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PubMed2000

Immunisation against varicella in end stage and pre-end stage renal failure. Trans-Pennine Paediatric Nephrology Study Group.

OBJECTIVES: To investigate the seroconversion rate and duration of persistence of protective antibody titres after varicella immunisation in children with renal failure. DESIGN: 32 children (25 end stage and 7 pre-end stage renal failure) were immunised using 2 x 2,000 plaque forming unit doses of varicella vaccine 3 months apart. Varicella antibody titres were measured by enzyme linked immunosorbent assay. RESULTS: All children initially seroconverted after immunisation. At a mean follow up of 20.3 months, 23 of 28 had protective antibody titres, 4 children having died of unrelated causes. Two children required a third booster dose. 11 children underwent renal transplantation; 10 had protective titres at the time of transplantation and, at a mean of 23.4 months after immunisation, 6 currently have protective titres. Minor side effects occurred after 11 vaccine doses in 9 children. No child developed varicella, despite 10 clear episodes of exposure to the wild-type virus. CONCLUSIONS: Varicella immunisation in children with end stage and pre-end stage renal failure results in a high rate of seroconversion and persistence of protective antibody titres. More widespread use of the vaccine before renal transplantation is recommended.

Antibodies, Viral↗

PubMed1993

T cell responses to pre-erythrocytic stages of malaria: role in protection and vaccine development against pre-erythrocytic stages.

Malaria remains a leading cause of human morbidity and mortality due to the inability of insecticides and chemotherapy/chemoprophylaxis to eliminate the vectors or disease caused by this protozoan parasite. In an effort to develop new methods of control, vaccines targeted to the various stages of the complex life cycle of Plasmodium have been developed. This review describes recent advances in the elucidation of cell-mediated immune mechanisms directed against sporozoites and liver stages of malaria parasites, their role in protection, and their relation to vaccine development. Recent data on the molecular basis of sporozoite-liver cell interaction are presented, and these may provide new approaches for chemoprophylaxis and immunoprophylaxis. We describe the role of the circumsporozoite protein, the major sporozoite surface antigen, in sporozoite movement and as a target of humoral immunity. The recognition of the circumsporozoite protein by human T cells is reviewed with emphasis on cytotoxic T cells and immune resistance against the exo-erythrocytic stage of the parasite. Earlier concepts regarding the polymorphisms of the circumsporozoite protein, the immunological relevance of this polymorphism, and predictions regarding vaccine development are reevaluated on the basis of recent data from different malaria endemic areas. Non-CS sporozoite antigens and liver stage antigens are discussed as potential targets for immune intervention. Recent experimental approaches such as multiple antigen peptides, recombinant live vectors, and new more potent adjuvants are considered for the development of more effective malaria vaccine formulations.

Amino Acid Sequence↗

PubMed1998

Evaluation of the Brusini glaucoma staging system for typing and staging of perimetric results.

BACKGROUND: Brusini's recently introduced glaucoma staging system (GSS) categorizes visual-field damages into different types (i.e. generalized, mixed and localized) and classifies them into stages similar to those of Aulhorn-Karmeyer. Basically, the Brusini GSS is a scatterplot of mean defect (x-axis) and corrected loss variance (CLV; y-axis). The Brusini GSS charts are claimed to be simple to understand due to their 2-dimensional spatial representation and there is no subjective interpretation necessary, since their numerical presentation provides an objective evaluation. Inter- and intraindividual comparisons are, thus, provided 'at a glance'. METHODS: Retrospectively, 610 visual fields (Octopus 201, Program G1) for each eye of 32 glaucoma patients were inspected on screen with PeriData 7.0. The performance of the Brusini GSS was evaluated in terms of typing of visual-field defect and staging as defined by the Aulhorn-Karmeyer classification. RESULTS: Typing of defects into 'normal' and various degrees of generalized and localized damage agreed with PeriData in 89% of fields; 5% were wrongly classified as normal by the Brusini GSS. The type of visual defect showed in 1.3% fields as marked and in 5% a minor discrepancy. Most of the 11% of nonagreement was due to high short-term fluctuation. Agreement could potentially be enhanced by using loss variance instead of CLV Staging of visual-field defects with Brusini GSS charts was in agreement with the Aulhorn-Karmeyer classification in 73% of fields. CONCLUSION: The authors recommend the Brusini GSS because of its simplicity to concisely describe visual-field damage for clinical use as well as research work and because of the remarkably good agreement with the well-known Aulhorn-Karmeyer classification.

Adult↗

PubMed1991

Tympanoplasty: to stage or not to stage.

No unanimity of opinion exists in regard to staged operations in tympanoplasty. The controversy centers around the degree to which one should attempt to obtain hearing improvement in badly diseased ears. The major factor is the extent of the mucous membrane disease. We review the history of staging, the mucous membrane indications for staging, and the variations involved in canal-wall-down (CWD) procedures. The opinions of nineteen other otologists also are presented, nine of whom do not regularly or ever stage tympanoplasty.

Humans↗

PubMed1997

Use of Truquant BR radioimmunoassay for early detection of breast cancer recurrence in patients with stage II and stage III disease.

PURPOSE: The Truquant BR radioimmunoassay (RIA) (Biomira Diagnostics Inc, Rexdale, Canada) uses the monoclonal antibody B27.29 to quantitate the MUC-1 gene product (CA 27.29 antigen) in serum. We evaluated CA 27.29 antigen in a controlled, prospective clinical trial for its ability to predict relapse in stage II and stage III breast cancer patients. PATIENTS AND METHODS: Over a 2-year period, 166 patients who had completed therapy for stage II (80.1%) or III (19.9%) breast cancer and were clinically free of disease were serially tested for CA 27.29 antigen levels. The study was double-masked and cancer recurrence was documented based on clinical findings. Patients with two consecutive CA 27.29 antigen test results above the upper limit of normal were considered positive. RESULTS: The Truquant BR RIA had a sensitivity of 57.7%, specificity of 97.9%, positive predictive value of 83.3%, and negative predictive value of 92.6%. The recurrence rate was 15.7%. A Cox regression analysis showed that the only variable to correlate with recurrent disease was the CA 27.29 antigen test result. Patients with a positive test result had increased odds of having a recurrence (odds ratio, 6.8; P < .00001). The test was effective in predicting recurrence in patients with both distant and locoregional disease. In a subgroup of patients with bone pain, CA 27.29 antigen level was found to identify reliably patients who would subsequently develop recurrent disease. CONCLUSION: These data demonstrate that the Truquant BR RIA can be used as an aid to predict recurrent breast cancer in patients with stage II and III disease.

Adult↗

PubMed1993

Hemodynamic parameters of stage 20 to stage 35 chick embryo.

Hemodynamic parameters of the chick embryo from stage 20 (3 d of a 21-d incubation) up to stage 35 (8 d) are described. Normal values of dorsal aortic flow velocity wave forms were measured with a 20-MHz directional-pulsed Doppler velocity meter that was validated to be accurate above 5 mm/s. An analysis of variance was carried out for each of the flow velocity parameters. The correlation coefficient that represents the reproducibility was satisfactory (r > 0.90). There was a 17-fold rise in mean dorsal aortic blood flow (mm3/s). Heart rate doubled from 123 +/- 12 to 239 +/- 8 bpm, and stroke volume increased from 0.14 +/- 0.08 to 1.28 +/- 0.55 mm3. A stage-related rise was seen in peak systolic and mean velocities and peak acceleration. These data may serve as a basis for flow velocity wave form investigation and interpretation in developmental stages of cardiac malformations.

Animals↗

PubMed2005

Drosophila N-cadherin functions in the first stage of the two-stage layer-selection process of R7 photoreceptor afferents.

Visual information received from the three types of photoreceptor neurons (R1-R6, R7 and R8) in the fly compound eyes converges to the external part of the medulla neuropil (M1-M6 layers) in a layer-specific fashion: R7 and R8 axons terminate at the M6 and M3 layers, respectively, whereas lamina neurons (L1-L5) relay R1-R6 to multiple medulla layers (M1-M5). Here, we show that during development, R7 and R8 neurons establish layer-specific projections in two separate stages: during the first stage, R7 and R8 axons sequentially target to the R7- and R8-temporary layers, respectively; and at the second stage, R7 and R8 growth cones progress synchronously to their destined layers. Using a set of mutations that delete different afferent subsets or alter R7 connectivity, we defined the mechanism of layer selection. We observed that R8, R7 and L1-L5 afferents target to their temporary layers independently, suggesting that afferent-target, but not afferent-afferent, interactions dictate the targeting specificity. N-cadherin is required in the first stage for R7 growth cones to reach and remain in the R7-temporary layer. The Ncad gene contains three pairs of alternatively spliced exons and encodes 12 isoforms. However, expressing a single Ncad isoform in Ncad mutant R7s is sufficient to rescue mistargeting phenotypes. Furthermore, Ncad isoforms mediate promiscuous heterophilic interactions in an in vitro cell-aggregation assay. We propose that Ncad isoforms do not form an adhesion code; rather, they provide permissive adhesion between R7 growth cones and their temporary targets.

Alternative Splicing↗

PubMed2001

[Preparation of a gel-forming ointment base applicable to the recovery stage of bedsore and clinical evaluation of a treatment method with different ointment bases suitable to each stage of bedsore].

A novel ointment base suitable for the treatment of bedsore at the recovery stage was developed by the use of hydroxypropyl methylcellulose (HM-HPMC) modified on the basis of the hydrophobicity. A considerable sustained release of drug (minocycline hydrochloride) formulated to the ointment (T50 of 170 min) was attained with a macrogol ointment (MO) mixed with the HM-HPMC and Carbopol (CP) of the formulating ratio of 3:7. It was also found that a change in the formulating ratio of HM-HPMC and CP lead to a change in the drug release rate. The water absorption property of the ointment base, required to absorb on exudative solution in applying to the bedsore treatment, was as high as that of an ointment base containing hydroxypropyl cellulose (HPC) and CP reported in our previous paper. We clinically evaluated the effectiveness of the bedsore treatment, in which different ointment bases were applied to patients at different stages of the bedsore. A total of 22 cases were divided into two categories for applying to the different treatments. One category comprised of 11 subjects was treated with a povidone-iodine sugargel, which was the conventional method in our hospital, while the other 11 subjects were treated by the use of the newly developed ointment bases in consideration for the different stages of the bedsore. In comparison of the clinical results with the healing index, we ascertained that the latter method was significantly more efficacious (p < 0.01-0.05) than the conventional one. The effectiveness was emphasized in treating the intractable bedsore classified into the grades IV and V. Therefore, we confirmed that the newly developed ointment base formulation is useful in treating bedsore at each stage.

Acrylic Resins↗

PubMed1998

Connection between synchronization of oscillatory activities at early stages and a final stage in the visual system.

Singer's group and we found synchronized oscillatory responses at early stages and at a final stage in visual processing, respectively. However, the former occurs on a millisecond time scale and the latter on a second time scale. We have considered that this results from a difference in scale of something which takes part in the oscillations. From this viewpoint, here we first find suppression effects on both figure and ground of a pattern and on only the ground in a binocular-rivalry situation and then examine, using the effects of two steps, what oscillates and synchronizes at the last stage for form. Finally, we conclude that the synchronous neuronal oscillations depend on firing patterns of neurons at early stages in the visual system and the psychophysical ones on configurations of the spread effect of strength of pattern involved closely in whole processing of the visual system and the latter originates in the former.

Field Dependence-Independence↗

PubMed1998

A comparison of the cost effectiveness of one-stage versus two-stage bilateral total hip replacement.

Forty patients underwent 80 bilateral primary total hip replacements (THRs) under the same anesthesia (one-stage). Forty other patients who underwent unilateral primary THRs during the same time interval were selected to match the first 40 patients with regard to age, sex, diagnosis, weight, medical comorbidity, type of prosthesis used, and perioperative management protocol. An assumption was made in that each unilateral case represented the first side of bilateral THRs performed during two separate hospitalizations (two-stage). Analysis of the total hospital charges submitted to the insurance companies was made between the groups. On average, there was a 24% reduction (P<.05) for each case if bilateral THRs were done in one stage. This was primarily due to a significant decrease (P<.05) in the length of hospital stay in the one-stage group. There was no difference between the two groups in the operative time, estimated blood loss, or perioperative complications.

Aged↗

PubMedDate not supplied

[In vitro induced activity of polymorphonuclear leukocyte myeloperoxidase at different stages of opisthorchis invasion and at stages of a different rehabilitative period].

Polymorphonuclear leukocytes from 115 patients with opisthrochiasis at its different (acute and chronic) stages were studied before and 1-3 days, 1-3 months, and 1-2 years after antihelminthic therapy with bilthricide. The functional activity of the cells in question was evaluated following an hour load with different drugs: bilthricide, ascorbic acid, decaris, cyclophosphane, doxycycline in a final concentration of 2.5 x 10(-5) mole/l. Physiological solution and autologous plasma were test controls. The changes in the activity of extracellular (secreted), intracellular (reserve), and summary myeloperoxidase on incubation with each test agent were found to depend on the stage of the disease and the interval after antihelminthic therapy. In early Opisthorchis invasion, the maximum increase in the induced activity of secreted myeloperoxidase is followed by a fall in the level of reserve myeloperoxidase in response to these drugs. With this, there is the most pronounced decrease in reserve myeloperoxidase of polymorphonuclear leukocytes in chronic opisthorchiasis, which may be due to the disrupted controlling processes of its production at late stages of the disease. The distinctive features of the action of agents on the overall activity of granular leukocytic myeloperoxidase in acute and chronic opisthorchiasis suggests that autologous plasma, ascorbic acid, and doxycycline should be used as a test control at the clinical stage of Opisthorchis invasion.

Anthelmintics↗

PubMed1992

[Stage-by-stage pneumonectomy in pleural empyema].

Staged pneumonectomy tactics in complication of the main lung affection by pleural empyema was described. Surgery was based on an open treatment of empyema cavity before and after the principal surgical stage--pneumonectomy, which was completed by closed treatment using the method of early pleural cavity filling with curative solutions. Use of staged surgical treatment tactics makes it possible to prevent serious postoperative complications such as empyema recurrence and bronchial fistulas. Full clinical effect was achieved in 11 of the 56 operations of staged pneumonectomy in the presence of empyema.

Adult↗

PubMed2004

Optimization of the schedule of gemcitabine-cisplatin combination as induction regimen for patients with biopsy-proven stage IIIa N2 - stage IIIb non-small-cell lung cancer: a prospective phase-II study.

Aim of this study was to define the optimal schedule of gemcitabine (GCB)\cisplatin (CDDP) combination as induction chemotherapy (CHT) in patients with stage IIIa pN2-IIIb non - small-cell lung cancer (NSCLC). Fifty patients with mediastinoscopically-proven stage-IIIa pN2 -IIIb NSCLC were treated with 3 cycles of induction CHT followed by surgery (if staged IIIa) and three-time-daily accelerated radiotherapy. Chemotherapy initially consisted of 3 courses of CDDP 100 mg\m(2) d1 plus GCB 1000 mg\m(2) dd 1,8,15 repeated every 4 weeks, than was modified in CDDP 80 mg\m(2) d1 plus GCB 1250 mg\m(2) dd 1,8 repeated every 3 weeks. Twenty-nine four-week scheduled treatment cycles were firstly administered to 10 patients (pts): treatment-related toxicity, mainly hematological, caused a dose-reduction or treatment omission on day 15 in 65% of cycles. After the protocol was amended, 119 three-week scheduled treatment cycles were administered to 40 pts. Treatment-related toxicity of the new schedule caused a dose-reduction or treatment omission in only 10% of cycles, no patients requiring chemotherapy discontinuation. Thirty-seven out of fifty patients (74%, 95% CI: 60-85%) achieved a partial response, 7 had stable disease and 6 had disease progression. Similar activity was seen with both schedules. One nodal pathological complete remission was observed among the 24 pts who underwent surgery. At present, with a median follow-up of 13 months (mos), 2-year (y) survival of all the 50 pts and of the 24 pts staged IIIa who underwent surgery is estimated as 37% (95% CI: 24-58%) and 47% (95%CI: 27-80%), respectively. When given as induction chemotherapy, a three-week schedule of CDDP plus GCB combination appeared to be effective, with lower toxicity and better compliance than a four-week schedule.

Adult↗

PubMed2005

[Construction of variants of Yersinia pestis EV76 (RIEG line) vaccine strain differing in antibiotic resistance spectra with stage-by-stage transduction of R-transposons].

Mono- and polyresistant variants of the plague vaccinal strain Yersinia pestis EV76 (RIEG line) were constructed with stage-by-stage transduction of transposons Tn5, T, Tn10 and Tn9 located in the phage vectors. Methods for stage-by-stage selection of the transductants that preserved intact determinants of surviving, antiphagocytic activity and immunogenic properties were designed for their further testing as model vaccinal strains in combined specific and emergent medicamentous prophylaxis of plague.

Animals↗

PubMed1990

[Immunophenotype of lymphocytic infiltrate in mycosis fungoides at the plaque stage and at the tumor stage. A comparative study].

An immunohistochemical study of 18 cases of mycosis fungoides (8 cases in tumor stage, 10 in plaque stage) is reported. Seven immunohistochemical parameters were set to evaluate the immunophenotype of the lymphocytes int he two stages of the disease. The results showed loss of differentiation and marked activation of the neoplastic lymphocytes with the progression of the disease from plaque to tumor stage.

Antibodies, Monoclonal↗

PubMed1988

Cryopreservation of first-stage and infective third-stage larvae of Strongyloides stercoralis.

Infective third-stage larvae of Strongyloides stercoralis were frozen over liquid nitrogen and remained infective to dogs when thawed. Successful cryopreservation depended on a 30-60-min incubation in a cryoprotectant (10% DMSO and 10% dextran) before freezing and thawing the frozen larvae into RPMI. First-stage larvae could also be frozen by this method. Thawed first-stage larvae remained viable and continued their development to third-stage larvae, which were shown to be infective to dogs.

Animals↗

PubMed1984

Transition from sensorimotor Stage 5 to Stage 6 by Down syndrome children: a response to Gibson.

Gibson (1978) has suggested that the transition from Sensorimotor Stage 5 to Stage 6 (i.e., the change from exclusive dependence on overt forms of representation and trial-and-error problem-solving to the beginning of internal representation and foresight in problem-solving) is particularly difficult for Down syndrome children. In order to test this "developmental wall" hypothesis, we compared longitudinally the performance of Down syndrome and nonretarded children on the Uzgiris and Hunt (1975) Object Permanence and Means-Ends Relations Scales. Results indicated that in contrast to Gibson's suggestion, the Down syndrome children progressed from Sensorimotor Stage 5 to Stage 6 at the same rate that nonretarded children did, once the generally slower developmental pace of the Down syndrome children was taken into account.

Child Development↗

PubMed1982

A reappraisal of limited-stage undifferentiated carcinoma of the lung. Does stage I small cell undifferentiated carcinoma exist?

Patients with small cell undifferentiated carcinoma of the lung (SCUC) have a poor prognosis. Surgical excision is avoided if the diagnosis can be made with small biopsy specimens or cytologic preparations. We reviewed 323 consecutive patients with pulmonary neoplasms diagnosed as SCUC, oat cel carcinoma, and undifferentiated or poorly differentiated carcinoma. At the time of diagnosis, only 18 patients had neoplasms classified as clinical Stage I, and only one of these had SCUC after histologic review. Fifteen patients had atypical carcinoid, a tumor with features intermediate between ordinary bronchial carcinoid and SCUC. In two instances, there was insufficient tissue for definitive diagnosis. Cumulative survival of the 15 patients with Stage I atypical carcinoid tumor was 80% at 1 year and 60% at most recent follow-up (mean follow-up 20 months). Mean survival for the 305 remaining patients was 7.9 months. Atypical carcinoid may be misdiagnosed as SCUC or poorly differentiated carcinoma, particularly with limited tissue samples or cytologic preparations. Stage I SCUC exists but is exceedingly rare. Many examples of purported Stage I SCUC probably represent atypical carcinoid. Because atypical carcinoid has a far better prognosis than SCUC, precise diagnosis is important and surgical resection should be considered.

Carcinoma, Small Cell↗