Access to a three-dimensional measure of vertebral axial rotation

BACKGROUND: A combined diphtheria-tetanus-whole cell pertussis-hepatitis B (DTPwHB) vaccine might facilitate the achievement of universal vaccination of infants against hepatitis B. METHODS: A double blind, randomized, two-armed, single center study was undertaken to evaluate the immunogenicity and reactogenicity of combined tetravalent DTPwHB vaccine, with two dosages of hepatitis B component (10 microg and 5 microg). The combined vaccine was tested in the context of a simplified vaccination schedule at 1.5, 3.5 and 6 months of age, to 120 healthy infants born to hepatitis B surface antigen-negative mothers after priming with one dose of hepatitis B vaccine (10 microg) at birth. Antibodies to each antigenic component were measured from blood samples collected immediately after birth, pre- and postvaccination blood samples. RESULTS: The reactogenicity profiles were similar in the two groups. No serious adverse events were reported. One month after completion of the four-dose vaccination schedule, all subjects except one in Group 1 (10 microg) had protective titers of anti-HBs (10 mIU/ml). At this time the geometric mean titer in Group 1 (10 microg) was higher than that observed in Group 2 (5 microg), 696 vs. 488 mIU/ml (P = 0.19). One month after three doses all subjects in both groups had protective antidiphtheria titers and antitetanus titers. The vaccine response rate to the Bordetella pertussis component of the vaccine was 88.0% in Group 1 and 96.2% in Group 2 (P = 0.86). CONCLUSION: Both combined tetravalent vaccines are safe and immunogenic when administered to infants born to a hepatitis B surface antigen-negative mother, with a 10-microg dose of priming hepatitis B vaccine at birth. This combined tetravalent DTPwHB vaccine may play an important role to promote integration of HB vaccine into the Expanded Program of Immunization in hepatitis B-endemic areas.     

Dacryocystantrostomy. A preliminary report

A new operative technique is described in which the lacrimal sac is drained into the maxillary sinus. The advantages of the procedure, especially of avoiding a facial incision, are emphasized. Five patients suffering from long-standing epiphora underwent surgery. Two patients had chronic dacryocystitis. Two other patients presented with a mucocele of the lacrimal sac. In the fifth patient, there was obstruction in the nasolacrimal duct. Short term follow-up results suggest its usefulness as a first line of surgical treatment in cases of epiphora due to obstruction in the lacrimal sac or the naso-lacrimal duct.     

Resection of a vertebral hemangioma after preoperative embolization. Case report

Preoperative arterial embolization of a vertebral hemangioma allowed surgical excision of the vertebral body, restoration of normal anatomic continuity of the spinal canal, and improvement in myelopathy.     

Eighteen-level analysis of vertebral rotation following Harrington-Luque instrumentation in idiopathic scoliosis

Accelerated atherosclerosis is the leading cause of death in patients with non-insulin-dependent diabetes mellitus (NIDDM). Impaired endogenous fibrinolytic activity may accelerate atherosclerosis by exposing vascular luminal wall surfaces to persistent and recurrent thrombi and clot-associated mitogens. This study was conducted to further characterize endogenous fibrinolysis in lean and obese nondiabetic subjects and in NIDDM patients and to identify mechanisms responsible for the alterations identified. Obese and diabetic subjects had threefold elevations of plasma concentrations of plasminogen activator inhibitor type 1 (PAI-1) compared with values in lean control subjects. Despite the lack of significant differences in plasma concentrations of tissue-type plasminogen activator in the obese and diabetic subjects, both basal and stimulated endogenous fibrinolytic activities were decreased. The decreases were associated with increased activity of PAI-1 in plasma, in turn correlated with increased concentrations of immunoreactive insulin and C-peptide. These results are consistent with our previous observations demonstrating direct stimulatory effects of insulin and its precursors on cellular expression of PAI-1 in vitro and observations by others demonstrating decreased basal fibrinolytic activity in NIDDM patients. Impaired endogenous fibrinolytic activity could lead to prolonged or recurrent exposure of luminal surfaces of vessel walls to microthrombi and clot-associated mitogens that may accelerate atherosclerosis in hyperinsulinemic subjects.     

Construction of a pseudolarynx after laryngectomy and radical neck dissection. A preliminary report

Oxytocin analogues which combine high oxytocic activities with negligible antidiuretic and pressor activities have been studied. [4-Threonine,7-glycine]oxytocin, [1-(L-2-hydroxy-3-mercaptopropionic acid),4-threonine,7-glycine]oxytocin, and [1-(L-2-hydroxy-3-mercaptopropionic acid)]oxytocin were found to possess the following specific biological activities respectively: rat uterotonic, 270 +/- 10, 337 +/- 23, 1542 +/- 0.4; rat antidiuretic, 0.002 +/- 0.0008, 0.048 +/- 0.005, 40.3 +/- 2.4. The results are analyzed from a conformation-activity viewpoint in a continued attempt to evaluate the scope and limitations of this approach in comparison to structure-activity studies.     

Radioisotope choroid plexography. A preliminary report

Radioisotope plexography seems as easy and innocuous as routine brain scanning. An introductory method is given which could be improved. The choroid plexuses of the four ventricles were well visualized in 15 patients. Consideration is given to the possible labeling process. Besides its morphological value, the test could give interesting clues in the dynamic study of hydrocephalus.     

Mental rotation of representations of two-dimensional and three-dimensional objects.

Empirical and theoretical considerations suggest that representations of three-dimensional objects should be more difficult to rotate mentally than representations of two-dimensional objects. In this study, subjects were asked to make mirror-normal decisions with stimuli that differed in perceived dimensionality and in angle of rotation in the image plane. In a series of four experiments, the time to make mirror-normal decisions increased with increased orientation discrepancy between the stimuli, as found previously in the literature. In every experiment, however, response times were smaller for representations of two-dimensional shapes than for representations of three-dimensional shapes when the stimuli being compared were presented with a large angular discrepancy. Whereas response times increased linearly with orientation when representations of three-dimensional shapes were rotated, the increase in response time for representations of two-dimensional shapes was generally nonlinear. Overall, the evidence suggests that representations of three-dimensional shapes are mentally rotated at the same rate as representations of two-dimensional shapes for angles of rotation between 0° and 60°. For larger angles of rotation, however, the rate of mental rotation is greater for representations of two-dimensional shapes than for representations of three-dimensional shapes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pulmonary hypertension in relationship to acidaemia after maximum forced exercise. A further preliminary report

Pulmonary hypertension was shown to occur in wild young zebra and wildebeest subject to forced exercise over 2 to 5 km distance. Measurements of pulmonary arterial pressure were made on a Devices recorder connected to a catheter passed via the jugular vein. Systemic pressure was recorded after puncture of the dorsal aorta. The electrocardiogram, PO2, PCO2 and pH were determined and enzyme levels such as CPK were estimated. Reduction of the pulmonary hypertension occurred after bicarbonate infusion.     

Endoscopically controlled sinus floor augmentation. A preliminary report

Sinus augmentation has been advocated to be a surgical technique with predictable results in peri-implant surgery. Endoscopic surgery of the maxillary sinus so far has been used as diagnostic procedure. In this paper, the use of endoscopy is described as a low invasive adjunctive technique in sinus floor augmentation. After preparation of the mucoperiosteum, bone grafts can be placed under endoscopic control between sinus floor and mucoperiosteum. A laterobasal approach via a small osteotomy and a transalveolar approach are possible for mucosal elevation and graft placement. First clinical results are reported. Endoscopic sinus lift may contribute to a reduction of perioperative morbidity, reduction of oroantral fistulae and control of graft position. The less invasive technique may allow to extend the indication for sinus augmentation.     

A biological basis for instantaneous centres of rotation of the vertebral column

BACKGROUND: The morbidity of treating benign parotid tumors is an important issue because the majority of patients are young. We therefore undertook this study to evaluate the outcome for these patients treated at the Princess Margaret Hospital. METHODS: A retrospective review was conducted on all patients registered with benign parotid tumors between 1970 and 1987. RESULTS: Seventy-six patients were included in this review; postoperative radiotherapy (XRT) was administered to 55 patients. Median follow-up time was 12.5 years. Postoperative XRT was particularly important for patients with recurrent disease. The risk of both temporary and permanent facial nerve paralyses increased with each operation. No patients in this study developed a malignancy. CONCLUSIONS: We recommend that all patients with benign parotid tumors be treated with a complete parotidectomy with preservation of the facial nerve. Consideration to postoperative XRT should be given to patients in whom there was tumor spillage, residual disease, or recurrences.     

Intraoperative brain shift and deformation: a quantitative analysis of cortical displacement in 28 cases

OBJECTIVE: A quantitative analysis of intraoperative cortical shift and deformation was performed to gain a better understanding of the nature and extent of this problem and the resultant loss of spatial accuracy in surgical procedures coregistered to preoperative imaging studies. METHODS: Three-dimensional feature tracking and two-dimensional image analysis of the cortical surface were used to quantify the observed motion. Data acquisition was facilitated by a ceiling-mounted robotic platform, which provided a number of precision tracking capabilities. The patient's head position and the size and orientation of the craniotomy were recorded at the start of surgery. Error analysis demonstrated that the surface displacement measuring methodology was accurate to 1 to 2 mm. Statistical tests were performed to examine correlations between the amount of displacement and the type of surgery, the nature of the cranial opening, the region of the brain involved, the duration of surgery, and the degree of invasiveness. RESULTS: The results showed that a displacement of an average of 1 cm occurred, with the dominant directional component being associated with gravity. The mean displacement was determined to be independent of the size and orientation of the cranial opening. CONCLUSION: These data suggest that loss of spatial registration with preoperative images is gravity-dominated and of sufficient extent that attention to errors resulting from misregistration during the course of surgery is warranted.     

A new method of treatment for mallet finger. A preliminary report

An infant with a typical Edwards syndrome and a modal chromosome number of 46 is reported. In all cells analyzed one chromosome G was missing and an additional chromosome similar to a pair No. 16 was present. The phenotype of the child indicates that the extra element is a translocation between G and 18 chromosomes as in one case described previously.     

Fetal response to voluntary maternal hyperventilation. A preliminary report

Maternal hyperventilation can cause transient reduction in fetal oxygen tension. Fifty women with normal and high-risk pregnancies, between the 32nd and 43rd week, were voluntarily hyperventilated; in 33, fetal heart rate (FHR) acceleration or transient tachycardia were observed (reactive FHR). Of the 33 pregnancies the outcome was good in 30 (91%) as judged by the absence of perinatal death, no fetal distress in labor and no intrauterine growth retardation (IUGR). In 14 patients in whom there was no FHR response to maternal hyperventilation (non-reactive FHR), the outcome of pregnancy was significantly worse; one infant died neonatally, 10 were either chronically (IUGR), or acutely distressed. Only in 3 was the outcome good (21%). The study showed that there is good correlation between a "reactive" FHR and favorable neonatal outcome, and between a "non-reactive" FHR and an unfavorable neonatal outcome.     

A comparison of the effects of depth rotation on visual and haptic three-dimensional object recognition.

A sequential matching task was used to compare how the difficulty of shape discrimination influences the achievement of object constancy for depth rotations across haptic and visual object recognition. Stimuli were nameable, 3-dimensional plastic models of familiar objects (e.g., bed, chair) and morphs midway between these endpoint shapes (e.g., a bed–chair morph). The 2 objects presented on a trial were either both placed at the same orientation or were rotated by 90° relative to each other. Discrimination difficulty was increased by presenting more similarly shaped objects on mismatch trials (easy: bed, then lizard; medium: bed, then chair; hard: bed, then bed–chair morph). For within-modal visual matching, orientation changes were most disruptive when shape discrimination was hardest. This interaction for 3-dimensional objects replicated the interaction reported in earlier studies presenting 2-dimensional pictures of the same objects (Lawson & Bülthoff, 2008). In contrast, orientation changes and discrimination difficulty had additive effects on within-modal haptic and cross-modal visual-to-haptic matching, whereas cross-modal haptic-to-visual matching was orientation invariant. These results suggest that the cause of orientation sensitivity may differ for visual and haptic object recognition. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Flow-microfluorometric analysis of nuclei isolated from various normal and malignant human epithelial tissues. A preliminary report

In order to obviate some of the technical problems associated with preparation of monocellular cell suspensions required for flow fluorometry, isolation of nuclei from several types of benign and malignant human tissues was undertaken. Satisfactory preparations of nuclei were obtained from epithelia of the uterine cervix and colon and from lung tissue using the citric acid method. The sucrose method was effective with colonic epithelium only. Distribution of deoxyribonucleic acid content in these nuclei was measured based on green fluorescence of acridine orange and red fluorescence of propidium iodide in a Bio-Physics Cytofluorograph. Essentially diploid patterns of deoxyribonucleic acid distribution were observed for all benign samples regardless of tissue origin whereas the malignant samples gave histograms suggestive of abnormal deoxyribonucleic acid distribution. Preliminary observations on distribution of single-stranded nucleic acids using acridine orange red fluorescence showed marked differences between populations of benign and malignant nuclei. Isolated nuclei appear to be suitable for flow-through microfluorometric analysis and offer some significant advantages over intact cells.     

The Comprehensive Object Relations Profile: A preliminary report.

This article reports a study of a newly created instrument designed specifically for the measurement of object relations concepts. The Comprehensive Object Relations Profile (CORP) is a semistructured projective test that asks the subject to respond to specific questions regarding interpersonal vignettes. Each question is designed to tap a particular dimension of object relationships. Three dimensions are measured: object constancy, object integration, and empathy. Validity was assessed by a comparison of three diagnostic groups: schizophrenics, borderlines, and neurotics. Reliability was measured by the interjudge method. The results indicated that the CORP significantly differentiated the three diagnostic groups in the expected direction and that the CORP is a highly reliable instrument. The implications of these results were drawn for both the usefulness of the CORP and the validity of object relations concepts. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Laparoscopic anterior gastroplasty. A preliminary report of a new technique

BACKGROUND: The treatment of the morbidly obese patient is difficult because compliance with dietary regimens is poor. As a result, most weight reduction programs fail very quickly. Surgical treatment, on the other hand, provides a reliable method for sustained weight reduction. The most frequently performed procedure has been the vertical banded gastroplasty. Adaptation of the standard open procedure to laparoscopic techniques has been technically difficult and imprecise. We have developed, in the laboratory, an anterior wall banded gastroplasty that can be performed precisely and reproducibly using laparoscopic techniques. METHODS: Five Yorkshire pigs were used in attempt to laparoscopically perform the standard vertical banded gastroplasty. The procedure was difficult and was associated with a risk of staple line leak and with bleeding along the lesser curvature of the stomach. Furthermore, a reproducible pouch of proper dimension could not be created reliably. Fifteen animals were then used to develop a new technique using a small gastric pouch based on the anterior gastric wall. RESULTS: A reproducible pouch, 4 cm in length, was created over an 18-Fr nasogastric tube. A standard polyproylene band of 5.2 cm in length was utilized at the gastric pouch outlet. CONCLUSIONS: This operation can be reproduced accurately and has not demonstrated any leaks on postmortem examination.     

Diagnosis of early pregnancy with A-mode ultrasound. A preliminary report

An A-mode ultrasonic analyzer was used to detect pregnancy and to determine gestational age in 102 patients, 77 of whom were pregnant and 25 of whom were not pregnant. All pregnant patients were in the first trimester. Polaroid photographs were taken of the echo pattern display and diagnosis was compared with that of the clinical examination. Results indicate, using only the Polaroid photograph of the patient's A-scope echo pattern, it is possible to (1) diagnose pregnancy with an accuracy rate of 87.2% and (2) estimate the week of gestation, within a tolerance of 21 days of the clinical examination, with an accuracy rate of 84.5%.