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PubMed2004

[Determination of the overall migration of chemicals from the plastic packaging into the aqueous models of food using the EU methods].

Overall migration from food plastic packaging to aquatic food simulants (distilled water, 3% acetic acid) was determined according to the EU methods. Testing conditions (time and temperature) reflected normal use of tested food packaging. The overall migration studies using different food simulants (distilled water, 3% acetic acid) shows that the migration rate was very low, far below the allowed limit (10 mg/dm2). The high results of overall migration into 3% acetic acid (average 250.2 mg/dm2), markedly exceeding the allowed limit, was found in the case of multilayer film. It means that the multilayer film tested does not comply with the migration limit and it can not be used as a food packaging for the sour foodstuffs of pH below 4.5. Differences between the magnitude of overall migration into distilled water (0.5-1.1 mg/dm2) and 3% acetic acid are probably due to the presence of easy washable substances into the sour medium. From that reason the application of such food packaging materials must be limited.

Acetic Acid↗
PubMed2004

Correlation of colposcopic anogenital findings and overall assessment of child sexual abuse: prospective study.

OBJECTIVE: To examine the relationship between colposcopic anogenital findings and overall assessment of sexual abuse. DESIGN: Prospective study. SETTING: Regional hospital, Hong Kong. PATIENTS: Seventy-seven children (mean age, 6.5 years; range, 6 months-16 years) referred consecutively for sexual abuse evaluation between July 1999 and June 2002 were included. MAIN OUTCOME MEASURES: Colposcopic anogenital findings (categorised as normal, non-specific, concerning for abuse, or clearly abnormal) were correlated with the overall assessment of likelihood of abuse (classified as no evidence of abuse, possible abuse, probable abuse, or definite abuse). The sensitivity and specificity of clearly abnormal findings in detecting definite abuse were computed, and the diagnostic impact of colposcopy findings were expressed as likelihood ratios. RESULTS: Anogenital findings were normal in 45% of patients, non-specific in 29%, concerning for abuse in 13%, and clearly abnormal in 13%. Seven of the 16 confirmed cases of sexual abuse had normal or non-specific findings. Overall assessment showed that 46% of all patients had no evidence of abuse, 20% had cases of possible abuse, 13% had cases of probable abuse, and 21% had cases of definite abuse. The sensitivity and specificity of abnormal anogenital findings in detecting definite abuse were 56.3% and 98.4%, respectively. Colposcopy showed a fair correlation with the overall assessment of abuse (weighted kappa, 0.245). The diagnostic impact of normal, non-specific, concerning, and clearly abnormal findings in terms of likelihood ratios were 0.23, 1.12, 0.00, and 34.30, respectively. CONCLUSIONS: Anogenital findings are often normal or non-specific in sexual abuse. In general, colposcopy examination findings do not directly reflect the final diagnosis. A category-4 finding on colposcopy is very helpful in confirming definite abuse, whereas other findings do not rule out the diagnosis.

Adolescent↗
PubMed1992

Respiratory, muscular, and overall perceptions of effort: the influence of hypoxia and muscle mass.

Overall, respiratory and peripheral muscular perceptions of exercise have been examined in 16 subjects (eight men and eight women), each performing four types of exercise (two-leg, one-leg, arm + shoulder, and arm ergometry) under both normoxic and hypoxic (12% oxygen) conditions. Subjects could distinguish ratings for the three types of sensation. Both overall and peripheral muscular perceptions associated with a given oxygen intake or power output increased more than respiratory perceptions as the volume of active muscle was decreased. Hypoxia tended to increase both overall and respiratory perceptions for a given absolute oxygen consumption. Cross-modal comparisons suggested an average overall RPE of close to 13 units at 70% of a task and environment-specific peak oxygen intake, irrespective of exercise conditions, but the SD of individual responses varied by at least +/- 2 units about this average. Peripheral muscular sensations dominated small muscle tasks, but the peripheral muscular RPE became relatively consistent when related to external work rate per liter of active muscle. Respiratory perceptions provided some guide to the intensity of physical activity with a given mode of exercise and fixed environmental conditions. However, if respiratory RPE is used to "fine-tune" cross-modal exercise prescriptions, account must be taken of the distorting influence of active muscle volume and of hypoxia.

Adult↗
PubMed2006

Intra-observer and overall agreement in the radiological assessment of tuberculosis.

OBJECTIVE: To assess the intra-observer and overall agreement in the interpretation of chest X-rays (CXRs) performed for detecting tuberculosis (TB) among immigrants in Switzerland. METHOD: Four hundred digitalised CXRs from the files of immigrant registration centres were selected and read twice in random order by three readers. The readers had to assess (1) if the picture was normal or abnormal; (2) if an abnormality was suggestive of TB; and (3) if the suspicion of TB needed an immediate examination (potentially smear-positive TB). The intra-observer and overall agreements were expressed as kappa with standard error. RESULTS: Due to losses for technical reasons, 377 of the 400 pictures were analysed. The intra-observer agreement was 0.39-0.90 for any abnormality, and 0.60-0.82 for TB needing an urgent examination. The overall agreements were: 0.55 (all three readers) and 0.84 (two best readers) for any abnormality, and 0.64 (all three readers) and 0.80 (two best readers) for active TB. CONCLUSIONS: The intra-observer and overall agreements for the detection of abnormalities on digitalised CXRs and for the presence of possible active TB depend on the reader's experience. It was good between experienced readers and fair between and within the inexperienced reader.

Emigration and Immigration↗
PubMed1990

[A method of cleaning overalls contaminated with sodium cyanide].

The contributors propose a new technique of cleaning overalls in galvanic shops from crystalline natrium cyanide (NC) and alkaline solutions. The technique includes washing in hot 0.05% syntamide-5 solution for 4-5 min., double rinsing and centrifuging. The remaining quantity of NC on washed overalls does not exceed 0.02 mg/m2 (evaluated in hydrocyanic acid). Subsequent contaminations of the overalls with NC do not entail the accumulation of NC residual content. The physical and chemical characteristics of this type of overall washing are more preferable as compared to those attained through soaking in ferric sulfate solution.

Cyanides↗
PubMed1989

Visual analogue scales as a measure of pain in arthritis: a study of overall pain and pain in individual joints at rest and on movement.

Visual analogue scales (VAS) for overall and individual joint pain at rest and on movement were completed by 105 patients with polyarthritis as part of a study of the relationship between overall pain and pain in individual joints. Not all subjects recorded pain on a conventional VAS although all had at least 2 painful joints on movement. At best only 25% of the variance in overall pain was explained by pain in individual joints. Our findings suggest that conventional overall measures of pain in arthritis may neglect aspects of pain experience which relate to individual joints and to pain on movement.

Adult↗
PubMed1980

[Overall and regional sensitivity of myocardial thallium-201 scintigraphy compared with the number and location of coronary lesions and the presence of previous myocardial infarction].

An evaluation is presented of (1) the overall sensitivity and specificity of 201Tl myocardial scintigraphy in 230 patients with suspected coronary artery disease and (2) the effects of the number and location of the diseased vessels, and the presence of previous infarction, on regional sensitivity in 151 patients. Overall sensitivity was 91% (80%, 95%, 97%) in patients with 1, 2 or 3 vessels respectively. Overall specificity was 81% or 89% if 7 patients with infarction and normal coronaries were excluded. In 80% of patients with one diseased vessel, in 41% of patients with 2 diseased vessels, and in only 24% with 3 diseased vessels were all lesions detected. 201Tl scintigraphy detected 52% of circumflex lesions as compared to 75% of right coronary and 74% of left anterior descending lesions. Of the 151 patients with proven coronary disease, 75 had a previous infarction. Overall and regional 201Tl sensitivity were greater (but not significantly) in this subgroup as compared to patients without myocardial infarction.

Adult↗
PubMed1976

The global assessment scale. A procedure for measuring overall severity of psychiatric disturbance.

The Global Assessment Scale (GAS) is a rating scale for evaluating the overall functioning of a subject during a specified time period on a continuum from psychological or psychiatric sickness to health. In five studies encompassing the range of population to which measures of overall severity of illness are likely to be applied, the GAS was found to have good reliability. GAS ratings were found to have a greater sensitivity to change over time than did other ratings of overall severity or specific symptom dimensions. Former inpatients in the community with a GAS rating below 40 had a higher probability of readmission to the hospital than did patients with higher GAS scores. The relative simplicity, reliability, and validity of the GAS suggests that it would be useful in a wide variety of clinical and research settings.

Hospitalization↗
PubMed1996

Extent of skin involvement as a prognostic indicator of disease free and overall survival of patients with T3 cutaneous T-cell lymphoma treated with total skin electron beam radiation therapy.

BACKGROUND: The goal of this study was to define the prognostic significance of the extent of skin involvement (ESI) with respect to disease free survival (DFS) and overall survival (OS) of patients with T3 cutaneous T-cell lymphoma (CTCL) after total skin electron beam therapy (TSEBT). METHODS: Between 1974 and 1993, TSEBT (36 Gray [Gy], 1 Gy/day for 9 weeks, 6 MeV electrons) was administered to a total of 213 patients. Forty-six of the 213 patients were classified as having T3 CTCL based on the presence of tumor nodules on the skin at diagnosis. Patient records were evaluated retrospectively, and the percentage of total skin surface involved was calculated. Patients were analyzed with respect to response to therapy, disease free and overall survival. The median follow-up was 37.5 months (range, 1.6-93 months). RESULTS: Thirty-six of 46 patients achieved complete clinical response (CCR) by the completion of TSEBT. DFS was 12% at 36 months with approximately 28% OS. When stratified by extent of skin involvement, 100% of patients with 9% or less ESI were disease free at 18 months compared with patients with 10% or greater ESI, all of whom had relapsed by 18 months (78% achieved CCR). Fifty percent of those with 9% or less ESI remained disease free at 36 months; median DFS and OS were not reached at 63 and 65 months, respectively. The median DFS and OS for the 10% or greater ESI group were 4 and 24 months, respectively. These differences were statistically significant (P < or = 0.005). Toxicity of therapy was minimal. CONCLUSIONS: The extent of skin involvement of patients with T3 CTCL is a prognostic indicator of disease free and overall survival for those who have been treated definitively with TSEBT.

Adult↗
PubMed2004

Circulating D-dimer levels are better predictors of overall survival and disease progression than carcinoembryonic antigen levels in patients with metastatic colorectal carcinoma.

BACKGROUND: Fibrin formation is required for tumor angiogenesis, metastasis, and invasion. D-dimer, a fibrin degradation product, is produced when crosslinked fibrin is degraded by plasmin. The current study prospectively examined D-dimer levels in patients with metastatic colorectal carcinoma treated in a Phase II randomized trial comparing bevacizumab (Avastin, Genentech, South San Francisco, CA) plus 5-fluorouracil/leucovorin (5-FU/LV) with 5-FU/LV alone. METHODS: At least one circulating D-dimer level was evaluable in 98 of the 104 previously untreated patients with metastatic colorectal carcinoma in the current trial. Plasma D-dimer levels were determined using a quantitative immunoassay kit at enrollment, before each treatment, and at the time of trial completion or disease progression. RESULTS: At trial enrollment, 86 of 104 patients (88%) had elevated D-dimer levels (> 20 ng/mL), and 86 of 102 patients (84%) had elevated carcinoembryonic antigen (CEA) levels (> 3 ng/mL). Baseline D-dimer levels were correlated with the following baseline characteristics: CEA (Pearson coefficient, 0.31; P = 0.002), albumin levels (Pearson coefficient, -0.32; P = 0.002), tumor burden (Pearson coefficient, 0.30; P = 0.003), and number of metastatic sites (Pearson coefficient, 0.21; P = 0.04). At the time of progression, plasma D-dimer levels reached a maximum postbaseline value in 51 of 61 patients (84%), whereas the CEA level was at its maximum postbaseline value in 39 of 55 patients (71%). Baseline D-dimer levels were a strong predictor of overall survival on univariate analysis (P = 0.008) and multivariate analysis (P = 0.03). Overall, treatment with bevacizumab (5 mg/kg) and baseline D-dimer levels were the only predictors of overall survival (P < 0.05). CONCLUSIONS: The current study indicates that fibrin remodeling is an important prognostic feature in metastatic colorectal carcinoma. D-dimer levels should be incorporated into prognostic models, and D-dimer may represent a useful biomarker for patients treated with antiangiogenic agents.

Adult↗
PubMed2007

Underestimation of malignancy of breast core-needle biopsy: concepts and precise overall and category-specific estimates.

BACKGROUND: A review of the literature indicated variable underestimation rates for breast core-needle biopsy (CNB) based on generally small series. In this article, the authors present precise estimates for overall underestimation and for categories of histologic underestimates (including categories that reflect contemporary classification) and examine the effect of lesion and sampling variables. METHODS: Among 4035 consecutive CNBs, the authors examined women whose CNB outcome represented a potential underestimate of malignancy (benign but of uncertain biologic or malignant potential or B3 and ductal carcinoma in situ [DCIS]). From 889 eligible women, all 758 women who had excision histology available were included. RESULTS: Overall underestimation of CNB was 27.7% (95% confidence interval [95% CI], 24.5-30.9%). The following category-specific rates were used: B3 underestimates, 36.2% (95% CI, 30.6-41.8%); B3 underestimates (excluding atypical proliferations), 17.9% (95% CI, 10.8-24.9%); atypical ductal hyperplasia underestimates, 29.0% (95% CI, 21.4-36.6%; upgraded to DCIS) and 44.2% (95% CI, 36.0-52.5%; upgraded to DCIS or invasive cancer); and DCIS underestimates, 22.8% (95% CI, 19.0-26.5%). There was a significant trend toward greater underestimation of malignancy with increasing lesion size on imaging studies for overall underestimates (P = .00008), B3 underestimates (P = .009), and DCIS underestimates (P = .0007). Underestimation rates did not differ between masses (27.9%) and microcalcifications (27.6%; chi-square statistic with 1 degree of freedom = 3.02; P = .98) and were significantly lower for vacuum-assisted CNB (11-gauge) than for automated CNB (14-gauge; P = .001). Underestimation rates, when sampling microcalcifications, decreased with increasing number of cores collected, but this was mainly for DCIS underestimates. CONCLUSIONS: CNB results that were not definitely negative or were not positive for invasive cancer were associated with high rates of underestimation of disease and with target lesion size. Identifying imaging or sampling factors that affect underestimation rates of CNB may assist in reducing their occurrence and better predicting excision histology outcomes.

Biopsy, Fine-Needle↗
PubMed2006

Decreased expression of phosphorylated JNK in breast infiltrating ductal carcinoma is associated with a better overall survival.

Phosphorylation/activation of c-jun NH2-terminal kinase (JNK) has an ambivalent role, pro-proliferation or antiproliferation, in human cancers, which is determined by different cell types and by its crosstalk with other kinases. So far, the role of phosphorylated JNK (p-JNK) in breast cancer is mostly undefined. In this study, we analyzed the expression of p-JNK, as well as p-ERK1/2 and p-38, in the pair of cancer and noncancer breast tissues, by using immunoblotting techniques. These results were further correlated with the clinicopathological characteristics and overall survival. Decreased p-JNK1/2 expression in cancer tissues was observed in 48.5% of breast infiltrating ductal carcinoma (IDC) cases and was correlated significantly with the increased tumor grade and the decreased age at diagnosis (p = 0.030 and 0.029). Interestingly, the Kaplan-Meier survival curve showed that the decreased p-JNK1/2 expression was associated with a better overall survival of IDC (p = 0.004). The expression of p-JNK1/2 was positively correlated with p-p38 (p = 0.002), but not p-ERK1/2. Furthermore, co-expressed p-JNK1/2 and p-p38 was associated with a poor overall survival of IDC (p = 0.007). In conclusion, our results indicate that the aberrant p-JNK1/2 expression and the co-expressed p-JNK1/2 and p-p38 in breast tissues may play a role in the carcinogenesis of breast IDC.

Biomarkers, Tumor↗
PubMed2004

Overall C as a measure of discrimination in survival analysis: model specific population value and confidence interval estimation.

The assessment of the discrimination ability of a survival analysis model is a problem of considerable theoretical interest and important practical applications. This issue is, however, more complex than evaluating the performance of a linear or logistic regression. Several different measures have been proposed in the biostatistical literature. In this paper we investigate the properties of the overall C index introduced by Harrell as a natural extension of the ROC curve area to survival analysis. We develop the overall C index as a parameter describing the performance of a given model applied to the population under consideration and discuss the statistic used as its sample estimate. We discover a relationship between the overall C and the modified Kendall's tau and construct a confidence interval for our measure based on the asymptotic normality of its estimate. Then we investigate via simulations the length and coverage probability of this interval. Finally, we present a real life example evaluating the performance of a Framingham Heart Study model.

Cohort Studies↗
PubMed1997

Unusual lack of internal mobility and fast overall tumbling in oxidized flavodoxin from Anacystis nidulans.

Anacystis nidulans flavodoxin, an electron-transfer protein containing a flavin mononucleotide (FMN) molecule as its prosthetic group, has a redox potential for the oxidized/semiquinone equilibrium close to that of free flavin. Whereas the redox potential for the semiquinone/hydroquinone equilibrium is more negative. To gain an understanding of the contribution of mobility to redox potential modulation, we studied the backbone mobility of the oxidized A. nidulans flavodoxin at pH 6.6, 303 K by 15N NMR relaxation measurements. The spin-lattice relaxation rate constants (RN(Nz)=1/T1), spin-spin relaxation rate constants (RN(Nx,y)=1/T2) and 1H-15N nuclear Overhauser effects (NOE) were obtained for 143 of the 166 protonated backbone 15N nuclei and for the FMN N3 nucleus without ambiguity. The 15N T1, T2 and NOE data were analyzed by reduced spectral density mapping, and the so-called model-free approach. In contrast to most other proteins studied with 15N relaxation experiments, we found an almost complete absence of internal mobility. The overall correlation time of this 169-residue flavodoxin (>19 kDa) is significantly shorter (7.4 to 7.8 ns) than that of other proteins of this size, suggesting that the absence of internal mobility is correlated with faster overall rotational diffusion. The uniformity of the motional parameters along the backbone is in strong contrast to the crystallographic B-factors, which vary significantly along the sequence in this and other flavodoxins. The NMR relaxation parameters are primarily sensitive to rotational diffusive motions of the N-H bond vectors, while the crystallographic B-factors would be sensitive to translational internal motions as well. However, the large B-factors in this protein may originate from crystal packing and crystal lattice disorder. The relatively fast overall tumbling results in sharp NMR resonances. Hence, much larger proteins with such favorable dynamic behavior could be excellent candidates for studies by NMR.

Computer Simulation↗
PubMed1984

Steady-state kinetics of the overall oxidative phosphorylation reaction in heart mitochondria. Determination of the coupling relationships between the respiratory reactions and miscellaneous observations concerning rate-limiting steps.

The linear sequence of steps involved in the oxidation of extramitochondrial succinate by O2 in bovine heart mitochondria was examined by a steady-state kinetic method to determine whether or not freely diffusible intermediates occur between the various inhibitor-sensitive steps. The kinetic method is based on the facts (1) that if two inhibitor-sensitive steps within a sequence are linked by a freely diffusible intermediate, inhibition of one will make the other less rate limiting in the overall reaction and thus will increase the amount of inhibitor of the other step required for half-maximal inhibition of the overall reaction, and (2) that if the two steps are not linked in this manner, inhibition of one will make the other more rate limiting and thus will decrease the amount of inhibitor of the other required for half-maximal inhibition. These two types of "coupling relationships" between steps were designated as "sequential" and "fixed," respectively. The results indicate the existence of freely diffusible intermediates (sequential coupling relationships) between the succinate transport and succinate dehydrogenase reactions, between the succinate dehydrogenase and cytochrome bc1 reactions, and between the cytochromes bc1 and aa3 reactions. Uncoupling respiration from phosphorylation results in the coupling relationship between the bc1 and aa3 reactions becoming partially fixed. This change is accompanied by marked decreases in the degrees to which the bc1 and aa3 reactions limit the overall reaction and appears to account for the large uncoupler-induced releases of inhibition at the levels of the bc1 and aa3 reactions observed previously by others. It is suggested that cytochrome c is the freely diffusible intermediate between the bc1 and aa3 reactions and that the uncoupler-induced changes occur as a result of formation of functional and highly efficient supercomplexes between cytochrome c and the cytochromes bc1 and aa3 complexes.

Animals↗
PubMed1982

Common phoneme and overall similarity relations among spoken syllables: their use by children and adults.

This paper contrasts two kinds of relations among spoken syllables. One relation is based on a single common phoneme; the second is based on overall similarity of whole syllables. On the basis of recent studies with multidimensional visual stimuli, we hypothesized that preliterate children respond primarily to overall similarity relations among syllables, whereas literate adults respond primarily to common phoneme relations. These hypotheses were tested in two experiments using spoken syllables. Experiment 1 investigated the classification of syllables by preliterate children (mean age: 4 years 4 months) and college students. Experiment 2 studied the memory confusions among syllables by children (mean age: 4 years 8 months) and college students. The results of both experiments suggest that overall similarity relations are primary for preliterate children, while common phoneme relations are primary for adults. Moreover, children's limited use of common phoneme relations is not confined to tasks that require explicit judgments about language. Implications for the learning of reading are discussed.

Child Language↗
PubMed1990

Does a single local absorptiometric bone measurement indicate the overall skeletal status? Implications for osteoporosis and osteoarthritis of the hip.

Regional bone mineral content (BMC) and density (BMD) (head, arms, chest, spine, pelvis, legs) of a total body dual photon 153Gd absorptiometry (DPA) scan were measured in 20 healthy postmenopausal women, 27 postmenopausal women with hip fracture, and 17 postmenopausal women with osteoarthritis of the hip. In addition, local BMC and BMD were measured in the proximal and distal regions of the distal forearm (BMCprox, BMDprox, BMCdist, BMDdist) by single photon absorptiometry (SPA); and in the lumbar spine (BMCL2-L4 and BMDL2-L4) by 153Gd DPA. The overall impression was a reduction of bone mass in hip fracture patients compared with healthy controls and an increase in the bone mass of osteoarthritic patients. These results were valid using both regional values of the total body scan, and local forearm and lumbar spine measurements, and statistically significant using one-way analysis of variance. There were, however, also significant within-group between-region differences (one-way analysis of variance), showing that the bone mass of the pelvis and legs in hip fracture patients was more reduced than in the remaining skeleton; in osteoarthritic patients it was not increased but rather unchanged or slightly reduced. The differences between the level of the three local measurements (BMDprox BMDdist BMDL2-L4), on the one hand, and the level of the six regional BMD values, on the other hand, were investigated by the two-way analysis of variance: local measurements = rows; regional values = columns. This analysis showed that none of the three local measurements was statistically better than the other two in predicting the overall level of skeletal bone mass as judged by the six regional values. We conclude that serious osteoporotic bone loss has a generalized nature, however, with a tendency towards lower values in the regions affected by fracture (viz: low bone mass in the legs of femoral neck fracture patients). Osteoarthritis may be associated with a high bone mass in most areas, but low values in the affected regions. Local lumbar spine measurement of bone mass by DPA is not superior to local forearm measurement of bone mass by SPA in predicting the nature of overall osteoporotic or osteoarthritic bone change.

Absorptiometry, Photon↗
PubMed2005

Clinicopathological factors predicting long-term overall survival after hepatectomy for peripheral cholangiocarcinoma.

Peripheral cholangiocarcinoma (PCC) is clinically challenging because patients typically do not present until the disease is relatively advanced. Three-year to 5-year survival rates even with resection thus remain dismal. This study aimed to determine the clinicopathological factors for predicting overall survival longer than 5 years in PCC patients treated with hepatectomy. From 1977 to 1997, the clinicopatholgical features of 11 PCC patients who underwent hepatectomy with long-term overall survival (group A) were reviewed. Comparison was made with the clinical features and factors influencing the outcome of 70 PCC patients who survived less than 5 years after hepatectomy (group B). Of 81 PCC patients undergoing hepatectomy, 11 (13.6%) were 5-year survivors. The 81 PCC patients comprised 32 men and 49 women, with a mean age of 56.0 years (range: 34-83 years). Univariate analysis showed that female gender, absence of physical findings, a higher percentage of presence of mucobilia, early staged tumor, intraductal papillary tumor growth, and curative hepatic resection were more frequent in group A patients than group B patients. However, multivariate logistic regression analysis showed that absence of physical findings, presence of mucobilia, early staged tumor, and curative hepatic resection were the four independent factors differentiating group A from B patients. The 1-, 3-, 5-, and 10-year survival rates of the group A patients were 100%, 100%, 100%, and 40%, whereas those of the group B patients were 46.0%, 9.5%, 0%, and 0%, respectively. Absence of physical findings, presence of mucobilia, early staged tumor, and curative hepatectomy could independently predict PCC patients with long-term overall survival after hepatectomy.

Aged↗