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PubMed2004

[Effects of surgery type on body image, sexuality, self-esteem, and marital adjustment in breast cancer: a controlled study].

OBJECTIVE: To examine the effects of surgery type on body image, sexuality, self-esteem and marital adjustment, and to determine the most frequent sexual dysfunction seen among breast cancer survivors. METHOD: A total of 75 breast cancer survivors (50 patients underwent total mastectomy alone and 25 underwent total mastectomy with breast reconstruction), and 50 healthy volunteers were recruited. All subjects were given the Rosenberg Self-esteem Scale (RS), Body Cathexis Scale (BCS), Golombok Rust Inventory of Sexual Satisfaction (GRISS), and Dyadic Adjustment Scale (DAS) after the Structured Clinical Interview Diagnosis for DSM-III-R, Non-Patient Form (SCID-NP) had been applied. RESULTS: The mean scores obtained from GRISS and DAS were similar, but there was a significant statistical difference in terms of the mean scores of the RS and BCS between the three groups. The sexual functioning profile of the subjects was examined by transforming the subscales scores of GRISS into standardized stanine scores. A significant statistical difference in non- communication and avoidance areas of sexual relations was found between the subjects. CONCLUSION: Surgery type had no effect on sexual satisfaction or marital adjustment. Total mastectomy had a negative impact on breast perception and self-esteem. Avoidance and non-communication areas of sexual relations were the most frequent sexual dysfunctions seen among breast cancer survivors. Young patients preferred breast reconstruction more widely.

Adult↗
PubMed2004

Does electrical stimulation of the pelvic floor make any change in urodynamic parameters? When to expect a cure and improvement in women with stress urinary incontinence?

OBJECTIVE: Our study aimed at determining the effects of pelvic floor electrical stimulation assessed by the number of leakages per day recorded in a voiding diary over 90 days of treatment and urodynamic parameters. STUDY DESIGN: This prospective study was carried out with 34 patients presenting stress urinary incontinence who were treated and evaluated by voiding diaries and urodynamic tests. The primary outcome measure was the number of leakages during the 90 days of treatment. Urodynamic tests were performed before and after treatment. RESULTS: In our series, average and maximum flow rates and residual urine volume were within normal range in all subjects before and after treatment. Maximum urethral closure pressure and functional profile length on urethral pressure profiles did not change after treatment. In the cystometry, bladder capacities at the first (p < 0.0082) and maximum sensations (p < 0.01) improved significantly after treatment. During the 90 days of treatment, we observed a gradual drop in the number of leakages. This decrease began around day 22. It dropped in half around day 45, tending to zero close to day 90 of treatment (p < 0.01). CONCLUSIONS: The number of incontinent leakage dropped to half around the 8th week, and on average, there was a tendency of the patients to be cured after the 12th week of treatment. At urodynamic studies we observed a significant increase in bladder capacity at the first desire to void and in the maximum cystometric capacity.

Adult↗
PubMed1992

Structural requirements for thioester bond formation in human complement component C3. Reassessment of the role of thioester bond integrity on the conformation of C3.

A unique thioester bond, formed between the side chains of neighboring C and Q residues, is present in complement components C3 and C4 and the protease inhibitor alpha 2-macroglobulin. This structure is essential for mediating covalent attachment to target acceptors and also for maintaining these proteins in their native conformation. An examination of the residues in the immediate vicinity of the C and Q reveals a very high degree of sequence similarity among the three proteins which crosses species barriers. The following is the sequence flanking the thioester residues in C3, the highly conserved amino acids being underlined and the the thioester-forming residues being indicated by italics: 1005V-T-P-S-G-C-G-E-Q-N-M-I-G-M-T-P-T1021. Through a site-directed mutagenesis and cDNA expression approach, we have examined the importance of the conserved amino acids in the formation, stability, and function of the thioester bond in C3. The behavior of the mutants fell into three categories. The potential loss in peptide backbone flexibility by the replacement of G1009 by A or S was permissive to thioester formation and function as was replacement of M1015 by the still fairly bulky residue F. In contrast, replacement of M1015 by A resulted in an alpha-chain which was highly unstable toward proteolytic degradation. The third category, which included mutant molecules P1007G, P1020G, E1012Q, and Q1013N, displayed an unusual phenotype in which both the autolytic fragmentation and the hemolytic activity characteristics of thioester-intact molecules were absent. However, like their wildtype counterpart, these molecules retained the ability to be cleaved by C3 convertase (C4b2a), a conformation-dependent property that is normally lost in the conversion of native C3 to thioester-hydrolyzed C3(H2O). Since an identical functional profile was obtained when the thioester was deliberately prevented from forming in the mutant C1010A, we conclude that if a stable thioester fails to form during biosynthesis, at least parts of the mature protein can adopt a more native-like conformation than is the case when the thioester is first formed and then hydrolyzed in the mature protein. In view of these new findings, the interpretation of the previously observed correlation between the loss of thioester integrity and the adoption of a C3b-like conformation must be reassessed.

Amino Acid Sequence↗
PubMed2004

Tidal breathing analysis in school-age children. Comparison with the parameters of forced expiration.

UNLABELLED: Tidal breathing analysis is a method which has the potential to be used for distinguishing and follow-up of airflow obstruction (AFO) in infants, children and critically ill patients. The aim of the present study was to analyse the tidal breathing parameters (TBP) in healthy and in asthmatic school-age children and to compare them with the parameters of forced expiration. SUBJECTS: Two hundred and twenty five healthy children and 100 asthmatics (7 to 14 years- old) took part in the present study. RESULTS: The results show that TBPs exhibit great inter- and intraindividual variability, even if the mean value of 10 consecutive breathing cycles is used. Parameters that reflect the tidal expiratory flow pattern--V(PTEF)/V(E) and T(PTEF)/T(E) demonstrate high variability and no correlation with age, sex and anthropometric parameters in healthy children. These indices are useful for detection of acute changes in bronchomotor tonus in asthmatics - V(PTEF)/V(E) = 36.1 +/- 6.6% vs. 32.6 +/- 6.2% (methacholine) vs. 37.4 +/- 7.5% (salbutamol) and T(PTEF)/T(E) = 34.2 +/- 6.2% vs. 28.6 +/- 7.8% vs. 35.3 +/- 7.5%, resp. (P < 0.05 everywhere; n = 34) as well as for discriminating a group of subjects with AFO vs. controls (V(PTEF)/V(E) = 30.9 +/- 6.5% vs. 35.3 +/- 8.0%; P = 0.005, and T(PTEF)/T(E) = 29.0 +/- 6.7% vs. 32.8 +/- 7.6%; P = 0.016). The evaluation of the area under the ROC curves (AUC) in the asthmatic group showed weak discriminative capacity of T(PTEF)/T(E) and V(PTEF)/V(E) in comparison to FEV1 (AUC of T(PTEF)/T(E) = 0.62; 95%CI 0.51-0.74). CONCLUSIONS: Tidal breathing parameters could add insight t.o the functional profile but are not capable of substituting forced expiration regarding detection of overt airflow obstruction in school-age children.

Adolescent↗
PubMed2005

Presence of TT virus infection in chronic hepatitis patients from a hospital in New Delhi, India.

BACKGROUND & OBJECTIVE: The recent discovery of a novel parenterally transmitted, unenveloped, single-stranded DNA virus called TT virus (TTV) in chronic hepatitis patients with unclear pathogenesis throughout the world led us to investigate, its presence in chronic hepatitis patients attending a hospital in New Delhi, India, and to evaluate its role in liver disease. METHODS: TT virus DNA was investigated in serum samples of 70 patients with various types of chronic hepatitis, and 100 healthy subjects from New Delhi, India by nested PCR using the primers that belonged to UTR (A) region of the genome. RESULTS: TTV DNA was detected in 6 of 23 patients (26%) with type B chronic hepatitis, 3 of 20 patients (15%) with type C chronic hepatitis, and 12 of 100 subjects (12%) from healthy control group with normal liver function profile tests. None of the 27 non-B, non-C chronic hepatitis patients had TTV DNA positivity. The prevalence of TTV was significantly higher in type-B chronic hepatitis patients as compared to normal subjects (P< 0.05) but comparable to type C chronic hepatitis patients. The clinical course and biochemical profiles of type B, or type C chronic hepatitis patients co-infected with TTV did not differ significantly from those without TTV infection. INTERPRETATION & CONCLUSION: Interestingly, in chronic hepatitis patients, TTV was always associated with either hepatitis B or C virus indicating a likely parenteral route of transmission. All TTV-positive subjects in healthy control group showed normal clinical and biochemical profiles. Thus, the presence of TTV infection is unlikely to influence the course of chronic hepatitis related to hepatitis B virus (HBV) or hepatitis C virus (HCV) or cause liver diseases in healthy subjects.

Case-Control Studies↗
PubMedDate not supplied

[Characteristics of Mexican asthmatic subjects attending an outpatient service].

BACKGROUND: Despite the high prevalence of asthma in Mexico, studies describing general characteristics of these patients are scarce. OBJECTIVE: To analyze the sociodemographic, clinical and respiratory functional profile of asthmatic patients attending for the first time the outpatient service of a tertiary-level hospital, as well as to investigate treatments already received and the abandonment rate. METHODS: Adolescent and adult asthmatic subjects seen from February 2000 to November 2002 in the outpatient service of the National Institute of Respiratory Diseases, in Mexico City, were prospectively studied. Sociodemographic information was gathered and clinical and spirometric evaluations were carried out. The severity of the disease was classified according to international criteria. RESULTS: A total of 1403 patients between 12 and 82 years of age, with predominance of the female gender, were included in the analysis. An 88.7% of patients had the mildest forms of the disease, 10% had moderate asthma, and 1.3% had severe asthma. While 21.4% had never received anti-asthma treatment, about one third of the remaining patients had received corticosteroids, independently of the asthma severity, indicating an over-treatment of the intermittent form of the disease and an under-treatment of persistent forms. A high abandonment rate (65.7%) was observed. A positive bronchodilator test was observed in 30.3% of patients with intermittent asthma, though this proportion increased to about 67% in those with moderate and severe asthma. CONCLUSION: Mildest forms of the disease predominate among asthmatic patients attending for the first time an outpatient service, with a still very high frequency of inadequate use of corticosteroids.

Academies and Institutes↗
PubMed2006

Factors causing delay in discharge of elderly patients in an acute care hospital.

INTRODUCTION: Prolonged hospitalisation not only increases cost, it is also associated with other complications. Length of stay (LOS) is one of the indicators that reflect total cost of care during hospitalisation. So, it is of paramount importance to find out why elderly patients overstay in acute care hospitals and address these issues proactively. Since no local data is available, a study was planned to ascertain reasons why the discharging of elderly patients from hospital is delayed and whether these reasons are avoidable. MATERIALS AND METHODS: Long-stay patients were defined as those whose LOS had notably exceeded the average LOS for the Diagnosis Related Group (DRG), based on principal admitting diagnosis. A separate analysis showed that the specialty-specific long-stay marker for geriatric medicine was 28 days, so casenote review was done for all patients with LOS of more than 28 days who were discharged from geriatric medicine service of an acute care hospital during a 1-year study period. Information was collected on demographic profile, functional and cognitive status, past medical and social history, admitting medical diagnoses, discharge limiting and delaying factors. RESULTS: During the study period, 150 patients stayed over 28 days and 137 casenotes were available for review. The mean age of the patients was 84 years, 55.5% were female, 77.4% were Chinese, mean abbreviated mental test (AMT) score was 3 and mean modified Barthel's score was 11. The commonest primary diagnosis was sepsis followed by neurological problems, falls-related complication and cardiovascular diseases. The 2 most common discharge limiting factors (the final event which resulted in delay in discharge) were social issues (54, 39.4%) and sepsis (47, 34.3%). Of 47 patients with sepsis, 37 (78.7%) were nosocomial infection. Urinary tract infection and pneumonia were the 2 most common nosocomial infections. The 4 most common factors contributing to delayed discharge (various problems that surfaced throughout the hospital stay) were sepsis (94, 68.6%), deconditioning (65, 47.4%), social issues (52, 38.0%) and cardiovascular disorders (37, 27.0%). CONCLUSION: Elderly patients are more prone to hospitalisation-related complications like nosocomial infection and deconditioning leading to prolonged hospital stay. Early interventions can reduce these complications. Early identification of social issues and prompt discharge planning should be done to avoid delay in discharge.

Acute Disease↗
PubMed2006

[Experimental models used in research into genetic disorders that involve intellectual disability].

INTRODUCTION: A basic principle of molecular and clinical medicine states that the function of the organs and the cells they are made up of is determined by the overall set of specific proteins. Therefore, the function of each organ depends on the molecules present in each cell, and hence it comes as no surprise to find that when tissue function is altered, different changes have taken place in the proteins. In the nervous system there are numerous examples of changes in proteins that correlate with functional alterations, either during normal or pathological development. DEVELOPMENT: In order to understand these relations, and to establish models in which to study the aetiopathogenesis of the disease, it is necessary to direct steady synthesis or to suppress synthesis in the brain of the protein that is potentially involved in the development of the disease. In consequence, it is possible to determine whether the presence or the absence of the protein is the direct or indirect cause of the effects; this is one of the main goals that must be achieved in order to enable researchers to define potential therapeutic targets in hereditary diseases. In order to manipulate the specific protein causing a pathology, we use experimental animal models as essential research tools, since they enable us to determine which mechanisms are altered and how the function of a particular protein affects the mechanisms being studied. CONCLUSIONS: Suppressing a gene or its over-expression in models using genetically modified mice will provide us with a means of modifying the genome and, eventually, the protein in the different tissues as well as in the nervous system in an attempt to imitate the genetic pathology that involves mental retardation. By controlling or suppressing the expression of a protein in the brain it becomes possible to remodel the functional profile of the tissue and study the consequences of molecular genetic manipulation, together with the biochemical, cytological and physiological processes, under normal basal conditions and under specific stimuli or conditions such as stress.

Animals↗
PubMed2006

[Thirteen cases of intrahepatic biliary cystadenoma and cystadenocarcinoma: a single center experience].

BACKGROUND/AIMS: Biliary cystadenoma (BCA) and biliary cystadenocarcinoma (BCACa) are rare cystic neoplasms that usually arise from the liver. We reviewed the clinicopathologic and radiologic findings of 13 cases of intrahepatic biliary cystic neoplasms. METHODS: Seven patients with BCA and 6 patients with BCACa which were pathologically proven within past 10 years were included in this retrospective study. RESULTS: BCA (7 of 7) was more common in female compared to BCACa (4 of 6). Mean age at diagnosis was 53.4 years (BCA) and 58.5 years (BCACa). Abdominal pain (54%) was the most common presenting symptom. Eleven patients (61.5%) exhibited normal liver function profiles and 5 patients (38%) showed elevated levels of serum CA19-9 levels (mean 894.2 U/mL, range: 78.7-2,080). Mean size of tumor was 11.7 cm (range: 5-15). Most frequent radiologic finding was a single cystic mass with septation. BCACa tended to have intracystic solid portion. The cut surface revealed a unilocular or multilocular cystic mass with mucinous contents. Complete surgical excision was done in 12 patients. After the complete resection, recurrence was observed in 1 case of BCACa. CONCLUSIONS: The possibility of biliary cystic neoplasm should be suspected when an intrahepatic cystic lesion with multiseptation or solid portion is noted on imaging study. In addition, complete excision for definite diagnosis and treatment need to be performed.

Adult↗
PubMed2006

Slipped capital femoral epiphysis (SCFE): a 12-year review.

Slipped capital femoral epiphysis (SCFE) is a relatively uncommon hip disorder in adolescents and its prevalence in Malaysia has not been studied. This retrospective study is undertaken to provide an overview of a 12-year review of SCFE treated in our institution. Fourteen patients (19 hips) with slipped capital femoral epiphysis (SCFE) admitted to Hospital UKM from 1990 to 2002 were reviewed with respect to demographic profile, functional outcome according to the Iowa Hip Score, and complications. There were ten boys (average age, 12.5 years) and four girls (average age, 12 years). Eight were Malays and six were Indians. The average body mass index was 26.1 verweight). The left hips (11 hips) were affected more than the right hips (eight hips). Five patients had bilateral slips. Thirteen hips were considered stable while the other six hips were unstable. The majority of cases were moderate slips (12 hips), four hips had severe slips while three hips had mild slips. Several methods of treatment were instituted. These include in situ cannulated screw fixation (11 hips), Knowles pin fixation (three hips) and gentle closed manipulative reduction with cannulated screw fixation (three hips). One patient with bilateral slips refused surgical treatment. Based on the Iowa Hip Score, most patients (nine) had satisfactory results (excellent or good), three had fair results while one patient had a poor result. Avascular necrosis developed in five hips while chondrolysis occurred in one hip. In situ cannulated screw fixation is the treatment of choice. SCFE is an uncommon condition in Malaysia.

Adolescent↗
PubMed2006

[Using the SHiPA with the elderly: a person-centered approach].

Qualitative differences in control, distance and relationship with other people were examined using multidimensional and configurational analyses with data from the SHiPA. The SHiPA, developed by Bouisson (2005), contributes to inform on psychological functioning the elderly, using open responses, no limited into choices, and assesses some aspects of distress and adaptative resources in common daily life events that are frequently causes of difficulties. Based on scores in differential weighting of SHiPA dimensions, multivariate analyses revealed five psychological functioning profiles, characterized by anxiety, depression, cognition, internality, satisfaction with life, and routinization levels. Analyse of the differences between SHiPA profiles suggested a first discrimination depending on the individuals, psychological resources level, and the situation of subjects in third and fourth age.

Aged↗
PubMedDate not supplied

[Functional topography of somatic muscles in euciscus idus].

The intensity of tissue respiration and anaerobic glycolysis, as well as the activity of succinic oxidase, cytochrome oxidase, lactate dehydrogenase and ATPase in skeletal muscles of the ide L. idus significantly increase from head to tail. Cranio-caudal gradients of the intensity of tissue respiration and the enzymic activity are especially evident in the red muscle, namely m. lateralis superficialis. In white m. lateralis magnus, the gradient of glycolytic activity is most pronounced. Biochemical and morphological peculiarities of muscles are discussed in relation to functional profile of the latter.

Adenosine Triphosphatases↗
PubMed1990

[Computer-assisted identification and comparative studies of the human skull].

The comparison of reconstructed skull profiles with photographic or other patterns for identification up to the reply to questions for sex, age, and race by the help of image analysis represents a relatively new development in forensic medicine. Using a Robotron image analyzing system 20 human skulls of different races were analysed morphometrically. Standardized profile functions, which were put through a morphometric analysis, showed characteristic individual features. By the help of the computerbased identification method mathematic differences between skulls of varions races became veritable.

Cephalometry↗
PubMed1986

Allogeneic substitution for nominal antigen-specific T-cell clone reactivity in schistosomiasis.

The present studies have established the nature of a T-cell clone which demonstrates dual reactivity directed against Schistosoma mansoni antigen presented by syngeneic antigen presenting cells and against allogeneic cells. Clone G4, when stimulated by either antigen (SEA) or allogeneic cells (PL/J), exhibits similar functional and phenotypic characteristics. A subclone of G4, G4A.1, which has been maintained in continuous mixed lymphocyte culture for 12 months (in the absence of SEA), retains comparable reactivity with respect to proliferation and ability to produce lymphokines, transfer delayed-type hypersensitivity, and produce in vitro granulomas in response to SEA. Normal antigenic stimulation is highly contingent upon I-Ab compatibility while antibody blocking experiments map allo-reactivity to I-Eu. The failure of B10.PL spleen cells to stimulate G4, however, suggests that alloreactivity may be directed against the recently described Mls X locus. Both allogeneic and nominal antigen induced T-cell activation are blocked by antibody directed against L3T4A, confirming Class II MHC restriction for both types of stimulation. These studies suggest that stimulation of T cells by either alloantigen or nominal antigen elicits qualitatively similar functional profiles, and further suggest the feasibility of producing large numbers of nominal antigen reactive cloned T cells in the absence of nominal antigen under mixed lymphocyte culture conditions.

Animals↗
PubMed1986

[Clinical study of allylestrenol (Org AL-25) on patients with prostatic hypertrophy--transrectal ultrasonography and urodynamic examination].

Seventeen patients with benign prostatic hypertrophy were treated with 50 mg allylestrenol per day for a long period of time (mean: 37.7 weeks), and subjective and objective findings, transrectal ultrasonotomography, urodynamics, serum lipids and hormone levels were examined. Improvement rates of subjective and objective findings were 42.9-92.9%. A significant decrease in weight and diameter (antero-posterior, lateral) of the prostate was observed, but the difference in the height of the prostate was not significant. Increase in intravesical pressure was observed in 9 out of 14 cases (64.3%) and the decrease in area under the urethral pressure curve at functional profile length was observed in 6 out of 11 cases (54.5%). Slight increase of the serum lipid levels was observed in a few cases, but in many cases the fluctuation was within normal range. Although clear decrease in the testosterone levels was seen, decrease of libido and potency was observed in only one case (5.9%). No other side-effect was found. The overall efficacy rate was 58.8%, and clinical usefulness of Allylestrenol on benign prostatic hypertrophy was confirmed.

Aged↗
PubMed1989

[Disorders of the immune system in benign lesions and cancer of the breast].

Immunologic vigor was studied in 225 cases of breast cancer at various stages, 99 patients with benign lesions of the breast and 154 healthy donors. The parameters of cell-mediated immunity under study included total, active and neuraminidase T-lymphocyte levels, concentration of T-lymphocyte subsets (Tm, T gamma, theophylline--sensitive and theophylline--resistant) and their profile, functional activity of lymphocytes in blastogenic reaction with PHA and natural killer levels. Also, such humoral immunity indexes as B-lymphocytes and immunoglobulins A, M and C were evaluated. Significant changes in functional activity of the immune system (mainly, its T-cell--mediated component) were identified as early as at the initial stages of breast cancer development and they became more pronounced as tumor advanced. Also, at initial stages, both T-lymphocyte and natural killer functional activity started to flag.

B-Lymphocytes↗
PubMed1987

Adolescents with learning problems.

The adolescent with learning problems presents a multifaceted diagnostic and therapeutic challenge to the primary care clinician. The adolescent failing in school often manifests secondary affective symptoms that tend to obscure underlying developmental deficits. Inadequate educational experiences, family stress, environmental deprivation, and preoccupation with nonacademic sources of gratification can further cloud the picture. Efforts at remediation must overcome the tendency of medical and school professionals, parents, and students themselves to be overly pessimistic about the long-term outcome. With the knowledge of the common causes of school failure and developmental dysfunction in this age group, the general physician can reach a reasonable diagnosis, develop a functional profile of strengths and weaknesses, and collaborate with parents, educators, and the adolescent to effect a comprehensive management plan. The physician's ongoing involvement can be a very important factor stimulating the school to continue to evaluate an individual student's needs and abilities. Parents may need assistance to recognize their child's own strengths and to help the child utilize them appropriately. If the adolescent is helped to see that he or she can make important contributions to society within the spectrum of his or her talents, then the clinician has played a crucial role in the development of a potentially happy and successful adult.

Adolescent↗
PubMed1988

[Radio-urodynamic evaluation of stress urinary incontinence in women].

This work is aimed at demonstrating the validity of conventional radiological procedures, correlated with urodynamics, in the study of female urinary stress incontinence. In a study population of 110 patients with a clinical-urodynamic diagnosis of stress incontinence, radiological evaluation was performed by means of retrograde cystography, bead chain cystourethrography, and voiding cystourethrography. Radiographic findings were correlated with urodynamic data, and in particular with urethral pressure profile (functional length of the urethra, maximum closing pressure, maximum urethral pressure). In all patients the posterior urethro-vesical angle values were higher than 100 degrees; moreover, a correlation was proven to exist between an increase in the angle of front urethral inclination, the lowering and mobility of the urethrovesical junction, and the severity of urodynamic findings. Furthermore, in the different stages of urodynamic severity , urethral funneling was most frequent, and the flattening of the posterior vesical floor in voiding cystourethrography. The high reliability of the radiographic findings, although obtained by means of conventional techniques, and the variability of the morpho-dynamic results confirm the importance of a combined radiographic and urodynamic study in the evaluation of stress incontinence.

Adult↗