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DNA-profiling of stains in criminal cases: analysis of measurement errors and band-shift. Discussion of match criteria.

DNA-profiling was performed on approximately 600 stains (blood, semen/vaginal secretion, tissue samples and saliva) deriving from criminal investigations. The restriction enzyme was HinfI, and the VNTR (variable number of tandem repeats) probes were MS1, MS31, MS43a and YNH24. DNA-profiles were obtained from 60% of the stains, and matches were seen for 65% of the profiles. The measurement errors and the differences between corresponding fragment lengths of blood and stain profiles were analysed statistically. Distinct band-shifts were observed for approximately 65% of the profiles. For 50% of the profiles, the fragments derived from the stain fragments migrated faster than those from the blood sample, and for 15% of the profiles the stain fragments migrated slower. The difference between the migration distance of the stain and the blood fragments of a given pair of profiles increased with increasing migration distance, i.e. with decreasing fragment length. After correction for this slope the measurement errors were independent of the fragment length, and of the same order of size as for duplicate determinations of fragments from blood samples. The differences between the fragment lengths of corresponding profiles were highly correlated (rho = 0.8). Based on the statistical analysis, different match criteria are discussed and an ellipsoid accept-area is suggested.

Blood Stains↗

Methods to evaluate profile preferences for the anteroposterior position of the mandible.

INTRODUCTION: Facial profile disharmonies in the anteroposterior (AP) position of the mandible are among the most frequent reasons that patients seek orthodontic treatment. Various methods are available for assessing profile preferences, and differences between them could affect treatment decisions. The purposes of this study were to compare and contrast 3 methods of evaluating profile preferences for the AP position of the mandible. METHODS: Facial profile preferences of white orthodontists (n = 28) and white (n = 56) and Japanese-American (n = 55) laypeople were evaluated. The esthetic significance of variations in the AP position of the mandible was investigated by using 3 methods: a traditional semantic differential scale, the Perceptometrics method (Health Programs Intl, Wellesley, Mass), and the implicit association test (IAT). RESULTS: Findings from the semantic differential scale show that, overall, there is a general preference among orthodontists and laypeople for an orthognathic profile (P <.001). Findings from the Perceptometrics method indicate that orthodontists consider the most pleasing profile to be more forward than do lay subjects (P <.001). The IAT results show a positive bias among all 3 groups toward orthognathic profiles and a negative bias toward profiles with mandibular retrognathism or prognathism. The IAT suggested that laypeople were more tolerant of mandibular prognathism in men than in women (P <.01), and more tolerant of mandibular retrognathia in white women than in men (P = .03). CONCLUSIONS: These results support the benefits of using both implicit and explicit methods to assess facial profile preferences.

Adult↗

Detection of non-standard EMG profiles in walking.

The amplitude of an EMG and the temporal pattern can be used when considering if an EMG profile is normal or not. In the method described in this paper a gain factor of the complete EMG profile was determined and then the profile normalised with this gain factor. This normalised individual profile was then compared with a standard profile, predicted on the basis of walking speed. Deviating profiles were identified when they fell outside the upper and lower 95% limits range for the average profiles of 14 leg muscles. The amount of deviation from the normal profile can be quantified with the normalised mean square difference D2. Gain factors varied over a factor of 4 within a group of 10 normal subjects. For a normal population D2 was below 1. Most muscles had consistent profiles but some patterns could be discerned which showed marked variability among muscles and subjects.

Adult↗

Identification of an urinary metabolite profile associated with osteoarthritis.

OBJECTIVE: Osteoarthritis (OA) is one of the most common diseases among the elderly. The main characteristic is the progressive destruction of articular cartilage. We lack quantitative and sensitive biomarkers for OA to detect changes in the joints in an early stage of the disease. In this study, we investigated whether a urinary metabolite profile could be found that could serve as a diagnostic biomarker for OA in humans. We also compared the profile we obtained previously in the guinea pig spontaneous OA model. METHODS: Urine samples of 92 participants (47 non-OA controls and 45 individuals with radiographic OA of the knees or hips) were selected from the Johnston County Osteoarthritis Project (North Carolina, USA). Participants ranged in age from 60 to 84 years. Samples were measured by 1H nuclear magnetic resonance spectroscopy (NMR) with subsequent principal component discriminant analysis and partial least squares regression analysis. RESULTS: Differences were observed between urine NMR spectra of OA cases and controls (P<0.001 for both male and female subjects). A metabolite profile could be determined which was strongly associated with OA. This profile largely resembled the profile previously identified for guinea pigs with OA (approximately 40 out of the approximately 125 signals of the human profile were present in the guinea pig profile as well). A correlation was found between the metabolite profile and radiographic OA severity (R2 = 0.82 (male); R2 = 0.93 (female)). CONCLUSION: This study showed that a urine metabolite profile may serve as a novel discriminating biomarker of OA.

Aged↗

Objective criteria to assess representativity of soil fungal community profiles.

Soil fungal community structures are often highly heterogeneous even among samples taken from small field plots. Sample pooling is widely used in order to overcome this heterogeneity, however, no objective criteria have yet been defined on how to determine the number of samples to be pooled for representatively profiling a field plot. In the present study PCR/RFLP and T-RFLP analysis of fungal 18S rDNA in ten soil samples obtained from a grassland plot of 400 m(2) also revealed this known heterogeneity in fungal community structures. Based on these data a three-step approach to assess representativity of fungal community profiles was established. First, soil DNA quantities needed for robust community profiling were determined. Second, profiles of single or multiple samples were theoretically averaged to test for statistically significant clustering in order to determine the minimal number of samples to be pooled to achieve representativity. Third, DNA extracts of single or multiple samples were pooled prior to profiling in order to test for statistically significant clustering. Analyses revealed robust profiles for 50 ng soil DNA but not for 5 ng. Averaged T-RFLP profiles from five or more soil samples and experimental T-RFLP profiles from pools of seven or more samples formed one significant branch. Theoretical averaging and experimental pooling revealed that five to seven samples have to be pooled for robustly representing the field plot. Our results demonstrate that representativity of soil fungal community profiles can objectively be determined for a field plot with only little deviation between theoretical and experimental approaches. This three-step approach will be of assistance for designing sampling and pooling strategies for comparative analyses of soil fungal communities in ecological studies.

Cluster Analysis↗

[Interest of performing systematically the protein profile in an internal medicine department. National survey and prospective study on 229 admissions].

INTRODUCTION: Despite a wide national use, the usefulness of the protein profile has only been evaluated in a small number of studies, essentially in patients with unknown diagnoses. METHODS: We conducted a survey on 339 french internal medicine departments to evaluate how the protein profile was used in these services. Concomitantly we achieved a prospective study on 229 patients in our department, with a mean follow up of 9 months, to evaluate how did the protein profile influence the diagnosis process. RESULTS: We received 183 responses to our national survey: the protein profile was available in 110/183 (60%) departments with 94/110 (85%) using it during hospitalisation and 20/94 (21.3%) using it systematically. Among the 229 protein profile analysed in our department, 44 (19.2%) were considered useful with 20 (8.7%) of them allowing the diagnosis of a new pathology. If the profile had not been done systematically, the physicians of our department would have performed the profile in 102/229 (44.5%) cases, whereas seven (3%) useful profiles would not have been done. CONCLUSION: We think that the profile has a consistent interest in hospitalized patients with a known or unknown pathology but performing systematically such a test appears to be of limited benefit.

Blood Proteins↗

Characterization of two HDL subfractions and LpA-I, LpA-I:A-II distribution profiles and clinical characteristics of hyperalphalipoproteinemic subjects without cholesterol ester transfer protein deficiency.

The aims of the present study were (i) to characterize the HDL2, HDL3 and the LpA-I, LpA-I:A-II distribution, (ii) to investigate the prevalence of atherosclerotic lesions and (iii) to assess the activity of cholesteryl ester transfer protein (CETP) in 29 hyperalphalipoproteinemic (HALP) patients (HDL-C=90+/-11 mg/dl) with combined hypercholesterolemia (LDL-C=180+/-16 mg/dl). According to the HDL2/HDL3 and LpA-I/LpA-I:A-II ratios, two HALP profiles (A and B) were defined: in 22 patients (HALP profile A) these ratios were increased compared to the normolipidemic control subjects (1.19+/-0.11 versus 0.53+/-0.19, P < 0.001 and 1.01+/-0.2 versus 0.51+/-0.25, P < 0.001, respectively) and in seven patients (HALP profile B) these ratios were within the normal range (0.64+/-0.20 and 0.69+/-0.2, respectively). The atherosclerotic lesions were assessed by ultrasonography of the carotid arteries. Amongst patients with HALP profile A, 17 were free from lesions, five had intimal wall thickening and none displayed plaques, whereas for patients within the HALP profile B, only one was free from lesions, two had intimal wall thickening and four displayed plaques. CETP activities (348+/-116 versus 371+/-75%/ml/h) and CETP concentrations (2.4+/-0.5 versus 2.5+/-0.6 microg/ml) were similar in HALP profiles A and B, however these values were both higher than in control subjects (190+/-40%/ml/h, P < 0.001 and 1.8+/-0.3 microg/ml, P < 0.001, respectively). Hence the hyperalphalipoproteinemic profiles (A and B) described here were not related to CETP deficiency. In conclusion, the HALP profile A was characterized by both increased HDL2/HDL3 and LpA-I/LpA-I:A-II ratios and was associated with a low prevalence of atherosclerosis, whereas the HALP profile B, characterized by HDL2/HDL3 and LpA-I/LpA-I:A-II ratios within the normal range, was less cardioprotective.

Adult↗

Metabolic profiles and progesterone cycles in first lactation dairy cows.

This study investigated the ovarian function, metabolic profiles and fertility in first lactation Holstein-Friesian dairy cows (mean 305 day milk yield: 7417+/-191kg, n=37). Reproductive profiles obtained from milk progesterone analysis were categorized into normal (n=17) and four abnormal profiles (delayed ovulation, DOV1, n=9; DOV2, n=2; persistent corpus luteum, PCL1, n=6; PCL2, n=4; 1: immediately post-calving, 2: subsequent cycles). Fifty-five percent of cows had abnormal profiles with half of these being categorized as DOV1. Fertility of DOV1 and DOV2 cows was reduced whereas PCL1 and PCL2 cows had similar reproductive competence to normal profile cows. DOV1 animals had higher milk energy values, lower energy balances, lower dry matter intakes (DMI) and greater body weight and body condition score (BCS) losses post-calving than normal profile animals. DOV1 animals also had lower insulin-like growth factor-I (IGF-I) and higher betahydroxybutyrate (BHB) concentrations and tended to have the lower insulin and glucose concentrations in the pre-service period than normal profile cows. All PCL animals had vulval discharges postpartum. Despite this, the DMI, body weight and BCS changes, IGF-I concentrations and fertility of PCL1 animals was similar to normal profile cows. In conclusion, the high prevalence of delayed ovulation post-calving (DOV1) in primiparous high yielding cows lasted long enough (71+/-8.3 days) to have a detrimental impact on fertility and was associated with significant physiological changes. This study did not establish any detrimental effects of PCL profiles on fertility or production parameters.

Animals↗

Soft tissue and dentoskeletal profile changes associated with maxillary expansion and protraction headgear treatment.

One of the goals of early treatment of Class III malocclusion with maxillary expansion and protraction headgear is to significantly improve the dentofacial profile. The objectives of the present study were to determine (1) the interrelationships of the soft tissue and dentoskeletal profiles after maxillary expansion and protraction headgear treatment and (2) which cephalometric variables could contribute to an accurate prediction of the protraction effect on the soft tissue profile. Lateral cephalometric radiographs of 20 consecutively treated Class III patients (10 males, 10 females) by protraction headgear were included in this study. Their ages at the start of protraction headgear treatment ranged from 6 to 11 years, with an average of 8.1 +/- 2.1 years. None of the patients had previous orthodontic treatment. For each patient, the first lateral cephalogram was taken 6 months before the initiation of headgear treatment (T0), and the second radiograph at the start of treatment (T1). Therefore (T1-T0) represented 6 months of growth with no treatment. A third radiograph was taken 6 months after start of treatment (T2). In this way, (T2-T1)-(T1-T0) represented the effect the result of appliance therapy alone and each subject served as his/her own control. A computerized cephalometric analysis was used including variables assessing sagittal and vertical relationships of skeletal and soft tissue profiles, incisal relationships, soft tissue thickness, and lip structure. Data were analyzed by means of paired t tests, Pearson's product-moment coefficient correlation, and multiple regression analyses. The results showed significant improvements in dentofacial profile after 6 months of maxillary protraction. The skeletal and soft tissue facial profiles were straightened and the posture of the lips was improved. The normal incisal relationship (overjet) that was achieved had a significant impact on the soft tissues overlying both upper and lower incisors resulting in better lip competence and posture. Significant correlations were found between changes in the sagittal relationships of skeletal and soft tissue profiles in both the maxilla and the mandible (p < 0.05). The forward movement of the maxilla was accompanied by a corresponding forward movement of the soft tissue profile at 50% to 79% of the hard tissue. In the mandible, the downward and backward movements of the soft tissues were equivalent to 71% to 81% of the corresponding hard tissues. The lack of high r square values in the multiple regression analyses reflected a low prediction value for the maxillary variables, but moderately high prediction value for the mandibular variables that could be used in preorthopedic treatment planning. This study showed that significant dentoskeletal changes and improvements in dentofacial profile resulted from 6 months of treatment with maxillary expansion and protraction.

Cephalometry↗

Profile changes in patients treated with and without extractions: assessments by lay people.

The purpose of this study was to assess the profile changes in subjects with Class II, Division 1 malocclusions who were treated either with or without the extraction of the four first premolars. The assessments were made by 39 lay persons. Profile silhouettes on 91 (44 extraction and 47 nonextraction) patients were evaluated at three stages: pretreatment, posttreatment, and approximately 2 years after treatment. Photographs matched for age and sex were also evaluated on 20 normal untreated subjects (10 males and 10 females). All rater assessments were analyzed statistically as to the effects of the following variables: (a) occlusion, i.e., normal or Class II, (b) treatment rendered, i.e., extraction or nonextraction, (c) gender, i.e., male or female, and (d) stage of observation, i.e., pretreatment, end of treatment or in retention. The current findings indicate that (1) before treatment, lay persons perceived the profile of normal patients more favorably than untreated patients with Class II, Division 1 malocclusions. (2) Immediately after treatment, raters perceived the changes in the profile of the extraction group more favorably than those in the nonextraction and normal groups. (3) At the end of the observation period (approximately 2 years posttreatment), raters did not evaluate the profile of any of the groups as being more favorable, but all groups were perceived more favorably than at the initial observation. (4) Raters perceived the profile changes with treatment more favorably in female subjects than in male subjects. In conclusion, orthodontic treatment seems to have a favorable effect on the profiles of both the extraction and nonextraction groups, both short- and long-term. Therefore, when based on proper diagnostic criteria, the posttreatment changes in the facial profile were perceived as favorable in both the extraction and nonextraction Class II, Division 1 groups when compared with the pretreatment profile.

Adolescent↗

Esthetic soft tissue profile preferences among the Japanese population.

The purpose of this study was to determine the facial profile preferences in a sample of 2651 randomly selected panelists (mean age, 29.3 +/- 10.1 years) from Japanese cultural and educational backgrounds. Five facial profile types were computer-generated by an orthodontist to represent distinct facial types. Subjects were asked to rank the profiles in descending order of attractiveness. The ranking was as follows: orthognathic profile, bimaxillary retrusive profile, bimaxillary protrusive profile, mandibular retrognathic profile, and mandibular prognathic profile. The differences in rank scores between all the profile types were statistically significant (p < 0.05).

Adult↗

Bilateral implantation of low-profile interbody fusion cages: subsidence, lordosis, and fusion analysis.

BACKGROUND CONTEXT: The use of interbody fusion cages as a treatment for degenerative disc disease has become widespread. Low-profile cages have been developed to allow a closer fit when implanting bilateral cages in patients with smaller vertebral bodies. Some surgeons feel the open design also allows better bone contact and visualization. This is particularly true when two low-profile cages are used adjacent to one another. Because of the open design of low-profile interbody fusion cages, there has been concern regarding such issues as subsidence, lordosis and fusion rates. PURPOSE: This retrospective review of paired bilateral reduced profile interbody fusion cages was completed to assess changes in subsidence, lordosis and fusion. As a secondary goal, patient outcomes were measured to determine overall health since surgery and the patient's satisfaction with the spine surgery, in an attempt to assess the effect of the outcome variables cited supra. STUDY DESIGN: This was a retrospective evaluation of patients who underwent anterior lumbar interbody fusion with low-profile interbody fusion cages. PATIENT SAMPLE: Seventy-one consecutive patients who underwent bilateral implantation of low-profile interbody fusion cages were evaluated. OUTCOME MEASURES: A patient self-evaluation, which included a Short Form (SF)-36 and questions regarding patient satisfaction were administered to patients who were at least 1 year postoperative. Subsidence and lordosis measurements were completed. Fusion was assessed by the operating surgeon. METHODS: Low-profile interbody fusion cages (BAK/Proximity, Centerpulse Spine-Tech, Inc., Minneapolis, MN) were implanted bilaterally in at least one level from L3-L4 to L5-S1. Most patients had degenerative disc disease with leg and back pain that was not responsive to conservative treatment and demonstrated segmental instability or collapse. A small percentage of patients had either a degenerative spondylolisthesis (7.0%) or an isthmic spondylolisthesis (4.2%). Autograft harvested from the iliac crest was used in all cases. Demographic, surgical and follow-up data were retrospectively collected from patient charts. A clinical outcome questionnaire that included an SF-36 as well as questions regarding patient satisfaction was either mailed to each patient who was at least 1 year postsurgery or given to patients to complete at their 1-year visit. Patients were routinely followed radiographically before surgery, immediately after surgery and at 3, 6, 12 and 24 months after surgery. Fusion was assessed by the operating surgeon using lateral radiographs often in conjunction with a thin-slice computed tomography (CT) scan. Criteria for a successful fusion were lack of motion, anterior bridging bone and lack of lucencies on flexion/extension X-rays and/or contiguous bone through the cage using a thin-cut sagittal CT scan. Lateral X-rays on each patient were also measured for subsidence and lordosis changes. RESULTS: A total of 71 patients (45 men, 26 women) with a mean age of 43.4 years (range, 25 to 74) were evaluated. Thirty-six percent of the patients were smokers, and 96% were worker's compensation patients. Thirty-two percent of the patients had previous lumbar surgery. A total of 100 operative levels were evaluated. There were 45 one-level, 23 two-level and three three-level cases. Forty-nine percent were level L5-S1, 43% were L4-L5 and 8% were L3-L4. The mean duration of symptoms was 31.5 months. Mean surgical time, mean blood loss and mean hospital stay were 139 minutes, 186 cc and 3.34 days, respectively. There were no intraoperative or postoperative complications attributable to the construct and no cases of cage migration or collapse. Patients who were at least 1-year postsurgery and had follow-up X-rays or had undergone a CT scan at this time point were evaluated for fusion status. Sixty-three patients were assessed for fusion. Fifty-four (86%) of these patients were determined to have a solid fusion. Mean time to fusion was 10 months. Fusion was assessed as solid only if all operative levels were fully fused. Mean subsidence of the anterior region was 1.97 mm, whereas the mean subsidence of the posterior region was 0.82 mm. Lordosis was unchanged at all surgical levels with mean lordosis in L3-L4 decreasing only slightly from 13 degrees before surgery to 12 degrees after surgery. L4-L5 and L5-S1 showed only slight increases in lordosis changing from 17 to 18 degrees at L4-L5 and from 17 to 19 degrees at L5-S1. These changes were not statistically significant. The clinical outcome questionnaires had a return rate of 68%. Of the 48 patients who completed the questionnaire, 75% responded that they were happy with the surgical results and would definitely recommend the surgery to a friend. Sixty-seven percent agreed that surgery met their expectations or that surgery improved their condition enough that they would go through it again for the same outcome. The results of the SF-36 portion of the survey revealed that the physical and mental composite scores were within normal range of the US population that has experienced back pain or sciatica. CONCLUSION: Bilateral implantation of low-profile cages in this patient population led to satisfactory outcomes. Subsidence and changes in lordosis were minimal. Fusion rates were good, especially for one-level cases. Patient satisfaction was relatively high, considering the population consisted of 96% worker's compensation cases. With proper surgical technique, bilateral low-profile cages can be used effectively to treat patients with degenerative disc disease.

Health Status↗

Diffuse large B-cell lymphomas with germinal center B-cell-like differentiation immunophenotypic profile are associated with high apoptotic index, high expression of the proapoptotic proteins bax, bak and bid and low expression of the antiapoptotic protein bcl-xl.

The aim of this study was to analyze the relations between differentiation immunophenotypes and the status of apoptosis and proliferation in diffuse large B-cell lymphomas. Therefore, the bcl6/CD10/MUM1/CD138 differentiation immunophenotypic profiles were studied in relation to (a) the apoptotic index, (b) the apoptosis-associated bcl2 family proteins bcl2, bcl-xl, bax, bak, bad and bid, (c) the proliferation index (Ki67) and (d) the cell cycle proteins cyclin A, cyclin B1, cyclin D3, cyclin E, p53, Rb, p16 and p27 in 79 cases of diffuse large B-cell lymphomas. Two major differentiation immunophenotypic profiles were distinguished: the germinal center B-cell-like profile; 31 cases (bcl6+/CD10+/-/MUM1-/CD138-: 29 cases and bcl6-/CD10+/MUM1-/CD138-: two cases) and the nongerminal center B-cell-like profile (bcl6+/-/CD10-/MUM1+/CD138-); 48 cases. The expression of bax, bak and bid and the apoptotic index were significantly higher in the germinal center B-cell-like profile than in the nongerminal center B-cell-like profile (P=0.045, 0.018, 0.003 and 0.034, respectively). In contrast, the expression of bcl-xl was significantly lower in the germinal center B-cell-like profile than in the nongerminal center B-cell-like profile (P=0.026). The expression of bcl6 and CD10 showed significant positive correlation with the expression of bax (r=0.659, P<0.001 and r=0.240, P=0.033, respectively), bak (r=0.391, P<0.001 and r=0.233, P=0.039, respectively) and bid (r=0.652, P<0.001 and r=0.238, P=0.035, respectively) and significant negative correlation with the expression of bcl-xl (r=-0.536, P<0.001 and r=-0.250, P=0.029, respectively). The expression of MUM1 showed significant negative correlation with the expression of bax (r=-0.276, P=0.014) and bid (r=-0.266, P=0.018) and significant positive correlation with the expression of bcl-xl (r=0.238, P=0.037). The above findings indicate that diffuse large B-cell lymphomas with germinal center B-cell-like immunophenotypic profile are associated with increased apoptosis status, high expression of the proapoptotic proteins bax, bak and bid and low expression of the antiapoptotic protein bcl-xl.

Apoptosis↗

Evaluation of forest nutrition based on large-scale foliar surveys: are nutrition profiles the way of the future?

This paper introduces the use of nutrition profiles as a first step in the development of a concept that is suitable for evaluating forest nutrition on the basis of large-scale foliar surveys. Nutrition profiles of a tree or stand were defined as the nutrient status, which accounts for all element concentrations, contents and interactions between two or more elements. Therefore a nutrition profile overcomes the shortcomings associated with the commonly used concepts for evaluating forest nutrition. Nutrition profiles can be calculated by means of a neural network, i.e. a self-organizing map, and an agglomerative clustering algorithm with pruning. As an example, nutrition profiles were calculated to describe the temporal variation in the mineral composition of Scots pine and Norway spruce needles in Finland between 1987 and 2000. The temporal trends in the frequency distribution of the nutrition profiles of Scots pine indicated that, between 1987 and 2000, the N, S, P, K, Ca, Mg and Al decreased, whereas the needle mass (NM) increased or remained unchanged. As there were no temporal trends in the frequency distribution of the nutrition profiles of Norway spruce, the mineral composition of the needles of Norway spruce needles subsequently did not change. Interpretation of the (lack of) temporal trends was outside the scope of this example. However, nutrition profiles prove to be a new and better concept for the evaluation of the mineral composition of large-scale surveys only when a biological interpretation of the nutrition profiles can be provided.

Algorithms↗

Optimization of dialysate sodium in sodium profiling haemodialysis.

Sodium profiling haemodialysis is a modified method of sodium gradient dialysis during which dialysate sodium follows a time-dependent profile. Sodium profiling haemodialysis has claimed to reduce intradialytic discomforts such as hypotension, muscle cramps, and disequilibrium syndrome. Having the low sodium period is an essential part of the sodium profiling haemodialysis to compensate for the sodium gain during the high sodium period. In spite of this, however, the incidence of interdialytic complications that results from the excessive sodium gain has been reported in previous literature. Making the prediction of optimal dialysate sodium concentration for isonatric dialysis is practically very difficult since too many variables influence the sodium gradient, including the initial plasma sodium and tonicity and/or dialysis dynamics that differ from patient to patient and from treatment to treatment. As for sodium profiling haemodialysis, complexities are added further since details of profile, such as type and form of profile, or initial, terminal, or time-distribution of dialysate sodium are varied considerably. We have recently reported that the intradialytic sodium balance and interdialytic weight gain are directly related to the time-averaged concentration of dialysate sodium (TACNa). The dialysate sodium can be optimized using this concept of TACNa for sodium profiling dialysis. TACNa should be approximately 0.5-0.8 mmol/L lower than patient's predialysis serum sodium concentrations to achieve a sodium balance neutral dialysis. In that study the optimal TACNa, seems to be between 137.8 and 143.5 mmol/L. Such an optimal value should be defined for the individual centres based on their profile protocols for clinical use. In the future, dialysate sodium should be optimized based on the exact prediction of the postdialysis plasma sodium levels.

Hemodialysis Solutions↗

Cerebral gigantism (Sotos' syndrome). Metacarpophalangeal pattern profiles.

The metacarpophalangeal pattern (MCPP) profile in 17 out of 22 patients with Sotos' syndrome was studied throughout the growth period, from 2 weeks to 19 years of age. Two typical MCPP profiles will be described. The first type of profile was found in 13 patients. Although the form of the profile is the same throughout the years, the lengthening of the fingers is most pronounced around 2 years of age. Before and after that period there is a flattening of the curve. The metacarpals are relatively longer below the age of 3 years, above 3 years the lengthening of the proximal phalanges is more pronounced in the profile. The second type of profile was found in 4 patients. This curve is almost a mirror image of the first profile. The fingers are not as long as in the first type and the profile is less pronounced. In one of the 17 patients the transition from the first type to the second type could be demonstrated. One patient had a normal profile.

Abnormalities, Multiple↗

Effect of lithotripsy on holmium:YAG optical beam profile.

PURPOSE: To determine the effect of holmium:YAG lithotripsy on the optical beam profile. MATERIALS AND METHODS: Beam profiles of the laser light from holmium:YAG optical fiber systems were characterized with a pyroelectric camera. Beam profiles were measured with 272-microm and 365-microm optical fibers both straight and bent to simulate lower-pole ureteronephroscopy. Struvite calculi were irradiated. Beam profiles and energy outputs were characterized for the fibers before and after ablation. Ablation crater geometry was characterized with optical coherence tomography. RESULTS: Undamaged, straight fibers produced a near-Gaussian beam profile. Craters showed a similar near-Gaussian shape. Undamaged, bent 272-microm fibers produced a near-Gaussian beam but slightly flatter profile than the straight fiber. The bent 272-microm fiber transmitted 99% to 100% of the energy, similar to the 100% transmission of the straight fibers. After ablation, measured energy output dropped by 30% within 50 pulses at 0.2 J pulse energy. The damaged fibers produced irregular beam profiles with hot spots. Craters showed irregular contours. CONCLUSIONS: During Ho:YAG lithotripsy, the beam profile at the optical fiber tip approaches a Gaussian distribution. This shape corresponds to the crater produced on the stone surface. With further ablation, the beam profile becomes erratic and unpredictable, with loss of lithotripsy efficiency. The findings provide further insight into the photothermal mechanism of Ho:YAG lithotripsy.

Humans↗

Three dimensional visualisation of velocity profiles in the normal porcine pulmonary trunk.

OBJECTIVE: The aim was to obtain detailed data of velocity profile development in the porcine pulmonary trunk. METHODS: Hot film anemometry was used for point blood velocity measurements in the entire cross sectional area one diameter downstream of the normal porcine pulmonary valve. Computerised three dimensional visualisations of the spatial and temporal development of blood velocity profiles were made. Measurement series were conducted under spontaneous and stressed haemodynamic conditions in 16 pigs with a body weight of approximately 90 kg. RESULTS: The velocity profiles revealed consistent temporal and spatial development characteristics. In the systolic acceleration phase the profile was flat, but during peak systole an initially counterclockwise rotation was seen; subsequently the profile turned clockwise and ultimately counterclockwise to become flat during early and late systolic deceleration phases. CONCLUSIONS: These skewed, rotating velocity profiles are in conflict with the generally accepted assumption that the velocity profile in the pulmonary trunk is flat. The rotating skewness of the velocity profile in the porcine pulmonary trunk has not been described before. The reason for the rotating velocity profile is obscure.

Animals↗