management .", "therefore , it is very important to correlate the clinical , radiographical , and histopathological findings for proper treatment ." ] ]

[ [ "when possible an endoscopic approach should generally be attempted in all patients with pseudocysts , and for pancreatic fluid collections endoscopic transmural drainage is the treatment of choice .", "endoscopic methods are among the most important and frequently employed means of treating pancreatic pseudocysts .", "this article discusses the unusual case of a stent that became dislodged and migrated into the omental bursa . following this migration some time", "if the cyst contains more than 2/3 solid material a self - expandable stent should be selected to ensure effective drainage .", "was allowed to elapse , and the gastrotomy closed completely . since a simple endoscopic retrieval was no longer possible , a combined laparoscopic - endoscopic technique ( rendezvous technique ) was used instead , and the stent was successfully retrieved .", "an additional advantage of the self - expandable metal stent is that the necrotic tissue contained within the cyst can be actively removed using an endoscope ." ], [ ", we decided to attempt a laparoscopic - endoscopic retrieval of the displaced wall stent . in the first step ,", "after localization of the stent via image converter we made a targeted 3 cm incision into the posterior gastric antrum using an endo knife ( erbe , germany ) . due to the location of the stent deep within the omental bursa neither optical nor palpatory contact could be made , and consequently , endoscopic retrieval was not an option . in the next step ,", "the pseudocysts had regressed significantly , and a computed tomography of the abdomen showed the migrated stent in the omental bursa with no direct contact to the gastric wall . in february 2014", "retrieval of the migrated stent was not possible . at follow - up gastroscopy 4 weeks later the gastric wall had completely closed and hence that endoscopic localization of the stent was no longer possible . in november 2013" ], [ "tllez - vila et al . , for example , report on fully covered self - expandable metal stents with an innovative anti - migration system .", "when endoscopic retrieval fails a combined laparoscopic - endoscopic approach offers an alternative to open surgery .", "describe a stent - in - stent combination which employs the mechanical advantages of both plastic stents and fully covered self - expandable metal stents .", "currently , endoscopic ultrasound - guided drainage is a safe and effective means of treating pancreatic fluid collections . compared with surgical or percutaneous drainage it is less invasive and results in lower mortality , costs , and hospitalization times .", "15% of stents will become accidentally dislocated , but efforts to develop technically superior stents continue .", "can be performed without difficulty . in cases of extraluminal loss , however , a surgical approach is often necessary , and a minimally invasive exploration of the abdominal cavity is the approach of choice .", "although these new solutions will help reduce the rate of migration , they will not eliminate it completely . in most cases of stent migration endoscopic retrieval" ] ]

[ [ "adenomyoepithelioma has been described as a rare benign neoplasm that occurs almost exclusively in the breast . in the breast", "we present the case of a 53-year - old woman with a clinically benign nodular cutaneous lesion that revealed histopathologic and immunohistochemical features of adenomyoepithelioma .", "it is defined as a neoplasm composed of two structures , namely , tubules limited by an inner epithelial layer of duct - like cells and an outer layer with mostly clear myoepithelial cells .", "these neoplasms seem to be exceedingly rare , with only few reports of adenomyoepitheliomas published to date [ 47 ] .", "apart from the breast , adenomyoepitheliomas have been described in the salivary glands and in the lung . in the skin ," ], [ "a 53-year - old woman presented to her dermatologist with a 3 cm asymptomatic nodule on the left forearm .", "each of the aggregates of neoplastic cells varied in sizes and shapes and some were large and nodular ( figure 1a c ) . at higher magnification , most of the cells that constituted the lesion displayed myoepithelial differentiation with polygonal and plasmacytoid features ( figure 2 ) .", "the cells presented sometimes as solid sheets , but also as cords and solitary units . in places glandular and ductal structures were evident ; in some areas apocrine - type secretion within glandular structures was found ( figure 2 a c ) .", "the myoepithelial cellular component of the neoplasm stained for s100 protein and was negative for cytokeratin and carcinoembryonic antigen ( cea ) expression .", ", there was a large , lobulated neoplasm , which for the most part was surrounded by a compressed fibrous pseudocapsule ." ], [ "we describe a cutaneous neoplasm composed of myoepithelial cells and a focal epithelial and glandular component .", "based on findings by conventional microscopy and immunohistochemistry , this neoplasm shows myoepithelial differentiation and focal epithelial lined tubules with features of apocrine secretion , findings that are consistent with the diagnosis of primary adenomyoepithelioma of the skin .", "while various adnexal neoplasms with a myoepithelial cellular component have been described in the skin , adenomyoepithelioma of the skin seems to be extremely rare ." ] ]

[ [ "consequently , a more accurate , robust and faster method that does not rely on sequence alignment is needed to distinguish ncrnas , especially lncrnas , from protein - coding genes . here , we present coding - potential assessment tool ( cpat ) , an alignment - free program , which uses logistic regression to distinguish between coding and noncoding transcripts on the basis of four sequence features .", "we expanded the availability of cpat to a larger scientific audience via a web interface , which allows users to submit sequences and receive the prediction results back almost instantaneously ( http://lilab.research.bcm.edu/cpat/index.php ) .", "accurate and quantitative assessment of coding potential is the first step toward comprehensive annotation of newly discovered transcripts .", "although the human genome sequence was released a decade ago , the role of functional noncoding rnas ( ncrnas ) is much less understood compared with their coding counterparts .", "recent genome - wide studies revealed tens of thousands of novel transcripts , the majority of which were long noncoding rnas ( lncrnas , > 200 nt ) ( 49 ) ." ], [ "this test set composed of 4000 high - quality protein - coding genes ( refseq annotated ) and 4000 lncrnas from a human lncrna catalog ( 5 ) .", "the hexamer score can be computed in numerous ways ; here , we used a log - likelihood ratio to measure differential hexamer usage between coding and noncoding sequences . for a given dna sequence , we calculated the probability of the sequence under the model of coding dna and under the model of noncoding dna , and then we took the logarithm of the ratio of these probabilities as the score of coding potential .", "we built an independent test data set to compare the performance of cpat with that of cpc , phylocsf and portrait .", "orf length is one of the most fundamental features used to distinguish ncrna from messenger rna because a long putative orf is unlikely to be observed by random chance in noncoding sequences . despite the simplicity , orf length has high concordance with more sophisticated discrimination methods and remains the primary criterion in almost all coding - potential prediction methods ( 21 ) .", "we evaluate the model with a 10-fold cross - validation and measured its sensitivity , specificity , accuracy , precision and area under the curve ( auc ) characteristics ." ], [ "we compared the performance of cpat with that of cpc , phylocsf and portrait ( protein - independent support vector machine model ) using an independent test data set composed of 4000 coding genes and 4000 noncoding genes .", "a multiple alignment of 45 vertebrate genomes , including that of human , was downloaded from the ucsc ( university of california , santa cruz ) genome browser and was used as the input alignment for phylocsf . in general , cpat ( sensitivity : 0.96 , specificity : 0.97 ) had greater classification power compared with all other programs ( figure 4 ; supplementary tables s1 and s2 ) .", "three - dimensional plot shows combinatorial effects of fickett score , hexamer score and orf size on 10 000 coding genes ( red dots ) and 10 000 noncoding genes ( blue dots ) .", "all four selected features were concordantly higher in coding transcripts and lower in noncoding transcripts ( figure 1 ) .", "we measured the computational speed of cpat , cpc and phylocsf on a sample of 200 sequences randomly selected from the test data set .", "one could argue that phylocsf underperformed in this study because we used whole transcripts for testing rather than consecutive protein - coding exons and intergenic regions as used in its original article ( 17 ) . to address this issue , we compiled another single - exon test data set consisting of 184 protein - coding and 278 noncoding transcripts . the test results with this data set indicated that cpat ( sensitivity : 0.962 , specificity : 0.842 ) still outperformed phylocsf ( sensitivity : 0.832 , specificity : 0.588 , supplementary figure s2 ) ." ], [ "these include maximum orf size , dinucleotide usage , codon usage bias , hexamer usage bias , nucleotide composition bias between codon positions and imperfect periodicity in base occurrences ( 23,26 ) . among these features , we selected orf features ( size and coverage ) because of their discriminatory power and ease of calculation ( 21 ) . in - frame hexamer score", "we developed cpat , a highly accurate alignment - free method , which uses a logistic regression model to discriminate between coding and noncoding transcripts using pure linguistic features . compared with other tools ,", "a number of linguistic features characterizing coding rna sequences have been developed over the past 30 years .", "cpat is more robust , markedly faster and more convenient to use . taken together , cpat is able to accurately assess the coding potential of tens of thousands of transcripts in real - time , and will be a valuable tool for the rapidly growing rna - seq community .", "distinguishing between protein - coding and noncoding sequences is the first and arguably the most crucial step in genome annotation .", "annotation of genomes has always been a challenging task for biologists , and these efforts have been accelerated by deep transcriptome sequencing ." ], [ "source code was implemented in c and python and is freely available at : http://code.google.com / p / cpat/. the web server was implemented in php , mysql and apache , with support for all major browsers : http://lilab.research.bcm.edu/cpat/index.php ." ], [ "supplementary data are available at nar online : supplementary tables 1 and 2 and supplementary figures 13 ." ], [ "department of defense prostate cancer program [ pc094421 to w.l . ] ; the cancer prevention and research institute of texas [ rp110471-c3 to w.l . ] ; the center for individualized medicine ( cim ) at mayo clinic ( to j.p.k . ) . funding for open access charge : cancer prevention and research institute of texas [ rp110471-c3 to w.l . ] ." ], [] ]

[ [ "beyond its role of cellular energy currency and phosphate donor , atp plays a potent signaling role through its extracellular release and activation of cell surface purinergic receptors .", "do release other nucleotides including utp and udp - sugars but our focus here is atp release . mechanisms of atp release during physiological processes remain diverse and controversial .", "however , atp can be released from cells physiologically and act as a critical signal for painful , inflammatory processes .", "cell surface purinergic receptors are activated by this atp damp signal which serves to initiate an inflammatory response and promote wound healing .", "fast responses to atp are mediated through activation of p2x receptors , a family ( p2x1p2x7 ) of atp - activated ligand - gated ion channels and metabotropic effects through the activation of p2y receptors ( p2y12 , p2y4 , p2y6 , p2y1114 ) which couple to heterotrimeric g proteins . human leukocytes including monocytes , mast cells , neutrophils and central microglia express a diverse repertoire of p2y receptors though p2x1 , p2x4 and p2x7 are the dominant p2x subtypes present .", "activation of purinergic receptors in leukocytes is coupled to the production and secretion of cytokines and other pro - inflammatory molecules including prostaglandin e2 .", "the release of cellular atp is unregulated and released due to cell lysis or puncture ." ], [ "investigation into how cellular stress stimulates atp release in non - leukocytes suggests roles for connexin and pannexin hemichannels , maxi- and volume - regulated anion channels and efflux through the p2x7 receptor , though release routes and signal transduction mechanism underlying atp release in leukocytes remain poorly defined ." ], [ "this raises the possibility that atp can act in a feed forward loop possibly amplifying responses to itself or other external cues which couple to atp secretion .", "bacterially derived lipopolysaccharide can stimulate central microglia to secrete atp which in - turn activates neighboring astrocytes and modulates excitatory neurotransmission .", "released atp and its subsequent metabolism to adenosine at the cell surface activate p2y2 and a3 receptors serving to direct cell orientation and promote migration in response to chemotactic signals .", "in neutrophils atp is released in response to activation of fmlp receptor by bacterially derived n - formylmethionine .", "the precise release mechanism is unclear but occurs at the leading edge of migrating neutrophils ." ], [ "the mechanism of lysosomal atp transport remains undefined though a nucleotide transporter ( v - nut ) has been characterized for other atp containing vesicles .", "this mode of constitutive secretion generates a constant pericellular atp cloud or halo which appears to be important in regulating intracellular calcium homeostasis following p2y receptor activation . in cells of hematopoietic lineage such as monocyte / macrophage , nk killer and mast cells , secretory lysosomes have evolved as bifunctional organelles which combine classical degradative properties with secretion .", "furthermore , such constitutive secretion leads to activation of cell surface gq - coupled p2y receptors which elevate intracellular calcium levels through release of calcium ." ], [ "what are the release machines in leukocytes and do they differ from other cell types ? it is expected that therapeutic intervention in agonist stimulated atp release is a potentially novel route to pharmacological modulation of innate immune responses but also in chronic inflammatory disease where normal inflammatory responses are heighten and act deleteriously .", "the signal transduction coupling external cues such as cytokines , chemokines and bacterially derived molecules to atp release is poorly defined ." ] ]

[ [ "also , transfection of pon1-deficient peritoneal macrophages ( isolated from pon1 knockout mice ) with human pon1 decreased level of peroxides , lowered release of superoxide , and increased intracellular level of reduced glutathione , key observations are summarized in table 1 .", "summary of key facts on pon1 expression , activity , and effects in in vitro and in vivo studies", "hdl from pon1 knockout animals were more prone to oxidation and were less efficient in the protection of ldl from oxidation in co - cultured cell model of the artery wall compared with hdl from control mice .", "after the introduction of the oxidative stress hypothesis of atherosclerosis and the discovery of antioxidant effect of high - density lipoprotein ( hdl ) , pon1 attracted significant interest as a protein that is responsible for the most of antioxidant properties of hdl .", "paraoxonases were originally discovered as enzymes hydrolyzing exogenous toxic organophosphate compounds such as insecticide paraoxon .", "some in vitro data suggest that antioxidant activity might be related to other components of purified pon1 preparations ." ], [ "the first pon1 messenger ribonucleic acid ( mrna)ionanalysis in different rabbit tissues was performed by northern blot , and revealed pon1 mrna expression predominately in liver .", "biopsies showed pon1 mrna and protein expression in human but not in mouse gastrointestinal tract .", "deletion analysis in cultured cells revealed that cell type specific expression in liver and kidney is determined within first 200 bp of promoter area .", "two major principal hdl proteins , that is , apoa - i and/or apoa - ii which differ in their properties are linked to atherosclerosis modulation . thus , transgenic mice with hdl consisting of both human apoa - i and apoa - ii developed 15-fold greater lesions compared with mice with hdl containing solely human apoa - i . in vitro study of reconstituted hdl demonstrated that apoa - i containing hdl stabilizes pon1 binding as compared with protein - free hdl particles , and apoa - ii in opposite destabilizes the hdl ", "western blot confirmed presence of intact and degraded pon1 in media of healthy aorta . with the development of atherosclerosis , pon1" ], [ "thus , phenylephrine - constricted segments of the aortas relaxed significantly better in response to endothelium dependent agonists ach , adenosine-5-triphosphate ( atp ) , and uridine-5-triphosphate ( utp ) observations on pon1 role in animal models is summarized in table 2 .", "plasma arylesterase activity of apoe-/- , pon1-tg mice was 2.5-fold higher than that of apoe-/- animals , however , there is no difference between their lipid profile . a decreased inflammatory status of aortas in apoe-/- , pon1-tg mice compared with apoe-/- mice was detected by examination of the expression level of mcp-1 cytokine gene .", "peritoneal macrophages in pon1 overexpressing transgenic mouse on apoe-/- background have been compared with apoe-/- control have been reported . in another transgenic mouse model , pon1-tg , which overexpresses human pon1 gene of 55l/192q genotype , plasma level of arylesterase activity was twice higher in pon1-tg mouse compared with control mouse when animals were fed normal chow .", "similar to the previous study , 55m/192q variant of human pon1 gene was delivered in 18 month old apoe-/- mouse fed normal chow using adenovirus vector .", "hdl isolated from pon1-tg mouse plasma or apoe-/- , pon1-tg mouse plasma provided better protection against ldl oxidation , than hdl isolated from control animals . beside pon1 studies on transgenic mouse , a transient overexpression of pon1 gene in mouse" ], [ "a novel pon1 polymorphism associated with atherosclerosis was recently revealed , snp rs854563(a / g ) . in conclusion ,", "summary of allele differences of pon1 in vitro , and conclusions from pon1 human studies recent human studies on the role of pon1 in cvd some alleles of polymorphous genes can be causative factors in development of diseases and reliable predictors .", "currently , analyses of association of pon1 polymorphism with atherosclerosis - related diseases determined just one reliable association , an association of q192r polymorphism with ischemic stroke .", "human studies confirm protective role of pon1 in cad and another atherosclerosis - related disease , ischemic stroke .", "transient overexpression of pon1 in mouse demonstrated beneficial effects of pon1 beyond its antiatherogenic properties .", "meta - analysis of 47 studies with 9853 cad and 11,408 control subjects published in 2012 confirmed association of lower plasma pon1 activity with increased cad risk ( 19% lower pon1 activity , p < 0.00001 ) ." ] ]

[ [ "although uterine infarction is a relatively common occurrence after uae for the treatment of fibroids or adenomyosis , uterine infarction after ivf - et in a patient with adenomyosis is very rare . to our knowledge", ", this is the first report of uterine infarction after ivf - et in a patient with uterine adenomyosis in korea .", "the advised treatment for severe adenomyosis is total hysterectomy , but for patients wishing to preserve their uterus , a minimally invasive alternative procedure , uterine artery embolization ( uae ) , can be performed ." ], [ "she had suffered severe dysmenorrhea , menorrhagia , and pelvic pain due to severe adenomyosis which was diagnosed following a pelvic magnetic resonance imaging ( mri ) and clinical examination three years earlier .", "the patient had undergone three unsuccessful cycles of frozen - thawed embryo transfer at an external infertility clinic , due to primary infertility , during the period from 4 - 7 months before hospital admission .", "the patient was admitted to hospital for treatment of ovarian hyperstimulation syndrome ( ohss ) arising after controlled ovarian hyperstimulation about four months before the initiation of embryo transfer .", "the patient presented to hospital with vaginal bleeding , fever and abdominal pain on eleven days after embryo transfer , and received antibiotic treatment followed by supportive care at a local clinic for three days .", "two months later , pelvic mri showed interval regression of the previously noted possible focal uterine infarction site with a remarkably improved blood flow ( figure 2 ) ." ], [ "uterine infarction after ivf - et in a patient with adenomyosis has not previously been reported .", "this case demonstrates that uterine infarction should be considered in the differential diagnosis of acute abdominal pain , vaginal bleeding and infectious signs in women with biochemical abortion after ivf - et , with a history of adenomyosis and hyperthyroidism .", "the insertion of a hormonal intrauterine device could be considered another option for treating the symptoms of adenomyosis in cases presenting with focal uterine infarction dysmenorrhea and menorrhagia .", "in addition , the surgical management of focal uterine infarction , may be considered in the management of uterine infarction after ivf - et in patients with uterine adenomyosis if future fertility is not desired .", "the objective of uae is to initiate tumor infarction resulting in substantial reduction of the uterine and tumor volumes .", "a follow - up mri three months later showed only traces of uterine infarction lesion and adenomyosis . in conclusion , we experienced a rare case of uterine adenomyosis that developed into uterine infarction after ivf - et and biochemical pregnancy ." ] ]

[ [ ", transumbilical single - port surgery uses an umbilical single incision technique to access the peritoneal cavity and target organs . owing to the nature of umbilicus , single - port laparoscopy through the umbilicus offers an exciting opportunity to perform laparoscopic surgery with no visible scar . however , transumbilical single - port laparoscopy is not a new concept in gynecologic surgery [ 15 ] . in 1969 ,", ", we report our initial 100 cases observations of spa - lavh ( with or without bilateral salpingooophrectomy ( bso ) ) using a homemade , single - port , three - channel system .", "to optimize the benefits of minimally invasive procedures , surgeons have attempted to reduce the overall abdominal wall trauma by decreasing either the size of the ports or the number of trocars . in these efforts", "wheeless and thompson first published the technique and the results of a large series of laparoscopic tubal ligations using single - trocar laparoscopy ." ], [ "ligation of uterine vessel , cardinal and uterosacral ligament , extirpation of uterus , and vaginal stump closure were undertaken in the vaginal phase .", "the following parameters were determined in the present observational study : age , parity , bmi , surgical history , indication for surgery , operative time ( from incision to final umbilical closure ) , largest dimension of the uterus , weight of the extirpated uterus ( as pathology report ) , hemoglobin change ( from before surgery to postoperative day 1 ) , and perioperative and postoperative complications .", "all the surgical procedures were performed as a standard lavh ( with or without bso ) technique using conventional nonarticulated rigid laparoscopic instruments and the ligasure system ( valleylab , boulder , co , usa ) . as has been established earlier , exploration of pelvis , coagulation and cut of ligaments and vessel above the uterine vessel , and bladder mobilization were undertaken in laparoscopic phase .", "a retrospective medical records review was performed for the initial 100 patients who underwent spa - lavh at eun hospital . between march 2010 and september 2011 ,", "the alexis wound retractor consists of a proximal ring , distal ring , and connecting retractable sleeve ." ], [ "bladder injury occurred in one patient who had a history of three caesarean sections but was repaired through intraoperative laparoscopic suture .", "the operative time between laparoscopic phase and vaginal phase was similar but depended on pelvic pathology .", "all procedures were successfully completed through the single - port system and vagina without the need for extraumbilical puncture or conversion to laparotomy .", "no port - related complications were noted , and the cosmetic results and patient satisfaction were excellent .", "thirty - three patients had a past history of abdominopelvic surgery , such as a caesarean section , laparoscopic tubal ligation , appendectomy , ovarian cystectomy , or salpingooophrectomy . among these patients , six had a history of caesarean sections , five had a history of repeat caesarean sections , and five had a history of three caesarean sections .", "the postoperative course was uneventful in most patients , but three had a transient paralytic ileus , and five had pelvic hematoma , all of whom recovered following conservative managements ." ], [ "spa - lavh is a technically safe and feasible procedure , and the homemade single - port system offers reliable and cost - effective access for single - port surgery ." ], [ "as mentioned earlier , lavh is most ideal for single - port surgery because the vagina of woman can be considered as an additional route for surgery ; thus , uterine manipulators can be applied through the vagina . unlike uterine repair after myomectomy", "our observations show that a history of abdominopelvic surgery is not a contraindication for single - port surgery ; however , central obesity is problematic to secure a route for the single - port system through a small intraumbilical incision .", "this is because the vaginal stump can be repaired not by laparoscopy , but through the vagina .", "thus , spa - lavh is safe , and the procedure can be learned by skillful surgeons over a short period of time , because a considerable portion of the procedure can be performed through the vagina .", "additional clinical data and long - term followup may be needed to address port - related complications ." ] ]

[ [ "drug eruptions are common , affecting 23% of all hospitalized patients , and complications associated with medications make up the largest proportion of adverse events seen in hospitals .", "we present 3 cases that highlight these difficulties and the broad spectrum of drug eruptions in the setting of lymphoma patients receiving multidrug regimens including bendamustine .", "drug eruptions can be difficult to diagnose , particularly causality , as even biopsies are nonspecific and patients are often on more than one potentially offending medication ." ], [ "the third patient was a 59-year - old female diagnosed with stage ivb splenic marginal zone lymphoma after presenting with constitutional symptoms and urticaria .", "a diagnosis of dress syndrome was made . despite a high dose of steroids , the rash spread , eventually involving 100% of her body surface area , including her eyelids , conjunctiva , oral and vaginal mucus membranes . despite the use of filgrastim and broad spectrum antibiotics", "the decision was made to treat with bendamustine and rituxan as an inpatient due to nonresolving malignant pleural effusion .", "she was treated with splenectomy and systemic chemotherapy consisting of bendamustine and rituxan . prior to the third cycle ," ], [ "a diagnosis of dress syndrome was made . despite a high dose of steroids , the rash spread , eventually involving 100% of her body surface area , including her eyelids , conjunctiva , oral and vaginal mucus membranes . despite the use of filgrastim and broad spectrum antibiotics", "she developed a bullous rash involving 6070% of her skin as well as mucosa ( fig .", "a 60-year - old caucasian female presented with a 6-month history of constitutional symptoms , dyspnea on exertion , lymphadenopathy and pleural effusions and was diagnosed with stage iv marginal zone lymphoma with bone marrow involvement .", "the decision was made to treat with bendamustine and rituxan as an inpatient due to nonresolving malignant pleural effusion ." ], [ "the second case was a 66-year - old male diagnosed in 2009 with chronic lymphocytic leukemia associated with the deletion of chromosome 13 . in 2012 , his lymphocyte count reached 253,000 , and he developed autoimmune hemolytic anemia .", "this resolved as well . given the timing of the reaction , it was questioned that the offending drug was bendamustine in both events .", "the initial cycle was again given without rituxan due to the high burden of the disease .", "his rash slowly resolved . a second episode of nonneutropenic fever , hypotension and acute renal failure occurred with the second cycle of bendamustine and rituxan 2 months later .", "two days following the second admission ( day 7 following bendamustine ) , he developed a generalized erythematous rash with desquamation that did not resolve with the discontinuation of cefepime or the administration of rituxan .", "he initially received one cycle of intravenous immunoglobulin , cyclophosphamide , vincristine and prednisone ( without rituxan ) .", "he received antibiotic therapy with cefepime , fluconazole , azithromycin and levofloxacin during two separate hospitalizations ." ], [ "the third patient was a 59-year - old female diagnosed with stage ivb splenic marginal zone lymphoma after presenting with constitutional symptoms and urticaria .", "prior to the third cycle , the patient developed a mild pruritic eruption with raised plaques .", "the eruption worsened 2 weeks later as the lesions became intensely pruritic , erythematous and ulcerative . despite the treatment with antibiotics and corticosteroids , she progressed over the course of 1 week to a tense bullous rash covering the extremities ." ], [ "a biopsy revealed interface dermatitis with a lymphohistiocytic infiltrate . in our case of dress syndrome ,", "severe drug eruptions associated with high morbidity and mortality include stevens - johnson syndrome and toxic epidermal necrolysis .", "we also postulate that both the patient 's lymphoma and bendamustine itself may have induced a quicker response based on already reduced immunoglobulin levels and a rapid reduction in b - cell lymphocytes .", "another case report described a severe desquamating rash involving > 75% of the skin as well as oral mucosa .", "the term dress syndrome was later coined in 1996 as a syndrome specifically describing a drug eruption with internal organ involvement and hematologic abnormalities , particularly eosinophilia or atypical lymphocytosis .", "dress syndrome can be difficult to diagnose , as onset is typically 26 weeks after the drug was administered but is more probable when associated with hypereosinophilia , liver involvement , fever and lymphadenopathy .", "severity and likelihood of the diagnosis of dress as well as other severe cutaneous drug reactions are scored using the regiscar in europe ." ] ]

[ [ "although indomethacin is usually well tolerated , some patients developed gastrointestinal side effects , specially those patients who require long term therapy", ". therefore , the use of cyclo - oxygenase-2 specific inhibitors could reduce secondary effects and they are essentially equipotent to indomethacin in vitro and in vivo .", "indeed , some reports in the literature indicate the usefulness of the cox-2 inhibitors in the treatment of indomethacin - responsive headaches [ 38 ] .", "we report four cases of hemicrania continua and a patient suffering chronic paroxysmal hemicrania completely responsive to cox-2 inhibitors ." ], [ "a 42 years - old woman had sudden onset of short - lived pains on the left side of her head .", ". we discontinued indomethacin and introduced celecoxib 200 mg twice a day with completely recovery that persists 10 month later . a 76 years - old man with 6 month history of continuous left - sided headache and facial pain .", "we decided to discontinue indomethacin and introduced celecoxib 200 mg twice a day with completely recovery that persists 6 month later .", "we discontinued indomethacin and introduced celecoxib 200 mg twice a day with completely recovery that persists 18 month later ." ], [ "a 42 years - old woman had sudden onset of short - lived pains on the left side of her head .", "she suffers for a month an intense headache with short attacks ( about 510 min ) but high frequency ( 1018 attacks per day ) .", "we put her on indomethacin 25 mg 3 times a day , and in 24 h her hemicranial pain completely disappears . because of legs oedema we discontinued indomethacin and 1 week later the pain returned ." ], [ "a 56 years - old man present with an 8 month history of a continuous left - sided headache strictly unilateral .", "two - month later he started to have gastric symptoms , indomethacin was discontinued and the hemicrania return .", "the pain was moderate in intensity but fluctuating ( between 2 and 7/10 vas ) .", "the pain exacerbations were associated with lacrimation but not phono , photofobia , nausea or vomiting ." ], [ "a 78 years - old woman with 1 year history of continuous and strictly left - sided headache , fluctuating in intensity ( 39 in vas ) and accompanied by conjuntival injection and nasal congestion during exacerbation time .", "with indomethacin 50 mg 3 times a day the hemicrania disappear , however , she developed disabling subjective tinnitus 1 month later .", "we discontinued indomethacin and introduced celecoxib 200 mg twice a day with completely recovery that persists 18 month later ." ], [ "a 64 years - old woman with 3 years history of right - sided headache , fluctuating in intensity ( 28 in vas ) .", "with indomethacin 25 mg 3 times a day the hemicrania disappear , however , the patient suffer gastrointestinal disturbances .", "we discontinued indomethacin and introduced celecoxib 200 mg twice a day with completely recovery that persists 10 month later ." ], [ "a 76 years - old man with 6 month history of continuous left - sided headache and facial pain .", "we decided to discontinue indomethacin and introduced celecoxib 200 mg twice a day with completely recovery that persists 6 month later .", "after 2 weeks on indometacina he complaint about pyrosis , that persists after omeprazol 40 mg per day ." ], [ "we present five patients suffering indomethacin - responsive headache case 1 suffering from paroxysmal hemicranias and cases from 2 to 5 from hemicranias continua ( table 1 ) .", "anyhow , in our experience celecoxib is a good option treatment for patients suffering from hemicrania continua or chronic paroxysmal hemicranea that presents indomethacin adverse effects .", "all of them have absolutely response to indomethacin , but the presence of adverse reactions or intolerability let us discontinued and introduce celecoxib with completely recovery of the symptoms.table 1clinical characteristics of the patientscaseagegenderheadache typesidedoses ( mg)time in month142fhpleft20012256mhcleft40010378fhcleft40018464fhcright40010576mhcleft4006all doses correspond to celecoxibf female , m male , hc hemicrania continua , hp hemicrania paroxistica clinical characteristics of the patients all doses correspond to celecoxib f female , m male , hc hemicrania continua , hp hemicrania paroxistica indomethacin is consider the first - choice drug for the treatment of indomethacin - responsive headaches , and the headache resolution is consider as a diagnosis criteria in some of theses headaches .", "celecoxib have been previously reported to be effective in the treatment of other indomethacin - responsive headache [ 311 ] , however , there was no absolutely response in all patients ." ] ]

[ [ "according to early treatment of diabetic retinopathy study ( etdrs ) , protocol panretinal photocoagulation ( prp ) can prevent severe visual loss in proliferative diabetic retinopathy ( pdr ) .", "several studies have shown histopathologic changes in choroid of diabetic patients [ 24 ] . meanwhile , using panretinal photocoagulation ( prp ) , as was suggested beneficially by diabetic retinopathy study for proliferative diabetic retinopathy , has gotten general acceptance . with the advent of enhanced depth imaging optical coherence tomography ( edi - oct ) , it is now possible to visualize and measure choroidal changes easily .", "to the best of our knowledge , no other study has compared these two laser modalities in changing choroidal or central retinal thickness . in this study , we have evaluated the subfoveal choroidal , central retinal , and peripapillary retinal nerve fiber layer ( rnfl ) thickness changes before and after prp using edi - oct and we compare the green and red laser in this regard ." ], [ "primary objective was to determine subfoveal choroidal and retinal thickness and peripapillary nerve fiber layer thickness changes 6 weeks after red versus prp laser . a complete ophthalmic examination including best corrected visual acuity ( bcva ) using snellen chart , goldmann applanation tonometry , and dilated indirect ophthalmoscopy was conducted .", "spectral domain optical coherence tomography images were obtained using spectralis oct ( heidelberg engineering , heidelberg , germany ) to measure central retinal thickness and enhanced depth imaging ( edi ) mode to measure subfoveal choroidal thickness .", "one eye of all patients was randomly assigned to red laser and the other eye to green laser .", "laser setting parameters did not differ significantly between two groups ( mean power 303 mwatts in red and 290 mwatts in green laser group , p value : 0.14 ; mean laser spots 1789 spots in red and 1869 spots in green laser group , p value : 0.13 ) .", "bcva measurement and an oct scan were performed at baseline and 6 weeks after completion of prp .", "also retinal nerve fiber layer ( rnfl ) thickness analysis was done at baseline and 6 weeks after treatment .", "a paired sample t - test was used to compare macula and choroid thickness before and after treatment ." ], [ "the mean visual acuity of patients was 0.32 0.28 logmar and 0.27 0.23 logmar in red laser group and green laser group , respectively .", "there was not a significant difference between red and green laser in terms of choroidal thickness changes from baseline ( p value 0.184 ) .", "the mean subfoveal ct increased significantly in each group at 6 weeks follow - up ( in red laser group , 202.14 24.5 micron at baseline and 211.7 26.6 micron at 6 weeks , p value < 0.00 , showing 4.86% ct increase compared to baseline ) ( in green group , 201.9 21.13 micron at baseline and 208.9 25.0 at 6 weeks , p value <", "there was no significant association between choroidal thickness change and retinal thickness change in each group ( p values : 0.051 and 0.52 , resp . ) .", "there was no significant difference between macular thickness increase between two groups ( p value : 0.404 ) ( table 2 ) ." ], [ "in this study , in eyes with proliferative diabetic retinopathy and without significant macular edema , the mean subfoveal choroidal , central retinal , and peripapillary rnfl thickness increased significantly after both red and green argon laser treatments .", "nonetheless , this study showed significant increase of subfoveal choroidal , foveal retinal , and peripapillary rnfl thickness after red and green laser prp and no significant difference between these two lasers in aforementioned measurements .", "one of the novel analyses done in this study is the comparison between red and green laser in changing retinal , choroidal , and rnfl thickness ." ] ]

[ [ "the objective of this analysis was to estimate the cost - effectiveness of erlotinib versus best supportive care when used as first - line maintenance therapy for patients with locally advanced or metastatic nsclc and stable disease following first - line therapy in three european countries , ie , france , germany , and italy .", "bevacizumab has been approved for use in patients with metastatic non - squamous nsclc in combination with platinum - based chemotherapy until disease progression.9 however , there remains an unmet need for further treatment options that extend survival in patients with advanced or metastatic nsclc .", "an alternative treatment strategy that can be used to prolong duration of first - line treatment and extend survival in metastatic nsclc is first - line maintenance therapy .", "maintenance therapy is defined as the prolongation of treatment duration or administration of additional treatment at the end of a defined number of initial chemotherapy cycles , after maximum tumor response has been achieved ( this may be complete response , partial response , or stable disease ) .", "the prognosis for patients with non - small cell lung cancer ( nsclc ) deteriorates with advancing disease stage , and only about 1% of patients with metastatic nsclc are alive after 5 years.1 the most appropriate treatment for these patients is palliative , systemic , platinum - based chemotherapy in first line.25 however , platinum - based , first - line treatment is limited to 46 cycles due to cumulative toxicity and a plateau in effectiveness . following discontinuation of chemotherapy , most patients will experience disease progression within 23 months.6,7 previous guidelines have recommended withholding second - line treatment until disease progression.2,3 however , cappuzzo et al suggested that 30%50% of patients were not receiving second - line treatment due to rapid disease progression and decreasing performance status.8 hence , there is a need for therapies that prolong the clinical benefits of first - line treatment ." ], [ "to estimate the incremental cost - effectiveness of erlotinib , an economic decision model was developed using patient data on progression - free survival and overall survival for erlotinib and best supportive care as first - line maintenance therapy from the saturn trial.8 an area under the curve ( or partitioned survival ) model was developed consisting of three health states , ie , progression - free survival , progression , and death ( figure 1 ) .", "administration costs were obtained from france,15 germany,16 and italy.17 country - specific estimates of the most likely minimum and maximum costs of treatment - related adverse events were employed to propagate the gamma distribution to express uncertainty in the cost of treating the event.18 the cost values were then applied to the frequency of adverse events.1921", "the model was developed from the perspective of the national health care payer in three european countries , ie , france , germany , and italy ; therefore , indirect costs , including travel costs , and costs to other public agencies were not included .", "distributions around the following parameters were used to reflect uncertainty in the model ( ie , the probability of erlotinib being cost - effective ) : estimates for the parametric progression - free survival and overall survival functions , and cost and frequency of adverse events .", "the cost of erlotinib was incorporated into the model using the country - specific list price of a pack of 30 150 mg tablets ( 2130.00 , 2928.24 , and 1864.57 for france , germany , and italy , respectively ) and was applied in the base - case analysis for the average treatment duration during the clinical trial ( table 1 ) . as per the study protocol", ", patients received a single daily dose of erlotinib 150 mg orally . in order to calculate the monthly cost of erlotinib , the cost per 150 mg tablet ( 71.00 , 83.63 , and 49.10 , respectively ) was multiplied by the average number of days per month ( 30.4 days , table 1 ) . to estimate the resource use associated with administration of erlotinib" ], [ "the model was developed from the perspective of the national health care payer in three european countries , ie , france , germany , and italy ; therefore , indirect costs , including travel costs , and costs to other public agencies were not included .", "an area under the curve ( or partitioned survival ) model was developed consisting of three health states , ie , progression - free survival , progression , and death ( figure 1 ) . survival data from the trial were used to follow patients from the progression - free survival to the progression and death states , and allowed for extrapolation of the data beyond the trial period .", "in addition , insufficient data were reported in the saturn study on second - line treatment dosing and duration .", "distributions around the following parameters were used to reflect uncertainty in the model ( ie , the probability of erlotinib being cost - effective ) : estimates for the parametric progression - free survival and overall survival functions , and cost and frequency of adverse events .", "adverse events were selected for inclusion in the model by grade of severity and frequency of occurrence by event and treatment arm , according to the following rules : all treatment - related adverse events grade 34 , and adverse events that occurred from the start of the study and 28 days after the last cycle of first - line treatment inclusively .", "the model uses the stable disease population , as indicated in the european union label,12 to calculate efficacy and the same dose as was used in the trial , ie , erlotinib 150 mg / day orally + best supportive care or placebo + best supportive care .", "probabilistic sensitivity analyses were performed to investigate the impact of changes in the key input parameters and assumptions on the results of the base - case analysis ." ], [ "the gamma function13,14 provided the best fit for overall survival , whereas for progression - free survival the gompertz distribution14 was shown to be the best fit for the stable disease population .", "survival curves were fitted parametrically to the kaplan meier progression - free survival and overall survival curves to facilitate extrapolation beyond the clinical trial period .", "the cost of erlotinib was incorporated into the model using the country - specific list price of a pack of 30 150 mg tablets ( 2130.00 , 2928.24 , and 1864.57 for france , germany , and italy , respectively ) and was applied in the base - case analysis for the average treatment duration during the clinical trial ( table 1 ) . as per the study protocol , patients received a single daily dose of erlotinib 150 mg orally . in order to calculate the monthly cost of erlotinib , the cost per 150 mg tablet ( 71.00 , 83.63 , and 49.10 , respectively ) was multiplied by the average number of days per month ( 30.4 days , table 1 ) . to estimate the resource use associated with administration of erlotinib ,", "therefore , these functions were used in all analyses to estimate and extrapolate progression - free survival and overall survival beyond the clinical trial period .", "administration costs were obtained from france,15 germany,16 and italy.17 country - specific estimates of the most likely minimum and maximum costs of treatment - related adverse events were employed to propagate the gamma distribution to express uncertainty in the cost of treating the event.18 the cost values were then applied to the frequency of adverse events.1921", "the appropriate reference costs associated with administration of oral medication in the pharmacy were used ( table 1 ) ." ], [ "treatment with erlotinib in first - line maintenance resulted in a mean life expectancy of 1.39 years ( 16.7 months ) in all countries , compared with a mean 1.11 years ( 13.3 months ) with best supportive care , which represents 0.28 life - years ( 3.4 life - months ) gained with erlotinib versus best supportive care .", "comparison of the total average costs of alternative therapies for first - line maintenance shows that erlotinib was more costly than best supportive care in all three countries .", "the cost per life - year gained was 39,783 , 46,931 , and 27,885 in france , germany , and italy , respectively . in the probabilistic analysis , the cost per life - year gained was 39,214 , 46,816 , and 27,864 , respectively .", "these curves show that there is a 50% chance that erlotinib would be cost - effective in first - line maintenance with a willingness to pay approximately 50,000 in france and germany and 40,000 in italy .", "the variation in cost per life - year gained between countries was due to the difference in the total monthly cost of erlotinib , which comprises administration costs , acquisition costs , and costs of adverse events ( table 3).2225 a cost - effectiveness acceptability curve for each country , generated from the probabilistic analysis , is presented in figure 2 .", "results of the base - case and probabilistic analyses , presented as mean values and corresponding 95% ci for the latter are shown in table 2 . in the base - case analysis ," ], [ "in addition to the clinical similarity and economic advantages of erlotinib over pemetrexed , erlotinib may also have other advantages due to a lower incidence of adverse events and an oral , as opposed to intravenous , formulation.8 oral treatment is often considered more convenient and is not usually associated with any administration costs .", "an increase in health care expenditure in cancer care makes cost - effectiveness analysis an important tool for national health care payers.26 this is the first analysis of its kind to present a cross - market analysis of cost per life - year gained for first - line maintenance therapy in patients with locally advanced or metastatic nsclc . in each country , erlotinib resulted in a survival gain when compared with best supportive care .", "treatment of advanced or metastatic nsclc is often considered costly ; however , the value of a new treatment should incorporate the clinical benefit it provides compared with current treatment options , and the incremental cost of funding the new therapy versus the unmet need . in view of the current poor survival outcomes in metastatic nsclc" ], [ "erlotinib is a cost - effective treatment option versus best supportive care when used as first - line maintenance therapy for locally advanced or metastatic nsclc in patients with stable disease .", "this study suggests that , in conjunction with toxicity and efficacy data , economic analyses are useful in defining the best maintenance strategy for patients with locally advanced or metastatic nsclc ." ] ]

[ [ "therefore , we hypothesised that if we administer la and the adjuvants separately , it may minimise the effect of the changes in densities and also hence their actions . thus , in this study we aimed to compare block characteristics , intra - operative haemodynamics and post - operative pain relief in parturients undergoing cs under subarachnoid block ( sab ) , after administering hyperbaric bupivacaine ( hb ) and clonidine as a mixture in single syringe and sequentially in two syringes .", "density is known to influence the spread of la , but the effect of adjuvant solution density on its movement in the csf has not been studied extensively .", "clonidine , a selective partial agonist for alpha-2 adrenoreceptors , is an attractive alternative to commonly used opioids , and is known to increase both sensory and motor block of la .", "several studies have shown that clonidine also has antihyperalgesic effect and thus reduces the post - operative analgesic requirement .", "spinal anaesthesia has been widely used for caesarean section ( cs ) deliveries because of greater maternal safety , foetal benefits , higher parental satisfaction , and consumer demand . however , to address the problem of limited duration of action and to improve the quality of analgesia , various adjuvants are added intrathecally with local anaesthetics ( la ) .", "the adjuvants gained widespread popularity as they reduce the amount of la and thus the incidence of side - effects ." ], [ "group b ( n = 30 ) received clonidine 75 mcg ( 0.5 ml ) followed by hyperbaric bupivacaine ( 0.5% ) 10 mg ( 2 ml ) in different syringes . for our study", "( n = 30 ) received hyperbaric bupivacaine ( 0.5% ) 10 mg ( 2 ml ) and clonidine 75 mcg ( 0.5 ml ) as a mixture .", "monitor for heart rate ( hr ) , non - invasive blood pressure , electrocardiography and oxygen saturation ( spo2 ) was connected and baseline parameters were recorded . after establishing 18 gauge venous cannula , patients were pre - loaded with 15 ml / kg of lactated ringer 's solution 15 - 20 min before spinal block . under all aseptic precautions sab was administered with 23 g quincke spinal needle through mid - line approach in sitting position .", "the patients were familiarised with the concept of visual analogue scale ( vas ) for pain assessment with 0 = no pain and 10 = worst possible pain . in the operating room ,", "patients having multiple pregnancy , intrauterine deaths or known foetal anomaly , severe pregnancy induced hypertension , contraindication to sab , patients on cardiovascular medications and those having history of hypersensitivity to clonidine and la were excluded from the study . using a sealed envelope technique ,", "duration of effective analgesia was defined as time from it injection till vas was 3 , when rescue analgesia in the form of injection i.v diclofinac sodium 75 mg was administered .", "intrathecal ( it ) drug was injected in l3-l4 interspace over 30 s ( including the time for change of syringe in sequential administration ) ." ], [ "intra - operative incidence of hypotension , bradycardia , respiratory depression , nausea / vomiting , dry mouth and additional analgesic requirement are comparable in both groups [ figure 4 ] .", "the onset time of sensory and motor block and also the highest level of block achieved ( t4 ) were comparable in both groups [ table 2 ] . mean time to reach maximal cephalad sensory block height was significantly less in group b ( 3.21 0.13 min ) than in group m ( 4.43 0.26 min ) and the total duration of analgesia lasted significantly longer in group b ( 474.3 20.79 min ) as compared to group m ( 337 18.22 min ) ( p = 0.000 ) .", "there was an overall trend of fall in sap and dap in both groups , except during the time intervals of 20 and 25 min ( during delivery of baby ) where there was rise in both sap and dap [ figures 2 and 3 ] .", "the resolution time of motor block back to modified bromage i was significantly prolonged in group b ( 292.23 15.24 min ) than in group m ( 189.50 16.31 min ) [ table 2 ] .", "newborn 's well - being , assessed by the apgar scoring system was observed in both groups .", "complete motor blockade was achieved earlier in group b ( 4.75 0.40 ) than in group m ( 5.84 0.36 ) ( p = 0.000 ) ." ], [ "is observed only with intermediate doses of spinal clonidine ( 150 mcg ) and relative haemodynamic stability is maintained after larger doses ( 300 - 400 mcg ) , we were interested to test a dose of lower range of efficacy . hence , we selected a 75 mcg of preservative free clonidine as an adjuvant for spinal anaesthesia in cs .", "kaabachi et al . , in their study used 2 mcg / kg of it clonidine and reported extended duration of post - operative analgesia , but with moderate side - effects .", "sethi et al . , used 70 mcg of clonidine and found a significant decrease in mean arterial pressure and hr in clonidine group , but no therapeutic intervention was required for either . since marked decrease in blood pressure", "various authors have used different doses of it clonidine ranging from 15 mcg to 300 mcg along with local anaesthetics .", "patients scheduled for cs were chosen for the study because it is a well - known fact that visceral discomfort and pain is common occurence in cs under sab ." ], [ "sequential administration of clonidine reduces the time to achieve complete sensory and motor block and significantly prolongs the total duration of analgesia .", "however , we noticed that sequential technique did not increase the level of sedation and incidence of hypotension or bradycardia as compared to the administration of drugs as mixture .", "addition of clonidine to hyperbaric bupivacaine provided a dense surgical anaesthesia irrespective of the technique of administration ." ] ]

[ [ "thus , we report the perioperative outcomes of 106 consecutive patients treated with partial nephrectomy by a single surgeon using all three surgical approaches opn , lpn , and rpn .", "in experienced hands , laparoscopic partial nephrectomy ( lpn ) is associated with similar oncologic outcomes to open partial nephrectomy ( opn ) with the added benefit of decreased narcotic use , decreased hospital stay , and earlier convalescence [ 57 ] .", "renal cell carcinoma ( rcc ) is one of the most lethal genitourinary cancers and comprises 85% of these new diagnoses .", "numerous treatment options exist for clinical t1a disease , including total nephrectomy , partial nephrectomy , radiofrequency ablation , cryoablation , and high - intensity focused ultrasound ( hifu ) . in 2009 ,", "our hypothesis is that when performed by a single surgeon , open , laparoscopic , and robotic partial nephrectomy could differ in postoperative complication rates and overall kidney function .", "robotic partial nephrectomy ( rpn ) and lpn have also been compared with similar outcomes , if not superior rpn outcomes , in the hands of an experienced minimally invasive surgeon .", "the american urologic association ( aua ) published the guideline for the clinical stage 1 renal mass which concluded that partial nephrectomy is the standard of care for clinical t1a disease suggesting that the open approach is preferred over minimally invasive techniques ." ], [ "after obtaining institutional review board approval , a retrospective chart review of a prospectively collected kidney cancer database was performed . from august 2006 to february 2012 , a single surgeon ( rm ) with minimally invasive and urologic oncology fellowship training performed 106 consecutive partial nephrectomies using any of the three available surgical modalities opn , lpn , or rpn .", "initially in the practice , lpn was offered to patients with tumors of favorable size and location .", "opn was reserved for patients who were uninephric , had compromised kidney function , or had large tumors in an unfavorable location . in early 2008 , rpn gradually replaced lpn as the preferred minimally invasive approach .", "the decision for the approach was multifactorial and was based on patient and tumor characteristics .", "the indication for partial nephrectomy was an enhancing renal mass found on cross - sectional abdominal imaging .", "preoperative variables and demographics analyzed included age , gender , body mass index ( bmi ) , american society of anesthesiologist ( asa ) score , glomerular filtration rate ( gfr ) , hematocrit ( within 30 days of surgery ) , tumor laterality , and tumor size .", "postoperative variables included length of stay , discharge hematocrit , transfusion , gfr , 3-month gfr , and 30-day complications ." ], [ "among the 106 patients in the study , 23 patients ( 22% ) underwent opn , 48 patients ( 45% ) underwent lpn , and 35 patients ( 33% ) underwent rpn .", "there was no difference in intraoperative complication rate , tumor pathology , or margin status between the opn , ldn , and rpn patients ( table 2 ) .", "there was a statistical trend towards lower preoperative hematocrit for opn patients compared to the minimally invasive patients ( opn40 4% , lpn43 4% , rpn42 4% , p = 0.09 ) .", "discharge hematocrit was significantly lower for opn patients ( 30 3% ) compared to lpn ( 36 4% ) and rpn ( 35 4% ) patients ( p < 0.0001 ) . upon follow - up", "there were no differences in length of stay , blood transfusion , discharge gfr , or 3-month gfr for the three cohorts of patients ( table 3 ) ." ], [ "surgical confounders were minimized as only operations performed by a single surgeon were analyzed . secondly , renorrhaphy differed between the opn and minimally invasive cohorts along with the use of renal cooling in the opn group compared to warm ischemia time for the minimally invasive approaches .", "the current study is the first , to our knowledge , which compares all three modalities of pn ( opn , lpn , and rpn ) by a single surgeon .", "radical nephrectomy ( rn ) has been the mainstay of treatment for clinical stage i tumors resulting in excellent cancer specific survival , local tumor control , and progression free survival ; however , reports have highlighted a negative impact on renal function and chronic kidney disease ( ckd ) associated with rn .", "furthermore , recent studies have established that partial nephrectomy ( pn ) provides similar oncological outcomes when compared to rn [ 1214 ] ." ], [ "nephron sparing surgery has emerged as the optimal surgical approach for t1a and in experienced hands t1b kidney masses . by removing surgeon as a confounding variable ,", "although not currently the gold standard for partial nephrectomy , robotic surgery continues to emerge as the future for renal surgery secondary .", "rpn offers less blood loss and fewer postoperative complications than opn and overcomes the technical difficulties of lpn ." ] ]

[ [ "job syndrome is one of the hyper immunoglobulin e ( ige ) syndrome ( hies ) conditions characterized by signal transducer and activator of transcription 3 ( stat3 ) signaling mutations .", ", it was hypothesized that there would be a lower incidence of clinical anaphylaxis among pediatric job syndrome patients .", "patients with job syndrome have characteristic clinical features in association with mutations in stat3 signaling .", "these include marked elevation in serum ige and susceptibility to staphylococcal infections of the pulmonary tract and skin.1 one of the hallmark features of the disease includes the formation of abscesses . on the basis of the elevation of serum ige levels" ], [ "the total number of patients was identified with 1 ) job syndrome / hies ; 2 ) asthma with anaphylactic shock ; 3 ) anaphylactic shock with and without peanut allergy , and with and without milk allergy ; and 4 ) job syndrome / hies with anaphylactic shock .", "the anonymous data generated for anaphylactic shock , asthma with anaphylactic shock , and job syndrome / hies were used to identify patients .", "the database from a large urban children s medical center was searched from january 1 , 2009 to december 31 , 2014 , using the international classification of diseases , ninth revision ( icd-9 ) codes assigned to each diagnosis , job syndrome , hies , and anaphylaxis .", "the icd-9 codes used corresponding to each diagnosis were as follows : asthma , 493.00493.99 ; job syndrome , 288.1 ; and anaphylactic shock , 995.61 ( peanut ) and 995.67 ( milk ) .", "an electronic medical record database , including both inpatient and outpatient records , was utilized .", "the database search was conducted with the medical center health information support and did not involve personal health information analysis ." ], [ "there were 250 cases ( 40.7% ) of peanut allergen - induced anaphylaxis and 78 cases ( 12.7% ) were because of milk products .", "the total number of patients with job syndrome / hies identified in the database was 18 . among the 22,890 patients evaluated with asthma", "of the 614 total anaphylactic patient cases identified , 286 ( 46.5% ) had anaphylaxis with no determined specific cause .", "some patients may have been coded for one or more causes of shock . despite the elevation of ige associated with hies / job syndrome", "a one- and two - tailed t - test showed that there was no statistically significant difference when comparing asthma and anaphylaxis and hies with anaphylaxis ." ], [ "a one- and two - tailed t - test showed that there was no statistically significant difference when comparing asthma and anaphylaxis and hies with anaphylaxis ." ], [ "this study finds support for a potential protective effect of stat3 mutations in preventing anaphylaxis and demonstrates this finding in a pediatric population .", "the association between allergic disease and autosomal - dominant ( ad ) hies was studied in a murine model .", "this study shows that there were no identified cases of anaphy - laxis among the job syndrome / hies population studied .", "the incidence of anaphylaxis among children and adolescents has been reported as between 0.05% and 2%.2 this study identified > 600 cases of anaphylaxis , during the same time period at the same medical center , among the non - hies pediatric population ." ] ]

[ [ ", the exhibition of markers of apoptosis by the parasite could be a contributing factor during host - parasite interactions as a possible immunosuppressive mechanism of dcl .", "once infecting mammalian hosts , these organisms , from free - living protozoa , become obligate intracellular parasites , residing and proliferating inside phagolysosomes of mononuclear phagocytic cells as amastigote forms . in humans , leishmania parasites can cause a broad spectrum of clinical manifestations from mild , self - resolving skin diseases to potentially fatal , disseminated visceral diseases .", "the determinants of dcl are multifactorial and may be associated with both immunologic and genetic events of the patient and the pathogenic factors related to the parasite and vector .", "the outcome of the infection is dependent on multiple , interdependent factors , such as vector species , parasite species and strain , genetic background , and immunological status of the host .", "the participation of factors associated with the parasite has been shown by some authors although it is a point that still remains to be further explored . in this context" ], [ "the mechanisms underlying pathogenic role of t cells for the disease need to be determined .", "experimental infection models with leishmania parasites have been extensively used as a tool to study immune responses , especially regarding t - cell differentiation [ 8 , 9 ] .", "actually , there are several papers that suggest that most correlations between cd4 t - cell response and disease development are not straightforward .", "these events are necessary to evade the early immune response culminating with the ineffective t - cell response observed in most cases . in parallel to l. major infection in balb / c mice , where the oligoclonal v4 v8 cd4 t - cell population is necessary to the development of susceptibility in the host and is considered as pathogenic t cells , in l. amazonensis infection , t cells , in a general way , seem to be highly pathogenic .", "effective macrophage activation is the key to control the infection ; however , the phenotype displayed by t cells in different situations is not as polarized as observed in the classical model ." ], [ "we believe that understanding the dynamics of ps expression , along with identification of the mechanisms involved in the immunosuppression of dcl patients , can result in therapeutic targets for intervention in the immunopathogenesis of this chronic and severe form of leishmaniasis . in a similar way we are interested in the immunomodulatory mechanisms underlying ps exposure in different inbred mice strains . for that we are currently evaluating these mechanisms during balb / c infection , which induces high levels of ps exposure on intracellular amastigotes . we observed that ps exposure is intrinsic to the intracellular parasite and", "we summarized our hypothesis regarding the t - cell - dependent modulation of ps exposure on intracellular amastigotes of l. amazonensis .", "we understand that the unique characteristics of the t - cell response to l. amazonensis infection contribute to the generation of a perfect environment to stimulate and maintain increased levels of ps on the surface of intracellular parasites .", "this observation demonstrates that the amount of ps at the surface of the amastigotes has a positive correlation with the severity of the disease and suggests that the host is able to modulate this phenotype of the parasite .", "we propose that high levels of ps exposure are induced by parasite stress delivered by inos activity .", "actually the results so far are promising . in murine models of lassa fever ( pichinde virus ) or murine" ], [ "the observation of ps exposure as a strategy to evade the immune system and persist in the mammalian host , made initially in the experimental model of l. amazonensis infection , was a breakthrough since it stimulated different groups around the world to look for the possibilities for basic and applied research on the field .", "we believe that this could be a major strategy in different systems where avoidance from immune surveillance is necessary to establish a disease .", "our group is still studying the immunological , cellular , and molecular mechanisms underlying control of ps exposure in parasites and the effects of its recognition by parasitized cells and organisms ." ] ]

[ [ "despite of presentation of medical ethics as a new science in academic teaching , the ethical concepts have been alongside the medicine , and its antiquity back to the medicine history .", "taken together , we decided to evaluate the nurses knowledge about patients rights in one of the teaching hospitals of tehran city .", "considering that health is the most important existence aspect of every person and according to the article 29 of the constitution , providing health is the most important commitment of the government of islamic republic of iran ; because of this , in 2002 , for the first time the patients right charter was developed in iran and was notified by department of health , treatment and medical education ( 7 )", "for instance , literatures such as hippocratic oath letter , liturgy of ibn maymun , and shirazi ethics ordinance are the old literatures in which the principles such as the necessity of patient preference defender on the physician and observing the principle of confidentiality have been emphasized . however , in the past literature using physician s commitment and pledge ", ". the patients right charter of iran was approved by health policy council with a new and comprehensive viewpoint aimed to clarify the rights of the health services recipients and observance of moral standards in the treatment and medical fields in november 26th , and in december 1st it was communicated to the relevant centers ( 1 , 8 , 9 ) . in this charter patient satisfaction is considered as one of the characteristics of hospital effectiveness ( 9 ) ." ], [ "right to announce personal satisfaction from ending the treatment and referring to other centers , and right to preserve privacy and being ensured about confidentiality of all of the medical information .", "this was a descriptive cross - sectional study in which the nurses knowledge about patient rights was determined .", "the study samples consisted of 156 nurses who have been selected randomly from one of the teaching hospitals of tehran .", "the data collection instrument was a two - part questionnaire ; the first part included the demographic information ( age , gender , marital status , work experience , educational level , etc . ) ; the second part consisted of 10 questions according to the 10 section of patients rights charter of iran ( 11 ) .", "the validity was done using content validity i.e. the questionnaire was given to 10 faculty members of universities of tehran and after collecting the comments , the relevant comments were applied .", "the validated questionnaire was given to 10 eligible study subjects for reliability and in both stages the questionnaire was completed with a 10-day interval and the required correlation of the first and second answers and confidence was obtained r = 0.90 and finally these people were excluded from the study population .", "the answers of the study subjects to the questions were quantified by measuring a three - score scale ; good ( 3 scores ) , moderate ( 2 scores ) and weak ( 1 scores ) .", "the maximum score in the questionnaire was 30 scores which were considered 2130 as high knowledge , 1020 as moderate knowledge and less than 10 as weak knowledge .", "right to receive respectful and quick treatment and care regardless of cultural and racial factors .", "right to know about the probable complications , treatment options and participate in the ultimate treatment choosing ." ], [ "most of them ( 91.2% ) had bachelor degree and were married ( 62.82% ) . in terms of employment and work experience , almost half of nurses ( 47.43% ) were contractual , 46.79% had 610 years of work experiences , 30.99% never passed any course about patient rights and 30.99% of them had the simultaneous experience in public and private sectors .", "there was no significant difference between them in terms of work section , work experience and simultaneous work in the public and private sectors , however there was a significant difference between their level of knowledge about patient rights and simultaneous work in the public and private hospitals and work experience ( table 1 ) .", "the review of the demographic variables indicated that the majority of the nurses were females ( 76.28% ) with mean age of 34.31 7.3 .", "the findings of the study about the nurses level of knowledge in different areas indicated that the highest level of knowledge ( 95.51% ) was in the area of right to preserve privacy and being ensured about confidentiality of all medical information and the lowest level was right to receive essential information about health care providers , rate of tariff , target insurance coverage if sent to the other medical centers .", "no association between the variables of gender , age , degree and marital status and nurses knowledge about patient rights was found ." ], [ "according to the considerable gap between development and realization of the patient rights ( 20 ) and the increased knowledge , claims and demands of the patients and also the results of this study , in order to observe patients right the following solutions are suggested : - encouraging the nurses to consider patients right charter seriously . - establishing and empowering the sanction of patients right charter - more emphasizing on concepts of professional ethics and patient rights in teaching nursing students - attending expertise meetings with presence of beneficiaries for evaluating barriers and presenting strategies in order to implement the patients right charter as soon as possible - providing periodic educational programs for health care providers and patients about patient rights", "the findings of the present study indicated that in the area of right to preserve privacy and being ensured about confidentiality of all the medical information , the nurses had the highest level of knowledge . in the patients", "the results indicated that there was a significant and direct association between level of knowledge and simultaneous jobs in the public and private hospitals ( p=0.01 ) i.e. the nurses who provided services simultaneously in the public and private hospitals had higher level of knowledge .", "the results indicated that 66% of the nurses was aware of the right to access to the health care providers during hospitalization , instead of 90% of turkish nurses ( 17 ) . nowadays ethical and legal concepts such as patient rights are included in the educational curriculum of greek and turkey ( 18 , 19 ) ." ], [ "generally , since 41.6% of the nurses of the study had not a proper level of knowledge about patient rights and considering the fact that awareness and knowledge can be the base of nurses performance and also patients increasingly are getting informed about their rights , the implementation of patients right charter is highly recommended .", "holding educational programs , seminars , workshops and academic panels for nurses , and nursing students help overcome difficulties ." ] ]

[ [ "our study cohort consisted of 5,465 singleton children of european ancestry with recorded birth weight information .", "we performed high - throughput genome - wide single nucleotide polymorphism ( snp ) genotyping using the illumina infinium ii humanhap550 or human 610 beadchip technology ( illumina , san diego , ca ) at the children 's hospital of philadelphia 's center for applied genomics , as described previously ( 23 ) .", "only being described on the affymetrix array , we either already had that snp on our illumina array or identified and used the best surrogate snp available based on the ceu hapmap ( supplementary table 1 , available in the online appendix at http://diabetes.diabetesjournals.org/cgi/content/full/db09-0506/dc1 ) .", "we used two snps at the cdkal1 ( rs4712523 and rs7756992 ; r = 0.677 ) , hhex - ide ( rs1111875 and rs7923837 ; r = 0.698 ) , and pparg ( rs17793693 and rs6802898 ; r = 0.011 ) loci as the association with type 2 diabetes , taken from various gwa studies that reported various snps that were in imperfect linkage disequilibrium with each other .", "most loci described from gwa studies published to date have been found using either the affymetrix or illumina platform . in the event", "a locus was reported using both the illumina and affymetrix arrays , we used the snps present on the illumina array . in the event of a signal" ], [ "our study cohort consisted of 5,465 singleton children of european ancestry with recorded birth weight information .", "all subjects were consecutively recruited from the greater philadelphia area from 20062009 at the children 's hospital of philadelphia .", "all of these participants had their blood drawn in an 8-ml ethylenediamine tetraacetic acid blood collection tube and subsequently dna extracted for genotyping .", "this study was approved by the institutional review board of the children 's hospital of philadelphia .", "parental informed consent was given for each study participant for both the blood collection and subsequent genotyping ." ], [ "our study cohort consisted of 5,465 singleton children of european ancestry with recorded birth weight information .", "all subjects were consecutively recruited from the greater philadelphia area from 20062009 at the children 's hospital of philadelphia .", "all of these participants had their blood drawn in an 8-ml ethylenediamine tetraacetic acid blood collection tube and subsequently dna extracted for genotyping .", "this study was approved by the institutional review board of the children 's hospital of philadelphia .", "parental informed consent was given for each study participant for both the blood collection and subsequent genotyping ." ], [ "we used two snps at the cdkal1 ( rs4712523 and rs7756992 ; r = 0.677 ) , hhex - ide ( rs1111875 and rs7923837 ; r = 0.698 ) , and pparg ( rs17793693 and rs6802898 ; r = 0.011 ) loci as the association with type 2 diabetes , taken from various gwa studies that reported various snps that were in imperfect linkage disequilibrium with each other .", "a locus was reported using both the illumina and affymetrix arrays , we used the snps present on the illumina array . in the event of a signal", "we performed high - throughput genome - wide single nucleotide polymorphism ( snp ) genotyping using the illumina infinium ii humanhap550 or human 610 beadchip technology ( illumina , san diego , ca ) at the children 's hospital of philadelphia 's center for applied genomics , as described previously ( 23 ) .", "only being described on the affymetrix array , we either already had that snp on our illumina array or identified and used the best surrogate snp available based on the ceu hapmap ( supplementary table 1 , available in the online appendix at http://diabetes.diabetesjournals.org/cgi/content/full/db09-0506/dc1 ) .", "most loci described from gwa studies published to date have been found using either the affymetrix or illumina platform . in the event", "the snps analyzed survived the filtering of the genome - wide dataset for snps with call rates < 95% , minor allele frequency < 1% , missing rate per person > 2% , and hardy - weinberg equilibrium p < 10 .", "in addition , rs4712523 is a proxy ( r = 1 ) for rs10946398 , which was previously associated with birth weight ." ], [ "we used two snps at the cdkal1 ( rs4712523 and rs7756992 ; r = 0.677 ) , hhex - ide ( rs1111875 and rs7923837 ; r = 0.698 ) , and pparg ( rs17793693 and rs6802898 ; r = 0.011 ) loci as the association with type 2 diabetes , taken from various gwa studies that reported various snps that were in imperfect linkage disequilibrium with each other .", "a locus was reported using both the illumina and affymetrix arrays , we used the snps present on the illumina array . in the event of a signal", "we performed high - throughput genome - wide single nucleotide polymorphism ( snp ) genotyping using the illumina infinium ii humanhap550 or human 610 beadchip technology ( illumina , san diego , ca ) at the children 's hospital of philadelphia 's center for applied genomics , as described previously ( 23 ) .", "only being described on the affymetrix array , we either already had that snp on our illumina array or identified and used the best surrogate snp available based on the ceu hapmap ( supplementary table 1 , available in the online appendix at http://diabetes.diabetesjournals.org/cgi/content/full/db09-0506/dc1 ) .", "most loci described from gwa studies published to date have been found using either the affymetrix or illumina platform . in the event", "the snps analyzed survived the filtering of the genome - wide dataset for snps with call rates < 95% , minor allele frequency < 1% , missing rate per person > 2% , and hardy - weinberg equilibrium p < 10 .", "in addition , rs4712523 is a proxy ( r = 1 ) for rs10946398 , which was previously associated with birth weight ." ], [ "from our database , we eliminated outliers with birth weight < 1 or > 8 kg , i.e. , those individuals not within the credible range for birth weight at term , to avoid the potential consequences of error or mendelian causes of extreme birth weight .", "each birth weight value was adjusted for each sex separately then expressed as a z score ." ], [ "from our database , we eliminated outliers with birth weight < 1 or > 8 kg , i.e. , those individuals not within the credible range for birth weight at term , to avoid the potential consequences of error or mendelian causes of extreme birth weight .", "each birth weight value was adjusted for each sex separately then expressed as a z score ." ], [ "ethnicity for our cohort was derived using the multidimensional scaling feature within plink . by treating birth weight as a quantitative trait ( treated as a z score after correcting for sex ) , association analysis for each snp", "was carried out using linear regression analysis with the snp included as an independent variable ( coded as 0 , 1 , and 2 ) . with 5,465 subjects , the powers to detect 0.2 , 0.3 , 0.4 , 0.5 , 0.6 , 0.8 , and 1% variation at the p = 0.002 level ( i.e. , the corrected p value for the number of tests ) were 47.4 , 74.6 , 90.0 , 96.6 , 98.9 , 100 , and 100% , respectively .", "all statistical analyses were carried out using the software package plink v. 1.05 ( 24 ) ." ], [ "we detected nominal association with rs1387153 ( p = 0.02 ) at the mtnr1b locus ; however , the corresponding type 2 diabetes risk allele was tracking with higher birth weight .", "we observed strong association with rs7756992 ( p = 8 10 ) at the cdkal1 locus with low birth weight ; this snp yielded strongest association to type 2 diabetes in an icelandic gwa study carried out on the illumina humanhap500 platform ( 21 ) .", "in our initial analysis , 12 snps corresponding to the 9 type 2 diabetes loci previously studied in the context of birth weight were investigated in our cohort , namely , tcf7l2 , hhex - ide , pparg , kcnj11 , slc30a8 , igf2bp2 , cdkal1 , cdkn2a/2b , and jazf1 ( 4,6 ) ( table 1 ) .", "quantitative association results for previously studied type 2 diabetes risk alleles with birth weight in the european american cohort ( n = 5,465 ) , sorted by chromosomal location the direction of effect is shown for the minor allele in each case . *", "snps rs10946398 or rs7754840 at the same locus have been reported to be most strongly associated with type 2 diabetes from gwa studies on the affymetrix platform or the illumina humanhap300 beadchip ( 16,18,19 ) ; however , using a perfect surrogate , rs4712523 ( r = 1 ) , we only observed nominally significant association ( p = 0.01 ) .", "major allele previously reported to be associated with type 2 diabetes ; * * p 0.002 ." ], [ "from this interim analysis of our ongoing gwa study of birth weight in a european american cohort , it is clear that the cdkal1 locus , which was uncovered in gwa analyses of type 2 diabetes , is strongly associated with birth weight in our study population .", "our data contributes another piece of evidence supporting the hypothesis , namely , that the same genotype conferring lower birth weight can also confer higher type 2 diabetes risk later in life .", ", we strongly confirm that the established type 2 diabetes locus cdkal1 also influences birth weight .", "in addition , of all the other established type 2 diabetes loci to date , we do not observe a convincing role for them in the determination of birth weight ." ] ]

[ [ "the aim of this study was to determine how physical ( weight , volume , and density ) and morphological ( md and bl dimensions ) properties affect the fracture resistance of roots , and which criteria are important for standardization in fracture resistance evaluated studies .", "the null hypothesis was that different physical properties of roots would not affect the fracture resistance of endodontically treated roots .", "extracted human teeth are also widely used for in vitro studies in fracture resistance tests . however standardization among the extracted teeth should be performed in order not to affect the study 's results .", "if roots were not distributed among the groups equally , these variables could have affected the results of the studies . in many studies , the mesiodistal ( md ) and buccolingual ( bl ) dimensions and the lengths of the roots", "standardization of the roots is one of the important steps in the study in which fracture resistance is evaluated .", "it is important to examine systems in an in vitro model prior to in vivo use in order to identify treatment or materials that might improve clinical performances ." ], [ "seventy - five human canine teeth extracted for periodontal reasons with completed apices and similar lengths were used in this study .", "root canal shaping procedures were performed with protaper universal rotary files ( dentsply maillefer , ballaigues , switzerland ) , and apical region was prepared to size # 30 ( f3 ) in all specimens .", "mesiodistal ( md ) and buccolingual ( bl ) radiographs were taken of the specimens to evaluate the anatomical structures of the teeth .", "the teeth with internal or external resorption , those which had two or more root canals , and those with calcification were discarded .", "the teeth were examined under a stereomicroscope to discard specimens with cracks and craze lines .", "md and bl dimensions at 16 mm ( the coronal end of the root ) from the apex of the each root were recorded with root number . a size 10 k - file ( dentsply , maillefer , ballaigues , switzerland ) was inserted into the canal until it was visible at the apical foramen , and the working length was determined to be 1 mm short of this position ." ], [ "< 0.001 ) of the roots had a more significant effect than bl ( r = 0.197 , p = 0.085 ) , md ( r = 0.239 , p = 0.037 ) dimension which implying that volume or weight had greater importance regarding the prediction of fracture strength [ table 1 ] .", "the results indicated that volume ( r = 0.427 , p < 0.001 ) and weight ( r = 0.394 , p", "physical and morphological properties of the samples along with pearson correlation coefficients and p values ." ], [ "when extracted human teeth are used for evaluating the fracture resistance of roots , there is a potential for large uncontrollable variations to affect strength . for that reason , all controllable factors should be standardized as much as possible .", "many researchers who have carried out this type of study - performed standardization , according to root length , md and bl dimensions . however , many of these studies admitted very high standard deviations as normal .", "thus , this study aimed to control factors such as weight , volume , and density , which can affect the fracture resistance of teeth in order to contribute to the standardization process . in the current study , the volumes or weights of root specimens have more statistically significant value than density , md , and bl dimension . in previous studies , however , these variations did not take into account when the standardization of groups was performed .", "thus , it is important to determine the alternative properties of roots which could be useful for the standardization process in future investigations .", ", this study has shown that the physical properties of teeth can affect the resistance of roots .", "standardization is generally achieved based on the lengths , and md and bl dimensions of roots with referrals to other studies in the literature . however", "future studies should be standardized to inhibit high standard deviations . during the study design ," ], [ "this is the first study in the literature to conclude that the volume or weight of root as the most important determining factors in root fracture. within the limitations of this study , it can be concluded that when forming groups to evaluate fracture resistance , after the root length is standardized , the roots should be equally distributed according to their volumes or weights , rather than their md and bl dimensions , as these dimensions can not closely simulate the entire strength of the root as much as the volume or weight ." ] ]

[ [ "intensive insulin therapy using basal - bolus insulin regimen is the standard therapy for patients with type 1 diabetes mellitus . by mimicking the endogenous insulin secretion profile in healthy subjects ,", "could provide great benefit to patients with type 1 diabetes . in this study , to evaluate the efficacy of insulin degludec as a basal insulin for basal - bolus regimen for japanese patients with type 1 diabetes mellitus who are treated with twice - daily basal insulin injection therapy , we investigated glycemic control , daily , and day - to - day variability in plasma glucose using continuous glucose monitoring before and after switching to once - daily insulin degludec injection in 22 patients with type 1 diabetes .", "unfortunately , many patients with type 1 diabetes can not achieve the target glycemic control , and insulin therapy leaves room for improvement ." ], [ "all patients provided a written informed consent prior to trial initiation . in this prospective , single - center , single - arm , open - label , 12-week study , we compared the effects of switching from twice - daily basal insulin to once - daily insulin degludec on glycemic control , daily , and day - to - day variability in plasma glucose . ", "the primary outcome of the study was change in hba1c before and 12 weeks after switching .", "after that , the patient was switched from twice - daily basal insulin to once - daily insulin degludec , which involved 10% reduction in insulin dosage without any change in the rapid acting insulin therapy .", "patients who satisfied the following conditions were included : ( 1 ) treated with basal - bolus insulin regimen with twice - daily injections by insulin glargine or detemir and ( 2 ) aged more than 20 and less than 80 years . also , patients were excluded if they ( 1 ) had serious liver disease ( ast and/or alt > 100 ", "we recruited 24 eligible japanese patients ( 8 males and 16 females ) with type 1 diabetes who visited the outpatient clinic of juntendo university hospital between july 2013 and january 2014 .", "confirmed hypoglycemia was defined as a glucose value of less than 70 mg / dl by cgm and was reported in percentage (= times < 70 mg / dl / total time of measurement ) .", "safety variables included the frequencies of severe hypoglycemia , which was defined as low blood glucose level requiring assistance from another person to treat , nocturnal hypoglycemia , and adverse events .", "then , the increase of the dose of basal insulin or titration of rapid acting insulin was performed by the judgement of each physician in charge . at the end of the study ( 12 weeks )" ], [ "the mean basal insulin and total daily doses at 12 weeks after switching to insulin degludec were significantly reduced compared to the baseline ( 15.2 7.6 versus 11.6 6.9 u , p < 0.01 , and 40.0 17.3 versus 37.9 16.7 u , p < 0.01 , resp . ) whereas the bolus insulin dose did not significantly change after switching . \n", "blood glucose level at 2 hours after lunch was significantly low before and after switching ( 207.6 87.7 versus 158.2 90.3 mg / dl , p < 0.01 ) .", "thus , the frequency of nocturnal hypoglycemia did not change significantly after switching , similar to other parameters , and no severe hypoglycemia was recorded during the study period . \n", "table 3 summarizes fluctuations in glucose level and the frequency of hypoglycemia recorded by cgm over 4 days before and after switching .", "glycosylated albumin levels before and 4 and 8 weeks after switching were 24.9 5.0% , 25.3 5.2% , and 24.7 3.6% , respectively ." ], [ "the present study investigated the efficacy and safety of switching from twice - daily basal insulin injections to once - daily insulin degludec injection in japanese patients with type 1 diabetes .", ", our study demonstrated that glycemic control 12 weeks after switching to once - daily insulin degludec injection with 20% dose reduction was comparable to that in patients treated with twice - daily injection of basal insulin injections and that such switching did not change the frequency of nocturnal hypoglycemia recorded by cgm .", "therefore , it is clinically worthy to investigate the efficacy and safety of switching from twice - daily insulin glargine or detemir to once - daily insulin degludec in type 1 diabetes patients with severely reduced insulin secretion ." ] ]

[ [ "a 33 year old healthy male of afro - caribbean origin presented to the emergency department with acute generalised abdominal pain of three hours duration .", "he was subsequently referred to a specialist in a distant tertiary unit for further evaluation of the residual tumour and for the prospect of further elective surgery .", "the estrogen receptor status was not reported . due to continuing abdominal discomfort on the ward after the second laparotomy , an ultrasound scan was arranged that revealed the following : a rather ill - defined , fairly ovoid , inhomogeneously - hypoechoic mass lesion is identified in the lower abdomen ( infra- umbilical ) para - sagittal plane .", "the patient underwent a second laparotomy to drain the subphrenic abscess and no masses were seen during this procedure .", "the pain eventually resolved and after making a good recovery , he was commenced on oral tamoxifen , 20 mg once a day ." ], [ "a 33 year old healthy male of afro - caribbean origin presented to the emergency department with acute generalised abdominal pain of three hours duration .", "he had not noticed any recent change in bowel habit , bleeding per rectum or any systemic symptoms .", "it was of note that there was no family history of inflammatory bowel disease or gastrointestinal malignancy ." ], [ "blood tests revealed a neutrophilia of 25,000 but urea and electrolytes were within normal range ." ], [ "he was resuscitated with intravenous fluids and an emergency laparotomy was performed . during the laparotomy , a 0.5 cm perforation was noted in the ileum 25 cm proximal to the ileocaecal valve on the mesenteric border .", "30 cm of small bowel was resected with a right hemicolectomy , hence removing the mass and the perforation .", "an inflammatory mass measuring 5 3 cm was noted directly adjacent to the perforation in the mesentry ." ], [ "no obvious cause of sepsis was identified and it was thought that he may have a subphrenic collection . therefore a computed tomography ( ct ) scan was arranged .", "he was subsequently referred to a specialist in a distant tertiary unit for further evaluation of the residual tumour and for the prospect of further elective surgery .", "however , he had a severe reaction to the intravenous contrast medium which resulted in hypotension .", "the pain eventually resolved and after making a good recovery , he was commenced on oral tamoxifen , 20 mg once a day .", "the patient underwent a second laparotomy to drain the subphrenic abscess and no masses were seen during this procedure .", "although estrogen receptor status was not reported , the patient was commenced on this therapy as it was assumed that most desmoid tumours have estrogen receptors .", "due to continuing abdominal discomfort on the ward after the second laparotomy , an ultrasound scan was arranged that revealed the following : a rather ill - defined , fairly ovoid , inhomogeneously - hypoechoic mass lesion is identified in the lower abdomen ( infra- umbilical ) para - sagittal plane ." ], [ "desmoid tumours ( fibromatosis ) are benign fibrous neoplasms originating from the musculo - aponeurotic structures throughout the body .", "bowel perforation is extremely rare and my research has yielded one previous case report ( 1 ) .", "other rare manifestations reported in the literature include deep vein thrombosis , pyrexia of unknown origin , gastrointestinal bleeding and intra - abdominal abscess formation ( 5 , 6 ) .", "desmoid tumours can arise from any skeletal muscle but commonly affect the rectus abdominus in post - partum females and in old surgical scars of the abdomen .", "an intra - abdominal desmoid , also known as mesenteric fibromatosis , is the most common solid primary neoplasm of the mesentry .", "colonoscopy may reveal multiple colonic polyps and fundoscopy may demonstrate multiple pigmented lesions affecting the fundus of the eye ( 2 , 3 ) . complete surgical excision may be the only effective way of providing a cure but complete excision is often impossible and therefore adjuvant treatments have been employed with various degrees of success ( 1 , 2 ) ." ], [ "desmoid tumours originate from the musculo - aponeurotic structures of the body and can be peripheral or intra - abdominal .", "patients should be screened for gardner s syndrome and familial adenomatous polyposis coli since these can often present with dermatoid , epidermoid or other benign tumours .", "ct and mri are the imaging modalities of choice , particularly if surgery is contemplated and also in postoperative follow up to detect recurrence .", "emergency presentations are not common , but are usually secondary to mass effect on the viscera .", "surgery is usually the mainstay of treatment but recurrence is common and adjuvant therapy is used .", "some tumours possess estrogen receptors , hence they regress in response to anti - estrogens , such as tamoxifen ." ] ]

[ [ "the technical success of tae was defined as the complete disappearance of arterial bleeding following tae . technically impossible or incomplete", "the following items were documented retrospectively : the presumptive causes and locations of arterial bleeding , the technical and clinical success rates of tae , and the complications .", "clinical success was defined as an amelioration of the presenting signs or symptoms of arterial bleeding following tae .", "between april 1999 and march 2001 , 32 ( 26 men and 6 women ; age range , 7 - 62 years ; mean age , 43 years ) of 195 patients who had undergone ldlt underwent 42 sessions of conventional arteriography in search of bleeding foci of arterial origin within 6 months of the operation .", "major complications were defined as those necessitating an increased level of care , surgery , prolonged hospital stay , permanent adverse sequelae or death ." ], [ "between april 1999 and march 2001 , 32 ( 26 men and 6 women ; age range , 7 - 62 years ; mean age , 43 years ) of 195 patients who had undergone ldlt underwent 42 sessions of conventional arteriography in search of bleeding foci of arterial origin within 6 months of the operation .", "six patients underwent two or three sessions of arteriography or tae , because of recurrent arterial bleeding .", "the underlying causes of hepatic failure and ldlt in these 32 patients were hepatitis b - related liver cirrhosis with or without hepatocellular carcinoma ( n=29 ) , secondary biliary cirrhosis due to intrahepatic stones ( n=1 ) , fatal fulminant hepatitis due to wilson 's disease ( n=1 ) , and biliary atresia ( n=1 ) .", "the arterial bleeding occurred within two months ( mean , 14 days ; range , 1 - 56 days ) after ldlt ." ], [ "a provisional identification of the bleeding arteries was made based on the patient 's symptoms or signs , radiological findings , including dynamic ct and rbc scans , and the surgical information obtained during ldlt . in the patients with abnormally increased drainage of fresh blood through the jp tube , selective arteriographies were performed of several specific arteries , for which the arterial bleeding might be stagnant in the jp tube placed area . in those patients with hematochezia or melena , inferior mesenteric or left gastric arteriography was performed following superior mesenteric and common hepatic arteriographies , according to the available clinical information . in those patients with hemothorax or hemoptysis , selective arteriographies of the inferior phrenic artery ,", "tae was intended to be the primary treatment , however , surgical management was considered as the primary treatment if the bleeding foci were technically too difficult or dangerous to be embolized , such as in the case of a hepatic arterial anastomotic site or hepatic resection margin . for tae", "aortography for the purpose of gaining an understanding of the arterial anatomy prior to selective arteriography was not routinely performed .", "however , aortography was performed to rule out the possible of there being any missed bleeding foci , if the selective arteriographies of the presumptive arteries did not demonstrate any active bleeding foci . if the bleeding foci were present on the arteriograms , then either tae or surgery was undertaken to control the bleeding , subject to the mutual agreement of the surgeons and interventional radiologists ." ], [ "the following items were documented retrospectively : the presumptive causes and locations of arterial bleeding , the technical and clinical success rates of tae , and the complications .", "the technical success of tae was defined as the complete disappearance of arterial bleeding following tae . technically impossible or incomplete", "in all patients , a complete retrospective review of the medical and surgical records and radiological imaging were performed .", "clinical success was defined as an amelioration of the presenting signs or symptoms of arterial bleeding following tae .", "a bleeding focus was defined as an extravasation of the contrast media or a pseudoaneurysm that was a likely cause of bleeding ." ], [ "after either conservative or surgical management , the signs of active bleeding ameliorated in all 11 patients . during the 6 month follow - up period after ldlt , there were no major tae - related complications .", ", it was demonstrated that , in addition to surgical bleeding ( 36% ) , iatrogenic bleeding ( 40% ) was also a major cause of arterial bleeding after ldlt .", "conventional arteriography demonstrated 42 bleeding foci of arterial origin in 30 sessions ( 23 patients ) .", "tae was technically successful in 33 of the 42 foci of active arterial bleeding ( table 1 ) ( figs . 1 , 2 )", "however , tae failed in the remaining 9 foci of active arterial bleeding , due to technically difficult superselection of the corresponding bleeding artery or the potential high risk associated with tae ( fig ." ], [ "the number of bleeding foci detected were one in 22 sessions ( 15 patients ) , two in six sessions ( 6 patients ) , and more than three in two sessions ( 2 patients ) .", "based on a complete review of the clinical , interventional and surgical data , the bleeding foci were classified into 4 categories corresponding to the most likely causes of arterial bleeding ( table 2 ) . in this way", "conventional arteriography demonstrated 42 bleeding foci of arterial origin in 30 sessions ( 23 patients ) .", ", it was demonstrated that , in addition to surgical bleeding ( 36% ) , iatrogenic bleeding ( 40% ) was also a major cause of arterial bleeding after ldlt .", "the bleeding foci originated most frequently from the hepatic artery ( 14/42 , 33% ) and intercostal artery ( 11/42 , 26% ) ." ], [ "tae was technically successful in 33 of the 42 foci of active arterial bleeding ( table 1 ) ( figs . 1 , 2 )", ". however , tae failed in the remaining 9 foci of active arterial bleeding , due to technically difficult superselection of the corresponding bleeding artery or the potential high risk associated with tae ( fig .", "after either conservative or surgical management , the signs of active bleeding ameliorated in all 11 patients . during the 6 month follow - up period after ldlt , there were no major tae - related complications .", "however , there was no evidence of active arterial bleeding in the operation field in any of these cases . in 20 of the 21 sessions , the patients showed a clinical improvement in the active arterial bleeding after successful tae .", "surgery did not lead to the discovery of any bleeding focus , and they only underwent hematoma evacuation ." ], [ "technical limitations were encountered when using tae for the management of hepatic arterial bleeding . however , in the other locations , tae seems to be effective and safe for the control of arterial bleeding after ldlt .", "although tae can be performed in some patients with massive bleeding from the hepatic artery , we consider that surgical management is the treatment of choice for the management of surgically induced bleeding from the hepatic artery anastomotic site , hepatic resection margin or hepaticojejunostomy site .", "in fact , bleeding from the hepatic artery was the most common cause of bleeding in our study . however , performing tae in the case of bleeding from the hepatic artery following ldlt was virtually impossible , because of the difficulty involved in the superselection of the bleeding arteries , due to the existence of fine arterial feeders , hepatic arterial anastomotic stenosis , a tortuous arterial course or multifocal occurrences .", "furthermore , performing tae of the hepatic artery runs the risk of hepatic infarction or failure following inadvertent diffuse proximal embolization ( 16 ) ." ] ]

[ [ "fibrodysplasia ossificans progressiva ( fop ) is a rare genetic disoder characterized by bone formation within muscles tendons and ligaments .", "we hereby report a case of fop in a four year male child from a tribal family in orissa ." ], [ "4 yr old male child presented with gradual development of stiffness of neck and hard nodules on his body for which his parents had sought all sort of indegenous treatment and manipulations by traditional bone setters .", "patient returned to our hospital at the age of four years with widespread ossification and stiffness of neck , shoulders and back .", "he also had upper tibial osteochondromas and scalp nodules and valgus deformity of bilateral great toes ." ], [ "though rare , diagnosis of myositis ossificans progressiva should be considered in a child with heterotopic bone formation and valgus deformities of great toes .", "being a rare condition , treatment guidelines are not clear and this condition need further research ." ], [ "fop is an extremely rare and most crippling form of heterotopic ossification in humans with an incidence of 1 in 2 millions .", "kitterman et al reported that it takes atleast six physician evaluations to reach the diagnosis and 90% of these individuals will have received some wrong or hazardous treatment before appropriate diagnosis .", "we hereby report a case of fop in a 4 year old boy coming from tribal family in orissa .", "fibrodysplasia ossificans progressiva ( fop ) is also known as myositis ossificans progressiva , stone man disease , munchmeyer s disease .", "the diagnosis of this patient was delayed due as the parents tried all sorts of indigenous medications and even manipulations by traditional bonesetters whose influence has been deep rooted in minds of the tribal population in this part of the country ." ], [ "a- bilateral hallux valgus and hypoplastic proximal phalynx of great toe with short and widened first metatarsal .", "diagnosis of fop was made in basis of all these radiological and clinical findings radiological findings .", "our patients was a four year old boy who presented with chief complains of stiffness of neck , decreased movements in bilateral shoulders and had bony hard swellings in his back ." ], [ "our case once again highlights the deleterious effects of trauma in the form of manipulations and massage that can aggravate the ossification process in case of fop .", "this lead to rapid progression of disease in our case with early development of deformities .", "the rare incidence of this disease and unpredictable nature of flare - ups makes it difficult to formulate an ideal treatment for it .", "early diagnosis and high index of suspicion will not only prevent the itrogenic harm but may also slow the disease progress and avoid rapid and early deterioration in patients quality of life . in our case ," ], [ "valgus deformity of great toes and neck stiffness are important pointers towards diagnosis of fop and this condition needs further research to find an effective treatment modality for it", "thus in conclusion clinical suspicion , early diagnosis and expectant treatment are the main management strategy in cases with fop .", "fop demands further research to treat individuals suffering from this dreaded form of heterotopic ossification ." ] ]

[ [ ". herein we report transfection efficiencies , cytotoxicity profiles , and biophysical structure / activity studies for a new class of water - soluble c60 vectors prepared using the hirschbingel reaction which is one of the simplest , highest - yielding , and most versatile c60 functionalization methods known . as shown in figure 1 ,", "these vectors , which have been analyzed for their ability to promote dna transfection , offer the opportunity to elucidate the roles that hydrophobicity ( due to the fullerene core ) , hydrophilicity ( due to the water soluble substituents ) , and overall charge state displayed by the c60 derivatives have on dna transfection , gene expression , and cytotoxicity .", "the structurally derivatized c60 vectors reported herein were synthesized to yield either positively charged , negatively charged , or neutral chemical structures when solvated under physiological conditions .", "depiction of the structures of the derivatized c60 vectors ; the positively charged amino - c60 compounds ( iiv ) , the neutral serinolamide - c60 compound ( v ) , and the negatively charged c3-c60 compound ( vi ) ( chemical structures depicted at neutral ph in aqueous solution ; counterions in solution not shown ) ." ], [ "dna / polymer complexes were prepared in serum - free dmem to achieve a ratio of polymer to dna of 4 .", "this assay makes use of 2 different fluorescent dyes , calcein am and ethidium homodimer ( ethd-1 ) , to measure the number of live and dead cells respectively . the lipid permeable dye , calcein am , when taken up by living cells with intact plasma membranes , emits green fluorescence ( excitation / emission : 495/515 nm ) upon being cleaved by esterase enzymes in the cells .", "mixtures of individual derivatized c60 vector material and plasmid dna were allowed to form a complex in serum - free dmem , as described below , prior to adding to cells in the transfection assays .", "the live / dead viability / cytotoxicity assay ( molecular probes , eugene , or ) was used to determine cytotoxicity levels in cells treated with either c60-vector or c60-vector / dna solutions .", ", control cell populations were also transfected with plasmid dna alone ( no c60 vector ) , or with plasmid dna complexed with an optimal level of one of two commercially available transfection reagents ; such that the dna was complexed with either 25 kda polyethylenimine ( pei ) , or with cytopure transfection reagent , which is reported by the manufacturer to exhibit very low levels of cytotoxicity .", "this assay was preferred over the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide ( mtt ) assay for evaluation of cell viability because c60-vectors compounds i and ii interacted and attached to the mtt - formazan making the formazan crystals insoluble for the next colorimetric assay ." ], [ "the small , but statistically significant , expression of the reporter protein from c60/dna conjugates formed from compounds v and vi was surprising and interesting since these samples do not possess a net positive charge under the physiological conditions used to form the complexes , although there have been limited reports of other nonpositive charged nanoparticles translocating into cells(35 ) and , indeed , also demonstrating gene transfection.(36 ) thus , at least for some derivatized c60 molecules , the hydrophobic nature of the c60 carbon nanostructures may be the common important property in their binding to dna and their subsequent translocation into the interior of the cell .", "the comparable transfection efficiencies of compounds iii and iv on nih 3t3 cells to those of commercially available nonviral vectors 25 kda pei and cytopure is encouraging .", "variation in transfection protocol and/or cell types can also dramatically affect transfection efficiencies , as positively charged amino - derivatized c60 similar to compound iv have previously been shown to be inefficient at effecting transfection.(17 ) in general , the condensation behavior of nonviral vector / dna complexes is governed by several factors including the molecular weight of the dna condensing agent , the density of the charges on the condensing agent , and the ratio of composition ( r values ) between the condensing vector and the dna.(5 ) in addition , it is now well - documented that the size of the transfection vector / dna complex is one of the most important parameters for efficient dna delivery into cells , with the most efficient uptake observed for complex with sizes < 150200 nm in diameter.(5 ) the rh values shown in table 3 suggest that only dna complexes formed with compounds iii and iv satisfy these criteria .", "these reports , along with the favorable c60-based gene transfection results reported here and by others , offer opportunities for development of analogous gd@c60-based vectors to monitor noninvasively the biodistribution and pharmacokinetics of gene therapy vectors in vivo.(49 )", "in addition , carbon nanomaterials such as gd@c60 , gd@c82 , gd@c80 and gd@ultrashort single - walled carbon nanotubes ( gd@us - tubes ) have shown potential as high - performance magnetic resonance imaging ( mri ) contrast agents suitable for advanced applications such as tracking and/or delivery of magnetically labeled cells by mri in vivo .", "these studies were carried out to help generate correlations between the different c60 vectors , and the various c60 vector / dna structural attributes resulting in the different transfection efficiencies and cytotoxicity results observed under serum - free conditions .", "c60 vectors are listed in order of their measured efficiency at promoting transfection in nih 3t3 cells under serum - free conditions . to assess the transfection ability of c60 vectors in different cell types ," ], [ "a new class of water - soluble c60 transfecting agents with positively charged , negatively charged , or neutral chemical functionalities under physiological conditions was prepared using hirschbingel chemistry .", "transfection , cytotoxicity and biophysical structure / activity studies were performed in an effort to elucidate the relationship between the hydrophobicity of the fullerene core , the hydrophilicity of the water - solubilizing groups , and the overall charge state of the c60 vectors in gene delivery / expression .", "structural analyses using dynamic light scattering and optical microscopy confirmed that higher positive charge on c60 compounds is a dominant physical attribute necessary for optimal c60/dna structural features leading to increased transfection efficiency , and that aggregation is the major factor that negatively affected the cytotoxicity profiles of the c60 vector / dna complexes .", "the successful demonstration of intracellular dna uptake , intracellular transport , and gene expression from dna using c60 vectors suggests the possibility of developing analogous gd@c60-based vectors to serve simultaneously as both therapeutic and diagnostic agents .", "aggregation is presumably also the dominant reason for increased cytotoxicity of certain specific derivatized c60 compounds ( most notable for compound i ) even in the absence of dna , at least when analyzed under the serum - free conditions utilized in this study .", "however , only two positively charged c60 derivatives , namely , an octa - amino derivatized c60 and a dodeca - amino derivatized c60 vector , showed efficient in vitro transfection ." ] ]

[ [ "previously we reported that deletion of neutral endopeptidase ( nep ) provides protection from obesity- and diabetes - induced neural complications .", "however , little information is available about the effect of vasopeptidase inhibitors in animal models of diet - induced obesity . in order to further elucidate the effects of vasopeptidase inhibitors in peripheral nerve dysfunction associated with obesity we examined the effect of diet - induced obesity on nerve conduction velocity and thermal response latency in the hindpaw of c57bl/6j mice and mice deficient in nep treated with ilepatril , enalapril , ace inhibitor , or candoxatril , nep inhibitor [ 1 , 2 ] .", "regard we have demonstrated that treating type 1 and type 2 diabetic rats as well as a genetic rat model of obesity with ilepatril improves vascular and neural dysfunction [ 1416 ] .", "we have also shown that treating obese and streptozotocin - diabetic mice with the vasopeptidase inhibitor ilepatril prevented neural complications including slowing of nerve conduction velocity , thermal hypoalgesia , and decreased intraepidermal nerve fiber density ." ], [ "we have found that these doses provide maximal inhibition of nep and/or ace activity in vivo [ 2 , 19 ] .", "for the intervention study the same five groups of c57bl/6j and nep mice at 12 weeks of age were fed the control diet ( group 1 ) or high - fat diet ( groups 25 ) for 12 weeks .", "afterwards , the four groups of high - fat - fed mice were fed a high - fat diet with no additions ( group 2 ) or high - fat diet containing ilepatril , candoxatril , or enalapril ( groups 35 ) for 12 weeks .", "a second group was fed a high - fat diet containing 24 gm% fat , 24 gm% protein , and 41 gm% carbohydrate ( d12451 ; research diets , new brunswick , nj ) .", "the primary source of the increased fat content in the diet was soybean oil and lard .", "deficiency of nep activity was confirmed in nep mice by measuring the specific activity of nep in kidney homogenates using the method described by ayoub and melzig with modification .", "for the prevention protocol c57bl/6j and nep mice at 12 weeks of age were divided into five groups .", "this test was performed on all mice used in these studies in order to confirm that nep was functionally knocked out in the nep mice ." ], [ "the mass of the epididymal fat pad was significantly increased in high - fat - fed mice and mice fed the high - fat diet treated with candoxatril compared to control mice or mice fed the high - fat diet containing ilepatril or enalapril . when calculating the epididymal fat pad mass as a percent of total body weight epididymal fat pad mass was significantly increased in high - fat - fed c57bl/6j mice and mice fed a high - fat diet containing candoxatril compared to control . treating the high - fat diet with ilepatril and to", "nonfasting blood glucose levels were not significantly different between c57bl/6j and nep mice fed the control or high - fat diets and not affected by ilepatril , candoxatril , or enalapril treatment . in the intervention study all mice fed the high - fat diet for the initial 12 weeks of", "when fed a high - fat diet c57bl/6j and nep mice both gained a similar amount of weight . treating the high - fat diet with ilepatril or enalapril but not candoxatril completely prevented the gain in weight .", "in the intervention study feeding c57bl/6j ( figure 3 ) or nep ( figure 4 ) mice for 24 weeks a high - fat diet caused an impaired glucose clearance curve . treating high - fat - fed c57bl/6j or nep mice with enalapril for the last 12 weeks of the 24-week period partially corrected glucose utilization . treating nep mice with ilepatril" ], [ "the main findings from these studies were that diet - induced obesity caused significant weight gain and impaired glucose utilization in c57bl/6j and nep mice that was improved when the mice were treated with ilepatril or enalapril using a prevention protocol . using the intervention protocol enalapril but not ilepatril treatment was effective improving glucose utilization by c57bl/6j mice .", "these data suggest that increased nep activity / expression but not ace activity contributes to diet - induced obesity - related deficits in sensory nerve function . ", "these data suggest that inhibition of ace and not nep activity was responsible for improving weight gain and glucose utilization in high - fat - fed mice .", "since nep degrades both calcitonin gene - related peptide and substance p , peptides important in pain signaling pathways , it is likely that blocking nep activity or mice deficient in nep would maintain higher levels of both of these neuroactive peptides and perhaps be more sensitive to painful stimuli .", "the mechanisms proposed for the improvement in obesity and glucose tolerance with treatment of rodent models with ace inhibitors are increased energy expenditure , liver and adipose tissue metabolic modulation , lower concentration of leptin , improved insulin signaling , and increased glucose and fatty acid utilization by muscle [ 2130 ] . in a study comparing the effects of ramipril , an ace inhibitor , to ilepatril in jcr : la - cp rats , an obese , insulin - resistant , hyperinsulinemic , normoglycemic model , it was found that both compounds reduced the surge of plasma insulin in a meal tolerance test by about 50% but ilepatril was more beneficial in improving vascular reactivity . in our study" ], [ "in contrast , inhibition of nep improved sensory nerve dysfunction and had no effect in improving weight gain or glucose utilization . treating high - fat - fed mice with a vasopeptidase inhibitor improved weight gain , glucose utilization , and sensory nerve function .", "data from clinical trials clearly suggest that activation of the renin - angiotensin - aldosterone system plays an important role in the pathophysiology of the metabolic syndrome through interaction of a wide range of physiological and molecular mechanisms . more recently in humans activity of nep", "thus , we conclude that increased activity of nep is associated with sensory nerve dysfunction in an animal model of diet - induced obesity and that dual inhibition of ace and nep may be more effective than monotherapy in reducing insulin resistance and the sensory nerve complications associated with metabolic syndrome .", "has been shown to correlate with body mass index and measures of insulin resistance with increasing activity found in subjects with multiple cardiovascular risk factors . in these studies we found that feeding mice a high - fat diet causes weight gain , impaired glucose tolerance , and sensory nerve dysfunction . inhibition of ace was effective in reducing weight gain and improving glucose utilization but generally noneffective in improving sensory nerve dysfunction ." ] ]

[ [ "they are effective against both gram - positive and gram - negative bacteria and , due to the relative lack of major side effects and cheap cost , have been used extensively in the treatment of infections as well as growth promoters in animal husbandry . bacterial resistance to", ", a study by caryl et al . reported that when tet(u ) was cloned and expressed in escherichia coli , the transformants were not resistant to tetracycline . to be considered a new class of tetracycline resistance gene", "although it has yet to be assigned a mechanistic class , tet(u ) has been identified in enterococcus and staphylococcus isolates . however", "determinants representing new classes were originally assigned a letter from the english alphabet . however , as all letters are used , they are now assigned an arabic numeral , with new determinants referred to the levy group ( bonnie.marshall@tufts.edu ) in order to obtain a designation prior to publication to avoid duplication and ensure taxonomic consistency .", "tetracyclines bind to the a - site on the bacterial ribosome , resulting in steric blocking of the aminoacyl - trna binding site , which prevents protein synthesis ." ], [ "it must be stressed here that the progenitors of mosaic genes are assumed based purely on the order in which they were discovered and we can not be sure of the directionality of mosaic gene formation .", "however , a subgroup of rpp genes has been identified that consist of regions of different , already characterized rpp genes that appear to have undergone recombination forming a mosaic gene .", "rpps are a related group of proteins that , when bound to the ribosome , result in the release of tetracycline from the ribosome , enabling protein synthesis to proceed ( reviewed by thaker et al . ) . of the 12 classes of rpp gene currently reported [ tet(m )", ", ( o ) , ( q ) , ( s ) , ( t ) , ( w ) , ( 32 ) , ( 36 ) , ( 44 ) , b(p ) , otr(a ) and tet ] , tet(m ) is considered the most prevalent due to its association with the broad host range tn916/tn1545 family of conjugative transposons ." ], [ "the guideline for determining a new resistance gene class was established prior to the discovery of these mosaic rpp genes and none of the mosaic genes qualified as a new class when analysed as one single continuous sequence .", "in 2003 , stanton and humphery reported two rpp genes in megasphaera elsdenii that encoded predicted proteins showing 89.1% and 91.9% identity to tet(w ) ( accession number aj222769 ) from butyrivibrio fibrisolvens .", "therefore , an expansion of the nomenclature system was suggested whereby the mosaic gene would receive a designation that reflected the structural order and class of the genes they comprised , better reflecting their variable nature .", "subsequently , the proposed full , non - mosaic sequences of tet(32 ) have been reported in several isolates identified from the human oral cavity , with the tet(o/32/o ) mosaic determinant now showing 89% amino acid identity to these ." ], [ "therefore , the prevalence of certain mosaic gene variants could suggest that they are in some way more beneficial to the host than the non - mosaic genes they comprise . \n", "a summary of the mosaic tetracycline genes reported to date the number given in square brackets indicates the instances of that mosaic gene variant reported , if more than one .", "to date , a total of 30 mosaic genes have been reported in the literature , of which 26 currently have sequences deposited in genbank ( table 1 ) .", "some studies have reported multiple occurrences of known genes ; however , many of these have been characterized by pcr amplification only .", "given the prevalence of tet(m ) in certain samples , and the previous reports of self - recombination , it is surprising that there are so few reports of mosaic genes containing tet(m ) ." ], [ ", almost all the mosaic genes reported to date have originated from faecal samples , with the majority identified from a porcine origin and less commonly from humans ( table 1 ) .", "in fact , tet(o/32/o ) was found to be the most common mosaic gene in both the human and pig faecal samples tested and was present in almost as many samples tested as the non - mosaic tet(o ) and tet(w ) genes .", "stanton and humphrey describe an assay that distinguished between the non - mosaic genes tet(o ) and tet(w ) and the mosaic tet(o / w / o ) from megasphaera strains , enabling them to detect tet(o / w / o ) variants in six additional m. elsdenii strains .", "in contrast , mosaic genes have not yet been reported in faecal samples from bovine and ovine origin or in human saliva . why they are predominantly found in pigs while as yet unreported in other animals" ], [ "furthermore , the tetracycline resistance genes present in campylobacter jejuni subspecies jejuni 2008 - 894 , campylobacter coli 202/04 , c. coli 317/04 ( accession numbers aioq01000025 , ainh01000038 and nz_ainj01000054 , respectively ) and roseburia intestinalis xb6b4 ( accession number fp929050 ) are also structurally novel variants of tet(o/32/o ) ( figure 1 ) . the three mosaic genes present in the campylobacter spp .", "for example , the tet(m)-like gene ( accession number nz_aujs01000017 , location 41 62643 545 bp ) in the draft genome of dorea longicatena agr2136 from a human faecal sample appears to be a previously unreported variant of tet(o/32/o ) ( figure 1 ) .", "further examination indicates that some are as yet uncharacterized and unreported mosaic genes , which have been further defined for this review using the nucleotide sequence to determine the crossover points .", "taking into account these newly defined genes , the total number of mosaic genes reported increases from 30 to 35 ( not including those identified via pcr amplification only ; table 1 ) and suggests that other generically labelled tetracycline resistance genes present in the database [ e.g. those labelled as tet(m)-like ] could be further classified , helping to understand mosaic gene proliferation and diversity .", "many contain tetracycline resistance genes that are generically labelled simply as tetracycline resistance protein or as tet(m)-like , the designation of which may be a result of automated annotation pipelines . a preliminary search of the ncbi nucleotide database , using tet(o ) ( accession number y07780 ) as the query , found that some of these generically labelled tetracycline resistance genes gave a partial match to tet(o ) .", "the advent of high - throughput genomic sequencing has led to an increase in the number of genomes being deposited in sequence databases ." ], [ "our knowledge of the mosaic rpp gene group is steadily increasing since their discovery in 2003 , with the majority derived from tet(o ) , tet(w ) and tet(32 ) and others deriving from tet(m ) and tet(s ) .", "further work and increased attention on mosaic rpp genes is important if we are to understand the evolutionary selective pressures driving their fixation in bacterial populations and the subsequent effects on resistance and mobile genetic element evolution within their host .", "it is clear that these genes are being under - reported both in terms of experimental detection and also within genomic data ." ], [] ]

[ [ "metastasis to skull and skin as the presenting feature of ftc is infrequently reported in the literature .", "skull and skin are uncommon sites and usually manifest well after the diagnosis of primary malignancy .", "follicular thyroid cancer ( ftc ) metastasizes most commonly to the lungs and non - cranial bones ." ], [ "a 65-year - old caucasian woman with a history of thyroid nodule presented with the complaint of rapidly growing skull nodules which had been present for 3 years but were stable previously .", "magnetic resonance imaging of the brain demonstrated 7.13.8 cm and 3.74.5 cm fairly homogeneous , enhancing , relatively well - defined masses centered in the posterior and left anterior lateral calvarium with intracranial and extracranial extensions but without any vasogenic edema or mass effect on the brain .", "she had two non - tender gray cystic lesions one on her left temporal region and the other on the right parietal region .", "histopathological studies of the thyroid gland revealed a well - differentiated ftc in the left lobe .", "she did not have any recurrence of the ftc or metastases during the follow - up period and will be receiving radioactive iodine treatment ." ], [ "bone and lung are the common sites of metastasis from ftc , but involvement of skull or skin is unusual , particularly as the presenting feature .", "metastases from ftc should be in the differential of patients with new osteolytic hypervascular skull lesions or cutaneous lesions in head and neck area ." ], [ "a 65-year - old caucasian woman with a history of thyroid nodule presented to dermatology clinic with the complaint of rapidly growing skull nodules .", "histopathological studies of the thyroid gland revealed a well - differentiated ftc in the left lobe , pathological stage pt2nxm1 , a 1-cm focus of classic papillary thyroid cancer in the right lobe of thyroid , with a background of multinodular goiter ( fig .", "then she underwent resection of the tumor in multiple stages with resection of the posterior and left frontal tumor , and calvaria , followed by cranioplasty .", "she underwent intravascular embolization of the feeding blood vessels of her metastatic skull lesions from the external carotid system ." ], [ "vascular invasion is characteristic for follicular carcinoma accounting for more common distant metastasis ( 5 ) .", "however , in most of these cases metastases occurred long after the diagnosis and institution of treatment for ftc and it is extremely unusual to encounter skull and cutaneous metastases as the presenting feature of ftc ( 3 ) .", "surgical approach should be considered as one of the treatments of choice for bone metastasis , if possible , and curative resection of solitary bone metastasis is associated with improved survival ( 7 ) .", "these cutaneous metastases are more common in head and neck region and can manifest in a variety of histological appearances ( 1012 ) .", "likewise cutaneous metastases from dtc are uncommon with less than 30 reported cases of cutaneous metastases in the english literature until 2010 ( 9 ) ." ], [ "bone and lung are the common sites of metastasis from ftc but involvement of skull is unusual , especially as the presenting feature .", "metastases from ftc should be included in the differential of patients with new oteolytic hypervascular skull lesions or cutaneous lesions in head and neck area ( 7 , 14 ) ." ], [ "the authors have not received any funding or benefits from industry or elsewhere to conduct this study ." ] ]

[ [ "thus , the aims of this study were to investigate whether metal interferes with the surface hardness and roughness of a visible light - polymerized acrylic resin and to compare these values to those of water - bath- and microwave - polymerized resins .", "in addition , light - polymerized resins can be processed directly in the mouth using a portable light - curing device , which simplifies the clinical procedures9 .", "while denture base acrylic resins polymerized by microwave irradiation and conventional water bath curing systems are composed of pmma6,8 , visible light - polymerized resins are similar to composites , having an organic instead of an inorganic filler content ." ], [ "a separating medium ( al - cote , dentsply ltd , rio de janeiro brazil ) was applied to the exposed areas of the mold . before packing the resin ,", "the matrix was flasked in type iii dental stone ( herodent soli - rock ; vigodent , rio de janeiro , rj , brazil ) using standard metal dental flasks ( uraby ; dlc , so paulo , sr brazil ) or plastic flasks ( onda cryl ; artigo odontolgicos clssico ltd , so paulo , sp , brazil ) for water bath and microwave polymerization , respectively .", "this assembly was put into a light box ( edg lux ; edg equipamentos e controles , so paulo , sp , brazil ) containing four 75 w halogen lamps .", "a rectangular ( 28 mm 8 mm 0.5 mm ) insert of co - cr alloy bar ( degussa , hanau , germany ) was centered at the bottom of each mold . as the size of the metal bars was almost the same as that of the mold cavities , once positioned at the bottom of each mold", "knoop penetrations were made on the acrylic surface of each sample at distances of 50 , 100 , 200 , 400 and 800 m from the co - cr metal bar ( figure 2 ) .", "light - polymerized resin specimens were prepared using a transparent matrix , consisting of an acrylic resin plate containing a circular hole measuring 30 0.05 mm in diameter and 4 0.05 mm thick .", "microwave acrylic resin specimens were polymerized in a microwave oven ( continental aw-42 , with 2,450 hz frequency and 900w maximum potency ; bosch , manaus , am , brazil ) , according to the manufacturer 's directions ( 3 min at 360 w ; 4 min resting and 3 min at 810 w ) .", "specimens polymerized by hot water bath were processed in an automatic polymerization unit ( termotron p-100 ; termotron piracicaba , sp , brazil ) at 74c for 9 h. once processed , all flasks were allowed to bench cooling for 2h .", "the resin was polymerized for 6 min , according to manufacturer 's instructions . after processing , the same finishing , polishing and cleaning procedures used for heat and microwave polymerized acrylic resins" ], [ "comparisons between acrylic resins showed that the visible light - polymerized resin ( triad ) exhibited significantly higher means ( p<0.05 ) .", "means and standard deviations for acrylic resin surface roughness m ) are presented in table 2 . the visible light - polymerized resin ( triad ) showed the highest means ( p<0.05 ) , but the metal alloy did not interfere with surface roughness .", "however , no differences in hardness values at several distances from the metal alloy were found .", ". means and standard deviations for knoop hardness ( kg / mm ) of acrylic resins at several distances from the metal are described in table 3 .", "mean followed by different letters are statistically different ( p<0.05 ) lowercase letters indicate differences between acrylic resins and uppercase letters indicate differences between distances from metal ." ], [ "bath- and microwave - polymerized resins with respect to the hardness means at pre - determined distances from a metal alloy . in this study , roughness and knoop", "a visible light - polymerized resin was compared to microwave- and heat - polymerized acrylic resins , which have similar composition and surface characteristics6,8 .", "acrylic resin roughness is dependent on the polishing method used2 . in this study , polishing was done with 360- , 400- , 600- and 1000-grit abrasive papers , resulting in roughness values below 0.2 m , which is considered clinically acceptable for preventing plaque accumulation2 . although the same polishing procedure was carried out for all resins , higher roughness means were found in the light - polymerized resin group ( 0.11 0.02 m ) .", "hardness results indicated that triad has clinically acceptable properties and its polymerization was not affected by the presence of metal .", "however , further studies about the clinical behavior of visible light - polymerized acrylic resins should be conducted ." ], [ "within the limitations of this in vitro study , it may be concluded that the presence of a metal framework did not interfere with the roughness and knoop hardness of the tested visible light - polymerized ( triad ) , microwave - polymerized ( onda cryl ) and water - bath - polymerized ( clssico ) acrylic resins , indicating that all materials can be used in removable partial dentures ." ] ]

[ [ "however , some studies debate on the effective and beneficial method of skin cancer screening as mass screening or high risk group screening and the real impact of skin cancer screening result on the society health . in iran , there are limited studies about prevalence and incidence of skin cancers .", "the two most common variants are basal cell carcinoma ( bcc ) and squamous cell carcinoma ( scc ) ; regardless of their low mortality rates , these tumors can provoke severe consequence as a result of their treatment . the third most frequent skin cancer type , malignant melanoma ( mm ) , has a more destructive behavior and accordingly a poor prognosis ; malignant melanoma accounts for approximately 75% of all deaths from skin cancer .", "there is limited data upon skin cancer screening program in western asia region and especially iran .", "therefore , this study was planned as a pilot one - week skin cancer screening campaign in tehran , iran to evaluate its profit and failure and design further large - scale screening program more definitely .", "there is strong data that whole - body clinical skin examination reduces the incidence of thick melanoma and , as a result , screening would reduce melanoma mortality . in us and", "skin cancer screening includes the complete cutaneous examination and 2 - 3 minute visual inspection of the skin ." ], [ "this study was planned as a skin cancer screening campaign in the public health centers of shahid beheshti medical university in a one - week period in tehran , iran .", "we applied for the collaboration of the public health centers in tehran as the location of this screening program .", "due to distribution of these centers in different areas of tehran , we discussed with the health deputy of the university for the collaboration of these health centers in this screening campaign and finally , thirty one public health centers were selected in different areas of tehran .", "the usual services provided in these centers include prenatal and pediatric care , women health , vaccination , health education , environmental or occupational health , etc . ,", "practical information upon skin cancer risk factors and its early symptoms or signs along with any needed guideline of this screening project provided to them in a two - day course by an expert board certified dermatologist . an illustrated educational pamphlet in the case of the risk factors especially sun exposure , ways of prevention and early detection of skin cancer published and distributed in the health centers for general patient education .", ", the suitable treatment would be provided for the patients in the dermatology ward or referred to the proper department ." ], [ "a morphoeic basal cell carcinoma found on the eyebrow of a middle - age man squamous cell carcinoma on the ear in an elderly man we found no significant difference in the number of common moles , multiple freckling , family history of skin and non - skin cancers between skin - cancer diagnosed patients and other participants . outdoor occupations and personal history of non - skin cancers was significantly higher in skin cancer diagnosed patients ( p < 0.05 , chi - square test ) .", "in a one - week period of screening , 1314 patients , 194 males ( 14.8% ) and 1120 females ( 85.2% ) , with mean age of 51.81 10.28 years were attended the allied health centers and underwent the whole - body skin examination . regarding the considerable attendance of female volunteers , most of them had indoor occupation especially being housewives .", "we have found the personal history of non - skin cancers in 14 ( 1.1% ) of participants . these were ovarian , prostate , breast and gastrointestinal carcinoma .", "thirty six ( 2.74% ) cases of dysplastic nevus were also diagnosed in this study . in the case of confirmed malignancies , the proper treatment provided for the patients in the dermatology ward or surgery department ." ], [ "early diagnosis of skin cancer is very crucial to improve the prognosis , for best treatment results , and increase the quality of life of the patient . in this regard , there are many studies upon skin cancer screening with valuable results upon the importance of early detection of skin malignancies . however , there is no strong evidence to establish whether there is a decrease in mortality due to regular physical examination of the skin . in this study", "this study gives us many practical clues to plan and perform large - scale skin cancer screening better .", "more educational activities for both patients and physicians regarding the skin cancer risk factors and their early signs and symptoms might be more beneficial and cost - effective to decrease the skin cancer mortality and morbidity . to the best of our knowledge , there was no similar study in iran to perform skin cancer screening and this study provides us useful information upon the profit and failure of a screening program .", "therefore , further controlled study could be beneficial to elucidate the more practical and cost - effective method of skin cancer screening in our country .", "there are different methods of skin cancer screening including population - based or targeted screening ." ] ]

[ [ "there is no report about the effects of combination therapy after avf creation using clopidogrel in combination with prostacycline analog as a potent vasodilator agent after autogenous avf creation .", "on the basis of these considerations , we performed a study to test the hypothesis that clopidogrel as an irreversible antiplatelet and oral prostacycline analog as an arterial vasodilator and additional antiaggregant drug may increase venous distensibility and arterial elasticity and would prevent primary avf failure in hemodialysis patients with diabetes mellitus .", "furthermore , only a few studies have addressed the safety of aspirin use after avf creation .", "as a result of this study , they concluded that venous line distensibility was a better predictive factor than vein size ." ], [ "major exclusion criteria of the patients to detect the quality of the brachial artery ( ba ) and a venous line , doppler usg was used .", "first , we investigated the need of re - intervention after avf due to thrombosis or occlusion during the follow - up period .", "suitability was defined as use of the fistula at a dialysis machine blood pump rate of 300 ml / min . or more during 8 of 12 dialysis sessions .", "the primary outcome measure was final avf failure , which required the creation of a new avf .", "the resistive index was a measure of the downstream flow resistance and was calculated as the difference between the respective measurements obtained after fist release ( post ) and during fist clenching ( pre ) .", "after randomization , the two groups of subjects are followed in exactly the same way , and the only difference between the care with which they receive drugs , outpatient visits and follow - up calls should be those intrinsic to the treatments being compared . in the first group of patients ,", "early patency or failure was defined according to a thrill and/or bruit 4 weeks after the surgery ." ], [ "the t - test was used when the means of two groups were compared . on the basis of intention - to - treat principles , all other participants were monitored according to the research protocol for whom study medications were continued .", "all hypothesis tests were conducted by using a significance level of 0.05 ( two - sided ) . for evaluation of the relationships between the avf maturation and independent variables ,", "multivariate cox proportional hazards models were used to determine factors associated with reduced avf patency .", "test results were presented as hazard ratios with 95% confidence intervals ( cis ) , and two - sided p < 0.05 was considered statistically significant .", "the statistical program , spss version 13 ( spss , chicago , il ) was used to analyze the data .", "differences between matured and failed groups were tested with the wilcoxon rank - sum test for continuous variables ." ], [ "four weeks after the surgery , avf maturation failure developed in 14 patients ( 30.4% ) in placebo group and in 4 patients ( 8% ) in clopidogrel and oral prostacycline analog group ( p = 0.001 ) . fistula maturation and survival has been confirmed using physical examinations and by a doppler usg every month for each patient .", "end points due to flow monitoring in the group 1 ( study group ) and group 2 ( placebo - treated control group ) are compared to total end points demonstrates the comparison of the mean avfs ' flow diagram ( left columns ) and the differences of arterial end - diastolic velocity ( right columns ) between the groups . in the early period , we detected high blood flows and lower arterial velocity in study group when we compared groups no bleeding episode such as intracranial hemorrhage in gastrointestinal tract was recorded during the active treatment period .", "hemodialysis was successfully performed in 36 patients ( 72% ) in the study group and 22 patients ( 47.8% ) in the placebo group at the end of study ( p = 0.001 ) .", "the hemodialysis period in group 1 was significantly longer and more successful than in the placebo group ( p = 0.001 ) .", "the median duration of patency was 5.8 months ( 95% confidence interval ( ci ) : 4.37.1 ) in the group 1 ( study group ) and 4.3 months ( 95% ci : 3.65.4 ) in the group 2 ( placebo group ) clinical outcomes at the end of the study the preoperative mean diameter of ba was 4.3 1.5 mm in clopidogrel plus oral prostacycline analog group and 4.04 1.3 mm in placebo group ( p = 0.94 ) .", "overall , the hazard ratio for primary avf failure was 0.82 ( 95% ci : 0.310.94 ) . during the follow - up period , from 4 weeks to 6 months , tenderness of the extremity ,", "multivariate logistic regression analysis revealed that avf maturation and survival rate was more than in study group ( odds ratio 2.27 ; 95% ci : 1.078.50 ; p = 0.001 ) .", "edema , and hematoma occurred in nine patients in study group , and in six in placebo group ." ], [ "in this prospective double - blind research , we presented our experiences of a new combination therapy and its efficacies on avf access after surgery in our esrd population . according to the study , clopidogrel in combination with oral prostacycline analog as an arterial vasodilator", "thus , blood flow from the fistula increased significantly in patients who were given a combination therapy than in patients who were given placebo .", "our study findings support the importance of distensibility and quality of vessel access . as we know that after avf creation , anastomotic or juxta - anastomotic stenosis is the most common cause of a fistula failing to mature .", "can be used to provide early avf maturation in esrdp with diabetes . according to previous reports , the size and quality of the arterial and venous access and distensibility after avf creation play important roles .", "our study differences may be related to surgical experiences , patients ' age , smoking history , bmi , patients ' arterial and venous diameters , and distensibility ." ], [ "multiple individuals are involved in the management of vascular access , including nephrologists , access surgeons , radiologists , dialysis nurses , and the patient .", "achieving optimal vascular access outcomes requires agreement on a common set of goals by all these individuals , close collaboration , and good communication .", "however , primary avf failure remains a major problem for hemodialysis patients worldwide . according to our study ,", "clopidogrel and oral prostacycline analog , which begins 710 days prior to avf creation and continuing during follow - up period seems to be effective and safe , and inhibit primary avf failure with acceptable side effects in hemodialysis patients .", "it is observed that prophylaxis of vascular access thrombosis needs to start earlier in the hemodialysis patients ." ] ]

[ [ "the objective of this study was to determine the efficacy and complication associated with transurethral removal ( tur ) of the intravesical or intraurethral mesh following midurethral sling procedures .", "tension - free vaginal tape ( tvt ) is now the treatment of choice for female stress urinary incontinence because of its ease of use , minimal invasiveness , and high success rate .", "since the first case of urethral mesh erosion was reported in 2001 , several case series have provided various techniques to manage this difficult complication [ 7,8 - 10 ] .", "bladder injury that is recognized during the operation is not usually related to long - term sequelae . however ," ], [ "a retrospective chart review was performed for women who had undergone transurethral surgery for bladder or urethral mesh between january 2002 and december 2010 .", "the surgical outcomes and complications were evaluated . to remove the mesh , transurethral resection with an electrode loop ( tur - e )", "thereafter , transurethral resection with a holmium laser ( tur - h ) was performed .", "a total of 23 consecutive women were identified , and their demographics , midurethral sling procedures , and removal procedures were reviewed .", "seven patients were treated with the tur - h procedure with a rigid scope : 5 cases of intravesical mesh and 2 cases of intraurethral mesh .", "the usual surgical techniques of tur - e and tur - h are described below ." ], [ "1 . seven patients were treated with the tur - h procedure with a rigid scope : 5 cases of intravesical mesh and 2 cases of intraurethral mesh . the surgery was similar to that for tur - e except a holmium laser was used .", "tur - e was performed for 15 women with intravesical mesh and 1 woman with intraurethral mesh . with the patient under spinal anesthesia in the lithotomy position ,", "three women required concomitant transvaginal surgery for remnant mesh after tur - h : 2 with intravesical mesh and 1 with intraurethral mesh .", "the median operation time was 215 minutes ( range , 180 to 220 minutes ) and the median hospital stay was 8 days ( range , 6 to 22 days ) .", "the median operation time was 125 minutes ( range , 30 to 180 minutes ) and the median hospital stay was 4.5 days ( range , 3 to 10 days ) .", "the median operation time was 57 minutes ( 40 to 135 minutes ) , and the median hospital stay was 8 days ( 4 to 36 days ) ." ], [ "the median period between the midurethral sling and mesh removal was 31.3 months ( range , 2.2 to 247.6 months ) , and the median follow - up period was 2.1 months ( range , 0.3 to 35.9 months ) after mesh removal .", "two cases of vesico - vaginal fistulas occurred in women treated with tur - e .", "one case of stress incontinence ( stamey grade i ) recurred in a woman who had remaining intraurethral mesh after tur - h .", "sixteen women had the tur - e procedure and 7 women had the tur - h procedure . at the time of surgery , the median age was 51 years ( range , 40 to 67 years ) .", "patient demographics and the clinical characteristics of a total of 23 women are described in table 1 according to the removal technique .", "most women presented with multiple symptoms , including dysuria , hematuria , and irritative or obstructive urinary symptoms ." ], [ "in this retrospective study , 26% of women ( 6/23 ) had a mesh remnant after transurethral removal of intravesical or intraurethral mesh .", "mesh exposure in the bladder or urethra is an uncommon but troublesome complication of midurethral slings .", ". our results can provide information on the outcomes and complications of different transurethral removal techniques and can help physicians to choose the best treatment modality .", "however , there are only limited data on the effectiveness of transurethral management for bladder or urethral mesh" ], [ "transurethral surgery is associated with low morbidity and is familiar to urologists . to remove intravesical or intraurethral mesh after midurethral sling procedures", "in contrast , tur - h has less risk of tissue damage , but complete resection seems to depend on the location of the mesh and the range of motion of the instrument .", ", tur - e has a high success rate , although it has a high risk of bladder perforation .", "the evidence for tur - h is not sufficient to conclude that this is an ineffective method for mesh removal ; however , it should be performed in selected patients .", "transurethral resection has good functional outcomes and a low risk of recurrence of stress incontinence ." ] ]

[ [ "finally , self - reported quality of life , disability and other patient - reported - outcomes were studied as a measure of the overall well - being of gad patients .", "the current study examined prospectively the evolution of gad symptoms in two groups of diagnosed patients in public and private mental healthcare settings ; one group according to the existing dsm - iv criteria and the other according to broader criteria ( at least 1 month but less than 6 months of excessive or non - excessive worry and 2 associated symptoms listed on dsm - iv for gad diagnosis ) . by using the total ham - a scores , changes in evolution of anxiety symptoms", "broadening of gad criteria could lead to earlier diagnosis of gad patients and to diagnosis of otherwise under diagnosed patients .", "gad is difficult to diagnose by primary care physicians and psychiatrists . in people who suffer gad , commonly occurring comorbid conditions ( e.g. , depression , alcoholism , other anxiety disorders ) often mask the underlying anxiety and result in a missed diagnosis of gad [ 7 , 8 ] .", "generalized anxiety disorder ( gad ) is a chronic disorder mainly characterized by pathological worry ." ], [ "this questionnaire consists of two parts , the first one aims to evaluate patient s health profile in five dimensions ( mobility , self - care , daily living activities , pain , and anxiety / depression ) .", "hamilton anxiety rating scale ( ham - a ) : the validated spanish version of the ham - a scale was used to evaluate the evolution of anxiety symptoms during all 3 visits of the study .", "functional and clinical outcome measures were completed in all three visits and included the following instruments : hamilton anxiety rating scale , montgomery - asberg depression rating scale ( baseline and 6 month visit only ) , clinical global impression - severity of illness scale , sleep scale from medical outcomes study ( mos - sleep ) , world health organization disability assessment schedule ii ( baseline and 6 month visit only ) , and the quality of life questionnaire , eq-5d ( all described in detail below ) . at baseline , socio - demographic data ,", "montgomery - asberg depression rating scale ( madrs ) : the validated spanish version of the madrs scale was used to measure the intensity of depression symptoms .", "patients were considered to respond to treatment when a higher than 50% reduction was observed for the total ham - a scale score at the study final visit when compared to that of the baseline visit .", "this was a multicentre , prospective and observational study carried out in outpatient psychiatric clinics between october 2007 and january 2009 ." ], [ "functional and clinical outcome measures were completed in all three visits and included the following instruments : hamilton anxiety rating scale , montgomery - asberg depression rating scale ( baseline and 6 month visit only ) , clinical global impression - severity of illness scale , sleep scale from medical outcomes study ( mos - sleep ) , world health organization disability assessment schedule ii ( baseline and 6 month visit only ) , and the quality of life questionnaire , eq-5d ( all described in detail below ) . at baseline , socio - demographic data ,", "this was a multicentre , prospective and observational study carried out in outpatient psychiatric clinics between october 2007 and january 2009 .", "the study was approved by the local ethics committee of the hospital clnico de san carlos ( madrid ) and was conducted according to the helsinki declaration for research in the human being .", "psychiatrists participating in the study made a confirmatory diagnosis of gad in 6 consecutive patients , 3 according to dsm - iv criteria and 3 according to broad criteria .", "although patients could have symptoms and receive treatment before entering the study , they had nt been diagnosed before by the psychiatrist .", "current therapy and psychiatric and medical illnesses information were collected . for the 3 and 6 months visits ," ], [ "eligible patients were men and women over 18 years of age that were diagnosed with gad by a trained psychiatrist at the baseline visit .", "one psychiatrist per clinic was chosen randomly within those with previous experience in clinical and epidemiological research in psychiatry , and with at least 5 year experience in mental health diseases diagnosis .", "psychiatrists were encouraged to maintain the above mentioned proportion of 3 subjects diagnosed following dms - iv criteria and 3 subjects diagnosed following the broad criteria . ", "exclusion criteria included previous gad diagnosis , inability or difficulty to understand patient - reported - outcomes questionnaires written in spanish .", "sample size was calculated taking into account study s main variable : evolution of anxiety symptoms according to the total ham - a scores for each patient group .", "first stage consisted on a selection of the outpatient psychiatry clinics ( mental health centres ) in each healthcare region ." ], [ "the other group ( broad criteria group ) was diagnosed according to broader criteria consisting on shortening of anxiety duration from at least 6 months to at least 1 month ( but less than 6 months ) , including excessive or non - excessive worry and reducing the associated symptoms from a minimum of 3 to a minimum of 2 .", "gad was diagnosed following the dsm - iv criteria ( dsm - iv criteria group ) in one group ." ], [ "this questionnaire consists of two parts , the first one aims to evaluate patient s health profile in five dimensions ( mobility , self - care , daily living activities , pain , and anxiety / depression ) .", "hamilton anxiety rating scale ( ham - a ) : the validated spanish version of the ham - a scale was used to evaluate the evolution of anxiety symptoms during all 3 visits of the study .", "eq-5d : this is a standard self - reported quality of life questionnaire developed in several european countries and validated for spain .", "montgomery - asberg depression rating scale ( madrs ) : the validated spanish version of the madrs scale was used to measure the intensity of depression symptoms ." ], [ "patients were considered to respond to treatment when a higher than 50% reduction was observed for the total ham - a scale score at the study final visit when compared to that of the baseline visit .", "if the only missing data was that from the 3 months visit , this was estimated proportionally to the change observed at the 6 months visit , given that the missing data at 3 month visit were completely at random .", "for statistical analysis , last observation carried forward approach was used for those patients for whom data from the 6 months visit were missing .", "the clinical relevance of observed differences in baseline characteristics was ascertained by means of the effect size that was calculated using the difference of means for each group , divided by the combined standard deviation of the variables .", "qalys gain after the 6-months follow - up was calculated from patients responses to the eq-5d as described previously using tariff calculated with this instrument .", "descriptive statistics were prepared for the continuous variables in the study , including the assessment of central position and dispersion ( two - tailed 95% confidence interval ) ." ], [ "moreover , the percentage of patients without symptoms of anxiety , showing ham - a<9 , increased up to 22.3% and 31.4% at the 3 month visit for the dsm - iv and broad criteria groups ( p<0.001 vs. basal visit in both groups , and p=0.006 between groups ) , and up to 49% and 58% at the 6 month visit ( p<0.001 vs. basal visit in both groups , and p=0.261 between groups ) , indicating similar results for both groups at the end of the study . also , patients responding to anxiety treatment increased when considering the responder criteria ( > 50% reduction of baseline scores ) ; 30.7% and 38.2% for the dms - iv and broad criteria , respectively , at the 3 months visit ( p= 0.004 ) ; increasing up to 59.7% in the dms - iv and 67.7% at the 6 month visit ( p=0.103 ) .", "a total of 3,549 patients were finally recruited by 618 psychiatrists in spanish psychiatric clinics for this observational study .", ", there was a significant improvement in all 7 domains of the who - das ii scale after the 6 month follow - up in both criteria groups .", "the improvements were not significantly different in the dsm - iv group when compared to the new criteria group except for household activity domain , in which the improvement in the dsm - iv group was significantly better when compared to the broad criteria group .", "health - related quality of life was measured by the eq-5d questionnaire . as seen in table 3 , both the health status ( visual analogue scale ) and the frequency of severe problems in each domain had significantly improved at the 6 month visit in both study groups ( p<0.001 in all cases ) . also , comparisons between both criteria groups in quality - of - life gain by domain were significant in favour of the broad criteria group in health status , daily living activities and mood status .", "as described in table 3 , all sleep domains in the mos - sleep scale changed significantly after 6 months when compared to basal visit scores ." ], [ "a total of 3,549 patients were finally recruited by 618 psychiatrists in spanish psychiatric clinics for this observational study .", "remaining patients were diagnosed of gad according to dsm - iv criteria ( 1,815 patients ) or to broad criteria ( 1,281 patients ) as described on the methods section .", "a total of 529 ( 17.0% ) patients drop - out from study , with no significant differences between study groups ( dsm - iv criteria : 313 patients , broad criteria : 216 patients ; p=0.899 ) ( fig .", "significant differences were also observed in the percentage of patients presenting with each individual gad symptom . all ham - a scores indicated severe anxiety on both patient groups , being the scores in the dsm - iv group significantly higher ( table 1 ) .", "however , main reasons for drop - outs were a somewhat different between groups with 52.7% lost to follow - up in dsm - iv group , compared with 67.1% in broad criteria group ( p=0.033 ) , and unknown reasons in 22.0% of withdrawals in dsm - iv group compared with 13.6% in broad criteria group ( p=0.023 ) .", "however , the magnitude of the effect was low for all quantitative variables at baseline ( effect size < 0,50 ) so the statistically significant differences observed were of small or negligible clinical relevance ." ], [ ", there was an increase in the number of patients under pharmacological treatment ( 97% in both groups , p<0.001 versus baseline in all cases ) . the use of antiepileptic drugs increased by 3.2 and 3.8 fold in the dsm - iv and broad criteria groups , respectively , by the end - of - trial ( p<0.001 in all cases ) .", "most patients in both groups ( 87.9% for dsm - iv ; 82.0% for broad criteria ) were following a pharmacological treatment in the six months previous to the baseline visit .", "( 2 ) , benzodiazepines were the most commonly used drugs followed by antidepressants and antiepileptics . at the end of the study", "the percentage of antiepileptic drugs users in dsm - iv group at baseline and at 6 months was significantly higher , albeit only slightly ( p=0.002 in both cases , fig .", "both groups showed a significant reduction in the percentage of benzodiazepines users after 6 months of follow - up ( p<0.001 ) , being this reduction even higher in the broad criteria group ( p=0.011 ) . also a slight but", "statistically significant increase was observed in the percentage of anti - depressive users in both groups ( p<0.001 , see fig ." ], [ "at the study entry , the percentage of subjects in dsm - iv and broad criteria groups that had at least one psychiatric comorbidity was 51.4% and 43.7% , respectively , ( p<0.001 ) .", "however , neither the mean number of comorbid psychiatric disorders nor the medical illnesses were different between both criteria groups , except for comorbid major depression and other depressive disorders which were slightly more frequent , but statistically significant in dsm - iv group ( p<0.01 and p=0.05 , respectively , table 2 ) . regarding psychiatric disorders , most of them were present around 5 months before the diagnosis of gad , without significant differences between groups in disease evolution .", "major depression and panic disorders were the most frequent comorbid psychiatric disorders in both study groups . for medical illnesses ,", "table 2 describes the most frequent psychiatric comorbidities and medical disorders in both study groups .", "chronic pain was present in more than half of patients in both groups , although a higher percentage was seen in dsm - iv group ; 64.3% versus 52.0% , p<0.001 ( table 2 ) ." ], [ "anxiety severity was assessed with ham - a and cgi - s scales at 3 and 6 month visits . fig .", "moreover , the percentage of patients without symptoms of anxiety , showing ham - a<9 , increased up to 22.3% and 31.4% at the 3 month visit for the dsm - iv and broad criteria groups ( p<0.001 vs. basal visit in both groups , and p=0.006 between groups ) , and up to 49% and 58% at the 6 month visit ( p<0.001 vs. basal visit in both groups , and p=0.261 between groups ) , indicating similar results for both groups at the end of the study . also , patients responding to anxiety treatment increased when considering the responder criteria ( > 50% reduction of baseline scores ) ; 30.7% and 38.2% for the dms - iv and broad criteria , respectively , at the 3 months visit ( p= 0.004 ) ; increasing up to 59.7% in the dms - iv and 67.7% at the 6 month visit ( p=0.103 ) .", "( 3 ) shows the evolution of ham - a total and sub - scores over study time in the dsm - iv and broad criteria groups .", "however , higher significant reductions were observed in dsm - iv group for the following symptoms : fatigue , irritability and sleep disturbance ( p<0.05 in all cases , fig . 5 ) . in this study ,", "all ham - a scores improved after 3 and 6 months in both criteria groups .", "( 5 ) shows the reduction in the percentage of patients presenting with each anxiety symptom ." ], [ "mos - sleep scale scores revealed an overall improvement in sleep patterns over study time in both criteria group .", "health - related quality of life was measured by the eq-5d questionnaire . as seen in table 3 , both the health status ( visual analogue scale ) and the frequency of severe problems in each domain had significantly improved at the 6 month visit in both study groups ( p<0.001 in all cases ) . also , comparisons between both criteria groups in quality - of - life gain by domain were significant in favour of the broad criteria group in health status , daily living activities and mood status .", "as described in table 3 , all sleep domains in the mos - sleep scale changed significantly after 6 months when compared to basal visit scores .", "differences between the dsm - iv and broad criteria groups were observed for the total score ( p= 0.018 ) , sleep disturbance domain ( p=0.012 ) , sleep quantity ( p=0.016 ) , sleep adequacy ( p=0.031 ) , and sleep problems ( p=0.019 ) scores , always favouring the broad criteria group . ", "at the 6 month visit , the percentage of patients reporting an improvement in their health status as compared with that of one year earlier increased by 13.8% for the dsm - iv criteria group , and 16.6% for the broad criteria group ( differences not significant ) . for measuring the disability degree in both groups of patients , the who - das scale was used . as shown in table 4 , there was a significant improvement in all 7 domains of the who - das ii scale after the 6 month follow - up in both criteria groups .", "the improvements were not significantly different in the dsm - iv group when compared to the new criteria group except for household activity domain , in which the improvement in the dsm - iv group was significantly better when compared to the broad criteria group .", "nevertheless , a trend toward statistical significance was observed in the total scoring of the disability scale favouring broad criteria group ." ], [ "this real world prospective study in usual medical practice has shown that broadening of gad dsm - iv diagnostic criteria , by reducing the duration of excessive or non - excessive worry to one month and associated symptoms to two , does not significantly affect patient s responsiveness to psychiatrist - prescribed therapy .", "there was a high proportion of patients treated with antiepileptics ; that could be explained by the fact that most subjects included in the study were non responders to recommended first line drug treatment according to the european guidelines on the treatment and management of gad patients .", "the present study is the first one to compare two groups of gad patients with dsm - iv and broader criteria following a prospective design .", "health status improvements in our study were similar to those observed in primary care patients receiving treatment over six months for their gad .", "according to our results , broadening of gad diagnostic criteria does not affect the response to the prescribed therapy , since ham - a scores , total and domains , improved similarly in both groups , and so did the presence of gad symptoms ( fig .", "although patients in this study received a confirmatory diagnosis of gad , a high percentage of them were already following a therapy recommended for gad at baseline ." ], [ "broadening criteria for gad diagnosis , by reducing excessive and non - excessive anxiety and worry duration to one month and the number of associated symptoms to two , captures a similar population of patients compared to the one identified by applying standard dsm - iv criteria .", "broadening diagnostic criteria is able to identify the core symptoms of gad according to the dsm - iv criteria and could lead to an earlier diagnosis ." ], [ "funding for this study was provided by pfizer spain ; pfizer spain participated in the idea and design of the study .", "mara perez and vanessa lpez - gmez are employed by pfizer spain , the body funding the study .", "enrique lvarez , jose l. carrasco and jos m. olivares declare not to have any conflict of interests as a consequence of participating in this study .", "inma vilardaga was employed of the european biometric institute , a consulting agency which was responsible for logistic of study and analysis of data ." ] ]

[ [ "the aim of this study was to determine whether a minimum set of criteria could be established to identify suspected hereditary renal cell cancer patients when there is restricted information about the familial occurrence of disease .", "renal clear cell carcinomas represent about 3% of all visceral cancers and account for 85% of renal cancers in adults .", "the tumours occur most often in older individuals , usually in the sixth and seventh decades of life , and are often diagnosed at incurable stages . in western countries", ", there is a necessity to be able to identify hereditary renal cell cancer families with a minimum set of criteria that will provide a high likelihood of ascertainment .", "there are two aspects of these criteria that can be problematic in the clinical setting with respect to the identification of familial renal cell cancer patients .", "genetic syndromes characterised by an increased risk of renal cancer ( familial cancer database - facd , http://facd.uicc.org ) the identification of genetic predispositions to renal cell cancer remains a priority since knowledge about the underlying molecular genetic basis of the disease will allow for a better understanding of the mechanisms giving rise to the disease and , perhaps more importantly , allow for the identification of individuals who are at risk of disease development .", "the first is the difficulty in fulfilling criteria in countries where large families and extensive pedigrees are impossible to identify , for whatever reason , even though the incidence of hereditary renal cell cancer may be quite high ." ], [ "group a ( familial renal cancer ) : comprising 46 patients affected by ccrc from 22 randomly selected families with at least two renal cancers among first or second degree relatives , independent of age at diagnosis of tumours .", "group b : a total of 100 individuals diagnosed with ccrc between the years 1993 and 1997 irrespective of family history were collected from the city of szczecin ( total population 400,000 ) .", "the following inclusion features ( if ) for the identification of suspected hereditary forms of clear cell renal cancer were used and compared against one another for their sensitivity and specificity : if 1 : at least one of the parents of the patient with ccrc was affected by lung cancer if 2 : at least one of the parents of the patient with ccrc was affected by gastric cancer if 3 : ccrc diagnosed at the age of 45 years or younger if 4 : ccrc diagnosed at the age of 50 years or younger if 5 : ccrc diagnosed at the age of 55 years or younger univariate statistical analysis ( chi - squared , odds ratio ( or ) , and sensitivity and specificity of selection were performed using the sas and logit programs .", "group a1 ( nuclear pedigree ) : comprising 25 patients affected by ccrc from group a. none of the parents of these patients have been diagnosed as affected with renal cell cancer .", "a total of 146 clear cell renal carcinoma ( ccrc ) patients comprising 3 groups were enrolled in the study ." ], [ "univariate statistical analysis ( chi - squared , odds ratio ( or ) , and sensitivity and specificity of selection were performed using the sas and logit programs ." ], [ "the comparison of the five ifs was undertaken to identify the most consistent criteria that can be employed in a clinical setting for the identification of suspected hereditary renal cell cancer , based on nuclear pedigree data .", "the results indicate that there is a very strong correlation between hereditary ( familial ) predisposition to ccrc and occurrence of at least one of the following ifs : if1 , if2 or if5 - or 13.4 ; p < 0.00001 .", "the first comparison was between group a ( associated with a genetic predisposition to disease ) compared to unselected cases from group b ( table 2 ) .", "the results indicate that all inclusion features are more frequent in group a ( or 1.62 - 4.88 ) .", "the second comparison was performed between group a1 and group b ( table 3 ) ." ], [ "the recognition of features that can be used for the identification of familial predispositions to ccrc in situations where extensive pedigree analysis is unknown or impossible to ascertain but the prevalence of the disease is relatively high in the population will aid in the identification of individuals at increased risk of developing ccrc . by using the criteria", "so far , the list of genetic changes associated with ccrc is somewhat limited but should be extended in the near future as more knowledge is gained about the genetic factors associated with altered ccrc predisposition . in summary , we advocate the use of our criteria for suspected hereditary clear cell renal cancer identified in this report in order to : a. offer an ultrasound examination option , b. create repositories of nuclear clear cell renal cancer families for future studies on the efficiency of surveillance for individuals with genetic predispositions to renal cancer , c. perform further studies to aid in the identification of genetic factors associated with ccrc .", "with respect to surveillance the real value of this will have to be established by studies on large cohorts of individuals from families matching pedigree and clinical criteria of suspected hereditary ccrc with identified constitutional dna variants associated with genetic predispositions .", "described herein and the consequent recognition of significant odds ratios for some of the inclusion features to identify ccrc families , we believe that the identification of additional genes associated with this malignancy will be expedited ." ] ]

[ [ "we report a case of a 54-year - old man who was successfully treated with epidural blood patches for intracranial hypotension due to csf leakage into the lumbosacral area after l4 - 5 discectomy .", "intracranial hypotension syndrome ( ihs ) is characterized by a postural headache that is aggravated in the erect or sitting position and relieved in the supine position .", "it is often associated with one or more of the following symptoms : nausea , vomiting , dizziness , diplopia , photophobia , hearing impairment , neck stiffness , and blurred vision6 ) . acquired or secondary intracranial hypotension is less common but has been reported after spinal procedures such as lumbar discectomy and dural puncture for myelogram , spinal anesthesia ." ], [ "a 54-year - old male admitted to the er complaining of headache \n from 13 days ago .", "2 ) . we decided to perform one more procedure of epidural patch placement because of the residual csf leakage 6 days after the first intervention .", "a mr myelogram was performed , showing a pseudomeningocele accompanied by large csf leakage in the lumbosacral area ( fig .", ", a 22 gage touhy needle was inserted through the l5-s1 epidural space through a paraspinal method . after confirming the epidural space by the loss - of - resistance technique , a dye was injected to confirm the epidural space with the c - arm ." ], [ "intracranial hypotension syndrome can occur spontaneously . acquired or secondary intracranial hypotension is less common but has been reported after spinal procedures .", "however to our knowledge , there have been no previous studies which compared the effects of epidural blood patch for the treatment of incidental durotomy with other treatments .", "epidural blood patch has been employed over the last five decades in the treatment of postdural puncture headache ( pdph ) and has proven to be beneficial .", "good long - term clinical results were noted in all patients with durotomy repaired at identification and are comparable to long - term results of patients undergoing similar surgical procedures but without durotomy . however , cammisa et al.1 ) reported the incidence of clinically significant durotomy occurred during surgery but not indentified at the time was 0.28% , and patients had subsequent surgical repair of dural defects because of failure of conservative therapy . in one study which investigated incidental durotomy during spine surgery and its treatment , in addition to primary repair , drain , bed rest , hydration , antibiotics had been used for treatment by spine surgeon7 ) .", "the effects of ebp in postoperative intracranial hypotension can not be discussed after one successful clinical trial , but additional trials and studies can provide the basis of epb treatment in such cases ." ], [ "epidural blood patch can be used as an effective treatment modality for csf leakage after lumbar spine surgery ." ] ]

[ [ "we report the cases of two children with \n xanthogranuloma of the sellar region , presenting central diabetes insipidus ( di ) .", ", there is no detailed clinical report of xanthogranuloma of the \n sellar region in cases of pediatric age . here ,", "pituitary insufficiency in childhood is often secondary to pituitary or hypothalamic \n space - occupying lesions .", "after their original \n report , several patients with xanthogranuloma of the sellar region have been described \n ( 8 , 9 ) . \n however , to our knowledge", "the differential diagnosis in etiologies of a mass in the sella is \n broad in spectrum , including rathke s cyst , tumor , autoimmune diseases , primary or \n metastatic neoplasms , and granulomatous inflammation . among them , xanthomatous pituitary \n diseases are rare in childhood ." ], [ "a 9-yr - old japanese boy was referred to our clinic because of a 6-mo history of polyuria \n and polydipsia .", "a 6-yr - old japanese boy was admitted to our hospital for evaluation of polyuria and \n polydipsia of 6-mo duration .", "the patient is currently well only on ddavp \n medication , 12 mo after surgery .", "after one - year follow - up , the patient continues to have di , but his basal \n levels of igf-1 , ft3 , ft4 and tsh are within normal ranges . radiological appearance on magnetic resonance imaging ( mri ) .", "the capsule of the tumor \n had tightly adhered to the dura of the sellar floor .", "gadolinium \n administration caused no enhancement of the mass . ) and hypointense on the t2-weighted images ( fig . \n", "brain mri showed an intrasellar mass , which was high on the t1-weighted ( fig .", "the corticotropin releasing hormone ( crh ) tolerance test showed normal \n responses of acth and serum cortisol ( table \n 1 ) . magnetic resonance imaging ( mri )", "the growth hormone ( gh ) releasing \n hormone ( ghrh ) and the thyroid stimulating hormone releasing hormone ( trh ) tolerance tests \n showed subnormal responses of gh and tsh , respectively ( table 1table 1 endocrinological findings of cases 1 and 2 ) .", "cyst was suspected preoperatively by the mri findings , however a definite diagnosis could \n not be made ." ], [ "a 9-yr - old japanese boy was referred to our clinic because of a 6-mo history of polyuria \n and polydipsia .", "the capsule of the tumor \n had tightly adhered to the dura of the sellar floor .", "after one - year follow - up , the patient continues to have di , but his basal \n levels of igf-1 , ft3 , ft4 and tsh are within normal ranges . radiological appearance on magnetic resonance imaging ( mri ) .", "postoperatively , di remains and has been treated with desmopessin \n acetate ( ddavp ) .", "cyst was suspected preoperatively by the mri findings , however a definite diagnosis could \n not be made .", "the growth hormone ( gh ) releasing \n hormone ( ghrh ) and the thyroid stimulating hormone releasing hormone ( trh ) tolerance tests \n showed subnormal responses of gh and tsh , respectively ( table 1table 1 endocrinological findings of cases 1 and 2 ) .", "the corticotropin releasing hormone ( crh ) tolerance test showed normal \n responses of acth and serum cortisol ( table \n 1 ) . magnetic resonance imaging ( mri )" ], [ "a 6-yr - old japanese boy was admitted to our hospital for evaluation of polyuria and \n polydipsia of 6-mo duration .", "brain mri showed an intrasellar mass , which was high on the t1-weighted ( fig .", ". the mass had a high appearance on the t1-weighted \n images ( a ) .", "gadolinium \n administration caused no enhancement of the mass . ) and hypointense on the t2-weighted images ( fig . \n", "ghrh , trh , and crh \n tolerance tests showed normal responses one month after surgery ( table 1 ) ." ], [ "we report the cases of two children with xanthogranuloma in the pituitary region with di . \n", "currently , whether this condition is a truly distinct entity or merely a different \n manifestation of adamantinomatous craniopharyingioma is unclear . to clarify the natural \n history , pathogenesis and prognosis in childhood , further accumulation of well - characterized \n pediatric cases with xanthogranuloma", ", xanthogranuloma of the pituitary in children was reported , but the frequency \n in children , and the clinical and endocrinological findings were not mentioned ( 7 ) . to answer whether clinical manifestations of \n xanthogranuloma in children are different from those of adults , more patients with \n xanthogranuloma of pediatric age must be studied . if xanthogranuloma is different form adamantinomatous craniopharyingioma , what is the \n origin of xanthogranuloma in the sellar region ?" ] ]

[ [ "a 52-year - old female patient visited the hospital complaining of pain in both breasts .", "the patient was laid on her side and the epidural space was checked using the loss - of - resistance method with a 22-gauge epidural needle ( hakko , japan ) in between the t4 and t5 , applying an aseptic technique in the interlaminar approach .", "the pain started immediately after breast reduction surgery she underwent 3 years previously at a private plastic surgery hospital , and it had continued despite a subsequent surgery .", "because the previous treatments were not effective in improving the symptoms and because the patient wanted another method of treatment due to the continued pain , it was decided that a thoracic epidural block would be performed , and informed consent was obtained from the patient ." ], [ ", we report a case in which prf was applied to control the pain of a patient who came to the hospital complaining of chronic severe neuropathic pain at the operation site that arose after breast reduction surgery .", "the patient in this case study was also a chronic neuropathic pain patient whose pain had continued for 3 years following breast reduction surgery .", "a nerve block using a local anesthetic is easy to perform in the treatment of pain and is effective in reducing pain .", "the effect of a nerve block in controlling pain after breast surgery is well known . in particular , it was reported that a paravertebral block ( pvb ) reduced pain , nausea and vomiting after breast surgery .", "these results show that a nerve block can be used in controlling pain following breast surgery effectively , preventing it from becoming chronic ." ] ]

[ [ "the algorithm uses the translation reading frames predicted by using blastx ( 2 ) as a guide for the identification of the coding region in sequences that have a hit ( 3 ) and predicts a coding region ab initio for sequences without a hit .", "we have implemented a web server called orfpredictor for the prediction of protein - coding regions within est - derived sequences .", "the generation of expressed sequence tags ( ests ) was originally proposed as a strategy for cdna characterization over a decade ago ( 1 ) .", "consequently , the number of organisms with est sequences deposited in the genbank dbest database is increasing rapidly ( ) . to maximize the value of these ests , ncbi has built unigenes that incorporated est data for a number of species ( ) , and the institute for genomics research ( tigr ) has been working on the gene indices for more than 70 species ( ) . annotating est and cdna sequences", "two tools that have been designed for locating protein - coding regions in cdna and est sequences are orffinder ( ) and estscan ( ) , respectively .", "the estscan server is designed for processing a batch of est sequences for identifying the protein - coding regions with a function for correcting insertions or deletions , but it is only trained for mammals and yeast .", "for example , using a full - length cdna sequence encoding glucoamylase , a well - characterized enzyme in a.niger , we found that estscan could not identify its correct coding region and had the undesired side effect of inserting nucleotides even when the test sequence was correct ." ], [ "the server provides a user interface for copy and paste , or for loading the users ' sequences and blastx outputs .", "sequencing errors may disrupt the conceptual translation of orfs , blastx could also detect frame shifts if there are insertions / deletions in the coding regions of the query sequences . when significant blastx alignments can be generated our algorithm uses them as a guide to identify the translation reading frames and coding regions . for est - derived sequences without a database match , their frames and coding sequences are predicted based on the presence and the location of intrinsic signals in a sequence that include start codons , 5 or / and 3 stop codons and stretches of poly(a ) ( figure 1 ) .", "however , blastx using a nucleotide query against a protein database is able to reliably identify protein - coding regions within a dna sequence if sufficient similarity exists between the translated query and an entry in the database ( 3 ) .", "targetidentifier server uses the uniprot / swiss - prot protein database.e - value : the user can also set a threshold e - value for their blastx file .", "if a blast output file is provided by a user , the frame used in blastx for alignments will be used for the prediction of the protein - coding region . for query sequences without a blastx hit or for which the blastx output is not provided , predictions will be performed based on the intrinsic signals of the query sequences using the rules described above ." ], [ "sequencing errors may disrupt the conceptual translation of orfs , blastx could also detect frame shifts if there are insertions / deletions in the coding regions of the query sequences . when significant blastx alignments can be generated our algorithm uses them as a guide to identify the translation reading frames and coding regions . for est - derived sequences without a database match , their frames and coding sequences are predicted based on the presence and the location of intrinsic signals in a sequence that include start codons , 5 or / and 3 stop codons and stretches of poly(a ) ( figure 1 ) .", "however , blastx using a nucleotide query against a protein database is able to reliably identify protein - coding regions within a dna sequence if sufficient similarity exists between the translated query and an entry in the database ( 3 ) .", "most ests encompass only a portion of the mrna sequence . therefore , it is more challenging to predict the coding region within an est than it is to predict the coding region of a fully sequenced cdna . distinguishing the translation start codon from other atg codons" ], [ "the server provides a user interface for copy and paste , or for loading the users ' sequences and blastx outputs", "if a blast output file is provided by a user , the frame used in blastx for alignments will be used for the prediction of the protein - coding region . for query sequences without a blastx hit or for which the blastx output is not provided , predictions will be performed based on the intrinsic signals of the query sequences using the rules described above .", "the poly(a ) or poly(t ) signatures that identify mrna poly(a ) tails should be retained , as they are used to determine the strand to be used for coding region and reading frame prediction.blastx output for all the est - derived query sequences .", "targetidentifier server uses the uniprot / swiss - prot protein database.e - value : the user can also set a threshold e - value for their blastx file .", "if a blast output file is provided by a user , the frame used in blastx for alignments will be used for the prediction of the protein - coding region . for query sequences without a blastx hit or for which the blastx output is not provided , predictions will be performed based on the intrinsic signals of the query sequences using the rules described above .", "these various inputs are summarized as follows : \n a sequence file in the fasta format .", "the poly(a ) or poly(t ) signatures that identify mrna poly(a ) tails should be retained , as they are used to determine the strand to be used for coding region and reading frame prediction .", "users can also use our targetidentifier server ( ) to obtain blastx outputs for their query sequences ." ], [ "it contains the following information for each input sequence . an identifier for the sequence , the reading frame for the predicted coding region , the location of the beginning and end of the predicted coding region , a flag shown as fs that locates any translation frame shifts detected in the blastx alignment and the predicted protein sequence .", "the other file contains the query identifiers for those sequences that do not have predicted protein - coding regions ( figure 1j ) ." ], [ "we first compared the predicted arabidopsis protein sequences obtained when blastx alignments were used as a guide with the annotated protein sequences in genbank , and confirmed that our program was able to predict the protein - coding regions with 100% accuracy .", "we found that the reading frame predicted ab initio was identical with the frames predicted by using blastx for 3943 ( 91.9% ) of the a.niger sequences and 2867 ( 93.5% ) of the p.chrysosporium sequences .", "we then examined the prediction accuracy using the a.niger and p.chrysosporium sequences , which had a blastx hit in the ncbi nr database with an e - value 1 10 .", "we evaluated the accuracy of orfpredictor using 2127 arabidopsis cdna sequences that have annotated protein sequences in genbank , and 4289 a.niger and 3065 phanerochaete chrysosporium sequences assembled from ests with phrap ( ) .", "then , we compared the ab initio predicted protein sequences with the results obtained by using blastx .", "the ab initio predicted frames were then compared with the frames identified by using blastx ." ], [ "we implemented a web server , orfpredictor , for predicting protein - coding regions in est - derived sequences .", "the predicted protein sequences can then be used as the input for additional annotation tools , such as interproscan ( 5 ) , for identifying protein families , domains and functional sites , the conserved domain search service ( 6 ) for the detection of structural and functional domains , and signalp ( 7 ) for locating potential signal peptides .", "orfpredictor uses the reading frame predicted by using blastx when a significant alignment is produced , whereas for sequences that do not return a significant blastx alignment protein - coding regions are predicted ab initio ." ], [ "( b ) a full - length cdna without a stop codon in the 5-utr . ( c ) a sequence containing a 5-utr with a stop codon and a portion of the coding region .", "categories of information derived from the est sequences . ( a ) a typical full - length cdna sequence including one or more stop codons in the 5-utr , a start codon and a stop codon", "( d ) a sequence containing a 5-utr with a stop codon . ( e ) a sequence containing a 5-utr without a 5 stop codon , and a portion of the coding region .", ". the coding region may contain multiple atg codons encoding methionine and the 3-utr may harbor additional stop codons .", "( f ) a sequence containing a portion of 5-utr without a 5 stop codon . (", "( i ) a sequence containing a portion of the coding region with no internal atg codons , a 3 stop codon and a 3-utr ." ] ]

[ [ "we tested our apparatus by measuring absorption spectra on the eyespot and chloroplast of the unicellular alga dunaliella and emission spectra on the photoreceptor and chloroplast of the unicellular alga euglena gracilis .", "the photosynthetic and the photoreceptive compartments are the main location of chromophores inside algal cells . absorption and emission spectra measured in vivo on these compartments can provide very precise and accurate information about the spectral range in which chromophore molecules capture photons in their natural environment and their de - excitation pathways 4 .", "a microspectrophotometer is a simple apparatus consisting of a modified microscope that can measure absorption or emission spectra of very small areas inside a cell 1 .", "the main feature of this instrumentation is the possibility to measure in vivo absorption or emission spectra at the same time on different sub - cellular compartments using extremely low light intensities .", "this set - up represents a better strategy with respect to traditional instruments , since it eliminates errors typical of microspectrophotometry , such as photobleaching , distributional errors , the schwarzschild - villiger effect , and allows in vivo reliable spectroscopic investigations 2 , 3 ." ], [ "the outer bundle of the probe was used for centering the photoreceptor and the chloroplast in the apical portion of the cell , while the central bundle of the probe was used for acquiring light emitted by the two structures .", "the central bundle of the probe was centered on both the structures in the apical portion of the cell ( is ) , in such a way that some light - guides were located outside the cell ; these guides measure ir .", "is results from the interaction of light with the sample ( it is related to absorption cross section of the molecules and the number of absorbing molecules ) 7 , while ir results from the interaction of light with the reference material . therefore , we can consider the absorbance of a sample ( as ) as derived from the measures as follows : this equation is known as the lambert - beer 's law . for the discussion on the theoretical aspects of image formation and the light transmission in microspectrophotometry see barsanti et al .", "emission spectra were performed on both the photoreceptor and chloroplast of the photosensitive alga euglena gracilis .", "absorption spectra were performed on both the eyespot ( screening device ) and the chloroplast ( photosynthetic apparatus ) of the unicellular alga dunaliella .", "absorption measurements are based on the comparison of two radiant fluxes density is and ir ." ], [ "it clearly shows that dunaliella belongs to the green lineage of eukaryotic algae since only chlorophylls a and b and carotenoids are present in this spectrum .", "it is the typical emission spectrum of a chloroplast that contains only chlorophyll a and b whose bands are centered at 685 for the photosystem ii and at 725 nm for the photosystem i , 18 .", "the eyespot is recognizable as a the bright orange spot located on the left side of the cell in the apical portion .", "the photoreceptor is recognizable as a the bright green spot located in the apical portion of the cell .", "the 27 kda protein extracted from the photoreceptor shows a similar behavior , the photochromic reaction cycling between two different stable conformers , the parent and the excited conformers 17 ." ], [ "b ) position of the probe upon dunaliella absorption spectra of the eyespot ( a ) and a chloroplast ( b ) of dunaliella a ) fluorescent image of euglena gracilis ; b ) position of the probe upon euglena gracilis emission spectra of the photoreceptor ( a ) and a chloroplast ( b ) of euglena gracilis", "set - up of the polychromator - based microspectrophotometer entrance ( a ) and exit ( b ) pupils of the light guide probe layout of the software interface a ) bright field image of dunaliella ." ] ]

[ [ "the mammalian target of rapamycin ( mtor ) , a conserved serine - threonine protein kinase that is inhibited by the effective clinical immunosuppressant rapamycin , regulates several intracellular processes in response to various extracellular signals and thereby modulates mrna translation .", "accordingly , we used a spared nerve injury ( sni ) model to evaluate the role of mtor in the rvm in neuropathic pain in rats .", ", we thus hypothesize that 5-htergic spinally projecting neurons in the rvm contain mtor , the activation of which could in turn increase the excitability of the 5-htergic neurons and thus may potently potentiate the descending facilitation pain control pathway and exaggerate neuropathic pain conditions .", "therefore , considering the important role of the rvm in descending pain facilitation , targeting mtor in the rvm might be a promising way to combat pain . because serotoninergic ( 5-htergic ) neurons are the primary constitutive element in the rvm and can send projections to the superficial spinal dorsal horn ( sdh ) [ 1820 ]", "the rostral ventromedial medulla ( rvm ) is an important relay region that contributes to the descending pain control pathway from the periaqueductal gray ( pag ) to the superficial laminae ( laminae i and ii ) of the spinal cord [ 1 , 2 ] ." ], [ "these rats were randomly divided into two groups designed for different purposes , as shown in figure 6(c ) : group 1 : to investigate whether rapamycin could influence the induction stage of sni - induced neuropathic pain , behavioral tests were performed before the first drug or vehicle injection , followed by sni ( pre - sni ) , and 30 min after the second injection on day 1 after sni ( sni - d1 ) ( figure 6(c ) , top ) and group 2 : behavioral tests were performed before sni ( pre - sni ) , 6 days after sni ( sni - d6 ) , and 30 min after drug or vehicle injection on day 7 after sni ( sni - d7 ) for the purpose of demonstrating the effect of rapamycin on the maintenance stage of sni - induced neuropathic pain ( figure 6(c ) , bottom ) .", "mechanical allodynia , as a behavioral sign of sni - induced neuropathic pain , was assessed by measuring the 50% paw withdrawal threshold ( pwt ) as described previously .", "spontaneous discharge and the number of action potentials were used to investigate sni - induced changes in neuronal excitability in the rvm .", "the membrane excitability of the recorded neurons was measured in current - clamp mode by determining the number of action potentials elicited by intracellular injection of 0 , 10 , 20 , 30 , 40 , 50 , and 60 pa depolarizing currents for 400 ms .", "the excitatory postsynaptic currents ( epscs ) of the rvm 5-htergic neurons , which are mediated by ampa receptors , were voltage - clamped and recorded at 60 mv with an axon 700b amplifier ( molecular devices , sunnyvale , ca , usa ) after blocking gabaergic transmission by picrotoxin ( 100 mm , sigma ) , a gabaa receptor antagonist .", "fluoro - gold ( fg ) was used as a retrograde tracer to label the rvm neurons that project to the sdh .", "the 50% pwt in response to a series of ascending von frey filaments ( stoelting , kiel , wi , usa ) was determined by the up - and - down method ." ], [ ", we concluded that the effect of rapamycin in partially reversing the mechanical allodynia was exerted via inactivation of the mtor signaling pathway , thus decreasing the excitability of 5-htergic spinally projecting neurons in the rvm .", "these results indicate that sni - induced neuropathic pain caused a substantial upregulation of p - mtor , which primarily occurred in 5-htergic neurons in the rvm . as reported previously , rapamycin is a specific and effective inhibitor of mtor . to investigate the inhibitory effect of rapamycin in vitro", "these results indicate that rapamycin inhibited the excitability of 5-htergic neurons in the rvm under neuropathic pain conditions .", "these results suggest that rapamycin can decrease the postsynaptic excitability of 5-htergic neurons in the rvm after sni .", "subsequently , we investigated whether rapamycin could reverse established neuropathic pain . on day 6 after sni ," ], [ "in the current study , we provide the first demonstration of the following : ( 1 ) mtor is expressed in the rvm region and can be activated in nerve injury - induced neuropathic pain ; ( 2 ) this mtor is largely expressed in 5-htergic neurons , which mainly comprise the descending pain control pathway ; ( 3 ) inhibition of the activated mtor restores the overexcitability of the 5-htergic neurons to normal ; and ( 4 ) inactivation of mtor by intra - rvm rapamycin microinjection alleviates established hyperalgesia ( abolished at the maintenance stage of neuropathic pain ) rather than influencing the beginning priming ( induction stage ) of neuropathic pain .", "these findings suggest that the mtor signaling pathway in the rvm is involved in the maintenance of nerve injury - induced neuropathic pain and that inhibition of mtor in the rvm could effectively alleviate neuropathic pain in sni rats . due to the importance of the descending pain control pathway in mammals ,", "the behavioral pharmacological data suggest that inhibition of mtor in the rvm at the late phase ( maintenance stage ) of neuropathic pain might be effective , even though pain has already been well established . by contrast , inhibition of mtor in the rvm had no effect on the development ( induction stage ) of neuropathic pain .", "rapamycin could effectively inhibit 5-ht overexcitability and thus attenuate hyperalgesia ( figure 6 ) , which indicates that 5-ht in the rvm is probably involved in the descending pain facilitation pathway under nerve injury - induced neuropathic pain conditions ." ], [ "through the deactivation of 5-htergic spinally projecting neurons in the rvm and thus the weakening of descending pain facilitation , specific targeting of the activation of mtor in the rvm is a promising avenue for the management of neuropathic pain ." ] ]

[ [ "while negative laparotomy was previously accepted as the inevitable and innocuous result of this policy , recent reports by renz and others have highlighted the 6 - 40% incidence of complications that accompany nontheraputic abdominal exploration . in view of these data , and", "how should the stable patient with penetrating abdominal or lower chest wall trauma be evaluated ?", "traditional diagnostic methods and liberal indications for surgery have resulted in negative laparotomy rates ranging from 12 - 40% .", "we review our experience with 70 consecutive patients who underwent diagnostic laparoscopy , and discuss the benefits and pitfalls in diagnosis we encountered utilizing this technique .", "dissatisfied with our own 33% negative laparotomy rate , prospective evaluation of the role of diagnostic laparoscopy in the evaluation of suspected penetrating abdominal injury was undertaken in september 1995 to identify those patients who could safely avoid surgical intervention , with the expectation that the rate of negative trauma celiotomy would markedly decrease . in this report" ], [ "a prospective study of patients with penetrating injuries to the lower thorax and anterior abdomen admitted to the bellevue hospital trauma and shock unit , a level i trauma center in new york city , was performed between september 1995 through november 1997 .", "we did not utilize the technique of gasless laparoscopy , or perform minilaparoscopy in the emergency department with local anesthesia utilizing 3 - 5 mm videoscopes .", "trauma service records were reviewed for the two years which preceded this study ( 1993 1994 ) ; the overall negative exploration rate for all patients with penetrating abdominal trauma during that time period was 33% .", "patients with known or suspected central nervous system injuries were initially excluded from the protocol . however , the use of diagnostic laparoscopy may be appropriate in head - injured patients when intracranial pressure monitors are in place ." ], [ "sixty - four ( 91% ) patients were male and six ( 9% ) female .", "forty - four patients ( 63% ) suffered stab wounds to the anterior abdomen , eleven ( 16% ) stab wounds to the left chest with suspicion of intra - abdominal injury , ( 19% ) with abdominal gunshot wounds .", "forty - one ( 59% ) procedures met criteria for positive laparoscopy : thirty - nine were converted to celiotomy and two additional nonbleeding liver injuries were treated nonoperatively .", "the mean operative time for laparoscopy was 16 minutes ( range : 3 60 ) .", "the mean time for negative laparoscopy was 23 minutes , and 10.8 minutes for laparoscopy with positive findings .", "ten were performed in patients with peritoneal penetration visualized on laparoscopy but found to have no intraperitoneal injury at laparotomy , three revealed only minor nonbleeding liver injuries early in our study that the individual attending surgeon was unwilling to treat nonoperatively , and one was performed for free blood secondary to a minor omental laceration . in patients without associated injuries ,", "the mean length of stay following negative laparoscopy was 1.5 days in 21 patients ( range : 1 4 ; the single 4-day stay was due to social service issues ) , compared to 5.2 days ( range : 3 8) for 12 negative explorations following positive laparoscopy ." ], [ "the mean operative time for laparoscopy was 16 minutes ( range : 3 60 ) .", "forty - one ( 59% ) procedures met criteria for positive laparoscopy : thirty - nine were converted to celiotomy and two additional nonbleeding liver injuries were treated nonoperatively .", "the mean time for negative laparoscopy was 23 minutes , and 10.8 minutes for laparoscopy with positive findings .", "ten were performed in patients with peritoneal penetration visualized on laparoscopy but found to have no intraperitoneal injury at laparotomy , three revealed only minor nonbleeding liver injuries early in our study that the individual attending surgeon was unwilling to treat nonoperatively , and one was performed for free blood secondary to a minor omental laceration . in patients without associated injuries , the mean length of stay following negative laparoscopy was 1.5 days in 21 patients ( range : 1 4 ; the single 4-day stay was due to social service issues ) , compared to 5.2 days ( range : 3 8) for 12 negative explorations following positive laparoscopy .", "twenty - five ( 65% ) of the 39 laparotomies were considered therapeutic by the operating surgeon . among the 14 nontheraputic laparotomies ,", "however , two of ten patients ( 20% ) who underwent negative laparoscopy for lower left chest stab wounds required urgent return to surgery from the recovery room for missed ongoing hemothoraces ." ], [ "the mean operative time for laparoscopy was 16 minutes ( range : 3 60 ) .", "forty - one ( 59% ) procedures met criteria for positive laparoscopy : thirty - nine were converted to celiotomy and two additional nonbleeding liver injuries were treated nonoperatively .", "ten were performed in patients with peritoneal penetration visualized on laparoscopy but found to have no intraperitoneal injury at laparotomy , three revealed only minor nonbleeding liver injuries early in our study that the individual attending surgeon was unwilling to treat nonoperatively , and one was performed for free blood secondary to a minor omental laceration .", "the mean time for negative laparoscopy was 23 minutes , and 10.8 minutes for laparoscopy with positive findings .", "twenty - five ( 65% ) of the 39 laparotomies were considered therapeutic by the operating surgeon . among the 14 nontheraputic laparotomies ," ], [ "in patients without associated injuries , the mean length of stay following negative laparoscopy was 1.5 days in 21 patients ( range : 1 4 ; the single 4-day stay was due to social service issues ) , compared to 5.2 days ( range : 3 8) for 12 negative explorations following positive laparoscopy ." ], [ "one small bowel injury resulted from insertion of the hasson trocar , and was repaired primarily in a patient during laparotomy for a thoracoabdominal gunshot wound with liver , adrenal and diaphragmatic injuries .", "there were no anesthetic complications in the study group , and no tension pneumothoraces or air emboli occurred ." ], [ "no intra - abdominal injuries were missed in the negative laparoscopy group ( table 1 ) . however , two of ten patients ( 20% ) who underwent negative laparoscopy for lower left chest stab wounds required urgent return to surgery from the recovery room for missed ongoing hemothoraces .", "one was a 23-year - old female stabbed in the left anterior axillary line at the 7th intercostal space .", "she was returned to the operating room , where thoracotomy revealed an actively bleeding injury to the lingula which was successfully controlled by stapled wedge resection .", "the second patient also required a left thoracotomy to oversew bleeding from the lung parenchyma ." ], [ "the applications of thoracoscopy in the trauma patient are expanding ; this technique can be used to detect and repair diaphragmatic injuries , evaluate the pericardium , and treat both ongoing and established hemothoraces .", "however , two of the remaining ten patients with thoracoabdominal stab wounds who underwent negative diagnostic laparoscopy manifested ongoing thoracic blood loss that necessitated return to the operating room , reinduction of general anesthesia and thoracotomy for definitive control of pulmonary parenchymal bleeding . clearly , routine diagnostic laparoscopy in these patients resulted in initial evaluation of the wrong body cavity , and lulled us into a false sense of security regarding the extent and severity of injury .", "laparoscopy has been championed by some authors as a routine maneuver in the evaluation of penetrating lower chest injuries to detect clinically and radiologically occult diaphragmatic injuries . in this study ,", "is an additional group of 26 patients who underwent therapeutic laparoscopy , including repair of diaphragmatic and anterior gastric lacerations , and control of hepatic bleeding ." ], [ "this experience confirms that laparoscopy is a safe and accurate tool for identifying peritoneal penetration following penetrating abdominal trauma , and adoption of this technique resulted in significant decreases in both the rate of negative laparotomy , and the hospital length of stay following a negative evaluation .", "it also proved useful in the evaluation of the hiv+ patient with equivocal findings on physical exam , and of stable patients with indeterminate or ", "one drawback is that the rate of negative laparotomy , while reduced , remains in the range of 1020% in our experience and recent comparable series .", "while other authors have demonstrated its sensitivity in the detection of diaphragmatic injuries , we urge caution in its use as the primary diagnostic study in penetrating thoracoabdominal trauma based on our experience with missed major intrathoracic injuries , and are currently investigating the complementary role of thoracoscopy in penetrating lower thoracic injuries .", "diagnostic laparoscopy reliably identifies those injuries to the liver that can be safely managed nonoperatively ." ] ]

[ [ "the aim of this work was to use a simple , rapid , and sensitive spectrophotometric method ( dithizone as chromogenic reagent ) for determination of trace amounts of selenium ( iv ) ( 5100 ng ml ) in micellar medium ( triton x-100 ) in cosmetic and pharmaceutical products . to improve", "the detection limit of this method , cloud point extraction ( cpe ) has been used .", "selenium ( se ) has been recognized as an essential nutrient for plant , animal , and human body , but at high concentration it can become toxic . the range between the concentration in which selenium is essential and toxic is very narrow [ 1 , 2 ] .", "an interesting alternative to traditional liquid - liquid extraction is the micelle - mediated extraction , firstly developed by watanabe and tanaka .", "evidence is accumulating that most of the degenerative diseases have their origin in deleterious free radical reactions ." ], [ "was used for all spectral measurements . in order to investigate the accuracy of method a perkinelmer ( model optima 7000 dv ) inductively coupled plasma optical emission spectrometer ( icp - oes )", "the effect of temperature was investigated by a gfl thermostated bath ( model 1003 , germany ) .", "under optimum conditions , a calibration graph was used for determination of selenium in cosmetic and pharmaceutical products .", "hence , the corrected absorbance , a \n corr , was used to overcome the problem : \n ( 1)acorr = a424(a424a592)la592 , \n where a \n 424 and a \n 592 are the absorbance of the complex measured at 424 and 592 nm , respectively , and ( a \n 424/a \n 592)l is the absorbance ratio of dithizone at 424 and 592 nm . the complex does not show any absorbance at 592 nm .", "the absorption maxima of the complex ( 424 nm ) and dithizone ( 434 nm ) were overlapping ( figure 1 ) .", ". 1 ml of treated sample solution was dropwise passed through an eichrom cation exchange resin ( sulfonic acid groups , mesh ranges : 50100 m , 8 cm ) , for removal of interferences , and selenium was determined with the recommended procedure . " ], [ "the method was applied to the determination of selenium in two multivitamin tablets ( centrum and selen plus ) and a selenium sulphide shampoo ( for treatment of dandruff ) .", ", selenium was determined in centrum tablet ( containing 0.25 mg se as sodium selenate ) by icp - oes as reference method . in both methods the results agreed well ( table 6 ) . ", "the results for selenium sulphide shampoo , centrum , and selen plus multivitamins are given in tables 3 , 4 , and 5 , respectively . in order to evaluate the accuracy of procedure", "the dependence of corrected absorbance upon centrifugation time was studied within the range of 530 min .", "these cations can be removed using a cation exchange resin ( sulfonic acid groups , mesh ranges : 50100 , 8 cm ) . for this purpose , 25 ml solution containing 2.5 g of se(iv ) and various amounts of desired cations" ], [ "the simplicity , rapidity , and inexpensiveness of the proposed method in combination with the use of dithizone as a chromogenic reagent were utilized for selenium determination in cosmetic and pharmaceutical samples .", "precision and recovery data clearly indicated the reproducibility and accuracy of the method . in this investigation ,", "because of the overlapping of absorption maximum of complex at 424 nm with absorption maximum of dithizone at 434 nm , a \n corr was applied .", "spectrophotometric determination of selenium was carried out in micellar medium without the need for an extraction step ." ] ]

[ [ "data on individuals aged 029 years diagnosed with any type of diabetes ( excluding gestational ) from 1 january 1991 to 31 december 2006 were extracted from clinical notes by a dedicated register manager and entered onto the population - based yorkshire register of diabetes in children and young people for residents of west yorkshire , which has a 97.6% level of completeness ( 1 ) .", "ethnicity was assigned as south asian ( pakistani , indian , bangladeshi ) or non - south asian ( all other ethnicities ) using the south asian names analysis program ( nam pehchan ) and the south asian name and group recognition algorithm ( sangra ) , two independent name recognition programs that are validated and sensitive tools for identifying south asians ( 11,12 ) . where the programs disagreed ( < 1% ) , a local expert examined the names and assigned ethnicity .", "type of diabetes was defined in accordance with world health organization guidelines ( 10 ) as type 1 , type 2 , maturity - onset diabetes of the young ( mody ) , ", "effects on incidence of age at diagnosis ( 5-year groups ) , sex , ethnicity ( south asian or not ) , and year of diagnosis on all types , type 1 , type 2 and uncertain / unclassified diabetes were analyzed using poisson regression .", "average annual percentage change ( aapc ) and 95% cis were derived using the coefficient for year in the poisson model .", "original diagnoses of uncertain / unclassified were reclassified as type 1 for 18% ( n = 32 ) and type 2 for 11% ( n = 20 ) .", "incidence was defined as the number of newly diagnosed cases per calendar year and 100,000 population at risk .", "populations for west yorkshire were provided by the office for national statistics , supplemented by estimated midyear population denominators by age , sex , and ethnic group ." ], [ "diabetes was diagnosed in 2,889 children and young people , with 83% ( n = 2,410 ) type 1 , 12% ( n = 337 ) type 2 , 0.7% ( n = 19 ) mody , 0.1% ( n = 1 of each ) j-type or other , 0.1% ( n = 4 ) not recorded , and 4%", "the incidence ( 95% ci ) of all diabetes ( aged 029 years ) was 21.0 ( 20.221.7 ) per 100,000 , with no statistically significant differences between south asians and non - south asians .", "the proportion of uncertain / unclassified cases per year rose from 0% in 1991 to 8% in 2006 .", "incidence of uncertain / unclassified diabetes was 0.8 ( 0.670.98 ) and was lower for non - south asians ." ], [ "the incidence ( 95% ci ) of all diabetes ( aged 029 years ) was 21.0 ( 20.221.7 ) per 100,000 , with no statistically significant differences between south asians and non - south asians .", "the incidence of type 1 diabetes was 17.6 ( 16.918.3 ) , with significantly higher rates in non - south asians ( 18.3 [ 18.319.0 ] ) than in south asians ( 13.1 [ 11.414.8 ] ) .", "type 2 incidence was 2.5 ( 2.22.7 ) , which was significantly lower for non - south asians ( 1.8 [ 1.62.1 ] ) than south asians ( 6.9 [ 5.68.1 ] ) .", "incidence of uncertain / unclassified diabetes was 0.8 ( 0.670.98 ) and was lower for non - south asians ." ], [ "aapc was 4.0% ( 95% ci 3.24.8 ) overall , and significantly greater in south asians ( 7.0% [ 4.89.2 ] ) compared with non - south asians ( 3.6% [ 2.74.4 ] ) ( fig . 1 ) and females ( 5.3% [ 4.16.4 ] ) compared with males ( 3.0% [ 1.94.0 ] ) . for type 1 diabetes , aapc was 1.3% ( 0.42.2 ) overall , with a significant increasing trend seen in non - south asians ( 1.4% [ 0.52.3 ] ) compared with no trend in south asians ( 0.0% [ 2.8 to 2.8 ] ) .", "annual incidence increased significantly for children ( aged 014 years ) at 2.9% ( 1.74.0 ) , but was stable for young people aged 1529 years ( 0.6% [ 1.9 to 0.7 ] ) . for type 2 ,", "the incidence in those aged younger than 30 years rose from 0.1 to 4.9 per 100,000 between 1991 and 2006 and aapc was 19.4% ( 16.522.2 ) overall , with incidence increasing at a similar rate for both ethnic groups .", "( a high - quality color representation of this figure is available in the online issue . ) the proportion of uncertain / unclassified cases per year rose from 0% in 1991 to 8% in 2006 .", "aapc was 26.4% ( 95% ci 20.732.1 ) overall , with similar increases for both ethnic groups ." ], [ "the previously reported steep rise in incidence of type 1 diabetes in south asian children up to 1999 ( 5 ) was not sustained , possibly as a result of a change in the recognition that type 2 and other forms of diabetes are emerging in younger age groups .", "we acknowledge that we may have underestimated the incidence of type 2 especially in earlier years , a problem identified in an earlier survey ( 15 ) , but these observations confirm the importance of including all forms of diabetes in our analyses .", "an increasing burden of diabetes was observed in non - south asian and south asian children and young people , with a rising incidence of type 1 diabetes confirmed in children ( 3,4 ) and stable rates for young adults ( 1,2 ) .", "there are clinical challenges in the differential diagnosis of type 1 and type 2 diabetes ( 13,14 ) .", "although the proportion of south asians in the diabetes population ( 13% ) was similar to the background population , south asians had a lower incidence of type 1 diabetes but an excess of type 2 , with an apparent shift from diagnosis of type 1 to type 2 from 2000 onwards ." ] ]

[ [ "familial adenomatous polyposis ( fap ) is a rare cause of colorectal cancer and is caused by a wide spectrum of mutations in the apc gene.1 \n 2 fap usually presents with a 100 to 1,000 of precancerous colonic polyps . without colectomy ,", "although it is most frequently observed in the first decade of life , with 78% of the cases being diagnosed before 10 years of age,9 neonatal gf has only been reported in a single case report so far.10 in our report , we relate the cases of two patients with neonatal gf and very different findings .", "while pathogenic apc mutations have a complete penetrance in the colon , this is not the case in extracolonic manifestations ." ], [ "subsequent testing of the parents showed the same apc deletion in the father who had no complaints . after having established the diagnosis he underwent colonoscopy , which led to the diagnosis of cancer of the sigmoid colon .", "known fap in the father the soft tissue tumor was assumed to be an extracolonic manifestation of fap . because of tumor progression during the next 4 months ( fig .", "the father of the boy had developed clinical symptoms of fap at the age of 27 and underwent prophylactic restorative proctocolectomy and ileal pouch ", "deletion / duplication analysis using multiplex ligation - dependent probe amplification showing monoallelic deletion affecting most of the apc coding region , showing that the gene dose of exon 4 onwards is reduced by 50% and proving the heterozygous deletion of a large portion of apc .", "molecular genetic analysis by pcr and sanger sequence analysis of all coding exons showed a heterozygous frameshift mutation c.4393_4394delag , p.ser1465trpfs*3 in exon 15 , segment h ( equals exon 18 , segment h [ genbank nm_000038.5 ] ) of the apc gene leading to introduction of a stop codon at amino acid position 1467 , thereby causing a truncated nonfunctional or functionally impaired apc protein ." ], [ "subsequent testing of the parents showed the same apc deletion in the father who had no complaints . after having established the diagnosis he underwent colonoscopy , which led to the diagnosis of cancer of the sigmoid colon .", "the paternal grandmother did not show the familial apc deletion , the paternal grandfather was unavailable for investigation .", "deletion / duplication analysis using multiplex ligation - dependent probe amplification showing monoallelic deletion affecting most of the apc coding region , showing that the gene dose of exon 4 onwards is reduced by 50% and proving the heterozygous deletion of a large portion of apc .", "the deletion was confirmed on a second blood sample and classified as a bona fide pathogenic alteration because of its large size . \n", "anal anastomosis , the histological workup verified a pt3 , pn2 ( 11/52 ) , l1 , g2 adenocarcinoma .", "mri scans of patient a. ( a ) tumor at the age of 9 months ." ], [ "molecular genetic analysis by pcr and sanger sequence analysis of all coding exons showed a heterozygous frameshift mutation c.4393_4394delag , p.ser1465trpfs*3 in exon 15 , segment h ( equals exon 18 , segment h [ genbank nm_000038.5 ] ) of the apc gene leading to introduction of a stop codon at amino acid position 1467 , thereby causing a truncated nonfunctional or functionally impaired apc protein .", "known fap in the father the soft tissue tumor was assumed to be an extracolonic manifestation of fap . because of tumor progression during the next 4 months ( fig .", "the father of the boy had developed clinical symptoms of fap at the age of 27 and underwent prophylactic restorative proctocolectomy and ileal pouch ", "anal anastomosis at the age of 28 . within 3 years after surgery he developed severe retroperitoneal desmoid disease leading to hydronephrosis necessitating nephroureterectomy ." ], [ "whereas early childhood gf have been reported and the assumption has been made that there is a strong connection to fap,9 to our knowledge there is only one report of a neonatal onset of gf leading to the diagnosis of fap in an otherwise asymptomatic child.10 in this report the patient 's parents were healthy and had negative genetic testing , so that a de novo mutation is most probable . in contrast , in our patient a , testing of the parents revealed the same mutation in the father and the diagnosis of abundant intestinal polyposis and sigmoid cancer in colonoscopy .", "this is to our knowledge the first report of a neonatal gf requiring immediate total proctocolectomy in a parent .", "although the overall ( and possibly underestimated ) association rate with fap is as high as 69% in this study , no information is available about relevance of gf as a sentinel lesion for fap in neonatal patients ." ], [ "continuous follow - up is mandatory because of unpredictable growth behavior and early onset of intestinal polyps ." ] ]

[ [ "we present two cases of type 2 dm with ds and believe that this is the first report of type dm with ds .", "down 's syndrome ( ds ) is one of the common chromosomal disorders and the most common cause of mental retardation .", "it is well - known that patients with ds have an increased prevalence of autoimmune disorders affecting both endocrine and non - endocrine organs .", "although cases of ds associated with diabetes mellitus ( dm ) have been reported in the past , invariably all cases were associated with type 1 dm ." ], [ "a 28-year - old male patient with a body mass index ( bmi ) of 25.1 kg / m and positive family history of dm reported to the out - patient clinic of the department of endocrinology , medwin hospital with the clinical features of polyuria and polydipsia for last 1 year .", "later , the doses of insulin were reduced and subsequently withdrawn completely and he is maintained well on oral hypoglycemic agents alone . a 26-year - old female patient with a bmi of 33.4 kg / m with strong family history of dm", "were admitted in the in - patient department of endocrinology , medwin hospital for proper control of hyperglycemia .", "he was initiated on basal glargine insulin at a dose of 15 units subcutaneously at night along with oral hypoglycemic agent ( glimepiride 2 mg / metformin 1000 mg ) once daily and l - thyroxine 100 g daily ." ], [ "a 28-year - old male patient with a body mass index ( bmi ) of 25.1 kg / m and positive family history of dm reported to the out - patient clinic of the department of endocrinology , medwin hospital with the clinical features of polyuria and polydipsia for last 1 year .", "later , the doses of insulin were reduced and subsequently withdrawn completely and he is maintained well on oral hypoglycemic agents alone . a 26-year - old female patient with a bmi of 33.4 kg / m with strong family history of dm", "were admitted in the in - patient department of endocrinology , medwin hospital for proper control of hyperglycemia .", "he was initiated on basal glargine insulin at a dose of 15 units subcutaneously at night along with oral hypoglycemic agent ( glimepiride 2 mg / metformin 1000 mg ) once daily and l - thyroxine 100 g daily ." ], [ "a 28-year - old male patient with a body mass index ( bmi ) of 25.1 kg / m and positive family history of dm reported to the out - patient clinic of the department of endocrinology , medwin hospital with the clinical features of polyuria and polydipsia for last 1 year .", "later , the doses of insulin were reduced and subsequently withdrawn completely and he is maintained well on oral hypoglycemic agents alone .", "other investigations ( hemogram , renal and liver function parameters , serum electrolytes and lipid profile ) were within the normal limits .", "he was initiated on basal glargine insulin at a dose of 15 units subcutaneously at night along with oral hypoglycemic agent ( glimepiride 2 mg / metformin 1000 mg ) once daily and l - thyroxine 100 g daily ." ], [ "physical examination revealed features of ds ( short stature , obesity , brachycephaly , gynecomastia , protruding tongue , simian crease , pot belly , short neck and acanthosis nigricans , wide occipital region with characteristic small eyes ) .", "a 26-year - old female patient with a bmi of 33.4 kg / m with strong family history of dm were admitted in the in - patient department of endocrinology , medwin hospital for proper control of hyperglycemia .", "the laboratory evaluation revealed fasting and postprandial sugar levels as 175 mg / dl and 240 mg / dl , respectively hba1c of 8.9% .", "his fasting and stimulated c - peptide levels were 1.4 pmol / ml and 2.5 pmol / ml with negative gad - antibody test ( 4.1 iu / ml ) ." ], [ "previous studies had suggested that type 1 dm is more prevalent in people with ds than in the general population and vice versa . to the best of our knowledge ,", "this indicated toward the fact that impaired insulin sensitivity might have contributed to a greater extent in the development of type 2 dm in these two patients .", " cell function was fairly preserved in these two patients ( as indicated by c - peptide levels in the blood ) with negative antibody testing for gad - ab .", "since rare forms a disease often provide insight into the possible mechanisms of the disease and since each candidate gene contributes a small amount of genetic risk to the disease , individuals with ds and type 2 dm may therefore provide the clinical insights into possible mechanisms underlying susceptibility to diabetes .", "impaired cell function and insulin sensitivity are the main factors in the pathogenesis of type 2 dm .", "a variety of genetic syndromes have been described in which dm occurs with increased frequency .", "the etiology of the disturbance in glucose homeostasis in these diverse and unrelated syndromes remain undefined ." ], [ "further investigations are warranted to prove whether the presence of type diabetes in patients with ds was a chance association or whether there is a genetic basis for this association . however , these two cases point to the fact that one should screen patients with ds for type 2 diabetes ." ] ]

[ [ "the challenge that remains is how to unlock the neurogenic potentials of the mammalian mg in vivo .", "recent progress in our understanding of brain development has significantly altered concepts for treating neurodegenerative diseases , including those that affect the retina to cause blindness .", "contrary to previous thought , it is now recognized that neurons are generated in the sub ventricular zone ( svz ) of the lateral ventricle , and the sub - granular zone ( sgz ) in the hippocampus from neural stem cells ( nsc ) of glial origin throughout life ( 1 ) . outside these discrete regions in the mammalian cns , including the retina , active neurogenesis has not been reproducibly demonstrated under normal conditions ( 2 ) .", "however , rare neurogenic changes are observed in the injured adult mammalian retina ; the source of injury - induced neurogenesis is traced to mller glia ( mg ) ( 35 ) ." ], [ "to address this challenge , the neurogenic potentials of mg need to be evaluated against the backdrop of two models , with the understanding that examples from lower vertebrates would constitute a framework , but that solutions will be unique to the mammalian retina : ( 1 ) svz / sgz model , where mg have nsc properties and thus the capacity for neuronal differentiation like radial glia - derived nscs in svz and sgz .", "characterization of these cells for gene regulatory network and epigenetic signature is essential to shed light on the status of their neurogenic potential and approaches to unlock it .", "this raises the possibility that , in addition to internal constraints discussed above , the environment in the mammalian retina might not be conducive for neurogenic conversion of mg . a niche - based approach to unlock neurogenic potential of mg will involve examining the relationship of mg with neighboring retinal cells , microglia , immigrant astrocytes , and endothelial cells in the context of signaling pathways and their capacity to engage the molecular axes involved in reprograming along neuronal lineage .", "the recent success of reprogramming to induce pluripotency in somatic cells and lineage - specific differentiation of pluripotent cells , whether through directed differentiation ( svz / sgz model ) or trans - differentiation ( extra svz / sgz model ) , is owed directly to the knowledge of developmental mechanisms ( 12 ) .", "knowledge of the developmental mechanism for the lineage switch , the reaction of mg to different kinds of injuries , phenotypes of the activated mg in spatial and temporal contexts , transcriptional and epigenetic status , and niche - related signals will be critical ." ], [ "recent observations that the decision of retinal progenitors during late histogenesis to differentiate along glial or neuronal lineage is influenced by lin28 ( 17 ) and that ezh2 plays a role in constraining the generation of mg ( 18 ) posit these genes as potential targets for pivoting mg torwards neuronal differentiation .", "given the contextual role of notch signaling ( 4 ) , its complexity due to the oscillatory expression of its effector hes1 ( 13 ) , and its gliogenic interactions with the eye field gene lhx2 ( 14 ) , this information will be essential to formulate niche - based approaches for facilitating neuronal differentiation of mg . along this line", ", it will also be advantageous to know whether genes involved in neurogliogenesis elsewhere in the cns , such as lin28 , a heterochronic gene regulating the developmental timing ( 15 ) and ezh2 , an epigenetic regulator of gene expression ( 16 ) participate in mg differentiation and coordinate the influence of the niche .", "there is a significant knowledge gap in our understanding of how neurogenesis shifts to the generation of mg in the mammalian retina , information essential to navigate the cellular or molecular roadblocks to neuronal differentiation .", "for example , although we know that notch signaling regulates the generation of mg , how it is incorporated into the gliogenic program and to what extent it is involved in suppressing neuronal differentiation remains rather unknown ( 4 ) .", "the recent success of reprogramming to induce pluripotency in somatic cells and lineage - specific differentiation of pluripotent cells , whether through directed differentiation ( svz / sgz model ) or trans - differentiation ( extra svz / sgz model ) , is owed directly to the knowledge of developmental mechanisms ( 12 ) ." ], [ "together , these observations posit these molecular axes as valid intrinsic targets for studying and unlocking the dormant regenerative potential of mg .", "regardless of whether or not mg possesses dormant stem cell properties according to the aforementioned models they must initiate and complete an intertwined program of activation and neuronal conversion for successful regeneration ( 4 ) . given that injuries in general lead to proliferation of mg across species , but not to their neuronal differentiation in higher vertebrates , it is likely that the cross - talk between transcriptional networks sub - serving the activation and neuronal differentiation are either not connected to the process , or the network components are in place but are not epigenetically primed for optimal expression in the mammalian mg .", "will yield corroborative evidence and facilitate the means to test putative mechanism(s ) by manipulating gene expression .", "for example , the molecular axis defined by lin28 and ascl1 , which facilitates mg - mediated regeneration in zebrafish , is a valid target for study in mammals ." ], [ "this raises the possibility that , in addition to internal constraints discussed above , the environment in the mammalian retina might not be conducive for neurogenic conversion of mg . a niche - based approach to unlock neurogenic potential of mg will involve examining the relationship of mg with neighboring retinal cells , microglia , immigrant astrocytes , and endothelial cells in the context of signaling pathways and their capacity to engage the molecular axes involved in reprograming along neuronal lineage .", "emerging evidence , once again from the zebrafish model , suggests that these pathways , including notch signaling , may act in concert and mg integrate the diverse niche - based influence of a variety of signaling molecules for a calibrated regenerative response to injury ( 8) .", "although the identity of cells delivering notch signaling in mg remains speculative , emerging evidence from zebrafish and higher vertebrates posit it as an important niche - based target for mg - dependent regeneration .", "therefore , niche - related information is crucial for understanding the temporal and spatial modulation of signaling required for activating mg and shifting them from the state of activation to neuronal differentiation ." ], [ "currently , the identity of the activated mg represents cells in the inner nuclear layer of the retina , which have incorporated brdu in response to injury and express mg - specific markers .", "given the transition of mg from a quiescent to a proliferative state and the generation of their progenies in different stages of development , the identity based on brdu incorporation , though important , is of limited value .", "therefore , to follow mg - mediated regeneration , spatially and temporally , and to identify the stage - specific intrinsic players , a concerted effort is needed to search for reliable and reproducible markers .", "attempts have been made to prospectively enrich activated mg by hoechst dye efflux assays and to characterize them as sp cells , a phenotype shared by the majority of stem cells ( 4 , 6 ) . however , since sp cells are also heterogeneous , this functional approach has limitations in the absence of specific cellular markers .", "insight into regeneration in the svz has come from the characterization of b1 quiescent and active progenitors and resulting neuroblasts ( 37 ) .", "progress in understanding the regenerative mechanisms in tissues like blood ( 34 ) , intestine ( 35 ) , and skin ( 36 ) has been facilitated by the identification and characterization of markers of the resident stem cells and their progenies . within the cns ," ], [ "furthermore , cell type specific injury models would test the ability of mg to replace specific neuronal types , which will be helpful in designing approaches for mg - dependent therapeutic regeneration .", "characterization of these cells for gene regulatory network and epigenetic signature is essential to shed light on the status of their neurogenic potential and approaches to unlock it .", "the neurotoxin injury models where exposure of the retina to n - methyl - n - nitrosourea ( mnu ) ablates photoreceptors ( 39 ) and nmda causes the degeneration of rgcs ( 40 ) would reveal whether or not mg could differentiate along specific neuronal types . also , it may shed light on if mg - dependent therapeutic regeneration would be a practical approach to address degenerative changes in amd and/or glaucoma .", ", unpublished observations ) , and that within the same species there are strain differences in responses ( 38 ) , a case may be made for developing injury- and species / strain - specific models for reproducible and unambiguous examination of mg neurogenic potentials .", "these models will be valuable in incorporating transgenic technology for reliable lineage tracing , and more importantly for molecular characterization of activated mg .", "currently , there is no consensus on reliable and reproducible mammalian models to study the activation and neurogenic potential of mg .", "rodent models representing retinal injuries , ranging from those caused by the exposure to light , neurotoxins , and genetic mutations have been used ." ], [ "the activated mg and the molecular axes mediating their response to the niche , aided by reproducible animal models and lineage reporters , a pharmacological recruitment of these endogenous progenitors for therapeutic regeneration is a near possibility . in addition , information emerging from these studies will help us understand how the neurogenic potential in the adult mammalian brain is constrained relative to that of lower vertebrates , currently a significant knowledge gap .", "the discipline of mg - based regeneration is a recent one , particularly in mammals . with information on the nature of" ] ]

[ [ "recently our own group has started to investigate the use of diamines in a bimetallic context , reporting in a communication the synthesis of the diazaethene zincate complex ( tmeda)li[(ipr)nch = chn(ipr)]zn(tbu ) 1 .", "the field of utility organometallics is increasingly turning to more complex mixed - metal systems to deliver superior results , whether this be for metal halogen exchange , alkylation , insertion , or the trapping of reactive intermediates . in theory", "the synthesis of this complex from the fully saturated ( ipr)nhch2ch2nh(ipr ) ( diisopropylethylenediamine ) 2 ( scheme 1 ) displayed a new mode of hydrogen activation previously unseen within zincate chemistry .", "the combination of an alkali metal with a range of different subordinates ( i.e. , metals that would be expected to be less reactive than the alkali metals - zn , mg , mn , cr , fe , cu , cd , al ) have been integrated with a diverse array of ligands ( alkyl , amido , alkoxy , halide ) and have been efficiently deployed in both ethereal and hydrocarbon media to overcome some of the great challenges facing deprotonation chemistry such as the incapability to metalate low brnsted acidity substrates , lack of compatibility with sensitive functionalities , low selectivity and the need to perform reactions under cryogenic conditions .", "we now report a detailed mechanistic overview of this surprising transformation from both experimental and theoretical perspectives .", "1,3-diazabutadiene ligands , from which diazaethene ligands are often prepared , are increasingly important within coordination chemistry due to their flexible coordination modes and redox properties .", ", mixed - metal reagents can offer more flexible , tunable solutions to any problem compared to more traditional monometallic alternatives due to the increased number of components which can be varied ." ], [ "therefore , the synthesis of the sodium zincate 10 , along with the lithium zincates detailed in our recent communication , appear to represent the first such complexes to be synthesized via a double ch activation of a saturated diamido ligand . molecular structure of the diazaethene sodium zincate ( thf)3na[(ipr)nch = chn(ipr)]zn(tbu ) 10a . hydrogen atoms and minor disordered thf components have been omitted for clarity .", "although diamido 4 has thus far not crystallized , it has been characterized by multinuclear nmr spectroscopy , and we have succeeded in the crystallographic identification of several analogous structures . using the homologous ( ipr)nhch2ch2ch2nh(ipr ) ( diisopropylpropylenediamine ) , the dimetalated diamido ( tmeda)li[(ipr)nch2ch2ch2n(ipr)]zn(tbu ) 5 ( scheme 2 and figure 1 ) could be crystallized from the corresponding reaction of li[(ipr)nch2ch2ch2nh(ipr ) ] with ( tbu)2zn(tmeda ) .", "the synthesis of several alkali metal zincate diazaethene complexes has been achieved previously . however , to the best of our knowledge , all previous examples were synthesized by the reduction of unsaturated bis - imino ligands .", "molecular structure of the diamido zincate ( tmeda)li[(ipr)nch2ch2ch2n(ipr)]zn(tbu ) 5 . hydrogen atoms and disordered tbu / tmeda components have been omitted for clarity .", "returning to experimental studies , a molecular hydride species [ ( tmeda)li]2[(ipr)nch2ch2n(ipr)]zn(tbu)h 7 has been isolated by using a variation of this mixed - metal approach with the ethylenediamide ligand , demonstrating that this system has the ability to encapsulate lih ( scheme 4 and figure 6 ) .", "mixed - metal zincate complex 4 can thus be described as a molecular scaffold for the molecularization of the usually insoluble polymeric lih .", "large aggregates of liotbu have previously been found to activate and retain lih in solution ." ], [ "however here we show through a combination of experimental ( nmr spectroscopic , x - ray crystallographic ) and theoretical ( dft ) studies that working co - operatively in a molecular mixed - metal system , an alkali metal ( lithium or sodium ) and zinc can bring about such transformations under challenging redox - inactive conditions .", "conversions of saturated diamines into unsaturated diazaethenes are usually associated with redox - amenable transition metal catalysts ." ] ]

[ [ "a gestational age of 40 weeks was assigned to 3 ( 27% ) of 11 infants with bacteremia and 4 ( 14% ) of 28 infants with meningitis who were reported as born following term gestation without a specific gestational age mentioned .", "we reviewed the literature for reports of e. sakazakii disease in infants . using medical subject heading terms \" e. sakazakii \" or \" enterobacter \" in combination with \" newborn , \" \" infant , \" or \" meningitis ,", "infants with cultures of cerebrospinal fluid or brain abscesses yielding e. sakazakii were considered to have meningitis . because bacteremia is usually an intermediate step during the process of developing meningitis , patients with both bacteremia and meningitis", "bacteremia was defined as e. sakazakii grown from the blood of a case - patient without evidence of meningitis .", "finally , we reviewed e. sakazakii case consultations conducted by the centers for disease control and prevention ( cdc ) from 1998 to 2005 and reviewed results of a french outbreak reported to cdc in 2005 ( 14 ) .", "infants with gestational ages < 37 weeks , or those reported to be premature , were considered premature .", "we defined birthweight < 2,500 g as low birthweight ( lbw ) , < 1,500 g as very low birthweight ( vlbw ) , and < 1,000 g as extremely low birthweight ( elbw ) ." ], [ "forty - six infants met the case definition ( table 1 ) . reported onset years ranged from 1958 to 2005 ; 32 ( 70% ) cases", "cases were reported in 7 countries in north america , europe , and the middle east .", "twenty - nine ( 69% ) of 42 infants experienced disease onset within a hospital .", "although the proportion of infants who experienced nosocomial disease onset was not significantly different between the meningitis and bacteremia groups , other infant characteristics differed by site of infection ( figure ) .", "thirty - three ( 72% ) infants had meningitis , 12 ( 26% ) had bacteremia , and 1 ( 2% ) had a urinary tract infection ." ], [ "although numerous reports include infants with e. sakazakii isolated from nonsterile sites , such as respiratory secretions or stool , 46 infants identified from the literature and cdc sources met the case definition for this analysis ( 1,9,10,12 ) . of the infants with sterile - site infection", "meningitis developed , rates of adverse outcome were similar to those reported in the literature : in this case series , 74% of meningitis survivors experienced an adverse neurologic outcome , while other studies cite adverse outcome in 20%78% of neonatal or infant meningitis survivors ( 2123 ) .", "those in whom meningitis developed tended to be of greater gestational age and birthweight than those with bacteremia alone .", "in fact , infants in whom meningitis developed tended to attain near - term gestational age and birthweight .", "most infants with e. sakazakii bacteremia fared better than those with meningitis . among those in whom", "infants with nearly normal gestational ages and birthweights are likely to be tended in normal newborn nurseries during the first 2472 hours of life . in such nurseries , powdered formula is frequently given to babies who are not breast - fed , and it may also be used as a supplement by mothers who have chosen to breast - feed . since infants are at highest risk for meningitis during the first several weeks of life , possibly because of immaturity of the blood - brain barrier , exposures to e. sakazakii in powdered formula or other sources during this time may quickly lead to central nervous system disease ( 26,27 ) .", "contrary to previous characterizations of e. sakazakii disease , we found that infants with meningitis and bacteremia alone fell into 2 distinct groups ." ] ]

[ [ "the aim of the present study was to evaluate the effect of sterilization with dry heat and steam on load - deflection characteristics of -ti wires , with different brands .", ". however , some manufacturers have used different methods to solve this problem , including incorporation of a titanium nitride and titanium oxide layer on the wire surface through ion implantation , changing their composition , highly polishing of the surface and increasing the surface smoothness.[71724 ] some previous studies have evaluated the effect of sterilization on wires with various alloy combinations ( -ti , niti , ss),[82528 ] with contradictory results in relation to -ti wires . in addition , after the expiration of patent on -ti wires by ormco ( glendora , california , usa ) various manufacturers produce these wires with different compositions and processing methods , resulting in different mechanical properties and different effects as a result of sterilization processes .", "-titanium ( tma ) wires are alloys of titanium and molybdenum , which were introduced in the early 1979 by goldberg and burstone for use in orthodontic treatment .", "orthodontic wires are selected in different stages of the treatment procedure not only based on wire diameter , but also biomechanical and deactivation properties of wires in order to achieve the best treatment results ." ], [ "-titanium wires tested in the present study group i was assigned as the control group .", "load - deflection apparatus with the wire in place data was analyzed using repeated measures anova to compare load - deflection properties of the five types of -ti wires and determine the changes in characteristics during loading and unloading separately after sterilization of each wire type .", "in the present study five different types of -titanium wires with a cross - section of 0.43 0.64 mm ( 0.017 0.025 inch ) were evaluated [ table 1 ] .", "the wires were of the straight type . in cases in which only the preformed arch forms were available their straight posterior segments", "a total of 30 wire segments from each type were provided ; each segment measured 30 mm in length .", "a single maxillary first premolar bracket ( american orthodontics , master series , wis , usa ) , with a 0.022 0.028-inch slot size with zero angulation and zero torque was bonded on each of the half - cylinders [ figure 1 ] , with a distance of 14 mm between the brackets ." ], [ "according to hysteresis evaluation ( energy loss upon unloading ) of wires before and after sterilization showed that only sterilization with dry heat resulted in an increase in hysteresis of tmal and hone wires ; however , autoclave sterilization did not have any effect on hysteresis of the wires under study .", "figures 26 show load - deflection curves . means and standard deviations ( sd ) for loading forces at 0.1 mm intervals of deflection for wire samples in groups i - iii means and standard deviations ( sd ) for unloading forces at 0.1 mm intervals of defl ection for wire specimens in groups i - iii load - deflection graph of beta wires in the control group and after sterilization with dry and moist heat load - deflection graph of cna wires in the control group and after sterilization with dry and moist heat load - deflection graph of res wires in the control group and after sterilization with dry and moist heat load - deflection graph of hone wires in the control group and after sterilization with dry and moist heat load - deflection graph of tmal wires in the control group and after sterilization with dry and moist heat repeated measures anova showed that during loading , hone wire had the least force level ( p < 0.05 ) and res wire had the highest force level .", "the force levels of different hone wire groups during loading and unloading had the following relationships , respectively : iiii < ii and iii < iii .", "the force levels of res and cna wires were significantly higher than that of tmal wire ( p < 0.05 ) . during unloading , tmal and hone wires exhibited the lowest force levels ( p < 0.05 ) ; although the force of tmal wire was a little less than that of hone wire", "there were no significant differences in force levels between the dry heat ( ii ) and control ( i ) groups ( p > 0.05 ) .", "there were no significant differences in force levels during loading and unloading between groups i , ii and iii ( p > 0.05 ) ( iiiiii ) .", "there were no significant differences in force levels between the control ( i ) and steam sterilization ( iii ) groups ( p > 0.05 ) . during unloading , the steam sterilization group ( iii ) had the highest force levels ( p < 0.05 ) ." ], [ "the force levels of res and cna wires were significantly higher than that of tmal wire ( p < 0.05 ) . during unloading , tmal and hone wires exhibited the lowest force levels ( p < 0.05 ) ; although the force of tmal wire was a little less than that of hone wire", "repeated measures anova showed that during loading , hone wire had the least force level ( p < 0.05 ) and res wire had the highest force level .", "res wire exhibited the highest force level , which was significantly higher than those of beta , tmal and hone wires ( p < 0.05 ) .", "although res wires exhibited force levels slightly higher than those of cna wires , there were no significant differences between the two wires ( p > 0.05 ) .", "however , there were no statistically significant differences in force levels between res , cna and beta wires ( p > 0.05 ) .", "there were no significant differences in force levels between beta and cna wires ( p > 0.05 ) ." ], [ "there were no significant differences in force levels during loading and unloading between groups i , ii and iii ( p > 0.05 ) ( iiiiii ) . according to hysteresis evaluation ( energy loss upon unloading ) of wires before and after sterilization showed that only sterilization with dry heat resulted in an increase in hysteresis of tmal and hone wires ; however , autoclave sterilization did not have any effect on hysteresis of the wires under study .", "repeated measures anova revealed the following [ figures 26 ] : dry heat sterilization group ( ii ) exhibited the highest force levels during loading and unloading ( p < 0.05 ) .", "the force levels in the group sterilized by steam ( iii ) were significantly higher than those in the control group ( i ) during both loading and unloading ( p < 0.05 ) .", "the dry heat sterilization group ( ii ) exhibited the highest force levels during loading and unloading ( p < 0.05 ) .", "there were no significant differences in force levels between the control ( i ) and steam sterilization groups during loading and unloading ( p > 0.05 ) .", "there were no significant differences in force levels between the control ( i ) and steam sterilization ( iii ) groups ( p > 0.05 ) . during unloading ," ], [ "the force levels in the group sterilized by steam ( iii ) were significantly higher than those in the control group ( i ) during both loading and unloading ( p < 0.05 ) .", "dry heat sterilization group ( ii ) exhibited the highest force levels during loading and unloading ( p < 0.05 ) .", "the force levels of various groups of beta wires during loading and unloading were as follows : i < iii < ii ." ], [ "there were no significant differences in force levels between the control ( i ) and steam sterilization groups during loading and unloading ( p > 0.05 ) .", "the dry heat sterilization group ( ii ) exhibited the highest force levels during loading and unloading ( p < 0.05 ) .", "there were more differences between groups i ( control ) and ii in the higher deflection ranges [ figures 3 and 4 ] .", "the force levels of various res and cna groups during loading and unloading were as follows : iiii < ii ." ], [ "during loading , the dry heat sterilization group ( ii ) exhibited the highest force level ( p < 0.05 ) .", "there were no significant differences in force levels between the control ( i ) and steam sterilization ( iii ) groups ( p > 0.05 ) . during unloading ,", "the force levels of different hone wire groups during loading and unloading had the following relationships , respectively : iiii < ii and iii < iii .", "there were no significant differences in force levels between the dry heat ( ii ) and control ( i ) groups ( p > 0.05 ) .", "the steam sterilization group ( iii ) had the highest force levels ( p < 0.05 ) ." ], [ "there were no significant differences in force levels during loading and unloading between groups i , ii and iii ( p > 0.05 ) ( iiiiii ) . according to hysteresis evaluation ( energy loss upon unloading ) of wires before and after sterilization showed that only sterilization with dry heat resulted in an increase in hysteresis of tmal and hone wires ; however , autoclave sterilization did not have any effect on hysteresis of the wires under study ." ], [ "a modified version of the three - point bending test was used in the present study to evaluate load - deflection properties of orthodontic wires .", "the results of the present study did not show any effect of steam sterilization ( autoclave ) [ figures 26 ] on load - deflection characteristics of the majority of -ti wires tested ; however , it increased force levels during loading and unloading of beta and unloading of hone wires , which is reflected by an increased slope of loading and unloading of beta and unloading of hone wires [ figures 2 and 5 ]", "high autoclave or dry heat sterilizer temperatures , too , might influence the mechanical properties of wires .", "the results of the present study showed that dry heat sterilization significantly increases force levels during loading and unloading of cna , beta and res and loading of hone wires , making them stiffer .", "multi - stage processing of orthodontic wires by manufacturers has a significant influence on their mechanical properties .", "the load - deflection properties are significant parameters in determining the biologic nature of tooth movement .", "as indicated by the increased slope of the graphs [ figures 25 ] dry heat sterilization influences the clinical performance of cna , res , beta and hone wires ." ], [ "\n the results of the present study showed differences in force levels during loading and unloading between the five brands of -ti wires under study after 1.5 mm of deflection ; res , cna and beta wires exhibited different force deflection behaviors in comparison with the two products of ormco company ( tmal and hone).there are different changes in load - deflection characteristics of various -ti wires after sterilization with dry heat and heated steam.the clinicians who want to provide maximum safety for their patients can sterilize res , tmal and cna wires in an autoclave without any worries before placing them in the oral cavity . \n ", "the results of the present study showed differences in force levels during loading and unloading between the five brands of -ti wires under study after 1.5 mm of deflection ; res , cna and beta wires exhibited different force deflection behaviors in comparison with the two products of ormco company ( tmal and hone ) .", "the clinicians who want to provide maximum safety for their patients can sterilize res , tmal and cna wires in an autoclave without any worries before placing them in the oral cavity .", "there are different changes in load - deflection characteristics of various -ti wires after sterilization with dry heat and heated steam .", "however , further in vivo studies are required to substantiate the results of the present study ." ] ]

[ [ "we present a case in which sd - oct was used to diagnose an asymptomatic pituitary macroadenoma .", "most pituitary adenomas are clinically inactive . in patients with long - standing compression of the optic chiasm , ganglion cells may undergo axonal degeneration .", "spectral domain optical coherence tomography ( sd - oct ) is able to identify retinal nerve fiber layer ( rnfl ) and ganglion cell loss in the retina ." ], [ "sd - oct identified atrophy of the ganglion cell and nerve layers , with preservation of outer layers bilaterally ." ], [ "the sd - oct demonstrated a symmetrical loss of the rnfl and the ganglion cell layer in both eyes , indicating important optic nerve damage .", "as macroadenomas enlarge , they can induce uncrossed axon loss , resulting in nasal field defects and reduced visual acuity . in these cases , there is atrophy of the nasal and temporal portions of the optic disc , thus occupying a horizontal band across the disc .", "sd - oct is able to identify rnfl loss in eyes with band atrophy of the optic nerve , which correlates with visual field defects found in perimetry .", "sd - oct is a useful tool to assess the structural and functional damage of ganglion cells . in our case" ], [ "optical coherence tomography ( oct ) is able to identify retinal nerve fiber layer ( rnfl ) and ganglion cell loss in retina.6,7 we present a case in which the oct ( 3d oct-2000 spectral domain oct , topcon corporation , tokyo , japan ) was used to diagnose an asymptomatic pituitary macroadenoma .", "pituitary adenoma is the most common cause of the chiasmal syndrome.1 the tumor is classified based on size as microadenoma , smaller than 10 mm , or as macroadenoma when it exceeds 10 mm in diameter.2 some tumors secrete one or more hormones in excess , so - called secretory pituitary adenomas , but most are clinically inactive.3 classically , the nonsecretory tumors present with vision loss,4 whereas patients with secretory tumors are usually referred to ophthalmologists for evaluation due to hormonal imbalances that affect bodily functions.5 in patients with long - standing compression of the optic chiasm , ganglion cells may undergo axonal degeneration4 .", "the authors adhere to the international standards developed in the 2 conference on research integrity in singapore ( 2010 ) , while performing this study .", "the patient agreed to have their case published , and all information presented is non - identifiable.8" ], [ "a 48-year - old , caucasian female presented with progressive vision loss in both eyes for several months .", "spectral domain optical coherence tomography ( sd - oct ) demonstrated diffuse atrophy of the ganglion cell and nerve layers , with preservation of outer layers bilaterally ( figure 1 and figure 2 ) .", "magnetic resonance imaging of the brain was performed and a pituitary macroadenoma with suprasellar extension was observed ( figure 3 ) ." ], [ "a number of studies have demonstrated that oct is able to identify rnfl loss in eyes with band atrophy of the optic nerve.6,7 the degree of rnfl thickness reduction has been shown to correlate with that of visual field defects using goldmann perimetry4 and automated static perimetry.14,15 this fact gives oct prognostic value regarding the visual outcome , as demonstrated in different studies.16,17 oct is a useful tool to assess the structural and functional damage of ganglion cells , objectively and quantitatively.4 in our case the sd - oct demonstrates a symmetrical loss of the rnfl and the ganglion cell layer in both eyes , indicating important optic nerve damage .", "pituitary adenomas are common benign tumors of the pituitary gland that account for 12% of all intracranial tumors.9 people can develop pituitary adenomas at any age .", "some adenomas secrete hormones in excess . of the secretory tumors , the most common are prolactinomas.5 they may be relatively small when detected ." ], [ "sd - oct can help in the diagnosis of adenomas in equivocal situations in which there is only subtle optic nerve pallor in the setting of nonspecific visual complaints or visual field defects , or when patients are referred to screen for subclinical compressive optic neuropathies ." ] ]

[ [ "complications of this procedure are well reported ; however , to our knowledge no mention has occurred in the literature of a retained nephrostomy tube after pcnl .", "percutaneous nephrolithotomy ( pcnl ) is a widely accepted treatment for urinary calculi > 2 cm or resistant to other modalities .", "thus , we will present the management of a retained council tip catheter after pcnl ." ], [ "a 76-year - old gentleman underwent a pcnl for a 2.2x1.4-cm lower pole calculus via an uneventful upper pole puncture .", "after transection of the balloon port valve , attempted passage of a 0.038 movable core bentson guidewire down the balloon port was unsuccessful .", "the balloon was successfully punctured by the chiba needle with clear efflux through the needle .", "contrast was then instilled through the chiba needle to evaluate the integrity of the balloon and exclude the possibility of retained balloon fragments from a ruptured balloon ( figure 2b ) .", "an antegrade nephrostogram outlined the catheter balloon within the renal pelvis ( figure 1 ) . with the c - arm in a vertical orientation ,", "flexible nephroscopy was performed to evaluate for balloon fragments , which were not identified , and to remove the lower pole stone ." ], [ "a retained urethral catheter due to balloon malfunction is a well - recognized urologic complication .", "our familiarity with the use of the chiba needle and 3-dimensional fluoroscopy for percutaneous renal access facilitated percutaneous puncture of the catheter balloon .", "many solutions to this problem have been attempted , including overinflation until rupture , puncture of the balloon via a wire through the balloon port , and puncture of the balloon under ultrasound guidance via a suprapubic or transvaginal route . given this infrequent but known complication of balloon - type cystostomy catheters , it is not surprising that a similar complication occurred in our patient .", "prevention of a retained catheter due to a balloon - port malfunction requires use of sterile water instead of saline and limiting the time of catheter placement ." ] ]

[ [ "radical prostatectomy ( rp ) is a common curative surgical treatment option in localized prostate cancer ( pca ) .", ", we investigated the histopathologic evaluation outcomes of anterior periprostatic fat ( appf ) tissues that were separately sent for pathologic evaluation in order to examine presence of lns and metastasis .", "pelvic lymph node ( ln ) dissection is performed in order to determine the disease stage , prognosis , and the necessary future treatment options [ 1 , 2 ] .", "the fatty tissue overlying the prostate is removed in order to have a better exposure of the dorsal venous complex , the puboprostatic ligaments , and the prostate apex . however ,", "this might ultimately have an impact on the postoperative disease stage , treatment , and oncologic outcomes . in our study", "if this fatty tissue is not examined separately by a pathologist , the presence of lns and possible metastasis might be missed and underreported ." ], [ "all of the rarp procedures were performed via a transperitoneal approach and patients who had history of transurethral surgery or radiotherapy were excluded from the study . during the rarp procedures ,", "overall , 129 patients who underwent rarp between january 2012 and october 2014 were included in our study .", "if metastatic ln(s ) was /were detected , immunohistochemistry for prostate specific antigen ( psa ) and prostate specific acid phosphatase were performed .", "parameters including serum psa , prostate weight , body mass index ( bmi ) , positive surgical margins ( psm ) and gleason score ( gs ) were included for further evaluation .", "appf covering prostate , endopelvic fascia , dorsal venous complex , prostatic apex , puboprostatic ligaments , prostate - vesical junction and the bladder neck was dissected en bloc laterally and cephalad .", "patients were classified according to bmi ( kg / m ) as follows : < 18.5 underweight , 18.524.9 optimal weight , 2529.9 overweight and > 30 obese ." ], [ "prostate , endopelvic fascia , puboprostatic ligaments , junction between prostate and bladder neck are seen clearly following excision of the fat tissue .", "prostate , endopelvic fascia , puboprostatic ligaments , junction between prostate and bladder neck are covered with fat tissue .", "puboprostatic ligaments , prostatic apex , surface of the prostate and junction between prostate and bladder neck are all cleared ( figures 1 and 2 ) .", "we then pushed it back up to the junction between the prostate and bladder neck and excised the tissue by applying monopolar and bipolar cautery . following excision of the appf tissue , the area of endopelvic fascia ,", "no additional complication or morbidity due to excision of the appf was found in any of the patients . \n " ], [ "prognostic significance of ln metastases in prostate cancer and assessment of rates of lns and ln metastases in periprostatic fat pads in radical prostatectomy were reported before . in our experience , we performed extended plnd in intermediate or high - risk pca patients and in those with at least 5% risk of pelvic ln involvement by pca , according to partin 's tables .", "identified lns in periprostatic region in 19 ( 5.5% ) patients of 356 in their rrp series and 4 ( 1.2% ) of them had metastasis , one of 4 patients had also pelvic ln metastasis . in this study they reported that there is no connection between periprostatic ln meta - stasis and pelvic ln metastasis , but in order to provide exact staging , pathologic examination of periprostatic lymphatic area should be a routine procedure .", "in addition , because we think that complete removal of appf tissue leads to better exposure of the surgical field to the operating console surgeon , we excise it even in patients with low - risk pca . in our study , no association was detected between bmi and presence of lns or ln count in the appf tissue .", "outcomes of published literature on periprostatic fat tissue and presence of lymph nodes the european association of urology ( eau ) and national comprehensive cancer network ( nccn ) recommended extended pelvic lymph node dissection ( plnd ) in patients at 10% or greater and 7% or greater calculated risk , respectively , for ln metastases . likewise , the american urological association ( aua ) recommended plnd in patients at higher risk for nodal involvement .", "due to the published literature , ln metastasis rate in anterior periprostatic lymphoid tissue varied between 1.22.5% [ 58 ] . in our study , no metastatic ln was detected , which might be related to the limited number of patients in our series compared to the other published articles with a larger number of patients .", "we summarized the outcomes of published literature on appf tissue and presence of lns in table 2 . \n " ], [ "identification of metastatic lns in the appf might have an impact on postoperative staging and management of the patients .", "in addition , removal of appf leads to a better exposure of the surgical field .", "lymph nodes might be present in the appf tissue which should be removed and sent for histopathologic evaluation following rarp ." ], [] ]

[ [ "this study reviews previous parasite prevalence reports from american marten in north america , presents data from the parasitological examination of live - trapped american marten in michigan , and identifies a possible association between hookworm infection and anaemia in affected american marten .", "the aim of this parasite survey was to describe the presence and prevalence of parasites in the huron - manistee national forest of the nlp and to determine whether there are differences in presence or prevalence of parasites between the nlp and up .", "the american marten ( martes americana ) is an arboreal mesocarnivore that ranges from the boreal forests of northern north america into coniferous and mixed coniferous / deciduous forests of the northern and northeastern united states , including the great lakes region ( clark et al . , 1987 ) .", "a collaborative research effort has begun in order to investigate factors that may be contributing to the difference in sustainability between the up and nlp populations ." ], [ "parasite species richness by host was calculated as the number of parasite species present per host ; species richness by sample was calculated as the number of parasite species present per sample .", "an unidentified capillarid species was not included in the prevalence or host species richness if one or more species of capillaria was identified in other samples from the same host .", "if both samples had unidentified capillaria , then the host was included in the calculation of prevalence of unidentified capillaria .", "american marten ( n = 49 ) were sampled from the manistee national forest in the nlp ( n = 31 ) , hiawatha national forest in the up ( n = 13 ) and ottawa national forest in the up ( n = 5 ) .", "thus , an individual american marten found with unidentified capillarid at the initial exam and aonchotheca sp . at a subsequent exam" ], [ "american marten infected with hookworms were significantly more likely to be anaemic than non - infected american marten ( p = 0.01 ) with an odds ratio of 8.75 ( 95% confidence interval : 1.456.4 ) .", "once the use of zinc sulfate solution was implemented , no trematode other than alaria species was identified , and the authors concluded that trematode eggs identified in the early samples were most likely alaria species , as suspected . in the up , 3 samples that were positive on sedimentation for trematode ova were suspected to be alaria species and 7 were confirmed via zinc sulfate flotation ; in the nlp , 14 samples positive on sedimentation were suspected to be alaria species and 5 were confirmed via zinc sulfate flotation .", "there was no significant difference in prevalence of any of the identified parasites between male and female american marten .", "capillaria eggs were seen in 79% and 78.1% of samples from the up and nlp , respectively .", "capillaria eggs were further identified as eucoleus aerophila , eucoleus boehmi , or aonchotheca putorii based on size and morphologic characteristics . a hookworm egg is shown in fig . 1 ." ], [ "overall , parasite prevalences were similar between the up and nlp in our samples and we conclude that the up may be suitable source for a translocation of marten to the nlp from the point of view of parasite translocation .", "parasites identified as a concern for reintroduction of north american river otter included alaria canis , strongyloides lutrae , crenosoma goblei , capillaria and coccidia due to potential for pathogenic effects or high prevalence ( kimber and kollias , 2000 ) .", "the red fox is the typical host for crenosoma vulpis and is sympatric with american marten in both the up and nlp . given the global distribution of c. vulpis , it is likely that this parasite exists in the nlp red fox population although the parasite was not identified in american marten from the nlp in this study .", ". other species of trematodes have caused disease in north american river otters , but the pathogenicity of alaria in american marten is not known ( kimber and kollias , 2000 ) .", "( 2005 ) reported a case of meningoencephalitis in a fisher caused by sarcocystis neurona in maryland , usa . the virginia opossum ( didelphis virginiana ) is the definitive host for the parasite in north america , but the natural intermediate host for s. neurona has not been discovered ( gerhold et al . , 2005 ) .", "cryptosporidium and giardia species cysts were detected in the faeces of american marten from the up of michigan , both having a prevalence of 4% ( n = 5 ) ( veine - smith et al . , 2011 ) ." ], [ "north american marten are infected with a wide variety of endoparasites , but information regarding the pathologic effects of parasitism remains limited .", "multiple faecal exams from individuals destined for relocation , including sedimentation and molecular techniques when available , are warranted to identify novel parasites and parasites with pathologic or zoonotic potential and to make appropriate treatment or management decisions .", "are frequently trapped as a furbearer species , this information could guide prevention of disease transmission to trappers and researchers working with the species .", "the majority of previous studies examined american marten carcasses for parasitism , which allows characterization and speciation of the adult parasite and information about intensity of infection .", "however , a non - invasive method of detecting endoparasitism is desired for reintroduction programs and our results provide baseline information about parasites detected by faecal examination from american marten in michigan .", "american marten infected with hookworms in the current study were found to be at risk for anaemia , and this association warrants further investigation ." ] ]

[ [ "there are currently insufficient studies examining the effects of osteoarthritis on the frp \n of the erector spinae and on how the frp of the erector spinae observed in young adults is \n different from that of the elderly in whom osteoarthritis has occurred . therefore , the \n present study compared the frps of the erector spinae occurring during ( 1 ) trunk flexion , \n ( 2 ) complete trunk flexion , and ( 3 ) trunk extension motions in both healthy , young females \n and elderly females with chronic knee osteoarthritis . in addition , data regarding whether \n the frp of the erector spinae can be used as a method of evaluating the degree of pain in \n chronic osteoarthritis in the elderly will be presented .", "if the erector spinae \n flexion - relaxation rates can be used as a pain scale , it may assist healthcare professionals \n to improve elderly patients quality of life .", "normal frp of the erector spinae is an important precondition for smoothly \n performing the functional activities of daily living and is an important measurement \n variable in the evaluation of treatment effects at clinics8 .", "the erector spinae muscle is a posture - maintaining muscle that is \n used in all daily living activities in which trunk forward - tilting and straightening motions \n are performed .", "chronic osteoarthritis , therefore , often leads to stooped postures \n as a result of the tension experienced when assuming postures in which the erector spine is \n elongated3 , 4 .", "osteoarthritis mainly \n occurs in the hip joints and knee joints , which are weight - bearing joints , and most elderly \n persons aged 65 years or older have this disease1 , \n 2 ." ], [ "this study was a randomized controlled trial , which included healthy adult females \n attending a university and elderly females aged at least 65 years diagnosed with chronic \n osteoarthritis in the leg , among the elderly community residing in a metropolitan area of \n chungcheongnam - do in south korea .", "the general characteristics of the subjects that \n participated in the present study are shown in table \n 1table 1.general characteristics of study subjects ( n=30)elderly females with chronicosteoarthritis \n ( n=17)healthy adult females ( n=13)age ( years ) , m sd 75.8 12.0 * 21.1 0.8height ( cm ) , m sd153.5 6.3159.6 3.7weight(kg ) , m sd56.5 8.752.9 5.4*p<0.05 . in the present study , surface electromyography ( emg ) ( trigno wireless system , delsys inc . , \n boston , ma , usa ) was used to measure the muscle activity of the healthy adult females and \n elderly females with chronic knee osteoarthritis while they were performing trunk flexion , \n complete trunk flexion , and trunk extension .", "the independent variable was \n the presence or absence of chronic knee osteoarthritis , and the dependent variable was the \n frp of the erector spinae .", "independent t - tests were used to examine the erector spine \n flexion - relaxation rates according to whether the presence or absence of chronic knee \n osteoarthritis . to test the statistical significance ,", "the mean values of the three \n trunk flexion extension motions were used to determine the flexion - relaxation rates ." ], [ "the effect of chronic knee osteoarthritis on the frp of the erector spinae was first \n examined .", "the values obtained by dividing the data for trunk extension by that of complete \n trunk flexion were not different for the left and right lumbar erector spinae or right \n thoracic erector spinae ; however , they were significantly different for the left thoracic \n erector spinae ( p<0.05 ) ( table 2table 2.flexion-relaxation phenomenon ( frp ) values obtained by dividing the data for \n trunk extension by those for complete trunk flexion from healthy adults and elderly \n individuals ( units : % ) musclesmean sdelderly females withchronic osteoarthritishealthy adultfemalesleft thoracic erector spine1.67 0.61 * 1.22 0.45right thoracic erector spine1.87 0.822.31 1.35left", "the values obtained by dividing the data for trunk flexion by that of \n complete trunk flexion , were not different for the left and right lumbar erector spinae and \n right thoracic erector spinae , but were significantly different for the left thoracic \n erector spinae ( p<0.05 ) ( table 3table 3.flexion-relaxation phenomenon ( frp ) values obtained by dividing the data for \n trunk flexion by those for complete trunk flexion from healthy adults and elderly \n individuals ( units : % ) musclesmean sdelderly females with chronic osteoarthritishealthy adult femalesleft thoracic erector spine1.47 0.55 * 1.12 0.31right thoracic erector spine1.41 0.491.99 1.43left lumbar erector spine2.00 1.082.58 2.75right lumbar erector spine1.76 0.901.62 1.31*p<0.05 ) ." ], [ "in the present study , the frp of the erector spinae in elderly females with chronic knee \n osteoarthritis and healthy young females were measured to determine whether the erector \n spinae flexion - relaxation rates could act as a useful pain evaluation tool for patients with \n knee osteoarthritis . although no significant differences were evident in the \n flexion - relaxation rates of the left and right thoracic erector spinae or right lumbar \n erector spinae , significant differences were shown in the flexion - relaxation rates of the \n left thoracic erector spinae .", "therefore , the present study intended to examine the differences in the frp of the erector \n spinae between elderly persons with degenerative knee osteoarthritis and healthy adults . \n although not clinically significance , the results showed significant differences only in the \n left thoracic erector spinae , but not in the left and right lumbar erector spinae or right \n thoracic erector spinae .", ", \n knee osteoarthritis was believed to affect the frp of the lumbar erector spinae .", "first , the study sample was small and was limited to females \n with chronic knee osteoarthritis" ] ]

[ [ "though some data suggests metformin is safe in the setting of chronic kidney disease , the use of metformin in kidney transplant patients is still quite controversial due to the concern about lactic acidosis and lack of data regarding metformin use in this patient population [ 911 ] .", "however , evidence supporting the efficacy and safety of long - term use of sitagliptin in kidney transplant recipients is lacking .", "therefore , it is important to identify an alternative first - line oral agent for the treatment of nodat in kidney transplant recipients .", "\n new - onset diabetes after transplantation ( nodat ) represents a common comorbidity after solid organ transplantation .", "we hypothesized that in kidney transplant recipients sitagliptin would improve nodat control , as assessed by hemoglobin a1c", "additionally , in a 3-month trial of kidney transplant recipients , sitagliptin use did not alter immunosuppressant levels .", "metformin is the first - line agent of choice for the treatment of type 2 diabetes in the general population ." ], [ "in this single center study , we performed a retrospective analysis of kidney transplant recipients in the multidisciplinary transplant clinic at the university of nebraska medical center ( unmc ) between october 2006 ( release date of sitagliptin in the united states ) and december 2012 .", "all subjects in this study received their kidney transplant at unmc . between 2009 and 2013 , 125 to 149 kidney transplants were performed per year at unmc ( http://optn.transplant.hrsa.gov/ ) .", "the first was a 12-month followup to assess the subacute efficacy and safety of sitagliptin in terms of diabetes control , side effects , immunosuppressant levels , and graft function .", "the patient medical records were reviewed in detail for a number of different diabetes and transplant - specific outcomes including dates of sitagliptin initiation / discontinuation ; dates of initiation / discontinuation of any other diabetes medications ; patient or physician - reported side effects ; reason for discontinuation of sitagliptin ; acute rejection episodes ; graft loss ; immunosuppressant regimens and dosages ; opportunistic infections ; and death .", "this longer followup allowed for assessment of long - term efficacy and safety in terms of diabetes control , acute rejection episodes , allograft function , and other side effects .", "mmol / l after no caloric intake for at least 8 hours or random plasma glucose 200 mg / dl or 11.1 mmol / l with symptoms of diabetes or 2 h plasma glucose in a 75 g oral glucose tolerance test ( ogtt ) 200 mg / dl or 11.1 mmol / l ) and diabetes care received at the unmc diabetes center to allow for accurate record of diabetes medication changes and reporting of side effects . additionally , to specifically understand the efficacy and safety of sitagliptin for the treatment of nodat , patients included in the study either used sitagliptin as the initial agent for nodat or had other diabetes medications stopped prior to or at the time of sitagliptin initiation ." ], [ "glucagon - like peptide-1 ( glp-1 ) therapies have been implicated to potentially increase the risk of pancreatitis , a matter of significant controversy . in the current study , no episodes of pancreatitis were reported during the follow - up period . additionally , other transplant - specific adverse events were rare in our cohort , including one episode of acute rejection ( 47 months after sitagliptin initiation ) ; two episodes of opportunistic infections ( 13 and 14 months after sitagliptin initiation ) ; no graft loss ; and one death ( due to end - stage liver disease ) .", "a total of 65 patients were identified to have received sitagliptin after kidney transplant during the study dates . of these , 37 patients met criteria for nodat ( figure 1 ) . of these 37 patients ,", "hemoglobin a1c was significantly lower at baseline in patients who were able to continue on sitagliptin alone for the duration of the study ( n = 9 ) compared to patients who discontinued sitagliptin and were switched to more aggressive diabetes management ( n = 5 ) ( figure 4(d ) ) .", "similarly , the patient with noncompliance required frequent sirolimus dose adjustments during the follow - up period while 3 patients had single , protocol - related sirolimus dose adjustments . to assess the long - term efficacy and risk for adverse effects of sitagliptin in kidney transplant recipients" ], [ "our study represents the largest cohort investigating the safety and efficacy of sitagliptin for the treatment of nodat in kidney transplant recipients .", "kidney transplant recipients with viable grafts remain at higher risk of diabetes development , a significant portion of the risk being ascribed to immunosuppressant therapy .", "safe , effective therapies are needed for patients who develop nodat regardless of the timing of the diagnosis , and sitagliptin may be useful for this purpose given the favorable side effect profile and lack of interaction with immunosuppressant medications .", "the use of dpp-4 inhibitors for the treatment of hyperglycemia and nodat in kidney transplant recipients is gaining more interest ." ], [ "sitagliptin was also well tolerated and renal function and immunosuppressant levels and dosing were stable during 12 months of therapy .", "in conclusion , we have shown that , in a small cohort of kidney transplant recipients who developed nodat , sitagliptin was efficacious as a single agent or in combination with other glucose - lowering medications .", "sitagliptin may be valuable as a first - line agent in kidney transplant recipients diagnosed with nodat who are candidates for oral therapy ." ] ]

[ [ "although cm remains the most common cause of adult meningitis in the overall population in sub - saharan africa , there are only a few recognized , reported cases of gastrointestinal ( gi ) involvement with cryptococcus in the literature .", "substantial improvement in survival of people living with hiv has been observed with the introduction of antiretroviral therapy ( art ) in sub - saharan africa .", "iris is a frequent complication that is most often associated with exaggerated inflammatory responses in the central nervous system .", "an hiv - infected patient on art with a history of recent cm presented with chronic abdominal pain , thickened ileum , and abdominal lymphadenopathy .", "he was initially treated for abdominal tuberculosis ( tb ) but later , he was shown to have a histologically confirmed cryptococcoma in the ileum . the major objective of this case report is to highlight the challenges in diagnosis and management of intra - abdominal cryptococcosis , especially in the setting of recent initiation of art ." ], [ "the patient 's marked clinical improvement after surgery , the lack of any evidence of cryptococcal infection elsewhere in the body especially in the central nervous system and a well formed granuloma formed the basis for the patient 's continuation with maintenance dose of fluconazole 200 mg / day under observation .", "a decision was made to initiate empiric anti - tb treatment for possible gastrointestinal tb .", "a 37 year old hiv - positive male was initially diagnosed and treated for cm in may of 2009 with amphotericin induction therapy for 2 weeks followed by fluconazole 400 mg / day ." ], [ "we have presented a 37 year old hiv positive male , with a history of recent cm who subsequently developed chronic abdominal pain , eventually manifesting as a cryptococcoma of the ileum .", "we have discussed an hiv - infected patient with profound immunosuppression and recent cm who developed a gi cryptococcoma during initial immune recovery followed by virological failure after initiation of art .", "we recommend that health workers have a high index of suspicion for unusual complications of opportunistic infections in the setting of art - associated iris .", "although , the initial immune recovery coupled with falling hiv-1 viral loads is consistent with iris , the subsequent virological failure makes the diagnosis of paradoxical iris less clear . in cryptococcosis ,", "the cryptococcoma was not identified and he developed perforation of the ileum , requiring surgery . we anticipate that with the roll out of art in sub - sahara africa , we are bound to see rare presentations of some of common conditions such as cm ." ], [ "the authors declared no potential conflicts of interest with respect to the research , authorship , and/or publication of this article ." ] ]

[ [ "the present study was conducted to know the prevalence , etiology and common clinical presentations of dermatophytosis involving skin and hair .", "dermatophytic infections are of major importance , as they are widespread and cause discomfort . reactions to dermatophyte infection may range from mild to severe .", "these dermatophytes are closely related filamentous fungi and cause the disease by virtue of their unique ability to degrade keratin and invade the skin and its appendages .", "dermatophytosis is a common clinical entity characterized by the infection of keratinized tissues such as skin , hair , and nails .", "the mildness and severity depend on a variety of factors such as the host reactions to the metabolic products of the fungus , the virulence of infecting species or particular strain , anatomical location of the infection and local environmental factors .", "overcrowding , poor hygiene , low standards of living along with high humidity environments are contributing to the increased prevalence of these fungal infections ." ], [ "scales were collected from erythematous growing margins of the lesion with a sterile blunt scalpel , and in case of tinea capitis , hairs were plucked with sterile surgical forceps .", "a total of 110 samples which included 101 skin samples and 9 hair samples , from clinically suspected to have dermatophytosis were collected .", "fungal growth was identified by colony morphology ; pigment production and microscopic examination by tease mount technique in lactophenol cotton blue .", "urease test and in - vitro hair perforation tests were also performed to differentiate trichophyton rubrum and trichophyton mentagrophytes when there was difficulty in identification by microscopic and macroscopic examination .", "a detailed history regarding age , sex , occupation , social status , duration of complaint and others were taken .", "samples were collected after cleaning the affected surface with 70% alcohol . from skin lesions ,", "direct examination of fungal elements from skin scales and hair samples was done by using 10% and 20% koh mounts respectively .", "samples were collected in sterilized whatman filter paper envelope and transported to the microbiological laboratory .", "all the samples were cultured on sabouraud 's dextrose agar ( sda ) with gentamicin and cycloheximide ( sda with actidione ) and dermatophyte test medium ( dtm ) ( hi - media ) ." ], [ "scales were collected from erythematous growing margins of the lesion with a sterile blunt scalpel , and in case of tinea capitis , hairs were plucked with sterile surgical forceps .", "samples were collected after cleaning the affected surface with 70% alcohol . from skin lesions ,", "samples were collected in sterilized whatman filter paper envelope and transported to the microbiological laboratory ." ], [ "fungal growth was identified by colony morphology ; pigment production and microscopic examination by tease mount technique in lactophenol cotton blue .", "all the samples were cultured on sabouraud 's dextrose agar ( sda ) with gentamicin and cycloheximide ( sda with actidione ) and dermatophyte test medium ( dtm ) ( hi - media ) .", "urease test and in - vitro hair perforation tests were also performed to differentiate trichophyton rubrum and trichophyton mentagrophytes when there was difficulty in identification by microscopic and macroscopic examination .", "direct examination of fungal elements from skin scales and hair samples was done by using 10% and 20% koh mounts respectively ." ], [ "fungal growth was identified by colony morphology ; pigment production and microscopic examination by tease mount technique in lactophenol cotton blue .", "urease test and in - vitro hair perforation tests were also performed to differentiate trichophyton rubrum and trichophyton mentagrophytes when there was difficulty in identification by microscopic and macroscopic examination .", "all the samples were cultured on sabouraud 's dextrose agar ( sda ) with gentamicin and cycloheximide ( sda with actidione ) and dermatophyte test medium ( dtm ) ( hi - media ) ." ], [ "use of occlusive or synthetic fabric dressing regularly was there in 40.32% of patients and 32.25% of patients were in contact with soil regularly because of their occupation .", "dermatophyte species causing different clinical presentations all culture positives were grown both on sda with actidione and dtm on primary isolation .", "but , the appearance of growth was only after 10 days for most of the isolates when grown on sda with actidione 57 ( 91.94% ) . species level identification on primary isolation was possible for 42 ( 67.74% ) of culture positives when grown on sda with actidione .", "on dtm first appearance of growth was within 10 days of inoculation for most of the isolates that is , 56 ( 90.32% ) [ figure 7 ] .", "but , no culture positive was identified up to species level from dtm on primary isolation ." ], [ "but , the appearance of growth was only after 10 days for most of the isolates when grown on sda with actidione 57 ( 91.94% ) . species level identification on primary isolation was possible for 42 ( 67.74% ) of culture positives when grown on sda with actidione .", "( f ) trichophyton violaceum \n among culture positive cases 19.35% were from rural area , and 80.65% were from urban area and 67.74% were from low socio - economic status , 30.65% were from middle socioeconomic status and 1.61% were from high socioeconomic status . in this study ,", "on dtm first appearance of growth was within 10 days of inoculation for most of the isolates that is , 56 ( 90.32% ) [ figure 7 ] .", "8.06% of patients were diabetics , 6.45% were anemic , 3.23% of patients had a history of atopy and 1.61% were hiv positive .", "use of occlusive or synthetic fabric dressing regularly was there in 40.32% of patients and 32.25% of patients were in contact with soil regularly because of their occupation .", "but , no culture positive was identified up to species level from dtm on primary isolation .", "all culture positives were grown both on sda with actidione and dtm on primary isolation ." ], [ "in this study , highest incidence of dermatophytosis was observed in the age group of 2140 years and in males .", "efficacy of sda with actidione and dtm in isolation of dermatophytes is equal in the present study .", "t. rubrum was the most common dermatophyte to cause all clinical types of dermatophytoses followed by t. mentagrophytes .", "species level identification was possible for 67.74% of isolates on primary isolation on sda with actidione ." ], [ "dtm is a good screening medium in laboratory diagnosis of dermatophytosis compared to sda with actidione ." ], [], [] ]

[ [ "the esr results clearly identify the c3 formation \n in one - electron oxidized gemcitabine and the production of c2 \n in one - electron oxidized mefdc .", "these calculations show \n that in the case of one - electron oxidized mefdc , the lowest energy \n path is the rapid formation of c2 from c3 \n via f loss .", "this f loss is a \n barrierless reaction between the 2-f - atom and the proximate \n h3o which was formed via deprotonation of h3 \n in the cation radical .", ", it is expected that the negative \n inductive effect ( i ) of two highly electronegative f - atoms \n at c2 should increase the acidity of h3. from our \n previous work on nucleoside cation radicals , the gemcitabine cation radical formed upon one - electron oxidation \n is expected to produce c3 after deprotonation of the \n acidic proton h3. in this work , esr spectroscopy has been \n employed to investigate one - electron oxidation of gemcitabine and \n other 2-modified derivatives , for example , 2-deoxy-2-fluoro-2-c - methylcytidine ( mefdc ( psi-6130 ) ; scheme 2 ) and 2-fluoro-2-deoxycytidine ( 2-fdc , scheme 2 ) , in order to test the influence of 2- \n substituent on radical site formation ." ], [ "the electronic energy profile \n of f dissociation from c2 site of c3 \n in mefdc as well as the electronic energy profile of f dissociation for each of the two f - atoms from c2 site of \n c3 in gemcitabine were obtained in the presence of \n a single water molecule at the same level of theory ( supporting information figure s4c , d ) .", "the hyperfine coupling constants ( hfccs ) of the radicals were calculated \n using the same method and basis set , i.e. , b97x/6 - 31g(d ) in \n the gas phase . in order to treat the effect of solvent on hf loss \n from the c3 in gemcitabine and in mefdc , we employ \n the integral equation formalism polarized continuum model ( ief - pcm ) as implemented in gaussian 09 . in \n addition to pcm , for c3 in both systems", "furthermore , employing \n the wb97x/6 - 31++g(d , p ) method along with the ief - pcm model for the \n solvent effect , the pka of the c3-oh \n group for the c3 of gemcitabine and also of the c3-oh \n group for the c3 of 2-dc was calculated .", "gaussview and jmol programs were used to plot the spin densities \n and molecular structures .", "a h3o is placed in the vicinity of the c3-oh bond \n for c3 in gemcitabine and for c3 in \n mefdc and have optimized the structures .", "the ph of gemcitabine in 7.5 m licl / h2o \n and the ph of other compounds ( 2-dc ," ], [ "as indicated in ( a ) the c3 \n in gemcitabine involves a barrier of 5 kcal / mol ( detailed electronic \n energy profiles are provided in supporting information figure s4c , d ) to hf loss in the presence of h3o . in ( b ) , the c3 in mefdc is unstable in the presence \n of h3o and reacts without a barrier to form \n c2 via hf loss . the animations ( movies ) of the optimization steps for reaction involving h3o for c3 in both gemcitabine ( a ) \n and mefdc ( b ) are provided in the supporting information ( s5 ) .", "alternatively , we consider the fact that deprotonation \n of h3 \n will form h3o initially in close proximity \n of the c2-c3 bond which may then induce hf loss ( reaction 5 ) . employing the b97x/6 - 31g(d ) method and \n considering the full solvent effect through the polarized continuum \n model ( pcm ) , this mechanism have been modeled by placing a h3o in the vicinity of the c3-oh bond for c3 \n in gemcitabine and for c3 in mefdc and have optimized \n the structures . from our calculations , we have observed that for c3 \n in gemcitabine , a minimum structure exists in the electronic energy \n profile in which the h3o stabilizes the f-atom \n through forming a hydrogen bond ( 1.57 ) ( see figure 3a and supporting information figure s4c ) .", "thus , these calculations show that the \n hf loss from c3 \n in gemcitabine has a ca .", "it is evident \n that for c3 of mefdc , the formation of c2 \n via hf loss with deprotonation of 3-oh has a significant barrier \n of ca . 18 kcal / mol .", "5 kcal / mol barrier ( supporting \n information figure s4c , d ) while for c3 in mefdc , \n the loss of hf is barrierless , and the c2 production \n is exothermic in nature as shown in figure 3 .", "in contrast , in gemcitabine only c3 formation \n is observed without any conversion to c2 in the same \n temperature range ." ], [ "160170 \n k. thus , our study in one - electron oxidized mefdc provides the first \n evidence of formation of c2 ( via the unstable intermediate \n c3 ( reaction 5 ) ) in a nonenzymatic \n system even at low temperature.5", "theoretically , \n dft calculations support the mechanism involving a h3o induced barrierless conversion of c3 to c2 \n in one - electron oxidized mefdc .", "experimentally , c2 \n is observed in one - electron oxidized mefdc upon annealing to ca .", "the two highly electronegative f - atoms \n at 2-position , through their negative inductive effect , lead \n to a substantial increase in the acidity of h3. therefore , \n c in gemcitabine is highly unstable toward the \n loss of h3 as deprotonation at 150155 k. this is evidenced \n by the free energy changes of the cation radical for the loss of h3 \n as deprotonation to the surrounding solvent ( see supporting information table t2 ) ; this deprotonation shifts \n the unpaired spin from the cytosine base of metastable c in gemcitabine to sugar at c3 via a pcet \n process ." ] ]

[ [ "the present study reports our intermediate experience in men who underwent implantation of adjustable perineal male sling using a tissue expander for ppi .", "it has a significant impact on the patient s quality of life ( 1 ) .", "mild degrees of ppi in the early postoperative period may be improved by pelvic muscle exercises , physiotherapy , and pharmacotherapy ( 3 ) . however , for most patients who have moderate to severe ppi , conservative methods are not sufficient to return to their normal lives .", "post - prostatectomy urinary incontinence ( ppi ) is a potential complication of prostate surgery and although it is more frequently seen after radical prostatectomy it can also occur after endoscopic or open surgery for benign prostate hyperplasia ( bph ) ( 2 ) .", "initial management is usually conservative and includes the use of diapers or pads , penile clamps , or various collecting systems ( such as a condom catheter ) ." ], [ "the underlying etiologies of ppi in patients were : radical prostatectomy for prostate cancer in 13 patients ( open radical retropubic prostatectomy=12 , transperitoneal laparoscopic radical prostatectomy=1 ) , open prostatectomy in 5 patients and transurethral prostate resection for bph in 3 patients .", "a total of 21 men with ppi underwent implantation of adjustable perineal male sling using a tissue expander .", "also , an urethrocystoscopy was conducted in all the patients to exclude urethral stricture and/or bladder neck contracture .", "all the patients underwent a standard urodynamic study including both cystometry and pressure - flow study to evaluate bladder storage and voiding capabilities , and to exclude overactive bladder .", "incontinence in the patients was defined according to the use of incontinence pads over a 24 hours period : mild ( using 1 to 2 pads ) , moderate ( 3 to 5 pads ) and severe ( more than 5 pads ) ( 4 ) .", "the patients who had a history of previous surgery for ppi were not included in the study ." ], [ "the critical point is not to remove periurethral fat tissues from urethra . both sides of urethra", "figure 1a ) both sides of urethra are dissected ; b ) a balloon expander ; c ) a balloon expander between two layers of the mesh ; d ) the mesh is stapled to the pubic bone using autosuture stat tacktm ; e ) prepared scrotal pouch for placing the inflation component . \n a standard polypropylene mesh of 100 x 100 mm was used as the sling material .", "after the insertion of a urethral catheter , a midline perineal incision of 40 to 50 mm was made .", "the device contains a silicone balloon expander , a connecting tube and an inflation component ( injection port ) that allows the expander to gradually fill up to a volume of 25 ml saline solution ( figure-1b ) . \n", "a eurosilicone ( laboratoires eurosilicone , france ) tissue expander device was used with an adjustable male sling in our patients .", "( 5 ) used a polypropylene mesh that was fixed on the pubic bone with non - absorbable sutures . in our case , this method was modified and staples were used to prevent the sutures and the mesh from loosening and moving . after the sling tension was properly adjusted , the sling was placed as tightly as possible in all patients since urinary leakage had been observed in our patients postoperatively ." ], [ "the mean values of the parameters were calculated using the statistical package for social sciences version 13.0 for windows ( spss inc . , chicago , il , usa ) ." ], [ "after the follow - up period , 16 of the 21 patients ( 76.2% ) were dry ( 11 patients , 0 pads ; 5 patients using safety pads ) , 3 patients ( 14% ) had mild degree ppi and 2 patients ( 9.8% ) had moderate degree ppi . in the last assessment of the patients , qmax and estimated pvr were found to be 15.64.7 ( 10 - 31 ) ml / s and 10 ml , respectively .", "the mean volume of the postoperatively inflated balloon was 11.65.7 ( 5 - 25 ) ml .", "the mean age of the patients was 66.27.3 ( 50 - 79 ) years and the mean pad usage was 6.40.6 ( 6 - 8 ) per day .", "in these two patients , the polypropylene mesh with balloon , connecting tube and inflation component were removed and they did not undergo any additional intervention . local scrotal infection developed around the inflation component in three patients . in these patients ,", "only the inflation component was removed , the connecting tube was clipped and the polypropylene mesh with inflated balloon was kept in place . in these patients , polypropylene mesh with inflated balloon provided suitable pressure on the urethra . in the follow - up period , they were completely dry .", "six patients reported mild perineal pain in the early postoperative period but this was resolved using non - steroidal anti - inflammatory drugs .", "no complications occurred in relation to mesh erosion , voiding dysfunction , voiding difficulty or mechanical failure ." ], [ "since its introduction in 1973 , the artificial urinary sphincter ( aus ) has been considered the gold standard treatment for stress urinary incontinence after prostatectomy , offering the patient the greatest chance of a cure ( 6 ) .", "they concluded that the male sling procedure is an effective and safe procedure for the management of stress urinary incontinence .", "although , aus is an effective and durable treatment , many patients are hesitant about implantation or refuse the procedure . most patients could not manipulate the scrotal pump ( 10 ) .", "furthermore , aus is expensive and requires a complex surgical procedure that is associated with significant rates of complications ." ], [ "although complications occurred in this study , including the removal of the device and the removal of inflation component due to local scrotal infection , our intermediate follow - up study suggests that an adjustable perineal male sling using a tissue expander appears to be an efficient and safe alternative surgical treatment option for patients suffering from ppi .", "the major limitations of our study were the small number of patients and the duration of the follow - up period .", "additional follow - up and larger series of patients are necessary to confirm our results ." ] ]

[ [ "we aimed to study the reliability and validity of the turkish version of the first by \n correlating this tool with the acr 2013altcr and the hospital anxiety and depression scale \n ( hads ) .", "fibromyalgia syndrome ( fms ) is a prevalent chronic pain condition among middle - aged females \n and is characterized by chronic widespread pain .", "the original \n version of the fibromyalgia rapid screening tool ( first ) was demonstrated to have excellent \n discriminative properties , especially divergent validity in terms of psychological aspect , \n which is an important property for an fms screening tool9 . the spanish version of the first", "was also demonstrated to have \n acceptable internal consistency , reliability , and criterion validity10 ." ], [ "the validity and \n reliability of the turkish version of the hads was demonstrated previously11 . concurrent validity of anxiety subscale \n with spielberger s trait anxiety inventory , correlation coefficient was 0.7544 and of \n depression subscale with beck depression inventory it was 0.7237 .", "testing the reliability of \n had scale , cronbach alfa coefficient for anxiety subscale was 0.8525 and for depression \n subscale it was 0.778411 .", "the reliability of the \n hads was tested using cronbach s alpha coefficient . for criterion validity of the first , we \n used the acr 2013altcr for comparison .", "the \n concordance between the acr 2013altcr and the first was evaluated using a mcnemar test .", "the sensitivity , specificity , and positive and negative likelihood ratios of the first were \n calculated according to acr 2013altcr criteria .", "we \n used the acr 2013altcr8 , which includes \n the pain location inventory ( pli ) including 28 sites and the symptom impact questionnaire \n ( siqr ) consisting of 10 symptom items ( pain ; energy ; stiffness ; sleep ; depression ; memory \n problems ; anxiety ; tenderness to touch ; balance problems ; and sensitivity to loud noises , \n bright colors , odors , and cold ) .", "the second version was tested on 5 patients , all of whom were native turkish speakers , \n and comprehension was determined through face - to - face interviews . after this final step , a \n third version of the questionnaire" ], [ "first : \n fibromyalgia rapid screening tool ; hads : hospital anxiety and depression scale ; pli : \n pain location inventory ; siqr : symptom impact questionnaire , * p<0.001 statistically \n significant logistic regression analysis was carried out to find the confounding effect of the hads on \n the first to discriminate the patients with fms .", "the first was not statistically \n different from the acr 2013 altcr in defining patients with fms ( table 1table 1.sensitivity , specificity , and positive and negative likelihood ratios of the \n first to discriminate patients with and without fms according to the 2013 \n altcrvalueconfidence intervalsensitivity83.8276.589.6specificity68.4259.876.2+lr2.652.33.0lr0.240.10.4lr : likelihood ratio ) .", "first : \n fibromyalgia rapid screening tool ; hads : hospital anxiety and depression scale ; pli : \n pain location inventory ; siqr : symptom impact questionnaire , * p<0.001 statistically \n significant ) .", "the first global score explained 30% of \n the proportion of uncertainty ; each point increase in first global score meant 10 times \n greater odds of experiencing fms .", "one hundred fifty - six ( 58% ) patients had score of 5 , which is the cut - off score for the \n first ; 116 of these patients ( 74.4% ) were diagnosed as having fms according to acr 2013altcr \n criteria .", "the model was able to discriminate patients \n with fibromyalgia and without fibromyalgia ( 2 log likelihood=274.82 ; =95.29 , \n d.f=2 ; p < 0.001 ; nagelkerke r= 0.4 ) ." ], [ "in this study , we showed that the turkish version of the first is a reliable \n patient - completed instrument for identifying patients with fms .", "the acr 2013altcr was used \n for comparison , and the first was similar to the acr criteria in terms of defining patients \n with fms .", "the first demonstrated high correlation with acr 2013altcr subscores and hads \n scores . in our study , we examined the consistency of the first over time .", "surgeons and interventionalists may also benefit from using an \n easy - to - administer patient - completed screening tool to avoid unnecessary procedures ." ], [] ]

[ [ "based on this premise , this study was designed to examine the students possible role in changing their own negative practices , by first assessing their perceptions of the obstacles to positive dietary practices and increased physical activity .", "overweight and obesity are conditions that have been increasing in the united states and these risk factors for diseases are estimated to affect more than one - half of those over the age of 20 . over the last few years", "public health officials have begun to monitor the health status of school - aged children because it is believed that many of them exhibit risk factors that create the potential for developing chronic disease as adults . in 1994 ,", "obesity is a major public health concern because it increases the risk for many chronic conditions , such as cardiovascular diseases , particularly diabetes , hypertension , coronary artery disease , and cancer [ 1,811 ] .", "the study also solicited students recommendations for reducing the negative practices that are associated with the rise in obesity and the development of cardiovascular diseases .", "the rate of cvd for african americans in mississippi was deemed serious enough to compel the national institutes of health ( nih ) to initiate the jackson heart study to focus on identifying risk factors for the development of cvd in african - americans . among the known risk factors for cvd", "this increase in overweight children has underscored the challenges faced by young people as they grow into an adult group where over 50% are overweight , and at significant risk for developing cardiovascular and other metabolic disorders [ 1 , 12 ] ." ], [ "the students were assured that their responses would be confidential and their honest responses could shed some light on a perplexing health dilemma that currently faced public health officials .", " what do you think is preventing you or other students from taking part in daily physical activity ? what suggestions do you have that would help students to start eating better and exercising more ? these were open - ended questions and the students had the freedom to think and enumerate their perceptions .", "the high school under investigation in this study educates students in grades 912 , and all students enrolled in the health and physical education courses comprised the sample for this project .", "the data for the study were obtained from the administration of the project health high school survey ( phhss ) , which was a modification of the mississippi youth risk behavior survey ( yrbs ) that was developed by the centers for disease control and prevention ( cdc ) .", "the students responses on each of these issues were recorded and analyzed to fully understand their perceptions and recommendations .", "these questions specifically asked students to respond about their perceptions , and were the following : ", "the phhss was designed to measure the prevalence of risk behaviors associated with leading causes of illness and death ." ], [ "this descriptive study sought to ascertain the students perceptions through the use of questions that were presented in the form of a self - administered questionnaire . upon completion of the survey ,", "the students perceptions on each of the areas under investigation were recorded and reported based on the rankings ( highest number of responses received and recorded ) from highest to lowest .", "the high school students perceptions about current practices and possible solutions were calculated and presented in the tables that follow .", "the statistical package for the social sciences ( spss ) was used to evaluate the student responses ." ], [ "completed phhss surveys were returned for 126 students which represented 42% of the 300 students enrolled in the health and physical education classes .", "the number two reason for not eating healthy was that students believed that the food they were served in the school s cafeteria was of poor quality : 15.7% of the students responses supported this view .", "the number eight ranked reason for students not practicing positive eating habits was the presence of snack machines at school , laden with junk food .", "a small number of students believe that being fat or overweight was a contributing factor to their failure to participate in physical activity . there were approximately 19.0% of the students who had no opinion about what was keeping them and other students from taking part in sufficient exercise ( daily physical activity ) .", "health problems were cited by 2.4% of the students as obstacles , and 1.6% of them indicated that disagreements with the gym teacher resulted in their non - participation .", "another 6.3% of the students suggested that school should make exercise and nutrition programs more fun to encourage students to participate .", "approximately 4.2% of the students indicated that the students themselves should eliminate junk food and fast foods from their daily lunch menus ." ], [ "the major limitation of this study was the fact that only 42% of the total number of students eligible to participate in the study provided surveys that could be analyzed .", ". however , their responses are valuable enough to shed some light on obstacles to good health and possible solutions to improve the quality of life and develop ways of helping them to eliminate negative practices and reduce risk factors ." ], [ "it is evident that adequate support and guidance from adults are not available often enough to facilitate the kind of learning and training that could ensure that students are afforded the opportunity to acquire knowledge to help them make positive responsible choices and decisions .", "recommendations for future studies should involve examining the responses of students enrolled in predominantly white institutions with those of the predominantly african american canton public school district . studies could also be designed to compare the responses of students from urban schools and rural schools to determine what their perceptions and recommendations are concerning risk factors and ways of reducing them .", "it is clear that culture and family customs have a great influence on the direction students take in their dietary practices , as well as their involvement in physical activity .", "the convenience and easy accessibility of low nutritious foods is also seen as a contributing factor , as are the negative influences that are presented through advertising of non - nutritious foods .", "the current absence of learning strategies to adequately address and educate students about the pitfalls of negative dietary and physical behaviors is a major shortcoming of the school s education system .", "the students suggested that modifying the schools curriculum to address student risk behaviors should become an embedded characteristic of their educational systems .", "so children have little desire to take the initiative to make improvements in their daily practices ." ] ]

[ [ "this review focuses on the role of emps in angiogenesis , coagulation , and inflammation during age - related vascular diseases and the contribution of estrogen to these diseases .", "vascular diseases are among the most common causes of morbidity and mortality , and both number and severity of morbid vascular conditions increase with age . regulations of angiogenesis , coagulation , and inflammation are very important issues in vascular biology , both in normal physiology and pathology .", "numerous studies have reported that microparticles ( mps ) play an important role in endothelial dysfunction .", "it is now well established that disruption of endothelial integrity represents a crucial event in the initiation and development of cardiovascular ( cv ) diseases ." ], [ "all these data indicate that formation of emps links together inflammation , coagulation , and angiogenesis and causes the impairment of the last two phenomena ( figure 3 ) . among many signaling molecules , t - cadherin ( t - cad ) on the surface of ecs", "these data suggest that there are distinct mechanisms for the formation of emps in apoptotic and activated cells and several studies suggest that these types of emps have different functions in vascular diseases [ 40 , 44 ] .", "recently , philippova et al . have demonstrated a mechanism of t - cad - dependent signaling in the vascular endothelium .", "might be upregulated and may serve as a characteristic marker of ec activation and stress .", "both inflammatory cytokines and coagulation factors participate in the generation of emps ( figure 2 ) ." ], [ "the authors provide evidence that microparticles with plasminogen activators are rare in healthy populations but are observed more frequently in pathological conditions suggesting that plasmin generation on microparticles may be important in the modulation of hemostatic balance . therefore , complex functions of emps have an ambivalent role both in physiological and pathological conditions , either promoting or inhibiting coagulation , inflammation , or angiogenesis .", "recent studies by sapet et al . have shown that release of emps by endothelial cells in response to thrombin involves a group of genes that regulate angiogenesis and are linked to the cytoskeleton reorganization family . among these genes ,", "s1p has also been shown to be involved in the process of angiogenesis and inflammation [ 6264 ] .", "increasing evidence has also accumulated to implicate an impaired coagulation system in many vascular diseases ." ], [ "these observations support the notion of a high prevalence of proinflammatory conditions in advanced age .", "all of these factors lead to increased generation of emps and impaired coagulation , inflammation , and angiogenesis in cv diseases ( figures 3 and 4 ) .", "it has been reported that in addition to activation of d - dimers and c - reactive proteins in coagulation , the inflammatory cytokine il-6 is associated with mortality , declines in all measures of function , and leads to the frailty phenotype in the elderly .", "inflammatory mediators increase several procoagulant factors , inhibit endogenous anticoagulants , and attenuate the fibrinolytic response", "recently , it has been shown that increased levels of il-6 are present in aged aortas and that aging induces a proinflammatory phenotype in vascular smooth muscle cells ( vsmc ) due in part to increased signaling of toll - like receptor 4 ( tlr4 ) and its signaling adaptor myd 88 .", ". however , the interaction between these two systems is bidirectional , as coagulation is also capable of modulating inflammatory activity .", "inflammation and coagulation are linked processes in many diseases and emps may amplify the responses by activating the endothelium ." ], [ "emps are clearly implicated in the impairment of angiogenesis in vascular diseases associated with aging however , the specific pathways through which emps augment this process are unknown .", "defective angiogenesis has been found in many vascular diseases and it has been established that emps play an important role in this process .", "moreover , emps may be one of the major factors leading to reduced effectiveness of therapies for treating impaired angiogenesis in humans and should be further explored .", "impairments in the regulation of vascular tone , coagulation , and hemostasis contribute to damage of the vascular system and dysfunctional angiogenesis [ 8183 ] ." ], [ "the tree - city cohort studies have shown that increased thrombin generation is an independent predictor of ais in elderly women suggesting that hypercoagulability may play an important role in the pathogenesis of ais .", "furthermore , estrogen levels have been connected to thrombin generation , a central molecule in the coagulation cascade in postmenopausal women .", "studies published by reed and edelberg have suggested that a physiological decrease in the concentration of steroid hormones ( e.g. , estrogen and testosterone ) as a result of menopause and chronological aging may contribute both directly and indirectly to subsequent deficits in the synthesis and function of the angiogenic growth factor tgf- . in humans endogenous", "it has been shown that estradiol promotes myocardial angiogenesis by increasing microvascular density through estrogen receptors .", "all these data may indicate that estrogen probably does not exert its protective effects on cv diseases through the emp axis ." ], [ "furthermore , circulating emps show great promise not only as biomarkers in the diagnostics of vascular diseases but also as a target for the treatment of these disorders , especially in elderly patients .", "furthermore , in age - related vascular diseases , steroid hormones are among the factors that have been shown to have an influence on vascular homeostasis .", "however , the direct link between emp generation , emp release , and estrogen is understudied and the further investigation of cellular and molecular mechanisms of these correlations is imperative for understanding and providing a basis for new translational investigations .", "lack of estrogen has been suggested to be directly involved in the endothelial cell injury with emp release that is observed in ischemic diseases .", "thrombin and pai-1 seem to be key factors involved in emp generation in age - related vascular disease .", "endothelial microparticles , as pleiotropic factors , play a role in both physiological and pathological conditions and thus may contribute to regulation of vascular homeostasis .", "specifically , estrogen plays a regulatory function on vessel inflammation , injury , and repair ." ] ]

[ [ ", we assessed the effects of eight weeks of three grams per day cinnamon supplementation ( cinnamomum zeylanicum ) on glycemic status , lipid profiles , blood pressure and body composition in type 2 diabetic patients .", "the present study investigated the proposed benefit of cinnamon use in patients with type 2 diabetes .", "therefore a randomized , placebo controlled , double blind study was performed in 44 patients with type 2 diabetes . in this study", "however , data from vanschoonbeek et al . shows no effect of cinnamon spice ingestion on whole body insulin sensitivity , oral glucose tolerance or lipid profiles in postmenopausal type 2 diabetic patients .", "several clinical trials[1216 ] have investigated the impact of cinnamon on glucose and plasma lipid concentrations in patients with diabetes but yielded conflicting results .", "they reported a substantial reduction in fasting serum glucose ( 18 - 29% ) and blood lipid profile after 40 d of daily supplementation with one , three , or six grams of whole cinnamon in patients with type 2 diabetes .", "more recently , mang et al . reported a 10.3% reduction in fbg after four months of supplementation with a purified aqueous cinnamon extract ." ], [ "subjects were instructed to ingest two capsules at each main meal ( breakfast , lunch and dinner ) for eight weeks .", "two moved and five were unwilling to continue ; so 37 patients completed the study ( 19 patients in the intervention group and 18 in the control group ) .", "a total of 44 individuals with type 2 diabetes were selected to participate in this study .", "subjects were selected based on inclusion criteria among patients who came to the endocrinology and metabolism center , tehran university of medical sciences and randomly assigned to cinnamon ( n=22 ) or placebo group ( n=22 ) .", "we chose this dose because it is achievable if we want to use it as a spice in future and there is no side effect for this dose in this target group based on literature.[1316 ] all medication was continued as usual and subjects were advised to maintain their normal diet and continue their habitual physical activity throughout the study . to verify this , subjects completed three day food records ( two weekday and one weekend day ) at baseline and end of study .", "physical activity levels were measured with international physical activity questionnaire at baseline and end of study .", "weight , height , body composition and blood pressure were measured in the fasting state with minimal clothing and without shoes in the beginning and end of study ." ], [ "subjects were instructed to ingest two capsules at each main meal ( breakfast , lunch and dinner ) for eight weeks .", "two moved and five were unwilling to continue ; so 37 patients completed the study ( 19 patients in the intervention group and 18 in the control group ) .", "a total of 44 individuals with type 2 diabetes were selected to participate in this study .", "subjects were selected based on inclusion criteria among patients who came to the endocrinology and metabolism center , tehran university of medical sciences and randomly assigned to cinnamon ( n=22 ) or placebo group ( n=22 ) .", "we chose this dose because it is achievable if we want to use it as a spice in future and there is no side effect for this dose in this target group based on literature.[1316 ] all medication was continued as usual and subjects were advised to maintain their normal diet and continue their habitual physical activity throughout the study . to verify this , subjects completed three day food records ( two weekday and one weekend day ) at baseline and end of study .", "physical activity levels were measured with international physical activity questionnaire at baseline and end of study .", "weight , height , body composition and blood pressure were measured in the fasting state with minimal clothing and without shoes in the beginning and end of study ." ], [ "the objectives of study and risks of experimental procedures were explained to the volunteers , after which their written informed consent was obtained .", "a total of 44 individuals with type 2 diabetes were selected to participate in this study .", "type 2 diabetes was verified according to the criteria set by the who in 1999 .", "inclusion criteria were non - insulin dependent type 2 diabetes , aged between 30 - 65 years , hba1c between 6 - 8% and fbg levels between 126 - 160 mg / dl .", "all subjects were stable because medication had not modified over the last month and there were homogeneity regarding their treatments ( metformin : 1 - 1.5 gr / d , gliclazide : 160 - 240 mg / d ) .", "exclusion criteria were cholesterol > 240 mg / dl , triglyceride > 400 mg / dl , smoking and alcohol consumption , pregnancy and lactation , allergy to cinnamon , liver or renal or thyroid diseases and hemolytic anemia .", "the study was approved by the medical ethical committee of tehran university of medical science ( code p/26/d5/147 ) and was supported by grants from vice chancellor of research ( grant number p/608 ) ." ], [ "two moved and five were unwilling to continue ; so 37 patients completed the study ( 19 patients in the intervention group and 18 in the control group ) .", "subjects were instructed to ingest two capsules at each main meal ( breakfast , lunch and dinner ) for eight weeks .", "we chose this dose because it is achievable if we want to use it as a spice in future and there is no side effect for this dose in this target group based on literature.[1316 ] all medication was continued as usual and subjects were advised to maintain their normal diet and continue their habitual physical activity throughout the study . to verify this , subjects completed three day food records ( two weekday and one weekend day ) at baseline and end of study .", "weight , height , body composition and blood pressure were measured in the fasting state with minimal clothing and without shoes in the beginning and end of study .", "subjects were selected based on inclusion criteria among patients who came to the endocrinology and metabolism center , tehran university of medical sciences and randomly assigned to cinnamon ( n=22 ) or placebo group ( n=22 ) .", "physical activity levels were measured with international physical activity questionnaire at baseline and end of study .", "fasting plasma glucose and hba1c were analyzed immediately ; aliquots of plasma were stored at 70c until lipid profile and insulin analysis ." ], [ "serum concentrations of triglyceride and total cholesterol were analyzed using the glycerol-3-phosphate oxidase - phenol+aminophenazone ( gpo pap ) kit as described in our previous study and the cholesterol oxidase - phenol+aminophenazone ( chod pap ) kit , respectively ( pars azmoon kit , iran ) .", "fasting plasma glucose was analyzed by the glucose oxidase method ( pars azmoon kit , iran ) .", "apo lipoproteins ai and b were analyzed by immunoturbidometry method by using auto analyzer cobas ( pars azmoon kit , iran ) .", "insulin was analyzed by immunoradiometric assay ( irma ) method ( immunotech co. kit , france ) ." ], [ "adjustment for differences in baseline covariates and changes in variables during study were performed by analysis of covariance ( ancova ) .", "qualitative variables , such as physical activity , were analyzed using chi square test . for comparison variables before and after the intervention within each group , paired t test was used .", "statistical analyses were performed using statistical package for the social sciences ( spss ) software ( version 14 ; spss inc , chicago , usa ) ." ], [ "energy intake , macronutrient and micronutrient composition of the diet did not differ between groups at baseline and did not change in the placebo or cinnamon group during the intervention period .", "while the fbg , hba1c and triglyceride levels in the cinnamon group was significantly reduced after the intervention compared with baseline ( p=0.005 , p=0.008 , p=0.038 respectively ) , no such effect were observed in the placebo group .", "body weight and bmi in both groups were significantly reduced after the intervention compared with baseline ( p=0.017 , p=0.010 respectively ) .", "fat body mass was significantly reduced in cinnamon group , ( p=0.047 ) but not in placebo group .", "table 2 shows the fasting plasma glucose concentrations , hba1c , serum lipids , anthropometric variables and the corresponding differences of these variables for the cinnamon and placebo groups .", "baseline characteristics did not differ between the two groups of the study population [ table 1 ] .", "physical activity levels did not differ between groups at baseline and did not change during the study ." ], [ "our findings indicate that consuming three gram per day of cinnamon for eight weeks leads to significant reduction in some biochemical and anthropometric variables compared with baseline ( i.e. , fbg decreased by 9.2% , hba1c decreased by 6.12% , triglyceride decreased by 15.38% , body weight decreased by 1.19% , bmi decreased by 1.54% and fat body mass decreased by 1.36% ) . but these reductions were not significant compare to placebo group .", ", we observed a significant reduction of plasma glucose ( 9.2% ) after eight weeks of treatment but not in the placebo group .", "consequently the authors concluded that small amount of cinnamon represent a safe and effective mean to reduce the risk factors associated with type 2 diabetes . in the cinnamon group", "study and the strong decrease of serum glucose in the poorly controlled pakistani diabetics ( mean fasting glucose ( 140 - 400 mg / dl ) concentrations ) , suggest that subjects with poor glycemic control may benefit more from cinnamon intake .", "it is possible that the improvements in fbg , as well as plasma antioxidant status are responsible , at least in part , for cinnamon 's beneficial effects on body composition and features of the metabolic syndrome like blood pressure .", "the decreases of plasma glucose and insulin concentrations and weight in our study were not sufficient to induce an improvement of the blood pressure ." ], [ "in conclusion , our study shows that in type 2 diabetic patients , the intake of three grams per day cinnamon may lead to a moderate effect on glycemic status indicators , but does not improve blood pressure , blood lipid profile or body composition parameters ." ] ]

[ [ "management of an unexpectedly difficult airway consists of laryngeal mask ventilation , gum - elastic bougie and video laryngoscopy - assisted intubation .", ". failed endotracheal intubation and inadequate ventilation with insufficient oxygenation may lead to serious complications , even death .", "gum - elastic bougie is the easiest and cheapest tool used in case of an unexpected difficult intubation occurring in the operating room ." ], [ "a 53-year - old male patient with hypogonadotropic hypogonadism presented as an unexpected difficult intubation after the induction of anesthesia ." ], [ "a difficult airway has been described in patients with a variety of endocrine disorders , including pituitary diseases , but not with hypogonadism . there may be an unrevealed relationship between hypogonadism and difficult airway .", "gum - elastic bougie is still the most attainable and effective tool in the operation room in this situation ." ], [ "anesthesiologists are responsible for maintaining a patent airway in the anesthetized patient . failed endotracheal intubation and inadequate ventilation with insufficient oxygenation may lead to serious complications , as even a few minutes of deoxygenation can result in catastrophic outcome like brain damage or even death.1 anesthesiologists are occasionally faced and challenged with this significant problem in practice .", "a difficult airway has been described in patients with pituitary endocrine disorders such as acromegaly and dwarfism ; however , airway problems with hypogonadism have not been well identified in the literature.2" ], [ "a 53-year - old married man ( weight : 85 kg , height : 187 cm , body mass index : 24 kg / m ) presented with a history of nasal obstruction for two years .", "after the operation , the patient was extubated successfully without any complication and then examined by otorhinolaryngologists via fexible laryngoscopy .", "he was admitted to the operating theater , and following the induction of anesthesia with a dose of 5 mg / kg intravenous thiopental , bag - mask ventilation was barely sustained .", "glottic visualization was assessed with cook s modification of the cormack lehane classification ; a grade of 3a ( with direct laryngoscopy , only the epiglottis can be visualized ; the epiglottis can be lifted using an introducer or bougie ) was assigned.3 the patient was subsequently successfully intubated with a gum - elastic bougie .", "no other pathological finding was obtained as the result of magnetic resonance imaging of the pituitary gland ." ], [ "further , magnetic resonance imaging of the pituitary gland did not reveal any adenoma or mass lesion.2 pulsatile release of follicle stimulating hormone and lh in puberty instigates the development of the male larynx and secondary sexual characteristics .", "high - affinity androgen receptors have been found in the human larynx.5,6 in this case , the patient s laryngeal development was compatible with his age and sex . only the epiglottis was located in a slightly lower position than normal , partially leaning toward the laryngeal passage .", "however , difficult airway with a hypogonadotropic patient has not yet been clearly defined . in our case ,", "the growth of laryngeal cartilages and maturation of the male larynx is also facilitated by androgen ." ], [ "thus , anesthesiologists must take into account difficult airway in endocrinological disorders like hypogonadotropic hypogonadism and be prepared for difficult intubation ." ] ]

[ [ "incidence ( cases per 1,000 admissions ) of human listeriosis and serotype distribution of all isolates , national taiwan university hospital , taipei , taiwan , 19962008 .", "all of the patients with listeriosis lived in northern taiwan , and no obvious geographic correlation was observed between listeriosis patients in each year .", "patient distribution and incidence of human listeriosis , by age group , national taiwan university hospital , taipei , taiwan , 19962008 ." ], [ "we observed an upsurge of listeriosis beginning in 2005 in ntuh . the increase might not be attributable to common - source outbreaks because no clustering was detected .", "therefore , the incidence of and risk factors for human listeriosis in taiwan could not be determined precisely , and potential outbreaks might have been overlooked .", "an increase of listeriosis was noted since 2005 in our hospital , and all of the affected patients had predisposing factors that hampered their immunity .", "we found that mortality was related to hepatic decompensation and effective antimicrobial drug therapy after culture results were reported .", "food monitoring and human disease surveillance systems need to be established in taiwan to control this potentially fatal foodborne disease ." ] ]

[ [ "two of the three cats had undergone onychectomy several years before presentation . a permanent flexion of the proximal interphalangeal joint of one or more digits , associated with a difficult and painful extension of the proximal interphalangeal joint ,", "previous anti - inflammatory administrations were unable to improve lameness consistently in the three cats .", "three cats , siamese or siamese cross , were presented with a chronic thoracic limb weightbearing lameness .", "for all cats , treatment consisted of a tenectomy or tenotomy of the superficial and deep digital flexor tendons in order to release the contracture .", "the three cats responded well to the surgical treatment and became sound around 24 weeks after surgery ." ], [ "it should be considered in a differential diagnosis of feline lameness whenever onychectomy has been performed in the past .", "the precise etiology that explains this tendon contracture is unknown , but trauma or breed predisposition could represent potential causes ." ], [ "feline digital flexor tendon pathology , especially tendon contracture , is not well described . to our knowledge ,", "this case series reports three different clinical presentations of digital flexor tendon contracture in three cats , all successfully treated by tenectomy .", "various surgical interventions are feasible , and digit amputation or luxation reduction is the most frequently performed treatment .", "feline onychectomy is also a common surgery in north america , despite debate over the ethics of this procedure .", "digit lesions are most often associated with fractures , luxations , wounds , shearing injuries or tumors , and , less commonly , osteomyelitis or osteoarthritis ." ], [ "surgery involved a palmar approach to the proximal interphalangeal joint of the second digit , with a midline skin incision extending from the distal aspect of the carpal pad to the proximal aspect of the metacarpal pad .", "intraoperative plantar visualization of the flexor tendons of the third digit before tenectomy ( black arrow ) , exposed with a periosteal elevator ( * ) .", "a permanent flexion of the proximal interphalangeal joint of the left forelimb second digit was noted .", "radio - graphic views of the left forelimb extremity revealed an abnormal positioning of the middle phalanx ." ], [ "a 7-month - old neutered female siamese weighing 3 kg was presented for a lameness of the left forelimb of 2 months duration .", "a tenectomy of the deep and superficial digital flexor muscle tendons was performed as previously described for the first case .", "the cat still presented a mild lameness of the left thoracic limb , although the extension of the proximal interphalangeal joint of the fourth digit was improved compared with preoperative examination .", "one month after surgery , the cat was totally sound and manipulation of the digit was not painful ." ], [ "these observations were considered to be consistent with a chronic degeneration or trauma of this tendon . a definitive diagnosis of flexor tendon contracture was made ( figure 6 ) .", "a digital flexor tendon contracture of both forelimb digits was then suspected , and , after discussion , the owner agreed to surgical treatment .", "thoracic limbs of case 3 , 4 weeks after flexor tendon tenectomy and tenotomy photomicrograph of a tendon section from a domestic cat .", "a 7-year - old neutered male siamese cross weighing 6 kg presented with right forelimb lameness , which had appeared a month earlier .", "flexor contracture of all digits can be visualized ( left is distal , right is proximal , up is dorsal , down is plantar ) forelimb oblique extremity radiographic view of the left limb in case 3 ." ], [ "the surgical treatment consists of resection of the metacarpophalangeal transverse ligament , with or without resection of the superficial flexor tendon , and is highly effective with low associated complication and recurrence rates .", "the three cats reported in this study presented with chronic mild forelimb lameness associated with reduction of the normal extension of the proximal interphalangeal joint of one or more digits .", "this case series is of particular interest because it describes three different presentations of digital flexor tendon contracture in cats . in case 1 , which involved an onychectomized cat , tendon contracture involved only one digit , which is different from the two cases reported by cooper et al . in case 2 ,", "however , such an important delay , as seen in this case , between onychectomy and the development of digital flexor tendon contracture has not been previously reported .", "this pathology is a flexor tendon entrapment of the digits that is characterized by locking of the fingers , with or without pain ." ], [ "digital flexor contracture can affect an isolated digit or all digits of a limb and is characterized by a chronic lameness and a painful permanent flexion of the affected digit .", "this pathology could therefore be considered as a long - term complication of onychectomy in some cases . however , further cases need to be reported to better understand the pathogenesis of this condition .", "in contrast to medical management , tenectomy of the deep and superficial flexor tendons is associated with a good - to - excellent surgical outcome for this condition .", "digit evaluation seems to be of paramount importance when investigating cases of chronic lameness in cats .", "etiology of this contracture is unknown but trauma , whether related to an onychectomy or not , seems to predispose a cat to this condition ." ] ]

[ [ "therefore , the aim of this study was to investigate the expression of the adiponectin gene by real - time pcr , to determine the concentrations of adiponectin protein in the porcine ovary ( corpora lutea , granulosa and theca interna cells ) and to compare gene and protein expression levels during different stages of the oestrous cycle in pigs . additionally , we sought to determine the in vitro effect of adiponectin on the secretion of steroid hormones ( progesterone , oestradiol , testosterone , and androstenedione ) by ovarian luteal , granulosa , and theca interna cells of sexually mature swine .", "the possible influence of adiponectin on the production of steroid hormones by porcine ovarian cells remains unexplored .", "the existing evidence points to the presence of a common endocrine system comprising several hormones , including ghrelin , leptin , and orexin that controls metabolism and reproductive functions [ 1215 ] .", "the influence of the hormonal status of swine related to the stage of the oestrous cycle on adiponectin expression in corpora lutea , granulosa , and theca interna cells remains unknown ." ], [ "those cells are thought to be generally more autonomic than follicular cells which is a reason of luteal cells ' hard response to stimulators [ 3133 ] .", "the phase of the oestrous cycle was also determined based on ovarian morphology . additionally , to fully confirm correctness of the evaluation of the oestrous cycle phase , the level of progesterone was determined .", "adiponectin doses used in the experiment were close to physiological concentrations of this hormone in the porcine blood .", "calculation of relative expression levels of adiponectin was conducted based on the comparative cycle threshold method ( ct ) and normalized using the geometrical mean of reference genes expression levels : gapdh and cyclophilin a. western blotting analysis was performed as described by smolinska et al . .", "a and gapdh were the suitable reference genes for this study , we revealed that there were no statistically significant differences in ct values between the examined ovarian structures throughout all investigated stages of the oestrous cycle .", "both of the housekeeping genes were also indicated as suitable reference genes ( internal controls ) in the independent studies ." ], [ "the expression of adiponectin mrna was significantly higher in corpora lutea during all investigated days of the luteal phase than in theca interna cells isolated on days 1719 of the cycle ( p < 0.05 ) .", "secretion of a4 by theca interna cells was inhibited by combination of adiponectin ( 10 g / ml ) with insulin compared to insulin alone ( p < 0.05 ) .", "however , lh + insulin - induced secretion of e2 by the cells was increased in response to the higher dose ( 10 g / ml ) of adiponectin ( p < 0.05 ) ( figure 6(b ) ) .", "in contrast , there was no effect of adiponectin ( both doses ) on fsh- and fsh + insulin - induced production of p4 in porcine granulosa cells ( figure 3 ) .", "adiponectin at the lower dose ( 1 g / ml ) increased lh + insulin - induced a4 secretion by the cells ( p < 0.05 ) ( figure 6(c ) ) ." ], [ "the inhibitory influence of adiponectin on lh secretion could be attributed to a decrease in gnrh receptor gene expression in the pituitary .", "the results of our in vitro studies and the presence of both adiponectin receptors in porcine ovaries indicate that adiponectin may directly affect ovarian steroidogenesis .", "this is the first ever study to demonstrate the changes in adiponectin gene and protein expression in the porcine ovary throughout the oestrous cycle .", "higher levels of adiponectin gene and protein expression during the luteal phase and lower expression levels during the follicular phase could point to the stimulatory effect of progesterone and the inhibitory influence of oestradiol on ovarian adiponectin production . in our previous study ,", "our results indicate that adiponectin is more highly expressed in luteal cells derived from ovaries in all examined stages of the luteal phase than in follicular granulosa and theca interna cells ." ], [ "the presence of adiponectin mrna and protein in porcine ovaries observed in this study as well as the presence of adiponectin receptors 1 and 2 in the gonads noted in our previous work could provide evidence for auto / paracrine actions of the analysed hormone .", "the variations in adiponectin gene and protein expression during the oestrous cycle indicate that adiponectin expression is determined by the hormonal status of pigs .", "the effect of adiponectin on ovarian steroidogenesis suggests that this adipokine influences reproductive functions in pigs . yet for definitive conclusions to be drawn , especially concerning precise localization of adiponectin mrna and protein in different ovarian structures , intracellular mechanisms of adiponectin influence on the gonadal steroidogenesis and its possible effect on other functions of the ovaries , further studies are required to determine the role of adiponectin in ovarian physiology ." ] ]

[ [ "molecular and morphological evidence together support the idea that the anterior end of the amphioxus nerve cord contains regions homologous with vertebrate forebrain and hindbrain 1,2 , though it is generally the ventral portion of these regions that are best represented 3 .", "the quintessential identifying feature in vertebrates is the dorsal optic tectum , but this is absent in amphioxus .", "in addition , the vertebrate midbrain marker dmbx is not expressed in the amphioxus nerve cord 11 .", "brunet , personal communication ] . evidently then , the cells of the neck region in ascidian larvae serve as a pool of precursors from which most if not all post - metamorphic cns neurons are derived . assuming the genes expressed in the vertebrate mhb include major players in the overall process of neuronal specification and differentiation , one can argue that their expression in the neck region is to be expected , irrespective of any homology between this site and the mhb ." ], [ "from the above it is clear that there is a certain plasticity in the way expression patterns of genes identified with the mhb have diverged among chordates . in fact , the vertebrates seem to be most conservative : it is their pattern that most closely resembles that of hemichordates 19,20 , the closest available model for an ancestral deuterostome , and there are remarkably similar patterns in protostomes , e.g. drosophila . in hemichordates", "a further problem is to discover why amphioxus and ascidians have altered their mhb - related expression patterns when they are elsewhere so well conserved . in the case of ascidians , there have evidently been major changes in the way key patterning genes , notably those of the hox cluster , are structured and regulated .", "there is a second issue integral to any consideration of chordate cns origins that relates to how the main organ systems of the body , including the nervous system , are positioned in relation to the dorsoventral axis .", "if these did indeed serve in some way as the core of the evolving chordate brain , then the progressive incorporation of centers for locomotory control into the brain is yet another story , and one that would have unfolded quite independently of the evolutionary process by which a centralized brain and nerve cord arose in the protostome lineage . in this version of events ," ], [ "two alternatives for explaining the origin of a dorsally positioned brain in chordates , using the hemichordate embryo ( a ) as a starting point ; indicates the mouth ( m ) , anus ( a ) , apical plate ( orange ) , and the ancestral dorsal ( a - dorsal ) and ventral ( a - ventral ) surfaces ; the light blue rectangle is the expression hot zone ( hz ) in which homologs of genes characteristic of the vertebrate mhb are expressed , typically in circumferential bands within ectoderm of the collar and anterior trunk .", "dorsal views of the larval nerve cords of ( a ) amphioxus and ( b ) ciona , a representative ascidian , showing expression domains for the main cns patterning genes .", "this is somewhat simplified , as the exact extent of the expression domains can vary with developmental stage , and the ascidian hox genes , in particular , are expressed in non - overlapping domains with some gaps .", "older explanations of chordate origins , e.g. garstang 's hypothesis , retain an ancestral dorsoventral orientation ( as in b ) ." ] ]

[ [ "the patient was posted for partial nephrectomy with the provisional diagnosis of renal tuberculosis or renal infarction involving upper pole .", "he was put on cisplatin and sunitinib on the suspicion of primary lung tumour and showed no response .", "a seventy five year old libyan man was seen in the urology department of tripoli medical centre , tripoli , libya with six month history of left loin pain .", "the patient 's vomiting subsided with proton pump inhibitors , but the loin pain showed partial response to analgesic .", "the dilated calysis showed areas of squamous metaplasia and severe dysplasia with focal invasion of basement membrane into renal parenchyma to form the tumour ( figure 5 ) ." ], [ "the patient was suspected clinically to have renal tuberculosis and was later found to have renal squamous cell carcinoma with possible lung secondaries ." ], [ "the present case demonstrates the transition from calyseal urothelium to squamous metaplasia , dysplasia and invasive squamous malignancy .", "there is a well known association between chronic pyelonephritis , renal pelvic stones , phanecetin ingestion and radiotherapy with squamous cell carcinoma .", "haematuria , the classical presenting complaint of renal cell carcinoma , is not common in this entity as in this case .", "usually , renal squamous carcinoma is highly aggressive and of a high grade at presentation ." ] ]

[ [ "the goal of this study was to investigate the chemical composition and in vitro antifungal and antibiofilm activities of essential oils of the leaves of m. piperita collected in the region of fars from iran .", "mentha piperita , ( family lamiaceae ) is a species found in iran and many parts of the world which has an economical value for its flavoring , odor , and therapeutic properties in foods and cosmetic industrial products . in addition , the leaves and flowers of m. piperita have medicinal properties [ 2 , 3 ] .", "the presence and concentration of certain chemical constituents of eos also fluctuate according to the season , climatic condition , and site of plant growth [ 25 , 26 ] .", "moreover , eos especially with known antibacterial effects have the potential to be used in food industry as preservatives and to increase the shelf life of products .", "medicinal plants have been used for centuries in traditional medicine because of their therapeutic value .", "therefore , determining the antimicrobial properties of eos might help to overcome microorganism resistance to antibiotics and prevent food spoilage ." ], [ "the antifungal susceptibility of clinical isolates of the tested fungi against fluconazole was examined by microdilution and disk diffusion methods [ 31 , 32 ] . ", "minimal inhibitory concentrations of the eo against standard and clinical species of the fungi were determined by the broth microdilution method as recommended by the clinical and laboratory standards institute ( clsi ) , with some modifications [ 31 , 32 ] .", "the compounds were identified by comparing their ri with those reported in the literature , and their mass spectrum was compared with those reported in wiley library .", "double dilutions of fluconazole were also prepared for each of the tested fungi with the final concentration of 0.25 to 128 g / ml . stock inoculums were prepared by suspending three colonies of the examined yeast in 5 ml sterile 0.85% nacl and adjusting the turbidity of the inoculums to 0.5 mcfarland standard at 630 nm wavelength ( this yields stock suspension of 15 10 cells / ml ) . for moulds ( aspergillus spp . ) , conidia were recovered from the 7-day - old cultures grown on potato dextrose agar by a wetting loop with tween 20 .", "mfcs were determined as the lowest concentration yielding no more than 4 colonies , which corresponds to a mortality of 98% of the fungi in the initial inoculums . according to behnam et al . , c. albicans and c. dubliniensis strains were maintained on sabouraud dextrose agar ( difco ) plates .", "mfcs were of the lowest concentration that showed either no growth or fewer than 4 colonies , which corresponded to 98% killing activity of the initial inoculums ." ], [ "in this study , the eos exhibited fungistatic and fungicidal activities against both of the standard and clinical strains of candida species at concentrations ranging from 0.5 l / ml to 8 l / ml , which can be best compared to the previous investigations [ 6 , 8 , 9 , 33 ] .", "the eo inhibited the growth of all of the tested yeasts at concentrations of 0.124 l / ml . furthermore , the eo exhibited fungicidal activity ( mfc ) for all of the above - mentioned yeasts at concentrations ranging from 1 to 8 l / ml .", "in addition , the eo inhibited the growth and killed the standard strain of cryptococcus neoformance at the concentration of 4 l / ml . all of the aspergillus standard strains were susceptible to m. piperita eo at concentrations of 0.54 l / ml ( table 3 ) .", "as shown in table 4 , the eo completely inhibited the biofilm formation of c. albicans and c. dubliniensis at concentrations of 1 l / ml and 2 l / ml , respectively . ", "no significant differences in inhibitory concentrations were found between azole - resistant and -susceptible strains .", "gc / ms analyses showed that the main constituent of the eo was menthol ( 53.28% ) followed by menthyl acetate ( 15.1% ) and menthofuran ( 11.18% ) ." ], [ "as the industries tend to reduce the use of chemical preservatives in their products , eo of m. piperita with potential active antimicrobial properties might be considered as a natural source for the maintenance or extension of the shelf life of products .", "in addition , delectable taste of the eo at the concentrations needed for antimicrobial properties was a bonus to its antimicrobial effects . on the other hand , these eos might also be considered for developing products for controlling fungal infections . as these tests have all been done in vitro ,", "the next step may be further investigations in animal models to see if infection can be inhibited by the eo ." ] ]

[ [ "the hardware and software realization of the device is mainly based on a single triaxial accelerometer and gps / gsm module .", "the device uses an efficient fall detection algorithm with less resource and power consumption , which means that it is a proper design for outdoor application .", "mems ( microelectro mechanical systems ) sensors have simplified the design and implementation of sensor system .", "besides this , the accelerometer coordinate does not have to be fixed if only the magnitude of sum vector is needed , and that is quite convenient for wearable application . in this paper , a fall detection system based on a wearable device is developed .", "external supports such as motion sensors could be used to enhance computer vision based fall detection method , and a data fusion algorithm can operate the validation and correlation among the two subsystems to raise robust performance of fall detection .", "there are several kinds of detection methods which differ in constitution of motion sensors and detection algorithms ." ], [ "so the elderly who has fallen can get timely help to minimize the negative influence .", "then it will get the elderly 's geographic position and send fall alarm short message to caregivers ." ], [ "quaternion is an effective tool to describe rotation movement in human 's gait change which also includes falling .", "as human 's motion has low acceleration , it is feasible to get gravity component in each axis by using a low pass filter . if gravity components could be separated before and after human 's fall , then it is possible to calculate the rotation angle of accelerometer coordinate in 3d space , which is also equivalent to the rotation angle of gravity vector relative to fixed coordinate .", "machine learning assistance may enhance system robustness to some extent , but its algorithm design is always high computing resource consumed which limits its application in wearable device . as the compact wearable device requires low power consumption and a single triaxial accelerometer could provide effective information , threshold based fall detection algorithm will be used in this system . algorithm used in this fall alarm system", "for single triaxial accelerometer application , accelerations and derived angular parameters could be used as recognition features . fall detection algorithm design", ", frequency domain parameters could be extracted from basic sensor measurements by techniques such as fft and wavelet [ 11 , 12 ] .", ", the classification of fall and normal activities is available with the assistance of technologies such as support vector machine ( svm ) and neural network [ 14 , 15 ] ." ], [ "there is a url ( universal resource locator ) which links to a web map in the alarm short message .", "the fall location information will be highlighted on a web map when the caregiver opens this link .", "one of them is the software design in wearable device , and the other is in the caregiver 's handset .", "ti 's 16 bits mcu msp430f1611 is used to control the whole system and imply the detection algorithm .", "each hardware component of the wearable device is working under low voltage and the detection algorithm does not need complex calculation resource , so the power consumption of the whole device is quite low .", "sim908 can offer gps and gsm service on serial port communication with mcu , and it can also work in low power mode ." ], [ "an alarm sms ( short message service ) containing a map url has been received by the handset as shown in figure 12 when a fall has been detected . clicking", "system test contains five kinds of activities of daily living ( i.e. , walking , jumping , squatting , sitting , and resting ) and four kinds of fallings ( i.e. , forward , backward , leftward , and rightward ) .", "each kind of motion has been repeated 20 times on each volunteer , and the detection results of the proposed algorithm and an acceleration threshold based algorithm are listed in table 1 . the sensitivity and specificity [ 21 , 22 ] of the proposed system can be got from the test data in table 1 .", "the url will open a map in web browser on which the fall location will be displayed accurately as shown in figure 13 .", "system test of the fall detection system has been conducted based on the system design described above . the sampling rate of accelerometer is set at 100 hz and the measurement range is 16 g with a maximum precision of 4 mg .", "considering that the tilt of the ground or the lying posture of the elderly may affect the rotation angle , rotation angle between ( 90 30) and ( 90 + 30) will infer that the elderly has fallen ." ], [ "this paper developed a fall detection system based on a single triaxial accelerometer based wearable device .", "there is no special requirement of the device 's mounting orientation because the algorithm does not claim the axes of accelerometer to be fixed strictly .", "the system has low power consumed hardware design and highly efficient algorithm which could extend the service time of the wearable device .", "sufficient sample number collected from subjects with different age and gender will improve the reliability and robustness of the threshold . beside these , technologies such as svm and neural network are considerable to seek out a proper classification method based on the features used in this system .", "as normal activity of resting also has similar rotation as falling , it may trigger fall alarm when the body hits ground heavily .", "so the choice of athreshold is quite important to distinguish falling from heavily lying activity ." ] ]

[ [ "one radiologist retrospectively reviewed the medical records of the patients who received tfesi using the conventional approach at our department during a 1-year period , from june 2003 to may 2004 .", "a successful outcome required a patient satisfaction score of 3 ( very good ) or 4 ( excellent ) , and a reduction on the vas of > 50% two weeks after the tfesi .", "the patients with a successful outcome were referred to as having received effective treatment and those patients without a successful outcome were referred to as having received ineffective treatment .", "thirteen patients who met all the criteria were included and they were referred to as the conventional tfesi group .", "this involved performing tfesi at the location of the exiting nerve root , regardless of the level of the nerve root compression .", "however , since june 2004 , we have used tfesi with the preganglionic approach at the supra - adjacent intervertebral disc ( for example , at the neural foramen of l4 - 5 for a l5 nerve root ) if the nerve root compression was at the level of the supra - adjacent intervertebral disc . using the same inclusion criteria", "the inclusion criteria were ( a ) the presence of lumbar radiculopathy , ( b ) nerve root compression in the paracentral or subarticular region at the level of the supra - adjacent intervertebral disc ( for example , at the l4 - 5 disc level for the l5 nerve root ) , ( c ) one level tfesi from l1 to s1 , ( d ) no prior therapeutic tfesi , ( e ) no prior surgery , and ( f ) clear identification of the nerve root compression by using a cross - sectional imaging study ( either computed tomography or magnetic resonance imaging ) .", "after a consensus meeting between three radiologists who were unaware of the clinical results after tfesi , we selected those cases treated by conventional tfesi with supra - adjacent nerve root impingement ." ], [ "this involved performing tfesi at the location of the exiting nerve root , regardless of the level of the nerve root compression .", "however , since june 2004 , we have used tfesi with the preganglionic approach at the supra - adjacent intervertebral disc ( for example , at the neural foramen of l4 - 5 for a l5 nerve root ) if the nerve root compression was at the level of the supra - adjacent intervertebral disc . using the same inclusion criteria", "for example , tfesi for l5 radiculopathy was performed at the neural foramen of l5-s1 even when the l5 nerve root compression was in the paracentral or subarticular region at the level of the l4 - 5 disc .", "after a consensus meeting between three radiologists who were unaware of the clinical results after tfesi , we selected those cases treated by conventional tfesi with supra - adjacent nerve root impingement .", "the inclusion criteria were ( a ) the presence of lumbar radiculopathy , ( b ) nerve root compression in the paracentral or subarticular region at the level of the supra - adjacent intervertebral disc ( for example , at the l4 - 5 disc level for the l5 nerve root ) , ( c ) one level tfesi from l1 to s1 , ( d ) no prior therapeutic tfesi , ( e ) no prior surgery , and ( f ) clear identification of the nerve root compression by using a cross - sectional imaging study ( either computed tomography or magnetic resonance imaging ) .", "one radiologist retrospectively reviewed the medical records of the patients who received tfesi using the conventional approach at our department during a 1-year period , from june 2003 to may 2004 .", "thirteen patients who met all the criteria were included and they were referred to as the conventional tfesi group ." ], [ "ttransforaminal epidural steroid injection using the conventional approach was conducted under biplane fluoroscopic guidance by two radiologists who were very experienced in spinal interventions .", "this length of follow - up has been proposed in the literature and relates to the duration of the therapeutic effect of corticosteroid ( 7 ) . to check the effect of tfesi ,", "the goal of positioning the needle tip was medial and inferior to that used in the conventional approach . in our department , we target injections just lateral to the pars interarticularis on the oblique view during the preganglionic approach ( fig .", "all the treatments were performed as outpatient procedures , and written informed consents were obtained from all the patients . with a patient lying in the prone position , the tube was rotated obliquely to ensure injection at the neural foramen . the goal of positioning was to allow a perpendicular needle tract toward the classic injection site underneath the pedicle , in the so - called \" safe triangle \" ( 5 , 7 ) .", "a fortnight after tfesi , the patients were followed - up at our outpatient department .", "all the patients were recommended not take any drugs or to participate in any physical therapy for their sciatica before this 2-week follow - up ." ], [ "the treatment outcome was assessed using a 5-point patient satisfaction scale , i.e. , 0 ( poor ) , 1 ( fair ) , 2 ( good ) , 3 ( very good ) , and 4 ( excellent ) , and by using a vas ( visual assessment scale ) that ranged from 0 to 100 . a successful outcome required a patient satisfaction score of 3 ( very good ) or 4 ( excellent ) , and a reduction on the vas of > 50% two weeks after the tfesi .", "the level and cause of nerve root compression on the ct or mr imaging and the level of radiculopathy were documented in the medical charts before performing tfesi .", "the duration of radiculopathy was also treated as a potential predictive variable , and it was classified as acute or subacute , i.e. , < 6 months or chronic ( > 6 months ) ( 8) . the effectiveness of tfesi was evaluated two weeks after the procedures .", "the patients ' demographic variables were also detailed at the initial clinical evaluation . for statistical analysis , we classified the patients ' ages into six age groups ; < 29-years - old , 30 - 39 , 40 - 49 , 50 - 59 , 60 - 69 and > 70 .", "after retrospectively reviewing medical records , we classified the cause of radiculopathy as being due to a herniated intervertebral disc ( hivd ) or it was due to spinal stenosis .", "the patients with a successful outcome were referred to as having received effective treatment and those patients without a successful outcome were referred to as having received ineffective treatment ." ], [ "logistic regression analysis was performed and the factors included were conventional or preganglionic tfesi , the cause of radiculopathy , the patients ' age and gender and the duration of radiculopathy .", "the mann - whitney u test was also used to evaluate for age differences between the two groups ( the conventional and preganglionic groups ) .", "spss , version 10.0 ( spss , chicago , il ) was used throughout the analysis ." ], [ "of the 13 patients in the conventional tfesi group , nine showed effective treatment two weeks after tfesi ( 69.2% ) , and 18 of the 20 patients ( 90% ) in the preganglionic tfesi group showed effective treatment , and the difference in the two rates of effective treatment was of borderline significance ( p = 0.056 ; odds ratio 10.483 ) .", "the study subjects were 22 women and 11 men with a mean age of 55.1 years ( age range : 17 - 76 , standard deviation [ sd ] : 14.1 ) .", "the cause of radiculopathy , the age of the groups , gender and the duration of symptoms were not found to be statistically related to the effectivness of tfesi ( p > 0.05 ) .", "the mean age was 53.9 years ( sd : 13.4 ) in the conventional tfesi group and it was was 55.8 years ( sd : 14.8 ) in the preganglionic tfesi group .", "these results are summarized in tables 1 , 2 . in the conventional tfesi group , seven patients ( 53.8% ) had spinal stenosis and six patients ( 46.2% ) had hivd , and in the preganglionic tfesi group , 13 patients ( 65% ) had spinal stenosis and seven patients ( 35% ) had hivd . in the conventional tfesi group ,", "the radiculopathy was acute or subacute in eight patients ( 61.5% ) and chronic in five patients ( 38.5% ) ; in the preganglionic tfesi group , radiculopathy was acute or subacute in six patients ( 30% ) and it was chronic in 14 patients ( 70% ) . in the conventional tfesi group , tfesi at l5-s1 was performed in 10 patients and tfesi at l4 - 5 was performed in three patients ; in the preganglionic tfesi group , tfesi was performed at l5-s1 in five patients , at l4 - 5 in 14 patients and at l3 - 4 in one patient ." ], [ "in contrast to an interlaminar or a caudal epidural steroid injection , tfesi provides a low volume of concentrated medication to a selected nerve root .", "therefore , they suggested that the therapeutic procedure be referred to as a ' transforaminal epidural steroid injection ' and that the diagnostic procedure should be referred to as a ' selective spinal nerve block ' or a ' selective ventral ramus block . ' in the case of tfesi with using the conventional approach , the spinal needle is positioned within the \" safe triangle \" ( bordering the pedicle , the exiting nerve root and the lateral border of the vertebral body ) , with the bevel placed below the inferior aspect of the pedicle ( 5 , 7 ) . using this conventional approach", "lumbosacral radiculopathy is a common and costly medical disease , and its lifetime prevalence has been estimated to be 40 - 60% ( 9 ) . based on the recent concepts of pain generation in the sciatic condition , it 's believed that concomitant chemical irritation of the nerve root that 's caused by disk material is the decisive factor for the development of severe sciatica , rather than the pain being due to mechanical compression alone ( 10 - 16 ) . according to this concept , the local application of corticosteroids in the area of the compressed", "thus , percutaneous injection based therapies , including tfesi , are being used with increasing frequency to treat the radiculopathy resulting from a herniated disc or degenerative lumbar spinal stenosis ( 17 - 19 ) ." ] ]

[ [ "although the rotation includes both \n photochemical and thermal steps \n that involve different parts of the motor , the structural evolution \n is largely governed by the excited - state properties of the central \n c = c group , which , in turn , are dictated by the potential energy \n surfaces of the excited states that are accessed upon electronic excitation . \n despite the large number of theoretical and experimental studies that have focused on characterizing \n this process , there are several key questions outstanding including \n identification of the main structural coordinates and the role of \n various electronic states involved in the excited - state dynamics . \n", "these techniques offer \n a high time resolution but provide only indirect information as to \n how the structure evolves spatially over time . in the present contribution \n we show that this information can be obtained through a combination \n of picosecond time - resolved vibrational spectroscopy of the electronically \n excited states together with quantum - mechanical calculations .", "hence both \n from a fundamental perspective and in achieving the goal of complete \n molecular design , gaining insight into the excited - state properties \n of light driven molecular - sized machines is essential .", "time - resolved studies are essential to elucidate these dynamics but \n have thus far focused on probing the change in the electronic structure \n after photoexcitation through uv / vis absorption and fluorescence studies ." ], [ "we \n investigate a 10 mm solution of compound i in deuterated cyclohexane \n ( aldrich , 99.6 atom% d ) .", "for the investigation of the ground - state \n conformers ( including \n vertical excitation energies and forces acting at the franck ", "the setup for the time - resolved infrared measurements has been \n described in detail previously .", "the gaussian09 program package was employed to study the excited - state properties \n in more detail and in particular to optimize the structure of the \n dark - state species .", "geometry optimization \n and normal - mode analysis were performed by ( time - dependent ) density \n functional theory ( ( td)-dft ) using the hybrid functional b3lyp . for the geometry optimization the d3 correction \n method of grimme et al .", "the diameter \n of the uv pump focus was 180200 m ; that of \n the ir probe focus , 150 m . the sample cell with caf2 windows spaced by 500 m was placed in the ir focus . \n to avoid accumulation of the thermally unstable conformer p * during \n the measurements ," ], [ "carbon \n double bonds ) that it primarily proceeds along torsional and pyramidalization \n coordinates . the present study , in contrast , leads to the conclusion \n that the fluorescence decay is mediated by the passage through the \n conical intersection of the homo lumo and homo1 \n lumo potential energy surfaces . inspection of the structural changes \n that occur upon geometry relaxation to the minimum on the homo1 \n lumo potential energy surface show that the central c = c \n bond length increases from 1.381 to 1.461 and that only relatively \n small changes occur in the torsional and pyramidalization coordinates . \n in combination with the forces that act on the molecule at the franck ", "proposed multistate dynamics of the photoinduced \n unidirectional \n rotation of the molecular motor starting from conformer i to conformer \n p * ( projected into one dimension ) : dotted arrow , ultrafast process \n reported in previous work ; fast ( red arrow ) and slow process ( blue \n arrow ) observed in the present time - resolved infrared study . ( a ) calculated \n energy profile along the torsion coordinate showing how the energies \n of the electronic states change as the molecules evolves to conformer \n p*. ( b ) schematic representation of the proposed model .", "vibrational cooling of these isomers leads to the sas of the final \n species , which is in excellent agreement with the steady - state ftir \n difference spectrum of room - temperature i and p*. the present \n experimental and theoretical data allow a complete \n picture of the mechanism by which the molecular rotary motor undergoes \n isomerization after electronic excitation ( figure 3 ) .", "the present data show that the s1 state actually decays to an intermediate , dark electronic \n state , and from there to the ground state . in the sas of the \n second species ( supplementary \n figure" ], [ "the results show that conversion of photon \n energy into directed motion proceeds on the potential energy surfaces \n of two different electronic states , which is the more important as \n it implies that the conical intersection between the dark \n electronically excited state and the ground state determines the efficiency \n of the motor . to rationally tune", "the performance of photoinitiated \n unidirectional rotation thus involves a multicoupled - state optimization \n of nuclear motion .", "the photodynamics \n of a unidirectional molecular motor has been \n studied by time - resolved ir spectroscopy in which both vibrational \n and electronic structures are probed . in combination with quantum \n mechanical calculations , the high structural sensitivity and real - time \n character of the technique allows us to understand fundamental aspects \n of the operation mechanism ." ] ]

[ [ "the objective of our study was to determine the impact of knee position and quadriceps contraction on patellofemoral indices measured on mri .", "the patellofemoral joint is one of the most common sources of knee pain in younger people .", "differences in the morphology of the patellofemoral joint have been shown to be associated with altered kinematics and patellofemoral instability29 ) .", "the position of the knee and its weight bearing status have been shown to influence patellofemoral kinematics and measurement of patellofemoral indices1215 ) ." ], [ "1 ) was determined by drawing a line connecting the posterior femoral condyles and a perpendicular line was then drawn through the deepest point of the trochlea groove to where it intersects the patellar width line . in cases where the trochlea was flattened ,", "the caton - deschamps index was defined as the ratio of the distance between the lower edge of the patellar joint surface and the upper edge of the tibial plateau to the length of the patellar articular surface ( fig .", "the bisect offset is defined as the proportion of the patella lying lateral to the midline as a percentage of the whole patellar width .", "the insall - salvati ratio was determined by comparing the length of the patellar tendon with the length of the patella .", "patellar tilt was defined as the angle between a line connecting the posterior femoral condyles and the maximum patellar width ( fig .", "bisect offset27 ) and patellar tilt angle28 ) were measured on axial mri images using the slice showing the widest view of the patella .", "the insall - salvati index and caton - deschamps index were measured on the sagittal view using the slice showing the widest view of the patella .", "the student t - test ( unpaired ) was used to compare the difference between these values in the various states of knee flexion and quadriceps contraction ." ], [ "the change in the insall - salvati ratio from the flexed , relaxed state to the extended , contracted state was 0.07 ( range , 0.17 to + 0.11 ) , which was not statistically significant ( p=0.97 ) .", "the mean values of the insall - salvati ratio were normal in all combinations of knee position and quadriceps contraction .", "all 20 patients were assessed with the knee in extension and flexion , with and without quadriceps contraction .", "the mean values of the patellar tilt , bisect offset , insall - salvati ratio and caton - deschamps index of the patients are detailed in table 1 .", "the mean patella tilt averaged 9 with the knee flexed and quadriceps in any state ." ], [ ", we aimed to assess the influence of knee position and quadriceps activity on frequently measured patellofemoral indices . in our cohort of patients", "mri evaluation of the knee forms an integral part of the investigation of young patients with knee pain .", ", none of whom had patellofemoral symptoms , an increase in the measured patellofemoral indices was observed with the knee extended and quadriceps contracted .", "this suggests that the flexed position protects against erroneous or exaggerated patellofemoral measurements caused by inadvertent quadriceps contraction as well as trochlea engagement .", "thus , it is important that potential confounders ( e.g. quadriceps contraction and knee extension ) are minimised in order to achieve more reliable measurements upon which surgical decision - making is based .", "patients undergoing mri scanning of the knee may be anxious and as a result involuntarily contract their quadriceps ." ], [ "patellofemoral indices measured on mri are affected by the position of the knee and quadriceps muscle activity . with the knee in extension and the quadriceps contracted , as may occur in an anxious patient , there was a tendency towards abnormal patellofemoral measurements in our cohort of asymptomatic patients .", "performing mri of the knee in 30 of flexion helps to reduce the confounding effect of quadriceps contraction and may result in more reliable radiological assessment of the patellofemoral joint ." ] ]

[ [ "the elastic fracture theory is a suitable tool to compute the mechanical behaviour in case of coatings , composites , and welded structures .", ", the interface of solid materials covers a sinusoidal surface layer due to a rotation of successive constraints in tensile and compression stress in the structure .", "a robust approach was proposed by yu et al . in order to formulate analytical solutions through the use of linear spring - like model . according to this theory we can define the type of contact between the surfaces by the fraction of the adherent area , applying the following formula : \n ( 5)=aacac , \n where is used to quantify the extent of bonding at the interface , a is the total area of the interface , and ac is the area covered by paper ( see example on figure 2 from ) . according to the study made by panin et al .", "the coating procedure developed and studied in this work refers to the hot - dip galvanizing treatment , considered as a better treatment to fight against corrosion ." ], [ "this paper addresses two goals : first of all , to experimentally characterize the layer of zinc applied during the hot - dip galvanization process , in order to obtain necessary information about the uniformity of the zinc layer and the number of cracks and their length , and finally to estimate the behaviour of the cracks located in zinc layer when the mechanical loading is imposed .", "secondly , we proposed to corroborate the experimental results with analytical and numerical computations , ascertaining where the crack discontinuities spread while considering the three main possibilities of crack development : arrest at the bimaterial interface , crossing into the second material , in our case steel , and finally creating a deflection between the two materials . in the literature" ], [ "the debonding area in steel - zinc adhesive layers is illustrated in figure 7 , created by the propagation of cracks at the interface between the zinc and steel and into the zinc substrates zeta ( ) and eta ( ) . for bimaterials , the interface crack problems could be due to the nonhomogeneity of the materials , which develop in the direction parallel to the crack tip . from these preliminary findings", "we could confirm that during the hdg process the zinc layer is uniformly deposited and the average number of cracks is significant on this layer .", "the optical measurements confirmed that the thickness deposited over the steel pieces was uniform and show that the zinc layer is composed of several multilayers .", "the specimens obtained after hot - dip galvanization were submitted in laboratory to fatigue tensile test in order to detect their behaviour under fatigue conditions conforming to real life and to observe the changes that occurred in the metallic zinc layer .", "this metal may develop problems that could be prevented by applying the above - described process of hot - dip galvanization ." ], [ "the principles of linear fracture mechanics ( lfm ) were implemented in the numerical model in order to explain behaviour of crack at the interface steel / zinc that is assuming that all the materials contain a minimum flow that will grow during the mechanical loading .", "numerical computational technique was implemented by abaqus software , in order to corroborate the experimental data with analytical and numerical simulations and to highlight the effects of cracks that develop during the hot - dip galvanizing process . in order to implement the experimental data in the numerical model ,", "it should be noted that in the numerical model a mechanical loading of 500 mpa corresponding to an average of ultimate tensile strength of galvanized materials ( see table 1 ) was imposed .", "however , we know that the crack is bounded by two fronts , a and b. in this model , we assumed that the front of crack b was static and so it could not propagate , whereas the only front of crack a would spread ." ], [ "the shape of the curve grows wide with the increasing of crack length in front of crack tip a. the effect of stress distribution in front of crack can be converted into basic parameters that show the impact of crack behaviour , that is , the stress concentration factor ( scf ) . obviously , the stress concentration factor is the ratio of the maximum stress over the nominal stress , denominated kt and expressed as \n ( 15)kt=maxnom. while the front of crack b does change , the main role in this research was played only by the front of crack a located near the interface of the bimaterial .", "the results are shown in figure 12 , demonstrating the trend of the ( crack ) stress intensity factors ( sif ) during applied stress , in front of cracks a and b. from the curves drawn below , it can be seen that the value of the sif increases with the crack length , and the crack propagates up to a length of about 50 m . then stabilization and even a decline of the sif value", "the motivation to implement a model with three cracks aims to detect whether the situation changed due to the increased ( crack ) stress intensity factor ( sif ) values , as a result of the cumulative energy developed by these 3 cracks .", "settlement of the crack propagates performance was evaluated using the stress intensity factor ( sif ) parameter , derived from the singularity 1/r advanced in front of the crack tip ." ], [ "the main objectives of this paper were to assess the behaviour of the crack / cracks generated at the end of the hot - dip process and to reveal that the numerical computations are in a good agreement with the experimental outcomes .", ", the results may confirm that cracks reduce the life span of the bimaterial but are not responsible for a direct degradation of the steel .", "this method is therefore useful for employment in damage models that include the safety factor condition .", "optical microscopy and scanning electron microscopy ( sem ) techniques were involved to evaluate the experimental performance of the bimaterials compound .", "the sif were calculated to obtain value of the stress singularity that characterizes the crack evolution in the bonding area of bimaterial , for both crack tip values , that is , the fronts of cracks a and b. the analytical , numerical , and experimental assessments prove that the crack / cracks that arise during the hot - dip galvanized steel process will propagate during the mechanical fatigue test .", "finally , a nondestructive method should be employed to detect the behaviour of bimaterials for a better calibration ." ] ]

[ [ "our results establish that targeting mir-134 offers broad anticonvulsant and possibly disease - modifying effects in experimental epilepsy , which may encourage pre - clinical development of ant-134 as a treatment for epilepsy .", "proof of seizure - suppressive effects of ant-134 in a non - status epilepticus model or in another species would bridge the gap in evidence and facilitate pre - clinical development of ant-134-based treatment for epilepsy.26 , 27 here , we evaluated mir-134 expression in the resected hippocampus from patients with pharmacoresistant tle and we tested ant-134 in three different models .", "finally , we used a high - potassium model of epileptiform activity , using ex vivo brain slices from rats pre - treated with ant-134 .", "we used the pentylenetetrazol ( ptz ) model in mice , a popular method for screening putative anticonvulsive effects that triggers seizures via -amino butyric acid ( gaba ) blockade.26 , 28 second , the perforant pathway stimulation ( pps ) model , a toxin - free model of acquired epilepsy based on nonconvulsive status epilepticus that avoids the confounding influence of exposing the brain to chemoconvulsants , was used in rats ." ], [ "this finding suggests that ant-134 can confer seizure resistance in naive tissue and thus mediate its effect even in the absence of epileptogenesis .", "in addition , preservation of the seizure resistance in isolated slices indicates that at least some of the effects of ant-134 are due to local changes in activity .", "for this , we analyzed levels of mir-134 in the surgically obtained hippocampus from adults with pharmacoresistant tle and we compared findings to autopsy hippocampal samples from people who died of causes unrelated to neurological disease .", "pre - treated with ant-134 , the severity of evoked seizures in the pps model was similar : eeg total power during seizures was a mean ( s.e.m ) of 1,244.6% 82.7% ( percent of baseline ) . despite not seeing an acute anticonvulsant effect of ant-134 in the pps model , we were nevertheless interested in whether silencing mir-134 after status epilepticus in the model would alter the emergence of recurrent spontaneous seizures . a key prior" ], [ "the therapeutic potential of targeting mir-134 in established epilepsy will require additional studies , but our findings may encourage further research or pre - clinical development of this mirna - based treatment for epilepsy . despite the recent introduction of two additional aeds ( perampanel and brivaracetam ) , new drug development in epilepsy", "ant-134 also confers resistance to epileptic activity in naive tissue , reflected as a delay to activity onset following a seizure challenge in ex vivo brain slices .", "our study shows that ant-134 is an anticonvulsant in an acute chemoconvulsant model ( ptz in mice ) and ant-134 had anti - epileptogenic activity in the perforant pathway stimulation model of epilepsy in rats .", "the present study provides important additional evidence of the anticonvulsant and disease - modifying effects of lna - based antagomirs targeting mir-134 in animal models of epilepsy .", "we also report that mir-134 levels are elevated in the hippocampus of patients with pharmacoresistant tle .", "the effectiveness of ant-134 and the potency of seizure suppression suggest a target for drug development in epilepsy that could provide additional effects beyond those provided by any currently marketed drug for epilepsy ." ], [ "rats were randomly divided in three cohorts to assess the following : ( 1 ) mir-134 expression after pps ( 24 hr , 4 days , and 14 days ) ; ( 2 ) the effect of ant-134 on pps - induced status epilepticus , in which rats were pre - treated with ant-134 or scr ( 0.36 nmol/6 l , i.c.v . ; exiqon a / s ) 24 hr before the 8-hr stimulation ; and ( 3 ) the effect of ant-134 on epileptogenesis , in which rats were injected with 0.36 nmol/6 l ( i.c.v . ) of ant-134 or scr ( exiqon a / s ) immediately after 8-hr stimulation .", "patients ( n = 12 ) were referred for surgical resection of the temporal lobe by an epileptologist ( n.d . ) following neurological assessment , video - eeg recording , and mri / neuroimaging . each patient was determined to have medically intractable tle with a history of recurring seizures ( table s2 ) .", "after recovery from surgery , mice were connected to the lead socket of a swivel commutator , which was connected to a grass twin digital eeg system .", "we injected ant-134 ( 0.12 nmol ) in 1 l te buffer ( life technologies ) at coordinates relative to the bregma : ap , 0.92 mm ; medial - lateral ( ml ) , + 1.3 mm , and dorsal - ventral ( dv ) , 3.3 mm to target the lateral ventricle . to allow the rats to fully recover from the analgesic drugs and to coincide with the maximal anti - epileptic effect seen in vivo", "mice were followed for 30 min or 4 hr after ptz administration for the appearance of seizures by electrographic and behavioral methods .", "] ) with different doses of ptz ( 60 , 80 , or 100 mg / kg ) . lorazepam ( 8 mg / kg , i.p . ) was administered after the first tonic - clonic seizure to reduce morbidity and mortality .", "lorazepam ( 8 mg / kg , i.p . ) was administered after the first tonic - clonic seizure to reduce morbidity and mortality ." ], [ "wrote the paper and all co - authors contributed to data interpretation , review , and editing of the final paper .", ", d.f.o . , and n.d . provided human samples and data ; c.r.r . , s.s ." ], [ "the royal college of surgeons in ireland filed for a patent on the inhibition of microrna-134 for the treatment of seizure - related disorders and other neurologic injuries ." ] ]

[ [ ", we sought to estimate the association between analgesic use and headache among adults in a large sample of the jordanian population in relation to age , gender and headache frequency .", "most of the recurrent headache cases are due to benign chronic primary headache disorders , such as tension headache and migraine .", "it is a common discomfort making to the top ten list of complaints in ambulatory medical care , but our understanding of the epidemiology of headache disorders is still incomplete .", "the study of headache epidemiology can address a number of important questions such as variation in the occurrence and severity of headache in the population , and the relationship between headache and other medical disorders .", ". chronic and inappropriate use of over - the - counter drugs such as analgesics , particularly nonsteroidal anti - inflammatory drugs ( nsaids ) , can lead to overuse syndromes and drug - induced headache [ 25 , 26 ] . in the present study", "in general , self - medicating for headache is highly prevalent and self - care is likely to increase in the era of health - care reform [ 22 , 23 ] ." ], [ "the questionnaire gathered information that included demographic data , frequency and type of headache , and its impact on everyday activities , analgesic use , consultation of a doctor or pharmacist on the use , increase or decrease in the frequency of headache after painkiller usage , increase or decrease in painkiller dose and family history of headache .", "the study was conducted in various regions of jordan during the period from january 2007 to november 2008 .", "for the small group of participants who were illiterate , the questionnaire was administered by the researcher in the form of an interview .", "retest reliability , 50 subjects were selected randomly ; they answered the questionnaire twice with a 1-week interval . test ", "data were aggregated into groups and only the authors and the investigator were allowed access to the collected data .", "the questionnaire was distributed , in person , by the researchers , and was completed in the presence of the researcher .", "each participant was provided with a full explanation of the study and how to complete the questionnaire ." ], [ "to estimate the prevalence of headache among adults in jordan , a sample of participants ( 4,836 participants ; mean age 27 0.4 years , and male : female ratio of 59:41 ) was allowed to complete a self - conducted screening questionnaire . as shown in table 1 , about half of the participants ( 49.2% ) were university students and 78.3% were jordanian citizens . moreover ,", "for both the 1829 and the 3039-year - old groups , the yearly prevalence of headache was found to be the same ( 82.8% ) , while it was 79.9 and 81.7% for the 4049 and older than 50-year - old groups , respectively . among the participants , 17.2% had daily headache attacks ,", "in addition , 13.1% of participants complained of increased headache severity or frequency on medication use ." ], [ "in this study , we report for the first time an overall 1-year period prevalence of headache among adults in jordan . a sample ( 4,836 ) of participants", ", headache is a major health problem in jordan , where 82.3% of participants experienced troublesome headache attacks at least once per year .", "analgesic overuse without seeking medical advice is regarded as potential for development of chronic headache .", "the higher prevalence of headache in jordan indicates that it is one of the major health problem ." ] ]

[ [ "she has remained disease - free for six years postoperatively , with regular coumadin anticoagulation therapy due to the presence of the prosthetic aortic and mitral valves .", "based on this finding , we diagnosed the patient with a pseudoaneurysm of the left ventricle , and surgical treatment was planned .", "ten years before this admission , the patient had undergone double valve replacement with aortic and mitral mechanical valves due to aortic regurgitation and mitral steno - insufficiency .", "the leak in the left ventricle was located in the sub - mitral valve prosthesis area ." ], [ "we performed a left lateral thoracotomy via the fifth intercostal space to approach the operative field directly and successfully repaired the sub - mitral lv pseudoaneurysm using a prosthetic patch .", ", we have reported a case of lv pseudoaneurysm that occurred as a late complication after mvr .", "a few cases of lv pseudoaneurysms have been previously reported ; however , no case reports have previously been presented of korean patients with an lv pseudoaneurysm following mvr who were treated with an operative technique employing a left lateral thoracotomy .", "the cause of lv pseudoaneurysm in our patient was a late - term complication of mvr ." ] ]

[ [ "posterior urethral valve ( puv ) is the most common cause of congenital bladder outlet obstruction in boys and causes renal failure in 25% to 30% of cases before adolescence .", "puv is associated with considerable morbidity , including urinary tract infection ( uti ) , chronic renal failure , urinary incontinence , and even death [ 1 - 3 ] .", "the diagnosis is made on average in 1 in 1,285 fetal ultrasound screenings . as a result of recent prenatal diagnosis , improvements in respiratory support and resuscitation at birth , and adequate management of end - stage renal disease ,", "the mortality rate in patients with puv has significantly decreased in the past four decades .", "endoscopic ablation of a puv is the current gold standard of therapy , but approximately 10% to 30% of patients require a second procedure to achieve satisfactory valve ablation [ 3,6 - 8 ] . as animal models have proven , even partial outlet obstruction can lead to structural and functional deterioration in the detrusor muscle and bladder if the obstruction is not released soon enough [ 9 - 11 ] , which indicates the need for close follow - up after valve ablation . although studies about prognostic factors for outcome of renal function after puv ablation are available [ 8,12 - 15 ] , to date , the effects of preoperative factors on the rate of residual valves have not been precisely addressed . in this study , therefore , we sought to evaluate any possible relationship between preoperative clinical and imaging findings of patients with puv and remnant leaflets after their valve ablation to identify high - risk patients and achieve purposive follow - up ." ], [ "we evaluated 64 patients with clinical evidence of puvs , confirmed by voiding cystourethrography ( vcug ) , who were admitted between 2008 and 2012 at the shiraz university of medical sciences .", "we evaluated age at surgery , history of uti , level of serum creatinine and blood urea nitrogen , specific gravity of urine , hemoglobin , presence of scarring in the dmsa scan , vesicoureteral reflux ( vur ) and grade of reflux , renal parenchymal thickness , echogenicity of kidney , bladder wall thickness , renal cortical thickness , anteroposterior diameter of the renal pelvis , diameter of the distal ureter , and hydroureteronephrosis and side between groups . for statistical analysis ,", "we performed cystoscopy in all patients at a follow - up session , at least 3 months after valve ablation ( range , 3 - 12 months ) .", "group a had no evidence of obstructive remnant leaflets and in group b a second ablation was done owing to obstructive residual leaflets .", "patients were divided into two groups on the basis of observation of obstructive residual leaflets in a second cystoscopy to analyze the possible preoperative factors that were related to obstructive remnant leaflets .", "the median patient age at the time of diagnosis was 10.0 months ( range , 5 days to 120 months ) ." ], [ "data on renal parenchymal thickness , bladder wall thickness , renal cortical thickness ( in the sagittal plane over a medullary pyramid , perpendicular to the capsule ) , hydroureteronephrosis and side of hydroureteronephrosis , anteroposterior diameter of the renal pelvis , and distal ureteral diameter demonstrated no influence on puv ablation outcome in our patients ( table 2 ) .", "our review of the ultrasound studies showed that the echogenicity of the renal parenchyma separated into normal echogenicity and hyperechogenicity , and echogenicity was higher in 94.4% of the preoperative ultrasounds of patients with residual leaflets ( p=0.000 ) .", "a pediatric resectoscope was used in 25 boys ( 67.6% ) in group a and in 11 boys ( 61.1% ) in group b , whereas in the other children a 3-fr ureteric catheter was applied . in both groups of patients , no significant statistical relationship was observed between method of ablation ( resectoscope versus urethral catheter method ) and remnant leaflets ( p=0.764 ) .", "sixteen patients had a dmsa scan and scarring was detected in all except one boy , with no significant predictive value for valve remnants ( p=1 ) . in vcug , vur and side and grade of reflux", "follow - up cystoscopy was performed at least 3 months ( range , 3 - 12 months ) after primary valve ablation in 55 boys with a 6.75-f pediatric cystoscope ( richard wolf gmbh , knittlingen , germany ) .", "a total of 37 patients ( 67.3% ) had no significant remnant leaflets ( group a ) , whereas 18 boys ( 32.7% ) required a second ablation as a result of valve remnants .", "significant differences were shown in the presence of vur and grade 4 or 5 reflux ( p<0.05 ) ." ], [ "most previous studies have focused on prognostic clinical and imaging factors in relation to the long - term outcome of renal function . to our knowledge , this is the first study to compare preoperative factors regarding the presence of postoperative obstructive leaflets . although endoscopic primary valve ablation is the preferred initial surgical treatment in most patients with puvs , the absence of obstructive residual valve remnants should be confirmed by careful clinical , radiological , and endoscopic evaluation after surgery .", "the presence of vur and hyperechogenicity of the kidney can affect the long - term prognosis of renal function and should be considered in the management of patients with puv .", ", it seems that more research is inevitable to facilitate proper screening and the detection of patients with residual leaflets .", "the results of such research can help to provide a better algorithm for management of puvs and achieve purposive follow - up for high - risk patients instead of invasive procedures ." ], [ "younger age at surgery time , hyperechogenicity of the renal parenchyma , presence of vur , and grade of reflux before surgery in our patients had a significant relationship with residual valves , but more research is needed to confirm these results .", "more studies may result in enhanced management of patients at high risk of residual valves after puv ablation , because the sooner the obstruction is entirely resolved , the better the long - term outcome ." ] ]

[ [ "the objective of this study was to determine whether calculus , hypocalcification , and stain are confounding factors affecting wsl detection with optical coherence tomography and polarized raman spectroscopy .", "clearly , a new technology is needed that will not be affected by factors in the oral environment . a new optical approach to detect white spot lesions clinically is jointly being developed at the national research council of canada - institute for biodiagnostics , the university of manitoba and dalhousie university , using a combination of optical coherence tomography ( oct ) and polarized raman spectroscopy ( prs ) .", "prs is a noninvasive spectroscopic method that provides details on the biochemistry and molecular structure of white spot lesions .", "new technologies such as the diagnodent and quantitative light fluorescence ( qlf ) devices have been developed for the detection of early carious lesions ." ], [ "samples were separated into 5 groups : sound enamel , wsls , calculus , hypocalcification , and stained enamel .", "postextraction , the teeth were rinsed with water and clinically examined by two clinicians independently .", "figure 3(a ) displays a photo of a tooth being scanned with the oct system ( laser scan line circled ) with the corresponding 2-dimensional depth image of sound enamel ( figure 3(b ) ) .", "three scans were collected across the area of interest with the proximal surface of interest oriented perpendicular to the laser beam .", "three vertical scans were also taken of sound enamel on the same tooth surface for comparison .", "the laser was focused to the thinnest line on the tooth surface and the scan length was 2.0 mm ." ], [ "sound enamel was not statistically significant from hypocalcified enamel , carious enamel was not statistically significant from stained enamel , and lastly stained enamel was not statistically significant from hypocalcified enamel . in raman spectra acquired from areas of stain ( figure 6 ) , there is a large background sloping fluorescence that is not observed in spectra from areas of sound enamel or wsls without stain where these spectra have a flat background .", "average raman depolarization ratios ( ) from the various groups are depicted in a box - and - whisker plot ( figure 5 ) . in order to determine whether the mean depolarization ratio values of the various groups were statistically significant from one another ,", "in contrast , the oct image of a wsl shows significant light backscattering beneath the surface with a triangular shape characteristic of a subsurface lesion as observed on histological sections . the two - dimensional oct image displayed as figure 4(b ) shows a deposit of material on the tooth surface that is attributed to calculus .", "it was determined that the mean values were statistically significant in all cases at p < .05 except for three cases .", "a one - way analysis of variance ( anova ) followed by unequal n hsd post - hoc comparisons ( statistica ) was performed ( table 1 ) ." ], [ "the combination of oct and prs technologies can decrease the risk of false - positive reading and increase the potential for the detection of wsls with high sensitivity and specificity .", "in addition to demonstrating the performance of these methods for providing high sensitivity for wsl detection , high specificity is also desirable . optical coherence tomography and polarized raman spectroscopy are methods that potentially can address the need for a technology with high sensitivity and high specificity . to date there are no studies outside our research group that investigate a combination of oct and prs to detect wsls , and in particular the effects of the calculus , stain , or hypocalcification on the utility of these two technologies .", "stain does not influence wsl detection with oct . with improved analysis methods , the current limitations with prs analysis in the presence of stain", "similar to conventional caries assessment methods , scaling of calculus is recommended before an assessment is made using oct and prs .", "this initial study has pointed out limitations that should be taken into consideration when using these methods and highlighted further analyses that need to be undertaken to better understand the effects of calculus , hypocalcification , and stain on oct and prs technologies ." ] ]

[ [ "the histologic characteristics of i - hca are presence of inflammatory infiltrate , marked sinusoidal dilatation , and thick - walled arteries.8 steatosis may be present in patients with i - hca but is not as extensive as that in patients with h - hca.8 diffuse or focal cytoplasmic immunostaining for saa was interpreted as a positive result .", "the histological characteristics of the tumors were evaluated with emphasis on steatosis , sinusoidal dilatation , inflammatory infiltrate , cytological atypia , acinar growth pattern , telangiectasia , and peliosis .", "each case was categorized based on combined clinical , histologic , and immunohistochemical parameters . the histologic characteristics of h - hca are marked steatosis and an absence of cytological abnormalities and inflammatory infiltrate.6,7,13 this subtype shows negative staining for l - fabp because hnf1 positively regulates fabp1 in normal liver tissue .", "the histological characteristics of -hcas are nuclear atypia , an acinar ( pseudoglandular ) growth pattern , and lack of steatosis.6 -catenin and gs immunostaining was used to detect -hcas.12,13 diffuse or focal cytoplasmic gs staining was interpreted as a positive result .", "characteristic -hca histologic characteristics and positive gs and/or -catenin immunostaining results were indicators of -hca .", "hcas without genetic changes in hnf1 or -catenin and without protein expression of the previously mentioned markers are categorized into this group.8 hcas with complete or near - complete necrosis can also be classified in this group.13" ], [ "the histological characteristics of the tumors were evaluated with emphasis on steatosis , sinusoidal dilatation , inflammatory infiltrate , cytological atypia , acinar growth pattern , telangiectasia , and peliosis . the percentage of steatotic area was recorded .", "histological parameters were recorded as negative if less than 10% of the tumor showed the corresponding morphology .", "hematoxylin and eosin - stained slides of each case were reviewed independently by two authors ( h.k ." ], [ "focal cytoplasmic staining in the perivenular area of normal hepatic parenchyma served as a positive control for gs immunostaining .", "cytoplasmic staining of normal hepatic parenchyma served as a positive control for l - fabp immunostaining .", "diffuse cytoplasmic granular staining with or without membranous staining was recorded as a positive saa immunostaining result .", "immunohistochemical stainings was performed using the following antibodies : l - fabp ( 1:50 , rabbit polyclonal ) from abcam ( cambridge , ma , usa ) ; -catenin ( 1:50 , mouse monoclonal ) , saa ( 1:50 , mouse monoclonal ) , and glutamine synthetase ( gs ; 1:200 , mouse monoclonal ) from bd biosciences ( san diego , ca , usa ) ; cd3 ( 1:100 , mouse monoclonal ) , cd20 ( 1:100 , mouse monoclonal ) , p53 ( 1:50 , mouse monoclonal ) and ki-67 ( 1:50 , mouse monoclonal ) from dako ( carpentaria , ca , usa ) ; and glypican3 ( 1:50 , mouse monoclonal ) from cell marque ( rocklin , ca , usa ) ." ], [ "the recent hca classification system proposed by the bordeaux group was used.8 the histologic and immunohistochemical characteristics for each subtype are described below .", "the histologic characteristics of i - hca are presence of inflammatory infiltrate , marked sinusoidal dilatation , and thick - walled arteries.8 steatosis may be present in patients with i - hca but is not as extensive as that in patients with h - hca.8 diffuse or focal cytoplasmic immunostaining for saa was interpreted as a positive result .", "the histologic characteristics of h - hca are marked steatosis and an absence of cytological abnormalities and inflammatory infiltrate.6,7,13 this subtype shows negative staining for l - fabp because hnf1 positively regulates fabp1 in normal liver tissue .", "characteristic -hca histologic characteristics and positive gs and/or -catenin immunostaining results were indicators of -hca .", "the histological characteristics of -hcas are nuclear atypia , an acinar ( pseudoglandular ) growth pattern , and lack of steatosis.6 -catenin and gs immunostaining was used to detect -hcas.12,13 diffuse or focal cytoplasmic gs staining was interpreted as a positive result ." ], [ "the histologic characteristics of h - hca are marked steatosis and an absence of cytological abnormalities and inflammatory infiltrate.6,7,13 this subtype shows negative staining for l - fabp because hnf1 positively regulates fabp1 in normal liver tissue .", "the presence of steatosis and negative l - fabp immunostaining were indicators of h - hca .", "diffuse or focal cytoplasmic staining was interpreted as a positive result for l - fabp immunostaining ." ], [ "the histological characteristics of -hcas are nuclear atypia , an acinar ( pseudoglandular ) growth pattern , and lack of steatosis.6 -catenin and gs immunostaining was used to detect -hcas.12,13 diffuse or focal cytoplasmic gs staining was interpreted as a positive result . diffuse or focal nuclear -catenin immunostaining was interpreted as a positive result , whereas cytoplasmic -catenin immunostaining was recorded as aberrant expression .", "characteristic -hca histologic characteristics and positive gs and/or -catenin immunostaining results were indicators of -hca ." ], [ "the histologic characteristics of i - hca are presence of inflammatory infiltrate , marked sinusoidal dilatation , and thick - walled arteries.8 steatosis may be present in patients with i - hca but is not as extensive as that in patients with h - hca.8 diffuse or focal cytoplasmic immunostaining for saa was interpreted as a positive result ." ], [ "hcas without genetic changes in hnf1 or -catenin and without protein expression of the previously mentioned markers are categorized into this group.8 hcas with complete or near - complete necrosis can also be classified in this group.13" ], [ "there were three cases of h - hca , four cases of i - hca , and one cases of -hca .", "this case was classified as -hca because all morphologic and immunohistochemical findings were in agreement with known characteristics of -hca except for the -catenin immunostaining result .", "all eight cases were determined to belong to the above subtypes therefore none were categorized as an unclassified hca .", "this was confirmed by negativity for glypican 3 and p53 immunostaining and a ki-67 index < 1% in all eight cases . three cases ( a , b , and c ) were classified as h - hca .", "glutamine synthetase immunostaining , should be negative in i - hca , was positive in cases e and f. cases d ( fig .", "cases a ( fig . 1 ) and b were in accordance with the known characters of h - hca , but case c was not fully concordant and shared some characteristics with i - hca . four cases ( d , e , f , and g ) were categorized as i - hca . three were male and one was female ." ], [ "morphologically , cases a and b revealed marked steatosis of 30 - 40% and 20% , respectively , and did not show most of the characteristic histologic features of the other subtypes , such as sinusoidal dilatation , inflammatory infiltrate , cytological atypia , acinar pattern , thick - walled arteries , or peliosis ( table 2 ) .", "three cases ( a , b , and c ) were classified as h - hca .", ". there was faint l - fabp staining in the tumoral area , but it was interpreted as negative because the staining intensity was very weak and identical to the non - specific staining of blood vessels . based on these findings , these three cases were classified as h - hca .", "cases a ( fig . 1 ) and b were in accordance with the known characters of h - hca , but case c was not fully concordant and shared some characteristics with i - hca .", "case c did not show steatosis but presented with thick - walled arteries and cytological atypia ." ], [ "although these three cases had a negative history of alcohol consumption , cases d and g had high bmis ( 27.8 kg / m and 25.9 kg / m , respectively ) .", "all three cases had morphological characteristics typical of i - hca , including marked sinusoidal dilation , presence of inflammatory infiltrates , and thick - walled arteries ( table 2 ) .", "four cases ( d , e , f , and g ) were categorized as i - hca . three were male and one was female .", "glutamine synthetase immunostaining , should be negative in i - hca , was positive in cases e and f. cases d ( fig .", "in all four cases l - fabp immunostaining was negative and saa immunostaining was positive ( table 3 ) ." ], [ "this case was classified as -hca because all morphologic and immunohistochemical findings were in agreement with known characteristics of -hca except for the -catenin immunostaining result .", "satining the tumor cells were positive for l - fabp and glutamine synthetase ( fig .", "morphologic analysis showed lack of steatosis and inflammatory infiltrate , but the presence of an acinar pattern with cytological atypia ( table 2 , fig .", "however , -catenin immunostaining showed an aberrant pattern of diffuse cytoplasmic staining and was interpreted as negative because there was no nuclear staining ( fig ." ], [ "all eight cases were determined to belong to the above subtypes therefore none were categorized as an unclassified hca ." ], [ "the hca subtype classification based on genetic and phenotypic characteristics provides new insight into the pathological and radiological diagnosis and clinical management of these tumors .", "the diagnostic and clinical implications of the new classification scheme may need to be validated by other studies .", "the incidence of hca in korea is very low and only a few cases of hca have been reported in korea during the past 25 years.19 the recent hca classification was established based on previous studies of genetic and phenotypic characteristics of hca and hepatic nodular hyperplasia.9,10,15,17,18,20 pathologically , the subtype classification enables an accurate diagnosis of this rare entity even with a small biopsy specimen.8,21 l - fabp immunohistochemistry is especially helpful in the identification of h - hca because hnf1 positively regulates fabp1 in normal liver tissue .", "overall , our results both support and contradict other reports on hca . in conclusion ," ] ]

[ [ "this article aims to review the use of pet imaging to promote the understanding of activated microglia in neurodegenerative disease .", "microglia account for approximately 10% of the adult brain cell population and represent the first and main form of immune defense in the central nervous system ( cns ; lawson et al .", "hence , the acute inflammatory response is generally beneficial , as it tends to minimize injury and promotes tissue repair .", "however , chronic neuroinflammation is closely related to various neurodegenerative disorders such as parkinson s disease ( pd ) , huntington s disease ( hd ) , dementias , and multiple sclerosis ( ms ) , although the consequences of sustained microglial activation in these diseases is unclear ." ], [ "parkinson s disease is the second most common neurodegenerative disorder of the elderly and is associated with the motor symptoms of tremor , bradykinesia , and rigidity .", "pd is the most common of a group of parkinsonian movement disorders that also includes multiple system atrophy ( msa ) , corticobasal degeneration ( cbd ) , and progressive supranuclear palsy ( psp ) .", "bpnd , binding potential ; cbd , corticobasal degeneration ; msa , multiple system atrophy ; nc , normal control ; pd , parkinson s disease ; psp , progressive supranuclear palsy .", "these findings suggest that activated microglia has a pathogenic importance in the disease and indicate that the early introduction of a neuroprotective drug to suppress microglial activation could be favorable in pd . additionally , pd patients exhibited significantly increased c - pk11195 bpnd in the basal ganglia , pons , and frontal and temporal cortical regions ( gerhard et al . , 2006a ) .", "progressive supranuclear palsy is an adult - onset progressive neurodegenerative disease of unknown cause , characterized by pd - like symptoms such as postural instability and bradykinesia .", "corticobasal degeneration is a neurodegenerative disorder that affects both cortical and basal ganglial regions , with considerable clinical heterogeneity between patients ." ], [ "huntington s disease is an autosomal , dominant inherited progressive neurodegenerative disorder associated with motor , cognitive , and psychiatric symptoms .", "these results imply that microglial activation is an early event in the hd disease course , with a possible pathogenic involvement that is associated with a subclinical progression of the disease .", "although the role of chronic neuroinflammation in the hd pathogenesis is not fully understood , post - mortem assessments have reported high levels of activated microglia close to degenerating neurons ( mcgeer et al .", "it is caused by an abnormal polyglutamine - repeat expansion on the it15 gene that codes huntingtin , and involves the progressive loss of medium spiny dopaminergic receptor - bearing striatal gaba - ergic neurons ( vonsattel and difiglia , 1998 ) ." ], [ "ad is the most common cause of dementia and is the most common neurological disorder of the elderly .", "ad is characterized by the presence of amyloid plaques , neurofibrillary tangles , and activated microglia ( for review , see hardy and selkoe , 2002 ) .", ", 1999 ; leung et al . , 2011 ) reporting a high accumulation of activated microglia in close proximity with the amyloid plaques , and upregulated levels of pro - inflammatory cytokines ( akiyama et al . , 2000 ; eikelenboom et al . ,", "it has been shown that in the presence of pro - inflammatory cytokines , phagocytic functions of microglia are compromised ( koenigsknecht - talboo and landreth , 2005 ) ." ], [ "multiple sclerosis is a disease characterized pathologically by inflammatory demyelination and axonal transection , and is the most common cause of non - traumatic disability in young adults ( compston and coles , 2008 ) .", "2002 ) , while histopathological studies have implicated microglia in lesion pathogenesis ( for review , see lassmann , 2008 ) .", "the involvement of activated microglia has long been proposed in ms ( benveniste , 1997 ) .", "pathological aspects of ms such as neuroinflammation , demyelination , and neurodegeneration may be explored in vivo with pet ( for review , see kiferle et al . , 2011 ) ." ], [ "for these reasons , we aim to characterize a second generation tspo pet radioligand in vivo in humans , and to evaluate its application as a disease biomarker in ms . among second generation tspo tracers ,", "c - pk11195 was the first tracer to be consistently used for the study of activated microglia and neuroinflammation in vivo .", "promising preclinical data , and ongoing studies in neurological patients , suggest it could be a good choice amongst second generation tspo ligands to progress into studies in ms patients .", "this has prompted the search for novel pet tracers ( termed , second generation radioligands ) with improved capacities to quantify tspo expression .", "although , data obtained from first generation studies have been promising and suggested that c - pk11195 could be useful to image acute inflammatory lesions and microglial activation in ms , a conclusive demonstration of the potential of tspo imaging for the application as disease biomarker , indicative of microglial activation in ms , is still lacking ." ], [ "furthermore , with the development of newer tspo tracers , the potential for pet imaging research to promote our understanding of activated microglia in cns disease can only increase .", "therefore , the early detection of microglia using pet could offer opportunities for pharmacological interventions to limit the potential disruptive effects of chronic microglial activation .", "inflammation coupled with the presence of activated microglia seems to be a common feature of a wide range of cns diseases .", "however , despite a large number of research studies , the exact role of microglia in chronic neurodegenerative diseases remains uncertain . in line with the high plasticity of microglia that allows them to perform numerous cns functions , microglia are likely to play a dichromatic role in disease , depending on signals present in their microenvironment and the duration of activation . while early microglial activation could represents a beneficial response ( i.e. , removal of cns threat , promoting tissue repair and removal of misfolded protein ) , chronic exposure could induces detrimental effects by promoting neuronal death ( i.e. , through the sustained release of neurotoxic factors ) , thus , contributing to progression of disease . pet imaging with the use of tspo radioligands", "provides a valuable tool that allows us to track the progression and severity of neuroinflammation in the living brain , and is a useful indicator of active cns disease ." ], [ "the authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest ." ] ]

[ [ "to this aim we evaluated also conventional arthritic parameters ( hpv , arthritic score , body weight change , and weight of the liver ) along with changes in plasmatic levels of il-1 and crp and the activity of 12/15-lox in the liver .", "yet application of a combination therapy of mtx with other potential immunomodulators , synthetic drugs or natural substances [ 3032 ] , might elevate the therapeutic efficacy : decrease the dose of mtx and thus its side effects . in our previous study , we showed that administration of n - f-5ht to mtx - treated arthritic rats lowered the dose of mtx for the required sustained antirheumatic impact . in this study , we focused on the therapeutic impact of n - f-5ht and mtx administered in monotherapy and on details of the inflammatory state in the arthritic rat liver with the aim to elucidate the molecular mechanisms of their effect .", "rheumatoid arthritis ( ra ) is a chronic systemic inflammatory disease affecting predominantly joints , synovial membranes , articular cartilages , and subchondral bones .", "it is a useful tool to study immunopathologic processes , autoimmune chronic inflammation , and inflammatory cachexia in rodents .", "numerous studies reported natural polyphenols as potential therapeutic agents of diseases caused by os and inflammation [ 1517 ] .", "methotrexate ( mtx ) , used as a standard drug in our study , represents the most frequently used pharmacotherapy of ra in clinical practice ." ], [ "the fourth group comprised adjuvant arthritis rats treated with n - feruloylserotonin dissolved in suspension of methylcellulose tween 80 at a dose of 3 mg / kg / day orally ( aa - n - f-5ht ) .", "drugs were administered orally by gastric gavage from day 0 ( the day of treatment ) to day 28 of the study .", "the third group comprised adjuvant arthritis rats treated with methotrexate ( methotrexat ebewe sol inj 20 mg/2.0 ml ) in oral dose of 0.4 mg / kg twice a week ( aa - mtx ) . \n", "concentration of proteins in liver homogenates was determined by using the bradford method and expressed in mg / ml of enzyme preparation ( cytosolic fraction from rat lung and liver tissues ) .", "linoleic acid ( 99% , sigma - aldrich , usa ) was used as a substrate prepared in solubilized state as described in the concentration of 0.2143 100.7143 10 m. the assay of lox was monitored for 60 seconds as an increase in the absorbance at 234 nm , reflecting the formation of hydroperoxylinoleic acid . for the lox activity assay ,", "rat cytokine present in the samples binds to anti - rat cytokine antibodies absorbed in the microwells .", "the reaction of secondary biotin - conjugated anti - rat cytokine antibody is evaluated by hrp ." ], [ "the enhanced influence of mtx and n - f-5ht on il-1 transcription in the spleen in comparison to the liver may be the consequence of different predominance of inflammatory pathways in this organ , presumably with a stronger nf-b contribution .", "nevertheless , the n - f-5ht impact on chronic inflammatory and os - inducing arthritis , which could widen the possibilities of the ra therapy , remains to be elucidated . in our previous study in the model of aa , n - f-5ht in the dosage of 15 mg / kg markedly potentiated the therapeutic effect of low - dose ( nontherapeutic dose ) mtx ( 0.3 mg / kg ) on arthritic ( hind paw volume and arthritic score ) and inflammatory parameters ( il-17 , mcp-1 , and crp ) , yet it resulted in insignificant effect in monotherapy . as data about the optimal n - f-5ht dose in the rat model", "details about the relevance of these pathways and the role of n - f-5ht in the transcription regulation of il-1 , inos , and tnf- in the liver and other organs in ra are to be further elucidated .", "antioxidant properties of polyphenols including n - f-5ht have been reported [ 21 , 40 , 41 ] .", "interestingly , combination therapy ( mtx + n - f-5ht ) potentiated the effect of a single drug , suggesting different mechanisms leading to nf-b inhibition .", "blocking tnf- with anti - tnf- monoclonal antibodies significantly decreased the signs and symptoms of ra compared to placebo in ra patients with active disease receiving mtx [ 65 , 66 ] ." ], [ "the present study contributed additional evidence about the beneficial effect and mechanism of action of n - f-5ht and of mtx on a systemic inflammatory process in the liver and its association with the pathogenesis of adjuvant arthritis .", "the confirmation would support n - f-5ht as a promising agent for the treatment of ra in combination therapy with mtx .", "a synergistic effect of tnf- and il-1 was shown to influence the balance between protein degradation and protein synthesis causing among others an increase in resting energy expenditure and net efflux of amino acids from muscle to liver ." ] ]

[ [ "they advised future studies to investigate the direct relationship between psychological health problems and internet dependency ( 8) . in this study we tried to investigate the prevalence of internet , computer games , and dvd and video addiction among high school students in southern iran , shiraz , and its relation to depression and anxiety", "some studies revealed a significant association between internet addiction and depressive symptoms in adolescents and high school students .", "many investigations suggest the necessity of the evaluation of the potential underlying depression in the treatment of internet - addicted adolescents ( 6 ) . moreover , the level of internet addiction correlated positively with the level of depression and suicidal ideation among high school students . based upon several studies ,", "previous studies about internet addiction have investigated several associated psychological variables such as shyness , loneliness , self - consciousness , anxiety , depression , and interpersonal relations ( 5 ) .", "although studies on the effects of children s use of computers are still undetermined , some initial studies showed positive and negative effects in this regard ." ], [ "during the years 2008 and 2009 and in a cross - sectional study 1020 high school students ( males and females ) were selected randomly by area and cluster sampling from different areas of shiraz in southern iran .", "demographic data ( age , sex , and economic status according to income of the family ) , duration of internet usage , computer games playing , tv and satellite watching , dvd and video cd usage , and the reasons of the usages were asked at the interviews . ", "mild depression : decreased mood , presence of anxiety symptoms , and increased symptoms in the afternoon , without suicidal idea . \n moderate depression : decreased activity , depressed mood , agitation , decreased energy , and decreased concentration , sense of guilt , hypochondriacs , sleep disturbance , depersonalization symptoms , decreased appetite , and decreased sexual activities . \n", "the students were interviewed for addiction , generalized anxiety disorder , and major depressive disorder according to the dsm - iv criteria . \n", "dependent : dysfunctional , and withdrawal symptoms ( restlessness , anxiety , decreased concentration , insomnia , irritability , fatigue , and craving ) after discontinuing . \n" ], [ "students who watched tv or satellite for film , football , and music had lower levels of anxiety ( p < 0.05 ) . students who watched tv or satellite for film and football had lower levels of depression ( p < 0.05 ) .", "the prevalence of anxiety and depression were significantly higher in students who were computer games abusers or dependents ( p < 0.05 ) .", "the prevalence of anxiety and depression was significantly lower in students of the third year compared to other grades ( p < 0.05 ) .", "prevalence of anxiety and depression were significantly higher in females ( p < 0.05 ) .", "the prevalence of anxiety was significantly higher in students who were dvd or video cd dependents(p < 0.05 ) .", "the prevalence of depression was significantly higher in students with lower economic status ( p < 0.05 ) ." ], [ "the rate of internet , computer games , and dvd addiction in our study were significantly lower than reports from other parts of the world .", "the prevalence of anxiety was significantly higher in the students who used internet for chat , amusement , and news .", "the prevalence of anxiety was significantly higher in students who did not use the internet .", "similar to other studies , the prevalence of anxiety and depression was significantly higher in students who were computer game abusers or dependents , although it did not have any relation with the reason of playing of the computer games . ", "the behaviors related to internet addiction may be a symptom of depressive disorders in adolescents ( 9 - 11 ) .", "they added that the behaviors related to internet addiction may be a symptom of depressive disorders in adolescents . " ], [ "it is a very complicated problem and it is difficult to state whether it is more accurate to treat the problem totally as an addiction or not ( 15 - 17 ) . in summary , it can be concluded that the results presented in this study are for the most part in accordance with those of other authors and other studies on this subject .", "while internet addiction is a new phenomenon , it has already become a subject of numerous studies . on the other hand ,", "some differences could be the result of different conditions , instruments , and differences in the number and structure of the studied group ." ], [ "ja conceived and designed the evaluation and helped to draft the manuscript and its revision and re - evaluated the clinical data .", "agh participated in conceiving and designing the evaluation and helped to draft the manuscript and re - evaluated the clinical data .", "aa participated in the evaluation and collection of the clinical data , and helped to draft the manuscript .", "mkh , zkh , and zgh participated in the evaluation and collected the clinical data ." ], [ ". prevalence of addiction to the internet , computer games , dvd and video and its relationship to anxiety and depression in a sample of iranian high school students .", "\n declaration of interest : none . \n citation : ahmadi j , amiri a , ghanizadeh a , khademalhosseini m , khademalhosseini z , gholami z , et al" ] ]

[ [ "the samples are from a cohort of 16 pregnant women , with each subject sampled a median of 18 times . because this represents a significant increase in the number of tests per subject compared to previous studies", ", we applied the multiplex array approach to evaluate the changes in 42 cytokines in rich detail during pregnancy .", ", we also describe a strategy addressing within - subject correlation with repeated measurements using unconditional growth modeling . with this approach", ", we have been able to detail the typical longitudinal variation of serum cytokines throughout pregnancy in this cohort of women .", "others have used multiplex arrays to study the maternal cytokine milieu , but the studies have been predominantly limited time point cross - sectional [ 68 ] or case - control [ 911 ] in design .", "one approach to such immune profiling is through the use of multiplex cytokine arrays , allowing for simultaneous quantification of many proteins with a very small amount of plasma or serum .", "the normal maternal immune response to pregnancy is increasingly recognized as a dynamic process , with changes in the maternal pro / anti - inflammatory profile occurring at different stages of gestation [ 13 ] . despite this recognition , a complete , longitudinal immunologic profile of normal", "the results of some longitudinal studies have been published in recent years , although results have been based on relatively few time points ( 5 or fewer ) [ 13 ] . in this study" ], [ "most cytokines are stable in storage at 80 degrees c for up to 2 years , but stability beyond that time is not well known . therefore , before proceeding with studies on the samples of interest , we first tested protein levels of a small number of individually stored serum aliquots from other subjects archived on this protocol . since we found detectable levels of cytokines in the pregnant serum samples that were within range of control samples , we proceeded with the entire study involving a cohort of 16 healthy , primigravid women who completed a term pregnancy without any significant complications .", "each participant had a serum sample collected and cryopreserved biweekly from study enrollment during the first trimester ( average of 9.7 weeks ' gestation for first samples ) until 34 weeks ' gestation , then weekly from 34 weeks until delivery .", "comparison of baseline ( first trimester ) and end of pregnancy levels of cytokines / growth factors was carried out between the 16 primigravid subjects and the 11 nonpregnant control subjects using the kruskal - wallis tests .", "we only used samples from subjects who had specimens obtained throughout the entire course of pregnancy and whose complete , longitudinally collected specimens appeared intact and nondesiccated .", "as a result of this repeated sampling , a median of 18 samples per participant were obtained longitudinally throughout pregnancy ." ], [ ", we found that the linear trimester helps to explain 27% of the within - subject variation in il-1ra .", ", approximately 50% of cytokines measured by multiplex array did not show any association with gestational week or trimester .", "when comparing the estimated within - subject variance of the ugm with that from the umm , we found that the linear gestational age in weeks helps to explain 34% of the within - subject variation in mdc .", "il-1ra showed the greatest percent explanation by inclusion of linear trimester in the model . when comparing the estimated within - subject variance of the umm with that from the ugm", "differences in cytokine profiles between baseline ( first trimester ) pregnancy samples and nonpregnant control samples could be identified by pca ( figure 1 ) ." ], [ "our results suggest that the third trimester of pregnancy is characterized by an increasingly inflammatory ( e.g. , il-1 , il-6 , il-12 , il-15 , ip-10 , and scd40 ligand ) as well as counterregulatory ( e.g. , il-1ra and flt3-ligand ) milieu compared to earlier stages of pregnancy .", "tolerance at the fetomaternal interface is complex and technically challenging to study in humans longitudinally . as a result , many recent studies have sought to understand how pregnancy changes maternal systemic immunity .", "although not the original focus of this study , we also identified several differences in cytokine / growth factor milieu when comparing pregnant women to healthy controls .", "a novel finding of this study is the decline in mdc levels throughout pregnancy ( figure 5 ) ." ], [ ", it seems that the description of pregnancy in terms of type 2 immune responses may be oversimplified , both in the overall description of key cytokines / growth factors as well as in the temporal dynamics , and it is in need of further refinement .", "successful pregnancy has previously been described as predominantly a type 2 immune response - biased phenomenon [ 3436 ] . in light of the collective evidence" ] ]

[ [ "however , data supporting this hypothesis remain controversial \n . clinical features of this disease include the following nonspecific symptoms : cough , dyspnea , erythema nodosum , febrile arthritis , uveitis , and parotitis", "sarcoidosis - related granulomatous reaction of the immune system could be attributed to environmental factors .", "the diagnosis is established on the basis of compatible clinical and radiological findings and supported by histological evidence in one or more organs of noncaseating epithelioid cell granulomas in the absence of organisms or particles \n .", ", we report a case of non - luminal her-2/neu - positive breast cancer in a patient without history of sarcoidosis and initially suspected to have metastatic disease . \n", "the correlation between sarcoidosis and malignancy remains unclear , despite that this topic has been increasingly investigated . in this article", "sarcoidosis commonly targets hilar and mediastinal lymph nodes , which are found in more than 90% of the patients \n ." ], [ "this article , the patient had been undergoing radiation therapy and directed to immunologist for sarcoidosis management and follow - up . \n mammography scan demonstrating a 19 mm 18 mm mass on the border of the inner quadrants of the left breast ( white arrow ) . ( a ) craniocaudal .", "histological examination of the obtained material revealed no cancer but multiple epithelioid cell granulomas . based on these results , lumpectomy with urgent histology of resection margins", "excisional biopsy of the left supraclavicular lymph node was performed to verify the diagnosis and differentiate the nature of the lesion .", "the molecular type of breast cancer was identified as non - luminal her-2/neu - positive through immunohistochemistry ." ], [ "this study reports a case of non - luminal her-2/neu - positive breast cancer in a patient presenting non - caseating epithelioid cell granulomas of sarcoidosis after treatment and initially suspected to have metastatic disease .", "this case report emphasizes the importance of differential diagnosis of lymph node involvement in cancer patients .", "furthermore , the present case report highlights the importance of histological determination in lymph nodes for distinguishing metastasis from sarcoidosis .", "a very recent retrospective study described the clinical biological and radiological characteristics of 12 patients presenting sarcoidosis associated with solid tumor ; sarcoidosis frequently affects patients with breast cancer ( 32.3% ) and thus must be considered in the differential diagnosis of the disease \n . in the current study , a review of literature is also presented and included 61 other patients showing similar association between cancer and sarcoidosis . \n ", "blank et al . \n defined breast cancer , cervical cancer , and b - cell lymphoma as the most common malignancies in patients with sarcoidosis . \n ", "although several epidemiological studies reported the association between cancer and sarcoidosis , further studies , including case reports , may represent an opportunity to obtain additional biological and clinical information to clarify the mechanisms underlying the association of cancer and sarcoidosis ." ], [] ]

[ [ "formation of the plateau at 5 years was characterized by the loss of the overlying rpe causing marked thinning of the hyperreflective rpe - basal lamina complex now reduced to just blamd , compared with at 4 years . at 7 years", "amd eyes were identified through an ex vivo imaging screen of eyes accessioned for research purposes from nondiabetic white donors to the alabama eye bank during the period 1996 to 2012 .", "therefore , we call the hyperreflective band that anteriorly delimits a ped the rpe - bl complex . the definition of a plateau was a distinct oct signature where a mound - like structure with a flattened apex and a wide base was observed within an area of ga after complete loss of the overlying rpe . to determine the volume of the drusenoid ped and ensuing plateau ( fig .", ", the downwardly deflected opl is seen to move progressively toward the edge of the plateau following the advancing border of ga .", ", progressive loss of the onl has caused the opl ( yellow arrows ) to approach the surface of the ped .", "patients with ga were identified from the tertiary practice of retinal specialists ( kbf , js , and ly ) if they exhibited plateau signatures in at least one eye ( study eye ) on oct imaging and if they also had at least 3 years ' follow - up with consecutive eye - tracked spectral - domain ( sd)-oct scans taken at least every 6 months .", "origin and evolution of a plateau , as revealed by nir ( a ) and oct ( b ) images ." ], [ "patients with ga were identified from the tertiary practice of retinal specialists ( kbf , js , and ly ) if they exhibited plateau signatures in at least one eye ( study eye ) on oct imaging and if they also had at least 3 years ' follow - up with consecutive eye - tracked spectral - domain ( sd)-oct scans taken at least every 6 months", ". eyes with macular neovascularization , other retinal pathology , or media opacity preventing adequate imaging were excluded ." ], [ "these extracted sd - oct images were then stacked , aligned , and saved as a video file using the fiji distribution ( fiji is just image j , http://fiji.sc ; in the public domain ) for the qualitative analysis of the progression of the lesion ( see supplementary video ) . at each time point , the plateau appearance on sd - oct was correlated to the appearance in cfp , nir , and faf .", "then , serial eye - tracked b - scans of the region of interest were tracked back to baseline . in cases", "in which the scanning protocol varied during the course of follow - up , the b - scan closest to the area of interest was matched manually and extracted for analysis .", "the sd - oct protocol used in all eyes comprised 20 horizontal raster line scans over the area of interest , ranging from 19 to 49 b - scans per eye , with each scan spaced 115 to 250 m apart , and automatic real - time averaging set between 4 and 23 . to study the origin and progression of plateaus , the most recent sd - oct with this signature was identified .", "oct scans taken before the acquisition of eye - tracked spectralis scans were assessed qualitatively but not included in the quantitative analysis .", "medical records and multimodal imaging , including color fundus photography ( cfp ) , red - free photography ( rf ) , fundus autofluorescence ( faf ) , near - infrared reflectance scanning laser ophthalmoscopy ( nir ) , and sd - oct was performed on all the patients ." ], [ "therefore , we call the hyperreflective band that anteriorly delimits a ped the rpe - bl complex . the definition of a plateau was a distinct oct signature where a mound - like structure with a flattened apex and a wide base was observed within an area of ga after complete loss of the overlying rpe .", "in a healthy eye , the fourth outer retinal hyperreflective band includes the rpe and brm . in a ped , by definition", ", the rpe is separated from the brm . in the course of this separation , either a basal lamina ( bl ) of 0.15-m thickness or a blamd of variable thickness adheres to the rpe and not to the brm ." ], [ "formation of the plateau at 5 years was characterized by the loss of the overlying rpe causing marked thinning of the hyperreflective rpe - basal lamina complex now reduced to just blamd , compared with at 4 years . at 7 years , a closed ort ( pink arrowhead ) is present adjacent to the plateau .", ", progressive loss of the onl has caused the opl ( yellow arrows ) to approach the surface of the ped . also at 4 years , a ", ", the downwardly deflected opl is seen to move progressively toward the edge of the plateau following the advancing border of ga .", "origin and evolution of a plateau , as revealed by nir ( a ) and oct ( b ) images ." ], [ ", eyes underwent additional multimodal ex vivo imaging . from each globe , an 8-mm - diameter full - thickness tissue punch containing the fovea and temporal portion of the optic nerve head was held in a tissue holder mounted on a spectralis , as described . a 30 20 sd - oct volume ( 143 scans , 30-m spacing ,", "amd eyes were identified through an ex vivo imaging screen of eyes accessioned for research purposes from nondiabetic white donors to the alabama eye bank during the period 1996 to 2012 .", "after vitreous removal , maculas were photographed in color on a stereomicroscope ( smz - u ; nikon , melville , ny , usa ) . when prepared for histology ( 20112013 ) and uploaded to the project macula web site ( http://projectmacula.cis.uab.edu , in the public domain )", "automated real - time averaging [ art ] = 25 ) was captured along with red - free and near - infrared reflectance scanning laser ophthalmoscopic images .", "eyes were preserved by immersion in 1% paraformaldehyde and 2.5% glutaraldehyde in 0.1 m phosphate buffer following anterior segment excision .", "median death - to - preservation time was 3:49 hours ( range , 0:4011:40 hours ) .", "tissue punches were postfixed by osmium tannic acid paraphenylenediamine to accentuate extracellular lipid and embedded in epoxy resin ( polybed 812 ; polysciences , warrington , pa , usa ) ." ], [ "onl thinning resulted in the opl approximating the surface of the ped in all cases in which the ped was present at baseline ( figs . 2 , 3 ) .", "atrophy spared the fovea in this eye , as seen with ex vivo cfp and 488-nm autofluorescence , and small reflective puncta in the atrophic area were apparent on nir ( figs .", "pigmentary changes noted on cfp were also found on nir , rf , and faf in six eyes , and these corresponded to intraretinal hyperreflective foci on oct ( fig .", "figure 6 shows histology of a donor eye with ga , for which local relationships and cellular processes in the interior of outer retinal corrugations were particularly clear yet also representative of other ga eyes available for review .", "pigmented cells were of the subducted phenotype , that is , rpe - originated cells located external to blamd , in contact with brm . for reference , in the henle fiber layer of a normal eye , obliquely oriented mller cell processes are parallel to , and interleaved with , inner fibers of cone and rod photoreceptors . in the presence of severe photoreceptor degeneration ," ], [ "plateau signatures were observed in eight eyes of seven patients , of whom six were female .", "mean age was 75 years ( range , 6089 ) and mean follow - up period was 7.7 years ( range , 3.711.6 ) .", "final va was logmar 1.16 ( snellen equivalent 20/289 ) ( range , 0.182.3 ) . in two eyes ,", "baseline visual acuity ( va ) was logmar 0.42 ( snellen equivalent 20/52 ) ( range , 0.181 ) ." ], [ "multimodal imaging of two patients ( a , b ) at baseline and follow - up ( a , 4 years ; b , 7 years ) .", "four years later , a region of hypoautofluorescent ga contains a plateau that can not be appreciated in the cfp , nir , rf , or faf .", "bottom row : seven years later , the ga has markedly enlarged , and the ped is no longer visible on cfp , nir , rf , or faf . the oct b - scan shows that following progressive loss of the onl , the opl ( yellow arrow ) appears draped over a plateau with a shape similar to the baseline ped .", "pigmentary changes noted on cfp were also found on nir , rf , and faf in six eyes , and these corresponded to intraretinal hyperreflective foci on oct ( fig .", "at baseline , the presence of a drusenoid ped with homogeneous hyperreflective contents and an intact overlying rpe was noted in six eyes ( 75% ; figs . 2 , 3 ) ." ], [ "during follow - up , onl thinning resulted in the opl approximating the surface of the ped in all cases in which the ped was present at baseline ( figs . 2 , 3 ) .", "deep to these focal defects are hyperreflective features ( faf and en face oct : green arrowheads ) that are also seen on faf as punctate hyperfluorescence within the confluent area of hypoautofluorescence .", "a distinct hyperreflective surface surrounds the plateau interior and focal defects ( yellow arrows ) can be seen in some areas .", "an en face oct taken at the plateau surface allows better appreciation of focal defects in this hyperreflective layer ( en face octa : surface yellow arrow ) ." ], [ "in seven of eight eyes , the plateau was located in the macula . in one eye ,", "patient 2 has two separate peds that evolve to two separate plateaus ( a , b ) .", "the point at which the plateaus form ( complete loss of rpe from the hyperreflective rpe - bl complex over the ped ) is shown by the dotted line .", "the thinning of the hyperreflective band over the ped surface after rpe loss ( at which point we consider the plateau to be formed ) was preceded by a sharp decrease in ped volume ( fig ." ], [ "figure 6 shows histology of a donor eye with ga , for which local relationships and cellular processes in the interior of outer retinal corrugations were particularly clear yet also representative of other ga eyes available for review .", "pigmented cells were of the subducted phenotype , that is , rpe - originated cells located external to blamd , in contact with brm . for reference , in the henle fiber layer of a normal eye , obliquely oriented mller cell processes are parallel to , and interleaved with , inner fibers of cone and rod photoreceptors . in the presence of severe photoreceptor degeneration , including ort in this ga eye , the trajectories of gliotic mller cell processes were oriented in many directions , as indicated by arrows in figure 6e . in one instance", "( c ) ex vivo nir imaging shows small and highly reflective puncta in the atrophic area .", "detailed ( d ) and panoramic ( e ) views of the atrophic area in histology .", "atrophy spared the fovea in this eye , as seen with ex vivo cfp and 488-nm autofluorescence , and small reflective puncta in the atrophic area were apparent on nir ( figs ." ], [ "plateaus were seen on oct to contain heterogeneous reflectivity enclosed by a thin overlying hyperreflective surface . a focal defect in the hyperreflective surface , in addition to intraretinal and sub - rpe hyperreflective dots , was observed during the evolution of ped into plateau signatures .", "there was a gradual increase in volume due to an increase in hyporeflective contents initially , followed by complete loss of the rpe and a sharp decrease in ped volume , at which time the plateau was considered to have formed .", "through a retrospective review of amd patients with long - term serial eye - tracked sd - oct , we identified a series of eyes in which drusenoid peds progressed into plateau signatures within areas of ga .", "opl subsidence was noted to begin at the surface of the ped and progress toward the edge following the areas of expanding atrophy .", "the study of drusen life cycles and ped evolution are important to improve our understanding of the pathogenesis of amd . understanding the origins and evolution of various oct findings and correlating these findings to histology enable the in vivo study of microscopic cellular changes occurring in these eyes with progressive ga .", "finally , the distinctive reflectivity of persistent blamd in outer retinal corrugations , and , now , plateaus , provides strong motivation for renaming the fourth outer retinal hyperreflective band of normal eyes , which is currently called the rpe - brm complex , to the rpe - blam - brm complex ( abbreviated as rbb ) to accommodate the appearance of ped and persistent blamd in eyes with amd ." ], [] ]

[ [ "pulmonary arterial endarteritis is a rare event , even in patients with congenital heart disease ( chd ) .", "endocarditis of the right side of the heart is uncommon by virtue of the low hemodynamic pressure and lack of isolated or significant right - sided valvular deformities .", "further , a combination of pulmonary endarteritis with a systemic suppuration in chd invites greater attention .", "the valves fall prey to an infective process in settings of congenital heart disease or endothelial injury ." ], [ "a full - segmental echocardiography revealed a single ventricle of the double - inlet left ventricle type [ figure 2 ] .", "a 4-year - old male child , born from a non - consanguineous marriage , was admitted with the history of fever and progressive right - sided weakness for 1 week and cyanosis noted since 6 months of age .", "a rudimentary rv type of ventricle is also visualized echocardiography ( subcostal anatomically corrected view ) showing aorta arising from a rudimentary right ventricle which is connected to the left ventricle through a nonrestrictive foramen ( a ) and ( b ) shows the pulmonary vegetation suggesting pulmonary endarteritis ct scan of the brain showing bilateral cerebral abscesses the child was started on parenteral ceftriaxone ", "an attempted drainage of the largest cerebral abscess resulted in some improvement of the hemiparesis ." ], [ "pulmonary endarteritis as an entity of right - sided endocarditis is rare , even in patients of congenital heart disease .", "most of the reported pulmonary endarteritis cases have been associated with a patent ductus arteriosus ( pda ) .", "apart from pda , a single report exists of pulmonary endarteritis occurring after anatomical correction of complete transposition of the great arteries . to the best of our knowledge and available resources , our case report of pulmonary endarteritis in a child of single ventricle is probably the first such so far .", "the risk of infective endocarditis is considerably increased in children with congenital heart disease , and the disease can occur with almost any lesion , more so with cyanotic congenital heart disease ( cchd ) ." ] ]