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PubMed2001

Analysis of factors predictive of survival based on 49 patients with systemic Wegener's granulomatosis and prospective follow-up.

OBJECTIVES: This prospective study attempted to determine factors predictive of survival in systemic Wegener's granulomatosis (WG) based on 49 patients. Patients and methods. All patients had previously untreated systemic WG. Treatment was with oral or pulse cyclophosphamide plus corticosteroids. Univariate and multivariate analyses of survival were performed using 13 parameters evaluated at diagnosis. RESULTS: The mortality rate was 37% during a mean follow-up period of 1.9 yr. Among the 13 parameters evaluated, univariate analysis selected the following factors as predictors of a poor outcome: serum creatinine > or =18.1 mg/dl, age > or =57 yr, and erythrocyte sedimentation rate (ESR) > or =90 mm/1st h. The absence of ear, nose and throat (ENT) involvement also tended to predict a greater risk of mortality. Glomerulonephritis, when present and regardless of creatininaemia, and pulmonary involvement had no significant effect. Multivariate analysis retained serum creatinine > or =18.1 mg/dl and age > or =57 yr as significant predictors of poor prognosis. CONCLUSIONS: Our results suggest that impaired renal function and older age are independent factors predicting poor outcome in WG. ESR proved to be a good marker of disease severity. Conversely, univariate analysis indicated that patients with ENT involvement tended to have a better outcome, suggesting a more benign evolution of granulomatous disease compared with more aggressive vasculitis.

Administration, Oral↗
PubMed2003

Comparative analysis of superintegrons: engineering extensive genetic diversity in the Vibrionaceae.

Integrons are natural tools for bacterial evolution and innovation. Their involvement in the capture and dissemination of antibiotic-resistance genes among Gram-negative bacteria is well documented. Recently, massive ancestral versions, the superintegrons (SIs), were discovered in the genomes of diverse proteobacterial species. SI gene cassettes with an identifiable activity encode proteins related to simple adaptive functions, including resistance, virulence, and metabolic activities, and their recruitment was interpreted as providing the host with an adaptive advantage. Here, we present extensive comparative analysis of SIs identified among the Vibrionaceae. Each was at least 100 kb in size, reaffirming the participation of SIs in the genome plasticity and heterogeneity of these species. Phylogenetic and localization data supported the sedentary nature of the functional integron platform and its coevolution with the host genome. Conversely, comparative analysis of the SI cassettes was indicative of both a wide range of origin for the entrapped genes and of an active cassette assembly process in these bacterial species. The signature attC sites of each species displayed conserved structural characteristics indicating that symmetry rather than sequence was important in the recognition of such a varied collection of target recombination sequences by a single site-specific recombinase. Our discovery of various addiction module cassettes within each of the different SIs indicates a possible role for them in the overall stability of large integron cassette arrays.

Attachment Sites, Microbiological↗
PubMed2004

[Mechanism analysis of optimized model of conversion from farmland to forestland in the hill-gully sub-region of Loess Plateau].

Conversion from Farmland to Forestland Program (CFF) is one of the six great ecological forest programs in China. This study covered the CFF model area of the hilly-gully sub-region of loess plateau, and introduced system dynamics and other latest theories and methodologies. Based on the analysis of five modules including that of the site observation of field stations and extensive investigations, and over 10000 original data obtained in the fields of natural science, social science and economics, the operational mechanism of the optimized model was studied. The optimized operational models integrated maximized ecological, economic and social benefits, while sustainability concepts were proposed for typical CFF sites: The Pinus tabulaeformis + Platycladus orientalis + Zanthoxylum spp. + Robinia pseudoacacia model at the eroded flat ridges of the middle reaches of the Yellow River. The result showed that the ecological, economic and social benefits of the optimized model reflected by main indexes were the best or better, and in the other models, either individual one was the best or others were not. From the viewpoint of comprehensive comparison of three great benefits, the optimized model was most excellent, and had eminent difference comparing to other ones through F test. The relationship between ecological and social benefit was eminent positive correlative. Social benefit was the same with economical one at some degrees. The relationship between ecological and economical benefit was more complicated. On the whole, they were positive correlative, but the economical benefit was not the greatest when the ecological one was the greatest. In general, from the viewpoint of largest comprehensive benefit, the three great benefits were not all the best, indicating that the combination of the modules must be reasonable. In order to achieve the ultimate goal of CFF, we must choose the optimized combination of ecological, economical and social benefits, and can't only pursue any one maximum of three great benefits.

China↗
PubMed2002

Risk factors and risk for mortality of mild hypoparathyroidism in hemodialysis patients.

Relative hypoparathyroidism (parathyroid hormone [PTH] < or = 200 pg/mL) is prevalent in hemodialysis (HD) patients, with unknown pathogenesis and prognosis. Thus, to clarify risk factors and prognosis of time-dependent relative hypoparathyroidism in HD patients, a retrospective cohort study was performed for 126 HD patients with four or more PTH determinations and no previous total or subtotal parathyroidectomy. Values for intact PTH, ionized calcium, phosphate, magnesium, albumin, creatinine, urea reduction ratio (URR), glucose, hemoglobin A1c (HbA1c), aluminum, and 1,25(OH)2D were obtained at enrollment and at some time during follow-up. The prevalence of relative hypoparathyroidism at entry was 76 of 126 patients (60.3%). Univariate analysis showed that patients with hypoparathyroidism were older, more likely to have diabetes, and had greater ionized calcium levels and lower phosphate, albumin, blood urea nitrogen (BUN), and creatinine levels. Patients with diabetes were older and had a shorter duration of dialysis therapy and lower PTH, phosphate, albumin, BUN, and creatinine levels and URRs. Conversely, multivariate analysis showed that PTH levels at entry were associated directly with creatinine levels and inversely with age and ionized calcium levels (but not diabetes). During follow-up, PTH levels fluctuated concomitantly with ionized calcium and phosphate levels over time in all patients. Time-dependent PTH levels were associated directly with duration of dialysis therapy and use of vitamin D and phosphate and albumin levels, but inversely with age and ionized calcium and magnesium levels (but not glucose or HbA1c levels). Interestingly, time-dependent PTH levels were independently associated with survival after adjusting for traditional risk factors (diabetes, age, albumin and creatinine levels, and URR) and duration of dialysis therapy. We conclude that in HD patients, relative hypoparathyroidism was not associated with diabetes per se. Time-dependent PTH levels were associated with age, duration of dialysis, and levels of ionized calcium, phosphate, albumin, and magnesium. Moreover, relative hypoparathyroidism at entry and lower time-dependent PTH levels predict mortality.

Age Factors↗
PubMed1999

[Not Available].

Psychotherapy is an interpersonal and interactive process. As this view gained acceptance, methods in psychotherapy research for analysing the intersubjective dimension of the psychotherapeutic dialogue became more important. Ethnomethodology with its research program of conversation and context analysis has a long tradition in research on social interaction and can follow this development. With a conversation analytic approach means and practices can be reconstructed that patient and therapist use to coproduce the psychotherapeutic encounter.

Conversation analysis↗
PubMed1993

Spectral analysis of 24 h blood pressure recordings.

Spectral analysis of blood pressure and heart rate signals allows overall blood pressure and heart rate variabilities to be split into their different frequency components. When used to analyze 24 h discontinuous blood pressure recordings, the low sampling frequency that characterizes these devices allows only the slow fluctuations in day and night blood pressure to be adequately described by the spectral approach. Conversely, spectral analysis of continuous blood pressure recordings provides information both on fast and slow changes in blood pressure and heart rate. Because blood pressure and heart rate powers are characterized by a 1/f distribution over the 24 h, slow fluctuations in blood pressure and heart rate contribute most importantly to 24 h variance, while faster components provide only a minor contribution. However, spectral analysis of the latter has raised considerable interest due to the possible association of these components with cardiovascular regulatory mechanisms. It is now possible to perform 24 h dynamic spectral analysis of blood pressure and heart rate on continuous blood pressure recordings obtained noninvasively by a finger pressure device.

Blood Pressure↗
PubMedDate not supplied

Analysis of the degree of conversion of LED and halogen lights using micro-Raman spectroscopy.

This study determined the degree of conversion of two LED (light-emitting diodes) (Elipar FreeLight [FL], 3M ESPE; GC e-Light [EL], GC), a high intensity (Elipar TriLight [TL], 3M ESPE) and a very high intensity (Astralis 10 [AS], Ivoclar Vivadent) halogen light. The degree of conversion of these lights was compared to a conventional halogen light (Max [MX] (control), Dentsply-Caulk). Ten different light curing regimens, including pulse (EL1), continuous (FL1, EL2, TL1), turbo (EL3, AS1) and soft-start (FL2, EL4, TL2) modes of various lights were also investigated. Composite specimens of dimensions 3 x 3 x 2 mm were cured with the 10 different light curing regimens investigated. Micro-Raman spectroscopy was used to determine the degree of conversion at the top and bottom surfaces of a composite restorative (Z100, [3M ESPE]) at 60 minutes post-light polymerization. Five specimens were made for each cure mode. The results were analyzed using ANOVA/Scheffe's post-hoc test and Independent Samples t-tests at significance level 0.05. The degree of conversion ranged from 55.98 +/- 2.50 to 59.00 +/- 2.76% for the top surface and 51.90 +/- 3.36 to 57.28 +/- 1.56% for the bottom surface. No significant difference in degree of conversion was observed for the 10 light curing regimens when compared to MX (control). The curing efficiency of LED lights was comparable to halogen lights regardless of curing modes.

Analysis of Variance↗
PubMed2004

Intravenous amiodarone for conversion of atrial fibrillation: misled by meta-analysis?

Therapeutic goals for atrial fibrillation (AF) include ventricular rate control, stroke prevention, conversion to normal sinus rhythm, and maintenance of normal sinus rhythm. The optimal strategy of rate versus rhythm control for acute management of patients with AF is a continuing debate. However, selected patients may require acute treatment with antiarrhythmic agents for conversion of symptomatic AF episodes to normal sinus rhythm. Recently published randomized controlled trials, qualitative systematic reviews, meta-analyses, and evidence-based international consensus guidelines have addressed the controversy regarding acute conversion of AF using antiarrhythmic therapy. Although meta-analyses often provide the highest level of evidence, the validity and application of their results are based on the quality of their methodology and accuracy of reporting. Authors of the most recent meta-analysis of amiodarone for conversion of AF state that the drug is effective and relatively rapid acting in converting AF to normal sinus rhythm in a wide range of patients, and they recommend it as a first-line drug. We feel that these conclusions are overstated and potentially misleading due to methodologic limitations of the analysis. The results of this meta-analysis and others concerning acute conversion of AF should be viewed as hypothesis generating and not the definitive answer to this question. Ultimately, well-designed, adequately powered, randomized placebo- or rate-controlled trials are needed in specific patient populations with AF to determine the absolute benefit of intravenous amiodarone for conversion of AF to normal sinus rhythm. Until more data are available, intravenous amiodarone cannot be promoted as a first-line agent for this purpose.

Administration, Oral↗
PubMed2000

Intraocular pressure and progression in exfoliative eyes with ocular hypertension or glaucoma.

PURPOSE: This retrospective study was conducted in exfoliative eyes in order to study the influence of IOP and other possible factors on the conversion from ocular hypertension (OHT) to glaucoma and progression of glaucoma. METHODS: 139 patients with exfoliation OHT or glaucoma with exfoliation syndrome were included (mean follow-up 5.2 +/- 3.6 years). The effects of age, gender, weighted mean IOP, maximum IOP, stage of glaucoma at the first visit, refraction, glaucoma medication, and interventions on the hazard of progression were studied by multivariate survival analysis. RESULTS: Conversion from OHT to glaucoma or progression of glaucoma was detected in 63 eyes (45.3%). A significant association with progression was found for age (relative risk 1.042; p-value 0.043), weighted mean IOP (1.076; <0.001), and stage of glaucoma (1.436; <0.001). History of trabeculectomy (0.360; 0.002) related to a decreased risk. CONCLUSION: The risk of conversion from OHT to glaucoma and progression of glaucoma increased in exfoliative eyes with severity of stage of glaucoma, weighted mean IOP, and the age of the patient. A history of trabeculectomy was related to decreased risk of progression.

Aged↗
PubMed1981

In vitro conversion of S13 viral DNA in phage particles to the double-stranded DNA.

The conversion of single-stranded DNA in S13 intact phage particles to the double-stranded replicative form DNA was observed in cell extracts prepared from Escherichia coli H560 (S13s, polA, endA) cells lysed with lysozyme and the non-ionic detergent, Brij 58. The DNA product, which associated with a rapidly sedimenting component, was identified as RFII-DNA with a gap by sedimentation analysis. The conversion was inhibited by N-ethylmaleimide, but not by rifampicin, nicotinamide mononucleotide or polymyxin B. The dnaB gene product was involved in the replicative system. Similar extracts prepared from a S13-resistant E. coli strain K12W6 also catalyzed this synthesis.

Bacterial Proteins↗
PubMed2003

Integration of proteomics and genomics in platelets: a profile of platelet proteins and platelet-specific genes.

Platelets, while anucleate, contain RNA, some of which is translated into protein upon activation. Hypothesising that the platelet proteome is reflected in the transcriptome, we identified 82 proteins secreted from activated platelets and compared these, as well as published proteomic data, to the transcriptional profile. We also compared the transcriptome of platelets to other tissues to identify platelet-specific genes and used ontology to determine gene categories over-represented in platelets. RNA was isolated from highly pure platelet preparations for hybridization to Affymetrix oligonucleotide arrays. We identified 2,928 distinct messages as being present in platelets. The platelet transcriptome was compared with the proteome by relating both to UniGene clusters. Platelet proteomic data correlated well with the transcriptome, with 69% of secreted proteins detectable at the mRNA level, and similar concordance was obtained using two published datasets. While many of the most abundant mRNAs are for known platelet proteins, messages were detected for proteins not previously reported in platelets. Some of these may represent residual megakaryocyte messages; however, proteomic analysis confirmed the expression of many previously unreported genes in platelets. Transcripts for well-described platelet proteins are among the most platelet-specific messages. Ontological categories related to signal transduction, receptors, ion channels, and membranes are over-represented in platelets, while categories involved in protein synthesis are depleted. Despite the absence of gene transcription, the platelet proteome is mirrored in the transcriptome. Conversely, transcriptional analysis predicts the presence of novel proteins in the platelet. Transcriptional analysis is relevant to platelet biology, providing insights into platelet function and the mechanisms of platelet disorders.

Blood Platelets↗
PubMed1994

Iodine-131-MIBG imaging to monitor chemotherapy response in advanced neuroblastoma: comparison with laboratory analysis.

UNLABELLED: The rationale of this study was the evaluation of response to chemotherapy in children with advanced neuroblastoma using currently available diagnostic modalities. METHODS: Iodine-131-metaiodobenzylguanidine (MIBG) imaging and 24-hr urinary vanillylmandelic acid (VMA) measurement were evaluated in 14 patients (7 males, 7 females, age range: 2-68 mo) with advanced neuroblastoma both pre- and postchemotherapy (5.6 +/- 2.8 mo) as well as serum ferritin (FER) and neuron-specific enolase (NSE) levels in 9 and 8 patients, respectively. MIBG images were qualitatively compared in each patient. RESULTS: Prechemotherapy, a total of 39 abnormal foci of MIBG uptake was detected. Postchemotherapy, 15 of these showed unchanged MIBG uptake, 7 had decreased uptake and 17 showed no uptake. In addition, four new abnormal foci of uptake were found. Postchemotherapy, a significant reduction of abnormal MIBG uptake (p < 0.01) was observed using a lesion-by-lesion analysis. When biochemical and MIBG postchemotherapy changes were compared, a significant relationship was found only between MIBG and VMA results (r = 0.84, p < 0.01). CONCLUSIONS: In postchemotherapy follow-up of children with advanced neuroblastoma, laboratory evaluation using VMA, FER and NSE measurements reflect only the global functional status of the disease, and are not helpful in defining the response of individual tumor lesions to treatment. Conversely, qualitative analysis using MIBG imaging may allow lesion-by-lesion evaluation of the heterogeneity of neuroblastoma response to chemotherapy. In this setting, changes in MIBG uptake are mirrored by the changes in catecholamine production, as measured by VMA levels.

3-Iodobenzylguanidine↗
PubMed2002

Predictors of aneurysmal formation after surgical correction of aortic coarctation.

OBJECTIVES: We sought to identify the predictors of aneurysmal formation after surgical correction of aortic coarctation. BACKGROUND: In 9% of patients, aneurysms develop late after corrective surgery of coarctation of the aorta, with a 36% mortality rate if left untreated. However, the predictors of postsurgical aneurysmal formation are unknown. METHODS: Of 25 aortic aneurysms requiring corrective surgery 152 +/- 78 months after the initial coarctation repair, 8 were located in the ascending aorta (type A) and 17 at the site of previous repair (local type). Seventy-four patients without progression of the aortic diameter within 189 +/- 71 months after coarctation repair were used for categorical data analysis in an attempt to identify the predictors of postsurgical aneurysmal formation. RESULTS: Advanced age at coarctation repair (p = 0.004) and patch graft technique (p < 0.0005) independently predicted local aneurysmal formation. Type A aneurysm was univariately associated with the presence of a bicuspid aortic valve (p = 0.02), advanced age at coarctation repair (p = 0.044) and a high preoperative peak systolic pressure gradient of 74 +/- 21 mm Hg (p = 0.041). Conversely, multivariate analysis confirmed only the presence of a bicuspid aortic valve (p = 0.015) as an independent predictor of type A aneurysm. Receiver operating characteristic curve analysis revealed that 72% of patients with a postsurgical aneurysm had an operation at age 13.5 years or more, whereas 69% with no postsurgical aneurysm had an operation at a younger age. CONCLUSIONS: Use of the patch graft technique and late correction of coarctation can predict aneurysmal formation at the site of coarctation repair, although patients with a bicuspid aortic valve may be at risk for an aneurysm developing in the ascending aorta, particularly after late repair of aortic coarctation with high preoperative pressure gradients.

Adolescent↗
PubMed2000

Transgenic coexpression of v-Ha-ras and transforming growth factor alpha increases epidermal hyperproliferation and tumorigenesis and predisposes to malignant conversion via endogenous c-Ha-ras activation.

Previously, transgenic mice were generated that overexpressed v-Ha-ras or human transforming growth factor alpha (TGFalpha) exclusively in the epidermis, by means of a targeting vector based on the human keratin 1 gene (HK1). Both transgenics exhibited a similar neonatal phenotype of epidermal hyperplasia/hyperkeratosis and, in adults, spontaneous and 12-O-tetradecanoylphorbol-13-acetate (TPA)-induced papilloma formation. To assess the synergism in vivo between Ha-ras and TGFalpha, mating experiments were performed. All ras/TGFalpha double genotype progeny (HK1 less than, with dotras/alpha) exhibited an increased epidermal hyperplasia/hyperkeratosis in neonates and accelerated spontaneous papillomatogenesis, compared with single transgenic siblings. HK1 less than, with dotras/alpha mice from the mild lines of HK1 less than, with dotrasxHK1 less than, with dotTGFalpha developed spontaneous papillomas that were not shown in either their parental mice or single transgenic littermates. Unlika in parental or single-genotype siblings, in which TPA promotion-elicited papillomas remained benign, TPA promotion elicited autonomous papillomas in HK1 less than, with dotras/alpha mice and exhibited a novel susceptibility to malignant conversion. Sequence analysis of the endogenous c-Ha-ras from spontaneous and TPA-induced HK1 less than, with dotras/alpha papillomas revealed wild-type sequence. However, carcinomas exhibited c-Ha-ras mutations at codon 61. All tumors analyzed to date expressed wild-type p53. These data provide in vivo evidence that Ha-ras and TGFalpha cooperate in the induction of epidermal hyperplasia and spontaneous tumor formation and predispose to malignant conversion via endogenous c-Ha-ras activation.

Animals↗
PubMed1999

Kinetics of chlorophyll degradation and color loss in heated broccoli juice.

Degradation of chlorophyll in broccoli juice occurred at temperatures exceeding 60 degrees C. Chemical analysis revealed that degradation of chlorophyll a and b to pheophytin a and b, respectively, followed first-order kinetics and that chlorophyll a was more heat sensitive than chlorophyll b. Temperature dependencies of chlorophyll a and b degradation rate constants could be described by Arrhenius equations with activation energies (E(a)) of 71.04 +/- 4.89 and 67.11 +/- 6.82 kJ/mol, respectively. Objective greenness measurements, using the -a value as the physical property, together with a fractional conversion kinetic analysis, indicated that green color degradation followed a two-step process. Kinetic parameters for the first degradation step were in accordance with the kinetic parameters for pheophytinization of the total chlorophyll content, as determined by chemical analysis (E(a) approximately 69 kJ/mol). The second degradation step, that is, the subsequent decomposition of pheophytins, was characterized by an activation energy of 105.49 +/- 4.74 kJ/mol.

Beverages↗
PubMed1997

Autonomic nervous function during haemodialysis assessed by spectral analysis of heart-rate variability.

1. Short-term autonomic response to haemodialysis-induced hypovolaemia was studied in 30 patients undergoing chronic haemodialysis by analysing power spectra of heart-period variability. Patients were classified as haemodynamically stable (15 patients) and unstable (15 patients) according to their past history of cardiovascular collapse during the treatment. Blood volume, systolic arterial pressure and heart period were measured during sessions that ended without the occurrence of collapse. 2. No significant differences were observed when comparing blood volume, heart rate and arterial pressure of stable and unstable patients during the dialysis, and the two groups could not be distinguished merely on the basis of these haemodynamic parameters. Conversely, spectral analysis of beat-to-beat heart-period variability showed markedly different power patterns: in stable patients power was mainly in the low-frequency (LF) band (0.06-0.15 Hz), whereas in unstable patients it was mainly in the high-frequency (HF) band (0.15-0.4 Hz). 3. The efficiency of the autonomic response to hypovolaemia was evaluated by the ratio between the powers in the LF and HF bands. Stable patients exhibited an LF/HF power ratio systematically greater than unstable patients during the entire dialysis, and on the basis of this index the two groups were clearly separated. 4. Results obtained with spectral analysis lead us to conclude that reduced efficiency in the autonomic control of cardiovascular functions could be the main cause of the haemodynamic instability of patients prone to collapse.

Aged↗
PubMed2002

Effect of filler fraction and filler surface treatment on wear of microfilled composites.

OBJECTIVES: The aim of this study was to determine the effect of filler content and surface treatment on the wear of microfilled composites. METHODS: Four microfilled composites with different filler contents (A=20, B=25, C=30, and D=35 vol.%) were made with a light-cured resin (Bis-GMA/UDMA/TEGDMA). The surface treatment of the colloidal silica in each varied: F=functional silane, NF=non-functional silane, U=untreated. Silux Plus served as a control. Specimens were made in steel molds and cured in a light curing unit Triad II (40s/side). Abrasion and attrition wear were evaluated in vitro in a wear tester (OHSU oral wear simulator) with an abrasive slurry (poppy seeds + PMMA) and a human enamel antagonist. The average of five specimens was computed and compared using a ANOVA/Tukey's test at P < or = 0.05. The surface of the wear patterns and the distribution of filler particles were examined using a scanning electron microscope and digital imaging. RESULTS: As filler volume increased, wear was reduced regardless of filler treatment. Amounts of wear for specimens C and D were significantly lower than specimens A and B. Composites with functional silane treated microfiller (Group F) produced significantly less wear than those with non-functional microfiller (Group NF) at 30 and 35 vol.%, and less than the untreated microfiller (Group U) at 30 vol.%. Scanning electron microscopy of specimens of group NF showed large filler agglomerates (size > 1 microm) in the resin matrix, while specimens of group F and U showed fewer agglomerates. Digital imaging analysis revealed small filler clusters (size < or = 1 microm) in the resin matrix of all specimens. SIGNIFICANCE: Wear resistance of microfilled composites is enhanced by higher filler volumes irrespective of surface treatment, but good filler/matrix adhesion is needed to minimize wear.

Analog-Digital Conversion↗