Dramatic Improvement (dramatic + improvement)

Distribution by Scientific Domains
Distribution within Medical Sciences

Selected Abstracts

Dramatic Improvement of Pyoderma Gangrenosum with Infliximab in a Patient with PAPA Syndrome

Dorothee S. Stichweh M.D.
Patients with the syndromic triad of pyogenic sterile arthritis, pyoderma gangrenosum, and acne, an autoinflammatory process caused by mutations in the CD2 binding protein-1 (CD2BP1) gene, can have severe pyoderma gangrenosum. We describe a 14-year-old patient with this syndrome who was unresponsive to multiple therapies. A dramatic improvement in his pyoderma gangrenosum was observed after one infusion of infliximab, and a second infusion led to its resolution. Our observation extends the therapeutic use of infliximab to this component of PAPA syndrome. [source]

Dramatic Improvement of the Enantiomeric Excess in the Asymmetric Conjugate Addition Reaction Using New Experimental Conditions.

CHEMINFORM, Issue 38 2002
A. Alexakis
Abstract For Abstract see ChemInform Abstract in Full Text. [source]

ChemInform Abstract: A Dramatic Improvement of Epoxide Selectivity of [Ti,Al]-, by Ion-Exchange with Quaternary Ammonium Salts.

CHEMINFORM, Issue 2 2002
Yasuhide Goa
Abstract ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 100 leading journals. To access a ChemInform Abstract of an article which was published elsewhere, please select a "Full Text" option. The original article is trackable via the "References" option. [source]

Dramatic improvement of crystal quality for low-temperature-grown rabbit muscle aldolase

HaJeung Park
Rabbit muscle aldolase (RMA) was crystallized in complex with the low-complexity domain (LC4) of sorting nexin 9. Monoclinic crystals were obtained at room temperature that displayed large mosaicity and poor X-ray diffraction. However, orthorhombic RMA,LC4 crystals grown at 277,K under similar conditions exhibited low mosaicity, allowing data collection to 2.2,Å Bragg spacing and structure determination. It was concluded that the improvement of crystal quality as indicated by the higher resolution of the new RMA,LC4 complex crystals was a consequence of the introduction of new lattice contacts at lower temperature. The lattice contacts corresponded to an increased number of interactions between high-entropy side chains that mitigate the lattice strain incurred upon cryocooling and accompanying mosaic spread increases. The thermodynamically unfavorable immobilization of high-entropy side chains used in lattice formation was compensated by an entropic increase in the bulk-solvent content owing to the greater solvent content of the crystal lattice. [source]

Dramatic improvement of psoriasis with gemcitabine monotherapy

D. Landi
No abstract is available for this article. [source]

Enhanced automated structure elucidation by inclusion of two-bond specific data

Steve F. Cheatham
Abstract The availability of cryogenically cooled probes permits routine acquisition of data from low sensitivity pulse sequences such as inadequate and 1,1-adequate. We demonstrate that the use of cryo-probe generated 1,1-adequate data in conjunction with HMBC dramatically improves computer-assisted structure elucidation (CASE) both in terms of speed and accuracy of structure generation. In this study data were obtained on two dissimilar natural products and subjected to CASE analysis with and without the incorporation of two-bond specific data. Dramatic improvements in both structure calculation times and structure candidates were observed by the inclusion of the two-bond specific data. Copyright © 2010 John Wiley & Sons, Ltd. [source]

Comparative study: conventional cervical and ThinPrep® Pap tests in a routine clinical setting

A. Grace
The conventional Papanicolaou smear is associated with variable false positive and false negative rates, difficulties with interpretation and high unsatisfactory and suboptimal rates. Newer fluid-based methods such as the ThinPrep® 2000 system (Cytyc Corp., Boxborough, MA) are said to overcome these difficulties. The aim of this study was to compare the conventional smear with the ThinPrep® method in a busy, routine cytology screening laboratory setting. One thousand split samples were evaluated. Using ThinPrep®, the results showed an increased sensitivity and a dramatic improvement in specimen adequacy, with a combined 17.2% reduction in ,unsatisfactory' and ,suboptimal' reports. Screening time per slide was also reduced to 3,4 min. In conclusion, we report an increase in sensitivity, a reduction in screening time and a dramatic improvement in specimen adequacy with the ThinPrep® method. [source]

Botulinum-A Toxin Treatment of the Lower Eyelid Improves Infraorbital Rhytides and Widens the Eye

Timothy Corcoran Flynn MD
Botulinum-A exotoxin (BTX-A) can be used cosmetically to improve rhytides, particularly of the upper one-third of the face. In this study, fifteen women had BTX-A (BOTOX, Allergan, Inc.) injected into the orbicularis oculi muscle. One lower eyelid received two units just subdermally in the midpupillary line three millimeters below the ciliary margin. The opposite periocular area received two units BTX-A in the lower eyelid with 12 units BTX-A injected into the lateral orbital ("crow's foot") area. Three injections of four units each were placed 1.5 cm from the lateral canthus, each 1 cm apart. Patients and physicians independently evaluated the degree of improvement (grade 0 = no improvement, grade 1 = mild improvement, grade 2 = moderate improvement, and grade 3 = dramatic improvement). An independent photographic analysis was performed. Patients reported a grade of 0.73 when two units were injected alone into the lower lid, and a grade of 1.9 when the lower eyelid and the lateral orbital areas were injected. Physician assessment was grade 0.7 with injection of the eyelid alone and grade 1.8 with injection of the lower eyelid and lateral orbital area. Single investigator photographic analysis demonstrated that 40% of the subjects who had injection of the lower eyelid alone had an increased palpebral aperture (IPA), while 86% of the subjects who had injection of the lower eyelid and lateral orbital area had an IPA. Subjects receiving two units alone had an average 0.5 mm IPA and a mean 1.3 mm IPA at full smile. Concomitant treatment of the lateral orbital area produced a mean 1.8 mm IPA at rest and a mean 2.9 mm IPA at full smile. The results were more notable in the Asian eye. Two units of BTX-A injected into the lower eyelid orbicularis oculi muscle improves infraorbital wrinkles, particularly when used in combination with BTX-A treatment of the lateral orbital area. [source]

High-dose immunoglobulines and extracorporeal photochemotherapy in the treatment of febrile ulceronecrotic Mucha-Habermann disease

Federica Marenco
ABSTRACT Febrile ulcero-necrotic Mucha-Habermann disease (FUMHD) is a rare subtype of pityriasis lichenoides et varioliformis acuta (only 41 cases described to date), characterized by an acute onset of ulcero-necrotic papules accompanied by high fever and severe constitutional symptoms. We report a case of a 23-year-old man with a steroid-resistant FUMHD treated by intravenous immunoglobulins (IVIG) combined with methotrexate. Only one case of FUMHD treated by IVIG has been reported to date in literature. Also in our case, IVIG proved to be effective in inducing a dramatic improvement of ulceration and in arresting the appearance of new lesions. Moreover, in our experience we decided to perform a maintenance treatment with extracorporeal photochemotherapy (ECP), to the best of our knowledge not previously used in the treatment of pityriasis lichenoides et varioliformis acuta. ECP, which involves extracorporeal exposure of peripheral blood mononuclear cells to photo-activated 8-methoxypsoralen, induces an immunological reaction against auto-reactive T cell clones, without immune-depression and thus could potentially be useful particularly in FUMHD avoiding the risk of an infective reactivation. [source]

Planarization of Polymeric Field-Effect Transistors: Improvement of Nanomorphology and Enhancement of Electrical Performance

Kumar A. Singh
Abstract The planarization of bottom-contact organic field-effect transistors (OFETs) resulting in dramatic improvement in the nanomorphology and an associated enhancement in charge injection and transport is reported. Planar OFETs based on regioregular poly(3-hexylthiophene) (rr-P3HT) are fabricated wherein the Au bottom-contacts are recessed completely in the gate-dielectric. Normal OFETs having a conventional bottom-contact configuration with 50-nm-high contacts are used for comparison purpose. A modified solvent-assisted drop-casting process is utilized to form extremely thin rr-P3HT films. This process is critical for direct visualization of the effect of planarization on the polymer morphology. Atomic force micrographs (AFM) show that in a normal OFET the step between the surface of the contacts and the gate dielectric disrupts the self-assembly of the rr-P3HT film, resulting in poor morphology at the contact edges. The planarization of contacts results in notable improvement of the nanomorphology of rr-P3HT, resulting in lower resistance to charge injection. However, an improvement in field-effect mobility is observed only at short channel lengths. AFM shows the presence of well-ordered nanofibrils extending over short channel lengths. At longer channel lengths the presence of grain boundaries significantly minimizes the effect of improvement in contact geometry as the charge transport becomes channel-limited. [source]

Deletion of interleukin-6 in mice with the dominant negative form of transforming growth factor , receptor II improves colitis but exacerbates autoimmune cholangitis,

HEPATOLOGY, Issue 1 2010
Weici Zhang
The role of interleukin-6 (IL-6) in autoimmunity attracts attention because of the clinical usage of monoclonal antibodies to IL-6 receptor (IL-6R), designed to block IL-6 pathways. In autoimmune liver disease, activation of the hepatocyte IL-6/STAT3 (signal transducer and activator of transcription 3) pathway is associated with modulating pathology in acute liver failure, in liver regeneration, and in the murine model of concanavalin A,induced liver inflammation. We have reported that mice expressing a dominant negative form of transforming growth factor , receptor II (dnTGF,RII) under control of the CD4 promoter develop both colitis and autoimmune cholangitis with elevated serum levels of IL-6. Based on this observation, we generated IL-6,deficient mice on a dnTGF-,RII background (dnTGF,RII IL-6,/,) and examined for the presence of antimitochondrial antibodies, levels of cytokines, histopathology, and immunohistochemistry of liver and colon tissues. As expected, based on reports of the use of anti,IL-6R in inflammatory bowel disease, dnTGF,RII IL-6,/, mice manifest a dramatic improvement in their inflammatory bowel disease, including reduced diarrhea and significant reduction in intestinal lymphocytic infiltrates. Importantly, however, autoimmune cholangitis in dnTGF,RII IL-6,/, mice was significantly exacerbated, including elevated inflammatory cytokines, increased numbers of activated T cells, and worsening hepatic pathology. Conclusion: The data from these observations emphasize that there are distinct mechanisms involved in inducing pathology in inflammatory bowel disease compared to autoimmune cholangitis. These data also suggest that patients with inflammatory bowel disease may not be the best candidates for treatment with anti,IL-6R if they have accompanying autoimmune liver disease and emphasize caution for therapeutic use of anti,IL-6R antibody. HEPATOLOGY 2010 [source]

Breast lymphoma in Sjögren's syndrome complicated by acute monocular blindness

Abstract A 69-year-old hypertensive woman presented with eye and mouth dryness, bilateral parotid gland enlargement, associated with anasarca and proteinuria. Family history was notable for malignancies including breast, nasopharyngeal and colon cancers. Physical exam disclosed hypertension, bilaterally enlarged, firm, non-tender parotid glands, fine bibasilar crackles and bipedal edema. Anti Ro/Sjögren's syndrome antigen A antibody was positive, with negative tests for anti La/Sjögren's syndrome antigen B and anti-nuclear antibody (ANA). Chest radiographs showed basal infiltrates. Sjögren's syndrome associated with glomerulonephritis and interstitial lung disease was diagnosed, and she received pulse methylprednisololone followed by oral prednisone with dramatic improvement. Two months later, while on prednisone 5 mg/day, she returned to the clinic with an enlarging fixed non-tender right breast mass. She underwent modified radical mastectomy of the right breast, and pathologic report revealed diffuse, small cell, non-Hodgkin's lymphoma of the breast; axillary lymph nodes were negative for tumor. She opted for alternative therapy and did not return to the clinic until 7 months later when she developed sudden monocular blindness in the right eye with no other systemic manifestations. Magnetic resonance imaging (MRI) revealed swelling and enhancement of intracanalicular and pre-chiasmatic segments of the right optic nerve and right side of the optic chiasm. Considerations were Devic's disease versus metastases. She received pulse methylprednisolone therapy (1 g/day for 3 days) with partial recovery of vision. She is scheduled for lymphoma chemotherapy to include rituximab. [source]

Properties of nanocomposites based on maleate-vinyl ether donor,acceptor UV-curable systems

Neena Ravindran
Abstract UV-curable nanocomposites based on donor,acceptor crosslinking chemistry were prepared containing organically modified montmorillonites. The coatings were characterized for thermal, mechanical, and morphological properties. X-ray diffraction and transmission electron microscopy showed that nanocomposites were formed in all samples. Results showed that an increase in the percentage of clay caused an increased modulus and glass-transition temperature. It was also seen that tensile modulus showed dramatic improvement when compared with the unmodified polyester sample. Real time IR kinetic data showed that higher conversions were obtained at higher clay loadings. Pendulum hardness values and tensile modulus values showed different trends in properties depending on the combination of polymer matrix and organomodification. © 2007 Wiley Periodicals, Inc. J Appl Polym Sci 2007 [source]

A multilayered approach to approximating solute polarization

Richard I. Maurer
Abstract A hybrid multilayered "ONIOM"-type approach to solvation is presented in which the basic free energy of hydration is taken from the Poisson Boltzmann method and the contribution to the solute polarization is taken from a quantum mechanical implementation of the Born method. The method has been tested on the 52 neutral molecules used in the AM1,SM2 parameterization, and the polarized continuum method is taken as the standard by which the results are assessed. Regression analysis shows that the method gives a small improvement over the standard Poisson Boltzmann method or a dramatic improvement over the Born method. The system presented here represents one of the more straightforward applications of the multilayered approach to solvation, but other more sophisticated approaches are discussed. © 2004 Wiley Periodicals, Inc. J Comput Chem 25: 627,631, 2004 [source]

Successful treatment of severe recalcitrant erosive oral lichen planus with topical tacrolimus

R Shichinohe
Abstract Oral lichen planus (LP) is a severe, painful form of LP, and is often resistant to topical corticosteroid therapy. Recently, open trials demonstrated that topical tacrolimus therapy was effective for the treatment of chronic erosive oral LP. We report two cases with severe recalcitrant erosive oral LP, who dramatically benefited from topical tacrolimus therapy. In case 1, a 64-year-old man presented with a 5-month history of painful erosions on his entire lower lip and buccal mucosa. Physical and histological examination confirmed a diagnosis of LP. He experienced rapid relief from pain and a dramatic improvement was obtained within 5 weeks of topical tacrolimus treatment. No significant irritation was observed and blood tacrolimus level was kept within a safe level (2.5 ng/mL). In case 2, a 68-year-old man developed painful erosions on his right lower lip and buccal mucosa 2 months before his arrival at our hospital. Histopathological analysis confirmed a diagnosis of oral LP. He experienced a rapid dramatic improvement of both lesions within 4 weeks of the start of tacrolimus application. No significant irritation or recurrence was observed. Thus, topical tacrolimus is suggested as a well-tolerated, effective therapy for oral LP. [source]

Improvement in hepatopulmonary syndrome after methadone withdrawal: A case report with implications for disease mechanism

Edmund M. T. Lau
Spontaneous resolution of hepatopulmonary syndrome (HPS) without liver transplantation or improvement in the underlying liver disease has rarely been reported in the literature. Increased endogenous production of nitric oxide has been implicated in the pathogenesis of HPS. We report the case of a 50-year-old man with hepatitis C cirrhosis who demonstrated dramatic improvement in HPS after withdrawal from chronic methadone therapy. We speculate on the potential role of opiate receptors in the pulmonary vasculature and their effect on nitric oxide signaling as a potential mechanism accounting for the patient's clinical improvement. Liver Transpl 16:870,873, 2010. © 2010 AASLD. [source]

Lower stimulation frequency can enhance tolerability and efficacy of pallidal deep brain stimulation for dystonia

Ron L. Alterman MD
Abstract We report the case of a patient with medically refractory primary dystonia who was treated with bilateral pallidal deep brain stimulation. Stimulation at 130 Hz or higher, by means of the more ventral contacts generated capsular side effects, which made their use impractical. Consequently, the patient was treated for 9 months at 130 to 185 Hz, by means of the more dorsal contacts, achieving modest results. By reducing the stimulation frequency to 80 Hz, we were able to activate the ventral contacts without inducing side effects. Within days, the patient experienced a dramatic improvement in function that has persisted for 1 year. A further reduction in stimulation frequency to 60 Hz resulted in a worsening of his symptoms. We conclude that chronic stimulation at frequencies of <100 Hz may be efficacious in dystonia and may enhance the tolerability of stimulation by means of contacts that are positioned posteroventrally within the internal globus pallidus, nearer the internal capsule. © 2006 Movement Disorder Society [source]

Dramatic Improvement of Pyoderma Gangrenosum with Infliximab in a Patient with PAPA Syndrome

Dorothee S. Stichweh M.D.
Patients with the syndromic triad of pyogenic sterile arthritis, pyoderma gangrenosum, and acne, an autoinflammatory process caused by mutations in the CD2 binding protein-1 (CD2BP1) gene, can have severe pyoderma gangrenosum. We describe a 14-year-old patient with this syndrome who was unresponsive to multiple therapies. A dramatic improvement in his pyoderma gangrenosum was observed after one infusion of infliximab, and a second infusion led to its resolution. Our observation extends the therapeutic use of infliximab to this component of PAPA syndrome. [source]

Role of intra-arterial steroid administration in the management of steroid-refractory acute gastrointestinal graft-versus-host disease,

Arafat Tfayli
Abstract We report here a case of severe steroid-refractory gastrointestinal graft-versus-host disease treated with intra-arterial administration of corticosteroids. A 53-year-old female with non-Hodgkin's lymphoma received peripheral blood hematopoietic stem cell transplant from her HLA-matched sibling. She developed grade II skin and grade IV gastrointestinal graft-versus-host disease with no hepatic involvement. Therapy with oral prednisone easily controlled her skin rash but she had profuse diarrhea that did not respond to high dose intravenous corticosteroids and denileukin diftitox. Infusion of methyl-prednisolone into superior and inferior mesenteric arteries produced dramatic improvement of diarrhea, with complete resolution of gastrointestinal graft-versus-host disease. Am. J. Hematol., 2006, © 2006 Wiley-Liss, Inc. [source]

Enhancing plant growth and fiber production by silencing GA 2-oxidase

Jonathan Dayan
Summary Enhancing plant height and growth rates is a principal objective of the fiber, pulp, wood and biomass product industries. Many biotechnological systems have been established to advance that task with emphasis on increasing the concentration of the plant hormone gibberellin, or on its signalling. In this respect, the most studied gibberellin biosynthesis enzyme is the GA 20-oxidase which catalyses the rate limiting step of the pathway. Overexpression of the gene resulted in an excessively high activity of the gibberellin deactivating enzyme, GA 2-oxidase. Consequently, this feedback regulation limits the intended outcome. We assume that silencing GA 2-oxidase transcription would abolish this antithetical effect, thereby allowing greater gibberellin accumulation. Here, we show that silencing the gibberellin deactivating enzyme in tobacco model plants results in a dramatic improvement of their growth characteristics, compared with the wild type and GA 20-oxidase over-expressing plants. Moreover, the number of xylem fiber cells in the silenced lines exceeded that of GA 20-oxidase over-expressing plants, potentially, making GA 2-oxidase silencing more profitable for the wood and fiber industries. Interestingly, crossing GA 20-oxidase over-expressing plants with GA 2-oxidase silenced plants did not yield consequential additive effects. Our findings unveil the benefits of silencing GA 2-oxidase to substantially increase tobacco growth and fiber production, which suggest using this approach in cultivated forest plantations and industrial herbaceous plants, worldwide. [source]

The effect of low pressure chemical vapor deposition of silicon nitride on the electronic interface properties of oxidized silicon wafers

Hao Jin
Abstract The effect of LPCVD Si3N4 film deposition on oxidized Si wafers, to form Si3N4/SiO2/Si stacks, is studied using capacitance,voltage and carrier lifetime measurements. The deposition of a nitride film leads to an increase in the density of defects at the Si,SiO2 interface, with the increase being greater the thinner the oxide. However, even the presence of a very thin intermediate oxide results in a dramatic improvement in interface properties compared to the direct deposition of the Si3N4 film on Si. The interface degradation occurs in the initial stages of nitride film deposition and appears to be largely the result of increased interfacial stress. Subsequent thermal treatments do not result in significant further degradation of the Si,SiO2 interface (except for a loss of hydrogen), again in contrast to the case where the nitride films is deposited onto Si. Copyright © 2007 John Wiley & Sons, Ltd. [source]

Long-term stability of dye-sensitised solar cells

A. Hinsch
Accelerated ageing tests on large numbers of nanocrystalline dye-sensitised solar cells (nc-DSC) show that, to first order, separation between the effects of the stresses of visible light soaking, UV illumination and thermal treatment on long-term stability is possible. The corresponding mechanisms are electrochemical, photochemical and purely chemical in nature. It was found that visible light soaking alone is not a dominant stress factor. A dramatic improvement in UV stability has been achieved by using MgI2 as additive to the electrolyte. Thermal stress appears to be one of the most critical factors determining the long-term stability of nc-DSC and is strongly related to the chemical composition of electrolyte solvents and additives. Encouraging stability results have been obtained for cells based on pure nitrile-based solvents: (1) A minor decrease in performance of initially 5.5% solar efficient cells has been found after 2000 h at 60°C without light soaking; (2) After 900 h ageing at 85°C, a decrease of 30% in maximum power has been observed; (3) After 3400 h of combined thermal stress and continuous light soaking (45°C, 1 sun equivalent) good stability with 15% decrease in maximum power can be demonstrated. It should be noted that such good thermal stability has not been reported previously for dye-sensitised solar cells so far. Copyright © 2001 John Wiley & Sons, Ltd. [source]

On the use of low-resolution data for translation search in molecular replacement

Andrei Fokine
Low-resolution reflections (approximately 15,Å and lower) are very useful for the translation search in molecular replacement because they are less sensitive to model errors compared with the traditionally used reflections of resolution 4,10,Å. At low resolution, however, the contribution from the bulk solvent is quite significant and corresponding structure factors calculated from a macromolecular model cannot be compared with experimental values if this contribution is neglected. The proposed method provides a way of fast translation searches where low-resolution reflections are taken into account. Test calculations using several experimental data sets show a dramatic improvement in the signal after the bulk-solvent correction and low-resolution reflections were included in the calculation; this improvement allowed unambiguous identification of the solution. [source]

Significant progress in predicting the crystal structures of small organic molecules , a report on the fourth blind test

Graeme M. Day
We report on the organization and outcome of the fourth blind test of crystal structure prediction, an international collaborative project organized to evaluate the present state in computational methods of predicting the crystal structures of small organic molecules. There were 14 research groups which took part, using a variety of methods to generate and rank the most likely crystal structures for four target systems: three single-component crystal structures and a 1:1 cocrystal. Participants were challenged to predict the crystal structures of the four systems, given only their molecular diagrams, while the recently determined but as-yet unpublished crystal structures were withheld by an independent referee. Three predictions were allowed for each system. The results demonstrate a dramatic improvement in rates of success over previous blind tests; in total, there were 13 successful predictions and, for each of the four targets, at least two groups correctly predicted the observed crystal structure. The successes include one participating group who correctly predicted all four crystal structures as their first ranked choice, albeit at a considerable computational expense. The results reflect important improvements in modelling methods and suggest that, at least for the small and fairly rigid types of molecules included in this blind test, such calculations can be constructively applied to help understand crystallization and polymorphism of organic molecules. [source]

Thalidomide dramatically improves the symptoms of early-onset Sarcoidosis/Blau syndrome: Its possible action and mechanism

Kozo Yasui
Objective Early-onset sarcoidosis (EOS), which occurs in children younger than 5 years of age, is associated with granulomatous lesions and a sporadic genetic mutation of the nucleotide-binding oligomerization domain 2 that causes constitutive NF-,B activation. The symptoms of EOS can be uncontrollable, progressive, and associated with profound complications. However, appropriate therapy is still under investigation. The aim of this study was to assess the efficacy of thalidomide in patients with severe EOS, based on etiology supporting an initial role of NF-,B in activation of this disease. Methods Thalidomide was given to 2 patients with EOS (a 16-year-old girl and an 8-year-old boy) at an initial dosage of 2 mg/kg/day, and the dosage was increased if necessary. To elucidate the mechanism of the drug, peripheral blood monocytes were isolated from the patients and stimulated with cytokines (macrophage colony-stimulating factor, tumor necrosis factor ,, and interleukin-4), and their ability to form multinucleated giant cells (MGCs) and osteoclasts was measured. Results Both patients showed dramatic improvement of their clinical symptoms (alleviation of fever and optic nerve papillitis, achievement of a response according to the American College of Rheumatology Pediatric 50 and Pediatric 70 criteria) and laboratory findings. Monocytes from patients with EOS had a greater ability to survive and induce MGCs and osteoclasts than those from healthy control subjects. The formation of MGCs and osteoclasts was inhibited by the presence of thalidomide. Conclusion The ability of thalidomide to improve clinical symptoms and laboratory findings in patients with EOS indicates a central role for NF-,B activity in this disorder. Inhibition of IKK might be a pharmacologic action by which thalidomide down-regulates NF-,B signaling. Thalidomide may be an effective medication in patients with severe complications of EOS, including ocular involvement. [source]

Laparoscopic obesity surgery in an Asian Institute: A 10-year prospective study with review of literature

Wei-Jei Lee
Abstract Objective: Obesity surgery is the most effective treatment for morbid obesity and leads to dramatic improvement in related co-morbidities. The aim of this study was to present the long-term results of a prospective trial studying the efficacy of laparoscopic obesity surgery in a group of oriental patients. Method: From April 1998 to March 2009, 2385 patients who underwent obesity surgery in a single bariatric center in Asia were recruited. Various procedures have been adopted so far, including laparoscopic vertical banded gastric partition in 652 patients (27.3%), laparoscopic gastric bypass (LGB) in 1228 patients (51.5%), laparoscopic adjustable gastric banding in 226 patients (9.5%), laparoscopic sleeve gastrectomy in 128 patients (5.4%), gastric balloon in 68 patients (2.8%) and laparoscopic revision surgery in 83 patients (3.5%). We evaluated the clinical data and effect of obesity surgery on different procedures. Results: Overall, the major complication rate and mortality were 1.5% and 0.12%. There was an increase of surgical risk in laparoscopic sleeve gastrectomy and laparoscopic revision surgery patients. The mean total weight loss for the population was 28.1%, 33.9%, 21.3% 18.7% and 17.4% at 1, 3, 5, 7 and 9 years after surgery, respectively. LGB had a better weight loss (30.1%) than that of the restrictive-type procedures (20.9%) at 5 years after surgery. After surgery, most of the obesity-associated co-morbidities were resolved or improved in these patients. Conclusion: Laparoscopic obesity surgery resulted in significant and sustained weight loss in morbidly obese Asian patients with resolution of associated co-morbidities. LGB had a better result in weight reduction than other restrictive procedures. [source]

The value of laparoscopic skills courses

Objectives: To evaluate the effectiveness of ,hands-on' laparoscopic skills course. Methods: A prospective observational study conducted between May 2005 and June 2006. All gynaecologists who attended ,hands-on' laparoscopic skills course held over a five-day period were assessed initially and at the end of the intensive course. Subjective assessment involved each attendee self-scoring their own knowledge in laparoscopy in different fields; this was done using visual analog scoring (VAS). Objective assessment was done through multiple choice questions (MCQs) and motor skill tasks. The difference between the performances of each of the candidates at pre- and post-course periods was evaluated using the Wilcoxon signed rank test. P -values < 0.05 represented statistical significance. Setting: Centre for Advanced Reproductive Endosurgery (CARE), Royal North Shore Hospital, University of Sydney, Sydney, Australia. Results:, Twenty-four consecutive gynaecologists have been enrolled in the study , 14 were specialists and ten were obstetrics and gynaecology trainees. Mean age was 44.4 years (range 35,58 years). Pre- and post-course subjective assessment measuring VAS improved significantly for all variables. Objective measurements of pre- and post-course mean MCQ results also improved significantly from 71% to 84.5%, respectively (P -value < 0.0001). There was dramatic improvement in the performing of motor skills in the dry laboratory. Conclusions: Laparoscopic skills workshops can improve both knowledge base and motor skills. Such courses result in a short-term measurable improvement. Future studies should focus on assessing the impact of such ,hands-on' courses to see if these skills are transferred to the operating room. [source]

Clinical diagnosis and treatment of suspected neuropathic pain in three dogs

RG Cashmore
Three dogs were referred to The Queen's Veterinary School Hospital at University of Cambridge for chronic behavioural or locomotor disorders associated with pain. All three had been unsuccessfully treated with conventional analgesics, including non-steroidal anti-inflammatory drugs, glucocorticoids and opiate agonists, prior to referral, with minimal or no response. They were investigated by neurological examination plus conventional ancillary diagnostic tests and therapeutic drug trials. Ruling out other causes of pain and applying previously well-described criteria, each case was diagnosed as consistent with neuropathic pain, a poorly recognised condition in domestic dogs. Treatment with the tricyclic antidepressant drug, amitriptyline, or the antiepileptic drug, gabapentin, resulted in either a dramatic improvement or full resolution of clinical signs in all cases. [source]

Parenchymal imaging adds diagnostic utility in evaluating haematuria

Jay S. Belani
OBJECTIVE To compare the findings of renal ultrasonography (US) in the evaluation of patients with and with no haematuria. The increased use of cross-sectional imaging and US has led to a dramatic improvement in the diagnosis of renal masses, such that computed tomography and/or US have been integrated into the diagnostic evaluation of haematuria, and many more incidental renal lesions are now detected. Thus it is possible that the lesions identified during evaluation for haematuria are incidental, i.e. identified serendipitously, and unrelated to the haematuria. PATIENTS AND METHODS We retrospectively compared the US findings obtained from 301 patients referred for new-onset haematuria to those obtained from 600 patients being evaluated for other than urological reasons. All imaging and patient charts were reviewed to verify the clinical and radiological data. RESULTS Haematuria was associated with all renal abnormalities, with an odds ratio (OR, 95% confidence interval) of 4.7 (3.6,7.3). Importantly, haematuria was associated with a renal mass, with an OR of 6.7 (2.8,16.3). Subset analysis revealed that patients with macroscopic and microscopic haematuria had significantly more renal abnormalities (OR 4.7, 2.7,8.2, and 5.3, 3.2,8.8, respectively) and renal masses (OR 7.3, 2.7,20.3, and 6.5, 2.3,18.6, respectively) than controls. CONCLUSIONS Both macroscopic and microscopic haematuria are associated with a greater risk of identifying renal lesions. This supports the conclusion that the renal lesions identified with modern imaging techniques during the evaluation of both microscopic and macroscopic haematuria are not serendipitous. [source]

Bobble-head doll syndrome: some atypical features with a new lesion and review of the literature

K. B. Bhattacharyya
Bobble-head doll syndrome is a rare and unique movement disorder encountered in children. It is characterized by continuous or episodic involuntary forward and backward and side to side movement of the head at the frequency of 2,3 Hz. Neuroimaging in most of the cases reveals third ventricular tumors, suprasellar arachnoid cysts, aqueductal stenosis and other lesions in the region of the third ventricle along with communicating hydrocephalus. In most of the circumstances, the problem starts in the first decade of life and diversion of cerebrospinal fluid by shunt operation is very often accompanied by dramatic improvement. We report one case where bobbing of the head started at around 12 years of age. Additionally, there was evidence of partial left abducens nerve palsy, tremor in the outstretched hands, difficulty in finger-nose test and tandem walking, hyperreflexia and extensor plantar response. He was unconscious on two occasions and there was evidence of gross hydrocephalus along with a thin membranous web, running transversely across the lower part of the aqueduct of Sylvius without any cerebrospinal fluid flow void. Ventriculo-peritoneal shunt abolished the abnormal movements. We propose that the aqueductal web was the offending agent for the pathogenesis of bobble-head doll syndrome in our case and this lesion has not been identified in the cases reported so far. Relevant literature in this regard has also been reviewed. [source]