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1.
J Appl Physiol (1985) ; 131(4): 1380-1389, 2021 10 01.
Article in English | MEDLINE | ID: mdl-34410849

ABSTRACT

Although the health benefits of exercise in adults with obesity are well described, the direct effects of exercise on adipose tissue that may lead to improved metabolic health are poorly understood. The primary aims of this study were to perform an unbiased analysis of the subcutaneous abdominal adipose tissue transcriptomic response to acute exercise in adults with obesity, and to compare the effects of moderate-intensity continuous exercise versus high-intensity interval exercise on this response. Twenty-nine adults with obesity performed a session of either high-intensity interval exercise (HI; 10 × 1 min at 90%HRpeak, 1 min recovery between intervals; n = 14) or moderate-intensity continuous exercise (MI; 45 min at 70%HRpeak; n = 15). Groups were well matched for BMI (HI 33 ± 3 vs. MI 33 ± 4 kg/m2), sex (HI: 9 women vs. MI: 10 women), and age (HI: 32 ± 6 vs. MI: 29 ± 5). Subcutaneous adipose tissue was collected before and 1 h after the session of HI or MI, and samples were processed for RNA sequencing. Gene set enrichment analysis revealed 7 of 21 gene sets enriched postexercise overlapped between HI and MI. Interestingly, both HI and MI upregulated gene sets involved in inflammation (IL6-JAK-STAT3 signaling, allograft rejection, TNFα signaling via NFκB, and inflammatory response; FDR q value < 0.25). Exercise also downregulated adipogenic and oxidative metabolism gene sets in both groups. Overall, these data suggest genes involved in subcutaneous adipose tissue metabolism and inflammation may be an important part of the initial response after a session of exercise.NEW & NOTEWORTHY This study compared the effects of a single session of high-intensity interval exercise versus moderate-intensity continuous exercise on transcriptional changes in subcutaneous abdominal adipose tissue collected from adults with obesity. Our novel findings indicate exercise upregulated inflammation-related gene sets, while it downregulated metabolism-related gene sets - after both high-intensity and moderate-intensity exercise. These data suggest exercise can alter the adipose tissue transcriptome 1 h after exercise in ways that may impact inflammation and metabolism.


Subject(s)
Exercise , Obesity , Abdominal Fat , Adipose Tissue , Adult , Female , Humans , Inflammation/genetics , Obesity/genetics , Subcutaneous Fat
2.
Gynecol Oncol Rep ; 30: 100502, 2019 Nov.
Article in English | MEDLINE | ID: mdl-31720357

ABSTRACT

OBJECTIVE: To examine associations of body mass index (BMI), subcutaneous fat area (SFA) and density (SFD), visceral fat area (VFA) and density (VFD) and total psoas area (TPA) to outcomes among patients receiving chemotherapy with or without bevacizumab for advanced or recurrent endometrial cancer (EC). METHODS: This was a multi-institutional, retrospective study of patients with EC treated with and without bevacizumab as part of front-line, platinum based chemotherapy. Demographics and clinical characteristics were collected. SFA, VFA, SFD, VFD, and TPA were determined from pre-treatment CT scans using a deep learning algorithm. Data was compared with overall survival (OS) and progression free survival (PFS). RESULTS: Seventy-eight patients were analyzed. The majority were Caucasian (87.2%) with a mean BMI of 34.7 kg/m2. PFS and OS did not differ between patients with BMI, SFA, VFA, SFD, VFD, or TPA ≥ the 50th percentile compared to <50th percentile (p = 0.91, 0.45, 0.71, 0.74, 0.60, and 0.74 respectively) and (p = 0.99, 0.59, 0.14, 0.77, and 0.85 respectively). When adjusting for prognostic factors, elevated VFA trended towards shorter OS (25.1 vs 59.5 months, HR = 1.68 [0.92-3.05]).Patients receiving bevacizumab had similar OS compared to those who did not (37.6 vs 44.5 months, p = 0.409). When stratified by adiposity markers, no subset demonstrated benefit from bevacizumab. CONCLUSION: Obesity has been associated with increased levels of vascular endothelial growth factor (VEGF), the main target for bevacizumab therapy. Imaging measurements of VFA may provide prognostic information for patients with EC but no adiposity marker was predictive of improved response to bevacizumab.

3.
Gynecol Oncol ; 146(2): 268-272, 2017 08.
Article in English | MEDLINE | ID: mdl-28583323

ABSTRACT

OBJECTIVE: Intraperitoneal (IP) chemotherapy (CT) for treatment of epithelial ovarian cancer (EOC) has been shown to provide a substantial OS advantage. This study aims to compare the toxicity and benefits of IP CT in patients ≥70 with those <70. METHODS: We performed a single institution retrospective review of patients diagnosed with Stage IIA-IIIC EOC from 2000 to 2013 who received IP CT. Clinicopathologic characteristics were extracted, and survival was calculated. RESULTS: 133 patients were included with 100 pts. <70years old and 33 pts. ≥70years old. Clinical trial enrollment was similar despite age. In trial enrolled patients, older patients received statistically fewer cycles of therapy (6.4 vs 5.8, p=0.002) but had similar dose delays (0.9 vs 0.7, p=0.72), and modifications (0.9 vs 0.36, p=0.11). Median PFS (27 vs 31months) and OS (71 and 62months) were not statistically different. Grade 3/4 neutropenia was significantly worse in the older patients (82% vs 100%, p=0.04). Neuropathy grade ≥2 and other non-hematologic toxicities were not different between age groups. CONCLUSIONS: Despite completing fewer cycles of IP CT, older EOC patients had comparable survival to younger patients. The population of older patients receiving IP CT in this study were on clinical trial and likely to be heartier than the general older population. IP CT appears well tolerated and effective among select older patients and is likely under-utilized outside of clinical trials.


Subject(s)
Adenocarcinoma, Clear Cell/drug therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Endometrioid/drug therapy , Cytoreduction Surgical Procedures , Neoplasms, Cystic, Mucinous, and Serous/drug therapy , Neoplasms, Glandular and Epithelial/drug therapy , Ovarian Neoplasms/drug therapy , Adenocarcinoma, Clear Cell/mortality , Adenocarcinoma, Clear Cell/pathology , Age Factors , Aged , Bevacizumab/administration & dosage , Carcinoma, Endometrioid/mortality , Carcinoma, Endometrioid/pathology , Carcinoma, Ovarian Epithelial , Chemotherapy, Adjuvant , Disease-Free Survival , Female , Humans , Infusions, Parenteral , Neoplasm Staging , Neoplasms, Cystic, Mucinous, and Serous/mortality , Neoplasms, Cystic, Mucinous, and Serous/pathology , Neoplasms, Glandular and Epithelial/mortality , Neoplasms, Glandular and Epithelial/pathology , Neutropenia/chemically induced , Ovarian Neoplasms/mortality , Ovarian Neoplasms/pathology , Paclitaxel/administration & dosage , Platinum Compounds/administration & dosage , Retrospective Studies , Survival Rate , Taxoids/administration & dosage , Treatment Outcome
4.
J Environ Qual ; 44(4): 1210-5, 2015 Jul.
Article in English | MEDLINE | ID: mdl-26437102

ABSTRACT

Carbon dioxide off-setting policy in the agricultural sector is focused on manipulating the terrestrial carbon cycle by reafforestation and increasing the retention of carbon within agricultural soils. We quantified the amount of carbon stored in the living and dead biomass and the surface soils of a previously grazed woodland ecosystem. We demonstrate that modification of coarse woody debris management could potentially store 8 to 15 t C ha. This large carbon pool raises the prospect that appropriate management of temperate woodlands to retain coarse woody debris and increase its volume into the future could achieve increased landscape carbon storage.

5.
Nano Lett ; 12(5): 2631-8, 2012 May 09.
Article in English | MEDLINE | ID: mdl-22509936

ABSTRACT

We report bandlike transport in solution-deposited, CdSe QD thin-films with room temperature field-effect mobilities for electrons of 27 cm(2)/(V s). A concomitant shift and broadening in the QD solid optical absorption compared to that of dispersed samples is consistent with electron delocalization and measured electron mobilities. Annealing indium contacts allows for thermal diffusion and doping of the QD thin-films, shifting the Fermi energy, filling traps, and providing access to the bands. Temperature-dependent measurements show bandlike transport to 220 K on a SiO(2) gate insulator that is extended to 140 K by reducing the interface trap density using an Al(2)O(3)/SiO(2) gate insulator. The use of compact ligands and doping provides a pathway to high performance, solution-deposited QD electronics and optoelectronics.

6.
Diabetes Obes Metab ; 14(6): 575-7, 2012 Jun.
Article in English | MEDLINE | ID: mdl-22268455

ABSTRACT

High-volume endurance exercise (END) improves glycaemic control in type 2 diabetes (T2D) but many individuals cite 'lack of time' as a barrier to regular participation. High-intensity interval training (HIT) is a time-efficient method to induce physiological adaptations similar to END, but little is known regarding the effect of HIT in T2D. Using continuous glucose monitoring (CGM), we examined the 24-h blood glucose response to one session of HIT consisting of 10 × 60 s cycling efforts at ~90% maximal heart rate, interspersed with 60 s rest. Seven adults with T2D underwent CGM for 24-h on two occasions under standard dietary conditions: following acute HIT and on a non-exercise control day (CTL). HIT reduced hyperglycaemia measured as proportion of time spent above 10 mmol/l (HIT: 4.5 ± 4.4 vs. CTL: 15.2 ± 12.3%, p = 0.04). Postprandial hyperglycaemia, measured as the sum of post-meal areas under the glucose curve, was also lower after HIT vs. CTL (728 ± 331 vs. 1142 ± 556 mmol/l·9 h, p = 0.01). These findings highlight the potential for HIT to improve glycaemic control in T2D.


Subject(s)
Blood Glucose/metabolism , Diabetes Mellitus, Type 2/blood , Exercise Therapy , Exercise , Hyperglycemia/blood , Postprandial Period , Blood Glucose Self-Monitoring , Diabetes Mellitus, Type 2/therapy , Female , Humans , Hyperglycemia/prevention & control , Male , Middle Aged , Prevalence , Time Factors
7.
Eur J Appl Physiol ; 112(5): 1839-48, 2012 May.
Article in English | MEDLINE | ID: mdl-21922261

ABSTRACT

We describe the effects of multi-day relay trail running on muscle soreness and damage, and systemic immune, inflammatory, and oxidative responses. 16 male and 4 female athletes ran 894 km in 47 stages over 95 h, with mean (SD) 6.4 (1.0) stages per athlete and 19.0 (1.7) km per stage. We observed post-pre run increases in serum creatine kinase (qualified effect size extremely large, p = 0.002), IL-6 (extremely large, p < 0.001), urinary 8-isoprostane/creatinine (extremely large, p = 0.04), TNF-α (large, p = 0.002), leukocyte count (very large, p < 0.0001) and neutrophil fraction (very large, p < 0.001); and reductions in hemoglobin (moderate, p < 0.001), hematocrit (moderate, p < 0.001), and lymphocyte fraction (trivial, p < 0.001). An increase in ORAC total antioxidant capacity (TAC, small, p = 0.3) and decrease in urinary 8-OHdG/creatinine (small, p = 0.1) were not statistically significant. During the run, muscle soreness was most frequent in the quadriceps. The threshold for muscle pain (pain-pressure algometry) in the vastus lateralis and gastrocnemius was lower post-run (small, p = 0.04 and 0.03). Average running speed was correlated with algometer pain and leukocyte count (large, r = 0.52), and TAC was correlated with IL-6 (very large, r = 0.76) and 8-isoprostane/creatinine (very large, r = -0.72). Multi-day stage-racing increases inflammation, lipid peroxidation, muscle damage and soreness without oxidative DNA damage. High TAC is associated with reduced exercise-induced lipid peroxidation, but is not related to immune response or muscle damage.


Subject(s)
Antioxidants/metabolism , Exercise/physiology , Inflammation/metabolism , Muscle, Skeletal/metabolism , Oxidative Stress/physiology , Pain/metabolism , Running/physiology , Adult , Creatine Kinase/blood , Dinoprost/analogs & derivatives , Dinoprost/urine , Female , Humans , Interleukin-6/blood , Lipid Peroxidation , Male
8.
Opt Express ; 19(14): 12984-91, 2011 Jul 04.
Article in English | MEDLINE | ID: mdl-21747450

ABSTRACT

In this paper we demonstrate a technique that can create non-equilibrium vortex configurations with almost arbitrary charge and geometry in a Bose-Einstein condensate. We coherently transfer orbital angular momentum from a holographically generated light beam to a 87Rb condensate using a two-photon stimulated Raman process. Using matter wave interferometry, we verify the phase pattern imprinted onto the atomic wave function for a single vortex and a vortex-antivortex pair. In addition to their phase winding, the vortices created with this technique have an associated hyperfine spin texture.


Subject(s)
Holography/methods , Interferometry/methods , Lighting/methods , Light , Scattering, Radiation
9.
Science ; 329(5991): 547-50, 2010 Jul 30.
Article in English | MEDLINE | ID: mdl-20558666

ABSTRACT

Quantum gases in optical lattices offer an opportunity to experimentally realize and explore condensed matter models in a clean, tunable system. We used single atom-single lattice site imaging to investigate the Bose-Hubbard model on a microscopic level. Our technique enables space- and time-resolved characterization of the number statistics across the superfluid-Mott insulator quantum phase transition. Site-resolved probing of fluctuations provides us with a sensitive local thermometer, allows us to identify microscopic heterostructures of low-entropy Mott domains, and enables us to measure local quantum dynamics, revealing surprisingly fast transition time scales. Our results may serve as a benchmark for theoretical studies of quantum dynamics, and may guide the engineering of low-entropy phases in a lattice.

10.
Talanta ; 76(4): 949-55, 2008 Aug 15.
Article in English | MEDLINE | ID: mdl-18656683

ABSTRACT

We present a methodology for fabricating polymer microspheres using inkjet printing of a biodegradable polymer containing either high explosives or high explosive simulant. Poly(DL-lactide/glycolide) 85:15 (PLGA) microsphere production is based on an oil/water emulsion solvent extraction process. The inkjet printing process allows for precise control of the microsphere diameter and the chemical composition. The microspheres can be used as calibrants or verification standards for explosives trace detection instruments. Gas chromatography/mass spectrometry analysis demonstrated that the composition of the microspheres was consistent with predicted concentrations based on the amount of analyte incorporated into the polymer solution and the inkjet operating parameters. We have demonstrated that the microspheres can be fabricated with a mass fraction of 70% of an analyte compound.

11.
Magn Reson Med ; 46(6): 1144-51, 2001 Dec.
Article in English | MEDLINE | ID: mdl-11746581

ABSTRACT

The transport of sodium and potassium between the intra- and extracellular pools and the maintenance of the transmembrane concentration gradients are important to cell function and integrity. The early disruption of the sodium pump in myocardial infarction in response to the exhaustion of energy reserves following ischemia and reperfusion results in increased intracellular (and thus total) sodium levels. In this study a method for noninvasively quantifying myocardial sodium levels directly from sodium (23Na) MRI is presented. It was used to measure total myocardial sodium on a clinical 1.5T system in six normal dogs and five dogs with experimentally-induced myocardial infarction (MI). The technique was validated by comparing total sodium content measured by 23Na MRI with that measured by atomic absorption spectrophotometry (AAS) in biopsied tissue. Total sodium measured by 23Na MRI was significantly elevated in regions of infarction (81.3 +/- 14.3 mmol/kg wet wt, mean +/- SD) compared to noninfarcted myocardial tissue from both infarcted dogs (36.2 +/- 1.1, P < 0.001) and from normal controls (34.4 +/- 2.8, P < 0.0001). Myocardial tissue sodium content as measured by 23Na MRI did not vary regionally in the lateral, anterior, or inferior regions in normal hearts (ANOVA, P = NS). Sodium content measured by 23Na MRI agreed with the mean AAS estimates of 31.3 +/- 5.6 mmol/kg wet wt (P = NS) in normal hearts, and did not differ significantly from AAS measurements in MI (P = NS). Thus, local tissue sodium levels can be accurately quantified noninvasively using 23Na MRI in normal and acutely reperfused MI. The detection of regional myocardial sodium elevations may help differentiate viable from nonviable, infarcted tissue.


Subject(s)
Magnetic Resonance Imaging , Myocardial Infarction/metabolism , Sodium/metabolism , Animals , Dogs , Image Processing, Computer-Assisted , Myocardial Infarction/pathology , Myocardial Reperfusion , Myocardium/metabolism , Phantoms, Imaging , Sodium-Potassium-Exchanging ATPase/metabolism , Spectrophotometry, Atomic
12.
Magn Reson Med ; 46(6): 1164-8, 2001 Dec.
Article in English | MEDLINE | ID: mdl-11746583

ABSTRACT

An intravascular iron-based contrast agent was used as a sodium (23Na) MRI T2 relaxant in an effort to suppress the blood signal from the ventricular cavities in normal and infarcted canine myocardium in vivo. 23Na MRI signal decreases in blood were attributed to decreases in the fast (T2f) and slow (T2s) transverse relaxation components, which were quantified as a function of dose and MRI echo time (TE). In vivo 23Na MRI signal decreases up to 65% were noted in ventricular blood when imaging under dose and TE conditions of 10 mg/kg body weight and 5 ms, respectively. Contrast injection followed by subsequent 23Na MRI in canine myocardial infarction led to a clear delineation of the location of the injured tissue, as identified by postmortem triphenyltetrazolium chloride staining, and to an improvement in the contrast-to-noise ratio between the blood in the ventricular chamber and the infarcted tissue that was as high as 3.3-fold in the postcontrast images in comparison to the precontrast images.


Subject(s)
Contrast Media , Iron , Magnetic Resonance Imaging/methods , Myocardial Infarction/metabolism , Oxides , Animals , Dogs , Ferrosoferric Oxide , Myocardial Infarction/diagnosis , Myocardium/metabolism , Sodium/metabolism
13.
Cogn Affect Behav Neurosci ; 1(2): 161-71, 2001 Jun.
Article in English | MEDLINE | ID: mdl-12467111

ABSTRACT

Working memory for names and faces was investigated to ascertain whether verbal and nonspatial visual information is maintained in working memory by separate neural systems. The subjects performed a delayed match-to-sample task for famous or unfamous faces and names and a sensorimotor control task. Several occipital, temporal, parietal, and prefrontal areas were activated during all memory delays, in comparison with the control delays. Greater delay activity for unfamous faces than for names was obtained in the right fusiform gyrus, right inferior frontal gyrus (IFG), right IFG/precentral gyrus, and right medial superior frontal gyrus, whereas greater delay activity for unfamous names than for faces was observed in the precuneus, left insula/postcentral gyrus, and left IFG/precentral gyrus. There was no significant difference in the prefrontal activity in the comparison between famous faces and names. Greater delay activity for famous names than for faces was obtained in visual association and parietal areas. The results indicate that there is a functional dissociation based on information type within the neural system that is responsible for working memory maintenance of verbal and nonspatial visual information.


Subject(s)
Cerebral Cortex/physiology , Long-Term Potentiation/physiology , Magnetic Resonance Imaging , Mental Recall/physiology , Pattern Recognition, Visual/physiology , Verbal Learning/physiology , Adult , Association Learning/physiology , Face , Female , Humans , Male , Psychomotor Performance/physiology
14.
Radiology ; 216(2): 559-68, 2000 Aug.
Article in English | MEDLINE | ID: mdl-10924586

ABSTRACT

PURPOSE: To use sodium 23 magnetic resonance (MR) imaging to quantify noninvasively total sodium in human muscle and to apply the technique in exercise and musculoskeletal disease. MATERIALS AND METHODS: Total [Na] sodium was determined from the ratio of the relaxation-corrected (23)Na signal intensities measured from short echo-time (0.4 msec) (23)Na images to those from an external saline solution reference. The method was validated with the blinded use of saline solutions of varying sodium concentrations. [Na] was measured in the calf muscles in 10 healthy volunteers. (23)Na MR imaging also was performed in two healthy subjects after exercise, two patients with myotonic dystrophy, and two patients with osteoarthritis. RESULTS: (23)Na MR imaging yielded a total [Na] value of 28.4 mmol/kg of wet weight +/- 3.6 (SD) in normal muscle, consistent with prior biopsy data. Spatial resolution was 0.22 mL, with signal-to-noise ratio of 10-15. Mean signal intensity elevations were 16% and 22% after exercise and 47% and 70% in dystrophic muscles compared with those at normal resting levels. In osteoarthritis, mean signal intensity reductions were 36% and 15% compared with those in unaffected knee joints. CONCLUSION: (23)Na MR imaging can be used to quantify total [Na] in human muscle. The technique may facilitate understanding of the role of the sodium-potassium pump and perfusion in normal and diseased muscle.


Subject(s)
Magnetic Resonance Imaging/methods , Muscle, Skeletal/metabolism , Muscular Diseases/diagnosis , Physical Exertion/physiology , Sodium/analysis , Adult , Algorithms , Analysis of Variance , Biopsy , Bone Diseases/diagnosis , Bone Diseases/metabolism , Electron Spin Resonance Spectroscopy , Fourier Analysis , Humans , Least-Squares Analysis , Male , Muscle Contraction/physiology , Muscle, Skeletal/anatomy & histology , Muscular Diseases/metabolism , Myotonic Dystrophy/diagnosis , Myotonic Dystrophy/metabolism , Osteoarthritis, Knee/diagnosis , Osteoarthritis, Knee/metabolism , Phantoms, Imaging , Reproducibility of Results , Signal Processing, Computer-Assisted , Single-Blind Method , Sodium Chloride
15.
J Cereb Blood Flow Metab ; 19(12): 1289-95, 1999 Dec.
Article in English | MEDLINE | ID: mdl-10598932

ABSTRACT

The oxygen extraction ratio (OER) of a tissue describes the interplay between oxygen delivery and consumption and, as such, directly reflects the viability and activity of any organ. It is shown that OER can be quantified using a single magnetic resonance imaging observable, namely the relaxation time T2 of venous blood draining from the tissue. This principle is applied to study local OER changes in the brain on visual stimulation in humans, unambiguously demonstrating a mismatch between changes in blood flow and oxygen metabolism on activation.


Subject(s)
Brain/physiology , Cerebrovascular Circulation , Magnetic Resonance Imaging/methods , Oxygen Consumption , Oxygen/blood , Brain/blood supply , Hematocrit , Humans , Photic Stimulation
16.
Magn Reson Med ; 42(4): 617-26, 1999 Oct.
Article in English | MEDLINE | ID: mdl-10502748

ABSTRACT

The spin-echo response to visual activation was studied as a function of spatial resolution at a field of 1.5 T. The results showed that the increase in absolute T(2) upon activation was as large as 22.8 +/- 3.1% (P < 0.05) at the highest resolution (5.3 mm(3)), while it was as small as 3.5 +/- 0.2% (P < 0.05) at the lowest resolution (42.2 mm(3)). In addition, upon increasing resolution, the spin-echo signal decay as a function of echo time changed from monoexponential to nonexponential. These data indicate that, when using the standard resolution for fMRI studies at 1.5 T, the effects of spin-echo changes in the draining veins are of major contribution to the total blood oxygenation level-dependent (BOLD) signal changes measured in voxels encompassing the activated brain areas. The data can be quantitatively accounted for using a model based on the intravascular origin of the spin-echo effect including both macrovascular and microvascular effects. Existing theories for the spin-echo BOLD effect based on diffusion through field gradients predict negligible spin-echo effects inside the large vessels and are therefore incompatible with the data. Magn Reson Med 42:617-626, 1999.


Subject(s)
Evoked Potentials, Visual/physiology , Magnetic Resonance Imaging/methods , Visual Cortex/blood supply , Brain/physiology , Cerebral Veins/anatomy & histology , Cerebral Veins/physiology , Humans , Microcirculation/physiology , Oxygen/blood , Visual Cortex/physiology
17.
Plast Reconstr Surg ; 103(6): 1608-23, 1999 May.
Article in English | MEDLINE | ID: mdl-10323693

ABSTRACT

Anthropometry and clinical examination best evaluate the morphology of repaired cleft lip and nose. An original, accurate, and practical image analysis of the lip and nose, which takes advantage of the mathematic, geometric, and organizational capabilities of public domain NIH-Image software (http://rsb.info.nih.gov/nih-image/), has been developed and tested over the past 6 years. A modified structured physical examination form that complements this analysis is under study. Accuracy of NIH-Image-based anthropometry was compared with direct measurements of 22 linear distances on the lip and nose. Twenty-five sets of direct measurements were taken, prospectively, on 15 children with repaired cleft lip over a 6-year period. The results were submitted to regression analysis. Then, relevant lip and nasal tip aesthetics were evaluated by the measuring capabilities of NIH-Image to create a quantitative assessment tool. For each episode, 15 possible faults were weighted, according to aesthetics and deformity, to provide an adverse score. The sum of the 5 lip scores, 10 nose scores, and combination gave respective grades. The analysis was modified to stratify congenital deformity to relate severity of disease to outcome. This analysis was applied to digitized images of 19 consecutive children, immediately prior to repair of complete unilateral cleft lip and nose, at the time of palate repair, and annually from the age of 3 to 6 years. There were 19 NIH-Image-based measurements of the congenital deformity and 35 measurements of surgical results; four children had three sets of records, eight had two sets, and seven had one set Descriptive statistics were applied. Following 556 paired direct and computer-assisted measurements, exceptional linear correlation was shown with a Pearson R coefficient of 0.96. The best correlation was lines within the plane of the camera lens, with the average difference ranging between 0.025 and 0.997 mm. Visual inspection of frontal and submental photographs of excellent, good, and poor results substantiates the ability of this analysis to quantify and grade a spectrum of relevant cleft lip and nasal anatomy. For these 19 patients, there was a broad range of performance scores, approximating a normal distribution. The mean of the NIH-Image-based analysis scores, 16.91, was a (very) good grade. A single standard deviation of 6.88 extended up into excellent and down to fair. The congenital analysis indicated a range of deformity. Comparing deformity with outcome, simple regression analysis had a coefficient of determination (R2) of 0.223, indicative of a weak positive relationship. An accurate and practical morphologic computer-assisted outcome assessment of repaired cleft lip and nasal deformity has been developed. There is a weak direct correlation between severity of deformity and outcome. Testing in multiple clinics is warranted.


Subject(s)
Anthropometry , Cleft Lip/surgery , Diagnosis, Computer-Assisted , Child , Humans , Postoperative Care , Treatment Outcome
18.
Acad Emerg Med ; 5(12): 1150-6, 1998 Dec.
Article in English | MEDLINE | ID: mdl-9864127

ABSTRACT

OBJECTIVE: To evaluate two solutions, lactated Ringer's (LR) and a balanced salt solution (BSS Plus, Alcon Laboratories, Ft. Worth, TX), compared with normal saline solution (NSS), for ocular irrigation in healthy adult volunteers with and without the Morgan therapeutic lens (MTL). METHODS: This was a prospective, double-blind, randomized study of healthy volunteers who were at least 18 years of age. Exclusion criteria included the use of analgesics within four hours of the study. A complete ophthalmologic examination was performed at baseline and at the completion of the study. Following randomization and prior to any intervention, baseline discomfort scores were obtained by means of a verbally administered, horizontal, 100-mm, unnumbered analog discomfort scale. Both eyes of each volunteer were irrigated simultaneously for 15 minutes, with additional discomfort scores being recorded every 5 minutes using the same 100-mm, unnumbered analog discomfort scale. A global evaluation to assess the method of irrigation and the solutions used for irrigation was completed by both the physician blinded to the treatment groups and the volunteers. The volunteers were continuously monitored for any adverse effects resulting from the irrigation solutions or MTL. RESULTS: Sixty-three volunteers were recruited into the study, with 61 entered in the final analysis. Age and gender were balanced within each group. There was no significant difference in discomfort scores between the two groups; however, all discomfort scores decreased over time (p = 0.008). A lens-solution interaction was identified, with LR being the most tolerated when administered with the MTL. A statistically higher ocular pH difference was seen between the pre- and postirrigation readings for the control eye in volunteers irrigated with MTL (p = 0.046). Analysis of the global evaluations for each group revealed no difference in the distributions of physician and volunteer scores. No adverse event was reported in either group. CONCLUSION: There does not appear to be any difference in discomfort scores between the ocular irrigation fluids when used without the MTL. Overall, the use of the MTL appears well tolerated by healthy, adult volunteers. However, there does appear to be a significant lens-solution effect on volunteers' discomfort scores, with LR having significantly lower discomfort scores when used for ocular irrigation with the MTL. The authors conclude that the use of the MTL for ocular irrigation is well tolerated and recommend using LR as the irrigation solution for maximal patient comfort.


Subject(s)
Acetates , Eye , Isotonic Solutions , Minerals , Saline Solution, Hypertonic , Sodium Chloride , Therapeutic Irrigation , Adult , Double-Blind Method , Drug Combinations , Female , Humans , Male , Prospective Studies , Ringer's Lactate
19.
Laryngoscope ; 108(9): 1346-50, 1998 Sep.
Article in English | MEDLINE | ID: mdl-9738754

ABSTRACT

HYPOTHESIS: Vocal fold immobility is a sign of underlying disease. When the etiology remains unclear, evaluation may become time consuming and costly, and directed work-up imperative. This study examined the hypothesis that the etiologies of vocal fold immobility are changing, with extralaryngeal malignancies and nonthyroidectomy surgical trauma having become more common causes. METHODS: A retrospective review of consecutive patients with vocal fold immobility who had an adequate workup to determine the etiology. RESULTS: Three hundred ninety-seven cases with a determined etiology were identified, yielding 280 unilateral and 117 bilateral immobilities. The largest single category in unilateral immobility was nonlaryngeal malignancy--69 patients (24.7%)--80% of which were pulmonary or mediastinal, followed by 67 patients (23.9%) with immobility secondary to surgical trauma. Thyroidectomy accounted for only 8.2%. The leading cause of bilateral immobility was surgical trauma-30 patients (25.7%)--21 (18%) of whom had thyroidectomy. Acute and chronic intubation injuries accounted for 21 unilateral (7.5%) and 18 bilateral (15.4%) cases. CONCLUSIONS: These data indicate a changing etiology of vocal fold immobility, with growing percentages of extralaryngeal malignancies and surgery-related injuries. These findings have implications for the timing and method of management based on anticipated outcome.


Subject(s)
Vocal Cord Paralysis/etiology , Adolescent , Adult , Aged , Aged, 80 and over , Electromyography/methods , Female , Follow-Up Studies , Humans , Male , Middle Aged , Retrospective Studies , Terminology as Topic , Vocal Cord Paralysis/diagnosis
20.
Am J Emerg Med ; 16(4): 406-8, 1998 Jul.
Article in English | MEDLINE | ID: mdl-9672465

ABSTRACT

This report describes the case of a 67-year-old male victim of an auto-pedestrian accident who was alert and neurologically intact on initial presentation. The patient denied head or neck pain and was without evidence of craniocervical injury. A lateral c-spine radiograph did not show any abnormal findings. The patient deteriorated during his trauma evaluation and was refractory to resuscitation. At autopsy, he was found to have an atlanto-occipital dislocation (AOD). The case is discussed and the anatomic, clinical, and radiographic features of atlanto-occipital dislocation are reviewed.


Subject(s)
Atlanto-Occipital Joint/injuries , Joint Dislocations/diagnostic imaging , Accidents, Traffic , Aged , Emergency Treatment , Fatal Outcome , Femoral Fractures/etiology , Humans , Humeral Fractures/etiology , Joint Dislocations/classification , Joint Dislocations/etiology , Male , Multiple Trauma/etiology , Radiography , Tibial Fractures/etiology
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