A semiautomated electron backscatter diffraction technique for extracting reliable twin statistics

A framework has been developed for extracting reliable twin statistics from a deformed microstructure using crystallographic twin identification techniques with spatially correlated electron backscatter diffraction (EBSD) data. The key features of this analysis are the use of the mathematical definition of twin relationships, the inclination of the common K ₁ plane at a twin boundary, and the correct identification of the parent orientation in a parent/twin pair. Methods for identifying the parent in a parent/twin pair will be briefly discussed and compared. Twin area fractions are then categorized by operative twin systems, number of active twin variants in each system, and corrected twin widths. These statistics are reported here for α-zirconium samples deformed in quasi-static four-point bend beams and in a 100 m/s Taylor cylinder impact test. Analysis of the statistics also begins to reveal the roles that deformation rate and relative orientation of the boundary conditions to the material’s symmetry axes play in determining the twinning activity that accommodates the imposed boundary conditions. These improved twin statistics can help quantify the deformation processes in materials that deform by twinning as well as serve to provide better validation of proposed models of the deformation processes.     

Sub-Tenon's anaesthesia: an efficient and safe technique

AIM: To evaluate sub-Tenon's anaesthesia as an alternative to peribulbar anaesthesia. METHODS: 109 consecutive patients listed for various eye operations (including cataract, trabeculectomy, and vitrectomy) under peribulbar anaesthesia were operated on under sub-Tenon's anaesthesia instead. After topical anaesthesia a buttonhole was fashioned through the conjunctiva and Tenon's capsule 10 mm posterior to the limbus. 1.5 ml of lignocaine 2% was then delivered to the posterior sub-Tenon's space using a blunt cannula. The surgical procedure was performed immediately after the completion of the anaesthetic procedure. Chemosis, conjunctival haemorrhage, degree of akinesia, and pain scoring were analysed. RESULTS: There were no anaesthesia related complications. The administration of the block was painless for 99.1% of the patients. In all, 97.3% reported no pain during surgery. There was no akinesia when assessed just after the completion of the block and akinesia was limited when assessed after surgery. Chemosis and conjunctival haemorrhage were frequent but caused no intraoperative problems. CONCLUSION: Sub-Tenon's anaesthesia is an efficient and safe anaesthetic technique. It is a good alternative to peribulbar anaesthesia.     

A simple and safe technique for closure of trocar wounds using a new instrument

An easy and safe method for closing trocar wounds with a new hook-type instrument is presented. The procedure is performed quickly without the need for pneumoperitoneum or a video camera and is done under direct vision.     

A reliable sociometric measure for preschool children.

Examined the reliability of a rating-scale sociometric technique with 19 4-yr-old children. The test–retest reliability of scores Ss received over a 4-wk interval was high compared to the stability of the traditional positive and negative nomination scores. This preschool sociometric measure has applications for the study of the behavioral correlates of early peer acceptance and for research on the effects of social skill training on children's acceptance by peers. (10 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Idiopathic coccygodynia. Lateral roentgenograms in the sitting position and coccygeal discography

STUDY DESIGN: The authors hypothesized that the source of coccygodynia was a lesion of the coccygeal disc. OBJECTIVES: This study analyzed the motion of the painful coccyx in the sitting position as compared with the lateral decubitus in a patient and a control group and reported the first results of coccygeal discography (dynamic study). SUMMARY OF BACKGROUND DATA: Coccygodynia are usually attributed to soft tissue injuries or psychologic disturbances. No previous study has assessed the coccygeal discs as a source of pain. METHODS: Fifty-one patients with coccygodynia and 51 controls sustained a dynamic study. Coccygeal mobility was documented by superimposing graph paper with a double reading. The accuracy of the measurement was +/- 2.6 degrees intra- and interobserver variations 15.3 and 12.5%. This dynamic study was followed by coccygeal discography in the patient group. RESULTS: An abnormal motion (luxation or hypermobility) of the coccyx that occurred in the sitting position and spontaneously was reducible when placed in the lateral decubitus position was found in 25 patients. Such lesions could be responsible for the pain because no similar findings were seen in the controls and coccygeal discography was positive in these cases. Of the 26 patients with a normal dynamic study, coccygeal discography, using a combination of provocation and anesthetization, was positive in 15 of 21. CONCLUSIONS: Common coccygeal pain could come from the coccygeal disc in approximately 70% of cases.     

MIBI-scintigraphy. A simple and reliable method for localization of pathological parathyroid glands

99Tcm-sestamibi scintigraphy was used to localise enlarged parathyroid glands in 25 patients with primary hyperparathyroidism previously operated in the neck, 20 of whom had recurrent disease and five had previously undergone surgery for thyroid disorders. Of the 18 patients for whom positive scans were obtained, nine were operated on the scan findings being confirmed. Crucial information was provided in two cases of intrathyroidal and one case of intramediastinal localisation of the pathological gland were not operated on as the hypercalcaemia was only marginal or the symptoms were vague. Though preoperative localisation of pathological parathyroid glands is a prerequisite for neck exploration in patients with persistent or recurrent hypercalcaemia due to primary (or secondary) hyperparathyroidism, the procedure is not cost-effective before the initial operation.     

A reappraisal of the bladder cumulative method as a reliable technique for the measurement of glomerular filtration rate

Neurooncology requires the integration of the clinical history, physical examination, neuroimaging studies, neuropathology, surgery, radiation therapy, and chemotherapy in order to properly diagnose and treat patients with suspected brain tumors. The review herein serves to illustrate and emphasize the pitfalls that can potentially occur during each step of the process of managing patients with malignant gliomas. Familiarity with these pitfalls will enhance the neurologist's ability to successfully manage patients with neurooncological disease.     

A safe high-yield technique for cutting needle biopsy of the lung in patients with diffuse lung disease

The approach to the diagnosis and management of patients with diffuse infiltrative lung disease (DILD) is controversial. The results of transbronchial biopsy are often unsatisfactory. The role of open lung biopsy is highly variable. Percutaneous cutting needle biopsy (CNB) is not recommended because of its reported high morbidity/mortality relative to its low diagnostic yield. We report a technique for CNB with a high diagnostic yield and a low morbidity and no mortality in 228 patients with DILD over the past 23 years. METHODS: The salient features of the technique for CNB are as follows: the anesthetic needle does not enter the pleural space; a Franklin Silverman needle is inserted into the intercostal space posteriorly at outer one-third of chest wall; the biopsy is performed with the breath held at normal end expiration; the plane of pleural space is broken with sudden insertion of needle 8 to 15 cm into lung; and the pathway of the needle is maintained parallel to the lateral chest wall. RESULTS: A diagnosis was established in 129 of 145 biopsies (89%) performed by a trained operator (A.H.N.). There were 36 pneumothoraces (25%), four minimal hemoptyses (3%), and two chest tube placements (1%). There were no deaths (0%). CONCLUSION: With meticulous attention to technique and careful selection of patients, the procedure offers a relatively safe alternative to open lung or thoracoscopic lung biopsy in patients with DILD.     

Touch cytology. A reliable and cost-effective method for diagnosis of Helicobacter pylori infection

A variety of reliable methods are available for detecting Helicobacter pylori (Hp) during upper gastrointestinal endoscopy. We evaluated the clinical utility and cost-effectiveness of rapid urease test (RUT), touch cytology (TC), and histology (H). Two hundred thirty-eight consecutive patients (178 without previous medical treatment and 60 formerly treated with anti-Hp therapy) were tested for Hp infection by RUT, TC, and H (H&E stain). The infection status for each patient was established by a concordance of two test results. The time to carry out the three tests and their cost were also calculated. Sensitivity of TC (100%) was significantly higher than that of RUT (86.8%; P < 0.001), but not than that of H (94.9%). RUT was significantly more specific than H (100% vs 95.6%; P < 0.05), but not than TC (96.4%). Hp infection was more frequent in the patients with chronic active gastritis than in those with chronic nonactive gastritis (P < 0.001). No Hp infection was detected in absence of chronic antral inflammation. RUT resulted the cheapest method and H the most expensive; TC is faster and cheaper than H. When additional information about the severity of mucosal damage or the presence of cell atypias is not necessary, histologic examination can be omitted, and a cost-effective strategy for assessing Hp status might consist in taking two antral biopsies, the former for performing RUT and the latter for preparing a slide by TC, which should be stained and examined only when the RUT result is negative.     

Putting time in perspective: A valid, reliable individual-differences metric.

Time perspective (TP), a fundamental dimension in the construction of psychological time, emerges from cognitive processes partitioning human experience into past, present, and future temporal frames. The authors' research program proposes that TP is a pervasive and powerful yet largely unrecognized influence on much human behavior. Although TP variations are learned and modified by a variety of personal, social, and institutional influences, TP also functions as an individual-differences variable. Reported is a new measure assessing personal variations in TP profiles and specific TP "biases." The 5 factors of the Zimbardo Time Perspective Inventory were established through exploratory and confirmatory factor analyses and demonstrate acceptable internal and test-retest reliability. Convergent, divergent, discriminant, and predictive validity are shown by correlational and experimental research supplemented by case studies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cytologic examination of the breast: a safe, simple, and accurate technique

Aspiration cytology of the breast is a rapid, accurate diagnostic technique which can be easily and safely performed in the physician's office in conjunction with clinical examination of the breast. When evaluated by an experienced pathologist, cytologic preparations are useful in assessing solid masses in the breast or abnormal secretions of the nipple. The procedure has few complications, and spread of tumor cells along the needle track is not likely.     

The Personal Functioning Inventory: A reliable and valid measure of adaptiveness in coping.

This article reports the development and validation of the Personal Functioning Inventory (PFI), a new measure of adaptiveness in coping. In Study 1, two adult samples (Ns of 105 and 101) showed the PFI to be highly reliable and to correlate substantially with a summed rating scale for adaptiveness. Study 2 with 140 undergraduates again showed the PH to be highly reliable and to relate positively to problem-solving confidence and negatively to perceived stress. Study 3, a two-wave longitudinal study with a three-week intersession interval, involved 149 undergraduates at Time 1 and retained 107 at Time 2. It demonstrated strong reliability and stability for the PFI, concurrent and predictive positive relations with selfrated adaptiveness and prolonged state anxiety, and discriminant validity against abstract curiosity. Factor analyses consistently supported a one-factor structure for the PFI. Possible applications for the scale are noted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A simple procedure for easy and safe deflasking

OBJECTIVE: African-Americans have an increased prevalence of both diabetes and diabetes complications, creating an imperative for improved metabolic control. Because American Diabetes Association guidelines recommend that action be taken when HbA1c is > 8.0%, but access to rapid-turnaround HbA1c assays remains limited, we tested the utility of fasting and random plasma glucose cutoffs as indicators of HbA1c > 8.0%. RESEARCH DESIGN AND METHODS: Using receiver operating characteristics (ROC) analysis, we evaluated the sensitivity, specificity, and predictive value of fasting and random plasma glucose measurements in identifying an HbA1c > 8.0% (fasting n = 974, random n = 552). The population studied was predominantly African-American, middle-aged, and non-insulin-dependent. RESULTS: Fasting plasma glucose was a significant indicator of HbA1c > 8.0%, both in the whole group and in subgroups for diet, sulfonylureas, and insulin; the corresponding areas under the ROC curve were 0.87, 0.90, 0.87, and 0.84, respectively (all P < 0.0001). A fasting plasma glucose cutoff of > 9.2 mmol/l (165 mg/dl) provided a sensitivity of 80% and a specificity of 83% for the whole group and a 77% positive predictive value. Random plasma glucose was also a good indicator of HbA1c > 8.0%, both in the whole group and in subgroups for diet, sulfonylureas, and insulin; the corresponding areas under the ROC curve were 0.85, 0.91, 0.85, and 0.77, respectively (all P < 0.0001). A cutoff > 9.8 mmol/l (177 mg/dl) provided a sensitivity of 78% and a specificity of 77% for the whole group and a 78% positive predictive value. Overall, a plasma glucose > 11.1 mmol/l (200 mg/dl) identified an HbA1c > 8.0% with a predictive value of approximately 90% if done while fasting and a predictive value of approximately 80-85% if random. The utility of both fasting and random plasma glucose cutoffs was subsequently confirmed in a prospective study of another 2,309 and 1,396 patients, respectively. CONCLUSIONS: Although glucose levels cannot replace HbA1c determinations, measurement of fasting or random plasma glucose may be used during a clinic visit to identify poorly controlled type 2 patients with reasonable certainty and allow timely patient education and therapeutic intervention.     

Head-upright tilt table testing. A safe and easy way to assess neurocardiogenic syncope

Head-upright tilt table testing has emerged as an exciting technique for evaluating episodes of autonomically mediated syncope. It may be performed using gravity alone as the provocative stimulus or with the addition of isoproterenol. The classic neurocardiogenic response to the test is a sudden drop in blood pressure followed by a decrease in heart rate, but other abnormal response patterns have also been reported. Continuing investigations will improve understanding of autonomic disturbances that cause orthostatic intolerance and will help elaborate the role of tilt table testing in their evaluation and management.     

Myocardial contrast echocardiography: reliable, safe, and efficacious myocardial perfusion assessment after intravenous injections of a new echocardiographic contrast agent

Reliable and reproducible myocardial opacification after intravenous administration of echocardiographic contrast agents has remained elusive. This study was performed to determine whether a new agent, FS069, a suspension of perfluoropropane-filled albumin microspheres (3.6 microns average microbubble size, concentration 8 x 8(8)/ml), could achieve safe and successful myocardial opacification in open-chest dogs. Seventeen dogs (group 1, n = 7, group 2, n = 10) underwent two-dimensional echocardiography before, during, and after the administration of intravenous FS069. Safety was evaluated by measuring arterial and pulmonary artery pressures, heart rate, blood gases, systolic function, myocardial blood flow, and postmortem analysis of myocardial viability by triphenyl-tetrazolium chloride staining. Efficacy to detect changes in regional myocardial perfusion was assessed by injecting FS069 at baseline, after sequential coronary occlusions and reperfusion, and during intravenous vasodilators with and without coronary occlusions. Results were compared with radiolabeled microspheres. FS069 was found to be safe and effective. In the absence of coronary occlusions, uniform myocardial opacification was observed in all dogs. A perfusion defect was observed in all dogs during coronary occlusions. Background-subtracted peak contrast intensity in the myocardium correctly identified regional myocardial blood flow changes and showed a significant correlation with radiolabeled microspheres (r = 0.65, p = 0.0001).