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PubMed2001

Effects of hyperoxia on ventilatory limitation during exercise in advanced chronic obstructive pulmonary disease.

We studied interrelationships between exercise endurance, ventilatory demand, operational lung volumes, and dyspnea during acute hyperoxia in ventilatory-limited patients with advanced chronic obstructive pulmonary disease (COPD). Eleven patients with COPD (FEV(1.0) = 31 +/- 3% predicted, mean +/- SEM) and chronic respiratory failure (Pa(O(2)) 52 +/- 2 mm Hg, Pa(CO(2 ))48 +/- 2 mm Hg) breathed room air (RA) or 60% O(2) during two cycle exercise tests at 50% of their maximal exercise capacity, in randomized order. Endurance time (T(lim)), dyspnea intensity (Borg Scale), ventilation (V E), breathing pattern, dynamic inspiratory capacity (IC(dyn)), and gas exchange were compared. Pa(O(2)) at end-exercise was 46 +/- 3 and 245 +/- 10 mm Hg during RA and O(2), respectively. During O(2), T(lim) increased 4.7 +/- 1.4 min (p < 0.001); slopes of Borg, V E, V CO(2), and lactate over time fell (p < 0.05); slopes of Borg-V E, V E-V CO(2), V E-lactate were unchanged. At a standardized time near end-exercise, O(2) reduced dyspnea 2.0 +/- 0.5 Borg units, V CO(2) 0.06 +/- 0.03 L/min, V E 2.8 +/- 1.0 L/min, and breathing frequency 4.4 +/- 1.1 breaths/min (p < 0.05 each). IC(dyn) and inspiratory reserve volume (IRV) increased throughout exercise with O(2) (p < 0.05). Increased IC(dyn) was explained by the combination of increased resting IRV and decreased exercise breathing frequency (r(2) = 0.83, p < 0.0005). In conclusion, improved exercise endurance during hyperoxia was explained, in part, by a combination of reduced ventilatory demand, improved operational lung volumes, and dyspnea alleviation.

Aged↗
PubMedDate not supplied

Role of the Gianturco expandable metal stent in the management of tracheobronchial obstruction.

This paper reports our experience in treating localized airway obstruction with expandable metal stents. Nine patients were treated for malignant obstruction and 6 for benign obstruction. The main indications for treatment were imminent asphyxia, breathlessness and/or repeated chest infections. All but 2 patients had received other treatments before referral. Seven patients with malignant obstruction had extrinsically compressed airways and all derived a sustained symptomatic improvement. Two patients with recurrent tracheal obstruction caused by intraluminal tumor gained lasting relief with the use of a covered expandable metal stent. All 6 patients with benign strictures were improved, although 2 developed recurrent obstruction caused by granulation tissue growing within and beyond the stent. It is concluded that the expandable metal stent provides an effective and noninvasive method of relieving large airway obstruction. As the long-term tissue tolerance to this type of stent is not known, caution is advised in the management of benign strictures. In patients with malignant obstruction, however, the expandable metal stent would appear to have considerable potential as a palliative treatment.

Adult↗
PubMed1998

[Taste and lacrimation after acoustic neuroma surgery].

AIM OF THE STUDY: Postoperative sensory component of the facial nerve after acoustic tumor surgery has received little attention in the literature. The object of the present investigation was to review this specific topic analyzing the postoperative frequency of taste and lacrimation (crocodile tears or dry eye) abnormalities. MATERIAL AND METHODS: 54 patients who underwent acoustic tumor removal were selected for this study. Each of these patients was recalled and pre and postoperative evolution of the sensory dysfunction were assessed. The latters were correlated with the facial function evaluated according to the House-Brackmann classification. RESULTS: Postoperative taste dysfunction (reduced or changed sensation) was complained by 38.5% of the patients. After surgery, 42.3% of the cases had crocodile tears, while in 59.6% altered tearing occurred. DISCUSSION: The present study, according to the Irving et al's experience confirmed a significant incidence of postoperative abnormal function of the sensory facial nerve. The influence of the motor component on these outcomes was variable. Lacrimation worsened when facial function was poor. On the other hand, grades V or VI did rarely manifest crocodile tears. Clinically, these findings implies the importance of a preoperative counseling of such particular aspect in the candidates to surgery of acoustic neuroma in order to adequately motivate them and, at the same time, to reduce their psychological discomfort.

Adult↗
PubMed2003

Ciclopirox gel in the treatment of patients with interdigital tinea pedis.

UNLABELLED: BACKGROUND Tinea pedis (athlete's foot) is the most common fungal infection in the general population. Ciclopirox, a broad-spectrum hydroxypyridone antifungal, has proven efficacy against the organisms commonly implicated in tinea pedis; Trichophyton rubrum, T.mentagrophytes and Epidermophyton floccosum. OBJECTIVE: Two multicenter, double-blind, clinical studies compared the efficacy and safety of ciclopirox gel with that of its vehicle base in subjects with moderate interdigital tinea pedis with or without plantar involvement. METHODS: Three hundred and seventy-four subjects were enrolled and randomized to one of two treatment groups: ciclopirox gel 0.77%, or ciclopirox gel vehicle, applied twice daily for 28 days, with a final visit up to day 50. The primary efficacy variable was Treatment Success defined as combined mycological cure and clinical improvement >/= 75%. Secondary measures of effectiveness were Global Clinical Response, Sign and Symptom Severity Scores, Mycological Evaluation (KOH examination and final culture result), Mycological Cure (negative KOH and negative final culture results) and Treatment Cure (combined clinical and mycological cure). RESULTS: At endpoint (final post-baseline visit), 60% of the ciclopirox subjects achieved treatment success compared to 6% of the vehicle subjects. At the same time point, 66% of ciclopirox subjects compared with 19% of vehicle subjects were either cleared or had excellent improvement. Pooled data showed that 85% of ciclopirox subjects were mycologically cured, compared to only 16% of vehicle subjects at day 43, 2 weeks post-treatment. CONCLUSIONS: Ciclopirox gel 0.77% applied twice daily for 4 weeks is an effective treatment of moderate interdigital tinea pedis due to T. rubrum, T. mentagrophytes and E. floccosum and is associated with a low incidence of minor adverse effects.

Administration, Topical↗
PubMed2005

A human phase 1 vaccine clinical trial of the Plasmodium falciparum malaria vaccine candidate apical membrane antigen 1 in Montanide ISA720 adjuvant.

A dose escalating, placebo-controlled phase 1 trial was conducted to test the safety and immunogenicity of a vaccine containing recombinant Plasmodium falciparum apical membrane antigen 1 (AMA1) formulated in Montanide ISA720. Three groups of volunteers were vaccinated intramuscularly with 5 microg, 20 microg or 80 microg of AMA1, respectively, in 0.5 mL of formulation at 0, 3 and 6 months. Anti-AMA1 antibody levels and T cell stimulation indices were measured before and after each vaccination. No vaccine-related serious adverse events were recorded. Most subjects generated a mild to moderate, transient local reaction after the first vaccination. Three subjects developed a local reaction approximately 10 days following vaccination. Six of the 29 subjects seroconverted. Only one of these developed a high antibody titre. However, the interpretation of this trial was compromised by a loss of potency of the formulated vaccine during the course of the study.

Adjuvants, Immunologic↗
PubMed1999

Measuring the noise attenuation of shotblasting helmets.

Air-fed blasting helmets are used in abrasive blasting operations to provide essential face, eye and respiratory protection. BS EN 271: 1995 (equivalent to the European Standard EN 271: 1997), the standard that deals with the construction of blasting helmets, addresses the above matters and also the problem of noise generated by the breathing air supply. However it has no requirements for manufacturers to measure or report the helmet's ability to attenuate the very high levels of noise generated by the blasting process. The aim of the project was to develop a test method to measure the noise attenuation of shotblasting helmets. The method developed is an objective measurement, using a head and torso simulator (HATS), which provides a suitable means for helmet manufacturers to report their product's ability to attenuate blasting noise. The results from this project showed that the HATS currently prescribed by BS EN 271: 1995 can be used for measuring the noise attenuation of helmets against typical shotblasting noise. Using such a HATS in the proposed test method will give attenuation values that correlate well with those measured using human subjects. Therefore the HATS already used by manufacturers to show compliance of their product with BS EN 271: 1995 could also be used to provide information on the helmet's noise attenuation. Results from this project also showed that the same HATS can be used, in place of human subjects, to measure the air supply noise according to the method defined in BS EN 271: 1995. BS EN 271: 1995 is due for revision in 2000. The results from this work should be used to influence future revisions of the standard so that requirements to measure and report noise attenuation of shotblasting helmets are considered, a major omission in the present standard.

Equipment Design↗
PubMed1987

A comparison of some gradient-encoded volume-selection techniques for in vivo NMR spectroscopy.

Four of the techniques proposed for in vivo volume-selected NMR spectroscopy have been compared using a simple phantom with a large background water signal which was outside the region of interest. The methods VSE, SPACE, SPARS, and DIGGER all use pulsed field gradients for spatial encoding and were tested with a symmetric and an asymmetric phantom. SPACE was used to obtain volume-selected 1H NMR spectra of a human leg, demonstrating excellent discrimination between bone marrow and muscle.

Humans↗
PubMed2006

Effects of periodontal therapy during pregnancy on periodontal status, biologic parameters, and pregnancy outcomes: a pilot study.

BACKGROUND: Few studies have examined the potential effects of periodontal treatment during pregnancy on pregnancy outcomes, periodontal status, and inflammatory biomarkers. METHODS: A randomized, delayed-treatment, controlled pilot trial was conducted to evaluate the effects of second-trimester scaling and root planing and the use of a sonic toothbrush on the rate of preterm delivery (<37 weeks gestation). Secondary outcome measures included changes in periodontal status, levels of eight oral pathogens, levels of gingival crevicular fluid (GCF) interleukin-1beta (IL-1beta), prostaglandin E(2) (PGE(2)), 8-isoprostane (8-iso), and IL-6, and serum levels of IL-6, soluble intercellular adhesion molecule 1 (sICAM1), 8-isoprostane, soluble glycoprotein 130 (sGP130), IL-6 soluble receptor (IL-6sr), and C-reactive protein (CRP). Logistic regression models were used to test for effects of treatment on preterm delivery. Secondary outcomes were analyzed by analysis of covariance adjusting for subject baseline values. RESULTS: Periodontal intervention resulted in a significantly decreased incidence odds ratio (OR) for preterm delivery (OR = 0.26; 95% confidence interval = 0.08 to 0.85), adjusting for baseline periodontal status which was unbalanced after randomization. Pregnancy without periodontal treatment was associated with significant increases in probing depths, plaque scores, GCF IL-1beta, and GCF IL-6 levels. Intervention resulted in significant improvements in clinical status (attachment level, probing depth, plaque, gingivitis, and bleeding on probing scores) and significant decreases in levels of Prevotella nigrescens and Prevotella intermedia, serum IL-6sr, and GCF IL-1beta. CONCLUSIONS: Results from this pilot study (67 subjects) provide further evidence supporting the potential benefits of periodontal treatment on pregnancy outcomes. Treatment was safe, improved periodontal health, and prevented periodontal disease progression. Preliminary data show a 3.8-fold reduction in the rate of preterm delivery, a decrease in periodontal pathogen load, and a decrease in both GCF IL-1beta and serum markers of IL-6 response. However, further studies will be needed to substantiate these early findings.

Adult↗
PubMed2003

Effect of polishing systems on the surface roughness of microhybrid composites.

PURPOSE: This study was undertaken to examine the effect of three different polishing systems on surface roughness of five newly developed resin composites. MATERIALS AND METHODS: Three microhybrid composites (Point 4, Kerr, Orange, CA; Esthet-X, Dentsply/Caulk, Milford, DE; Vitalescence, Ultradent, South Jordan, UT, USA), one microfilled composite (Renamel Microfill, Cosmedent, Chicago, IL, USA), and one experimental microhybrid composite (FZB, Ivoclar Vivadent, Schaan, Liechtenstein) were light cured with a Mylar strip. Fifteen specimens of each composite (6 mm in diameter and 3 mm in depth) were fabricated and randomly assigned to three groups. Specimens in each group were finished with a carbide bur (16 fluted) and three polishing systems (Astropol, Ivoclar Vivadent; Diagloss, Axis Dental, Irving, TX, USA; Sof-Lex, 3M, ESPE, St. Paul, MN, USA). The average surface roughness (Ra) and the mean peak spacing (Sm) were measured with a surface profilometer after polishing. Five tracings at different locations on each specimen were made. Data were analyzed by analysis of variance. RESULTS: For Astropol, Ra ranged from 0.10 to 0.15 microm and Sm ranged from 24 to 40 microm for the five composites; for Diagloss, Ra ranged from 0.24 to 0.34 microm and Sm from 38 to 74 pm; for Sof-Lex, Ra ranged from 0.06 to 0.10 microm and Sm ranged from 16 to 22 microm. Significant differences between materials and polishing systems were observed. Polishing systems had the most important role in determining the surface roughness of resin composites. CLINICAL SIGNIFICANCE: Of the polished systems tested, Sof-Lex discs provided the lowest roughness for polishing microfilled and microhybrid composites, and the microfilled resin composite showed the lowest roughness.

Analysis of Variance↗
PubMed1998

Human antiretinal antibodies in toxoplasma retinochoroiditis.

BACKGROUND/AIMS: Toxoplasma retinochoroiditis (TR) is an important cause of blindness and visual morbidity, affecting young adults. It has been postulated that some of the retinal damage observed in TR is due to antiretinal autoimmune mechanisms. METHODS: Humoral antiretinal autoimmunity in TR was investigated by indirect immunofluorescence (IIF) on normal human cadaveric retina and by a human retinal S-antigen ELISA. 36 patients with TR were separated on clinical grounds into those with first recurrence of disease (n = 18) or those with multiple recurrences (n = 18). Patients were also segregated into those with active (n = 28) or quiescent disease (n = 8). Serum from 16 normal controls (six with positive toxoplasma serology and 10 without) with no evidence of eye disease and 12 patients with idiopathic retinal vasculitis (IRV) were also tested. RESULTS: Sera from 34 of the 36 patients (94%) with TR demonstrated photoreceptor layer reactivity by IIF contrasting with six of 16 normal controls (p = < 0.001) and three of 12 IRV patients (p = < 0.001). Titres of antiphotoreceptor antibody were also higher among TR patients than controls. Sera from 27 of the 36 TR patients, 10 of 16 normals, and nine of 12 retinal vasculitis patients possessed anti-human retinal S-antigen antibodies at a titre of 1:400 or more as assessed by ELISA (p = > 0.05). Antiretinal autoantibody as detected by IIF did not run in parallel with S-antigen reactivity. CONCLUSIONS: The data indicate that the extent of antiretinal reactivity within TR is not accounted for by anti-S-antigen antibodies alone. This remarkably high prevalence of antiphotoreceptor antibody in TR as opposed to that found in either healthy or disease controls suggest that these antibodies may be co-pathogenic in toxoplasma retinochoroiditis.

Adult↗
PubMed1977

Protection of the skin around intestinal fistulas.

The use of two recently introduced skin protective preparations in the treatment of perifistular skin inflammation is described. Karaya gum in paste form (karaya paste) and a compressed wafer of gelatin, pectin and methyl cellulose (Stomahesive) were used, alone or in combination; with drainable collecting appliances. The method protects the inflamed skin from fistula discharge and allows healing to proceed beneath the dressing. A technique to improve the adhesion of the appliance, in spite of large fluid losses, is outlined. Healing of skin excoriation was obtained in nearly all cases. Complete control of leakage was achieved in a group of patients with a high output fistula.

Administration, Topical↗
PubMed1999

The narrow therapeutic window of glycated hemoglobin and assay variability.

Glycated hemoglobin is measured by a variety of assays, each of which has a unique normal level. Our purpose is to show that among the different assays available in the United States, using the same patient's blood sample, assay results may vary widely and may more or less easily achieve a glycated hemoglobin value within the normal range. The following assays were compared using the same patient's blood sample for each pair of assays: glycohemoglobin affinity assay (GHB Reader; Isolab, Akron, OH) versus gel electrophoresis assay (n = 76); Isolab versus ion capture assay (IMX; Abbott Laboratories, Irving, TX) (n = 57); monoclonal antibody assay (DCA2000; Bayer Diagnostics, Pittsburgh, PA) versus IMX (n = 100); and high-performance liquid chromatography (HPLC) assay (Bio-Rad Variant A1c; Bio-Rad Laboratories, Richmond, CA) versus IMX assay (n = 55). Our analyses indicate that a relative ranking can be established for the ease of achieving a normal glycated hemoglobin level. The ranking indicates that the most stringent or difficult assays for achieving a normal level are the Isolab and DCA2000 assays. The intermediate assays are the IMX and Bio-Rad Variant, and the easiest method for achieving a normal value is the gel electrophoresis assay. Our results indicate that various glycated hemoglobin assays vary widely and are associated with more or less difficulty for an individual patient to achieve a glycated hemoglobin level within the normal range. These results are especially significant with respect to (1) the clinically narrow therapeutic window of glycated hemoglobin values in type 1 diabetes to avoid rapidly advancing severe hypoglycemia rates and chronic microvascular complication rates, and (2) the glycated hemoglobin threshold for rapidly advancing macrovascular disease in both type 1 and type 2 patients.

Adolescent↗
PubMed1999

Human phase I vaccine trials of 3 recombinant asexual stage malaria antigens with Montanide ISA720 adjuvant.

Two phase I vaccine trials were conducted to test the immunogenicity and safety of a vaccine containing three recombinant malaria antigens from the asexual stage of Plasmodium falciparum. The three antigens are a fragment of MSP1 (190LCS.T3); MSP2 and a portion of RESA and were formulated in Montanide ISA720 adjuvant. These trials investigated the dose response of each antigen for eliciting both antibody and T-cell responses and the immunogenicity of a mixture of the antigens compared with the antigens injected separately. All three antigens elicited both antibody and T-cell responses. Strong T-cell responses were observed with 190LCS.T3 and RESA with stimulation indices exceeding 100 for peripheral blood leucocytes in some individuals. The antibody responses were generally weak. The human antibody responses observed with MSP2 in Montanide ISA720 were not significantly different from those obtained in an earlier trial which used MSP2 with alum as the adjuvant. No antigenic competition was observed: volunteers receiving a mixture of antigens had similar responses to those receiving the three antigens at separate sites. Tenderness and pain at the injection site were common over the first few days following immunization. In some volunteers, especially those receiving the highest doses tested, there was a delayed reaction at the injection site with pain and swelling occurring approximately 10 days after injection.

Adjuvants, Immunologic↗
PubMed2005

Systematic design of chemical oscillators using complexation and precipitation equilibria.

Concentration oscillations are ubiquitous in living systems, where they involve a wide range of chemical species. In contrast, early in vitro chemical oscillators were all derived from two accidentally discovered reactions based on oxyhalogen chemistry. Over the past 25 years, the use of a systematic design algorithm, in which a slow feedback reaction periodically drives a bistable system in a flow reactor between its two steady states, has increased the list of oscillating chemical reactions to dozens of systems. But these oscillating reactions are still confined to a handful of elements that possess multiple stable oxidation states: halogens, sulphur and some transition metals. Here we show that linking a 'core' oscillator to a complexation or precipitation equilibrium can induce concentration oscillations in a species participating in the equilibrium. We use this method to design systems that produce periodic pulses of calcium, aluminium or fluoride ions. The ability to generate oscillations in elements possessing only a single stable oxidation state (for example, Na+, F-, Ca2+) may lead to reactions that are useful for coupling to or probing living systems, or that help us to understand new mechanisms by which periodic behaviour may arise.

Journal Article↗
PubMed2004

Molecular insights into Cumacean family relationships (Crustacea, Cumacea).

Cumaceans are a diverse order of small, benthic marine crustaceans. Phylogenetic hypotheses for the eight currently recognized cumacean families have not been formally proposed. However, based on external morphological traits and Linnean classification, a few conflicting hypotheses of relatedness have been proposed. Family definitions rely on morphological characters that often overlap and diagnoses are based on a combination of non-unique characters. Morphological analysis does not provide a well-resolved phylogeny. In the present study, we use amino acid sequences from the mitochondrial cytochrome oxidase I gene to produce a molecular phylogenetic hypothesis for the families of Cumacea. Phylogenetic analyses at the amino acid level were performed under Bayesian, likelihood, and parsimony methods. Results strongly suggest that families lacking an articulated telson form a monophyletic group. This pleotelson clade, composed of the families Bodotriidae, Leuconidae, and Nannastacidae, is the most derived within the Cumacea. Within this group, the Bodotriidae resolve paraphyletically, with Leuconidae and Nannastacidae embedded within it. Comparison of the molecular phylogeny with that based on morphology suggests that many "diagnostic" characters are homoplasious.

Animals↗
PubMed2001

Protein affinity maturation in vivo using E. coli mutator cells.

This protocol provides a simple in vivo strategy for introducing random mutations to a target DNA sequences using E. coli mutator cells. The method has been used in our laboratory for affinity maturation of proteins encoded by target DNA sequences. Selection conditions can be modified for antibody fragments with increased production levels. Growth conditions in E. coli mutator cells can be adjusted to introduce a single random point mutation per kilobase of DNA, approximately equivalent to one codon change per scFv fragment.

Antibodies↗
PubMed1995

Detection of cytomegalovirus using PCR in serum from renal transplant recipients.

AIMS: To develop a polymerase chain reaction (PCR) assay for the detection of cytomegalovirus (CMV) DNA in serum and leucocytes of renal transplant recipients and compare this assay with CMV culture and serodiagnosis. METHODS: Monthly specimens were obtained from 12 patients starting immediately before transplant. CMV infection was monitored by IgM enzyme linked immunosorbent assay, virus culture and PCR on serum and leucocytes. RESULTS: Two of four IgG positive patients had reactivation of CMV disease confirmed by culture, three of eight seronegative patients had a primary infection, one confirmed by serology and two by culture. PCR was positive earlier than conventional methods in three cases and concurrently in two. No positive PCR reactions occurred in the seven patients who remained negative by culture and serology. CONCLUSIONS: CMV DNA is detectable in serum; serum may be positive before virus is detectable by buffy coat culture; and PCR may be useful as an early indication of potential CMV disease in renal transplant recipients.

Adult↗
PubMed1975

A double-blind trial of patient-controlled nitrous-oxide/oxygen analgesia in myocardial infarction.

The analgesic effect of self-administered nitrous oxide 50%/oxygen 50% ('Entonox" analgesic apparatus) was compared with air given by the same method in a double-blind trial in 81 patients with myocardial infarction. Self-administered nitrous oxide/oxygen, which was associated with a low frequency of side-effects, proved significantly more effective than air in the early relief of severe cardiac pain, but not in the relief of moderate or slight pain or when administration was continued after ten minutes.

Adult↗