[Determination of Du factor using Groupamatic. Comparison with manual technics. Report of 203,240 determinations].
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OBJECTIVE: To determine whether a valgus knee brace altered the alignment of the shank segment with respect to the thigh segment of patients with medial gonarthrosis of the knee. DESIGN: Twelve (subject) x 2 (brace condition) x 2 (speed) repeated measures design. METHODS: Twelve male subjects (mean age 55 yr, SD 5 yr) who were prescribed a valgus knee brace for medial gonarthrosis walked on a treadmill at normal (mean 1.5 m/s, SD 0.3 m/s) and fast walking speed (mean 2.1 m/s, SD 0.2 m/s) while filmed by two gen-locked video cameras. Flexion, coronal and axial rotation angles of the thigh and shank segments in a global co-ordinate system were determined from kinematic data of reflective markers on the affected leg. Data were calibrated with respect to the standing 'no-brace' condition and averaged over five step cycles at four specific points in time during the stance phase. RESULTS: The brace had no effect on thigh coronal angle but reduced shank coronal angle at toe-off (statistically significant). The brace also prevented full extension (statistically significant) during mid-stance by resisting valgus forces in the coronal plane transmitted though the brace's helical strap. This same strap was believed to be responsible for axial forces that created statistically significant external rotation of the thigh axial angle throughout the stance phase and internal rotation of the shank axial angle during knee extension at heel strike and mid-stance. The brace hinge may explain the unexpected external rotation of the shank axial angle that accompanied knee flexion. CONCLUSION: This study demonstrated that the brace altered the kinematics in all three planes of motion and transmitted forces from one plane to another. This study also indicates that the subject-brace interaction was more complex in nature than initially anticipated. RELEVANCE: Clinical evidence suggests that there can be a reduction of knee pain by wearing a valgus brace for medial gonarthrosis and that the brace alters the orientation of thigh and shank segments during gait in such a manner to reduce the inter-joint pressure of the afflicted compartment. Therefore a biomechanical analysis of a possible kinematic effect was warranted.
As a follow-up to the Brown et al., 1993 technique, we have made several improvements to the micro-cannula, osmotic pump procedure, enabling chronic intracochlear infusions while maintaining hearing. In addition, acute bolus injection techniques are briefly described in guinea pig, rat and mouse.
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Medical practice produces much in the form of written text. The under-usage of this medical text for research is largely due to difficulties in processing the information. The objective of the Aristotle project is to build an automatic data system that is capable of producing a semantic representation of the text in a canonical form. Understanding the text requires identifying objects mentioned in the text, their properties, and the links between them. The nature of the syntactic process allows the connection, step-by-step, of two lexical units. This connection is immediately controlled by the Interpreter, which assumes the semantic process and queries a knowledge base. The syntactic-semantic Interpreter processes one sentence at a time. The Assembler module links the meaning of the different sentences and structures into the output's shape.
The Metafer2 fluorescence scanning system was used for routine analysis of radiation-induced exchange aberrations measured by fluorescence in situ hybridisation (FISH) chromosome painting in human peripheral lymphocytes. The system enables a rapid and unbiased fully-automated finding and image acquisition of fluorescently stained metaphase spreads. The chromosome aberration analysis is performed interactively from stored digitised processed gallery images, presented on a screen. Appropriate software image filters are available to further improve these pictures by background correction, noise reduction and fluorescence signal enhancement. Data sets generated by computer-assisted and manual scoring of radiation-induced reciprocal translocations (2B) and total 2B (2B+related 'one-way' types) or complete dicentrics (2A) and total 2A (2A+related 'one-ways') involving painted target chromosomes 2, 3 or 4 were compared and no significant differences were found.A linear-quadratic dose-response curve for total translocations (2B+'one-ways'+complex-derived types) based on computer-assisted analysis of 27,741 metaphases with chromosome 4 painting was compared to a curve obtained earlier for manually scored translocations in a set of target chromosomes 1, 4 and 12. After extrapolation to the whole genome, no significant difference between both curves was found. From our results it can be derived that computer-assisted aberration analysis using the Metafer2 system is a reliable alternative to manual analysis. Since time saving for computer-assisted translocation analysis is about 50% compared to manual scoring, this system is highly promising for a practical application in retrospective biodosimetry of human radiation exposure.
A method of internal fixation of adjacent vertebrae that have been dislocated or subluxed has been presented. In the author's hands and in the hands of associates this has proven to be a satisfactory method of fixation in this type of injury. It has the advantage over many other posterior techniques that only two verbebrae are fixed together.
A paucity of information exists to characterize the relationship between the health status of elderly people and their physical environment. The Canadian Study of Health and Aging (CSHA) is a multicenter study of the distribution of dementia among community-dwelling and institutionalized Canadians aged 65 years and older. The study also provides the opportunity to examine issues such as the physical environment which may be related to the health of elderly people. Six items were used to assess the cleanliness, neatness, and maintenance of the inside and outside of the homes of 8,134 community-dwelling individuals. Data were also obtained to evaluate cognition, physical health, and functional capacity. Five years after the original survey, information pertaining to subsequent institutionalization and/or mortality was obtained. A significant relationship was found between classification of physical environment and the outcomes of institutionalization and mortality. The likelihood of both adverse outcomes was notably higher for individuals living in a "less than ideally maintained environment" compared to an "ideally maintained environment." Limitations of the six items used to assess the physical environment and ways in which to improve the sensitivity of the items, consequently avoiding measurement bias, are discussed.
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BACKGROUND/METHODS: Molecular Adsorbent Recirculating System (MARS) was used in three consecutive critically ill patients at the Singapore General Hospital with advanced malignancy and acute liver failure (ALF). Case 1 was a male patient with hepatocellular carcinoma (HCC) for which initial right hepatectomy was followed by left hepatectomy 5 months later for recurrent HCC. The postoperative course following second surgery was complicated by severe methicillin-resistant Staphylococcus aureus (MRSA) sepsis, mild azotaemia and subacute cholestatic liver failure. MARS was used thrice in this patient. Case 2 was a female patient with advanced acute lymphoblastic leukaemia (ALL) with post bone marrow transplantation (BMT) acute haemolytic-uraemic syndrome (HUS) secondary to cyclosporin A (Cy A), cytomegalovirus (CMV) infection, severe nosocomial pneumonia, acute renal failure (ARF) treated with continuous haemofiltration and acute veno-occlusive disease resulting in Budd-Chiari syndrome. The latter precipitated ALF. MARS was instituted twice. Case 3 was a male patient with advanced, refractory Hodgkin's disease previously treated with multiple courses of chemotherapy. ALF developed secondary to acute viral hepatitis B flare. He was given a trial of MARS once in the ICU. All the three patients eventually died. RESULTS: Mean MARS intradialytic systemic pressures were as follows: systolic pressure range was 95 +/- 17 to 128 +/- 17 mmHg and diastolic pressure range was 51 +/- 5 to 67 +/- 7 mmHg. Pressure at albumin dialysate exit point from dialyser 1 (Ae) ranged from 253 +/- 11 to 339 +/- 15 mmHg and that at albumin dialysate entry point into dialyser 1 (Aa) ranged from 142 +/- 11 to 210 +/- 6 mmHg. Ultrafiltration (UF) was 633 +/- 622 mL over mean treatment duration of 6.3 +/- 0.9 h with a total heparin dose of 1583 +/- 817 IU. Coagulation status pre- and 6-h post-MARS was similar: aPTT (P=0.116) and platelet count (P=0.753). There were no bleeding complications or circuit thromboses. MARS had a significant de-uraemization effect (pre- and post-MARS serum creatinine and urea: P=0.046 and 0.028, respectively) but did not significantly attenuate blood lactate, ammonia or total bilirubin levels. Albumin dialysate (Ae - Aa) urea and creatinine concentrations appeared to be sharply attenuated after 6 h of MARS. In contrast, the removal of total bilirubin by albumin dialysate from the blood compartment appeared to plateau after 4 h of continuous MARS operation. CONCLUSIONS: MARS was well-tolerated in critically ill patients with advanced and complicated cancer. Low-dose heparin was safe and did not compromise MARS circuit integrity. Although MARS had a significant de-uraemization effect, this appeared to be limited by the duration of MARS operation. Our data suggested that such a limit was reached earlier for total bilirubin. More data are needed to confirm the present findings and further delineate the saturation limit of MARS for different toxins that accumulate in ALF. This would affect the optimal duration of MARS therapy.