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PubMed2006

Impact of sodium and ultrafiltration profiling on haemodialysis-related hypotension.

BACKGROUND: Symptomatic hypotension is the most frequent complication in patients receiving haemodialysis (HD). Previous studies have reported that the use of modulating dialysate sodium concentration or ultrafiltration (UF) rates, or the combination use of sodium profile and UF profile may better preserve blood volume and reduce the incidence of hypotensive episodes. The aim of this study was to evaluate the effects of sodium balance-neutral sodium profile and UF profile and their combination on preservation of blood volume, cardiac function and occurrence of hypotensive episodes. METHODS: Using Fresenius MC 4008S, eight stable HD patients underwent four treatments: (1) control, constant dialysate sodium concentration of 138 mmol/l with constant UF; (2) sodium profile, a linearly decreasing dialysate sodium concentration (148-131 mmol/l) with constant UF; (3) UF profile, a linearly decreasing UF rate with dialysate sodium concentration of 138 mmol/l; (4) sodium+UF profile, combination of sodium and UF profile. Each treatment was applied in 10 dialysis sessions. Relative blood volume (RBV), mean blood pressure (MBP), heart rate (HR), interior vena cava diameter (IVCD), stroke volume (SV), cardiac output (CO), plasma sodium concentration and the frequency of symptomatic hypotension were monitored. RESULTS: There were no significant differences in the IVCD, MBP, SV, CO and body weight before dialysis between the three profiles and the control. The total plasma protein, haemoglobin, and intradialytic sodium mass removal showed similar results. Compared with the control, better preservation of RBV and MBP at 4 and 5 h and a higher stability in SV variation, but larger UF volume were achieved during sodium+UF profile (P<0.05, respectively), the incidence of intradialytic hypotension was significantly reduced (P<0.05). CONCLUSIONS: With the similar intradialytic sodium removal, during sodium balance-neutral linearly decreasing sodium profile combined with linearly decreasing UF profile, greater intradialytic stability of the blood volume, blood pressure and cardiac function could be obtained, and hypotensive episodes were significantly reduced.

Blood Pressure↗
PubMed1999

The future of physician profiling.

Although enthusiasm for physician profiling dates back to the origins of scientific medicine, the track record of profiling as an intervention is not strong. Profiling appears to be most valuable for simple interventions and processes, but its acceptance, usefulness, and impact will be influenced by future trends. Health care organizations will continue to be complex, and multiple overlapping profiles will be the norm. Technology will advance, but concerns over privacy and confidentiality will influence the social, political, and regulatory approaches to profiling. Public sector purchasers and consumers will increasingly demand profiling, but data will continue to lack the ability to interpret complex profiling data. Medical practice will increasingly accept profiling as part of ongoing quality improvement efforts, but profiling may become focused on key processes, not outcomes. Statistical, cognitive, and epistemological challenges to profiling will remain, and profiling may simultaneously become more complex and more simplified with the rise of information brokers. Greater attention to the human side of profiling will enhance its effectiveness.

Data Collection↗
PubMed2004

Corneal asphericity change after excimer laser hyperopic surgery: theoretical effects on corneal profiles and corresponding Zernike expansions.

PURPOSE: To determine the theoretical relationships between the changes in corneal paraxial power, asphericity, and the corresponding Zernike polynomial expansion after conventional and customized excimer laser correction of hyperopia. METHODS: The initial corneal profile was modeled as a conic section of apical radius of curvature R1 and asphericity Q1. The theoretical value of the postoperative apical radius of curvature R2 was computed by using a paraxial formula from the value of R1 and hyperopic defocus D. The postoperative asphericity Q2 of the corneal surface was computed within the optical zone of diameter S after the delivery of a Munnerlyn-based profile of ablation for hyperopia using conic section-fitting and minimization of the squared residuals. These calculations were repeated for different values of defocus, initial apical radius of curvature, and asphericity. Taylor series expansions were also used to provide an approximation aimed at predicting change in asphericity. The coefficients of a Zernike polynomial expansion of the rotationally symmetrical corneal profile (defocus C2(0), spherical aberration C4(0), secondary spherical aberration C6(0)) were also computed, by using scalar products applied to the considered corneal profile modeled as a conic section and were expressed as a function of both its apical radius and asphericity. This allowed approximation of the variations of the Zernike polynomial expansion of the corneal profiles by subtracting the postoperative coefficient weighting a particular aberration from that of the preoperative one in different theoretical situations, after both conventional and customized hyperopia treatments aimed at controlling the postoperative corneal asphericity and delivered over a normalized pupil diameter. RESULTS: Conical least-squares fitting was unambiguous, allowing approximation of the postoperative corneal profile as a conic section of apical radius R2. After a Munnerlyn-based hyperopia treatment, the sign of the asphericity of this profile remains theoretically unchanged, but its value decreased for initially oblate and increased for initially prolate corneas, respectively. A similar trend was noted with the approximation obtained by the Taylor series expansion. The alteration of the apical radius and/or of the asphericity of the corneal surface resulted in variations of both the corneal profile Zernike coefficients C2(0) and C4(0). The former was essentially dependent on the variation of the apical radius and the latter essentially on the variation of both apical radius and asphericity. CONCLUSIONS: Conventional and customized profiles of ablation for hyperopia alter the postoperative corneal asphericity and the Zernike coefficients of the corneal profile. The results of this study may be useful in the interpretation of the postoperative variations of the corneal profile and their impact on corneal wavefront expansion variations after both conventional and customized profiles of ablation.

Cornea↗
PubMed2004

Believing is seeing? Investigating the perceived accuracy of criminal psychological profiles.

This study investigated whether perceptions of criminal psychological profiles are influenced by the identity of the profile's author. Police officers were given a profile they were told was written by either a professional profiler or by an unspecified author. When judged in relation to the actual perpetrator of the crime, police officers tended to perceive greater accuracy in a profile when it was labeled as authored by a professional profiler independent of the actual content of the profile. But officers' judgments of the usefulness of the profile were not affected by knowledge of who wrote the profile. Explanations for this result focus on the ambiguous nature of criminal profiles and how this ambiguity enhances the likelihood that beliefs about the validity of profiling can color perceptions of the content of the profile.

Adult↗
PubMed2006

Novel knowledge-based mean force potential at the profile level.

BACKGROUND: The development and testing of functions for the modeling of protein energetics is an important part of current research aimed at understanding protein structure and function. Knowledge-based mean force potentials are derived from statistical analyses of interacting groups in experimentally determined protein structures. Current knowledge-based mean force potentials are developed at the atom or amino acid level. The evolutionary information contained in the profiles is not investigated. Based on these observations, a class of novel knowledge-based mean force potentials at the profile level has been presented, which uses the evolutionary information of profiles for developing more powerful statistical potentials. RESULTS: The frequency profiles are directly calculated from the multiple sequence alignments outputted by PSI-BLAST and converted into binary profiles with a probability threshold. As a result, the protein sequences are represented as sequences of binary profiles rather than sequences of amino acids. Similar to the knowledge-based potentials at the residue level, a class of novel potentials at the profile level is introduced. We develop four types of profile-level statistical potentials including distance-dependent, contact, Phi/Psi dihedral angle and accessible surface statistical potentials. These potentials are first evaluated by the fold assessment between the correct and incorrect models generated by comparative modeling from our own and other groups. They are then used to recognize the native structures from well-constructed decoy sets. Experimental results show that all the knowledge-base mean force potentials at the profile level outperform those at the residue level. Significant improvements are obtained for the distance-dependent and accessible surface potentials (5-6%). The contact and Phi/Psi dihedral angle potential only get a slight improvement (1-2%). Decoy set evaluation results show that the distance-dependent profile-level potentials even outperform other atom-level potentials. We also demonstrate that profile-level statistical potentials can improve the performance of threading. CONCLUSION: The knowledge-base mean force potentials at the profile level can provide better discriminatory ability than those at the residue level, so they will be useful for protein structure prediction and model refinement.

Algorithms↗
PubMed2002

Impact of obesity on glucose and lipid profiles in adolescents at different age groups in relation to adulthood.

BACKGROUND: As obesity is rapidly becoming a major medical and public health problem, the aim of our study was to determine: 1) if obesity in Caucasian adolescents at 5 different Tanner stages are associated with obesity in adulthood and its obesity-associated abnormal glucose and lipid profiles, 2) the type of fat distribution is associated with glucose and lipid profile abnormalities, and 3) the risk level and the age of appearance of these abnormalities. METHODS: For the first study, data analyses were from a case-control study of adolescents classified according to their BMI; a BMI >or= 85th percentile for age and sex as overweight, and those with a BMI >or= 95th percentile as obese. Subjects with a BMI < 85th percentile were classified as controls. WC:AC ratio of waist circumference to arm circumference was used as an indicator of a central pattern of adiposity. Two other indices of central adiposity were calculated from skinfolds: Central-peripheral (CPR) as subscapular skinfold + suprailliac skinfold)/ (triceps skinfold + thigh skinfold) and ratio of subscapular to triceps skinfold (STR). The sum of the four skinfolds (SUM) was calculated from triceps, subscapular, suprailliac and thigh skinfolds. SUM provides a single measure of subcutaneous adiposity. Representative adult subjects were used for comparison. Glucose and lipid profiles were also determined in these subjects. Abnormal glucose and lipid profiles were determined as being those with fasting glucose >or= 6.1 mmol/l and lipid values >or= 85th percentile adjusted for age and sex, respectively. Prevalence and odds ratio analysis were used to determine the impact of obesity on glucose and lipid profiles at each Tanner stages for both sexes. Correlation coefficient analyses were used to determine the association between glucose and lipid profiles and anthropometric measurements for both sexes. The second study evaluated in a retrospective-prospective longitudinal way if: 1) obesity in adolescence is associated with obesity in adulthood and 2) the nature of obesity-associated risk factors. Incidence and odds ratio analysis were used to determine the impact of obesity on glucose and lipid profiles at 7 different age groups from 9 to 38 years old in both sexes between 1974 to 2000. RESULTS: Overall, glucose and lipid profiles were significantly (P < 0.01) associated with all anthropometric measurements either in male and female adolescents. WC:AC, CPR, STR and SUM are stronger predictors of both glucose and lipid profiles than BMI. Obese and overweight adolescents of Tanner stages III and higher are at increased risk of having an impaired glucose and lipid profiles than normal subjects with odds ratios of 5.9 and higher. Obesity in adolescents of 13-15 years old group is significantly (P < 0.01) associated with obesity in adulthood (with odds ratios of at least 12 for both men and women) and abnormal glucose (odds ratio of >or= 8.6) and lipid profiles (odds ratio of >or= 11.4). CONCLUSIONS: This study confirmed that adolescents aged between 13 and 15 years old of both sexes with a BMI >or= 85th percentile are at increased risk of becoming overweight or obese adults and presenting abnormal glucose and lipid profiles as adults. This emphasizes the importance of early detection and intervention directed at treatment of obesity to avert the long-term consequences of obesity on the development of cardiovascular diseases.

Adolescent↗
PubMed1989

Performance profiles: new tools for characterization and comparison of clinical chemical results.

It is current practice to record the performance of immunoassays by means of precision profiles (according to Ekins), in which the variation coefficient (relative standard deviation) is plotted against the analyte concentration. On the other hand, precision profiles are only occasionally used for evaluating the performance of conventional clinical-chemical methods. It is relatively uncommon to find bias plotted against analyte concentration, presumably because this type of analysis requires reference specimens, whose true analyte concentrations are known or guaranteed by reference methods. If the relative systematic variations are plotted against the true analyte concentrations, and a confidence interval is added to the resulting regression curve, the result is a "bias profile"; if tolerance limits are added, the result is a "deviation profile". The present work describes the preparation of specimens, which can be used to provide experimental data for the three performance profiles. A computer program is used to construct the precision profile, bias profile and/or deviation profile. The mathematical-statistical basis of the program is described in detail. For evaluation of the statistical procedure, three analytes and six methods were used: determination of sodium activity/concentration with an ion sensitive electrode and by flame photometry; determination of creatinine by a manual enzymic and a mechanized Jaffé method; determination of thyrotropin by radioimmunoassay and by luminescence immunoassay. Different purposes are served by bias and deviation profiles. Thus, bias profiles can be used to compare the bias of two methods, whereas a deviation profile can be used to define the analytical range of a method. If the acceptable limits of deviation are added to the deviation profile, then the useful analytical range of the method is immediately apparent.

Chemistry, Clinical↗
PubMed2000

Comparison of two methods of MMPI-2 profile classification.

The present study investigated the extent of agreement of the highest scale method and the best-fit method in matching MMPI-2 profiles to database code-type profiles and considered profile characteristics that may relate to agreement or disagreement of code-type matches by these two methods. A sample of 519 MMPI-2 profiles that had been classified into database profile code types by these two methods was studied. Resulting code-type matches were classified into three groups: identical (30%), similar (39%), and different (31%), and the profile characteristics of profile elevation, dispersion, and profile code-type definition were studied. Profile code-type definition was significantly different across the three groups with identical and similar match profile groups showing greater profile code-type definition and the different group consisting of profiles that were less well-defined.

Adult↗
PubMedDate not supplied

Estimation of structural similarity of membrane proteins by hydropathy profile alignment.

Many membrane proteins consist of bundles of alpha-helices that are reflected in typical hydropathy profiles of the amino acid sequences. The profiles provide a link between the amino acid sequence of the polypeptide chain and its folding and are much better conserved during evolution than the amino acid sequences from which they are deduced. In this paper, the hydropathy profiles are used to compare structures of membrane proteins or families of membrane proteins. A technique is proposed that computes the optimal alignment of hydropathy profiles without making use of the underlying sequences. The results show that two membrane proteins with only marginal sequence identity or two non-related families of membrane proteins can have very similar hydropathy profiles, indicating similar global structures. Two parameters are defined that measure differences between hydropathy profiles. The Structure Divergence Score (SDS) provides a measure for the divergence in profiles that reflect one and the same global structure. The SDS is derived from the individual hydropathy profiles of the members of a homologous protein family that are believed to share the same structure. The Profile Difference Score (PDS) quantifies the difference between two hydropathy profiles. Comparison of the PDS of the optimal alignment of the hydropathy profiles of two families of membrane proteins with the SDSs of the two families provides a criterion for structural similarity. Using this technique, pairwise alignment of the family profiles of eight families of secondary transporters suggests that the families fall into four structural classes.

Algorithms↗
PubMed1992

Stereological study of the synaptic profiles belonging to interneurons in the dorsal lateral geniculate nucleus of the rabbit.

This study is concerned with some characteristics of the interneurons belonging to the dLGN (dorsal Lateral Geniculate Nucleus) of the rabbit. The work deals with the distribution of such cells in the alpha E sector of the nucleus and their F1 and F2 presynaptic contacts. The F1 and the F2 profiles are present in all three of the alpha E zones studied. The F1 profiles are significantly more numerous in the upper zone (57 +/- 2 profiles per 10(4) microns2 of section) and the middle zone (59 +/- 3 profiles per 10(4) microns2 of section) than in the lower one (41 +/- 2 profiles per 10(4) microns2 of section). The F2 profiles are more abundant in the alpha E sector than the F1 ones are, particularly in the lower zone, where F2 profiles (104 +/- 4 profiles per 10(4) microns2 of section) are not only significantly more numerous than F1 profiles but also more abundant than the F2 profiles in the middle zone (84 +/- 3 profiles per 10(4) microns2 of section) and upper zone (88 +/- 2 profiles per 10(4) microns2 of section). These results and their comments reveal diverse density of the element distribution from the dorsal to the ventral part of the alpha E sector as well as the possible relationship or independence from the extranuclear afferent inputs.

Animals↗
PubMed1979

Visual classification of banded human chromosomes. III. Classification and karyotyping of density profiles described by band transition sequences.

Band transition profiles (BT-profiles) representing extracted band pattern features of 898 density profiles of banded chromosomes were classified and karyotyped by a cytogeneticist in order to investigate how much information was lost by substituting for the original density profiles their extracted features. The results were evaluated and compared with visual classification and karyotyping of the same 898 density profiles from which the BT-profiles were derived. Six per cent errors were made in classification of isolated BT-profiles and 0.7% errors were made in karyotyping BT-profiles. These error rates were comparable to the corresponding error rates in classifying and karyotyping density profiles, which were 5% and 0.5%, respectively. It is concluded that most of the important band pattern information of the density profiles is retained in the BT-profiles, and it is supposed that the condensed BT-sequences (from which the BT-profiles are derived) constitute a sufficient and appropriate basis for automated karyotyping.

Chromosome Banding↗
PubMed1993

Criteria for clinically important changes in outcomes: development, scoring and evaluation of rheumatoid arthritis patient and trial profiles. OMERACT Committee.

OBJECTIVE: To further the development of criteria for clinically important changes in outcomes seen in rheumatoid arthritis (RA) patients and trials. METHODS: Small group discussions and voting on specially designed profiles based on a 6 factor 2 level factorial design for changes seen in patients and trials. The purpose was to bring out the implicit opinions of participants on these issues, to complement the explicit opinions expressed in the OMERACT questionnaire. This took place at a conference of rheumatologists, methodologists, biostatisticians, regulatory, pharmaceutical and biotechnology industry personnel with an interest in therapies for patients with RA. Data from patients with RA and randomized clinical trials of second line drugs in patients with RA formed the basis to create 64 patient profiles and 64 trial profiles. The profiles contained information on changes in 6 measures: swollen joint count, tender joint count, pain, patient global assessment, physician global assessment and physical disability. The profiles were prepared on 4" x 5" cards and presented to the participants in packages of 64 in random order, in 2 different group sessions. Participants were assigned to 8 groups that contained a mix of all types of participants, with a majority of clinicians in each group. In the patient profile session, individual participants scored whether the profile represented important improvement. In the trial profile session, participants did likewise for important difference between the drugs. After structured discussion the group then voted: consensus was defined as agreement by at least 70% of the group. We decided that an important improvement or difference was present in the profiles on which at least 6 of the 8 groups had achieved consensus. The changes in the profiles showing important improvement or difference can be used to suggest minimum criteria for each of the 6 measures. RESULTS: The lower quartile of the change present in the patient profiles with important improvement varied from 17% (swollen joints) to 49% (disability); the median of these quartiles was 36%. The lower quartile of the differences present in the trial profiles with important differences varied from 13% (tender joints) to 26% (physician global); the median of these quartiles was 18%. CONCLUSIONS: This approach has provided a beginning for less arbitrary definition of criteria for important change in patients and trials. It might be suggested that for patients, an improvement of at least 36% should be clinically important, while an active drug needs to be at least 18% better than placebo to be clinically important.

Arthritis, Rheumatoid↗
PubMed2003

Testing the validity of c-fos expression profiling to aid the therapeutic classification of psychoactive drugs.

RATIONALE: Different stimuli, including pharmacological stimuli, induce different neuroanatomical profiles of c-fos expression. Can these profiles be used in classifying psychoactive drugs and predicting therapeutic utility? OBJECTIVE: To test the validity of c-fos expression profiling to aid therapeutic classification. METHODS: Anxiolytics, antidepressants, antipsychotics and psychostimulants were compared. (i) A meta-analysis was performed and profiles compiled from literature reports of changes in c-fos expression in rat brain regions, measured by in situ hybridisation histochemistry or immunohistochemistry, after acute injection of psychoactive drugs. (ii) Male rat brains were profiled for changes in c-fos mRNA expression induced by acute injection of psychoactive drugs. RESULTS: (i) The meta-analysis showed that anxiolytics activate few (mostly stress-related) brain regions; antidepressants activate more regions, including the central amygdaloid nucleus; antipsychotics activate more regions still, including the nucleus accumbens and striatal areas; and psychostimulants activate the greatest number of all, including the most cortical regions (especially the piriform cortex). Profiles also varied within drug classes. (ii) Our experimental profiles confirmed and extended meta-analysis profiles, showing more downregulation. (iii) Sites activated by mirtazapine (an antidepressant not previously profiled) matched those of the antidepressant imipramine. CONCLUSIONS: (i) Differences between drug classes support their classification by means of c-fos profiling. Differences within classes may reflect mechanistic variations. (ii) Greater downregulation in our experiments might be because of inclusion of low, clinically relevant, drug doses and fuller coverage of brain regions. (iii) The agreement between mirtazapine and imipramine increases our confidence in the validity of c-fos expression profiling to aid drug classification and predict therapeutic utility.

Animals↗
PubMed2004

Differentiation of DNA reactive and non-reactive genotoxic mechanisms using gene expression profile analysis.

Genotoxic stress triggers a variety of biological responses including the transcriptional activation of genes regulating DNA repair, cell survival and cell death. Here, we investigated whether gene expression profiles can differentiate between DNA reactive and DNA non-reactive mechanisms of genotoxicity. We analyzed gene expression profiles and micronucleus levels in L5178Y cells treated with cisplatin and sodium chloride. The assessment of cisplatin genotoxicity (up to six-fold increase in the number of micronuclei) and gene expression profile (increased expression of genotoxic stress-associated genes) was in agreement with cisplatin mode of action as a DNA adduct-forming agent. The gene expression profile analysis of cisplatin-treated cells identified a number of genes with robust up regulation of mRNA expression including genes associated with DNA damage (i.e. members of GADD45 family), early response (i.e. cFOS), and heat shock protein (i.e. HSP40 homologue). The gene expression changes correlated well with DNA damage as measured by DNA-protein crosslinks and platinum-DNA binding. To differentiate the genotoxic stress-associated expression profile of cisplatin from a general toxic stress, we have compared the gene expression profile of cisplatin-treated cells to cells treated with sodium chloride, which causes osmotic shock and cell lysis. Although the sodium chloride treatment caused a two-fold induction of micronuclei, the gene expression profile at equitoxic concentrations was remarkably distinct from the profile observed with cisplatin. The profile of sodium chloride featured a complete lack of expression changes in genes associated with DNA damage and repair. In summary, the gene expression profiles clearly distinguished between DNA reactive and non-reactive genotoxic mechanisms of cisplatin and sodium chloride. Our results suggest the potential utility of gene expression profile analysis for elucidating mechanism of action of genotoxic agents.

Animals↗
PubMed1998

Age-race subgroup compared with renin profile as predictors of blood pressure response to antihypertensive therapy. Department of Veterans Affairs Cooperative Study Group on Antihypertensive Agents.

CONTEXT: Renin profiling and age-race subgroup may help select single-drug therapy for stage 1 and stage 2 hypertension. OBJECTIVE: To compare the plasma renin profiling and age-race subgroup methods as predictors of response to single-drug therapy in men with stage 1 and 2 hypertension as defined by the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure. DESIGN: The Veterans Affairs Cooperative Study on Single-Drug Therapy of Hypertension, a randomized controlled trial. SETTING: Fifteen Veterans Affairs hypertension centers. PATIENTS: A total of 1105 ambulatory men with entry diastolic blood pressure (DBP) of 95 to 109 mm Hg, of whom 1031 had valid plasma and urine samples for renin profiling. INTERVENTIONS: Randomization to 1 of 6 antihypertensive drugs: hydrochlorothiazide, atenolol, captopril, clonidine, diltiazem (sustained release), or prazosin. MAIN OUTCOME MEASURE: Treatment response as assessed by percentage achieving goal DBP (<90 mm Hg) in response to a single drug that corresponded to patients' renin profile vs a single drug that corresponded to patients' age-race subgroup. RESULTS: Clonidine and diltiazem had consistent response rates regardless of renin profile (76%, 67%, and 80% for low, medium, and high renin, respectively, for clonidine and 83%, 82%, and 83%, respectively, for diltiazem for patients with baseline DBP of 95-99 mm Hg). Hydrochlorothiazide and prazosin were best in low- and medium-renin profiles; captopril was best in medium- and high-renin profiles (low-, medium-, and high-renin response rates were 82%, 78%, and 14%, respectively, for hydrochlorothiazide; 88%, 67%, and 40%, respectively, for prazosin; and 51%, 83%, and 100%, respectively, for captopril for patients with baseline DBP of 95-99 mm Hg). Response rates for patients with baseline DBP of 95 to 99 mm Hg by age-race subgroup ranged from 70% for clonidine to 90% for prazosin for younger black men, from 50% for captopril to 97% for diltiazem for older black men, from 70% for hydrochlorothiazide to 92% for atenolol for younger white men, and from 84% for hydrochlorothiazide to 95% for diltiazem for older white men. Patients with a correct treatment for their renin profile but incorrect for age-race subgroup had a response rate of 58.7%; patients with an incorrect treatment for their renin profile but correct for age-race subgroup had a response rate of 63.1% (P = .30). After controlling for DBP and interactions with treatment group, age-race subgroup (P<.001) significantly predicted response to single-drug therapy, whereas renin profile was of borderline significance (P= .05). CONCLUSIONS: In these men with stage 1 and stage 2 hypertension, therapeutic responses were consistent with baseline renin profile, but age-race subgroup was a better predictor of response.

Adult↗
PubMed1986

Thallium circumferential profiles in the detection of coronary artery disease--assessment by receiver operating characteristic curve analysis.

Thallium uptake and redistribution in the myocardium was quantitated using circumferential activity profiles. The profiles were determined from images in the LAO 35, LAO 70 and anterior views, obtained after peak exercise and after 3-4 h redistribution. A retention curve was constructed from these profiles, displaying the redistribution profile as a fraction of the stress profile. Normal values were obtained from 21 normal patients and compared to the images from 68 patients suspected of having coronary artery disease (CAD). Of the latter, 20 had normal/non-significant CAD and 48 had 70% or greater stenosis of one or more vessels on coronary angiography. Several methodological variations were examined: calculation of the profiles using the peak or average counts around the ventricle, uniform or interpolative background subtraction, normalisation of the profiles to their peak or mean counts. Receiver operating characteristic (ROC) curves were generated for profiles calculated using these variations and compared with the ROC curves obtained by visual interpretation of both analogue and computer-enhanced images by two experienced observers. The uniform background subtraction method was found to be better than the interpolative method, and normalisation to the mean of each curve was preferable to normalisation to the peak. ROC curves using profiles calculated using the peak myocardial counts were identical to the ROC curves from profiles using the average counts, but the operating points on the two curves differed. Computer enhancement of the digital images resulted in increased sensitivity for CAD without loss of specificity when compared to the interpretation of the analogue images. The circumferential profiles were found to provide a further increase in sensitivity and were highly reproducible.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1995

Biophysical profile testing as an indicator of fetal well-being in high-order multiple gestations.

OBJECTIVE: The purpose of this investigation was to determine the value of biophysical profile testing in preventing intrapartum death in patients with high-order multiple gestations (triplets or quadruplets). STUDY DESIGN: A retrospective review was performed of patients with triplets and quadruplets cared for by Phoenix Perinatal Associates from October 1988 to December 1991. Biophysical profile testing was used as the primary method of fetal surveillance in these pregnancies. Fetal heart rate monitoring on an external monitor was used as back-up and in cases sent to labor and delivery for problems. The ultrasonographic parameters of the biophysical profile score were used without the nonstress test component because of technical difficulty with that test in high-order multiple pregnancies. A score of 6 to 8/8 was therefore considered reassuring, 4/8 equivocal, and 0 or 2/8 possibly abnormal. Testing was done twice per week. RESULTS: Eighteen patients with triplets and six patients with quadruplets constituted the study group. The last biophysical profile before delivery was examined to evaluate the value of the test. There were no antepartum deaths in these 78 babies. The last biophysical profile score was 2/8 in nine fetuses of five triplet pregnancies and two fetuses of one quadruplet pregnancy. These six pregnancies (25%) were delivered on the basis of biophysical profile results and clinical circumstances. There was no morbidity or mortality in the 19 babies delivered because of abnormal biophysical profile testing. Four pregnancies had poor outcome at delivery in spite of 8/8 biophysical profile scores on all babies within 4 days of delivery. Of these four, two patients had worsening pregnancy-induced hypertension, one had abruptio placentae, and one had a severely growth-retarded infant. CONCLUSION: There were no stillbirths in this series. Twenty-five percent of these pregnancies eventually were delivered for nonreassuring biophysical profile testing, with good outcome. Four pregnancies had poor neonatal outcome in spite of normal biophysical profile testing. All of these pregnancies had active changes in physiologic features leading to delivery (two worsening pregnancy-induced hypertension, one abruptio placentae, one spontaneous rupture of membranes and labor). The biophysical profile appears to be a reliable antepartum test of fetal well-being in triplets and quadruplets.

Female↗
PubMed2005

Anteroposterior lip positions of the most-favored Japanese facial profiles.

INTRODUCTION: Soft tissue analysis is a basic tool in planning orthodontic treatment. However, the components of a well-balanced Japanese facial profile have not yet been established. The purpose of this study was to assess the most-favored or most well-balanced profile from a series of facial silhouettes with varying anteroposterior lip positions by a group of Japanese orthodontists and a group of young adult Japanese dental students. METHODS: Average female and male profiles were constructed from the profiles of 30 Japanese men and women with normal occlusions. The lips in each average profile were protruded or retruded in 1-mm increments, and the 13 images were arranged with the average profile in the center. Forty two orthodontists and 42 dental students were asked to select the 3 most-favored, well-balanced profiles for each sex and rank them in order of preference. RESULTS: Both the orthodontists and the students preferred a profile with slightly retruded lips. The dental students favored a more retruded lip position for women. The least-favored profile was the most protrusive. CONCLUSIONS: These findings suggest that Japanese orthodontists and young adults prefer a retruded profile, even though Japanese profiles have historically been characterized by more convex facial features.

Adult↗