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High levels of cellular proliferation predict pseudoprogression in glioblastoma patients  

PubMed Central

Radiochemotherapy (RT) with concomitant followed by monthly temozolomide (TMZ) chemotherapy is the gold standard for the treatment of glioblastoma (GBM) patients. GBM patients can experience transient radiological deterioration after concurrent RT/TMZ that stabilizes or even resolves after additional cycles of adjuvant TMZ, a phenomenon defined as radiological pseudoprogression. The aim of this retrospective study was to identify a reliable marker associated with pseudoprogression processes. Patients with histologically proven newly diagnosed GBM were identified from a retrospective database between 2005 and 2009. Predictive factors for pseudoprogression were analyzed from clinical, radiological and biological data. Of the 130 analyzed patients, 63 underwent RT/TMZ treatment followed by cycles of TMZ and were evaluated for radiological responses every two months by magnetic resonance imaging. Early progression was confirmed in 52% (33/63) of the patients, and, within this group, 21% (7/33) displayed evidence of pseudo-progression. The predictive factors were evidenced in terms of clinical or radiological findings. In GBM patients, the level of cellular proliferation (Ki67 indices) emerged as a statistically significant prognostic marker for distinguishing pseudoprogression from actual progression. Our observation, suggesting that GBM associated with a high level of cellular proliferation may differentiate tumor progression from pseudoprogression, warrants further investigation in a large multi-center prospective study.




High levels of cellular proliferation predict pseudoprogression in glioblastoma patients.  


Radiochemotherapy (RT) with concomitant followed by monthly temozolomide (TMZ) chemotherapy is the gold standard for the treatment of glioblastoma (GBM) patients. GBM patients can experience transient radiological deterioration after concurrent RT/TMZ that stabilizes or even resolves after additional cycles of adjuvant TMZ, a phenomenon defined as radiological pseudoprogression. The aim of this retrospective study was to identify a reliable marker associated with pseudoprogression processes. Patients with histologically proven newly diagnosed GBM were identified from a retrospective database between 2005 and 2009. Predictive factors for pseudoprogression were analyzed from clinical, radiological and biological data. Of the 130 analyzed patients, 63 underwent RT/TMZ treatment followed by cycles of TMZ and were evaluated for radiological responses every two months by magnetic resonance imaging. Early progression was confirmed in 52% (33/63) of the patients, and, within this group, 21% (7/33) displayed evidence of pseudo-progression. The predictive factors were evidenced in terms of clinical or radiological findings. In GBM patients, the level of cellular proliferation (Ki67 indices) emerged as a statistically significant prognostic marker for distinguishing pseudoprogression from actual progression. Our observation, suggesting that GBM associated with a high level of cellular proliferation may differentiate tumor progression from pseudoprogression, warrants further investigation in a large multi-center prospective study. PMID:22086066

Pouleau, Henri-Benjamin; Sadeghi, Niloufar; Balériaux, Danielle; Mélot, Christian; De Witte, Olivier; Lefranc, Florence



High levels of untreated distress and fatigue in cancer patients  

Microsoft Academic Search

The purpose of the study was to assess a large representative sample of cancer patients on distress levels, common psychosocial problems, and awareness and use of psychosocial support services. A total of 3095 patients were assessed over a 4-week period with the Brief Symptom Inventory-18 (BSI-18), a common problems checklist, and on awareness and use of psychosocial resources. Full data

L E Carlson; M Angen; J Cullum; E Goodey; J Koopmans; L Lamont; J H MacRae; M Martin; G Pelletier; J Robinson; J S A Simpson; M Speca; L Tillotson; B D Bultz



Is 24,25(OH)D level really high in dialysis patients with high FGF23 levels?  


Deficiency of 1,25-dihydroxyvitamin D [1,25(OH)(2)D] and excessive fibroblast growth factor (FGF23) are suggested to be associated with increased mortality in patients with chronic kidney disease (CKD). Generally, 24-hydroxylation has been considered the first step in the degradation pathway of 1,25(OH)(2)D and 25(OH)D. 24,25-dihydroxyvitamin D [24,25(OH)(2)D] was believed to be a degradation product, with no important biological effects. However, some data have accumulated showing that 24,25(OH)(2)D has biological effects on its own. Under conditions of eucalcemia, the synthesis of 24,25(OH)(2)D is increased, and the synthesis of 1,25(OH)(2)D is decreased. In patients with CKD, both high parathyroid hormone levels, which decrease the activity of enzyme CYP24A1 (24-hydroxylase), and high FGF23 levels, which increase the activity of enzyme CYP24A1, were often detected. However, information about 24,25(OH)(2)D levels in these patients is very limited. Whether compensatory changes in levels of FGF23 and 24,25(OH)(2)D in CKD patients are protective or harmful remain unknown issues. Therefore, more studies are needed to identify the nature of the interactions between these molecules and to fully elucidate their clinical significance. PMID:22467088

Taskapan, Hulya



Glucose Levels Predict Hospitalization for Congestive Heart Failure in Patients at High Cardiovascular Risk  

Microsoft Academic Search

Background—Patients with diabetes mellitus (DM) are at high risk of developing congestive heart failure (CHF). However, the relationships between glucose levels and CHF in people with or without a history of DM have not been well characterized. Methods and Results—We evaluated the associations between fasting plasma glucose and risk of hospitalization for CHF during follow-up in patients at high cardiovascular

C. Held; H. C. Gerstein; S. Yusuf; F. Zhao; L. Hilbrich; C. Anderson; P. Sleight; K. Teo



Low serum vitamin B12 levels in chronic high-flux haemodialysis patients.  


The occurrence of vitamin B12 (B12) deficiency in chronic haemodialysis patients and the need for its supplementation in these patients are still matters of debate. We measured serial predialysis serum B12 levels, at 3- to 6-month intervals, in 67 unselected patients on our high-flux haemodialysis programme. Over a 12-month period, there was a significant fall in serum B12 from 497 +/- 200 (SD) to 391 +/- 131 ng/l (p < 0.001). 22 patients developed subnormal serum B12 levels and were commenced on hydroxocobalamin supplements. We were unable to demonstrate B12 clearance during dialysis using blood side studies. Measurement of B12 in the dialysate showed that 0-4.5 microg B12 was cleared per dialysis. Using these B12 measurements, in vivo B12 clearance was estimated at 9.1 ml/min. Dietary studies on 24 unselected patients showed borderline or low B12 intake in 4 patients. Absorption studies by whole-body counting on 6 patients using 57Co and 58Co showed normal B12 absorption. The same radioisotope studies demonstrated no B12 adsorption to the dialyser membrane. This study demonstrates that low serum B12 levels occur in high-flux haemodialysis patients and that losses during dialysis and dietary deficiency may be contributing factors. PMID:9069445

Chandna, S M; Tattersall, J E; Nevett, G; Tew, C J; O'Sullivan, J; Greenwood, R N; Farrington, K



Altered galectin-1 serum levels in patients diagnosed with high-grade glioma.  


High-grade gliomas (HGG) are the most common and most aggressive intrinsic human brain tumors in adults. Galectin-1, a glycan-binding protein that is overexpressed in HGG, has been shown to contribute significantly to the aggressive nature of HGG. It is unknown whether increased galectin-1 expression levels are exclusively found at the tumor site or whether galectin-1 can also be detected in the serum of HGG patients. Galectin-1 serum levels were analyzed in a prospective dataset of 43 healthy controls and 125 patients with newly diagnosed or recurrent HGG. Samples were taken at the moment of surgical resection and/or 2-3 weeks after surgery. Galectin-1 serum levels were determined using an ELISA for galectin-1. Galectin-1 serum levels depended significantly on age and sex in the control group. Age- and sex-adjusted galectin-1 serum levels were significantly higher in all patient subgroups compared to healthy controls with a high discriminative ability that increased with age. We did not observe a significant decrease in the galectin-1 serum levels upon surgical resection of the tumor. Collectively, the data presented here may represent a first step to establish galectin-1 as a biomarker in HGG disease monitoring. Further longitudinal evaluation is required and ongoing to investigate the value of galectin-1 serum levels in HGG patients as an additional diagnostic marker, but more importantly as a predictor of treatment response and prognosis. Furthermore, galectin-1 serum levels could also provide an important tool for the identification of HGG patients that could benefit from galectin-1 directed therapies that are currently under development. PMID:23824536

Verschuere, Tina; Van Woensel, Matthias; Fieuws, Steffen; Lefranc, Florence; Mathieu, Veronique; Kiss, Robert; Van Gool, Stefaan W; De Vleeschouwer, Steven



Are primed polymorphonuclear leukocytes contributors to the high heparanase levels in hemodialysis patients?  


Patients on chronic hemodialysis (HD) are at high risk for developing atherosclerosis and cardiovascular complications. Heparanase, an endoglycosidase that cleaves heparan sulfate (HS) side chains of proteoglycans, is involved in extracellular matrix degradation and, as such, may be involved in the atherosclerotic lesion progression. We hypothesize that heparanase is elevated in HD patients, partly due to its release from primed circulating polymorphonuclear leukocytes (PMNLs), undergoing degranulation. Priming of PMNLs was assessed by levels of CD11b and the rate of superoxide release. Heparanase mRNA expression in PMNLs was determined by RT-PCR. PMNL and plasma levels of heparanase were determined by immunoblotting, immunofluorescence, and flow cytometry analyses. The levels of soluble HS in plasma were measured by a competition ELISA. This study shows that PMNLs isolated from HD patients have higher mRNA and protein levels of heparanase compared with normal control (NC) subjects and that heparanase levels correlate positively with PMNL priming. Plasma levels of heparanase were higher in HD patients than in NC subjects and were further elevated after the dialysis session. In addition, heparanase expression inversely correlates with plasma HS levels. A pronounced expression of heparanase was found in human atherosclerotic lesions. The increased heparanase activity in the blood of HD patients results at least in part from the degranulation of primed PMNLs and may contribute to the acceleration of the atherosclerotic process. Our findings highlight primed PMNLs as a possible source for the increased heparanase in HD patients, posing heparanase as a new risk factor for cardiovascular complications and atherosclerosis. PMID:18032524

Cohen-Mazor, Meital; Sela, Shifra; Mazor, Rafi; Ilan, Neta; Vlodavsky, Israel; Rops, Angelique L; van der Vlag, Johan; Cohen, Hector I; Kristal, Batya



Caspase-1 level in synovial fluid is high in patients with spondyloarthropathy but not in patients with gout.  


Activation of caspase-1 by NALP3 inflammasomes has been shown to be important in initiating acute gouty arthritis. The objectives of this study were to measure the levels of caspase-1 in synovial fluid in gout and various arthritides, and to elucidate the clinical significance of caspase-1 levels in synovial fluid. Caspase-1, IL-1?, IL-18, and uric acid were measured in synovial fluid from 112 patients with gout and other arthritides, such as rheumatoid arthritis, osteoarthritis, and spondyloarthropathy. Caspase-1 in synovial fluid from patients with crystal-induced arthritis, inflammatory arthritis, osteoarthritis, and spondyloarthropathy was 35.9 ± 86.7, 49.7 ± 107.7, 2.1 ± 7.0, and 152.6 ± 155.7 pg/mL, respectively. The mean level and the frequency of high levels (?125 pg/mL) of caspase-1 in spondyloarthropathy were significantly higher than those in the other arthritides including gout. Caspase-1 was detectible in the synovial fluid of patients with the various arthritides. Contrary to our hypothesis, the caspase-1 level in the synovial fluid of patients with gout was not higher than in that of other arthritides. High levels of caspase-1 may be helpful in differentiating spondyloarthropathy from other arthritides. PMID:24015032

Son, Chang-Nam; Bang, So-Young; Kim, Ji Hae; Choi, Chan-Bum; Kim, Tae-Hwan; Jun, Jae-Bum



Correlation between high blood IL-6 level, hyperglycemia, and glucose control in septic patients  

PubMed Central

Introduction The aim of the present study was to investigate the relationship between the blood IL-6 level, the blood glucose level, and glucose control in septic patients. Methods This retrospective observational study in a general ICU of a university hospital included a total of 153 patients with sepsis, severe sepsis, or septic shock who were admitted to the ICU between 2005 and 2010, stayed in the ICU for 7 days or longer, and did not receive steroid therapy prior to or after ICU admission. The severity of stress hyperglycemia, status of glucose control, and correlation between those two factors in these patients were investigated using the blood IL-6 level as an index of hypercytokinemia. Results A significant positive correlation between blood IL-6 level and blood glucose level on ICU admission was observed in the overall study population (n = 153; r = 0.24, P = 0.01), and was stronger in the nondiabetic subgroup (n = 112; r = 0.42, P < 0.01). The rate of successful glucose control (blood glucose level < 150 mg/dl maintained for 6 days or longer) decreased with increase in blood IL-6 level on ICU admission (P < 0.01). The blood IL-6 level after ICU admission remained significantly higher and the 60-day survival rate was significantly lower in the failed glucose control group than in the successful glucose control group (P < 0.01 and P < 0.01, respectively). Conclusions High blood IL-6 level was correlated with hyperglycemia and with difficulties in glucose control in septic patients. These results suggest the possibility that hypercytokinemia might be involved in the development of hyperglycemia in sepsis, and thereby might affect the success of glucose control.



Voriconazole serum levels measured by high-performance liquid chromatography: a monocentric study in treated patients.  


In this study we present the results of a therapeutic drug monitoring retrospective analysis involving 14 patients with several underlying diseases who were receiving voriconazole for the treatment of fungal infections. A simple high performance liquid chromatography assay with ultraviolet detection was used in the drug monitoring. We report here that serum concentrations were highly variable and unpredictable in most patients. We also found that lack of response was more frequent in patients with levels persistently lower than 1 mg/l. The number of samples with voriconazole concentrations below 1 mg/l was significantly higher in patients who exhibited therapeutic failures (88% versus 27%; P < 0.001). In addition, the period of time in which voriconazole concentrations were maintained below 1 mg/l was slightly higher in patients in the failure group. We suggest that serum concentration should be individually quantified for patients receiving voriconazole therapy. Further prospective studies are needed to clarify the potential benefit of the individualization of treatment. PMID:22070341

Gómez-López, Alicia; Cendejas-Bueno, Emilio; Cuesta, Isabel; García Rodríguez, Julio; Rodríguez-Tudela, Juan L; Gutiérrez-Altés, A; Cuenca-Estrella, Manuel



High frequency of low serum levels of vitamin 12 among patients attending Jordan University Hospital.  


This study aimed to estimate the status of serum vitamin B12 level in patients attending Jordan University Hospital in Amman, and to examine the relationship with demographic data, chronic illness, dietary habits, haematological parameters and symptoms related to vitamin B12 levels. A total of 838 patients completed a questionnaire and gave blood samples; 44.6% were vitamin B12 deficient (< 180 pg/mL) and 34.2% had hypovitaminosis (180-300 pg/mL). Vitamin B12 deficiency was associated with memory impairment, low meat intake and strict vegetarian (vegan) diets. The high frequency of low vitamin B12 warrants the development of a strategy to correct this problem in Jordan. PMID:20187536

Barghouti, F F; Younes, N A; Halaseh, L J; Said, T T; Ghraiz, S M


High preoperative blood levels of HE4 predicts poor prognosis in patients with ovarian cancer  

PubMed Central

Abstract The aim of this study was to assess the clinical value of preoperative blood levels of HE4 as a predictor of overall survival in patients with ovarian cancer and to validate previous data of HE4 and the ROMA algorithm including HE4 and CA125 in discriminating benign and malignant ovarian tumors. Experimental design The preoperative plasma levels of HE4 and CA125 were analyzed with ELISA in 312 patients with adnexal lesions. Tumors were classified as benign (n= 206), borderline (i.e. low malignant potential tumors) (n= 25), and well (n= 14), moderately (n= 15), and poorly (n= 51) differentiated malignant. Results In univariate Cox regression analyses high levels (dichotomized at the median) of HE4, CA125, increased age (continuous variable), advanced-stage of disease 2–4, histological grade 3 and non-optimal tumor debulking at primary surgery were all significantly associated with shorter overall survival. A multivariate Cox regression model including pre-operative available covariates HE4 and CA125 both dichotomized at median in addition to age as continuous variable showed that high levels of HE4 was an independent prognostic marker for worse prognosis HR 2.02 (95% CI 1.1-3.8). In postmenopausal women the ROMA algorithm gave the highest AUC of 0.94 (95% CI, 0.90-0.97) which was higher than the separate markers HE4 AUC 0.91 (95% CI 0.86-0.95) and CA125 AUC 0.91(95% CI 0.87-0.96). Conclusions High concentration of plasma HE4 is an independent preoperative marker of poor prognosis in patients with ovarian cancer. The algorithm ROMA discriminates in postmenopausal women between malignant and benign tumors with an AUC of 0.94.



High expression level of TMPRSS4 predicts adverse outcomes of colorectal cancer patients.  


Transmembrane protease/serine 4 (TMPRSS4), a member of the type II transmembrane serine protease family, is highly expressed in some human cancers and involved in the EMT regulation of cancer cells. The prognostic value of TMPRSS4 in colorectal cancer (CRC) has not been discussed. This study aims to evaluate the association between TMPRSS4 expressions and survival in CRC patients. Immunohistochemistry revealed high expression of TMPRSS4 in 69/122 CRC samples, compared with 14/47 in normal tissues (P < 0.01). Correlation analysis showed high expression of TMPRSS4 was significantly associated with advanced TNM stage (P = 0.011), pT (P = 0.019), pN (P = 0.035), and pM status (P = 0.004). Higher TMPRSS4 predicted shorter overall survival (OS) and disease-free survival (DFS) in CRC patients (P < 0.01, both). Moreover, both TMPRSS4 expression and TNM stage were independent predictive factors of OS and DFS in Cox regression analysis. The findings in our study demonstrated the potential value of TMPRSS4 expression level as a prognostic biomarker for CRC patients. PMID:24072509

Huang, Ao; Zhou, Houmin; Zhao, Hongchao; Quan, Yingjun; Feng, Bo; Zheng, Minhua



ALS-LAUS syndrome in a patient with high level of antiphospholipid antibodies: a case report.  


When evaluating a patient with amyotrophic lateral sclerosis (ALS), a number of other motor neuron disorders and related motor syndromes should be considered. Herein, we describe a 55-year-old Persian man with typical presentation of ALS in whom based on further finding of elevated level of antiphospholipid antibodies, final diagnosis of ALS with laboratory abnormalities of uncertain significance (ALS-LAUS) was made. With respect to persistent increased titre of antiphospholipid antibodies, he was treated with plasma exchange and prednisolone. After 3 months of treatment, the symptoms improved and antiphospholipid antibody titres decreased. To the best of our knowledge, this is the first case of ALS-LAUS accompanied by high titre of antiphospholipid antibodies with response to plasma exchange and corticosteroids. PMID:19235108

Saadatnia, Mohammad; Fatehi, Farzad; Basiri, Keivan; Sariaslani, Payam


High levels of serum angiogenic growth factors in patients with AL amyloidosis: comparisons with normal individuals and multiple myeloma patients.  


Serum levels of five angiogenic cytokines were evaluated in 82 patients with primary systemic amyloidosis (AL). Angiopoietin-1, vascular endothelial growth factor, basic fibroblast growth factor and angiogenin were higher in AL patients than in controls (n = 35) and newly-diagnosed, symptomatic, myeloma patients (n = 35). Angiopoetin-1/Angiopoetin-2 ratio was lower in AL compared to controls but higher than in myeloma patients. Angiopoetin-2 correlated with cardiac dysfunction indices; however, none of the angiogenic growth factors was prognostically significant. The increased angiogenic cytokine levels observed in AL seem to represent either a toxic effect of amyloid fibrils or light chains, or a compensatory response to organ dysfunction. PMID:20618328

Kastritis, Efstathios; Roussou, Maria; Michael, Michalis; Gavriatopoulou, Maria; Michalis, Evridiki; Migkou, Magdalini; Delimpasi, Sossana; Kyrtsonis, Marie Christine; Gogos, Dimitrios; Liapis, Konstantinos; Charitaki, Evangelia; Repousis, Panagiotis; Terpos, Evangelos; Dimopoulos, Meletios A



Reversible skeletal disease and high fluoride serum levels in hematologic patients receiving voriconazole.  


We here investigate the occurrence of fluoride intake-associated alterations in patients with hematologic disease on triazol antifungal medication. Clinical, laboratory, and radiology data of overall 43 patients with hematologic malignancies taking voriconazole (n = 20), posaconazole (n = 8), and itraconazole (n = 4), and a hematologic patient control group (n = 11) are described. Bone pain and radiologic evidence of periostitis were exclusively observed in patients receiving long-term voriconazole. Cessation of treatment led to clinical improvement in all cases. In line with clinical evidence, fluoride serum concentration was elevated in patients receiving voriconazole (median, 156.5 ?g/L; interquartile range, 96.8 ?g/L; normal < 30 ?g/L) but not in the other treatment groups (P < .001 for all comparisons vs voriconazole). We conclude that serum fluoride levels were elevated on average 5-fold above normal levels in hematologic patients receiving voriconazole. Clinically relevant skeletal disease was associated with renal insufficiency and above 10-fold elevated fluoride levels, and was reversible on termination of voriconazole treatment. PMID:22859610

Gerber, Bernhard; Guggenberger, Roman; Fasler, David; Nair, Gayathri; Manz, Markus G; Stussi, Georg; Schanz, Urs



Highly elevated levels of prostaglandin D synthase in the serum of patients with renal failure  

Microsoft Academic Search

Objectives. To investigate whether prostaglandin D (PGD) synthase levels differ in the serum of patients with or without renal dysfunction. PGD synthase or beta-trace protein is a major constituent (approximately 3% of total protein) of human cerebrospinal fluid (CSF). We previously reported that PGD synthase levels in serum are approximately 40- to 60-fold lower than those in CSF.Methods. We measured




High levels of unintegrated HIV1 DNA in brain tissue of AIDS dementia patients  

Microsoft Academic Search

IN the host cell, retro viral DNAs exist in three main forms: unintegrated linear, unintegrated circular, and integrated (the provirus)1. High levels of unintegrated forms of retroviral DNA often correlate with superinfection and accompanying cytopathic effects2-8, as, for example, in the case of feline acquired immunodeficiency7,8. In culture, HIV-1 infection also results in high levels of unintegrated viral DNA although

Shen Pang; Yoshio Koyanagi; Steven Miles; Clayton Wiley; Harry V. Vinters; Irvin S. Y. Chen



Determinants of post-intensive care mortality in high-level treated critically ill patients  

Microsoft Academic Search

ObjectiveTo assess the predictive ability of preillness and illness variables, impact of care, and discharge variables on the post-intensive care mortality.Setting and patients5,805 patients treated with high intensity of care in 89 ICUs in 12 European countries (EURICUS-I study) surviving ICU stay.MethodsCase-mix was split in training sample (logistic regression model for post-ICU mortality: discrimination assessed by area under ROC curve)

Gaetano Iapichino; Alberto Morabito; Giovanni Mistraletti; Luca Ferla; Danilo Radrizzani; Dinis Reis Miranda



Low-level versus high-level placement of gold plates in the upper eyelid in patients with facial palsy  

PubMed Central

Background: Lagophthalmos is a condition that results from facial paralysis causing functional as well as esthetic problems. This condition can be treated by a range of techniques, including tarsorrhaphy, facial slings, and canthopexies. Gold plates provide a solution for temporary or permanent lagophthalmos resulting from facial paralysis. This study discusses the use of gold plates in the treatment of lagophthalmos but with the introduction of gold plates in two different positions in the upper lids. Methods: Group 1 (38 eyes) had a low level of placement (2 mm from the lid margin) of gold plates, while Group 2 (23 eyes) had a high level of placement (5 mm from the lid margin). Results: Noticeable bulge was seen in 18.4% of Group 1 eyes compared with 13% in Group 2, and migration of the plate occurred in 2.6% and 0% of eyes in Group 1 and Group 2, respectively, as well as ptosis (7.8% and 4.3%) and conjunctival perforation (0% and 4.3%). The degree of improvement of eyelid closure, keratopathy, and visual acuity were the same for both techniques. Conclusion: Placement of gold plates at a higher level could avoid some of the drawbacks of lower level placement of these plates, such as upper eyelid bulge and ptosis, especially given the thinning of the eyelids and orbicularis muscles that occurs in facial palsy.

Amer, Tarek A; El-Minawi, Hisham M; El-Shazly, Malak I



Successful pregnancy in a patient having high basal serum levels of sex steroid hormones  

Microsoft Academic Search

A 25-year-old infertile woman who had higher basal levels of serum progesterone (P) and estradiol (E2) was examined. Ultrasonography and gonadotropin-releasing hormone test suggested polycystic ovarian syndrome. The high serum\\u000a E2 and P concentration increased even more along follicle growth and after ovulation, respectively. Although the source of the\\u000a higher levels of steroids was unclear, she became pregnant with artificial

M. Furuhashi; N. Suganuma; K. Nishimori



Recurrent Unprovoked Venous Thromboembolism in a Young Female Patient with High Levels of Homocysteine  

PubMed Central

Hyperhomocysteinemia is a rare condition which predisposes to atherothrombosis. Recurrent venous thromboembolism (VTE) with hyperhomocysteinemia is known but extremely uncommon. Homocysteine levels of more than 22 umol/L can predispose to VTE in a middle-aged women. We describe a case of a middle-aged woman, community ambulant with recurrent VTE with intermediately high homocysteine levels. She had no other risk factors for recurrent venous thrombosis. In our article, we also discuss hyperhomocysteinemia and its link to VTE.

Sule, Ashish Anil; Chin, Tay Jam; Khien, Lee Hwei



The presence of high level soluble herpes virus entry mediator in sera of gastric cancer patients  

PubMed Central

The development of gastric cancer (GC) is closely related to chronic inflammation caused by Helicobacter pylori infection, and herpes virus entry mediator (HVEM) is a receptor expressed on the surface of leukocytes that mediates potent inflammatory responses in animal models. However, the role of HVEM in human GC has not been studied. Previously, we showed that the interaction of HVEM on human leukocytes with its ligand LIGHT induces intracellular calcium mobilization, which results in inflammatory responses including induction of proinflammatory cytokine production and anti-bacterial activities. In this study, we report that leukocytes from GC patients express lower levels of membrane HVEM (mHVEM) and have lower LIGHT-induced bactericidal activities than those from healthy controls (HC). In contrast, levels of soluble HVEM (sHVEM) in the sera of GC patients were significantly higher than in those of HC. We found that monocyte membrane-bound HVEM is released into the medium when cells are activated by proinflammatory cytokines such as TNF-? and IL-8, which are elevated in the sera of GC patients. mHVEM level dropped in parallel with the release of sHVEM, and release was completely blocked by the metalloprotease inhibitor, GM6001. We also found that the low level of mHVEM on GC patient leukocytes was correlated with low LIGHT-induced bactericidal activities against H. pylori and S. aureus and production of reactive oxygen species. Our results indicate that mHVEM on leukocytes and sHVEM in sera may contribute to the development and/or progression of GC.

Heo, Sook-Kyoung; Ju, Seong-A; Kim, Gyu Yeol; Park, Sang-Min; Back, Sung Hun; Park, Neung-Hwa; Min, Young Joo; An, Won G.; Nguyen, Thu-Ha Thi; Kim, Sun-Min



Very high levels of SGOT and LDH in patients with extrahepatic biliary tract obstruction  

Microsoft Academic Search

Very high levels of SGOT (1710, 2450 and >1250) and LDH (1275, 1740 and 1300) are reported in 3 cases of extrahepatic obstruction due to gallstones. The diagnoses were established at operation, and viral hepatitis was ruled out by liver biopsy. Marked SGOT elevations in extrahepatic biliary obstruction are rare, but isolated case reports and experimental biliary obstruction in animals

Allen L. Ginsberg



Niacin administration significantly reduces oxidative stress in patients with hypercholesterolemia and low levels of high-density lipoprotein cholesterol.  


Oxidative stress has been implicated in the pathogenesis of cardiovascular disorders, including atherosclerosis. In pharmacological doses, niacin (vitamin B3) was proven to reduce total cholesterol, triglyceride, very-low-density lipoprotein, and low-density lipoprotein levels, and to increase high-density lipoprotein (HDL) levels. The aim of this study was to evaluate the effect of niacin treatment in patients with low levels of HDL cholesterol (HDL-C; <40 mg%) on their lipid profile and oxidative stress status. Seventeen patients with hypercholesterolemia and low HDL-C and 8 healthy control subjects were enrolled in the study. The patients were treated with niacin for 12 weeks. Lipid profile, oxidative stress and C-reactive protein (CRP) levels were determined at the time of enrollment, and 2 and 12 weeks after initiation of niacin treatment. Subjects with lower HDL-C levels exhibited higher oxidative stress compared with subjects with normal HDL-C levels. Niacin treatment in hypercholesterolemic patients caused a significant increase in HDL-C and apolipoprotein A1 levels, and a decrease in triglyceride levels. Niacin also significantly reduced oxidative stress, as measured by a significant decrease in the serum content of thiobarbituric acid reactive substances, lipid peroxides and paraoxonase activity, compared with the levels before treatment. Although serum CRP levels were not affected by niacin treatment, a correlation between CRP and HDL levels was obtained when computing the results. Niacin treatment in hypercholesterolemic patients with low HDL levels caused a significant decrease in their oxidative stress status. These results indicate an additional beneficial effect of niacin beyond its ability to affect the lipid profile. PMID:22990043

Hamoud, Shadi; Kaplan, Marielle; Meilin, Edna; Hassan, Ahmad; Torgovicky, Rafael; Cohen, Raanan; Hayek, Tony



In-patient medical resource utilization for high-level cervical spinal cord injury without bone fracture in Taiwan  

Microsoft Academic Search

Study design:Retrospective review of secondary data obtained from the Bureau of National Health Insurance (BNHI) on medical resource utilization in in-patient cervical spinal cord injury patients in Taiwan.Objectives:Since the start of the National Health Insurance Program in Taiwan in 1995, costs have continued to increase each year. High-level cervical spinal cord injury, a catastrophic illness, consumes a large amount of

J-C Tsai; W-Y Chang; I-H Hsueh; M-C Yang; W-T Chiu; W-S Huang; S-S Huang



Prolonged QTc Interval and High B-Type Natriuretic Peptide Levels Together Predict Mortality in Patients With Advanced Heart Failure  

Microsoft Academic Search

Background—The role of QTc interval prolongation in heart failure remains poorly defined. To better understand it, we analyzed the QTc interval duration in patients with heart failure with high B-type natriuretic peptide (BNP) levels and analyzed the combined prognostic impact of prolonged QTc and elevated BNP. Methods and Results—QTc intervals were measured in 241 patients with heart failure who had

Bojan Vrtovec; Reynolds Delgado; Aly Zewail; Cynthia D. Thomas; Barbara M. Richartz; Branislav Radovancevic



The Population Genetics of Pseudomonas aeruginosa Isolates from Different Patient Populations Exhibits High-Level Host Specificity  

PubMed Central

Objective To determine whether highly prevalent P. aeruginosa sequence types (ST) in Dutch cystic fibrosis (CF) patients are specifically linked to CF patients we investigated the population structure of P. aeruginosa from different clinical backgrounds. We first selected the optimal genotyping method by comparing pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST) and multilocus variable number tandem-repeat analysis (MLVA). Methods Selected P. aeruginosa isolates (n?=?60) were genotyped with PFGE, MLST and MLVA to determine the diversity index (DI) and congruence (adjusted Rand and Wallace coefficients). Subsequently, isolates from patients admitted to two different ICUs (n?=?205), from CF patients (n?=?100) and from non-ICU, non-CF patients (n?=?58, of which 19 were community acquired) were genotyped with MLVA to determine distribution of genotypes and genetic diversity. Results Congruence between the typing methods was >79% and DIs were similar and all >0.963. Based on costs, ease, speed and possibilities to compare results between labs an adapted MLVA scheme called MLVA9-Utrecht was selected as the preferred typing method. In 363 clinical isolates 252 different MLVA types (MTs) were identified, indicating a highly diverse population (DI ?=?0.995; CI ?=?0.993–0.997). DI levels were similarly high in the diverse clinical sources (all >0.981) and only eight genotypes were shared. MTs were highly specific (>80%) for the different patient populations, even for similar patient groups (ICU patients) in two distinct geographic regions, with only three of 142 ICU genotypes detected in both ICUs. The two major CF clones were unique to CF patients. Conclusion The population structure of P. aeruginosa isolates is highly diverse and population specific without evidence for a core lineage in which major CF, hospital or community clones co-cluster. The two genotypes highly prevalent among Dutch CF patients appeared unique to CF patients, suggesting specific adaptation of these clones to the CF lung.

van Mansfeld, Rosa; Jongerden, Irene; Bootsma, Martin; Buiting, Anton; Bonten, Marc; Willems, Rob



The importance of social comparisons for high levels of subjective quality of life in chronic schizophrenic patients  

Microsoft Academic Search

In schizophrenic patients, quality of life (QoL) studies often find high levels of general life satisfaction and satisfaction\\u000a in various life domains despite deprived living conditions. Therefore, the usefulness of QoL as an outcome indicator has been\\u000a questioned. Since social comparison processes have been postulated to be related to the level of satisfaction, this hypothesis\\u000a was analysed empirically by the

Michael Franz; Thorsten Meyer; Tilman Reber; Bernd Gallhofer



Serological levels of mutated p53 protein are highly detected at early stages in breast cancer patients  

PubMed Central

The aim of this study was to compare the sensitivity of the serological level of anti-p53 antibodies in breast cancer patients and to correlate its expression level with patient age, histological stage and grade of tumor differentiation. Total p53 protein expression (mutant and wild-type) was also determined in the breast cancer tissues using immunohistochemistry (IHC). The serological levels of mutant p53 expression were found to be age-dependent, reaching the highest level at 50 years of age. Faint or low detection was observed in patients ?30 years of age. Anti-p53-antibodies were detected in patients ?40 and ?61 years of age. The serological levels of mutant p53 protein were highly detected in all stages of breast cancer, including the early stages. However, anti-p53 antibodies reached a high level of detection only in stage III breast carcinomas. No expression was found in patients with benign breast disease. The detection of p53 mutations was dependent on the grade of tumor differentiation, achieving the highest level in the poorly differentiated breast carcinomas. Results from IHC were highly correlated with serological p53 mutational analysis. Our findings indicate that mutant p53 in serum is a promising novel parameter for the evaluation of cellular biology and the prognosis of breast cancer from its early stages using blood samples. Anti-p53 antibodies were demonstrated to be less sensitive in this study. It is also possible to use the expression of mutant p53 protein as a molecular marker to differentiate benign breast disease from breast carcinoma prior to surgery.




Low-serum, high-density lipoprotein cholesterol concentration is an important coronary risk factor in chinese patients with low serum levels of total cholesterol and triglyceride  

Microsoft Academic Search

This study assessed low serum high-density lipoproteins concentrations with respect to coronary atherogenesis in Chinese patients with low levels of total serum cholesterol and triglyceride. Patients with this lipid profile pattern still have a high coronary risk factor.

Wen-Pin Lien; Ling-Ping Lai; Kou-Gi Shyu; Juey-Jen Hwang; Jin-Jer Chen; Meng-Huan Lei; Jun-Jack Cheng; Por-Jau Huang; Keh-Sung Tsai



A high serum level of eotaxin (CCL 11) is associated with less radiographic progression in early rheumatoid arthritis patients  

PubMed Central

Introduction Prognosis in rheumatoid arthritis (RA) is difficult to assess. The aim of this study was to examine whether serum levels of a spectrum of cytokines were predictive of radiographic progression in early RA patients. Methods A total of 82 early RA patients (disease duration < 1 year) were followed for 12 months. Clinical assessments, X-rays of hands and magnetic resonance imaging (MRI) of the dominant wrist were assessed at baseline and after 3, 6 and 12 months. The X-rays were scored according to the van der Heijde modified Sharp score (vdHSS). Cytokine analyses were performed with multiplex technology. Associations between cytokines and radiographic progression were examined by logistic regression. Results In all, 49% of the patients developed radiographic progression. The median (interquartile range (IQR)) baseline eotaxin level (pg/ml) was significantly lower in patients with (193 (119 to 247)) than without progression (265 (166 to 360)). In the univariate logistic regression analyses, eotaxin was negatively associated to radiographic progression, and this association was maintained in the multivariate model with an odds ratio (OR) (95% confidence interval (CI)) for progression of 0.58 (0.41 to 0.82) per 50 pg/ml increase in eotaxin level. None of the other measured cytokines showed any association to radiographic progression. Conclusion This study raises the hypothesis that high serum levels of eotaxin predict less radiographic progression in early RA patients.

Syversen, Silje W; Goll, Guro L; Haavardsholm, Espen A; B?yesen, Pernille; Lea, Tor; Kvien, Tore K



Health status improvement after surgical correction of primary hyperparathyroidism in patients with high and low preoperative calcium levels  

Microsoft Academic Search

Background: We conducted a prospective cohort study to determine whether there are differences in functional health status between patients with low (<10.9 mg\\/dL) and high (?10.9 mg\\/dL) serum calcium levels before surgical correction of primary hyperparathyroidism (HPT) and to compare changes in health status after correction of primary HPT. Methods: The SF-36 Health Survey, which provides demographic and condition-specific information,

Richard E. Burney; Katherine R. Jones; Barbara Christy; Norman W. Thompson



Calcium dobesilate reduces endothelin-1 and high-sensitivity C-reactive protein serum levels in patients with diabetic retinopathy  

PubMed Central

Purpose To determine the benefits of calcium dobesilate (CaD) administration on endothelial function and inflammatory status in patients with diabetic retinopathy through measurement of serum levels of endothelin-1 and high-sensitivity C-reactive protein (hsCRP). Methods In a double-blind, randomized clinical trial, 90 patients with either severe nonproliferative or proliferative diabetic retinopathy and with blood glucose level of 120–200 mg/dl were randomly allocated to treatment with either CaD tablets (500 mg daily) or placebo for 3 months. Visual acuity, intraocular pressure, and macular status were performed before the study. The serum levels of endothelin-1 and hsCRP were evaluated in both groups before and at the third month of the trial. Results The median serum level of hsCRP significantly differed between the groups 3 months following the CaD or placebo administration (2.2 mg/l in the CaD group versus 3.7 mg/l in the placebo group, p=0.01). The mean endothelin-1 serum level was 0.69±0.32 pg/ml in the CaD group and 0.86±0.30 pg/ml in the placebo group (p=0.01). Furthermore, in the CaD group, the serum levels of both endothelin-1 and hsCRP were significantly decreased 3 months after administration of CaD (p<0.001). Conclusions Administration of the CaD in the patients with diabetic retinopathy may reduce the serum levels of endothelin-1 and hsCRP. This might imply amelioration of the endothelial function and inflammatory status following CaD therapy in these patients.

Javadzadeh, Alireza; Ghorbanihaghjo, Amir; Adl, Farzad Hami; Andalib, Dima; Khojasteh-Jafari, Hassan



Postoperative transarterial chemoembolization benefits patients with high ?-glutamyl transferase levels after curative hepatectomy for hepatocellular carcinoma: a survival stratification analysis.  


Hepatocellular carcinoma (HCC) is the most common liver tumor in Asian countries, and hepatectomy is currently regarded as the optimal curative treatment for HCC; however, the postoperative outcome remains unsatisfactory. Aiming at further clarification of prognostic factors after hepatectomy, we adopted a detailed stratification on survival periods. A total of 428 HCC patients undergoing curative hepatectomy were firstly divided into two groups using 2-year survival as cutoff point. Multivariate analysis showed that tumor-related factors, including vascular invasion (P < 0.001), high Edmondson grade (P < 0.001), large tumor size (P < 0.001) and high serum alpha-fetoprotein level (P = 0.001), were significant determinants for early death within 2 years, while postoperative transarterial chemoembolization (TACE) was demonstrated a protective factor (P = 0.013). Then the 281 patients with survival > 2 years were divided into two subgroups according to survival or death during follow-up to examine the late death related factors. We found that high serum ?-glutamyl transpeptidase (GGT), indicating severity of underlying liver disease, was significantly linked to death in this stage (P = 0.006). In further comparison of survival rates between subgroups stratified by early- and late-death indictors, we found the long-term outcomes of patients with high serum GGT were poor, regardless of the factors related with primary tumor. Furthermore, postoperative TACE decreased late death rate of patients with high GGT levels. In conclusion, despite the overwhelmed effects of primary tumor in the early stage after hepatectomy, postoperative TACE is beneficial for HCC patients with poor liver status. PMID:22820835

Liu, Hansheng; Zhang, Aiqun; Qian, Niansong; Gao, Lijie; Xu, Lining; Zhang, Wenzhi; Jiang, Kai; Cai, Shouwang; Huang, Zhiqiang; Dong, Jiahong



Low vitamin D serum concentration is associated with high levels of hepatitis B virus replication in chronically infected patients.  


Vitamin D is an important immune modulator that plays an emerging role in inflammatory and metabolic liver diseases, including infection with hepatitis C virus (HCV). In contrast, the relationship between vitamin D metabolism and chronic hepatitis B (CHB) is less well characterized. Therefore, we quantified 25(OH)D3 serum levels in a cohort of 203 treatment-naďve patients with chronic hepatitis B virus (HBV) infection and tested for their association with clinical parameters of CHB. Of 203 patients, 69 (34%), 95 (47%), and 39 (19%) had severe vitamin D deficiency (25(OH)D3 <10 ng/mL), vitamin D insufficiency (25(OH)D3 ?10 and <20 ng/mL), or adequate vitamin D serum levels (25(OH)D3 ?20 ng/mL), respectively. In both uni- and multivariate analyses, HBV DNA viral load (log10 IU/mL) was a strong predictor of low 25(OH)D3 serum levels (P?=?0.0007 and P?=?0.000048, respectively) and vice versa. Mean 25(OH)D3 serum concentrations in patients with HBV DNA <2,000 versus ?2,000 IU/mL were 17 versus 11 ng/mL, respectively (P?patients had lower 25(OH)D3 serum levels than HBeAg-negative patients (P?=?0.0013). Finally, 25(OH)D3 and HBV DNA serum levels showed inverse seasonal fluctuations. Conclusion: Low 25(OH)D3 serum levels are associated with high levels of HBV replication in patients with CHB. This represents a major difference from chronic hepatitis C, where numerous previous studies have shown a lack of correlation between HCV viral load and vitamin D serum levels. Inverse seasonal fluctuations of 25(OH)D3 and HBV DNA serum levels are suggestive of a functional relationship between both variables. (Hepatology 2013;58:1270-1276). PMID:23703797

Farnik, Harald; Bojunga, Jörg; Berger, Annemarie; Allwinn, Regina; Waidmann, Oliver; Kronenberger, Bernd; Keppler, Oliver T; Zeuzem, Stefan; Sarrazin, Christoph; Lange, Christian M



Comparison of C-reactive protein and high-sensitivity C-reactive protein levels in patients on hemodialysis.  


Chronic inflammation is highly prevalent in patients on hemodialysis (HD), as evidenced by increased levels of C-reactive protein (CRP). We compared CRP to high-sensitivity C-reactive protein (hs-CRP) to determine whether it has any clinical implications and prognostic significance in terms of mortality. CRP was measured using a standard immunoturbidometric assay on the COBAS® INTEGRA system and hs-CRP was measured using the Dade Behring on the Konelab Nephelometer in 50 patients on HD. CRP (?6 mg/L) and hs-CRP (?3 mg/L) levels were elevated in 30% and 54% of the patients, respectively. A significant correlation was noted between hs-CRP and CRP levels (r = 0.98, P <0.001). Deming regression analysis showed that the slope was near one (r = 0.90; 0.83-0.94) and that the intercept was small. Multivariate regression confirmed that age above 40 years (RR = 3.69, P = 0.027) and duration on HD greater than five years (RR = 3.71, P = 0.028) remained significant independent predictors of serum hs-CRP. Thirteen patients died during follow-up (26%). Multivariate Cox regression demonstrated that hs-CRP (RR = 1.062, P = 0.03) and CRP levels (RR = 1.057, P = 0.009) and age (RR = 1.078, P = 0.001) were the most powerful predictors of mortality. The CRP standard assay presents a reasonable alternative to the hs-CRP assay in patients on HD. The advantages of the CRP standard assay are its online and real-time availability as well as lower costs, particularly in developing countries. PMID:22569431

Helal, Imed; Zerelli, Lilia; Krid, Madiha; ElYounsi, Fethi; Ben Maiz, Hedi; Zouari, Bechir; Adelmoula, Jaouida; Kheder, Adel



High levels of B-type natriuretic peptide predict weaning failure from mechanical ventilation in adult patients after cardiac surgery  

PubMed Central

OBJECTIVE: The failure to wean from mechanical ventilation is related to worse outcomes after cardiac surgery. The aim of this study was to evaluate whether the serum level of B-type natriuretic peptide is a predictor of weaning failure from mechanical ventilation after cardiac surgery. METHODS: We conducted a prospective, observational cohort study of 101 patients who underwent on-pump coronary artery bypass grafting. B-type natriuretic peptide was measured postoperatively after intensive care unit admission and at the end of a 60-min spontaneous breathing test. The demographic data, hemodynamic and respiratory parameters, fluid balance, need for vasopressor or inotropic support, and length of the intensive care unit and hospital stays were recorded. Weaning failure was considered as either the inability to sustain spontaneous breathing after 60 min or the need for reintubation within 48 h. RESULTS: Of the 101 patients studied, 12 patients failed the weaning trial. There were no differences between the groups in the baseline or intraoperative characteristics, including left ventricular function, EuroSCORE and lengths of the cardiac procedure and cardiopulmonary bypass. The B-type natriuretic peptide levels were significantly higher at intensive care unit admission and at the end of the breathing test in the patients with weaning failure compared with the patients who were successfully weaned. In a multivariate model, a high B-type natriuretic peptide level at the end of a spontaneous breathing trial was the only independent predictor of weaning failure from mechanical ventilation. CONCLUSIONS: A high B-type natriuretic peptide level is a predictive factor for the failure to wean from mechanical ventilation after cardiac surgery. These findings suggest that optimizing ventricular function should be a goal during the perioperative period.

Lara, Thiago Martins; Hajjar, Ludhmila Abrahao; de Almeida, Juliano Pinheiro; Fukushima, Julia Tizue; Barbas, Carmem Silvia Valente; Rodrigues, Adriano Rogerio Baldacin; Nozawa, Emilia; Feltrim, Maria Ignes Zanetti; Almeida, Elisangela; Coimbra, Vera; Osawa, Eduardo; de Moraes Ianotti, Rafael; Leme, Alcino Costa; Jatene, Fabio Biscegli; Auler-Jr., Jose Otavio Costa; Galas, Filomena Regina Barbosa Gomes



High level of serum AMBP is associated with poor response to paclitaxel-capecitabine chemotherapy in advanced gastric cancer patients.  


Gastric cancer is one of the most common human cancers and ranks the second in the global cancer-related mortality. The clinical outcome of patients with advanced gastric cancer (AGC) is markedly dependent on their response to the chemotherapy. Paclitaxel plus capecitabine, as a first-line regimen, is widely administrated in AGC patients, but more than a half of the patients have a poor response, possibly due to their resistance to the treatment. Therefore, it is important to identify potential responders to improve the efficacy of the chemotherapy. In the present study, we used an isobaric tag approach for relative and absolute quantification combined with ESI-QUAD-TOF/MS to identify potential predictive biomarkers for the chemotherapy. We found 211 serum proteins, and confirmed 17 candidates that were differentially present in the progression of disease (PD) group and the partial response (PR) group to the treatment of paclitaxel plus capecitabine. In further validation of the 17 candidates in the set of 12 PD and 12 PR AGC patients, we identified a higher level of AMBP (Alpha-1-Microglobulin/Bikunin Precursor) in the sera of PD patients than of the PR patients assayed by ELISA (9.13 ± 0.45 vs. 8.11 ± 0.26 ?g/mL, p = 0.06) and by the Western blotting (relative gray value 396.4 ± 39.1 vs. 275.0 ± 34.76, p = 0.03), respectively. The receiver operating characteristics curve showed 75 % sensitivity and 75 % specificity of AMBP in AGC patients treated with the chemotherapy. Our data indicated that the high level of serum AMBP could predict the poor response of the AGC patients treated with the paclitaxel-capecitabine chemotherapy, which could be used as a potential biomarker to identify patients who would benefit from this chemotherapeutic regimen. PMID:24135868

Huang, Hao; Han, Yong; Gao, Jing; Feng, Junnan; Zhu, Lei; Qu, Like; Shen, Lin; Shou, Chengchao



High potassium levels  


Hyperkalemia; Potassium - high ... The kidneys normally remove excess potassium from the body. High potassium levels are more likely to occur when the kidneys are not working properly and are less ...


Clinical manifestations in ten patients with asymptomatic metal-on-metal hip arthroplasty with very high cobalt levels.  


Reports of adverse reactions to metal particle debris with metal-on-metal (MoM) hip arthroplasty have increased recently. Apart from the formation of pseudotumours and higher revision rates, another major cause for concern are the systemic effects of metal ions. Several effects of elevated systemic cobalt ions have been reported (e.g. myocardial and neurological effects, hypothyroidism). All 643 patients who underwent a stemmed large head MoM total hip replacement in our clinic were screened with repeated whole blood samples of metal ions (cobalt, chromium). We included ten asymptomatic unrevised patients with the highest cobalt concentrations, determined at a minimum of three years after implantation. These patients were subjected to an extensive neurological and cardiological screening protocol. In addition, blood samples were taken to assess renal and thyroid function. Ten patients with a cobalt level of 18-153 µg/L (mean 46.8 µg/L) were included. Nine patients were female, mean age was 65 years (range 56-75). The mean follow-up period was 4.2 years (range 3.0-6.1). Seven patients had bilateral stemmed MoM hip arthroplasty. No signs or symptoms of neurological dysfunction, cardiomyopathy, or renal or thyroid dysfunction could be identified or attributed to elevated cobalt levels. The clinical relevance of this study is that after short-term follow-up highly elevated blood cobalt levels do not cause systemic effects in our population. Hence in asymptomatic patients metal ions appear not to be a significant factor in the decision of when to revise a MoM large head total hip replacement. PMID:23813157

van Lingen, Christiaan P; Ettema, Harmen B; Timmer, Jorik R; de Jong, Gosse; Verheyen, Cees C P M



High plasma endothelin-1 levels in hypertensive patients with low-renin essential hypertension  

Microsoft Academic Search

Endothelin-1 (ET-1) is a potent vasoconstrictor peptide derived from endothelial cells and may be important in the control of systemic blood pressure (BP) and local blood flow. Immunoreactive ET-1 plasma levels may be normal or elevated in human arterial hypertension, although the exact pathophysiological role of ET-1 remains to be established. The aim of our study was to determine the

C Letizia; S Cerci; G De Toma; C D’Ambrosio; A De Ciocchis; S Coassin; D Scavo



Increased cancer cell proliferation in prostate cancer patients with high levels of serum folate  

Technology Transfer Automated Retrieval System (TEKTRAN)

Introduction: A recent clinical trial revealed that folic acid supplementation is associated with an increased incidence of prostate cancer (1). The present study evaluates serum and prostate tissue folate levels in men with prostate cancer, compared to histologically normal prostate glands from can...


High salivary alpha-amylase levels in patients with schizophrenia: A pilot study  

Microsoft Academic Search

Previous studies have demonstrated the autonomic dysregulation in patients with schizophrenia using electrophysiological methods, such as electrodermal measures and heart rate analysis. Several theories have been proposed to explain the underlying mechanisms of schizophrenia and its autonomic function. Recently, the measurement of salivary alpha-amylase has been considered to be a useful tool for evaluating the sympathetic-adrenal-medullary (SAM) system. Psychosocial stress

Takuji Inagaki; Tsuyoshi Miyaoka; Shihoh Okazaki; Hideaki Yasuda; Tetsuya Kawamukai; Etsuko Utani; Rei Wake; Maiko Hayashida; Jun Horiguchi; Seiichi Tsuji



Histologic Disease in Patients with Chronic Hepatitis B, High HBV DNA, and Normal Alanine Aminotransferase Levels  

Microsoft Academic Search

Recent advances in the treatment of hepatitis B virus (HBV) infection have presented new options as well as challenges. Serum\\u000a alanine aminotransferase (ALT) continues to be one of the three principal parameters used by all existing treatment guidelines\\u000a to identify candidates for antiviral therapy. Although there is little controversy that inactive carriers and young immune\\u000a tolerant patients can be monitored

Joseph K. Lim; Walid S. Ayoub; Mindie H. Nguyen



High-level beta-lactamase activity in sputum samples from cystic fibrosis patients during antipseudomonal treatment.  

PubMed Central

The in vivo activity and source of beta-lactamase in sputum samples from 43 patients with cystic fibrosis (CF) during a 2-week antipseudomonal treatment were studied. A colorimetric method, based on the conversion of nitrocefin, was used for quantitation of the sputum beta-lactamase activity. beta-Lactamases in sputum were characterized by isoelectric focusing and inhibition profile and were compared with the beta-lactamases extracted from Pseudomonas aeruginosa isolated from the paired sputum samples. We found that the beta-lactamase activity increased to high levels in sputum from patients with CF during the course of piperacillin, ceftazidime, cefsulodin, or imipenem therapy. Aztreonam therapy lead to opposite results because the beta-lactamase activity decreased and aztreonam was able to mask beta-lactamase activity by acting as an inhibitor. All sputum beta-lactamases displayed characteristics indicative of a class I enzyme, identical to the beta-lactamases extracted from P. aeruginosa. The presence of beta-lactamase at such levels could lead to in vivo inactivation of beta-lactam antibiotics. This study supports the hypothesis that beta-lactamase production is an important in vivo resistance mechanism in P. aeruginosa-infected patients with CF.

Giwercman, B; Meyer, C; Lambert, P A; Reinert, C; H?iby, N



Molecular Analysis of HS111 and 3`HS1 Variations in ?-Thalassemia Intermedia Patients with High Levels of HbF  

Microsoft Academic Search

Objective: To study the possible association between high levels of fetal haemoglobin (HbF) in ?-thalassemia intermedia patients and HS-111 and 3`HS1 sequence variations. Materials and Methods: In this study, the 3' HS-1 and HS-111 regions of 30 ß-thalassae- mia intermedia patients (ß°\\/ß°) with high levels of HbF, 21 ß-thalassemia major patients and 40 normal Iranian individuals were analyzed by single-strand

Mohammad Hamid; Morteza Karimipoor; Sirous Zeinali; Mohammad taghi Akbari; Leila Kokabi; Frouzandeh Mahjoubi



High level nuclear waste  

SciTech Connect

The DOE Division of Waste Products through a lead office at Savannah River is developing a program to immobilize all US high-level nuclear waste for terminal disposal. DOE high-level wastes include those at the Hanford Plant, the Idaho Chemical Processing Plant, and the Savannah River Plant. Commercial high-level wastes, for which DOE is also developing immobilization technology, include those at the Nuclear Fuel Services Plant and any future commercial fuels reprocessing plants. The first immobilization plant is to be the Defense Waste Processing Facility at Savannah River, scheduled for 1983 project submission to Congress and 1989 operation. Waste forms are still being selected for this plant. Borosilicate glass is currently the reference form, but alternate candidates include concretes, calcines, other glasses, ceramics, and matrix forms.

Crandall, J L



[Study of a cohort of patients with Enterococcus spp. Bacteraemia. Risk factors associated to high-level resistance to aminoglycosides].  


Objectives. To analyze a cohort of patients with Enterococcus sp. bacteraemia. Patients and methods. Retrospective and observational study of a cohort of non-pediatric in-patients with Enterococcus spp. bacteraemia (June 2007-September 2009). Data collection from clinical records was done according to a standard protocol. We analyzed epidemiological, clinical and microbiological data. Treatment with glycopeptides in non allergic patients or in case of betalactam susceptibility (ampicillin) was considered "optimizable". Results. Three were 106 cases of bacteraemia (2.2/1000 admitted patients; 84% E. faecalis); 83% had an underlying condition; 88% nosocomial or health related cases. Urinary infection was present in 20% and primary bacteraemia in 47%. High level resistance to gentamicin (HLRG) was present in 60%; there was no vancomycin or linezolid resistance. Most frequent empiric treatments were penicillin-betalactamase inhibitor (25%) and glycopeptides (22%). Most frequent definitive treatment was glycopeptides (34%), being "optimized" 21% and 44% of empiric and definitive treatments, respectively. Mortality was 23% (related, 14%). In the multivariate analysis, risk factors associated with HLRG were nosocomial acquired infection (OR 6.083; 95CI% 1.428-25.915) and no-abdominal origin (OR 6.006; 95CI%1.398-25.805). In multivariate analysis, independent risk factors for mortality were: Pitt > 3 (OR 14.405; 95CI%2.236-92.808) and active empiric treatment (OR 8.849; 95CI% 1.101-71.429). Incidence in previous cohort was similar but HLRG rate has increased. Conclusions. Risk factors associated with HLRG were nosocomial acquired infection and no-abdominal origin. Risk factors for mortality were initial clinical severity and having received active empiric treatment. HLRG rate has increased. PMID:24080886

García-Vázquez, E; Albendín, H; Hernández-Torres, A; Canteras, M; Yagüe, G; Ruiz, J; Gómez, J



Resolution of Tracheostomy Complications by Decanulation and Conversion to Noninvasive Management for a Patient With High-Level Tetraplegia  

PubMed Central

Objectives: To report conversion from tracheostomy (TIV) to noninvasive intermittent positive pressure ventilation (NIV) for a continuously ventilator-dependent patient with high-level spinal cord injury (SCI) with no measurable vital capacity (VC = 0 mL) to resolve tracheostomy-associated complications. Methods: A case report of a 38-year-old female in a chronic care facility in Japan with a 10-year history of ventilator-dependent tetraplegia (C1 ASIA-A) presented for increasing difficulty vocalizing. She had been using a fenestrated cuffed tracheostomy tube to produce speech with the cuff deflated. Speech was increasingly hypophonic, because of tracheostoma enlargement, tube migration, and tracheal granulation. Results: The NIV was provided via nasal and oral interfaces, the ostomy was surgically closed, and vocalization resumed. Airway secretions were expulsed using manually assisted coughing. The patient returned to the community. Conclusion: Conversion to NIV should be considered for ventilator-dependent patients with SCI who have adequate bulbar-innervated muscle function to permit effective speech and assisted coughing.

Toki, Akiko; Hanayama, Kozo; Ishikawa, Yuka



A Decrease in AFP Level Related to Administration of Interferon in Patients with Chronic Hepatitis C and a High Level of AFP  

Microsoft Academic Search

It is known that there is a very high incidence of hepatocellular carcinoma (HCC) among patients with type C chronic hepatitis\\u000a and cirrhosis, and ? -fetoprotein (AFP) has been widely used as a diagnostic marker for HCC. However, there are some patients\\u000a showing continuous high AFP values but no evidence of HCC, and some studies have defined such patients as

Shiro Murashima; Masatoshi Tanaka; Makoto Haramaki; Shigeru Yutani; Yutaka Nakashima; Kazunori Harada; Tatsuya Ide; Ryukichi Kumashiro; Michio Sata



[Vancomycin and high-level aminoglycoside resistant Enterococcus carriage and the risk factors related to resistance in hospitalized patients].  


The aims of this study were to detect the prevalence of fecal vancomycin resistant Enterococcus (VRE) colonization with high-level resistance to aminoglycoside and other antibiotics and, the risk factors related to resistance in hospitalized patients in Düzce Medical Faculty Hospital, Turkey. A total of 105 patients (61 from internal medicine, 44 from surgery clinics; 54.3% female, mean age: 47.2 +/- 24.54 years) were included to the study and a single stool sample was collected from each of the patients. Specimens were cultivated in Enterococcus selective media (BioMerieux, France), and the isolates were identified by conventional microbiological methods together with the API 20 Strep test. Beta-lactamase activities of the isolates were tested with nitrocefin disk, and antibiotic susceptibilities were determined by the disk diffusion method. Enterococcus spp. were isolated from 81 (77%) of the patients' samples and 60.5% were identified as E. faecium, 13.6% as E. faecalis, 11.1% as E. gallinarum, 7.4% as E. durans, 2.5% as E. raffinosus, 2.5% as E. mundtii, 1.2% as E. casseliflavus, and 1.2% as E. avium. High-level streptomycin and gentamicin resistance rates were found in 19.8% and 9.9% of the isolates, respectively. The resistance rates for the other antibiotics were found as follows; 18.5% to ampicillin, 27.2% to penicilin, 34.6% to nitrofurantoin, 65.4% to norfloxacin, and 70.4% to both tetracycline and ciprofloxacin. No vancomycin resistance was detected, and none of the enterococci had beta-lactamase activity. Long hospitalization period, antibiotic usage and experience of intra-abdominal operation were found as the significant risk factors for colonization of the resistant bacteria. Our results demonstrated that there was no fecal VRE carriage in our hospital during the study period, however, it was concluded that the screening tests should be done periodically in order to detect resistant strains as soon as possible. PMID:17682714

Yildirim, Mustafa; Sencan, Irfan; Ozdemir, Davut; Oksüz, Sükrü; Yilmaz, Zeynep; Sahin, Idris



High level perinuclear antineutrophil cytoplasmic antibody (pANCA) in ulcerative colitis patients before colectomy predicts the development of chronic pouchitis after ileal pouch-anal anastomosis  

PubMed Central

BACKGROUND—The reported cumulative risk of developing pouchitis in ulcerative colitis (UC) patients undergoing ileal pouch-anal anastomosis (IPAA) approaches 50% after 10 years. To date, no preoperative serological predictor of pouchitis has been found.?AIMS—To assess whether preoperative perinuclear antineutrophil cytoplasmic antibody (pANCA) expression was associated with acute and/or chronic pouchitis after IPAA.?METHODS—Patients were prospectively assessed for the development of clinically and endoscopically proved pouchitis. Serum obtained at the time of colectomy in 95 UC patients undergoing IPAA was analysed for pANCA by ELISA and indirect immunofluorescence. pANCA+ patients were stratified into high level (>100 ELISA units (EU)/ml) (n=9), moderate level (40-100 EU/ml) (n=32), and low level (<40 EU/ml) (n=19) subgroups.?RESULTS—Sixty of the 95 patients (63%) expressed pANCA. After a median follow up of 32 months (range 1-89), 32 patients (34%) developed either acute (n=14) or chronic (n=18) pouchitis. Pouchitis was seen in 42% of pANCA+ patients compared with 20% of pANCA? patients (p=0.09). There was no significant difference in the incidence of acute pouchitis between the three pANCA+ patient subgroups. The cumulative risk of developing chronic pouchitis among patients with high level pANCA (56%) before colectomy was significantly higher than in patients with medium level (22%), low level (16%), and those who were pANCA? (20%) (p=0.005). Multivariate analysis revealed that the sole parameter significantly associated with the development of chronic pouchitis after IPAA was the presence of high level pANCA before colectomy (p=0.005).?CONCLUSION—High level pANCA before colectomy is significantly associated with the development of chronic pouchitis after IPAA.???Keywords: pouchitis; perinuclear antineutrophil cytoplasmic antibody; inflammatory bowel disease; ulcerative colitis; ileal pouch-anal anastomosis

Fleshner, P; Vasiliauskas, E; Kam, L; Fleshner, N; Gaiennie, J; Abreu-Martin, M; Targan, S



Psychiatric Symptoms and Community Violence among High-Risk Patients: A Test of the Relationship at the Weekly Level  

ERIC Educational Resources Information Center

|Given the availability of violence risk assessment tools, clinicians are now better able to identify high-risk patients. Once these patients have been identified, clinicians must monitor risk state and intervene when necessary to prevent harm. Clinical practice is dominated by the assumption that increases in psychiatric symptoms elevate risk of…

Skeem, Jennifer L.; Schubert, Carol; Odgers, Candice; Mulvey, Edward P.; Gardner, William; Lidz, Charles



High Level of Anticholesterol Antibodies (ACHA) in HIV Patients. Normalization of Serum ACHA Concentration after Introduction of HAART  

Microsoft Academic Search

Anticholesterol antibodies (ACHA) are natural antibodies against the 3?-OH group of cholesterol. Since lipid disorders are common in HIV infection and HAART may further enhance dislipidaemia, we determined by using an ELISA method serum ACHA concentrations in HIV patients and healthy HIV-seronegative controls.ACHA levels were almost 4 times higher in the sera of 46 patients than in 110 controls. No

Anna Horváth; Dénes Bánhegyi; Adrien BíRó; Eszter Ujhelyi; Amarilla Veres; Laura Horváth; Zoltán Prohászka; Attila Bácsi; Vera Tarján; László Romics; István Horváth; Ferenc D. Tóth; George Füst; István Karádi



High Telomerase Reverse Transcriptase (hTERT) Messenger RNA Level Correlates with Tumor Recurrence in Patients with Favorable Histology Wilms' Tumor1  

Microsoft Academic Search

Telomerase is a reverse transcriptase that maintains chromosome ends, compensating for the progressive loss of DNA that occurs during replica- tion. High telomerase enzyme activity is an unfavorable prognostic feature for several types of cancers. We investigated whether telomerase level predicts outcome for patients with the pediatric renal malignancy Wilms' tumor. In a case-cohort study of 78 patients with favorable

Jeffrey S. Dome; Seung Chung; Tracy Bergemann; Christopher B. Umbricht; Motoyasu Saji; Lisa A. Carey; Paul E. Grundy; Elizabeth J. Perlman; Norman E. Breslow; Saraswati Sukumar


High levels of carbonic anhydrase IX in tumour tissue and plasma are biomarkers of poor prognostic in patients with non-small cell lung cancer  

PubMed Central

Background: Carbonic anhydrase IX (CAIX) is an enzyme upregulated by hypoxia during tumour development and progression. This study was conducted to assess if the expression of CAIX in tumour tissue and/or plasma can be a prognostic factor in patients with non-small cell lung cancer (NSCLC). Methods: Tissue microarrays containing 555 NSCLC tissue samples were generated for quantification of CAIX expression. The plasma level of CAIX was determined by ELISA in 209 of these NSCLC patients and in 58 healthy individuals. The CAIX tissue immunostaining and plasma levels were correlated with clinicopathological factors and patient outcome. Results: CAIX tissue overexpression correlated with shorter overall survival (OS) (P=0.05) and disease-specific survival (DSS) of patients (P=0.002). The CAIX plasma level was significantly higher in patients with NSCLC than in healthy individuals (P<0.001). A high level of CAIX in the plasma of patients was associated with shorter OS (P<0.001) and DSS (P<0.001), mostly in early stage I+II NSCLC. Multivariate Cox analyses revealed that high CAIX tissue expression (P=0.002) was a factor of poor prognosis in patients with resectable NSCLC. In addition, a high CAIX plasma level was an independent variable predicting poor OS (P<0.001) in patients with NSCLC. Conclusion: High expression of CAIX in tumour tissue is a predictor of worse survival, and a high CAIX plasma level is an independent prognostic biomarker in patients with NSCLC, in particular in early-stage I+II carcinomas.

Ilie, M; Mazure, N M; Hofman, V; Ammadi, R E; Ortholan, C; Bonnetaud, C; Havet, K; Venissac, N; Mograbi, B; Mouroux, J; Pouyssegur, J; Hofman, P



High serum levels of soluble CD40-L in patients with undifferentiated nasopharyngeal carcinoma: pathogenic and clinical relevance  

Microsoft Academic Search

BACKGROUND: Engagement of CD40 promotes survival of undifferentiated nasopharyngeal carcinoma (UNPC) cells and similar effects are induced by the EBV oncoprotein LMP-1 that is expressed in a fraction of cases. Considering that CD40 may be activated also by the soluble isoform of CD40L (sCD40L), we investigated the serum levels of sCD40L in a series of 61 UNPC patients from Italy,

Laura Caggiari; Massimo Guidoboni; Emanuela Vaccher; Luigi Barzan; Giovanni Franchin; Annunziata Gloghini; Debora Martorelli; Paola Zancai; Maria Teresa Bortolin; Mario Mazzucato; Diego Serraino; Antonino Carbone; Paolo De Paoli; Riccardo Dolcetti



Effects of valsartan\\/ hydrochlorothiazide and amlodipine on ambulatory blood pressure and plasma norepinephrine levels in high-risk hypertensive patients  

Microsoft Academic Search

The efficacy and tolerability of the combination of valsartan and hydrochlorothi-azide (HCTZ) were compared with that of amlodipine\\u000a in reducing ambulatory blood pressure and plasma norepinephrine levels in patients with mild to moderate hypertension and\\u000a at least 1 cardiovascular risk factor. At the end of a 2-week washout period, 92 outpatients with a sitting diastolic blood\\u000a pressure ?95 and <110

Ettore Malacco; Simona Piazza; Luciana Scandiani; Annalisa Zoppi



Presence of High Levels of Leukocyte-Associated Interleukin8 upon Cell Activation and in Patients with Sepsis Syndrome  

Microsoft Academic Search

In inflammatory and infectious diseases, the presence of circulating cytokines in plasma strongly suggests, following their exacerbated production, that saturation of specific binding sites has occurred or that an equilibrium between receptor-bound and free cytokines has been reached. In this report, we demonstrate that in addition to circulating interleukin-8 (IL-8), high levels of cell-associated IL-8 were detected in blood samples



Lipoprotein (a) levels in those with high molecular weight apo (a) isoforms may remain low in a significant proportion of patients with end-stage renal disease  

Microsoft Academic Search

Background. Studies have reported an increase in median Lipoprotein (Lp) (a) in patients with high molecular weight (HMW) apolipoprotein (apo) (a) isoforms and renal impairment. Some studies identify Lp (a) levels as a risk factor for vascular disease in renal failure whilst others have demonstrated an association with apo (a) isoform type and vascular disease. Methods. A total of 239

Darren S. Parsons; David A. Reaveley; Darrell V. Pavitt; Madhukar Misra; Edwina A. Brown


Elevated serum high-sensitivity C-reactive protein levels in fibromyalgia syndrome patients correlate with body mass index, interleukin-6, interleukin-8, erythrocyte sedimentation rate.  


The levels of several inflammatory cytokines are abnormal in many patients with the fibromyalgia syndrome (FMS) and may play a role in its pathogenesis. The inflammatory marker C-reactive protein (CRP) is associated with the disease activity in patients with inflammatory rheumatic diseases, but its role in FMS is unknown. We undertook this study to determine whether high-sensitivity CRP (hsCRP) is elevated in FMS and whether its levels relate to key biologic or clinical measures. One hundred and five patients with FMS (1990 ACR criteria) and 61 healthy normal controls (HNC) at a ratio of 2:1 were recruited. The serum concentrations of hsCRP, interleukin-8 (IL-8), and interleukin-6 (IL-6) were assessed using enzyme-linked immunosorbent assays. The hsCRP levels were marginally higher in FMS than in HNC (p = 0.06) and its abnormality rate (>1.5 SD above the HNC mean) was significantly higher in FMS (25 %) compared with HNC (6.8 %) (p = 0.03). Serum IL-8 levels, IL-6 levels, and erythrocyte sedimentation rate (ESR) in FMS did not differ from those in HNC. Body mass index (BMI), ESR, IL-8, and IL-6 levels correlated with hsCRP levels in FMS. No associations were found between hsCRP and age, gender, ethnicity, or other clinical measures. Serum CRP levels were higher in FMS and significantly correlated with BMI, ESR, IL-8, and IL-6 levels, suggesting that inflammation may contribute to the symptoms in some FMS patients, particularly those who are obese. Weight loss and therapies directed against inflammation may be useful in the management of FMS patients with elevated hsCRP. PMID:23124693

Xiao, Yangming; Haynes, Wanda L; Michalek, Joel E; Russell, I Jon



A patient with acute lymphoblastic leukaemia presenting with an extremely high level (21.0%) of HbA(1c).  


A 52-year-old Japanese woman was referred to our hospital because of fever and coxalgia. She had a white blood cell count of 241 × 10(2)/?L with 59.6% blasts, which had a high nuclear/cytoplasmic ratio and variably condensed nuclear chromatin. Flow cytometry and chromosomal analysis of bone marrow cells indicated positive findings of CD10, CD19, CD34, HLA-DR antigens and t(9; 22)(q34; q11.2), respectively. No rearrangements of bcr/abl in peripheral blood neutrophils were found by fluorescence in situ hybridization, suggesting that she had B-acute lymphoblastic leukaemia with Ph chromosome. Blood glucose and HbA(1c) (glycated haemoglobin) levels on admission were 23.4 mmol/L and 21.0%, respectively. The results of 1.5 anhydro-d-glucitol and glycoalbumin tests revealed that she certainly had diabetes mellitus (DM). Insulin therapy was initiated. Her high level of HbA(1c) also suggested the possibility that the patient suffered from haemoglobinopathies in addition to DM. Sequencing analyses of ?1-, ?2- and ?-globin genes were all normal. The patient achieved complete remission (CR) by one month after her first course of chemotherapy, and the HbA(1c) level decreased to 10.4% following insulin therapy and chemotherapy, which were initiated when she attained CR. Her extremely high HbA(1c) level was due mainly to DM. Also, suppression of erythropoiesis by proliferation of leukaemic cells and latent iron deficiency might have partially contributed to the increased HbA(1c). This could result in a transient but extremely high HbA(1c) level. To our knowledge, this is the first report of an acute leukaemia patient who expressed an extremely high level of HbA(1c). PMID:21606072

Suzuki, Yuhko; Shichishima, Tsutomu; Yamashiro, Yasuhiro; Kimura, Hirokazu; Ishii, Ryuuji; Miyazaki, Koji; Horie, Ryouichi; Moriya, Tatsumi; Hattori, Yukio



Elevated PCSK9 Levels in Untreated Patients With Heterozygous or Homozygous Familial Hypercholesterolemia and the Response to High-Dose Statin Therapy  

PubMed Central

Background Proprotein convertase subtilisin kexin type 9 (PCSK9) is an enzyme that impairs low?density lipoprotein cholesterol (LDL?C) clearance from the plasma by promoting LDL receptor degradation. Patients with familial hypercholesterolemia (FH) have reduced or absent LDL receptors and should therefore have elevated PCSK9 levels. Methods and Results Fasting lipograms and PCSK9 levels were measured 51 homozygous FH (HoFH), 20 heterozygous FH (HeFH), and 20 normocholesterolemic control subjects. Levels were repeated following high?dose statin therapy. LDL?C levels were significantly higher in untreated HoFH (13.4±0.7 mmol/L) and HeFH patients (7.0±0.2 mmol/L) compared with controls (2.6±0.1 mmol/L) (P<0.01). Statin therapy decreased LDL?C levels from 13.4±0.7 to 11.1±0.7 mmol/L in HoFH and from 7.0±0.2 to 3.6±0.2 mmol/L in HeFH patients (P<0.01). PCSK9 levels were higher in untreated HoFH (279±27 ng/mL) and HeFH (202±14 ng/mL) than in controls (132±10 ng/mL) (both P<0.01). High?dose statin therapy increased PCSK9 levels from 279±27 to 338±50 ng/mL in HoFH, and significantly so in the HeFH patients from 202±14 to 278±20 ng/mL (P<0.01). Linear regression analysis showed a correlation between PCSK9 and LDL?C (r=0.6769; P<0.0001); however, this was eliminated following statin therapy (r=0.2972; P=0.0625). Conclusions PCSK9 levels are elevated in untreated FH patients, particularly in those with HoFH. High?dose statin therapy further increases PCSK9 levels. PCSK9 inhibitors might be a beneficial therapy for FH patients, even in those with HoFH.

Raal, Frederick; Panz, Vanessa; Immelman, Andrew; Pilcher, Gillian



Estimating patient-level nursing home costs.  

PubMed Central

This article presents a methodology developed to estimate patient-level nursing home costs. Such estimates are difficult to obtain because most cost data for nursing homes are available from Medicare or Medicaid cost reports, which provide only average values per patient-day across all patients (or all of a particular payer's patients). The methodology presented in this article yields "resource consumption" (RC) measures of the variable cost of nursing staff care incurred in treating individual nursing home patients. Results from the application of the methodology are presented, using data collected in 1980 on a sample of 961 nursing home patients in 74 Colorado nursing homes. This type of approach could be used to link nursing home payments to the care needs of individual patients, thus improving the overall equity of the payment system and possibly reducing the access barriers facing especially Medicaid patients with high-cost care needs.

Schlenker, R E; Shaughnessy, P W; Yslas, I



High Retention in Care Among HIV-Infected Patients Entering Care With CD4 Levels >350 cells/?L Under Routine Program Conditions in Uganda.  


Background.?In Africa, human immunodeficiency virus (HIV)-infected patients who present to care with CD4 levels >350 cells/µL (ie, current antiretroviral treatment thresholds) are often thought to be poorly retained in care, but most estimates do not account for outcomes among patients lost to follow-up. Methods.?We evaluated HIV-infected adults who had made a visit in the last 2.5 years in a program in Uganda. We identified a random sample of patients lost to follow-up (9 months without a visit). Ascertainers sought patients in the community in this sample and outcomes were incorporated into revised survival estimates of mortality and retention for the clinic population using a probability weight. Results.?Of 6473 patients, (29% male, median age 29 years, median CD4 count 550 cells/µL), 1294 (20%) became lost to follow-up over 2.5 years. Two hundred seven (16%) randomly selected lost patients were sought, and in 175 (85%) vital status was ascertained. In 19 of 175 (11%), the patient had died. Of the 156 (89%) alive, 74 (47%) were interviewed in person, and 38 of 74 (51%) reported HIV care elsewhere, whereas 36 of 74 (49%) were not in care. Application of weights derived from sampling found that at 2.5 years, retention among patients who enrolled with CD4 levels >350 cells/µL was 88.2% and mortality was 2.5%. Lower income, unemployment, and rural residence were associated with failure to be retained. Conclusions.?Retention in patients entering care with high CD4 counts under routine program conditions in Africa is high in a Ugandan care program and may be systematically underestimated in many other settings. PMID:23899683

Namusobya, Jennifer; Semitala, Fred C; Amanyire, Gideon; Kabami, Jane; Chamie, Gabriel; Bogere, John; Jain, Vivek; Clark, Tamara D; Charlebois, Edwin; Havlir, Diane V; Kamya, Moses; Geng, Elvin H



Preemptive alloimmune intervention in high-risk pediatric acute lymphoblastic leukemia patients guided by minimal residual disease level before stem cell transplantation.  


Relapse of pediatric acute lymphoblastic leukemia (ALL) remains the main cause of treatment failure after allogeneic stem cell transplantation (alloSCT). A high level of minimal residual disease (MRD) before alloSCT has been shown to predict these relapses. Patients at risk might benefit from a preemptive alloimmune intervention. In this first prospective, MRD-guided intervention study, 48 patients were stratified according to pre-SCT MRD level. Eighteen children with MRD level >or=1 x 10(-4) were eligible for intervention, consisting of early cyclosporine A tapering followed by consecutive, incremental donor lymphocyte infusions (n=1-4). The intervention was associated with graft versus host disease >or=grade II in only 23% of patients. Event-free survival in the intervention group was 19%. However, in contrast with the usual early recurrence of leukemia, relapses were delayed up to 3 years after SCT. In addition, several relapses presented at unusual extramedullary sites suggesting that the immune intervention may have altered the pattern of leukemia recurrence. In 8 out of 11 evaluable patients, relapse was preceded by MRD recurrence (median 9 weeks, range 0-30). We conclude that in children with high-risk ALL, immunotherapy-based regimens after SCT are feasible and may need to be further intensified to achieve total eradication of residual leukemic cells. PMID:20535148

Lankester, A C; Bierings, M B; van Wering, E R; Wijkhuijs, A J M; de Weger, R A; Wijnen, J T; Vossen, J M; Versluys, B; Egeler, R M; van Tol, M J D; Putter, H; Révész, T; van Dongen, J J M; van der Velden, V H J; Schilham, M W



Cholinergic Anti-Inflammatory Pathway Activity and High Mobility Group Box-1 (HMGB1) Serum Levels in Patients with Rheumatoid Arthritis  

PubMed Central

High Mobility Group Box-1 (HMGB1) is a cytokine implicated in the pathogenesis of rheumatoid arthritis (RA) and other inflammatory diseases. The cholinergic anti-inflammatory pathway, a vagus nerve-dependent mechanism, inhibits HMGB1 release in experimental disease models. Here, we examine the relationship between vagus nerve activity and HMGB1 in patients with RA. We compared RR interval variability, an index of cardiac vagal modulation, HMGB1 and hsCRP serum levels, and disease activity scores in thirteen RA patients and eleven age- and sex-matched controls. In RA patients, serum levels of HMGB1 and hsCRP were elevated as compared with controls (HMGB1 = 71 ng/mL [45–99] vs. 18 ng/mL [0–40], P < 0.0001; hsCRP = 14.5 mg/L [0.7–59] vs. 1 mg/L [0.4–2.9], P < 0.001). RR interval variability in RA patients was significantly decreased as compared with controls (HF = 38 msec2 [14–80] vs. 288 msec2 [38–364], P < 0.0001; rMSSD = 20.9 ± 9.79 msec, 52.6 ± 35.3 msec, P < 0.01). HMGB1 levels and RR interval variability were significantly related (rho = ?0.49, P < 0.01). HMGB1 serum levels significantly correlated with disease activity scores (DAS-28) in patients with RA (P = 0.004). The study design does not enable a determination of causality, but the results are consistent with the hypothesis that decreased cholinergic anti-inflammatory pathway activity is associated with increased HMGB1 levels in patients with RA.

Goldstein, Richard S; Bruchfeld, Annette; Yang, Lihong; Qureshi, Abdul R; Gallowitsch-Puerta, Margot; Patel, Nirav B; Huston, Brett J; Chavan, Sangeeta; Rosas-Ballina, Mauricio; Gregersen, Peter K; Czura, Christopher J; Sloan, Richard P; Sama, Andrew E; Tracey, Kevin J



High-level expression of the Smad ubiquitin ligase Smurf2 correlates with poor prognosis in patients with esophageal squamous cell carcinoma.  


Transforming growth factor beta (TGF-beta) regulates growth of various cells, and inactivation of the TGF-beta signaling pathway contributes to tumor progression. Smad2 is phosphorylated and activated by TGF-beta, resulting in the antiproliferative effects of TGF-beta signaling. Smurf2 (Smad ubiquitination regulatory factor 2) was identified as the Smad ubiquitin ligase that induces the ubiquitination and degradation of Smad2. This study was undertaken to elucidate the relationships between Smurf2 expression and the clinicopathological characteristics of patients with esophageal squamous cell carcinoma (SCC) and the correlation between Smurf2 and Smad2 expression. Surgical specimens obtained from 80 patients with esophageal SCC were subjected to immunohistochemical staining. Our data indicated that high-level expression of Smurf2 correlated with depth of invasion, lymph node metastasis, and a poor survival rate. We also found an inverse correlation between the expression of Smurf2 and Smad2. Western blotting analysis of esophageal SCC-derived cell lines revealed similar inverse correlations. We demonstrated that high-level expression of Smurf2 appears to correlate with tumor development and poor prognosis in patients with esophageal SCC and that alteration of Smad2 expression in the TGF-beta signaling pathway may be induced by enhancement of Smad2 degradation mediated by high-level expression of Smurf2. PMID:12499250

Fukuchi, Minoru; Fukai, Yasuyuki; Masuda, Norihiro; Miyazaki, Tatsuya; Nakajima, Masanobu; Sohda, Makoto; Manda, Ryokuhei; Tsukada, Katsuhiko; Kato, Hiroyuki; Kuwano, Hiroyuki



Pro-Con Debate: Steroid use in ACTH non-responsive septic shock patients with high baseline cortisol levels  

Microsoft Academic Search

Steroid use in critically ill, vasopressor-dependant, septic patients has gained increased acceptance in recent years with the publication of encouraging data. However, with renewed interest and\\/or attention comes increased debate and analysis. As a result, it is not surprising to find that there is still significant controversy with regards to the role of steroids in many patients. In this article,

Djillali Annane; Eddy Fan; Margaret S Herridge



High Serum YKL-40 Levels in Patients with Primary Breast Cancer is Related to Short Recurrence Free Survival  

Microsoft Academic Search

YKL-40 is a growth factor for connective tissue cells and stimulates migration of endothelial cells. YKL-40 is secreted by cancer cells, and elevated serum YKL-40 in patients with metastatic breast cancer and colorectal cancer is associated with a poorer prognosis as compared to patients with normal serum YKL-40. In the present study we evaluated the associations of preoperative serum YKL-40

Julia S. Johansen; Ib J. Christensen; Rikke Riisbro; Michael Greenall; Chen Han; Paul A. Price; Kenneth Smith; Nils Brünner; Adrian L. Harris



Improved Preservation of Residual Beta Cell Function by Atorvastatin in Patients with Recent Onset Type 1 Diabetes and High CRP Levels (DIATOR Trial)  

PubMed Central

Background A recent randomized placebo-controlled trial of the effect of atorvastatin treatment on the progression of newly diagnosed type 1 diabetes suggested a slower decline of residual beta cell function with statin treatment. Aim of this secondary analysis was to identify patient subgroups which differ in the decline of beta cell function during treatment with atorvastatin. Methodology/Principal Findings The randomized placebo-controlled Diabetes and Atorvastatin (DIATOR) Trial included 89 patients with newly diagnosed type 1 diabetes and detectable islet autoantibodies (mean age 30 years, 40% females), in 12 centers in Germany. Patients received placebo or 80 mg/d atorvastatin for 18 months. As primary outcome stimulated serum C-peptide levels were determined 90 min after a standardized liquid mixed meal. For this secondary analysis patients were stratified by single baseline characteristics which were considered to possibly be modified by atorvastatin treatment. Subgroups defined by age, sex or by baseline metabolic parameters like body mass index (BMI), total serum cholesterol or fasting C-peptide did not differ in C-peptide outcome after atorvastatin treatment. However, the subgroup defined by high (above median) baseline C-reactive protein (CRP) concentrations exhibited higher stimulated C-peptide secretion after statin treatment (p?=?0.044). Individual baseline CRP levels correlated with C-peptide outcome in the statin group (r2?=?0.3079, p<0.004). The subgroup with baseline CRP concentrations above median differed from the corresponding subgroup with lower CRP levels by higher median values of BMI, IL-6, IL-1RA, sICAM-1 and E-selectin. Conclusions/Significance Atorvastatin treatment may be effective in slowing the decline of beta cell function in a patient subgroup defined by above median levels of CRP and other inflammation associated immune mediators. Trial Registration NCT00974740

Martin, Stephan; Herder, Christian; Simon, Marie-Christine; Koenig, Wolfgang; Heise, Tim; Heinemann, Lutz; Roden, Michael; Schloot, Nanette C.



Relation of high-sensitivity C-reactive protein level with coronary vasospastic angina pectoris in patients without hemodynamically significant coronary artery disease.  


We prospectively investigated the relation of high-sensitivity C-reactive protein (hs-CRP) to coronary vasospasm and no hemodynamically significant coronary artery disease (CAD) in a sample of 428 patients who underwent coronary angiography. These patients were assigned to 1 of 3 groups. The control group consisted of 66 patients who had no coronary vasospasm and no hemodynamically significant CAD. The vasospasm group consisted of 116 patients who had coronary vasospasm and no hemodynamically significant CAD. The acute coronary syndrome (ACS) group consisted of 246 patients who had ACS and hemodynamically significant CAD. Serum hs-CRP was measured immediately before coronary angiography. Patients were followed for subsequent cardiac events and mortality. Median hs-CRP levels in the control, vasospasm, and ACS groups were 1.0, 5.5, and 8.2 mg/L, respectively. The proportion of hs-CRP increased from the lowest to the highest tertile in the control, vasospasm, and ACS groups, respectively. In the control and vasospasm groups, multivariate analysis showed that hs-CRP was independently associated with a diagnosis of coronary vasospastic angina pectoris (odds ratio 68.74, 95% confidence interval 8.03 to 588.71, p<0.001). During a median follow-up period of 26 months (range 0.4 to 48), 27 cardiac deaths occurred in the ACS group, whereas no cardiac death occurred in the control and vasospasm groups. In conclusion, serum hs-CRP level measured immediately before coronary angiography was an independent marker of coronary vasospasm in patients who had no hemodynamically significant CAD. PMID:16310426

Hung, Ming-Jui; Cherng, Wen-Jin; Yang, Ning-I; Cheng, Chi-Wen; Li, Li-Fu



Symptomatic hypoglycemia related to inappropriately high igf-ii serum levels in a patient with desmoplastic small round cell tumor.  


A 45-year old man was diagnosed with desmoplastic small round cell tumor (DSRCT) with involvement of the peritoneum and pelvis. Disease progression was observed despite systemic chemotherapy. Six months after diagnosis, he developed severe hypoglycemia presented with seizures. He received intravenous glucose infusion and hydrocortisone with poor glycemic control, but with seizures resolution. The investigation excluded insulinoma, adrenal, liver and GH deficiencies. Laboratory showed slight rise of IGF-II and significant increase of the ratio IGF-II : IGF-I, which is pathognomonic of non-islet cell tumor hypoglycemia (NICTH). He received the diagnoses of NICTH related to IGF-II inappropriate production by DSRCT. Despite the attempt to control tumor mass and hypoglycemia, the patient died 9 months after diagnosis. NICTH related to inappropriate IGF-II secretion should be investigated in all cancer patients with refractory hypoglycemia whom insulinoma and other metabolic abnormalities were excluded from. PMID:20592985

Barra, Williams Fernandes; Castro, Gilberto; Hoff, Ana Oliveira; Siqueira, Sheila A C; Hoff, Paulo M



Symptomatic Hypoglycemia Related to Inappropriately High IGF-II Serum Levels in a Patient with Desmoplastic Small Round Cell Tumor  

PubMed Central

A 45-year old man was diagnosed with desmoplastic small round cell tumor (DSRCT) with involvement of the peritoneum and pelvis. Disease progression was observed despite systemic chemotherapy. Six months after diagnosis, he developed severe hypoglycemia presented with seizures. He received intravenous glucose infusion and hydrocortisone with poor glycemic control, but with seizures resolution. The investigation excluded insulinoma, adrenal, liver and GH deficiencies. Laboratory showed slight rise of IGF-II and significant increase of the ratio IGF-II : IGF-I, which is pathognomonic of non-islet cell tumor hypoglycemia (NICTH). He received the diagnoses of NICTH related to IGF-II inappropriate production by DSRCT. Despite the attempt to control tumor mass and hypoglycemia, the patient died 9 months after diagnosis. NICTH related to inappropriate IGF-II secretion should be investigated in all cancer patients with refractory hypoglycemia whom insulinoma and other metabolic abnormalities were excluded from.

Barra, Williams Fernandes; Castro, Gilberto; Hoff, Ana Oliveira; Siqueira, Sheila A. C.; Hoff, Paulo M.



Ankylosing Spondylitis Patients Commencing Biologic Therapy Have High Baseline Levels of Comorbidity: A Report from the Australian Rheumatology Association Database  

PubMed Central

Aims. To compare the baseline characteristics of a population-based cohort of patients with ankylosing spondylitis (AS) commencing biological therapy to the reported characteristics of bDMARD randomised controlled trials (RCTs) participants. Methods. Descriptive analysis of AS participants in the Australian Rheumatology Association Database (ARAD) who were commencing bDMARD therapy. Results. Up to December 2008, 389 patients with AS were enrolled in ARAD. 354 (91.0%) had taken bDMARDs at some time, and 198 (55.9%) completed their entry questionnaire prior to or within 6 months of commencing bDMARDs. 131 (66.1%) had at least one comorbid condition, and 24 (6.8%) had a previous malignancy (15 nonmelanoma skin, 4 melanoma, 2 prostate, 1 breast, cervix, and bowel). Compared with RCT participants, ARAD participants were older, had longer disease duration and higher baseline disease activity. Conclusions. AS patients commencing bDMARDs in routine care are significantly different to RCT participants and have significant baseline comorbidities.

Oldroyd, John; Schachna, Lionel; Buchbinder, Rachelle; Staples, Margaret; Murphy, Bridie; Bond, Molly; Briggs, Andrew; Lassere, Marissa; March, Lyn



The Effects of Panax Ginseng on Lipid Profile, Pro-oxidant: Antioxidant Status and High-sensitivity C Reactive Protein Levels in Hyperlipidemic Patients in Iran  

PubMed Central

Background: Because of the conflicting results from previous studies regarding the efficacy of ginseng on lipid profile and anti-inflammatory and anti-proliferative activities of its components, we aimed to evaluate the effects of Panax ginseng on lipid profile, pro-oxidant – anti-oxidant status and high-sensitivity C reactive protein (hs-CRP) levels. Methods: Forty Iranian hyperlipidemic patients were randomly assigned to placebo (n = 20) or control (n = 20) groups in this double-blind randomized controlled trial. The ginseng or placebo was taken two capsules twice a day for 8 weeks. Total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), fasting blood glucose, serum creatinine and hs-CRP levels and pro-oxidant – anti-oxidant balance (PAB) were estimated before and after intervention. Results: There were no significant differences between the two groups with respect to changes in serum TG, LDL-C, HDL-C, and TC/HDL-C levels. Nor were there significant differences between the two groups with respect to changes in hs-CRP level and PAB from baseline to week 8. Conclusions: Our study demonstrates that ginseng does not have significant effects on lipid profile, Hs-CRP level and PAB. Further clinical studies, with a larger sample size, more prolonged period of therapy are needed to investigate the therapeutic effects of ginseng.

Delui, Mahdy Hassanzadeh; Fatehi, Hedayatollah; Manavifar, Morteza; Amini, Maral; Ghayour-Mobarhan, Majid; Zahedi, Mahdi; Ferns, Gordon



Low albumin levels and high impedance ratio as risk factors for worsening kidney function during hospitalization of decompensated heart failure patients  

PubMed Central

BACKGROUND: Patients hospitalized for decompensated heart failure (DHF) frequently experience worsening of renal function (WRF), leading to volume overload and resistance to diuretics. OBJECTIVE: To investigate whether albumin levels and whole-body impedance ratio, as an indicator of water distribution, were associated with WRF in patients with DHF. Methods: A total of 80 patients hospitalized for DHF were consecutively included in the present longitudinal study. WRF during hospitalization was defined as an increase of ?0.3 mg/dL (?26.52 ?mol/L) or 25% of baseline serum creatinine. Clinical and echocardiographic characteristics were assessed at baseline. Whole-body bioelectrical impedance was measured using tetrapolar and multiple-frequency equipment to obtain the ratio of impedance at 200 kHz to that at 5 kHz. Serum albumin levels were also evaluated. Baseline characteristics were compared between patients with and without deteriorating renal function using a t test or ?2 test. Subsequently, a logistic regression analysis was performed to obtain the independent variables associated with WRF. RESULTS: The incidence of WRF during hospitalization was 26%. Independent risk factors associated with WRF were low serum albumin (RR=0.11; P=0.04); impedance ratio >0.85 (RR=5.3; P=0.05), systolic blood pressure >160 mmHg (RR=12; P=0.02) and maximum dose of continuous intravenous furosemide required >80 mg/day during hospitalization (RR=5.7, P=0.015). CONCLUSIONS: WRF is frequent in patients with DHF. It results from the inability to effectively regulate volume status because hypoalbuminemia induces water loss from the vascular space (high impedance ratio), and high diuretic doses lower circulatory volumes and reduce renal blood flow, leading to a decline in renal filtration function.

Valdespino-Trejo, Adrian; Orea-Tejeda, Arturo; Castillo-Martinez, Lilia; Keirns-Davis, Candace; Montanez-Orozco, Alvaro; Ortiz-Suarez, Gerson; Delgado-Perez, D Alejandro; Marquez-Zepeda, Bianka



Plasminogen activator inhibitor-2 polymorphism associates with recurrent coronary event risk in patients with high HDL and C-reactive protein levels.  


The objective of this work was to investigate whether fibrinolysis plays a role in establishing recurrent coronary event risk in a previously identified group of postinfarction patients. This group of patients was defined as having concurrently high levels of high-density lipoprotein cholesterol (HDL-C) and C-reactive protein (CRP) and was previously demonstrated to be at high-risk for recurrent coronary events. Potential risk associations of a genetic polymorphism of plasminogen activator inhibitor-2 (PAI-2) were probed as well as potential modulatory effects on such risk of a polymorphism of low-density lipoprotein receptor related protein (LRP-1), a scavenger receptor known to be involved in fibrinolysis in the context of cellular internalization of plasminogen activator/plansminogen activator inhibitor complexes. To this end, Cox multivariable modeling was performed as a function of genetic polymorphisms of PAI-2 (SERPINB, rs6095) and LRP-1 (LRP1, rs1800156) as well as a set of clinical parameters, blood biomarkers, and genetic polymorphisms previously demonstrated to be significantly and independently associated with risk in the study population including cholesteryl ester transfer protein (CETP, rs708272), p22phox (CYBA, rs4673), and thrombospondin-4 (THBS4, rs1866389). Risk association was demonstrated for the reference allele of the PAI-2 polymorphism (hazard ratio 0.41 per allele, 95% CI 0.20-0.84, p=0.014) along with continued significant risk associations for the p22phox and thrombospondin-4 polymorphisms. Additionally, further analysis revealed interaction of the LRP-1 and PAI-2 polymorphisms in generating differential risk that was illustrated using Kaplan-Meier survival analysis. We conclude from the study that fibrinolysis likely plays a role in establishing recurrent coronary risk in postinfarction patients with concurrently high levels of HDL-C and CRP as manifested by differential effects on risk by polymorphisms of several genes linked to key actions involved in the fibrinolytic process. PMID:23874812

Corsetti, James P; Salzman, Peter; Ryan, Dan; Moss, Arthur J; Zareba, Wojciech; Sparks, Charles E



High pressure liquid level monitor  


A liquid level monitor for tracking the level of a coal slurry in a high-pressure vessel including a toroidal-shaped float with magnetically permeable bands thereon disposed within the vessel, two pairs of magnetic field generators and detectors disposed outside the vessel adjacent the top and bottom thereof and magnetically coupled to the magnetically permeable bands on the float, and signal processing circuitry for combining signals from the top and bottom detectors for generating a monotonically increasing analog control signal which is a function of liquid level. The control signal may be utilized to operate high-pressure control valves associated with processes in which the high-pressure vessel is used.

Bean, Vern E. (Frederick, MD); Long, Frederick G. (Ijamsville, MD)



Expression levels of induced sputum IL-8 and IL-10 and drug intervention effects in patients with acute exacerbated COPD complicated with chronic cor pulmonale at high altitude  

PubMed Central

The aim of this study was to assess the expression levels of induced sputum interleukin (IL)-8 and IL-10 levels in patients with acute exacerbated chronic obstructive pulmonary disease (AECOPD) complicated with chronic cor pulmonale (CCP) at high altitude, and to evaluate the intervention effects of an inhaled corticosteroid (ICS) and a ?2-adrenoceptor agonist in this disease. A total of 186 patients with AECOPD complicated with CCP were randomly divided into three groups, with 62 cases in each. With regard to the two treatment groups, group A was treated with salmeterol/fluticasone (50 ?g/250 ?g, respectively) by airway inhalation twice daily, while group B received budesonide (1 mg) as a spray inhalation, twice daily. The routine treatment group (group C) received only routine treatment. The levels of IL-8 and IL-10 in the induced sputum and the predicted percentage of forced expiratory volume in one second (FEV1%pred), partial pressure of oxygen in arterial blood (PaO2) and partial pressure of carbon dioxide in arterial blood (PaCO2) were examined on admission and at a stable stage two weeks following treatment. Forty healthy volunteers served as a control group (group D). Compared with group D values, the IL-8 induced sputum level and the PaCO2 were significantly increased, while the level of IL-10, FEV1%pred and the PaO2 were markedly decreased in the three COPD groups prior to treatment. Following treatment, the induced sputum IL-8 level and the PaCO2 were significantly decreased, while the induced sputum IL-10 level, FEV1%pred and the PaO2 were markedly increased in the three treatment groups compared with the values pre-therapy (all P<0.01). The post-treatment parameters were significantly different among the three groups (P<0.01). The results indicate that IL-8 and IL-10 are involved in the airway inflammation of AECOPD complicated by CCP. Treatment with an ICS was demonstrated to be a successful method of reducing the local expression of IL-8 and increasing the local expression of IL-10; however, ICS combined with a long-acting ?2-adrenoceptor agonist (LABA) was more effective than the sole administration of ICS in patients with AECOPD complicated by CCP at high altitude.




Molecular analysis of gamma-globin promoters, HS-111 and 3'HS1, in beta-thalassemia intermedia patients associated with high levels of Hb F.  


The nucleotide (nt) variations in the promoter region of the gamma-globin genes, HS-111 and 3'HS1 regions, were studied in Iranian patients with beta-thalassemia intermedia (beta-TI), beta-thalassemia major (beta-TM) and healthy individuals. Of the five nt variations at the 5' end of the (A)gamma-globin gene, -369 (C>G), -611 (-T) and -603/604 (GA>AG) were found in all samples, whereas -588 (A>G) and -AAGC at -222 to -225 were found at different frequencies in the studied groups. Therefore, the -369, -611 and -603/604 variations were considered common mutations in this population, and the difference with respect to the -AAGC deletion was not significant. However, the A allele of the -588 variation and [+] allele of the XmnI polymorphism were more frequent in beta-TI patients, especially those who had the IVS-II-1(G>A)/IVS-II-1(G>A) genotype. The + allele of XmnI also had complete correlation with the A allele of -588 variation. The HS-111 (-21 A) variation also showed association with beta-TI patients who had high levels of Hb F. Bearing in mind that the -588 variation lies within the postulated adult-specific silencer region and that the majority of beta-TI patients had allele A, then it can be envisaged that this allele could have a role in altering the repressor function at this region. Therefore, the A allele of -588, [+] allele of XmnI and HS-111 (-21 A) variation are useful genetic markers to differentiate between beta-TM and beta-TI patients. However, these nt changes alone may not be the only elements raising the level of Hb F, other regulatory and modifying factors also play a role in Hb F production. PMID:19958188

Hamid, Mohammad; Mahjoubi, Frouzandeh; Akbari, Mohammad T; Arab, Aida; Zeinali, Sirous; Karimipoor, Morteza



High-Level Radioactive Waste.  

ERIC Educational Resources Information Center

|Presents a method to calculate the amount of high-level radioactive waste by taking into consideration the following factors: the fission process that yields the waste, identification of the waste, the energy required to run a 1-GWe plant for one year, and the uranium mass required to produce that energy. Briefly discusses waste disposal and…

Hayden, Howard C.



High risk plaque, high risk patient or high risk procedure?  


SAPPHIRE, a randomised trial of endarterectomy versus angioplasty in 'high-risk' patients, concluded that angioplasty was 'not inferior' to surgery. This has subsequently been translated to mean that angioplasty was 'preferable' or 'advisable' in patients considered high-risk for surgery, with no further discrimination between symptomatic and asymptomatic individuals. Moreover, there have been suggestions that the accepted procedural risks may have to be increased in these patients. In fact, 71% of patients in SAPPHIRE were asymptomatic in whom there was an average 6% 30-day death/stroke rate. At this level of risk, neither surgery nor angioplasty could ever prevent long-term stroke. The concept of identifying high-risk patients is laudable, but they should be high risk for stroke (i.e. symptomatic). There is currently little systematic evidence to include asymptomatic patients within this definition. PMID:16870479

Naylor, A R; Golledge, J



Can high serum anti-M?llerian hormone levels predict the phenotypes of polycystic ovary syndrome (PCOS) and metabolic disturbances in PCOS patients?  

PubMed Central

Objective To evaluate correlations between serum anti-Müllerian hormone (AMH) levels, phenotypes of polycystic ovary syndrome (PCOS), obesity, and metabolic parameters in patients with PCOS. Methods A total of 175 patients with PCOS were diagnosed according to the Rotterdam Consensus were included. Exclusion criteria were age over 40, FSH>25 mIU/mL, and 17a-OHP>1.5 ng/mL. The Phenotypes of PCOS were divided into a severe form (oligo-anovulation, ANOV/hyperandrogenism/polycystic ovary morphology [PCOM]; n=59) and a mild form without HA (ANOV/PCOM, n=105). The serum AMH levels were classified into 3 groups (<5 vs. 5-10 vs. >10 ng/mL). Obesity was defined as body mass index (BMI) ?25 kg/m2 (n=34). Results The mean age was 25.9±5.7 year and mean AMH level was 10.1±5.4 ng/mL. The BMI (kg/m2) was higher in group 1 (24.2±6.3) than in group 2 (21.9±4.3, p=0.046) or group 3 (21.6±3.3, p=0.019). There was no difference among the three groups in age, menstrual interval, antral follicle counts, androgens, or other metabolic parameters. The obesity group showed significantly lower AMH (7.7±3.9 ng/mL vs. 10.7±5.6 ng/mL), p=0.004) and low-density lipoprotein levels (93.1±21.2 mg/dL vs. 107.5±39.3 mg/dL, p=0.031), and showed higher total T (0.74±0.59 ng/mL vs. 0.47±0.36 ng/mL, p=0.001), free T (2.01±1.9 vs. 1.04±0.8 pg/mL, p=0.0001), and free androgen index (6.2±7.9 vs. 3.5±3.0, p=0.003). After controlling for age factors and BMI, the serum AMH levles did not show any significant correlations with other hormonal or metabolic parmeters. Conclusion For PCOS patients under the age 40, serum AMH is not negatively correlated with age. High serum AMH levels can not predict the phenotype of PCOS and metabolic disturbances in PCOS patients in the non-obese group. Further study might be needed to define the relation more clearly.

Hwang, Yu Im; Sung, Na Young; Koo, Hwa Seon; Cha, Sun Hwa; Park, Chan Woo; Kim, Jin Yeong; Yang, Kwang Moon; Song, In Ok; Koong, Mi Kyoung; Kang, Inn Soo



An evaluation of serum soluble CD30 levels and serum CD26 (DPPIV) enzyme activity as markers of type 2 and type 1 cytokines in HIV patients receiving highly active antiretroviral therapy.  


This study evaluates serum CD26 (dipeptidyl peptidase IV, DPPIV) enzyme activity and serum levels of soluble CD30 as markers of T1 and T2 cytokine environments in HIV patients who achieved immune reconstitution after highly active antiretroviral therapy (HAART). Patients who had experienced inflammatory disease associated with pre-existent opportunistic infections after HAART (immune restoration diseases, IRD) were considered separately. Serum sCD30 levels and CD26 (DPPIV) enzyme activity were compared with IFN-gamma production by PBMC cultured with cytomegalovirus (CMV) antigen in controls and patient groups. High sCD30 levels were associated with low IFN-gamma production after antigenic stimulation in control subjects and, to a lesser extent, in immune reconstituted HIV patients. There was no association between serum CD26 (DPPIV) enzyme activity and IFN-gamma production or sCD30 levels. Serum sCD30 levels and CD26 (DPPIV) enzyme activity were significantly increased in immune reconstituted patients with high HIV viral loads. Patients who had experienced CMV retinitis as an IRD had significantly higher sCD30 levels than all other patient groups. Hence, high sCD30 levels may be a marker of a T2 cytokine environment in HIV patients with immune reconstitution and are associated with higher HIV viral loads and a history of CMV associated IRD. PMID:11678906

Keane, N M; Price, P; Lee, S; Stone, S F; French, M A



Vancomycin-resistant vanB-type Enterococcus faecium isolates expressing varying levels of vancomycin resistance and being highly prevalent among neonatal patients in a single ICU  

PubMed Central

Background Vancomycin-resistant isolates of E. faecalis and E. faecium are of special concern and patients at risk of acquiring a VRE colonization/infection include also intensively-cared neonates. We describe here an ongoing high prevalence of VanB type E. faecium in a neonatal ICU hardly to identify by routine diagnostics. Methods During a 10?months’ key period 71 E. faecium isolates including 67 vanB-type isolates from 61 patients were collected non-selectively. Vancomycin resistance was determined by different MIC methods (broth microdilution, Vitek® 2) including two Etest® protocols (McFarland 0.5/2.0. on Mueller-Hinton/Brain Heart Infusion agars). Performance of three chromogenic VRE agars to identify the vanB type outbreak VRE was evaluated (BrillianceTM VRE agar, chromIDTM VRE agar, CHROMagarTM VRE). Isolates were genotyped by SmaI- and CeuI-macrorestriction analysis in PFGE, plasmid profiling, vanB Southern hybridisations as well as MLST typing. Results Majority of vanB isolates (n?=?56, 79%) belonged to a single ST192 outbreak strain type showing an identical PFGE pattern and analyzed representative isolates revealed a chromosomal localization of a vanB2-Tn5382 cluster type. Vancomycin MICs in cation-adjusted MH broth revealed a susceptible value of ?4?mg/L for 31 (55%) of the 56 outbreak VRE isolates. Etest® vancomycin on MH and BHI agars revealed only two vanB VRE isolates with a susceptible result; in general Etest® MIC results were about 1 to 2 doubling dilutions higher than MICs assessed in broth and values after the 48?h readout were 0.5 to 1 doubling dilutions higher for vanB VRE. Of all vanB type VRE only three, three and two isolates did not grow on BrillianceTM VRE agar, chromIDTM VRE agar and CHROMagarTM VRE, respectively. Permanent cross contamination via the patients’ surrounding appeared as a possible risk factor for permanent VRE colonization/infection. Conclusions Low level expression of vanB resistance may complicate a proper routine diagnostics of vanB VRE and mask an ongoing high VRE prevalence. A high inoculum and growth on rich solid media showed the highest sensitivity in identifying vanB type resistance.



Determination of imatinib plasma levels in patients with chronic myeloid leukemia by high performance liquid chromatography-ultraviolet detection and liquid chromatography-tandem mass spectrometry: methods' comparison.  


The aims of this study were to validate and compare HPLC and LCMSMS analytical methods and their applicability for the quantitation of imatinib in human plasma. A total of 50 patients with chronic myeloid leukemia (CML) in chronic phase (CP) receiving 400 mg/day imatinib were enrolled in the study. Drug levels were determined by HPLC-UV and LCMSMS. HPLC intra-day accuracy ranged from 100.51 to 103.19%. LCMSMS accuracy ranged from 89.72 to 106.29%. The correlation coefficient between both methods was r(2)=0.96. HPLC can be used for imatinib levels' determinations in patients accurately and precisely. PMID:19744707

Awidi, Abdalla; Salem, Isam I; Najib, Naji; Mefleh, Razan; Tarawneh, Bothainah



Low MAD2 expression levels associate with reduced progression-free survival in patients with high-grade serous epithelial ovarian cancer.  


Epithelial ovarian cancer (EOC) has an innate susceptibility to become chemoresistant. Up to 30% of patients do not respond to conventional chemotherapy [paclitaxel (Taxol®) in combination with carboplatin] and, of those who have an initial response, many patients relapse. Therefore, an understanding of the molecular mechanisms that regulate cellular chemotherapeutic responses in EOC cells has the potential to impact significantly on patient outcome. The mitotic arrest deficiency protein 2 (MAD2), is a centrally important mediator of the cellular response to paclitaxel. MAD2 immunohistochemical analysis was performed on 82 high-grade serous EOC samples. A multivariate Cox regression analysis of nuclear MAD2 IHC intensity adjusting for stage, tumour grade and optimum surgical debulking revealed that low MAD2 IHC staining intensity was significantly associated with reduced progression-free survival (PFS) (p = 0.0003), with a hazard ratio of 4.689. The in vitro analyses of five ovarian cancer cell lines demonstrated that cells with low MAD2 expression were less sensitive to paclitaxel. Furthermore, paclitaxel-induced activation of the spindle assembly checkpoint (SAC) and apoptotic cell death was abrogated in cells transfected with MAD2 siRNA. In silico analysis identified a miR-433 binding domain in the MAD2 3' UTR, which was verified in a series of experiments. Firstly, MAD2 protein expression levels were down-regulated in pre-miR-433 transfected A2780 cells. Secondly, pre-miR-433 suppressed the activity of a reporter construct containing the 3'-UTR of MAD2. Thirdly, blocking miR-433 binding to the MAD2 3' UTR protected MAD2 from miR-433 induced protein down-regulation. Importantly, reduced MAD2 protein expression in pre-miR-433-transfected A2780 cells rendered these cells less sensitive to paclitaxel. In conclusion, loss of MAD2 protein expression results in increased resistance to paclitaxel in EOC cells. Measuring MAD2 IHC staining intensity may predict paclitaxel responses in women presenting with high-grade serous EOC. PMID:22069160

Furlong, Fiona; Fitzpatrick, Patricia; O'Toole, Sharon; Phelan, Sine; McGrogan, Barbara; Maguire, Aoife; O'Grady, Anthony; Gallagher, Michael; Prencipe, Maria; McGoldrick, Aloysius; McGettigan, Paul; Brennan, Donal; Sheils, Orla; Martin, Cara; W Kay, Elaine; O'Leary, John; McCann, Amanda



Low MAD2 expression levels associate with reduced progression-free survival in patients with high-grade serous epithelial ovarian cancer  

PubMed Central

Epithelial ovarian cancer (EOC) has an innate susceptibility to become chemoresistant. Up to 30% of patients do not respond to conventional chemotherapy [paclitaxel (Taxol®) in combination with carboplatin] and, of those who have an initial response, many patients relapse. Therefore, an understanding of the molecular mechanisms that regulate cellular chemotherapeutic responses in EOC cells has the potential to impact significantly on patient outcome. The mitotic arrest deficiency protein 2 (MAD2), is a centrally important mediator of the cellular response to paclitaxel. MAD2 immunohistochemical analysis was performed on 82 high-grade serous EOC samples. A multivariate Cox regression analysis of nuclear MAD2 IHC intensity adjusting for stage, tumour grade and optimum surgical debulking revealed that low MAD2 IHC staining intensity was significantly associated with reduced progression-free survival (PFS) (p = 0.0003), with a hazard ratio of 4.689. The in vitro analyses of five ovarian cancer cell lines demonstrated that cells with low MAD2 expression were less sensitive to paclitaxel. Furthermore, paclitaxel-induced activation of the spindle assembly checkpoint (SAC) and apoptotic cell death was abrogated in cells transfected with MAD2 siRNA. In silico analysis identified a miR-433 binding domain in the MAD2 3? UTR, which was verified in a series of experiments. Firstly, MAD2 protein expression levels were down-regulated in pre-miR-433 transfected A2780 cells. Secondly, pre-miR-433 suppressed the activity of a reporter construct containing the 3?-UTR of MAD2. Thirdly, blocking miR-433 binding to the MAD2 3? UTR protected MAD2 from miR-433 induced protein down-regulation. Importantly, reduced MAD2 protein expression in pre-miR-433-transfected A2780 cells rendered these cells less sensitive to paclitaxel. In conclusion, loss of MAD2 protein expression results in increased resistance to paclitaxel in EOC cells. Measuring MAD2 IHC staining intensity may predict paclitaxel responses in women presenting with high-grade serous EOC. Copyright © 2012 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

Furlong, Fiona; Fitzpatrick, Patricia; O'Toole, Sharon; Phelan, Sine; McGrogan, Barbara; Maguire, Aoife; O'Grady, Anthony; Gallagher, Michael; Prencipe, Maria; McGoldrick, Aloysius; McGettigan, Paul; Brennan, Donal; Sheils, Orla; Martin, Cara; W Kay, Elaine; O'Leary, John; McCann, Amanda



MicroRNA array and microarray evaluation of endometrial receptivity in patients with high serum progesterone levels on the day of hCG administration  

Microsoft Academic Search

Background  To determine the effect of higher progesterone (P) level on endometrial receptivity.\\u000a \\u000a \\u000a \\u000a Methods  This was a prospective analysis conducted in the Reproductive Medical Center of Peking University Third Hospital. All patients\\u000a received IVF treatment and canceled embryo transfer in the same cycle and were divided into group 1 (normal P; 7 patients)\\u000a and group 2 (elevated P; 12 patients). Endometrial biopsies

Rong Li; Jie Qiao; Lina Wang; Li Li; Xiumei Zhen; Ping Liu; Xiaoying Zheng



High levels of soluble VEGF receptor 1 early after trauma are associated with shock, sympathoadrenal activation, glycocalyx degradation and inflammation in severely injured patients: a prospective study  

PubMed Central

Background The level of soluble vascular endothelial growth factor receptor 1 (sVEGFR1) is increased in sepsis and strongly associated with disease severity and mortality. Endothelial activation and damage contribute to both sepsis and trauma pathology. Therefore, this study measured sVEGFR1 levels in trauma patients upon hospital admission hypothesizing that sVEGFR1 would increase with higher injury severity and predict a poor outcome. Methods Prospective observational study of 80 trauma patients admitted to a Level I Trauma Centre. Data on demography, biochemistry, Injury Severity Score (ISS), transfusions and 30-day mortality were recorded and plasma/serum (sampled a median of 68 min (IQR 48-88) post-injury) was analyzed for sVEGFR1 and biomarkers reflecting sympathoadrenal activation (adrenaline, noradrenaline), tissue injury (histone-complexed DNA fragments, hcDNA), endothelial activation and damage (von Willebrand Factor Antigen, Angiopoietin-2, soluble endothelial protein C receptor, syndecan-1, soluble thrombomodulin (sTM)), coagulation activation/inhibition and fibrinolysis (prothrombinfragment 1 + 2, protein C, activated Protein C, tissue-type plasminogen activator, plasminogen activator inhibitor-1, D-dimer) and inflammation (interleukin-6). Spearman correlations and regression analyses to identify variables associated with sVEGFR1 and its predictive value. Results Circulating sVEGFR1 correlated with injury severity (ISS, rho = 0.46), shock (SBE, rho = -0.38; adrenaline, rho = 0.47), tissue injury (hcDNA, rho = 0.44) and inflammation (IL-6, rho = 0.54) (all p < 0.01) but by multivariate linear regression analysis only lower SBE and higher adrenaline and IL-6 were independent predictors of higher sVEGFR1. sVEGFR1 also correlated with biomarkers indicative of endothelial glycocalyx degradation (syndecan-1, rho = 0.67), endothelial cell damage (sTM, rho = 0.66) and activation (Ang-2, rho = 0.31) and hyperfibrinolysis (tPA, rho = 0.39; D-dimer, rho = 0.58) and with activated protein C (rho = 0.31) (all p < 0.01). High circulating sVEGFR1 correlated with high early and late transfusion requirements (number of packed red blood cells (RBC) at 1 h (rho = 0.27, p = 0.016), 6 h (rho = 0.27, p = 0.017) and 24 h (rho = 0.31, p = 0.004) but was not associated with mortality. Conclusions sVEGFR1 increased with increasing injury severity, shock and inflammation early after trauma but only sympathoadrenal activation, hypoperfusion, and inflammation were independent predictors of sVEGFR1 levels. sVEGFR1 correlated strongly with other biomarkers of endothelial activation and damage and with RBC transfusion requirements. Sympathoadrenal activation, shock and inflammation may be critical drivers of endothelial activation and damage early after trauma.



[Correlation between CD4 T-cell counts and HIV-1 RNA plasma levels in HIV-1 patients receiving highly active antiretroviral therapy (HAART)  


The prognostic value of plasma HIV-1 RNA baseline levels in patients who are going to receive HAART has been recently questioned. In the present study the authors correlated the baseline counts of viremy and CD4 with the viral suppression induced by HAART in an ongoing cohort of HIV-1 positive patients. Data resulting from the study suggest that the HAART effect on CD4 T-cells depends both on the immunological status before starting therapy and on the degree of viral suppression. After briefly discussing about the possible causes of disconnection between CD4 T-cells count and plasma HIV-1 RNA levels, authors conclude that the viral suppression is the desired goal of antiretroviral treatment and that the maximum effect of HAART can be achieved by carefully clinically evaluating patients and individuating the best therapy. PMID:12748445

Maggiolo, F.; Bottura, P.; Capra, R.; Pravettoni, G.; Suter, F.



High baseline interleukine-8 level is an independent risk factor for the achievement of sustained virological response in chronic HCV patients.  


Hepatitis C virus (HCV), a major cause of liver disease throughout the world, is difficult to treat with interferon (IFN) (and various formulations and combinations thereof) being the only approved molecule available. It has been investigated recently that proinflammatory chemokine interleukin-8 (IL-8) induced by HCV partially inhibits the antiviral IFN-? therapy. Therefore, the current study was aimed to prospectively utilize the baseline IL-8 levels in the HCV infected serum and predicts its role in sustained virological response (SVR) to IFN-?+ribavirin therapy, in chronic HCV patients in Pakistan. One hundred and ten hepatitis C patients without any other infections underwent IFN-?+ribavirin combination treatment. Baseline IL-8 levels were determined before starting of the therapy for all these patients. Fifteen normal volunteers negative for HCV were kept as control. The baseline IL-8 levels were found significantly higher in all HCV positive patients as compared to normal healthy volunteers (1083.54 ± 85.72 pg/ml versus 6.99 ± 1.05 pg/ml [mean ± SEM], p<0.01) and were also significantly higher in non-responders than responders (p<0.05). Comparatively higher mean baseline IL-8 levels were observed in non-responders (2442.02 ± 159.92 pg/ml), than late (1009.31 ± 45.31) and rapid (540.91 ± 27.06 pg/ml) responders. Significant relation was observed between baseline IL-8 level and response to IFN therapy (p<0.01). Results of this study suggest that increased levels of IL-8 in HCV infection might be involved in pathogenesis, persistence and resistance to IFN-?+ribavirin combination therapy. PMID:21554996

Akbar, Haji; Idrees, Muhammad; Butt, Sadia; Awan, Zunaira; Sabar, Muhammd Farooq; Rehaman, Irshad ur; Hussain, Abrar; Saleem, Sana



Optimizing High Level Waste Disposal  

SciTech Connect

If society is ever to reap the potential benefits of nuclear energy, technologists must close the fuel-cycle completely. A closed cycle equates to a continued supply of fuel and safe reactors, but also reliable and comprehensive closure of waste issues. High level waste (HLW) disposal in borosilicate glass (BSG) is based on 1970s era evaluations. This host matrix is very adaptable to sequestering a wide variety of radionuclides found in raffinates from spent fuel reprocessing. However, it is now known that the current system is far from optimal for disposal of the diverse HLW streams, and proven alternatives are available to reduce costs by billions of dollars. The basis for HLW disposal should be reassessed to consider extensive waste form and process technology research and development efforts, which have been conducted by the United States Department of Energy (USDOE), international agencies and the private sector. Matching the waste form to the waste chemistry and using currently available technology could increase the waste content in waste forms to 50% or more and double processing rates. Optimization of the HLW disposal system would accelerate HLW disposition and increase repository capacity. This does not necessarily require developing new waste forms, the emphasis should be on qualifying existing matrices to demonstrate protection equal to or better than the baseline glass performance. Also, this proposed effort does not necessarily require developing new technology concepts. The emphasis is on demonstrating existing technology that is clearly better (reliability, productivity, cost) than current technology, and justifying its use in future facilities or retrofitted facilities. Higher waste processing and disposal efficiency can be realized by performing the engineering analyses and trade-studies necessary to select the most efficient methods for processing the full spectrum of wastes across the nuclear complex. This paper will describe technologies being evaluated at Idaho National Laboratory and the facilities we’ve designed to evaluate options and support optimization.

Dirk Gombert



Reduction of Plasma 24S-Hydroxycholesterol (Cerebrosterol) Levels Using High-Dosage Simvastatin in Patients With Hypercholesterolemia: Evidence That Simvastatin Affects Cholesterol Metabolism in the Human Brain  

Microsoft Academic Search

Background: Previous studies have shown that pa- tients with early onset of Alzheimer disease and vascu- lar dementia have higher levels of circulating brain- derived 24S-hydroxycholesterol (cerebrosterol).Two recent epidemiological studies indicated that treatment with inhibitors of cholesterol synthesis (statins) re- duces the incidence of Alzheimer disease. Objective: To test the hypothesis that treatment with high-dosage simvastatin reduces circulating levels of

Sandra Locatelli; Dieter Lutjohann; Hartmut H.-J. Schmidt; Carsten Otto; Ulrike Beisiegel; Klaus von Bergmann



Excess 1-year cardiovascular risk in elderly primary care patients with a low ankle–brachial index (ABI) and high homocysteine level  

Microsoft Academic Search

Previous studies in selected patient samples suggested a high risk for total mortality and cardiovascular (CV) morbidity associated not only with symptomatic, but also with asymptomatic peripheral arterial disease (PAD). Our aim was to assess the 1-year risk of death and CV morbidity associated with PAD in primary care. Furthermore, we quantified the strength of association between low ankle–brachial index

Stefan Lange; Hans Joachim Trampisch; Roman Haberl; Harald Darius; David Pittrow; Alexander Schuster; Berndt von Stritzky; Gerhart Tepohl; Jens Rainer Allenberg; Curt Diehm



High anti-cyclic citrullinated peptide levels and an algorithm of four variables predict radiographic progression in patients with rheumatoid arthritis: results from a 10-year longitudinal study  

Microsoft Academic Search

Objectives:New effective therapies with particularly good effect on joint destruction have highlighted the need for reliable predictors of radiographic progression in rheumatoid arthritis (RA). Our objective was to assess the combined predictive role of a set of laboratory markers with regard to 10-year radiographic progression, and to examine the effect of anti-cyclic citrullinated peptide (anti-CCP) level.Methods:A cohort of 238 patients

S W Syversen; P I Gaarder; G L Goll; S Řdegĺrd; E A Haavardsholm; P Mowinckel; D van der Heijde; R Landewé; T K Kvien



High levels of carbonic anhydrase IX in tumour tissue and plasma are biomarkers of poor prognostic in patients with non-small cell lung cancer  

Microsoft Academic Search

Background:Carbonic anhydrase IX (CAIX) is an enzyme upregulated by hypoxia during tumour development and progression. This study was conducted to assess if the expression of CAIX in tumour tissue and\\/or plasma can be a prognostic factor in patients with non-small cell lung cancer (NSCLC).Methods:Tissue microarrays containing 555 NSCLC tissue samples were generated for quantification of CAIX expression. The plasma level

M ?lie; N M Mazure; V Hofman; R E Ammadi; C Ortholan; C Bonnetaud; K Havet; N Venissac; B Mograbi; J Mouroux; J Pouysségur; P Hofman



High in vitro immune reactivity to Escherichia coli in neuromyelitis optica patients is correlated with both neurological disabilities and elevated plasma lipopolysaccharide levels.  


The pathogenesis of neuromyelitis optica (NMO) is influenced by a combination of genetic and environmental factors, including infectious agents. Several infectious diseases can both trigger or exacerbate autoimmunity. The objective of the present work was to evaluate the in vitro immune responsiveness to Escherichia coli (EC), Staphylococcus aureus (SA) and Candida albicans (CA) in remittent-recurrent NMO patients, and correlate it with the level of neurological disability. Our results revealed that the extent of lymphoproliferation and cytokine profile in response to SA- and CA-stimulated PBMC cultures was similar between NMO patients and healthy individuals. Nevertheless, a higher in vitro CD4(+) T cell proliferation associated with elevated IL-1?, IL-6 and IL-17 release was observed in NMO-derived EC-stimulated cell cultures. Additionally, in these last cultures, the IL-10 production was significantly lower as compared with control group. The in vitro EC-induced levels of IL-6 and IL-17 were positively related with neurological disabilities. This higher tendency to produce Th17-related cytokines was proportional to the production of IL-23 and IL-6 by LPS-activated monocytes. Interestingly, elevated LPS levels were quantified in the plasma of NMO patients. The results suggest that a higher Th17-responsiveness to E. coli could be involved in the NMO pathogenesis. PMID:23777933

Barros, Priscila O; Linhares, Ulisses C; Teixeira, Bruna; Kasahara, Taissa M; Ferreira, Thais B; Alvarenga, Regina; Hygino, Joana; Silva-Filho, Renato G; Bittencourt, Vera Carolina B; Andrade, Regis M; Andrade, Arnaldo F; Bento, Cleonice A M



Serum immunoglobulin levels in pediatric burn patients.  


Infections remain the leading cause of death in burn patients. Immune responses play an important role in patient's defense mechanism against infection and decreasing morbidity and mortality associated with burn. Our goal was to determine serum immunoglobulin levels in pediatric burn patients in order to understand role of humoral immune defense in these patients. During this analytic cross sectional study from January 2011 to February 2012, all patients with burn and younger than 6 years old that were referred to Shahid Motahari burn and reconstruction center were enrolled. Patients had no inhalation injury or sepsis. Immunoglobulin levels were measured once on 3-5 days after burn. The burn size in 12 patients (24%) was less than 30%, in 30 patients (60%) were between 30% and 50% and in the remained 8 patients (16%) were more than 50%. In 45 patients (90%) depth and severity of burn were 2nd degree (superficial and deep) and in the remaining 5 patients (10%), it was 3rd or 4th degree. In 28 (56%), 1 (2%), 3 (6%), 35 (70%), 48 (96%), 19 (38%) and 6 (12%) patients IgG, IgM, IgA, IgG1, IgG2, IgG3 and IgG4 were lower than normal values, respectively. No significant correlation was seen between burn size (TBSA) and value of immunoglobulin (P>0.05). Although the drop in the serum concentration of immunoglobulins is irrespective to the burn size, more severe burn is associated with more decrease in the serum levels of IgA, IgM, IgG and its subclasses. However, further studies are needed to provide complementary data on this issue. PMID:23000373

Sobouti, Behnam; Fallah, Shahrzad; Ghavami, Yaser; Moradi, Masoud



Role of Baseline HIV-1 DNA Level in Highly-Experienced Patients Receiving Raltegravir, Etravirine and Darunavir/Ritonavir Regimen (ANRS139 TRIO Trial)  

PubMed Central

Objective In the ANRS 139 TRIO trial, the use of 3 new active drugs (raltegravir, etravirine, and darunavir/ritonavir), resulted in a potent and sustained inhibition of viral replication in multidrug-resistant treatment-experienced patients. The aim of this virological sub-study of the ANRS 139 TRIO trial was to assess: (i) the evolution of HIV-1 DNA over the first year; and (ii) the association between baseline HIV-1 DNA and virological outcome. Methods Among the 103 HIV-1-infected patients included in the ANRS-139 TRIO trial, HIV-1 DNA specimens were available for 92, 84, 88, and 83 patients at Week (W)0, W12, W24, and W48, respectively. Quantification of total HIV-1 DNA was performed by using the commercial kit “Generic HIV DNA Cell” (Biocentric, Bandol, France). Results Baseline median HIV-1 DNA of patients displaying virological success (n ?=?61), viral blip (n ?=?20), and virological failure (n ?=?11) were 2.34 log10 copies/106 PBMC (IQR ?=?2.15–2.66), 2.42 (IQR ?=?2.12–2.48), and 2.68 (IQR ?=?2.46–2.83), respectively. Although not statistically significant, patients exhibiting virological success or viral blip had a tendency to display lower baseline HIV-1 DNA than patients experiencing virological failure (P ?=?0.06). Median decrease of HIV-1 DNA between baseline and W48 was -0.13 log10 copies/106 PBMC (IQR?=?-0.34 to +0.10), mainly explained by the evolution from W0 to W4. No more changes were observed in the W4-W48 period. Conclusions In highly-experienced multidrug-resistant patients, HIV-1 DNA slightly decreased during the first month and then remained stable during the first year of highly potent antiretroviral regimen. In this population, baseline HIV-1 DNA might help to better predict the virological response and to tailor clinical therapeutic management as more aggressive therapeutic choices in patients with higher baseline HIV-1 DNA.

Charpentier, Charlotte; Fagard, Catherine; Colin, Celine; Katlama, Christine; Molina, Jean-Michel; Jacomet, Christine; Visseaux, Benoit; Taburet, Anne-Marie; Brun-Vezinet, Francoise; Chene, Genevieve; Yazdanpanah, Yazdan; Descamps, Diane



Oxidative stress and ferritin levels in haemodialysis patients  

Microsoft Academic Search

Background. Increased oxidative stress (OS) and inflammation are associated with atherosclerotic cor- onary artery disease in haemodialysis (HD) patients. Ferritin may have other effects in addition to its role in storing intracellular iron. This study was performed to determine any relationships between markers of OS, nutrition and inflammation in HD patients with normal and high ferritin levels. Methods. Our cohort

Emel Senol; Alpaslan Ersoy; Selda Erdinc; Emre Sarandol; Mustafa Yurtkuran


Serum erythropoietin level in anemic cancer patients  

Microsoft Academic Search

Anemia is a frequent complication of cancer and its treatment. A defect in erythropoietin production has been advocated as\\u000a being the main cause of anemia in cancer patients. We studied serum erythropoietin levels in 74 patients with solid tumors\\u000a and in a control group consisting of 20 otherwise healthy individuals without any malignancy, who have only iron deficiency\\u000a anemia. Serum

M Ozguroglu; B Arun; G Demir; F Demirelli; NM Mandel; E Buyukunal; S Serdengecti; B Berkarda



Serum selenium levels in Korean hepatoma patients.  


The aim of this study was to determine serum selenium (Se) levels during the development of liver disease as well as the possible Se supplementation benefits in liver disease patients. Serum was collected from 187 patients with liver diseases and 120 normal healthy people living in Seoul. The samples were collected at the Kangnam St. Mary's Hospital College of Medicines, The Catholic University of Korea, in accordance with procedures approved by the Institutional Review Board of the Catholic University of Korea. Serum Se levels were quantified by inductively coupled plasma mass spectrometry and were compared between healthy and liver diseases patients. Se levels were 92.65?±?32.50 ?g/l in hepatitis infection, 92.33?±?30.66 ?g/l in hepatitis B virus infection and 96.41?±?51.50 ?g/l in hepatitis C virus infection, 96.42?±?32.80 ?g/l in cirrhosis, and 67.47?±?14.30 ?g/l in hepatoma patients. Findings were significantly lower in hepatitis and hepatoma as compared with the healthy participants (P?level of the healthy population was 108.38?±?29.50, 119.37?±?28.31 for males and 97.87?±?26.99 ?g/l for females. Our data shows the same parallelism between liver disease progression and decrease of Se levels except in the case of liver cirrhosis. And also, our study confirms the previous findings of significantly lower Se levels in Korean hepatoma patients. Se levels that decrease parallel to liver disease progression should be further integrated and analyzed with liver function blood biomarkers. PMID:22328307

Kim, In-Wook; Bae, Su-Mi; Kim, Yong-Wan; Liu, Hai-Bo; Bae, Si Hyun; Choi, Jong Young; Yoon, Seung Kew; Chaturvedi, Pankaj Kumar; Battogtokh, Gantumur; Ahn, Woong Shick



Prevalence of Molecular Mechanisms of Resistance to Azole Antifungal Agents in Candida albicans Strains Displaying High-Level Fluconazole Resistance Isolated from Human Immunodeficiency Virus-Infected Patients  

Microsoft Academic Search

Molecular mechanisms of azole resistance in Candida albicans, including alterations in the target enzyme and increased efflux of drug, have been described, but the epidemiology of the resistance mechanisms has not been established. We have investigated the molecular mechanisms of resistance to azoles in C. albicans strains displaying high-level fluconazole resistance (MICs, >64 g\\/ml) isolated from human immunodeficiency virus (HIV)-infected

SOFIA PEREA; J. L. Lopez-Ribot; W. R. Kirkpatrick; R. K. McAtee; R. A. Santillan; M. Martinez; D. Calabrese; D. Sanglard; T. F. Patterson



Annotated Definition of BCL11A and HMIP-2 Haplotypes Through the Analysis of Sicilian ?-Thalassemia Patients with High Levels of Fetal Hemoglobin.  


Fetal hemoglobin (Hb F) is the principal ameliorating factor of ?-thalassemia (?-thal) and sickle cell disease. Persistent production in adult life is a quantitative trait regulated by loci inside or outside the ?-globin gene cluster. From genome-wide association studies, principal quantitative trait loci (QTL) (accounting for 50.0% of Hb F variability in different populations) have been identified in the BCL11A gene, HBS1L-MYB intergenic polymorphism and the ?-globin gene cluster itself. In this study, we analyzed quantitative trait haplotypes in two Sicilian families with extremely mild ?-thal and unusually high Hb F expression, in order to examine possible genetic background variations in a similar ?-thalassemic phenotype. This study redefines the linkage disequilibrium blocks at these loci, but also shows slight differences between probands in haplotype combinations which could reflect different mechanisms of high Hb F production in patients with ?-thal. We proposed a haplotype-based approach as a useful tool for the understanding of ?-thal phenotype variation in patients with similar ?-thalassemic backgrounds in an attempt to answer the recurring question of why patients with the same ?-thalassemic genotype show different phenotypes. PMID:23777413

Buccheri, Maria A; Spina, Sonia; Ruberto, Concetta; Lombardo, Turi; Labie, Dominique; Ragusa, And Angela



Ghrelin levels in chronic periodontitis patients.  


Ghrelin is a peptide hormone that has modulatory effects on the immune system. This study was designed to evaluate plasma ghrelin levels in patients with chronic periodontitis and to investigate if a relationship exists between ghrelin and periodontal parameters, serum cytokines, and bone turnover markers. Thirty-five chronic periodontitis patients (CP) and periodontal healthy individuals (C) were included in this study. Periodontal parameters were recorded. Blood samples were obtained to determine the levels of total and acylated ghrelin, interleukin-1 beta (IL-1?), tumor necrosis factor-alpha (TNF-?), the soluble receptor activator nuclear factor kappaB ligand (sRANKL), alkaline phosphatase (ALP), and osteocalcin (OSC). Plasma levels of total and acylated ghrelin were significantly elevated in the CP group compared with the C group (p < 0.05). The difference was significant only between males in the two groups (groups were compared with respect to gender) (p < 0.05). There was no difference between the groups regarding the levels of serum sRANKL, TNF-?, and ALP. A relative increase in the serum levels of IL-1? and a decrease in the serum levels of OSC of the CP group were observed (p < 0.05). In addition, positive correlations between total ghrelin/ALP and total ghrelin/acylated ghrelin were discovered. We found no direct correlation between ghrelin levels and periodontal parameters. Our results indicate an increase of total and acylated ghrelin levels in patients with chronic periodontitis. Further, studies in larger populations (which could include ghrelin levels in gingival tissue, gingival crevicular fluid, and saliva) are needed in order to confirm the role of ghrelin in periodontal disease. PMID:23292319

Y?lmaz, Gülin; K?rz?o?lu, Fatma Ye?im; Do?uç, Duygu Kumbul; Koçak, Havva; Orhan, Hikmet



High plasma fibrinogen level represents an independent negative prognostic factor regarding cancer-specific, metastasis-free, as well as overall survival in a European cohort of non-metastatic renal cell carcinoma patients.  


Background:In recent years, plasma fibrinogen has been ascribed an important role in the pathophysiology of tumour cell invasion and metastases. A relatively small-scale study has indicated that plasma fibrinogen levels may serve as a prognostic factor for predicting clinical outcomes in non-metastatic renal cell carcinoma (RCC) patients.Methods:Data from 994 consecutive non-metastatic RCC patients, operated between 2000 and 2010 at a single, tertiary academic centre, were evaluated. Analyses of plasma fibrinogen levels were performed one day before the surgical interventions. Patients were categorised using a cut-off value of 466?mg?dl(-1) according to a calculation by receiver-operating curve analysis. Cancer-specific (CSS), metastasis-free (MFS), as well as overall survival (OS) were assessed using the Kaplan-Meier method. To evaluate the independent prognostic impact of plasma fibrinogen level, a multivariable Cox regression model was performed for all three different endpoints.Results:High plasma fibrinogen levels were associated with various well-established prognostic factors, including age, advanced tumour stage, tumour grade and histologic tumour necrosis (all P<0.05). Furthermore, in multivariable analysis, a high plasma fibrinogen level was statistically significantly associated with a poor outcome for patients' CSS (hazard ratio (HR): 2.47, 95% confidence interval (CI): 1.49-4.11, P<0.001), MFS (HR: 2.15, 95% CI: 1.44-3.22, P<0.001) and OS (HR: 2.48, 95% CI: 1.80-3.40, P<0.001).Conclusion:A high plasma fibrinogen level seems to represent a strong and independent negative prognostic factor regarding CSS, MFS and OS in non-metastatic RCC patients. Thus, this easily determinable laboratory value should be considered as an additional prognostic factor for RCC patients' individual risk assessment. PMID:23922109

Pichler, M; Hutterer, G C; Stojakovic, T; Mannweiler, S; Pummer, K; Zigeuner, R



High levels of microRNA21 in the stroma of colorectal cancers predict short disease-free survival in stage II colon cancer patients  

Microsoft Academic Search

Approximately 25% of all patients with stage II colorectal cancer will experience recurrent disease and subsequently die within\\u000a 5 years. MicroRNA-21 (miR-21) is upregulated in several cancer types and has been associated with survival in colon cancer.\\u000a In the present study we developed a robust in situ hybridization assay using high-affinity Locked Nucleic Acid (LNA) probes\\u000a that specifically detect miR-21 in

Boye Schnack Nielsen; Stine Jřrgensen; Jacob Ulrik Fog; Rolf Sřkilde; Ib Jarle Christensen; Ulla Hansen; Nils Brünner; Adam Baker; Sřren Mřller; Hans Jřrgen Nielsen



An omega-3 polyunsaturated fatty acid concentrate increases plasma high-density lipoprotein 2 cholesterol and paraoxonase levels in patients with familial combined hyperlipidemia.  


A remarkable reduction of plasma concentrations of high-density lipoproteins (HDL), especially of the HDL(2) subfraction, is one of the typical lipoprotein alterations found in patients with familial combined hyperlipidemia (FCHL). Fourteen FCHL patients received 4 capsules daily of Omacor (an omega-3 polyunsaturated fatty acid [omega3 FA] concentrate providing 1.88 g of eicosapentaenoic acid [EPA] and 1.48 g of docosahexaenoic acid [DHA] per day; Pronova Biocare, Oslo, Norway) or placebo for 8 weeks in a randomized, double-blind, crossover study. Plasma triglycerides were 44% lower, and LDL cholesterol and apoliporpotein (apo)B were 25% and 7% higher after Omacor than placebo. HDL cholesterol was higher (+8%) after Omacor than placebo, but this difference did not achieve statistical significance. Omacor caused a selective increase of the more buoyant HDL(2) subfraction; plasma HDL(2) cholesterol and total mass increased by 40% and 26%, respectively, whereas HDL(3) cholesterol and total mass decreased by 4% and 6%. Both HDL(2) and HDL(3) were enriched in cholesteryl esters and depleted of triglycerides after Omacor. No changes were observed in the plasma concentration of major HDL apolipoproteins, LpA-I and LpA-I:A-II particles, lecithin:cholesterol acyltransferase (LCAT), and cholesteryl ester transfer protein (CETP). The plasma concentration of the HDL-bound antioxidant enzyme paraoxonase increased by 10% after Omacor. Omacor may be helpful in correcting multiple lipoprotein abnormalities and reducing cardiovascular risk in FCHL patients. PMID:14767865

Calabresi, Laura; Villa, Barbara; Canavesi, Monica; Sirtori, Cesare R; James, Richard W; Bernini, Franco; Franceschini, Guido



Occupational therapists and patients' rights: their level of Clinical knowledge  

PubMed Central

Addressing patients’ rights issues brings occupational therapists ethical and political responsibilities that involve patients’ privileges and new facilitating factors which influence their needs. The goal of this study was to determine the level of occupational therapists’ knowledge about patients’ rights. The present research was a cross-sectional study which involved 125 occupational therapists chosen by a convenience sampling strategy in Tehran during the year of 2012. A four-part questionnaire was used for data collection, and the degree of the subjects’ self-assessment of their knowledge was measured based on the obtained numbers of correct answers in the third part. The validity and reliability of this questionnaire were assessed prior to its being distributed among participants. The results demonstrated no significant association between the level of occupational therapists’ knowledge about patients’ rights and their existing experiences within their areas of occupational therapy (P>0.05). Based on the result, 53.6% of the respondents had high level of knowledge about patients’ rights. Facilitating factors which influence the attainment of patients’ rights were classified into three groups: organizations, therapists and clients. The results of the present research demonstrated that the level of occupational therapists’ knowledge about patients’ rights were high. Furthermore, this study showed that for optimal result, there is a need to provide milieu for observing the patients’ rights in clinical occupational therapy services.

Dehghan, Leila; Dalvand, Hamid; Haghgoo, Hojjat Allah; Hosseini, Seyed Ali; Karimlou, Masoud



Serum uric acid level in acute stroke patients  

PubMed Central

Background The role of uric acid as a risk factor for vascular disease and acute stroke is controversial and there is little information about it. In this study, we determined serum uric acid levels in patients with acute stroke and assessed its relationship with cerebrovascular risk factors. Methods In this cross sectional study, we assessed patients with acute stroke who were admitted in Firoozgar Hospital from September 2010 to March 2011. Clinical records of patients and their serum uric acid level was investigated. Finally, collected data were analyzed using SPSS software Ver.16. Results Fifty five patients with acute stroke were evaluated who 25 of these patients (45.5%) were female and 30 of them (54.5%) were male. The mean age of patients was 67±14 years. Mean serum uric acid levels in the patients studied 5.94±1.70 mg/dl, and about half of the patients (47.3%) were hyperuricemic. There was a significant negative correlation between age of patients and their serum uric acid level (p=0.04, R =-0.27). Uric acid level was significantly higher in men than women (p=0.03). Hyperuricemia was associated with increased amounts of triglycerides and Low-density lipoprotein (LDL) cholesterol (p=0.03, p=0.02). In patients with acute stroke, there was no significant association between serum uric acid level and diabetes mellitus, hypertension, history of ischemic heart disease, smoking, prescription rTPA, and type of stroke. Conclusion Due to the high prevalence of hyperuricemia in patients with acute stroke, and its accompanying increase in triglyceride and LDL cholesterol levels, it can be considered as a risk factor for acute stroke.

Khuzan, Mahbubeh; Najimi, Neda; Motamed, Mohamad R.; Fereshtehnejad, Seyed-Mohammad



High HbA1c levels correlate with reduced plaque regression during statin treatment in patients with stable coronary artery disease: Results of the coronary atherosclerosis study measuring effects of rosuvastatin using intravascular ultrasound in Japanese subjects (COSMOS)  

PubMed Central

Background The incidence of cardiac events is higher in patients with diabetes than in people without diabetes. The Coronary Atherosclerosis Study Measuring Effects of Rosuvastatin Using Intravascular Ultrasound in Japanese Subjects (COSMOS) demonstrated significant plaque regression in Japanese patients with chronic coronary disease after 76?weeks of rosuvastatin (2.5?mg once daily, up-titrated to a maximum of 20?mg/day to achieve LDL cholesterol <80?mg/dl). Methods In this subanalysis of COSMOS, we examined the association between HbA1c and plaque regression in 40 patients with HbA1c ?6.5% (high group) and 86 patients with HbA1c <6.5% (low group). Results In multivariate analyses, HbA1c and plaque volume at baseline were major determinants of plaque regression. LDL cholesterol decreased by 37% and 39% in the high and low groups, respectively, while HDL cholesterol increased by 16% and 22%, respectively. The reduction in plaque volume was significantly (p?=?0.04) greater in the low group (from 71.0?±?39.9 to 64.7?±?34.7?mm3) than in the high group (from 74.3?±?34.2 to 71.4?±?32.3?mm3). Vessel volume increased in the high group but not in the low group (change from baseline: +4.2% vs ?0.8%, p?=?0.02). Change in plaque volume was significantly correlated with baseline HbA1c. Conclusions Despite similar improvements in lipid levels, plaque regression was less pronounced in patients with high HbA1c levels compared with those with low levels. Tight glucose control during statin therapy may enhance plaque regression in patients with stable coronary disease. Trial registration, Identifier NCT00329160



High Let-7a MicroRNA Levels in KRAS-Mutated Colorectal Carcinomas May Rescue Anti-EGFR Therapy Effects in Patients with Chemotherapy-Refractory Metastatic Disease  

PubMed Central

Preclinical and experimental data in vivo indicate that Lethal-7 (Let-7) microRNA downregulates KRAS with antitumor effects in the presence of activating KRAS mutations. We quantified the Let-7a isoform in KRAS-mutated colorectal carcinomas from patients who received salvage cetuximab plus irinotecan. The study population was retrospectively identified among metastatic colorectal cancer patients who underwent third-line therapy with cetuximab plus irinotecan in a period when only epidermal growth factor receptor (EGFR) expression was required for anti-EGFR therapy. In 59 patients harboring KRAS mutations, Let-7a levels were analyzed for association with overall survival (OS) and progression-free survival (PFS) times. An exploratory subgroup analysis was performed using the rs61764370 (LCS6 T>G) polymorphism that experimentally impairs Let-7 binding to KRAS mRNA. In the whole group, higher Let-7a levels were significantly associated with better survival outcomes. For the primary OS endpoint, the multivariate hazard ratio was 0.82 (95% confidence interval, 0.73–0.91; p = .01). The same findings with an accentuated positive effect of high Let-7a levels on both OS and PFS times were observed in an exploratory analysis of the 45 wild-type LCS6 patients (excluding 14 carriers of the LCS6 G allele variant). All survival associations were confirmed after excluding patients with KRAS codon 13 mutations. Among the clinicopathologic features, high Let-7a levels were associated with grade 2–3 skin toxicity (p = .002). In patients with KRAS mutations, Let-7a analysis may serve to identify subgroups of patients who may still benefit from EGFR inhibition and this may open up new perspectives for alternative treatment strategies.

Ruzzo, Annamaria; Vincenzi, Bruno; Canestrari, Emanuele; Perrone, Giuseppe; Galluccio, Nadia; Catalano, Vincenzo; Loupakis, Fotios; Rabitti, Carla; Santini, Daniele; Tonini, Giuseppe; Fiorentini, Giammaria; Rossi, David; Falcone, Alfredo; Magnani, Mauro



Tutorial on high-level synthesis  

Microsoft Academic Search

High-level synthesis takes an abstract behavioral specification of a digital system and finds a register-transfer level structure that realizes the given behavior. In this tutorial we will examine the high-level synthesis task, showing how it can be decomposed into a number of distinct but not independent subtasks. Then we will present the techniques that have been developed for solving those

Michael C. McFarland; Alice C. Parker; Raul Carnposano



Parallel Processing at the High School Level.  

ERIC Educational Resources Information Center

This study investigated the ability of high school students to cognitively understand and implement parallel processing. Data indicates that most parallel processing is being taught at the university level. Instructional modules on C, Linux, and the parallel processing language, P4, were designed to show that high school students are highly

Sheary, Kathryn Anne


Methemoglobinemia and dapsone levels in patients with leprosy  

Microsoft Academic Search

The objective of this work was to determine the methemoglobinemia and correlate with dapsone levels in multibacillary leprosy patients under leprosy multi-drug therapy. Thirty patients with laboratory and clinical diagnosis of multibacillary leprosy were enrolled. Dapsone was analyzed by high performance liquid chromatography and methemoglobinemia by spectrophotometry. The mean dapsone concentrations in male was 1.42 g\\/mL and in female was

Jose Luiz Fernandes Vieira; Juan Gonzalo Bardarez Riveira; Ana de Nazaré Silva Martins; Jorge Pereira da Silva; Claudio Guedes Salgado



Ghrelin plasma levels and appetite in peritoneal dialysis patients.  


Anorexia-associated malnutrition is a severe complication that increases mortality in peritoneal dialysis (PD) patients. Ghrelin is a recently-discovered orexigenic hormone with actions in brain and stomach. We analyzed, in 42 PD patients, the possible relationship between ghrelin and appetite regulation with regard to other orexigens [neuropeptide Y (NPY), NO3] and anorexigens [cholecystokinin (CCK), leptin, glucose-dependent insulinotropic peptide (GIP), tumor necrosis factor alpha (TNFalpha)]. All orexigens and anorexigens were determined in plasma. Eating motivation was evaluated using a visual analog scale (VAS). The patients were divided into three groups: those with anorexia (n = 12), those with obesity associated with high intake (n = 12), and those with no eating behavior disorders (n = 18). A control group of 10 healthy volunteers was also evaluated. Mean plasma levels of ghrelin were high (3618.6 +/- 1533 mg/mL), with 36 patients showing values above the normal range (< 2600 mg/mL). Patients with anorexia had lower ghrelin and NPY levels and higher peptide-C, CCK, interleukin-1 (IL-1), TNFalpha, and GIP levels than did the other patients. Patients with anorexia also had an early satiety score and low desire and pleasure in eating on the VAS and diet survey. We observed significant positive linear correlations between ghrelin and albumin (r = 0.43, p < 0.05), prealbumin (r = 0.51, p < 0.05), transferrin (r = 0.4, p < 0.05), growth hormone (r = 0.66, p < 0.01), NO3 (r = 0.36, p < 0.05), and eating motivation (VAS). At the same time, negative relationships were observed between blood ghrelin and GIP (r = -0.42, p < 0.05), insulin (r = -0.4, p < 0.05), leptin (r = -0.45, p < 0.05), and creatinine clearance [r = -0.33, p = 0.08 (nonsignificant)]. Ghrelin levels were not related to Kt/V or to levels of CCK and cytokines. Ghrelin plasma levels are elevated in PD patients. Uremic patients with anorexia show relatively lower ghrelin plasma levels than the levels seen in obese patients or in patients with normal appetite. The role of ghrelin in appetite modulation is altered in uremic PD patients, and that alteration is possibly associated with disorders in insulin and growth hormone metabolism. PMID:15384825

Aguilera, Abelardo; Cirugeda, Antonio; Amair, Ruth; Sansone, Gabriela; Alegre, Laura; Codoceo, Rosa; Bajo, M Auxiliadora; del Peso, Gloria; Díez, Juan J; Sánchez-Tomero, José A; Selgas, Rafael



Delayed progression of edema formation around a hematoma expressing high levels of VEGF and mmp-9 in a patient with traumatic brain injury: case report.  


The mechanisms accounting for the development of tissue damage following traumatic brain injury (TBI) have been studied for several decades. A variety of mediators, such as vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9 (MMP-9), which play a crucial role in edema formation after TBI, have been identified. We experienced a case of brain edema that progressed continuously at least until 13 days after head injury. The brain edema occurred around the hemorrhage from an intracerebral contusion. The evacuated hematoma was investigated based on the inference that the unexpected expansion of edema was induced by the mediators within the hematoma itself. A 64-year-old woman was admitted to our hospital following a traffic injury. Left brain contusion was revealed by head computed tomography (CT) on admission. Three hours later, formation of an intracerebral hematoma became evident. Serial CT examination revealed that brain edema had developed progressively till 13 days after the injury. A hematoma removal operation was performed on Day 13. The hematoma was centrifuged and the supernatant was analyzed for the expression of VEGF and MMP-9. The values of both (4400 pg/ml and 920 ng/ml, respectively) were extremely high compared with values reported previously in serum and cerebrospinal fluid collected from patients with intracranial infection or injury. This case suggested that the delayed exacerbation of edema following traumatic intracranial hemorrhage was possibly induced by secretory factors such as VEGF and MMP-9 released from within and around the hematoma. PMID:24067772

Hirose, Tomoya; Matsumoto, Naoya; Tasaki, Osamu; Nakamura, Hajime; Akagaki, Fuyuko; Shimazu, Takeshi



Relation of Admission High-Density Lipoprotein Cholesterol Level and In-Hospital Mortality in Patients With Acute Non-ST Segment Elevation Myocardial Infarction (from the National Cardiovascular Data Registry).  


Despite recent therapeutic advances, significant residual risk for in-hospital mortality persists among patients admitted with acute myocardial infarction (MI). Low levels of high-density lipoprotein cholesterol (HDL-C), a known independent predictor of increased cardiovascular events, may be an important modulator of heightened risk after acute MI. We evaluated admission HDL-C levels among 98,276 patients with non-ST elevation myocardial infarction with acute MI from the Acute Coronary Treatment and Intervention Outcomes Network Registry-Get With the Guidelines (ACTION Registry-GWTG) program who were enrolled from 490 United States hospitals from January 2007 to December 2010. Clinical characteristics, treatments, atherosclerotic burden, and in-hospital outcomes were analyzed by quartiles of admission HDL-C (Q1: 10 to 30 mg/dl; Q2: 30.1 to 36.9 mg/dl; Q3: 37 to 45 mg/dl; and Q4: 45.1 to 100 mg/dl). Logistic regression was used to explore the relation among HDL-C quartiles, coronary artery disease severity, and in-hospital mortality. Almost half of the patients with acute MI had low admission levels of HDL-C (less than the median 36.9 mg/dl). Such patients were younger, more often men, white, obese, diabetic, smokers, and had higher rates of previous cardiovascular events. After multivariate adjustment, patients with low HDL-C levels had greater extent of severe angiographic multivessel coronary narrowings and higher mortality. Among the 26% of patients in the lowest HDL-C quartile (?30 mg/dl), there was a 16% greater risk of in-hospital mortality compared with patients in the highest HDL-C quartile (p = 0.012). In conclusion, low levels of HDL-C were common in patients admitted with acute MI and were associated with more extensive angiographic coronary disease. Very low levels of admission HDL-C were observed in one-quarter of patients and associated with significantly higher in-hospital mortality. PMID:23891245

Acharjee, Subroto; Roe, Matthew T; Amsterdam, Ezra A; Holmes, Dajuanicia N; Boden, William E



Reflections on the development of resistance during therapy for advanced breast cancer. Implications of high levels of activity of docetaxel in anthracycline-resistant breast cancer patients  

Microsoft Academic Search

Anthracyclines play a central role in the treatment of breast cancer. They are perhaps the most active single agents available for the treatment of this disease. For patients with primary breast cancer for whom chemotherapy would be appropriate, anthracyclines are often incorporated in adjuvant regimens. For patients with endocrine-therapy-resistant metastatic disease, anthracyclines are nearly always included in the first or

P. M. Ravdin



High-Level Application Framework for LCLS  

SciTech Connect

A framework for high level accelerator application software is being developed for the Linac Coherent Light Source (LCLS). The framework is based on plug-in technology developed by an open source project, Eclipse. Many existing functionalities provided by Eclipse are available to high-level applications written within this framework. The framework also contains static data storage configuration and dynamic data connectivity. Because the framework is Eclipse-based, it is highly compatible with any other Eclipse plug-ins. The entire infrastructure of the software framework will be presented. Planned applications and plug-ins based on the framework are also presented.

Chu, P; Chevtsov, S.; Fairley, D.; Larrieu, C.; Rock, J.; Rogind, D.; White, G.; Zalazny, M.; /SLAC



Hair iron and other minerals' level in breast cancer patients.  


Little is known about hair minerals in cancer patients, and serum iron level has been shown to be elevated in breast cancer patients. Therefore, the aim of this study was to evaluate hair iron and hair minerals' level related to hair iron in breast cancer patients compared to controls. We compared hair mineral analysis data of 40 breast cancer subjects with age and body mass index-matched normal control data (n = 144) by cross-sectional analysis. All breast cancer patients were newly diagnosed at one Breast Cancer Center in Ajou University and had their hair cut before anti-cancer chemotherapy, and the normal controls (without breast cancer) also had their hair cut for various reasons in out-patient clinics of the Department of Family Practice and Community Health. Breast cancer patients had low calcium, magnesium, iron, copper, manganese, and zinc, whereas they had high arsenic, sodium, and potassium compared with the normal control. The hair iron level was positively correlated with hair calcium (r = 0.761, P < 0.001), magnesium (r = 0.643, P < 0.001), and manganese (r = 0.550, P < 0.001) and negatively correlated with arsenic (r = -0.537, P < 0.001). The hair iron level was significantly associated with the hair calcium (beta = 0.778, P < 0.001) and manganese (beta = 0.240, P < 0.001) by using multiple linear regression analysis. We observed different hair mineral patterns in breast cancer patients compared to normal controls. Especially, hair iron level was significantly reduced and associated with hair calcium and manganese levels. PMID:19043675

Joo, Nam-Seok; Kim, Sang-Man; Jung, Yong-Sik; Kim, Kwang-Min



A Software Architecture for High Level Applications  

SciTech Connect

A modular software platform for high level applications is under development at the National Synchrotron Light Source II project. This platform is based on client-server architecture, and the components of high level applications on this platform will be modular and distributed, and therefore reusable. An online model server is indispensable for model based control. Different accelerator facilities have different requirements for the online simulation. To supply various accelerator simulators, a set of narrow and general application programming interfaces is developed based on Tracy-3 and Elegant. This paper describes the system architecture for the modular high level applications, the design of narrow and general application programming interface for an online model server, and the prototype of online model server.




Increased levels of PD-1 expression on CD8 T cells in patients post-renal transplant irrespective of chronic high EBV viral load.  


Studies have identified solid organ transplant recipients who remain asymptomatic despite maintaining CHL. Factors which determine the CHL state remain poorly understood but are likely to involve immunological control of the viral infection. We monitored expression of PD-1, a marker of T-cell exhaustion and viral persistence, on CD8 T cells in patients who resolved EBV infection as determined by undetectable EBV DNA (REI) and CHL patients. PD-1 expression on CD8 T cells was increased in the first year post-transplant irrespective of EBV outcome, and most CD8 T cells continued to express PD-1 for up to three yr post-transplant. Although all patient groups showed similar frequencies of EBV-specific CD8+ T cells, PD-1 expression on these cells increased in the post-transplant groups compared with the pretransplant patients. Functional studies of EBV-specific CD8+ T cells stimulated with BZLF or LMP2 peptide pools revealed monofunctional IFN-? responses. Our results indicate that PD-1 expression on CD8 T cells post-transplant may result from factors other than antigenic stimulation. PMID:24118875

Moran, Julie; Dean, Jonathan; De Oliveira, Andre; O'Connell, Marie; Riordan, Michael; Connell, Jeff; Awan, Atif; Hall, William W; Hassan, Jaythoon



High Levels of IL17 in Rheumatoid Arthritis Patients: IL15 Triggers In Vitro IL17 Production Via Cyclosporin A-Sensitive Mechanism1  

Microsoft Academic Search

Recent data suggest that IL-15 plays an important role in the pathogenesis of rheumatoid arthritis. In the present study, we hypothesized that elevated in the joints of rheumatoid arthritis, but not osteoarthritis, patients, IL-15 may exert its proinflam- matory properties via the induction of IL-17, a cytokine known to stimulate synoviocytes to release several mediators of inflam- mation including IL-6,

Maria Ziolkowska; Anna Koc; Grazyna Luszczykiewicz; Krystyna Ksiezopolska-Pietrzak; Ewa Klimczak; Hanna Chwalinska-Sadowska; Wlodzimierz Maslinski


High levels of bcl-2 protein expression do not correlate with genetic abnormalities but predict worse prognosis in patients with lymphoblastic lymphoma.  


We aimed to investigate bcl-2, bcl-6, and c-myc rearrangements in patients with lymphoblastic lymphoma (LBL), especially focus on the correlation of protein expression with genetic abnormalities. Moreover, their prognostic significance was further analyzed in LBL. Protein expression and genetic abnormalities of bcl-2, bcl-6, and c-myc were investigated in microarrayed tumors from 33 cases of T cell LBL and eight cases of B cell lineage. Immunohistochemical (IHC) staining was performed to evaluate protein expression, including bcl-2, bcl-6, c-myc, TdT, CD1?, CD34, Ki-67, PAX-5, CD2, CD3, CD4, CD8, and CD20. Genetic abnormalities of bcl-2, bcl-6, and c-myc were detected by dual color fluorescence in situ hybridization (FISH). Bcl-2 protein was positive in 51.2 % (21/41) of the patients, bcl-6 protein in 7.3 % (three out of 41), and c-myc protein in 78.0 % (32/41). Bcl-2 breakpoint was found in two cases by FISH analysis. There was no evidence of bcl-6 or c-myc rearrangement in patients with LBL. However, both gene gain and loss events occurred in bcl-2, bcl-6, and c-myc. A univariate analysis showed that stage III or IV, elevated lactate dehydrogenase (LDH), and positivity for bcl-2 protein were associated with shorter survival (p<0.05). Enhanced protein expression and detectable genetic abnormalities of bcl-2, bcl-6, and c-myc were observed in patients with LBL. No statistical correlation was found between IHC results and cytogenetic findings. Stage III or IV, elevated LDH, and positivity for bcl-2 protein were identified as adverse prognostic factors. The patients with more adverse factors would have increasingly worse prognosis. PMID:23494176

Gu, Yajun; Pan, Yi; Meng, Bin; Guan, Bingxin; Fu, Kai; Sun, Baocun; Zheng, Fang



Nurses' fear of death and comfort level with dying patients  

Microsoft Academic Search

This study examined differences in nurses' fear of death and level of comfort with patients having a poor prognosis for survival, as a function of the nurses' occupational level, work setting, and level of exposure to such patients. In addition, the relationship among the multidimensional aspects of fear of death and level of comfort with patients' poor prognosis was assessed.

Jan Hare; Clara C. Pratt



High levels of NK cells in the peripheral blood of patients affected with anti-phospholipid syndrome and recurrent spontaneous abortion: a potential new hypothesis  

Microsoft Academic Search

Objectives. No data regarding phenotypic assets of circulating lymphocytes in anti-phospholipid syndrome (APS) are reported in the literature. Role of anti-phospholipid antibodies (aPL) in recurrent spontaneous abortion (RSA) remains uncertain, while natural killer (NK)- cells are involved in RSA pathogenesis. In this study, patients affected with APS without RSA, APS with RSA and RSA without aPL were studied for NK-cell

C. Perricone; C. De Carolis; R. Giacomelli; G. Zaccari; P. Cipriani; E. Bizzi; R. Perricone



Box Calculus with High-Level Buffers  

Microsoft Academic Search

In this paper, we propose a high-level process algebra al- lowing to express the exchange of data values using both handshake and buffered communication. This allows a sim- ple and compositional expression of interprocess communi- cation; in particular the buffered one makes easy the repre- sentation of program variables, allowing a compact repre- sentation of large systems. The process terms

Cécile Bui Thanh; Hanna Klaudel; Franck Pommereau


Incentives for Partitioning High-Level Waste.  

National Technical Information Service (NTIS)

This document reports work to develop a general method for estimating the safety incentives for partitioning nuclear power economy wastes and to apply that method to a single waste type (accumulated high-level waste through the Year 2000 plus all tritium,...

H. C. Burkholder M. O. Cloninger D. A. Baker G. Jansen



High Level Synthesis Tool for Systolic Designs,  

National Technical Information Service (NTIS)

Decomposer is a high level synthesis tool for automating the design of systolic systems. It is the newest entry in a tool set currently under development at Penn State. Decomposer takes as inputs a hierarchical description of the computation to be perform...

P. P. Hou R. M. Owens M. J. Irwin




SciTech Connect

The primary objective of this study is to demonstrate a mission scenario that uses pairwise and incidental blending of high level waste (HLW) to reduce the total mass of HLW glass. Secondary objectives include understanding how recent refinements to the tank waste inventory and solubility assumptions affect the mass of HLW glass and how logistical constraints may affect the efficacy of HLW blending.




The Department of Defense High Level Architecture  

Microsoft Academic Search

The High Level Architecture (HLA) provides the specification of a common technical architecture for use across all classes of simulations in the US Department of Defense. It provides the structural basis for simulation interoperability. The baseline definition of the HLA includes (1) the HLA Rules, (2) the HLA Interface Specification, and (3) the HLA Object Model Template. This paper describes

Judith S. Dahmann; Richard M. Fujimoto; Richard M. Weatherly



Applying simulated evolution to high level synthesis  

Microsoft Academic Search

A general optimization algorithm known as simulated evolution (SE) is applied to the tasks of scheduling and allocation in high level synthesis. Basically, SE-based synthesis explores the design space by repeatedly ripping up parts of a design in a probabilistic manner and reconstructing them using application-specific heuristics that combine rapid design iterations and probabilistic hill climbing to achieve effective design

Tai A. Ly; Jack T. Mowchenko



Triggering and High-Level Data Selection  

NASA Astrophysics Data System (ADS)

This document is part of Part 1 'Principles and Methods' of Subvolume B 'Detectors for Particles and Radiation' of Volume 21 'Elementary Particles' of Landolt-Börnstein - Group I 'Elementary Particles, Nuclei and Atoms'. It contains the Section '4.2 Triggering and High-Level Data Selection' of Chapter '4 Data Treatment and Analysis Methods' with the content:

Smith, W. H.


Mercury levels in high-end consumers of fish.  

PubMed Central

Consumption of food containing mercury has been identified as a health risk. The U.S. Environmental Protection Agency (U.S. EPA) and the National Academy of Sciences recommend keeping the whole blood mercury level < 5.0 microg/L or the hair level < 1.0 microg/g. This corresponds to a reference dose (RfD) of 0.1 microg/kg body weight per day. All patients in a 1-year period (n = 720) who came for an office visit in a private internal medicine practice in San Francisco, California, were evaluated for mercury excess using the current RfD. One hundred twenty-three patients were tested (93 females, 30 males). Of these, data were statistically analyzed for 89 subjects. Mercury levels ranged from 2.0 to 89.5 microg/L for the 89 subjects. The mean for 66 women was 15 microg/L [standard deviation (SD) = 15], and for 23 men was 13 microg/L (SD = 5); 89% had levels exceeding the RfD. Subjects consumed 30 different forms or types of fish. Swordfish had the highest correlation with mercury level. Sixty-seven patients with serial blood levels over time after stopping fish showed a decline in mercury levels; reduction was significant (p < 0.0001). A substantial fraction of patients had diets high in fish consumption; of these, a high proportion had blood mercury levels exceeding the maximum level recommended by the U.S. EPA and National Academy of Sciences. The mean level for women in this survey was 10 times that of mercury levels found in a recent population survey by the U.S. Centers for Disease Control and Prevention. Some children were > 40 times the national mean.

Hightower, Jane M; Moore, Dan



Mercury levels in high-end consumers of fish.  


Consumption of food containing mercury has been identified as a health risk. The U.S. Environmental Protection Agency (U.S. EPA) and the National Academy of Sciences recommend keeping the whole blood mercury level < 5.0 microg/L or the hair level < 1.0 microg/g. This corresponds to a reference dose (RfD) of 0.1 microg/kg body weight per day. All patients in a 1-year period (n = 720) who came for an office visit in a private internal medicine practice in San Francisco, California, were evaluated for mercury excess using the current RfD. One hundred twenty-three patients were tested (93 females, 30 males). Of these, data were statistically analyzed for 89 subjects. Mercury levels ranged from 2.0 to 89.5 microg/L for the 89 subjects. The mean for 66 women was 15 microg/L [standard deviation (SD) = 15], and for 23 men was 13 microg/L (SD = 5); 89% had levels exceeding the RfD. Subjects consumed 30 different forms or types of fish. Swordfish had the highest correlation with mercury level. Sixty-seven patients with serial blood levels over time after stopping fish showed a decline in mercury levels; reduction was significant (p < 0.0001). A substantial fraction of patients had diets high in fish consumption; of these, a high proportion had blood mercury levels exceeding the maximum level recommended by the U.S. EPA and National Academy of Sciences. The mean level for women in this survey was 10 times that of mercury levels found in a recent population survey by the U.S. Centers for Disease Control and Prevention. Some children were > 40 times the national mean. PMID:12676623

Hightower, Jane M; Moore, Dan



High level glucose increases mutagenesis in human lymphoblastoid cells  

Microsoft Academic Search

Epidemiological data have suggested an increased cancer rates in diabetic patients, for which the underlying mechanism is poorly understood. We studied whether high level of glucose (HG) treatment that mimic the hyperglycemic condition in diabetes mellitus is mutagenic. Mutagenesis studies were carried out at both hypoxanthine phosphoribosyltransferase (hprt) and thymidine kinase (tk) loci. Role of p53 in HG-induced mutagenesis was

Ying Zhang; Junqing Zhou; Tieli Wang; Lu Cai


Lower cardiac troponin T levels in patients undergoing cardiopulmonary bypass and receiving high-dose aprotinin therapy indicate reduction of perioperative myocardial damage  

Microsoft Academic Search

Nowadays in many European heart centers the activation of the fibrinolytic system, always occurring during cardiopulmonary bypass, is routinely reduced by high-dose application of the proteinase inhibitor aprotinin (total of >4 million KIU). In this study parameters of myocardial ischemic injury were investigated with the aim of identifying further benefits of aprotinin, particularly the protection of the myocardium during the

Hans Peter Wendel; Wolfgang Heller; Josef Michel; Gabriel Mayer; Christoph Ochsenfahrt; Uwe Graeter; Jochen Schulze; Hans-Martin Hoffmeister; Hans-Eberhardt Hoffmeister



Efficacy of glossopharyngeal breathing for a ventilator-dependent, high-level tetraplegic patient after cervical cord tumor resection and tracheotomy.  


This case study was undertaken to describe the use and limitations of glossopharyngeal breathing (GPB) by a ventilator-dependent, tracheotomized patient after cervical tumor resection. A 6-yr, 8-mo-old, tracheotomized, ventilator-dependent boy, after cervical tumor resection, learned GPB on his own and used it for ventilator-free breathing. Over the next 16 yrs, his GPB efficacy improved to the point that, with a vital capacity of 670 ml, his GPB maximum single-breath capacity increased to 3300 ml. This was limited by the fact that at 2.9 l of lung volume, air began to leak around the tracheostomy tube walls and out of the stoma. Still, GPB permitted up to 12 hrs/day of ventilator-free breathing. Measurements of assisted peak cough flow and GPB lung insufflations exceeding vital capacity are the main measures that demonstrate adequate tube fit to permit effective GPB in the presence of an indwelling tracheostomy tube. PMID:15043357

Bianchi, C; Grandi, M; Felisari, G



Serum adiponectin and leptin levels in patients with lipodystrophies.  


Lipodystrophies are characterized by selective but variable loss of body fat and metabolic complications of insulin resistance. We hypothesized that reduced synthesis and secretion of adipocyte-specific proteins may be related to the metabolic complications of lipodystrophy. Therefore, we compared fasting serum concentrations of adiponectin and leptin, in 18 patients with congenital generalized lipodystrophy (CGL), 11 with acquired generalized lipodystrophy (AGL), 46 with familial partial lipodystrophy-Dunnigan variety (FPLD) and 18 with acquired partial lipodystrophy (APL) and studied their relationship to metabolic parameters. Patients with CGL and AGL had markedly reduced serum adiponectin levels compared to those with FPLD and APL (median [range]: 1.5 [0.4-7.5], 3.2 [0.6-7.7], 6.9 [1.9-23.2] and 7.9 [3.1-13.3] microg/mL, respectively, p < 0.0001); the same trend was noted for serum leptin levels (0.63 [0.05-3.7], 2.18 [0.05-11.30], 2.86 [0.23-9.00] and 6.24 [1.21-10.4] ng/mL, respectively, p < 0.0001). Serum adiponectin levels correlated negatively with fasting serum triglycerides (r = -0.6, p < 0.001) and insulin levels (r = -0.5, p < 0.0001) and positively with serum high-density lipoprotein cholesterol levels (r = 0.5, p < 0.001). Serum adiponectin levels were lower in patients with diabetes compared to non-diabetic subjects (3.0 vs. 7.1 microg/mL, p < 0.001). Our results indicate that serum adiponectin and leptin levels are extremely low in patients with generalized lipodystrophies and may be related to severe insulin resistance and its metabolic complications in lipodystrophies. PMID:11994394

Haque, Wasim A; Shimomura, Iichiro; Matsuzawa, Yuji; Garg, Abhimanyu



Predictive factors for high mortality in hypernatremic patients  

Microsoft Academic Search

Hypernatremia (serum sodium level of > 145 mEq\\/L) is associated with high mortality. This study reports an analysis of mortality in 116 patients with hypernatremia from two large university-affiliated teaching hospitals. The purpose was to identify factors predictive of high mortality in hypernatremic patients. Medical records were reviewed to obtain the following data: serum sodium (Na+) levels; systolic (S) and

Anil K Mandal; Mohammad G Saklayen; Nosrat M Hillman; Ronald J Markert



High-level languages for SCADA  

SciTech Connect

Unlike business systems and even process control systems, SCADA systems incorporate a unique blend of real-time, rapid-time, soon-time, ''background,'' and even off-line processes. Depending on the computing power available, and the architecture chosen, the SCADA system builder may be able to use high-level languages to implement these processes. Advances in computer power and language efficiency have made it possible to minimize the use of assembly codes. A structured, modular, software design enables, the use of a mixture of various high-level languages, each with its own particular strengths. Experience gained over many years on projects executed by Rexnord Automation have ranged from SCADA systems based on the Digital Equipment Corp. PDP-11 computer family with software written in assembly code MACRO and a ''home-brew'' operating system, through SCADA systems based on the DEC VAX computer family with software written in ''C'' and running under the VMS system.

Shaw, T.



High-Level Waste Melter Review  

SciTech Connect

The U.S. Department of Energy (DOE) is faced with a massive cleanup task in resolving the legacy of environmental problems from years of manufacturing nuclear weapons. One of the major activities within this task is the treatment and disposal of the extremely large amount of high-level radioactive (HLW) waste stored at the Hanford Site in Richland, Washington. The current planning for the method of choice for accomplishing this task is to vitrify (glassify) this waste for disposal in a geologic repository. This paper describes the results of the DOE-chartered independent review of alternatives for solidification of Hanford HLW that could achieve major cost reductions with reasonable long-term risks, including recommendations on a path forward for advanced melter and waste form material research and development. The potential for improved cost performance was considered to depend largely on increased waste loading (fewer high-level waste canisters for disposal), higher throughput, or decreased vitrification facility size.

Ahearne, J.; Gentilucci, J.; Pye, L. D.; Weber, T.; Woolley, F.; Machara, N. P.; Gerdes, K.; Cooley, C.



High-Level Waste Melter Study Report  

SciTech Connect

At the Hanford Site in Richland, Washington, the path to site cleanup involves vitrification of the majority of the wastes that currently reside in large underground tanks. A Joule-heated glass melter is the equipment of choice for vitrifying the high-level fraction of these wastes. Even though this technology has general national and international acceptance, opportunities may exist to improve or change the technology to reduce the enormous cost of accomplishing the mission of site cleanup. Consequently, the U.S. Department of Energy requested the staff of the Tanks Focus Area to review immobilization technologies, waste forms, and modifications to requirements for solidification of the high-level waste fraction at Hanford to determine what aspects could affect cost reductions with reasonable long-term risk. The results of this study are summarized in this report.

Perez Jr, Joseph M; Bickford, Dennis F; Day, Delbert E; Kim, Dong-Sang; Lambert, Steven L; Marra, Sharon L; Peeler, David K; Strachan, Denis M; Triplett, Mark B; Vienna, John D; Wittman, Richard S



High-Level Integration of Data Systems  

NASA Astrophysics Data System (ADS)

One of the key capabilities required for data systems of the future is the integration of high-level systems and services into their design. Future systems need to provide users with integrated access to distributed and diverse scientific data holdings, models, services, and tools in order to increase the science and educational return from the data. These new capabilities go well beyond the garden variety "get me data" types of services and should be accomplished as part of a broader structure which ties together existing systems at the same time as introducing new capabilities. Here, we present the high-level integration of systems and services as the necessary pieces to accomplish this as well as some lessons learned. and

Weiss, M.; Morrison, D.; Daley, R.; Immer, E.; Hashemian, M.; Fortner, B.; Jen, J.; Holder, R.



Commissioning of the CMS High Level Trigger  

NASA Astrophysics Data System (ADS)

The CMS experiment will collect data from the proton-proton collisions delivered by the Large Hadron Collider (LHC) at a centre-of-mass energy up to 14 TeV. The CMS trigger system is designed to cope with unprecedented luminosities and LHC bunch-crossing rates up to 40 MHz. The unique CMS trigger architecture only employs two trigger levels. The Level-1 trigger is implemented using custom electronics, while the High Level Trigger (HLT) is based on software algorithms running on a large cluster of commercial processors, the Event Filter Farm. We present the major functionalities of the CMS High Level Trigger system as of the starting of LHC beams operations in September 2008. The validation of the HLT system in the online environment with Monte Carlo simulated data and its commissioning during cosmic rays data taking campaigns are discussed in detail. We conclude with the description of the HLT operations with the first circulating LHC beams before the incident occurred the 19th September 2008.

Agostino, L.; Bauer, G.; Beccati, B.; Behrens, U.; Berryhil, J.; Biery, K.; Bose, T.; Brett, A.; Branson, J.; Cano, E.; Cheung, H.; Ciganek, M.; Cittolin, S.; Coarasa, J. A.; Dahmes, B.; Deldicque, C.; Dusinberre, E.; Erhan, S.; Gigi, D.; Glege, F.; Gomez-Reino, R.; Gutleber, J.; Hatton, D.; Laurens, J.; Loizides, C.; Ma, F.; Meijers, F.; Meschi, E.; Meyer, A.; Mommsen, R. K.; Moser, R.; O'Dell, V.; Oh, A.; Orsini, L.; Patras, V.; Paus, C.; Petrucci, A.; Pieri, M.; Racz, A.; Sakulin, H.; Sani, M.; Schieferdecker, P.; Schwick, C.; Margaleff, J. F. S.; Shpakov, D.; Simon, S.; Sumorok, K.; Yoon, A. S.; Wittich, P.; Zanetti, M.



The effects of high level infrasound  

SciTech Connect

This paper will attempt to survey the current knowledge on the effects of relative high levels of infrasound on humans. While this conference is concerned mainly about hearing, some discussion of other physiological effects is appropriate. Such discussion also serves to highlight a basic question, 'Is hearing the main concern of infrasound and low frequency exposure, or is there a more sensitive mechanism'. It would be comforting to know that the focal point of this conference is indeed the most important concern. Therefore, besides hearing loss and auditory threshold of infrasonic and low frequency exposure, four other effects will be provided. These are performance, respiration, annoyance, and vibration.

Johnson, D.L.



Technetium Chemistry in High-Level Waste  

SciTech Connect

Tc contamination is found within the DOE complex at those sites whose mission involved extraction of plutonium from irradiated uranium fuel or isotopic enrichment of uranium. At the Hanford Site, chemical separations and extraction processes generated large amounts of high level and transuranic wastes that are currently stored in underground tanks. The waste from these extraction processes is currently stored in underground High Level Waste (HLW) tanks. However, the chemistry of the HLW in any given tank is greatly complicated by repeated efforts to reduce volume and recover isotopes. These processes ultimately resulted in mixing of waste streams from different processes. As a result, the chemistry and the fate of Tc in HLW tanks are not well understood. This lack of understanding has been made evident in the failed efforts to leach Tc from sludge and to remove Tc from supernatants prior to immobilization. Although recent interest in Tc chemistry has shifted from pretreatment chemistry to waste residuals, both needs are served by a fundamental understanding of Tc chemistry.

Hess, Nancy J.



High accuracy electronic material level sensor  


The High Accuracy Electronic Material Level Sensor (electronic dipstick) is a sensor based on time domain reflectometry (TDR) of very short electrical pulses. Pulses are propagated along a transmission line or guide wire that is partially immersed in the material being measured; a launcher plate is positioned at the beginning of the guide wire. Reflected pulses are produced at the material interface due to the change in dielectric constant. The time difference of the reflections at the launcher plate and at the material interface are used to determine the material level. Improved performance is obtained by the incorporation of: 1) a high accuracy time base that is referenced to a quartz crystal, 2) an ultrawideband directional sampler to allow operation without an interconnect cable between the electronics module and the guide wire, 3) constant fraction discriminators (CFDs) that allow accurate measurements regardless of material dielectric constants, and reduce or eliminate errors induced by triple-transit or "ghost" reflections on the interconnect cable. These improvements make the dipstick accurate to better than 0.1%.

McEwan, Thomas E. (Livermore, CA)



High accuracy electronic material level sensor  


The High Accuracy Electronic Material Level Sensor (electronic dipstick) is a sensor based on time domain reflectometry (TDR) of very short electrical pulses. Pulses are propagated along a transmission line or guide wire that is partially immersed in the material being measured; a launcher plate is positioned at the beginning of the guide wire. Reflected pulses are produced at the material interface due to the change in dielectric constant. The time difference of the reflections at the launcher plate and at the material interface are used to determine the material level. Improved performance is obtained by the incorporation of: (1) a high accuracy time base that is referenced to a quartz crystal, (2) an ultrawideband directional sampler to allow operation without an interconnect cable between the electronics module and the guide wire, (3) constant fraction discriminators (CFDs) that allow accurate measurements regardless of material dielectric constants, and reduce or eliminate errors induced by triple-transit or ``ghost`` reflections on the interconnect cable. These improvements make the dipstick accurate to better than 0.1%. 4 figs.

McEwan, T.E.



[Bradykinin levels in BAL fluid in patients with sarcoidosis].  


In 14 patients with sarcoidosis and in 9 healthy controls the bradykinin level was estimated in broncho-alveolar lavage fluid. The statistically significantly higher bradykinin concentrations was found in sarcoid patients than in controls. No relationship was found between level of bradykinin in BAL and lymphocytes % and no relationship was found between bradykinin level and pulmonary function parameters. PMID:8630467

Ziora, D; Gawlik, R; Baumgarten, C; Kunkel, G; Oklek, K; Rogala, E; Cie?licki, J; Kozielski, J



Serum Leptin and Cholesterol Levels in Patients with Bipolar Disorder  

Microsoft Academic Search

Low cholesterol levels have been reported in patients with manic episodes. Leptin seems to be strongly associated with lipid metabolism. In the present study, therefore, serum total cholesterol and leptin levels were compared in 16 patients with manic episodes, 16 with bipolar I disorder in full remission and 16 healthy controls. The serum total cholesterol and leptin levels were measured

Murad Atmaca; Murat Kuloglu; Ertan Tezcan; Bilal Ustundag; Yilmaz Bayik



Ethambutol Serum Levels of Tuberculous Patients after Oral Administration.  

National Technical Information Service (NTIS)

Ethambutol (ETM) is an effective new anti-tuberculous drug. Its absorption and blood levels in Egyptian tuberculous patients are reported in this communication. This investigation, conducted in 16 chronic tuberculous patients, showed a mean ETM serum leve...

I. A. Mikhail H. H. Youssef J. Sippel K. Sorensen M. E. Mahmoud



Effect of hemoglobin levels in hemodialysis patients with asymptomatic cardiomyopathy  

Microsoft Academic Search

Effect of hemoglobin levels in hemodialysis patients with asymptomatic cardiomyopathy.BackgroundHemoglobin levels below 10 g\\/dL lead to left ventricular (LV) hypertrophy, LV dilation, a lower quality of life, higher cardiac morbidity, and a higher mortality rate in end-stage renal disease. The benefits and risks of normalizing hemoglobin levels in hemodialysis patients without symptomatic cardiac disease are unknown.MethodsOne hundred forty-six hemodialysis patients

Robert N Foley; Patrick S Parfrey; Janet Morgan; Paul E Barré; Patricia Campbell; Pierre Cartier; Douglas Coyle; Adrian Fine; Paul Handa; Iris Kingma; Cathy Y Lau; Adeera Levin; David Mendelssohn; Norman Muirhead; Brendan Murphy; Richard K Plante; Gerald Posen; George A Wells



Serum YKL-40 levels in patients with coronary artery disease.  


Atherosclerosis is considered to be an inflammatory disease in which the initial process is the augmented infiltration of monocytes into the vessel wall and their subsequent differentiation from macrophages into lipid-laden foam cells. Human cartilage glycoprotein-39 (YKL-40) is a new inflammatory marker found to be secreted by lipid-laden macrophages inside human atherosclerotic vessel wall. The aim of this study was to investigate the association of serum YKL-40 levels with the presence and extent of coronary artery disease (CAD) assessed by coronary angiography. We also studied the relation of high-sensitivity C-reactive protein with the presence and angiographic severity of CAD. A total of 200 participants undergoing to coronary angiography was divided into four subgroups: control patients without CAD (n=53), and those with one-vessel disease (n=52), two-vessel disease (n=47), or three-vessel disease (n=48). Serum YKL-40 levels were measured by enzyme-linked immunosorbent assay. Both serum YKL-40 levels and high-sensitivity C-reactive protein concentrations in patients with CAD were significantly higher than in control participants (P<0.001). We also found a significant association between the levels of YKL-40 and the extent of CAD defined by the number of stenosed vessels (P<0.001). The relationship between the serum YKL-40 level and atherosclerosis may represent a new opportunity for the possible utility of serum YKL-40 as an inflammatory marker for coronary artery disease. Moreover, our findings revealed that plasma YKL-40 measurement might also be regarded as a quantitative indicator of disease extent besides being a marker of disease presence. PMID:17627189

Kucur, Mine; Isman, Ferruh K; Karadag, Bilgehan; Vural, Vural A; Tavsanoglu, Sedat



Airway injury during high-level exercise.  


Airway epithelial cells act as a physical barrier against environmental toxins and injury, and modulate inflammation and the immune response. As such, maintenance of their integrity is critical. Evidence is accumulating to suggest that exercise can cause injury to the airway epithelium. This seems the case particularly for competitive athletes performing high-level exercise, or when exercise takes place in extreme environmental conditions such as in cold dry air or in polluted air. Dehydration of the small airways and increased forces exerted on to the airway surface during severe hyperpnoea are thought to be key factors in determining the occurrence of injury of the airway epithelium. The injury-repair process of the airway epithelium may contribute to the development of the bronchial hyper-responsiveness that is documented in many elite athletes. PMID:22247295

Kippelen, Pascale; Anderson, Sandra D



Umbra's High Level Architecture (HLA) Interface  

SciTech Connect

This report describes Umbra's High Level Architecture HLA library. This library serves as an interface to the Defense Simulation and Modeling Office's (DMSO) Run Time Infrastructure Next Generation Version 1.3 (RTI NG1.3) software library and enables Umbra-based models to be federated into HLA environments. The Umbra library was built to enable the modeling of robots for military and security system concept evaluation. A first application provides component technologies that ideally fit the US Army JPSD's Joint Virtual Battlespace (JVB) simulation framework for Objective Force concept analysis. In addition to describing the Umbra HLA library, the report describes general issues of integrating Umbra with RTI code and outlines ways of building models to support particular HLA simulation frameworks like the JVB.




National high-level waste systems analysis  

SciTech Connect

Previously, no mechanism existed that provided a systematic, interrelated view or national perspective of all high-level waste treatment and storage systems that the US Department of Energy manages. The impacts of budgetary constraints and repository availability on storage and treatment must be assessed against existing and pending negotiated milestones for their impact on the overall HLW system. This assessment can give DOE a complex-wide view of the availability of waste treatment and help project the time required to prepare HLW for disposal. Facilities, throughputs, schedules, and milestones were modeled to ascertain the treatment and storage systems resource requirements at the Hanford Site, Savannah River Site, Idaho National Engineering Laboratory, and West Valley Demonstration Project. The impacts of various treatment system availabilities on schedule and throughput were compared to repository readiness to determine the prudent application of resources. To assess the various impacts, the model was exercised against a number of plausible scenarios as discussed in this paper.

Kristofferson, K.; O`Holleran, T.P.



Very High Serum CA 19-9 Levels: A Contraindication to Pancreaticoduodenectomy?  

Microsoft Academic Search

Aim  To assess the outcome of patients with resectable pancreatic adenocarcinoma (PA) associated with high serum CA 19-9 levels.\\u000a \\u000a \\u000a \\u000a Methods  From 2000 to 2007, 344 patients underwent pancreatoduodenectomy for PA. Fifty-three patients (elevated group) had preoperatively elevated serum CA 19-9 levels (>400 IU\\/ml) after resolution of obstructive jaundice. Of these,\\u000a 27 patients had high levels (400–899 IU\\/ml (HL)) and 26 patients had very high

O. Turrini; C. M. Schmidt; J. Moreno; P. Parikh; J. M. Matos; M. G. House; N. J. Zyromski; A. Nakeeb; H. A. Pitt; K. D. Lillemoe



An exploratory study of serum urate levels in patients with amyotrophic lateral sclerosis  

Microsoft Academic Search

Urate is a natural antioxidant, and high serum urate levels could be protective against the development of amyotrophic lateral\\u000a sclerosis (ALS). To determine if serum urate concentrations were lower in ALS patients than in healthy controls, we compared\\u000a serum urate levels in 132 ALS patients and 337 age\\/sex-matched controls. Median urate levels were lower in ALS patients compared\\u000a to controls

Stefano Zoccolella; Isabella Laura Simone; Rosa Capozzo; Rosanna Tortelli; Antonio Leo; Eustachio D’Errico; Giancarlo Logroscino



Studies in understanding patient behavior from a multifaceted level  

Microsoft Academic Search

The universal healthcare environment has changed greatly over the past decade. Understanding patients’ behaviors becomes ever more necessary for healthcare providers to better adapt to the new environment and to improve their performance. With this purpose, the current research adopts the meansend model from the process perspective to investigate patient behaviors from multifaceted levels (from the means level to the

Jie Chen



Hair Iron and Other Minerals’ Level in Breast Cancer Patients  

Microsoft Academic Search

Little is known about hair minerals in cancer patients, and serum iron level has been shown to be elevated in breast cancer\\u000a patients. Therefore, the aim of this study was to evaluate hair iron and hair minerals’ level related to hair iron in breast\\u000a cancer patients compared to controls. We compared hair mineral analysis data of 40 breast cancer subjects

Nam-Seok Joo; Sang-Man Kim; Yong-Sik Jung; Kwang-Min Kim



Increased IL10 plasmatic levels in Fanconi anemia patients.  


Fanconi anemia (FA) is a rare disease, autosomal recessive and X linked, which is clinically prone to development of hematological abnormalities and neoplasms, especially acute myeloid leukemia. In this work IL-10 and TGF-? levels were measured on FA patients' plasma since they are the regulatory cytokines of TNF-? and INF-? which had been described to be overexpressed in this genetic disease. Our results show increased IL-10 plasma levels in 25% of FA patients studied, but levels of TGF-? within the normal range. TNF-? and INF-? were also measured and found to be increased in 24% and 23% of FA patients, respectively. However, no inverse correlation was observed between augmented levels of IL-10 and TNF or IFN-?. Patients with elevated levels of TNF-? and INF-? presented bone marrow hypocellularity. IL-10 levels did not appear to be determinant for bone marrow cellularity. These data suggest that IL-10 is also a feature of Fanconi anemia pathophysiology. PMID:24021704

Justo, Graça A; Bitencourt, Marco A; Pasquini, Ricardo; Castelo-Branco, Morgana T L; Rumjanek, Vivian M




SciTech Connect

The purpose of this Analysis/Model Report (AMR) is to document the analyses that were done to develop models for radionuclide release from high-level waste (HLW) glass dissolution that can be integrated into performance assessment (PA) calculations conducted to support site recommendation and license application for the Yucca Mountain site. This report was developed in accordance with the ''Technical Work Plan for Waste Form Degradation Process Model Report for SR'' (CRWMS M&O 2000a). It specifically addresses the item, ''Defense High Level Waste Glass Degradation'', of the product technical work plan. The AP-3.15Q Attachment 1 screening criteria determines the importance for its intended use of the HLW glass model derived herein to be in the category ''Other Factors for the Postclosure Safety Case-Waste Form Performance'', and thus indicates that this factor does not contribute significantly to the postclosure safety strategy. Because the release of radionuclides from the glass will depend on the prior dissolution of the glass, the dissolution rate of the glass imposes an upper bound on the radionuclide release rate. The approach taken to provide a bound for the radionuclide release is to develop models that can be used to calculate the dissolution rate of waste glass when contacted by water in the disposal site. The release rate of a particular radionuclide can then be calculated by multiplying the glass dissolution rate by the mass fraction of that radionuclide in the glass and by the surface area of glass contacted by water. The scope includes consideration of the three modes by which water may contact waste glass in the disposal system: contact by humid air, dripping water, and immersion. The models for glass dissolution under these contact modes are all based on the rate expression for aqueous dissolution of borosilicate glasses. The mechanism and rate expression for aqueous dissolution are adequately understood; the analyses in this AMR were conducted to provide models and parameter values that can be used to calculate the dissolution rates for the different modes of water contact. The analyses were conducted to identify key aspects of the mechanistic model for glass dissolution to be included in the abstracted models used for PA calculations, evaluate how the models can be used to calculate bounding values of the glass dissolution rates under anticipated water contact modes in the disposal. system, and determine model parameter values for the range of potential waste glass compositions and anticipated environmental conditions. The analysis of a bounding rate also considered the effects of the buildup of glass corrosion products in the solution contacting the glass and potential effects of alteration phase formation. Note that application of the models and model parameter values is constrained to the anticipated range of HLW glass compositions and environmental conditions. The effects of processes inherent to exposure to humid air and dripping water were not modeled explicitly. Instead, the impacts of these processes on the degradation rate were taken into account by using empirically measured parameter values. These include the rates at which water sorbs onto the glass, drips onto the glass, and drips off of the glass. The dissolution rates of glasses that were exposed to humid air and dripping water measured in laboratory tests are used to estimate model parameter values for contact by humid air and dripping water in the disposal system.

W. Ebert



Plasma levels of acylated ghrelin in patients with functional dyspepsia  

PubMed Central

AIM: To investigate the relationship between plasma acylated ghrelin levels and the pathophysiology of functional dyspepsia. METHODS: Twenty-two female patients with functional dyspepsia and twelve healthy volunteers were recruited for the study. The functional dyspepsia patients were each diagnosed based on the Rome III criteria. Eligible patients completed a questionnaire concerning the severity of 10 symptoms. Plasma acylated ghrelin levels before and after a meal were determined in the study participants using a commercial human acylated enzyme immunoassay kit; electrogastrograms were performed for 50 min before and after a standardized 10-min meal containing 265 kcal. RESULTS: There were no significant differences in plasma acylated ghrelin levels between healthy volunteers and patients with functional dyspepsia. However, in patients with functional dyspepsia, there was a negative correlation between fasting plasma acylated ghrelin levels and the sum score of epigastric pain (r = -0.427, P = 0.047) and a positive correlation between the postprandial/fasting plasma acylated ghrelin ratio and the sum score of early satiety (r = 0.428, P =0.047). Additionally, there was a negative correlation between fasting acylated ghrelin plasma levels and fasting normogastria (%) (r = -0.522, P = 0.013). Interestingly, two functional dyspepsia patients showed paradoxically elevated plasma acylated ghrelin levels after the meal. CONCLUSION: Abnormal plasma acylated ghrelin levels before or after a meal may be related to several of the dyspeptic symptoms seen in patients with functional dyspepsia.

Kim, Yeon Soo; Lee, Joon Seong; Lee, Tae Hee; Cho, Joo Young; Kim, Jin Oh; Kim, Wan Jung; Kim, Hyun Gun; Jeon, Seong Ran; Jeong, Hoe Su



Estimating HIV levels and trends among patients of tuberculosis clinics.  

PubMed Central

Symptomatic tuberculosis (TB) can occur as an opportunistic disease in immunosuppressed persons who are infected with human immunodeficiency virus (HIV) and who have been previously infected with Mycobacterium tuberculosis. Increases in TB cases have occurred in areas which have reported large numbers of cases of the acquired immunodeficiency syndrome (AIDS), and a high proportion of these TB cases have been HIV seropositive. Therefore, increasing numbers of HIV-infected persons may be found in TB clinics and hospitals. HIV serologic surveys in TB clinics and hospitals providing clinical services to TB patients are needed to assess the local prevalence of HIV infection in TB patients and the consequent need for public health intervention to prevent further spread of HIV and TB infection. The Centers for Disease Control (CDC), in collaboration with State and local health departments, has initiated HIV surveillance of patients with confirmed and suspected TB in TB clinics and hospitals in the United States. Blinded (serologic test results not linked to identifiable persons) HIV seroprevalence surveys are conducted in sentinel TB clinics and hospitals that provide TB clinical services each year to obtain estimates of the level of HIV infection in TB patients and to follow trends in infection over time. Nonblinded (voluntary) surveys will also be conducted to evaluate behaviors that have placed TB patients at risk for or protected them against HIV infection. Data from these surveys will be used to target education and prevention and control programs for TB and HIV infection and to monitor changes in behavior in response to such programs.

McCray, E; Onorato, I M; Miller, B I; Dondero, T J; Bloch, A B



Commissioning of the CMS High Level Trigger  

Microsoft Academic Search

The CMS experiment will collect data from the proton-proton collisions delivered by the Large Hadron Collider (LHC) at a centre-of-mass energy up to 14 TeV. The CMS trigger system is designed to cope with unprecedented luminosities and LHC bunch-crossing rates up to 40 MHz. The unique CMS trigger architecture only employs two trigger levels. The Level-1 trigger is implemented using

Lorenzo Agostino; Gerry Bauer; Barbara Beccati; Ulf Behrens; Jeffrey Berryhil; Kurt Biery; Tulika Bose; Angela Brett; James Branson; Eric Cano; Harry Cheung; Marek Ciganek; Sergio Cittolin; Jose Antonio Coarasa; Bryan Dahmes; Christian Deldicque; Elizabeth Dusinberre; Samim Erhan; Dominique Gigi; Frank Glege; Robert Gomez-Reino; Johannes Gutleber; Derek Hatton; Jean-Francois Laurens; Constantin Loizides; Frank Ma; Frans Meijers; Emilio Meschi; Andreas Meyer; Remigius K Mommsen; Roland Moser; Vivian O'Dell; Alexander Oh; Luciano Orsini; Vaios Patras; Christoph Paus; Andrea Petrucci; Marco Pieri; Attila Racz; Hannes Sakulin; Matteo Sani; P. Schieferdecker; Christoph Schwick; Josep Francesc Serrano Margaleff; Dennis Shpakov; Sean Simon; Konstanty Sumorok; Andre Sungho Yoon; Peter Wittich; Marco Zanetti



High levels of plasma brain natriuretic peptide and interleukin-6 after optimized treatment for heart failure are independent risk factors for morbidity and mortality in patients with congestive heart failure  

Microsoft Academic Search

OBJECTIVESThe aim of this study was to evaluate whether repetitive measurements of plasma levels of neurohumoral factors and cytokines before and after additional treatment are useful for predicting mortality in patients with congestive heart failure (CHF).BACKGROUNDNeurohumoral and immune activation play an important role in the pathophysiology of CHF. However, the effects of serial changes in these factors on the prognostic

Keiko Maeda; Takayoshi Tsutamoto; Atsuyuki Wada; Naoko Mabuchi; Masaru Hayashi; Takashi Tsutsui; Masato Ohnishi; Masahide Sawaki; Masanori Fujii; Takehiro Matsumoto; Masahiko Kinoshita



Selenium Levels in First-Degree Relatives of Diabetic Patients  

Microsoft Academic Search

The present study was conducted to evaluate the serum selenium levels in first-degree relatives of diabetic patients (FDR)\\u000a according to controls. Insulin resistance, serum lipid levels, inflammation markers, and blood pressure were also studied\\u000a in these patients. Serum levels of selenium in FDR were significantly lower than control group (74.65?±?5.9 vs 88.7?±?8.7 µg\\/dl,\\u000a p?levels were significantly

Mesut Ozkaya; Mustafa Sahin; Erman Cakal; Kadir Gisi; Fidan Bilge; Metin Kilinc



The Plasma Level of Brain Natriuretic Peptide Is Increased in Malnourished Hemodialysis Patients  

Microsoft Academic Search

Background: In hemodialysis (HD) patients, the plasma brain natriuretic peptide (BNP) level is associated with left ventricular dysfunction and patients’ survival. Malnutrition is common in HD patients, it is associated with inflammation and contributes to the high incidence of cardiovascular (CV) disease in this setting (malnutrition-inflammation-atherosclerosis syndrome). In a cross-sectional study, we assessed the relationship between predialysis plasma BNP level

Charles Chazot; Guillaume Jean; Cyril Vo-Van; Cecile Collonge; Jean Claude Terrat; Thierry Vanel; Christie Lorriaux; Jean Marc Hurot; Bernard Charra



Osteocalcin serum levels in patients following renal transplantation.  


Osteocalcin serum levels reflect bone turnover. In renal insufficiency secondary hyperparathyroidism and reduced renal clearance might be responsible for elevated serum levels of osteocalcin. Renal transplantation might improve renal osteodystrophy and therefore could influence osteocalcin serum levels. We determined the influence of renal transplantation on osteocalcin levels in 37 consecutive patients (25m/12f) by RIA. Blood samples were collected prior to, 3 days, 28 days, 6 months and 12 months after renal transplantation. Prior to renal transplantation osteocalcin levels were significantly elevated (mean +/- s: 23.4 +/- 12.8 ng/ml) compared to healthy volunteers (4.1 +/- 1.4 ng/ml). Following renal transplantation osteocalcin decreased significantly (9.4 +/- 8.9 ng ml) 3 days and (7.1 +/- 7.8 ng/ml) 28 days. However, 6 and 12 months following renal transplantation the mean osteocalcin level increased again (8.3 +/- 5.7 ng/ml, 12.1 +/- 15.4 ng/ml). At 6 months 11 and at 12 months only 6 of 37 patients had osteocalcin levels in the normal range. 12 months following renal transplantation 21 out of 37 patients with elevated osteocalcin levels had parathyroid hormone levels above the normal range. Additionally to increased osteocalcin levels patients prior to renal transplantation had elevated alkaline phosphatase. Alkaline phosphatase had following renal transplantation a similar pattern as osteocalcin with initial decrease and secondary increase 6 and 12 months after renal transplantation. Parathyroid hormone was elevated in all patients before renal transplantation. Following renal transplantation mean parathyroid hormone levels tell significantly, however remained above normal range in 57% of these 37 patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:2651790

Schmidt, H; Stracke, H; Schatz, H; Scheuermann, E H; Fassbinder, W; Schoeppe, W



Decreased high-density lipoprotein cholesterol levels in polyarticular juvenile idiopathic arthritis  

PubMed Central

OBJECTIVES: To investigate the prevalence of dyslipoproteinemia in a homogeneous cohort of polyarticular juvenile idiopathic arthritis patients. METHODS: Based on the National Cholesterol Education Program, fasting lipoprotein levels and risk levels for coronary artery disease were determined in 28 patients with polyarticular juvenile idiopathic arthritis. The exclusion criteria included diabetes, thyroid dysfunction, smoking, proteinuria, lipid-lowering drugs, and hormone/diuretic therapy. Disease activity, disease duration, and therapy with corticosteroids and/or chloroquine were defined at the time of lipid measurements. RESULTS: Dyslipoproteinemia was identified in 20 of the 28 (71%) patients with polyarticular juvenile idiopathic arthritis. The primary lipoprotein risk factor was decreased high-density lipoprotein cholesterol (57%), followed by elevated levels of low-density lipoprotein cholesterol (18%), triglycerides (14%), and total cholesterol (7%). The male patients had decreased high-density lipoprotein cholesterol levels than the female patients (p<0.05). The incidence of decreased high-density lipoprotein cholesterol levels did not seem to be affected by disease activity or therapy because the incidence was similar in patients with active or inactive disease, with or without corticosteroid use and with or without chloroquine use. In addition, the frequency of decreased high-density lipoprotein cholesterol levels was similar in patients with short (?5 years) vs. long (>5 years) disease duration. CONCLUSIONS: Dyslipoproteinemia is highly prevalent in patients with polyarticular juvenile idiopathic arthritis and is primarily related to decreased high-density lipoprotein cholesterol levels; therefore, early intervention is essential.

Marangoni, Roberta Goncalves; Hayata, Andre L.; Borba, Eduardo F.; Azevedo, Pedro M.; Bonfa, Eloisa; Goldenstein-Schainberg, Claudia



Apelin Serum Level in Egyptian Patients with Chronic Hepatitis C  

PubMed Central

Objective. Highlighting the apelin system would present a new therapeutic target for liver disease. Apelin; endogenous ligand for the orphan receptor APJ, was recently suggested to be associated with fibrosis progression and cirrhosis in addition to insulin resistance (IR) and inflammation. The present study was conducted to evaluate blood apelin level changes among 73 chronic hepatitis C (CHC) Egyptian patients and if associated with body mass index (BMI), IR, and tumor necrosis factor-alpha (TNF-?). Serum apelin levels were significantly higher in patients with CHC with median value (3.25) when compared with controls (1.11), at P < 0.0001, with significant apelin variations among asymptomatic carriers (ASC), fibrosis, and cirrhosis patients, and also among obese and nonobese patients. Multiple regression analysis depicted that BMI, triglycerides, and total cholesterol were independent correlation factors to apelin levels, whereas TNF-? was found to be significantly negatively correlated to adjusted apelin in CHC patients (r = ?0.5944, P < 0.0001). IR was positively correlated to adjusted apelin in CHC patients (r = 0.2663, P < 0.05). Conclusion. Apelin level varies among stages of CHC, which may contribute to fibrosis progression. In addition, obesity and IR could act as comorbid factors affecting apelin level in patients with CHC.

El-Mesallamy, Hala O.; Hamdy, Nadia M.; Rizk, Hanan H.; El-Zayadi, Abdel-Rahman



Soft Scheduling in High Level Synthesis  

Microsoft Academic Search

In this paper, we establish a theoretical framework for a newconcept of scheduling called soft scheduling. In contraststo the traditional schedulers referred as hard schedulers, softschedulers make soft decisions at a time, or decisions thatcan be adjusted later. Soft scheduling has a potential to alleviatethe phase coupling problem that has plagued traditionalhigh level synthesis (HLS), HLS for deep submicrondesign and

Jianwen Zhu; Daniel D. Gajski Cecs



Low Catalase Levels in the Epidermis of Patients with Vitiligo  

Microsoft Academic Search

Suction blister roofs taken from the involve and uninvolved epidermis of patients with vitiligo showed a consistent reduction in level of catalase compared to normal healthy controls of matched photo-skin types (Fitzpatrick classification). A decrease in catalase activity is expected to increase the concentration of hydrogen peroxide in the epidermis of these patients. Hydrogen peroxide function as a reversible inhibitor

Karin U. Schallreuter; John M. Wood; Jürgen Berger



Increased plasma S-nitrosothiol levels in chronic haemodialysis patients  

Microsoft Academic Search

Background. An impairment of nitric oxide (NO) bioavailability anduor metabolism may contribute to the excessive incidence of atherosclerotic complica- tions observed in haemodialysis (HD) patients. Recent evidence indicates that NO metabolism involves a family of NO-related molecules that have not yet been explored in such patients. The aim of our study was to determine the plasma levels of S-nitrosothiol and

Ziad A. Massy; Didier Borderie; Thao Nguyen-Khoa; Tilman B. Drueke; Ohvanesse G. Ekindjian; Bernard Lacour



Understanding the level of fatigue in cancer patients undergoing radiotherapy  

Microsoft Academic Search

This study tests the hypothesis that a discrepancy between resources and demands explains most of the variance in fatigue in cancer patients undergoing radiotherapy. Patients (n=250) were interviewed at pretreatment, posttreatment, and at 9-month follow-up. Resources involved physical condition, neuroticism, optimism, social support, gender, age, and level of education. Demands entailed prognosis, radiotherapy dose, the effort associated with actual activity,

E. M. A. Smets; M. R. M. Visser; B. Garssen; N. H. Frijda; P. Oosterveld



Human hepatocyte growth factor levels in patients undergoing thoracic operations  

Microsoft Academic Search

Human hepatocyte growth factor (hHGF) is the most potent mitogen identified for alveolar type II cells, and may have other important functions in the repair of the alveolar epithelium and compensatory lung growth. A study was conducted to evaluate the changes of serum hHGF levels in patients who underwent thoracic surgical procedures. The patients comprised 17 males and 14 females

E. Dikmen; M. Kara; U. Kisa; C. Atinkaya; S. Han; U. Sakinci



Soluble ICAM-1 serum levels in patients with intermediate uveitis  

PubMed Central

AIM—To investigate whether serum levels of soluble intercellular adhesion molecule 1 (sICAM-1) can serve as a marker of the presence of systemic disease in intermediate uveitis.?METHODS—In a multicentre study sICAM-1 serum levels were measured in 61 patients with idiopathic intermediate uveitis, controls included 56 uveitis patients with a systemic disease (26 sarcoid associated uveitis and 30 HLA-B27 positive acute anterior uveitis), 58 uveitis patients without systemic disease (30 toxoplasma chorioretinitis and 28 Fuchs' hetrochromic cyclitis), and 21 normal controls. The clinical records of the patients with intermediate uveitis were analysed for disease characteristics at the time of blood sampling and for a relation with the development of a systemic disease after a mean follow up of 4.5 years. ?RESULTS—Increased serum levels of sICAM-1 were found in 34 out of 61 patients with intermediate uveitis and were significantly different when compared with toxoplasmosis, Fuchs' cyclitis, and healthy controls (p<0.001). Elevated sICAM-1 levels were also found in 18 out of 26 patients with sarcoid uveitis and in 11 out of 30 patients with HLA-B27 associated anterior uveitis. Raised sICAM-1 levels in the intermediate uveitis group were significantly associated with active ocular disease (p<0.01) and the presence of vitreous exudates (p<0.05). Increased levels of sICAM-1 correlated with interleukin 8 levels (IL-8) (tested in a previous study in the same group of intermediate uveitis patients) in patients with active systemic involvement. Follow up of the patients showed that an established or suspected systemic disease was found more often in the 21 intermediate uveitis patients with increased sICAM-1 and IL-8 levels compared with the other 40 patients with intermediate uveitis (p<0.01).?CONCLUSIONS—The measurement of both sICAM-1 and IL-8 can be used as a marker for ocular disease activity and for a predisposition of developing an associated systemic disease in intermediate uveitis patients.??

Klok, A.; Luyendijk, L.; Zaal, M.; Rothova, A.; Kijlstra, A.



Endothelin-1 levels in scleroderma patients: a pilot study.  


Endothelin-1 (ET-1) is a potent endogenous vasoconstrictor, which mediates vascular wall cells proliferation, fibrosis, and inflammation through two types of ET-1 receptors (ET-A and ET-B). In our retrospective study the serum levels of ET-1 in 18 systemic sclerosis (SSc) patients with and without digital ulcers (DUs) were assessed to observe possible correlation between the levels of ET-1, the evolution of SSc, and the therapy with an ET-1 antagonist (bosentan). In all our patients, the levels of ET-1 were found higher than normal range and correlate with the severity of the disease. Furthermore we also observed that in patients without DUs the levels of ET-1 were higher and did not correlate with new DUs development. In conclusion, the levels of ET-1 in our studied patients do not correlate with the possible development of DUs. The reduction of ET-1 levels in DUs patients in therapy with bosentan confirms the efficacy of this molecule both for treatment and prevention of digital ulcers. The inhibition of ET-A receptor by its antagonist may activate the opposite ET-B receptors, with well-known function ET-1 degradation and reducing of ET-1 serum level as confirmed in our pilot study. PMID:23984086

Cozzani, Emanuele; Javor, Sanja; Laborai, Erika; Drosera, Massimo; Parodi, Aurora



VHDL as Input for High-Level Synthesis  

Microsoft Academic Search

High-level synthesis is defined, and the feasibility of high-level synthesis from a behavioral, sequential description in VHDL (VHSIC hardware description language) is examined. It is seen that in some cases the semantics and descriptive power of the language create difficulties for high-level synthesis, and in other cases the high-level synthesis framework used imposes limitations. Restrictions in the form of rules

Raul Camposano; L. F. Saunders; R. M. Tabet



Serum Cholesterol Level Comparison: Control Subjects, Anxiety Disorder Patients, and Obsessive-Compulsive Disorder Patients  

Microsoft Academic Search

Objective: To determine whether panic disorder is associated with elevated serum choles- terol levels. Serum cholesterol levels of panic disorder patients are reported to be elevated. This could explain the higher-than-expected cardiovascular mortality in this population. Some evidence exists wherein cholesterol levels are also increased in patients with general anxiety disorder and phobias. To date, there are only 2 reports

Helmut Peter; Iver Hand; Fritz Hohagen; Anne Koenig; Olaf Mindermann; Frank Oeder; Markus Wittich


Trace Element Levels in Hashimoto Thyroiditis Patients with Subclinical Hypothyroidism  

Microsoft Academic Search

The present study was conducted to evaluate the serum copper, zinc, magnesium, and selenium levels in patients with subclinical\\u000a hypothyroidism in the iodine-rich region of Ankara, Turkey. The effects of hormone replacement therapy on these elements were\\u000a also studied in these patients. Basal levels of selenium and iron in patients were significantly lower than control group\\u000a (67.7?±?10.4 vs. 83.7?±?17.3 ?g\\/dl, p?=?0.02;

Muhammed Erdal; Mustafa Sahin; Adnan Hasimi; Gökhan Uckaya; Mustafa Kutlu; Kenan Saglam



Cortisol levels in patients with severe community-acquired pneumonia  

Microsoft Academic Search

Objectives  To evaluate cortisol levels and prevalence of adrenal insufficiency in patients with severe community-acquired pneumonia (CAP).\\u000a \\u000a \\u000a \\u000a Design and setting  Retrospective cohort study in a 24-bed medical-surgical intensive care unit (ICU).\\u000a \\u000a \\u000a \\u000a Patients  Forty patients with severe CAP admitted to the ICU from March 2003 and May 2005.\\u000a \\u000a \\u000a \\u000a Measurements and results  Random cortisol levels were measured up to 72?h after ICU admission. A threshold of

Jorge I. F. Salluh; Juan C. Verdeal; Gustavo W. Mello; Leonardo V. Araújo; Gloria A. R. Martins; Marcelo de Sousa Santino; Márcio Soares



46 CFR 182.530 - Bilge high level alarms.  

Code of Federal Regulations, 2011 CFR

...2011-10-01 2011-10-01 false Bilge high level alarms. 182.530 Section 182.530...Ballast Systems § 182.530 Bilge high level alarms. (a) On a vessel of at...operating station to indicate a high water level in each of the following normally...



46 CFR 182.530 - Bilge high level alarms.  

Code of Federal Regulations, 2012 CFR

...2012-10-01 2012-10-01 false Bilge high level alarms. 182.530 Section 182.530...Ballast Systems § 182.530 Bilge high level alarms. (a) On a vessel of at...operating station to indicate a high water level in each of the following normally...



46 CFR 153.409 - High level alarms.  

Code of Federal Regulations, 2012 CFR

...2012-10-01 2012-10-01 false High level alarms. 153.409 Section 153.409...Cargo Gauging Systems § 153.409 High level alarms. When Table 1 refers to this...cargo's containment system must have a high level alarm: (a) That gives an...



46 CFR 153.409 - High level alarms.  

Code of Federal Regulations, 2011 CFR

...2011-10-01 2011-10-01 false High level alarms. 153.409 Section 153.409...Cargo Gauging Systems § 153.409 High level alarms. When Table 1 refers to this...cargo's containment system must have a high level alarm: (a) That gives an...



40 CFR 227.30 - High-level radioactive waste.  

Code of Federal Regulations, 2013 CFR

...2013-07-01 2013-07-01 false High-level radioactive waste. 227.30 Section 227.30 Protection... Definitions § 227.30 High-level radioactive waste. High-level radioactive waste means the aqueous waste resulting...



ICONDENSATION: Unifying Low-Level and High-Level Tracking in a Stochastic Framework  

Microsoft Academic Search

. Tracking research has diverged into two camps; low-level approaches which are typically fast and robust but provide little fine-scale information, and high-level approaches which track complex deformations in high-dimensional spaces but must trade off speed against robustness. Real-time high-level systems perform poorly in clutter and initialisation for most high-level systems is either performed manually or by a separate module.

Michael Isard; Andrew Blake



Longitudinal study of leptin levels in chronic hemodialysis patients  

Microsoft Academic Search

Background  The influence of serum leptin levels on nutritional status and survival in chronic hemodialysis patients remained to be elucidated.\\u000a We conducted a prospective longitudinal study of leptin levels and nutritional parameters to determine whether changes of\\u000a serum leptin levels modify nutritional status and survival in a cohort of prevalent hemodialysis patients.\\u000a \\u000a \\u000a \\u000a \\u000a Methods  Leptin, dietary energy and protein intake, biochemical markers of

Ilia Beberashvili; Inna Sinuani; Ada Azar; Hila Yasur; Leonid Feldman; Zhan Averbukh; Joshua Weissgarten



Period analysis at high noise level  

NASA Astrophysics Data System (ADS)

Analytical expressions are derived for the variances of three types of periodograms due to normal-distributed noise present in the data: the conventional Fourier spectrum, the method of Warner and Robinson (1972), and Jurkevich's method (1971). The equivalence of the Jurkevich method and that of Warner and Robinson is proved. The optimum phase cell number of the Warner-Robinson method is given; this number depends on the data length, signal form, and noise level. Results are illustrated by the analysis of two typical forms of light curves: an eclipsing type light curve and an RRa curve.

Kovacs, G.



Serum melatonin levels in melanoma patients after repeated oral administration.  


The goal of this study was to determine the effect of oral melatonin in divided doses on plasma melatonin levels in patients with metastatic melanoma. Hourly blood samples were obtained from five patients for 24 h prior to melatonin administration and for 24 h during oral administration of melatonin, 50 mg every 4 h. In two of the five patients, the expected nocturnal plasma melatonin peak was observed. Oral melatonin was well absorbed. Plasma melatonin levels exhibited six peaks and troughs, were two to four-fold higher during peaks than troughs, and remained more than 25 times higher than peak pretreatment melatonin levels, even during troughs. Divided oral doses of melatonin were well tolerated and maintained plasma melatonin levels 25-80 times higher than endogenous peak values. PMID:8032220

Kane, M A; Johnson, A; Nash, A E; Boose, D; Mathai, G; Balmer, C; Yohn, J J; Robinson, W A



Elevated serum CA19-9 levels in poorly controlled diabetic patients.  


Serum CA19-9 levels were measured in 60 diabetic patients and 40 healthy volunteers. Serum CA19-9 concentration was correlated with hemoglobin A1 (HbA1) (r = 0.4368 P less than 0.005) and fasting plasma glucose levels (r = 0.3410 P less than 0.01). None of the 40 healthy subjects showed elevated CA19-9 concentrations over 37 units/ml as the upper normal value. The percentage of positive serum CA19-9 levels in poorly controlled patients (fasting plasma glucose greater than 200 mg/dl or HbA1 greater than 13%) and moderately to well controlled patients was 50% and 10%, respectively. No correlation was found between the level of CA19-9 and those total cholesterol, and triglycerides, or the duration of diabetes. In patients who had diabetic retinopathy or persistent proteinuria, the CA19-9 concentration was significantly elevated when compared with those without these complications. It has been shown that patients with adenocarcinoma of the gastrointestinal tract have high plasma CA19-9 levels and those who have benign disease have normal CA19-9 levels. Even though diabetes mellitus is not a malignant disease, serum CA19-9 levels were increased in diabetic patients. These results indicate that HbA1 and fasting plasma glucose should be examined in patients with high CA19-9 levels. PMID:3464790

Nakamura, N; Aoji, O; Yoshikawa, T; Mori, K; Kajiyama, S; Kitagawa, Y; Kanatsuna, T; Kondo, M



Effect of Health Information Technology Expenditure on Patient Level Cost  

PubMed Central

Objectives This study investigate the effect of health information technology (IT) expenditure on individual patient-level cost using California Office of Statewide Health Planning and Development (OSHPD) data obtained from 2000 to 2007. Methods We used a traditional cost function and applied hospital fixed effect and clustered error within hospitals. Results We found that a quadratic function of IT expenditure best fit the data. The quadratic function in IT expenditure predicts a decrease in cost of up to US$1,550 of IT labor per bed, US$27,909 of IT capital per bed, and US$28,695 of all IT expenditure per bed. Moreover, we found that IT expenditure reduced costs more quickly in medical conditions than surgical diseases. Conclusions Interest in health IT is increasing more than ever before. Many studies examined the effect of health IT on hospital level cost. However, there have been few studies to examine the relationship between health IT expenditure and individual patient-level cost. We found that IT expenditure was associated with patient cost. In particular, we found a quadratic relationship between IT expenditure and patient-level cost. In other word, patient-level cost is non-linearly (or a polynomial of second-order degree) related to IT expenditure.

Dowd, Bryan



Serum thyrotropin (TSH) levels in patients with suppressed pituitary function  

SciTech Connect

The diagnosis of borderline hyperthyroidism is difficult. A sensitive radioimmunoassay capable of detecting subnormal levels of serum TSH may be of value in confirming this diagnosis because of the suppressed pituitary function in this disease state. This sensitive assay may also be useful in monitoring the suppression of pituitary function in thyroid cancer patients receiving thyroid hormone therapy. A sensitive radioimmunoassay capable of detecting serum TSH levels as low as 0.25 with coefficients of variation less than 17.2% was used to measure serum TSH levels in 80 healthy subjects, 44 hyperthyroid patients, and 25 athyrotic thyroid cancer patients on daily suppressive doses of thyroxine. All healthy subjects had detectable TSH levels with a mean value of 1.17 and two standard deviation ranges of 0.41 - 2.70 (lognormal distribution). Although the mean +-1 SEM value of 0.63 +- 0.003 for hyperthyroid patients and 0.76 +- 0.08 for thyroid cancer patients were significantly lower than that of healthy subjects (t-test, p<0.05), subnormal levels of serum TSH were found in only 28.6% (12/42) and 24% (6/25) of hyperthyroid and thyroid cancer patients, respectively. TSH stimulation tests performed in 6 of the cancer patients all gave suppressed responses. Because of considerable overlap, serum TSH levels alone cannot distinguish hyperthyroidsm from euthyroidism. However, a sensitive TSH radioimmunoassay such as the one described here may be of value in evaluating the extent of pituitary suppression in thyroid cancer therapy.

Vasavada, P.; Chen, I.; Maxon, H.; Barnes, E.; Sperling, M.



The high-level synthesis of digital systems  

Microsoft Academic Search

High-level synthesis systems start with an abstract behavioral specification of a digital system and find a register-transfer level structure that realizes the given behavior. The various tasks involved in developing a register-transfer level structure from an algorithmic level specification are described. In particular, it is shown how the high-level synthesis task can be decomposed into a number of distinct but

M. C. McFarland; A. C. Parker; R. Camposano



Increased plasma agmatine levels in patients with schizophrenia.  


Agmatine is an endogenous substance, synthesized from l-arginine, and it is proposed to be a new neurotransmitter. Preclinical studies indicated that agmatine may have an important role in the pathophysiology of schizophrenia. This study was organized to investigate plasma agmatine in patients with schizophrenia and in healthy controls. Eighteen patients with schizophrenia and 19 healthy individuals constituted the subjects. Agmatine levels in the plasma were measured using the HPLC method. The S100B protein level, which is a peripheral biomarker for brain damage, was also measured using the ELISA method. While plasma levels of agmatine in patients with schizophrenia were significantly increased (p < 0.0001) compared to those of healthy individuals (control), there were no significant changes in the levels of S100B protein (p = 0.660). An ROC (receiver operating characteristic) curve analysis revealed that measuring plasma agmatine levels as a clinical diagnostic test would significantly differentiate between patients with schizophrenia and those in the control group (predictive value: 0.969; p < 0.0001). The predictive value of S100B measurements was not statistically significant (p > 0.05). A multiple regression analysis revealed that the age of the patient and the severity of the illness, as indicated by the PANSS score, significantly contributed the plasma agmatine levels in patients with schizophrenia. These results support the hypothesis that an excess agmatine release is important in the development of schizophrenia. The findings also imply that the plasma agmatine level may be a potential biomarker of schizophrenia. PMID:23664672

Uzbay, Tayfun; Goktalay, Gokhan; Kayir, Hakan; Eker, Salih S; Sarandol, Asli; Oral, Sema; Buyukuysal, Levent; Ulusoy, Gokhan; Kirli, Selcuk



Fermilab Tevatron high level rf accelerating systems  

SciTech Connect

Eight tuned rf cavities have been installed and operated in the F0 straight section of the Tevatron. Their mechanical placement along the beam line enables them to be operated for colliding beams as two independent groups of four cavities, group 1-4 accelerating antiprotons and group 5-8 accelerating protons. The only difference is that the spacing between cavities 4 and 5 was increased to stay clear of the F0 colliding point. The cavities can easily be rephased by switching cables in a low-level distribution system (fan-out) so that the full accelerating capability of all eight cavities can be used during fixed target operations. Likewise, the cables from capacitive probes on each cavity gap can be switched to proper lengths and summed in a fan-back system to give an rf signal representing the amplitude and phase as ''seen by the beam,'' separately for protons and antiprotons. Such signals have been used to phase lock the Tevatron to the Main Ring for synchronous transfer.

Kerns, Q.; Kerns, C.; Miller, H.; Tawser, S.; Reid, J.; Webber, R.; Wildman, D.



Crystalline Order in High Landau Levels  

NASA Astrophysics Data System (ADS)

We numerically study electrons confined to a higher Landau level (e.g., N=2), by exact diagonalization. The use of periodic boundary conditions allows the clear detection of various broken symmetry electron crystal states, at filling factors not close to 1/2 (e.g., 1/4). These states appear to be the ``bubble'' phases predicted by Shklovskii et al. The broken symmetry is signaled by a striking quasi-degeneracy of the ground state, where the quasi-degenerate set of quantum numbers forms a 2D superlattice of Bragg vectors that characterizes the crystalline state (number of electrons per unit cell, shape, etc.), and also by quasi-divergent response functions. Variation of the pbc cell shape to optimize the quasi-degeneracy allows the intrinsically-preferred crystal structure to be found. These results are also consistent with recent experiments of Eisenstein et al. where a reentrant ? = 4 quantum Hall plateau was seen near near ?=4+1/4, suggesting a pinned crystal phase.

Haldane, F. D. M.; Rezayi, E. H.; Yang, Kun



Progress in high-level exploratory vision  

NASA Astrophysics Data System (ADS)

We have been exploring the hypothesis that vision is an explanatory process, in which causal and functional reasoning about potential motion plays an intimate role in mediating the activity of low-level visual processes. In particular, we have explored two of the consequences of this view for the construction of purposeful vision systems: Causal and design knowledge can be used to (1) drive focus of attention, and (2) choose between ambiguous image interpretations. An important result of visual understanding is an explanation of the scene's causal structure: How action is originated, constrained, and prevented, and what will happen in the immediate future. In everyday visual experience, most action takes the form of motion, and most causal analysis takes the form of dynamical analysis. This is even true of static scenes, where much of a scene's interest lies in how possible motions are arrested. This paper describes our progress in developing domain theories and visual processes for the understanding of various kinds of structured scenes, including structures built out of children's constructive toys and simple mechanical devices.

Brand, Matthew



Cardiometabolic risk and educational level in adult patients with type 1 diabetes.  


A low educational level and a poor socioeconomic status could be associated with increased risk for chronic diseases. The aim of the study was to evaluate the relationship between the educational level and cardiometabolic risk in adult patients with type 1 diabetes (n = 437; age: 38.0 +/- 10.4 years, duration of diabetes: 19.2 +/- 11.1 years; x +/- SD). Educational levels were classified as low [primary school, n = 56 (12.8%)], middle [high school, n = 251 (57.4%)] or high [university, n = 130 (29.7%)]. The prevalence rate of the metabolic syndrome proved to be higher in patients with low versus high educational levels (ATP-III criteria: 42.9 vs. 21.5%, P = 0.0006). Antihypertensive treatment and cardiovascular diseases were more prevalent in patients with low versus high educational level (46.4 vs. 26.2%, P = 0.01; 12.5 vs. 2.3%, P = 0.02; respectively). Overall glycemic control was worse in patients with low versus high educational level (HbA(lc): 8.8 +/- 1.6 vs. 7.9 +/- 1.4%; P = 0.0006). Patients with low versus high educational level differed significantly regarding smoking habits (smokers: 28.6 vs. 11.6%; P = 0.01) and regular physical activity (5.4 vs. 33.1%; P = 0.0001). Higher prevalence rate of certain cardiometabolic risk factors was associated with low educational level in middle-aged type 1 diabetic patients with relatively long duration of diabetes; therefore, these patients should have priority when preventing cardiovascular complications. PMID:18843447

Nádas, J; Putz, Z; Fövényi, J; Gaál, Z; Gyimesi, A; Hídvégi, T; Hosszúfalusi, N; Neuwirth, G; Oroszlán, T; Pánczél, P; Vándorfi, G; Winkler, G; Wittmann, I; Jermendy, G



High-level design and synthesis of a resource scheduler  

Microsoft Academic Search

Given the increasing complexity of current embedded systems, hardware design is being pushed to a higher level of abstraction, with High-Level Synthesis tools enabling hardware synthesis from untimed C++. Still, HLS technology does not provide a clear methodology to derive both hardware and software implementations from a single high-level code. This paper describes the design, implementation and evaluation of a

Joao Paulo Pizani Flor; Tiago Rogerio Muck; Antonio Augusto Frohlich



Serum zinc and magnesium levels in patients with blastocystosis  

Microsoft Academic Search

The aim of the study was to investigate the total content of the essential elements of zinc and magnesium levels in patients\\u000a infected with Blastocystis hominis. Zinc and magnesium concentrations were measured in 52 patients who were positive for the intestinal parasite Blastocystis hominis. Scores were obtained for the positives and their age- and sex-matched 60 Blastocystis hominis-negative healthy controls.

Eser Kilic; Süleyman Yazar; Recep Saraymen



Low Plasma Prolactin Levels in Patients with Functional Dyspepsia  

Microsoft Academic Search

Background: The purpose was to compare the levels and patterns of plasma cortisol and prolactin in patients with functional dyspepsia (FD) during a controlled laboratory experiment. Method: 25 patients (12 men, 13 women), aged 24–50, with recurrent FD, and 25 pair-wise gender- and age-matched community control subjects were studied at a gastroenterological laboratory in a Swedish university hospital. In an

Bo H. Jonsson; Töres Theorell



[Plasma fibronectin level in patients with depression of hematopoiesis].  


Plasma fibronectin is regarded to play an important part in a decrease of the resistance to infections. To specify the role of fibronectin in the pathogenesis of infectious complications in patients with depressions of hemopoiesis, the content of this opsonin was measured by ELISA in 113 patients with different patterns of hemoblastoses, lymphoproliferative diseases and with an aplastic syndrome. In 42 patients, the concentration of opsonin was measured in the presence of the superimposed infection of varying gravity. The fibronectin content was examined in 39 patients before, during and after completion of the cytostatic polychemotherapy. It turned out that in patients with paraproteinemic hemoblastoses, lymphogranulomatosis, aplastic anemia, chronic lympholeukemia, acute lympho- and myelo(mono)blastic leukemias, cyclic neutropenia, chronic myelosis and hematosarcomas, the concentration of fibronectin remained normal in the absence of infections. The computation of the linear correlation ratio did not reveal any association between the opsonin level and the concentration of neoplastic elements in the peripheral blood. Repeated measurements of the fibronectin level in patients whose underlying disease ran its course in association with marked neoplastic fever failed to detect any deficiency of the glycoprotein. The lowering of the fibronectin level was recorded in patients with a grave concomitant infection of the type of sepsis, necrotic enteropathy and lobar pneumonia. The degree of opsonin deficiency correlated with the patients' disease gravity. Prolonged reduction in the blood fibronectin level was of unfavourable prognostic importance. Cytostatic polychemotherapy, myelotoxic agranulocytosis as well as infectious complications of low gravity did not influence the concentration of fibronectin.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:4049264

Vasil'ev, S A; Savchenko, V G; Margulis, E Ia; Ermolin, G A; Kotelianski?, V E



Autism Consumer Health Web Sites: Are Readability Levels Too High?  

Microsoft Academic Search

Are excessively high reading levels creating a barrier for parents seeking information about autism on the Internet? Although the average American reads at the eighth grade level, medical information is frequently written above the twelfth grade level. Readability of 14 autism consumer health Web sites was determined. The average reading score on the Flesch-Kincaid Grade Level Index was grade 11.9

Robin M. Sabo



Weight gain in risperidone therapy: investigation of peripheral hypothalamic neurohormone levels in psychotic patients.  


The use of antipsychotic drugs has started a new era in the treatment of psychotic disorders. Nevertheless, they cause complications in the long-term treatment, which is mainly weight gain. In this study, we investigated circulating levels of hypothalamic neuropeptides, which are related to appetite regulation, neuropeptide Y (NPY), ?-melanocyte-stimulating hormone (?-MSH), cocaine- and amphetamine-regulated transcript (CART), and leptin, in first-attack psychotic patients who were treated with an atypical antipsychotic drug, risperidone, for 4 weeks. We used a case-control association design to compare the neuropeptides in the control group versus before and after treatment of the patient group. Samples were obtained from psychotic patients who were admitted to the Psychiatry Outpatient Clinics, Gulhane School of Medicine, Ankara, Turkey. When compared with the control group, NPY and ?-MSH plasma levels of psychotic patients were severely reduced, and the CART levels were substantially increased when they were first diagnosed (before treatment). However, the patients' body mass index and circulating leptin levels were markedly high after the treatment. Circulating levels of those neurohormones were not significantly changed between before and after treatment of the patients. These data demonstrate that peripheral ?-MSH and NPY, although reflecting only secretion from peripheral organs, nevertheless, may provide an insight into the patients sympathetic tone and also suggest change of their appetite regulation. ?-Melanocyte-stimulating hormone, NPY, and CART plasma levels may be used as a predictor of weight gain in the early treatment of the patients along with the leptin levels. PMID:23807284

Yanik, Tulin; Kursungoz, Canan; Sutcigil, Levent; Ak, Mehmet



Longitudinal stability of CSF tau levels in Alzheimer patients  

Microsoft Academic Search

Background: Antemortem levels of tau in the cerebrospinal fluid (CSF) of Alzheimer’s disease (AD) patients have repeatedly been demonstrated to be elevated when compared to controls. Although CSF tau has been reported to be elevated even in very mild AD, it is unknown how tau levels change during the course of the disease.Methods: We have followed 29 mild-to-moderately affected AD

Trey Sunderland; Benjamin Wolozin; Douglas Galasko; James Levy; Ruth Dukoff; Marcel Bahro; Robert Lasser; Ruth Motter; Terho Lehtimäki; Peter Seubert



Electrophrenic pacing and decannulation for high-level spinal cord injury: A case series  

PubMed Central

Background In 1997, guidelines were developed for the management of high-level ventilator-dependent patients with spinal cord injury who had little or no ventilator-free breathing ability (VFBA). This article describes the three categories of patients, the decannulation criteria, and the successful decannulation of four patients with no VFBA and electrophrenic/diaphragm pacing, using these criteria. Method Case series. Conclusion Lack of VFBA in patients with high-level spinal cord injury does not mandate tracheostomy or electrophrenic/diaphragm pacing.

Bolikal, Priya; Bach, John R.; Goncalves, Miguel



Soluble interleukin-2 receptor, intercellular adhesion molecule-1 and interleukin-10 serum levels in patients withelanoma  

PubMed Central

Serum soluble interleukin-2 receptor (sIL-2R), intercellular adhesion molecule-1 (sICAM-1) and interleukin-10 (IL-10) have each been reported as useful markers for melanoma progression. To evaluate the clinical relevance of these three markers, we simultaneously analysed their serum levels in patients with melanoma. A longitudinal study with a 3-year follow-up was performed and different stages of the disease were considered. Mean values of sIL-2R were significantly higher than in normal controls in all stages and correlated with the disease progression. The prognosis of patients with levels > 529 U/ml of sIL-2R was significantly poorer than in patients with sIL-2R levels < 529 U/ml. Levels of sICAM-1 were also elevated in melanoma patients, specially at the time of the metastatic disease. Serum IL-10 levels were more frequently detectable in the patients that developed metastasis during follow-up, and the prognosis of patients with detectable IL-10 levels was significantly poorer than in those patients with IL-10 undetected levels. Statistical analysis based on Logistic and Cox regression models showed that only sex, stage and sIL-2R value are factors significantly associated with metastatic progression. Moreover, high levels of sIL-2R could be a risk factor for malignant progression in melanoma. © 2000 Cancer Research Campaign

Boyano, M D; Garcia-Vazquez, M D; Lopez-Michelena, T; Gardeazabal, J; Bilbao, J; Canavate, M L; Galdeano, A Garcia De; Izu, R; Diaz-Ramon, L; Raton, J A; Diaz-Perez, J L



Serum Adiponectin Levels in Advanced-Stage Parkinson's Disease Patients  

PubMed Central

Patients with advanced Parkinson's disease (PD) experience body weight loss and reductions in the most common cardiovascular risk factors. At present, the pathogenetic mechanisms involved have not been elucidated. Increased serum concentrations of adiponectin, which possesses antiatherogenic and anti-inflammatory properties, are associated with a reduction in cardiovascular risk. The objective of this study was to determine adiponectin serum concentrations in PD patients. Thirty PD patients underwent a full nutritional status assessment, including the determination of adiponectin serum concentrations. Mean ± SD adiponectin concentrations were 9.59 ± 5.9??g/mL (interquartile range: 5.92–12.9??g/mL). In PD patients, adiponectin serum levels were similar to those in normal-weight, healthy, young subjects and significantly higher than that in an aged-matched group of morbidly obese subjects. Further studies are warranted to establish the role of adiponectin in the management of PD patients.

Cassani, Erica; Cancello, Raffaella; Cavanna, Ferruccio; Maestrini, Sabrina; Di Blasio, Anna Maria; Liuzzi, Antonio; Pezzoli, Gianni; Barichella, Michela



High Level Waste Canister Emplacement and Retrieval Concepts Study.  

National Technical Information Service (NTIS)

Several concepts are described for the interim (20 to 30 years) storage of canisters containing high level waste, cladding waste, and intermediate level-TRU wastes. It includes requirements, ground rules and assumptions for the entire storage pilot plant....



Intercurrent clinical events are predictive of plasma C-reactive protein levels in hemodialysis patients  

Microsoft Academic Search

Intercurrent clinical events are predictive of plasma C-reactive protein levels in hemodialysis patients.BackgroundIn chronic hemodialysis (HD) patients, the repetitive induction of the acute phase response (APR) may induce a chronic micro-inflammatory state, leading to various long-term complications.MethodsThe present prospective study was designed to assess the alterations in the APR in 74 patients who were randomized to HD with a high-flux

Anne Van Tellingen; Muriel P C Grooteman; Margreet Schoorl; Piet C M Bartels; Marianne Schoorl; Tjeerd Van Der Ploeg; Piet M Ter Wee; Menso J Nubé



Enhanced BDNF serum levels in patients with severe pathological gambling.  


Although the pathophysiology of gambling is unknown, an involvement of midbrain dopaminergic pathway has been hypothesized. In this study, the association between brain-derived neurotrophic factor (BDNF) and pathological gambling was investigated. We measured BDNF serum levels in (1) video players (n=10); (2) card players (n=9); (3) mixed players (n=21; both video and card players) and (4) age-matched controls (n=18). Mixed players had increased BDNF serum levels as compared to controls and higher South Oaks Gambling Screen score as compared to card or video players. Thus, the data demonstrate that patients affected by severe pathological gambling show enhanced BDNF serum levels. PMID:22044515

Angelucci, Francesco; Martinotti, Giovanni; Gelfo, Francesca; Righino, Elisabetta; Conte, Gianluigi; Caltagirone, Carlo; Bria, Pietro; Ricci, Valerio



Relationship between serum trough infliximab levels, pretreatment C reactive protein levels, and clinical response to infliximab treatment in patients with rheumatoid arthritis  

PubMed Central

Objective: To investigate the relationship between serum trough infliximab levels and clinical response to infliximab treatment in patients with rheumatoid arthritis (RA). Methods: Disease activity and serum trough infliximab levels before and 2, 6, and 14 weeks after initiation of infliximab treatment at a dose of 3 mg/kg in a cohort of 105 patients with RA were assessed. Serum trough infliximab levels in responders and non-responders were compared. Additionally, the clinical responses of patients with high, intermediate, and low serum trough infliximab levels at 14 weeks were compared. Results: After 14 weeks of treatment non-responders had lower serum trough levels of infliximab than responders (median (interquartile range) 0.5 (0.2–2.2) v 3.6 (1.4–8.2) mg/l; p<0.01)). Patients with low serum trough infliximab levels at 14 weeks had significantly less improvement in the 28 joint count Disease Activity Score (DAS28) score than patients with intermediate or high serum trough infliximab levels at 14 weeks. Pretreatment C reactive protein (CRP) levels correlated negatively with serum trough infliximab levels at 14 weeks after the start of treatment (Spearman rank correlation rs = –0.43, p<0.001). Conclusion: Serum trough levels of infliximab correlate with the clinical response to treatment with infliximab and pretreatment CRP levels. This study indicates that patients with high pretreatment CRP levels might benefit from higher dosages of infliximab or shorter dosing intervals.

Wolbink, G; Voskuyl, A; Lems, W; de Groot, E; Nurmohamed, M; Tak, P; Dijkmans, B; Aarden, L



The petrol approach to high-level power estimation  

Microsoft Academic Search

High-level power estimation is essential for designing complex low-power ICs. However, the lack of flexibility, or restriction to synthesizable code of previously presented high-level power estimation approaches limits their use. In this paper we present a novel, more general and flexible high-level power estimation approach, that avoids these limitations. Petrol, as we call it, is not limited to specialized application

Rafael Peset Llopis; Kees G. W. Goossens



Safety handling characteristics of high-level tritiated water  

Microsoft Academic Search

In a fusion reactor, high-level tritiated water of more than one PBq\\/m3 will be generated and stored in various areas. The high-level tritiated water decomposes by itself and generates mainly hydrogen, becoming tritiated hydrogen peroxide water. In order to summarize safety requirements for long-term storage of high-level tritiated water, the characteristics, such as effective G-values of hydrogen and hydrogen peroxide,

T. Hayashi; T. Itoh; K. Kobayashi; K. Isobe; M. Nishi



Serum Alkaline Phosphatase Levels and Left Ventricular Diastolic Dysfunction in Patients with Advanced Chronic Kidney Disease  

PubMed Central

Background High levels of alkaline phosphatase (ALP) have been associated with increased mortality in patients with advanced chronic kidney disease (CKD). We hypothesize that elevated ALP could be partly explained by subclinical liver congestion related to left ventricular diastolic dysfunction. Methods Doppler echocardiography was performed in 68 patients with advanced CKD followed up for a median of 2.1 years. Time-averaged levels of ALP and ?-glutamyl transferase (GGT) were compared between patients with and without diastolic dysfunction. We also evaluated the effect of intensifying diuretic treatment on ALP levels in a small group of 16 patients with high ALP and signs of volume overload. Results ALP correlated significantly (p < 0.001) with GGT but not with parathyroid hormone (p = 0.09). Patients with diastolic dysfunction showed higher ALP (p = 0.01), higher GGT (p = 0.03) and lower albumin (p = 0.04). The highest values of ALP were observed in patients with diastolic dysfunction plus pulmonary hypertension (p = 0.01). Intensifying diuretic therapy in a subgroup of patients with signs of fluid overload induced a significant reduction in body weight, GGT (p < 0.001) and ALP levels (p < 0.001). Conclusions Elevated ALP in patients with advanced CKD could be partly explained by subclinical liver congestion related to left ventricular diastolic dysfunction, hypervolemia or both. The worse prognosis of these patients could be explained by their myocardial damage.

Ortega, Olimpia; Rodriguez, Isabel; Hinostroza, Julie; Laso, Nuria; Callejas, Ramiro; Gallar, Paloma; Mon, Carmen; Herrero, Juan Carlos; Ortiz, Milagros; Oliet, Aniana; Vigil, Ana



Serum Prohepcidin Levels Are Lower in Patients with Atrophic Gastritis  

PubMed Central

Background/Aim. Hepcidin, an iron regulatory hormone, is increased in response to inflammation and some infections. We investigated the relationships among serum prohepcidin, iron status, Helicobacter pylori infection status, and the presence of gastric mucosal atrophy. Methods. Seventy subjects undergoing esophagogastroduodenoscopy underwent multiple gastric biopsies, and the possibility of H. pylori infection and the degree of endoscopic and histologic gastritis were investigated. In all subjects, serum prohepcidin and iron parameters were evaluated. Results. No correlations were observed between serum prohepcidin levels and the other markers of anemia, such as hemoglobin, serum iron, ferritin, and total iron binding capacity. Serum prohepcidin levels were not significantly different between the H. pylori-positive group and the H. pylori-negative group. Serum prohepcidin levels in atrophic gastritis patients were significantly lower than those in subjects without atrophic gastritis irrespective of H. pylori infection. Conclusion. Serum prohepcidin levels were not altered by H. pylori infection. Serum prohepcidin levels decrease in patients with atrophic gastritis, irrespective of H. pylori infection. It suggests that hepcidin may decrease due to gastric atrophy, a condition that causes a loss of hepcidin-producing parietal cells. Further investigations with a larger number of patients are necessary to substantiate this point.

Kim, Hyung-Keun; Jang, Eun-Chul; Yeom, Ju-Ok; Kim, Sun-Young; Cho, Hyunjung; Kim, Sung Soo; Chae, Hiun-Suk; Cho, Young-Seok



Temporomandibular disorders, otologic symptoms and depression levels in tinnitus patients.  


The aim of this study was to determine the prevalence of signs and symptoms of temporomandibular disorders (TMD) and otologic symptoms in patients with and without tinnitus. The influence of the level of depression was also addressed. The tinnitus group was comprised of 100 patients with tinnitus, and control group was comprised of 100 individuals without tinnitus. All subjects were evaluated using the research diagnostic criteria for temporomandibular disorders (RDC/TMD) to determine the presence of TMD and depression level. Chi-square, Spearman Correlation and Mann-Whitney tests were used in statistical analysis, with a 5% significance level. TMD signs and symptoms were detected in 85% of patients with tinnitus and in 55% of controls (P?0·001). The severity of pain and higher depression levels were positively associated with tinnitus (P?0·001). It was concluded that tinnitus is associated with TMD and with otalgia, dizziness/vertigo, stuffy sensations, hypoacusis sensation and hyperacusis, as well as with higher depression levels. PMID:22035253

Hilgenberg, P B; Saldanha, A D D; Cunha, C O; Rubo, J H; Conti, P C R



Discontinuation of proton pump inhibitors during assessment of chromogranin A levels in patients with neuroendocrine tumours  

PubMed Central

Background: The aim of this prospective study was to examine whether discontinuation of proton pump inhibitors (PPIs) or replacement by H2-receptor antagonists (H2RA) resulted in a decrease of chromogranin A (CgA) levels in 196 patients with well-differentiated neuroendocrine tumours (NETs). Methods: Patients with an unexpectedly high CgA level not connected with NET disease discontinued PPIs, or used H2RA instead; 2 weeks later CgA level was measured again. Results: In all, 19 out of 196 (10%) patients showed unexpected elevated CgA levels, they all used PPI. In 11 out of 19 patients with no evidence of the disease, median CgA decreased from 390??g?l?1 during PPI treatment to 56??g?l?1 after discontinuation (P=0.003). In 8 out of 19 patients with stable disease, median CgA decreased from 618 to 318??g?l–1 (P=0.012). In 12 out of 19 patients who ceased all acid inhibition, CgA levels decreased by 82%, while in the seven patients who replaced PPI by H2RA, CgA decreased by 77% (P=0.967). Conclusion: Proton pump inhibitor use causes falsely elevated CgA levels in patients with NET. We recommend to stop, or replace PPI by H2RA, to obtain a reliable CgA value.

Korse, C M; Muller, M; Taal, B G



Characterization of high-level quinolone resistance in Campylobacter jejuni.  

PubMed Central

High-level resistance to quinolones has previously been shown to occur in Campylobacter spp. both in vitro and in patients treated with quinolones. We have selected isolates that are resistant to quinolones by plating cells from a susceptible C. jejuni strain, UA535, on medium containing nalidixic acid at 32 micrograms/ml. Fluctuation analysis indicated that resistance occurred by mutation at a frequency of 5 x 10(-8) per cell plated. Unlike what is observed with other gram-negative organisms, the nalidixic acid-resistant mutants demonstrated high-level cross-resistance (MIC, greater than or equal to 4 micrograms/ml) to newer quinolones, including ciprofloxacin, norfloxacin, and temafloxacin, yet remained susceptible to coumermycin A1 and several other unrelated antibiotics. Mutants with an identical resistance phenotype could also be selected from UA535 with ciprofloxacin and norfloxacin at a similar frequency. To study the mechanism of quinolone resistance, DNA gyrases were purified from C. jejuni UA535 and two resistant mutants by heparin-agarose and novobiocin-Sepharose chromatography. After the respective enzyme concentrations were adjusted to equivalent units of activity in the DNA supercoiling reaction, the DNA gyrases from the resistant mutants were found to be 100-fold less susceptible than the wild-type enzyme to inhibition by quinolones. Subunit switching experiments with purified A and B subunits from the wild type and one of the quinolone-resistant mutants indicated that an alteration in the A subunit was responsible for resistance. These results show that a single-step mutation can occur in vitro in the gene encoding DNA gyrase in C. jejuni, producing clinically relevant levels of resistance to the newer quinolones. Images

Gootz, T D; Martin, B A



Adverse Outcome of Pregnancies with Extremely High Levels of Maternal Serum Human Chorionic Gonadotropin  

Microsoft Academic Search

Background: The associated risk of elevated levels of maternal serum human chorionic gonadotropin (MShCG) with pregnancy complications was reported in many studies. However, the outcome of pregnancies with extremely high levels of MShCG was never independently studied. Methods: We report on 6 out of 45,990 studied patients with extremely high levels of MShCG (>15 multiples of the medians) analyzed during

Reuven Sharony; Deganit Itzhaky; Aliza Amiel; Anat Hershko; Yulia Grinshpoon; Moshe Fejgin



Increased plasma LIGHT levels in patients with atopic dermatitis  

PubMed Central

LIGHT [the name of which is derived from ‘homologous to lymphotoxins, exhibits inducible expression, competes with herpes simplex virus glycoprotein D for herpes simplex virus entry mediator (HVEM), and expressed by T lymphocytes’], is a member of the tumour necrosis factor superfamily that is involved in various inflammatory diseases. We aimed to estimate the relevance of plasma LIGHT levels as a biomarker for atopic dermatitis (AD). In order to understand the putative role of LIGHT in AD pathogenesis, we also investigate the effects of LIGHT on a monocytic cell line, human acute monocytic leukaemia cell line (THP-1). We examined plasma LIGHT levels, total serum IgE, serum value of CCL17 and peripheral blood eosinophil counts in patients with AD and healthy subjects. The effects of LIGHT on activation and apoptosis in THP-1 cells were also investigated. The plasma concentrations of LIGHT in AD patients were significantly higher than those in healthy individuals and the concentrations decreased as the symptoms were improved by treatment. The LIGHT plasma concentrations correlated with IgE levels and the Severity Scoring of AD (SCORAD) index. In addition, LIGHT stimulation increased expression of CD86 and induced production of interleukin-1? in THP-1 cells. Apoptosis was inhibited, the Bcl-2 level increased and the caspase-3 level decreased in THP-1 cells stimulated with LIGHT, compared to unstimulated control cells. These results suggest that plasma LIGHT levels may be one of the promising biomarkers for AD.

Kotani, H; Masuda, K; Tamagawa-Mineoka, R; Nomiyama, T; Soga, F; Nin, M; Asai, J; Kishimoto, S; Katoh, N



A Framework for Translating a High Level Security Policy into Low Level Security Mechanisms  

NASA Astrophysics Data System (ADS)

Security policies have different components; firewall, active directory, and IDS are some examples of these components. Enforcement of network security policies to low level security mechanisms faces some essential difficulties. Consistency, verification, and maintenance are the major ones of these difficulties. One approach to overcome these difficulties is to automate the process of translation of high level security policy into low level security mechanisms. This paper introduces a framework of an automation process that translates a high level security policy into low level security mechanisms. The framework is described in terms of three phases; in the first phase all network assets are categorized according to their roles in the network security and relations between them are identified to constitute the network security model. This proposed model is based on organization based access control (OrBAC). However, the proposed model extend the OrBAC model to include not only access control policy but also some other administrative security policies like auditing policy. Besides, the proposed model enables matching of each rule of the high level security policy with the corresponding ones of the low level security policy. Through the second phase of the proposed framework, the high level security policy is mapped into the network security model. The second phase could be considered as a translation of the high level security policy into an intermediate model level. Finally, the intermediate model level is translated automatically into low level security mechanism. The paper illustrates the applicability of proposed approach through an application example.

Hassan, Ahmed A.; Bahgat, Waleed M.



Peritoneal dialysis patients with high effluent fibrin degradation products.  


Encapsulating peritoneal sclerosis (EPS) is a major and fatal complication of peritoneal dialysis (PD). For treatment, the efficacies of steroids, tamoxifen, immunosuppressants, and surgical total intestinal enterolysis have been reported, but the results have not been sufficient. Because treatment after the onset of EPS is limited, a prophylactic therapy is needed. We previously reported that the level of effluent fibrin degradation products (eFDPs) is predictive of EPS. In the present study, we investigated the clinical course of PD cases with high eFDP levels, and the effect of prophylactic steroid therapy against EPS. Between January 2002 and August 2008, we investigated 310 PD patients, of whom 22 had an eFDP level of 30 microg/mL or more in 4-hour effluent from a fast peritoneal equilibration test (PET). Mean patient age was 62.6 +/- 11.1 years, and mean duration of dialysis was 42.7 +/- 45.5 months (range: 1 - 202 months). During a fast PET performed every 6 months, we measured, in 4-hour effluent, eFDPs, cancer antigen 125 (eCA125), and dialysate-to-plasma creatinine (D/P Cr). In addition, we calculated D/P beta2-microglobulin (beta2MG) from levels in overnight dialysis effluent and blood. In the 22 cases, the mean eFDP level was 66.6 +/- 39.2 microg/mL; the D/P Cr 0.78 +/- 0.1; and the D/P beta2MG 0.45 +/- 0.2. Steroid (5 - 30 mg daily) was administered to 8 of the 22 patients. In the 8 treated cases, the eFDP level, the D/P Cr, and the D/P beta2MG declined, but did not return to normal, and EPS developed in 2 patients. The eFDP level was high when dialysis was introduced, but returned to normal in 2 of the remaining 14 patients. In 1 of the 14 cases, peritonitis developed 5 times, followed by rapid elevation in the eFDP level. The patient with this intractable peritonitis was switched to hemodialysis. The other 11 patients received no steroid therapy. In 1 of these 11 patients, the eFDP level declined, but not in the others. We suggest that active steroid therapy for patients with a high level of eFDPs may prevent EPS development. PMID:19886315

Moriishi, Misaki; Kawanishi, Hideki; Tsuchiya, Shinichiro



Bound vitamin B12 absorption in patients with low serum B12 levels.  


In many patients with low serum levels of vitamin B12, the absorption of the free vitamin has been normal. The present study, using a total body counter 57CoB12 absorption method that clearly separated those with intrinsic factor deficiency from controls, found that of 94 patients with low B12 levels and intact stomachs in whom the absorption of free and bound B12 was determined, 44 (47%) had normal absorption of both. However, 20 of the 94 (21%) with normal absorption of free B12 had low absorption of bound B12. The remainder (32%) had low absorption of both free and bound B12. All patients with high serum gastrin levels had low bound B12 absorption, but so did 21% of those patients with normal serum gastrin levels. PMID:1609768

Miller, A; Furlong, D; Burrows, B A; Slingerland, D W



Alteration in plasma glucose levels in Japanese encephalitis patients  

PubMed Central

A unique factor, human T cell hypoglycaemic factor (hTCHF), has been shown to produce hypoglycaemia during the convalescent stage in the plasma of patients with Japanese encephalitis virus (JEV) infection. The present study was undertaken to investigate the ability of T cells from fresh peripheral blood mononuclear cells (PBMC) of such patients to produce hTCHF. The PBMC, as well as the individual subpopulations, were cultured for 24 h and the culture supernatants (CS) were assayed for hypoglycaemic activity. The activity was observed in the CD8+ T cells. The hypoglycaemia in JE-confirmed patients coincided with the gradual rise in circulating glucagon level, with no significant alterations in insulin, growth hormone and cortisol levels. The hTCHF was purified by ion exchange chromatography and the purified protein was observed as a ?25 kDa band on SDS-PAGE. Secretory hTCHF in the sera of patients and T cell CS was present in 88% of convalescent serum samples. We conclude that during the convalescent stage of JEV infection, a unique factor, hTCHF, is secreted by activated CD8+ T cells from patients and that this is responsible for the development of hypoglycaemia.




Process for solidifying high-level nuclear waste  


The addition of a small amount of reducing agent to a mixture of a high-level radioactive waste calcine and glass frit before the mixture is melted will produce a more homogeneous glass which is leach-resistant and suitable for long-term storage of high-level radioactive waste products.

Ross, Wayne A. (Richland, WA)



Physical Activity Levels in Portuguese High School Physical Education  

ERIC Educational Resources Information Center

|The main aim of this study was to evaluate the physical activity (PA) levels of high school Portuguese students during physical education (PE) and investigate the association of PA levels with students' goal orientation and intrinsic motivation. Forty-six students from three high schools participated. Heart rate telemetry and pedometry were used…

Marmeleira, Jose Francisco Filipe; Aldeias, Nuno Micael Carrasqueira; da Graca, Pedro Miguel dos Santos Medeira



Are High-Level Languages Suitable for Robust Telecoms Software?  

Microsoft Academic Search

In the telecommunications sector product development must minimise time to market while delivering high levels of dependability, availability, maintainability and scalability. High level languages are con- cise and hence potentially enable the fast production of maintainable software. This paper investigates the potential of one such language, Er- lang, to deliver robust distributed telecoms software. The evaluation is based on a

Jan Henry Nyström; Philip W. Trinder; David J. King



Defense High Level Waste Disposal Container System Description Document  

Microsoft Academic Search

The Defense High Level Waste Disposal Container System supports the confinement and isolation of waste within the Engineered Barrier System of the Monitored Geologic Repository (MGR). Disposal containers are loaded and sealed in the surface waste handling facilities, transferred to the underground through the accesses using a rail mounted transporter, and emplaced in emplacement drifts. The defense high level waste

N. E. Pettit



High-Performance Leadership at the Organization Level  

Microsoft Academic Search

The Problem and the Solution. High-performance leaders must have competencies to lead organization-level goal setting, design, and management This chapter descnbes two competency domains, strategic thinking and strategic stewardship, and nine competency groups that leaders must master to achieve high performance in an organization These competencies address Rummler and Brache's [1995] organization level of performance

Doris B. Collins; Janis S. Lowe; Carson R. Arnett



High-level synthesis from VHDL with exact timing constraints  

Microsoft Academic Search

We present a solution to the interface timing problem in high-level synthesis by requiring that the algorithmic specification must completely determine the interface timing on the basis of cycles. We show how this approach has been integrated into the high-level synthesis system CA LLAS.

A. Stoll; Peter Duzy



Testability Expertise and Test Planning from High-Level Specifications  

Microsoft Academic Search

The testability expertise of boards and ASICs (application-specific integrated circuits) relies on high-level models in the Prolog language. This high-level modeling makes it possible to describe chip and board functions at an adequate level of accuracy without giving useless details. Each chip is successfully considered as a test goal; difficult chips are identified. Design modifications in terms of multiplexers or

Michel Crastes De Paulet; M. Karam; Gabriele Saucier



The Future of High-Level Modelling and System Level Design: Some Possible Methodology Scenarios  

Microsoft Academic Search

We discuss the future of high-level modelling in the context of system-level design, as the two concepts are inextricably interlinked. This is described as several possible methodology scenarios for the future of system level design as it unfolds within the electronics industry. Although these scenarios are presented as orthogonal, of course in actual fact the future may present us several

Grant Martin


Plasma protein C levels in immunocompromised septic patients are significantly lower than immunocompetent septic patients: a prospective cohort study  

PubMed Central

Introduction Activated Protein C [APC] improves outcome in immunocompetent patients with severe sepsis particularly in those who are perceived to have high mortality risk. Before embarking on a trial of APC administration in immunocompromised septic patients, a preliminary study on plasma levels of protein C in this cohort is essential. Objective To assess serum Protein C concentrations in immunocompromised patients as compared to immunocompetent patients during sepsis, severe sepsis, septic shock and recovery. Methods Prospective cohort study in a tertiary hospital. Patients satisfying inclusion criteria were enrolled after informed consent. Clinical variables were noted with sample collection when patients met criteria for sepsis, severe sepsis, septic shock and recovery. Protein C levels were measured using monoclonal antibody based fluorescence immunoassay. Results Thirty one patients participated in this study (22 immunocompromised, 9 immunocompetent). Protein C levels were found to be significantly lower in the immunocompromised group compared to the immunocompetent group, particularly observed in severe sepsis [2.27 (95% CI: 1.63-2.9) vs 4.19 (95% CI: 2.87-5.52) mcg/ml] (p = 0.01) and sepsis [2.59 (95% CI: 1.98-3.21) vs 3.64 (95% CI: 2.83-4.45) mcg/ml] (p = 0.03). SOFA scores were similar in both the groups across sepsis, severe sepsis and septic shock categories. Protein C levels improved significantly in recovery (p = 0.001) irrespective of immune status. Conclusion Protein C levels were significantly lower in immunocompromised patients when compared to immunocompetent patients in severe sepsis and sepsis categories. Our study suggests a plausible role for APC in severely septic immunocompromised patients which need further elucidation.

Panwar, Rakshit; Venkatesh, Bala; Kruger, Peter; Bird, Robert; Gill, Devinder; Nunnink, Leo; Dimeski, Goce



Predictors of Placement in Lower Level versus Higher Level High School Mathematics  

ERIC Educational Resources Information Center

|Educators and researchers have long been interested in determinants of access to honors level and college prep courses in high school. Factors influencing access to upper level mathematics courses are particularly important because of the hierarchical and sequential nature of this subject and because students who finish high school with only…

Archbald, Doug; Farley-Ripple, Elizabeth N.



Predictors of Placement in Lower Level versus Higher Level High School Mathematics  

ERIC Educational Resources Information Center

Educators and researchers have long been interested in determinants of access to honors level and college prep courses in high school. Factors influencing access to upper level mathematics courses are particularly important because of the hierarchical and sequential nature of this subject and because students who finish high school with only lower…

Archbald, Doug; Farley-Ripple, Elizabeth N.



Type 2 cytokine serum levels in healthy sickle cell disease patients.  

PubMed Central

Sickle cell disease (SCD) is characterized by significant morbidity and early mortality. Children with this hemoglobinopathy exhibit many of the manifestations associated with immunodeficiency disorders. Serum was obtained from 56 healthy SCD subjects and 45 normal healthy controls. Type 2 cytokines interleukin (IL)-4, IL-6, and IL-10 serum levels were measured. Concentrations were determined by reference to a standard curve, and results were expressed in pg/mL. Results revealed significant levels of IL-4 in 6 (13%) of 45 SCD patients compared with 1 (2%) of 45 controls. Increased levels of IL-6 were present in 35 (78%) of 45 SCD patients and 12 (41%) of 29 controls. Elevated levels of IL-10 were detectable in 13 (41%) of 42 SCD patients and 1 (4%) of 25 controls. High circulating levels of type 2 cytokines may suppress both humoral and cell-mediated immune functions in SCD, with resultant increased morbidity.

Taylor, S. C.; Shacks, S. J.; Qu, Z.; Wiley, P.



Plasma Shh levels reduced in pancreatic cancer patients  

PubMed Central

Objectives Normally, sonic hedgehog (Shh) is expressed in the pancreas during fetal development and transiently after tissue injury. Although pancreatic cancers express Shh, it is not known if the protein is secreted into the blood and whether its plasma levels change with pancreatic transformation. The goal of this study was to develop an ELISA to detect human Shh in blood, and determine the levels in subjects with and without pancreatic cancer. Methods A human Shh ELISA assay was developed, and plasma Shh levels were measured in blood samples from normal volunteers and subjects with pancreatitis or pancreatic cancer. The biological activity of plasma Shh was tested using NIH-3T3 cells. Results The average levels of Shh in human blood were lower in pancreatitis and pancreatic cancer patients than in normal individuals. Hematopoietic cells did not express Shh suggesting that Shh is secreted into the bloodstream. Plasma fractions enriched for Shh did not induce Gli-1 mRNA suggesting that the protein was not biologically active. Conclusions Shh is secreted from tissues and organs into the circulation but its activity is blocked by plasma proteins. Reduced plasma levels were found in pancreatic cancer patients, but alone were not sufficient to predict pancreatic cancer.

El-Zaatari, Mohamad; Daignault, Stephanie; Tessier, Art; Kelsey, Gail; Travnikar, Lisa A.; Cantu, Esperanza F.; Lee, Jamie; Plonka, Caitlyn M.; Simeone, Diane M.; Anderson, Michelle A.; Merchant, Juanita L.



Serum coenzyme Q10 levels are associated with coronary flow reserve in hemodialysis patients.  


Accelerated atherosclerosis is the major cause of mortality in patients on chronic hemodialysis (HD). The aim of this study was to evaluate the relation between coenzyme Q10 (CoQ10) levels and coronary flow reserve (CFR) in HD patients as an indicator of atherosclerosis. Seventy-one chronic HD patients and 65 age- and sex-matched healthy individuals were included in the study. Plasma CoQ10 levels were performed by high-performance liquid chromatography measurements. CFR was assessed by transthoracic Doppler echocardiography. Serum CoQ10 levels (1.36?±?0.43 vs. 2.53?±?0.55, P?patients compared with controls. There was a significant positive correlation between CFR and serum levels of CoQ10 (r?=?0.669, P?levels of CoQ10 were still significantly and positively correlated with CFR (regression coefficient?=?0.235, P?patients exhibit decreased plasma CoQ10 levels and CFR values. The study also showed for the first time that serum CoQ10 levels independently predict CFR in HD patients. PMID:23185999

Macunluoglu, Beyza; Kaya, Yuksel; Atakan, Aydin; Ari, Elif; Kaspar, Cigdem; Demir, Halit; Alp, Hamit Hakan; Asicioglu, Ebru; Kedrah, Alla Eldeen



Fusing high- and low-level features for speaker recognition  

Microsoft Academic Search

The area of automatic speaker recognition has been dominated by systems using only short-term, low-level acoustic information, such as cepstral features. While these systems have produced low error rates, they ignore higher levels of information beyond low-level acoustics that convey speaker information. Recently published works have demonstrated that such high-level information can be used successfully in automatic speaker recognition systems

Joseph P. Campbell; Douglas A. Reynolds; Robert B. Dunn



Probable high ground-water levels on Cape Cod, Massachusetts  

USGS Publications Warehouse

Water-level records from 146 short-term (1 year) observation wells and 13 long-term (16-28 years) observation wells were used to estimate the probable high ground-water level that could occur at any site on Cape Cod. The estimation was based on correlation of a single water-level measurement from a test site with water-level records of the nine index wells. Maps showing areas of Cape Cod represented by the nine index wells and showing five ranges of water-level fluctuation are used in conjunction with tables of water-level adjustments to make the estimates. (USGS)

Frimpter, Michael H.



Principled fusion of high-level model and low-level cues for motion segmentation  

Microsoft Academic Search

High-level generative models provide elegant descrip- tions of videos and are commonly used as the infer- ence framework in many unsupervised motion segmentation schemes. However, approximate inference in these models often require ad-hoc initialization to avoid local minima is- sues. Low-level cues, obtained independently from the high- level model, can constrain the search space and reduce the chance of inference

Arasanathan Thayananthan; Masahiro Iwasaki; Roberto Cipolla



Motivating patients to higher levels of oral health.  


Opportunities for practice and personal growth remain incredibly high in dentistry. Earnest attention to factors affecting the marketplace and willingness to add and change practice strategies are essential for satisfying patient priorities and tantamount to a dentist's personal success. PMID:15645900

Rempfer, Roger K



Changes in cytokinin levels of Phalaenopsis leaves at high temperature  

Microsoft Academic Search

The effect of high temperatures on cytokinin levels in Phalaenopsishybrida leaves was investigated. Endogenous cytokinins were identified and quantified in Phalaenopsis leaves grown under high temperature conditions (30\\/25 °C day\\/night) using high performance liquid chromatography, bioassay and gas chromatography-selected ion monitoring-mass spectrometry. After 5 and 20 d of low temperature (25\\/20 °C day\\/night), zeatin, zeatin riboside and dihydrozeatin levels in the leaves were

Chin Chih Chou; Wen-Shaw Chen; Kuang-Liang Huang; Hsiao-Ching Yu; Li-Jen Liao



Elevated circulating fibrocyte levels in patients with hypertensive heart disease  

PubMed Central

Objective Autopsy and biopsy studies have shown that there is significantly more fibrosis in hearts of patients with hypertensive heart disease compared to normal hearts. Fibrocytes, a population of circulating bone marrow-derived cells, have been shown to home to tissues and promote scar formation in several diseases, but their role in human hypertensive heart disease has not been investigated to date. Our objective was to determine whether fibrocyte levels are elevated in individuals with hypertensive heart disease. Methods We measured peripheral blood fibrocyte levels and their activated phenotypes in 12 individuals with hypertensive heart disease as determined by increased left ventricular mass on noninvasive imaging and compared them to fibrocyte levels from 19 healthy normal controls and correlated them to cardiac MRI findings. Results Compared to normal controls, individuals with hypertensive heart disease had significantly higher circulating levels of total fibrocytes [median (interquartile range); 149000 (62200–220000) vs. 564500 (321000–1.2900e+006), P < 0.0001, respectively] as well as activated fibrocytes [15700 (6380–19800) vs. 478500 (116500–1.2360e+006) P < 0.0001]. Moreover, the fibrocyte subsets expressing the chemokine markers CXCR4 (P < 0.0001), CCR2 (P < 0.0001), CCR7 (P < 0.0001) and coexpression of both CXCR4 and CCR2 (P < 0.0001) were significantly elevated in patients with hypertensive heart disease compared to controls. Lastly, in patients with hypertensive heart disease there was a strong correlation between left ventricular mass index and total fibrocytes (r = 0.65, P = 0.037) and activated fibrocytes (r = 0.70, P = 0.016). Conclusion Our data suggest that bone marrow-derived circulating fibrocytes are associated with the presence and extent of left ventricular hypertrophy in patients with hypertensive heart disease.

Keeley, Ellen C.; Mehrad, Borna; Janardhanan, Rajesh; Salerno, Michael; Hunter, Jennifer R.; Burdick, Marie M.; Field, Joshua J.; Strieter, Robert M.; Kramer, Christopher M.



Increased blood mercury levels in patients with Alzheimer's disease  

Microsoft Academic Search

Summary.   Alzheimer's disease (AD) is a common neurodegenerative disorder that leads to dementia and death. In addition to several\\u000a genetic parameters, various environmental factors may influence the risk of getting AD. In order to test whether blood levels\\u000a of the heavy metal mercury are increased in AD, we measured blood mercury concentrations in AD patients (n = 33), and compared

C. Hock; G. Drasch; S. Golombowski; F. Müller-Spahn; B. Willershausen-Zönnchen; P. Schwarz; U. Hock; J. H. Growdon; R. M. Nitsch



Serum myeloperoxidase level predicts reperfusion in patients with myocardial infarction receiving thrombolytic therapy.  


Polymorphonuclear leukocytes play a central role in all stages of the atherothrombotic inflammatory process. The atherothrombotic activity of polymorphonuclear leukocytes is exerted by mediators such as myeloperoxidase (MPO). Although the role of MPO has been studied with respect to the development of adverse cardiac events in acute coronary syndromes (ACS), the association of this molecule with effectiveness of reperfusion in patients receiving thrombolysis is not yet known. The study population consisted of a total of 158 patients with acute coronary syndromes. Final diagnosis was ST-segment elevation myocardial infarction in 86 patients, 80 of whom received thrombolysis. Blood samples were drawn at presentation of the patients and serum myeloperoxidase levels were measured. Reperfusion was defined in terms of electrocardiographic ST-segment resolution. The serum levels of MPO were found to be correlated with rates of in-hospital adverse events including death (P < 0.001), reinfarction (P < 0.001), recurrent ischemia (P < 0.001), arrhythmias (P < 0.001), clinical heart failure (P < 0.001), and cardiogenic shock (P < 0.001). There was a significant difference in serum MPO levels between subjects with three-vessel disease and two- or one-vessel disease (P < 0.001). Pre-lytic serum high-sensitivity C-reactive protein levels in patients with successful reperfusion were lower than in patients with failed reperfusion (P < 0.001). Analysis of patients with ST segment elevation myocardial infarction receiving thrombolytic therapy revealed that pre-lytic serum MPO levels in patients with successful reperfusion were significantly lower than those of patients with failed reperfusion (P < 0.001). In the present study, serum MPO levels were found to be a strong predictor of response to thrombolytic treatment in patients with ST-segment elevation myocardial infarction. Therefore the level of inflammatory activity in acute coronary syndromes seems to influence the effectiveness of fibrinolysis. PMID:19626395

Karadag, Bilgehan; Vatan, Bulent; Hacioglu, Yalcin; Duman, Dursun; Baskurt, Murat; Keles, Ibrahim; Ongen, Zeki; Vural, Vural Ali



Anesthesia for the High-Risk Patient  

Microsoft Academic Search

In fewer than 300 pages, this book covers the complex topic of anesthesia for the high-risk patient in a comprehensive and complete way. Each chapter covers the most up-to-date literature, providing a summary of evidence as well as practical advice on how to approach and tackle the multitude of diff erent problems of highrisk patients. Th is book describes anesthesia

Maurizio Cecconi; Andrew Rhodes



New Facility, New Flow, and New Levels of Patient Care  

NSDL National Science Digital Library

This paper describes how lean concepts were applied to the healthcare system.Waiting is an activity that few find rewarding or of value; its simply a waste of time that reduces anyone's level of satisfaction. Yet, somehow, healthcare and waiting often are synonymous. The Clearview Cancer Institute in Huntsville, AL, is a dramatic exception.Physicians and staff have tirelessly reengineered the institutes processes and patient flow to eliminate as much waiting and waste as possible. They have implemented a range of healthcare process innovations that make the new facility atypical, and, in doing so,improved their ability and capacity to serve cancer patients and, most important, they improved the patient experience.

Taninecz, George



Altered levels of serotonin in lymphoblasts derived from migraine patients.  


We previously reported that dysfunctions in the autonomic nervous systems of patients with migraines occur not only in the brain, but throughout the whole body. Serotonin and neuropeptides are also known to have important roles in the pathophysiology of migraine. With this background in mind, we analyzed human lymphoblast cell lines from migraine with aura (MwA) patients to investigate the pathophysiology of migraine. The characteristics of these lymphoblasts and the involvement of the lymphoblasts in serotonin metabolism were examined. The lymphoblasts expressed serotonin receptors as well as some enzymes related to serotonin metabolism. The serotonin level in the MwA lymphoblasts was higher than that in the control cells. However, serotonin uptake into the lymphoblasts in MwA patients was similar to that in the control subjects. These findings suggest that lymphoblasts in MwA patients have altered levels of serotonin metabolism. Moreover, we propose that this lymphoblast cell system could serve as a novel modality for migraine research. PMID:17125868

Nagata, Eiichiro; Hamada, Junichi; Shimizu, Toshihiko; Shibata, Mamoru; Suzuki, Shigeaki; Osada, Takashi; Takaoka, Rie; Kuwana, Masahiro; Suzuki, Norihiro



Clinical implications of elevated serum soluble CD137 levels in patients with acute coronary syndrome  

PubMed Central

OBJECTIVES: Atherosclerosis is a chronic inflammatory disease. Research has focused on identifying specific serum biomarkers to detect vulnerable plaques. These markers serve as diagnostic tools for acute coronary syndrome and assist in identifying high-risk patients. However, the existing data are limited and conflicting. This study tested the hypothesis that CD137 levels identify patients with acute coronary syndrome who are at a heightened risk for recurrent cardiac events. METHODS: The levels of soluble CD137 (sCD137) were measured using ELISA in 180 patients with acute coronary syndrome and 120 patients with acute chest pain. Platelet activation was assessed by flow cytometry. Receiver operating characteristic curve analysis was performed to evaluate the prognostic characteristics of sCD137. RESULTS: The levels of sCD137 were elevated in 75 patients with acute coronary syndromes and 20 patients with acute chest pain (>35.0 ng/ml). In patients with acute coronary syndrome, elevated sCD137 levels (>35.0 ng/ml) indicated an increased risk for major adverse cardiovascular events (OR?=?1.93, 95% CI: 1.39-2.54). Elevated serum levels of sCD137 and cTnT were correlated with a significantly increased risk of major adverse cardiovascular events in both groups after 30 days, six months and nine months of follow-up. The increased sCD137 levels were significantly correlated with the levels of troponin I (r?=?0.4799, p<0.001). Importantly, 26 patients with normal cTnI levels had acute coronary syndrome. However, elevated sCD137 levels identified these patients as a being high-risk subgroup (OR?=?2.14, 95% CI: 1.25-4.13). CONCLUSIONS: Elevated sCD137 levels indicate an increased risk of cardiovascular events in patients with acute coronary syndrome. Soluble CD137 may be a useful prognostic marker or indicator for adverse events in patients with acute coronary syndrome.

Yan, Jinchuan; Wang, Cuiping; Chen, Rui; Yang, Haibing



Postoperative vasopressin and copeptin levels in noncardiac surgery patients: a prospective controlled trial.  


Further information on the endogenous arginine vasopressin (AVP) response in patients with postoperative systemic inflammatory response syndrome (SIRS) and vasodilatory shock would provide more insight into the pathophysiology of SIRS-associated cardiovascular failure and help indicate AVP therapy. Patients after uncomplicated abdominal surgery without SIRS (n = 10), critically ill patients after noncardiac surgery with SIRS (n = 9), and patients with SIRS plus vasodilatory shock (n = 22) were included in this prospective trial. Plasma AVP (radioimmunoassay) and copeptin (immunoluminometric assay) concentrations together with clinical parameters were documented daily during the first 7 days postoperative. The AVP response significantly differed between the three groups. Patients without SIRS had lower AVP concentrations than SIRS patients with (P = 0.001) or without shock (P = 0.003). Patients with SIRS and shock had higher AVP levels than patients with SIRS alone (P < 0.001). Arginine vasopressin decreased over time (P = 0.007) in all groups. At day 28, nonsurvivors had higher AVP levels than did survivors (P < 0.001). In SIRS patients without shock, serum osmolarity was indirectly associated with AVP levels, whereas mean arterial blood pressure and serum osmolarity were associated with AVP in SIRS patients with shock. Arginine vasopressin and copeptin correlated significantly with each other (P < 0.001; r = 0.76). In patients without hemofiltration, copeptin levels predicted 28-day mortality with high sensitivity and specificity. The postoperative AVP response in noncardiac surgery patients seems well maintained. The possibility that AVP plays a contributory role in the failure to restore vascular tone in patients with vasodilatory shock cannot be excluded but seems less important than in septic or postcardiotomy shock. PMID:18650776

Jochberger, Stefan; Zitt, Matthias; Luckner, Günter; Mayr, Viktoria D; Wenzel, Volker; Ulmer, Hanno; Morgenthaler, Nils G; Hasibeder, Walter R; Dünser, Martin W



Serum triiodothyronine level as an indicator of inflammation in patients undergoing dialysis.  


INTRODUCTION. It has been shown that inflammation affects thyroid function. In patients with end-stage renal disease, low plasma triiodothyronine (T3) may be an unsuspected expression of the inflammatory state of these patients. This study evaluated the correlation between T3 and high-sensitivity C-reactive protein (HSCRP) levels in patients on peritoneal dialysis (PD) and hemodialysis. MATERIALS AND METHODS. This is a cross-sectional study aiming at the correlation between T3 and HSCRP levels among 30 patients on PD, 30 patients on hemodialysis, and 20 healthy individuals. Serum levels of HSCRP, T3, thyroxine (T4), thyroid stimulating hormone, T3 resin uptake, and free T3 index (FT3I) and free T4 index (FT4I) were compared between the three groups. RESULTS. There were no significant differences between hemodialysis and PD patients in respect to T3, T4, FT3I, and FT4I. In PD and hemodialysis patients, T3 and FT3I were lower than in controls (P < .001), but there was no significant difference between PD and hemodialysis patients. T3 resin uptake and thyroid stimulating hormone differed significantly between PD and hemodialysis patients. There was a significant inverse correlation between HSCRP and T3 and FT3I among hemodialysis patients (P = .04); however, there was no such correlations in PD patients. CONCLUSIONS. The relationship between T3 and HSCRP suggests that inflammation might be involved in the low T3 syndrome in hemodialysis patients, but we did not find a significant correlation between T3 and HSCRP levels in patients on peritoneal dialysis. PMID:21189433

Zeraati, Abbas Ali; Layegh, Parvin; Famili, Yalda; Naghibi, Massih; Sharifipour, Farzaneh; Shariati Sarabi, Zhaleh



Reference commercial high-level waste glass and canister definition.  

SciTech Connect

This report presents technical data and performance characteristics of a high-level waste glass and canister intended for use in the design of a complete waste encapsulation package suitable for disposal in a geologic repository. The borosilicate glass contained in the stainless steel canister represents the probable type of high-level waste product that will be produced in a commercial nuclear-fuel reprocessing plant. Development history is summarized for high-level liquid waste compositions, waste glass composition and characteristics, and canister design. The decay histories of the fission products and actinides (plus daughters) calculated by the ORIGEN-II code are presented.

Slate, S.C.; Ross, W.A.; Partain, W.L.



Reference commercial high-level waste glass and canister definition  

NASA Astrophysics Data System (ADS)

Technical data and performance characteristics of a high level waste glass and canister intended for use in the design of a complete waste encapsulation package suitable for disposal in a geologic repository are presented. The borosilicate glass contained in the stainless steel canister represents the probable type of high level waste product that is produced in a commercial nuclear-fuel reprocessing plant. Development history is summarized for high level liquid waste compositions, waste glass composition and characteristics, and canister design. The decay histories of the fission products and actinides (plus daughters) calculated by the ORIGEN-II code are presented.

Slate, S. C.; Ross, W. A.; Partain, W. L.



National high-level waste systems analysis report  

SciTech Connect

This report documents the assessment of budgetary impacts, constraints, and repository availability on the storage and treatment of high-level waste and on both existing and pending negotiated milestones. The impacts of the availabilities of various treatment systems on schedule and throughput at four Department of Energy sites are compared to repository readiness in order to determine the prudent application of resources. The information modeled for each of these sites is integrated with a single national model. The report suggests a high-level-waste model that offers a national perspective on all high-level waste treatment and storage systems managed by the Department of Energy.

Kristofferson, K.; Oholleran, T.P.; Powell, R.H.




Microsoft Academic Search

Objective. To evaluate whether altered levels of progesterone and its main neuroactive metabo- lite allopregnanolone do occur in premenopausal women. The second part of this study deals with allopregnanolone levels in thyreoidectomized women. Methods. Allopregnanolone, a neurosteroid acting by its allosteric interaction with GABAA receptors and progesterone, were determined in two groups of patients which have in common certain psychic



High plasma-GFAP levels in metastatic myxopapillary ependymoma.  


Myxopapillary ependymoma (MPE) is a rare tumor of the distal spinal cord. Despite benign histopathology, local recurrences occur in ~30 % of patients and distant metastases have been described in few cases. MPE tumor cells typically express glial fibrillary acidic protein (GFAP), which could be released to the circulation. In this current report, we investigated circulating plasma-GFAP in a series of MPE patients. We analyzed circulating plasma-GFAP using a commercially available ELISA kit in 3 patients with completely resected MPE, 1 patient with locally advanced MPE and 2 patients with pleuropulmonary metastases of MPE. As controls we used blood samples of age and gender-matched healthy volunteers (n = 3), 6 glioblastoma patients with known plasma-GFAP status (positive for 3 and negative for 3 patients) and 3 brain metastases patients with known plasma-GFAP negativity. We found very high concentrations of plasma-GFAP in two MPE patients with pleuropulmonary metastases, while in none of the other MPE patients circulating plasma-GFAP was detectable. Circulating GFAP could be useful as marker for early detection or follow-up of distant metastases in MPE patients. PMID:23624779

Ilhan-Mutlu, Ayseguel; Berghoff, Anna S; Furtner, Julia; Dieckmann, Karin; Slavc, Irene; Czech, Thomas; Marosi, Christine; Wagner, Ludwig; Preusser, Matthias



Probable high ground-water levels in Massachusetts  

USGS Publications Warehouse

Water-level records from an observation-well network are analyzed for utility in estimating probable high ground-water levels in three different geohydrologic environments in Massachusetts. Analyses were made of 83 observation wells with between 8 and 37 years of records. Maximum annual water levels occur most frequently in March and April. The maximum range of water levels equaled or exceeded at 10 percent of randomly selected sites is estimated to be 16 feet in till, 9.2 feet in sand and gravel on terraces, and 4.0 feet in sand and gravel in valleys. An approach to estimating probable high ground-water levels at construction sites is suggested. An estimate of the high water level at a site may be derived by solving the proportion in which the ratio of the potential water-level rise at a test site to the potential water-level rise at an observation well is equal to the ratio of the water-level range at the site to the historic water-level range at an observation well in a similar geohydrologic environment. Precise description of the probabilities of exceedence of estimates made by this approach with the data available has not been made. Assuming that the data are representative of the future, estimates would not be expected to be exceeded at more than 1 in 10 sites over a period of 10 years or longer. (USGS)

Frimpter, M. H.



Diminished plasma levels of vitamin E in patients with severe viral hepatitis.  


RRR-alpha-Tocopherol (Vitamin E) was assayed in plasma of 48 patients with viral hepatitis and of 32 healthy controls. In patients with highly elevated serum transaminases (ALT > 100 U/L) vitamin E plasma levels were significantly lower (17.5 +/- 4.8 mumol/L) than in controls (22.7 +/- 4.2 mumol/L, p < 0.01). The vitamin E/lipid ratios (3.12 +/- 0.63 mumol/g) in these patients were 33% lower than those of the controls (4.68 +/- 0.54 mumol/g). The lowered vitamin E levels in patients with acute or chronic viral hepatitis with high activity of disease may be due to free radical-mediated liver injury. PMID:8951419

von Herbay, A; Stahl, W; Niederau, C; von Laar, J; Strohmeyer, G; Sies, H



High Response, Low Level Pulse Engine Thrust Stand System.  

National Technical Information Service (NTIS)

A high response, low level pulse engine thrust stand system has been designed, fabricated, and installed at the Air Force Flight Test Center, Rocket Propulsion Laboratory, Edwards Air Force Base. This system is designed to measure rocket engine thurst in ...

A. J. Couvillion J. D. Smith R. Kuberek



Use of ARTEMIS with High-Level Applications.  

National Technical Information Service (NTIS)

ARTEMIS is an online accelerator modeling server developed at CEBAF. One of the design goals of ARTEMIS was to provide an integrated modeling environment for high- level accelerator diagnostic and control applications such as automated beam steering, Lina...

B. A. Bowling H. Shoaee S. Witherspoon



Potential for erosion corrosion of SRS high level waste tanks.  

National Technical Information Service (NTIS)

SRS high-level radioactive waste tanks will not experience erosion corrosion to any significant degree during slurry pump operations. Erosion corrosion in carbon steel structures at reported pump discharge velocities is dominated by electrochemical (corro...

P. E. Zapp



FEDEF: A High Level Architecture Federate Development Framework.  

National Technical Information Service (NTIS)

The development of High Level Architecture (HLA) federates can be repetitive and time consuming, with development time better spent on the aspects that differentiate the functionality provided by federates. The common tasks and design patterns involved in...

J. W. Van Spengen



Organic Compounds in Savannah River Site High-Level Waste  

SciTech Connect

The present study identifies organic compounds or classes of compounds that may occur in SRS high-level waste (HLW) based on a review of previous sample analyses and records of disposals of organic compounds to the HLW tank farms.

Walker, D.D.



Test Procedures for High Level Architecture Interface Specification.  

National Technical Information Service (NTIS)

This document contains test procedures for the High Level Architecture (HLA) Interface Specification, v1. 3. Section I discusses the terminology used, the organization of the procedures, and how the procedures are defined.

M. L. Loper



Plasma cytokine levels predict mortality in patients with acute renal failure  

Microsoft Academic Search

Plasma cytokine levels predict mortality in patients with acute renal failure.BackgroundCritically ill patients with acute renal failure (ARF) experience a high mortality rate. Animal and human studies suggest that proinflammatory cytokines lead to the development of a systemic inflammatory response syndrome (SIRS), which is temporally followed by a counter anti-inflammatory response syndrome (CARS). This process has not been specifically described

Edith M. Simmons; JONATHAN HIMMELFARB; M. Tugrul Sezer; Glenn M. Chertow; Ravindra L. Mehta; Emil P. Paganini; SHARON SOROKO; STEPHANIE FREEDMAN; KAREN BECKER; DANIEL SPRATT; YU SHYR; T. Alp Ikizler



Laser recanalization in high risk patients.  


Laser recanalization was attempted in 13 patients in whom the risk of surgical therapy was increased by severe angina, infection, absent venous conduit, or recent deep venous thrombosis, and in 4 patients at high risk for limb loss due to severe infrapopliteal arterial occlusive disease. Total occlusions of the superficial femoral, tibial, or peroneal arteries were treated. Recanalization was accomplished using Argon laser power and a Spectraprobe-PLR. Two patients also required common femoral artery endarterectomy to improve inflow. Laser recanalization was successful in 9 patients (53%), and 8 (47%) had relief symptoms. None of the 4 patients with tibial and peroneal artery occlusion had successful recanalization or limb salvage. Restenosis or reocclusion developed in 4 patients during the first year after successful recanalization, but only 1 had recurrent symptoms. Limb salvage was initially achieved in 5 of 8 recanalization failures by surgical reconstruction but 3 developed graft infections requiring graft removal in 2 and amputation in 1. Thus, laser recanalization can accomplish limb salvage in selected patients whose medical or surgical risks complicate arterial bypass surgery. PMID:2139708

Seeger, J M; Kaelin, L D; Barbeau, G; Abela, G S



Increased plasma neopterin and hs-CRP levels in patients with endemic fluorosis.  


Although fluoride induced inflammatory reactions have been shown in animals and in vitro humans, there are few studies about fluoride induced inflammatory reactions in human beings at clinical setting. We aimed to measure the plasma neopterin, a marker of activation of the monocyte/macrophage system, and high sensitivity C-reactive protein (hs-CRP) levels in patients with endemic fluorosis to investigate the possible role of inflammatory processes (monocyte/macrophage activity) in the underlying pathophysiology of fluoride toxicity at clinical level. Plasma neopterin and hs-CRP levels were determined in endemic fluorosis patients and control subjects. Plasma neopterin levels were significantly higher among patients with endemic fluorosis when compared with control group (2.40 ± 0.66 vs. 1.63 ± 0.27 ng/mL respectively; p < 0.001) and plasma hs-CRP levels were also significantly higher among patients with endemic fluorosis when compared with control group (2.41 ± 1.23 vs. 1.93 ± 0.64 mg/L respectively; p < 0.001). Plasma neopterin levels were positively correlated with urine fluoride levels (r = 0.67, p < 0.001) and serum hs-CRP levels were positively correlated with urine fluoride levels (r = 0.36, p < 0.001). We have found that plasma neopterin and hs-CRP levels are increased in patients with endemic fluorosis. We have concluded that inflammation play an important role in the pathophysiology of fluoride toxicity in patients with endemic fluorosis. PMID:22926451

Varol, Ercan; Aksoy, Fatih; Icli, Atilla; Arslan, Akif; Yuksel, Ozlem; Ersoy, I Hakki; Varol, Simge; Dogan, Abdullah



Theory of Fermi Level Pinning of High-k Dielectrics  

Microsoft Academic Search

Fermi-level pinning of poly-Si and metal-silicide gate materials on Hf-based gate dielectrics has been systematically studied theoretically. Fermi-level pinning in high-work-function materials is governed by the O vacancy generation and subsequent formation of interface dipoles near gate electrodes due to the electron transfer. On the other hand, O interstitial formation plays a crucial role for Fermi-level pinning in low-work-function materials.

Kenji Shiraishi; H. Takeuchi; Y. Akasaka; Heiji Watanabe; N. Umezawa; T. Chikyow; Y. Nara; K. Yamada; Tsu-Jae King Liu




Microsoft Academic Search

In 1997, the first two United States Department of Energy (US DOE) high level waste tanks (Tanks 17-F and 20-F: Type IV, single shell tanks) were taken out of service (permanently closed) at the Savannah River Site (SRS). In 2012, the DOE plans to remove from service two additional Savannah River Site (SRS) Type IV high-level waste tanks, Tanks 18-F

C. Langton; H. Burns; D. Stefanko



High-order level-spacing distributions for mixed systems  

Microsoft Academic Search

We apply some of the methods that have been successfully used to describe the nearest-neighbor-spacing distributions of levels of systems with mixed regular-chaotic dynamics to the calculation of high-order spacing distributions. The distributions for chaotic spectra are described in terms of a previously suggested generalization of Wigner's surmise, which assumes that the high-order level repulsion function is given by a

A. Y. Abul-Magd; M. H. Simbel



Decision Document for Heat Removal from High Level Waste Tanks  

SciTech Connect

This document establishes the combination of design and operational configurations that will be used to provide heat removal from high-level waste tanks during Phase 1 waste feed delivery to prevent the waste temperature from exceeding tank safety requirement limits. The chosen method--to use the primary and annulus ventilation systems to remove heat from the high-level waste tanks--is documented herein.




Enforcing High-Level Security Properties for Applets  

Microsoft Academic Search

Smart card applications often handle privacy-sensitive information, and therefore must obey certain security policies. Typically, such policies are described as high-level security properties, stating for example that no pin verication must take place within a transaction. Behavioural interface specication languages, such as JML (Java Modeling Language), have been successfully used to validate functional properties of smart card applications. However, high-level

Mariela Pavlova; Gilles Barthe; Lilian Burdy; Marieke Huisman; Jean-louis Lanet



Provably Correct High-level Timing Analysis Without Path Sensitization  

Microsoft Academic Search

This paper addresses the problem of true delay estimation during high level design. The existing delay estimation techniques ei- ther estimate the topological delay of the circuit which may be pes- simistic, or use gate-level timing analysis for calculating the true de- lay, which may be prohibitively expensive. We show that the paths in the implementation of a behavioral spec-

Subhrajit Bhattacharya; Sujit Dey; Franc Brglez



Field Trips as Cognitive Motivators for High Level Science Learning  

ERIC Educational Resources Information Center

Using a composite example of field trips from several years of traveling to Yellowstone with high school biology students, the author illustrates how to raise the cognitive level of science instruction and student learning through science field trips. The author examines what teachers can do to raise the level of both teaching and learning in all…

Hurley, Marlene M.



High precision levelling supporting the International Comparison of Absolute Gravimeters  

Microsoft Academic Search

High precision levelling is an indispensable method used to monitor benchmark and terrain stability at the Bureau International des Poids et Mesures (BIPM). Associated with the International Comparison of Absolute Gravimeters (ICAG), levelling measurements were carried out repeatedly over the past decades. A local gravity field strongly depends on vertical terrain deformation. 1 cm displacement implies about 2 µGal change

Z Jiang; M Becker; P Jousset; A Coulomb; L Tisserand; P Boulanger; D Lequin; F Lhermitte; J L Houillon; F Dupont



Hierarchical High Level Information Fusion (H2LIFT).  

National Technical Information Service (NTIS)

The primary objective of this effort was the progression of Level 2/3 fusion of informational content to obtain an advanced multi-intelligent system for hierarchical high-level decision making processes. The goal was to develop an information integration ...

A. Crassidis A. Stotz J. Crassidis M. Sudit R. Nagi



Discovery of high-level tasks in the operating room.  


Recognizing and understanding surgical high-level tasks from sensor readings is important for surgical workflow analysis. Surgical high-level task recognition is also a challenging task in ubiquitous computing because of the inherent uncertainty of sensor data and the complexity of the operating room environment. In this paper, we present a framework for recognizing high-level tasks from low-level noisy sensor data. Specifically, we present a Markov-based approach for inferring high-level tasks from a set of low-level sensor data. We also propose to clean the noisy sensor data using a Bayesian approach. Preliminary results on a noise-free dataset of ten surgical procedures show that it is possible to recognize surgical high-level tasks with detection accuracies up to 90%. Introducing missed and ghost errors to the sensor data results in a significant decrease of the recognition accuracy. This supports our claim to use a cleaning algorithm before the training step. Finally, we highlight exciting research directions in this area. PMID:20060495

Bouarfa, L; Jonker, P P; Dankelman, J



Impact of longitudinal plasma leucine levels on the intellectual outcome in patients with classic MSUD.  


Maple syrup urine disease (MSUD) is an inherited deficiency of branched chain alpha-ketoacid dehydrogenase (BCKDH) activity impairing the degradation of the branched chain amino acids valine, leucine, and isoleucine. Classic MSUD may lead to severe neonatal encephalopathy including coma and impaired cognitive outcome in later life. Early start of dietary treatment and careful metabolic control may improve the outcome of patients with classic MSUD. The aim of this study was to investigate the impact of long-term metabolic control assessed by plasma leucine levels on cognitive outcome in patients with classic MSUD. Plasma leucine levels of 24 patients were obtained retrospectively for the first 6 y of life and yearly medians of mean plasma leucine levels were calculated. At the age of 6 y, IQ tests were performed. Yearly medians of mean plasma leucine levels yielded three homogeneous clusters (low, intermediate, high). Patients of the low cluster showed statistically significant higher IQ scores compared with those of those of intermediate and high clusters. Long-term plasma leucine levels are associated with impaired cognitive outcome in patients with classic MSUD. To achieve the best possible intellectual outcome for affected individuals, we recommend that in infants and preschool children the target range for plasma leucine should not exceed 200 micromol/L. PMID:16326996

Hoffmann, Björn; Helbling, Christoph; Schadewaldt, Peter; Wendel, Udo



Elevated CSF histamine levels in multiple sclerosis patients  

PubMed Central

Background Histamine is an ubiquitous inflammatory mediator of numerous physiological processes. Histamine and its receptors have been implicated in multiple sclerosis (MS) disease pathogenesis. We prospectively enrolled 36 MS patients and 19 age and gender-matched healthy volunteers for cerebrospinal fluid (CSF) histamine analysis. Findings CSF histamine levels in MS patient samples were significantly higher (median: 35.6 pg/ml) than in controls (median: 5.5 pg/ml; Beta?=?0.525, p?



Myeloneuropathy from Nitrous Oxide Abuse: Unusually High Methylmalonic Acid and Homocysteine Levels  

Microsoft Academic Search

A 23-year-old patient developed diffuse paresthesias and sensory loss. He had mildly reduced serum vitamin B12 (B12) concentration with unusually high levels of methylmalonic acid (MMA) and homocysteine and no evidence of B12 malabsorption. Following parenteral B12 administration, his neurological deficit promptly resolved and B12 and MMA levels normalized, but ele- vated levels of homocysteine persisted. One year later, he

Andrew J. Waclawik; Christopher C. Luzzio; Katalin Juhasz-Pocsine; Valerie Hamilton


Association between Periodontopathogens and CRP Levels in Patients with Periodontitis in Serbia  

PubMed Central

Background and aims Recent epidemiological studies have shown that individuals with periodontitis have a significantly higher risk of developing coronary heart disease, which might be attributed to the complex microbiota in the dental plaque. Periodontopathogens have been reported as risk factors for cardiovascular disease. This study evaluated association of chronic periodontitis and periodontopathogens with CRP in systemically healthy Serbian adults. Materials and methods Serum C-reactive protein levels were measured in 24 patients with moderate periodontitis, 26 patients with severe periodontitis, and 25 periodontally healthy subjects. Periodontal health indicators included gingival bleeding on probing and periodontal disease status. Patients with moderate periodontitis had low attachment loss and pocket depths of <4 mm. Patients with severe periodontitis had high AL and pocket depth of >5 mm. The control group with healthy gingiva had gingival sulcus of <2 mm and no attachment loss. Presence of periodontopathogens in subgingival plaque samples was analyzed by polymerase chain reaction. Results The periodontal parameters and CRP levels were significantly higher in the patients with periodontitis. Patients who had both severe and moderate periodontitis had higher mean CRP levels. The percentage of subjects with elevated CRP leves of >5 mol/L was greater in the higher clinical AL group compared to the group with less attachment loss. Presence of periodontopathogens was also associated with elevated CRP levels and poor periodontal status. Conclusion PD and subgingival periodontopathogens are associated with increased CRP levels. These findings suggest that periodontal infection may contribute to systemic inflammatory burden in otherwise healthy individuals.

Pejcic, Ana; Kesic, Ljiljana; Milasin, Jelena



Strict Volume Control and Longitudinal Changes in Cardiac Biomarker Levels in Hemodialysis Patients  

Microsoft Academic Search

Background: Our aim was to analyze the longitudinal changes in cardiac biomarker levels in hemodialysis patients with high comorbidity treated in our special hospital unit. We hypothesize that strict volume control strategy (salt-restricted diet, extended dialysis sessions and dry weight clinical assessment and reassessment in every session) could prevent progression of left-ventricular damage and, therefore, progressive increment in cardiac biomarker

Olimpia Ortega; Isabel Rodriguez; Carolina Gracia; María Sanchez; Carolina Lentisco; Carmen Mon; Paloma Gallar; Milagros Ortiz; Juan Carlos Herrero; Aniana Oliet; Ana Vigil



Plasma nucleosome levels in node-negative breast cancer patients  

Microsoft Academic Search

Background  A nucleosome is a primary repeating unit of organized DNA in chromatin, and cell death may lead to increased levels of circulating\\u000a nucleosomes in plasma (PNLs) in various circumstances such as inflammation, pulmonary embolism, autoimmune disease and cancer.\\u000a \\u000a \\u000a \\u000a Materials and Methods  We investigated PNLs in 96 patients with stage 0–III breast cancer (nodenegative, n=57; node-positive, n=39), and in 111 women\\u000a without

Katsumasa Kuroi; Chikako Tanaka; Masakazu Toi



Neurone-specific enolase levels in pleural effusions in patients with rheumatoid arthritis.  

PubMed Central

BACKGROUND: High pleural fluid levels of neurone-specific enolase (NSE) have been reported, not only in patients with small cell lung cancer but also in those with chronic inflammatory diseases. METHODS: NSE concentrations were determined in pleural fluid and serum from 342 patients with pleural effusions including 17 with rheumatoid arthritis. RESULTS: The median NSE concentration in pleural fluid was higher in rheumatoid effusions than in any other condition studied. The median pleural fluid:serum NSE ratio was highest in patients with rheumatoid arthritis (11.6) and about unity in all other diseases including small cell lung cancer (0.9). In patients with rheumatoid arthritis pleural fluid concentrations of NSE correlated inversely with pleural fluid glucose concentrations and the pH of the pleural fluid. CONCLUSIONS: A high pleural fluid:serum NSE ratio was found consistently in pleural effusions from patients with rheumatoid disease.

Nyberg, P.; Soderblom, T.; Pettersson, T.; Riska, H.; Klockars, M.; Linko, L.



Decreased parathyroid hormone levels despite persistent hypocalcemia in patients with kidney failure recovering from septic shock.  


Introduction: Hypocalcemia is a common and poorly understood finding in critically ill patients. The current study was designed to assess the association of ionized calcium, vitamin D, phosphorus and Parathyroid hormone levels in a cohort of patients with and without kidney dysfunction admitted for sepsis or non-infectious causes. Methods: Prospective cohort clinical and biochemical study. Results: We confirmed that hypocalcemia and hypovitaminosis D are a common finding in critically ill patients. Parathyroid hormone levels significantly rise in septic shock. In the recovery phase, however, despite persistent hypocalcemia, Parathyroid hormone levels abruptly decrease in patients with kidney dysfunction, but not in patients with normal renal function. Conclusions: The systemic inflammatory response syndrome probably leads to inappropriately high Parathyroid hormone levels during septic shock. In the recovery phase, Parathyroid hormone levels decrease, but calcium levels remain low, displaying evidence that the parathyroid is not responding as expected. Since Parathyroid hormone receptors and calcium-sensing receptors have been described in immune cells and other cell types, we propose that these effects may have a plethora of other deleterious effects, with important implications to the pathogenesis of septic shock. PMID:23270481

Pinheiro da Silva, Fabiano; Zampieri, Fernando Godinho; Barbeiro, Hermes Vieira; Filho, Francisco Torggler; Goulart, Alessandra Carvalho; Jorgetti, Vanda; Velasco, Irineu Tadeu; da Cruz Neto, Luiz Monteiro; de Souza, Heraldo Possolo



Elevated VEGF Levels in Pulmonary Edema Fluid and PBMCs from Patients with Acute Hantavirus Pulmonary Syndrome  

PubMed Central

Hantavirus pulmonary syndrome is characterized by vascular permeability, hypoxia, and acute pulmonary edema. Vascular endothelial growth factor (VEGF) is induced by hypoxia, potently induces vascular permeability, and is associated with high-altitude-induced pulmonary edema. Hantaviruses alter the normal regulation of ?3 integrins that restrict VEGF-directed permeability and hantavirus infected endothelial cells are hyperresponsive to the permeabilizing effects of VEGF. However, the role of VEGF in acute pulmonary edema observed in HPS patients remains unclear. Here we retrospectively evaluate VEGF levels in pulmonary edema fluid (PEF), plasma, sera, and PBMCs from 31 HPS patients. VEGF was elevated in HPS patients PEF compared to controls with the highest levels observed in PEF samples from a fatal HPS case. VEGF levels were highest in PBMC samples during the first five days of hospitalization and diminished during recovery. Significantly increased PEF and PBMC VEGF levels are consistent with acute pulmonary edema observed in HPS patients and HPS disease severity. We observed substantially lower VEGF levels in a severe HPS disease survivor after extracorporeal membrane oxygenation. These findings suggest the importance of patients' VEGF levels during HPS, support the involvement of VEGF responses in HPS pathogenesis, and suggest targeting VEGF responses as a potential therapeutic approach.

Gavrilovskaya, Irina; Gorbunova, Elena; Koster, Frederick; Mackow, Erich



Malondialdehyde, Glutathione, and Nitric Oxide Levels in Toxoplasma gondii Seropositive Patients  

PubMed Central

The aim of this study was to investigate the difference in the serum malondialdehyde (MDA), glutathione (GSH), and nitric oxide (NO) levels between normal and T. gondii-infected patients. To this end, MDA, GSH, and NO levels in the sera of 37 seropositive patients and 40 participants in the control group were evaluated. In Toxoplasma ELISA, IgG results of the patient group were 1,013.0 ± 543.8 in optical density (mean ± SD). A statistically significant difference was found between patients and the control group in terms of MDA, GSH, and NO levels. A decrease in GSH activity was detected, while MDA and NO levels increased significantly. Consequently, it is suggested that the use of antioxidant vitamins in addition to a parasite treatment shall prove useful. The high infection vs control ratio of MDA and NO levels probably suggests the occurrence as a mechanism of tissue damage in cases of chronic toxoplasmosis. Moreover, it is recommended that the patient levels of MDA, GSH, and NO should be evaluated in toxoplasmosis.

Karaman, Ulku; Kiran, Tugba Raika; Colak, Cemil; Daldal, Nilgun Ulfet



Decreased Exhaled Nitric Oxide Levels in Patients with Mitochondrial Disorders  

PubMed Central

Background: Nitric oxide (NO) deficiency may occur in mitochondrial disorders (MD) and can contribute to the pathogenesis of the disease. It is difficult and invasive to measure systemic nitric oxide. NO is formed in the lungs and can be detected in expired air. Currently, hand-held fractional exhaled nitric oxide (FeNO) measurement devices are available enabling a fast in-office analysis of this non-invasive test. It was postulated that FeNO levels might be reduced in MD. Methods: Sixteen subjects with definite MD by modified Walker criteria (4 to 30 years of age) and sixteen healthy control subjects of similar age, race and body mass index (BMI) underwent measurement of FeNO in accordance with the American Thoracic Society guidelines. Results: Sixteen patient-control pairs were recruited. The median FeNO level was 6.5 ppm (IQR: 4-9.5) and 10.5 ppm (IQR: 8-20.5) in the MD and control groups, respectively. In 13 pairs (81%), the FeNO levels were lower in the MD cases than in the matched controls (p=0.021). Eleven (69%) cases had very low FeNO levels (?7ppm) compared to only 1 control (p=0.001). All cases with enzymatic deficiencies in complex I had FeNO ?7ppm. Conclusions: Single-breath exhaled nitric oxide recordings were decreased in patients with MD. This pilot study suggests that hand-held FeNO measurements could be an attractive non-invasive indicator of MD. In addition, measurement of FeNO could be used as a parameter to monitor therapeutic response in this population.

Mosquera, Ricardo A.; Samuels, Cheryl L.; Harris, Tomika S.; Yadav, Aravind; Hashmi, S. Shahrukh; Knight, Melissa S.; Koenig, Mary Kay



The serum vaspin levels are reduced in Japanese chronic hemodialysis patients  

PubMed Central

Background Visceral adipose tissue-derived serine proteinase inhibitor (vaspin) is an adipokine identified in genetically obese rats that correlates with insulin resistance and obesity in humans. Recently, we found that 7% of the Japanese population with the minor allele sequence (A) of rs77060950 exhibit higher levels of serum vaspin. We therefore evaluated the serum vaspin levels in Japanese chronic hemodialysis patients. Methods Healthy Japanese control volunteers (control; n?=?95, 49.9±6.91?years) and Japanese patients undergoing hemodialysis therapy (HD; n?=?138, 51.4±10.5?years) were enrolled in this study, and serum samples were subjected to the human vaspin RIA system. Results The measurement of the serum vaspin levels demonstrated that a fraction of control subjects (n?=?5) and HD patients (n?=?11) exhibited much higher levels (> 10?ng/ml; VaspinHigh group), while the rest of the population exhibited lower levels (< 3?ng/ml; VaspinLow group). By comparing the patients in the VaspinLow group, the serum vaspin levels were found to be significantly higher in the control subjects (0.87±0.24?ng/ml) than in the HD patients (0.32±0.15?ng/ml) (p?levels were found to be independently and significantly associated with the vaspin concentrations in all subjects. Conclusions The creatinine levels are negatively correlated with the serum vaspin levels and were significantly reduced in the Japanese HD patients in the VaspinLow group.



CKD patients: the dilemma of serum PTH levels.  


Recent observational studies of patients with stage 3-5 chronic kidney disease (CKD) not undergoing dialysis have shown that even slight increases in parathyroid hormone (PTH) levels are associated with an increased cardiovascular risk, regardless of the serum levels of calcium and phosphorus and vitamin D therapy. These studies suggest paying particular attention to monitoring PTH levels from the early stages of CKD, and preventing any mineral metabolism disorders that may trigger the excessive synthesis and secretion of PTH. However, it is not easy to determine when an appropriate response becomes maladaptive and requires the pharmacological suppression of the parathyroid gland because the gland's adaptive response can vary widely from one person to another. Furthermore, PTH levels are not always a good predictor of bone turnover and current PTH assays have various methodological limitations. Treating the early mineral metabolism abnormalities of CKD may help prevent the cardiovascular complications whose frequency, costs and mortality have a profound effect on society as a whole. For this reason, there is great interest in establishing adequate target ranges for PTH at different stages of CKD, and determining the most appropriate strategies for reaching them. PMID:20639672

Pontoriero, Giuseppe; Cozzolino, Mario; Locatelli, Francesco; Brancaccio, Diego



A Testing Instrument for High School Arabic, Level III.  

ERIC Educational Resources Information Center

The Arabic language examination was designed for Jewish immigrants from Syria wishing to satisfy New York State language requirements for high school graduation by indicating their proficiency in Arabic. The test is essentially a translation of a state test of Hebrew, and is intended to test Arabic at the third-year high school level. The…

Wolowelsky, Joel B.


High-Level Modeling and Design of Asynchronous Interface Logic  

Microsoft Academic Search

Asynchronous digital interface circuits exhibit a high degree of concurrency. Self-timedimplementation is the most appropriate design discipline for such circuits. Their complexitydemands that a formal design methodology, amenable to automation, is used to designthem. Existing specification models suffer from severe limitations when it comes to describingthe circuit function at a high level, which requires decomposing the specification intointercommunicating sub-modules and




A Testing Instrument for High School Arabic, Level III.  

ERIC Educational Resources Information Center

|The Arabic language examination was designed for Jewish immigrants from Syria wishing to satisfy New York State language requirements for high school graduation by indicating their proficiency in Arabic. The test is essentially a translation of a state test of Hebrew, and is intended to test Arabic at the third-year high school level. The…

Wolowelsky, Joel B.


Comparative leach testing of high-level waste forms  

SciTech Connect

Four candidate waste forms (borosilicate glass, high-silica glass, tailored ceramic, and Synroc) for Savannah River Plant high-level nuclear waste were compared in MCC-1 standard static leach tests. Relative leaching behavior differed for each element, and none of the waste forms was clearly superior to the others.

Stone, J A



Plasma levels of lipoprotein-associated phospholipase A(2) are increased in patients with ?-thalassemia.  


Lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) is an independent cardiovascular risk factor. We investigated the plasma levels of Lp-PLA(2) activity and mass as a function of plasma lipid levels, LDL subclass profile, and oxidative stress in patients with ?-thalassemia. Thirty-five patients with ?-thalassemia major (?-TM) and 25 patients with ?-thalassemia intermedia (?-TI) participated in the study. Lp-PLA(2) activity and mass were measured in total plasma, in apolipoprotein (apo)B-depleted plasma (HDL-Lp-PLA(2)), and in LDL subclasses. Lp-PLA(2) activity produced and secreted from peripheral blood monocytes in culture was also determined. Patients with ?-thalassemia are characterized by a predominance of small-dense LDL particles, increased oxidative stress, and very high plasma levels of Lp-PLA(2) mass and activity, despite low LDL-cholesterol levels. A significant positive correlation between plasma Lp-PLA(2) activity or mass and 8-isoprostane (8-epiPGF2a) and ferritin levels as well as intima-media thickness (IMT) values was observed. An increase in secreted and cell-associated Lp-PLA(2) activity from monocytes in culture was observed in both patient groups. The HDL-Lp-PLA(2) activity and mass as well as the ratio of HDL-Lp-PLA(2)/plasma Lp-PLA(2) were significantly higher in both patient groups compared with the control group. In conclusion, patients with ?-thalassemia exhibit high plasma Lp-PLA(2) levels, attributed to increased enzyme secretion from monocytes/macrophages and to the predominance of sdLDL particles in plasma. Plasma Lp-PLA(2) is correlated with carotid IMT, suggesting that this enzyme may be implicated in premature carotid atherosclerosis observed in ?-thalassemia. PMID:20625038

Tselepis, Alexandros D; Hahalis, George; Tellis, Constantinos C; Papavasiliou, Eleni C; Mylona, Panagiota T; Kourakli, Alexandra; Alexopoulos, Dimitrios C



Plasma levels of lipoprotein-associated phospholipase A2 are increased in patients with ?-thalassemia  

PubMed Central

Lipoprotein-associated phospholipase A2 (Lp-PLA2) is an independent cardiovascular risk factor. We investigated the plasma levels of Lp-PLA2 activity and mass as a function of plasma lipid levels, LDL subclass profile, and oxidative stress in patients with ?-thalassemia. Thirty-five patients with ?-thalassemia major (?-TM) and 25 patients with ?-thalassemia intermedia (?-TI) participated in the study. Lp-PLA2 activity and mass were measured in total plasma, in apolipoprotein (apo)B-depleted plasma (HDL-Lp-PLA2), and in LDL subclasses. Lp-PLA2 activity produced and secreted from peripheral blood monocytes in culture was also determined. Patients with ?-thalassemia are characterized by a predominance of small-dense LDL particles, increased oxidative stress, and very high plasma levels of Lp-PLA2 mass and activity, despite low LDL-cholesterol levels. A significant positive correlation between plasma Lp-PLA2 activity or mass and 8-isoprostane (8-epiPGF2a) and ferritin levels as well as intima-media thickness (IMT) values was observed. An increase in secreted and cell-associated Lp-PLA2 activity from monocytes in culture was observed in both patient groups. The HDL-Lp-PLA2 activity and mass as well as the ratio of HDL-Lp-PLA2/plasma Lp-PLA2 were significantly higher in both patient groups compared with the control group. In conclusion, patients with ?-thalassemia exhibit high plasma Lp-PLA2 levels, attributed to increased enzyme secretion from monocytes/macrophages and to the predominance of sdLDL particles in plasma. Plasma Lp-PLA2 is correlated with carotid IMT, suggesting that this enzyme may be implicated in premature carotid atherosclerosis observed in ?-thalassemia.

Tselepis, Alexandros D.; Hahalis, George; Tellis, Constantinos C.; Papavasiliou, Eleni C.; Mylona, Panagiota T.; Kourakli, Alexandra; Alexopoulos, Dimitrios C.



Increased serum high mobility group box-1 level in Churg-Strauss syndrome.  


Churg-Strauss syndrome (CSS) is a rare form of systemic vasculitis occurring in patients with asthma and hypereosinophilia; however, its mechanisms involved in the severe tissue inflammation with vasculitis are poorly understood. High mobility group box 1 (HMGB1) protein, originally identified as a DNA binding protein, also has potent pro-inflammatory and proangiogenic properties. In this study, we hypothesized that HMGB1 might be associated with CSS, and examined serum HMGB1 levels and compared those of asthma patients and healthy volunteers. We also investigated HMGB1 expression in the lesion, and eosinophil HMGB1 amount in CSS patients. We found that the serum HMGB1 levels in CSS patients were significantly higher than those of asthma patients and healthy volunteers. Eosinophils in the CSS lesion expressed HMGB1 and HMGB1 level in eosinophils from CSS patients was significantly higher than that of asthma patients, while there was no significant difference in HMGB1 levels in peripheral mononuclear cells. The serum HMGB1 level in CSS patients decreased after the steroid therapy, and showed significant positive correlations with several molecules, including soluble interleukin-2 receptor, soluble thrombomodulin, and eosinophil cationic protein in sera. We propose that HMGB1 might contribute to the pathogenesis of CSS. PMID:17437420

Taira, T; Matsuyama, W; Mitsuyama, H; Kawahara, K-I; Higashimoto, I; Maruyama, I; Osame, M; Arimura, K



Increased serum high mobility group box-1 level in Churg-Strauss syndrome  

PubMed Central

Churg–Strauss syndrome (CSS) is a rare form of systemic vasculitis occurring in patients with asthma and hypereosinophilia; however, its mechanisms involved in the severe tissue inflammation with vasculitis are poorly understood. High mobility group box 1 (HMGB1) protein, originally identified as a DNA binding protein, also has potent pro-inflammatory and proangiogenic properties. In this study, we hypothesized that HMGB1 might be associated with CSS, and examined serum HMGB1 levels and compared those of asthma patients and healthy volunteers. We also investigated HMGB1 expression in the lesion, and eosinophil HMGB1 amount in CSS patients. We found that the serum HMGB1 levels in CSS patients were significantly higher than those of asthma patients and healthy volunteers. Eosinophils in the CSS lesion expressed HMGB1 and HMGB1 level in eosinophils from CSS patients was significantly higher than that of asthma patients, while there was no significant difference in HMGB1 levels in peripheral mononuclear cells. The serum HMGB1 level in CSS patients decreased after the steroid therapy, and showed significant positive correlations with several molecules, including soluble interleukin-2 receptor, soluble thrombomodulin, and eosinophil cationic protein in sera. We propose that HMGB1 might contribute to the pathogenesis of CSS.

Taira, T; Matsuyama, W; Mitsuyama, H; Kawahara, K-I; Higashimoto, I; Maruyama, I; Osame, M; Arimura, K



The effects of high presentation levels on consonant feature transmission  

NASA Astrophysics Data System (ADS)

The effect of high speech presentation levels on consonant recognition and feature transmission was assessed in eight participants with normal hearing. Consonant recognition in noise (0 dB signal-to-noise ratio) was measured at five overall speech levels ranging from 65 to 100 dB SPL. Consistent with the work of others, overall percent correct performance decreased as the presentation level of speech increased [e.g., G. A. Studebaker, R. L. Sherbecoe, D. M. McDaniel, and C. A. Gwaltney, J. Acoust. Soc. Am. 105(4), 2431-2444 (1999)]. Confusion matrices were analyzed in terms of relative percent information transmitted at each speech presentation level, as a function of feature. Six feature sets (voicing, place, nasality, duration, frication, and sonorance) were analyzed. Results showed the feature duration (long consonant duration fricatives) to be most affected by increases in level, while the voicing feature was relatively unaffected by increases in level. In addition, alveolar consonants were substantially affected by level, while palatal consonants were not. While the underlying mechanisms responsible for decreases in performance with level increases are unclear, an analysis of common error patterns at high levels suggests that saturation of the neural response and/or a loss of neural synchrony may play a role.

Hornsby, Benjamin W. Y.; Trine, Timothy D.; Ohde, Ralph N.



Myeloneuropathy from nitrous oxide abuse: unusually high methylmalonic acid and homocysteine levels.  


A 23-year-old patient developed diffuse paresthesias and sensory loss. He had mildly reduced serum vitamin B12 (B12) concentration with unusually high levels of methylmalonic acid (MMA) and homocysteine and no evidence of B12 malabsorption. Following parenteral B12 administration, his neurological deficit promptly resolved and B12 and MMA levels normalized, but elevated levels of homocysteine persisted. One year later, he admitted to inhaling nitrous oxide (N2O). After halting N2O abuse his homocysteine level normalized. This case demonstrates the importance of serum homocysteine level measurements in cases of suspected N2O toxicity [corrected]. PMID:12967021

Waclawik, Andrew J; Luzzio, Christopher C; Juhasz-Pocsine, Katalin; Hamilton, Valerie



Building Level Administrators' Attitudes toward Teacher Effectiveness at the High School and Middle School Levels  

ERIC Educational Resources Information Center

This study investigated the attitudes of administrators about differences and similarities between middle and high school teachers. The research question that guided the study was, "Do attitudes about what makes an effective educator differ between building administrators at the middle and high school levels?" A formal, sequential, mixed-methods…

Hanson, Nathan K.



High fluoride exposure in hemodialysis patients.  


The observation of higher plasma flouride levels in our hemodialysis (HD) patients than our continuous ambulatory peritoneal dialysis (CAPD) patients (4.0 +/- 0.5 mumol/L [n = 17] v 2.5 +/- 0.3 mumol/L [n = 17], P less than 0.005) prompted an evaluation of fluoride metabolism during HD. We found that serum fluoride was completely ultrafiltrable across cuprophane membranes (99% +/- 4%) and that HD produced acute changes in plasma fluoride levels that correlated well with the fluoride gradient between plasma and dialysis fluid at the start of dialysis. Our HD fluids contained significantly higher fluoride concentrations than were present in commercially prepared peritoneal dialysis fluid. Our fluids are prepared from fluoridated tap water that is purified by reverse osmosis (RO). We conclude that the different concentrations of fluoride in our dialysis fluids account for the differences in the plasma flouride concentrations between our dialysis groups. Since many HD units rely on RO systems to purify fluoridated tap water, it is likely that many HD patients are being exposed inadvertently to increased concentrations of fluoride. PMID:2321644

Bello, V A; Gitelman, H J



Homocysteine levels in patients with schizophrenia on clozapine monotherapy.  


We tested the hypothesis that homocysteine levels are higher in blood of schizophrenic subjects on clozapine monotherapy than in healthy controls and they correlate with anthropometric measurements, laboratory tests and results of bioimpedance analysis of body composition. Data for 24 subjects with schizophrenia treated with clozapine and 24 age- and sex-matched healthy volunteers was analyzed. Regarding the whole group, homocysteine levels were significantly higher in men (17.0 ± 3.4 vs. 12.1 ± 4.0 ?mol/L, p = 0.009). Homocysteine levels correlated with waist circumference (R = 0.58, p = 0.003), waist-to-hip ratio (R = 0.57, p = 0.003), basal metabolic rate (R = 0.48, p = 0.01), lean body mass [kg] (R = 0.53, p = 0.008), body water [L] (R = 0.53, p = 0.008) and triglycerides (R = 0.57, p = 0.003). There were no significant differences of homocysteine levels for impaired fasting glucose, abdominal obesity, obesity/overweight, and dyslipidemia. Homocysteine levels did not correlate with age, treatment duration, clozapine dose, weight, body mass index, abdominal circumference, blood pressure, total body fat, cholesterol, high density lipoproteins, low density lipoproteins, uric acid, calcium, glucose, insulin, homoeostasis model assessment of insulin resistance 1, and homoeostasis model assessment of insulin resistance 2. We did not find significant differences in blood homocysteine levels between subjects with schizophrenia and controls. Association with waist circumference may support homocysteine role as an important cardiovascular risk factor. Association with lean weight may explain why men have higher levels of homocysteine than women. PMID:23873378

Wysoki?ski, Adam; K?oszewska, Iwona



Elevated HGF Levels in Sera from Breast Cancer Patients Detected Using a Protein Microarray ELISA  

SciTech Connect

We developed an ELISA in high-density microassay format to detect hepatocyte growth factor (HGF) in human serum. The microassay can detect HGF at sub-pg/mL concentrations in sample volumes of 100 uL or less. The microassay is also quantitative and was used to detect elevated HGF levels in sera from recurrent breast cancer patients. The microarray format provides the potential for high-throughput quantitation of multiple biomarkers in parallel.

Woodbury, Ronald L. (BATTELLE (PACIFIC NW LAB)); Varnum, Susan M. (BATTELLE (PACIFIC NW LAB)); Zangar, Richard C. (BATTELLE (PACIFIC NW LAB))



Decreased Serum Selenium Levels are Correlated with Diminished Coronary Flow Reserve Among Hemodialysis Patients.  


Cardiovascular diseases are the main reason of high mortality among hemodialysis patients. Decreased serum selenium levels may have a role in accelerated atherosclerosis in this patient group. The hypothesis of this study was to show a correlation between decreased serum selenium levels and coronary flow reserve as an indicator of endothelial dysfunction and atherosclerosis in HD patients. Seventy-one chronic hemodialysis patients and age 65 and sex-matched healthy controls were included in the study. Plasma selenium levels were measured by spectrophotometry, and coronary flow reserve was assessed by transthoracic Doppler echocardiography. Serum selenium levels (34.16?±?6.15 ng/ml vs. 52.4?±?5.51 ng/ml, P?patients compared with controls, respectively. There was a significant positive correlation between coronary flow reserve and serum levels of selenium (r?=?0.676, P?levels of selenium were independently and positively correlated with coronary flow reserve (regression coefficient?=?0.650, P?levels and diminished coronary flow reserve as an indicator of endothelial dysfunction and atherosclerosis in hemodialysis patients. Our data suggest that decreased serum selenium levels may facilitate the development of endothelial dysfunction and disruption of coronary flow reserve which occur before the development of overt atherosclerosis. PMID:24178732

Atakan, Aydin; Macunluoglu, Beyza; Kaya, Yuksel; Ari, Elif; Demir, Halit; Asicioglu, Ebru; Kaspar, Cigdem



High pentraxin-3 plasma levels associate with thrombocytopenia in acute Puumala hantavirus-induced nephropathia epidemica.  


Our aim was to investigate whether plasma levels of the long pentraxin-3 (PTX3) associate with the severity of Puumala hantavirus-induced nephropathia epidemica (NE). Sixty-one prospectively identified consecutively hospitalized NE patients were examined. Plasma PTX3, interleukin (IL)-6, terminal complement complex SC5b-9, complement component C3, C-reactive protein (CRP), creatinine, sodium, kynurenine, and tryptophan levels, as well as the blood cell count, were determined for up to five consecutive days after hospitalization. Receiver operating characteristic (ROC) analysis revealed that the maximum PTX3 level >101.6 ng/ml (high PTX3) showed a sensitivity of 71% and a specificity of 89% for detecting platelet level <50 × 10(9)/l, with an area under the curve (AUC) value of 0.78 (95% confidence interval [CI] 0.63-0.94). High PTX3 level was also associated with several other variables reflecting the severity of the disease: patients with high PTX3 level had higher maximum blood leukocyte (16.1 vs. 9.7 × 10(9)/l, p < 0.001), plasma IL-6 (16.9 vs. 9.0 pg/ml, p = 0.007), and creatinine (282 vs. 124 ?mol/l, p = 0.007) levels than patients with low maximum PTX3 level. They also had longer hospital stays (8 vs. 5 days, p = 0.015) compared to patients with low PTX3 level. High plasma PTX3 levels are associated with thrombocytopenia and the overall severity of NE. PMID:21901638

Outinen, T K; Mäkelä, S; Huhtala, H; Hurme, M; Meri, S; Pörsti, I; Sane, J; Vaheri, A; Syrjänen, J; Mustonen, J



MAP17 and SGLT1 Protein Expression Levels as Prognostic Markers for Cervical Tumor Patient Survival  

PubMed Central

MAP17 is a membrane-associated protein that is overexpressed in human tumors. Because the expression of MAP17 increases reactive oxygen species (ROS) generation through SGLT1 in cancer cells, in the present work, we investigated whether MAP17 and/or SGLT1 might be markers for the activity of treatments involving oxidative stress, such as cisplatin or radiotherapy. First, we confirmed transcriptional alterations in genes involved in the oxidative stress induced by MAP17 expression in HeLa cervical tumor cells and found that Hela cells expressing MAP17 were more sensitive to therapies that induce ROS than were parental cells. Furthermore, MAP17 increased glucose uptake through SGLT receptors. We then analyzed MAP17 and SGLT1 expression levels in cervical tumors treated with cisplatin plus radiotherapy and correlated the expression levels with patient survival. MAP17 and SGLT1 were expressed in approximately 70% and 50% of cervical tumors of different types, respectively, but they were not expressed in adenoma tumors. Furthermore, there was a significant correlation between MAP17 and SGLT1 expression levels. High levels of either MAP17 or SGLT1 correlated with improved patient survival after treatment. However, the patients with high levels of both MAP17 and SGLT1 survived through the end of this study. Therefore, the combination of high MAP17 and SGLT1 levels is a marker for good prognosis in patients with cervical tumors after cisplatin plus radiotherapy treatment. These results also suggest that the use of MAP17 and SGLT1 markers may identify patients who are likely to exhibit a better response to treatments that boost oxidative stress in other cancer types.

Perez, Marco; Praena-Fernandez, Juan M.; Felipe-Abrio, Blanca; Lopez-Garcia, Maria A.; Lucena-Cacace, Antonio; Garcia, Angel; Lleonart, Matilde; Roncador, Guiovanna; Marin, Juan J.; Carnero, Amancio



Low triglyceride levels are associated with a better metabolic control in patients with type 1 diabetes  

PubMed Central

Background Although it is well known in the literature that high triglyceride serum (TG) levels can jeopardize the metabolic control, little is known about the influence of low TG on type 1 diabetes patients (T1D). The aim of this study is to investigate the distribution of TG serum levels in individuals with T1D and its relationship with metabolic control. Findings We reviewed the medical charts of 180 patients with T1D, who were classified in groups according to TG levels: 1) low (below 50 mg/dL); 2) normal (50-150 mg/dL); 3) high (above 150 mg/dL). TG were low in 21.1% (n = 38; group 1), normal in 68.6% (n = 123; group 2) and high in 10.6% (n = 19; group 3). High TG was associated with a poor metabolic control (p < 0.001). Patients with TG lower than 50 mg/dL had a lower HbA1c than those with TG between 50 and 150 mg/dL (7.41+/-1.50% vs 8.56%+/-1.94%; p = 0.002). Conclusion TG lower than 50 mg/dL was common and might be associated with a better metabolic control in patients with T1D, although it is not clear whether the former is the cause or consequence for the latter.



High initial blood levels of tacrolimus in overweight renal transplant recipients.  


For the purpose of both efficacy and safety, exposure to tacrolimus and other immunosuppressive drugs must be monitored, since initial levels influence the development of acute rejection episodes, nephrotoxicity, and posttransplantation diabetes mellitus. The aim of this study was to identify risk factors for developing high initial tacrolimus blood levels. We analyzed clinical and biochemical parameters of 85 renal transplant recipients receiving tacrolimus-based immunosuppressive therapy by stratifying into subgroups of patients who displayed first tacrolimus concentrations higher and lower than 15 ng/mL. Patients with a first level of tacrolimus higher than 15 ng/mL were older (52 +/- 13 vs 40 +/- 12 years, P < .05) and had a larger body mass index (27 +/- 4 vs 23 +/- 3 kg/m2, P < .05) than patients with lower levels, despite receiving a lower weight-adjusted cumulative steroid dose (8.2 +/- 2.2 vs 9.3 +/- 2.5 mg/kg, P < .05). Upon logistic regression, age (RR 1.047, 95% CI 1.007 to 1.08, P = .021) and body mass index (RR 1.176, 95% CI 1.009 to 1.371, P = .036) remained significant risk factors for high initial blood levels of tacrolimus. As these subgroups of patients are most prone to develop posttransplantation glycemic disorders, attention must be paid to avoid high tacrolimus blood levels by diminishing initial tacrolimus doses or estimating them from ideal body weight. PMID:15866635

Rodrigo, E; de Cos, M A; Sánchez, B; Ruiz, J C; Pińera, C; Fernández-Fresnedo, G; Palomar, R; Pérez-Ceballos, M A; Cotorruelo, J G; Zubimendi, J A; de Francisco, A L M; Arias, M



High-level software energy macro-modeling  

Microsoft Academic Search

This paper presents an efficient and accurate high-level software energy estimation methodology using the concept of characterization-based macro-modeling. In characterization-based macro-modeling, a function or sub-routine is characterized using an accurate lower-level energy model of the target processor, to construct a macro-model that relates the energy consumed in the function under consideration to various parameters that can be easily observed or

Tat Kee Tan; Anand Raghunathan; G. Lakishminarayana; Niraj K. Jha



Solidification of Savannah River plant high level waste  

NASA Astrophysics Data System (ADS)

Authorization for construction of the Defense Waste Processing Facility (DWPF) is expected in FY-83. The optimum time for stage 2 authorization is about three years later. Detailed design and construction will require approximately five years for stage 1, with stage 2 construction completed about two to three years later. Production of canisters of waste glass would begin in 1988, and the existing backlog of high level waste sludge stored at SRP would be worked off by about the year 2000. Stage 2 operation could begin in 1990. The technology and engineering are ready for construction and eventual operation of the DWPF for immobilizing high level radioactive waste at Savannah River Plant (SRP). Proceeding with this project will provide the public, and the leadership of this country, with a crucial demonstration that a major quanitity of existing high level nuclear wastes can be safely and permanently immobilized.

Maher, R.; Shafranek, L. F.; Kelley, J. A.; Zeyfang, R. W.



Mortality Benefit of Transfer to Level I versus Level II Trauma Centers for Head-Injured Patients  

PubMed Central

Objective To determine whether head-injured patients transferred to level I trauma centers have reduced mortality relative to transfers to level II trauma centers. Data Source/Study Setting Retrospective cohort study of 542 patients with head injury who initially presented to 1 of 31 rural trauma centers in Oregon and Washington, and were transferred from the emergency department to 1 of 15 level I or level II trauma centers, between 1991 and 1994. Study Design A bivariate probit, instrumental variables model was used to estimate the effect of transfer to level I versus level II trauma centers on 30-day postdischarge mortality. Independent variables included age, gender, Injury Severity Scale (ISS), other indicators of injury severity, and a dichotomous variable indicating transfer to a level I trauma center. The differential distance between the nearest level I and level II trauma centers was used as an instrument. Principal Findings Patients transferred to level I trauma centers differ in unmeasured ways from patients transferred to level II trauma centers, biasing estimates based on standard statistical methods. Transfer to a level I trauma center reduced absolute mortality risk by 10.1% (95% confidence interval 0.3%, 22.2%) compared with transfer to level II trauma centers. Conclusions Patients with severe head injuries transferred from rural trauma centers to level I centers are likely to have improved survival relative to transfer to level II centers.

McConnell, K John; Newgard, Craig D; Mullins, Richard J; Arthur, Melanie; Hedges, Jerris R



The Use of ARTEMIS with High-Level Applications  

SciTech Connect

ARTEMIS is an online accelerator modeling server developed at CEBAF. One of the design goals of ARTEMIS was to provide an integrated modeling environment for high- level accelerator diagnostic and control applications such as automated beam steering, Linac Energy management (LEM) and the fast feedback system. This report illustrates the use of ARTEMIS in these applications as well as the application interface using the EPICS cdev device support API. Concentration is placed on the design and implementation aspects of high- level applications which utilize the ARTEMIS server for information on beam dynamics. Performance benchmarks for various model operations provided by ARTEMIS are also discussed.

B. A. Bowling; H. Shoaee; S. Witherspoon



High Level Waste (HLW) Feed Process Control Strategy  

SciTech Connect

The primary purpose of this document is to describe the overall process control strategy for monitoring and controlling the functions associated with the Phase 1B high-level waste feed delivery. This document provides the basis for process monitoring and control functions and requirements needed throughput the double-shell tank system during Phase 1 high-level waste feed delivery. This document is intended to be used by (1) the developers of the future Process Control Plan and (2) the developers of the monitoring and control system.




Prognostic value of soluble MICA levels in the serum of patients with advanced hepatocellular carcinoma.  


Serum levels of soluble MHC class I-related chain A (sMICA) are related with the prognosis of various types of cancer; however, few studies on the prognostic value of sMICA in hepatocellular carcinoma (HCC) have been reported. In this study, we retrospectively investigated the relationship between sMICA levels and clinical features of advanced HCC, and we assessed the prognostic value of sMICA in advanced HCC. Furthermore, the relationship of serum sMICA levels and natural killer group 2, member D (NKG2D) expression on natural killer (NK) cells was also evaluated. We detected sMICA levels in the serum of 60 advanced HCC patients using enzyme-linked immunosorbent assay (ELISA) and measured expression levels of NKG2D on NK cells using flow cytometry. We found that serum sMICA levels in HCC patients were in the range of 0.10-6.21 ng/mL. Chi-square analyses showed that sMICA level was significantly related with only tumor size. Survival analysis showed that a high sMICA level was significantly related with poor prognosis among HCC patients. Multivariate analyses indicated that sMICA was an independent prognostic factor. In addition, the levels of CD56+NKG2D+ NK cells were within the range of 11.2%-55.4%, and correlation analyses indicated that sMICA level was negatively correlated with the level of NKG2D+ NK cells. Our results suggest that serum sMICA levels may be an independent prognostic factor for advanced HCC. PMID:22704489

Li, Jian-Jun; Pan, Ke; Gu, Mo-Fa; Chen, Min-Shan; Zhao, Jing-Jing; Wang, Hui; Liang, Xiao-Ting; Sun, Jian-Cong; Xia, Jian-Chuan



Low-Level Information and High-Level Perception: The Case of Speech in Noise  

PubMed Central

Auditory information is processed in a fine-to-crude hierarchical scheme, from low-level acoustic information to high-level abstract representations, such as phonological labels. We now ask whether fine acoustic information, which is not retained at high levels, can still be used to extract speech from noise. Previous theories suggested either full availability of low-level information or availability that is limited by task difficulty. We propose a third alternative, based on the Reverse Hierarchy Theory (RHT), originally derived to describe the relations between the processing hierarchy and visual perception. RHT asserts that only the higher levels of the hierarchy are immediately available for perception. Direct access to low-level information requires specific conditions, and can be achieved only at the cost of concurrent comprehension. We tested the predictions of these three views in a series of experiments in which we measured the benefits from utilizing low-level binaural information for speech perception, and compared it to that predicted from a model of the early auditory system. Only auditory RHT could account for the full pattern of the results, suggesting that similar defaults and tradeoffs underlie the relations between hierarchical processing and perception in the visual and auditory modalities.

Nahum, Mor; Nelken, Israel; Ahissar, Merav



Serum levels of selected chemokines in systemic lupus erythematosus patients.  


Chemokines promote leukocyte traffic into the site of inflammation. Serum levels of monocyte chemotactic protein 1 (MCP-1), stromal cell-derived factor-1 (SDF-1), interferon-gamma-inducible protein 10 (IP-10), and interleukin-8 (IL-8) were evaluated in 48 treated women with systemic lupus erythematosus (SLE) and mild-to-moderate disease severity. The results were compared between the whole SLE group and the control (29 women). The relationships between chemokines, their concentrations, and peripheral blood leukocyte count and between the chemokines and individual leukocyte populations (polymorphonuclear leukocytes-PMNs, lymphocytes-Ls, monocytes-Ms, eosinophils) counts were determined. The relationships between the analyzed chemokines were also determined in the control. SLE subjects had significantly higher MCP-1, SDF-1, IP-10, and lower IL-8 concentrations compared to the control. Moderate, positive correlations between MCP-1/SDF-1, SDF-1/IP-10 and a negative correlation between MCP-1/IL8 were observed in the patient group. Moderate, negative correlations were found between SDF-1/total leukocyte count, SDF-1/absolute number of PMNs as well as between IP-10/total leukocyte count, IP-10/absolute PMNs, Ls, and Ms counts in peripheral blood of SLE group. We suggest that the obtained results and correlations observed between the examined parameters might be used to monitor SLE course and progression. However, further randomized clinical studies should be carried out on in untreated and treated patients with SLE. PMID:22461186

Hrycek, Eugeniusz; Franek, Andrzej; B?aszczak, Edward; Dworak, Justyna; Hrycek, Antoni



Plasma levels of brain natriuretic peptides and cardiac troponin in hemodialysis patients.  


Patients with End-Stage Renal Disease (ESRD) are at high risk of death as a result of the cardiovascular disease (CVD), which cannot be explained by the conventional risk factors only. Haemodialysis patients frequently have elevated serum concentrations of the cardiac troponins T, specific markers of myocardial injury. Plasma levels of brain natriuretic peptide (BNP) are elevated in fluid volume overload and heart failure, and decreased during dialysis. Currently, LV hypertrophy and LV dysfunction are considered the strongest predictors of cardiovascular mortality in dialysis population, and the synthesis of cardiac natriuretic peptides is high in the presence of alterations in the left ventricular (LV) mass and function. The aim of this study was to investigate the factors associated with the increased serum levels of BNP and CTN in haemodialysis patients, and their impact on cardiovascular morbidity. In this cross-sectional study we included 30 patients with ESRD, without coronary symptoms, who were subjected to regular dialysis treatment three times a week for the duration of four hours. Heart failure was defined as an ejection fraction (EF) of < 35%, and dyspnoea associated with either elevated jugular pressure or interstitial oedema evidenced in chest X-ray. All patients were in sinus rhythm at the time of the study. Twenty-five patients were on erythropoietin treatment. Blood samples were taken before and after the dialysis session. Our study included 30 patients (17 males, 13 females). The average age was 53,8 years (total range 31-74) divided into two groups: euvolemic and hypervolemic. The average dialysis time was 70,3+/-46,95 months. All haemodialysis patients had excessively high levels of BNP 2196,66+/-4553,86 ng/cm3. Plasma cTnT was found to be increased in 33,3% of patients. Patients with hypervolemia had significantly higher cTnT levels (0,0577+/-0,0436), as compared to the euvolemic patients 0,0184+/-0,0259 p<0,05. The elevated cTnT significantly correlated with the level of BNP (p<0,01), while average post-dialysis BNP was not significantly lower (1698,06+/-3499,15; R=0,191; p-ns.) as compared to the pre-dialysis BNP (1839,13+/-3691,55; R=432; p<0,01). The pre-dialysis cTnT was lower (0,0315+/-0,0372) as compared to the post-dialysis cTnT (average 0,0399). Euvolemic patients had BMI 24,28+/-3,15, as compared to the hypervolemic patients BMI 25,71+/-4,20 (p-n.s.). Increased BNP was not in correlation with older age (R-0,271 p-ns.) and duration of dialysis (R-0,198). The hematocrit level increases significantly during haemodialysis (39,9%; p<0,05). Patients with higher BNP and cTnT have significantly higher indexed left ventricular mass, as compared to the patients with normal ventricular function. Our study shows that 33,3% of asymptomatic patients on haemodialysis have elevated cTnT while all patients have elevated BNP. Measuring the plasma concentration of brain natriuretic hormones may be useful for identification of the dialysis patients with LVH. PMID:19485946

Resi?, Halima; Ajanovi?, Selma; Kukavica, Nihad; Masni?, Fahrudin; Cori?, Aida



A high blood level in the air trap reduces microemboli during hemodialysis.  


Previous studies have demonstrated the presence of air microemboli in the dialysis circuit and in the venous circulation of the patients during hemodialysis. In vitro studies indicate that a high blood level in the venous air trap reduces the extent of microbubble formation. The purpose of this study was to examine whether air microbubbles can be detected in the patient's access and if so, whether the degree of microbubble formation can be altered by changing the blood level in the venous air trap. This was a randomized, double-blinded, interventional study of 20 chronic hemodialysis patients. The patients were assigned to hemodialysis with either an elevated or a low blood level in the air trap. The investigator and the patient were blinded to the settings. The numbers of microbubbles were measured at the site of the arteriovenous (AV) access for 2?min with the aid of an ultrasonic Doppler device. The blood level in the air trap was then altered to the opposite setting and a new measurement was carried out after an equilibration period of 30?min. Median (range) for the number of microbubbles measured with the high air trap level and the low air trap level in AV access was 2.5 (0-80) compared with 17.5 (0-77), respectively (P?=?0.044). The degree of microbubble formation in hemodialysis patients with AV access was reduced significantly if the blood level in the air trap was kept high. The exposure of potentially harmful air microbubbles was thereby significantly reduced. This measure can be performed with no additional healthcare cost. PMID:22360799

Forsberg, Ulf; Jonsson, Per; Stegmayr, Christofer; Stegmayr, Bernd



Quality of life in patients suffering from seborrheic dermatitis: influence of age, gender and education level.  


Seborrheic dermatitis is a common inflammatory skin condition occurring mostly on the face, scalp and chest. Despite its high frequency, the impact of seborrheic dermatitis on patients' quality of life (QoL) has not been studied well so far. The objectives of this study were to analyse how seborrheic dermatitis affects the patients' QoL and which socio-economic factors could modulate QoL in these patients. A total of 3000 patients with seborrheic dermatitis and/or dandruff were enrolled into the study. All participants were divided into subgroups according to gender, age and education level. A specially designed questionnaire with demographic and clinical details of patients as well as Dermatology Life Quality Index (DLQI) was completed during a patient visit in an outpatient clinic. Data were collected by local dermatologists who were instructed regarding the inclusion and exclusion criteria and the questionnaires were sent back to us upon completion. The mean DLQI score for all patients was 6.92±5.34 points. Patients with dandruff had significantly better QoL than subjects with seborrheic dermatitis (5.34±4.67 points vs. 7.73±5.3 points, respectively; P<0.001) or individuals with dandruff plus seborrheic dermatitis (7.54±5.6 points, P<0.001). In addition, women, younger patients and subjects with higher educational level were more affected than the rest of the patients. Seborrheic dermatitis had significant, negative influence on patients' QoL. Observed discrepancies between subgroups could be explained by different roles played by different patient subgroups in the society. DLQI can be successfully used for the assessment of QoL in large populational studies. PMID:18793259

Szepietowski, Jacek C; Reich, Adam; Weso?owska-Szepietowska, Ewa; Baran, Eugeniusz



High levels of fluctuating asymmetry in isolated stickleback populations  

PubMed Central

Background Fluctuating asymmetry (FA), defined as small random deviations from the ideal bilateral symmetry, has been hypothesized to increase in response to both genetic and environmental stress experienced by a population. We compared levels of FA in 12 bilateral meristic traits (viz. lateral-line system neuromasts and lateral plates), and heterozygosity in 23 microsatellite loci, among four marine (high piscine predation risk) and four pond (zero piscine predation risk) populations of nine-spined sticklebacks (Pungitius pungitius). Results Pond sticklebacks had on average three times higher levels of FA than marine fish and this difference was highly significant. Heterozygosity in microsatellite markers was on average two times lower in pond (HE ? 0.3) than in marine (HE ? 0.6) populations, and levels of FA and heterozygosity were negatively correlated across populations. However, after controlling for habitat effect on heterozygosity, levels of FA and heterozygosity were uncorrelated. Conclusions The fact that levels of FA in traits likely to be important in the context of predator evasion were elevated in ponds compared to marine populations suggests that relaxed selection for homeostasis in ponds lacking predatory fish may be responsible for the observed habitat difference in levels of FA. This inference also aligns with the observation that the levels of genetic variability across the populations did not explain population differences in levels of FA after correcting for habitat effect. Hence, while differences in strength of selection, rather than in the degree of genetic stress could be argued to explain habitat differences in levels of FA, the hypothesis that increased FA in ponds is caused by genetic stress cannot be rejected.



A Preview of High School Level Economic Software.  

ERIC Educational Resources Information Center

|The purpose of this study was to locate and evaluate high-school-level economic software compatible with an Apple II or IIe computer. To identify software, computer searches were run, bibliographies were scanned, and reviews were collected. Only software that was recommended by some outside source was included in the evaluation. The following…

Kincade, Jeannine H.


Level 1 Tornado PRA for the High Flux Beam Reactor  

Microsoft Academic Search

This report describes a risk analysis primarily directed at providing an estimate for the frequency of tornado induced damage to the core of the High Flux Beam Reactor (HFBR), and thus it constitutes a Level 1 Probabilistic Risk Assessment (PRA) covering tornado induced accident sequences. The basic methodology of the risk analysis was to develop a ``tornado specific`` plant logic

G. E. Bozoki; C. S. Conrad



Student Achievement Levels Climb at Ribault Senior High School.  

ERIC Educational Resources Information Center

Ribault (Florida) Senior High School has reported a dramatic increase in student achievement levels since implementing a comprehensive college preparation curriculum. Among the program changes that contributed to those gains are: (1) the establishment and consistent enforcement of a strong discipline program, including rules for student conduct, a…

Profiles, Programs & Products, 1983



High level radioactive waste management facility design criteria  

Microsoft Academic Search

This paper discusses the engineering systems for the structural design of the Defense Waste Processing Facility (DWPF) at the Savannah River Site (SRS). At the DWPF, high level radioactive liquids will be mixed with glass particles and heated in a melter. This molten glass will then be poured into stainless steel canisters where it will harden. This process will transform

N. A. Sheikh; S. R. Salaymeh



High-level manpower movement and Japan's foreign aid.  


"Japan's technical assistance programs to Asian countries are summarized. Movements of high-level manpower accompanying direct foreign investments by private enterprise are also reviewed. Proposals for increased human resources development include education and training of foreigners in Japan as well as the training of Japanese aid experts and the development of networks for information exchange." PMID:12285771

Furuya, K



The Estuary Guide. Level 3: High School. Draft.  

ERIC Educational Resources Information Center

Estuaries are marine systems that serve as nurseries for animals, links in the migratory pathways, and habitat for a complex community of organisms. This curriculum guide intended for use at the high school level seeks to teach what estuaries are; provide opportunities to practice decision-making that affects estuaries; and encourage students to…

Alexander, Glen; And Others


Examination of High Quality Enlistees on a Recruiting District Level.  

National Technical Information Service (NTIS)

In this thesis two distinct analytical techniques were used to develop models to forecast the number of high quality nonprior service males enlisting monthly in the U.S. Navy on a recruiting district level. The Box-Jenkins methodology was applied to a mon...

R. E. Irlam



A comparison of high-level waste form characteristics  

Microsoft Academic Search

There are currently about 1055 million curies of high-level waste with a thermal output of about 2950 kilowatts (KW) at four sites in the United States: West Valley Demonstration Project (WVDP), Savannah River Site (SRS), Hanford Site (HANF), and Idaho National Engineering Laboratory (INEL). These quantities are expected to increase to about 1200 million curies and 3570 kw by the

R. Salmon; K. J. Notz




EPA Science Inventory

Flammable gases can be generated in DOE high-level waste tanks, including radiolytic hydrogen, and during cesium precipitation from salt solutions, benzene. Under normal operating conditions the potential for deflagration or detonation from these gases is precluded by purging and...


Hierarchical Test Pattern Generation Based on High-Level Primitives  

Microsoft Academic Search

It is demonstrated that the exploitation of high-level primitives (HLPs) and, in particular, of the knowledge concerning their function in ATPG (automatic test pattern generation) leads to significant improvements in implication, unique sensitization, and multiple backtrace. Motivated by this observation and the necessity of covering all faults inside HLPs, the authors present the extension of the ATPG system SOCRATES to

Thomas M. Sarfert; Remo G. Markgraf; Erwin Trischler; Michael H. Schulz



High level radioactive waste: Doing something about it  

Microsoft Academic Search

In addition to a growing inventory of spent power reactor fuel, there are approximately 100 million gallons of high-level radioactive waste (HLW) containing more than one billion curies of radioactivity stored in the United States today. This waste has been generated mainly from the production of plutonium and tritium and is primarily located on three federal sites. The waste is

G. G. Wicks; D. F. Bickford



High Level Exploration of Quantum-Dot Cellular Automata (QCA)  

Microsoft Academic Search

In this work, we present a high level evaluation of an emerging nanotechnology to determine a set of technology requirements. The technology under question is Quantum-Dot Cellular Automata (QCA). As a vehicle, we present two different QCA circuits and evaluate the technology requirements based on the specifications of these circuits. These circuits are a simple 4-bit arithmetic logic unit (ALU)

K. Walus; G. Schulhof; G. A. Jullien



Humanoid Robot Painter: Visual Perception and High-Level Planning  

Microsoft Academic Search

This paper presents visual perception discovered in high-level manipulator planning for a robot to reproduce the procedure involved in human painting. First, we apply a technique of 2D object segmentation that considers region similarity as an objective function and edge as a constraint with artificial intelligent used as a criterion function. The system can segment images more effectively than most

Miti Ruchanurucks; Shunsuke Kudoh; Koichi Ogawara; Takaaki Shiratori; Katsushi Ikeuchi



Teaching for Higher Cognitive Level Learning in High School Science.  

ERIC Educational Resources Information Center

|Designed to focus on teaching for higher-level cognitive learning, this study measured student perceptions of psychosocial aspects of their classroom learning and involved a team of six researchers. The study consisted of an intensive 10-week investigation of two above-average science teachers in a suburban high school in Perth, Western…

Fraser, Barry J.


Life Extension of Aging High Level Waste (HLW) Tanks  

Microsoft Academic Search

The Double Shell Tanks (DSTs) play a critical role in the Hanford High-Level Waste Treatment Complex, and therefore activities are underway to protect and better understand these tanks. The DST Life Extension Program is focused on both tank life extension and on evaluation of tank integrity. Tank life extension activities focus on understanding tank failure modes and have produced key

D. Bryson; V. Callahan; M. Ostrom; W. Bryan; H. Berman



High Level Waste Lag Storage and Feed Blending  

Microsoft Academic Search

SRTC performed small-scale tests to determine the behavior associated with blending streams in the High-level Waste (HLW) Lag Storage and Feed Blending Process System for the Hanford Waste Treatment and Immobilization Plant (WTP). The work reported here was planned and designed in response to the test specification. The Office of River Protection Hanford Waste Treatment and Immobilization Plant consists of



Hanford high-level waste melter system evaluation data packages  

Microsoft Academic Search

The Tank Waste Remediation System is selecting a reference melter system for the Hanford High-Level Waste vitrification plant. A melter evaluation was conducted in FY 1994 to narrow down the long list of potential melter technologies to a few for testing. A formal evaluation was performed by a Melter Selection Working Group (MSWG), which met in June and August 1994.

M. L. Elliott; P. J. Shafer; D. A. Lamar; R. A. Merrill; W. Grunewald; G. Roth; W. Tobie



Risk assessment methodology for Hanford high-level waste tanks  

Microsoft Academic Search

A methodology is presented for applying Probabilistic Safety Assessment techniques to quantification of the health risks posed by the high-level waste (HLW) underground tanks at the Department of Energy's Hanford reservation. This methodology includes hazard screening development of a list of potential accident initiators, systems fault trees development and quantification, definition of source terms for various release categories, and estimation

T. F. Bott; D. R. Mac Farlane; D. W. Stack; J. Kindinger



Risk assessment methodology for Hanford high-level waste tanks  

Microsoft Academic Search

A methodology is presented for applying Probabilistic Safety Assessment techniques to quantification of the health risks posed by the high-level waste (HLW) underground tanks at the Department of Energy`s Hanford reservation. This methodology includes hazard screening development of a list of potential accident initiators, systems fault trees development and quantification, definition of source terms for various release categories, and estimation

T. F. Bott; D. R. Mac Farlane; D. W. Stack; J. Kindinger



HADES-high-level architecture development and exploration system  

Microsoft Academic Search

The authors propose a new approach to high level behavioural synthesis starting from an algorithmic description in Hardware C. The algorithm is compiled into a corresponding data\\/control flow graph including several optimizations. The behavioural synthesis part of the system performs transformations like loop unrolling, parallelization, etc., whereby the user is supported through a feedback loop. For final structural synthesis an

P. Poechmueller; M. Held; N. Wehn; M. Glesner



HLW (high-level waste) site characterization plan in Switzerland  

Microsoft Academic Search

The Swiss concept for high-level waste (HLW) disposal is based on the following important premises: (a) Spent fuel from a relatively small nuclear power program is reprocessed in facilities abroad; (b) the vitrified waste will be returned to Switzerland where an intermediate storage period of â40 yr allows adequate decay of radiation and heat production; potential sites are being selected

M. Thury; C. McCombie



High-Level Radioactive Waste Fixation in Sintered Vitreous Matrix.  

National Technical Information Service (NTIS)

The safe storage of high-level wastes from fuel elements reprocessing includes, as a first step, the fixation of the same in materials having a good resistance to the leaching in aqueous medium, such as borosilicate glass. As an alternative to the usual m...

D. O. Russo N. Messi de Bernasconi M. A. Audero



Space Augmentation of Military High-Level Waste Disposal.  

National Technical Information Service (NTIS)

Space disposal of selected components of military high-level waste (HLW) is considered. This disposal option offers the promise of eliminating the long-lived radionuclides in military HLW from the earth. A space mission which meets the dual requirements o...

E. Divita L. Lees T. English



High-level nuclear waste management: analysis of options  

Microsoft Academic Search

A new approach is introduced for evaluating strategies for the safe disposal of high-level nuclear waste. Five strategies are considered, and by means of the effective method of 'analytic hierarchy process' these strategies are prioritized with respect to a set of tangible and intangible criteria. The results are compared with criteria adopted by the United States Department of Energy. The

T L Saaty; H Gholamnezhad



Some high level language constructs for data of type relation  

Microsoft Academic Search

For the extension of high level languages by data types of mode relation, three language constructs are proposed and discussed: a repetition statement controlled by relations, predicates as a generalization of Boolean expressions, and a constructor for relations using predicates. The language constructs are developed step by step starting with a set of elementary operations on relations. They are designed

Joachim W. Schmidt; Universitiit Hamburg



Teaching for Higher Cognitive Level Learning in High School Science.  

ERIC Educational Resources Information Center

Designed to focus on teaching for higher-level cognitive learning, this study measured student perceptions of psychosocial aspects of their classroom learning and involved a team of six researchers. The study consisted of an intensive 10-week investigation of two above-average science teachers in a suburban high school in Perth, Western Australia.…

Fraser, Barry J.


Time management in the DoD high level architecture  

Microsoft Academic Search

Recently, a considerable amount of effort in the U.S. Department of Defense has been devoted to defining the High Level Architecture (HLA) for distributed simulations. This paper describes the time management component of the HLA that defines the means by which individual simulations (called federates) advance through time. Time management includes synchronization mechanisms to ensure event ordering when this is

Richard M. Fujimoto; Richard M. Weatherly




Microsoft Academic Search

This paper addresses the issues of simulation interoperability within the emergency management training context. A prototype implementation in Java of a subset of the High Level Architecture (HLA) is described. The use of Web Browsers to provide graphical user interfaces to HLA is also investigated.

Roderick J. Williams



A comparison of high-level waste form characteristics  

SciTech Connect

There are currently about 1055 million curies of high-level waste with a thermal output of about 2950 kilowatts (KW) at four sites in the United States: West Valley Demonstration Project (WVDP), Savannah River Site (SRS), Hanford Site (HANF), and Idaho National Engineering Laboratory (INEL). These quantities are expected to increase to about 1200 million curies and 3570 kw by the end of year 2020. Under the Nuclear Waste Policy Act, this high-level waste must ultimately be disposed of in a geologic repository. Accordingly, canisters of high-level waste immobilized in borosilicate glass or glass-ceramic mixtures are to be produced at the four sites and stored there until a repository becomes available. Data on the estimated production schedules and on the physical, chemical, and radiological characteristics of the canisters of immobilized high-level waste have been collected in OCRWM's Waste Characteristics Data Base, including recent updates an revisions. Comparisons of some of these data for the four sites are presented in this report. 14 refs., 3 tabs.

Salmon, R.; Notz, K.J.



Geology of high-level nuclear waste disposal  

Microsoft Academic Search

The concept of geological disposal is set out by describing the major rock types in terms of their ability to isolate high-level nuclear waste. The advantages and problems posed by particular rock formations are explored and the design and construction of geological repositories is considered, along with the methods used to estimate their safety. It gives special consideration to the




Analytical macromodeling for high-level power estimation  

Microsoft Academic Search

This paper present a new macromodeling technique for high-level power estimation. Our technique is based on a parameterizable analytical model that relies exclusively on statistical information of the circuit's primary inputs. During estimation, the statistics of the required metrics are extracted from the input stream, and a power estimate is obtained by evaluating a model function that has been characterized

Guiseppe Bernacchia; Marios C. Papaefthymiou



Analytical Macro-Modeling for High-Level Power Estimation  

Microsoft Academic Search

1 Abstract In this paper, we present a new analytical macro-modeling technique for high-level power estimation. Our technique is based on a parameterizable analytical model that relies exclusively on statistical information of the circuit' s pri- mary inputs. During estimation, the statistics of the re- quired metrics are extracted from the input stream and a power estimate is obtained by

Giuseppe Bernacchia; Marios C. Papaefthymiou



SciTech Connect

XAL is a Java programming framework for building high-level control applications related to accelerator physics. The structure, details of implementation, and interaction between components, auxiliary XAL packages, and the latest modifications are discussed. A general overview of XAL applications created for the SNS project is presented.

Shishlo, Andrei P [ORNL; Allen, Christopher K [ORNL; Chu, Paul [Stanford University; Galambos, John D [ORNL; Pelaia II, Tom [ORNL



The Estuary Guide. Level 3: High School. Draft.  

ERIC Educational Resources Information Center

|Estuaries are marine systems that serve as nurseries for animals, links in the migratory pathways, and habitat for a complex community of organisms. This curriculum guide intended for use at the high school level seeks to teach what estuaries are; provide opportunities to practice decision-making that affects estuaries; and encourage students to…

Alexander, Glen; And Others


Interpreting a Dynamic and Uncertain World: High-Level Vision  

Microsoft Academic Search

When interpreting a dynamic and uncertain world it is important to have a high-level vision component that can guide the reasoning of the whole vision system. This guidance is provided by an attentional mechanism that exploits knowledge of the specific problem being solved. Here we survey work relevant to the development of such an attentional mechanism, using surveillance as an

Richard J. Howarth



Teaching UML Modeling Before Programming at the High School Level  

Microsoft Academic Search

This paper describes experience teaching modeling at the high school level prior to teaching programming and embedded control. An implementation- independent form of UML modeling is being used to teach students to analyze various applications, systems and problem domains. The objective is to introduce the abstract thinking processes involved in modeling before introducing the more concrete thought processes involved in

Cortland Starrett



Assigning Blame: Mapping Performance to High Level Parallel Programming Abstractions  

NASA Astrophysics Data System (ADS)

Parallel programs are increasingly being written using programming frameworks and other environments that allow parallel constructs to be programmed with greater ease. The data structures used allow the modeling of complex mathematical structures like linear systems and partial differential equations using high-level programming abstractions. While this allows programmers to model complex systems in a more intuitive way, it also makes the debugging and profiling of these systems more difficult due to the complexity of mapping these high level abstractions down to the low level parallel programming constructs. This work discusses mapping mechanisms, called variable blame, for creating these mappings and using them to assist in the profiling and debugging of programs created using advanced parallel programming techniques. We also include an example of a prototype implementation of the system profiling three programs.

Rutar, Nick; Hollingsworth, Jeffrey K.


Decreased serum chemerin levels in male Japanese patients with type 2 diabetes: sex dimorphism.  


Chemerin, a recently discovered adipocytokine plays an important role in obesity and obesity-associated metabolic complications. However, the role of chemerin in the pathogenesis of type 2 diabetes mellitus (T2DM) has not fully been elucidated. We compared the serum chemerin levels and metabolic parameters between 88 control subjects, 86 patients with metabolic syndrome (MS), and 147 patients with T2DM in a Japanese population and further analyzed their correlation. Enzyme-linked immunosorbent assay was used to measure the serum chemerin levels. The chemerin levels were significantly higher in male than in female control subjects (p < 0.005), with significant decreases in patients with T2DM compared with those with MS and control subjects (164.9 ± 6.3 ng/mL vs. 209.8 ± 7.7 and 218.7 ± 7.3 ng/mL; p < 0.0001 vs. p < 0.0001, respectively) but no significant differences in female subjects. The multiple regression analysis revealed that the chemerin levels negatively correlated with the fasting glucose and HbA1c levels in total and male subjects. In the patients with T2DM, the chemerin levels negatively correlated with fasting glucose and high-density lipoprotein cholesterol but positively correlated with body mass index (BMI), and total cholesterol and triglyceride levels. The negative correlation between the chemerin and fasting glucose levels remained significant after adjustment for age, sex, and BMI in the total and male subjects and those with T2DM. These results suggest the role of chemerin in sex dimorphism and a potential link between chemerin levels and T2DM pathogenesis in a Japanese population. PMID:22986456

Takahashi, Michiko; Inomata, Sumie; Okimura, Yasuhiko; Iguchi, Genzo; Fukuoka, Hidenori; Miyake, Kazuaki; Koga, Daisuke; Akamatsu, Suguru; Kasuga, Masato; Takahashi, Yutaka



Low neutral endopeptidase levels in bronchoalveolar lavage fluid of lung cancer patients.  


Neutral endopeptidase (NEP) is a cell surface enzyme found in normal human lung and which hydrolyzes small bioactive peptides, some of which act as growth factors for normal and malignant airway epithelial cells. Expression of NEP varies widely in human lung tissue from different individuals. NEP is often expressed at low or undetectable levels in both small-cell and non-small-cell lung cancer, and inhibits the growth of lung cancer cell lines. Variation in the expression of NEP could be a factor in susceptibility to lung cancer. We hypothesized that NEP could be measured in bronchoalveolar lavage fluid (BALF) and that airway levels of NEP would be low in lung cancer patients as compared with normal controls. We measured NEP and total protein in cell-free BALF supernatant, and expressed the respective concentrations as a ratio. NEP levels showed wide variation in BALF of healthy volunteers. Most patients with lung cancer had no NEP detectable in BALF. The mean NEP/total protein ratio was significantly lower in patients with lung cancer (0.87 +/- 0.7 ng NEP/mg protein) than in normal healthy subjects (14.0 +/- 4.3, p < 0.0003). We conclude that NEP levels are highly variable in BALF of normal volunteers, and are low or undetectable in most BALF specimens from patients with lung cancer. Low NEP levels in the airways may be a factor in the pathogenesis of carcinoma of the lung. PMID:10051271

Cohen, A J; Franklin, W A; Magill, C; Sorenson, J; Miller, Y E



Repeated Assessment by High-Throughput Assay Demonstrates that Sperm DNA Methylation Levels Are Highly Reproducible  

PubMed Central

Objective To assess reliability of high-throughput assay of sperm DNA methylation. Design Observational study comparing DNA methylation of sperm isolated from three divided and twelve longitudinally collected semen samples. Setting Academic Medical Center Patients One man undergoing screening semen analysis during evaluation of the infertile couple and two healthy fertile male volunteers. Interventions Spermatozoa were separated from seminal plasma and somatic cells using gradient separation. DNA was extracted from spermatozoa, and DNA methylation was assessed at 1,505 DNA-sequence specific sites. Main Outcome Measures Repeatability of sperm DNA methylation measures, estimated by correlation coefficients. Results DNA methylation levels were highly correlated within matched sets of divided samples (all r?0.97) and longitudinal samples (average r=0.97). Conclusions The described methodology reliably assesses methylation of sperm DNA at large numbers of sites. Methylation profiles were consistent over time. High-throughput assessment of sperm DNA methylation is a promising tool for studying the role of epigenetic state in male fertility.

Cortessis, Victoria K.; Siegmund, Kimberly; Houshdaran, Sahar; Laird, Peter W.; Sokol, Rebecca Z.



Contribution of Interfacility Patient Movement to Overall Methicillin-Resistant Staphylococcus aureus Prevalence Levels  

PubMed Central

Objectives The effect of patient movement between hospitals and long-term care facilities (LTCFs) on methicillin-resistant Staphylococcus aureus (MRSA) prevalence levels is unknown. We investigated these effects to identify scenarios that may lead to increased prevalence in either facility type. Methods We used a hybrid simulation model to simulate MRSA transmission among hospitals and LTCFs. Transmission within each facility was determined by mathematical model equations. The model predicted the long-term prevalence of each facility and was used to assess the effects of facility size, patient turnover, and decolonization. Results Analyses of various healthcare networks suggest that the effect of patients moving from a LTCF to a hospital is negligible unless the patients are consistently admitted to the same unit. In such cases, MRSA prevalence can increase significantly regardless of the endemic level. Hospitals can cause sustained increases in prevalence when transferring patients to LTCFs, where the population size is smaller and patient turnover is less frequent. For 1 particular scenario, the steady-state prevalence of a LTCF increased from 6.9% to 9.4% to 13.8% when the transmission rate of the hospital increased from a low to a high transmission rate. Conclusions These results suggest that the relative facility size and the patient discharge rate are 2 key factors that can lead to sustained increases in MRSA prevalence. Consequently, small facilities or those with low turnover rates are especially susceptible to sustaining increased prevalence levels, and they become more so when receiving patients from larger, high-prevalence facilities. Decolonization is an infection-control strategy that can mitigate these effects.

Barnes, Sean L.; Harris, Anthony D.; Golden, Bruce L.; Wasil, Edward A.; Furuno, Jon P.



High-Level Waste Vitrification Facility Feasibility Study  

SciTech Connect

A ''Settlement Agreement'' between the Department of Energy and the State of Idaho mandates that all radioactive high-level waste now stored at the Idaho Nuclear Technology and Engineering Center will be treated so that it is ready to be moved out of Idaho for disposal by a compliance date of 2035. This report investigates vitrification treatment of the high-level waste in a High-Level Waste Vitrification Facility based on the assumption that no more New Waste Calcining Facility campaigns will be conducted after June 2000. Under this option, the sodium-bearing waste remaining in the Idaho Nuclear Technology and Engineering Center Tank Farm, and newly generated liquid waste produced between now and the start of 2013, will be processed using a different option, such as a Cesium Ion Exchange Facility. The cesium-saturated waste from this other option will be sent to the Calcine Solids Storage Facilities to be mixed with existing calcine. The calcine and cesium-saturated waste will be processed in the High-Level Waste Vitrification Facility by the end of calendar year 2035. In addition, the High-Level Waste Vitrification Facility will process all newly-generated liquid waste produced between 2013 and the end of 2035. Vitrification of this waste is an acceptable treatment method for complying with the Settlement Agreement. This method involves vitrifying the waste and pouring it into stainless-steel canisters that will be ready for shipment out of Idaho to a disposal facility by 2035. These canisters will be stored at the Idaho National Engineering and Environmental Laboratory until they are sent to a national geologic repository. The operating period for vitrification treatment will be from the end of 2015 through 2035.

D. A. Lopez



SMN transcript levels in leukocytes of SMA patients determined by absolute real-time PCR  

PubMed Central

Spinal muscular atrophy (SMA) is an autosomal recessive neuromuscular disorder caused by homozygous mutations of the SMN1 gene. Three forms of SMA are recognized (type I–III) on the basis of clinical severity. All patients have at least one or more (usually 2–4) copies of a highly homologous gene (SMN2), which produces insufficient levels of functional SMN protein, because of alternative splicing of exon 7. Recently, evidence has been provided that SMN2 expression can be enhanced by pharmacological treatment. However, no reliable biomarkers are available to test the molecular efficacy of the treatments. At present, the only potential biomarker is the dosage of SMN products in peripheral blood. However, the demonstration that SMN full-length (SMN-fl) transcript levels are reduced in leukocytes of patients compared with controls remains elusive (except for type I). We have developed a novel assay based on absolute real-time PCR, which allows the quantification of SMN1-fl/SMN2-fl transcripts. For the first time, we have shown that SMN-fl levels are reduced in leukocytes of type II–III patients compared with controls. We also found that transcript levels are related to clinical severity as in type III patients SMN2-fl levels are significantly higher compared with type II and directly correlated with functional ability in type II patients and with age of onset in type III patients. Moreover, in haploidentical siblings with discordant phenotype, the less severely affected individuals showed significantly higher transcript levels. Our study shows that SMN2-fl dosage in leukocytes can be considered a reliable biomarker and can provide the rationale for SMN dosage in clinical trials.

Tiziano, Francesco Danilo; Pinto, Anna Maria; Fiori, Stefania; Lomastro, Rosa; Messina, Sonia; Bruno, Claudio; Pini, Antonella; Pane, Marika; D'Amico, Adele; Ghezzo, Alessandro; Bertini, Enrico; Mercuri, Eugenio; Neri, Giovanni; Brahe, Christina



Process induced deep-level defects in high purity silicon  

NASA Astrophysics Data System (ADS)

Deep-level defects appear in silicon upon heat treatment of wafers with surface disordered by mechanical lapping or introducing high concentration impurity in diffusion layer, i.e. in regimes typical of fabrication of high voltage devices. By means of capacitance transient spectroscopy, combined with other methods, it was shown that dominant electron traps with ionization energies of 0.28 and 0.54 eV of double level donor have low recombination activity, but affect the resistivity of high purity Si and play a key role in limiting the p-n junction breakdown voltage 0268-1242/13/5/008/img1. A careful study of the defect parameters showed their similarity to sulphur-related centres in Si.

Astrova, E. V.; Voronkov, V. B.; Kozlov, V. A.; Lebedev, A. A.



Serum ?-glutamyl Transferase Levels, Insulin Resistance and Liver Fibrosis in Patients with Chronic Liver Diseases  

PubMed Central

Background and Aims Serum levels of ?-glutamyl-transpeptidase(?-GT) were associated with liver disease severity and metabolic alterations, which in turn are able to affect hepatic damage. In patients with nonalcoholic fatty liver disease (NAFLD), genotype 1 chronic hepatitis C (G1CHC) and chronic hepatitis B (CHB), we assessed the link between liver fibrosis and ?-GT serum levels, and we evaluated if normal or high ?-GT serum levels affect the association between insulin resistance (IR) and severity of liver fibrosis. Methods 843 consecutive patients with chronic liver disease (CLD)(193 NAFLD, 481 G1CHC, 169 CHB) were evaluated by liver biopsy (Kleiner and Scheuer scores) and clinical and metabolic measurements. IR was diagnosed if HOMA>3. A serum ?-GT concentration of >36 IU/L in females and >61 IU/L in males was considered the threshold value for identifying high levels of ?-GT. Results By multivariate logistic regression analysis, abnormal ?-GT serum levels were independently linked to severe liver fibrosis in patients with NAFLD (OR2.711,CI1.120–6.564,p?=?0.02), G1CHC (OR3.461,CI2.138–5.603,p<0.001) and CHB (OR2.778,CI1.042–7.414,p?=?0.04), together with IR and liver necroinflammation, and with a negative predictive value>80%. Interestingly, among patients with high or normal ?-GT values, even if IR prevalence was significantly higher in patients with severe fibrosis compared to those without, IR remained significantly associated with severe fibrosis in patients with abnormal ?-GT values only (OR4.150,CI1.079–15.970,p?=?0.03 for NAFLD; OR2.250,CI1.211–4.181,p?=?0.01 for G1CHC; OR3.096,CI2.050–34.220,p?=?0.01 for CHB). Conclusions In patients with CLD, IR is independently linked to liver fibrosis only in patients with abnormal ?-GT values, without differences according to liver disease etiology, and suggesting a role of ?-GT as a marker of metabolic-induced liver damage. These data could be useful for the clinical and pharmacologic management of patients with CLD.

Petta, Salvatore; Macaluso, Fabio Salvatore; Barcellona, Maria Rosa; Camma, Calogero; Cabibi, Daniela; Di Marco, Vito; Craxi, Antonio



Relationship of ?-fetoprotein levels and development of hepatocellular carcinoma in hepatitis C patients with liver cirrhosis  

PubMed Central

?-fetoprotein (AFP) is a tumor marker of hepatocellular carcinoma (HCC) and has also been reported to reflect the effectiveness of long-term low-dose interferon (IFN) therapy in hepatitis C virus (HCV)-infected patients with chronic liver disease. The correlation between AFP levels and the incidence of HCC has been discussed over a long period. We investigated whether high levels of AFP at the time of diagnosis were associated with an increased incidence of HCC in patients with HCV. A total of 107 HCV patients with liver cirrhosis without other risks were evaluated for the predictive value of non-invasive risk factors for HCC, including age, gender, alcohol intake, aspartate and alanine aminotransferase levels, bilirubin, albumin, platelet count and AFP levels at study entry, as well as the IFN therapy received. During the follow-up period, HCC developed in 68 (63.6%) patients. Kaplan-Meier estimates were made to assess the cumulative risk of HCC. The 10-year cumulative incidence rate of HCC was 80%. Cox regression analysis was performed on several variables, including age, gender, alcohol consumption, experience of IFN therapy and biochemical parameters. The following factors were identified as exhibiting an increased risk of HCC by univariate analysis: aspartate transaminase (AST) ?71 IU/l, alanine transaminase (ALT) ?60 IU/l, AFP ?6 ng/ml and IFN therapy. Multivariate analysis identified that the AFP level [6–19 ng/ml: hazard ratio (HR), 2.22; P=0.006 and ?20 ng/ml: HR, 2.09; P=0.003] was an independent and significant risk factor for the development of HCC. A slightly elevated (6–19 ng/ml) AFP level may be a risk factor for HCC in certain cases. By contrast, AFP levels <6 ng/ml indicate a low risk of HCC development in HCV patients with liver cirrhosis.




High frequency of lipoprotein risk levels for cardiovascular disease in Takayasu arteritis.  


The objective of this study is to characterize the lipoprotein risk levels in Takayasu arteritis (TA) patients and its possible association with disease activity and glucocorticoid use. Twenty-five female TA patients were consecutively included and compared with 30 age-, gender-, and body mass index-matched healthy controls. Demographic features and the lipid profile were determined and cardiovascular risk levels were evaluated according to NCEP/ATPIII. Total cholesterol (TC), LDL-c, HDL-c, and triglycerides were determined after a 12-h overnight fast. Exclusion criteria were conditions that interfere in the lipid profile. The disease duration was 6.6 +/- 7.4 years; 30% had clinical activity and 80% had laboratory activity. Regarding NCEP/ATPIII risk levels, TA patients presented higher frequency of lipid risk compared to controls: high TC (48% vs. 20%, p = 0.04), low HDL-c (20% vs. 0%, p = 0.015), and high triglycerides (36% vs. 10%, p = 0.026). No difference was observed related to LDL-c risk levels between both groups (40% vs. 20%, p = 0.14). Remarkably, 60% of the patients had at least one lipid risk factor for cardiovascular disease. No difference in the lipids was observed between patients with and without clinical activity; however, those with laboratory activity showed lower levels of HDL-c (1.37 +/- 0.42 vs. 2.00 +/- 0.63 mmol/L, p = 0.012) than patients without this activity. A negative correlation was found between HDL-c and CRP levels (r = -0.42, p = 0.04). Lipids were similar in patients under glucocorticoid compared to those without this therapy. This is the first study to identify that TA, an inflammatory disease, has a proatherogenic lipid profile which is associated to laboratory disease activity. PMID:19283329

de Carvalho, Jozélio Freire; Bonfá, Eloísa; Bezerra, Mailze C; Pereira, Rosa Maria Rodrigues



Patient Dose Reference Levels for Interventional Radiology: A National Approach  

SciTech Connect

A set of patient dose reference levels (RLs) for fluoroscopically guided interventional procedures was obtained in a survey launched by the National Society of Interventional Radiology (IR), involving 10 public hospitals, as recommended by the European Medical Exposures Directive. A sample of 1391 dose values (kerma area product [KAP]) was collected randomly during clinical procedures for seven of the most frequent procedures. Third quartiles of the KAP distributions were used to set the RLs. A regular quality control of the X-ray systems and a calibration of the dose meters were performed during the survey. The fluoroscopy time and total number of digital subtraction angiography images per procedure were also analyzed. The RL values proposed were 12 Gy cm{sup 2} for fistulography (hemodialysis access; sample of 180 cases), 73 Gy cm{sup 2} for lower limb arteriography (685 cases), 89 Gy cm{sup 2} for renal arteriography (55 cases), 80 Gy cm{sup 2} for biliary drainage (205 cases), 289 Gy cm{sup 2} for hepatic chemoembolization (151 cases), 94 Gy cm{sup 2} for iliac stent (70 cases), and 236 Gy cm{sup 2} for uterine embolization (45 cases). The provisional national RL values are lower than those obtained in a similar survey carried out in the United States from 2002 to 2004. These new values could be used to improve the practice of centers consistently working with doses higher than the RLs. This national survey also had a positive impact, as it helped increase the awareness of the members of the National Society of IR on a topic as crucial as patient dose values and programs on radiation protection.

Vano, Eliseo, E-mail:; Sanchez, R.; Fernandez, J. M. [Hospital Clinico San Carlos, Department of Medical Physics (Spain); Gallego, J. J. [Hospital Clinico San Carlos, Department of Radiology (Spain); Verdu, J. F. [Hospital General Universitario de Alicante, Department of Radiology (Spain); Garay, M. Gonzalez de [Hospital de Basurto, Department of Radiology (Spain); Azpiazu, A. [Hospital Txagoritxu, Department of Radiology (Spain); Segarra, A. [Hospital Valle de Hebron, Department of Radiology (Spain); Hernandez, M. T. [Hospital Funacion Alcorcon, Department of Radiology (Spain); Canis, M. [Hospital Reina Sofia, Department of Radiology (Spain); Diaz, F. [Hospital Universitario de Canarias, Department of Radiology (Spain); Moreno, F. [Hospital Juan Ramon Jimenez (Spain); Palmero, J. [Hospital Clinico de Valencia (Spain)



Long-term management of high level wastes. [75 million gal of high level wastes presently stored by ERDA  

Microsoft Academic Search

As of Jan. 1976, some 75 million gal of high-level wastes were reported to be held in storage by ERDA. The options for treatments and long-range storage of radioactive wastes as studied at Hanford, Savannah River, and the Idaho National Engineering Laboratory were discussed. Typical compositions of the radioactive wastes at the three reprocessing sites were tabulated. (DDA)

M. S. Kearney; R. D. Jr. Walton



High-density lipoprotein particles are large in patients with variant angina  

Microsoft Academic Search

Objective: Dyslipidemia in patients with coronary vasospasm may be characterized by low level of high-density lipoprotein . . HDL -cholesterol as well as apolipoprotein apo A-I but not high level of low-density lipoprotein-cholesterol. This study sought to examine the HDL particle size in patients with variant angina. Methods: The HDL particle size was examined by analyzing serum lipid levels in

Kunihisa Miwa; Naohiro Yoshida; Keiko Nakagawa; Hiroshi Inoue


CBIR: from low-level features to high-level semantics  

NASA Astrophysics Data System (ADS)

The performance of a content-based image retrieval (CBIR) system is inherently constrained by the features adopted to represent the images in the database. Use of low-level features can not give satisfactory retrieval results in many cases; especially when the high-level concepts in the user's mind is not easily expressible in terms of the low-level features. Therefore whenever possible, textual annotations shall be added or extracted and/or processed to improve the retrieval performance. In this paper a hybrid image retrieval system is presented to provide the user with the flexibility of using both the high-level semantic concept/keywords as well as low-level feature content in the retrieval process. The emphasis is put on a statistical algorithm for semantic grouping in the concept space through relevance feedback in the image space. Under this framework, the system can also incrementally learn the user's search habit/preference in terms of semantic relations among concepts; and uses this information to improve the performance of subsequent retrieval tasks. This algorithm can eliminate the need for a stand-alone thesaurus, which may be too large in size and contain too much redundant information to be of practical use. Simulated experiments are designed to test the effectiveness of the algorithm. An intelligent dialogue system, to which this algorithm can be a part of the knowledge acquisition module, is also described as a front end for the CBIR system.

Zhou, Xiang S.; Huang, Thomas S.



Increased levels of plasma soluble Sema4D in patients with heart failure.  


Semaphorin 4D (Sema4D/CD100) is a 150-kDa transmembrane glycoprotein expressed by platelets and T-cells. When these cells are activated, Sema4D is cleaved proteolytically, generating a biologically active 120-kDa fragment (soluble Sema4D) capable of targeting receptors on platelets, B-cells, endothelial cells and tumor cells. However, its plasma levels and significance in heart failure (HF) have not been reported. In this study, we established an ELISA and detected soluble Sema4D in human plasma. In healthy controls, plasma Sema4D levels were higher in men than women (5.15±3.30 ng/mL, n?=?63, vs. 4.19±2.39 ng/mL, n?=?63, P<0.05). In HF patients, plasma Sema4D levels were significantly higher than those in healthy controls (8.94±5.89 ng/mL, n?=?157 vs. 4.67±2.99 ng/mL, n?=?126, P<0.0001) with the highest levels being in HF patients with diabetes mellitus (DM) (10.45±5.76 ng/mL, n?=?40). We also found that there was a higher percentage of Sema4D(high) CD3(+) (P<0.01), CD4(+) (P<0.001), and CD8(+) (P<0.01) T-cells in samples from HF patients, but no changes in Sema4D expression levels in B cells and platelets. Therefore, our investigation shows that plasma Sema4D levels are increased in HF patients, especially in those who also have diabetes. There was an accompanying increase in the Sema4D(high) population of T-cells, suggesting a potential role of these T-cells in heart failure. PMID:23741311

Lu, Qiongyu; Dong, Ningzheng; Wang, Qi; Yi, Wenxiu; Wang, Yuxin; Zhang, Shengjie; Gu, Haibo; Zhao, Xin; Tang, Xiaorong; Jin, Boquan; Wu, Qingyu; Brass, Lawrence F; Zhu, Li



Levels of plasma lipid peroxides before and after choledocholithotomy in patients with obstructive jaundice.  


Plasma lipid peroxide levels were measured in a group of 40 healthy controls and 11 patients with jaundice. In the case of these 11 patients, we checked the plasma lipid peroxide concentrations prior to and after choledocholithotomy. Before choledocholithotomy, there were significantly higher mean concentrations of plasma lipid peroxides and bilirubin in patients with jaundice than in the control cases (11.8 +/- 2.3 vs. 2.0 +/- 0.1 nmol/ml and 10.3 +/- 1.82 vs. 0.7 +/- 0.03 mg/dl, respectively, P < 0.05). In addition, patients with jaundice had lower plasma vitamin E levels in comparison to the controls (8.2 +/- 0.6 vs. 12.2 +/- 0.5 micrograms/ml, P < 0.05). In patients with jaundice, the increased plasma lipid peroxides were clearly related to the serum levels of bilirubin (r = 0.87, P < 0.05). After surgery, the higher plasma levels of lipid peroxide and bilirubin were reduced markedly (11.8 +/- 2.3 vs. 3.7 +/- 0.4 nmol/ml and 10.3 +/- 1.82 vs. 3.1 +/- 0.47 mg/dl, respectively, P < 0.05) with the restoration of bile flow which was associated with improvement in liver function tests. Consequently, these results suggest that there is an involvement of lipid peroxidation in liver cells damaged by obstructive jaundice in patients with cholelithiasis, and that these high plasma lipid peroxide levels may correlate with the severity of the disease. PMID:1470776

Tsai, L Y; Tsai, S M; Lee, K T; Yu, H S



Low IGF-1 levels are associated with cardiovascular risk factors in haemodialysis patients  

Microsoft Academic Search

Cardiovascular diseases (CVD) constitute a significant risk and may, in part, explain the high morbidity and mortality rates\\u000a among haemodialysis (HD) patients. Several studies have implicated reduced insulin like growth factor (IGF-1) levels in the\\u000a development of CVD. However, it is not clear whether IGF-1, and its relationship with other hormones such as leptin, insulin,\\u000a and growth hormone (GH), as

Abdishakur M. Abdulle; Michael P. T. Gillett; Samra Abouchacra; Sufyan M. Sabri; Mona Al Rukhaimi; Enyioma N. Obineche; Jaipaul Singh



Plasma levels of amino acids and hypermetabolism in patients with chronic obstructive pulmonary disease  

Microsoft Academic Search

Plasma levels of amino acids were measured by ion-exchange, high-pressure liquid chromatography in 30 ambulatory patients with chronic obstructive pulmonary disease (COPD; mean ± SD: age 64 ± 13 y and forced expiratory volume in 1 s [FEV1] 0.85 ± 0.25 L) and 30 age- and sex-matched healthy control subjects with regard to nutritional status, resting energy expenditure (REE), and

Takahiro Yoneda; Masanori Yoshikawa; Akihiro Fu; Katsuhiko Tsukaguchi; Yukinori Okamoto; Hideaki Takenaka



Comparable Low-Level Mosaicism in Affected and Non Affected Tissue of a Complex CDH Patient  

Microsoft Academic Search

In this paper we present the detailed clinical and cytogenetic analysis of a prenatally detected complex Congenital Diaphragmatic Hernia (CDH) patient with a mosaic unbalanced translocation (5;12). High-resolution whole genome SNP array confirmed a low-level mosaicism (20%) in uncultured cells, underlining the value of array technology for identification studies. Subsequently, targeted Fluorescence In-Situ Hybridization in postmortem collected tissues demonstrated a

Danielle Veenma; Niels Beurskens; Hannie Douben; Bert Eussen; Petra Noomen; Lutgarde Govaerts; E. W. M. Grijseels; Maarten Lequin; Ronald de Krijger; Dick Tibboel; Annelies de Klein; Dian van Opstal; Rory Edward Morty



Reduced phenytoin levels in an epileptic patient following Roux-En-Y gastric bypass for obesity.  


Despite widespread uptake of bariatric procedures for severe obesity, changes in pharmacodynamics after surgery are poorly understood. We report an epileptic patient who had a seizure following gastric bypass, although he had been asymptomatic for 30 years and without any change in his treatment. Phenytoin levels were undetectable despite a high dose. Drugs with a narrow therapeutic range such as phenytoin should be prescribed with caution after bariatric surgery. PMID:20186578

Pournaras, Dimitrios J; Footitt, David; Mahon, David; Welbourn, Richard



The SuperSID project: exploiting high-level information for high-accuracy speaker recognition  

Microsoft Academic Search

The area of automatic speaker recognition has been dominated by systems using only short-term, low-level acoustic information, such as cepstral features. While these systems have indeed produced very low error rates, they ignore other levels of information beyond low-level acoustics that convey speaker information. Recently published work has shown examples that such high-level information can be used successfully in automatic

Douglas Reynolds; Walter Andrews; Joseph Campbell; Jiri Navratil; Barbara Peskin; Andre Adami; Qin Jin; David Klusacek; Joy Abramson; Radu Mihaescu; Jack Godfrey; Doug Jones; Bing Xiang



Lipoprotein (a) Levels in Relation to Severity of Coronary Artery Disease in North Indian Patients  

PubMed Central

Background: Lipoprotein (a) [Lp (a)] is an established risk marker of coronary artery disease which is independent from other risk factors. Objective: The aim was to address the association between Lp (a) and CAD risk in North Indians. To evaluate whether high levels of lipoprotein (a) [Lp (a)] is a predictor of risk and is related to the severity of CAD. Materials and Methods: This was a cross-sectional study done on 360 patients presenting with chest pain. Coronary angiography revealed CAD in 270 patients and 90 patients without CAD. Lipoprotein (a) level, lipid profile, fasting blood glucose, anthropometric and clinical parameters were analyzed. Results: Lipoprotein (a) 21.0 mg/dL is associated with the presence of coronary lesions (P = 0.0001). A highly significant difference in Lp (a) levels was observed between normal coronaries vs. single-vessel disease, double-and triple-vessel disease ( P < 0.0001). Body mass index (BMI) was significantly raised in CAD group compared to normal coronary. Conclusion: Multivariate analysis found that Lp (a) was considered an independent predictor for severity of CAD and Lp (a) levels 21.0 mg/dL are associated with severe patterns of coronary atherosclerosis.

Ashfaq, Fauzia; Goel, Pravin Kumar; Sethi, Rishi; Khan, Mohd Idrees; Ali, Wahid; Idris, Mohd Zafar



High-level waste management technology program plan  

SciTech Connect

The purpose of this plan is to document the integrated technology program plan for the Savannah River Site (SRS) High-Level Waste (HLW) Management System. The mission of the SRS HLW System is to receive and store SRS high-level wastes in a see and environmentally sound, and to convert these wastes into forms suitable for final disposal. These final disposal forms are borosilicate glass to be sent to the Federal Repository, Saltstone grout to be disposed of on site, and treated waste water to be released to the environment via a permitted outfall. Thus, the technology development activities described herein are those activities required to enable successful accomplishment of this mission. The technology program is based on specific needs of the SRS HLW System and organized following the systems engineering level 3 functions. Technology needs for each level 3 function are listed as reference, enhancements, and alternatives. Finally, FY-95 funding, deliverables, and schedules are s in Chapter IV with details on the specific tasks that are funded in FY-95 provided in Appendix A. The information in this report represents the vision of activities as defined at the beginning of the fiscal year. Depending on emergent issues, funding changes, and other factors, programs and milestones may be adjusted during the fiscal year. The FY-95 SRS HLW technology program strongly emphasizes startup support for the Defense Waste Processing Facility and In-Tank Precipitation. Closure of technical issues associated with these operations has been given highest priority. Consequently, efforts on longer term enhancements and alternatives are receiving minimal funding. However, High-Level Waste Management is committed to participation in the national Radioactive Waste Tank Remediation Technology Focus Area. 4 refs., 5 figs., 9 tabs.

Harmon, H.D.




SciTech Connect

High level radioactive wastes are being vitrified at the Savannah River Site for long term disposal. Many of the wastes contain sulfate at concentrations that can be difficult to retain in borosilicate glass. This study involves efforts to optimize the composition of a glass frit for combination with the waste to improve sulfate retention while meeting other process and product performance constraints. The fabrication and characterization of several series of simulated waste glasses are described. The experiments are detailed chronologically, to provide insight into part of the engineering studies used in developing frit compositions for an operating high level waste vitrification facility. The results lead to the recommendation of a specific frit composition and a concentration limit for sulfate in the glass for the next batch of sludge to be processed at Savannah River.

Fox, K.



Management of data quality of high level waste characterization  

SciTech Connect

Over the past 10 years, the Hanford Site has been transitioning from nuclear materials production to Site cleanup operations. High-level waste characterization at the Hanford Site provides data to support present waste processing operations, tank safety programs, and future waste disposal programs. Quality elements in the high-level waste characterization program will be presented by following a sample through the data quality objective, sampling, laboratory analysis and data review process. Transition from production to cleanup has resulted in changes in quality systems and program; the changes, as well as other issues in these quality programs, will be described. Laboratory assessment through quality control and performance evaluation programs will be described, and data assessments in the laboratory and final reporting in the tank characterization reports will be discussed.

Winters, W.I., Westinghouse Hanford



Multipurpose optimization models for high level waste vitrification  

SciTech Connect

Optimal Waste Loading (OWL) models have been developed as multipurpose tools for high-level waste studies for the Tank Waste Remediation Program at Hanford. Using nonlinear programming techniques, these models maximize the waste loading of the vitrified waste and optimize the glass formers composition such that the glass produced has the appropriate properties within the melter, and the resultant vitrified waste form meets the requirements for disposal. The OWL model can be used for a single waste stream or for blended streams. The models can determine optimal continuous blends or optimal discrete blends of a number of different wastes. The OWL models have been used to identify the most restrictive constraints, to evaluate prospective waste pretreatment methods, to formulate and evaluate blending strategies, and to determine the impacts of variability in the wastes. The OWL models will be used to aid in the design of frits and the maximize the waste in the glass for High-Level Waste (HLW) vitrification.

Hoza, M.



Nondestructive examination of DOE high-level waste storage tanks  

SciTech Connect

A number of DOE sites have buried tanks containing high-level waste. Tanks of particular interest am double-shell inside concrete cylinders. A program has been developed for the inservice inspection of the primary tank containing high-level waste (HLW), for testing of transfer lines and for the inspection of the concrete containment where possible. Emphasis is placed on the ultrasonic examination of selected areas of the primary tank, coupled with a leak-detection system capable of detecting small leaks through the wall of the primary tank. The NDE program is modelled after ASME Section XI in many respects, particularly with respects to the sampling protocol. Selected testing of concrete is planned to determine if there has been any significant degradation. The most probable failure mechanisms are corrosion-related so that the examination program gives major emphasis to possible locations for corrosion attack.

Bush, S.; Bandyopadhyay, K.; Kassir, M.; Mather, B.; Shewmon, P.; Streicher, M.; Thompson, B.; van Rooyen, D.; Weeks, J.



Life Extension of Aging High-Level Waste Tanks  

SciTech Connect

The Double Shell Tanks (DSTs) play a critical role in the Hanford High-Level Waste Treatment Complex, and therefore activities are underway to protect and better understand these tanks. The DST Life Extension Program is focused on both tank life extension and on evaluation of tank integrity. Tank life extension activities focus on understanding tank failure modes and have produced key chemistry and operations controls to minimize tank corrosion and extend useful tank life. Tank integrity program activities have developed and applied key technologies to evaluate the condition of the tank structure and predict useful tank life. Program results to date indicate that DST useful life can be extended well beyond the original design life and allow the existing tanks to fill a critical function within the Hanford High-Level Waste Treatment Complex. In addition the tank life may now be more reliably predicted, facilitating improved planning for the use and possible future replacement of these tanks.

Bryson, D.; Callahan, V.; Ostrom, M.; Bryan, W.; Berman, H.



Long-term high-level waste technology  

NASA Astrophysics Data System (ADS)

Work performed at sites to immobilize high-level radioactive wastes is described. Program management and support with subtasks of management and budget, environmental and safety assessments, waste preparation, storage or disposal; waste retrieval, separation and concentration are discussed. Waste fixation and characterization, process and equipment development, final handling, canister development and characterization and onsite storage or disposal are also reported. Event trees defining possible accidents were completed in a safety assessment of continued in-tank storage of high-level waste. Two low-cost waste forms (tailored concrete and bitumen) were investigated as candidate immobilization forms. Comparative impact tests and leaching tests were also conducted on glasses, ceramics, and concretes. A process design description was written for the tailored ceramic process.

Corman, W. R.



Radioactive high level waste insight modelling for geological disposal facilities  

NASA Astrophysics Data System (ADS)

Within this paper we present a simplified analytical model to provide insight into the key performance measures of a generic disposal system for high level waste within a geological disposal facility. The model assumes a low solubility waste matrix within a corrosion resistant disposal container surrounded by a low permeability buffer. Radionuclides migrate from the disposal area through a porous geosphere to the biosphere and give a radiological dose to a receptor. The system of equations describing the migration is transformed into Laplace space and an approximation used to determine peak values for the radionuclide mass transfer rate entering the biosphere. Results from the model are compared with those from more detailed numerical models for key radionuclides in the UK high level waste inventory. Such an insight model can provide a valuable second line of argument to assist in confirming the results of more detailed models and build confidence in the safety case for a geological disposal facility.

Carter, Alexander; Kelly, Martin; Bailey, Lucy


The Astronomy Diagnostic Test at the High School Level  

NASA Astrophysics Data System (ADS)

The Astronomy Diagnostic Test version 2, as a pre-test, has been used for several years to gauge the preparedness of students in the basic astronomy courses at many universities and colleges. Surprisingly, students at many levels of universities and colleges, from the most selective to the least selective, seem to do about the same on this test. Astronomy misconceptions would therefore seem to be as ubiquitous among the students most prepared for college in other subject areas as among those least prepared. Since the design of the test supposedly includes only concepts recognizable to most high-school graduates, it was decided to extend this test to the high school level. We wanted to see if the astronomical concepts became more recognizable as students progressed through their high school years or if those concepts, and misconceptions, were already in place when they entered high school. The test has been administered to several (non-astronomy) science classes from ninth through twelfth grade at a typical mid-western, non-selective, public high school in Ozark, Missouri. The results of this study will be presented.

Wolf, G. W.; Long, C.




SciTech Connect

Waste streams planned for generation by the Global Nuclear Energy Partnership (GNEP) and existing radioactive High Level Waste (HLW) streams containing organic compounds such as the Tank 48H waste stream at Savannah River Site have completed simulant and radioactive testing, respectfully, by Savannah River National Laboratory (SRNL). GNEP waste streams will include up to 53 wt% organic compounds and nitrates up to 56 wt%. Decomposition of high nitrate streams requires reducing conditions, e.g. provided by organic additives such as sugar or coal, to reduce NOX in the off-gas to N2 to meet Clean Air Act (CAA) standards during processing. Thus, organics will be present during the waste form stabilization process regardless of the GNEP processes utilized and exists in some of the high level radioactive waste tanks at Savannah River Site and Hanford Tank Farms, e.g. organics in the feed or organics used for nitrate destruction. Waste streams containing high organic concentrations cannot be stabilized with the existing HLW Best Developed Available Technology (BDAT) which is HLW vitrification (HLVIT) unless the organics are removed by pretreatment. The alternative waste stabilization pretreatment process of Fluidized Bed Steam Reforming (FBSR) operates at moderate temperatures (650-750 C) compared to vitrification (1150-1300 C). The FBSR process has been demonstrated on GNEP simulated waste and radioactive waste containing high organics from Tank 48H to convert organics to CAA compliant gases, create no secondary liquid waste streams and create a stable mineral waste form.

Williams, M



Associations of Triiodothyronine Levels with Carotid Atherosclerosis and Arterial Stiffness in Hemodialysis Patients  

PubMed Central

Summary Background and objectives End-stage renal disease is linked to alterations in thyroid hormone levels and/or metabolism, resulting in a high prevalence of subclinical hypothyroidism and low triiodothyronine (T3) levels. These alterations are involved in endothelial damage, cardiac abnormalities, and inflammation, but the exact mechanisms are unclear. In this study, we investigated the relationship between serum free-T3 (fT3) and carotid artery atherosclerosis, arterial stiffness, and vascular calcification in prevalent patients on conventional hemodialysis. Design, setting, participants, & measurements 137 patients were included. Thyroid-hormone levels were determined by chemiluminescent immunoassay, carotid artery–intima media thickness (CA-IMT) by Doppler ultrasonography, carotid-femoral pulse wave velocity (c-f PWV), and augmentation index by Sphygmocor device, and coronary artery calcification (CAC) scores by multi-slice computerized tomography. Results Mean fT3 level was 3.70 ± 1.23 pmol/L. Across decreasing fT3 tertiles, c-f PWV and CA-IMT values were incrementally higher, whereas CACs were not different. In adjusted ordinal logistic regression analysis, fT3 level (odds ratio, 0.81; 95% confidence interval, 0.68 to 0.97), age, and interdialytic weight gain were significantly associated with CA-IMT. fT3 level was associated with c-f PWV in nondiabetics but not in diabetics. In nondiabetics (n = 113), c-f PWV was positively associated with age and systolic BP but negatively with fT3 levels (odds ratio = 0.57, 95% confidence interval 0.39 to 0.83). Conclusions fT3 levels are inversely associated with carotid atherosclerosis but not with CAC in hemodialysis patients. Also, fT3 levels are inversely associated with surrogates of arterial stiffness in nondiabetics.

Kircelli, Fatih; Asci, Gulay; Carrero, Juan Jesus; Gungor, Ozkan; Demirci, Meltem Sezis; Ozbek, Suha Sureyya; Ceylan, Naim; Ozkahya, Mehmet; Toz, Huseyin; Ok, Ercan



Case for retrievable high-level nuclear waste disposal  

USGS Publications Warehouse

Plans for the nation's first high-level nuclear waste repository have called for permanently closing and sealing the repository soon after it is filled. However, the hydrologic environment of the proposed site at Yucca Mountain, Nevada, should allow the repository to be kept open and the waste retrievable indefinitely. This would allow direct monitoring of the repository and maintain the options for future generations to improve upon the disposal methods or use the uranium in the spent fuel as an energy resource.

Roseboom, Jr. , Eugene, H.



High-level constructs in the READY event notification system  

Microsoft Academic Search

This paper describes high-level constructs (operating overmultiple events, multiple consumers, etc.) provided byREADY, an event notification system being developed atAT&T Labs [7]. Entities in the READY model include: consumerspecifications that match over both single and compoundevent patterns; communication sessions that managequality of service (QoS) and ordering properties for eventdelivery; grouping constructs for both specifications and sessions;event domains and boundary routers...

Robert E. Gruber; Balachander Krishnamurthy; Euthimios Panagos



High-Level Waste Systems Plan. Revision 7  

Microsoft Academic Search

This revision of the High-Level Waste (HLW) System Plan aligns SRS HLW program planning with the DOE Savannah River (DOE-SR) Ten Year Plan (QC-96-0005, Draft 8\\/6), which was issued in July 1996. The objective of the Ten Year Plan is to complete cleanup at most nuclear sites within the next ten years. The two key principles of the Ten Year

J. N. Brooke; M. V. Gregory; P. Paul; G. Taylor; F. E. Wise; N. R. Davis; M. N. Wells



Security Mechanisms in High-Level Network Protocols  

Microsoft Academic Search

The implications of adding security mechanisms to high-level network protocols operating in an open-system environment are analyzed. First the threats to security that may arise in such an environment are described, and then a set of goals for communications security measures is established. This is followed by a brief description of the two basic approaches to communications security, link-oriented measures

Victor L. Voydock; Stephen T. Kent



A Multithreaded Compiler Backend for High-level Array Programming  

Microsoft Academic Search

Whenever large homogeneous data structures need to be processed in a non-trivial way, e.g. in computational sci- ences, image processing, or system simulation, high-level array programming in the style of APL offers a far more concise and abstract approach than traditional scalar lan- guages such as C\\/C++ or FORTRAN-77. The same sort of applications often can also be characterized as

Clemens Grelck



Design of secure operating systems with high security levels  

Microsoft Academic Search

Numerous Internet security incidents have shown that support from secure operating systems is paramount to fighting threats\\u000a posed by modern computing environments. Based on the requirements of the relevant national and international standards and\\u000a criteria, in combination with our experience in the design and development of the ANSHENG v4.0 secure operating system with\\u000a high security level (hereafter simply referred to

Sihan Qing; Changxiang Shen



An appraisal of the Hanford high-level waste program  

Microsoft Academic Search

As set forth in the CPD Waste Management Program (HW-63958), new and improved methods of waste processing are planned to be initiated at Hanford. A major part of this program is concerned with the high-level wastes from the Purex Plant, with major objectives being the control of long-term hazards, the insurance of production continuity, and the attainment of positive waste



Burning experiments and late Paleozoic high O2 levels  

Microsoft Academic Search

The Paleozoic rise of land plants brought about increased burial of organic matter and a resulting increase in atmospheric oxygen concentrations. Levels as high as 30-35% O2 may have been reached during the Permo-Carboniferous (Berner and Canfield, 1989; Berner, 2001). However, burning experiments based solely on paper (Watson, 1978) have challenged these results, the claim being that if the oxygen

R. Wildman; R. Essenhigh; R. Berner; L. Hickey; C. Wildman



The ATLAS High Level Trigger infrastructure, performance and future developments  

Microsoft Academic Search

The ATLAS High Level Trigger (HLT) is a distributed real-time software system that performs the final online selection of events produced during proton-proton collisions at the Large Hadron Collider (LHC). It is designed as a two-stage event filter running on a farm of commodity PC hardware. Currently the system consists of about 850 multi-core processing nodes that will be extended

F. Winklmeier



High Level System Design and Analysis Using Abstract State Machines  

Microsoft Academic Search

We provide an introduction to a practical method for rigorous system development which has been used successfully, under industrial\\u000a constraints, for design and analysis of complex hardware\\/software systems. The method allows one to start system development\\u000a with a trustworthy high level system specification and to link such a “ground model” in a well documented and inspectable\\u000a way through intermediate design

Egon Börger



Expectation Grammars: Leveraging High-Level Expectations for Activity Recognition  

Microsoft Academic Search

Video-based recognition and prediction of a temporally ex- tended activity can benefit from a detailed description of high-level expectations about the activity. Stochastic gr am- mars allow for an efficient representation of such expecta- tions and are well-suited for the specification of temporall y well-ordered activities. In this paper, we extend stochast ic grammars by adding event parameters, state checks,

David Minnen; Irfan A. Essa; Thad Starner



High-level CAD melds micromachined devices with foundries  

Microsoft Academic Search

The use of the Magic technology file to build transducer devices in the form of micro-heaters for use as IR pixels in a thermal display is described. Magic is a high-level computer-aided design (CAD) software system. The design methodology incorporated into the current MOSIS SCMOS technology file for Magic to implement the fabrication of silicon micromachined device structures is presented.

Janet C. Marshall; M. Parameswaran; M. E. Zaghloul; Michael Gaitan



Using high-level tools to implement software engineering projects  

Microsoft Academic Search

Describes a one-semester software engineering course that takes advantage of the high-level programming tools that are becoming increasingly available. It has always been difficult to include necessary theoretical material as well as a complete software project in a one-semester course. In most traditional computer science degree programs, many students do not have room to take more than one semester of

Pearl Brazier



Deep borehole disposal of high-level radioactive waste  

Microsoft Academic Search

Preliminary evaluation of deep borehole disposal of high-level radioactive waste and spent nuclear fuel indicates the potential for excellent long-term safety performance at costs competitive with mined repositories. Significant fluid flow through basement rock is prevented, in part, by low permeabilities, poorly connected transport pathways, and overburden self-sealing. Deep fluids also resist vertical movement because they are density stratified. Thermal

Joshua S. Stein; Geoffrey A. Freeze; Patrick Vane Brady; Peter N. Swift; Robert Paul Rechard; Bill Walter Arnold; Joseph F. Kanney; Stephen J. Bauer