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Symptom subtypes of obsessive-compulsive disorder in behavioral treatment studies: a quantitative review.

Recent reviews and meta-analytic studies have provided an encouraging account of the effectiveness of behavioral interventions for obsessive-compulsive disorder (OCD). One question regarding these estimates concerns their degree of generalizability to the range of OCD subtypes encountered in clinical settings. The purpose of the present study was to provide a quantitative description of the prevalence of various OCD subtypes (i.e. type of compulsions) within the behavioral treatment literature. We examined 65 studies that permitted classification of patients according to symptom subtype. Patients with primarily cleaning and/or checking compulsions predominated, accounting for 75% of the treatment population. On the other hand, patients with multiple compulsions or other compulsions, such as exactness, counting, hoarding, or slowness rituals were underrepresented, comprising only 12% of the population, which is markedly less than clinical epidemiological estimates. Rates of improvements in patients with OCD are most applicable to patients with cleaning and checking compulsions, but may not yet be generalizable to patients with other symptoms. These findings encourage studies of the efficacy of existing and novel interventions for patients with counting, repeating, symmetry, hoarding, or multiple compulsions in order to broaden the clinical application of OCD behavioral treatment.

Behavior Therapy↗

Evaluation of functional ovarian reserve in 60 patients.

Diminished ovarian reserve is a condition occurring in women at any adult age, although it is more frequent in women in their 30s and in couples with unexplained subfertility. Different tests are employed to diagnose the problem. The most common are basal tests for FSH, LH, oestradiol and inhibin B, or dynamic endocrine tests such as the clomiphene citrate challenge test and gonadotrophin analogue stimulating test. In recent years, great attention has been devoted to direct tests such as the antral follicle count and ovarian biopsy results. The basal FSH concentration is the most common test utilized for ovarian screening. An abnormal value is correlated with a decrease in pregnancy rate and an increase in cycle cancellation rate. Among other basal endocrine tests, inhibin concentrations appear promising, although more data are necessary before this can be included in clinical practice. The clomiphene citrate challenge test can unmask patients who might have not been detected by basal FSH screening alone, and appears to be more sensitive than day 3 FSH alone. A prospective study was performed on the simultaneous application of various markers of ovarian reserve (FSH, LH, oestradiol, inhibin B, antral follicle count) in the natural cycle preceding assisted reproductive therapy, in 60 women. The present study suggests that counting ovarian follicles by ultrasound appears, at the moment, the most reliable test of ovarian reserve, although it is influenced by subjective factors and more studies are needed in order to confirm its predictive value.

Adult↗

Automatic volumetric capillary cytometry in the routine of an apheresis unit involved in multicomponent collection.

In apheresis, leukodepletion by secondary filtration of the platelet components or by the primary use of special high efficiency apparatuses is widely used to meet current clinical practice. Leukodepletion of RBC is mandatory for hematooncological patients and new filters for plasma are progressively being introduced in the routine of European blood banks. However, since the monitoring of leukodepletion efficiency continues to be carried out manually using the Nageotte or the microdroplet fluorescence assay (MFA), inaccuracy and labour-intensity of counting will limit the possibility of satisfying the increasing demand for leukodepletion monitoring. Volumetric capillary cytometry (VCC) is a totally automated system that has been shown to correlate well with Nageotte, MFA and flow-cytometric countings of residual leukocytes in platelet and RBC product. In this article we describe the application of VCC in the quality control program of our hemapheresis unit in which all apheresis donations are of the multicomponent collection type.

Automation↗

Automated techniques in haematology.

BACKGROUND: Manual techniques have been mostly in use in developing countries until recently because of its low cost even though it is laborious. Many laboratories are however changing to automated techniques since many samples can be analysed within a short time. It is likely that more laboratories will use these instruments either as semi automated or fully automated multichannel instruments. There is therefore a need for laboratories to become more responsive to the needs of physicians making request by providing help in the presentation and interpretation of results. METHOD: Available literature on automation in Haematology was sourced for using both manual library search and Medline search. RESULTS: Quality control in automated blood cell counts and related topics are extensively researched but there is still dearth of knowledge on automation in other areas of Haematology and on the clinical implications of automation. CONCLUSION: It is therefore necessary to make provision for automated facilities in laboratories in view of the high precision and cost effectiveness of these machines. This review is geared towards a critical look at this technology and its application to disease states.

Autoanalysis↗

Application of a computer-controlled infrared beam device to behavioral research.

An experimental control system was designed to evaluate the effects of toxic substances. This system consisted of a personal computer (Apple II), shuttle boxes, and their controller. The shuttle box (33 X 20 X 53 cm) was divided into two compartments of equal size with a hurdle (8 cm). An infrared beam device was set up 8 cm from each side of the hurdle and 5 cm above the floor to detect the occupied compartment. Signals from detectors were put into the Apple II through a peripheral interface adapter unit. Since the control program was written in assembly language, which could operate at high speed, it was possible to conduct experiments using four shuttle boxes simultaneously. During the execution of the experiments, the timer unit generated pulses 100 times/sec. Every pulse was counted and used to measure a response latency at intervals of 10 msec. The application of a computer-controlled infrared beam device made it possible to detect the location and operant responses of a subject mechanically from moment to moment and to construct an extremely flexible experimental control system.

Avoidance Learning↗

Monitoring human blood dendritic cell numbers in normal individuals and in stem cell transplantation.

Dendritic cells (DC) originate from a bone marrow (BM) precursor and circulate via the blood to most body tissues where they fulfill a role in antigen surveillance. Little is known about DC numbers in disease, although the reported increase in tissue DC turnover due to inflammatory stimuli suggests that blood DC numbers may be altered in some clinical situations. The lack of a defined method for counting DC has limited patient studies. We therefore developed a method suitable for routine monitoring of blood DC numbers, using the CMRF44 monoclonal antibody (MoAb) and flow cytometry to identify DC. A normal range was determined from samples drawn from 103 healthy adults. The mean percentage of DC present in blood mononuclear cells (MNC) was 0.42%, and the mean absolute DC count was 10 x 10(6) DC/L blood. The normal ranges for DC (mean +/- 1.96 standard deviation [SD]) were 0.15% to 0.70% MNC or 3 to 17 x 10(6) DC/L blood. This method has applications for monitoring attempts to mobilize DC into the blood to facilitate their collection for immunotherapeutic purposes and for counting blood DC in other patients. In preliminary studies, we have found a statistically significant decrease in the blood DC counts in individuals at the time of blood stem cell harvest and in patients with acute illnesses, including allogeneic bone marrow transplant (BMT) recipients with acute graft-versus-host disease (aGVHD).

Adolescent↗

Afferent neurons of the hypoglossal nerve of the rat as demonstrated by horseradish peroxidase tracing.

Cell bodies of sensory neurons of the rat's hypoglossal nerve were demonstrated by the somatopetal horseradish peroxidase (HRP) transport technique. Labelled perikarya were found within the second and third cervical spinal ganglia and in the vagal sensory ganglia. After application of HRP to the cut peripheral trunk of the hypoglossal nerve about 200 labelled cell bodies were counted in each animal. The vast majority of the axons from cervical spinal ganglion cells reach the hypoglossal nerve via the descending ramus (N. descendens hypoglossi). However, there may exist an additional pathway, probably via the cervical sympathetic trunk. Application of HPR to the medial and lateral end branches led to a labelling of much fewer spinal ganglion cells while the number of labelled vegal sensory neurons remained unchanged. Thus, it is suggested that the majority of the cervical afferents of the hypoglossal nerve originates within the extrinsic tongue musculature and the geniohyoid muscle, whereas the vagal afferents may perhaps derive exclusively from the intrinsic muslces. Histograms of the mean diameters of labelled cell bodies show a predominance of very small perikarya. This contrasts with the diameter distribution of sensory perikarya labelled after HRP application to nerves supplying other skeletal muscles. It is therefore assumed that the afferent component of the hypoglossal nerve is composed mainly of small-calibre axons.

Animals↗

Systemic effects and percutaneous absorption of topically applied 0.1% hydrocortisone 17-butyrate.

The systemic effects of topically applied 0.1% hydrocortisone 17-butyrate during treatment with and without occlusion were measured in terms of the functions of the pituitary-adrenal axis. Corticosteroid levels in the blood were determined by the modified method of MURPHY, a competitive protein-binding radioassay. Circulating eosinophils were counted and the urinary 17-OHCS and 17-KS excretion were also determined. Percutaneous absorption following the topical application of 14C hydrocortisone 17-butyrate 1 (HC 17-B, Locoid) was measured by means of autoradiography. The application of the corticosteroid to the normal skin without occlusion did not induce systemic effects, whilst the application of the drug under occlusive dressing showed that systemic effects may possibly be induced. The number of circulating eosinophils, corticosteroid levels in the blood and urinary 17-OHCS excretion all decreased. However, these values returned to normal about 2 days after the withdrawal of the application, so we consider the systemic effect induced by the topical corticosteroid to be of a temporary nature. The percutaneous absorption of the corticosteroid was proved by an autoradiographic technique using 14C-labelled HC 17-B. At various intervals after the application, radioactive substances were observed as silver grains in the horny layer of the epidermis and skin appendages, and the density of the silver grains gradually increased with the course of time. It may be surmised that locally applied HC 17-B will be retained in the horny layer of the epidermis at a very early stage after the application and then absorbed in the blood via the epidermis and skin appendages. The reservoir of the corticosteroid in the skin was demonstrated 24 h after the withdrawal of the application.

17-Hydroxycorticosteroids↗

Using qubits to measure fidelity in mesoscopic systems.

We point out the similarities in the definition of the "fidelity" of a quantum system and the generating function determining the full counting statistics of charge transport through a quantum wire and suggest to use flux or charge qubits for their measurement. As an application we use the notion of fidelity within a first-quantized formalism in order to derive new results and insights on the generating function of the full counting statistics.

Journal Article↗

Sterilization of infected root-canal dentine by topical application of a mixture of ciprofloxacin, metronidazole and minocycline in situ.

The aim of this study was to observe the potential of a mixture of ciprofloxacin, metronidazole and minocycline to kill bacteria in the deep layers of root canal dentine in situ. After the crowns of extracted teeth had been removed, the drug combination (0.5 mg of each drug), or sterile saline, as the control, was placed in the root canals which had been previously irrigated ultrasonically with G4M EDTA. The penetration and bactericidal efficacy were estimated by various procedures as follows. (1) A cell suspension of E. coli was placed into small cavities prepared parallel to the root canals on the cut planes of nine single-rooted teeth. The teeth were then entirely covered with blue inlay wax. At time 0, and at 5h, 24h and 48h after the drug combination had been applied, cells of E. coli were recovered from the cavities by washing the cavities several times with sterile saline solution, and were cultured on the surfaces of heart-infusion (HI) agar plates. Total colony-forming units were tuen counted. Bacterial recoveries decreased with time, and no bacteria were recovered 48 h after application of the drug combination, while bacteria survived in all cases with the controls, (2) After the drug combination or sterile saline had been placed into and sealed in the root canal with blue inlay wax, the teeth were placed into HI agar plates where cells of E. coli had been inoculated. After culturing, a clear zone caused by the inhibition of bacterial growth was observed around the teeth, but not in the control experiment. (3) After sampling infected root dentine of 12 freshly extracted teeth as positive controls, the drug combination (0.5 mg each) was placed in the root canals. No bacteria were recovered from the infected dentine of the root canal wall 24 h after application of the drug combination, except in one case in which a few bacteria were recovered. On the basis of these results, penetration through dentine and antibacterial efficacy of the drug combination can be expected against bacteria infecting the dentine of the root canal wall in situ when the drugs were placed in root canals which had been irrigated ultrasonically.

Anti-Bacterial Agents↗

[Bacteriologic studies of bicarbonate dialysate and suitable initial solutions].

Dialysates for the haemodialysis are produced unsterile and usually contain bacteria. Own investigations of bicarbonate dialysate and adequate initial solutions comprised sterility tests, determinations of the germ count and germ tolerance experiments. Only the "acid concentrate" was sterile. In the other solutions Corynebacteria, Acinetobacter and Pseudomonas bacteria dominated as typical water germs. In the fresh reverse osmosis water and the bicarbonate dialysate as well as in the recently produced 35-mmolar and 1-molar NaHCO3-solution the germ count was in each case about 10(5)/l and did not change itself essentially at room temperature within 6 hours. The "acid concentrate" and at a lower level also the 1-molar NaHCO3-concentrate have an antibacterial effect. The reverse osmosis water is the main contamination source for the bicarbonate dialysate, the application of which within 6 hours seems worth being used on account of the low germ count.

Bacteriological Techniques↗

Simultaneous dual-isotope technetium-99m/thallium-201 cardiac SPET imaging using a projection-dependent spilldown correction factor.

A spilldown correction method is proposed for the thallium-201 window image in simultaneous dual-isotope technetium-99m/thallium-201 single-photon emission tomographic (SPET) imaging based on a single acquisition into three energy windows. In this method, images are simultaneously acquired in two standard energy windows over the 99mTc and 201Tl photopeak regions and a third spilldown window adjacent to the 201Tl window. Using a Monte Carlo simulation of SPET, the fractional amount of 99mTc and 201Tl spilldown in the 201Tl window with respect to the total counts from the spilldown window, k12, was calculated for simulated images of point sources at varying depths within a water-filled elliptical tub phantom. When applied to experimental acquisitions, k12, multiplied by the total counts from the spilldown window, is then subtracted from the 201Tl window image to produce the corrected image. However, for successful applications in SPET, k12 must be determined on a projection-by-projection basis since k12 is depth dependent. Thus, a regression relation was obtained between k12 and the total count ratio of the spilldown to 99mTc windows, k23. The spilldown correction method was applied to 201Tl photopeak images of an extended source distribution in uniform and nonuniform attenuating media with dual-isotope 99mTc/201Tl and single-isotope 201Tl. A marked improvement in image contrast was observed between the corrected and uncorrected 201Tl window images. The average count ratio of uncorrected dual-isotope 201Tl/single-isotope 201Tl was 3.08 for uniform and 2.99 for non-uniform attenuating media.(ABSTRACT TRUNCATED AT 250 WORDS)

Heart↗

Modelling bivariate count series with excess zeros.

Bivariate time series of counts with excess zeros relative to the Poisson process are common in many bioscience applications. Failure to account for the extra zeros in the analysis may result in biased parameter estimates and misleading inferences. A class of bivariate zero-inflated Poisson autoregression models is presented to accommodate the zero-inflation and the inherent serial dependency between successive observations. An autoregressive correlation structure is assumed in the random component of the compound regression model. Parameter estimation is achieved via an EM algorithm, by maximizing an appropriate log-likelihood function to obtain residual maximum likelihood estimates. The proposed method is applied to analyze a bivariate series from an occupational health study, in which the zero-inflated injury count events are classified as either musculoskeletal or non-musculoskeletal in nature. The approach enables the evaluation of the effectiveness of a participatory ergonomics intervention at the population level, in terms of reducing the overall incidence of lost-time injury and a simultaneous decline in the two mean injury rates.

Accidents, Occupational↗

Automatic vessel segmentation and quantification of the rat aortic ring assay of angiogenesis.

BACKGROUND: Pharmacologic control of angiogenesis is a promising new approach to the treatment of a variety of pathologic conditions including cancer. The recently developed in vitro rat aortic ring model provides a simple, reproducible assay for discovering angiogenic agonists and antagonists. However, quantification of results in this assay is time consuming, tedious, and subjective, because it involves visual inspection of images and manually counting the newly formed microvessels extending from the cultured aortic ring. This report describes an automated image analysis-based procedure for quantification of this assay that overcomes these difficulties. EXPERIMENTAL DESIGN: The designed image processing algorithm segments the vessels from gray scale images. A high-pass filter is used, and the results are separated into nonvascular and vessel compartments based on object size and shape. Quantification relies on identification of vessels intersecting a closed transect set a fixed distance from the aortic ring. The number and the total area of these vessels are determined. The entire operation has been automated and packaged in an application called Vessels. RESULTS: The correlation between computer-determined vessel area/vessel number and visual microvessel count is high (r2 = 0.91 and r2 = 0.86, respectively). CONCLUSION: Vessels offers high-speed, fully automatic batch processing including production of a hard copy for documentation. The application runs on the Apple family of computers. On a Quadra 800, the application can process approximately 30 images/hour, which is approximately 2.5 times faster than manual quantification of this assay.

Animals↗

[Clinical report on treatment of thrombocytopenia with rhIL-11 (Mega) in 10 chronic aplastic anemia patients].

In order to evaluated the curative effect of rhIL-11 (Mega) on thrombocytopenia in chronic aplastic anemia (CAA) patients, ten CAA cases with thrombocytopenia after administration of conventional drugs were selected and subcutaneously injected 0.75 mg Mega per day in 1 - 2 courses of treatment on the basis of conventional therapy. Results showed that platelet counts were obviously increased and the bleeding symptoms were alleviated in all CAA patients after application of Mega for treatment. In conclusion, the rhIL-11 (Mega) could be used as an effective drug for treatment of thrombocytopenia in CAA patients.

Adolescent↗

Evaluation of sperm counts and total sperm counts in 2543 men requesting vasectomy.

Semen analyses were performed on semen specimens from 2543 men requesting vasectomy at Planned Parenthood of Houston and the results were compared to earlier reports of semen analyses in allegedly fertile men. The comparisons suggest that mean sperm counts and mean total sperm counts are significantly lower than those reported in 1951. Furthermore, a shifting pattern of frequency distribution of sperm counts and total sperm counts was noted. Greater percentages of men with sperm counts 20 million/ml and total sperm counts below 100 million/ejaculate were found in the present report and other recent reports than had been noted in 1951. These data suggest that standards of male infertility proposed in 1951 are no longer applicable.

Cell Count↗

Dependence of whole blood luminol chemiluminescence on PMNL and RBC count.

Luminol chemiluminescence (LCL) of whole blood as response to zymosan stimulation was used to assess the activity of polymorpho-nuclear leukocytes (PMNLs). Since PMNL and red blood cells (RBCs) are the primary components determining LCL response, the influence of PMNL and RBC count on the response was investigated over wide ranges of cell count and time interval. A linear relationship was found between maximum LCL intensity (Imax) (reflecting PMNL activity) and PMNL count. This allows a proper correction of Imax to be made as related to the sample PMNL count. This correction was valid for PMNL concentrations from 3.10(3) PMNL/ml to 6.10(5) PMNL/ml. When concentrations range from 6.10(3) PMNL/ml to 3.10(4) PMNL/ml the relationship was valid for a time interval round the peak. During the same interval the inhibitory effect of RBC count was studied. A correction of LCL was found possible for different RBC concentration ranging from 2.5.10(6) RBC/ml to 10(8) RBC/ml. These independent corrections of LCL response to PMNL and RBC counts were applied to diluted whole blood samples. The common correction of Imax was applicable in dilutions not less than 1:50. To correct light intensity for the time interval around Imax, the dilutions used had to be not less than 1:200. The results obtained permit an objective assessment of PMNL activity to be made by testing whole blood samples from different individuals and/or samples diluted to different extents.

Adult↗

[From automation to robotics].

The introduction of automation into the laboratory of biology seems to be unavoidable. But at which cost, if it is necessary to purchase a new machine for every new application? Fortunately the same image processing techniques, belonging to a theoretic framework called Mathematical Morphology, may be used in visual inspection tasks, both in car industry and in the biology lab. Since the market for industrial robotics applications is much higher than the market of biomedical applications, the price of image processing devices drops, and becomes sometimes less than the price of a complete microscope equipment. The power of the image processing methods of Mathematical Morphology will be illustrated by various examples, as automatic silver grain counting in autoradiography, determination of HLA genotype, electrophoretic gels analysis, automatic screening of cervical smears... Thus several heterogeneous applications may share the same image processing device, provided there is a separate and devoted work station for each of them.

Automation↗