The impact of transcutaneous electrical stimulation therapy on appendicostomy operation rates for children with chronic constipation--a single-institution experience.

PURPOSE: Appendicostomy for antegrade continence enema is a minimally invasive surgical intervention that has helped many children with chronic constipation. At our institution, since 2006, transcutaneous electrical stimulation (TES) has been trialed to treat slow-transit constipation (STC) in children. This retrospective audit aimed to determine if TES use affected appendicostomy-formation rates and to monitor changes in practice. We hypothesized that appendicostomy rates have decreased for STC but not for other indications. METHODS: Appendicostomy-formation rate was determined for the 5 years before and after 2006. Children were identified as STC or non-STC from nuclear transit scintigraphy and patient records. RESULTS: Since 1999, 317 children were diagnosed with STC using nuclear transit scintigraphy with 121 during 2001 to 2005 (24.2/year) and 147 during 2006 to 2010 (29.4/year). Seventy-four children had appendicostomy formation. For 2001 to 2005, appendicostomy-formation rates for STC and non-STC children were similar: 5.4 per year (n = 27) and 4.8 per year (n = 24), respectively. For 2006 to 2010, appendicostomy-formation rates were 1.2 per year (n = 6) for STC and 3.2 per year (n = 16) for non-STC (χ(2), P = .04). CONCLUSION: Since 2006, appendicostomy-formation rates have significantly reduced in STC but not in non-STC children at our institute, coinciding with the introduction of TES as an alternative treatment for STC. Transcutaneous electrical stimulation has not been tested on non-STC children in this period.

A prospective study to compare the diagnostic performance of breast elastography versus conventional breast ultrasound.

AIM: To compare the diagnostic performance of breast elastography versus conventional ultrasound in the assessment of breast lesions. MATERIALS AND METHODS: The study was approved by the hospital's institutional review board. A prospective study involving 99 consecutive women who gave informed consent were enrolled from September 2007 to March 2008. One hundred and ten breast lesions were evaluated separately by conventional ultrasound, elastography and combined conventional ultrasound with elastography. Ultrasound assessment was based on the BIRADS classification, whereas elastographic assessment was based on strain pattern and the elastographic size ratios. Histological diagnosis was used as the reference standard. The sensitivity, specificity, and accuracy of each technique were compared. RESULTS: The mean age of the patients was 46.7 years. Twenty-six lesions were malignant and 84 were benign. Sensitivity, specificity, and accuracy were 88.5, 42.9 and 53.6%, respectively, for conventional ultrasound, 100, 73.8, and 80%, respectively, for elastography, and 88.5, 78.6, and 80.9%, respectively, for combined imaging. The specificity and accuracy of elastography and combined imaging were significantly better than that of conventional ultrasound (p<0.0001), whereas there was no statistically significant difference in the sensitivity between all three groups. Two-thirds (66.7%) of sonographic false-positive lesions had benign elastogram findings, which might have been spared from biopsy. CONCLUSION: This initial experience with ultrasound breast elastography showed that it was more specific and more accurate than conventional ultrasound. Combining elastography with ultrasound improved specificity and accuracy of ultrasound and can potentially reduce unnecessary breast biopsies.

Real time mass flow rate measurement using multiple fan beam optical tomography.

This paper presents the implementing multiple fan beam projection technique using optical fibre sensors for a tomography system. From the dynamic experiment of solid/gas flow using plastic beads in a gravity flow rig, the designed optical fibre sensors are reliable in measuring the mass flow rate below 40% of flow. Another important matter that has been discussed is the image processing rate or IPR. Generally, the applied image reconstruction algorithms, the construction of the sensor and also the designed software are considered to be reliable and suitable to perform real-time image reconstruction and mass flow rate measurements.

The use of the external fixator in the treatment of intra-articular fractures of the distal radius.

BACKGROUND: A study to assess the use of the external fixator in the treatment of intra-articular fractures of the distal radius was initiated in late 1994. METHOD: Thirty patients with these fractures have been treated at our hospital between 1991 and 1994 with the use of either the AO or the Pennig external fixator. The patients were assessed at least one year post-operatively (mean 90.2 weeks) after a course of physiotherapy. RESULTS: The majority of patients (65%) had either good or excellent results, based on objective and subjective criteria. The common complications included early finger stiffness, pintract infections and loss of reduction.

Gamma radiation induces CD69 expression on lymphocytes.

Gamma radiation activates protooncogenes that are involved in early signal transduction, e.g., Raf-1. Most studies of effects of gamma radiation on lymphocytes deal with regulation of gene expression. However, early surface receptor expression in response to radiation has not been reported. We studied the effect of radiation on lymphocyte CD69 expression and BrdU uptake in the absence or presence of phytohemagglutinin (PHA). Radiation induces CD69 expression on T and B cells in a dose- and time-dependent manner. Four hours after a dose of 906 cGy, approximately 90% of B and 12% of T cells express CD69. CD69 expression diminishes after 6 h and requires de novo protein synthesis and protein phosphorylation. Radiation alone does not stimulate cell proliferation, as measured by BrdU incorporation, at any radiation dose tested. Furthermore, radiation enhances PHA induced CD69 expression at 2 h, but inhibits BrdU incorporation at day 3 in a dose-dependent fashion. CD69 functions as a marker for response to radiation, but unlike antigen or mitogen, radiation-induced CD69 expression does not lead to proliferation.

The impact of five-month basic military training on the body weight and body fat of 197 moderately to severely obese Singaporean males aged 17 to 19 years.

The impact of five-month basic military training on body weight and fat mass was studied in 197 male obese recruits, aged 17 to 19 years old. The training programme of five days per week lasted for 20 weeks. Of these sessions, 57% could be considered to be physically intense for the obese subjects. No dietary restriction was imposed. The cohort was divided into three categories based on their percentage body fat, i.e. %BF 24 to < 30, %BF 30 to < 35 and %BF > or = 35. The overall mean weight loss was 12.5 kg or 0.63 kg per week. Mean weight losses for each category were 10.7 kg, 13.1 kg and 16.1 kg, respectively. Most of this weight was lost in the 2nd month of training. The weight loss is attributed to a decrease of body fat as determined by skinfold measurements. Attrition rate, due to training injuries resulting in temporary disabilities, was negligible at 6.1%. In conclusion, this study shows that intense physical activity over a duration of 20 weeks is effective in reducing the body fat of our obese subjects and in training obese subjects for combat duties.