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Biomedical subjects

L Hahn

Publications and source records attributed to L Hahn.

At least 19 recordsLinked to original sources

A novel method to identify gene-gene effects in nuclear families: the MDR-PDT.

It is now well recognized that gene-gene and gene-environment interactions are important in complex diseases, and statistical methods to detect interactions are becoming widespread. Traditional parametric approaches are limited in their ability to detect high-order interactions and handle sparse data, and standard stepwise procedures may miss interactions that occur in the absence of detectable main effects. To address these limitations, the multifactor dimensionality reduction (MDR) method [Ritchie et al., 2001: Am J Hum Genet 69:138-147] was developed. The MDR is well-suited for examining high-order interactions and detecting interactions without main effects. The MDR was originally designed to analyze balanced case-control data. The analysis can use family data, but requires a single matched pair be selected from each family. This may be a discordant sib pair, or may be constructed from triad data when parents are available. To take advantage of additional affected and unaffected siblings requires a test statistic that measures the association of genotype with disease in general nuclear families. We have developed a novel test, the MDR-PDT, by merging the MDR method with the genotype-Pedigree Disequilibrium Test (geno-PDT)[Martin et al., 2003: Genet Epidemiol 25:203-213]. MDR-PDT allows identification of single-locus effects or joint effects of multiple loci in families of diverse structure. We present simulations to demonstrate the validity of the test and evaluate its power. To examine its applicability to real data, we applied the MDR-PDT to data from candidate genes for Alzheimer disease (AD) in a large family dataset. These results show the utility of the MDR-PDT for understanding the genetics of complex diseases.

Algorithms↗

Fracture characteristics of carbon fibre, ceramic and non-palladium endodontic post systems at monotonously increasing loads.

A carbon fibre post system, three non-palladium and one palladium metal post systems, two ceramic post systems, and a metal post system with a ceramic core were studied in vitro. The control group consisted of root-filled test teeth without posts. The test teeth were identical artificial roots of an upper central incisor made from a posterior composite whose module of elasticity was similar to that of natural dentine. All posts were cemented in the roots using Panavia 21 TC. Subsequently, standardized full crowns were cemented onto all roots. On a universal testing machine, the test teeth were loaded palatally at monotonously increasing loads until root fracture. The highest mean fracture loads were found for the carbon fibre post system (312.5 +/- 58.8 N). The fracture load of non-palladium metal posts (242.3-300.4 N) did not differ significantly from that of the Perma-dor post (265.9 N), which does contain palladium. Values of 300.3 +/- 89.3 N (aluminium oxide ceramics) and 193.5 +/-57.0 N (zirconia ceramics) were found for the ceramic posts. The control group exhibited a fracture load of 228.8 +/- 35.7 N. The mean distance between the vestibular end of the fracture gap and the point of force application was between 10.1 +/- 2.3 and 14.7 +/- 1.2 mm.

Carbon↗

[Chronic pelvic pain in women. A condition difficult to diagnose--more than 70 different diagnoses can be considered].

Chronic pelvic pain, CPP, with a prevalence of about 15 percent of the female population between 18 and 50 years, has vast psychosocial and economic consequences. The cause(s) are often elusive despite invasive procedures including laparoscopy. There is a connection between CPP and abuse in childhood, sexual as well as non-sexual. Usually the woman initially seeks a gynecologist, who should have some knowledge also of lesser known causes of CPP such as pelvic congestion and nerve entrapments. A multidisciplinary approach can offer more possibilities to reach a plausible diagnosis and adequate treatment.

Adolescent↗

Advanced biomaterials used for a new telescopic retainer for removable dentures.

Removable dentures supported by cast-metal telescopic crowns often exhibit an unpredictable increase or decrease in retentive force after being in clinical use for some time. The objective of the present in vitro study was to develop a new retainer for removable dentures and to evaluate its tribological properties. The new retainer is based on a tapered crown design and consists of a conical all-ceramic abutment crown and a coping made of electroplated gold. It was compared with conventional telescopic retainers made of cast metal. There were 30 specimens in groups of equal size by material used (abutment crown/coping): Group 1, gold/gold; Group 2, titanium/titanium; Group 3, ceramic/electroplated gold. Each specimen consisted of 2 conical-shaped abutment crowns (alpha =4 degrees; h = 6 mm; O(base) = 4,5 mm); their copings were rigidly connected at 25 mm intervals. Retentive forces were measured with a universal testing machine following axial loading to 5-400 N. Wear was simulated by 500-100, 000 joining and separating cycles in the presence of artificial saliva. Metallographic cross-sections were made to evaluate the specimens' fit and surfaces with an SEM. Retentive forces in Groups 1 and 2 increased with load, exhibiting nondirectional changes after induced wear. Sometimes the alloys' functional surfaces showed considerable tracks of wear. Neither load nor wear had any effect on Group 3 retentive forces (mean(force) = 5.03 N). The functional ceramic and gold surfaces showed no traces of wear and the best fit (median(gap) = 4.9 microm). Replacing cast metals by ceramics and electroplated gold results in retainers with clinically advantageous tribological effects, implying, in particular, high wear resistance.

Ceramics↗

The effects of oestrogen replacement therapy on haemostatic variables in postmenopausal women with non-insulin-dependent diabetes mellitus.

Women with diabetes mellitus have an increased risk of developing coronary heart disease which may be related at least partially to unfavourable changes in haemostasis. The effect of oestrogen replacement therapy on haemostasis has not been studied systematically in women with non-insulin-dependent diabetes mellitus (NIDDM) and therefore this study was performed for that purpose. Twenty-five postmenopausal women with NIDDM were treated with 2 mg of 17-beta-oestradiol orally for 3 months in a double-blind, crossover, placebo-controlled trial. During the last 16 days of active treatment, 1 mg of norethisterone acetate was added for 10 days for endometrial protection. Blood samples were taken at baseline and after 68 days of active or placebo treatment. Treatment with oestradiol was followed by a marked decrease in the activity of plasminogen activator inhibitor, compared with placebo. The activity of tissue plasminogen activator increased significantly. Levels of antithrombin decreased during treatment with oestradiol, whereas no changes were seen in levels of fibrinogen, von Willebrand factor, prothrombin fragment 1+2, protein S, protein C or resistance to activated protein C. In conclusion, oestrogen replacement therapy in postmenopausal women with NIDDM improved the fibrinolytic activity, while only clinically insignificant alterations in the clotting system were seen. These changes in haemostasis may have a favourable impact on the risk for coronary heart disease in diabetic women.

Aged↗

Reliability audit of a regional cardiac surgery registry.

OBJECTIVE: The British Columbia Provincial Cardiac Registry collects demographic and clinical data on all patients who undergo cardiac surgery procedures in the province. The purpose of this study was to compare the reliability of data contained in Registry with data contained in hospital charts. METHODS: Registry and hospital charts were compared for 480 cases. Thirty cases were randomly selected for the province's 16 cardiac surgeons. For each case, 10 distinct fields were selected for analysis and classified as consistent, inconsistent, or rejected (data unavailable in one or other source). RESULTS: The overall rate of consistency between charts and the Registry was 86.4%, with an inconsistency rate of 9.9% and a rejection rate of 3.7%. Consistency rates varied significantly across the 10 fields and among the 16 surgeons. Pairwise comparisons of rates between fields indicated that specific field types were problematic and should be targeted for improvement. In addition, pairwise comparisons of rates between surgeons indicated that further education on Registry use is required. CONCLUSIONS: Recommendations for database design and management include provision of standard definitions for all fields; education of users; extension of the number of mandatory fields; revision of check-off box fields to yes/no/unsure fields; and collection of data close to the time that it is generated.

British Columbia↗

Estrogen replacement therapy decreases hyperandrogenicity and improves glucose homeostasis and plasma lipids in postmenopausal women with noninsulin-dependent diabetes mellitus.

Hyperandrogenicity in women is closely associated with insulin resistance and a risk factor for cardiovascular disease and noninsulin-dependent diabetes mellitus (NIDDM). Therefore, 25 postmenopausal women with NIDDM and sex hormone-binding globulin values less than 60 nmol/L, as an indicator of a moderate hyperandrogenicity, were treated with 2 mg 17-beta-estradiol orally for 3 months in a double-blind, cross-over, placebo-controlled trial. During the last 16 days of active treatment, 1 mg norethisterone acetate was added for 10 days for endometrial protection. Blood glucose, glycosylated hemoglobin, insulin, c-peptide, lipoprotein profile, sex steroid hormones, GH, and insulin-like growth factor I (IGF-I) were measured, and insulin sensitivity was determined by the euglycemic hyperinsulinemic clamp method. All metabolic measurements were taken at baseline and after 68 days of active or placebo treatment. Estradiol treatment, compared with the placebo period, was followed by a marked increase of sex hormone-binding globulin and a decrease of free testosterone. Blood glucose, glycosylated hemoglobin, c-peptide, total cholesterol, low-density lipoprotein cholesterol, and IGF-I decreased significantly (P < 0.01-P < 0.001), whereas high-density lipoprotein cholesterol rose (P < 0.001). In conclusion, estrogen replacement therapy in postmenopausal women with NIDDM ameliorated hyperandrogenicity, and this was accompanied by marked improvements in glucose homeostasis and lipoprotein profile.

Androgens↗

[Liver cirrhosis and chronic hepatic porphyria].

Chronic hepatic porphyrias (CHP) are associated with different degrees of liver damage. They range from minimal histological changes to cirrhosis and primary liver carcinomas. Forty patients with early stages of porphyrias were compared to 85 patients with clinically manifest porphyrias, Porphyria cutanea tarda. This comparison resulted in the fact that cirrhosis occurred more often in early (or latent) stages (65%) than in PCT (31%) confirmed by laparoscopy. Thus the severity of the liver disease does not depend on the duration and intensity of cutaneous symptoms or pathobiochemical syndromes but they more often depend on the long-term influence of so-called trigger factors, among them above all alcohol and iron overloading. We conclude that the proof of latent CHP has an index function for severer liver damage.

Female↗

Acute abdomen due to adenomyosis of the uterus: a case report.

A Japanese woman with severe abdominal pain underwent an emergent exploratory laparotomy. Intraperitoneal bleeding from the uterine serosal surface was observed, and a pathologic examination showed that the bleeding was caused by an exudative hemorrhage from the endometrial tissues in the myometrium close to the uterine serosal surface.

Abdomen, Acute↗

Stopping smoking in pregnancy: effect of a self-help manual in controlled trial.

For medical reasons, encouraging women to stop smoking during pregnancy and post partum has high priority. Many smokers want to stop smoking but decline clinical treatment when it is offered. The aim of this study was to find a method which was accepted by a large number of smokers, had a high success rate and, at the same time, required little involvement from personnel. For one year, all pregnant smokers attending 13 of the 14 public health maternity clinics in Gothenburg for their first appointment were invited to participate in this study. Inclusion criteria were daily smoking, a gestational age of less than 12 weeks and ability to understand Swedish. A total of 745 women was registered, but 22 of them stopped smoking before the treatment. The remaining women were randomized to a treatment group (n = 492) and a control group (n = 231). Of the 492 women in the treatment group 417 (85%) accepted the idea of using the self-help manual written especially for pregnant women and given to each woman in the treatment group by the obstetrician. Overall 10.4% of the treatment group stopped smoking up to 8 weeks after delivery compared with 5.2% of the control group (odds ratio 0.5, 95% CI 0.2-0.9). The ex-smoking status was verified by measurement of thiocyanate in blood. The self-help manual had a high acceptance rate and a success rate that was double the rate in the control group.

Adult↗