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PubMed1983

Combined analysis of kidney stones by X-ray diffraction and electron microprobe.

Oxalate, apatite, struvite, uric acid and cystine stones were routinely analysed by X-ray diffraction. A second analysis was performed by electron microprobe. The substances not detected by X-ray diffraction were apatite and struvite in oxalate and cystine stones. Oxalate was not found in uric acid stones because of insufficient routine sample preparation, but could be detected in a second X-ray analysis. Conclusions concerning the exact stone composition can only be reached after X-ray diffraction has been completed in conjunction with a second procedure, such as electron microprobe analysis. For clinical routine use X-ray diffraction is sufficient if adequate sample preparation is performed. The electron microprobe analysis provides further information about mixed phase formations (single or multiple layers, diffuse distributions etc.) and about inclusions in a phase, which have some clinical consequences.

Crystallization↗

PubMed1980

Mucus secretory vesicles in conjunctival epithelial cells of wearers of contact lenses.

Biopsy specimens from the upper tarsal conjunctivae of ten patients with clinically evident contact-lens-associated giant papillary conjunctivitis (GPC) and eight asymptomatic contact lens wearers without clinically evident conjunctival changes were compared by light and transmission electron microscopy to determine the contribution of nongoblet epithelial cells to increased mucus. A control group consisted of five subjects who had never worn contact lenses. The apical cytoplasm of superficial nongoblet epithelial cells in specimens from all groups showed single-membrane-limited vesicular inclusions that stained metachromatically with toluidine blue and were positive with PAS staining, which indicated muco-protein content. Some vesicles appeared to discharge their contents into the conjunctival sac. More vesicles were found in the GPC subjects and the asymptomatic contact lens wearers than in the normal subjects. These observations, coupled with the sign of increased or excessive mucus discharge in GPC subjects and in asymptomatic lens wearers, support the premise that the superficial layers of non-goblet conjunctival epithelial cells can contribute to an increase in mucus production.

Adult↗

PubMed1994

Management of heart failure. III. The role of revascularization in the treatment of patients with moderate or severe left ventricular systolic dysfunction.

OBJECTIVE: This article reviews the benefits and risks of coronary artery bypass grafting and angioplasty for patients with moderate or severe left ventricular systolic dysfunction and summarizes the recommendations of the expert panel for the Agency for Health Care Policy and Research Heart Failure Guideline. DATA SOURCES: Data were obtained from studies published in English and referenced in MEDLINE or EMBASE between 1966 and 1993. We used the search terms heart failure, congestive; congestive heart failure; heart failure; cardiac failure; and dilated cardiomyopathy in conjunction with the terms coronary artery bypass grafting and angioplasty. STUDY SELECTION: All cohort studies and case series that provided separate outcomes data on a subgroup of patients with a left ventricular ejection fraction less than 0.40 were reviewed. DATA EXTRACTION AND SYNTHESIS: Studies were reviewed for inclusion and exclusion criteria, survival, and functional status measures using a standardized form. Cohort studies were assessed on eight aspects of study quality using a defined list of study flaws. CONCLUSION: Coronary artery bypass grafting improves 3-year survival by approximately 30% to 50% and physical functioning by approximately one New York Heart Association class in patients with moderate to severe left ventricular dysfunction and limiting angina. However, the operative mortality ranges from 5% to 30% depending on patients' ejection fractions and comorbidity. It is not clear whether patients whose predominant symptom is heart failure rather than angina benefit from bypass surgery or how much ischemia is required to justify surgical intervention. Clinical outcomes after angioplasty have not been adequately studied to determine the relative risks and benefits compared with bypass grafting.

Aged↗

PubMed1992

The development of a light curing prosthesis for chest wall replacement.

In conjunction with colleagues in the chemical industry, we have developed and evaluated a new plastic prosthesis which we hope will supplant presently used materials for chest wall replacement. We have modified the basic chemical of a reactive resin routinely used in orthopaedic and dental work by the inclusion of a polypropylene mesh. The resultant material is thin enough to cut with scissors and yet supple enough to shape to fit the defects. It is hardened by exposure to UV light and has a practical cure time when exposed to normal light in the operating theatre. When set it is strong and rigid. The mechanical properties have been studied with the Flexural 3-point bend test and compared with the best of the presently available prostheses. The inert nature of the material was studied in a subcutaneous implant in 29 rats over 3 months. Histology has shown a lack of reactivity. The stability in vivo was studied using the material to replace portions of the chest wall in rabbits for up to 6 months. Subsequent histology and in-vitro testing have proved satisfactory. The ability of this material to withstand the dynamic stresses of the chest wall have been studied by its implantation into the chest wall of 3 minipigs for 6 months. The material looks promising and has proved more "user friendly" than existing prostheses for flat bone replacement. We hope to refine its production to allow its use in humans.

Animals↗

PubMed2006

Orthodontic retention regimes: will we ever have the answer?

DATA SOURCES: The Cochrane Oral Health Group Trials Register, CENTRAL, Medline and Embase were searched to May 2005. Key journals were searched by hand, together with bibliographies of all retrieved papers and review articles. No language restrictions were applied. Authors of trials were contacted to identify unpublished trials. STUDY SELECTION: Inclusion criteria specified randomised and quasi-randomised controlled trials which involved children or adults who had retainers fitted or adjunctive procedures undertaken, following orthodontic treatment with braces to prevent relapse. The outcomes were amount of relapse, survival of retainers, adverse effects on oral health and quality of life. DATA EXTRACTION AND SYNTHESIS: Screening of eligible studies, assessment of the methodological quality of the trials and data extraction were conducted independently and in duplicate. For dichotomous outcomes, the estimate of effect of an intervention was expressed as risk ratios together with 95% confidence intervals. For continuous outcomes, mean differences and 95% confidence intervals were used to summarise the data for each group. RESULTS: The search identified 27 articles, of which five met the inclusion criteria. These trials all compared different interventions. There was weak unreliable evidence, based on data from one trial, that a statistically significant increase in stability occurs in both the mandibular (P<0.001) and maxillary anterior segments (P<0.001) when the circumferential supracrestal fiberotomy is used in conjunction with a Hawley retainer, compared with a Hawley retainer alone. There was also weak, unreliable evidence that teeth settle quicker with a Hawley retainer than with a clear overlay retainer after 3 months. The quality of the trial reports was generally poor. No data were available from any study on quality of life assessment. Meta-analysis could not be undertaken as no two studies compared the same retention techniques. CONCLUSIONS: There are insufficient research data on which to base our clinical practice on retention at present. There is an urgent need for high quality randomised controlled trials in this crucial area of orthodontic practice.

Comment↗

PubMed1992

Global and local genome mapping in Arabidopsis thaliana by using recombinant inbred lines and random amplified polymorphic DNAs.

A population of Arabidopsis thaliana recombinant inbred lines was constructed and used to develop a high-density genetic linkage map containing 252 random amplified polymorphic DNA markers and 60 previously mapped restriction fragment length polymorphisms. Linkage groups were correlated to the classical genetic map by inclusion of nine phenotypic markers in the mapping cross. We also applied a technique for local mapping that allows targeting of markers to a selected genome region by pooling DNA from recombinant inbred lines based on their genotype. We conclude that random amplified polymorphic DNAs, used in conjunction with a recombinant inbred population, can facilitate the genetic and physical characterization of the Arabidopsis genome and that this method is generally applicable to other organisms for which appropriate populations either are available or can be developed.

Chromosome Mapping↗

PubMed2003

Proteinuria and its consequences in renal disease.

UNLABELLED: Chronic renal diseases that involve proteinuria are typically characterized by an inexorable progression to end-stage renal failure. Many studies suggest that this progression may be the result of factors, such as intraglomerular hypertension and glomerular hypertrophy, that are unrelated to the initial disease. This paper reviews the mechanisms of progression of chronic renal diseases and discusses therapeutic strategies that should prevent or minimize further renal damage and the applicability of these strategies to patients with the rare X-linked lysosomal storage disorder Fabry disease. Renal involvement is a major feature of Fabry disease, which is characterized by vacuolated epithelial cells in the glomerulus and distal tubules, resulting from lipid inclusions within these cells. Although enzyme replacement therapy is the key strategy to halt the progression of Fabry disease, additional therapeutic options include blood pressure control, reduction of proteinuria, lipid control and inhibition of the renin-angiotensin system. CONCLUSION: A range of therapeutic options, used in conjunction with enzyme replacement therapy, may have beneficial effects on the renal manifestations of Fabry disease.

Angiotensin II↗

PubMed1993

Bone morphology after bone marrow transplantation for Hodgkin's and non-Hodgkin's lymphoma.

The osteogenic consequences of bone marrow ablation followed by bone marrow transplantation for Hodgkin's and non-Hodgkin's lymphoma were examined. Pre- and post-transplantation iliac crest bone biopsies were reviewed for all patients undergoing transplantation at the Johns Hopkins Oncology Center between January 1981 and December 1989. Histomorphometric measurements included percentage of filled trabecular lacunae to estimate osteocyte viability, marrow cellularity and marrow fibrosis. A total of 37 non-Hodgkin's and 32 Hodgkin's patients had adequate biopsies for study inclusion. Twenty-seven received chemotherapy alone, while the remaining 42 had lethal total body irradiation plus chemotherapy. Twelve transplants were allogeneic. Estimated osteocyte viability was decreased for over 4 weeks after bone marrow transplantation. Continuing osteocyte dropout in the central regions of trabeculae was seen in conjunction with active new osteocyte formation along the periphery. Marrow fibrosis was significantly increased and marrow cellularity decreased. There were no major distinctions based on lymphoma type, pretransplant treatment regimen or type of bone marrow transplant. The results indicate that disruption of marrow hematopoiesis causes a diminution in osteocyte viability. Although there is an early appearance of new osteogenesis, the source of progenitor cells cannot be determined from this study.

Adolescent↗

PubMed1991

Ecological applications using a novel expert system shell.

Much of the information used by ecologists in modelling and decision making is imprecise. The imprecision arises both from data that are inexact or incomplete and from the use of ecological principles that are sometimes less than fully reliable and may be conflicting. Nevertheless, expert ecologists are able to construct usable models and make decisions that are used to manage and control ecological resources. This paper describes a unique expert system shell, developed in conjunction with user ecologists, which incorporates features enabling ecologists to represent knowledge and uncertainty in their expert systems in a way that is natural and appropriate. The reasoning mechanism was similarly developed in conjunction with user ecologists. It produces solutions to a class of expert level problems along with explanatory mechanisms and an appropriate analysis of the reasoning process. Three expert systems have been constructed by ecologists using this expert system shell. This enabled the shell designers to evaluate features for inclusion in the shell. The successful use of the shell by the ecologists has shown that significant economies arise when expert system shell design is tailored to use by a specific class of experts, in this case ecologists.

Ecology↗

PubMedDate not supplied

Hierarchical edge bundles: visualization of adjacency relations in hierarchical data.

A compound graph is a frequently encountered type of data set. Relations are given between items, and a hierarchy is defined on the items as well. We present a new method for visualizing such compound graphs. Our approach is based on visually bundling the adjacency edges, i.e., non-hierarchical edges, together. We realize this as follows. We assume that the hierarchy is shown via a standard tree visualization method. Next, we bend each adjacency edge, modeled as a B-spline curve, toward the polyline defined by the path via the inclusion edges from one node to another. This hierarchical bundling reduces visual clutter and also visualizes implicit adjacency edges between parent nodes that are the result of explicit adjacency edges between their respective child nodes. Furthermore, hierarchical edge bundling is a generic method which can be used in conjunction with existing tree visualization techniques. We illustrate our technique by providing example visualizations and discuss the results based on an informal evaluation provided by potential users of such visualizations.

Journal Article↗

PubMed1981

Identification of Mallory bodies with rhodamine B fluorescence and other stains for keratin.

Rhodamine B staining in conjunction with fluorescence microscopy is shown to demonstrate Mallory bodies. Mallory body morphology, localization, and distribution in hepatocytes from griseofulvin-fed mice, human hepatoma, and human alcoholics were similar to those observed in the same tissues after conventional staining methods for Mallory bodies. The presence of these inclusions was further confirmed by specific cytochemical localization with indirect immunoperoxidase labeling, horseradish peroxidase labeling, and electron microscopy. Other tinctorial or histochemical procedures previously used for keratin or prekeratin (modified Mallory stain, Kreyberg method, Pauly method for histidine) also stained Mallory bodies for study with white light microscopy but with decreasing sensitivity respectively. Mallory bodies from mouse and human liver both appear to contain a keratin-like moiety. This entity may be simply, rapidly, and permanently stained with rhodamine B, and selectively and reproducibly demonstrated with fluorescence microscopy.

Animals↗

PubMed2000

Reiter's syndrome and reactive arthritis.

Reactive arthritis is an infection-induced systemic illness characterized by an inflammatory synovitis from which no viable microorganisms can be cultured. The paradigm of reactive arthritis is an infectious trigger that occurs in a genetically susceptible individual in whom the immune system continues to be stimulated or "react" to an ongoing or cleared infection, resulting in intermittent exacerbations of a variety of immune-mediated signs and symptoms. Although the terms Reiter's syndrome and reactive arthritis are sometimes used interchangeably, Reiter's syndrome is actually the complete clinical triad of urethritis, conjunctivitis, and arthritis. Some patients will never fulfill all three components of Reiter's triad, however, and although the term incomplete Reiter's syndrome is often used in such cases, the authors believe that the term reactive arthritis should be used, as it is less confusing and is inclusive of any extra-articular manifestations.

Arthritis, Reactive↗

PubMed1997

Histopathological and immunohistochemical investigation of naturally occurring chlamydial conjunctivitis and urogenital inflammation in koalas (Phascolarctos cinereus).

Formalin-fixed conjunctival and urogenital (urinary bladder, urogenital sinus and prostate or penis, or both) samples obtained from 29 free-living koalas were examined histopathologically and immunohistochemically for the presence and character of inflammation and for evidence of chlamydiae. Five koalas had no inflammation at any site examined and were chlamydia-negative. Twenty-four koalas had inflammation at one or more sites and 18 were positive for chlamydiae by serology or antigen detection tests, or both. Histopathological and immunohistochemical findings were consistent with those seen in chlamydial infections in other species. The inflammatory infiltrate was most dense in the lamina propria-submucosa and, in most tissues, predominantly consisted of lymphocytes and plasma cells. Neutrophils and macrophages were variable in number. Lymphocytes in uninflamed and inflamed tissues consisted largely of T cells. B lymphocytes and plasma cells were mainly distributed immediately beneath the epithelium, but T cells were widely distributed. MHC H-positive lymphoid cells were present in variable numbers and, in some inflamed tissue samples, epithelial cell labelling was also seen. Chlamydial inclusion bodies were uncommon in routinely stained sections. Immunoperoxidase labelling for chlamydiae was positive in 16 of 52 inflamed tissues. The proportion of positive test results for chlamydial antigen by any method was directly related to the severity of inflammation.

Animals↗

PubMed1989

[Malpighian epithelia infected by DNA viruses and Langerhans cells].

Malpighian epithelia exhibit an immune surveillance through Langerhans cells (LC) against the DNA viruses, which induce various epithelial lesions, mainly on the skin, conjunctiva, mouth, uterine cervix. These viral infections are usual during childhood. The most common DNA viruses are: adenoviruses (more than 40 types), human papillomaviruses (HPV, more than 50 types) and Herpes viruses (herpes simplex type 1 and 2, varicella and Zooster, Epstein-Barr virus). Different clinical aspects are observed (exanthema, erythema, eruption, papillomas, vesicle, bullous) are well as histological signs. All of these viruses are replicating in the nuclei of epithelial cells which show eosinophilic inclusions and finally cell degeneresence with a typical aspect for each virus such as koilocyte for HPV infection. These lesions are commonly infiltrated with T lymphocytes; the intensity of the local cellular immune response varies with the lesion. LC are reduced in infected epithelia; they are sometimes found in conjunctive tissues and their morphology can be altered; their role in antigen presentation to T lymphocytes has only been demonstrated in herpes simplex virus infections. Profound modifications of membrane antigens of epithelial cells (loss of HLA class 1 antigen) might contribute to the disappearance of LC or to their functional inability. Most of the DNA virus infections are inapparent, benign and transient. However some lesions can evolve towards malignancy; this progression depends on the oncogenic potential of the viruses (such as HPV types 16 and 18 or herpes simplex virus type 2) associated to a local or a general immune deficiency of the patient as well as to other exogenous factors (UV for example).

Adenoviridae↗

PubMed1986

Dietary antioxidants and chronic pancreatitis.

Fifteen patients with idiopathic chronic pancreatitis (aged 17-78 years), who had not altered their diet since their first symptoms, completed 7-d weighed dietary records at home. The computed information was compared with that from 15 age- and sex-matched volunteers. Attention was focussed on the intakes of antioxidants and unsaturated fatty acids. The patients ingested less selenium, vitamin E, vitamin C and riboflavin than did controls (P less than 0.001, P less than 0.02, P less than 0.001 and P less than 0.05 respectively, using paired t-tests): selenium was by far the best discriminator on step-wise analysis. When the selenium intakes were examined alongside the results of theophylline tests--which reflect cytochromes P450 activities and, thereby, provide an index of antioxidant demand--a line of discrimination separated the majority of patients (with faster drug clearances and lower selenium intakes) and controls. There were no differences in the intakes of individual unsaturated fatty acids, C14:1 through to C24:6, between the two groups. However, amongst six subjects in the overlap zone, three with chronic pancreatitis habitually ate greater amounts of highly unsaturated fatty acids C20:4 to C24:6 inclusive (1970, 1049, 750 mg/d) than did three controls (329, 320, 82 mg/d). Animal experiments show that suboptimal intakes of dietary antioxidants and/or excessive intakes of highly unsaturated fatty acids and/or induction of cytochromes P450 facilitate peroxidation of cellular lipid membranes by free radicals. Our dietary data, taken in conjunction with pharmacokinetic data, thus suggest that a similar situation--favouring lipid peroxidation--may underlie human chronic pancreatitis.

Adolescent↗

PubMed2006

The Combitube, self-inflating bulb, and colorimetric carbon dioxide detector to advance airway management in the first echelon of the battlefield.

Combat lifesavers and Army medics are regular combat soldiers who possess skills that enable them to provide lifesaving assistance to combat casualties. Although their training is not equal to that of paramedics, combat lifesavers and Army medics are trained to assess casualties for airway obstruction, as well as the presence or absence of spontaneous ventilation. They are also familiar with the same basic airway maneuvers that are required for blind insertion of the esophageal-tracheal double-lumen airway (ETDLA). Use of the ETDLA in combination with an esophageal detector device and a colorimetric carbon dioxide detector would require skill similar to that which they already possess in performing many mission-essential and combat lifesaver tasks. Because the U.S. Army has introduced the ETDLA for use, it is important that providers at all echelons understand the dynamics of the ETDLA. Inclusion of the ETDLA, esophageal detector device, and colorimetric carbon dioxide detector in combination with the bag-valve ventilation device could provide a viable alternative to mouth-to-mouth rescue breathing with the oral airway, as currently used by combat lifesavers on the battlefield. Improved airway management, in conjunction with other lifesaving measures, could potentially improve survival rates for combat casualties and assist in stabilizing them for evacuation to higher echelons of combat medical care.

Carbon Dioxide↗

PubMed1978

Fine structure of palpebral molluscum contagiosum and its secondary conjunctival lesions.

One case of molluscum contagiosum of the lid, which has been followed by follicular conjunctivitis and superficial punctate keratitis, has enabled us to compare the ultrastructure of the skin tumor and of the conjunctival lesion. Electron microscopic observation is the only way for discovering the causal Poxvirus. Up to now isolation of the viral strain has not been possible. Examination of the skin tumor showed different maturation forms of the virus and associated cell alterations. In the conjunctiva there was an inflammatory reaction, with exocytosis and infiltration of the chorion by lymphocytes and plasma cells. Intracytoplasmic organelles were formed in the superficial epithelial cells. Their size and structure resembled that of the immature virions found in the epidermic cells. The comparison between skin and conjunctival lesions suggests the following sequence of events in the pathogenesis: the virus, leaving the lid tumor, probably penetrates the conjunctival cells and, without finding the conditions necessary for its full development, produces abnormal viral inclusions unable to become a mature virus. The excision of skin nodules thus cures the infection, since it prevents further reinfection by the skin virus. The morphological criteria on which this hypothesis is based must be confirmed by chemical and morphometrical studies.

Adolescent↗

PubMed2005

Model identity SN2 reactions CH3X + X- (X = F, Cl, CN, OH, SH, NH2, PH2): Marcus theory analyzed.

The structures of seven gas phase identity S(N)2 reactions of the form CH(3)X + X(-) have been characterized with seven distinct theoretical methods: RHF, B3LYP, BLYP, BP86, MP2, CCSD, and CCSD(T), in conjunction with basis sets of double and triple zeta quality. Additionally, the energetics of said reactions have been definitively computed using focal point analyses utilizing extrapolation to the one-particle limit for the Hartree-Fock and MP2 energies using basis sets of up to aug-cc-pV5Z quality, inclusion of higher order correlation effects [CCSD and CCSD(T)] with basis sets of aug-cc-pVTZ quality, and additional auxiliary terms for core correlation and scalar relativistic effects. Final net activation barriers for the reactions are E(b)(F,F)= -0.8, E(b)(Cl,Cl)= 1.6, E(b)(CN,CN)= 28.7, E(b)(OH,OH)= 14.3, E(b)(SH,SH)= 13.8, E(b)(NH2,NH2)= 28.6, and E(b)(PH2,PH2)= 25.7 kcal mol(-1). General trends in the energetics, specifically the performance of the density functionals, and the component energies of the focal point analyses are discussed. The utility of classic Marcus theory as a technique for barrier predictions has been carefully analyzed. The standard Marcus theory results show disparities of up to 9 kcal mol(-1) with respect to explicitly computed results. However, when alternative approaches to Marcus theory, independent of the well-depths, are considered, excellent performance is achieved, with the largest deviations being under 3 kcal mol(-1).

Journal Article↗